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VALLI VUE ESTATES #2 BLK 5 LT 14
Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201136 PID Number: 015-123-43 Dwelling: Single Family (SF) with ADU Duplex (D) Two Single Family Project: New Upgrade Name ROBERT & PATRICIA NIELSEN ABSORPTION FIELD - EXISTING Deep Trench Wide Trench Bed Mound Site Address 6831 CROOKED TREE DRIVE, ANCHORAGE Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 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 14 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 Toi Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft2 Ft. Well 20Q'+ __ 25'+ TANK Septic S.T.E.P. Holding Other Manufacturer GREER Capacity 1500 Gal. surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks No connection was made to original, abandoned field. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 3034 Installer PCN drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection151 6/4/20 �0 6/5/20 Location and description dates: 2 3 r 41h GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL .d Conditional Approval: Date,: F Al w ` /` ` Septic System • . • • `� Curtis Huffman AEA rov •\�`4 Date `� �� ;;- CE 128991 4 F fIF • . ,6/10/2020. Note: this approval does not include well permit requirements.'�`5,`"'`m (Rev Ob/02/18) VALLI VUE ESTATES #2 B5, L 14 PID: 015-123-43 / ';� d\ <-k ,F, 4� WATER LINE Dc� APPROX. LOCATIONS, SERVED BY CLASS A PUBLIC WATER PAVED D/W PERMIT: OSP201136 G ti a6 OGs� a�� INSTALLED NEW DA 1500 -CAL HDPE D ® MH SEPTIC TANK / •CD O" CO 0 CONNECTION X99, O�FO MAD TO FIED1979 CPQ •�g ®/ .BOJ 2\ ' <1 A A—C=14,1' B—C=37,5' A—D=1&6' B—D=40.2' SEPTIC SECTION VALLI VUE ESTATES #2 135, L 14 PREPARED FOR: ROBERT & PATRICIA NIELSEN 6831 CROOKED TREE DRIVE ANCHORAGE, AK 99507 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK©gmail.com SUPPORT® SERVICE DATE: 6/11/2020 SURVEY: FH 9/2/05 DRAWN: FWCS SCALE: 1" = 30' SCALE, NTS OF A.L� *ir�t TH isHuffman r CE 128991 w 6/11/2020 �10, �D�ssioK�' r Surveys, LLC Project No: 20-192 Ordered By: Stevi Alford I LOT 13___ ryy9pv �p 81, Lot 14, Block 5 pe Valli Vue Estates #2 tip 29,161 Sq. Ft. 6831 Crooked Tree Drive _ 3 Story Wood Frame House _ w/Attached 2 Car Garage PAVED DRIVEWAY qPv ® a SHED rT RETAINING WALL \\ Zwo O �8 �O O 4 'rte rna, O 'off s'� C, L 30/x. ' y Electric Meter/Outside Power Found Rebar y Gas Meter ® Deck Fence $; Septic Water Valve Mailbox EL Elec. Pedestal Date: 6/12/2020 St \ `S rLL$�I' YS 6 31 1 p1 \ _0 3 LOT 15 General Notes: 0 20 40 80 1 Plat: 77-296 I Grid: 2538 3. All measurements/setbacks are to the visuallapparent building footprint. Scale in Feet 4. All dimensions to property lines are plus/minus 0.1ft. \ LE, This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and LE conditions s document does not constitutes subject to any ir O /� �1 inaccuraciesuracies that a subsequent bou dory survey may reveal. veal. It responsibility of hOwner Ow to determine he • . ; 9s 11 •. �,9 JJJ existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances — should this document be used for construction or for establishing a boundary or fence line. JJ AS -Built Survey of. �S 3399 \ \ Lot 14, Block 5 Valli Vue Estates #2 I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or o SHED \ N \ 0 ttt�9F0 •''•......• '• ayJ- \ , �. \ 1111 pROFESSIONAU y" IItIt«��������� \ t_ u \ \ m m \ 907.460.1686 - info@frontiersurveys.com &"�*z PROFESSIONAL SEAL www.frontiersurveys.com m 330 \ 2ND \ St STORY DECK \ St \ `S rLL$�I' YS 6 31 1 p1 \ _0 3 LOT 15 General Notes: 0 20 40 80 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visuallapparent building footprint. Scale in Feet 4. All dimensions to property lines are plus/minus 0.1ft. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and F j 1111+ conditions s document does not constitutes subject to any ir O /� �1 inaccuraciesuracies that a subsequent bou dory survey may reveal. veal. It responsibility of hOwner Ow to determine he • . ; 9s 11 •. �,9 JJJ existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances — should this document be used for construction or for establishing a boundary or fence line. JJ AS -Built Survey of. (� H ><i ' "' '"" """ '' Lot 14, Block 5 Valli Vue Estates #2 I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or 9 '• Vier M.St gier �= JJ IS •• N ,B. ,_ �� JJJ r� os/terzozc = under my direct supervision on June 11th, 2020. ttt�9F0 •''•......• '• ayJ- 1111 pROFESSIONAU y" IItIt«��������� Frontier Surveys, LLC FRONTIER, 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 907.460.1686 - info@frontiersurveys.com &"�*z PROFESSIONAL SEAL www.frontiersurveys.com 6/1/2020 MUNICIPALITY OF C�5 i ft' -'Of Development Services Department On -Site Water & Wastewater Section T Parcel I.D. 015-123-43 ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) ROBERT & PATRICIA NIELSEN Day phone 907-360-1772 Mailina address 6831 CROOKED TREE DRIVE, ANCHORAGE, AK 99507 Site address 6831 CROOKED TREE DRIVE, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #2 BLOCK 5, LOT 14 Legal description (Township, Range & Section) Lot Size 29,161 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade F Duplex (D) ❑ Holding Tank ElRenewal 1-1Multiple 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: Date of Payment: Receipt Number: Permit No. G'5P20113& Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com May 26, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: VALLI VUE ESTATES #2 BLOCK 5, LOT 14 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon HDPE Greer as shown on the attached design to serve the existing 5-bedroom residence. The lot and area are served by a public Class A water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201136, Rebecca Carroll, 06/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201136, Rebecca Carroll, 06/01/20 Municipality of Anchorage Page ! of ,'~'~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: '~e~ ~ ~'~l~ Wastewater System: D New ~Upgrade Address: ~/ C,~o~ ~ ABSORPTION FIELD Phone: ~[~ ~ JNo. of B~oo~: ~DeepTrench ~ Shallow Trench ~Bed ~Mound DOther Total Depth from original grade: LOt: i ~ Block: Subdivision: ~ Depthtopipebotlomfromoriginalgrade: Gravel depth be~eath pipe · ow..~,p:,~,~ I.e..e: ~ Section: ~ Fill added aboveorigi~l~de:. Ft. Graveilength: WELL: D New D Upgrade Gr~ve~:~t~: ~ ~ I Numberoflines: ~Dista~cebetweenlines: Pipe material: Driller: Date Drilled: StaticWater Level: Installer: SEPARATION DISTANCES ~ s~pt,c ~ Ho~di.~ ~ s.~.~... To S~p0c Absorption Lift Holding ~ubJic/Priwte Manufacturer: Capacity in galJo~s: ~ Material: Number of Compartments: Well Surface Wafer ~/~ F~ LIFT STATION Lot Size in gallons: ~ Manufacturer: Cu~ainDrain ~ ~ U Pump Make & Model ~ Electrical Inspections performed by: Remarks: BENCH MARK 72-013 (1/91) MOA 25 JN SC,4LE, 1' = SO ,cE ITO~]~EN SPURKLAN]) P'E' IIL~?- 203 W 15TN, AVENUE ANCH, AK. 99501. DI~NALD STEELE 6831 CRI2flKED TREE DRIVE SEPTIC SYSYEN AS BUILT DAYE, ND~ 2~ 1991 Nonltor Clean Elu~ S~ondord Trench; 60' LDNG TO[AL ]2' ~EEP 8' ElF SEN/ER RElCK 4' mln. Cover Cleon 10 MIN · Monltor Cleon Elu_f_._;_I I EXIS TING TRENCH Mech, Plu9 & 2~4 8 Peet o£ Septlc Rock Nionltom 4' Cover 1500 GAL SEPTIC TANK EXISTING 1500 GAL SEPTIC TANK .I O l ./ Ex~si:, Ground 4' Min Cover over Tank TDBBEN SPURKLANZ~ P,E, II II 203 N,/15TH. AVENUE ANCH, AK. 99501 ~177 r, 77-,~16 LOT Z4 J2LDCK 5 VALL] Z2DNALD STEELE 683] CREIDKE~ TREE VUE SHEET, 3/3 6RZ~, Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: (ENGINEER'S sEAL) ~/~ ~/~Township, Range, Section..~j / ~' ,~.\ SLOPE SITE 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O A WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT ~- DEPTH? pO E Oeplh Io Water Aiter Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop ECEivE[ Dept, Fe~lth ~, Humtn PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ ~A ~/- '&;¢('IZ/'/V CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: I /' ~ ~ ~ , 72-008 (Rev. 4/85) PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910356 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:STEELE DONALD & OWNER ADDRESS:6831 CROOKED TREE DR ANCHORAGE, ALASKA 99516 DATE ISSUED:il/05/91 EXPIRATION DATE:il/05/92 PARCEL ID:01512343 LEGAL DESCRIPTION: iVALLI VUE ESTATES #2 BLK ~T 14 5 L¸ LOT SIZE: 29161 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 2. 3. 4. RECEIVED BY: ENGINEER MUST PROVIDE ADDITIONAL TESTHOLE AT WEST END OF TRENCH TO VERIFY SOILS THROUGHOUT TRENCH LENGTH. ENGINEER MUST VERIFY INTEGRITY OF EXISTING SEPTIC TANK AND INSTALL NEW ONE IF NECESSARY. INSTALL ADDITIONAL CLEANOUT AFTER TANK (TOTAL OF 2) AND CLEANOUT ON DIVERSION VALVE. NEW TRENCH MAY NOT ENCROACH~N DRIVEWAY/PARKING AREA. ISSUED BY: /f- ~- ~/ / BL DCK ~ ! ! 34 DCK 6 N SCALE: F -- 100 FT, £50 TOB3EN SPURKLAND P.E. 203 W /5TH. AVENUE ANCH. AK. 99501 DL1NALD STEELE 683] CRDDKED TREE DRIVE SEPTIC SYSTEH DESIGN DC, rE, NDV, 1 1991 SHEET, 1/3 6RItJ, 2_539 WALL . · *,5',%~.~ ~ ~,'*~,~,~ ~ PR~ED ~IVERTE~ VALVE 99. ~" PRDPDS~E~CH 25 ~0 Is 100 125 150 TOg~EN SPURKL^N~ P.E, I[L~T 203 W 15TH, AVENUE ANCH, AK, 99501 DDNAL]? STEELE II 6831 CR{]{]KED T£EE DRIVE SEPTIC SYSTEM DESIGN DATE, N~ ! 199! SHEET, P/3 6RID, 2539 Clean Out O Hodtor 6O _1 Clean aura S~ondord Trench: 60' LONG TO?AL ]2' DEEP 8' OF SEWER ROCK 4' min. Cover Monitor Clean Cleon Out EXISTING TRENCH 10 INSTALL D1VER TA VALVE EXISTING ]SOO GAL SEPTIC TANK Feet o£ Septic Rock - ExL~t:, Ground 4' ~'0 Cover ~over Ton/< TDBBEN SPURKLAND P.E, ~03 ~15TH. AMENUE ANCH. AK. 9950) LOT 14 BLOCK 5 YALLI ~DNALD STEELE 683I CR£OKEY} TREE VUE SEPTIC SYSTEM DESIGN BATE, NOV. ], 1991 SHEET, 3/3 G~D, 2539 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: L~"~; WAS GROUND WATER ENCOUNTERED? iF YES, AT WHAT DEPTH? 10 11 12 13 14 15- 16- 17- 18- 19- 20- (EI~GINEER'S SEAL) DATE PERFORMED: ~.. Township, Range, Section: 7~N t~-~ SLOPE SITE PLAN De,th lo Water Aite~ , Moniloring? ~ Date: S Reading Date Time ;¢q 7: 7~ Net Time It.) Depth to Net Water Drop ~O '~ //~o~ q PERCOLATION RATE ~' (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN -'~ FT AND ~1~ ~' FT COMMENTS PERFORMED BY: I ( - ~' CERTIFY THAT THI TEST WAS PERFORMEO iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / 72~008 (Rev. 4/85) ANCHORAGE, ALASKA 99501 (907) 279-3916 LI~T SEPTIC SYSTEM DESIGN BLOCK 5 VALLI VIlE DONALD STEELE ESTATE No Ground Water or- Impervious Layer to Use Standard Trench Soil Rating. From test Oct. 23,~ 1991 5 rain/in =1.2 gal/rain 18 'F t. Required Area per Bedroom: 150/ .8= :87.5 sq.~t.. Finished Fl~or E].evation Lowest Floc~r Gr'c:iur~d Sur-Face at Absorption Fie].d -Festhole Total Depth Lees 6 ~eet 6 I..ees Cover 4 Roc. L D ~p ~:.h 18 ~t 10 8 1 } 'Z. "0 10 A + - Number o~ Bedrooms 5 Length c).F Trench 187.5).,' 5 /(2x8) SYSTEM CONFIGURATION = 58 STANDARD TRENCH TOTAL LENGTH 60 FT. TOTAL WIDTH 5 FT. TOTAL DEPTH 11 FT. ROCK DEPTH S,FT. COVER 3 FT. SEPTIC TANK 1500 GAL. EXISTING The installation o~ this septic system wi].], not prevent w~lls -~rom be installed on the adjacent lots. Sept:~c System Design L..ot 14 Block 5 Valli VLe Estate pg. There~ are no developed or r.~atur,a! surface / sub sur-~ace dra:[nage . ' ~-~'-- this or' 'J:he adjacent lots. The proposed sep'tic system will not chap. ge the general slope the area. Ponding and/or concentr'ation o~ surface runc~ ~/,dll not result ~rom this installation. ~3E~ptJ. c: System Design Lot 14 Block 5 Va].li Vue Eetate pg.2 203 1tISTH, /t?E, ~IJETE 206 ~ICHORAGE~ ~LA~KA 9~501 SPECIFICATIONS FOR SEPTIC SYSTEM INSTALLATION LOT 14 BLOCK 5 VALLI VUE ESTATE SEC 14 T12N RSW 1.0 GENERAL il.. I Owner is Donald Steele~ 6831 Crooked tree Drive~ An- chora~e Alaska 99516. Phone 346--2829. 1.2 Engineer is tine person or entity hired by the Owner to inspect this prc~ject~ The Engineer must be recognized by the Municipality of Amchorage~ Department of Health and Human Services. ]..3 Contractor is the person or entity hired by the Owner to install this project. The Contractor must be recognized by the Municipality of Anchorage~ Department of Health and Human Services. 1.4 The Drawin~s~ sheets 1 throu§h 3~ shall be part of this specificati~n~ :1..5 Al]. materials and workmanship shall meet the require- ments of the Municipality of Anchorage~ Dep~lrtment of Health and Human Services~ the cc~nditions of the permit~ and all applicable rules and regulations currently im effect. J..6 Ali. excavation depths are advisory~ and are to be verified and may be modified in the field by the Engineer~ 1.7 It is the responsibility o.F the Owner or the Contractor te adhere to the approved design~ to verify that the speci- fied separation distances are met~ and that the required inspect, i_ons are performed. 1.8 The Contractor or the Owner shall report to the 'Engi- neer any observed condition ~hich weuld put the septic system in wiolation e~ State or Municipal regulations., 2.0 SEPTIC TANK 2.1 If there is an existing septic tank, it may be used if it meets tine capacity r-ecluirememt for the residence. The tank shall be inspected by the Engineer~ and its water' tightness and structural integrity shall be verified. 2.2 A ne~ septic tank shall be one fabricated by either Anchorage Tank and Welding or- by Greet Tank Speci.fications-for' septic system installation L(~t 14 Block 5 Valli Vue Estate pg. 1 The septic tank shall be a UPC--approved two--compartment tan,~::~ constructed of 12 gauge~ or better~ steel with bitu mastic coating. The tank shall be se~ level on undisturbed soil. The tan~ shall be covered with the equivalent of four feet of soil. 2.3 The septic '~ank shall be installed a minimum of five feet from the house foundation and a minimum of five ~eet from the absorptien area. 2.4 The septic tank shall be a minimum of 100 feet. from any well serving a single residence; 100 -Feet from any body of water~ creeks or drainage ditches with flowing water'; !50 feet from Class "C" welts~ and 200 feet from Class A or Class B wells. 2.5 All pipe conne~."tions te the tank shall be mechanical watertight c:alder couplings. Cleanouts shall be installed as designated and capped wi'~h air-tight rain caps. Clean- outs shall extend a minimum of 12 inches above final ground elevatien. Provisions shall be made for landscaping and importation if tepseil. 2.6 Lift station shall be as manufactured by Anchorage Tank and Welding 3.0 ABSORPTION FIELD 3.1 Gravel used in the absorption field shall be {7.5 to 2.5 inch screened reck~ with less than 3% passing the No. 200 3.2 Sand~ used for leveling or for' fi].tering~ shall have art effective grain size between No. 40 sieve and No. 18 sieve. Uniformity coefficient shall be less than 4~ Not mere than 5% by weight shall pass the No. 200 sieve. 3.3 4-inch perforated pipe shall be ASTM F810. For' pres- sure distribution~ pipe shall be Schedule 40 PVC or ABS. 3.4 Solid 4-.-inch pipe shall be Cast Iron or ASTM D3034. 3.5 Monitor standpipes shall be installed as shown. ]"hat section of the pipe pene'l:rating the gravel shall be perfo- rated,~ either by drilling 0.5" holes on 6-inch centers or by joining a section of F810 perforated pile to a solid section of pipe. 3.6 Geotextile shall, be Mirafi 140. 3.7 Insulation shall be extruded direct burial polystyrene. Dow Chemical Styrofoam HI 4{7. ~.8 Topsoil shall be a mixture of 40-60% organic matter~ Specifications for' septic system installation Lot 14 Bleck 5 Valli Vue Estate pg. 2 20.--30% sand and more that 20% si lt. measurE, d by vol t~tme. All quantities are 3.9 Grass-'. seed shall be Kentucky bluegrass. 3. 10 Diversi(~n valve shall be NATIONAL DIVERSIFIED SALES INC. "DIVERTER VALVE" as supplied by Western Utilit. ies. 4.0 INSTALLATION 4. 1 Lecate al 1 underground uti lities ~ property lines ~ ~uture driveways~ e,~isting or proposed water wells~ water ways, eur~ace and eob surface d~ainage ~acilities,~ lakes,~ ponds~ aed all other ~acilities requiring separation dis- tar~ces ~rom the proposed septic system. Notify Owner or Engineer cr~ any observed possible con-~lict. 4,,2 Stake alignment of system with markers showing the protective distances ~rom wells and water bodies. 4.3 Establish an elevation benchmark~ ]'his BM shall be eaeily identi~iable, stable and permanent,, An arbitrary elevatioc~ o~ 100 can be assigned. 4~4 Install the tank as shown on the drawings. Record the inlet and outlet elevations o¥ the tank. Tank shall be placed on undisturbed native soil. 4.5 Excavate the absorption -~ield. Bottom o~ excavation shall be level and scari~ied~ I~ sidewalls smears~ they shall also be scari¥ied,, Record elevation o~ beginning, middle and end o~ trench. Record elevatJ, on o~ each corner and center point o~ bed. Construction equipment shall not operate on the ~loor o¥ the excavation. Any material com- pacted by the operation o~ the construction equipment shall removed and replaced with uncompacted materials. 4.6 Place the rock to the depth specified. Do not contami-- hate rack with native ma'~erials or spoils ~rom the excava- tion. Level the rock surface (+-1") be~mre installing the per¥orated pipe. 4.7 Install '[he distributimn pipe. Record the elevation o~~ each joint. For pressure system solvent weld the joints,, 4.8 Cever excavation :i. r; s u ]. a t i o n, the distribution pipe with rock, arid cover the with geetextile be~er'e backfilling and placing i~ required. 4.9 Record the ~inislned ground elevation at the beginning~ middle and end o~ trench. Record the ~inish ground eleva- tion a'[ each corner and at the midpo~.ot, o.~: the bed. 4.10 Furnish a copy of all sorvey notes to the Engineer. Speci¥ications ~or septic system installation Lot 14 Block 5 Valli Vue Estate pg.3 5.0 INSPECTIONS 5.1 A minimum of three inspections are required. The first inspection will be of the open excavation. At this time the soil conditions will be observed and compared to the design assumptions. Ground water conditions or presence o~ bedrock will be verified. The second inspection will be aYter placement of gravel, standpipes~ distribution piping~ tank(s) and ether compo- nents ass specified. The third inspection will be after' completion of the ~ork. Any deficiencies will be noted and the Contractor notified. Such deficiencies shall be corrected ~,ithin ten days. 5~2 All electrical work requires either an MOA electrical inspection or certification by an licensed electrician. Submit proof of inspection or certification to the Engineer. 5.3 Submit catalog data of all mechanical equipment. 5.4 Notify Engineer at least 24 hours in advance c:~f begin- ning any work. Specifications for septic system installation Lot 14 Block 5 Valli Vue Estate pg. 4 NAM 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 ~UPGRADE MAILING ~% LEGAL DESCRIPTION .~ ~ I DISTANCE TO: ~ z Manufactu~ DISTANCE TO: NO, OF 8EDRO~ No. of co~,~,,artments Width Dwelling Well Foundation rest lot line No. of lines Top of tile to finish grade Length of ea¢~.~.LD~t Total length of li,~. I Material beneath Length Width Depth Type of crib Crib depth PERMIT NO. Liquid capacity PERMIT NO. effective absorption area Well foundation Depth Driller Distance to lot line DISTANCE TO: Building foundation Sewer line Septic tank OTHER PIPE MATERIALS SOl ~EST ~TING INST ER REMARKS PROVED 72:013'(R~. 3/78) DATE LEGAL F'I:{fi:H ]: 'r NO. I::iF:'PL I Ci::!I'.,i-i" CU':S'FEIt,! :{];"f'RI._I(]:'I"LII:::'.[:Z[a; l NC ~ E:OX :bk;~'-5:ii:± :})95':.:i!2 LOCFiTI'ON CREIOKE!::) TREE I..!i::(3FIL. !2La,. E~5 ',,,'FILL:[ ',,,'UE S,-'"[) LOT ~-'_'5~)EH~:iI '_:!;~;:[I..II:'tRF~ FEET 'T?F'E OF' 5OIL. I.':IE:¢:;OI:4:E:'I']:EIN '.~;q.'~i;'f'Ehi :IS: "f'I-;~:F. NCH ?!R;:4_~:I"iLff'I h!I. If,!E~ER :F: EF::Z,!:;:ZZI',I'ii == ? SOZL F;:F:IT!i'.,!di ,:::!i;6:! [-I,..E,!,..... .t ...... THE [;;:E(;!U i[ RIEl) 2; I ZE OF THE '_E;O I L.. f:lB~i;OlTF'-r :( ON ~;'¢t:~;TE{',I 1:5: THE: LE!qEi'f'H [:,]:P'IEi',IE;):Eff.,t ):E; THE LEF,!GTH ,:::[i",l '['HE [:,EPTH OF FI TR[.-'.:i'.,!E:H OF,: PIT I:E; T'HE [:, :[ 'L:;TFLI',!C:E BET.[,.!EI::~]',! TIqE '_--:;LIRFFICE OF THE: E¥;.'.OI. JF,I[) F:lJ'.,IP "I'I-{E ErOT'TOi?I OF: THE E::.::CFI',,,'F:ITJ:O!',! ,;:iN FEET'f'>. T'r.iE,[,;:E :r.:i~; i'qO SET !.,.IZDTH FOF?. 'FRENCHE:5. 'Fi. IE GFd:::I',,,'EL [>IEF'TH ][!~; THE blI!'.,llf'l. Ui',l DEf:'TH OF:' EiRF:]',,,'EL E:E::'FI,~EE~N THE OUTI::'!ZlL.I._. Pi'PE; F:II-,ID THE E',I3T'I"Cd,'I OF: "I"HE E2,:.:',I_-::f:t',,,'F:ITION ,{]:l'.,I FEET>. F'E;Fi:[','i):T I:::IPPL]iE:FIhFf' HFtS -rile F~:ESPON:E;.T_E:IL.I'T'.? TO I!qFORI',I :[ N:~F'Ff::II..L.FtT I O1'..[ I ,~..I:~!;P[.T.E:T Z CiN~!~.; O1::' F~N'T' i'.,!I. Ji',E3ER Ci[:: IRE:E;IB, ENCE~; "f'HFIT 'THE: I-,IEt..L. ]'HIE; [>EI:'f::iRTPll:.T.I'.,IT [:'l_hrF:'.:[NG THE!: l'l'iI!~; F:'REIF'I.:.:FT:T'-/ F:IN[:, THE E:RCKF' :!; L.L :1: !qG ElF F:IF,!~¢ ?./STEi"I t,.I ]: 'FHCIUT F' :[ NFl[. [:,!~F:I::!F?.Tf'tENT HIL. L. [!!',E i~;UE',./rE33T 'T'O i'i :[ l'.,I :( f'lLti,! I)]: :E;"FI::II'..!,CE E~E TFiEEN I::1 NEL.[.. FIND Ffi",!'T' ON--":E; I TE ~;EkIRI3E [:, :[ SF:'OSF:![. :E;'T':E;'T'Fd"! ;[ ~; :j. En;::.~ FEETf' FI:3R Fl I:::'F~:I',/F:ITE f.,.IELL.~ CII:R ::iSE~ TO 2E~G FEET FRO!'4 f::l PLIBL.]:C: I,!ELL. [:,E:P[EN[)];NG LIPON THE T"/F'E OF' PUBL. ZC HEI....[ O'I'HER [~:[Zl:::it..I][[,;:[~:l'd[~;l",lT:~i; HF:I"~' RF'PL'T'. :E;F:'ECZFIE:F]TJ:ON:F¢ FIND I:::CtF,!IE~;'!'Iii:I.IE::-f':[IZI!",t [) )71:tl31:~'.Fl[4'.:~; I::'![;'.[C FI',,,'FI]:Lfi~E~I..E TO ]:NSLIRE PROPER II",ISTFi!_.LEIT:(Oi".I. ::[: F:'OR'rH I.%.' THE i',!I.JN:[C:]:PF:IL.}:T'-¢ 0[::' F:!I'.,ICttCIRFIGE. 2: Z ].,IIL/.. !N'STFIL. L TFIt:-..' '_:~;'.,.".FJTEH :[i'.,! FIE:CORDF:II'.,ICE H.['T'!t 'T'HE :~:: Lr UN[)I~:F;:':'STFIND THF:IT TIi[E (3N-::':;]:TE: ~i;E.7i.,.IER '.~;'-,.':':];'f'E:PI t','[F:FT' !:,~:I:Ei;:!I..tZRE ~:{NLF:it::::G[EI',IEI'-,!T :[[::' THE: RE~ii;:[[:,EHC:E Z::~; I,?.EP'IO[)E:!~E.:[:, TO :I:NCL. LI[:,[F: i',1ORE THFff..I 5 I::[F'PL ]: d:.t':l~[ E:Ll:ii;Tt)l'l '.:i;TF~I_I(::TIJ[;~:~ CL:]I'--'.'.T ]; F'T' TI-iF:IT ): F:tI'd F'Ai','I:[I_iFIR I.,!]:'I'H Tt,IE RE6~U:£F:EP'tEh,FI"'_:~] F'OF~: ON.-.'-:~;IT,.r'~: :!.~;E!,IE'R:?.; laND kiEL.!_..'_:~!; MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVI RONNIENTAL PROTECTION Pouch ~650, Anchorage, Alaska 99502 276-2221~ SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: Custom Structures DATE PERFORMED: 5/21/79 LEGALDESCRIPTION: Lot 14, Block Sandy Silt (HL) Brown, Si. Moist 7- 8- 9- __10- 11- 12 13 14 15- 16 17 18 19 2O Gravelly Sand (SW-SP) w/cobbles grading to" Sandy Gravel (GW-G~P) w/cobbles Brown, Si. Molst 14.0 ToDo Valley Vue Subdivision~ SLOPE 2.0 '~.~ WAS GROUND WATER N 0 ENCOUNTERED? IF YES, AT WHAT n a DEPTH? Unlt No. 2 SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop 1 ~/21/79 12:55 - 0.14' 2 1:00 5 rain 0.67' R.53' 3 1:05 5 " 0.89' 0.22' 4 1:06' - 0.11' - 5 1:11 5 ~in fl.61~ R.51] 6 1:;16 5 " 0.77' 0.16' 7 1:21 5 " 8.87' fl.lFl' PERCOLATION RATE 5 rain/inch minutes/inch) TEST RUN EETWEEN ~.0 , FT AND 6 o0 FT COMMENTS PERFORMED BY: S. Shrader CERTIFIED BY: $. Shrader DATE: 5/21/79 72-008 (7/76) \ ¥~A CT B \ \ \ It is the responsibi]/ty of the owner or bu/lder, prior to construction, to verify the proposed building grade relative to finished grade and utilit~ conncct,;ons and to determine the existence of any easements, covenants, or reatrictions wB/ch do not appear on the re- corded subdivision plat. ,gC~OLD S~WARD HI ~HWAY CAt_E:/": '5-~' .~.~~ ,/',JO']- LOT' VA,,; GRID: Z.5'.~$ ,; q 3ROJ. NO: )WG. //I MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-123-43 ANCHORAGE Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: t , ` — Ct r2 O Z L 1. GENERAL INFORMATION Complete legal description VALLI VUE ESTATES #2 BLOCK 5, LOT 14 Location (site address) 6831 CROOKED TREE DRIVE, ANCHORAGE, AK 99507 Current property owner(s) ROBERT & PATRICIA NIELSEN JOINT REV. TRUST Day phone Mailing address 6831 CROOKED TREE DRIVE, ANCHORAGE, AK 99507 Real estate agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank' ❑ Community Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J6b – Irl-A•5D Waiver Fee $ Date of Payment (P IQ I �zo-,* Date of Payment Receipt Number Receipt Number COSA # 10 6 « Waiver # Distance: COVID-79 ' 25?'o DISCOUNT APPLIED 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/6/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the N system and maintenance. 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 P"� • •�"1�``� well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FW[.S *� -49 6. DSD SIGNATURE Curtis Huffman •� System #1 Approved for bedrooms �m,�r CE 128991 �l�F���pROfES ONPLc.,�,.r System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following sti` �{itildl(f/�� �.Qg`TY OF :�C, ON-slr �- /A r, 6 a Original Certificate Date: rZ _00 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 Legal Description: VALLI VUE ESTATES #2 BLOCK 5 LOT 14 Parcel ID: 015-123-43 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA — PUBLIC CLASS A WATER ❑ 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) 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) 11/13/1991 ® ALL standpipes present per record drawing Total measured depth from grade 13.5 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? I-1 Yes n 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 5/22/2020 Results M Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 0 in Elapsed time <1 min ® Code -required soil cover over field Final fluid depth 0 in F-1 System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies:. NIB E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) NA— PUBLIC WATER Septic Tank/Lift Station on Lot > 100' if No ft Community Sewer Manhole/Cleanout > 100' Property Line > 10' ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100'❑ Yes if No ft ____ Holding Tank > 100' _ __ _ ❑ Yes if No ft Neighboring Absorption Fields > 100' F. ENGINEER'S COMMENTS Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft ❑ 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' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review ,AM',�f. . •' •' •�e���� of Municipal records that the above systems are in conformance •;� �� with MOA COSA guidelines in effect on this date. : • • 'rH • • . •': . • Curtis Huffman jq,•.• CE 128991 •. �® #0,�t,,-'°ROFESSION��-�® Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~,/,~ I~-- ~ HAA# /~/~/~/~ GENERAL INFORMATION Complete legal description t_o-'~' Location (site address or directions) Property owner Mailing add?ess Lending agency Mailing address Agent Address Day phone Day phone %Day phone Unless otherwise requested, NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: TYPE OF WASTEWATEFI DISPOSAL: Individual on-site Holding tank Community on-site Public sewer HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmat!on from State ADEC attest- ing to the legality and status of system. :,., If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72*025(Rev, I/91) Front MOA~21 = STATEMENT OF INSPECTION BY ENGINEER As certified by my sea[ affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm t ~-~ ~'~~ Phone Address o~.~C~ ~ U~ I ~ ~ Engineer's signature ~ ~ Date 1, ~ ~q~ DHHS SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~)25 (Rev, 1/91) Back MOA #21 Legal Description: A. WELL DATA Well type ~ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. O J ~ -- t ~-,~ -- {"[ ~:~ If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION g.p.m. Septic/holding tank on lot ; On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main Sewer service line WATER SAMPLE RESULTS: Public sewer manhole/clee, nout Petroleum tank Coliform Date of sample: Nitrate Other bacteria ' Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size I ~'~'E~ Compartments Foundation cleanout (Y/N) Y Depression (Y/N) Alarm tested (Y/N) Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots Foundation Absorption field /'¢O Water main/service line /-¢/,~ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level · "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed I I/l"~q I Length c/P0 Width Total absorption area Depression over field (Y/N) Results (pass/fail) Soil rating ~' System type ._"~ Gravel thickness ~ Total depth ~ f/~'~) Cleanouts present (Y/N) ["f/ Date of adequacy test ~for ~ bedrooms Peroxide treatment (past 12 months) (Y/N) /'-4 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain ~/~/"'~ On adjacent lots Property line t'7/(~ To existing or abandoned system on lot Cutbank /'¢/,,~ Water main/service line Driveway, parking/vehicle storage area E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Engineer's Name HAAFee$ / 70~ Date of Payment Receipt Number ~ ~ ~-/~- Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) BSCk MOA 21 DEPT. OF ENVIRONMENTAL CONSERVATION WALTER J. HICKEL, GOVERNOR ANCHORAGE DISTRICT OFFICE 3601 "C" STREET, SUITE 322 ANCHORAGE, ALASKA 99503 563-6775 November 15, 1991 FOR: Tobben Spurkland PWSID#210605 My review of the records on file in this office reveals that the Valli Vue Subdivision Ctass "A" Public Water System, is in compliance with the routine coliform bacteria samples requirements listed in Table C, and with the inorganic sampling listed in Table B of 18 AAC 80.200. Si~cerely, Byron Roys Environmental Engineer BR/of MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTiOI'~ DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block~ subdivision, section, township, range) Location (address or directions) (b) Applicant Name ;~,'~,, ~'i~-¢[ Telephone: Home ~~"{'~-.2,,~2 9 Business ."2 '~&-~'4-/~l Applicant Address ~_~,,~ u-z (c) Applicant is (check one): Lending Institution []; Owner/builder ~; Buyer []; Other [] (explain); ~- ___ (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms ~ Other individual Wel~ Community¢ 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 Onsitefl~ Public [] Community [] Holding Tank [] Note: [f corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown beJow, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functionaJ and adequate for the number of bedrooms and type of structure indicaled 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 regulations in effect on the date of this inspection. NameofFirm ,~/L/m,~)"~},'~'r~l~: ~ ~,~.~F' Telephone T¢~¥4- ~'"/1/ Address ~1~ Date WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. ON-SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Approval inspection mere;y certifies that the subject on-site sewage disposal system accepted at least 150 gallons of water per bedroom per day as determined by methods approved by the Municipality of Anchorage Department of Health and Human Services. No warantee or certification is expressed or implied concerning the long term adequacy of the on-site sewage disposal system. Construction data reported on buried system components is from MOA files and was not verified during this inspection. Approved for/~ bedrooms by ~' Y /' / ~' ~.,~,~.~,¢''Tv ~ Date Approved ~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. 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. Page 2 of 2 WELL DATA Well Classification Well Log Present (Y/N) Total Depth M..,C,PAUTY OF A.C.O.A E CMO*, (] HEALTH AUTHORITY APPROVAL (HAA) 4f~A/. CHECKLIST - FEBRUARY 1984 v~/~. 264-4720 ~O ' OF ~ - · · NOI~]~O~ ~V~N~NOal ~. ~ 4~c~egal Descnpt~on: ~ AN~ .' ~ ~;, ~C~/o~.~/~ I I ~ ~ ~ 3 CJ Date ~2~,eted Yidd Cased to _ Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line cleanout/Manhole Water Sample Coliected by Water Sample Test Results Comments Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date installed Standpipes (Y/N) Y'~,'~ Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well Z<~ / To Property Line /'<~ / ~' To Water Main/Service Line ~ z ,,-- Course -~--,~ -~ Size /,:~'~'~'~'~'~'~'~'~.~','~ No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped "~/~'~ -~:~ ~' ;for '~. ,//,'"'~ Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72~026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata /~,,~.~ Square Feet of Absorption Area ~ '~' Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~-~:~ To Building Foundation ~'-~/ Lot -'/~¢ '¢~ To Water Main/Service Line c:~¢ To Stream/Pond/Lake/or Major Drainage Course Type of System Design Length of Field Depth of Field <~' · Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots C-'~'~·' TO Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that l ~¢~ec'tf 9d/', ve~.!~ed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed /./?/~/, ~~ Date ~/I/ Company ~q&~¢J~¢.¢ ~F~. W MOA NO. Receipt No. ~ ~ k Date of Payment Amount: $ ~ ~O Page 2 of 2 72 O26 {11/84) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD, GOVERNOR Telephone: (907} 274-~533 DATE: June 10, 1986 PWS I.O.# 210605 To Whom it May Concern: \~!~, ~:,.,~: According to records on file in this office the VALLEY VUE SUBDIVISION Water System is in compliance with the State Drinking Water Regulations Sincerely, Steven W./En~, PE Distric~ngineer GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274L4561 Date Received July 19, 1976 Time of Inspection d~.?~[]) ~ Date of Inspection 7-~ (7~/L~z4S REQUEST FOR APPROVAL OF ~-~. INDIVIDUAL SEWER & WATER FACILITIES ..~. ~ ~ FOR Appr0va] requested by: fA~l~ska Mutual Savincjs Bank Mailin9 Address: Post o£fico Box 1120 % Fran Brown Phone: 274-3561 x 233 2. Property Owner: Roger and Penny Bates Phone: 344-3717/277-1553 w ¸4. Mailing Address: 3761 Crooked Treet Drive Legal Description: Location: Lo~t~4 Block 5 V. allie Vue Estates ~2 Type of facility to be inspected No. of bedrooms 6. Well Data: A. Type /' ~m/~ ~,,~,m C~ Construction Sewage Disposal System: xD~a~ A. Installed C. Septic T6nk: 1. Size B. Depth D. Bacterial Analysis B. Installer ~.~12. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 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 twJ gages - Re~-'~'st for Approval o'f Individual .'~er & Water Facilities Legal Description ~,ot 1~1 Block 5 Vall±~.Vua tgstate$ #2 Comments Approved Date Greater Anchorage Area Borough, Department of Environmental Quality Disapproved Approval Valid for one year from date signed DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~2~ East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO. 2. Property Owner: Mailing Address: 3. Name of Buyer: VA FHA CONV r-~//[/'t'~/ Mailing 'Address: Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Day Phone:. Phone: .c~7~/'--J--'~' / Mailing Address: Legal Description: Location: Phone: 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility. ~ Individual if Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility Individual (on-site). ""~ If Individual, date of installation 72-003(3/76)