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Home My WebLink AboutEAGLE RIVER VALLEY RANCHETTES LT 12DOnsite File Eagle River Valley Ranchettes Lot 12D #050-222-28 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211113 PID Number: 050-222-28 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name VIK JAMES & KATHLEEN A1.�SORPTION FIELD ❑ e Trench ❑ Wide Trench E]Bed ❑ Mound Site Address 19002 Whirlaway Road Eagle River Other Phone Number of Bedrooms Soil Soil Rating Total depth from original grade 3 D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origina'lg de Gravel depth beneath pipe Ft. Subdivision Block Lot EAGLE RIVER VALLEY RANCHETTES 12D Fill added above original grade Ft, Gra lel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distamce between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t ches From Tank Field Tank Line Ftz t. Well >1 0�� it I n NA VA �A N /� /-� TANK MSeptic E]S.T.E.P. El Holding ❑ Other Manufacturer greer Capacity 1250 Gal. Surface Water >100, NA NA NA Material Number of compartments Lot Line >10' NA NA I NA NA plastic 2 Foundation >1 0' NA NA NA UET STATION Manufac are _ Capacity Gal. Remarks Alarm location Elec '_ stalled'� PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Installer JRs Septic Drainfield CO/MT3034 Inspector Brent Western BENCH MARK (Assumed elevation) 100 ft Inspdectio ts, 5/2'1/2021 8/4/2021 Location and description 2�a 3`d 4th bottom of siding point B ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ,�.,c� •'' `�.�� 1 7H Date Septic System Approved Date R ,1 .9o2l No.CEt, ��®�PROFESSO - Note: this approval does not include well permit requirements. LOT 21 C THESE PROPERTIES ARE SERVED BY AWWU AND THERE ARE NO WELLS WITHIN 200'. NEIGHBORING SEPTIC IS > 10' FROM PROPERTY LINE I MT I I I DCO EXISTING 52' x 30" x96" EFFEC TI VE DEP TH TRE CH WHIRLAWAY ROAD CO FCO B V � NEW 1250 GALLON TANK SLOPE 7% LOT 12E — - -w w W - w-- w 3 BEDROOM HOUSE LOT 21 DI LOT 20C WA TER LINE ALIGNMENT VERIFIED PRIOR TO CONSTRUCTION -W--W --W SCOPE OF WORK 1. REMOVED EXISTING SEPTIC TANK. 2. PLACED NEW 1,250 GALLON PLASTIC SEPTIC TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH MINIMUM 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. Tank Replacement Record Drawings Prepared for James and Kathleen Vik 19002 Whirlaway Road, Eagle River Alaska 99577 EAGLE RIVER VALLEY RANCHETTES LOT 12D OSP211113 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 406-1058 DATE: JB I' 1 8/10/2021 CLT SCALE: 1" = 30' PID: 050-222-28 SHEET 2 OF 3 • LOT 11 C W No • 4.6 92.0 9.0 MARK A W SV1 34'-2" M SV2 36'-5" 18'-2" DCO 37'-7" 21'-0" 0O O w O I— J z z m Q O W OJ 111J � O U No • 4.6 92.0 9.0 MARK A B SV1 34'-2" 13'-5" SV2 36'-5" 18'-2" DCO 37'-7" 21'-0" Tank Replacement Record Drawings Prepared for 44 0 James and Kathleen Vik .•�P�E OF 440 19002 Whirlaway Road, Eagle River Alaska 99577 `?� ''•: �� TH �. EAGLE RIVER VALLEY RANCHETTES LOT 12D� OSP211113 �' EKLUTNA ENGINEERING, LLC DATE: 8/10/2021 "" "'..................... �� ; C TIS TOWNSEND � i 04 19162 MOUNTAIN ROAD �♦;; No. C/o 199•: DRAWN: CLT � s ••' �jE.. � CHUGIAK, ALASKA 99567 SCALE: 1" = 5' �Y •• ( f.. �� (907) 406-1058 PID: 050-222-28 SHEET 3 OF 3 0 WHIRLA WA Y h V M •MH � N � 403 OF c . 49 TH N SHANE A. HOLT w�a OP, LS -6914 n Pa .. e FAROMMI-MIN910fII] DECK S11vGLEF4M/L y 11 0 0SE um 0 N DECK CONCRETE STAIRS 10' UTILITY EASEMENT I��E.Y�xlfb7(�I�Ki><�TiI�] THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES ANDIOR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANYENTITY NOT ON THE RECORD PLAT ARE NOT SHOWN HEREON, UNLESS NOTED. NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANYPAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW ANDIOR ICE. ROAD AS -BUILT SURVEY I" =20, NO CORNERS SET THIS DATE /HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY L0T12D, EA GL E RI VER RA NCHE TTES SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKATHIS — DAYOF AUGUST 2021 HOLT LAND SETRVEYINi 9309 GROVER DRIVE ANCHORAGE,AK 9950 MUNICIPALITY OF ANCHORAGE a%cnc On -Site Water & Wastewater Program 10 '::So PO Box 196650 4700 Elmore Road a Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:llwww.munLorglonsite Q' De parement On -Site Wastewater Disposal System Permit Permit Number: OSP211113 Effective Date: 5/3/2021 Work Type: SepticTank Upgrade Expiration slate: 5/3/2022 Tax Code Number: 05022228000 Site Legal Address: EAGLE RIVER VALLEY RANCHETTES LT 12D G:0054 Site Mailing Address: 19002 WHIRLAWAY RD, Eagle River Owner: VIK JAMES I & KATHLEEN L Lot Size in Sq Ft: 17955 Design Engineer: EKLUTNA ENGINEERING, LLC* Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 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 (2417). 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: Water service line location shall be confirmed prior to construction to verify minimum 10 ft bV separation between water service line and septic system. Received By: / Date: Issued By: A1trGd L� Date: a'l / MUNICIPALITY OF ANCHORAGE Development Services Department F. r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-222-28 Property owners) JAMES & KATHLEEN VIK Mailing address 19002 Whirlaway Road Site address 19002 Whirlaway Road Eagle River AK 99577 Eagle River Day phone AK 99577 Legal description (Sub'd., Block & Lot) EAGLE RIVER VALLEY RANCHETTES Legal description (Township, Range & Section) Lot Size 17,955 Sq. Ft. Number of Bedrooms 3 LT 12D APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo AD U) Septic Tank 0 Upgrade (D) ❑ Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above informs bn is correct. I further certify that this is in accordance with applicable Municipal Codes. / , j Z/ZP Z( (Signature of property owner or authorized agent) Permit/Rush Fees: j �$zz S Waiver Fees: Date of Payment: �i -2- _2( Date of Payment: Receipt Number: U701q D Receipt Number: Permit No. (iSP2-1 ] lI 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211113, Rebecca Carroll, 05/03/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211113, Rebecca Carroll, 05/03/21 AM11rAr wlV rE'ea� i f .•--�• ® n1 �nt /p d ^)ra�resi Hind o '� k a ffir 3 • • � oz.s 3 v Q OF At. 49i ='k 1 ••e..•.•oe.e•.eeese.eo•os.e. �� /lid G%Y�.•%IY ��+��ff S /t�f'• -' f 111 301 • .1••ee•e••o•eae•e vee Ne=e.•�� 9 �i��/•��:•t/. /33.OQ Shone A. Holt • Q � w � ri ••, is 6914 �t9Fo p+..•,•�••,..�a 4 AS -BUILT •St]RVEY NO CORNERS SET THIS DATE Y hereby certify that i have performed a Nortgagea'h inspection of the following described property I Itlf-0fNAT10�1 HEnEON IS FOR THE USE OF LENDING Lot 12D Ea s River Ranchettes Sub, 11101101,15 SPECIFICALLY TO SHOW ANY CONFLICTS 1 WEEN EXISTING STRUCTURES AND FLATTED LOT LINES EASEMEIITS MID 13 NOT 10 BE USED FOR POSITIONIN3 Anchorage Recording Diatrict.Alaska and that the improve- 4TIONAI STRUCTURES OR FENCELINES. vtents situated thereon are within the property linea ancf do not overlap or encroach on the property lying adjacaut theretoethat no improvements on property lying adjacent thereto encroach on the premises in question and that the. ;EHENTS OF RECORD.OTHEA THAN THOSE are no roadwaye a transmission lineseor other visible ease- •NN ON THE RECORDED PLAT, ARE NOT menta on said property except as indicated hereon. Dated NN HERR-Oli at Anchorage, Alaska this 6th qday of Juns 1991 f 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 NO. OF BEDROOMS . DISTANCE TO* ~ ~H RLIC O C D~llin7 ~ [~ No'°f lines / "englh ~,in~ Total le~* ~i~, Trench J~ Length Width ~pth P~RMIT ~ Buil~ng'l~n~tion Nearest lot line DISTANCE TO: Well ~ DISTANCE TO: Building foundation S~er line Septic tenk Absorption erea(s). OTHER PIPE MATERIALS REMARKS E ' APPHOVE~., ~ lg0X , DATE LEGAL 72~113 (Rev. 3178) MUN I C I PAL I T'Y OF ANCHORAGE DEPARTMENT OF HEALTH,AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 ON--SITE SEWER PERMIT~ PERMIT NO: DATE ISSUED: .840878 10/15/84 APPLICANT: ADDRESS: CONTACT PHONE: BILL BETHEL % S&S ENGINERRING EAGLE RIVER, AK 99577 694-2979 LEGAL DESCRIP: SUBDIVISION: E.R. VALLEYRANCHETTE LOT: 12D BLOCK: SECTION: 7 TOWNSHIP: 14N RANGE: 1W LOT SIZE: 17955 (SQ.FT. OR ACRES) MAX.BEDROOMS:· Listed below are the options available to you in designing your septic system. Choose the option that best~fits your site. NA TRENCH BED W~ DRAIN DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 8.0 0.5 5.5 TOTAL DEPTH (FT.) 12.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 24.0 5.0 GRAVEL LENGTH (FT.) 51.0 45.0 87.0** GRAVEL VOLUME~ (CU.YDS.) 40.2 40.0 64.5 TANK SIZE (GALS) 1~000.0 ** 1,000.0 ** 1~000.0 ** SOIL RATING (SQ.FT./BR) 268 259 268 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT L.EAST TWO COMPARTMENTS I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set' forth by the Municipality of Anchorage (MOA) ~and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design c~iteria of this permit. 5. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 5 bedrooms and any enlargement will ~equire an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICA~.RMIT AND INSPECTION MUST'BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROV~I~WI~M~OUT AN ELECTRICAL INSPECTION REPORT; AND <5) THE ELECTRICAL WORK ~ST B~ DONE BY A LICENSED ELECTRICIAN.· SIGNED ~~ ~_ ..... ..... DATE: ~_ ~~ APPLICANT: ISSUED BY ~_~_~~___.__..:_~__ ~DATE: ~,~~~ /V unicip nty o¥ Anchorage P O Uf~',~ 6-650 ANCHORAGE. ALASKA 99502-0650 (907) 264-411 ! TONY~NOWZ£$ MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840841 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 12D Eagle River Valley R Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sipcerely, Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 ERMIT NO: ~DATE ISSUED: iAPPLICANT: iADDRESS: ~ ~CONTACT PHONE: I"IUN I C I PAL I.TY OF- ANCHORAGE .~' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE~ AK 99501 2~4-47P__0 ON--SITE SEWER PERMIT 840841 lO/O /G4 RONALD E. FIELDER 125 EAST FIREWEED, SUITE ANCHORAGE, AK 99505 277-5702 I02 LEGAL DESCRIP: LOT SIZE: 'MAX BEDROOMS: SUBDIVISION: EAGLE RIVER VALLEY R LOT: SECTION: 7 TOWNSHIP: 14N RANGE: 1W 15400 (SQ.FT. OR ACRES) 5 BLOCK: Listed below are'the options available to you in designing your septic syste~. Choose the option that best fits your site. TRENCH BED. W- DRAIN DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 4.0 GRAVEL DEPTH (FT.) 8.0 0.5 5.5 TOTAL DEPTH (FT.) 12.0 4.5 7.5 GRAVEL WIDTH (FT.) 2.5 24.0 5.0 GRAVEL LENGTH (FT.) 51.0 45.0 87.0 ** :GRAVEL VOLUME (CU. YDS. ) 40.2 40.0 64.5 'TANK SIZE (GALS) 1,000.0 ** 1,000.0 ** 1,000.0 SOIL RATING (SO.FT./BR) 268 259 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE 'RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS 'I certify that: 1. I am familiar with the requirements ~or on-site sewers and w~lls as set forth by the Municipality of Anchorage (MOA) and the State o~ Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 5.ii will adhere t~ all MOA and State of Alaska requirements ~or the set back distances from any existing well, was~ewater disposal system or public sewerage system on thi~ or any adjacent or nearby lot. 4. I understand that this permit is valid ~or a maximum of 5 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALEED IN AN AREA COVERED BY MOA BUILDING CODES, ?HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED~ITHOUT AN ELECTRICAL INSPECTION REPORT; AND (5) THE !ELECTRICAL WORK M~T_~R~E DONE BY ~ LICENSED ELECTRICIAN. · ........... APPLICANT:~ RONA'~~DER · / / -- ISSUED ~~~ ...... DATE: _~~/~¢ SOILS LOG PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION LEGAL DESCRIPTION: o r~'~ ~ ~ sLo. E 1 PERCOLATION TEST 825 L, Street, Anchorage, Alask~ 99501 264-4720 SOILS LOG - PERCOLATION TEST t~L=7'14~4- OATE PERFO.MED: [~ ,.<"/ L TiY 4- ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ~ " ~ ~0 ', Cy~ ~," PERCOLATION RATE TEST RUN BETWEEN t~ FT AND 7 CERTIFIED ~~-----~/' COMMENTS 6- 7 8 9 10 11 12 13. 14 15 16 17 18 19 20 No. 1457.E MUNICIPALITY OF ANCHORAGE Development Services Department r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-222-28 1. GENERAL INFORMATION Expiration Date: _f ,avtA d 5, aW 3 Complete legal description EAGLE RIVER VALLEY RANCHETTES LT 12D Location (site address) 19002 Whirlaway Road Eagle River AK 99577 Current property owner(s) VIK JAMES & KATHLEEN Day phone Mailing address 19002 Whirlaway Road Eagle River Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) AK 99577 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well [_] Private Septic Fx_1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System [ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ SSD Date of Payment $ y 2 Receipt Number 0 (01 3� COSA# 05C 2 t Jy _� Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Phone 907.406.1058 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date .. 6. DSD SIGNATURE.°"""'"" Geese ,� V System #1 Approved for 3 bedrooms : '�t'T Date `< - _Z0 No. CE 11904 System #2 Approved for bedrooms ��OFESSIO?a AV Disapproved ��-isoO� Conditional approval for bedrooms, with the following stipulations: A"e o>1 Iy 4ou 1.2 I. Ind ike ,t<<<<cccctttt��r �' V e \I W1 a �esi ; ; ON-SITE W TER LkV\ noWv% �o rnuCk Of i-t\e "Lk Sed:z r-1 IAIASV�IJVATER z^ PROGRAM By: Original Certificate Date: F 1 d- 02 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: EAGLE RIVER VALLEY RANCHETTES LT 12D If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground in. Date of flow test f SA Static r level at beginning of test ft. omments public water system B. TANK DATA Age of tank(s) 'c1 years Tank type/material septic plastic Measured operating fluid level in septic tank new ❑■ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA Parcel ID: 050-222-28 Structure served by this system Well production at time of test gpm Water storage tank v e gallons Well disinf for coliform test? E] Yes ❑ N oliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance com Age of lift station veart Lift stationmaterial Comment Which system tested (date installed) 1984 Adequacy test date 3/25/2021 ❑■ ALL standpipes present per record drawing Results [DPass For 3 bedrooms Total measured depth from grade 9 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4.6 ft (min) Water added 721 gal ❑ N/A — pressurized field 0 New depth in ❑ Monitor tubes go to bottom of effective. If not, state f 0 Elapsed time min depth into effective 1.2' 70Code-requiredsoil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate ' 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: water never presented itself in the monitor tube throughout the test. COSA Checklist yellow sheet E. SEPARATION DISTANCES ivate Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station o > 100' e Sewer/Septic Line > 25' F,-'� Yes if No ft o ' Tank > 100' [✓ Yes if No ft if No ft Neighboring Tank > 100' F Yes if No I ft Absorption Field on Lot > 100' Fv� Yes if No ft Neighboring Absorption Fie 0' ft Private Wells > 100' P( Yes if No ft Q✓ Yes if No ft Co nity Sewer Main > 75' Yes if No ft Community Sewer Manho eanout > 100' ❑✓ Yes if No ft e Sewer/Septic Line > 25' F,-'� Yes if No ft o ' Tank > 100' [✓ Yes if No ft Animal Containm 50' R✓ Yes if No ft Manure/Animal Excreta Storage > Yes n Yes I ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F✓ Yes if No ft Surface Water > 100' F✓ Yes if No ft Property Line > 5' [✓ Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' P( Yes if No ft Water Main > 10' FV -1 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' F✓ 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' (D Yes if No ft If absorption field is under driveway comment below Property Line > 10' ED Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' El Yes if No ft Community Wells > 200' F Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet .... ; n� �.,..T wns Data ' �- �d�FC�s No CE 119 \V�` FEWONP�� .� ENGINEERS Parcel I.D, # 1, MUNICIPALITY 0FANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ?/ GENERAL INFORMATION Complete legal description Eagle River Valley Ranchettes, Lot 12D T14N R1W Sec.7 Location (site address or directions) 19002 Whirlawoy Road Property owr~er FDIC Mailing address Lending agency Mailing address Agent N/A Address 1966392 Anchorage. AK Day phohe 261-7400 99519 Day phone Daypho~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: -.~ TYPE OF WATER SUPPLY: NOTE: Individual well Community well X Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site X Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater.disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~'.,~gl~, l~ivr, t- 1~n_o~n~,~.,'in_cr ~?~'i~"es Phone 694-~1 q~ Address P.O. Box 773294, Eag].e R~.vm:, AK 99577 Engineer's signature Date DHHS SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: ~ . _ _ Date . The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type If A, B, or C, attach ADEC letter. Parcel I.D. ~ ~-~_~ ADEC water system number Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots g.p.m.; .~ Absorption field on lot ;On adjacentlots Public sewer main Public sewer manhole/cleanout Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date Installed ~) ~"~P,/(~ Tank siZe Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y <'--- Compartments Depression (Y/N) High water alarm (Y/N) /X/ Date of pumping (~ ?/9! · Alarm tested (Y/N) " /'//~ Foundation /O ~ Water main/service line SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To propertyline Surface water/drainage On adjacent lots Absorption field ~,.o~ (R..:~,~) ~on~ ~o^~'~ CONTINUED ON BACK PAGE C. LIFT-STA~ Date installed Size In gallons v(~nt (y/N)" ' Manufacturer ' ~ Manhole/Access (Y/N), , "pump on" level at ~ "Pump off" level at High water alarm level Meets'MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed ~)~7" ~ ' 5z' jo" Le. ngth Width :~;r0tal a, bsorPtion area ~3~.. f~ Z ,LDepression Over field (Y/N) '~:l~esults (paC'/fail) P4 ss Peroxide Ireatment {past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ,/',//~ ' On adjacent lots ~/' 2?' To building foundation On adjacent lots '/' ,.-~ · Surface water /~//,4 Curtain drain /~//,~ Soil rating 2/0~' Gravel thickness Total depth System type F' Cleanouts present (Y/N) Date of adequacy test for -~ -- If yes, give date Propertyline /~) / To existing or abandoned system on lot '/' I[.)' bedrooms Cutbank /,//.,4 'Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on_tZze,.date of this inspeciion. Engineer's Name Date ~/'~//'// NAA Fee $ //",',~/'~, Date of Payment '~-~" ~'~/ Receipt Number Waiver Fee: $ Date of Payment Receipt Number 72-029 (Re~. 3~91) eack MOA 21 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 July 2, 1991 WALTER J. H/CKEL, GOVERNOR 563-6775 FOR: Eagle River Engineering Services PWSID 21O875 My review of the records on file In this office reveals that the Nod'ok Ulities: Eagle River Ranchette Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.060, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer r"" .UN~C~PAUT~ OF ANCHORAGE DEPA.T.E.T OF.EALT. A.~ E..V, RO.ME.TAL DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR H~LTH AUTHORITY APPROVAL o~ o.-s,~ s~w~. ~.~ w~. ~c,u~ 264~720 Application Date GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, r~nge) Location (address or directions) Applicant Name ~ ~~~q~elephone: Home Applicant is (check one): Lending Institution g; Owner/builder ~; Buyer ~: Other ~ (explain); Business ~'~! ~ "~, ,~ (d) Lending Institution l..[IJl'1~_~;~ Address 4'/~O (e) Real Estate Company and Agent - Address Telephone ~-7~z-/~;// Telephone · (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Family I~Multi-Family I-] Other Number of Bedrooms -'~ 3.WATER SUPPLY ~ndiv!dua~ we, n Communityl~ PUUicD Note: If community well system, must have written Confirmation from the State Department of Environmental Conservation ' .attesting to the legality and status. Onsite ~ Public I-I Community I-I Holding Tank I-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 ENGINEERING FIRM PROVIDI~INSPECTIONS, TESTS, FILE SEARCH, ['~'~ 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 ~uthority 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. _ l Nameof Firm ~f"t,x.~;r~ ~ ~~ ~ Telephone -~[-~[~] Engineer's Seal DHEP APPROVAL Approved for ~. ('~%edrooms by,~ Approved ' Disapproved Terms of Conditional Apl~roval 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 t~' OF ^NCHO~'UkGt: MUNICIPALITY OF ANCHORAGE (MOA) ^. WELL DAT~c~C''*~'~j ~0 Well Classification C o I'Y~ I.~u~,L~ 2~1--4720 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line CleanoutJManhole Water Sample Collected by Water Sample Test Results Comments J Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression A~N) __ ~k"dj~ ning Lots .,"~o Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed C~ /0/"3"//8~/~ SizeI~'o '~ .o. ot Compartments Standpipes (Y/N) ~.~-~ Air-tight Caps (Y/N) L/.~ ~ Foundation Cleanout {Y/N) Depression over Tank (Y/N) /~ O Date Last Pumped Pumping/Maintenance Contract on File (Y/N) /~. i0, * ; for Holding Tank High-Water Alarm (Y/N) ~J, I~. Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~ILC~(~~ To Property Line To Water Main/Service Line Course Comments ~ r~'Or~ ~ ~ ~-~ To Building Foundation ~ I To Disposal Field /0" To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test ~.~O. ~///~:~.~V Type of System Design Length of Field Depth of Field Gravel ~ Thickne~ Standpi~ Pre~nt (Y/N) Date of ~st Ad~uacy Test Separation Distance from Absorption Field: To Water-Supply Well 1-o~00 t To Building Foundation Lot TO Water Main/Service Line ~.~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments U To Property Line I0r To Existing or Abandoned System on ; On Adjoining Lots ~' ~ To Cutbank (if present) /'J I~ * D. LIFT STATION Date Installed f Size in Gal, lensL "Pump On' Level'al....._ High Water Alarm Leveler'--. Tested for Electrical Codes (Y/N) Dimensions Pumping Cycles during Adequacy Test. Meets MOA ** Check P/~itted Be~m Rating Against HAA Request ** I certify t h atarlT'ave che~tifd, verified, or conformed to ail MOA a)q d HAA guidelines in effect on the date of this inspection. . Date of Payment Amount: $ Page 2 of 2 Engineer's Seal United Bank Alaska COMMERCIAL BANKING CENTER June 1, 1987 Health Department Municipality of Anchorage 437 E Street Anchorage, Alaska 99501 Re: Lot 12D Eagle River Valley Ranchettes Dear Sir or Madam: The above referenced property is owned by United Bank Alaska. This house has been under construction since 1984 and has never been occupied. The water was turned on for the first time May 19, 1987, by Norfolk Utilities. Alpine Construction has recently been awarded the contract for final completion of this project. If you have any questions concerning this project, please do not hesitate to contact me. Sincerely, Property Manager Special Credits Department MCL/aa 440 EAST 36th AVENUE ,, ANCHORAGE, ALASKA 99503 · (907) 276.1911 DEPT. OF ENVIRON MENTAL CONSERVATION T,~,~o.o: ~9o7~ Address: ANCHORAGE/WESTERN DISTRICT OFFICE---_ · 437 "E" STREET, SUITE 303 ~"O~N~ P~O~(:~ON 274-2533 ANCHORAGE, ALASKA qgso1 UUN 8 RECEIVED DATE: Hay 28, 1987 PWS I J).# 210875 To Whom it May Concern: According to records on file in this office the R~NOPEI~ES Water Regulations EAGLE RIVER VAI,LI~F Water System is in compllance with the State Drinking £or monthly bacteriological s~J~pling. Sincerely, ~ Michael P. Lewis Environmental Engineer