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HomeMy WebLinkAboutMCKINLEY VIEW ESTATES BLK 2 LT 17Onsite File McKinley View Estates Block 2 Lot 17 #051-792-21 Drainfield is adequately sized for up to 3 bedrooms. A® k.- UU/UL/ 10) Municipality of Anchorage IF On -Site Water and Wastewater Section • 907 343-7904 a8e"1 f 2 ( ) so G� ORI -SITE WASTEWATER INSPECTION REPORT qUG 1 180 Permit Number: OSP201130 PID Number: 051-792-21 ?® Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ®❑' Upgrade Name Robert & Megan Webb ABSORPTION FIELD El Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21304 Baron Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot McKinley View Est 2 17 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station I Holding I Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well I n/a TANK ❑ Septic ❑o S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1500 Gal. Surface Water 100'+ Material Number of compartments Lot Line 51+ NA Plastic 2 Foundation 10'+ I LIFT STATION Manufacturer Capacity Remarks Orenco 250 Gal. Alarm location House Electrical installed by DRS Electric Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Jr's Septic Services Drainfield co/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 340.5 g Inspdctio 1.1 6/23/20 8/6/20 Location and description 3rd 2,d 4m NE Bottom House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: DateOF F. A�, AC 4.9 TH` Stever. R, Fenno. , C_ 8149 Septic System Approved �V/u Date Note: this approval does not include well permit requirements.�����4 k.- UU/UL/ 10) m�oV�=CO ---I -0 z c i z ' FTI O .c CD D �O C r m T m I Z NQXC ��� r,immcn< oZ��-'D !ip�Z X00 �g C z =-i z0�mo— m £ m Om c� O C 0 y,,z I N N cn w o D C) ID� o Z� z mD m O D o� �� momM mD A I+ w w -j 22 N O CLO n Cm \ i) % LAA N r) It> Ln � o m XV J o � A W 1 0 � 0 / cn w mo J Q� oo n 0 f/ O D m zr 0 / D V D O \ Np . Z \ � Q / x� czi) OD m j D 1 \ �0 N 6, o o m m ° / G7 0 N (T, \ c< 0 O � \ cn NOTES: PANNONE ENG SVC LLC (C.i. 1088) P.O. BOX 1807 PALMER,RAK 99645 At REVISIONS DATE 8/6/2020 RECORD DRAWING PHONE (907) 745-8200 FAX (907) 745-8201 Q"" ' "' •. SCALE MCKINLEY VIEW ESTATES B2 L17 ROBERT &MEGAN WEBS 21304 BARON DRIVE *:9 M 4 :* •••• • ....... "�}eY cmnp.e 8148 1.. = 50 P.I.D. NO 051-792-21 DRAWN ACP PERMIT NO. OSP201130 SITE PLAN CHUGIAK, AK 99567 •• SHEET 2 OF 2 ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-082 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: (� OF Al, ' DATE: AND THAT NO ENCROACHMENTS EXIST &CEP'T'� AS Ar INDICATED. IT IS THE RESPONSIBILITY OF THE LH OWN .ER TO DETERMINE THE EXISTENCE OF ANY GRID: .. ... EASEMENTS, COVENANTS, OR RESTRICTIONS ,yam may% WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 0 UNDER NO CIRCUMSTANCES SHOULD FB - VISION PLAT Duane Mark. Sawa; LS —6 8 ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE ARY LINES. LINES, OR FOR ESTABLISHING BOUND- DRAWN.N �� 57� . MUNICIPALITY OF ANCHORAGE On -Site Wmter& Wastewater Program POBox 19GG5U 47VOElmore Road Anchorage, Alaska 99519'O05O Phone: 904 Fax: (3V7)343 -79g7 hUp:0wvw.mun|.org/onoite Permit Number: OSP201130 Work Type: 8epUcTankUpgradn Tex Code Number: 05179221000 Site Legal Address: iNCNJNLEYVIEW ESTATES BLK 2 L 17 G:1459 Site Mailing Address: 21304 BARON DR. {|huQiek Owner: WE8BROBERT L&MEGAN R Design Engineer: PANN(}NEENGINEERING SERVICES This permit isfor the construction of: 5/29/2020 5/2Q/2O21 0 Disposal Field R1 Septic Tank 0 Holding Tank 0 Privy n Private Well 11 Water Storage All construction shall bmin accordance with: 1. The attached approved design. 2. All requirements specifiedi Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) — The wastewater code requires ^inspections during the "installation. The engineer shall notify the Development Services Department per AMC 15.65.Provide notification by calling (QO7)343-79O4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a. Opened and Closed oDthe same day, or b. Covered, sealed, and heated hoprevent freezing Received B� Issued By: / =� V1. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201130, Rebecca Carroll, 05/29/20 McKinl y Vi Estates W Block Lot :t7 #051-792-21 ) Municipality of Anchorage Development Services Department ~_~. Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 '~ ~' www.ct.anchorage.ak,us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:, SW050034 PID Numbe~ 051--792--21 Name: THOMAS & KELLY RILEY WastewaterSystem: [] New · Upgrade 21504 BARON DRIVE * CHUGIAK, AK 99577 ABSORPTION FIELD Phone: No. of Bedrooml: (907) 688-1500 5 BID~ep Trench r'lShallow Trench f'lBed I'lMound flOr. her LEGAL DESCRIPTION ~...~ ,o~ ~.~ ,~ ~, 0.45 ~/s~, ~ 2,0-2.5 2 17 McKINLEY VIEW ESTATES SEE DWG. n. 1.0 Townl~hlp: Range: Section: ra ceded ~ e,~-,~ ~m~B: ~ ~ - - - SEE DWG. r~ 174 TOTAL ( 2 © 87)fL WELL: [] New [] Upgrade 5 ~ 2 5+ , \I~ r~ r~ 1000 S~.F~ D 5034/ F-810 ~'~' ~C~,[~,j~~~ ~'~' ~.~.,~.~ ~ ~'~"'3~=12_17/2005 r~ A+ HOME SERVICES ~ ~ r~ TANK SEPARATION DISTANCES =s.,~ ~.o~0~.~ =s.T.~...~ Tank Field St(3flan Tank ~ Nur~v~r ~' ~ Well - 200'+ - -- 25'+ s~fo=o Wotor - ~00'+ - - - LIFT STATION Lot Une - *5'+ - - - I ,-m\~'~ ~ Fo,,~aot~on - ~0'+ - - - ~ ""' ~ "~ C...~ "~ Iw~ '~ 0~ Curtain Drain NC~NE KNOW~ /-~.d~: . ,Remork~:*LOT UNE WA~'ER GRAINED WITH ~SSUA. CE BENCH MARK OF PERMIT. TOP OF BACK DECK BY PATIO DOOR ADDITIONAL FILL AND GRADING TO BE DONE IN SPRING/SUMMER OF 2003 AJ-1LR GROUND HAS THAWED. 100.00 ENGINEEI~ ~F-~ THE EXISTING 1250 GALLON S.T.E.P. TANK WAS _~:><~k{,.~-,~I Inspections performed by: AKWWC. INC. Dates: 2nd.lSt 5/12/:~0033/15/2oo5.,/"' **** ~ ~i[_~i !~' "**"~ · .~.... ~A ................. 3rd. 3/17/2oo5,n.~ .. efl~e Development Services Department Appro,v, al ~1~5,,,......~ .**..~,,=,~, R~viewed and approved by: ~'~/'~"- ,/ /~. /'-~,~7/'' Dote. J',3':Z/,- o~ ~E~,~,~_'***' , / ~ ~: AS BUILT DRAWING ~' © ~O~E~: SW050054 -- 051-792-21 ~ / / ~5 ~ LOT LINE ~S~ WATER & WASTEWATER THOMAS & KELLY RILEY (907) 688-1500 2 OF McKINLEY VIEW ESTATES SUBDIVISION; LOT 17, aLOCK 2, U~,"':l .[~ ..."_~x~ AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE A B C ST1 - 13.1 29.0 ~2 - 17.5 25.6 MH - 18.7 25.0 MT1 25.4 85.0 - MT2 92.0 66.0 - MT3 96.4 82.4 - MT4 47.5 104.0 - PERMIT NUMBER: swo~oo~, AS - BUILT D RAWIN G ~,R~0~,_~_~, '~ NUMBER: NOTE: ADDITIONAL FILL AND GRADING TO BE DONE IN SPRING/SUMMER OF 2003 AFTER GROUND HAS THAWED., /~F1NAL GRADE - =ORiOINAL (;RADE /105.70-104.06 ~fl~L GRADE m 102.18-102.68--~I ."1l / r-i NSULA~ON OR,GINAL GRADE /101.64-101.66 · m+ nrrr Bo..rmu or ~REU 3/18/2003 C.J.G. " ALASKA WATER & WASTEWATER ,~,[: ,'.,, ..' 4, ,-~m ~," ~ CONSULTANTS, INC.' , ....: ........ r.], ...... ;....~) ~REPARED FOR: PHONE NUMBER: PAGE NUMBER: THOMAS & KELLY RILEY (907) 688-1500 3 OF .3 McKINLEY VIEW ESTATES SUBDIVISION; LOT 17, BLOCK 2, ITPE OF WORK: PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE MUNICIPALITM OF ANCHORAGE Development Sendces Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (g07) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Mar 05, 2003 Expiration Date: Mar 04, 2004 Permit Number: SW030034 Legal Description: MCKINLEY VIEW ESTATES BLK 2 LT 17 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Thomas & Kelly Riley Owner Address: PO BOX 671665 CHUGIAK, AK 99567-1665 Parcel ID: 051-792-21 Site Address: 021304 BARON DR Lot Size: 30090 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Ail 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. Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAHILY DWELLING 051-792-21 Permit Number Property owner(s) Mailing address (1) Mailing address (2) THOMAS ~ KELLY RILEY P,O. BOX 671665 * CHUGIAK. AK Day phone 688-1500 Zip Code 99567 Legal description (Lot, Block& Sub'd.) LOT 17. BLOCK 2: McKINLEY VIEW ESTATES SUBDIVI~.;ION Legal description (Section, Township & Range) Lot Size .~ C~ ~ Acre~'"~ Number of Bedrooms 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 Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. Permit Fees: Date of Payment: Receipt Number: Waiver Fees; Date of Payment: Receipt Number: ALASKA WATER & WASTEWATER CONSULTANTS, INC. February 17, 2003 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic Upgrade for Lot 17, Block 2; McKinley View Estates Subdivision To whom it may concern: The existing 3 bedroom house is served by a community water system and a private septic system. The existing septic system consists of a 1250 gallon S.T.E.P. tank and a pressurized bed type drainfield. The drainfield is surcharged and must be upgraded prior to selling the house. A test hole was excavated west of the existing drainfield. The drainfield will be designed around the 30 foot radii of our test hole and David Dayton's test hole #2. We are proposing that the existing 1250 gallon S.T.E.P. tank be excavated and the integrity verified. If the integrity is poor, than we propose to replace the existing tank with a new 1250 gallon S.T.E.P. tank We are also proposing that a dual pressurized 5-wide type drainfields be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.45 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 40 minutes/inch b. Proposed Application Rate: 0.45 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 1000 ft2 f. Total Depth: 2.5 feet (max.) g. Effective Depth: 1 h. Width: 5 feet i. Reduction Factor: 0.87 j. Minimum Length: 2 ~ 87 feet long each (174 feet total length) k Effective absorption area = 1000 ft2 Note: the distribution lines are to 1.25 inch sch. 40 pve with 1/8 inch diameter holes spaced 28 inches on center (18 holes per lateral / 72 holes total in entire system). 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The area for the proposed drainfields is a 54- percent slope running approximately northwest/west to southeast/east; in short, there are no slope concerns. 5. LOT LINE WAIVER: We request a 5 feet lot line waiver from the north lot line to the proposed drainfields. We are unaware of any adverse effects on the neighboring property with the granting of this waiver systems. If yo)~ave assistance, t We are unaware of any adverse impacts this installation would have on adjacent wells or septic any questions, please contact us at 337-6179. Thank you for your E., M.S. NOTE: A site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com / / 7""~ MCKINLEY VIEW EST. .cK,,~ ~, ~. ,/o:1 '~.. ; ,' /"-"c~'. ,,,, ,, BLoc~'2/".. /V'/' LOT 5, BLOCK 2, / '~ / / .7".~'.~. ...... / / \ / / / '-C~.~-. / / / ~ ~' , v / ......... '-L'~.~¢. / / / ~ ~~oc~..i7 .. ,,, / /' All DD~ Z ~T 3, BLOCK 2, ~ Flay // MCKIN~ ~ ~. $ID; ' BY OOMMUNI~ WATER SYSTEM I~ ~ ~,.~ocK 2, ~SI~ ~VAI ER & ;VASTE;VATER ~ ' f~:'z 9 ~ ,, , CONSULTANTS, INC., ' ~" - ~00' ~'~':~ ....... t 6001 OEBfl~R ROAD. SUITE 2B" ANCHORAGE, AK ~qSOG * PHONE (q07~7~17~ ' F~ (q07)338-~Z~6 , " ~ ' ~ I , ] ~ / ~.~ to. ~.o.~ .u~8~: ~ .u~: ~ ~ ~/1 l. ~ ......... .~ THOMAS & KELLY RILEY 688-1500 1 OF 5 ~ '~.Je~re, [A[/G~nest.: ~K~.L[Y W[W [STA;[S SUaD~V~S~OS; LOT ~7, aLOCK 2, ~,.~..~ ...... SITE P~N FOR PROPOSED SEPTIC UPGRAUE .... ~ / / / E:x~ ~2~o c~u.o~ '~.'r.r..,. ~,~< 'to .~' " / / / OR I.~RCER WITH DUN. OUTLETS.-..7 ,,,-,-tF THE: INTECRrTY OF THE: / / ~ / /'--5 FLI:,I' LOT UNr' ,/ / p pi:' TO DIVERT FLOW ,,' I. " / ~ \' ,/~/ ?/." -/ ~ / / / / TO BE USED AS A / / ~"o~"~ //, /'""'~'" 212112003 . CONSULTANTS INC .... 1:" ' ~"~"-"'' ,oo, o;..~, ~o~o su,,i ~. ~.c.o,.~ .K °°soL. ;.o,~ ;oo,,,,,.,,o. ~, ~o~,,,8~,~, = 40 ., ..... , ..... /..~ ....... THOMAS ~ KELLY RILEY 688-1500 20[ 3 McKINLEY VIEW ESTATES SUBDIVSION; LOT 17, BLOCK 2, ~~[[;' ~, .."'~x~ T* I.<TO I I .................. I , LO__~_ -/~ '---' ,- I--'THE: 131STRIBUTIOH LINES ARE: 3'0 1.2,5 INCH - I'~OM S.3..E:.P. 3.ANK ~ SCH. 40 PVC WI'IH 1/8 INCH DIAMETER " ~ HOLES SPACED 28 INCHED ON CEI,,rrER .~8 HOLES PER I,.A'TERAL ! 72 HOLES 3.0TAL). r ..................... 1,41'01 ._[ .............. 87 ~-~ r--F3NAL CRA~E. MUST HAVE: ORIGINAL / ~--FINAL CRADE. MUST HAVE I /2+ I~LL' OFcOVER p' blONITORINO3UBE / , MAXIMUM-- _- .0 FEET OFT EFFECTIV~ -- - I $ FEET · / J.L.M. ALASI{A WATER & WASTEWATER ,~.. THOMAS &: KELLY RILEY (907) 688-1500 McKINLEY VIEW ESTATES SUBDIVISION; LOT 17, BLOCK 2 TYPE OF DETAIL DRAWING OF PRESSURIZED TRENCHES ......................................................... aSIFU~ WATER & WASTEWATER ~'"'"z 9T~ ~"~!0~'"' . = -- , ..... CONSULTANTS, INC.· ,,, ISOIL LO~ - PERCO~TION TESTI ~.~ ...~ ~G~ DESCRIPTION: LOT 17, BLOCK 2; McKIN~ ~ E~A~S S/D PERFORMED FOR: ~o~ · ~E~Y R~ ~AT[: =/~/~003 ....... fee~ ORGANICS ITEST HOLE ~1l SOIL C~SSIRCATIONS / / jj[.,,, ~ GW =~=: ORG/ / / / P.&  ~c. ~NC. / / / ',, ~ GP HL [[ '. ~, GM CL 4 :' 'GC 0L ./ / X ./ ~ ~N~ jj[, ~ SW J HH / / X/ ~ ~ /t s~c ~ ~J~~:~ SM I OH 6 ~,,; ~SC "~ , 7 ~' DEPTH TO DATE GM/SM GROUNDWATER ~, (HARDPAN) DRY 2/~ 4/2003  J~Jt:' W/ DEPTH I '-'~ mE. I/ ~/ 11 ~' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (HINUTES) READING (INCHES) 'I ' 2/14/2003 1 3:40 - ~' - 13~j~J~' I" 3 4:10 - 6- - 14 ' , 5 4:40 - 6" - ~ 5:~0 ~0 5-1/~' ~/4' ~9~ PERCOLATION R~TE 40 (HIN./INCH) PERC, HOLE Dia. 6 .(INCHES) / TEST RUN BETWEEN 3.5 FT. AND 4.0 FT. ~0~ I A FOUR HOUR PRESOAK WAS PERFORHED: ~ YES gNO SOILS LOGGED BY: dOOY ~AUS PERCOLATION TEST PERFORHED BY: ~O9Y ~AUS COHHENTS: PERFORMED BY A.W.W.O., INO. I, ~E~R~ ~ OARNESS, CERTI~ T~T THIS ~5 P~RrOR~ED IN ACCORDANCE WITH ~L ~ATE AND MUNICIPAL OUIDEUNES IN EFFECT ON ~lS DATE: DEPTH TO DATE GROUNDWATER DRY 2/14/2003 1 O' 2/17/2003 ."'.:",: ,',' ~'..:. ::. : ' M..~C~."y' 0f A"c.0.,0o ' ~:".: '. :. ' DEPARTMENT OF HEALTH & HUMAN 8ERV ,~. ,~. ~ , . , - 825 ~ Str~Anchomge A~ka995~-0~ ~/(;~0 L~ Township, Ra~e, S~tlon: - SLOPE ,SITE PLAN J -j WAS GROUND WATER ENCOUNTER IF YE$o AT WHAT C~ O I ~ DEPTH? , "' p E Mo~flg? ~ ~',~ , !k :'~. ~:::.!.',. - g. ;~" "~:' *~ 10- ::4 ~.. 12 ~.-- :: ,! :' ,,,k', :-".' ': 13 H:,.' ' . ~J ::.'. ' 14 !A: ; .- *' 18- · ' Grou · Net Depth to Net Reading ; Date Tlma Tim* ..... W~t~ . .,:Drop ' . PERCOLATION RATE ~J~ (mlnute~/lnchJ PERC HOLE DIAME-I'ER ~ "'' , TEST RUN BETWEEN ~ FTAND ,,, '~' F~ ' COMMENTS ' . .,. 72~(Rev. 4/~) -- . r, :.. :. ?' ~ Munlcipaflty of Anchorage ' '.:."': :'.", DEPA.R.T, .MENT OF HEALTH &'HUMAN SERVICES ~' :' 825 L Street Anchorage, Alaska'99502-0650 .. ~ ' ~ ' . .~/,r4 ~,,,,,~ .. ~' '...~.~, ..:, ;.. ~ .. · '---:." ~,~.*rw~- -' . :. : ~ ~.'~ . _ . W~ GROUND WATER ~. O~ ~' ENCOU~ERED1 DEPTH? ' ~ '' IF YES. AT WHAT ~/.,/.~.. / P I. I r } '' '' i r DePth to., : Net * , Gross .* N~t :' W~t~ ' Drop :,., Time TIm~ " I .- ' ' PERCOLATI(~N RATE (n~nutes/inch) PER(] HOLE DIAMETER '. ...... TEST RUN BEYWEEN . FT AND ' ~r · · COMMENTS : ; . ,::".:: ' ' .. ., ,., .... f ~. , / .... .. ,, ?'. ...'~.. ..... ~.'~ .' ~ · , .. ,1 . /.. .:.'..' ':.. . ~:' ;'" '; PERFORMED BY; ' ;/~'/~ '~'~ ,r"z',e,../, I '~" //~*'"/'~-/*~"'~<-*~' CERTIFYTHATTH STESTW^SPERFORMED N ~: ' ','. ACCORDANCE WITH ALL STATE ANO MUN ClPAL GUIOEL NE$ N EFFECT ON TH S DATE. DATE ~' . , .,: .... .. T2-Q~(Rev. 4/85): .... . ,.l,' ; ..' :." .' ~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak, us (907) 343-7904 Waiver Review Worksheet WR#: W~030015 PID~: 051-792-21 HA#: Permit~: Date Received: 2125103 Legal Description: McKinley View Estates Block 2 Lot 17 Engineer: Jeffrey A. Garnees. PE Alaska Wpter & Wastewater Ccn~pltants. I13c, Applicant: Thomas & Kelly Riley Waiver Requested: ~i feet fr~m North prooerty line to dralnflelds Criteria: I Geology A, Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver is Granted: ~X Waiver is not Granted: ListConditionsorReasonaforabove: .~ ~ E £1t/ (~ I~ F E I~ /$ Date: By: ~ Name of Reviewer Rec~: 31762 Amount: $150.00 Date Paid:, 2125/03 Municipality of Anchorage Page / of '~ ,, 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 Permit Number: ~/t¢/ ~' O/V/ PIDNumber: (~-*;-\-~' ,:~ ''~'\ Name: ~u~ ~, ~~ Wastewater System: ~ew U Upgrade Address: ABSORPTION FIELD Phone: ~O ~ ~ ~ No. of BeSoms: ~ Deep Trench ~ Shallow Trench ~ Bed ~Mound D Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION ~.% o~/s.. ~. /~ / ~ ~ ¢, ~ ~. ~¢ ,t. WELL: ~ New ~ Upgrade Gravelwidth: ~ ~ Ft. Number oflines:~ Distance between lines:~ Ft. Yield: t P~mp Set at: Casing Height Above Ground: TAN K SEPARATION DISTANCES ~ Septic D Holding ~.T.E.P. From Tank Field Station Tank S .... Lines ~ ~¢O¢ ~ Well ~+ ~o+ ~t ~+ ~ ~ ~ Surface LIFT STATION Water ~ ~ ~ ~ + ~ Lot Sizeingallons: Line J~ IO 1~ ~ ~ I~D~ O~ Foundation lO ~ I O ~ ~ ~ Drain ~ ~ ~ ~ ~ ~ ' ~ BENCH MARK Remarks:~ ~ ~~ L O0 9°, Fl, ENGI~ SEAL Inspections performed by: P ~ ~ ~ Dates: ls~ 7~ ~ "'~""~'"---'*'~'- "~ ~ ~ ' 2nd Depar~men~ of Hearth and Human Services approval ~evi~wed and approveO by: Date: 72~013 (Rev. 9/91) MOA 25 Permit No. ;~PO/ ~'~ ':~ ~/// Page ~'_ of ~ Municipality of Anchorage 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 Legal Description: /~>-r- 17 ~-'~¢. 2_- }t./~e4~',m~.~w, ~J,~,~ ~ PID No' / / / / / / "-L / "~ / % / %. / '%,-,-% x. / 72-013 A [Rev. 9/91] MOA 25 Permit No. ~V~ ~' Z. ~o/~-~/ Page ~' of ~ Municipality of Anchorage 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 Legal Description: d 72-013 A (Rev, 9/91) MOA 25 ~ PERFORMED FOR: LEGAL DESCRIPTION: 1 2 10- 11 12 13 14 15 16 17 18 19 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: ~'!¢/-'~Township, Range, Section: ~ ~-/ WAS GROUND WATER ENCOUNTERED? Y~.-~ ~ SLOPE SITE PLAN S L IF YES, AT WHAT ! 0 DEPTH? ? p E Depth to Water Aiter hlonitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FTAND FT COMMENTS PERFORMED BY:_ '1~'~,.~:2__,}/~':' ~* '~- ~'~- r'~ , ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:--~Z~/~"~ 72-008 (Re',,. 4/851 SLOPE ' SITE PLAN 1 2 3 4 6 8 9 10, 11 12- 13 14 15 16 17 18 19, 2O WAS GROUND WATER ENCOUNTERED? COMMENTS Reading Date ~ Net ~ ' ' ': Del~th to , Net, Time Time ~." ~ - Water . Drop 9/ ¢'~ "'"" ~, ?~" PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER ~ ,'7 AND ~ FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LO6 -- PERCOLATION TEST DEPTH 3 4 7 8 17 18 19 20 DATE PERF( /tlzZ ~P¢~¢z~¢ ~" ~/?¢~:'~ ~5~-- Township, Range, Section: SLOPE I J WAS GROUND WATER ENCOUNTER ED7 SIT~ PLA~ IF YES, AT WHAT DEPTH? (]epth to Waler After Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE I (m~nutes/mch) PERC HOLE DIAMETER __ TEST RUN BETWEEN FT AND -- FT ,i;tcw--,,~- ..'~_< 2'7/ ~ f /'~'~'-'~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: THAT THI)~ TEST WAS PERFORMED IN 72-008 (Rev. 4/85) PERFORMED FOR: LEGAL OESCRIPTION: 1 2 3 4 5 6 ?,~ 7 8 9 DEPARTMENT OF HEALTH & HUMAN SERVICES ., ~S % Township, Range, Section: S~T~ 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 11 12 13 14 15 16 17 18 19. 20 COMMENTS Reading Date Net Time t2.: PERFORMED BY: ~, '~' ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Depth to Water PERCOLATION RATE ,~'7 (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 5~"~' FT AND FT / , / Net Drop CERTIFY THAT THIS TEST WAS PERFORMED IN PAGE 1 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 PERMIT PERMIT NUMBER:SW920141 DESIGN ENGINEER:DAVID R. DAYTON, P.E. OWNER NAME:KUNKLE CAROLYN R OWNER ADDRESS: 825 N. ONTARIO STREET BURBANK, CAL. 91505 PARCEL ID:05179221 LEGAL DESCRIPTION: MCKINLEY VIEW ESTATES BLK LT 17 DATE ISSUED: 6/22/92 EXPIRATION DATE: 6/22/93 LOT SIZE: 30090 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: IN THE CONSTRUCTION OF THIS BED DRAINFIELD, THE ORGANICS AND SILTY SAND MUST BE REMOVED TO A DEPTH OF APPROXIMATELY 3 FEET BELOW GROUND LEVEL AND A 2 FOOT SAND FILTER LAYER THEN INSTALLED PRIOR-%TO-PLAC/~G T~ SEPTIC ROCK. /! ISSUED BY: DATE David R. Dayton P.E, HO 78 Box 1026, Chugiak, Alaska 99567 9o0 Chuglu~ ...... ~J587 E[ECTR C E~EcTRICAL CONT (~94-9993 Dec. 26,1992 D.R. Dayton,P.E., R.L.S. 20210 Donalar Chugiak,AK. 99567 This is to confirm that the on site sewer lift station of Lt. 17,BLK. 2 McKinley View Estates has been wired in acc- ordance with the National Electrical Code.All electrical functions have been tested and performed to manufacturers specifications. e y, D. R. DAYTON, P.E., R.L.S. HC 78 Box 1026 Chugiak, Alaska 99567 (907) 696-2417 DESIGN NARRATIVE Lot 17, Block 2, McKinley View Estates The soils found in both the original system and reserve area test holes were the same. The receiving soils are a silty sand with a percolation rate of 8 minutes per inch~ which allows a loading of 0.5 gpd/SF. For a 3 bedroom homer the bed size is calculated at (3 x 150)/0o5 = 900 SF of absorbtion area. The lot slopes form Northwest to Southeast at approximately 3%° The subdivision is served by a "Class A" Public Water System and therefore contamination of wells is remote. The system will have no significant impact on future systems on adjacent lots, reserved space/surface or subsurface, or on drainage. Respectfully, David R. Dayton PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15 16 17 18 19 20 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After~ Monitoring? Gross Net Depth to Net Reading Date Time Time Water Drop ~; o~~ ~, 6, PERCOLATION RATE (~ (minutes/inch) PERC HOLE DIAMETER ~*~' /'' · TEST RUN BETWEEN FT AND '~:' FT COMMENTS : .':~ ""' ,: ,. : ;'?) . /'/: L ':'~¥"~' CERTIFY THA~ THIS/TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~?-~-'~.~ /,-~ ~ ..,.: ~ / 11 12 13 14 15 16 17 18- 19- 20 COMMENTS DATE PERFORMED: /F/c' ,~,',~.fz e'¢ 1/I U7~.~ ~¥~7 Township, Range, Section: ,~ ~:. ~ X~5' /~!' SLOPE SITE PLAN WASGROUND WATER ENCOUNTERED? S L IF YES, AT WHAT DEPTH? ~'~/.5' . pO E Deplh fo Water After .... ¢~ ~onitoring? ,~, 7 Dale: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FT AND FT " l(: '"" ' ' PERFORMED BY: :' )~ '¢:' /~?/~ ':/'2'.:L,/'I ' :-'~:'::::/:~< ' CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~'/~> ~- 72-008 (Rev. 4/85) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. 1. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLINGI: 0 051-792-21 HAA# H /7 ('") ~ GENERAL INFORMATION Expiration Date: /-'/J ' Completelegaldescription McKINLEY VIEW ESTATES SUBDIVISION; LOT 17~ BLOCK 2~ Location (site addressordirections) . 21304 BARON DRIVE * CHUGIAK, AK 99567 Current Property owner(s) THOUAS & KELLEY RILEY Day phone 688-1500 Mailing address 21304. BARON DRIVE * CHUGIAK~ AK 99567 Lending agency Day phone · Mailing address Real Estate Agent MANNA w/ PRUDENTIAL JACK WHITE Day phone 563-55{30 Mailing address ,3201 "C' STREET SUITE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [] Individual On-site [] Individual Water Storage [] Individual Holding tank r-~ Community Class. "A" ¥~ell [] Community On-site Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Aht~ority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professiona! 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 Authoriiy 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 samples. (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. i Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy 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 ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory les! results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. Phone 337-6179 Date ,~/~/~/0~ I / DSD SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: 5 ; V STEWATER : : Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety OIvtslon On-Site Water & Wastewater Program 4700 South 8ragaw SL P.O. 80x 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-79O4 HEALTH AUTHORITY APPROVAL CHECKLIST LegalOescflpUon: , McKINLEY VIEW EST.. S//D.t LOT 17~ BLOCK 2~ ParcellD: , ,051-;792-21,, W1ELL DATA COMMUNITY WATER welltype ,,,'A' IfA, B, orCprovtdePWSID~ 210697 Well Log (Y/N) , ~ -- :, completed ~ re ps rope~y protected (Y/N) , ...... Oata To Cased to ff. Casing,height (above ground) ~_ in. FROM VVELL LOG Date of test ..... StaUo water level . welt production _/, ,, g,p.m. WATER SAMPLE RESULTS: AT INSPECTION / ........ g.p.m. Coliform __._....._ colonies/100 mi. Nitrate ~mg./L. ' colonies/100 mi. · · ...,_.._ . of sample: Collected bY: Date ~ SEPTIC/HOLDING TANK DATA *INTEGRITY OF EXISTING S.T.E.P. TANK VERIFIED ON 5/17/2005. Tenk Type/Matadal ..... STEEL/$.T~E.P. Tank size 1-!250 gal. Number of Compartments. 2 Foundation cleanout (Y/N): YES Depression over tank (Y/N) NO Date of pumping r ' 5/20/2005 Pumper .. Date installed , , , ,'10/~2//1992 Cleanouts (Y/N) _ . ~ YES ,, High water alarm (Y/N) YES_ ,: ,JR'$ PUblPINO ...... *BELOW RNAL GRADE. ADDm0NAL F~LL AND GRADING TO BE DONE AB$0RPTIONFIELODATA IN SPRING/SUMMER OF 2003 AFTER GROUND HAS THAWED. Date Installed, ~,/$2-;t7/f28o3 Soil rating {~or ft~/bdrm) .0.45 System type TRENCH Length 174, (20 87)ft. Width, ,5 ...... ~ Gravelbelow pipe ,,, 1 ff. Total depth**=.,'~)--3.ssff. Eft. absorption ama 1000 flz Monitoring tube YES Date of adequaCy test NEW , Results (Pass/Fall) _ 'T ' Fluld depth in absorpUon field before test ~-. in. Wateredded ;-, gal. Newdepth Elapsed Time: ~,, rain. Final fluid depth - in. Absorption rate >= - g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ~ _ - ...... If yes, give date ~-T Depression over field, ,N,,O For .3 bedrooms - ill. LIFT STATION Date installed 10/2/1992 Size in gallons -1-see-- Manhole/Access (Y/N) YES "Pump on' level at 42 in. "Pump off' level at 4.2 in. High water alarm level at 44 Datum BOTI'OM OF TANK Cycles tested 3 Meets alarm & cimuit requirements?. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WATER Septic tank/lift station on lot Absorption field on lot Public sewer main On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line. 10'+ Surface water, 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '5'+ Building foundation 10'+ Water main 10'+ Water service line ** 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ COMMENTS **PER DAVID DAYTON P.E. AS-BUILT DRAWlN~ G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. *LOT UNE WAIVER GRANTED WITH ISSUANCE OF PERMIT. JEFFREY A, GARNESS ." ~ Engineer's P~nted/Name Date H Fea$ 3'/5.'° Date of Payment Waiver Fee $ Date of Payment Receipt Number Receipt Number (Rev. 12/01) 03/28/03 FRI 10:02 Fl! I 907 762 3189 Jack White Estate PAGE ~002 /8 '/ · ~JRVLr'f I::E:R'RFICA'llC~N PLOT ~ i.a,t ·JmlL~ PLOT PLANS & LOT SURI~'YS IT IS '~,,1~ RILI~ONIIlIUTY OF 11~g IUILOER 0tl O'lell:R, PI~OR TO COHSTRuc'rlON, TO W. RIFT F,i~F.a~OgE~ BUILDIN(I GRADE TO IrINI~'~E2) ~,ADE AND UTI~J'Y C~ONh~(~i~ AND T~ "PrepQred by_ Robert E. dohns, ~Jr. & Asso · · P. rofesslonc~ L~nd Surveyor,, ~ ! ALJ3(A It~0t ~ 1" .~ 40' 2003 -- N~14Sg , B%OCK 2, McKINDEY VIEW ESTATES AND FOR ~ IWllAL 1RANSA~IOI4 C~LY al~ ,LISI. J~D ~ IJASILrrY ~q.Y FOe THC ~ ~ ~ SUR~. 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. GENERAL INFORMATION Complete legal description Location (site address or directions) ' L--~Acz~.~,<) ~,;, ~,. -/~'ET,~-~X~ (._.,¢_,:~,.....,~/~- Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone 4.. Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 1~21 · Njo~ S,JOoU!ISuo I'etlo!ss%toJd at4:l u! :;uobgs!uJo Jo g Jo J JO Joj olq!suodsaJ lou s! oBe.iOLIOUV ,to X),!led!o!un~ OLt± 'panss! s! o]eo!,tl:lJao e oJot. oq alep OZZleUe .~o suofioodsu! !onpuoo ~.ou op SHHG ~.o saaXoldUJ-] 'siuat.uo.qnbaJ a!.e]s pue [eJopa,t u!e~,Joo XJ. sp, e~4 o~, JopJo u! suo!),n]!]su! [3u!puol JpLtt pue souJoq jo sJaseqoJnd o] Asa~J noo e se SILl] saop SHHEI OLLL 'eNSelM ,to o- :!els aLI!. u! pa.ia]s!5oJ Joau!fJuo leUO!SSOjoJd luapuadapu! ue Xq aAoqe. 9 LtdeJDeJed u! UaA[6 suo!~.e]uasoJdoJ OLI1 uodn ZlUO poseq ,sa:!eo!t.!l.~o,O I~^oJcld'v' XlpOLp, nv tOlUOH sanss! (SFII-IG) SOO!AJa$ UeLUnH pue Lt~leOH ,to ],uot.u'IJedaG ODUJoLpuv ]o A'dled!.o!unlAl OH_L situou~woo leUO!:l!ppt/ :suo!~elndBs 6UmAOIlO~ Or8 q~!t~ 'SLUOOJpoq 'suuooJpoq '9 ssoJppv 'uo]toadsu! siql jo elep oq~ uo ~ooCp ui suo~llslnDoJ put? 'soout~/J~pJo 'sopoo e~elS pus led!o!un~ IlS LI~im aoUe!ld~lo9 ui si LUOlSXS lesods!p ~o~eao~e~, .io/puls Zlddns Jo~e~ o~j9-uo 8~ 'uo!~oodsu! pue UO~e~SOAU~ X~ ~OJ} pus sol!~ o~eJOMOU'F }o Z~!ledpiunld o~. ~oJJ peu!e~qo uo!le~Jojuf a~l uo poseq ~e~ X}~JOA JOL~n} I 'LI~OJOLI po}es!pul O.ll3~gnJ)¢s :~o odX~ pue s~ooJpoq $o Joq~nu OLt~ ]O) o~enbope pue leuo!~oun~ 'o~es s! uJo;sZs Issods!p Jo~emo~se/A JO/pLll? Xlddns Ja~em a~!s-uo alii ~eLll SmOgS uoReo!ldde leAOJddv X~ ~e~l X~JOA I '~olaq u~o~s oi.ep uoi~epHea -fi Legal Description: WELL DATA Well type ~¢' Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST i7 ~- Parcel I.D. If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number Driller Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line AT INSPECTION ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: SEPTiC/HOLDING TANK DATA Date insta,,ed Cleanouts (Y/N) ~¢ High water alarm (Y/N) Date of pumping ,,/~f~ Tank size i-Z~'~'"~c~) Compartments Foundation cleanout (Y/N) Y Depression (Y/N) ~ Alarm tested (Y/N) ~ ~,/'$/"-Z~'q Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot A~./,C- To property line I ~ Surface water/drainage On adjacent lots Absorption field /t~///_.~-"~ Foundation ~ ~ Water main/service line /od-- 72-026 (Rev, 7/91) Front CONTINUED ON BACK PAGE BFT STATION Date installed ___ Size in gallons . Vent (Y/N) High water alarm level _ Meets MOA electrical codes (Y/N) "Pump on" level at Manhole/Access (Y/N) _ ~--2 ~'~ "Pump off" level at ~) z- _ Cycles tested _ SEPARATION DISTANCE FROM I_IFT STATION TO: Well on lot AJ//~ _ _ On adjacent lots Surface water ABSORPTION FIELD DATA Date installed .. Length ....... ~7/'¢ Width ._ _'~ ¢; Total absorption area .... ~ ~, C> Depression over field (Y/N) .... ~/~, Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Gravel thickness ~ ~' / Cleanouts present (Y/N) _'~ _ Date of adequacy test for .... bedrooms If yes. give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots A~///~ Property line '?_ o To existing or abandoned system on lot _ On adjacent lots G ~:~ .~. _Cutbank ,~//~ _Water main/service line.__ Surface water '2,~',,~> ~. _ _ Driveway, parking/vehicle storage area _ -~ - Curtain drain . /v~//~'' _ Well on lot _ To building foundation E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date David R. Dayton P.E, 90210 Donalar St. ChuCak, Alaska 99567 HAA Fee $ ..... Date of Payment Receipt Number 72 026 (HEY. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number WALTER J. HICKEL, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 (907) 349-7755 Januaw 28,1993 Mr. Ray Shafer S & S Engineering SUBJECT: McKinley View Subdivision Class "A" Public Water System, PWSID 210697 Dear Mr. Shafer: I have completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on January 4, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on February 4, 1991. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. o The last Radioactive Contaminants Sample results were submitted to the Department on October 30, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on June 23, 1992. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. If you have any questions on the above information, please do not hesitate to contact this office at 349-7755. Sincerely, ~'c~ael Lu Environmental Eng. Asst. II