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SPRING FOREST BLK 1 LT 11
Municipality of Anchorage Page I 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: ~)~lJc~)O°~l __ PID Number: ~l~ ' ~ ' ~5 Name: , ¢ll],~ ~ EI;~ ~1~ Wastewater System: ~ New ~ Upgrade Address: OO(,~2~ I~ ~r,,. ~C~u~. ABSOFIPTION FIELD .,o.~: (~o7) ~7~--~ I"°.°fm'°°~':3 D DeepTrench ~ShallowTrench ~Bed ~Mound DOther Total Depth from original grade: LEGAL DESCRIPTION Soil Rating: J,~ GPD/Sq. Ft. Subd[v~ion: Depth to pipe bo~om from original grade: Gravel depth beneath pipe ~ Ft. i i Township: Range: Section. Fill added above original grade: Gravel length: ~ ~ Number of lines: ~ D]staflce be~eenlines: C~;~ ~e ~ Upgra~ Gravelwidth: 5 + .:. / Total Depth' Total absorption~ Pipe material: Classification ( ~A.B.C): /~ Cased TO: ~. . ~t. SO. Ft. ~TI~ ~dller: .'~ .Date Drilled: StalicWater Level:Ft. [nstalle,~x' ~,~ Date installed: 51rolm ~ asing Height A~ove Ground: Yield: ~"u mp Set at: F~. Ft. TAN K -- _/ GPM I /SEPARATION DlSl'ANCES~% Zs..tio u Holding B S.T.E.P. Manu acturer: Capacity in gallons: TO Septic Absorption I Lift Ho,ding 'ublic/Pr,vat, ~ T~K From Tank Field Stat[on Tank Sower Lines s;~;~ I~'+ ~'~ N/A ~/A N/A ~ LIFTS'rATION Lot "Pump on" level at: ~~ High water alar~ at: CudainDrain ~ ~ ~ _~_~ ~el ~ Electricallnspections pedormed by: Remarks: BENCH MARl( A~umed Elevation' Io~. E~ NEll,S SE&L inspections pedormed b~: _ flo~stmmA~ ~. Dates: lsLOlI-I!~g ~~m~.~o _)'~ Depa~ment of Health and Human Se~ices approval ~;~ g:~;''~ Reviewed and approved by' ~~ ~ ~ Date:~'/'~¢ 72-O13 (Rev. 9/91} MOA 25 PE..,T ....ER: AS BUILT DRAWING PARDEL ,D SW990091 ' 015-321 - 15 STI - 14.6 3 ST2 18.5 36.0 DBL1 21.6 40.0 DBL2 22.3 40.9 / FD 23.2 41.6 C02 75.7 53.3 003 41.~ 4~.3 - MT2 42,0 47.0 - ~ ~SUUEO LOCATION C04 - 69.7 89.~ OF THE WATER LINE / ~ I /h' 3 BEDROOM ~ ] ,~' ~ C01 NEW 1000 GALLON SEPTIC ~ TANK INSTALLED. OLD TANK ~ co4 ~ ~' REMOVED AND BURIED ~T3 - ALAS~ WA~ AND WASTEWATER CONS~,TANTS, INC. 6901 DEBARR ROAD. SUITE 2B. ANCHO~GE. AK. 99504 PHONE: (907) 337-6179/F~: (907) 338-3246 SPRING FORESI SUBDIVISION, ~OT 11, BkOCK 1 AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE '":""~ SW990091 ' 015-521 - 15 5~ / 5r2 ALAS~ WATER AND WASTEWATER CONSULTANTS, INC. ~ 0 AS-BUILT DRAWING 0F SEPTIC SYSTEM UPGRADE MUNICIPALITY OF ANCHORAGE Department of Health and Haman Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 11, 1999 Expiration Date: May 10, 2000 Permit Number: SW990091 Legal Description: SPRING FOREST BLK 1 LT 11 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: William & Elizabeth Elmer Owner Address: 5029 17TH AVENUE NE SEATTLE, WA 98105-4212 Parcel ID: 015-321-15 Site Address: 006020 WEST TREE DR Lot Size: 53054 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding 'rank ~] 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 Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water ReguLations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 Ilours 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, Received By: Issued By: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage N Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers April 29, 1999 Municip~flity of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 995 ! 9-6650 Reft Septic Upgrade Design for Lot 11, Block 1, Spring Forest Subdivision To whom it may concern: The existing 3 bedroom house is served by a private septic system and a community well. The existing drainfield will not pass an adequacy test and must be upgraded prior to the sale of the house The existing septic system consists of a 1250 gallon septic tank and a drainfield (60' long by 3' ~wde w~th 4' of depth). One test hole was excavated to~est of the house. We propose to inspect the existing septic tank and, if' of poor integrity, replace it with a new 1000 gallon (or larger) septic tank. Also, we propose to use the existing drainfield as a reserve site. The end of the existing drainfield may be inside the 20' utility easement along the south property line. Any portion of the drainfield that is inside the easement is to be abandoned, and a cleanout & monitoring tube is to be installed outside of the easement. Comments regarding the proposed upgrade design are smnmarized as follows: 1. SOILS: Attached is a log which shows the soil profile, and the percolation test results. The soils below the organic layer are a ML (dense) material to a depth of 6 to 7 feet and then transitions to a SP/SM material to a depth of 15 feet. At 15 feet, the soils then transitions to a SM/ML material to a depth of 17.5 feet (bottom of test hole). No groundwater was encountered during the excavation of the test hole. The percolation test was performed between the depth of 6.5 feet to 7.0 feet and the rate was of <1 minute/inch. It is our opinion that due to the high percentage of sand, the insitu soils will serve as a sand filter. A grab sample can be provided if deemed necessm% 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/fl2 ¢. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption 3a'ea: 3752 f. Total Depth: 11 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet minimum i. Reduction Factor: 0.50 i. Mirfimum Length: 40 feet long j Effective absorption area = 400 1l2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average slope is 3-5% running fi'om approximately east/southeast to west/northwest; in short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337,6.179, at' 344-9612. Thank you, for your assistance. ~.E., M.S. NOT~: 'dltached is a site plan d(awing, a design drawing, a soils log, c~ lOt~ogrftphY site pt(tn, anti a q l~ftge construction apecification letter which are all part of ihe de, slgn Paglwge for {his s{s~tic ,,ystem. ~7,7, ~ I NOTE' ALL PROPERTIE., IN SPRING FOREST S/ ,///' ~ EA_'RE ~ERVED BY A COMMUNITY WATER SYSTEM. WEST TREE DRIVE-?~ SPRING FOREST SPRING FOREST S/D ~ SPRING FOREST S/D ~ TH~.i ~ SPRINg FOR / PROPOSED SEP'rI~ ~M~ ~~ ~-EXISTiNG ~ ' ~ ~k HOUqE SEI~IC SPRING FOREST S/O ., ~g OF PROPOSED SEP~C ~ ~ ~ OF PROPOSED SEFfflC ~S~ WA~R AND I'~ CONS~TA~S, INC, SPRING FOREST ~U~DIVISIONi LOT il, ~LOCK 1, ~ .......... SITE P~N e.~ c/o PRUDENTIAL VISTA ATTN: MANNY ESCOBEDO 563-5500 I NOTE: I '~ \ / / REGISTERED LAND SURVEYOR PRIOR TO , // / - ~ // / , / ; PRO'POSED DRAJNFIELD UPGRADE. EXCAVATE 11 FE~ DEEP M~IMUM' ~-- ~ BY 5 FED WIDE: BY 40 FE~ LONG. i ADD 4 FE~ OF CL.~N, WASHED [ I ' ~ EXISTINC I , TH#~ J , ~ ~ 3 BEDROOM , ~ ' ~'~ HOUSE i ~NdONED kNY PORTION OF .~ % % TANK. EXCAVA~ ~D ~RI~ ,4E ~I.IN~ TRENCH T~T [ ~ 20' U~L~ I~SEME;NT ' ~EXISTING TRENCH TO BE ~ USED AS A RESE~E SITE. ;~ ' ' ~S~ WA~ AND WAS'~WA~ CONS~LTA~S, ~C. 6901 DEBARR RO~ SUJ~ 2B, ANCHO~GE, ~ g950¢ c/o PRUDENTIAL VISTA ATTN: MANNY ESCOBEDO 563-5500 ~[~... ........... ...~>~ J.L.M. 1 = ~0' 2 OF 2 LEGAL DESCRIPTION: PERFORMED FOR: BATE PERFORMED:_ ALASKA WATE~ 8~ W,ASTEWATEI{ CONSULTAN'rs, INC. 7320 E, CHESTER HTS. CIRCLE * ANCHO. R^GE, .A~.., gg504. PHONE (gO7) 337-6179 * FAX (g07) 33a-3246 I SOIL LOG - PERCOLATION TEST[ SPRING FOREST SUBDIVISION: LOT 11, BLOCK 1, WILLIAM AND ELIZABEI'H ELMER 4/21/99 ;-7953 ,.' -DENS[-- SOIL CLASSIFICAT ONS. ORG ML CL OL HH CH OH SC DEPTH TO DATE $ROUNDWATER DRY 4/21/99 DRY 4/28/99 SP/SM DATE READING CLOCK NET TIME DROP TIME (MINUTES) READING (INCHES) SM/ML COMMENTS: PERCOLATION RATE __ TEST RUN BETWEEN INSITU SOILS SHOULD ACT AS A SAND PERFORMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFOR; ACCORDANCE WITH ALL STATE DATE. BATE: <1 (MIN./INCH) 6.5 FT, AND HOLE DIA. 6" (INCHES) FT. , CERTIFY THAT )ELINES IN bH-ECT ON THIS ALI_ :lES IN WATER WEST TREE LOT 14, BLOCK SPRING LOT 1 SPRING SPRING LOT 9, BLOCK 1, SPRING FORE5~T S/B PROI (SEE DESIGN. PAGE 2 OF LOT B, BLOCK 1, SPRING FOREBT S/D 6§0' LEGAL FOREST OF WORK: SITE PLAN FOB: WILLIAM AND ELI BY: A, GW 1 14. TI2N, L WITHIN PROPOSED ANCHORAGE, 11, 100' 5 1 OF INC. LOT 2, SW I/4, x~ BEC. 1~, T12N, R3W NO WELL WITHIN 200' OF PBOPOSED SEF~[C 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 INSPE"CTION REPORT LOCATION NO. ~BE DROOMS ~ ~ I Wo,~ ~ ~ Absorption area Dwellin~ Z' PE~5 NO ~ i Liql ~p~ gallons Inside length Width Liquid depth O z ~ Manufacturer Material Liquid cap~clty in gallons ~ DISTANCE TO: Well~m~ Founda~% / Nearest~li~e PER~ ~O Distance et e lines ~~· ~ ~' Oo~ inches Total e~t~s~ption area~/[' No. of lines/ Length of 9ach I~e Total len~,h of :~nes Trenci~d~ ~e}~e~ , ~ ~ Top of tile t~ finish grade Material beneath tile --" Length Wid7 Oepth ~ ~ inches . ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO'. ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO:-- ~uilding foundation Sewer line Septic tank Absorption area(s) OTHER ~OILTPIPE MATERIALS ~f/~eZ IN ,~ ~- ' ---- ..... 72-013 F'EF:'.H :1: T i',ICL D[EF'RR:THEI'.,IT L., HEFILTH FII'4[:, EI'.,I',,,'IF..'OI'.,IHE:NTF:iL I .O]"ECTIOI'.,I :3;2!5 '"L..,:'. :~TF.:E:ET., FINCF'IOF::FIC:iE., Fir<:. ; . ,2::~ [%~ -.-. ~i!!: :]1:: T' IE ET:;; IEZ !1...[ EE IF;i: IF" IE IF;-" II".'l~ :]1:: "'T" ( ',.-3::i:E'EgE:E~ .':, F-FI ]..HI,17 I .,OCI::IT ]~ 0 [",i LEGFI[.. F,l...I. I',1 F F.P .[ ,:.F.E E.LI,J..L ...F f...l',la F' .RE.:, I 'TF~:Ei",ICH .-':,U I L. RFIT ]: i",l]3 ,:: ~:: Q FT,."E:E:, = t50 THE LENGTH [.'.,:[I'IEI',I~;IOI',I i:~Z, "I"HE [...E:I',IG'TI...I ,:::IN FEET) OF THE TRENCH O1:.~: E.',RRINFIELD. 'fl--lB DE:F'TFI OF FI TRENCH OF;: F'ZT :[2; THE [XI::~TF¢.,ICE BET!.qEEi',I THE [SLIRFRE:E OF' THIE GI:;:OLIND FII',IE:, TFIE BCFI"TOH OF' THE E',:qCR'v'RTtOI'.~ ,::II',l FEET). THERI!.::: .i':;~ NO SET HIE:,TH FOF: 'TRIEI'.,ICFIE$. TFIE GI':,'.R'v'EL.. I)E:F'TH ]::~ THE IqIN]:HI.JH E:,IEPTH OF' GFi:FI',,,'E:L.. [:3ETI.qEEN THE: OLITF:'F:ILI._ F:II',IE:, "I'HE: E;Ct'1'TC, H OF THE: E',:':',CI::I",,'FIT].ON ,::II",l F'I~JE'I':.,. PERh'I]:T' FIF'F'LZC;I::I[',IT HR:E:; 'TlqlE F,:ESF'ON'.5]:E:IL.IT'T' T(jl INFORH '!'ELIS DEPI::IRTHEI",IT DLIRING 'I"HE ]:N2:,TRLL..F:ITION II",I~SF'ECT:[OI',I:5 OF:' RN"r' HEL. L.2; I::ID3RCEbFI' TO TH:[E; I:'ROF'EITTV FINE:, THE 1"4UHE:E:I'~'. OF 17EtL:;I.I)ENC:E::E; THRT THE HELL H]:LL. 2;ER',,,'E. H:[i',II HUH D I :ZI"F:II',iE:E: EEE'THEEN R HEL. L. RND FIKIY ON--.:E, I TIE 'L:;EHRGE D I SF:'OSRL. S"r'STEI"I :[ E; :LC~E!~ I:::E;ET I::'OR R PI;t.I',/f:I'T'E HEL.L OR :.LSO 'TO 2EIE) FEET FF.'.OH F'I F'UEIL]:C HEL. L DEPEN[)tI'.,II3 I..II::'L")N THE T"r'F'E OF PUBI...IC HELl H]:NIHLIH DIE;TT:INCE F'I:~:OH F:I F:'RiVRTI~ HELL TO FI F'F..':[',/FrTE 2:EHEER L:[NE ]:':~; 25 FLEET FIi'.,ID TO FI COHI,'IUNIT'f ~;IEHE:F..' L.]:NE ]:'.~; 7!!5 FEET. OTHER: F:EX/!!.I]:F?.EHENT~; I',IFIV F:IF'F:'L'¢. t~;F'FECiFICF¥'I~IOI'.~S FII'.,II) OOI'.,Ib~TRLIOTD3N I)IRGRI'.:IH:.~; FIF.:.'IZ FI',/F:I:[L. FIE',I...E "1"O ]:I'.,[~.:..';L.IF:::E F'F:OF:'EI:;~: II'-,I:~TFIL. I_FITIEd'.,I. i CEFUI"]:F'"¢ THFIT ::1.: ~ RH FFIHIL.~FIR kl:I:TH THE F~:EC!U]:F:IEHENT::; FOR OI",I-E;]:TE SFJHEIR:5 FIND HEL..L:'5 Fr:T, SET i::©R"FI...I I!.:.Y./ 'THE HI...IN]:CIF'FiI..]:T'¢ OF FINCHOR:Fi(~iE. ;2: ]: H:[LL. II",IE;TF~LL. THE :ETCE;I'I/~H :1:1",1 FIE:C. ORDFiNCE HITH TFIE CL')DES. ::~:: :1: UNDEITZf'F:iNE:, THF:iT THE ON-EU:'I"E: tSEI4ER '.E~h.':E;TITH I','IF:I'¢ F~!E¢.UIRE ENLRRGEHENT IF 'TRE RE':'SII)E:I'.,ICE ]:'.!~: F:EI'"I I"IOF?.E TI-..IRI'.~ '2: [~SO ILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION:_ 1 2 4- 5- 6- 14- [] PERCOLATION TEST SLOPE ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? ~¥ ~.. R~i~:l~ Jr. ~ PROFESS\~X~,~m PERCOLATION RATE ~'~ TESTER UN BE~RNEEN Gross Net Depth to Net Reading Date Time Time Water Drop · /7,/£ / (minutes/inch) -- FT AND -- , FT COMMENTS PERFORMED BY: CERTIFIED BY: DATE: 72-008 (6/79) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. o~-5-32:~-:~5 1. GENERAL INFORMATION Complete legal description Spring Forest Block ~, Lot ~.~. Expiration Date: Location (site address) 6020 West Tree Drive Current Property owner(s) Jens & Megan Nannestad Day phone Mailing address Lending agency Mailing address Day phone Real Estate Agent Butch Jacques / Keller Williams Day phone 865-65o9 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF 'BEDROOMS: 3 I ndiv(dual Well .,, [] IndividUal Water StOrage [] Community Class A Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer E] E] The Municipality of Anchorage Development Services Department (DSD) iSsues Certificates of On-Site SYstems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my inveStigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone 2.72-8218 Address P.O. Box 100217, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 2/9/2_011 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the 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. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~ - / Z-/-- / / Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 , www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Spring Forest Block ~m Lot =~ A. WELL DATA ParcellD: o=F-~a-aF an Well type Community A If A, B, or C provide PWSID # AKa2=~56,- Well Log (Y/N) Date completed Sanitary seal (Y/N)__ Wires properly protected (Y/N) Total depth ~.ft. Cased to ... ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Dat~ Static water level ~ ft. ft. ~ ~ g.p.m. Well production WATER SAMPLE RESULTS: ~ ' Coliform colonies/100 mL _Nitrate_~ mg/L .... ~ Oth~'t~~__ colonies/100 mL Arsenic: ug/I Date of sample: Collected by: SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size aooo gal. Foundation cleanout (Y/N) Y Anchorage Tank I Steel Date installed ~12ola~99 Number of Compartments _~ Cleanouts (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Pumper A+ Home Services Date of pumping ~.l~l',m.., C. ABSORPTION FIELD DATA Date installed ~laolx999 Soil rating (g.p.d./~ or ~/bdrm) ~..~ GPDISF 60 3 Length 4o ft. Width 5 ft. Total depth ~. ft. Eft. absorption area 400 ~ Monitoring tube Y Date of adequacy test z/=n/=o=.a Results (Pass/Fail) Fluid depth in absorption field before test o_ in. Elapsed Ti~e: 8_.Qo min. Final fluid depth _o in. Any rejuvenation treatment (past 12 mo.) (YIN & type) System type Shallow Trench Gravel below pipe ~ Depression over field _N Pass * For 3 bedrooms Water added465 gal. Absorption rate >= 450+ New deptho in.' g.p.d. If yes, give date D. LIFT STATION ~__ . gallons Manhole/Access (Y/N) Size in ~.P~mp on" leve~,,~. "Pump off" level at in. High water alarm level at Datum, '"-.,,~es tested _ m m Meets alarm & circuit requirements? ~SEP..ARAT. IO.._.N DISTANCES FROM WELL ON ~~.~ .S~ptic t. an k/_llft, stati0n on lot Otll,a~t lots ~ A~ ~P~i_o. ~ _fi_ei~_o, _n lot __ _On. ~djacen~..... ~ublic sewe~ main --__ Public sewer manhole/c~~ SeWer/septic serVice line Holding tank Animal containment areas in. Manure/animal excrete storage areas SEPARATION DISTANCES FROM'SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~o+ Property line zo+ Absorption field. Water main ~o+ Water serVice line 25+ Surface water ~oo+ Wells on adjacent lots ~.oo+ Property line =o+ Water SerVice line Curtain drain 50+ F. COMMENTS Building foundation ~.o+ Surface water ~.oo+ Wells on adjacent lots ~.oo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water main 75+ Driveway, parking/vehicle storage 10+ * lCi<~9 Drainfield appeared to be inundated, flow was switched back to 1983 field which easily passed adequacy test. G. ENGINEER'S CERTIFICATION review of Municipal records that the above systems are in -' ~.-' 49TH ~ ¥'-% ~.....~,~.~,~.....~ ..... conformance with MOA COSA guidelines in effect on this date. · ~ · o Eng,neer s Pnnted Name Steven R. Pannone, P.E. Date 2/ql203.1 ~;~'?' .............'"' ~"~ COSA Fee $ Waiver Fee $ Date of Payment Receipt Number O) ~:) ~:?b~''- (Rev. 11/05) Date of Payment Receipt Number A+ HOME SERVICES, INC.... 7501. E. 140th Avenue CUSTOMER Anchorage, Alaska 99516 345-1890 P.O. Box 100217 _A~,&~t-.~_B:,.A~-~ ~51~,-0217 INVOICE # 39489 Block Lot DATE DESCRIPTION AMOUNT ......... , TOTAL ~ ~ Gallons ~ Septic Leach Ama Holding Tank ~ Standpip~/D'~ Time ~ PROBLEM AREA -- CALL ~OR MORE I"~ORMATIO. ~ NEED8 TO B~ DON8 AGAIN I~ 6 MONTH~ Good Shape ~ SludGe buildup on bo~om ~ Floater on top ' dim cap missing or ~ Cut standpipe to 1' above 9round ~ Needs Septictrine needs replacing SCALE' 1"= 30' LOT 10 / / / / / / / / / I / / I / .O9 / 8356D ,/ / / / ( / / / / / LOT 11 LOT 12 LOT 9 LOT 8 .? 23.0 20.I 9.0 2 Story Frame House 19.5 deck 14.0 27.0 L_ 20' UTILITY EASEMENT N89°56'54"E 219.79 TRACT A NOTE: SURFACE FEATURES INCLUDING ASPHALT & GRAVEL DRIVEWAYS, CONCRETE SIDEWALKS & DECKS ARE APPROXIMATE DUE TO SNOW AND ICE. THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 10-8, pg 68-69, JKD BE 01 o o o Z FIRE DEPT. STA. AS-BUILT NO CQRNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 11, BLOCK 1, SPRING FOREST SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not ovedap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 21st day of January ,2011 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) Affiliated Appraisers of Alaska Loan~0110037272 Uniform Residential Appraisal Report F,eNo. SBW 11-26 There are 15 comparable properties currently offered for sale in the subiect neighborhood renq n.q in price from $ 449,000 to $ 695,000 There are 22 comparable sales in the subiect neiqhborhood within the past twelve months ranc'nq in sale price from $ 133,350 to $ 745,000 FEATURE I SUBJECT COMPARABLE SALE NO. 1 COMPARABLE SALE NO. 2 COMPARABLE SALE NO. 3 6020 West Tree Drive 9300 Spring Hill Drive 6700 MacBeth Drive 6010 West Tree Drive Address 11/1 Spring Forest 4/2 Spr nfl Hill 2/2 MacBeth 10/1 Spring Forest Proximityto Subiect 1.04 miles NW 0.55 miles SE 0.01 miles SSW !..;~;~ ~...-, ~ ;;] $ 540,000 460,000 $ 525 000 ~-~ MLS #1011219 AMDS/MLS#101835 I AMDS/MLSCf0914792 Veritication Source(s) Municipality of Anchorage Municipality of Anchorage Municipality of Anchorage VALUE ADJUSTMENTS DESCRIPTION DESCRIPTION et-) $Ad, iustrnenl DESCRIPTION +(-) $ n~us~mem DESCRIPTION +(9 S Adiustme~l Sale or Financing ~!. !,~ conventional conventional conventional Concessions ";' .'~'?' seller paid -7,500 none known seller paid -4,000 Date of SalefTime 11/16/2010 05/07/2010 04/28/2010 Location average average average average Leasehold/Fee Simple fee simple fee simple fee simple fee simple Site 53,054 sf/arge 37,099 sf/large +8,000 60,195 sf/arge -4,000 39,939 sf/large +7,000 View average average average average Desiqn (Style) 2 story/avg multi-level/avg tri-level/avg 2 story/avg Quality of Construction average average average average Actual Aqe 27 years 28 years +1,000 33 years +6,000 27 years Condition average+ average+ average +10,000 average+ RoomCount '13 3 3.5 12 3 3.5 5 3 2 +6,000 9 4 3 +2,000 Gross LivingArea 35 3,340 sq. rt. 3,341 sq. ft. -35 3,037 sq. ft +10,605 2,883 sq.~t. +15,995 Basement & Finished none none none none Rooms Below Grade na na na na Functional Utility average average average average Heatin,q/Coolin,q GHWBB GFA GHWBB GFA Ene~,/Efficient Items average average average average Garaqe/Carport G2A G3BI -10,0001 G2BI G2BI~G1 D -10,000 Porch/Patio/Deck c/ent,dks,fp,itub c/ent,dks,3fp -4,000 c/ent,lgdk,2fp -1,000 c/ent, dks,fp,Htub -1,000' Other RDMC,shed RDG +1,500 RDGC,shed RDG +1,500 ,AdjustedSaleP~ce ~'~;~.~ NetAdj. -2.0%% NetAdj. 6.0% of Comparebles ~ ~¢~¢~?i GmssAdi. 5.9%% $ 528,965 GrossA~l. 8.2%% $ 487,605 C.~oss~.7.9%% $ 536,495 [~did E~ did not research the sale or transfer histo~-j of the subject property and comparable sales, if not, explain Myresearch E~did [~didn~trevea~anYpriorsa~esor~ansfers~thesubiectpr~Pe~Wf~rthethreeYearsPriort~theeffectivedateofthisapPraisaL Data source(s~,MuniC~rCr~ality of Anchorage, recorder's office, owner Myresearch Udid XLXJdidn~trevea~anY~rsa~esortrans~ersofthec~mporab~esa[es~ortheYearpdort~thedateofsa~eofthec~mporab~esa~e. Datasoume(s) MunicipalityofAnchorage, recorder's office Report the results of the research and analysis of the prior sale or transfer histoff of the subject prope~ and compareble sales (report additional prior sales on paqe 3). ITEM SUBJECT COMPARABLE SALE NO. 1 COMPARABLE SALE NO. 2 COMPARABLE SALE NO. 3 Dateof Prior Sale/Transfer no prior 3 yr. sales activity no prior 1 yr. sales activity no prior 1 yr. sales activity no prior 1 yr. sales activity Price of Prior Sale/Trensfer na na na Da Data Source(s) recorder's office, MLS recorder's office, MLS recorder's office, MLS recorder's office, MLS Effective Date of Data Source(s)January 28, 2011 January 28, 2011 January 28, 2011 January 28, 2011 ~ Analysis of pr or sale or transfer history of the subject property and comparable sales The subject has had no sales activity within the last three years. None of the Comparable Sales other than noted have had any sales activity within the last year. Summary of Sales Comporison Approach. See Attached Addendum. I~d;~,~Lud Value by Sales Comparison Ap~'oach $ 515~000 IndicatedValueby: SalesCornpadsonApproach$515~000 CostApproach(ifdeveloped}$ Da IncomeApproach(irdeveloped)$ Da . The Income App~oad, is not used as the sale price of single family houses are not based on income. Sole we ght is ,q yen to the Sales Comparison App~uach. The Cost Approach is not a reliable indicator due to the subject's age This per plans specifications on the basis of a hypothetical condition that the improvements have been completed is to [] subject to he following repa rs or alterations on the basis of a hypothetical condition that the repairs or alterations have been completed, or [] subject to the following required inspection based on the extraordinary assumption that the condition or deficiency does not require alteration or repair: See Attached Addendum conditions, and appraiser's certification, rny (our) opinion of the marker value, as defined, of the real property that is the subject of this report is $ 515,000 asof February 11, 2011 ,whichisthedateofinspectionandtheeffectivedateofthisappraisal. Affiliated Appr. of Alaska Fannie Mae Form 1004 March ~005 1004 050909O9 Affiliated Appraisers of Alaska Loan#0110037272 Uniform Residential Appraisal Report FileNo. SBW 11-26 The purpose of this summary appraisal report is to provide the lender/client with an accurate, and adequately supported, opinion of the market value of the subject property. I PropertyAddress 6020 West Tree Drive City Anchorage State AK Zip Code 99507 I Borrower Philip J. & Elizabeth H. Tremarco Owner of Public Record Jens F. & Megan C Nannestad County Anchorage Municipality ! Legal Description Lot 11 ~ Block 1 ~ Spring Forest Assessor's Parcel ,~ 015-321-15 Tax Year 2010 R.E. Taxes $ 7,032.05 NeighbarhoodName Spring Forest Subdivision ~ , Map Reference Grid SW 2538 Census Tract 0028.13 = Occupant E}owner E~Tenant [~)vacant Special Assessments $ []PUD HOA$ 62.50 E}peryear [~permonth ~ Property Riqhts Appraised [~Eee Simple ~E~Leasehold E]Other(describe) AssiqnmentType []PurchaseTransection URefinance Transaction []Other (describe) Lender/Client Residential Mortgage, LLC Address 100 Calais Drive, Suite 100, Anchorage, AK 99503 Is the subiect property currently offered for sale or has it been offered for sale in the twelve months pr or to the effective date of this appraisal? [] Yes [] No Report data source(s) used, offering pace(s), and date(s), inspection~ agent~ MLS #11-25, $475,000~ January 3, 2011 - January 7, 2011 (4 DOM). I []did [~didn~tana~yzethec~ntractf~rsa~ef~rthesubjectpurchasetransa~ti~n~Exp~aintheresu~ts~ftheanaiysis~fthec~ntractf~rsa~e~rwhytheana~ysiswasnetpert~rmed, There is a current earnest money agreement to purchase the subiect for $475,000 dated for January 5, 2010. In the appraiser's opinion the purchase price is below market value. Contract Price $ 475,000 Date of Contract 01/05/2010 Is the proper~y seller the owner of public record? [] Yes [] No Data Source(s) recorder's office Is there any financial assistance (loan charges, sale concessions, g ft or downpayment assistance, etc.) to be paid by any party on behalf of the borrower? [] Yes [] No If Yes, report the total dolIar amount and describe the items to be paid. none known Note; Race and the racial composition of the neighborhood are not appraisal factors. Location []Urban []Suburban []Rural P~;P;rtivaJues "Ella;rea;i;; []~;;;i;'"" ' DDeofi;'i';'4'"' PRICE AOE One. Unr[ 90 % Built-Up [~]Over75% [~25-75% [~Under25% Demand/Supply E]Shortaqe []lnBalanceE]overSupply $(000) (,frs) 2-4Unit 1 6rowth []Rapid []Stable E~slow MarketingTime []Under3mths []3-emths E]Overemths 100 Low new Multi-Family % ,' Neighborhood Boundaries Abbott Road on the north, Hillside Drive on the east, DeArmoun Road on 800 High 50 Commercial % · the south and The New Seward Highway on the west. The area is predominantly residential. 450 Pre& 20 Other vacant 9 % i Neighborhood Description See Attached Addendum. Market Conditions (including support for the above conclusions) See Attached Addendum. Dimensions irre§u ar - see attached plat map Area 53,054 Sq. Ft. Shape irregular View average Specific Zonin,~ Classification 96 Zonin,q Description Suburban Residential District (large lot) Zoning Compliance [] Legal [] Legal Nonconforming (Grandfathered Use) E~ No zoning [] Illegal (describe) Is the highest and beet use of the subject property as improved (or as proposed per plans and specifications) the present use? [] Yes E~ No If No, describe. Utilities Public Other(describe) Public Other(describe) orr-site Improvements--Type Public Private Electricity [] [] underground Water [] [~] community well Street asphalt paving [] Gas [] [] Sanitary Sewer E~ [] private septic A~ley none [~ [] FEMA Special Flood Hazard Area []Yes [] No FEMA Elood Zone D FEMA Map # 020005 0769 D FEMA Map Date not listed Are the utilities and off-site improvements typical for the market area? [] Yes [] No If No, describe. Are there any adverse site condftions or extema factors (easements, encroachmen s, any ronmental conditions, land uses, etc.)? [] Yes [] No If Yes, describe. An as built survey was not supplied. At the time of inspection the site was covered with snow. No adverse easements of encroachments noted. Units [~_)0ne EJOnewithAccessor,/Unit E]concreteSlab [~CrawlSpace Foundation Wall, concrete/avg ~,a0r,' cp;:til~.lamlhw/av9 # of 5todes 2 [] FullBasement [] Partial Basement Exterior Walls redwood/avg Walls SPJavg Type [] Dot. []Att. [] S-Dat./End Unit Basement Area none sq. ft. Roof Surface cedar shk/assm nv§ Trim/Finish wd,stn/avg [] Existina [] Proposed [] Under Coast. Basement Finish na % Gutters & Downspouts yes/yes/avg Bath Floor tile,vin/avg Besign (Style) 2 story [] Outside En~/Exit [] Sump Pump Window Type wood csmtJavg Bath Wainscot tile/avg Year Built 1984 Evidence of []Infestation Storm Sash/Insulated none/nm CarStoraqe []None EffectiveAqe0'rs) 18e []Dampness [~ Settlement Screens none/nm X~Ddveway #of Cars 4+ Attic , None Heating [] FWA ][] HWBB I E~ Radiant Amenities ..tWoodStove(s) # :Driveway Surface asphalt [] Drop Stair Stairs [~Other IFuelgas []Fireplace(s)# 1 ._)Fence [_~OGara,qe faf Cars 2 []Floor 2 Scuttle Cooling E]ceetralAirCondifioninq [] PatiotDeck large X~Porch c/ent [~Carport #of Cars [~)Finished Heated []Individual lB]Other [~]Pool letted tub X~Other shed [~)Att. [~Det. L~Built-in Appliances [~Refriqerator []Range/Oven []Dishwasher [~Disposal []Microwave [~WashedDryer []Other(describe)trashcompactor Finished area above qrade contains: 13 Rooms 3 Bedrooms 3.5 Bath(s) 3,340 Square Feet of Gross Living Area Above Grade Additional features (special energy efficient items, otc.). See Attached Addendum. Describe the condition of the property (including needed repairs, deterioration, renovations, remodeling, etc.). A Home Inspection Report was not supplied. The subject was kept in above average condition for it's are. Accord ng to the seller all of the electrical repairs required by the buyers have been completed. No health or safety required repairs were noted. Are there any physicaI deficiencies or adverse conditions tha affect the vability, soundness, o s~uctural integrity of the property? [] Yes [] No If Yes, describe. Does the property generally conform ta the neighborhood (func cna ut ty, stye, conditon, use, construetion, etc.)? []Yes E~No If No, describe. The subject conforms to the surrounding neighborhood. Produced ~Jng ^CI software, 800,234,8727 w~w adwed.comFannie Mae Form 1004 Ma~ch 2005 Page 1 of 6 1004 os 090909 Parcel I.D. # ./,~--~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On"Site Services Section P.O. Box 196650 Ancllorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 01'5-321-'15 GENERAL INFORMATION Corn plete'[~.gal description Lot 41; Block 1; Spring Forest Location (site address or directions) 6020 West Tree Drive · Anch6rage, AK ProPerty owner _ wl 1 1 i ~rn ~, F.] ~ zabeth Elmer . Day phone Mailing address _C/c) Prudential Jack white Real Estate ~nding agency Day p'hone Mailin. g address Agent _Man~y ~..~dnh~dn/ Prud~_ns. inl Jack w,hi~t..eDayphone Address 563-5500 Unle, ss otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well Public water xx _ NO'I'E: 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 ' XX Community on-site . ~: , . · ' Public sewer NOTE: If community wastewater system, provide W~i~tei~ confirmation from State ADEC ' attesting to the legality andsta~us ~)f's~/stern'. :':" ~ ' : ' 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. I further verifythat based on the information obtained from the Municipality of Anchorage flies 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, Address Engineer's signature ordinances, and regulations in effect On the date of this in~ A aska Water & / DHHS SIGNATURE I.'"" Approved for "'~/t'//~2~ ~ bedrooms. Disapproved. ,ection. Phone Date Conditional approval for bedrooms, with thee 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 g~ven 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 conduc~ !nspections.or analyze data before a certificate is issued. The Municipality of Anchorage ia not responsible for errors or omissions in the professional engineer's work, Municipality of Anchorage MAY 2 DEPARTMENT OF HEALTH & HUMAN c.,~i~IFJI~¥ Environmental Se~ices Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: ±:;)~3f'lrv-.~ JO',oeec, ~:){' II. {~-~l'( J Parcel 1.1:::),:~OI5 - 3~,1 - 15 ! ',J · A. WELL DATA Log prese~J~N',, Date completed Total death "'""~.~.....~ Cased to Sanitary seal (Y/N) FROM~~WELL Date of test f A, B, or C, attach ADEC letter. ADEC water system numeer ~13~ _ Static water level Well productien WATER SAMPLE RESULTS: Coliform Date of sample: Casing height (abeve grouno) Wires properly protected (Y/N) AT INSPECTION Nitrate g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed 5/cJ~ Tank size Foundation cleanout (Y/N) _ y Depression (Y/NJ Date of Pumping J~¢.~.~.~_ Pumper. Other bact~ Collected by: Number of Comeartrnents o~ __ Cleaneuts (Y/N) High water alarm (Y/N) C, ABSORPTION FIELD DATA Date installed 5,/~J'cJ~J Soil rating Cft~or ftVbdrm)_ /.2 Length _ ~)1 Width 5 ' Gravel thickness below pipe_ Effective absorption area ~,~ Monitoring Tube present (Y/N) ~ _ DeoressJon over field (Y/N) ~ a~acy test Results (Pass/Fail) For bedraoms Fluid depth in absent, re test (in,); Immediately after gal. water added (in.): Fluid depth (ins) Minutes later: ~. Absorption rate = g,p,d, Peroxide treatment (past 12 months) (Y/N) If ye~ 72-026 (Rev. 3/96)* ~~~ _ System type ,.,~ ¢~.~ 4 _ Total desth II "~'-' ~ Size in gallons Manhole/Access (Y/N)"~'~'"'~- "Pump on" level at* __ "Pump off" level at* High' water alarm level at* SE"ARATIO W 's c/ eldin ankon,ot ON LOT TO: On adjacent lots Absorption field on lot ~ On adjacent lots Public sewer main Pu~bli~cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I J Property line [,¢O / Absorption field Water main/service line /4~) ~ Surface water/drainage 1~'+ Wells on adjacent Iots¢ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~* Building foundation .~,~,~,~,~,~,~,~,~ ' Water main/service line Surface water ~'~' Driveway. parking/vehicle s(~age area /~,' Curtain drain ~:~, ~ Wells on adjacent lots -- ~.O~ "~ ENGINEER'S CERTIFICATION ~/ ~ OF A , ceflify that, ha~e~ine~eld inspections and review of Municipal re~~tems are in conformanc[wit~ ~¢A HX~l~/ines in effect on this date Signature ~ ~~ _ ~nglneers Name t/ ~ ~ , ,-- ~ HAA Fee $. Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTM£NT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. lox 196650 Anchorage,~,laska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA # 1. GENERAL INFORMATION Complete legal description Location (site address or directions) ~, 0 ~_0 I.¢J.~ ¢- Property owner Mailing address _/o2-q dC,/ Lending agency Mailing address Agent ~..~- ~¢ Address ~-~ Day phone_ Day phone 2. NUMBER OF BEDROOMS: 3. TYPE-' OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4, TYPE OF WASTEWATER DISPOSAl_: NOTE: Individual on-.site ~< Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOA ¢t21 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. 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 -'/~*J~/~'~-H ~;/¢'j,C~-~;'~¢ I">L~ Phone Address ;~0'~ b~ Engineer's signature ~~¢~¢ Date DHHS SIGNATURE ,~ Approved for ~>~ bedrooms. Disapproved. Conditional approval for 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. Em ployees 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} 8ack MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type ~' Log present (Y/N) Parcel I.D. If A, B, or C, attach ADEC letter. Date completed ADEC water system number Driller Total depth Sanitary seal (Y/N) Cased to_ Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot g.p.m. AT INSPFCTION ; On adjacent lots __ g.p.m. Absorption field on lot ; On adjacent lots Public sewer main Public sewer manbole/cleanout Public sewer service line Petroleum tank WA-I-ER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B, SEPTIC/HOLDING TANK DATA Date installed I ~/~/_~2~ Tank size Cleanouts (Y/N) _ ~ Foundation cleanout (Y/N) High water alarm (Y/N) I'¢/,~, Alarm tested (Y/N) Date of pumping _ It'~% I**[ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot_ To propertyline Surface water/drainage _On adjacent lots Absorption field ~ ,~.~ Compartments Depression (Y/N) Foundation ~ Water main/service line 72-026 (Rev. 3/91) F~ont MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION ~,,~/^ //....~ Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ,~O / Width Total absorption area Depression over field (Y/N) Results (pass/fail) "'-~ Peroxide treatment (past 12 months) (Y/N) Soil rating Gravel thickness Cleanouts present (Y/N) Date of adequacy test for System type Total depth If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I%///, To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ~/,~,, Property line To existing or abandoned system on lot Cutbank ¢'.//",.z~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify t/Tat I have checked, verified, or conformed to all MOA and HAA guideli~e.s.!n~e/fect on the date of this inspection. Signature Engineer's Name Date HAA Fee $ / Date of Payment (/ /~' ~1/~:/// Receipt Number ~ ~..t'fi0 Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3191) Back MOA 21 675i ~1. D~NOND SLVD, ANI]HORAGE, ALASKA 99502-3904 (907) 248-5095 LEGAL: LOCATiI]N: OWIqER: RES I DENCE ~: I~}EI_.L: .~EP'I' I C ..~ Y'E~,TIEM: DA'IE OF LAST PUI¥1PII',I~: Anl:::l'~ il;~::.!s;i!~ I:::'l::*c:*l Jull(::~' '2/,~ :lC;"v';J DATIS; OF TIES'F.' ~,;a'(:(~r' ]. ~:p,,'~::)l ho.d (:tr"(}l:;d:)dhJ tot 't'.he J id. t.~ a] I. e,,n.:Hl ,, i rid~ cal":~ nqj th,e,'L TEE;-F RESULT,* t:. J ]/:;, i Jc, E~i[ 1.7 Il :?dgd E~(:]C: J L~Z!. I:lie I'1u¢ d. c::i. p,?, L.t' ~.+ ),' (:)'(:: I'fftC.}l(]i" .... ~::,(.l(: ,, WALTER J. HICKEL, GOVF. RNOR DEPT. OF ENVIRONMENTAL CONSERVATION 3601 C STREE'F, SUITE 322 ANCHORAGE, ALASKA 99503 July 8, 1991 FOR: Tobben Spurkland, P.E. Consulting Engineer 563-6775 [ ECEIVED ,JUL. 8 1991 Mu;~ici },~hty of Anchorage Dept. -leal£h & Human Services PWSID #210605 My review of the records on file in this office reveals that the Valli Vue Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, ~ Keven K. Kleweno Lead Engineer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 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 IcL block, subdivision, section, townsh p, range) /'_~ ,/ .8/~/z. / ~?,4.)/v~ /~o~E~,~' Location (address or directions) 0¢o t,v. (b) Applicant Name Telephone: Home t~/~'-6,1 /'"'¢~') Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); (d) Lending Institution. Telephone Address Real Estate Company and Agent Address l'elephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family'~ Multi-Family [] Number of Bedrooms ?~ Other Individual Well [] 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 Onsite'~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84} Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and lype of structure indicated herein. I further verify that based on tile information obtained from tile Municipality of Anchorage files and from my investigation end inspection, the on-site water supply cad/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Address Approved for-~.~-¢-~' bedrooms by Approved ___ .'~ Disapprov~ Terms of Conditional Approval Conditi~rf~ 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 s certificate is issued, The Municipality of Anchorage is not responsible~ for errors or omissions in tile professional engineer's work. Page 2 of 2 72-025 I11/84) MUNICIPALITY OF ANCHORAGE (MO~j HEALTH AUTHORITY APPROVAL [HAA) CHECKLIST- FEBRUARY 1984 264-4720 MUNICIPALffY OF ANCHORAGE DEPT. OF HEALTH & Legal Descdeuon: ENViP, ONMENTAL PROTECTION WELL DATA Well Classification *~F'~Pi¢/Vr'~u~ ~'/" I" i ILL~ j~ B. C. D.E.C. Approved (Y/N) KEL, E! v Wel Log Present (Y/N) Date Completed Yield Total Depm _ _ Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot,t1 To Nearest Edge of Absorenon Field on Lot To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by Water Sample Test Results Deoth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depresmon Around Wellhead (Y/N) ; On Adjoining LOtS : On Adjoining Lots _ To Nearest Public Sewer To Nearest Sewer Service Line on Lol ; Date SEPTIC/HOLDING TANK DATA Date Installed l/2~/¢.7/~ Size /'2'~'~'~:;~ - NO. of Corr 2ar[merits '~' Standpipes (Y/N) ,y~z;~ Air-tight Caps (Y/N) _')/~-e; Foundation Cleanout IY/N) - Depression over Tank (Y/Nt - ~./LO Date Last Pumpea Pumping/Maintenance Contract on File (Y/N) ~ for Holding 'Tank High-Water Alarm (Y/N) -- Temporary Holding Tank Permil (Y/N) Separation Distances from Septic/Holding Tank: ,~)/..:) 1'7 / To Water~SL pply Well 't'. I~0/,'~-,'~k¢~ ~' To Building Foundation To Property Line ;~' ~,"~ ~'O! To DJseosal Field ~-'/ To Water Mair/Service Line .4,' 0,.~ I Course /~ 4" To Stream Pond, Lake, or Major Drainage Comments Page ' ol 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field ,_~¢, ii Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separatior~ Distance from Absorption Field: To Water-Supply Well / To Building Foundation Lot /"J lA' ~?~[ ~'~)/"~0~'1"?/~ '¢/ Type of System Design Length of Field ¢(2 / Depth of Field Gravel Bed Thickness ,'¢/~'O .-~,.,¢' Standpipes Present (Y/N) j~O Date of Last Adequacy Test To Water Main/Service Line ...r /..¢~I,~.o,~-- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) 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 Page 2 of 2 z2.026 (1 U84) ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have check6~, verified, ¢r'~onformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed IA_~ ~t~,~. ¢ 2/~7~.O Date Date of Payment // DEPT, OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 To Whom it May Concern: According to records on file in this office the t ' ~ ~: ~/:~/~/~/~ Water System is in compliance with the State Drinking Water Regulations Sincerely, MUNICIPALITY OF ANCEORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF '~D~ALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORI~"f APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicants Name ~rl,.~ t~,.~ ~'-? ~e. Telephone - (c) Applicant is (check one) Lending ~nstitution ~ ; ~er/builder ~ ; (d) Lending Iastitution A d~.~ls s Telephone (e) Real Estate Co. & Agent Address Tel(:phone (f) Mail the HAA to tile following address: ~%p9 of Residence Single-Family~_~ Number of Bedrooms Multi-Family Other ~describe) ~at___~er Su~y_ Zndividtml Well L--_] Community Public ~__~ Note: If community well system, must have written confirmation from the State Department of Environmental Consezwation attesting to the legality and status. S ewe a~i s___p_o sal Onsite [~ Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. ~E~.8.ineerin8 Firm Providt_ng_I_~nppections, Test.8_~ File Sear___ch~ Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I varify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastews, ter 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-sits water supply and/or wastewater disposal system is in compliance with all Municipal ar~! State codes, ordinances, and re§ula- tions in effect om the date of this inspection. Terms of ConditionaJ. Approval CAUTION TH]Z MUN][CIPALITY OF ANCHOR&GE DEPARTMENT OF 'HEALTH AND ENVIRONMENTAL PROTECTION (DItEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIF][CATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAJ?H 5 ABOVE BY AN INDEPENDENT PROFESS]iONAL ENG][NEER REGISTERED IN THE STATE OF ALASKA. TRE DHEP DOES THIS AS A COURTESY TO PURCHASERS 0F HOMES AND THEIR LENDING INSTITUTIONS IN 0RDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- bfENTS. 5~MPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCEORAGE IS NOT P~-SPONSIBLE FOR ERRORS OR 0M~SS][ONS IN THE, PROFESSIONAL ENGYNEER'S WORK. (DEEP SEAL) IU[4/eJ/D18 [Page 2 of 2] 7-19-84 WELL DATA Well Classification Well Log. P~esent'~_L~y/N Total Depth... MUNICIPALITY OF ANCHORAGE (MOA) HEALJ~ ~JTHORITY APPROVAL (HAA) C~CKLIST - FEBRHARY 1984 MUNICIPALITY OF ANCI,IORAG~ DEFT, OF HEALTII & ENVIRONMENTAL PROT:CTION Cased to Depth of G~ot~._tj. ng: Static Wate~ Level ~ __ Pump Set At Casing ~ight Above G~ound x~~ ~anl~a~y Seal on Casing (.Y/N) Eleetzric:al Wi~ing in Conduit (.Y/N~ /. ~P~esszon A~ound We] lhead (Y/N) Separation Dis.tances f~,om Well: To Septic/Holdzng Tank o~ ]Lot_ // ~%, _; On Adjoining Lots__ TO Near, st ~ge of Abso~ption~ie~.d et1 Lot ~ ; On Adjoining Lots To Nearest ~%Jblie Sewez,~L~ Cleancut/Manhole~~ /- Wate~ Sampl~e~C~oilected By, Wate~Sample Test Results ~T~Nea~est Public Sewe~ To Nearest Se~xxSe~vice Line on Lot: ; Date ~ B. SEPTIC/HOLDING TANK DATA Date Installed ..IZ-/~-?/~5 Size__.lz ~ o No. of Con~a~tments Stan~i~s ~) ~/~ Ai~-tight Caps ~) ~ Foun~tion Cleanout (Y~) ~p~ession o~ Ta~ (Y__~ 5~te ~st P~d . ~ [k ~ - P~.ng~intenan~ ~n~ac~ on File !Y~) ~ ~ ; fo~ Holding Tank Hig~-Wate~ ~a~ (Y~) ~ ~ ~,~a~ HoldiD~ Tank Perm~) ~p~,ation Distan~s ~ Septie~olding Tank~ Foundat lqD</~ ' To Wate~--Supply ~11 ~OO-P _ To ~ilding ' To ~o~ty Li~ '50 _. To Dis~sal Field To ~ter Mai~Se~vi{~ Li~ ~~%_ To S~e~n, ~e~, ~e, ~ Majotr ~aina~ O/.~ Date Paid: ~oun t: ~c-~ ' of 2] [Page 1 2-15-84 C. ABSORPTION FIELD DATA De Soils Rating in Absorption Strata Date Installed~-' ;~ /Z~ / ~ width of Field ~ %6 ' Square Feet of Absorption A~ea Depression ove~ Field (Y~ Results of Last Adequacy Test ~ '/~ Type of System Ees ign Length of Field ~p~ of Field ~ Grail ~d Thick.ss ~ Stan~ims ~esent ~ of ~st A~a~ Test Separation Distance f~cm Absorption Field: To ~ate~-Supply Well ~¢~co ~ ¢ To P~o~e~ty Line ~ To Building Foun~tion ~ 7- ~ To Existing o~ ~ndo~d System To Wate~ Main/~vi~ Line ~-~ To ~t~(if p~e~nt) ~ ~ _ To ~way, Pa~k~~ ~ea, ~ V~hxcle Stora~ ~ea &o' ~ q' : ~o1~~ / "~ Size in Gallons ~ "P~p On" Level at High Water Alal-mLevel at Tested fo~ Electrical Codes(Y/N) Comments Manhole/a~/N) ~ Vent (Y/N) Pump' ~ycles ~nO~ dequacy Test. Meets MOA ** Check Permitted Bedroom Rating A~ainst HAA Request I certify that I have checked, verified, o~ conformed to all MOA on the date of this inspection. Signed ~ ~ Co. an:, 'r KB1/d5/s [Page 2 of 2] HAA Guidelines in effect 2-15-84 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA gg501 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom it May Concern: Accord ingQ. · '__t° records on file in this of fi ce the Water Regulations Sincerely,