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Home My WebLink AboutKNIK VIEW BLK 1 LT 7Knik View Lot 7 Block 1 #051-031-30 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 Permit Number: 5 (,',.2 OttO0 '7 '~. PlO Number: ,,m,: ~rOv ~ld~r~ W.stewaler System: ~New ~ Upgrade *~"'~:0 ~t ~700~5' ~;~ ~K 9q56'7 ABSORPTION FIELD Phone:/ NO. of Bedrooms:~ LEGAL DESCRIPTION SoilRaling: {'~GPD/Sq. FI. [otalDepflifromori,ir,algrade:. 10~ ~i. ~ I~'~ ,I. ~,.~ .,,~,,, ..,..,~,..~,~ ~'~'"'~: '"'""""'~:~ ~ ~°'" ~'~'""~" ~'": ~In.,. ,~... I~' ~ a~o~ IF ~i'"'"'Z'""": - ~"""'~ ri. TAN K SEPARATION DISTANCES ~s~p~ u Ho~di.~ u s.~.~.~. ~ ~ ¢O/y~v t Number o, Oo,,,.artrnenl.: ~ S;r~r~ l¢~ ~¢'~ ~ ~ LIFT STATION ~ Inspections performed by:~=!~ R!~er, ~J-~k~ ~.~ Dates: 1st .... ~,~ RevDepartment ewed and approved°f Healthby: ~~and Human~ ~-~ r v~e SDete.approval.~. ~ ¢' ' *~'~*'t,,,.., ' .'",.,~ ~.o.*'~'0"'~""" "'"' .--"' ' PERmiT NO $W000072 PAOE 2 O? Municip. cH~ oF Anchorcae DEPARTMENT OF HEA~THAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box ]96650 Oanchorcge, Alaska 99519-6650 @Telephone: 343 4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 7, BLOCK 1, KNIK VIEW S/D P.I.D. NO. 051--051--50 PERN[? NO SW000072 PAGE 3 OF 3 Municip. aUt; oF DEPARTMENT OF HEA[TH SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box ]96650 OAnchorage A[aska 99519-66500Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL NSPECTION REPORT LEGAL LOT 7, BLOCK 1, KNIK VIEW S/D P.I.D. NO. 051 031 30 MT1 = 94.0 97.5'~ yFINAL GRADE ' INSULATION 93.7 CO1 C02 C03 MT1 MT2 CO1 C02 = 96.? H ~ ~ //~IC04 - 99.3' CO1 = 93 O' III ~co~ ., ~ Ioo3 - 9~.~ 91.5 91.5'ff MT4 = 91.4' MT3 = 91.4'~ A g !FCO 7.0' 27.5' ST1 10.5' 34.0' ST2 14.0' 36.0' DBL1 17.0' 37.0' DBL2 18.5' 58.0' C01 21.0' 24.0' C02 40.0' 42,5' C03 32.0' 13.5' C04 60.0' 52.0' MT1 23.0' 22.0' MT2 38.5' 40.0' MT3 55.5' 15.0' MT4 61.0' 51.5' NO WATER FOUND 85.4' B.O.H. Municipality of Anchorage. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESORIPTION: ( E N G I.~ii~il~Pl~F~L~ ) .:; * ........ DATE PERFORME~i.(~,-.G / O..g.. ~ ~ Township, Range, Section: 2 3 4 5 6- 7- 8- 9- 10- 11 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT '- O DEPTH? p E Depth t0 Water Alter ,~- -- Monitoring? Date: SLOPE SITE PLAN ;N I ,~ 5 p~ Reading Date Gross Net Depth to Net Time Time Water Drop )0 I0 ,~,,.~ ~ 3 " 5'-'"4" ~. 0 / ~ ~'~, ~ ! 9,. 3/~, ,, ..~- ,/.~" '~ o - ~ %" --- PERCOLATION RATE __ TEST RUN BETWEEN ). C~ (minutes/inch) PERC HOLE DIAMETER JO FTAND /] FT PERFORMED B : 17034 Eagle River Loep Road No. 204 i , ACCORDANCE W~J~J~J~T~TI~ J/~Ji~JJ~J~PAL GUIDELINES iN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT.7 ~. //3-Hi TEST WAS PERFORMED IN DATE: 00 MUNICIPALITY OF ANCHORAGE Depa~lment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Apr 24, 2000 Expiration Date: Apr 24, 2001 Permit Number: SW000072 Legal Description: KNIKVIEW BLK 1 LT 7 Design Engineer: 0003 S & S Engineering Owner Name: Leroy Alderman OwnerAddress: PO Box 670045 Chugiak, AK 99567- Parcel ID: 051-031-30 Site Address: Lot Size: 20103 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ~ Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Araska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN CONCRETE SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS PASSING THE #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED OR OBTAINED FROM AN APPROVED SOURCE. i'7-7-00 SOILTEST ROBERT C, COWAN, P,E, April 11, 2000 CIVIL ENGINEEr~ (907) 694-2979 FAX (907) 694-12 ! 1 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 1, Knik View S/D It is requested that you issue a permit to install a septic system to serve the proposed four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 4-4-00, no water was found. After seven days of ground water monitoring, no water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 7034 NORTH EAGLE RIVER LOOP · SUITE 204 . EAGLE RIVER, ALASKA 99577 1" = 60' DESIGN SITE-PLAN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 525 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR,PT'O": Township, Range, Section: /~//]~ SLOPE SITE PLAN 10 11 13- 14- 15- 16- 17- 18- 19- 20- IF YES, AT WHAT DEPTH? Depth to Water After _ Menitoring? /)/~- V Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~' ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN "~ FT AND ~;~ FT COMMENTS Eagle River, Alaska 99577 ' ' " ' ACCORDANCE WITR ALL STATE AND MUNICIPAL GUIDELtNES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/~) ROBE6~ C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-121 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 7, Block 1, Knik View S/D April 11, 20O0 GENERAL: The scope of this project includes the installation ora 1250 gallon~septic tank and a new trench to serve the proposed four bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval l~om the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH P~GLE RIVER LOOP · SUITE 204 . EAGLE RIVER, ALASKA 99577 Page 2 Lot 7, Block 1, Knik View S/D April 11, 2000 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 fi. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 7, Block 1, Knlk View April 1t~ 2000 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast kon Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 7, Block 1, Knik View S/D April 11, 2000 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251466 Parcel ID 051 -031-30 Legal description KNIK VIEW BLK 1 LT 7 Expiration Date: 10/20/2026 Site address 22433 INLET VISTA DR Current property owner(s) FIRST WATER CONSULTING X The On-site system(s) is/are approved for 3 bedrooms M Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date 10/21/2025 This C ificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sy m{s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, D elopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-031-30 Complete legal description KNIK VIEW BLOCK 1 LOT 7 Location (site address) 22433 INLET VISTA DRIVE CHUGIAK, ALASKA 99567 Current property owner(s) CHARLES P RADLIFF 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑ Private Well serving # dwelling units D Other Non-public well as regulated by MOA 0 Water Storage MR Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: FN Private Septic F Private Septic serving 2 dwelling units E Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: F Steel FE -1 Plastic 0 Concrete ❑ Fiberglass Age 25 _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: 7 AWVVTS F] Bed 7 Deep Trench � Wide Trench 7 Seepage Pit Waiver request for: Expedited review requested: 7 Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $_ 56-D Waiver Fee $ Date of Payment COSA # Date of Payment Waiver # COSA Application—Ap2025.doc COSA Checklist_May2025.docx COSA Checklist Legal Description: KNIK VIEW BLOCK 1 LOT 7 Parcel ID: 051-031-30 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA PUBLIC &/OR 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. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank *38” Date of pumping 10/20/25 Required maintenance completed, if AWWTS Comments: *This is a Premier Plastic tank. C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 7/7/2000 ALL standpipes present per record drawing Total measured depth from grade 13.3 ft (max) Measured depth to pipe invert from grade 7.8 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 1.33’ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/9/25 Results Pass Fluid depth prior to test 2 in Water added 620 gal New fluid depth 9 in Elapsed time 1440 min Final fluid depth 1 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 18 in (MOA 1.5’ ED) Effective depth used 3 in (Final Fluid Depth & missing) Effective depth remaining 15 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA records & appears approximately that 2” or 0.17’ is unmeasurable / missing. COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *6 ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *Waiver #WR000076 G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/20/2025 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 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 well and septic system. Therefore, any or NO 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 & 10/20/25 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D ,.'051-031-30 · ,:7'_;.- ,, ,;.,, 1. GENERAl:. INFORMATION Complete legal description ~.o t 7, Expiration Date: Block 1, Knik View Subdivision Location (site address or directions) NH[,I Inlet Vista Drive Current Property owner(s) Leroy Alderman Day phone 688-3403 Mailing address PO Box 670045, Chugiak, AK 99567 Lending agency Mailing address Day phone Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: r n Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show that the on-site water supply and /or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. $ & S ENGINEERING Name of Firm ........ '~ "':.,~- Lc~ Read,lo,-204 Address Eaqle River, Alaska 99577 Engineer's Printed Name Robe~'t. C. Co~an DHHS SIGNATURE Approved for Disapproved. Conditional approval for Phone ~ ~ '~ - ~ ~ "2 ~____ Date ~r~ / ~ ~ F' .... bedrooms, h :": ................... bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: c/_ LD-. 9- ~) I Original Certificate Date: Reissue Date: MUnicipality of Anchorage R E C E I V E Department of Health and Human Services Division of Environmental Services SEP 2 Z000 On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us MUNICIPALITY OF ANCHORAGE (907) 343-4744 ENVIRONMENTAL SEI~VICES DIVISION HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: ]-.O~--~ /~poc~ ! /4,,¢l/4 w~-~,' A. WELL DATA Well type __ Date completed __ Total depth Date of test Static water level Well production WATER SAM~k~~S: Coliform ,~ colonies/100 mi Nitrate D e~o~ sample: Collected by: B. SEPT C/HOI.~,I. NG TANK DATA Tank Type/M~tefia~l, ~'~ 7-, c_ // Date insi'~Jled '7/'~-v/O'e Tank size ,/o o o clea60'~[~''¥,¢5' Foundation cleanout ':* Date of pumping ~ ~ ,v ~.~..~ C. ABSORPTION FIELD DATA Parcel I.D.: o,.~'/ -o:~/-7 o If A, B, or C provide PWSID # Well Log ~ Sanitary seal ~otected ft Cased to _ ft C~eight (above ground) FROM WELL LOG ~ AT INSPECTION colonies/100 mi __ mg/I Other bacteria__ gal Number of Compartments ~ Depression over tank /v¢ High water alarm Pumper Date'instaileB'?/7{0o Soilrating,~g~rft2/bdrm) )'~' Systemtype Length G ~ ft (ro~,~} Width ~-- ft Gravel below pipe ), ,5- ft in, Total depth I0 Date of adequacy test P//', __- _/v ~. ~' Results (Pass/Fail)~--'''~'''~ Fluid depth in absorption field before test .~ter added Time:--~id depth _ in Elapsed ~.._ .... Any rejuven~ment (past 12 mo.) (Y/N & type) ft Effective absorption area ~Y~o fF Monitoring tube ¥~'$ Depression over field ,w0 For -~ bedrooms __ gal. New depth___ in. Absorption rate >= __ g.p.d. If yes, give date __ 72-026 (Rev. 01/00)* D, LIFT STATION "Pump on" level at__ in Pump off le~ in High water alarm level at Datum .~--~cles tested SEPARATION DISTANCES ~o o ~.~ c_ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On a~- Absorption field on lot ...-------'"~n adjacent lots Public sewer main ~ Public sewer manhole/cleanout S~~ne Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: in Meets alarm & circuit requirements Building foundation .5' Property line S- d- Absorption field __ Water main /o ~ Water service line /0 ..¢- Surface water Drainage ~ /,4 Wells on adjacent lots ~ o o ¢ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line _~/("~.,,-~4~'- Building foundation )/ Water main Water Service line /o '4- Surface water / 0 o /H-- Driveway, parking/vehicle storage__ Curtain drain /d~,,~.. ,k;,v¢~,,~ Wells on adjacent lots ~o~) F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date ~ /a-I /o~ HAA Fee $ ,_~. Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)* Rick Mystrom. Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577- September 28, 2000 Subject: Waiver Request forK~NIK VIEW BLK 1 LT 7 Waiver # WR000076 Lot Line Request for Parcel ID 051-031-30 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 6 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any futare upgade to the on-site wastewater disposal system and lot line will require ali separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. JeffPoet Engineering Technician III On-Site Water Qualiw Progam MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Wa'iver Review Worksheet PID~ O~/- ~/-~O HA# D OO~O Permit # S~/~OO0 ~- Date Received: Legal Description: Engineer: ~ ~ Applicant: Waiver Requested: Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: List Conditions or Reasons Waiver is NOT Granted: for above: · N~m~e/~f Reviewer Rec %: Amount: $ //~oo Date Paid: ~ ~_ ~-o O ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE, September 21, 2000 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS ROAODE$1GN 8OILTEST STRUCTURAL& MECHANICAL INSPECTIONS ON SiTE W~STEWATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage Department of Health and Human Services PO Box 196650 Anchorage, AK 99519 REFERENCE: Lot 7, Block 1, Knik View Subdivision NHN Inlet Vista Drive Request that you issue a waiver for the horizontal separation distance between the leachfield and the south property line at 6 feet. We do not anticipate any adverse effect on adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/skh letters/waivers/7 iknik 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577