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Home My WebLink AboutTHUNDERBIRD HEIGHTS #1 BLK 5 LT 3Thunderbird 'm Heights #1 Block 5 Lot 3 #051-581-04 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201077 PID Number: 051-581-04 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JOEL & JACQUELINE BOURNE ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24810 THUNDERBIRD DRIVE, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot THUNDERBIRD HEIGHTS #1 5 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line FtZ Ft. Well 200'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ __ NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. 3BR HOUSE — 4BR SYSTEM. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 3034 Installer PCN drainfield Drainfield CO/MT 3034. Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspect'on 1" 5/12/20 2nd 5/13/20 Location and description 3'd 4'" BOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL r pF �i �. 1 • Conditional Approval: Date .�,f.�� '��Q' Of g. TH �� • ' Curtis Huffman Septic System Approve r �� cn•• 128991 •� �� ]' Date S- L'2C� isrFCE ��.•. sn8/202p.•-��,� OPROFESS\0 SSIONP -� Note: this approval does not include well permit requirements. kmuv LID/ U// 1 o) PID: 051-581-04 PERMIT: OSP201077 KEY BOX J Q QLu Z Lu L WATERLINE ¢� APPROX. �. LOC. .00 ,c9 23.4 Lot 3 �. N D 28,253 S.F. PORCH 'p J 2.0'x5.0' CANT q 4 0' 0 8.4'x12.1' 11.7 3BR CA N 2 N01 STORY SHED RESIDENCE A KEY 4.2'x9.7' 49.1 & WATERXLINE 0 STORAGE B ON OTHER SIDE OF HOUSE C D DFCO DCO A—C=14.0' B—C=46.5' A—D=15.3' B—D=51.2' 12.0'x20.0'-' NEW DECK 1250 -GAL HDPE SEPTIC TANK 2.0'x23.4' CANT NTH NEW FCO & DCO. SCALEt 1' = 50 SEPTIC SECTION THUNDERBIRD HEIGHTS #1 BLOCK 5, LOT 3 PREPARED FOR: JOEL & JACQUELINE BOURNE 24810 THUNDERBIRD DRIVE CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com SUPPORTeERVICES: SCALES NTS ��'• OF • ALF -w �`��r C TH DATE: 5/18/2020 rtis Huffman.•• SURVEY: KGL CE 128991 . DRAWN: FWCS 5./18/2020 SCALE: 1 " = 30'bFEssTotz�' MUNICIPALITY OF ANCHORAGE On -Sita Water & Wastewater Program PO Box 196650 4709 Elmore Road Anchwage, Alaska 99819-8850 Phone: (5O7� 343-7-BG4 Fax: {997i 343-79 97 http:1hwrn.mufii.org1an:9ite 0n -Site Wastewater DiaposaI System Perm it Permit Number: OSP201077 Work Type' SepticTank Upgrade Tax Carte Nurnber: 06158104050 Site LegaI Address, THUNDERBIRD FIEI HTS #1 13LK 5 LT 3 0:1885 Site Mailing Address: 24131Q THUNDERBIRD DR, Chngiak Owner: BOURNE JOEL & JACQUELI-NE IDesign Engineer: FIRST WATER CONSULTING TYals permit is for the construction or: Effoctive Date: Expiration Dame Lok Size in Sq Ft: Iri�'ll �� •�• �� 1=20 511±2021 28253 11 Disposal Field 0 Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Wator Storage All construction shall be in accordance with: 1. The attached approved de8ign. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15,65 and the State Of AlaSka Wastewater 1)isposal Regulations (18AAC72) and Drinking Water Regulations (I8AAC80) 3. The wastewater coda requires inspections during ths inatal latrcn, The engineer shall notify die Development Services Department per AMC 15.65. Provide notftation by calling (007) 343-7004 {24f7j. 4. From 00ober 15 to April 16_ a subsurface soil absorption systern under construction daring freezing weather shall be eiftr: a- Cperied and Closed on the sanmr day, or b. Covered. sealed, and heated to prevent freezing Received By, tssu sd ByjUtcad,7--rV1-U 5/1 !2.020 Date: D: 4 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com April 27, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: THUNDERBIRD HEIGHTS #1 BLOCK 5, LOT 3 PHYSICAL: 24810 THUNDERBIRD DRIVE, CHUGIAK, AK 99567 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank to serve the existing 3-bedroom residence. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201077, Rebecca Carroll, 05/01/20 Carroll, Rebecca M. From: Tobish, Thede G. Sent: Friday, May 1, 2020 11:02 AM To: Carroll, Rebecca M. Subject: Re: Thunderbird Heights #1 B5 L3 Follow Up Flag: Flag for follow up Flag Status: Flagged Then they should not require a wetland permit. From: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> Sent: Friday, May 1, 2020 10:58 AM To: Tobish, Thede G. <thede.tobish@anchorageak.gov> Subject: Re: Thunderbird Heights #1 B5 L3 The tank replacement would most likely be digging out old tank and placing new tank in same location. I would not anticipate new fill. Becca From: Tobish, Thede G. <thede.tobish@anchorageak.gov> Sent: Friday, May 1, 2020 10:55 AM To: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> Subject: Re: Thunderbird Heights #1 B5 L3 If they are using the same footprint probably not. Do they show new fill in wetlands or a basic replacement? From: Carroll, Rebecca M. <rebecca.carroll@anchorageak.gov> Sent: Friday, May 1, 2020 9:12 AM To: Tobish, Thede G. <thede.tobish@anchorageak.gov> Subject: Thunderbird Heights #1 B5 L3 Hello Thede, I am reviewing a tank replacement permit for Thunderbird Heights #1 B5 L3. There are Class C wetlands mapped on the lot that are in the area of the existing tank, which is also where they are proposing to place the new tank. Do they need to apply for any permits from you? Thanks, Becca 1 \ ( MUNICIPALITY OF ANCHORAGE 1 ye\ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1 ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-0720 ON-SITE SEWAGE DISPOSAL SYSTEM ANDIOPAVErt INSPECTION REPORT NAME�/ 1 Gar S' r� OcAer PHONE /��/ EW • /YS-�SS,3 ❑UPGRADE MAILING ADDRESS fr' 6 & 1< ICL5- LEGAL DESCRIPTION � 1 LoT 8Iocr- Jr ^ 1 kVvf8Crb,rd i4s S LOCATIQNITh Jn'CLj.e.�'r 1`{r-s1J\ , I J � NO. OF BEDROOMS u7� DISTANCE TO: Well Absorpb nares Dwelling /J PERMIT NO. DD�� Uy 7 i Z Manufacturer V Material No. of compartments Liq. !FFa t� allons / .S IF HOMEMADE: Inside length Width Liquid depth d y DISTANCE TO: Well Dwelling PERMIT NO. JZ2 O _ F Manulact Material quid capacity in gallons = DISTANCE TO: Well ^^,JN Foundation 164 Nearest Nearest lot line /v PERMIT NO. /O 0 615— Z No. of lines Length of each lin Total len th�o(f li s Trench width Distance between lines W inches H Top ofble to finish g 2 rade .Fr- APtw SrC Material berjKth the Total effective absorption area oTE LpJ 1 inches Length Width Depth PERMIT NO. <I- Type of crib C iameter Crib depth To eclive absorption area W L � DISTAN TO: Well Building foundation Nearest lot line ih Driller Distance to lot line PERMIT NO WBuilding foundation ISTANC r Sewer ' Septic tank sorption steals) OTHER I O PIPE MATERIALS p✓C D3o3 SOILTEST RATINCy,�S IOYY /ih INSTALLER sbi S 70 REMARKS TMST✓c En7D o or/mac` � t:9rT � i"r' G GO ✓r,t I D o� C Vii✓ -nlc /tif o ✓- Sa C. '✓.r . TN o a. -5,c)x Id 4 adz' 9C S of-- P�ftJA APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERMIT NO. C MUNI TY OF= RNC^•0RnOE: DEPARTMENT Or HEALTH AND ENVIRONMENTAL i..OTECTION 825 'L' STREET. ANCHORAGE, RK. 99501 264-4720 O N —SITE SEWER P E R M I T 810065 ) s kaII APPLICANT O.S.K. SRA 6105 A-3 PALMER AK LOCATION THU14DERSIRD DRVIE LEGAL LOT 3 BLK 5 THUNDERBIRD HT LOT SIZE TYPE OF SOIL ABSORPTION SYSTEM I : TRENCH c3 745-2553 22000 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS - 4 SOIL RATING CSO FT/BR)- 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ' D>EF"TH— F LENQTH� 43! 13RFiVEL. l7EP'TH— 4 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REQUIRE[? SEPTIC TF4NK S I =E® 12 4 OFiILLONS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- — T W O C:2> I N S P E C T I O N S n R E R e Q U I R E a --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND' TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. i PERM I T E}{P I RES [?ECEMBER 31+ 15x51 1 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE.1 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED; ISSUED �T HE V4. 0 Russell Oyster 694-2774 O & E ENG JEERING & DEVELOF MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis 688-2280 Performed for. Name: STS ✓E SKq G 5 Tel. No. Mailing Address: Legal Description: ��'T 3 , v %fUnlDE.Q B/2y h`TS . Depth (feat) Soli Charactorlstics 0 1 ti1L Ste- T� So/�. 2 3 GP .5ANoY 4 S".dl/B..e• 5- 6- 7- 8 676 SPet Ido AMT- C 10 S BoJ^To�l, •�F TrJ 12- 13- 14 2- 13-14 15 16 Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments: /of PLOT PLAN Ala Se&& PERC.TEST 42 I MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section �' - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-581-04 1. GENERAL INFORMATION Expiration Date:_.5--L(-2_0z1 Complete legal description THUNDERBIRD HEIGHTS #1 BLOCK 5, LOT 3 Location (site address) 24810 THUNDERBIRD DRIVE, CHUGIAK, AK 99567 Current property owner(s) JOEL & JACQUELINE BOURNE Day phone Mailing address Real estate agent PSC 3 BOX 6731, APO AP 96266 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank, ❑ Community Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J�J� 41;z6b Date of Payment 511 gj0-w a0 Receipt Number COSA # JX 2611 Q6 Waiver Fee $ Date of Payment Receipt Number Waiver # COVID-19 257o' DISCOUNT APPLIED 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/13/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & F�lrs 6. DSD SIGNATURE System #1 Approved for �_ bedrooms System #2 Approved for bedrooms Disapproved 1` k 4 . —49_ .......f� .... ..... • • Curtis Huffman CE 128991 1312 0 Aw � 1 PPROFE S Q Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: 5--q �2aZo 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 Legal Description: THUNDERBIRD HEIGHTS #1 BLOCK 5 LOT 3 Parcel ID: 051-581-04 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA —PUBLIC WATER Well log is filed vvith Onsite (or attached) Date drilled Total depth _ft Cased to _ft (INTO BEDROCK) Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) _in Date of flow test for COSA. Static water IevP! at beginning of test _ft. Commo lts B. TANK DATA Age of tank(s) NEW 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW Standpipes/foundation cleanout per record drawing Date of pumping NA - NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 8/4/1981 ALL standpipes present per record drawing Total measured depth from grade 5_9 ft (max) Measured depth to pipe invert from grade 2_0 ft (min) N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective 3.9' INTO THE 4' ED. Code -required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies:. Structure served by this system _ Well production at time of test _gpm Water storage tank vo!ame_ gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate _mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by_ Date of Sample C. LIFT STATION Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/4/2020 Results `Il Pass For 4 bedrooms Fluid depth prior to test 28 in Water added 630 gal New depth 42 in Elapsed time 1380 min Final fluid depth 26 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date E. SEPARATION DISTANCES Front -Rd` ate Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station �'a�[ot > 100' Community Sewer Manhole/Ckiout > 100' 'Yews �if No Neighboring Tank > 100' ® Yes if No Absorption Field on Lot > 100' ® Yes if No Neighboring Absorption Fields?,.-`l--00U`- 1N Yes if No Commurft yt Sewer Main > 75' ® Yes if No ft --�'' ® Yes if No �6 L -,L— ewer/Septic Line > 25' ® Yes if No Nt�Id r g Tank > 100' ® Yes if No Animal Cont n &h1'-> .50' ® Yes if No ft Manure/Animal Excreta Storage 100 ft ® Yes if o From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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. -.m. 1 low. -I ... .. ....�:* 0 jj Curtis Huffman d CE 128991c�`�®®'� F�F�pROFESSIO ft ft it ft ft ft ft ft i L=134.08' �_ o --X00.23, .. 10' UTILITY EASEMENT .Q� �G Lot 3 : \ \ otc• 28,253 S.F. \ �A PORCH 2.0'x5.0• CANTgyp°' P14.O w �d 10, 8.4'x12.1' w Lot 2 1N 2 STORY SHED RESIDENCE 2.0'x5.0' \tT 4.2'x9.7' 49.1CANT' N. STORAGE .. MANHOLE J \ 5�j 1SEPTIC \ \ 12.O'x2O.O' PIPES DECK 2.0'x23.4' CANT W NOTE: THE LOT IS ED COMMUNITY WATER ERVICE. 5 1153'25 Unsubdivided PLOT PLAN ___ AS BUILT _X_ SCALE _ 1 " = 40' GRID _ NW 1865__ Project No ------ 11500 ____11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone oaoo0�� (907) 522-4625 Fax as Q Professional Land Surveyors ken0langsurvey.com F q �p jonathan®longsurvey.com ov 'gSQ4o I hereby certify that I have surveyed the following described property: LOT 3, BLOCK 5, THUNDERBIRD HEIGHTS SUED. — ADDN. No. 1 (PLAT No. 78-19) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the _Sect __ Day of M_� `+ ZOZ-L) , at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH �—yc 1, KENNETH ................... . N o� .LS -5202.• gJo� ��0 ORSSS1ONA1 w000�� AECC963 \ Municipality of Anchorage 1 Development Services Department • �;' Building Safety Division On -Site Water and Wastewater Program s r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _o5is8i-o4 COSA # nC10,2 60 Expiration Date: R " / --z — / O 1. GENERAL INFORMATION Complete legal description —Thunderbird Heights #i Blocks Lot 3 Location (Site address) 24810 Thunderbird Drive Chugiak AK 99567 Current Property owner(s) Strawderman Roy Jr & Tyann Day phone _276-6664 Mailing address Same Lending agency Day phone Mailing address Real Estate Agent C. Rolf Milton/ Partner's Real Estate Day phone 694-4g94 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or 8 wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system !slate) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of Installation. Name of Firm Pannone Engineering Services LLC Phone 272.8218 Address P.O. Box 202954Anchorage. AK 945io Engineer's Printed Name Steven R. Pannone P.E. Date 816/oa Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the lest, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the 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. S. DSD SIGNATURE _ Z Approved for 4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: tY OFadj WATFR ANS WASTEWATER Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By; g� Original Certificate Date: 0 (R. 11,05) Municipality of Anchorage ' Development Services Department i Building Safety Division < — On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Thunderbird Heights gl Blocks Lot 3 Parcel ID:_osi-cai-oq A. WELL DATA Well type A tf A, B, or C provide PWSID k 2aais6 Well Log (Y/N) Date completed _ Sanitary seat (Y/N) _ Wires properly protected (YM) Total depth ft. Date of test Static water level Well production Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Casing height (above ground) in. AT INSPECTION ft. g.p.m. Other bacteria colonies/100 mL Arsenic: — ug/1 Date of sample:_ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material _ Greer- Steel Date Installed -01411991 Tank size 11So gal. Number of Compartments 2 Cleanouts (YM) Foundation cleanout (Y/N) y Depression over tank (Y/N) )Y High water alarm (Y/N) N/A Date of pumping 8/5 zoog Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 8/412gaz Soil rating (g.p.d./It2 or ftz bdrm) System type _DEEP TRENCH Length ng ft. Width zs ft. Gravel below pipe A.o ft. Total depth SaS ft. Eff. absorption area 36o ft' Monitoring tube Y Depression over field N1 Date of adequacy test a/sh000 Results (Pass/Fail) Pass For g bedrooms Fluid depth in absorption field before test 335 In. Water added¢000 gal. New depthrg8 in. Elapsed Time: arko min. Final fluid depth 39Z In. Absorption rate >= 600a g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D.IFT STATION Date ins "Pump on. level at in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" Ievel at _ in. cies tested SEPARATION DISTANCES FROM WELL ON Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /seotic-se6ice line Manhole/Access (Y/N) _ High water alarm level at Meets alarm & On=adjacent On VVVPublic sewer ma Holding tank A' al containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ia' Property line so'+ Absorption field 6' Water main at+ Water service line _zS+ Surface water -aoo+ Wells on adjacent lots Zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ao+ Building foundation zo+ Water main 2S+ Water Service line _a5+ Surface water soo+ Driveway, parking/vehicle storage 3S+ Curtain drain none known Wells on adjacent lots zoo+ F. COMMENTS G. ENGINEER'S CERTIFICATION•.� P�...: ••• «' 1 certify that 1 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. • ,Steven R. Ponnone. Engineer's Printed Name Steven R Pannone P E eec% :, No. CE 8149 Date 816/200g MX ��6• COSA Fee $ U Waiver Fee $ _ Date of Payment 10 o Date of Payment Receipt Number 10 0 2 �v q L Receipt Number (Rev. 11/05) In. Municipality of Anchorage Development Services Department Building Safety Division t On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-riBI-D-9 COSA# Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 3; Block 5; Thunderbird Heights Subdivision 'r Location (site address) 24810 Thunderbird Dr. Chugiak, AK99587 Current Property owners) Bill Longbrake Day phone 688-5282 Mailing address s_ Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD forpickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑� Day phone Day phone 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 On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm S 3 S Engineering Address 15861 S. Birchwood Loop . C'14giak^9 67 Engineer's Printed Name O C 5. DSD SIGNATURE _ittffo' Approved for bedrooms. Disapproved. Phone 694-2979 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: l L / Original Certificate Date: R— Ll – t^ 7 (n.+. (+Ae) Municipality of Anchorage Development Services Department Building Safety Division on-Sbe water & WastBwater Program--_ - - - -- 4700 Bragaw Street _ P.O. Box 198850 Anchorage, AK 99519.8650 www.murd.orglonsite . (907) 343-79D4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST ^� �rtTS s/e Legal Description: A. WELL DATA �. � Well type mIVX)IT l If A, B, or C provide PWSID #ItJ56 Well Log (Y/N) Date completed _ Sanitary seal (YIN) _ Wires properly protects ) Total depth fl. Cased to fl. Casing he' ve ground) in. FROM WELL LOG SPECTION Date of test Static water level ft' Web production 9 -P.M. g.p.m. WATER SAMPLE RESU . Cobform oniesM00 mL Nitrate mglL Other bacteria colonies/100anL Ar mgfl Date of sample: _ Collected by. B. SEPTICIHOLDING TANK DATA Tank Type/Material SLPTf�Lelit9L Date installed 9 Tank sias I960 gal. ,Number of Corn ants rD dEpyot.�i't'RGE /)O Foundation cleanou ( Q Depression over tank (YdV "d High water alarm ()(g) Date of pumping Pumper `T� rS t+Vl+Pta 7� C. ABSORPTION FIELD ATA Qc Data installed I Soil rating (9•P•d• �� C) System type —aEKXH Length 061 ft. Width ft. Gravel below pipe I Total depth ft. Eff. absorption area W fe Monitoring tube _*S Depression over field O Date of adequacy test Results�Fall� For '� bedrooms Fluid depth In absorption field before test 21 1n. Water added gal. New depth in. x ,y Elapsed Time: 110 min. Final fluid depth 426 in. Absorption rate >= ��• 9•p•d• Any rejuvenation treatment (past 12 mo.) type) A� 0 If yes, give date D. UFT STATION Date installed Size in gallons - M 'Pump on" level at _ in. ve at —in. High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES - SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtft station on lot On adjacent lots Absorption field on lot On adiacan lalr Public sewer main Sewer /septic service Public sewer manhole/cleanout Holding tank Animal ent areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S tl Property line _Ij + Absorption field Water main Water service line /O l fr Surface water � O Q -� Weiss on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line �� t Building foundation�-� MIA Water main Water Service line /D f Surface water Driveway. parkirVvehide sbrage /o L, Curtain drain Wells on adjacent lots S?Krp I t F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determ6 review or Municipal records conformance with MOA COS/ Engineer's Printed Date h field inspections and above 4fOns aro in COSA Fee $ Waiver Fee $ Date of Payment fl � D Date of Payment Receipt Number (7 �. f!> Receipt Number (Rev. 11/05) err M in. Rub 02 2007 10:05 Country Garden Farms. 307-688-2327 P•1 _ Pa- a- f e �� X •�o t'o 9 -1 r31 1 f/ •'mar ry 9. �• •• 1 NN MOUILT-NO CORNiAB @ET ~' 'fHls .D TE. HEREBY CERTIFY •THAT 1 HAVE1�BO.TH6; SCALD , ' A•►+►��►rA DLLOWINO DESCRIBED PROPERTY! OF' A waiierbird IIB! Ee 8ubd-IMR. LLbt 3 Ilk. 3 'DATEd W RR ��hh'44N, P •........ Stt, 10 THAT NO, UM0AO11MOM FacII A� . ti:• IDICATM IT. 10 THE ftUMN3191L1 Of TH6 0,4-92 ��r 491►��. •.'��'�� . YNSR TO Dl;TERMINEII{E ]MSTEM P lWY ORID� , ..� •4�•.. :: f LSEINUMM COVENANTS OR Ag�pJ 8 ii CN DO N6f APPEAR Olf 'Nit, R 1- I • ' fi7 � W5. } ewe. aru� i.««G• aION PLAT. UNDER NO CIACUNi9T 9.8liDl!<.D. 'FBS ,� � •,�'„ IY DxM HEREON BE UQ6b R CAN LJOTybN•' .'Roil tFZHC LINIZA OR FOR �ABLI! NO60UN31-ff1 •!� '••..�.1i..,' OM i,1rL,.� " DMS MUNICIPALITY OFANCHORAGE- _ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Service§ - " On-Site Services Section = ` "P.O. Box•196850 -Anchorage, Alaska 99519-8650 _ 343-4744 - CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. S OS-)- 1._- GENERAL INFORMATION - Complete legal description Lot •3: Stock • 5: Thunde4b.utd Hu.4ht6 01 Location (site address ordirection., 24810 Thundu6ind Drtive Chuaiak, AK 99567 Property owner' Mike and Kdiati- Davis Dayphone '688-0755 Mailing address `24810 Thrc d )tb •nd D / , ua•iah AK 99567 Lending agency = Day phone Mailing address Agent - ' Day phone _ Address _ Unless otherwise requested, HAA will be held for pickup.. _. 2 NUMBER OF BEDROOMS H 3. TYPE OF-WATER SUPPLY -- - . -Individual well Community well XXX _ - - -- 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 - r XXX Holding tank ,k Community on-site o ^ Public sewer" NOTE If community wastewatersystem, provide. written_ confirmation from State ADEC attesting to the legality and status of system. .R-0]!MB V1,) F, MOA ql .. - :.. ..._ 5. 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 of this Health -Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations In effect on the date of this inspection. Name of Firm s a s EMGrAEEWLIp Phone 17034 Enlo River LOOP Road N*.P4 Address Engineer's signature Date �d-C,�E Cl .�� ROSERr C COWAN CE -6301 f 6 ' DHHS SIGNATURE r P --Approved for ' � bedrooms. �~- _: Disapproved .:., Conditional approval for bedrooms, 'with the following stipulations: Additional Comments - By: Date '2 a The Municipality of Anchorage Department of Health and Human Services'(DHHS) Issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasersof homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work ncntw..wir 5. MCAm Municipality of Anchorage AL Department of Health and Human Services us HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 3 8cL S Ti+i/.1ac ¢pito �/ Parcel I.D. OS -1 — S Y / - e `f A. Well Data Well type A If A, B, or C, attach ADEC letter. ADEC water system number 2 /1/ 5-eS Log present (Y/N) Date completed Driller Tdtal depth Cased to Casing height Sanitary seal (YM) Wires properly protected (YM) FROM WELL LOG Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/hetding_tank on lot Absorption field on lot _ Public sewer main Sewer service line WATER SAMPLE RESU Coliform Dati5Zf sample: I f- -700'.0 B. SEPTIC/NOLDR4&TANK DATA AT INSPECTION adjacent lots On adjacent lots sewer manhole/cleanout tank by: Other bacteria W �0 0 UJ m m I O C o W 3 V L.0 Cie Date installed 0-4,61 Tank size /ZxV Compartments Z Cleanouts&9N) 4Foundation cleanout (`gq)) Depression (ya High water alarm (Ya^l Alarm tested (Y/N) //d Date of pumping Pumper Tom- IEfJPao c SEPARATION DISTANCES FROM SEPTIC/H9tDtN6 TANK 0: 1 Well(s) on lot zvo 14- On adjacent lots " /A Foundation / Z / To property line /D f Absorption field L' Water main/service line /o 1y Surface water/drainage /oo I -P 72-028(397) Front CONTINUED ON BACK PAGE 7A. C. LIFT STATION Date Installed Size in gallons Vent (YIN) High water alarm level Meets MOA electrical i SEPARATI STAT Well on lot 'Pump on' level at FROM LIFT STATION TO: D. ABSORPTION FIELD DATA On adjacent lots Manufacturer Manhole/Access 'Pump off' Level at tested Surface water Date installed 8 - +a I Soil rating (GPD/Ff) 8 S' � System type 7!-E5./69 Length `lS-' Width LL 2s' Gravel thickness ' Total depth to' Total absorption area -3V> r Cleanout present.CM) ! Depression over field (YO.1 Date of adequacy test /-3/-9t Results aiis)(ail) OkSs for Z/ Bedrooms Water level in absorption field before test 0 Aftertest 3" Peroxide treatment (past 12 months) (Y „ro..1J/- —/-"JO ad If yes, give date rf � SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot On adjacent lots 1114 Property line /01 To building foundation Zs , To existing or abandoned system on lot "/4 On adjacent lots '-';c> 14- 'Cutbank ''/1 Water main/servioe line /o' � Surface water /on r+ Driveway, parking/vehicle storage area Curtain drain '•//i1 E. ENGINEER'S CERTIFICATION I certify that I have checked, vedfed, or conformed to all MOA and HAA guidelines in effect Signature 2 �✓� �� Engineer's Name R t"i f .c T C• C o w q.✓ Date / / 71 / '15— HAA S— HAA Fee $ 3OD �dU Date of Payment a Receipt Number dam' i3 nes (ysa)• Back T ROMT C. COY I�c�tyy CE -8801 Waiver Fee $ Date of Payment Receipt of this inspection. MUNICIPALANCHORAGE • �' DEPARTMENT OF HEALTH 8 HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. q r✓- 1 -!519,1 - CtA HAA tl II R Qf 1 x,01 GENERAL INFORMATION Complete legal description lir 3u�r+� S I Nuuvr�AFo fiE�cr.rs �/ Location (site address or directions) 311 '11140,3 vcxs/i-n �A N, Property owner�TfWq Of -3►�^»r (.l7 6 ism Day phone 24.3 -spy 666- :'E #JA - Mailing address °511 DOi%)a 0gcgj4k. Ar- 917sz7 Lending agency Day phone Mailing address Agent 2d ats;!: &w Aof 2+4"evJ'-A/ico(.Avss.J Day phone CSL4"1�0 Address IG�00 0 icto Z>p � �, ja ,�4 #kr- gga711 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well 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 — 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-M(ge.1/91) Front MOA271 5. 6. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 effectonthe date of this inspection. Name of Firm � 1= *0 , `J►. )" -�MiJ G Phone 616 b2y,17 Address Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date 4t214'110Z-- David R. Daylwl NO. 230SE bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72M5(Rsv.1A1) Bs k MOAs21 Municipality of Anchorage Department of Health & Human Services' HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L42_3 %/,tt� B so Parcel I.D. A. WELL DATA Well type If A. B, or C, attach ADEC letter. ADEC water system number -0 2 rl f 6 Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG 4:1J Date of test Static water level .� Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot �� + Wires properly protected (Y/N) g.p.m. AT INSPECTION MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION '.UG 18 1992 tMVED ; On adjacent lots z-eoa'f' Absorption field on lot Z +- ; On adjacent lots 2-cv y" Public sewer main Public sewer manhole/cleanout ^� Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: _ Other bacteria B. SEPTIC/HOtS#NQTANK DATA �' / — Date installedTank size Compartments Z Cleanouts (Y/N) y Foundation cleanout (Y/N) A/ Depression (Y/N) Al High wateralarm (Y/N) Nva Alarm tested (Y/N) Date of pumping SEPARATION DISTANCES FROM SEPTIC . Well(s) on lot Axl/v tr On adjacent lots Zoo 'f Foundation �y To property line /4�1 " Absorptionfield Co Water main/service line /O /- Surface water/drainage Najd rxax(Rw.oni)F� MOA - CONTINUED ON BACK PAGE C. LIFT STATION Date installed - AhI Manufacturer _ Size in gallons Manhole/Access (Y/N) Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off" level at Cycles tested Surface water Date Installed` t37 Soil rating System type Tis/ Length�r Width ��i-� = Gravel thickness - d� Total depth Total absorption area Cleanouts present (Y/Ny Depression over. field (Y/N) Al Date of adequacysest Results (pass/fail) p4 -S5 for bedrooms Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot Alone On adjacent lots Property line 8 To building foundation To existing or abandoned system on lot 'yfH On adjacent lots` 3�'� r Cutbank NA Water main/service line /cll''4— Surface water 4 Driveway, parking/vehicle storage area &P= Curtain drain 6 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in affec4oqB d!e of this Inspection. OF 41. Signature srf 93� Engineers Names �4 Date 14 i99z �(d aNo oars - >1OFESSI`��+ - HAA Fee $ �6f Waiver Fee:; Date of Payment B d 9Z Date of Payment Receipt Number �'3 9 6d (JS¢�) Receipt Number 12-020 (R".1121) 8. MOA 21 WALTER J. NICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 August 13, 1992 Mr. Ray Shafer S & S Engineering 17034 Eagle River Loop Eagle River, Alaska 99577 SUBJECT: Thunderbird Heights Subdivision Class "A" Public Water System, PWSID 211156 Dear Mr. Shafer: (907) 349-7755 have completed a review of this office's files concerning the status on the above - referenced Class "A" Public Water System and found following: Inorganic Chemical Contaminants: Date of last samples on record: Organic Chemical Contaminants: Date of last samples on record: Volatile Organic Chemicals (VOC's): Date of last sample on record: Radioactive Contaminants: Date of last sample on record: Total Coliform Bacteria: Date of last sample on record: Final Operation Certificate: Date Issued: 18 AAC 80.200 09/13/89 18 AAC 80.200 06/04/92 18 AAC 80.400 06/04/92 18 AAC 80.200 Under current composite sampling program 18 AAC 80.200 07/06/92 Present in file 11/12/81 Outstanding Violations: No August 13, 1992 Page 2 A. Based on the above information, this Public Water System is in compliance with State Drinking Water Regulations (18 AAC 80). If you have any questions on the above comments, please do not hesitate to contact this office at 349-7755. Sincerely, Michael Lu Environmental Eng. Asst. II ML/pf cc: Jaylene Peterson, Eklutna Utilities, Inc. David Dayton D. R. DAYTON, P.E., R.L.S. `MaUNUMI N Chugiak, Alaska 99567 (907) MxxNM 20210 Donalar St. 696-2417 August 3, 1992 ADEQUACY TEST Legal Description: Lot 3, Block 5, Thunderbird Heights Al Date of Test: August 3, 1992 Septic Tank: 1250 gallon, 2 compartment, steel tank (DHHS Records) Absorbtion Syatem: 45' x 4' effective depth trench (DHHS Records) Soils Rating: 85 sq. ft. per bedroom (DHHS Records) Daily Design Flow: 4 BR x 150 gal/day/BR = 600 gal/day Test: 600 gallons of water were injected into the absorbtion trench in 2 hours. Results: The absorbtion trench absorbed the daily design flow with no water rising in the cleanout pipe. Conclusion: The absorbtion system is currently functioning adequately for a 4 bedroom home. K, David R. Dayfaa NO. 22M MUNICIPALITY OF ANCHORAGE n DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL j�j9 � _ (fl�a L OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date L FS 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 1 -.OI 3 ?- LCA S &z> - Location (address or directions) (b) Applicant Name&K-h-Ek" Telephone:Home /esN-HSfN Business _ Applicant Address a� (c) Applicant is (check one): Lending Institution 13; Owner/buildej ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution _14A Ma)'yA 4- Telephone Address (e) Real Estate Company and Agent Address pwf� tzb a-vc-. itc, V- FK- `1 �'j i i Telephone G G 4`' jeV 9 y (f) Mail the HAA to the following address: S IS ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle ver, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms y 3. WATER SUPPLY Individual Well ❑ Community M --Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGEDISPOSAL Onsite 0 Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) n. 5. ENGINEERING FIRM PROVIDIN . .NSPECTIONS, TESTS, FILE SEARCH, DA !AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health' Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, f unctional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGiNcERING Telephone Address 17034 Eagle River Loop Road No. 204 4 ZY-?"?/7 y Date Eagle River, AiasKa 77211 .7 p� S i9 7 -.�ttity SOF i.. p.bMt A. ShalkK ; Ho, t4i7•1 6. DHEP APPROVAL Approved for bedrooms by Date 3—`f —2,7 Approved !� Disapproved Terms of Conditional Approval Conditional 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 engineers work. Page 2 of 2 72-025(11/84) A. WELL DATA r r1 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY Of ANChH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL SERVICES DP/IfMCKLIST - FEBRUARY 1804 2644720 RECEIVED Legal Description L— — r '4-K S INiI/J/�/IZli % S Well Classification If A. B, C, D.E.C. Approved/N) _ Well Log Present (Y/N) Date Completed Yield Total Depth _ Static Water Level Cased to Casing Height Above Ground — Electrical Wiring in Conduit (Y/N) Depth of Grouting _ Pump Set At Sanitary Seal on Casing (Y/N) _ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Z06 14 : On Adjoining Lots To Nearest Edge of Absorption Field on Lot Zcw ''- ; On Adjoining Lots — To Nearest Public Sewer Line Cleanout/Manhole — Water Sample Collected by Water Sample T#st Results Comments _ B. SEPTIC/HOLDING TANK DATA _ To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date Date Installed -T Size lZSt> No. of Compartments Z Standpipe&N) Air -tight CapsO/N) Foundation Cleanout (Y4:51 )— Depression over Tank (YI Date Last Pumped -2� s �g7 Pumping/Maintenance Contract on File (Y/N) NIA ; for NSA Holding Tank High -Water Alarm (Y/N) VIA Temporary Holding Tank Permit (Y/N) N14 Separation Distances from Septic/Holding Tank: i To Water -Supply Well Z� F To Building Foundation i To Property Line To Disposal Field To Water Main/Service Line /0 To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/64) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strat 85Type of System Design �� / T N 4111 Date Installed --8�7 87- Length of Field ysi Width of Field -?0/1 =` Depth of Field & Gravel Bed Thickness Square Feet of Absorption Area 3&046 Standpipes Present (Y/N) Depression over Field (Y6 Date o1 LasttAAdequacy Test 31 `7 ,0 i_ Results of Last Adequacy Test Roe- 7` 13Z Separation Distance from Absorption Field: To Water -Supply Well Z.oc>/f' To Property Line To Building Foundation Lot On Adjoining Lots To Water Main/Service Line 10/,Z To Stream/Pond/lake/or Major Drainage Course To Existing or Abandoned System on D '-/- To Cutbank (if present) "IA !V/A To Driveway, Parking Area, or Vehicle Storage Area r��t Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at ZA Tested for Electrical Codes (Y/N) Comments •' Check Permitted Bedroom Rating Against HAA Request •a Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SigngcgS ENGINEERINCDate 2F s' IS % Com Eagle Rlvar L99p Read Nr Z MOA No. Eagle RWw, Alaska 99577 Receipt No. 4QO D OZO +•`'•� �\ Date of Payment 3IL/ R-'(- Amount: $ i6 Page 2 of 2 72-026 (11,84) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: February 23, 1987 PWS I.n.# 211154• To Whom it May Concern: STEVE COWPER, GOVERNOR Telephone: (907) Addmu: 274-2533 According to records on file in this office the Thunderbird Heights Water System is in compliance with the State Drinking Water Regulations Sincerely, mes C. Allen gional Sanitarian Supervisor INSPECTION APPOINTMENTS G. RECEIVED .TIME TIME TIME C�?? GATE DATE DA INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOWVIRONMENTAL a2S L Burt • Andminw, Also BBBOt • ENVIRONMENTAL SANITATION DIVISION Telephone 2844720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND DEPT. OF HEALTH 8 F. OTECTION AUG 17 1981 RECEIVED SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incompleb requsta will not be proceed. Please allow ten J1 0) days for processing. 1. PROPERTY OWNER G. S. K. Construction PHONE 745-2553 MAILING ADDRESS SBA 6105 A-3, Palmer, AK 99645 PROPERTY RESIDENT (It dMerent from above) PHONE 2. BUYER Gary E. & Anne Graham PHONE 338-2459 MAILING ADDRESS 8616 Boundry, #3, Anchorage, AK 99504 J. LENDING INSTITUTION Alaska Mutual Savings; Attn: -Lorrie Cate PHONE 274-2551 MAILING ADDRESS 1503 W. 31st Avenue, Anchorage, AK 4. REALTOR/AGENT Totem Realty/William J. Schlegel PHONE 272-0571 MAI LI NG ADDR ESS 724 E. 15th Avenue, Anchorage, AK 99501 ❑ Other Al wells drilled ae, give well NSTALLED. 4N BE INITIATED, w THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Lina Nearest Lot Lim Absorption Area to nearest Lot Line 5. COMMENTS M"�APPROVEDFOR 7- BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE By LV 72010 (Rev. 6/79)