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Home My WebLink AboutOVERLOOK ESTATES BLK 3 LT 4Overlook Estates Block 3 Lot 4 #068-041-18 Municipality of Anchorage Development Services Department liv�-_ Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 3 www ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _'440007/ PID Number: -(U — Qt,// -Ar /� Name Wastewater System: 2 New ❑ Upgrade Adtrsas r 0/ ¢/r2QGE ABSORPTION FIELD Number of Beandome O Dasp TraMdl O Snenw Tragi O Bed D Llgnds L� �0 F �on,.r LEGAL DESCRIPTION sou Ra.hg Total D.pthe ogmel pada GPD/Fta R. eipMLq InLgl $ra' Depth W pips Donn ftm aepnal grade Gravel depth beneath pipe V Q /� FI. FI Tw.nsh,p Riga soawn Ful added awe ong ra, pada IFl. Gravel Length 0 S FI. Well: New ❑ Upgrade Gravel w,qh Number Ines Dnlrh,e Dehvowt Ines Ft. Ft CMWa wlPwre A Cl Tgel Depth Cow aM 4101,11, el P'PePP QV FL FTOW .9410 FS 30.3 Dhur SocG,Jfi Dee belied o- sUlK welr rel 6,2E - ee Mlel 6 / Q 6 / 2s F, Ywd Pune set MCYMrg 12 3S6 I .gm Adp.e GrcJW 2 TANK GPM FI. FI SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Lift Holding ubuuPmate ' .W. +pacer From TankStation Tank Sewer Line �� K ZS'•Q GaiMa 6a't — -- O'r xwen EELLIFT pAbsorption STATION Lev 6 ./- r Gal arw .✓rLq Foueatgn /Q �f 7o I,�. 'Pump qi M.el a 'Pure oir to el a i,7h weir arm e •7 in n in Pwp Maue d i Elect I Insgw.om pa mM by Culrn Dian -• �• '� Renrks BENCH MARK Lou rpt Desuiptro E�i2 oGR S f� AiWnMd La ..hoh /OQ Ft F.AOnzeV'Swrip Inspections performed by: dor lk firM Dates: 1� �. 0 0 '•+ ; r.! n 2 � / Q� F �7 Fee n : .-^ :r.7 •• Development Services Department Approval N x :aF _ : f>= Conditional Approval Date: ;? �,• I; ��✓_�, r Eny : �•a� Reviewed and approved by:(/" 2 'z -0 ieA •....a... rnp`"". " • ate: ' las. eros+ Paraoust Driv — 10'_ E Ease e �o I R10 I 4 Bdrri I wEtt FCO orae I Perk Test During Constructio 2J Gallon Septic Tank I C01/MT1 Double C.O.'s 4. MT2 co2 tH 2 I TH I O Absorption Trench Reserve Site NORTHRIM ENGINEERING 17237 Bear Pow Circle Eagle River. Aloako 99577 907.694. 7028 23.5 23 24.5 50.5 54.5 50 OVERLOOK ESTATES LOT 1' = 40" WATER/WASTEWATER AS -BUILT BLOCK 3. LOT 4 12/21/06 12 of 3 F.C.O. 9�5_ ST C❑1 25 STC❑2 33 D.C.❑. 36 C❑1/MT1 46 C❑2 77 MT2 72.5 NORTHRIM ENGINEERING 17237 Bear Pow Circle Eagle River. Aloako 99577 907.694. 7028 23.5 23 24.5 50.5 54.5 50 OVERLOOK ESTATES LOT 1' = 40" WATER/WASTEWATER AS -BUILT BLOCK 3. LOT 4 12/21/06 12 of 3 4� 0 O d d d U 0 O 41 C5 I � 0 i � S u C d L H ca Y C d I - u CL a, N c a, a, 3 N W W 4' 3 O L d U Ol C in O CL a O N LN L N d O U U d Y L dC OW HW W i IT o O� u 0 O p d o, s u >v L L U O C O CL I f O I N D` W / p, Y a, L f�/1 I- o 0 -• d d L U S CD u in N Q ft ... n Q O u L N U> O) a i U U U O o a -0 °a o u O >, 0 -to d a, L.9- N A sZze �o 033 3- + O £ �+ CQ L d nc� 0) +04U oo d ° to rnS E u VI -04' a, cn LO Cl 0 a, C a ( N uN LJ O O Doli aL,'a a)U OU N �U NF -C'0 L mL�F-N ~ Nu 0fd"0 a,Y aa, O p, 1 a L L zsusLL0O� LO Qa ; � a,3 a� vi a cn `n cn 3 cn Li —; cu m v W W d f - Q � J W Y � 0M J 0 F --I JY =) Wu P4 i 0 (t1 Q 3 -i W ~ i --i LL. o A � z Y LJ z U ~ z U LLI F— CL W z W F— N U F— Cl W C/) i Z U a o TilaY o � C7m�� n n� W � TL SOILS LOG - PERCOLATI❑N TEST 11i' I� Date Perforried: 5/31/06 E �QINEERING Performed For: Steve Wakeland Legal Description Overlook Estates, Lot 4, Block 3 DEPTH (FEET) Slope @ 10% Groundwater? No Depth Water Depth After Monitoring. 4211111arr llntP, # Date Gross Time Organic Depth Net Drop 1 5/31 0 -- 5' GP 3 - 15 Sandy Gravel 4 - Q•; ` W/low Silt 5 - 5' -- 6 - 31 15 min. 7 - 5 5/31 8 - 5'-- 9 - 47 15 min. 10 - 6' 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - Slope @ 10% Groundwater? No Depth Water Depth After Monitoring. 4211111arr llntP, # Date Gross Time Net Time Depth Net Drop 1 5/31 0 -- 5' -- 2 5/31 15 15 min. 11' 6' 3 5/31 16 -- 5' -- 4 5/31 31 15 min. 11' 6' 5 5/31 32 -- 5'-- 6 5/31 47 15 min. 11' 6' 21 - Percolation Rate 2.5 min./Inch Perc Hole Diameter 6' Test Run Between 4' and 5' Comments: Performed By NorthRim Eng. I Performed in Accordance with F ON THIS DATE. DATES 6/1/06 ri •`F'... Ai A4 NORTHRIM :~s ENGINEERING 17257 Bear Pow Circle meq• Cagle River. Alaska 99577 a -w• 907-694-7028 P CERTIFY THAT THIS TEST WAS tate/Municipal Guidelines in Effect OVERLOOK ESTATES !LOT 4 ----- BLOCK 3 CONSTRUCTI❑N PERK T. �• — 6/1/06 13 Of 3 Certf f Log by DOC co. da SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688.2759 OWNER OF LAND: _AJ0gK,14r%JJ C' ,,jI i ADDRESS: LEGAL DESCRIPTION: Fi7— /J4 ,k: S , T <{ DATE: ---r) C- PERMIT NUMBER:f%=7 % Date of Issue S TAX IDENTIFICATION NUMBER: 6Z11_ _Ol L_ Is well located at approved permit location? &-y6s- ONO Method of Drilling: 6 -mi rotary O cable tool Depth of well: �: O Casing Type Wall Thickness inches Diameter inches, depth 4a- 5 feet Liner Type: P-) - li f Casing Stickup Above Ground: feet Static Water Level: I o� feet lecover Rate: _tL1A_gpm ithod of Testing: Intake Opening Type: O open end O open hole 'eened: Start feet Stopped feet orations Start _ eii C feet. Stopped feet olume — )m 0 feet, to J 2- feet ected Upon Completion? (3rles O No )isinfection:_ 2IJ 3 C,41,.., Tier _l P 0 j4z4i3J4D.-. r Q dAe -r /w0 Qi1��•� a 1�.4,cO�i+•J /�rORo <•c /�.r.c l .a r SF/Aa._ �/.4•t0 �1L..O•CJC �� /.Ca��'p7 S H.4c.r_ iYA•c0 13� OBJ C ,)c L D./rrK 6.C.4,i lA.t�L-Wer �i}R K Gil A7 .rN./ c Driller's Name i--( ie ie responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality utment of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: )nmental Conservation. 11 npn P7 nn 1;:PPp Jim Sullivrtn nn? p.t Development Services Deportment Building Safety Division On -Site Water & Wastewater Program al 4/w era90w arreer ' P.O. Box 1966W `691" Mark Bench Anchora3e. AK 99519-6650 r�a� rww r�nl erq/nnfifa (901) 34}79,4 Pump Installation Log %vett Drilling Permit Number: S%VP (-071 Date of Issue: Parcel Identification. Number ULA`!/- 5 - Legal Deserlption L 116's Pump Installation Date: Pump intake Depth Bekix Top of Wdt Casing. -3s15 feet Pump Manufacturer's Name: Pump NUMM: #1-7Y — /. S rump sitc M hp 15lkss Adapter Durial Deplb:l j_ feet t,ticss Adapttr Manuractvttr''ss tiame: 67,-- c -r Pidess Adapter installer: A j- Wcll Disinfected Upon Complctlon? �Jvvs ❑ No Method of Disedeetkm: L yr.. „'f Commends: Pump lastallcr Namc n Property (honer Name & Address: Attention: Tia pmnp installer stall provide a pimp installation log to the DSD within:kO da}a or romp instal!aticn. k 'S i • i� J 2 }i'1 ( Iflt�-�. �+ I '�hj t1f y j{ 3 j t i �{• ,t f r rl.,�p r��t� SIG 4 fY y✓�� .� � / � -4 +414. 4 1 � .. r � ♦• j/ f ; �. � Y 1 �.! �• T VIP CA Oe '• i 4 i l " a � MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SWO60071 Legal Description: OVERLOOK ESTATES BLK 3 LT 4 Design Engineer. 0838 NORTH RIM ENGINEERING Owner Name: AUDREY CHAPMAN Owner Address: 19048 MOUNTAIN POINT CIRCLE EAGLE RIVER. AK 99577 - Date Issued: May 01, 2006 Expiration Date: May 01, 2007 Parcel ID: 068-041-18 Site Address: Lot Size: 60641 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: 0 Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by catling (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. 5. The following special provisions. Engineer needs to do an additional percolation test during construction of septic field. The percolation test procedure Is to follow Table 3-8 of the EPA Design Manual. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending Onsite review and approval. Received Bv: �/ , C _ �\ �/� Date: d1-66 c Issued B ( Date: o TABLE 3-8 FALLING HEAD PERCOLATION TEST PROCEDURE 1. Number and Location of Tests Commonly a minimum of three percolation tests are performed within for an absorption system. They are spaced uniformly throuqhout the conditions are highly variable, more tests may be reouired. 2. Preparation of Test Mole The diameter of each test hole is absorption systems or to the most surface, the sides of the hole are loose material is removed from the in, gravel are placed in the hole water is added. 3. Soaking Period the area proposed area. If soil 6 in., dug or bored to the proposed depths at the limiting soil horizon. To expose a natural soil scratched with a sharp pointed instrument and the bottom of the test hole. Two inches of 1/2 to 3/4 to protect the bottom from scouring action when the The hole is epth of water Should cbeemaintained efor iat least a4thr2and preferably In. of clear wovernight iifdclay soils are present. A funnel with an attached hose or similar device may be used to prevent water from washing down the sides of the hole. Automatic siphons or float valves may be employed to automatically maintain the water level during the soaking period. it is extremely important that the soil be allowed to soak for a sufficiently long period of time to allow the soil to swell if accurate results are to be obtained. In sandy soils with little or no clay, soaking is not necessary. If, after fiilino the hole twice with 12 in. of water, the water seeps completely away in less than ten minutes, the test can proceed immediately. 4. Measurement of the Percolation Rate Except for sandy soils, percolation rate measurements are made 15 hr but no more than 30 hr after the soaking period began. Any soil that sloughed into the hole durinq the soaking period is removed and the water level is adjusted to 6 in. above the gravel (or 8 in. above the bottom of the hole). At no time during the test is the water level allowed to rise more than 6 in. above the gravel. Immediately after adjustment, the water level is measured from a fixed reference point to the nearest 1/16 in. at 30 min intervals. The test is continued until two successive water level drops do not vary by more than 1/16 in. At least three measurements are nude. After each measurement, the water level is readjusted to the 6 in. level. The last water level drop is used to calculate the percolation rate. In sandy soils or soils in which the first 6 in. of water added after the soaking period seeps away in less than 30 min, water level measurements are made at 10 min intervals for a 1 hr period. The last water level drop is used to calculate the percolation rate. 5. Calculation of the Percolation Rate The percolation rate is calculated for each test hole by dividinq the time interval used between measurements by the augnitude of the last water level drop. This calculation results in a percolation rate in terms of min/in. To determine the percolation rate for the area, the rates obtained from each hole are averaged. (if tests in the area vary by more than 20 min/in., variations in soil type are indicated. Under these circumstances, percolation rates should not be averaged.) Example: If the last measured drop in water level after 30 min is 5/8 in., the percolation rate - (30 min)/(5/8 in.) • 48 min/in. 41 Municipality of Anchorage Development Services Department _Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. prg_bgI- IX Property Mailing Site ad( Q /o ZD phone t20-7Lc%G Code 4 9s 7 7 Legal description (Sub'd, Block & Lot) 0�/E.�:t- oo Ed'7'i4rF_r BLOC/G 3 to c{ Legal description (Township, Section & Range) Lot Size LLo , L4j Sq. Ft. THIS APPLICATION IS FOR (®ail that apply): Absorption Field ,e— Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ,)Ell Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial ,e— Upgrade ❑ Renewal ❑ 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. Date of Payment: Date of Payment: Receipt Number: Receipt Number: (Rev. 11/05) N( hNER G- fN�,INEERING Northitim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907-694-7028 April 24, 2006 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Septic System Design; Overlook Estates, Block 3, Lot 4 A well & septic system permit are submitted for your review. This is a vacant lot which is being developed in an established neighborhood. Nearby lots utilize conventional septic systems. This will also utilize a conventional septic system for the single family, 4 - bedroom home. Two soil tests were conducted; the soils were found to be similar to the subdivision soils report. The slope is indicated on drawing 2. A stream is present along the east property edge. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Sincerely, i Steve Eng, PE, PH� Design Enclosures ENC,I E'ERWG Overlook Estates, Block 3, Lot 4 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4 -bedroom, single family home. Most of the neighboring lots are developed. Groundwater was monitored near the high time of the year and was not present. A conventional septic system is designed for this superior soil. This lot is over 1 acre in size and no adverse impacts are expected from development. The neighboring lots are similar. The lots are served by a private water wells. No conflicts to the other lots will take place by this septic system construction. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy gravel with low silt. An application rate of 1.2 GPD/FP with 0.5 reduction factor for utilizing a 5' wide trench. Trench Length = 500 FT'/5'x .5 reduction factor = 50'; 1 line @ 50'. No bedrock was encountered. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of I" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required V to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock. • Drain rock to be %: inch to 2 %= inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage over the trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. 0 Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal) Subdivisio Test HOLE C.O. ,0 a i Well Site ilI a 250 Gallon )ouble C.O.'s IT 1 Alsorption Trench I TH 2 I TH 1 Reserve S(te I\ I opsl otY Precl dns( 0 s rom San, a- ion rlprovements, DESIGN NOTES: 1. Total Depth of Trench is 8'. Remove organic layer. Thaw ground if fr\en. 2. Sewer Service Line2% slope. 3. System is Minimum 10' from Lot Line. 4. Lots Served by Private Water Wells. NORTHRIM ENGINEERING 17237 Bear Pow Circle £ogle River, Alaska 99377 907.694. 7028 OVERLOOK ESTATES • ••• - BLOCK 3, LOT 4 ctipn gining LOT V=40' LAYOUT "6'r4/24/06 1 of 4 DESIGN NOTES: 1. Total Depth of Trench is 8'. Remove organic layer. Thaw ground if frozen. 2. Sewer Service Line minimum 2% slope. 3. System is Minimum 10' from Lot Line. 4. Lots Served by Private Water Wells. Well j Septic Area n Drive Wit New Area Septic Well Area E �172,r —1=:e.Id <•]] )p I 491 NORTHRIM ENGINEERING 17237 Bear Pow Circle Cagle Pl~. Alaska 99377 907.694.7028 o sl Jo sPreci 01 AdJoininn o s rorl an a Ion 9 improvements. I _Q 6 �\ eI 'v 1 zo 1 a o Iw s ti I a c I '.w I I I I � I 1 � \ j,4%. \ 67 p o IS4.yC N Well �w? v i \ i Septic Area OVERLOOK ESTATES BLOCK 3 LOT 4 SUBDIVISION LAY❑UT LOT PLAN 1' = 100' 4/24/06-12_0.f-4- S u L L i F- dS Y L d H u i' CL w N L a a, a a, CQ tA 0 0 L d ajU rn L N O CL CL 0 N 0 as ON d. T tn I - W d � Lr LL- c ~ 3 O M F— N L W O ~ N Z W 2 U H W F— N >- (� i � W O� U O O o ti O PCI cu 41 v LU +) S, •r L O (L A. 1 f O 0 c Liu s f +• l� lC5 Z CL a, A a uu v w w a CL a a N x N N OL o d o s° U u L o ai a a (4- a) a _ O Y u 0 >1 _d N i-• d L N tL tn.- C L u, F- W OLi N CL s u tn 0 001 L 033 LO LO L U 3 l7 di a0� OW l� O u In L to ��- CO 4. i m N E u IT o �¢ Na`' a, D o n o 0).9 a a., N UN LJ O O La Nada' yU CV N u }, - N L0 F- Oi CZT- �F- WF UY E O 0 yN 1 aL i Z US L LN 0 3 2 .L '*'L3 CLad 3+F+d3 O' Vl n�-(nNN3V1Q� W A _; tU f`') v LO %D T tn I 3 - W d � u LL- � ~ .. 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No Depth Water Depth After Monitnrinn. Nnna nn+oi d iaa inh # Date Gross Time Net Time Depth Net Drop 1 4/19 0 -- 5- 2 4/19 2 2 Min. 6' 1' 3 4/19 5 -- 5' -- 4 4/19 7 2 Min. 6' 1' 5 4/19 10 -- 5' -- 6 4/19 12 2 rain. 6' 1' Percolation Rate 2 Min./inch Perc Hole Diameter Test Run Between 4' and 5' Commentsi_PrP-SnnkPci 6' Performed ByNorthRim Fng. I -==>\ — CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATES 4/24/06 NORTHRIM ENGINEERING 17237 Bear Pow Circle Eagle River. Alasko 99377 907-694-7028 M.. w a -4a. OVERLOOK ESTATES GE❑TECHNICAL T.H. 1 LOT 4 BLOCK 3 4/24/06 1 1 --of 2 l" r \\, SOILS LOG — PERC❑LATI❑N TEST R1\11r-TFRIM Date Performed: 4/17/06 INEERING Performed For; Steve Wakeland Legal Description: Overlook Estates, Lot 4, Block 3 1 - 2 - 3 - 4 - 5 - 6 - 7 - e - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) Organic <: Q GP Slope e 10% Sandy Gravel ,Q:• w/low silt Groundwater? No Depth Water Depth After Monitoring, None Date: 4/24/06 # Date Gross Time Net Time De th Dro 1 4/19 0 -- 4' - 2 4/19 4 4 rain. 6' rNe '3 4/19 8 -- 3 - 4 4/19 12 4 rain. 5' 2- 5 4/19 14 -- 1 3' -- 6 4/19 18 4 min. 5' 2' Percolation Rate 2 min./Inch Perc Hole Diameter 6' Test Run Between 4' and 5' Comments:PrP-SnnkPd Performed By NorthRim Fng, I Performed In Accordance with All S ON THIS DATE. DATE: 4/24/06 NORTHRIM :~a9111' ENGINEERING 17237 Bear Paw Clrcl ;Cagle River, Alaska 99577 a-nw 907-694-7028 CERTIFY THAT THIS TEST WAS ate/Municipal Guidelines in Effect OVERLOOK ESTATES LOT 4 BLOCK 3 GE❑TECHNICAL T.H. 2 'wte --- -- 4/24/06 2 Of 2 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 068 -041-18 Certificate of On -Site Systems Approval OSC251534 Expiration Date: 11/12/2026 Legal description OVERLOOK ESTATES BLK 3 LT 4 Site address 27628 PARAMOUNT DR Current property owner(s) ENNIS RODNEY X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: Original Certificate Date: 12/1/2025 This ertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sy em(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 Development Services Department Phone: 907-343-7904 On -Site Water &Wastewater Section -'f Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 068-041-18 Complete legal description OVERLOOKESTATES BLOCK 3 LOT 4 Location (site address) 27628 PARAMOUNT DRIVE EAGLE RIVER, ALASKA 99577 Current property owner(s) ENNIS RODNEY Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units Holding Tank ❑ Community Septic or Public Sewer 6. SEPTIC TANK: a Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 19 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench R Wide Trench ❑ Seepage Pit Waiver request for: ` Distance: Expedited review requested: ❑ 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 $ Waiver Fee $ Date of Payment 6/1/t5 Date of Payment COSA #% SE/ Waiver # COSAApplication Apr2025.doc COSA Checklist_May2025 .docx COSA Checklist Legal Description: OVERLOOK ESTATES BLOCK 3 LOT 4 Parcel ID: 068-041-18 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 5/11/2006 Total depth 400 ft Cased to 104 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 11/20/25 Static water level at beginning of test 92 ft. Well production at time of test 1.4+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 11/20/25 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 48" Date of pumping 11/12/25 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 6/1/2006 ALL standpipes present per record drawing Total measured depth from grade 8.3 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) 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 2000 gallons 11/19/25 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 11/20/25 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 1 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth remaining 48 in Comments/Deficiencies: Total measured depths from existing grade. 4’ ED per measurements, visual observations, MOA records & appears approximate. COSA Checklist_May2025 .docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ 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’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 12/01/2025 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 12/01/25 MUNICIPALITY F ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 068-041-18 1. GENERAL INFORMATION Expiration Date: J O'n 1 I, 9, 0�2 a Complete legal description OVERLOOK ESTATES BLOCK 3, LOT 4 Location (site address) 27628 PARAMOUNT DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) TIFFANY & RYAN JOHNSTON Day phone Mailing address Real estate agent 12110 BUSINESS BLVD. STE. 6, PMB 413, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ 550 Date of Payment /00S�Z I Receipt Number OI 8052 Waiver Fee $ Date of Payment Receipt Number COSA # OSC Z 11600 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Date 10/6/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the1® system and maintenance. The operational life of all well and septic systems are subject to ®� or— . A/ these various and dynamic characteristics and are outside the control of the evaluator of the ^��•�,Q well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q: • • • • _, for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWN . � TM �•* 6. DSD SIGNATURE••-• -•-� . ' • Curtis Huffman �, • CE 128991 ,••�`�`�� .% System #1 Approved for bedrooms ¢��sTF9FOP10/6/? 1P�� System #2 Approved for bedrooms ll ROFESSIQ Disapproved Conditional approval for bedrooms, with the following stipulations: J2 ON-SITE WATER AND -'J))))))Im))"' By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: OVERLOOK ESTATES BLOCK 3, LOT 4 Parcel ID: 068-041-18 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 5/11/2006 Total depth 400 ft Cased to 104 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/6/2021 Static water level at beginning of test 113 ft. Well production at time of test 1.4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 10/5/2021 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 15 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 52” Standpipes/foundation cleanout per record drawing Date of pumping 10/6/2021 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 6/1/2006 ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 4 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective 4’ ED Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Adequacy test date 10/6/2021 Results Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth <1 in Elapsed time <5 min Final fluid depth 0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S 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 COSA guidelines in effect on this date. 10/12/21 Parcel I.D. 068-041-18 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: d — / b "/ Overlook Est. Block 3, Lot 4 27628 Paramount Dr. Current Property owner(s) Kenneth & Audrey Chapman Mailing address 27628 Paramount Dr. Day phone Real Estate Agent Day phone 2. TYPE OF DWELLING: i] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ll Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance Received by: Date: COSA to be released to the engin er, unless otherwise requested by the engineer \ COSA Fee $ 52_(0 Date of Payment ('0 y % Receipt Number 00" 1b G COSA #_ 05e -N 1231 Waiver Fee $ _ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for hg— bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone (907)272-8218 Date 4/14/2014 bedrooms, with the following stipulations: BY % Original Certificate Date: _& T upi ip of or' ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon thele" re rese ations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible forerrors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 7 ' c If more than 1 septic system is on the lot: COSAChecklist# 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Overlook Est. Block 3, Lot 4 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 5/11/2006 Sanitary seal (Y/N) Y Total depth 400 ft. Cased to 104 ft FROM WELL LOG Date of test 5/11/2006 Static water level 125 Well production 1.2 ft. g.p.m. Parcel ID: 068-041-18 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 4/11/2014 126 1.65+ ft. g. p. m. WATER SAMPLE RESULTS: Coliform M�colonies/100 mL Nitrate /��f% mg/L Arsenic N—D ug/L Date of sample: �� Zo+ `� Collected by: pi� B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 10/18/2013 C. ABSORPTION FIELD DATA Date installed 6/1/2006 Length 54 ft Depression over tank (Y/N) N Pumper JR's Pumping Soil rating (g.p.d./ft2 or ftz/bdrm) Width 5 Date installed 6/1/2006 Cleanouts (Y/N) Y High water alarm (YIN) N 1.2 GPD/SF ft. Total depth 8 ft. Eff. absorption area 540 flMonitoring tube 411 1 12 0 1 4 P System type Shallow Trench Gravel below pipe 4 ft. Y Depression over field N Date of adequacy test Results (Pass/Fail) aSS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 602 gal. New depth 0 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO Size in gallons "Pump off' level at in. Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS 4,-R,-14 G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 4/14/2014 COSA brown sheet -1 0-10-1 2.doc Absorption field 5+ Surfacewater 100+ Water main 10+ Driveway, parkingtvehicle storage 110+ Municipality of Anchorage �z�za�oc Development Services Department Building Safety Division On -Site Water and Wastewater Program r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ParcelCOSA # mcpt3 Expiration Date: 3— 2 8 0 7 1. GENERAL INFORMATION Complete legal description _t7 L QO f< iZ37—ATES BLoCfC 3 L11T y Location (site address) 2408 P/fRAix ourrT 4 /& Current Property owner(s),4CiQi� 0.,MP C4AQ( Day phone 7q.Z-3 2 SQ Mailing address 170 q e &AX., PG w7— J10i✓F_ ytz.'AC'' R1*26< Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone Day phone TYPE OF WASTEWATER DISPOSAL: The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. Individual On-site ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 Certificate of Onsite 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 Address Engineer's Printed Name _"� %6✓F iW 9 Phone G 94/— 7 CZJ- Date /aLz fl d S wf M� w 4 V n ^^ •7 LL i �} 3. . �c : • c ,• r 7r�� 5. DSD SIGNATURE s(sva, w. Eng"", L. Approved for LIt' bedrooms. •. ...... Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date:2—;LQ—O 6 (Rev. 11105) Municipality of Anchorage /• Development Services Department Building Safety Division On -Site Water & Wastewater Program ' • "' 4700 Bragaw Street P.O. Box 198850 Anchorage, AK 99519-8850 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: eS4:!,ZL.aOK ESTATES 93 J,V Parcel ID: A. WELL DATA Well type L If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed,�&/a6 Sanitary seal (Y/N) Wires properly protected (YIN) Total depth *JQ6_ft. Cased to L�ft. / Casing height (above ground) �L�in. FROM WELL LOG Date of test .51/1 06 Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: AT INSPECTION ft. 9 - p.m - Coliform 6 colonies/100 mL Nitrate Z01 mg/L Other bacteria O colonies/100 mL Arsenic: a 31P mg/l Date of sample:8L7/06 Collected by. r' XS B. SEPTICIHOLDING TANK DATA Tank Type/Material A&ffQ,Z�,E T7 41k ISM,64 Date installed Tank size /ZSa gal. Number of Compartments Z Cleanouts (Y/N) V Foundation cleanout (Y/N) T Depression over tank (Y/N) High water alarm (Y/N) N Date of pumping A461&2 Pumper C. ABSORPTION FIELD DATA Date installed CZ, ZQ Soil rating (g.p.dJW or ) % 2 System type �� 7 4JhO Length �LZ4 ft. Width s ft. Gravel below pipe Total depth 4? ft. Eff. absorption area �Ofi2 Monitoring tube 4- Depression over field Date of adequacy test I(EW_ Results (Pass/Fail) • For,L bedrooms Fluid depth in absorption field before test _ In. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date r - D. LIFT STATION Date installed Size In gallons I Manhole/Access (YM) `Pump on' level at in. `Pump off" level at in. High water alarm level a in. Datum Cycles tested Meets alarm & circuit r uirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot /•f- On adjacent lots Absorption field on lot I0 4 '-f- — Public - - Public sewer main Sewer /septic service line l 0 r,& Animal containment areas mo ;,.- On adjacent lots 10611— Public 061 rPublic sewer manhole/cleanout orf— Holding tank Manure/animal excrete storage areas /OG rt SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation _/ 0 rt' Property line 1� rt Absorption field r� Water main /41) r'f• Water service line O �+' Surface water Wells on adjacent lots IL70 "- SEPARATION SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / D rt Building foundation 30 Water main 16 rt' r Jrd r Water Service line Surface water e100 'f' Driveway, parking/vehicle storage Curtain drain 6% Ar Wells on adjacent lots Id o `t F. COMMENTS G. ENGINEER'S CERTIFICATION .^r Or wit .•^ �� I certify that I have determined through field inspections and ,c c11 �i/',� .,•lllL� review of Municipal records that the above systems are in w x �.q is; t%�•i ' " Od conformance with MOA COSA guidelines in effect on this date. �;'• • . ri Engineers Printed Name LI)e i d '[nv SJO Date 21�0 C tC�%PE 656 ..<c VT Cf �••.... �. .V COSH Fee $ Waiver Fee $ �a �g�0 Date of Payment Date of Payment Receipt Number 8 %AReceipt Number (Rev. 11/05) ANALYTIC GROUP Northrim Eng Attn: Steve Eng 17237 Bear Paw Circle Eagle River, AK 99577 907-693-7028 Far: 907-694-7026 Client Sample ID: Overlook Est. Sampling Location: B3 14 Client Project: Northrim Eng Sample Matrix: Aqueous COC #: 53805 PWS#: Residual Chlorine: Comments: Lab#: A0612069 -01A Analytica International, Inc. 4307 Arctic Blvd. Anchorage, AK 99503 Phone: 907-258-2155 Fax: 907-258-6634 Report Date: 12/20/2006 Receipt Date: 12/7/2006 Sample Date: 12/7/2006 Sample Time: IO:OO:OOAM Collected By: SE Flag Definitions: MRL = Method Reporting Limit MCL = Maximum Contaminant Limit B = Present also in Method Blank H = Exceeds Regulatory Limit M = Matrix Interference I = Estimated Value D = Lost to Dilution "= RL higher than MCL; target not detected Analysis Method Pre s AIRL i11CL Method Pref Analysis Parameter Result Units Flags Date Date Analyst 4500-NO3E (Aqueous) - Nitrate Test was conducted by. Analytica - Anchorage Nitrate as N 2.01 mg/L 0.50 10 12/8/2006 12/8/2006 A3 Lab#: A0612069 -01B Analysis Method Pre s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst 200.8/200.8 (Aqueous) - Family Well Water I Test was conducted by: Analytica - Thornton Arsenic 0.318 ug/L 0.15 10 200.8 12/18/200612/18/2OOOCSB Lab#: A0612069 -OIC Analysis Method Pre s MRL MCL Method Prep Analysis Parameter Result Units Flags Date Date Analyst 223B -PA (Aqueous) - Coliforms in DW Test was conducted by: Analytica - Anchorage E. Coli <s9RL PASS/FAI 1.0 1 12/7/2006 12/7/2006 PL L Total Coliform <MRL PASS/FAI 1.0 1 12/7/2006 12/7/2006 PL L Reported by: Claire Toon, Laboratory Project Manager Page I oft '\ � \ Lor s PLOT PLAN _ AS BUILT X SCALE I. - 40. GRID SW 465 Project No. 06-022 Lang & Associates, inc, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 907 522-6476 Phone Registered Land Surveyors 907; 522-4625 rax ( kglangisOolaska.net / jolonglsOalaska.net OF 4` 9s 1 hereby certify that I have surveyed the following described Property: LOT 4, BLOCK 3, OVERLOOK ESTATES SUBDIVISION (PLAT No. 84-287) Ar49� y AnRecording District, Alaska, and that the Improvements thereon an ............ .... .......... within the property Imes and do not encroach onto the property adjacent thereto, that no Improvements on the properly lying adjacent thereto encroach on the surveyed .............. promises and that there am no roadways, transmission Bnes or other visible KENNETH G easements on sold property except as Indicated hereon. Doted this the 1041 LS -5 02 Day of 9G'c>ar.IPK+R— . Zawfo at Anchorage, Alaska �•I?�II��`.••'A,6"� It Is the responsibility of the owner to determine the existence of any easements, covenants. or restrictions which do not aooear on the recorded subdivision elaf.