HomeMy WebLinkAboutEAGLE RIVER HEIGHTS BLK 8 LT 1Eagle River'
Heights
Block 8
Lot !
#050- 281 - 16
Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181156 PID Number: 050-281-16
Dwelling: ® Single Family (SF) ❑ Duplex(D) ❑ Multiple(SF and/or 0) Project: ❑ New ® Upgrade
Name:
SIDNEY BERTZ & .... ABSORPTION FIELD
Address ❑ Deep Trench Z Shallow Trench ❑ Bed ❑ Mound
8233 SKYHILLS DR., ANCHORAGE, AK 99502 ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 0.6 GPD/SF 11 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 4 Ft. 7 Ft.
EAGLE RIVER HTS. 8 1 Fill added above original grade Gravel length
Township Range Section Varies 0.55-1.31 +1- Ft. 72 Ft.
Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 2 Ft. Ft.
To Septic I Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
Tank I Field I Lift Station Tank
From I Line 1008 Ft2 1 Ft.
Well — TANK IZ Septic 0 S.T.E.P. 0 Holding 0 Other
100'+ � — NA � NA
Manufacturer Capacity
_.. EXISTING Gal.
Surface Water -- 100'+ I — NA
Material Number of compartments
Lot Line -- I 1 0'+ I -- : NA
Foundation : -- I 10'+ -- NA NA
I LIFT STATION
Manufacturer Capacity
Curtain Drain ' NA !*50'+ -- I NA " Gal.
i
Remarks *Norte known. Diverter added. Pump on level at Pump off level at High water alarm at
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer NORTHERN EXCAVATION dramfield
Drainfield 3034 CO/MT 3034
inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft
Inspection ates: 1 7/3/18 2�� 7/5/18 Location and description
3r° 7/5/18 4°' 7/7/18 Bottom of door sill
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Erin
'41116. 1111k.1,
Adir ^ OF AL \
Conditional Approval: Date Air (SN..› 46).
,,
t'
r *- 4,9 111*
Y A
in1741 '
�� 1 '.NETH :S . /
711• "�
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Ale
Approve % Date 7'/7-1 s7 k ;�;f, u.,l y oc'Ar
Air
eer's Stamp
Inspection Report_9-1-12.doc
AS-BUILT SYSTEM DETAILS/SITE PLAN Permit OSP181156
EAGLE RIVER HEIGHTS LOT 1 BLOCK 8 PID# 050-281-16
J
w
LOT 1 0 0
U
r;,d BLK 8 ■
are A _-_ -
• += ia 60.0'
N\i/,
T
v �
a b a. o
oEXISTING tn
a
A - 4-BR HOUSE
co c co
MT C( 4t; BM 60.0
co Q' \
D
_RC. ,,,.A 4'--•-•-- DIV
DIV DECK I- w a
EXIST FIELD ----._ Cp 8 w
11-:#1 1Mr a v
G
\* .co
EMT —I-' MTF
i
69.6'
S89°59'00"E 263.90' -
SCALE' 1' = 30'
A--C- 83.1' 1 ii
A D=85.2` T ! di i!
B-D=74,6' . 95.i FINAL GRADE 95,8 1 94,5
A-E=100,6' - I �' ��-4 --I
B-I =71.5'
w Fa,� V��
A-F`=84,2' 8 -`'EXISTING • \ �_.._ _._..-._ ___
B_F-_42.5' 1300-GAL 90.57 90.57 1
r 1 lANK
A-G=82.0' SEWER ROCK r
11-G=40.7' 83:5 P""`
Tti 11
(L71KM
,r►711111```' I 72' i
OF ` SCALE' NTS
# Arid, PREPARED FOR:
1, cT
/r& ,...C.-- I, CHRIS BERTZ ti A' RR
� ��
10330 WILDWCIOD ST, r" 01
k / * 49 TH •" * + EAGLE RIVER, AK 99577 ��o
o . e i i
a 4� I, S FIELD BOOKS oa°vu n n x
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R, '. • 80UHOMY.S'LS WWI BMW
if i'/f/` 4A, sr"aNa SLS KMD �' R°
1 Ayr' AmJR.T: SLS °ATE: 7/13118 .**.. ..
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DI' _._ ^ GM' N W0053 No C' N• ,IC'
IActio FlLE: FILE 49 Ho.: 18-164 fR AK.89577--
A4IW
cTERRq ti I2('' I+:RRA /<S� U-.._AI•,;/tS
�
CONSULTING, INC, /raj,.
212 E.51 Ave,Anchorage,AK.99503 �' �,
= Office(907)868-3791,Fax(907)868-3793 /f„:;791f l l _..__7
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7
io4'+e .W' # -xi KENNETM. our �w Ai
6 16
SOILS PERCOLATION TEST
err. !L/ f -:c,
Vii. �•• .I
'4 F1;:�cs�`N" Aar
Performed for: CHRISTOPHER BERTZ Date Performed:-_ 7/3/2010 \\\w+.:f
1'roieei• EAGLE RIVER HTS. RS. 1.1 1.1 1/4;1r 1101 is tF n FERC 18-1
Depth
(Feet) SEE ATTACHED SITE PLAN
a7:77-,.."=4„„ FOR HOLE LOCATION
1- : ; -7a Org/OI.
2- `Y '.+;at
GM Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NA Date? NA
Reading Date Gross Net ; Depth of Net__.
5.. PERC BENCH i ! Time Time I Water Drop-
6 1 7/3/18 l:(X) . - 6" -
7- - 2 1 1:30 30 min 4 9116" 1 7/16" 1
8- 3 * 1:31 - 6" -
9- 4 2:01 30 min 49/16" 1 7/16"
10- } 5 * 202 6"
11- 6 2:32 30 min 4 10/16" 1 6/16"
12- 7
I
13- HOLE PRESOAKED 8
PRIOR TO TEST
14- 9
15- 10
16- 11
17 12 - ---
I
18- * Water Added
19- Percolation Rate.42.._(min/in)Pere Hole Diameter,, , '_
20- Test Run Between 5 feet and_______6 __feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal Guidelines in effect on this date.
No""""'y MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program �� ;•
PO Box 196650 4700 Elmore Road <
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite
I)c•partmcnt
4'�CM ON p,E
On-Site Wastewater Disposal System Permit
Permit Number: OSP181156 Effective Date: 6/25/2018
Work Type: Septic Upgrade Expiration Date: 6/25/2019
Tax Code Number: 05028116000
Site Legal Address: EAGLE RIVER HEIGHTS BLK 8 LT 1 G:0053
Site Mailing Address: 10330 WILDWOOD ST, Eagle River
Owner: BERTZ SIDNEY C & Lot Size in Sq Ft: 34848
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4
This permit is for the construction of:
Q Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: A percolation test is required prior to construction of the proposed drainfield. See site plan
for location of percolation test. If results require a design change, construction shall stop pending On-site review
and approval of a change order. Please submit stamped and signed results with the inspection report.
Received By: (� (j Date:
Issued By: 41 �i'A Y1L Date: 5 1F
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D.
050-281-16
Property owner(s) SIDNEY & THOMAS BERTZ... Day phone 227-9107
Mailing address 10330 WILDWOOD STREET, EAGLE RIVER, AK 99577
Site address 10330 WILDWOOD STREET, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) EAGLE RIVER HTS. B8, L1
Legal description (Township, Range & Section)
Lot Size 34,848 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field l>1 Initial Single Family (SF) IxI
(w/wo ADU)
Septic Tank ❑ Upgrade I>I Duplex (D)
Holding Tank n Renewal ❑
Multiple Dwellings
Privy I I (SF and/or D)
Private Well ❑
Water Storage
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of pro owner or authorized agent)
Permit/Rush Fees: 6(oCi Waiver Fees:
Date of Payment: to- 22-If Date of Payment:
Receipt Number: OQi a 1 h Receipt Number:
Permit No. 05P1c 11510 Waiver No.
Permit App_9-1-12.doc
N_RcTTRRq
t , R ARC )CR12A
4( CONSULTING, INC
(f':1,vsitT,NG 212 E. 51st Ave,Anchorage,AK. 99503
•AK ppT1� D
Office(907)868-3791, Fax(907)868-3793
June 21, 2018
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit—Eagle River Hts. Block 8, Lot 1
It has been determined that the absorption field of the subject property is
saturated. Subsequently, the owner has requested we proceed forward to obtain
a septic permit to upgrade the septic system.
The general slope of this lot is from east to west / south at a grade of
approximately 3-8% over the septic area. We will be utilizing the existing soils
data found in the MOA file and propose to install the alternate field as originally
planned, which will serve the existing 4-bedroom single-family residence. An
additional percolation test will be performed at construction at the western end
of the proposed trench.
The property and adjacent lots are served by private and public water. There is
no surface water within 100' of the proposed system and there are no known
curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system. If you have any questions,
please contact me at 868-3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Kenneth M. Duffus, . .
Attachments: On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
EAGLE RIVER HEIGHTS LOT 1 BLOCK 8
R
` BARANOFF AVE
/NOI\
'�AIrk S89 59.00-E 283.90'
g
1
I 8 LOT I 1 a . I
i Y' .' �. 3-6T741,-6( 8
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8 'S °°�_ �- 84110160.. . 0
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50959'00T 263.90'
33' 33 -
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s
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-13E
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E FLAG PROPERTY LINES
WELL RADII & EASEMENTS
J
PRIOR TO CONSTRUCTION Scale. 1'= 100'
NCI SLOPES >25% DESIGN DETAILS PAGE 1 OF 2
,, 4 BDRM X 150 GPD = 600 GPD
= W/IN 100' OF PROPOSED 600 GPD/.6 GPD PER SQ. FT. = 1000 SQ, FT
TRENCH (1000 / 2 x (7' GRAVEL) = 72 FT, TRENCH
USE 1 TRENCH - 72' (L) X 2' (W) X 7' (ED)
Total depth of system is 11' max from original grade.
w Total depth of gravel below distribution pipe Is 7' ,
NO PUBLIC WELLS WITHIN 200' OF
6PROPOSED SYSTEM. NOTES:
o' NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED. 1. CONNECT TO EXITING 1300-GAL HDPE SEPTIC TANK,
)., NO SEPTIC SYST200' O
OD PROPOSED WELL E XMS C PTHIN AS NOTED. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL,
MIN. 2' FILL WITH INSULATI❑N, >3' COVER NO INSUL REQ.
Ii 3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INT❑ SEPTIC TANK,
I 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
0 WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC...
OF Aza.
`\
\
/�� .4.16'' t PREPARED FOR: RcTER
v �r� . '' '1 Chris BertWIldw a�� �����\\ �s��
0 1 10330 Wlldwood Street
o / . TH_ * Eagle River, AK 99577
7 10111111 \ To_
/ KENNETH •.,. to • / FlELD BOOKS COMPUTED: , fI`i3IIIII•Il cn
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Q 1'PWI T�' ' ASBUILT: DATE: -- . If214 1 I�7
FEssla�Al' / SLS 6/20/18 '-14."-‘7
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\ DWG. FILE: GRID: NW0053 GlF C,\\�'���'� 611
j \`_ ACAD ALE: JOB No.: ��I'E'NS�-TING ' 36�9
'. FILE 18-164 R, AK.99577—�
WASTEWATER DISP❑SAL SYSTEM DETAILS
EAGLE RIVER HEIGHTS LOT 1 BLOCK 8
0
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0
0
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LOT 1 6°.°
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BLK 8
W
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PERFORM ADDL. PERC b. EXISTING a
TEST PRIOR TO CONST. EXISTING 1300—GAL 3—BR HOUSE `n
CO / HDPE TANK
MT` -5-1____% \ CO
CO�� 60.0
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3 36 EXISTING FIELD MT LJ_
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NO SLOPES >25% FLAG PROPERTY LINES
W/IN 100' OF PROPOSED WELL RADII & EASEMENTS
TRENCH
PRIOR TO CONSTRUCTION scale: 1°= 30'
N ����\T� PAGE 2 OF 2
<s� O•F `•�'�&.s, t PREPARED F❑RI CTE
�rr�� ' Chris Bertz .t, �R ��q
o / �l �' `g 10330 WIldwood Street w° �����\\ s��
0 7k �, 9TH �� * Eagle River, AK 99577 •' �1
l •• It I ll`i��111�11
KE•• . . M. D FIELD BOOKS coMPuiID: J 11 x
p ` K2r CE-71 • �4' / BOUNDARY.SLS DRAM: BMW 16111,"11110� '
X ,'� SLS KMD ``a `�!Tvir ,�
L 1 �' ���� ' STAI4NG CHECKED:
>,, Ph0 sSIO11p'ti / ASBUILT: SLS DATE: 6 20/18 `'�y" \ 060
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1"1111046:411."4"w
DWG. FILE cRiD: N W0053 c�F eoA„ ���G 9P
Z AOAD FILE` FILE 108 " 18-164 SFR K 99577'ei3e
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LEE STREET
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N00'02'00"E 132.00' i
bd
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LOT 1
00 • BLK 8 (, Z
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OD (tra) o0. `l7
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P. O.
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LOT 2 38.5II DECK DECK DECK
50.0'
•
11
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0 EXISTING o
N o HOUSE o Iv
rno")cA FP CANT W
ZO (o
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41.6' 50.0'
COVERED SINN
ENTRY
PAVED
D/W
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a, 6 WELL
c'.
33' 30'
N00'02'00"E 132.00'
CA
CA..
WILDWOOD STREET
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1 I I 1
ANCHORAGE RECORDING DISTRICT,ALASKA
ASBUILT OF:
EAGLE RIVER HEIGHTS
LOT 1 BLOCK 8 PLAT P-419 —__``�A`
SURVEY CERTIFICATE:1,John L.Schuller,Have conducted a i OF AZ��% .> LAND OD S Rv_k
physical survey of this property as shown on this drawing and that the /// �;.••• '•.ItS 1 �Q' �O Sei,',(-
improvements situated hereon are within the property lines and no A,':• 1— �`
enchroachments exist other than noted. % : 49TH /\ *,,/ a xCI
EXCLUSION NOTES:It is the owners responsibility to determine % V j xa' 0 r.4
the existence of any easements,covenants,or restrictions which l 0 o t
do not appear on the recorded subdivision plat.Under no circumstance r ; It 0
'.1.
should any information on this drawing be used for construction of I,0 '.JOHN L. SCHULLER. / ' r 1
fences,structures,improvements,or for establishing boundary lines. t a LS-10408 '‘••.,,,.,4....AN'-
1 �„ • �,/ 1831 Talkeetna Street
WORK ORDER NUMBER: DALE: SCALE -YAL• P q
o �..z,,.�•� a,� Anchorage, Alaska 99508
18—033 DRANK BY:a�ECXED B GM NUYBEIN BOOK/PAGE: 1\\\tOfessi0n01 �� (907) 227-1455 office
I JLS NW0053 180159 �\`���1� (907) 274-4992 fax
Municipality or Anchorage "
Development Services Department
BulMi~g Safety Division
On-Site Waler and Wast~waler Program. 4700 S. Bragaw St.
P.O. Boxlg6650 Anchorage. AK 99519-6650 Page { of3
www. cl.anchorage.ak.us (907) 343-7904
o.-s~tE W^STEWATEr D,SPOS^L SYStEm ^.o/or WEL~ ~.SPECT~O. RE~O.T
eermitNumber: 5~OlO 115 P,DN~b~ 05o -~1-1~
"-- 5,'d'~y ~ ~Z WastewaterSystem: ~New DUpgrade
~'~l Le~5~e~ E~I~ ~;v~,~ eq577 ABSORPTION FIELD
LEGAL DESCRIPTION ~..w a 6 o~,,, '"~'~" ti ,,,..
'~ "~: ~ "--'~": 0+
Well: ONew O Upgrade e'--
SEPARATION DISTANCES ~s~c ~Holding DS.T.E.P. ~Olhe~
~o Septic Absorption LIE Holding
lift' lO&' ~ __ ~5,. --- ~DpE
s~--w..~V I00; ~/ ' LIFT STATION
"~" BENCH MARK
Engl~p
Inspections performed by:._~ ~:;;;, ~::~: .~S.~ : , ~9,~
DevelOpment Se~ices Department Approval
~ ', ~, .... ~.~,
Reviewed and approved by: / Z~ ~ Date: ~-~-O~
P£R.',,T No. SWO1 O1 1 5 PACE 2 OF 5
D ...... Nlu~ip. 9~i .ty_o..F .A.n._c h.o.r a g.q
bI-'AI'~IMENI UP HbAL/H ANIJ HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. BOX 196650 eAnchor'age, Ataska 99519-6650eTetephone: :342-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
L£CAL LOT 1, BLOCK 8, EAGLE RIVER HEIGHTS P.I.D. NO. 050-281-16
~ BARANOFF AVENUE
0 TELECOM MANHOLE /
100' WELL RADIUS ·
o--~- ~-~-~-] CRAVEL DRIVE~
~ NEW
~. ~,~ j~ 4 BEDROOMHouSE (/ /'
,,oo /
~¢ ~' * '"..7~ '~,
- -- %~, CE.~o~ /.~
P£R.m? ~0. SWO1 O1 1 $
PAGE 3 OF 3
Municip. o, tit: o¢ .A.n_c h.o r- a 9.e.
DEPARTMENT OF HEA~.TH AND HUMAN SERVICES
ENVlRONHENTAL SERVICES DIVISION
P,O. Box 196650 ·Anchorage, Alaska 9951g-6650·Tetephone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 1, BLOCK 8, EAGLE RIVER HEIGHTS
P.I.D. NO. 050-281--16
ST1 ST2 /-96.5'
'o .su,A -'Foo
92"7'~" ~ %-92.4'
CO1 =95.2'
C02=97.8'
FINAL GRA
CO1 =91.9'
C02=9! .8'
MTi =84.~;'_~
MT2=84.6'
A B C
FCO 10.0' - -
ST1 16.0' 49.0'
ST2 18.0' 52.5' -
DBL1 21.0' 55.5' -
DBL2 22.5' 57.0' -
301 55.0' 76.0' -
~T1 49.5' 73.0' -
;02 20.5' - 47.5'
dT2 19,5' - 50.5'
·
NO WATER FOUND
78.2' B.0.H.
ROBERT C. COW,U'/. RE.
ROBEITr A. StlAFER. P.E.
CMLENGINEER3
& FLOWTEST
Date:
(907) 694-2979
FAX (907) 694-12
Municipality of Anchorage
DEPARTMENT OF SEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE t
Tile septic inspections for_t~e..referenced property were
performed on ~-~-0! and 5--26 OI · Prior to submitting
the On-site Wastewater Disposal System and/~r Well Inspection
Report we are waiting for tile ~-b-,]~ &~{[¢~? to be
completed.
If we may be of furti~er service please contact us.
Sincerely,
Robert C. Cowan, P.E.
· i·
17034 NORTH EAGLE RIVER LOOP * SUITE 204 * EAGLE RIVER. AL~,KA 99577
'LEE STREET
38.5'
N 00"07'00' E
WILDWOOD STREET
43.3' ~ "T1
? m
4 0.~" I 1~1
I
0
!
F&M PROPERLY DEVFJ.OPING,IN(L
:For All Your C~ntractin~
~l-t UG IA.'¢, Al
Certi{i£b ri{ling 7L0 ....
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA ~9~7 · TELEPHONE
ADDRESS:
LEGAL DESCRIPTION:
DATE:,~~
PERMIT NUMBER:
m~ IDE~R~ON NUMBS:
L~Tyse-.
Casing Stickup AIx)ve Grot:nO; $'~ feet
StatJc Water Level: ,~ Jr, feet
Recover Rate: ~ 9pm
Method of Testiflg:
Welt Intako Openincj Type:/,~3'~ end ~3 open ~ole
'~ Screened: Stzgt feet Stopped feet
Q Perforations Start feet Stopped feet
GroutType: i~~'~u?O'4/'l'~ ~'~rl~F
· ~,~tume /_fi-ut;O,'
De0th: from ~) feel. to ~- ~ ~ feet
Well Disinfected UpOn Completion? ~t'es O NO
Method of Dis~fectton: ,~s~e~''~'~1~'' ~"O,~,'~'"'~ '
Comments:
o...s
Al I ~-N'i'ION: It l$ the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Depaament of Heaith& Human Sa'vices end/or Department of Environmental Conservatico. MatSu Boroog~:
Departmenl of Environmental Conservation.
~g/to 3E~d H~A:~T'I'IS 6Szz889 'tg:0g 666t/la/to
~-d ~t,E:I-BBg-LO$ saeIIeZ ~lUed_-J eOt:O! IO 33 unc
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: May 14, 2001
Expiration Date: May 14, 2002
Permit Number: SW010113
Legal Description:, EAGLE RIVER HEIGHTS BLK 8 LT 1
Design Engineer: 0003 S & S Engineering
Owner Name: SIDNEY BERTZ
OwnerAddress: 10331 LEE STREET
EAGLE RIVER , AK 99577-
Parcel ID: 050-281-16
Site Address: 010331 LEE ST
Lot Size: 34848 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastawater 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 calling
(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.
Received By:
Date:
Date: .~-- /¢ --~/
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. LO b" O -- '~- ~' / -- ! fo
Permit Number swOI OI 13
Property owner(s) ~ i4rl(~ F '~'~
Ma ,ng address (2)
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
LotSize 0,, ~' ~Sq. Ft.
~4, 048 ~. ,~.'"-"
THIS APPLICATION IS FOR:
Sewer Only ~
Sewer and Well
Sewer Upgrade []
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Day phone
Zip Code 9 ~ ~' 77
Number of Bedrooms L~
Well Only []
Water Storage []
Jacuzzi
Water Softening Unit
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.
$ & S ENGINEERING
Ea~le River, Alaska 99577
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
o o'~6c/~
Waiver Fees:
Date of Payment:
Receipt Number:
ROBERT C. COWAN, P.E.
April 30, 2001
CIVIL ENGINEERS
(9O7) 694-2979
FAX (907) 694-I 211
MUNICIPALITY OF ANCHORAGE
Department of ttealth and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 1, Block 8, Eagle River Heights S/D
It is requested that you issue a permit to install a well to serve the proposed four
bedroom dwelling on 1he referenced property. A septic system permit (SW000214) has
previously been issued for this property. The property owner has decided against
connecting to public water.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed well. The construction of this
system will not prevent any future development on any of the adjacent properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
Rcc 33
Enclosure
17034 NORTH EAGLE RIVER LOOP - SUITE 204 · EAGLE FUVER. ALASKA 09577
~~
B.J.J. I ~.c.c. I 6-20-00 I
, .
~) / 4 3
DRAINFIELD CRI~ERIA~
7.0 EFFECTIVE I
~.o' w,~
72' LONG
4 BEDROOM
~ ~s ~ ~ ~
I
Municipality of Anchorage '
George I~. Wuerch, Mayor
Bttilding Safety Dix4sion
P.O. l~x 196650 · ~700 $. Bragaw Street
Anchorage, Alaslm 99519-6650 · (907) 848.8801
http://www.cl.m~chorag¢.ak.us
Public ~'orks
618/2001
Sidney B~tz
BablofLoop
Eagle River AK 99577
Subject:
On-Site Water and/or Wastewater Permit.
Permit Number: SW000214
Parcel ID: #050-281-16
Dear Sidney:
An On-Site Water/Wastewater Permit, number SW000214, issued by this office for a single-family
system, will expire on July 6, 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 reviexv, approval and documentation. This as-built inspection report must be signed by
the licensed Professional Engineer who inspected the installation ofthe system. As-built inspection
reports arc required to be submitted within 30 days of the completion of the system.
If no system xvas 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. A new permit may be issuedJ?ee of
charge for a second year if the application for lhe renewal is received on or before the date of expiration
ofthe original permit.
When applying for a new 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.
Manager
On-Site Water and Wastewater Program
eno: 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) 343-4744
ON-SITE WASTE'~NATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jul 06, 2000
Expiration Date: Jul 06, 2001
Permit Number: SW000214
Legal Description: EAGLE RIVER HEIGHTS BLK 8 LT 1
Design Engineer: 0003 S & S Engineering
Owner Name: Sidney Be~z
Owner Address: Bablof Loop
Eagle River, AK 99577-
Parcel ID: 050-281-16
Site Address: 010331 LEE ST
Lot Size: 34848 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
Ail 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 ( 18MC72 ) and Drinking Water Regulations ( 18MC80 ).
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:
Date: '7 --'7 "OO
ROBERT C. COWAN, P.E.
June 21, 2000
CML ENGINEERS
(907) 694-2979
FAX (907) 694-121 !
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 1, Block 8, Eagle River Heights S/D
It is requested that you issue a permit to install a septic system to serve the proposed
four bedroom dwelling on the referenced property.
Two test holes were ex.cavated, and percolation tests performed. The approximate location
of the test hole is located on the attached site plan. At the time of excavation 6/13/00 water
was not found.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
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.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
Rccrojj
Enclosure
17034 NORTH EAGLE RIVER [.OOP * SUITE 204 * EAGLE RIVER, N.ABKA 99577
B.J.J. R.C.C. 6-20-00 1 OF
~ri~ D IGN CRITERIA:
4 ~ = 600 GPD ~ ~ p.~o~ ro A~* rxcAwt~o~ ,,,.~ ....... ~.~.~
~2.6 = 1000 SO.FT. REO'D.
DRAINFIELD CRI AVENUE
7.0' EFFECTIVE
5.0' WIDE
72' LONG
~, ~ 4 BEDROOM
~% LOT ~ °F LOT 8/- '
:LOT 11: _,'
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:~''~''~
DATE PERFOR
Township. Range, Section:
SLOPE
10
11
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT t~/ ~)
DEPTH? ~c' p
E
13-
14-
15-
16-
17-
18-
19-
2O
COMMENTS T' ~ :~ ~
Depth to Waler AJter
Idon~ori~g? ~Oale: fo,'~,A
/
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE O~17 (minutes/tach) PERC HOLE DIAMETER
TEST RUN BETWEEN ~/'~ FTAND 7~' FT
PERFORMED BY: 17034 Ea~lle River Leap Read No. ~0~ ~ CERTIFY THAT THIS TEST WAS PERFORMED
^CCORD^NCE OU,DEL'NES '" EFFECT ON THIS OATE. OAT[
72-~ (Rev.
PERFORMED FOR:
LEGAL DESCRIPTION:
4-
5-
6-
7
8
9
10
11
12
13,
14-
15-
16-
17-
18-
19-
20-
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORM~
Township. Range. Section:
SLOPE
f
WAS GROUND WATER ~
ENCOUNTERED? 0
OEFT.?'P~E~'ATW"AT ~ ~
£
SITE PLAN
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
~:~O [m~nutes~lncl~) PERC HOLE DIAMETER
PERFORMED BY; 17D~& I~_nl~ ~Iv~ I ~ ~A.A ~ 2~ CERTIF~ THAT TH~ TE~ WAS PERFORMED tN
72-008 {Rev. 4/85)
$tTE PLANS
S~T£ST
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 l, Block 8, Eagle River Heights S/D
June 21, 2000
GENERAL:
The scope of this project includes the installation of a 1300 gallon Premier
polyethylene septic tank and a drainfield trench to serve the proposed four
bedroom residence located on the referenced property.
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.
o
Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
Contractors installing wastewater 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 INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE R~/ER, ALASKA 99577
Page 2
'Lotl, Block 8, f. aglu R~ur Helghtm
June 2t, 2000
All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
Septic tanks installed with less than 4 ft. ofcover shall be insulated.
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 cie, snouts 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 15om the
septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom ofthe
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (rafted-up) before gravel (sewer rock)
placement.
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.
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.
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.
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 06) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Pa;e 3
· Lot 1, Block 8, Eagle River H®lght$
June 21, 2000
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
The following pipe materials arc spproved for use in septic system installations in the
Municipality of Anchorage:
T_vp. e of Pipe P~fo~t~ Solid
Cast Iron Yes Yes
ASTM D3034 0aVC) 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).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or
eq~).
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.
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, 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:
P~e 4
'Lott~Block 8, Eagle R~er Height.
June 21, 2000
The f~t 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.
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 owner's representative and will inspect thc work as stated above to document thc contractors
activities. Final acceptance ofthe 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
carry out the work in accordance with these construction documents. S & S Engineefing'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
•,
89 'p77
ur\,�\`J.F4tH I
2 •
• B
nicof
Anchor's a 2019
On-Site Water and Wastewater Prog :
(907) 343-7904 �a SAFETY
cu
CERTIFICATE OF ON-SITE SYSTEMS A'` ='4 ' , A
Parcel I.D. 050-281-16 Expiration Date: QCT /7 020 18
1. GENERAL INFORMATION
Complete legal description EAGLE RIVER HEIGHTS BLOCK 8, LOT 1
Location (site address) 10330 WILDWOOD STREET, EAGLE RIVER,AK 99577
Current Property owner(s) SIDNEY BERTZ&DEBORAH THOMAS&CHRISTOPHER BERTZ Dayphone
Mailing address 10330 WILDWOOD STREET, EAGLE RIVER,AK 99577
Real Estate Agent Day phone
2. TYPE OF DWELLING:
• Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY: Individual
Individual Well ® Holding Tank ❑
Individual Water Storage ❑ Community ❑
Community Class Well ❑ Public Sewer ❑
Public Water System ❑
WaiverNariance request for: Distance:
Received by: 44/Airf, L .r_i Date: 7— /7 l
COSA to be released to the engineer,unless oth=y^'suested by the engineer.
COSA Fee $ 42.q•(Qo Waiver Fee $
Date of Paymenti(D LUf6 Date of Payment
Receipt Number NBC!,ID Receipt Number
COSA# ( 5C t 34O Waiver#
lia
NW..tom'.` .
5. STATEMENT OF INSPECTION BY ENGINEER: ,aEe-
t4teNist
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 ARCTERRA CONSULTING,INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 7/6/2018
THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED
WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with
ADEC and MOA regulations. 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 inland use,
local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the
system. 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, ArcTerra can not give any estimate of how long a system will function
satisfactory for current or future occupants or can ArcTerra guarantee that no unseen r� ..' .\
encroachments,deficiencies or discrepancies exist. i OF AL\\
4r 1
y `96
14 _9f
* TE1 r\ A
6. DSD SIGNATURE 41111 aliriWIP. 3'11
V System #1 Approved for y bedrooms. i f�emeA...I's
r� KENNETH M. M r' ,.• if
System#2 Approved for bedrooms. i °: ss e ,,,
Disapproved. , ���0 n4•�F•e;,ro ''''��
Conditional approval for bedrooms, with the following stipulations:
j ON-SITE
WATER AND
o WASTEWATER c
PROGRAM e
c
By: fikiieif C Original Certificate Date: Jt l 7 ‘,2O/E
J
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 Advisorq,; ' :,.`,1
Septic System Advisory Arsenic Advyspdy -.Jr...
Well Flow Advisory Other `"`' '
•',kV-Zt1y t .4i.
COSA blue sheet 10-10-12.dx
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: EAGLE RIVER HEIGHTS BLOCK 8, LOT 1 Parcel ID: 050-281.16
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID#_ Well Log (Y/N)Y
Date completed 513012001 Sanitary seal (Y/N)Y Wires properly protected (Y/N)Y
Total depth 107 ft. Cased to 107 ft. Casing height(above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 5130/2001 6114/2018
Static water level 46 ft. 50 ft.
Well production 20 g.p.m. 6.1 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 2.77 mg/L
Arsenic: ND ug/L Date of sample: 6114/2018 Collected by: ARCTERRA _
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC 1 HDPE _ Date installed 512612001
Tank size 1300 gal. Number of Compartments 2 Cleanouts (Y/N)Y__
Foundation cleanout (Y/N)Y Depression over tank(Y/N) N High water alarm (Y/N) N
Date of pumping 1-v2 3- 1 S Pumper Sf&t,Letd.A7
C. ABSORPTION FIELD DATA
Date installed 7/612018 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6_ System type DEEP TRENCH
Length 72 ft. Width 2 _ft. Gravel below pipe 7 ft.
Total depth 10.5+ft. (Measured 7/7/208) Eff. absorption area 1008 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NA—NEW SYSTEM Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at __ in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10'+ _ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 1001+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water Service line 10'+ _ Surface water 100'+ _ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NONE KNOWN Wells on adjacent lots _100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in conformance _
with MOA COSA guidelines in effect on this date. OF ALS
Air <Sy
Engineer's Printed Name KENNETH M.DUFFUS Or� �1— ,
Date 7/712018 _ r *4 TH
Allir
AV
COSA canary sheet_2-6-15.doc NETH • D '�
` KENNETH D !V Aar/
'F•.tO
• \\N6+
v
, .......4-'" If
LEE STREET
w
w
N00'02'00"E 132.00'
.. td
LOT 1 w a
••coS • AN C BLK 8 10
co (typ) 0 'x]
0
o • r'i a
m 1
LOT38 5, I DECK DECK
50.0'
•
1
o o
EXISTING
N o HOUSE c N
rna)
GJ FP CANT (�J
(D CO
CI I CONC CI
41.6' 50.0'
COVERED NM
ENTRY
PAVED
0/W
m / / /w WELL
at
33' 30'
N00'02'00"E 132.00'
w
w
WILDWOOD STREET _ _
SIw
C'
I 1 1 /
ANCHORAGE RECORDING DISTRICT,ALASKA
ASBUILT OF:
EAGLE RIVER HEIGHTS
LOT 1 BLOCK 8 PLAT P-419 `_```�N�
SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a i 0 F A��V •y� , LAND-'
physical survey of this property as shown on this drawing and that the /�/ ��. `Qs1'' ��, 10 Sr,,�t.r�
improvements situated hereon are within the property lines and no c�,.•• �F'
enchroachments exist other than noted. %*: 49Tx %\ • ,,� -a Gl
EXCLUSION NOTES:It is the owners responsibility to determine % I x a' 0 r'
the existence of any easements,covenants,or restrictions which G 0 a ',. r
do not appear on the recorded subdivision plat.Under no circumstance r 73 /.2‘ . L/ ; '� a
should any information on this drawing be used for construction of �, L. SCHULLER: o/ t 1fences,structures,improvements,or for establishing boundary lines. +s� S-10408 �70 •...i._,,,r' •
1,c) ' 1831 Talkeetna Street
WORK ORDER NUMBER: DATE: SCALE: E-YAL• ',�d 1:/3:24.• ac,i Anchorage, Alaska 99508
JULY 13, 2018 1'=40' At�
18-033 DRANKBY:ICECKED CND NUMBER BDDK/PADE A /-0fessiono\ Vs (907) 227-1455 office
JLS NW0053 180159 %%������ (907) 274-4992 fax
' Mu.icipality of Anchorage
Development Services De~aHment
Building Safe~y Division
On-Sile Water and Wastewater Program
4700 South ~ragaw St.
P.O. Box t99650 Anchorage. AK 99519-6650
www.cLanchorage.ok.0s
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVA.,L
FOR A SINGLE FAMILY DWELLING .....
Parcel I.D. 0 ~'¢ -3-.3'1 - I G
GENERAL INFORMATION
Complete legal description .Lot: '1 + B1 oek *R;
Location (sile address or directions) 10331 Lee
HAA#
Expiration Date:
Street Eagle River, AK 99577
Current Property owner(s)
Mailing address
Lending agency
Sidney Bertz Day phone249-6125
19237 Bablof Loop Eagle River AK 99~77
Day phone
Ivlaili,g address
Real Estate Agent
Day phone
Mailing Address
Unles= otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class__
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
~[] Individual On-site []
[] Individual Holding tank []
Community On-site ~
[] Public Sewer
The Municipality of Anchorage Development Sen/Ices Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil
-.,gineer registered in the Stale of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (excepl between spouses) for propedies served by a single family on-site wastewater disposal and/or water
.~.Jpply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with
,aw waler sample results less than 30 days old. (Cedificates may be reissued for a period of up Io one year wilh
valid water samples.) Certific~les are valid for one year for pfopedies served by Class A or B wells er a public
water system. The Municipalily of Anchorage ts 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 Ih~ validation da{e shown below, I verify that my Inves[tgalion,
based on procedures outlined In Ihe Heal[h Authority Approval Guidelines for this application, shows that the
on-site water supply' and/or wastewater disposal system Is(are) safe, functional and adequate for Ihe number of
bedrooms and type of structure Indicated herein. I furfller Verify Ihal based on the Information obtained from the
Municipality of Anchorage files and from my Investigalion and Inspection, the on-site wa[er supply and/or
wastewa~er disposal system Is(are) in compliance With all applicable Municipal and Stale codes, ordinances,
and regulations In effect at Ihe time of Installalion.
Name of Firm
Address
$ & $ ENGINEERING
~. 7C~4 -"~;e R;,.~r L~p kOad NO. 204
Eagle River, Alaska ~577
Engineer's Printed Name Robert C..
Phone ~ 3*'/-~-q "'/~
Dale ~ /, / o ~
5. DSD SIGNATURE
/ Approved for
Disapproved.
Conditional approval for
~'[NEE R'..~--.'''.,
bedrooms, e~ ,.,~.. . ...',~ ~
bedrooms, with Ihe following stipulations:
Additional Comments
.,t..', ,-.,,~,,. ..... . ".,~ ~
~..- ... o~.~.
,~.¢J. . ~-~
~';. ON-StTE . ~:
~.=. ,..,,,_,.Atto . -
-~_.,',~ -. .... · ~.;,,.
Attachments:
HAA Checklist
Septic Syst. em Advisory
Well Flow Advisory
X
Maintenance Agreements
SUpplemental Engineer's Report
Olher
Original Cedificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bmgaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchomge.ak, us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescfiption:LOT- i ~LOC~C ~ ~..,f~,-~-'L. A,V4.< #~'5 ParcellO:.OS-*-~'~'1--I(,
A. WELL DATA
Wall type ~°R ' va ;'t
Date completed 5-/~o/o I
Total depth IOV ff.
Date of test
Static water level
Wall production
WATER SAMPLE RESULTS:
Coliform C) .colonies/100 mi,
Arsenic: ~ mg./I.
e. SEPTIC/HOLDING TANK DATA
If A, B, or C provide PWSID #
Sanitap/seal (~N) Y; /
Cased to /0 ~ ft.
FROM WELL LOG
'~ O g.p.m.
Wall Log
Wires property protected ~N)
Casing height (above ground)
AT INSPECTION
/
g.p.m.
in.
Nltrata I,'f~ mg./I. Other bacteria C~ colonies/100 mi.
Date of sample: ~...~...~/o ~-. - - $ & $ ENGINEERING
HOPf..
Tank size I '~ O0 gal. Number of Compartments '2-
Fo0ndation cleanout ~}Ni ¥ ~ / Depression over tank (Y(~ /vo
Date of pumping /~/4- - ,,, '~ ,-' Pumper ~
Data installed
Cleanoute ~/N)
High water alarm
ABSORPTION FIELD DATA
Date installed 5'/,~=/e / Soil rating ~r ft2rodrm) C), G, System type -/' ,~ 4 ,- c/v
Length "/ '~ ft. Width -~ ft. Gravel below pipe '7 ft.
Totaldepth Il lt. Eff. absorption area 10~.3.~ MonitoringtubeY~J Depmssion over field
Dataofapequacytast ~'/~'-'~"/ Resulta(Pa~,..~a~ll)~----'---- For ~' bedrooms
Fluid depth in absorption field basra ~es~ Water added gal. New depth in.
Elapsed Time: min~.......~ Gi depth in. Absorption rate >= g.p.d.
Any mju~t (~st 12 mo.) ~/N & type). If yes, give date
D. UFT STATION
Date installed Size in gallons
· ~' ManholeJAccess (Y/N) ~
Pump on' level at in, 'Pump off' . High wateralarm level
at
Datum ~ Cycles tested
__ Meets alarm & circuit requirements?
SEPARATION DISTANCES
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenMIIt station on lot ~1 ~/
Absorption field on lot /O G
Public sewer main ~'/,'~
Sewer/septic service line
On adjacent lots
On adjacent 10ts
Public sewer manholeJcleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation )1 ' Property line 3 5-
Water main / o ' ~
Water sewice line
Walls on adjacent lots / o 4) ~-
SEPARATION DISTANCE FROM'ABSORPTION FIELD ON LOT TO:
Property line ~t .3 Building foundation
Water Sentice line I o ~.~-- Surface w~ter ; 0
:Curlai~draJn .?~."~-. /( ,vo~,,; Walls on adjacent lots
F. COMMENTS
Absorption field
Surface water
Water main
Dray, parkingNehicie st~xage .?
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections end
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer'sPdntedNama (~0,~.~.~'- (~. ~)~,,~,,,,
~OWAN
Waiver Fee $
Date of Payment
Receipt Number