Loading...
HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 1 LT 12Glenn View Estates North Biock 1 Lot 12 #051-821-25 Municipality of Anchorage • • • ,•,1 Development Services Department =;'._:_ Building Safety Division =_ •; On-Site Water & Wastewater Program, 4700 South Bragaw St. `' :` __-= �_ 5i P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW030289 PID Number 051-821-25 r i 7 of 3 Name: JOHN THOMSON Wastewater System: ■ New • Upgrade Address: NORTHWOODS CIRCLE * CHUGIAK, AK * 99577 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 240-2020 3 ■ Deep Trench. D Shallow Trench D Bed DMound DOther LEGAL DESCRIPTION soli Rating: 0.6 GPD/Sq. Total Depth from original grade: 4 (MAX) FL Block: Lot: Subdivision: 1 12 GLENVIEW NORTH Depth to pipe bottom from original grade: 2.0(MAX) Ft. Craves depth beneath pipe: 2.0+ FL Township:Range: Section: — — — Fal added above original grade: SEE DWG. FL Grovel length: 2©53' (106 TOTAL) rt. WELL: • New • Upgrade Crawl width: 5.0 FL Number of lines: 2 Distance between lines: 15 FL Classification (Private. A.134 C P�757+ Cased To: Total absorption area: sic. Ft. Pipe material: D 3034/ F-810 Driller. s \\ P V Dots Drilled: Static Water Level: Installer. DAN GREEN Dat. tnetat 8/13-15/2003 Yield: GPM Pump Set At: FL Casing Height Above Ground: FL TANK SEPARATION DISTANCES ■Septic DHolding 0S.T.E.P. DOther To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Linn Manufacturer. ANCHORAGE TANK Capacity In gallons: 1000 Well 200'+ 200'+ — — 25'+ Material: Number Number of compartments: 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Size in gallons: Manufacturer. Foundation 5'+ 10'+ — — — "Pump on level at 'Pump off , at: High water alarm at Curtain Drain Pump Make • •d: Electrical Inspection performed by: NONE KN0W'1 Remarks: , BENCH MARK Unction and Description: BOTTOM OF TANK Assumed Ekevation: 9•.70 n• U,_ `i_'l, ENGINEER'SS o 4.. ... • • • • , • r—.....eff °a: ,�� f ��4p° •L � �al' �04 ' . Garne.s. 79 pr. fessio�°oma O‘..OoOa S�40 0 . * VA vA J �voO _ AKWWC, INC. 8/13/2003 Inspections performed by: Dates: 1 stp• 2nd 8/14/2003 3rd 8/15/2003 Development Seri es Department Approval Reviewed and approved by: Date. o 2 3 (Rev. 12/01) U\i PERMIT NUMBER: SW030289 AS -BUILT DRAWING PARCEL ID NUMBER: 051-821-25 GENERAL LOCATION OF WATER LINE KEYBOX MT4 ALTERNATE SITE WILL REQUIRE THE USE OF AN ADVANTEX SYSTEM -J NEW 3 BEDROOM HOUSE 10' UTILITY EASEMENT ALASKA WATER & WASTEWATER CONSULTANTS, INC. 3701 E. TUDOR ROAD. SUITE 101 •• ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX PREPARED FOR: JOHN THOMSON LEGAL DESCRIPTION: (907)338-3246 PHONE NUMBER: (907) 240-2020 GLENVIEW NORTH SUBDIVISION; LOT 12, BLOCK 1 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE DATE: 9/2/2003 DRAWN BY: A.J.G. SCALE: 1" = 40' PAGE NUMBER: 2 OF 3 A B C ST1 38.95' 12.38' - ST2 44.65' 10.92' - DBL1 46.83' 11.34' - DBL2 48.00' 11.66' - FS - 29.73' 30.54' C01 - 13.36' 46.61' MT1 - 17.80' 37.84' CO2 - 53.44' 16.44' MT2 - . 45.71' 16.57' CO3 - 28.21' 52.77' MT3 - 31.27' 46.88' C04 - 58.60' 29.94' MT4 - 51.22' 29.95' PERMIT NUMBER: SW030289 AS—BUILT DRAWING PARCEL ID NUMBER: 051-821-25 ST1 TOP OF TANK AT INLET = 97.47 INVERT OF BUNG AT INLET - 96.90 FINAL GRADE - 99.50+ TOP OF TANK AT OUTLET = 97.43 pomimiWlj�ll%!/J///IJ/IJ/IJJf/I/-% NEW 1000 GALLON SEPTIC TANK 4' INSULATION INVERT OF BUNG AT OUTLET = 96.65 TH#1 FILTER FABRIC INSULATION FINAL GRADE - 98.32+ FILTER FABRIC INSULATION ORIGINAL GRADE = 97.33-97 FINAL GRADE _ 98.30 ORIGINAL GRADE = 97.94-97.44 TH -� RELATIVE ELEVATION OF BOTTOM OF TEST HOLE =84.33 (TEST HOLE DRY) INVERT OF PIPE 95.97 (AVG) 5'-1 BOTTOM OF TRENCH = 93.83 (AVG) INVERT OF PIPE = 95.95 (AVG) BOTTOM OF TRENCH = 93.94 (AVG) RELATIVE ELEVATION OF BOTTOM OF TEST HOLE =84.44 (TEST HOLE DRY) ALASKA WATER & WASTEWATER M - .--•-.r r•^.-^• CONSULTANTS, INC.=�,�_^- N.�'•.^ .5;.. e..T.:;;uF' AcA:..:+.: TE 0. • A7.0 hCR, 0E. AK 99507 • PHONE (9C7)357-6179 • FAX (907)338-3246 DATE: 9/2/2003 DRAWN BY: A.J.G. SCALE: N.T.S. PREPARED FOR: JOHN THOMSON PHONE NUMBER: (907) 240-2020 PAGE NUMBER: 3 OF 3 LEGAL DESCRIPTION GLENVIEW NORTH SUBDIVISION; LOT 12, BLOCK 1 TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE o . 4 ip• .yOO D f y A. G rn ss. 795. o`p� 1c°v4 Dea �D\ ��o �ofess0 a" MUNICIPALITY OF ANCHORAGE Development Services 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 PERMIT Initial Permit Number: SW030289 Legal Description: iGlenn. View Estates _North'Block-'1 Lot 127 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: John Thomson Owner Address: 17343 Santa Maria Drive Eagle River , AK 99577- �1 31Q� c Z Kos —1 (DI- Date DY Date Issued: Aug 04, 2003 Expiration Date: Aug 03, 2004 Parcel ID: 051-821-25 Site Address: Unknown Lot Size: 40414 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ 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 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: Issued By: vA4/p rdyie Date* 54' LI ' Date: /4/03 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number 5 (,vO39Z8? Property owner(s) JOHN THOMSON Day phone 240-2020 Mailing address (1) 17343 SANTA MARIA DRIVE * EAGLE RIVER. AK Maung a�ddress (2) Zip Code 99577 GLENN VIEW EST# TES NORTH 5-u.81). Legal description (Lot, Block & Sub'd.) LOT 12 BLOCK 1 Legal description (Section, Township & Range) N/A LK) Lot Size " 4 1 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ■ Well Only Sewer and Well ❑ Water Storage Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi Swimming Pool ❑ 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. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees: 400 !1 Date of Payment: 1 2j' 03 Date of Payment: Receipt Number: D 1 1111 C Receipt Number: Waiver Fees; ALASKA. WATER & WASTEWATER July 24, 2003 CONSULTANTS, INC. „" 2"ell Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Lot 12, Block 1; Glenview North Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a community water system and a private septic system. A test hole was dug on the property by Toben Spurkland P.E.. The drainfield will be designed around the 30 foot radius of this test hole. We are proposing that a 1000 gallon septic tank and dual 5 -wide type drainfields be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.6 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 20 minutes/inch b. Proposed Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 750 ft2 f. Total Depth: 4 feet (max.) g. Effective Depth: 2 h. Width: 5 feet i. Reduction Factor: 0.70 j. Minimum Length: 2 @ 53 feet long each (106 feet total length) k Effective absorption area = 757 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The area for the proposed drainfields is a 5-10 percent slope running approximately south/southeast to north/northwest. In short, there are no slope concerns. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you h.ve any questions, please contact us at 337-6179. Thank you for your assistance. NOTE: A site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ALTERNATE SITE TOBEN SPURKLAND TEST HOLE PROPOSED SEPTIC SYSTEM (SEE DESIGN PAGE 2 OF 2) PROPOSED 3 BEDROOM HOUSE NOTE: ALL PROPERTIES SHOWN ARE SERVED BY A COMMUNITY WATER SYSTEM. ALASKA WATER & WASTEWATER -�- CONSULTANTS, INC. 6901 DEBARR ROAD. SUITE 28 • ANCHORAGE. AK 99504 • PHONE (907)337-6179 • FAX (907)338-3246 PREPARED FOR PHONE NUMBER: JOHN THOMSON 240-2020 DATE 7/24/2003 DRAWN BY: C.J.G. SCALE 1" = 100' PAGE NUMBER: 1 OF 2 LEGAL DESCRIPTION: LOT 12, BLOCK 1; GLENVIEW. NORTH SUBDIVISION TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM �� •{/ f ey ; 1 Ss.• 1;0 3, II�, \ICE ( 7953 ,•'��' 0 �4h@'e •••......•••• (A.. 1,t�.ad Pro f e ss10�0� r� ALTERNATE SITE WILL REQUIRE THE USED OF AN ADVANTEX SYSTEM TOBEN SPURKLAND TEST HOLE INSTALL FLOW SPLITTER r— APPROXIMATE LOCATION OF PROPOSED WATER UNE APPROXIMATE LOCATION OF KEYBOX — PROPOSED 3 BEDROOM HOUSE 10' UTILM' EASEMENT PROPOSED DRAINFIELDS. EXCAVATE TWO TRENCHES THAT ARE 4 FEET DEEP MAXIMUM BY 5 FEET WIDE BY 53 FEET LONG EACH (106 FEET LONG TOTAL ADD 2 FEET OF CLEAN, WASHED SEWER DRAINROCK. INSTALL DOUBLE CLEANOUTS PROPOSED 1000 GALLON SEPTIC TANK INSTALL FOUNDATION CLEANOUT ALASKA WATER & WASTEWATER CONSULTANTS, INC. 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)338-3266 DATE 7/24/2003 DRAWN BY: C.J.G. SCALE: 1" = 40' PREPARED FOR: JOHN THOMSON PHONE NUMBER: 240-2020 PAGE NUMBER: 2 OF 2 LEGAL DESCRIPTION: GLENNVIEW NORTH SUBDIVISION; LOT 12, BLOCK 1, TYPE OF WORK: DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM ..7V000 0 me ' ' 953 ..`0 ' • 01 •. r •••••' �pAoO rP�o . ssion000 Performed Fcr: Leal Description: 3- 6- 7- 8- 9- 10- 11- 12- 13 14- 15- 16- 17- 18- 19- 20- Depth Municipality ofAnchorage 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.cLanchoracte.ak.us (907) 343-7904 Soils Log - Percolation Test s J� CLEW V 11=W ND Ei>-4 LoT 1.21 3%-1 (Feet) //\.•G, O1 ANICS Satel.t S; 1 -u ML oLy r Sa ct.-//S1-i- w-ko c y s ML ll 1 E- A'R.D CO?/:LENTS ' 0-rro M o 5 Hot_C • Slope • Date Performed: Township: Range. Section: WAS GROUND WATER ENCOUNTERED? N t� S IF YES. AT WHAT DEPTH? 1. Depth to Water After Monitoring? (,lam E Date: liagiD 44/Zoog tl:o, d 8 s1( Site Plan Reading Date Gross Tinel Net Time Depth to Water Net Droo F. ILL. 1^'-R1=s K 1-1'2v4 1Ile(o2. 12.: A6 .- 5b _ 1'0'.5 �.l en / '-] 342 57,9, Li 3/'>< I J Lis 1-i o 70 z o L1 % 2 ' ,.5 40 6 3/t 4, /� 0 .20 S:o5 Ho PERCOLATION RATE 2 0 (minetesenct+) PERC HOLE DIAMETER TEST RUN BETWEEN .3 FT AND t4 FT 6" PERFORMED BY: % , s 1 S CERTIFY THAT THIS TET AS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. ./WAS2-Z10 Z_ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL • FOR A SINGLE FAMILY DWELLING Parcel I.D. DSI- g2'1''e2� COSA # Expiration Date: q/1/4 7 Complete legal description Henn nn V1 Pu)j-1A.4n N. 1...1 a R I Location (site address) at.5 I NUY-1-kainnd C.1 If C li _ Current Property owner(s) C 1) Y 4-i S `r SGmlD4hMt WI P P KC Day phone OARS I NOrPnwoad c C (v r1 Q� f ac t r i2iv4 - A-!~ 99577 Day phone 1. GENERAL INFORMATION Mailing address Lending agency Mailing address Real Estate Agent Mailing Address SU S QY1 Pel(' KI'ynn Y1 Day phone al -i0 -103 RS 1 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY:. Individual Well Individual Water Storage Community Class Well Public Water System0 0.0 TYPE OF WASTEWATER DISPOSAL: 0 0 Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 'On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal end/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be'reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public Water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm Address Eagle River Engineering Services IC 21 VFW Md., Suite 201 Fagla Rivet Ake pc577 Engineer's Printed Name C tt/&tsrvPtf612 Q. L/or,tj 5.\DSD/SIGNATURE V Approved for 3 bedrooms. Disapproved. Conditional approval for By: Phone (aG4 - 4j 95 Date 7/2010 6 bedrooms, with the following stipulations: Additional Comments k‘.t .0 CIF Atielke Af ON-SITE ••• cR,'s ' vo TEWATER FROG�M : �?`_: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. t1A5) Worya.. .1 40Aiej Set\ ON Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: 97/1/06 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ALE.AV VITO ESTATr'S OM* Lt2 ? / Parcel ID: A. WELL DATA Well type Neat If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected Total depth ft. Cased to ft. Casing height Date of test Static water level Well production FROM WELL LOG WATER SAMPLE RESU Coliform ..Ionies/100mL Nitrate mg/L mg/I Date of sample: _ Collected by: B. SEPTICIMCtDING TANK DATA Tank Type/Material ANGifTAA/K/treed_ g.p.m. AT INS ECTION ALV ground) in. ft. g.p.m. Other bacteria colonie 100 mL Date installed 4/f 4/'3/7,o3 Tank size Iieeo gal. Number of Compartments 2- CleanoutsaN) Ye 5 Foundation cleanoutef N) YI'S Depression over tank (Y© A/O High water alarm (Y/© A/01 Date of pumping 15 /0 9 /IC Pumper T R (5 C. ABSORPTION FIELD DMA Date installed $i/51/4 3 Soil rating (g.p.d./ft2 or.&Ibdvm) O.6 System type SIM L.Loa TQ tat /9 Length 10 6 ft. Width S ft. Gravel below pipe Z ft. Monitoring tube S Depression over field " A/O Total deptht5=3ft. Eff. absorption area1757ft2 Date of adequacy lest 7/03A/6 Result Fail) P.55 For 3 bedrooms Fluid depth in absorption field before test L C in. Water added$l0 gal. New depth 4.S i in. Elapsed Time: ''/ Zemin. Final fluid depth R Sin. Absorption rate >= NSSO g.p.d. DV If yes, give date NM - Any rejuvenation treatment (past 12 mo.) (Y/& type) D. LIFT STATION Date installed Size in gallons ManholelAcce "Pump on" level at _ in. 'Pump off I7jIe Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Iif etatien on lot On adjacent lots Absorption field on lot On adjacent Public sewer main cc t HHig• h water alarm level at Meets alarm & circuit requirements? Sewer /septic service line in. PubtICsewer manhole/cleanout Holding tank Animal • - - areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/Het-DING TANK ON LOT TO: Building foundation 1 S / , Property line 15 Water main Water service line fi / 0 Wells on adjacent lots -Firm r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line + (0 r Building foundation + /0 Water Service line 110 r Surface water + /00 r Curtain drain 4 SO F. COMMENTS 7f A/ONE ,KNOWAJ G. ENGINEER'S CERTIFICATION Wells on adjacent lots t /CO r I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name G filth S/C046R R, Wath Date 7/70/0 6 COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) 430 S 5 an'1 Absorption field + S Surface water # /oc) r I Water main 4 /t9 Driveway, parking/vehicle storage 'f /O r Waiver Fee $ Date of Payment Receipt Number 08/15/2006 07:54 9073449821 JRS SEPTIC JRs Pumping PO Box 773415 Eagle River, AK 99577 (907)694.6451 IDillinp Information Eagle River Engineering At Description: 1000g 10421 VFW Rd Ste #201 P.O. Number Terme: Net 30 sdeerep: Karlia Map Book: Cross Str..ts. Oberg Road Eagle River, AK 99577 (907) 694-5195 Job Site Information Stephanie 23351 Northwoods Drive Chuglak, AK 99567 (907) 694-5195 Job Comments PAGE 01 Service Agreement Number: 020645 Order Date: 31 -Jul -2006 Service Date: 04 -Aug -2006 12:0 Technlclan: Tony Tot %; 0 Job Type, Repeat Map Grld: 155. . Last Sery Unknown Pump Tank Only pump tank -all ok levels normal Additional Location Comments as7ratt' S \Dlaar gyar045 bmo Ws on Home - gray w/white trim 7w Septic © East Side of home Service Type Septic Service 15K a >ink Qty Price Each 1 $135.00 Tax? No Gallons Planned: 1000 Gal. Actual: _ Hose Length: Double Tank: ❑ Pump System: 0 Baffles Inlet. 0 Baffles Outlet: 0 Extension $135.00 Actual NonTutI. Total Estimated Chirps: 513500 Actual Chagas! Taxable Total 5000 Tax Total 50.00 Grand Total 3135 00 Customer press b the tar and conditions shown. THIS ISA BINDING AGREEMENT. Signature and Ties or Customer Representative Dat. Accepted by JRa Pumping Date Accepted For your added convenience we accept, American Express, Dlcover, Vlsa and Master Card payments over the phone. After 30 Days accounts wil be turned as b eolecdons. 525.00 For NSF Checks Ratund. eacor ASBUILT doe: ":t•t(rW I HEREBY CERTIFY -THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY'• • AND THAT NO ENCROACHMENTS EXISY EXCEPT AS INDICATED. .IT IS THE RESPONSIBILITY OF THE MWNER IV DETERMINE THE EXISTENCE QF AMY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT: UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON SE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING DOUND- ARY LINES. • SEWARD & ASSOCIATES LAND SURVEYING 694-082 SCALE' /sera?� DATE!/B/y GRID ,vwrr6o Fel DRAWN, 40 f � t of• '•A[`�i dor.„. &t'` ••••• •sr CI lei Dawn ASA S• -•M u-6918 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.clanchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-821-25 1. GENERAL INFORMATION HAA# OLf-fl 2 %'T Expiration Date: GLENN vr'E5Tel ^rE ' Complete legal description NORTH SUBDIVISION; LOT 12, BLOCK 1 Location (site address or directions) NHN NORTHWOODS CIRCLE Current Property owner(s) JOHN THOMSON Day phone 240-2020 Mailing address 17343 SANTA MARIA DRIVE * EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address 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 ❑ Individual On-site II Individual Water Storage 0 Individual Holding tank 0 Community Class Well 0 Community On-site 0 Public Water System 1 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulaffons. 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. GEG, Ltd. 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. Phone 337-6179 Date S/344-. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Bv: (Rev. 12/01) ``tctto((tOFr�C ••...... yon, : ON-SITE •, m WATER AND WASTEWATERROCRi�M.:..: ▪ •▪ •P J7ji111)))110 Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: 1p-��-off Municipality of Anchorage Development Services Department Building Safety Division On -Site Water &Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST GL -E -444 -EW- NORTH SUBDIVISION; LOT 12, BLOCK 1 Parcel ID: 051-821-25 I t N 'theta s'THT rf I. Legal Description: A. WELL DATA 11 Well type PUBLIC k Date completed Total depth 1 I t If A, B, or C provide PWSID# N/A Date of test Static Water level I I I'r Well production I' WATER SAMPLE RE S: � Isla. Sanitary seal (Y/N)_ Cased to ft. FROM WELL LOG gpm Coliform '' colonies/100 ml. Nitrate mg./L. enic: mg./L. B. SEPTIC/HOLDING TANK DATA I TanktTYpe/Material Tank size - 1000 gal. Foundation cleanout (Y/N) Date of pumping C. ABSORPTION FIELD DATA 11 Date:in stalled 8/15/2003 Well Log (Y/N) Wires properly protecte• ' N) Casing hei• - • in NSPECTION ove ground) ft gpm. Other bacteria colonies/100 ml. Date of sample: Collected by: STEEL Number of Compartments 2 YES Depression over tank (Y/N) NO :NEW Pumper Len hI�106 g (2053) ft Total depth 4.36+ Date Fluid I! Elapsed Time: min. ' F. Date installed II I, YES High water alarm (Y/N) 8/15/2003 N/A *BELOW FINAL GRADE Soil rating .p.d./ r ft2/bdrm) 0.6 Width i 5 ft. ; Eff. absorption area 757+ 'ft' of:adequacy test Ii depth in absorption field before test NEW 1 I l' tl System type SHALLOW TRENCH Gravel below pipe 2.0+ ft. Monitoring tube YES,' Depression over field NO Results (Pass/Fail) PASS edrooms New depth in g.p.d. A depth on treatment (past 12 mo.) (Y/N & type) in D. LIFT STATION Date installed Size in gallons Manhole/Ac "Pump on" level at in. "Pump off' in. High water alarm level at Datu Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lotPU8`IC A-fER 0 Public sewer main On adjacent Tots Sew in ots Public sewer manhole/cleanout service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT. TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent Tots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:. Property line 10'+ Building foundation 101+ Water main 10'+ Water service line Curtain drain F. COMMENTS 101+ . Surface water 100'+ Driveway, parking/vehicle storage 10'+ NONE KNOWN Wells on adjacent Tots 200'+ G. ENGINEER'S CERTIFICATION 1 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 JEFFREY A. ,GARNESS Date 543/0¢ J/ Aoo i� -fry�•rness: 0 9s E-7.53 . ••• Z. ti vQedp�ofess�o�.c� 000� HAA Fee$ Date of Payment & i (11 01 Receipt Number 3327' (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-O82 C I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE: U, ..DATE: 34 8/ ' GRID: ,vw/.5-6o FB: /O/- DRAWN: OF, AL %14 49J • �. r• w � -. . . Duane Mark Seward• �� •• LS - 6918 •. .,,a' `