No preview available
HomeMy WebLinkAboutTONJESS ESTATES BLK 3 LT 20Tonjess Estates Block 3 Lot 20 #051-532-06 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201176 PID Number: 051-532-06 Dwelling: H Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Al Upgrade Name SOELLERS ERIN & KATEY ABS%RPTION FIELD ❑T� renchOt❑ Wide Trench El Bed ❑Mound Site Address 25295 Homestead Rd Chugiak her Phone Number of Bedrooms 4 Soil Rating \ Total depth from original grade GPLZ/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original g?a a Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot TONJESS ESTATES 3 20 Fill added above original grade Ft. Grab1 length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distaa between lines Ft. SEPARATION DISTANCES Tol Septic AbsorptionI I Holding Lift Station Sewer Total absorption area Number of trenches Dist. between t ches From Tank I Field Tank Line FP Ft. Well I > 100'I NA NA NA TANK [ISeptic [MS.T.E.P. ElHolding ElOther Manufacturer Greer Capacity 1500 Gal. Surface Water > 100' NA NA NA Material Number of compartments Lot Line > 10'I NA I NA NA NA plastic 2 Foundation> 10' NA NA NA LIFT STATION Manufacturer Capacity Remarks Orenco pump 1500 Gal. Alarm location on house Electrical installed by Rising Sun Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield ARM Services Drainfield COIMT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspdect Sn 1r 8/20/2020 2� 8/21/2020 Location and description 3id 9/7/2026 41' rear door threshhold at point B ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp a4 Conditional Approval: Date .... j ✓- ... ... pug..ovm'end' (� Dale Septic System Approve t pP div Date PROF SS Note: this approval does not include well permit requirements. kr t!V voivu ion NEIGHBORING WELL IS > 100' FROM hj PROPERTY LINE 0 v NEIGHBORING SEPTIC IS > 10' FROM PROPERTY LINE EXISTING 1250 GAL SEPTIC TANK AND 500 GAL LIFT STATION WERE REMOVED. A NEW 1500 GAL STEP TANK WITH ORENCO PF2005 PUMP WAS PROVIDED. TANK IS 10' AWAY FROM FOUNDATION + EXISTING 60' x 60" x 30" t$; H EFFECTIVE DEPTH TRENC/C-0 (SIZED FOR 4 BR), 4" PERFORATED PIPE GRAVITY / D NING / MT NEIGHBORING SEPTIC IS > 10' FROM PROPERTY LINE VACANT LAND, NO * \ WELL OR SEPTIC 2 % SLOPE \ ti \ �o" \ `9 � ST1 FCO ST2Si$` ) ST1 \ <1% SLOPE My 4o/ SCOPE OF WORK 1. REMOVED EXISTING SEPTIC TANK AND LIFT STATION. 2. PLACED NEW 1,500 GALLON STEP TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH A MINIMUM 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. 0 Septic As Built Permit Drawing Prepared for ERIN AND KATEY SOELLERS •••�� OF 25295 Homestead Rd Chugiak, Alaska 99567 `�'•- �, � ,n �' TH TONJESS ESTATES BLOCK 3 LOT 20 AV ¢9, ............................ 0 OSP201176 0..........:�..........................� EKLUTNA ENGINEERING, LLC DATE: 9/24/2020 . CURTIS TOWNSEND: �. 00% No. c 11904 191 62 MOUNTAIN ROAD DRAWN: CLT ##&'Zy/ CHUGIAK, ALASKA 99567 SCALE: 1" = 40' •• •......... � :•� (907) 406-1058 ,,4�� PID: 051-532-06 SHEET 2 OF 3 6 U E.) `1. Y MARK A B STI 22'-4" 19'-5" ST2 19'-6" 2"-5" Septic As Built Permit Drawing Prepared for ERIN AND KATEY SOELLERS 25295 Homestead Rd Chugiak, Alaska 99567 TONJESS ESTATES BLOCK 3 LOT 20 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 406-1058 OSP201176 DATE: 9/18/2020 DRAWN: CLT SCALE: 1" = 10' PID: 051-532-06 SHEET 3 OF 3 BM IS DOOR THRESHOLD AT POINT B, ASSUMED ELEVATION 100'. oma_ 4g4� OF q4�S44 �`♦i Aff 49!H- or 9TH ■.....::... .......................:..... .. n 00i 0 ...................................... .M 1=;CURTIS TOINNSEND; A ff �j�i No. CE 11904 .V 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:tfwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201176 Work Type: SepticTank Upgrade Tax Code Number: 06153206000 Site Legal Address: TONJESS ESTATES BLK 3 LT 20 G:1462 Site Mailing Address: 25295 HOMESTEAD RD, Chugiak Owner: SOELLERS ERIN CORDELL & Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: Effective Date: Expiration Date: �o n� t. Q_. Dcpai•tment Lot Size in Sq Ft: Total Bedrooms: 6/22/2020 6122/2021 54618 ❑ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: r Date: 4 MUNICIPALITY OF AN HO.RAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section -`'� Fax: 907-343-7997 .i ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-532-06 Property owner(s) SOELLERS ERIN & KATEY Day phone Mailing address 20536 Williamsburg Drive Eagle River AK 99577 Site address 25295 Homestead Rd Chugiak Legal description (Sub'd., Block & Lot) TONJESS ESTATES BLK 3 LT 20 Legal description (Township, Range & Section) Lot Size 54,618 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Upgrade Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade 0 Renewal ❑ TYPE: OF DWELLING: Single Fa SF) Q (w o D Duplex (D) ❑ Multiple Dwellings ❑ (tSF and/or D) THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: 1 Distance: I certify that the above information is correct. I further certify that this is in -accordance with applicable Muni ci I Codes. J. (Signature of prope4 owner or authorized agent) Permit/Rush Fees: 2Z5 — 1%$•I5 Date of Payment: 41 ri-1=6 Receipt Number: (3C151o6D Permit No. QSP)L5I Waiver Fees - Date of Payment: Receipt Number: Waiver No. I I G:SDevelopment Services\Building Safety\On Site Water and WastevMefforrns\Client FormsTermit Application.doc COVID-19 IV% DISCOUNT APPLIED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201176, Rebecca Carroll, 06/22/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201176, Rebecca Carroll, 06/22/20 LOT 19 LOT 13 LOT 14 N6 5 ° 0 0 ' 0 0 " W 3 1 5 . 9 9 M E A S .N30° 30' 09"E 230.52 MEAS.N6 5 ° 0 0 ' 0 0 " W 3 1 5 . 2 4 RE C .N30° 39' 50"E 230.19 REC.BA S I S O F B E A R I N G S OHUOHUOHUT T S 4 8 ° 2 2 ' 2 4 " E 2 7 2 . 6 5 R E C . S 4 8 ° 2 2 ' 3 5 " E 2 7 4 . 0 7 C A L C . GRAVEL DRIVEWAY 1 0 ' D R A I N A G E E S M T . W S S S S S ; ;;;;;; ; ; ; ; ; ; ; ; ; ;;;℄ HOMESTEAD DRIVEEDGE OFPAVEMENT30.0 R.O.W .51.363.210 4 . 1 SEE DETAIL "A" DETAIL "A" SCALE: 1" = 25' 1 0 0 ' WELL R A D I U S S13° 18' 21"W 154.26 REC.LOT 21 CULVERT G ELot 20, Block 3 Tonjess Estates 54,618 Sq. Ft. +/- 25295 Homestead Drive 2 Story Wood Frame House With Attached 2 Car Garage 9.06 . 3 30.42 . 0 7.71 4 . 1 13.83.8 3.81 4 . 04.15 . 1 2.82.85 . 0 12.28 . 2 27.83 . 9 30.43 0 . 4 PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. May 19th, 2020. Legend: Scale 1" = 50' Gas Meter Electric Meter/Outside Power Deck Septic Telephone Pole Fence Overhead Utility Lot 20, Block 3 Tonjess Estates General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Erin Soellers 20-150 5/22/2020 82-59 1462 T W Water Well Tel. Pedestal [STA T E O F ALA S K A49 TH ROYEVRUSDNALLANOISSEFORP DERE T S IGER Pierre M. Stragier NO. LS-9812 05/23/2020 G E S Found 5/8" Rebar Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com October 7, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Tonjess Estates, Block 3, Lot 20 Septic Tank Replacement Inspection Report Ladies and Gentlemen: I am writing to document the findings for this lot. PES requested a permit to replace the septic tank serving this property on May 9, 2013 because settling was observed over the tank and during the last pump, gravel was removed from the tank.. Your department issued a permit to replace the tank on May 20, 2013 (OSP131088). The tank was exposed to be removed. An inspection was performed and the tank was found to be intact with no noticeable holes. We tested the integrity of the tank with a hammer and the tank was found to be structurally sound. The tank was backfilled to the surrounding grade. It was not replaced. If you have any questions or concerns, please contact me at 272-8218. Sincerely, • • • •i '1. a_ Steven R. Pannone +' 74 f •air i Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 On -Site Wastewater Disposal System Permit Permit Number: OSP131088 Tax Code Number: 05153206000 Work Type: Septic Permit Effective Dates: May 20, 2013 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 to May 20, 2014 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: TONJESS ESTATES Site Legal Address: TONJESS ESTATES BLK 3 LT 20 G:1462 Owner/Address: GONZALES MARIANO JR & LINDA G PO BOX 671816 CHUGIAK AK 995671816 Site Mailing Address: 25295 HOMESTEAD RD, Chugiak Lot Size in Sq Ft: 54618 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: cmmeD MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-532-06 Property owner(s) Marino & Linda Gonzales Mailing address P.O. Box 671816, Chugiak, AK 99567 Day phone Site address 25295 Homestead Road Legal description (Sub'd., Block & Lot) Tonjess Estates, Block 3, Lot 20 Legal description (Township, Range & Section) Lot Size 54,618 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: ❑X I certify that the above information is correct. !further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Permit App_:- 51t3I13 ci-vj c (o) a -L{ 4 cSSf 131ofg Waiver Fees: Date of Payment: Receipt Number: Waiver No. Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@apaneneak.com May 9, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Tonjess Estates, Block 3, Lot 20 Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1250 gallon septic tank be issued for this lot. The proposed systems will serve an existing four-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a four-bedroom house and is operating adequately for three bedrooms. The existing 1250 gallon septic tank is perforated, leaking, and collapsing. The existing tank will be abandoned per code. This lot and the surrounding developed lots are served by private wells. There are no wells within 100' of this system. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 20 slopes from southeast to northwest at approximately 5% in the area of the tank replacement, with a slope to the northwest. The proposed installation will be located in the central portion of the lot next to the existing septic tank and absorption system. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AI( 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, 40410P • • • gal al •�`� ;s Steven R. Pannone g dAaar ♦�1,•e.V Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 / / /~-/' LOT NO WELLS OR SEPTICS ' / <` ��� U \ �n ��\ ' -~-''1250gSEPTIC TANK (P)'�`/ / W/ DCO ''' '. '' / / ' � � / ,� , .',500g UFT ',, -_ ��50g3EPOCTANK (E) / / / ' TO REMAIN ABANDON PER OODE \,' ^ ' / '/ ��� -/ /` -- \ ' ~// /' // S�P0C&R� /7\': / � � 4BKH0US[ // (E) ` Nit WELL 8.5 4,4 � / � / / � NOTES: TANK REPLACE PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 PLAN TONJESS ESTATES, BLOCK 3, LOT 20 MARINO & LINDA GONZALES 25295 HOMESTEAD ROAD CHUG/AK, AK 99567 5/9/13 , teven R. Pannope II PERMIT NO. Sheet 1 OF 1 MUNICIPALITY OF ANCHORAGE ( ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL. ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME i PHONE 'Don Cz0.pbc11 1748 1974I MAI LI NG ADD ESS oBex Zz84 Calle fel) er Art 9977.7 LEGAL DESCRIPTION Lzei B 3 LOCATION Vy t2 FNW D fi Z 024 0 -4 LLD -Zw Qs 0 O W 0 ad„ a. W N J J Ton, 235 &laic% 5 Z T15cJ (Z A) Sin NO.OF B- EDROOMS 4 go~te,zzci tribe wee ICO rf DISTANCE T0: Absorpnonrarea Manufacturer AA nit T a Liqh capacity. in gallons l E: Inside length IF HOMEMADE: DISTANCE TO: Well Dwelling Manufacturer DISTANCE TO: Well 10114-10 Foundation Length of eac r No. of linesz. h ,line Total length of lines Top of tile to finish,rade Maternal) beneath tillef, Length Width Type of crib Ni pi Crib diameter Well Depth Building foundation DISTANCE TO: Class DISTANCE TO: OTHER Depth Crib depth Building foundation Driller Sewer line PIPE MATERIA GS 7 3c:131— SOIL TEST RATING so st Pr ) J rc»tor INSTALLER J Q C L erson REMARKS I't of trv+portcc4 rr, erlas(iI) plated °J t. -IDP off'-kreY+r}• . LT+ Sh4+on rtra>L cared btu .140 . y ••;�yrr :ori '40g . NO.3082S : • Q% !, jiffs •.a — a•a,,,` riikce APPROVED Dwelling r D Materiy , _ I Width if�. Material Nearest lot lin, 4-10 Trench width 7i0 inches 'inches lj NEW ❑ UPGRADE PERMIT t85 0447 No..pf compartments Liquid depth PERMIT NO. Liquid capacity in gallons PEHMIT�ID. 0467 Distance bbetYyger1lines Total effective abs orption area O6 PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line Septic tank PERMIT NO. Absorption weals) �7jfr MM CZ —�1 FI.bM;r : rouses DATE LEGAL S -r Ft/ -az 3 72-013 (Rev. 3178) /fonit'rr .4» Gof to 8Loc/c 3 .t K014 -E, 77,4; ass 65 s .rt 7 -fib .52 iipNfc) tJ PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: r1 r"1 MUNI I CI FAL. I TY 'OF ' ANCI-IORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION '825 L STREET, ANCHORAGE, AK 99501 264-4720 ON—SITE SEWER Sc WELL FERMI T CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS; 850467 08/01/85 DON CAMPBELL P 0 BOX 2284 EAGLE RIVER, AK. 99577 268-5741 SUBDIVISION: TONJESS ESTATES SECTION: 2 TOWNSHIP: 15N RANGE: 1W 1.25A (SO.FT. OR ACRES) 4 2-; aZta, fAver LOT: 20 BLOCK: 3 Listed below are the options available to t systema Choose the option that best fits T R E N C H DEPTH TO PIPE BOTTOM (FT.) 4.0 GRAVEL DEPTH (FT.) 4.0 • TOTAL DEPTH (FT.) • 8.0 GRAVEL WIDTH (FT.) 2.5 GRAVEL LENGTH (FT.) 75.0 GRAVEL VOLUME (CU.YDS.) 31.3 TANK SIZE (GALS) 1,250.0 ** SOIL RATING (SQ.FT./BR) 150 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS you in designing your site. your septic SED 4.0 0.5 4.5 22.0 41.0 33.5 1,250.0 150 ** 11? DRAIN 4.0 3.0 7.0 5.0 70.0 45.4 1,250.0 150 ** I certify that: 1. I am familiar with forth by the Manic 2. I will install the and in compliance 3. I_will•adhere to a distances from any sewerage system on I understand that any enlargement wi 4. the'requirements for on-site sewers and wells as set ipality or Anchorage (MOA) and the State of Alaska. system in accordance with all MOA codes and regulations, with the design criteria of this permit. 11 MOA and State of Alaska requirements for the set back existing well, wastewater disposal system or public this or any adjacent dr nearby lot. this permit is valid for a maximum of 4 bedrooms and 11 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-BUILTS WILL NOT BE AP!'OVEd WITHOUT AN'ELECTRICAL INSPECTION REPORT; AND•(3) THE ELECTRICAL WO MUST MUSTT- 41.5 E BY,AJ&ICENSED ELECTRICIAN. SIGNED APPLICANT: ISSUED BY ON CAMPBELL DATE: 67/ rs DATE: 5,41/b--- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST 14 I� anon II'�•t••" 4 -0.04� NO. 1732t •,V/ g9"t brie 27.1966 0/4v44 Cret, .44_ PERFORMED FOC IV/ art/ di. DATE PERFORM 1- 2- 3- 4- 5- 6- 7- a- 9- 10 - 11- 12- 13- 14 - 15- 16- 17- 18- 19- 20 - • LEGAL DESCRIPTION: ej 483 DEPTH /OA jt.S$ L:Sownship, Range, Section: sj SZ /.?s'0 it /ed 7% SLOPE SITE PLAN / 0-7 o rja,h/cs /'3 Bre 5-r%fts)4i jradtz f/'We/ it) sat, coarse Sethi C,0_ /SD 5.4 5nrt/ (izrei rgct fo ra,k) tedvf f WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth W Water Alter Monitoring? Reading Date PERCOLATION RATE Dalt 0- Gros, Time S L 0 PR,ap. Ilse) 16 30' tea!/ &,f E nf. Net Time Depth to Water (minutes/inch; PERC HOLE DIAMETER T N Net Drop 'l "EST RUABETWEEN FT AND FT L COMMENTS act f$e n t,te, r/L'LI rat,v4Ti Y .4“ 44k% cf rc Jt. J2''' ine,..$6.) U sy , ..ti /fl s,4, n'af 4Ce Ari orae, ,o PERFORMED eva,is1( era C 1 "� a CERTI Y////Tjjjjjj������������////AT THI_Vale,. ES l P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:Jv f 7 //'( 72-008 (Rev. 4/85) -57 • • i LOCATION OF WELL (Please compiele Other la, Ib or Ic.) • Ie. 1/. Borough Subdivision Let Block tb. elrs. Section N. Anch 1fonjess .2o 3 -.at—of—of —, 1c. I DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS S Addr.is end Arse 01 Well Lotttlon 2. WELL LOG M 'starlet Typo Feat Belo. Surface Top Bottom Stir-lctip 0 7 Gravel 2 14 Brown bedrock 14 95 Grey bedrock 9S 130 Black. bedrock 130 165 Bedrock greenstone 165 235 MINMAIrrlyStter44 C"" RONMENIAL ISO 6 ligan Id. WATER WELL CONTRACTORS CERTIFICATION: S 'IeIER WELL RECORD STATE CF ALASKA DEPARTMENT OF NATURAL PESDURES Division of Geoleglcot 6 Gec:I)s:col Surveys Drilling Permit N.. A.0 L. No. iu.nahip NO Rong• EG Mr;s.a• BO' WO 3. OWNER OF WELL: Ns. Don Campbell Address: r rt laic s•!. 4. WELL DEPTH: (1hae1) 235 n. S. DATE CF COMaLETICN L-23.-.Ei_ 6. 0 Cable tool Mira cry F0 Or:rc• Cita 7.USE:i] 001”111.6P•t'a SMMI Q 'rf MO Irrigation G Ictarge 0 Limon: 0 Tool Wan Cher; B. CASINO: 0 Thresds1 •:e.e diam.�ln, to_20., 11. C•pn ••.M'1 itt /1• Blom. In. Ib f1. 0ac•t 1rang ft. 0. FINISH OF WELL: Typs: Clasen Slot/Mo•N She: La cgrt: Set be nee f1 14e ft B000111ing Stow Fero 10, STATIC WATER LEVEL: f1. / CI Abort or O 6.:.. lead aarfa:a Eeuipm•nt nee: Dots 11 PUMPING LEVEL Wee I•N atrtaoe boa TIELO ft. otter M, ae•aW g.o... __ ft. after era. papal 1 r .- 12.GROUTING Well 0 0 Tae 0 Re Material: O Nkat Caw, 0 Orson 13, PUMP: (If aceiloble) HP Length of Drop Pipe ft sem :ey IC •l• 0 Subs.. O dot O owning.. 0 Oren te.REMARKS: IS. Water Tam Production of 21 GPM Tela well .as drilled ender my Jurisdiction and Inb r•porl Ie True to Inc bat of my kno.lcdg• rind 1.11e1; _Magnuson Drilling_ AA 5385 Contract Lionise Numar R.gleler.d Business Name • F Adrian: P,Q ]sjp504 F. 1P iver Ak. 99577 r/i(.�/i/'ln �tq n444544.- DOH: July 25. 1985 A Iscd Rep n444544.- Signed : Form 02•WWR (11/41) Copy Distribution: WHITE- State DOGS, PINK•Drlll•r, CANARr• C•stem•r 0c ION IOI EOM MUMCIPAUTY OF ANCHORAGE Development Services Department =f Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-532-06 Certificate of On -Site Systems Approval Expiration Date: Z -Z� ZO Z O 1. GENERAL INFORMATION Complete legal description TONJESS ESTATES BILK 3 LT 20 Location (site address) 25295 Homestead Rd Chugiak - - - -- ---SOELLERS ERIN & KATEY --- Current property_ownes(s) Day phone Mailing address- - - 20536 Williamsburg Drive Eagle River AK 99577 Real estate agent 2. TYPE OF DWELLING: rx-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private.Well 0 Private Septic F Water. Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 b CoU - �� Waiver Fee $ Date of Payment Date of Payment Receipt Number j �% �q� Receipt Number COSA# oscoo 1501 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Phone 907.406.1058 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date �` r` ( V 6. DSD SIGNATURE )_6 System #1 Approved for .--[— bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms look •..• • .h.............. •!r` . ....'Curti; i_�1. Date 51d� 9FGi� No. C. Ca �tl�,� PROFESSWJAIL�. bedrooms, with the following stipulations: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other COSA Checklist Legal Description: TONJESS ESTATES BLK 3 LT 20 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA X Well log is filed with Onsite (or attached) Date drilled 1985 Total depth 235 ft Cased to 20 ft ❑■ Sanitary seal is functioning correctly ❑� Wires are properly protected Casing height (above ground) ' 12 in. Date of flow test for COSA 6'112020 Static water level at beginning of test 30 ft. Comments B. TANK DATA Age of tank(s) 'f 1 years Tank type/material STEP p18StIC Measured operating fluid level in septic tank Al Standpipes/foundation cleanout per record drawing Date of pumping newly installed Aug 2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 1986 A ALL standpipes present per record drawing Total measured depth from grade 12.8 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 051-532-06 Structure served by this system _ Well production at time of test 3.2 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑■ N FO -1 Coliform bacteria is Negative Nitrate 0.337 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Curtis Townsend Date of Sample 8119r2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station ": 1 years Lift station material plastic Comments: newly installed Aug 2020 Adequacy test date 51112020 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 23 in Water added 600 gal New depth 30 in Elapsed time 1440 min X Code -required soil cover over field Final fluid depth 23 in F-1 System presoaked Absorption rate ' 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: FIELD IS GRAVITY DRAINING THROUGH 4" PERFORATED PIPE, GROUND ELEVATION AT MT IS HIGHER THAN AT CLEANOUT COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Q Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft M Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25'M/ Yes if No ft Absorption Field on Lot > 100' R� Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Yes Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Yes if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' �✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' El Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet •• �i .l V 11 .]�i:Y'�O+s Via•... Frontier Surveys, LLC Project No: 20-448 Ordered By: Curtis Townsend Scale 1" = 50' y LOT 14 Date: 9/9/2020 Plat: 82-59 Grid: 1462 r ti$ c o � LOT 19 ' DETAIL O = h SCALE: 1•=25' co Lot 20, Block 3 1' .0 X3.8 0 q3a LOT 13 'Yq \ 110 Lot 20, Block 3 Tonjess Estates 54,618 Sq. Ft. 25295 Homestead Drive °off 2 Story Wood Frame House o With Attached 2 Car Garage S. \ \ 3o.0 I SEE DETAIL A' \ ROW / M GRAVEL . DRIVEWAY ' 1 I Nss. Nss, so•oo• e-9`p�S•oo �' 37599 l OF6 3TSZ �� �9i''�NGS FC LOT 21 y Electric Meter/Outside Power cO, Telephone Pole ft Found 5/8" Rebar Gas Meter ® Deck — ` Fence 15; Septic I I Water Well --c— OverheadUtility L.T� Tel. Pedestal `Wl i General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footpdnL 4. All dimensions to property lines are plus/minus 0.1 IL QqE OF q�''y _it F�rrtI�•1M•StfaBier ..• �(,, •� eNO. LS -9812 �• �'�T •.• 09/16/2070 •:+ 1� F� . • .••�oyJ '+{I1 PROFESSIONAL SEAL 0 25 50 100 Scale in Feet This survey complies with the ASKS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. As -Built Survey of. Lot 20, Block 3 Tonjess Estates I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on September 9th, 2020. Frontier Surveys, LLC 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 907.460.1686 - info@frontiersurveys.com www.frontiersurveys.com Parcel I.D. 051-532-06 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Expiration Date: /- 1. — 1. GENERAL INFORMATION Complete legal description TOnJeS ,Block 3, Lot 20 Location (site address) 25295 Homestead Road Current Property owner(s) Mariano & Linda Gonzales Day phone PO Box 671816 Mailing address 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 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank 0 Community Class Well ❑ Community 0 Public Water System 0 Public Sewer 0 WaiverNariance request fqr: ` + Distance: �L ! ate, Received by: , i` COSA to be released to the enginee6 unless otherwise requested by the engineer. Date: COSA Fee $ '7 q. Waiver Fee $ Date of Payment 01, (IN Date of Payment Receipt Number !)tn/ta4`7e eo/�/ q, 6 Receipt Number COSA# OSt�J/`i 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. Name of Firm Pannone Engineering Services LLCPhone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for 14 bedrooms By: System #2 Approved for bedrooms Disapproved Conditional approval for Date 5/2/13 4.*Ss \N.+ r P4. of t%fielk ` •./irgda TH�`U. sitre /s ••CE -614 ,-•/i ,ki\\\ bedrooms, with the following stipulations: ,1t'( OFfurf�(7(( ON SITF �^ WATER AND WASTEWATER grz PROCRAM Original Certificate Date: / (0 -9-1 3 ThenicipA orage 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 X Other COSA blue sheet 5 c If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist fro pi 5t s talcs Legal Description: S, Block 3, Lot 20 051-532-06 Parcel ID: A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 7/23/85 Sanitary seal (Y/N) Total depth 235 ft. Cased to 20 ft. Date of test Static water level Well production 2 5 g.p.m. 0.4 g.p.m. WATER SAMPLE RESULTS: 1 lits/t3 9/)-0/13 Coliform f' e? . colonies/100 mL Nitrate os I mg/L {� Arsenic G^• �- . -163 ug/L Date of sample: 5 Collected by: 1 FROM WELL LOG 7/23/85 UNK ft. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 4/30/13 129 ft. B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P./Steel Date installed 1/6/86 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Date of pumping i / t S Depression over tank (Y/N) High water alarm (Y/N) Y PumperZf1 5 aLvv.(,> 1 i C. ABSORPTION FIELD DATA Date installed 1/6/86Soil rating (g.p.d./ft2 orft2/bdrm) 150 SF/BR System type Deep Trench ft. Width 2.5 ft. Gravel below pipe 5 600 ft2 Length 2 @ 30 Total depth 13.6 ft Eff. absorption area Date of adequacy test 4/30/13 Monitoring tube Y Results (Pass/Fail) Pass For 4 bedrooms ft. Depression over field N Fluid depth in absorption field before test 30 in. Water added 605 gal. New depth 35 in. Elapsed Time: 130 min. Final fluid depth 30 >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) No If yes, give date in. Absorption rate D. LIFT STATION Date installed 1/6/86 "Pump on" level at 43 in. Datum Bottom of Tank Size in gallons 250 "Pump off' level at 41 in. Cycles tested 3 E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ Manhole/Access (Y/N) Y High water alarm level at 45 in. Meets alarm & circuit requirements? Yes On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ 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+ ABSORPTION FIELD ON LOT TO: Property line 10+ Water Service line 10+ Curtain drain 50+ F. COMMENTS Building foundation 10+ Surface water 100+ Wells on adjacent lots 100+ Water main 10+ Driveway, parking/vehicle storage 10+ G. ENGINEER'S CERTIFICATION I certify that t 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 Steven R. Pannone Date 5/31/13 COSA brown sheet 10-10-12.doc AO' 21:194skli 0 qg LH- e\ *9 ka •. .+.. . M.nini CE— 49 ? „j 1` rr Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131494 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 20 of Tonjess Estates subdivision, the well's productivity was determined to be 0.4 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.42 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 Certificate of On - Site Systems Approval. Municipality of Anchorage Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131494 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 20 of Tonjess Estates subdivision. This inspection revealed a nitrate concentration of 8.59 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ASBUILT 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SEWARD & ASSOCIATES LAND SURVEYING 694-082q SCALE: >.S© DATE. 7 6 57/16,45..? GRID: FS: /.%9-78 DRAWN: Gait t . OF AIZ 4t i %)� Lam! n f t ; 4JtGIf•[/ri '6S/S3 MUNICIPALITY OF ANCHORAGE L' ; ; ••• •'4 DEPARTMENT OF HEALTH & HUMAN SERVICES W X DO-'ti:•E/� DIVISION OF ENVIRONMENTAL SERVICES /4[� n '7 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL tr,(` �rD OF ON-SITE SEWER AND WATER FACILITY cG /' 264-4744 1- 2'1.- 8e? Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot• block, subdivision. section, township. range) 01.–,7e,S 1 L -or 20 J 1 Location (address or directions) ktncs (b) Property Owner t=••• U. f G . Telephone: Home Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent/1-447 — 17/x2NI Address \b(cdz' , �-r> *-z. i - i Telephone tC1 (e) Mail the HAA to the following address: or. Check hereif hold for pick up. List contact person and day phone number below. 5 & 5 ENGINEERING 17034 Eagle RNer Loop Road No.204 Eagle River. Alaska 99577 2. TYPE OF RESIDENCE Single -Family. Number of Bedrooms 3. WATER SUPPLY Individual Well Community 0 Public 0 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 0 Community 0 Holding Tank 0 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 72-07515Iry 8 861 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND 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 $ & $ ENGINEERING 17034 Eagle River Loop Road No.204 ragfw Diver, Aller, 99577 Address Date Telephone I, 10r-- 4'9-oa r t JG 1 Y "R 01 (L.4, Q10C:or SJ9_vnE. 17Jr-S - care= MUNICIPALITY OF ANCHORAGE (MOA) MUNIOPAUTY OF ANS AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 ENy1RONMENTAL PROTECTION 264-4744 Legal Dlscription: A. WELL DATA Well Classification Well Log Present CAN) Total Depth Static Water Level FE83 1988 RECEIVED -Leo f5► -1! 3 err7 1 la P\Jt DJ,b.-t, If A, B, C. D.EC. Approved (Y/N) • Date Completed - 2.3 - 85 Yield Y 2of Cased to -7,a I M Casing Height Above Ground 30 Electrical Wiring in Condult6Y N) Separation Distances from Well: To Septic/Helding.Tank on Lot To Nearest Edge of Absorption Field on Lot t o I I To Nearest Public Sewer Line ' J ' To Nearest Public Sewer CleanouVManhole/�'a d To Nearest Sewer Service Line on Lot •� Water Sample Collected by h.; - - 41 rartia •x" ; Date \ Water Sample Test Results Sot tin -.1! - 17P ��• » N YT''r&, Comments Pc.,4 Nom. ft -o..3 'Ttnr b1Z 1-7-13-456 eske,,J;cc, -Tye, Lot -a_ T& �S7aDJ� nriz•ox 1 11 C -1t r-1. *(. St's t,•4-rb ,P-17.�J pc. &E -LL... t—i 'to -12S t� 1L.Lib. B. SEPTIC/HOLDING TANK DATA Depth of Grouting Pump Set At Sanitary Seal on Casing CDN) Depression Around Wellhead,9N) 111G-,Pri On Adjoining Lots On Adjoining Lots Date Installed 1 - - 0(0 Size / 1-5-o Standpipes ON) y Air -tight Caps(l N) Depression over Tank ((WNP r� Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) PA Temporary Holding Tank Permit (Y/N) No. of Compartments Foundation Cleanout (V N) Y Date Last Pumped ' � n ;for Separation Distances from Septic/ Ivld;ny Tank: . f-�- To Water -Supply Well 1 an:. To Building Foundation To Property Line 1 d 14 z To Water Main/Service Line 1 o -{•- Course (Z]o 14 Comments. 00 1 o.. 6 t i_. -1-7-1- MI- /kj t--brir-n lay /6-49.9-0 Vii -1..- Onr, 3 -4--e% TRS C-fSr4 coo t.- ' rJ'-tPr%t f b To Disposal Field. e;,,ll ,•2A• r: •^•-• To Stream, Pond; L°akC, br'fviajor Drainage a�A Page 1 of 2 72-026 IRev 8.1861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed • Width of Field YTutrin,...:M ISt> / tz)4� Type of System ()Sigh' tT'�' *---11 1 — to — 81.9 : Square Feet of Absorption Area Depression over Field (Y/a Results of Last Adequacy Test t Length of Field 1 , Gravel L,cc,* Depth of• Bed Thickness—• r -, -.7 . it � V I Standpipes Presentd37N) Date of Last Adequacy'Test ' 1-2A3 —S6 4t>--ns�� Separation Distance from Absorption Field: Id1/ To Water -Supply Well To Building Foundation Lot ' ' , Ph• To Water Main/Service Line n 1t - To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION : % "1 , Date Installed' " Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for - Electrical Codes tPN) Comments . To Property Line 1 01 4 To Existing or Abandoned System on o -I— A Q . On Adjoining Lots To Cutbank (if present) 1 0o I -4- Sb-F 1-to-3to . two 250 Dimensions ta• ' •f , t%_ .>r :Manhole/Access®N) - "Pump or Level at 1 Go�+f`L Vent CON) Pumping Cycles during Adequacy Test. Meets MOA •• Check Permitted Bedroom Rating Against HAA Request •• I certify that 1 have checked, verified, or conformed to all MOA and Sigr $ 5-ENOINEERING Date 2-'2 -S Cor1a9Af Eagle River Loop Road No. 204,AOA No. Eagle River, Alaska 99577 Receipt No. loCO 1 — CaCbi Date of Payment 7 "— 3 Amount: $ / 70 00 HAA guidelines in effect on the date of this inspection. t3 07 -obi Page 2of2 72-0261Rev 84361 Berk 4 r G3 r . tjw. frTh ,isVi .414414 Sear" - .. •lwi A. Shafer ; It n CHEMICAL & GEOLOGICAL LABORA7I9RIES OF ALASKA, INC. 5633 8 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID 1192-0040440 Cl lent POI : VERBAL Req is Client 9:p1 ID: LOT 20 BLL 3 TONJESS Sample Rec'd : JAN 29 88 Ordered By : R.J.S. Send Repots To: S 6 S ENGINEERING R SCHAEFER 17034 EAGLE RIVER LOOP RD., 1204 EAGLE RIVER, AI. 99577 Special COLLECTED 1-28-88 BY RJS Instruct: Chemlab Ref 1: 8972 Lab awl 10: 1 Parameter Tested NITRATE -N ANALYSIS REPORT BY SAMPLE York Order No.. : 4986 Client Account : SNSENGP Date Report Printed: FEB 2 88 9 14:11 Released By Reports Address 12 • Matrix: Yater Allowable Result/Onits Method Limits 0.46 mg/1 EPA 353.2 10 Sample PRESERVED VITN ICE. Remarks: ROUTINE SAMPLE. ANALYSIS COMPLETED: 2-1-88 LABORATORY SUPERVISOR: STEPHEN C. EDE .JS•��� 1 Tests Perfoned 1 See Special Instructions Above ND None Detected *4 See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT -Greater Than MUNICIPALITY OF ANCHORAGE ! DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 46.-r - /9 1. GENERAL INFORMATION (a) Legal Descriptiori lot, block, subdivision, section, township, range) L2°83 4915 ESA S2, j /S)/ 2/w/ S/r) Location (address or directions) Mid go es -re -4p FZ o A -D (b) ApplicantName2)0a C41P13CLL Telephone: Home Business Z6irSYr7/ Applicant Address RG•Box 77Z tif gay k. Q/✓6v/ Act 479572 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder; Buyer 0 ; Other 0 (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent N"4 Address Telephone (1) Mail the HAA to the following address: $f rCannp/e:// w//7 A/cog ("fit 2. TYPE OF RESIDENCE Single -Family Multi-Fami y 0 Other Number of Bedrooms 3. WATER SUPPLY Individual We iZ Community 0 Public 0 • 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 0 Community 0 Holding Tank 0 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 72-05 (11-01) n n I. 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND 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 fifes 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 dateQ oft hisinspection.t aX c 'f' fo✓ St rile -roof /I el 4<-4 /GF// (-sf 4. gridtd 74-71a a/ flame of Firm ',Peres e— ✓'S ret Telephone 3y6 —Z.0 -0 -lb 7(0 S✓Cit y ate re? A.r 7 r re4 Z� / a, Address Date 6ampinl :vDHEPAaaPRtOVAL Approved for erew" • Approved aaa bedrooms byt 47.17""".`"a "/'"'"'a Date Disapproved Conditional Terms of Conditional Approval n tett Essen. -/4-•-•••4 -to /Yjr+aa- �•'o.A. ett.�K • CI 0%son. S e - CAUTION 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) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: LZ 0 3t) -rises)) R A. WELL DATA MONIOPAU1Y Of ANCHORAGE pugwimt of PRR01MCTMON MAR 03 Well Classification �YI va' If A, B, C, DEC. Approved (Y/N) Well Log Present (Y/N) Y Date Completed i `r CY � !q 7S—Yield Total Depth 2-35r Cased to Z3 Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Z Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) / Separation Distances from Well: To Septic/Holding Tank on Lot /OO To Nearest Edge of Absorption Field on Lot4 10 To Nearest Public Sewer Line N CleanouVManhole Ai el- ate 4114.c -h eci • Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed J -'h Size Standpipes (Y/N) y Air -tight Caps (Y/N) 'Depression Over Tank (Y/N) 12 -So 5, Depression Around Wellhead (Y/N) N On Adjoining Lots + O 0 On Adjoining Lots 4- /0 O To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date + /0 O i b21,)Rg6 No. of Compartments 2--- Pumping/Maintenance Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) N 4 Separation Distances from Septic/Holding Tank: To Water -Supply Well 'f X00 4-7-0 To Property Line To Water Main/Service Line Course Comments 10 6e Page 1 of 2 72-026(11194) 1V / Foundation Cleanout (Y/N) Altai Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) i At di To Building Foundation /o To Disposal Field 7—(91 To Stream, Pond, Lake, or Major Drainage •100 ,p�h//e,nc.9 / has occoar✓ej o, vet repra-led a -44r jrovOd 7`haws. eo,// 4 r� fl C. ABSORPTION FIELD DATA SoilsRatingin Absorption Strata Date lrstalled •J 1 n 24 .. 30/. Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well -1-10/ 4 10 150 hap To Building Foundation Lot AJ ic To Water Main/Service Line -J- 2-5-1 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design 600 9, S� Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line T✓e r1 G it" f /O Ak To Existing or Abandoned System on ; On Adjoining Lots "f"' 3 O To Cutbank (if present) 4/00' ar D. LIFT STATION Date Installed Ja O g Dimensions 7 14-. 1 Size in Gallons "Pump On" Level at High Water Alarm Level at SOO "L SO 5- 30O a Tested for Electrical Codes (Y/N) n/- Comments �7 d.&,/5 shown Manhole/Access (Y/N) "Pump Off' Level at /OOj. Vent (Y/N) Y Pumping Cycles during Adequacy Test. Meets MOA X4.5/ //ems %/ Nor79/ S% -v" ,c/Ec7-7c� eeweof .e /ecitric a/ Gwl/,"r1c-767 par 1 � E/c64 Design ma •• Check Permitted Bedroom Rating Against HAA Request " I certify that hhaaye checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 0%/0240A"— Signed Date rilMb Zg/ /984 Company l%onsA Ejs3Zr • MOA No. sr 86 -0 2.3 Receipt No. V131 (1,9 Date of Payment 3 -3-7C cr Amount: $ L 5'- Page2of2 72-026 01i84) •Y 1 - .> • ESC ¶1-zD __... i .. _...._ _ ... .. .. _ _ 4 I�- it .i.: �`lt..5. �. •� _'}1 I�C.pcG ; i • ti o a��r *ars �U e 3 a act: eiA"i 99O 4 j Oar awg aro 9,4 `$ 7 'i:: .135 it! 0445-i D34 ro ^a z4: r,4