HomeMy WebLinkAboutRIVERVIEW ESTATES BLK 9 LT 6Onsite File Municipality of Anchorage t , t Development Services Department • - Building Safety Division ...... Onsite Water and Wastewater Program, 4700 S. Eragaw St. P.O. Box 190650 Anchorage, AK 99519.6650 P2geI of 1 www.ci.anchorage.ak.us (907) 343-7904 ... JJJ ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ij0 0 a L'q PID Number. 0570 — o I — 13 NameWastewater WA IA4c orne5 System: VNew ❑Upgrade © Parkvie& a ac .1� tS g ABSORPTION FIELD Phone: — Roo O Nuirter N Bedrcems: a Weep Trench t] Shallow Trench O Bed ❑ L%owA 0 other. SailRaRating`�ol So ToRre: Depth from oripnal ad LEGAL DESCRIPTION I. oC/ GPDFT Ft. }/ Block:/1 Lot 5 I P S �A1 `SIJ C Depth to pipe bollen frontorM,ira e� ♦ 5 Ft. Gravel depN berca9h pipr. - J S Ft. Township: Rance: Bect5m , FJ added above original grade: _1 _ 'T Gravd L 'A ` L !`, Ft. L'l— T 1. Well: New ❑ Upgrade Gravel widttr 'r 4 Nurrter or 4:es: Distance behveen Wes: Ft. FL GIe3s,GUGon (Private, q B. C): TECasirV Cased to B 7d Total absorption area O P e Maredat 10 PAJVA r1L 300 Ft. X � Fl Fe-45Ti�'I Driller. D stat:ewaterteed -7 Instill. DAIS Date Datetrularted:Q G� SVL)/V¢A/ p Ft. Yield: Pump Set at 7 / Ns5NAboveGna+d a- TANK • `- GPLt V k FL FL SEPARATION DISTANCES Of Septic []Holding ❑ S.T.E.P. ❑ Other, To Septic Absorption Lift Holding PuCBctpdvat M actrec /I e_ko e A/% capacty. a 0 From Tank Field Station Tank SenerLire pt • Gal. Well I OT ' i D I �5'I`'- Llaterial: ���� Nu erorCaryanments: .9 Surface Water 004- 6L4- LIFT STATION ` Sae: Ltanutacarer. Lot Line Gal. 1 , 'Pump on- levet at uep eM' level Wsh water slam at Foundation ' I In. Ft ht Pump Llake b Lt^ Vech:tal Irspections perrcrtned Curtain Drain Motile re WA Remarks: ,i J1J�TI)d JGN D�J11NG� BENCH MARK Lonbcn era Descpticrt l O✓1tL4 C01,,11:,,CT1onj F2om 6 FFa-,,.V. 1—C trirlywFdeTrV( Ae+4 L4.rGT N Assurree E' ,xn: G j(jJo':':FL 0M 11a, to yb, TC ALLiW ELKVATIaN DAjP OJT or TO1vXZ�2 'a�h All �:.:.4 S SE ,. River Lorp pond, No. 4 17034 Eagle Dates: tatEagie �—Ig-O��...�Y.1�A Yom, M,•, I t" lli..lf •.1. �.I.,.•) rl n Inspections performed by: r 2"d�—/jamI ,.. R03ERT C COWAN 42 y Development Services Department Approval o�•�y ce-aaol f J. Reviewed and approved by: PERMIT NO. SW020248 PAGE 2 OF 3 MunicI .t of Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 Tele hone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WpELL INSPECTION REPORT LEGAL. LOT 6, BLOCK 9, RIVERVIEW ESTATES P.I.D. NO. 050-801-13 LOT 7A SCALE: 1" = 30' Ell q! ROB//E��fiT GC�O♦WAN_,e` �Q NEW TRENCHES \ , \ 0 .G Clf� co FS (FLOW SPLITTER) C01 MT2 04 \ (n DBL1 & DBL2 0 \9S TH 2 TBM O„ ST2 ST1 1 02 B ALTERNATE\ SITES C-- FCO 5r NEW 1250 GALLON A 4�`''OVFn� O/.'I� SEPTIC TANK O GRAVEL DRIVEWAY \ SF 0 \ \ Qom SCALE: 1" = 30' Ell q! ROB//E��fiT GC�O♦WAN_,e` �Q PERMIT N0. SW020248 PAGE 3 OF 3 Municipalit of Anchora e DEPARTMENT OF HEALTH AND HURXN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 eAnchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 6, BLOCK 9, RIVERVIEW ESTATES P.I.D. NO. 050-801-1 ST 1 ST2 101.2 FINAL GRADE 2" INSULATION 96.7' NEW 1250 96.5' GALLON SEPTIC TANK C01=100.8' CO3=99.2' CO2=100.8' C04=100.1' INSULATION FINAL GRADE -/2" 42 C01=96.1' CO3=95.5' SR CO2=96.2'SR C04=95.5' MT1=90.7' //Jl MT2=90.1' A B N. T. S. FCO 9.5' *2.0IR�^� 41w ST1 ST2 21.0' 28.0 44.0 50.5 .,: i o `i / �Y:fit ; o FS 44.5' 53.5' C01 CO2 43.5 26.5 53.0' 33.5 NO WATER FOUND 84.1' B.O.H.35.D klv�ol* C COWANC04 03 55.0 490BERT CE f2w,,�' MT2 41.5' 40.5' 27.5 29.0'#'d ��,�CE *OFFSET FROM FOUNDATION Performed For. Legal Description: Depth Municipality of Anchorage%, w Development Services Department ,/ Bu lding Safety Division 'I :;' On -Site Water and Wastewater Program ,( 4700 South Bragaw SL , P.O. Box 196650 Anchorage, AK 995 19-6650 %P www d anchorave.ak.us y�t� (907) 313- M. �J Soils Log - Percolation Test r2 r 0'r V Dale Performed:_ COM-MEFITS V;A 61-1SCP.0LrlDY/ATER `r� ENCOU:RERED7 ,y 5 I. IF YES. AT OYFIAT DEPT) I? r O Depth to water After Monitoring? Dole: '7wdbS 'L --.. h......... j..w Weetr C. COWAN !�C CE•8801 f.Z• r V Flan F— 0 F"c�COl4TIC)I P.,ITEG--1y---Ir-. hn:teslrcti) T_ST PUN Gc—r? E=tl -- FT AND PERFORMED BY: PERFOR?.IED IN ACC RDANCE VATH ALL STATE AND MUMCI 0 RC POLED6:Ll_TER 62 FT CERTI=Y TI IAT THIS TECT Y/A Orl THIS DATE. DATE: G /S C .?— sir titrl /H r' 14 F"c�COl4TIC)I P.,ITEG--1y---Ir-. hn:teslrcti) T_ST PUN Gc—r? E=tl -- FT AND PERFORMED BY: PERFOR?.IED IN ACC RDANCE VATH ALL STATE AND MUMCI 0 RC POLED6:Ll_TER 62 FT CERTI=Y TI IAT THIS TECT Y/A Orl THIS DATE. DATE: G /S C .?— MAR -10-2003 09:35 S&S ENGINEERING 907 694 1211 P.01 Certifieb Drttting '.jog by DOC CO, dtv SULLIVAN WATER WELLS P.O. BOX 670272. CHUGIAK, ALASKA 89567 • TELEPHONE 699.2750 )WNER OF LAND: W 44.j"'*fe g ' 14o �. EGALDESCRIPTION: 'G.3 GAC d r 4sn.J S 1 xt&. q A o t (c. -ATE' I A 3 1 4 CJ �, ERMIT NUMBER: Q0 0 Date of Issue_ --, `-- :,X IDENTIFICATION NUMBER: ,'7_• well located at approved permit location? 41mrs J No letnod of Drilling: a rotary U cable tool •epth of well: 3�0 rasing Type$*�4 Wall Thickness -' Inches iameter Inches, depth '' feet net Type: ^}, x. z i using Stickup Above Ground: 01 - feet tatic Water Level: feet ecover Rate: I o qpm tethod of, Testing:�- fell Intake Opening Type: U open erd open hole j Screened; Start feet Stopped feet t Perforations Start feet Stopped feet ,rout 7ype: ��� Volume oc'dS )epth. from .-�� feet, to a feet Fell Disinfected Upon Completion? J No tethod of Disinfection: cl%'ka A("% 1-r JOA47 Comments 71 Id I Drilfer's lame is ,TTENTION: It is the responsibility of the property owner to submit a copy of the well log to tate proper authority. MunicipVy f Anchorage: Department of Heafth & Human Services and/or Department of. Environmental Conse nation. MatSu Borough: ,epartment of Environmental Conservation. CS RSA rl �. f i.. sc .J 070 �rq�Cit?� ee�ac.t. 6,44 (a 90 efrl _13AE-0coc.t 6 .* J 1w7l BAa Kz..) 1. 750 19 A,4 - F7 a GG iQ N 71 Id I Drilfer's lame is ,TTENTION: It is the responsibility of the property owner to submit a copy of the well log to tate proper authority. MunicipVy f Anchorage: Department of Heafth & Human Services and/or Department of. Environmental Conse nation. MatSu Borough: ,epartment of Environmental Conservation. IEAL111AUTIIOh11Y APMOVALS sEmnswmm MAM EXIENS1011S -SMn s WA1En OMPECTIO" ENOINEEhHX7911A�9 NWEPOMS wEMISPECTION A FLOW TEST SIZE PLANS nOADDESIGN SOIL TESI 1'EnCOIAT" FEST 31mmuVLA MECOW M *rPECT018 ONSITE wASTEWA1En USPOSALSYSTEIA M51011 S&SN nOBEnrC. COWAN, P..E. nOBEnTA. SFIAFEn. P.E. CML ENGIITEEnS (907) 694.2979 FAX (907) 694.1211 Date: Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorages Alaska 99519-6650 REFERENCE: Lo -v6, 81.,_k9, ✓G/✓/CIJ�S e The septic inspections for the referenced property were performed on_9—ICf -OP and Prior to submitting the On-site Wastewater Disposal System and/or Viell Inspection Report we are waiting for the 1 `on - , to be completed. L4r✓ey If we may be of further service please contact us. Sincerely, 7 Z ' C. Cowan, P.E. t 17034 NOnu 1 EAGLE nIVEn LOOP 4 SUITE 204 • EAGLE nIVER ALASKA 99577 5 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW020248 Legal Description: RIVERVIEW ESTATES BLK 9 LT 6 Design Engineer. 0003 S & S Engineering Owner Name: Wallace Homes Owner Address: not provided Anchorage , AK 55555-5555 v/!cl (E io.3 0 Date Issued: Jul 26, 2002 Expiration Date: Jul 26, 2003 Parcel ID: 050-801-13 Site Address: Lot Size: 49659 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1 BAAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. $/12/U2 SAF �rvG: /Q ✓tS �D VES.bN P'gr6p 8/-7/62 �TTigCy6O. Received By: Issued By: Date: 7 -- ;" o Date: 7-12 `- 0 2 Maitielp;lity of Atteltordgt • bevelophietit SeWlCes bepai-tmetit building Safely bivision On -Site Water and Wasle%kaler Program 4700 South gragaw Sl. P.O. box 196650 Anchorage,Ak 99519-6650 www.ci.anchotage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION l=oR A SINGLI= FAMILY DWELLING Parcel I.D. D 57D - '?Q Permit Number SW O a Property owner(s) \r) ke-k,- �AorA E<� Day phone Z4Z- 8 Zo b Mailing address (1) Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) L o—U c,r—k _9_ _ 9 NF.ui Legal description (Section, Township & flange) -� Lot Size Al ; In s% AcceslSq.Ft. . Number of Bedrooms o u rz THIS APPLICATION IS Poll: Sewer Only ❑ Well Only ❑ Sewer and Well 10 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Not Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information Is correct. I further certify that this application is being made for a Single Family bwelling and is In accordance with applicable Municipal Codes. 2 (Signature of property owner or authorized agent) Permit fees: bate of Payment: 7 �/ �o z_ Receipt Number: 0 'a ';L 7 17 (Rev. 12100) a ver ees. bate of payment: Receipt Number: S & S ENGINEERING 17034 Eagle River Loop road, Eagle River, Alaska 99577 ROBERT C. COWAN, P.E. 11 CMLENGINEERS ALMA (907)6942979 NEnIgineening FAX(907)694-1211 July 15, 2002 HEA APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK. 99519 L MMENSIONS REFERENCE: Lot 6, Block 9, Riverview Estates S/D SEWER&WATER INSPECTION It is requested that you issue a permit to install a well & septic system to serve the proposed four bedroom dwelling on the referenced property. ENGINEERINGSTUDIES A test hole was excavated and a percolation test was performed. The approximate location ANDREPORTS of the test hole is located on the attached site plan. At the time of excavation on 6/04/02 no water was found. After seven days of ground water monitoring the test hole was still found to be dry. WEUMSPECTION a FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent SITE PLANS properties. If you require additional information, please contact us. ROAD DESIGN Sincerely, SOIL TEST Robert C. Cowan, P.E. RCCrjhm PERCOLATION TEST Enclosure STRUCTURALR MECHANICAL INSPECTIONS CN SITE WASTEWATER DSPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP SURE 204 i EAGLE WER, ALASKA 99577 > + ICW oua � w U zcXa Nmz \ �'. 00 � F �ZZ �y'•gr aozo / j uoat z o Gyp / 0 w Z GFo / Si az tit <V)0ool oU -C Uiwra `� o a a'zmZ�-•az oN N O m<Z-C.�3 QAC w � �o =moa CL =� w c, a- m ✓� NNK SOC �/ rL I I �7oo3cw>*cc6t; / ~ eO� O LO t- E sib / /F— 0 J r:1 ' VC mos N>Fz / ZJd ? 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Z 1� m7-0 Ly/ p ego •o � V N = / � N > O r�i pp X 4NOW --] 0c A• d Z 'D NV' '� 00OM i m W _ Sm0'L NII 0 -3 II .- O --O D Q z Z c•s O C) 0 n O O O z OOO z0� _� °_7 / V) 0 c0 D m /0Z-S t .-3 m�'a -3 � 0 CZ m D r0 -1mrr- Q co m Cb Or >0CA r- 9p. a r ;r\z0 N o 00 CO C)�D: D I �p0 X n 00 � �< O rn N r Z m vi N Z c CT cz y m � ro ���// o>m �=N N 20 Z: �c+O�Oz�0 N O� �•y tJ O N 2.1 C) O m. p / As?�. o N C7 i� \\ 0>n :les y to dy> Z -�.nl zO zy �. z o�oo l` � Dazs i J��S �'�•+fir OcQ vG f• p zCA Ar n p "' •ice cl �' m it iC� N \ m 0j p Zii mac I z I �N -�-� OF q .qlkt �•...... N....... • `\ Municipality of Anchorage C2 NGINEER• E ` ip.I ;« z. Development Services Department :•: Building Safety Division , a„{ On -Site Water and Wastewater Program 4700 South Bragaw St.*.,.' t.•-� P.O. Box 196650 Anchorage. AK 99519-6650 rjo,�\ ROBERT C. COWAN www.cf.enchoraae.ak.us CE(907) 343.7904l�! Soils Log - Percolation Test Performed For: I M O SA-,I+V I rel r-- Dale Performed: Legal Description:_t7C.k . G ' QIy t.1t-Vie--..J CE 5T- S/ 7 7-/1 s Slooe Rile Plan Depth `'I 0"ATi (65 1- 3 4- 5- 6- 7 - 8. - 5- 6- 7- 8_ 9 'ell: 10- COMMENTS S� M WAS GROUND WATER ENCOUNTERED? . Net Time _A/0 S IF YES, AT WI IAT DEPTII? L o Depth to Water After Monitoring?////L-�" E Dale: Reading Dale Gross Time Net Time Depth to Water Nel Drop oA & D Lig )0&29G — 4-✓ P 7'4- z R J3 0A 13Fs 4-r ,1-$" 4 PERCOLATION RATE 4,( (mawlesWh) Ptn<eriULtUiAnntitn< �FT E& OUNOF t EN 1 M P1 AfID�*_FT Ar Z Sy iu O% /)AJI NC. it it9Y4— C CYCI...AIJA1j- 1­012h4t /Z4 C.6cS J PERFORMED BY: �1 G 14i)t Z;LV ���L� i CERTIFY TI IAT 71115 TESIT WAS PERFORMED IN ACCO DANCE WITH ALL STATE AND MUNICIPAL 15UIDELINES IN EFFECT ON THIS DATE. DATE: i / s- a 2- EtIGInECiZ1nG ROBERT C. COWAN, P.E. LV CIVILENGINEERS (907)894-2979 FAX(907)694-1211 HEUTHAUTHaaTY ON-SITE WASTEWATER DISPOSAL SYSTEM APPROVALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER& WATER MAN EXTENSIONS REFERENCE: Lot 6, Block 9, Riverview Estates S/D July 15, 2002 SEWER 6 WATER MPECTION GENERAL: 1. The scope of this project includes the installation of a 1300 HDPE gallon MNEERINGSTUDIES septic tank and a new trench to serve the proposed four bedroom residence ANOREPORTS located on the referencedro P PertY• 2. Construction shall be in accordance with the approved site plan and design WELLSJSPECTION drawings, Municipal permit with any special provisions or conditions, and all Q FLM TEST applicable State and Municipal Wastewater Disposal Regulations. ' 3. The contractor shall be responsible for obtaining any necessary underground SITE PLANE , utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROIODESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SOILTEST own systems must also receive prior approval from the Municipal Health Department. PERCOLATION SEPTIC TANK INSTALLATION: TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. STRUCTURAL& Construction shall include two 4" cleanouts for pumping access. MECRMICAI. INSPECTIONS 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER DISPCMSVSIEU DESIGN 17034 NORTH EAGLE RNER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 6, Block 9, Riverview Estates 31D July 15, 2002 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 6. A subsurface disposal field may not be located on a slope greater than 25 percent unless there is an approved exception documented. Page 3 Lot 6, Block g, Riverview Estates WD July 13, 2002 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pike Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 6, Block 9, Riverview Estates SID July 15, 2002 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER Ila - I In ILA 4t 1w f)w-. 44 P ■ - aw, M-4�t-x0i17 --3 [JUdi A ril .�Itu lffl oil 1c) p roll: j 5Q, DRIC-11-Fill 46MF11iiiyil I rtuF A(;) fill pi lo"I You yu j"N ItEVMF Oki 1, )i ' i . I p ........... A Pi 44" olU U.1 tiiuw or "jt6 U4 Rau vr� P .b A- Rd v t iw 1p 4boaD 06 1 '+k IF p mom" odrON6 -mom WWOC r : ..... oft. —.* 1P.ldp4mmum+F -W A .r. IN -.wa .. 4ilbOPM'*" •• .fes P4 Rri# � r a'' ■� AW + ■ i O** 0. ANDOMMOM" SNPb illi* ~ /4 moo i t 440 .fto, mow ■ i ■ t + IF p ct, Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program *A1 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1.D.05' 0 - 9 01 - 13 HAA # n �_R D 3 O dL Expiration Date: 1. GENERAL INFORMATION Complete legal description 1- 0 T (o 13L0 C - OC !? IV e& v r C c,✓ E S r d r j S Community Class Well ❑ Public Water System Location (site address or directions) NNN R /vt A /SARK Cr2 e- � [ 10 Current Property owner(s) W Ac0_R G f_ No M * S ' Day phone Mailing address Lending agency Mailing address Real Estate Agent 1 c9 30 6 POAKVIEw -rf_ tA4 c.r LavP 14rjrGr.,, Pjv#.f y9r�> Mailing Address Unless otherwise requested, HAA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone /rt� q�2r�o3 TYPE OF WASTEWATER DISPOSAL: Individual On-site B Individual Holding tank ❑ Community On-site ❑ 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 fcr 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 pub!!c 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. 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. S & S ENGINEERING G yH % Name of Firm 17034 U-96Ri~ Loop Road No. -zv4-- Phone Address Eagle River, Alaska 99577 Engineer's Printed Name I?c 06'fg r C. COWA,%/ Date $��SYo3 -`� `fid „-i'= f . �:.. � t... ..NF1 n ROCERT C. LOWAN / Q• S. DSD SIGNATURE 46; _� Approved for _ bedrooms. fit ......... `��� ` �c . Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �t( D`� Original Certificate Date: " a2. ✓r— �3 (Rev. 0113! Municipality of Anchorage .,.. ' Development Services Department Building Safely �Division s .. OnSfte Water & Wastewater Program. " «, 4700 South Bragaw St E P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo T- & 012C2c 9 k J241t vrt w ZStArijparceI ID: 0S'U - t0l -13 A. WELL DATA Well type &wc If A, B, or C provide PWS1D # — Well Log &N) YE S Date completed 7/11/01 Sanitary seal (9N) _Y1- f Wires property protected ®/N) 'If J ro 41. ft. i Q't Total depth 300 ft. Cased to a l ft Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test 713/42 Static water level 7s- ft. ft. Well production 1.75- g.p.m. Z g.p.m. WATER SAMPLE RESULTS: Coliform !! colonies/100 ml. Nitrate Other bacteria�_ colonies/100 ml. GI�sI_o� Arsenic: Data of sample �- Collected by:$ A S ENGINEERING 0034 Eagler Uip Road No. 204 B. SEP nCIHOLDING TANK DATA Eagle River, Alaska 99577 Tank Type/Material S E AT l c. S r& E i Date installed ? / 1'f / 0 Z Tank size ) 4ILS-0 gal. Number of Compartments a Cleanouts®/N) Yf S Foundation cleanout ®N) _Y_tj Depression over tank (Y(D Nu High water alarm (Y49 ^� U Date of pumping )V14 - 4- w Pumper -' C. ABSORPTION FIELD DATA Date installed 9111/0')- Soil rating g.p.d./ftz or ft2lbdrm)1_z System type T/u,-, c N d 1 Length a a3 ft. Width ft. Gravel below pipe S. S ft. Total depth 0 ft. Elf. absorption area s p 6 fe Monitoring tube YE f Depression over field At 0 Date of adequacy test A'/,4 - N y Results (Pass/Fail) For Y bedrooms Fluid depth in absorption field before test _ in ter added_ gal. New depth_ in. Elapsed Time: _ min. _ ,Find(iluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation t ent (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons 'Pump on' level at _ in. 'Pump ofr levi Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot i O H i Absorption field on lot )0/ Public sewer main N /.4 Sewer /septic service line a S f High water alarm level at Meets alarm 8 circuit requirements? On adjacent lots / 0 0 + On adjacent lots Public sewer manhole/cleanout A' / Holding tank T) / A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ) I Property line a r Absorption field g Water main N A Water service line ) 0 / Surface water > 0 0 Wells on adjacent lots 100 A in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 Building foundation )f Water main N A Water Service line )0 'f' Surface water J00 -- Driveway, parking/vehicie storage 410 f . Curtain drain Non/fd Wells on adjacent lots % 0 f F. COmwi4TS' G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ��••»� ••• -••• review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. t �.�ownrr�� c T�1 r'88U1 \> Engineer's Printed Name d 8 E ,4 C • tip c✓,9,v Y+�; ,;,� :,``�c,�! tt i ....... Date 6�0 3 !' = HAA Fee $ 3 S ' Waiver Fee $ Date of Payment 6 /;1 4/D-7 Date of Payment Receipt Number 0 T7 4 34 0 Receipt Number (Rev. 12/01) FROM : FteminV Surveying Services FHX NO. : 907-243-4890 Feb. 12 2003 07:i2PN F1 mI0 j N (A CJ N r r.�l 5- m $ c o ovv z o C (0 r c'� 9 Orn O F I N A C O' O. o o m O. <° ^ i ,�,. Q O � p �� aw d�.a moom3'n"'3 2 • y m �' m c .� -. m 0 mc0 go fl n N d N O- C O N w w CP O G p m O N O a n G m g�� VJ j' A c 3 c r 0-00 a 0 A Ql [n h� d0. O.N m w` Age iv 2K K O l Vi 10 lV •�� fD w m O n � m �� y, w Q W m 2L o �. mI0 j N (A CJ N r.�l V1 O W i � 2