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HomeMy WebLinkAboutVALLI VUE ESTATES #2 BLK 6 LT 2Valli Vue Estates #2 Block 6 Lot 2 #015-123-16 Municipality of Anchorage Development Services Department - „ Building Safety Division h: On-Site Water 8 Wastewater Program, 4700 South Bragaw, St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Pogo 1 of 2 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW020082 PID Number. 015-123-16 Name: Wastewater System: ❑ New ■ Upgrade BRIAN MEISSNER Address: 6611 ROUNDTREE DRIVE • ANCHORAGE, AK 99516 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 561-5543 3 O Deep TrenchO Shattow Trench O Bed D Mound O SW Ra m9, iotl ppt hom rqw LEGAL DESCRIPTION cpDysa. R In. Block: Lot: Subdivision: Depth b 01" bolt" Ram "�rol ora1.: I a b.nwtn P": 6 2 VALLI VUE EST. #2 R Township: Range: Section: M oaa•e oba'a WVrAl grad.• GM.l Iwgaa — — — R R Gravel wldN: Number of 1"r Da ba~ W WELL: ❑ New ❑ Upgrade Ct.wD6.abon pnwt.. A.B.0 : Tata Ce..d To: Toll oD Don ena pip. • n. R SO. R MY.r; Dat• DN : Stella Waw' Lwel: HdaNr: A+ HOME/SERVICES Dal• tMaIW: R n.Ia: pump Set u: C"ng H*WA Above Grouts: TANK Cu R R SEPARATION DISTANCES ■septic 0Holding OS.T.E.P. bather To Septic Absorption Ull Holding uDlkyPrlwl• N'"da`t' . ANCHORAGE TANK WpaaRY N golbnc 1250 From Tank Rete Station Tank sewer lkw Nalwt� Humor of aemparN+ w Well 200'+ - - - 25'+ STEEL 2 Surface Water 100'+ — — — — LIFT STATION Sus In oawrrc Nanaaclurn: Lot Line 5'+ — — — — en le..l at: amp off al• Nqn waw aorm a1: Foundation 5'+ — — — — p,vwp yy. ENcbkal kupeadone pMomr.d by Curtain Droin NONE KNOWN —OLD SEPTIC TANK WAS ABANDONED BENCH MARK Remarks: lacalon arrd pwcHpuw: PER THE UPC. TOP OF GARAGE SLAB —DOUBLE CLEANOUTS INSTALLED BEFORE Awum.d o..abom 100.00 TANK. VERBAL APPROVAL PER DAN ROTH. R ENGINEE WS SEA *' 4 y°..DO Inspections performed by: AWWC, INC. Dates: 1st 4/29/2002 2nd 4/30/2002 e r y A. Gerness: OOjf E 7953 :O Development Services Departm t pproval 4 ewe" o Reviewed and approved by: Date:��- °°° pro reseion o O °04000 (R.. 11/01) ' NUMBER: SW020082 AS -BUILT D SW0 J�v / Q� Ate: n OJT/ � vi DRNEWAY RAWING PARCEL ID NUMBER: 015-123-16 APPROXIMATE LOCATION OF KEY BOX ISDNG CRIB E DRAINFIELD NEW 1250 GALLON SEPTIC TANK IFli GRADE - 95.99-95.92 EW 1250 CALL SEPTIC TANK DATE: 5/1/2002 DRAWN BY: �.Y'.-_.___. ...i` _.. _. . .. ...,.... ALASKA «'ATE. & �VASTEMIATI:R SCALE: C.J.G. CONSULTANTS, 6001 OFSAPP POAO. SUITE 78 - ANI*9514 INC. 1 - 3G, 07)337*u9 - FAX (007)338-1766 PREPARED FOR: PHONE NUMBER: PAGE NUMBER BRIAN MEISSNER (907) 561-5543 2 OF 2 LEGAL DESCRIPTION: LOT 2. BLOCK 6; VALLI VUE ESTATES SUBDIVISION #2 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC TANK UPGRADE TNM AT 93.05 if BUND AT 92.]7 5Tl9�B9l�'/� e y A...... less,:... 7953 Rd DBL2 —'J \ DBL7 \ \ '0 \ kN>e_ \ A �f� \ TOP OF B 9AET \ DBLI 25.98 66.31 DBL2 26.74 66.52 \ \ ST1 27.79 66.63 \ ST2 36.01 68.07 \ AT ME DBL3 37.53 68.15 DBL4 38.40 68.12 RAWING PARCEL ID NUMBER: 015-123-16 APPROXIMATE LOCATION OF KEY BOX ISDNG CRIB E DRAINFIELD NEW 1250 GALLON SEPTIC TANK IFli GRADE - 95.99-95.92 EW 1250 CALL SEPTIC TANK DATE: 5/1/2002 DRAWN BY: �.Y'.-_.___. ...i` _.. _. . .. ...,.... ALASKA «'ATE. & �VASTEMIATI:R SCALE: C.J.G. CONSULTANTS, 6001 OFSAPP POAO. SUITE 78 - ANI*9514 INC. 1 - 3G, 07)337*u9 - FAX (007)338-1766 PREPARED FOR: PHONE NUMBER: PAGE NUMBER BRIAN MEISSNER (907) 561-5543 2 OF 2 LEGAL DESCRIPTION: LOT 2. BLOCK 6; VALLI VUE ESTATES SUBDIVISION #2 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC TANK UPGRADE TNM AT 93.05 if BUND AT 92.]7 5Tl9�B9l�'/� e y A...... less,:... 7953 Rd MUNICIPALITY OF ANCHORAGE 60110Z. Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Apr 29, 2002 Expiration Date: Apr 29, 2003 Permit Number: SW020082 Parcel ID: 015-123-16 Legal Description: VALLI VUE ESTATES #2 BLK 6 LT 2 Design Engineer: 0041 AK Water & Wastewater Consultarr Site Address: 006611 ROUND TREE DR Owner Name: Brian Meissner Lot Size: 20557 SO. FT. Owner Address: 6611 ROUND TREE DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99516-6816 This permit is for the construction of: ❑ Disposal Field Ej Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify 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. Received By: Y Date: 14/Znlz Issued By: �. Date: 4129/OZ Parcel I.D. 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 (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 015-123-16 Permit Number 5W020082. Property owner(s) BRIAN MEISSNER Day phone 561-5543 Mailing address (1) 6611 ROUND TREE DRIVE • ANCHORAGE. AK Mailing address (2) Zip Code 99516 Legal description (Lot, Block & Sub'd.) LOT 2. BLOCK 6: VALLI VUE ESTATES SUBDIVISION #2 Legal description (Section, Township & Range) N/A Lot Size 20SS i Acres/ q.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot 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 Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. (Signature of property owner or authorized ogcnt) 00 Permit Fees: �i00• Waiver Fees: Date of Payment: "51— e -2y-0 Date of Payment: Receipt Number. 0/c4 9"C� P tai Receipt Number. ALASKA April 23, 2002 WATER & WASTEWATER CONSULTANTS, INC. - Municipality of Anchorage Development Service Department Building Safety Division On -Site Water R Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Tank Upgrade for Lot 2, Block 6, Valli Vue Estates Subdivision #2 To whom it may concern: The existing 3 bedroom house is currently served by a community water system and a private septic system. The septic system contains a 1000 gallon septic tank and is in a collapsed state and needs to be upgraded. We are proposing that the existing 1000 gallon septic tank be replace with a 1250 gallon septic tank. 1. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 2. TOPOGRAPHY: There are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your nssistnnce. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing„ and a 3 page constriction specification letter which are all part of the design package for this septic system. 6901 Dcbarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: akwwc.cotn LOT 16, BLOCK S, NOTE: ALL PROPERTIES SHOWN SERVEDI VAW VUE EST. S/D 12; BY A COMMUNITY CLASS W WATER IY/ SYSTEM AND PRIVATE SEPTIC SYSTEM j 1 I rT vim 1 I �� I I Cad ki s3 / LAT 34, BLOCK G. PROPOSED SEPTIC TANK UPGRADE,/ VALII VUE EST. S/0 12: (SEE DESIGN PACE 2 OF 2 �/ LOT 1, BLOCK 6, ' .• ♦ / / / VALU VUE EST. S/D 12: EXISTING 3 BEDROOM / Me / / '� �• , HOUSE ;J % /' / /% VAW BLOCK VUE EST. /D 12: EXISTING SEPTIC SYSTEM `♦ % / j y" `♦ `V LOT 32, BLOCK 6, i yob GARAGE > < VAW VUE EST. S/D 12; rte/ /�♦ \♦ v LOT 26. BLOCK 6, LOT 3, BLOCK 6, Cl \`♦ \\♦ VAW VUE EST. S/0 12; VAw VUE EST. S/0 12: I `♦. ♦`\ C/�„ 1 I LOT 31, BLOCK S. `♦ ' / ryALl,l VUE EST. S/D /2;if LOT 27. BLOCK S. / VAW WE EST. S/D 12;; / = LOT 4, BLOCK 6. I 1 VAW VUE EST. S/D 12; DATE: `L 4/23/2002 DRAWN BY: ALASKA R'ATI;R & WASTE NVATER Ste: C.a.G. CONSULTANTS, INC. 1" c 100 6001 DFRARR ROAD. SUITE ?A • ANCNORAGE. AK 9050L • PNONF (007)317fig9 • FAX (907)158-5746 PREPARED FOR PHONE NUMBER: PAGE NUMBER: BRIAN MEISSNER 561-5543 1 OF 2 LEGAL DESCRIPTION: LOT 2, BLOCK 6, VALLI VUE ESTATES SUBDIVISION #2 TYPE OF WORK. SITE PLAN FOR PROPOSED SEPTIC TANK UPGRADE \ \ — wsunu IUL TANK TO BE 'LL \ \ FILLED Wfl \ \ SUSEPDI /O• \ COMPACTS \ '1 \ \ \ \ \ NOTE: CONTRACTOR SHALL HAVE THE \ 4ATER UNE PROFESSIONALLY LOCATED \ PRIOR TO CONSTRUCTION. AI.ASK1 WATER & WASTENNIATER CONSULTANTS, INC. 6001 DFAARR ROAD. SUITE 7A • ANCHORAGF. AK OOSOI. • FNONF (007)337-079 • FAX (007)33A -37L6 PREPARED FOR: PHONE NUMBER: BRIAN MEISSNER (907) 561-5543 LEGAL DESCRIPTION: LOT 2, BLOCK 6; VALLI VUE ESTATES SUBDIVISION #; TYPE OF WORK: DESIGN OF PROPOSED SEPTIC TANK UPGRADE INSTALL FOUNDATION CLEANOUT (FCO) (APPROXIMATE LOCATION OF FOUNDATION CLEANOUT INSIDE GARAGE DATE 4/23/2002 DRAWN BY: C.J.G. i GRE 'ER ANCHORAGE AREA BOA'" IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SE AGE DISPOSAL SYSTEM !� NAME MY1 40YnStyOnqMAILING ADDRESS VOA -0-2f 4- -2 D,�77 / I PHONE'S/�/ LOCATION LEGAL DESCRIPTION /_ V, 2 8& ,d; SEPTIC TANK: FROM WELL MANUFACTURER5fC( -/k -Zee I MATERIAL 5k COMPARTMENTS -21 INSIDE LENGTH —INSIDE WIDTH ✓�7g� QUID DEPTH LIQUID CAPACITY 10459U GALLONS. SEEPAGE PIT: Q y/ NUMBER OF PITS DIAMETER OR WIDTH LENGTH_? DEPTH LINING MATER IALQ&21?2C✓'ee CRIB SIZE: DIAMETER DEPTHL DISTANCE FROM: WELL c/ TOTAL BUILDING FOUNDATION � ' NEAREST LOT LINE 20'. ABSOR TIONCTIVE AREA (WALL AREA) p SQ. FT. ADDITIONAL ABSORPTION WELL: (f07mmunify wahV4 TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE—,SEWER LINE—,TANK—,SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES INSTALLED BY: �Y5�✓r'l NGI 0 q1/ C05;i;IP0 PIPE MATERIAL: S t6 LOT SLOPE: , REMARKS: Form No. EQ -031 DIAGRAM OF SYSTEM I r DATE r� GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT NAME OF APPLICANT -JG MAILING PERMIT NO PHONE INSTALLATION LOCATION �(J LEGAL DESCRIPTION Z 46" VL If u INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD , OTHER TYPE AND SIZE OF FACILITY TO BE r hA FINANCED THROUGH 'To / Y. TO BE INSTALLED BY SOIL TEST RESULTS �� !V x^"y� V ` -,v oap )K &III TES COMPLETION DATE ANTICIPATED THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE O 4'a TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT _z_ 0 DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT�' DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANI( DRAIN FIELD WATER MAIN TO SEPTIC TANK SEEPAGE AREA SIZE /2/\/- w � I_y 4 TYPE SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD —. SEPTIC TANK, SEEPAGE PIT '" DRAIN FIELD, TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGARDING INSTALLATION. ;;G.A .A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED YST M IS IN ACCORDANCE WITH SAID CODE. DATE - �� APPLICANT'S SIGNATURE r 1 M, r;EATER ANCHORAGE AREA. BOROI,, . , DEPARTMENT OF ENVIRONNENTAL QUALITY CASE # 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For 4�,%-c- Lu, Date Performed Legal Descrir• oti n: Lot_ -_Block. _Subdivision j)a/L'r z� This Form Reports Soils Log jlPercolation Test_ _ Oenth Feet 1 — 2 — Soil Characteristics 10 _ rU i Was Ground Water Encountered? %Pb If Yes, At what Depth? Reading Date Gross Time Net Time Depth to H2O I Net Drop; � I i—' Percolation Rate Minute Proposed Installation: Seenaae Pit Drain Field Depth of Inlet Depth To Bottom Of Pit Or Trench COMMENTS: c�����/�// ��7�� — _ Test Performed By Data Certified By: Date: 'artment of Environmental QualiV"W--� eater and Sewer Questionnaire Date , --4 - .ra , Time 3� /O/Y Subdivision ��t�%`� ppUC Block ( Lot Owner's Name: Ce it "q Mailing Address: ��';. �%,<<% • �- �x1,;+/� �' G-" .L�y' / Questions: 1. How many house?3.r 2. How many bedrooms were in the house at the time of purchase? 2 ���i?' c✓ l t 3. Were the basemennt, bedroom walls "roughed in" at the time of purchase? % 4,t'4d 6.`fi`:t-1' 4. Was the basement bathroom plumbing "roughed in" at the time of purchase? , 5. Did the realtor or builder inform you that you would have to enlarge the existing sewer system if you finishedthe bamen bedroom (s)? 0,:) X14-W,4W44 , �s � 6. If on a public water supply, do you always have an adequate supply of water? 7. Is�t�lle pressure allwayadeq ate? � �l�ti t0 // L�.�.- �..,S.i•a n...� <rt,bi.,tFC.t..,, U�/> A 8. Who was the buil'&er? �.%�Rl �l�S'����'�-�; C i��� 9. Who was the home purchased from? OTHER COMMENTS: MUNI CPAUTY OF ANCHORAGE Development Services Department � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 015-123-16 1. GENERAL INFORMATION Expiration Date: Complete legal description Valli Vue Estates #2 B6 L2 Location (site address) 6611 Round Tree Dr. Current property owner(s) Bill Pearson Mailing address Real estate agent Mackie Derrick 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic E Water Storage ❑ Holding Tank ❑ Community Well El 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 $ 912-50 CO V I D Date of Payment q—% 2'Z ©ZD Receipt Number 0 (9 3 Z) O COSA # OSC ZO I L -I23 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I' verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MCA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Date OIF 6. DSD SIGNATURE r3 System #1 Approved for ' .eve • •' 15annorie y pp bedrooms Sievers r CE 3149 System #2 Approved for bedrooms Disapproved ,N'�l°����� Conditional approval for bedrooms, with the following stipulations: T IL N11 t1k l Original Certificate Date:" (ZU The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet I,. Legal Description: Valli Vue Est #2 B6 L2 Parcel ID: 015-123-16 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test gpm Date diffled —Water storage tanR vo ume galions Total depth ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate rng/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments Community Well B. TANK DATA Age of tank(s) 18 years Tank type/material SW'C,s!W Measured operating fluid level in septic tank 48" ❑® Standpipes/foundation cleanout per record drawing Date of pumping 'f /7/dLow D. ABSORPTION FIELD DATA Seepage Pit Which system tested (date installed) 72511073 it ALL standpipes present per record drawing Total measured depth from grade 8.8 ft (max) Measured depth to pipe invert from grade 2 ft (min) ❑ N/A — pressurized field FE -1 Monitor tubes go to bottom of effective. If not, state depth into effective ON Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Drain Field approximately 50% used COSA Checklist yellow sheet Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7!3012020 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 40 in Water added 451 gal New depth 50 in Elapsed time 1440 min Final fluid depth 40 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) No If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) 0✓ Yes Septic Tank/Lift Station on Lot > 100' ft Surface Water > 100' Community Sewer Manhole/Cleanout > 100' Property Line > 5'✓0 Q✓ Yes if No ft jam✓ Yes if No ft Neighboring Tank > 100' ✓0 Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' E✓ Yes if No ft Holding Tank > 100' 0✓ Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' ✓❑ Yes if No Neighboring Absorption Fields > 100' If septic tank is under driveway comment below Animal Containment > 50' 14 Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft ✓� 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' ®✓ Yes if No ft Property Line > 5'✓0 Yes Yes if No ft Wells on Adjacent Lots: ✓M Absorption Field > 5' ✓0 Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ✓0 Yes if No ft Community Wells > 200' 0 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' ✓M Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Q 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 I 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 Steven R Pon one CE 8140 ��v �O �o Q CD lb ,,;i.;, -:''i:',' :r:c- '• ,' ', t0� `Gf'' G ram` / .yt ,...,,.._'�., - ...-,,::� by av yr 00 �� ' `<lsp� alt .' �,_ 't "K / 0 \ Line of deck over garage, Lot 2 / onc. ret. wall �/ hf `"Wood fence r / L overed storage 70 g \ a`� / / 03�� Lot 32 Lot 3 Gr / / N � 49th ' •;9 ! ` s 0011, � I F/ . , 0�^ •. Fred Walatka; ff s► � -�% • 3255 - S. `o SCALE: V= 30' O ..ySN a swot+-+- EASEMENTS OF RECORD, OTHER THM I THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. F1373- -5 5,6 BE 5623 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property; LOT 2, BLOCK 6, VALLI VUE ESTATES, UNIT No. 2 Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. 0viy 10 -20-73 Dated at Anchorage, Alaska this _ 12th day of Q9,gQmber ,2014,. FRED WALATKA & ASSOCIATES (907-248-1866) Engineers and Surveyors "0 Lot 0101 4571 71 ��v �O �o Q CD lb ,,;i.;, -:''i:',' :r:c- '• ,' ', t0� `Gf'' G ram` / .yt ,...,,.._'�., - ...-,,::� by av yr 00 �� ' `<lsp� alt .' �,_ 't "K / 0 \ Line of deck over garage, Lot 2 / onc. ret. wall �/ hf `"Wood fence r / L overed storage 70 g \ a`� / / 03�� Lot 32 Lot 3 Gr / / N � 49th ' •;9 ! ` s 0011, � I F/ . , 0�^ •. Fred Walatka; ff s► � -�% • 3255 - S. `o SCALE: V= 30' O ..ySN a swot+-+- EASEMENTS OF RECORD, OTHER THM I THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. F1373- -5 5,6 BE 5623 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property; LOT 2, BLOCK 6, VALLI VUE ESTATES, UNIT No. 2 Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. 0viy 10 -20-73 Dated at Anchorage, Alaska this _ 12th day of Q9,gQmber ,2014,. FRED WALATKA & ASSOCIATES (907-248-1866) Engineers and Surveyors Parcel I.D. 015-123-16 Municipality of Anchorage =,Ff x au r4 On -Site Water and Wastewater Program (907) 343-7904 1 f,r Certificate of On -Site Systems Approval Expiration Date: / d, - f - / (U 1. GENERAL INFORMATION Complete legal description Valli Vue Est. #2, Block 6, Lot 2 Location (site address) 6611 Round Tree Dr. Current Property owner(s) cT12 ssi e e E,,:c_ We W r'✓ e Day phone Mailing address 6611 Round Tree Dr. Anchorage, AK 99507 Real Estate Agent 2. TYPE OF DWELLING: Fx1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 171 Individual Water Storage ❑ Holding Tank ❑ Community Class A Well E Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance COSA to be released to the engineer, unless otherwise requested by the engineer COSA Fee $' a!S 1-00 Waiver Fee $ - Date of Payment f+" A k Date of Payment Receipt Number 40P * 6 b6 35-67' Receipt Number COSA # 05 C 15-/ 03.0 Waiver # )�,o 113 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition., ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R -Pannone 8. DSD SIGNATURE System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Date 12/2/2014 Conditional approval for bedrooms, with the following stipulations: If[flRli� By: (�(� . �� Original Certificate Date: Th i ity Anch Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r ., .. If more than 1 septic system is on the lot: COSA Checklist # I of Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Valli Vue Est. #2, Block 6, Lot 2 A. WELL DATA Well type Class 'A' Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE RF: Coliform Coto If A, B, or C provide PWSID # 210605 Sanitary seal (Y/N) Cased to ft. FROM WELL LOG 00 mL Nitrate ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA 9.p -m. mg/L Parcel ID: 015-123-16 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Collected by: ft. 9 - p.m - Tank Type/Material Septic/Steel Date installed 4/30/2004 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N �7 �) Date of pumping I $' l A-6 A i �-I Pumper _t (``I c •e, e :�' e J • r z_-17, C. ABSORPTION FIELD DATA Date installed 9/25/1973 Length 12 ft. Soil rating (g.p.d./ft2 or ft2/bdrm) 85 SF/BR System type Crib Width 12 ft. Gravel below Dioe 6 ft. Total depth 8 ft. Eff. absorption area 288 ftz Monitoring tube Y Depression over field N Date of adequacy test 12/1/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 51 in. Water added 471 gal. New depth 58 in. Elapsed Time: 180 min. Final fluid depth 51 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in mp off' level at in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjace Absorption field on lot On adjacent lots Public sewer main Sewer /septic areas Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTICIHOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through Feld 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 12/2/2014 COSA brown sheet -1 0-10-1 2.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ �q'n-111 ven )2. Quinone CE -8149 .Og in. `?O \N, Line of deck over 700 \ \ Lot e \ FdsP'i \ \ elf \ Y 70 Lot 3 00 / 5623 Lot 1 tis2o u'�S2ry� 779 y OA ` d? C? �c 2 / .0 / garage -,V. 2 one. ret. wall / may `Wood fence overed storage M1aC / ^Q) N, Lot 32 Aw 0 * 49th ,% if 7` .. Wclatka ow 3255 - S ••� s SCALE: 1"= 30' 1O .. • �,�� EASEMENTS OF RECORD, OTHER THAI %'k THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. F13 73- 5 P Sb BE Recec- f 12-M-1414/ AS -BUILT NO CORNERS SET THIS DATE I hereby certify that 1 have performed a Mortgagee's inspection of the following described property: LOT 2. BLOCK 6. VALLI VUE ESTATES, UNIT No. 2 Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are within the property lines and do not overiap or encroach on the property lying adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Ov/y 10-20-73 Dated at Anchorage, Alaska this 12th day of December ,2014 - FRED WALATKA & ASSOCIATES (907-248-1666) Engineers and Surveyors Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-123 !f-16 COSA # n���' 7- Expiration Date: ?— -2, 3 ` ID % 1. GENERAL INFORMATION Complete legal description Lot 2 Block 6 Valli Vue Estates #2 Location (site address) 6611 Round Tree Drive, Anchorage. AK ggc16 Current Property owner(S) Meissner Family Trust Day phone Mailing address 6611 Round Tree Drive, Anchorage. AK 89516 Lending agency Day phone Mailing address Real Estate Agent Teresa Bell Day phone 240-2148 Mailing Address Unless otherwise requested, COSA 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 A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 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 Finn Pannone Engineering Services. LLC Phone 272-8218 Address P.O. Box 202984. Anchorage. AK nano Engineer's Printed Name Steven R. Pannone. P.E. Date 7/i8/o8 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 7',2 3 — 0sf (Rev 11A6 Municipality of Anchorage • i'r Development Services Department Building Safety Division ` -- On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: lot 2 Block 6 Valli Vue Estates #2 Parcel ID: ova -121-26 A- WELL DATA Well type If A, B, or C provide PWSID #o� i��iJ-� Well Log (Y/N) Date Total depth Date of test Static water level Sanitary seal (YM) _ Wires property protected (YM) _ Cased toft Casing height (above ground) in. ELL/LOl9 AT INSPECTION Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL Arsenic: _ mgA B. SEPTIC/HOLDING TANK DATA Nitrate mg/L Date of sample: Other bacteria _ ft. g.p.m. —colonies/100 mL Collected by: Tank Type/Material Anchorage Tank Steel Date installed 41'tof2oo2 Tank size 1750 gal. Number of Compartments a Cleanouts (Y/N) 7 Foundation cleanout (Y/N) Y Depression over tank (Y/N)/ ZI High water alarm (YM) N/A �o Date of pumping l( Pumper A I-FyN�I 50—rV z'o- S C. ABSORPTION FIELD DATA Date Installed 912cl7o7a Soil rating (g.p.d./ftz or fe/bdrm) 8S_ System type Seepage Pit Length s2 ft. Width %2 ft. Gfavel below pipe 6 ft. Total depth 111�ft. Eff. absorption area a88 W Monitoring tube Y Depression over field N Date of adequacy test 8/16/2008 Results (Pass/Fail) �Ct!55 For 3 bedrooms Fluid depth In absorption field before test �O in. Water added o al. New depth 6 3 in. Elapsed Time: Mo min. Final fluid depth � In. Absorption rate >= ysy g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION L4 9.)n � Date of Payment Date Installed Si)tnJs Manhole/Access (YIN) `Pump on" level at _ In. "Pel at _ in. High wateralarm level at in. Datum C ' Meets alarm & circuit requirements? E. SEPARATION DISTANCES 11 SEPARATION DISTANCES M WELL ON LOST TOO: Septic tank/lift station on lot / v On adja ots Absorption field on lot r n adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line r� r , Iding tank Animal containment areas Manure 'mal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation zo+ Property line so+ Absorption field io+ Water main %o+ Water service tine ac+ Surface water zoo+ Wells on adjacent lots Zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line so+ Building foundation %o+ Water main io+ Water Service line zt+ Surface water ioo+ Driveway, parking/vehicle storage %o+ Curtain drain None Observed Wells on adjacent lots aoo+ F. COMMENTS G. ENGINEER'S CERTIFICATION •�-\� ; °....;+(. 'e P,..... ....;�Srsei 1 certify that I have determined through field Inspections and review of Municipal records that the above systems are in " conformance with MOA COSA guidelines In effect on this date. i ........ Engineer's Printed Name Steven R. Pannone, P.E. 0 c = 1e en h P.:.no ftp rioCE 8149 J �feeF .....•'� i Date --7/(o ................ "r rcV`=.•. COSA Fee $ L4 9.)n � Date of Payment 1-1171a Receipt Number $5514_ (Rev. 11105) Waiver Fee $ _ Date of Payment Receipt Number, �5 Municipality of Anchorage Development Services Department�la. Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING, / Parcel I.D. 01 2���o HAA# / '6 DI D 1. GENERAL INFORMATION Expiration Date: 6:1 Complete legal description VALLI VUE ESTATES: LOT 2, BLOCK 6 2 Community On-site ❑ Public Sewer Location (site address or directions) 6611 ROUNDTREE DRIVE Current Property owner(s) Mailing address Lending agency Mailing address JIM HARPSTER Day phone 346-1740 6611 ROUND TREE DRIVE ANCH. AK. 99516 Day phone Real Estate Agent AUDREY MASON Day phone 694-4200 Mailing address REMAx 16600 CENTERFIELD DR. ANCH. AK. 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well Is Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 5 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 less than 30 days old. (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. Note: Alaska Water and Wastewater Consultants, Inc. shall bo pald $700.00 at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation data shown below, I verily that my Investigation, based on procedures outlined In the Health AuthodlyApproval 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 mylnvestigation 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 ALASKA WATER & WASTEVIATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 28 * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provldo a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations The reported results described the performance of the system undor the conditions encountered at the time of the lost, and separation distances measured to readily idontifiable features. The operational life of all wells and soptic systems depend on the kcal soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWI , inc. can therefore not provide any warranty or future estimate of how long the systorn will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole bonetit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal tight whatsoever. 5. DSD SIGNATURE -� Approved for 3 Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date oo600pp0 bedrooms, with the fllowing stipulations: Attachments: HAA Checklist Manitenence Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other ..`y.: Gorness: 1953 k wt�ttlltii(f(f//// OF APfc ori �QP . . • • 's0 is ON-SITE • '• WATER AND : n WASTEWATER PROGRAM 1EM 111117)) By:—a Original Certificate Date: 6-1/-01 (Rr. tzoo) 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.sk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: VALLI VUE; LOT 2, BLOCK 6 * Z Parcel ID: O /,S • J -a 3 -/ (, A. WELL DATA Well type CLASS A Date completed Date of test Static water level If A, B, or C provide PWSID# N/A SanitaSanita=l. Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Well Log properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. g.p.m. mg./L. Otherbacterinies/100 ml. •IN GARAGE. Date Installed 9/25/73 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 5/24/01 Pumper NORTHLAND PUMPING C. ABSORPTION FIELD DATA • rCAU EDTA R9SE�OF07 25'Ntr Date installed 9/25/73 Soil rating (g.p.dMor®) 85 System type SEEPAGE PIT Length 12 ft. Width 12 ft. Gravel below pipe 6.0 ft. Total depth e.5 ft. Eff. absorption area 288 ft' Monitoring tube YES Depression over field NO Date of adequacy test 5/24/01 Results (Pass/Fail) PASS Fluid depth in absorption field before testt 2 in. Water addeC 7122 gal. For 3 bedrooms New depth38_251n. Elapsed Time: 32 min. Final fluid depth31 in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at—in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main On adjacent lots On Public sewer manhole/cleanout line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: '+ Absorption Building foundation 5'+ Property line 5field 5'+ Water main 10'+ Water service line t 0'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation t 0'+ Water main 10'+ Water service line 10'+ Surface water 100'4- Driveway, parking/vehicle storage uNK Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i 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. CE A Corn Engineer's Printed Na a JEFFREY A. CARNESS QQO� 953 ;'.�e�p 4�e� '•.......... Date 5/70 OJ DO°dProress°^°o HAA Fee $ Waivpr FAA S Date of Payment 6—/ R7 X:51 Receipt Number _56 -an 7 (Rev. MOO) Date of Payment Receipt Number Y 42 1 l . afY K J 5 J,d ',• T1eKy., � .1+v fes' ,' , .. �.w , `.»:f,� `, ..• 'Y.\ <.-)•��t'yi: i' w 51. 46' er.. •fit jo 47 �r 48 t• ;' c t �. � iK- :? is • - � � r ,r � , : .�! 1' -. , ,}'/t�.�. All, '�J '•i it `.fx1 1- -10 32► r as *�•s. 'vim t t.4 .• • s <-� ..ajt fy{ tt r u f rt`ri ♦ v r_ t - r r _.,j. t a�ll�a1•¢¢ - y •11."{-+. !J li •, V � 1 fl �_�- • • h • �.4 � :.0 .rar yf ♦.S •= _���• a, '' V � y:+rry� - A, .+ r I� c ri � ... z t • .... x�x. r- ` - i Y�'� rP� it �'t� +�.K i•t iSYGV f. +,1 •J• ti�' ),a .'J•( ,.; • c ,,at✓ °'� }, � • -•� i a•t`4. 1 L •,• �_a;•�� nt,1 �yJ/ �i• i..fi !G- J'' , �� i � al('. a�. �, Y�-4.t' `4'G�ic:-te�Ylx :. - , X1+5 1' � .s . �'r ` '.��, ,o �• (y •� 1 ♦ 4 y'Y t� � ♦s J ' f Ji 1 t . Y J� i f,Iw•= f a -io� I i4at < itib �,}}�.r.i / - / ` .,7- c'' ,' x •Il 'fit ;�;L,1k-t�,•%' w J ti ari•. i 1, t P +.•• t 1 J•1 �4 :'a�� 4 . •t t t ''• J. ' • .., '! •y ,� •�'� n� . A s NOTE: ELEV. OF LOT COR FROM PREVIOUS I ASBUILT BY WALATKA AND ASST. I JI I / !1• 1637.00 Z.. � 0 CO 32 6 p J� 00c `C .1 y _ DRIVE 2 Cage v i �6 / ♦ \ � _ �,�9•y / \ \ 4 / .634.00 T O•a� / v 3♦3�. o/4oD / \ 9 • .• ` / sae/.\ y / \ 1•♦ 3e r \ q` FENCE �P,�rG•..... G•gS'1 663.00 i rCo., 4 3 ••••' I� // :. .......s. at ... .� I''r"^•�• ALT03 N. OSAit ••�o% SURVEYOR'S CERTIFICATE AS Ihereby certify that I have surveyed the 6UILDII property described hereon, and that the LOT 2 improvements ,situated thereon are located VALLI Vl as shown on this plat, and that there are SU no roadways, or other visible easements on surveyed y. sold property except as Indicated hereon. ALTON N.OGARD DOX21DO47' ANCH epistered�reyor_ 0,9005 DATE :'2 MAY 01 SCALE: I" • 40 FENCE t/ I L G60.00 0