HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 3 LTS 9 AND 10Lakeridge Terrace Lot 9 & 10 Block 3 #051-313-14 Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES. ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW000440 PID Number. 051-313-14 Name: RAY PRICHARD Wastewater System: O New ■Upgrade Address: 17719 BLUE SPRUCE EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: (907) 345-0043 No. of Bedrooms: 3 0Deep Trench ■Shallow Trench ClBed OMound ■Other* LEGAL DESCRIPTION sss R•tv r. •2.0 Told Depth from orlg� pear cpo/5a. n. TOP OF SAND ® O.G. it Lot Black: Subdivision: 9 & 10 3 LAKERIDGE TERRACE Depth M pipe eoaorn eom odgh l pwr +0.5' &svW depth ew th p,pr 0.5 n. rL Township: Range: Section: FM soda Deep.. a,psd rode: Gow k gin: _ — — 3.0'-3.5' Ft. 45 r< WELL: ❑ New l7 Upgrade Draw .Wlh: 5 W ew of anew 1 DYtenoe ed.ewl Lner — r< In. Ck,eefc Pdvote, A C : Told Depth: Ta Told oboorptlon vex pipe mdvbk R rL 225 so. rL ASTM D-3034/SCH 40 PVC Dr . Dote DrOW: Slnlio Wdv Lew: Lwtop . EAGLE MTN. EXC. Date kwWW: 10/18-20/2000 R ndx P SO w � Height &� TANK DPM r, n SEPARATION DISTANCES aseptic 0Holding ■S.T.E.P. To Septic Tank Absorption Feld Uft Station Holding Tank Mk/PrNats Soww Lkeq Maedechaer: ANCHORAGE TANK Copa4d ti ed 1500 From Well 100'+ 100'+ too'+ — 25'+ Nale bk STEEL Nunlbw d eanwanrn 2 SurfacWater Water 100'+ 100'+ 100'+ - - LIFT STATION Llano 5'+ 10'+ 5'+ — — 1500 ANCHORAGE TANK/ RENCO SYSTEMS Foundation 5'+ 10'+ 5'+ — — saw on � —TIMER A r.d aL TIVATED— N—o evw d 0. 1 46" Curtain Drain NO�N Pump slake a MW - 20 051 05 HHF Deculow ewpedlane Wfomwd ey: ALCAN ELECTRIC 7MKNOW �E Remarks: • THIS IS AN ADVANTEx FILTRATION BENCH MARK Loadfan era D••crliuo•: SYSTEM. TOP OF FLASHING OVER CMU AT POINT "C" ON GARAGE Aernwd Etvvot : 100.00 In. eMaetee¢s oo�0 4 o� 4 P Inspections performed by: AWWC, INC. Dates: 1st 10/18/2000 -37 ........ . . .......... 21 2nd 10/18/2000 3rd -4th 10/19-20/00 D QO. P • J fr A. rness.: T7 �4 H Department of Health and man Services approval � • -7953 svv Reviewed by:106-1-Date-11-Ag-10D and approved 10rofesslon0005' oO00�0��� —015 . 91") Lrae 25 PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO SW000440 051-313-14 1 — 10' UTILITY EASEMENT 4 I \ \ TEST HOLE \ PERFORMED BY I KENNETH M. DUFFUS, \ P.E., ON 6/22/98 8 Al, NEW DRAINFIELD� LOT 9 NEW 1500 GALLON• S.T.E.P. TANK WITH ADVATEX FILTRATION SYSTEM A 1 B 1 C FC01 149.770134.585 76.725 C01 63.655 38.415 61.280 FCO2 79.080 52.035 4.085 ST1 91.080 76.965 45.655 MH 97.740 85.215 54.695 CO2 105.28 94.415 64.635 MT1 103.82 93.645 65.475 co -3-1140.711135.38 109.01 MT2 1139.821134.86 109.17 LAIRUNE. INSTALLED I INTO CRAWLSPACE IN GARAGE FOR POSSIBLE FUTURE CONNECTION TO _�A NR BLOWER � I r NG THREE OM HOUSE \ LOT 10 GARAGE BLUE SPRUCE LANE \ / 9 SEPTIC TANK AND DRAINFIELD WERE f" a 10/26/2000 P a F e i SA 1 DRAWN BY: pp . ALASKA WATER & «TASTENVATER SSE: C.J.G. �. CONSULTANTS, INC. 1 ^ = 40 6901 DFRARR ROAD. WTE ER • ANCHORAGE. A6 00504 • P~(007)337-0170 • FAX 07)336-3716 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: O •• RAY do MARGIE PRICHARD (907) 345-0043 2 OF 3 Q fir A. LEGAL DESCRIPTION: QQ °L• E-7! LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 do 10, BLOCK 3, �04�, ' •.., TYPE OF AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE (ADVANTEX SYSTEM) 4 %= II PERMTTSWO NUMBER: A S � B U I LT DRAWING F051 ID NUMBER: SW000440 051-313-14 ORIGINAL GRAM Af TE5f HOLE - 95.83 iPJCX1.N4f POD5 for Oft Af Wf - 95.55 - 95M CAVGJ 965 Af A fP19.lXN)E -99.55 mi NSW 1500 ci&LON 5,T.U. TANK Mf f0F 0f W- 9589 (AVG.) � Bottom Of lee - 9535(AVGJ `MxXOf PPE - 963!,(AVG) ODER 0.5'+ Of LEVELiz 5AW 10/26/200 DRAWN BY: ALASKA «'ATKR & NVASTIMIATL'R SCALE: C.J.G. CONSULTANTS, INC. N.T.S. 6901 DERARR ROAD. MATE NI • ANCHORAGE. AK 99304 • P~ (901)337-6179' FAX (007)3393246 PREPARED FOR: FHONE NUMBER: PAGE NUMBER: RAY do MARGIE PRICHARD (907) 345-0043 3 OF 3 LEGAL DESCRIPTION: LAKERIDGE TERRACE; LOT 9 do 10. BLOCK 3. TYPE OF WORK: PROFILE AS—BUIT OF SEPTIC SYSTEM UPGRADE (ADVENTEX SYSTEM) of mMNOLB -10.49 07 Of f" )LW -9588 rmw TOP Of %V IS Af ORIGINAL GRAM GROIACIWATER Af 9083 ON I 10/ I5/ 00 8 10/ 18/ 00. 5EE AffAC&P LETTER. —7953 : f� ALASKA WATER & WASTEWATER CONSULTANTS, INC. November 9, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED NOV 15 2000 Municipality of Anchorage Jf3Pt Health & Human Service,, Ref: Groundwater Concerns at Lake Ridge Terrace Subdivision; Lot 9 & 10, Block 3 To whom it may concern: This letter is to address any groundwater concerns for the new drainfield installed on 10/18-20/2000 for the referenced property. According to Kenneth M. Duffus, P.E. (KND Engineering) soils log, groundwater was encountered at 5 feet on 6/22/98 and then at 4.1 feet on 8/3/98. Prior to the installation of the drainfield.the monitoring tube was checked and groundwater was found to be at 5 feet on 10/15/2000 and on 10/18/2000, which is considered to be the high groundwater season. It is our opinion that the 8/3/98 performed by KND Engineering, which showed groundwater to be at 4.1 feet, is probably not accurate, given that the test hole around the monitoring tube was an open pit which probably allowed rainfall and surface runoff to skew the readings. It is our opinion that the groundwater readings taken by our firm on 10/15/00 & 10/18/00 is the accurate high groundwater level. Prior to the installation of the drainfield, original grade shots were taken and found the ground level at the test hole to be at 95.83. Due to that irregularities in the contours, excavation was limited to 4.5 feet above the groundwater level taken on 10/18/2000 and a 0.5 foot below the original grade shot at the test hole (95.33). The sand filter level was brought up to the elevation of the original grade at the test hole (95.83) which would give a 5 foot groundwater separation distance from the bottom of the new drainfield to the high groundwater level. If you have any gftstions, please contact us at 337-6179. Thank you for your assistance. P,E.. M.S. 6901 Dcbarr Road, Suite 213 * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com i i Alcan Electrical Engineering, Inc. 6570 Arctic Spur Rd. Anchorage, Alaska 99518 Fax Cover Sheet DATE. November2, 2000 TIME: 12:17 PM TO: AWWC PHONE: 337$179 Jeff Gamess FAX: 338-3246 FROM: Alcan Electric PHONE: 563-3787 SMpp Bringmann FAX: 5628286 RE: Lot 9 and Lot 10, Block 3 of Lakeddge Subdivision RECEIVED N0V 15 2000 Municipality of Anchor++,a Oept. Health & Human So.. ces Jcff- In regards to the sewage lift stations that Akan connected at the above mentioned locations. All electrical work performed by Alcan was done to 1999 National Electrical Code, (NEC) standards. If you have any questions please contact me. Thank you! Number of pages Including cover Asst 1 i l 'd OZWON X1810313 NV31V N11:1 0001'Z 'AON MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 3434744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW000440 Legal Description: LAKE RIDGE TERRACE BLK 3 LT 10 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Ray Prichard Owner Address: 17719 Blue Spruce Anchorage . AK 99516- 1-no�ec tray--� /o/Woo Gg lc2 p' ,'� is// 9/od Date Issued: Oct 17, 2000 Expiration Date: Oct 17, 2001 ParcelID: 051-313-14 Site Address: 017719 BLUE SPRUCE LN Lot Size: 26500 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy El Private Well El Water Storage All construction must 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by tailing (907) 343-4744 ( 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. Received By: Issued By: Date: Date:/0 —/7-0O ALASKA WATER & WASTEWATER CONSULTANTS, INC. October 3, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lots 9 & 10, Block 3, Lake Ridge Terrace Subdivision RECIRCULATING TRICKLING FILTER (AdvantexT,) SYSTEM To whom it may concern: 1. GENERAL: The existing 3 bedroom home is served by a private well and septic system. The existing septic system is surcharged and must be upgraded prior to the sale of the house. The property owners recently purchased Lot 9, which is vacant. On 9/15/98 a sewer permit was issued (SW980359) for the installation of a Reactex septic system on Lot 9. This permit has since expired. Per your approval, we are proposing to revise the previous design to utilize the Advantex technology, and modify the drainfield size to meet the application rates recently established by the department. 2. SOILS: See the attached log prepared by Ken Duffus, P.E., which shows the soil classifications, groundwater monitoring, and the percolation test results. 3. DRAINFIELD APPLICATION RATE: The intent is to install a Recirculating Trickling Filter (Advantex) System that will allow the use of a small drainfield in the area around the 30 foot radius of the test hole. The size of the drainfield will be based upon an application rate of 2 GPD/FT2. We are proposing to install a 5 foot wide drainfield that is 45 feet long and has an effective depth of G'. We will excavate to a depth of 1 foot, install a 1 foot layer of filter sand, and then 6 inches of clean, washed sewer drainrock below the distribution line. 4. TRENCH DESIGN: a. Percolation Rate: 20 minutes/inch b. Allowable Application Rate: 2 gallons/day/O c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 225 f12 6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Far: (907)338-3246 f. Total Depth: 1 foot (max.) g. Effective Depth: 0.5 feet It. Width: 5 feet i. Reduction Factor: 1 i. Minimum Length: 45 feet long j Effective absorption area = 225 fi2 4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling filter will be manufactured by Anchorage Tank A Welding to meet the latest design criteria established by Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their standard STEP tank, it is equipped with a high water alarm per M.O.A requirements. 5. SURFACE NATER: There is no surface water within 100 feet of the proposed septic system upgrade. 6. TOPOGRAPIIY: As can be seen on the attached site plan, the average topography of this property is less than 10 percent, running from approximately east to west. In short, there are no slope concerns. 7. CLOSING: I am open to any suggestions from your department that would be an improvement to the proposed system. I am unaware of any negative impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call us at 337-6179. .E., M.S. NOTE: Attached is a site plan drawing, a design drawing, a trench profile, an Advantex profile, one soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debart Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246 i --------------------- ------------------------1 I JAMES WAY �� 1 LAKERIDGE TERR.S/D FRIDGE TERR. S/D LAKERIDGE TERR. S/D LAKERIDGE TERR. 5/D LOT 6, BLOCK .3 LDT S, BLOCK J. OCK J, LAKERIDGE TERR. S/D I LOT 6, BLOCK 3, LOT 7, BL�--���`♦ LOT 1, BLOCK 6, LAKERIDCE TERR. S/D 1 A -'1/ __— LOT 2, BLOCK 6, t— I --f"--- 1 T---—,-1 EXISTING BEDROOM HOUSEI ♦ / / 1 I / ♦ �1 �_ � ` ' �� ♦ uvroi/irr �ro1 LAXERIDGE TERR. S/D LAT J, BLACK 6. 2 1 i LAKERIDGE TERR. S/D \ LOT 4, BLOCK 6, \\ 1 1 I I 1 1 1 LAKERIDC LAKERIDGE TERR. S/D LOT 4, LOT 6, BLACK Sym `-SARC --J ------------'7 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD. SUITE TB • ANCHORAGE. M 99504' M4ONF (907)377-0179' FAX (907),736-074 PREPARED FOR PHONE NUMBER: RAY & MARGIE PRICHARD (907) 345-0043 LEGAL DESCRIPTION: LAKE RIDGE TERRACE S/D; LOTS 9 & 10, BLOCK 3, TYPE OF WORK- SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE `3EPRC ARE�D H JANE'-- \ \ 1 1 7�S/D" BLOCK 5. 10/3/2000 r------------ 1WN BY; 11 1 LAKERIDCE TERR. S/D / I I LOT 12A, BLOCK 3 H JANE'-- \ \ 1 1 7�S/D" BLOCK 5. 10/3/2000 1WN BY; K.D.W. � 74) qA uE loo, 1 " = 100' ..... 1 .......1 14 ;E NUMBER: iI .. 6: 1 OF 4 61 f r A. Gorness;% —7953 .` V1.�._•� ..... 'neo? 4• NR LINE TD TRICKLING FILTERS \ FROM CRAWL SPACE OR GARAGE. 3' / MINIMUM BURIAL AND INSULATE WfT I 1 / 2' WIDE BOARD NSULATION THAT IS 2' THICK. NO BUD OR NR COMPRESSOR REQUIRED AT THIS TIME. — . —PROPOSED DRAINFIELD. EXCAVATE k—1 LAT 9 1 TRENCH THAT IS ONE FOOT BELOW ORIGINAL GRADE MAXIMUM (REMOVE ALLI ORGANICS). BY 3 FEET WIDE, BY 45 JJ ABANDONED FEET WAC. ADD ONE F00T OF LEVEUN� \ \SAND, AND 0.9 iEET 01 CLEAN. WASH 3 OF 4 \ SEWER pRNNROCK. SEE PAGE FQR DETAILS. NSfALL TRENCH PARALLEL \ TO SLOPE CONTOURS.TEST \ HOLE I 7.777-71��. PERFORMED BY I PE. ON 8/22/98 CO \ \ LOT 10 i EXISTING THREE / BEDROOM HOUSE INSTALL FOUNDATION UT PVC. MOUND SOIL COVER I OLEAPREESENT NOT & INSULATE AS REOUIRED PROPOSED 1500 GALLON ( \ S.T.E.P. TANK AND ADVANTEX INSTALL FLOW r FILTRATION SYSTEM. SEE PAGE DNERTER IF GARAGE I T 4 OF 4 FOR DETAILS. GRAVITY FLOW TO EXISTING I I FIELD CAN BE I I OBTAINED I I I / � I BLUE SPRUCE LANE_ �C I a ALASKA «'ATF4,k & NVASTI;`VATER CONSULTANTS, INC. ...... wen•m w•n n•Ts sw • .R .,Cl AK 0930L • PHORF (907)3374179 ! FAX O7)338-374. 10/3/2000 K.D.W. 1"=40' RAY AND MARGIE PRICHARD (907) 345-00432 OF 4 LL DESCRIPTION: LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 & 10, BLOCK 3 OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE (ADVANTEX) EXISTING SEPTIC -EXISTING SEPTIC SYSTEM TO BE USED AS A RESERVE SITE. LOCATIONS ARE APPROXIMATE TANK TO BE COMPLETELY ABANDONED 7.777-71��. •. -EXISTING SEPTIC SYSTEM TO BE USED AS A RESERVE SITE. LOCATIONS ARE APPROXIMATE 9PP0RTA5REQIA I' or arm WA4fD 5`NER DRAA=. PROPOSED GRAINFIELD. EXCAVATE A TRENCH THAT 5 ONE FOOT BELOW F'�' ORIGINAL GRADE. BY 5 FEET WIDE. BY 45 FEET LONG. ADD ONE FOOT MINIMUM OF SAND. AND 0.5 FEET OF CLEAN. FUER FAXIC r -T' NRLATIQN EXfAVATEOUFN.L QFCvH.1C5. Am A" PERFORATED DP FFM Vft T' OF A MALML'M OP I' DFAIN?LL'X OVER TOP OF PPE AkV OF 5w 6" OF DMAARA7.INTER hE FPE. %1� SLQPE 10/3/2000 0 ► �p LASKA «ATKR & «A DRAWN BY: A ' f r [� � � WASTE CONSULTANTS, INC. 6001 OEBARR ROAD. $lX7E n' ANCHORAGE. AK 995M+PONE H 001)371 -0I]0 + FM(907)336-3246e-!]LO N.T.S. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RAY AND MARCIE PRICHARD (907) 345-0043 3 OF 4 QQ m : fr A. arnes- LEGAL DESCRIPTION: Q $� ' E-7953 LAKE RIDGE TERRACE SUBDIVISION; LOTS 9 do 10 TYPEPROFILE VIEW OF PROPOSED TRENCH 44��D0000��oo� AdvanTex Treatment System s NOTE: THEOSS ADVANTEX MANUAL AX Series - Mode I C9 c• "e9 Three (3) 34x48 Pods `r THE BOARD INSULATION TO BE INSSTTALLLL•ED CHER THE SEPTIC TANK & 4' BEYOND ON ALL SIDES EXCEPT UNDER THE ADVANTEX FILTER. THIS WILL ALLOW FOR HEAT TO ESCAPE FROM TANK & RISE TO THE FILTER ABOVE R. INLI FILTERS CONNECTED TOGETHER. THE TANK SHALL BE SIZED PER ANCHORAGE TANK FOR A THREE BEDROOM HOUSE TOP OF TANK A INLET - 96.81 Y n+wunoN�l[� INLET INVERT OF BUNG—/ AT INLET - 98.31 FINAL GRADE - 99.0 + FASSK AM K0(T M9AA= F809" M05 i 1500 GALLON C MIN.) Ak 5SEPA" 4e 7 10/3/200 if _.. _f'. _ I DRAWN BY: ALASlU «TATER & `VASTI:WATER SCALE. K.D.W. CONSULTANTS, INC. N.T.S. 6901 OFBARR ROAD, WTE 28 • ANCIIORAGF, AK 99504' "40NE 907).557'6179 • FAK 9072358-526 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RAY AND MARGIE PRICHARD (907) 345-0043 4 OF 4 LEGAL DESCRIPTION: LAKERIDGE TERRACE SUBDIVISION; LOTS 9 do 10. BLOCK 3 TYPE OF WORK: PROFILE VIEW OF PROPOSED TRENCH AND ADVANTEX SEPTIC TANK L'I1iPH EFFLUENT PUMP OF TANK AT ET - 96.73 1 1 THE AX -10 PODS SHALL BE PLUMBED SO THAT THEY CAN EACH BE ISOLATED. j ..: -C ••0lS9! C 7953 ..• •' .�oQ�, 0 PrOfee sl0naa j � �''n\ TT��1 �1�LJ ENGINEERING 20441 PTARMIGAN BLVD. �~~ EAGLE RIVER, AK 99577-8736 0�,.C' 49M • %'f 71 SOILS LOG - PERCOLATION TEST D�"• Q/7c/fib Performed for: -Rr' -1 �,��� Date Performed: G�u ,, , ; Legal Description: %u k[ ✓� d4c Te ma[ -en 3f k � Lee 4- 9 TEST HOLE s %8 Lepcn / (Feet) as4a"/"" r7kT 2- 3- 1 � 4 C; /ay 5- J Ia 7- $iown, /oaJe' s- Sme4e'j $-7 9- 10- >3o N 11- 12- 13- 14- 15- 16- 17- is- 19- 20- SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered?— What depth?.5 Deoth to water after monitoring? L Date —16,12418 Reading Date Gross Time Net Time Net Drop 2 /1.00/q '03 oDeh Wo1 - 9 (o 2-— 3 /:34/zo /� /Ni' ✓ 7/roy 4 rro M /2 /I:SS /�nlih •`' /o Percolation Rated (min/in) Perc Hole Diameter_ Test Run Between - 5 feet and /• 5 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date: 51VA5 Sent By: Alaska Water and Wastewater Con; 907 338 3246; Oct -4-00 11:49; • V. VV ♦V.. VY.VV •.,., YVIY�Y,. VV V,Y.• ....`.,.V.`M...`....• J` -- Municipality of Anchorage Department of Health and Human Services 825 OU Street P.O. Box 198880 Anchorage. Alaska 99519.6650 bryrJMww. da rrhora9a. dcus Dear Homeowner/Prospective Buyer. Page 1/1 The on-site wastewater disposal system you are purchasing/installing is an "alternative" wastewater disposal system. This system, known as an AdvanTex Treatment System Septic System:, is undergoing testing within the Municipality of Anchorage under the Alternative System section of the Wastewater Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership of one of these systems: 1. The technology used in this system has been shown to be effective in other areas. The system is currently undergoing a two-year testing period in Anchorage under the guide= of the Department of Health & Human Service$ (DHHS) and the State of Alaska Department of Environmental Conservation (ADEC) to determine its effectiveness in a subarctic environment. 2. The system for this property received a vertical separation distance waiver fiom both the State of Alaska and Anchorage Municipal Codes to ground water. This waiver was granted due to the system's expected performance within the site conditions on this property. I (we) certify that I (we) have read the above statements and am(are) aware of the risks outline. I (we) also certify that I (we) am (are) in the process of purchasing (property legal description): LOT 10, BLK 3,5 LOT 9, BLK 3 LAKERIDGE TERRACE EAGLE RIVER ,ALASKA RAY A. PRICHARD urebaser N (Purchaser Name) orthaser tvm=) (Purchaser Siouan) Notadu: Below State of� On � day of C 2019 _ personally appeared before me, V/ who is personally known tome whose iderrity 1 proved on the basis of whose Identity 1 proved on the oathhlinmarion of a credible witness to be the signer of the above docomeat, and hels ow a si c — - (Notary Public Signature) (Notary Public Printed Name) My commission expire 615- 02 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES ANCHORAGE RECORDER'S OFFICE 550 W 7TH AVE SUITE 1200 ANCHORAGE AK 99501-3564 (907) 269-8899 REC DATE RECEIPT NUMBER 10/17/2000 1478370 BANK CD/CHECK NUMBER: 2108 RECEIPT DESCRIPTION RECORDERS OFFICE FEE CASH AMOUNT: 0000 RECEIPTED AMOUNT: $0.00 $23.00 SERIAL NUMBER INFORMATION YEAR:2000 BEGINNING NUMBER : 52486 ENDING NUMBER : 52486 BEGINNING BOOK :3708 PAGE NUMBER :206 ENDING BOOK :3708 PAGE NUMBER :20 RECORDING FEES $21.00 FILING FEES COPY FEES CONFORMED COPY FEES PLAT FEES CERTIFICATION FEES MANUALS OVER SIX NAMES FEES NON REFUNDABLE UNAPPROVED FORM FEES OTHER FEES PLAT COPY FEES COPY SEARCH FEES INFORMATION SEARCH FEES MICROFICHE COPY FEES REMITTER: RAY A PRICHARD 12790 OLD SEWARD HWY UNIT B ANCH AK 99515 COMMENTS: D/EASEMENT R&M PRICHARD RECEIPT - DO NOT PAY NOTE: ORIGINAL RECORDED DOCUMENTS WILL BE RETURNED FROM MICROFILMING IN 4-6 WEEKS. $2.00 ,ice sai: BK 03708PG0206 DEED OF EASEMENT Grantor RAY PRICHARD and MARGIE PRICHARD, Grantor, of 12790 Old Seward Highway, Suite B, Anchorage, Alaska 99515, hereby grants to Grantee, RAY PRICHARD and MARGIE PRICHARD, of 12790 Old Seward Highway, Suite B, Anchorage, Alaska 99515, a certain easement with respect to the following described real property: Parcel 1 - Burdened Property Lot 9, Block 3, Lake Ridge Terrace Subdivision, Anchorage Recording District, State of Alaska Parcel 2 - Dominant Property Lot 10, Block 3, Lake Ridge Terrace Subdivision, Anchorage Recording District, State of Alaska 1. SEWER and DRAINFIELD EASEMENT. Grantor grants to Grantee, his heirs, successors and assigns, an easement for installation, access, repair and maintenance of a septic and drainfield on and across Parcel 1; said easement being conveyed for the use and benefit of Parcel 2; the users of said easement assume all risk of use, releasing the other user. Said easement is more particularly described in the attached Exhibit 1. 2. DURATION OF USE. Grantor grants to Grantee, his heirs successors and assigns, a continuing and uninterrupted right to the easement until such time as a community or municipal sewer system is installed adjacent to Parcel 2 and made available to the owner of Parcel 2. At such time as the municipal or community sewer system is installed, then this easement shall terminate within 18 months of the date that such system is made available to Parcel 2. Termination may be effected by the filing of a notice of vacation of easement by either of the owners of Parcel 1 or Parcel 2 at the end of the 18 month period noted above. DATED is _1 day of October, 2000. in 10/13/00 FRI 09:53 FAX 907 345 0247 DIOMEDE 12)003 BK03106PG0.201 Ll� TOOL 1 L__-_-- --- -- -- -----a -- ---r— ---- --- I f ------ ------ E14STRW Nou I II I mum" 1TEM. se Lm 14A2A.. 3. OU" I $ tAun 3. TERM Lm a 9LOCK turB� Rmc sa F#,= 2 O!' 3 roll newts. � 1 1 - - - - - - - - - - \ I 1 1 ! I 1 • 1 L / / T I I UIwu= IOtR. s/9 ► I / ! LOT 4. MACu R. L% \ `\ •• Ste/ % % 1\`` 111==K x3!/D IDT 4. MDC),f ��/ K IAKEm000 TOM. S/O / I �i 7••C� tA. MOCK S. • / / _/ / CAM FN' •rl� 10/3/2000 Q i� • _ ft ALASKA WATER & WASTEWATER ,G,L K ' moi;' CONSULTMITB.MIC.•---�-�• 1. s 100• •• •• ......L"ns•• Lutes • rpeow7/ • Pat PHM TRAetR VACS NL%URX .... ...:.. ' •' IOR ... RAY t MAROIE PRICHARD (907) 343-0043 1 OF 4 r A. LtwL OmmwnR-7953 ,•f� LAKE RIDGE TERRACE S/D: LOTS 9 t 10, BLACK 3. ,' •...,.. .. •''' ; PC 61f Wft5. ~�qbe S M PLAN..FOR ; DESIGN OF'S&M SYSTEM UPGRADE (ADVANTEft) EXHIBIT PAGE . OF 2 ' JAMES WAY _— --- ------ cim 4Lw I LA VIXIM nM. s�O IAKEIWCE 1[RR, S/0 LOT 7. MDCK3�- a. A= J. --++` ULm fx IDT !. MACK ]. 0. i `+++ � e �`♦ Ll� TOOL 1 L__-_-- --- -- -- -----a -- ---r— ---- --- I f ------ ------ E14STRW Nou I II I mum" 1TEM. se Lm 14A2A.. 3. OU" I $ tAun 3. TERM Lm a 9LOCK turB� Rmc sa F#,= 2 O!' 3 roll newts. � 1 1 - - - - - - - - - - \ I 1 1 ! I 1 • 1 L / / T I I UIwu= IOtR. s/9 ► I / ! LOT 4. MACu R. L% \ `\ •• Ste/ % % 1\`` 111==K x3!/D IDT 4. MDC),f ��/ K IAKEm000 TOM. S/O / I �i 7••C� tA. MOCK S. • / / _/ / CAM FN' •rl� 10/3/2000 Q i� • _ ft ALASKA WATER & WASTEWATER ,G,L K ' moi;' CONSULTMITB.MIC.•---�-�• 1. s 100• •• •• ......L"ns•• Lutes • rpeow7/ • Pat PHM TRAetR VACS NL%URX .... ...:.. ' •' IOR ... RAY t MAROIE PRICHARD (907) 343-0043 1 OF 4 r A. LtwL OmmwnR-7953 ,•f� LAKE RIDGE TERRACE S/D: LOTS 9 t 10, BLACK 3. ,' •...,.. .. •''' ; PC 61f Wft5. ~�qbe S M PLAN..FOR ; DESIGN OF'S&M SYSTEM UPGRADE (ADVANTEft) EXHIBIT PAGE . OF 2 10/13/00 PRI 09:57 FAX 907 375 0277 UlU3EUE '� 10002 BK031.08PG020B.; 40 Amt Lig TO TROCLIMC m7m ' MINIMI OLWOL AND IdURATL W7TN / 2' WIC OWD INSUTAT" 71MT is RAIrWItE75lm TWM mummtma Im Oft Tm LOT 0 1 r'S 6� � aT is Ow .tel NU wll LOT 10 \PUTNo APO ERIC !t>e'r a / \IpY1�11Q CIA OCrEffR. � rACK 3 0! \ 70 @41ALLIADICH COMPLETELY JMIDIA�'P �I TEST HOU ONTWO Pr_ owmi 6/22/00 PC r ! AOM MND WSULL t01/1OM71T MOUSOL ONO t PVC uuAS XCONAM \ t PROPOSED 1500 GMIOW I \ \ ` ".•• S.TLP. TANK AND ADWMa�Q � I GAWC Ir— TLTWAMsa R"M Ow" W" FLO . TOM IN or . rDA OQAIt 70 OIMnw4 arrAmm /r^--�\ ..r �.i:: �. L' is :=��•I 1t f / r:nrrG��/G!NE- .mil •' � sueq��!�7ALS SMap:2OVE SAM -0 BL SPRUCE LANE APPROVED A5_b T`5f, —� - --'�•7CN pI oup, REr:_)FIA1T . 1 ALASKA WATER & WASTEWATER K.D.W. �`. .r..�..� CONSULTANTS, INC. •-•�^'^� �; 40' ...:. .. .......:" • [ • 141H • rY MUYOER: P , ••• ••••�•• MOMO ITlIt PIIOIIE RAY AND YARWE PRICHARD (907) 345-0043 2 Or 4 �'t r y A., LEGAL 000FIF110 LAKE RIDGE TERRACE SUBDMSION; LOTS 9 t 10. BLOCK 3 . '' • .•' ,•,••. •+hWIN • or BOOL DESIGN 'Or%SEPTIC-SYSTEM UPORADE (ADVANTE* 0 5 2 4 8'6 `� 2000 OC 17 Ali 10:16 EXHIBIT.=_ H011CRAGE U' REQUESTED BY ' PAGE2- OF 2- RECQRDICG DISIRICT _ ' ""— GREA."\R ANCHORAGE AREA BOR( GH �flll�s Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /!y' �F �P CL MAILING ADDRESS PD 1�3ox 9�9 ellKs4k ##S PHONE -777-1'179 LOCATION LEGAL DESCRIPTION �QT /0 0ce0Afre /'Ipfe, TP.',Iee SEPTIC TANK: DISTANCE-�7 f . NUMBER OF FROM WELL MANUFACTURER - MATERIAL 44411elerc COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY_kc GALLONS. TILE DRAIN FIELD: s°/sr'y �vST7L<<D ' ,` - , TOTAL LENGTH, DISTANCE FROM WELL AQ_FOUNDATION �f' NEAREST LOT LINE OF LINES J a-F3L.. NUMBER OF LINES7DISTANCE BETWEEN LINESi; � H >/ TRENCH WIDT. IN. TOTAL EFFECTIVE ABSORPTION AREA �Il SQ. FT. LENGTH OF EACH LINE Y3/ X 51/7 M )a3 DEPTH OF FILTER �/ DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILEIN. ABOVE TILE IN. WELL: //��*, TYPE✓0lel��V CONSTRUCTION SrI%V12'¢4eU' DEPTH �DISTANCE FROM: BUILDING NEAREST NEAREST FOUNDATION 10e. LOT LINE 30 . SEWER LINE CESSPOOL -11'4. APPROVED DISTANCES INSTALLED BY: SEWER LINE DEPTH: OTHER SOURCES DISAPPROVED REMARKS PIPE MATERIAL: LOT SLOPE: REMARKS:`Uell/ re 3 / �a3 r• /%' 7//73. Form EQ -032 SEPTIC ;0 SEEPAGE i TANK 73 .- SYSTEM- 0087f YSTEM DIAGRAM OF SYSTEM DATE &27,4�p APPROVED G.A.A.B. H Y In % 3 I�CSj). A r M � T esu • `'• 4- DATE &27,4�p APPROVED G.A.A.B. �[ R ANCHORAGE AREA BOROUGH iIw Uv \ PARTMENT OF ENVIRONMENTAL OALITrrJ E MIT N i 4 q ]0 "C" STREET ANCHORAGE, ALASKA 993 f e \ TELEPHONE 214.4561 :fid QF _., WA DISPOSAL SYSTEM — APPLICATI D PERMIT 1.3o NAME OF APPLIt A� �"Q'G MAILING AD E P�E 2- +�-'--ZLk INSTALLATION LOCATION LEGAL DESCRIPTION 'G / /n T�"'�x INSTALLATION OF; SEPTIC TANK � BE 'AG IT AIN FIELD � O MER TYPE AND 612E OF FACILITY TO BE SERVED FINANCED THROUGH TO TALL 1 BY SOIL TEST RESULTS �"J OTE, T P IIS NOT VALID WITHOUT SOIL TEST ♦COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR 41OTICE R IR D. BACKFILL OF YSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL OU ITY ,rte H/ORITY W BE U(Al c�_{`F•.�TO PROSECUTION. ,,J//�n SEPTIC TANK SIZE �L o�� TYPE 1!! ^" i� SE AREA SIZE �1CLL'�5.� TYPE C/ ���� MINIMUM DISTANCES. REOUIREMENTS r FOUNDATION TO SEPTIC TANK -7/ FOUNDATION TO SEEPAGE �1T SEPTIC TANK TO SEEPAGE PM WAIL - "� SEPTIC TANK _—�*TAN";f�-- DRAIN TO NEAREST LOT LINWELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIFIELD SEPTIC TANK. SEEPAGE P/ — TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND EXCAVATION 5 FEET INTO UNDISTURBED SOIL. V N FIELD _ a GE il•i• 0 CONSIDERAREAWELLS. EEPAGE�PTY. DRAIN FIELD 14122' CRIB CROSSING GAP OF 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPT 7, TANK AND SEEPAG71T FITTED WITH AIRTIGHT REMOVABLE CAPS. \\\ GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALL1011. N. �[1 G.A.A.U. OR LICENSED DESIGNER DIAGRAM OF SYSTEM F I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AN T OVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I DALE` U 'u 9 1 I� APPLICANT'S SIGNATURE m�S'�.;� Zt ` /1 FORM NO. EO -01 6 ui J � I 4 Sol■■■■ ■ f■.■E■■■■■ ■� , fid, ■ F I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AN T OVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I DALE` U 'u 9 1 I� APPLICANT'S SIGNATURE m�S'�.;� Zt ` /1 FORM NO. EO -01 6 .001A it i 6011 U Lli', i KION'•ILi'.. �,u QJ AL J i Y CASL I 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For James Polyefko Date Performed July 2, 1973 Legal Description: Lot 10 Block 3 Subdivision Lake Ride Terrace This Form Reports Soils Log xx 1'erco anon est Depth Feet 2' 4 6. Soil Characteristics sandy silt 2 71 'ML Gray silty gravel' GM with 6" seam of clean sand Was Ground Water Encountered? No �o P If Yes,•At What Depth? Reading Date I Gross Time I Net Time iDepth to H2O Net Drop , rercoiation ►tate minute Proposed Insta ation: Seepage Pit xx Drain Field Depth Of Inlet Depth To Bottom Of Pitr -Trench ench_ COMMENTS: 210 sq. ft. of drainage area is required per bedroom. lest Performedy R. E. Carlisle Data Certified By: ALASKA mi\FR At R ►..ten-cnra* e * An' m777 Date: tuly 3. 1973 Municipality of Anchorage MAT • 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.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05,11-q`151-114 HAA # 04406-71 Expiration Date: Ll- — S' O 1. GENERAL INFORMATION Complete legal description Lake Ridge Terrace, Rlpck 3, Late 9 & 10 Location (site address or directions) 17719 Blue Spruce Lane,FaglA River, AK 99577 Current Property owner(s) Robert & Theresa Wick Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. Day phone 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 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 4 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. (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 KND FNrINFFRING, Inr_ Phone (407) F;c)f;-I;l 11 .. a ... Engineer's Printed Name __Kenneth M_ Duffi is Date 17129104 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 in land 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, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory r.. 0.,�_ Z ATER AND WA"— SIEVPAItK PROGRAM o ' X Maintenance Agreements J1JTSEv:. Supplemental Engineer's Report Other By:C%���'OLZ: Original Certiricate Date' — .S ' 0 6, ryir' t/�ir%; 1-0-r- C? I ".7o . AS -BUILT LcT 10 1 hereby certify that 1 have suryyed the following described property: L v �. E� /�� 3 L o -1�_. R:.I,y' _•• `, ;r -r r s r_t_ '�U 1. .: Anchorage Recording Precinct, Alaska, and that the improve- I..- ments situated thereon are within the property lines and do not K rt ; overlap or encroach on the property lying adjacent thereto, that •. �: ;; .,•, +.� ''-''1 '`.'. `Qr no improvements on property lying ad'acent thereto encroach s ti - on the premises in question and that t�ere are no roadways, transmission lines or other viable easements on. said property except as Indicated hereon. Gr Dated at Eagle River, Alaska thisayo( 3i4N,, fg2.aDLi ROBERT C. JOHNSON Rr�• . SCALE: Registered land Surveyor No. 88O -LS 30' Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694-2543 a` , t rn �! art � L'• ' • ;+,p, - 'fl .i>�•r.'• L i{�^: V'.A Niter. si Fr..i1 c{..e�kl:rarie.aa•' AS -BUILT A hereby certify that I have aurveyee t?he following described property:-� O ' 'Anchorige'Recording Precinct, Alaska, and that the improve• ments situated thereon are within the Property lines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on property IvfngR adjacent thereto encroach. on the premises In question and. that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon.. Dated at gle River Alaska this Z day ni_wk) ]a' RO�[tiKTC,JOil\SON' [� SCALE: Registered I and Sun•evor hu. &ry 7740456, Eagle River, Alaska 995:, Phone (9(Y•) 694.25.17 .I lip iCll t ;• •j 1 1, t,i a` , t rn �! art � L'• ' • ;+,p, - 'fl .i>�•r.'• L i{�^: V'.A Niter. si Fr..i1 c{..e�kl:rarie.aa•' AS -BUILT A hereby certify that I have aurveyee t?he following described property:-� O ' 'Anchorige'Recording Precinct, Alaska, and that the improve• ments situated thereon are within the Property lines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on property IvfngR adjacent thereto encroach. on the premises In question and. that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon.. Dated at gle River Alaska this Z day ni_wk) ]a' RO�[tiKTC,JOil\SON' [� SCALE: Registered I and Sun•evor hu. &ry 7740456, Eagle River, Alaska 995:, Phone (9(Y•) 694.25.17 .I MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC241231 Parcel ID 051-313-34 Expiration Date: 6 �/ Legal description LAKE RIDGE TERRACE BLK 3 LTS 9 AND 10 site address 17719 BLUE SPRUCE LN Current property owner(s) RAY JESSE x The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Note from Chuck Leet: "prior to presoak on 12/28/2024 the sand layer was seen and had no standing effluent in both MT. I was able to slide my tape measure down the sides of the MT and catch the bottom of the monitoring tube which confirmed the bottom of the MT was a depression in the sand layer below the field. measurements from the bottom MT were adjusted accordingly and noted on the COSA checklist." There is a depression in the sand layer below the bottom of the monitor tubes. I - By: Original Certificate Date: 1 /2/2025 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development 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 Absorption Field Advisory Tank Age Advisory Other KI Well Flow Advisory Nitrate Advisory Arsenic Advisory MUNICIPALITY OF "Wr Development Services Department V On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. #051-313- Complete legal description Lots 9 & 10, Block 3 Lakeridge Terrace Subdivision Location (site address) 17719 Blue Spruce Lane, Eagle River AK, 99577 Current property owner(s) Jesse Ray 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-317-7787 3. TYPE OF WATER SUPPLY: nN Private Well n Private Well serving 2 dwelling units R Private Well serving 3+ dwelling units El Community Well or Public F1 Water Storage 4. TYPE OF WASTEWATER DISPOSAL: OR Private Septic 0 Private Septic serving 2 dwelling units ❑ Holding Tank R Community Septic or Public Sewer 5. SEPTIC TANK: 110-1 Steel F-1 Plastic R Concrete R Fiberglass Age 23 1/2 _ See advisory if steel older than 20 years 6. ABSORPTION FIELD: R AWV\1TS MR Bed R Deep Trench E] Wide Trench F1 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 $ Date of Payment COSA # Waiver Fee $ Date of Payment Waiver # COSA ApplicationJune2022 COSA Checklist Legal Description: Lots 9&10 Block 3 Lakeridge Terrace Sub Parcel ID: 051-313-34 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 3 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 08/1975 Total depth 174 ft Cased to 40 ft Fol Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 6/4/2024 Static water level at beginning of test 114 ft Comments Date Drilled is Estimated. Total Depth was Probed. B. TANK DATA Measured operating fluid level in septic tank N/A Date of pumping N/A X Required maintenance completed, if AWWTS Comments: Advantex System Well production at time of test 5.2 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑■ Coliform bacteria is Negative Nitrate 2.102 mg/L 'Nitrate less than MRL (ND) Arsenic <MRL ug/L 0 Arsenic less than MRL (ND) Collected by W.N. Whaley Date 6/4/2024 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA WHERE DOUBLE NOTATION IS USE (EAST END/WESTEND Which system tested (date installed) 2000 ❑■ ALL standpipes present per record drawing Total measured depth from grade 3.9/3.4 ft (max) Measured depth to pipe invert from grade 3-112-8 ft (min) ❑ N/A — pressurized field. FN Per record drawings, field is insulated. F0 Monitor tubes go to bottom of effective. If not, state depth into effective see note ❑■ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 360 gallons 12/28/24 date Any rejuvenation treatment (past 12 months) No If yes, enter date Adequacy test date 12/29/24 Results 0 Pass Fluid depth prior to test 1.8/1.3 in Water added 501 gal New fluid depth 6.6/7.9 in Elapsed time 1440 min Final fluid depth 2.2/2.5 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 2/2.5 in Effective depth remaining 4/3.5 in Comments/Deficiencies: Careful measurements indicate MT was different than Inspection Report, therefore 6" was used. Measurements reflex the following adjustments: 3" (.25') East End and 1" (.09') West End respectively to account for difference. *MTs had no fluid in the MT prior to presoak. Vol of presoak.5'x45'x5'x7.48(gal/cft)X.4=337gallons Maintenance Done 6/10/2024 by Anch. Tank. Test water was introduced at west end. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' DYes if No ft Yes if No ft Neighboring Tank > 100' n Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft ❑■ Yes if No ft Manure/Animal Excreta Storage > 100' NA Community Sewer Main > 75' no if No ft ❑ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' M Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5'❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ❑■ Yes if No NSA ft Community Wells > 200' ❑Q Yes if No NA ft Water Service Line > 10' 0 Yes if No NSA 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 Alaska Rim Engineering, Phone 907.775.2347 Engineer's Printed Name Charles A. Leet Date January 2, 2025 40 4 COSA Checklist June 2022 MUNICIPALITY ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Seticn �� ��; � Fax: 343-7997 www.muni.org/onsite \ Septic Tank Advisory Certificate of On -Site Systems Approval # OSC241231 Subdivision: LAKE RIDGE TERRACE Block:3, Lot: 9 and 10 The septic tank for this property is 24 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more, not including engineering, surveying, MOA permitting fees or site restoration. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. 6093e8a ■ as■a■ + e� la ■ a ■a■■ ■■a■■ ■■■seas a a■ as a ^ $ aw a■ ■ ■ ■a■ ■ a a a 1a as a = ■ a■ aaaa■■ a ■ aa■ �wa- Field[s1ea11Ce Report An eTank 907 2 2 3543 Annual Inspection oa.ro� v v,q o. wrrnwMne • Larry Betts Jesse Rey w nee+vow . �e�p -- 907-317-7707 17719 Blue spruce LanetsVw'Z"'0'30��4�0 River AK 99677 Isms w�.---j eau m ra.e i�.vxw^ 05131 pz024RTU10CAX-100082 Retrieve 06M Info goolrc rm3o F Tknor 6e11111w podorm Field Sampan111/0beerva"O" NTU Its: NTUD) PH (e-9) DO 12A o.3 9,1 -7 odsr er samara Ken-lypbLd r iwwo ❑cabo.cge ❑DooeY oilylrfrfl M PW ❑Yee Na Fo-rn In to"[ ❑Ycs Ne Check Caniral Panel Reakc Amps Discharge Amps 1 a•3 JUldu%e and Visual a331rne VrOK Dial tone Matemetry only) ;Z Yes ❑ No Impswcfe■n PuatP System inspaot Clean Bptla sox .................... Flost Cords .................. PwrQ ........................ 1!J Slaarbee Filter ................ 6106AW Pump vaunt ............ lZl Rsdroulatingsplitisrvdve....... K I (1 Measure Sludge/Scum scum let Comparlmont Cunerrtt 1 Provlous Current Provlous 3 Current Previous 2nd ComPartmont current Previous Inepect/Clean AdvanTex Filter Odor. Normal ❑ Pungent Blomat:Normal QEJ(eeaalvO BrldgingWending: ONono/lrtlnor 0ExC06e1Ve Inspectlaean Discharge Pump System Inspect RlserAIld ❑ Spllco Box ❑ Flood cords ❑ Inspect Clean Laterals/Odflcos Z A Pod Bottom V Intake Vent Inspect Clean Fkmts ❑ ❑ Pump ❑ ❑ Ingmct/Servlce Other System Components [Aspect Clean Inspect Clean Disinfection EqulpmoM Vjil nispersal tBtaralalOt<Eicov C r � Obeervations G F CL� 6 Addidonal Services Rendered []Cleaned texfNe sheets? ❑ Replaced UV Items? ❑ Re0aced/tlead other lMe e? Pads Used: W . Warranty, B : Billable (vf appropriate selection) W a Item Number Desce0lon Flnal/Safety Inspection RRSV rolnrtallad ® Lids baked on Wrtlfold reconnected; flush valves closed Control panel reactivated Summary/Recommendations ❑ System performing; no further action neoded [)Tank needs pumping ❑ Cell for service ❑ other? aipttanwa_� y _4 Date �V Tj �� �F• F&K aompleted brnt to 1-866-384-7404 .tt VANC KD "t'1'AgFE WA TEIt 'I"REA',I-,NI"NI' SVSTl Ai MAINTENANCE AND REPAIR AGREEMENT 'I~i-Iis NMAIN°i`FNANt..ii AND REPAIR AGREEMENT, herein ita tine. �Cit�f i �tia s"I" rra tcli ;anal cntcreel intca as of thrti i �._� _ kr-� of, cat t a Ens and betwe as herein the <aO NER " and the kMnkQWhy of Anchorage, herein tlac `NIUNlt.IPALITI °, in accordance with ,a Anchorage Nitanici al Code a MIC) 1515365. 65. In consideration of the mutual covenants contained herein, the parties tia tbis t 44tceme.nt ;agree as ti llcaxts, 1. Advanced Wasteavater Treatment Symemy The MmAcipathy Ig ams l:eti dsvi n io the t Owner to utilize and operme an Advanced anced Wastewater Treaatnaent Systems (ANVA a S) t describcd as V An/C� irk located ;at description) 1 Maintenance, IQuirs and Aherations. (Owner is required to rca d, understand and initial c,ach section) as Throughout the term ofthis Agreement, the Owner shallenter° into a service;£i;:a,.t,r1{ent m ith arl ,s1WXV S service and naaimenarncc lartw ider approved by dw NkmiepalkyOr th ru;u1nl:acttarer's representative, The A\\`NV' `s slrattl be aa.attataained to as satin aactorij condition capable cafpcilbrnaing as designed arracl producing treat"! septic e f ucaat in accordance with ttac ecittilanaent's approval al fat Lapel ation in titc Mun cin,atuy, It siaaatl be dw responsibility cal"the Owner eluting, the term ol'Oar Agn-c•errten jo i aal.' ft r atll repair(s), maintenance, a acilttstnacnt(s), replacement costs. and inspecd n comy This tnc hides an animal nminten,tnee fee Oypic ally S400 to $600). Owner aerces that only m0ntcnatncc moral repair personnel :iPlirc,ved b the N-ju trcipailtty or tire naanuf,acturcr`s representative "ill inspect and tataai.c any ncc.c:ss;ay, as annenance, repklirs or permitted aitcratttcrns ro the system, Owner ackncaavlc.ciftcs that regular maintenance of an AWVV'rS reduces the pti)terarr.ai liaihtrc, of the sotc" , "Tic h could include sm aage backup and costly .-,piatror draari icai I replacement. (rey.. 0511800IS) Page I caN r t (Kner acklKnviedges that the NItrnicipaht} nra y request records of Inarrucriance and repairs from tic marnutacrurer"s represeritative or nraaimeriance pmvWcr. r ' Owner acknowledges that the tine for failing to maintain and repair an AWWTS may y b�; assessed in accordance with VNIC 14160,030. Owner agrees to grant this. Adunicipality reasonable access to test and Aspect the AWWTS. The N unicipahty will give at least 24-hour notice, Tins,.O" rer agrees th rt any sale or transfer of title of dig property,v ill nor occur without a new Certificate of 011-Site Systerrrs Approval, Owner agrees that the: /YVVVV'I'S installation and arraainrenance recluirenic rats ,as provided by the .1W\ FS vindor`installer and approved by the Nlunicipa rite are the g veining 11tridellnes for the construction, rrraaintenaanc:e and repair of the Owner's AWWTS Owner agrccs to malt ain remote rnorritoriny. of Me .-1WTS as recltiked by the AVVVVYT'S approval. 3. ..t`enm The term ord is Agreement shall begin on the elate of'approval by the Nhnicip ality to opervatc the; rim alled gvenr, w upon Waansfar of t4le, and shall ca nditue while [lie =1W\VTS is operational or until title is tr,aw,'feraed, A Nnnwaivet% Ile Won orthe Wnwiriaiky ,at any time to crrttarce a provision ofthis grecnlent shall in no "my constitute ~a w arVa of Me provrsion,4, nor in at1y ,{ tt' ;fl-f,e t the; validity of We ,•'agmearaent or any part herecrr, or die rrj calm �f ra :ei€?,t1it thereafter to cntorc ; cvery provision heroof- S Amendment. This Aurcemeart Ah,all c>raly tic° aarwndcd by <atatllodz,: i ives of the:, (r wwr and klunicipality. Any attempt to amend this a greerneut by either all unaaathorized repre°sent.rtK or uratauthorked means dr ill be void. Jurisdiction: (:huiee of" I.<aEw. Any civil action arising frorrr this Agreerrieni, shall be ?mugl t in Me Staiienor C nin for the Third Judie ixal r)wnct ofthe Starter` orAimka at Ai chaarrag, The laws or Me Rate crt'Al ask a shalI govern tlas: rights and obli rxitac lls of the: Parties tinder this AL},i crnent. Sc+ercrribil ty. Any provisions of this Agi-c:enient di rood invalid by ra court k,A (rainn icru ,jurisdiction ;hall not invalidate the rc maaining provisions of the ,Agrec3rn nt: ( rev. tip 18/20l S) Page 2 of 0WA IT: -jprint name) THIRD .It. MCIAL DISTRICT Ile btyl}wg lloll�lTlly "as ,iAltxrw ic0ged betbiC tilt this day Ire Nl t An min ion e cpircy =1K1,lR11$T10lFFERlsa:=c�J 1 By: 1 � ✓r�i7 1i O ter-'S {print name) �I",II� � t v lnew ON IW?0N I'i LOT 8 LOT 7 LOT 6 60' - - - S 89°58'10" E 125.76' (M) - - - - - - -S 89°49'03" E 124.63' (M)- - - - - - - - - - S 89°5300" E 125.00' (R) 10' UTILITY EASEMENT S 89°53'00" E 125.00' (R) 10' UTILITY EASEMENT -- - -��-x -- -- --_---x--- -x - --- - - - - } m COVERED DECK CHAIN W/STEPS LINK FENCE DECK -x-- s03' _ (TYPICAL) LOT 9 SSF W/ PARTIAL N BLOCK 3 m o o BASEMENT W w CD MT rn N LLl 39 6' C °a O Z o f ` I ) j MT ADVANTEX o LO CO TANK o - CHIMNEY CO w o Q z QQ AX o CO O CANT WINDOW m o FLU O CANT LL �? Z CO (TYPICAL) o � 1" = 50' ofFGAT CO 20.5'± o w o fS± O COVERED fit' - I Q o LOT 11 0N o24.3 Nw DECK 26 9' m o I O . I37 -x- rn W pi ¢ CONCRETE 1 14.8'± Q J p I FRAME< (TYPICAL)-� ADJ. I z i SHED-�-k____x_/ �" cn SHED 43'~ / WALLRETAINING I Im+1m w LOT 10 BLOCK 3> N 89°58'17" W 125.95' (C) 126.50' (R) N 89°48'51" W 125.19' (M) 125.00' (R) ( f N 89°5 -00" W (R)1 , BLUE SPRUCE LANE (R) = RECORD PER PLAT (M) = MEASURED VALUE (C) = CALCULATED VALUE W'21)ri I NORTH I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOTS 9 & 10 BLOCK 3 LAKE RIDGE TERRACE SUBDIVISION PLAT NO. P-549 _ 1190 N. Helen Ln Wasilla, Ak 99654 IF —LEGEND Phone (907)376-9535 ANCHORAGE RECORDING DISTRICT, AND THERE ARE NO ENCROACHMENTS VISIBLE AT THE TIME OF THIS SURVEY, EXCEPT AS INDICATED. DATED THIS 4TH DAY OF JUNE 2024 AT EAGLE RIVER, ALASKA. IT IS THE RESPONSIBILITY OF THE OWNERS OR BUILDERS TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR ESTABLISHING BOUNDARY OR FENCE LINES. THIS IS NOTA LOT CORNER SURVEY. JOB NO. FIELD BOOK/PG(S). 24-085 316/10 SCALE: 1"=50' PLOT PLAN ASBUILT X DRAWN HW I CKD. WW O❑ FILTERBOX ���a��.���� of A ���# -0- POWER POLE �# QQ MANHOLE ■r �> �� SEWER ALARM 00 90 'r UTILITY PEDESTAL ` �► ® WELL l 4 T d ® FOUND 5/8" REBAR O SEPTIC PIPE )1( AIRVENT ® SUMP PUMP CA 0 FOUND 1/2" REBAR ©2024 Traverse PC 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.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0511-1111-114 1. GENERAL INFORMATION g,o •J 1..i de <z C' fir' HAA # NUP1.1 Expiration Date: 3 ` A I - OS • • - -•. •- • .•1.4 •T -To . 1 PTA 9 k 0 991M1 Location (site address or directions) 17719 Rlue BlueSpruce Lane,Fag-le River, AK 99577 Current Property owner(s) Robert & Theresa Wick Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone 205 E Benson Blvd.. Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ CommunityClass 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 4 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. (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 engineers 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. '•• �' a •.� . .. .. Engineer's Printed Name -Kenneth M ntiffue Date 12122/04 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 in land 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, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. X Conditional approval for 3 bedrooms, with the following stipulations: attached maintenance agreement which shall be returned to this office before an unconditional approval is issued. Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other BY: n �• �� �P "� Original Certificate Date: )L 2 `� Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal DescriptiA L7 0 Parcel ID: 051-313-1 4 A. WELL DATA Well type-MLYM if A, B. or C provide PWSID # Well Log (Y/N) N Date completed 8/1975 approx.-Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 138 ft. Cased to -4D*—Jt. Casing height (above ground) 1 8' FROM WELL LOG AT INSPECTION Date of test 12121104 Static water level ft• 1 1 6 ft. Well production 9 -p -m 5.67+ 9•P•m. WATER SAMPLE RESULTS: Coliform __Q_colonies/100 ml. Nitrate 0.724 g.A. Other bacteria _0 coloniss/100 ml. Arsenic: _1 mg.A. Date of sample: 12/17/04 Collected by: KND Engineering B. SEPTICIHOLDING TANK DATA Tank Type/Materiat PST�/STEEL Date installed 10/18/00 Tank size 1500 gal. Number of Compartments 2 Cteanouts (Y/N).X Foundation deanout (Y/N) depression over tank (Y/N) N High water alarm (YM) Y Date of pumping 12/22/04 maintenance/not _pumped Pumper A+ Home Services, Inc. C. ABSORPTION FIELD DATA Date installed 1 O/20/00 Soil rating (g.p.d.Ae or ft lbdrm) _Z.QSystem type TRENCH - Advantex Length 45 ft. Width S ft.Gravel below pipe 0.5 ft. Total depth 3.233.48 ft. Eff. absorption area 22.5_fe Monitoring tube Y Depression over fteld N Date of adequacy test 12/21/04 Results (Pass/Fall) PASS For 3- bedrooms Fluid depth in absorption field before test 0 fdrvt in. Water added 510 gal. New dept LSA in. Elapsed Time: 1440 min. Final fluid depttL 0 LIIW in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) N if yes, give date D. LIFT STATION Date installed 10/18/00 Size in gallons 1500 Manhole/Access (Y/N1 Y `Pump on' level at Timer in. 'Pump off" level at Timer in. High water alarm level at 411in. Datum Bottom of tank Cycles testeQZ_ Meets alarm 6 circuit requirements?—Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAifl station on lot 100'+ Absorption Held on lot 100'+ Public sewer main 75'+ On adjacent lots _ 100'+ On adjacent lots 100'+ Public sewer manhole%learlout 10 0 1 + Sewer /septic service line 251+ Holding tank 10 0'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line _5_' + Absorption Held 5' + Water main 10'+ Water service line 10'+ Surfacewater 100'+ Wells on adjacent lots 100'+ 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, park)ngivehide storage 10 1 + Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS Absorption Held _surcharged w/ 1500 gallons on 12/20/0: thouse vacant for 7 months)- Advant Y System/Lift Station serviced by A+ Home Services. Inc. G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M. Duffus Date 12/22/04 HAA Fee S430.00 +116-0 n Date of Payment Receipt Number 10 (Rev. 12(01) Waiver Fee $ Date of Payment Receipt Number X« Olh M. CE 711 V, 9' S�Ir�fn lit, t 0 Fr cr rex t rex /YOU J.1t. s 4.� m I lEsck<1•, j— Df7 t v--, It, rt AS•BUII.T 1 hereby certify that I have sumeyejthe following described property:l.oi' /O, f.��c__ c• Y <� . Anchorage Recording Precinct, Alaska, and that the improve itu ments sated thereon arc within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on property lying adjacent thereto enrnoach on the pn•mises in questum and hoar there are no roadways. transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this Z `- day of— 4e 19.�� SCALE: RU ERT C. )U)LNSnki a.g� �[(�� e 1„ I Registered Land Surveyor No. ha4�LS "3 O WX 77-)456. Eagle River, Alaska 99577 Phone (907) 694-2543 , p/ u{ J$aWsr- r LoIr t? I hereby i 4 AS -BUILT that'l have suryyad the following described r Y. 8 /oe- l< i i -]- A & 4 G 9" I S—N R 2 W S M Anchorage Recording precinct. Alaslu, and that the Improve- ments actuated thereon are within the property lines and do not overlap or encroach on the Property tying adlaoent thereto, that no Improvements on property Id gad attnt thereto encroach on the premises in queanon and that trere are no roadwa" . trarumisscon Bnea or other visme easements on saki property txeept as indicated hereon. Dated at Ea ]a River, Alaska . l2- day o��„a_rei, tl20oC SCALE. ROBERT C. JOHNSON .�N, 1„ Registered Land Surveyor No: LS �O Phone (M (M6 �Rhyer, Alaska 99577 ■I MCS ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M}i Division of Environmental Services _ On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519.6650 (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 051-313-14 HAA # Al R C'1' �r 1. GENERAL INFORMATION Location (site address or directions) 17719 SLUE IF SPRUCE I ANF EAG1117 RIVER- AK 99577 Mailinq address Lending agency Day phone Mailin,c kTent aY W/ REMAX PROPFRTIFS D.(007) 694-2761 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 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 ing to the legality and status of system. 72-025 (Rev. IM) Front MCA #21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid 51,500.00 at,. or prior to, closing for the engineering services provided. 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 Munlcip I and State codes, ordinances, and regulations in effect on the date of this inspection. 4` Name of Firm Address Phone (907)337-6179 Engineer's Signature 1l Date 11 Aa: In conducting this evaluation, AK=, Iryc. ttempte rovide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MO 6j hS Guidelines & Regulations. The reported results described 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 soils condition, ground water levels that may fluctuate during the year, and the usage of the family being served by the system. These conditions are outside the control c the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. All=, Inc can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal tight whatsoever. 6. DHHS SIGNATURE Approved for 3 bedrooms Disapproved Conditional approval for Additional Comments M bedrooms, with the following stipulations: Date 1I—��-00 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. 72-025 (Rev, 1191) Back MOA 921 Computer Version RECEIVED Municipality of Anchorage 15 2000 DEPARTMENT OF HEALTH & HUMAN SERVI09 Environmental Services Division 825 wV street, Rm 502 Anchorage, Alaska 99501 (90'QliMtiil4$VOF ANC HORA ENVIRONMENTAL SERVICES D Health Authority Approval Checklist Legal Description: LAKE RIDGE TERRACE: LOT 9 do 10. BLOCK 3. Parcel I.O.: 051-313-14 A. WELL DATA *PER 8/27/1975 INSPECTION REPORT Wen Type PRIVATE If A. B. or C, attach ADEC letter. ADEC water system number N/A Log present (YM) NO Date completed *APPROX. 8/1975 Total depth 0138* Cased to 40'+ Casing height (above ground) 18"+ Sanitary seal (YIN) YES Wires property p (Y/N) YES Date of teat Static water level Well production 0 0 0 92—'T01TWI131N[�.'c� AT INSPECTION 9/5/2000 115' g.p.m. 7.0 +/— g.p.m. WATER SAMPLE RESULTS: Conform 0 Nitrate 1.14 ma/L Other bacteria 0 Date of sample: 11/1/2000 Collected by: A.w.W.C.. INC. B. SEPTICfHOLDING TANK DATA *THIS IS AN ADVANTEX FILTERATION SYSTEM. Date instaned 10/18-20/00 Tank size $1500 Number of Compartments 2 Cleanouts (YIN) YES Foundation deanout (YIN) YES Depression (YIN) NO High water alarm (YIN) YES Date of Pumping NEW Pumper C. ABSORPTION FIELD DATA *THIS IS AN ADVANTEX FILTERATION SYSTEM. "BELOW FINAL GRADES Date installed 10/18-20/00 Son rating (j�or fMftrm) *2.0 System type TRENCH Length 45' Width 5' Gravel thickness below pipe 0.5' Total depth **3.23'-3.48' Effective absorption area 225 SO.FT. Monitoring Tube present (YM) YES Depression over field (YIN) NO Date of adequacy test NEW Results (Pass/Fall) — For 3 Bedrooms Fluid depth in absorption geld before test On.); — Immediately atter — gal. water added (In.): Fluid depth — (Ins) Minutes later. — Absorption rate' — Perordde treatment (past 12 months) (YIN) — if yes, give dal — 72-Q25(RW.3WCWWAWVffWW D. LIFT STATION 'THIS IS AN ADVANTEX FILTERATION SYSTEM. Date Installed 10/16-20/2000 Size to gallons '1500 Manhole/Access (YIN) YES •Pump oW level ar TIMER pump Or level at- TIMER High Water alarm level at* 46' —*Datum BOTTOM OF TANK Cycles tasted NEW E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SepUdholding tank on lot 100•+ On adjacent kris 100•+ Absorption field on krt 100,+ On adjacent kris 100•+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer/septic serve one 25'+ LIR station 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Foundation 5•+ Property line 5•+ Absorption field 5•+ Water malNseMce line 10•+ Surface water/drainage 100'+ Wella on adjacentkris 100•+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property one 10•+ Building foundation 10'+ Water malNseMce one 10'+ Surface water 100•+ Driveway, parkingivehicle storage area 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S I car* that I I orMuMdpal rlry with MOA U4 Engineers it o� HAA Fee S field Inspections and review systems are In conformance on this date. Date of Payment — �'� — a v \ Receipt Number4 G A/ / 9 ��/ca l 72-M OW. 3W Comp Aw V w w `T Walver Fee Date of Payment Receipt Number l yd Ameee' CE -7933 j4�rNEVf/ /74, P6 "HORAGE • DEF •11 j,t ' 'c or•: f•..d<� HUMAN M AN SERVICES tion Cts 6 / c 1 iska 99519-6650 " I AUTHORITY APF MILLY DWELLING Par cel l.D.# 051-313-14 • HAA# HA 00oX-6 r 0/0101 1. GENERAL INFORMATION Complete legal description JAKE RIDGE TERRACE SUBDIVISION- LOT 10 BLOCK i Location (site address or directions) 17719 BLUE SPRUCE LANE EACIF RIVER AK 99577 - Property owner RAY & MARGIE PRICHARD Day phone (9 7) 345-0043 Mailing address 17719 BLUE SPRUCE LANE EAGLE RIVER AK 99577 Lending agency Day phone Mailing address Agent RANEY W/ REMAX PROPERTIES —Day phone (907)_694-2761 Address 16600 CENTERFIELD DRIVE EAGLE RIVER AK 99577 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 xxx 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 ing to the legality and status of system. 72-025 (Rev. 1191) Front MOA #21 Computer Version 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 oulrned In the Health AuthorltyApproval Guidelines for this application,'. shows that the on-site water supply and/or wastewater disposal system !s(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein../ further verify that based on the Information obtained from the Munidpairty of Anchorage riles and from my Investigation and Inspection, the on-site watersupplyand/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 Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A GARNESS, P.E. Engineer's Comments: in conducting this evaluation, AWWt , Inc. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidollnes 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test and separation distances measured to readiytdontiriable features. The opera tionalllfo of a.11 wells and septic systems depend on the tical soils condtion, groundwater levels that may . fluctuate during fire year, and the water usage of the familybeing served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroa chmon is. AM%V, Ina can therefore not provide any warranty or &lure estimate of how long the system will continue to meet rho operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will h confor any legal tight whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Phone 337-6179 Date Manitenance Agreements Supplemental Engineers Reort Other ON-SITE ••�,�� WATER AND WASTEWATER PROGRAM By:- Original Certificate Date: 3 " 2 ' 0 Qw. 1avo> Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services DMslon 825'L• Street Rm 602 Andro950 rege. Alaska 91 (97) 0 9434744 Health Authority Approval Cheddist Legal DeSdiption: LAKE RIDGE TERRACE,• LOT 9 & 10. BLOCK 3. Parcel I.D.: 051-313-14 A. WELL DATA *PER 8/27/1975 INSPECTION REPORT Weti Type PRNATE if A. 8, or C, attach ADEC letter. ADEC Water system number N/A Log present (YM) NO Date completed *APPROX. 8/1975 Total depth '138' Cased to 40'+ Casing height (above ground) 180+ San" seal (YIN) YES Wltes Properly, p (YM) YES Static water level AT INSPECTION 9/5/2000 115' 7.0 +/— 9.PJM WATER SAMPLE RESULTS: Q ,+�( Coliform Co Nitrate �� Z oil - Other bacteria_—[--- Dew of sample: 3/16/01 Collected by: A.W.W.C.. INC. B. SEPTICIHOLDING TANK DATA *THIS IS AN ADVANTEX FILTERATION SYSTEM. Date Witalled 10/18-20/00 Tank size '1500 Number of Compartments 2 Clesr>outs (YIN)- ES Foundation deanout (YIN) YES Depression (Y/N) NO Hgh water alarm (YRO YES Data of Pumping NEW Pumper C. ABSORPTION FIELD DATA *THIS IS AN ADVANTEX FILTERATION SYSTEM. '*BELOW FINAL GRADES Deta inalalted 10/18-20/00 SOP reting 0�or it2lbdnn) 02.0 SYStam type TRENCH Length 45' Width 5' Gravel Iwdaness below Pipe D.5' TOtai depth ••;.23'-3.48' Effective absorption area 225 SO -Fr. Monitoring Tube Present (YIN) Depression over field (Y/N) NO Data of adequacy test NEW Results (PasslFapl) — For.3 Bedrooms Fluid depth In absorption Held before test pn* — immediately atter — gal. water added Qn.r — Fluid depth — ons) Minutes later: — Absorption rate • — Peroldde treatment (past 12 months) (YIN) — If yes. give dal — 72-M Ww. 3W cbmpuhw VOrdw D. LIFT STATION ' THIS IS AN ADVANTEX FILTERATION SYSTEM. Data installed 10/18-20/2000 Size in gallons •1500 Manhde/Ac ess (YM) YES "Pump ow level or TIMER 'Pump otr level or TIMER Hgh water alarm level at' 46' 'Datum BOTTOM OF TANK Cycles tasted NEW 13 SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septidholding tank on lot 100'+ On adjacent lots 100'+ Absorption geld on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A Sewedseptlo service Une 25'+ LIR station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property One 5'+ Absorption geld 5'+ Water mainfservice One 10'+ Surface wateddralnage 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property one 10'+ Building foundation 10'+ Water maln1serAce one 10'+ Surface water 100'+Driveway, perang%rag nlae storage area 10.+ Curtain draln NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S CERTIFICATION I cer* that I"deftlWnG4 with Engineers HAA Fee Date of Payment Receipt Number rl-MO r M 3=r CwvuW Vw" WeV 6rsPoWons and revfew � syt�ptems are in confamence on Is date. Waiver Fee $ Date of Payment Receipt Number