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HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 2 LT 1Glacier View 40 Heights #4 Block 2 Lot i #050-491-55 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of3 www.ci.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. 5W0701 q 8 PID Number. Name P1 GYrC t 1 iG jG7' Wastewater System: ❑ New ❑ Upgrade AOdasa a� Ec>cIe(�Iatie Lm Fay thlyA ff577 ABSORPTION F -7d o Dealt, Twc:1, o Shall" h«at Cl eaa and 0 Otw LEGAL DESCRIPTION S° Ftatma Ta.IDeM'�M VV'lGPDaIr FI. elo La I SuDdtnam L < T Depen W ppa broom R Ignal padaavN depth pW LI F6 FI TO hthlpRaga se tim. Fill weed abpv wgmtl Oracle Ca .a Lanpm F FI. Well: El ElUpgrade Gravll.+a' Nu Inas Dnunu WFaaen lnee FI. FI Clayylln!Wl ovale. ACDepen I TVM [G_ TOWab tom Rpa MatenY L' ! 0 FL FI Fl° prmer .a ONb Static Wats Laval mst"a, , Data Msteaad FI S Yrlcl Pump Seta aanp H.. . Grov,d TANK GPM FI. FI SEPARATION DISTANCES Vseptic []Holding ❑S.T.E.P. ❑Other. To Lift Station Holding Tank ubhnlPnvate Sewer lineGal i°"•' , apaa'rFrom MaaW Nv a LmpnmsnHwen SolaceWela 4SepticAbsorption LIFT STATION La Ln. . t.a ' ' Pump W. Nva at 'Pum v.m H.p,.ata aamM FafWatw, in n Pump Make I El w l Nspecams padb by CwanDan -- clot Wawa Rs^a•ks XIS t} 311 BENCH MARK Lxaem as Dew-PRm m.cl ...ton ';4" 'r dI DO FL Inspections by: Englnwdng Engineer' amp performed ,tia61 i 2kchweod Lp Rc Dates: 1"9-17-(37 CbQ0*AM0 "5U ,2nd t'lFA�� e.w•.e '♦�:. V .� Development Services Department Approval O*' Conditional Approval Date: 1,00, """ •'• ti » A. ..»..lav, e� A►atar • c M.. 1447. r ••a....»..i•'fw Reviewed and approved by:�F� PERMIT No. SW070198 PACE 2 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH 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 LOT 1 BLOCK 2, GLACIER VIEW HEIGHTS #4 P.I.D. NO. 050-491-55 \\ HOusi O y NEW 1500 CALLON FCO \\STEEL SEPTI TANK S O \DOUBLE CLEANOUT \ TH#1♦ ST2 ECk TBM S \ MT MT CO \ CO EXISTING TRENCH \ ♦TH#2 _] SITE �P{ \ X90 \ SCALE: 1' - 40' 9+1 LOT 2 00`.�... ....:....'.` LOT 4\\ 100' wE�� ,�„�•...,.,...••,,g`�`�" \ � �RDPEes��•r PERMIT No. SW070198 PACE 3 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Te'lephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1 BLOCK 2, GLACIER VIEW HEIGHTS #4 P.I.D. No. 050-491-55 ST1 FINAL GRADE ST2 89 4,// I NEW 1500 GALLON SEPTIC TANK A B ST1 34.0 7.0 FS—T2 38.51 16.5 95.4' 89.2' N. T. S. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070198 Legal Description: GLACIER VIEW HEIGHTS #4 BLK 2 LT 1 Design Engineer: 0003 S & S ENGINEERING Owner Name: PIERRE & MEGAN NICOLET Owner Address: 22501 EAGLE GLACIER LOOP EAGLE RIVER. AK 99577 - Date Issued: Aug 08, 2007 Expiration Date: Aug 07, 2008 Parcel ID: 050-491-55 Site Address: 022501 EAGLE GLACIER LOOP Lot Size: 45217 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 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. 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by catling (907) 343-7904 ( 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. 5. The following special provisions. -NEED TO CHECK THE INTEGRITY OF EXISTING SEPTIC TANK AND DETERMINE SOURCE OF POSSIBLE SEPTIC LEAK. PLEASE PROVIDE INFORMATION WITH INSPECTION REPORT. - (EMERGENCY TANK REPLACEMENT) - SEPTIC TANK INSTALLATION MAYBE LOCATED NO LESS THAN FIVE FEET FROM ANY PROPERTY LINE OR BUILDING FOUNDATION; TEN FEET FROM ANY WATER SERVICE LINE; ONE HUNDRED FEET FROM ANY SURFACE WATER; AND ONE HUNDRED FEET FROM ANY PRIVATE WELL; AND THE SEPARATION DISTANCES REQUIRED BY 18AAC72 FROM WATER SUPPLY WELLS. Received By- Issued y Issued By. Date: V n / Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 ON-SITE SEPTICIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D.Std - Uq t-I� Property owner(s) -P t erre_ " * e qn t t /t%f ole -t .; Day phone Mailing address ;l,� F-eete- lr1Ac6%Cr TD Fgc�X'Lle'I{ }t/� Zip Code Site address Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size Lk t5, 'g I q Sq. Ft. Code Number of Bedrooms 5 _MQ KTI E-5-Ptno-'MllGZr THIS APPLICATION IS AN: Initial ❑ THIS APPLICATION IS FOR (®all that apply Absorption Field ❑ Septic Tank (� Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Code Number of Bedrooms 5 _MQ KTI E-5-Ptno-'MllGZr THIS APPLICATION IS AN: Initial ❑ Upgrade �( Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: D qy o . °p Waiver Fees: Date of Payment: 112/07 Date of Payment: Receipt Number: 0 9 4 M S Z Receipt Number: (Rev. 11105) S& I1G ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 August 7, 2007 NEA<rNAurNowTr APPROVALS MMCIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAIN E MNSICI S REFERENCE: Lot 1; Block 2; Glacier View Heights Subdivision #4 SEWERS WATER INSPECTION It is requested that you issue a permit to install an emergency tank replacement. The existing tank serving the existing five bedroom dwelling on the referenced property Is leaking, and will be replaced with a 1500 gallon HDPE septic tank. ENGINEERNGSTUCIES AND REPORTS We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic tank. The construction of this system will not prevent any future development on any of the adjacent properties. WEUNSPECrION a OW TEST If you require additional information, please contact us. Sincerely, SITEPIINS ROAD DESIGN Robert C. Cowan, P.E. RCC1bjj Enclosure SM TEST PERCOLATION TEST STRUCTWL& MECHANICAL INSPECTIONS ONSITE WASTEWATER SPCSAISYSTEM DESIGN 15681 S. Birchwood Lp. Rd. —Chugiak, AK 99567 1" = 40' DESIGN SITE—PLAN n•a yio Mi 'o o �• Z CAD O / � f��t � � i• f / _ m r o _ Zx v C= / Oc ma OnD� Co/> W Z .> A s r O i£n0 r 9 /0 C O m2CZ Z m riy r /\ mDSm/O .0 Z f�fyfl n y ZOOZ m JCOZA m / n >II Q i� ti LAI 1 00 r N S ra N -'1Z xpZA 1-3 9�F a c =CA iN'•' ►� oar d� �/� c` $ sif - s j: S& FEALTNAURHMN APPROVALS SEWER&WATER WMEXTENSIONS SEWER & WATER MPECTION ENGINEEnINGSTMES ANOREPORTS WELLMPECTION &FLOW TEST SITEPLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANCAL NSPECTICNS ONSITE WASTEWATER CISPOSALSYSTEM DEMN ROBERT C. COWAN P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 1; Block 2; Glacier View Heights Subdivision #4 August 7, 2007 GENERAL: 1. The scope of this project includes the replacement of the existing 1500 gallon septic tank with a new 1500 gallon HDPE septic tank to serve the existing five bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Development Services Department or ADEC if required, for system installations. Owners installing their own systems must also receive prior approval from the respective agency. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. All HDPE septic tanks are required to have a 4" monitoring pipe installed next to the tank extending to the bottom of the tank. 15681 S. Birchwood Lp. Rd. — Chugiak,AK 99567 Page 2 Lot 1, Block 2, Glacier View Heights Subdivision 04 August7,2007 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. All HDPE septic tanks are required to be covered with a minimum of 2" direct burial insulation, and a maximum of 4 feet of cover. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type ofPipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Page S Lot 1, Block 2, Glacler View Heights Subdivision $4 August7,2007 INSPECTIONS: Typically there will be a minimum of two (2) inspections required during the installation of the septic tank. These inspections will occur as follows: 1. The first inspection must be conducted after the septic tank is set in place, but may not be backfilled until after this inspection. 2. The final inspection is to occur upon final grading of the property. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to cant' out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER (' Municipality of Anchorage , Development Services Department / Building Safely Division - On -Site Water and Wastewater Program, 4700 S. Biagaw St. 7 P.O. Boz 196650 Anchorage, AK 99519-6650 Page of www.cl.anchorage.ak.us (907) 343.7904 J ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5W000140 PID Number. 050 — 4 q 5 "'m'LJo61 Varidery I k Wastewater System: %New []Upgrade O E6i 771 5P c Alr 19 5 ABSORPTION FIELD Prwn. r 5 q/ r. q a tMboanr r n 1 �zDESCRIPTION J "T,» o S M T,wwh o e W o Lk r o Ol , LEGAL gyp" I• Pte' TNNDpFhwnap WWr IOrta abeh:� La'I VIS �Ys 1�� r Dsphbpdv benan han R,Ipi1W7.Js'_ • 5 il. Gs"d 0hb.r pip: Ft. TP hsp Pang. aea.n FM edded abw• W" Waf:O S+ GIRVN Le'v". / 1�'f'5FI. • Ft. Well: KNew C] Upgrade GsvN wlal[ 3FI. rnp s' Dlsfb_w lha•F! ' DaM•SMMrullm IPmws, T'[j�. B. EI VNTG TNN Dh:^C•Wb Ft. I FI. VZOFls PWMNMN - iV om.o. 6 SIN.W 0Fr (e /j Deb bW~sc7-0 U 1 _ if Al r YISN Q Pump uNzFtN'Dw Cramp lbgb Abm. G-n-,fnd of TANK V GPM rl. FL SEPARATION DISTANCES VSeptic ❑ holding ❑ S.T.E.P. ❑ Other. TorseAbsorption From Field LIR Station Holding Tank PubnUPrivat Sewer Line M'• »' I ryy0/ n Q ✓1 �•p•aly I S�� GN. wa IOLC MN«r1 eCsbtK.wNM IOD'+••JLIFT STATION La L.w �3, s MMu x1.M , 6 f � , 'Pvl,O •n' IwM N •Pump ar I Iph wNM Nrm N' FMMdNvI • In. Pump Myst Elsd,.N MPscllens ps,lN,nsd O/ 7- BENCH MARK C ThF a 1) O'(4kR.,r4 Du A, LocNb,l w D.wrylron / I ' TO pf. ^ oweula; on COvrT,2votT•ev — Ss(,4 R7.7.4L.iftro L i' LI A.» EIseM.. [y' PPrAT D 100 FI S41r_S LLT` Eni( OF 14(r i 11• S d S ENGINEERING Eagle River Looe RNo 1TI � � � — OQ E7, Inspections performed by:t7o34 47Voad, ates: ROBERT C. CO1YA* %@ Develdpment Servi es Department A proval 9 � �lyc, CE -8001 Reviewed and approved by:ate: ' 3 0 - 0 ttt`'Q . :.. 1 PERMIT No. SW000140 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele e hon343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 1, BLOCK 2, GLACIER VIEW HEIGHTS#q P.I.D. NO. 050-491-55 \\ NEW 150 \ SEI \ DBL1 410 \ 40 rte. LOT 4 Off\ P G� SCALE: V - 50' 2 'I, P\10BERT r- COWAN S B NEW HpUSfOAf 'o\ �f< _LOM FCO TANK BL2 STI OfCA B TH/11 T2 T8 MT1 CO1 CO CO T NEW TRENCH 14' MIN. ATH/2 lC:- 7 ALT SITE \J� a� rte. LOT 4 Off\ P G� SCALE: V - 50' 2 'I, P\10BERT r- COWAN PERMIT NO. SW0001 40 PAGE 3 OF 3 Municipalit of Anchoraqe DEPARTMENT OF HEATH 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 LOT 1, BLOCK 2, GLACIER VIEW HEIGHTS -'H P.I.D. No. 050-491-55 ST1 ST2 96.9' FINAL GRADE 89 g, NEW 1500 89 �, GALLON SEPTIC TANK A B FCO 15.0 32.5 ST1 17.5 34.5 CO1=93.4' ST2 25.5 39.0 CO2=97.5' 6BL1 27.0 40.0 DBL2 28.0 40.5 C01 41 .5 57.0 MT1 39.5 55.0 CO2 1 50.0 1 6.5 FINAL GRADE IMT2 1 46.5 18.5 COI=89.5' SR CO2=89.7' N. T. S. MT1=82.4' - E. ry ~ 95�9�+2 MT2=82.4' t �• r f NO WATER FOUNDr c " 76.4' D.O.H. i ....._..._.._...... ............ .. y ROBERT C. COWAN�? r ~��� Ot-�•1C,gc�h IY MN••W Municipality of Anchorage ,. Cj INEE 's. Development Services Department Building Safety Division �. On -Site Water and Wastewater Program 4700 South Bragaw SL •••^•-^•• ••--•'` P.O. Box 196650 Anchorage, AK 99519-6650 yt'4 ROBERT G COWAN • WQ www.cianchoraoe.okm (� 4;f:` CE -8801 •r{`�= (907) 343-7904 Soils Log—Percolation Test Performed For. ZG H %) V 4 A/D O.^ VA L K Date Performed: 7 / // /00 Legal Description: LOT- / IRK :1. GLACIt2 Vrtw Hr•S0ownship. Range, Section: -rw5;— Hall IL j- 2— Depth Depth 1 15- 16- 17- 18- 19 - GM slt_r, stro WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: wo, 5 0 P E Reading Date Gross Time Net Time Depth to Water Net Drop 7/01/00— % qic-& to IJ Mrar i'/i.. 3 ./1♦ >0 7 '/L" '3 yy •r J0 .76/2-" 3 vL• yu 7 Va., U O 1/ 1 �s PERCOLATION RATE a.9 (rnn.1eefeirh) PERC HOLE DIAMETER b TEST RUN BETWEEN —7Fr AND g FT COMMENTS FOR P/c2t,V1-4r/o,4 7—/c -J T— eA;JI­ y PERFORMED BY:S & S ENGINEERING 1 77;(.,(4 G' cycA.__ CERTIFY THAT THIS TEST WAS PERFORMED INA i1l.tICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7b//00 Eagto Rivulas a , A 577 JUL-19-00 WED 08:37 AM SULLIVAN WATER WELLS 688 2739444444444444 P.02 aer#tftib xYXCtxC �` ' by ooc eo. ee. SULLIVAN WATER WELLS P.O. BOX 670272, CHU(NAK, ALASKA 216/1. TWPHONZ 661-2761 OWNEROFLAND JZH#J 019►JAM L)IQL' ADDRESS LEGAL DESCRIPTION PERMIT NUMBER 1130/4 IN Date of Issue -k, TAX INDENTIFICATION NUMBER OS0L-. Is well located at approved permit location? es Q No I4dJ C.aJrjtc S--rc-edp Method of Drilling: 4Wir rotary Q cable tool Depth of well: /I 'I Casing Type -%,1NaIThickness. .a�lnches Diameter 4 1 Inches, depth /0_faet Liner Type: ✓J T Casing Stickup Above Ground: foot Static Water Level (from ground level): 01,0 lost Pumping level _feet agar hrs. Pumping _gpm Recover Rate: —ff--91)m Method of Testing: 4)k Well Intake Opening Type: "pen End Q Open Hob Q Screened; Start feet Stopped feet Q Perforations Start�t Stooped teat Grout Type: J3e#Qrt+-:k recm -I Sb I Depth: from {) feet. to Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? 43Kes Q eNo Method of Msinfection: G//A►.trw Comments: 7��a J�ood 0 y 64 73,3 en ed ,Tjc7i .(i4..1/I s (. ef#1.Jc L Llk SO4,1 (094.>lL I Sid 6A4dISL W dT Drillers Name —a,&4 f�� ATTENTION: It Is the responsibility of the property owner to subml a copy of the well W to the proper authority. Municipa.ity of Anchorage: Department of Heath & Human Services and/or Department of Envlronmental Conservation. MatSu Borough: Department of Environmental Coronation. Municipality of Anchorage George P. 115[Crch, Mayor Department of niMic Forks Btillding Safcty M ision P.O. Box lMi50 • 4700 S. Bragaw Street Anchorage, Alaslut 99510.6650 a ((X)7) 343.9301 6/7/2001 hltp://ttitiv.cf.unchonage.uk.us John Vandervalk rZLs � fo Cori,--e4l .4Jdresa `/1v1e/ Eagk4�uo111.77�c-AIG"'�- �a3o7� 771 S`bz Subject: Expired On -Site Water and/or Wastewater Permit. Permit Number: SW000140, Coopy Parcel ID: #050491-55 ,,Czktcaer v;c'a gelylta-s *y Dear John Vandervalk: An On -Site Water/Wastewater Permit, number SW000140, issued by this office for a single-family system, expired on June 1, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. When applying for anew permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, (Letters Sent 6/7/01 without copies being made, second printing for file copies) , James Cross, PE Manager On -Site Water and Wastewater Program enc: Copy of permit 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) 3434744 [hg�fi�a� 7/i/ /00 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW000140 Date Issued: Jun 01, 2000 Expiration Date: Jun 01, 2001 Parcel ID: 050-491-55 Legal Description: GLACIER VIEW HEIGHTS 114 BLK 2 LT 1 Design Engineer: 0003 S & S Engineering Site Address: Owner Name: John Vandervalk Lot Size: 45217 SO. FT. Owner Address: 9518 Trinity Cir. Total Bedrooms: 5 Permit Bedrooms: 5 Eagle River . AK 99577 - This permit is for the construction of: 0 Disposal Field F.✓ Septic Tank Holding Tank ❑ Privy Z✓ Private Well E] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1 SAAC72 ) 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. Received By: Issued By: 1181jor a Date: 6—/ —00 May 12, 2000 ROBERT C. COWAN. P.E. ROBERT A. SHAFER, P.E. CML ENGINEERS (907)694-2979 FAX(907)694-1211 APFRIONssHOfan MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER 6 WATER LIMN DMNSIONS REFERENCE: Lot 1, Block 2, Glacier View Heights S/D #4 SEWERBWATER INSPECTION It is requested that you issue a permit to install a septic system and well to serve the proposed five bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location AAREPPOORTTSSS S of the test hole is located on the attached site plan. At the time of excavation on 2/4/00 water was not found. WE INSPECTION We do not anticipate any adverse effects on neighboring wells, septic systems, reserve SPLOWTEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PIANS If you require additional information, please contact us. Sincerely, ROADDESIGN 0z /rlv� SOILTEST Robert C. Cowan, P.E. RCC/jhm Enclosure PERCOIARCN TEST sTwcTuaKa MECHANICAL ICKCTIONS CNSRE WASTEWATER CISPOSALSYSTEIA DESIGN 17034 NORTH EAGLE RNER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 17034 w E- 651 3 "° LOT 1, BLOC m" B.: C.QaEu J.H.M. ming DESIGN CRITERIA: 5 BDRM = 750 GPD SOILS = 750 GPD/SQ.FT. 750/1.2 — 625 SQ.FT. REQ -D. TRENCH CRITERIA: Ram 10.5' DEEP P7 7' EFFECTIVE IR 2.5' WIDE I 45' LANG SEPTIC AREA ALL PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATIO 2, GLACIER VIEW HEIGHTS S D C.C. 5-31-2000 2 OF 2 STRUCTURES. EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PIAN ARE AS SHOWN ON AN AS-BVII.T SURVEY DRAWN BY: WILLIAM D. FLEMING IT IS THE RESPONSIBD.TY OF THE CONTRACTOR TO VERIFY EASEMENTS. REQUIRED SEPARATION DISTANCES. AND PROPERTY LINES PRIOR TO CONSTRUCTION. \ f INSTALL \ DOUBLE CLEANOUTS PROPOSED TRENCH c�F 1500 GAL. 1� SEPTIC TANK INSTALL r FCO ROBERT C. COWAN i �Q- 11 c� CE -8801 ff k� L�. • N CONTRACTOR IS REQUIRED TO AIN UTILITY LOCATES P TO ANY EXCAVATION WORK LOT 2 z 0 In w c z I E cn LOT 1, BLOCK 2, GLACIER VIEW HEIGHTS S D c wm W. ECKEU dv: WiE: SxCEI: J.H.M. R.C.C. 5-31-2000 1 OF 2 !' DESIGN CRITERIA: STRUCTURES. £ASENENTS. OR ENCROACHMENTS . iEngineering SHOWN ON THIS SITE PLAN ARE A3 SHOWN ON 0 /) 5 BDRM = 750 GPD AN AS—BUILT SURVEY DRAWN BY: _.G.c_., "!^,.' SOILS = 750 CPD/SQ.Ff. WILLIAM D. FI.EMING, ROEERT C. COWAN ? f2 750/1.2 = 825 SQ.Ff. REQ'D. IT 13 THE RESPONSIBILTY OF THE CONTRACTOR 2 \ TRENCH CRITERIA: TO VERIFY EASEMENTS. REQUIRED SEPARATION lj +� CE -8801 {\.' DISTANCES. AND PROPERTY LINES PRIOR TO (t1 �`•`'-__ ,,' • ti' CONSTRUCTION. 1 „ 1"34 EP EGLEFA6EE9RNERLOOPUI 77D 07)694-2979 70.EFFE TIVE (itlj`��<=='.'` + FAX/ (907)694-1711 2.5' WIDE 45• LANG CONTRACTOR IS REQUIRED TO \ OBTAIN UTILITY LOCATES \ PRIOR TO ANY EXCAVATION LOT 1 WORK Y y � \ LOT 1 MYRTLEDOUBLE— CLEANOUTS PROPOSED - 4m mc \ 1 ,Sao GAL. AREA I 8 TANK RW� °qo \ LOT 16 \ d ECD 9 I LO 2 s< LOT 3 <S£PI,C LOT 2 EPTIC OT 4 �"�"� LOT 3 ALL PORTIONS OF SYSTEM LOT 5 (�/ WITH LESS THAN 3.5. OF \ SEDC COVER REQUIRE INSULATION. AREA i F;J9+. Municipality o1 Anchorage :'•?� • ir^ DEPARTMENT OF HEALTH &HUMAN SERVICES / 825 "L" Street, Anchorage, Alaska 99502-0650 " SOILS LOG - PERCOLATION TEST �� f,, ROEERT G COWAN PERFORMED FOR: JOF'� A-iq OZ"e_-VAUL DATE PERFORMEDt _ LEGAL DESCRIPTION: I �/-+'i`��h✓ Township, Range, Section: YI&I'i � LL TS � SLOPE SITE PLAN (FEET) I VA!&7-N(G5 1 2 4 5- 6-0 7 9 - 10- 11 12 13 14 15 D'•' 16 ` ,7 11M 19 6m wlco6w- 6 P s WAS GROUNDWATER 4 /O ENCOUNTERED? �`( S IF YES AT WHAT DEPTH? Depth to Water Aller DRi Monitoring? D�� Dete:.� ®=®®m �---fir 20-{ o IL�1 PERCOLATION RATE Z� 3 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS Af Sont 14.r'3 it"' +� 0E2L µ•i•rt S & S ENGINEERING PERFORMED BY: 1 � _;nr_ CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road No. 204 ACCORDANCE WLT}b"*Ta#jA iGA+' %7JPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72-008 (Rev. 4/85) W-4 ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694.1211 ON-SITE WASTEWATER DISPOSAL SYSTEM IEALTNAIRNORITV CONSTRUCTION PRACTICES APPROVALS and MATERIAL SPECIFICATIONS SEWERS WATER MAINE CTENSIOKKS REFERENCE: Lot 1, Block 2, Glacier View Heights S/D #4 May 12, 2000 SEWERS WATER INSPECTION GENERAL: 1. The scope of this project includes the installation of a new 1500 gallon septic tank and installation of a new trench to serve the proposed five bedroom ENGINEERNGStt101ES ANDREPORTS residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WELLINSPECTION SFLOWTEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITEPlANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing SOIL TEST their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: PERCOLATION TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCTURAL& .TECNa+IC& INSPECTIONS 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER DER'OSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP - SURE 204 - EAGLE RIVER, ALASKA 99577 Papa 2 • Lot 1, Block 2, Glacier View Heights SID 94 May 12, 2000 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCHIDRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Pope 3 • Lot 1, Block 2, Glacier View Heights En7 94 May 12, 2000 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Tyne of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Ppga 4 Lot 1, Block 2, GlacNr View Heights WD 04 May 12, 2000 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the ownees representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to cavy out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTORIINSTALLER f Municipality of Anchorage Development Services Department Building Safety Division 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 Parcel l.D. COSA # 61033 -1 - Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 1; Back 2; Glacier Yaw Heights subdivision #4 Location (site address) 22501 Eagle Glacier Loop Eagle River, A<995" Current Property owner(s) Pierre a Megan N LO OtLT Day phone 952-2174 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA w#1 be held by DSD for pickup 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Weil✓❑ Individual On-site ❑✓ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Weil ❑ 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 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 ls(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm S 6 S Engineering Phone 6942979 Address 15861 S. Birchwood LP Ch iak, 4 567 Engineer's Printed Name r Date o Z M_• .. 5. DSD SIGNATURE ✓Approved for / bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: X110 .1 n ucuw. COSA Checklist ?i_ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By�— �� / '�Original Certificate Date: (Rw.. IM) Municipality of Anchorage Development Services Department Building Safety Division On -Sete Water & Wastewater Program s 4700 Bragaw Street P.O. Box 196850 Anchorage, AK 99519 -OM www.muni.org/onske (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description:l�fXaZ'1 I Parcel ID: 0.-0 — 4-9 A. WELL DATA Well typ;R1V)fM K A. B, or C provide PWSID # Date completed yr *06 Sanitarysealah) YF - Total de r p �_ft. Cased to (_�ft. FROM WELL LOG Date of test 117J z d0 Static water level qz) ft. Well production Snc g.p.m. WATER SAMPLE RESULTS: Coliform --o_colonies/100 mL Nitrate D./S0mg1L Arsenic: T mgll Date of sample: AID/ B. SEPTICIHOLDING TANK DATA Tank Type/Material L Tank siva 15CO gel. Number of Compartments Well L., ) Wires property protected) Yff-; Casing height (above ground) aq it 1i in. AT INSP CT ON 2 t7 89 .Other bacteria ft. g.p.m. © colonies/100 mL Collected by: 'd& a- S tic * LX* lXZ Date installed t / ` F Cleanouts&) 7 LA`S Foundation cleanout & _-ism' Depression over tank (Y6_AJ!;O High water alarm (Y4T)_JLJP Date of pumping' A.,M' 224/[ 7Pumper " ILI�Ii C. ABSORPTION �FIELD /DATA Date installed II 00 Soil rating p.d or htr/bdnn) System type —Dt-ey, —Ir60LxY r r Length_ ft. Width 3 ft. Gravel below pipe ft. Total depth —/a!;ft. Eft. absorption area j6EOft Monitoring tube )&s Depression over field _&)—c' Date of adequacy test —� Resul (Pas all) �R'�i For bedrooms Fluid depth M absOlin. p orption field before test � in. Water added]v poi. New depth Elapsed Time: 20 ^, `�r min. Final fluid depth � in. Absorption rate >= '7 50+ g.p.d. Any rejuvenation treatment (past 12 mo.) ()6k type) oep If yes, give date = D. LIFT STATION t0l A Date installed - - - Size in gallons -.114anheh 'Pump on' level at _ in. 'Pylnp efPt8tia at _ in. High water alarm level at Datum / Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 1 Septic tank/itrt station on lot (� f Absorption field on lot Public sewer main VIA Sewer /septic service line as 1 Animal containment areas $D r-1 r On adjacent lots /00 f- On adjacent lots too '#.- Public sewer manhole/cleanout A_!f? Holding tank lu it i Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation $ r f Property line 5 + Absorption field "r r 1 Water main ANA /610Water service line /Q Surface water �a- r Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r r Property line + Building foundation 104 Water main jl)A Water Service line fQ Surface water /G7D 1 Driveway. parking/vehicle storage �© r Curtain drain Az" Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I car* that 1 have determined field inspections and • review of Municipal records ,that the bove syste in conformance with MOA COSH uidel sin !fe is e. t .... 'f Engineer's Printed Name A. i/er J n.. taxa Date 0*�••.��...� ��1 1 COSA Fee $ �.7U ,- Waiver Fee $ Date of Payment S �� Date of Payment Receipt Number 3 s� 8� Receipt Number (Rev. 11/05) in. r i h vo it N n l� /'�• Frew.. __- tlµ •a W r \C 3e 4•A r + •. ` Ile fo" \ HER M-r"h .r m AS -BUILT 1 hereby certify that 1 have surveyed the following described property, L O-1.. J. F L G r—K�! Z C-ltiG V'-aI— 1L10AI�tt/NtT NC !r S c4 -%on M, T!4 N P1LSMJ Anchorage Recording Precinct, Alaska, and that the improve. merits situated thereon are within the Property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and tfiat there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this LFY� ay of A V C 2002 ROBERT C. JOHNSON -e-,r4 SCALE: Registered Land Surveyor No.4WZ-LS 1" .f O' Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694-2543 Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 471X) 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. 050.4Q1-55 COSA# �lnQl 1. GENERAL INFORMATION Expiration Date: — 3-0& Complete legal description GLACIER VIEW HTS f4: LOT 1. BLOCK 2. Location (site address) 22501 EAGLE GLACIER LOOP • EAGLE RIVER, AK 99577 Current Property owner(s) JOHN VANDERVALK Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing address P.O. BOX 771562 • EAGLE RIVER, AK 99577 Day phone 694-5448 JERRY CURLEE w/PARTNER'S REAL EST. Day phone 694-4994 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ "The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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 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. 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P Engineers Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines B 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 U confer any legal right whatsoever. 5. DSD SIGNATURE l� Approved for bedrooms. Disapproved. Phone 337-6179 Date 14126 /Of. Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Other Qr.•.....,�.�, •, ON-SnE ,'. WASTEWATER PROGRAM By: �i(/ r� Original Certificate Date: -6--3-06 Municipality of Anchorage • Development Services Department Building Safety Division On -Sits Water & Wastewater Program 4700 South Bragew St. P.O. Box 196650 Anchorage, AK 995195650 www.cl,anchorage.ak.us (907)943.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLACIER \AEW HTS #4• LOT 1, BLOCK 2, Parcel ID: O �i 0 ' 4 q (' S _ A. WELL DATA Well" PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 7/12/2000 Sanitary seal (YM) YES Total depth 160 ft. Cased to 159 ft. FROM WELL LOG Date of test 7/12/2000 Static water level 90 ft. Well production B — 9 -p.m -WATER SAMPLE RESULTS: Coliform 0 oolonies/100 ml. Nitrate ND mg./L. Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. AT INSPECTION 4/20/2006 89 ft. 6.1 g.p.m. Other bacteria 0 colonies/100 ml. Arsenic: ND ug./L. Date of sample: 4/20/2006 Collected by: GEG Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/12/2000 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 4/10/2006 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed Z=2000 Soil rating .p.ir ft'/bdrm) 1_2 System type DEEP TRENCH Length 45 ft. Width 3 A. Gravel below pipe 7 ft. Total depth ro.s ft. Eff. absorption area 630 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/20/2006 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 31 in. Water added 100 1 gal. New depth 41 in. Elapsed Time: 184 min. Final fluid depth 31 in. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN if yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements?, SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiR station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25•+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A 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 t0$+ Surface water 100'+ Driveway, parkinglvehide storage 10'+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION�� • 1 `•: �. i oertNy that 1 have determined through field inspections and + `J .. review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this . • • • • , . • • • • • • • • • • , date. rness.* Engineer's Printed Name JEFFREY A. GARNESS E— Date' '•r0fe5 olesSilo 1,d COSA Fee Date of Payment 's�lX% Receipt Number a 4 %r (Rev. 1IMS) Waiver Fee $ Date of Payment Receipt Number m �Ec o=r -o co m ro�pc ^'^LtJ m m Q� a•. 0 o e o 2 c q W m2�"�•� vN_ w gyy o V a W N N N m O m to 1p E^ m ao _ L L C is J ti Woma � cvic w CD c P o z Q 1 m yv rn um�• o d W S a v c w n >= p J Z a W O m yr ti S o O Q m J G to IV9-4 Z00/Z00'd IBE -1 BOlEZ9lLO8+ MOW 1VI1N30n8d-wOJA me9VI0 90-BZ-Jd4