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HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 2 BLK 2 LT 15Glenn View Estates West #i Block 2 Lot 15 #051-793-32 Municipality of Anchorage Development Services Department Building Safety Division , • - On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of 1 www.d.anchorage.ak.us (907)347-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number- _50 q _7q PID Number: QS(---M;— oZ Hato Leo e Wastewater System: ® New pg Y ❑ Upgrade 5-4h r' ABSORPTION FIELD 5 C! DW T,M I(Slwlm 7,e 17 BW I7 M"W t] DIMr. LEGAL DESCRIPTION SOa RMMq Tal D" kan aprW ese P "• Ft. Bmck LM 1 F— SWe7n J DMO/ m Pew"" km a�7^M` "14"" a.om eM ..m ow a S Ft TO+n,ka Renee Swan -tra O: Faa00s0tl OnyWSrM nis MLMpin 15_..+. �F t— ' t_7 f1. Well: El New ❑ Upgrade Grm1+WIM1 NuroM altos a ,Mam , Deelw..n lW % FI. FI Cle,oOu+an (PlMlt,(A, e. e) rar DlpM1 c.uEm Npi f er- FI tar aUbplan M.. ZQ J�J Ft' P MnMW M D3o3y F o p•er OM SIMM WMM Level 1a1~ ! l SOL Doe kulaLW 5— '� FL GOn.Sriy oC Y,em Pt SM M. Ca,. AD eWOW TANK GPM Fl. FL SEPARATION DISTANCES IK Septic ❑ Holding ❑ S.T.E.P. ❑ other. To From Septic Tank Absorption Field LIR Station Holding Tank PuMc/PlIvat Sewer Line Mani°ad w y C . TQl&- Capaah 1606 GA Wee 't- J f' ^ ^/ C� t MMM�r 5tee_ Hume« a Daro.nMa, a S1dm weler !+- +- LIFT STATION LOILM 57' 13' °' MvWXIVM FOuraaan —7 , �/I. , 'Pump OI IaM M 'Play) •I Hqn ryMM MYm N JL/ i . In CMIem Olam t° vow PMIyr MM4 E1.VK31 Mlpatl,pna pvfw WOr RemwMa BENCH MARK Laeaeon and De,oMeon ; B&tbrvl Of L >t yL A. Ie.Man. FI En ' 1 " •• '•y S b S ENGINEERING 17034 Eagle River Loop Road, No. 204 al 5 Inspections performed by: Dates: 1 9951, * 9t a Elgle 'Alask, 2nd 5-3-00 ,� .� , �-....._.[; ROBERT G COWAN /W Development Services Department Approval sf` CE $801 Reviewed and approved by: ct ✓� Date: 2- 11 IRo CMI J t'/ PERMIT NO. SW010479 PACE 2 OF 3 Municipalit of Anchoraqe 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 LOT 15, BLOCK 2, LEGAL GLENN VIEW ESTATES WEST #2 P.I.D. NO. 051-793-32 LOT 14 KEYBO% MTI NEW TRENCHES C04 CO' [,k MT2 TH I Mi! TCO2C01 E.MTI GR4y ES (FLOWSPLITTER) CNEW 1500 GALLON ST2 DBLI & DBL2ALT. SITE SEPTIC TANK M TBW STI TCO O� y0`t'Jy� A N SCALE: V - 50' ;�[O ��� ��,�. • ••-.1s- LOT 16 WPA ROBERT C. COWAN g CE -8801 �'� PERMIT No. SWD10479 PACE 3 OF 3 DEPARTMENT ANDhHUM9AN 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 LOT 15, BLOCK 2, LEGAL GLENN VIEW ESTATES WEST #2 P.I.O. No. 051-793-32 FINAL GRADE MTI MTI = 90.3' ST1 ST2 95.0'/ I NEW 1500 GALLON SEPTIC TANK 98.1' 2" INSULATION 94.8' CO1 CO3 CO2 MT2 CO1 = 97.6' MT3 C04 b1T4 CO2 = 97.6 CO3 = 97.3' C04 = 97.3' (FINAL GRADES 111i,Jill oil C01 = 'Lft(fGlL'L' I ..0 • 92.8' • IN - MT2 = 90.2' MT3 = 90.5' A NO WATER FOUND 83.7' B.O.H. CO3 = 93.1' C04 = 93.1' MT4 = 90.5' N. T. S. A B C FCO 22.0 1 18.0 - ST1 33.0 1 13.0 - ST2 43.0 1 16.5 - DBL1 45.0 1 18.0 - DBL2 46.0 18.5 - FS 55.0 25.5 - 001 65.5 48.0 - MT1 64.0 45.0 - 0O2 - 52.0 44.0 MT2 - 51.5 45.5 CO3 81.0 62.0 - M T 3- 80.0 59.0 - 994- 63.0 59.0 MT4 - 63.0 61.5 - MT2 = 90.2' MT3 = 90.5' A NO WATER FOUND 83.7' B.O.H. CO3 = 93.1' C04 = 93.1' MT4 = 90.5' N. T. S. Performed For: I f•M*+/ Legal Description: Lor Depth (Feet) On�,,q-NAGS 2-10 7- 7- o•�/� 8- /. 9- • o 10- it- 12- 13- O 13- ' v O 15- 16- 17- 18- 19- 20- 15- 16- 1 7- 18- 19- 20- unicipality 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 Aww. cl.anchorane. ak, us (907) 343-7904 w Solis Log - Percolation Test Date M %3t nrJ/_ Z•' WAS GROUND WATER A10 ENCOUNTERED? a IF YES, AT WHAT DEPTH? - L Depth to Water Aher D Monitoring? E Date: OL phi ROBERT C. COWAN CE -6601 Site Plan 7. Reading Date Gross Time Net Time Depth to Water Net Drop O y '4. — 3 o M,., g 34 3 V3 4, rr� p _ q#4 r. _ 70 10 f r ✓ 8 res " 3 7/s " PERCOLATION RATE !. / (m Ies&xh) PERC "OLE DIAMETER ly ' TEST RUN BETWEEN .3 FT AND Al FT COMMENTS_ -ttS7- NO LE -# -2- PERFORMED BY: 7h rKt G t.aR C 1 �1 ./ e , /R.4,_ CERTIFY THAT THIS TESI WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: P01/07— S& n0DEnt C. cowAN, CE. nG©EnTA. SI IAFER PE. CIVIL ENGINEEnS (907)694-2979 Date: 5-13 - o a rAx(907) 694.1211 IEALII1ALn1*"TY ArTMNALS Municipality of Anchorage SEK119WAR" DEPARTMENT OF HEALTH AND HUMAN SERVICES IAMIXTENSMS 025 L Street P.O. Sox 196650 Anchorage, Alaska 99519-6650 .SEWEn A WAIEn 111SPECIIOII / / .L REFERENCE: Ldf IS., D p l oek 24 6:1emnV eL4)tSIA7l eS Vesf FIgnEEMk17111[ME9 AtD`emni7 The septic ins actions for the referenced P P property were performed on and 5 -'3 -Oa . Prior to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the /45'builfsuryev to be WEILEArECTM aFLOWTEst completed. If we may be of further service please contact us. SITE rt" Sincerely, FXWDESIM Robert C. Cowan, P.E. SMIESt PEMOIATnN IES1 elructuvLA • ,. LEawacAa !AI'ECIOIA i ONSITE WASIEWAI En OWWALSY MEM OESIa1 17004NG1n11EAGLE 11NEnLoop SUItE204-EAGLE MER ALASKA 99577 MUNICIPAUTY 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 PERMIT Initial Permit Number: SWO10479 Legal Description: GLENN VIEW ESTATES WEST PH 2 BLK Design Engineer. 0003 S & S Engineering Owner Name: Leroy Alderman / M2C1 Inc. Owner Address: PO Box 670045 Chugiak , AK 99567 - Date Issued: Dec 05, 2001 Expiration Date: Dec 05, 2002 Parcel ID: 051-793-32 2 LT 15 Site Address: 021243 POLLY CIR Lot Size: 40108 So. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of 0✓ Disposal Field 0 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: Issued By: Date: );L/ G /of Date: 2 �� -\ Municipality of Anchorage • -- Development Services Department << Building Safety Division 8 On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. b .S-1- xis -3a Permit Number SWO/0479 Propertyowner(s)Day phone 9100 Mailing address (1) PO �ox 670 0 45 Mailing address (2) ('/11 &I!g r a k Zip Code gq$67 Legal description (Lot, Block & Sub'd.) Lo+ 15, RIor_k:?j GI inn Vjewzffate5 WegrzQ Legal description (Section, Township & Range) Lot Size 140107 Acres Number of Bedrooms +-/D(O $ THIS APPLICATION IS FOR: S Sewer Only K 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. ZS & S ENGINEERING 44_,V✓ 17034 Eagle River Loop Road No. 404 (Signature of property owner or authorized agent) YC Permit Fees: 3 3 0. Date of Payment: h/3. �� f Receipt Number: (Rev. 12100) 000 3 Waiver Fees: Date of Payment: Receipt Number: November .,2001 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 " s"p`ry A MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWEq 6 WATER MAINEXTENSIONS REFERENCE: Lot 15, Block 2, Glenn View Estates West #2 SEWEnCTTIC" It is requested that you issue a permit to install a septic system to serve the proposed firebedroom dwelling on the referenced property. EWT NEMWSTUWS A test hole was excavated and a percolation test was performed. The approximate location ANDREPORTS of the test hole is located on the attached site plan. At the time of excavation 4/20/99, water was not found. After monitoring, no ground water was found. L We do not anticipate any adverse effects on neighboring wells, septic systems, reserve ow TEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. &TE PlA48 If you require additional information, please contact us. Sincerely, ROADDEMN 1 4ye? �y . ,s SM TEST Robert C. Cowan,- P.E. RCC/bjj Enclosure TETXXArTDN EST STSLCTUM MECITNACAL NSPECRONS ONSITE WASTEWATER CTSPOSALSYSTEM CESTON 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 90577 SITE PLAN DESIGN 1" = 20' AI Sm ^ O=r A 0 00 � ���°' O0Omm�o C.z u•� ���y� � .. �oMa ZO eV� b cines Loa i /may .�/ \ >O nom? II OII 7 r O s mo O v nV ^ C1 O C V) ^ z :3 cf) CD -U Q p :n -moi ;a 0 o x n r� �z\ 0 m 4 I D �/Z cm ton n Z C O A C D 2 I+n W Opvq cr OA 0 N S O(1 N �O C� V /�� � % N z I ogo ami N^ U: 1 % — 0�ctj O m ^^ OV O(�// ~�K�A�N �R -3 7 n n� 13 mNNm NA r I+ w90- y> ro Om%) n_ 0 -in 'G I•: O % LO O -i O m D KCn Ar� i •�n y.�i,1 O I I m> I I "^� H g Cf) rl <.,�c 'o o p SITE PLAN DESIGN 1" = 50' SCAI T�4 wx \ 0Fr rte,= �Tm OHO �nNa �.i�p mZ0 •O o�� p N to N n e .p+• CNK r m 'OM K e / Op�G�0�C7 �cO-C c)) F � moo,m+mim n oil C7 .. c r''n mph n o u 7 C z , m y rr rr ® m (� moo v 19 mo� c ►. x � � b O/N A C 03' Ci n�� (sC^1 0 < yx•�• Z9 CN n + lV N FC'gn lV/T C -3 S !QED cn H Roo Lai o a 7-• SUS dJnyy 2,2 '�'-�i ?.Q y d 110� wo TO I Al Is oomo yym N� U tz ow mo I I I G UFFF m FYn 3 mNI"'r Y i u uj �mK;i� = U c �] C'i?oCiya N.. V. ' oRim 7� [-� vmnm Ino mmol O am N> N y y�MO ox CD oor� <m 1. O CF 'LN y f m o n 0 ocoal _ = m / n nnm H �n��• In ley` bid i, effect an this date. Cola 0158d !njto:a oo-e?-QOA KA TION TEST 41k tOMF HOLE# 2!IwWo SEE ATTACHEDSITS HOL13 LOCATIONNO.- 7. ,t;r after vwniWdng? MY mle Dall - E� to, I. Pt aDaMUIRG % - ,20.441-FrAXmMm BLVD. Tim ERCC Perforated &6-` Arctlg'Divio/Tuiiiie Cone L& is, Blciek,2� dliten Vli :Ndcnbotb= lam 30 utin V & wa 0n tbp wifirA 1210 4 - boo 30 ulln 4/160 Mod dww, fine sud 2' 00" to 61 4 Added , /dandty. ILOJL 7 ... ... ... 13. 9 US HOLEPRISOAKM 20- PRIOJLTO.TESMNC:,%.. bid i, effect an this date. Cola 0158d !njto:a oo-e?-QOA KA TION TEST 41k tOMF HOLE# 2!IwWo SEE ATTACHEDSITS HOL13 LOCATIONNO.- 7. ,t;r after vwniWdng? MY mle 3.0 feet and i -O ^ leo !VNIU33NIDN3 CNN :As iuss Dall E� to, Net Tim 12a5 30 utin 1210 boo 30 ulln 4/160 Added 3.0 feet and i -O ^ leo !VNIU33NIDN3 CNN :As iuss S& ROBERT C. COWAN P.E. CMLENGINEERS (907)694-2979 FAX(907)694.1211 W-kTN,,,,,HMTY ON-SITE WASTEWATER DISPOSAL SYSTEM AMOVALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWER& WATER MU40CTENSIOM REFERENCE: Lot 15, Block 2, Glenn View Estates West #2 November 14, 2001 SEWER & WATER "5PEC00N GENERAL: 1. The scope of this project includes the installation of a 1250 gallon minimum ENONEEM4SRMMS septic tank and new trenches to serve the proposed four bedroom residence ANOREPCRTS located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design WELLMPECTM drawings, Municipal permit with any special provisions or conditions, and all &FLOW TEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground SITE PLANS utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. BOAT OESN71 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SOIL TEST own systems must also receive prior approval from the Municipal Health Department. PEAL ARON TEST SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. STRUCTURAL& Construction shall include two 4" cleanouts for pumping access. WCIWaOAL OSPECRONS 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER CISPOSALSISTEM CESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 Page 2 Lot 13, Block 2, Glenn View Estates West 02 November 14, 2001 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 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: 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 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. 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 1S, Block 2, Glenn View Estates West 02 November 14, 2001 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pike Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (IIDPE) 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, Miraf1 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 requirement applies. 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: Page 4 Lot 15, Block 2, Glenn View Estates West 02 November 14, 2001 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 Municipality of Anchorage T° Development Services Department �- I Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 % CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING l L Parcel I.D. �I S� �! COSA# 0C1 L-9 6 1. GENERAL INFORMATION Expiration Date: 'q - / 0 / 0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GLENN VIEW ESTATES WEST #2, LOT 15, BLOCK 2 21243 POLLY CIRCLE • CHUGIAK, AK 99567 ELECTA KEAN Day phone PO BOX 671630 ' CHUGIAK AK, 99567 Day phone 360-0158 KAY HANKS W/ PRUDENTIAL Dayphone 689-6529 3801 CENTERPOINT DR. 4200 'ANCHORAGE. AK 99501 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System (! TYPE OF WASTEWATER DISPOSAL: Individual On-site E Individual Holding lank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site System's 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage (les 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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. 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 test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. 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. 5. DSD SIGNATURE l� Approved for Disapproved. bedrooms. Phone 337-6179 Date 6)10 0 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: D ' � ' d� (Rev. 11/05) Municipality of Anchorage ° Development Services Department . Building Safety Division �_.. On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLENN VIEW ESTATES WEST #2, LOT 15, BLOCK 2 Parcel ID: D 5 % q 3 '32_ A. WELL DATA PUBLIC WATER Well type If A. B, or C provide PWSID# _ Well Lo Date completed Sanita s Wires properly protected (Y/N) T ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. 9•p•m- WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg./L. Oth ie ml. Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 5/3/2002 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Dale of pumping 7/27/09 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA OBELOW EXISTING GRADE NORTH TRENCH/SOUTH TRENCH Date Installed 5/3/2002 Soil rating OEorft'ibdrm) 0_8 System type 5—WIDES Length 120 (2 ® 60)ft, Width 5 ft. Gravel below pipe 2.5 ft. Total depth* 6.41 /7.75 ft. Eff. absorption area 938 ft' Monitoring tube YES Depression over field NO Date of adequacy test 2/21/2008 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test -2/-9 in. Water added 520 460gal. New depth 18 17in. Elapsed Time: 300/360 min. Final fluid depth 15 121n. Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE KNOWN If yes, give date D. LIFT STATION Date Installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. 'Pump off" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service areas PUBLIC WATER On adjacent On adjacent sewer manhole/cleanout Holding tank Manure/animal excrete storage areas 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 10'+ 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'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field Inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 8 /r 4J,__0 C) COSA Fee $ "l J O Date of Payment g I 10 109 Receipt Number 0 5 9 3 O (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number E Q; POL Y 0�._, CIRCLE z k R£— . �2 q|ƒƒ I &ƒ|f K § a �f§ [w %f*7{{�� s fn§§n § �§ ®n k|§!�;| F!ki�(�`k�' �32[,i� § }!I f�(■E&�§— ,�,�.��%.': �f�ftM, A . X-.SBJ �k k! §$ �-°/—/e % i~(f\ f0[(•14 93 LA % 1'j Sq 0 1 §M§ j. FS g i SIB, �. F,& § ■ . Rw 9Zo, m'd a,1 -41a::1 9841 aM B!■, Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. _alai off COSA# &� 1. GENERAL INFORMATION Expiration Date: Complete legal description GLENN VIEW ESTATES WEST #2 LOT 15 BLOCK 2 Location (site address) 21243 POLLY CIRCLE • CHUGIAK AK 99567 Current Property owner(s) DONNA ALDERMAN Day phone 360-0158 Mailing address PO BOX 670045 • CHUGIAK AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines /or 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 inspection, the information robtained supply i ply a dl thewastewater Municiplity of disposal system isles and from my investigation (are) in compliance with all applicable Municipal on-site water supply and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, ltd. 3701 E. TUDOR ROAD, SUITE 101 isANCHORAGE, AK 99507 Address Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, VD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with A orEmance and OA DSD Guidelines & Regulations. The reported results described the pe system under the conditions encountered at the time of the test, and separation distances measured to readily identiriable 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. ar, Those conditions arearaoutside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. 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 bei of the owner listed other person orparty is not authorized, norr will it ( confer any legal right iance upon or use of whais tsoever.ort any 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date 2Z6 0 6 rness: 1.� •� C - Conditional approval for bedrooms, with the filowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Nitrate Advisory Other By: J`:.•••• . O ON-SITE • WATER AND WASTEWATER PROGRAM Original Certificate Dale: 6!— 6—e?� Municipality of Anchorage Development Services Department e Building Safety Division Onsite Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: GLENN VIEW ESTATES WEST /12 LOT 15 BLOCK 2 Parcel ID:DJ /— 7—?j2 A. WELL DATA PUBLIC WATER Well type If A. B. or C provide PWSID# Well Lo _ Date completed Sanitary se -- Wires properly protected (Y/N) T°s'I �o 'r ft• Cased to g, Casing height (above ground) in, FROM WELL LOG AT INSPECTION Date of lest Static water level ft. ft. Well production 9 -P.M. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate mg./L. Oth ies ml. Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed_ 5/3/2002 Tank size 1500 gal. Number of Compartments 3 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 _ 10/22/07 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA FBELOW EwSnNG canoe Date installed _ 's/s/2ooz : NORTH TRENCH /SOUTH TRENCH Soil rating p.d./ or ft /bdrm 0.8 )— ,System type 5—WIDES Length 120 (2 ®60)t. Width 5 ft ' Gravel below pipe 2.5 ft, Total depth •6.41 7 7 ft. Eff. absorption area 938 ft=Monitoring tube YES Depression over field NO Date of adequacy test 2/21/20o8 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 9/9 in, Water added 520 460 —_gal. New depth 16 17in. Elapsed Time: 300/360 min. Final fluid depthl5 12in• Absorption rate >= 750+ g.p.d. Any rejuvenation treatment (past 12 me.) (Y/N & type) NONE KNOWN If yes, give date ---= D. LIFT STATION Date installed "Pump on" level at in• E. SEPARATION DISTANCES Size in gallons Manhole/Access (rfry Hi h water alarm level at in. "Pump off" level g Cycles tested Meets alarm &circuit requirements SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main PUBLIC WATER On adjacent On adjacent sewer manhole/cleanout Sewer /septic service line Holding tank jpima n ainmenI areas— Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: 5'+ 5'+ Property line 5'+ Absorption field Building foundation 100'+ Water main 10'+ Water service line 10'+ Surface water Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1�+ Building foundation 70'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 1 certify that 1 have determined through field inspections and +! :, •, • • , , review of Municipal records that the above systems are in O conformance with MOA COSA guidelines in effect on this O J A. Garness: date. FFG Engineers Printed Name JEFFREY A. GARNESS Q �; '' E-795 �OQre .�Z.A��ao Date Zzof 3111 00000 4000 COSAFee� rr Date of Payment $ I r LE Receipt Number y 43z� (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number T-640 P.003/003 F-011 ...6c toms. - ' M v'%Ck 'I y r °a ID co Fn h C O psisa_, s u~$° v o" Nod u� 'ii In M ry ,s ♦��1TA it 404', 6 gn R • F � I E •: J♦ a�4� �r��5 0,� J K •s, 1 r{ ry �5 Fes+ a0. %O: d ; Go cm Ap ca 1 1 Sao�•.►� ,,, g�fi.��� oa u — C n W ~ Qo y ~ Oy sr�� igS-8r_c"Q n1 w O W) o ZGG.O$SY - ' M v'%Ck 'I Municipality of Anchorage • Development Services Depitiment Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. ' A, C P.O. Box 196650 Anchorage, AK 99519-6650 www.chanchorage.ak.Us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D._�,51_�032 HAA # 02036, Expiration Date: 'i- 3 O - 03 1. GENERAL INFORMATION r Completelegaldescriplton Lot 15; Block 2; Glenn View Estates west, # Location (site address or directions) Current Property owner(s) Lp r ny A 1 A p rma n Day phone —-223 8 } 08 Mailing address PO Box 670045 Ch hoiak AX 99567 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 741," 2 4+ 7 A /a z- 2. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site B Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well El 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 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties serv?d by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date 1shown 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 Slate codes, ordinances, and regulations in effect at the time of Installation. Name of Firm S & S Engineers no Phone 594-2479 Address 17034 N Eagle River Loop Ste. 204 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date -7/;L6/oz '�'„ ROBERi C c COWA CE. N 8801 5. DSO SIGNATURE i Approved for bedrooms. , Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments WGCTFWGTFR Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By. %I - ',�. �.c�l Original Certificate Date: %, 3 G " C� M" uwi Municipality of Anchorage • Development Services Department Building Safety Division On -She Water & Wastewater Program 4700 South Bragew St. P.O. Box 1W650 Anchorage, AK 99519.6650 www.d.anchomge.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: %D i -AWN VIAIJ Parcel ID: A. WELL DATA &Sr WG'Sr Q%4*W C., Won type _ B A, B, or C provide PWSID # Date completed _ Sanitary seW*/N) _ Total depth ft. Date of test Static water level Cased ft. FROM WELL ft. Well production _ WATER SAMPLE RESUL Coliform colonies/100 ml. Date of sample: Nitrate ` mg.A. Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material *;Ori(,, Tank size gaf. = Number of CompaAments v !�v Foundation cleanout (Y/N) Depression over tank (YIN) Date of pumping Pumper i C. ABSORPTION FIELD DATA Wen Log (Y/N) Wires ply protected /N) Casing height (above round) In. AT INSPECTION ft. 9 - p.m -Other bacteria colonies/100 ml. Date installed S Z Cleanouts (Y/N) High water alarm (Y/N) _Al S Hzco-u� Date -installed '� Soil rating ( p.d.AN ft2lbdrm) � System type00 6-1,4 Length . ft. Width ft. Gravel below pipe Z•, Q. Total clap � Eft. abs�orpJtion area Sft° Monitoring tube Depression over field Date of adequacy test N Gill Results (Pass/Fall) Fluid depth in absorption field before test _ in. star added_ gal. Elapsed Time: _ min. Final fluid depth in. Absorption rate >= For �edrooms New depth_ in. Any rejuvenation treatment (past 12 mo.) (Y/N 8 e) If yes, give date ... D. UFT STATION Date installed _ "Pump on" level at Datum E. SEPARATION D' �IA Size in gallons Manhole/Access (Y/N) In. "Pump ofr level at _ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line TO: 1014 6i C� . On adjacent lots On adjacent lots _ Public sewer manhoi Holding tank SEPARATION DISTANCES FROM SEPTIC/H1G TANK ON LOT TO:do r / Property line S r Absorption field Building foundation Water main /0 Water service line _! D Surface water L� — Wells on adjacent lots �J�C/ w#rtR SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: r/ Water man 0 Property line l � f Building foundation i � � t � Water Service line f �� j Surface water — " �.n Driveway. oidn9i hicie storage Curtain drain /ere+ Wells on adjacent lots 1 �atr c w f r4 �2 F. COMMENTS G. ENGINEER'S CERTIFICATION I codify that I have determined through Beld inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name e A J `r C. e o wArj Date / x �o HAA Fee $ 3 % S - d� Waiver Fee $ _ Date of Payment 7 /,IL;-/ o z Date of Payment Receipt Number 2 3298 Receipt Number _ (Rev. 12100) 11% qtr "A" `c� � Cf • aBol