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Home My WebLink AboutTONJESS ESTATES BLK 3 LT 10Tonjess Estates #051-532-02 IC3-.. ACIAIW40% Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221321 PID Number: 05153202 Dwelling: 9 Single Family (SF) 0 with ADU n Duplex (D) n Two Single Family Project: n New EK Upgrade Name Fritz Todd ABSORPTION FIELD El Deep Trench D Wide Trench El Bed n Mound Site Address 21510 TONY CL El Other Phone Number of Bedrooms Soil Rating depth from original grade 319-558-9527 13 GPD/SF ITotal Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft Subdivision Block Lot TONJESS ESTATESBLK 3 LT 10 Fill added above original grade Ft. Gravel length FL Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist, between trenches From Tank Field Lift Station Tank Line Ftp Ft. well 100' na 25+ na ' + TANK 0— Septic E] S.T.E.P. 7 Holding Cl Other Manufacturer GREER Capacity 1000 Gal, Surface Water 100' + na na Material Pistc Number of compartments 2 Lot Lim 10'+ na na NA Foundation 10'+ _T na na LIFT STATION Manufacturer Capacity Gal, Remarks Alarm location Electrical installed by PIPE MATERIAL HTank to D3034 House to tank D3034 drainfield Installer Drainfield CO/MT D3034 Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 915/23 9/512311 ocation and description dates: 2"" deck X0 41 ON-SITE WATER AND WASTEWATER SECTION APPROVAL AP Conditional Approval: Date Awr Wr Ve, ar A9 Q:0 Steve Eng CE 6256a=r Septic System Approved Date 2-T Note: this approv/Ad'oes not include well permit requirements. IC3-.. ACIAIW40% SteveEng.com Steve Eng, PE, PH PO Box 770724, Eagle River AK 99577 907-694-7028 SteveEngPE@gmail.com Date: 9/5/23 Number of Pages: 1 To: MOA On-Site Services Subject: Tonjess Estates Block 3 Lot 10- PERMIT RENEWAL Septic System Upgrade OSP221321 Permit recently expired. Please renew the Permit. All conditions remain the same. The new septic tank was actually installed on 9/5/23. An email was sent to your office the morning of 9/5/23, reporting the inspection for noon that day. After this inspection, we were notified of the Permit Renewal requirement. The subject property has been served by a septic system for a number of years. The old tank was decommissioned and a new tank installed. The existing absorption field to remain for continued use. The entire subdivision is on private wells and septic systems. The terrain is generally flat as indicated. Please review the wastewater system design for the existing 3-bedroom home. I have included design plans & specs, design guidelines. If there is need for additional information or clarification please give me a call. Thanks-Steve C u �;0 SDH l _J F9 F9 OD 1-1N 0) 1-1 R) m 0 LA -u V) ;;U F9 o 9 --1 l J F9 VV) / r F9 td —1 70 F- o Fl oz (-) (-)C— � �o d w" tj F- o ;;u o c) �D z oF9 c� V) n Q ro QQ �o :5O <+ 0 l � ro rD Q < <+ Q O C+ O p 0 ,D 0� �,O (O fU N Q O C+ LA bd ro C+ ro ro V) ro C+ n Q 90 5 ro n s I f'l N o m -- D ro V) 3 - CD ro < Q O -P, o o 0 Fr] O h 1 n D� :5-0 h -0 Q ro Q '5 0 .o O Q O 0 ro Cn ro Q n Q ro QQ �o :5O <+ 0 l � ro rD Q < <+ Q O C+ O p 0 ,D 0� �,O (O fU N Q O C+ LA bd ro C+ ro ro V) ro C+ n Q 90 5 ro n s Flat Slope ` W of Driveway Well 0 El Flat Slope Flat Slope 3 Bdrm '1 Ex+5tin9 Bed Flat Slope 0' Utility Easement Anchor Easement T1 New 1000 Gallon Septic Tank w/DC❑'s J� Decommissioned ❑W Septic Tank PER UPC Flat Slope AS -BUILT MEASUREMENTS A B T1 39 36 T2 43 40 dco 43 42 NOR THRI M OF A� r r °F ACa4� T❑NJESS ESTATES ENGINEERING s*'�P9m1 11 BLOCK 3 LOT 10 steveEng.com PO Box 770724 Eagle Rlver, Alaska 99577 oE-e�s .•' WASTEWATER L 907.694.7028 $'' 1z7i2 UPGRADE SEPTIC TANK 1" = 50' RECORD LAYOUT Dote: ET.. 12/3/24 2 of 3 LOT 3 PLAT #2005-37 LOT 6 PLAT #2005-37 LOT 7 PLAT #2005-37 CID cnD 0 ao D 70 z z 0 0 0 0 csi CJ J Z O F'7 LOT 9 BLOCK 3 PLAT #82-59 N 81 49„ E 204.1 °33' 81.5' GARAGE A J 36.4' (10' UTILITY ESMT), (R=50.00') \ (L=36.49') 122.6' OVERHANG LOT 10 49.8' BLOCK 3 PLAT #82-59 100' WELL n RADIUS, 24.8' / 2 STORY p 9' RESIDENCE A 29.3 co co MH .� 100' WELL RADIUS 00 Cb O CO N� 0' 40' 80' SCALE: 1" = 40 FEET (11"X1�"> � pF. A�gsl �?• •: X111 *:49TH •.* •Ryan G. Johnson; , •• No. 192159 AW ;��• 8/20/202•-'S�; `kiOoisslo% t� ASPLS MORTGAGE LOCATION SURVEY NOTES: NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. X(10'x30' ANCHOR ESMT) \ LEGEND () RECORD DATA PER PLAT #82-59 O FOUND 5/8" REBAR, NO CAP EDGE OF ASPHALT FENCE E E OVERHEAD UTILITIES P � POWER POLE 0 UTILITY PEDESTAL SEPTIC PIPE �H SEPTIC TANK LID O WELL DECK 0 CONCRETE LOT 11 BLOCK 3 Z PLAT #82-59 Z Z Z LOT 23 BLOCK 3 PLAT #82-59 AS -BUILT OF: LOT 10, BLOCK 3 TONJESS ESTATES PLAT #82-59 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 On -Site Wastewater Disposal System Permit Permit Number: OSP221321 Work Type: SepticTank Upgrade Tax Code Number: 05153202000 Site Legal Address: TONJESS ESTATES BLK 3 LT 10 G:1462 Site Mailing Address: 21510 TONY CIR, Chugiak Owner: WIRTH SUSAN Y Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: ❑ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 1»ent X04 n llepartment 8/23/2022 8/23/2023 51126 ❑ Private Well ❑ 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: • Locate the edge of the field prior to installation to confirm that the 5'separation between the tank and field will be met. Repair the cleanout/monitor tube so the field can be located in the future. i Received B) Issued By: 8/23/22 Date: Date: 0 2 3/_Z_ Z' 3 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05153202 Property owner(s) WIRTH SUSAN Mailing address 21510 TONY CIR Site address same Day phone 863-4484 Legal description (Sub'd., Block & Lot) TONJESS ESTATESBLK 3 LT 10 Legal description (Township, Range & Section) Lot Size 51,126 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank 0 Upgrade 0 (w/wo AD U) Holding Tank E]Renewal ElDuplex (D) E] Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. er;;;-1rZ (Signature of property owner or authorized agent) Permit/Rush Fees: 2 2 Waiver Fees: Date of Payment: ��//�Z Z Date of Payment: Receipt Number: 0( 2 YO D Receipt Number: Permit No. DSP 2Z 132 1 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Tonjess Est B3 L10 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the seepage bed still functions. This lot is fairly large and on private water wells. No adverse impacts are expected from tank replacement. Easements are presented on the lot. The slope is indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet.  5 minimum between the tank and trench. 5  to property lines & 10 to house.  4 of cover or insulation is required for tank; an equivalent of 1  insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil.  No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel.  4 diameter cleanouts with airtight caps are required 1  to 4 from foundation wall, prior to any 90 degree bend in 4 inch line, in 2 nd tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 st tank compartment.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Insulation must be placed over any pipe installed under driveways or parking areas.  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661,  Sewer Service Line is minimum 2% slope.  Septic Tank to be pumped every two years or when required.  Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221321, Deb Wockenfuss, 08/23/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221321, Deb Wockenfuss, 08/23/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221321, Deb Wockenfuss, 08/23/22 MUNICIPALITY OF ANCHORAGE DE, ITMENT OF HEALTH ANIS HUMAN SEEM =S Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 -SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES TO SEPTIC ABSORPTION Address FROM TANK FIELD WELL WELL Phone(s) Permit No. No. of Bedrooms 1.88- s�9s �3S'a38� 3 LOT LINE, LEGAL DESCRIPTI, Lot I O Block 1 -5 Subdivision FOUNDATION / Township, Range, Section AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, --t--•I�„ ( TZ `w 1pt'1�� N dnveway, water bodies, etc.) TAPS SEPTIC ❑ HOLDING wL. Manufacturer Capacity in gallons Material No. of Compartments TYPE OF SYSTEM Z I G, 11 ❑ TRENCH < BED ❑ W. DRAIN ❑ OTHER � Depth to pipe bottom from Total depth from original grade original grade 6,3 FT j�,, FT 6 3 v Fill added above original grade Gravel depth beneath pipe U FT Q, lv FT 2 I 31 \ Gravel length Gravel width FT 141 FTI Y I Totai absorption area Distance between lines �8'l SQ FT. -el— AIA- FT -- Number of lines Soil rating Pipe material G f /5'D SQ FT \ Installer Date Installed ,- Zr ELLS jZ PRIVATE ❑ OTHER (ldentifv) C. a. o —Classification (A,B,C) Total Depth Cased to 1a0/v/4v/a.1_1 5/A/ P;Ati(fL e. ao FT -t6, o p FT Installer Date Installed: REMARKS: A` l3G1.lic%,-' L17�1� I ��S iso LPaa f Lc� � S scale: Inspections Performed by A OOp OO Op Op Dale: 00000000 000 g000gOOU003f 000000 ODO a O Ob0000D OOOgO inspection was performed according to all 0° '' WIt L' fisnm-bura ° i! CE-6739 1 = 7"� r`�''� �� certify that this Municipal and State guidelines in effect on this date: /a—/-85'' S,00°pO°DUO00°0p0' 4. E:r.>�t�i6''.a y .. Health �'1`` "� <`L.^✓� �s ®T � Department Approval: Date: 72-013 (3/85) CHUGIAK, AK 688-3199 WE SERVE A VJ I LL14 NVIDRILLING CO. P.O. BOX 670042 - CHUGIAK, ALASKA 99567 ALLALASKA WASILLA, AK .376-3199 OWNEROF LAND ....................................................................................... DEPTH OF WELL ....................................................................................... ADDRESS ...................................................................................................... STATIC LEVEL OF WATER FT . ................................................................ WELL - SITE .............. .................................................................................... DRAW DOWN FT...............:. DATE- STARTED .......................... . .......................................................... GALS. PER HR.....:'....:::......:. ....................................................................... DATE - ENDED ........................................................................................... KIND OF CASING ........................................................... KIND OF FORMATION: FROM ...................... FT. TO ....................... FT.....' ........................ FROM...................... FT. TO ...................... FT....... .......................... FROM...................... FT. TO ...................... FT . ................................... FROM ...................... FT. TO ............... I ......... FT . ........ . ............................. FROM....................... FT. TO ............. I ............ ...... .................... FROM...................... FT. TO ....................... FT . ................................... FROM ......................... FT. TO ...................... FT.................................... FROM ...................... FT. TO ...................... FT..:................................. FROM...... ............. FT. TO ...................... FT...",............� ......................... FROM...................... FT. TO ....................... FT......::..........:................. FROM...................... FT. TO ................ ; ...... FT . ................................... FROM...... w ............... FT. TO ........................ FT . .................................... MISCL. INFORMATION: P,0:✓ :7,y FROM .......... .. FT. TO . FT . ................................ I FROM ......... * ............... FT. TO ........ I ........... FT. ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM....................... FT. TO ........................ FT . ................................ FROM ....................... FT. TO ........................ FT. .o . .............. FROM....................... FT. TO ..................... . . ............ :j'.1 ............... ly FROM....................... FT. TO ................................ FT5X . . ........... 4 DRILLER'S NAME ................................................................................................................... C-,# •-I , IT, WE SERVEA V LL#4 ALL ALASKA N pRILUm6 C041 P.Q.13OX_670042 --CHUGIAK, ALASKA 99567 CHUGIAK, AK WASiLLA, AK 688-3198 .376-3199 OWNER OF LAND ..ft . Hattenur. ... ......... ..... DEPTH OF WELL . 5€4f t. ........ .... ....---•.......... ... ADDRESS .,P..%......lUSI..cht7:ia.. ... ....... STATIC LEVEL OF WATER FT........ 5fI. ............................................. WELL — SITE .L. &.-m. ,aa--B•.-3-.... Ta, s� je4*..Zst&te. DRAW DOWN FT.S9Of t........ ......... .......... 7-26-85 _GALS. PER HR. DATE - STARTED .........: , ................................... ...... 3��..LI...P.CX ... hiAY .. AtA... ..... . l DATE - ENDED ...� ...........- , 29.,-85•............... .......... ........., " KIND OF CASING ...1t3�f... � 1A. S+c� .4{i 95-250 w•-fj KIND OF FORMATION: ri We'll ✓a...�-� 3 Qvetl�urden '''�! :. FROM ., �......:........ FT. TO ...:.............. FT.......... ...,..........--•---. FROM ;.:...3�.�......... FT. TO ....:��.,'�1,......... FT. �`.Xr��#K.�i�...r.5?ck Sand & Gravel 3 5- 455 Bedroc. FROM . . FT. TO 12 . FT. ........ FROM --... FT. TO .... ••-•--•. FT. ..... I moulder X455 463 Shell FROM........................ FT. TO . .................. FT... ............... ........... FROM ................... FT. TO ........................ FT....... ..................... FROM ,.. �. . FT. TO . 5.6 FT. Sand b Gr v 1 FROM 463 .. FT. TO b�fl - • F Cdr k ............ FROM ' ...... FT. TO ..-.8� • FI, Fine Sid FROM FROM,...... .......... FT. TO... ............. FT: . ........ FROM . $ ....... FT. TO _9 3 ..... FT. Fine .. Sand a 1. FROM ....:. FT. TO . .... FT ........... ................... FR M r ..... FT. TO :,� FI• jglm .......... FROM.. .. FT. TO ................ FT .. .. .... 9? 154Cdr&ck FROM.................... .... FT. TO ......................... FT ..-..-- ....... FROM ............. ... FT. TO, . FT .......... ,..�. ........ Fac turedkock FROM FP. TO ........g. ..... FT...r......... FROM................... FT. fO ............ FT. ...*. . I5? 2�5 FT Bedrock FROM .... !P ........ FT. TO........ .......... ............. .......... FROM,.................:.... FT. TO ... ..... FT ...... ...._ FROM ....265......... FT. TO. ..... .� ....•. FT. Fractured rock" FROM ....................... FT. TO ......... .... .,.. ........ 2?4 310 Bedrock � c� � FROM - FT. TO ....................... FT. FROM :. FT. TO .......... • FT. ............;. MISCL.INFORMATION: -Pump should be set at 585ft. No warranty or no warranti DRILLER'S NAME .ice an-s..�Aj.11a.a �.s........... .................. ...... ....................... ........... ." PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: RVI ��= 1: 11� 11"!:11 .... ..... :*'!�. -1F " �'h;"t lf�,! 11 !1 111!i 11:E'"� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ' 825 L STREET, ANCHORAGE, AK 99501 264-4720 850387 07/03/85 RUSS HATTENBURG P.O. BOX 104504 ANCHORAGE, AK 99510 333-2106 LEGAL DESCRIP: SUBDIVISION: TONGESS EST. LOT: 10 SECTION: 2 TOWNSHIP: 15N RANGE: 1W LOT SIZE: 51126 (SQ.FT. OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to you in designing system. Choose the option that best [its your site. DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 GRAVEL DEPTH (FT.) 6.0 0.5 TOTAL DEPTH (FT.) 10.0 4.5 GRAVEL WIDTH (FT.) 2.5 19.0 GRAVEL LENGTH (FT.) 38.0 36.0 GRAVEL VOLUME (CU.YDS.) 22.9 25.4 TANK SIZE (GALS) 1,000.0 ** 1,000.0 ** SOIL RATING (SQ.FT./BR) 150 150 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS BLOCK: 3 your septic 4.0 3.5 7.5 5.0 49.0 36.3 1,000.0 ** 150 I certify that: I. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements [or the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maxim � 3 bedrooms um o e rooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS -BUILT--_-., WILL NOT BE APPROVED WrTHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: '_-_______---------------------------- ------------------ APPLICANT: _____________APPLICANT: RUSS HATTENBURG ISSUED BY DATE: //// -------------------------- -------------- LCM-F Limited 723 W. Sixth Avenue Anchorage, Alaska 99501 a SOILS LOG 0 PERCOLATION TEST PERFORMED FOR: DATE PERFORMED - LEGAL DESCRIPTION: Lor ic SLOPE SITE PLAN 2 Date Gross Time Net Time 0 �p 3 Mton .5AQDI- co(36LE3 8 - J0 -"C- 12 13 o 14 -- Of--40LE, 15 OF At %k .z!7 16 49LH 0 00 000000017 Haber - S" L i 18 *: CE -k 6739 19 - % 20 COMMENTS SAMD-CWMCWJ PERFORMED 8 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S KIC) L 0 P E Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED BY: DATE: -I- J5-- Well Drilling Permit Number SW Parcel Identification Number: Date of Issue Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. f Municipality of Anchorage • Development Services Department Building Safety Division � <e On -Site Water and Wastewater Program , y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.sk.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.soy /—�'rz-o t� HAA# = Expiration Date: 1. GENERAL 1,N9,ORfillAbN Complete 1eal descriptions '.,T._,,rat+ gra,. 7_y �S,o d Location (site addross or directions) Currenf Property pwner(s) Mailing address Lending agency Day phone bar- iib to Day phone Mailing address Real Estate Agent e�'iyoy Dayphone 165-/93o Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site ,® Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On=site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health 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 the number of bedrooms and type of structure indicated herein. 1 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 Eagle River Engfn6@fulg SAfV106E Phone Address Eagle River, AK 99577 Engineer's Printed Name A.4gn Date �f (• 1D S 5. DSD SIGNATURE 1/ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: (Rev. 01102) Municipality of Anchorage • '� Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us i (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: dF�s7-_4rmr5 ..cue -8 3 Parcel ID: eS/ S'92-0%2 A. WELL DATA Well type 9ewAnc If A, B, or C provide PWSID # Well Log &N) Yl-=.5 Date completed /ss%aS Sanitary seal &N) y,jw Wires properly protected (T/N)ycs Total depth Gee • ft. Cased to iao ft. Casing height (above ground) �_in. j is 3 R / •• FROM WELL LOG AT INSPECTION' Date of test /,0y / znr' /;2 Aa ip ley Static water level 1 �e ft. Well production g.p.m:O•y_/ 0. 3' g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mi. Nitrate �mg.& Other bacteria O colonies/100 ml. Arsenic: mg./t. Date of sample: 12 Zo%y : Collected by: G N3'P cortiR72_.4er B. SEPTIC/1496 F6 TANK DATA Tank Type/Material TGB! Date installed 99 X091 /711— Tank size logo gal Number of Compartments Z Cleanouts (T/N) y.Fs Foundation cleanout SYN) -Y,9:5: ;Depression over tank (Y6) .uo High water alarm (Y1fq 4 rte' 4bate of pumping /7//3 /e 5/ Pumper Tz s It SbE 'Cer4MtTi(5- C. ABSORPTION FIELD DATA : Date installed Soil rating (g.p.d./ftp or ft2/bdrm) /fie System type Length Ae� ft. Width /9, ft. Gravel below pipe D. e� ft. Total depth __?_ ft. Eff. absorption area &re ft' Monitoring tube _ = Depression over field .ve Date of adequacy test iaGrw fT Result ass ail) Pg a 3 For _3 bedrooms Fluid depth in absorption field before test _.It in. Water addedj3Tbal. New depth in. Elapsed Time: ZP_/-rW Final fluid depth 73 in. Absorption rate >= ySD g.p.d. Any rejuvenation treatment (past 12 mo.) (Y6)& type) ws err If yes, give date Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _ in. "Pump Cycles tested Af wa er alarm level at E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/W+etatier+on lot Z/10 Absorption field on lot ioc.' Public sewer main t _7.1' Sewer /septic service line 7-P94— Meets alarm & circuit requirements? On adjacent lots tiao ' On adjacent lots t-,ere9' Public sewer manhole/cleanout lidD Holding tank f/aO ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Afe, ' Property line 3!0' Absorption field S' Water main V'o' Water service line )0 /o ' Surface water t/oc' Wells on adjacent lots 7'~' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line 3-5-, Building foundation .t 3 ' Water main " ,e ' Water Service line t /o ' Surface water Hero ' Driveway, parking/vehicle storage "",91 Curtain drain •t T-0' F. COMMENTS t Sr. DrTZ_ -rA.w APAP AFFt G. EN Wells on adjacent lots tiao ' Pwm l certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date T�0 S HAA Fee $ W Date of Payment Receipt Number �) (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number CE, L77 i41V?_ - Municipality of Anchorage Development Services Department Building Safety Division *A. On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 050012 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 3, Lot 10 of Tonjess subdivision, the well's productivity was determined to be 0.9 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. 82-59 TONJESS ESTATES LOT 10' BLOCK 3 51,126 S.F. ooc O 4 GAs.Re.. 4 GRAVEL PNRETE NE aWELL BUILDING 1 11=40' 111=40' TONY CIRCLE �0 10' unL ESMT. 112Y —0. X 30' ANCHOR ESWr. BUILDING DETAIL SCALE: 1 "-20' YAS -BUILT I HEREBY GEKnFY THAT I HAVE SURVLYED THE GASTAL01 LAND PROPERTY DEPICTED A80VE AND THAT NO .��\��,• ENCROACHMENTS EXIST EXCEPT AS INDICATED. OF 44 �� SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO ��;.•••••••...4, `I� JEFF A. GASTALDI. R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, Q� ••. " 4726 WEST BOTH AVENUE OR RESTRICTIONS WHICH DO NOT 4 IV 0 ANCHORAGE. ALASKA 99502 APPEAR ON THE RECORDED SUBDIVISION PLAT. •••• ••• PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR • A. Gastolel : •; GRID �� NW 1462 ��tG�2oo5 ESTABLISHING BOUNDARY OR FENCE LINES. • '�T •' 3� ANCHORAGE RECORDING DISTRICT. ALASKA @ap"0haalonat�aa��•• F.B. JOB N0. +1��r��! 04-75 TE103 NOTE: NO CORNERS SET THIS DATE. �. SEPTIC SYSTEM �ry ui • '.i �m Z.- 1 11=40' 111=40' TONY CIRCLE �0 10' unL ESMT. 112Y —0. X 30' ANCHOR ESWr. BUILDING DETAIL SCALE: 1 "-20' YAS -BUILT I HEREBY GEKnFY THAT I HAVE SURVLYED THE GASTAL01 LAND PROPERTY DEPICTED A80VE AND THAT NO .��\��,• ENCROACHMENTS EXIST EXCEPT AS INDICATED. OF 44 �� SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO ��;.•••••••...4, `I� JEFF A. GASTALDI. R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, Q� ••. " 4726 WEST BOTH AVENUE OR RESTRICTIONS WHICH DO NOT 4 IV 0 ANCHORAGE. ALASKA 99502 APPEAR ON THE RECORDED SUBDIVISION PLAT. •••• ••• PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR • A. Gastolel : •; GRID �� NW 1462 ��tG�2oo5 ESTABLISHING BOUNDARY OR FENCE LINES. • '�T •' 3� ANCHORAGE RECORDING DISTRICT. ALASKA @ap"0haalonat�aa��•• F.B. JOB N0. +1��r��! 04-75 TE103 NOTE: NO CORNERS SET THIS DATE. 1' 1 �sl�3y0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date %� -s7 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) "7— io �3ioGi� 3 -��'c �3 65s Location? (address or:directions) (b) , .Property Owner ,r�loSS'.�,7/!�y�'� Telephone: Home Business Nlailing=Address r,�•Y�k 6.7a 9� �` � / i %_19 (c)1. Lend'irig lnstittition MOL14 Oy &LOelephone "Mailing Address -' (d) Real Estate Compariy arid Agent Address %lelo011 L'� r G'- %idr 7-1VbR, he 9 T. "77 Telephone V7,0V (e) Mail the HAA to the following address: or: Check hereX if hold for pick up. List contact person and day phone number be] w. � l/ 2. TYPE OF RESIDENCE Single -Family Number of Bedrooms 3. WATER SUPPLY Individual Well`x Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsiteo Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (Rev 8/86) Front 13138 (99/8 Aaa) szo-ZL Z to Z abed .� Jom s,jaauIbua leuolssalo.id aql ul suolsslwo ao s.iona aol aiglsuodsaa lou sl abeaogouy to Alliedlolunw aql •ponssl sl aleoggiao a ajolaq elep azAleue,ao_suolloadsul lonpuoo lou op SHHQ to saaloidw3 -sluawa.imba.i alels pue leaapol uleljao Alslles of aap.ro ul suolln ilsul buipual clay; pue sawoy to sieseyo.ind of Aselanoo B se sly4 seOP SHHo aql •"sely;o alelS 9143 ui paaa4sl6aa aaaulbuo leuolssaload }uopuadopu ue Aq anoge g ydeAmd ui u9Al6 suolleluesaada.i aqj uodn Aluo, paseq saleoill ao lenoaddy Aluoylny glleaH sanss! (SHHQ) saolAjaS uewnH Pug ylieaH to luawliedap a6eaogouy to AlliedlolunVN eql N O unv3 ignoaddy, leuolllpuoO to swaa_L Ieuoil!PuoO. _ Panoiddeslo -- .. , , _; :; :Panoiddy Aq swooapaq J 0 panoaddy IVAOUddV SHH4 9 AV 1� o° 15ZZ � �� • �� ® ar 'alae AO 0 , em eg "a .ee. 6 eeseoe eo me seomm� V Coo Ap LA0 , w g- OZ-/ / alta =9'Y/ rir M' QP2 ssaaPPd auoydalal � wa!J to aweN uolloadsul slgl to alep aql uo loalla ul suolleln6aa pue 'seoueulp,io 'sopoo alelS pue ledlolunW lie glint aouelidwoo ul sl walsAs lesodslp aalemalsum ao/pue Alddns aalem ails-uo aql 'uolloadsul pue uolle61ls9nui Aw wojl pue sell} 96eaogouy to AlligdlolunW ayl woe; paulelgo uoilewaolul ayl uo paseq leyl AllaaA aaylanl I -ulajaq paleolpul a.inlonals to adAj pue swooapaq to aagwnu ayl aol alenbape pue leuoilounl'ales sl walsAs lesodslp aalemalsem ao/pue Alddns aalem ails-uo aql legl smogs ienoaddy Al!joglnH glleaH Slgl to u01le6lls9nui Aw legl Al!aaA I 'molaq unnogs alep uo!lep!IUA ayl to se pug olaaay paxille leas Aw Aq paippeo sy NOIlt/WUOdNI aNV v.Lva `HOUV3S 3lld 'S1S31'SNOI103dSNI JNIQIAOUd Wild JNIH33NIJN3 'S /-1-2 /Zac- JVDI i / ^ Z--2 A. WELL DATA MUN'' �WLITY OF ANCHORAGE (MOA) �1TY OF �P�if +,AUTHORITY APPROVAL (HAA) t1,UNtCtP �0-SE��`I HECKLIST - FEBRUARY 1984 �>\1V 1RONN' 264-4744 �tIU,J 2 01g8? Legal Description: �e i 10 ;2KI-0 e 3 s ji glg'f at ' Well Classification / If A, B, C, D.E.C. Approved (Y/N) sib - �-LS-bS Well Log Present ON) Date Com lilted ¢z- 7-Z9 Yield ^-7j 6 -PA/ Total Depth GQD� EA• Cased to �y - ioo' Depth of Grouting tilAl zsl- Static Water Level z - s7a•9' Pump Set At -e/ ' /-� 1 Casing Height Above Ground 9%Z - /�� Sanitary Seal on Casing��N) Electrical Wiring in ConduitCYN) Depression Around Wellhead (YON) Separation Distances from Well: To Septic/Holding Tank on Lot //6, 1 ; On Adjoining Lots foD /'' s To Nearest Edge of Absorption Field on Lot°b ; On Adjoining Lots To Nearest Public Sewer Line /o/A To Nearest Public Sewer J Cleanout/Manhole / To Nearest Sewer Service Line on Lot 5 Water Sample Collected by SCS �`� ; Date Water Sample Test Results> Comments 7- da-i-5-5'oey%. lkti5c . Cis '�,?Xx(PW '7,A9 -/&h -rr A40'7GA4Z," .%Af B. SEPTIC/HOLDING TANK DATA Date Installed Size Size %1-D No. of Compartments I?-- Standpipesom Air -tight Caps CY N) Foundation Cleanout��) / Depression over Tank (Y() Date Last Pumped i Pumping/Maintenance Contract on File (Y/N) ti ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well A!U To Building Foundation To Property Line --36 To Water Main/Service Line %a Course fd'D 171�_ Comments Page 1 of 2 72-026 (Rev 8/86) Front To Disposal Field 15—a 1 To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design 04-51 Length of Field --3r(I — Depth of Field 6A, / c� Gravel Bed Thickness a' "F Square Feet of Absorption Area �/ Standpipes Present& r Depression over Field (YI Date of Last Adequacy Test Results of Last Adequacy Test��`" Separation Distance from Absorption Fie IFd: To Water -Supply Well /04, To Property Line _ 9 ..3�' To Building Foundation To Existing or Abandoned System on Lot On Adjoining Lots To Water Main/Service Line /© To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course Alt To Driveway, Parking Area, or Vehicle Storage Area //® Comments D. LIFT STATION Siz7=lled nGaI lons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping s during Adequacy Test. Meets MOA I certify that I�e hec ed, ve ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed ° /V1 �- Date ll � �7 r ��®y �$ Company �f MOA No. ,-d �© g A4�� Receipt No.yC) � AV 1 ; ' Date of Payment /Z 02 U ` - a I Amount: $ / O dam_ Page 2 of 2 72-026 (Rev 8/86) Back 49 _ • sir.• �oo•000 sow%oe' soo•o•o�� _ �nino I K`Jo••oa aonew•n�o•eo � j LER C. REID, JR. : r E - 2251 '•d�,� t- (d) Lending Institution.NSA Telephone Address (e) Real Estate Company and Agent N/A Address Telephone (f) Mail the HAA to the following address: pickup by agplitant 2. TYPE GE RESIDENCE Single-Family:l Multi -Family ❑ Other Number of Bedrooms 3 3. MATER SUPPLY a Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11184) 5. ENGINEERING FIRM PROVIDING Er.SPECTIONS, TES'T'S, FILE SEARCH, DATA. .ND INFORMATION 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 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. Name of Firm Telephone Address EAGLE RIVER ENGINEERING SERVICES Date 1��6�.5" EAGLE RIVER, AK 99577 :0. BO 173294 694-5195 Grigineer's Seal b t 4 V• J The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84)