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HomeMy WebLinkAboutKNIK VIEW BLK 3 LT 9Knl*k View Block 3 Lot 9 #051-031-62 certifieb jDdtting log by 00Co.am SUIVA�/L�/L�WN[`MW��A� yT��ER WELLS L 4' ADDPAM I.�nl. Dtrtot� k "1t x. ;tri rip _ _ - �� t>e---2 life Z 11 PI3t1MT M7Ni ud 0 Daied h9ue-�!� - ECJ iAXIDt3YfIPICKf10NNEMdt t ekill 1sweRbabdoappoodpMebealT w Irime filo Ntamw d oriArm &wfi; v a mhb tops Daptlrofwot X1,0 ' I,.IflBrTWK 0LIgVj*VAbomG=n A- %d stmwawupjak a last Flewuar R wt fi 9wm MwkwafTesaw -A,4 Vmhl ft0pwftT m 4469 w aqmhotb is=_ Sart--pat Sto�fpell int 3 Pwaraoaat Sbd t0 * g oat•type % O yT �04 VAIs Depnr km V teat, to au -t teat Waq Dji,(a j p t7P0m C=Vk i g files Cl M 1�isthoadobitae Ct�c.ore�...te 5"a ���" Gei s4�1'~c"•�- � it AfthmW pDspWV e 9 of s H~ Sw he PMWLY km andV D i fot���'Dcamw ation. Maft e 79parenont of awkaraftI Cawovam. S0 39Vd NVAi- ns GGZZB89 Z0.00 666T/TB/T0 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 WATER SUPPLY PERMIT Upgrade Permit Number: SW040028 Legal Descriptior4laM.VBLK, S;LT 9 Date Issued: Mar 10, 2004 Expiration Date: Mar 10, 2005 070 - 03t- 6Z Parcel ID: 051-04344). Design Engineer: 0003 S & S Engineering Site Address: Owner Name: MARIE WARNKE Lot Size: 53981 SQ. FT. Owner Address: 22030 BIRCH CREEK DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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. Received By: Issued By: Z" Date: 3 1( / 0,/ �• �7� Date: .3 .00104 Municipality of Anchorage Development Services Department s' Building Safety Division w On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancho rage. ak. u s (907) 343-7904 rCIN-SITE SLYJER/L": LLL PERMIT APp':_tC-ATIOIN' FOR A SINGLE FAMILY DWELLING 05-1 - 631 - �Z Parcel I.D. v'"'��" Permit Number SW 0447028 Property Mailing address (1 Mailing address At 2 203v � Legal description (Lot, Block & Sub'd.) !� Day phone Legal description (Section, Township & Range) Lot Size 5 J, ! 9/ Acre /Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only 19 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 Single Family Dwellin (Signature of propefty o/ner or, Permit Fees: P f�s-; w nation is correct. I further certify that this application is being made for a is in ccordance with applicable Municipal Codes. Date of Payment: 212041 Receipt Number: (Rev. 12100) UV agent) s-� Waiver Fees: Date of Payment: Receipt Number: ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 February 19, 2004 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAINEKTENSIONS REFERENCE: Lot 9; Block 3; Knik View Subdivision SEWERS WATER INSPECTION It is requested that you issue a permit to drill a new well to serve the existing four bedroom dwelling on the referenced property. The existing well contains silt and will not clear up with use. ENGINEERINGSTUDIES ANDREPORTS We do not anticipate any adverse effects on neighboring septic systems, reserve areas or drainage patterns by the installation of the proposed well. The construction of this well will not prevent any future development on any of the adjacent properties. WELL INSPECTION &FLOW TEST If you require additional information, please contact us. Sincerely, NS SITE PLA/ ROAD DESIGN � �:/ RCC/ J Enclosure SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 1" = 50' WELL DESIGN \ A b _1 sniava 1GM .00� � \ SITE -PLAN Nfk, \o H co W �A ti Mm \ rA T�AZA n y ~ m DSO W o Z A < j L m5o L DDD <yC ymA �m 00 y A t x \q o \ I(� ✓ti A \o n m \ \ X N x � \ OO 9 nA ✓itiD A \ \ v iLo\\'v\mz\ \q O \ A b _1 sniava 1GM .00� � \ SITE -PLAN Nfk, \o H co W Mm T�AZA n y ~ m DSO W o Z A < j L m5o L DDD <yC ymA �m 00 y A t x O o K I(� ✓ti A n 2-06-1996 6:33AM FROM p,t j s STATEMENT OF NON -OBJECTION FOR ENCROACHMENT jiI WITHIN UTILITY EASEMENT i Matanuska Electric Association, Inc. (MEA) has no objection With the location of i a welt within the platted transmission line easement located in the seat WWUn = of the following property; + Lot 9, Block S, KnIk View Subdivision, Anchorage Recording District, State of { Alaska. ii Section 3, T1SN, R1W, S.M. < i This non -objection is granted with the Cult understanding and agreement by all parties having an interest in the above property that thistML cricrosiohmerill will In no restrict or limit the current or future ability of MEA to fully eNoy the enefits of the ay easement for any and all WRY purposes that it presently enjoys under the easement. i This non-ol�eotlon Is further coriffoned by the stipulation that MEA will be held harmless from liability for any and all damages to the encroachment that may result from the U126119 and future use of said easement by MEA, its contractors, successara, agents, licensees, or assigns, i r Matanuska ElectricAssocistlon, Inc. s. i By: �, General Ma ager or his Representat a X4 roste c MEA ACKNOWLEDGMENT STATE OF ALASKA. ) i THIRD JUDICIAL DISTRICT j The A N(Y ag foregoing agreement was acknowled ad before ms this --,day of dj ,by, Notary Public for the My commission expires: " /_ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page ' of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: J � I03C / PID Number: 3 1-_� 2, Name: +5 00'k�bu, l 1�5 Wastewater System: tK New ❑ Upgrade Addresvp '13ok5-:215- 77Ri<bike �g� jr ABSORPTION FIELD Phone:- P"') o f3 410 Nmber of Bedrooms: [3Deep Trentlp Shallw TrexV/h� Dead ❑ Mond KOther]✓N LEGAL DESCRIPTION Soil Rating: rD Total Dph from original grade: �fSFL GpO/F' Block:3 Lot: Subdlvisia¢ , ' , / �S�: �eW Depth to pipe bottom from onginal gra^de�: `f/�s'�f t' Gravel depth beneath pipe: \\ fGP + p5mr Township: Range: Fill added above original grade: G esag Ft. Well: UR New ❑ Upgrade Gravel width: Number tlnes: Distance be en Ynes: Ft. Clpl;fi adan (Pnv le, A. B, C): Total Depth: casedIv. / ��� ��� ^� Total absorplion area: ��O P (Hb;7 �'// (�o�, S��{�/FFt. �O� " / ' " ( Ft. Ft. FO JV f� / / 1 Driller: 1 1 „ Y //�/�J� lG�t ! �1 Data Drilled: s 30 0< Stagc Water Level: /1 Ft. I s Iter: J r wCe� F CC{UaTrA Dale Installed: �!-`�-O Yield: 1,7 GPM Pump B/el aC_ Pump Cl/ G� Fl. Casing Height 7Above Ground: G Ft. TANK SEPARATION DISTANCES ❑ septic ❑ Holding KS.T.E.P. ❑ Other: To From Septic Tank Absorption Field Lilt Station Holding Tank PublidPrivat Sewer Line M�^�ranarac / PJ er { `C capacity; �{.+tJ Gal. Well ©^ , 3 .� t ') r— t d) J + Material: HDPF r� YC Number of Compartments: Sudace Water ©D �Qfi �I - LIFT STATION Lot Line t ��\ `75 \ 5 Size: 5 aL ManWacluren 0 em/ i GS Foundation g 'Pump on' level at. "/ � in. "Pump og' level at: y(ry High water alarm al: _3 in. 418 In. Curtain Drain _ �/ O/�, OW Pump Make B Model �Gr Eleclncal lnspeccl'iJ�Ga/p dorm by: T Remarks BENCH MARK Lowgon and Deaviplion: (� eo Ttow oT 51, / n ry t9q%% med Elevation: to© Ft. E p S & 5 ENGINEERING 17034 Eagle River Loop Road, at 'I— 1 -0-a Inspections performed by: 1� ra-a •' '' '""` ° telile River, AlasVad 2nd§,n. .£. .. Development Services Department Approval A. �'Yn . lar{ r Reviewed by: Gt°.• Date: rx and approved PERMIT NO. SWO1 0367 PAGE 2 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH 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 LEGAL LOT 9, BLOCK 3, KNIK VIEW P.I.D. NO. QS_ j,0 (a,2 BLM LOT 46 ALT. SITE F_ I I I I J TH NEW LDS MT FV1 —FV8 (FLUSHMC VALVES) NEW 550 GALLON FAT ALBERT HDPE TANK W/ S.T.E.P. NEW 1300 GALLOP HDPE SEPTIC TANK BURIED LOT / / / / / -7 / ASPHALT / DRIVEWAY i 10 / 31L 011IN&W 441117d PERMIT No. SWO10367 PAGE 3 OF 3 MunicipaJt of Anchora e DEPARTMENT OF HEATH AND HUI`�AN 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 LEGAL, LOT 9, BLOCK 3, KNIK VIEW P.I.D. NO. °r/_ 0 31- (,2 FINAL GRADE 96.5' 9 6.1' 97.0' INSULATION ELECTRICAL CONDUIT 92.8' NEW 1300 GAL. IY." DISCHARGE PIPE POLY. TANK 92.5' _ 550 GALLON FAT ALBERT WITH PUMP ASSEMBLY FINAL GRADE MTI=94.5' MT1 ORIGINAL GRADE INSULATION PEA GRAVEL 9' VNUER LATERALS PIL1'6RJ. ALR LINE - 13AN0 DIST. LINE=92.2' MT1=91.9' BOTTOM OF SAND=89.9' N. T. S. ENGINEI•;R _STAMP FCO 20.0' 2.5' GROUNDWATER AT 86.4' '� ST1 ST2 19.0' 19.0' 10.5 14.0' 81.4' B.O.H. K Y TMT 22.0' 12.5' ° MH 20.0' 19.0' FV1 32.5' 33.5' —TV 8 48.5' 47.0 +� MT1 48.0' 48.0 �L e Jun.16 '03 23:45 FAX P. 1 Certttteb OrIth(tig 'Log by ooc co. oo, SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2750 OWNER OF LAND:fn....— ADDRESS: LEGAL DESCRIPTION: DATE:.h.1 PERMIT NUMBER: _0/0 34 3Date of Issue- - /.!Z - 01 1AX IDENTIFICATION NUMBER: Is well located at approved permit location? &Ws� _j No Method of Drilling: Mary L cable tool Depth of well:. Casing Type ,WallThickness�V#Z� inches Diameter inches, depth feet Llner Type:` Casing. Stickup Above Ground:. -feet Static Water Level: /5!_ Poet Recover Rate: / I gpm Method of Testing: _JILA2 Well Intake Opening Type: G-epiri end U open hole a Screened; Start feet Stopped _, __._., feet iJ Perforations Start feet t feet C1 0 Grout Type: ie.�T"a`u�r� Volume Depth: from Q feet, to _..........feet Well Disinfected Upon Completion? b -715s ❑ No Method of Disinfection: C him a rt 4, 44 To fo�0'ri - Comments: d f`sIC-C'm- � aylz�4'�.✓_�.0r b l T I a4.7 S g4. i df S.4r R47990 Driller's Name . (A:&g ArrENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. 08/17/03 TUE 10:21 FAS 907 3733833 Jim or Teresa Nelson TJ Electric 2750 Donovan Dr., Wasilla, Alaska 99654 (907) 376-0173 or 357-0173 R&S Construction PO Box 521577 Big Lake, AK 99652 (907)892-3511 June 17, 2003 Dear Roger, 3 Please be advised that the lift station at Lot 9 Block)KKnik View, Birchwood, was wired to the directions of the schematics on the control, in conjunction to the National Electrical Code (NEC). All work was performed by a licensed journeymen electrician, under the direction of an Electrical Administrator. If you have any further questions about the above mentioned lift station, please feel free to contact me at the numbers listed above. Thank you, James C. Nelson, Owner Electrical Contractor - #16873 Electrical Administrator - #719 Cc: S&S Engineering - 694-1250 Tweed Excavation - 694-1211 fa 0 01 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 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SWO10367 -- --jam i V Design Engineer: 0003 S & S Engineering Owner Name: Ted Schmelzer Owner Address: PO Box 999 Neches , WA 98937 - ?1710 z ZP" �//D1-z Date Issued: Sep 12, 2001 Expiration Date: Sep 12, 2002 Parcel I D: 061_03(_ 62 Site Address: Lot Size: 64796 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: 0✓ Disposal Field ❑✓ Septic Tank E] Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑✓ 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. Received By: Issued By: Date: Date: / -12 ' �� 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 3 ( — G -2- Permit Number SW 010367 Property owner(s) I f la 5 C 4M t L -z- 't R Day phone G 1' 91 Mailing address (1) yO- D • 3 o X 9 �l j /}�'� -5 w .4 Mailing address (2) p I f Zip Code Legal description (Lot, Block & Sub'd.) L O t�/ b 1_ OG K 3: Kn; t V ,'BuJ- Legal description (Section, Township & Range) /' Lot Size I, -a �1`T Acres q.Ft Number of Bedrooms &6/ 7141 THIS APPLICATION IS FOR: 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. (Signature of property owner or authorized agent) Permit Fees: i 'y yo • J - Waiver Fees: Date of Payment: S—/?o /O / Receipt Number: 0 of'o G 3 (Rev. 12100) 5 & S ENGINEERING 17034 Eagle River Loop Road No. 204 Date of Payment: Receipt Number: S& May 15, 2001 ROBERT C. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 SEWER&WATER MAIN EXTENSIONS REFERENCE: Lot 9, Block 3, Knik View S/D INSPEcnONTER It is requested that you issue a permit to install a well and a septic system to serve the proposed four bedroom dwelling on the referenced property. Two test holes were excavated and percolation tests performed. The approximate locations ENGINEERINGSTUDIES ANDREPORTS of the test holes are located on the attached site plan. At the time of excavation 5/2/01 rlcioi water was found at 8 feet. After monitoring, ground water was found at 8 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELLINSPECTION BFLOWTEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITEPLANS If you require additional information, please contact us. Sincerely, ROADDESIGN /J SOIL TEST Robert C. Cowan, P.E. RCC/bjj PERCOLATIONEnclosure TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 N �o O w 0 - CD CD 30 o a ~z O f=O Y r Q f F p�0,5, n K a Vl 0 M OME O W os O) a_ M W K M N N W ~ rr1-�-I � J d m N �l > N � C, a� ow r p4 Z> OLL ZY O z �a 0 v �a �> ao <� W OV Q oa m W Z r N U p o of C� U O N s w� z m 0 M m W ~ m N O W o-�Ln O ~ U�O a 0EL00 O II II o N U NI Q m u 0 D W d a rIL W w w 0 J� Q m w m O .�z z o Q� Ln O Of U a� W W iti o^\�s H d > j • !2 {.44N \ a' uj co (n U Ei o r \ \ 0 0 3 0 N3 a\ ti N Q_ DL W 11 o r N �o O w 0 - CD CD 30 o a ~z O f=O Y r Q f F p�0,5, n K a Vl 0 M OME O W os O) a_ M W K M N N W ~ rr1-�-I � J d m N �l > N � C, a� ow r p4 Z> OLL ZY O z �a 0 v �a �> ao <� W OV Q oa m W Z r N U p o of C� U O N s w� z m 0 M m W ~ m N O W o-�Ln O ~ U�O a 0EL00 O WIMMIM a 0 NOIS34 ofM II II o N U NI Q m u 0 D W d a rIL W w w 0 J� Q m w m O .�z z o Q� Ln O Of U a� W W iti H d > WIMMIM a 0 NOIS34 ofM mm- u 0 D W d rcmm rIL W w w ><�^ W �_ Z p300 wm�m i .�z ^In Q 00 a� WIMMIM a 0 NOIS34 ofM D W d 7-1 J W w 0 Z eel "` •v C)WE-4 z cn TZp i w��a c7 �awz's p IP — I O N S ISA - a N W o 9 2 a ra-d %a GL 3 Moo MA c' S�U m ci o F CJ ci 0 s O U � LL: �(n fw a WN °!� N U �m.63 s N CD W W ppFw w \ n 6 6 L �v b'm W�° IILD II Cf) o m g II O U O-0 W m O cf ; ae rc-t ON tOO �a [If W W z F > wn jy N � ow W � �w y NNN H pYpi LyJ LJ` r_ ./� W oh1 >6�^ W Q Z w wpm O O o0 npa4 � d,N^ a ow Awn'; 311JONcl NOIS30 S '1 "N N � V �j O W r' 3 \ gc 0 5i pc M� .s�s� .oe }1 �_K V p OJp WW Z <V GSJ KF S �Z �Ww O Uw (ENGINEER'S SEAL) e Municipality of Anchorage R �r DEPARTMENT OF HEALTH &HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650'` SOILS LOG - PERCOLATION TEST PERFORMED FOR: q/�C-V`I%r`�iL' DATE PER FORR4da�'+��D) LEGAL DESCRIPTION:_ 1 3 ^"I IL V. Township, Range, Section: tit aq .,, DEPTH SLOPE SITE PLAN (FEET) 2 �, d�/Mie N 3 �✓ 5� 1 4 7[l rf.r C t.,,,/,y j 5 i'J Gross Time Net Time '.6 a� Net Drop 6 '. Lk) 7 r 8 9 �r 7 C, 10 11 12- 13- 14- 15- 16- 17- 18- 19 213141516171819 20 �Ze]SI7d�+7b9 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT Q t L DEPTH? D Depth to water Agerr _ Monitoring? �' Date: `� J D 1 Reading Date Gross Time Net Time Depth to Water Net Drop "1 •+ 7' � �1 S ]—Y4 "J n V N N 1 „ 7h to PERCOLATION RATE Z- (mmutesrinch) PERC HOLE DIAMETER b- TESTRUNBETWEEN 4/6— FTAND 'r -r FT S & 5 ENGINEERING PERFORMED BY: 1 70J4 begie yer +_ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITIEatle8LW41F+AI&I0t R007L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PERFORMED LEGAL DESC 1 oe, 2 Depth to Water Net Drop d J 0 3 r, 4 g .Y 1 S'IU-�^I{� a r 7 8 s � " N IN - B. 11 12 i 13 .r. '.a.11. 14- 4151617 L' 15- 16- A 17 s192018- 19- 20 COMMENTS o(E`G,IINREER SaSEAL) Municipality of Anchorage DEPARTMENT OF HEALTH R HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST +a'_P"-•,%E - 8801 DATE PERFORAr� le- lb- c SLOPE WAS GROUND WATER 1,.. ENCOUNTERED? N� S IF YES, AT WHAT /-ll A' L DEPTH? •T5 O P E Depth to Water Alter Monitoring? Dater O I SITE PLAN S Z Reading Date Gros Time Net Time Depth to Water Net Drop 0 1 S'IU-�^I{� r N N IN � a„ 2ft i Le •1 L' j?, A PERCOLATION PATE .2 — (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN J1� FT AND 5, t FT PERFORMED BY: S -$.S F=169EEP NG / L/Zv�� 77034 Eag e ( � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WIT1ag6 ft� Af0k1ILM;f7AL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) CC 88 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 OSC251324 Parcel ID 051-031-62 Legal description KNIK VIEW BLK 3 LT 9 Site address 22030 BIRCH CREEK DR Current property owner(s) HURD MARIA S Expiration Date: zo X The On -site system(s) is/are approved for 4 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 8/19/2025 This Certificafe of Ob-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 X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF Development Services Department . . . . . .... On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-031-620-00 Complete legal description Lot 9, Block 3, Knik View Subdivision Location (site address) 22030 Birch Creek Drive, Chugiak, AK 99567 Current property owner(s) Hurd, Maria S Day phone (907) 317-7285 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: RE Private Well serving k-1— dwelling units R Other Non-public well as regulated by MOA 171 Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic M Private Septic serving 2 dwelling units 1771 Holding Tank F-1 Community Septic or Public Sewer 5. SEPTIC TANK: M Steel FMJ Plastic E] Concrete R Fiberglass Age 23 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: R AwwTs F-1 Bed F Deep Trench F Wide Trench El Seepage Pit Waiver request for: Distance: Expedited review requested: f_1 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 $ XM cro Waiver Fee $ Date of Payment Date of Payment COSA # 2e, Waiver # COSA Application—Apr2025.doc Legal Description: Lot 9, Block 3, Knik View Subdivision (22030 Birch Creek Dr) parcel ID: 051-031-620-00 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system House A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 25* gpm Date drilled 3/16/2004 Total depth 121 ft Water storage tank volume gallons Cased to 120 ft Well disinfected for coliform test? ❑ Yes ❑ No ❑ Sanitary seal is functioning correctly ❑ Coliform bacteria is Negative OR Wires are properly protected Nitrate mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) 18 in. Arsenic 5.28 ug/L ❑ Arsenic less than MRL (ND) Date of flow test for COSA 7/14/2025 Collected by Scott Roelfs, P.E. - VEI Consultants Static water level at beginning of test 24* ft. Date 7/14/2025 Comments *From well log. Used 150' garden hose for adeauacv testina. Solid 4 to 5 anm for 25 hours B. TANK DATA Measured operating fluid level in septic tank 46" Date of pumping 7/16/25 ❑ Required maintenance completed, if AWWTS Comments: HDPE tank installed in 2002 D. DISPOSAL FIELD DATA Which system tested (date installed) 9/10/2002 ❑ ALL standpipes present per record drawing Total measured depth from grade 2.8 ft (max) Measured depth to pipe invert from grade ft (min) ❑ NIA — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) No If yes, enter date C. LIFT STATION ❑ Required maintenance completed Age of lift station 23 years Lift station material HDPE Comments: IDSF Maintenance Log prepared by JRs Septic on 7/16/25 Adequacy test date 7/14/2025 Results Q Pass Fluid depth prior to test 0 in Water added 600 oal New fluid depth 0 in Elapsed time 150 min Final fluid depth 0 in Absorption rate Ovu gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 27 in Effective depth used ** in Effective depth remaining ** in Comments/Deficiencies: Intermittent Dosing Sand Filter system. 3" pea gravel overtop 24" filter sand. **Monitoring tube is to bottom of pea gravel and was dry for duration of test. IDSF Maintenance Log prepared by JRs Septic on 7/16/25 COSA Checklist_May2025.clocx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes if No ft Neighboring Tank > 100' J❑ Yes if No ft Disposal Field on Lot > 100' ® Yes if No ft Neighboring Disposal Fields > 100' ® Yes if No ft Sewer Line/Main > 100' ✓❑ Yes if No ft Sewer Manhole/Cleanout > 100' Q Yes if No ft Sewer Service/Septic Line > 25'® Yes if No ft Holding Tank > 100' ® Yes if No Animal Containment > 50' JD Yes if No Manure/Animal Excreta Storage a 100' ❑ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' ❑ Yes if No 8 ft Surface Water > 100' Z Yes if No Field to Foundation > 10' Q Yes Tank to Property Line > 5' ✓❑ Yes Field to Property Line > 10' El Yes Water Main/Service Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: if No ft Wells > 100' if No ft if No ft Community Wells > 200' M Yes if No Z Yes if No If tank or field is under driveway comment below F. ENGINEER'S COMMENTS See attached water sample lab results and IDSF Maintenance Log ft u, T ft ft ft 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 VEI Consultants Engineer's Printed Name Scott T Roelfs Phone (907) 337-3330 Date 8/18/2025 _,, TH COSA Checklist_May2025.docx MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 13 John Powers Day of August of 20 25 , by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Residential Septic located at (legal description) 22030 Birch Creek Drive, Chugiak AK 99567 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) j ` Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. � V J It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. `j Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 I Owner acknowledges that the Municipality may request records of maintenance and j� repairs from the manufacturer's representative or maintenance provider. O Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60,030. S Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. J Owner agrees that any sale or transfer of title of the property will not occur without a new D Certificate of On -Site Systems Approval. J ! Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. J B Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: (signature) John Powers (print name) STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT Date: 13 Aug 2025 The foregoing instrument was acknowledged before me this —N,�Aay of 20 by NOTARY PUBLIC FOR ALASKA My Commission expires: MUNICIPALITY: By: 14 _(signature) Date: TO &-1., 5 F,1:) (print name) Title: ti r r (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE • Community Development Department • On -Site Water & Wastewater Program P: 907-343-7904 • F: 907-343-7997 • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.oTouilding Intermittent Dosing Sand Filter Maintenance Log OwnerStreet Address_ 2 r Phone L al Desc. PID Septic Tank: -Sludge level _inches -Pumping: required Yes 6:' -Pumping completed a no Absorption Field: -Liquid level v inches -Flushing valves per approved design s no -All flushing valves opened, distribution lines flushed, and flushing valves closed a no Lift station: *Pump basket cleaned es no •Biotube effluent filter cleaned e '' no -Timer float settingRinc es -High level float settinA riches -Reference point L` -Pump on _seconds n / -Pump offIVA' _minutes •Cumulative lifetime cycles / V -Cumulative run time A/A hours *Operation satisfactory a no Air System: �' Jr •Air pump filter cleaned no -Air pressure psi -Date of latest install or re uild UNIGMwkgir system operation is ac ory not satisfactory Alarm System: •Dedicated electrical circuit (�e no •Audible and visual alarm inside dwelling yes *Float setting 0 inches -Alarm system operatio atisfa cto not satisfacto ry Comments: .... ...q 1:..1..1 .- . 666 ... ................... ..............................................................................................................................�:. ................... ................................................................................................................... ............................................................................................................ .................................................................................................................... ................................................................................................................... Maintenance Provider: Technician 0_& Date of maintenance Company, Signature,e C IDSF Maintenance Log_040313.doc Dayna M. Rumfelt R E GISTEREDPROFESSIO N A L L A N D S URVEYORNo. LS 13322 NORTH0 SCALE: 1" =40' 40 ' 80 ' 8/18/25 Civil Engineering and Surveying Consultants Serving All of Alaska August 18, 2025 Curtis Townsend, P.E. Municipality of Anchorage — Development Services On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 1345 Rudakof Circle, Suite 201 Anchorage, Alaska 99508 Phone: (907) 337-3330 Re: Lot 9, Block 3, Knik View Subdivision — COSA Application Well Investigation Summary Mr. Townsend, Thank you for your comments on the COSA Application for the above referenced property. I would like to address your first comment, which gives a historical overview of the system and requests a decommissioning log for the well drilled in 2002. A review of the historical records to -date suggest the following approximate timeline: Sept 2001 — Permit is issued by MOA Onsite for construction of private well, septic tank, and disposal field May 2002 — Private well is drilled by Sullivan Water Wells to a depth of 61 feet Sept 2002 — Construction of septic tank and disposal field completed May 2003 — As -built survey completed by Fleming Surveying Services June 2003 — MOA Onsite approval granted March 2004 — Permit is issued by MOA Onsite for construction of private well; documents suggest existing well contained silt and was not clearing up with use March 2004 — Private well is drilled by Sullivan Water Wells to a depth of 121 feet Unfortunately, there is no further information in the records addressing the final location of the 2004 well and the abandonment of the 2002 well. Verbal Investi ation I first contacted Cole Sullivan with Sullivan Water Wells and requested a copy of the decommissioning report for the 2002 well. He was unable to find any reports in his files; only the well logs already available to us. Cole referred me to Jim Sullivan with Arctic Pump, who (at that time) installed pumps and completed that kind of work in conjunction Well Investigation Summary — Lot 9, Block 3, Knik View Subdivision August 18, 2025 Page 2 of 2 with Sullivan Water Wells. Jim also had no records of decommissioning a well on this property. In the meantime, the homeowner contacted Randy Warnke (original homeowner) to discuss what he remembered. Randy was certain that the 2002 well was never abandoned, but rather was extended in 2004 (as opposed to drilling an entire new well). I mentioned this new finding to Cole, who stated he thought "that is exactly right" and apologized for not initially remembering. Comparing both well logs in the records, the top 61 feet are the same for both wells. Field Investi ation We re -visited the property and took additional measurements to validate the well location on the 2003 as -built survey. We measured distances from five house corners, the northeast property corner (monument), and the power pole; all locations common to the 2003 as -built drawing. We found that all our measurements suggest the well is approximately 14 feet south from the location shown on the 2003 as -built drawing. I believe the well location shown on the 2003 as -built drawing is inaccurate; for this reason I have requested a new as -built survey be performed. I suspect the well location shown was carried over from the permitting documents. We also examined the front yard for any anomalies that might suggest an improperly abandoned well; we found none. We followed up using a metal detector and did not find any obvious targets. Summary From our investigation, I believe that the current well on this property was initially constructed in 2002 and extended to its current depth in 2004. The proposed well shown on the 2004 permit documents was never constructed. This would explain why a new well log was submitted to MOA Onsite, but an updated as -built survey and well decommissioning log were not. If you have any questions, please contact me at (907) 337-3330. Sincerely, VEI CONSULTANTS Sc ^ Municipality of Anchorage • Development Services Department Box 521577, 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 Rt,ERTIFICATE OF HEALTH AUTHORITY APPROVAL R FOR A SINGLE FAMILY DWELLING t Parcel I.D.. O 5—T-0 3 l -(ate- Expiration Date: 9 - l fj - O 3 1. GENERAL INFORMATION Complete legal description Lot 9: Block 3: Knik View _ -Z _ Location (site address or directions) NHN Birch Creek Drive, Chugiak, AK 99567 _ Current Property owner(s) R & S Homebuilders Day phone 232-0242 Mailing address PO Box 521577, Big Lake, AK 99652 __ Lending agency Day phone �^ _ Mailing address Real Estate Agent Day phone Mailing Address — Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: ' TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site F 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. f, 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, basbd 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. Namo of Firm S & S Engineering Phone 694. 2979 Address 17034 N. Eagle River Loop RD. Eagle River, AK 99577 Engineer's Printed NameRobert Shafer Date June 17, 2003 S. DSD SIGNATURE _AZ Approved for 4 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �W. �o P// Original Certificate Date: (Rev. 01102) Municipality of Anchorage ' Development Services Department e Building Safety Division " On -Site Water & 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 Description: 9 T ' &YI 06K 3; T 11 14 V[�h/ Si Parcel iD: U S 1' L A. WELL DATA Well type if A, B, or C provide PWSIDI# Well Log (YIN) Date completedd_ Sanitary seal (Y/N) `7 Wires properly protected (Y/N) / Total depth 6/ft. Cased to —ki—ft. Casing height (above ground) _A8_'1' in. FROM WELL LOG AT INSPECTION Date of test i Static water level Well production.. —1 g.p.m. ____ 9.p -m. WATER SAMPLE RESULTS: Coliform _ colonies/100 mi. Nitrate O• l mg ./I. Other bacteria colonies/100 mi. Arsenic: mg./l. Date of sample: Collected by: S & S INGINRtRINO B. SEPTICIHOPM6 TANK DATA/ / L 17034 Eagle River Loop Read N0.404 Tank Type/Material �(�iIG 1 t` Dateeinsta River, Alaska 995 O 2 Tank size/ 300 gal. Number of Compartments Z Cleanouts (Y/N) % Foundation cleanout (Y/N) / Depression over tank (YIN) n� High water alarm (Y/N) Date of pumping 1XI&I- I Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ftZ or ftzlbdrm) G• System type Length ft. Width l I? ft. Gravel below pipe ft. Total depth ft. Eff. absorption area �W ftZ Monitoring tube % Depression over field Date of adequacy test IV61 Results (Pass/Fail) //! SS For bedrooms Fluid depth in absorption field before test Q in. Water added gal. Newdepth —in. Elapsed Time: _ min. Final fluid depth = in. Absorption rate >= 1007 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) Al, _ If yes, give date D. LIFT STATION Date installed 10 0 "Pump on" level at 44 in. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) i "Pump off"level at _3& in. High water alarm level at 46 in. Cycles tested k — Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot / o o r+ Absorption field on lot 1 00 1+ Public sewer main pJ S er /septic service line '9 On adjacent lots _ / O® 14 - On adjacent lots /00 f+ Public sewer manhole/cleanout /V /a Holding tank ti A SEPARATION DISTANCES FROM SEPTIC/HO12t1VG TANK ON LOT TO: Building foundation r� Property line _��� Absorption field i 1 Water main Water service line / © F Surface water /00 / t - Wells on adjacent lots 100 / t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t t0 i•/- Building foundation _ 10 � Water main 0 t+ Water Service line 1tZ Surface water / 00 /'t- Driveway, parking/vehicle storage Curtain drain f V Dnl� m o w Wells on adjacent lots 100 f F. COMMENTS 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 guid in in effe t on i dat . ^r"'" Engineer's Printed Name n Date 6_/21d3,. t+ert AI ti fi HAA Fee $ '� 25� i` 15-0 X✓14 Date of Payment �to7 - 1-2 - Q 3 ? Receipt Number % 1 (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number N 00°03' I I "W 73.38' N W N _ � m �ti• a � — W � x m , A � m n `� �e0 ��Is � ICk a �03g.d�^�C,\ 27.6' %1 'tri � °pNCyi ` . N , n ti "1..,, ,,, � • i?� 9j � r o e2 S R. m 3 EFk D °° b �O n io mON t o-RRZ f js o v� x Sn 30as° o5 � lol- co a 0 o � S/ ••��� C 110 M 2L C7 34a 5 Ta8� �. 7. f • • / x �o.•�w gin (lq•• n n o ao ao o a v R3 pOc.'