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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS BLK 3 LT 3Thunderbird Heights Block 3 Lot 3 #051-711-07 Municipality of Anchorage .. Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragew St. P.O. Box 196650 Anchorage. AK 99519-6650 Page 1 of 2 www ci.anchorage.ek.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SM70250 PID Number. 051.711-07 Iwo. KMAN Wastewater System: ❑ New ® Upgrade Aanee ABSORPTION FIELD P p" N n°""Bi6a""' D Deep TrMch ® Snell" heath o e.d a L&mM O oth«• LEGAL DESCRIPTION Sa RMey Taal Depth can a" pea 1.2 GPDMe 6.7 Ft. 81a La subdiwMm Dpth W Pipe bman Lan W" pea CrevM apo, b PM 3 3 THUNDERBIRD HEIGHTS 3.7/1.5 Ft. 4.514.8 Ft TOwww Rarge wean Faaoadom*ag.WpWe C"LMpth 16N 1W 9v 0.5.1.5 Ft. 20120 Ft. Well: ❑ New ❑ Upgrade Grovel w . RawMaw,ee aNrc.bM...n"m 515 Fr. 2 15 Fr CWO~M(PMMe, A, 9. c): TOW Depth Cased W. Taal ebeapbm arw Pipe MMral PUBLIC WATER Ft. I FL -•437 LIDO Fr ASTM 3034 OrMr Doe DnMf SMta Wnr Laval MrMMr ONe "ooM FL GREY'S CONSTRUCTION 9/2012007 YMa Pump sM M Cama HMpM Abaa Grana TANK GPM Ft. Ft SEPARATION DISTANCES ❑ Septic ❑ Holding ® S.T.E.P. ❑ Other. To Septic Absorption LM Holding lublrJPrtvate 'a"" w ty From Tank Field Station Tank sewer Line ANCHORAGETANK 1250 Gr +25 STEEL 3 e $1111MM wMr +100' +100' +100' — LIFT STATION Let,. +5 +10' +5 — �a 250 GM ORENCO FanaManomo+_10 +5 +�CC1AA6 - 'Poop of N M TP Mf MMM Hpn M. Mrm M I 46 in 42 L, 47 K CDw +50' 11 +50' +.1y' — Pump MMu a M EMamiw Frpeaane Prrama0 by OSI-0SHFF RISING SON ELECTRIC RMnrL. BENCH MARK Laawn w Meapr.On TOP OF GAS METER "• AlW N wx n •v. :'� ��. 100.00 FL `y E Inspections performed by: FRES Dates: 1N 9/2012007 2nd 912012007- Development Services Department Approval Conditional Approval Date: CHRISTOPHER R WOOD CE:1 387 r r Reviewed and approved by: (Rr OM) - % L B Permit No. SW070250 Municipality of Anchorage Page 2 of 2 DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: THUNDERBIRD HEIGHTS LOT 3 BLOCK 3 051-711-07 SWING TIES il JA IC 13b' B lO.Y M.1' l6.Y 70.0' •• • w LOT 3 > •SCALE r-�o• 0 D DRAINFIELDSO [Y M HOUSE CK Ld 0 TH 1 Z I.=_ NEW 1250 GAL STEP TANK f r LOT 4 O - CLEANO T - L A PROX. *ATE K BOx'LOCATI N a r +Er a — MONITOR • ASSUMED ELEVA l00' 10/25/2007 ELEVATION ORIGINAL GROUND (NOT TO SCALE) LEVEL ATI 106' ENGINEER'S SEAL o�0000pp�4 0.5'FILL MT -1 ILL MT- TH-1 0 ()F At Atq��p INSULATION A;W • ' 00� INSULATION :: QD 1 4. 2 TYPAR 1 4.SI TYPAR 4.5 0 ppTS5ANKG o 4:8eGRA°VE6 ° 4:5°,GRA°VE� ° O Q% CHRISTOPHER R. wooD;' 0 93.0 1'S.T�E.PAL 93. QQ C'�, •. CE -10387 O BOTTOM OF T.H 100, 88. 99.7 99.7 100.0 100.0' NO G.W.T ��ooOp E rnlpJ o 88.7 �40000�0 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street T� P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 0 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070250 Legal Description: THUNDERBIRD HEIGHTS BLK 3 LT 3 Design Engineer: 0848 EAGLE RIVER ENGINEERING SEI Owner Name: RON RICKMAN Owner Address: 27333 GOLDEN EAGLE CHUGIAK , AK 99567 - Date Issued: Sep 13, 2007 Expiration Date: Sep 12, 2008 Parcel ID: 051-711-07 Site Address: 027333 GOLDEN EAGLE CT Lot Size: 26269 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 ( 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: r Issued By. Date: `{ Date: `� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 ^ p I Anchorage, AK 99519-6650 � www.muni.org/onsite `' Q (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION M FOR A SINGLE FAMILY DWELLING Parcell.D. Property owners) f`n �1 c �~~a y+ Day phone bfg- 970 Mailing Code `1`1Sfo2 - SI'AS Site address 2-7 6-V44-2 irjp Cr"/L-t Zip Code 1225(o-1- Legal `)S(o'FLegal description (Sub'd, Block & Lot) 3 83 Legal description (Township, Section & Range) -ChOA1 5cG ol6 k1VJ Lot Size &. -1-105 Sq. Ft. THIS APPLICATION IS FOR (®all that apply) Absorption Field 0 Septic Tank jo Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade El Renewal ❑ 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. (Signature of property owner or adthorized agent) Date of Payment: Receipt Number: �`7 / 7tJ Receipt Number: (Rev. 11105) Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax September 13, 2007 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Thunderbird heights Lot 3 Block 3 Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (FRES) was contacted by the owner of the property noted above to perform a COSA inspection. At the time of inspection, it was determined that the leachfield was surcharged, and a new leachfield would have to be installed. A test hole and soils percolation test has yielded slightly silty sand and gravel SW and GW, with a percolation rate of 4 minutes per inch. No water table was noted after our 7 -day water monitoring. We propose to install a 7' deep pressurized drainfield with 4 feet effective sewer rock. The proposed 3 bedroom leachfield is located gently sloping land, less than 25% slope. There is a slope steeper than 25% located near the house. Downgradient, the steep slope is more than 50' away. Laterally, the steep slope is approximately 45' from the nearest point of the leachfield. The proposed septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are all connected to public water, so there is room for primary and reserve sites on neighboring lots. 2. Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 200' of the proposed septic system. 3. Drainage will not be affected and is not a major consideration in our design. Installation of this 3 bedroom septic system upgrade, to our best available knowledge, will not adversely affect the wells or septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAG LEF,![LING ERVICES Christopher ood, P.E. Principal \2003\07-083DRAMELDLIMEPTICNARRATI VE Ld ry0 Ld Z lay LOT 3 SEPTIC +30' -r— r G( SEPTIC AREA/ HOUSE a w N L� Fes' o CLEAN UT of v IC TAN N TO gE FR. J ROX. *ATI 80X 'LOCA GOLDEN EACLE Cr C LOT 2 INSTALL 2 NEW 5'X20' DRAIN FI LDS' 10, V e/SEPTIC AREA S.T.E.P. ANK LOT 4 C +30' 1 NO KNOWN SURFACE WATER +100'. NO KNOWN CURTAIN GRAINS 3. NO SEPTICS WITHIN 30' UNLESS NOTED . 0 WELLS WITHIN 200' UNLESS NOTED 5. KNOWN LOTS ON COMMUNITY WATER ® - TEST HOLE — — - EASEMENT • - MONITOR TUBE - = - PROPOSED LEACH FIELD o - SEWER CLEAN OUT - EXISTING LEACH FIELD + - WELL - ORNEWAY WELL/SEPTIC SITE PLAN LEGAL: THUNDERBIRD HEIGHTS LOT 3 BLOCK 3 OWNER: RON RICKMAN CONTRACTOR: UNKNOWN JOB# 07-083 1 DATE:9/11/2007 SCALE 1"=30' EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD. SUITE#201 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 �•<<c. OF 444444 i* Vii+ '.CHRISTOPHER R.� . CE -10387 z 0 a U � CLEAN UT of v IC TAN N TO gE FR. J ROX. *ATI 80X 'LOCA GOLDEN EACLE Cr C LOT 2 INSTALL 2 NEW 5'X20' DRAIN FI LDS' 10, V e/SEPTIC AREA S.T.E.P. ANK LOT 4 C +30' 1 NO KNOWN SURFACE WATER +100'. NO KNOWN CURTAIN GRAINS 3. NO SEPTICS WITHIN 30' UNLESS NOTED . 0 WELLS WITHIN 200' UNLESS NOTED 5. KNOWN LOTS ON COMMUNITY WATER ® - TEST HOLE — — - EASEMENT • - MONITOR TUBE - = - PROPOSED LEACH FIELD o - SEWER CLEAN OUT - EXISTING LEACH FIELD + - WELL - ORNEWAY WELL/SEPTIC SITE PLAN LEGAL: THUNDERBIRD HEIGHTS LOT 3 BLOCK 3 OWNER: RON RICKMAN CONTRACTOR: UNKNOWN JOB# 07-083 1 DATE:9/11/2007 SCALE 1"=30' EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD. SUITE#201 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 �•<<c. OF 444444 i* Vii+ '.CHRISTOPHER R.� . CE -10387 Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD Suite tot (907) 694-5195 tel Eaele River. AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Thunderbird Heights Lot 3 Block 3 September 13, 2007 A. GENERAL 1. The proposed septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Building Safety, Onsite Division, and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. A licensed surveyor should locate any utility easements and exact 100' radius from the existing and neighboring on-site wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK WITH LIFT STATION 1. The septic tank shall be an Anchorage Tank 1,250 gallon septic tank with integral OSI lift station pump model OSI -05-20-111117, or other engineer approved configuration (example: 1000 gal septic tank with auxiliary lift basin of 250 gal min.) 2. A receipt and/or statement from a licensed electrical contractor shall be provided to the engineer verifying lift station wiring to all applicable codes. C. DRAINFIELD 1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield bottom. 2. The bottom of the drainfield shall be level, plus or minus 1.5". 3. The elevation of the gravel layer is not to be more than 7' below grade as measured at the monitor tube for test hole # 1. 4. The effluent lines (2) are to be 1.25" PVC lines with 1/8" holes drilled 24" OC within the leachrield, placed face down, or up with orifice shields placed over holes. Line from tank to field is to be 1-1/4" HDPE, ASTM 3034. The distribution lines for both trenches shall be at the same elevation to ensure equal dosing of both fields. 5. The drainfield gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the bcd. Mounded side slopes not to exceed 3:1. 7. The septic tank and leachficld must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACIIFIELD DIMENSIONS: BOTTOM OF GRAVEL LAYER = 7' max Below Grade at monitor tube GRAVEL THICKNESS = 4.0' under pipe, 2" over pipe DRAINFIELD LENGTH = 2 a 20' DRAINFIELD WIDTH = 5' SOIL RATING = 1.2 GPD/R5 BEDROOM CAPACITY = 3 SEPTIC TANK = 1,250 Gal S.T.E.P or Engineer approved equal EFFLUENT PIPE = 1.25" PVC with 1/4" holes oriented down, or up with orifice shields spaced at 12" OC. \2003\07-083diainreid-rn- spcc Twenty-four (24) hours notice required for all inspections Additional Charges will be incurred for the 3 required inspections and preparation of septic system as-builts. After 5:00 PM and weekend inspections are double our normal rates. \2003\07-083dro nrad-un- spec •' OF ql EAGLE RIVER ENGINEERINGAw 10421 VFW RD, SUITE 201jw EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 SOILS LOG - PERCOLATION TEST PERFORMED FOR: RON RICKMAN DATE PERFORMED 8/24/2007 LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS LOT 3 BLOCK 3 TEST HOLE #—1 SSPE t DATE - DEPTH TO WATER NETDROP(IN) 2- 12:42 0:00 3- 3 5 0 4- 45 �.� 010 5— 7 TAN SW -GW 2 . SAND 08/24/2007 114 AANND GRAVELTM 6' 5 0 M08/24120071 7- 1:15 010 6' 7 1/2 2 1/2 9- 910 125 0:00 6' 5 10- 08/24/2007 138 0:10 11 11 318 12 o� 13 1:39 0:00 16 17 20 21 WATER TABLE DATA DATE WATER LEVEL 08/24/2007 DRY 08/31/2007 DRY .CHRISTOPHER R. WOOD. CE -10387 TOWNSHIP RANGE SECTION T16N, R1W, SEC.25 PERC TEST RESULTS PERCOLATION RATE=4 (MPNNCH) PERC HOLE DIAMETER=6' SOIL G 1 TOPHER WOOD PERCOLATION TEST BY: CHARLES BALZARINI I _CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i'31 O7- DATE GROSS TIME NET TIME DEPTH TO WATER NETDROP(IN) 08/24/2007 12:42 0:00 6' 5 0 08/24/2007 1:04 010 6' 7 3/4 2 3/4 08/24/2007 114 000 6' 5 0 M08/24120071 08/24/2007 1:15 010 6' 7 1/2 2 1/2 08/24/2007 125 0:00 6' 5 0 08/24/2007 138 0:10 6'7 318 2 3/8 08124/2007 1:39 0:00 6' 5 0 1:49 0:10 6' 7 1/4 =21/4 PERCOLATION RATE=4 (MPNNCH) PERC HOLE DIAMETER=6' SOIL G 1 TOPHER WOOD PERCOLATION TEST BY: CHARLES BALZARINI I _CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i'31 O7- EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle Rivet, Alaska 99577 (907) 69"195 ERES Project No.: 07-083 Calculated By: CB Date: 09/13/2007 Legal: THUNDERBIRD HEIGHTS LOT 3 BLOCK 3 SINGLE FAMILY 3 BEDROOM RESIDENCE Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 4 • minutes per Inch Wastewater application rate = 1.2 • gallons per day per square foot Required absorption area = 375 square feet Trench width (W) = 5 feet Gravel depth (D) = 4 feet Required length = Shallow trench factor' Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor= 0.50 Total Excavation Depth = 7.0 feet Required length = 38 feet 07-083TBIRD.xls 11:40 AM09/132007 • O c rej ua11 PeeH oiweuAa moi 71 CL cm ai _ u O o = 0 O MEN MEN M_ 0 r EMO ME ME IN IN ME IN IN ME IS IN ME ME rej ua11 PeeH oiweuAa moi 71 CL cm ai _ u O o = 0 O Dees. c., - YwNIC:;1AL:TY O1= AXC.:O:iAG:i f I �1 %f es v �`, DE?ARTR7ENT O. YEALTet & £NVI ON;.:c 'TAL PROTECTION ENVIRONM°ENTAL ENGINEERING DIVISION 825 L Ssreaz • Anchor:ga, Alaska 000507 Tole; hong 2-34.4720 RECEIVED OV•S:TE SEWAGE DISPOSAL SYSTEM AND/OR Wti—LL INVEC T ION RVORT ,. r J.c:2 3 1' �• � �: uPGrrADz _..,.._ DcSCi.P7;0.% jz Ausorpt.Or. area 1 u �rCLr — i No. J: r.nos Lenin Of •'c;, Lna - O.3 of ...a to Ln:sn yr aog teeny:: I L'Y.Sn I = 7ypa of cr,b I Crib d.ama-,er O:STANCETO: IL•:ea IC.ass I Oep;n 1 6.wd n„ fo�nda Lon O:S T. :.\Cc TO: OTHER l,PE .1:A7cn,A LS P. V. c bG.L-es: FATAL D.se... ng C' I PERS.:I'i 1\O. No. of compartments 'X.'7AL. Z P:wu, 1 L,gem deptn PZmMiT NO. Aaa:AA:s .! Liquid capacity in gallons InsIce lend:n Owe„ing IfJ,.nJLbOA :, ! Toto. lenfth Of brief j Matenai beneam l,ia Depm Crib depth IaJ::d:r,g }Oundation Dnser Sawer lana LLGAL 4” f .! I No. OF ai:oRcoMs D.se... ng C' I PERS.:I'i 1\O. No. of compartments P:wu, 1 L,gem deptn PZmMiT NO. Matena, .! Liquid capacity in gallons INearost lot ,no I PERMIT :0 _ 1 r nen wA::, O.>tance br n'een I.,;. ?, , incites n •, Total eifect.va autorpnon arca �'/ inches �(.r(`i ,r•)= PEAMIT \0. I 17o -,4i effective absorption area 1 \cares -,fez line D.stanee to tot line PERMIT ra0. Sept:c tank Absorption,rea(s) n 1Viu 6j)a►lity Of I`0101 POU(.., 6-650 ANCHORAGE, ALASKA 99502 (907) 279-2511 GEORGE M. SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (825 "L" Stmet) December 29, 1978 Forest Ridge Homes General Deliverr Eagle River, Alaska 99577 MUNICIPALITY OF ANCHORAGE ENVI D Pr OF 1:FALTH 4 NMFNTAL P;O1,CT10N JAN 2 61979 RECEIVED Subject: Lot 3 Block 3 Thunderbird Heights Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, 4 s N. Buchholz, R.S. Senior Environmental S cialist LNB/ljw enc: copy of permit 0 n n BOMHOFF S ASSOCIATES, INC. Engineering• Planning- Surveying 1020 West International Airport Road Anchorage, Alaska 99502 Telephone(907) 279.5522 LOCATIONroT-s, ae, TS,.THL)tiDC—tZt'S12D= 0 BORING NO. NO. BORING NO. STATION STATION ELEVATION ELEVATION 0•••-�•�� .OYE-2P�U QT7 f�t-1 0 • 'O iZBpl�il-7 ZOIL-l.�24VEI,.TO 3u - I- ' 2• .�Q DGG4T�Ot-lAL 12�_iSOL1LCEfZ ((aW/�+W� 2• 4- 4• C A;,b mo (GI 7• ' 7• t3-DQ�C� t0• 10• F II• F- 11• W12• 4 12- ? 13• 13- 1 14. 14. a 0 15- a o 15- 16- 16• 17• 17• 16• 18- 19- 19- 20• 20- 21• 21- -22- 22- 23• 23- 24• 24- 25• 25- 0 I 4 n F~ I rt. 233.8 "Ah Fltl. 252.5 'I . 57 D W a L U - I r- - 7:---- -L- 7.�LO:.GU I E rl tifzoa m &-r to o w H :i ems-ory ai Jlj if "Ah Fltl. 252.5 'I . 57 D W a L U - I r- - 7:---- -L- 7.�LO:.GU I E rl tifzoa m &-r to o w H :i ems-ory TO Os,C£Sr el,gGE 116A?SS ' feN QFl �No-�E•��E� • � ,� Y3- 9S� 3 F R o °d M 745078Ls SUBJECT/07% 'w.L `J e'%ZMlip� lf"4 .S11 - MESSAGE REPLY 'p, r DATE y,� .Gu.eA /�j� C / I 1 \1 poop SIGNE _DATE_ RRdifprm®4S 471 SEND PARTS I AND 3 WITH CARRON INTACT - f PART 3 Will Of RETURNED WITH REPLY. �"""�'°"^�•"' n ® BOMHOFF & ASSOCIATES, INC. Engineering - Planning- Surveying 1020 West International Airport Road • Anchorz;e. Alaska 99502 • Telephone(907)279-5322 PO. Box 800 Palmer, Alaska 99645 MUMC'PAL'V OF ANCH0*0101)hone (907) 745-4201 DEPT. OF HEALTH 6 ENVIRONMENTAL PROTECTION September 22, 1978 SEP 2 61918 RECEIVED Les Buckholtz Municipality ofAnhcorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 RE: Thunderbird Heights Subdivision; Lots 3 & 6 Block 3, and Lot 10 Block 2 Dear Mr. Buckholtz: The three above referred lots have had the on-site sewage systems in- spected and the systems do conform to the design 3 in all cases. Thank you for your attention in these matters. Sincerely, BOMHOFF & ASSOCIATES, INC. John T. Felton, P.E. Office Manager RRK/pnk highways • airports • drainage • planning • shopping centers • subdivisions • streets • water . sewage September 27, 1978 Bomhoff and Associates, Inc. Engineering -Planning -Surveying Post Office Box 800 Palmer, Alaska 99645 Subject: Lot 3 Block 3 Thunderbird Heights Subdivision Lot 6 Block 3 Thunderbird Heights Subdivision Lot 10 Block 2 Thunderbird Heights Subdivision We have received your letter dated September 22, 1978, this letter is inadequate for sewer inspection finials and does not meet our criteria. Enclosed please find three(3) On-site Sewage Disposal System and/or Well Inspection Report forms. This rust be completed in full and signed and sealed by your state seal as a engineer. When they are completed, please return then to this office no that we can close out these permits. If there are any further questions, please contact this office at 264-4720. Sincerely, Les V. Buchholz, R.S. Senior Environriental Specialist Lr;D/l j w enc: three ' DATE RECEIVED INSPECTION APPOINTMENTS TII1E TIME TIME n t �f r�t n•. o DATE DATE DATE � INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE -\ DEPARTMENT OF HEALTH 6 ENVIRONMENTAL PROTECTION CFot Cr 1' !t ' a- 1 825 LStreet • Anchorage, Alaska 98501 ENVIR.):U._h.A....U. TION • ENVIRONMENTAL SANITATION DIVISION GOT 2 1 39322 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWAj" D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE Robert G. Lerman 272-6451 MAILING ADDRESS 101 Golden Eaclle Court PROPERTY RESIDENT (If different from above) PHONE 2. BUYER Western Relocation MAILING ADDRESS P.O. Box 10457 Oakland, California 94610 3. LENDING INSTITUTION no lender as yet MAILING ADDRESS 4. REALTOR/AGENT Jack White Co. / Clair J. Ramsey MAILING ADDRESS 3201 C St. Anchorage, 99503 5. LEGAL DESCRIPTION Lot 3, Block 3, Thunderbird Heights STREET LOCATION 101 Golden Eaglo Court 6. TYPE OF RESIDENCE NUMBER OFsBEDROOMS IN SINGLE FAMILY ❑ One ❑ Four ❑ Two ❑ Five ❑ MULTIPLE FAMILY E3 Three ❑ Six 7. WATER SUPPLY PHONE (415) 436-5656 PHONE PHONE 277-1553 ❑ Other ❑ INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ® COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM ® INDIVIDUAL/ON-SITE" ir)I,l 1lR YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED 72-0101 Rev. 6/79) D _ 4t`'`� X51-� a o2 5 ❑Septic Tank or C1 Holding Tank Size:1.). '�D_IfTank ishomemade SOILSRATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank (Absorption Area (Sewer Line I Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line 5. COMMENTS E3--APPROVEDFORBEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 72010 (Rev. 6/79) BY roc ,ems i THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMITNUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLICUTILITY ' Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED ❑PUBLIC UTILITY 16 - Connection Verified INSTALLER ❑Septic Tank or C1 Holding Tank Size:1.). '�D_IfTank ishomemade SOILSRATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank (Absorption Area (Sewer Line I Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line 5. COMMENTS E3--APPROVEDFORBEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 72010 (Rev. 6/79) BY roc ,ems October 27,.1902 Robert G. Lerman 101 Golden Eagle Court Chugiak, AK 99567 Subjects Lot 3 Block 3 Thunderbird Heights Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The septic tank pumped with a receipt submitted to this department. ' A four (4) inch cleanout to be installed to the leaching urea. 6 V� ' An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. RP210/p/EII Enclosure Sincerely, Robert C. Pratt Associate Environmental Specialist _ . __. _ - - _l - __ Jack White Realty Company ATTN: Clara Ramsey 3201 C Street Anchorage, Alaska 99503 Dear Ms. Ramsey, n EXCAVATION WORK ag Reference: Lot 3; Block 3; Thunderbird Heights Subdivision ROBERT A. SHAFER CIVIL ENGINEER 694.2979 October 26, 1982 MUNICIPALITY OF ANCHORAGE CF" C- 1'--.T'' R ENVI6JI4:.:_t..A_ :.,U._LJION GOT 2 9 1922 RECEIVED A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of approximately 1,000 gallons. The seepage bed was tested by a continuous flow of water through the lift station for a period of 24 hours, without any adverse effects on the system. It can be concluded from this test that the waste water disposal system is currently functioning adequately for the three bedroom residence located on this property; however, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to contact us. cc: Municipality of Anchorage Department of Health and Environmental Protection SRO 196X EAGLE RIVER, ALASKA Junc 19, 1979 Forestedge Homes General Delivery Chugiak, Alaska 99567 Subject: Lot 3 Block 3 Thunderbird heights Subdivision At the current time, there exists approved distribution and storage systems. However, there is not an approved adequate source serving these lots. The public well owners are continuing to search for adequate water supplies, however at this time, an adequate supply does not exist. Therefore, this department can not approve or disapprove the public water system as an adequate sourco is not available to be evaluated. The on-site sewer system for the individual structure is approved. If theee are any further questions, please contact this office at 264-4720. Sincerely, Les 17. Buchholz, R.£. Senior L'nvironmental Specialist LH3/1jw cc: Alatha Pacific Bank Mortgage Loan Department 101 Benson Boulevard 99503 f T - 14ACC" 1:36)-C11:3d CC9fAA x'1`7 ORAGE �\ �+'-'VtYnnrMCH rvr nersu nerAncn..n ENTAL PROTECTION 826 L Street • cboraee, Alaska 99601 l ENVIRONMENTAL ENGINEERING DIVISION Telephone 26447200 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all pans on page 1. Incomplete requests will not be procerd. Raw allow ten (10) days for Is , rig. 1. PROPERTY OWNER�oPHONE r�rs7L MAILING ADDRESS PROPERTY RESIDENT (if d_iffffeerent from above) PHONE 2. BUYER 5=44 ONE MAILING ADDRESS CS, hh � / e'� —' / !' 3. LENDING INST�IJT�ITId1� - ///�/Y�l�/. /J� I PHONE MAILING ADDRESS •IL;, A / Ak 4. REALTOR/AGENT A/ I PHONE MAILING ADDRESS 6. LEGAL DESCRIPTION�,��� ��'� •� STREET LOCATION ^ ��� ^ � ^ �✓� S. TYPE OF RESIDENCE•70� -El SINGLE FAMILY ❑ MULTIPLE FAMILY 7. WATER SUPPLY ❑ INDIVIDUAL' ❑ COMMUNITY 99 UBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM 1L--IMtSI V I D UA L/ON-SITE" ❑ PUBLIC UTILITY NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other ❑ Two ❑ Five C;;-�hree ❑ Six ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) d "If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(7n8) G/fll7 � Wit IV I THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: t. TYPE OF RESIDENCE Cl SINGLE FAMILY ❑ ONE ❑ MULTIPLE FAMILY ❑ TWO 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON-SITE DATEINSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: NUMBER OF BEDROOMS ❑ THREE ❑ FIVE ❑ FOUR ❑ SIX TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS Sewer Line ❑ OTHER Nearest Lot Line b"'APPROVED FOR k BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) 4 DISAPPROVED DATE BY 17 1, LEGAL DESCRIPTION r)' 72-010 (Rev. 3ne) • Municipality of Anchorages s.4 On -Site Water and Wastewater Program JUN 2 L (907) 343-7904 s r c T �aretchaa� St s Certificate of On -Site Systems Approval Parcel I.D. 051-711-07 Expiration Date: 6 " / 2 - Z�z 1. GENERAL INFORMATION Complete legal description Thunderbird Heights, Block 3, Lot 3 Location (site address) 27333 Golden Eagle Ct. Current Property owner(s) Chugiak Properties LLC. Day phone Mailing address Real Estate Agent 16801 Carmel Cir. Eagle River, AK 99577 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 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 50Waiver Fee $ Date of Payment (Qlaalr5 Receipt Number Qla COSA # Oc�-)Cj 5x l 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 lime 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 fife of all wells and septic systems depend on the local soil condition,--grouiia 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 guaranteefuture 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 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE V System #1 Approved for 9 bedrooms System #2 Approved for bedrooms Disapproved Date 6/1F12015 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date:. /Jf The.tic ity ge 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—C ,. If more than 1 septic system is on the lot: COSA Checklist # of 1 Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Thunderbird Heights, Block 3, Lot 3 Parcel ID: 051-711-07 A. WELL DATA Well type Public If A, B, or C provide PWSID # AWWU Well Log (YIN) Date completed Sanitary seal (Y/N) _ Wires properly protected (YIN) Total depth ft. Cased to' ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: %# Coliform colonies/100 mL Nitrate Arsenic ug/L Date of sample: B. SEPTICIHOLDING TANK DATA mg/L Collected by: ft. a= Tank Type/Material Septic/Steel _ Date installed 9/20/2007 Tank size 1,250 gala Number of Compartments 2 Cleahouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 8/29/2014 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 9/20/2007 Soil rating (g.p.d.M2 or ft2/bdrm) 1.2 GPD/SF System type Shallow Trench Gravel below pipe 4'5/4'8 ft: Length 20/20 ft. Width 5/5 ft. •6.3/9.7 400. Y ..N Total depth ft. Eff. absorption area ftZ Monitoring tube Depression over field 6/12/2015 Pass 3 Date of adequacy test Results (Pass/Fail) For _bedrooms Fluid depth in absorption field before test 0/9 in. Water added 477 gal. New depth 0/9 in. Elapsed Time: 100 min. Final fluid depth 0/9 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 9/20/2007 "Pump on" level at 4b in. Datum Bottom of Tank E. SEPARATION DISTAWdES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot _ Public sewer main Sewer /septic service line _ Animal containment areas Size in gallons 250 "Pump off" level at 42 Cycles tested 4 in. Manhole/Access (Y/N) Y High water alarm level at 47 in. Meets alarm & circuit requirements? Yes On adjacent lots _ Oh adjacent lots _ Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 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 .�0+ Wells on adjacent lots 100+ F. COMMENTS *2" rigid insulation per inspection report. r LJ IP -AA b,.. F , 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. Engineer's Printed NaMe Steven R. Pannone Date 6/25/2015 COSA canary sheet -2-6-1 5.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ �wa�i n. ru�3riw3c I.s . CE -8149 : &; C' H RT -79 vJ-a--�b 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. O1J -'�1 l-D'� COSA # f7�D�ifl3 Expiration Date: -�z — 7 — 0 R 1. GENERAL INFORMATION Complete legal description Tf II,+NDE7zFSI12D f+I _- I C-rti TS L-3 6S Location (site address) 6roL:DeQ F-ACxt-F_ Current Property owner(s) Roil (L IC V-1` A -J Day phone VW - 5`1► 9 Mailing address 2-432'5 CTo L-17F�.! FACTLE . C++i tc-rIAV - Sri S Lending agency Day phone Mailing address Real Estate Agent Day phone 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 Well ❑ Community On-site ❑ Public Water System 9-10' 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. Eagle River Engineering Services phone (rel - SI S Name of Firm 10421 VFW fid., Guile Address Eagle River, AK 99577 Engineer's Printed Name G -1-P_ Ss opFF— - (A T) S. DSD SIGNATURE Approved for -9 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: _ a4e'=V/ 1/_/1✓— E Original Certificate Date: (Rw. NAS) Municipality of Anchorage • Development Services Department Building Safety Division On -Sirs WasTier Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsits (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description:-NtANb0RDA?D W&T,6 rS 1-3 B3 Parcel I13:00- 711 - 4>7 A. WELL DATA Well type k,Ij j L K A, B, or C provide PWSID # Date completed _ Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOGLv Date of test Static water level ft. Well production WATER PLE RESULTS: 7 cotonies/100 mL Arsenic: moll B. SEPTICIMOLO NCi TANK DATA 9.p -m. properly protected (YIN) Casing height (above ground) in. AT INSPECTION Nitrate - mg1L ... Other bacteria Date of sample: _ Collected by: ft. 9— p.m- colonies/100 mL _ Tank Type/Material� 964. 1+14 rL A�� L Date Installed 9 /ZO /o 7 Tank size 12 SD gal. Number of Compartments Z Cleanouts (Y/N) It7 5 Foundation cleanout& .&i� Depression over tank (Y© NU High water alarm *W Date of pumping Kt M- Pumper NtMJ 49 AKTR C. ABSORPTION FIELD DATA Date installed 9 /Zo/b Soil rating (g.p.dJW orililbdrm) System type W2.4Zy7'o'jea Length L417 ft. Width 5 ft. Gravel below pipe y S ft. Total depth L.1 ft. Eft. absorption area Y Monitoring tube Depression over field 00 c .r Date of adequacy test V/4- Results (Pass/Fe" P+S S For .3 bedrooms Fluid depth in absorption field before test 444 in. Water added N ¢gal. New depth in. Elapsed Time: *4 min. Final fluid depth _&&- in. Absorption rate >= 9so g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N/A- if yes, give date N 4 �I D. LIFT STATION Date installed 917010-' - Size in gain --17,50 — Maehele/Aecesst-f,�" y 'Pump on' level at_& in. 'Pump ofP level at�i ZZ in. High water alarm level at in. Datum Q o lro M nP BASKS Cycles tested 3 Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankliitt station on lot Absorption field on lot Public sewer main C� On adjacent lots On adjacent lawl—C-8-0�m- r manhole/cleanout Sewer /septic service line Holding tank Animal conte' M areas Manure/animal excrete storage areas SERARATION DISTANCES FROM SEPTIC/1-1191:191NG TANK ON LOT TO: Building foundation r Property line Absorption Water main 't' /0 Water service line +10 Surface water -t• f tX� r Wells on adjacent lots 'f 100 r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r _ Property line 419) r Building foundation 'J" 10 / Water main f0 Water Service line +'/0 r Surface water +/AD t Driveway, parkugtvehide storage Curtain drain '13'0,(~46 -Wells on adjacent lots cA&Wu) F. COMMENTS 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 COSA guidelines in elfed on this date. Engineers Printed Name CQrSm tFSk R- LJV4_,t� Date /z/05-/07 COSA Fee $ Date of Payment Receipt Number In (Rev. 11/05) Waiver Fee $ _ Data of Payment Receipt Number, 11 c ASBUILT Zoz 7y SE4ARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY Q6e, OF At 14% AND THAT ENCROACHMENTS SS TE 6EPT DATEr��,.• '9s,�� INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID EASEMENTS, COVENANTS, OR RESTRICTIONS iyG/ /96s j WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' p.•^• M&A s. word, ANY DATA HEREON BE USED FOR CONSTRUCTION 79" y-� �?; L5-ev OF FENCE LINES, OR FOR ESTABLISHING BOUND- + " : 1,c ARY LINES. DRAWN, �� �0h:sbxz� " MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box.196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # __A \ _n, HAA # W AQ'i0 gtk7) 1. GENERAL INFORMATION Complete'leg aIdescript!on Los �, 6toc�✓�1, 3�Tut�ye'2Bn¢p ryeiC/rs>��i%yrs S�.dod�6io.J Location (site address or directions) .995,6 9' Property owner �OeCc`"'E rl'eo"�yrE` Day phone Mailing address 7O. gox E"I"Z E'.oGCE.2.y�.2 -57 errC9 99S> Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF KI i 117 l�•I 3`i L•1 i �:l F3�1 � 7 � H Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-023 pl•,.1/91) Front MOA F21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations In effect on the date of this inspection. Name of Firm OodttAs '��- .C�ev<ES� Address g96oE, Engineer's signature 6. DHH6 SIGNATURE Approved for Disapproved. M TY RE t bedrooms. Conditional approval for Additional Comments Phone (9o�J 7yG io73 Date ' -7' `29 C� \� • �F' A4• ;9s i '•gyp:• •.,'�+�! 9' DOUG T. KENL.EY- 0 bedrooms, with the following stipulations: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate Is issued. The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineers work. nca m.•. unit 9. u0A m cEIVtl e Municipality of Anchorage SEP v7 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNOPAUTY OF AnmcNO 825 L Street, Room 502 • Anchorage, Alaska 99501 • (9"r$?)I`V ° Health Authority Approval Checklist Legal Description: .4 v s J B, s c, t ? -/rs. Parcel A. WELL DATA Well type PcidA0 a Log present (YM) — Total depth Sanitary seal (Y/N) — Date of test _ Static water level _ Well production _ WATER SAMP 1 nn Date of sample: If A, B, or C, attach ADEC letter. ADEC water system number zii s L Date completed Cased to FROM WELL LOG Nitrate _ Casing height (above ground) _ Wires property protected (Y/N) 7 �/P Collected by: Other bacteria B. SEPTICfHOLDING TANK DATA Date Installed "41' `/7B Tank size 12 so Number of Compartments z Cleanouts (YM) Y Foundation cleanout (YM) 'y Depression (YM) A/ High water alarm (Y/N) i Date of Pumping 624 Pumper -�"�•r v cY ���s.�et C. ABSORPTION FIELD DATA Date installed I' V78 Soil rating (g.p dAF or ttMbdSystem type d`to Length • 160 F/. Wldfth Gravel thickness below pipe d •! Total depth Effective absorption area *1f v Fi z Monitoring Tube present (Y/N)_ Depression over field (YM) Date of adequacy test 9�y�99 Results (Pass/Fall) For 3 bedrooms Fluid depth In absorption field before test On.); Immediately after:Oj gal. water added On.): y Fluid depth $' (Ins) Minutes later. Absorption rate - "3 o C. ' a.p.d. Perwdde treatment (past 12 months) (Y/N) 'V If yes, give date 72-026 (Rev. 3196)• D. LIFT STATION Date installed Size in gallons --;,417" L Manhole/Acoess (Y/N) Y "Pump on" level at* " � `Pump otr level at' + High water alarm level at* Cycles tested 9 E. SEPARATION DISTANCES iB *Datum Aaao T. )Ae- SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent k>ts Public sewer main Public sewer manhde/dearwut Sewe is service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /C 6f Property line Z �f% Absorption field Water main/service line -.L.=Suriace wateddrainage /c,0`F/ Wells on adjacentlots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property fine iB 'ff. Building foundation -54C `�f Water mainiservice line -0 -f Surface water /6'c ` -,� . Driveway, parking/vehide storage area yc Curtain drain .✓e1✓6A-"AJ014J,J fo 6✓isy- F. ENGINEER'S CERTIFICATION Wells on adjacent lots I cerfify that I have detemdned Ihnr field brspecdons and review of hfumt paf in conformance with MDAjHAA gt d#ellnes in effect an fhfs date. Signature v (-� Engineer's Name k6, os T t o cJ[y'j� HAA Fee $ 4 �m Date of Payment & q - 1 on Receipt Number n 4-a I n 1 ( Cl 72.028 (Rev. 3196)• Waiver Fee $ Date of Payment Receipt Number cE W76 are