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IRVINE LT 2
Onsite File Irvine Lot 2 #015 - 472 - 24 Municipality of Anchorage On-Site Water and Wastewater Program • (907)343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181364 PID Number: 015-472-24 Multipleand/or Dwelling: Q Single Family (SF) El Duplex (D) ❑ (SF D) Project: ❑ New 4 Upgrade Name: ABSORPTION FIELD Rebecca Boys Address [' Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 11161 Snowline Drive, Anchorage, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 748-4748 14 1.0 GPD/SF 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.0 Ft.6.0 Ft. Irvine 2 Fill added above original grade Gravel length Township Range Section 0 Ft. 50' Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 3.0 Ft. Ft. HoldingToSewer Total absorption area Number of trenches Dist.between trenches Septic Absorption Lift Station z Ft. From Tank Field Tank Line 600 Ft 1 >100' N/A N/A >25' TANK 0 Septic IDS.T.E.P. 0 Holding 0 Other Well >100' Manufacturer Capacity N/A N/A Greer Tank 1250 Gal. Surface Water >100' >100' Material Number of compartments Lot Line >10' 3' N/A N/ANA Steel 2 N/A N/A LIFT STATION Capacity Foundation >10' >1Q' Manufacturer y Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks *Tied into and rebuilt trench from 1975. 10' added to west end to total 50' of trench. in. in. **Tank and west end of trench are insulated. Pump make and model Electrical Inspections performed by Tank to D3034 PIPE MATERIAL House to tank drainfield D3034 Installer Wilco Contractors Drainfield D3034 CO/MT D3034 Inspector J. Millette/ J. Williams BENCH MARK (Assumed elevation) 100 ft Inspection 1st 10/19/18 2rd 10/19/18 Location and description dates: 3'° 10/22/18 4« Bottom of siding on SW wall of garage Engineer's Stamp COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ��``\‘‘‘ Date �•�• •\et_t Conditional Approval: /••P- •, • N -. •'f9+t j*:'49TM i� •*rl4 rd ' y . Benjachiller •:� j 0 i •• CE 12592 • `�/ 1 GAJ'.. 10/24/18.,••..0"= Date(d-2'� .. U it\444,8,; gOFESSIO. ,<� Approved \\tx"`��- Inspection Report_9-1-12.doc IRVINE, LOT 2 PERMIT # OSP181364 PID # 015-472-24 .S=11 I I I - - - LOT!_ — LOT 1 TIFFANY TLCE 1 NLOT 2 LOT 2 I \ w tit \ \ .\ _ .\ f'�rt�iiA;'S }� 4 BEDROOM ROME /_ \ ' �•\ �/� w A B _ ��AOI 4*• • ' s FV 47.2 24.1 Z �\`` 0 ©, jj w SV1 34.9 13.1 SV2 44.3 21.3 2C0 45.5 22.5 EXISTING BED °• 2C. /• V SV1 ,CO1 J CO1 23.8 18.0 / T1 _MT1 25.1 16.0 I z — — — , CO2 71.6 50.8 30 ROAD FASFMFNT . MT2 68.4 48.2 1250-GAL SEPTIC TANK W/ DOUBLE CLEANOUTS AND // BULL-RUN VALVE CO22 T2 ._ — — _ __ — _— PAYNE SUB, LOT 1 STONERIDG E LOT 1 ,I• I I 50'LONG x 3'WIDE x 6'EFFECTIVE DEPTH ABSORPTION TRENCH NOTE: LEGEND A94!. 4��L1�i NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE PROPOSED SEPTIC SYSTEM CO-CLEANOUT A feb.• I,''1,v 2C0 DOUBLE CLEANOUT 0-k:491H /N '� *�/ ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN.NO CONFLICTS WITH FCO-FOUNDATION CLEANOUT -.. � ; / WELLS OR SEPTIC SYSTEMS. DV-DIVERTER VALVE Benj �Schiler : j MH-MANHOLE I •CE 2594 f� 0 50 100 � I SLOPES>25% MT MONITORING TUBE GE im m EN mi FEET _SLOPES>46% SV-SEPTIC VENT l�\\ `."�' 1"=50' TH-TEST HOLE IRVINE, LOT 2 PERMIT # OSP181364 PID # 015-472-24 o N 0 UL CO0 0 L - - 99.2 - - - - INSULATION 1 •\- 96.8 96.2 250 GAL 95.0 SEPTIC TANK V .41/4''' 91.8 02 99.8 ORIGINAL AND FINAL GRADE g� �� INSULATION 95.8 --_---_�- _ -- 95.8 DRAINFIELD ROCK ``-- 89.8 89.8 ABANDONED TRENCH REPAIRED AND 10'ADDED 50' i7; GofQ � , 1 ' f*4911i� ` 0#t 0• ••• m Schiller PROFILE AS-BUILT �+'I ..CE• i12582• ` %, •) •GE (NO SCALE) t`�\\\N� ~— PO BOX 240773 Aor ANCHORAGE, AK 99524 allow ' IiIE 577.7773 677.7766 (FAX) ' ENGINEERING FORGECIVIL.COM October 24, 2018 Airrect :4 MOA Development Services, On-Site Water& Wastewater Program 3, ' TM *T 4700 Elmore Rd / r—, Anchorage, AK 99507 ... ... .. ...... Benja 7 hiller fei***. CE 12592 '�/ Subject: Irvine Lot 2—11161 Snowline Drive 1) f4,••..10/24/18 � � Re-activation of abandoned trench kk ��\`ESS •O" Dear On-Site Engineer: During our investigation of this property for the purpose of replacing the failed septic bed, we discovered the previously abandoned trench. The records indicated it had been failing, but after decades it has recovered. We submitted a permit for the tank replacement and expressed our intention of re-activating this trench. As we were repairing the trench,we found that the trench was shorter by about 12' than expected. It appears that during the construction of the bed, the septic tank was placed in a section of the trench, which was then removed. We proposed and received permission to extend the trench on the far end to match the previously-approved design. We did our best to maintain the 10' separation to the property line,but the location was constrained by topography and several large trees. When we took final measurements, we found that the end of the trench was actually 3' from the property line. This will not impact the neighboring property at all, and the trench is outside the 100' well radius for the property. There is no health or safety threat, so we request a waiver for a 3' separation from the trench to property line. Sincerely, Benjamin Schiller, PE ent 3, Municipality of Anchorage `°,n' P.O. Box 196650 • 4700 Elmore Road Anchorage,e, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 pa_i_m e 9 Department http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181087 COSA#: Permit#: OSP181364 PID#: 015-472-24 Legal Description: Irvine Lot 2 Engineer Forge Applicant: Scott Romine Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. in The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. n Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: t9-7-' Approved by: Name of Reviewer 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: OSP181364 Effective Date: CX,'A1 Work Type: Septics Upgrade Expiration Date Tax Code Number: 01547224000 »r �S, 1)clrirtu�cnt 10/12/2018 10/12/2019 Site Legal Address: Z (��/ E_ LLT 2 - Site Site Mailing Address: 1 1 �no���he �r�V�� C'V1orc�0 Owner: ROMINE SCOTT M & REBECCA A Lot Size in Sq Ft: Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: G" 1 l� Disposal Field Q 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: Prior to reconnection to the 1975 trench, a confirmation test hole will be required to confirm separation to seasonal high groundwater. ID/ 1911? Co it 1 : �rc� +D 5z Received By: V Date: V Issued By: ( Date: E.PLJ4NS Rusal MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-472-24 Property owner(s) Rebecca Bests R.. Gm 1 n C.. Day phone 748-4748 Mailing address 11161 Snowline Drive, Anchorage, AK 99507 Site address 11161 Snowline Drive Legal description (Sub'd., Block & Lot) Irvine, Lot 2 Legal description (Township, Range & Section) Lot Size 49,438 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ® Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade ❑X (w/wo ADU) Holding Tank ❑ Renewal ElDuplex (D) El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. A-11 (Signature of property owner or authorized agent) Permit/Rush Fees: 3 5 Waiver Fees Date of Payment: 10I It I /!S I0 2ZI Ii'Date of Payment: Receipt Number: 03gq&6 OB 53+x* Receipt Number: Permit No. Waiver No. Permit App_.:-:• :�.�c October 11, 2018 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Irvine Lot 2 – 11161 Snowline Drive 10/11/18 Septic tank replacement Dear On-Site Services Engineer: The septic tank on the above lot is nearly 30 years old, and the existing bed has failed. The existing home is a 4-bedroom. We are submitting this permit application for the placement of a new septic tank. The attached site plan identifies the location of the existing home, well and septic system, as well as the location of the new septic tank. In addition, the approximate location of an abandoned absorption trench is shown. The existing tank will be pumped dry and decommissioned per code. The new tank will be placed in approximately the same spot. A double cleanout will be placed after the tank, and then a bull run valve. The new tank will tie into the previously-permitted trench, and all piping will be repaired. The end result of this tank replacement and trench repair will be two approved absorption systems. The existing bed will recover with several years of rest, and then the homeowner can alternate between the two systems as they see fit. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181364, Rebecca Carroll, 10/12/18 F- 0 �- z y�--- w w LU Z F- .. !—UO> _ZZ W a Om> 0 0_ 0 I 01 E o -jow0¢OwW m W U li int- ,. = 600 w C H � o 0 Lo Co N d' +- I l U w w '- W z w W a CL .... � U w E- w 00 z YQ Z ?>- O ) U Cn - F- h ; W U� ti QUz t=p w � Oz Z W w; X Q} 00 to Z Q U Q W U W m>� w O �w> ����Zc~a0 O E- ` Lc) M o w � W o �_�Fr�<,t-wt9www O � w Q 4, �� �;0ZwF-Wo Of LU < o w CD-- < w Zsm` On~- w ry m f te, cn o F- rr w �sNrma>w O 0 CL U p Z Q �LLJ Z W cn O d 6 .t LL > I-- F- W �� Z C%jt— Xww�W�Z f— Lij °; � wn0-1 JU,[[p_O > ZLo Z moolo 15 LL - ....Ya 4q W = o U - LL Z O J Q W O CJ � CD C) Z U) Lo r) 75; U)oa -Ind Z Z W = U)F- CE >-- Z C4 Q Z r :DU > m Ln co N Z � XZ n O w 2i W t Cl)U U) W X O W O X T z W J s ___I OI O Q w , t - z. z _ jKU� x�1--3N���a. .._... - 3.„ CSS « W , �8't9 l M„51,bO.00s — — — — — — — I I I a) o MO' _ CD c 40.9 O ro ,12'V91 ]„g �,tO.00N 0 73.5 0W u I I I I I I I I I I I I I I I GAIJ(] @UiIMOUS d�P� �L: 2 N L;7 Ln 00 cn o®o::. C N E Y C °1 y r- N d L u E 0 L _ O Q) J N O Qi O 7 O q J Q CL (Y -A tl 0 3 U LL zo N OC a 6� vi Q7oa C9 0 i V N N0.0ED O N \ CL N CN :� c N O : � O C to may M �6- m L L ° C Y LV C O —.2 N -- -° 07 + U � O C - N CLO 0-0 NO L Ln ate+ a N W a� ` -0'JNC” N O c4 C m :': N •ta �::::i:i:i: is i:5��[:ii[: i:i: i:i 00 N U NJ O ro ,12'V91 ]„g �,tO.00N 0 73.5 0W u I I I I I I I I I I I I I I I GAIJ(] @UiIMOUS d�P� �L: 2 N L;7 Ln 00 cn o®o::. C N E Y C °1 y r- N d L u E 0 L _ O Q) J N O Qi O 7 O q J Q CL (Y -A tl 0 3 U LL zo N OC W E vi Q7oa o 0 i V N N0.0ED O N \ CL N CN a \ ao � O O � O C to may M m L L ° C Y 4 C O —.2 N -- -° 07 + U � O C - N CLO 0-0 NO L Ln ate+ a N W a� ` -0'JNC” N O c4 C m rn N U L o d_ V, y y yNi .Q O ow CL 3 p N 0 CO = O- 0 t L, O LL O> W L 3C 7L, v` ISD v O E � r7 U ° y 0Nom O rn y(DN �aui0 L O Z C O C L O oq LO Ln cn fn � J d Y a M E C a ao � �+ m � may M m Lu .� � 0�0 Y 4 C4 CO cu C Q E V 0 U � oq Attachments: Irvine L2 -Septic Plan.pdf; 18-067 L2 Asbuilt 18.10.08.pdf Follow Up Flag: Follow up Flag Status: Flagged in concept, ROW has no objection to the location this time because the field is not yet encroaching. when the as -built is available with the application, Lynn McGee Senior Plan Reviewer Right of Way Section lynn.mcgee@anchorageak.gov 343-8226 343-8250 (fax) We cannot issue a ROW Encroachment Permit at A ROW Use Permit is required to install it and we can issue an Encroachment Permit for the field. From: Ben Schiller [mailto:ben@forgecivii.com] Sent: Thursday, October 11, 2018 3:33 PIVI To: Right of Way Requests <MOAROWRequests@muni.org> Subject: Fwd: Irvine L2 Good afternoon MOA ROW We are proposing (design ng re -connecting to an existing septic trench on the property and survey ASB attached). I rz, The trench runs partly through at "road easment". Could we get a letter/email of Non -objection from ROW for this encroachment? Is there an application that we need to fill out? Thank you, Ben Schiller, PE Forge Engineering 310-9090 --7----_-- Forwarded message --------- From: Carroll, Rebecca M. <rebeeca.carrollganchorage ik.,�ov> Date: Thu, Oct 11, 2018 at 1:14 PM Subject: Irvine L2 To: Ben Schiller (Ben(_-ct) .,forgeeivil.com) <Ben@forgecivil.com> Development Services Department Building Safety Division On -Site Water & Wastewater Program 4" 4700 Elmore Roade s P.O. Box 196650 Markaegich Anchorage, AK 99507 $ ° ` `T' Mayor www.munt.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: C71 V4 72211 Legal Description Property Owner Name & Address: s4edT ' Kfktn%.n 11141 5401"i"f Dit. L o'(- Z or"Cua,*44C 1 1 to. Pump Installation Date: Pump Intake Depth Below Top of Well Casing: 78 feet Pump Manufacturer's Name: A Y )"C000lot3l Pump Model: 9L_'J0'f0✓31J5 Pump Size %/,':?-hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? S/Yes ❑ No Method of Disinfection: Cg6letnjC PkEL(E3 Comments: Pump Installer Name: &W 10J Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name C DISTANCES Tp FROM SEPTIC TANK ABSORPTION FIELD WELL Address 4%3 6 tuf1- 6LU9-SA mI4jJ.G Phone(s) Permit No. No. of Bedrooms hi3�SS©D g / WELL `'V �.. lQ(' f LOT LINE PTION LEGAL DESCRIPTION Lot Block Subdivi V /�� �/ FOUNDATION Township. Range, Section w� 12A) 3 w e Z AS -BUILT DIAGRAM drive ay, water bodies, (Show location of well, etc.) septic system. property lines, foundation, TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons nj[ , Material^ No. of Compartments no EzzL. TYPE OF SYSTEM il� ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER jr 27 Depth to pipe bottom from / Total depth from original gradePh 7 Z original grade FT S FT �y f J V Fill added above original gracle Gravel depth beneath pipe �• S FT Gi S FT Gravel length //// Gravel width `�" 2 FT leFT Total absorption area Distance between lines 0 7 sFJ SO FT FT v Number of lines Soil rating Pipe material 6 I26- SO FT Dao 11C-11 Poo Cf, ILI Date Install L5 l lJ �G WELLS PRIVATE ❑ OTHER Ocientiiv classific - ,C) Total Depth Cased to FT FT Installer Iled: REMARKS: L� d.0 '(8oFLtbss 3,- Scale: JiID ! 1 -LED. 040 inspections erformd by: �% Date: / ! f.� ti, i '"` q `- °-•° +ftvER, O �® �� 46 CI. i @c -' O'x^. �• R"r�s'�tk .• S ENGINEERING 17034 Eagle River Loop Road No. Zit ce 'ly that Is inspection was pedgrmed according to all Eagle River, Alaska 99577rias Municipal and State guidelines in effect nn this date Health Department Approval� Ua 4'�R o s tact s` ,,. :: -... A, 2 72-013 (3/85) Mai f lei ROBERT A. SHAFER A CIVIL ENGINEER May 30, 1989 694-2979 Fq �p CSF FIV ER. AV PS HEALTH AUTHORITY APPROVALS Mn. Robert W. Robinson Muwicipatity o6 Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street SEWER &WATER P.U. Box 1966p50 MAIN EXTENSIONS Anchorage, Alaska 99519-6650 REFERENCE: Lot 2; Inv.ine Subdivision; As -built dnaw.ing SEWER &WATER Dean Mr. Robinson, INSPECTION Thi.6 2etter..is .in reply to your 2etten dated May 24, 1989 and serves as an explanation bo,% the modi6.ication and design o6 the septic system .insta22ed on the re6e7eneed property. As I .indicated to you .in aur ENGINEERING STUDIES tete hone conversation, tion to atlowin the excavator to begin wokk p p g g AND REPORTS at the site, I again checked the monitoring tube .in the test ho2e prev.iousty used to estabtish .the dezign parameters. When checking the monitoring tube I Uound a water 2ev./e2 at 8k 4eet. Based upon this I WELL INSPECTION determined that it was necessary to modi6y the system 6rom a deep &FLOWTEST trench to a seepage bed with a maximum excavated depth o6 42 beet. A6ter the bed was constructed I requested the mow%to&ing tube and old test ho2e be excavated and bound the test ho2e actua22y contained snow SITE PLANS and .ice. There was no evidence og a water table elsewhere in the area o6 the test hole. I concluded 6rom this that the water level which I had prev.iousty obtained 6rom the moni toning tube was, .in 6aet, a 6a2se reading and was cheated by the melting o{y snow and .ice .immed.iatety around the monitoring tube. Fon this reason, 6urther monitoring 6or a ROAD DESIGN watelt table in this area was determined not to be necessary. As 6or your coneer.n 6or the existing trench - you w.itt note that on ou,% as -built under remarks we had ptaeed a statement stating the old 4iber SOIL TEST glass septic tank was crushed and g-iUed and the old trench had been abandoned. As to your concern 6or a cleanout .immediately downstream 6rom the PERCOLATION septic tank - this cleanout has been estab2-ushed and .indicated on the TEST otigina2 as -built. Thank you 6or yours review and i6 you require additional .in6ormation, please eo STRUCTURAL& MECHANICAL INSPECTIONS Sir )Lely, ON SITE RUBE A. SHAFER, P.E. WASTE WATER ( /,6h DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Municipality of Anchorage Department of Health and Human Services h5 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 24, 1989 S & S Engineering 17034 Eagle River Loop Road Eagle River, Alaska 99577 Subject: Lot 2 Irvine Subdivision - As -built Drawing Dear Mr. Shafer: As you and I discussed yesterday, the as -built drawing of the recent upgrade of the subsurface disposal system on Lot 2 Irvine Subdivision is completely different than the design you submitted with the permit application. Your explanations given during our telephone converstaion are certainly valid and acceptable, however, there are several things you still must do before we can approve the as -built you submitted. These are as follows: 1. Submit a letter of explanation (which will be attached to the as -built) outlining the reasons for the change. V2. If the existing trench is still a part of the subsurface � disposal system, this needs to be so indicated on the as -built. 3. The as -built does not show a cleanout immediately downstream of the new septic tank. If this was an oversight in preparing the as -built, it needs to be shown. If a cleanout was not installed at the downstream side of the septic tank, one must be installed immediately. In view of the urgency indicated Health Authority, I will handle must also respond to the herein possible. Sincerely, Robert W. Robinson Civil Engineer On-site Services RWR/ljw in processing the related it immediately, however, you contained requests as soon as MUNICIPALITY OF ANCHORAGE `` Department o{ Health & Human Services 825 L Street, Anchorage� Alaska 99501 343-4720 ON~SITE GEWER PERMIT Permit Number: 890059U p q d FS f*'~~-~ � Date Issued: 04/25/89 Engineer Designed Owner Name: FHMC Owner Address: 15303 VENTURA BLVD. GUITE 500 SHERMAN OAKS, CA 91403 Parcel Id: 015�472~24 Lot LegaI: Subdivision: Section: 24 Lot Size 49438 (sq,ft" Max Bedrooms: This Permit: IRVINE Lot: 2 Block: NA Township: 12N Range: 3W or acres> 4 Total Capacity: 4 Day Phone: 563'5500 SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons, Each septic tank must have at 2 compartments" Qepth to top of septic tank(s) < 4"0 [eet requires insulation over tank(s). PERMIT EXPIRES DECEMBER 1989" CALL 343-4781 OR TO REPORT INSPECTION TIMES, ��ENGINEER MUST PRIOR ��. ` TO ITS CONTINUED USE. REPLACEMENl MAY F!E )EU, I CERTIFY THAT: 1, I am f'amiliar with the requirements Air 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 criter1a oE this permit. 3. I will adhere to all MOA and State of Alaska reguirements {or the set back distances f'rom any existing well, wastewater disposal system or public sewerage syste� on this or any adjacent or nearby lot" 4. I understand that this permit is valid for a maximum of 4 bedrooms" I also understand that the capacity o{ the total system is 4 bedrooms and any enlargement will require an additional permit. Si2-^5~ -7�~_������ ~�~~-_ ~.~~���_-_~�___ (Owner) FHMC , » ���^ ^ lssued By: DATE: � / ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: C��i �GLo./ - �Gr�tL w{'� ` ty DATE PERFOR LEGAL DESCRIPTION: L--6;11 2— �X-51 C 2 r 0 A 3 P, �f, 4- 5 5 r p 6 �rQ 7 l Cl( 8 -L C - 9 10 6 1 Ls 11 � F� 12 O n 13 �9 14 15 T 17- 18- 19- 20- SITE 718 1920 COMMENTS Township, Range, WAS GROUND WAT ENCOUNTERED? SLOPE S IF YES, AT WHAT L O DEPTH? P E Depthto Water A Monitring? lex Monito�i�L�1 Date: Reading Date Time SITE Net Depth to Net Time I Water I Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN.. FT AND FT S & S ENGINEERING PERFORMED BY: 17034 �vgiepD�7a..er�LOOP Road Nn ACCORDANCE wifR%LeLRrffE`AND�fvt 9Ni571P7A L GUID 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: _t/ _•_ 31VOS 600 TELEPHONE AVENUE, ANCHORAGE, ALASKA 99503-6091 it TELEPHONE (907) 561-3000 Tom Fink, Telex 090-26-532 Mayor Facsimile (907) 561-1703 Mr. George McCoy Jack White Company 3201 "C" Street Suite 100 Anchorage,Alaska 99503 Owned by the Municipality of Anchorage The Anchorage Telephone Utility (ATU) has no objection to the encroachment into a platted easement located on the east property line of Lot 2, Irvine Subdivision with a private well as depicted on the as -built drawing attached X not attached Acceptance and use of this letter of non --objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. ATU will be held harmless, now and forever., for any damages or injury to any person or property as a result of this encroachment. 2. Any ATU facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ATU. 3. Any costs incurred by zTU for special construction necessitated by this encroachment will be borne by the property owner. 4. All applicable safety -ode regulations will be observed and maintained. 5. This letter of non -objection will in uo way preclude ATU from full use and enjoyment of its rights within any portion of its right--of-way. Sincerely ANCHORAGE TELEPHONE UTILITY Victor P. Slaughter, Supervisor Outside Plant Engineering DATE: x ENSTAR Natural Gas Company A DIVISION OF SEAGULL ENERGY CORPORATION 3000 Spenard Road P.O. Box 190288 Anchorage, Alaska 995190288 (907)277-5551 May 16, 19£39 Mr. George McCoy Jack White Co. 3201 "C" St. Anchorage, AK 99503 Dear Mr. McCoy: ENSTAR Natural Gas Company has no objection to the well that encroaches into the utility easement on Lot 2 Irvine Subdivision. If you have any questions, please call me at 264-3743. DVW/ j kk Very Iruly yours, Dani1 V. Westervelt Ri 911of-bJay Agent 1GU.i-L9ti G-2640 ENCROACHMENT AGREEMENT THIS AGREEMENT, made and entered into this 4th day of May, 1989, by and between CHUGACH ELECTRIC ASSOCIATION, INC., an Alaska non-profit electric cooperative membership corporation of Anchorage, Alaska, hereinafter called "First Party" and Federal Home Loan Mortgage Corporation of Sherman Oaks, California, hereinafter called 'Second Party',,WITNESSETH THAT: WHEREAS, First Party occupies an easement on the East side of Lot Two (2), Irvine Subdivision, Anchorage Recording District, Alaska; and WHEREAS, Second Party has constructed a well which encroaches approximately Two Feet (2') on to the foregoing easement. NOW, THEREFORE, for and in consideration of their mutual agreements and other good and valuable consideration, the receipt of which is hereby acknowledged, First Party, for itself, its successors and assigns; waives its objections to Second Party's encroachment on the said easement for the purpose mentioned, subject to the F:�]_.Iowi_ng conditions: 1. Second -rty will. hold First Party harmless from liability for any in %.-v or damage to any person or property which may result from ',.ch encroachment. 2. The sai oncroachment „ill be without prejudice to First Party's full en °anent of any and all rights it may have in and to such easement. 3. Any fa( i.ities or property of First. Party which are damaged or dextro} df as a result of such encroachment will be repaired or replaced E no cost to First Party. 4. Second Party will comply with all applicable safety codes and regul.tions. 5. Any ex; �nses which First Party may incur in .the,,, relocation or modific-'_ion of its facilities to accommodate the said encroachment will be paid by Second Party. By its exE:ution of this Agreement, Second Party agrees, for itself, its successors, and assigns, that its encroachment upon the named easement as hereinabove mentioned will be subject to the foregoing conditions. IN WITNESS AHEREOF, the parties have caused this Agreement to be execut.d by their duly authorized representatives and agents. -as of the e y and year first above mentioned. CHUGACH ELECTRIC ASSOCIATION, INC. (Firs Party) By: avid L. Hi Wrs LSRW2/37 Federal Home Loan Mortgage Corp. (Secopd Party) By: r, t.. -�� --�_ Ge6r'gh Mc o of Jack Whit Company Vs Representative for Federal Home Loan Mortgage Corporation GRE1,'_ R ANCHORAGE AREA BOk,,_JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMF��/A-AI' J`i-' W'e MAILING ADDRESS/ C x �� /� r� PHONF��& LOCATION Z�"��� ✓C /C� LEGAL DESCRIPTION d� D SEPTIC TANK: DISTANCE �JJ/ I GS 7�� NUMBER OF FROM WELL. MANUFACTURED • MATERIAL�COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYGALLONS. TILE DRAIN FIELD: j TOTAL LENGTH Yf DISTANCE FROM WELL -FOUNDATION .3'1' NEAREST LOT LINE OF LINES zSd0--' NUMBER OF LINES_ -_— DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA �'� SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE &/7 IN WELL TYPE CONSTRUCTION BUILDING NEAREST NEAREST SEPTIC FOUNDATION LOT LINE , SEWER LINE , TANK_ CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: �" 1"�'� LOT SLOPE: REMARKS: Form EQ -032 REMARKS 0ABOVE TILE 1!61 IN. DEPTH DISTANCE FROM: SEEPAGE SYSTEM_ DIAGRAM OF SYSTEM /C � i l oF Al, i .9- DATE� APPROVED 'ARTMENT OF ENVIRONMENTAL QUAL' 3`J "C" STREET ANCHORAGE, ALASKA 9�__A3 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT wI PERMIT NO. MAILING ADDRESS 67'f k/ b �- PHONE �7%_e a l INSTALLATION LOCATION LEGAL DEC;CRIPTION 1 � LJT P INSTALLn'f10N O.°: SEPTIC TANK ---- ~�GPAGE PIT_ . DRAIN FIELD -_._ r":--' OTHER �j /" #c r TYPE AND SIZE OF FACILITY TO BE SERVED P ` ♦ AV, T�/L FINANCE THROUGH TO BE INSTALLED BY . � �� a NOTEa THIS PERMIT IS NOT VALID WITHOUT SOIL TEST so!1 TEST REsutrs ,I I� I^ �'r r•/r Sf1f j O /�/ .. CO:d'r•'_fiTir,:pi DATE ANTICIPATED ~INS'E.:T:ON: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TH€ U^ ENVIRONMENTAL QUALITY AUTHORITY TWILL BE SUBJECT TO PROSECUTION. GEPT:C TANK SIZE _ �- TYPE +SEEPAGE AREA SIZE �� TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEI] FOUNDATION TO SEPTIC TANK a • a GJ ♦ FOUNDATION TO SEEPAGE PIT � DRAIN FIELD T SEPTIC TANK TO SEEPAGE PIT WALL j SEPTIC TANK -l'- SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK ,.SEEPAGE PIT DRAIN FIELD �~ n ALSO CONSIO$ft-AREA WELLS, WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT r SEPTIC TANK, /I `YZ_ SEEPAGE PIT - L<1_2 DRAIN FIELD `I TO RIVER, LAKE, STREAM. - CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP O 3:CAVATION 5 FEET INTO UNDISTURBED SOIL. At INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGc; i'I FITTEO WITH AIRTIGHT REMOVABLE CAPS. c, a GR:cV%L 3A.1-.KFILL _ n ♦ .- ' y, CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. - i 6� OR LICENSED DESIGNER 0 MEN ME ON ..MMIMIMMM M ■nMm�.�!v.... .nOMEN EMO�:7 V ■ moon 0 .ic.yil� M I Www=MMIN s aim �=m�.... ME Noon=.n 0 I ME. .ONMIM EN �. .V=Emm�o.� - i I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. - � i% ♦� tom' `J ` - "- \... _ DATE APPLICANT'S SIGNATURE r � FORM NO. EQ -016 - .SLI F . 4 ` WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 WELL OWNER & 6vrJ2 s fr'j✓;. h v USE OF WELL I Dlrr � LOCATION )i0l7 0_ cP-, 11"Yu»Pe, Sr�t1VuSUD1� SIZE OF CASING JrDEPTH OF HOLE 1di'PT. CASED TO J:§-, FT. STATIC WATER LEVEL�_FT. YIELDJy�GAL.PER.MIN. WITH �� Q �3e.ln W Srwr�o.�,p� FEET OF DRAWDOWN. MKIM DATE COMPLETED 2- % 9- %,� PUMP TO BE SET AT r✓� dl -t o--�ZA At o-i� J i La t opI at o -a r _t 0- 0_ _t 0� �t0- _o_o0- _ 0_ to_ t0- _0_o0 - _ 0_ _to_ MUNICIPALITY OF ANCHORAGE laj Development Services Department 'i " � p � Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 015-472-24 Expiration Date: I - - 19 1. GENERAL INFORMATION Complete legal description Irvine Lot 2 Location (site address) 11161 Snowline Drive Current property owner(s) Rebecca Boys Day phone Mailing address 11161 Snowline Drive, Anchorage, AK 99507 Real estate agent Vivian Bowman 748-4748 Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ y 2-6/ k9 Waiver Fee $ Date of Payment ( 22-fg Date of Payment Receipt Number 0 '31 (p Receipt Number COSA# ac_181 5��� 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 Forge Engineering Phone 907-522-7773 Address PO Box 240773, Anchorage, AK 99524 Benjamin Schiller, PE Date 10/23/18 Engineer's Printed Name ���®�xkv. ���4E OF ••.e ki �Gj • `� ..9 y ;*. 49� y,, ..*9 � 6. DSD SIGNATURE I( ? \—_�7• C '�-- _ fri System #1 Approved for 4 bedrooms �y . Benjan 'Schiller :� 0 � �c�•1,,,,* CE 12592 •.• `�� System#2 Approved for bedrooms O ��fF9 �0123��a .���?� Disapproved �k� wPROFESS\ow...... Conditional approval for bedrooms, with the following stipulations: ��Y�-t i i L,, v • ,.. ON_ , '� blTE . WASTER AND c, o pRGGRq TFR oma_ ''r.sERVlces° By: j/1/\----I Original Certificate Date: I D is--ie 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 Y Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet 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: Irvine Lot 2 Parcel ID:015-472-24 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well LogY/N ( ) Y Date completed 7/19/75 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y Total depth 85 ft. Cased to 55 ft. Casing height(above ground) 12 in. FROM WELL LOG AT INSPECTION Date of test 7/19/75 10/23/18 Static water level 20 ft. 21 .5 ft. Well production 1 5 g.p m 1.1 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 6.71 mg/L Arsenic ND ug/L Date of sample: 9/26/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/22/18 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 Pumper New Tank C. ABSORPTION FIELD DATA Date installed 6/30/75 Soil rating2 or ft2/bdrm) 155 SF/BDRM Trench (g.p.d./ft System type Length 50 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 10 ft. Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/24/18 ResultsPass/Fail Pass 4 ( ) For bedrooms Fluid depth in absorption field before test 0 in. Water added 733 gal. New depth 0 in. Elapsed Time: 420 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment(past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION 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: >100' On ad acent lots >100' Septic tank/lift station on lot j > On ad'acent lots >100' Absorption field on lot 100 1 Public sewer main >75' Public sewer manhole/cleanout >100' tank >100' Sewer/septic service line >25' Holding Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: 10' >5' >5' Building foundation Property line Absorption field >10' >10' >100' Water main Water service line Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' Property line *3' Building foundation >10' Water main 10 Water Service line >101 Surface water >100'100' >10' Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Waiver submitted for 3' separation to property line G. ENGINEER'S CERTIFICATION ��-OF eAtt 1 certify that I have determined through field inspections and �,�Q. • '�• •�,��� review of Municipal records that the above systems are in .0.'0).• �. •;9 conformance with MOA COSA guidelines in effect on this date. f*; a' TT1 / �,� � Benjamin Schiller, PE p 'Y'.` '7* ' -' Engineer's Printed Name , • �,'-� ..•- ` `=-= i£–`- l Date 10/24/18 01 • Benjamin Schiller •� �F •. CE 12592 .• `�e • g �s '. 10/24/18 .•' V �kik�®pROFESSIO -4. COSA brown sheet_10-10-12.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT ' �'7� � 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC181565 Subdivision: Irvine, Lot: 2 A water sample revealed a nitrate concentration of 6.71 milligrams per liter (mg/L). 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. Mailing Address: P.0.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org Nitrate Fact Sheet 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. Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org •r_ r3 ' . (--- . .,......„. ....... .... ..... .. ..... •••••••••• N89'45.45”E 299.97' 30 ' ••••••••• .:::::::::::::::::.::•::•:. .... .... -...........,,, • :::;::.::::::::•::::::::::•:•:•:•:. ..... v:::::::•::::::,..::•:•:•::: ..y.....,;:::::.:,..:::::::::.::::::::•:,:•:•:::::::::':.. .........., .-..-.-- :...:-..-..:•:•::.:•:::::.:::•:•:•:•:•:•:::•:::::::•::::..::.::... ........,............,. • ......, .,.........,, .....„......:................................:...„......„..., . . .f Zo ./ 8 /•• ") si .,5 0 . .-...:::4:,..:•:•:•::,.-:::::...:........... ..X.X.X........x.B&tgigt. • .. ExisHe. Hou se 61.5 --.- •,- Existing Paved Drive.x.H., :,i.i, 6: g • 9 4 .. .-....., : : ,.:F.::::-:-::,111:::::-:-:-:-:-:-X-F.X.:-:-:-:-::::•:::::•:•:•:•:•:- ",:-::::::::::-::::•:•:•:•:•:•:•:,,,,:i•Fil.•:•:.:•:•:•:•:•:•77-*" ji,;:".,,r7' / ,iir •:•:::•::::::•:•:•:•::..:•:•:•:•:•::•:•:. c ,-- 0 ...::::2.:.. ::..::.::.:.......:: ..:.• -- — ' ':-::::•::::•:•: .. :...- ............... P-I ',:••••••••,,,,,,,,' ,, ..— :::::::::::::.:::::.::..:.:::...,...:.----....., ::v.v.-4:::•::::::::•:::::: 26' C, -2 Ab .., ,_ r -P s mg , p•e, E p 0 e) G°roge 0 d, o ci Z 'ii ii i 0 :., aCP ( ). 0 --.. '#S174742‘1‘ . ) CP -0 ,e•-`7,<„,..............1 rt/,e, ille ,_ see note 1 •••1 4 * . 0 i* vr- . „ ?: 1•3 to /,73 30' Rood insernent / • Thomas H. Dreyef/ .6/ I 43- • : ."..... LS-762',- , - 1 • •. Note 1) Septic locations are per Forge Engineering septic see note 1 I ". Nj6`,4- ..... ‘ 0,„ •• os-built permit # OSP/181364, PID # 015-472-24. (VS) , ,-„,„ \..00-- •,\,tii4zon......0......t....___,- o , ir) S89'45'45"W 299.97' Legend: AL Monument 0 S4 124 E 7th Avenue Legal Description: Rebor 0 Tom H Dreyer,P.L.S. Anchorage,Alaska 99501 Survey Certification: Asbuilt Well I hereby certify that a Mortgagee's Inspection was performed Septic Asbuilt 0) on the described property. Notes: tEI See note 1 0 (907)306-8104Pavement .::::•.:::::::::..: It is the owner's responsibility to determine the existence of G rou p maii@S4AK.com any easements, covenants, or restriction which ore not on the recorded subdivision plat. This asbuilt shall not be used Lot 2 Overhang gl:....1r.qi111M,, Land Surveying 1 for construction or for establishing property lines. • Wood Deck V7Z/ZA Land Development Consultants — Subdivision Specialists Checked by THD Scale 1` .= 30' Drown by CB Grid 2640 Irvine Subdivision Concrete Construction Surveying ..___ - Job 2018-67 Plot 75-93 Field Book: 142-25 Date: 10/7/2018 Fence —•—• t,...... MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# HAA# 519 1. GENERAL INFORMATION Complete legal description Lot 2: - Uvi.ne Subdi.v.i sion Location (site address or directions) 11161 Snocufine Dti.ve Anchorage AK Property owner 'Adair Heath - Day phone 346-3346 Mailing address , " 11.161 SnouzZine Dr�i.ve Anchona eAK 99516 Lending agency, Day phone ;e _. - Mailing address Geon e _McCo 7 Jack White Co Agent 9 N Day phone 762-3118 ; Addre`3201 °C" Street Scute 100 Anchorage; AK 99503 ss '-- ,. Unless otherwise requested, HAA will be held for pickup.;` 2• ::.' NUMBER OF BEDROOMS.' 4 ,. _. - 3. ` TYPE OF WATER SUPPLY Individual ;welt -XXX Community well J f l. Public water NOTE If communitywell system, provide written confirmation from`'State A&. (attest-V ' ing to the legality and status of 4stem. y 4 4. ,TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX rt 5'1,i Holding tank ww Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 furtherverify 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 S& S ENGINEERING 6 9 `( _ '7q 17034 ragiS KIVOr LOOP RUdd NO. A04 Phone Address Eagle River, Alaska 995 / Engineer's signature Date �/ ( l R S }10; ;M 1 ,1 �l Additional"Comments Note: The well for this property meets existing StaAe and -?Municipal Codes. There are nitrates present. It is fwacfgested i that a p ri odi r t-PGt; ng b4c-,pprformed to ; n ,rt- the wt -11 �contr'inued;suitability. Nitrate concentration is 6.0 mg/1. EPA 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. 72-M (Rev. 1/81) Back MOA #21 s Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legat Description: IR v I -i SSD Parcel I.D.:`O I S- - y 7 A. WELL DATA Well type PRS V *7- e If A, B. or C. attach ADEC letter. ADEC water system number Log present &IN) V6 S i Total depth Sanitary seal 6m) Y £ S Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 Nitrate Date completed 7 / 1 G1 / -7 S i Cased to 5 S FROM WELL LOG � l Cl 5 -- . 's - g.p.m. Casing height (above ground) Wires properly protected (I) _ AT INSPECTION 11 ! 3 / y S- a3` t. a g.p. m. (0.0 Other bacteria 0 Date of sample: 1 / S Collected by: S & S ENGINEERING 1/034 age River Loop Road No. 204.. B. SEPTICMOL0--3 TANK DATA Eagle River, Alaska 99577 Date installed 5 /I ? 5-9 Tank size I a S�O Number of Compartments I Cleanouts (01N) YES Foundation cleanout ((YIN) yes Depression (YAj A' d High water alarm (Y/& y`' O Date of Pumping 11 ( 3/ '7 S- Pumper A N r. , 2 5-,'6 t vi J C. ABSORPTION FIELD DATA Date installed S // Y I k1 Soil rating (g.p.d./ft'` or ft'`/bdrm. 1 a System type 13E D Length 'i a r Width ) 8 Gravel thickness below pipe 0- S Total depth 3 Effective absorption area 7 Monitoring Tube present( y -f-3 Depression over field (YO A'0 Date of adequacy test 11/3/9S- Results C as ail) P4 s S For z{ bedrooms Fluid depth in absorption field before test (in.); 0 Immediately after 3v F gal. water added (in.): O Fluid depth (ins.) Minutes later: 1 S Absorption rate = 6 ob } g.p.d. Peroxide treatment (past 12 months) (Y/N) iIj °'��" ° If yes, give date D. LIFT STATION Date installed Manhole/Access (YM) High water alarm level at* Cycles E. SEPARATION DISTANCES Size in gallons ..Pump on *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/Ito ittg tank on lot l 0 0 4 ; On adjacent lots Absorption field on lot Public sewer main Sewer /septic service line 100 r t On adjacent lots "Pump off' level at* /v0 + /OV .� Y - N /A Public sewer manhole/cleanout N /y Lift station N J 14 SEPARATION DISTANCES FROM SEPTIC/H9bHhAi6 TANK ON LOT TO: Building foundation 0 4- Property line 30 t Absorption field Water main/service line o -1- Surface water/drainage /00 t Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation I r Water main/service line O �' t Surface water /00 t Curtain drain POxC tr'�aw,J F. ENGINE, CERTIFICATION ATION Driveway, parking/vehicle storage area S � -f- Wells on adjacent lots /01) "4- Property line 3b �4- I certify that I have determined thru field inspections and revietiv of Municipal records i 'IRPn" .Vstems are in conformance with A10A 11AA guideli s in effect on this date. Signature � r /t 01845A C., Engineer's Name CoC wNJ✓ e in al Mere Date ROBERT C. COWAPI L l fJ ------------------------------------------------------------------------------------------------------ HAA Fee $ ��t `� Waiver Fee $ Date of Payment 1%� /�` q4--� Date of Payment Receipt Number AY6,3 9 Receipt Number Rev. 8/95 OSS: Iraa.wk.doc MUNICIPALITY OF ANCHORAGE a" • 'a DEPARTMENT OF HEALTH & HUMAN SERVICES Ii 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 Parcel l.D. # Clf �- �� 1� - �L� HAA # 12� QIS (_)lQ1,q 1. GENERAL INFORMATION Complete legal description bot 2; Dwine Subdi.viz i,on Location (site address or directions) 11161 Snowti.ne Dkive Anchorage, AK Property owner Adam Heath Day phone 346-3346 659-4205 w Mailing address 11161 Snowtine Dkive Anchorage, AK 99516 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. 'TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer ` NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of systema 72-025 (Rev. 1/91) Front MOA 421 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. 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Note The well for this property meets existin State and Municipal Codes. There are nitrates present. It is _ ____ _ J 1.. -. , +1,o S,, continued suitability. Nitrate concentration is 6.15 mg/1. EPA Jq Rig/l_ l By: /�� a moi-= Date �-t-�a xx 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 engineefte work. S & S ENGINEERING Phone Name of Firm Eag a River L Road N 04 Address Eagle River, Alas Date Engineer's signature go fa L •® ,at +taJ et6 Mot 3' S � P ♦DD 5 �} a �. A. ;{66itA .9 / cz' 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Note The well for this property meets existin State and Municipal Codes. There are nitrates present. It is _ ____ _ J 1.. -. , +1,o S,, continued suitability. Nitrate concentration is 6.15 mg/1. EPA Jq Rig/l_ l By: /�� a moi-= Date �-t-�a xx 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 engineefte work. Municipality of Anchorage Department of Health and Human Services 44 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Loi Z N6- SID Parcel I.D. �� " A r;Z A. Well Data Well type P/'41VA _1 Z-:- If A, B, or C, attach ADEC letter. ADEC water system number Log present&N) `t'c�S Date completed —Driller FOSS 091LQN6o Total depth _�� Cased to SS– Casing height Sanitaryseal &N) Vi5S Wires properly protected ON) YDS Date of test Static water level Well flow FROM WELL LOG 7//1/25-- Z0 1.5- Pump .5 Pump levell 9,Z *1f 4CVSTICAL P2016E covt_D No -1 PAST - SEPARATION DISTANCES FROM WELL TO: g.p.m. AT INSPECTION zLz z- -3 ( o - Cy+b/NCS 2 3 ,dELow rU� r � 2 g.p.m. CJ_J a6z)✓zc,C1.0 P'2dT_tzuJIWUS Ai '660" Septic/holding tank on lot /(� �� ; On adjacent lots Absorption field on lot no �� ; On adjacent lots Public sewer main Nv�� /�✓GCrS�/ �7- Public sewer manhole/cleanout W;4JA= Sewer service line ZS'-- Petroleum tank WATER SAMPLE RESULTS: Coliform a Nitrate Date of sample: Lt> - 2\ ' 0t'5 B. SEPTIC/FieEeRiG TANK DATA to . ( S Other bacteria D Collected by: S � S G,"2 - Date installed --5'/t P/ Sy Tank size / Z_ 5-0 CoAC _ Compartments Z 11 Cleanout (Y N) 6S Foundation cleanout N) Y{' S Depress N� //ion (1 N� High water alarm (Y/& .No Alarm tested (Y/N) /V/A Date of pumping 1014- 3 Pumper /SNCL fv2�%E C�SS{�CRY �U�f"INC> SEPARATION DISTANCES FROM SEPTIC/TANK TO: r Well(s) on lot 100 /-/- On adjacent lots / 6 _Foundation 3Z To property line /() i4- Absorption field S Water main/service line L U 1 f Surface water/drainage 100 (*- FROM * CONTINUED ON BACK PAGE 72-026 (3/93)` Front C. LIFTSTATION AIOP6_p&LSENT" Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DIST, Well D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots Manufacturer Manhole/Access Cycles tested off" Level at Surface water Date installed Soilratin GPD/Ft2 Z��/�� /I % y g ( ) System type 4 Length Z Width �t� r Gravel thickness S Total depth `f S Total absorption area p Cleanout present N) `(� Depression over field (Yo ,/6 Date of adequacy test Z 3 Results/fail) 1 J S for Bedrooms Water level in absorption field before test D After test d Peroxide treatment (past 12 months) (Y/N) IVU �L�' kWOt t!J If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /,00(/-- On adjacent lots / OU/ I— Property line I To building foundation QL- To existing or abandoned system on lot lift On adjacent lots 20 r 4– Cutbank i✓b..vLr A1L6CJLXqWater main/service line Surface water /(JU f Driveway, parking/vehicle storage area S r Curtain drain 902c KA)al-W E. ENGINEER'S CERTIFICATION tf- l certify that l have checked, verified, or c9nfslrmed to all MOA and HAA guidelines in effect on the date of this inspection HAA Fee $ (-e Date of Payment Receipt Number 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES — 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C' 1 :!� — Lt - aLA HAA # 0 L)sq 0 1`1 a 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Z �� Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address (d) Real Estate Company and Agent Telephone: (home) Business Telephone Addressor G� 'I97 Telephone (e) Mail the HAA to the following address: (or check here�if hold for pick up.) - List contact person and day phone number below: 5-& 5 ENGINEERING 17034 Eagle River Loop Road No 204 - Eagle River, Alaska -99577 2. TYPE OF RESIDENCE Single -Family Number of bedrooms 3. WATER SUPPLY Individual WeII73_ Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. 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 inspection. Name of Firm 5 & 5 ENGINEERING Telephone 17034 Eagle River Loop Road No. 204 Address Eagle River, Alaska 99577 Date �( OF ✓ � ° • e .•��i 1'." �0 was V ! 1 /�..p. ro e•. °•4A. •, J � T IXC l •O ,T.. O J ! �q 6. DHHS APPROVAL/- Approved PPROVAL -Approved for bedrooms by VDate Approved._—Disapproved Conditional Terms of Conditional Approval /U_ - CAUTION. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 notconduct 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. 72-025 (Rev. 7/88) Back Page 2 of 2 e A' CJ`�p� MUNICIPALITY OF ANCHORAGE (MOA) P� Health Authority Approval (HAA) oMei �i _,e CHECKLIST - FEBRUARY 1984 dhC15 �P4 343-4744 Legal Description: A. WELL DATA�� N Well Classification J �"t� If A, , C, D.E.C. Approved (Y/N) Date Co15leted 7 i S Yield Well Log Present N), t Total Depth -_Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground \2 k ` Sanitary Seal on Casing 4�%) V i/ Electrical Wiring in Conduito?N) Depression Around Wellhead (Y/M) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot �) 4- ; Ordjoining Lots To Nearest Edge of Absorption Field on rot ��( 4- ; On Adjoining Lots k To Nearest Public Sewer Line `� To Nearest P is Sewer Cleanout/Manhole A To Nearest Sewer Service Line on Lot 2 - Water Sample Collected by SSS �iJG 1 r-t�� ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installedtete)- � Size VZ51D No. of Compartments Standpi pes QY?N) T—Air-tight Caps((ZN) _ Foundation Cleanout((Y?N) Depression over Tank MY R rs Date Last Pumped Pumping/Maintenance Contact on File (Y/N A for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) /1 SEPARATION DISTANCES FROM SEPTIC/MOL TANK: To Water -Supply Well 1 �� / To Building Foundation To Property Line — To Water Main/Service Line To Disposal Field t To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88) Front Page 1 Of 2 _'5Z 1 r% C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata \ ZS�eM- Type of System Design Lz!5�C� Date Installed `'z� - \� - �`I L� Length of Field Width of Field I� Depth of Field ( Gravel Bed Thickness Square Feet of Absortion Area Sb` Statndpipes Present PN) �! f Depression over Field (YV Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIED: To Water -Supply Well To Property Line (2)t ( To Building Foundation ) �`� To Existing or Abandoned System on 'l70 ✓ Lot � ; On Adjoining Lots -- _- - To Water Main/Service Line a To Cutback (if present) N J6, To Stream, Pond, Lake, or Major Drainage Course 4 - To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION I ,n Date Installed Size inns "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request*" "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe'"��� ��f@ inspection. eNGINEERir�d �,, o .`�, � `` •<�.o+f4 1K,.8 Signed —_ 17o;a4 Ea -le Myer L,� EaglaRiver, Alaska Company Date MOA No. Receipt No. 116 w6 s �9 / Date of Payment Amount: $ Receipt No Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 this 4 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE fox Work Order # 12693 Date Report Printed: APR 17 89 @ 08:11 Client Sample ID:L2, IRVINE PWSID :UA Collected APR 11 89 @ 16:10 hrs. Received APR 12 89 @ 14:30 hrs. Preserved with :AS REQUIRED Analysis Completed :APR 14 89 Laboratory Super i or STEPHEN C. EDE Released By Special Instruct: Chemlab Ref #: 4868 Parameter Tested ------------------- NITRATE-N Lab Smpl ID: 1 Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY RJS. Client Name S & S ENGR Client Acct SNSENGP P.O.# NONE REC D Req # Ordered By : RJS Send Reports to: 1)3 & S ENGR 2) Matrix: WATER Allowable Result/Units Method Limits ------------------------------------------------------------- 4.3 mg/l EPA 353.2 10 ------------------ -- 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT=Greater Than �J r CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street 3y6!� Anchorage, Alaska 99518 /� I, ,j Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY I ❑ PUBLIC WATER SYSTEM LD.# An sls shows this Water SAMPLE to be: PRIVATE WATER SYSTEM Satisfactory ❑ Unsatisfactory Name Phone No. 5 & 5 ENGINEERING ❑ Sample too long in transit; sample should not be over 30 hours old at examination Mailing d as - to indicate reliable results. Please send agfe Fiver, Alaska 99577 new sample via special delivery mail. City - State Zip Code SAMPLE DATE: 8 Mo. Day Year SAMPLE TYPE: ,�4-Routine ❑ Check Sample (for routine sample with lab ref. no. ) ❑ Treated Water ❑ Special Purpose ❑ Untreated Water SAMPLE Time Collected NO. LOCATION Collected By 2 1 3 4 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Date Received Time Received _ Analytical Method: :5 -17- 9- 4 L 20 Membrane Filter * No. of colonies/100 ml. Lab Ref. No. Result* Analyst I�� m L� m U m BACTERIOLOGICAL WATER ANALYSIS RECORD R /347 Membrane Filter: Direct Count Verification: L N BGB Coliform/100m1 Final Membrane Filter Results Coilforml100ml Reported By Date S Time: /7a a.m. p.m. TNTC = Too Numberous To Count OB = Other Bacteria 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 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 2 IRVINE SUBD. SECTION 24,T12N,R3.-<, Location (address or directions) 11161 SNOWLINE DRIVE 7-22-86 (b) Applicant Name Tom Torkelson Telephone: Home 346-1850 Business Applicant Address 11161 Snowline Drive (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder a; Buyer ® ; Other D (explain); (d) Lending InstitutionTelephone Address —40M &_/z SZy7 , "Wc�A�46%:c am (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA �too/�. szFe!5aiythe following address: ✓1�,n dE71 J— "R� M 4w'o Z � D )Ll�uz 2. TYPE OF RESIDENCE Single -Family aMulti-Family ® Other Number of Bedrooms 4 3. WATER SUPPLY Individual Well 13 Community[], Public D Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite13 Public D Community D Holding Tank ❑ 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(11/84) 5. 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 inspection. Name of Firm QoAd g.d �A%G/!� � i� fN(� Telephone � �� Addre Date (20 6. DHEP APPROVAL n Approved for A0011 bedrooms by Approved Disapprove Terms of Conditional Approval "Avg {c ,aoa�a� . •oo a a= u' a9? •jAichael 10 An erso a E. e F 49 Ix CAUTION Date Engineer's Seal 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 »_ms n 1 /941 E DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) % `%; 1986 CHECKLIST - FEBRUARY 1984 ®/ _ 264-4720 V - Legal Description: SEC 24, T12N A. WELL DATA - - Lot 2-IrVIN� 6W.< R3W Well Classification Private Individual If A, B, Q D.E.C. Approved (Y/N) N/A Well Log Present (Y/N)_ y Date Completed 7/19/86 -.Yield 1 1/2 GPM Total Depth 850 Cased to 55A Depth of Grouting NONE Static Water Level 20' 5" Pump Set At 75' Casing Height Above Ground 30 Sanitary Seal on Casing (Y/N) y Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) n Separation Distances from Well: To Septic/Holding Tank on Lot 110' On Adjoining Lots 200' To Nearest Edge of Absorption Field on Lot 125' On Adjoining Lots 200' ± To Nearest Public Sewer Line 1,000' ± To Nearest Public Sewer Cleanout/Manhole 1,000 ± To Nearest Sewer Service Line on Lot Water Sample Collected by A.M.H. QUADRA ; Date 7-21-86 Water Sample Test Results Satisfactory Comments Well is weak but capable of .104GPM / Bedroom therefore adequate. B. SEPTIC/HOLDING TANK DATA Date Installed 6/75 Size 1250 GAL No. of Compartments 1 Standpipes (Y/N) y Air -tight Caps (Y/N) v Foundation Cleanout (Y/N) y Depression over Tank (Y/N) N Date Last Pumped 7-16-86 Pumping/Maintenance Contract on File (Y/N) y ; for 1986 Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) N/A Separation Distances from Septic/Holding Tank: To Water -Supply Well 110' To Building Foundation 10' To Property Line 55' To Disposal Field 10' To Water Main/Service Line 54' To Stream, Pond, Lake, or Major Drainage Course 300' + Comments Septic system is adequate Page 1 of 2 72-026(11184) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 1 1;5 Type of System Design Trench Date Installed 6/75 Length of Field 52' Width of Field Depth of Field 9' Gravel Bed Thickness 6' Square Feet of Absorption Area 660 Standpipes Present (Y/N) v Depression over Field (Y/N) N Date of Last Adequacy Test 7/18/86 Results of Last Adequacy Test Passed Separation Distance from Absorption Field: To Water -Supply Well 125' To Property Line 15' To Building Foundation 35' To Existing or Abandoned System on Lot None ; On Adjoining Lots 1001± To Water Main/Service Line 75' To Cutbank (if present) None To Stream/Pond/Lake/or Major Drainage Course 300' To Driveway, Parking Area, or Vehicle Storage Area 75' Comments Aborption field is adequate D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments — Dimensions Manhole/Access (Y/N) — "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify thatiI have checked e, vified, or conformed to all N)OA a%d HAA guidelines in effect on the date of this inspection. Signed `��*�"' "-Date //ZZ7 (a Company a�i'1 Y�"N 1b& MOA No, Receipt No. L4y(s '' CC) o Date of Payment % " e. .–L Amount: $ Page 2 of 2 72-026 (11/84) _ FJ eaon i G�4�ry+ is Sr 9It /.S'0 faaB'J®I2t0GyaBOOdafiL000�ap[,a�`� A e Michoel E. Anderson en 4361-G Ile-"BO.woaOF" e PROFESSO Engineer's Seal GR aSCNO[A4[ ARFi • u I .\ Y `�JPIO JAf�U.YY �• 1 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 J Date Received I� IINv Time of Inspection ; ►L Qry-, Date of Inspection Ia - �GYIo►� REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: Phone: 2. Property Owner ��n, n o c, 1 �c�a�fJ Phone: %kALA,-- (DQ(Dn Mailing Address: 1 r� ori � � a Q �nY ;--AC) Q ( hh 3. Legal Description: a Q( m( 1 n , �l i )E- 4. Location: RL,rv,l� , �s nR A , 1g 5. Type of facility to be inspected No. of bedrooms Ttn o 6. Well Data: A. Type I , -A , I �IcMl1 rN J C. Construction B. Depth 2c)' D. Bacterial Analysis 7. Sewage Disposal System: /Ov- �aJL0J .rn ire A. Install ed �, „� , l °l rid B. Instal ler C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 2. Manufacturer 2. Material 8. Distances: A. Well to: Septic tank_, Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1174) Page 1 of two pages MUNICIPALITY OF ANCHORAGE r; DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES -- 1. Type of Inspection: (CMRO VA FHA CONVr 2. Property Owner: (2 \� =`� IN :) (� � Mailing Address: (� Day Phone i`}' –� C)L, �l�> <�}�, `i C)f� 3. Name of Buyer. Mailing Address: Day Phone 4. Name of Lending Institution: \I. r Phone Mailing Address: 5. Name of Realtor or Age Phone Mailing Address: E Legal Description: �= Location: `I It A •i Type of Facility to be inspected:(a`Z� �r.?: �.- �°J1 �'3 �`uNo. Bdrms. - Water Supply \4 � r Type of Supply: Public Utility -Individual X If Individual, number of dwellings presently served V� If Individual, depth of well Sewage Disposal System ,Type of System: Public Utility Individual (on-site)— If Individual, date of installation 3\. n31 EQ -037 (1/74) Page 2 of two pages - Re,,_..=st for Approval of Individual \ er & Water Facilities Legal Description Comments Approved Disapproved Date */41LO — Approval.Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and curate representation of the subject sewer and water facilities and these facilities e operating satisfactorily. VED Date iZ�231 1 1�4 (1/74)