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HomeMy WebLinkAboutFOREST VIEW HEIGHTS LT 19AOnsite File Forest View Heights Lot 19A #014-141-88 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201444 PID Number: 014-14188 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name BILL & NIKKI STOKOE TRUST... ABSORPTION FIELD - EXISTING ❑ Deep Trench El Wide Trench El Bed ❑ Mound Site Address 3320 E 72ND AVENUE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 3 GPD/SF JTotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. FOREST VIEW HEIGHTS 19A Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft2 Ft. Well 100'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. Deck piling driven. Alarm location Electrical installed by Installer NORTHERN EXCAVATION PIPE MATERIAL House to tank 3034 Tankto dra afield 3034 Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection1s` 10/28/20 ad 10/29/20 Location and description dates:L 3rd 4`h IBOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL 0 \� �, 1 1 Conditional Approval: Date Aw •� • .' r Curtis Huffman rj {r1�'�c��,• CE 128991 .•��� Septic System _ Appro - ' J Date v�lF�FO 111 ,pROF10/30/20�o�v�_� Note: this approval does not include well permit requirements. ESSION- �iW6P�C— (Rev 05/02/18) PID: 014-141-88 PERMIT: OSP201444 EAST 72ND AVENUE A—C=18.4' B—C=26,0' A—D=19,8' B—D=30.5' A—E=22,0' B—E=34.9' SEPTIC SECTION FOREST VIEW HEIGHTS LOT 19A PREPARED FOR: BILL & NIKKI STOKOE 3320 E 72ND AVENUNE ANCHORAGE, AK 99507 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK©gmoil. com SCALE, NTS SUPPORT#SERVICES: OF AL,46, twcs C * 9 7R DATE: 11/2/2020 tis Huffman .44 SURVEY: HOLT 2020 ✓J, CE 128991 DRAWN: FWCS11/2/2020�� SCALE: 1" = 30'�'Esstp��' EAST 72ND AVENUE N 89 56' 57' E 133.58 CHAIN I CO 81 MT EXISTING STAKED WELL �+ f1ELD RADII PRIOR � TO CONST. i oE°"ac s�G DRIVEWAY DECOMMISSIONED / REMOVED A OP EXISTING SEPTIC TANK 1R3 Cp E & INSTALLED NEW BM MF� 1000—GAL HDPE SEPTIC TANK —p IN SAME LOCATION fr rl :L FAMILY WITH NEW DCO & SPUTTER. D SINGLE HOUSE C) m x 3BR HOUSE FCO MAINTAINED 5' TO EXISTING FIELDS & DROVE E STiN PILING TO BOTTOM B so. ELL OF TANK ELEVATION. F - CO } 3 LL OVE RCAVE w N O V) Q O W O O M ZN 8 v Z .N- b RODE SCALES 1' = 30 A—C=18.4' B—C=26,0' A—D=19,8' B—D=30.5' A—E=22,0' B—E=34.9' SEPTIC SECTION FOREST VIEW HEIGHTS LOT 19A PREPARED FOR: BILL & NIKKI STOKOE 3320 E 72ND AVENUNE ANCHORAGE, AK 99507 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK©gmoil. com SCALE, NTS SUPPORT#SERVICES: OF AL,46, twcs C * 9 7R DATE: 11/2/2020 tis Huffman .44 SURVEY: HOLT 2020 ✓J, CE 128991 DRAWN: FWCS11/2/2020�� SCALE: 1" = 30'�'Esstp��' EAST 72ND A VENUE ------------ --- ------------ - -- ------ - --- - - - - -- - - - - - - - i i i i i i i i i i i c N 89 56'57"5 13356 i CNAINLINXFFNCF AS-BUILTSURVE'Y 7" =20' �4 m LS -6914 . 'o` O p.•. ..• Al NO CORNERS SET THIS DATE Loo IHEREBY CERTIFY THATI HAVE PERFORMEDA SURVEY O��000pQ o rn LOT 19A, FOREST WEWHEIGHTS(FLA T 2014-96) THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOWANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLA T TED LOTLINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS 31TUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCEIINES. THE PROPER, TYLINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT EXIST OTHER THAN NOTED. ARE NOT SHOWN HEREON, UNLESS NOTED. DATED AT ANCHORAGE.ALASKA THIS 2ND DAY OF NOTE. FENCELINES THAT MAYAPPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE NOVEMBER . 2020 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. i I I Q' DECK L 111 11 � ' — —3a�-- I I 193 ------ — • e I ?' �. FAMILY HOUSE SINGLE o i� I '-j— ras a.o ff 3.90' 1 ,'ETF I pATIC, ' O WELL I S ?OOF SAVE c i I J 0 t � ' I ROOF AV � , , , ` I:' 'Ae7lv!: i � I i opo OF OOO ` QUONSETMETAL BUILDING ai GG 49 TH .70�� I "v v o 0 N 89 57'36" E 133.55 SHANE A. HOLT..., DO AS-BUILTSURVE'Y 7" =20' �4 m LS -6914 . 'o` O p.•. ..• Al NO CORNERS SET THIS DATE Loo IHEREBY CERTIFY THATI HAVE PERFORMEDA SURVEY O��000pQ OF THE FOLLOWING DESCRIBED PROPERTY LOT 19A, FOREST WEWHEIGHTS(FLA T 2014-96) THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOWANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLA T TED LOTLINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS 31TUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCEIINES. THE PROPER, TYLINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT EXIST OTHER THAN NOTED. ARE NOT SHOWN HEREON, UNLESS NOTED. DATED AT ANCHORAGE.ALASKA THIS 2ND DAY OF NOTE. FENCELINES THAT MAYAPPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE NOVEMBER . 2020 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. xoaT LAND sURVEYZNi VEYIN LANDGROV 9309 x 14812, F6208-58,209-46 ANCHORAGE,AK 9950 MUNIMPALITY OF ANCHORAGE Onsite Water a Wastwatst Program PO Bax hem 477 Eln&&l08d A,::hDm�x. Ala6ko 5951P4G50 Ph (907):341,179M Fait X907) 343-7£07 hltpjlwn W.MLkr i3OW0r1sile 0n-8fte Wastwimiftr DIsPosaI SYStOm POrrtit Permit plumber: OSP201444 Work Types, SepticTank Upgrade Tax Cede Number 0141418800-D Site Legal Address: 'FOREST VIl IN HEIGHTS LT 19A '.2134 SiteMaillrigAddressi 3320E 72NDAVE, Anchorage Owner; STC KOE Rll-� & Nl i{K4 TRUST Da%i!9n 1=ngin-�L%r- rIRSTV'ATDR DCINSULTING This permit is Far the oenstructlror+ af: 7:1 D is poral F: eld Cry 8eptia Tank U Molding Tarok ❑ Privy Effective Date; 'Expiration Date; ,IL,c n z% Q, K. ;.j�pnrtmen[ 1 3)2020 1 01=02i Hct SFzs fry S4 Ft: 17074 Total Bedroom: � 0 Private Wall ❑ Wnter Storage All construction shall be lr4 ucasdsrroewith; 1, The stl�-acncd @� proved i!Un- 2. All requlr-9:r7 cnts spedrfied in AArttioraga Municipal code Chapters 16-55 and 16,65 and the State of Alaska Wastawat@r Disposal Regukoons (18M072) and Ddnkinq WaWr Regdiataans (1 BAA 80) 3. The wastowater cads requires inspectians duHrig tM insWlatlorr. The w1gineer shall notify the DevWpMent Services Department peg' AMC 15.65. Provide notilil',86on by calling (W7� 343-7 4�7), 4. Fram October I5 W April 1S, a subsurface toil absorptonn spstem ufidor construe&n wring free;ting weathar stmill be either. a, Opened. and Closed on the same day, or b. Covered, sealed, and homed to prevent keazing Issued 6y: 1 X13,+0 Dente: �a r zS Ue 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com October 15, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: FOREST VIEW HEIGHTS LOT 19A The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. The lot and area are served by private wells and public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201444, Rebecca Carroll, 10/23/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201444, Rebecca Carroll, 10/23/20 Mark Begich Mayor Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Rood P.O. Box 196650 Anchorage, AK 99507 www.muni.orq/onsite (907) 343-7904 Well Drilling Permit Number: SW Parcel Identification Number: Pump Installation Log Date of Issue: 0H -m t -&8 Legal Description roR ES r V/EW /its L - l'1 A Property Owner Name & Address: am 5T8(oL p06ax VS14,1 1.9s03 35.40. E -77- diri/f• ►%htrioweir ci rl K %9s -01 - Pump Installation Date: 4 " a.- /5' Pump Intake Depth Below Top of Well Casing: 90 feet Pump Manufacturer's Name; )R E D 3 AcKtr Pump Model: 5b G3ri 0 510- 1aPump Size 1,4. hp Pump Pitless Adapter Burial Depth: /0 feet Pitless Adapter Manufacturer's Name: / Pitless Adapter Installer: / • Weil Disinfected Upon Completion?' 1/ Yes J No Method of Disinfection: c /a009/4C et i/E 75 Comments: Pump Installer Name: fl r9c/d0✓IA9C uJCl( 4- /%' 1 t 5 (port 330 E 1/01.2 / ✓€ AnMo✓ctrze, At eMrig Attention: The pump installer shall provide a pump installati$n log to the DSD within 30 days of pump installation. 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: ~'-') ~0 ~-~0 PIDNumber: O/ ~ - I~,jJ %me: ~ o ~ ~ A ~> kt 0 ~ m Wastewater System: ~ New ~ Upgrade Address:~ '~O L ?~¢ Ave ,q~)~o'/-~ ABSORPTION FIELD ~ No. ~f Bedrooms: Phone: ~- ~ ~ ~ ] ~ c~ ~ ~ g,,~r.~/¢~o,).~ ~ ~DeepTrench ~ShallowTrench OBed OMound BOther I Total Depth from original grade: LEGAL DESCRIPTION SoilRating: 0 , ~ GPD/Sq. Ft. Block: ~ Subdiv~ion:, Depth to pipe boltom from original grade: G ravel depth beneath pipe -- Section: Township: Range: Fill added above original grade: Gravel length: ~ELL: ¢ B Ne.w Q U pg rade er~ve, width: Number of lines: Distance between lines: Classificat~n'(P4~e, A,B,C): Total Depth: Cased To: Total absorption area:. {~ P pe material:, ~ / ~riller: '% Date Drilled: Static Water Level: ;Installer: Date installed: ~, Ft. Yield:GPM PumpSetat: FL OasJng~Jgh~veGround:~. ~ TA~K SEPARATION DISTANCES ~ Septic ~-Q~Holding ~ S.T.E.P. ~ ~ '~p~city in gallons: TO Septic Absorption Lift Holding ~ublic/Private Manufacturer: . From Tank Field Station Tank Sewer Lines Well- /¢0 -i /¢0 4 ~ ~-~ ~ Materiah Number of Water ~'~ /~0:~- ~ LIFT STATION LineL°t /¢/ ~ / Size in gallons: ]~anu~cturer:/ %~--. Cudain Pump Make & Model ~ Electrical Inspections pedormed Drain ~ ~[OM'~- ~¢ 0¢p // ........[ Remarks: 7~,~ v¢6.4,}~ ADP~Z ,~ BENCH MARK Location and Description: i 8~a,eo(,,~ T~b~ C I-1 ~¢5~/~ C, ~ ~ -/-421© ¢~' /~'1~1~//~'~ Assumed Elevation: Inspections performed by: s &S ~l~E~!~6 Dates: 1st '2-29'-9.~ ~ j Eagle River, Alaska 99577 '* ¢ , ~, - ., Department of Health and Human Services approval -~(,%..,.~', ....... . .... Reviewed and approved by' , ~/~ Date: ¢'//-~ ~ 72-013 (Rev. 9/91) MOA 25 PERMIT NO, ~ ~j ~// ~ d ~ ~ O PAGE 2 OF 2 M u n i~- i p, ,a_.L i ~. ¥_o, -F Anchoro. Qe DEPARTMENT OF HEAL/hi AND HUIWAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 eAnchor0, ge, Atasl<o, 99519-6650eTetephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 20, FOREST VIEW HEIGHTS S/D P.I.D. NO. 0//'/' -/~/-~7 ST1 ST2 /-FINAL GRADE-~ MTi C01 = 93.4' I MT1 = 87.~ NO WATER FOUND 8~.5' B,O.H. EAST 72ND. AVENU~ A B FCO 19.0' 14.5' ST1 19,0' 25.0' ST2 20,0' 32.0' C01 26,0' 27.0' MT1 40.0' 16.5' 002 41.5' 16.5' FS 20,0' 54.0' CO,] 21.5' 57.0' , < , { ~EX[STING -~----~ EXISTING HOUSE A BEDROOM LOT 19 LOT 1, 2 & 3 EXISTING 1000 GAL. SEPTIC TANK NEW TRENCH Rick Mystrom, Mayor o o o ~_/~ ~ ;:~ h~'.~-~-,~ ~,t'~-J ,~ ~,',~.~ ~.~':~,~ ~ ,,_, v ,~ ~I .... ~ .~,. ~,~..,....~-~., ~,~UJ,_ (',.~_~,%~ Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 995'19-6650 http://www.ci.anchora~je.ak us August 12, 1998 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 20 Forest View Heights Subdivision Waiver Request #WR980043, PID #014-141-27, HA980206 Dear Mr. Cowan: Your request for a waiver of the required i0 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 0 feet from the property line to the leachfield. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system ~ill require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 3~3-4744. Sincerely, Jeffrey W. Poet Engineering Tech On-site Services ljw #7 WR~ WR980043 PID# 014-141-27 Date Received: August 3 1998 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet HA~ HA980206 Permit Legal Description: Lot 20 Forest View Heights Engineer: Robert C. Cowan, P.E., S & S Engineerin~ 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska Applicant: Howard Holm 99577 Waiver Requested: 0 feet Lot line waiver of the leachfield to the property line of Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: Rec #: 04005/3835 Amount: $ 115.00 Date Paid: August 3, 1998 MUNICIPALITY OF ANCHORAGE Deparfment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 13, 1998 Expiration Date: Jul 13, 1999 Permit Number: SW980230 Legal Description: FOREST VIEW HEIGHTS LT 20 Design Engineer: S & S Engineering Owner Name: Howard Holm Owner Address: 3320 E 72ND AVE ANCHORAGE , AK 99507-2816 Parcel ID: 014-141-27 Site Address: 003320 72ND AVE E Lot Size: 8721 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 1 This permit is for the construction of: i¢'i Disposal Field i i Septic Tank Holding Tank ~ Privy i 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. 5. The following special provisions. Percolation test shall be performed according to b-PA guidelines during construction and results submitted with As-Built Package. Received By: ' '~~ (~' ~J~.,-- Date: Issued By: ,"~¢ Date: ROBERT C. COWAN, P.E. HEAl.TH AUTHORITY ,4PPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL iNSPECTiON & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN June 18, 1998 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Semices P.O. Box 196650 Anchorage, Ali. 99519 REFERENCE: Lot 20, Forest View Heights Subdivision Request you issue a permit to install a septic system to serve the existing two bedroom being upgraded to three bedroom house on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 6/10/98 water was not encountered in the test hole. After seven days of ground water monitohng, the ground water monitoring tube was found to be dry. 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 There are no points of contamination within the proposed well radius that can be seen on the attached site plan. If you require additional infonaation, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ,, EAGLE RIVER, ALASK-,A 99577 1" = 40' DESIGN DETAIL ~ ~ ~ ~o _mo L--rJ ,..,. L~W]S o ' ~ ~ > ~ ~ ..~ , ~ .. ~,,.~ o ~ ~ o SPRUC~ STREET ~ .~,"~ ; ~ .' Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'TEST PERFORMED FOR: LEGAL DESCRIPTION: - c, cow,. N~,r.~Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1 7 18 19- 20- COMMENTS £ o m '~'- $'/-] ,v/) WAS GROUND WATER ENCOUNTERED? )~/ ~) SLOPE SITE PLAN S L IF YES, AT WHAT '- O DEPTH? p Oeplh Io Waler Alter Monitoring? ~?"Y Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE -~ 0 TEST RUN BETWEEN '7 '/~.. (m~nutesnnch) PERC HOLE DIAMETER ,~, -- FTAND ~/~FT :- CERTIFY THATTHIS TEST WAS PERFORMED IN PERFORMED BY: '~/0;~, Eagle I(iver Loop Road No, 204 .... (~ /I '7 /C:l ~' ACCORDANCE WI~I~I~Le.I~,~]'~I~I~LI~P~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85} MUNICIPALITY OF ANCHORAGE DE. ;rrMENT OF HEALTH AND HUMAN SER' ~.S Environmental Health Division 0 / q' I L/-- / ?~ 825 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address Phonet$) '"F l TANKS WELL LOT LINE DISTANCES SliPTIC ABSORPTION TANK FIELD W£LL FOUNDATION AS-BUILT DIAGRAM {Shov¢ JoceJlon ol well seph( system property hnes. Ioundatron, dHvuw~W water bOdlOS, cio ) SEPTIC ~] HOLDING TYPE OF SYSTEM )~J~FRENCH ~ BED [~ W. DRAIN EJ OTHER WELL8  PFIIVATE [] OTHER fldentifv) Cased Io Insiail(uDale icslalled FT FT REMARKS: Scale: Inspections Pedouned by __.__ cedily that this ills.~eclJo, was perlormed accordinB Io all d, oa E'N dtNB~f(S PERFORMED FOR: LEGAL. DESCRIPTION: 1 2 3 4 5 6 7 8 9 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 m PERCOLATION TEST DATE PERI 020, FoE.~.?ST Vl/~,;cCz/TE!&iTc)wnship, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED, S L IF YES, AT WHAT 0 DEPTH? p E OeCh to Waler Alter /~/ Monitoring? ~0~ Oate: ~ I ~2 SITE PLAN , I I Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE /~,--,.-~ V'1%.L9~,_ tn~nu~estrrrc'h) PERC HOLE DIAMETER TEST RUN BETWEEN -- FT AND __ _FT COMMENTS PERFORMED BY: ~:]' ACCORDANCE WITH ALL S~ATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE 72-008 (~ev 4~85) CERTIFY THAT THIS TEST WAS PERFORMED IN / ~,,,,..1~ ~: ~..._. ~ ..... ~::::" ~;;E ~:~': ~'"'11:1/~ "11' I::'L~;l:~l'"l ~ '1'' 1",t0. [...~Y~]...~ ';:;';;;?.r.,ll:::," L.I?3.,.1:1: S H :E r'4:1:I'"fl...tF,1 [::,:l: STFiN(::E F:'E~'.OI"I HEL. L. '10 I:::lN"r' ~;["'::F::"I' :[ I::: 'I'I::ff',tI'::,.'"I:::'~;II:::~:::FII31~ F'L~r',FF I::1~: SI:I ~ L I:IB:?~:I::II;~:F:'"I' :[ S¥S'I'Er'I :I:S :5. OO F'i F'UI~: I::~ PI:;~:I.¥1:::ITE::141~:LL. FIND ;~tO t:::'t FI::I[~'. F:I I::'I...IE~:I.... :I: I::: HELL.. I.,.IEL...L I....O(.?iS F'tl...ISF E:E I;~:I~?H'I..II:,~:NI~:I:::, I'O I'HE Dk;:F:'F:I~Ff'HE~:I",IT I.,.I]:"tH:I:N :?~:O [::,Fl"dS OF' TFLX: I.,.l~:l...I..u (::: O ~'1F'I.... ET :1: O I"J. :}~;F'~(::]:F:I:(:.:FI'I':i:(::~I'.,IS 1::11"41:::, (::I3NSTF;~IJ(:':T:I.(::IN D:[FII:31'~'.I::IHS F:IF;;~I~ F:I',,,'FI:EI.J::IE:LE?: "1'O ]:NSIJF;;'.E~: I:":'f~:OF:'l~[l:~'. :1: t",IS 'f F:I L I... FI T :1: O N. ( Z~,/ :I i UMMPAUTY OF �.-P1, Development Services Department , On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 014-141-88 Expiration Date: S-2-0 Z( 1. GENERAL INFORMATION Complete legal description FOREST VIEW HEIGHTS LOT 19A Location (site address) 3320 E 72ND AVENUE, ANCHORAGE, AK 99507 Current property owner(s) BILL & NIKKI STOKOE TRUST Mailing address Real estate agent PO BOX 231434, ANCHORAGE, AK 99523 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ y1?' SO Date of Payment i 3 a 0,2 O Receipt Number 03, r y COSA# osc"?o/�06 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 10/30/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to �• these various and dynamic characteristics and are outside the control of the evaluator of the i well and septic system. Therefore, any estimate of how long a system will function satisfactory Q: • • • for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FW[S ' *•. 9 TH ....•.* 6. DSD SIGNATURE I Curtis Huffman j System #1 Approved for bedrooms tt c� CE 128991 S .��r Y Pp ,9 low, r System #2 Approved for bedrooms PROFESSION Disapproved Conditional approval for bedrooms, with the following stipulations: ,..#,e,Tt.-.%0&TFR ? PROGRAM By;Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other • Legal Description: FOREST VIEW HEIGHTS LOT 19A Parcel ID: 014-141-88 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 1/6/1977 Total depth 89 ft Cased to 40+ ft (PER MOA DOCS) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/5/2020 Static water level at beginning of test 45 ft. Well production at time of test 1.38 gpm Comments B. TANK DATA Age of tank(s) 0 — NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping NA — NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) 1987 & 1998 ® ALL standpipes present per record drawing Total measured depth from grade 11 / 13.4 ft (max) Measured depth to pipe invert from grade 6 / 7.9 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.304 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) NES Collected by Date of Sample 10/16/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/6/2020 Results � Pass For 3 bedrooms Fluid depth prior to test 0 143 in Water added 900 gal New depth 11 / 61 in Elapsed time 1300 min ® Code -required soil cover over field Final fluid depth 0 144 in ® System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced 2000 gallons If yes, enter date Comments/Deficiencies: NEW MT INSTALLED IN 1987 TRENCH. (1987/1998 TRENCH) 1998 SOUTH TRENCH MOSTLY SATURATED. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No *0 ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *MOA WAIVER 1998. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. . tQ �� SAV, ' :'q Curtis Huffman 0 CE 128991la.� (}1 Pic •.,10/30/20 ��� ft ft ft ft ft ft ft ft MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. If 1. GENERAL INFORMATION Complete lega description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address or directions) P¢'o p'ert.y owner 'Mailing address _ 3'3 ~ o [.ending agency Mailing address · ' Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUi~BER OF OEDROOIVIS: ~'~ TYPE OF WATER SUPPLY: Individual well Community welt Public water NOTE: NOTE: If community well system, provide written confirmation h'om State ADEC attest- ing .to the legality and status of system. TYPE OF WASTEWATER DIISPOSAL: Individual on-site Holding tank Community on-Site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-825 (Rev, 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I ver.ifythat my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm S&SENGINEERING Phone (:;q L/ _ ~ ~'1 '7 cf 37034 E, agie/(iver Loop Road No. 204 Address Eagle River, Alaska f19577 ,,z n inee,'ssi . ture DHHS SIGNATURE Approved for _~T_/L/~'~' bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipali~ of Anchorage Department of Health and Human Se~ices (DHHS) i~ues Health Authori~ Approval Ce~ificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a coudesy to purchasers of hom~ and their lending institutions in order to satisfy cedain federal and state requirements. Employes of DHHS do not conduct inspections or analyze data before a ce~ificate is issued. The Municipali~ of Anchorage is not responsible for errors or omissions in the profe&sional engineeds work. 72~25 (Rev. 1/91) ~ck MOA Municipality of Anchorage AUG 0 3 1998 DEPAP, TMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALFfY OF ANCHORAGE 825 L Street, Room 502 · Anchorage, Alaska 99501 ~,x(~I~F~L.~E-~'~.ES DIVlSIC Health Authority Approval Checklist LegalDescription: LOT- P-O ~'-~R~¢~T vJ~,v HF,/(~¢/~-~ ParcelI.D.: A. WELL DATA Well type Log present (~)'N) Y/~ ~ Total depth ~ ct 5' Sanitary seal (~/N) ¥ 6 ~ ~ ,~ J v A T ~ If A, B, or C, attach ADEC letter. ADEC wateE system number Date completed / / 6 J '7 7 / Wires properly p~otected ~/N) FROM WELL LOG AT INSPECTION Date of test ! / f~ / ~/ 7 G /'7 / / Static water level ,5" / '~ ~' 3,? Well production ~- - ~ g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate / ,3 o / q ~' Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ! o / 't / ~' 7 Tank size ) o o o O,t(-i5~ Collected by: Other bacteria '~ S & S ENGINEERING 17034 E~gle River Loop Road No. 204 Eagle River, Alaska 99577 g.p.m. Number of Compartments. ~L Cleanouts t~N). ,~ J Depression (Y/~fl. Pumper t O. b System type Foundation cleanout (:~YN) Y ~ > Date of Puhil~ing ~'/q cj: C. ABSORPTION F'IEI~D D.~.TA =: Date.installed '7 / ~0 / ¢i"~' Soil rating (g.p.d./ft~ or fF/bdrm) Length: · P- 3 width ' :' 3, Gravel thickness below pipe ~. ~'- Total depth ¢ '~ '/¢- ,;L 5'0 · Effectiv~ absorption area ~z ~-~, ,~r z_ Monitoring Tube present ~/N)~Y~'J' Depression over field (Y/~ ,v 0 Date of adequacy test 6 /? /q [¢ Results P~/Fail) P4-~J ~ For bedrooms Fluid depth in absorption field before test (in.); ~ / Fluid depth q ~ (ins) Minutes later:. '~ G Absorption rate = 4,,c0 ¢ g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ ¢ ¢~ ¢ ¢ ,~'o~ If yes. give date -- 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" I_ev~eLaE- ....- .... "Pump off" level at* High water alarm level at* _ ~ ~'~-~-~-- *Datum Cycl ~.d~.~_~...~-~''~-' El. SFPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~;- / -/- ' Property line 5" -¢- Absorption field Water main/service line /o ~ Surfacewater/drainage /oo '~ Wells on adjacent lots Water main/service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line (2 t~{e¢~,*~r~,¢uilding foundation /0 '/- Surface water ! 0 d 4- Driveway, parking/vehicle storage area )d Curtain drain /v ,~ .,,& k/vo ,v¢~ Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review .of Municipal recor~ ams are Engineer's Name ~0~ ~,~ -~ C. HAA Fee $. Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Fleoeipt Number