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HomeMy WebLinkAboutGLACIER VIEW HEIGHTS BLK D LT 3Glacier View Heights B 1ock D Lot 3 #050-491-25 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. • Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 181218 PID Number: 050-491-25 Dwelling: 0 Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑ New • Upgrade Name: ABSORPTION FIELD Address ❑ Deep Trench ❑ Shallow Trench 0 Bed El Mound 22354 GLACIER VIEW ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. GLACIER VIEW HEIGHTS D 3 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To' Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line Ft2 Ft. Well Igo* TANK CA Septic 0 S.T.E.P. LI Holding ❑Other Manufacturer Capacity Surface Water 100'+ Greer tank 1000 Gal. Material Number of compartments Lot Line 10'+ plastic 2.0 NA Foundation 101+ LIFT STATION Manufacturer Capacity Curtain Drain UN Gal. Pump on level at Pump off level at High water alarm at Remarks * New Waiver on file in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 draTanfieldnk to Installer 3034 i Mike N. Anderson, P.E. Drainfield CO/MT 30gct Inspector Mike N. Anderson, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection 1' 8-4-18Location and description dates: 2"` 3 4" Garage slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL " `�kt p g� OF Atq)9 Conditional Approval: Date ,1:\';'..**1 •... # J /r a! A �! MICHAEL N. ANDERSON .� Approved Ca.vurQfl Date ! �•Pp ��k� \ ROF 510, \� E S 1-- Inspection Report_9-1-12.doc Permit No. OSP181218 Page 2 of 2 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 Well Inspection Report Legal Description: GLACIER VIEW HEIGHTS BLK D, LOT 3 PID No.: 050-491-25 MARK A 8 CO1 11 1 • TC01 11 2 TCO2 13 6 CO2 15 7 CO3 16 7 S' . ..... .„ __ QIRECTLY_ ENDER THER TANK ODE MONITORING TUB 4.,� , _ _, / r _ ...,. — 1 I,i . . \ N. , ,./ _GARAGE SLAB, BENCH i #4s.), / ` 02 TCO2 0� A \ \ \ \ \ \ DRIVEWAY \ \ 1 1000 t'LLON PLAS 0 TANK 1 \ 1 93.W/ 'VER 1 0 I 1 1 I 1 1 1 // / i / / / / / / / / SCALE: 1"=30' ,' / co, *co, rC0 wa 4,..% OF %%._ ..2 not 1 1 . o �...... .....f.... :16♦♦♦♦ _I wsu Anon '■III i ••••-.7,°04 _1 l'III 49TH ! �t 0/ PLASTIC TANK • ; al ./77/4/4 >. . . , �• ';MICHAEL N. ANDERSON;' . . ♦♦ j, . No. E 46 ..N .Y a SEPTISECTION • NT ♦ ,1I . �4I I\im`lt� I.- 1 1 534'51'40"W 166.01 30 30 I i A a Q 1 0in 16- o o ••� > r I Irrl O I 73 V W cii \C".� I cri 6 N I 57 s do `-P°'f' \L- 7 ,:). In z I� O �� 47.2 � r' ' o9m�c� o \' " .. • 9,p j.,,, rn toI N \ *.' N.) �i 46....•.:46:16,I, 0 I N i ��OF qs N32'03'58"W 186.33 i �. err \ 9*`` I 30 CURVE CHART 4 _. NO DELTA RADIUS LENGTH /, BOBBY F. BUw+rrr11/Bobb F. Burnett GRAPHIC SCALE. 1 Inch = 30 Feet ''..,.X.-- -s`84 2941 Carriage Drive 10 08'14'38" 170.00 24.46 � 7-/fes Anchorage, Alaska 99507 1 • r (907) 350-5541 15 0 15 30 60 15'08 14 360.00 95.11 \ saIONly \'Ilk._.46-'4.' Date Scale Legal Description 8/7/2018 1" - 30' I hereby certify that the property described hereon has been surveyed Lot 3 Block D by me, or at my direction, and that the improvements situated thereon Grid AS BUILT are within the property lines and do not overlap or encroach on the NW 0059 property lying adjacent thereto unless otherwise shown. That no GLACIER VIEW HEIGHTS SUBDIVISION improvements on the property lying adjacent thereto encroach on the \ ...Drawn by Field Book PLAT # 71-151 premies in question and that there are no roadways, transmission BFB ASB-2018 lines or other easements on said property except as shown. e/r//� -� MUNICIPALITY OF ANCHORAGE ..cnr / On-Site Water&Wastewater Program •S PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http://www.muni.org/onsite I)cp trtint•nt S NCHORR( On-Site Wastewater Disposal System Permit Permit Number: OSP181218 Effective Date: 8/2/2018 Work Type: SepticTank Upgrade Expiration Date: 8/2/2019 Tax Code Number: 05049125000 Site Legal Address: GLACIER VIEW HEIGHTS BLK D LT 3 G:0059 Site Mailing Address: 22354 GLACIER VIEW DR, Eagle River Owner: COGAR RICHARD P JR & Lot Size in Sq Ft: 26109 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Record drawings shall document that tank is outside the soil bearing prism of the foundation. Received By: "nt Date: 7 /V Issued By: � `C4dicte-eiDate: E© 8 Municipality of Anchorage ,,A.„n ;. f Ll• ' - i P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 e Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Department On-Site Water and Wastewater Section **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181052 COSA#: Permit#: OSP181218 PID#: 050-491-25 Legal Description: Glacier View Heights Block D Lot 3 Engineer: Mike N. Anderson Applicant: Richard & Ann-Marie Cogar Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is,Sokg feet. 93.0 -12,en c 8ISI1% This waiver approval applies to the proposed plastic septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: ?1/4-//g Approved by: , ' / eazi/z0Z/ Name of Reviewer **** VARIANCE/WAIVER REVIEW **** a MUNICIPALITY OF ANCHORAGE Development Services Department j' Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-491-25 Property owner(s) COGAR RICHARD & ANN-MARIE Day phone Mailing address 22354 GLACIER VIEW DR EAGLE RIVER, AK Site address SAME Legal description (Sub'd., Block & Lot) GLACIER VIEW HEIGHTS BLK D LT 3 Legal description (Township, Range & Section) Lot Size 26,109 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank 7.` Upgrade g ❑ Duple. kaa Holding Tank ❑ Renewal ❑ , ..11_�d �p ts ❑ Privy ❑ o 1' Private Well ❑ M .• : " •P" Water Storage ❑ \'' c.,w r moo- y THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: 0) 41,.Z� 11 0. 6 � l waiver of 95' between well and tank .Istance: 93 --pm c 011K I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 7/Ik (Signature of property owner or authorized agent) Permit/Rush Fees: 4 215/ Waiver Fees: 1128 Date of Payment: -3-Inite Date of Payment: 347,8 I10 Receipt Number: Q Lt -Jd(3 Receipt Number: 1u 3 Permit No. OSP 1S12J& Waiver No. a 5V 01Ua G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Aug 8, 2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Tank replacement & waiver request, REVISED 8/8/18 Legal: GLACIER VIEW HEIGHTS BLK D LT 3 To Whom it may concern: This is a request for a new septic tank replacement permit and plus a revision of the current 95' waiver to 93'. The lot has a waiver for the tank and crib and both have been working fine for the past 44 years. The steel tank needs replacing therefore we are requesting a new 93' wavier for the tank only. A new plastic tank will be installed for future protection of the system. The crib was tested and found to be functioning well. The slope of the lot is away from the well, see attached asbuilt survey. The lot has been sold numerous times over the past 8 years and the water tests show a slight increases in nitrate levels but nothing excessive. This new tank replacement will only make the system better for the future owners. The well log shows a good confining layer also for better safety of the water table. We are only asking for a 7 percent waiver from the normal 100 separation between the well and the septic tank. The septic crib waiver will remain at 95 feet. This new tank waiver will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely Michael N. Anderson, P.E. 4661 Natrona Ave. Anch, Ak 99516 Ph 727-8864 N. e. S� =� ."e 11 L=95.11' ° ,�,kr.°' . °•.^s a,, R=360.00' �, r -0•° Y H •.,•it ti, A=15°08'14" \ 49..— olialliimi r/ v� .�c°• MICHAEL N'.. �E;SOA: • SGS Ref.# 1183239001 Client Name Mike N.Anderson.P.E. Printed Date/Time 07/02/2018 11:16 Project Name/# Glacier View Collected Date/Time 06/27/2018 16:30 Client Sample ID Glacier View Received Date/Time 06/28/2018 9:00 Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allomable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date hut Metals by ICP/MS \r,cnic ND 5.00 ug/L EP200.8 C (<10) 06/29/I8 06/29/I8 USI1 Waters Department Total Nitrate/Nitrite-N 7.05 0.It10 mg/L SM21 4500NO3-P B (<10) 06/30/18 AYC Microbiology Laboratory L.Coli Negative 1 100tnL SM21 9223B A 06/28/I8 K.11 Total Coliform Negative 1 100mL SM21 9223B A 06/28/18 K.W\ ARCTIC PUMP & WELL INC. - Jim Sullivan, CPI r R -z, PO Box 770197 Eif9y v,,,� Eagle River, AK 99577 (907) 688-2510 (907) 258-2510 apw@g gci.net Decommissioni Well Drilling Permit Number: SW Parcel Identification Number: Date of Issue: rl� Arctic Pump & Well, Inc. Page I of 1 Legal Description: Glacier View Property Owner Name & Address: Heights Kathy Mccue Lot:') it- V 1312 W 15th I I AnA AK QQ1;n1 Pump Installation Date: 10/21/2011 Pump Intake Depth Below Top of Well Casing: Feet Pump Manufacturer's Name: Pump Model: Pump Size: hp Pitless Adapter Burial Depth: feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Well permanently decommissioned by procedurel5.55.060L.c. Pump Installer Name: Arctic Pump & Well, Inc. Arctic Pump & Well, Inc. Page I of 1 10/11/2011 15:46 FAX 907 343 7997 ON SITE. -7-77F7.`7:* 7...7, -7 a 001/001 7 '77T -W D 4-1224• 1310C International Airport (907) 274-4611 ANCHORAGE, ALASKA 99509 Lod DRILLING Cmcnit •ttWell Owner Location (address of: Toiwnship, Range, Section, own; or dYstance main roa !J3 El - 2, cl-':cIer W ,41, d iv. Earle 'R iv Size of casing Depth of Hole2�_�__feet Cased to" 1I1 Static water (ibio've'). (below) land surface. Finish_ ell (checkone) open end -Y Screen Perforate Describe e screen or pe Well pumping test at___j_gajj6nspei (4)' (minute) ..."V of drawdown from static leveL';',­` 7;5 Date of completion— 'jp V1 Depth in feet from ground surface Give, 'details 'of' fi7i To TO O - 0 LOG 5 Denetratd. of ma 4"P. + 4 41 -,.A mks !rial- Wir and har 2 r rn e Lj c cl- ;-TrT 727 7,1 Ity. v IS M t. t ICIPALIIY 00 DEPT -z. ":e tb ;W EN'TAL +Ip ONM 6-"VED­ 3 — CONTRACTOR TO To___c TO O - 0 LOG 5 Denetratd. of ma 4"P. + 4 41 -,.A mks !rial- Wir and har 2 r rn e Lj c cl- ;-TrT 727 7,1 Ity. v IS M t. t ICIPALIIY 00 DEPT -z. ":e tb ;W EN'TAL +Ip ONM 6-"VED­ 3 — CONTRACTOR McKay Well Drilling P.O. Box 557 Wasilla, Alaska 99687 Phone 376-5058 Well Owner Date Well Location Phone Size Casing Depth of Hole Cased to . feet Static Water Level `_feet Well Test Gal per Minute for Hours Date of Completion WELL LOG AUTHORIZATION TO DRILL I hereby authorize McKay Drilling to proceed with the above work. Payment shall be made in the followingmanner: MUNICIPALITY OF ANCHORM?M DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIOW Rig up Minimum feet. @ per foot FEB 1 '171988 Balance due upon completion. RECEIVED In the event it is necessary to insitute legal proceedings to collect any amounts due on this con- tract, I agree to pay an additional sum of fifteen percent (15%) of the original contract price. Plus attorney's fees, and cost for legal proceedings. Name Date Address WELL: Log must be submitted to Municipality of Anchorage Department of Health and Human Services within 30 days of well completion. I CERTIFY THAT: ' 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from ter disposal system W public sewerage t r near'by lot. 4. I understaid thaf t is permit is valid for a maximum of 0 bedrooms. I also un total system is 2 bedrooms and any enlargem At -requi ~�-----nal permit. Signed: DATE: -4-/-- --------------- (Owner) S EN COWLES Issued 8y: �^� �y�Yy-/,�' __-_-c�n����c__-���__'�---__________ _ MUNICIPALITY OF ANCHORAGE " Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 ON - SITE WELL PERMIT Permit Number: 870246 Upgrade Date Issued: 09/16/87 Owner Name: STEVEN & KAREN COWLES Day Phone: ` Owner Address: 1481 NORTHVIEW DRIVE #8 338-1809 ANCHORAGE, AK 9950-11- 9504Parcel ParcelId: 050-491-25 Lot Legal: Subdivision: GLACIER VIEW HEIGHTS Lot: 3 Block: D Section: 16 Township: 14N Range: 1W Lot Size .75A (sq.ft. or acres) Max Bedrooms: This Permit: 0 -Total Capacity: 2 WELL: Log must be submitted to Municipality of Anchorage Department of Health and Human Services within 30 days of well completion. I CERTIFY THAT: ' 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from ter disposal system W public sewerage t r near'by lot. 4. I understaid thaf t is permit is valid for a maximum of 0 bedrooms. I also un total system is 2 bedrooms and any enlargem At -requi ~�-----nal permit. Signed: DATE: -4-/-- --------------- (Owner) S EN COWLES Issued 8y: �^� �y�Yy-/,�' __-_-c�n����c__-���__'�---__________ ON:, 6,� This smbbi it shall riot he used for any purpose other than financing requirements. Under no circumstances mould any data hereon he used for Construction or for esta l i siling boundary or feMe AJAM J r r r 2- r r I `K t �a 77 f G t, '✓ > i Cf I,/hereby certify that l have surveyed the following described property: i t $ is f age Reco_aing Precinct, Alpska, and that the 9 -pro ementsift we thereon are within the property li ,es and do not overlap or enc oach on the property lti ing adz scent thereto that no JIMprovernents on prop- erty lying adjacent thereto encroach on the premises in question and that there are no roadways, Iran=m .ssian 3 lines or other visible easements on Said property except as indicated hereon. Dated at Anchorage, .Alaska ti this. � .-,._day of--- 7 _ i uJ r w r I n,t=.r 7 R l RED WAI ATK $ 8 ASSOCIATES ; t�_�ti >Ei1 �L'' r Engineers and Surveyors FLAT fAx ivyi E0,W_ ��L_� -1- 1 9=D L_ 1 -F C3 F� FA 14 CT F4 CD FZ FA C3 E-_ ' DEPARTMENT G HEALTH AND ENVIRONMENTAL < - OTECTION \ S00-1 ./ 825 _ STREET, ANCHORAGE, HK 264-4720 ANCHORAGE 694-2131 : EAGLE RIVER CH t-4 EE 'S EE NJ E---: Ir- F"EE r7e_ 1-1 1 -T PERMIT NO. 831100 APPLICANT: PHTTI SEYIER GLACIER VIEW PRE-SCH PHONE: 694-9708 ADDRESS: SR BOX 193 H / EAGLE RIVER, RK 99577 LEGAL DESCRIPTION - SUBDIVISION: GLACIER VIEW HTS BLOCK: D LOT: ] LOT SIZE 0 SQ.FT. TOWNSHIP: - RANGE: - SECTION: - MAXIMUM NUMBER OF BEDROOMS = Q SOIL RATING = 0 0 0 (SQ.FT./BR) LISTED BELOW ARE THE'OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE .... ..... ... .... ..... ________________________ I CERTIFY THAT: 1. I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE AND THE STATE OF ALASKA. 2. 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES AND HAVE RECEIVED H COPY OF THE CODE SUMMARY AND DIAGRAM ATTACHMENTS WHICH IS PART OF THIS PERMIT. ] I UN[)ERSTHND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 0 BEDROOMS. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM PERSONNEL DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. IF H LIFT STATION IS INSTALLED, AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED. HS-BUILTS CANNOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT. THE ELECTRICAL WORK MUST BE DONE BY H LICENSED ELECTRICIAN. SIGNED ----------------------------- _------- APPLICANT: PRTTI SEYIER GLACIER VIEW PRE-SCH ISSUED Dy: DATE: 12/1]/8] ___--_____________-_-_-------------- ���, MUNICIPALITY OF ANCHORAGE Department,Health and Environmenta3 ,rotection 825 Street, Anchorage, AK. -1,501 264-4720 Permit # # HANDWRITTEN PERMIT # # W A -R ON-SITE SEWER PERMIT WY 7 re�.sci.h Applicant: AW -1 SeVle ci /&/aQ-iP r Vl eW PMailngoo /Address: Address: /93-4`( F -e. Location: / Phone Number: 6611L1 -??6e Legal Description: L 3 (3Iou( -0 ( lV C I Y V I Pi s Lot Size Type of Soil Absorption System Is: ri 5 P -e ;- C� eco d eS i o n Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: fie, Soil Rating(sq.ft/br) 150 A7r(�ched The Required Size of the Soil Absorption System Is: S.c- e A�- ilqc,hc--'-�( __ DEPTH LENGTH . GRAVEL DEPTH µJIDTH The length dimension is the length(in feet) of the rench o drainfield. The depth of a trench or pit is the distance e-Eween t -h surfac of the ground and the bottom of the excavation(in�` feet) . There is no set wid4h for nches. The gravel depth is the minimum// inimum depth gravel bets en theloutfatipe and the bottom of the excavation(i feet). # # REQUIRED SEPTIC(HOLDjNG) TAN SIZE Permit applicant has the respons'bil' \inf installation inspections of any ells adj cent of residences that the well Wil serve. O -GALLONS # this department during the this property and the number \, TWO(2) INSPECTIO S ARE REQUIRED A. # Backfilling of any system witho t final i spec ion and approval by this departmez will be subject to prosecution. Minimum distance between a wel for a private well or 1�0 to 2 of public well. Minimdist is 25 feet and to a comm pity and must be returned to t is d Other requirements may app y. available to insure proper in� * * * PERMiT and any on-site sewage disposal system is 100 fe( 0 feet from a public well depending upon the type nce from a private well to a private sewer line ewer line is 75 feet. Well logs are required partment within 30 days of the well completion. Specifications and construction diagrams are allation. EXPIRES DECEMBER 31, 1.9 u 3 I certify that: (1) I am familiar with the requirements for on-site set forth by the Municipality of Anchorage. (2) I will install the system in accordance with co (3) I understand that the on-site sewer systemmay the residence is remodeled to include more th t 1 Signed: Issued by`:, Applicant Date: SWP/024(1/81) ewers and wells as des. requfire e ; la gemen if edr ALASKA ENVIRONMENTAL CONTROL S Ex C Ni ## WestANCHORAGE, # Phone y JCB SHEET NO, OF —2 - CALCULATED 8Y �.� DATE 7 f r CHECKED 6Y l DATE SCALE Ph'w"Xl,:f 208-1 E�s'j 1x_ i+r8ea, 4N?1.. ALASKA ENVIRONME NTAL CONTROL VICE" INC. 1200 West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 276-1361 JOB SHEET NO. OF ' CALCULATED BY _r ` DATE C. CHECKED BY DATE SCALE PP.W,o n' t., G"m- M., Ute. c.. h� Al l U i', (., _ U � Q J e � c.. h� Al l U i', (., Ilk Z � 0 ►3 Fli V fi ti SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST n I C- '-, Ll I - PERFORMED FOR: 11 (j,1 / Z'= DATE PERFORMED: / LEGAL DESCRIPTION: /7 SLOPE SITE PLAN 10 11- '0 12 13- 14 15- 16- 17- 18- 19- 20 -4 OF At tti C; 4* O p roy C. Recd, Jr No. 2251-,E 40 04 AIV 4 ......... COMMENTS WAS GROUND WATER Avv J 1� S ENCOUNTERED? I L 0 IF YES, AT WHAT E DEPTH? Reading Date o M, t ra V'e' Net Time Depth to Water Net Drop 2- 4 G CS I 3 tl� 5q; 7 - 8 4_-, 9 � 41 10 11- '0 12 13- 14 15- 16- 17- 18- 19- 20 -4 OF At tti C; 4* O p roy C. Recd, Jr No. 2251-,E 40 04 AIV 4 ......... COMMENTS WAS GROUND WATER Avv J 1� S ENCOUNTERED? I L 0 IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN PERFORMED BY: 7_+ 'V�- I —CERTIFIED BY: 72-008 (6/79) FT AND (minutes/inch) 11-ro M 'f to DATE:, le GRE' ER ANCHORAGE AREA BOf JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME�lc C6�4J-YG�(� Ce!ref"I MAILING ADDRESS ��76, �ay��1 '2- PHONE LOCATION LEGAL DESCRIPTION_ SEPTIC TANK: 6a */mg -77 DISTANCE `� NUMBER OF FROM WELL MANUFACTURER C216_e44 MATERIAL C71(1&- 7(&- COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /-_ e,K,) GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER 72 OR WIDTH G LENGTH lei , DEPTH (% LINING MATERIAL t-&'(- CRIB SIZE: DIAMETER ', t DEPTH , DISTANCE FROM: WELL 7i I TOTAL EFFECTIVE BUILDING FOUNDATION C•7 NEAREST LOT LINE 7C ABSORPTION AREA (WALL AREA) -Z SQ. FT. ADDITIONAL ABSORPTION WELL: /J T MaUld Ar 11<�e 0 kUS�ec /(i" TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE -,TANK -,SYSTEM CESSPOOL APPROVED DISTANCES: INSTALLED BY: �% PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ -031 , OTHER SOURCES DISAPPROVED REMARKS DIAGRAM OF SYSTEM Static water level ft. {above, [ow) land surface. dr) (minute) for - WELL LOG f formations penetrated, size well material, color and hardness — CQNTRACTOF 11� lclpnL1 f'F <C x` TU g4 '0 -1 -- TO — CQNTRACTOF GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO } 3330 "C" STREET ANCHORAGE, ALASKA 99503 E TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT? ��'C (A-C��� �y" MAILING ADDRESS"Z1��'� �( PHONE INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK //moi •D SEEPAGE PIT DRAIN FIELDof OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS - E . �J ra/i "-✓'Vl NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED 12/i FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE -� •'� TYPE ✓`�`` "`SERFAGE AREA SIZE u MINIMUM DISTANCES, REQUIREMENTS J FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT O / { DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL , SEPTIC TANK �, SEEPAGE PIT �, DRAIN FIELD /v TO NEAREST LOT LINE. WELL TO SEPTIC TANK /'� `� SEEPAGE PIT DRAIN FIELD - fn ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK l� SEEPAGE PIT /U , DRAIN FIELD /01 1 / /� SEPTIC TANK, /CIO ,, SEEPAGE PIT 1O�'"/� DRAIN FIELD /`,G, / TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE v �C APPLICANT'S SIGNATU FORM NO. EQ -016 Box 90, Davis St., Eagle River, Alaska 99577 694-2774 'or 333-5240 Russell Ouster 694-2774 Earl Ellis Civil Engineering 333-5240 Surveying Soils Er Foundations Land Development SOIL LOG Performed for: ame:. _, �VQ", \0 c .A Tel. No. MJI,­-:z�(�j Mailing Address: . '4 Legal Description: -: Depth (feet) Soil Characteristics 0 3 �- 4 f v 9 10- 11 1 Ground Water countered. Yes r,. o If yes, what depth Proposed Installation. Seepage Pit' Drain Field Comments: AL Performed by. Date. ° t,,7 F1 I I k11 f ) I I I I f , , ., , -. I: •.; i " V ,.b , Iik 327 LAiILE '1110ET ANCHORAGE, ALK KA 99501 C1 is F11 ;fi11 Pc,rtor-med For C Z) ID Date Peri ormed -.1 DcscripTion; 17� Lot C!, v1slor . . ... .... . .... Zl I - 0 T s Fern .Re7orts . a. Soils Lo —Percolatiron F;S Depth ?"e CU Coil Char,--,.,: teristics s0u/kcly v e G 1-11, Was Ground Water Encountered? /v v / 0 If Yes, At What Depth Location SRetcj-, C _� 1—>tdiiaiion: Seepage pit / _— Depth of inlet Drain Neld .1) e '17FT� �ro B`ottOM -Of Fit Or Tr,encT7------­— COMMENTS: _7 77 7, L (-0 0 Test Performed By: 0 0,1Com: b'tSu 1%AA J Data Certified By: Date: • <` •'' Municipality of Anchorage aPr ',�. 1 On-Site Water and Wastewater Program ro'u'.�;f c. (907) 343-7904 $n! f T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-491-25 Expiration Date: Nov Q 018' 1. GENERAL INFORMATION Complete legal description _GLACIER VIEW HEIGHTS BLK D LT 3 Location (site address) _22354 GLACIER VIEW , EAGLE RIVER AK Current Property owner(s) _RICHARD COGAR Day phone Mailing address _SAME Real Estate Agent Day phone 1L.. 567 89� 2. TYPE OF DWELLING: 40 ° ® Single Family (w/wo ADU) Q 9(/6O k a ❑ Duplex � i!),8 ' ❑ Multiple Dwellings (Single Family and/or Duple .a 3. NUMBER OF BEDROOMS: 3 686 9 9 7 �ti� 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 ❑ Waiver/Variance request for: Distance: mss. ,.. ..,., - - u w... �. o . Received by: �� hA Date: 11/`� COSA to be released to the engineer, unless otherwise� requested by the engineer. . _ ii1 COSA Fee $ Cj a (o'f` 3156' D -ANI bWaiver Fee $ Date of Payment ?Il 1 t ' r; low 1 Date of Payment Receipt Number 2.28 q- Receipt Number COSA# clkAg 1 Waiver# 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 MIKE N ANDERSON.P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 8/7/18 c P i 'l y 1{ 110 J O 0 0 0 0 0 O • >D O O s 0 6. DSD SIGNATURE f' � ICHAEL r,, AN:6DER .. �9 System #1 Approved for 3 bedrooms. 0 • t•. System #2 Approved for bedrooms. Pp Disapproved. Conditional approval for bedrooms, with the following stipulations: \( OF AA/c., _. ON-SITE GR'-. WATER AND m WASTEWATER c PROGRAM • c- ,J„ �I1 r�+rp\I\C�G By: � J Original Certificate Date: a 01 $ 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12 doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: GLACIER VIEW HEIGHTS BLK D LT 3 Parcel ID:_050-491-25 A. WELL DATA Well type Private If A, B. or C provide PWSID# Well Log (YIN) Y Date completed 9.24-87 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 80 ft. Cased to 80 ft. Casing height(above ground) 24"+ FROM WELL LOG AT INSPECTION Date of test 1987 6.28.18 Static water level 45 ft. 50 ft. Well production 12 g.p.m. 4.0+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 7.05 mg/L Arsenic: ND ug/L Date of sample: 6.28-18 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material PLASTIC Date installed 8-4-18 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) art( Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA—1985 SYSTEM TESTED Date installed 1974 Soil rating (SF/BEDROOM) 117 System type CRIB Length 19 ft. Width 17 ft. Gravel below pipe 6.0 ft. Total depth 12.5 ft. Eff. absorption area 432 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6.28.18 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 11 in. Water added 500+gal. new depth 15 in. Elapsed Time: 1350 min. Final fluid depth 12 in. Absorption rate >=_500_g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes. give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off" level at in.High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: 1Septic tank/lift station on lot "'96'++ On adjacent lots 100'+ Absorption field on lot *95'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 10'+ Absorption field 5' Water main 100'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 100'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage ** 0'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ c. F. COMMENTS .•�'`p� 'OF . • dC• 'WAIVERS FOR TANK AND CRIB ON FILE. **APPROVED ON PAST COSA • 49TH ^ •. A // G. ENGINEER'S CERTIFICATION • MICHAEL N. ANDERSON '�i' CE- 69 •• � 1 certify that I have determined through field inspections and t�`�J ••• ��• „/• ,; review of Municipal records that the above systems are in 1k D•• • • •• •• •�.. conformance with MOA COSA guidelines in effect on this date. \\\�`E”`>;-= Engineer's Printed Name MIKE N. ANDERSON, PE Date 817/2018 COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT ; • 907-343-7904 On-Site Water and Wastewater Section „ /' Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC181396 Subdivision: Glacier View Heights, Block: D, Lot: 3 A water sample revealed a nitrate concentration of 7.05 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL PY w Ay a"chan Parcel I.D. 050-491-25 Expiration Date: 11�lf 0– L%21 fjmx#n#�• v2irnyren Complete legal description GLACIER VIEW HEIGHTS S/D; BLOCK D, LOT 3 Location (site address) 22354 GLACIER VIEW DRIVE, EAGLE RIVER, AK 99577 Current Property owner(s) JASON AND ALEXANDRA ROACH — Day phone 808-754-4856 Mailing address 22354 GLACIER VIEW DRIVE, EAGLE RIVER, AK 99577 Real Estate Agent KATHY GERACI W/ GREAT LAND REALTY Day phone 694-9125 2. TYPE OF DWELLING: M Single Family (w/wo ADLI) F -I Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4.'' TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community ClassWell Public Water System 3— TYPE OF WASTEWATER DISPOSAL: Individual On-site F] Individual Holding tank ❑ R Community On-site ❑ EJ Public Sewer ❑ Waivermariance request for: N/A Distance: As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply andlor 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 andlor wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. in conducting this evaluation, GEG provided an engineering evaluation of the well andlor septic system in accordance with the guidelines and regulations established by the Muniopalifp of Anchorage and industry practices. The reported results describe the condition of the systemis on the datels of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater le vets (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systemVs. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event a therof the current systems fait. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the pemonlparty who paid for this report. 6. DSD SIGNATURE _AZ System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date fl OF 6 rrrr. ON-SITE WATER AND =_ bedrooms, with the following stipulations: WASTEWATER " PROGRAM -- Jt! C ANT sr -PN By: lej. Original Certificate Date: The Gthereprie gene �tions Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only uponn 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. ATTCHMENTS: COSA Checklist tz Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other [R., 1nh1W191 If more than I septic system is on the lot: COSA Checklist # of Structure served by this system Certificate On-Site t s Approval Checklist Legal Description: GLACIER VIEW HEIGHTS S/D; BLOCK D, LOT Parcel ID- 050-491-25 A. WELL D.A,TA. Well type PRIVATE If A, B, or C provide PWSID#, N/A ' Well Log (Y/N) YES Date completed 9/24/1987 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 80 ft, Cased to 80 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 9/24/1987 4/30/2915 Static water level 45 ft. 48 ft. Well production 12 g.p.m. 64 g.p.m. WATER SAMPLE RESULTS: ColiformQ colonies/100 ml. Nitrate mg/L. Collected by: GEG,':Ltd. Arsenic: N P ug./L. Date of sample: 5/1/2015 STEEL`SEPTIC TANK IS LIKELY APPROACHING B. SEPTIC/HOLDING TANK DATA THE END OF ITS USEFUL LIFE. Tank Type/Material STEEL Date installed 1974 Tank size 1000; gal. Number of Compartments 1 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Nigh water alarm (Y/N) N/A Date of pumping 4/15/2015 Pumper ONE STOP SERVICES C. ABSORPTION FIELD DATA "BELOW EXISTING GRADE ©ate installed 1974 Soil rating (g.p.d./ft or EE)*117 System type CRIB Length 19 ft. Width 17 ft. Gravel below pipe 6 ft. Total depth x12.3 ft Eff. absorption area 482 ft2 Monitoring tube **YES Depression over field NO Date of adequacy test 4/3012015 Results (Pass/Fail) PASS For 3 'bedrooms Fluid depth in absorption field before test 18,5 in. Water added 913 gal, New depth 33.5 in. Elapsed Time: 285 min. Final fluid depth 20.5 in. Absorption rate}= 450+ gp,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give` date - *BASED UPON 10/1/1974 SOIL LOG. "BOTTOM OF CRIB IS 4.5'(+/-) BELOW TOP OF CRIB. D. LIFT STATION ©ate installed Size in gallons Manhole/Access'(Y/N) "Pump on" level at in'. "Pump off" level at wa er alarm` level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO Septic'tank/lift station on lot *901+ On adjacent lots 100'+ Absorption field on lot *90"+On adjacent lots 1001+ Public sewer main N/A Public sewer'manhole/cleanout N/A Sewer /septic service line 25'x" Holding tank ' N/A Animal' containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ***5'+ Property line 51+ Absorption field 5'+ Water main N/A Water service line ****10'+ Surface water 100'+ Wells on adjacent lets 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LCAT TO: Property line 10'+ Building foundation 101+ Nater main N/A Water service line ****101+ Surface water 100'+ Driveway,' parking/vehicle storage **0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WR990044. **PORTION OF CRIB UNDER DRIVEWAY/PARKING AREA. (APPROVED ON PAST COSA) ***DECKIPORCH IS RIGHT NEXT TO ST'I, NO DECK PILES OR PIER BLOCKS ARE OVER TANK. ****ASSUMED BASED UPON LOCATION OF WELL AND 1992 COSA. NOTE CRIB CIO IS 36"FROM CUTBANK AT EDGE OF DRIVEWAY. CONDITION HAS EXISTED FOR OVER 40 YEARS. to G. ENGINEER'S CERTIFICATION'�;.•.." ..., e; ! certify that I have determined through field inspections and... >�� * ........I... .... review of Municipal records that the above systems are in �, 0 conformance with MCRA COSA guidelines in effect on this #� ••r }.•' •• .. date. � � �Gar4 * 0 a GE-7gr 5 Engineer's Printed Name JEFFREY A. GARNESS Date r wSS\ yva(Rev. 10112/12) Municipality of Anchorage Community Development Department Development Services 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 # 151219 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block D, Lot 3 of Glacier View Heights subdivision. This inspection revealed a nitrate concentration of 5.64 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 0 HMO 0® ^ ._ o �j�j �P � p n n < O m O 3 ggO cn W � m z o.2Z i m T O > 5v 3 r a �o 20 0 m cn I --1C4 " z _ m < cp mR m' HQ w 3 c' Ci i Fey n n h C.n1 r L z Y.' co r. 489 n �, �L `' 1 rt.� O m m G \. 73 co 3 ?4 a i z ROT. _ 6 'Tag V A a aCD CD N Z o ® O wCD � G 07 (� t�F �cn0 CD • W od yTp V O X SD O 0` D co N W 77 SD (0 0) 3ti, 0 o �j�j �P � p n n < O m O 3 ggO cn � m z o.2Z i m T O 5v 3 r a 0 m cn I --1C4 _ m < cp Ci i O z co �L G 3 ?4 a i z V A a aCD CD N Z o ® O wCD � G 07 (� t�F �cn0 CD • W od yTp V O X SD O 0` D co N W 77 SD (0 0) 3ti, 0 Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 ae > U& C � CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-491-25 Expiration Date: Complete legal description GLACIER VIEW HEIGHTS; BLOCK D, LOT 3 Location (site address) 22354 GLACIER VIEW DRIVE *ANCHORAGE, AK 99577 Current Property owner(s) JOHN & GAIL WEAVER Day phone C/O AGENT Mailing address 22354 GLACIER VIEW DRIVE *ANCHORAGE, AK 99577 Real Estate Agent TIM RITTAL W/ REMAX Day phone 244-4472 2. TYPE OF DWELLING: Single Family (w/wo ADU) Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: Individual Well 11 Individual On-site Individual Water Storage EJ Individual Holding tank ❑ Community ClassWelln Community On-site ❑ Public Water System El Public Sewer ❑ Received by: /11� Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number COSA # 056---- / /`Z' -7-6 Waiver Fee $ Date of Payment Receipt Number Waiver # 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 andlor wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. AM _. System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for Phone 337-6179 Date 2 /7/1,3 �CE-7Q_53,1.m� .113 kZfofessior°o bedrooms, with the following stipulations: Original Certificate Date: -;' 2—'s 'tel 2 - The Whiciodlity gr 4&66rage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory (Rev. 11/05) Nitrate Advisory Arsenic Advisory Other Legal Description: GLACIER VIEW HEIGHTS; BLOCK D, LOT 3 Well type _PRIVATE _ If A, B.orCprovide PVVS|D# N/A Date completed _9z/24/87Sanitary seal (YYN) YES Total depth b{}_ -ft. Cased to 80 ft. FROM WELL LOG Date oftest 9/24/87 Static water level 45 � productionWell WATER SAMPLE RESULTS: Coliform -_oo|onios/100nn| Ifmore than iseptic system i000the lot: CDSAChecklist # of Structure served bythis system ___ Parcel ID: 050-491-25 YES Wires properly protected (YYN) YES Casing height (above ground) 12f in. AT INSPECTION 9/19/11 45 � 4 _-------Q-p-mn- N nlg.0- Collected by: GEG, Ltd, Oa�ofeomp�� - �7~~1���/.� ��-~/ /'��0� B. SEPTIC/HOLDING TANK DATA TankType/Mateha| Date installed 1974 Tank size- 1000 Qoi Number ofCompartments _i_ C|eanouts (Y/N) YES Foundation d YES Depressionover tank (Y/N) NO High water alarm (Y/N) Date of pumping 2-6/(2- Pumper 130— " C. ABSORPTION FIELD DATA �*QELQW EXISTING GRA Date installed 1974 Soil rating (g4d./ft2o*117 System type CRIB Length Width Gravel below pipe Total depth -** 12.33 ft. Ef[absorption area 432 ft2 Monitoring tube YES Depression over field NO Date ofadequacy test Renu|ta(PaaaFai|) PASS For 3 bedrooms Fluid depth in absorption field before test 14 in. Water added 615 gal. New depth 28.5 in. Elapsed Time: 914 min. Final fluid depth 20 in. Absorption rate >= -g-p.d. Any rejuvenationtreatment (past 12mo.)(YYN&type) SEPTI CLEAR |fyes, give date *BASED ON 10/1/74 SOIL LOQ. NO �W M e 2 Size in gallons Manhole/Access (Y/N) '"Pump off" level.�_gh wateralarmlevel at in. : . �HF�ii Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *90, Absorption field on lot *90, Public sewer main N/A On adjacent lots On adjacent lots 100'+ 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ — Absorption field 5'+ Water main N/A Water service line 10'+ - Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ — Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ —Driveway, parking/vehicle storage **0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ NPIP410MMAU *WR990044 "PORTION OF CRIB UNDER DRIVEWAY/PARKING AREA. 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 JEFFREY A. GARNESS Date lo (Rev. 11/05) /* r TH ...... .. .. ....... .......... Jif rb ...... Garn . e s: - 11 (CE 79r1w-,-.-* e P, 0 f e s Municipality of Anchorage 81, 151; Community Development Department Development Services 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 I Certificate of On -Site Systems Approval # 111438 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block D, Lot 3 of Glacier View Heights subdivision. This inspection revealed a nitrate concentration of 5.68 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-491-25 ZI Z, I :I :?A melath E.W601 Expiration Date: Complete legal description GLACIER VIEW HEIGHTS; BLOCK D, LOT 3 Location (site address) 22354 GLACIER VIEW DRIVE *.,a* 9.tv_'=' AK 99577 Current Property owner(s) JOHN & GAIL WEAVER Day phone C/O AGENT Mailing address 22354 GLACIER VIEW DRIVE AK 99577 Real Estate Agent TIM RITTAL W/ REMAX Day phone 244-4472 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well In Individual On-site Individual Water Storage El Individual Holding tank ❑ -Community Class Well ❑ Community On-site El Public Water System ❑ Public Sewer El Received by: Date. ///37 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number COSA # / / / y 3 Waiver Fee $ Date of Payment Receipt Number Waiver # As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply andlor wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein../ 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 andlor wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date Is/17-/ ZZ _ bedrooms, with the following stipulations. S1�pra f e sslon°� OF AA, ON-SITE v WATER AND a WASTEWATER '^ PROGRAM 1J������ The Municipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist ' Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other By:- Original Certificate Date: > n ' 1 -3 -,12— (Rev. 12 -(Rev. 11/05) Legal Description: GLACIER VIEW HEIGHTS; BLOCK D LOT 3 Well type _PRIVATE _ |fA'B.orCprovide PVVG|D# N/A Date completed Sanitary seal (YYN) YES Total depth 80 ft. Cased to 80 ft. FROM WELL LOG Date oftest 9/24/87 Static water level 45 ft. Well production 12 —g.p.m. Ifmore than 1septic system immnthe lot COSAChecklist # Structure served bythis system ___ Parcel ID: 050-491 —25 Well Log MYN) YES Wires protected (YYN) YES Casing height (above ground) 12+ in. AT INSPECTION 9/19/11 45 24 om WATER SAMPLE RESULTS: Coliform _-L=oo|oniee/1OUmi. Niirata-� mg./L. Collected by: GEG. Ltd. ArsenicA Q ug./L. Date of sample: 11 Z1 4/12 B. SEPTIC/HOLDING TANK DATA TonkType/Mohehg| SEPTIC/STEEL Tank size V]OO gal. Number ofCompartments 1 Date installed 1974 Cleanoute(Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YYN) Date cfpumping Pumper C. ABSORPTION FIELD DATA l"BELOW EXIST Date installed 1974 Soil rating (g.pd./t\z *117 System type CRIB Length 19 Width 17 _ft. Gravel below pipe 6 Total depth ** 12.33 ft. Eff.absorption area 432 M/ Monitoring tube YES Depression over field NO Date ofadequacy test 9 Reeu|bs(Pass/Fai0 PASS For 3 bedrooms Fluid depth in absorption field before test 14 in. Water added 613 gal. New depth 28.5 in. Elapsed Time: 914 min. Final fluid depth 20 in. Absorption rate >= 458f U.p,d. . Any rejuvenationtreatment (past 12nno.)(Y/N&type) SEPTI CLEAR |fyes, give date 8/18/11 .� �4 k�"A&� Date installed Size in gallons Manhole/Access (Y/N "Pump onn level at—in. "Pump off" leveL,7t---- water alarm level at I Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *90' Absorption field on lot *90' Public sewer main N/A On adjacent lots On adjacent lots 100'+ 100'+ Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ — Absorption field 5'+ Water main N/A Water service line 10'+ - Surface water 100'+ Wells on adjacent lots ---. 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ — Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ —Driveway, parking/vehicle storage **0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ *WR990044 "PORTION OF CRIB UNDER DRIVEWAY/PARKING AREA. 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 JEFFREY A. GARNESS Date (Rev. 11/05) ....... ... 6 Gar f r.e y,' ess: 79y Zero fess*'Olidll® Municipality of Anchorage Community Development Department Development Services Division C T Y On -Site Water and Wastewater Program 5 r, 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 Z= www.muni.org/onsite (907) 343-7904 Certificate of On -Site Systems Approval 4 111438 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block D, Lot 3 of Glacier View Heights subdivision. This inspection revealed a nitrate concentration of 5.92 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water fron-i private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 470OElmore Road P.D.Box 1ASG5U Anchorage, AKAQ51Q'8G5o vmwwmuni.nrg/onaiha (907) 343-7904 CERTIFICATE OF ON—SITE SYSTFMs APPROVAL FOR A S|NC|F FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION Expiration Date: Complete legal description GLACIER VIEW HEIGHTS; BLOCK D, LOT 3 Location (site address) 22354 GLACIER VIEW DRIVE *ANCHORAGE, AK 99577 Current Property cxwner(s) KATHY MCCUEDay phone 317-2818 Mailing address 22354 GLACIER VIEW DRIVE *ANCHORAGE, AK 99577 Lending agency Day phone —Mailing address ~ ' — 223 48S3 'Real Day phone dress M� �ailing.�� 110 W. 38TH AVENUE SUITE 100 *ANCHORAGE, AK 99503 Unless otherwise requested, CO3Awill beheld byDSD fxpickup � ^ `2�^ NUK0BER'QFBEDROOKOS: 3i___ � 3' TYPE QFWATER SUPPLY: TYPE C)FWASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage Individual Holding tank || Community Class Well �l Community On-site { | Public Water System El Public Sewer | | The Municipality ofAnchorage Development Services Department U3S0Issues Certificates ofOn-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 | sham DSD (�erb�oabasofOn-Site 8ygtanoo wa rauppysy � � Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may boreissued with new water samples. (Certificates may bereissued for aperiod ofuphoone year with valid water samp|eo.)Certificates are validforoneyoarforpnopartiesoervedbyC1ass/\orBvve||aoropub|iuvvabaroystem. The Municipality ofAnchorage is not responsible for errors or omissions in the professional engineers work. 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE i✓ Approved for bedrooms. Disapproved. Conditional approval for 337-6179 Date t t 1-7 ft _ bedrooms, with the following stipulations: l s Ie, 01,7e- 0 1 7 e - Attachments: COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other of Quos®oo®meg," rr ®'@ ON-SITE r$6 0 WATER AND r WASTEWATER ffi PROGRAM e. h j6 By: Original Certificate Date:' (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division - On -Site Water & Wastewater Program 47OOElmore Road P.U.Box 1QOO5U Anchorage, AKQQ51S'0G5O vwww.muni.nng/onoiVe (907)343-7904 [~FRT|F|C/\TF OF ON—SITE SYSTFms APPROVAL CHECKLIST Legal Desorption: GLACIER NBN HEIGHTS; BLOCK D LOT 3 A. WELL DATA Well type _PRIVATE _ |fA.B.orCprovide PVVS|D# /N/A_ Date completed _9}/24/87_. Sanitary seal (Y7N) YES Total depth 8{}_ -ft. Cased to 80 ft. FROM WELL LOG Date oftest 9/24/87 Static water |ova| 4_ft. Well production 12 g.p.m. � WATER SAMPLE RESULTS: - Parcel |D: 050-491 —25 Wires properly protected (Y/N) Casing height (obovegnzund) AT INSPECTION 9/19/11 45 � YES YES 12+ in. ColiformO coloniesMOOnd. Nitrate 5-29 mg./L. Collected by: GEG, Ltd. Arsenic: ND ug./L. Dateofeampks: 8/18/11 B. SEPTIC/HOLDING TANK DATA TankTvpe/K8eteho| SEPTIC/STEEL Date installed 1974 Tank size 1000 gal. Number ofCompartments _'i_ C|eanoute(YYN) YE ""/ . Foundation cleanout (Y7N) ) Depression over tank (Y7N) NO High water alarm (Y7N) 8/18/�O11 JR'S PUMPING Dateofpumping ' ' Pumper C. ABSORPTION FIELD DATA *BASED ON 10/1/7+ SOIL 0Q 1**BELOW EXIST Date installed 1974 Soil rating (Q.p.d./ft\zr *117 System type CRIB Length 19 ft. Width 17 ft. Gravel below pipe S ft. Total depth **12.33 ft. Ef[ absorption area 432 ft^ Monitoring tube YES Depression over field NO Date ofadequacy test 9 Reou|bs(Poas/Fai|) PASS For 3 bedrooms Fluid depth in absorption field before test 14 in. Water added 613 Oe|. New depth 28.5 in. Elapsed Time: 914 min. Final fluid depth 20 in. Absorption rate >= 450f g.p.d. Any rejuvenation treatment (past 12rno.)(Y/N&type) SEPTI CLEAR ifyee.givedota 8/18/11 *BASED ON 10/1/74 SOIL LOG. Date installed Size in gallons Manhole/Access "Pump on" level at—in. "Pump off" level at �--Jfi-. -----Fiigh water alarm level at Cycles tested Meets alarm & circuit requirements? 7F. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *90, On adjacent lots Absorption field on lot *90, On adjacent lots 100,+ 100,+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100,+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ — Absorption field 5'+ Water main N/A Water service line 10'+ - Surface water 100,+ Wells on adjacent lots 100,+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ — Building foundation 10,+ Water main N/A Water service line 10,+ Surface water 100'+ —Driveway, parkinglvehicle storage **0' Curtain drain NONE KNOWN Wells on adjacent lots 100'+ IB UNDER DRIVEWAY/PARKING AREA. I certify that I have determined through field inspections and L Y. V, review of Municipal records that the above systems are in ........ conformance with MOA COSA guidelines in effect on this .......... O date. e f y A,.- G, o �n e s s. Engineers Printed Name JEFFREY A. GARNESS Q 9�.1 CE -7 53 Date P rofesslono\ -I COSA Fee $ 9 Waiver Fee $ Date of Payment Date of Payment Receipt Number CA. Receipt Number (Rev. 11!05) Municipality of Anchorage Community Development Department Development Services 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 # 111428 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block D, Lot 3 of Glacier View Heights subdivision. This inspection revealed a nitrate concentration of 5.29 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. L=95.1 1' 9 R==360,00' A= 1 F081 4" 0 L=24.46 R=170.00' A=8'14'38" 23.2' �C- .).- TH 49 M cheat J, 1omeQ No. LS -5318 NOTE: 1) Bearings and distances are as per Plat No. 70-151 w4� E N T E LEGEND M TELECOM. PEDESTAL Surveying - Engineering SURVEY CERTIFICATION: SENTEC has conducted c7D., Ell EC POLE 2525 Gambell Street, Suite 200, Anchorage, Alaska 99503 a physical survey of this property as shown on this Tele: (907) 563-3835 Fax: (907) 563-3817 drawing and that the improvements situated thereon are 0 FOUND 5/8" REBAR within the property lines and no encroachments exist Q WELL AS BUILT RECERTIFICATION OF: other than noted, Lot 3, Block D, Glacier View Heights EXCLUSION NOTES: It is the- owners —responsibility -- — — — — — -- Subdivision, Eagle River, Alaska to determine the existence of any casements, covenants, FENCE or restrictions which do not appear on the recorded t� 7 jc�� �F�v DATE ctobe, 29-. 0 2011 V=40� E'--MAII sentec@eeiteam 'Com subdivision plat. NOTE: Under no circumstances —R Gwlb NAME" should any data hereon be used for the construction or 09-5178 GAMMY [HkKmay JAN MJH SW 0059 rompAG',.2 592137-38 for the establishing of property lines. Parcel I.D. HA\# 1. GENERAL INFORMATION Expiration Date: Complete legal description GLACIER VIEW HEIGHTS SUBDIVISION; LOT 3, BLOCK D Location (site address or directions) 22354 GLACIER VIEW DRIVE * EAGLE RIVER, AK 99577 Current Pmpertyowner(s) KAY SHEARER Day phone 694-8449 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 22354 GLACIER VIEW DRIVE * EAGLE RIVER, AK 99577 Day phone LES BAILEY wl PRUDENTIAL VISTA 16635 CENTERRELD DRIVE * EAGLE RIVER, AK 99577 Unless otherwise requested, HAA will bmheld byDSD foroickuo 230-8628 2. NUMBER OFBEDROOMS: 3. TYPE QFWATER SUPPLY: TYPE C1FWASTEWATER DISPOSAL: Individual Well 0� �� Individual On-site Individual Water Storage Individual Holding tank CommunityC|oss___VVeU F� Community On-site F� Public Water System 0 Public Sewer El 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 inthe State ofAlaska. Certificates ofHealth Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-lamily on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request tohomeowners. Certificates ofHealth Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may bereissued with new water samples. (Certificates may bmreissued for speriod ofuptoone 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 nv�c_, at, or prior to closing for the engineering services provided. MINVINIATMATHIA111 121&14�91 0 As certified by my seal affixed hereto and as of the validation date shown below, / verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply andlor 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 informa tion" obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply andlor wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. —6179 Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. 337 Name of Fi Phone Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. A WWC, 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 it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. .7 13 07 Date Conditional approval for bedrooms, with the f1lowing stipulations: 0 A A U N--6,rl E• - WATER AND VVA61 FWATER PROGRAM z Attachments: ' HAA Checklist Manitenance Agreements J 'ZNT 2) ..... ........ Septic System Advisory Supplemental Engineer's Reort Weil Flow Advisory Other By:Original Certificate Date: -7 C tRcv. 12/01) Legal Description: A. WELL DATA HEALTH AUTHORITY APPROVAL CHECKLIST GLACIER VIEW HEIGHTS S/D; LOT 3, BLOCK D Parcel ID: 050-491-25 Well type _PRIVATE_ If A, B.orCprovide PVVS|O# N/A Date completed 9\/24/'1 98[7 Sanitary seal (YYN).YES - Total depth 8K}ft. Cased to 80 ft. Date of test FROM WELL LOG 9/1987 _Static water level 45 Well production WATER SAMPLE RESULTS: Coliform - colonies/1 00 ml 12 ft. am Well Log (Y/N) Wires properly protected (YYN) Casing height (above ground) AT INSPECTION 6/18/2002 25 ft. 475 YES YES l2+ in. Nitrate _3.9u4mg/L. Other bacteria I_-co|onieo/100 mi Arsenic- mg./L. Date of sample: Collected by: AKYVYVC B. SEPTIC/HOLDING TANK DATA TonkTyp*/Mab*ha| STEEL Date installed 1974 Tank size 1000 gal. Number ofCompartments _'�_ C|eanouts(Y7N) YES Foundation cleanout (YYN) YES Depression over tank (Y7N)_N{}_ High water alarm (Y/N) NZA Date of pumping Pumper JR'S PUMPING ^ C. /\8SORPT|ONFIELD DATA CRIB C/O EXTENDS ONLY 58^ BELOW TOP OF WHERE PIPE ENTERS CRIB , ^^ 7 BELOW TOP OF WHERE PIPE ENTERS CR/8 SYSTEM 90% FULL Date installed 1e74 Soil rating /g.p.d./ftzo117 System type CRIB Length ly ft. Width 17 ft. Gravel below pipe tift. Total depth 12Lft. Eff.absorption area 432 ft' Monitoring tube *YES� Depression over field —NO _' Date ofadequacy test Resu|ta(P000/Fai|) PASS For 3 bedrooms Fluid depth in absorption field before test **51 in. Water added 325 gal. New depth 5{8_in. Elapsed Time:�*^^O min. Final fluid depth 53 in. Absorption rata >= 450+ g.p.d, Any rejuvenation treatment (past 12mu.)(Y7N&type) NONE KNOWN |fyes, give date –____ ***CRIB FULL *^**983 MINUTES RECOVERY AND LEVEL HAD DROPPED TO 51" 450+ GPD D. LIFT STATION Date installed Size ingallons ________ "Pump on" �C lev jn LDDatum-�ed______- ` E. SEPARATION DISTANCES *SEE ATTACHED LETTER SEPARATION DISTANCES FROM WELL 0NLOT TO: High water alarm level at in. Meets alarm & circuit naquiremanta?______. ��P4 �����a��� Septic tank/lift station kd On adjacent lots Absorption field onlot - Onadjacent lots Public sewer main m Public sewer manhole/cleanout Sewer /septic service line 2 5'+ Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line ' Absorption field Water main Water service line lO'+ Surface water lUO'+ Wells onadjacent lots --_1{X7+�_- SEPARATION DISTANCE FROM ABSORPTION FIELD ONLOT TO: Property line lO'+ Building foundation 104- Water main Water service line 10+ Surface water ' Dhveway, parking/vehicle storage Curtain drain NONE KNOWN Wells onadjacent lots 1004' 100'+ l0O'+ UNK F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review ofMunicipal records that the above systems are /n conformance with MOA HAA guidelines /neffect onthis date. EngineehsPhn&adNmme JEFFREY A. GARNESS Date 3 62 _ Date of Payment 02, Receipt Number Waiver Fee $ Date ofPayment Receipt Number , rel ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 15, 2002 Municipality of Anchorage On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Glacier View Heights Subdivision, Lot 3, Block D To Whom It May Concern: Attached is the HAA package for the subject property. As per your direction, we obtained water samples from the inactive well. The water samples were taken by Arctic Pump & Well Service (Jim Sullivan). The lab results indicated nitrate levels of 0.213 mg/L and no bacteria were present. Attached is a copy of the as -built survey prepared by Shane Holt, L.S. Per the survey, the approximate separation distances between the wells and the septic system are summarized as follows: Per Shane Holt Survey Well #1 to septic tank: 90 feet Well #1 to perimeter of log crib: 90 feet Well #2 to septic tank: 83.5 feet Well #2 to perimeter of log crib: 80.0 feet Per Previous HAAs/waivers 97 feet per Lou Butera, 1999 95 feet per Lou Butera, 1999 85 feet per Lou Butera, 1999 *100 feet per all previous documentation * Lou Butera, P.E.'s 1999 drawing that was submitted to the MOA showed the edge of the crib & the septic tank approximately 83 feet away from the old well (well #2). We are requesting that the all of the waivers be amended to the separation distances shown on the Shane Holt, L.S. Survey. Water quality data from well #2 indicates that there as been no adverse impact on the groundwater quality due to this encroachment. The water quality in well #1 is essentially the same as it was in 1999 when Lou Butera, P.E. applied for an HAA. If you have any gpeAons, please contact me at 337-6179. PIE., M.S. 6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com Cz. 0 0 v C MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section co P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# HAA # 1. GENERAL INFORMATION Complete legal description 7' 7 /Y/-,-4- P Location (site address or directions) C5 114 e, 7- ... - 2,,, ;� L.�,- e, - Property owner -2 & - 1-/ Day phone ? s Mailing address SSI -72 Lending agency __ phone —Day Mailing address — Agent Day phone.... Address -75- S-Tf le -3 —72 Unless otherwise requested, HAA will be held for pickup. P�- NUMBER OF BEDROOMS: Individual well 2L Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing.to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site — 11<1 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 As certified by my seat 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 re 6h S7f this inspection. EAGLE RIVER, AK 99577 Name of Firm . f4 -J' P_ 0. BOX ZZ3294 Phone 694-5195 Address tp Engineer's signature Date X Approved for bedrooms. to]�# 0 *�_ A•I IN Conditional approval for Additional Comments M iffft bedrooms, with the following stipulations: Date 7-- 2 7-- FF 72-025 (Rev. 1/91) Back MOA #21 �����o����� ������ Municipality of Anchorage JUL 14 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALITY OF ANCHO O(*D ENVIRONMENJJI�JRVICESDI 825 L Street, Room 502 - Anchorage, Alaska 99501 - (907) 343- . Legal Description: Parcel iD.- Well type If/\B'orC,attach AOECletter. AOECwater system number '-`/o Lon present ` , Y Date _completed ___� / ft°7" Total depth Cased to E>O71, ' Casing height (above ground) Sanitary seal (YYN) Y Wires properly protected 0YN\ FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date ufsample: AT INSPECTION /o-�f OUherbac1eha Date installed Tank size_Number of Compartments C|eamouts Foundation cleanout (Y/N) Depression (Y/N)1/High water alarm HYN> Date ofPumping /u- IS Pumper Date installed SoU radng or 8ymtemtype '=''-7~ 1�5 Length/7—Width7 Gn�othickness below pipe 4 ' Total depth Effective absorption area Monitoring Tube present Depression over field (YYN) RM Date of adequacy test (—bedrooms Fluid depth in absorption field before test (in.); Immediately after 1/rO gal. water added (in.): Fluid depth (ins) Minutes late Peroxide treatment (past 12 months) (Y/N) /V14-/ 72-026 (Rev. 3/96)° Absorption rate = 7^V4 -e -p.d. ' If yes, give date D. LIFT STATION Date installed Manhole/Access High wate larm level at* Cy s tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: it A Jt ---r Septic/holding tank on lot see ,, ,f_,.,zOnadjacent lots "Pump off" level at* Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Lift station NA/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line �/-­ " —Absorption field Water main/service line 7-1-- " Surface water/drainage " Wells on adjacent lots 3 Q Qnx - *10 L91 6�1 MAN U*1 = IS 01TUTAX, 00 040"0 Property line -f-/0 Surface wateriir Curtain drain i Building foundation /,5- Water main/service line Y /4,) 1, Driveway, parking/vehible storage area f39,re u✓1211y 4,-ely Wells on adjacent lots f r e-, , i certify that / have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. S i g n a t u r e -_-- Engineer's _ - n — Engineer's Name -, Ze Date 7– 1y_ - HAA Fee Date of Payment Receipt Number 72-026 (Rev. 3/96)* )r Ma-AbQ s are 0 Louis A. Butera 4: - CE -6736 Waiver Fee $ rc-,, Date of Payment ReceiptNumber July 30, 1999 Lou Butera, PE Eagle River Engineering Services PO Box 773294 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 3 Block D Glacier View Heights Waiver Request #WR990044 Parcel ID #050-491-25 HA990349 Dear Mr. Butera: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 98.0 feet. The approved separation distance from the private rivate well to the leachfield is Wfeet.. q' 0 "1 3, /-. This waiver approval applies to the existing on-site wastewater disposal system to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On -Site Water Quality Program / I- "'i - it MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# -c PID# 1 11 C) 050-491-25 Permit # Date Received: July 14, 1999 Legal Description: Lot 3 Block D Glacier View Heights Engineer: Lou Butera, PE, Eagle River Engineering Services PO Box 773294. Eagle River. Alaska 99577 Applicant: James & Dawn Davis Waiver Requested: Private well to septic tank of 98 feet: private well to the .1eachfield of 95 feet Zjjz2&t-,,je 10 Criteria: 1. Geology:" A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: X Waiver is NOT Granted: List Conditions or Reasons for above: 5'F -,F jqAe-",=49 Date: 7-1 f -IT By: PA Al Name of Reviewer Rec #: 05078/6679 Amount: $ 920.00 Date Paid: 7-14-99 ,Z WAIVER to 7- FoR L of .7 8LK P &L,961ER VIEW IIE16117,r W111VEK PEIUEir ! t' IS AAIP -/C SY`srpm rs c& Srj?ue7-e L7 /A/ A 6P TY f satL rm*r /s Pied iqdr' A.4/de ('LE 61VEAI rkE P.4er TH.4r r/.Ic CRIO is OPEJ?ArlA16 197' J�",P%® srOr7r- 4reie L. F vF L 19Ala 13 Tats CA'10 tt rqt, n ro% <rfirtc Ea. 7*6e L�v�4 f�%t7te�aT�s T�F�+F � 5 �! A,9&d?uq7,&- r w6LL /A/ OAFSrt6Pty' WAU CaA.trRkei,&o !Al Spur 19,67. i Af tr W 1+r M IQ f r m ra iz rj C om Es F,?v,4 P� r`" 5'0 `— 70 ;v,*7'eR LEveL 4vv rm& a o)l riiE tvczz- gcrf PmeA., rme &,8-dL Flow rr— g r- u+&5 PE -Foe ,rp /2 6 ION L.►rx A Sri dt.taEo Y2.0IeaR, 0r f S/// /o-, PleArrf rl-f E iA► T C&^t 6' P Rleo^,L 4 e 0AI Ft C0 )4 Q u t Fj-- ,R tOx`R.+r'l� L u A-P4r R 'r slurp Tk.F-cL LaG Aces AlOr #OWEVER /VP/cnrF SiteN 7 -MR uf,# -501L ljvt?tzv4tS pg$ -41 r&'Et9. 7-14 Ir 4,e:1,G 1,,6 FOR 7 -HE tstA I -PLL Agoas 5yo S oA(P-r 5/try ®rLf PR IOW r -o EAYe vu,, r"Svi i, i.tvrne. 1&� 6 rem PLEj FROM 7/4E" i Et.- C ? k C- LL le Ao-O Pt9-C r•P-Fet* -4NV N llRi°1 j'&.Y Atte' rYPte4L cpcTK_' t.EdGS f4,,' 61,9[tCR V+Eh, f/fort 47' Li9w4'-rvF4S. 32 I V. R/ 0. 1:201 A/ r.S k/ 14 r T we sa/re TBU'/ 6i?4AEL 7-,* j-0 W vm va W X ZKI x FERNS oil- I ry oaatlz A75- IA�'JWME Colvfele,1.471✓E 'hr% i POZ 0 iv rn L .57 fr P-4 R J; 7-t 19 /V 29 -Y 2 Ir 2.9 ..... ..... 6RA-mT 1,wm'vJ=-9 r,agle River i5 ga•g Services Louis P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax July 11, 1999 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Glacier View Heights, Lot 3 Blk D Waiver & HAA Application Dear Mr. Cross: -3, MUNICIPALITY QP ANCI-IORACE ENVIROMENTAL SERVICES DIVISION The septic system for the above referenced lot requires a waiver of well to septic tank distance of 98' and well to leachfield of 95 feet. This lot has had previous health approvals with the distance listed as 100 feet, cleanout pipes are located at 100' separation. The septic system was installed in 1974 with municipal inspection at that time. The original well was located at 88' from the septic tank and a waiver was applied for in 1985 by S&S Engineering. A new well was drilled in 1987 and was logged as 80' total depth being perforated at the 50 foot level with a flow rate of 12 GPM and a 45' static water level. This is the well that requires a waiver. The well log is attached. Our flow test showed a static water level of 39' and a stabilized level of 47 feet at 8 gallons per minute. Soil rating for the septic system was a sandy gravel with silt and an average soil rating of 117 SF per bedroom. The property is sloping steeply to the south at an average grade of 25% or greater. A site plan detail is attached for the system layout Granting this waiver will have very limited impact on the well for the following reasons: 1. The well is located at the same elevation as the septic system on a steep slope that would direct surface and subsurface flow away from the well location. 2. The water sample history since 1987 shows no coliform and a low nitrate level. 3. The distance being waived is a small amount. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. `r \1999\98-071-wAv- C) �8 7- C: Ltd. CT&E Environmental Services Inc. ..... CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Parameter 985808001 Eagle River Engineering Lt 3 B D Glacier View Hts Lt 3 B D Glacier View Hts Drinking Water 9 Client PO# Printed Date/Time 10/13/98 17:29 Collected Date/Time 10/05/98 15:40 Received Date/Time 10/06/98 09:50 Technical Director: Stephen C. Ede Released By Results POL Units Method Nitrate -N 2.83 0.100 mg/L Total Coliform 0 col/100mL EPA 300.0 SM18 92228 Altouabte Prep Analysis Limits Date Date Init 10 max 10/08/98 10/08/98 GCP 10/06/98 KAP /1 CT&E Environmental Services Inc. j La bo ra t o r� Division Drinkinc Water Analysis Report for Total Coliform Bactencho ria Anchxo,Potter Drive Arage. AK 99518-1505 RE4D L. 'STR UCTIOA'S 0X PEVERSE SIDE BEFORE COLLECTI.VG S,+vFLE Tel: (907) 552-23=3 Fax: (907) 561-5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE CO.NIPLETED BY L.ABOKATORY ❑ PUBLIC WATER SYSTEM I.D. T I ( I I Analysis shows this Water SAMPLE to be: �( PRIVATE WATER SYSTEM Satisfactory �f Send Results �2 EJ Send Invoice W lIM JTtT .\Y.ylq.µ.r �\y.y `N•.1 nM� ani, ume<r ru. �mwr Date Tim. e: l,ty >Ylr M C. Unsa.ista..tory Sample over 30 hours old. results may be unreliable ❑ Sample too long in transit-, sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via speci 1 d^livery mail.- Date Received Time Received ❑ Send Rerulu ❑ Send Invoice Analysis Bevan �-1 W .\IWm[ ANJ6J I C. Comments: Analytical ;Method: Membrane Filter ❑ MMO-,NiUG Number of colonies/ 100 ml. Result* .analyst 985808 r O � 9ll Fbks Jun Cl SA,IvIPLE DATE: - Date Tim. e: Client notified of unsatisfacton• Month Dav Year SAMPLE TYPE: % Routine ❑ Treated %Vatcr ❑ Repeat Sample (for routine sample Untreated Water with lab rcf. no. ) ❑ Special Purpose Time Collected SAMPLE LOCATION Collected By Picaae Pnm Comments: Analytical ;Method: Membrane Filter ❑ MMO-,NiUG Number of colonies/ 100 ml. Result* .analyst 985808 (-t7 Fbks Jun Cl Faacd Date Tim. e: Client notified of unsatisfacton• results: Phoned Date: BACTERIOLOGICAL WATER ANALYSIS RECORD N1,,N10-SMUG Result: Total Coliform E. Coli Membrane Filter: Direct Count " Colonies/100 ml Verification: LTB Fecal Coliform Confirmation BGB COLIFIRM Spoke with Time: Final ,Nlcmbrane Filicr Results O Coliform/100 ml Reported By Date 10 0FOV Time / Ze "lihrs UM - IAA" M^eTn/ 11 Fu:cd ' MUNICIPALITY DFANCHORAGE DEPARTMENT OFHEALTH & HUMAN SERVICES Division of Environmental Services --=-~ On -Site Services Section P.O.Box 1S8G5O Anchorage, Alaska 89519-6650 348-4744 CERTIFICATE DFHEALTH AUTHORITY APPROVAL FOR ASINGLE FAMILY DWELLING Parcel iD.# Complete legal description Lot 3; Block "D"; Glacier View Heights Location (site address 0[directions) 193 H Myrtle Drive Property owner Karen Cowles Day phone Mailing address Lending agency UaypOone Mailing address Agent -Day phone Address Unless otherwise requested, HAA will b8held for pickup. 2. NUMBER OF BEDROOMS: _1 Individual well XX Community well Public water NOTE: /fcommunity well system, provide written confirmation from State ADEC8tteS ing to the legality and status of system. Individual on-site _XX____ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State A DEC attesting to the legality and status of system. 72-02 m= m o"m MOA 021 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 ohOxvs 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 furtherverify that based on the information obtained from the Municipality 0fAnchorage 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, OndinnnC8S. and regulations in effect on the date of this inspection. Name OfFirm S & S ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address I:Pqi;- Rlvg-r, Alaska 99577 Engineer's signature XL Approved for _�>_ bedrooms, Disapproved. Conditional approval for Additional Comments ATw 4,4 r4 4 bedrooms, with the following stipulations: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:1-H-S-_42 Parcel I.D. Well type A, B, or C, attach ADEC letter. ADEC water system number . . ... ..... Log present ON) \1 Date completed Driller Totaidepth— �C>' Cased to t5c� Casing height Static water level - 7--,q -e I Wires properly protected O/N) Well flow 17-0 — 9 -p -m. Pump level 12 P_ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent lots — Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: C'o Coliform () Nitrate 41 Other bacteria Date of sample: Collected by: S & S ENGINEERING - 17034 Eagle River Lo*p 611 k B. SEPTIC/HOLDING TANK DATA %rk SbA,T.A," I Eagle River, Alas a 99577 Date installed \ ak-11A Tank size \c>� 0 - . Compartments _Z_ Cleanouts ON) Foundation cleanout (Y& Depression/(Y High water alarm (YQ Alarm tested (Y/N) at of pumping -I -- Pumper _5 PQ 6 4 - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /oto , I— On adjacent lots /00 14- - Foundation- /of To property line /61 Absorption field 16f —Water main/service line /6 Surface water/drainage LOO td 72-026 dl - 72 -026 (Rev. 7/91) Front CONTINUED ON BACK PAGE rn Z AT INSPECTION :5 ;11� �: C 0 Z Z Z C,, 7. 9. P. M<. Mrs Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent lots — Public sewer main Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: C'o Coliform () Nitrate 41 Other bacteria Date of sample: Collected by: S & S ENGINEERING - 17034 Eagle River Lo*p 611 k B. SEPTIC/HOLDING TANK DATA %rk SbA,T.A," I Eagle River, Alas a 99577 Date installed \ ak-11A Tank size \c>� 0 - . Compartments _Z_ Cleanouts ON) Foundation cleanout (Y& Depression/(Y High water alarm (YQ Alarm tested (Y/N) at of pumping -I -- Pumper _5 PQ 6 4 - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /oto , I— On adjacent lots /00 14- - Foundation- /of To property line /61 Absorption field 16f —Water main/service line /6 Surface water/drainage LOO td 72-026 dl - 72 -026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) — High water alarm level Manhole/Access (Y/N) Meets MOA electrical code (Y-Pq) SEPARAT ISTANCE FROM LIFT STATION TO: "Pump off" level at Cycles tested Surface water E. ENGINEER'S CERTIFICATION certify that / have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspe6�tion. S St S ENGINEERING Signature 17034 Eagle River Loop Road No, 204 River, Alaska Engineer's Name Date Of 4WV HAA Fee $ 7Q, Waiver Fee: $ Date of Payment q Z- Date of Payment Receipt Number �z-q xr4/791) Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Date installed Soil ratin4lc System type iii Length — -Width 1-1 Gravel thickness Lit Total depth I Total absorption area Cleanouts present (WN) —*— Depression over field (Yd9P Date of adequacy test /- Results fail) for bedrooms Peroxide treatment (past 12 months) (Y& N/0'149— A--:A1QtJ1J If yes, give date aZ1061,X S-Jtt-s t--J>C^ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /L20 (4- On adjacent lots /oo r4- Property line To building foundation —It To existing or abandoned system on lot On adjacent lots. 4- — Cutbank 1�1 t,- Water main/service line Surface water h- Driveway, parking/vehicle storage area ARFEPY- 156�% 34�92- Curtain drain E. ENGINEER'S CERTIFICATION certify that / have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspe6�tion. S St S ENGINEERING Signature 17034 Eagle River Loop Road No, 204 River, Alaska Engineer's Name Date Of 4WV HAA Fee $ 7Q, Waiver Fee: $ Date of Payment q Z- Date of Payment Receipt Number �z-q xr4/791) Receipt Number 72-026 (Rev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPA RTNIEEST 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 /'7 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) %er (b) Applicant Name Telephone: Home Applicant Address v -F-, f". > A, V_ (c) Applicant is (check one): Lending Institution Owner/buildQ4_ Buyer 13 Other 10 fexpiain); (d) Lending Institution --------- relephone 1"L I Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 1P WER, ALASM IOKOW Ci Ct 2. TYPE OF RESIDENCE Single -Family o Multi -Family El Other Number of Bedrooms — — — 3— — 3. WATER SUPPLY Individual Well Pd Community Public Note: If Community well system, must have written confirmation from the State Department of ErVvironmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Pf Public 0 Community 0 Holding Tank El Note: If community well system, must have written confirmation from the State Department of Envuronmental Conser4ation attesting to the legality and status. Page 1 of 2 vvo t�K 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my sea[ 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 bedroorns 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 Telephone Address 1i'30" im 6. DHEP APPROVAL Approved for L-0 bedrooms by Date Approved 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 OF ANCHORPGE H�LJH & Of �Rc �4MFNTINL aCTION MUNICIPALITY OF ASC! ORIC )A (MA) ENNIF'O HEALTH AUTHORITY APPROVAL (HAA) n CHECKLIST - FEBRUARY 1984 J 264-4720 z VD Legal Description: -3 131k A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present Date Completed 7 Y i e I d Total Depth Cased toy Depth of Grouting — Static Water Level a e Pump Set At 14' 41-1 Casing Height Above Ground — Sanitary Seal on Casing 6(y N) Electrical Wiring in Condui N) Depression Around Wellhead (Y(ON Separation Distances from Well: U To Septic/Holding Tank on Lot ;"On Adjoinfi4g"Lots To Nearest Edge of Absorption Field on Lot /00 On Adjoining Lots P I - To Nearest Public Sewer Line To Nearest Public Sewer IJ I Cleanout/Man hole To Nearest Sewer Service Line on Lot Water Sample Collected by Date Water Sample Test Results Comments Date Installed Size 61 No. of Compartments Standpipe C(-YY)N) Air -tight Caps ON) Foundation Cleanout (Y/i Depression over Tank (Y N Date Last Pumped 7 Pumping/Maintenance Contract on File (Y/N) for �J Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Per (Y/N) Separation Distances from Septic/Holding Tank: P L'U" To Water -Supply Well To Building Foundation 0 To Property Line To Water Main/Service Line Course To Disposal Field To Stream, Pond, Lake, or Major Drainage A /-I- /--le 0 r_a 410A 1-00i< Comments 09 0 A - Page 1 of 2 72-026(11184) Soils Rating inAbsorption Strata A Type ofSystem Design Date Installed ZIF 7 4Z Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Presen�'(Y)N) Depression over Field (Y No Date of Last Adequacy Test Results of Last Adequacy Test -7/ C -70- -r 1-�2 Separation Distance from Absorption Field: To Water -Supply Well 14,20/ Lot � ToProperty Line ToExisting o/Abandoned System on ' ToWater Main/Service Line ToCutbonk(if present) ToS1ream/Pond/Laho/orMajor Drainage Course ^J IJ / To Orivewoy, Parking Area, or Vehicle Storage Area Comments - Date Installed Size in Gallons Dimensions Manho|*/Auoeon(Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (y/N) Tested for umping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments Check Permitted Bedroom Rating Against HAA Request °° I certifythat|h hooked verified, orconformed to all MOA and HAA guidelines inoffeo onthe daUaofthis inspection. Signed _ Receipt No. ^ Date of Payment Page 2 of 2 o*o n`mw -�.�ot- " Z, �A 7, L U Z_L;:, __ DLPARTFAENT OF HEALTH AiNM POTI EC TI ON August 13, 1985 Robert A. Shafer S & S Engineering SRB 196X 0 rD '2-- Eagle River, Alaska 99577 Subject: Lot 3 Block D Glacier View Heights Subdivision Dear Mr. Shafer; Your request for a waiver to 88 feet from the septic tank to the well on the above lot has been approved. This waiver is valid for a three bedroom single family dwelling. Sincerely, Susan E. Oswalt Acting Program Manager C On-site Services SEO/pah V016 ep, MUNICIPALITY OF ANCHORAGE ROBERT A. SHAFER ENVIRONMENTAL - PROTECTION CIVILENGINEER 694-2979 x r) 0 July 27, 1985 ����E RIVER, A�PS�� RECEIVED HEALTH AUTHORITY APPROVALS Municipality of Anchorage Department of Health and Environmental Protection 825 L Street - Anchorage, Alaska 99501 'g SEWER & WATER, MAIN EXTENSIONS REFERENCE: Lot 3; Block D; Glace -r -View Heights Subdivision SEWER &WATER e. Request you issu.-the attached Health Authority Approval INSPECTION and approve a ---waiver for the existing septic tank located 88"feet from the private well on the referenced property. SYSTEM DESIGN The existing on-site waste water disposal system was installed in 1974 and was approved by the MOA on August 19, 1976. It is our opinion that the horizontal separation WELL INSPECTION distancesrescribed b 18AAC72.021 are not required & FLOW TEST p y q in this case. The existing well is 275 feet in depth and extends into bedrock of 108 feet. The static water level is approximately 180 feet from the surface. The topography in the area is such that surface flows SITE PLANS and the tilt of bedrock, if any, would not be in the direction of the well. Included for your review in addition to the Health ROAD DESIGN Authority Application are the following documents: A. A copy of your approval dated August 19, 1976 SOIL TEST B. Copy of the well log C. A recent coliform bacteria analysis showing PERCOLATION satisfactory results TEST If you require additional information, please contact US. STRUCTURAL& S' cere y,'' tt t MECHANICAL k INSPECTIONS r�t s R BERT A. SHAFER, P.E. ASjss ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA 99577 HEALTH AUTHORITY APPROVALS August 11, 1985 Municipality of Anchorage SEWER &WATER Department of Health and Environmental Protection MAIN EXTENSIONS 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 3; Block D; Glacier View Heights Subdivision SEWER & WATER INSPECTION ATTENTION: Susan Oswalt This letter is intended to supplement our submission SYSTEM DESIGN of July 27, 1985 for a Health Authority Approval with waiver on the referenced property. At your request, the septic tank was excavated and water tight couplings were installed on the entrance WELL INSPECTION - and the outlet to the septic tank. & FLOW TEST If we may be of additional service, please contact US. SITE PLANS Sin rel , ROAD DESIGN 0 E T A. SHAFER, P.E. S/ss SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN SRB 196X EAGLE RIVER, ALASKA 99577 ROBERT A. SHAPER CIVIL ENGINEER 894-2979 M#. D that surveyOf # 1 hereby. C01 tA and— de on improvementsSubdiviSiOn ithin the property lines thattheproperty # lying adjacentthereto, N ,h on the and do not adjacent # # oft Property # that # # # the premises in # # that there are $s indicated 'd Pr# }' nts, on sat lines or # ,s. hereon. #r xCONSTRUCTING ENGINEFAS- INC. SAA B ., ArKhormP, Alaska 99507 Municipality of Anchorage MEMORANDUM DATE: November 10, 1982 TO: Niki Strickland, Child Care Specialist FROM: Associate Specialist SUBJECT: Lot 3 Block D Glacier View Subdivision Glacier View Pre -School On November 9, 1982, 1 inspected the sewer and water facility -es at the subject school. The following descrepancies were noted and will need to be corrected: (1) The well is only 100 feet from the leaching area. The leaching area will need to be relocated 150 feet or 200 feet away from the well unless a waiver can be obtained from the State of Alaska, Department of Environmental Conservation. (2) The septic tank is 1,000 gallons and is inadequate for the size of house and the number of children. A 7_50 gallon septic tank, will need to be added to the existing 1,000 gallon tank (3) If the State grants a waiver for the distance between the well and sewer system, you will need to have the leaching area tested for adequacy. It should be noted that there rtia-,/ be 25 children j_n bot1h morning and afternoon classes. Prior to any upgrade of the sewer system, a permit must be obtained from this office. Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: State of Alaska Department of Environmental Conservation 437 E Street, Second Floor Anchorage 99501 91-010 (5178) Howard Wagner, Box 1549 Eagle River, Alaska 99577 DAVID A. SLEN KAMP ROBERT A. SHAFER MECHANICAL ENGINEER MUNICIPALITY OF ANCHOR?VF,IL ENGINEER 694-9055 DEPT. OF HEALTH & 694-2979 ENVIRONMENTAL PrOTECTION May 21, 1981 Dear Mr. Wagner, Reference: Lot 3; Block D; Glacierview Heights Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you had requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trenches were tested by a continuous flow of water over a period of 48 hours. The average flow for a 24 hour period was 605 gallons without any adverse effect on the system. It can be concluded from the above test that the septic tank is adequate for a three bedroom residence and the absorption trench is currently functioning adequately for the four bedroom residence located on this property. However, the system cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. Sincerely, S/ss cc: Dynamic Realty ATTENTION: Marilyn Ward Municipality of Anchorage Department of Health and Environmental Protection 0 SRB 196X EAGLE RIVER, ALASKA to Sewer Line to Nearest Lot Linc., Nearest Lot line Absorption Are -a EAGLE RIVER AREA MUNICIPALITY OF ANCHORAGE DEPARTMENt OF HEALTH AND ENVIRONMENTn� FRCILF''n", 825 L UiwwL, Anchoranw. Alaska 9 9 01 264-472() Datn Received November 2l, 1977 e 42: Time 13: T i D a t e D a t D a 0, L/4, Insp insp -Y "p ---- ------ PSqUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1 a ending institution Request: Coast Mortgage Company Mailing Address: Post Office Box 1200 Phone: 279-0665 2. Prcperty Owner: Ben if. Sevier Phone: 694-9908 Mailing Address: Star Route A Box 193H 99577 Lot 3 Block D Glacier View kotmtes Subdivision 3. Legal Doscriptinn : 4: Single Family Residence: 9x) Number of Bedrooms: -Two--------- Multiple Family Residence: ( ) Numbur of Bedrooms: --------- 5. Well System: individual W(-111 (k)( ) Permit Depth K Well Well Log on Me Construction Bacteria! ,'�nalysis 6. Sewage Disposal System: On-site System (x) Public Wlity Permit 1 n st,.� ILI. 1974 in s ta 1 lei- Tank Size Manu f ac t ur ", r 't- Septic C _0 Absorption Area soils Rato Material, 7. Distances: Well to Septic Tan'k, to Absorption Are,a . ...... to Sewer Line to Nearest Lot Linc., Nearest Lot line Absorption Are -a WUMK]PAl�YOF ANCH�RxGZ - DEPTOf HEALTH � MUNICIPALITY OF ANCHORAGE PR0/u-/�° DEPART0ENT0FHEALTH AND ENVIRONMENTAL PROTECTION S -25I, Street- Anoborage, /\laska 99501 �0V9 i 07 279-251I, ext. 224' 225 REQUEST FOR APPROVAL OF �� �u�� �� INDIVIDUAL SEVVERand VV/\TER FACILITIES ��&������ �~u 1. Type of Inspection: VA XXX FHA_____-___-CO0 2. Property Owner: Ben W. Se -vier Mailing Address:_ SBA Box I93B Eagle River, a� DayPhon�� 99O8 Ben W.--Sevier694 3. Name ofBuyer: � Mailing Address: game as above DayPhone: Same 4. Name of Lending Institution: Coast Mortgage Mailing Address: P 0 -Box 1200 Anchorage, AK Phone: 279 0665 5. Name ofRealtor orAgent: �»ue Mailing Address: Phono� O. Legal Description: Lot 3' Block D' Glacier View Estates Location:---- Mile 4.2 Eagle River Road, Eagle Ri aK S Type of Facility to be Inspected: Single family Water Supply Type of Supply: Public Utility -- |f Individual, number ofdwellings presently served IfIndividual, depth ofwell Sewage Disposal System Type of System: Public Uti|ity____. If Individual, date of installation 72-003(3176) Individual (on'site)___x- l975 p L01-1 0 C, C, T Jleg,,J- Lot 3 Block D Glacier View Estates Subdivision A.-ffadavit At`L-ached: ( ) Ap pro -v e(I 1 11 L C Let'-er A' tzichec" i._) r t e -, PRESENTATION OF ON-SITE FEE TO COMMUNITY COUNCILS by Lee B. Thur, Nov 5: Attended the HALO meeting at Amazing Grace Lutheran Church with Helen Beirne to brief the group on the proposed fee and respond to questions. There were approximately 30 people in attendance. A lot of questions were asked about the fee, what services were being provided for it and why shouldn't the present permit fees bear more of the cost of the program. Generally, the group was not supportive of the fee. It is my subsequent understanding that the group selected a committee from their membership to review the justification for the proposed fee; however, they have not made contact with this office to date (11/13). Thur, Nov 12: Attended the Hillside East Community Council meeting at the Dimond Center Library. There were 17 people present including Assemblyman Barnett. Generally, the council was not supportive of the fee. Two concerns raised were that the indirect costs assigned to the program were too high and that the cost of the present permits should be raised to fully cover the effort necessary to process them. One individual also questioned why it should cost approximately $150K (2 staff plus estimated indirects) just to administer this $600K effort. No motion relative to the fee was made by the council while I was present.