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DENALI VIEW BLK 2 LT 2
Denali View Lot 2 Block 2 #015-461-17 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP201286 Work Type: Well Upgrade Tax Code Number: 01546117000 Site Legal Address: DENALI VIEW BLK 2 LT 2 G:2741 Site Mailing Address: 8701 SULTANA DR, Anchorage Owner: ELLISON VIKKI L & ROBERT A Design Engineer: This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date V n Department Lot Size in Sq Ft: Total Bedrooms: ; 7/31/2020 7/31/2021 40520 ❑ Private Well Q Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: Date: I 5 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 019_ `f61-17 Property owner(s) R d X36 E C.(_ 19 Q /\j Day phone ,2 51; -4 2 ( '0571 Mailing address `x-101 .S'UC_TAAJA �)Q Site address :o.r11t"', Legal description (Sub'd., Block & Lot) v,vA,QAI .PrSkE. anj ► 1hCW 62 LZ Legal description (Township, Range & Section) ViJAuA/ LA Sc Lot Size Sq. Ft. Number of Bedrooms .`J .� >ZCSI DiE�;1� APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) X Septic Tank E] '"Upgrade [� (w/wo AD U ) Holding Tank ❑ RenewalDuplex ❑ (D) El Privy ❑ Lr'&bu.& Multiple Dwellings ❑ (SF and/or D) Private Well ❑ (3c,g�G�t t•�r ClL+ SF�u Water Storage )� THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal S>s - of property owner or authorized agent) Permit/Rush Fees: ..126Waiver Fees: Date of Payment: I -/As Date of Payment: Receipt Number: C>Gc/(04G Receipt Number: _ Permit No. Oslo Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc L.a�e\ inl�-t I l.. it nO� � Arc r oa y i i I !? I i; Q \ ■ \ ƒ \ { ■ \ \ \ M \/ \ \ \/ \ /\ /\ /& \\ g= \{ /\ 10/01/2004 17:04 1-907-456-5808 GREER TANK & WELDING A Hexene Copolymer Unear • Density Polyethylene Formolene L63935U meets all requirements of the U.S..Food and Drug Administration as specified in 21 CM 117.1520, covering safe use of potyoiefin articles intended for direct rood. contact. • i�. v 10 - Melt Index, /10 min. ASTM D1238 3.5 Density, glcm3 ASTM D1505 0.939 Field Tensile Strep th, (50 mni/min), .psi ASTM D639 3,306 Flexural .Modulus (1.3 tztzn/mjn), psi ASTM D790 110,000 Mort axion at Yield, (50 nam/min}, % ASTM i?638 _11-3 Heat Deflection Tem ttrre, °C at 66'psi ASTM D648 54 E.S.Ck, 100% Igepal ASTM D1693 >1000 hrs. 10% Igepal x400 yrs. Low Temperature impact (ft -lbs.) its° Sped men ARM Std. 60 '/s° S itne2 ' ARM Std. 196 Formotene L63935U is fully beat and. UV stabilized. 4j,VVc WAGE 01/03 The inlosmatinss on thiq dtxtun+,at is, to q ur ltnnwledgG Tttlt: and atcurato. Tf Velars listed above era typical, aril are ru)t to be construed as specifications. Uscsssliauid oortttn results by their own tests. PubtLshed 10198 . 150 90M & 1St? 14001 3129 NWOM FM , EMS 35710 -chs 4+tor:r�lori arw r+torrtrT�atKfattotW m itYi! pt�Toatip,t tnre. !q the tmCt of etC tOgaPi.Asr1CS t�!,11M0ciCa trnf ttactm NwuXf perforinth�avn to bac•.attso d r+utwiow teclme uti•cty,S ttis tsw�ls, +'tJ18'fK.9 LOAF i1F kcANl7FACiiJR6Jq Ahs fRt1E� t ettiet �'tlux the irx�rbnn, - �+;,wY arauo�.eme ra inw4e pe tho putetuaw qAe• a1 the co,mtntad as rotom the Ydrltlp�rnmtt d any Amtert a+sd �'a**++oaRPtamt"m C --,,anon, Aim". 0 40 e 9 Pettah 7aee MH Rd. Ph.: 1898} FPOUSA9 tivtrjOon, NJ 07039 Fax: (97'3)716-72:30 t!+txt e•tdable. ionecon wftwosoran3Labmateotgyftopmnoi nd�ert+t�teiMarik�theleprpdueSsfot+TkkaxrtpWt3cuWDufp0�1. ticraeVCr MEAAGA MAKEStK/ SttiY OF,ariY KiNU. E�PAD�30F[�+11PLIED. it�1C+l.UFJiiJO itis ttne to tha apt b1UJ*eutroat t3t+vdard br>n S at+nW to *4tn. tJwraroos, raOomIMMA QLAR7ICgOOFiP:AItt3ilCJ:tnet2ncafvMgalito!W+b�ehMwArmay.negugoinq� o Corrcondng the cue of thoyrod+ots of tamtxtdran, CeectlDed Y erein tme tat to be ?amortmriaingouidany wchtow fam wffsbQ 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: SW000166 PID Number: 015-461-17 Name: DENNIS SMITH wastewater System: ❑ New ■ Upgrade Address: P.O. BOX 91592, ANCHORAGE, AK 99509 ABSORPTION FIELD Phone: (907) 376-1493 No. of Bedrooms: 3 El Deep Trench ❑ Shallow Trench ■ Bed 11Mound ■ Other" LEGAL DESCRIPTION Soil Rating: 2 Total Depth from original grade: 2.8 — 4.0 CPD/Sq. P. Ft, Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 2 2 DENALI VIEW 0.42 — 1.62 Ft 0.25 pt Township: Range: Section: Fill added aba. original grade: G.] length: — — — 0.7 — 3.5 P. 30 Pt. WELL: ❑ New ❑ Upgrade Gravel width: 12 Number of linea: 6 Distance between lines: 2 FL FL classification (Private, AB,C): Total De Cased To: Total absorption area: Pipe material: M. I Ft. 360 SQ, FL D 3034 / SCH-40 Driller. Data Drilled: Static Water Level: Installer. CARL'S EXCAVATING Date installed: 7/26/2000 Yold:Pump Set AL Casing Height Above around: TANK GPM Ft. R. SEPARATION DISTANCES 11 Septic ❑Holding ■S.T.E.P. To Septic Absorption Lift Holding Public/Private Sower unse Manufaehnan ANCHORAGE TANK Capacity in gallons: 1250 From Tank Field Station Tank Well 100'+ 100'+ 100'+ — 25'+ Material: STEEL Number of compartments:. 2 Surface 100'+ 100'+ 100'+ - - LIFT STATION Water Line 5'+ 10'+ 5'+ — — Size in gallons: 1250 Manufacturer. ANCHORAGE TANK •Pump on' level at: *pump off.level at High water alarm at: Foundation 5'+ 10'+ 5'+ — — TIMER I TIMER 46" Curtain Pump Make & Model: Electrical Inspections performed by: Drain NONE KNOWN #20 OSI OS HHF M.O.A. BENCH MARK Remarks: Lacaaon and Description: *THIS IS A BOTTOMLESS INTERMITTENT SAND FILTER. TOP OF MANHOLE LID. NORTHERN CORNER OF GARAGE FLOOR = 110.85 Assumed Elevation: 106.67 Ft, ENGINEEWSSEAL by: AWWC, INC. 1st 7/26/2000 Inspections performed Dates: 2nd 7/26/2000 � ...:....:...... .:....0 3rd 7/26/2000 p 4th 7/27/2000 OO '. e r Gayness; Department Health Sees 03 Q 9. •, C 7953 mQ ''co�o� �p�fe ' of anHuman approval Reviewed and approved by: Date: S -// o •.,• „•,.• professl°^°oma 72-013 Rev. 9/91 MDA 25 6111444000�� PERMIT NUMBER: AS -BUILT DRAWING P015-1 SW000166 461-17 I NEW BOTTOMLESS INTERMITTENT SAND FILTER 1 00' +L =SETBACK FROM RATA _ i *I k161 IN UTILITY EASEMENT — NEW 1250 GALLON S.T.E.P. 1 TANK WITH DUAL OUTLETS i SULTANA DRIVE \ I DATE: '1 —CONTROL PANEL MOUNTED OUTSIDE OF GARAGE EXISTING DRAINFIELD TO BE USED AS A RESERVE SITE .a ...... ' L S.i".. "447✓-�.®. -'+c:: xnxi .ALA....�:v:ti. SKA WXrER & WASTEWATER K.D.W. �•_��� CONSULTANTS INC. SCALE: an nnn CI TC 1D . AY!`Y I.DAf.G AY D4511/ - PYIIIJF (O(1]lii] RI]O - FAY (D!1]liiP i9/.R 1"=30' DENNIS SMITH 376-1493 1 2 OF 3 DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 4 OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE INSULATED AIR LINE i— AIR COMPRESSOR A. G ness;' —7953 .- mJ A B ST1 41.3 93.2 ST2 43.8 99.1 MH 44.7 100.4 MT1 71.8 87.8 MT2 81.1 94.5 MT3 75.5 117.1 MT4 62.7 108.3 A. G ness;' —7953 .- mJ PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO - SW000166 015-461-17 TOP OF fMK AT INI.Ef < 102,20 IM/ERf 0"r 6LN6 Af INLET 101.70 Mf TOP OF 5AN7 92.93 (AVG.) f3OffOM OF 5Y5TEM 90.63 ( AVG.) 5fl NSW 1250 6& ON -FINAJ, 6mIN5II,A10M <953-96.9 W OF MANNO 619 -106'65 . TOP OFfANK Af OIItI.ET - 102,21 ORIGINAL c4m 93.4 -94,6 -.......,�1v. ,.,.,. .s DRAWN BY: ALASKA WATER & WASTEWATER K.D.W. *� •' �* SCALE: CONSULTANTS, INC • -_ ...... ... ...............S T. . 6901 DEBARR ROAD, SUITE 28 *ANCHORAGE, AK 99504 •PHONE (907)337-6179 •PAX (907)✓'38-3246 N.O PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DENNIS SMITH (907) 376-1493 3 OF 3 DO J f r A. arness,: LEGAL DESCRIPTION: - O s� ' , E-7953 DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2"p •..• Ag TYPE OF WORK: 04Qa professioOON co AS -BUILT PROFILE OF SEPTIC SYSTEM UPGRADE 4�O�ODp06o Sent 8y: Alaska Water & Wastewater Consu; 907 338 3246; Aug -11-00 14:32; Page 1/2 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Facsimile Transmittal Date: '? - // ` Do Number of Pages including cover TO: iOri el-f-&t FROM: 6Y� EIJrS ALASKA WATER & WASTEWATER CONSULTANTS, INC. Jeffrey A. Garness, P.E., M.S. Comments: 4 , 4el4A& V r-ew Lg z z 2) Oid &w,19A szf,*& ihlpk uw.� ja44�qt urm- ,e'k,14,M, 6t'd� c -X 66W - r 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179' Fax: (907) 338-3246 * email: info@akwwc.com Sent By: Alaska Water & Wastewater Consu; 907 338 3246; Aug 01 00 04*39p Marilyn Elsenbast Aug -11-00 14:32; Page 2/2 3463559 P.1 Pan V :TOM INSIPR i lCriv AE P i Mf AVETY DIVI'StION EvILTINICIPALITY OF A.NT4-"IiORAGL�--RU',(LD-ti"vTGIS , 4700 SOUTf I BRACAW STIZL' E-", ANC"n`RA-GE, AL.-'1STKA L,N'SPEC'f?0NS: T,'oice: (9071343-8300 Fier., (W) 34.3-8235 j1VF0XW4H0N- (90�-) 343-82.0 . ......... elfc E-VJSZ �3F3iY7310_>: L07" — ------ -- - ------- .. . .............. . ... . 42� 03: TYPE OF INSPFC-IYON. F'I No non-Compli%nmobserved. F] Corrections essential as explained txlow. [71 C.C. approved. [Iwill -exandnz at next inspection. Do UOL conceal until re.inspeoted. C.C.a. approved (corruneWs below). R einspection? Pj' COMMEMS.- _0 k_j F0F� MAIhJ, MAIA) O� SF -AL',' 61 J YYAGE N CORK E, C-2 IRMW A RE A14DE, Pl. C.ASE CALL POR -fA;XPFe'I?Y0A; DO MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 -7/0-to /o -O@ "i %t3Opc, , `7/o2(,P/ov P TeCPry-) M2 7 /vv ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 14, 2000 Expiration Date: Jun 14, 2001 Permit Number: SW000166 Parcel ID: 015-461-17 Legal Description: DENALI VIEW BLK 2 LT 2 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 008701 SULTANA DR Owner Name: DENNIS & DORTHY SMITH Lot Size: 40520 SQ. FT. Owner Address: PO BOX 91592 Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE , AK 99509-1592 This permit is for the construction of: P Disposal Field ❑✓ Septic Tank Holding Tank ❑ Privy Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: (n —w --y0 ��v Date: —/4 - OO ALASKA WATER �& WASTEWATER %� CONSULTANTS, INC. June 14, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Denali View Subdivision; Lot 2, Block 2 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic system consists of a 1250 gallon concrete septic tank and a trench type drainfield. The existing drainfield is surcharged and must be upgraded. We are proposing that the existing 1250 gallon septic tank remain in place. A 500 gallon lift station will be added and an innovative Bottomless Intermittent Sand Filter (ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows: 1. GENERAL: One test hole was excavated to determine an area suitable for a septic system upgrade. Given the site constraints, it is our opinion that a Bottomless ISF system is the most viable option. 2. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and the percolation test results. The soils below the organic layer are a SM/ML material to a depth of 11.5 feet (bottom of test hole). Groundwater was encountered at 11 feed during the excavation of the test hole. Twenty-four (24) hours later, it had risen to within 6.25' from ground surface. Seven days later, ground water had subsided to a depth of 6.5 feet. Two percolation tests were performed in this test hole. The upper test was performed between the depths of 2.5 feet to 3.0 feet which had a percolation rate of 11.4 minute/inch. 3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF) a. Percolation Rate: <11.4 minutes/inch b. Allowable Application Rate for ISF: 2 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day 6901 Debarr Road, Suite 213— Anchorage, AK 99504 —Ph: (907)337-6179— Fax: (907)338-3246 e. Minimum Absorption Area Required: 225 ft2 f Effective Depth below pressure pipes: 2.5+ inches g. Width: 12 feet h. Length: 30 feet. i. Effective absorption area = 360 ft2 j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank". k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch LD, "Anchorage Tank". 1. Sand Material: In accordance with M.O.A. latest standards m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less than 1% passing the #8 sieve. We are proposing to excavate down to a depth of 4 feet (maximum), place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can be intermittently dosed to the ISF. 4. SURFACE WATERS: There is a small drainage ditch running in the northern utility easement. The proposed septic system will be greater than 100 feet from this surface water. 5. TOPOGRAPHY: Based upon the M.O.A. topography maps, the average slopes in the vicinity of the proposed drainfield site are approximately 20%. However, the new ISF will sit on a "bench" that has a slope of about 10%. 6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation & Maintenance Manual". The contractor should read this document prior to construction. Copies are available at the Municipal Onsite Services office (5th floor, 9th & L St.). 7. CLOSING: I am open to any suggestions from your department, which would be an improvement to the proposed design. 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 337-6179. Thank ypu for your assistance. P.E., M.S. 6901 Debarr Road, Suite 2B— Anchorage, AK 99504 — Ph: (907)337-6179 —Fax: (907)338-3246 I I I I II l i II I € I € I€ ANCHORVIEW S/D I I TRACT A 1 I I 1 k € t S i € I 3 I € I I ___ -------------7 L_-------------- ___ ___---\ ti— i DENALI VIEW S/D --- 41 t LOT 1, BLOCK 2. t 41 + 100' SETBACK FROM SURFACE WATER \ \ + PROPOSED---,,, INTERMITENT SANDt i FILTER. SEE DESIGN _ - t t ______ _______ __ + PAGE 2 OF 3. TH#1 DENALI VIEW S/D tt ' ,/ , DENALI VIEW S/D LOT 4, BLOCK 2, EXISTING LOT 3, BLOCK 2, t �+ SEPTIC..4, t Q SYSTEM EXISTING \ 3 BEDROOM\ i 10 HOUSE \ r I < < R7p too' WELLaAO1u5 + I 0%n zuS _SULTANA -DRIVE —_—_—_ \ 64 II CS���i II 1 VIEW S DENALI VIEW S/D / DENALI VIEW S/D i (\\\ LOT�4. BLOCK 3,, DENALI VIEW S/D . I LOT 2, BLOCK 3, / LOT 3, BLOCK 3, 1 I \ LOT 5, BLOCK 3, ii II / II 1 II I II ( I WELL RADIUS 1 ( I S€ t II I DATE: Q 6/13/2000 DRAWN BY: ALASKA WATER & WASTEWATER K.D.W. ._ SCALE: ;; tr 7 •�{r+;i CONSULTANTS, INC. �,..,.,._a — ••••• 100 ✓ ' vn curta va • eN[HOR4GE. AK 99504 •PHONE (907)337-6179 • FAX (90A338-3246 DENNIS SMITH 376-1493 1 1 OF 3 DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2, OF WORK: SITE PLAN A. Gayness; —7953 m, 10' UTIL EASEMENT NOTES: NOTE: THE CONTRACTOR MUST THE AIR COMPRESSOR SHALL BE LOCATED WITHIN THE BASEMENT OR THE GARAGE. THE CONTRACTOR SHALL HAVE THE 100' SETBACK FROM w PROVIDE A 0-10 PSI PRESSURE GAUGE AT A LOCATION THE SURFACE WATER TO THE ¢ WHICH IS READILY ACCESSIBLE FROM WITHIN THE HOUSE . NORTH, AND THE WEST LOT LINE NOTE: A 30 PSI GAUGE WILL NOT WORK. FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY THE AIR COMPRESSOR SHALL BE A THOMAS CONSTRUCTION. p LL INDUSTRIES MODEL 5070, AS SUPPLIED BY ANCHORAGE TANK. THE AIR LINE SHALL BE 1/2 INCH DIA. HDPE (1 PROPOSED 500 GALLON PIECE), INSIDE A 2 INCH SCHAD PVC JACKET. THE LINE 1 LIFT STATION EQUIPPED SHALL BE BURIED TO A MINIMUM DEPTH OF 3 FEET. + WITH INTERMITTENT o DOSING CONTROL THE CONTROL PANEL FOR THE STEP TANK SHALL BE o PANEL AS SUPPLIED INSTALLED OUTSIDE THE RESIDENCE WITH AN BY ANCHORAGE TANK. I AUDIBLE/VISUAL INDICATOR INSIDE THE HOUSE. PROPOSED BOTTOMLESS INTERMITTENT SAND FILTER. --------- ------ ------------ EXCAVATE A BED THAT IS 4 FEET DEEP MAXIMUM BY 12 FEET WIDE TH#1 �'t �VO INSTALL FLOW BY 30 FEET LONG. SEE ATTACHED / DIVERTER INSULATED AIR DETAIL AND PROFILE (PAGE 3 OF /� j LINE (SEE NOTES) 3) FOR CONSTRUCTION DETAILS<\ 1 INSTALL DOUBLE CLEANOUTS AND REQUIREMENTS. \ /� I EXISTING DRAINFIELD \ TO BE USED AS A RESERVE SITE.:`".`".,a• 4•"':'. ..' V • AIR COMPRESSOR \ " ' (SEE NOTES) 100• +/— SLOPE FROM DRIVEWAY DOWN TO ISF SITE. DRAWING THE TOPOGRAPHICAL SHOWS STEEP CONTOURS. IN / \ fJ. ACTUALITY, THERE IS A NATURAL BENCH IN THE AREA OF THE PROPOSED LSF. `%:; <q-i.�. \\ •, • R JSF,\ EXISTING 1250 GALLON �� '•` CONCRETE SEPTIC TANK IN PLACE. N5 0 .` •} TO REMAIN VERIFY CONDITION OF .• (( ::... _..�`�+.. • �.+' BAFFLES. RppIUS 100' WELL ^•�, I'., .4."_ ;` ,� `�.' loo' O0 WELL RADIOS I \ SULTANA DRIVE DATE: 0006`..1 6/13/2000 .... •. �] (140 DRAWN BY: .....FK K.D.W. QOp��Ci p ALASKA WATER & WASTEWATER o ;' SCALE: _.,.: _. .. CONSULTANTS, INC 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 • PHONE (907)337-6179 • FAX (907)338-3246 1 " = 40, ....... ... ............. D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: DENNIS SMITH (907) 376-1493 2 OF 3 QO e r A. r eSS:' 0 O —7953 •'• 00 0od,orofess.o.°o��O LEGAL DESCRIPTION: ENALIWORVIEW SUBDIVISION; LOT 2, BLOCK 2 TYPE DESIGN OF SEPTIC SYSTEM UPGRADE (ISF) ��4OOo�oo AIR UNK COIL SPACED Af 3/ 4" PIA, SCN, 40 PVC LAgM5 —APPROX, 2 FEEf, mNCO (HO 1. 5 9J EI 75, AND FLUSHING NO ' 0P ON (30ffOM�P555. WASfEFLOW fYPK PROVIDED VALVES PER CeNCO DM51GM PIPING 2M5I6NK9 PY ORENCO ANP 6Y ANCHORAGE TANK. SLRPUKDl3YANCHOWA fANK. ----------------------------- ---------� 1 � I 1 I I � N I I 1 I 1 � I 1 L----------------------------------------- I I/ 4" DIA, CIi 40 HDPE 4" PIA, MONITORING TTM Af EPLN DIxP[A. LINE FROM CORNER. PKITOkAtI2 f3KTWi:EN f0P SEEP TANK AND MANIOLD OF SAND ANP D15f IPPON PIPK INVM ,(DRILL 1/4INCH PIA NOI.MS) PLAN VIEW 6" LAYER OF 3/ 8" KA GRAVEL WfHfNMPVC LAt M5f51RIKP MIDWAY IN TW 5CAtk--� (GRAVEL Xww PIPE < 2 FKMf MIN. OF rl= SMP---" Alk UK 18" for OF `. 3/ 4" PVC Lt" 5 <fYr Mf Mf FINAL 6mA 2' MIN. OF COVMk PROFILE VIEW ALASKA WATER & WASTEWXFER v,._.._... CONSULTANTS, con: nconoo Donn c:n+c zP + nurunanr.P eK 99304 + PNONP (907)33]-61)9 • FAX (907)338-324 DENNIS SMITH (907) 376-1493 4L DESCRIPTION: DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 OF WORK: DETAIL OF BOTTOMLESS INTERMITTENT SANF FILTER FL115HING VAL (WITH PROTCle I (KXTND ABOVE I '13/2000 ( BY: K.D.W. O `: 49 TH N.T.S. ......................... NUMBER: 3 OF 3 �....., ........... :... �O •Jeffrey A. Garness: CE -7953 m� 0�4 0.............. ,moo 4%vgo'p ofeesion°oo 0��0000W ALASKA WATER & WASTEWATER CONSULTANTS, INC. 69 PHONEARR ( 07) 337SUITE61928 FAX (907) 338 9504 3246 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 PERFORMED FOR: DENNIS SMITH DATE PERFORMED: 5/30/2000 DETH (feet)^""" TEST HOLE #1 1 ORGANICS/LOAM (PAGE 1 OF 2) 7 8 9 1 13 14 15- 16- 17- 18- 19- 20 51617181920 COMMENTS: DEPTH TO GROUNDWATER DATE 11' 5/30/00 WEEPS ® 7.5' SOIL CLASSIFICATIONS 2 5/31/00 6.5' 6/4/00 6" — 2 4:44 30 MIN. 2 3/8" <o 11 aIsm GW ORG 3GP HOUSE — & �100' WELL RADIUS 4 ,''Ct'�'`'3 30 MIN. ML 2 5/8" SULTANA DRIVE 5 SM/ML 6„ GM CL 4 5:44 30 MIN. 3 3/8" DENSER WITHGC W..SW OL DEPTH MH 5 SP CH ,' OH 6 SC 7 8 9 1 13 14 15- 16- 17- 18- 19- 20 51617181920 COMMENTS: DEPTH TO GROUNDWATER DATE 11' 5/30/00 WEEPS ® 7.5' 5/30/00 6.25' 5/31/00 6.5' 6/4/00 eVA. Gdrri?ss;' C 7953 o`Q� Prof.s swfva Ec O ------------------------------------------------- READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING *TH#1 5/31/00 1 4:14 6" — 2 4:44 30 MIN. 2 3/8" —EXISTING\ 3 BEDROOM 1 4:44 HOUSE — & �100' WELL RADIUS 4 ,''Ct'�'`'3 30 MIN. 3 3/8" 2 5/8" SULTANA DRIVE 5 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/31/00 1 4:14 6" — 2 4:44 30 MIN. 2 3/8" 3 5/8" 3 4:44 6„ — 4 5:14 30 MIN. 3 3/8" 2 5/8" 5 5:14 6„ — 6 5:44 30 MIN. 3 3/8" - 2 5/8" PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFORME�/D, PACCORDANCE WITH ALL DATE. DATE: L//3//0 11.4 (MIN./INCH)) PERC. HOLE DIA. 6" (INCHES) I 2.5 FT. MJ I 3.0 FT. CERTIFY THAT I GUIDELINES IN EFFECT ON THIS ALASKA WATER & WASTEWATER CONSULTANTS, INC. SOIL LOG — PERCOLATION TEST I LEGAL DESCRIPTION: DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 PERFORMED FOR: DENNIS SMITH DATE PERFORMED: 5/30/2000 (feet) TEST HOLE #1 1 (PAGE 2 OF 2) 2 SOIL CLASSIFICATIONS d`_ " GW ORG 3 :�f��-. GP ML 7 8 9 10 11 12 13 14 15 w LL 0 W Q LJ LJ co 16- 17— is- 19- 20 617181920 COMMENTS: -v_------------------------------------------ GMCL &TH#1 NET TIME (MINUTES) GC SW SP OL MH CH o ° o ®= a 4:14 SM .' OH — SC 2 -v_------------------------------------------ READING &TH#1 NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/31 /00 1 4:14 ANC 6" — 2 4:44 30 MIN. 5 7/8" EXISTING\� 3 BEDROOM% 4:44 HOUSE — 700' WELL RADIUS 4 5:14 30 MIN. 5 7/8" 1/8" SULTANA DRIVE 5 DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 5/31 /00 1 4:14 ANC 6" — 2 4:44 30 MIN. 5 7/8" 1/81" 3 4:44 6" — 4 5:14 30 MIN. 5 7/8" 1/8" 5 5:14 5. — 6 5:44 30 MIN. 5 7/8" 1/81" PERCOLATION RATE 240 (MINJINCH) PERC. HOLE DIA. 6" (INCHES) I TEST RUN BETWEEN 5.5 FT. ANC 6.0 FT. PERFORMED BY ALASKA WATER & WASTEWATER I, THIS WAS PERFO ME IN ACCORDANCE WITH ALL DATE. DATE: , CERTIFY THAT I DELINES IN EFFECT ON THIS II I : , J' .I I I 1 T J3S �I 1 „ Will I'lyr-�Ir�...� V ice' ' � .' ' ' .ti �J�� r�►sit►�•����� A�rM!�•/ PROPERTY OWNER MAINTENANCE AGREEMENT ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated A `0 IL , 200 0, is made between the Municipality of Anchorage Department of Health and Human Servif:es (DHHS) and the property owner(s) of This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owner(s) agree to the following: The property owner(s) will have an annual inspection of the system performed by a registered professional engineer. This inspection shall verify that all effluent and air pumps, timers, and alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's statement that the system is functioning as designed shall be filed annually with the DHHS. Property Owner Name (Notarize Here) STATE OF ALASKA NOTARY PUBLIC Bethany A. Weiser 0 My Commission Expires May 01, 2003 Property Owner Name State of 1�Aa0 � Judicial District SS. On thisI�1 day of ">A,t v\_� in the year before me, the undersigned notary ublic, personall appeared: w+n I'.� ry A-1, known to me to be the person(s) whose name(s) istare subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained. (Notary's printed My commission e band and �� GREk I ANCHORAGE AREA BOR .GH ���'���� Department of Environmental Quality �� �'�I�l �r,c P Y ��xuW 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM +� p NAME,) "W s JfT7/ 1 MAILING ADDRESS PHONCx LOCATION��Y�/ `✓�aLEGAL DESCRIPTION �e�a!✓l�✓�«� ��� SEPTIC TANK: DISTANCE � NUMBER O i_ FROM WELL MANUFACTURER MATERIAL COMPARTM�� INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYAlm-ALLONS. UL-E-vnni l"'�i �i=D: TOTAL LENGTH DISTANCE FROM WELL / i FOUNDATION P -7 _NEAREST LOT LINE_ �� OF LINES Cir NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH�IN/. TOTAL EFFECTIVE ABSORPTION AREA ��?n SQ. FT. LENGTH OF EACH LINE �EPTH OF FILTER //^� ��� �f�r� DEPTH: TOP OF TILE TO FINISH GRADE �' MATERIAL BENEATH TILE_A . •'FN. ABOVE TILE _�" IN. WELL: Exs� iu // TYPE n";�)Pr�y CONSTRUCTION C ��✓/ f DEPTH �' DISTANCE FROM: BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL , OTHER SOURCES NEAREST SEPTIC SEWER LINE , TANK_ APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: - SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: d' Form EQ -032 V SEEPAGE SYSTEM_ DIAGRAM OF SYSTEM DATE II4APPROV ED G.A.A.B SON WELL DRILLIi 3 1305 W. 45TH STREET ANCHORAGE, ALASKA 99503 PHONE 272-9343 LOG Well Owner Location (address of: Township, Range, Section, if known; or distance main road se of Well 24 ' Size of casing- --&'% Depth of Hole o ' e, feet Cased to � S feet Static water level IS ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ) ; Perforated Describe screen or perforation Well pumping test at 5 gallons per (hour) (minut) for�ours with --ft• of drawdown from static level. Date of completion V4 Depth in feet from ground surface To _ is TOS TO TO TO TO TO f t i TO 2n C) TO TO TO TO TO WELL LOG Give details of formations penetrated, size of material, color and hardness qq i i . Ill1 `' . \ Ali- rY1n �. ..Gl� %} wA it :l� !C! ClV- �� �I — - - 6Vf_Q4- %JLL%I�.2<�T rl ,.- — _ I ( , "_ 4 4- /) i- l_ n,: _1 Or I ,,,o 0 0 ae0t/ "� / J., d �t.Aa L) & TO - /1). V- TO GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. O 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 2`74-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT /""� f MAI�LINGADADDDRESSS AdIr�T "�`-/PHONE INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK �— SEEPAGE PIT �— DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY GC SOIL TEST RESULTS���E'�'��'i NOTE: THIS PERMIT IS NOT VALFD WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE " TYPE 496doZ �/Gi' y�ZSEEPAGE AREA SIZE MINIMUM DISTANCES, REQUIREMENTS s / FOUNDATION TO SEPTIC TANK -5 FOUNDATION TO SEEPAGE PIT / U DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL / �✓ / � A �i SEPTIC TANK SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. e' d WELL TO SEPTIC TANK { U SEEPAGE PIT / V , DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK / � SEEPAGE PIT ! DRAIN FIELD SEPTIC TANK, /SEEPAGE PIT-aF---P--9, DRAIN FIELD , TO RIVER, LAKE, STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE IT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE -J .LA/\ FORM NO. EQ -016 7 ' I � I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE -J .LA/\ FORM NO. EQ -016 Greater Anchorage Area 3330 "C" Street Anchorage, Alaska September 2, 1975 Borough Anchorage, Alaska 99503 Gentlemen: The enclosed test boring log accurately represents soils beneath the planned sewage effluent disposal area of Lot 2, Block 2 of the Denali View Subdivision. I understand that this information, together with the in-place percolation test, will be used to determine leach field (or trench) require- ments for an on-site sewage disposal system. Very truly yours, DAMES & MOORE A) William D. Pyle Engineering Geologist Registration Number 500 WPD:If Enclosures I I OO W W 0 O • h- F- W W 1- F - o c N & m In W O } d1 oW O W34 F, W d m u u 946.1 FILE SUBJECT 'j L `•..f SHEET r OF` RP�✓off( ,w r`aHa�� f -" CFO . crew) l.�t,i _ IO� i Lj C I r.. ,, } • 1w �.: ! ,� s,, ! l 20 r U";, 'C.d A, 0 3,'o Am � 2'.31-1 Am 6nor. Q 30 Pvi1 71 3 rr _ w , �tc•rycy. �t . 1.✓w•cca �»45 r Fulvil off, G.0 )AJAJ l C/1� M CU tJ45 t�C1 `4o % Lit A7 C )Cf Lk-) ® &Y_c d '44 -YI,A-YJ A -D 6-3 .S' C-- 169 10 7/ 7 • � [ ra l� 6L B •� �_ Municipality of Ancho e��N 0 On-Site Water and Wastewater Progr.,• c,'y. mai (907) 343-7904 5 a f ETT L- C).' (1> ll OL_69L Certificate of On-Site Systems Approval Parcel I.D. 015-461-17 C 'Expiration Date: r r 11---/ 1 1. GENERAL INFORMATION Complete legal description Denali View, Block 2, Lot 2 Location (site address) 8701 Sultana Drive Anchorage, AK 99516 Current Property owner(s) Albert & Forooz Sakata Day phone Mailing address 8701 Sultana Drive Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: I1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: /JI. 1-41/fJ1 / ' ) Q7(2LI Date: (VAV/7 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ Sod(.. Waiver Fee $ Date of Payment togOi t? Date of Payment Receipt Number 00567-6 Receipt Number COSA# £ 5G 1'7-1219 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 Anderson Engineering Phone 522-7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 64:41oalv 1 4 ° AL 47 , • a C/P 49 �� %:. 6. DSD SIGNATURE System #1 Approved for bedrooms ��V51$,,4MICNAi 1 . ANDERSON; ,�cf•� Cc-4381 •. �� System #2 Approved for bedrooms 6'�`i?•'���`'m Disapproved 4�� p%Oa�a�Q�o Conditional approval for bedrooms, with the following stipulations: ��,�11 - r J OIN�Sirg ° VvATER AND r.: 2 WASTEL0-1 V ATTR PROGRAM .o . By: w-fl Original Certificate Date: &"-13 - ( 7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_E c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Denali View, Lot 2 Parcel ID:01 5-461-17 A. WELL DATA Y Well type Private If A, B, or C provide PWSID# Well Log (YIN) Date completed 5/24/76 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 200 ft. Cased to 15 ft. Casing height(above ground) >12 in. FROM WELL LOG AT INSPECTION Date of test 5-24-76 9-14-16 Static water level 15 ft. 26.4 ft. Well production 5 g.p.m. 3'1 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1 .47 mg/L Arsenic NDug/L Date of sample: 5/18/17 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/STEPDate installed 7/26/2000 Tank size 1 ,250 gal. Number of Compartments 2 Cleanouts (YIN) Y Y N Y Foundation cleanout(YIN) IDepression over tank(YIN) High water alarm (Y/N) Date of pumping &I�/ 17 4Af Pumper Around the Clock C. ABSORPTION FIELD DATA Date installed 7/26/00 Soil rating (g.p.d./ft2 or ft'/bdrm) 2 GPD/SF System type Bed Length 30 ft. Width 12 ft. Gravel below pipe '25 ft. Total depth 2.6-4.2 ft. Eff. absorption area 360 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/14/16 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450 g p d N Any rejuvenation treatment(past 12 mo.)(Y/N & type) If yes, give date D. LIFT STATION Date installed 7/27/00 Size in gallons 1,250 Manhole/Access (Y/N) Y "Pump on"level at Timer in. "Pump off' level at Timer in. High water alarm level at 46 in. Datum Bottom of Tank Cycles tested 3 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: >100' >100' Septic tank/lift station on lot On adjacent lots Absorption field on lot >100 On adjacent lots 100 Public sewer main '75' Public sewer manhole/cleanout 100 Sewer/septic service line 5 Holding tank >75 Animal containment areas - Manure/animal excrete storage areas >100 SEPTIC/HOLDING TANK ON LOT TO: >5'Building foundation Property line >5 Absorption field >5 ' Water main X10' Water service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line Building foundation >10 Water main X10 Water Service line 0 Surface water >100 Driveway, parking/vehicle storage >10 Curtain drain None Noted Wells on adjacent lots �100� F. COMMENTS G. ENGINEER'S CERTIFICATION ...4‘47- OF AZ. 9 I certify that I have determined through field inspections and .171e!:•. review of Municipal records that the above systems are in H.(O;: � `�0 conformance with MOA COSA guidelines in effect on this date. d :- 9 pJ Engineer's Printed Name Michael E. Anderson, P.E. •• ri 6/5/2017 4�c�:MICHAEL E. ANDERSON Date GE-c,1381 `'.:" ' COSA brown sheet 10-10-12.doc ADVANCED WASTEWATER TREATMENT SYSTEM ;'1AIN:'EiANCE AND REPAIR AGREEMENT BETWEE1': _=pit T.'`^;''.::'moi t 1' ,7 1,7 AND Robert &Vikki Ellison THIS MAI1\T ANCE AND REPAIR AGREEMENT made and entered into as of this Day of JwK of 20 11, l'y and between Robert & Vikki Ellison herein the"OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: l. Advanced VVcscewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Bottomless Sand Filter located at(legal description). Lot 2, Denali View Subdivision 2. 7:7nfinitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts,components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (CGSA). An appro"al the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter,"AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces ot'an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 1. Term. The term of this Maintenance and Repair Agreement shall begin on the date;of approval by the Municipality to operate the installed system or issuance of COSA,and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional F i uipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service aureement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the A WWTS_ In addition, it shall be the responsibility of the Owner during the termof this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1)repair(s),(2) maintenance, (3)adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with ail applicable ordinance, laws, regulations,rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a writt:n schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the s}stem vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will ;aspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines fcr the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwa!ver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a wai'•zr of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof; or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing,executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with. and such writing shall be attached to this Maintenance and Repair .Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: Robert & Vikki Ellison b. Municipality: Director,Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. . • r 3. Jurisdiction: Choice of Law. .any civil action arising from this Maintenance and Repair _Ag►eement shall be brought in the Superior Court for the Third Judicial District of th:, State of Alaska at Anchorage. The laws of the State of Alaska shall go-'an the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement dccr,:ed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agrecmeni. OWNER: By A (-------•_�_s. / `1/ `e " .J w tsignature) Date: C « .Pon 1. ,), L. Liis ,-� €.b��4 ..JM -- (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acowledg:,d before me this t day of,' A,6 20 / 7, by vi i Z. /.:4L;s.+/"/'La be.�A,.!=t[,.$0.✓ 01111 I ,...PEAS tst, ARS' nr; , C FOR AT_.AS A S14OTA / _ My Commies►on expires: 7 d7G dCi ‘44:;;; � $L Cyre rE O co x')1111111111 MUNICIPALITY: / II y: - IAA 1< : (signature) Date: f3 ` � l (print name) Title: Municipality of Anchorage Development Services Department Building Safety Division ° On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-461-17 HAA# 1. GENERAL INFORMATION Expiration Date: -- / (p " O Complete legal description DENALI VIEW SUBDIVISION: LOT 2 BLOCK 2 Individual Water Storage ❑ Individual Holding tank Location (site address or directions) 8701 SULTANA DRIVE * ANCHORAGE AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address ALBERTO & FOROOZ G. SAKALA Day phone 8701 SULTANA DRIVE * ANCHORAGE AK 99516 Day phone GEORGE McCOY W/ PRUDENTIAL J. W. Day phone 783-2937 3201 "C" STREET SUfTE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ■ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone 337-6179 Address 3701 E TUDOR ROAD SUITE 101 " ANCHORAGE. AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Date Engineer's Comments: in conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKW WC, inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. x Conditional approval for 3 bedrooms, with the fllowing stipulations: At the time of title transfer, the new Property owner shall n'^^ 'ham at*arhPd— maintenance agreement which shall - «,__ t_o_.a an lmrnnll— Attachments: / HAA Checklist C/ Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other By. Original Certificate Date: 1 a r d 3 (Rev. 12101) $AN .. 9 `y* ....... ......... u e Go ess: —7953 011 fe. ............. cc'v0 Disapproved. x Conditional approval for 3 bedrooms, with the fllowing stipulations: At the time of title transfer, the new Property owner shall n'^^ 'ham at*arhPd— maintenance agreement which shall - «,__ t_o_.a an lmrnnll— Attachments: / HAA Checklist C/ Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other By. Original Certificate Date: 1 a r d 3 (Rev. 12101) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST i Legal Description: DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 Parcel ID: 015-461-17 j A. WELL' DATA 'CASED TO BEDROCK Well type PRIVATE If A. B, or C provide PWSID# NIA Well Log (Y/N) YES Date completed 5/24/1976 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Totel'depth 200 ft. Cased to `15 ft. Casing height (above ground) 12+ in. j FROM WELL LOG AT INSPECTION bate of test 5/24/1976 12/3/2003 Static water level 15 ft. 12 ft. Well production 5 g,p,m. 2.3+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate 2.09 mg./L. Other bacteria 8 colonies/100 ml. lli, Arsenic: N A mg./L. Date of sample: 12/3/2003 Collected by: AKWWC, INC. B. SEPTIC/HOLDING TANK DATA Tank:Type/Material - STEEL/S.T.E.P. ;; Date installed 7/26/2000 Tank size' 1250 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES ii Date of pumping 11/7/2003 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA *BELOW EXISTING cRAOEI 11�1:1,7/26/2000 Date installed 6/2/1976 Soil rating p.dJft r /bdrm 2/250 System type _BED (ISF)/TRENCH Length t' 30/40 ft, Width 12/3 ft.. Gravel below iP P e 0.25/10 ft. •2.8-4.5 360 Total depth 15.8 ft. Eff. absorption area 50d ft' Monitorin tube YES g Depression over field NO Date of adequacy test 12/3/2003 Results (Pass/Fail) PASS For 3 bedrooms DRY/ DRY/ Fluid depth in absorption field before test DRY In, Water added 453 _gal. New depth DRY in. sed Time: N A DRY/ Ela P _L min. Final fluid depth DRY in, Absorption rate >= 450+ g,p.d, Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE KNOWN If yes, give date i D. LIFT STATION Date installed 7/26/2000 Size in gallons 1250 "Pump on" level at TIMERin Datum BOTTOM OF TANK E. SEPARATION DISTANCES "Pump off' level atTIMERn Manhole/Access (Y/N) YES High water alarm level at 46 in. Cycles tested 2+ Meets alarm & circuit requirements? YES 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'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/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'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ A' F. COMMENTS G. ENGINEER'S CERTIFICATION `N<.• I certify that 1 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. ............... of a ness: Engineers Printed Name JEFFREY A. GARNESS OQQ09• —7953 i,.' c�G p ANo Date t 2 �i5�o3 4edProressl0f% HAA Fee $ :K1' S Date of Payment I2 —4oz Receipt Number 4 (Rev. 12101) Waiver Fee $ Date of Payment Receipt Number w E�C-4-2003 09:07A FROM:A+ HOME SERVICES9 IN 907-868-6770 TO:3383246 A4- HOME SERVICES INC. CUSTOMER 7501 E. 140th Avenue Anchorage, Atdska 99516 345-1890 13M & Tb=u Reed 8701 Sultana Drive A-- —004MC Block Lot P:1/1 INVOICE #' 23896 DATE DESCRIPTION AMOUNT 11-07. D3 Pump Scptic & Lift_._.... MOO T 7�, rair�..Untif lam 4.4 rcMed fiscif nv 62. co 1AM TOTAL REMARKS Gallons --�_Septic Leach Area Holding Tank � Standpipes 7): -.7( -.)Time ❑ PROBLEM AREA — CALL FOR MORE INFORMATION El NEEDS TO BE DONE AGAIN IN 6 MONTHS Good Shape r] -sludge buildup on bottom 13 Floater on top Jim cap missing or El Cut standpipe to V above ground 13 Needs Septictrine needs replacing IN tS7!J b'4 J"t= 1-)LI.I III SULTANA DRIVE I STRUCTURES AND PLATTED LOT LINES OR CASEMENTS ANBED IS NOT TO1 -1 I'll INIr-LTWr USED FOR POSITION NGLADDRIONAL IES OR FENCEUNES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREON.(UNLESS I NOTE: ANY FENCEUNES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY OR LOCATE STRUCTURES. ANY PAYING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS, 0 OF _a cgs�o 49-*TH .v ................................ SHANE A. HOLT LS -6914 i 4P 4\\n ����101101 �•d� IS -BUILT SURVEY ( NO CORNERS SET THIS DATE ) I" w SO' I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 2, BLOCK 2, DENALI VIEW SUB. ANCHORAGE RECORDING DISTRICT, ALASKA AND THA THE VISIBLE IMPROVEMENTS SITUATED THEREON , WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. Mh AT ANCHORAGE, ALASKA THIS 2ND____ Y OF DECEMBER_____ 2003 __• VYLT LAND SURVEYING 9208 FB 109-27 TEL. 345-5513 12-09-03 08:27AM FROM -CUE ESI, SGS ENV SERVICES -SG-S SCS ReLq 1037721001 Client Name AK Water & Wastewater Consultants Inc. Project Nameip Denali View S/D Lot 2, Block 2 Client Sample ID Denali View S/D Lot 2, Block 2 Matrix Drinking Water 9075615301 T-782 P.02/03 F-515 All Dates/TImes are Alaska Standard Time Printed Date/Time 12/08/2003 9:55 Collected DatelTime 12/03/2003 11.-38 Received Date/Pime 12/03/2003 12:10 Technical Director. -,� Stephyt Q. Ede Sample Remarks: F.P 300.0 - Nitrate detected in the method blank at > 1/2 PQL; concentration of nitrate in the sample is l OX greater. Parameter Results PQL Units Method Container ID ll ALim ie to p Analysis u !reit Waters Department Nitrate -N 2.09 0.100 Microbiology Laboratory mg/L' EPA 300.0 B (<=10) 12/03/03 J1B Total Coliform 8 OB, No Coli col1IOOmL SM18 9222B A (<=1) 12/03/03 DKC MUNICIPALITY OF ANCHORAGE •(;`};'�I DEPARTMENT OF HEALTH & HUMAN SERVICES �p 1 Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 3434744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcell.D.# 015-461-17 HAA# 1. GENERAL INFORMATION Complete legal description QFNAI I VIEW 50DIVISION, LQI 2, 01013W Location (site address or directions) 8701 SULTANA DRIVE ANCHORAGE AK 99516 Property owner DENNIS SMITH Day phone (907) 376-1493 Mailing address 2281 E SUN MOUNTAIN AVE WASILLA AK 99654 Lending agency Mailing address Day phone Agent BONNIE MEHNER w/ PRUDENTIAL JACK WHITE Day phone (907) 689-6464 Address 3201 "C" STREET ANCHORAGE AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 Computer version �' iOQU Note: Alaska Water and Wastewater Consultants, Inc, shall be paid $900:00 at, or prior to, closing for the engineering services provided. 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 apState codes, ordinances, and regulations in effect on the date of this inspection. J Name of Firm Address Engineer's Signature Phone (907) 337-6179 4- In In conducting this evaluation, AWWC, Inc.tte pV d to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOID fH Guidelines & Regulations. The reported results described 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 soils condition, ground water levels that may fluctuate during the year, and the water oo�op�� / usage of the family being served by the system. These conditions are outside the control of o OF t the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the�TH I' system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any C/ reliance upon or use of this report 6 an otherperson ora is not authorized, u .. `' P P byany P P rtY � [7".:.. ffffr • • • • •� nor will it confer any legal right whatsoever. �O J Je'rey A. artless 6. DHHS SIGNATURE Approved for 3 bedrooms Disapproved Conditional approval for Additional Comments bedrooms, with the following stipulations: Date—9 -/,/- e) — IMMEMMEME The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Back MOA #21 Computer Version KLCEIVEU Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICEVIS 04 200 Environmental Services Division 825 "Lu Street, Rm 502 Anchorage, Alaska 99501 (907) 34344MOALITr CE ANC "WN FNITAL SERVICES Health Authority Approval Checklist Legal Description: DENALI VIEW SUBDIVISION; LOT 2, BLOCK 2 Parcel I.D.: 015-461-17 A. WELL DATA Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) YES Date completed 5/24/76 Total depth 200' Cased to 15' Casing height (above ground) 18"+ Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES FROM WELL LOG Date of test 5/24/76 Static water level Well production 5 g.p.m. AT INSPECTION 5/23/2000 WATER SAMPLE RESULTS: a 8' 9'd- _ - Coliform 0 Nitrate �7 mg/L Other bacteria Date of sample: 900 g�i�oo Collected by: A.W.W.C., INC. B. SEPTIC/HOLDING TANK DATA S.T.E.P. TANK Date installed 7/26/2000 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) YES Date of Pumping NEW Pumper C. ABSORPTION FIELD DATA TO TOP OF SAND FROM FINAL GRADE. Date installed 7/26/2000 Soil ratin p.d./ft2 r ft2/bdrm) . 2 System type BED (ISF) Length 30' Width Gravel thickness below pipe 0.25' Total depth *2.6 — 4.2 Effective absorption area 360 SQ FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test NEW Results(Pass/Fail) For Fluid depth in absorption field before test (in.); Fluid depth (past 12 months) (Y/N) 72-026 (Rev. 3/96)' Computer Version Absorption rate = If yes, give gal. water added (in.): D. LIFT STATION Date installed 7/27/2000 Size in gallons 1250 Manhole/Access (Y/N) YES "Pump on" level at* TIMER _"Pump off' level ar* TIMER _ High water alarm level at* Cycles tested NEW *Datum BOTTOM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septictholding tank on lot 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ ___ On adjacent lots Public sewer main N/A Public sewer manhole/cleanout— N/A Sewer/septic service line 25'+ Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ .Absorption field 5'+ Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+ ._ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main/service line_ 10'+ ._ Surface water Curtain drain F. ENGINEER'S I certify that I i of Municipal n with MOA HAS Engineer's HAA Fee Driveway, parking/vehicle storage area NONE KNOWN (field inspections and review systems are in conformance on this date. Date of Payment Receipt Number D t�O S 7 ci 72-026 (Rev. 3/98)' Computer Version Wells on adjacent lots 100'+ Waiver Fee Date of Payment Receipt Number y A. Gdrfiess� E-7953 pro f e s sVo0°4 08-07-00 15:38 FROM -CTE ENVIRONMENTAL CT&E Environmental Services Inc. rrisrsirrrvr.�+e'e 5615301 T-360 P.02/03 F-143 CT&E Ref.R 1004242001 Client POR Client Namc Al: Water & Wastewater Consultants Inc. Printed Date/Time 08/07/2000 1344 Project Namd* Denali View Lot 2 Rik 2 Collected Date/Time 08/01/2000 13:40 Client Samplc ID Denali View Lot 2 BIL 2 Received DatefTime 08/01/2000 15:20 Matrix Drinking Water Technical Aire or tephen C Ordered By Released PWSID 0 Sample Remarks Allowable Prcp AaalyS,s Parezueter Results PQL Units Method Limits Dau Date [Till Waters Department Ntnatc-N 288 0 500 mWL EPA 300.0 10 max 08/01/00 SCL Microbiology Laboratory Total Coliform 8 OB, No Coli col/100mL SM18 92228 08/01/00 KAP MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA # ���°la �Qa 1. GENERAL INFORMATION \ Complete legal description Lor `� UE -D J fait � ICU �ur� Location (site address or directions) "Q1 to bfnvU — Property owner �C ti►-� 5 �M k h//�� 11 Day phone pp3 6 - 10 3 Mailing address �Z91Q cc -,ME: Qcnt� lJrta\L�A Lending agency Mailing address Agent — Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site !� Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MO/1 021 - 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. Name of Firm ALASK►a IGt___% GNG%}_L_:4i2#1vG �P{hone �4�-��-� Address i`�x L7.� ' Q�0L;; '�41t C1ILigS Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments In bedrooms. -Date. s 26 9 2- p` 4 O .v T. ftII a �?�► ROFF�Ssig c ' bedrooms, with the following stipulations: Date zz The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the pr9fessional engineer's work. 72-025 (Rev. 1/91) Back MOA 021 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lam'Parcel I.D.- bLD1RL% VICC J SJb A. WELL DATA Well type ` �''%Je_ �_ If A, B, or C, attach ADEC letter. ADEC water system number `' � v,Y Z4i. IR441 Driller t�tL1%6x, UtELL b,1� Log present (Y/N) 7� Date completed Total depth 200' Cased to Sanitary seal (Y/N) Ve_% Date of test Static water level Well flow Pump level Casing height Wires properly protected (Y/N) `L S FROM WELL LOG Maw Z 4 , t9i-6 rg S AT INSPECTION - 9 Z MUNICIPALITY OF ANCHORAGE —{ �..nonNMENTAL SERVICES DIVISION AV RECEIVED SEPARATION.DISTANCES'FROM WELL TO: Septic/holding tank on lot 10,6 r ; On adjacent lots Absorption field on lot los-, ' ; On adjacent lots oo Public sewer main �`'� Public sewer manhole/cleanout &I A Sewer service line M 114 Petroleum tank WATER SAMPLE RESULTS: Ad 1191 . $ Coliform SZ'11 _15_ � Nitrate _ �'`� I� Other bacteria Date of sample: TZ 1 1_ Collected by: 1 B. SEPTIC/HOLDING TANK DATA Date installed Tank size Compartments p i►ti Cleanouts (Y/N) Foundation cleanout (Y/N) G,?_rL%e_ Depression (Y/N) High water alarm (Y/N) KIIA Alarm tested (Y/N) tJI) Date of pumping Pumper Neuert a L Ivan SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: , �O tom Foundation �� �►TL� Well(s) on lot � On adjacent lots To property line 40 Absorption field uN« Water main/service line ff Surface water/drainage IN Sw,_ uLR 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed . Size in gallons Vent (Y/N) N/A High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water _ Date installed �r"� ���� Soil rating ZSo 34 %rZ System type i•+ � tr Length 40 Width Gravel thickness 0' Total depth IG If Total absorption area '% � Z Cleanouts present (Y/N) l` us Depression over field (Y/N) �� Date of adequacy test 1; -ZZ -9 2 - Results (pass/fail) ` �S% for `' bedrooms Peroxide treatment (past 12 months) (Y/N) If yes, give date Nin SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 100 -V On adjacent lots 10©} Property line 16 r To building foundation It' dU To existing or abandoned system on lot Ai 1A On adjacent lots 18o Cutbank Water main/service line �A Surface water j00 Driveway, parking/vehicle storage area k,z 4 Curtain drain �'A E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature t Engineer's Name �--~-�o N►,- �zT�� Date In J9 -Z_ HAA Fee $ /70 Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number V �A60MATRAT CHEMICAL Edi GEOLOGICAL ,Tall ORATORY 5633 B STREET Client Sample ID 2/2 DENALI VI9N 3/0 PW3ID UA Collected A hxe• Receiyed MAY 27 92 b 06:00 hte. Prtsoryed with : A9 REQUIRED Analysis Coaplotsd : MAY 29 92 Labotetoxy Supe rieor EPNEN C. E Rvlvavvd By o c - A DIVISION OF COMMERCIAL TESTING & ENGINIEI_pING CO. ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 ANALTSIS RESULTS for INVOICE t 54072 Chemlab Ref.t 92.2314 Sample t 1 Matrix: WATER Client Name :AR RIM INGINBERING Client Acct :SLVBNGT BPOt : Regi : Otdet•d By :PAUL CAMPBELL Sona Ropotte to: 1)AE RIM ENGINEERING 2) Pot :NONG RECEIVI .......■......•.........................nw...-M..................................................._.■....................�......... Pazamvter Results Unite Method Allowable Limits NITRATE -N 2.9 mg/l BPI 353.1 10 sample ROUTINE SAMPLE COLLECTED BI: D.L. Remarks: ...................................----------------...............,..................------------- 1 Tests Peifoined Sae Special Instructions Aboye UA-Unarailable NU- mono Detected "' Sae samply lomarks Ahoye $A- Not knalyzed LT -Leve TIAn, G7-0teater Than r9'%9GE3 M$mber of the 803 Group (Socidtd GAnkale do SUrveManoe) �� AWCNGWAGE AgEq GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality oAGA9jP£0 ApnUA*b"e 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received September 16, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Alaska Mutual Savings Bank Mailing ,Address: Post Office Box 1120 99510 Phone: 274-3561 x 217 2. Property Owner: Dennis G. & Dorothy A Smith Phone: 344-9686/349-2682(h) Mailing Address: Box 4-1592 Anchorage 3. Legal Description: Lot 2 Block 2 Denali View Subdivision 4. Location: NHN Sultana Drive 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual s A. Type C. Construction B. Depth D. Bacterial Analysis 7. Sewage Disposal System: On—site system A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECT16 ' 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV xxx 2. 3. 5 C 7. A F Property Owner: SMTTf4, Dcnni. G_ & llnrnj-h3z A Mailing Address: Box 4-1-592 Anchorage, AK Day Phone: 344-96,99 - IkIQ-A 9,260. Name of Buyer: Mailing Address: Day Phone: Name of Lending Institution: Alaska M„ttjal Saying.-, Rank Mailing Address: p- n Rnx 1120Achor_qge, AS Phone: 271E-3561 ex- 217 Name of Realtor or Agent: n/a Mailing Address: Legal Description: r.nt 2. Rlk 2, Denali View subd Location: NHN Sultana Drive Phone: Type of Facility to be Inspected:- Well & Septic No. Bdrms. -3 Water Supply Type of Supply: Public Utility Individual— well, $6,000.00 If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation 72-003(3/76) Individual (on-site) Page 2 of two pages - Re st for Approval of Individual ,er & Water Facilities Legal Description Lot 2 Block 2 Denali View Subdivision Comments Approved Disapproved Date `:?/j W Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Da to