HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 2 LT 23
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181137 PID Number: 01532235
Dwelling: R Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
EILEEN & MATTHEW REILLY
ABSORPTION FIELD
❑ Deep Trench ®❑ Wide Trench ❑ Bed ❑ Mound
Site Address
6210 WEST TREE DR, ANCHORAGE AK 99507
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
0.45 GPD/SF
8.5/9.9 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.5/5.9 Ft.
Gravel depth beneath pipe
4.0/4.0 Ft.
Subdivision Block Lot
VALLI VUE ESTATES #2 2 23
Fill added above original grade
0.0 Ft.
Gravel length
90/45 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
I Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
1333.3 FP
2
13 Ft.
Well
100'+
100'+
25'+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Capacity
Surface Water
100'+
100'+
Gal.
Material
Number of compartments
Lot Line
101+
10'+
NA
Foundation
T1+
10'+
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank Tank to 3034
drainfield
Installer
WILCO
Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering
BENCH MARK (Assumed elevation) 100.0 fl
Inspection 1s' 7/13/18 7/16/18
Location and description
pie
3rd 411,
HOUSE TRIM
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
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�-teveii R. Pannone
Septic System
P:. cF_ 0140��
Approved Date
_
Note: this approval�es not include well requirements.
permit
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MUNICIPALITY OF ANCHORAGE
On -Site Water& Wastewater Program
pOBox 190s5O 4rO0Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
PermitNumnbec OSP181137
Work Type: Septic Renewal
Tax Code Number: 01532235000
Site Legal Address: VALL|VUEESTATES #2BLK 2 L 23 G:2538
Site Mailing Address: 8210WEST TREE DR, Anchorage
Owner: RE|LLYE|LEENK4&MATTHEVV8
Design Engineer: PANNONEENGINEERING SERVICES
This permit is for the construction of:
2 Disposal Field 0 Septic Tank El Holding Tank 0 Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft:
6/15/2018
6/15/2019
[] Private Well [] Water Storage
All construction shall bainaccordance with:
i. 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65.Provide notification bycalling (807)343'7SO4(24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall beeither:
e. Opened and Closed onthe same day, or
b. Covered, sealed, and heated to prevent freezing
111
C \ v 'd^ " --` ` cl
P
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c7 .
Received B`
Issued By:
Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water&Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-322-35
Property owner(s) Eileen & Matthew Reilly Day phone
Mailing address 6210 West Tree Dr. Anchorage, AK 99516
Site address 6210 West Tree Dr.
Legal description (Sub'd., Block& Lot) Valli Vue Estates #2 Block 2 Lot 23
Legal description (Township, Range & Section)
Lot Size 20,061 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(E)all that apply)
Absorption Field ❑x Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑ Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑X Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4 ILIO Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: DY 9..LrbA Receipt Number:
Permit No. OOP 1211'63 Waiver No.
Permit App_:-:•::..,.c;
Pannone Engineering Services LLC CJUNv6
1 8
Steven R. Pannone, Principal Registered Professional Engineer
E-mail:Steve@panenRak.com aO 201'
June 8, 2018 c>��
Subject: Expired On-Site Water and Wastewater Permit
Permit Renewal Request
Permit Number: OSP161291
Legal Description: Valli Vue Estates #2 Block 2 Lot 23
This is a request to renew the permit for the above mentioned lot. All site conditions remain the same.
The construction still will not affect the health, safety, or development of the surrounding lots.
Sincerely,
OP It
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
N 'Y MUNICIPALITY OF ANCHORAGE
" ,1v1 1]I
\ On-Site Water&Wastewater Program ��� .,s.
�„e\ PO Box 196650 4700 Elmore Road 'f
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 v
;'r ),-F http://www.muni.org/onsite r .,
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/ epa/'(men
4NCNOAA4s
On-Site Wastewater Disposal System Permit
Permit Number: OSP161291 Effective Date: 5/23/2017
Work Type: Septic Upgrade Expiration Date: 5/23/2018
Tax Code Number: 01532235000
Site Legal Address: VALLI VUE ESTATES#2 BLK 2 LT 23 G:2538
Site Mailing Address: 6210 WEST TREE DR, Anchorage
Owner: REILLY EILEEN M & MATTHEW S Lot Size in Sq Ft: 20061
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
10 Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received B . 0 -i% .fl Date: 5/ZZO7-
Issued By: r X0-.). �� Date:
/Z14/7
y
?/34?-ct /N.') Mil
MUNICIPALITY OF ANCHORAGE- SEP 30 2016 t
Community Development Department Phone: 907' ,79Q4 E 9
Development Services Division Fax: 907-343-7M'
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-322-35
Property owner(s) EILEEN & MATTHEW REILLY Day phone
Mailing address 6210 WEST TREE DRIVE, ANCHORAGE, AK 99507
Site address 6210 WEST TREE DRIVE, ANCHORAGE, AK 99507
Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #2 B2 L23
Legal description (Township, Range & Section)
Lot Size 20,061 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(El all that apply)
Absorption Field E Initial ❑ Single Family (SF) E
(w/wo ADU)
Septic Tank ❑ Upgrade (] Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
,____________423ce..)
(Signature of property owner or authorized agent)
Permit/Rush Fees: 6661 ' Waiver Fees: 2.15
Date of Payment: 10- 3-I Date of Payment: /(/c14.6
Receipt Number: OCt°15 Receipt Number: O %q (4 6-
Permit No. oSf I to 126i I Waiver No. 05U 16113 0
Permit App_: c
Pannone Engineering Services uc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
May 22, 2017
Subject: VALLI VUE ESTATES#2 B2 L23
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade absorption field to be issued for this property.
The proposed system will serve an existing four (4) bedroom house. Currently the lot is developed. The
lots in this subdivision are served by public water service.
1. Soils. One test hole was performed on this lot by PES in September of 2016 & one test hole was
performed by David Paul in 1977 for the original system, and groundwater was monitored in the 2016
test hole for at least seven days. Ground water was observed at a depth of 14' below the surface in the
test hole monitor tube in October of 2016. Bedrock was not encountered in the test hole. Based on
the results of the percolation tests and overall soils appearance; an application rate of 0.45
gallons/day/square feet was used for a conventional wastewater system in the area of the test hole.
The test hole performed in 1977 is not to the required depth for the system (see Waivers)
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100' of the proposed septic system. The system will
maintain 100' of separation to all surface water.
4. Topography: The existing topography generally slopes from the southwest to the northeast in the
area surrounding the septic system at approximately 0%-1%. There are no steep slopes within 50' of the
proposed drain field. The proposed drain field will maintain 50' separation all steep slopes.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On-Site Department,
the note will be removed and "Issued for Construction" drawings will be issued.
6. Waivers: We are requesting a waiver to the need to conduct additional test holes on the subject property. A
test hole was performed on the subject property September 2016 and another on June 1977. The soil profile
was found to be a layer of organics underlain by Silty Sand material (SM) and had a percolation rate of 38.9 mpi
in TH-PES and 40 mpi in TH-1977 with groundwater at 14' below the ground surface following the seven-day
water monitoring period in the 2016 test hole.
The results of the visual classification of the subsurface soil strata and resultant percolation rate is consistent
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
with the results of soils testing throughout the immediate geographic area surrounding the subject property.
The surrounding soil logs show no groundwater above 14' below the ground surface and all display a percolation
rates ranging from 8.5-50mpi. Attached to this request are copies of surrounding soils logs.
These results show a definite consistency to both the soil makeup and percolation rate within the area of the
subject property.
The Technical Review Board has been re-writing Chapter 15.65 of the AMC and among the approved revisions to
be codified with the update reads as follows:
15.65.201 C. Soil Evaluation,percolation test,and groundwater monitoring.A soil evaluation,percolation
test, and groundwater monitoring is required by this chapter.
Exception:A soil evaluation,percolation test,and groundwater monitoring as required by the
code for the subject disposal field may not be required, if an engineer can demonstrate by
means of existing documented soil evaluations, percolation tests and groundwater
monitoring, to the satisfaction of the department, that the subject disposal field location is
likely to have soils consistent with the surrounding area.
Based upon this future revision to the code which was arrived at through good engineering practice and
experience we request that the requirement to conduct and additional test hole on a property that has
an existing system installed be waived due to the amount of documented data showing the continuity of
the soil strata throughout the area of concern. The result of performing another test hole would yield the
same results within the standard deviation of the sets of soil logs for the area in question.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
-i X 4. t 't
•
•
•
�...
•• : Steven R.Pannone '
♦....•
5511 ;• .
x •
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL UPGRADE SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 14 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION,
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
DATE:
ABBREVIATIONS
TH
TEST HOLE
(P)
PROPOSED
(E)
EXISTING
FS
ZOELLER TRU—FLOW SPLITTER
CO
CLEAN OUT NO.
MT
MONITOR TUBE NO.
TYP
TYPICAL
TITLE:
WATER LINE /
WELL RADIUS
— SS — SS — NEW SEPTIC
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1250g
PERC RATE: 38.9 MPI (PES) / 40 MPI (1977)
SOIL RATING: 0.45 GPD/SF
AREA ROD: 1333.3 SF
SYS. TYPE: WIDE TRENCH 4.0'ED
RF: 0.50
MIN LENGTH: 133.3 LF
USE:
(TRENCH #1)90.OLFx5'Wx4.0'E.D., 10.0' TD
(TRENCH #2)45.OLFx5'Wx4.O'E.D., 10.0' TD
TOTAL AREA: 1350 SF
NOTES: PAM�"�"1'4�
CHANOE ORDER — P.O. BOX 102954 ANCHORAGE, NE ENG AK 99510 ^ - P •''S�'�r Da7/13/2018
PHONE (907) 272-8218 FAX (907) 272-8211 -" 5J�i Scale
49th NTS
P.I.D. NO
VALLI VUE ESTATES #2 32 L23'' �" = 015-322-35
r S RIE PACiNONE
DRAWN JRL EILEEN & MATTHEW REILLY 't� CE -8149 4 = PERMIT (v'0.
6210 WEST TREE DRIVE osP1612e1
DESIGN NOTES ANCHORAGE, AK 99507 �ffr;{�1� �1`' Shea OF 3
TEST HOLE 1
OR TOPSOIL
1 GM/SM Brown Silty SAND
& GRAVEL
2
3
4
5
6
7
Silty SAND
8
9
10
11
12
13
SOILS LOG — PERCOLATION TEST
SLOPE
TH
PES
WAS GROUND
14 SM = Silty SAND ENCOUNTERED
15 W/ COBBLES
BOH
DATE PERFORMED: 23SEP16
NO GROUNDWATER AT TIME
OF TEST
IF YES, AT WF
DEPTH?
DEPTH TO WA
MONITORING?
BATF: 250., —1—
.,
im
READING GATE
CLO
NET TIME
WATER
LEVEL
READING
NET DROP
RATE
NPI)
1 23SEP16
1400
6.265"
2
1430
30 MIN
7.122"
0.857"
35.0"
3
1437
6.265"
4
1501
30 MIN
7.040"
0.775"
38.7"
5
1502
6.265"
6
1532
30 MIN
7.037"
0.772"
38.9"
SOIL TEST RESULTS /ANALYSIS
® PERCOLATION RATE 38.9 (min/inch)
(Hydrologic Soils Group: HSG A)
• PERC HOLE DIAMETER 6"
• TEST RUN BETWEEN 5 FT AND 6 FT.
® TEST RUN FOR OVER AN HOUR, LAST
THREE READINGS PROVIDED.
COMMENTS: Test hole excavated by ISAAC'S. Test Hole was NOT required to be presoaked before Perc test
due to sandy material (Table 3-8, Para.3, EPA Design Manual).
PERFORMED BY: Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: �} 1� �+ �•�`'OI 1171 Date
l� r
CHANGE ORDER P.O. BOX 102954 ANCHORAGE, AK 99510 �'.'�'h� 10%21%2016
PHONE (907) 272-8218 FAX (907) 272-8211 z � .*
• 71/ Scale
Oath { NTS
NO
VALLI VUE ESTATES #2 B2 L23 , P.LD. 3
;'••• -� � •- 015-322-35
EILEEN & MATTHEW REILLY ' s=EfE Fae�NONE
DRAWN JRL `�{ ', CE -8149
w PERMIT N0.
6210 WEST TREE DRIVE '�r �r �` = OSP161291
SOILS L�vS ANCHORAGE, AK 99507 {rf r�s� " cssi'~w-` Sheet
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LOT SURVEY CERTIFICATION LEGEND / ',' '.'•moo
: 4:-
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I hereby certify that!hove surveyed the property shown and described 0 Bross or Aluminum capped my• .1 :I; eysre•. . 11• l
hereon,and that the improvements situated thereon ore within the prop. 0 Iron'pipe and/or mbar recove ed. i •. ••��o
erIi II nos and do not overtop or encroaoh on adjacent property and that 0 2 x 2 hub F.tack recovered e.`•►+s•-a••.•
no Improvements on adjacent property overlap or encroach on the premises • 5/8"x 30"robot- set this survey 0,'° ,. 4, .a�pY0,e
In question and that therre are no roadways, utility linos,or other visible �• �ti,y t
easements on sold property exoept as Indicated hereon. •
Scale ///- 3Q Dat _ _3 Prepared by: R.L. BUTTON
/ Registered Land Surveyor
(907)279 6200 5/9 W Eighth Ave. Anchorage Alaska 9%0/
r
.• .,, • ., Q F B. No. ,—, , , .-. Property of: A L__/ i"7'
MUNICIPALITY OF ANCHORAGE ,,,, ;,
• On-Site Water & Wastewater Program �`, .°s ,.
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ._
hitpa(www.mum.orglonsite
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On-Site Wastewater Disposal System Permit
Permit Number: OSP161291 Effective Date: 5/23/2017
Work Type: Septic Upgrade Expiration Date: 5/23/2018
Tax Code Number: 01532235000
Site Legal Address: VALLI VUE ESTATES #2 BLK 2 LT 23 G:2538
Site Mailing Address: 6210 WEST TREE DR, Anchorage
Owner: REILLY EILEEN M & MATTHEW S Lot Size in Sq Ft: 20061
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
Disposal Field ❑ Septic Tank ❑ Holding Tank 0 Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
1 /
Received B B . :t „ ��. ,_il s,/I Date: 57Z/4 7.
Issued By: r Date: 5/Z-44/7
?/30l amt C2 7N7 1111111111 '''-i\
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MUNICIPALITY OF ANCHORAGEi SEP 3 0 2016 t
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Community Development Departments Phone: 907=343-7.
Development Services Division Fax: 907-343=7
On-Site Water& Wastewater Program
ON-SITE SEWERNVELL PERMIT APPLICATION
Parcel I.D. 015-322-35
Property owner(s) EILEEN & MATTHEW REILLY Day phone
Mailing address 6210 WEST TREE DRIVE, ANCHORAGE, AK 99507
Site address 6210 WEST TREE DRIVE, ANCHORAGE, AK 99507
Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #2 B2 L23
Legal description (Township, Range & Section)
Lot Size 20,061 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(Z all that apply)
Absorption Field ❑X Initial iii Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑ Upgrade ❑X Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
. ._________4::ctr5ce.....)
(Signature of property owner or authorized agent)
Permit/Rush Fees: 6CA ' Waiver Fees: 2. 15
Date of Payment: 10- 3-1 Date of Payment: ii/q 446
Receipt Number: 0-3QV15 Grr l Receipt Number: n66 y q G
Permit No. 05QI to 125211 Waiver No. 0,5U 161 H 30
Permit App_:- • ::.,t
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
May 22, 2017
Subject: VALLI VUE ESTATES #2 B2 L23
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade absorption field to be issued for this property.
The proposed system will serve an existing four (4) bedroom house. Currently the lot is developed. The
lots in this subdivision are served by public water service.
1. Soils. One test hole was performed on this lot by PES in September of 2016 & one test hole was
performed by David Paul in 1977 for the original system, and groundwater was monitored in the 2016
test hole for at least seven days. Ground water was observed at a depth of 14' below the surface in the
test hole monitor tube in October of 2016. Bedrock was not encountered in the test hole. Based on
the results of the percolation tests and overall soils appearance; an application rate of 0.45
gallons/day/square feet was used for a conventional wastewater system in the area of the test hole.
The test hole performed in 1977 is not to the required depth for the system (see Waivers)
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100' of the proposed septic system. The system will
maintain 100' of separation to all surface water.
4. Topography: The existing topography generally slopes from the southwest to the northeast in the
area surrounding the septic system at approximately 0%-1%. There are no steep slopes within 50' of the
proposed drain field. The proposed drain field will maintain 50' separation all steep slopes.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On-Site Department,
the note will be removed and "Issued for Construction" drawings will be issued.
6. Waivers: We are requesting a waiver to the need to conduct additional test holes on the subject property. A
test hole was performed on the subject property September 2016 and another on June 1977. The soil profile
was found to be a layer of organics underlain by Silty Sand material (SM) and had a percolation rate of 38.9 mpi
in TH-PES and 40 mpi in TH-1977 with groundwater at 14' below the ground surface following the seven-day
water monitoring period in the 2016 test hole.
The results of the visual classification of the subsurface soil strata and resultant percolation rate is consistent
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
with the results of soils testing throughout the immediate geographic area surrounding the subject property.
The surrounding soil logs show no groundwater above 14' below the ground surface and all display a percolation
rates ranging from 8.5-50mpi_ Attached to this request are copies of surrounding soils logs.
These results show a definite consistency to both the soil makeup and percolation rate within the area of the
subject property.
The Technical Review Board has been re-writing Chapter 15.65 of the AMC and among the approved revisions to
be codified with the update reads as follows:
15.65.201 C. Soil Evaluation,percolation test,and groundwater monitoring.A soil evaluation,percolation
test,and groundwater monitoring is required by this chapter.
Exception:A soil evaluation,percolation test,and groundwater monitoring as required by the
code for the subject disposal field may not be required, if an engineer can demonstrate by
means of existing documented soil evaluations, percolation tests and groundwater
monitoring, to the satisfaction of the department, that the subject disposal field location is
likely to have soils consistent with the surrounding area.
Based upon this future revision to the code which was arrived at through good engineering practice and
experience we request that the requirement to conduct and additional test hole on a property that has
an existing system installed be waived due to the amount of documented data showing the continuity of
the soil strata throughout the area of concern. The result of performing another test hole would yield the
same results within the standard deviation of the sets of soil logs for the area in question.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
♦ OF 114.
'i
10
.01Steven R.Pannone
149 s
C
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
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INSTALL ABSORPTION FIELD(P)
(3EA 40 'W ' , 1E . z,'
W ~— W -___ _ _ W - R&R.OLFx2.5TRENCH #1x6.0, E.D.SCARIFY O.0EDGES T.D
-� AND REMOVE BIO-MAT MATERIAL,
I I w ADD 1.0' SAND,
AraW/ MTs AND COs AT ENDS
I iI
I '. REMOVE ABSORPTION FIELD,
REPLACE WITH CLEAN FILL
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111-1977i % \
APPROX LOCATION
n III ,
INSTALL DCO & NEW FS ZOELLER
TRU-FLOW SPLITTER P AFTER
I • I OW S SEPTIC TANK(E)
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-SEPTIC I �0 SF0
II.AREA� I I , 23
TH-PES I
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ALL LOTS SERVED BY PUBLIC
I H2O SYSTEM
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NFOR CONSTRUNOTES.TION PANNONE ENGSVC, LLC I .., Dote
10/31/2016
P.O. BOX 102954 ANCHORAGE, AK 99510 �'�••"
PHONE (907) 272-8218 FAX (907) 272-8211 s. • Score
*•.49TM 2\ •* 1,. = 50'
• • ; •• •• P.I.D. NO
VALLI VUE ESTATES #2 B2 L23 . ., .�► �> 015-322-35
EILEEN & MATTHEW REILLY 1eren 1 . .n aie' PERMIT NO.
DRAWN JRL CE 8149
6210 WEST TREE DRIVE -�'•, OSP161291
SITE PLAN ANCHORAGE, AK 99507 sheet
/ 1 OF 3
1
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL UPGRADE SOIL ABSORPTION SYSTEM.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 14 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE
ENGINEER. THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION.
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY An ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: . TITLE:
DATE: DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
ABBREVIATIONS TANK SIZE: 1250g
TH TEST HOLE PERC RATE: 38.9 MPI (PES) / 40 MPI (1977)
(P) PROPOSED SOIL RATING: 0,45 GPD/SF
(E) EXISTING
—W —W — WATER LINE / AREA RQD: 1333.3 SF
WELL RADIUS SYS. TYPE: DEEP TRENCH 6.0'ED
FS ZOELLER TRU—FLOW SPLITTER MIN LENGTH: 111.1 LF
CO CLEAN OUT NO.
MT MONITOR TUBE NO. —ss ss — NEW SEPTIC USE:
TYP TYPICAL (TRENCH #1)40.0LFx2.5'Wx6.O'E.D., 10.0' TD
(TRENCH #2)40.OLFx2.5'Wx6.0'E.D., 10.0' TD
(TRENCH #3)40.OLFx2.5'Wx6.0'E.D., 10.0' TD
TOTAL AREA: 1372 SF
NOTES: Do
FOR CONSTRUCTION PANNONE ENG SVC, LLC4. Dote
te10/31/2016
P.O. BOX 102954 ANCHORAGE, AK 99510 P •"'
PHONE (907) 272-8218 FAX (907) 272-8211 . 1 Scale
*1 %! 1H ,;� .* NTS
• � P.LD. NO
VALLI VUE ESTATES #2 B2 L23 -
_ 015-322-35
.levenDRAWN JRL EILEEN & MATTHEW REILLYCZ $149n e, PERMIT NO:
6210 WEST TREE DRIVE .• . •��� OeP161291
Sheet DESIGN NOTES ANCHORAGE, AK 99507 `'�qp
3 OF 3
SOILS LOG — PERCOLATION TEST
TEST HOLE 1
OR I TOPSOIL
SLOPE 51
1 GM/SM Brown Silty SAND co
& GRAVEL W y�Y
•
2 �y-t:, i 34
S
3 TH-1977 ae
APPROX LOCATION .
4 T
5
10
6 r t
TH
PES
7
SM Silty SAND 1 23
8
TH-PES
0
10 y Y
11
12 ' 'I
13
SLOPE
WAS GROUND WATER
14 SM Y Silty SAND ENCOUNTERED? N
W/ COBBLES
15 TH PES
BOH IF YES, AT WHAT
DATE PERFORMED: 23SEP16 DEPTH? -NA-' X
NO GROUNDWATER AT TIME
OF TEST DEPTH TO WATER AFTER
MONITORING? - 14' -
DATE: 250CT2016
CLOCK RATE RATE SOIL TEST RESULTS/ANALYSIS
READING DATE TIME NET TIME LEVEL NET DROP (MPI) • PERCOLATION RATE 38.9(min/inch)
READING (Hydrologic Soils Group: HSG A)
1 235E16 1400 - 6.265" • PERC HOLE DIAMETER 6"
2 1430 30 MIN 7.122" 0.857" 35.0" • TEST RUN BETWEEN 5 FT AND 6 FT.
• TEST RUN FOR OVER AN HOUR, LAST
3 1431 6 265" THREE READINGS PROVIDED.
4 1501 30 MIN 7.040" 0.775" 38.7"
5 1502 6 265"
6 1532 30 MIN 7.037" 0.772" 38.9"
COMMENTS:Test hole excavated by ISAAC'S. Test Hole was NOT required to be presoaked before Perc test
due to sandy material (Table 3-8, Para.3, EPA Design Manual).
PERFORMED BY:Joseph Lawendowski. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE
AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES: PANNONE ENG SVC, LLC 1F t c
POR CONSTRUCTION P.O. BOX 102954 ANCHORAGE, AK 99510 . ••• X940t. 10/21/2016
PHONE (907) 272-8218 FAX (907) 272-8211 • •• =. •.y ;cele
*/4 1't .* , NTS
y•• ,1••• t•••• P.I.D. NO
VALLI VUE ESTATES #2 B2 L23 , _ . L-' ; 015-322-35
EILEEN & MATTHEW REILLY Zevven'I�. Pannone - PERMIT NO.
DRAWN JRL
6210 WEST TREE DRIVE - . CE 8149 OSP161291
'
SOILS LOGS ANCHORAGE, AK 99507 :,i' E Sheet
2 OF 3
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LOT SURVEY CERTIFICATION LEGEND i `"` '�•+terra
I Meshy certify that I hays survsysd the property shorn and described Brass of Aluminum capped m.�• � ': eyere'. _ t• g,
hereon, and that tM Improvements sttuotsd thereon are within the prop. 0 iron pipe and/or rebar recove ed. i V. •ctp
•rttt tInes and do not overtop or encroach on adjacent property and that 0 2 x 2 hub6 tack recovered �'"••+•.,•'••� e,
no Improvements on odjoant property overlap or encroach on His pnmisss • 5/8"x 30"rebor set this survey 14,-- s�+
In question and that than ars no roadways, utility Ilnss, or other visible � s •,SI.
•asem•nts on sold property sxospt as indicated hereon,
Scale /l f- 0Dat .. _,.9Prepared by: R.L. BUTTON
/ Registered Land Surveyor
�907�279 6200 519 W.Eighth Ave. Anchorage Alaska 9950/
`' F.B. No.
•• �.c -i o r, , ,-. , .-. Property of: A L _/ /--/"Th
GRE~,,'t~R ANCHORAGE AREA BOR~]GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska gg503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL~
INSIDE LENGTH
MANUFACTURER ~ MATERIAL
INSIDE WIDTH LIQUID DEPTH
~ NUMBER OF
~"~'.~¢.~1¢ COMPARTMENTS
LIQUID C A P AC I T Y/'~"~'~"/-G A L L O N $-
TILE DRAIN FIELD:
DISTANCE FROM WEL FOUNDATION {~) NEAREST LOT LINE/O
NUMBER OF LINES ~ DISTANCE BETWEEN LINES.~ .~ TRENCH WIDTH,'~IN. TOTAL EFFECTIVE
ABSORPTION AREA /~/~/~'~ SQ, FT. LENGTH OF EACH LINE
~.~ ~ DE~TH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE~ ~4-. ABOVE TILE~ IN.
TYPE _ CONSTRUCTION DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE __ SEWER LINE TANK-- SYSTEM
CESSPOOL_ OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCE FROM:
DISTANCES:
SEWER LINE DEPTH:
PIPE MATE R I AL ' ~'"~'-?~
REMARKS:
DIAGRAM OF SYSTEM
Form LQ-032
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'~HE: K:,tit:'TH OF FI 'TF;:EZNCIi O!~ FIZ[T };:::; THE}' D]:S"i'F~Nii:E E:Ei'I.,JE:EEN THE :[~J._l[[:~cfjl3[~ OF: TI-E
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FIND 7lie BOTTEd'I OF' THE EHCFIVF'N'ZON (];N FEE'F).
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$. ::,::,.,..~: L.' [::2~ .......... L. ,-[ i ~._...~ ...........................
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)1 F:ii'"i F~t .iL. hrs. I,.fl["['lY TNE R[::3;¢,.I):REhI[ENTS,; F'TF:' OI",I-S]:TE .::,~:II~.R.:, r-tt',h.. I'.IEIJ,.S FIS SEiT
T_ F THE
Performed For
Leoal Oescri.tion:
This Form Renorts
"On,~ ~ is ~or~, ,~ tt~ous,~n~ opinions"
2204 Cleveland Anchorage, Alaska 99503
Bud Jackson Enterprises Date Performed
lot 23 8lock 2
Soils hoq yes
6/1/77
Subdivision Valley View
Percolation Test__~es
neoth
Feet Soil
Reddish Sl±t
Characteristics
Brown Gravelly Silty Sand
6--
Perc 8--
zone
10-- Bottom of Test Hole
12--
14--.
16--
18--
20--
Was Ground Water Encountered?
IF Yes, At what Deoth?
No
Reading
Date
6/1/77 .
6/1/77.
6/1/77 .
6~1/77
6/1/77
6/1/77
6Z1/77
Gross Time
Percolation Rate ~inute
Pronosed Inst~llation: Seeoaoe
De0th of Inlet
C~U?ENTS: 275 Squar~ Feet drainage area
Net Time
minut_~______
0
3~3ZJ__.
Net Dron
Depth to H20
2
2-1/4 1/4 _
2-3/4 1/2___
3 1/4
Field
Pit Or Trench
reg_9_ired per bedroom.
Test Performed BY ~-~'~,~-~0~
David-Paul
Data
Certified B~ CONSTRUCTION TEST
Date: 6/2/77
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-322-35 Expiration Date: 31 Z O Z <'
Legal description VALLI VUE ESTATES #2 BLK 2 LT 23
Site address 6210 WEST TREE DR Anchorage AK 99507
Current property owner(s) EILEEN & MATTHEW REILLY
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
concrete tank is 46 years old. Septic field is approximately 70 - 80% used.
M
Original Certificate Date: 7/13/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval—June 2022
iP1.l�tUMUPAUTY OF AHCHO AGE
Development Services Department _' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax. 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-322-35
d -2 -
Complete legal description Valli Vue Estates Block 2 Lot 23
Location (site address) 6210 West Tree Drive
Current property owner(s) Eileen &Matthew Reilly Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑! Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic 0 Concrete ❑ Fiberglass
Age 46 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ 5 0 Waiver Fee $
Date of Payment r / I / ti3
COSA # l > �- �- 3 1 Z
Date of Payment
Waiver #
COSA Appliration_June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A.WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B.TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D.ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Phone
Engineer’s Printed Name Date
2023.07.13
.¢' ...... , ........ .:':.--:~/--; ~:,DiV SlON2OF ENVIRONMENTAL SERVICES ,'.;.~:) ,' ':':f
~r~, ...... o - ..~,~,.:~., * - CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF:.~ ~:¢~ ,
ON-SITE SEWER AND WATER FACILITY,FOR SINGLE FAMILY DWELLING
Parcel..~_~ ~ ~ ~.~-~ -- HAA~ ~q~%'~ ~'' ....
1. GENERAL INFORUATION [Must be completed prior to submittal) , - .'
(a) Legal Description (iB~ude lot, block, subdivision, section, township, range) ...... '~',.' __ .
.... Location. (a8dress ¢~e eti~¢'~... __ .....
(b) Property-o.wn~ -~,~,%.~ ~ Telephone: (home] Business
- Mailing Addr'b~', ....... ,,'~,¢' ' * ' '
(c) Lending Institution * '" ...... Telephone
- Mailing Address
id) Real Estate Company and Agent ,/~--¢J//'¢-~ P~/ ',~3-/a~ -/,~¢'~:~ .... ' ............
Address
..... Telephone ~" ' ' '"'- "~'~:~'-~:~' '* '~'"' -' '
(e) Mail the HAA to the following address: (or cheGl~ hire I~,if hold for pic'l~ u'~;) ¢::.;,i.4 ?. ·
List contact person and day phone number below: ~, .~.,,
2. TYPE OF RESIDENCE
, Single-Family/~ Number of bedrooms
3..WATER SUPPLY
Individual Well [] Community/~ Public []
~¥..N..~te.~:l,f~i,co.,.m.r~uni.ty ~wel!.syste.,rg, ~tS.t',h.. ay.e, wr~it,temconfirm, ation fr;f~..t.b~¥S,_ta.t,.?.~.epA~e~.t~,o~f~Ep~ironmental
4;~,,,s?. ~G E DISPOSAL ~
Omsite:,l~[J ,.."Public• -Community E] .:,;HoldingTankE]. "': '.'-;.'--' ......
No. te-',lf commumty well system, must. have written conflrmabon from the State Department of Environmental
C0~'s~vation attesting to the legalitY; a~l ~tatus. :
72-025 (Rev. 7/88) Page '~ of 2
IBAoJddv IBUOB!puoo Jo SLUJe I
IgUO!~ipuoo' 3e,'~oJddBsK]
.t
,~/ o@^oJddv
~ Joj p~)AoJddv
'lVAOI~ddV SHHa '9
A. WE L L"~;~TA
Well Classification
Well Log Present (Y/N)
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description:
,'7"./=2 /~
Date Completed
I~,B, C, D.E.C. Approyed.(Y/N)~
Total Depth Cased to Depth of Grouting
Static Water Level Pump Set~'''~
Casing Height Above Ground _ _ S~Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) ~ : _ ..../..~epression Around Wellhead (Y/N)
To Nearest Edge of Absorp~
Lot
To Nearest Public S~,~Eine __
To N~ewer Service Line on Lot
Comments /Y~./'~5'/¢~ ~ ~/o ¢0%
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
; Date
B. SEPTIC/HOLDING TANK DATA
Date Installed ~'/?? Size /zj~ No. of Compartments
Standpipes ~N) Air-tight Caps'/N)
Depression over Tank (Y~)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Date Last Pumped c-//,~/~
/x~,/.,,¢~ ;for
Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
Foundation Cleanout~/N)
To Building Foundation
To Disposal Field
To Water-Supply Well ~ ~-oo ~
To Property Line ¢'2 ~ / '
To Water Main/Service Line ~ ~J-- /
To Stream, Pond, Lake or Major Drainage Course
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y~
Results of Last Adequacy Test ,~/,~-~
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well .~ 2~? ¢~ /
To Building Foundation ,~,?'- /
Lot
TO Water Main/Service Line ~'> 2~ /
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments "~ ;~/~-~ ,~/.~
Type of System Design
Length of Field
Depth of Field /? /
Gravel Bed Thickness
Statndpipes Present(C~N)
Date of Last Adequacy Test
To Property Line / ¢
To Existing or Abandoned System on
; On Adjoining Lots _~. ~-~ /
To Cutback (if present)
D, LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Code~._J
Comments J
Dimensions
Manhole/Access (Y/N) //~/
"Pump Off" ~.v.v~el~t~-/'~
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
Signed
Company
[)ate ¢'//'/~ ~ ¢, ,r's Seal
MOANo. ~¢ ~¢/Z
Receipt NO,
[)ate of Payment
Amount: $
Receipt
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88} Back
Page 2 of 2
~ ~ DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME
DATE DAT DATE
INSPECTOR INSPECTOR ~ I NSPECT~ ~
MUNICIPALITY OF ANCHORAGE MUNICIPALI~ OF ANCHO~GE
825 L Street - Anchorage, Alaska 99501 ENVIRO -
) ENVIRONMENTAL SANITATION DIVISION OEO I 1980
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~[~'~ ~
DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER ~ PHONE
MAILING ADDRESS ~2 ~ O · ~
PROPERTY RESIDENT (If different from above) PHONE
MAILING ADDRESS ~ ~ ~ ~ ~ ~~
MAILING ADDRESS ~ ,~' %. ~ ~ ~O ~k~ ~
PHONE~
5., LEGAL DESCRIPTION
NUMBER OF~BED O0
~ Two '~ ~-
~ MULTIPLE FAMILY ~¢hree ~ Six
7. WATER SUPPLY
~ INDIVIDUAL~ ~ ATTACH WELL LOG. A well log is required for all wells drilled
~ COMMUNITY since June 1975. For wells drilled prior to that date, give well
~ PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** ~ ~ ' YEAR ON-SITE SYSTEM WAS INSTALLED.
~ PUBLIC UTILITY
STREET LOCATION
6. TYPE OF RESIDENCE
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY -. ·
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE E~] OTHER
SINGLE
FAMILY
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
~ COMMUNITYbL'bt' ~0~ DATEORILLED
[] PUBLIC UTILITY
Comlection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY ~.~
Connection Verified INSTALLER
E]Septic Tank or []Holding Tank
Size:_/~_~d-JLJ If Tank is homemade SOILS RATING
give dimensimrs:
TYPE OF TANK MANUFACTURER
TOTAl_ ABSORPTION AREA MATERIAL
---- Sewer Line
4. DISTANCES Septic/Holdlng Tank Absorption Area Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
FOR __~ BEDROOMS
[~--"~PPROV ED
[] CONDITIONAL APPROVAL (letter must ac/~d~ertificate)
[] DISAPPROVED
DATE BY
72-010(Rev. 6/79)
DEPT. OF ENVIRONMENTAL CONSERVATION
STEVE COWPER, GOVERNOR
A~,~1C,::tO~X.GE WESTERN DISTRICT OFFICE
3~01 C STREET, SUITE 322
AN,.HOLAG.~., ALASI~A 99503
Septennber 11, 1990
563-6775
FOR: AECS
Attn: Mr. Reed
PWSID: ~210605
According to the records on file in this office, the Valli Vue
Subdivision Water System is in compliance with the State of Alaska
Drinking Water Regulations.
Sincerely,
VERA E. Ci.P~.,IG
Environmental Specialist
VEC:pf
APPLI(. NT FILLS OUT UPPER HAL %ONLY
Pro~erty Owner Tim,pthy and Joan Diestel Phone
Mailing Address Live out of State Zip Code
Buyer Peter J. and W. arlene LaPlante
Address SPA Bo~= ?6, 6210 West Tree Anchorage, ~K mpCode 99516
Lending Institution I-st National ,Eastchester Brancb Phone
~rocessor: ~ebby Green 265 3745
Address Zip Code
Realty Co. & A~nt Totem Realty - 7~4 E. ].Eth Avenue Phone
Address PLEASE CO~gT A~E%~T. VOR A~ APPOI~ A~ ~SO T0 ~ APPROV~ ~; ~N READY OR
Lega, Descnpt,on ...... "-TO I{A~DE~g~fEY ~ST ~, IV REQUI~'
Street Locati~ Lot 23, Block 2 WALLI ~ S~, ,' 6210 WEST T~E
Type of Resi~nce
~ Single Family
~ Multiple Family No. of 8edroo~ ~onr
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A w~l Icg is requked for all wells drilled since June 1975.
~ Community For wells drilled prior to that date. g~ve well depth (attach icg if available).
~ Public Utility
Sewer Disposal
~' Individua~ Year ~ndJv~ual ;nstal~ed:
~ Public Utility When Connected to Public Util}ty:
~. Holding Tank
NOTE; TH~ ~NSPEGT~ON FHE MUST ACCOMPANY ~ACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date :' ; ~
Insp~tor Insp~tor ,nsp~tor In s p ~,~~ ~
DEPT. O~ HEALIH &
~NvIRONM~NIAL pRoIECIION
JUL 3 8 't9 '3
RECEIVED
sPROVED BEOROOMS 'CONDITIONS OF APPROVAL
APPROVED
( ) GO~I~L APPROVAL'
~79 Well ,o Tank Septic ,.k Size ~
72 023 (3182)
· ALASKA elqUIROFImelqTAL COFITROL SeRUlCeS, Inc.
~n§Jnecrin§ ~- ~nuJronmealal $1udJcs
AUGUST 5 i983
TIMOTHY DIESTEL
SRA BOX 26
ANCHORAGE AK 99516
SELLER - TIMOTHY DIESTEL BUYER - PETER LAPLANTE
SUBDIVISION - VALLI VUE #2 BLOCK - 2 LOT - 23
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 1140 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 700 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 8/16/83 ·
SEPTIC TANK ADEQUACY
THIS HOUSE HAS A PACKAGE PLANT IN LIEU OF A SEPTIC TANK.
.,..~.~ OF ~1~,']~
~V~...," '~...,~,~ t~
1200 LUest 33rd Aucnue, Stljl¢ [~ · Anchoraq¢, Alaska 99503 · (907) 276-1361
August if ].983
Timothy and Joan Diestel
9['otem Realty - [<onni Snyder
725 E. l~tn Avenue
Anchorage, AK
Subject: Lot 23, Block 2, Valli Vue Sub.
Approval for the individnal sewer and water facilities
be granted until the following items have been completed:
o The septic tank pumped ~ith a receipt submitted to this
department.
o An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system
adequate according to National Standards° A listing of
private firms performing
needs to ]De submitted to
cannot
the test is enclosed. This report
this office for our review.
A maintenance contract for the Jet unit serving the sewer
system needs to be obtained from Consteel Company,
376-5919, and a copy submitted to this office for our
review and our files°
Please notify this Department for a reinspection ~hen tile
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
RP19/p/E
Enclosure
Robert C. Pratt
Associate Environmental Specialist
I
--
duALASKA COMPANY, INCORPORATED
P.O. Box 128
999 E. Tudor Rd. Northgate Sra.
Anchorage, AK 99503 Seattle, WA 98125
(907) 272-0814 ~ (206) 284-5531
TO 'Ronald & Kate Morris'
6240 West Tree 22 Block 2
Anchorage, AK 99507 Valley View
NEW BUYERS
Mr. g Mrs. Jim Hubbell
No 1633
PLEABE INDICATE THE ABOVE NUMBER WHEN ORDERING
OUANTITY : ,
DESCRIPTION
SERVICE CONTRACT
for Jet Cloure Sewage Treatment System
(duAlaska Company, Inc. Manufactures
Representatives of)
55.00 per hour-per man
Plus expenses and materials in year
1983
of
pRICE
AMOUNT
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
December 3,
DEPARTMENT OF H EALTR AND ENVIRONMENTAL PROTECTION
1980
Graham Young
% Marston Real Estate
2804 West Northern Lights
Anchorage, Alaska 99503
Boulevard
Subject: Lot 23 Block 2 Valli Vue Estates Subdivision
Approval for the individual
cannot be granted until the
completed:
sewer and water facilities
following items have been
(l)
The septic tank pumped with a receipt submitted
to this office.
(2)
The on-site sewer system has a Jet aeration unit
in it and this office will need a copy of the
maintenance contract on the unit for our files.
If there are any further questions, please call this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
CC:
Peoples Bank and Trust
Pouch 7-007 99510
% Ann Roderick
,/~ CONSTEEL CO, ~/
Concrete Proc ucts
of Wasilla, Inc.
HONE & COMMERCIAL SEWAGE TREATMENT PLANTS
BOX 1490- WASILLA, AK. 99687 - PHONE 376-5919
JET Home Plant Service Policy
This Agreement entitles: Owner OlmsLead
Street
Address ~2qO West, Tree
Valley View Estates
L. 2~ Bi. 2
City Anchorage ~ Alaska
Phone
to the following service for fl year~) from the date of acceptance.
Upon receipt of this signed agreement and $ l~O,00~,:L-~'i~l~Xs Concrete Products agrees to perform the
following services during the term of the agreement:
~¢a~J~'~ Concrete Products will inspect the JET plant at the above address twice a year. These inspections
will include:
PLANT SERVICE
Removal of aeration unit, inspection, adiustment, cleaning of aerator's shaft, field service of aeration
unit, if needed, and re-installation.
Inspection, cleaning, and adjustment, if necessary of surface skimmer and/or tube setter.
Examination of final effluent for color and odor, if there is access at time of inspection.
Check of discharge point and wet weather overflow for blockage (if applicable).
Inspection and adjustment of control panel setting and overload protection, if there is access at time
of jnspectlon.
inspection for sludge accumulation with 'arrangements for removal when build-up warrants removal.
]~[J~ Concrete Products further agrees to the following:
EMERGENCY SERVICE
· There will be no charge for emergency service calls.
· There will be no service or labor charges for removal or re-installation of aerator, if required.
· If improper operation cannot be corrected at time of service, homeowner will be notified immediately
and given estimated date of correction.
· If improper operation cannot be corrected at time of service, the Department of Environmental Quality,
GAAB, will also be notified.
e If necessary, the entire mechanical unit or any parts w~ll be replaced according to the manufacturer's
warranty program.
Freight charges to the factory or to an unauthorized repair station and aerator repair charges are not
covered under this agreement.
Ac ~les Concrete Products Date
TO
duALASKA COMPANY, INCORP(~..,ffED
P. o. Box 128
999 E. Tu(~or, Rd.' Northgate Sra.
Anchorage, AK 99503 Seattle, WA 98125
(907) 563-3004
QUANTITY
(206) 284-5531
Present owner: Timothy & Joan Diestel
Legal Discription:, Lot 23, Blk. 2
Vallivue Subdivision
New Owner: Peter & Marlene LaPlante
SRA Box 26
6210 West Tree
Anchorage, Alaska 99516
DESCRiPTiON
SERVICE CONTRACT
for Jet WaSte Water Treatment Plant
1013
PLEASE NDICATE THE ABOVE NUMBER WHEN ORDERING
duAlaska, Inc. manufactures representative
$55.00 per hour-per man plus the expences and
materials in the year 1983.
Net 30 days
PR~CE AMOUNT
-]
WE ARE PLEASED TO SUSMIT THE ABOVE QUOTATION FOR YOUR CONSIDERATION. SHOULD YOU PLACE AN ORDER, SE ASSURED IT WILL RECEIVE OUR PROMPT ATTENTION. THIS
QUOTATION IS SUBJECT TO THE COND S PRINTED ON REVERSE SIDE, AND IS VALID FOR DAYS. THEREAFTER IT IS SUBJECT TO CHANGE WITHOUT NOTICE.
SIGN AND RETURN YELLOW ACCEPTANCE COPY WHEN ORDERING.
DATE