HomeMy WebLinkAboutEAGLE CREST #1 TR A LT 59Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number.- OSP141229 PID Number: 050-304-12 El New 0 Upgrade
Name:
MICHAEL & JEANINE WHEELER
ABSORPTION FIELD
❑ Deep Trench FZI Shallow Trench R Bed El Mound
Address
19535 FIRST STREET, EAGLE RIVER AK 99577
El Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
1 4
0.8GPD/SF1
10 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6.5 Ft.
Gravel depth beneath pipe
3.5 Ft,
Subdivision Block Lot
EAGLE CREST #1 A 59
Fill added above original grade
0.0 Ft.
Gravel length
82 Ft.
Township Range Section
Gravel width
5.0Ft.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
759 Fe
2
10 Ft,
Well
116.7
118.3
N/A
N/A
50+
TANK El Septic El S.T.E.P. El Holding [I Other
Manufacturer
ANCHORAGE
Capacity
1 1250Gal.
Surface Water
100+
100+
N/A
N/A
Material
STEEL
Number of compartments
2
Lot Line
35.8
14.4
N/A
N/A
NA
Foundation
15.9
8.0
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
50+
50+
N/A
N/A
Remarks
Pump on level at
in.
Pump off level at
in,
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House totank 3034 drainfield Tankto 3034
Installer
JR'S SEPTIC
Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering Services
BENCHMARK (Assumed elevation) 100ft
Inspecttes:ion 1 M 11/19/17 11/20/17
Location and description
2-d
da
TRIM, NW CORNER HOUSE
3d 401
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
A4, kkk
Conditional Approval: Date
e en PLInW8ra;*
CE 8149
lip
Approved I�Auua emmu_ Date
Adw
Aw
Inspection Report-1-1-12.doc
Municipality of Anchorage
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 215
hftp:llwww.muni.org/Onsite I
Development Services Division //.2
On-Site Water and Wastewater Program / 7 1
Waiver#: OSVI71149 COSA#.- Permit#: OSPI41229
PID#: 050-304-12
Legal Description: Eagle Crest #1 Tract A Lot 59
Engineer: Pannone Engineering Services
Applicant: Michael & Jeanine Wheeler
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to a foundation has been approved. The approved separation distance is 8.0 feet.
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
r_1 The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
Z Adjacent properties are not affected by this waiver.
M a K K U a U a a K a 0 a a a a M Z X a U M a 2 K a a a a a a a a a a X a X a a a a a M a U a a a a a a a a a a a K a a a a Z a a X R U K K K a M a Ill a a a I
Waiver is Granted: X Waiver is not Granted:
Date: fV20,2011 Approved by: aa,�11
Name of Reviewer
0 N K K 0 K M 8 9 K 9 M N K 8 K K K 0 K K a N a 0 a V a a a 9 a a U a M K M a a a a a a a 0 a w a a a x n a w a v a a a n u a z M u a V M a M M a U a a U a I
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: Steve@panengak.com
27 November 2017
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road
P. O. Box 196650
Anchorage, Alaska 99519
Subject: EAGLE CREST #1 TRA L59
ABSORPTION FIELD TO FOUNDATION SEPARATION DISTANCE Waiver Request
Ladies and Gentlemen:
We request a waiver to eight feet (8') to the foundation for the single-family dwelling and the garage from the drain
field. Due to the existing well radius and the location of the house and driveway the only location remaining for the
field is along the front lot line. Due to the nature of the soils surrounding the absorption field the drainage prism is
such that the effluent will not migrate towards the footings and foundations but will drain at a steeper infiltration
grade and dissipate well prior to the structures. Granting this waiver is not likely to cause damage to the structures
now or in the future.
If you have any questions or concerns, please contact me at 907.272.8218.
Sincerely,
".*mom„a
®m�E OF
Steven R. Pannone a°
•� � s
81g9 :
m�rq�FEss�o�`�a,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mad!H"g: P,0. Box 10021-17, Anchorage, AK 995_110-0'217
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NOTES:
PAMONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
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even none
Date
11/21/16
RECORD DRAWING
Scale
1"=50'
EAGLE CREST #1, TRACT A, LOT 59
MICHAEL & JEANINE WHEELER
EAGLE RIVER, AK 99577
050-304-12
PERMIT NO.
PLAN
Sheet
2 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE
STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE
WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS.
3. SCOPE OF WORK: INSTALLED 1250g SEPTIC TANK. INSTALLED SOIL ABSORPTION SYSTEM WITH DIVERTER VALVE.
4. GROUNDWATER WAS NOT ENCOUNTERED TO DEPTH OF 16.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE.
DAYTON
TH-1 (6/1993)
EL. 100.0
-"
FILTER FABRIC
4" 0 PERF PIPE
T.
6.5 [1
DRAIN ROCK 6" ABOVE
PIPE INV
SP/
—T
GW
15
a
0
DRAIN ROCK
610
SECTION
-84.0
NO GROUNDWATERw
w
m
w
m
(6/12/93 & 8/11/93) ?
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N
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PROFILE
ABBREVIATIONS
CU COPPER
DESIGN PARAMETERS LEGEND DIP DUCTILE IRON PIPE
PRIMARY/RESERVE SEPTIC SYSTEM W WATER LINE/ TH FC TEST HOLE CLEAN OUT
NO. BEDROOM: 4 (600 gpd) WELL RADIUS
TANK SIZE: 1250g (E) T# TANK CLEAN OUT NO.
PERC RATE = 7.2 MPI SS NEW SEPTIC C# CLEAN OUT NO.
SOIL RATING: 0.8 GPD/SF M# MONITOR TUBE NO.
AREA ROD: 750 SF R.I. RIGID INSULATION
SYS. TYPE: WIDE TRENCH 3.5'ED DCO DOUBLE CLEAN OUT
RF: 0.54 DV DIVERTER VALVE
MIN LENGTH: 81 LF FS FLOW SPLITTER
USED: BFG BELOW FINISH GRADE
(2EA) 41 LF X 5' WIDE, 3.5' E.D., 10.0' TD OG ORIGINAL GRADE
TOTAL AREA: 759 SF FG FINISH GRADE
TS&V TOPSOIL & VEGETATE
NOTES:
.%S' -%-'*
RECORD DRAWING t p �' BF A/- D11/21/16
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211 Scale
•49 �� NTS
...... :.. P.I.D. NO
EAGLE CREST #1, TRACT A, LOT 59 .__,.., -- 3�-��4--12
Steven R. e
MICHAEL & JEANINE WHEELER Pannon
� � � PERMIT N0.
�� CE 8149 OSP 141229
19535 FIRST STREET �� 60s�..REV:11/29/1¢•' �
DESIGN DETAILS EAGLE RIVER, AK 99577 �� F�Fo' ••NP�� Sheet
ki� 0 _*''��� 3 OF 3
~ ~umc~pa,ty /~ncnorage 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: 5v..3 ~' ~o ~, Z.?e PID Number:. O~o~
Name:
.~ ~~ Wastewater System: ~New D Upgrade
I~ 55~ ~sr ~ ~v~ ABSORPTION FIELD
4~'Z~Z> IN°'olBeZ~m`: DDeepT,ench ~hallow~rench DBed OMound O0,her
LEGAL DESCRIPTION SoilRating: 0,~ GPD/S~ FI.
WELL: ~New D Upgrade Gravelwidth; ~ ~ FI ~ / Ft
SEPARATION DISTANCES ~Septic D Holding D S.T.E.P.
Surface
w~t~ t~ ~ ~ -- ~ LIFT STATION
Lot Sizelngallons: lManufacture~ ~
Cu~ain ~ ~ Pump Make I M~el I Electrical Ins~tions performed by:
I
Remarks: BENCH MARK
Inspect ons performed by: ~ '~ ~ ~~~I
~epa~tm~nt bf Health and Human Services approval
Permit No.
'~¥~J ~ '~ Z4- Page ~' of ~
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-665,3 · Telephone: 343-4744
On-Site Wastewaler Disposal System and/or Well Inspection Report
PID No.:
!
i/' /
/
.
NILE 501/2 PARKS HWY ·
892-7950
JOE GIELAROWSK!
DRll LING CO.
LIFETIME ALASKAN SERVING ~
· . _ ___ ~a<~ SC. Eaole River.Ak. 99577
~ ~.,-,J 1st. ~ .............................
.r..I' .. e~ Lot 59 Tract A Ea~le Crest Su_b..
DATE-- ENO£O ,., .. 083193
KI~D OF FORMATION: '.
$~ vr~ 68 rr silt
FROM ........ IrT .......
140:'*m-'~n 152 ' ~r cobblestone
FROM .... --: o. ........ -
FROM 245 ~r ~n 251 FT boulder
De.r~ H OF WELL .~ .~.~..~. ..... ----'--
~t-VrW.~W~TFn~T 160ft. in hole est.
~A~C ........................ ~'~
.~ISC L. INFORMATION:
Hang pump 5£t ogg
DRAW DOWN ~r 95% ,,-
GALS. PER HR..~-O.-g~O,....P-~-,t--~-q r=-e S.t,, ......
FROM .._2.~1 · -- Frl To--2-~-~ .... Fr.~_a..r_dm.~
FROM ~28.~ _ IrT. TO = ~, 2,9.0 ,.....~'r --_c°bblest°ne ~ ',.._____
299 . cla~
FROM _.Zg~ ...... tr. T° ...... - FT .... -
299 ~r ~ 325 ~r clay.~ravel&
FROM ......... - ............. .
FROM ~ .2.5- ..... Fr. TO _.~./~_.5 _ ~-r eravel&water
FROM_ --- IrT. TO ..... FT. --
FROM _ _ - -~_ Fl'. TO_ , - FT. ', -
FROM ~ IrT. TO ..----.7----- FI~.
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES 6;~.~1~
P.O. BOX 196650, 825 'L# STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW930324
DESIGN ENGINEER:DAVID R. DAYTON, P.E.
OWNER NAME:WHEELER MICHAEL R &
OWNER ADDRESS:19535 FIRST ST.
EAGLE RIVER, AK 99577
DATE ISSUED: 8/25/93
EXPIRATION DATE: 8/25/94
PARCEL ID:05030412
LEGAL DESCRIPTION: EAGLE CREST TR ALT 59
LOT SIZE: 17820 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL 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 343-4744 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:
GRAVEL DEPTH SHALL EXTEND SIX FEET BELOW THE BOTTOM OF THE
PERFORATED PIPE. ,~ ,//~ , //~
DATE:
DATE:
~"ovld R,
NO.
David R. ~ P~.
20210~St. '"
C'nug~lc, AI-~,i 99547
.D.R. DAYTON, P.E., R.L.S.
~xx~]T~)~ Chugiak, Alaska 99567
20210 Donalar
(907)
696-2417
LOt 59, Eagle Crest, 1St. Addn.
The proposed septic system which will serve a 4 bedroom home will
have very limited impact on adjacent properties.
The lot has sufficient area'for an on-site system. Neighboring
systems are 25' or greater distance away and reserve area is adequate.
Drainage ~ not be affected.
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
5
6
7
8
9
10
11
12
13
14
15
17
18
19
20-
COMMENTS
{)ATE PERFORMED:
S~OPE SITE P~N
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ~'~ ~ (m,nutes~mch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND 7 FT
PERFORMEO BY: '-'DA~ ~ ~o P~'~/ ~*~ , ~(~'~'~/~-' CERTIFY THAT THIS TEST WAS PERFORMEO IN
ACCOROANCE WITH ALL STATE AND MUNICIPAL GUIOELINES IN EFFECT ON THIS DATE. DATE;
72-0~8 (Rev. 4~85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
I
2
3
4
5
6
7
8
9
10
11-
12-
13-
14-
15-
17-
18-
19-
20-
COMMENTS
DATE PE.FORMEO= ': ,Z',,,'"/~:-~'~:-'"'
Township. Range, Section:
SLOPE
WASGROUND WATER
ENCOUNTERED? ,~o
SITE P~.AN
Gross Net Depth to Net
Reading Date Time Time Water Drop
Iz.,,~-~ ~ o Ioy? z,:',f
PERCOLATION RATE /&~' / (m,nutes/,nch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~a, FTANO ~ FT
6 7 8 •.0
t Municipality of Anchorage CV
Ott ,' °z
On-Site Water and Wastewater Program I
(907) 343-7904 a APf�� : . � .
ti
Certificate of On-Site Systems Approval << hcu
. 0� 68L9c'
Parcel I.D. 050-304-12 Expiration Date: 3— 2g - I c
1. GENERAL INFORMATION
Complete legal description Eagle Crest #1 Tract A Lot 59
Location (site address) 19535 First Street
Current Property owner(s) Michael & Jeanine Wheeler Day phone
Mailing address 19535 First Street Eagle River, AK 99577
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
LI Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: • 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System Q Public Sewer ❑
WaiverNariance request for: Distance:
Received • • , i i1 •.,( 1. AL AO Date: O O7, J /P>
v ice..
COSA to be released to the engineer,unles otherwise requested • :sneer.
COSA Fee $ 62G - 'p Waiver Fee $
Date of Payment Li—\ � �� 0 Date of Payment
Receipt Number Oka 85 06k Receipt Number
COSA# Or—JC-13 1\LN 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.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 4/12/2018
��OF
N.,\‘‘
qs t
C� 1i
0*:•49 n-! \ *�r�/
6. DSD SIGNATURE r :� • `
System#1 Approved for bedrooms A • •S even R.• Pannone•
System #2 Approved for bedrooms •• CE-8149
Disapprovedk `�fNOFESSION��'
Conditional approval for bedrooms, with the following stipulations:
\c'N( OF Aite/50
ON-511 E yc,
WATER AND
WASTEWATER g
PROGRAM
Original Certificate Date: (11' —I 2
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet f ..
If more than 1 septic system is on the lot:
COSA Checklist# I of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Eagle Crest #1 Tract A Lot 59 Parcel ID:050-304-12
A. WELL DATA
Well type Public If A, B, or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA i l 1
Tank Type/Material Septic/Steel Date installed 11/19 i!' 4aOI'1
Tank size 1250gal. 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/A
Date of pumping 3-2� -t9 Pumper JR's Pumping
C. ABSORPTION FIE ' DATA g
Date installed 11/1• '•4 a Moil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Shallow Trench
Length 82 ft. Width 5.0 ft. Gravel below pipe 3.5 ft.
Total depth 10 ft. Eff. absorption area 759 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 3/30/2018
Results(Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in.
Elapsed Time: 90 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) 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 On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO: K.{�) t
Property line 10+ Building foundation Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION + OF A`�1
''�'�P .49, 4
1 certify that I have determined through field inspections and �r
review of Municipal records that the above systems are in 0*: 49 TH /\ ••*tt6
conformance with MOA COSA guidelines in effect on this date. /••••• • •'
Steven Pannone Ali •• r
Engineer's Printed Name r••.Sieven 1.•Ponnone
Date
4/12/2018 61:f•• CE-8149• �/f
`\vx.►\124
COSA canary sheet_2-6-15.doc
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Lot 42
Lot 43
Lot 41
S 89°56'00" E 132.00 Wood fence
a s a a a a 1r y a y
10' Utility Easement
0
00
'Septic vent(typ) °
O
Lot 58 C
�O ; } Stl[iI 2.o OH deck �
6 Ret.walk �--r — — 44.9 — M
Cr) 2.0 OH 44.0
`— 0, 0 2 Story Frame I
: i House M _ _
o Lot 60
E 0 1_ Lot 59 00
� ' 20.6 -.4- .. .o OH
%— M M deck 20.0 = -.--
•—•
o I C7 Shed cm N € _ -.
0 11.3 20.6 co , 2.0 OH o
o :: - 24.0 a_ `1 ' Z
Z &:Y`:y :, ;.5,d,s-v::\. F; die ,, i '�
:1••;:lz,r;f;•!:::S .,;'.i)-iNi:4:::'.?Vre:,,t,.?,,,..,:_.:t.
'=As p halt: - •- rl
S 89°56'00" E 132.00
0
O co
M
c.
FIRST STREET
-
Note: This lot is served by a public water system.
AS-BUILT NO CORNERS SET THIS DATE
`�\A N.
\
OF 111 I hereby certify that I have performed a Mortgagee's inspection
,`/ • 9 iof the following described property: LOT 59, TRACT A,
�Q,• ,5� � EAGLE CREST SUBDIVISION. FIRST ADDITION
i `�' 49th j-.S"'" •v ,
//
• / Anchorage Recording Precinct,Alaska,and that the
•• improvements situated thereon are within the property lines
• ••• and do not overlap or encroach on the property lying
IN / •• lizobeth L. Wolotka:,a., adjacent thereto,that no improvements on the property lying
adjacent thereto encroach on the premises in question and
�,�T • 8036• LS •• �e ,o that there are no roadways,transmission lines or other
F''F•• `'_— visible easements on said property except as indicated
#'O •
Q,'oFrSSIONp� .•�� hereon.
SCALE: 1"= 30' \vt 44:14-
Dated at Anchorage,Alaska
\\�� this 5th day of APRIL ,2018.
EASEMENTS OF RECORD,OTHER THAN
THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES
PLAT ARE NOT SHOWN HEREONEngineers and Surveyors
UNLESS OTHERWISE NOTED. FB 18-3, pg 29 BE 907-248-1666
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
e
Location (site address or directions)
~lct~"~- ~ ~H~ Day phone ~'~
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of {he validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and Inspection, the on-site water
supply and/or wastewater disposal system Is In compliance with all Municipal and State codes,
ordinances, and regulations In effect on the date of this Inspection.
David R. Dayton P.E.
Name of Firm ,~w~n n~,,,~t., ~, Phone
Address Ch~lak,
Engineer's signature /~'~~'~~*--' "'Date
DHHS SIGNATURE
~' Approved for ~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
Date
The Municip.~lity of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasem of homes
and their lending institutions in orderto s~tisfy certain federal and state requirements. Employees of DHHS do not
conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work. .
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
Pamel I.D. o 5-O~ O~.-~,/'Z...
A. Well Data
Well type "~/~-JV,~'~' If A, B, or C, attach ADEC letter. ADEC water system number.
Log present (Y/N) Y Date completed '~.//3/~/'~-~ _Driller ~ ~'/~'~.-
Total depth -~ ~"' Cased to 3,~5" Casing height
Sanita~ seal (Y/N) Y Wires properly protected (Y/N) "/
Date of test
Static water level
Well flow
Pump level1
FROM WELL LOG
{4.0 '
g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot /o/
Absorption field on lot
Public sewer main
Sewer sen/ice line
AT INSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
.Petroleum tank ~
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Nitrate ~, ~'~., Other bacteria
:~/7/qV Collected by: 3:;) ~)
/// --
Tank size /Z~ 5-z..3 Compartments
Foundation cleanout (Y/N) Y' Depression (Y/N)
A//~ Alarm tested (Y/I~I)
~1~ L~-~3 ~r~,,w Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot //
To property line ~
Sudace water/drainage
On adjacent lots
Absorption field
/' u¢) ~-- .Foundation /
/ ~ Water main/sen/ice line
~2.02e (3~93)- Freer CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
'Pump on' level at
Meets MOA alectdcal codes (Y/N)
Manufacturer
.Manhole/Access (Y/N)
'Pump off' Level at
Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water,
D. ABSORPTION FIELD DATA
Date Installed
Length ~ /
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide ireatment (past 12 months) (Y/N)
/o/z./~;3 Soil rating (GPD/FF)
Width .~' · Gravel thickness
,Cleanout present (y/N)
,~//~f.~.) .~/,~,r~'?,~ Results (pass/fail)
,System type :~=~'7-,~3
· .~-.~"' Totaldepth /0,?~'.~- ~',~--
Depression over field (Y/N)
for Bedrooms
After test
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot //o
To building foundation
On adjacent lots
Surface water !
Curtain drain
On adjacent lots /~o ~ Property line / O
~'~ To existing or abandoned system on lot /~,v~
Cutbank /.~//'~/- Water main/service line z ~'-.'-
/
Driveway, parking/vehicle storage area Z. ~
E. ENGINEER'S CERTIFICATION
I cerb'fy that I have checked, ye#fled, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
David R. Dayton P.E.
20210 Donalar St.
Signature ~_ h,_-!.~..~_~.__.~_
HAA Fee $ ~,~/)/) - ~
Date of Payment
Receipt Number
724326 (3/93)' Back