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HomeMy WebLinkAboutSUN VALLEY BLK 1 LT 5Sun Valley Lot 5 Block 1 #078-111-11 Municipality of Anchorage Page 1 of 3 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 > LA) 0, 03c.5-PID Number: C.)7g-III -1 i Name: Di r'I. 5 laii /_e' { K Wastewater System: NI New 0 Upgrade Address: C PO �i,;< �7C9.,6% �a�l� ;vel/ Q 4k 94)577 ABSORPTION FIELD Phone: 6 clip/4 //—13 i / No. of Bedrooms: 3 ,� Deep Trench 0 Shallow Trench 0 Bed 0 Mound 0 Other LEGAL DESCRIPTION Soil Rating: 1 M v GPD/Sg. Ft. Total Depth from original grade:. Lot Block: / Subdivision: do Valley Depth to pipe bottom from original grade: Ft. Gravel depth beneath pipe 6\ Ft. Township: Range: Section: Fill added above original grade: a Ft. Gravel length: Q .� J Ft. WELL: ( .New 0 Upgrade Gravel width:5 r FL Number of lines: 1 Distance between lines: Ft. Classification (Private, A,B,C): P i(VF% rt Total Depth: )- S-0 Ft. Cased To: to �> Ft. Total absorption area: ft"' e• 1 0 SQ. Ft. Pipe material: ( t_rj A5TM b o3CIJI�/JiQ Driller: cS`3L11 Vt3 I-4-r4i,Lw.t.t1 DatePr'lle : i cilli/9 c6 Static Water Level: 96 Ft. Installer: / / 3o ±/I �o��(d��rl[t;�l Date installed: 6. �[�._�cj / Yield: .S GPM Pump Set at: J I6< Ft. Casing Hight Above Ground: / i/?. ' Ft. TANK SEPARATION DISTANCES tit Septic ❑Holding ❑S.T.E.P. To From Septic Tank Absorption Field Litt Station Holding Tank Public/Private Sewer Lines Man factur/er: Capacity in gallons: 4/, C crai,e 7 A I ®0�� h Well. 100\÷ 00 t"fr ,_-- p.9., 5, i- Material: 5fee / Number of Compartments: ^-0 Surface Water (00.i_1 O3' LIFT STATION/7C / / Lot Line 1 3% 11�1\ �( Size in gallons: Manufacturer: Foundation 6' 1, 79‘ 'Pump on" level at: "Pu "level at: High water alarm at: Curtain Drain �f NO/tie // (�/1AU/V1 Pump Make atter Electrical Inspections performed by: _ Remarks: BENCH MARK Location and Description:c ISo orn Cr t Siid ln9 C ,/A„ Assumed Elevation: I 0 ^ (' Ft EN L �P�OFq(1 tirc,>• \. ?! 4 ti- 4:34114:3411Inspections iLIZ,f3_ S & b ENGINEERING 17034 Eagle River Loop Road, No.2ff4 performed bygayl®Bruer. Alaska 99577 Dates: 1st // 2nd `7 'lig T \ ROBERT C. COWAN i ,� �C:,,5\t CE-6601 .1.7.. asr' a+td,acor wf- 'a; �. - `I vly,1 7—a—igti Department t of Health and Huma�ervic s Date !� approval Reviewed and approved b W'. jy/�i 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW980355 PAGE 2 OF 3 NunicipaUt of Anchora e DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 1, SUN VALLEY S/D P.I.D. NO. 078-111-11 1 \\'' - \ \-&.:7, \ LOT 7 \\' SCALE: C' = 60' \ I...r./» ... ..Ulf :.....u.'.nn.. , ... ...::t_. -11.-7...-c„, , ceT a ROBERT C. COWAN a, N 'g. \ CE -8801 /44 fr' tt( .... .'sy Ct'4' '° �� al211 ... \ \ \ \ \ (V9, CO2�F4�T,r MT2\r T,p \ TF e 'SA TH TI 001 1000 GALLON SEPTIC TANK CO3 T2 STI DBLI 1. DBL2 100' WELL RADIUS TBM PERMIT NO SW980355 PAGE 3 or 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 1, SUN VALLEY S/D P.I.D. NO, 078-111-11 FINAL GRADE FINAL GRADE C01=90.3' CO2=90.9' --..INSUL/F n0 ,ll MT1 =80.9' MT2=80.9' CO1=86.9' CO2=86.9' • NO WATER FOUND 71.9' B.O.H. A B FCO 4.5' 25.0' ST1 63.0' 73.0' ST2 69.0' 79.0' DBL1 70.5' 80.5' DBL2 71.5' 81.5' C01 180.0' 185.5' MT1 1 81 .5' 187.0' CO2 217.0' 221.0' MT2 214.0' 218.0' CO3 160.5' 167.0' N. T. S. a94P i 9t ;�. ,,. . 0 Pt- kyr ‘ ROBERT C. COWAN / c:1 CE • 8801 /44444 ° k SEP -25-99 SAT 12:49 PM SULLIVAN WATER WELLS T&rtifiet prilling 688 2759444444444444 P.01 by 000 Co. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND %Phi 10L /5 _Oil "Jet- ADDRESS JkgADDRESS /a aori Ho 567- 1'. LEGAL DESCRIPTION V 304 duce r/ _BAk / A or PERMIT NUMBER ggo3SsDate of Issue 9 - JJ 98- TAX INDENTIFICATION NUMBER 07? -. JI s 1 Is well located at approved permit location? itYrec Q No Method of Drilling: Depth of well: d8 0 tairrary ❑ cable tool Casing Type STEEL Wall Thickness Diameter N/7 Liner Type: /t)aa•JC Casing Stickup Above Ground: a Static Water Level (from ground level): ago inches inches, depth [)4311 feet feet 9 6 feet Pumping level: feet after hrs. pumping gpm Recover Rate: gpm Method of Testing: A 112 Well Intake Opening Type: Q Open End LG}e en Hole ❑ Screened; Start feet Stopped feet Q Perforations Starte � t, Stopped feet Grout Type:/\ ...3N—lire VolumePlu/fp 4!{S Depth: from 0 feet to " feet Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? (],Yes Q No Method of Disinfection: SD fl'ni C iA 1,.46. BORE HOLE DATA DEPTH From To 0 a a 9 9, Fs - Fr to/ /t%Jr Id loI 10 C I2 1* ,I s _12 (0.0 as0 il644o c'4r4 ep aEA 434-e. 6 4e AJ ocJ/ Comments: RECEIVED SEP 2_9 1999 Municipality 01 4ncnarage Dept. Health & Human Services Driller's Name /2* --1? r _. ATTENTION: It Is the responsibility of the property owner to submit a copy of the well logtothe proper authority Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Depaitiiier>t of EhVironmetttal Conservation. S&S GineeRinq my HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, RE, ROBERT A. SHAFER, P.E. Date: / lel'-l Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 5, .flock 1, 5- 140 VglJey CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED JUL 22 1999 Municipality at Anchorage Dept. Health & Human Services The septic inspections for the referenced property were performed on 6 -X3 -9c) and 6'Q1 -q' . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the 45-InAta 51n//&. to be completed. If we may be of further service please contact us. Sincerely, 711E Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 AO Gov3 1 -i. G P CYC MUNICIPALITY OF ANCHORAGE / Department of Health and Human Services ( l �^ ti," 1 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 / WATER SUPPLY PERMIT 2) - 1 k Permit Number: SW980355 Legal Description: SUN VALLEY BLK 1 LT 5 Design Engineer: 0003 S & S Engineering Owner Name: Phyllis L. Janke Owner Address: PO Box 770567 Eagle River , AK 99577-0567 This permit is for the construction of: Disposal Field ✓ Septic Tank Holding Tank Initial ACM_ Date Issued: Sep 15, 1998 Expiration Date: Sep 15, 1999 L.k0OA. Parcel ID: 078-111-11 Site Address: Lot Size: 268821 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 Privy Private Well 1 1 Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify 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. 8. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Inspections of the septic system installation must be performed by an engineer. Received By: Issued By: Date Date: 9,1,5*.q& Rick Mystrom, Mayor Mantel alLity 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 343-4744 August 25, 1998 Phyllis L Janke Joseph F Janke III PO Box 770567 Eagle River, Alaska 99577 0567 Subject: Lot 5 Block 1 Sun Valley Subdivision Permit #SW970271, PID #078-111-11 The subject permit, issued August 25, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of August 25, 1998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If y have any questions, please call this office at 343-4744. erely, 4)/ ames Cross, P.E. rogram Manager On-site Services enc: Copy of Permit cc: S & S Engineering MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970271 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:JOE JANKE OWNER ADDRESS:P.O. BOX 770567 EAGLE RIVER, AK 99577 PARCEL ID:07811111 LEGAL DESCRIPTION: SUN VALLEY BLK 1 LT 5 LOT SIZE: 268821 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 M O /1 DATE ISSUED: 8/25/97 EXPIRATION DATE: 8/25/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS:: RECEIVED BY: C�L�✓YC.._ C-1 Z,lii_._ DATE: J��.i>0 /0 ISSUED BY: DATE:7Y���-) / ~�� r S&S "'EncineeR1nq FASO HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. August 11, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 5, Block 1, Sun Valley Subdivision CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. This property has enough area for a fixture septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, et2 G1`ly� Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 d 0 \ 1- § § ) j D 0 § 0 woo \\I. 00n0 - 0 \( S/ (§ ) 0 / /, A© \ �. #00 $)- #«-\)% 6§ \\ §N, ƒ§ �.� NV -Id -311S a9 = Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST ✓�' 41( er` ROBERT C. COWAN /4.�� • CE - 8801 I' PERFORMED FOR: J ©_ d P V'- . DATE PERFORMED: LEGAL DESCRIPTION 2- 10- 11 - Ley \ SJp� \dxt,tyvTownship, Range, Section: SLOPE OUT H Fades U b 12 -ey- • 13- (0 14- 15 - • . 6 16- 9 •. 17 18- 19- 20 - fr 0.0 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? N � E Depth to Water I�ry¢r�� Monitoring 621—'1- Oat • Abe SITE PLAN T N Reading Date Gross Time Ne Time Depth to Water Net Drop p 1 f° --r2-5 o.nr4 — ?(� , b D t 1.46-cil I I/4-4 -- 2— % Ms) --i. 'iv i'" 5 II f -1r; t4 -4n vie- ,— N rZ I L I (, IA i/v 1" 1 N 41.Iv f' PERCOLATION RATE (mnutes/inch) PERC HOLE DIAMETER to TEST RUN BETWEEN 4, FT AND 7 FT COMMENTS PERFORMED BY' 17014 Fagle River Loop Road No. 204 ac1le River. Alaska 99577 ACCORDANCE WITHRI.L ATE, MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE CERTIFY THATTHIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) �� �,^'S&S Englneenlnq EAGLE HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 5, Block 1, Sun Valley Subdivision August 11, 1997 GENERAL: CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 1. The scope of this project includes the installation of a 1000 gallon septic tank and a leachfield trench to serve the proposed three bedroom residence located on the referenced property. 2. 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. 3. The contractor shall be responsible for obtaining any necessary underground utility locates, 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. 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 from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be .insulated. 17034 NORTH EAGLE RIVER LOOP • SUITE204 • EAGLE RIVER, ALASKA99577 Page Two Lot 5, Block 1, Sun Valley Subdivision August 11, 1997 5. 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. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCEUDRAINFIELD INSTALLATION: 1. 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. 2. 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. 3. 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. 4. 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 front 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. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the bacicfill 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Page Three Lot 5, Block 1, Sun Valley Subdivision August 11, 1997 Type of Pipe Perforated Solid Cast Iron 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). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, 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. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. 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: 1. 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. 2. 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. Page Four Lot 5, Block 1, Sun Valley Subdivision August 11, 1997 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 1• Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 078-111-11 1. GENERAL INFORMATION HAA# no:nt Expiration Date: Complete legal description SUN VALLEY SUBDIVISION; LOT 5, BLOCK 1, G1 -3-o3 Location (site address or directions) 2995 HILAND ROAD * EAGLE RIVER, AK 99577 Current Property owner(s) ALAN MADISON Mailing address 2995 HILAND ROAD Lending agency Mailing address Day phone 694-6627 * EAGLE RIVER, AK 99577 Day phone Real Estate Agent RAE HALL W/ PRUDENTIAL VISTA Day phone 689-6627 Mailing address 16635 CENTERF1ELD DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) 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. :; Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority 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. 1 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(aro) in compliance with al! applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179 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, AKWWC, inc. 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 fest, 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 fest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. 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 3 bedrooms. Disapproved. Date 5-12-010.3 D n Conditional approval for bedrooms, with the fllowing stipulations: y A. ness! t' CE -7953 .** tlw; • oet Oor ONINZ fe39`OnOgo O0000��• • Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: f/' t `l��t . ... A Cti 4fO� J4: 'ON-SITE c � ' WATER AND • Il`' WASTEWATER .: i'ROGRAM Manitenance Agreements 4 0 Ail4FnrrS �) Supplemental Engineer's Reort '1))JJ))ii)))))ti� Other (Rev. 12!01) Original Certificate Date: 6 ' 3- 0 3 • 'BELOW EXISTING GRADU Municipality of Anchorage Development Services Department Building Safety Division On-Sfte Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: SUN VALLEY SUBDMSION; LOT 5, BLOCK 1. Parcel ID: 078-111-11 A. WELL DATA Well type PItWATE If A, B. or C provide PWSID# N A Well Log (YIN) YES Date completed 9/15/1998 Sanitary seal (YM) YES Wires properly protected (Y/N) YES fl Casing height (above ground) 18+ in FROM WELL LOG AT INSPECTION 915/1998 5/13/2003 Total depth 280 ft. Cased to 126 Date of test Static water level 96 ft. Well production 5 WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate Arsenic:. N/A mg/L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Tank size 1000 gal. Number of Compartments 2 Foundation deanout (Y/N) YES Depression over tank (Y/N) NO g.p.m. 0.1 mgJL. Date of sample: 5/13/2003 Date of pumping 5/13/2003 C. ABSORPTION FIELD DATA Date Installed 8/23-24/1999 Soil rating Length 38 ft Width 78 ft. 5.4 g p m Other bacteria 0 colonies/100 ml. Collected by: AKWWC. INC. Date installed 6/23-24/1999 Cleanouts (YM) YES High water alarm (WN) N/A Pumper JR'S PUMPING r ftTdrm) 1.22 2.5 ft. System type TRENCH Gravel below pipe 6 ft. Total depth '9.33-9.5Of1 Eff. absorption area 456 fta Monitoring tube YES Depression over field NO Date of adequacy test /13/2003 Results (PassIFall) PASS For 3 bedrooms 25.5/ 311 Fluid depth In absorption field before test 26 in. Water added 714 gal. New depth3Z in 23/ Elapsed Time: 943 min. Final fluid depth 2 in. Absorption rate >= 450+ Any rejuvenation treatment (past 12 mo.) (YIN & type) g.p.d. NONE KNOWN If yes, give date , D. UFT STATION Date installed "Pump on" level at in. Datu E. SEPARATION DISTANCES Size in gallons Manhote/A "Pump off" - - = in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ On adjacent Tots 100'+ On adjacent Tots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 59+ Absorption field 5'+ Water main N/A Water service line 109+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 109+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 5'+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent Tots 100'+ I certify that I have determined through field inspections and review of Municipal monis that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Prints Na a JEFFREY A. GARNESS Date 5Za �03 HAA Fee $ 3r7 5- ©° Date of Payment 5 - 3 0 - 03 Receipt Number 3Q,2.. 7 (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number . 5-19-03; 2:IOPM; SGS Ref.# Client Name Project Name/# Client Sample ID Matrix 1032626001 AK Water & Wastewater Consultants Inc. Sun Valley S/D. Lot 5. Block 1 Sun Valley S/D, Lot 5, Block 1 Drinking Water ;907 5615301 it A- 2 MI Dates/Times are Alaska Standard Time Printed Date/Time 05/16/2003 11:41 Collected Date/Pine 05/13/2003 16:45 Received Date/Time 05/14/2003 12:30 Technical Director tepp5, e Released Sample Remarks: Parameter Results PQL Units Method Allowable Prep Limits Date Analysis Date Init Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.100 U 0.100 mg/L EPA 300.0 (<=10) 0 05/14/03 JS co1/100mL SM18 9222B (<=1) 05/14/03 SKW TR A j s ■ § §) 1 R § ) CO NVId 1Old _ sorwraa a z c G #: _z/LO 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 HAA # J{f000U '11/45 Parcel I D # 078-111-11 1. GENERAL INFORMATION Complete legal description Rrct,vc4 fJ v ., Lot 5, Block 1, Sun Valley S/D Location (site address or directions) NHN Hiland Road Property owner Phyllis & Joe Janke III Day phone 694-4351 Mailing address PO `.Box 770567, Eagle River, AK 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. - 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 T XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XXX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 )Rev. 1/91) Front MOA M21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. $ & $ ENGINEERING y 7y Name of Firm 702,4 r..G:e nivel,/'9 —a Loop Road No. 2n4 Phone b Eagle River, Alaska 99577 Address Engineer's signature Date a /`] / ° 0 ,::: A'ir. ).jaOdecizi t irci7C7. 'Pa"' 630 ' ..2M fi I ROBERT C. COWAN •• /0 / 14Q�,., CE -8801 {4a 6. DHHS SIGNATURE 0 °l. �aas Ott ..> Approved for 3 bedrooms. �' --', `�� q ` ° Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By i� a re Date a.—/6`OO CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Beck MOA #21 Municipality of Anchorage C F I V f DEPARTMENT OF HEALTH & HUMAN SERVIC $ Environmental Services Division FF 2000 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907 3 3-4q 44 y, ��et „Jr Health Authority Approval Checklist wlsotwENI"L StRviCES olvls Legal Description: Loi s"-- /3Loctc / $u,j V/lLLwy Parcell.D.: O7 cd 1/f — 1/ A. WELL DATA Well type pa ) T'2 If A, B, or C, attach ADEC letter. ADEC water system number Log present((/N) y% S Date completed q// 7 1' 9 g Total depth 3- SO Cased to / d- G Casing height (above ground) I 1/4_, / t Sanitary seal/N) Y4- 5 Wires properly protected 0/N) Y�-J FROM WELL LOG AT INSPECTION Date of test 6 (17 / ' Static water level c1 G Well production 5 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 4j Date of sample: z_ 1 /et Collected by: B. SEPTIC/HOLDING TA K DATA Date installed C � 4/� `, Tank size 100 0 Foundation cleanout&N) Y6 3_ J¢i Nitrate f% 7 Other bacteria �J S & S ENGINEERING 17034 Eagln n•„o. I onp Rnm.I No 904 Eagle River, Alaska 99577 Number of Compartments off. Cleanouts1a'N) Y6J' Depression (Y@ M 0 High water alarm (Ye 1" 0 Date of Pumping nils} - N4;1,1 Pumper C. ABSORPTION FIELD DATA Date installed 613-4/61 9 Soil rating 'g.p.d./ or ft2/bdrm) /< .- System type T4 £^v ci-N Length 3 g i Width , 'A Gravel thickness below pipe 6 Total depth Effective absorption area 95-6 s.r zMonitoring Tube present 6y N) Y'L-J Depression over field Date of adequacy test hi 4 — ✓i e Results (Pass/Fail) Fluid depth in absorption field before test (in.); For 3 /0 bedrooms Immediately after gal:a er added (in.): Fluid depth (ins) Minutes later: Absorption rate = g.p.d. Peroxide treat 2 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) "Pump o " ev- at* "Pump off' level at* High water alarm level at* 'Datum Cycles teste. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / DO / On adjacent lots Absorption field on lot / 0 0 On adjacent lots /Do '4 Public sewer main N /* Public sewer manhole/cleanout Sewer /septic service line ; s -/Lift station N /4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Size in gallons /O0 /v /4 Foundation G / Property line l 5 .3 Absorption field 1 00 -/- / Water main/service line 10 t Surface water/drainage JO t Wells on adjacent lots / 00 1 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: / Property line / / a Building foundation /1 zi Water main/service line /0 Surface water i 00 -f- Driveway, parking/vehicle storage area / 0 .y Curtain drain 'N01J4- k ^' 01n F. ENGINEER'S CERTIFICATION Wells on adjacent lots I certify that I have determined thru field inspections and review in conformance with MOA/%%HAA uidelinnee in effect on this date. Signature 17?"/ Engineer's Name /vatd*Zr C. CA4,-) Date I)` [/`. /0 0 /o0 11 - of Municipal records tL f`t dgiv les a!, $are fdd 1) y^3 ROBERT C. COWAN i1 c- CG:3 :o 0;c • CE - 8001..:Z:),° HAA Fee $ 501. Date of Payment oC I 1 I 00 t-5- 1 CI ( L(w1 Receipt Number 72-026 (Rev. 3/96)" Waiver Fee $ Date of Payment Receipt Number FEB -15-2000 16:43 AL CT&E Ref.; Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID S&S ENGINEERING CT&E Environmental Services Inc. WitialataalaretataaaWAWAI 1000502001 S & S Engineering Lot 5 Blk 1 Sun Valley Lot 5 Blk 1 Sun Valley Drinking Water 0 907 694 1211 P.02/03 Client POR Printed Date/Time Collected Date/itne Received Date/Titne Technical Director, Released 02/11/2000 10:27 02/08/2000 16:15 02/08/2000 17:00 Stephen C. Edc Sample Remarks: Parameter Results Pat units Method allowable Prep Analysis timiss Date pate Init WATERS DEPT Nitrate•a AICR0 LAB Total Califon 0.500 u 0.500 IPO/t EPA 300.0 10 max 0 co1/100mt SM18 92228 02108/00 sct 02/09/00 RAP