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HomeMy WebLinkAboutCANDLELIGHT LT 6AOnsite File Candlelight Lot 6A #051-063-88 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 4 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201496 PID Number: 051-063-88 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name KEN GREENLEE (C/O DON BEATTIE -AGENT) ABSORPTION FIELD Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21935 CLOVERLEAF ROAD, CHUGIAK, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 10.25 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 6.02 Ft. Subdivision Block Lot CANDLELIGHT - 6A Fill added above original grade SEE DWG. Ft. Gravel length 33 Ft. Township Range Section - - - Gravel width p Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 397 Ft2 1 - Ft. Well 1001+ 100'+ _ _ 25'+ TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity INFILTATOR SYSTEMS 1060 Gal. Surface Water 1001+ 100'+ _ _ Material Number of compartments Lot Line 5'+ 10'+ - - NA PLASTIC 2 Foundation 10'+ 10'-x• - _ ATION Manufacturer Capacity Remarks TIM EKLUND PRESENT FOR BOTTOM OF TANK Gal. INSPECTION AND BOTTOM OF TRENCH INSPECTION. Alarm location Electri ed by 77 Installer PIPE MATERIAL House to tank D3034 drainfieldTank to D3034 ARM SEPTIC SERVICES Drainfield D3034 CO/MTD3034 Inspector GEG CONSULTANT, JODY MAUS BENCH MARK (Assumed elevation) 100.00 ft Inspection im 12/11/20 12/23/20 Location and description Znd 3rd 12/23/20 4111 - BOTTOM OF SIDING NEAR POINT "B" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp _oo6oOp�0 �F Conditional Approval: Date o ��• 0 • X11` , 1-�.. � -. V Septic System 5arness; ° Q i/ Approved Date Pp C� �f tZZ o Pggzo Note: this approval does not include well permit requirements. p�0fess'10" #AECC884 ��OOOo� kncv vwvci 10/ PERMIT NUMBER: PARCEL ID NUMBER: OSP201496 RECORD DRAWING 051-063-88 FAT B C / NOTE: THE OLD SEPTIC TANK WAS MH 25.4 40.7 EXCAVATED, REMOVED, AND DISPOSED STI 24.6 36.4 / OFFSITE PER THE CONTRACTOR. DBLt 24.5 34.2 / DBL2 24.6 33.4 / BR 25.1 33.5 1 C01 40.4 1.3 49.7 --�-- --------------- MT1 39.3 155.4 49.5 - 0O2 44.1 22.8 57.8 / \ MT2 44.8 1 23.1 57.7 \ 1985 DRAINFIELDW_�Mi_T4 CO3 41.3 31.9 70.0 I 40.0 30.9 69.0 JA 34.5 46.3 I N 30' ROAD RIGHT OF WAY (UNDEVELOPED) \ \ 33.5 45.1 48.7 69.7 499 70.9SCALE: 1.1 0' RIGHT OF WAY ENCROACHMENT PERMIT REQUIRED FOR DRAINFIELD WITHIN R.O.W. 100' WELL RAD�US- INSTALLED BULL RUN VALVE (BR) INSTALLED DOUBLE CLEANOUTS (DBL1 &DBL2) De r A \\ \ EXISTING \ \\ \ FOUNDATION \ GEG`j' \ \ CLEANOUT TH#1 \ \ 1985 DRAINFIELD NOTES: CONTRACTOR INSTALLED (FCO) STEEL MONITORING TUBES AND CLEANOUTS IN EACH COS, DRAINFIELD. THE WEST TRENCH WAS NEW 1060 INFILTRATOR l/ PROFESSIONALLY LOCATED BY THE CONTRACTOR PLASTIC SEPTIC TANK. AND THE 100 FOOT WELL RADIUS FOR THE WELL ON I PROPERTY AND THIS DRAINFIELD IS JUST OUTSIDE NEW DRAINFIELD - - THE RADIUS AND ALSO 10 FEET AWAY FROM ' FOUNDATION. PER THE CONTRACTOR, THE CLEANOUTS WERE INSTALLED AT THE END OF THE DISTRIBUTION LINES FOR THE WEST AND MIDDLE J ' TRENCHES, HOWEVER THE DRAINROCK EXTEND 7.8 / FEET NORTH OF THESE CLEANOUTS. 101x10' ELEC. ESMT. 100 FEET WELL RADIUS 0Fj 141 0� 0 *# ESS E ISG CJIJh IJt'....:...'40(�......:........... ENGINEERING SALES-CONSULTING � � - � � la�t�'�t ���a •• m . 3701E TUDOR_._,.z._ . es w� 0-4..... i�/ . ROAD. SUITE 101 'ANCHORAGE. AK 99507' PHONE (907) 337-6179' FAx (907) 33B-3246.4VEBSRE. www.gamessengmeering.wmf _ i..............' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: �� �'� )fey A. Garn@SS l 4! a KEN GREENLEE (C/O DON BEA-ME,- AGENT) 244-8456 (AGENT) 2 OF 4 ���i�'. CE-795 ®® PROJECTILEGAL DESCRIPTION: DRAWN BY: ®® �••, / CANDLELIGHT S/D; LOT 6A J.L.M. s♦ Fp .. F® TYPE OF WORK: DATE: ��e $oi05® \ RECORD DRAWING FOR SEPTIC TANK UPGRADE 12/26/2020 LICENS84 ® / PERMIT NUMBER: PARCEL ID NUMBER: OSP201496 RECORD DRAWING 051-063-88 INVEI IN[ GA NESS ENGINES NG C�IJ 9 Lid ENGINEERING , SALES ° CONSULTING - .y-- _.. 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907)337-6179- FAX (907) 330.3246' WEBSITE. aw .gamesseng.neenng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KEN GREENLEE (C/O DON BEATTIE -AGENT) 244-8456 (AGENT) 3 OF 4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: CANDLELIGHT S/D: LOT 6A J.L.M. TYPE OF WORK: DATE: � RECORD DRAWING FOR SEPTIC TANK UPGRADE 12/26/2020 04 RT OF PIPE @ ITLET = 88.19 40, 8,0 Ar Aff • 49'' , ss m.........!E .�............ v ®..t....l.. ! �/ ......................u........ v Jbffrey A Garness r iu® ®SGS CE -79531 .... . �®� `°ROFESS10NPa ®® LICENSE #AECC884 / PERMIT OSP201496 RECORD DRAWING PARCEL ID NUMBER: 051-063-88 MT4 C04 ESS ENGINES BJP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE, AK 99507' PHONE (907) 337.6179 -FAX (907) 338-3246' WEBSITE wx .garnessengmeering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KEN GREENLEE (C/O DON BETTIE -AGENT) 907-244-8456 4 OF 4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: CANDLELIGHT S/D; LOT 6A J.L.M. TYPE OF WORK: DATE: ,,_ RECORD DRAWING FOR DRAINFIELD UPGRADE 12/26/2020 ®® 8$O OFAAl- 149 ( o®®e AV ........... ..fir. .n..........•y....... 1 dIn 4 ,J . eyA.•Gaeness ®1®�J,•, CE -7913 LICENSE e®®Y41kEL,*614, #AECC884 ®®04 / MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201496 Work Type: Septic Upgrade Tax Code Number: 05106388000 Site Legal Address: CANDLELIGHT LT 6A G:1460 Site Mailing Address: 21935 CLOVERLEAF RD, Chugiak Owner: GREENLEE KENNETH E Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: n C Uei�artment 12/10/2020 12/10/2021 14366 2 Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. A copy of the ROW permit for the absorption field partially located in the right-of-way is required prior to inspection report approval. Please correspond directly with the MOA right-of-way section for requirements to obtain permit. 3 1,If new absorption field is to be constructed, please submit change order to show piping, cleanouts and monitoring tube for field. 1� $ _ aA I i Scope_ .4b 0_* Received By: Date: 1 Issued By: Date: l o�ho/?0.20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201496, Rebecca Carroll, 12/10/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201496, Rebecca Carroll, 12/10/20 NOTE: CONTRACTOR SHALL HAVE ALL 100 FOO RADII SHOWN ON THIS DESIGN DRAWING AND THE NORTH AND EAST LOT LINES FLAGGED/STAKED BY A REGISTERED LAND SURVEYOR PRIOR TO ANY CONSTRUCTION. AA-- -- N 30' ROAD RIGHT OF WAY (L SCALE: 1"-20 GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND / PROPERTY OWNER AGREE THAT THEY HAVE / READ THESE SPECIFICATIONS AND AGREE TO / ACCEPT THE TERMS AND CONDITIONS OUTLINED. I DEVELOPED) RIGHT OF WAY ENCRO�ENT PERMIT 100' WELL RADIUS REQUIRED FOR DRAINFIELD WITHIN R.O.W. x� �� EXISTING DRAINFIELDS. NEW CO'S AND MT'S INSTALLED IN EACH TRENCH.--` s Ro o 30%O Ao 0 25ojo 1� WELL \ EXISTING \ FOUNDATION CLEANOUT \' DESIGN CRITERIA (IF NEEDED): (FCO) NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 NEW 1060 INFILTRATOR 10'x10' PERCOLATION RATE/S: 3.1 MINJINCH PLASTIC SEPTIC TANK.— ELEC. PROPOSED APP. RATE: 1.2 GPD/SQ.FT. ESMT. MINIMUM DRAINFIELD SQ.FT.: 375 DRAINFIELD DESIGN (IF NEEDED): _ MAXIMUM DEPTH: 10.25 FEET WIDTH: 2.5 FEET (@ ANY POINT) / i LENGTH: 32 FEET EFFECTIVE: 6 FEET ACTUAL SQ.FT.: 384 100 FEET WELL RADIUS kxARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING » - - 3701 E TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907) 337-6179' FAX (907) 338-3246 WEBSITE wvAv gamessongineering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KEN GREENLEE (C/O DON BEATTIE -AGENT) 244-8456(AGENT) 2 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: CANDLELIGHT S/D; LOT 6A J.L.M. TYPE OF WORK- DATE: �, SITE PLAN FOR SEPTIC TANK UPGRADE REVISED 12/21/2020 —INSTALL FLOW DIRECTOR I CLEANOUTS (D\BL1 & DBL2) S�1 \ 1p°l GEG \ \ TH#1 \ , J h 2yojo 15 PROPOSED DRAINFIELD 0 F 41 •>�o �49 lei;odo ,t .10- ...•gym®�,T-I/„A�Je reym. 1 - ” 6ss a # CE -7953 (Z3AW t4w ®� 4 "ROFESS��®o®® LICENSE >$tlr�d®H1�O #AECC884 / Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201496, Rebecca Carroll, 12/10/20 NAME MAILING ADDRESS LO~ATION DISTANCE TO: ' ~ I ~ ~ D~lling DISTANCE TO: j Well Dwelling PERMIT NO. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE~ I ~O~ -~,t I [] UPGRADE Manufacturer DISTANCE TO: Well~ No, of lines.~ h of lines Top of tile to finish Type of crib Crib diameter Material NO. OF BEDROOMS PERMIT "O. 5qO 12E NO.~O f~_.~mpar t me nts ~width inches inches PERM,T NO. <~'(O I ~[ Total effective absorption area Building foundation Nearest lot line =lass Depth Driller PERMIT NO. Septic tank Absorption area(si Sewerline OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 724)13 (Rev. 3178) LEGAL  MUNICIPALITY OF ANCHORAGE ! · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 254-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE MAILING AD~R ES~'~ D STANCE TO: ~O~ ~ /~ D~lli~.__ PERMIT NO. ~ Manufacturer ~ ,~.~. Materiag ~.._ ~ No. of c~artments ~o~ DISTANCE TO: We,, Dwe,,i~ p MiT20 ~ . DISTANCE TO: ~ ~~ ~ ' O~ OTHER O~ ~,~,~,~. o~ ~I ~ ~~..,.... ~ ~,~°'~ ...~ ... ... ,~. ~ ~ ~~iD S 7&- ~V'TO !~11J !'~i Z ~3 T F'F~L [ T~t" I:~F I--lt-I G DEF'RRTHENT OF HERLTH RHD EN,¢IF.'0f.iHENTRL PROTECTION 825 L STREET, RNCHOF:FIGE.' RK .99501 264-4?20 C,[-4--5 T .TE 5EI..3EF: ":~: i..3ELL pEF:I"I I T PERHIT HO: DATE ISSUED: RPPL I CAHT: RDDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT siZE: E:4012C: 0.4/03/84 GREGORY A. V~NCE P.O. E:C'~ i7t543 E~GLE RIVER, 8K 9~577 6E'.E:-3001 . ~ (SE. FT. OR RCRES) LOT: RRNGE :' BLOCK. i MR>,' BEDROOMS: 3 · LISTED BELCH RRE THE OPTIONS RVRILRBLE TO YOU IN DESIGHING YOUR SEPTIC S¥STEt'I. CHOOSE THE OF'TION THAT BEST FITS YOUR SITE. - ...... .... · . TRE~-4CI4 BED E8CH) 'l.q. DRRI DEPTH TO ~IPE E:0TTOH (FT.) 4.0 4.0 4.0 G~RVEL DEPTH (FT.) 8.0 0.5 ~.5 TOTRL DEPTH (FT.) 12.0 4.5 7.5 GRRVEL HIDTH (FT.) 2.5 25.0 5.0 GRRVEL LENGTH (FT.) 58.0 47.0 GRAVEL VOLUME (CU.~'DS. > 45.6 4~.5 ?~'~ TRNK siZE (GRLS) ,1,000.0 **. 1,000.0 ** 1,000.0 SOIL RATII'IG.(SQ'FT''/E:R) ~0~ 260 ..+::,,.: .GRRVEL LEHGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. ¢¢m TRNK MUST HA',/E RT LERST THO COHPRRTHENTS I CERTIFY THRT: I RH FRt,IlLIRR HITH THE REQUIREHEHTS FOR ON-SITE SENERS RND biELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE (ldOR) RND THE STRTE OF RLRSKR. 2. I HILL INSTRLL THE SYSTEI'I IN RCCORDRNCE HITH RLL MOR CODES RND REGULRTIONS, RND IH COMF'LIflHCE blITH THE DESIGN CRITERIR OF THIS PERMIT. ~: I HILL RDHERE TO RLL HOR RND STRTE OF RLRSKR REQUIREMEHTS FOR THE SET BRCK DISTRNCES FROH RNY EXISTING HELL, HRSTEHRTER DISPOSRL sYSTEH OR.PUBLIC SEHEF:RGE SYSTEH ON THIS OR RNY RDJRCENT OR NERRBY LOT. 4. I UHDERSTRND THRT THIS PERHIT IS VRLID FOR R MRXIHUH OF ~ BEDROOMS RND RH'¢ ENLRRGEHENT HILL REQUIRE RH RDDITIONRL PERHIT. ' IF R LIFT STRTIOH IS' INSTRLLED IN RH RRER COVERED E:~ MOR BUILDING CODES, THEH (~) RN ELECTRICRL PERHIT RHD INSF'ECTIOH HUST BE OBTRINED~ (2) RS-BUILTS HILL NOT E'.E RPPROVED HI~HOUT RN ELECTRICAL INSPECTION REPORT¢ RND (3) THE ELECTRICRL H~RK HUST E=E DONE BY R LICENSED ELECTRICIRN. S I GNED .... --- · ISSUE[) BY ..... -- ,,:..~ E~NGINEERS, INC. · ~ SOIL LOG ~'ESTPERCOLATION P.O. BOX 873448 WASILLA, Ali. 99887 (907) 376~3776 PERCOLATION TEST .~LBEDROOMS < /4". _ G,I,1 SfTE PLAN 1~34-E W F Reading Dali Gross Net De, th to Net TI~ Tinge Walm' 1 3 4 5 6 7 8 9 lO 16 I0 DEPTH (FEET) F'£~COLAT~ON RATE ~ ~ ' (mlnutesAnch) TEST RUN BETWEEN ~' FT AND ~ ~" ' CERTIFIED BY: DATE: (2) TYPE OF WORK (check~. ~ Well O' I~n~ C] Reconditioning (3) TYPE OF WELI~'I (4) PROPOSED USE (check): (5) CA~G ~,&WJ'.l~,~): Steel ............ -~..,~ ............... ,~..Z.L&,. o., ...,..~.~.~ ............ LINER INSTA~ J.~.D: (6) PERFORATIONS: P. rfo.-.u~ ................................................... p~rfor~io~a from ............... fL to ............... lc ................................................... perfere~ioaa from ............... ~t. ~o ............... ft. ................................................... i~d~i~ fro~ ............... ft. to .............. a,. (7) ~C~: We. ,e~en i,~.~.~r~ 0 Ye~ CX~o Typm ........................................................................ Mo~l No ...................... [limas ......................... Slot~ ............ Ssi from ............... fi. lo ............... ft. ~ ........................ ~iot~ ............ ~fmm ............... fi. to ............... ft. ~o~ C-1064 Is, u,,d b~: PACIFIC MARINE This w~ll w~s dHIl~l umler my Jurisdi~ion and thi~ ~ la tru~ ~o ~ ~ my ~1~ ~ blJef. ~ ..~ ~G ~. INC. ~ ............ ~i.~.~!~!,.~.~!~, ~. ............ WM A,~atwellloation: b/71 (.o~d'/( /.'~' (11) WATER LEVEL: Completed well. DatewelldriUingmachinemovedoffofw~l ) /g Is -' / ~' / (> 19 / - Workstartmd ~l/t~ IS ~. Compb~d (12) WELL LOG: O.~d,,,~,d /~',) rt. n.z.v~,~.~.~z /K.~ for .e~c~.. ehan~ o~ formm~Aon. Re,et e~d~ ehan~e in pemtlee~ e( ~-e~ Water ~r~l (I) OWNER: ~) ~E OF WORK (check): s,,~ ./f9¢ (3) TYPE OF W~t,t.?l (4) PROPOSED USE (check): g ~ . /I ~' ~ller'ewellnumher /~7~errat, eeA.. . (5) CASING INSTb, T-T.~D: ste~l ~ Plafae · / Threaded 0 Welded ..... f:.....'Dilm, from-...:.]. ...... .. "te...l..,~..?...h. G&ug, ' '(~ ~ ~ ........... : Diuril from ............... It`to ............... it. (~auge .............................. LINER INSTALLED: ........... .' Diam. fr~m ............... fLto ...............ft. (lau~e .............................. (6) PERFOI'CATIONS: P, do~atod? O V,, ~No Si~ of gerforatlott! in, bT, in, ................................................... perforationa Imm ............... ft. to ............... fL ................................................... petforationa from ...............ft. to ........... ;... fL ................................................... ~erforatloedl from ............... ft. to ............... ft. (7) SCREENS: wen ~reen instalIM? {23 Yea ~nuf&cturer'l l~ame .................................................................................... ~ : ................. : ..................................................... Model No ...................... Diam. ' ........................ $1~ Size ............ Set from ............... ft`to ............... It. Di&m ......................... $Ioi Size ............ Set from ............... fi. lo ............... ft. (8) WELL TESTS: t~ow static level " ~<~ ~,~I:' ;~.,.; ' gal.~min, wlthdrill em*t /.~' [~ ft. / Orawdow~ ia amount water level ia lowered Depth artesian flow encountered ......... ft. Bond C-1054 Issued by: PACIFIC MARINE ·his well was drilkd under my jur~adictlon and this report is true to the best. of my knowledge and be el. P.O. BOX 972174, WASILLA, AK (11) WATER LEVEL: Completed well. De~Rh al which water was first found ' /0/ ~--'~) r ft S~,i¢~e,,.I/6 0 .-~o.,~-~..,~.~lU.,,, ¢/7/~'/ (12) WELL LOG: ~pmdri.ed /~ ft. ~pthofmmplet~lwdl /,~ ,, Workstarted -//.O 19 )"/ Compl,~<} ~V/,// ~..) · 19 ~' -" Datewelldrillln~machlnemovedoffof_weU Y /~' Ig '~ 'J r.e Ruo • Municipality of Anchorage On -Site Water and Wastewater Program < (907) 343-7904 s F E r'Y Certificate of On -Site Systems Approval Parcel I.D. 051-063-88 1. GENERAL INFORMATION: Complete legal description CANDLELIGHT S/D; LOT 6A Expiration Dater - 3O .�2 OV Location (site address) 21935 CLOVERLEAF ROAD, CHUGIAK, AK 99567 Current Property owner(s) KEN GREENLEE Day phone C/O AGENT Mailing address Real Estate Agent DON BEATTIE Day phone 244-8456 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ', f A ❑ Multiple Dwellings (Single Family and/or Duplex) s; 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ $336 /Coyid Waiver Fee $ _ Date of Payment / �80//'-)_ O�_) o Date of Payment Receipt Number 6 (02 R6 6 Receipt Number COSA # OSC201698 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Z In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for S bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the _0 4 .JdVrev A. Garn CE -;7J53 8; P . CP4 s �G 4,W,1pr0 f essiof°o5 #AECC884 %G):�: ON-SITE g WATER AND m" _a virfVAtfflt.iAti0ffEER �? JL� PROGRAM 6�,_�' By: Original Certificate Date: 12 -7d �zC� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory _ Well Flow Advisory Other COSA blue sheet 10-10-12.doc COSA Checklist Legal Description: CANDLELIGHT S/D; LOT 6A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 2/28/85 Total depth 183 ft Cased to 183 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 11/25/20 Static water level at beginning of test 162.1 ft Comments B. TANK DATA Age of tank(s) NEW years Tank type/material PLASTIC Measured operating fluid level in septic tank NEW ❑ Standpipes/foundation cleanout per record drawing Date of pumping NEW Parcel ID: 051-063-88 Structure served by this system Well production at time of test 3.1 + gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 6.13 mg/ L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG,LTD. Date of Sample 12/7/20 . FT STATION ❑ ReFT aint, Age of lift station , Lift station material Comments/" com D. ABSORPTION FIELD DATA DEEP TRENCHES Which system tested (date installed) N/A Adequacy test date new ❑ ALL standpipes present per record drawing Results RPass For 3 bedrooms Total measured depth from grade 11.1 ft (max) Fluid depth prior to test NEW in Measured depth to pipe invert from grade 4.6 ft (min) Water added - gal ❑ N/A — pressurized field NEW New depth In ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time NEW min depth into effective ❑ Code -required soil cover over field Final fluid depth NEW in ❑ System presoaked Absorption rate NEW gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: 1985 DRAINFIELD DID NOT PASS ADEQUACY TEST. NEW CO'S AND MT'S INSTALLED 1985 DRAINFIELDS, COSA Checklist yellow sheet 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' 0 Yes Community Sewer Manhole/Cleanout > 100' r✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' 0 Yes if No ft Q✓ Yes if No ft Yes if No ft Water Service Line > 10' [Z] Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' p✓ Yes if No ft C]✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' M Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' [Z] 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' R Yes if No ft Community Wells > 200' R Yes if No ft Surface Water > 100' ✓Gj Yes if No ft F. ENGINEER'S COMMENTS "CONTRACTOR HAD 100 FOOT WELL RADIUS FLAGGED/STAKED BY REGISTERED LAND SURVEYOR AND 1985 DRAINFIELD LINE LOCATED. PER THE FLAGGING/STAKING AND LOCATES, CLOSEST 1985 DRAINFIELD IS JUST OUTSIDE 100 FOOT WELL RADIUS. "PER THE 1985 DRAINFIELD LOCATES PERFROMED BY THE CONTRACTOR, THE DRAINFIELD APPEARS TO BE 10 FEET FROM FOUNDATION. "'ONE OF THE DRAINFIELDS APPEARS TO BE JUST OVER PROPERTY LINE IN UNDEVELOPED RIGHT OF WAY (ROW). ROW ENCHROACHMENT PERMIT BEING OBTAINED. G. ENGINEER'S CERTIFICATION 1 certify that l 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. COSA Checklist yellow sheet #AECC884 Nitrate Advisory Certificate of On -Site Systems Approval # OSC 201698 Subdivision: Candlelight Lot 6A A water sample revealed a nitrate concentration of 6.13 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. t Mail�ng'Address P O Box196650 *Anchorage, Alaska 99519 6650 *`www�Mun� or From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. 4 MaiUng Address P O' Box 196650 * L1nchorage, Alaska`99519-6650-1z* www"- org \ _ RIGHT OF WAY o - o M m N89° 56'52"E 159.70' _ N acC) (6) Ln N `r —73.2' r~ p rn Q rnSHED O 00 00 LLl o ,: :: .. :.......:. E N�V�E r nH CO (2) M LOT 8A wJ d/ I a�, > C) `J 381 0~ CD 0 o Q�o���U Z 63.5' g� co Of o �� • . • ... �.1• N,9S�o LOT 6A CO (2) 10'x10' ELECTRICAL v 49TH � 7 0, I 30 EASEMENT N )(—I X —\ x .. -.--. ...................... � x �, S89° 57'37'W 159.71' STEVEN CALLA o NOTES: �. ,LS -12034 Q� LOT 5A 1) THIS DRAWING SHALL NOT BE X MODIFIED FOR USE AS A PLOT PLAN 44©a /2 Iaca� o� WITHOUT THE EXPRESSED WRITTEN 40�°fession°�©� CONSENT OF LCG LANTECH. �40000��' 2) SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. 250 H Street Anchorage, Alaska 99501 Survey Department Phone 562-5291 rt.LEGEND: r Inc Mainline Phone 243-8985 AECC668 LEGAL DESCRIPTION: LOT 6A CANDLELIGHT SUBDIVISION //�� ((,� AS -BUILT ADDRESS: 21935 CLOVERLEAF ROAD PARCEL #: 051-063-88-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT TH E IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED AND SHOWN. EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OFANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOTAPPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABL15HING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. CLEAN OUT COo WATER WELL ® FENCE - X- MANHOLE l DRAWN DATE: 12/24/2020 WORK ORDER: 20102Grave DRAWN BY: ADS/AP/SC PLAT: 84-252 Concrete ,a Overhang CHECKED BY: SC GRID: NW1460 ORDERED BY: DON BEATTIEnH SCALE: 1 ° = 30' FB/PG: 819/30 Wood Deck ~"~ MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 2~720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) ApplicantName.J~,~/~,~ ~-~'//~e TeIephone:Homc~Z.,.-~.~,/.~/' Business (c) Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain); Address · (e) Real ~te Company and Agent ~~ ~/~ Address .~ ~0 ~. ~~., (f) Mail the HAA to the following address: S & S ~GINEEEING 17034 Eagle RiYer Loop Road No. ~04 ~.ag;. ~.;',,-,-, A|..,'- - TYPE OF RESIDENCE . ,~,.,I ~. ~/,, Single-Famil Multi-Family 1"1 Other , , " · ' Number of Bedrooms ~ ~ ,r :.., .:.' ,.-' .: ~ . WATER SUPPLY ~ · ': Ind~wdual WoII.~ Commumty I-I Pub c I-I .,... ,.. . · ~, · (t · , · ..11 ~, · Note:lfcommunitywe system~musthavewr~tten~~n~rmati~nfr~mthestat~Depar1ment~fEnvir~nmenta~C~nservati~n` attesting to the legali~ and status. SEWAGE DISPOSAL Onsite/~ Public [] Community I-I Holding Tank F1 Note: If community well system, must have written contirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION AS certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation of this Health Authority Approval 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 ir~i~$tL~I~GINEERING Name of Firm 17034 Eagle RIYe~ Lo~p Road Ne. 2~ Telephone ~' ~;;:~7~'- ~--~;~ ~' Eagle River, Alaska 99577 Address DHEP APPROVAL Approved for ~/~' (~) bedrooms by Approved ?'~ __ Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based aolely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Pa'ge 2 of 2 .,~ ~ 72-025 (11/~1) ,MUNICIPALITY OF A~GE ENVII[ONMENTN- SERVICES DIVISION IMAR 2 0 ]987 RECEIVED A. WELL DATA MUNICIPALITY OF ANCHORAGE (MO~,/ HEALTH AUTHORITY APPROVAL (HA.a,) CHECKLIST- FEBRUARY 1984 264-4720 Legal De~ription: Well Classification /~::~/~'"/'~ If A. B. C, D.E.C. Approved (Y/N) Well Log Present~N/) Date Completed ~,..-'2...~-,~ S Yield .~- c~ ~..~,~...~ L..--- Total Depth /,~"~? · · . Cased to /·"~'~ Depth of Grouting Static Water Level /"~" Casing Height Above Ground ~:'~D · · Electrical Wiring in Condui (~N) Separation Distances from Well: To Septic/J~Tank on Lot /"/'~ To Nearest Edge of Absorption Field on Lot ~"'~ ~' Pump Set At ~ ~ Sanitary Seal on Casin~N) Depression Around Wellhead (Y/~ ; On Adjoining Lots ; On Adjoining Lots /~O To Nearest Public Sewer Line CleanouUManhole Water Sample Collected by Water Sample Test Results Comments To Nearest Public Sewer /J/K3' To Nearest Sewer Service Line on Lot B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes Y~.~) Depression over Tank (YN~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~")/,~ separation Distances from Septic/Holding Tank: Size /cc>c:, No. of Compartments Air-tight Caps ~(~. N) Foundation Cleano~"~N)~ Date Last Pumped .~/? ~'~ ,o/f ;for Temporary Holding Tank Permit (Y/N) To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation ~--~ To Disposal Field /~ To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026( 11/84 ) ABSORPTION FIELD DATA Soils Rating in Absorption Strata .'~ C)/.~ ~//~/.~- Type of System Design Date Installed ~'~-~ V /VP~ 5'~'~ Length of F e d ~ ~ Depth of Field / Width of Field ~ ~" / ;~ _ Gravel ~d Thickness ~uare F~t of Absorption Area - ~ ~[~andpip~ Pre~nt ~N) Depression over Field (Y~ Date of Last Ad~uacy Test Results of Last Adequacy Test -/l(-- Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Sen/ice Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments L)/"~/ZJ) ~~ . S o. UF' STATION To Property Line ~' To Existing or Abandoned System on ; On Adjoining Lots ,~"~ To Cutbank (if present) Date Installed Size in Gallons . .. / "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments *° Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signe~ & ~ Receipt No. Date of Payment Amount: $ Page 2 of 2 ENCROACHMENT THX$ AGREEMENT, made this day of ,x 198 , between MUNICIPALITY OF "ANCHORAGE, G~antor~ and HUD , Grahtee, WITNESSETH.. The Grantor does hereby grant an Encroach- ment Permit in the following described Public' Right-of-Way or 'Easement Area to Wit: .Candleli~ht .~ubd%~}~{.nn Lot 6~ located .within the SE 1/4 of Section ~. T.]5~ ~]w. ~ ~' Grid NW 1461 The encroachment hereby authorized is described as and limited to the following~ Absorption system encroaches 6 feet into undevelope road easement. See Attachment "A" · In consideration for this permit, the Grantee agrees that he will indemn~fy and hold harmless the Grantor against any and all claims which may arise or be caused by the construction, alteration or maintenance and existence of the above described encroachment or for any damages whatsoever arising out of the granting.of this permit. The Grantor reserves the right to revoke this permit upon twenty (20) days written notice to the Grantee. The Grantee, agrees upon said notice of revocation, to immediately remove said encroachment from the easement, street or public right-of-way. Should the Grantee refuse or fail to comply with said written notice, the Grantor, may without further notice to the Grantee, remove or cause to be removed the encroachment, and the Grantee hereby agrees to reimburse the Grantor for all cost incidental to the~removal thereof. The Grantee hereby agrees to pay an annual fee of $ 10.00 . IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Grantee.' //~oe D. BeI1, R/S - Grantor: ANCHORAGE Secretary of HUD Municipal Enoineer S 0° 04' 57" Power Easement / ..~. ¢~ , CIeorl 0 utT~ Clean EXIST ~"~'"~ jZO' Power Easement N 0° 06° W 140' LEG END e FND. 3" ALUM. MON. (~) FND. I"O.O. IRON PIPE C) FND. 5/8" IRON ROD OEVEIOPMEHI' SE£WC£S .'.~. I $01.01' 5°Utility rose ~ - Utility Easement ;501.41' I O~ Z 30' 3d NOTE: NO CORNERS SET THIS DATE. ' GRID 3034 '.. ....... .. c;,'.".: ~",.. .:':.:'LS ~5 ;cEa 53 SEPT. 76 $ca/e f'" hereby certify that / have surveyed' PROPOSED 'i -) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) Application Date LegalDescription(includelot, block, subdivision, section, township, range) Lot 6A Candlelight Subdivision, TI5N R1W Section 3 Location(addressordirections) Clover Leaf Drive (b) (c) Applicant Name Gregory A. Vance Telephone:Home 688-3001 Business Same Applicant Address Post Office Box 771542, Eagle River, Alaska 99577 Applicant is (check one): Lending Institution I-I; Owner/builder:[~; Buyer D; Other D (explain); ., (d) Lending Institution City Mortc~ac~e Telephone 694-3503 Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: Vance Construction Co. 688-3001 Post Office Box 771543 Eagle River, Alaska 99577 TYPE OF RESIDENCE Single-Family:[k Multi-Family D Number of Bedrooms three Other WATER SUPPLY Individual Well ~X Community I-I Public r3 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL OnsiteEk PublicD Community1'1 Holding Tankl-I Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,64) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certilied by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval 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. Name of Firm Telephone Address Date Engineer's Seal DHEP APPROVAL Approved for t. hree bedrooms by Approved ,~ Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP} issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors Or omissions in the professional engineer's work. Page 2 of 2 r2-o2~ {11/~4) - H~C~PALTTY OF ANCHORAGE DIWiSION OF ENVIROItHENTAL HEALTH DEPARI~EI~ OF HEALTH ~ ENVIROI~NTAL PROTECTION APPLICATION FOR HEALTH ADTHOItlTY APPROVAL CEI~TIFICATE General Information Application Date ~-7-~' ~'(a) Legal Description (includelot, block, subdivision, section, ~ovnship, range) ~' O NOue C ~ ~ r .... r Location (address or recti6nz) - (b) Applicants Name C~-O (c) Applicant is (check one) Lending Institution ~; Ovner/butlder~; Buyer~; Other~(explain); (d) Lendinglnstitution (gjl~- ~i¢.-~ Telephone (s) Real Estate Co. & ABent Address Telephone (f) HaLt the ILiA to the following address: Type of Residence Single-FsmtlYF--~ Number of Bedrooms Hulti-Family ~-~ 6ther (describe) 3. ~ater Supply Individual We11.~-~. Com~uniry~--~ Public~--~ Note: If community w~ll system, must have written confirmation from the State Department of Enviromnental Co~servation attesting to the legallt7 and status. Sewage Disposal ' Onsite.~. Public~ Communi~yF-~ Holding Tank~--~ Note: If c~nity ~11 system, must ~ve ~itten co~i~ation from the Stat~ Department of lnviro~ental Conse~ation attesti~ to the legality a~ status. [PaEe I of 2] En~ineerin~ Firm Providin~ Tns~ections~ Tes~s~ File Searcht Da~a and Information 'As certifie~ by my seal affixod hereto ~ as of the validation date shown below, ! verify that my investigation of th~s Health Authori~y Approval sho~s tl{at the on-site water supply --~/or wastewater d/sposal system is safe, functional and a~equate for' the number of bedrooms and t.ype of structure indicated herein.. I further verify that,' based on the ~formation obtained from the l~nicipali~y of Anchorage f~les and from my Investigation ~ ~pectton, the, on-s~te water supply and/or wastewater c~sposal ' system ts ~n compliance w~th all Hunictpal .~d State codes, ordinances, and resu/a- ttons ~n effect ou the date of th~s Inspection. SEAL) P,.tt~/eJ/D18 [Page 2 of 2] 7-19-84 ae MUNICIPALITY OF ANCHORAGE H~ALTH AUT~O~TY APPROVAL (HAA) · C.'HECKLIST - FEBRUARY 1984 I,IAR 'L t 'Lg$5 RECEIVED Well Classification I · Well Iai P~esent (Y/N) ~/ Date C~¥1eted Static Weter ~evel ! ~ O ' , Pump Set At Casing Height Above Ground ~ L~" Electrical Wiring in Conduit (Y/N) ~/ Sepa~ation Distancss f~cm Well: If A, B, ~ C, D.E.C. App~o~.~d(Y/N) ~ - & - ;5 L4 xie d_L Depth o~ ~essi~ ~nd ~l~ad (Y~) To Septic/Holding Tank To Nea=est Edge of A~tion Field on Lot I Oq ' ; on Adjoining Lots J dX~9 '-~ To Neacest Public Sewer Line bi //~ To Nsa=est Public Sewer Cleancut/Manhole ~//% To Nea=est Sewer Servio~ Line on Lot (~O ' Water Sample Collected By Water Sample Test ~sults Cc~nta B. CSEFrIC_~/~OLDING TA~( DkTA Standpipes (Y/N) y At~-tight Caps (Y~) y Foundation Cleanout (Y/N) Depression cve~ Tank (Y/N) ~ Date Last Pumped Pumping/Mainter~n~s Contract on File (Y/N)~/A ; fc~ Holding Tank High-Were= Alarum (Y/N) .~,//% Tem[x~ra~y Holding Tank Permit (Y/N) Separatio~ Distanoss f~cm Septic/Holding Tank: To Wete~-Supply Wall [ 0 (~) ' To Building Foundation To P~operty Line .'~O' To Disposal Field 'To Water Main/Service Line ~ To Stream, Pond, fake, c~ Majo~ D~ainage [Page 1 of 2] 2-15-84 Co ABSOI~PTICN FIEI.D DATA Soils Ratir~ in Abso=pti~ St=ata __~_~~ o~ System Design Date Installed [~.~t~ .[]tb~'g~_ ~-~ ~ength of Field q Width of Field '{/E~C[~ ~_P_~?4~ Depth of Field sgu~ n~t of Absc~tio. ~-ea 6{ 9-~9 stan~ims ~e~nt (Y/N> h/ pe~ession o~= Field (Y/N) ~ Pete Of Last ~quaey Test D. LIFT STATICN Pete Installed Size in Gallons 'Pump On" Lavel at High hlater Alarm Lavel at Tested fo= Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Lavel at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. ** Che~k Permitted Bed~ocm Reting Against }{AA ~sgusst ** I certify that 'I have checked, verified, o= oonfc~nsd to all MOA HAA G~ide//oes in effect si ~ate KS~/dS/s [Page 2 of 2] 2-15-84 . wumc pa o¥ Anchorage P.O. BL"~ 96650 ANCHORAGE. ALASKA 99519-6650 (907) 264--4111 TONY KNOWLE$, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES July 2, 1986 Rlck and Kathleen tlanson P.O. Box 671627 Chugiak, Alaska 99567 Subject: Lot 6A Candlelight Subdivision Dear Mr. and Mrs. Hanson: Ron Hoffine of Denalt Engineers and Surveyors has indicated that a portion of your septic system drainfteld encroaches on the Municipal road easement to the north of your property. A Health Authority Approval for your septic system cannot be issued with the drainfield in its present location. Municipal ordinance requires that a septic system drainfield be setback a minimum of ten feet from a property line. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/lJw DENALI ENCINEERS & SURVEYORS Rick and Kathleen llanson P.O. Box 671627 Chugiak, AK 99567 June 11, 1986 RE: Lot 6A, Candlelight Subdivision Anchorage, AK Dear Mr.'and Mrs. llanson: Based upon the revised survey as-built dated May 30, 1986 by James B. Rodgers and the sewage system dimensions shown on the Municipality of Anchorage On-Site Sewage Disposal System And/Or Well Inspection Report dated March 8, 1985 by Denali Engineers & Surveyors, it is apparent that the middle leg of the drainfield encroaches onto the road easement north of your property. A monitor tube was not found above grade on this drainfield line. Sincerely, Ron 3,. Encjineering Manager ~6308 RAIl: ket P.O. BOX 873.1.17 · %VASILLA · ALASKA · 09<'~7 · (007) /2 -- 30--- CLOYE£LEAF ~O~qD AS-BUll T dAMES B. RODGERS