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aT sa uotszntpgnS s3,zBd T?iquoTo0 `4}[TS `9`I PL -01 UTsm aOusIszp zo !Umou-q 3z 'uoTioaS 'a$usg 'dTgsuMoS :3o ssaapps) uoTapooZ u:oQ TTaM 3o astl uos}joBr °Z°y zauMO TTaM saav .ON a3s3z3T3190 uos mogy/uapaop zaTTTJa 'ON ITml@d 'ON TTaM °o uI ` uTTTtzQ A—W °00 2UTTTIzQ 99/9.,` NI 'I'II3 SON OQ 001I NalillI2IQ 'TISM HailvM T�Z M -10A 'M MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 050 -301-16 Certificate of On -Site Systems Approval OSC251250 Expiration Date: 6/19/2026 Legal description COLONIAL PARK BLK 3 LT 6 S2 Site address 19807 FIRST ST Current property owner(s) MAY FREDRICK G & DEBRA J X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or conditions: No comments M bedrooms, with the following stipulations: Original Certificate Date: 7/9/2025 ThisCe icate of On -Site Systems Approval (COSA) is intended to demonstrate the subject syst (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Dielopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-301-16 Complete legal description COLONIAL PARK BLOCK 3 LOT 6 S2 Location (site address) 19807 FIRST STREET EAGLE RIVER, ALASKA 99577 Current property owner(s) MAY FREDRICK & DEBRA 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: FN Private Well serving # 1 dwelling units El Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: EJ Private Septic E] Private Septic serving 2 dwelling units ❑ Holding Tank FE] Community Septic or Public Sewer 5. SEPTIC TANK: M Steel ❑ Plastic E] Concrete F-1 Fiberglass Age - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: [] AWWTS F] Bed R Deep Trench R Wide Trench R Seepage Pit Waiver request for: Expedited review requested: F-1 Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $0 0 U Waiver Fee $ Date of Payment &13 s— Date of Payment COSA # o S C � �-) 9-m — Waiver # COSA App1jcafion_Apr2025.doc COSA Checklist_May2025 copy 2.docx COSA Checklist Legal Description: COLONIAL PARK BLOCK 3 LOT 6 S2 Parcel ID: 050-301-16 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 1971 Total depth 325 ft Cased to 325 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/19/25 Static water level at beginning of test 286 ft. Well production at time of test 4.5+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.72 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by & Sullivan Date 6/19/25 & 7/1/2025 Comments: Sullivan extended casing & chlorinated water system. B. TANK DATA – PUBLIC SEWER Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_May2025 copy 2.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No NA ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No NA ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 07/05/2025 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 07/05/25 MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE: (907)564-2762 BLOCK/LOT/TRACT BLK 3 LT 6 S2 WASTEWATER CONNECT PERMIT DATE OF APPLICATION SCHEDULED COMPLETION DATE 00 - 5675 11/02/2000 12/31/2000 SUBDIVISION COLONIAL PARK JX' SINGLE FAMILY [] MULTI-DWELLING No. APTS [] COMMERCIAL TAX CODE 5030116 GRID nw55 AS-BUILT STREET ADDRESS 19807 FIRST ST OWNER MAY FREDRICK G & DEBRA PHONE MAIL ADDRESS 19807 1ST STREET EAGLE RIVER, AK 995778432 CONTRACTOR SOUTHFORK , ' Repair Existing Service [X] On Property Only Hydrant Only City Tap SO' or Longer Main Tap - ToJProperty Line Only "" \~\n tap & On Property Connect | | Disconnect [ I R & R - Main Tap Only Row No. ASSESSMENTS _ | Have Been Levied K-Jo Be Levied Comments: 7 ••V pwner CONNECT SIZE 4 "ISSUED REIMBURSABLE NUMBER INSPECTION FEE $ PERMIT FEE $ $ DEPOSIT $ TOTAL $ 104.00 35.00 0.00 0.00 PAID Q CASH [] CHECK # [BOTHER INSPECTED BY 139.00 DATE // / i-oy REMARKS PERMITTEE (Please Print) MAIL ADDRESS SIGNATURE Cr.PHONE -Tf I POST IN A CONSPICUOUS PLACE AT THE JOB SITE AWWU INSPECTOR Original DATE SCHEDULED TIME SUBDIVISION COLONIAL PARK INSPECTOR BLOCK/LOT/TRACT BLK 3 LT 6 S2 JOo. +* * SIZE MAIN:TYPE MAIN:DEPT AT MAIN:AT PROP. LINE: CONNECT LOCATION: U' L FAST COMMENTS: AT QtH/nd <?c INSPECTED BY:DATE: 0V LIP, fij�. at -m- -.1 . -� Sb9'bb' UU" E 132. UU' 0 ro X FIRST STREET -- — — — — — — — — ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: COLONIAL PARK SUBDIVISION SOUTH 1/2 LOT 6 BLOCK 3 PLAT P-688 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoulc any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E—MAIL: JUNE 28, 2025 1 "=30' schullerak®gmall.com 25-069 DRAWN BY: CHECKED BY GRID NUMBER: BOOK AGE: JLS NW0055 250222 OO = FND 5/8" REBAR Aqw- 0 F �\ i�..• 4 CITH �. .:.... ........... ........ ?A ,.� ... .? OHN L. S CRULLER.• o / LS -10408 � 1e �i 1 Ar'•� \� o f 4( 6 e s n o� �' O„ 0 SUR V N V�`o � �cn `' • �,.,.� • .... tea'" 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax }tai ;r- - r xui4 6u1ploH r z .T i &.. i tar. .:} z..»+,z F^x :_ { EMM t x ' • 8j!s LnpIAIPUj�� 1 s x F. :lVSOdSia U31VM31SVAh:J0 3dAl �wa;sits jo snjr?js pus OleBal ay; of But,<- JsaJ4s 03Oy assts woJJ uollsw.aluoo ua.4uM apinord `wa;s�Ss paM iunwwo0 � 31ON Jaz t*s f Y, jjaM i nww naN► tpnniAMU 3. 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LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANC Well on D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent lots Manufacturer Manhole/Access "Pump off" Level at Cycles tested Surface water ► 91 1 `� e, ► Soil rating ��� S stem e G�iB G Date installed � ng (GPD/Ftz) /ov y type r � � Length I' -S- /?3' Width -2 • Gravel thickness u� ,sTotal depth //P Total absorption area 920 i-ul lc2 Cleanout present(D/N) __Depression over field (Y/� Date of adequacy test & -,2 / e/ s Results (pass/fail) 1 ,9 5 for - F Bedrooms Water level in absorption field before test D H After test l Peroxide treatment (past 12 months) (Yqg If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot lb o On adjacent lots 97 Property line /b ' !� To building foundation 3-o ' To existing or abandoned system on lot On adjacent lots 30 ( 4-- Cutbank r•I 1 Water main/service line !c 4 - Surface water l 0 ° (4-- Driveway, parking/vehicle storage area Curtain drain IJ/4 Sf--J— (-r� V- /tri E. 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