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VALLI VUE ESTATES #2 BLK 2 LT 11
Valli Vue Estates #2 Block 2 Lot I I #015-322-47 Municipality of Anchorage Department of Health and Human Services Building Safety Division On-Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 4 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWSW030479 PID Number: 015-322-47 Name: Wastewater System: ❑ New ® Upgrade Address: 6730 Corner Iree Circle, 99616 ABSORPTION FIELD Phone: Number of Bedrooms: ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound ❑ Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: Block: Lot: Subdivision: 2 11 Valle Vim Est No. 2 Depth to pipe bottom from original grade: 2 Pi Gravel depth beneath pipe: 0.5 Ft Township: Range: Section: Fill added above original grade: Gravel Length: Well: ❑New El Upgrade Gravel width: Number of lines: Distance between lines: Classification (Private, A, B. C): Total Depth: cased to: Total absorption area: Pipe Material: CIass A (Existal Ft. Ft. 225 Ft 34 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. + m rv' 1112112 Yield : Pump Set al: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. ® Other: Orenco Advantex To Septic Absorption Lift Holding ublicrPrivate Manmacturer: Capacity: Poo From Tank Field Station Tank Sewer Line Anchorage Tank /Tell Gal. Well 200+ 200+ 200+ N/A Material: Steel Number of Compartments: 1 2 Surface Water 105 69.3 105 LIFT STATION Lot Line 20 7.2 20 Size: 250 Gal. Manufacturer: Fiber lass Foundation 5.7 12 15 Pump on" level at: Pump off'level at: High water alarm at: 44 in. 41 in. 46 in. Curtain Drain 100+ 100+ 100+ Pump Make &Model Ele rical Inspections pertarmed by Remarks: Re uest lot line to drainfield waiver to 7.2 feet. Two BENCH MARK inches of blue bored R.I. over entire field. Three Location and Description: East Door Threshhold exist'g tanks abandoned in place. Exist'g drain fields Assumed Elevation: 100.0 Ft. abandoned in place. Tank coated to STIP-3 Standards. Engineer's Stamp .�p�aaaallo 1 •�+� Inspections performed by: Pannone Eng. SVC Dates: 1x'11/19/2003 .• 4oTH 9 - 2"d11/21/2003 i Department of Health Human Services approval + """ "" """"""""- - 'or ?Steven R. Pannone; Zt_Date: +, j-u ff +�j No. CE 8149 0� Reviewed and approved by: �/ 2¢ O3 (Rev. 11/99)Z.,,.••4V1 P,::, I .0 PERMIT NO:SWO30479 AS—BUILT DRAWING WASTEWATER DISPOSAL SYSTEM Lot 11 Block 2 Valli Vue Estates #2 �F7CISTING FIELDS IN FAILURE — IN PLACE z 100' CREEK SETBACK Yl 11��LOT SERVED BY COMMUNITY WEI. U _� NO WELLS W/IN U U 2ooFr N P.I.D. NO: 015-322-47 NEW 5' ' WIDE X 45 LF, 0.5' ED, 2.5TD DR IN FIELD PVC XISTING TEST HOLE Y AWW — ON FILE ITH DEPT. 3% % NEW ADVANTEX AX20 TANK REMOVE APPROX. EXISTING CENTERLIN NOTES: TANKS OF CREEK 1) All work shall be performed in accordance with AMC15.65. 3% 0 2) Materials used shall be in accordance with those w specified in AMC15.65, NEW PUMP Wastewater Disposal. UNIT J 3) Connect post tank line to LOT SERVED BY N midpoint of drain field, typical. COMMUNITY WELL 11 4) Maintain 10' separation to NO WELLS W/IN D all lot lines. 200FT N �\ 5) Lot served by class A water service. No wells within 200' of j proposed system. DESIGN: C PERC RA E 30-60 MPI CO ANM1 16.8 56.9 \ D APPLICA N RATE: 2 SF BR N��� M2 20.4 34.9 225 GPD SF OF FC 18/6 9�R 3 BR HO SE ..��P�E"' I�j� C1 10..9 15.2\�` REO'D A :225 SF ;' ♦ L1 )'8.7 23.6 �� 0.5' EF ' DEPTH, 45 LF X 4' T.D � ;z:j, 225 S T TAL � A' 49TM �DVA E AX20 TANK .....:::: , .......� •••• PREPARED FOR: PANNONE ENG. SVC, LLC even R. Pannone S = z David Fagerskog P. 0. BOX 102954 ♦ No. CE 8149 i 6230 Corner Tree Dr. �j�d(f2'� ANCHORAGE, ALASKA 99510 Anchorage, AK 99507 441-8680 227-3522 27 � 35 22 P00 272-8218 Fax D SCALE: 1"=40' AS—BUILT PERMIT NO: SWO30479 DESIGN DETAILS P.I.D. NO: 015-322-47 WASTEWATER ABSORPTION SYSTEM Lot 11 Block 2 Valli Vue Estates #2 rn NOTES: aeru aOLNOW 1) ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH, AND ALL MATERIALS SHALL CONFORM TO, AMC15.65. 2) MAINTAIN 30' SEPARATION FROM ALL E SLOPES GREATER THAN 25%. a '?�';`:'.'-v d > a fJl U •L � 0) 0 � ""�.f B �z _ C .: 5 N LZ p C O c 0 ID 2 10 .'" W 3901 a0LNOW ::.'.!•?, O rn rn rn rn r' c 26 m `o 0�a o Ew `vY rn um 3 O m a0 c o T� O a U, 100 Ntl310 J 3 = UO � m m m m Ln � LO Ntl3lO CO O g N u� ao o I I I rn NO NMO NOLLvaNnoi """"''" ��yy"i PREPARED FOR: =n R. Pannone Pannone Eng. Svc., LLC At David Fagerskog P. 0. BOX 102954 CE 8149 \♦� 6230 Corner Tree Dr. ANCHORAGE, ALASKA 99510 �3 1'` ♦ Anchorage, AK 99507 55�U����♦♦ 441-86e0 272-8218, PHONE & FAX I�{{{{,♦♦♦ DATE: 11-22-200 AS—BUILT NOT TO SCALE t. NW -22-2003 08:i&i FROM:A+ HOME SERVICES, IN 907-068-6770 70:2728218 P: 1.1 Ri.ghtrax 1.1/21/2003 9:39 PAGE 1/1 RightPax Inspection Report Municipality of Anchorage, Building Safety Division 4700 South Dragaw iNSPlC=Ni YOiC9 347-$300 7NSPBCMNr FAX (907]24$-7777 iNPOr 343-7992 Nan" Addreee La$al SubdivisloN Comments or Diraationa ED% ELECT 6230 CORNER TREE OR SK2LT11 VALU VUE ESTATES x2 P.M. SEPTIC SYSTEM CALL B-4 ftrheit 93-9873 Phone 272.4S91 Inspection Gate 41/21/2003 inspection Rough ElacricaI Reinspection N NO NONCOMPLIANCE OBSERVES ❑ CORREC71ONS ESUN77ALAS EXPLAINED BELOW ❑ WILL RE-EXAMINE AT NEKT [] DO NOT CONCEAL UNTIL R@INSPECTION INSPECTION COMMaNTBi (for inapecicr woo only) J f Inspector N0V-21-2003 FRI 04.6%Prl IC:A+ HOME SERVICES, INC. PAGE:1 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Z'o I�2j _ID" I Date Issued: Nov 17, 2003 Expiration Date: Nov 16, 2004 Permit Number: SW030479 Parcel ID: 015-322-47 Legal Description:VALLI VUE ESTATES #2 BILK 2 LT 11 Design Engineer: 0062 Pannone Engineering Services Site Address: 006230 CORNER TREE DR Owner Name: DAVID FAGERSKOG Lot Size: 20680 SQ. FT. Owner Address: 6230 CORNER TREE DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99516-6715 This permit is for the construction of: ❑✓ Disposal Field F✓ Septic Tank ❑ Holding Tank ❑Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: L4Z1z Date: ( / L /� Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.32.247 Permit Number SWO 30479 Property owner(s) David Fagerskog Mailing address (1) 6230 Corner Tree Drive Day phone 3463177 Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Lot 11, Block 2 Valli Vue Estates, No. 2 Legal description (Section, Township & Range) Lot Size 20680 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Waiver Fees: Date of Payment: Receipt Number: 7 Z Receipt Number: (Rev. 12/00) Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax November 5, 2003 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 11, Block 2 Valli Vue Estates, No. 2 Septic Upgrade Permit/ Waiver Request FAILED SYSTEM Gentlemen: My firm was contacted to conduct a Health Authority Investigation of the septic system serving this lot for a pending house sale. There are three existing permitted systems on this lot. The two drain fields are connected by a four -inch solid pipe. Both systems were completely inundated with liquid. The fluid levels were approximately two to three inches above the lateral pipe. The third system is a holding tank installed in 1994. I informed the owners that the drain field systems were in failure. The owners requested my firm investigate the possibility of installing a new Advantex system for the house and abandon the holding tank. A single test hole was excavated on October 24th. The soils report and a percolation test result is attached. Ground water was monitored for seven days. No groundwater or bedrock was encountered in the test hole. This lot is served by the Valli Vue water association and there are no wells within 200 feet of the proposed installation. The lot is approximately 0.475 acres in size. Lot 11 slopes to the west at approximately 1 to 2 percent. The proposed installation will be located in the northwest portion of the lot. The existing fields will be reused and connected to the new Advantex tank by a diverter valve. The septic tank and holding tank will be removed during the installation. A new 1,500 -gallon steel advantex tank will be installed outside the 100' creek -setback. Double clean -outs will be installed down stream from the tank. The proposed location is greater than 100 feet away from the existing well serving this property and 25 feet from the water service lines. The surrounding wells are located greater than 200 feet from the proposed installation. The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. The proposed drain field will be installed approximately 68 feet from the creek on the northwest corner of the property. A waiver was issued in the summer of 1993 for a bed to go in this area, but the bed was not installed. The proposed field will be separated from the creek by means of a constructed berm to prevent sewage from migrating to the creek. There will be a distance in excess of 100 feet overland from the proposed be and the creek. I would request that the distance be waived to 68 horizontal feet from the end of the drainfield and the existing creek. In my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted. If you have any questions or concerns, please contact me at 227-3522 or 272-8218. Sincerely, Steven R. Pannone, P.E. Attachments: O -N XIMP d\ i PWPPQ\ 1 1 _O V A i T T Vi 1R9 001 nnrr PERMIT No: DESIGN DRAWING WASTEWATER DISPOSAL SYSTEM Lot 11 Block 2 Valli Vue Estates #2 16 LOT SERVED BY COMMUNITY WELL NO WELLS W/IN NOTES: 1) All work shall be performed in accordance with AMC15.65. 2) Materials used shall be in accordance with those specified in AMC15.65, Wastewater Disposal. 3) Connect post tank line to midpoint of drain field, typical. 4) Maintain 10' separation to all lot lines. 5) Lot served by class A water service. No wells within 200' of proposed system. /FIELDS IN FAILURE — ABANDON IN NEW ADVi AX20 12 EPARED FOR: David Fagerskog 6230 Corner Tree Dr. Anchorage, AK 99507 441-8680 111f, 100' CREEK SETBACK SLOT SERVED BY COMMUNITY WEI NO WELLS W/IN 20OFT NEW PUMP UNIT P.I.D. NO: 0 14EW 5' WIDE X 45 LF, 0.5' ORAI FIELD WITH 1— /2"0 PVC EXISTING TEST HOLE BY AWW — ON FILE WITH DEPT. 37 EXISTING I CENTERLINE TANKS OF CREEK PERC T : 30-60 MPI APPLI ATI N RATE: 2 SF/BR 225 PDrF 3 BR HOUSE REQ' AREA: 225 SF 0.5' FF'T DEPTH, 45 LF X 4' T.D 225 F TOTAL ADVA TEX A420 TANK PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax JE: 11-5-2003 DESIGN :ALE: 1"=60' U U EXIST'G VANTEX TANK i o.o U U x10.0 /FIELDS IN FAILURE — ABANDON IN NEW ADVi AX20 12 EPARED FOR: David Fagerskog 6230 Corner Tree Dr. Anchorage, AK 99507 441-8680 111f, 100' CREEK SETBACK SLOT SERVED BY COMMUNITY WEI NO WELLS W/IN 20OFT NEW PUMP UNIT P.I.D. NO: 0 14EW 5' WIDE X 45 LF, 0.5' ORAI FIELD WITH 1— /2"0 PVC EXISTING TEST HOLE BY AWW — ON FILE WITH DEPT. 37 EXISTING I CENTERLINE TANKS OF CREEK PERC T : 30-60 MPI APPLI ATI N RATE: 2 SF/BR 225 PDrF 3 BR HOUSE REQ' AREA: 225 SF 0.5' FF'T DEPTH, 45 LF X 4' T.D 225 F TOTAL ADVA TEX A420 TANK PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax JE: 11-5-2003 DESIGN :ALE: 1"=60' PERMIT No: DESIGN DETAILS WASTEWATER ABSORPTION SYSTEM Lot 11 Block 2 Valli Vue Estates #2 a i a w NOTES: aero NOLNON 1) ALL WORK SHALL BE PERFORMED IN ACCORDANCE WITH, AND ALL MATERIALS ? SHALL CONFORM TO, AMC15.65. 2) MAINTAIN 30' SEPARATION FROM ALL SLOPES GREATER THAN 25%. c , a 0 3 � o N � GL � N fl Y \c o —v c C n O v°, � n n O David Fogerskog 6230 Corner Tree Dr. Anchorage, AK 99507 441-8680 3erLL MUNON F4418aNN] NO NVMO NO NVM3 NOMWNOOJ P.I.D. NO: w J L� O n Pannone Eng. Svc., LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 ESIGN a � m lLn 00 O N Oo o I David Fogerskog 6230 Corner Tree Dr. Anchorage, AK 99507 441-8680 3erLL MUNON F4418aNN] NO NVMO NO NVM3 NOMWNOOJ P.I.D. NO: w J L� O n Pannone Eng. Svc., LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 ESIGN PERMIT NO: DESIGN DRAWING P.I.D. NO: WASTEWATER DISPOSAL SYSTEM Lot 11 Block 2 Valli Vue Estates #2 AX -20 FILTER WITH INSULATED LID. ROTATED 90 FOR CLARITY. INLET CLEAN—OUT 3" PVC PIPE TO AMBIENT AIR DESIGN CALCULATIONS Number of Bedrooms — 3 Total Bedrooms — 3 Design flow — 150 gal/br/day, Total flow — 450 g/day 0 en R. Pannone CE 8149 0 500g FIBERGLASS .T.E.P. TANK MANHOLE SCHARGE TO RAIN FIELDS INSTALL 4" RIGID INSULATION OVER TANK & DRAINFIELD. EXTEND R.I 2' BEYOND SIDE OF TANK. INSTALL R.I. AROUND AX -20 FILTER. ADVANTEX TANK DETAIL TANK SIZE: 1500 gallon Advantex tank SOIL ABSORPTION SIZE: Advantex Sewer System AX20 Pod — Class III System Perc Rate = 30-60 min/inch Application Rate — 2 GPD/SF Size Required = 450 GPD/2 GPD/SF = 225 SF Use 5' wide trench x 45 LF, 0.5' effective PREPARED FOR: David Fagerskog 6230 Corner Tree Dr. Anchorage, AK 99507 441-8680 Pannone Eng. Svc., LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 DESIGN , SOILS LOG - PERCOLATION TEST •••oP�E„OF q�q ♦♦♦♦♦ PANNONE ENGINEERING SERVICES �' ♦� P.O. BOX 102954 i ;; 49TH ................... ANCHORAGE, AK 99510 0 907 272-8218 ....Ste .... .. .............;. � � ) Steven R. Pannone i i ♦�0. No.CE 8149 PERFORMED FOR: David Fagerskog DATE PERFORMED: 10/17/03 ♦♦h�FEs��:�•• LEGAL DESCRIPTION: Lot 11, Block 2, Valli Vue Estates #2 TEST HOLE 1 SLOPE SITE P Organics LJ 1 O 9 2 ML/GM Gray silty D_' 10 gravel Z 1w x 3 16 pL U U 4 GW/GP Well graded x snxcrzvr xoa 5 sands and gravel TEST 6 HOLE a i 7— GM GM Silty gravel r �c 8 i 9 12 10 13 BOH 11 12 13 WAS GROUND WATER SLOPE 3 14 ENCOUNTERED? NO a N 15 IF YES, AT WHAT TEST HOLE w DEPTH? -N/A- 16 DEPTH TO WATER AFTER 17 MONITORING? -DRY- m 1S DATE: 10/25/03 J 19 N READING DATE GROSS NET DEPTH OF NET TIME TIME WATER DROP 20 w J J N ll J Y O 3 PEROLATION RATE 27 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN AT 6 FT TO 7 FT. m U COMMENTS: Test hole excavated by At Home SVC. Test Hole was presoaked before perc test. PERFORMED BY: Steven R Pannone P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. 0 - 10/17/03 7:25 ---- 6-1/e ---- 7:55 30 5 1-1/8 7:55 ____ 6 ____ 8:25 30 4-7/8 1-1/8 8:25 ---- 6-1/4 ---- 8:55 30 5-1 /e 1-1/8 T'C--ST prr:o t .t= -4x- P. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Dir—V— (ZDSSTOI"I DATE LEGAL 2 3 MFG 2- %I V P.t_u viA E tf Z b QC -4,.41 c -S .NOT Sut"rAS�F.�-- T(--, S&-P'TiC- �W w iT?4 P1LF�1� of SP. VEJ7-y pf>P--nu S ej w rr+t L.E�35E OP vP�r TI4F� CLAY/StL' W µi Gl+ I.�A3 AS$vM£D 't -U BE IhPERMEA-8� WAS GROUND WATER ENCOUNTERED? SLOPE a y A. Go W a� o -7953 PERFORMED`, %,pR 10N % i 9 Section: N SITE PLAN IF YES, AT WHAT DEPTH? yi= S 0 P E I n L} DA"f S Depth In Water After 8 -Ip z3 93 MornTo�a6- Monitoring? Date 14- 15- LJ�L�s r paiva �0A) ,8 ,9 ®mmm • ., M C/o 20 { uPERCOLATION RATE' (a*7 (minutes inch) PERC HOLE DIAMETER / TEST RUN BETWEEN FT AND 6 • S FT � /� 'OMMENTS L7`r" "— �i v' ,� IS �'�O QO'(LoUS WIIJIJ rc�j-y vUIQ. S4�Uf! %'/i -!>c4. COCOMr EA Bre ofL S�L.,1vE wl l�tl Eve f 9'7.0 -79 Ac<.«, "T` w2 6rc ,oW--' PERFORMED BY: Jam- �"" i I � S CERTIFY THA THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: %JZ -3 [ 3 72-008 (Rev. 4/85) /Jo"i^6-t '5 5�2i�6/SvMr�l�. NAS 065-1 c,-nE- of --RAF— 02rErG' o� ZISOW-0, Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax RECERCULATING SEPTIC TANK AND TRICKLE FILTER SPECIFICATIONS Lot 11 Block 2 Valli Vue Estates No. 2 1. GENERAL STATEMENT OF WORK 1.1 The work and plans covered by these specifications consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an recalculating septic tank with trickle filter system as described herein and on the attached Contract Drawing. All work under this project shall comply with current Municipality of Anchorage (MOA) Regulations and shall conform to the following: • Three (3) Bedroom Private House 1.2 The Contractor shall carefully examine the project documents, have full knowledge thereof, have investigated the site and be satisfied with all conditions affecting the work. The Contractor shall notify the Engineer IMEDIATELY if conditions are encountered during the site investigations that affect the work. Any failure of the Contractor to become acquainted with the available information will not relieve the Contractor from the responsibility of performing the work as stated in these specifications. 1.3 The Contractor shall call for locates of utilities. Damage to utilities by the Contractor if locates are not called for is the responsibility of the Contractor. 2. MATERIAL 21 Tank: Septic: Tank shall be a two (2) compartment tank of at least the minimum size indicated on the drawings and shall be MOA approved. The compartments shall have a separate 4" clean-out riser. Steel tanks shall be protected to StiP3, under ground fuel tank standards. 2_2 Manhole Riser or Lift Station Tank: An additional second compartment manhole riser shall be capable of being equipped with the following: a. A junction box (Nema 4x) or equal, bonded or attached to the pump basin. b. UL listed electrical cord grips, installed in the J -box. C. An additional tank (MOA Approved) may be provided for the effluent pumping assembly and the items above. 2_3 Effluent Pumping Assembly, Controls, Alarm & Piping: a. Effluent pumping assembly shall be of approved materials, including: A 110 volt or equal UL listed effluent pump; High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen ('•\�rinrlr\ C..P�; F;ro r;n..�\ A.i..n.. raoR;lrcr C..r,.. A" Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax from clogging; All piping shall be PVC or other non corroding material approved by the MOA. b. Pump controls and alarm system shall be an approved system with the following options: - Event Counter - Elapsed Time Meter - Program Timer - 10 Watt Heater - Remote alarm panel option with a minimum of 80 dB sound pressure at 24 inches, operating temperature 30 AC to 65 AC, and continuous sound to be located in the house. - Oil tight visual alarm with push -to -silence feature. Automatic audio alarm reset. - 15 amp motor rated toggle switch, double pole, double throw with three positions; Manual (man), Automatic (auto), and off. - Nema 4x rated fiberglass enclosure with hinged cover, or equal. - All controls to be installed per manufactures instructions. - Control panel to be installed on outside wall of home within sight of septic/lift station. c. Piping from septic tank to the trickle filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded and sloped to drain back to the lift station. Insulation board shall be placed over the line where the cover is less than four feet. d. The Air Compressor shall be a Thomas Linear Series model No. 5060-A or 507OV-A or MOA Approved equal. 2.4 Trickle Filter a. Trickle Filter Pod shall be AX20 manufactured by Orenco Systems Inc. and distributed by Anchorage Tank & Welding. b. Install all materials according to manufacturers instructions and in accordance with MOA regulations. 2.5 Soil Absorption System a) The drain field shall be constructed as shown on the drawings and in accordance with all applicable regulations described in Municipality of Anchorage AMC Title 15.65, "Wastewater Disposal Regulations" (MOA). b) Gravel to be used in the soil absorption system shall be well graded rocks and cobbles with size ranging from '/2" to 2 '/2" and approved for use in soil absorption systems by MOA. c) Perforated pipes shall be F810 LDPE or PVC 3034 pipe, with two rows of perforations and shall be approved for use in soil absorption systems by MOA. Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax d) Clean-out pipes and monitor tubes shall be 3034 PVC solid pipe. e) Clean-out caps shall be rubber "Jim Caps" securable with adjustable metal bands. Friction fit caps will not be accepted. PART 3 EXECUTION 3.1 LOCATION AND GRADE a) The septic tank shall be placed at the locations and elevations as shown on the Drawings. Fiberglass tank shall have a minimum of six inches of sand bedding under the tank and around the sides to the spring line of the tank. b) The drain field shall be placed in the location shown on the Drawing, with minor adjustments allowed to minimize excavation and accommodate the existing terrain. The drain field piping shall remain level over the length of the drain field. c) Dewatering may be required for all excavations that penetrate the groundwater surface. Dewatering costs shall be incidental to the excavation. If ground water is encountered during the excavation for the septic system, notify the engineer immediately. 3.2 EXCAVATION a) General: The Contractor shall accomplish all excavation required by the drawings through whatever substances encountered, to the depth as shown on the plans. All excavation shall be accomplished in accordance with the State of Alaska safety code and other applicable safety requirements. b) Water Removal: Water is expected in the limits of excavation as evidenced by the soil test pit information. If an apparent water table is observed in any of the excavations less than 5 feet below existing grade, notify the engineer immediately. 3.3 INSTALLATION A. Septic Tank 1. After excavation the tank shall be placed on undisturbed soil on a level grade at a depth as indicated on Drawings. Backfill around the tank with structural fill. Fill shall be installed in 12 -inch lifts, compacted to 95% maximum density. Any damage to the protective coating during installation shall be repaired as recommended by the manufacturer. 2. The tank inlet shall be set at the elevation shown on the drawings. Care shall be taken during installation to ensure the proper elevation drop Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax between the inlet and the outlet. Install flexible "furnco" rubber fittings at connection from tank to inlet and outlet pipes as indicated on Drawings. B. Joining Pipe Sections 1. Pipes shall be joined to one another, to the polyethylene fittings, cleanouts, and electrofusion couplings. 2. Cleanouts: (1) All earthwork and fill necessary to install the cleanouts shall be considered incidental. 3. Jointing: a. Fit the heat channel in place, ensuring that ends are deburred and square to allow easy passage of electrocal or glycol heat trace. b. Fit the insulation half -shells snugly in place. Band with strapping to hold tightly in place. c. Heat Shrink Coupling: Cover entire exposed joint plus an overlap of four inches on pipe coated on either end. Heat in accordance with manufacturer's instructions. 4. Installation: a. Install insulation half -shells and heat -shrink wrap at pipe connections. Maximum gap in half -shells shall be '/4 inch. b. Lower assembled insulated pipe carefully into trench. Do not allow joints to deflect greater than the elastic capacity of the heat shrink sleeves. If sleeves are found to be damaged, reduce the deflection and repair the damages sleeves. c. Tolerances: (1) Lay mains to indicated line and grade. Perform earthwork in accordance with the Drawings. (2) Minor Changes in Direction: Pipe deflection will be allowed for small changes in direction, provided that the pipe bending radius is less than 30 times the diameter of the outer jacket of the insulated pipe system. C. Drain Field a) The drain field area shall be excavated to the elevation and dimensions as shown on Drawing. Remove all organic and silt material to the top of the well -graded sand layer. After excavation, the open bed shall be protected from surface runoff to prevent the entrance of silt and debris. Under no circumstances shall the use of heavy equipment be permitted on the drain field surface. All smeared or compacted surfaces shall be raked to a depth of 1 inch, and loose material removed, before any of the drain rock is placed. !'•\[E/nrL\ C..P�If�rotinne\ 4A.�ontcvRil tPr C..r,.. rinr Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8218 Fax b) After all organic and silt material is removed, sand bedding shall be placed to an elevation shown on the drawings. Sand shall not be compacted. c) The bottom of the bed should be as level as practical. d) The gravel -less system and distribution piping shall be installed as shown on the drawings. e) The drain field shall then be backfilled with sand bedding to a depth of 1.0 above gravel -less system. Filter fabric and insulation shall be placed over the sand bedding. Backfill above insulation with material excavated from the building pad to the elevation shown. The material shall be mounded over the drain field as shown on Drawings. Backfill of drain field shall not be compacted. D. Close -Out A. Contractor shall submit unqualified as -built drawings and certificates on MOA approved forms to the Engineer, and MOA for approval to Operate. Municipality of Anchorage Page 0f3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -tSNN 93 D365 PID Number: O15 3 2247 Name: RIGt1dR�D (ZoSSTO/J Wastewater System: [1 New Upgrade Address 1o3g ► vaS1Y-oF D�' ABSORPTION FIELD Phone:_ I ��� J/(F.. No. of B drooms: ep Trench 17 Shallow Trench ❑Bed []Mound ❑ Ot r \,^ LEGAL DESCRIPTION Soil Rating: Total Depth from original de: �J GPD/S. Ft. Lot: Block: '. Subdivision: f ^ Depth to pipe bottom from o' ' al grade: Gravel depth b ath pipe �7 i 1 Z y �t f t VNO 7� z Ft. Ft. Township: Range: Section: Fill added above original grade: Gra ength: T4 �" K Ft. Ft. WEkL: ❑ New ❑ Upgrade Gravel width: Numbe lines: Distance between lines: Ft. Ft. Classificatio ivate, A, B,C)'. Total Depth: ed To: Total absorption ar Pipe material: Ft. Ft. SG. Ft. Driller:eDrilled: Sialic Water Level: Install Date installed: Ft. yield:p Set at: Casing Height Above Ground: TANK M Ft. Ft. SEPARATION DISTANCES )(Septic XHolding S.T.E.P, -nc. To septic Absorption Lig Holding Public/Private Manufacturer: ''II 11 Capacity in gallons: Zwo I000 From tank Fieltl Station Tank Sewer Lines WwM { �� Well ri �( A A �f N A Material: L Number of Compartm tits: "I'W 0 �6v( n/4 >6o/ >efl rLngallons LIFT STATION Water Lot ( n ( � A Manu Line Foundation N��`/�/at: rdCurtain p off' level at: High water alarm at: 7 ti j'� /T /. N N l Electrical Inspections performed by: Drain �{- BENCH MARK Remarks: EXC,G�� NS7XFCCf�2 wt t�C.. Location and Description: Tb -o o /.! b NFA PX_ eA,0�' P]/ioP►� NYXT SP/21 N / _7S„a I L)Assumetl b /p. Elevation: loo . 00 Ft SETTt6 sej A001T1W ENGINEER'S SEAL ••••e°"�>v,"'�ty WILL Fa P6Wf-- N&-?CT- SP12,063-, / Q,{L Inspections performed by:�Ss Dates: 1st /O 3 93 .•.r ••� •••• • •. 2nd o ....... ...:... �t F A. Garnea a eY r• CE-7453. � Department of Healt and Human Services approval , ,• /J by: ' Date: if -3 •,.���� ~p•NN•• O Ph it+1� 0FES A.�e Reviewed and approved �y 72-013 (Rev, 9/91) MOA 25 P.O. Box .196650 • Ancnorage, AIaSKa yyo l y-uoou • I uiup lul IC. JVJ'Y! YY On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: l � !/� BK 2 d JA -LW VY6 AZ PID No.: 0/5-322' /Q E i / ..........10 .. .. .. ... .. .. ... .. ... .. .. .. ..... ..... ... .. z- ='7 O 30., 6v m 1 Dv^' By : 60,ress 12013 A (1/93)' A fffo A.Gai E-7953 n 12013 A (1/93)' A fffo A.Gai E-7953 100.00 85.00 Permit No. SvJ9303657' Page 3 of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: t.Ci' IIS BV -2) VAd A Vua 44 2 PID No.: D/5' 32249 6-2c6op oVF-P-51PnIc SND oJE21*oWia6 QF . s j qtc vP2 ESS �K vaa res : a9.6 8 ,, q 6% 'F FOU,tVA1µ+1 e.�o PSSvr-+FD q- CIU FLOPT 1 ... ......... .,............ ; ............. Doo G.Ak'0-1 _ sEarlc-�o,rlL ZC C/o wveal- Tr -41z- !aLerr = 94 81 '�vk. ou7t6,.i = ci4�%3 � •1-o.v�L ! l (�20VNDWA L WR5 F�.1C0-- .TWt 0 Ate' a F,/41DA3 OF A Arv'l oN 4e,w i N 6 'b..rK cup's coN'i'r C -i q_ To IS 430 fpalLON S CaP a_ c.T`i...._S,.Fr.r"_.......!.N._.._T+4£.....::irL+!. FLoA� _...._...R............._;......................................... E...................................... I_F_QS . CA J 12E 4-0..1uSTEr> \AA 4INJn4 .DiA. M-013 A (1193)' ID/3i 4 roA-Lwnj AIARM PAGE 1 OF 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930365 DATE ISSUED: 9/14/93 DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES EXPIRATION DATE: 9/14/94 OWNER NAME:ROSSTON RICHARD M & OWNER ADDRESS:10341 VOSIKOF DR ANCHORAGE AK 516 PARCEL ID:01532247 LEGAL DESCRIPTION: VALLI VUE ESTATES #2 BLK 2 L T 11 LOT SIZE: 20680 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: HOLDING TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS PERMIT IS BEING REISSUED FOR THE INSTALLATION OF A HOLDING TANK. CONSTRUCTION OF THE ORIGINALL PROPOSED BED SYSTEM WAS NOT FEASIBLE DUE TO PRESENCE OF UNACCEPTABLE SOIL AND FILL MATERIAL AT THE PROPOSED BED SITE. HOLDING TANK SYS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 TEM WILL CONSIST OF A 1,000 SEPTIC TANK AND A 2,000 GALLON HOLDING TANK. CONSTRUCTION AND OPERATION OF WAIVER TO SURFACE WATER. WAI RECEIVED BY: PAGE 2 OF 2 THE HOLDING TANK REQUIRES A E$ 930047 HAS BEEN ISSUED. / DATE: c; i' 5 ISSUED BY: JGt h�1 Sil4l'r-4 DATE: lU ZE) r�3 0 MUNICIPALITY OF ANCHORAGIP Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR970050 PID# 015-322-47 HA# HA970352 Permit # Date Received: August 11, 1997 Legal Description: Lot 11 Block 2 Valli Vue Estates #2 Engineer: Jeff Garness, Alaska Water & Wastewater Services 8471 Brookridge Drive, Anchorage, Alaska 99504 Applicant: James & Lisa Wheeler Waiver Requested: Lot line waiver of 7 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: ,_, .,_ ��_O_l.tnA 7f i10 `ir-'i�u'Zwnf /.", Date: LI—Q By: Na of Rev Rec #: #03047/2001 Amount: $ 115.00 Date Paid: Augst 11, 1997 • Munieipality ®f Aneh®rage A MayoorDepartment of Health and Human Services825 U' Street RickMyrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 August 22, 1997 Jeff Garness, P.E. Alaska Water & Wastewater 8471 Brookridge Drive -- Anchorage, Alaska 99504 Subject: Waiver Request for Lot 11 Block 2 Valli Vue Estates #2 Waiver Request #WR970050, PID #015-322-47 Dear Mr, Garness: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 7 feet from the leachfield to the property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Sseph M. Barvinchak Engineering Tech On-site Services ljw #7 00, OF AL,�"►Y�, 9t 4 �� �� ••• NO. 31555 � ,� < of • •' of'E 1c, FA. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. 1 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's in- spection of the following described property: LST ._J.1�_ _IE?Ly_ -Z 1l�Lt I VIJP =t TATs= t/ nJ t 4 2_ _ Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and -do- not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this -ZCrFsay of Luc, t_) -.T 19 1=1 FRED WALATKA & ASSOCIATES Engineers and Surveyors VI Alaska Water 8c Wastewater Services "Preserving the Last Frontier" October 12, 1993 RECEIVED OCT 1 31993 Mun,apal ry of Anchorage Dept. Health & Human Services Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: John Smith Ref. Septic System Upgrade for Lot 11, Block 2, Valli Vue Estates #2 Subdivision. Dear John: As discussed with you, via telephone, the design previously approved/permitted by your office for the subject property could not be installed due to unacceptable soil conditions encountered during the installation. When excavating for the "bed" on the north side of the house, it was discovered that the soil in the berm area was actually a pile of organic material (stumps, logs, lumber, act) down to the groundwater table- Investigation on the top of the berm, near the south property line, by the excavator ("Acheson and Sons") revealed similar conditions. I considered moving the proposed bed further to the west, on the north side of the lot, however, an exploratory test hole revealed that the absorption layer we intended to utilize was only 1 foot thick there. The remaining soil layers there appeared to be organic fill, or tight silt- In short, it does not appear that there are suitable soils remaining on the property, which would allow for a septic system that has a reasonable chance of lasting. At this time I am proposing the installation of a new 1000 gallon septic tank, and a 2000 gallon holding tank= In order to avoid installing the holding tank in the area of the old drainfield, or an area of known telephone wires, I am requesting that the holding tank be installed to the southeast of the new septic tank, only about 60 feet from the creek setback. As you are aware the creek is on the opposite side of the berm, consequently, it is not possible for wastewater to flow over the ground surface and into the creek. Telephone - Fax 338-3246 0 8471 Brookridge Drive 0 Anchorage, Alaska 99504 I am unaware of any impacts that this installation would impose on adjacent wells (neighborhood is on a community water system), or septic systems. If you have any questions, please call me at 337-6179. Sincerely, i 9r Je _ Garne Owner/ nsultant JAG/jag Rosston6.WPS E., M.S. So� o rim S�P51L UPGP DE torIk L3V-2�Vv��,IVwa ES �S Z QREPAO—E.D FO'R: �IGK (�SS'�� P PQEPa� D UY ALASKA WATEZ WAS7aWAMEP `e -P -y s PATE. = 10 2./93 fleAWN GA�E� sCA� E % 1"= 30 y 16 0 ;y A•Gar ness�•�W� CE -7953 �j �FES51�N44 p cSvr ED EtFvAalo 7 0 Co. 00 SGP�L uIL tNl;i = 94^81 SEP � iL. ip.,K 6u'T"lG� = 94.63 o rim S�P51L UPGP DE torIk L3V-2�Vv��,IVwa ES �S Z QREPAO—E.D FO'R: �IGK (�SS'�� P PQEPa� D UY ALASKA WATEZ WAS7aWAMEP `e -P -y s PATE. = 10 2./93 fleAWN GA�E� sCA� E % 1"= 30 y 16 0 ;y A•Gar ness�•�W� CE -7953 �j �FES51�N44 Alaska Water 8c Wastewater Services ,Q "Preserving the Last Frontier" WlLL4Il July 23, 199:3 Municipality of Anchorage RECEIVED ()epartment of Health and Human Services Division of Environmental Services C:tn-Site Services Section JUL 2 91993 P _ 0. Box 196650 i iunici Iit of Anchorage D Anchorage, Alaska 99519-6650 �Y ept.1-,eai.h & Human Services Attn: Robby Robinson i=tef. Septic System Replacement for Lot 11, Block 2, Valli Vue Estates #2 Subdivision. Gear Robby= Attached is the application, site. plan, and design drawings for the subject septic system replacement. Comments regarding the proposed system are as follows 1. Location of drainfield changed because of new information regarding foundation problems= Rather than placing a trench system to the east of the house as previously discussed, T have opted to place a bed type system to the northeast of the house. 7"his auion was t.a.kcrt r 1 t t r X" l ea rrrec that the humcr�wne r, as av'n Z Z as the, ne! y*ht�c� rs� have Pratt j_.roblerns Pith grvuncvwater leaking into tPreir "c�urrrwatic�ns in the spring time. rreicghbors have freoch c+rafns with sumo Pumps tu the water arvuncr their fou r>('ki °ions . St is my belief that the water migrates 'Prom east to west across the property, and that placing a septic ystem along the east side of the foundation would only magnify the problem. By placing the system to the north, the potential for foundation water problems should be less_ Regardless of the alternative, the homeowner will need to take action to waterproof the foundation, but it wi�tl not be possible to install a drainage system, due to the proximity of the proposed drainfield, unless the french drain is tied into one of the old septic systems on the lot. 2_ Bed design= As can be seen from reviewing the attached percolation test results, the soil "perked'' at 67 minutes/inch at the location proposed forthe system, consequently, a sand filter will be required_ For a bed system, this corresponds to the maximum application rate of Telephone - Fax 338-3246 0 8471 Brookridge Drive • Anchorage, Alaska 99504 ,8 gpd%ft=_ Since the existing home has 3 bedrooms, the total _design flow is 450 gpd, rased upon this, the minimum amount of absorption area is 563 ft2. The proposed system is a 15' wide by 40' long, and provides a total.- absorption area of 600 ft2. 3. Five foot separation distance from trench to lot line: The subject bed will be installed only 5' away from the lot line and a cutbank which drops off to the neighbors property. In order to prevent wastewater from migrating out the side of the cutbank, I am requiring that the installer place a vertical visqueen barrier to prevent the passage of 1,vater horizontally towards the north. See the attached drawing 4. 20 foot separation distance from creek set back to edge of bed: As you probably remember from our site visits, to the east of the proposed bed is a steep bank which rises up and then drops back down towards the creek. It is impossible for wastewater to travel up and over this bank_ To the north of the proposed bed the property drops cuff at 20--50% slope down to the neighboring property, If the septic system were to overflow it is possible that sewage could run down the slope and flow to the creek- Therefore, ]: am requiring that the installer build a berm along thio north property line so as to ensure positive drainage back towards lot 11, bk 2 (see the attached drawing), Basked upon the steps taken, I am requesting that the 100 foot separation distance to the nearby creek setback be waived, 5. Absence of surface waters and, subsided groundwater: Due to unseasonably dr'y' it is j7(Ja S.G f:�l,w that there are areas which would nor,nrally' hate rurtrrzrr* waI.&r frr them but are currently cry. In addition, the dry weather may have significantly altered the normal groundwater profile, Consequently, it is possible that f+iture groundwater monitoring on this property may indicate the presence of water closer to the ground surface, and surface waters which were not present during my site visits, In order to compensate for possible fluctuations in the groundwater elevation, I have place the bed 6' above the elevation I encountered groundwater, However, without monitoring groundwater through the spring it is not possible to absolutely establish the high groundwater elevation, 6- Bed will be installed on or next to test hole: Because of the space constrictions, the bed will be placed right next to the excavation for the test hole_ If necessary, I can angle the east end of the bed to the north so that this won't be necessary, Please specify your preference on the permit, assuming it is issued, I am unaware of any impacts that this installation would impose on adjacent wells (neighborhood is on a community water system), or septic systems, If you have any question, please call me a. 337-6179= sincerely, 4e,/ , /Ga 0 e / ,onsultant r ,JAG/jag Ross 'ton2. WP.`.",' M.S. A w y NOT - C1 ✓ ��%9�r P � �T «BVI AJ6 -T� L'V14 (11 �7/2ZV/93 ti'L;I V _ 2 U Illi >'�/Liz'i✓7, Tz: L°a.^.nJ57�'�� � �L) n% Alaska Water 8c Wastewater Services "Preserving the Last Frontier" ,lune K. 1993 Municipality of (anchorage Department. of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 1956150 Anchorage, Alaska 99519-6650 Ret: Sewer System Upgrade at Lot li, Bk 2, Valli Vue 42. Attnr. John Smith, P.E. Dear John: Per our discussion I am requesting a preliminary evaluation of the subject system prior to proceeding with the, percolation tests and design. Attached is the sewer permit application and some general information regarding the subject sewer system. The original system was installed in 1971, failed, and was replaced in 1933. The existing system has now failed and needs to be replaced. I have attached a drawing which shows the general location of these two systems. There is a creek which runs along the back property line, and in order to maintain the 100 foot set back from it, the existing and abandoned systems have been crowded into the west portion of the lot. The problem now is that there is no portion of the lot on which to put the replacement, field without encroaching on the 100 fool, setback The only alternatives are to install a holding tank, or obtain a waiver to the 100 foot setback Obviously, the latter alternative is preferable to the homeowner_ prior to digging any test holes, and preparing a design which would be based upon the issuance of a waiver, we are requesting that a member of your staff meet with us at the site to perform a preliminary evaluation on the 'feasibility of a waiver. once receiving a preliminary approval, we will proceed with the percolation tests and the design_ In order to schedule the site visit please contact me, at 337-5179. First thing in the morning would be the most convenient time for both we and the homeowner, however, we will adjust our schedules to meet your staffs, Currently, Telephone - Fax 338-3246 • 8471 Brookridge Drive • Anchorage, Alaska 99504 there is a sale pending on the home which must Close by July 20th, therefore, if there is any way to expedite the initial, site site visit, so we can proceed with the design, it would be appreciated. It you have any question, please call me. Sincerely, J ;f y Ate- farness, P.E. , M.S. Ow e /Consultant JAG/jag RosstonI MPS) MUNICIPALITY OF ANCHORAG� Department of Health and Human Services T On-site Services Section WR# WR930047 PID# Waiver Review Worksheet 015-322-47 HA# Permit # Date Received: July 29, 1993 Legal Description: Lot 11 Block 2 Valli Vue Estates #2 Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Services 8471 Brookridge Drive, Anchorage, Alaska 99504 Applicant: Richard M. Rosston Waiver Requested: Lot line from leachfield to property line - 5 feet; Leachfield to surface water - $0 feet Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: D� Waiver is NOT Granted: List Conditions or Reasons for above: 5EE 19 FI;9CAI,E_V Rec #: 24954/9201 Amount: $ 590.00 Date Paid: July 28, 1993 Municl�ality of Anchorage Department of Health and Human Services d1-1 Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 20, 1993 Jeff Garness, P.E. Alaska Water & Wastewater Services 8471 Brookridge Drive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 11 Block 2 Valli Vue Estates S/D #2 Waiver Request #WR930047, PID #015-322-47, SW930365 Dear Mr. Garness: Your request for a waiver(s) of the required 100 foot horizontal separation of a holding tank to the surface water has been approved. The approved separation distance is a holding tank to to surface water of 60 feet. The waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. If there are any further questions, please call our office at 343-4744. Si erely, hn Smi P. E. rogram anager On-site Services JS/ljm 6t/f1/ R R F4 eEsF FUR Lor // �L oCk 11194E I V& F Ef A IWgiVER R1Q uEST Nu.KBE2 WR 93 00 4 7 �+�ff/SER %'EQuEST FOR PROPOSE19 AFF TO 8f LaagTEb 5 Fool F?pN /-YC 4109 hl / OF L.1NE ANA 20 FaO TO Stel?r- -cE L-✓iTE S E pTrc s1hv oW a — %lYE FNO/HFF/? /S Pl?OPOs/a ( jp SQ H 4'526 A RFD TYPE W/Thf ff Sit*V FILTER 8kEtASA771' /T Ta rZ0H %/.!E FPfLu6�T NT Ti '000 l�S/%� SO/L /S r 6/Z1 -7 -vet Tfr,*i /s !/F_R2ypO/Pa�cS f,9RT OF THE PWPOIEP ffRM/i 0fIN REgLiEfrEP TO CO/1/fr/? if c ii ff-p S Faar A L Or L/a NYJ � O f EE r HO,?, z O�.T,,�L S E Pfi /? /4 % /dA/ 6�z t p _ %V /?E5pFCr ro T/4F 5TrR M, /T /S u/'GR�O/E.1iT F,gon TYF_ PROpOf6/' w l ry fJ l Ak6 e- BERAl Ni4Tu R/iLL j' ®c car /P/ a 3Era-EEti rl-(F- 5/TE ofCdvsrR�� roti , T TO TrtE NAtu1eI$4 vFRr1, 09 Ft,avngPE pEr{., >s GOrti6 ro l3F1 a,v s TR u c rE o 4 l a E D r. / rH 6 1O014, r/ / S (> u FEA/. 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THIS DQA+J iN 6 Ara ( M \jAu % vuE ES 1�S S�D#2 UN S O-T}� W t Sa N 6T�fl 11,�ST \jry 4 /el e Bk- 2 sE � �o-r t3 t3 K z L.OT 10) 6K2. �NSg LOT 4t 8K -Z Lar 12 3v- z OMAL,L)EEN . plvAD Tt2N � �3vJ 1gSF'Ec-rED,� oLo 2vW5 �� gUit,DiN(r �OJ.ND : S6P'rIG VNK�OWnI, UN- pOGVMF�JTED pa�Av 6aG1�� 1953..:; , Nei : /� L LOTS t vPL�� vuE z A-a�— of -J A COF'IM UNiT'� l.vF't.l- . LpCP-�or1S OF A -LL. 1--oNSSS �( 58P�C SvsrF.atS AP£ 4aE NO WDLL$. �,-,D .._. .... Cycac t_ocF,-roti �S mzrr cp-Lr[Um- 7'0 PEStC-tQ , S�--PTGUP6P�-0E 0- Lar fly 6K2y VA�t i �/U� #Z ®,r.' _ /�• .�. eeea n PREpad-�D Fo+2: DICK �oss'rvnt s �B . fee A. c P2cPA��D W`/ : ALASKA WATER WAsiEWA R SEp.utGEs a�' 1.7953 pATE :-7jz3�93 .'nepWN �Ft2NE5S -. 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Garne , �✓ e a„ C • CE-7953 TPfzEPA�ED BY ALASKA WATER W4slEW�kTF� p1lIGEs ,1 t•. ��e �Z , P?f8 7/23/93 D AWN GARP f___... 1�`\O®a g o N ara* w 3� N �I� '° � 20 v i D� St"�'D F t �-�'- 3 E lav-► Q �D Ta �I�VA-1�DN OF 94- FEE1 C/o 6„ o , d 1` Fl16 N 1-7M1 N 6r TUBE. 4"4) DR/110 P1P� w 1'f1+ PFJzFoPJa-T low LBW NOTE DQA1r,1 RocK S"ALL P5E /Z ro 2'/ten scecF�6D RFK '�oTAL A650Q P'rlprl PPSA(000, PIT y ° d d � 0• ° d 4 h o n e • I o, d v a ,o ce e. A Y I j'—j MoN l'rd21r�6 �'uSE PE�f-a�TGO I..I GS'A�ELLL � T/.F7% �.;�L,.$pCICFiLt�w1TN f�W�lvE �: so1� � 1-,LLouNo �lrl"'i�oGK r TOP5a1s. •r. ". ,"'r� 1N y'se,. r� ` NSULAil01,1 BOAP� SOIL ��P��:�F A�•qS A®r SED D1=TAIL i.o1` ll) QK Zi Vp141 VuC=$#2 of H *I� �•.Qs• ....... . ..� p2-EPAf>>=D F'o� p1dL �Ci � fr A. Gayness pQEPA4Z,F_S> B� AASLA VSA -LES �Jf�SI�WAiE�. �c�IICES S •. CE -7953 >7t -j l23/ t3 p QAW KI : -'DE OF sLCP£ (.AovND Soil No2'Tit -tA_So-+ T>-�- S Po s, nvE (P-Se-elD e>VI52- gfjzm, F, I sn N' `j>=G�l DJC - S� STAG j cF- 71:1 l uT-o 4 i L L o <a^6D Tn � OF Al At 1._SEPT7c VP6r,-ADe : il) BK2� VA-uI VuE#Z _I pflapAv-ESD r-oR: P�osS-Do A. I_P2EPaaED M : ALASKA WAFER. � WAS-CEWAI-ER, SEP-VICZe- I X3/93 Dei wN : Ga PjJesS - = NTS '1 PERFORMED LEGAL DESC DEV l� 1 2 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST "DICK. (LoSSTdN 1_o -r ate vre-t_tS Uua_ # 2. 7 8- 9 10- 11 0 11 12 13 14 15 16 17 18 19 DATE PEF Township, Range, Section: NIA WAS GROUND WATER yE ENCOUNTERED? IF YES, AT WHAT ( l�d DEPTH? �p^^P Depth to Water AlterN A 1L9 a3 q of monitoring? _Dae: kyr St'a SITE PLAN ® a MM 20 L__ /• b PERCOLATION RATE dB' T (minutes/inch) PERC HOLE DIAMETER 6 4.57 5. o TEST RUN BETWEEN 6. S FT AND 7'-5 FT 'OMMENTS ML U2w-16P, t. A$ DAAIP I -D Ie>%46" Q. Oh `J��iTU �tI% NClT� X'c_c ave• ^G�O_L`Ay1a^f PID NtYi Sw.�/jaDW� DuYLia6r PERFORMED BY: ��� s-^�''_� ISL S� CERTIFY THAT TH 5 TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/2 93 72-008 (Rev, 4/85) m ,� � Z NOT✓;' BE-OGt L iS -We U �rjJN 07ATow1 c -%O. ASSum too, w Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 •'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: D tGir-, 2-0 SS"n5. j L -O -r- IIJ 13K 2 LEGAL DESCRIPTION: \jA Lt -1 VuE -ttr 2 T 7 F ,��►+1�1�a .�► .,.,. . j� 'S SEAL) 7 OF * �^ r y A. Gorn t ra: 00 SATE PIR �Of*lill•�/ J/s3 7�i 43 Section: 11 P IZO Sr�U'( D wE 'T'D I N 1✓1 U�Z�N' 12 O� SEw/r PSE 14 19 03 15 16 17 18 19 S IF YES,ATWHAT Nr L DEPTH? i3oi-rvr+�P0 E Depth to Water Allerfl- Monitoring? / Dale: I I ON 14 WE ---- --__I-�11►11�iuY� 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER A- n TEST RUN BET-W,.EEENNc � /A FT AND " 4 FTS /� p COMMENTS `Jb1L WCJ� 0t:1 -1S ✓��I Q F �rsu I r�3 rot or- -.6-pr--- Sa-vn C PERFORMED BY: �'"I 36r -r— 64f2j6.sS CERTIFY THAT THIS T T WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: CERTIFY THAT 2 72-008 (Rev. 4/85) K =3o I 22 DEP FEET) SL PE 2 5P. •' i'FJ i 4-�ot E SID 6L>�-S 3 a 5 71 HL '� EVERY 6Lvf UV -F- so�Ls 6 8 '�/ a U^tSiYl�il1= SrDPi--*-`LL'J LD rjT 6c --.r Iry 7(26JUa• ONUi (3LvE IBJ C-DLo(2o,^) NoJI� H. SIDE_ of F+ol� 9 S-hh81 lib ! WAS GROUND WATER 6" ENCOUNTERED? \' Y�5 11 P IZO Sr�U'( D wE 'T'D I N 1✓1 U�Z�N' 12 O� SEw/r PSE 14 19 03 15 16 17 18 19 S IF YES,ATWHAT Nr L DEPTH? i3oi-rvr+�P0 E Depth to Water Allerfl- Monitoring? / Dale: I I ON 14 WE ---- --__I-�11►11�iuY� 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER A- n TEST RUN BET-W,.EEENNc � /A FT AND " 4 FTS /� p COMMENTS `Jb1L WCJ� 0t:1 -1S ✓��I Q F �rsu I r�3 rot or- -.6-pr--- Sa-vn C PERFORMED BY: �'"I 36r -r— 64f2j6.sS CERTIFY THAT THIS T T WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: CERTIFY THAT 2 72-008 (Rev. 4/85) K =3o I 22 x- j Munlclpality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: D1GK 10 sST"01'1 DATE LEGAL 1 2; 3 4 LOT I 1 d QIL 2 V,,LL.i VIAE 3f -'Z Fi�l./6rck-S/ C n� Gw w'T+1 W -_A-5 o"�- >p. vrfa--/ ( D fz-u S G'M w r' 4 L-E.JSE OP VrJ" Tl6?r+�_ CLA-1/5i L:7 WH;Ct+ WAS ASSvnF_P Tv BE IMPERr••tEA6, 4� WAS GROUND WATER ENCOUNTERED? Township, Range, Section: SLOPE or 0 09n� yA. Gar •tom C -7953 ' a9F •••...».•••�� do /1 PERFORMED OpR 10N rt j -A m *\I E S S IF YES, AT WHAT �� IQ O DEPTH? P E SDepth to Water Alter Yj -10 7 Z3 qj M o>`•rroW�l [r Z Monitoring? Oaa: 14- 15- 16 415 ,6 ry 17 P s7 7d14 ,a ,9 40 20 Lj ! PERCOLATION RATE _(a7 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 6 FT AND 6'S FT �c r� 'OMMENTS v"_—�l � IS _�O POQZouS WILL lu--Cy UI( 'els% �I LI QEGOMKE�D Bre op 5/WIID6. W1 -1-l+ (3oTTj>.1 G q -1.o "IDAc.cW""r FOIAaov,aowA4� , 6•--ee.J PERFORMED BY: JeF_L 6A'2_�1:.ss I C>or Js ?S ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) moo -1,h,y SP2.ira6/Sumr-�.f� uM1S Qom" CERTIFY THA THIS TEST WAS PERFORMED IN DATE: ��z.3I�13 a�aE.. � SIE O 2'r EtG' � ��m'20 • Y' 4 A. a AWAM, lu ruin uuL EXi ST��6 SYS or- A-94-J10cw6lD S`sSTFJ`j , C eFFIlK P,6A 4:7 ,...r G ..-r-- Re c e v'l i 1-�e J1 4 -I Z -`l 31A, r^h Frei V:'�tn r';� '.. 'tp : t4O..255.5 01,,,�" >lo, r[a, i"1'i r5 .,?'C.:, EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have porrnrmed a Mortgagee's i spection of the following described property:_? _r. . Anchorage Recording Precincts Alaska, and that the ilnpr meats situated thereon are. within the property lines cn� not overlap tn• encroach an the property lying adjacent t: i to, that no improvements on Property lying Adjauont th. 1 encroach on Lha premisch In question and that Chore n^ roadways, transmission lines or other visible ee::eme.-.r avid property except as indicated hereon, Datcd at Anchorage, Ah.Iera thin._. 'tlay or......... !?,!: :_'',. ���..._.__., ID.- YHED WALA'rXA & ASSOC:IA'i .1 Engineers and Surveyors • MUNICIPALITY OF ANCHORAGE to DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE EINE 'UPGRADE n_ MAILING ADDRESS 2-7(�I LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ' Trpe. Well Absorption area Dwelling PERMIT NO. DISTANCE TO: Uy a ZZ Manufacturer Material No. of compartments w I-. y Liq. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. J C7Z = Z Manufacturer Material Liquid capacity in gallons D DISTANCETO: Well} Foundation Nearest lot line PERMIT N m= i iT13 � w z H z au4/1 No. of lines ength o each lin Total length of lin Trench width /00 inches Distance between lines y C H Top of rile to finish gradelj E .Material beneath the �- Total effective ab�ption,a,re� 1J O i inches Length Width I Depth PERMIT N0. La 0 Q I— Type of crib Crib diameter Crib depth Total effective absorption area wa y DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J DISTANCE TO: Building foundation Sewer line Septic tank Absorption @reals) OTHER PIPE MATERIALS VV l; C SOI L TEST RATING ER INSTALL11 �y q S 1 �� 1 I U3 — Lo REMARKS Y� bi allrQ t. i v J pl o cin APPROVED DATE LEGAL 71_ 72-013 (Rev. 3178) 1 7s -e1 i T ®_: 1 _ T 0'`r' 1_aF= FA t4�_= CA Fa E DEPARTMENT i- K_HEALTH AND ENVIRONMENTAL N TEC:TION 4� 825 'L' STREET, ANCHORAGE, AK 99501 .64-4720 CA 14— = -T -T-K _:E=Q°-1Er F=' F=°E=F0O^t i -- PERMIT NO. tBENCt 4A a1 z l AP'P'LICANT DICK/JOY ROS_;TONd SRA 27 D ANCHORAGE, AK' 276-5121- LOCATION 7E-5121- 1_OCATIONd LEGAL LOT it BLK 2 VAL I VUE SUB LOT SIZE 9_ 999_? SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DR:AINFIELD MAXIMUM IAL44BER OF BEDROOMS = = SOIL RATING (SO FT/BRA= 183 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E -a E: F i 1-A1 — to g_ EE 1- j CC:n -C1-1== ' v CA F= FA Baan° I` L_ E:a E F' -1-1-4 == THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR: DR:AINFIELD. THE DEPTH OF A TRENCH OR: PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET}. I- 1--1 F= _ 5 ° : E A1 -a e 1 1 1-°-1 T 1 : F''s-1 -T :E: 15- - k -a �_-e !D F= E : EE _F - THE GRAS+EL. DEPTH IS THE MINdIMUPI DEPTH OF GRAVEL BETWEEN THE OUTFALL FIFE AND THE BOTTOM OF THE EXCAVATION IN FEET;. iit 1•= y_+ 1_6 I F' E= En _° E= F' 7- T !2 -F fol 04 F:: _ _"1:== :lL CJ c_a CD CA FA 1-1— CD 4 ° PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURINdG THE INSTALLATIONd INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. — — — e 1.°.1 CA c_ I> 1. i F F" E. a_: F T e a P I - FA FR EE BACKFILLING OF ANY SYSTEM WITHOUT FINIAL INaSPECTIONa AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEE14 A WELL AND ANY ONJ--`=ITE SEWAGE DISPOSAL SYSTEM IS. 1040 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENdDINdG UPON THE TYPE OF PUBLIC: WELL. MININ'lUM DISTANCE FROM H PRIVATE WELL TO A PRIVATE SEWER: LINdE I_ 25 FEET AND TO A COi°MUNITY SEWER: LINdE. IS 7:5 FEET. OTHER REOUIRE9ENdT:S MAY APPLY. =.PECIFICATIONS• AND CONdSTR:UCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INdSTALLATION. e---1=. F =-1 °'1 t1- JL S� Lv - I CERTIFY THAT 1: I AN FAMILIAR WITH THE REQUIREMENTS FOR: ON --`=ITE '=EWERS AND WELLS AS SET FORTH BY THE MUNdICIPALITY OF ANCHORAGE. i WILL_ INdSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 1: I UNDERSTAND THAT THE ONd-SITE SEWER: SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS, REMODELED—TO INCLUDE MORE THAN _ BEDROOMS. SIGNdED IC:ANfT v Dk CK/JOY ROSSTON ISSUE[. B'T f��� =r�-sr z — - fa �� �� 01 NICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST ST83-a3t PERFORMED FOR: D;,.k R^ LST^r3 DATE PERFORMED: C,./i1 lr3 _ LEGAL DESCRIPTION: V, I: v u! '54,Ldir Sion �� 104' %I��Bio- 1 r� SLOPE SITE PLAN I I 1 I pLt Si1li' and orgc�onict w.+% I I 1 9ravcIs and cat 105 2 11 1F 3 ISI S 4 Irrl s�>Jq�WJ 9r Tel 11/Yp7 1V811 afia@ Soh /09 !ZS 6 •01 I; i•si♦ 17 GMj Qravels ,nd silfs wifh sand oIt- n P 11 WAS GROUND WATER S ENCOUNTERED? Y..L O 12 P E IF YES, A7 WHAT _13� 13it ka DEPTH? 'ro/ C V_" r, Lt_1_ 14 ( End 15- 16 17 I" 19 4 H*1 ■ME ■■���v Gross Time Net Time Depth to Water Net prop 4Ha0 /y/83 9157 10 Ininr. A. 710 1 +HaO 6 9 83 lo:t8 eZ Minr +NaO la:TB 3.30 a 6 q A3 o ao a Mins T1 d +Hao ,, 9 83 to. lo: as a rn.n:it.Ocr �,aa to:74 ;,It Na0 6I9I83 to:34 a w ns o MEMO MEMIME Reading Date Gross Time Net Time Depth to Water Net prop 4Ha0 /y/83 9157 10 Ininr. A. 710 1 +HaO 6 9 83 lo:t8 eZ Minr +NaO la:TB 3.30 a 6 q A3 o ao a Mins T1 d +Hao ,, 9 83 to. lo: as a rn.n:it.Ocr �,aa to:74 ;,It Na0 6I9I83 to:34 a w ns o 201 +Mao d 61VS3 ioiab aninS. 3,aS 606 PERCOLATION RATE S_ (minL'tesl%mch) TEST RUN BETWEEN FT AND FT COMMENTS 0)" f 4.r r•,n .44 in in n in'-fes,ca, so7-eo4-Iyl, 13- 11 of—d Ics}C^ �• -�� a -1 1 � inM�s rcadb's aero -hkrn (seeg�-Fac�.ed-'Far �''..1 r.4dln,j PERFORMED BY: dor nar7!"^1 JP.110 ias++�er CERTIFIED BY: DATE:,.,_�� 72-OOB (6/79) *NICIPALITY OF ANCHORAGE • PERCOLATION DEPARTMENT DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST `\\ t 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: -G'TG"IS--R..z 4 r DATEPERFORMED: LEGAL DESCRIPTION: �tS' SITE PI aN' 1 1 `i GM, 8rcwn sNf wi44 gravels 2 and Cobbles 3 4> ML, Very Sil+7 gravel 6- 7 11 12 13 14 16 . H.*a 17- 18 19 20 WAS GROUND WATER 1L� Safura+ed SIl�S� ENCOUNTERED? YeT tw San<iJ/ oecasie.gl i Obbles qnd 9rartl IE YES, AT WHA-F/6/BJ' 9 - DEPTH? C�16/83nyont End Mw I Reading Date Gross Net Depth to Net J Time Time Water prop H'20 3. fnins. 1.90 a a43 Hao (0 9 83 00 MIn♦ 0 1.85 Hao s 0003 0003 1, 88 93 o Mias .13 Hao os3o I,85 9 43 a o Mina l� H,0 0540 d 9 83no go I o M.ns Ja PERCOLATION RATE ,�'F (minutes/inch) TEST RUN BETWEEN FT. AND FT / ,! / fI '— PERFORMED BY;Ctn11e11�c>•r lZal-6rt�1�7L DATE: CERTIFIED BY: J 72-0.08 (6/79) S/A ( 1L11')1\n "I Ii UIIIiI iiiHL [riJi, UL �rginctring Enuironmcnto! Studics �tllu*.), 1i 7+A ohd {�lnq raadin� T. H, '� 1 PERCOLATION TEST DATA SHEET CLIENT Dick Ross�on DATE CJ8183 ADDRESS ZIP CODE LEGAL LOCATION Loi' IIA Block a,, I/gllyue 5"LdivfaSon DOTAL DEP,TH QF !OLE S ft. ZONE TESTED %a ft TO ft READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) +NaO '7 e to s a rn'ns. ,q ,06 S FINAL PERCOLATION RATE $ (min/in) PERFORMED BY Corrne r f, �es 1200 Ilial 33rd Aunuc, Sul ,-Ye Anchorage. Alaska 99503 9 (907) 276-1361 khnh ,�i *011(1STAL d(SOL Enginccrinq 6 Enuiror.nc lal Smdics PERCOLATION TEST DATA SHEET CLIENT D;ck Rr,6T4cn DATE r19,18S ADDRESS (See a4lc,cAp-d.) ZIP CODE LEGAL LOCATION TOTAL DEPTH OF HOLE C> ft. ZONE TESTED S �KK ft TO (l ft READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) ro,00 30 M,ns a,56: — ,00 FINAL PERCOLATION RATE PERFORMED BY Cgrlsan 3 ,b oy C. Reid, Jr. Q No. 2251-E min/in) VW West 33rd Auenuc, Sui b3• Anchorage, Rlc4a 99503 • (907 2761361 GRER ANCHORAGE AREA BOAGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME Svc -rte . (;7_ 4C- + MAILING ADDRESS 3%11�(e PHONE LOCATION LEGAL DESCRIPTION �-y � ��L 2 - SEPTIC SEPTIC TANK: DISTANCE1 NUMBER OF FROM WELL MANUFACTURER Z"- MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY (T GALLONS. TILE DRAIN FIELD: /�• DISTANCE FROM WELL(-0v'iWv�, FOUNDATION NUMBER OF LINES DISTANCE BETWEEN LINES TOTAL LENGTH EST LOT LINE OF LINES /to TRENCH WIDTH�'/ IN. TOTAL EFFECTIVE ABSORPTION AREA `L yd SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE WELL: TYPE _ CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL DISTANCES: n, INSTALLED BY: SEWER LINE DEPTH: I PIPE MATERIAL: OTHER SOURCES DISAPPROVED LOT SLOPE:. Lo aj- REMARKS: Form EQ -032 �f IN. ABOVE TILE IN. NEAREST SEPTIC SEEPAGE SEWER LINE TANK , SYSTEM_ Ii11111"WA 7.49 DIAGRAM OF SYSTEM DISTANCE FROM: DATE rga^,'APP ROV ED flee e.�P T�e6z 0 9 q. SOILS LOG �• r MUNICIPALITY OF ANCHORAGE •//�\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6550, Anchorage, Alaska 99602 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: fC C U St ®y t`AU `f }}DATE PERFORMED: 7—(-,-77 LEGAL DESCRIPTION: L ! �� !/ %�'� �' I V L f, Ll-" r—� SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 6tf, /,-" Reading Date Gross Time Net Time Depth to Water Net Drop 7 c) o f �� 20 u PERCOLATION RATE � ! � (minutes/inch)'—"1-� TEST RUN BETWEEN FT AND FT COMMENTS /A'/A,lil. � 5 FGA /i1 r-14, � /!i - A�<i'%� PERFORMED BY:%1, Y .,%� �t7 I?GL�rII CERTIFIED BY: �� 7�'%'� DATE: i 72-008 (7/76) • '� Municipality of Anchorage u "4a� 8L``� On -Site Water and Wastewater Program <` (907)343-7904 snrc.r Certificate of On -Site Systems Approval Parcel I.D. 015-322-47 Expiration Date: / ©— 1. GENERAL INFORMATION Complete legal description Valli Vue Est. #2, Block2, Lot 11 Location (site address) 6230 Corner Tree Dr. Current Property owner(s) Jason Ward & Sarah Erkman Day phone Mailing address 6230 Corner Tree Dr. Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class A! Well it Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6 Date of Payment tl0� I Receipt Number 01 OSI a G COSA# 05(—Ib ISSI Date: ///7/1'5 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE V System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Date 10/15/13 bedrooms, with the following stipulations: By: Original Certificate Date: The Municipalit "o nchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based onty_ upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAbluashM f ., c If more than 1 septic system is on the lot: COSA Checklist # + of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Valli Vue Est. #2, Block 2, Lot 11 A. WELL DATA Class 'A' 210605 Parcel ID: 015-322-47 Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL ft. 9 -P.M. Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTICIHOLDING TANK DATA Collected by: ui aM Tank Type/Material Septic/Steel pri�,�N,-��c Date installed 11/21/03 Tank size 1,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 11/21/03 Soil rating (g.p.d./11:2 or ftZ/bdrm) 2 System type Shallow Trench Length 45 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth 3.7 ft. Eff. absorption area 225 ftz Monitoring tube Y Depression over field N Date of adequacy test 10/11/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 488 gal. New depth 0 in. Elapsed Time: 80 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 11/21/03 "Pump on" level at 44 in. Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas Size in gallons 250 "Pump off"level at 41 in. Cycles tested 4 Manhole/Access (Y/N) Y High water alarm level at 46 Meets alarm & circuit requirements? Yes On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ in. (dD VA rix T2T, ti SYS CI Et (✓L � 7 n 0 j o -Y< I conformance with MOA COSA guidelines in effect on this date. I dni,-[•P,� �f� i��� c��,-•s:St�.,.J�: DeLTe.s U� e` -r-) G. ENGINEER'S CERTIFICATION d 41k, 1 certify that I have determined through field inspections and 001.6r review of Municipal records that the above systems are in T conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone :$}evenV•PNA1.e ' Date 10/15/13++ of -13749 COSA brown sheet 10-10-12.doc 07/02/2013 08:04 8686770 APLUS PAGE 04 imew on ■d loops or OEM ■ol iia R■asaRss some 205 717 ■rplrpa■aI �i7ivenTexe, Field Maintenance Report Annual Inspection Jason Ward Dim Addmn 5230 Corner Tree Drive, Anchorage AK 99507 AIf SImIDn coa.ty me rudk AX -102724 SW030479 1 202016 Retrieve O&M Info Dany*lcev Realm ratio_ 7inw setdnge: Perrorm Field Sampling/Ol sarverticns NTU (l6 t N7USj PN 16-9) DO 12-11) . 5 5 Oder of ISamp.,lfe Typical VS]Musarthy Musty ❑E❑moldy Non-typlcal gsullwe ❑Cabbage F -Il 011y fpm lm li ❑Yes UNo Foam In l [I Yes gNo Check Control Panel Reclrc Amps Discharge Amps (1a �l Audible and visual afanns 90K Dlelt0molemevyonil . krYes ❑No Ingpect/Clean Pump System Comments Clean Measure SludgaISCUM E Son a asse 11 l a a soli 9 s■ ■aa I^ a AnchorageTank 907-272-3543 Mike Blakeslee .moan Phm+e (907)346-3614 RTU 102429 105/31/20`12 nom. istcomparmlent Il id.................... splil Box . . Fast Cords , , . • ........... I . Floats........................ Riser/Lid . Pump ........................ Current aiotubes Filter ................. 1[ E intube Pump Veuh ............ 2. h Recirculating Splitter V9l.re...._.. , Comments Clean Measure SludgaISCUM E Son a asse 11 l a a soli 9 s■ ■aa I^ a AnchorageTank 907-272-3543 Mike Blakeslee .moan Phm+e (907)346-3614 RTU 102429 105/31/20`12 nom. istcomparmlent Current Pravlous Current prar'rous ❑ Excaealve Inspact/Clean Placharga Pump System Inspect Riser/Lid . 2nd Compartment Current Previous Current Prei'loue 2. h Inspeauclwn AdvenTest Fllter Otlon Normal ❑pungent all ja it l ❑ fnalva Bridging/Pondno: q 4one✓Mlnor ❑ Excaealve Inspact/Clean Placharga Pump System Inspect Riser/Lid . Splits Box Float Colds L4 Impppaa�aet clean lateralsfOdncae pod Bottom,�y, Intel Vent Inspect Clean Home Pump ek InWist/Ser Ace Other system Gompanelfla spout Clean Inspect Clean OlslMectlon %ull Z, ❑ Dispersal Laterslaloriom ❑ ❑ Observations Addttionsl Services Rand ❑ Cleaned textlle shoots? ❑ Replacadlused other lams? parts used! W = warranty, W B ttom�msor Q Replaced UV hams? (.4 appropriate selection) Final/Safety Inspection ZQRSV reinstalled jbAanlfold reconnected; flueh valves closed Turn neary/Recommendatlons 59ystam perfarming; no further aetion needed ❑ call vier solVke ids honed on ornrol ponel reactivated ❑Tank needs pumping ❑Other? - rax compseseu rvrm w t-vnu-uvt-, ww� ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND /e,.e& ///1,A01eeA/ TH�ISS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Z0 Day of Dlj/ of 20, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Svstems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as 71Z?yA� located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's A W WTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: /ell O-lz/� AvIf ��!✓ b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: (signature) Date: F�� rint name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this Aft --day of , 201�, by Ll- 14 W'(t3'r( r-_ NOTARY PUBLIC FORASIA My Commission expires: i I r t� MUNIC ALITY: B signature) (print name) Date: Title: Municipality of Anchorage Development Services Department a 8 Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-322.47 HAA # I. GENERAL INFORMATION Expiration Date: via Complete legal description Lot 11 Block 2 Vanr Location (site address or directions) 6230 Corner Tree Drive A--.-- a AK 99516 Current Property owner(s) David Fanerskog Day phone 441-8680 Mailing address Lending agency U. S. Insoect/Evens Duclai. Day phone 800-872-3660x529 Mailing address 3650 Concorde P Ste. 100 Chantill VA 20151-1129 Real Estate Agent Chris Swires (a omm— Dayphone 338-8292 Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Water Storage ❑ ❑ Individual On-site Community Class A Well ® Individual Holding tank ❑ Public Water System ❑ Community On-site 1:1Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water s upon st to home owners. valid Iy system. d or 90 days from also fromthe date of ssue for properties served by a privateorCertificates Class C wellaa dAmay buthorie reissued Approvaare new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (Rev. 11/99) 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eng. Svc. Phone 272-8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date ll�zSl� 3 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of 14 the test, and separation distances measured to readily identifiable features. The operational life of all Iwo, ' wells and septic systems depend on the local soil condition, ground water levels that may fluctuate i gc during the year, and the water usage of the family being served by the system. These conditions are Mr M1..... outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects 0J.r or encroachments. PES can therefore not provide any warranty for future performance nor give any ��0 estimate of how long the system will continue to meet the operational requirements of the ADEC or 0 t; #. MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon by or use of this report any other person or party is not authorized nor will it confer any legal right whatsoever. 6. DSD SIGNATURE V Approved for _3�1 bedrooms. Disapproved. OF "T_ tt 49TH ven R. Pannone-? No. CE 8149 e\ AN . �f�TESS ♦♦♦ Conditional approval for bedrooms, with the following stipulations: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By AA�Original Certificate Date: i Expirat Vale: %lllZv /.q Reissue Date: (Rev. 1159) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-32247 HAA #t)_�> b 3 _ Expiration Date: j 2 1. GENERAL INFORMATION �_5A_64 Complete legal description Lot 11 Block 2 Valli Vue #2 Location (site address or directions) 6230 Corner Tree Drive Anchorage AK 99516 Current Property owner(s) _David Fagerskob Day phone 441-8680 Mailing address Tilvecf brt agency U. S. Inspect/Evens Duclair Day phone 800-872-3660x529 Mailing address 3650 Concorde Pkwy, Ste. 100, Chantilly VA 20151-1129 Real Estate Agent Chris Swires 17g ReMax Day phone 338-8292 Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. NAA picked up by: 2. NUMBER OF BEDROOMS: 3 3.; TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (Rev. 11199) 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Eng Svc Phone 272-8218 Address P.O. Box 102954 Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 1(1221C,3 Engineers Comments: In conducting an adequacy tcSt,-1 attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances treasured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or parry is not authorized nor will it confer any legal right whatsoever. 6. DSD SIGNATURE Approved for bedrooms. Disapproved. Steven R. Pon No. CE 81z XXX Conditional approval for _3 bedrooms, with the following stipulations: An unconditional Health Authority Ctifi .ill be Irsued by t!48 - -- Wh011 Comments Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's I Flow Advis ry Other A2 Expiration Date:j12 1C4 (Rev. 11199) Y} w �N . VyqSr,w.ar ° . m. 10 I Original Certificate Date: 23 C� i Reissue Date: Municipality of Anchorage 0.46E s� • "'� Development Services Department Building Safety Division On -Site Water and Wastewater Program s • E _. 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 11 Block 2 Vail! Vue #2 Parcel I.D.: 015-322-47 A. WELL DATA Well type Class A If A, B, or C provide PWSID # 210605 Well Log Date completed _ Sanitary seal Wires pro protected Total depth ft Cased to ft Casing h ' t (above ground) in. Date of test Static water level Well production WATER SAMPLE Coliform FROM WILL LOG ml Nitrate mg/l Other bacteria colonies/100 ml Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Tank Type/Material Anchorage Tank Steel 15VU Date installed 11119/2003 Tank size *W gal Number of Compartments 2 Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm N/A Date of pumping kkuJ Pumper C. ABSORPTION FIELD DATA Date installed 11/21/2003 Soil rating (g.p.d./ft2 or ft2/bdrm) 2_0 System type Shallow Trench Length 45 ft Width 5 ft Gravel below pipe 0.5 ft Total depth 2_5 ft Effective absorption area 225 ft2 Monitoring tube Y Depression over field N Date of adequacy test KkIfLO Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test N/A in Water added_ gal. New depth— in. Elapsed Time: 0 min Final fluid depth — in Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date (Rev. 11/99) D. LIFT STATION Date installed 11/21/2003 Size in gallons 250 Manhole/Access Y "Pump on" level at 44 in"Pump off' level at 41 in High water alarm level at 46 in Datum Bottom of Tank Cycles tested New Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTAN S FROM WELL ON LOT TO: Septic tank/lift station on lot Ona ' ent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic ice line ding tank SEPARATION DISTANCES FROM SEPTIC/HOLDIN TANK ON LOT TO: Building foundation 5.7 Property line 20 Absorption field 47 Water main 75+ Water service line 25+ Surface water 105 Drainage None Observed Wells on adjacent lots 200+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 7.2 _.U2- i )�_ r� Building foundation —12 Water main 35+ Water Service line 35+ Surface water 69.34 Driveway, parking/vehicle storage 20+ Curtain drain None Observed Wells on adjacent lots 200+//� Wr% F. COMMENTS- of C-`1;15HPI, .' "I'�"'octN ai'e <5�` 5 < �y15 CCb(?YIGC vCCC� 'I ti P �CkC _ i e�hrle<.feCbew�er1 1�t�3 E W(3,!� tf'�v'�If2e�KUVe(�v`P_�yYl, New Advantex Svstem 2" Rina Rnarri nvcr o..w.e a;,.iA 1� G. ENGINEER'S CERTIFICATION ���P """ i GJ; • 9 � 1 certify that t have determined through field inspections and 0 ` review of Municipal records that the above systems are in 49 �•••••'�••• •• •• .'s... conformance with MOA HAA guidelines in effect on this date. •••••.••• �•,;:ever. .. . ............... Engineer's Printed Name Steven R. Pannone P.E. - • o No C. 81 49 1� ��� Date (Ir'2Z(03 •\•'•. 31,2 Fes• HAA Fee Date of Payment, —LLLV— t I (; - Zj Receipt Number-tU (Rev. 11/99) J --- Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # i . \ - Z 1 - HAA # 1f1 1-1 C _ 1. GENERAL INFORMATION Complete legal description -� (� � � ��t vu F_�-2' Z Location sn(site address ordirections) l 7-3U Cou�, e� P. Property owners Lending Mailing address -? A-,-- Lending agency f_j ( Mailing address ` r o. Agent • ,�; ,2-�-� �i �� r�� �S _r_rc �c�r,..�-J Address < I - - Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 224-6 -. Day phone »a - r Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer 1< NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe number of bedrooms and type of structure indicated herein. I furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature 6. DH\H/S SIGNATURE Approved for Disapproved. M 8471, Sjoor.ida'r)r`- 'An h,. AK;.; ;iO4 Conditional approval for bedrooms. Phone — r Date e Z e sv Via,, sa ae nntx -�' f` k . -nu aron.�1� w9<<ea`Do-3r YYYyyy r� �ef?_"7A ar.,ess— r bedrooms, with the following stipulations: Additional Comments 2� = %z-� �L-__ U✓���j - <- WTIC Date ? -z_�? -�;y The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The D HHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 92-025(Rev.1/91) Back MOA#1 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage AUG 11 1997 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division RECEIVED 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: 1 , 6 V- Z, \ha-L.L,i VU C- Parcel I.D.: I t - Z A. WELL DATA Well type 0" r-1 1O0 B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed Total depth ed to Casing height (abovlwifr Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESUL Coliform Dat sample: B. SEPTIC/HOLDING TANK DATA Nitrate Wires g.p.m. Collected by: (Y/N) INSPECTION Other bacteria SEpT7c -r'a.jy. ) /+vcDiJb —ra•JIL g.p.m. io/93 i000 2 Date installed Tank size �-oOL7 Number of Compartments / Cleanouts (Y/N.) YAGS Foundation cleanout (Y/N) YF --,S Depression (Y/N) NO High water alarm (Y/N) YJG--� e Date of Pumping 92bL4 Pumper O! h7 DoN� r�Os C. ABSORPTION FIELD DATA Date installed `a�g 3 Soil rating (g.�. . 2 or ft2/bdrm) 16 3 System type Lengthy / Width 5 r Gravel thickness below pipe 2 Total depth 5.O lTo 5.5� Effective absorption area 557 Monitoring Tube present (Y/N) SDepression over field (Y/N) No Date of adequacy test �� "%f,� Results (Pass/Fail) PA -c- S For 3 bedrooms /41.1,6,1 � 535 "'00- 113S Gn-ccoNl 7aN L• X8.9 wEii Fluid depth in absorption field before test (in.); �•�11 Immediately after gal. water added (in.): 1i "Fos 21.2' w�i Fluid depth i 3.2 F� 55 (ins) Minutes later: (140 Absorption rate 450 g p d Peroxide treatment (past 12 months) (YIN) No If yes, give date ^f 72-026 (Rev. 3/96)* P%j�SGLYIL 9��1917 __� � ]�7b_ �•f_ o GL0�1 '2oo� e16 1_ D. L TION Date installed Manhole/Access(Y/N) _ High water alarm level ' C sted E. SEPAR DISTANCI SEPARATION DISTAN Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/ eotic service line on" level at* WELL ON LOT TO: Ona ' lots djacent lots Public sewer manho E Lift station "Pump off" level at* SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: f Foundation e � A TO Property line 7-4- ± Absorption field > > ' � Water main/service line > 10r Surface water/drainage > r Wells on adjacent lots > 'O 0'Pug " c SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 3 `+ Building foundation 10 + Water main/service line r � v�1Dt2 Dcz�vG..,�a� Surface water 1 on .+ Driveway, parking/vehicle storage area Z�- 190' Curtain drain Wells on adjacent lots >?oD' puguc F. ENGINEER'S CERTIFICATION I certify that I in conforman. Signature Engineer's Date eLo b j'' �F W4zvrZ f2F�v6S-rEJ! field inspections and review of Municipal felines in effect on this date. HAA Fee Date of Payment Receipt Number 3D#, / 72-026 (Rev. 3/96)* A' Gass k Waiver Fee $ am ?'ROFFSSt��.► N Date of Payment h/ /-'17� (/I Receipt Number are Alaska Water & Wastewater 8471 Brookridge Drive — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers h August 8, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: HAA for Private Septic System. Lot 11, Bk 2, Valli Vue Estates #2 S/D. To whom it may concern: The subject lot has a 3 bedroom house on it which is served by a private septic system with a back-up holding tank. The specifics are summarized as follows: A. SEPTIC SYSTEM ADEQUACY: Attached is a copy of the report submitted to your department in October, 1996 regarding the septic system. I rechecked the liquid level in the monitoring tubes on 4/5/97 and there was 15.5 inches in the west trench (24 inches effective) and 11 inches in the east trench (24 inches effective). When the drainfield fails, the homeowner can switch back to the holding tank until the field recovers again. NOTE: The adequacy of a septic system is influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary napkins, mist. objects), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the speck day of the test. Furthermore, because of the limited nature of this investigation, it is possible that there are hidden defects which may not have been detected No warrantee is made regarding the future performance of this septic system. B. SEPARATION DISTANCE FROM THE SEPTIC SYSTEM TO THE LOT LINE: Per the 1983 inspection report the absorption field is 10 feet per the nearest lot line; however, according to the attached as -built survey, the northwest trench c/o is only about 6 feet from the west lot line. Since the trench is 5 feet wide, the edge of the field is probably only 3.5 feet from the lot line. This situation has existed for almost 14 years, and to the best of my knowledge there has been no adverse impact associated with it. Therefore, we are requesting that the separation distance from the absorption field to the lot line be waived from 10 feet, down to 3.0 feet. Attached is a check for $115.00 to cover the M.O.A lot line waiver review fee. LOCATION OF WATER SERVICE LINE IN RELATIONSHIP TO THE ABSORPTION TRENCHES: The separation distance from the absorption trenches to the water service fine was not addressed on the 1984 inspection report. The key box is located at the southwest corner of the lot, but it is unknown where the service line is. Most likely, it runs in a straight line from the key box to the southwest corner of the house. In short, it is uncertain whether the service line is greater than 10 feet from the trenches. If you have any questions, please contact me at 337-6179, 244-9612, or on my digital pager at 1-800-481-1162. Thank you for your assistance. Sincerely, M.S. c.c Dynamic Properties, Tom Stiegelman D 1'�-3Q)a-u-1 Alaska Water & Wastewater 8471 Brookridge Drive — Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers October 6, 1996 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEI OCT Municipality of Dept. Health & Hu Ref: Reconnection of septic system at Lot 11, Bk 2, Valli Vue Estates #2.. To whom it may concern: The subject 3 bedroom house has been served by a holding tank (1000 gallon septic tank & 2000 gallon holding tank) since October of 1993. The old drainfield has rested since that time. Recently the homeowner arranged for a contractor (Acheson Enterprises) to reconnect the drainfield. The connection was made by installing an alternator valve between the 1000 gallon septic tank and the holding tank. This valve will allow the homeowner to periodically switch back to the holding tank, and rest the drainfield. Prior to the reconnection, an adequacy test was performed. The results of the adequacy test are summarized as follows. Prior to performing the test, the system (installed in 1983) was filled with 2000 gallons of water and allowed to soak for approximately 48 hours. Prior to starting the test, the liquid depth was 7.6 inches in the east trench and 16 inches in the west trench. Six hundred (600) gallons was added to the east trench, and the water level rose to a depth of 21 inches (44.9 gallons/inch). Five hundred & thirty-five (535) gallons was added to the west trench and the water level rose to 28.9 inches (41.2 gal./inch). In both cases I could see that the water level was below the invert of the drainpipe in the sump. Nineteen hours later the liquid level had dropped 7.8 inches in the east trench (349.4 gallons), and 7.7 inches in the west trench (317 gal.). Based upon this data it was concluded that the absorption capacity is approximately 35 gallons/hour, or 842 gallons/day, which exceeds the requirement for a 3 bedroom house (450 gpd). RECEIVED OCT 71996 Municipality of anch0r80e Dept. Health & Human Services I am unaware of any adverse impacts this reconnection would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Sincerely, Garness, P.E., M.S. Lisa Wheeler Report.wps ----------- _...... ......... _ . _..._ ............ APR -0$-97 TUE 02:23 PM DYNAMIC PROP. 261-7600 9072677670 � rr n •"7 D � Alf }'6V' U1 ,r a sj s iZ- i u F v k,� •,S 'pc AS -BUILT N6 CORNEAS SET THIS DATE • a}ia..}r,l� Jala.� a.. as f�.. c No. Sw M'w •�� • ,w F ?' I hereby certify, that I have performed a Mortgagee's i apeetfon of the following described property -_W27 --i _ Y Uri 1 v,)a �K�nrr -4 2 Anchorage Recording Precinct, Alaska, and that the impr.: menta situated thereon are within the property lines anti not overlap or encroach on the property lying adjacent the,, to, that no improvements on property lying adjacent then encroach on the premises in question and that there are n roadways, transn Iasion lines or other visible easement _ said property except as indicated hereon. Dated at Anchorage. Alaska -- this �r1tlay oC_�_ MUNICIORAGE DEPARTMENT OFF HEALTH & HUMAN SERVICES M}� Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # CA 5-3 22g'% HAA # 14 f-) gSL) LD 1. GENERAL INFORMATIONG� Complete legal description I01— I I� $K z .. VA-LL1yuff_y 2 Location (site address or directions) (:�Z3Q 11.1�h} . . Q Li . G 4cn G Property owner D I c i Day phone Mailing address ( 0341 Vo SI KOG14.JGH • A-V_ 99S/ 6 Lending agency /A— Day phone 1` 4A. Mailing address 1-4 /o Agent lA-, Day phone Address r4 1A Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Cz—ow`1&2—��'2 3. TYPE OF WATER SUPPLY: Individual well Community well X Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status: of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF ENSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulatioAs in �,ffgctpn the date of this inspection. Name of Firm Address Engineer's signature 6. DHHS SIGNATURE —X Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments In Phone 337—(0/79 Date 0 3 bedrooms, with the following stipulations: Date //- 30 - y-? a The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA#21 ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT I)�kZ�VALU Vuf= Parcell.D. Qi�E32242- A. Well Data Well type pV BL1 G II A, B, or C, attach ADEC letter. ADEC water system number 'L I a �60 5 (Y/N) Date completed Driller Total depth Sanitary seal (Y/N) WELL LOG Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAM Pkl� RESULTS: 11 Nitrate to Casing height Wires properly protected (YIN) AT INSPECTION _; On adjacent Ic On adjacent lots is sewer manhol troleum tank of sample:_ Collected by: RECEIVED NOV 41993 3.p.m. nicipaiity of Anchorage Health & Human Services Other bacteria B. SEPTIC/HOLDING TANK DATA NUJ SfeP it L � i- L_D1,J 5e-pri C_ — /a/3193 /000 ? 3000 Date installed/a,���a�r— ro%�43 Tank size 2000 C row^ Compartm Z Cleanouts (Y/N) yt-S Foundation cleanout (Y/N) V 515; Depression (Y/N) N D High water alarm (Y/N) YE S Alarm tested (Y/N) Date of pumping N 11,6 Pumper N IA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: % 9EP'T)G Well(s) on lot 14/4 On adjacent lots N J4 Foundation 9R Ew<Orae To property line 241 Absorption field A- q A/ _Water main/service line -7/0' 0P?DSiTe- Surtace water/drainage >601 i C. LIFT STATION NN I Date instaW Manufacturer Size in Vent(Y/N) High water alarm level Meets MOA electrical codes (Y/N) on" level at SEPARATION DISTAbroE-FROM LIFT STATION TO: FIELD DATA _On adjacent lots NIA, ass (Y/N) "Pump o Date inst Soil rating (GPD/Ft') System type Length Width Gravel thickness Totald Total absorption area Cleanout present(Y/N) Depre n over field (Y/N) Date of adequacy test Results (pass/fail) for Bedrooms Water level in absorption field before test _ Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION Well on lot On To building foundation On adjacent lots Ci Surface water Curtain drai E. ENGINEER'S CERTIFICATION lots yes, give date Property line To existing or abandoned sys on lot _ Water parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in Signature Engineer's Date 10.6/ A?3 HAA Fee $ 3CX:> ' Ci% Date of Payment wL-t-'i3 Receipt Number��tt�" 7 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number_ ✓ CE -7953 inspection. u L'acr Recei•:;od; December 8, 1977 *1, z �r,� 1' ()IF1 ��� ,� 9 0�if��ss.w - i t �F, E- 0— t T i�' ��s 1 ��� �i� Ir( Namber o B(i ,,ro ol;is Date. .� _-J-� 1 �1 .:.-�. tial Da e F%, 1, Tanli j -?.e. Manu`acturri In s1 ln:; L'acr Recei•:;od; December 8, 1977 I L an ixic[ J1 z-, �,ution .est : United Bank Alaska aJ' Addr _:.,: 645 G Street 99501 2 h on.,e: 278-9526 2. Property O� no, i- Robert D. Cousineau "hone: 349-2522 •,aili._,e. c°i c. r. bas: 7800 De Barr Road Space 316 Legal Des c:.iu tion: Lot 11 Block 2 Valli Vue Estates Subdivision 4 : ; in i e rami. l y res ,.ince : - .u;u0- o1-droo:a� ,, s 'Public Ut l_i_ty ,nl t e Ya,- J Perm; 4- Namber o B(i ,,ro ol;is Date. .� _-J-� 1 �1 .:.-�. tial Da e F%, 1, Tanli j -?.e. Manu`acturri In s1 ln:; :r R G:,:,Ss `r_ : L P..CO AL Or iN )I`, I )I7L_ P ;,ND LFR i'-'/�C L T».T �u I L an ixic[ J1 z-, �,ution .est : United Bank Alaska aJ' Addr _:.,: 645 G Street 99501 2 h on.,e: 278-9526 2. Property O� no, i- Robert D. Cousineau "hone: 349-2522 •,aili._,e. c°i c. r. bas: 7800 De Barr Road Space 316 Legal Des c:.iu tion: Lot 11 Block 2 Valli Vue Estates Subdivision 4 : ; in i e rami. l y res ,.ince : Disposal :,,stem: .u;u0- o1-droo:a� : Four--- s 'Public Ut l_i_ty ,nl t e Ya,- J Perm; 4- Namber o B(i ,,ro ol;is Install_:d 5, Ne11 S, steaa: Tndt a-idual Installer Co:-Iunit/Pub lo c F%, 1, Permit 4 Construction Depth of Well ,,ilei]_ Log. on File ; Bacterial Analysis 6. Sewage Disposal :,,stem: on-site System s 'Public Ut l_i_ty Perm; 4- Install_:d Installer Se -,-)tic Tanli j -?.e. Manu`acturri / Absorption Area _1tIL �� � -- soils l=ate 7. Distances: Well to Septic T nk to Se,oer Eine Nearest Lot line material to Absoration :area. Fabsorpt__on Aroa Pag2 Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 11 Block 2 Valli Vue Estates Subdivision Comments: Affadavit Attached: Q ) Approved: Disapproved: Department Worksheet: Letter Attached: >> ( ) Date: Date: 1. 2. 3. 4. 5 7 N UNICIPALITY OF ANCHORAGE Department of Health and Environmental ProtecLt}pn� 825 L Street, Anchorage, Alaska 996O.1.1oa 264-4720_ h1! equest for Approval of Individual Sewer and water Facilities � r c(.s_k .,. Pro erty Owner: A �'/ Mailing Address: 1�2�.�12/1 S/� ��� Phone: 3S'A- 2S2 2 Name of Buyer: Mailing Address: Phone: Lending Institution: Mailing Address: Realtor/Agent: Phone: /t' c1_ Mailing Address: Phone: j�9//D s .,� '� :7 E' Legal/ .. Description: G. d Street Location: /;&e Single Family Residence: I=4 Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ( ) Public/Community System IP�-) If Individual Well, well depth If Community System, name of system Sewage Disposal System: *,bn-site System ( ) Public System (A If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77