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Home My WebLink AboutMCKINLEY VIEW ESTATES BLK 2 LT 12NOTE: THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM. PLOT PLAN ___ AS BUILT _X_ SCALE _ 1" _=_ 40' _ GRID _ NW_ 1459 Project No. 22—_70Q/ 2 Y 11500 Daryl Avenue, Anchorage, Alaska 99515-3049Y Lang & A S 5 o C l a t e S, inc. (907) 522-6476 Phone QQo0�044� Prof e s s i o n a l Land S u ry e o rS ken0 ken�lan g2-46surveY5 Fax v�4 F q L oQ �/ com jonathan®langsurvey.com I hereby certify that f have surveyed the following described property: LOT 12, BLOCK 2, McKINLEY VIEW ESTATES SUBDIVISION (PLAT No. 82-225) p 49TH Anchorage Recording District, Alaska, and that the improvements situated thereon are 0"""""""" within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed �.. I<E�fN F... ..L... . premises and that there are no roadways, transmission lines or other visible o� easements on said property except as indicated hereon. LS -5202.•• gJv� Dated this the ----- _- _ Day of at Anchorage, Alaska ��4�po�SS10AG o N It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 McKinl y View sta Block 2 Lot 12 #051-792-16 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231120 Work Type: Septic Upgrade Tax Code Number: 05179216000 Site Legal Address: MCKINLEY VIEW ESTATES BLK 2 LT 12 G:1459 Site Mailing Address: 22547 CENTURION DR, Chugiak Owner: LIPSCOMB CLEMENT J JR & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: i U � O Departnient Lot Size in Sq Ft: Total Bedrooms: 7/12/2023 7/11/2024 20016 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: j S S �� t✓G Issued By: Date: Date: 4 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-792-16 Property owner(s) Clement J Jr & Sabrina D Lipscomb Day phone _ Mailing address 12110 Business Blvd ST6 PMB240 Eagle River, AK 99577 Site address 22547 Centurion Drive Chugiak, AK 99567 USA Legal description (Sub'd., Block & Lot) McKinley View Estates Block 2 Lot 12 Legal description (Township, Range & Section) Lot Size 20,016 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ® Initial ❑ Single Family (SF) X❑ (w/wo AD U) Septic Tank X❑ Upgrade X❑ (D) ❑ Holding Tank ❑ Renewal ElDuplex 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 ofproperty owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number: i 12030 Receipt Number: Permit No. C25 P2 3 1 120 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! July 10, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: MCKINLEY VIEW ESTATES BLOCK 2, LOT 12 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one absorption trench and an anchored 1500-gallon Advantex FAP 2.0 to serve the existing 3-bedroom residence. The design has been increased to up to 4 bedrooms and we respectfully request the permit be amended to 4 bedrooms. The design is based on the recent test hole conducted on October 7, 2022. Groundwater was observed at test hole excavation at 6-7’ and at 6.2’+ at monitoring. Using a conservative soils application rate which per code would have allowed up to 5 GPD/SF we are proposing to use only half that at 2.5 GPD/SF. The absorption system is proposed to be of a maximum depth of minus 3’ from existing grade. The slopes are moderate or even flat at 0-3% at the proposed upgrade location. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231120, Curtis Townsend, 07/12/23 FIRST WATER CONSULTING MCKINLEY VIEW ESTATES BLOCK 2, LOT 12 DESIGN CALCS: NO WELLS WITHIN 200' OF PROPOSED SEPTIC SYSTEM. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. SITE & AREA SERVED BY PUBLIC WATER. LOCATE WATER LINE PRIOR TO CONSTRUCTION. STAKE EASEMENT & N PL PRIOR TO CONST. USED CONSERVATIVE SOILS APPLICATION RATE.PROPOSED ABSORPTION TRENCH & EXISTING BED SAS IS ADEQUATE FOR UP T0 4 BEDROOMS WITH THE AX FAP 2.0 SYSTEM. PER RECENT TH, SITE ELEVATIONS,MOA FILE & 1989 TH -BOTTOM OF ABSORPTION SYSTEMS ARE 2-3'+ ABOVE MONITORED SEASONAL HIGH GROUNDWATER. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231120, Curtis Townsend, 07/12/23 FIRST WATER CONSULTING DESIGN DETAILS: MCKINLEY VIEW ESTATES BLOCK 2, LOT 12 MUST STAKE PL PRIOR TO CONST. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231120, Curtis Townsend, 07/12/23 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 FirstWaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: MC KINLEY VW. EST. B2, L12 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5/30/23 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 GM/SM 5 6 7 8 9 10 11 BOH 12 13 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 10/11/22 30 min 6 3 11/16 30 min 6 3 11/16 30 min 6 3 11/16 PERCOLATION RATE 8.2 (MIN / INCH) TEST RUN BEWTWEEN 2 & 3 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 6-7 DEPTH TO WATER AT MONITORING: 6.5 & 6.2 DATE: 10/14/2022 & 10/25/22 USE 6 (7 ON 5/30/23) TESTHOLE # 22-1 DATE PERFORMED: 10/07/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: AT EX: SEEPS AT 6 W/ RUNNING WATER AT 7 VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: CLEMENT & SABRINA LIPSCOMB 5/30/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231120, Curtis Townsend, 07/12/23 NOTE: THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM. PLOT PLAN -__ AS BUILT _x_ SCALE __1.=_40__ GRID _ NW 1459__ Project No. ___ 22=70QA1____ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone 0000�p�0 (907) 592-46Y5 Fax Professional Land Surveyors OF A��pp� kenOlan surve com ionathanOlanasurvev.com s Q I hereby certify that I have surveyed the following described properly: LOT 12, BLOCK 2, McKINLEY VIEW ESTATES SUBDIVISION (PLAT No. 82-225) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the properly lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the Z�Day of _= t-zz�__, =_0 -, at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. a �. •KENNETH ;.�LANG�: t OQ pFa '•.�S-5202.•• y�aG aR .. Ngo ppn��FESSIONA�- �o 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 .Z S Day of -.I *s L y of 20 11 , by and between � Mew i .T �, ,1)?tuft+tjA lk"N . LL6%,, jierein 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 AN ADVANTEX SYSTEM located at (legal description) MCKINLEY VIEW ESTATES B2, L12 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) .i 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 accordance 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). L� 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. COwner 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 1 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. L Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. y 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. 1r 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: "�a, i , (signature) Date: 712-512-3 ClGr�z�N� J L;,QP4mb(print name) � L c'6Ci7M�3 STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 25E�,day of ''(-r ly 203 by Pa u/ //as C%Ogel NOTARY PUBLIC FOR ALASKA My Commission expires: 02 7 MUNICIPALITY: r By: (signature) v/ U �L� S 'tO +-5 riv o (print name) PAUL GANDARILLAS Notary Public State of Alaska My Commission Expires Feb ]2027 Date: 2 �� Title: C1 (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES /z~,/'~7~,.,~,, C, ~ ~. ~-'~'~'---.~ TO SEPTIC ABSORPTION Add ....r.u., ~ TANK FIELD WELL Phone(s)...~,,/- f,,~ ~ J Permit No.~ ~ ~ J~¢No of Bedrooms WELL ~ Block ~ ~ -~ ~ ~ FOUNDATION ~IZ / ~o' Lot Subdivision ~ ~ ~,~.i ~ Township. Range. Section A~-BUILT DIAGRAM (Show location ol well. septic system, property lines, foundation. ~ ~ ~ /~ ~ c . ~ driveway, water bodies, etc.) TANKS Manu~acturor Caoacity in ~allons ~atorial ~o. o~ Compa~ments TYPE OF SYSTEM -~ ~ ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER ~, ~,,/~ Depth to p~pe bottom from Total ~epth from original grade on~m~rade ~ FT ~ ~ FT ~ Fill added above originel grade [ Gravel depth beneath pipe / 3/ FT ~ FT ~ / ~ SOFT ~' /~ ~ FT ,umberoflJ~es SoJlratJng Pipemater,~,--'''~ ?~ ~ ~ ~ O~te installed ~ / WELLS X /-- ~ ~~ ~ / : ProrATE ~ OTHER ad,miry) ~ ~; ' ~lassiflcat~on (A,B,C) Total Depth Cased to ~ ~ Installer Date Installed: ~ ~ ~ ~ ~ / REMARKS: ~ -~~ ~ , / Scale: ENG NEER'S ~EAL ~agle H]V~rbrlggteorh~g S~rvJog3 ' " Date: I ~~ cedily thal t~is i~spe~ion was ~edormed accor¢ino 1o all . Date: 72-013 (3/85) 7:~ Z MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 925 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG-- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 - -- , - ~ WAS ENC~ IF YI DEP' PER( ROUND WATER TERED? y -r O P E ;, AT WHAT ~, /_ f / Gross Net Depth to Net Reading Date Time Time Water Drop ~ /~: ~ 7 /~ ~ ,~ ~ - ~ '~ / ~'" 14 15- 16 17, 18- 19- 20- :O LATION RATE ~' °e'- (minutes/inch) TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS Eagle River Engineering Services ~ DATE: PERFORMED BY: p, o Rnv 77.~?~4 CERTIFIED BY: Eagle River, AK 99577 694-5195 72-oo8 (6/79) [] - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT + - WELL PROPOSED LEACHFIELD NO KNOWN CURTAIN DRAINS LEGAL: McKinle~ View ~+~ L~t 12 BIk 2 CONTRACTOR: N/A EAGLE RIVER ENOINEERING SERVICES EA~LE BIVER, AN. 995~ (907) 694-5195 FAX: (907) 694-3297 SPECIFICATIONS FOR ON-'SITE SEPTIC SYSTEM MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAl.TH & ENVIRONMb:NTAL PROTECTION ENVIRONMENTAl_ ENGINEE!:~fI\IG r)~VISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL ~NSPECT~ON REPOR'F NAME I/(~PHONE [ ~-"-~NEW [ (.C,'/Z. ' ~"/ -~.~;~ [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION , LOCATION ~ Well-- I F- ~acturer /' ...,,.- .- ~Well . No~-of lines ~ / Length of~c-~-ii~.e, f~ Trench width Top of tle to f n sh grade ? I~ ' ' 7 ~T, ~/(~ inches Length Type of crib DISTANCE TO: DISTANCE TO: Width r Fou ndation ,~, ~ / / Material beneath tile / NO. OF BEDROOMS PERMIT NO. No. of compartme[~s~ Liquid depth PERMI-r NO. ' Liquid capacity in gallons PERMFI- NO. Distance be[ween lines Total effective abso~r,~tion area 5~.*/'V PERMIT NO. Crib diameter ~/~ ~rib depth ............ To[at effective absorption area Well Building foundation Nearest lot line Depth ! Driller Distance to lot line I PERMIT NO. Building foundation Sewer line Septic tank l ~,~s~ ~-rea(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER /~? , REMARKS f DATE 72-013 (Fl'er. 3/78) MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta' ~rotection 825 ~ Street, A~chorage, AK. 9501 264-4720 * * * HANDWRITTEN PERMIT * * * Location: Legal Description: ~ /~ ~ Lk Mailing Address: ~/~'~ /~/--,¢/"~Z~['J"~, ~., ~/~ Phone Number: ~¢ ~%-~ .~ ~ g'i~ Type of Soil Absorption System Is: Trench: ~/ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ,3 Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH // LENGTH t . GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~)~<9 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS' ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31j 1 9 8 2 * * * Z certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if f~e resid~e is remodeled to include more that 3 bedrooms. ~/~7/ '7/ ~ / O&E ENC.NEERING & DEVELO, Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 MENT CO. Russell Oyster 694-2774 SOIL LOG 688-2280 Performed for: Name: dLJj/]jq.~_ ~- /~¢~(~,i?~ ~ D,~_:/)'~Z_ .- Tel. N0 ~"~ ~?~ Mailing Address: Legal Description: J.o 'r /2./ ~z_o c/<_ ~, //~ ~//~/'~ ~ ~ -~ ~'. Depth (feet) 0 1 2__ 3__ '4 -- 5__ 6__ 7, 8__ 9__ 10__ 11 Soil Characteristics PLOT PLAN 14__ PERC. TEST 16__ Ground Water Encountered: Yes Proposed Installation: Seepage Pit__ Comments: No ~'~ If yes, what depth. Drain Field__ Performed by: Date:_ Municipality of Anchorage :~,. · Development Services Department .~.'-=* Building Safety Division On*Site Water & Wastewater Prcgram 4700 South Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.a k.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 'arce,,.D. 051-792-16 1. GENERAL INFORMATION Expiration Date: ~ - //./ - O '~ Completelegaldescription McKINLEY ViEW ESTATES SUBDIVISION; LOT 12~ BLOCK.2, · Location (site address or directions) 22547 CENTURION DRIVE * CHUGIAK, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address PAUL SANGL Day phone 696-0296 18540 ROADS ENO DRIVE * EAGLE RIVER~ AK 99577 Day phone Day phone Unlessothe~erequeste~ HAAw~beheldbyDSD ~rpickup. 2. NUMBER OFBEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class "^" Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates of Health Authority Approval (HA,&) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-fatuity on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to' homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ to closing for the engineering services provided. at, orpdor 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authodty Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate forthe number of bedrooms and type of structure indicated herein. I further vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone 3.37-6179 Address 6901 DEBARR ROAD, SUEE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEF'F~EY A. CARNESS, P.E. Date Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results desc#bed the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being se~,ed by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future pedormance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will il confer any legal right whatsoever. 5. DSD SIGNATURE ~ Approved for "~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: · ~'.' ON-SITE ~ .' WbTr:~ AND ~_ · WASTEWATER ...; k %f '/j/. .. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory (Rev. 12~01) Manitenance Agreements Supplemental Engineer's Reor[ Other Original Certificate Date: -~ ' //"/ ' dj ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewster Program 4700 8outtt Bmgaw St. P.O. Box 196650 Anchorage, AK 99519-6650 (90r~ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: McKINLEY VIEW EST. S/D; LOT 12~ BLOCK 2~ Parcel ID: 051-792-16 A. WELL DATA Well type '^' If A, B, or C provide PWSIDt~ 210697 Well Log (Y/N) ~ Date completed Sanitary s~y protected (Y/N) ~ ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production _J g.p.m. WATER SAMPLE RESULTS: Coli~mg/L. _.. ~. '. on,es/100 mi. · - . Date of sample: ~ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL · Tanksize 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 5/1/2002 Pumper Date installed 12/15-15/89 Cleanouts (Y/N) YES High water alarm (Y/N) N/A JR'$ PUMPING C. ABSORPTION FIELD DATA Date installed 12/I,I-15/69 Soil rating (g.p.d./ft=or~-'~ 166 System type BED Length 51 ft. Width 24 .ft, Gravel below pipe 0.5 ft. Total depth 4.5 ff. Eft. absoq~tion area 744. ft= Monitoring tu~~l: YES Depression over field NO Date of adequacy test 3/28/02 Results (Pass/Feil) PASS For 5 bedrooms Fluid depth in absorption field before test 5.5 in. Water added 466 gal. New depth Elapsed Time: 285 min. Final fluid depth 6 in. Absorption rate >= 450+ Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date ~ E,~=.~O£ '7~ g~.~,~ o~ 1~.~ e./o 8 in. ,g.p.d. D. LIFT STAT]ON Date installed Size in gallons ~ ' "Pump on" level at in. "Pump off" m. High water alarm level at .in. Datum Cycles tssted Meets alarm & circuit requirements?. E. SEPARATION DISTANCES COMMUNITY WATER SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots . Absorption field on lot ~ Public s~er main Public s~ter manhol~/cleanout ~ Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water. 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water service line 10'+ Surface water 100'+ Cudain drain NONE KNOWN Wells on adjacent lots 200'+ · Water main 10'+ Driveway, parking/vehicle storage 10'+ 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 HAA guidelines in effect on this date. Engineer's Prin~ed ~lame Date J~'"/<~ ~0 2- JEFFREY A. GARNESS HAA Fee $ ~7-'.'.'.'5 Date of Payment Receipt Number (Rev. lZ~01) Waiver Fee $ Date of Payment Receipt Number I~C~TIFICATION !2-27-89 ASBUILT-.NO CORNERS SET THIS DATE. SD/A.~.D & ~S$OCIAT; LAND I HEREBY CERTIFY .THAT I HAVE SURVEYED THE SCALE, ; ..... FOLLOWING DESCRIBED PROPERTY, 1"-30' ,...~'~¢~ OF.. A/. M~tnle~ Vte~ Estates Su~.,Lot 12~1k. 2 ~.........~.~ ~O ~AT NO ~HMEN~ ~IST ~CE~ A$ ~TE~ 12/27/89 ~.~.. ~ I~ICA'~. IT lB THE RES~SlBILI~ OF THE 11-9-89 ( ~/~TH~ VISION. ~T. UND~ NO ClROUM~ANO~S 8~ F~ ~i~ ~-6~18 .:~ ~ DATA H~ ~ US~ F~ O~U~ION 9-64 ~%:~...,...,. AEY LINES. - MUNICI'PALITY OF ANCHORAGE Department of H~alth & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address ¢,~, ,,z;./:,, ,,~..~-, Telephone: (home) ,4-,/~ Business ,,,v//~ Telephone (d) Real Estate Company and Agent Address //~ .~..2~ ~--' Telephone (e) Mail the HAA to the following address: (or check here [], if hold for pick up.) List contact person and day phone number below: TYPE OF RESIDENCE Single-Family ~E, Number of bedrooms -.~ WATER SUPPLY Individual Well E~ Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th tegality and status. SEWAGE DISPOSAL On-site,l~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by mysealaffixed hereto and as of thevalfdation date shown below, Iverifythatmyinvestigation 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 suppty 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. NameofFirm ~_.~c_~,~_ ¢.;v~.¢ I~,~'~¢~,'~, .~'v~.Telephone (,¢c1~ ' Date 6. DHHS APPROVAL Approved for --~ bedrooms by Approged X~ Disapproved 'Forms of Conditional Approval ,-,~0 H-~ ~'[ ~ Ti-f Conditional Date The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health Authority Approval cerificated 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 DH HS 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, 7/88) Back Page 2 of 2 A. WELL DATA Well Classification Well Log Present (Y/N) · ' MUNICIPALITY OF ANCHORAGE (MOA) ~ Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ~.,¢,/- /2. Date Completed If A, B, C, D.E.C. Approved (Y/N) Yield Total Depth Cased to Static Water Level Depth of Grouting Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ; on Adjoining Lots ; On Adjoining Lots To Nearest PubliC Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed /~o~'~ Size Standpipes (Y/N) /V Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) ,.v/.~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: No. of Compartments ,P' Foundation Cleanout (Y/N) Date Last Pumped ?¢--/8/~-5' ~ Jta ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field /~ To Water-Supply Well ~'.z~¢, / To Property Line /Cd / To Water Main/Service Line /-'/~ / To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88) Front Page 1 of 2 Width of Field C. AIBSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Square Feet of Absortion Area ~ /¢'z./ Depression over Field (Y/N) Results of Last Adequacy Test .... SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well /_2¢~ To Building Foundation .;~5- L. ot z¢? ~ / To Water Main/Service Line =,"z'¢ / To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design .... /v Length of Field ~"~? "' Depth of Field '4/¢-r- / Gravel Bed Thickness ~' '''~ Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line ?/'¢ To Existing or Abandoned System on ; On Adjoining Lots z~-~'~ To Cutback (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) _ Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAAguidelines n.effect on ~ne date of this inspection.~ Signed Company Ear~le P. 0. 80x 773294 ngineer's Seal Date ~( MOA No. Receipt No Date of Payment Amount: /2 026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE / 3601 C STREET, SUITE 322 ANCHORAGE~ ALASKA 99503 December 4, 1989 STEVE COWPER, GOVERNOR 563-6775 FOR: EAGLE RIVER ENGINEERING ATTN: RUSSELL PWSID: #210697 According to the records on file in this office, the McKinley View Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Environmental Field Officer VEC:bas Time Time ,[e Date Date Date Inspector Inspector Inspector Comments Conditional Approval ENVIRONMLN'~AL PRO FEC'fK}N Date Sewer Installed Permit No. Septic Tank Size ~-' ; Holding Tank Size -~oils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~'/v '~, ...... ~ ~ ~ ~ ~; ~?~ Lendinglnstitution ~ ~-~__~L / l..''x~. '~ ~' ~'~'"~ (:~} Phone s: Legal Description ~ ~ ~ '~5 ~- I~ t'~,~ t.~ ~( (..],~ ~ ~ Typ~f Residence ~Single Family ~ Multiple Family No. of Bedrooms ~ Othe~ Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June Commm~ity 1975. For wells drilled prior to that date, give well depth (attach log if C: Public Utilit~ available.~ ~lndividual Year Individual Installed: __~ EJ Public Utility When Connected to Public Utility: ~ ~ Hod n~Tan_~ ~'4OTE: THE ~NSP~::C%~ON FEH ~UST AOCO~PANY EACH REQUEST BEFORE PROC~(SSING CAN BE APPL C IT FILLS OUT UPPER HAL"' ONLY Phone Property Owner - , ~ . ~ · Mailing Address · · ., / Zip Code Buyer ~ ' , ; ; ~ . , Address ,' ;, - Zip Code ' ; , Phone Lending Institution , : . Address " Zip Code , · ¢ Phone Realty Co. & Agent Address , Zip Code Legal Description : . ~ ;-,_ ~ : ; .,,;. ,,,.. Street Location Typ~ of Residence E3 Single Family [] Multiple Family No. of Bedrooms_ [~ Other Water Supply [] Individual , ~.-; ·, ? '~ ¢.4 t'~ ~l;;~..~,,~ [ ¢~ H,~4 ATTACH WELL LOG. A well Icg is required for all.wells drilled since June 1975. [] Community ':(_.. ',....' ~ ~- ~ · 7 For wells drilled prior to that date, give well depth (attach Icg if available)· '~] Public Utility ' Sewer Disposal ,~. Individual Year individual Installed: ,' '" ' [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date ~i'~ Inspector Inspector Inspector Inspector Field .otes~..%~ ¢~I,.~.~ '~<~.- ~ O ~ ~ ~, (~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Soils Rating Date ~wer Installed Well To Absorption Area ~, Well Log Received ~EPT. O~ ~NV~RONN~ENTAL CONS~R¥/~TIO~ BILL SHEFFIELD, GOVERNOR r Telephone: (907) 274-2533 Address: 437 E. Street Suite 200 Anchorage, AK 99501 October 7, 1983 To Whom It May Concern: According to records on file in this office, McK ~l'2y View Subdivision Water System is in compliance w±th the State Drink±rig Water Regulations. Sincerely, ~6~ E. Ermckson Environmental Engineer BEE/msm