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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 5H LT 21ARabbit Creek ViewHeights Block 5H Lot 21 A #020-561-28 Municipality of Anchorage Page I of z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -5W960403 PID Number: 020 -'117 --fig Name: &L.L. rAvoo Wastewater System: ❑ New upgrade Address: IID L aC ScE,nc ORFCeJ 9Ts ABSORPTION FIELD Pnone: S; Z5 - 379'6 No. of Bedrooms: x;41 1 eepTrench ❑Shallow Trench ❑Bed ❑Mound Other LEGAL DESCRIPTION Soil Ratin Total Depth from o' nal grade: GPD/S Ft. Lot: Block: p Subdivision: 1 Z- t 5 RAeR r 6Kr s %_ I#1L1i13 Depth to pipe bottom h riginal grade: Gravel d beneath pipe F Ft Township: —..- Range: .--. Section: Fill added above original grade: travel length: FL Ft, WELL:New 13Upgrade X1ST! Gravel width: Numbs roes: ontantaew been lim: Ft 11 Ft. Classification (Private. A.B,C): Total Depth: o: Total absorption a: Pipe material: Ft. Ft. SO. Ft, Duller. Date Drilled: Static water Laval: Install Date Installed: Ft. Yrold: Pump set at: Cd ing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ❑SepticWLHolding 0S.T.E.P. Manufacturer. Capacity in gallons: To Septic Ataorption Lm Holding blic/Prirale From Tank Fiold station Tank sewerunas A 1LACs6 TA,JK ZooO Welh -- �— �. too I252 t 4 Material: STQ E Number of Compartments: Waee — — loo'+ — LIFT STATION Lot Line "' ^•• 262+ Size In ManWacturer. Foundation �-- ,^ •�� 20 •� �� 'Pump on' oval at: 'Pu et: High water alarm at: Curtain Drain l+ 2D r Pump Mak Electrical Inspections performed by: Remarks: GX2 Tr/IG SerT,� grJK qNo BENCH MARK SE -0 O { LKX O EO lr•1 �L►.G.E Location and Description: /1 � nn v g TfoOA 0F• 48LA1PX 1&14 WAMA, GJ A, C, INs L TA41r_ 2►.3 CA I Assumed Elevation: E%11�ri` �l xJ s Inspections performed by: - Imo_ Dates: is */ 1 1 s t ..». 2nd 3ci1 'Z 2 .11 c JL Gey Department of Heal and man Services approval_ , . CE 7 53 .• ��_� Reviewed and approved by: Date: /_1 t6% FIOFES510NP�+ %�"��.t T2-017 (Fiat, fust) MOA 25 \ EXISTING CURTAIN I \ (APPROXIMATE LOC) A B Icol 26.0 35.2 16 ' CO 27.0 40.0 CO2 28.0 43.5 /X 161 , /.-- - , - IEW 2000 GALLON HOLDING TANK , \ \ EXISTING CURTAIN DRAIN (APPROXIMATE LOCATION) rm [RADE 5•+ a LODE M LL NSW 2000 GALLON NO PING TANK ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E CHESTER HEIGHTS CIRCLE, ANCHORAGE. AK 99504 PHONE (907) 337-6179/FAX: (907) 376-3246 LECAL DLSCRIPOON: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 21, BLOCK 5, TYPE OF WORK: AS -BUILT OF HOLDING TANK PREPARED FOR: BILL MUDD PHONE NUMBER: C/O DYNAMIC PROPERTIES ATTN: PETE FERRIS 261-7600 DRAWN 8Y:t) N eA 12/28/98 1.L.M. 1 = 30' 2 OF 2 e} rey GO L" •_ C 7953 / NOV-11-98 WED 08:42 AM -1 o 9 i� y 0 0 X L T J �o o 3 a b r r� rA /Jt o A C.d /OX fICtSY-\ MUNICIPALITY OF ANCHORAGE Department of Health and Human Services' On -Site Services Program �` f bL 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 12, 1998 Expiration Date: Oct 12, 1999 Permit Number. SW980403 Parcel ID: 020-112-38 Legal Description: RABBIT CREEK HEIGHTS BLK 5 LT 21 Design Engineer. 0041 AK Water & Wastewater Consulta Site Address: 016500 DIANE DR Owner Name: Bili Mudd Lot Size: 20348 SO. FT. Owner Address: 3111 C. Street Suite #100 Total Bedrooms: 3 Permit Bedrooms: 3 Anch. , AK 99503 - 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 (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: ��+/ Date: Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers October 7, 1998 Municipality of Anchorage Department of Health and Human Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref. Sewer Upgrade for Lot 21, Block 5, Rabbit Creek Heights S/D. HOLDING TANK To whom it may concern: The existing 3 bedroom house is served by a private well and a septic system that consists of a 1000 gallon septic tank and a bed type drainfield. The system is in a state failure and must be upgraded prior to the sale of the house. Due to the location of the existing curtain drain, the house, the well radii, and the existing septic system; there is very limited area for a septic upgrade. As can be seen on the attached soil log from S & S Engineering dated on 3/22/85, the soils were marginal for permeability. Due to the limited area and the nature of the soils in this area, an innovative septic system would be a risky installation, at best. It is our opinion that a holding tank is the only viable option for this property. The neighboring property (Lot 22, Block 5, Rabbit Creek Heights S/D) has a holding tank that serves the residence. It is our recommendation that your department allow us to install a 2000 gallon holding tank. The tank will be located on the northwest side of the house and 100 feet away from the well. A copy of the proposed designls attached. If you have any questions, please contact us at 337-6179. RABBIT GREEKBLHEIGHTS LC LOT 24, BILK 5, (n /RABBIT ` RABBIT CREEK HEIGHTS LOT 23, BLK 5, RABBIT CREEK HEIGHTS / LOT 26. BLK 5```� RABBIT CREEK HEIGHTS` �`� ' WELL I LOT 22, BLK 5. RABBIT CREEK HEIGHTS LOT 27, BLK 5. RA13011 CREEK HEIGHTS (: 0:D LOT 28, BLK 5, RABBIT CREEK HEIGHTS \O�s ^ \O' ✓- \c/l LOT 29, BLK 5, RABBIT CREEK HEIGHTS �µoLVF1AP� LOT 30, BLK 5. RABBIT CREEK HEIGHTS 18, E CREEK LOT 19. BJ 3, RABBIT CREEK HEJCHTS z1W J I YIU 13 —{I1 � I i —PROPOSED 2000 GALLON HOLDING TANK (SEE DESIGN, PAGE 2 OF 2) I —EXISTING 3 BORM HOU E t LOT 20, BLK 5, RABBITREEEKKHEIGH T S CREEK HE DENISE L-UMO"- LOT 19, BLK 5, Z, RABBIT CREEK HEIGHTS EXISTING SEPTIC SYSTEM i�OLyFyOP� C.a1N I J - ------------------ UI --------- ---------._________ J LOT 32. BLK 5,�� RABBIT CREEK HEIGHTS L07 17, BLK 5, LOT iB, BLK 5, RABBIT CREEK HEIGHTS RABBIT CREEK HE ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE, AK 99504 PHONE. (907) 337-8179/FAX: (907) 338-3248 _ECAL DLSCRIYIION: RABBIT CREEK HEIGHTS SUBDIVISION, LOT 21, BLOCK 5, 1' SITE PLAN 'RLPARLU fOR: BILL MUDD DRAWN UY: 10/6/98 J.L.M (541)535-3794 YAL L' 1 = 100' I 1 OF 2 REM GI A. Carness: =-7953 ' d .c X42 ILIJ DENISE (ni_ CIRCLE Z, W W I J r_j UI � I REM GI A. Carness: =-7953 ' d .c X42 \ I EXISTING CURTAIN DRAIN \ (APPROXIMATE LOCATION) \/ EXISTING SEPTIC)'A< \ TO BE ABANDONED COMPLETELY— v 0 WELL /X 100' WELL RADIUS\. \ / WELL �/ 7 nz, O / (—PROPOSED 2000 GALLON _- HOLDING TANK / I / EXISTING CURTAIN DRAIN (APPROXIMATE LOCATION) —EXISTING BED TO BE ABANDONED COMPLETELY ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 7320 E CHESTER HEIGHTS CIRCLE. ANCHORAGE. AK 29504 PHONE: (907) 337-5179/FAX: (907) 339-32445 _LGAL OLSCKIPIION: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 21. BLOCK 5. YPE OF WORK: DESIGN OF HOLDING TANK 'RLPARLO FOR: BILL MUDD PHONE NUMOLK: C/O DYNAMIC PROPERTIES ATTN: PETE FERRIS 261-7600 .Jnnwn nr: x.4c: r.u;�: 10/6/98 J.L.M. 1 = 30' 2 OF 2 o �F-• �F.... 5�� ..ya .. . ................ f r A. ess; E.t 7953 ♦t /I PERFORMED LEGAL 1 V 1 0 V1 u � to k(-% 2 t( Y J 3 C7 � 4 `C r 5 L ,, 6 1/ys`jR 7 8 , 10 QQ 11 poYToM OF HOLE WASGROUNDWATER S ENCOUNTERED? ��L L 12 O wi IF YES, AT WHAT e e • 1 13 DEPTH? DATE PERFORMED:�—oZ•c?.— 14 ❑ SOILS LOG 0O .' 2 Readingpato ` MUNICIPALITY OF ANCHORAGE Depth to ..1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL ROTECTIONkEy' P PERCOLATION ? 625 L. Street, Anchorage, Alaska 99501 264.4720 TEST � GI h SOILS LOG — PERCOLATION TEST 1 V 1 0 V1 u � to k(-% 2 t( Y J 3 C7 � 4 `C r 5 L ,, 6 1/ys`jR 7 8 , 10 QQ 11 poYToM OF HOLE WASGROUNDWATER S ENCOUNTERED? ��L L 12 O wi IF YES, AT WHAT e e • 1 13 DEPTH? DATE PERFORMED:�—oZ•c?.— 14 . Readingpato Gross Time Net Time Depth to Net 15 �_�,a•t�' Water Drop Or 17 It •..••MH •.I � .' F.MN 16:7.E •X •e 19 No. it•.. • • •'RJ .........•• 1 �.'� Ts•Y'v PERCOLATION RATE L 610 /I (minutes/inch) , TEST RUN BETWEEN �L FT AND F7 LAMENTS_ J45i/.ST"/ /6' PERFORMED BY: /C .1 ..i CERTIFIED B N Jul 15 98 O2:O7p JERRY LEACH (907) 694-8501 To: DHHS Date: July, 15 1998 We hereby notify DHHS as required by permit of the intention to terralift the following property. Lot: 21 Block: 5 �-t OL Yi Address: 16500 Dianne Ave. Anchorage, Alaska Engineer Consulted: Yes X RECEIVED JUL 16 1998 Municipality of Anchorage Dept. Health & Human Services No Jerry Leach Alaska Drainfield Restoration President 17229 Juanita Loop N.. Easte River. AK 99577 Ph. 907-694.8500 Fax. 907.694.9501 p.2 „,, MUNICIPALITY OF ANCHORAGE DE 1TMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 "L” Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES FROM TO SEPTIC TANK ABSORPTION FIELD WELL Access {�ya A ' -,•wiLNo �155110 WELL �Aitl l J tYf I r� N rs•r 1 IJ prronelsl 3/i'S- 33'12 perms No. SSb 2'1 °1 No 01 Bedrooms LOT LINEL tplT I pl.r LEGAL DESCRIPTION Lot y1 taOCk $ubDIVRIOn \ In FOUNDATION aF a Townsnlp. Range. Section 2 AS-BUILT DIAGRAM (Snow location of well. Septic system. property ones. IOundBtion. Urweway. walur clothes. etc) TANKS . SEPTIC ❑ HOLDING Manylactuler FC Cd awry In gallons n o Mate"., No of compartments 2- TYPE OF SYSTEM ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER P Depen to p1m, Doltum Item or.ginal grade ts. S FT Total Depth Item Original grace �. 0 FT Fol added atrove ong.nal grade OEO FT Gravel Oeplh beneath pipe 0.5 FT Gravel wnqu. 151!l O FT Gravel w,aih 7-0-OFT Ioral absorption area 1 2 SOFTI "I I Distance between ones fJ FTlo 0 q \ �j 'ale- E" r humuer a sJ� '�A Soil rating 3120SOFt pipe material ar►+C303IFT In61a1ler Date Installed WELLS h . A� ❑ PRIVATE C1 OTHER (Identilv GammCa:wn IAPB. LI ICtar Depth FT G`E a le\ Instaue1 Da • mstalleD REMARKS: r inspection performed by EL+GlMEfLRSSEAL F its . ..• 4.i •a•. -I i v irc .� s� a 9 iI .. .. s...rt Mo1Q7-P .emsrteV.. ;6ebert A. Ehfw •/7 +J,..e•.. ............ t ieop........•.•X, ,1�;OFESS10 �r Date_� t2-19 S . I SrB 196x _bertily IMI �ian was performed a.ver, a 95 Municipal and Stale guidelines in ¢IIeL1 On this date: Health Department Approval: �� Date. g 3 72-013 (3,85) DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTICN C25 L STREET, ANCHORAGE, A:'. 99501 ^_E,4-4720 C P'•7 —.'� I T F= S E 0.'1 F. V -c r1 L J P_ F_ P= 1- F F'-1 I -y- ERMIT NO: 850279 FTE ISSUED: 06/10/e5 rPLICANT: BILL MUDD DDiESS: 16500 DIANE DRIVE ANCHORAGE, AK 99516 0^ITACT F'HONE: 345-3372 EC''- DESCRIP: SUBDIVISION: RAF:BIT CSEEI: HEICHTS LOT: 21 SECTION: 1 TOt'NSHIr: 11N RAP1CC: M,1 CT SIZE: 2%1528 (SO.FT. 0:; ACRES) AX DED 00,41-1: 3 istcd below a.ro the options available 'to ycu in designing yste,m. Choose the option that best fits - your site. - - - Z- EPTH TO PIPE COTTON (FT.) 4.0 4.0 RAVEL DEPTI1 .(FT. �. 0 0.5 CTAL DCrTH (FT.) 7.0, 4.S RAVCL WIDTH (FT.) 2.5 28.0 RAVEL LENGTH (FT.) ^23,0 54,0 rAVEL VOLUME (CU. YDS. 72,3 56.0 ANE: SIZE (GALS) 1,%i0%t,0 ** I�O;t0.0 *. CIL RATING (S�.FT. /BR) 445 330 SLOG;. 5 y,r_tr Eip' is nE D ! f�A I rll 4,0 •q 7. 0 0 156. 0 101.2 445 r,x GRAVEL LENSTH ? 75 FT. RECUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) '* TF.NEC MUST HAVE AT LEAST TWO COMPARTMENTS cc r t i f y that: J.. I -,m familiar with the requirements for on -mite sewers and wells aj:; set forth by the Municipality of Anchorage (MOA) and the Sto.te of Ale.sic„ �. I will install the system in accordance with all MO codes and rogulaticns, and in compliance with the design criteria of this perm: i. I will adhere to all MOA and State of Alaska req_tiremavtte far the s=t bacl•: distances from any existing well, w,:.stewatcr dispos_.l cyctcm,or public ser�;erag2 system on this or any adjacent or naarby loL 4. I understand that this permit is valid for e. n-:aximu:- of 3 bedroc;^a �s nd any enlargement will. require an additional permit. F A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MC:^; LUILDING CODES, H7`1(1) AN ELECTRICAL PERMIT AND INS-=TJON MUST BE CPTAINFD; ("`) AS-EL'ILTS ILL NOT DE APPROVED WITHOUT AN ELECTRICAL INS::!=TION REPORT; C,;.:D (7) THE LECTRICAL WORK MUST PE DONE BY A LICENSED ELECTRICIAN. 113NED - DATE:S- -- - --------------------• - ----- -- r"LICANT: BILL "IJDD - -r"-UED B ----- DATE: r ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE \1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street, Anchorage, Alaska 89501 2643720 TEST 6 SOILS LOG — PERCOLATION TEST PERFORMED FOR: -1B1L_L /`l ` in N DATE PERFORMED:_ coy aa- R LEGAL DESCRIPTION: "-r d �t-^0 st S TZ[ ZA (� n U _ _ I s11, DEPTH JFEE 1 1 V v oK.bY> 131es 2- 3- 4 34 - t0 5 G s � o 'a a � 9 ,✓G 10 VI G SLOPE 11 t7 6�Rop-e 'pp IrAos-c WAS GROUNDWATER ENCOUNTERED? �o IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net - Drop k S , I va o Go 1, PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND 1� FT PERFORMED BY: /C�-+t-� C�IGIPIC'ctlii�:: CERTIFIED -,:.",LS FIVER. ALAS l �:47T 72-008(6/79) ----_-----_ DATE rIIIII`\ . I COMPUTATION SHEET SUBJECT: .1' C -f .7 / 131.x. 6- r"I DATE: SHEET OF BY— CKD I L --T 1 -':I- L -T- L L[ LJ Lil , I , - i LL - i t�-' .1 j I T -T LL ij OF A,(, III A. Shef;or I 14577! Pip 7— T– WXI t LL 4� 7451 es? is A 7 I T–T T 7_'_I DMAA -:-D6�P�A LE6EUD ora I,1 error, WA C. 3° , Cis♦` .S twee Pr• �`.\ �� / 1 •`,tori vtA1rS `.� h o� SGgGE y •i �, 6RAVCL PRIvEWAY U LUL) L7 „ La 1 o ho 4Lt, i�V ti 03 ,♦.A , A° a �a 11 Arere. rN/S Sa6LYViS,aJ 15 BErNb REPLA rfo fror.•,ta Al- rMS DATE (3•zt •.) DAsi,o/ /int REGugp rnd..:r. ir5 pr „Pr°rA bound ary K OF .4"L, bra-ir, �,.,......•, �p i 7�4�J��/I•��j�/yai *r srro Yl•Iwr4o a ►. a 110. 3224 t J � "•...•w 01 R AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: L o T 2IA 1 et CC k 51 �AkBrT CR.rrK fiE1C�IITS (Ner Rfc••d aa) Anchorage I Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska flus _Z6 "k dayof MARC" 20 GG EASEMENTS OF RECORD, OTHER THANI FRED WALATKA & ASSOCIATES I THOSE SHOWN ON THE RECORDED Fb `j}• 5 a r' (907) 246•1666 Engineers and Surveyors PLAT ARE NOT SHOWN HEREON. 05. q1 RE Lora DATA MEASuPel DATA o Faun s/C/o"Rztar / A -P) LoM h+rEo II Eear;nrfS t aiS4arKc /Vo%e' .Ra 4a.". 6ea,;A'd i a✓is4. res ora I,1 error, WA C. 3° , Cis♦` .S twee Pr• �`.\ �� / 1 •`,tori vtA1rS `.� h o� SGgGE y •i �, 6RAVCL PRIvEWAY U LUL) L7 „ La 1 o ho 4Lt, i�V ti 03 ,♦.A , A° a �a 11 Arere. rN/S Sa6LYViS,aJ 15 BErNb REPLA rfo fror.•,ta Al- rMS DATE (3•zt •.) DAsi,o/ /int REGugp rnd..:r. ir5 pr „Pr°rA bound ary K OF .4"L, bra-ir, �,.,......•, �p i 7�4�J��/I•��j�/yai *r srro Yl•Iwr4o a ►. a 110. 3224 t J � "•...•w 01 R AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: L o T 2IA 1 et CC k 51 �AkBrT CR.rrK fiE1C�IITS (Ner Rfc••d aa) Anchorage I Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska flus _Z6 "k dayof MARC" 20 GG EASEMENTS OF RECORD, OTHER THANI FRED WALATKA & ASSOCIATES I THOSE SHOWN ON THE RECORDED Fb `j}• 5 a r' (907) 246•1666 Engineers and Surveyors PLAT ARE NOT SHOWN HEREON. 05. q1 it, A n ROBERTA. SHAFER CIVIL ENGINEER 694.2979 ua April 21, 1985 MEALTH AUTHORITY APPROVALS Mr. Bill Mudd 16500 Diane Drive SEWERS WATER Anchorage* MAIN EXTENSIONS g . Alaska 99516 REFERENCE: Lot 21; Block 5; Rabbit Creek Heights .-Subdivision SEWERS WATER Attached is a copy of the on-site sewer and well INSPECTION permit application, soil analysis, and curtain drain design for the referenced property. The Municipality will not issue the required permits SYSTEM DESIGN until your lot has been individually surveyed and a copy of that survey attached to the above information and submitted to the DHEP, 825 L Street, Anchorage. WELL INSPECTION If we ma a of further service, please contact us. S FLOW TEST Sincerel , SITE PLANS ss ROAD OE SIGN SOIL TEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN P. E. SAB 196X EAGLE RIVER, ALASKA 99577 SET NCL 5 REBAR FNDS/8' REBAR CERTIFICATE OF OWNER I, Bill I'ludd, the undersigned, hereby certify that, to my know- ledge, no easements, covenants or restrictions legally exist on this property which I have not revealed to the surveyor of this tract, namely Lot 21, Block i 5, Rabbit Creek Heights Subdivision.: TIM PEARIA 2055 CAMPBELL ANCHORAGE, ALASKA II,=40' I hereby certify that a lot survey of Lot 2t, Block 5, Rabbit Crock Subui-Ision, Anchorage Recording District, Alaska, has been made by me or under my direct supervision; that improvements are situated as shown hereon and rnat no visible easements exist ra r.pt as ind.1cated hereon. Encroachments: None Dated at Anchorage, Alaska this 20th Day of May, 1985. i, essa s LAND SURVEYOR PLACE 99507 ; (907)561-1285 DATE SURVEYED: 5/2/85 DRAWN BY: W.M. EPL,4N • E Municipality of Anchorage =PPS On-Site Water and Wastewater Program <`'o� (907)343-7904 SAFETY Certificate of On-Site Systems Approval Parcel I.D. 020-561-28 Expiration Date: ?� ` 3 ( 7 1. GENERAL INFORMATION: Complete legal description RABBIT CREEK VIEW&HEIGHTS; BLOCK 5H, LOT 21A Location (site address) 16500 DIANE DR.*ANCHORAGE,AK 99516 Current Property owner(s) ROBERT&TIFFANY CREELMAN Day phone CIO AGENT Mailing address 16500 DIANE DR.*ANCHORAGE,AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® 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 ® Individual ❑ Individual Water Storage ❑ Holding Tank Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ • WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 557) Waiver Fee $ Date of Payment 5 / 1 /q Date of Payment Receipt Number 351-11/6) Receipt Number COSA# 65C6/1172- 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 02-‘›ii JEngineer's Printed Name: Jeffrey A. Garness Date: '( In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o" C r A�� in accordance with the guidelines and regulations established by the Municipality of Anchorage and K\�..•-"" ��t0 industry practices. The reported results describe the condition of the system/s on the date/s of the i v evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ✓ ' .../.„-,(//) �n encroachments may exist that were not identified during the evaluation. The operational life of all wells Q �- q ni(�/. .7*VO and septic systems depend upon a variety of variables, including but not limited to, soil conditions, " •o0lik groundwater levels (that may fluctuate during the year), quality of construction (materials and / Q workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the /' .•,J:ff : . Corn; s•. system/s; therefore, GEG makes no warranty(express or implied)regarding the future performance of OA CE—7• :',Q • Q the well or septic system. GEG makes no representation whether an alternative well or septic system VQ 9 •. .ceQ can be installed on the property in the event either of the current systems fail to perform adequately in il6 e,. •-(2' ' �°o the future. The content of this report is for the sole benefit of the person/party that retained GEG to Q' 0'p 0resson0�c' perform the evaluation. Reliance upon the information provided in this report by any other person or �IOOpOOo� party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE /6 System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved ..�cvNLITYgclq Conditional approval for bedrooms, with the follow44pulatd '144%,: O * t17 I ts 1:' ia'1Sr R'4bp F. rn^ %9 pROG q�TFR -,�f�� M coo``:. .., 6,, ��lllrt;,111,)J� / y: .--141....., Original Certificate Date: J^ �' I —( cl . 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---7- 4, fr(-4,./6 f COSA blue sheet 10-10.12.doc COSA Checklist Legal Description: RABBIT CREEK VIEW& HEIGHTS; BLOCK 5H, LOT 21A Parcel ID: 020-561-28 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA N Well log is filed with Onsite (or attached) Well production at time of test 1.2+ gpm Date drilled 2112186 Water storage tank volume NSA gallons Total depth 69 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to UNK ft N Coliform bacteria is Negative 0 Sanitary seal is functioning correctly Nitrate mg/L t❑ Nitrate less than MRL(ND) ❑Q Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) 12+ in. Collected by GEG, LTD. Date of flow test for COSA 4117119 Date of Sample 4"7h19 Static water level at beginning of test *UNK ft. Comments *ARTESIAN WELL WITH PLUG B. TANK DATA C. LIFT STATION Age of tank(s) 21 years ❑ Required maintenance completed Tank type/material "°" " Age of lift station years E Standpipes/foundation cleanout per record drawing Lift station material Date of pumping SEE ATTACHED RECEIPTS Comments: NO LIFT STATION HOLDING TANK D. ABSORPTION FIELD DATA Which system tested (date installed) Adequacy test date ❑ALL standpipes present per record drawing Results ❑Pas For bedrooms Total measured depth from grade ft(max) Fluid d-• prior to test in Measured depth to pipe invert from grade ft(min) eater added gal ❑ N/A—pressurized field New depth in 0 Monitor tubes go to bottom of drainfield. If n. , ate depth into effective Elapsed time min 0 Code-required soil cover over ' • . Final fluid depth in 0 System presoaked Absorption rate gpd (Required if vacan • greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test If yes, enter date Gal • introduced gallons ments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout> 100' N/A ❑Yes if No NI'°` ft 0 Yes if No ft Neighboring Tank> 100' Z Yes if No ft Private Sewer/Septic Line>25' ['Yes if No ft Absorption Field on Lot> 100' ❑Yes if No N/A ft Holding Tank> 100' ❑Yes if No '75+ ft Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Z Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' 0 Yes if No *5'+ ft Surface Water> 100' 0 Yes if No ft Property Line > 5' 0 Yes if No ft Driveway/Parking > 0' ✓QYes if No, comment Absorption Field > 5' ['Yes if No ft Wells on Adjacent Lots: Water Main > 10' E Yes if No ft Private Wells > 100' Z Yes if No ft Water Service Line> 10' Z✓ Yes if No ft Community Wells>200' 0 Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft Driveway/Parking > 0' 0 Yes ' •, comment Property Line> 10' fl Yes if No ft Wells on Ad'. - ots: Water Main> 10' fl Yes if No Private Wells> 100' 0 Yes if No ft Water Service Line > 10' . 'es if No ft Community Wells>200' 0 Yes if No ft S •--- +Tater> 100' fl Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME 21 YEAR OLD YEAR OLD STEEL HOLDING TANK MAY BE APPROACHING THE END OF IT'S USEFUL LIFE _ao600pp\/ G. ENGINEER'S CERTIFICATION o6 OF .• 'Ni • I certify that I have determined through field inspections and review , `f;:. 5 •()0 T If ,: 0 of Municipal records that the above systems are in conformance with � � 9 � •. * MOA COSA guidelines in effect on this date. '� I� Q '07:;...J ( t "'. Gam-.s.: I Q 9 •E— 95 z�p a 0 COSA Checklist yellow sheet %..%.,--,-0 r ess10 a #AECC884 �00�0 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT tb.e 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval #0SC191172 Subdivision: Rabbit Creek V&H B 5H L 21A Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. 4ic''' •,,,,r'''?,.. , ' , d., it ) c -s ..,,, .t-i- K ,,Lx �, • , . .„,,,, , e", .. -,,„, ,-- 111' _, ..1 _ ... .., -: ?I.. arto , -17: nim *-: 4. 1 '- `10 NPirJ+' f � 41'.'' !a ,.i' • .• Mailing Address: P.O. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org Municipality of anchorage -�- Development Services Department I Building Safety Division r; • - ' On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 1 r r Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D, 09,00561 -?_93 COSA# HA DaDi30 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address Expiration Date: RABBIT CREEK HEIGHTS: BLOCK 5H. LOT 21A 16500 DIANE DRIVE *ANCHORAGE. AK 99516 BRITT ARNESEN Day phone 522-0530 16500 DIANE DRIVE *ANCHORAGE, AK 99516 Day phone AMY MACKEY—HORNEK W/ KELLER WILLIAMS Day phone 830-1294 101 W. BENSON BLVD, 8503 • ANCHORAGE, AK • 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 we 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: 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 samples. (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) sale, 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 riles 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 Finn GARNESS ENGINEERING GROUP, Ltd, Address 3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSO. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Phone 337-6179 Date tS p U e ee UM Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Nitr a Advisory Other By: 14 , (Rev 1L05) A. Ga ess: 79 FG Original Certificate Date: S / Au 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 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: RABBIT CREEK HEIGHTS; BLOCK 5H, LOT 21A Parcel ID: COaO— Vo I -a%' A. WELL DATA Well type PRNATE If A, B, or C provide PWSID# N/A Date completed 2/12/1986 Sanitary seal (YIN) YES Total depth 69 ft. Cased to 69 ft. FROM WELL LOG Date of test 2/12/86 Static water level ARTESIAN ft, Well Log (YIN) YES Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION 4/27/09 ARTESIAN ft, Well production 4 g.p.m. 0.9+ 9•p•m- WATER SAMPLE RESULTS: Coliform! �� colonies/100 ml. Nitrate N Qmg./L. Other bacteria colonies/100 ml. Arsenic:'L/�_-�ug./L. Date of sample: 4/27/09 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/HOLDING TANK Date installed 12/21/98 Tank size 2000 gal. Number of Compartments 1 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping C. ABSORPTION FIELD DATA Pumper-: A+ HOME SERVICES Date installed Soil rating (g.p.d./feor ft'/bdrm)_ System type Length ft. Width ft. Gravel below Total depth ft. Eft, absorption area ft' Monitoring tube Depres Date of adequacy test Results P Wil) Fluid depth in absorption field before In. Water added _gal over field For bedrooms New depth _in. Elapsed Time: —nin/ Final fluid depth _ in. Absorption rate >= g.p.d. treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots 100'+ Absorption field on lot N/A On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout Sewer /septic service line 25'+ Holding tank 75'+' Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field N/A Water main N/A Water service line 10'+ Surface water Wells on adjacent lots 75'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water service line Curtain in F. COMMENTS Building foundation Water Surface water on adjacent lots G. ENGINEER'S CERTIFICATION storage I certify that I have determined through field inspections and* ;' `•Tt review of Municipal records that the above systems are in ... " ' """"' conformance with MOA COSA guidelines in effect on this Q .. (.... date. e A. Car ss; Engineer's Printed Name JEFFREY A. GARNESS �Q �, Car e —79 Date S 1 ��y 5 0 ped oto �nPrO(e 93iOf�Ocao COSAF Date of Receipt (Rev. 11/0! Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage • '� Development Services Department j Building Safety Division -- On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907) 343-7904 Nater Well Advisory Certificate of On -Site Systems Approval (COSA) # HA090130 During a recent COSA on-site inspection and test of the potable water supply well on Block 5H, Lot 21A of RABBIT CREEK HEIGHTS subdivision, the well's productivity was determined to be 0.9+ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SGS ReEa 1091618001 Client Name Garness Engineering Group, Ltd. Project Name/N Rabbit Crcck IIts B511,1 -21A Client Sample ID Rabbit Crcek Ills B511.1-21A Matrix Drinking Watcr Samplc Rcmwks: Printed DatelTime Collected Date/Time Reeebed Date/Time Technical Director 04292009 14:47 04272009 15:45 04272009 16:30 Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Mated Container ID Limits Date Date [nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (40) 0428109 0429/09 NRB Waters Department Total Nitmtc/Nitritc-N ND Microbiology Laboratory Colony Count 0 Total Coliform 0 Fecal Coliform 0 0.100 mg/L S\120 4500NO3-F B (<10) wV100mL SM209222B coVIOOmL SN1209222B col/100mL SM20 92228 A (<200) A (<I) A (<I) 0428/09 1DZ 0427/09 DLC 0427/09 DLC 0427/09 DLC 0 07-0 -'107 14:00 rh'url- 1-014 1'000110001 r -lilt l C *fGO l oca+e) u,de,- de(, . by. &�6-1 L +4 LOT 22A / 0%. 14\ ro9 SCALE: V= 30' ,a LF R�103 \ °oo LOT i LOT21A __•� / •o V �o ae° F° �'ka LOT 20A \ yP Z,d'tio •(� � �E OF 49irTrH,r \ ti�'a�• fit° „'S^ % �� . r`1(.�r . � LOT 28A �"'�9° \ 0 s^ a0 /j cn •. Fred Walatka No. 3255-S \ \ AS -BUILT NO CORNERS SET TWS DATE d0 LOT 29A I hereby eertiry, that 1 have performed a Morlpagees InspeWon '�� of the following desc ibed property. 10 L21A. BLOCK 5H, ('REFI EK FIe! EASEMENTS OF RECORD, OTHERTHAN THOSE SHOWN ON THE RECORDEDJ7_9 P9 17-18 PLAT ARE NOT SHOWN HEREON. Anchorage Recording Precinct, Alaska, and that the Improvements situated thereon are within the property Ines and do not overlap or encroach on the property lying adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the premises N question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated herec Dated at Anchorage, Alaska this 31 Ct day of October .2007 FRED WALATKA d ASSOCIATES Engineers and Surveyors MAY -11-2009 08:48A FROM: 70:3383246 P:2/2 A+ Nome Services, Inc. Killm Customer QuickReport May 11, 200^ through May 11, 2003 OM Arneson, OM Invoke Payment Invoice Invoice Payment Paemem Invoice Payment Invoice Payment Invoice Payment Invace Payment Invoice Paymem Inv olce Payment Dale Num demo 7n2/X109 38807 7nzr= 2A9 6na/20079 348% 9/17/2000 3=3 9/1312009 995042 tOn7Z= 92$.k43 1117/2008 35533 11/17.2008 995050 11.28/2008 3$590 12/32000 9-06= 1/20/1009 3$80-0 11=2003 995060 2117/2009 2/1.,/1009 3$.491 3121M009 p9mea 35991 3/3 nW9 954074 !,21/200-0 36112 1.294089 935718 Account ACCOUms ReceNa... L'ndepOsned Funds Accounts ReCerra... ACCOUnts P.ecena... Undeposned Funds Undeposned runes Accounts ReeeNa... Undeposned Funds Accounts Redeha... Undeposned Funds ACCOUms P.eCelra.. Undeposned Funds Accounts Rece"... Undeposned Funds Aceoums ReceNa... Undeposned Funds Accounts Recena... Undeposned Funds Clr Split Amount 100.00 100.00 105.00 105.00 105.00 110.00 105.00 10$.00 105.00 105.00 110.00 110.00 110.00 110.00 110.00 110.00 110.00 110.00 -SPUT- ( ACCOUmsRe.. -SPUT- -SPllr- X ACCOUnts Re... X ACCOUM; Re... -SPUT- X Accounts Re... -SPUT- X ACOOUms Re... -SPLIT. Y ACCourds Re... -SPUT- Y AOcounts Re... -SPUT- Y ACcounts Re... -SPUT- X Accounts Re... Amount 100.00 100.00 105.00 105.00 105.00 110.00 105.00 10$.00 105.00 105.00 110.00 110.00 110.00 110.00 110.00 110.00 110.00 110.00 Municipality of Anchorage • Development Services Department e''r Building Safety Division i 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. O ZO - 5 -gr/ - ZR COSA # 1490-700c45" Expiration Date: z 1/1 f! 98 1. GENERAL INFORMATION �— Complete legal description hof 2 / .4 (? loc k S y rt e< 4;,L 1jt'�A& Location (site address) 16srro D ,u„ p , , zle Current Property owner(s) Leo* W -4,l a 6etk,— 1 Gnat* p Ez ,./Day phone C9 Ze .sem/ -bice x„1. Mailing address P -o- Oar "11601<0 A loan„c, A';-- B solo — /60 Lending agency 1{er.ore� / ctC. y e Day phone 2 22 -86o9 Mailing address Real Estate Agent Akty Mce.key - Harnek no /'pax Day phone ?6 - ► 9 X Mailing Address Jla W. --?,6 Unless otherwise requested, COSA will be held by DSD for pickup. p l ¢ae call R ee+0b- AOn/ 2. NUMBER OF BEDROOMS:_ 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank 91 Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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. RerSSuRnee o04 e4cLs f ,f!- C%70ayy - new A -VA rwe/ -I& =/A/ e4 w Name of Firm Flex fZvoc-roe hra/ fe r✓.cam Phone ?Yr -)3,5'r Address IgS30 Echo ROP4, 4, cj'. 225' /r Engineer's Printed Name '%xtod�,�r f- rroc'-e Date /plod f3. �ro7 .. w ryjl•LL<� • • Otr \' :- 5. DSD SIGNATURE®0 ' *.THEODORE F. 40pRE Approved for bedrooms.Y$ ��•,,�� /0... 7.... CyE.� ti _, ,,•ti�C! Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Dater o7 (Rev.11105) S r. G9 SCS Ref.N Client Name Project Name/p Client Sample ID Matrix P%1 SID Sample Remarks: 1075838001 Tobben Spurkland P.C. Rabbit Creek I [eights D5A L21A Rabbit Crcck I leights DSA L21A Drinking Water 0 All Datesfrimes are Alaska Standard Time Printed Daterrime 11/062007 13:55 Collected Date rime 10/302007 16:00 Rectired Datefrime 10/302007 16:30 Technical Director Stephen C. Fade Allowable Prep AwI5 sis Parameter Results PQL Units Method Container ID Limits Date Date Init Waters Department Total Nitmte/Nitritc-N ND Microbiology Laboratory Total Coliform 0 0.100 mg/L Sh1204500NO3-F B (<10) coU100ml. S\120922211 A (<I) 11/01/07 LCP 10/30/07 SDI' T:5?—M Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street s P.O. Box 196650 Anchorage, AK 99519650 www.muni.org/onsile (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. 0 20 .5(01-1V COSA# 00049 Expiration Date: 6 - a-07 1. GENERAL INFORMATION Complete legal description L.ot 2/As (3/0eleT'H Ra46-0f Creek r4etakr Location (site address) l 6 Soo D r a A e D rr Vr Current Propertyowner(s) Len Whlhc Sere >S Cr*;7D.,tce,lDay phone C928 / -efcyaX //2,g Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Fcal-nnu 9,w1am- PrMd<nh'o/ Dayphone 301-01,69 3Sol �l�%P/Ponf D�.� /9-ACA0/a42Q_ Ak 99S-03 Unless otherwise requested, COSA will be held by DSD for pickup. p/ ecwe eq. (i T ,I lroo r @ 3 YS• 13�'s WAl" Cc1 A L rpaot� �a� P,ck _ y� 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 Onsite 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 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 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 Firm 7-erAl 4 c -al S mer Phone 3 Ys - r 3S't Address / H S 3,J 15', A, )3c(, A•n e<i 9q5 ie Engineer's Printed Name 'Ttieodol; Date 28 Fes. Zoo> �� Ls �: �•it�fp"�r'A 49T)' a••a•a•aaa aaa•••aw•a••... �, S. DSD SIGNATURE n _-.ThE00= F. MOORE J Approved for 3 bedrooms. ��•'•?��''• <: Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory ly Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 3 - —0 7 (R. I V05) Municipality of Anchorage *S' Development Services Department -Building Satety DivisionOn-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 -"/ —2-6 Legal Description: Loh- 2/A• Qlock.I"M, Rclibilt Ck. H6, Parcel ID: 020—ttJ!=J-W A. WELL DATA Well type Pto f If A, B, or C provide PWSID # N• A. Well Log (YIN) Date completed 2/I 2./ AC Sanitary seal (YIN) `/' Wires properly protected (YIN) Y Total depth -42—ft. Cased to -0—ft. Casing height (above ground) 3 min. FROM WELL LOG Date of test 2/ /2 / B� Static water level d ft. Well production 'tI 9.p -m. WATER SAMPLE RESULTS: Coliform _O colonies/100 mL Nitrate 40.1 mg/L Arsenic: -e ppb date of sample: 1-111/2cra6 B. SEPTICIHOLDING TANK DATA Tank Type/Material Fir, I4do n s / S-« / Tank size Zpo gal. Number of Compartments / Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 1 / 15'/ 07 Pumper At AT INSPECTION 12/lI / Zop� � ft. O • F3 g.p.m. Other bacteria U colonies/100 mL Collected by: rA=,4 s4 7-sco4 SSG Dale installed 12 / 2/ ! 9 8 Cleanouts (YIN) Y High water alarm (YIN) Y C. ABSORPTION FIELD DATA N• I4. /�efollilq 724nk, Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length Total depth _ ft. ft. Width U Eff. absorption area _ft2 Monitoring tube Gravel below pipe ft. Depression over field _ Date of adequacy test Results (Pass/Fail) Fluid depth in absorption field before test _ in. Water added_ gal. For _ bedrooms New depth_ in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION CN • A' Date installed 'Pump on' level at _ in. Datum Size in gallons "Pump off" level at_in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot IV. A _ Absorption field on lot Al. A Public sewer main N• A Sewer /septic service line �;p Zr' Animal containment areas N. A . Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots �> 100 Public sewer manhole/cleanout Holding tank baa* ' Manurelanimal excrete storage areas W. 4. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 20 Property line 2O' Absorption field N-4 Water main N• A. Water service line > so' Surface water > loa Wells on adjacent lots 100 ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: N• /{, Property line _ Water Service line Curtain drain F. COMMENTS Building foundation Water main Surface water Wells on adjacent lots Driveway, parking/vehicle storage 12" G. ENGINEER'S CERTIFICATION "''' ' q '•.�tt �'. `..., 1 certify that 1 have determined through field inspections and„• ��.�••�.a a<.E a+I review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. °.•.;;,.. 1,k4 *coae F. Engineer's Printed Name iAeooPo ►z. !_. / tao. `«- 35e9 •� r Date 2B Februa i -)e 2C -Po 7 : 'il ••. � COSA Fees hr30 �® Waiver Fee $ Date of Payment 26 Ff lr 'L00 7 Date of Payment Receipt Number I j Receipt Number (Rev. 11105) Municipality of Anchorage ,,. .. Development Services Department .<•• <.+r°; Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 070045 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 5H, Lot 21A of Rabbit Creek Heights subdivision, the well's productivity was determined to be 0.8 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. NMI SCS ReLN 1067210001 Client Name Flattop Technical Srv. Project NameJN Lot 21A Blk 5 Rabbit Creek Fits Client Sample ID Lot 21A Dik 5 Rabbit Creek [Its Nlatris Drinking Water PWSID 0 Sample Remarks: All Dates/Timm are Alaska Standard Time Printed DatcMme 12/1912006 17:01 Collected Date/Time 12/1112006 12:00 Received Date/time 12/11/2006 14:25 Technical Director Stephen C. Ede Parameter Results PQL Units Method Metals by ICP/KS Arsenic ND 5.00 ug/L EP200.8 Waters Department Nitrate -N ND 0.100 m8/L EPA 353.2 Allowable Prep Aselysis Container ID Limits Date Due Init C (<10) 12/13/0612'1&06 TK B (<10) 12'1 V06 JDS Microbiology Laboratory Total Coliform 0 col/100ml. SM209222B A (<I) 1211/06 DPT MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH i£ HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING — CONDITIONAL Parcel I.D. # 020-112-38 HAA # 1161,90251-- 1. 16980251- 1. GENERAL INFORMATION Complete legal description Lot 21; Block 5; Rabbit Creek Heights Location (site address or directions) 16600 Diane Drive Anchorage, AK Property owner Bill Mudd Day phone ( 541) 535-3794 Mailing address 1105 Quail Lane Scenic, Oregon 97535 Lending agency Day phone Mailing address Agent Pete Farris/ nvnamic Properties Day phone 261-7600 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 1 ti 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank XX Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72auM".1A1) Fel MOA621 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone ??7-07"7_ Address cc/of Z!c r d , S „ r Ll..ae,.4 • Ak. % -jST.a_ Engineer's signature 1 Date - 12 REQUEST YOU ISSUE A CONDITIONAL HEALTH AUTHORITY APPROVAL DUE TO WINTER CONDITIONS. FOUNDATION CLEANOUT TO BE REPAIRED NO LATER THAN 15 JUNE, 1999. A!o'all% t Or . It • �. s �.•f .r�.Y•..«wC... 6. DHHS SIGNATURE 'ti A. cc .;,�;'�W j Approved for bedrooms. �ti •.'% SE -7953 •�a� Disapproved. i FCF- N Conditional approval for -� bedrooms, with the following stipulations: Money shall be put in escrow in the amount of 1.5 times the high bid from three certified excavators to accomplish the repair of the foundation cleanout as described by the engineer above. Additional Comments a Date ! — 6 _FX CAUTION I The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority 11ir�if�tes based only upon the representations given in paragraph 5 above by an independent o al engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes =C%ons in order to satisfy certain federal and state requirements. Employees of DHHS do not u n ions or analyze data before a certificate is issued. The Municipality of Anchorage is not MunTpXnq%ledprpaiotg®r omissions in the professional engineer's work. Oept. Health & Human Services 72-M (e. Wt) 11c LOAM RECEIVED Municipality of Anchorage DEC 29 1998 DEPARTMENT OF HEALTH & HUMAN SERVIQE 'PALLiTM OF A=0PA Environmental Services Division ENWROW"AL savKrs DIV 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: AA8A4'* C^aek • 14&i -rS SID; Parcel I.D.: Oto - 112-38 LoT- Z1, B6eck 5 A. WELL DATA ' well type PRIJAtE If A, B, or C, attach ADEC letter. ADEC water system number n1Ipt Log present d7M Yes Date completed z r z I8 G I Total depth L°Ir Cased to 69 Casing height (above ground) 24� + Sanitary seal O YES Wires properly protected &M Yes FROM WELL LOQ AT INSPECTION Data of test ` ✓z'I 2/8(. Static water level AKTact^#4 Or'�At -rap eP 4CAsI.4G) Well production `'f g.p.m. O. + g.p.m. WATER SAMPLE RESULTS: o��y . t u.i �Q'a fi/L I t bye Colitorm D Nitrate G 1 f�7�L Other bacteria 15— Date of sample: 17- ^z. ► 11% Collected by: A .yJ • W • C. aL B. SEPTICIHOLDING TANK DATA Date installed 1144199 Tank size A000 Number of Compartments I Cleanouts ift YES Foundation deanout (f S Depression 00 t� in High water alarm &A lies Date of Pumping lJ bAp� Pumper C. ABSORPTION FIELD DATA Date Soil rating (g.p.dJfN o fte/bdrm) Systemtype Length Gravel thickness below pipe T 6pth Effective absorption area M Tube present (YM) pression over field (YM) Fluid depth In absorption Held Fluid depth 72-028 (Rev. &W* iAL Inuneolately atter_ i. water added '(In.): Minutes later. Absorption rate (past 12 months) (YIN) if yes, give date D. UFT STATION Date Manhole/Access (Y/N) High water alarm level at" E. SEPARATION DISTANCES F. Size In gallons on" 'Datum "Pump ofr level at* SEPARATION DISTANCES FROM WELL ON LOT TO: %11111104didi k on lot -7-41 + Pn adjacent lots 100 1 f Absorption field on lot 400Lr N a On adjacent lots 1001t Public sewer main O l A Public sewer manhole/deanout N /4 Sewer /septic service line 7-6 + Litt station SEPARATION DISTANCES FROMAOMSXOLDINQ ANK ON LOT TO: Foundation 101+ Property line 51+ Absorption field /A Water main/service line 101 t' Surface water/drainage t oo ' 4, Wells on adjacent lots -151 +' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: P Building foundation Water mairdse Surface water D hide storage area Curtain drain Wells on a I cafffly fiat I In confoomi n �.: ecfect and review of Municipal in in effect on this date. ,r Engineer's Name / / U t) v - c- '- `- SS Data I L Z 0 A -0d HAA Fee 5 ' teWaiver Fee $ 72-026 (Rev. V96)- Date of Payment _ C-�� Receipt Number e ms are • % j J ray A Gwnwo 6 cl¢. °vs� Alaska Water & Wastewater Consultants, Inc. 6901 ba" Rd. Suite 26 — Anchorage —Alaxka99501 . Phone (907) 337-6179 — Fax (907) 3384246 December 28, 1998 Municipality of Anchorage Department of Health & Human Services P.O. Box 196650 Anchorage, AK 99519-6650 REFERENCE: Lot 21; Block 5; Rabbit Creek Heights Conditional Health Authority Approval request Request you issue a Conditional Health Authority Approval on the referenced property due to winter conditions. On November 6, 1998, a new 2000 gallon holding tank was installed at the referenced Property. At the time of installation, the foundation cleanout was found to be broken off below grade. The foundation cleanout is located under the deck. Due to winter conditions and the need to dig it by hand to avoid removing the deck, we are requesting a conditional approval. The repair is to be completed no later than 15 June, 1999. A If you have any q^e��i�i�s or require additional information, please contact us. P.E. JAG/gk