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THUNDERBIRD HEIGHTS BLK 3 LT 10
• Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water& Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650 •http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: _ OSP171329 PID Number: 051-721-21 El New •Upgrade Name: WALTER & DEBBIE GOSS ABSORPTION FIELD Address: 0 Deep Trench 0 Shallow Trench 0 Bed 0 Mound 27366 GOSHAWK COURT*CHUGIAK, AK 99567 0 Other Phone: No.of Bedrooms: Soil Rating: Total Depth from original grade. (304)685-1025 4 .FL Ft. Depth to pipe invert from original grade Gravel depth beneath pipe- LEGAL DESCRIPTION FL t Ft. Subdivision: Block: Lot: F81 added above original grade: THUNDERBIRD HEIGHTS 3 10 Ft. Township: Range: Section: - Gravel width: �j Beds Number of lines: Distance between tines: FL Ft. SEPARATION DISTANCES Tota absorption Number of trenches: Dist.between trenches: To Septic Absorption Litt Holding Public/Private From Tank Field Station Tank Sewer Lines S4.Ft Ft. Well N/A - - 25'+ TANK • Septic 0 S.T.E.P. ❑Holding 0 Other -- -- --- Manufacturer: Capacity: Surface Water 100'+ -�=co - - ANCHORAGE TANK 1250 Gal. h Material: Number of compartments: Lot Line 5'+ t} - - N/A STEEL 2 Foundation 5'+ LIFT STATION Curtain Drain NONE KNOWN Manufacturer G.' I Gal. Remarks: PER CONTRACTOR,EXISTING SEPTIC TANK WAS Pump on'level at. -Pump off"level at High water alarm at: ABANDONED IN-PLACE AND FILLED WITH GROUT ON 10/26/2017 Pomp Make S Modal Electrical Inspections performed by: (SEE ATTACHE?). Q.9t p - F- 2 CO W cJ2i f k PIPE MATERIAL S"p °-e;n e....rr TTLON+ c. w' ti-aia.. House to tank D3034 Tank to D3034 drainfield Installer NORTHERN EXCAVATION Drainfield EXISTING CO/MT 03034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Inspection 100.00 F,. Dates: 1st 10/25/2017 2nd - Location and Desorption: 3rd - 4th - TOP OF CONCRETE SLAB @ NE CORNER OF HOUSE ENGINEER'S SEAL Community Development Department Approval �.s•OF `,4_t+ o. Conditional approval: Date: � ' _ ' �ot al ..... jj, ey 49..E • • ic70^�; A. Qa ess c Ws C 793 i p -,c4..,-......4? hia..., c§;,„-, Approved: .i Date: (0 --/ LICENI44h ESS\M�4 #AECC884 M��\\\111* Inspection Report 1-1.12 AOC c PERMIT NUMBER. RECORD DRAWING AVV I N G PARCEL ID NUMBER. OSP 171329 051-721-21 A B C D FCO 50.0 6.2 5.6 31.8 ST1 55.6 9.0 14.1 39.2 ST2 57.5 13.9 13.9 46.8 DBL1 57.8 15.5 23.5 49.1 THUNDERBIRD HEIGHTS.BLOCK 3.LOT 9 DBL2 57.3 15.8 24.0 50.0 APPROXIMATE LOCATION OF KEYBOX PER 1985 INSPECTION REPORT BY JAMES A ROBERTS.P.E. EXISTING 1995 TRENCH NEW 1250 GALLON I 1 STEEL SEPTIC TANK ` k1 I-. CO Op. 1 1 k � k kUo 1 1 'm 1 1 11 0 -(--)C 1 1 " 1 ` m'. ♦ oF� pmt .. 1 1, ` } GOSHAWK CT. W l Dg1VEWPy ��;,�c , 1 6C }1 I I W .� 0 11 5 I .Ao 1 b / / / ill SCALE: I ' 1'=40' THUNDERBIRD HEIGHTS:BLOCK 3,LOT 11 I VACANT, (SERVED BY AWWU WATER&PRIVATE SEPTIC SYSTEM) I T16N 111W SECTION 25 N2SE4 PTN ,- ...,,,,,,,,,,in '', tip GARNESS ENGINEERING GROUP, Ltd (31 .�'_ . CIVIL&ENVIRONMENTAL ENGINEERS % M3701 E TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)3383246'WEBSITE.www.garnessengineenng.ccim R 4 }�'' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: C" 'I/"t GGa(r S : W 1 WALTER & DEBBIE GOSS (304) 685-1025 2 OF 3 �j� C 795 ��". PROJECT/LEGAL DESCRIPTION: DRAWN BY: . ....,,K\,,• :•. TYPE OF WORK: DATE. LICENSE �5,,��r7� RECORD DRAWING 10/30/2017 8AECC884 PERMIT NUMRECORD DRAWING PARCEL ID NUMBER: OSP171329 29 051-721-21 2'INSULATION PER CONTRACTOR FINAL GRADE=98.75-99.10 ST ST2 TOP OF TANK AT INLET-95.70 Q TOP OF TANK AT OUTLET=95.70 i //ffff//////f//ff. f1 �fff/ r NEW 1250 GALLON INVERT OF BUNG AT INLET=95.06 SEPTIC TANK INVERT OF BUNG AT OUTLET=94.91 \l \l 444 ._ OF S.& i9 • A / 1G . ,•I . (FARNESS ENGINEERING GROUP, Ltd ;� . ... CIVIL&ENVIRONMENTAL ENGINEERS • a� 3701 E.TUDOR ROAD,SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)3383246'WEBSITE:www.p9rnessenymeenny.com ;�ke Zr , • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: :• • 1 ;,A. Game s ; -5 WALTER & DEBBIE GOSS �� '� `i (304)685 1025 3 OF 3 �? tr,if. CE 795 PROJECT/LEGAL DESCRIPTION. DRAWN BY: 4 •• 3[••• TYPE TOHUNDERBIRD HEIGHTS; BLOCK 3, LOT 10 RK: DATE:L.K.B. ,�+• ' FESS1�Pi 4• LICENSE ,,1I la\s*r%4� RECORD DRAWING 10/30/2017 *AECC884 i MUNICIPALITY OF ANCHORAGE � On-Site Water & Wastewater Program 1, PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 -, http://www.muni.org/onsite _ 11II (Illt•11I N O ,hcP►G0 On-Site Wastewater Disposal System Permit Permit Number: OSP171329 Effective Date: 10/24/2017 Work Type: SepticTank Upgrade Expiration Date: 10/24/2018 Tax Code Number: 05172121000 Site Legal Address: THUNDERBIRD HEIGHTS BLK 3 LT 10 G:1865 Site Mailing Address: 27366 GOSHAWK CT, Chugiak Owner: GOSS WALTER B & DEBORAH J Lot Size in Sq Ft: 23552 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field II Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15-65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: � � / �+ � Date: I o / 2- ` / 1 Issued By: ie /'LeArk ame-�-if Date: /0/5/1/401 7 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services —� 2 3, 2dllil `fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Suiiivfln On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 051-721-21 Property owner(s) WALTER Sc DEBBIE GOSS Day phone 304-685-1025 Mailing address 27366 GOSHAWK COURT *CHUGIAK, 99567 Site address 27366 GOSHAWK COURT *CHUGIAK, 99567 Legal description (Sub'd, Block & Lot ) THUNDERBIRD HEIGHTS; BLOCK 3, LOT 10 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial ❑ Single Family(SF) Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: St2iS Waiver Fees: Date of Payment: 1O/20/0- Date of Payment: Receipt Number: OSP/ 71329 noc.I2.q r6 Receipt Number: U Permit No. S r f 7`329 Waiver No. (Rev. 01/11) Quanics GARNESS ENGINEERING GROUP, Ltd .L.,,„«.c,T.—«krr ---" CIVIL&ENVIRONMENTAL ENGINEERS e�1er October 23, 2017 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Thunderbird Heights; Block 3, Lot 10 To whom it may concern: The existing 4 bedroom house is served by public water and a private septic system. The existing steel septic tank is 33 years old and located under, or in close proximity to, structural supports for a 2nd story deck with a roof (see attached pictures). We are proposing to fill the existing tank with concrete, connect to the existing sewer line at the foundation cleanout and install a new 1500 gallon steel septic tank. We are 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 as '.tance. In. erely, - r• • . C: ness P.E., M.S. Pre.i• - nt 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179 Fax: (907)338-3246*Website: www.garnessengineering.com 11. N‘ GEG,Ltd.HAS A 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN.TO OBTAIN A COPY OF THE LETTER CONTACT GEG.BY PROCEEDING FORWARD WITH THIS INSTALLATION,THE ENGINEER,WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. /` THUNDERBIRD HEIGHTS;BLOCK 3,LOT 9 VACANT APPROXIMATE LOCATION OF EXISTING TRENCH APPROXIMATE LOCATION OF KEYBOX PER MOA RECORDS PER 1985 INSPECTION REPORT BY JAMES A.ROBERTS,P.E. PROPOSED 1250 GALLON STEEL SEPTIC TANK;INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK .77 EXISTING 12513 GALLON STEEL 1 1 1 1 SEPTIC TANK(UNDER DECK)TO 1 1 BE DECOMMISSIONED AND 1 FILLED WITH CONCRETE ar 1 1 \ 1 1 LU *0 �11 w • ! 1 1 0004 v BEDROOM EXISTING 4 0 GOSHAWK CT. ; 4 • .- , 1� ASSUMED LOCATION OF J HOUSE 1 EXISTING SEWER LINE 1 1 PER MOA RECORDS T it 1 1 1 / jQ' ____ SCALE ........-- 1 1 I VACANT THUNDERBIRD HEIGHTS;BLOCK 3,LOT 11 (SERVED BY AWWU WATER&PRIVATE SEPTIC SYSTEM) I T16N R1W SECTION 25' LN2SE4 PTN 10101"11:el 0 G VI ++sh � of GARNESS ENGINEERING GROUP Ltd • •.•4 .'m CIVIL&ENVIRONMENTAL ENGINEERS / or 3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)3383246'WEBSITE:www.pemeaaen9wteenng cornt...,... ..• � 10 PREPARED FOR: PHONE NUMBER: PAGE NUMBER. ••• f-1 A. Gar -ss `t/i IN WALTER & DEBBIE GOSS (304)685-1025 1 OF 1 A-., ,pi..... C,% E-7953 '� 4 PROJECTiLEGAL DESCRIPTION: DRAWN BY: ( �� THUNDERBIRD HEIGHTS; BLOCK 3, LOT 10 L.K.B. #� p/��'.•. � ..�.�..4+ TYPE OF WORK: DATE: LICENSE,�1 ` ,S`+��� SEPTIC TANK DESIGN 10/23/2017 AECC884 ,� 1 Rhone: Permit Number: .3(.,.J q 5'o ~. I'/ 'Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report PID Number: LEGAL DESCRIPTION Lot: BlOCk: Subdiviaion: Township:. .~-- IRange: WELL: ~.~o~ New ~ Upgrade ca~ Classification (Prwate, A.B,C): Total Dept~: -- SEPARATION DISTANCES Surface Water Lot Line Foundation Cu~ain Drain Remarks: ~ ~ ,,~,.~q,~._.t..._.-~¢..~ .'~.~,~' Wastewater System: n New J~. Upgrade ABSORPTION FIELD E] DeepTrench I~.~haflowTrench n Bed n Mound rl Other Soil Rating: Total Depth/rom_o$iginal grade: 1.~ GPO,SO Ft Oepth to pi~e tx)horn from Original grade: Gravel depth beneath pipe I.S/ Ft /.~. r Ft Fill added above original grade: Gravel length: o.(J/- I.~" Ft. ,~' Ft Gravel width: ~ / Ft Numper of~ lines:ii Oislance~.twee~ I~nes:Ft Total absorption area: Pipe material: ~a,~>TIM~- ~1. sc, F,~ ~o/z~5'/ InstalleC"r'~E~r]o ~-)c'C. Date installed: ~.. /~ ~-'~'~"" ~x,sr/~'~, TANK 3[~.Septic [] Holding ~ PubllC/~Hvat $ Manufacturer: ~ in gallons: . Number of Compartments: LIFT STATION "Pump on' level at: ~ I High water alarm at: EIoctrtcal Inspections performed by: BENCH MARK LOCation and Description: S & S ENGINEERING 17034 Eagle River Loop Read, No. 204 Inspections performed II~le Rlvar, AI.~,- ~s~ Dates: 1st D ~ m ~"~) 2nd g-lu-q~' epartment of Health~Hu ~an~ees an~al Reviewed and approved by: ~~~~at~~ F) Permit No. SW950217 Page 2 of' 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 bn-Site Wastewater Disposal System and/or Well Inspection Report LegalDescrtptionL:OT 10, BLOCK 3, THUNDERBIRD HEIGHTS S/D PiDNo.:0517212! g 1250 GAL · FINAL CRADE ~ MT1.]~,~'~7'5' ' D~'$U[~TION ~ . 95 4.-/~. FCO 5' STI 9' 5 $T2 1 6' ......"001' 18' C02 21' C05 55' 0 GAL C04 76' EXISTING SYSTEM , · 7-28-95 48' 49' bl' 52' 53' 85' 47' 48' PAGE I OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW950217 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:RIESS L PAUL & SUSAN S OWNER ADDRESS:27366 GOSHAWK CT DATE ISSUED: 8/14/95 EXPIRATION DATE: 8/14/96 PARCEL ID:05172121 LEGAL DESCRIPTION: THUNDERBIRD HEIGHTS BLK 3 LT 10 LOT SIZE: 23552 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: DATE: ~-~/~-- ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS July 31, 1995 (907}694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, ~%K. 99519 REFERENCE: Lot 10; Block 3; Thunderbird Heights S/D RON}DESIGN Request you issue a per~2 to upgrade the septic system serving the four bedroom house on the referenced proper~y. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation, water was encountered at 7 feet in the test hole and after seven day ground water monitoring, water was found at 7 feet. Attached is the proposed upgrade design This property is served by a Community Water System. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RNER, ALASKA 99577 I LEOALLoT 10, BLOCK IDR^WND.H.L. DESIGN CRITERIA: 4 BDRMS = 600 GPD SOILS = 1.20PD/SQ.FT. 600/1.2 = 500 SQ.I REDUCTION THUNDERBIRD HEIGHTS S/D cAD' R.C.C. J DATE7--31 --95 J SHT'I OF 1 STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS-BUILT SURVEY DRAWN BY: ROBERT C. JOHNSON IT IS THE RESPONSIBILTY OF THE CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO CONSTRUCTION. TRENCH DESIG ?-.' DEEP 1,5-. EFFECTIVE 5' WIDE '7~,' LONG ~ 250KG~ / '/~/ £ X I S~TI~ O¢o~SY~-~S,T E U-J ALL PORTIONS OF WITH ~SS THAN 3[~,-~- CO~R REQUIRE INSU~TION. CONTRACTOR IS REOUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION WORK. THIS PROPERTY SERVED BY COMMUNITY WATER SERVICE TRENCH CLIENT Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 11- 12- WAS GROUND WATER ENCOUNTERED? ~[~-~ S IF YES. AT WHAT ~ L DEPTH? ~/ 0 P (E,~. k/Ik ~ &) Township, Range, Section: SLOPE SITE PLAN N 13 - Moflit~rin6? . ~ . ~,1~ '"~o'2-'6 "ct~" 14 - Reading Date Gross Net Depth to Net Time Time Water Drop 16 - t "/-"7.J. -.~ ~' ~- ~' 'Z. '/a, ' 17- '~ ~ ?_. ~,~, 18 - 5- '-" ~ '"'-" ~'/'~' 19- 20- PERCOLATION RATE ~ Im~nutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN '~ ~'' FTAND '~'~"' FT COMMENTS S $ ENGINEERING PERFORMED BY: I 1~-'/x,~. ,~ b,,~.~ CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop R~d No. 2~~ ~t ~ ACGORDANCE WiTH ~~~UIDELINE5 IN EFFEGT ON THIS DAT~ DATE: 72~ (R~. 4/~) Page Two Lot 10, Block 3, July 31, 1995 Thunderbird Heights S/D Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INST~?3.%TION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. me Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. e Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 10, Block 3, Thunderbird Heights S/D July 31, 1995 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: TvDe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. e All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 10, Block 3, July 31, 1995 Thunderbird Heights S/D INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be hackfilled before this inspection. me The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will he more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S &. S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 10, Block 3, Thunderbird Heights S/D July 31, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INST~?~.ER NAME ~ MUNICIPALITY OF ANCHORAGE '- DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION DISTA N C E~TO: Well Manufacturer Material DISTANCE TO: II Wet' '~/~' , TotaIF°undati°n ~. ~length of lines Nearest lot hn, No. of lines Length of each llne Trench width Top of t*le to finish grade ~ / Material ~neath ti~e Length Wadth Depth Type of crib Crib diameter Crib depth Total ef f~ti~ absorption area Well Building foundation Nearest lot line OISTANCE TO: Class Depth Driller D~stance to lot line DISTANCE TO: Building foundation S~e~ line Septic rank LOCATION Absorption area No. oP SEO.OOUS D~lling ~ PERMIT NO. Material No. of compa~ments Inside length Width Liquid depth Dwelling PERMIT NO. inches Liquid capacity in gallons PERMIT NO. PERMIT NO. OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 72-013 (Rev. 3/78) DATE LEGAL HJ.'tV~H JO 'ld3O ~' .dI~CIPALIYY OF ANCHORAGE DEPARTME.T OF HEALTH AND ENVIRONMENTAL PROTECTION B25 L STREET, ANCHORAGE, AK ~501 PERMIT NO: 840310 DATE ISSUED: 05/0?/84 APPLICANT: ADDRESS:. CONTACT PHONE: PAUL MILLER 129 TOAKOANA EAGLE RIVER, 694-9302 LEGAL DESCRIP: sUBDIVISION: THUNDERBIRD HTS. LOT: SECTION: 25 TOWNSHIP: LOT SIZE: 22000 (SQ. FT. OR ACRES) MAX BEDROOMS: 4 BLOCK: LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU SYSTEM. CHOOSE' THE OPTION THAT BEST FITS YOUR SITE. TRENCH BEE> IN DEE~GNING YOUR SEPTIC mtmm [4. DRAIN 'DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 ~ORflVEL DEPTH (FT.)' 4.0 0.5 3.0 :,TOTAL DEPTH'(FT.) ,~.0' 4.5 ' 7.0 ~.GRRVEL WID~H'(FT. > 2.5 .20.0 5.0' IGRAVEL LENGTH (FT.) ' 63:0 , 38. 0 59. 0 t G~RVEL VOLOME (CU. YDS. TANK SIZE <GALS) 1,250.0 ** i, 250.0 ** i, 250.0 ** SOIL RATING (SQ. FT./BR) ,i25 TANK NUST HAVE AT LEAST TWO COMPARTMENTS CERTIFY THAT: i. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS,AND WELLS 2. IF R THEN WILL ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. & ISSUED BY DATE: AS SET FORTH BY THE MUNICIPALITY Of ANCHORAGE (MOA) AND THE STATE OF ALASKR. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AND REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREmeNTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR PUBLIC -. SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. I UNDERSTAND THAT THIS PERMIT IS VALID FOR R MAXIMUM OF 4 BEDROOMS~AND ANY ENLARGEMENT WILL REQUIRE jAN ADDITIONAL PERMIT. LIFT STATION IS INSTALLED IN AN RRER COVERED BV MOA BUILDING CODES, (i) RN ELECTRICAL PERMIT AND INSPECTION MUST BE 08TRINED~ (2) RS-BUILTS NOT BE APPROVED WITHOUT RN ELECTRICAL INSPECTION REPORT; AND (3) THE unicip li o nchor e 825 'L' STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 G~ORGE M. SULLIVAN, MA YOF~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31~ 1980 Mark Simmons 211 North Bliss Anchorage, Alaska 99504 Permit f 800009 Subject: Lot 10 Block 3 Thunderbird Heights Subdivision A permit issued by this department for well.and/or sewer system has expired as of this date. 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 an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, / / /~ Les N. Buchholz, R.S.///. Senior Environmental ~cialist LNB/ljw enc: Copy of Permit SWP/057 r-lLl~-~ I iD 1 .-'AL I T'T' OF FI~',I CF DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 ~L~ STREET, ANCHORAGE, ~K. 99501 2~4-4~20 SEI-IER PEa:r4 I T OI'-.I--S T TE F'ERMIT N0. ( 888809 ) APPLICANT MARK SIMMONS -"!1 I',1. LOCAT I ON CHUG I AK LEGRL ~LT. 10 E:LK. _-.'~ THUNDERBIRD. HTS.~ TYPE OF SOIL ~BSORPTION SMSTEM IS: TRENCH LOT SIZE 2~00 SQUARE FEET rtRxIrIUM NUMBER OF E:EDROOMS = ~ SOIL RATING (SO FT?BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEF'TH= :~:: LE~iGTF-t= ~--2 GRR'-..'EL B. EPTH= 4 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TREHCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IH FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GR~'Y'EL DEPTH IS THE MIHIMUM DEPTH OF GR~YEL BETHEEN THE OUTFALL F'IPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTRLLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THaT THE HELL WILL SERVE. TL-IO ( 2 ;, I [-~SF'ECT I E~[-~S I IRE REQI_I I F:ED BRCKFILLING OF ANY SYSTEM HITHOUT FINAL IHSF'ECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIrtUM DISTRHCE BETI.IEEN R WELL AND ANY ON-SITE SEWAGE [:,ISPOSFtL SYSTEM IS lO0 FEET FOR F~ PRIVATE WELL OR :LSO TO 200 FEET FROM A PUBLIC WELL DEPEHDING UPQN THE TYPE OF PUBLIC HELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRLICTIQN DIAARFff. IS ARE AVAILABLE TO INSURE PROPER INSTALLRTION. PERt1 I T E.'=-~ F' I RES ~--.Ew~_-Et'IBER --~--~-~1-- I CERTIFY THAT l: I RM FRMILIRR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AND HELLS RS SET FORTH BY THE MUNICIPALITY OF RHCHORRGE. 2: I HILL IHSTRLL THE SYSTEM IN RCCOR[:,RNCE WITH THE CODES. ~: I UNDERSTAND THRT THE ON-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO IHCLUDE MORE THRN 3 BEDROOMS. ; .-. ' 0 & E ENG,NEERING & DEvELO,'~'~,vlENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Ruuell O¥8ler 694-2774 Performed for:. Legal Description: Depth (feet) SOIL LOG 16, ~c~ 5. Soil Characterl8llca Earl EI]Ie 688-2280 Tel. No.S~ 3-~ -~547 0 1 2__ 3~ 4__ 5~ 6__ 7__ 8 9 10__ 11 12 13 PLOT PLAN PERC. TEST 141 15__ 16__ Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: No ~ If yes, what depth Drain Field Performed by: //~/-,/~/~,~_,~/c~ Rick Mystrorn. Mayor ' ' of Anchorage Munic palit). Department of Health and Human Services 825 %" Street P.O, Box 196650 Anchorage. Alaska 99519-6650 September 1, 1995 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 10 Block 3 Thunderbird Heights Waiver Request #WR950041, PID #051-721-21, SW950217 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between a septic system and a lot line has been approved. The. waived distance is 3 feet from the leachfield to the property line. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Civil Engineer On-site Services RWR/ljm MUNICIPALITY OF ANCHORAG.~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# ~ ,%~9~ PID# 051-721-21 HA# Date Received: August 25, 1995 Permit #SW950217 Legal Description: Engineer: Robert C. Lot 10 Block 3 Thunderbird Heiqhts Cowan, P.E., S & S Enqineerinq 17034 Eagle River Loop Road, Suite 204, Eagle River 99577 Applicant: Paul & Susan Riess Waiver Requested: Lot line waiver of 3 the property line. feet from the leachfield to Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient e Points: E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is G.ranted: ~ Waiver is NOT Granted: List Conditions or ~eas~ns for. above: -~ ~Name of Reviewer Rec #: #01245/2597 Amount: $ 115.00 Date Paid: 8-25-95 August 23, 1995 ROBERT C. COWAN, P.E. ROBERTA. SHARER, RE. CML ENGINEERS (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED AUG 2 4 1995 Municipah,,y ol Anchorage Dept. Hea~th & Human Services REFERENCE: Lot 10 Block 3 Thunderbird Heights Subdivision Request you issue a Health Authority Approval on the referenced pr0pgrty and grant a waiver for the.horizontal separation'distance between the new leachfield and the property line at 3 ft. Due to site conditions and the elevation from the septic tank to the upgrade leachfleld we were unable to maintain a 10 foot separation. We do not anticipate any adverse affects on the adjacent properties. The Property line is adjacent to the Chugach State Park. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. MUNICJPAUTY OF ANCHORAGE ENVIRONMENTAL SERVICEs DIVISION 1995 RECEIVED 17034 NORTH EAGLE RIVER LOOP · SUFTE 204 * EAGLE RIVER. ALASKA 99577 I D 3©c4- 7897p - Ef.r+-� U E. BLS _ Municipality of Anchora�j „r% On-Site Water and Wastewater Program Oir31 -2017 1 (907) 343-7904 4.wQ ,-/A r E T Y Certificate of On-Site Systems Approva ` is 3 I. ° Parcel I.D. 051-721-21 Expiration Date: X)r 3 1 -l 1 1. GENERAL INFORMATION: Complete legal description Thunderbird Heights; Block 3,Lot 10 Location (site address) 27366 Goshawk Court*Chuaiak,AK 99567 Current Property owner(s) Walter&Debbie Goss Day phone (304)685-1025 Mailing address Real Estate Agent Kelleigh Shea Day phone 301-5873 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex 0 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: 7 Received by: • -�✓ ✓`f Date: 1 9 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ V-1 L Co° Waiver Fee $ Date of Payment 16/310- Date of Payment Receipt Number 61-1 I/5(j Receipt Number COSA# 0 0,171511 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Qoaoop�q In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system4 � OF 4 in accordance with the guidelines and regulations established by the Municipality of Anchorage and ��•.• industry practices. The reported results describe the condition of the system/s on the date/s of the O evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ' 4 * T , �. y„A encroachments may exist that were not identified during the evaluation. The operational life of all wells r *VD and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0' groundwater levels (that may fluctuate during the year), quality of construction (materials and 4 - Q workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and /.. Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / ..f -y . ness. system/s; therefore. GEG makes no warranty(express or implied) regarding the future performance of (//) 'CE—l 95 opt the well or septic system. GEG makes no representation whether an alternative well or septic system 00'f • 1/.1. .ceQ . can be installed on the property in the event either of the current systems fail to perform adequately in 4 P •a•0.f• '• �0p the future. The content of this report is for the sole benefit of the person/party that retained GEG to ' Pro fessloc\o\ perform the evaluation. Reliance upon the information provided in this report by any other person or sOOpao�� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE System #1 Approved for ``t bedrooms System #2 Approved for bedrooms ` \Qp. Y • Disapproved ON-SIT S F V Conditional approval for bedrooms, with the follog I iiAND ►T. • PROGRAMEWATER <= 8ERvac Original Certificate Date: -/ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist / Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other • COSA blue sheet_1 o-1412.doc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Thunderbird Heights; Block 3, Lot 10 Parcel ID: 051-721-21 A. WELL DATA AWWU Well type If A. B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (abo - .round) in. FROM WELL LOG AT IN ' CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESU Coliform colonies/100 ml. Nitrate mg./L. Collected by: :-nic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/25/2017 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A Date of pumping New Pumper — C. ABSORPTION FIELD DATA 'Below Existing Grade at MT Date installed 8/15-16/1995 Soil rating .p.d_/f or ft-/bdrm) 1.2 System type Shallow Trench Length 83 ft. Width 5 ft. Gravel below pipe 1.5 ft. Total depth *3.7+ ft. Eff. absorption area 532 ft` Monitoring tube**Yes Depression over field No Date of adequacy test 10/16/2017 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added **620 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — **New MT (driven into drainfield by ARM Services, LLC) extends approximately 42" below invert of lateral. ***Test run immediatley following 2,000 gallon pre—soak. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circui -.uirements? E. SEPARATION DISTANCES AWWU SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /se. - ervice line Holding tank mal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line5'+ Absorption field 5'+ Water main - 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *3'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots "100'4- F. *100'+F. COMMENTS *WR#950041 **Per AWWU wetlands/stream mapping oo�Op�`' G. ENGINEER'S CERTIFICATION v�� OF 'Q %% Oho P_.• . •S•--570 I certify that I have determined through field inspections and * • 49-T', * review of Municipal records that the above systems are inVA conformance with MOA COSA guidelines in effect on this date. / • - r , • Gam-ss.: Engineer's Printed Name JEFFREY A. GARNESS /O 9• • •• uE-79 op Date '4' ,, .t• 4.3.l .1,r ‘ovo '°rsst(P ofeo �P��00000�� #AECC884 (Rev. 11/05) 4. . , • ,,, • . .\„. , , q, ..„..., ,. , vx 51 • ° b O • U7 M 3 la UTILITY EASEMENT ° 8 'I- ,;;;'m ba m O • D -O Z (Si nS �CP` � � o.--1 YN0 M ASPHVR1VE . � ,F GOSHAWK W � �Po � COURT s II 1 .o' p h 64, 0,>+ 7$,, 1.y '43?' w 44 OO ,gyp. 3� 56 Qo400p%‘, --.. #OF At oQ cS'�� o'.r. 41 . 000 A* . 49THin: * a � v AS-BUILT SURVEY 1" = 30 ' 05 si. fig o Q a . o d NO CORNERS SET THIS DATE Vir- SHANE A HOLT �e00 VV s 040 so. .' L5-891 a�oO I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY 4�p`0jeae+oael�Qc SURVEY DQE ORDERED BY OF THE FOLLOWING DESCRIBED PROPERTY %�DOoO�Qo KELLER WILLIAMS LOT 10, BLOCK 1, THUNDERBIRD HEIGHTS SUB OCTOBER 25.2017 ( PLAT 77-226) ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS;AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES,IMPROVEMENTS,OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD,OTHER THAN THOSE APPEARING ON THE RECORD PLAT,ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON(UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA LASKA THIS 26TH DAY OF NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. _OCTOBER , 2017 HOLT LANG SURVEYING ANY PAVING SHOWN HEREON MAY RE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. • 9309 GROVER DRIVE \\` ANCHORAGE,AK 99607 13746, FB 186-3 345-551.3 I y 3aa- 5678970 `,a .Gy0 'Shit . v Municipality of Anchora ,= r 3:t `41:‘,) rT.. A On-Site Water and Wastewater Program ,$1� 1 2017 (907) 343-7904 ' Certificate of On-Site Systems A ppro a 8 et 9 ca� Parcel I.D. 051-721-21 Expiration Date: )(0'3 1 1. GENERAL INFORMATION: Complete legal description Thunderbird Heights; Block 3, Lot 10 Location (site address) 27366 Goshawk Court*Chugiak, AK 99567 Current Property owner(s) Walter&Debbie Goss Day phone (304)685-1025 Mailing address Real Estate Agent Kelleioh Shea Day phone 301-5873 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: I � Received by: `��/ �I-�" Date: 10 /3 I // COSA to be released to the engineer,unless otherwise requested by the engineer, COSA Fee $ U r- C 0 Waiver Fee $ Date of Payment lb/310.- Date of Payment Receipt Number OLi (15( Receipt Number COSA# JCl-7-!571 Waiver# · ~ 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. # O51-721-21~ HAA # 1. GENERAL INFORMATION Complete legal description [,ot 10, Block 3, Thunderb~.rd Retghts Location (site.address or directions) 27366 Goshauk Court Property owner ott Price · Mailing address · 27366 Goshawk Court, Day phone 99567 Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ~, Day phone Day phone TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water 688-4036 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Comm'unity on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validati0r~ date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewa!e[ 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 ?egulations in effect on the date of this inspection. Name of Firm s & s ENGINEERING Phone 6 q '-/- ~-,~ '7 ~'] 17034 Eagle River Loop Road No. 204 Address F=gle Rlv~ty~ Alaska 99,~7'/ . Engineer's signature ..)//~'/~//,~?z' / ~ Date 5" /.~ / a~ c~ ... C ; .."- .O.._'~h 6. DHHS SIGNATURE ~l~ cO-.'~ ............ ~ Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 engineer's work. Municipality of Anchorage DEP^RT EN Or HE^LTH & HU . SE.V,C S Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 Health Authority Approval Checldist A. WEII DATA Wall ty~e ~/~.~s,/~4//,e i T~ I~ B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~/ Date completed Total depth Cased to C~bove ground) Sanitan/seal (Y/N) /..~$ properly pmtectad (Y/N) · FROM WELL LOG / AT INSPECTION Date of test Static water level Well production J g.p.m, g.p.m. WATER SAMPLE~JLT$: C~aal;f;~samr/~a'. Nitra~ Ccllec~e d by: Other bacteria B. SEPTICJNOLDING TANK DATA Foundation cleanout (Y/N) V~-.~ Depmsalon (Y/N) ,/~ High water alarm (Y~ ¢. ABSORPTION FIELD DATA · ~ Length ~:~ ~ / Width Gravel thickness below pipe /, ~' / Total depth ¥ Fluid depth In absorption field before test (in.);~.~_~ Immediately affer~/~ gal. water added (In.): Fluiddepth ~// (ins)Minutes later:. ,/.'~'" Absorplionrate = ~'JD Od- .g.p.d. Pen=Jdetmstment (past 12 months) (y/N) /%//.) /v ~. If yes, give date -' 72-026 (Rev. W96)° D, UFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested SEPARATION DISTANCES 'Pump off" level at' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~On adjacent lots Absorption field on lot Public sewer main SEPARATION DISTANCES FROM SEPTIC,/H~i~I~d~ TANK ON LOTTO: Foundation "~ / Property line ~'":~ / Absorption field Water malrVse~ce Ilne/<~/''/' Surlace water/drainage Public sewer manhole/cleanout Wells on adjacent lots R SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Probertylln, 3 (~,~5"0~ ~ulldlngfoundation"'~jg:-"~;~J~'L ~*~'/Watermaln/servicellne Surface water /('2~'~ '~ Driveway, parking/vehicle storage area ~ '~' ENGINEER'S CERTIFICATION ~.~,Cll?~_ _ ~.,,. ' in ~n~ ~ MOA ~ ~idellnes ~ eff~ ~ ~is ~re. ~ / ~,~ ~ .~'Y, ~ Da~ -- -- - / 7 v ~j?. ',., . ·. '.. ~- -~ , D - .::.:...:"_ ... :., ', ~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. oJ-- Waiver Fee $ Date of Payment Receipt Number 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description . Location (site address or directions) 57566 Go~k Co,,~ 'Proi~erty owner ' Lou.,~ 1~.~.~6 Day phone Mailing address C/0 R~c~. E6~tte S~ppo~. Suc~. 8500 Hu~bold~ AIls. S Su.~,~e. 204 · · I~Jut~po/5~, MN 55451 Lending agency Day phone "_.~.Mailing address Agent -'" Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 / Individual well Community well ~/NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legahty and status of system. e 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. 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 inves.ti.,qation 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 S & S ENGINEERING Phone I/u.14 Eagle RIwr L,oep Road No. 21)4 Address ~ Rlwr, Alaska Engineer's signature '"~/~ .~-~'-~-.- Date ~"/;.-,/'/qS"' Se DHHS SIGNATURE ._~ Approved for Disapproved. bedrooms. __ Conditional approval for 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 engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L' Street, Room 502 · Anchorage. Alaska 99501· (907) 343-4744 Health Authority Approval Checklist I.,cgaIDcscfiption: Lor lO, ~oc~ 5, ~o-o~s,ev [fi'5 ~'/v Parccll. D.: 0~1'7,?1~1 A. WELL DATA wen t>,c Log present (Y/10 Total depth Sanitary se. al (Y/N) Date of test Static water Icvcl Well production WATER SAMPL~ If ~B, or C, attach ADEC letter. ADEC x~ter ~stem numbcr ::~ ~ I I t~'~ Date complcted Cased to Wires propcrly~ §.p.m. g.p.m. Nitrate Other ba~eria Collected by: B. SEPIICJIIOLDING TANK DATA Date installcd Foun,..datlon cleanout ~ V~-'~ Dcpression (Y~[) '"' : Y ~ DatcofPumping M~ I~¥l~q5' Pumpcr ~"'~' ' F r C. ABSORPTION FIELD DATA '.Date instali~l ¢'1¢"-t~'':'' Effective absorption area Date of adequacy tcst ,'J,/~- Fluid depth in absorption field before test (in.); Fluid depth Minutes later: NumberofCompartments ~ Clca~outs(~t, Oyc~ High x~=ter alarm (Y/~ /,,Jo Soil ratin~r ft:&drm) (.~- System Grovel thickness Ix:low pipe I,~' ' Total depth Monitoring Tube pmsent(~q) ~te'~ Depression over field (Y,~ Results (Pass/Fail) For bedrooms . Immediately after "---rial. water added (in.):"---- (in.) Absorption rate = ~ g.p.d. Peroxide treatment (past 12 months) (Y/N) -- ffyes, give date -.------ LllVr STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons ~ ~'Pump on" level a '.~R~~mp off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot __ AbsOrption field on lot · Public sewer main ~ .~esv~, Iscpuc scnnce linc On adjacent lots On adjacent lots ~P-.sffMic'~wer manhole./cleanout Lift station SEP.~R,~TION DISTANCES FROM SEPTI~ TANK ON LOTTO: Foundation .../t Property line ~ ~ t Absorption field Water muin/~e~ice line lo + Surfac~ water/drainage leo ~- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Building foundation Zffl ' Surface water Ioo '4. Curtain drain t4o~- K~to~ d Water main/scrvice line /O ti' Drivex~ay, parking/vehicle storage area Wells on adjacent lots 30~ ~ Fe ENGINEER'S CERTIFICATION ~certifyt~at~ ha~e detern~inedthru~e~d~nspec~nsandreview~fMunicipa~recc~ee'a~&.~.y~e in conformance with 3,10~ [L4,4 £uidelines)n effect on this date. Date of Payment ~' ~'~dT/- Fc3'---- Receil3tNumber /gY Rev. 8/95 OSS: haa.wk.doc Waiver FCC $ //~ ~ Date ofpuymcnt ~?" ~'~ff~'- Receipt Number MUNICIPALITY OF ANCIIORAG~ DIVISION OF ENVIR0~NTAL H~ALTH DEPARTMENT OF HZALTH AND ENVIROR~kL FROTECTION APPLXCATXON FOR HEALTH AUTHORITY APPROVAL CERTIFXCATE l. Ceneral Infor~ation Application Date ia) Legal Description (inc.lude lot, block, subdivision, sec?ion, to~mship, range) Location (address or directions) (b) Applicauts Name Telephone - Nome Business d,'?~- ~, ?~;~ (c) Applicant is (¢hec~ one) Lending Institu~ion ~-~ ~ Ow~er/builder~.~ (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Hail the HAA to the follo~rlng address: 2. Type of Residence $ingle-~amily~ Number o£ ~edrooms Hulti-Family~ Other (describe) Note: If community ~11 system, must have ~itten codimatiou from the State Department of gnvtromental Couse~ation attestl~ to the legality aM status. 4. Sewage Disposal Onsite~ Public~ CommunitY F-q Holding Tank~ Note: If community ~ell system, must have written con~ir~ation from the State Department of gnviror~ental Conservation attesting to the legality and status. [Page I of 2] Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval sho~ that the on-site water supply and/or ~-astewater 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 ~rater supply and/or %rastewater disposal system is in compliance %rlth all Municipal and State codes, ordinances, and regula- tions in effect on the dace of this inspection, Name of Firm //~.~-~-'- 0. 'ff/;/~.~.. /~' ..~...~/_-; Telephone ~,~:.'% .-./,-.:~,/ '~ Address 'Id--''-' ~I? ~'~;-~..~-~."..~ -~.~/ ~;~z~ ~. ~,~.~. ~ g/~-~'~ % DHEP Approval '~ ~. ~-1516 /~/ Approved. ~ Disapproved Co~ ~ ~O Terms of Conditional Approval CAUTION T~LE MUNICIPALITY OF AHCIIO~IGE DEPARTMENT' OF [~3.%LTH kND ENVIRO~EhTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPIt $ ABOVE BY ~N INDEPENDENT PROFES$IO~%L ENGI[~ER REGISTERED IN THE STATE OF ALASKA. THE E~IEP DOES THIS AS A COUt~TESY TO PURCIIASERS OF EOMES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. ~'HPLOYEES OF ~IEP DO NOT COI~UCT INSPECTIONS OR ~NALYZE DATA BEFORE A CERTIFICATE IS ISSUED. T~E MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBL~ FOR ERRORS O~ OMISSIOL~ IN ~ PROFESSIONAL ENGINEEK'S WORK. (DHEP SEAL) RR4/eJ/DI8 [Page 2 of 2] 7-19 DEPT. OF ENVIRONMENTAL CONSERVATION SOUTHCE;4T~AL REGIONAL OFFICE 457 "E" STREET° SUITE 200 ~NCHO,RAGE, ALASKA 99501 BILL SHEFFIELD, ~uOVERNOR Telephone: (907) ,4ddress: 274-2533 To Whom It t~y Concern:l f~p~ /i~--/j~/~_~ Water System Is in compliance with the State Ormnking ' Water Regulations. '.. Sincerely, MUNICIPALITY (F ;%NODR~E (MOA) HFALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. ~ [1%TA Well C~_a--sif icatio~ At Well Lo~ Present (Y/N) ~W Total Depth Static ~ater Le~sl Cased to Pump Set At Casing Hsight Abo~ Ground Elect=leal Wiring in Conduit (Y/N) Separation Distancss f~ Wsll: To Septic/Holding Tank cn Lot To Nearest m~ Of A~tion Field on Lot To Nee=est Public Sewer Line Water Sample Collected By Water Sample Test Bssults Depth of G~outing Sanitary Seal on o*~ing (Y/N) De[=ession Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewsr Servi~e Line on Lot / [PaGe 1' of 21 ::', ' 2-15-84 C. ABSOI~PTIGN FIELD E~TA Soils Rating in Absorption Strata Date Installsd Width of Field Squaxe Feet of A~tion A~ea Dap~essio~ over Field (Y/N) ,~ Results of Last Adequacy 7~st Date Installed Sizs in Gallons "Pump On" Level at Hi~ ~ter Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) ~ Off" Level at Vent (Y/N) Pumping Cycles ck~ing Adequacy ~st. ** Check Permitted Bedroom Rating A~ainst HAA Raqusst I certify that I have ~hscksd, verified, c~ confc~d to all ~DA HAA Guidalines in effect [Pa9~ 2 of 2] 2-15-84