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HomeMy WebLinkAboutSUN VALLEY NORTH BLK 4 LT 3Sun Valley North Block 4 Lot 3 #050-652-16 U Municipality of Anchorage Development Services Department = "' Building Safety Division • . k . On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.chanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. �WCQ®O33 PID Number: CSO_t5�a-11� Name�!_OMs, `� J I'� Ao �j l e PO�/_ Wastewater System: t� New F! Upgrade Add ass /", ��,W L q' /�/ !�)ABSORPTION FIELD ]0?al Lbl(y/Ylac(�so� Ck, tg,ek;lverl/K gW77 Phone: Number of Bedrooms: p Deep Trench kShallow Trench ❑Bed ❑Mound ❑ Other. Sal Rating: (/�' Total Depth from adginat grade: LEGAL DESCRIPTION i 0r 6GPDIF' 3,5.- Block- - Ft. Block: ) ' Lot: °'-� Subdivision,/ i) rl / 1 ..j./ Depth ro pipe bottom Iran original grade: Gravel depth beneath pipe: y{• J` 7f/iV�% UQ((JeyNi%II/'^/ a-7 FL Ft. Township: Range: section Fill added above original grade: + G�Lengt7h:`� J/�j 'r Ft. 5 - 1 V 6 Ft. Gravel width Number Ynes: Distance between lines: Well: New ❑ Upgrade .5 Ft_ ' 1 1-7 FL Classificatiop (Private, B, C): Total Depth Cased to:)IIFl Total absorption area 757re P' FM 5m I ' I 303 /`916 Driller. Date Drilled: Static Water Level Ft Insta!er Date Installed: ��®—Q� St il/01 r Lidef �0� 6- �-Dd 105 S Yield: P/u MPS tat Casing Height Above CtmtLnd TANK �D GPM/ �n Vlowel Ft. C; FL SEPARATION DISTANCES ❑ Septic I] Holding VS.T.E.P. ❑ Other: To Septic Absorption Lift Holding Public/Private Ma V1 urer. Capac ty From Tank Field Station Tank Sewer line A,//G�� a /J �Q n ' � 5©Gal. /�/tyr /) 1 '/�]( ��� blaterial:� rO +' Number of Compartments: Well Q 1 t l 67, l 1, ���-I}C�CO.- Surface Water 1001+ I � f I (Ay.) +1 \ LIFT STATION , Size: Ma aaure. Lot Line 110, � 1 1 6 � � �� Gal. 11411 11 A) � 14i4 k ` f 'Pump on' level at: 'Pump otr level at: High water alarm at: Foundation 1 a 64' 1•L 1 a` 1 qa in. 3a in T� in. 1y' Pump Make & Model Electrical Inspections performed by Curtain Drain �/10 A y110�'dl �-' Q�1 D�� ALL-' K-00 Ac.45-,c.q fir-�C Remarks: �����llllll//////,, 11CC�i 1 ` I l BENCH MARK Location and Description Ass mevasion: 1,0C) Ft. Engineers Stamp S & 5 ENGINEERING £� , n g �"� g-0�' Inspections performed by: 17034 Eagle River Loop Road, p0.204 5t Dates: 1V. Eagle River, Alaska 99577 2nd Development S rvices Department Approval` ' •••-�- f Reviewed and approved by: Date: //�©� $`E m� �� _�5 PERMIT No. SW020033 PAGE 2 OF 3 Municipatit of Archorag_e DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P Box 196650 •Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 4, SUN VALLEY NORTH S/D P.I.D. NO. 050-652-16 100' WELL RADIUS x J � � l , , , GRAVEL DRIVE LOT 2 M STH#Z 10' MIN. i#1 "\' SEPT AREA LOT 4 3 --NEW TRENCHES SCALE: 1" = 50' ��•/ all A amzsaHbO�����8 r zwf PERMIT NG. SW020033 PAGE 3 OF 3 Muni palit c ArEhorace DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.G. Box 196650 0Arc: horage, Atask a 99519-6650 • Telephcne 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 4, SUN VALLEY NORTH S/D P.1.D. No. 050-652-16 ST1 ST2 93.4' FINAL GRADE MH -2" INSULATION 9 NEW 1250 GALLON S. T. E. P. SYSTEM MT3 MT4 MT1 MT2 105.8' 106.4' 102.6' - - -102.5" �iFINAL GRADE / ,,,"2'7 2„ INSULATION DISTRBUTON PPE 103.2'- S -' SRR 00.0' MT3 == 1.01.2' MT4 = 101.2' � MT2 - 98.0' MTI = 98.0' - WATER FOUND @ 92.0' 88.5' B.O.H. N. T. S. A B FCO 17.3' 1 4.0' ST1 21.5' 19.5' ST2 25.5' 24.0' MH 27.0' 26.0' MT1 80.0' 66.0' MT2 122.0' 115.0' MT3 90.0' 70.5' MT4 126.0' 114.5' WATER FOUND @ 92.0' 88.5' B.O.H. N. T. S. .Jan 13 03 07:46a P. r AZAf�"� ELEGTf?Ic.� L e Olt /a4,er4erl; A MA Ac, e w,.T, January 13, 2003 M2CI, Inc. (Builder/Seller) Chugiak, AK (907) 689-3403 fax RE: Lot 3, Block 4 - Sim Valley North 'I'o whom it may concern: The lift station at lot 3, block 4 - Sun Valley North subdivision was inspected and tested by a licensed electrician and meets all requirements of the national electric code. Please reference the following license numbers: Electrical License number for Martin D. Bi own: 19991557 - State of Alaska Contractor's License number: 27843 -- State of Alaska I certify this information to be true and correct. Sincerely, ALLIED ALASKA ELECTRIC, LLC Martin D. Brown, Owner 61 I I_ P.O. Box 876310, Wasilla. Alaska 99687 Office (907) 373-3893 / Cell 232_8687/ Fwc 373-3894 CUtt"filtb Drifting IL09 by DOC CO. dba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2750 OWNER OF LAND: � r /L o Y f z- (✓C1Cj-17 4.1'1/ ADDRESS: t LEGAL DESCRIPTION: J j A t.i44.4.4 V DEPTH DATE: (-"� �G f._ 00 '�" To PERMIT NUMBEF(: !?cC}03 J _ Dale of Issue .._'i _. _/.._. - O_ TAX IDENTIFICATION NUMBER: {);E -- Is well located at approved permit location? -16s U No I Method of Drilling: � air rotary U cable tool Depth of well: l (. l Casing Type f 7 F i:4Wall Thickness inches r Diameter / inches, depth feet Liner Type: (nI `� "`�tZ r , Casing Stickup Above Ground: feet Static Water Level: l U T - feet Recover Rate: / 0 gpm Method of Testing: / Well Intake Opening Type: 6-epg-n-end iJ open hole J Screened; Start _ feet Stopped feet U Perforations Start feet Sto p �.. 1 feet r <S� Grout Type: d� i d" ' ` { volume77 j �n y t �ffeet Depth: from (—) feet, to "'f Well Disinfected Upon Completion? �FJ-Yes ❑ No Method of Disinfection:' u �4 f • ` `a tQr�� Comments: BORE HOLE DATA DEPTH From To S.M�rCw •"� r , 1753 i, Irl l 2 Driller's Name ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or bepartment, of Environmental Conservation. MatSu Borough: Department of Environmental Conservation.. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Permit Number: SW020033 Legal Description: SUN VALLEY NORTH BLK 4 LT 3' Design Engineer: 0003 S & S Engineering Owner Name: THOMAS G & LINDA NIEPOTH Owner Address: 10721 DOLLY MADISON CIRCLE EAGLE RIVER, AK 99577 - VIII ATV\ clad//" Date Issued: Mar 01, 2002 Expiration Date: Mar 01, 2003 Parcel ID: 050-652-16 Site Address: Lot Size: 103123 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of - F,/ Disposal Field Z 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: &2 �' Issued By: 50 . �/� 3/ /o z_ Date: Date: 3///02 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW020033 Property owners) Thorn et -5 /V ;e r1ntii Day phone 69j1 - 614// Mailing address (1) I 0 7a i DollyMad/So n 6 rde Mailing address (2) EA9le RfVel 114/Zip Code &79577 Legal description (Lot, Block & Sub'd.) Lof 3 y Aloe Voi lle y Nor th Legal description (Section, Township & Range) Lot Size D. 3 �7Acre q.Ft. Number of Bedrooms 103,123, THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municial Codes. S & S ENGINEERING G 17034 Eagle River Loop Road No. 204 '�— Eagle River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: j 10. a� Waiver Fees: Date of Payment: �/ a $ r� 7— Date of Payment: Receipt Number: J 16 Receipt Number: (Rev. 12100) 7-1415 PERA4f7' OXI&IMOLLY PAID fo/e ¢%2-$197 fo,�$I'P-e' RcoT'OP249; nq February 26, 2002 HE&THAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAJNEXTENSIONS REFERENCE: Lot 3, Block 4, Sun Valley North Subdivision ROBERT C. COWAN, P.E. CIVILENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION It is requested that you issue a permit to install a septic system with a pressurized drainfield and lift station to serve the proposed three bedroom dwelling on the referenced property. ENGINEERING STUDIES ANDREPORTS Two test holes were excavated and percolation tests performed. The approximate locations of the test holes are located on the attached site plan. At the time of excavation 6/5/97water was found at I I feet. After clay of ground water monitoring, water &FLOWTEST WELL INSPECTION was found at 9.5 feet. T I?- S r Pla �,L, I*, I -f D" -Y A3 dl� 7 We do not anticipate any adverse effects on, neighboring wells, septic systems, reserve areas or drainage patterns by the - installation of the proposed septic system. The SITE PLANS construction of this system will not prevent any future development on any of the adjacent properties. ROADDESIGN If you require additional information, please contact us. Sincerely, SOILTEST Robert C. Cowan, P.E. PERCOLATION TEST RCC/bjj Enclosure STRUCTURAL& MECHANICAL INSPECTION$ ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP - SUITE 204 - EAGLE RIVER, ALASKA 99577 `LCAL LOT 3, BLOCK 4, SUNVALLEY NORTH SID DRAWN BY B.J.J. CHECKED BY: R.C.C. DATE: 2-19-02 (SHEET: 1 OF 1 DESIGN CRI'T'ERIA. STRUCTURES, EASEMENTS, OR ENCROACHMENTS PrSTIJ3 SHOWN ON THIS SITE PLAN ARE AS SHOWN ON 3 BDRM = 450 GPD AN AS -BUILT SURVEY DRAWN BY: S FT. WILLIAM D. FLEMING SOILS = 0.6 GPD / Q IT IS THE RESPONSIBILTY OF THE CONTRACTOR 450/0.6 = 750 SQ.FT. REQ D. TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO CONSTRUCTION. 17034 EAGLE RIVER LOOP ROAD EAGLE RIVER, ALASKA 99577 I f PHONE# (907)694-2979 FAX# (907)694-1211 TRENCH CRITERIA: 3.5' DEEP LOT 2 2' EFFECTIVE / 5' WIDE W m W 105' LONG (2 @ 53' LONG) Q RF = 0.70 c /O DISTRIBUTION DATA: �vwF —30 GPM PUMP Tyti/sus A 2 LATERALS @ 51' EACH / 700�pTss cG� 30 HOLES / LATERAL / 1Q,>1 3/16" HOLES, 1.8' APART/ Z 100' WELL RADIUS SAREA LOT 2 i / PR0,3 sF o LOT 3 10 OPOSED ,BEDROOM r'o?� l 113 HOUSE ALL PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATION. 7g�2p9 ALL FCO PROPOSED -1250 GALLON S.T.E.P. TANK TH//\\��\ ` J ` U \ °MT MT 10-15% \ ♦TH#1 \ \OO ORP\C\ ZO \ 20% \5� ROBERT C. COWAN V� 'Gi •a CE -8801 100' WELL RADIU" SEPTIC c AREA 1.0T 4 CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION WORK. O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "U' Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: C_.1A9.1— VAtd YECKKogeA ROBERT C. COWAN CE -8801 DATE PERFORMED+i��'/+..�' LEGAL DESCRIPTION: L-o'r '3, 5L oc y- 4 Township, Range, Section: - 61J J X11 �B �0p,,r1{ S'10 SLOPE SITE PLAN 1 `:SSSS oa&4nsc f 1 N -4-/3- J`EE 4-/ 51'7 E - 7-~-7GM 8 .- 9- 10 WAS GROUND WATER 0 ENCOUNTERED? N 11 - S L IF YES, AT WHAT O 12 -_. !_.L.. DEPTH? 8.0, l�. aeyle P I f„7, E / Depth to Water After ' I 13- Monitoring? 00'y Date: I C 1 14 — Reading Date Gross Net Time Time Depth to Water Net Drop 15- ---- Pae %*Ak P&R,00 16- i g(/10%973:3o 5 ?" 3:35 7 '/Z n rV2 ,t 17— 3 3: 4'o ° _T 3/Y" t/4 `+ 3:45 it F3" lh 0 18- 5 W 3: go n $%Y" y4%1 19- 20- ^A PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER it. 6 TEST RUN BETWEEN FT AND 5 FT COMMENTS PERFORMED BY: S & S ENGINEERING I ��- 17434 Eagle River Loo No. 20 e?"*', CERTIFY THAT THISTE T WAS PERFORMED IN �g ACCORDANCE WIT�J pRpoad ftE J%g;4 L GUIDELIN S IN EFFECT ON THIS DATE. DATE: y % 72-008 (Rev. 4/85) IEN�� OA. F qqs Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES.A 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST - Gsrci P� -A_0% ROBERT C. AN , �• II2L VAO �CGKi'IOLiE•hJ DATE PERFORMED. •� t(J/ 4�( PERFORMED FOR: 2 ` LEGAL DESCRIPTION: LeT 3 {iLOG1C Stw J�u4=X ,VTownship, Range, Section: 4gEPTH SLOPE 1 — SF �Eip ��• vR4AurcS I 2- "f o rt= 3- 4- % 1 A , An 6 7 - o �/ 8_ m � f 9- ® a 10 _( G�wQI WAS GROUND WATER Yes -o eI- ENCOUNTERED? 11 s L IF YES, AT WHAT / L DEPTH? �1 P- 12- - 12 - I�/, E t•} D to t w t an !— t l SITE PLAN T � rN wa �4C ` A rO �► ELkha2N C. R, 13— (� , ep o a er er 9 to 6 Monitoring? Date 14— Reading Date Gross Net Depth to Net Time Time Water Drop 15- G SOAR 1 4/411-7 IS: 0(. 3 44 3uo I MIS► 17- ad X',a'q i Mlle S -'/T At vS•.*' 18- 19- 20- PERCOLATION RATE _-IA (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN _4 FT AND FT COMMENTS S & S ENGINEERING 97034 Eagle River Loop Road. NO.?V4 /y/ PERFORMED BY: Easy Rivaf ,�s AIa6ka 177 I .. �--� Lr� _CERTIFY THA/T THIS TE-S?T WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: `1419 72-008 (Rev. 4/85) HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS nG ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907)694-2979 FAX (907) 694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 4, Sun Valley North Subdivision February 26, 2002 GENERAL: 1. The scope of this proji t aect incl des the installation of a pressurized five foot SEWER&WATER }}, EL INSPECTION wide drainfieldQX altion to serve the proposed three bedroom residence located on the referenced property. ENGINEERING STUDIES 2. Construction shall be in accordance with the approved site plan and design ANDREPORTS drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. WELL INSPECTION 3. The contractor shall be responsible for obtaining any necessary &FLOWTEST underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be SITE PLANS responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the ROAD DESIGN Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SOIL TEST SEPTIC TANK INSTALLATION: PTEST ERCOLATION 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCTURAL& 2• The septic tank shall be sufficiently bedded to prevent settling or shifting of MECHANICAL the tank. INSPECTIONS 3. All standpipes on the septic tank shall extend a minimum of 12 inches ` above final grade. ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 3, Block 4, Sun Valley North Subdivision February 26, 2002 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCEUDRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 3, Block 4, Sun Valley North Subdivision February 26, 2002 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type 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. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever specifications applies. Page 4 Lot 3, Block 4, Sun Valley North Subdivision February 26, 2002 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: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER fh%)N_ s a Rrc-jF . %//i//b 3 0tv-w4rk4 ¢ iaCCA+P., rLF: L,4 -y 3 13 LOCK # Svw vaLt-ry dvan.rN TIf✓}T ivjL L SLaY� %lf�L P_4pjinY�A.L,,O S�ATc 14 r- i� JT L✓,41 045..Crtjr� *� '% b/dC 7- 7 "i�cya i Tf� 2kc��y.T�v.✓ i f sorL_,f �¢A-°c ,g. MsxT VAS oc GL� 1i¢o // .¢r/J SlL.y ttiN{�ty �fLL 4,3 To If ta2B Vz 4, 1 10. C y & 5 ENGINEERING 17034 Eagle River Loop Road A[0.20--, eagle River, Alaska 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES On-Sfte Services Transmittal Shoe TO; GAL: cyC7/F L 3i g ( f The attached paperwork has been reviewed and is being returned for the following reason(s): Discrepancy in legal description and/or owner name. Discrepancy in.number of bedrooms. Signature and/or stamp missing on Show measured distances to sewers/wells; curtain drains` and streams within 200 feet of proposed system. Replacement disposal site not shown and/or tested. Calculation error in design. Show locations of -all" soils,percolation or water table' tests. Proposed system too deep for soil test submitted. Topographic information missing or inadequate. "Narrative missing or inadequate. Additionalsoil/perc test needed. Sand filter requirements not 'satisfied. Water monitoring results missing or inadequate because . x_ MQU) 'CtATIMNK NAIIOf,- 9¢uas Ac t -c r� W���n �l/, A u.S, _ Incomplete; missing —� F. 'C ur &(=-_ tl E. 76 dui (3�-jK—_ &7 til. _ Well log required. Water sample unacceptable because Other�Ufi�[2 /��UNi702E0 6>Q,IS;S, t7F51 N �oII MA/N7+N_}� N1//V• q l/icJZ7�CRC CC Please `supp y the nece sary information and re -submit your request. ur-cooper` "ion is appreciated. J Reviewer LEAVE THIS FORM ATTACHED TO PAPERWORK /203 -rev. 4/93 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On -Site Sewer/We![ permit Application NOTE: Application must be iced pot completely. SINGLE FAMILY DWELLING Parcel Itlentification Number Property Owner Name N'WyK �Or,GTI. r.�J ATrN: CAIL� JAN ` I Day Phone 355 — 3907 Mailing Address P.O. gox 871(.L47 CIJAS,�LA Q k t Zip Code %q 68i Legal Description 3 Ll Lot ! �J Block '�`� Att6Y r"4rli Subdivision Section Township b Lot Size R. Acre o� Inspections will be conducted by: N• I mber of Bedrooms: 3 —1s_ Approved Engineering Firm Municipality (permit fee included) Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, _,PI or Water Softener Unit? �F� If Yes, which one? This application is for: Sewer Only Sewer and Well- Sewer Upgrade Well only � i certify that the above information is correct. I further certify that this application is being made for and in accordance with applicable Municipal codes. a Single Family Dwelling S & S ENGINEERING ` OCA 1734 Eagle River LoogriWita Rc^ eu Driller Fees: Y—� i �I Eagle River, Alaska 99577 72-0t2 (Rev. to/s6) t Receipt # Permit # 7373 0S p2q-ol S&S HEALTHAUTHORITY APPROVALS SEWER&WATER MAIN G(TENSIONS SEWERMATER WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER OISPOSALSYSTEM DESIGN vI April 18, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 3, Block 4, Sun Valley North S/D ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVILENGINEERS (907)694.2979 FAX(907)694-1211 Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring tube was found to be dry. This property has enough area for a future septic upgrade which can be- seen on the attached site plan. We do not anticipa't'e 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. Si e7l.v, Robet=-C::''C�wan, P.E. RCC/gk</ Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 LEGAL LOT 3 BLOCK 4 SUN VALLEY NORTH S D t•'�G•Or s DRAWN J.L.M. CKD. R.C.C. DATE 4-18-97 T. 1 OF 1 �•( f�'•:'S�\?Z, S&S f ,� p STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON ��• ='r•••••-`�-•••� AN AS-BUILT SURVEY DRAWN BY: EnGineeninG WILLIAM D. FLEMING —•_ J.• -6 EAGLE IT IS THE RESPONSIBILITY OF THE CONTRACTOR C. COWAN' @ �nwA TO VERIFY EASEMENTS, REQUIRED SEPARATION LOT 2 DISTANCES, AND PROPERTY LINES PRIOR TO ��• CE'a8�1 CONSTRUCTION. 8�•, -�"M DESIGN CRITERIA:SE ' ���� CONTRACTOR IS REQUIRED TO 3 BDRM = 450 GPD APPROX. TION OBTAIN LOCATES LOCATION PRIOR TOO ANY EXCAVATION SOILS = 0.6 GPD/SQ.FT. WORK. / 450/0.6 = 750 SQ.FT. REQ'D. LOT 2 TRENCH CRITERIA: ~ 6' DEEP i I "oke((�� 4' EFFECTIVE I i r�s°FT 5, WIDE 75' LONG % 2 @ 37.5' LONG EACH PROP. REDUCTION FACTOR = 0.50 N g / WELL PROPOSED 3 BERM HOUSE I FCD \ LOT 3 I ®� J • PROPOSED 1000 GAL SEPTIC TANK COco INSTALL DBL CO IN5TN,`dF•LL FLOW \ `S�iTA COQ DIVIDER (FD) AE-20%Co \ 0W PROPOSED TRENCH 5ti I \ ��� 1� 2Aq v vv vvV v v 0v 0 LOT 12 A\ II < o ALT. E \\ ,5,2 LOT 4 CLIENT 4' \ THE ENGII NAY vAW THE ALL PORTIONS OF SYSTEM �� iAaeuts Iv ii\E ME DESIGN i WTTH LESS THAN 3.5' OF a1� \ CESSMr. To N.�ET SITE COVER REQUIRE INSULATION. coxomoxs. ZN Municipality of Anchorage t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG —PERCOLATION TEST PERFORMED FOR: CARL-. \I P, i,,Ii \'—VEG KNoJE-I DATE PERF LEGAL DESCRIPTION: LOT 3 M1 R�-oGK li Township, Range, Section: I o� F I SUN J ALLHY OPCrN SID SLOPE 1 5555 2 3-a. 4 6 .?,,y 7 s 9 Z. o 10 11 12 31415 13- 14- 15 16- 17 81920 18- 19- 20 COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? oRY 0a S L O i/I+1 9� E Date: I o ti JI I t VLHIN Reading Date Gross Net Time Time Depth to Water Net Drop PRESoA P&RIO f ro v7 3: 30 5 Mitt. -7 ° --- 2 3: 5 It I� I, t $ 3:Lto n i 3/4" t �� `I 3:45 it It _II" PERCOLATION RATE 20 (minutes/Inch) PERC HOLE DIAMETER b TEST RUN BETWEEN µ _ FT AND 5—FT PERFORMED BY: S & S ENGINEERING _ I z z�— CERTIFY THAT THIS TE T WAS PERFORMED IN 17034 Eagle River Loop � pR,poad No. 204 y /� y 7g ACCORDANCE WIT�J 6 §T�tE AVAkW 5/7 L GUIDELINES IN EFFECT ON THIS DATE. DATE: _ 72-008 (Rev. 4/85) HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN IXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION &FLOW TEST SITE PLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN N ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS Lot 3, Block 4, Sun Valley North S/D April 18, 1997 ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694.2979 FAX(907)694-1211 The scope of this project includes the installation of a 1000 gallon septic tank and five foot wide drainfield to serve the proposed three bedroom residence for the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all l.eachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. IC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Block 4, Sun Valley North S/D April 18, 1997 (� 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. 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. once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be .installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot .3, Block 4, April 18, 1997 Sun Valley North S/D MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type 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.. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caul.der, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mi.rafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill.. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with loss than 3% passing the $200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever is required. Municipality of Anchorage • Development Services Department p"GE Building Safety Division On -Site Water and Wastewater Program ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, Ak 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 00-0—CS-XIJ6 HAA# Expiration Date: I I �5� 1. GERAL INFORMATION Cobipletelegal description Lot 3; Block 4; Sun Valley North Location (site address or directions) 4241 Elkhorn Dr. Current Property owner'(sj _ Tom Niepoth Mailing address same Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well X❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone 271-2114 Day phone _ Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply. system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid 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 Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Fngi n�ri ng Phone 6g4-9,979 Address 17034 Eagle River Lip, Rd Eagle River, Ak. 9957/7 / Engineer's Printed Name Rohart C_ CnwAn Date `3 / rql 0 5. DSD SIGNATURE _L Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: jf�,, Original Certificate Date: (Rev. 01102) 11 1V1L Devel AT15 If A, B, or C provide PWSID #=Ty "Well CogQS�N) y � d % q "©Z Sanitaryseal (@A!) s ... Wires properly protected�l) EsfS Z ft Cased to 1 l_ft Casing'height (above ground) 3 ?Lin. F} OWW5LIAO' a A For oms l9� 6c- _gal. New epth"_ in.` me: mui. Pin `"" v.,,,' _ in Absorption rate >= 9.p.d. wel©.. ft ft. 10 9 P m• g.p.m. pjy+i'yyrY�, p,� Wmt"' mw..+++•R�.�x...w:wC*i v`hw�.uRw'r'wyuwmvam'rry .9 colonies/100"mi. Nitrafe 0.4?fmg.A.Other bacteria colonies1100ml. Date in§tailed ieo jZw L-1 Soil rating (g.p,d./ft` orft`/bdrm) vto , System type _ 'S f -hp -Z. UA-) TzSkUzA ft Width S ft. -Gravel below pipe "" i 5 ft Eff. absorptiorr`area�y ftz Monitoring tube ` Depression over field" �© :quacytest W(rf� ReSuTfs (Pass Fail For oms m absorption field before' e("sf _ i' n "` a er a _gal. New epth"_ in.` me: mui. Pin `"" v.,,,' _ in Absorption rate >= 9.p.d. ]atie eatment (past 12 mo.) (Y/fJ &type) If yes, g1111ve date D. LIFT STATION Date installed g � 1 'O2 Size in gallons / z Sb Manhole/Access(IN T� r r. v "Pump on" level at q7Z, in. "Pump off, level at 3Zin. High water alarm level at _ in. Datum 1 p" O F �itrly6`ycles tested Meets alarm & circuit requirements? ` 63 E. SEPARATION DISTANCES w SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station onlot !co + On adjacent lots 100 4- Absorption field on lot l co1 On adjacent lots C r% '- Public sewer main Public sewer manhole/cleanout _._�.._F. __. ,..,, _...v, Sewer /septic service line 11�t } ZS ( Holding tank N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO { A ¢ Building foundation s f Property line Absorption field _.. . Water main A,)A Water service line 10 4, Surface water (6C f Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r_ . h mavr vre. .[wenNVWir.+ww r .' /J Property line 4- Water main 01 e f©� Building foundation „ _ r' Water Service line l0 / Surface water Driveway, parking/vehicle storage f Curtain drain Wells on adjacent lots F. COMMENTS rs ,t G. ENGINEER'S CERTIFICATION yy f I certify that I have determined through field inspections and review of Municipal records that the above systems are in ..... conformance with MOA HAA guidelines in effect on this date. p ROBERT C COW AN Engineer's Printed Name �t�k' 0 �`�`��"� �Ci�r'`.. -8801 ;rte /m0 Date 4i `r' ` ...._. HAA Fee $ _, / Waiver Fee $ Date of Payment l i T /O Y Date of Payment Receipt Number o S' 7 0 El -Y Receipt Number x -------- (Rev. 12/01) _... ... 8-24-04; 2:43PM; WWI SCS Ref.# 1045210001 Client Name S & S Engineering ProjectName/ll ' t3, MMey orifi T"' Client Sample ID Lt 3, Bk 4 Sun Valley North SD Matrix Drinking Water PWSD) 0 Sample Remarks: ;907 5615301 # 2/ 3 All Datesfrimes are Alaska Standard Time Printed Date/Time 08/20/2004 9:09 CollectedDate/Time 08/16/2004 16:00 Received Date/Time 08/16/2004 17:05 Technical _Director Stephen Ede Released / ✓ i Parameter Results PQL Units Method Container ID Allowable Prep Analysis Limits Dale Date Init Waters Department Nitrate -N 0.678 0.100 Microbiology Laboratory Total Coliform 0 mg/L EPA 300.0 B (<=10) 08/17/04 JJB COVIOOML SM20 9222B A (r-1) 08/16/04 DKC F�ky 0RiV p / C N ma 0 � zm n2 i rm .DO m 0 a� mX j im N n o� c O � y �a W 'gym a N n to M A m r CTS m 1 oo.00' _ N W t 1'33'W o m n El Sd IJN�1V:Nt 'AOz ZT '��Q �6�b Eb 'LG1f t 'Clhl YtN� toxic, Eurtun(� yr at u;m O m n cove z vm�s'lm�r� W 'O ZO ro F!m cy ^I = rp H w w la -C t7 t,w m pc dim' Z. oo t^p�F�im o...c ooa ai`Se=:Co d m O m G � ' e FF Z m O 0 {V ? no G �O. 4 n ka C C.3C _ 0. Ste. veH��O�06 CT m (� C O m m o m n El Sd IJN�1V:Nt 'AOz ZT '��Q �6�b Eb 'LG1f t 'Clhl YtN� toxic, Eurtun(� • pe�; Development Services Depailment �";�1 n,<o v:. / Build lnQ f `'y Division r .'•+� a uAI L. 4700 South Bragaw St. P.O. Box 1966650 Anchorage, AK 99519-66.3'.0 veh1v.0 anchorage.ak.us r1 (2,01)343 -,OIC u i"` I` 90 CERTIFICATE, oF- HEALTH AUTHORITy'APPROVAL 11FORA SINGLE FAMILY'DWELLING :.. Parcell.p. 05.0,-;652, 16, HAA# ,, t;;3,,i%:.i'%.ri�; Expiration Date: s / x�3 1 GENERAL INFORMATION Complete legal description Lot.3; Block ,4 Sun Valley North S/D� Location (site address or directions) Current Property owners) Thomas & Linda. Nie Day phone.: -' E Mailing address 10721 Dolly Madison "Circle, :EagiP Riper, :AK 99577 Lending agency Day phone Mailing" address' Real Estate Agent Day phone. Mailing Address . - Unless otherwise requested, HAA will be held by DSD far pickup. 2. NUMBER OF.BEDROOMS: 3 3. TYPE, OF WATER„SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Wel( FE Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ ” Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage' Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid 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 Health Authority Appro+ial Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are)"•safe, functional and adequate for the numb&—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'ihvestigation and inspection, the on-site water. supply' wastewatef idisposal system is(are) in compliance with all applicable Municipal and Sta' Late 060es; ordinances; 4 and•regulations in effect at the time of installation. ^••11�0r. ^'Name of Firm S&S t:ngi nce.r. in Phone 694-2979 Address 1. /034 K. V al. 1_e River Loon IZ(I . Lil<.? l (+ iN i \Pty :1K Engineer's Printed NameRobor. t Shafer. Date o 3�0 .it A. 5. DSD SIGNATUREs.�ic+• moi `fti �• !.� Approve) for bedrooms Disapproved "Conditional approval for bedrooms, with the following stipulations Additional Comments sem. NZ L: VJATERAND. V�II�STEWATER . 41 �JJJJJJJO��.r����l�llll Attachments: HAA Checklist X Maintenance Agreements u Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other BY. C�� Original Certificate Date: (Rev. 01/02) 1l�i nisi a f A.JMCho�age :'' e 12-31-02 16:15 FROM -CUE ENVIRONMENTAL SRV CT&E Environmental Services Inc. C La CT&E Ref.# 1028640002 Client Name S & S Engineering Project Name/# N/A Client Sample 1D Sun Valley N S/D L3, 134 Matrix Drinking Water PWSID 0 Sample Remarks: 9075615301 T-301 P.03/03 F-129 All Dates/Times are Alaska Standard Time Printed Date/Time 12/31/2002 8:55 Collected Date/Time 12/27/2002 12:00 Received Date/Time 12/27/2002 18:05 Technical Director Stephe .. d�� Released By Allowable Prep Analysis Parameter Resaits PQL Units Method limits Date Date knit Waters Department Nitrate -N 0.566 0.200 mg/L EPA 300.0 (<=10) 12/28/02 is Microbiology Laboratory Total Coliform TNTC OB co!/100mL SM18 9222B (<=1) 12/27/02 SKW °'• SIA1RS B — LAAOVIGS ao in 10/8/02 9.9' 6.0' � r: ` d 4/9i97 HOUSE DETAIL — 4tf 11 8► DATE rc _ u O � � N DECK ti 2 10'. TELEPHONE 8 j ELECTRIC MT. / N 89°48'220E 531.72' Q ;,) NOTES: Easemi q M plat are not st by provided c1i; GRAVEL DWM or builder. prlo EXISTING HOUSE building grade Well t (SEE DETAIL AME) Z connection, 0t easements. coy appear on the Elevations bast �.9 a• �♦ PVC SEPTIC Indicated, and ��,�' 910 -PIPES (YVP) V WIRE FNC. � d( 0 0 ENCROACHES Z X. —X �p6J i two 0 o M � G LOT 3, BLOCK SUN VALLEY PLAT NO 83-2$7