HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 1 BLK 1 LT 5Onsite File Glenn View Estates West Ph 1 Block 1 Lot 5 #051-793-05 An updated as-built survey is required prior to next COSA approval (1/14/22) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201097 PID Number: 051-793-7)W65 Dwelling: V Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New © Upgrade Name Scott Hoover A ORPTION FIELD ❑ D Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21440 Linda Jo Cir: Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 !SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original e Gravel depth beneath pipe Ft. Subdivision Block Lot Clenn View Est West #1 1 5 Fill added above original grade Ft. Gr I length N411, Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist between lines Ft. SEPARATION DISTANCES To Septic Absorption ( Holding Sewer Total absorption area Number of trenches Dist, between t hes From Tank Field Lift Station Tank Line Ftz Well NA TANK W Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100+ i i Greer 1250 Gal. Material Number of compartments Lot Linei s+ E NA Plastic 2 Foundation 10+ . l jTI ON Manufacturer Capacity j Remarks Gal. Alarm location Elec±ri lied by Installer PIPE MATERIAL HousetotankTankto D3034 drainfield D3034 Schuetter Construction Drainfield CO/MT D3034 Inspector Areterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection dates: 7/14/20 2"d 7/15/20 Location and description 3rd 4'" House door frame ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp TAJKhIt. Conditional Approval: Date 4 A C - L. Bar., llfHikiJllltf A Tt:�iltii I 'hl YlYtii a YiFk '; n 1Nit{ ![ ,NI1. , sL� �` � Q� 71-11 ��`' Septic System Approved pP Date 1 1�/ 20�a�z•4; 11,811 � Note: this approval does not include well permit requirements.F k�cv "IU41 101 X N _ bu" S"n4"Cy .X etv-mun4A;.t w aut d -/-o cuse ©vJ PvLfvc�, a,, �, 1 // Cd S� to n, -ca/ P'LC *D n4o�- COS/4. AS -BUILT SYSTEM DETAILS/SITE PLAN °Permit ❑SP201097 GLENN VIEW ESTATES WEST#1 BLOCK 1 LOT 5 PID# 051-794-05 C❑f. \ kAT VACANT A—C=35,0' B—C=22.4' A—D=38.5' B—D=25.5' A a 1250 GA y SEPTIC TANK r ��. C) � 1 PREPARED FOR; SCOTT HOOVER 21440 LINDA J❑ CIR TH ,k CHUGIAK, AK / KENNET*Ds FIELD BOOKS cDMPUTED: C�� BOUNDARY: N A DRAWN` KSD 8 x11 1•L`�, STAKING: N A CHECKED: KMD '/ • ' V4Ar ASBUILT DATE 7/25)' 5510 DWG. RLF GRID: NW14,` ACAD RLE FILE I J00 N` 2019 DRIVE SCALES 1' = 30' SCALE: NTS Onsite File Glenn View Estates West Ph 1 Block 1 Lot 5 #051-793-05 MUNICIPALITY OF ANCHORAGE mens On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://w .muni,org/onsite ' a MINCn U n On -Site Wastewater Disposal System Permit Permit Number: OSP201097 Effective Date: 5/8/2020 Work Type: SepticTank Upgrade Expiration Date: 5/8/2021 Tax Code Number: 05179305000 Site Legal Address: GLENN VIEW ESTATES WEST PH 1 BLK 1 LT 5 G:1459 Site Mailing Address: 21440 LINDA JO CIR, Chugiak Owner: HOOVER DONALD SCOTT Lot Size in Sq Ft: 40007 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: 0�0 Date:C�^� Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201097, Rebecca Carroll, 05/08/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201097, Rebecca Carroll, 05/08/20  Municipality of Anchorage ~.*" Development Services Department :~ Suilding Safety Division '~ On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.cJ,anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number:. SW000186 PID Number:. 051.793-05 "~"~ Wastewater System: [] New [] Upgrade Arctic Oevco. Inc. PO Box 3489. Palmer. AK 99645 ABSORPTION FIELD LEGAL DESCRIPTION 0.8 G,o,~ 5.88 - 6.48 1 5 Glenn View West 2.67 - 3.32 ,,. 3.18 0 - 5' F,. 90 Well: [] New [] Upgrade c.,.~.,,~ ~'~'~ I 5 Ft. 1 NA Public Water .. n 775 F~ SCH40 & F810 Ft Turner Construction,..-f. OtO O SEPARATION DISTANCES 23 septic [] Holding ri S.T.E.P. [] Other:. Tank Field Station Tank S~ Une Anchorage Tank 1250 c.~ w~ "~O0'+ ';[00'+ NA NA 25'+ Steel 2 s~,,w~, 100'+ 100'+ NA NA ~ / LIFT STATION ~,~,, 5'+ 10'+ NA NA/~ ~'~ F,,-,~ 5'+ 10'+ NA NA '.,,,.F -,',..-.,: .,~o,~-,..~.: ~'c~,, ~,,- NA '50'+ NA NA ~.F ~,', a ~ ~,,~ ~ ~ ~ n,~,,~ BENCH MARK Bottom of siding 100 FL E['~ir~'~.Stamp ~,.~, ......~/.., t~. ,~,v-.... · ....'Z~.~I. Inspecti°ns perf°rmed bY: KND Enqineerinq Developmej~t Se~ices Department Appr°val'Dates:2"1"7[T/00OZ//(~/Oj ~/1~1/[~'0~/.C .~X,'e~ ..,: 49~'l~o Kenne,h ~A.'"' ...... ~;~.. .~...o.~... ... .... Reviewed and approved by: Date: Z -,~ -~/ - ~" ""~'" · t- ~'~- "... .... AS-BUILT SYSTEM DETAILS/SITE PLAN Permit S~/000186 GLENN VIE~/ ESTATES WEST S/I], BLOCK 1, LOT 5 PID#051-793-05 TH #KND99-V i,.i?.':..~".:.':"' %~, =~ ' Lof 6 M VACANT B-C:3~.~' A-D=~5,7' FINSH ORAD~ -- ~-~:~,~, ~'.~ ~ : ~~~ ~ ~--teso GAL .~ ~T A-F=IOt,O' ~ /~ T~N~ ~ a ~ ~' "'~;"'¢ ................ '"'="" .., ¢,%~ ..... ~:~, SEVER RBCK ~ ARCT~6 ~EVOB, IN~ PALMER, ALASKA 99645 ~ LANG ~ ~ LANG ;~ KMO 20441 PT~MIG~ BL~. ~ ~ i ~ N~ 459 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 22, 2000 Expiration Date: Jun 22, 2001 Permit Number: SW000186 Legal Description: Glenn View Estates West, Lot 5, Block 1 Design Engineer: 0070 KND Engineering Owner Name: KND Engineering OwnerAddress: 20441 Ptarmigan Blvd. Eagle River, AK 99566- Parcel ID: 051-793-05 Site Address: Linda Jo Lot Size: 40000 SQ. FT. Total Bedrooms: 4 . Permit Bedrooms: 4 This permit is for the construction of.' [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either:. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: - Data:/~.~-- ]~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 RECEIVED APR 172000 (907)696-6111/FAX (907)696-8111 · ,n~r'Nt~ITAL SERVICI~ ~ .... April 17, 2000 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New On-site Sewer -Glenn View Estates West S/D, Block 1, Lot 5 Gentlemen: The owner has requested we proceed forwar.d to obtain a septic permit for new on-site system. One testhole, was dug and perco!ation test conducted on April 19, 1999 and April 21, 1999 respectively.. The.result of this tes. t is attached. The general slope of this lot is from east to west, which directs at a maramum grade of approximately 2-5% as indicated on the drawing. We have designed our system utilizing an absorption rate of 0.8 gpd/SF for the four-bedroom house, which is proposed for this lot. We propose to install a 5' wide shallow trench. The soils consistently percolate at 8.14 min./inch and the material appears to be uniform per the logs. Water was not encountered during the excavation or monitoring. Ail lots are served by public water. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ~(~D Engineering attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAK GLENN VIEW ESTATES WEST S/D, BLOCK 1, LrlT 5 5 4 3 14 8 11 Lof 5 ...,.~" Lof 4 Lof 6 .- VACANT Lot 1 0 VACANT 'VACANT ~" ~ ............................ ~ ~ PREPARED FBRI Lof Lof 8 Lof 7 DESIGN DETAILS 4 BDRH X 150 GPO = 600 GPD 600 OPD/O.8 GPO PER SO, FT. (8.14 MIN/IN.)= 750 SO. FT (750/5'(W)) X O.58(RF) (3.0 GRAVEL) = 87 FT. TRENCH USE 1 TRENCH - 87 (L) X 5' Totat depth oF system Is 6.0' FrOM or'lDln~,[ 9r'(;,de. Toter depth oF gr(tve[ below distribution pipe Is 3.0' . NDTES~ 1, USE 1850 GALLON SEPTIC TANK, INSULATE TANK IF (4' COVER, INSULATE TRENCHES WITH 8' HD DUE]AL FOAM, CONTRACTOR WILL ENSURE MAXIMUM 8% SLOPE INTO SEPTIC TANK, ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF' REOUIRED. REX TURNER ARCTIC DEVCO, INC. P.O. BOX 3489 PALMER, ALASKA 99645 ~' LANG ~^~,t KMD ~e LANG ~ KMD ~ O0007.dwg Sccde, l'= 100' PAGE 1 DF- 8 3/27/00 NW145g 00008 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 ]{907)896-8111/~AX (907)696-8111 WASTEWATER DISP[]SAL SYSTEM DETAILS GLENN VIEW ESTATES WEST S/D, BLOCK 1, LOT 5 K D ED PRIMARY SYS' )-1/ RE SYST REX TURNER ARCTIC DEVCD, INC. P.O. BDX 3489 PALMER, ALASKA 99645 ~^~: KMO c~c:x,~: KMD 3/27/00 NW145g ScaLe, 1'= 20' PAGE 8 DF 3 ~.~ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 ~*"- 00008 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Performed for:. Project: SOILS PERCOLATION TEST Arctic Devco/Tumer Construction Date Performed: 4/19/9c/ Lot 5, Block 1, Glenn View Estates West "I-'I-'I-'I-'I-'I~T HOLE # 99-1/$ Depth 1- 2- 3- 4- 5- 6- ?- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- Org- soft, black, root mat SM on bottom loose Loose & soft on top Reddish bm to grey bm SM/GM - Med dense, w/gravel & silt. dry Silt increasing on bottom B.O.H. HOLE PRESOAKED PRIOR TO TESTING SEE ATrACHED SITE pLAN FOR HOLE LOCATION Wa~ Ground water encountered? NO Depth to water after monitoring? DRY What depth? N/A Date? ~/15/99 Reading Date Gro~ Net Depth to Net Tune Tune Water Drop 1 4/21/99 3'.37 2 4.~7 30 rain 3 4/16" 3 12/16" 3 * 4:08 4 4'.38 30min 3 S/16" 311/16" 5 * 4'.39 7" 6 5:09 30 rain 3 5/16" 3 11/16' ? 8 9 10 11 12 · Water Added Percolation Rate 8.14 (rain/in) Perc Hole Diameter Test Run Between 3.5 feet and t,~ ' feet' I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. Municipality o.f Anchorage Development Services Department Building Safety Division j~ ~/,~ On, ire Water & Wastewater Pmg~m 4700 Sou~ Bmgaw St. P.O. Box 196650 ~chorage. AK 99519~650 J CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-79,3-05 1. GENERAL INFORMATION Expiration Date: Complete legal descdption CLENN VIEW ESTATES WEST SUBDIVISION #1; LOT 5, BLOCK Location (site address or directions) 21440 LINDA JO CIRCLE" CHUCIAK~ AK 99567 Current Property owner(s) DAVID & SUSAN KINKE Day phone 688-8044 Mailing address c,/o EVENS DUCLAIR w,/ U.S. INSPECT Lending agency Mailing address Real Estate Agent Mailing address Day phone EVENS DUCLNR w. U.S. INSPECT Day phone(SOO) 872-3660 EXT. 529 3650 CONCORDE PARKWAY SUITE 100 ' CHANTILLY, VA 20151 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site · Individual Holding tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and WastewaterConsultants, lnc. shall be paid $I~£E..~3 at, orprior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, show~ 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 inspectio~,"the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS. INC. Phone Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE. AK 99504 Engineer's Pdnted Name JEFFREY A. GARNESS. P.E. Date 337-6179 Engineer's Comments: In conducting this evaluation, A WWC. 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 peffon'nance 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 evafuator 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. AWWC, Inc. can therefore not previde 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. Conditional approval for bedrooms, with the fllowing stipulations: WATER AND_ Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements SupplementaJ Eng~neeffs ~eo~ Other (Rev IZ~1) Original Certificate Date: Municipality of Anchorage Development Services Department Bulk:ling Safety Division On-Site Water & Wastewster Program 4700 South Bragaw St. P.O. Box 196650 Anct~orage. AK 99519-6650 www.ci.anchomge.ak.us (9O7) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: GLENN ViEW EST. WEST S/0 ~1; LOT 5, BLOCK 1, ParcellD: 051-793-05 A. WELL DATA [PUSLIC WATER] Well type. If A, B, or C provide PWSID~ ~ ~ Date ~ Wires pmpedy protected (Y/N) __ T . Cased to ft. Casing height (above ground) in. FROM WELL LOG ATINSPECTION Date of test Static water level Well production ,,,-' f /--.. ./'ft. .J g.p.m. .,J g.p.m. WATER SAMPLE RESULTS: Coliform __ colonies/100 mi. Nitrate A '' . . Date of sample: B. SEPTIC/HOLDING TANK OATA Tank Type/Material STEEL Tank size 1250 .gal. Number of Compartments 2 Foundation c~eanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 5/28/2002 Pumper mgJL.~__~.?r b'--=-'_r__,;~ ~'-----'-~'~n~ml. Collected by: Date installed 8/10/00 Cleanouts (Y/N) YES High water alarm (Y/N) N/A JR'S PUMPING C. ABSORPTION FIELD DATA Date installed s/~ o/oo Soil rating ~r ft2/bdrm) 0.8 System type TRENCH Length 90 .ft. Width 5 ft. Gravel below pipe 3.18 ft. /Totaldepth~'~'ll)'~t. Eff. absorpfionaraa 775 fi= Monitodngtube YES Depression over fleld NO Date of adequacy test 5/29/2002 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 7/7 in. Water added 920 gal. New depth 116/ in. 12/ Elapsed Time: 935 min. Final fluid depth 12.5 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons ~ "Pump on" iovel at in. ~ High water alarm level at in. ~ ~ Cycles tasted. Meets alarm & circuit requirements?. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot. Absorption field on lot. Public sewer main On adjacent lots Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 1 O' + Water service line 10'+ Surface water. 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10' + Building foundation 10'+ Water service line 10'+ Surface water 100' + Curtain drain NONE KNOWN Wells on adjacent lots 200'+ Water main 10' + Driveway, parking/vehicie storage g5'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems ere in conformance with MOA HAA guidelines in effec~ on this date. Engineer's Printed I~lame Data JEFFREY A. GARNESS HAA Fee $ '~ Date of Payment Lo - \,~- Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number NORTM I ·OODS SUBD. ~4 UNiT I fi/ Lot 5 40,007 I.f. Lot 6 6.0' x I DECK OUTS iLO' x I I.~ CANT 5.0' X PO~CN Lo~4 15' TELECO~L 6 .'-'T,~ / 'Lo$5.00' ~ ~CT, F.A,,~MENT ~.' / R-~O. O0' / , · . , PLOT PLAN ASBUILT .~-- SCALE I 50 GRID m~ 14~ Prelect No. se-isa I nan ~ iean~lnla~ Im~ 11500 D~ Avenue, Anchorage, ~aaka 99515 : (9071 522-~76 Phone Reglatered ~nd Su~eyo~ ~g07~ 522-4625 Fax I he~ ~ ~ I hew lu~ ~e fel~ng ~ ~ ~..~ ..... ~.~,~ Mnnicipality of Anchorage . Development Services Department ' ' Buildifig :Safety ~ivision On-Site Waterand Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage;ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLINGj Parcel I.D. 051.793.05 GENERAL INFORIVlATION Complete legal description Location (s!te address or directions) HAA # l!~010044 Expiration Date: fi-- Z O "- O// Glenn View Estates West, Block '1, Lot 5 " Llnda Jo Circle CUrrent Property owner(s) Mailing address Arctic Devco, Inc. PO Box 3489, .palm~r, AK 99645 Day phone Lending agency. .... Day phone Mailing address Real Estate Agent Gary Gearhart Day phone ..242.3294 Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community ciass__ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HA,&) based only upon the 'representations given in paragraph 5 by an independent professional civil engineer registered in .the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates ,of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for 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. wWW.ci.ancho'rage.ak.us MuniCiPality of Anchorag© Development SerVices Department . · Building Safety Division', ~ ~ . , 'On-Site :Water & Wastewater Program ' · ' ~.4700 South Bragaw St. ~P.o. B0x~.196650 Anchorage, AK 99519-6650 (907) 343-7904 Legal De§cription: A. WELL~ 'DATA Well tyPe,PUBLIC Date :com~ ~)leted Total ~depth Date of test I Static water level HEALTH AuTHoRITY APPROVAL CHECKLIST Glenn View Estates West, Lot 5, BlOck 1' : . .:... · . "IfA, B,:°r.C provide PWSlD # . sa,nitarY seal .(Y/N) ft. -'cased to" ~; "ft. FROM WELL· LOG :; pamel ~ Well Log (y/N) , Wires prOperlylprotected (Y/N). Casing~ height'.iabove grOUnd) AT,. INSPECTION :. - ID: 051-793-05 Well, tpr0duction ~, + .~ ~it, :!t?: . "·~, WATER' SAM PLE'RESUL.TS: ; · Coliform i .... . colonies/100 mi. Nitrate Date'.bf Sample: ' Collected by: Other baCte~'ia .g.p.m...,~ 'colonies/100mi B.' sEP~ICiHOLDiNGTANKDATA ;::' ' : !" -'.' ';"i Tank~Type/Matei:ial AnchoraqeTank-Steel ' ' .. ' ' ~ :: ~ ~ :~it!: .,.!;.:. ~l..,10~ '"-nksize t250 ,~al Number of Com artments2 ' Date install,eo ' ~ t' I . '"' .... = · ' , P .... - c.~=~dl~ ~ivFoundation Cleanout y_Depression over tank E_High water, alarm na ,,I'~ ,~ ~, ' . , ~ . · ~,, .I1{.. , : Date' :of '~"Bping .... '...'," '.:. Pumper '"' ~.: L .':!:~'i' C. ABSORPTION FIELD DATA ': i - .: ' . i ....',~" , Date: i~tailed e/lo/oa 'soil rating (g.p.d./~ or~lbdrm) O.S . ;i' SyS.!e~;type .Sh.,owtr, nch Len~ih :~0~!,,:'' '.. ft. Width S' ~' :' .~ft. · ~r~vel below pipe .3.t1~ ' ~.ft.: , i':.~:!: I= 'I: ! ' : : ' 2 · · ' ..... ' · Total depth '1'1.48 - 5.88 ft. Eft. absorption area 77~ ft Monitoring tub~ y,.. i Depression over field n Dat~ °f'~dequacy'test ha" ' Results (Pass/Fail)" ' "For! . '":be,droomS · . Fluid'de~Sth in absorption:field before test in. ~ Water added ' ': gal~,.,,~?i'.'. New depth , . . Fin;! fluid depth". ' in. Elapsed Time: , min.: ' treatment (past ;12mo.) (YIN & type) AbSo~Pti0n~ rate >= '. '; '_~!ifiyes, give'date ,· ; Any .~juvenabon in.