Loading...
HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 2 BLK 2 LT 20Glenn View Estates West #2 Block 2 Lot 20 #051 - 793 - 37 Anchorage . Municipality of Services Department 4, ,�_ ,, ��� Development Building Safety Division ,r-- On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 On-Site Wastewater Disposal System and/or Well Inspection Report SW060203 PID Number: 051-793-37 Page 1 of 3 Permit Number Name: JOHN BOBICH Wastewater System: 0 New ■Upgrade 21304 POLLY CIRCLE * CHURGIAK, AK 99567 ABSORPTION FIELDAddress: (907) 317-3228 4 Phone: No. of Bedrooms: O Deep Trench O Shallow Trench O Bed O Mound I ■Other LEGAL DESCRIPTION Soil Rating: 0.7 AVG spa,:,. n. Taal Depth Iran enrol peer: SEE DWG. n. Block: Lot: Subdivision: 2 20 GLENN VIEW EST. W. PH. 2 Depth to pipe bottom horn origami Erode: SEE DWG. n. Grovel depth beneath pipe 3 n Township:Range: — Section: — N added *bore onglna grade` SEE DWG. n. Garel length:— 100 n. _ WELL: ❑ New 0 Upgrade Gravel Gravel width: Gravel5 n Number of line 1 Delano. between Ines: i< Cb.ortw.uon (prlret.. A.9.C% Dosed 1Netzwpc,D n Total abeorpuo• snot 862 so. n.k.�.gD p . malarial: 3034/ l F-810 wk1Cj a W, Dote DWI: Static Noted Levet ln.`own GEG Ltd. Date i/ 18-19/2006 MMv`.C( Yeld�Fusty awl AL s� pL Casing height Nan eraana FL TANK SEPARATION DISTANCES °Septic OHolding 0S.T.E.P. I • •her 7o Septi. Tank Absorption field Litt Station Holding Tank pubf Lin to Sewer Linn Nawloctfl4 7 Co•• .• edbre: i I From well — 200'+ — — — �`CI\NCj Wterd: E Number of comp.NmwNv I Surface Water — 100•+ — — — LIFT STATION 1 Lot Line — 10'+ — — — Ste In yellow: M•nl'r•chne: I Foundation — 10•+ — — — en ins eL . ane el le..l et c •r alone at. Pump Yoe. * . •. . local inspections p.rio nwd by. Curtain Drain NONE KNOWN Remarks: INTEGRITY OF EXISTING SEPTIC TANK VERIFIED. BENCH MARK L«oh.n ane Descripben TOP OF BOTTOM STEP OF DECK a.•ned (Imola 100.00 . Inspections by: GEG, Ltd. Dates: 1st 7/16/2006 ENGINEERS SEAL 0p performed 2nd 7/19/2006 QF. q�;�o0 3rd P�, %�• - 0 Development Services Department Approval p by:td0 Date• S -Al- 06 •# �. ' % �* SOD Y/ p. P Reviewed and approved • CE-795 ot;:O by: Date: Ott :000000a Reviewed and approved (Rev. 4/06) PERMIT NUMBER: SW060203 AS—BUILT DRAWING PARCEL ID NUMBER: 051-793-37 A B FD 27.9 24.5 DBL1 28.3 27.3 DBL2 26.6 28.2 CO1 55.2 74.0 MT1 55.7 76.0 CO2 86.3 60.5 MT2 83.2 57.4 5 E: 1 - 40' NTT two COG. 00uA7 'TELT 1110L.0 NEW DRMNFIELD 2 131.1 & D012 hoe—P. Fpa • �-• EXISTING 1250 GALLON SEPTIC TANK EXISTING DRAINFIELD 310210 lllOd r GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3701 C Ma Row. N11[ 101 • M41Cewf. Mf WO? • e.c,[ (104330-0170 • FaX (101)331-3244 • 110511T4 ewp••••,•y.—M•R• PAGE NUMBER: 2 OF 3 PREPARED FOR: JOHN BOBICH PHONE NUMBER: 317-3228 LEGAL DESCRIPTION: GLENN VIEW EST. WEST PH 2, LOT 20, BLOCK 2 DRAWN BY: B.F.M. 0 / J f re A. porness. QQO s E-7951//`�DO �Q7e. •'•46.(19•tcejd 0 ��professto�°o' TYPE or WORK: AS—BUILT FOR NEW DRAINFIELD (Rev. 01105) DATE: 7/31/2006 PERMIT NUMBER: SW060203 AS -BUILT DRAWING FINAL GRADE - (97.28 NORTH SIDE) -98.78 INSULATION OVER 70' OF NORTH END FILTER FABRIC INVERT OF PIPE g• 94.76 BOTTOM OF TRENCH . 91.75 r' GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTOR � � ITT L TKO* 0000. SSR 101 • 0110€10/04M MSD) • w[ ,0, (007)337-0170• IM (007)100-32011 PREPARED FOR: I PHONE NUMBER: I PAGE NUMBER: JOHN BOBICH 317-3228 3 OF 3 LEGAL DESCRIPTION: GLENN VIEW EST. WEST PH. 2, LOT 20. BLOCK 2 TYPE OF WORK: AS -BUILT FOR NEW DRAINFIELD (ROV. 01/05) DRAWN BY: B.F.M. DATE: 7/31/2006 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade 71/ t r 7�� q 'r Date Issued: Jul 13, 2006 Expiration Date: Jul 13, 2007 Permit Number: SW060203 Parcel ID: 051-793-37 Legal Description: GLENN VIEW ESTATES WEST PH 2 BLK 2 LT 20 Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 021304 POLLY CIR Owner Name: JOHN BOBICH Lot Size: 40100 SQ. FT. Owner Address: 21304 POLLY CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. 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. S/OG awl" c to 3i. a%, 41h Received By: Issued By: Date. Date: %43,06 Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.c.i.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 05- ?'1332 Property owner(s) JOHN BOBICH Day phone 317-3228 Mailing address 21304 POLLY CIRCLE. CHUGIAK. AK Site address Zip Code 99567 Legal description (Sub'd, Block & Lot) GLENN VIEW ESTATES WEST S/D j7: BLOCK 2 LOT 20 Legal description (Township, Section & Range) N/A Lot Size 116 , � Ob Acre THIS APPLICATION IS FOR ( [gall that apply): Number of Bedrooms 4 THIS APPLICATION IS AN: Absorption Field 0 Initial 0 Septic Tank 0 Upgrade 0 Holding Tank 0 Renewal 0 Privy 0 Private Well 0 Water Storage 0 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. GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees• cy/( 0 f / % 5 fl'S &Waiver Fees: Date of Payment: Date of Payment: Receipt Number: n S 0 yU �' 9 P Receipt Number: (Rev. 11/05) GARNESS ENGINEERING GROUP, Ltd. July 11, 2006 CONSULTANTS & GENERAL CONTRACTORS Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 at z. Ref: Proposed Septic Upgrade for Glenn View Estates West SID; Lot 20, Block 2, To whom it may concern: The existing 4 bedroom house is served by public water and a private septic system. The septic system consists of a 1250 gallon septic tank and a 5 -wide type drainfield. On 6/30/2006, we performed a septic adequacy test for the purpose of selling the home and found the system did not absorb the 600 gallons per day. It should be noted that the system was filled to it maximum capacity during our test. Based upon this information, the septic system is in the state of failure and needs to be upgraded. We are proposing to use the existing 1250 gallon septic tank and that the alternate site for a new 5 -wide trench type drainfield be installed as shown on the attached KND Engineering site plan. We are proposing that a confirmation test hole be excavated and a percolation test be performed prior to the construction of the alternate site. Based upon our experience in this subdivision, it is our opinion that a 0.6 application rate should be used for the alternate site. Comments regarding the design are summarized as follows: 1. SOILS: See the attached two KND Engineering Togs which shows the soil classifications, groundwater monitoring, and the percolation test results. As stated before, it is our opinion that an application rate of 0.6 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 4.21 & 12.31 minutes/inch b. Proposed Application Rate: 0.6 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1000 ft2 f. Total Depth: 7 feet (maximum) g. Effective Depth: 4 feet (minimum) h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 100 feet long k. Effective absorption area = 1000 ft2 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907)337-6179 • Fax: (907) 338-3246 • Website: gamessengineering.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The average slope in the area is a 5 to 10 percent running approximately east to west. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. ely effre Pres: s, P.E., M.S. NOTE: A 7 page construction specification letter is attached which is part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamesscngineering.com AS-BUILLSYSTEM DETAILS/SITE PLAN Pernit 1t SW010087 GLENN VIEW ESTATES WEST S/D, LOT 20, BLOCK 2 PIDtt 05I-793-37 Atta.04.7t _erre Ti $f tat'TALL O . 5CE Dena Lcrret, av (8099-2/20 c -$cPiic"�t Y Ta T1PCRC 01-1 Wk. ,ST xtSTM6 e 0Rh tent tRtvc BMI Lot 20 FaaPeseo C.aF4.M11T,e44 ltt 11at.t 1311.400Wkr"r0 Qstiod_ (OA C7(WL'I1 ar) SCALE. 1' • 50' A -C=20.4' B -C=16.8' A -D=26.2' B -D=22.4' A -E=39.5' B -E=62.8 A -F=64.5 B -F=37.4 «> V �}1 n a a as a6 iII=II= = -1.411111=p ag 1250 GAL _ir t"' R: SEPTIC iI I TANK i 88.9 88.8 I.S Wit IM.KN FINAL GRADE ► -II-O -•I-II it -u -n= =n-nuTn=a=n.=nv OF AL \ 4 r3s1011/+ SEVER ROCK 84.3 1 Se 81.3 PREPARED FOR: TURNER CONSTRUCTION PO BOX 3489 PALMER. AK 99615 (907) 713-8334 e.10 D0H Scale: NTS PAGE 1 OF 1 raw ROOKS mann tQ"O'"It I ANC swot .11AAY sun* LANG d ettet KMD Ana% LANG Mme' 12/07/01 nn o+c NW1459 *C PIL 010026.DW a b 010026 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, MC 99577-6736 (907)698-6111/FAX (907)696-8111 2 11C IDENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER,-,1C995ii-tiilb SOILS PERCOLATION TEST Performed for: Arctic Devco Project Depth (Tett) Date Performed 1 1 1 2 4 _ ,,.-...; ea, ... doe 'f Pit %sTti ?•1,•�/ `• ••:. .•: 1 1 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Performed for. Project: Depth 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - SOILS PERCOLATION TEST Turner Construction Glenn View West Estates Phase 2 B2, L20 TESTHOLE it •• 1. Pit•• c2 • • ••,'f-9 c -STH .+/ ...........:,_,k3 K•nnr,, M. L' -L• 4'..• CE7116 V 5 Icte l le P •••ESSIO • ..r Date Performed: 4/27/01 Org/CP—w/ red -brown overburden & loose gravel SM/GM—med dense gray w/cobbles to 8; dry MATERIAL CONSISTENT ALONG TRENCII B.O.H.-TRENCH FIOLE PRESOAKED mom TO TEST 0I.1 I SEE ATTACHED SITE PLAN I FOR HOLE LOCATION IWas Ground water encountered? NO Depth to water atter monitoring? NA What depth? NA Date? NA Reading Date Cross Time Net Time Depth to Water 1 4/28/01 1:00 6" Net Drop 2 130 30 min 38/16" 2 8/16' 3 • 131 6" 4 2:01 30 min 39/16" 2 7/16' 5 • 2:02 • 6" 6 2:32 30 min 3 9/16" 2 7/16" • Water Added Percolation Rate 1? 11, (min/in) Pere Hole Diameter 6" Test RunBctween 7 ,feet and 8 •feet f, Kenneth M. Duffus, certify that this test was performed In accordance with alt State and Municipal guidelines In effect on this date. Municipality of Anchorage :r ;' °•, •/'r 1_ Development Services Department :Snail: Kc -, ,; Building Safety Division \ A - On-Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page www.d.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW010087 PID Number. 051.793.37 / of Turner Construction Wastewater System: '2 New 0 Upgrade Address: PO Box 3489. Palmer. AK 99645 ABSORPTION FIELD Phone: Number or Bedrooms: 4 141 O Bed O Mond O Other: D Deep trench Shallow trend, LEGAL DESCRIPTION Sod Rating: p. 0.8 GPD/W27 taD.pthp�«.w.. W 7.0 Ft. Block: Lot BubG.twn: 2 20 Glenn View West Est. Phase 2 Iran Grave depth beneath pips 4.09 FL Depth b pips bottom original grade: 2.91 Ft. towshp: Ran' pe: Swoon: Fa added above oglnel grade: 1.44 Ft. Growl Length: 82 Ft. Well: • New ■ Upgrade Grew wdt: 5 Ft. Number of Yves: Distance between Mies: 1 NA Ft Ciawbcabon (Pnmb, A B, cF Public Water Total Depth: Ft. Geed to: n. trxa abeap on area: 820 Fr Pp Matew: SCH40 & F810 Dnuar. Date Dwell: Static WoW Lew: FL pietaW: Turner Const. Dat. lnewbd: 4/28/01 Yield: GPM Pump 5e at FI. Casing Hewn Above Growd: FL TANK SEPARATION DISTANCES t83 Septic 0 Holding • S.T.E.P. 0 Other. To From Septic Tank Absorption Field Litt Station Holding Tank Pudic/Private Sewer cane Manufacturer:caviar: Anchorage Tank 1250 Get. Wel 200'+ 200'+ 200'+ NA NA 25'+ Material: Number d Co.paanets: 2 Surface water 100'+ 100'+ NA NA LIFT STATION IAune 5+ 10'+ NA NA Sins Gal. Hamada kae. Foundation 5'+ 10'+ NA NA 'Pump on' level at n. *Pump off leve atNgh n. wets alarm at h. Curtain Drain NA 'SO'+ NA NA Pump Make & Madel Saimaa Inspections pnnamed by *nonne known no BENCH MARK Location and Damp a .% Bottom of siding Assumed Lb.aban. 100 FL - Engineer's .4c.•OF 4(gstl, i x f g N - - refi Stamp assn. .. �c to Inspections performed by: KND Engineering Dates: 1M 4/27/01 Ir.001 Development Services Department App ov�j Slot �` Date:/o--/9- Reviewed and approved by: ,�/•a•• �1•••Kanne:h M•�d;t• 143% 4 3S GE 7115 4 Fyeo ..,.e..-�•, • ,1,� 0�V4InP�a W tsi i !&S (Rev. I2/00) AS—BUILT SYSTEM DETAILS/SITE PLAN GLENN VIEW ESTATES WEST S/D, LOT 20, BLOCK 2 Permit # SW010087 PID# 051-793-37 KD KND99-2/20 T —igsTINO T TII/PERC 01-1 14. DRIVE EXISTING 4 HRH HOUSE BM Lot 20 A -C=20.4' B -C=16.8' A -D=26.2' B -D=22.4' A -E=39.5' B -E=62.8 A -F=64.5 B -F=37.4 0 FINAL GRADE aftail-lAsib: i= woks 13 84.34 84.3 I H =li=11=11=11.-11-11-111= ., 1250 GAL 111- 41: SEPTIC I: — TANKII II I II IIII= SEWER ROCK 45c) 9.A.44 ;57„ .4 H M. DU #CE -7116 .................... IPOFESS1014A. wNIICt.•16:111.* 132' 4-09' PREPARED FOR: TURNER CONSTRUCTION PO BOX 3489 PALMER, AK 99645 (907) 745-8334 (-78.10.)BOH Scale: NTS PAGE 1 OF 1 FIELD BOOKS CC4841.1110: inniUlt LANG WtA". JMAY SWUNG' LANG "e'icct KMD Main LANG °ATE' 12/07/01 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 0.44. 41-C; cite. NW1459 " n't 010026.DWG Na: 010026 (907)696-6111/FAX (907)696-8111 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed fon. Turner Construction Project: Depth Feet OF4 �l '(E....•...,zgs�+ in to• TH •...t s'k o .1 i c. Kenno:n M. C -.;w L..,., fy CE7116 `C✓ • F�.r t`1��\vim SS\0 .• "a Date Performed: 4/27/01 Glenn View West Estates Phase 2 B2, L20 TEST HOLE # 01-1 Org/GP — w/ red -brown overburden & loose gravel SM/GM — med dense gray 3- ri .'" w/cobbles to 8", dry 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - MATERIAL CONSISTENT ALONG TRENCH B.O.H. - TRENCH HOLE PRESOAKED PRIOR TO TEST SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO Depth to water after monitoring? NA What depth? NA Date? NA Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/28/01 1:00 - 6" - 2 1:30 30 min 3 8/16" 2 8/16" 3. 1:31 - 6" - 4 2:01 30 min 39/16" 2 7/16" 5• 2:02 - 6" - 6 2:32 30 min 39/16" 2 7/16" * Water Added Percolation Rate 12.31 (min/in Perc Hole Diameter 6" Test Run Between 7 feet and 8 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial ¢ -2.7—o/ /ire, l2:00a' 2 .f' : O O p. w . tot co 4.A. Date Issued: Apr 26, 2001 Expiration Date: Apr 26, 2002 Permit Number: SW010087 Parcel ID: 051-793-37 Legal Description: GLENN VIEW ESTATES WEST PH 2 BLK 2 LT 20 • Design Engineer: 0070 KND Engineering Owner Name: TURNER CONSTRUCTION Owner Address: PO BOX 3489 PALMER . AK 99645 - Site Address: Lot Size: 40100 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: E✓ Disposal Field 0 Septic Tank Holding Tank 111 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. P/7 '7 —0/ Received By: Date: Issued By: Date: 4 - 2 7 — 0/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel ID 051-793-37 Permit Number SW 010087 Property owner(s) Turner Construction Day phone 242-4555 Mailing address (1) PO Box 3487, Palmer, AK Mailing address (2) Jip Code 9 9 6 4 5 Legal description (Lot, Block & Sub' Legal description (Section, Township & Range) Lot Size 40"800+ Acres q.Ft. Number of Bedrooms 4 d,) Lot 20 lock 2,Slenn View Estates West Ph 2 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: ® Well Only ❑ Water Storage 0 Hot Tub 0 Jacuzzi Swimming Pool 0 Water Softening Unit Therapy Pool 0 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. (Signature of property owner or authorized agent) Permit Fees: 037-0 — Waiver Fees: Date of Payment: 0f/2o,/off Date of Payment: Receipt Number: 3(.4q'/ r Receipt Number: (Rev.12100) KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 April 18, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: New sewer permit — Glenn View Estates West, Block 2, Lot 20 Gentlemen: The owner has requested we proceed forward to obtain a septic permit on the subject lot. On April 21, 1999 we dug one testhole for the proposed system. The results of the test are attached. The general slope of this lot is from east to west at a grade of approximately 5 - 8%. We have designed our system utilizing the testhole we excavated for the 4 -bedroom house, which is proposed for this lot. The lot will be served by, public water. We propose to install a 5' wide shallow trench. Water was not encountered during the excavation or monitoring. An additional percolation test will be conducted during construction. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IICND Engineering enneth M. Duffus, P.E. Attachments: On -Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE GLENN VIEW ESTATES WEST S/D, LOT 20, BLOCK 2 NO PUBIC YELLS VITHIN COY IT PROPOSED SYSTEM. MO PRIVATE WELLS VITHIN LW' DE PROPOSED SYSTEM EXCEPT AS NITER NO SEPTIC- SYSTEMS VITHIN 200' OF PROPOSED YELL EXCEPT AS NOTED. Lot 22 Lot 21 1,It VACANT CUM MUCK( PLAN Lot ' Lot 20 / X911 * ; • IH ....\ *# VACANT Lot 19 Lot DESIG IETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPO/0.8 GPD PER SO. FT. (4.21 MIN/IN.)= 750 SO. FT (750/5'(V)) X .50(RF) (4.0' GRAVEL) = 75.0 FT. TRENCH USE 1 TRENCH - 75 (L) X 5' (V) X 4.0'(D) Total depth of system Is 7.0' from original grade. Total depth of gravel below distribution pipe Is 4.0' . NOTES: 1. USE 1250 GAL. SEPTIC TANK. INSULATE IF <4' OF COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM. 3. CONTRACTOR VILL ENSURE MINIMUM 27. SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS 6 SEPTICS. PREPARED FOR: TURNER CONSTRUCTION PO BOX 3489 PALMER, AK 99645 (907) 745-8334 Scale: 1'= 100' PAGE 1 OF 2 KENNET DUFF CE -7116 / C AIbFYgg10NA� DDPOART' LANG Ita14 LANG CE•sPUTEEt DRAIN: acorn: KMD ASe'n° LANG Owl FAL DATL 4/18/01 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8736 o-. NW1459 ACRD at' 010026.DWGNa: 010026 (907)898-8111/FAX (907)698-8111 WASTEWATER DISPOSAL SYSTEM DETAILS GLENN VIEW ESTATES WEST S/D, LOT 20, BLOCK 2 ELE( KND fJ PROPOSED SYSTEM TH#KN SED PRIMARY M FCO POSED 1250 GAL/ PTIC TANK KENNETH M. DUFF CE -7116 ‘,.neorEssioloir 0 n MT CO FOR: TURNER CONSTRUCTION PO BOX 3489 PALMER, AK 99645 C907) 745-8334 Scnle 1'= 20' PAGE 2 OF 2 I1ELD BOOKS coynurzu n ' s" LANG o"".,: VBG "'SC LANG CHEaCtil KIM "a"% LANC o ra nc: o"'c: 4/18/01 END ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 °aQ NW1459 "c"0' 010026.DWG'108 "" 010026 (907)696-6111/FAX (907)696-8111 • JKbV D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 OrAlpb;••..... ;.............. .• rq .•' 9 �B Litt * ?49111 •• *• II floe �0 SOILS PERCOLATION TEST Performed fon Arctic Devco Project: Depth (Feet) 1 1 Lot 20, Block 2, Glenn View West TEST HOLE 41 99-2/20 ORG — brown SM — red brown/black SM/GM —mostly SM w/gravel, loose/med. density on top increasing density w/depth t: HOLE PRESOAKED 20- PRIOR TO TEST SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO Depth to water after monitoring? NO What depth? NA Date? 05/15/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/21/99 2:40- 6" - 2 2:50 IO min 32/16" 214/16" 3• 251 - 6" - 4 3:01 10 min 35/16" 211/16" 5 • 3:02 - 6" - 6 3:12 10 min 3 6/16" 210/16" 7 • 3:13 - 6" - 8 323 IO min 310/16" 26/16" 9• 324 - 6" - 10 3:34 10 min 310/16" 26/16" 11 • 3:35 - 6" - 12 3:45 10 min 310/16" 26/16" • Water Added Percolation Rate 4.71 , (min/in) Perc Hole Diameter 6" Test Run Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. • • 6 N B 4 -: Municipality of Anchorage " `4a On-Site Water and Wastewater Program `,>®,ii®i " (907) 343-7904 s. r< ,, , Certificate of On-Site Systems Approval Parcel W. 051 -793-37 Expiration Date: / Q -.‘2 7i'7 1. GENERAL INFORMATION Complete legal description Lot 20, Bk 2 , Glenn View Estates West, Phase 2 Location (site address) 21304 Polly Circle, Chugiak, AK 99567 Current Property owner(s) Charlie & Kathryn Martin Day phone(907) 240-3780 Mailing address 21304 Polly Circle, Chugiak, AK 99567 Real Estate Agent Audrey Mason/RE/Max of ER Day phone(907) 622-3344 19 9 70 77 2. TYPE OF DWELLING: u� 4)n 0 k,.,1 :, ,off U Single Family (w/wo ADU) _M ❑ Duplex 212017 ❑ Multiple Dwellings (Single Family and/or Duplex) .1.4 1� )0ti 3. NUMBER OF BEDROOMS: 3 t->4 a6 8 ,; w 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well E Individual IE Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: i I) Received by: 1----- —y-1-- --- Date: 1(z(( COSA to be released to the engineer,unless otherwise requested by the engineer. L COSA Fee $ 42-4:, - Waiver Fee $ Date of Payment 112.1 I ti Lk 13\4 Date of Payment Receipt Number 2t 42 Receipt Number COSA# 05C11131\ 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 Pinard. Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, AK 99687_ Engineer's Printed Name Paul E. Pinard Date 7/20/17 f�jOF Ad�� r. .• 6. DSD SIGNATURE � ,r tFl �'\ •�;� e hl tiK System#1 Approved for 3 bedrooms r :,,,.. 1 k------.-•' k4 System#2 Approved for bedrooms Si �.c, Paul . Pinard��� %...11;.# GT.' .4793 .:G• 0 Disapproved a*k.Y„tsoasea �'l�at�� e"q?�'�¢� �t\tYk.�I p I Conditional approval for bedrooms, with the following stipulations 4i`"oftt fr '. \CJAP N�,I t i r. %QST �qi�Q ?3 li 'TOG yvA rcl? -,� �'Al�,°� ,c "_ ------ ,(j B.. . �_ Original Certificate Date: 77_ I� 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_f c • If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On Site Systems Approval Checklist Legal Description: Lot 20, Bk 2, Glenn View Estates West2 Parcel ID: 051 -793-37 A. WELL DATA NA - Public Water System Well type If A, B, or C provide PWSID# Well Log (YIN) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth 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. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 4/27/01 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 8/23/16 Pumper JRs Pumpi n8 C. ABSORPTION FIELD DATA 4/28/010.8 Date installed 7/19/n Soil rating (g.p.d./ft2 antatintritS 0 7 System type 5 WideSha L low Trench Length 100 ft. Width 2 5 ft. Gravel below pipe 3 ft. Total deptl- 2 7ft. Eff. absorption area 862 ftft2 Monitoring tube Y Depression over field N Date of adequacy test 7/1 '7/1 7 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 12 in. Water added 600 gal. New depth 19 in. Elapsed Time: 1 280 min. Final fluid depth 1 3 in. Absorption rate >= 450 g.p.d_ Any rejuvenation treatment (past 12 ma.) (Y/N &type) No If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: NA Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 ' + Property line 5 ' + Absorption field 5 ' + Water main 101 + Water service line 10' + Surface water 100' + Wells on adjacent lots 200' + ABSORPTION FIELD ON LOT TO: Property line 101 + Building foundation 101 + Water main 101+ Water Service line 101 + Surface water 1001 + Driveway, parking/vehicle storage 20 t+ Curtain drain None Known Wells on adjacent lots200'+ F. COMMENTS The adequacy test was performed on the newest of the 5 Wide Shallow Trenches. The other, older 5 Wide is shut off with a Diverter Valve . This home is being sold as a 3 bedroom, single family residence . G. ENGINEER'S CERTIFICATION f1��E OF At I certify that / have determined through field inspections and 1 A ,..•""•. 5 . review of Municipal records that the above systems are in � co••. , conformance with MOA COSA guidelines in effect on this date. Nit i* { ttt'_ *.,*8 Engineer's Printed Name Paul E. Pinard s • .�� Vd Z�''` Date 7/20/17 `�;�Paul E. Pinard+u , • ��� •. Cir -4793 .• -S wleg#i,E�l��l►<<1 --�l l -1 COSA yellow sheet_2-6-15.doc 410 1.-", 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.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 057- 793-W- 1. 93-W- 1. GENERAL INFORMATION Complete Legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COSA# (031' Expiration Date. R -.2-q- 0 7 GLENN VIEW EST. W. PH 2; LOT 20, BLOCK 2 21304 POLLY CIRCLE • ANCHORAGE, AK 99567 JOHN BOBICH Day phone 21304 POLLY CIRCLE • ANCHORAGE, AK 99567 Day phone 317-3228 DONNA ALDERMAN w/ PRUDENTIAL Day phone 3600158 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding tank ❑ Community On-site • Public Sewer Tt1a-Mcmtelpality-6fAnchorage-DevetopmentServlces-Department jDSO)-Issues-Certificates-ofOn 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 disposa 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, 1 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. 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, LtD. 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 solo benefit of the owner listed above. Any reliance upon or use of this report by any other person a party Is not authorized, nor will It confer any legal right whatsoever. Phone 337-6179 Date 8bola 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing stipulations: Attachments: rOSA_Checldst t/ O '••• •••. Arsenic -Advisory .`�,v`�P�`�YtOF glN06, tee: tr ; ON -TTL c `�; WATER AND : °1= WASTEWATER : _ e. PROGRAM Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Reort Other IR.. 11.1151 Original Certificate Date' g " a q —o G Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6850 www.muni.arg/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description. GLENN VIEW EST. W. PH 2; LOT 20, BLOCK 2 Parcel 10:05'/- 793-37 A. WELL DATA Web typePte_ If A, 6, or C provide PWSID# _ Well L Date completed Sanitary seal i. Wires party peed (YIN) Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: ft. El p.m. ft. g.p.m. Coliform colonies/100 ml. Nitrate �� • •'i -r bacteria colonies/100 ml. Arseni .. . Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size 1250 gal Number of Compartments 2 Cleanouts (Y/N) TES SEPTIC/STEEL Date installed 4/27/2001 Foundation deanout (Y/N) YES Depression over tank (WN) NO Date of pumping 6/28/2006 C. ABSORPTION FIELD DATA SHALLOW TRENCH 4/28/2001 0.8 Date installed 7/18-19/2006 Soil rating •.p.d 'r •r fL bdrm) 0_7 System type S WIDE 82 5 4 ft Length 100 ft Width 5 ft. Gravel below pipe 7 820 YES Depression over field NO Total depth e•2r7•oaft. ER. absorption area 862 re Monitoring tuba pre Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms Pumper High water alarm (Y/N) N/A SANITARY PUMPERS ;:14.11 aNiAd&teli0C3 Fluid depth in absorption field before test = in Water added - gal New depth =in. Elapsed Time: - min. Final fluid depth = in Absorption rate x 600+ g.p d Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date D. UFT STATION Date installed Size in gallons Manhole/Access (Y/N) Pump on" level at _in. -Pump off' leve : — . • igh water alarm level at Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Uft station on lot Absorption field on lot Public sewer main in. Meets mann & circuit requirements? PUBLIC WATER On adjacent lots On adjace ublIc sewer manhole/deanout Sewer /septic service line Holding tank Ani lnment areas 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 Tots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parldng/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have detemwned through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in etfed on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 8 Isola. COSA Fee $ -*Ts--,7/ � Waiver Fee $ Date of Payment 2/] / /06 Date of Payment Receipt Number /60100, Receipt Number (Rev. 11/05) (n co P 2.5' X 7.9' CANT 1 1"" to 25.1' 26.5 O M 11.o' x 8.6' CANT in v N W000 FORAME RY 14.5' M o M RESIDENCE in /11111/11 2.0' X 4.7' CANT i 14.0' 2.0' ;n 25.9' 25.1' .111\ o' X 5.7' CANT HOUSE DETAIL 10-30' PORCH Lot 21 S 89•51'021‘v 300.00' 30.00' 15' TELECOM. & ELECT. EASEMENT EATLAALm z SEPTIC CLEAN -OUTS 19.7' X 12.3' SHED Lot 20 40,100 s.f. 209.8' 4.6'X8.6'SHED S 86'42 35 E 280.60 Lot 19 NOTE: THIS PROPERTY 15 SERVED BY A PUBLJC WATER SYSTEM. PLOT PLAN _ AS BUILT X SCALE 1e — 50' GRID 5. 77378;777"S 'ASPHALTS DRIVEW,AY,= t.. L-32 I17' R-50.00' L-29'1/ R-50.00' m rn u u NW 1459 ProJeat No. 06-159 310810 Al10d Lang• & Associates Inc. 11500 Daryl Avenue, Anchorage. , 907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax kglanglsOalaska.net / JelanglsOalaska.nst I hereby certify that 1 have surveyed the following described props LOT 20, BLOCK 2, GLENN VIEW WEST SUBDIVISION, PHASE No. 2 (PLAT 2000-89) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property Tines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission Tines or other visible easements on said property except as Indicated hereon. Dated this the 1 Day of h'-1 r itt4'[ , Zmf° , at Anchorage, Alaska M Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdMsion plat. Alaska 99515-3049 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-8650 www.muni.orglonsite (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Jeff harness Legal description: Glen View Estates West Phase 2 Block 2 Lot 20 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy In information submitted. _ ❑ Topographic information missing or inadequate. r..�,�3 ® Incomplete; missing Test Holes on Inspection Report. S ti & J's.. -41/4 a ® Incomplete; missing 0.6 soils and 1000 square feet proposed on permit only 862 ssqs�are feet installed. No confirmation test hole submitted.— fc(643 on i/W'f mak_ e .)sc.0.1 p 1:...-liq (�w�c. AISoco". ❑ Additional adequacy test information needed. i-t-st A< J,A . on) .y. +.sal•), Water sample unacceptable. .}1,.vt-4..c,,.,NS'SeS �r.y.cN ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. ___ Name of reviewer: Poet Date: 8-21-06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-793-37 1. HAA# HA O /a G 9 7 Expiration Date: / 2 - (`1- 0.2 - GENERAL INFORMATION Complete legal description c Glenn View West Esates Phase 2. Block 2. Lot 20 Location (site address or directions) Current Property owner(s) Turner Construction Day phone Mailing address PO Box 3489 Palmer. AK. 99645 Lending agency Mailing address Real Estate Agent Day phone Gary Gearhart - Prudential -Vista Day phone 242-3294 Mailing Address 16635 Centerfield Dr.. Eagle River. AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site O Individual Holding tank O Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates .of Health Authority Approval (HAA) based only upon the representations given in paragraph 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 served 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 shown below, I verify that my investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND Engineering Address 20441 Ptarmigan Blvd. Eagle River, AK. 99577 Engineer's Printed Name Kenneth M. Duffus Phone 696-6111 Date 12/18/01 0 Ataapa4 ,Cresp B ,,Tm Ci e•••C. ,pe NEER S F. 5. DSD SIGNATURE v r, • Kenr,C 11 ;i. •' C •,• a7115 b.i.� Approved for bedrooms. 44, St. 'he ''•••.....••';'�`�a.„"� Disapproved. aa(i%a1��-�'b Conditional approval for bedrooms, with the following stipulations: ttt11 kkFJ�Y OFagrt_ ,;. Additional Comments SS : ON-SITE •t t' WATFR AND ' in WASTEWATER : e. PROGRAM • o' �i t( ...,,)pcy�; €wr .'`N71\\�� Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: 0� � Id . / (Rev. 12/00) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: / L , / '7- O % Legal Description' Municipality of Anchorage Development Services Department Building Safety Division On-SIte Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Glenn View West Estates Phase 2. Block 2. Lot 20 Parcel ID: 051.79337 A. WELL DATA Well type PUBLIC Date completed Total depth fL If A, 13, or C provide PWSID # Sanitary seal (YM) Cased to ft. FROM WELL LOG Date of test Static water level ft. Wen production g.p.m WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate mg./1. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION ft. g.p.m. Other bacteria colonies/100m1 Date of sample: Collected by: B. SEPTICMOLDING TANK DATA Tank Type/Material Anch. Tank! steel Date installed 4127101 Tank size 1250 gal. Number of Compartments 2 Cleanouts Y.Foundation cleanout Depression over tank 0_Hlgh water alarm's Date of pumping na-new tank Pumper C. ABSORPTION FIELD DATA Date installed 4128101 Soil rating (g.p.dift2 or ft2/bdrm) System type shallow trench Length $t_ ft. Width 5 ft. Gravel below pipe 4.09 ft. Total depth L ft. Eft. absorption area 820 ft' Monitoring tube y. Depression over field n• Date of adequacy test Daenew system Results (Pass/Fail) sass For i bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. UFT STATION Date installed na Size in gallons Manhole/Access (Y/N) 'Pump on" level at _ in. 'Pump off' at _ In.High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent Tots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'. Property Zine 'LF Absorption field 5'+ in. Water main 10'. Water service line 10'+ Surface water 100'+ Wells on adjacent Tots 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, parkinglvehicle storage '+ Curtain drain 50'+ Wells on adjacent lots 200'+ _ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through held 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 Kenneth M. Duffus Date 12118101 i� Keine h N.. W6.•. f / N G I t -ii i4 S \\_ rO ESSICn HAA Fee $300 Date of Payment 12/18/01 Receipt Number !?ji M (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number