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Home My WebLink AboutEAGLE RIVER VALLEY RANCHETTES LT 1D L � MUNICIPALITY OF ANCHORAGE ,tali r.r On-Site Water&Wastewater Program ti•� • 'S• r,. . PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone: (907)343-7904 Fax: (907)343-7997 ,�- http:!lwww.muni.orglonsite rl _ CI?;II'tn tlll• 4'YCHDR pVF On-Site Wastewater Disposal System Permit Permit Number: OSP171306 Effective Date: 10/10/2017 Work Type: SepticTank Upgrade Expiration Date: 10/10/2018 Tax Code Number: 05022101000 101 1 I ti -CcaJR- 1'. 3 0 Site Legal Address: EAGLE RIVER VALLEY RANCHETTES LT 1D G:0054 Site Mailing Address: 19131 CITATION RD, Eagle River Owner: LOCHNER GEORGE J & SUSAN J Lot Size in Sq Ft: 17955 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well D Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: /d//6- / Issued By: 46, - � �� ,, Date: WO 7 r V UNDC ALfl-y OF `..ENCU IIO ! SAGE Community Development Department ' �' '� ` one: 907-343-7904 Development Services Division On-Site Water & Wastewater Program ON-SITE SEWERM/ELL PERMIT APPLICATICH71 CT 0 9 2017Rj 14 "2- D� Parcel I.D.050- el--.0( a Property owner(s) L OC/f/ e/e Day phone f q Fc -(?32 Mailing address /?l!/ (3/, ,ed Site address SC 71 Legal description (Sub'd., Block & Lot) � /� ✓e, 43 1 wicJ 6 l Z Legal description (Township, Range & Section) Lot Size / Z 755 Sq. Ft. Number of Bedrooms 4( APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply} Absorption Field ❑ Initial ❑ Single Family (SF) ?.) (w/wo ADU) Septic Tank 733 Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Sign re of property ow or author ed agent) Permit/Rush Fees: 4 S4c!- Waiver Fees: Date of Payment: 'OM /j Date of Payment: Receipt Number: c57g3b Receipt Number: Permit No, 4SPI'7-/30., Waiver No. Permit App 9-1-12.doc TI- IM ENGINEERING SteveEng.com Steve Eng, PE, PH (907) 694-7028 SteveEngPE@gmail.com Date: 10/9/17 Number of rages: To: MOA On-Site Services Subject: Eagle River Valley Ranchettes Lot 1D Septic Tank Replacement The subject septic tank has failed- a new tank will replace the old one. The existing trench/crib appears to be working OK. Please issue a permit so the tank can be replaced. The existing trench/crib will remain. Please review as soon as possible. If there is need for additional information or clarification please give me a call. Thanks-Stev ENGINEERING SteveEng.com Eagle River Valley Ranchettes Lot 1E SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 4-bedroom home. Most of the neighboring lots are developed. The current septic tank has failed-the trench still functions. These lots are near an half-acre and are served by the public water system. No adverse impacts are expected from tank replacement. The easements are depicted on the lot. The slope is indicated in the area of the septic system. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 2- compartment, 1250 gallon septic tank. Watertight couplings on inlet&outlet. • 5' minimum between the tank and bed. 10' to property lines. • 4' of cover or insulation is required for tank; an equivalent of 1" insulation for 1' foot soil cover. Minimum of 2' soil with insulation. Tank& solid pipe must be set on well compacted, stable soil. • 4" diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) if R� qtr 4;:..4:;1 /0/y/r7' DESIGN NOTES: 1. ExistingTrench/Crib Remains. Match Elevations. 2. Sewer Service Line minimum 2% slope. 3. Public Water System. 4. Decommission Old Tank Per UPC. 5. Install Foundation Cleanout If Absent. / No Conflicts 7 10' Utility asernent Water Service —1 4 Bdrri s u c o, L 3% Slope ~ ; d 3% Slape m -5 > w i0 IL IL X kilU W Decommission Old I Septic Tank PER UPC & Citation Road Replace w/ 1250 Gallon Existing Crib eptic Tank w/ Double Cleanouts +„ `,,St.-Ljr 14 t44\ EAGLE RIVER VALLEY 1' = ao' NOR THRIM �~P- ENGINEERING • `'�% RANCHETTES LOT 1D PLAN PO Box 770724 LAYOUT Eagle River, Alosko 99577 is-' ' .l��t -�' WASTEWATER DESIGN 907. 694. 7028 REPLACE SEPTIC TANK 0/9/17 irOf 3 Foundation Cleanout Tank Cleanouts Fin ade Opposing Cleanouts Between Septic Tank & Trench 4 Foot Cover or Equal r- I 1250 Galton Steel r To Trench/Crib 'Anchorage Tank' Or Equal lid Pipe Match Elevations To DESIGN NOTES Existing FCO & Line 1. Use Existing Trench/Crib. 2. Septic Tank & Solid Pipe to be Placed on Compacted, Stable Soil, Free from Boulders. 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. 4. Water-Tight Couplings. 5. See Specification Sheet. 6. All Work To Conform to Municipality of Anchorage (AMC) Requirements & Specifications. 7. Decommission Old Septic Tank Per UPC. 8. Check Condition Of Sewer Service Line. Replace And/Or Insulate If Necessary. 9. Locate Foundation Cleanout- Install If Required. 4,c.. °F• ' �� '� EAGLE RIVER VALLEY NOR THRIM � . SEPTIC TANK PROFILE ENGINEERING ' ' 9m� �� '�� RANCHETTES LOT 1D PO Box 770724 (ogle Rivrr. Alaska 99577 a • C 907.694.7028 ?61110 TANK REPLACEMENT Date:10/9/17 rwn BY: SE I ° 1' = 5 ' I :3 of 3 SE Municipality of Anchorage Page / of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~-)'~ ~/~=" ~ PID Number: ~"~'~.-'~-/4~ / "~~ ~. ~~ Wastewater System: D New ~ Upgrade Address, ~ ~~ ~/~ ABSORPTION FIELD Phone ~~/~~edr~ms D Deep Trench ~ Shallow Trench ~Bed ~OOther LEGAL DESCRIPTION so,'",,,,~' ~"D'Sq ~, I~ GPM Ft Ft TANK SEPARATION DISTANCES ~s~p,c ~ Ho~ing D S.T.E.P. Well ~ ~ ~j+ Mate,~~ Num~rolCompa.ments. Surface w~,~ I~'+ i~ -- ~ -- LIFT STATIO~ Lo, Cu.ainDraln ' ' ~,~ ~'d ~ ~um~.M.el IEl~tricallnsp~t,onspedo,medby: Remarks: BENCH MARK ENGINEER'S SEAL ~170~EaGleEiverLoopRfld, Ho.~ . /_ ,_ F ~~ Inspections performed D~gt~t.s~ Dates: 1st ~/~ Department of H?I e~ices aRprov~l/ ~/~'~ ~~.~,~~"7~ .. Reviewed and approved by:~~ ~ Date: ~ ~¢~x~. ~ ~- Pern~it No. SW950182 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:EAGLE RIVER VALLEY RANCIIE'rrES SUBD., LOT ID PID No.: 05022101 COl C02 ~FmA~ CP. ADZ PROPERTY SERVED BY A PUBIC WATER SYSTEM. NO WELLS WITHIN 200' OF SEPTIC SYSTEM. 4 HOUSE TRENC}~ 12:,50 GAL TANK ~ ~10' UTIL. ESUT. I CITATION ROAD COt C02 3E:.3 40.5 38.8 4'7.5 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930182 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HAGMAN WARREN L & OWNER ADDRESS:836 SHOREVIEW DRIVE HENDERSON, NV 89015 DATE ISSUED: 6/24/93 EXPIRATION DATE: 6/24/94 PARCEL ID:05022101 LEGAL DESCRIPTION: EAGLE RIVER VALLEY RAN~HETTES LT 1D LOT SIZE: 19955 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM 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 (ISAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: APPROVAL GRANTED FOR FOUNDATION WAIVER TO FIVE FEET. RECEIVED DATE: SITE P!.ANS ROAD DESIGN SOIL TEST ROBERT SHAFER, P,E. ROGER SHAFER, P.E. June 21, 1993 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Hunicipality of Anchorage 3EPARTMENT OF HEALTH AND HUMAN SERVICES 325 L Street P.O. Box 196650 ~nchorage, Alaska 99519-6650 REFERENCE: Eagle River Valley Ranchettes Subdivision, Lot 1D Request you issue a permit to replace the septic tank serving the four bedroom home on the referenced property and issue a 5' Foundation to Leachfield Separation Distance Waiver. During an inspection of the existing septic system, water in the septic tank was found to be at 2'8". Water was added to the system, measurements taken, and water was then measured at 3'8". After two days the water level in the septic tank was again measured and found to be at 2'8". It appears from this data that the septic tank is of poor integrity. We request a permit to excavate the existing septic tank, verify its integrity, and replace it if necessary. The existing leachfield was installed on April 2, 1980. The garage was added to the house some time after the leachfield was installed. When the garage was added, the foundation was located only 5' from the existing leachfield. We request a waiver be issued for a 5' separation distance from the leachfield to the foundation. If you require additional information for your review or have any questions, please contact us. A. Shafer, P.E. SU/lsu 17034 NORTH EAGLE RIVER LOOP " SUITE 204 · EAGLE RIVER, ALASKA 99577 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFKRENCE~ EAGLE RIVER VALLEY RANCHETTES SUBDIVISION, LOT 1D GENERAL~ 1. The scope of this project includes the excavation of the existing 1200 gallon concrete septic tank serving the four bedroom residence located on the referenced property, to verify its integrity. If the integrity of the existing septic tank is poor the existing septic tank is to be excavated, pumped, filled, and abandoned in place and a new 1250 gallon septic tank installed. 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. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wast.water disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INST~?.?.%TION~ A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" clean.uts for pumping access. mo The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a mlnlmum of 12 inches above final grade. Page Two Eagle River Valley Ranchettes Subdivision, June 20, 1993 Lot 1D 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. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorages Type of Pipe 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. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). J Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafl 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Page Three Eagle River Valley Ranchettes Subdivision, June 20, 1993 Lot 1D 0 All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to~24C 15.65.060D. 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: 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. me 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. 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. ¢E°^'EAGLF~ RIVER VAI,LEY RANCHETTES SUBD., LOT 1D ' - ~.~..~ ............... ,.. ~ PROPERTY SERVED BY A PUBIC WATER SYSTE~. ~*~~.~x~?.. ' ~'~ NO WELLS WITHIN 200' OF SEPTIC SYSTEM. ~. ~.. · ........:,,.~ ~ 5' FOUNDATION SEPARATION TRENCH~ 4 BDRM HOUSE CITATION ROAD GAL CONCRETE VERIFY UT~. ESMT.! ( ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IPHONE I [~NEW MAILING ADDRESS ~ LEGAL DESCRIPTION Well ~sorpt~on area PERMIT NO. ~ Manuf~turer Material ~d~" .o. of compartments ~ ~ DISTANCE TO: Well ~erling PERMIT NO. m DISTANCE TO: * "" Nearest lot Fine sol L TEST RATING 72-013 (Rev. 3/78) PERMIT NO. MUr4ICI PALITY OF Ar~CHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 ~L' STREET, ANCHORAGE, RK. 99501 264-4720 APPLICANT LOCATION LEGAL EVERETT CAULKINS ~i~ SR BOX 9030 CHUGIAK .LI~T-!~AGL£'~i~ER.R~NGHETTS LOT SIZE 688-9280 20000 SQURRE FEET TYPE Of SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER Of BEDROOMS = 4 SOIL RATIWG (SQ fT/BR)= 220 THE REQUIRED SIZE Of THE SOIL ABSORPTION SYSTEM IS: DEPTH= 7 LENGTH= :L'le GRRVEL DEPTH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> Of THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. REQU'rRED ~;EPTIC TRNK STZE= '1250 GRLLOhlS PERMIT APPLICANT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ------ TPlO (2 > I t~SPECT IONS RRE REQU I RED BACKFILLING OF ANY SYSTEM WITHOUT FINRL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN 8 WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO 8 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. PERM I T EXP I RES DECEr'IBER 3:L.' :LS:~ 80 I CERTIFY THAT 1: IRM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF RNCHORRGE. 2: I WILL INSTALL THE SYSTEM ZN ACCORDANCE WITH THE CODES. 3: I UNDERSTA~ THAT/~HE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE SIGNED: ...... ENG, ,qEERING & DEVELOP.[,lENT CO. Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Ru~ell Oyater 694-2774 Performed for: Name' ,~,~/d,~'$ 0/~/ Mailing Address: Legal Description: ~/¢7' .~' Ead Ellis SOIL LOG 688-2280 Depth (feet) $oll Charactedatlca 3 9~ 10 11 12 PLOT PLAN 13 14 15 16 PERC. TEST Ground Water Encountered: Yes No ~ If yes, what depth Proposed Installation: Seepage Pit Comments~ ~'///J ~"U/~---~,EL~ ~ W,~ D U ~ '7'° ~9~5~.~ ~ ~,, ,,r.,,,~ ,,~m)~,~ ~t.< ~i Pedormed by: /~~ ~ Drain Field.__ Date: ~NSPECTION REPORT ON-SITE SEWAGE DISPOSAL SEPTIC T~K: Dtst~ce f~m well-- Mate~lal(~.~,~Wf~e~ of co~a~nts,,,/ L~qutd capac~ty/DO D gallons, Inside length,, ~' Inside w~dth~' L~quid depth S~PAGE SYSTE~: Seepage P~: Nu~e~ of p~s~Outs~de d~a~te~ o~ well -- , building fo~datl~ -- , nea~st lot line, ,/~' Total effec~ive ~sorptton a~a (wall a~a) ~ ~ ~ sq. f~. ~ILE~N FIELD: Distance from well , lo.darVon , ne~st lo~ line 'rotal len~h of llr..s~ Nu~er of lines Distance between lines T~nch width~ In. To~al effec~iv~ ~sorp~t~ area sq. f~. ~n~h of each line ~p~h: Top of ~ile ~o finish ~ade_ Depth of filter ~erlal beneath tile In. ~ove ~ile WELL: -_ , pt~ , dlst~ce from building fo~da~lon , nea~st lo~ line , nearest sewe~ line., , septic ~k , seepage system cessp~l_ ~ o~her 2ou~es DI STANCES: DIAGRAM OF SYSTEM o, APPROVED ~/~ th Authority r[ IMS :MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-221-01 1. GENERAL INFORMATION Expiration Date: —l'— 2 6 `Z6ZU Complete legal description Eagle River Valley Ranchettes L1 D Location (site address) 19131 Citation Rd, Eagle River Current property owners) George & Susan Lochner Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System El Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 226 Date of Payment 3-11,71 (q Receipt Number 05-(o,P'2 COSA # MLA 18 ( Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system In accordance with MoA COSA guidelines and regulations. The reported results describe 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 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 are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report Is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. DSD SIGNATURE VSystem #1 Approved for System #2 Approved for Conditional approval for Date / QO7/;7 bedrooms, with the following sti By: 1 Original Certificate Date: 7 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Eagle River Valley Ranchettes L1 D If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments Public Water B. TANK DATA Age of tank(s) 1 years Tank type/material Measured operating fluid level in septic tank , MR Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 1980 FE -1 ALL standpipes present per record drawing Total measured depth from grade 12.4" ft (max) Measured depth to pipe invert from grade 7.2* ft (min) ❑ N/A — pressurized field FBI Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: Structure served by this system 1 050-221-01 Well production at time of test gpm Water storage tank volume 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 7/15/19 Results E]Pass For 4 bedrooms Fluid depth prior to test 11 in Water added 600 gal New depth 12 in Elapsed time 150 min A Code -required soil cover over field Final fluid depth 11 in ® System presoaked Absorption rate >600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) n/a date of test) Gallons introduced 2000 gallons If yes, enter date Comments/Deficiencies: Perfield measurements taken on 7/15/2019 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) F-11 Yes Septic Tank/Lift Station on Lot > 100' n/a Surface Water > 100' Community Sewer Manhole/Cleanout > 100' n/a ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No n/a ft Private Sewer/Septic Line > 25' ❑ Yes if No n/a ft Absorption Field on Lot > 100' ❑ Yes if No n/a ft Holding Tank > 100' ❑ Yes if No n/a ft Neighboring Absorption Fields > 100' n/a ft Animal Containment > 50' 1771Yes if No n/a ft ElYes if No ft if No ft If septic tank is under driveway comment below Community Sewer Main > 75' F-1 Yes if No n/a ft Manure/Animal Excreta Storage > 100' ❑ Yes if No n�a ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F-11 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' El Yes if No ft Community Wells > 200' r7l Yes if No ft Water Service Line > 10' El 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 5* 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 a er ervlce me > 10' ✓Yes If No ft Community Wells > 200' V Yes if No ft Surface Water > 100' F71 Yes if No ft F. ENGINEER'S COMMENTS * Waiver on file for 5.0' on permit #sw930182 G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. J ?® 2 6-4 . , COSA Checklist yellow sheet OFA��k 1t� TH ~ .' .. '"a'it=", _ .. - 1 I ' v 01 N89'59'%5"1,11 733.00' ,c' u7n_ -Y EAS E , . 1_2.1', I _ IF --- u � 37.4' r t I ,j 50.2' { 1i N ! ' 1 i!. 2 STORY Q o LOT 1-Q I HGtiIE O 1 rn 4- 217. 0' I rnDECK -- LCT ;--C O — — — !n _O —x— CHAIN LINK FENCE O 1. SURVEY CERTIFICATION: RODNEY P. KINNEY — O ASSOCIATES INC. HAS CONDUCTED A PHYSICAL c 49 ,~ tc G ._. V Clark E. Kinney o wf Ls -127 ®A Ofessicnal —� o4? 1L 23,2 R- AiNING 0 ;.�_. DIRivEWAY ,n ; �i 58959'95'E 133, 00 CITATION ROAD LOT 1-D EAGLE RIVER VALLEY RANCHETTES AS -BUILT PxfilyP,fY12tfu (PLAT 63-129A) L� ew:mnxe sxmas. e::vncxx-'- ANCHORAGE RECORDING DISTRICT 7/241/19 FIGURE -1 — — — — — — CANTILEVER —x— CHAIN LINK FENCE 1. SURVEY CERTIFICATION: RODNEY P. KINNEY — — — OVERHANG ROOF ASSOCIATES INC. HAS CONDUCTED A PHYSICAL 0 POWER POLE SURVEY OF THIS PROPERTY AS SHOWN ON THIS DRAWING AND THAT THE IMPROVEMENTS c SEWER VENT SITUATED THEREON ARE WITHIN THE PROPERTY G¢ LINES AND NO ENCROACHMENTS EXIST OTHER ❑ TELEPHONE PEDESTAL THAN NOTED. TP r TV PEDESTAL 2. EXCLUSION NOTES: IT IS THE OWNERS �r RESPONISIBIUTY TO DETERMINE THE EXISTENCE WATER VALVE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE GRAPHIC SCALE RECORDED SUBDIVISION PLAT. NOTE: UNDER NO ao CIRCUMSTANCES SHOULD ANY DATA HEREON BE e is 30 USED FOR THE CONSTRUCTION OR FOR THE ESTABLISHING OF PROPERTY LINES. 1 inch = 30 feet LOT 1-D EAGLE RIVER VALLEY RANCHETTES AS -BUILT PxfilyP,fY12tfu (PLAT 63-129A) L� ew:mnxe sxmas. e::vncxx-'- ANCHORAGE RECORDING DISTRICT 7/241/19 FIGURE -1 (� U SANITARY PUMPERS 17545 KAHILTNA [SIR. EAGLE RIVER, AK 99577 907-6'58-46012 SANITARYPUMPERS.COM YOUR SOOPER DOOPER POOPER PUMPERS DAT 7- r 7 - Et IT, - -- - ------------------- 11 TAX LtM LDAY LATE FEE $L20.00 RECEIVED BY TOTAL All claims and returned goods rvjUST be THANK YOU accompanied by this bill, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Aiaska. 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1, GENERAL INFORMATION Complete legal description Location (site address or directions) 19151 CZ*ta~on e Property own'er Mailing address Lending agency Mailing address C/O R~c~ Ea~ EJ. ue~ Day phone 16600 Ce~e~Z~d Day phone e/o Remcc~ ~94-4£00 Ea.q,~e. I~Zu~,c~ AK Day phone AK 99F77 Agent V,/r_~Zn,/.a Koh~_le. td-REgiAX EAGLE RIVEI~ Address 16600 Cen. teAfZe,gd ft~Ol Unless otherwise, requested, HAA will be held for pickup, NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: ~q4-4900 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to th'e legality and status of system. 5. STATEMENT OF INSPECTION BY ENGINEER AS certified by my seal affixed hereto and as oi the validation date shown below, I verify that my investigation of this Health Authority Appro~,al 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 disposa! system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ' - .............. ~ :Phone ~ ~'~TL~ Z' ~'7 ~ Add ross 17034 Eagle River,,,J~p Roa~/140. 204 DHHS SIGNATURE ,~. C/Approved. for , bedrooms. Disapproved. Conditional approval for bedrooms, with the following Stipulations: By: Additional Comments L./"-- '1 I 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 indepe~Klent professional engineer registered irt 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 omissio,,s in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:~-"o~' ~;;) ~'~-~1 ~ ~'-~q,~'.~ A. Well Data Pamel I.D. we, type h- Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level1 * SEPARATION DISTANCES F~OM~O: Septic/holding tank on lot / Absorption field on lot Public sewer main J Sewer service~__ WATfi~J~M~E RESULTS: Col~rm Nitrate Date of sample: If A, B, or C, attach ADEC letter. ADEC water system number .Date completed .Driller .Cased to ' Casing height/......../ .Wires properly protectedx .~JSECTION FROM WELL LOG . ~ g.p.m. ~ ~ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank .Other bacteria Collected by: SEPTIC/HOLDING TANK DATA Cleanouts ~1) '~ High water alarm (Y~ Date Installed {-" ""~ ~ '-"~ 3> .Tank size ~ 'Z..~"c> Compartments '?-- Foundation cleanout (Y~__~Al'~arm,-~t ~ p ress~i~(Y/l~ pate of pumping j'-.-- P-~---~.-~' Pumper. r.,~::'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ c> ~ .L. On adjacent lots ~L .Foundation To property line ~ ~ ' ' Absorption field ~"' Water main/sen, ice line Surface water/drainage ~c> ~-e2s (:~3}' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons. Manhole/Access (Y/N) Vent (Y/N). 'Pump on' level at High water alarm level Meets MOA electrical codes (Y/N) SEP~TATION TO: Well"'6n lot On adjacent lots Surface water D. ABSORPTION FIELD DATA · Date installed ~ ---"7.- ~ o Soil rating (GPD/Ft~) "~"Z..o '~ I ~'~-- i'ength ~"o'~ }1~l..~/..~~ Width '~' ~'.%' Gravelthickness Z* Total ~bsor~on area ~'~O'~~ .Cleanoutpresent~l~) Date of ade'quacy test '5~ ~ "~' ~ '"~ Results~s~ail) Water level in absorption field before test Peroxide treatment (bast 12 months) (~) ~'~ ~-~ System type *~ ~/7- ~ Total depth Oepre~ion ~er field for ~ After test If yes, g~e date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot '~'~ ~' [*~" On adjacent lots ~"~L Propertyline \ ,.~[ To building foundation '~ ~ To existing or abandoned system on lot \'~' ~ On adjacent lots % c> Cutbank Water main/service line Surface water ~\ ,o 'D ~ Driveway, parking/vehicle storage area \o~ ~ Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, ven'fled, Signature ~ E Engineer's ~ . ' Date ,..~le HAA Fee $ /7~ Waiver Fee $ Date of Pa~ent ~-~ Date of Pa~ent Re~ip, .um~r ;~.~ ~ ( ~ ~ ~ Re~ipt Numar 72~26 (3/93)' Back DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DA~~ .~j INSPECTOR INSPECTOR l NSPECT.(II MUNICIPALITY OF ANCHORAGE JV~JNtClPALITf OF ANCHOIb~OE ENVIRONMENTAL SANITATION DIVISION MAR 2 6 1980 MAILING ADDRESS ' ' PROPERTYRESI~ENT(Ifdifferent from~o~) '~ - PHONE 2. BUYER PHONE I I 5. LEGAL DESCRIPTION I STREET LOCATION TYPEOF RESIDENCE NUMBER OF~BEDROOM$ r-I One D~ Four [] Other SINGLE FAMILY '=% I--1 Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY I--] INDIVIDUAL* * A3-rACH WELL LOG. A well log is required for all wells drilled J~L COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ,l~ INDIVIDUAL/ON-SITE** ~ ~c/~ YEAR ON-SITE SYSTEM WAS INSTALLED. r-I PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) _ THIS SIDE FOR OFFICIAL USE ONLY ... 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY I-'l ONE [] THREE [] FIVE [] OTHER I-'1 MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [~ COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED I-'IPU BLIC UTILITY Connection Verified INSTALLER []SeptlcTanl( or f-'lHoldingTank Size:. If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA , MATERIAL Absorption Area to neare$! Lot Line 5. COMMENTS ! ' · 4- . 'AP.ROVEDFOR BEDROOMS ~,,~ ~IOsNADpI;~(~EA~)APPROVAL(Iet~...~termusta/ce~.~! ~ ~ertificate) 72-010 (Rev. 6/79) DEPT. OF ENVIRONMENTAL CONSER%'ATION ANCHOP~GE DiSTRiCT OFFICE ANCHORAGE, ALASKA 99503 July 2, 1991 WALTER J. fllCKEL, GOVERNOR 563-6775 FOR: Eagle River Engineering Services PWSID 210875 My review of the records on file in this office reveals that the Norfok Ulities: Eagle River Ranchette Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer