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HomeMy WebLinkAboutDONAHO HOMESTEAD #1 BLK 2 LT 3ADonaho Homestead Block 2 Lot 3A #050- 211 -82 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211470 PID Number: 050-211-82 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name CHRISTOPHER MILLER rE01 ORPTION FIELD Site Address De Trench ❑Wide Trench ❑Bed ound 10411 HIGH BLUFF DRIVE, EAGLE RIVER, AK 99507 Other Phone Number of Bedrooms Soil Rating Total depth fr original grade 850-890-9294 4 /SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origi EXISTING Jel depth beneath pipe 'Subdivision Block Lot DONAHO HOMESTEAD #1 2 3A Ft. Fill added above original gr JGnh Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Dist a between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Tank Field Holding Sewer TTank Line F zotal orption area Number of trenches Dist. between t ches From -- - - - Well Surface Water 100'+ EXIST. - - Lot Line 5'+ EXIST. - - Nf Foundation 10'+ EXIST. - I - Remarks PR(IPGRTV CGC2\/Cn RV AMIA11 i 1ArA--moo L TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER TANK 1250 Material Number of compartments HDPE PLASTIC 2 L TION Manufacturer Capacity Alarm location ' IElectn ailed by PIPE MATERIAL House to tank D3034 Tankto Installer D3034 DEAN CONSTRUCTION Draintield EXIST. CO/MT D3034 Inspector GEG CONSULTANT, JODY MAUS BENCH MARK (Assumed elevation) 100.00 ft Inspdection r 2/2/2022 2 - Location and description nd 3`d - 4"' _ TOP OF MANHOLE LID (MH1) ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF,q�°pop . conditional Approval: Date oo 95,4 - Q ��.... !C . .................. n Septic System — UO effrey�gness• Approv Date Z QQ4 s CE 795391 Note: this approval does not include well permit requirements.#aecc 4�O�0000�\Lo (Rev 05/02/18) IPERMIT NUMBER:RECORD D RAVE I a , A PARCEL INUMBER: OS P211470 7I,i�1 fV= 050-2111 -82 I C� APPROXIMATE END OF DRAINFIELD PER ALASKA SEWER 8 DRAIN LOCATE (CONTRACTED BY DEAN CONSTRUCTION) INSTALLED DOUBLE CLEANOUTS (DBL1 & DBI -2) EXISTING 4BEDROOM HOUSE ,--NEW 1250 GALLON HDPE GREER TANK EXISTING FOUNDATION CLEANOUT A B MH 14.4 43.2 ST1 18.4 42.4 DBL1 19.8 42.3 DBL2 20.942.5 C01 1 27.1 1 47.2 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. KEY BOX CITATION ROAD �:..r.�_s......�-.'!1"a.^ ,est_.z.,...._......�._._..�_.,v.��._.. �_..,x._. .. AV •• 1 ♦# • GA IH SS GIDE I G IJ , Ltd. n*`• ..... •�'�'' ::..... =jam ENGINEERING SALES CONSULTING nE • / 10 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, ALASKA' PHONE (907) 337.6179' WEBSITE: www.gamessengineedng.wm . .. / .e(,....n............ PREPARED FOR: 0 70 PHONE NUMBER: PAGE NUMBER: I J. ffrey Aamess c �u CHRISTOPHER MILLER 850-890-9294 2 OF 3 ���'iJ, : C 7953 °•_� PROJECT/LEGAL DESCRIPTION: DRAWN BY: ? DONAHO HOMESTEAD #1; BLOCK 2, LOT 3A J.L.M. �� �........ ,..!•..••' TYPE OF WORK: DATE: LICENSE 44 4 RdFESS1 ���� RECORD DRAWING FOR TANK UPGRADE 2/14/2022 # LICENSE 4 lk�%,,Z� PERMIT NUMBER: RECORD DRAWING V Y I N G PARCEL INUMBER: OSP211470 050-2111 -82 FINAL GRADE T................. _ — nn a,) nn �o iOe GROUP,kNA (o ,� �c.. ...... o ..........a� a.1j ...... �,.... {r ENGINEERING .�:SALES .,CONSULTING 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, ALASKA' PHONE (907) 337.6179' WEBSITE. w�.gamessengineenng.eom �•.a� a„ r .................... . !K 0 ....... y...e PREPARED FOR: PHONE NUMBER: PAGE NUMBER: / i. 7 Jeffrey . arness 4l CHRISTOPHER MILLER 850-890-9294 3 OF 3 ®0 CE -7953 '® ♦ L'x •'•. PROJECT&EGAL DESCRIPTION: DRAWN BY: ®® �.� , �4 ��. (�,L .� �V DONAHO HOMESTEAD #1; BLOCK 2, LOT 3A J.L.M. ®® Fp=ppp'����•U•,,,....Klk�� 'PE OF WORK: DATE: LIENSE �� %i fERECORD DRAWING FOR TANK UPGRADE 2/10/2022 LIEENSE oTAa� Ln Ln Z N N O N � Ln N u1 00 O M � a tD n e-1 Z 41 v cu i O 0 a J � V1 N m L cu ;Ij L O -0 L li O N J O M II m u Ln l O + 1 66•EL4 M.A4,90o00N x x ZL'\ZS6 3 E0,90a00S -- 3AILfO -q-41 78 HJIH 3 -- �O O M to LO 6 coZ I I I I o CD @ U N L w Q > O U E +� o v (D CLa)O c 0C'n 0 a) a N i CC w a N = O > c c O w@ 3 ' Q)ca0o.ai a) (/) Cc: O 3 m = a,z r •O = N c O m ai n 0 O n L O N Co c c F_ .2 O Q (N.... r R Q U N O N N coc—cm @ O [0 .c y N N 00 c N U a ,� pp p c -i C w > L cp N U) Z > c a) t CL o E o 2 0 is O w c E' 2iY E vFu � 0 E�� 0 p io 0 N O) O OO (O0 .ow.. U O 13 N a>) O d �aLy l ' s o m y CL J~ C@ O 4T C L i �Za> O c°' O_ N w 0 d wc U U w 0 U o c «� S 0 N v Z =@1 HI �JJ/ m� �0��9 O� j H �paTi ai �� 0a) wmaci A V n N �S� J maxi Q= m(DE v O v i> C p o o a) 76 c v i m •� �_ to = 00 N LO cu T O w"O y y L 00 a -i C > a m N w •qj O w = Q N >- V1 D O ip 'C m a Z 0 N v w CnID v LO x = o +-+ v vu on m�O v o iv . HO Lon Qo 3 3 LL G iT w N r c :c CL o x �r N O O c yew, o Ou nma�a _���7 X11 b 11 O Y u aj 2 w Q- . 6/ w 0@ V1 O U O Owl Y > I ` •00 N N •. Q I Q CL 42 uj G Y N w LO 2.0 // \� Q� it oma=24 r16 �O O w l7 in ° n 8 E a 1� G\ C WQa O co co N �0 + ? 2 m o0 Q) co a O 0) � � -.U�.. 6e o. J = No 0 '9 C _ N cu k LQ �' V to �R Ng' 56.8 e (ty (�"'j Fi l s N O. 0 s. s o� CO � x � O� I x u I :. .. ? x12.3 Q. w v c .. p w. a � y'8 x h • x x ZL'\ZS6 3 E0,90a00S -- 3AILfO -q-41 78 HJIH 3 -- �O O M to LO 6 coZ I I I I o CD @ U N L w Q > O U E +� o v (D CLa)O c 0C'n 0 a) a N i CC w a N = O > c c O w@ 3 ' Q)ca0o.ai a) (/) Cc: O 3 m = a,z r •O = N c O m ai n 0 O n L O N Co c c F_ .2 O Q (N.... r R Q U N O N N coc—cm @ O [0 .c y N N 00 c N U a ,� pp p c -i C w > L cp N U) Z > c a) t CL o E o 2 0 is O w c E' 2iY E vFu � 0 E�� 0 p io 0 N O) O OO (O0 .ow.. U O 13 N a>) O d �aLy l ' s o m y CL J~ C@ O 4T C L i �Za> O c°' O_ N w 0 d wc U U w 0 U o c «� S 0 N v Z =@1 HI �JJ/ m� �0��9 O� j H �paTi ai �� 0a) wmaci A V n N �S� J maxi Q= m(DE v O v i> C p o o a) 76 c v i m •� �_ to = 00 N LO cu T O w"O y y L 00 a -i C > a m N w •qj O w = Q N >- V1 D O ip 'C m a Z 0 N v w CnID v LO x = o +-+ v vu on m�O v o iv . HO Lon Qo 3 3 LL G iT w N r c :c CL o x �r N O O c yew, o Ou nma�a _���7 X11 b 11 O Y u aj 2 w Q- . 6/ w 0@ V1 O U O Owl Y > I ` •00 N N •. Q I Q CL 42 uj G Y N w LO 2.0 // \� Q� it oma=24 r16 �O O w l7 in ° n 8 E a 1� G\ C WQa %in -Site Wastewater Disposal System Permil Permit Number.- OSP211470 Effective Date.- 11/12/2021 Work Type.- SepticTank Upgrade Expiration Date.- 11/12/2022 Tax Code Number: 05021182000 Site Legal Address: DONAHO HOMESTEAD #1 BLK 2 LT 3A G:0055 Site Mailing Address.* 10411 HIGH BLUFF DR, Eagle River Owner., MILLER CHRISTOPHER C & Lot Size in Sq Ft*o 25941 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms.- 4 This permit is for the construction 11 Disposal Field 2 Septic Tank 11 Holding Tank 0 Privy 11 Pri vate Well El Water Storage 0 -- Received Bly- fV4 AA Issued By: Date: t Date: 14P.2 I � yP' � � � � � r� � � U q�' A� J'^� Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - ; ax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-211-82 Property owner(s) CHRISTOPHER MILLER Day phone 850-890-9294 Mailing address 10411 HIGH BLUFF DRIVE *EAGLE RIVER, AK 99577 Site address 10411 HIGH BLUFF DRIVE *EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) DONAHO OMESTEAD #1; BLOCK 2, LOT 3A Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo_ADU) Septic Tank Upgrade Fx I (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ 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 Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 2 5- Waiver Fees: Date of Payment: to /,909-1 Date of Payment: Receipt Number: a n f G Receipt Number: Permit No. 05p2.1 I L170 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211470, Rebecca Carroll, 11/12/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211470, Rebecca Carroll, 11/12/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211470, Rebecca Carroll, 11/12/21 Scale 1" = 3D' E 1kE Frontier Surveys, LLC Project NO: 21-776 Date: 10/29/2021 Ordered By: Jim Standiford Plat: 83-552 Grid: NW55 LOT2 k X � EV SITED " 589° 53' 55"W DOG RUN x 158.54 Lot 3A, Block 2 Donaho Homestead Addn. No. 1 25,941 Sq. Ft. +/- T•;r — — x Gas Meter ® Deck aL Fence 10411 High Bluff drive Septic Concrete g,b x 2 Story Wood Frame House x With Attacher! 2 Car Garage ` x l fel x t1� •1' PAVED DRIVEWAY y�? t1 2.9 er ? j r � 6• 9 ly � e • v p, w w � I �o 44-7 a LOT3B 8 X60 35.0 $ ,,o a PAVED DRIVEWAY r, '0 1." N89°55' 5rW 130.61 mTm� mrmy rEDGE OF PAVEMENT - i CITATION ROAD -- - lO General Notes: 0 15 30 60 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting far gross negligence, the liability for this survey shall not exceed the cost of preparing this survey- Scale Irl �0@t 3. All measurements/setbacks are to the visuaVapparent building footprirnt- 4. All dimensions to property #n es are pluslmInus 0.1ft. This survey wmpfies wTh Y,�e ASf LS 1Aortgage Location Standards- TTie survey represents visible improvements and conditions at the time of the survey- This document does not constitute a boundary survey and is subject to any OF A4 1 I rrr Inaccuracies that a subsequent boundary survey may reveal. It Is the responsibility of the Owner to determine the W�� existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances - should this document be used far construction or for establishing a boundary or fence line. ; As -Built Sar'vey of: .Lot 3A, Block 2 Donaho Homestead Addn. No. 1 //S�1, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or 11► 10/2elx0 2 2 _ under my direct supervision on October 28th, 2021. f rt �!` Frontier Surveys, LLC FRONTIER. 4' ,■` 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 907.460.1686 - info@frontiersurveys.com A'17� PROFESSIONAL SEAL www.frontiersurveys.com y Electric Meter/outside Power(a Water Valve L.T_1 Tel. Pedestal Gas Meter ® Deck aL Fence D—a Culvert Septic Concrete ��sl Mailbox lO General Notes: 0 15 30 60 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting far gross negligence, the liability for this survey shall not exceed the cost of preparing this survey- Scale Irl �0@t 3. All measurements/setbacks are to the visuaVapparent building footprirnt- 4. All dimensions to property #n es are pluslmInus 0.1ft. This survey wmpfies wTh Y,�e ASf LS 1Aortgage Location Standards- TTie survey represents visible improvements and conditions at the time of the survey- This document does not constitute a boundary survey and is subject to any OF A4 1 I rrr Inaccuracies that a subsequent boundary survey may reveal. It Is the responsibility of the Owner to determine the W�� existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances - should this document be used far construction or for establishing a boundary or fence line. ; As -Built Sar'vey of: .Lot 3A, Block 2 Donaho Homestead Addn. No. 1 //S�1, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or 11► 10/2elx0 2 2 _ under my direct supervision on October 28th, 2021. f rt �!` Frontier Surveys, LLC FRONTIER. 4' ,■` 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 907.460.1686 - info@frontiersurveys.com A'17� PROFESSIONAL SEAL www.frontiersurveys.com MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT IpHONE ,~EW [] UPGRADE NAME MAILING ADDRESS ?,0, go z "7 4,1¢ z LEGAL DESCRIPTION LOCATION I I ~Well Absorption are~ 1~ I ~ ~ DISTANCE TO: ] ~O~~ )~ ~ ~ I ~ Z I Manufacturer a ,~ ~ ~,-~ DISTANCE TO: Well ~D elw Iling i~ 'Manufacturer I ~, ~ ~ I Well Foundation-~ .~ /~ ~ · I DISTANCE TO: I~~O'~ ~ ~ ~ ~]~ To of lietof, msh ~ ~ ~ '* ~ p t' ' ' grade~ /~ Materialbeneathtile Length Width . /] Depth  Typeofcrib I Cribdiameter ' ' Crib depth ~ DISTANCE TO Well /f Building foundation ~ Class~- ~e~h~ ~ . ~. ~ Driller " D~E T0 Building foundati~ Sewer line Dwe,,,ng 8 Materi.4~l,~ L~ W dth ~_ ~ NO. OF BEDROOMS No. of compartments Liquid depth PERMIT NO. Material Liquid capacity in gallons Nearest lot I~/~-- Trench wic~ ~_.) inches inches Distance between line./V/A TotalTf~s~ion area PERMIT NO. -- Total effective absorption area Nearest lot line Distance to tot line PERMIT NO. Absorption area(s) Septic tank OTHER PIPE MATERIALS SOILTESTRATING. ~/¢ ~/B~~r~.~ ) REMARKS 72-013 (Rev. ~3/78) DATE HUN I C: t PFlt.... I TY OF ~aNCHORFIGE DEF'FIF.:THE:NT OF HEFILTH FIND ENVIRONMENTFIL PROTECTION 6,¢25 L STF.'.EE:T., FINCHOF.'.FIGE., FIK 95'50± 264-47'20 F'EF.:I,'II T NO' [:,FITE 1. SSUE[:, · HF F L..1:....PINT FI E:, D F.: E :E; :5 · CEf. ITFIF. T PHONE · F.';'¢E:,NE'¢ I:1. ILtlJFFNREiLE F' 0 BOX 770±02 E FI G L E F.'. ]: ',,,' E F.:., R I'::: '_:"'Z: 5 77 !.-T,F.~ 4.- 9 7 4 ~F I....E:GFIL. E:,E'E, CR I P · L. OT S Z ZE · L..OT L.C' ' FIT 1.L~'l[',l ' MFIX B E .F.:,F.:O0 H:.:; · 'E, UBD 1. V I ::2;'I 01.4: I.':,ONFIFIO HOI.'IESTEFID ~..1 SE;CTION: 7 TOHNSHIP: :l. 4N 2594,:1. ,:.' SL.'.!. FT. OF.'. RCRE':.';.':, 4TH R',,,'ENUE FIN[:, FI I GHL..RND DR I ","E: LOT' -'.':FI F.:RNGE: ::1.1.4 L.. I S'I"E[:. BEI....OH FIF.:E THE OF'T t OI'..I:L:, FI',,,'FI I L. FlE:LE TO '~.'1.":11..I I N DE:.:."; I GI",I 11"46 'T'I])UF.: L--,EF'T T C :.F.','¢:.STEI"'I. CHC,.".)'.:.";E THE OF'T I ON THFIT E:E:2;-I' F I TS 'T' 3UF.' '.S, ITE. 'qF IF;..:: F,_zZ ~'..,li ,:Z::: Hi E-" Et. lC:, DEPTH 'ro P.T. PE BOTTOH ,:.'F'T. ::, 4. 0 4. C~ 4. GRFI',,,'EI.... DEPTH ,:.'FT..':, ±:.t.. 0 0. 5 .2:. TOTFIL DEF'TH r.:Ff'. ::' :1..5. 0 4. 5 7. GRFI',,,'EL. P.t l [::,TH ,:: FT..':, 2. 5 :'.".':1. 0 5. GRR',,,'EL.. L.E.I..~GTH (FT..) 77. 0 :+:* 62. ~"~ GRFI',,,'EL.. VOL. UI'IE ((]:l..j. "r'DS. ]:' 8.1. :.".-.~ 71. '1 .1~:4. TRNK ?Z., I ZE (GFlLS ::, % ;250. 0 :+::+: .1, 250. 0 SOIL. RFfT1.NG ,:::~;(;:!. F"T. ,.."BI:~:'..':, 4±9 2:t. 8 4t9 :+::+: .~F..I-,E:.I .... L. EI",tGTH ::::. 75 F'T. F.:EL:.!U1.RE:::; HJL}'TF'LE F. LN-:, ,::NOT E-LEEL IN~ 7.'=, FT. ERF:H::, :+:* TFINI.::: I',1 .':;T ~IH,E FIT L..EFI'Z;T THO CI3r,IF'IRF..:TI','IEENT:.:q :[ CEF..:T I F'h" 'THFIT · t. I Fti,'I F'FIH1.L..1.FII.T..: t.41.TH THE F.'.EQU1.F?.EHEN'T:~ FOR ON-'.E, ITE :~',E-'.P.IER$ FINE:, HELLS FlS E, ET .... HLFI.:,k.H. FORTH [::'"r' 't"HE h'tUNIIZ:1.PFiL. 1.T'T' 13F F"I~',IC:I-tO~.'.FII]E ,:.'l."ll"'lFt) Fl~',t[:, THE L~'I"FITE IqF - " ..... 2. 1. I.,~1.LL IN~TFtL. L. 'TIME :.::;"r:~'l':EH IN FIC:L':f"IF.:E:,FINL':F.':. HTTH FILL l.'lOFl F:O[i:,ES FiND RE'.3LI..FITTFIN$., FiND IN Cf"IHF'LiFINC:E HI.TH THE [:,E.:.E;IGN F:I:~'.ITEF.'.IFI ~'"~F 'l-f"11.~ 3:. 1. 'I.,.I1.LL FtDHERE "FO FILL I'lOFl FIND STFlTE 13F FILFI~;KFI F:'.EQUIF.'.EI,'IENTE, FI_-IR THE SET BFlCK D 1. STFII'.41ZES FROI"I FtNh.' E,:':, I :::,"1 T N..~ NELL, glFISTENFCF'EF.'. E, I'_:;F'O::SFII_ E,'¢:STEH OF.: F'UBL'f C: ::-..,EI.,~EF.:I'aGE E;'~::';TEM ON TH1.':S 01~: I::tN'¢ FID..TFIC:ENT OF.: NERF.'.E:'¢ I_OT. 4-. .T UNDEF..::!~;TI'-31'-,ID THFIT TH 1' '_--;, F. EF..111. T T L--., ',,,'FIL 1. D FOF.: R I"tFl::.:: T P1UI"I OF 4 BEE:,ROL31"tS RND I:1l'.,1'.¢ I::NLHF...:~[:.11EI'.,IT H .T L.L F.:EI:::.!U 1. F:E FII'.,t FIE:,E:, 1. TT ONFtL F'EF..:H 1. T. iF Fl L1.FT STFIT1.0N :IS Ti'.,iSTFILLEE:, IN FIN RF.'tEFI _-:.~',,,'EF.'ED B"r' HOFI E:UTLD1.NG F:OL":'E'=;., : [.. :,--P,l_l 1. I'TS THEN ,:: .1', FIN EL. EE:"FR I CFIL. F CF.[ 11. T FiNL':, F.I1'LL NOT BE'". I'FI f ."El FJ1'THOLfT FIN ELE3TF.'1'-FIL 1'1'.,ISF'ECT1.01"4 F.:EF'OF.:T.; FIND ,:'_3.", THE ELEC:TF.: 1' CFtL I.,.IOF.".K i"ll..IL:;,T BE DONE/B'¢ Fa L :[ CENSED ELEI..-.:TF.! I C 1' Fll",l. ~" MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] SOl LS~O~ 0 PERCOLATION TEST /9> 1 2 3 4 5 6 7 8 9 10 11 17 18 19 20 u J~ Y WA8 GROUND WATER ENCOUNTERED? SLOPE SITE PLAN / S IF YES, AT WHAT DEPTH? Gross Net f'41'11 Depth to Net Reading Date Time Time Water Drop /.; '.,,,~- ,.- 3 o 'Z Y~" ~'-~" )~OT~¢/~ Of: PERCOLATION RATE ~'~3 (minutes/inch) TEST RUN BETWEEN ~' FT AND L~ FT CERTIFIED BY: DATE: COMMENTS PERFORMED BY: 72-008 (6/79) GE QL • Municipality of Anchorage ° On -Site Water and Wastewater Program (907) 343-7904 s F F c T Y Certificate of On -Site Systems Approval Parcel I.D. 050-211-82 1. GENERAL INFORMATION: Expiration Date: /0 v Z3 z© z S Complete legal description DONAHO HOMESTEAD #1; BLOCK 2 LOT 3A Location (site address) 10411 HIGH BLUFF DRIVE *EAGLE RIVER AK 99577 Current Property owner(s) CHRISTOPHER MILLER Day phone 850-890-9294 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 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: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ .5-50 Waiver Fee $ _ Date of Payment 1,- Z<— Date of Payment Receipt Number _ 9_y Receipt Number COSA #1061 Waiver # 4 T1 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: Gamess Enqineednq Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Z f z3� i 2 - In In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and 0000O� industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ��,.• `� t encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), �• L1 C I �Q quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and �" "' ""' "' "'. ......... are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of Q. the well or septic system. GEG makes no representation whether an alternative well or septic system e A.*` _ s can be installed on the property in the event either of the current systems fail to perform adequately in �� L. "•1. C —7913 i OO the future. The content of this report is for the sole benefit of the person/party that retained GEG to ��,Sr • 2 Z 1—'. perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right 4e0 ���fessio�°o �O`10o�c #AECC884 6. QSP SIGNATURE L/ System #1 Approved for I bedrooms System #2 Approved for bedrooms \\`ll�lll((cffff/r�( Disapproved `�`\G\QPL�TY OF "'i'���� Conditional approval for bedrooms, with the folio stipuQf -TE Tz o WATER AND m = V� `ATER z J JJ0i0 �SPRVkGES.�`��� 1)))))1)11 i By: Original Certificate Date:�Z- 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 Nitrate. Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other _4 Legal Description: DONAHO HOMESTEAD #1; BLOCK 2, LOT 3A If more than 1 septic system on lot: COSA Checklist # of AWWU A. WELL DATA WATER ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above gr in. Date of flow r COS" level at beginning of test ft. Comments B. TANK DATA Age of tank(s) NEW years Tank type/material SEPTICMDPI Measured operating fluid level in septic tank NEW OR Standpipes/foundation cleanout per record drawing Date of pumping N/A D. ABSORPTION FIELD DATA Which system tested (date installed) 6/9/84 ❑ ALL standpipes present per record drawing Total measured depth from grade 14.5 ft (max) Measured depth to pipe invert from grade 9.75 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 5.66 Parcel ID: 050-211-82 Structure served by this system Well production at tim�test Water storage tank v Well disinf or coliform test? Yes ❑ No filiform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance com Age of l>mate ars Lift statiComme Adequacy test date 10128121 Results (✓ Pass For 4 bedrooms Fluid depth prior to test 36 in Water added 719 gal New depth 53 in Elapsed time 120 min ❑ Code -required soil cover over field Final fluid depth 45 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) N/A Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: SEE ATTACHED RECORD DRAWING OF THE APPROXIMATE DRAINFIELD LOCATION •C/O AND MT NOT REQUIRED ON WEST END OF DRAINFIELD, SEE ATTACHED EMAIL FROM MOA SYSTEM WAS NOT PRE-SOAKED BECAUSE IT WAS CONVEYED TO GEG THAT THE HOUSE HAD NOT BEEN VACANT FOR PREVIOUS 30 DAYS COSA Checklist yellow sheet E. SEPARATION DISTANCES IWWU WATER 1 From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' El Yes Community Sewer Manhole/Cie X00' If absorption field is under driveway comment below ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Priv er/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Yes Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > IAnimal Q Yes Containment > 50' ❑ Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Com ewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' [] Yes if No ft Surface Water > 100' [✓ Yes if No ft Property Line > 5' 21 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main ->-10'-- Q Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' Fl� Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' D Yes if No ft Wells on Adjacent tots: Water Main > 10' Q Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *DRAINFIELD WAS LOCATED DURING THE SEPTIC TANK INSTALLAITON AND FOUND TO RUN UNDER THE DRIVEWAY SEE ATTACHED EMAIL FROM THE HOMEOWNER REGARDING NO FREEZING ISSUES WITH THE DRAINFIELD G. ENGINEER'S CERTIFICATION�� C"��� l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with Q�p MOA COSA guidelines in effect on this date. , ; , q ; COSA Checklist yellow sheet effrey A. Ga ess: 9� '•, C 7953/ c8 Z3I L2./..00" �OQnpro f essio�°ate #AECC884 ft ft Frorn: Casey Miller caseco@be1!lsoLFtij.t_1et Subject: Re: Danaho Homestead #1; Block 2, Lot 3A - 10411 High Bluff Drive *Eagle River 99577 Date: Feb 11, 2022 at 1:27:52 PM To: David Garness David @garnessengineering.corn I have not had any freezing issues associated with the septic system at 10411 High Bluff Drive during my ownership. Christopher Miller 850-890-9294 Sent from my iPhone On Feb 11, 2022, at 11:39 AM, David Garness <David@garnessengineering.com> wrote: Christopher, Per the locate that was completed during the septic tank installation at 1.041-i_.Eligh 81u Driva *Eagle River, AK, the drainfield runs under the driveway. Mould you please respond to this email and confirm that you have not had any freezing issues associated with your septic system? Your response will be submitted to the MOA with the COSA application, thank you. Sincerely, David Garness, P.E., M.S. Civil Engineer Garness Engineering Group, Ltd. 3701 E._Tudor Road, 10.1 Anchorage, Alaaka,_99507 Phone: .(907) 337-6179 Mobile: .(907) 632-4528 Website: www.garnessengineering.com GARNESS ENGINEERING GROUP, Ltd ENGINEERING -SALES = CONSULTING ==+^ = =M Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore 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. - ~--- MbT ON Location (site'addr;ss) Current Property owner(s) Mailing address Lending agency Expiration Date: Day phone Mailing address Real Estate Agent ~?:)f'~ Mailing Address UnleSs otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE oF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] J~ Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address Engineer sPrintedName '~o[ -~. '~,,o~¢-c-~ ~)~.., bedrooms. DSD SIGNATURE b-'/'' Approved for ~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X (Rev. 11/05} Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: r~- ~ ,~/"-'-// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WELL DATA Well type f~ IfA, B, or C provide PWSID #~ Parcel ID: Well Log (Y/N) Date completed Total depth ~ ft. Sanitary seal (Y/N) ...... Cased to ft. FROM WELL LOG Wires properly protected (Y/N) casing height (above ground) AT INSPECTION in. Date of test Static water level ft. ft. Well production g.p.m, g.p.mo WATER SAMPLE RESULTS: Coliform __colonies/100 mL Nitrate ~ mglL Other bacteria 'colonies/100 mL Arsenic: ug/L date of sample: ~ Collected by: B, S PT,C,.O'D,.a T^.K D^T^ Tank Type/Material" ~~ / '~"{-e_e- { Tank si,ze t ~.50 gal. / Number of.Compa~ments ~ FoundSti~~ cleanout (y~)~ Y Depression over tank (Y/N) N Date installed ~/~ /~4 Cleanouts (Y/N) y High water alarm (Y/N) ~/ Length ~_.~ Total depth I~' ff. System type ~--~0 "l-"~& Gravel below pipe I { ft. y Depression over field ~ For '~r bedrooms New depth~'~ in. AB~EP;TION:FIELD DATA Date i~a['ted'- .~I~ [~'<~" Soil rating ~ft2/bdrm) ft. Width ...... ~o S ft. Eft. absorption area ~ft~ Monitoring tube . Date of adequacy test I[~o[ll Results (Pass/Fail) ~ Fluid depth in absorption field before test ~ in. Water added.~_Ogal. Absorption rate >= Elapsed Time: [3 J~'min. Final fluid depth '76 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ~0/~. ~4~v4N If yes, give date D. UFTSTAT O. Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at, in. "Pump off" level at ~ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SePtic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTI¢IHOLDING TANK ON LOT TO: Building foundation Property line Water main 'Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION: FIELD ON LOT TO:' Property line I ~) ! '{'- Building foundation ~-.Ot +' 'Water Service line ~' ~ / 4-- Curtain drain · Surface water ~ ~:)O ~ '{'' Wells on adjacent lots Absorption field Surface water F. COMMENTS 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 COSA guidelines in effect on this date. Engineer's Printed Name., Pt~rlJ [ ~ ~t~ ~"~. ,~ ~-"~ Date ~./"z"l J Water main l ~) t 4- Driveway, parking/vehicle storage · ~C)t COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) 15q al Waiver Fee $ Date of Payment Receipt Number PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 3A, Block 2, Donaho Homestead Subdivision, Addition #1 APPLICANT: Karen Jackman 10411 High Bluff Drive Eagle River, Alaska 99577 SEPTIC TANK TYPE/SIZE: Steel11250 Gallons, per MOA Records ABSORPTION SYSTEM: Deep Trench, per MOA Records DAILY FLOW: 4 BEDROOMS x 150 GAL/BR = 600 Gallons JOB NUMBER: 11-005 DATE OF TEST: 1/20/11 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 4 SCUM: 0.0' SLUDGE: Minimal NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes No XX TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank P1V[ (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS * Tube 1' Level Tube 2* Level 4:20 6.0 4.0' 6.3' Start Flow- Meter 384150 4:35 6.0 90 90 5.5' 1.5' 6.5' 0.2' 384240 4:50 6.0 90 180 4.7' -0.8' 6.9' 0.4' 384330 5:05 6.0 90 270 4.1' -0.6' 7.2' 0.3' 384420 5:20 6.0 90 360 4.0' -0.1' 7.4' 0.2' 384510 5:35 6.0 90 450 4.0' 0.0' 7.7' 0.3' 384600 5:50 6.0 90 540 4.0' 0.0' 7.9' 0.2' 384690 6:05 - 90 630 4.0' 0.0' 8.1' 0.2' Stop Test - 384780 RECOVERY Date Time ST MT SAS MT 1/21 4:00 4.0'/-0.0' 6.37-1.8' PM *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: This system appears to be operating satisfactorily. The rapid introduction of flow into the foundation CO caused a rise in the ST level. The location of input was changed to the SAS MT for the rest of the test. Absorption in the SAS was satisfactory, with the design daily flow being absorbed in less than 24 hrs. Reviewed by: Paul Pinard Date: 1/24/11 Bill Date ,~ Ae~!ui.s~or~ Commissio~'~ of A~ska 276.6222 ~ or Tb~ F~e~ Qu~s~e A~ ;ho 'a~e ~ ~800..398...2782 ACCOU~T~ li ~e: S~Cf Total Due $4'1.39 180475-520528 10411 HIGH BLUFF DR [2NV~J is a of Green Star, proud supporter i PDF i~ Water Sewer Total CHRISTOPHER C. MILLER Previous Balance Payment(s) Received ~ow that you can elect to stop the mail delivery ;r statements? Your AWWU bill is available in a !age for your use online at www. awwu.biz. The ime, image of your bill can be sto~,.r~., pdr~ted, or Fo c~oose a pape~ess option, click '1 want to go papedess" Eom your profile. retailed online? The process is easy. Under ss My Account" cIick Enroll under New Users. BATE CHARGES Adjustment(s) Balance Forward Current Charges Total Due 02/01/201! , . AWWU 7 "Where Quality is Clear" AVWVU'$ water ex ..c~e~.s bo.th fred. e.ral ~nd ~ drin?ng ~ sa.fete.' ,st~, nda.rds..Th? water coming from your tap is some of me nnest wa[er in me nauon aha mus[ aanere to nigher stanaams than bottled water. Current Previous 82.40 446.93 Current pedod 0.00 0.00 Pdor Period $82.40 $446.93 Same Period Last Year Charge SUMMARY OF CURRENT CHARGES R~ Code Un~ From ~ Wlg 0!/22r2011 02J~11 W20 1 01/22/2011 02r22~011 WgS ~ 01aW20~ 02/1~/20rt W510 01F22/2011 02/22/2011 Current Charges CURRENT METER DETAIL To DOS Pdor Curre~ GallonS 02/11/201t 31 920 93t 1t,000 Cost Charge From _ 01Ill/2011 Meter &34451~5 Page 1 of 1 4i .01 4t.01 0.00 0~00 $41.39 $41.39 Charge 10,80 30,03 0.56 $41.39 Chame :"' ::::~%.:;: /:,.~¢*,.,"~ ¢;;,.¢5' ~ ;.¢' 5 _': .":,' . :, *" SERVICE 10411 HIGH BLUFF DR I'~¢,¢E: CHRISTOPHER C. MILLER ACCOUNT~ 180475~20528 CHRISTOPHER C. MILLER 10411 HIGH BLUFF DR EAGLE RIVER AK 99577-8402 CYCLE 22 DUE DATE 03/14/2011 TOTAL DUE $41,39 00000413940 69180475520528 7000004139 J Rs Pumping PO Box 773415 EagleRivcr, AK 99577 (907) 694-6454 Invoice Number: 32835 Date: 04-Feb-2011 P.O. Number: Job Description: 12509 Order Num 32835 Serviced 03-Feb-2011 Manifest BILL TO: Remax of Eagle RiVer 11525 Old Glenn Highway Eagle River, AK 99577 842 JOB SITE Brook 10411 High Bluff Drive Eagle River, AK 99577 Quantity ServiceType Amount Tax Extension 1 Septic Serv 1250K $185.00 No $185.00 Taxable Amount Tax Rate Tax Description Subtotal NonTaxed: $185.00 $0.00 0 $0.00 Subtotal Taxable: $0.00 Subtotal Tax: $0.00 Payment Terms Payment Adjustment Late Charge Net 30 $0.00 $0.00 $0.00 ~k~s¢,: ~ ...... ,'~ <~, $185.00 Last Service ' 10/29/2009' 1250g ...... SERVICE & BILL ...... tank level normal back flushed 1 time For your added convenience we accept; American Express, Dicover, Visa and Master Card payments over the phone, After 30 Days account will be turned over to COLLECTIONS. $30.00 For NSF Checks Returned. From: Please detach here and return the bottom portion with your payment. Remax of Eagle River 11525 Old Glenn Highway ! ' Eagle River, AK 99577 I Order No. Invoice No. Date :"~.~:'~c<,,L,'~ ,','..~,,.~ 32835 32835 04-Feb-2011 $185.00 JRs Pumping PO Box 773415 Eagle River, AK 99577 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-21'1-82 1. GENERAL INFORMATION Complete legal description Expiration Date: ,..,Z'"_ ~- O ~ Lot 3A, Block 2~ Donaho Homestead Subdivision Addition No. t Location (site address or directions) t041'1 Hiqh Bluff Drive Current Property owner(s) Stephen Nebeker Day phone 696-7599 Mailing address 10411 High Bluff Ddve 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: Four (4) 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well [] 0 [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Depadment (DSD) Issues Certificates 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. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family eh-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 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 propedies 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. Legal Oesuiption: A. WELL DATA Weil type AWWU Date complated Total depth 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 (SO~ ~.3-~04 HEALTH AUTHORITY APPROVAL CHECKLIST Lot ~A~ Block 2, Oo~aho Homestead Subeqvlslon No. t Parcel ID: 050-21t.82 ff A, B, or C provide PWSID # Cased fo fL FROM WELL LOG wea Log (Y/N) VWes properly protected (Y/N) Casing height (above ground) AT INSPECTION Date of test Static water level Weti production WATER SAMPLE RESULTS: Celiform colonies/100 mi. Date of sample: . B. SEPTIG~OLDING TANK OATA Tank Type/Matedal Sepflc/StHI Tank size t,250 gal Fouedatl~ desnout (Y/N) Y_ C. AB~OIgJ:rllON FIELD DATA Date installed ~rlg84 Total depth 15 fL g.p.m. g.p.m. Pumper JR'I Pumping cotenies/100 mi. Ctaanoute (y/N) Y High water alarm (Y/N) N Soil rating (g.p.dJfl~ or ft~odrm) 419 8F/BDRM System type Oeep Trench fL Width 2.$ fL Gravel below pipe tl Eft. absorption erea 1,804 · MaaitMing tuhe Y_ ~i~ o,,mf field N_ Date of adequacy test 4t25J2002 Results (Pass/Fail) pass Fluid depth in absorption field before test 52 in. Water addedgt2 gal. Elapsed Time: 656 min. Final fluid depth 70 in. Absorption rate >= 600 Any rejuvenation treatment (past 12 mo.) (Y/N & type) N New depthT8 in. g.p.d. fi)es, give date ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773- 522-6779 (FAX) April 30, 2002 Mr. Stephen Nebeker 10411 High Bluff Road Eagle River, AK 99577 Subject: Lot 3A, Block 2, Donaho Homestead Subdivision Addition No. 1 Septic System Inspection, Testing and Certification Dear Stephen: At your request we inspected the septic system on the subject lot to determine whether it met the requirements for certification by the City. Prior to the inspection we inspected the Municipal records and found the septic syst,em was od,g, inally constructed in 1984 a. nd w. as compo, se.d .o.f a 1,250 ga on septic.tank an.d a 82 long by 11 .,effective depth absorption trench, t~ecoms lurmer indicate the trench is 30" w~de and a total of 15 below the ground surface. We noted the monitor tube in the trench extends only 83" below the distribution line in the trench instead of the required 132". We were also unable to locate the monitor tube at the opposite end of the trench. The exact dimensions and location of the trench could not be determined. The septic system was last tested and .certified in 1991. and .w. as app.are.ntl.y wo.~ing, well a.t that. time. Our measurements indicated 35.5 of standing water in me monitor lube at me beginning oT the test. We injected 760 gallons of water into the trench and the water elevation rose to 52". No drop in elevation was noted over the next 4 hours. We then injected another 912 gallons of water into the trench and the level rose to 78". The water was absorbed into the trench at a constant rate with a 2" drop in elevation noted in the first 26 minutes. A second measurement 10.5 hours later indicated an additional drop of 6". We conclude from these measurements the trench is ~.~nable of absorbina more than the required 600 gallons of wa!er per day and. mee. ts .M.,u.nic.!pal ;'~c~,;irp. rnents for cer~fication It appears, however, that the working area o.f the [rencn at t,n~s t~..me i'~b-e't~'~-~2" and 78" ab'ove t'h'e bottom of the monitor tube, wh'ch ,s 5" to 31" below me d stribut on line. It must be noted the septic system even though it is functioning adequately at this time is more than 18 years old and we past the average life of a typical absorption system. No guarantees are made or implied as to the future life of this septic system. Sincerely, Michael E. Anderson, P.E. Attachments 04/29/2002 10:47 6947112 SGTE:G-~IIO¢~ PAGE 09 Received Time Apr,29. 9:26AM 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. # (~,_-~t'"')- ~ \ \ - ,~ 1. GENERAL INFORMATION Complete legal description Lot 3A; Block 2; Donaho Homestead Subdivision Addition Location (site address or directions) 10411 High Bluff Drive, Eagle River, Alask~ Property O'wner Mailing address Thomas and Marsha Mitchel]. Day:phone 694-1071 ,10411 Hiqh Bluff Drive, Eagle River, Alaska 99577 Lending agency Mailing address Agent Beth Gaines - PHH/HOHEQUT~'%r Address 1855 Gateway Boulevard, P.O. Box 4039, Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SIJPPLY: Day phone Day phone (415) 246-6504 Suite 950f Concord~ California 94524-4039 4 ¼ Individual well Community well Public water xxx NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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 attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER Sm 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 Address Engineer's signature DHHs SIGNATURE Approved for Disapproved. s & s E.NG!NEER!HG 7034 Eagle Ri,ver Loop Eoa~ No, ~ bedrooms. Phone Date Conditional approval for bedrooms, with the following stipulations: Additional comments By: Date 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 th is 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 engineeYs work. 724)25 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL. CHECKI. IST Legal Description: L.:,~' "~ik ~;~.v- 'Z. ~;;~o~o ~'~,~,rc~t~i¥cel I,D. A. WELL DATA Well type A If A, B, or C, attach ADEC letter. Log present (Y/N) Date completed ADEC water system number Driller. Total depth Sanitary seal (Y/N) Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ?..,c:,~ ~ Absorption field on lot '?..o o ~'~' g.p.m. ; On adjacent lots AT INSPECTION ; On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer service line WATER SAMPLE RESULTS: Petroleum tank Coliform Nitrate Other bacteria ate of sample: , B.'SEPTIC/HOLDING TANK DATA Date installed (-,, --~t - ~, ~' Cleanouts High water alarm (Y~ Date of pumping Collected by: Tank size [ 7--~5'O Compartments Foundation cleanout (~)/N) ~ Depression (Y~ /v/ , Alarm tested (Y/I~) '"//~ ~ ~'1 0 Pumper '~".~7_... SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot '2.-o c:> On adjacent lots To property line /c) Absorption field Surface water/drainage I c~c> Foundation Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) "Pump on" level at' High water alarm level ~ Meets MOA electrical ~~~~~ SEPAR~ANCE FROM LIFT STATION TO: W~ lot On adjacent lots Manhole/Access (Y/N) ~ ...---~'"p--~mp off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed (_~, -~1 - Length Width Total absorption.area Depression overfield (Y~}~ Peroxide treatment (past 12 months) Soil rating '~ft%'b/~'F-- Gravel thickness Cleanouts present~)/N) Date of adequacy test for ~ ~z-- ~ ~~ If yes, give date System type "~_.~_.~ Total depth bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot .?...o c, ~' lc)~ On adjacent lots toc, ~' Property line To building foundation '~-"'~ To existing or abandoned system on lot On adjacent lots Surface water Curtain drain E. ENGINEER's CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. S & 5 ENGINEERING Signature 17034 Eagle RJ~er Loop Road Eagle River, Alaska 99577 Engineer's Name Date ~-'Z. ~ ~ ~ I HAA FeeS /,~ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION Application Date J~ly 28, 1986 (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 3A; Block 2; Donaho Subdivision Crestview to 4th, right Ist left is High Bluff, Location (address or directions) 10411 High Bluff Drive (b) Applicant Name Homeq~ity Telephone: Home Business Applicant Address on 4th, on corner of High Bluff (c) Applicant is (check one): Lending Institution []; Owner/builder'S; Buyer []; Other [] (explain); ~ 4th (d) Lending Institution Telephone Address (e) (f) Real Estate Company and Agent Jack White Realty/Connie Bat~s Address Eagle River, Alaska Telephone 694- 5500 ~'~e HAAtothefollowingaddress: S ~ S Engineering Eagl~ River, Alaska 99577 TYPE OF RESIDENCE Single-Family I~ Multi-Family [] Number of Bedrooms 4 Other WATER SUPPLY Individual Well [] Community [] Public,[;~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 (11/84) ENGINEERING FIRM PROVID,,~G INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 S & S ENGINEERING Address i96X Date ~G~.F' £;VF.;~, AK 9~5."7 Telephone Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) ,~\C,~ o'~ 0 _~.~.~ HEALTH AUTHORITY APPROVAL (HAA) ~',1 '"~ 'O 264-4720  ~ Legal Description: ~ ~ WELL DATA Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot If A, B, C, D.E.C. Approvedd~N) Date Completed Yield pepth of Grouting ± ,/~ /, Pump Set At lA ,/~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~ I~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~; On Adjoining Lots To Nearest Public' Sewer 'Line Cleanout/Manhole Water SamPle ColleCted by Water Sample Test Results Comments ~ ~ O, To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/I'I,OEERNG TANK DATA To Water-Supply Well To Property Line To Water Main/Service Line Course Date Installed .b,- ~- ~+ standpipes (~YN) ~, Air-tight Caps(/~N) Depression over Tank (Y/I~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic~ Tank: lc, '~' Size ~'7--''~0 No. of Compartments "Z-- Foundation Cleanout {~¢~N) 2/ te Last Pumped 7' Z.~ - ~.~ ; for ~/~ Temporary Holding Tank Permit (Y/N) /J//~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed (P -~ Width of Field Square Feet of Absorption Area Depression over Field Results of Last Adequacy Test Separation Distance from.Absorption Field: To Water-Supply Well ~ c, To Building Foundation f4 / / Lot Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~. { '~c, dC '~ Standpipes Present~/N) Date of Last Adequacy Test To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments '/~ ,/~E='~J,~-~-~ To Property Line t ,=, ~ 4- I To Existing or Abandoned System on ; On Adjoining Lots . ~ c:~ .-/- To CutbCnk (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all ~OA an/cl HAA guidelines in effect on the date of this inspection. $ & S ENGINEERING Date 7 /"~,//'~" ~' Signed SE B '~96X MOA No ~,-~"'~----c..a.~ ._~ Company . _ EAGLE RIVER, $77' Receipt No. ~ Date of Payment '~- /~//~'~ Amount: $ ~:~". 0 0 Page 2 of 2 72-026 (11/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) (c) Legal De..scription (inc ude lot, bock, subd v s on, section, townsh, ip, range) Locati~o (address or dir~c?ons) . ,~. ,,,~) / _.. /~ ./ Apphcan~a~~~~elephone: Home ~.~:..~' . Business _ Apphcant Address _ ~.~3 --_~:' ~ ~=~..._~/~/ .~.~<~ ~.~ Applicant is (check one): Lending Institution ~; Owner/builder~(Buyer ~; Other ~ (explain); (d) Lending Institution Address _~7~''~-~' Telephone (e) Real Estate Company and Agent .... ~./..._~¢_ Address · Tele. ph. ene (f~'-Mail the HAA to trne fgllowing address: PH. 694-2979 TYPE OF RESIDENCE Single-Family/~' Multi-Family [] Other Number of Bedrooms WATER SUPPLY Individual Well [] Community [] Public/~/ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite/~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Page 1 of 2 z2-02s ¢~,¢~' ~~ ENGINEERING FIRM PROVIDING h,,,SPECTIONS, TESTS, FILE SEARCH, DAT~ .,ND iNFORMATiON 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 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 __ ~ ~?~ :7' ~~.-~ Telephone Address ..... Date t'- DHEP APPROVAL Approved for _.L~;.. ~..~ Approved ~, bedrooms by,:~ ' ~r ~ ~ ~ '--~ ~ ~ ' ~ ~ ~ ~ ~ ' Disapproved Conditional "' Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 {11.'84) WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-472O Legal Description: /--"~.~'/' DEPT. OF HEALT~ R .CzE I V E D A Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/He!al!rig Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments -- ..,~,.. If A, B, C, D.E.C. ApProved{~,~N) Date Completed Yield Depth of Grouting Pump Set At itary Seal on Casing (Y/N) ession Around Wellhead (Y/N) ; On Adjoining Lots ~ ~--I'" On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/I-I~L=BI~ TANK DATA Date Installed ~' ~'" ~/-'/~ Size i..~-,~'''c=' No. of Compartments Standpipes ~}~1) Air-tight Caps ~N) Foundation Cleanout Depression over Tank (Y,~ Date L. ast Pumped Pumping/Maintenance Contract on File (Y/N) ~/~t ; for Holding Tank High-Water Alarm (Y/N) ~"5/A Separation Distances from Septic/Neldi+,~Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~:~ "' Width of Field Square Feet of Absorption Area / ~ Depression over Field (Y,~ Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design Length of Field ~Z.. ' Depth of Field /,~ Gravel Bed Thickness /3 Z Standpipes Present (~)N) Date of Last Adequacy Test ~_.~/4- To Property Line / To Existing or Abandoned System on · On Adjoining Lots '~ O To/~j/~p~tbank (if present) To Water-Supply Well To Building Foundation Z.~ ° Lot '~/~ To Water Main/Service Line /o /~-' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) · ~lPump Off" Level at ~.....) / Vent (Y/N) . //~ Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed SRB 196X PH, 694-2979 Receipt No. '~_ ~'~----------------~.-'~ O "~ Date of Payment Amount: $ Date MOA No. Page 2 of 2 72-026 (11/84)