The URL can be used to link to this page

Home My WebLink AboutKNIK VIEW ESTATES BLK 5 LT 3KnI*k View Estates Block 5 Lot 3 #051-043-43 Municipality of Anchorage Page 1 of 2 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: SW990049 PID Number: 051-043-43 Name: Wastewater System: ■ New ❑ Upgrade RON SHINE Address: ABSORPTION FIELD 4241 B STREET ANCH, AK 99503 Phone: No. of Bedrooms: (907) 344-7307/522-3889 4 ❑ Deep Trench ■ Shallow Trench ❑ Bed o Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth formoriginal grade: 1.2 GPD/Sq. R 5.04 — 5.54 rt Lot; Block: Subdivision: Depth to pipe bottom from original grade: Grovel depth beneath pips: 1.94 3 5 KNIK VIEW EST. 3.1 — 3.6 Ft. Pt Township: Range: Section: — FlII added above origieal grade: Grovel length: 72' —0 — — 0.5 rt. Ft. GnavM "am; Number of Knee: Distance betrssn Knee: WELL: ❑ New ❑ Upgrade 5.25 Ft 1 — ru Cl.wiRcadon (Private. A.B.C): Tolal be Cased To: Total absorption area: 500 Pips material: ASTM D -3034/F-810 � rt sa. a DHllsr. Dote Drilled: Static Water LevN: Installer. GLACIER EXC. Dots Installed: 5/19/99 R Yield: Pump Set At Casing Height Above around TANK GPM R F• SEPARATION DISTANCES ■ Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Manufacturer. GREEK Capacy in gallons: 1250 From Tank Feld Station Tank Swear Uses sewer ceras Material: Number et eomparlmems, Well 200'+ 200'+ — — N/A STEEL 2 Surface 100'+ 100'+ - - - LIFT STATION Water Stu In gallons: Nanufactunr. Lot 5'+ 10'+ — — — Line Pump on bvel at Pump a at: High water alarm at Foundation 5'+ 10'+ — — — Curtain Pump Mab I: Etecbkal Inspections performed by: Drain NONE KNOWN BENCH MARK Remarks: MONITORING TUBES DO NOT EXTEND TO BOTTOM lavation antl DseariDtion: TOP OF CMV 0 POINT "A". OF DRAINFIELD 2" TO 5" FROM BOTTOM). USED A REDUCTION FACTOR OF 0.72. M.T.'S.APPEAR TO HAVE Assumed asvatlon: BEEN PLACED ON THE ENDS WHERE GROUND STARTS 100.00 F- ENGINEEWS 6EAL §ZhN TO SLOPE UP.� 000d Inspections performed by: AWWC, INC. Dates: 1st 5/19/99 p *•:••• •• ... ••.....� 2nd 5/19/99 •••• re n C 7953: Department of Health and HumanServices approval 4 a o �) (.�. / Date: n _ f by: ,/ - 9 44�od F'rofesslo�°� pp0pfessio Reviewed and approved X 72-013 w. 9/91) MOA 25 44h,11 PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW99UMBE 051-043-43 NEW DRAINFIEL `PROPOSED WATER SI LINE LOCATION. 4SSUMED WATER KEY BOX LOCATION. (WATER MAIN IS IN KNIK VISTA STREET) 511 fop of fANK - Af INLEf - 95,18 FINN. G -99.16 5f2 NSW 1250 6&LON Nveu of m W11C fAW TOP OF fANK Af OL=f - 95,18 ALTERNATE SITE Mtl L01 FINAL c4m RUN& GSE Mfg cal 98,15 9835 - 975-98.0 I I - INVEKf of PIPE Af OLtfI.Ef - 94,51 Af INLEf - 94,60 60ffOM OF MNGN- 92,46 (AVC0 ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 0 PHONE: (907) 337-6179/FAX: (907) 338-3246 0�0� LEGAL DESCRIPTION: KNIK VIEW ESTATES SUBDIVISION, LOT 3, BLOCK 5 O TYPE OF WORK: O AS -BUILT OF SEPTIC SYSTEM PREPARED FOR: PHONE NUMBER: QO @ ••; RON SHINE 344-7307/522-3889 �O�s T� f DATE: DRAWN BY: SCALE: PAGE: u4` 5/24/99 J.L.M. 1 = 40' 2 OF 2 -INVERT OF PIPE I 94.40 (AZA.) C 1 •' BRORbsD, EXISTING o :;.:" 4 BEDROOM Of HOUSE o N I9 I Y NEW 1250 GALLON Z to I ASEPTIC TANK— `PROPOSED WATER SI LINE LOCATION. 4SSUMED WATER KEY BOX LOCATION. (WATER MAIN IS IN KNIK VISTA STREET) 511 fop of fANK - Af INLEf - 95,18 FINN. G -99.16 5f2 NSW 1250 6&LON Nveu of m W11C fAW TOP OF fANK Af OL=f - 95,18 ALTERNATE SITE Mtl L01 FINAL c4m RUN& GSE Mfg cal 98,15 9835 - 975-98.0 I I - INVEKf of PIPE Af OLtfI.Ef - 94,51 Af INLEf - 94,60 60ffOM OF MNGN- 92,46 (AVC0 ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 0 PHONE: (907) 337-6179/FAX: (907) 338-3246 0�0� LEGAL DESCRIPTION: KNIK VIEW ESTATES SUBDIVISION, LOT 3, BLOCK 5 O TYPE OF WORK: O AS -BUILT OF SEPTIC SYSTEM PREPARED FOR: PHONE NUMBER: QO @ ••; RON SHINE 344-7307/522-3889 �O�s T� f DATE: DRAWN BY: SCALE: PAGE: u4` 5/24/99 J.L.M. 1 = 40' 2 OF 2 -INVERT OF PIPE I 94.40 (AZA.) OCT -04-1999 2 04:34 m >I,Dis e m» m«, : 2 )Kip ° Zoo 4;? _ �»Nw jj( 1£kS Visz 2 @a. 3iA00: /2 ) - - ------------ - \ ,\. . Z9z k ( 2 p ) f � \26.2 . 2 -os a 2 \ 7 ~ : 4 m ® ° , ) - 2.1 D22 v 4 a g � R/ q< !§=e® | $ t .qR / .14 \_ ,m,| -M .. q. / . Z - ® \ % pq $ _M -|E m I2 Q .02'15'00" E ,+& !4 ®! ! / #!£ OR \ a6f j ƒ§} }\} � t \'.fes;^ rn MUNICIPALITY OF ANCHORAGE �A+") (Y\ Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Apr 02, 1999 Expiration Date: Apr 01, 2000 Permit Number: SW990049 Parcel ID: 051-043-43 Legal Description: KNIK VIEW ESTATES BLK 5 LT 3 Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: Owner Name: Ron Shine Lot Size: 21931 SQ. FT. Owner Address: % 4241 B Street Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99503-0000 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 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: a Date: q-5 Jam' `% Date: — 2 '_ Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 211 ~ Anchorage — Alaska 99504 (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers K k C E I v t u March 24, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design for Lot 3, Block 5, Knik View Estates Subdivision To whom it may concern: MAR 3 0 1999 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION The proposed 4 bedroom house will be served by a private septic system and a community water system. Two test holes were excavated on the property. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil profile, and the percolation test results. In both test holes, the soils below the organic layers are a GW/SW material a depth of 12 feet (bottom of test holes). No groundwater was encountered during the excavation of the test holes. A percolation test for TH#1 was performed between the depth of 5.0 feet to 5.5 feet which had a percolation rate of <1 minute/inch. No percolation test was performed on TH#2, but was visually rated as the same as TH#l. It is our opinion that due to the high percentage of sand, the insitu soils will serve as a sand filter. A grab sample can be provided if deemed necessary. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft2 f. Total Depth: 6 feet (max.) g. Effective Depth: 2 feet h. Width: 5 feet minimum i. Reduction Factor: 0.70 i. Minimum Length: 70 feet long j Effective absorption area = 500 ft2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The average topography of this property is mostly flat; in short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. NOTE: Attached is a site plan drawing, a design drawing, two soils logs and a 4 page construction specification letter which are all part of the design package for this septic system. LOT 3, BLOCK 1 KNIK VIEW S/D I i W Lu LOT 4, BLOCK 1, i (— KNIK VIEW S/D (n I I BLM LOT 28. NE 1/4, SECTION 5, T15N, R1W ALDER LEAF DRIVE PROPOSED (SEE DESIGN. ----------------------- I I I I I II I I I I I TRACT A. NE 1/4, i SECTION 5, T15N, R1W II II I NOTE- ALL PROPERTIES WITHIN 200' OF THE SEPTIC SYSTEM ARE SERVED BY LOT 12, BLOCK 5, KNIK VIEW ESTATES LOT 13. BLOCK S. ! KNIK VIEW ESTATES 1 b. PROPOSED I ��ALTERNATE �1 � n 1u LOT 14. BLACK 5, i 1 KNIK VIEW ESTATES ! ff LOT 4. BLOCK 5. 1 KNIK VIEW ESTATES r t LLI �E 2OF 2) LLI LAT 15. BLOCK 5. t! 1 qlu� KNIK VIEW ESTATES 1 1� ALTERNATE SITE 1 V 4 BEDROOM N� HOUSE 9 Gi m�i\Z)G� 9= \J gx Y I / JUDD-_STREET______ -- ---- �� LOT 3, BLOCK 1. \ S, KNIK VIEW ESTATESVol \C Cll*-"� ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD SUITE 28, ANCHORAGE, AK 99504 PHONE: (907) 337-6179/FAX: (907) 338-3246 - KNIK VIEW ESTATES SUBDIVISION; LOT 3, BLOCK 5, TYPE OF WORK: SITE PLAN FOR SEPTIC DESIGN (j/I PREPARED FOR: PHONE NUMBER: RON SHINE 344-7307/522-3889 J.L.M. 1 1 = 100' 1 1 OF 2 OFA •. 540 •,J a Ga � � s,'"• m ' C 7953 y�eG ie._ ..... CO )SED WATER SERVICE LINE LOCATION. N,SSUMED WATER KEY BOX LOCATION. (WATER MAIN IS IN KNIK VISTA STREET) ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD SUITE 20. ANCHORAGE. AK 99504 PHONE (907) 337-6179/FAX: (907) 338-3246 Q�O�•T �•� KNIK VIEW ESTATES SUBDIVISION, LOT 3, BLOCK 5, ,?•„ „ ...... OF WORK: PA DESIGN FOR SEPTIC SYSTEM f e Garn s: PARED FOR: PHONE NUMBER: oo �i •L•. CE 7953 RON SHINE 344-7307/522-3889 0 E: DRAWN BY: SCALE: PAGE �40e^nwgP�ofess{o� 3/24j" J.L.M. i = 30 2 OF 2 4 I I I NOTE: THE CONTRACTOR IS RESPONSIBLE FOR THE FLAGGING OF THE NORTH OR SOUTH PROPERTY LINE IS PERFORMED BY A REGISTERED LAND SURVEYOR I i I I PRIOR TO CONSTRUCTION. I ! I � PROPOSED DRAINFIELD EXCAVATE 5 FEET WIDE BY 70 FEET LONG BY I I 6 FEET DEEP (MAXIMUM). ADD 2 FEET OF CLEAN, �— I i I I I I WASHED DRAINROCK. i I I co r7 PROPOSED 1250 GALLON // 9MT SEPTIC TANK. / X W 1� LLJ ry (n I I, i ;pA OPOS PROPOSED 4 BDRM ! r 1 Q _- -- r r HOUSE Fca co rl j w o l j ALTERNATE SITE Z Y THS S I INSTALL DBL CO ! o I I I I � I � )SED WATER SERVICE LINE LOCATION. N,SSUMED WATER KEY BOX LOCATION. (WATER MAIN IS IN KNIK VISTA STREET) ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD SUITE 20. ANCHORAGE. AK 99504 PHONE (907) 337-6179/FAX: (907) 338-3246 Q�O�•T �•� KNIK VIEW ESTATES SUBDIVISION, LOT 3, BLOCK 5, ,?•„ „ ...... OF WORK: PA DESIGN FOR SEPTIC SYSTEM f e Garn s: PARED FOR: PHONE NUMBER: oo �i •L•. CE 7953 RON SHINE 344-7307/522-3889 0 E: DRAWN BY: SCALE: PAGE �40e^nwgP�ofess{o� 3/24j" J.L.M. i = 30 2 OF 2 4 LEGAL DESCRIPTION: KNIK VIEW ESTATES S/D• LOT 3 BLOCK 5. PERFORMED FOR: RON SHINE DATE PERFORMED: 3/6/99 DEPTH TEST HOLE #1 (feet) ORGANICS 1 11 8 9 10 11 12 13 14 15 16 GW/SW WITH SP LENSES LOOSE GRAVELY SAND AND GRAVEL 18 19 20 COMMENTS: INSITU PERFOMED BY THIS WAS PEF DATE. DATE: DATE XLQ NO. 9608 C.E. eo° I' SITE PLAN I° 100' „ 0000,a" PROPOSED SOIL CLASSIFICATIONS 2 0 o->°' � II GW GP I i ORG ML 3 r RNATE SFE 11 8 9 10 11 12 13 14 15 16 GW/SW WITH SP LENSES LOOSE GRAVELY SAND AND GRAVEL 18 19 20 COMMENTS: INSITU PERFOMED BY THIS WAS PEF DATE. DATE: DATE XLQ NO. 9608 C.E. eo° DATE I READING I CLOCK TIME I NET (MINUT S) WAREADING EL NET DROP T'M (INCHES) I 0•, Pss <Nw PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6'*8 (INCHES) TEST RUN BETWE 5.0 FT. AND 5.5 FT. VD SHOULD ACT AS A FILTER. WATER & WASTEWATER I, CERTIFY THAT IN ACCORDANCE WITH ALL A AND UNICIPA GUIDELINES IN EFFECT ON THIS I' SITE PLAN I° 100' „ PROPOSED W W STEM YSS " „ � II I i � ♦rr I r RNATE SFE „ IY „ „ Z II PROPOSED 4 BEDROOM Y „ HOUSE I „ „ ,I DATE I READING I CLOCK TIME I NET (MINUT S) WAREADING EL NET DROP T'M (INCHES) I 0•, Pss <Nw PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6'*8 (INCHES) TEST RUN BETWE 5.0 FT. AND 5.5 FT. VD SHOULD ACT AS A FILTER. WATER & WASTEWATER I, CERTIFY THAT IN ACCORDANCE WITH ALL A AND UNICIPA GUIDELINES IN EFFECT ON THIS R SOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: KNIK VIEW ESTATES S/D• LOT 3, BLOCK 5, PERFORMED FOR: RON SHINE DATE PERFORMED: 3/6/99 DEPTH {��' ^^^��-'''''''''��-� TEST HOLE #2 F====� (feet) ORGANICS 1 2 4 5 7 L 10 11 GW/SW WITH SP LENSES LOOSE GRAVELY SAND AND GRAVEL 12 P'"° ° `I B.O.H. 13- 14 15 16 17 18 SOIL CLASSIFICATIONS -�ET TIME (MINUTE) WATER READING LEVEL GW 7 OR • .i-?: GPML W L SYMEM " GM9OH CL 0 GCOL SWMH Qu;f-.•i„":;'fir i �TERNATE SIP CH I , > SM � Sc Z DATE DRY DRY NO. 9608 C.E. DATE SITE PLAN -�ET TIME (MINUTE) WATER READING LEVEL -�ET DROP (INCHES) I^ 100' II PROPOSED SEPT C W L SYMEM " 0 'CNS N` � tZP�O ' Qu;f-.•i„":;'fir i �TERNATE I L SITE I , > � Y Z iI PROPOSED 4 BEDROOM Y HOUSE DATE READING CLOCK TIME -�ET TIME (MINUTE) WATER READING LEVEL -�ET DROP (INCHES) 0 'CNS N` � tZP�O ' 6o99 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6' (INCHES) 20 TEST RUN BETWEEN 5.0 FT. AND 5.5 FT. COMMENTS: INSITU SAND SHOULD ACT AS A FILTER. PERFOMED BY ALASKA WATER & WASTEWATER I, CERTIFY THAT THIS WAS PERFORM D ACCORDANCE WITH ALL A E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage On -Site Water & Wastewater Program' (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcell.D. 051-043-43 Expiration Date: �Lf 1. GENERAL INFORMATION Complete legal description KNIK VIEW ESTATES S/D; BLOCK 5, LOT 3 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 22415 KNIK VISTA STREET, CHUGIAK, AK, 99567 ROBERT RICHMOND Day phone 688-8914 22415 KNIK VISTA STREET, CHUGIAK, AK, 99567 RUTH BARNDT W/ JACK WHITE Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 227-8040 Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 0 Community On-site Public Water System ❑ Public Sewer ❑ WaiverNariance request for: n/e Distance: — Received by: %= c eq, 1:,. Date: OOSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ to Waiver Fee $ Date of Payment ��U JlN Date of Payment Receipt Number /037-926 Receipt Number COSA# OSQU16g3- Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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. /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 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 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, LTO. 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 authonzed, nor will it confer any legal fight whatsoever, 6. DSD SIGNATURE V System #1 Approved for '_3 bedrooms. System #2 Approved for Disapproved. Conditional approval for Phone 337-6179 Date r� OF A lell A. GQ eSs;' CE -795 e cOO \ (LO Pr o f e s5io�o� bedrooms.tOF t /v& r r ON-SITE, bedrooms, with the following stipulations:` WnTFR AidD =t- ,,., . 1 AIASTFV+IATER o PROGRAM Original Certificate Date: The Murlottini rity,4dr AaXorage Develop,emt 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory lncv 111n16f Nitrate Advisory Arsenic Advisory Other 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: A. WELL DATA Well typecoMMUNITv Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE KNIK VIEW ESTATES S/D; BLOCK 5, LOT 3 Parcel ID: 051-043-43 If(A B, or C provide PWSID# 218409 Well Log (Y/N)- Sanitary seal (YIN)_ Wires properly protected Cased to ft. Casing height (abo n FROM WELL LOG W, Coliform _--� colonies/100 ml. Nitrate mg./L. Collected by: in. Ar5-enic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 5/19/1999 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 8/2B/2013 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 5/19/1999 Soil rating .p.d./ or ft2/bdrm) 1_2 System type 5 WIDE TRENCH Length 72 ft. Width 5.25 ft. Gravel below pipe 1.94 ft. Total depth *6.2-6.4ft. Eff. absorption area 500 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 3/14/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 1120 gal. New depth DRY in. Elapsed Time: min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off' level E. SEPARATION DISTANCES level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ PRIVATE/200'+ PUBLIC 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. Engineer's Printed Name JEFFREY A. GARNESS Date 3/1 5-)t rF (Rev. 11/05) 11 Y a MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ns1 -043-43 HAA# 1. GENERAL INFORMATION Complete legal description Lot 3 • Block 5; Knik View Estates Location (site address or directions) Knik Vista Drive Chugiak AK Property owner Ron Shine Day phone 227-9201 Mailing address 1 850 Minerva Way Anchorage, AK 99515 Lending agency Day phone Mailing address Agent Gloria Holflich/Vista REal Estate Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. . 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer 2 NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-=(Rev.1/91) Front MOAt21 A STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of tpection. Alaska Wates 4 Waste l 1 r G /17 Name of Firm Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. By: O OR bedrooms. Phone 33 /� I Date 10 Conditional approval for bedrooms, with the following stipulations: Additional Comments )a Date /0- The 0- The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. ]2-075 (Rw.1,91) Beck MOA 021