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HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 3 LT 28Kni*k View Estates Block 3 Lot 28 #015-043-30 Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030089 PID Number: 015.043-30 Nef18 MM&M Contracting Wastewater System: New Address: P.O. Box 670495 Chu iak AK 99567 ABSORPTION FIELD Phone: 688.1236 Number of Bedrooms: Four 4 Deep Trench LEGAL DESCRIPTION Sal Rating: Total Depth it=ongtnal grade: •8 GPD/F0 11.5 Ft. Block: Lot: Subdivision: Depth to pipe bottom from onginal grade: Gravel depth beneath pope: 3 28 Knik View Estates 3.5 Ft. 8 FL Township: Range: Section: Fill added above original grade: Gravel Length: 0.1 Ft. 47 Ft. Well: Class A Well Gravel width: 3-4 Number of lines 1 Distance between lines: Ft. FL Classification (Private. A. B. C) Total Depth: Cased to: Total absorption area: Pipe Material: Ft. I Ft. 752 Fe ASTM 3034 PVC Driller. Date Drilled: Static Water Level: Installer: DateInstalled: FL MM&M Contracting 1 8122.2512003 Yield: Puny Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding lublictPrivate J `°` ` y 'A wbons. From Tank Field Station Tank Sewer Line Anchorage Tank 1250 Well >200' >200' NIA NIA NIA leria: Steel Nurnoer of Cornpannts: Two (2) Surface Water >100' >100' NIA NIA LIFT STATION — NONE ON LOT Lot tine >5' >10' NIA NIA t. Gat. o:a J . Foundabon >5' >10' NIA NIA urpon eve a. umpo ve at. t water warms. In. In in cunan None Noted Pump Make 8 Model Electrical Inspections performed by: Dram Reraft: BENCH MARK ora.on and Dewip4on. Garage Slab. sume peva ion. 100.0 Ft. Engineer's Stamp OF Inspections performed by: MEA Dates: let 8124103' a9th .�...f;� 2nd 8125103 i-'...1 r Department of Health and Human Services approval r T = Ia1CHAEL E. ANDERSON 'C � '. in . : �= Reviewed and approved by: � Date: _ 03 ♦ No. CE -4381 Ar OJjF.dir ��� fp.... • (Rev 10") M\0,- Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030089 PID No. 015-043-30 A 8 51 10.0 17.8 52 17.9 15.0 C4 35.8 46.7 M1 36.8 45.1 CS 38.4 46.7 WEST 253.53 / C4 % Fou Bedroom 28 Home / S2` a /Alt. Sile TH3 51 A a /� TH2 M1 C5 TH1 Q WEST 278.08 AS -BUILT PLAN SCALE 1• • W 4 LOT 28, BLOCK 3, KNIK VIEW ESTATES SUBDIVISION MICHAEL E. ANDERSON . No. CE4381 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030089 N 1.250 CU UU Page 3 of 3 PID No. 015-043-30 Cn U U H X 2 er S U 49th' PROFILE AS -BUILT t MICHAEL E ANDERSON .�� f�, . No. cE-438I Scale: 1' = 19 ��.=�c7 ................... F 1 2 3 4 5 6 IZ 1 14 15 16 17 6 - MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: MM&M Contracting DATE PERFORMED: 8/22/200 LEGAL DESCRIPTION: Lot 28 Block 3 Knik View Estates Subdivision (�j� TEST HOLE # 3 SLOPE SITE PLAN II I I I I I II OG/OLPROJECT # I I s a: • •, *4.• • Silty Gravel "•: a W/Sand Clusters GM WAS GROUNDWATER • • ENCOUNTERED? a: GROSS TIME NET TIME DEPTH OF WATER •a ' Start 8/22 2:05 8.62" 1 2:35 30 6.12" 2" echarge 2:36 9.25" aW.• 3:06 30 7.25" 2" Recharge •. , �� E 3 3:37 '° BOH @ 18' IF YES, WHAT DEPTH? zoi DEPTH OF WATER None AFTER MONITORING: DATE: 8/29/2003 S L 0 P E SEE SITE PLAN SEE SITE PLAN READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 8/22 2:05 8.62" 1 2:35 30 6.12" 2" echarge 2:36 9.25" 2 3:06 30 7.25" 2" Recharge 3:07 9" 3 3:37 30 7" 2" PERC RATE: 15 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 7.0 FT. AND 8.0 T. COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED BY: M. ANDERSON I, MICHAEL E. ANDERSON. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 11/6/2003 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW030089 TLegal Description: Knik View Estates Block 3 Lot 28 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: PO Box 670495 Anchorage , A 99567 - This permit is for the construction of. r✓ Disposal Field 2✓ Septic Tank All construction must be in accordance with: 1. The attached approved design. ILIA I O Nil, < I/. 03 (�,3b_60 Date Issued: Apr 17, 2003 Expiration Date: Apr 16, 2004 Parcel ID: 051-043-30 Site Address: NHN Judd Cir Lot Size: 24188 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 Holding Tank F� Privy Ej Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. —x-03 Ocr.tiy 7`�/� �. ,xvv,:t-� systt.� to O ty e.- TCf S 7`,. 7r r on Received By: Issued By: flcda Date:ta�� / - 0- Z� Date: I / -7103 Municipality of Anchorage Development Services'Department'�, Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW 030089 Property owner(s)) MM&M Contracting Day phone 688-1236 Mailing address (1) P.O. Box 670495 Anchorage AK 99567 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 28, Block 3, Knik View Estates Subdivision Legal description (Section, Township & Range) Lot Size ,;Z,NI2q Acres 0q.FL THIS APPLICATION IS FOR: Number of Bedrooms Four (4) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. n1'L„G F_ (Signature of property owner or authorized agent) Io Permit Fees: 'q0D Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 337Y6 Receipt Number: (Rev. 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) April 14, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 28, Block 3, Knik View EstatesSubdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 28, Block 3, Knik View Estates Subdivision intends to construct a four- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the home. The subdivision is currently served by the Municipal water system. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and alternate site and the parameters used in the design. Also identified on the plans are the test hole locations and the water service lines and septic systems on the surrounding lots. Drainage arrows and contours are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test holes placed near the location of the proposed absorption trench indicated silty gravel with varying amounts of sand and a percolation rate of 12 minutes per inch. No ground water was found during placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a 1,250 gallon septic tank and a new 54' long by 3' wide by 7' effective depth absorption trench. The total depth of the trench will be 10' below the surface with the distribution pipe at 3' below the surface. Sufficient fill will be placed to prevent freezing of either the septic tank or the absorption trench. The ground surface on the lot slopes as shown on the site plan from south to north at varying slopes. The absorption trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from any surface water and wells in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells Lot 28, Block 3, Knik View Estates April 14, 2003 Page Two in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, :E• Michael E. Anderson, P.E. Attachments -'�),.- L9• : 49th WD-AEL E. ANOERSC% No. CE -4391 . fA�F SS Im 1 m RANKIN r j 29 28 f77 � �s yo �.t arA»y.rvr. / •// .(�`ro if 27 r _ r �.. isles _ JUDD^ Circle�s 22 26 4P 25 3 OF ••,. .• PSE ............ ^( AREA MAP 4t. .. 49th iyh..:............. SCALE 1" C 100' I�6, MICHAEL E ANDIRSON 1. �l ; No. CE MI �# •4 1��ES5���� o� WEST 253.53 YJ ,Q ` 4Valer 28 Cinee`Y��' i� 5d, \St 54' Long x 3' Wide o i�� x 7' Effective Depth a\ r Four 1.250 Gallon Absorption Trench \a O to Bedroom Septic Tank a C:) Home Alternate Site ® TH 2 C) 15 ® TH 1 .o WEST 278.08 OF SITE PLAN 4 h :., ............._.._ :.._ ............... _........... ................ .. SCALE 1" = 50' #)0-0. M�LE.ANDERSON l; •�; No. cE4xi e�i p+ LOT 28, BLOCK 3, KNIK VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Pere. Rate: 12 Min./Inch 1,250 Gallon Septic Tank Avg. Application Rate: .8 GPD/SF 7' Drain Field Rock 4 Bedrooms X 150 GPD /..8 GPD/SF = 750 SF of Absorption Area 750 SF/14 SF/LF = 53.6 LF Trench Length Therefore: Construct an Absorption Trench 54' in Length by 3' Wide with 7' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground . Total Depth of Each Trench to Be 10' Below Existing Surface. Cover Over Septic Tank a Minimum of 4' or 2" of Insulation and 2' of Cover. Cover Over Trench 3'. Ratural• Backfill 2'6" ' Geoteztile . Fabric 6" 710"�orated.PVC Schedule 40 " Drainfield Rock 00 3' ����aaaaaa TYPICAL DEEP TRENCH SECTION ' �j (NO SCALE) = ri••� 49tti !V NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. L,*, ; uiamu c .omrRSON Minimum 10' From Lot Line. �� s No. n-4381 .1 < ��i�F`•.. Minimum 4' Separation From Groundwater.Minimum ' 4��: a. ,�,; ♦� a ��• Minimum 10' Separation rat on From Water Service Li e. �S:a� 1 2 3 4 5 6 L MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 PROJECT #: M0312 SOILS LOG — PERCOLATION TEST PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION DATE PERFORMED: 3/27/03 LEGAL DESCRIPTION: LOT 28, BLOCK 3. KNIK VIEW SUED .TEST HOLE # 1 SLOPE j _0 OG -RED -BROWNISH SILTY SANDS W/ GRAVELS POORLY GRADED SANDS WITH GRAVELS & LITTLE FINES - SP WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: BOH 10%1 NO NONE 4/12/1003 S L 0 P E SITE PLAN N TH2 TH0 0 NO SCALE / SEE ASBUILT 2% READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 3/27/03 847 8.25" 1 917 30 5.75" 2.5" Recharge 9:17 901, 2 947 30 6.375" 2.615" Recharge 9.47 9.25" 3 10:17 30 7 0" PERC RATE: _2 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 4 5 FT. AND 55 FT. COMMENTS: NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE 11 WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 4/13/2003 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17. 18. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH a HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 PROJECT #: M0312 SOILS LOG - PERCOLATION TEST PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION DATE PERFORMED: 3/27/03 LEGAL DESCRIPTION: LOT 28 BLOCK 3 KNIK VIEW SUED TEST HOLE # 2 SLOPE SITE PLAN OG - RED - BROWNISH —r//A SILTY SANDS W/ GRAVELS .10i1 POORLY GRADED SANDS WITH GRAVELS & LITTLE FINES - SP WAS GROUNDWATER ENCOUNTERED? NO S NET TIME L IF YES, WHAT DEPTH? 0 DEPTH OF WATER NONE P AFTER MONITORING. E DATE: 4/13/2003 '_ 49th -7} MKNAEI E. ANDERSON No. EE•u&I �fR0FESS%to BOH N TH2 TH10 0 NO SCALE / SEE ASBUILT . 2% READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 3/27/03 9.00 11.0" 1 9 30 30 8.25" 2.75' Recharge 9.30 12.0" 2 1000 30 9.5" 2.5" Recharge 10.00 9.5" 3 10:30 30 7 0" PERC RATE: 12 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 45 FT. AND 55 T. COMMENTS: NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 4/13/2003 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 28, BLOCK 3, KNIK VIEW ESTATES SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 -gallon tank at the location shown on the site plan. Work also includes the construction of a new absorption trench 54' long by 3' wide by 7' effective depth also at the location shown on the Site Plan. The total depth of the trench will be 10' below existing ground and the distribution pipe will be placed at 3' below the surface. All components of the new absorption trench and septic tank must be constructed a minimum of 100' from any surface water or wells in the area. A minimum of 4' of cover is required over the septic tank and 3' over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,250 -gallon septic tank must be procured from a certified septic tank manufacturer if the existing tank is found to be defective. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. • Lot 28, Block 3, Knik View Estates April'14, 2003 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). • _ Lot 28, Block 3, Knik View Estates April 14, 2003 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-043-30 . Expiration Date: 1. GENERAL INFORMATION Complete legal description Knik View Estates Block 3 Lot 28 Location (site address) 22723Judd Dr. Chugiak:. AK Current Property owner(s) Troy Sayer Day phone Mailing address Real Estate Agent Po Box 772121 Eagle_Riv_e_r, 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ❑ Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 5 O Date of Payment q%%2'2% Receipt Number ? 1 COSA# 0SCa111 C0 s 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 ARCTERRA CONSULTING, INC._.___ Phone 696-6111 Address 204,41 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS _ Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ®. it encroachments, deficiencies or discrepancies exist.10, (, 7k 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. r T "10 Disapproved. Conditional approval for bedrooms,,ming stipulations: ON-SITE WATER AND __-WASE-v"ATER PROGKAM JJ� ©,0 SER�,�G, r Original Certificate Date: 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 Septic System Advisory Well Flow Advisory COSA blue sheet -10-10-12 doc X _ Nitrate Advisory Arsenic Advisory Other Legal Description: COSA Checklist Knik View Est. Block 3 Lot 28 If more than 1 septic system on lot: COSA Checklist # L DATA ❑ Welfed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 18 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49" E■E Standpipes/foundation cleanout per record drawing Date of pumping 4/21/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/214/03 01 ALL standpipes present per record drawing Total measured depth from grade 11.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field MI Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-043-30 of , Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) ug/L ❑ Arsenic less than MRL (ND) Collected be Date of Sample FT STATION ❑ Requir intenance completed Age of lift station ears Lift station material Comments: Adequacy test date 4/7/21 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 70 in Water added 600 gal New depth 74 in Elapsed time 1440 min Final fluid depth 70 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Li on Lot > 100' Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Iding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Con > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Stora _ Community Sewer Main > 75' ❑ Yes if No ft ❑ Ye ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5+* ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS * Meet requirements at time of construction. G. ENGINEER'S CERTIFICATION 1 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. COSA Checklist yellow sheet ft ft ft ft Municipality of Anchorage Development Services Department \ Building Safety Division t On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING SI Parcel I.D. 76-043.30 1. GENERAL INFORMATION Complete legal description Location (site address or dir HAA #��� S —1 Expiration Date: Current Property owner(s) MM8,M Contracting - Day phone 688.1236 Mailing address P.O. Box 670495 Chugiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing;Address • • reg Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER.OF.BEDROOMS: Four(4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) .safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522.7773 Address P 0 Box 240773 Anchorage AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 1116/2003 '' 49th �'. : E, MICHAEL E. ANDERSON ♦ . t 5. DSD SIGNATURE ♦�. �'' NoCE'M Approved for _ bedrooms. �h���,gt:•� Disapproved. Conditional approval for bedrooms, with the following stipulations: ON-SITE *: Additional Comments �S : 1AF�C Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: G[/, Original Certificate Date: (Rev. 12/00) Municipality of Anchorage Development Services Department �i Building Safety Division 7 " On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 28, Block 3, Knik View Estates Subdivision Parcel ID: 015.04330 A. WELL DATA Well" If A, B, or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft: ft: Well production 9.p-m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate mg./l. Other bacteria colonies/100 ml. Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material SepticiSteei Date installed 812412003 Tank size 1.250 gal. Number of Compartments 2 Cteanouts (Y/N) Y ` Foundation cleanout (Y/N) Y " Depression over tank (Y/N) N High water.alarm (YIN) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA I Date installed 812512003 Soil rating (g.p.d./ft2 or ft2/bdrm) .8 GPDISF System type Deep Trench Length 47 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 11.5 ft. Eff. absorption area 752 ftZ Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in Datum Size in gallons "Pump off"level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot NIA Absorption field on lot NIA Public sewer main NIA Sewer /septic service line NIA Manhole/Access (YIN) High water alarm level at Meets alarm & circuit requirements? On adjacent lots NIA On adjacent lots NIA Public sewer manhole/cleanout NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >5' Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections andAN : {c review of Municipal records that the above systems are in ..../ 49 h ................. conformance with MOA HAA guidelines in effect on this date. MICHAEL E. ANDERSON Engineer's Printed Name Michael E. Anderson. P.E. No. CE -4381 Date 111612003 HAA Fee S_' -Z -j f5 "— Date of Payment a Receipt Number �i�i % q L \ (Rev. 12/00) Waiver Fee S Date of Payment Receipt Number in. FROM COUNTRY REALTY PHONE NO. 9076881238 Oct. 13 2003 11:04AM P4 `•.� •`Qr •Sjy �r ��-• r.: ^, jr: ->•• :' .i. !%tt:}_+=:C. •�•• •'y` .:r+•' •"'�� L,'r'1 ii. j:r :i.%t'• .l�,t• .1 S•`j .wy :�,w...a �• L...,,_.r. •r` ;�s .♦� • .••�: is ;M,•,� _ I�•.:i: •l•I,^�y� yM1�l: r • •••t r ,: •:f; - •N •I:, '' •,4 .• •!•.J .:{ •, :_ :., S •4 t•._ Y.fj,` ,i. `�� �•4..R� •,.�•, v"".. Lr: iJG' .dtJ q• . }....•rp^' •.y. • sty:' .ti S. r.''J,.... "1•::.!_ .:at1-�C.it 't.i/•:,,°.'♦„' w:� ••,^L t �•. 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