HomeMy WebLinkAboutEARL RAY BLK 3 LT 37Earl Ray
Block 3
Lot 37
#051-113-17
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251287
Work Type: Septic Upgrade
Tax Code Number: 05111317000
Site Legal Address: EARL RAY BLK 3 LT 37 G:1360
Site Mailing Address: 23936 SKI RD, Chugiak
Owner: CAMDEN DANIEL J & DANI L
Design Engineer: AK BUILT CONSTRUCTION & DESIGN LLC^
This permit is for the construction of:
Disposal Field Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
8/22/2025
8/22/2026
41310
❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: Existing field is sized for 4 bedrooms. This permit is for a septic tank that will allow the
septic system to be sized for 4 bedrooms.
Received By:s Date:
Issued By: Date:
4
ON -SITE SEPTICMELL PERMIT APPLICATION
Parcel I.D. 05111317000
Property owner(s) Dani & Daniel Camden Day phone 9073172711
Mailing address 23936 Ski Rd, Chugiak, AK 99567
Site address 23936 Ski Rd, Chugiak, AK 99567
Legal description Earl Ray Block 3 Lot 37
Number of Bedrooms 4
Engineering Firm AK Built Construction & Design, LLC
Building Permit Number
Not Applicable 1*0
APPLICATION IS FOR:
APPLICATION IS AN:
(Z all that apply)
Disposal Field
Initial ❑
Septic Tank
0
Upgrade
Holding Tank
❑
Renewal E]
Privy
❑
Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
N/A
Distance:
Permit/Rush Fees: Waiver Fees:
Date of Payment: 5;-/ ra Date of Payment:
Permit No. 6'spp'ylirr? Waiver No.
May 2025
PO Box 771203, Eagle River, AK 99577 – Phone: (907) 854-9115 Page 1 of 1
AK Built Construction & Design , LLC
General Contracting - Engineering - Project Administration
August 21, 2025
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Section
PO Box 196650
Anchorage, AK 99519
RE: Earl Ray Block 3 Lot 37 – Septic System Construction – Tank Permit
A permit is requested to install a conventional septic tank for the subject property. The existing soil
absorption system is designed for a 4-bedroom structure, but the existing septic tank is sized for a 3-
bedroom structure. The proposed system will serve an existing 4-bedroom, single-family home. This
design is for a 4-bedroom structure.
Wells
The subject property is served by a community water well located to the southwest and is more than 200’
from the nearest property line. Neighboring parcels to the south and west (Troll Knoll Subdivision) are
served by a community water well. Neighboring parcels to the north and east are served by private water
wells. There are no wells within 100’ of the designed septic system.
Existing disposal site
The existing disposal site is a bed system, reported as 18’ wide by 37.5’ long, and 6” effective depth. The
existing system is sufficient to support 4-bedrooms based on historical soil log data. Neighboring parcels
with existing disposal sites do not impact the subject parcel and the proposed system will not negatively
impact neighboring parcels.
Drainage
There is no surface water located within 100’ of the designed system.
Topography
The designed system is in the southwest quadrant of the property. The surrounding property slopes up-
gradient to the southeast and slopes down-gradient to the northwest. Steep slopes exist at least 50-feet
from the designed system, as shown in the plans.
The designed system does not have probable adverse impacts to adjacent properties.
If you have any questions, please contact me.
Sincerely,
Robert Colles, PE
AK Built Construction & Design, LLC
Project Manager/Managing Member
907-854-9115
rlcolles@akbuilt.net
8/21/25
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EARL RAY
BLOCK 3 LOT 37
WHALEY SUBD
TRACT 1A
EARL RAY
BLOCK 3 LOT 36
EARL RAY
BLOCK 3 LOT 35
TROLL KNOLL
BLOCK 2 LOT 7
TROLL KNOLL
BLOCK 2 LOT 8
TROLL KNOLL
BLOCK 3 LOT 4
TROLL KNOLL
BLOCK 3 LOT 5
SKI R
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PRIVATE WELL
R100'
R100'
4-BEDROOM
HOUSE
GRAVEL
DRIVEWAY
WATER SERVICE LINE
EXISTING CHAIN LINK FENCE
EXISTING BED SYSTEM, 18' x 37.5'
EXISTING SEPTIC TANK,
ABANDON IN PLACE
1,250-GAL MINIMUM SEPTIC TANK
DCO
DCO
LOCATE EXISTING BUILDING
SEWER AND CONNECT
LOCATE EXISTING DISPOSAL
SEWER AND CONNECT
WELL RADIUS, TYP
EXISTING SEPTIC FIELD
EXISTING SEPTIC TANKS
EXISTING SEPTIC TANK
EXISTING SEPTIC FIELD
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AK BUILT
CONSTRUCTION & DESIGN, LLC
PO BOX 771203
EAGLE RIVER, AK 99577
(907)854-9115
CERTIFICATE OF AUTHORIZATION
#204451
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3OF
8/21/2025
DATE:
SHEET TITLE:
ROBERT COLLES, PE
No. CE-163739R
E
GISTEREDPROFES S I O N A L E N GINEER
8/21/2025
NOTES:
1.EARL RAY BLOCK 3 LOTS 35 AND 36, AND WHALEY TRACT 1A ON-SITE
SEPTIC SYSTEMS AND WELLS DO NOT INTERFERE WITH PROPOSED SEPTIC
SYSTEM.
2.EARL RAY BLOCK 3 LOTS 35 AND 36, AND WHALEY TRACT 1A ON-SITE
SEPTIC SYSTEMS AND WELLS ARE NOT NEGATIVELY IMPACTED BY THE
PROPOSED SEPTIC SYSTEM.
3.TROLL KNOLL BLOCK 3 LOTS 4 AND 5, AND BLOCK 2 LOTS 7 AND 8 ON-SITE
SEPTIC SYSTEMS DO NOT INTERFERE WITH PROPOSED SEPTIC SYSTEM.
4.TROLL KNOLL BLOCK 3 LOTS 4 AND 5, AND BLOCK 3 LOTS 7 AND 8 ON-SITE
SEPTIC SYSTEMS ARE NOT NEGATIVELY IMPACTED BY THE PROPOSED
SEPTIC SYSTEM.
5.EARL RAY BLOCK 3 LOT 37, TROLL KNOLL BLOCK 2 LOT 7 AND 8, AND TROLL
KNOLL BLOCK 3 LOTS 4 AND 5 ARE SERVED BY A COMMUNITY WELL
LOCATED SOUTHWEST OF PLAN VIEW.
1
SITE PLAN
Feet
0 20 40
SYSTEM DESIGN:
1.DESIGNED SYSTEM IS FOR EARL RAY BLOCK 3 LOT 37. MUNICIPALITY OF ANCHORAGE (MOA) PARCEL ID
05111317000.
2.DESIGNED SYSTEM WILL SERVE A 4-BEDROOM, RESIDENTIAL SINGLE-FAMILY HOUSE.
3.SEPTIC TANK CAPACITY IS A MINIMUM OF 1,000-GALLONS PLUS 250-GALLONS FOR EACH BEDROOM OVER
THREE.
3.1.SEPTIC TANK SHALL BE A MINIMUM 1,250-GALLON CAPACITY TANK. A STEP TANK SHALL HAVE AN
ADDITIONAL 250-GALLON OF CAPACITY.
MATERIALS SPECIFICATIONS:
1.WASTEWATER DISPOSAL SYSTEM COMPONENTS AND MATERIALS SHALL BE APPROVED BY THE MOA IN
ACCORDANCE WITH THE CURRENT EDITION OF MOA'S PUBLICATION "STANDARDS AND SPECIFICATIONS
FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL
SYSTEMS".
2.COMPONENTS INCIDENTAL TO THE SEPTIC SYSTEM INCLUDING BUT NOT LIMITED TO PIPING, FITTINGS,
PUMPS AND VALVES THAT ARE LISTED OR LABELED BY A MOA APPROVED ACCREDITED THIRD PARTY
LISTING AGENCY FOR THE INTENDED USE DO NOT REQUIRE THE MOA SUBMITTAL/APPROVAL PROCESS.
3.SEPTIC TANKS SHALL BE CONSTRUCTED FROM DURABLE, CORROSION-RESISTANT MATERIALS, INCLUDING
CONCRETE, FIBERGLASS, OR PLASTIC. SEPTIC TANKS CONSTRUCTED FROM STEEL SHALL BE COATED ON
BOTH THE INTERIOR AND EXTERIOR WITH AN APPROVED POLYURETHANE LINING OR SUPERIOR MATERIAL.
4.ALL SEPTIC TANKS SHALL BE FITTED WITH WATERTIGHT COUPLINGS, APPROVED BY MOA, AT THE
PUMP-OUT ATTACHMENTS AND ON THE INLET AND OUTLET OF THE TANK.
5.A SEPTIC TANK SHALL HAVE A 20" MINIMUM DIAMETER MANWAY RISER SERVING THE FIRST
COMPARTMENT. THE RISER, INCLUDING THE COVER, SHALL BE INSULATED WITH 4" MINIMUM INSULATION
EXTENDING 48" BELOW GRADE OR TO THE TANK INSULATION. THE INSULATION SHALL BE OF AN APPROVED
TYPE SUITABLE FOR BELOW GRADE APPLICATIONS. EXPOSED INSULATION ABOVE GRADE SHALL BE
PROTECTED FROM UV DAMAGE. THE RISER LID SHALL BE SECURED TO PREVENT UNINTENDED ACCESS.
6.PIPE AND FITTINGS SHALL BE IN ACCORDANCE WITH NOTE 1 AND "PIPE AND FITTINGS MATERIAL" TABLE.
7.PIPES USED IN GRAVITY DISPOSAL SYSTEMS SHALL BE 4" IN DIAMETER.
8.CLEAN OUTS SHALL BE LONG SWEEP.
9.SEWER ROCK/DRAIN ROCK SHALL BE COARSE, WASHED AGGREGATED THAT MEASURES 12" TO 2" IN
DIAMETER WITH NO MORE THAN 1% PASSING THE No. 200 SIEVE.
10.BEDDING MATERIAL FOR SEPTIC TANKS SHALL BE PER MANUFACTURER'S REQUIREMENTS.
11.FILTER FABRIC USED AS A SILT BARRIER IN THE CONSTRUCTION OF ABSORPTION FIELDS SHALL BE A
PERMEABLE GEOTEXTILE APPROVED FOR THE APPLICATION.
12.INSULATION USED IN THE CONSTRUCTION OF SEPTIC SYSTEMS FOR THE PURPOSES OF FREEZE
PROTECTION OF DISPOSAL FIELDS AND SEPTIC SYSTEM COMPONENTS SHALL BE MINIMUM TYPE IV
EXTRUDED OR EXPANDED POLYSTYRENE, 25 PSI COMPRESSIVE STRENGTH.
PIPE AND FITTINGS MATERIAL
PIPE TYPE OR ASTM
DESIGNATION
APPROVED AS PERFORATED
DISPOSAL FIELD PIPE OR
SOLID COLLECTOR PIPE
APPROVED AS CLEAN
OUT OR STANDPIPE
CAST IRON **YES YES
ASTM D3034 (PVC)YES YES
ASTM F789 (PVC)YES YES
ASTM D1785 (PVC)**YES YES
ASTM D2665 (PVC)**YES YES
ASTM D2751 (ABS)YES NO*
ASTM D2661 (ABS)**YES YES
ASTM F628 (ABS)**YES YES
ASTM F810 (HDPE)YES NO
*D2751 MAY BE APPROVED AS STANDPIPE MATERIAL IF THE MINIMUM WALL THICKNESS
IS 0.18", SDR 23.5.
**UNDERGROUND DWV PIPE MATERIALS LISTED IN UPC TABLE 701.1 (2012).
CONSTRUCTION SPECIFICATIONS:
1.SEPARATION DISTANCES AS IDENTIFIED IN THE "SEPARATION DISTANCES" TABLE SHALL BE MAINTAINED.
NOTIFY THE ENGINEER OF DISCOVERIES MADE DURING CONSTRUCTION THAT IMPACT SEPARATION
DISTANCE REQUIREMENTS.
2.FLAG AND SURVEY ALL PROPERTY LINES, WELL RADII, AND EXISTING FIELD SEPARATIONS PRIOR TO START
OF CONSTRUCTION.
3.LAYOUT ALL FIELD COMPONENTS AND LOCATIONS PRIOR TO START OF CONSTRUCTION. NOTIFY THE
ENGINEER IF CONFLICTS EXIST.
4.GROUNDWATER MONITOR TUBES SHALL REMAIN IN PLACE UNTIL CONSTRUCTION BEGINS. ABANDON
GROUNDWATER MONITOR TUBES BY CUTTING ONE FOOT BELOW GRADE AND ABANDON IN PLACE. IF THE
GROUNDWATER MONITOR TUBE IS WITHIN FIVE FEET OF THE DISPOSAL FIELD, REMOVE THE
GROUNDWATER MONITOR TUBE IN IT'S ENTIRETY.
5.TANKS WITH TWO TO FOUR FEET OF COVER SHALL BE INSULATED WITH A MINIMUM OF 2" OF APPROVED
INSULATION PLACED IMMEDIATELY ABOVE THE TOP OF THE TANK. TANKS SHALL NOT HAVE LESS THAN
TWO FEET OF COVER. INSULATION SHALL EXTEND 12" BEYOND THE EDGE OF TANK FOR EVERY 1" OF
INSULATION PROVIDED.
6.A SEPTIC TANK SUBJECT TO BUOYANCY FORCES SHALL BE ANCHORED OR BALLASTED AS REQUIRED TO
PREVENT FLOTATION REGARDLESS OF THE LIQUID LEVEL IN THE TANK.
7.A SEPTIC TANK SHALL HAVE A 4" MINIMUM STAND PIPE PROVIDING ACCESS TO OTHER COMPARTMENTS
NOT SERVED BY THE MANWAY RISER.
8.PROVIDE AIR TIGHT CAPS ON ALL CLEAN OUTS AND MONITORING TUBES.
9.PROVIDE A BUILDING CLEAN OUT INSTALLED ONE TO FOUR FEET FROM THE BUILDING FOUNDATION. IF NOT
PRACTICAL, A DOUBLE CLEAN OUT SHALL BE INSTALLED ON THE UPSTREAM SIDE OF THE SEPTIC TANK
WITHIN TEN FEET OF THE INLET.
10.A DOUBLE CLEAN OUT SHALL BE PROVIDED WITHIN TEN FEET OF THE SEPTIC TANK OUTLET. THE
OPPOSING CLEAN OUTS SHALL BE ORIENTED SUCH THAT THE CLEAN OUT CLOSEST TO THE TANK SHALL
BE TO CLEAN THE LINE AWAY FROM THE SEPTIC TANK, AND THE CLEAN OUT FURTHEST FROM THE TANK
SHALL BE ORIENTED TO ALLOW CLEANING TOWARD THE SEPTIC TANK. THE CLEANOUTS SHALL BE
LOCATED ON UNDISTURBED SOIL. A PRESSURE SYSTEM DOES NOT REQUIRE A DOUBLE CLEAN OUT.
11.SINGLE SEGMENTS OF SUBSURFACE DISPOSAL FIELDS SHALL NOT EXCEED 100 FEET IN LENGTH.
12.THE LONG AXIS OF A DISPOSAL FIELD SHALL FOLLOW THE CONTOURS OF THE ORIGINAL GROUND.
13.THE HORIZONTAL SEPARATION DISTANCE BETWEEN THE CLOSEST EDGES OF WORKING OR
DECOMMISSIONED SUBSURFACE DISPOSAL FIELDS, OR SEGMENTS OF SUBSURFACE DISPOSAL FIELDS,
SHALL BE AT LEAST TWICE THE DEPTH OF THE DRAIN ROCK BELOW THE LEVEL OF THE DRAINPIPE, BUT
NOT LESS THAN SIX FEET.
14.THE BOTTOM OF THE TRENCH SHALL BE LEVEL WITHIN 4". THE BOTTOM OF A WIDE TRENCH OR BED
DISPOSAL FIELD SHALL BE LEVEL WITHIN 2" BEFORE PLACEMENT OF DRAIN ROCK.
15.AFTER EXCAVATION HAS EXPOSED THE DESIGNATED INFILTRATIVE SURFACE, ANY NATIVE SOIL THAT IS
SMEARED SHALL BE SCARIFIED TO IMPROVE ITS POROSITY BEFORE PLACEMENT OF DRAIN ROCK.
16.PERFORATED DISTRIBUTION PIPE USED IN A SUBSURFACE DISPOSAL FIELD SHALL BE LAID LEVEL AND
BEDDED WITH DRAIN ROCK EXTENDING A MINIMUM OF 2" ABOVE THE TOP OF THE DISTRIBUTION PIPE, AND
LEVEL ACROSS THE ENTIRE WIDTH OF THE DRAIN FIELD.
17.NON-PRESSURIZED SUBSURFACE DISPOSAL FIELD PIPING SHALL HAVE A 4" DIAMETER CLEAN OUT
CONNECTED TO BOTH ENDS OF EACH PERFORATED SEGMENT. CLEANOUTS WITHIN 20 FEET AND IN LINE
WITH THE DOUBLE CLEAN OUT DOWNSTREAM OF THE SEPTIC TANK MAY BE OMITTED.
18.AT LEAST ONE 4" DIAMETER MONITORING TUBE SHALL BE INSTALLED IN EACH SEPARATE DISPOSAL FIELD
SEGMENT TO ALLOW MEASUREMENT OF THE FLUID LEVEL IN THE DISPOSAL FIELD. MONITOR TUBES SHALL
NOT BE CONNECTED TO THE DISTRIBUTION PIPE NETWORK. THE PORTION OF A MONITOR TUBE
EXTENDING DOWN FROM THE LEVEL OF THE HORIZONTAL DISTRIBUTION PIPES TO THE BOTTOM OF THE
DRAIN ROCK SHALL BE PERFORATED. THE PORTION OF THE MONITOR TUBE ABOVE THE HORIZONTAL
DISTRIBUTION PIPES SHALL BE NON-PERFORATED. MONITOR TUBES SHALL BE LOCATED AT ALL ANGLE
POINTS OF DISPOSAL FIELDS TO MARK THE LOCATION OF THE ABSORPTIONS SYSTEM. PRESSURIZED
TRENCH DISPOSAL FIELDS THAT DO NOT HAVE CLEAN OUT PIPES SHALL HAVE A MONITOR TUBE WITHIN
ONE FOOT OF EACH END OF INDIVIDUAL TRENCH SEGMENTS. PRESSURIZED BED DISPOSAL FIELDS THAT
DO NOT HAVE CLEAN OUT PIPES SHALL HAVE A MONITORING TUBE WITHIN ONE FOOT OF EACH CORNER
OF THE BED.
19.AN APPROVED PERMEABLE GEOTEXTILE SILT BARRIER SHALL BE INSTALLED COVERING THE ENTIRE TOP
SURFACE OF THE DRAIN ROCK PRIOR TO BACKFILL.
20.THE DISPOSAL FIELD COVER SHALL BE A MINIMUM OF TWO FEET DEEP, OVER THE TOP OF THE DRAIN
ROCK. IF THE DISPOSAL FIELD COVER IS LESS THAN THREE FEET, THE DISPOSAL FIELD SHALL BE
INSULATED WITH 2" OF APPROVED RIGID BOARD INSULATION. MINIMUM SOIL COVER OVER THE INSULATION
SHALL BE ONE FOOT. INSULATION SHALL EXTEND 12" BEYOND THE EDGE OF TANK FOR EVERY 1" OF
INSULATION PROVIDED.
21.THE FINISH GRADE OVER A SUBSURFACE DISPOSAL FIELD SHALL BE MOUNDED A MINIMUM OF 6" ABOVE
ADJACENT GROUND TO PREVENT THE FORMATION OF A DEPRESSION AFTER THE BACKFILL HAS SETTLED.
22.UPON COMPLETION OF CONSTRUCTION ALL CLEAN OUTS AND MONITOR TUBES SHALL BE ABOVE FINAL
GRADE A MINIMUM OF TWO FEET, A MAXIMUM OF 4 FEET, BE WATER TIGHT, AND LOCATED BY SWING-TIE
MEASUREMENTS TO ALLOW YEAR-ROUND LOCATION AND ACCESS.
SEPARATION DISTANCES
SEPTIC TANK SOIL ABSORPTION
SYSTEM
PROPERTY LINE 5 FEET 10 FEET
WATER MAIN/WATER
SERVICE LINE 10 FEET 10 FEET
BUILDING FOUNDATION 10 FEET 10 FEET
DECKS/STAIRS >30" ABOVE
GRADE 5 FEET 10 FEET
SURFACE WATER 100 FEET 100 FEET
PRIVATE WELL 100 FEET 100 FEET
PUBLIC WATER SUPPLY SEE 18 AAC 80 SEE 18 AAC 80
>25% SLOPE >10' TALL -50 FEET
>25% SLOPE <10' TALL -25 FEET
SUBSURFACE DRAIN -GREATER OF 10 FEET OR
TWO TIMES GRAVEL DEPTH
SOIL ABSORPTION SYSTEM -GREATER OF 6 FEET OR TWO
TIMES GRAVEL DEPTH
WATER TABLE -4 FEET
IMPERMEABLE LAYER -6 FEET
INSPECTIONS:
1.AN ON-SITE WASTEWATER DISPOSAL SYSTEM SHALL NOT BE BACKFILLED,
COMPLETED, OR USED UNTIL THE ENGINEER HAS INSPECTED AND TAKES NO
EXCEPTION TO THE INSTALLATION.
2.NOTIFY THE ENGINEER 48 HOURS IN ADVANCE OF ANTICIPATED CONSTRUCTION.
3.THE ENGINEER WILL MEET WITH THE CONTRACTOR PRIOR TO CONSTRUCTION TO
DISCUSS THE FOLLOWING,
3.1.PRECONSTRUCTION MEETING TO DISCUSS CONSTRUCTION PROCEDURES AND
DESIGN REQUIREMENTS.
3.2.VERIFY SITE CONDITIONS CONFORM TO THE DESIGN PLANS AND PERMIT.
3.3.VERIFY THE PROJECT LAYOUT CONFORMS TO THE DESIGN PLANS AND PERMIT.
4.THE ENGINEER SHALL PERFORM A BOTTOM OF HOLES INSPECTION FOR THE SEPTIC
TANK AND DISPOSAL FIELD.
5.THE DISPOSAL FIELD REQUIRES THE FOLLOWING INSPECTIONS,
5.1.AFTER EXCAVATION OF ALL NATIVE MATERIAL HAS BEEN COMPLETED, BUT PRIOR
TO PLACEMENT OF FILTER SAND AND/OR DRAIN ROCK. THE PURPOSE OF THIS
INSPECTION IS TO ALLOW VERIFICATION THAT THE NATIVE MATERIAL CONFORMS
TO THE SOILS LOG AND THE EXCAVATION IS TO THE CORRECT DEPTH.
5.2.AFTER THE PLACEMENT OF FILTER SAND, IF UTILIZED.
5.3.AFTER THE PLACEMENT OF DRAIN ROCK, AND INSTALLATIONS OF DISTRIBUTION
LINES, CLEAN OUTS, AND MONITOR TUBES, BUT PRIOR TO PLACEMENT OF
INSULATION, SILT BARRIER, OR BACKFILL.
5.4.AFTER THE SYSTEM HAS BEEN BACKFILLED TO VERIFY FINAL GRADING AND THE
LOCATION OF ALL STAND PIPES.
6.THE SEPTIC TANK REQUIRES THE FOLLOWING INSPECTIONS,
6.1.AFTER THE TANK IS SET IN PLACE WITH DISTRIBUTION PIPES AND CLEAN OUTS
INSTALLED, BUT PRIOR TO BACKFILL.
6.2.AFTER THE TANK HAS BEEN BACKFILLED TO VERIFY FINAL GRADING, ELECTRICAL
EQUIPMENT INSTALLATION, AND THE LOCATION OF ALL STAND PIPES.
2
SPECIFICATIONS
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AK BUILT
CONSTRUCTION & DESIGN, LLC
PO BOX 771203
EAGLE RIVER, AK 99577
(907)854-9115
CERTIFICATE OF AUTHORIZATION
#204451
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3OF
8/21/2025
DATE:
SHEET TITLE:
ROBERT COLLES, PE
No. CE-163739R
E
GISTEREDPROFES S I O N A L E N GINEER
8/21/2025
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0
67.5°
67.
5
°
P-1
P-2
P-3
P
-
4
10'
7.5'
5'
ABANDON
EXISTING
SEPTIC TANK
IAW UPC
LOCATE EXISTING
BUILDING SEWER
AND TIE-IN
DCO
1,250-GAL SEPTIC TANK
DCO
EXISTING CO, TYP
EXISTING
MT, TYP
LOCATE EXISTING DISPOSAL
SEWER AND TIE-IN
4-BED HOUSE
PRIVATE WATER LINE
EARL RAY
BLOCK 3 LOT 37
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
0+00 0+05 0+10 0+15 0+20 0+25 0+30 0+35 0+40 0+45 0+50 0+55 0+60 0+65 0+69.81
E-1 P-1 P-2 P-3 P-4 E-2 E-3 E-4
DCO
MOA MANWAY RISER CO
DCO
1,250-GAL SEPTIC TANK
ORIGINAL GRADE (2015 MOA LiDAR)
ORIGINAL GRADE (FIELD OBSERVATIONS)
WYE
18 BEND
CLEAN OUT
SEWER
PIPE TABLE
ID
P-1
P-2
P-3
P-4
∅
4"
4"
4"
4"
LENGTH
8.31'
5.00'
3.00'
8.31'
SLOPE
2.00%
2.00%
2.00%
2.00%
INLET
LOCATION
N:2889122.9679
E:3136249.1166
N:2889125.3389
E:3136241.1476
N:2889116.8146
E:3136234.2278
N:2889114.4854
E:3136232.3370
INLET
ELEV
441.94
441.77
441.50
441.44
OUTLET
LOCATION
N:2889125.3389
E:3136241.1476
N:2889121.4569
E:3136237.9963
N:2889114.4854
E:3136232.3370
N:2889107.1740
E:3136236.2955
OUTLET
ELEV
441.77
441.67
441.44
441.28
FI
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AK BUILT
CONSTRUCTION & DESIGN, LLC
PO BOX 771203
EAGLE RIVER, AK 99577
(907)854-9115
CERTIFICATE OF AUTHORIZATION
#204451
EA
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3OF
8/21/2025
DATE:
SHEET TITLE:
ROBERT COLLES, PE
No. CE-163739R
E
GISTEREDPROFES S I O N A L E N GINEER
8/21/2025
3
SEPTIC
NOTES:
1.PIPE LENGTHS ARE ESTIMATED AND PROVIDED FOR CONTRACTOR
REFERENCE ONLY. CONTRACTOR TO VERIFY MATERIAL QUANTITIES.
2.UNIFORMLY GRADE SITE UPON COMPLETION OF SEPTIC SYSTEM
INSTALLATION. MOUND MATERIAL TO ALLOW FOR SETTLEMENT OF
DISTURBED AREAS AND TO MEET MINIMUM SOIL COVER REQUIREMENTS.
GRADE SLOPES AT 3H:1V.
3.THE CONTOURS DEPICTED ARE DERIVED FROM MOA LiDAR DATA DATED
2015. THE CONTOURS IN THE AREA OF THE SEPTIC SYSTEM ARE NOT
ACCURATE AND DO NOT REFLECT OBSERVED GROUND CONDITIONS.
4.CONTRACTOR TO VERIFY DEPTH OF BUILDING SEWER AND DISPOSAL
SEWER. POSITIVE DRAINAGE IS REQUIRED FROM THE HOUSE TO THE TANK
AND THE TANK TO THE FIELD. NOTIFY THE ENGINEER IF POSITIVE
DRAINAGE CANNOT BE MAINTAINED.
TYPICAL DOUBLE CLEANOUT
Feet
0 5 10
SEWER SYSTEM PROFILE
48.
3
'
28
.
3
'
48.
3
'
28
.
3
'
CARPORT
12'x16'SHED
R ESID E N C E
10'x7'
SHED
(FABRIC)
LEGEND
EDGE OF GRAVEL DRIVEWAY
DECK
FENCE
OVERHEAD UTILITIES
RECORD DATA PER PLAT #64-78
SEPTIC PIPE
WELL
POWER POLE
CONCRETE
FOUND 5/8" REBAR, NO CAP
TIMBERLINE SURVEYING AND MAPPING
17035 BARONOFF AVE
EAGLE RIVER, AK 99577
907-242-5320
ryan@timberlinealaska.com
FILE NO.: 25.167
SCALE: 1" = 40 FEET
DATE: 7/18/2025
SHEET: 1 of 1
MOA GRID: NW1360
SCALE: 1" = 40 FEET(11"x17")
40'0' 80'
AS-BUILT OF:
ADDRESS: 23936 SKI RD, CHUGIAK, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
LOT 37, BLOCK 3EARL RAY SUBDIVISIONPLAT #64-78
MUNICIPALITY OF ANCHORAGEn pE HEALTH T If �:
�
DFTMENT OF HEALTH AND HUMAN SER ES L►wIRONMEMK PROTECTION
& roN
• - Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 Nov 10 �pC
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT �R7:
Name 't DISTAN
Add eaa /I r t TO SEPTIC ABSORPTION
WELL
P013 67/0.6 C,4,,q/4/r {}/r Qqr
pnone(sl Ipermlt No. INo of B
68B'-3760 3
LEGAL DESCRIPDON
Lot 737 1
blocs SUbmYI$,On
3 E4 r / R4Ty
Township, Range. Section
--- r/s /✓ /L /w Se. t, /0
TANKS
X SEPTIC ❑ HOLDING
Manotactorer Lapaoty In gallons
Grt�r /oov
total absorption area Distance between lines
675- SOFT 6",w, Qti( FT
N°mCer 01 ones Sal raging 1; a material
-3 /.%SO FT *rY.• .7e.7
mslale, Date lnstaneol
%/.4/e Gr JILL, /o/06
WELLS
❑ PRIVATE D� OTHER (Identily)
Gussd�uou0 (A.B.(:f Total Deptn Gsed to
I N
i1 FT FT
Ins'aeal I Date Installed
REMARKS:
S.,/ Jii; 7`�, 45-11 4VeoP. 73
%rH t
eG<Yiia
An a,i I *h-- A'ar
FROM
TYPE OF SYSTEM
FIELD
❑ TRENCH 6'c
BED
❑ W. DRAIN ❑ OTHER
Depth to vNe bottom from
Total depth from anginal grade
6,$- /
original grade7
/ '�1 FT
FOUNDATION
8 FT
Fill Wo tt •Love ougmal grade
^/lf
Gravel oepth beneath pipe
O FT
6 i,
Grave, leng:n
Gravel w.dth
Beal 1LwS>`A =
3 7= FT
geo(
FT
total absorption area Distance between lines
675- SOFT 6",w, Qti( FT
N°mCer 01 ones Sal raging 1; a material
-3 /.%SO FT *rY.• .7e.7
mslale, Date lnstaneol
%/.4/e Gr JILL, /o/06
WELLS
❑ PRIVATE D� OTHER (Identily)
Gussd�uou0 (A.B.(:f Total Deptn Gsed to
I N
i1 FT FT
Ins'aeal I Date Installed
REMARKS:
S.,/ Jii; 7`�, 45-11 4VeoP. 73
%rH t
eG<Yiia
An a,i I *h-- A'ar
FROM
TANK
FIELD
WELL bis, sr
t ;L00 /
0".20.0 /
LOT LINE
6,$- /
-31,11
Al4
FOUNDATION
1,
26 01
^/lf
AS -BUILT DIAGRAM (Snow location of well. septic system. property lines. lounoation.
drwewav water coolies- etc I A/Tt
/
e
L
Scale: x - '� „:.ENGINEERS SEAL
Inspections Pedormeo by,. -
Eagle RiverEnglneerin Services' ;s> ;a••`"• '
. Box 773294 !"�^ '�: i. •,J j „';., ,
D°1B Eagle River, AK 99577 _ `
894.5195 •/ �~' `*'C,--� �� e..:io--•••0:00:':1
I eeNly that this Inspection was perlormed according to all L4 ,"�; ': Louts A. ^_urora • a /y�; /
/ b6 �� •.ct ors ,
Municipal and State guidelines in ellen on this dale: •
� • J , P• •,•'
Health Department Approval: Date://—/3 _86 ���.::�,;;.:-''•
,,-um L.pop)
1`IIJN I C I .:AL I 7"Y OF= ANCI-iS�f2AGl=
DEPARTMENT HEALTH AND ENVIRONMENTALOTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
ON—Eu I TE SEW1 --- FR F---EF-ZM I T
PERMIT NO: 860307 ENGINEERED DESIGN /Jji
DATE ISSUED: 08/25/86
APPLICANT: KURT K.OHLER / ERES
ADDRESS: PO BOX 671026
CHUGIAK, AK. 99567
CONTACT PHONE: 688-3760
LEGAL DESCRIP: SUBDIVISION: EARL RAY LOT: 37
SECTION: 10 TOWNSHIP: 15N RANGE: IW
LOT SIZE: 41310 (SQ.FT. OR ACRES)
BLOCK: 3
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK, MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED DATE:
APPLICANT: KURT KOHLER / ERES
ISSUED BY DATE:
Z'sa�� /7.,— ���l,:ro( ,lei/,vim y.-,rurl !�-•
MUPA I C I PAL_ I TY OF 9=&P4r_-" MF:ZAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
C]N—S I TE SEWSF:
PERMIT NO: 850422
DATE ISSUED: 07/18/85•
APPLICANT: KOHLER CONSTRUCTION
ADDRESS: P O BOX 67-1026
CHUGIAK, AK 99567
CONYACT PHONE: 688-3760
F}EF1M I -7-
LEGAL
LEGAL DESCRIP: SUBDIVISION: EARL RAY LOT: 37
SECTION: 10 'TOWNSHIP: 15N RANGE: 1W
LOT SIZE: 1.25A (SO.FT.•OR ACRES)
LOT LOCATION: SKI ROAD
MAX BEDROOMS: 4
Listed below are the options available to. you in designing
system. Choose the option that best fits your site.
BLOCK: 141,
your septic
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MDA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid -for a maximum of 4 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED9Gh/�i��_JC_GC/v--------------- DATE:
APPLICANT: KOHLER CONSTRUCTION f� L
ISSUED PY DATE: �8 _ 8r
------ ----------------------------- a -,F--
1s
13EI7
W _ DFtiA I N
DEPTH TO PIPE BOTTOM (FT.)
4.0
4.0
GRAVEL DEPTH (FT.)
0.5
3.0
TOTAL DEPTH (FT.)
4.5
7.0
GRAVEL WIDTH (FT.)
18.0
5.0
GRAVEL LENGTH (FT.)
34.0
47.0 .
GRAVEL VOLUME (CU.YDS.)
22.7
30.5
TANK SIZE (GALS)
1,250.0 **
19250.0 **
SOIL RATING (SO.FT./BR)
100
100
BLOCK: 141,
your septic
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MDA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid -for a maximum of 4 bedrooms and
any enlargement will require an additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED9Gh/�i��_JC_GC/v--------------- DATE:
APPLICANT: KOHLER CONSTRUCTION f� L
ISSUED PY DATE: �8 _ 8r
------ ----------------------------- a -,F--
1s
W0
ZY
-^ yc•sa�
choradz
January 10, 1986
TO: Permit Applicant
r"\
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
'ova r.vJ.:�6s.
DEPARTMENT OF HEALTH 6 HUMAN SERVICES
Subject: Permit l 850422
Lot 37 BLock 3 Earl Ray Subdivision
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as -built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
a
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy o Permit
M�N1Ccpto tom` r��tF�tON
.f
` .01
Ra
B9. B0 / � ab yI'• i
• L� E , ret �, .� I
�rt(R
M
`W \ RESER✓. /! ` •y
X AREAPA
)�
�� \ � ♦` /� Bad !8 XSa • I
0 SG Q
v+ >.S / fsrfr I Q
T \
fill
OF .41t
�11•sl. � "CV v �
a. o
Gf d , rr •• A'?
7 •, 4
64.0 ..... -am- O.F...4C
• ..q\se; to• . "
I
^'?•W"Iliam McClintock'��ir*?,�� f�`r ••�••�,�,
ad r `fi% No. LS s no / �: ,�. T:1 i44 �I ~• a..,�
•` c • v i/ /. ••. •.• •• • q
0Ff 310,00.
AiO•fb\•L� 4: : Q•✓p pre.., ..t
c Louis A. Bufara
./i' •.
CE-6736 1
O•,••..•.•••,••�F<=,� *septic plan only
I hereby certify that LOT 37 , BLOCK 3 MCCLINTOCK
F.9,04 -�019y 'Su3D/✓/sib ✓ LAND SURVEY COMPANY
anchorage Recording District, Alaska, has been surveyed by me and P.O. Box 671089
that no encroachments exist except as shown hereon. It is the Chuglak, Alaska 99567
esponsibility of the owner to determine the existence of any
casements, covenants, or restrictions which do not appear on the
ecorded subdivision plat. Listed distances prevail and scaling
should not be attempted to determine unshown dimensions. This Phone (907) 688.4499
survey is not adequate for, nor should It be used for
establishing boundary or lance lines.
CatE X$- SG DRAWN BY 13M JOB NO. 940--/4/ GRID A/l✓i3G0 FIELD BOOK d64:-43 SCALE 4>
MUNICIPALITY OF ANCHORAGE
*11W
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street. Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
X SOILS LOG
❑ PERCOLATION
TEST
PERFORMED FOR: %'� O ICr Loa.r rte°.. -moi ^. DATE PERFORMED: ZO�/�i16
LEGAL DESCRIPTION: L 0t 3-7 131,0(3 i�54 r/ Re. y 7 -/S -,,v %Q/6J ,SGc , 1O
ru SLOPE 7 SITE PLAN
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
3 4 6789 10 11 . 0
12-
13
2
13
Tates.; /
(G r)
Tref P...aj S..•L•.•(
WAS GROUND WATER
ENCOUNTERED?
NO �
O 1. JG
ij IF YES, AT WHAT E
60 tY.^ DEPTH? c/4 lF
14
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
15
i 'l
17s
18j M ; La -.:s A. :wrc
J n a_ CCK 136
19
20
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
0,;.+(
P6Aetmi UN RATE /S
- O ft/Zi4sP-hn'rnw.,Snch)
EST RUN BETWEEN FT AND FT
COMMENTS Sii/ Zof ::;,Z,f�i'..TL dG,,r Lr a cc4e 7Y.,a., 47" Bum
Eagte River Engineering Services
PERFORMED BY: CERTIFIED BY: DATE: /��•%���
Eagle River, All 99577
694.5195
72.008 (6/79)
r1
X SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
825 L Street, Anchorage, Alaska 99501 264720 TEST
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:
/7e.? IG
Gross
Time
DATE PERFORMED: 71 /e/`Fx-
Dep In to
Water
13
14
LEGAL DESCRIPTION:
he7° 37
B3 Fo/`l .0ak .,
_5*— T/cn/ xP/ui Sri /O
1
2-
3-
4
3 4 -a .
5
`O
6
7 so
n;
6 0-
4a t
97Dr�
10 ,
11 o
Tpra;l - o.e"A.PIC
We& -% 4,1
/co ¢
12
Date
Gross
Time
Net
Time
Dep In to
Water
13
14
Oc A
�
Jr
IV
�( .........•
Y
15
16
Veto •
...
17
9t
(?� .
18
CE -6736
, %R0FES Of 55
V
19
WAS GROUND WATER
ENCOUNTERED?
8�Y'9rG IF YES, AT WHAT
DEPTH? n,i ;'
SITE
Reading
Date
Gross
Time
Net
Time
Dep In to
Water
Net
Drop
20 -{ I PERCOLATION RATE l''_.. _� •. (minutes/inch)
'UI TEST RUN BETWEEN FT AND FT
COMMENTS a44.
Eagle (liver Enllneerlin Services Ll
PERFORMED BY: P. 0. Box 773794 CERTIFIED BY: A*^ DATE: % /,11FJ'
- Eagle (liver, AK 99577 br'�ia/J6
694.5195
72-009 (6/79)
r-'
n
EAGLE RIVER ENGINEERING SERVICES
P.O. BOX 773294
EAGLE RIVER, ALASKA 99577
694-5195
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Lot 37, Block 3, Earl Ray Subdivision
A. GENERAL
1. The septic plan are for single family residence use only. 2.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the requirements of
the Anchorage Department of Health and State D.E.C..
4. All soil tests are advisory to the design and are to be
verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified or
modified in the field by the contractor to meet MOA, D.E.0 require-
ments.
6. It is the responsibility of the owner to obtain all necessary
permits or easements and to locate any adjacent multi -family wells.
7. It is always recommended that a surveyor locate the nearest lot line
position and the location of any easements.
B. DRAINFIELD
1. The drainfield is to an absorption bed with 2' sand filter.
2. The bottom of the bed shall be level, plus or minus 1.5."
3. The total depth of the bed is to be no more than 8' below ground
surface at monitor tube location. The bed should be excavated 2'
below the gravel depth and backfilled with sand designated filter
sand.
4. Soil or combination of soil and extruded board insulation to a depth
of 4' or equivalent is to be placed over the trench.
5. The area over the trench is to be finished graded to prevent ponding
of surface water runoff.
6. The septic tank and leachfield must not be closer than 100 feet to
any existing private well, 150' to any Class "C" well, or 200 feet
to any community well.
BED DIMENSIONS
;BED TOTAL DEPTH= 5-8'
BED WIDTH= 18'
BED LENGTH= 32' 1r7GQ
BED TOTAL SURFACE AREA= 563 SB. FT.
GRAVEL DEPTH= 6" under pipe/2" over
SEPTIC TANK SIZE= 1000 gallons
2' Sand filter required under bed
•
1:1 °A c-� Municipality of Anchorage
JOn-Site Water and Wastewater Program
/ (907) 343-7904 'i
S n r r r
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
113
Parcel I.D. 051-x,22-17 Expiration Date: 7r2,7-tg
1. GENERAL INFORMATION
Complete legal description EARL RAY SUBD. BLK 3, LOT 37
Location (site address) 23936 SKI RD CHUGACH AK
Current Property owner(s) Day phone
Mailing address SAME
Real Estate Agent Day phone
<-7, 34S6
7/.
2. TYPE OF DWELLING:
rv,® Single Family (w/wo ADU) , o❑ Duplexr l
❑ Multiple Dwellings (Single Family and/or Duplex) o cf. ) 3a
3. NUMBER OF BEDROOMS: 3 ��9 s 7 E Z \z,a
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class A Well ® Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
• ,1001111111 •
Received by: A- 4 _,_ _ Date: I Q:
COSA to be released to the engine-less otherwise requested by the engineer.
COSA Fee $ �Jo — Waiver Fee $
Date of Payment f gill fl Ck (oag-2 Date of Payment
Receipt Number ‘Lt -1-1 Receipt Number
COSA# OSC("JI 33 L Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm MIKE N ANDERSON. P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 8/3/17
armt'' p• '°
�•! ! •"• {^
(0/ .' ti�..�• °
-,'r•',•9-F t%//� ;et
•°J a•tiV ! .• • f.
6. DSD SIGNATURE y'." r;vCHAEL N. ANDERSON
t1-5;• CE 9469 ,••
System •
#1 Approved for bedrooms. I, � //
System #2 Approved for bedrooms. �',.eisi;rs�s�L'' y�
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
EneriC- C ---("°(-tvt S e61.5'..°0-V.,_C/C:(-,",
1 .kreA,6.9_to
� c
k 6-e ,Z)\ QCjeay‘c 3 ON-SITE SG;
VUAT E R A N U r"`
VVASTEWATER cI
`; PROGRAM
B � ._ Original Certificate Date: —2-ti
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheer 0-t0-t2 doc
r
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: EARL RAY SURD. BLK 3, LOT 37 Parcel ID: 051--132-17
A. WELL DATA
Well type CLASS A If A. B. or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (Y/N)— Wires properly protected (YIN)
Total depth _ft. Cased to ft. Casing height(above ground)
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic: ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 10.86
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) NA
Date of pumping 7-27-17 Pumper Alaska Quality Pumping
C. ABSORPTION FIELD DATA– 1985 SYSTEM TESTED
Date installed 10-86 Soil rating (sf/bedroom) 150 SF System type BED
Length 37.5 ft. Width 18 ft. Gravel below pipe 0.5 ft.
Total depth 7.6 ft. Eff. absorption area 675 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/27/2017 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 2 in. Water added 500+ gal. New depth 6 in.
Elapsed Time: 1440 min. Final fluid depth 2 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) UNKNOWN If yes, give date
• M
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off" level at in.High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5' Property line 5' Absorption field 5'
Water main 100'+ Water service line 25'+ Surface water 100'+
Wells on adjacent lots 100'+AND 200'+ FROM CLASS A
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10 Water main 100'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+ (None Known) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION yt�,ttia�d
OF Ain.1
1 certify that have determined through field inspections and •. ...is-
review of Municipal records that the above systems are in r Lj•• •q
conformance with MOA COSA guidelines in effect on this date. ' ;•497 A •• *111
Engineer's Printed Name MIRE N. ANDERSON, PE
Date 8/3/2017 MICHAEL N. ANDERSON ;4�
i•, CE 9 69 ' .
+•
COSA canary sheet_2-6-15.doc
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. 0S/- /f3 - 1-1 HAA# 1)5n5q.'
Expiration Date: . / / - Z - D G
1. GENERAL INFORMATION
Complete legal description ;
Location (site address or directions) .R 3 9 3(0 5L; '<d.
Current Property owner(s) _4nnq Taylor r, Marcys ltAtii Day phone 34:; - 81a,5
Mailing address
Lending agency
Mailing address
Day phone
Real Estate Agent tludn
arta aan-
Day phone
3344
4r-
Mailing Address get -
Mau of
F!aat,c. J;_';✓ ,L -
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
a
Individual Water Storage
❑
Individual Holding tank
❑
Community Class A_ Well
Q�
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
Eagle River Engineering Services Phone V74 5195-
1 D421 VFW Suite 20 1
,
Address EaoleRiver, AKsa5n
Engineer's Printed Name (lariSboghfr- A?• 1)ood Date C) l;L'r l05
5. DSD SIGNATURE
_L� Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
u(()
Additional Comments : • Ole�ff— m-_
WASTFWATFR c
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date:
(Rev 01102)
Municipality of Anchorage
• Development Services Department
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: CoL ✓ RA v Z a / 37 , /310 e It 3 Parcell
A. WELL DATA
Well typelf lass fi N
LOmWvrni'fJ
Dale completed _
Total depth ft.
Date of test
Static water level
Well production
WATER SAMPLE
Coliform
mg./I.
If A. B, or C provide PWSID # _ Well Log (Y/N)
Sanitary seal (Y/N)
Cased to ft.
05'/- //-3-/-?
Wires properly protected (Y/N)
Casing height (aboveyre d) in.
FROM WELL LOG AT
S� li
ft. _
g.p.m. _
JL
es/100 mi. Nitrate mg./I.
B. SEPTIC/HOLDING TANK DATA
ft.
g.p.m.
Other bacteria - colonies/100 ml.
Date of sample: _ Collected by:
Tank Type/Material '.rem -e 15 -t -La Date installed /01('b
Tank size Jri= gal. Number of Compartments Cleanouts (9N) ulr-�
Foundation cleanout ON) °' Depression over tank (Y(q)t� High water alarm No
Date of pumping 9/ 19 f OS a Pumper J# 's -Pi,rn,Pi"5
C. ABSORPTION FIELD DATA
Date installed /0196 Soil rating (g.p.d./ftZ or ft /bdr 0 System type WA d
Length 37.5 ft. Width 19 ft. Gravel below pipe
Total depth -_ ft. Eff. absorption area (e"IS ftZ Monitoring lube 14j,,4. Depression over field Y1 0_
Date of adequacy test &1'91040t; Results Fail) For 8_ bedrooms
Fluid depth in absorption field before test 0 in. Water added gal. New depths in.
Elapsed Time: 30 min. Final fluid depth Zr in. Absorption rate >= 45'0 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y& type) `11 &U ICnOWvt If yes, give date n/a
D. LIFT STATION
Date installed
"Pump on' level at_ in.
Datum
Size in gallons
'Pump off" level at_ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT
Septic tank/lift station on lot
Absorption field on lot
Public sewer mai
service line
Manhole/Access (Y/N)
High water alarm level at
Meets alarm i requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 415 Property line y S 1 Absorption field 4457,
Water main + f 0 ' Water service line -to' Surface water -too
'
Wells on adjacent lots +•t00 ' 1v PWJIt C aura +2L.0 '0 Cc) `. kA.M NCU-
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line + in' Building foundation 4 t0 ' Water main + t 0'
Water Service line + t0' Surface water +100' Driveway, parking/vehicle storage '15 '
Curtain drain +5'0 t Wells on adjacent lots + 100 7v pRaJA�,"5 UtecLS
+ZGU 1V C0.UW-#":,q 01L`,—
F. COMMENTS _mldme__
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 cmer"ifek 2. tnbr�
Date 9 %Z74T
HAA Fee $ 7' P
Date of Payment
Receipt Number����/
(Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number
in.
A�
A
8
ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829
1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE'
FOLLOWING DESCRIBED PROPERTY:~�
c an��9l�ta� �r.f!� a% OF At t►
AND THAT NO ENC�OACHMEWTS�7BEXIST EXCEPT AS DATE
INDICATED. IT IS THE RESPONS13ILITY OF THE � y;'4 , `�� •:"A •
OWNER TO DETERMINE THZ EXISTENCE OF ANY GRIDS ••••••• .s
EASEMENTS, COVENANTS, OR RESTRICTIONS if/ly/_�S�jo
� —
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- "
'� • • : D.sn. Mer4 S.v srd /
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F& 1 •, is -avis
ANY DATA HEREON BE USED FOR CONSTRUCTION If y��
OF FENCE LINES, OR FOR ESTABLISHING BOUND— DRAWN �A\ 's.xult��"r
ARY LINES. j e�*gwwr �•
MUNICIPALITY OF ANCHORAGE
• ^' DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # _OELLI —/;7
1. GENERAL INFORMATION
jjjh /f6cd/vtb1 i3y;
as
II�S�lvj
Completelegaldescription Lot 37, Block 3, Earl Ray Subdivision
Location (site address or directions) 23936 Ski Road
Propertyowner Kurt & Catherine Koehler Day phone 694-3760
MailingaddressP_ 0 Box 671026, ChuQiak, AK 99567
Lending agency Residential Mtg/Jim DiMaggio Day phone
222-8800
Mailing address_ 1400 West Benson. 2nd Floor. Anchora8e, AK 99503
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well XXX
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
attesting to the legality and status of system.
72.Mo5 ft.1/91) front MOAS21
5.
A
M
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 furtherverifythat based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
5 8 5 ENGINEERING Phone G q y- a h 7`�
Name of Firm 17034 age Iver Loop Road No. 234
Address Eagle River, Alaska 99577
Engineer's signature
DHHS SIGNATURE
_IG Approved for THISE E bedrooms.
Disapproved.
Conditional approval for
Additional Comments
•
Date
E OF
ROBERT C COWAN 1 WQ
1 :� CE -8801/4_,
rttlliJF�,v�c
bedrooms, with the following stipulations:
Date 11— T-1!7
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 orderto satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions In the professional engineer's work.
non fp«. Vail B. MOAm
htCE{Vt'
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES NOV 03 1999
Environmental Services Division
825 L Street, Room 502 •Anchorage, Alaska 99501 • (90
-N 1MX �:K'a KES DIVI510N
Health Authority Approval Checklist
Legal Description: ��LECK3��-�9CL A s�Parcel I.D.: Osr^//3 /
A. WELL DATA
/J 0&4ss f�
Well type C -OHI IIA11Ty 110 13, or C, attach ADEC letter. ADEC water system number --Z/07-L78
Log present (YM) Date completed
Total depth Cased to Casin ght (above ground)
Sanitary seal (Y/N) W s property protected (Y/N)
FROM WELL LOG AT INSPECTION
Data of test
Static water level
Well production g.p.m. g.p.m.
WATER SAMPLE RESULT .
Coliform Nitrate Other bacteria
Date of sam Collected by:
B. SEPTIC/HOLDING TANK DATA
Data Installed i0 Tank size /DDO% Number of Compartments —'? Clean0ut3dj1N)e---S
Foundation cleanout (ON) %5 Depression (YAjam! _ High water alarm (YM)
Date of Pumping 1L- Pumper Sa`nlifl9�i_Y
C. ABSORPTION FIELD DATA
Date installed 10 Soil rating (g.p.d./ft° � System type Fz--n
Length F� " L -'Width / R / Gravel thickness below pipe Total depth 9
Effective absorption area Monitoring Tube present 69Pq S Depression over field (Y/&
Date of adequacy test /O Result t -i Fail) �gss For %H -L& -E bedrooms
Fluid de In absorption field before test in. ; �/
depth rpti ( ) � Immediately after gal. water added (in.): �• +-
Fluid depth YZ & (ins) Minutes Tater. /0 Absorption rate =g.p.d.
Permdde treatment (past 12 months) (Y/N) Nao;jE- "OVAl If yes, give date
72.026 (Rev. 3198)'
D. UFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at'
`Datum
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/hoiding tank on tot �141,U V / t'`t A16 -C.(/ 1'`t A1G2(, On adjacent lots
Absorption field on lot
Public sewer main
Sewer /septic service line
On adjacent lots
"Pump ofP level at"
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation �4- Property line �'- Absorption Held
Water mainlservice line /O = Surface water/drainage BOO �< Wells on adjacent lots �O
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
i
Property line/fib /f Building foundation /O /'f Water main/service line /0 r
Surface water le67 /f- Driveway, parking/vehicle storage area
Curtain drain Of\/e- Af�ICWA/ Wells on adjacent lots :z6y-3��
F. ENGINEER'S CERTIFICATION
1 certfty that 1 have determined thru field inspectlons and review of Municipal realr the abQpB gtpms are
In conformance���0elines in effect on this date.Alf
Signature
l�
Engineer's Name Qahticr C. Ce>m7., �'� •acorn C. Cew�a I Q
CE- 1-
Date I,l 1 g� ,tri ..,
t
HAA Fee E goo
Date of Payment I ( - 3
Receipt Number �����1�
72-026 (Rev. 3/98)"
Waiver Fee $
Date of Payment
Receipt Number