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Home My WebLink AboutPARADISE VALLEY BLK 6 LT 11Paradise Valley Block 6 Lot 11 #020-412-14 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: OSP241269 Work Type: Well Initial Tax Code Number: 02041214000 Site Legal Address: PARADISE VALLEY BLK 6 LT 11 G:3538 Site Mailing Address: 6511 SWITZERLAND DR, Anchorage Owner: COOK CHRISTOPHER & RIMA L Design Engineer: This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 8/20/2024 8/20/2025 61733 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well 0 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 4 Received By: ;;'% Date: �. Issued By: - Date: ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 02041214000 Property owner(s) COOK, CHRISTOPHER & RIMA L Day phone 907-250-6964 Mailing address 6511 SWITZERLAND DR, ANCHORAGE, AK 99516 Site address 6511 SWITZERLAND DR, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) PARADISE VALLEY, BLK 6 LT 11 Legal description (Township, Range & Section) Lot Size 61.733 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (S all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Wefi Water Storage Initial 0 Upgrade ❑ Renewal ❑ TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: I certify that the above informat rrect. I further certify that this is in accordance with applica , Municipal C ApaffA A (Signature of property owner or authorized ag Permit/Rush Fees: 16 o Date of Payment: gLoeiv Receipt Number: L47 -,z2 Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. GAIDevelopment Services\Building Safety\On Site Water and Wastewater\Faffns\Cllent FormsTermit Application.doc Municipality of Anchorage Page 1 of 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: -SW030344 PID Number: 020-412-14 Name: John Ha.qmeier Homes, LLC WastewaterSystem: New Address: 2204 Cleveland Ave., Suite 201 Anch., AK 99517 ABSORPTION FIELD Phone: Number of Bedrooms: (4) 5' Wide Trench 248-6789 Four $o~1 Rating: Total Depth from original grade: LEGAL DESCRIPTION 1.2 OPD,~' 7 Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 6 11 Paradise Valley 3 rt. 4 Township: Range: Section: Fdl added above original grade: Gravel Length: 1-2 n. 56 Gravel width: Number of lines: I D~stance between lines: Well: New 5 n. 1I Ft. Classification (Private, A, B. C): Total Depth: Cased to: Total absorption area: Pipe Matenal: Private 407 n. 38 n. 560 n, ASTM 3034 PVC Driller: Date Drilled: Static Water Level: Installer: Date Installed: Alpine Drilling 10127103 42' vt. Hagmeier Homes 10118-1912003 Yield: 1 GPM [ Pump Set at:Ft. I casing ~ eight·2n.Ab°ve Ground: TANK I SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~ To Septic Absorption Lift Holding ~ublic/Privatet,'ianulac[urer; {.,apac~ty in {..iallon$: Field Station Tank SewerLIne Anchorage Tank 1,250 Tank Material: Number of Compartments: we,, >100' ·100' NIA NIA ·25' Steel Two (2) Surface Water ·100! ·100! NIA N/A ~ / LIFT STATION - NONE ON LOT Lot Une >5' ·10' NIA NIA vo.nda,on >5' ·10' NIA N/A -,ump on" level at: *Pump olT'level at: I High water alarm at; Curtain Drain None Noted Pump Make & Model Elecmcal Inspections performed by: .eme~s: BENCH MARK Locahon and DesCription: Garage Slab 100.0 n. Engineer's Stamp Inspections performed by: MEA Dates: 1't 10118/03 ~. ~.-"' 4Oth _'~' ..~\~' ~_[ MICHAEL E. ANDERSON Department of Health and Human Sq~ices approval ~2¢:".. No. c~-~t · Municipality of Anchorage page 2 of 3 'DEVEOPMENT SERVICES DEPARTMENT · 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 ~ On-Site Wastewater Disposal Inspection Report Permit Number: SW030344 PID No. 020-412-14 LOT 1 1, BLOCK PARADISE VALLEY SUBDIVISION 61,75..7, S.F. C5 89'51'39"£ 140.02' 10' UTIL, ESMT. Four Bedroom Home S2 C4 M1 I Alt §~tPeOt e JA b S1 28.7 J33,8 S2 36.2 140.4 C4 55.9149.5 M1 49.2 162,2 C5 54,5 ~79.2 50' TEMPORARY TURNAROUND TO BE AUTOMATICALLY VACATED WHEN STREET --IS EXTENDED. PLAN AS-]3UILT SCALE 1' = 60' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030344 Page 3 of 3 PID No. 020-412-14 ~92.8 88.7 / 97,0 Ge_q't;ex't;lte F.~brl.c . __ DrcdnFietcl Rock 56' / 79.0 ~ 92.8 PROFILE Scale: 1' = t0' FROM :JOHN HAGMEIER HOMES FAX NO. :907248G789 May. 05 2004 OI:41PM P2 Department of Health and Human Services 825 "L" Street ' P.O. Box 19~6'50 Anchorage, Alaska 99519-6650 ,, Rick Myatrom http:l/www, ci. Anchorage.ak.us Mayor Permit Number: #SW 0_30344 Date of Issue.'. 8-__29'.-03 Parcel Identification Nmaber: 020-412-1.4 D, ateS .ta~:~2~3 Date.Completed::~lO-27-03 .l~w¢lllo~atedatapprovedp~'mitlocati~n?]~ Yes [] No Borehole Dhta: ~oil Type, Thicknes~ & Water Sirata Legal Description:, ' Par~fis& .Valley'Blo. ck 6 Lot 11 Prop.erty O~ner Name & Address: . Chfig Cook 6933 Me~lOw Street . .Deptii (n) l~&hod of.!)ri~iiag F~'air r'.otao' From · To · · [] (Jable · . . .Casing type:, steel · .: 0 2' Wall..Thlclme~s:.;250 inches · ' '2 3 Diameter: 6'inches Depth: 38 feet : '9 '. ' 43 . '.Diamct~: -.. .inches .Depth: ~. feet , Cas. in~ .s, h.'C.k.'up a. bo~.e gr.o~d: 2 · ' Shifi'ewater.ii;vel (..fr.om'ground level): ~2 feet · P.u.mpln. g lev~: 40_7._feet l~te~ , " "' ! hours pumpi.ng ! ~pm . Recovery. Rat6..'~._! gpm. .. 'Method ofTestln§: ~ , ... . ' . Well Intake Op.ening .Typei. .. .~ open End. [] Open Hole [_']Screened.. Start ....__._,~eet Stopped_ feet [] l%foratio~s Smrt_~ _. f~et Stopped .. ·Grout Type: be~ztord'ie# 8 Volume: ]bE .Dcp. th: Start 0 feet Stopped ? fe~-t !: .. l~nmp: Intake Depth ' ' fe~t "· .. Purn. p.'siz~. , hp brand .". Comments:. .Well Driller:. Alpine D~71ing & Enterprises' ·., PO Box 1104.96. ·: Anchorage. Alaska 99,51 Thc w~ll driller shall ~rovide a well log to the.p~opmy owxter withlff 30 days'of comple{ion and the property .. ~tick-up " organic ~ silt. giavelJy'siit .sa. nd~, ~m. ve! · '~ravel'iysilt .bedrock Attention: MUNICIPALITY OF ANCHORAGE Development Sen/ices Department On-Site Water. & Wastewater Program 4700 South'Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Aug 29, 2003 Expiration Date: Aug 28, 2004 Permit Number: SW030344 Legal Description: rP~'Fa-di§~' vall~ Block'6 Lot 11:"- Design Engineer: 0014 Anderson Engineering Owner Name: Chris Cook Owner Address: 6933 Meadow Street Anchorage, AK 99507- Parcel ID: 020-412-14 Site Address: Unknown Lot Size: 61733 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: r~ Disposal Field ['~ Septic Tank Holding Tank r-~ Privy [] Private Well r-~ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: ~'~~ ~.'~~ Date: Issued By: Date: Parcel I.D. Municipality, of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number SW O;~ 0~- Property owner(s) Chris Cook Mailing address (1) 693~5 Meadow Street Mailing address (2) Anchorage. AK 99B07 Day phone 274-2248 Zip Code Legal description (Lot, Block & Sub'd.) Lot 11. Dlock 0, Para~ilee Valley Subdivlolon Legal description (Section, Township & Range) LotSize I~O~ ~"~'o''-z'~ Acres~ Number of Bedrooms Four (.4) THIS THIS APPLICATION IS FOR: Sewer Only I-'] Well Only E] Sewer and Well I~ Water Storage ['"1 Sewer Upgrade I--I PROPERTY CONTAINS: Hot Tub I'-I Jacuzzi [-] Swimming Pool ['-I Water Softening Unit Therapy Pool I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Numben qo.~ll, (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number:. ANDERSON .ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 IFAX) MEMORANDUM ATE: August 28, 2003 ;",TO: Dan Roth FROM: Mike Anderson, P.E. SUBJECT: Lot 11, Block 6, Paradise Valley Subdivsion Well Septic System Construction Permit We have added the dimensions between the house and septic tank and septic tank and absorption trench to the Site Plan for the subject lot. We have also included an addendum showing the location of the well and septic system on the lot to the north. No apparent conflicts are noted between the proposed well location and the existing septic system locations on adjacent lots. Please let me know if you have additional questions. ANDERSON ENGINEERING · P.O. BOX 240773 ANCHORAGE, AK 99524 ,~ · 522-7773 ~ .~' 522-6779 ~[FAX) : August19,2003 Municipality of Anchorage Development SerVices. Depadment On-Site Water and WaStewater Program 4700 South Bragaw Street Anchorage,' AK 99519-6650 Subject: Lot 11, Block 6, Paradise Valley Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 11, Block 6, Paradise Valley Subdivision intends to construct a new foUr-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a neTM well and septic system to serve the new home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and Septic system. Also identified on the plans are the locations of the alternate site, proposed well location and the well and septic system locations on the adjacent properties. Drainage 'arrows are shown indicating the current patterns. The drainage patterns will be'maintained after construction. Test holes placed on the lot indicate well graded silty sand with some gravel in the area of the new. absorption trench and alternate site. The percolation rate for this lense is between 1 and 5 minutes per inch. No groundwater was found during placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a new 1,250-gallon septic tank and a 50' long by 5' wide by 4' effective depth absorption trench. The distribution pipe will be placed at 3' below the existing ground surface. Sufficient fill will be placed atop the trench to prevent freezing. The ground surface on the lot slopes at varying grades from the north to the south. The new absorption trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from the proposed well on the lot and the existing wells on the adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. · Lot 11, Block 6, Paradise Valley August t9, 2003 Page Two If the system is apply: constructed in accordance with our design the following statements 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 future. The system, if constructed as designed, will have no adverse impact on reserve 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 3 2 1 13 R~'20 4 250.20 8 2 6 7 5 135,62 85.62 5 3 6 10 4 9 10 Septic Area 152' Deep Well Location I I Septic Area 11 This Project 150' Deep .6 GPM 6 7 49th MICHAEL E. ANDERSON NO. CE-438! AREA MAP SCALE 1" = 100' 6 6 5 lOJUt~l E~mt 354.75 Well Location I I Septic 1 0 Area 0 Well Location 7 9 IThis ProjectI 8 5 4381 L PARADISE VALLEY SUBDIVISION ~' LOT 11. BLOCK 6 Proposed Well 145° x Four Bedroom Home ~ - 14~ 4" Ineulatlon Under TH2 x 5' Wide LOT 11, BLOCK 6, PARADISE VALLEY SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom House 5' Wide Trench System Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 ,.GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area 500SF/5 LF (Width) .5 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 3' Below Odginal Ground Surface. Total Depth to be 7' Below Existing Ground. Maintain 100' Separation From Well on the Lot. Place 2' of Direct Bury Insulation and 2' of Fill Over Absorption Trench or Provide Minimum 3' of Cover to Prevent Freezing. Place 4' of Cover Over Septic Tank. Maintain 100' Separation From Surface Water in the Area. 2'6" # ~otextile Fabdc · % O 4" Perforated PVC (Holes Down) -- Drainfield Rock St TYPICAL 5' WIDE TRENCH SECTION NOTE: (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. I 2-- &-- 6 7 $ 9 18 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 6,700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Chris Cook DATE PERFORMED: 61312003 LEGAL DESCRIPTION: Lot 11, Block 6, Paradise Valley Subdivision TEST HOLE # PT/O§ Silty Sand Some Gravel - SW 1 SLOPE SITE PLAN TH2 O Switzerland Orive B0H WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: ....... ~ ~~i;~~~''' ~' ................. ~': '~'""~ y~?...~...'~ No None 6/15/2003 S L GROSS NET DEPTH OF NET READING DATE TIME TIME WATER DROP Start 6/3/2003 5:35 10.63" 1 5:&5 10 0 10.63" Recharge 5:Z,6 10.5" 2 5:56 10 0" 10.5" Recharge 5:57 10.5" 3 6:07 10 0" 10.5" PERC RATE: 1 MIN,/INCH PERC, HOLE DIAMETER: 6" TEST RUN BETWEEN &.5 FT, AND 5.5 FT, COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIs TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/19/2003 2 5 5 6-- 7 8-- 9 II PROJECT #: PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM /-,.700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST Chris Cook DATE PERFORMED: 6/3/2003 LEGAL DESCRIPTION: Lot 11, Block 6, Paradise Valley Subdivision TEST HOLE # PT/0G Silty Sand Some Gravel - SW 2 SLOPE SITE PLAN r.? TH2 O Switzerland Drive COMMENTS: BOH WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: ,,.~.~ I ~. ~ DATE: No None 6/1S/2003 S L GROSS NET DEPTH OF NET READING DATE TIME TIME WATER DROP Start 6/3/2003 6:2Z, 9.5" 1 6:3t, 10 0 9.5' Recharge 6;35 9.38" 2 6;36 10 0" 9.38" Recharge 6;37 9.5' 3 6;~.7 10 0" 9.5" PERC RATE: 1 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN & FT. AND 5 FT. Test Hole Pre Soaked Prior to Test. Same Haferial as Test Hole 1. TEST PERFORMED BY: MCA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/19/2003 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 11, BLOCK 6, PARADISE VALLEY SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250-gallon sePtic tank at the location shown on the site plan. Work also includes the cOnstructiOn of a new absorption trench 50' long by 5' wide by 4' effective depth also at the location shown on the Site plan. The total dePth of the trench will be 7' below existing ground and the distribution Pipe willbe placed at 3' below the surface. All components of the new:absorption trench and septic tank must be constructed a minimum of 100' from any surface water and 100' from the well on this and adjacent lots. A minimum of 4' of cover is required over the septic tank and 3'. over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 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. 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. 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. 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 1,250-gallon septic tank must be procured from a certified septic tank manufacturer. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. L6t 11, Block 6, Paradise Valley Subdivision August 19, 2003 Page 2 of 3 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. e 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. 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. 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. 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. 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 trench to drain away. A minimum 2' of accepting soil is required below the drainfield 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. L~t 11, Block 6, Paradise Valley Subdivision August 19, 2003 Page 3 of 3 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 tiffed with watertight couplings (Caulder, Fernco, or equal). 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: Municipal Ordinance requires a minimum of two inspections. 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 placel 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 comple(ed system. Municipality of AnCllorage Development Services Department Building Safety Division On-Site water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 AnchOrage, AK~ 99519-6650 wWW. ci.anch0rage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING F~arcel I.D. 20.412.14 1. GENERAL INFORMATION Complete legal description HAA# O/~Of~3 Expiration Dale:, ~' - [ ~ Lot 11, Block 6, Paradise Valley Subdivision Location (site address or directions) Switzerland Drive Current Proper{y owner(s) Mailing address Lending agency Mailing address Re'al Estate Agent Mailing Address JOhn Ha,qmeler Homes, LLC 2204 Cleveland Ave., Suite 20t Day phone 248.6789 Anchoraqe, AK 995 ' Day phone Day phone e Un/ess othen/vise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: Fou? {4) 3.. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] I--I Individual Holding tank r-'] [] Community On-site I'-I [] Public Sewer [] . The Municipality of Anchorage Development services Depadment (DSD) Issues Cedificates of Health Authority Approval" (HAA) based only upon the. representations' given in paragraph 5 by.an independent professional civil engineer registered in' the State of Alaska. Cedificates of Health Authority Approval are required for the transfer of title (except between spouses) for propedies served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Cedificates of Health Authority Approval are valid for 90 days from the dafe of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates 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. 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 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 En,qineerin,q Address P.O. Box 240773 Anchoraqe, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE Disapproved. , bedrooms. ·. Phone 522.7773 'Date 51'1012004 · , ,~,~,,~_. . ..... ~ ................ ~... ~ ' Conditional approval for bedrooms, witl~ the following stipulations: Additional Comments AttachmentS: HAA Checklist Septic System Advisory Well FIoWAdvisorY X Maintenance Agreements Supplemental Engin. eer's Report Other Original Certificate Date: (Rev. 12/00) MuniciPality of Anchorage D6vel0~ment Services Department ~.' '~ ';.: .B[~il~ling safety" Division :on-sit6 water & wastewater Program : 4700 South Bragaw St.: P.O. B'oX' 196650~ ;Anchorage, AK/99519-6650 · i~ ,' ~. www. ci.anchorage.ak, us ~ A. WELL DATA!::' " :, =~ ~ : '.' ~ Well type Private" ' iff A, B, or C prowde PWSiD # __ it: " "' .... "~"! : Date compl d 10127/2003_' ':: . Samtary seal !(Y/N) Y ~' Total depth ~:4~)~ 'ffl ~': : ~'Cased'~" to~ 38'.~' ff.' ;~ ': FROM WELL!LOG Dateoftest '~- : · '~i0127i~b0:J- i i~,~ ' Static water level 42 ~ ff. Well produbtion - : .... 1; ! ' ' g.p.m..; COliform 0:"[bl0rJiesJl0b~i.:' i !::~ i 'I,:i ! ' ': , Ni{ra{e'! ~34. mgJi. · ;' , . ! (9?7) 343-7904 ~' ' .i = HEALTH AUTHORITY APPROVAL,, ~ .... CHEC~KLIST ~ Legal DescriptiOn: Lot tl, BI6ck 6, Par~idise Valley Subdivision' '.;' ,F~r~ ID: :;- . .: Well Log(Y/N) Y ~ "'Wires prop~'rl~i p!Stected'(Y/N) Y ~, !, · ;:J:~" r, ~ I~ ' , ~ Casing height !above ground) 24 · AT INSPECTION g.p.m. in. bacteria 0. colonies/100 mi. Elapsed T md:' · min :,;, Final fluid depth '; in.: ,, ]: ,.',~Abs0rption rate >= Any rejuvenation tr~atment (past ~2 mo.) (y/N ;& type) ~ N .~ ::;i~;-::... ...~ Ilfyes, givedate ~ i. ;' :l : , ~ !:" ; ; I'l"'J : , ' :' , ~ ';:1 ' ' · ,· ':· , ;-'.' ! - i4 ~ . .¢ · , ;'! , i ,,; ' · : · . ; 'Z ; ,' .I ' , ,, , ~ .: . .. ;, ,. : , ~ ii. LIFT STATION Date installed "Pump on" level at Datum Size in gallons Manl~ole/Access (Y/N) in. 'pump off" level at in. High water alarm level at -" in. Cycles tested Meets alarm & circuit req uirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT'TO: Septic tank/lift station on lot Absorption field on lot, >100' >100' On adjacent lots >100' On adjacent lots >100' Public sewer main N/A Sewer/septic Service line >25' Public sewer manhole/cleanout Holding tank NIA N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 'F. Building foundation >5' Property line >5' Water main NIA Water service line >10' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PropertY line >10' Building foundation >10' Water Sewice line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' COMMENTS Absorption field >5' Surface water >100' Water main >10' Driveway, parking/vehicle storage >25' ,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 51t3/200-4 ..... 'HMFee $ q~0- .Date ~f Payr~ent''' ~'j J'~ Jo~ 'Receipt Number ~1 ~:~ (Rev. 12/00) i :~ ' . 'Waiver Fee $ Date of Payment Receipt Number May.18. 2004~7:49AM 9075226779 =~o~N~:§J~3, P. 2/3~ 2, ~ $G$ Ret.# Client Name l'roJ~ct h'amU~ Client Sample ID Mntrix 10424260O1 Anderson Engineeriag Lt 1 l,Block 6, Paradise Valley Ltl 1,BloCk 6) Paradise Valley Drinking Water Sm.,:ple Remarks: All Dates/Tim~ are Alask~ Stnndnrd Time Prln~d DntedT~me ' 05/14/2004 17;09 Col~/~ ~t~me 05/10~0~ 21:00 ~eived Dat~ime O~/l l~ Pm~met et Re~L~ I~L Unite Method Contn~n~r ~D L~m~ts Da~e Da~ Xnit Nitra~c-N 2.45 0.100 mg/L EPA 300.O B (<=1 O') 051]]/1:),I J,TB To~l Coliform 1 OB, No Coil coVl00rnL SM18 9222B A (~"I) 05~11/04 DKC 05:22 ~M P.01 W.~,TERWELL - TEST PUMP REPORT Owner: i i ' / Address: _ Casing Size: L! r/--- Screen Diam: -'-----' Screen Slol: Pump Information St~tte Water Level:: ~/_ Ay. D~Sdha~e: -~ GPM, Max Drawdwn: Pump On Time Water Flow Remarl;q Level : GPM