HomeMy WebLinkAboutHYLEN CREST #1 BLK 2 LT 10 Municipality of Anchorage I,~ Page i of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: .~c,J ~4~ OZ.Z~ PID Number: 030 .- ~'~Z --7~
Name: ~CRA~~ ~i~¢ ~o~T~CTIo~ WastewaterSystem: ~ New ~ Upgrade
Address: ~'J ~'~'~ ABSORPTION FIELD
No. of Bedrooms:
Phone: ~fl~ "~flS~ H D Deep Trench ~ShallowTrench DBed DMound DOther
Soil Rating: _~ ..., ~
LEGAL DESCRIPTI ON ZO (l'o~l~ Total Depth from original grade:
-- ~ ~GPD/Sq. Ft,
Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath p~pe
Township: Range:,~ I Section: ~ Fill added above, original,,igrade: Gravel~llength:(~ ~
WELL: ¢ B New ~ Up~ Gravelwidth: I Number of lines: Distance belween lines:
~0~ i~~ Z ~ Et, ~ IO I~ Ft.
Classification (Private, A,B,C): ~h: Cased To: Total absorption 8rea: Pipe material: ~ ~ O "'~
~~S~at Ft. Ft. ~O SO. Ft.
Driller: Date Drilled: Static Water Level'.Ft. Installer:~ ~ ~'o~%¢dc%~¢ Date installed: ~ "~
Casing Height Above Ground:
~ ~ : ~,. ~,. TANK
SEPARATION DISTANCES ~ septic ~ Holding U S.T.E.P~
To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~ ~ JS~~
Well- ~Oi+ ~00~ ~Oo{~ ~ ~51~ Material:~l~~ Number of Co, paYments:
Sudace~ -- ,~ LIFT STATION
Water Iool~ I~o
Lot Sizein gallons: Manufacturer:
Line ~ ~OI ~ ~ ~
"Pump on" level at: ~ "Pump off" level at: High water alarm at:
Foundation ~ ~ ti~ ~ ~ '~ ~ G~~~ G~ ~/~
CuNainDrain i 06~, j ~0 I JO~ t.+,~ ~ '~ G~LoPump Make&~Modelloi.Z Electrical inspections pedormed by:
Remarks: '~ '~R~5 [~ A~ ~o.V~'nv~ BENCH MARK
Location and Description:
Assumed Elevation:
L~~' IV~ 30-1/?" 0,4. IOo.o
,, ENGiN~L
Inspections pe,ormed by:,&s""el"E"Rl"e Dates: 1,, ' & ~:~~
170a4EagleRiverL~pRea~,Ne, 2~ 2nd 8/'1/~c ,~,z
I~ ~ ROBERT C, COWAN
Eagle River, Alaska 995~ ~r~ ~4 ~, ~, CE- 8801
a~~ a~~ '~. ~,',, .,.:,,~ ~
Department of He s approvm ' ¢ ·
Reviewed and approved by:/_/~ / - / ~ % Date: //-/~-~ ~-~2~.~
72-013 (Rev. 9/91) MOA 25
PERMIT NO. SW960228 PACE 2 OF 5
MunicipaLi't oF' Anchor'aae
DEPARTMENT OF HEA THAND HUMAN SERVICES
ENVIRONMFFNTAL SERVICES DIVISION
P,O, Box 19665D e~Amchorc§e, ALaska 99519-6650®TeLemhome: 343-4744
ON-SITE WASTEWATER ~ISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
L~.GAL LOT 10, BLOCK 2, HYLEN CREST S/D #1 P.I.D. NO. 050-472-75
ALT.
(LOT UNE W,'~R
CURTAIN DRAIN~
TH2
NEW PRESSURIZED
.... TRENCHES
SCALE 1" = 40'
- 94.0'
BtOCYCLE
WASTE WATER
A B C
FCO 29.5' 53.0' 4.8'
C1 86.5' 59.0' 9,0'
CE 41.0' 56.0' 14.0'
MT1 39.9' 78,0' 64.0'
MT2 18.~' 37.5' 44.5'
MT3 55.5' 84.0' 8~,0'
MT4 38.0' 50.0' 65.5'
TREATMENT SYSTEM
--FINAL GRADE
/ MT3 = 109.1'
--/ MT3 ~--MT4 = 110.7'
MT1 = 105.4', MTI / MT4 ./~
M~ : ~o4.*~MT~
~ II / ~,--INSULATION
3 ' I ~ ~ r~
I ~ ~ ~?~ = ~.~', ~ ~..~[ ~-~ ..............
WATE~ FOUND
93.9 B.0.H.
REVISED 10-27-97
Permit No. SW960228 5 ,5
Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Wel~ Inspection Report
LOT 10, BLOCK 2, HYLEN CREST S/D //1 PiD No 050-472-75
Legal Description: .:
MANHOLI, //--FI NAb GRADE
_ II II
EFFLUENI[ ~-~ li 'NFS
FROM HOUSE
TREATED_~ /:
EFFLUENT
~o s~c BI() CYCLE
ABSORBTION
72-O13 A (Rev. 9/91) MOA 25
PERFORMED FOR:
LEGAL DESCRIPTION: ~.~r~
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20-
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Municipality of Anchorage ~ ~
DEPARTMENT OF HEALTH & HUMAN SERVICES f~
DATE PERFORMED:
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
COMMENTS
IF YES, AT WHAT
DEPTH?
Oepthlo Waler Aiter..4 c~- ~
Monitoring? '1,'-~ Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
~(. ~' u ~' l~ _
PERCOLATION RATE v' (mmutes/inch} PERC HOLE DIAMETER
TEST RUN BETWEEN ~'~ ' '~'~ FTAND
17034 Eagle E vet Loop Road No. 2~ ' ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WIT~}~S~L GUIDELINES IN EFFECT ON THIS DATE. DATE: ( ~ / <j / E ~
72-008 (Rev. 4/85)
~?'~ -OF
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Streel, Anchorage, Alaska 99502-0650
sores Leo -- PERCOLATION TEST .~;% , .....~q
~..~
LEGAl. OESCHIPTION: ~[D ~L ~ ~ ~)~Township, Range. Section:
5
6
7
8
9
10
WAS GROUND WATER
ENCOUNTERED)
L __
13-
14-
15-
17
19
20
COMMENTS __
PERFORMEDOY. $&$ENGINE£RING i __ ~ CE~llIF¥1HAIlHISIESTWASPERFOnME{)(N
)7034 ~gl¢ Riv~ L~p Road Nu. 2~V
ACGOnOANC[ ~,~s~J~ . mN EFFE. C1 ON THIS DAlE DAlE w 1 GUIDELINES
DEC-- 9--96 MON 10 : 38 CARCEL ELECTRIC P . 0 i
CARCEL ELECTRIC INC.
10410 FINLEY ClR, · ANCHORAGE, AK, 99518
907-34§,4030 · 907-346-4032
Engineering:
R F.': C ,.E I V E D
lViuntcff)ality oi Anchorage
Dept, Health & Human 8e~j~
Re: Lot 10 Block 2 Hylencrest Sub.
Silve~ Tfp Cir. Eagle River:
De~. 9th, t996
Gtnny, the electrical wore that Cartel Electrlo did on the
the National ELectric Code (NEC}. If you have any que~tions
please Xeel free
Thank You ,~ /-~
Steve ClouO
General Manage~
ROBERTC. COWAN, RE.
ROBERTA. SHAFER, PF
Date:
HEALTH AUTHORITY
APPROVALS
SEWER &WATER
MAIN EXTENgfONS
SEWER &WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELl INSPECTION
&FLOWTEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ONSIfE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
RECEIVED
AUG 1 1996
Municipality of Anchorage
DEPARTMENT OF HED~LTH AND HUM_AN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 9~519-6650
Municipality ot Anchorage
Oept. Health & Human Services
The septic inspegtions for the referenced property were
performed on ~fV/q~ and ~/7 /92 . Prior to submitting
the On-site Wastewater Dispo~'al System and/er WellInspectzon
Report we are waiting for the ~ou~ ~T/O,t,/ to be
completed.
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
17034 NORTH EAGLE RIVER LOOP . SUITE 204 · EAGLE RIVER, ALASKA 99577
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960228
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:HYLEN CHARLES S
OWNER ADDRESS:P.O. BOX 772611
EAGLE RIVER, ALASKA 99577
DATE ISSUED:
EXPIRATION DATE:
PARCEL ID:05047275
PAGE 1 OF
8/01/96
8/01/97
LEGAL DESCRIPTION:
HYLEN CREST ~1 BLK
LOT SIZE: 22039 (SQ.
NUMBER OF BEDROOMS:
2 LT 10
FT.)
4 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 (iSAACS0) .
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
~ADDITIONAL SOILS TEST OF THE UPGRADE SITE SHALL BE PERFORMED
~AT %'HE TIME OF CONSTRUCTION OF THE PROPOSED WASTEWATER
SYSTEM.
RECEIVED BY: ~'~ ~/ '~-~
HEALTH AUTHORITY
APPROVALS
SEWER&WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, P.E.
March 13, 1996
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 10 Block 2 Hylen Crest Subdivision
Request you issue a permit to install an innovative (Bio-
cycle) system on the referenced property.
An innovative system has been chosen for this site based upon
the steep slopes, location of an existing curtain drain, soil
conditions, and general topography. To provide adequate area
for both a primary and alternate absorption field it is
necessary to achieve a polished effluent entering the
absorption area. With a quality effluent, down sizing the
absorption area will provide sufficient room to meet this
objective.
Special provisions have been made to restrain the effluent
within the absorption trenches and to decrease the slope in
the general area as shown on the attached detail sheet 4 of
5.
The lot is served by public water and installation of this
on-site wastewater disposal system will not adversely effect
the adjacent properties.
If we may be of further service, please contact us.
Sincerely,
Robert C. Cowan, P.E.
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
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NOI.LO3S-X 'S'.L'N
Municipality ol Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERPORMED POR: ~J~ lC-C*---
LEG^L DESCR,PT, ON:,L-'IO 15
4.3 - q~'
7'1"
9
10
11
12
13
14
15
16
17
18
19
20-
COMMENTS
DATE PERFORMED
Township, Range, Section:
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT ~ I 0
DEPTH? p
E
Oeplh lo Water After
Moniloring? Dais:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE . ~ (minutes/tach) PERC HOLE DIAMETER
TEST RUN BETWEEN . ~*~'~'~ FT AND ~"'~'"'" FT
,./ . ¢_.--/ /
PERFORMED BY: ~/~/ vi4., ¢¢~1~ i ¢~.~/~./Z..~c..~. __ CERTIFY TH/AT THi.~ TEST WAS PERFORMED iN
ACOORDANCE WITH ALL STATE AND MUNICIPAL GUiDELiNES iN EFFECT ON THiS DATE. DATE:
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
o,
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-472-75
Legal description HYLEN CREST #1 BLK 2 LT 10
Site address 10235 SILVERTIP CIR
Current property owner(s) STUDLEY JAMES W
Expiration Date: 7/20/24
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for
Comments or advisories:
By:
bedrooms, with the following stipulations:
Original Certificate Date: 7/20/23
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory X Arsenic Advisory
Other
COSA Approval_June 2022
MV UHMPAUTY -OF HCHORAGE
Development Services Department '� - Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-472-75
Complete legal description Hylen Crest #1 Block 2 Lot 10
Location (site address) 10235 Sllvertip Circle, Eagle River, AK 99577
Current property owners) James Studley Day phone (734) 730-1637
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units FN� Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑® Fiberglass
Age 27 yrs - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $-5-57()
Date
5 -
Date of Payment 3I i6-laa'13
COSA # 05C231054
4 ®qP Fi fl
Waiver Fee $
Date of Payment
Waiver #
COSA Application_ June 2022
Hylen Crest #1 Block 2 Lot 10 050-472-75
Property is served by public water.
8/7/96
N/A N/A
N/A
2/21/23
> 600
24
0/0
24
N/A N/A
N/A N/A
N/A N/A
N/A N/A
N/A N/A
(907) 522-7773
Benjamin Schiller, P.E.3/17/23
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC231054
Subdivision: Hylen Crest #1 Block:2, Lot: 10
The septic tank for this property is 27 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
;Mailing Address iP O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 17th Day of Jud of 20 23 , by and between
Michael & Rae Lyn Miller , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Biocvcle
located at (legal description)
HYlen Crest #1 Block 2 Lot 10
2. Maintenance, Repairs and Alterations.
0wrier is required to read, understand and initial each section)
throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
4�Naccordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage, backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page I of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
VVk Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On-Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature) Date:
�j //W (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing ' stc ment was
20Dby �A
me this 1 day of
AARY UBLIC FOt�ALASKA KATHERINE A. HALVORSON
Co mmi sion expiresNotary Public
J State of Alaska
My commission Expires Dec 7, 2025
Date: ZO Z
MUNICIPALITY:
By:(signature)
(print name)
Title:
(rev. 05/18/2018) Page 3 of 3
Inspection Report
3705 Arctic Blvd #313
Anchorage AK 99503
Email: crbioak@gmail.com
(907) 274-0314
Homeowner Info
Initial Inspection:
System Inspection
Customer Name:Tank #: Install Date:
Is System Lid Locked?
Inlet plumbing in working order?
Are all aerators functioning?
Pump float operating?
Date:
Filter cleaned?Discharge line condition:
Alarm float functioning?Any buildup of solids?
Clarification return system operating?
pH Reading:
(pH of 6-8 is ideal)
Dissolved Oxygen PPM
(2-5 is ideal)
Turbidity of discharge (in FTU)
(Under 35 FTU is considered compliant.)
Solids pillow normal?
Any buildup of solids?
Any buildup of solids?
Lid hardware in working order?Is there any noticeable odor?
Alarms Tested: Air High Water
Does system have a septic tank ?
Battery Tested:Yes
No
Yes
Yes
Yes
Good Replaced
Yes Yes
Yes
Yes
Yes
Yes
Strong Mild None
No
Yes
Yes Repaired
Replaced
Replaced
Replaced Replaced No
Adjusted
Requires Pumping
No
No
Yes Repaired
N/A
Primary Chamber
Aeration Chamber
Clarification Chamber
Effluent testing result
Discharge Chamber
Yes
Comments:
Inspected By:
N/A
(Recommend pumping tank every 2 years)
(Please make sure alarm is on "normal", not "mute")
Address:Area:
Has emailing or mailing of form been requested?
(contact office to request...)Yes No
DATE SCHEDULED / / TIME INSPECTOR
SUBDIVISION HYLEN CREST #1 BLK/LT/TRACT BILK 2 LT 10
SIZE CONN 1 °
DOMESTIC ONLY ❑ BOTH FIRE & DOMESTIC
FIRE LINE ONLY Fi FIRE HYDRANT ONLY
CORP. STOP
DATE OF TAP BY
CURB STOP C TO C
SIZE MAIN [] ALLEY STREET F� EASEMENT
. PPER PIPE
TYPE MAIN EXCAVATOR
1 1/4" OR 2" KEY BOX
DISCONNECTS F] YES NO SIZE OF DISCONNECT
THAW -WIRE
COMMENTS
THAW-PLATE/NUT
KEARNY CONNECTOR
KEY BOX. LOCATION
Gc��
OTHER
7—RAALS 6�.4ME.e SSU
INSPECTION REPORT
SIZE CONN
ON TAPPING SLEEVE
L • � INE BLOWN OUT. INSULATED
TAPPING VALVE
K.B. & T.W _ OK AFTER BACK -FILL
X X M:J. TEE
OPEN BORE FLUSH Si �� UAJI ZI )
M.J. VALVE
200 LB. TEST
FT. D.I. PIPE
❑ MAIN CHLORINATED
5" VALVE BOX COMPLETE
F] CHLORINE FLUSHED
TIE RODS
OK TO TURN -ON DO NOT TURN -ON
EYE BOLTS
3/4" WASHERS 3/4" NUTS
COMMENTS �
TEST TAP MADE Fj YES ❑ NO
OTHER
INSPECTOR DATE 5 /1/ �
INDICATE NORTH
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Prc~jrarn
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. 050-472-75
1. GENERAL INFORMATION
Expiration Date:
Completelegaldescripfion HYLEN CREST SUBDMSION ~1; LOT 10, BLOCK 2,
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
DAVID HOFFMAN Day phone 223-7408
10235 SILVER~P CIRCLE * EAGLE RIVERr AK 99577
Day phone
KEV1N TAYLOR w/ PRUDENTIAL VISTA Day phone
4241 'B' STREET * ANCHORAGE, AK 99503
273-7223
Unle$$othe~e~queste~ HAAwillbehe~byDSD~rp~k~.
2. NUMBER OFBEDROOMS: 4
3. TYPE OFWATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ~r~
Individual Holding tank
Community On-site B
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 ara 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 pdvate or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall bo paid $ I,~2 75.~'~at, or prior ,
to closing for the engineering sen/ices provided.
4. STATEMENT OFINSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I vetffy 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(am) safe, functional and adequate
for the number of bedmoms and type of strocture indicated herein. I further verify that based on the
information obtained from the Municipality of Anchorage files and frore my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone
Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GAENESS, P.E.
Date
337-6179
Engineer's Comments:
'In conduc§ng this evaluation, AKWI/VC, Inc. attempted to pmvide a thorough,
conscientious engineering analysis of the system in accordance wfth ADEC and MOA
DSD Guidelines & Regulations. The repotted results descttbed the performance of the
system under the conditions encountered at the time of the test. and separetion
distances measured lo readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate duttng the year, and the water usage of the family being served by the system.
These conditions ere 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. AKW1/VC, Inc. can therefore not previde
any warranty or future esiimate 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 sale benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authottzed, nor ~ll it confer any legal tight whatsoever.
5. DSD SIGNATURE
Approved for ¢
Disapproved.
Conditional approval for
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
bedrooms.
bedrooms, with the fllowing stipulations:
..
= ; W~IEWAIER : :
Manitonance Agreements
Supplemental Enginee¢s Reofl
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
BOlMIng ~afsty Division
On-Site Water & Wastewater Pmgrem
4700 South 8ragaw ~t.
P.O, Box 196650 A~chomge, AK 99519-6650
www.ct.anchorage.ak, us
(~37) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Descflptlon:
A. WELL DATA
Well type
Date completed
FROM WELL LOG
Date of test /
Static water level J lt.
Well production ~' g.p.m.
WATER SAMPLE RESULTS:
HYLEN CRr.~l SUBDMSION ~1; LOT 10r BLOCK 2~ Parcel ID: O ~'o - ~/'2.--'~'
PUBLIC WATER
If A, B, or C provide PWSII~ Well Log~Y/HI ~
Sanitary -~-~,~ ,,e+~---------'~s ~mperly protected (Y/N)
Casing height (above ground)
AT INSPECTION
lt.
**ll~llr. U UPPER TRENCH ONLY
Soil rating {~or fl~:ln, n) 2.0 System type TRENCH
Width 2.5 It. Gravel below pipe 2
Total depth,~.67-5.g$ff. Eft. absorption area ,300 lta Monitoring tube YES
Date of edequa~ test 7/2/2002 Results (Pass/Fall) **PASS
Fluid deplh in absorption field before test DRY in. Water added 764 gal.
Elapsed Time: 10 min. Finalflulddepth DRY in. AbsorpUon rate >=
Any rejuvenation ~ea~ment (past 12 mo,) (Y/N & type) NONE KNOWN
C. 'ABSORPTION FIELD DATA
· Date installed
Lenglh 75' (2037.5)ft..
Depression over field NO
For 4 bedrooms
New depth 7.5/21n.
600+ g.p.d.
If yes, give date -
D= ,'=teUed ./7/~ gg6
Cleanouts (Y/N) YES
High water alarm (Y/N) YES
Tank Type/Materldl ,BIO-CYCLE UNIT
Tank size *I 532 gal. Number of Compartments 4
Foundation deanout (Y/N) YES Depression over tank (Y/N) NO
Date.of pUn~plng ' ?/J2/~::O= Pumper ~"~ :'~
Coliform colonies/100 mi. NIbate ~mg./t.. m.
· . Date of ~ample: ~ Collected by: ~
B. SEPTIC/HOLDING TANK DATA ~rHIS IS A 810CYCLE TREATMENT UNIT
O. UFT STATION
Date installed. Size in gallons
E, SEPARATION DI~I'ANCES PUBLIC WATER
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Abserl~ion field on lot
Public sewer main
On adjacent lots
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Propert~ line 5'+ Abeo~pflon field 5'+
Water main 10'+ Water service line 100'+ Sur[ace water. 100'+
Wells on adjacent lots 200'+
~'WE REQUEST A
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property ilne '8'
Water service line 10'+
Curtain drain **20°
F. COMMENTS
8' LOT UNE WNVER
Building foundation 10'+
Sudace water 100'+
Wells o~ edJacent lots 200'+
Water main 10'+
Driveway, partdng/vehlcle storage 25'+
#PER 1997 INSPECTION REPORT BY S&S ENGINEERING
5'-8° OF THE Wl:~i END OF THE SOUTHERN TRENCH ONLY HAS ).
NO FRFFTING PROBLEMS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspecUona end
ret4ew of Municipal records that the above systems em in
conformance with MOA HAA guidelines in effect on this date.
Engineers Pdntj~l Nre Jt.I'I'~EY A. GARNESS
o.te ?-
Date of Payment
Receipt Number ~
(Rev. 12/01)
Wa ,er Fees !SD
Oate of Payment 7-1~'~-
R.ce,.t..mber
Municipality. of Anchorage
George P. Wuerch, Mayor
Building S cty Dix sion
P.O. Box 196650 · 4700 S. Bmgaw Strcct
· ~mchomgc, Alaska 99519-6650 · (907) 343-~301
h tt p://www.el.anchoragc.ak.us
7/16/2002
Jeffrey A. Gamess, P.E.
Alaska Water & Wastewater Consultants, Inc.
Subject: Waiver Request for Hylen Crest #1 Block 2 Lot 10
Waiver Request #WR020332
Parcel ID #050-472-75
HAA# HA020332
Dear Mr. Gamess:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
8.0 feet. ·
This ~vaiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval fi.om this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
G
C~il Engtneer
On-Site Water & Wastewater Program
ALASIG WATER & WASTEWATER
CONSULTANTS, INC.
July 9, 2002
Municipality of Anchorage
Development Service Department
Building Safety Division
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Lot Line Waiver for Lot I0, Block 2; Hylen Crest Subdivision #1.
To whom it may concern:
We request that your department issue a 8 foot lot line waiver from the east property line to the
existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent
wells or septic sy.~st~ ts. If you have any questions, please contact us at 337-6179. Thank you
for your assistaj~./g.}(
¢
.E., M.S.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 335-3246 * Web$ite: akwwc.com
LOT ~
$
LOT Il
................. D£SCRIBC0 PI~OPERT¥.
BLOCK B, HYLEN CREST SUB,IL~IT N0.1
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
HAA #
1. GENERAL INFORMATION
Complete legal description Lot 10; Block 2; Hylen Crest Subdivision
Location (site address or directions)
Silver Tip Circle
Eaqle River, AK
Prqpbrtybwner':' zchael Quinn Construction
, '::? i.. ';,' ..... '-- ". "..
,M~i'ling ~ddress .P;o.. Box 772641 Eaqle River,
f,( ,." :, , .. :,' .
,:;'Lending.acency ,Summit Title Attn: Sherrie
:~Mmhng address ' ' '
DaY phone
AK 99577
Day phone
694-4955
562-3770
Agent
Day phone
Unless otherwise requested; HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water x×x
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
Holding tank
Community on-site
Public sewer
xxx
NOTE: If community wastewater system provide written confirmation from State ADEC
attesting to the legafity and status of System.
72-025 (Rev. 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from'my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm '
Address
Engineer's signature
S & $ ENGINEERING
Eagle River, Alaska 9957~
Phone (~ q'/-/--~¢/7 c)
Date
PLEASE RELEASE CONDITIONALiHEALTH AUTHORITY APPROVAL AND ISSUE A FULL HAA.
ALL WORK ON THE CONDITIONAL HAA HAS BEEN SATISFACTORILY_ COMPLETED.
DHHS SIGNATURE
,/~ Approved for ¢ bedrooms.
Disapproved.
Conditional approval for .
bedrooms, with the following stipulations:
Additional Comments
Date//-/3 -¢7
The Municipality of An'~orage Department of Health and Human Services (DHH8) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(Rev. 1/91) B~cK MOAfF21
ROBERT C. COWAN, RI:=.
ROBERT A. SHAFER, RE.
HEALTH AUTHORITY
APPROVALS
SEWER&WATER
MAIN EXTENSIONS
SEWER & WATER
fNSPECTION
ENGINEERfNG STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL &
MECRANICAL
INSPECTIONS
ONSITE
W,~ST EWATE R
DISPOSAL SYSTEM
DESIGN
¢~';~'*~'~ ~.0/ 1997
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
RECEIVED
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK 99519
OCT 30 1997
Municipality of Anchorage
Dept, Health & Human Ser~ces
REFERENCE: Lot 10; Block 2; Hylen Crest Subdivision #1
A Conditional Health Authority Approval (HAA) was issued on 12/19/96
for the referenced property. All work required for the Conditional
HAA has been satisfactorily completed. /~,,,r,~,~c 6:~. ~z*~{~
Please issue a full Health Authority Approval at this time.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/gk
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
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. # 050-472-75
1, GENERAL INFORMATION
COmplete legal description
Lot 10;
Block 2; Hylen Crest Subd~vls~on ~1
Location (site address or directions) Silver Tip Circle
Eagle R~ v~r~ AI~
Property owner Michael ~]'inn con,~trum~nn Day phone
Mailing address P.O. Box 772641 Eagle River, AK 99577
694-4955
Lending agency
Mailing address
Day phone .
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4 ,
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
xxx
NOTE:
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
· .. . Holding tank
Community on-site
Public sewer
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
XXX :;'
If com.munity 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.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investiga.tion,.'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 regutat, iqns in effect on the date of this inspection.
$ & $ ENGINEERING
Name of Firm .............. '-- Phone
Address Eagle River, Alaska 99577
DHHS SIGNATURE
" Approved for
Disapproved.
~ Conditional approval for
bedrooms.
four(4) ,bedrooms, with the following stipulations:
Five-thousand dollars ($5,000) shall be placed in escrow to:complete
grading between the back side of the house and the septic system. Money
placed in escrow shall not be rel&ased2 until this office has given final
approval. Above shall be completed by no later than June 1~, 1997.
Additional Comments
Date December 19, 1996
.,'.~.i.~he MuniCipality of.Ahghorage 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 engin~r registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72.O25{Rev. 1/91) Back MOAf¢21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502 * Anchorage, Alaska 99501 * (907) 34~-7~-
Health Authority Approval Checklist
Legal Description: L-~ lo ~ ¢~,~- 2 ~ J-~YI.~:4 Parcel I.D.:
~F,~- ~;/o '~ t
A. WELL DATA
O~o ,-W'-/'Z - 75~
Well type ~;,~;~,C;"/~,''~ If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Date completed /,
Total depth ~ Casing height (above ground)
S_~an~'-J Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
Date of test
Static water level ~ ~
Well production J g.p.m. J
WATER SAMPLE RESULTS:
Coliform Nitrate
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Other bacteria
Date installed ~ --t-~ 6 Tank size'~'l ~'~,'~. Number of Compartments __
Foundation cleanout (~N) '~/~ Depression (Y~ I~ o High water alarm (~}N)
g.p.m.
~ Cleanouts ~,'N) 'Y'Es
Soil rating Qor ft2/bdrm) ~Z.O System type
Gravel thickness below pipe 2. Total depth
Monitoring Tube present (~'N) Ye5. Depression over field
Results (Pass/Fail) °--"' For '~-
Date of Pumping ~J Pumper
C. ABSORPTION FIELD DATA
Date installed
Length ' 7 b" (Z
Effective absorption area
Date of adequacy test
Immediately after ~gal. water added (in.): __
Absorption rate = ~ .g.p.d.
Fluid depth in absorption field before test (in.);
Fluid depth (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
bedrooms
72-026 (Rev, 3/96)*
Date installed ~,~--"~ ~L/ Size in gallons
Manhole/Access~(Y/N) "P~~ump off" level at*
~'-~"~%~ ~' */,.'~"--~ ~2.-" *Datum '
High water alarm level a~J~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
On adjacent lots
Absorption field on lot ~a~L.IC, e-~
Public sewer main ~-~'~ Public sewer manhole/cleanout
S~e Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
(,oI Absorption field
Foundation Property line ,2.9 I
Water main/service line Io14' Surface water/drainage ioo14-
,4,7
Wells on adjacent lots '2oct+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
I ~..~.
Property line ~ Building foundation I o Water main/service line
Surface water Driveway, parking/vehicle storage area
Curt~tin drain Wells on adjacent lots "~oo' ~-
ENGINEER,S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records~{ (~'6C'ab~"~ms are
in conformance with MOA HAA auidelines in effect on this date.
Signature
Engineer's Name /~0 ~,~
HAA Fee $
Date of Paymen, ,/ ,4
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number