Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
MANOR LT 3
Manor Lot 3 #050-671-45 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 NAME PHONE tKNEW \ ❑ UPGRADE MAILINGADDRESS ` 7 LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Well / Absorption ares Dwelling PERMIT NO. Uy DISTANCE TO: \ � r, - ' 2> F- z LU Manufacturer ' sc 12. Material No, of compartments Liq. ca actin gallons •,t-� IF HOMEMADE: Inside length Width Liquid depth �� �t=z DISTANCE TO: Well—� Dwelling ^� PERMIT NO. O z Q T�N Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. u� 2 LU i ;E No. of lines Length of each line "rota) length of lines Trench width Distance between lines zw H _ a inches � I= Top of the to finish grade Material beneath the Total effective absorption area ® _ inches Length t Width I Depth PERMIT NO. IL Type of crib Crib diameter Crib depth Total effective bsorption areae w9 off; Lu Well I DISTANCE TO: S C-) •-`-' Building foundation t`i'k'_>T 1 f�3 Nearest lot line I V C-3 a Clas _Depth Driller `A- r _ Distance to lot line PERMIT NO. LU � Building foundation DISTANCE TO: Sewer line k Septic tarAbsorption areas) OTHER 7 116 -1 PIPE MATERIALS _AIN 111 -;5'V L.A- SOI L TEST RATING f,q 2 I - �t-- INSTALLER REMARKS 1 I (=�b '7 ly' X # f µ to a oc u.,cen+� 1 © (�( 1 'e& 1 `•. Nil RI,P10fE$5w; APPROVED DATE LEGAL >�'1eI?. 1965 �1�>e'�£s i y /JS r'�t✓( u7 y. +li, '•'i tI'r'. !1%ASIK'({ :1ns'7 ' e �u, 3 Lida,. O 72-013 (Rev. 3/78) - - - .-- - --- DEpARTMENT UF 4LTH AND ENVIRONMENTAL PR( ]CTION 825 L 6|REET, ANCHORAGE, AK 99501 ` '264�4720 �, v 0 ��I'll~J" -41", 11 . ..... r---" 11.411 �������� v PERMIT NO: 850322 ENGINEERED DESIGN DATE ISSUED: 06/18/85 APPLICANT: % 13& S ENGINEERING IDAHO PINES ` ADDRESS: SRB 198~X EA�LE RIVER, AK 951577 CONTACT PHONE: 694~2979 LEGAL DESCRIP: SUBDIVISION: MANOR LOT: "'I BLQCK: 1 SECTION: 6 TOWNSHIP: 14N RANGE: 1W LOT SIZE: 28110 (SQ"FT" DR ACRES) I certify that: 1 I am familiar with the requirenents for on-site sewerg and wells as set forth by the Municipality of Anchorage (MOA) and the gtate of Alaska. 2. I will install the system in ac:cordance Nith all MOA codes and regulations, and in compliance with the design criteria of this permit" 3" I will adhere to all MOA and State of Alaska requirements for the set back distanc�s from any existing well, wastewater dispos5al system or public se�erage system on this or any adjacent or, nearby lot" IF A LIFT STATION IS INSTALLED IN AN ARE8 COVERED BY MOH BUILDII,\lG CODES, THEN (1) AN ELECTRI T AND INSPECTION MUST BE 8BTAINE0: (2) AS�8UILTS WILL NOT BE AP D W AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECT�ICAL �OR��1UST 8G/]}OU� BY A LICENSED ELECTRICIAN^ DATE: APPLICAN /�---��-�-��-- �--~~��� (_}l} [-Y�y {��� ` `- ��/��6r /~0o��( \ � K`� ' `' �» ` U ` � COMrtJTATION SHEET SUBJECT: (31" 3 1< 1� ) ikr��Z9f2✓ C'�r� DATE: (v In -- � SHEET OF BY CKD 0A D o 0 V o e c DATE: (v In -- � SHEET OF BY CKD 0A D o 0 ❑ SOILS LOG =� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION i, TEST 4 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST��� r PERFORMED FOR: ^D^Fh[-) eA J S DATE PERFORMED: `' I' / — LEGAL DESCRIPTION: FL (J SLOPE SITE PLAN F P}EIS 01K-.6Ar--> 1 L. 2 r> 3 Ca 'E> ,4 6 7 8 9 10 11 12 13 14- 15 16 17 �yy 7� 18 19 6II-A1 1-1?14 41IF-,fL, (U�o j UO5'-s iii- rl—L":�M (PCZi kA -I. OF A °e .e aye p e Y.0 n °° ° •• reg a a.. a .. 00"0666 iter �Jba rt A.-ShNfor ; No. IA77.6 a � ®�0 °ROFESSI��� WAS GROUND WATER ENCOUNTERED? c E E E IF YES, AT WHAT DEPTH?k- C Reading Date Gross Time Net -rime Depth to Water Net Drop 4 N iLl C)ODA, Icn I .e 20 lI PERCOLATION RATE L�I p (minutes/inch) I TEST RUN BETWEEN FT AND` FT COMMENTS Mfg r7` -Y2, -11� )C• T ) 1 fJ`-s��>iz.;•i PERFORMED BY: P r E >1fht't I FaII`�% CERTIFIED BY• DATE; sr n s 1 ) 72-008 (6/79) OY �Q V J v a ZJ J _ W 3 cc W uj W 0 *" 40P Y N �a) Q Y M Q00 U w H a 3 w w w z A rA A C¢7 EPLMJ • t Municipality of Anchorage On-Site Water and Wastewater Program (907)343-7904 s A, C,T .Certificate of On-Site Systems Approval Parcel I.D. 050-671-45 Expiration Date: Nov 30� 0 1 a 1. GENERAL INFORMATION Complete legal description Manor Lot 3 Location (site address) 18862 Inspiration Circle Current Property owner(s) Kristin & David Fishter Day phone Mailing address 18862 Inspiration Circle Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) El Duplex El Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual [] Individual Water Storage ❑ Holding Tank ❑ Community Class C Well LJ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: I Received by: - , c., ,411,' Date: clL /`2 COSA to be released to the engineer,unless otherwise reques ed by the enginee COSA Fee $ 52& Waiver Fee $ Date of Payment 1)0u1/? Date of Payment Receipt Number 09.0 oc46 Receipt Number COSA# U Sr I I t/J j Waiver# ` � o 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date 8/23/2018 kAL ki -.• i� •*��j 6. DSD SIGNATURE ? System#1 Approved for J bedrooms S�everi . f�cin.riOn.e:''jet System#2 Approved for bedrooms , CE-8149 �i' Disapproved �k R�oFES C x-� Conditional approval for bedrooms, with the following stipulations: ON SIS 1�1n V\IRST PTE c. QROGRp,M // By: / / 6 Original Certificate Date: S/.3/// 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 blue sheet_f Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE 0SC181431,Rebecca Carroll,08(31/1. If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Manor Lot 3 Parcel ID:050-671-45 A. WELL DATA Well type Private/Class C If A, B, or C provide PWSID# 213637 Well Log (YIN) Date completed Sanitary seal (YIN)_ Wires properly protected(Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: --yy �'-I Coliform I Q_C)) colonies/100 mL Nitrate P.dmg/L Arsenic NI\ ug/L Date of sample: 8/23/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/20/1985 Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(YIN) N High water alarm (YIN) N/A Date of pumping 4/3/2018 Pumper Alaska Quality Septic C. ABSORPTION FIELD DATA Date installed 7/20/1985 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 SF/BDRM System type BED Length 26 ft. Width 26 ft. Gravel below pipe 0.5 ft. • Total depth 4 ft. Eff. absorption area 676 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/13/2018 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 240 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment(past 12 mo.)(Y/N& 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: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 1 0+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Survey on file. 48" of liquid in T1 , 47" of liquid in T2 G. ENGINEER'S CERTIFICATION OF� `1 certify that I have determined through field inspections and ,,sA°'1 •' ��' •-v review of Municipal records that the above systems are in j /\ •.*0� conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven Pannone \� 0 9 •Steven R. Pannone 8/23/2018 �� � CE-8149 �� Date • kk OFESS1011P� •� COSA canary sheet_2.6-15.doc { +- U i\ ICIPALOTY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENTto 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC181431 Subdivision: Manor, Lot: 3 A water sample revealed a nitrate concentration of 8.24 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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*wwwmuni.org Parcell.D. 050-671-45 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description MANOR LOT 3 Expiration Date: LLZ Location (site address) 16862 INSPIRATION CIR EAGLE RIVER AK 99577 Current Property owner(s) SCOTT SANDIGER Day phone Mailing address SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual FN Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Received by: a ' - -I Date: ... COSA to be released o the engineer, unless otherwise requested by the engineer. COSA Fee $ C191) - Date of Payment I /Wlg Receipt Number G3703% COSA# 06Cl3/5yo? 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. Name of Firm SPURKLAND ENGINEERING Address 203 W. 15TH AVE. STE 202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6 DSD SIG ATURE Phone 279-3916 Date 10/14/j3sr-.,� 6 A `F'r J T ` !� V System #1 Approved for 3 bedroomsLAND., c_ i SIaoi System #2 Approved for bedrooms Disapproved -- Conditional approval for bedrooms, with the following stipulations: By: .�f Origitlal Certificate Date:/ `2 L2 3 Theunicip nchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) 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 X Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r , .. 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: MANOR LT 3 A. WELL DATA Parcel ID: 050-671-45 Well type C If A, B, or C provide PWSID # 213637 Well Log (YIN) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. Well production _ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 5.7 mg1L Arsenic ND ug/L Date of sample: 9123/13 B. SEPTICIHOLDING TANK DATA ft. Collected by: ANSON MOXNESS Tank Type/Material STEEL/SEPTIC Date installed 7120/85 Tank size 1250 gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 9/23/13 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 7120/85 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 System type BED Length 26 ft. Width 26 ft. Gravel below pipe 0'5 ft. Total depth 4 ft. Eff. absorption area 1296 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/23/13 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ Datum Size in gallons in. "Pump oft' level at _ E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot 1501+ Absorption field on lot 1501+ Public sewer main NIA Sewer /septic service line 75'+ Animal containment areas 150'+ Manhole/Access (YIN) in. High water alarm level at _ Meets alarm & circuit requirements? On adjacent lots150+ On adjacent lots 150'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 1501+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 50+ Property line 25'+ Water main N/A Water service line 10+ Wells on adjacent lots 1501+ ABSORPTION FIELD ON LOT TO: Property line 20+ Building foundation 80+ Water Service line 10+ Surface water 100+ Curtain drain N'O' Wells on adjacent lots150+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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. Engineer's Printed Name LARS SPURKLAND Date 10/10/13 COSA brawn sheet -1 0-1 0- 1 2.doc Absorption field 5'+ Surface water 100'+ Water main N/A Driveway, parkingtvehicle storage 100'+ .= P��•OF'At� �t1 T�H.6 � .4,,-�L . .. ............ � f�A E.SPURKLAND:� Ir uj . 11500 RO�.S Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www,muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 131542 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 3 of Manor subdivision. This inspection revealed a nitrate concentration of 5.7 milligrams per liter (mg/L) was reported for the property's well water sample. 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. eNwogn(ASSIAED) RRaRa naw OEe. zaxma arrNa - — _ _ RIwT pIlMC SBB/,a! R=200.00 CV INSPIRATION CIRCLE=15.00' 122.26' sea elwa•w sxral 583' 30' 00"E .— 1 D`UTIL ESMT NUA &wawa sneAa i ^ WELL y V 4. 17,0. I ?g EXISTING I b HOUSE ry ry y 3 h ry. 33.7 i I Tn 1 0 Z I N � y I U m J y a 4 0 V y C.O. U i I I I I I i I y 1D' T&E ESMT S85° 48' U4 YJ 86.61' UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE ONES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING REPRODUCTION MAY CAUSE ERRORS IN SCALE. Lor SURVEY SURVEY TYPE SYMBOLS Fd `[%N AS-&MILTSET REBAR O ASPHALT • DRAINAGE El FINAL STRUCTURE /S -&ULT O FOUND RESAR 6 9 e WOOD FENCE =- CONCRETE ❑ PLOT PUN ... AS-BULT ... LDT SURKY... TOPOdtMXY Yl ' ' * OD Il ASSUMED ELEV. �s---K 01 METAL FENCE ® WOOD DECK T ... XO CORlFRS SET PEC TION A WYT ... NO WRNQS SET PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS. SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION.• •aaaaaa��++ . OF +y Prepared by Robert E. Johns, Jr. & Assoc. PLOT PAN I.wre, a.UN awlbw Ngwewr—m � a�`P�•••.ii�9 Professional Land Surveyors ane.w w paswa sn ..werarMvea ra na..wm w m.,n... we.. a, Ub etl p tlw ewt a . Brink KA ANCHORAGE ALASKA 99501 o Oln mm AN� � ?• th -� Scale: n Rec. Lot S.F. Rx. Plat File No. - _ _ 50� 1 J FOUNDATION AS—BUILT •••• ••• •• �• Date Surwyed: 14/14!13 Drawn by. REJ Checked byMV JJ MK I. RRe1 E ANwA r.. nwq aah nw I .. - .... �- . p •.ROBERT N Q Date Dawn: 14/15!13 °"d NW254 W°' 13-541 FINAL STRUCTURE AS -BUILT RaM1 E AYt ne.q' qn 1 e xA 01-:•• d i 1 •♦ •. Le9a 4 Desv' hon: 4 .F., alaY ne.. rwpwra .AFdwl �wY a ar S •............• .• r�J �+ eo, dl` Wyeh•. a MY w N Nst ! M asrw w.e w...wr s "°'" e.a + Pr i anA �� :.�.a=="p"ww."" """ olessiond •• ++���►aaaa•� MANOR Municipality of Anchorage • Department of Health and Human Services Division of Environmental Services On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. ak. us (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FORA SINGLE FAMILY DWELLING Parcel I.D. 050-671-45 HAA#'~f�}/ Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 3, Manor Subdivision Location (site address or directions) 18862 Inspiration Circle Current Property owner(s) Terry Alexander Day phone 694.2'164 Mailingaddress 18862 Inspiration Circle, Eagle River AK 99577 Lending agency Mailing address Day phone Real Estate Agent Pete Strang/Remax Day phone 276-2761 Mailing Address 2600 Cordova, Ste 100, Anchorage, Ak 99503 z- Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3/���"� 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class C Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates e' Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served b% a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipalit,, of Anchorage is not responsible for errors or omissions in the professional engineer's work. 3-025 (Rev. 01'001' 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 Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. 5 & 5 ENGINEERING 7703« Eac'a ;:":::r Loop Road No. 204 (v `1 R 7 `7 Name of Firm ^31e-t�ive� AI __,,a 99579 Phone Address Engineer's Printed Name Robert Cowan 6. DHHS SIGNATURE 1/ Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date i a a- r .! ���..�........ _..................... r 9 ` ROBERT G COWAN CE - 8601 bedrooms, with the following stipulations. Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: j"_- ���/ Original Certificate Date: 9 -/6 -O o Expiration Date -5-025 , Rev. 01 BOOP Reissue Date: Municipality of Anchorage • Department of Health and Human Services Division of Environmental Services I� E C E I V E On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 AUG 14 2000 www.ci.anchorage.ak.us (907) 343-4744 MUNICIPALITY UP ANCHURAGE iVIRONWNM SERVICES I)IVISr HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L-or3 MHN,' 2 SID A. WELL DATA Well type G Date completed _ Total depth _ Date of test Static water level Well oro Ion If A, B, or C provide PWSID # a) 3 013 7 Sanitary seal ft Cased to ft FROM WELL LOG WATER SAMPLE RESULTS: m 9 -p.m Well Log Parcel I.D.: 09'0 _&7/ -LIS - protected ng height (above ground) AT INSPECTION ft 9 -p.m in. Coliform V colonies/100 ml Nitrate V.d7 mg/I Other bacteria ® colonies/100 ml Date of sample: V7/00 Collected by: S & S ENGINEERING B. SEPTIC/HOLDING TANK DATA 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Tank Type/Materia/l Date installed 7/0113- Tank size I2 -SL' gal Number of Compartments a Cleanouts r S Foundation cleanout yOs Depression over tank N 0 High water alarm N o Date of pumping `� w % Pumper T R- s C. ABSORPTION FIELD DATA Date installed 7 / V S Soil rating (g.p.d./ft2 or ft2/bdr System type Q�a Length 7.6 ft Width ft Gravel below pipe o• S' ft Total depth _�l ft Effective absorption area) a) 6 ft? Monitoring tube W -J Depression over field Date of adequacy test 07/00 ResultsPas Fail) PA -s3 For 3 bedrooms Fluid depth in absorption field before test O in Water added S 6 gal. New depth O in. Elapsed Time: N14- min Final fluid depth 04 in Absorption rate >= 5'0 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & 72-026 (Rev. 01/00)` IvJ v#_ KNo w1✓ If yes, give date - D. LIFT STATION Date installed "Pump on" level at Size in gallons _ in "Pump off' level at Datum— E. SEPARATION DISTANCES alarm level at in Meets alarm & circuit requirements SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot f S'0 -I" On adjacent lots 76-0 '4 - Absorption field on lot 7 S,0 `f On adjacent lots ( -o 4 Public sewer main N/k Public sewer manhole/cleanout NI A Sewer /septic service line 7S- -/- Holding tank N14 SEPARATION [DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S`o 4- Property line Q S + Absorption field - Water main N /H Water service line to f Surface water _ Drainage ry 14 Wells on adjacent lots 100 `+- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ;L0 1' Building foundation TO I/- Water main NA Water Service line ! 0 `+ Surface water loo -f- Driveway, parking/vehicle storage! 00 f Curtain drain ho4. KNoww Wells on adjacent lots JO° F F. COMMENTS EV G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and 9.h _ ip review of Municipal records that the above systems are in z -:� _r conformance with MOA HAA guidelines in effect on this date. n ` ao aTi�ownN �� Engineer's Printed Name n ��i' CE -8801 '04r g' u5 0 /3 E2 r C . Co w�tn/ welt � ;, N., '��� Date /111/00 '+�yL�.Za:����` � .. HAA Fee $ '?,00 • �'� Date of Payment Receipt Number 72-026 (Rev. 01/00)' Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICESi 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 I.D. # QS _0 6 -7 / L45- 1. GENERAL INFORMATION HAA# _ V��LL2) )--1LkL Complete legal description Lot 3; Manors Su,bdivi6ion .Location (site address or directions) 18862 Ivu,pikation Ci4c.2e Ea9.2e RiveA, AK Property owner Tex.ky A2exandeA Day phone 694-2364 Mailing address 18862 Ivu1piiLati.on Cincte. Eagte RiveA„ AK 99577 Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 Day phone Day phone 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 system. 72-025(Rev.1/91) Front MOA#21 5. 2 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 invest!gation 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 Phone 17034 Eagle River Lour Address Ene1e :.,,t elatice995�7 Engineer's signature DHHS SIGNATURE X Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments 1A 111Th. 69y—.;)c77`I A >t ROBERT C. COWAN t Q CE - 8801 bedrooms, with the following stipulations: Date /` - // 11S 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 ena-ineer registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto 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. 72-025 (Rev. 1/91) Back MOA k21 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 Legal Description: �� 3 1 \ vR— S'r� Parcel I.D.: 06C) Ca'] 1 ys /A7 � r'r'i A. WELL DATA ►'7`I o Well type If A, B, or C, attach ADEC letter. ADEC water system number Z13 (o�221 �.. Log present (YIN) _ Date completed _ Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) _ Wires properly protected (Y FROM WELL LOG Y SPECTION Date of test Static water level Well production g.p,nt. g.p.nt. WATER SAMPLE RESULT L m Nitrate Other bacteria sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed 117 -0 -55 -Tank size X256 Number of Compartments 2 Cleanouts MN)—#-- Foundation N)—.JFoundation cleanout ( I) _ Depression (YQ ri High water alarm (Yop Date of Pumping Pumper PJ�tPi,�t, C. ABSORPTION FIELD DATA Date installed ✓I -20-y5" Soil rating (g.p.d./f2 orft2/bdrm) System type Moo �0f-D t&rz-p Length -22 Le _Width Gravel thickness below pipe 0,6- Total depth Effective absorption area �'� l.� Monitoring Tube present(DN) Depression over field (Yo IJ Date of adequacy lest _ /O —/ _ 9S Results Q�s Fail) PAST For 3 bedrooms Fluid depth in absorption field before test (in.); O Immediately after `40 gal. water added (in.): U Fluid depth D (ins.) Minutes later: O Absorption rate = 75.0 t g,p,d, Peroxide treatment (past 12 mouths) (Yo do 46 X" AJ,J If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum 'Pump off' level al* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/bolding tank on lot Its -c>, ; On adjacent lots Absorption field on lot k rP � 1 Sv ; On adjacent lots � pc Public sewer main ', Ip Public sewer manhole/cleanout Server /septic service line 1 vc.-;> n Lift station D,�,C,. Wtx1Ut<fz SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Can Property line to nk Absorption field ZS Water main/service line \(2 Surface water/drainage \ov Wells on adjacent lots �1A SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation -75- t Water main/service line 1 L-.� t Surface water 1 op ik Driveway. parking/vehicle storage area 1 oc>r �- Curtain drain > 00 e- Wells on adjacent lots 1 IAS Property litre I D, F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review ofAllunicipal in conformance with 10 !I$aride[in� in effect on this date. Signature Engineer's Name r` a Q �c2 T C— C d w9,✓ Date I Q ( ;P— / q HAA Fee $ oe Date of Payment /C7 ` Receipt Number Rev. 8/95 OSS: baa.wk.doc Waiver Fee $ Date of Payment Receipt Number are -P 1 ROEERT C. COWAN { Q `c�s•.�� CE - 8801 1 . 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 ehM' J Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L—tc"T '� / '4<rJ ep(L S Iic> Location (address or directions) I r``tSP i Rp'fl B.-� La fZc-w u8�3 (b) Applicant Name Telephone: Home Business 3`7b - Applicant Address C6�x 8 1 Z25 L - � ✓/ �.�� _ - �.t� c c �! A �1 �i 1.67 (c) Applicant is' (check one): Lending Institution ❑ ; Owner/builder 0:-, Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address ` Telephone (f) Aeiill the HAA to the following address: 1) ; 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 111 I "0 3. WATER SUPPLY Individual Well ❑ Community ❑ Publictg 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 Onsite K Public ❑ Community ❑ 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 1. 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 Address Date Telephone P�yI�© A`��'q�g M oa o0oeep c�0• f noon 000+ea+a 6g Robert A. Shafer „a �'. No. 1457-8 !. e` 41 9 t�� �e •O eeYeO �'PPI 6. DHRO L,�r , Approved for " bedrooms by /��`� Date Approved Disap ved Condinnal Terms of'Conditional Approval Ilial\\� 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT, OF HEALTH & CNVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 [ 1985' 264-4720 r � r r r t .� • 1'� PAS jLW - A. WELL DATA Well Classification A If A, B, C, D.E.C. Approved 071N) Well Log Present (Y/N) Date Completed Total Depth Cased to�oD�pth of Grouting Static Water Level 11 Pump Set At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Hel4imng Tank on Lot A 1�s C7-. l Yield Sanitary Seal on Casing (Y/N) — Depression Around Wellhead (Y/N) On Adjoining Lots To Nearest Edge of Absorption Field on Loth 1 �2::;? -t ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments n ts/. S \T7. 2l 3lo3rl B. SEPTIC/HOLDING TANK DATA ; Date �[..� HT1-�', r-� `t'U1�-• l , Date Installed 71-ZC-55Size VL6C2 No. of Compartments 2 Standpipes (qr N) Air -tight CapsC)N) Foundation Cleanout 09N) Depression over Tank (Y/12 pate Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for (J A Holding Tank High -Water Alarm (Y/N) j° Temporary Holding Tank Permit (Y/N) !A Separation Distances from Septic/MekhTfo Tank: To Water -Supply Well t 5-r-_> / r/ To Building Foundation To Property Line To Water Main/Service Line Course Comments Pagel of 2 72-026(11/84) ,+ To Disposal Field rk rJ To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 28 4, t+. A-- Type of System Design MQQPJI•'60 TtNZ� Date Installed r? -2o X86 Length of Field 3(or Width of Field 120 cc Depth of Field 1 a o � Gravel Bed ThicknessPi= Square Feet of Absorption Area 12A L� Standpipes Present (4J 1) Depression over Field (Y/LQ Date of Last Adequacy Test Results of Last Adequacy Test A Separation Distance from Absorption Field: To Water -Supply Well I Sa To Property Line To Building Foundation Lot 'J x i To Water Main/Service Line t, k=> k To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed To Existing or Abandoned System on ; On Adjoining Lots )Tso �utbank (if present) Dimensions rJ 1/A Size in Gallons 4anhole/lAccess (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed If diri DateiX q-18 26 1 Company,ti� ��yy 4. ",Fy°/i'`{ rtr 1 MOA No. Receipt No. Date of Payment 1- / 9 S, Amount: $ Page 2 of 2 72-026 (11/84) tea^6�, }'P, s Imo' gln ry,.;' / 1 0 a Raharl A. Sh;afar • d & as No. 1457•E o' y pli. •na a^a*�`�J N37 CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT c, Plans for the construction of— _ I public water system located in k-_jJf I TZ l _l Alaska, submitted in accordance with 18 AAC 80.100 have been reviewed and are O approved. 41, conditionally approved (see attached conditions),j j�rr t` �Jt4 n( 51`s to 6c)u? c,� 0 BY TITLE U—ATE' . If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) 7-1 ^-(' `i1.4/'(- [i'i!,/C /rJ ( :/G i The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the `•` �!!� )c % kir public water system was completed on� " ^ (date). The system is hereby granted interim approval to operate for 90 days following the cpmpletion date. BY v — ea TITLE .__.... DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. Bti' TITLE DATE�� ( &A*VN`4M