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Home My WebLink AboutT15N R1W SEC 4 LT 11T15N RIW Sec 4 Lot I I #051-072-08 wne: Adaaa Fhww: Municipality of Anchorage Department of Health and Human Services j Di t ort of Envlmnmtat services On -Site services Sectlon 8251' Street Room 502 P.O. Dox 195650 Anchorage. AK M19-6650 Page of Www.dge.8jLUs (907) 3434744 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT :r. St ) 910308 PID Number. 051- 0-72---0 3ufiLt✓ Wastewater System: New 0 Upgrade Diivc 112 A.,L. Jk 99SDti ABSORPTION FIELD ane. a E.aom,a: S O Duo TWO V"W Tma O W O ►tend ' O orw LEGAL DESCRIPTION Qwn," / S,V ' /W °"° y Well: p New ❑ upgra, a/ CWut-eon F&DOW A 4 C: Ta41 Dapae Carie tx D r 0 tkra boo &. Sbec Waur IewC TNIG Ano Eat M: Caft H Mow 0707: CPU R. SEPARATION DISTANCES t Te —y— �f,�,,,.,�� k�,�� Fran T.M, ,vn..�i�N� .. � HOI& 1f Pld c & WON /Do'4 /Doi &rfbw JDD f; /ODr1 _ to Lk" Fameaam t` Qlrteh QMf /�Q'I /OQ nana'kf: '4 T"Deprnkom*0 AVada D. 8 opme //'v'- /2. vv, Dapa� 10me- aipV {Pada: '7.95'- b.G9 R. q F. addm Mow Mprul PaoL, ` cmw�Unpe� J n. /47 emww.ame aane«aYrc DWm b.t l S 2 0� rQW M,apwn...; Fq k1YaW: 211071 4 070 Fr TANK Nd ft ❑ S.T.E.P. 0 Other Llr /a.1.E, / $00 oar, ane. a ems: 'Y / Z LIFT STATION aa.ac or 1inV ad K 1kYn mMararmK h � 8 Vapec mFMmme OF BENCH MARK bf: I /1Lurriae Bawtlm: S' �'�F...A..... 1 9 f Inspections performed by: XAII Fr1S7nt_ _ Dates: 1" 1 2 9 U 12 9 / -* .ZZ .. * I 2nd /2///OD KENN ............. Department of Health and Human Services approval 1 Ca -7116 Reviewed and approved by: tf - / D4. Date: ' twkl IOz t/ -n X A -C=61.3' B -C=29.6' A -D=71.9' B -D=22.3' A -E=80.4' B -E=20.3' A -F=131.0' B -F=58.7' A -G=98.1' B -G=18.7' A -H=145.8' B -H=67,2' AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW990308 LOT 11, SWI/4, SEC. 4, T15N, RIW, S.M. PID#051-072-08 # 9 SFD k 010111HIM M00I NKIC5 GAL /'0,;�!of S' ' /sss11! KENNETH M. DU" f � CE -7118 ! SS10KN' Ar vot MM SYSTEM TH #99-1 ORIGINAL GRADE SEWER ROCK ORIGINAL GRADE SEWER ROCK i 53.7' PREPARED FOR, LEON BUTLER 249 ZAPPA DRIVE, #2 ANCHORAGE, AK. 99504 (907) 337-0265 FlE1D BOOKS Owwtm: WUMDA . JENNINGS— MAw VBG STMOMA JENNINGS GEDam' KMD "ETT JENNINGS DAID 7/27 ME cm NW145 "GD 11L' 99060.DWG ""O0 99060 SCALEo I' - 50' M I SCALE) NTS 81.8 a LL1A\i LW ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Municipality of Anchorage Development Services Department Building Safety Division - On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Boz 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW 996300 PID Number. O5/-072-4c)cr Nana. LUA) uTLFlL Wastewater System: ❑ New ❑ Upgrade Ames. Po '77/012 F.E. AK 77 ABSORPTION FIELD Ph" Nu dBedoane: 301 — g/L/O S D Deep rr.nat o shMbr rlrlw O Bea o Mauq LEGAL DESCRIPTION satRm V 7D D9p1Aft, oa. BbrA'. Ld'. SlDamelor[ GPoxt2 Dean b me balm from or,b W,,,, Ft. Grewt nbeMeln ppa: Toenanq. J`5/VI Rrge: /A) t se: FM ea •bow orgM 7•ae'. Ft. Gr"L.^pn: Ft Ft. Ft. Well: � New Upgrade Grnrwwl: Nunbr of lrlaa: Dulerc. Drwesn toes: C4aMprcM.t�m IPrnra, A B, C1: T" or Ceaaa b: Ft. TaW ebaorpuon Ft. p r Kt� L %L FI. / U F Ftp rr11 � 1721WNG Dr. Dubs. -1 21 199` 3W4 wx L", Mete DMI. mmew. FL Ybb: PunD sal M. Carp Hepnl Ab Gmule. 10-12 GPM LAID UiWA1 Ft. 2- FL TANK SEPARATION DISTANCES ❑ septic ❑ Holding ❑ S.T.E.P. er TO Septic Absorption Lift Holding lUblidPrWe awur. I,. From Tank Field Station Tank SL rune wed I D u"+ I Do f' /6D; 0- j0d f 1- 2 S 1- Met" of canpWnrr.: B" lacew"r ,✓A AIA X14 A-A LIF TATION LPI LM ,d4 NA .11A sue Fanaetm tl,+ NA A4 NA 'Poop an' Iava1 r 'Pump on' level M. Hqn weer Harm x In F in Cute- Drain I /� i/R /✓4' N d �i Pump .. a Moats Ebarrral •bpeCt m perk m by Remrk. BENCH MARK Loulm ane Deaapvl. wnba EwZon FL Inspections performed by: Dates: 1" Engineer's Stamp rw ,.��\\1 OF A� Development ment Services Department Approval P P PProval a,Me.e , •• ••• P�� Conditional Approval Date: W • .•MM . roVKenneth M. Dul%f fy ,II Reviewed and approved b : `/- � 0-2/� c PP Y v• Date: 7 - ` �•• ►o a d •' I F .• .� (Re. "%) RECEIVED: 10/16/06 8:43; ->KND INVESTMENTS. LTD.: #252; PAGE 2 OCT -16-2006 MON 09:17 AN FAX NO. STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL P. 02 ■GIIOUGM 6UeMMION LOT BLOCK 610TION OTe6 6ECTION TOVnYONi► MNOE MEIypI�q I J oIRA I Sc V W �� GLW LOCATIONISKETCH: WELL OWNER: DEPTHS MEASURED FROM: asing top ❑ground surface WELL DEPTH: EDATE OF COMPLETION f[ QeDth Of hole: V it Depth of easing: ft /�7 /_I_ BOREHOLE DATA: Depth Material Type and Color From To 64 DEPTH TO STATIC WATER LEVEL: ^ t ft below DZtop of casing O ground surface Date: / / 2 b .io LM V. METHOD OF DRILLING: zlitir rotary ❑ cable tool I,1 v .O other ' USE OF WELL: J�N<estic ❑ irrigation O monitor �lv� P tt Lt ❑ public supply ❑ other In 1. .. ••, / CASING STICK-UP: I. Diam: in, to It ,ti .itr 1 ♦ .� ti _J w . (� Casing type In. t0 _ft WELL INTAKE OPENING TYPE: E� Rpen end ❑ screened r :, v P ,.1 ..v¢ D perforated ❑ open hole L.LI( �- •,5 + �C Bbl b 7 U Y V 'Depths of openings: t6' ft \ SCREEN TYPE: Diam: in. Lv a`:P 10.l Slot/Mesh Size: Length: ft • GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE: Volume: Depth: from It to ft DEVELOPMENT MEN0 T0: r Durotian: PUMPING LEVEL AND YIELD: It after hr s pumping /p"/7 qpm PUMP INTAKE DEPTH: it Horsepower: WELL DISINFECTED UPON COMPLETION? YES ❑ NO CONTRACTOR INFORMATION: Is d uslness Name 5ighau e o uthon a espresentauveat$ e REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MGMT 3601 C St. Suhe 800 ANCHORAGE AK 99603-6935 ` Phone (9071269.8639.Fax 49071662.1394 -. -Eio�/� S MUNICIPALITY OF ANCHORAGE Department of Heafth and Human Services II 2-9� PVV1 On -Site Services Program 8251 Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 Q (907) 343-4744 JA ^ 9 - 99 ONSITE WASTEWATER DISPOSAL SYSTEM /WATER SUPPLY PERMIT Initial I (_ II_q I5�f1, Date Issued: Sep 01, 1999 Expiration Date: Aug 31, 2000 Permit Number. SW990308 Parcel ID: 051-072-08 1r t Legal Description: T1 5N R1 W SEC 4 LT 11 a Design Engineer. 0070 KND Engineering Site Address: PM Owner Name: Leon Butler Lot Size: 108900 SQ. FT. Owner Address: 249 Zappa Drive #2 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99504 - This permit is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( I8AAC72) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by catling (907) 3434744 (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. /•eVi5�o,1 crffacG�o� f% aPP/br/e� �� loz 9.9 9 Received By: Issued By: Date: / Date: ''� KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11/FAX (907)696-8111 August 7,1999 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer & well permit — Lot 11, SW 1/4, Sec. 4, T1SN, R1W, S.M. Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On July 14, 1999 we dug two testholes for the proposed system. The results of these tests are attached. The general slope of this lot is from northwest to southeast at a grade of approximately 2 - 5% for the northwest one-third of the property. From there it continues to a steep slope in excess of 25% and then flattens out for the remaining one-third to one-half of the property. We have designed our system utilizing the eastern testhole we excavated for the 5 -bedroom house, which is proposed for this lot. The lot will be served by an individual well. We propose to install a 2' wide deep trench. Although the lower soils strata was not percolated it only had trace silt noted and appeared significantly to be made of the same material. Water was not encountered during the excavation or monitoring. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, �jIIsN DEngineering `� ICennbth M. Duffus, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test (WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PL LOT 11, SW1/4. SECA, T15N, R1W, S.M. LOT 7 VACANT LOT 6 4� VACANT �4'Lm"r el TX E99-1 •' 0'' o A[RKK .• pN r 0 }}. TN VACANT I =r �,� / � I LOT 12 VACANT LOT 10 NO PUBLIC WELLS WITHIN 2W' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 2W' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. OF AZ /* 9TE* *� 1 KEN Y. S / CE -71 / �,; \gU' }ESSIO'0 A Q J ^ LOT 11 WELL A VACANT DESIGN DETAILS 5 BDRM X 150 GPD = 750 GPD 750 GPD/1.2 GPD PER SO. FT. (1.3 MIN/IN.)= 625 SO. FT 625/(2'(W)) X 7'(D) (7.0' GRAVEL) = 44.6 FT. TRENCH USE 1 TRENCH - 45'(L) X 2' (W) X 7'(D) Total depth of system Is 10.0' from original grade. Total depth of grovel below distribution pipe Is 7.0' . NOTESI 1. USE 1500 GALLON SEPTIC TANK. INSULATE TANK IF (4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK. 1 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS 8 SEPTICS. PREPARED FOR: LEON BUTLER 249 ZAPPA DRIVE, #2 ANCHORAGE, AK 99504 (907)337-0265 FIELD BOOKS BOUNDARY: JENNIt• STAKING JENNI< ASBU'LTI JENNIF DMC. RLE: ACA' "LE: 99060 COMPUTED: DRAW: KMD CHECKED. KMD DATE: 8/6/9 W.O: NW145 " "n.: 99060 Scale: 1'= 100' PAGE 1 OF 2 LLilJN LW ENGINEERING 20441 PTARMIGAN DLVD. EAGLE RIVER, AK 99577-0736 WASTEWATER DISPOSAL SYSTEM DETAILS LOT 11, SWI/4. SEC.4, T15N, R1W, S.M. K OF ALq' 1 P 'OFTH* 0 KENN Y. D CE -7116 a AO fib' FESS(ONp4 -dw \0 PREPARED FOR: LEON BUTLER 249 ZAPPA DRIVE, #2 ANCHORAGE, AK 99504 (907)337-0265 FIELD BOOKS CMPUTED: ea"ou:r. JENNINGS DRAM: KM ST""'"G; JENNINGS M[aEo: KMD Assuan JENNINGS o"T<' 8/6/9 0w . PLC: WID: NW145 "G"o FILL: 99060.DWG J'e "' 99060 #99-1 RESER' Scale: 1'= 20' PAGE 2 OF 2 IU-IlV LLY ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-0736 —6111 IIID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for: Leon Butler Date Performed: Project. Lot 11, Sec. 4, T15N, RI W TEST HOLE N 99-2 Depth 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - Org. - rootmat SM- sandy, silty, brown GW - Loose, gray, slight silt SW/GP - sand w/ trace silt B.O.H. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? NO What depth? Depth to water after monitoring? Dry Date? 7/27/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 7/14/99 2:00 - 101• - 2 2:10 10 min 2 5/16" 711/16" 3 • 2:11 101• - 4 2:21 10 min 2 4/16" 712/16" 5 • 2:22 10- 6 2:32 10 min 2 3/8" 7 5/8" 7 2:33 101 8 2:43 10 min 2 3/8" -- 7 5/8" 9 • 2:44 101• - 10 2:54 10 min 2 4/16" 712/16" 11 255 10" - 12 3:05 10 min 2 4/16" 712/16" • Water Added Percolation Rate 1.3 (min/in) Perc Hole Diameter 6" Test Run Between 3 feet and _9— feet HOLE PRESOAKED PRIOR TO TESTING I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. OF At KINID�E��,......... ENGINEERING j R= 9L 20441 PTARMIGAN BLVD. �e........... EAGLE RIVER, AK 99577-8736 . •..N ! Kenneth M. Dul SOILS PERCOLATION TEST Performed for: Leon Butler Date Performed: 7/14/99 Project•. Lot 11, Sec. 4, T15N, R1W TEST HOLE # 99-1 Depth 16- 17- 18- 19- 20- Org.- rootmat SM - sandy, silty, brown GW —Loose, gray, slight silt SW/GP—sand w/trace silt B.O.H. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? NO What depth? Depth to water after monitoring? Dry Date? 7/27/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 7/14/99 1:00 10" - 2 1:10 10 min 2 5/16" 711/16" 3 • 1:11 - 10" - 4 1:21 10 min 2 4/16" 712/16" 5 1:22 10" - 6 1:32 10 min 2 3/8" 7 5/8" 7 • 1:33 10" - 8 1:43 10 min 2 3/8" 7 5/8" 9 1:44 - 10" - 10 1:54 10 min 2 5/16" 711/16" 11 • 1S5 10" - 12 2:05 10 min 2 5/16" 711/16" • Water Added Percolation Rate 1.3 (min/in) Perc Hole Diameter__?= Test Run Between 4 feet and 5 feet HOLE PRESOAKED PRIOR TO TESTING I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. ITM ENGINEERING 20441 PTARMIGAN BLVD. 696-6111/FAX (907) 696-8111 October 25,1999 RECEIVED Municipality of Anchorage OCT 25 1999 Dept. of Health & Human Services w'., C ,,,l;,y or Anchorage On -Site Services Section -)het Health & Human Services P. O. Box 196650 Anchorage, Alaska 99519-6650 RE: DESIGN MODIFICATOIN—PERMIT NUMBER SW990308 BLM Lot 11, SW 1/4 Section 4, T15N, R1W, S.M. Gentlemen: On September V, 1999 you issued a permit for a new well and septic. However, the owner has built his foundation at a lower grade—which necessitates lowering the elevation of the septic system. This modification will put the field in a different material than previously designed. The soils log and percolation test for the new design are attached for your approval. All other items on the previous request will remain the same. If you have any questions, please contact me at 696-6111/FAX 696-8111. submitted, Duffus, P.E. Attachments: Wastewater Absorption System Details/Site Plan/Soil Log-Perc WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAT LOT 11, SWI/4. SEC.4, T15N, R1W, S.M. -► 1 NO PUBLIC WELLS WITHIN 200. Of PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS N07EIL NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. oF...AL4 1 ,00* 9 . .. .I9*1 1...............�.....�....:.........� i '.. CE -711 ..'' 4, 410a APO VACANT DESIGN DETAILS 5 BDRM X 150 GPD = 750 GPD 750 GPD/0.8 GPD PER SO. FT. (8.3 MIN/IN.)= 937.5 SO. FT (937.5/5'(W)) X 0.5(RF) (4.0' GRAVEL) = 93.75 FT. TRENCH USE 2 TRENCHES - 47'(L) X 5' (W) X 4'(D) Total depth of system Is 12.5' From original grade. Total depth of gravel below distribution pipe is 4.0' NOTESI 1. USE 1500 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MAXIMUM 27 SLOPE INTO SEPTIC TANK. 1 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS 6 SEPTICS. PREPARED FOR: LEON BUTLER 249 ZAPPA DRIVE, #2 ANCHORAGE, AK 99504 (907)337-0265 FIELD BOOKS BwNafr. JENNIP STAKING JENNIP "S`A`L° JENNIP DY10. EKE: ACED FKC nnnen COMPUTED: DR"'" KMD CHECKED: KMD DATE. 8/5/99 Nn.IC MD. NW145 99060 Scalel 1'= 100' PAGE 1 OF 2 ENGINEERING 20441 PTARNIIGAN BLVD. EAGLE RIVER, AK 99577-6736 -611 11 WASTEWATER DISPOSAL SYSTEM DETAILS LOT 11, SW1/4. SEC.4, T15N, RIW, S.M. K SED RESERVE 'low <' �01 , '; P L. � 2 1 ; KENNNF�rf CE_711�DS 6 V. CE -7116 '%oFrsSIOo Aw SPL h =-I 16 Im c F n PREPARED FOR: LEON BUTLER 249 ZAPPA DRIVE, #2 ANCHORAGE, AK 99504 (907)337-0265 FIELD BOOKS cmmm: MNOMr. JENNINGS —WAm: KMQ S'mNG: JENNINGS aMm: KMD AWAT. JENNINGS 0A1O8/6/gg .10 M ME: CM NW145 AM FM 99060.DWG Joa "' 99060 Scale: 1'= 20' PAGE 2 OF 2 1418V !VJ ENGINEERING 20441 PTARAIIGAN BLVD. EAGLE RIVER, AK 99577-8736 ll��D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for: Leon Butler Date Project: BLM Lot 11. SWI/4. SEC.4. T15N. R1W. S.M. TEST HOLE fl 99-3 Depth 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- Org—soft, black, root mat SM on bottom loose Loose & soft on top Reddish brn to gray brn CW—Med dense, gray w/ gravel & silt, dry cobbles to 'I SM — fine sand, silt/density increasing w/ depth HOLE PRESOAKED PRIOR TO TESTING Silt increasing on bottom w/density, platelets B.O.1I. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Groundwater encountered? NO What depth? N/A Depth to water after monitoring? DRY Date? ++;4A 101.44 I Reading Date Gross Time Net Time Depth to Water Net Drop 1 10/21 3:20 - 6" - 2 3:50 30 min 25/16" 311/16" 3 ' 3:50 - 6" - 4 4:20 30 min 26/16" 310/16" 5 3:06 - 6- 6 3:36 30 min 26/16" 310/16" 7 8 9 10 11 12 • Water Added Percolation Rate 8.28 (min/in) Perc Hole Diameter 6" Test Run Between 9 feet and 10 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. 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 X/1Et/ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-072-08 COSA # ose-1 (. 104H` 1 Expiration Date: G Co / �- 1. GENERAL INFORMATION Complete legal description T15N, R1 W, Section 4, Lot 11 Location (site address) 21801 Knik Vista Street Chugiak, AK 99567 Current Property owner(s) Federal National Mortgage Association Day phone Mailing address 400 National Way Simi Valley, CA 93065 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address 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✓❑ 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 3113/2012 OF ;� err 49TH ............ a.sfr............au 1 -MICHAEL E. ANDERSON 5. DSD SIGNATURE ��®%f.CE-4381 Approved for _,_ bedrooms. I� n�Fp ....... Disapproved. �$ TAtsvivtg Conditional approval for bedrooms, with the following stipulations Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory By:� (Rev. 11)05) ■mnn� Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage a Development Services Department =a. Y Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type Private Date completed 7/22/99 Total depth 80 ft. Section 4, Lot 11 If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 80 ft. FROM WELL LOG Date of test 7/22/99 Static water level Link ft. Parcel ID: 051-072-08 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 2/22/12 38 ft. Well production 10-12 9.p -m. 6.4 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic: N/D ug/I Date of sample: 3/8/12 Collected by: MEA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/11/99 Tank size 1,500 gal. Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 311 312 01 2 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 11/11/99 Soil rating (g.p.d./ft2 or ft2/bdrm).8 GPD/SF System type 6' wide Trench Length 107 ft. Width 5 ft. Gravel below pipe 3.614.0 ft. Total depth 11.5/12.8 ft. Eff. absorption area 1,070 ft2 Monitoring tube Y Depression over field N Date of adequacy test 2/22/12 Results (Pass/Fail) Pass For X 6 bedrooms Fluid depth in absorption field before test 010 in. Water added 850 gal. New depth 10/12 in. Elapsed Time: 1,440 min. Final fluid depth 0/0 in. Absorption rate >= 46 %.S D g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _ in. "Pump off" level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >low Absorption field on lot >100' Public sewer main N/A Manhole/Access(Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots >100' >100' Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manurelanimal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >t0' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' 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 Michael E. Anderson, P.E. Date 3/13/2012 COSA Fee $ L4 "b - Date of Payment _ J l 10 112- Receipt 12- Receipt Number i)� 57 (Rev. 11/05) Waiver Fee $ — Date of Payment Receipt Number 0 49-ia ..a......___:1 . * `F MICHAEL E ANDERSON �� •rs 1 it CE -4381 :=4 SGS Ref.# 1120728001 Client Name Anderson Engineering Project Name/# 21801 Knik Vista Client Sample ID 21801 Knik Vista Matrix Drinking Water Sample Remarks: Parameter ReSUItS LOQ Metals by ICP/MS Arsenic ND 5.00 Waters Department I and Nitrate/N itrite-N ND 0.100 Microbiology Laboratory (<10) E. Coli Negative I Total Coliform Negative I Printed Date/Time 03/13/2012 15:34 Collected Date/Time 03/08/2012 13:45 Received Date/Time 03/08/2012 14:30 Technical Director Stephen C. Ede Allowable Prep Analysis Units Method Container ID Limits Date Date Init ug/L EP200.8 C (<10) 03/12/12 03/13/12 NRB mg/L SM20450ONO3-P B (<10) 03/12/12 AYC 100mL SM219223B A 100mL SM219223B A 03/08/12 DLC 03/08/12 DLC - Municipality of Anchorage Development Services Department Building Safety Division k: 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 Parcel I.D. _051-072-08 COSA# a(n0530 Expiration Date: 1 2, 5' 0 Z 1. GENERAL INFORMATION Complete legal description 11 SN R1 W SEC 4 LOT 11 Current Property owner(s) LEON RLITLFR Day phone q01-8140 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual. Holding Tank Community Class Well ElCommunity On-sfte 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 seat 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. Engineer's Printed Name KENNETH M- DUFFIIS Date 10/23/06 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a system will function satisfactory for current or future occupants or can KND guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSDSIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By:l y z��/ %�. Original Certificate Date:_L0 0 -2 E_ -'O G � i i; Municipality of Anchorage Development Services Department-- '� Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 !' Anchorage, AK 99519-6650 i! www.muni.org/onsite (907) 343-7904 r. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T15N R1 W SEC 4 LOT 11 Parcel ID: OSI -077-08 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 7/22/1999 Sanitary seal (Y/N).Y Wires properly protected (Y/N).Y Total depth _IZft. ' Cased to -ID—ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 7/22/99 10/17/06 Static water level NA ft. 34 ft. Well production 1 0-1 2 g.p.m. 6.67+ g.p.m. WATER SAMPLE RESULTS: Coliform _D_colonies/100ml- Nitrate _kfl)_mg/L Other bacteria 0 colonies/100 mL Arsenic: mg/1 Date of sample: 10/16/06 Collected by- KND Engineering, Inc B. SEPTICIHOLDING TANK DATA Tank Type/Materia4 Septic/Steel Date installed 11/11/99 Tank size 1500 gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) b High water alarn (Y/N) N_Date of pumping 10/17/06 Pumper Sanitary C. ABSORPTION FIELD DATA Date installed 11/11/99 Soil rating (g.p.d./feorfe=bdrm) 0.8 System. type Shallow Trench Length _M ft. Width -1ft. Gravel below pipe 3.8/4.0 ft. Total depth 1 1.58/12.83 ft. Eft. absorption area 1070 fe Monitoring tube Y Depression over field N (measured 10/17/06) Date of adequacy test 10/17/06 Results (Pass/Fail) Pass For .- bedrooms Fluid depth in absorption field before test 0/1 in. Water added 510/600 gal. New depth 13/16 in. Elapsed Time: 1295 min. Final fluid depth¢ in. Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) N If yes, give date----- D. LIFT STATION Date installed 'Pump on" level at_in E. SEPARATION DISTANCES Size in gallons Manhole/Access (YIN) 'Pump off" level at_in. High water alarm level at—in. Cycles tested Meets alarm 8 circuit requiremwft?_ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 1 00'+ Holding tank 10 Q'+ Manum/animal excrete storage areas 1 00'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5 ' + Absorption field 5 ' + Water main 10'+ - Water service line 10'+ Surfacewater 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1 O'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 10 0'+ Driveway, parkinglvehide storage 10'+ Curtain drain' 50'+ Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION* I certify that I have determined through field inspections and ! ,s 90 0� review of Municipal records that the above systems are in ,00 conformance with MOA COSA guidelines in effect on this / ,,, 7* / date. �j cfi t i Engineer's Printed Name KENNETH M. DUFFUS �.� ``�� Date 10/23/06 COSA Fee Date of Payment /OOV/o4 Receipt Number cI- 97 q 6 g (Rev. I IM5) Waiver Fee S Date of Payment Receipt Number SGS Ref. #: Client Name: Project Name: Client Sample ID Matrix: PWSID 1066261 KND Engineering T15N r1W Secs/ L11 T15N r1W Seco L11 Drinking Water SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 All dates/times are Alaska Standard Time Printed Date/Time: 1023/06 11:05 Collected Date/Time: 10/16/06 16:00 Received DateTme: 10/16/06 16:30 Technical Director. Steohen FA,/i Parameter Results PDL Units Method Allowable Limits ' Prep Date Analysis Date snit Bacteria 0.00 9222B 10/16/06 10/16/06 dpt Nitrate ND 0.10 mg/L EPA 300.0 10.00 10/17/06 10/17/06 azs Arsenic ND 5.00 ug/L 200.8 10.00 10/19/06 1020106 tk 50' ACCESS EASEMENT F- 0 J J CD 0 F In Z W w U W Q Rn O Q U7 W OI I GRAVEL I I D/W O N • WELL I ELEC METER i KND ANCHORAGE RECORDING DISTRICT BLM LOT 6 SEPTIC VENTS S 89'59'00" E ASBUILT OF: BLM LOT 11 (PETERS CREEK) WITHIN SEC 4, T15N, R1W, SAL, ALASKA SURVEY CERTIFICATION: I, John L. Schuller, have conducted a physical survey of this property as shown on this drawing and that the improvements situated as are within the property lines and no encroachments exist other than noted. EXCLUSION NOTES:lt is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER:DATE: E SCALE: _ -MAI_ OCT. 23, 2006 1 -40' kndengOok.net 06-109A" BY: CHECKED BY MD NUMBER: BOOK AGI ILS NW1458 1 0603/01 330.00' (REC) BLM LOT 11 BLM LOT 14 i Q`�E.•�F .�9Lq` 49TH w f JOHN L' SCIiTTTI.EF 7�_, 1S-10408 W U 1KHD ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER,. AK 99577-8736 (907)868-3791/FAX (907)868-3793 W 3.8IAM K 6' GRAVEL FUEL OIL TANK D/W I 39.6' 30.7 U CONC 1 w PAD Doa0 O cc N H Z Z FO M v i UY J n WMm o•CO � W n C' M OI I GRAVEL I I D/W O N • WELL I ELEC METER i KND ANCHORAGE RECORDING DISTRICT BLM LOT 6 SEPTIC VENTS S 89'59'00" E ASBUILT OF: BLM LOT 11 (PETERS CREEK) WITHIN SEC 4, T15N, R1W, SAL, ALASKA SURVEY CERTIFICATION: I, John L. Schuller, have conducted a physical survey of this property as shown on this drawing and that the improvements situated as are within the property lines and no encroachments exist other than noted. EXCLUSION NOTES:lt is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER:DATE: E SCALE: _ -MAI_ OCT. 23, 2006 1 -40' kndengOok.net 06-109A" BY: CHECKED BY MD NUMBER: BOOK AGI ILS NW1458 1 0603/01 330.00' (REC) BLM LOT 11 BLM LOT 14 i Q`�E.•�F .�9Lq` 49TH w f JOHN L' SCIiTTTI.EF 7�_, 1S-10408 W U 1KHD ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER,. AK 99577-8736 (907)868-3791/FAX (907)868-3793 W