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HomeMy WebLinkAboutEKLUND #1 BLK 5 LT 3Eklund #1 Block 5 Lot 3 #050-541-09 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141170 PID Number: 050-541-09 Dwelling: H Single Family (SF) ❑ Duplex (D) [—]Multiple (SF and/or D) Project: ❑ New N Upgrade Name: CHRIS WOOD ABSORPTION FIELD ❑ Deep Trench Shallow Trench ❑ Bed ❑ Mound Address 4451 UPPER KOGRU DR., EAGLE RIVER, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 5.0 GPD/SF 0.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original gradeGravel +1.5 Ft depth beneath pipe 0.6 Ft Subdivision Block Lot EKLUND #1 5 3 Fill added above original grade 5-5 Ft Gravel length 30 Ft. Township Range Section Gravel widthBeds: 5 Ft. Number of Lines NA Distance between lines I NA FL SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 150 F. 1 NA Ft Well >100' >100' >100' NA >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ■ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water >100' >10()' >100' NA Material Number of compartments Lot Line >5' >10' >5' NA STEEL 2 NA Foundation >5' >10' >5' NA LIFT STATION Manufacturer Capacity Curtain Drain >50' >50' >50' NA Gal. Remarks EXISTING SEPTIC TANK ABANDONED PER Pump on level at in. Pump off level at in. High water alarm at in. MOA REQUIREMENTS Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL Housetotank 3034 Tank to dreinrield 3034 GUARANTEED SERVICES Drainfield3034 COIMT3034 Inspector LARS SPURKLAND BENCH MARK (Assumed elevation)100 It Inspeection f � 6/25/14 6/26/14 Location and description ction 2nd 306/27/14 0 TOP FOUNDATION @ SYSTEM CONTROL BOX COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp "Q a `I!! Conditional Approval: Date --~`* i .4}. d V e✓ d- V ne- 0- f a v 0 U P v 1✓f l d 410 .SPU.RKIAND.RQ 1150 Approved %�. ILf i! PROFESSIO N t Date/ m inspection Report_5-1-12.aoc Spurkland Engineering Environmental Consulting and Design Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Ladies and Gentlemen: Conditional COSA Eklund #1 Blk 5 Lt 3 October 22, 2014 On September 3`d, 2014 the mounded absorption field at the above referenced property was inspected. The ground surface of the mound is vegetated, please issue final approval of the septic system installation inspection report and COSA. If you have any questions, please give me a call at 279-3918 Sincerely, laws Spa'�-&d Lars Spurkland, P.E. 203 West 15« Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net �\ BARBE£ HOMESTEAD � NORTH LOT BY R£C1S 77' - INSTAUEDM 1500 GAL ADVANTEX AWWTS TRENCH LENGTH 30 FEET TRENCH WIDTH 5 FEET MAX EXCAVATION DEPTH 0.5 FEET - REMOVE ORGANICS MOA FILTER SAND 2.0 FOOT ROCK DEPTH 0.6 FEET 2' INSULATION ^,OVER 2 FEET (MIN.) 7.5' TOP 50/1 AND VEGETATION 2-BDRM NOUS£ LAND SURVEYOR il1IL_£A5E _ _77 LOT 3 SWING TIES A 8 S. T. M.H. C 23' 22' DBL CO. D 37' 32.5' DBL C.O. E 37.5' 33.5 OF. C.O. F 67' 60' OF. MT. G 67.5' 61' N0T£.• THIS IS NOT A SURVEYED PLAT. WELL h SEPTIC LOCATIONS TAKEN FROM ON -SIT£ WATER AND WASTE WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXIMATE. 25 0 25 50 75 100 125 150 SCALE, 1' = 50 FT 0 30' 4' CONTOUR LINES Al SPURKLAND No. CE -11500 0 SPURKLAND ENGINEERING I I EKLUND /1 B5 L3 I ( SEPTIC SYSTEM ASBUILT 203 W TH. AVENUE ANCH AK.K, 99501 CHRIS W170 BATE, JUNE 27, 2014 (907) 279-3916 4451 UPPER KD6RU DR EAGLE RIVER AK 99577 SHEET, 2/4 GRIDS SE0602 PERMIT # USP141170 PID # 050-541-09 EKLUND#25L3.SC50.DWG Soil Absorption System 5' x 30' trench Removed Organics 2.0' MOA Fliter Sand 0.6' Septic Rock Silt Barrier 2' Insulation 2' Cover lmin) 0,5' Top SoR and Vegetation ELEV.-85' Below Ell 2 -BEDROOM RESIDENCE Foundation CD 1500 GAL AOVANTEX Ca ftory-#tl AVVTS 1.%V GAL SA&E POD ADVANTEX CATEGORY -DT AVVTS BENCH MARK TOP FOUNDATION V ADVANT£X CONTROL BOX ASSUMED ELEVATION 100' ISPURKLAND ENGINEERINGI I EKLUND 11 BM 5 LT 3 I I SEPTIC SYSTEM ASBUILT 203 W15th Ave CHRIS WOOD DATE, JUNE 27, 2014 Anchorage Ak 99501 279-3916 4451 UPPER KOGRU DR EAGLE RIVER AK 99577 SHEETS 3/4 GRI➢, 0602 I PERMIT # OSPI41170 PARCEL IB # 050-541-09 Eklund#1B5L3.B3BVG I July 1, 2014 Rising Son Electric Services LLC, 36784 Eklutna Lake Rd. Chugiak, AK 99567 (907) 622-6777 Re: EKLUND #1 BLOCK 5 LOT 3 Two whom it may concern: - The lift station at the above referenced address has been wired in accordance with NEC and State/Local codes and is wired to the manufactures standards. Thank you for your business. Sincerely, Dakota Keller, Owner Administrator License Number 1284 Specialty Contractor license Number 38497 (907) 622-6777 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141170 Tax Code Number: 05054109000 Work Type: Septic Upgrade Permit Effective Dates: June 18, 2014 to June 18, 2015 6 - 2 G -/y Design Engineer: SPURKLAND ENGINEERING Subdivision: EKLUND #1 Site Legal Address: EKLUND #1 BLK 5 LT 3 G:0602 Owner/Address: WOOD CHRISTOPHER R 4451 UPPER KOGRU DRIVE EAGLE RIVER AK 995779743 Site Mailing Address: 4451 UPPER KOGRU DR, Eagle River Lot Size in Sq Ft: 38764 Total Bedrooms: 2 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage /2.'ja 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receive Issued COi--evv<oves �%e selp�.C_Lv,k �tloye�v�eyo�tiehorl cnv�d rev;s�t LIQ aes'3" -4 be 0V-MVJ'( M)ow. MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcell.D. 050-541-09 Property owner(s) CHRIS WOOD Day phone Mailing address 4451 UPPER KOGRU DR EAGLE RIVER AK 99577 Site address SAME Legal description (Sub'd., Block & Lot) EKLUND #1 BLOCK 5 LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: IN all that apply) Absorption Field Q Initial F] Single Family (SF) Q (w/wo ADU) Septic Tank Q Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ UBM�TTAI (SF and/or D) Private Well E3S Water Storage ❑ JUN 0 3 2014 THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: r Waiver Fees: _ Date of Payment: l.`7 Date of Payment: Receipt Number: 82wt� Receipt Number: Permit No. OS p 6L%(/] o Waiver No. Permit App_9-1-12.doc pndk Spurk.land Engineering Environmental Consulting and Design WELL & SEPTIC SYSTEM DESIGN Municipality of Anchorage May 30, 2014 Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Septic System Installation Permit Eklund #1 Block 5 Lot 3 Ladies and Gentlemen: I am writing to request a septic system installation permit for the above referenced property. The proposed system will serve a 2 -bedroom single-family residence. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: Groundwater observed at a depth of 3.0 feet below ground surface (5/29/14). Soil Rating. From 9.4 min./in. No. of Bedrooms Test hole 5/22/14 = 5.0 gal per sq.ft./day 3 Required Area per Bedroom: 150/5.0 = 30 sq.ft. Total area required: 30 x 3 = 90 sq.ft. System: We are proposing a 1500 gallon single pod Advantex category III AWWTS followed by wide trench field. The soil absorption system will consist of a 5 foot wide trench, 30 feet long consisting of 1.5 feet of MOA filter sand and 0.5 feet (150 sq.ft. effective) of sewer rock. . Soils: A test hole was excavated on May 22 d 2014. See the attached soil logs. Groundwater was observed at 3.0 feet below the ground surface on May 29h, 2014. Ground water monitoring will continue through construction of the septic system. Surface Water: No surface waters were observed within one hundred feet of the proposed septic system upgrade. Topography: The ground level slopes down towards the WSW at between a 15% and 25% 203 West 15`h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Spurktand Engineering Environmental Consulting and Design grade. Waivers: None The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sin erely, 4kIand, P.E. Civil Engineer 203 West 150i Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net Col SYSTEM r'S"INGS'EEpDOWUUIIRSYS TB B£ ABANDONED PER \BARBEE HOMESTEAD MOA REM=EMTS TO Bf SURVEYED BY R£GISI£RED LAND SURVEYOR x W UnUZASE OT 2-BDRM HOUSE INSTALL 2 -BEDROOM SEPTIC SYSTEM INSTALL 1500 GAL ADVAN7EX AWWIS TRENCH LENGTH 30 FEET TRENCH WIDTH 5 FEET ALAR Excumm DEPTH a5 FEET - REMOVE ORGANICS MOA FILTER SAND 1.5 FOOT ROCK DEPTH 0.5 FEET 2" INSULATION 0.5' TOP SOIL AND VEGETATION COVER 2 FEET (MIN.) 30' SLOPEIRAINT'r,�r- V TF 4' CONTOUR LINES lY e*M . ............. lw NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC Ap 0... A ..... ..... . ...... . ......... I ..... LOCATIONS TAKEN FROM ON--S17r WATER AND WASTE WATER 0 0 DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE........ APPROXAM 7E RS spu, MF AV N . CE -11500 AV ... 25 0 25 50 75 100 125 150 ♦4114VAU SCALE, 1' = 50 F7. SPURKLAND ENGINEERINGSEPTIC EKLUND 11 B5 L3 SYSTEM DESIGN 203 V 15TH. AVENUE 4NCH. 4K 99501 CHRIS 6IL717B B4TE.- MAY 29 2014 (907) 279-3916 4451 UPPER XDGRU DR EAGLE RIVER AK 99577 SHEET, 214 ERIB,• SE0602 PERMIT # USP141XXX PIB # 050-541-09 I]XZ.LNB#lB5L3.SC59BV6 Cot 2-8EDR00M RESIDENCE Foundation CO NOT TO SCALE 0 1500 GAL ADVANTEX Co teyory-W AWWTS Soil Absorption System 5' x 30' trench Renove Organics O 1.5' MOA F/lter Sand 0.5' Septic Rock (effective) 1 1/4' Dlstrlbution Piping Slit Barrier 2' insulation 346' holes 36' on Center 0.5' Top Soil and Vegetation 2' Cover (nin) o 0 ••��wwww��, •••(E OF.... ,....... �♦ .•�P,...., ♦♦ Monitors AV � ' i.' 49♦♦� N. TS 0.... `......................... .........� ••�, •• • �, LA SPURKLAND ♦ f ♦ f :, NO. E-11500 1A ♦j♦.. IpR� E � SS .4Ap 4 w CleanMonitors Clean outs r Insulation � Foundation Ca SBt Barrier TH w u V a. 4- �3 1l ur il- 4' nM E.G. A5 Ft of S tie Rock £FF�thz AS' Flier Sand 1500 GAL PGD A 15 T ADVANTEX CA AVWTS tEli ELEV.=10' Below Ea 5/29/14 N9 SCALE BBB £LEV.=A' Below E.G SPURKLAND ENGINEERING EM10 BLK 5 LT 3 SEPTIC SYSTEM SCHEMATIC oragh Ave Anchorage Anchorage Ak 99501 11 CHRIS WOOD 1 DATE, MAY 30 2014 279-3916 4451 UPPER KOGRU BR EAGLE RIVER AK 99577 SHEET, 3/4 GRIDi 0602 PERMIT # OSP141XX PARCEL ID # 050-541-09 Eklund#1B5L3.B3.BVG CDi INSTALL 6" F Is l s SLIDE SE( OF 6" OVER THIS CONNEC TO PRC SHEER PROTECT EXTENI BRIDGE EXCAVR.....I 1500 GALLON ADVANTEX TANK "q1;_ SPURKLAND ENGINEERING MUM /I B5 L3 SEPTIC SYSTEM DESIGN 203 W15th Ave CHRISWOOD DATES 5/30/14 Anchorage Ak 99501 4451 UPPER KOGRU DR EAGLE RIVER AK 99577 SHEETt 4/4 GRID- SW0602 I PERMIT / 131XXX PARCEL ID If 050-541-09 EKLUN01185L3.D4.DWG I Spurkland Engineering 203 W. 15th Ave. Ste. 202A Anchorage, AK99501 TEST HOLE I -I DEPTH 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SOIL LOG AND PERCOLATION TEST SOIL DESCRIPTION DATE._ 5/22,/14 __—_ ORGANICS WAS GROUNDWATER OBSERVED: —7 Yes IF YES, AT WHAT DEPTH. 3 AFTER MONITORING DATE OBSERVED: 5/29/14 SillyGrove! w/ Some Sand (GM) PERCOLATION TEST: NOTES.- PRE-SOAKED FILL DATE I GROSS TIME NET TIME DISTANCE DROP 8.875 522 14 3.•00 PM 0 min. 8.875 3:30 PM 30 min. 5.625' 3250' 9.000 4:00 PM 30 min. 5.625 3.250 6:00 PM 30 min. 5.813 3187 PERCOLATION RATE.• 9.4 minutes/ inch PERC HOLE DIAMETER: 6 inches TEST RUN BETWEEN 1 _ FT AND 1.5 FT SITE PLAN: PERFORMED BY. Lars Spurkland. 1, Lars Spurkland P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. SPURKLAND ENGINEERING MUND /1 BLK 5 LOT 3 SOIL LOG PERCOLATION TEST 203 V 15TH AVENUE ANCH AK. 99501 CHRIS VDUD BA TE.- MAY 23, 2014 1907) 279-3916 4451 UPPER KUGRU DR., EAGLE RIVER, AK 99577 GRID qr SE602 PERMIT # PID If 050-541-09 Municipality of Anchorage •• Development Services Department Building Safety Division •• �" - OnSile Water and Wastewater Program, 4700 S. Bragaw St. 1 P.O. Boz 196650 Anchorage, AK 99519-6650 Page 7 of 2 www.oi.snchorage.ak.us (907) 3437904 1 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW930198 PID Number. 050-541.09 1 Wastewater System: ® New ❑ Upgrade ER KOGRUABSORPTION FIELD Phar Nu «se°f 0"' p Deep Tmxh ® Shallow TMXh O Baa 0 M"Id I 0 Dew LEGAL DESCRIPTION Sod Rasp 1.2 GPDXe Total Depth can a9hal areae. 0.8 Ft. Block Lot 8Wdmswll: 5 3 EKLUNM Depth to ppe bonen eom ongno Vote 0.2 Ft. Grovel depth earem plea > . Fi TowrlelW R«qs Swan 14N 1E Faeadeaeooreonpn«Vede 6.2 Ft. rr"L«vh I 55 Ft. Well: ® New ❑ Upgrade GrM wd111. 5 Ft. Nunn« «IMe 1 Dm«pe oelween lnee I 0 Ft claMratan (Pm«e. A B. C) PRIVATE TOW 009e1 70 Ft. caeca b 65.1 Ft Tom aosarpeorl elle 275 Fr Ppe M«ernel I PVC 0104, BILL SULLIVAN Do* Drnea 71111993 SM1a w«4, l."ww1..� 15 FL ♦ �� . ru Date esulled I 811/1993 n«aPump 5 GPM Sel « 55 Ft. c••�^p Baht npor. Grp�nd 1.7 FL TANK SEPARATION DISTANCES 0 septic ❑ Holding ❑ S.T.E.P. I ❑ Other. To I From Septic Tank Absorption Field LtR Station Holding Tank ubtiHPtivate SelverLine a *` UNKNOWN b 1000 Gel Well +100' +100' — — +25' Mot. W STEEL Nu aDonpo~ts 1 2 suloewel« +100' +100' — — LIFT STATION Lata1. +5' +10' — — NO LIFT FwM«m +5' +10' — — Pury ons Mv« et h 'Pure a4, Mv« « ti HI ght« ««m « in CutOn a«n +56Ott' +JV5�0rt' — — Pulp Mete 8 Model EM Wooscborn p«lo n DY Ren'«1e DOCUMENTING EXISTING SYSTEM BENCH MARK Loralron.ria Deea�peat TOP OF SONOTUBE AT DECK CORNER eveucn. 100 FL Engine mp „<" L Inspections performed by: Dates: 1« 21101 Development Services Department Approval Reviewed and approved by: Date: fen' 12M) I 1. ! P- WOOD Elow /'~•• I...... ••G is -'N'ESSItX�" Permit No. SW930198 I Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: EKNLUND#1 LOT 3 BLOCK 5 SWING TIES 21.9 D 1 46.7-1 41.2 050-541-09 SCALE 10-40' ------ 5 ---- TH-1--------- _ _ 10' UTILITY EASEMENT _ _ I_ _ _ _ _ X55 ® 1000 GAL RESERVE SEPTIC TANK SITE \ i �..-CTV TH-2 GREEN HOUSE 2 -STY FRAME GARAGE \ UAA�R N p742 4S w Zroo 74$•65' ----------------- 1---45,69f .dlply�=lzo.00' 0 - CLEANOUT -� - WELL ELEVATIONS CNOT TO SCALE)/1 TOP OFiONCR T TBE i 0 - MONITOR TUBE ASSkU ELCVATION ` 100' ©Bfj— ORIGINAL GRADE191.4 I ENGINEER'S SEAL FINAL GRADE197.t / I o F MT -1 TH-1 o r\`...... 6.2't,,,,,,, Ili I I � 0 °%��✓���,1�:.°. TANK ';..6 • o o e •• o �....� ....:.... 1000 GAL a GRAVEL• 0 65.9 Q •, CHRISTOPHER R. W000: 95.2 0 •• •o ' • P o 0 0, QQ �f :. CE -10387 ' c 61.4 90. 91.2 BOTTOM' OTTOM O� Eagle River Engineering Christopher R. Wood, P.E. 10421 VIW RD. Suite 201 Eagle River, AK 99577 August 16, 2006 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Eklund #1 Lot 3 Block 5 Construction As -built Certification Request Dear Mr. Roth: Services (907) 694-5195 tel (907) 694-3297 fax Eagle River Engineering Services (EKES) was contracted to conduct a COSA inspection at the above referenced property. After doing research on-line, it was found that the inspecting Engineer, D.R. Dayton, had called in inspections, but had never completed the construction documentation. Unfortunately Mr. Dayton passed away shortly after conducting the inspections in 1993. Mr. 9/f/iIA&I/✓also has passed away, who was the excavator that installed the'system. ERES has conducted a thorough evaluation of the septic system, prepared construction documentation, and has conducted a COSA inspection, and requests that the Muni approve the construction documentation and issue a COSA Certificate. Thank you for your consideration in this matter. If you have any questions please call our office at 694-5195. Sincerely, EAGLE RIV ENGINEERING SERVICES 1 Wul Christopher R. Wood, P.E. Principal \2003\06-EKLUNDASBUILTCOSANARRATI V E X~( Municipality of Anchorage Department of Health and Human Services 825 "L" Street P,O. Box 196~50 Anchorage, Alaska 99519-6650 343-4744 July 1, 1994 Robbin Lamere & Lorelei Hass PO Box 772751 Eagle River, Alaska 99577 Subject: Lot 3 Block 5 Eklund Subdivision #1 Permit #SW930198, PID #050-541-09 The subject permit, issued July 1, 1994 by this office for a single family well and/or on'site wastewater system, has expired as of July 1, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater systemf the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. %fcere ly, Ja~e s~C~r o~s s~'1/ Acting Program Manager On-site Services cc: David R. Dayton, P.E. MUNICIPALITY OF A~CHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502~, ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930198 DESIGN ENGINEER:DAVID R. DAYTON, P.E. OWNER NAME:HASS LORELEI OWNER ADDRESS:12837 IRIS WAY EAGLE RIVER, AK 99577 DATE ISSUED: 7/01/93 EXPIRATION DATE: 7/01/94 PARCEL ID:05054109 LEGAL DESCRIPTION: EKLUND #1 BLK 5 LT 3 LOT SIZE: 38764 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 (iSAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE TOTAL DEPTH OF THIS DRAINFIELD MUST NOT EXCEED 2.0 FEET. ONLY THE ORGA~!~ ~RE TO BE EXCAVATED . ISSUED BY: L - DATE:.7I/~ Z /7v O • • W O h • O 0 Z Hca eoo+� - 3ov.lpet — 1ooc�9'a'}a..v.lC. �c P�.To 2.5' M�v��e.lA � luwot.Ja 1•L9Pd/Sf= -ML;wc. S WH4 , Lr-Oj6.TT1+ ? + SO'w-7 David R. Dayton NO. 2205•E h K 0 0 1 FK.�c.r„ M"yN l i y ' ti a <*A..T•l R"M .+.0064 4M .V. MSc Orxl T�qNC oyv Ld,r 7 15LY- S Eicw,et Sapom. David R. Dayton P•E 20210 Donalar St. Chuglak, Alaska 99567 SZ. Gf131 bi3 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION: (.~T5 ~Z:~.,~ ~"-- --'~,-VW~ .~'..~_~ Township, Range, Section: 4 5 6 7 8 9 10 11 12 13 t4 15 16 17 18 19 20 SLOPE WASGROUND WATER ENCOUNTERED? ¥'~ S IF YES, AT WHAT ! ~) DEPTH? 4-,'-~ p E Depth to Water Alter z~ I~onitoring? ,~ Oae Y/~/~'~ SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE '-~' ~' (mmute$tinch} PERC HOLE DIAMETER TEST RUN BETWEEN 2.. FT AND ''~ FT COMMENTS ,,~ r--~I P ERFORMBDBY: '~ ~ ~ ~ ~ ~ , ~,~-(~/) '~ ~//~~ CERTIFY THAT THIS TEST W ASPERFORMEDIN AOCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON TRIS DATE. DATE: ~./ 72-008 (Rev. 4185) PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 ..<,~- 6 7 8 9 t0 11 12 13 14- 15- 16 17 t8 19 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: SITE PLAN SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? ~.~- t P Depth to Water A~er Monitoring? ?,Z-' ,ate: ~/t:~/~ r i Gross Net Depth to Net Reading Date Time Time Water Drop /'P? iO I,.p PERCOLATION RATE ~t~-" (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN "Z-- FT AND -'~ FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 3 72-008 (Rev. 4/85) D. R. DAYTON, P.E., R.L.S. ~~:~ Chugiak, Alaska 99567 20210 Donalar 696-2417 Design Narrative Lot 3, Blk 5, Eklund Subdivision The proposed system is to be a 5' wide x 50' long shallow trench to serve a 2 bedroom home. The trench will be benched into the natural ground on the uphill side and covered above natural ground level to maintain the required separation distance from seasonal high ground water level. There are no Class A, B or C wells within 200' of the system, or private wells within 100'. There will be no significant impact on wastewater systems on adjoining lots. Drainage and reserved areas will not be impacted. TO FROM David R. Dayton P.a. 20210 Donalar St. Chugiak, Alaski 99567 D^'fl-! RECEIvEb [Vluniei De Patit Pt. HY ofA . ealth & F6,~ncnoraeo POD," PAK., o. o) 4P46B TO 3.9nofreU.2bi+cu __PROM__- _ ) �_ , tso^ Ci:2:Cc:ttclA,�l:iwd� < , REPLY _ "_ Dnte` '" -� SIGNED b / e / / David R. Dayton P.E. 20210 Donalar St. Chugiak, Alaska 99567 OWNER OF LAND /~ ADDRESS LEGAL DESCRIPTION DATE - Started PERMIT NUMBER by DOC CO. SULLIVAN-WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688.2759 t i)/~,/'~-3 g;,,./~ ,/~'l~7,~t:~ DEPTH OF' WELL 6~~'' / // I' ~- STATIC LEVEL OF WATER FT. DRAW DOWN FT. Ended '7//'~'..~ GALS. PER HR ."~ta<3 KIND OF CASING KIND OF FORMATION: Ft. to ~ Ft. '(Z'4~'-~)~ x~'7~L-/<0flrrom Ft. to /-4 Ft. O OC'~ ~O~5~ From~ . Ft. to 33 Ft. ~l~rT C~Y c . Ft. to ~ ~t.~;~':~ ¢d~ F~om Ft. to ~ Ft. ~q~g? ~o~c ? From ~Ft. to Ft. '" '"' ~ ~E~' From Ft. to ~ ~Ft. . ~ , ~, ~ :~ From vt. to 7~ ~t. ~'~,0;~ ~o~ From fi) From From From From (~ From From.CX:~ From "~ From~ From From ~ From.~ From__ From From ~rom From Ft. to Ft. Ft. to Ft. _ Ft. to Ft.. Ft. to FI, Fl to Ft Ft. to Ft. Ft. to Ft. Ft. to Ft. .Ft. to Ft. From Et. to__ Ft. From Ft. to Ft. From Ft. to Ft From_ Ft. to Ft From Et. to Ft From _ Ft. to Ft. From Et. to Ft. From__ Ft. to Ft.. From MISCL. INFORMATION: Ft, to_ Ft, to_ Ft. Fl to__Ft. Ft. to___Ft. __Ft. to Ft. Ft. to Ft. FLto Ft. Et. to Ft. Ft. to .Ft. DRILLER'S NAME Parcell.D. 050-541-09 1 r Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of Oh -Site Systems Approval F Expiration Date: e GENERAL INFORMATION I RUSH/ Complete legal description EKLUND #1 BLOCK 5 LOT 3 Location (site address) 4451 UPPER KOGRU DR., EAGLE RIVER, AK 99567 Current Property owner(s) CHRIS WOOD Day phone 242-2717 Mailing address SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU)�`�"'t F1 Duplex U boo' ❑ Multiple Dwellings (Single Family and/or Duplex) JUN 0Q = 2014 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water SySte.,. ❑ Pi lhlic Raurer WaiverNariance request -fpr. NONE Distance: Received b �._ ' 2 % o' y _ _- Date: COSA to be released to the engineer, unles othemise requested by the engineer. COSA Fee $_o2(OD,sD A-1 I' cera 7t o'er Date of Payment co (A-1 (ly (� Receipt Number ®12)(36 G COSA # OSCt Lf 12 $l 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 S(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm SPURKLAND ENGINEERING Phone 279-3916 Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date JUNEE?�4+�g1� G,. T / Conditional approval for bedrooms, with the following stipulations: ' ,2 -/ � By: Original Certificate Date: 7 Thenick r o horage 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet f , - If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: EKLUND #1 BLOCK 5 LOT 3 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID #- Date completed 7/93 Sanitary seal (Y/N) Y Total depth 70 ft. Cased to >40 ft. FROM WELL LOG Date of test 7/93 Static water level 15 ft. Well production 5 9.p -m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic NO ug/L Date of sample: 6/11/14 B. SEPTIC/HOLDING TANK DATA Tank Type/Material FIBERGLASS Tank size 1500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping NEW Pumper Parcel ID: 050-541-09 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 5/29/14 30 4.5 ft. 1-012M Collected by: ANSON MOXNESS Date installed 6/25/14 Cleanouts (Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed 6/26/14 Soil rating (g.p.d./f:2 or f 2/bdrm) 5.0 System type 5 -WIDE Length 30 ft. Width 5 % Gravel below pipe 0'6 ft. Total depth 3'5 ft. Eff. absorption area 150 fe Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off" level at Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main NA in. Manhole/Access (YIN) High water alarm level at. Meets alar & circuit requirements? On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout NA Sewer /septic service line 25+ Holding tank NA Animal containment areas 50+ Manure/animal excrete storage areas100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5'+ Water main NA Water service line10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100'+(N.O.) Curtain drain 50'+ (N.O.) Wells on adjacent lots 109+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name LARS SPURKLAND Date 6/27/14 coSA brown sheet 10-10-12.doc Absorption field 51+ Surface water 1004 Water main NA Driveway, parking/vehicle storage 10' of A[00 q;S�;t �....• RS .5PURKLAND: �) C 1150 I'1l�F�PflOFES in. $ m °<c Z M �N o o y 2 P >�D"= x i i D D M 0 p m g m n m m m m C m A 9 m m m O 5A< 0 o m S z=o 'm{ Z N Z C W N n r Z' m 5 z o m> Gm r r za�mOOm rT1 N-"zAmFA � m no�NAN� � O�NZA.mC fn•1 C7 Z Z OA m y 0 y D 0 o m N v O z��oyma z A nN�a�rS+ m oma' m�mN A== A O y A ��OOZZ� m O Z vm s o O CyO �o�yy z n -x- 0 mmmm o pD2-N-I~nm yxr^zXm�n �mcmimv�m 000�om zAm Av m man ui A{ D ON D.yy�< ONm �=1r A O Z O Z N ti ti u m I - I I I !l 7 `1O C r m m m z 1O_ ' ,99'OZI 3 ..00,OOo00 S I r I0 V) n N o o 7 v C nC > N n m 01 Z A r� \ r � r y O N O N O > D � O 0 O 0 � N _ 2y r PD J 5 J M z O �gti m n S O < m v o J v N a O U O m r y c"9�Fi D m o z n `• r N w W D m m m � m l0 O � A A O � v z z x � O m N w J 0 a m � N m > OC) ' ,99'OZI 3 ..00,OOo00 S I r I0 V) �a N o o 7 v nC > N n m 01 A r� \ r � r y ' ,99'OZI 3 ..00,OOo00 S I r I0 V) o A _ 2y z �gti m n �Aii• czi I c"9�Fi o z n `• co o v 5n a n F _ m N N OC) cyl m W n z 0£ ' ,99'OZI 3 ..00,OOo00 S I r I0 V) t Environmental Consulting and Design w Municipality of Anchorage June 27, 2014 Development Services Department On Site Water and Wastewater Program 4700 Elmore Rd. Anchorage, Alaska 99519 Subject: Conditional COSA Application Eklund #1 Block 5 Lot 3 Ladies and Gentlemen: I am writing to request a conditional COSA be issued. The well and septic system at the above referenced property was installed between 6/25 and 6/27/2014. The final grade inspection has not been completed yet and the system required top soil and vegetation. A final inspection will be complete to ensure the required cover is placed and vegetation covers the absorption field. If you have any questions or concerns, please contact me at 279-3916. Lars Sp, rkland, P.E. Civil Engineer 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland@gci.net ADVANCED WASTEWATER TREATMENT SYSTE t: MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE 6 AND 15 -: l tC'k,�, THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 22 Day of _ of 20Py by and between rs- "chi; L herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: Advanced Wastewater Treatment Svstems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Jax located at (legal description). 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original constriction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. P. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner aerees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: b. Municipality: Director Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. S. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severabilitv. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: f (signature) 1 I °r f' _= i>s1y (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was a(;knowlcdged before me 'Il by A Xfk/% Date: : c, ; y thi,5-2day of ' --j©/ My Commission expires: MUNICIPALITY: By: (signature) Date: name) Title: GriRis vvoen 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D.COSA# b(�07J$3 i Expiration Date: /I — / R O (o 1. GENERAL INFORMATION Complete legal description k P• rncl -01 L 3 96' I Location (site address) 4 q,51 f f o 2.t r fon ru Dr. Current Propertyowner(s)f-2- of,Hin LCtm«z— Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 4 q51 *geir KyRru -D-r. Era . R kl -15 51-7 Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 11 Individual On-site []___ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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 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 Eagle River Engineering Services Phone („g 41042 1 VFW , Suite 201 Address FaAln Riya AK OM Engineer's Printed Name _C•jnri sifyko j- R . 1.til�rl Date _g/ 15-10G, 5. DSD SIGNATURE _►Z Approved for *.:L bedrooms. Disapproved. Conditional approval for bedrooms, with the followir Attachments: COSA Checklist • X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: — % �/ /l� Original Certificate Date: (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division % On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Fiv ,r d # I L 3 S Parcel ID: A. WELL DATA Well typedvcrfL If A. B, or C provide PWSID # _ Well Log(MN) I �., �Q Date completed _IJ Cl 3 Sanitary seal aN) _(JAA- Wires properly protected 67N) Total depth __-LQ-ft. Cased to_ft. Casing height (above ground) ;20 n. FROM WELL LOG AT INSPECTION Date of test 7 1 Cl 3 -7.1,A 4 JO(, Static water level . 1 S ft. d S ft. Well production S g.p.m. oZ• b g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate Cr mg/L Other bacteria 0 colonies/100 mL I Arsenic: (e�,l ug/L date of sample: -7J!j, `l / Ob , Collected by: Cliorl r S Pd he%rir w B. SEPTICIHOLDING TANK DATA Tank Type/Material�.,i,'� /_ sht- -/ Date installed 2 1!2 .3 Tank size I eloQ gal. Number of Compartments _,�L_ Cleanouts Q41N) WSa- I Foundation cleanout CON) (Jt:o_ Depression over tank (Yig) •JJQ High water alarm (YO `-✓)v Date of pumping)ML / Pumper Jl2 S C. ABSORPTION FIELD DATA Date installed -O LIQ.? Soil rating (§� or ft=/bdrm) System type 5 I ft. Gravel below 0.6' ft. Length SO ft. Width pipe Total depth g, S ft. Eff. absorption area.220ftZ Monitoring tube Depression over field .10 a Date of adequacy test -r./a4 fl c(p Results as Fail)f�c gnu For X bedrooms Fluid depth in absorption field before test �_ in. Water added? ! gal. New depth__(�in. Elapsed Time: _C min. Final fluid depth J�5 in. Absorption rate >= S001 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y!C•D& type) vronc k_4 re U on If yes, give date I nyA D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at_ in. 'Pump off" level at 410n. 10 F ig water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot -r 100' On adjacent lots 1100 Absorption field on lot -1 1 o0 ' Public sewer main -t-100' Sewer /septic service line + a5 Animal containment areas * I oo On adjacent lots I o0 ' Public sewer manholelcleanout + I oo , Holding tank + —I S I Manure/animal excrete storage areas + I r)o ' SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation is, Property line t-5 Absorption field 5 1 Water main t to Water service line •t-10' Surface water + 100 ' Wells on adjacent lots t 100 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line +101 Building foundation * If)' Water main + I Water Service line ^hi 0 ' Surface water +100 , Driveway, parking/vehicle storage 40 , Curtain drain + S 0 ' Wells on adjacent lots 4100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and 'C review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. l R Engineer's Printed Name < lrlrf S -Ir oh r- 1Nom •, ' W07 Date g� 10b ' A low COSA Fee $ y00 - Date of Payment s111<l Receipt Number _ Ni V (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number 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.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 6 -241- 1. GENERAL INFORMATION COSA # UU00,66 Expiration Date: // - IS � O (o Complete legal description -/ L 3 Q 5 I Location (site address) r1 q,51 N Koe►ru -Dr. Current Property owner(s) Rot n La rvit fx. Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: —&.- 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 12,11' Individual On-site [-� Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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 iralid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the 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 Eagle River Engineering Services Phone (nq q10421 VFW S Suite 20 1 Address Eagle Riyar, AKcA= Engineer's Printed Name C kri s -f oak r 7-7-1. (.&)nnrl Date 15-1/01, 5. DSD SIGNATURE Approved for %Z— bedrooms. Disapproved. Conditional approval for bedrooms, with the followir Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By; /( Original Certificate Date: 8-13-06 (Rov. 7705) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Elegy ,e, c/ # I L 3 R9 Parcel ID: () 3- A. WELL DATA Well type -i ✓e4c Date completed 3_/ 113 Total depth _-I_Q_ft. If A. B, or C provide PWSID # _ Sanitary seal ON) tl&t- Cased to -(eft. FROM WELL LOG Date of test -7 1-13 Static water level I S ft. Well production S g.p.m. WATER SAMPLE RESULTS: Coliform Z colonies/100 mL Nitrate _Qr'_mg/L Arsenic: �l ug/L date of sample: aL-A, 4 / O(o B. SEPTIC/HOLDING TANK DATA Well LogON) Wires properly protected ON 0 Casing height (above ground) I,20 in. AT INSPECTION -7. A 4 106 as ft. -2-6 g.p.m. Other bacteria (Y Collected by: 00 mL Tank Type/Material 5�4 p:ki C_ / $+:I t4 Date installed ?/ 19 �7 3 Tank size I, o gal. Number of Compartments _.;L_ Cleanouts f W) LA 2 I Foundation cleanout(PN) Depression over tank (YQ'Yj0 High water alarm (Y" Ylv Date ofpumping. 81N41 ooh Pumper JIBS 7DJ_+m�inCi C. ABSORPTION FIELD DATA Date installed 91111,33 Soil rating d./ or ft'/bdrm) System type �rQirr ii' c ld Length SD ft. Width S ft. Gravel below pipe Q. ft. Total depth -qLS_ ft. Eff. absorption area,350 ft' Monitoring tube � t� 6 Depression over field � Date of adequacy test -r�a 4 /0Results as Fail) f a�U For a. bedrooms Fluid depth in absorption field before test �_ in. Water addedSW gal. New depth_erin. Elapsed Time: _( min. Final fluid depth _ in. Absorption rate >= 300 I g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/6D& type) vronc ke)&-J -n If yes, give date D. LIFT STATION Date installed Size in gallons 'Pump on' level at _ in. 'Pump ofr level at Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot -r 100' Absorption field on lot -f I o0 ' Public sewer main + 100' Sewer /septic service line + a5 Animal containment areas * t M, Manhole/Access (Y/N) w F-iig water alarm level at in. Meets alarm & circuit requirements? On adjacent lots -rt DO ' On adjacent lots + IL -0 ' Public sewer manhole/cleanout + t AO' Holding tank t -is Manure/animal excrete storage areas +- I N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation i S' Property line t-5_ Absorption field + S ' Water main i to ' Water service line + 10' Surface water + I00 ' Wells on adjacent lots t r tin ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line -f-1 c) Building foundation + 1(7' Water main + I() ' Water Service line + 1 0 ' Surface water +100 Driveway, parking/vehicle storage 4 0 Curtain drain +50 ' Wells on adjacent lots 4100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and 11Y 101�7014+41011 review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i R Engineer's Printed Name C V 1ri S -IT kXr- INOoi! �'•, Date g�� 1S� Ob qP .. COSA Fee $ y00 Date of Payment S'IG- /6 Receipt Number YL/q (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number W •u .�L�i$�c$ U 3 L o 0 0^ yi°n Z^ '� to o$ z 555E5a� b E9 0 €�•��fi8^ �.2 E Vi Sa o „' v' ox �, s °ob'F'�i� O^ ,99'OLI 3 .00.MOO s (n bao Z E F� o f N SDE Z K L W Y pC U ^ O �O �O O'�o~ hS SE a ^Zi 5 O O y �i 9OoYic5 o.6 '. m% Z rte« h�o5ua�o 'o I b~ Yn c.cc•Ro nno �S p Q V O D O I m b. r! �I'►L ^ Jp4 I g N vc�P or,'p�� %l P• IV. ft e i n GAv� . � m •�• tD W � t ^ I I ag4w N W wCS paNp WE t V.9 , 0+ =2 S� W v W P i f' W K W W o NC u Z "n U �i 71 Mw SCS ReLX 1064129001 Client Name Eagle River Engineering Project Name/tl Eklund N I Lot 3 Block 5 Client Sample ID Eklund #1 Lot 3 Block 5 Matrix Drinking Water All Data/rimes are Alaska Standard Time Printed Date/17me 08/032006 8:06 Collected DaieMme 07242006 15:30 Received Date/time 07242006 16:47 Technical Director Stephen C- Ede Sample Remarks: Allowable Prep Amlysis Pammew Results PQL Units Method Container ID Limits Dale Date Init Metals by ICP/mg Arsenic 6.18 5.00 ug/L EP200.8 C (<IO) 0726/06 07/31/06 Mll Waters Department Nitrate -N ND 0.100 mg/L EPA 353.2 D (<10) 0725106 ALR Microbiology Laboratory Total Coliform 0 col/100mL SM209222B A (<I) 0724106 TLF 08/16/2006 09:31 JRs Pumping FO Box 773415 Eagle River, AX 99577 (907)694-6454 9073449821 161111no Int do Eagle River Engineering 10421 VFW Rd Ste #201 Eagle River, AK 99577 (907) 6945195 JRS SEPTIC Job Dosalplion: 12509 P.O. Number. Terme Net 30 sal w.p: Karlia Map Bods: Jo Informatl n Crosssk.ses, Chris Job Comments: 4451 Upper Kogru Drive Eagle River, AK 99577 (907) 694-5195 Eagle River Road Sery Additional Location Comments Dltgrarnt °'Dinu114t�bme Last Home on Right - 2- Cedar buildings w/biue Steel Root Septic ® back of Home Service Type Septic Servioe 15K PAGE 01 Service Agreement Number. 020758 Order Date: 11 -Aug -2006 Service Date: 15 -Aug -2006 12:0 Technician: Tony Tax %: 0 Job Type: Repeat , Map Gnd: 141- - Tank- Med solids Oty Price Each Tax? 1 $135.00 No Gallons Planned: 1250 Gal. Actual: Hose Length: 1.5 Double Tank: O Pump System: 4 Baffles Inlet:'O Baffles Outlet: 0 Extension Actual $135.00 NonTsxabre Total Taxable Toted Tat Total tired Tad Estrmdad Charges: $135.00 $0.00 $0.00 $135.00 Actual Charges: Custw w wese to the toms end cwd*ms shown. THS IS A BINDING AGREEMENT. I Slpndure and TI/e or Customer Representative Date Aeeeptad by JRe PumpkV Des Accepted Fa yow added corrvwdence the accept Amwkwn Express. DIcVW. Mae and Master Card payments over One phone. After 30 Days •eeants wW be WmW ew to coll.ettms. $25.00 For NSF Checks RNurn.d.