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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 2 LT 11Majestic Valley Estates Lot 11 Block 2 #050-731-39 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: SW970310 PID Number: 05073139 Kenneth J. Gerard Wastewater System: :[:] New [] Upgrade ^ddraaa:30924 Prudhoe Bay Avenue Eagle River, AK 99577 ABSORPTION FIELD Phone: NO. of Bedrooms: 345-8085 3 [] Oeep Trench Z:] Shallow Trench C] Bed [] Mound r'] Other Total (Depth from original grade: LEGAL DESCRIPTION Soil Rating: o8 GPD/So. ,:t. 8lock: Subdivision: iDeDlh Io pipe boIlom lrom original grade: Gravel depth beneath pipe c0~: 11 2 Majestic Valley Es!t. 0 ~l. 2 Ft. Township: I Range: SecIion: Fill added above original grade: Gravel length: 3 ' Number ~f lines: 0[slanca ~e~ween line~: WELL: [] New [] Upgrade Gravelwidth: 5 ¢~. I - ~t.~. Classilicalion (Private, A,B,C): Total Oeplh: Cased To: Total absorption area: Pipe material: Private 400 ~. 70 ~t. 628 so.~. ASTM 3034. F810 -Oriller: Date Drilled: StalJc Waler Level: Installer: Date installed: Sullivan 9/18/9 205 FI. Haman Const. 10/1 ,17/97 Yield; PUld Set at: Casing He~gnt~bove Ground: 6 OPu F,. p~. TAN K SEPARATION DISTANCES x~ Septic [] Holding [] S.T.E.P. From Tank Field Slalion Tank Sewer Lines Anch. Tank 1 , 2 5 0 Well > 100 > 100 N/A N/A > 10 ' Malarial: Number of Compartments: Steel Surface >100 >100 N/A N/A >100' LIFT STATION - N/A Water Lot > 5 ' > 1 0 ' N/A N/A > 1 0 ' size in gallons: Manufacturer: Line Foundation >5 ' > 10 ~ N/A N/A N/A "Pump on" level at: "Pump off" level at: High water alarm at: Curtain None on Lo' Pump Make & Model Electrical Inspections performed by: . Orain Remarks: 2" Insulation over s~pt~c BENCH MARK Location and Description: tank. Top of Foundation Wall t Assumed 1 0 8.7 Elevation: - ,nspectionsperforrnedby: m-,,~-~- ¢.4]h¢~- Dates:lst 10/1/97 ~.:;'V~';~/:'''(::''~,,;.-,-.-.oo.-.-:-.-~,.,~.--r,~,r~ 2nd ~ n / 17 / 9 ? ~ . 3rd 3/22/98 Department of Health and Human ~erv~ces approvm ~/ (¢ /~¢(,¢,X,¢~ Date: ''/')'4/~ '¢~~~.~-~"~"~ Reviewed and approved by: r2-ola (Re-v. 9/91) MOA 25 Municipaiity of Anchorage' page ~ of-'.'.'.'.'.'.'.'.'~-- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 · Anchorage, Alaska 99519--6650 · Telephone: 343-4744 ' · On-$lte. Wastewater Disposal System and/or Well Inspection Report Permit.Numbe~. ,q~q'7 n '~ 1 n Driveway Three B Home C03 ~ TH1 ~ ~------ TH2 ~ Alternate Site 'PID Number:. __~o 7 3 1 3 9 Wel B C C04 44' 24~8 MT 43.6' 25.3 C03 50' 73.8 S1 8.9' 13oq' C04 TH3 PLAN AS-BUILT SCALE 1" = 20' Municipaiity of Anchorage' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 : On-$iteWastewater Disposal S~,stem and/or Well Inspection Report Permit Number: SW970310 PID Number: ' 0507~1~ . ^ - Ii G~_ot_~×tile Fabric / L II Il ^ ~ ~' ~ =~ Drain Rock I I, ~]lm~~ PROFILE AS-BUILT SCALE 1" = 10' EN 1S (10/78; 05/17/95 TUE 17:14 FAX 907 276 8357 by SULLIVAN WELLS P.O, BOX 670272, ~HUGIAK, ALA!~KA 99567 · TELEPHONE 6B8-2759 O02 BoRE HOLE DATA DEPTH ADDRESS: PERMIT NUMBER~D~IO Date of lssue T~INDENTIfflCATION NUMBER ~ ~0~~ _ Is well located et approved perm~ location? ~s ~ No Method of Drilling: ~r rotaw ~ cable tool Depthefwell:. ~0~ Casing Typo ~Wall Thickness · ~ ~ inches Diameter ~. ~ ¢1 inches, depth- 7~ ~ ~ II jeer Liner Type: _ ~ ~E ~ Casing Stickup Above Ground: ~ ~ feet Statb Water Level [.from ground level): ~G ~ f~et Pumping level:_ ~eet affe~ hrs. pumping ~ ..gpm Recover Rate: ~ ~ gpm Method of Testing; ~1~ Well Intake Opening T~e: ~ Open End ~en' Hob ~ Screened; Sta~~t Stopped feet ~ Perorations Sta~ feet Stopped feet GmutT~e:~Volume- /OO &~ . . Depth: from ~ ~eet, to ~ feet Pump intake Depth: feet Pump Size~ .hp Brand Name Well Disinfected Upon Completion? ~s ~ No Method of Disinfe~ion: ~N4~ ~ ~O ~ I)/t°mments: . ~ Driller's Name ATTENTION'. It is the responsibility of the property owner to submit a copy of the well lag to the proper authority, Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borou~h: Department of Environmental Consewation. Municipality of Anchorage .._~pt._Health & 14u~an ~ervi~t~ _ I PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ~uND HUFLAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NI/MBER:SW970310 DESIGN ENGINEER:2~qDERSON ENGINEERING OWNER NAME:GERARD KENNETH J OWNER ADDRESS:30924 PREYHDOE BAY AVE. EAGLE RIVER, AK 99577 DATE ISSUED: 9/15/97 EXPIRATION DATE: 9/15/98 PARCEL ID:05073139 LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES BLK 2 LT 11 LOT SIZE: 64776 (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: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 D/qD 15.65 ~ THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) kND 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 ~LND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. MAINTAIN 4 FT OF SEP~d~ATION FROM SEASONAL HIGH GROUNDWATER TABLE ~ BOTTOM OF THE SEPTIC SYSTEM. RECEIVED BY: ISSUED BY: '~ ~ DATE: DATE: MEMORANDUM RECEIVED DATE: September 12, 1997 SIP '1 2 199'~ ~ Municipality si Anct~orago TO: Anthony Klm, MOA- DHHS uept. Health a Human Services FROM: Mike Anderson, P.E. ?4'q~'.&~. SUBJECT: Lot 11, Block 2, Majestic Valley Estates Subdivision Septic System Construction Permit I have revised the septic system design to reflect an adjusted groundwater level of 6'. The absorption trenches will now be constructed with a maximum depth of 2' below the surface. Distribution piping will be placed .5' above the ground and 2' of drainfield rock will be placed beneath. Attached m'e plan sheets and specifications which have been modified and must replace those in the original package. Please replace the sheets modified and issue the permit for construction of the well and septic system on this lot. Thank you for your time and patience. September 11, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 RECEIVED SEP 12 1997 Municipality ot ^~cnorage Dept, Health & Human Services Subject: Lot 11, Block 2, Majestic Valley Estates Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to install a new septic system on Lot 1 1, Block 2, Majestic Valley Estates Subdivision. The attached site plan and backup documentation identify the location, size and components of the new septic system proposed to serve the three bedroom home on the lot along with the reserve system site. The testhole placed in the area of the proposed absorption trench revealed silty gravel with a percolation rate of 10 minutes per inch. Groundwater was encountered at 7' and remained stable during the monitoring period. We are therefore proposing placement of 2- 40' long by 5' wide by 2' effective depth absorption trench for disposal of septic effluent. 3' of cover will be placed over the trenches once construction is complete to prevent freezing. A minimum of 15' will be required between the distribution piping in the respective trenches. The ground surface of the lot slopes from north to south at varying grades ranging from 4% to 10%. The surface of the ground in the area of the new trenches is fairly flat. A flow splitter valve will be placed to assure the effluent is equally divided among the two trenches. The trenches may not be at the same vertical elevation. If the system is constructed as designed the following statements apply: THREE BEDROOM HOUSE FLOW SPLITTER VALVE O O O O MONITOR TUBE FOUNDATION CLEANOUT 1,000 GALLON SEPTIC TANK CLEANOUT O 40' LONG X 5' WIDE X 2' EFFECTIVE DEPTH ABSORPTION TRENCHES 'SYSTEM PLAN NO SCALE LOT 11, BLOCK 2, MAJESTIC VALLEY ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Perc. Rate: 10 Min./Inch Application Rate: .8 GPD/SF 5' Wide Trench System New 1,000 Gallon Septic Tank 2' Drainfield Rock 3 Bedrooms X 150 GPD / .8 GPD/SF = 552.5 SF of Absorption Area 562.5 SF/5 LF (Width) X .7 (Red. Factor) -- 78.75 LI= Trench Length Therefore: Construct a 5' Wide Absorption Trench System With Two Laterals Each 40' in Length with 2' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at .5' Above the Original Ground Surface. Laterals Must Be a Minimum of 15' Apart Center to Center. ///'~\ VI l x.\\tll ~'xX I I x\\lllx, x~ NOTE: TYPICAL 5' WIDE TRENCH (NO SCALE) Minimum 3' of Cover over Septic System. Minimum 4' Separation From Groundwater. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: Lot 11, BLOCK 2, MAJESTIC VALLEY ESTATES GENERAL: 1. The scope of this project includes the acquisition and placement of a new 1,000 gallon septic tank and the construction of two new 40' long by 5' wide by 2' effective depth absorption trench. The distribution pipe in the trench to be placed .5' above the existing ground surface. It also includes placement of a minimum of 3' of cover over the trenches. Trenches shall be a minimum of 15' apart from center of pipe to center of pipe. 2. Construction shall be in accordance with the approved site plan, 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 all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1.A new 1,000 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. September 1, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 11, Block 2, Majestic Valley Estates Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to install a new septic system on Lot 1 1, Block 2, Majestic Valley Estates Subdivision. The attached site plan and backup documentation identify the location, size and components of the new septic system proposed to serve the three bedroom home on the lot along with the reserve system site. The testhole placed in the area of the proposed absorption trench revealed silty gravel with a percolation rate of 10 minutes per inch. Groundwater was encountered at 12' and remained stable during the monitoring period. The water level in Testhole No. 2 however stabilized at 7' below the surface. We are therefore proposing placement of 2 - 36' long by 5' wide by 2.5' effective depth deep absorption trenches for disposal of septic effluent. 3' of cover will be placed over the trenches once construction is complete to prevent freezing. A minimum of 15' will be required between the distribution piping in the respective trenches. The ground surface of the lot slopes from north to south at varying grades ranging from 4% to as much as 10%. The surface of the ground in the area of the new trenches is fairly flat. A flow splitter valve will be placed to assure that effluent is equally divided among the two trenches. The trenches may not be at the same vertical elevation. If the system is constructed as designed the following statements apply: Lot 11, Block 2, Majestic Valley Estates September 1, 1997 Page Two The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the area. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments Undeveloped· 9 Undeveloped 13 THREE BEDROOM HOUSE FLOW SPLITTER VALVE © © O MONITOR TIJBE 1,000 GALLON SEPTIC TANK CLEANOUT © 36' LONG X 5' WIDE X 2.5' EFFECTIVE DEPTH ABSORPTION TRENCHES SYSTEM PLAN NO SCALE LOT 11, BLOCK 2, MAJESTIC VALLEY ESTATES SUBDIVISION DESIGN FACTORS: sYSTEM REQUIREMENTS: Three Bedroom Home Perc. Rate: 10 Min./Inch Application Rate: .8 GPD/SF 5' Wide Trench System New 1,000 Gallon Septic Tank 2.5' Drainfield Rock 3 Bedrooms X 150 GPD / .8 GPD/SF = 562,5 SF of Absorption Area 562.5' SF/SLF X .64 (Red. Factor) = 72 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench System With Two Laterals Each 36' in Length with 2.5' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at .5' Below the Original Ground Surface. Laterals Must Be a Minimum of 15' Apart Center to Center. NOTE: TYPICAL 5' WIDE TRENCH SEC'r'ION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Minimum 4' Separation From Groundwater LOT 11, BLOCK 2, IVIAJESTIC VALLEY ESTATES SUBDIVISION (Alternate Site) DESIGN FACTORS: Three Bedroom Home Perc. Rate: 30 Min./Inch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: 5! Wide Trench System New 1,000 Gallon Septic Tank 2.5' Drainfield Rock 3 Bedrooms X 150 GPD / .6 GPD/SF = 750 SF of Absorption Area 750 SF/SLF X .64 (Red. 'Factor) -- 96 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench System With Two Laterals Each 48' in Length with 2.5' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at .5' Below the Original Ground Surface. Laterals Must Be a Minimum of 15' Apart Center to Center. NOTE: TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Minimum 4' Separation From Groundwater Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Ken Gerard LEGAL DESCRIPTION: Lot 1 1 , Block 2. Township, Range, Section: Majestic Valley Estates SLOPE SITE PLAN N SE ~ · IT ~ · LA ~ OL I TEST HOLE NO. ~ GM Hard, Dry Olive Gray / WAS GROUND WATER ENCOUNTERED? ' Yes 1" to 6" ~ 11 Cobbles ~F YES, AT WHAT DEPTH? 1 2 ' p 12 E 33 I~10mmring? 1 2' ~~7 Gro~ Net De~th to Nat Reading Date Time . Time Water Drop / ~'' {s; ~'7 ~ o /~'I~" ~ ~I¢~ /~$ /~:57 /O $/¢~ -- ~ ? /; 57 /O 3/¢ ,, 14 i5 of Hole 16 17 18 19- J 20- 10 __ PERCOLATION RATE __ (m~nutes/~nch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN__4 FT AND 4.5 FT COMMENTS Test hole presoaked prior to test. PE. RFORMEDBY: Stuart Gil~er~. I ~/~'~¢;'~"' ~'~'~"'~--CERTIFY THAT THIS TEST WAS PERFOI:IMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: q / 1 / 9 7 72~O8 (Rev. 4/85} -/ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Ken Gerard PERFORMED FOR: LEGALDE~RI~ION: Lot 11. Block 2, Majestic Valley Estates OL 1 2 3- 4- 5- 6- 7- 8- 9- 10- 11 12 14- 15 16- 17- 18- 19. 20- TEST HOLE NO. ~ GM Damp @ 6' COMMENTS DATE PE, R FOR Township, Range, S~tion: of Hole SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? ' Yes .$ IF YES, ATWHAT 1 3 ' ~ DEPTH? p E 7' ~'8/1 5 m SEE ;I~E ~L~N PERCOLATION RATE 0__ (mlnutes/mch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN , 4 FT AND 4.5 FT 'Test hole presoaked prior to test. pF. aFORMEDB¥: Stuart Gilber~ , ~~ ~-"~"--0~T,~'TH~T'rH,STESTW~S,ERFORMF. D,N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE~ DATE: 9 ,/1 ,/9 ? 72.~o~ (R~. 4/85) ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: Lot 11, BLOCK 2, MAJESTIC VALLEY ESTATES GENERAL: 1. The scope of this project includes the acquisition and placement of a new 1,000 gallon septic tank and the construction of two new 36' long by 5' wide by 2.5' effective depth absorption trenches. The distribution pipe in the trench to be placed .5' below the existing ground surface. It also includes the placement of a flow splitter valve and the placement of a minimum of 3' of cover over the trenches. Trenches shall be a minimum of 15' apart from center of pipe to center of pipe. 2. Construction shall be in accordance with the approved site plan, 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 all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1.A new 1,000 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. Lot 11, Block 2, Majestic Valley Estates September 1, 1997 Page Two 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lot 11, Block 2, Majestic Valley Estates September 1, 1997 Page Three 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfieid rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted watertight couplings (Caulder, Fernco, or equal). with Lot 11, Block 2, Majestic Valley Estates September 1, 1997 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. DATE: TO: FROM: MEMORANDUM October 1, 1997 Anthony Kim, MOA- DHHS Mike Anderson, P.E. '~ -'~-/'k-' Ivlunic~pallty ct Anchorage Oept. Health & Human services SUBJECT: Lot 11, Block 2, Majestic Valley View Estates Subdivision Permit Number SW970310 Conditions encountered in the field during the construction of the new absorption trench to serve the throe bedroom home proposed for the subject lot are more conducive to a single trench than parallel trenches as shown on our original design. We am therefore requesting the permit be modified to allow construction of 1 - 87' long by 5' wide by 2' effective depth absorption trench. The cross section of the trench will be the same as that originally proposed. The attached site plan shows the location of the trench as well as the alternate site. It also shows the location of three percolation testholes which were placed at the bottom of the new trench. The results of the percolation tests are enclosed for your review. The trench is designed for percolation rates between 6 and 15 minutes per inch. The rates achieved in the new trench are faster, but the trench is designed for the slower rate. Placing a single trench will result in lower construction costs and will allow more usable area for a replacement site. We therefore request the permit be modified to allow the single trench as opposed to the parallel trenches. Thank you for your time and consideration with this project. PERFORMED FOR: LEGAL DESCRIPTION= Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE Township, Range, Section: I:: ~"" (~NGINEER'S SEAL) 9 10 11 12 13 14 15- 16- .. 17- 18- 19- COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN S IF YES, AT WHAT OL DEPTH? p E Gro~ Net Dep~,h to Net Readln~ Date Time . Time Wet~ PERCOLATION RAT .~ ' ~7 (minutes,tach) PERC HOLE DIAMETER . TERT RUN BETWEEN Z,~" FTAND 5 FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE~ DATE: 72-008 (Rev. 4/85) .. ' ' TH/~T TH}S TEST WAS PERFORMED IN 71 19'7 PERFORMED FOR: LEGAL DESCRIPTION; Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13- 14- 15- 16- 17- 18- 19- SLOPE SITE PLAN · WAS GRouND WATER ,/~D ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Gro~ Net Depth to Net Readln~ Da~ Time . Time Water Drop ~z. tt:~ I~ /z,', .~'-I ; /z. ,'"/9 / ~0 / Z" / P" PERCOLATION RATE / , (minuteS/tach) PERC HOLE DIAMETER TEST RUN BE"TWEEN ~* ~ FT AND '~ FT 72-008 (Rev. 4/85) · ' PERFORMED IN PERFORMED FOR:. LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "1." Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: 1 2 3 4. 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18- 19 20 COMMENTS SLOPE WAS GROUND WA. TER /,~ g · ' ENCOUNTERED? S IF YES, AT WHAT DEPTH? p E Depth I~ Warn' kJt4r MoAitaing? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ~ /~ ~ , /~ ?,, / ~ ,, _ . ~ /~ ~1 /~ 7" / ~/W~ PERCOLATION RATE ''~' '7 (minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN ~'" ~'FT AND '~ FI' , ~ D^T[ ' ~'/.~0/¢ ACCORDANCE WITH ALL STATE AND MUNICIPAL GU DEL NES IN EFFECT ON THIS DATE. ": -- / f , ~/ PERFORMED iN 72-008 (Rev. 4/85J 1 ClRCj i Lot 10 N N6 Z N'.000 M rN: Y N Q1. N aI..1...� _ :_�. In: A DU OO1f En /yuFol Q � : p z mm ....... �� 00... � ° o O ° N OM a C 0 a L ° O n ° Eo COOO °omo 0 00 c°t Ln `o°Zm `o Ea ,o> n aaioorn A n a 0 n c M W a c 0.2 N 30NN0CN��.C° 't ... O O > CV 10 N a° 0 0 t 0.0 D OPn0 m, h O.^ L° 0" ��amoc a c�°oo m m £0- '04.H o. m° c c dO>O.O. o 0 MY fn 0 Uro.°Q c a L o E+Z=°m 9 — °y mt O O joff Lw —� ° .9tn. O 0 C > ov�oro0 a 3 U /^ otn�00>.c < �O VI +yN� 'a. J O l c— 26 m O X Z><2 0 ° O O 9 p c% 0 L U F J a Q 0 �p —Oc+O° ° 0 -I c ` c •O 'Y'EOtLO °m RVI VI w O O O. c`° O fn :E wc,Eeo « 000 o o o- �0 ao..a�°.° ro O L 0J0LE£o m ho a J L m m w — 0-3 c°a°o C3 > sc Municipality of Anchorage • On-Site Water and Wastewater Program (907) 343-7904 Rel)! III CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-'782-12 Expiration Date: L.— I t 1. GENERAL INFORMATION Complete legal description Majestic Valley Estates Block 2 Lot 11 Location (site address) 26226 Vallihi Circle Current Property owner(s) Michalski Day phone 694-4994 Mailing address Same Real Estate Agent Partners Day phone 694-4994 A 4 ;. 2. TYPE OF DWELLING: 0 Z Single Family (w/wo ADU) ❑ Duplex ia(;;i i •L ❑ Multiple Dwellings (Single Family and/or Du I- ) _ rV c� c� 3. NUMBER OF BEDROOMS: 4 °l b 3 L 9,� 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well El Community ❑ Public Water System Cl Public Sewer ❑ Received by: Date: 7 /2 I COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ Date: Date of Payment $t 1 111 Date of Payment Receipt Number Ot}b Receipt Number COSA# Ii3G 1135D Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. . Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 8/14/2017 : IN <:: .q., 6. DSD SIGNATURE "� •'+ {' X. System #1 Approved for bedrooms. • • • 3' System #2 Approved for bedrooms. •:a ':,., Steven• ''f. ,,a ' el `o,, Disapproved. xetJ � '�<�'�• b<,,.:1 PRDFESs0'.•f Conditional approval for bedrooms, with the following stipulatIon3inz te `ok1/40lilllriir -1r-1�Y OFti,,,,r , cy,, ON-5g - �v�'; WATER AND m I�' WASTEWATER z t PROGRAM o 'yT SFR\ii6: f / B1y r 7 G _ ! �( L-, t C . - .__ .---_(/ Original Certificate Date: I t t - i, The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska,The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.dac If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Ste Systems Approva8 c:ieck@ust Legal Description:, 7,4J 7/C- vial yr gZ Li( Parce! ID:456/7616° Z6- A. WELL DATA Well type P If A, B, or C provide PWSID# Well Log (YIN) Date completed 7/4d°/7?7 Sanitary seal (Y/N) y Wires properly protected (Y/N) y! Total depth el 61 ft. Cased to 7?) ft. Casing height (above ground) /c0 f in. FROM WELL LOG AT INSPECTION Date of test 4740 7 i',[/ / 7 Static water level 2 a5 ft. 2G3 7 ft. Well production g.p.m. ‘t g.p.m. WATER SAMPLE RESULTS: Coliform d colonies/100 mL Nitrate I. / mg/L Arsenic 4► 7 ug/L Date of sample: c'//(J/7 Collected by: N./et r B. SEPTIC/HOLDING TANK DATA/ Tank Type/Material F+ATlC/S T. L. Date installed /WV p7 Tank size/05-0 gal. Number of Compartments Z ! Cleanouts (Y/N) ' / Foundation cleanout (YIN) Ci Depression over tank (Y/NI) /A/ High water alarm (Y/N) /V f` Date of pumping (f/F/1 Pumper Sct.?r 7 Pc...“47,cd-J C. ABSORPTION FIELD DATA I Date installed / //7 97 Soil rating 0.p.d./ft2 or ft2/bdrm) G. System type,j Te c f Length 1”1 ft. Width J`J ft. Gravel below pipe Z ft. Total depth 5 ft. Eff. absorption area 46.-04P ft` Monitoring tube `/ Depression over field // Date of adequacy test t�/((//7 Results (Pass/Fail) P / For 11 bedrooms Fluid depth in absorption field before test C in. Water added 6-00 gal. New depth 8 in. Elapsed Time: 60 min. Final fluid depth 4 in. Absorption rate >= 6.2:)6 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) 084— If yes, give date D. LIFT STATION Ail,} Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /OD On adjacent lots /46 It Absorption field on lot /o le- On adjacent lots /DO (•t` Public sewer main / r 40 't' Public sewer manhole/cleanout . leV (1- Sewer/septic service line 0,3 'Y Holding tank /410 r Animal containment areas Ea t" Manure/animal excrete storage areas /OO '- SEPTIC/HOLDING TANK ON LOT TO: Building foundation - Property line /D ft" Absorption field Water main / ‘ r7 Water service line /D `'f Surface water too 1-7.- Wells on adjacent lots l�'e.) r� ABSORPTION FIELD ON LOT TO: Property line / Q it- Building foundation lGi f r Water main lQ 'f Water Service line "f Surface water /Q'G r" Driveway, parking/vehicle storage fQ 16- Curtain Curtain drain (f//VC Wells on adjacent lots /4 4 11- F. YF. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and ' ''‘� review of Municipal records that the above systems are in 4 •. conformance with MOA COSA guidelines in effect on this date. •• x; • Engineer's Printed Named ���V b ', • Date �//C((( l V. • I • , qv COSA yellow sheet_2-6-15.doc _-^•••••...... •v`c. s 77.39.25. o -- _ — O E. 3j687' i•-) .."<---______ \ / ii L32.18' R=50.00' 7 - / . la / L=39.90' / GARAGE . R=50.00'RAi/ XRASPHALT . - . / `---, -- .../... PAVEMENT 36 \ ,� 111.1' 1 1`i1, 4 0 8.5' 0 2.0' CANT J4, ID \ + x 18.2' x �1 `i7s, i 12.2' SHED ��G� Lot 10 \ `�� 3.0' PROW\ QQ� I \ *kid,.. SS• SEPTIC / \ PIPES \ \ -......._ sod Lot 11 G 64,776 s.f. \ °° ' F .(1 \ Lot 12 Municipality of Anchorage DevelOpment Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I:D. 050-731-39 COSA# C~.~C I(~ i ~C/ Expiration Date: //- q GENERAL INFORMATION Complete legal description Lot 1 i, Block 2, Majestic Valley Estates Subdivision Location (site address) 26226 Vallihi Circle Eagle River, AK 99577 Current Property owner(s) Edwin and Nora Kozak Mailing address 26226 Vallihi Circle Eagle River, AK 99577 Day phone Lending agency Mailing addmss Day phone Real Estate Agent Mailing Address Day phone Unless othen~,ise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] 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 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DsD SIG..NATURE ~ Approved for Disapproved. Conditional approval for bedrooms. Phone 522-7773 Date 7/28/2010 bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK' 99507 www:muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 11, Block 2, Majestic Valley Estates Subdivision A. WELL DATA Parcel ID: 050-731-39 Well type Private Date completed 9/18/97 Total depth 4o0 ft. Date of test If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Ca~l to 70 ft. FROM VVELL LOG 9/18/97 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 AT INSPECTION 7/27/10 in. Static water level 205 Well. production 6 WATER SAMPLE RESULTS: g.p.m. 220 ft. 5.5 g.p.m. Coliform 0 colonies/100 mL Arsenic: 7.9 ug/I B. SEPTIC/HOLDING TANK DATA 'Nitrate .284 mg/L Date of sample: 7/15/10 Other bacteria o colonies/100 mL Collected by: M. Anderson Tank Type/Material Septic/Stee~ Tank size 1,25o gal. Foundation ..cleanout (Y/N) Date of pumping lO!Ol/O9 C. A .B~..ORPTiON FIELD DA~A Date installed lO/17/97 - Length es fL Total d~pth 5 .fL Number of Compartments 2 Y Depression ove~ tank (Y/N) N Pumper JRs Pumping - Soilmting (g.p.d./~ or ft2/bdrm) .8 GPD/SF ~.'~ Width 5 ft. I~ff. absorption area 628 .ft2 Monitoring tube Date of adequacy test 7/27/10 Results (Pass/Fail) Pass Fluid depth in absorption field before test 0 Elapsed Time:- 0 min, Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) Date installed 10/1/97 Cleanouts (Y/N) High water alarm (Y/N) Y N System type 5' Wide.Trench Gravel below pipe 2 ft. Y Depression over' field ... N For 4 bedrooms in. Water added 656 gal. New depth 0 in. in. Absorption rate >= 600 g.p.d. N If yes, give date septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas D. LIFT STATION Date installed "Pump on" level at ~ in. Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: > 100' > 100' N/A Size in gallons "Pump off' level at~ Cycles tested > 100' in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100'. Public Sewer manhole/cleanout >25' Holding tank N/A >5O' Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: N/A Building foundation >5' Property line >5' Absorption field >5' Water main N/A water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water main N/A Driveway, parking/vehicle storage 5' Property line >1o' Building foundation >1o' Water Service line >1,o' Surface water >1oo' Curtain drain None Noted Wells on adjacent lots >lOO' COMMENTS: in. G. ENGINEER'S CERTIFICATION. ~,., I ~ that I have ~te~ined through F~ld inspections and review of Municipal m~s that the above systems am in ~ ~ ~~~'~"~ ~n~an~ wEh MOA COSA guidelines in effe~ on this date. Engin~(s Pri~ed Name Mi~el E. ~dem~, P.E. ~e ~ Date 7/27~010 ' COSA Fee $~ Waiver Fee $ D.e of Payment ~ ~ D.e of Payment Re~i~ Number ~0 ~ ~Y ~ Re~ipt Number' (Rev. 11/05) ~c m ~ ~T (1~-~ JULY 2010 1"=50' sm~thalaska~ahoo CHECKEO BY: GRID NUMBER: BOOK/PAGE: CKS KMS SW56~ 04- 001 - 14 ANDERSON ENGINEERING P,O, BOX 240773 ANCHORAGE, AK 99524 522.7773 677.7766 (FAx) MEMORANDUM DATE: August 4, 2010 TO: Jeff Poet FROM' Mike Anderson, P.E. SUBJECT: Lot 11, Block 2, Majestic Valley Estates Subdivision COSA Percolation rates obtained during construction of the absorption trench for Lot 11, Block 2, Majestic Valley Estates ranged between 1 and 5 minutes per inch. The application rate would then become 1.2 gallons per day per square foot. The trench length for a 2' effective depth trench is required to be 70'. The trench on this lot is 88' long which is much longer than the 70' required. The trench is therefore more than adequate to serve a four bedroom home. The recent inspection of the trench found it to be completely dry. No water developed during injection of water into the trench. It is therefore in good condition and capable of absorbing more than 600 gallons of water per day. Municipality of Anchorage Department of Health and Human Services Division o1 Environmental Services On-Site Services Section 825 %" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING :arcel I.D. 050-731 -39 i. GENERAL INFORMATION Complete legal description HAA# Expiration Date: Lot 11, Block 2, Majestic Valley Estates Location (site address or directions) 2622 6 Vallihi Circle Current Property owner(s) Mailing address Ken Gerard 26226 Vallihi Circle Dayphone 696-1339 Eagle River, AK 99577 Lending agency Mailing address Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well Four (4) TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of -lealth Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent 2rofessional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are 'equired for the transfer of title (except between spouses) on properties served by a single family on-site ~vastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 3ertificates of Health Authority Approval are valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 2 025 (Rev. 01/00)' 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, tt~e on site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. ]Box 240773 Anchoraqe~_ Engineer's Printed Name Michael E. DHHS SIGNATURE L''''''/ Approved for L-iL- bedrooms. Disapproved. Conditional approval for __ Phone 522-7773 AK 99524 Anderson ¢____P.E. Date ~, 10/1,, 5/00 bedrooms, with the following st~ps~b(~ons. Additional Comments Attach ments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: //- / O / Original Certificate Date: / 0 - / ¢/- 0 0 Reissue Date: 75-025 fRet, 01/001' t-/Municipality of Anchorage Department of Health and Human Ser~t~.~ -. Division of Environmental Services '% ~ ~ E ! V E D On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us 0c'r ~. 6 2~;~ (907) 343-4744 NIUNtCJPALiTy OF ANCHO;~/<',~ HEALTH AUTHORITY APPROVAL C ~'v~l~%ITAL SERVICES DiviSiON Legal Description: Lot A. WELL DATA Well type Private Date completed 9/18/97Sanitary seal __ Total depth 400 ft Cased to 11, Block 2, Majestic Valley Estates Parcell.D.: 050_731_3~9- · FROM WELL LOG 9/18/97 : ft g.p.m Date of test Static water level 205 Well production 6 WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi Date of sample: 10/4/00 B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 1 0/1/97 Tanksize Cleanouts ¥ Foundation cleanout Date of pumping 3/00 C. ABSORPTION FIELD DATA If A, B, or C provide PWSID # __ Well Log y y Wires properly protected y 70 ft Casing height (above ground) > 2 ' in. AT INSPECTION 9/30/00 255 ~ 5.7 g.p.m Nitrate..5 mg/I Other bacteria 0 colonies/lO0 mi Collected by: MEA 1,250 gal Number of Compartments ¥ Depression over tank N High water alarm Pumper JR ' s Date installed 1 0/17/97 Length 68 ft Width 5 ft Gravel below pipe 2 fl Total depth 5 ft Effective absorption area 628 ft2 Monitoring tube Y Date of adequacy test 9/30/00 Results (Pass/Fail) 3.ass_ Fluid depth in absorption field before test 0 in Elapsed Time: 1 04 min Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type). Soil rating (g.p.d./ft2 or ft2/bdrm) .8 System type 5' Wide Trench __ Depression over field N For 4 bedrooms Water added 600 gal. New depth 5 in. 0 in Absorption rate >= 600 g.p.d. N If yes, give date N/A 72-026 (Rev. 01/00)* LIFT STATION - N/A Date installed "Pump on" level at __ Datum E. SEPARATION DISTANCES in Size in gallons __ "Pump off" level at__ Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot> 100 ' Absorption field on lot > 100 ' Public sewer main N/A Sewer/septic service line > 25 ' in Manhole/Access Righ water alarm level at in Meets alarm & circuit requirements On adjacent lots > 100 ' On adjacent lots > 1 o o ' Public sewer manhole/cleanout [~/A Holding tank __ N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation > 5 ' Property line > 5 ' Absorption field > 5 ' Water main N/A Water service line > 10 ' Surface water > 100 ' Drainage > 100 ' Wells on adjacent lots > 100 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line > 10 ' Water Service line > 25 ' Curtain drain None Noted COMMENTS Building foundation > 10 ' Water main N/A Surface water > 100 ' Driveway, parking/vehicle storage Wells on adjacent lots > 100 ' >10' G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E, Anderson, . P. E. Date 10/15/00 HAAFee $ ,3 0 Date of Payment Receipt Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 01/00)'