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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 5 LT 3Valli Vue Estates #2 Block 5 Lot 3 #015-123-54 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191474 PID Number: 015-123-54 Dwelling: © Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ✓❑ New ❑ Upgrade Name David Parret ABSORPTION FIELD ❑ Deep Trench El Wide Trench El Bed ❑Mound Site Address 10025 Main Tree ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)-529-1416 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Valli Vue Estates #2 5 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well TANK © Septic ❑ S.T.E.P. ❑ Holding ❑ Other 100+ 100+ Manufacturer Greer Capacity 1250 Gal. Surface Water 100+ 100+ 1 Material Plastic Number of compartments 2 Lot Line 10+ 10+ NA Foundation LIFT STATION 10+ 10+ Manufacturer Capacity Gal. Remarks * Moved water line to meet code. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Northern Excavation Drainfield CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100ft Inspection 1st Location and description dates: 12/3/19 2nd 12/12/19* 3id 4'" Building Foundation ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date t0 /491U + •*� �Y�Mi�1l Y1YiYWW YMYY-- ♦ + KENNETH FFUS c s Septic System�� Approv Date 3i 2 -OW 1 �c<,I, Note: this does include �� #��`4i��♦• approval not well permit requirements. (Rev 05/02/18) A -C=22.0' B -C=16.3' A -D=24.6' B -D=19.9' AS—BUILT SYSTEM DETAILS/SITE PLAN Tl 2N R3W SEC 15 LOT 126 ui O 0 LL 4 -BEDROOM HOUSE A /WATER LINE FCO O COs b MTCO SHED KEYBOX O COs 'c • �� V OF .AZ4, lk Y9TH *� KENNETH S CE- \OFESSIO� -Ar s,w o w �� o n nn 1250 GAL SEPTIC 94.14 TANK PREPARED FOR: DAVID PARRET 10025 MAIN TREE RD. ANCHORAGE, AK (907)-529-1416 FIELD BOOKS BOUNDARY: N A STAKING: N A ASBUILT., JLS DWG. FILE AGAD FILE` FILE COMPUTED: DRAWN: KSD CHECKED: KMS DATE: 1/23/2, GRID: 2538 JOB No.: 19-080 Perm it:OS P 191474 PID# 015-123-54 Q) C �u h ti J 0 SCALE: 1"=30' SCALE: NTS r:.�aQ MUNICIPALITY OF ANCHORAGE e n N��iPAti ty �,�.._*...` o it�lIt On-Site Water&Wastewater Program �o S. /a . !'..a,..\, PO Box 196650 4700 Elmore Road t j Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpa/www.muni.org/onsite ` .- el)ilrtnwnt NChoRPG On-Site Wastewater Disposal System Permit Permit Number: OSP191474 Effective Date: 10/28/2019 Work Type: SepticTank Upgrade Expiration Date: 10/27/2020 Tax Code Number: 01512354000 Site Legal Address: VALLI VUE ESTATES#2 BLK 5 LT 3 G:2538 Site Mailing Address: 10025 MAIN TREE DR, Anchorage Owner: PARRET VIRGINIA CRESS & DAVID Lot Size in Sq Ft: 20149 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank ❑ 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 Special Provisions: Prior to future COSA approval, the water service line routing through the 1983 drainfield shall be addressed. Options include: 1) Obtain a waiver from ADEC. 2) Reroute the water service line so that it is 10 ft from the septic system. 3) If the original 1976 drainfield can pass an adequacy test(with the 1983 addition disconnected), then decommission or shorten the 30 ft section of drainfield installed in 1983. Received By: //Q I Date: /d — 9 • Com- ,//f /0 d�S' / Issued By: / ,e,(2,4 Date: MUNICIPALITY OF ANCHORAGE . , arm Development Services Department F Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-123-54 Property owner(s) David Parret Day phone Mailing address 10025 Main Tree Drive, Anchorage, AK 99507 Site address SAME Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #2 BLK 5 LT 3 Legal description (Township, Range & Section) Lot Size 20,149 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (IE all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank Q Upgrade Q Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A 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: 5 Waiver Fees: Date of Payment: 1 Of I*9 Date of Payment: Receipt Number: )t-iy O Receipt Number: Permit No. OSP VI 1 L1 'I Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc „ RCTERR,y s ARCTERRA • CONSULTING, INC • ! 20441 Ptarmigan Bld, Eagle River, AK 99577 ���`f'��S�ITI NG•=a•� Office(907)696-6111,Fax(907) 868-3793 ' _ ("1_.�1G� y q 1`i i 2,26 October 16, 2019 015—P:3 - S y oeDelot r4 4 Municipality of Anchorage Development Services Department (2V 2440$0 On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Tank Upgrade Permit—VALLI VUE EST#2 BLK 5 LOT 3 The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 4-bedroom house. The adjacent lots are developed and are served by community water. There is no surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 696-6111/FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. ‘01 Ken - - . Duffus, P.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793 7 f7J9ig7/ DESIGN SYSTEM DETAILS/SITE PLAN VALLI VUE ESTATES#2 BLOCK 5 LOT 3 PID#015-123-54 (I) ---------7 /4/ • . / OD o CV DRIVEWAY ALI ^ O� 4-BEDROOM lio:1 / 0`V (� HOUSEIll 0� v • 1:REMOVE AND REPLACE L.EXISTINGFCC)TANK WITH 1250 GA TANK 10'FROM BUILDING / 2:INSTALL 2 POSyyII'ANK 10' in. u= CLEAN OUTS / �� 5 / / EXISTING TANK - • Q COs ti MTCO�� •UTFALL COSTING FVELD CONNECT TO o / EXISTING FIEL / 30 KEY BOX • / cos / / /1/,. .o_ / NOTES: NO PUBLIC WELLS WITHIN 200'OF SCALE: 1"=30' PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200'OF PROPOSED SYSTEM EXCEPT AS NOTED NO SEPTIC SYSTEMS WITHIN 200 OF PROPOSED WELL EXCEPT AS NOTED. PROPERTY SERVED BY CLASS"A'WELL SYSTEM PREPARED FOR: .......ib..\\ � T David Parret AA�� OF• `zC,S\, 10025 Main Tree Dr. ` RCTE R D /�� `) ��1 ANCHORAGE,AK ti �y 1 !Cq r (907)-529-1416 N° °��, r* 4! r 4 *Y 1 3� ��i�I 7 .al�`� .44,/� • / FIELD BOOKS COMPUTED: _q 1 < 1 �,r.2'�/ BOUNDARY:N/A DRAM: KSD Z �'� `-`� \ 41.4.-- it ' STAKING: N/A CHECKED: KMD •'�^" \`\' ASBUILT: _ DATE: 10/14/19 ~e"9l OA, M'/�� ,04 DWG. FILE GRID: 2539 FR °Ns �� `9S /P4. ',SU' •I NCI •trr30 ACAD FILE: FILE 'IDB No.' 19080 R• AK.09577— " IbM+!!e •tie .ri• - e" :t M.M - . . N. : a -IS' 'go ' a 0 - • 0 1••T.• ANK ` - C MNET 10.19.dwg -� MUNICIPALITY OF ANCHORAGE 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 ❑ NEW e� _ (o'-,5' 0 RUPGRADE MAILING ADDRESS t LEGAL DESCRIPTION ([, 4z t (A( v LOCATION NO. OF BEDROOMS / DISTANCE Well Absorption area "y© f Dwelling PERMIT NO. U Y TO: �_ �Q u Manufacturer �•+ cl fit✓'-�'/`' Mater % tr E L No. of compartments P),-- W< F a� y Lin. capacity in gallons Inside length Width Liquid depth L.S � IF HOMEMADE: O 1' DISTANCE T Wel Dwelling PERMIT NO. JUZ = z F Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well' Foundation— Nearest lot line PERMIT NO. y W= 1d a J LL z No. of lines Length of each line r Total leng f nest TrencFyi t - Distance between lines F Z w 2 1 ` 6 3 (� inches eaI_ Top of tile to finish grade Material beneath the yy �y Total effective abs rption are t p x W inches © 4 Length Width Depth PERMIT NO. w O Q H Type of ri rib diameter Crib depth Total effective absorption area w ° r" ell Building foundation Nearest lot line DISTA CE J Class Depth Driller Distance to lot line PERMIT NO. J WBuilding foundation DISTANCE TO: Sewer line Septic tank Absorption area(s) OTHER A 6- b r -J t PIPE MATERIALS li9sr� e 0 3 SOIL TEST RATING /tea G INSTALLER') jC ,11/'CJ t s✓ REMARKS (.A) C-^ 4 . 2eld I I u• r- APPROVED DATE LEGAL -2n -0 4. Jam' d S` 72- (Rev. 3178) DEPARTMENT O HEALTH AND ENVIRONMENTAL i STECTlON 825 .L., STREET, ANCHORAGE, AK 99501 264-4720 PERMIT NO. < =3E1E120 > APPLICANT BARBARA GARDNER LOCATION MAINTREE 10025 LEGAL L3 E 5 VALLI VUE 597 W. N. L. BLVD. LOT SIZE 20000 _,QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING x:50 FT: BR)= 140 THE R:E=!UIR:ED SIZE OF THE _.OIL ABSORPTION SYSTEM IS: A EaE�F"lFVA= uUMN 9_E07fhl®A--&l== ®�F Fi •�.6_ C_•EF'TF9= c=, THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR. PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE Et;C:AVATION (IN FEET). THERE IS NO _ET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I_ THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL F'IF'E AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE R:Et,F'ONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- -F L--ia l < > 1 PA-.F°KCD A" 1 C3VA-. FlFQI= FTEoCAi_i I FRE=E> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THI: DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON -'SITE SEWAGE DI=•POSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPEP•DING UPON THE TYPE_ OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRI`dATE '=EWER: LINE 15 25 FEET AND TO A COMMUNITY SEWER: LINE IS 75 FEET. OTHER: REQUIREMENTS MAY APPLY. SPECIFICATION'= AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INSTALLATION. F" K F=. P'ri 1 'F' i= y F• 1 Fp_ E 0w E> E= e_ i= Pl E3E F='_ = nLe A _o v: I CERTIFY THAT 1: I AM FAMILIAR: WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALIT'r OF ANCHORAGE. I WILL INSTALL THE 'SYSTEM IN ACCORDANCE WITH THE CODES. _. I UNDERSTAND THAT THE ON -'_ITE =EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE R:E_IDENCE IS REMODELED TO INC IDE MORE THAN 4 BEDROOMS. Wd SIGNEDA ------------------ APPLICANT ------ APPLICANT E;HRBARA GARDNER: ISSUED BY 41*- -- /-//- pll X14. 0 W, GREA .tR ANCHORAGE AREA BOR. JGH H R1 I til��,�s Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME •r P.M.cY: MAILING ADDRESS `�4'�d ao / 'J PHONEtA7 / _316 6 LOCATION LEGAL DESCRIPTION L& SEPTIC TANK DISTANCE (�y�qqq/���, '�/I NUMBER OF -� FROM WELL��`�YWw�• MANUFACTURER MATERIALCOMPARTME))NTS,, INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -AP— yyGALLONS. TILE DRAIN FIELD: j TOTAL LENGTH DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE—OF LINES 't NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH t" IN. TOTAL EFFECTIVE ABSORPTION AREA2 SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER a DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ -032 CONSTRUCTION DEPTH — NEAREST NEAREST SEPTIC SEEPAGE LOT LINE , SEWER LINE , TANK , SYSTEM_ OTHER SOURCES DISAPPROVED REMARKS 70" DIAGRAM OF SYSTEM APPROVED a� DISTANCE FROM: reams ^ � PERMIT NO. ( 4 A_ T 1`00 win NO- 521 PA co ! 1 CA F2 so CA A . MD .`� , DFlo HRTMEM' � HEHiJ}1 AND ENVIRONMENTHL —,",0 ECTION 2516 Ez UDCR RD., ANCHORAGE/ HK. S M7 276-2221 � ������ 44 is; T , 1- 11K IN EH U 4 E " 7 7 Fn KA vy 01 1 � ° 76710 HPPLlCHNT 2418 E 20TH AVE-,-.: /�-`` � LGCRTION MAlNTREE DR ��u�am»"�/" LA B5 VALLI VUE SUBD 02' LOT SIZE 20119 SQUARE FEE! TY7H OF SOIL HBSORBTION SYSTEM IS: TRENCH MAXlMUS NUMBER OF BEDROOMS - 4 SOIL RATING (SB FT/BR)- 14@ ' 1E REQUlRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �" 4���� ������= �� ������ �����= � ` � iLNS!ON IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. 'HE DE/ H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND H|tD [HE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THEE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE H�D THE BOTTOM OF THE EXCAVATION (IN FEET). Pot ������EI_� i; _-.� FO, -T- 1 ET 'T- 1010.0 K All 1: 2f No: ����,Hnl ������_�:;: 6-b"Any xT 0! J IC N, O"K n-::.- - �- ji: u1g V-4. to KKK �������r1I-:::u GHCKFILLIMG OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS D�PRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H HELL HND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 105 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER IFTSTRLLHTICN. ����A -T_ 10101.. T Ev F= CA Fe CDVAEK 41" k lot F& CA pi 1 nT1&H3E_ I CERTIFY THAI 1: l AM FHMILIRR WITH THE RLMENTS FOR Oh EWERS AND WELLS AS SET F0RTH BY THE MUNICIPALITY OK�'3RHGE. 2: I WILL INSTALL THE SYSTEM '�CORDHNCE WITH TUE CODES. I: I UNDERSTRND THRT THE ON -Si KWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLOu[ MORE THAN 4 BEDROOMS. � SIGNED:____-��_�-� _______________- FKqFoLlCHNT ^8D an.-::. u, 1\ zr / Dep-rtment of Health and Environment�-,Protection 2516 E. Tudor Road Anchorage, Alaska 99507 276-2221 SOILS LOG - PI:NOLATION TEST Performed for j dl JL=.c SpN _ Date Pcrfbrmed_- ._ ,3a-7� Legal Description:_ �— This form reports: Soils log. -- d Percolation Lest--.-.-- Depth est-. _•Depth Feet 2- 3 - 574 — S`✓ -S°% /`/4 4- 5 SA 0-0) 6- n _ r. 10 - Syape 11 12 - 13 - U 14 _ Is_ Was ground water encountered? ll/_ p e If yes, at what depth? Heading Uate Gross Time Net Time Depth to Water Net Urop Percolation rate minute. -Proposed installation: Sec age Pit '•� C 1 Drain Field I P �'/�._ --_ -- - - — -..._--_._------- Depth of Inlet Depth to bottom of pit or trench COMMENTS: - -- -- --^------ -- - ee��sY ci,h Jate:--�30=7 Performed 6y: `�..zO.n.Certified [fy:___.__. EQ -040 (6/74) rte,. LEGEND' �3Z� ill Bross Cap hlcm:mant 3 O Iron Pipe e Steal Pin n Survey Nub & Tock I herebv certify, that I have surveved Lot_ 3 0 2e Subdivision, Anchorage Recording Precinct, Alaska, and have replaced all lost corners with" 5/8" X 30" • rebar. It is the responsibility of the owner, prior to construction, to verify proposed building location on lot, grade, and utility connections, also to determine the existence of any easements, covenants, or restrictions which donot appear on the recorded plat. Dged at Anchorage, Ala ka this—2304 rel day of 4 y,- t!!z Y" , 19. Constructing Engineers, SRA Box 60�Anchorage, Alaska. 3440817 344.7960 61891 V�7,7 nV ®Municipality of Anc ora JAN 2 9 2020 On -Site Water and Wastewater Program (907) 343-7904 1 - CERTIFICATE OF ON-SITE SYSTEMS AP Parcel I.D. 015-123-54 1. GENERAL INFORMATION S A FI E T Y Expiration Date: E ^S —2-c -0- j Complete legal description Valli Vue Estates #2 Block 5 Lot 3 Location (site address) 10025 Main Tree Anchorage, AK Current Property owner(s) David Parret Day phone Mailing address Real Estate Agent 10025 Main Tree Anchorage, AK 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well Public Water System ❑ Waiver/Variance request for: Received by: 4 Day phone TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $SS0 .b O Date of Payment 0\119 Z02,0 Receipt Number 241 S�;4 COSA# UQ_010Zq Date: Waiver Fee $ Date of Payment Receipt Number Waiver # stance: z 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 ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date/l"19d Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future -ft- occupants or can ArcTerra guarantee that no unseen A-.��;; OF ALS Ilk encroachments, deficiencies or discrepancies exist. *Ty(� #i 6. DSD SIGNATURE ............_.. System #1 Approved for bedrooms. i "EN`�"1" t,'6 `'S 10( System #2 Approved for Disapproved. Conditional approval for bedrooms. r'�Fo d Z � �OF'ESaIOti�� AV O`lll`llt��n�c_� bedrooms, with the fQlta��pu rTrIlo ATFL,AAlp � r: By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only 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 COSA blue sheet 10-10-12.doc Legal Description: COSA Checklist Valli Vue Estates #2 Block 5 Lot 3 If more than 1 septic system on lot: COSA Checklist # of 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. Comments B. TANK DATA Age of tank(s) New years Tank type/material Septic/Steel Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) 11/4/76 +7/22/83* ALL standpipes present per record drawing Total measured depth from grade 10.4 ft (max) Measured depth to pipe invert from grade 6.5 ft (min) ❑ N/A — pressurized field 1011 Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 015-123-54 Structure served by this system 1 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes M No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/12/19 Results ❑/ Pass For 4 bedrooms 44 Fluid depth prior to test in 600 Water added gal 45 New depth in 10 Elapsed time min 44 Code -required soil cover over field Final fluid depth in F-1Systempresoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: *Addition to field was done on 7/22/83 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [7�j Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' R] Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' 0 Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Sok IJ LO CC) —i m V) LO �— y 0 Eg 0 (1Q, s p . 90e ....... ........ Cb ii. LL A5 Lo 0- cn -j- LO F-- y 0 LLC co 6 IN CR 2u 1 W E— 0 rc- c > m ell -j- LO F-- y 0 ell go C - 'Cl C,4 tL N LD go &. "3 (D Cc-- ct Municipality of Anchorage Development Services Department RUSH// EEYTIFICATE e OF ON-SITE SYSTEMS APPROVAL IZ�-K—e �vs H — FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-123-54 COSA# O U G la1VU1 1. GENERAL INFORMATION Expiration Date: 2 3 Complete legal description VALLI VUE ESTATES #2; BLOCK 5, LOT 3 Location (site address) 10025 MAIN TREE DRIVE *ANCHORAGE, AK 99516 Current Property owner(s) JAMES VOLLINTINE Day phone 346-4446 Mailing address 1-0025 MAIN TREE DRIVE *ANCHORAGE. AK 99516 Lending agency Day phone Mailing address Real Estate Agent MARK SPARROW W/ PRUDENTIAL Day phone 440-1122 Mailing address 3801 CENTERPOINT DRIVE #200 *ANCHORAGE. AK 99503- Unless otherwise requested, COSA will be held by DSD for pickup. 2. ,NUMBER OF -BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: _Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 0 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by asingle-family oh -site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for propert Community On-site ❑ Public Water System ❑ Public Sewer ❑ ies 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. 4. 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. t further verify that based on the information obtained from the Municipality of Anchorage riles 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 GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future 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 party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date 2 00 o��pp04 •S�Op�G p.9 .f. y.A.... Q CE -79 3 ,• ,R�p D�ndproression�oo Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory f v Other By:� (Rev. 11/05) J• ON-SITE` WATER AND WASTEWATER PROGRAM ,, ,_ •....• 65a� Original Certificate Date: I;)- - / 113 - /_?_ Municipality of Anchorage • -� Development Services Department Building safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: VALLI VUE ESTATES #2; BLOCK 5, LOT 3 Parcel ID: 015-123-54 A. WELL DATA COMMUNITY WATER Well type Date completed Total depth ft. Date of test Static water level Well production _ WATER SAMPLE RESU If A, B, or C provide PWSID# 210605 Well Log (Y/N) _ Sanitary seal (YIN) Wires properly protected Cased to ft. Casing height (abs FROM WELL LOG m. Coliform colonies/100 ml. Nitrate mg./L. ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA AT Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments E Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 5/24/11 Pumper A+ HOMESERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE 11/4 76 Date installed 7/22 83 Soil rating (g.p.d./Wor �/bdrm 140 Length 21, 27, & 30 ft. Width 3 ft. Collected by: Date installed 7/22/83 Cleanouts(Y/N) YES High water alarm (Y/N) N/A in. System type DEEP TRENCH Gravel below pipe 6 ft. Total depth *11.91 ft. Eff. absorption area 604 ft' Monitoring tube YES Depression over field NO Date of adequacy test 1/5/12 Results (Pass/Fail) PASS For E bedrooms Fluid depth in absorption field before test 28 in. Water added 1 100 gal. New depth 56 in. Elapsed Time: 129 min. Final fluid depth 44 in. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date TESTED 1983 TRENCH ONLY D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off" level High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WELL Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *6Property line 5'+ Absorption field UNKNOWN Water main 10'+ Water service line* * -10'+ Surface water 100'+ Wells on adjacent lots 200'+ PUBLIC/100'+ PRIVATE SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water 10'+ Water service lineA * L 0 -' Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ PUBLIC/100'+ PRIVATE F. COMMENTS *PER INSPECTION REPORT %31` f9c/ I $5 114 OA C Sfj G. ENGINEER'S CERTIFICATION t certify that t have determined through field inspections and ,' 4 T 7 review of Municipal records that the above systems are in ""' "" ' """ """"" conformance with MOA COSH guidelines in effect on this date......... e f e A. Go ess: Engineer's Printed Name JEFFREY A. GARNESS �d CE— m� Date COSA Fee a 1' C ' M Date of Payment oZ I l3 l oC Receipt Number 14 aay (Rev. 11105) Waiver Fee Date of Payment Receipt Number �¢ 7 v h/ 0 b WCo� UA F"/ri m 9 . tYg Alu F<: Z6)' $C�"�.�C"� 4�/FL bli cWotl4 r - r 9 / ,O ,• 9 is the responsib it•y of the o ner to determine e existence of an }v d "`�•�� rictions which do not ements, Cove nts, or re. QS`., Baa. Karl Dowling vision ear qit t • recorded sub 1564-5 Plat. Under no cir �tanc s.• should any I R ^9•• " to hereon be used for constr66c�ti�6n.or. for es tab- �"'••••"''aoe°.P"' shinq boundary or fence 1 fines. l e surveyor taker I HO WN ON TIdE RECORDED PbA M11ARE NOT I ' EASEM NTS OF RECORD OTHIfi'�i1iAl7jIy0SE sponsib{ti.t' for the initial, tran�acti.on only I„ SHOWN HEREON. T _ BLOCK S Lecervn .. GRASS CAP Ma NVMENT S ��'{ �? ,_, ✓'LAT NO. 1 ' j . RO"'MPE PROP coR./lra �N CHORAGE RECORDING DISTRICT ❑ Nva a TACK alEo� aTJ G�WLING �0 A5S�rrer�c -- - .... ._. _ •^ .. --- _... , ANCHORAGE' A�AS1<A u199, SCALE./�� 3c/, WORkORDEq: <3<0 ^ C+ 9 0 ZO 39dd -10A : S3wvf 868C9VELOE ZC:9T ZTOZ/T0/E0 • MUNICIPALITY OF ANCHORAGE O Department of Health & Human Services i DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel LD.# (illi 6 >a HAA# 96I�CL r5� 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3; Btock 5; Vatti-Vue Estates 02 Location (address or directions) 10025 Main Tnee DiL.ive (b) Property owner Bob Pkad'en Telephone: (home) 9/9-7691 Business Mailing Address 10025 Main Thee Dkive Anchorage Ataska 99516 (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Address Telephone Telephone (e) Mail the HAA to the following address: (or check hereA if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17034 Eagle wer Loop ROad No. 204 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE / Single -Family" Number of bedrooms 3. WATER SUPPLY Individual Well ❑ Community k' Public ❑ Note: If community well system; -must have:written confirmation .from the State Department of Environmental Conservation' attesting to th legality and status. 4. SEWAGE DISPOSAL . On-site,' Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 A. WELL DATA Well Classification MUNICIPA I�TY OF ANCHORAGE (MOA) • NAUTv of PI��IiiR rity Approval (HAA) i ` ENTAL SER €e - FEBRUARY 1984 _ 343-4744 AN 2 5 1990 RECEIVED 0 Well Log Present (Y/N) Date Completed Legal De�scf iption: L� S Total Depth Cased to Depth of Grouting Static. Water Level Casing Height Above Ground Electrical Wiring -in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: If A, B, C, D.E.C. Approved tel)__ Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot + ; On Adjoining Lots I To Nearest Edge of Absorption Field on Lot k ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments To Nearest Public Sewer Cleanout/Manhole ; Date B. SEPTIC/HOLDIN ANK DATA N 5 7G Date Installed Size 1S15-0 No. of Compartments Standpipesp/N) �y—Air-tight Caps PI) Foundation Cleanout<"N) Depression over Tank (Yeg) I-- ate Last Pumped Pumping/Maintenance Contact on File (Y/N) ? ; for — Holding Tank High -Water Alarm (Y/N) A Temporary Holding Tank Permit (Y/N) A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: I To Water -Supply Well -h To Building Foundation To Property Line To Disposal Field To Water Main/Service Line �a'r To Stream, Pond, Lake or Major Drainage Course NI Comments ist-216- 72-026 (Rev. 7/88) Front Page 1 of 2 ANCHORAGE WESTERN DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 January 10, 1990 FOR; Mr, Ted Moore 563-6775 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. CRAIG Environmental Fie d Officer VEC;bas s j MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date &// -7 p _ (a) Legal Description (include lot, block, subdivision, section, Lor -5. 6 bC s -Vz J E C Location (address or diretions) 100%X5 '✓pile- 8���' (b) Applicants Name 44�, POA. Telephone — Home Business Applicants Address (c) Applicant is (check one) Lending Institution ; Owner/builder ; Buyer = ; Other = (explain); (d) Lending Institution ` Telephone Address (e) Real Estate Co. S Agent Address ao'7, All, leiaka41 Telephone 2:76 (f) Mail the HAA to the following address: 2. Type of Residence Single—Family_eN4 Multi—Family Number of Bedrooms V 3. Water Supply Individual Well Community Other (describe) Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation.attesting to the legality and status. 4. Sewage Disposal Onsite Public E=j Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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 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 regula- tions in effect on the date of this inspection. Name of Firm Address � �/ / Telephone a7`—S91,6 Date (ENGINEER SEAL) i*a�490 6. DHEP Approval Approved for v/L bedrooms Approved -Xv— Disapproved Terms of Conditional Approval (i•eA••ea o°00000ee `^ate V 2225-E ° •',�� j NE 25. 4971 - BY �� � Date Conditional CAUTION THE 14UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. TIM DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 MUNICIRAIXT OF ANC1010RAU£ DEPT. OF HEAIRA & MUNICIPALITY OF ANCHORAGE (MOA) erav a®NQS Ssl Pitt?EeTION HEALTH AUTHORITY APPROVAL (HAA) I'7 9985 CHECKLIST - FEBRUARY 1984 E Legal Description: A. WELL DATA V LLI l/UI_ -qEC 1 MWe-iZ'5 Well Classification C k ASs Fk If A, B, or C, D.E.C. Approved(Y/N) x Well Log Present (Y/N) Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot '00-c> On Adjoining Lots To Nearest Edge of Absorption Field on Lot a s4D ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected By ; Date Water Sample Test Results Com vents B. SEPTIC/HOLDING TANK DATA Date Installed U hUG Size 12 5'o No. of Ccxnpartments 2 Standpipes (Y/N) bti1E Airtight Caps (Y/N) Foundation Cleanout (Y/N) y Depression over Tank (Y/N) N Date Last Pumped 6113 1 85 Pumping/Maintenance Contract on File (Y/N) KLA ; for N/A Holding Tank High -Water Alarm (Y/N) W/,q Temporary Holding Tank Permit (Y/N) IVIA Separation Distances from Septic/Holding Tank: i To Water -Supply Well 2vo To Building Foundation 13 To Property Line y O To Disposal Field 115 To Water Main/Service Lire 10+ To Stream, Pond, Lake, or Major Drainage Course NONE Comments Receipt #�(�3� Date Paid: 6-17 -! ST Amount: 5�S` [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 4c) Type of System Design / 2ENCN Date Installed UR6(2A1)E I4$3 Length of Field '30 pj,%O.¢c %O�2/Fi' Width of Field V(/i ,t Depth of Field I, Gravel Bed Thickness (� Square Feet of Absorption Area (p0 c/'c _ Standpipes Present Depression over Field (YM) Date of Last Adequacy Test 5/f 6 Results of Last Adequacy 'Ibst -France Separation Distance from Absorption Field: To Water -Supply Well AU -t> To Property Line To Building Foundation p--7 To Existing or Abandoned System on Lot ('CONI I= On Adjoining Lots /Q--0 To Water Main/Service Line to f To Cutbank(if present) 1 O To Stream/Pond/Lake/or Major Drainage Course NO N L-. To Driveway, Parking Area, or Vehicle Storage Area 50 comments Kfr�. Opfa-a A;34,W D. LIFT STATION N ()`J L Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(YM) Dimensions Manhole/Access (YM "Pump Off" Level at Vent (Y/N Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. �/ �l (a�S Signed ��- _ Date Company MOA No. F'61) I -p /( KB1/d5/s (Page 2 of 21 ®F ... °S�t�� l•.....°q 9 �9a RS i?i �1 1� • o. 2225- IN ¢�•:r:�•. JUNE 25 1971 nn ^o 2-15-84 J (� (0j ' ►�' LSK BILL SHEFFIELD, GOVERNOR DEPT. OFENVIRONMENTALL CO NSERVATI(((IJJJO IIINId Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 MUNICIPALITY OF ANCHO,PAGt DEPT. OF HEALTIJ $ ENVIRONMENTAL PROTECTION 1 i 9985 DATE: /l% — RECEIVED PWS I.D.#.I (JLo[ To 'Whom it May Concern: According to records on file in this office the Water System is in compliance with the State Drinking Water Regulations Sincerely, qaj�Lo J. k&JdLr'� 03 W. 15th AVE "C" SUITE 203 U Oa �G°P�QG3dGQaD9 PO�v 2ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER - - TELEPHONE: (907) 279-3916 S E P T I C S Y S T E M A D E Q U A C Y — — — — — — — — — — — — — — — — — — — — LEGAL: LOT 3, BLOCK 5, VALLI VUE LOCATION: 10025 MAIN TREE OWNER: KEN PARKER RESIDENCE: SINGLE FAMILY, FOUR BEDROOMS' WATER SYSTEM: CLASS A COMMUNITY SYSTEM T E S T SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: 1250 GAL. TWO COMP. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 604 SOIL RATING: 140 INSTALLATION DATE:ORIGINAL SYSTEM UNKNOWN, UPGRADE JULY 1983 DATE OF PUMPING: JUNE 13, 1985 DATE OF TEST: JUNE 134, 1985 TEST PROCEDURE: WATER WAS ADDED TO THE SYSTEM AT A CONSTANT RATE OF 9 GALLONS PER MINUTE. THE WATER LEVEL IN THE TRENCH AND TANK WAS MONITORED, NO CHANGE IN WATER LEVELS WERE OBSERVED AFTER ADDING 330 GALLONS. TEST RESULT: THIS SYSTEM MEETS THE OPERATIONAL REQUIREMENTS OF THE MUNICIPALITY. The operational life of all septic systems depends on the local soil conditions, groundwater 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 septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) L'7 3.43t.t . kl&h, \]ue Location (address or directions) /00AT_ Ma_ k T2' -e 2c, (b) Applicants Name K Sus4N Pkakee L_ Telephone - Home Business Applicants Address Alf[ -- (c) Applicant is (check one) Lending Institution Owner/builder ; Buyer F�Kr ; Other � (explain); &vex pA� (d) Lending Institution CJominl 94crLj¢ Telephone Address 70 1 L i "Ao 2 (e) Real Estate Co. & Agent To�c--ten Rewe{� (Co�A2 5Nyden. Address %a `i l= 1 Telephone A-) L -o T-0 (f) Mail the HAA to the following address: ; 2. Type of Residence Single -Family r"zMulti-Family Number of Bedrooms 3 on (• 3. Water Snpply Individual Well M Community Other (describe) Public Note: I£ community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite 11 Public E:] Community E:] Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. S451en1 4P�,.ucCEtai �4�/PVOUEP 14 Si• (Rw/t2wan.b-5 4-t<7Ct -C$�%" [Page 1 of 2] c"v) 4 1 5 Grs,rs&f U4/1"Uti(3- 5. Engineering Firm Providing Inspections Tests File Search, Data and Information 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 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 regula- tions in effect on the date of this inspection. Name of Firm AEC S Telephone Address ItOUW 33,( Avc, AVc.1.on.4,,- Ai- 44)'03 Date /0 St/J `F (ENGINEER SEAL) 6. DHEP Approval v ul Approved fo bedrooms Approved Disapproved Conditional Terms of Conditional Approval CAUTION oy C. Reid, Jr. No. 2251.1- THE iffiNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. RR4/ej/D18 [Page 2 of 2] F1 (DHEP SEAL) 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) b866 b �, d3S HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 N0110310dd lVlNavdN081AN9 18 H11V9H d0 'JAG 3 wo .)NV O A11lVdIDINQN A. WELL DATA Legal Description: �T Z,5 VR' UE Well Classification pu6li( If A, B, or C, D.E.C. Approved(9/N) Y Well Log Present (Y/N) /✓¢ Date Completed Al 4-- Yield Total Depth Cased to ui Depth of Grouting IoA- Static Water Level VA- Pump Set At X)4_ Casing Height Above Ground ran- Sanitary Seal on Casing (Y/N) 6u4 - Electrical Wiring in Conduit (Y/N) PQ Depression Around 4�bllhead (Y/N) W Separation Distances from Well: To Septic/Holding Tank on Lot uq- On Adjoining Lots /J4 To Nearest Edge of Absorption Field on Lot ua ; On Adjoining Lots A;4 - To ; - To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole „,,, To Nearest Sewer Service Line on Lot Water Sample Collected By uA- Date iv 'k - Water Sample Test Results Conr a nts B. SEPTIC/HOLDING TANK DATA Date Installed 0n1K Size 125_0 No. of Ccanpartments 2 - Standpipes 6/N) { Air -tight Standpipes Caps 61N) i' Foundation Cleanout ®/N) `( Depression over Tank (YQI NJ Date Last Pumped q- 5 - g5� Pumping/Maintenance Contract on File (Y/N) Ala- ; for 04 - Holding Tank High -Water Alarm (Y/N) uc-- Temporary Holding Tank Permit (Y/N) AN+ Separation Distances from Septic/Holding Tank: To Water -Supply Well —A) To Building Foundation * /D' To Property Lire :,/' To Disposal Field at) ' To Water Main/Service Lire To Stream, Pond, Lake, or Major Drainage Course (57 /Ou' Comnents x €,aw 7`1Z -3S Rs Bu•Ii Receipt # Date Paid:-[[_�u( Amount: [Page 1 of 21 2-15-84 ALASKA Ci 01ROf MenTAL COnTROL SRUS, InC. 6n9ineerin9 & Enuironmental Studies 09106184 KONNI SNYDER 724 E 15TH ANCHORAGE AK 99501 SELLER — TOTEM REALTY BUYER — SUBDIVISION — VALLI VUE BLOCK — 5 LOT — 3 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 604 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1506 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 915184 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. w6oder aq�vo...... P. - r. - v y C. Reid, Jr. .2251.E ) 1200 West 33rd Auenue. Suite 3 • Anchorage. Alaska 99503 • (907) 561-5040 r a ALASKA mUIROWnTAL COnTROL SeidCCS, InC. engineering & 6nuironmental Studies JANUARY 6 1983 LEE HOUSTON & ASS. 507 W. NORTHERN LIGHTS ANCHORAGE AK 99503 SELLER — MIKE VIERMEERSCH BUYER— SUBDIVISION—VALLI VUE #2 BLOCK -5 LOT -3 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 572 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 304 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 20 GALLONS: THE SYSTEM IS UNACCEPTABLE BECAUSE THE SURGE CAPACITY IS LESS THAN 75 GALLONS. THE SYSTEM IS NOT CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. THE SEPTIC TANK WAS PUMPED ON 1/6/83 . I SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR THIS 4 BEDROOM HOUSE. —011" A, :h Leroy C. eid, Jr. o% OB ST ae No. ' 51 E q � 4 PRQFESS\(J 'o' 1200 West 33rd Auenue, Suiie B • Anchorage, Alaska 99503 • (907) 276-1361 3 32 & J r f� E OF L #A, S DEPT. OF ENVIRONMENTAL CONSERV SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 9950; To Whom It May Concern: BILL SHEFFIELD, GOVERNOR ATION Telephone: (907) Address: DATE: '�6I4, l pw PWS I.D. #dl!66CJ5 274-2533 According to records on file in this office the Water System is in compliance with the State Drinking Water Regulations. Sincerely, - - • MUNICIPALITY OF ANCHORAGE - DE TMENT OF HEALTH & ENVIRONMENTAL PROT ECTBDNTRONMENTAL MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & PROTECTION ` 825 L Street - Anchorage, Alaska 99501 - - ®{-� SEP 18 1980 ENVIRONMENTAL ENGINEERING DIVISION El One Four El Other Telephone 264.4720 RE CE I VED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed.,Pleaseallow ten 1101 datsior processi .- 1. PROPERTY OWNER Lee W. and Patricia Rosenbaum PY814914 MAILING ADDRESS IIx COMMUNITY PROPERTY RESIDENT (If different from above) O PUBLIC UTILITY PHONE g@@g8x)gblxgxx4II8gxMx Owner **If individual/on-site, give installation date 6 —1 Ii0 349-4914 2. BUYER PHONE Room Michael L. and Patricia E. Vermeersch by this Department. 279-8671, 363 MAILING ADDRESS 429 W. 8th Ave., Anchorage 99501 3. LENDING INSTITUTION - PHONE National Bank of Alaska (Processor -Sue Benedetti) 265-2882 MAILING ADDRESS Mortgage Loan Production, Pouch 7-025, Anchorage 99510 4. REALTOR/AGENT PHONE Admiral Realty - Betty Halsey or C-21 Shennum Realty 279-8586 MAILING ADDRESS 930 W. 5th, Anchorage 99501 209 W. Dimond Blvd., Anchorage 9950 f 5. LEGA J-O1EESSRI"Mr 5, Valli Vue #2 - STREET ilbb' -(JONai nTree Dr. - - 6. TYPE OF RESIDENCE NUMBER OF BED El One Four El Other SINGLE FAMILY _ O Two O Five O MULTIPLE FAMILY IXI Three 0 Six - 7. WATER SUPPLY - O INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled IIx COMMUNITY since June 1975. For wells drilled prior to that date, give well O PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date 6 —1 Ii0 INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required O PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN :BE -INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY —"--- INSPECTION APPOINTMENTS DATE RECEIVED , TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE C7 SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑ PUBLIC UTILITY Connection Verified -_ PERMIT NUMBER DATEINSTALLED INSTALLER ❑Sept,i'$T��a�nk or ❑Holding Tank Size: �^-'� If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line _ Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS &--`APPROVED FOR _BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accom a y ertificate) [11 DISAPPROVED DATE BY (Title LEGAL DESCRIPTION 72-010 (Rev. 3/78) e A i CHMA6L a 6 -~ �= GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received February 1, 1977 Time of Inspection'��� Date of Inspection -1 77n �t�aS REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: National Bank of Alaska % Marva Goodson Mailing Address: Post Office Box 3-3859 Phone: 2. Property Owner: Taku Builders, Inc. Phone: 344-0364 Mailing Address: Star Route A Box 1735—J 3. Legal Description: Lot 3 Block 5 Valli Vue 4. Location: Maim:-. Tree Drive, 3rd house from the end on the right 5. Type of .facility to be inspected single Family No. of bedrooms 4 6. Well Data: 7 A. Type Community B. Depth C. Construction D. Bacterial Analysis Sewage Disposal System: On—site system, I'AMd '71,7/0. A. Installed iA7r B. Installer C. Septic Tank: 1. SizeQaLs. 2. Manufacturer lnaeop, D. Seepage Pit: 1. Absorption Area 67a sn 2. Material E. Disposal Field: Total length of lines '/q' 8. Distances: A. Well to: Septic tank Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two' pages - Rec�—J t for Approval -of Individual S' -';r & Water Facilities Legal Description Lot 3 Block 5 Valli Vue Comments Approved V Approval;Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certifv that the information contained in this reauest for approval to be a true anc accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT DEPT. OF HEALTH & 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 �Rt%iRONMENTAL PROTECTION REQUEST FOR APPROVAL OF FEB 1 1977 INDIVIDUAL SEWER and WATER FACILITIES MOEN 1. Type of Inspection: C RO^ VA FHA CONM 2. Property Owner: /�'�F/(//�-r�/���—� �� •�'v `— /�/ Mailing Address: �/ Day Phone: : � `� �� 3. Name of Buyer: z5a; Mailing Address: Day Phone: 4. Name of Lending Institution: a�0,l - D,--- & 5— Mailing Address: —C1�'�f //.111-5— 41y Phone: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description:'40-1— 3 Bl—<' 0*4 / ! �r -6 UA Location: /17/✓z2 /�/� .�ffE)US�o"> G�✓!J O�iall 7. Type of Facility to be Inspected: 41S�Z��No. Bdrms. 8. Water Supply etd/V?All cw� Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility—individual Individual (on-site) 1!7,7(o �— If Individual, date of installation �� i 72-003(3/76( i BLK 5 l - LOT 3 Certificatb of Occupancy ; 05 56 su6D Valli Vu P. MUNICIPALITY OF ANCHORAGE 11 Department of Public Works Building Division 3500 E. TUDOR ROAD a TELEPHONE 279-8686 THIS CERTIFICATE ISSUED PURSUANT TO THE REQUIREMENTS OF SECTION 306 OF THE UNIFORM BUILDING CODE CERTIFYING THAT AT THE TIME OF ISSUANCE THIS THE VARIOUS ORDINANCES OF THE MUNICIPALI FOLLOWING: New 6uiidinq. Si TYPE OR PORTION THEREOF, WAS IN COMPLIANCE WITH REGULATING BUILDING CONSTRUCTION OR USE, FOR THE Famii OWNER OF BUILDING Herzoq - ADDRESS Main Tree Dr. 81111 Film; ADDRESS Pain Tree Dr. LOCALITY Anchorages Ak. s - BY: sm DATE: 2/15/77 — NOTICE — No change shall be made in the use or construction of this building without prior notice and certificate from the -4 POST IN A building official. 84-003 (3/76) 3939-76 This certificate shall, except in the case of dwellings, be so conspicuously posted in or upon the premises to which they apply that the same may be readilyseen by anyone entering such premises. AUTHORIZED OFFICIAL ONSPICUOUS PLACE