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GLENN VIEW ESTATES WEST PH 1 BLK 2 LT 24
Glenn View Estates West #1 Block 2 Lot 24 #051-793-20 Municipality of Anchorage ' Development Services Department •r+� Building Safety Division Onsite Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 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. SW010116 PID Number. 051-793.20 N'm'rner Construction ' Wastewater System: ® New ❑ Upgrade PO Box 3489. Palmer, AK 99645 bereu: ABSORPTION FIELD Pbcne. Number of Bemooma: O Deep Trenci ® Stuoow Trench Cl Beet 0 Mane O Otlw. LEGAL DESCRIPTION Sod ftr'p Total Depen from agnel pace: 0.8 GPD,Ft' 4.0 Ft. 11 c Lot: SWwmwn: Depth b Poe bopmn "m ongnet pact, Grml eepm eataam PPe. 2 24 Glenn Yew West 1.48 Ft. 2.51 Ft 7cwnenp Rap Secmn: Fi aEEaet ebovw onpnel praee: Greve) Lerpm: 2.9+ Ft. 97 Ft. Well: [I New [I Upgrade Gravel vMlb. Number or Ynes: p.anca between Yn..: 5 Ft. 1 NA FL Cieaeaatton (Pmaa, A B. C): Tdel Depen.Gees b: T"abaapnon area. P" Melanie: Public Water Ft. Ft 758 Fr SCH40 & F810 Drover. Dae purse. BMW water Level: 10elelNr Date ewMaeet: Ft Turner Const. 5/18101 YwM Pump Set ML G.rp H.pn1M Grave. TANK GPM FL FL SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Litt Holding Public[Privatc M.facha. ty. From Tank Field Station Tank Sewer Line Anchorage Tank 1250Gai. wait 200'+ 200'+ NA NA 25'+ Maanai. Number a Canpannares 2 Svlwwater 100'+ 100'+ NA NA LIFT STATION Lel u» 5'+ 10'+ NA NA Founeeban 5'+ 10'+ NA NA P.nP on b N.t Pump elr ..Hqn water stern at: H H. etre"ban NA '50'+ NA NA '""° """ Ebcbral iaperlvt. °a"c"ne° W Rernerke: *none known BENCH MARK Locauan era De.vpbon. Top of blockfoundation w.a 100 FL Engineer's Stamp of A�as4► �P�E ••• �l Inspections performed by: KND Enoineering Dates: 1°' 5118101 i ��' `�•eee �9 / k 9L iV * •....... .. ..... .»•...� 2 n 5118101Ir" Development Services Department Approval t4 1017'1/0, Wit? Kenna. W Reviewed and approved by: Date: — N-01 iN act CE 7116 J•�4'/ f fF .%, a t11� tsry ,x001 pROFESSIONP'+ ©OUR AS -BUILT SYSTEM DETAILS/SITE PLAN GLENN VIEW ESTATES WEST S/D, LOT 24, BLOCK 2 Lot 24 SEPTIC Lot 23 8.37 8.l 9 A -C=16.3' W Sg B -C=42.1' 5 zi zi da A -D=20.5' B -D=49.9' A -E=26.0' o B -E=63.5' d 1250 GAL SEPTIC A -F=81.8' : TANK B -F=99.0' _ _ '-ft._\� q..OF .A... 4 i IV. CE -9116 ; C........................... - FESSI010, 4 DORM MOUSE C B FINAL GRADE MR. Permit SWO10116 PID#051-793-20 E. V = L-9 91.89 SEVER ROCK ;: `. 97' PREPARED FOR; TURNER CONSTRUCTION PO BOX 3489 PALMER, AK 99645 (907) 745-8334 FIELD BOOKS COWIRP. saro"R7: AN DRAB STM" LANG o[am KMD "ter' ANG WR: 11 o c ru W. NW14° "0"D rRc, 01030.DWC '108 8O'` 01030 SCALE, NTS 1 78.3 .a Mt INI LW ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 1 111 0 KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 epi M.D CE 7116 SOILS PERCOLATION TEST Performed for. Turner Construction Date Performed: Project: Glenn View Estates West Ph1, Block 2, Lot 24 TEST 11OLE # 01-1 Depth 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- IS- 19- 20- ORG- organics & overburden SP/SM Density & silt increasing HOLE PRESOAKED PRIOR TO TESTING SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO Whatdepth? N/A Depth to water after monitoring? NA Date? NA Reading Date Gross Time Net Time Depth to Water Net Drop 1 5/18/01 1:00 - 7" - 2 1:10 10 min 43/16" 213/16" 3 " 1:11 7 4 1:21 10 min 48/16" 28/16" 5 " 1:22 - r - 6 1:32 10 min 411/16" 25/16" 7 1:33 - 7" - 8 1:43 10 min 411/16 25/16 9 1:44 7" - 10 1:54 10 min 412/16 24/16 11 ' 1:55 - 7" - 12 2:05 lOmin 412/16 24/16 " Water Added Percolation Rate 4.44 (min/in) Perc Hole Diameter 6" Test Run Between _ 4 feet and _5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. MM ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11/FAX (907)696.8111 November 13, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Glenn View Estates West Phase 1, Block 2, Lot 24 Gentlemen: The slope direction was inadvertently stated in the original design. The general slope of this lot is from north to south at a grade of approximately 1 - 3%. At time of construction the necessary change was made and an additional testhole excavated as outlined in the previous submittal. All other design items remained the same and we do not expect there to be any adverse effect on adjacent lots. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, MD Engineering Kenneth M. Duffus, P.E. Attachments: DSD Inspection Report As -built System Details/Site Plan Soils Log/Percolation Test DSD HAA 5= IF - 0 1 @ OF: O"RA MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: May 15, 2001 Expiration Date: May 15, 2002 Permit Number: SW010116 Parcel ID: 051-793-20 Legal Description: GLENN VIEW ESTATES WEST Ph1 BLOCK 2 LOT 24 Design Engineer: 0070 KND Engineering Site Address: NHN GREEN GARDEN DRIVE Owner Name: TURNER CONSTRUCTION Lot Size: 40002 SO. FT. Owner Address: PO BOX 3487 Total Bedrooms: 4 Permit Bedrooms: 4 PALMER. AK 99645 - 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: s Date: Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program '1�•_ �' 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 037 - 7 Y 3 2 0 Permit Number SW Property owner(s) Turner Construction Day phone 242.4555 Mailing address (1) PO Box 3487, Palmer. AK Mailing address (2)AIWN trREEA! GARDE.V DR. Zip Code 99645 Legal description (Lot, Block & Sub'd.) Lot 24. Block 2. Glenn View Estates West ph j Legal description (Section, Township & Range) Lot Size 4ORW Acrellep 40 002 THIS APPL&TON IS FOR: Number of Bedrooms 4 Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 1200) Waiver Fees: Date of Payment: Receipt Number: KINID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-87 (907)696-6111/FAX (907)696-8111 May 2, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: New sewer permit — Glenn View Estates West, Block 2, Lot 24 Gentlemen: The owner has requested we proceed forward to obtain a septic permit on the subject lot. On April 21, 1999 we dug one testhole for the proposed system. The results of the test are attached. The general slope of this lot is from east to west at a grade of approximately 1 - 3%. We have designed our system utilizing tht testhole we excavated for the 4 -bedroom house, which is proposed for this lot. The lot will be served by public water. We propose to install a 5' wide shallow trench. Water was not encountered during the excavation or monitoring. An additional percolation test will be conducted during construction. 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, MAD Engineering Kenneth M. Duffus, P.E. Attachments: On -Site Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test (WELL & .1'a WASTEWATER DISPOSAL SYSTEM DETAILS/SITE GLENN VIEW ESTATES WEST S/D, LOT 24, BLOCK 2 ig aXk NW145 Lot 1(i '� �� Lot N iA VACAN K T I 1 A NO PUSLIC WELLS WITHIN [OO OE PROPOSED SYSTEM NO RIVNTE WELLS WITHIN 2W R RSC OPOO SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN ew OEtt PROPOSED VL EXCEPT AS NOTED VACANT Lot 25 i SEPTIC .: eaP ` LANG Dum: STN ' LANG wo'Ea KMD em�r. LANG Dem 5/2 Lot 24 10V. M. �" AMRDrvl4fe aXk NW145 Am ftL' 01030.DWG 'IDD "'1 01030 ••. coc. a T.�nc `SEPTIC i LRIH�('i0Po(GD Lot 23 DESIGN DETAILS i �E.�F..AL9. i9 TE* ... "wESSIO0 A I 0 C PLA 11 VACANT Lot 10 VACANT Lot 9 4 BDRM X 150 GPD - 600 GPD 600 GPD/.8 GPD PER SO. FT. (2.00 MIN/IN.)= 750 SO. FT (750/5'(V)) X .64(RF) (2.5' GRAVEL) = 96.0 FT. TRENCH USE I TRENCH - 96' (L) X 5' (W) X 2.5' (D) Total depth of system Is 4.0' from original grade. Total depth of gravel below distribution pipe Is 2.5' . NOTES: 1. USE 1250 GAL. SEPTIC TANK. INSULATE IF <4' OF COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MINIMUM 2X SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS 6 SEPTICS. PREPARED FOR: TURNER CONSTRUCTION PO BOX 3489 PALMER, AK 99645 (907) 745-8334 FIELD BOOKS COMPUTER eaP ` LANG Dum: STN ' LANG wo'Ea KMD em�r. LANG Dem 5/2 DNC. rRm- aXk NW145 Am ftL' 01030.DWG 'IDD "'1 01030 RC Scale: 1'= 100' PAGE 1 OF 2 1Q]1V LLU ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 1 11 WASTEWATER DISPOSAL SYSTEM DETAILS GLENN VIEW ESTATES WEST S/D, LOT 24, BLOCK 2 RESERVE SY THWND-99-1 .ft!' ' -d. - -"kqk OF AZ4, 14 ............................ . SN iz 9 'Wo co 1-3% PROPOSEI BDRM HOL F C 0 CO 00 _E:§, 0 0 0 PROPOSED 1250 GAL. SEPTIC TANI PROP SED PRIMARY SYSTEM MT PREPARED FOR: TURNER CONSTRUCTION PO BOX 3489 Scate: I'= 20' PALMER, AK 99645 (907) 745-8334 PAGE 2 OF 2 KENNETH -FIELD BOOKS M. DUFFUS CE -7116 LANG ................................. LANG sslONNV LANQ AM FLL cowunch OOA�' V13G KIM) ENGINEERING CKO'M- KMD 20441 PTARMIGAN BLVD. OAIL' 5/2/01— EAGLE RIVER, AK 99577-8736 ce NW1459 If ........... Joe'" 01030 (907)696-6111/FAX (907)696-8111 RC V D ENGINEEI%-4G 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8; SOILS PERCOLATION TEST Performed for. Arctic Devco Date Performcd:_O1/22/99 Project: Lot 24 Block 2 Glenn View West TEST HOLE # _ 99_2he 1 2 3 4 5 6 7• 8& 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- Depth ORG — rootmat SEE ATTACHED SITE PLAN FOR HOLE LOCATION SM —soft loose SP — dean loose SM -increasing density /depth I.O.H. HOLE PRESOAKED 20- PRIOR TO TEST Was Ground water encountered? NO What depth? NA Depth to water after monitoring? NO Date? 05/15/99 Rea Date Gross Time Net Time Dep t0 Water Net Drop 1 4/22/99 11:10 6" _ 2 1120 10 min 2/16"514/16" 3 • 1121 _ 6" 4 1131 10 min 12/16" 54/16- 5 1132 - 6" 6 11:42 10 min 14/16" 52/16" 7 • 11:43 6" _ 8 11:53 10 min 1" 5" 9 • 11:54 6" 10 12.'04 10 mut 1" 5^ 11 ' 1205 - 6" _ 12 1215 10 mm 1" 5" ' Water Added Percolation Rate 2.00 (min/in) Perc Hole Diameter_¢= Test Run Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. 1`JH0� P rt L� u Y OF AHCH0R\, rt GFE Development Services Department '4 P p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-793-20-000 Expiration Date: 2/6/2023 Legal description GLENN VIEW ESTATES WEST PH 1 BLK 2 LT 24 Site address 22811 GREEN GARDEN DR Chugiak AK 99567 Current property owner(s) SMITH COREY WILLIAM &ELSIE JEAN X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 11/6/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-793-20 Complete legal description GLENN VIEW ESTATES WEST PHASE 1 BLOCK 2, LOT 24 Location (site address) 22811 GREEN GARDEN DRIVE, CHUGIAK, AK 99567 Current property owner(s) COREY & ELSIE SMITH Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ® Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 22 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5 50 Date of Payment (1 20 2 COSA# D.SC231 y2g Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: GLENN VIEW ESTATES WEST PHASE 1, B2, L24 Parcel ID: 051-793-20 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 50” Date of pumping 10/23/2023 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 5/18/2001 ALL standpipes present per record drawing Total measured depth from grade 8.8 ft (max) Measured depth to pipe invert from grade 4.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/23/23 Results Pass Fluid depth prior to test 19 in Water added 820 gal New fluid depth 24 in Elapsed time 1175 min Final fluid depth 18 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 30 in (2.51’ ED) Effective depth used 18 in (Final Fluid Depth) Effective depth remaining 12 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/01/2023 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/01/23 NAUNEW LITY OF A INCHO OCA DEVELOPMENT SERVICES DEPARTMENT o f4c � 907-343-7904 On -Site Water and Wastewater Section ��`4� = Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231428 Subdivision: Glenn View Estates Wewst Phase 1 Block:2, Lot: 24 The septic tank for this property is 22 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. 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 30 year old steel tank MAY look like. (f E AN 0- A � T MUMCPAUTY OF ANCHORAGE i Development Services Department ��% Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-793-20 1. GENERAL INFORMATION Expiration Date: Complete legal description GLENN VIEW ESTATES WEST PH 1 BLK 2 LT 24 Location (site address) 22811 Green Garden Drive Chugiak Current property owner(s) Mailing address Real estate agent PURCELL SEAN Day phone 907.229.4777 22811 Green Garden Drive Chugiak 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment � l/� Date of Payment Receipt Number Receipt Number COSA # IQ"5j Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on -site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on -site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Phone 907.355.9820 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE Date 6. DSD SIGNATURE f System #1 Approved for LI bedrooms System #2 Approved for Disapproved Conditional approval for By: bedrooms •� AQ CuWli 9Da•� I ���®A�'�PROFESS10Np���� bedrooms, with the following stipulations: Original Certificate Date: r/" The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: GLENN VIEW ESTATES WEST PH 1 BLK 2 LT 24 Parcel ID: 051-793-20 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system _ A. 1fUE L� DATA ❑ Well log is Pled. ith Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water-levt+�eei4:4 a orb. public water system B. TANK DATA Age of tank(s) 18 years Tank type/material steel sepkic Measured operating fluid level in septic tank 5 © Standpipes/foundation cleanout per record drawing Date of pumping 8/21/19 D. ABSORPTION FIELD DATA Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Flitrat mg/L ❑ Nitrate less than MRL (ND) Arsenic tg1L� ❑ Arsenic less than MRL (ND) Collected by _, Date of Sample C. LIFT STATION. ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 2001 Adequacy test date 8/20/19 ® ALL standpipes present per record drawing Results Q Pass For 4 bedrooms Total measured depth from grade 6.9 ft (max) Fluid depth prior to test 7 in Measured depth to pipe invert from grade 4.4 ft (min) Water added 604 gal ❑ N/A - pressurized field 10 Monitor tubes go to bottom of effective. If not, state New depth in Elapsed time 1260 min depth into effective F0 Code -required soil cover over field Final fluid depth 6 in ❑ System presoaked Absorption rate ' 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If es, enter date y Comments/Deficiencies: 30" effective depth, water inserted into MT nearest house, seater depth measurements reported for this MT. COSA Checklist yellow sheet no 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' ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Se ti Luae->- _ 5"C3"Yes if No ft Absorption Field on Lot> 100' ❑Yes if No ""Folding Tank> 100' ❑Yes if No ft Neighboring Absorption Field Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Comm nity Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' ✓Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F-11 Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' F-71 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' 7 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' R1 Yes if No ft If absorption field is under driveway comment below Property Line > 10' F-1 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' [] Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION i certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. _oa COSA Checklist yellow sheet OF 2 . TH �F•, Date.. � �,.�� i No. CE 1-191 �rb FDPRn�cectniR�� 8t6vr c✓rsnloJ Municipality of Anchorage Development Services Department • - :; ° Building Safety Division Onsite Water and Wastewater Program s • �.� 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051-793-20 COSA# /000001 Expiration Date: 1. GENERAL INFORMATION 6rY trS A Complete legal description GLENN VIEW WEST BLOCK 2. LOT 24 Ph Location (site address) 22811 GREEN GARDEN DRIVE CHUGIAK AK 99567 Current Property owner(s) ETHAN OLDHAM & MARTIN WASCHE Day phone Mailing address PO BOX 773486 EAGLE RIVER AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSH will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: _.---_--.TYPE ORWASTEWATER DISPOSAL: Individual Well ❑ Individual On-site El Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Ps! blic_Water-System IRI -- P-ublic 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 Ude (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, 1 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 Finn ARCTERRA CONSULTING, INC Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 01/14/10 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, OF At \ ArcTerra can not give any estimate of how long a —W "�E 0, 11 ,.......,ej� system will function satisfactory for current or future AV C� . � occupants or can ArcTerra guarantee that no unseen p t < ; encroachments, deficiencies or discrepancies exist. g _ .519. 7t4 _ 1 iA B0, a... _.. 5. DSD SIGNATURE Approved for _ bedrooms. Disapproved. Conditional approval for Kenneth Ai. Cuffs: 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: 0, Original Certificate Date: (Rev. 11N5) Municipality of Anchorage Development Services Department `•; j Building Safety Division ? g - On -Site Water & Wastewater Program '"' `• 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Est.lfi Legal Description: GLENN VJQWWEST BLOCK 2. LOT 24 PA 2-0-L Parcel ID: 051-793-20 A. WELL DATA Well type PUBLIC Date completed Total depth ft. If A, B, or C provide PWSID # Well Log (Y/N) Sanitary seal (YIN)_ Cased to ft. Wires property protected (Y/N) Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m, g.p,m, WATER SAMPLE RESULTS: Coliform colonies/100mL Nitrate mg/L Other bacteria colonies/100 mL Arsenic: mgA Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5118/01 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (YM) N Date of pumping 12/09/09 Pumper Sanitary C. ABSORPTION FIELD DATA Date installed 5/18/2001 Soil rating (g.p.d./ft2 or fe/bdrm) 0.8 System type Trench Length 97 ft. Width 5 ft. Gravel below pipe 2.51 ft. Total depth 6_9 ft. Eff. absorption area 758 ftp Monitoring tube Y Depression over field N Date of adequacy test 92/10/09 Results (Pass/Fail) Pass' For 4 bedrooms Fluid depth In absorption field before test 1.2 in. Water added 750 gal. New depth 12 in. Elapsed Time: 140 min. Final fluid depth 1_2 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) : NIf yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' level at _in. 'Pump off" level at _in. High water alarm level at _in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot On adjacent lots Absorption field on lot On adjacent tots Public sewer main Sewer /septic service line Animal containment areas Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 51+ Water main 10'+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parkinglvehicle storage 10'+ Curtain drain 50'+ Wells on adjacent lots 200'+ F. COMMENTS OF G. ENGINEER'S CERTIFICATIONy S f' vR1YgTN 4t' 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. I m Kenno',n r. L W 11 f'•• CE 11 J Engineer's Printed Name KENNETH M. DUFFUS Date 01/14/2010 COSA Fee $490.00 ff Waiver Fee $ Date of Payment 1 // Iu�U Date of Payment Receipt Number�5 7 4 C_ Receipt Number (Rev. 11105) . 2 STORY WOOD FRAME RESIDENCE 2' W HOUSE DETAIL SCALE: I' - 20' Lot 25 I 15' DRAINAGE EASEMENTS—I E— — — — — — — — — — — — — — — — �_ N 89651'02'E 30(100' � oQdZ M r Lot Lot 24 40,002 s.f. H alm-«m 41 0 5�Cl e �P 0 -I I 0 I m I z y 39. I D rnz I Z I I v I m 10 I 15' TELECOM, 8 ELECT. EASEMENT ---- I I Lot 23 3000' PLOT PLAN _ ASBUILT X SCALE V - W GRID NW 1459 Project No. 01-056 Lang do Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515 907 522-6476 Phone Registered Land Surveyors sol; 522-4625 Fax OF A� I hereby certify that I how surveyed the following described property, •�k..• '9s Lot 24. Block 2, GLENN VIEW ESTATES WEST, Phase No. I (Plat No. 20DO-42) Mohorage Recording District, Alaska. and that the Imprevemerlle situated (7; thereon an within the property lines and do not encroach onto the properly or ; 49IN :� adjacent "wrote. that no Improvements on the property tying aetlasent twreto ' ........ .. ' •.••••.. encroach on the surveyed promises and that then an no roadwaayyss, transmission tines or other WeVe ewemen"s on sold property except as kwoamd hereon. '•. .KENNETH 0. A r Dated this the � Day of U0Q sy.,,Pb -nrope. Alaeko LS -52 k - Zoo I . at Aneho 02 .� �Is thereeponsib(INy of Nye owner M determine theexletenoe of ober "'' •••• easements, covenants, or restrictions which do not appear on the recorded �0gssawx- subdmslon plot. Municipality of Anchorage • -- Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051.793-20 HAA #_Hl-:� O I 0,5— Expiration S -Expiration Date: / 1. GENERAL INFORMATION Complete legal description Glenn Yew West Block 2. Lot 24 Location (site address or directions) Current Property owner(s) Turner Construction Day phone Mailing address PO Box 3489 Palmer, AK. 99645 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND Engineering Phone 696.6111 Address 20441 Ptarmigan Blvd. Eagle River, AK. 99577 Engineer's Printed Name Kenneth M. Duffus Date 11/12/01 5. DSD SIGNATURE __Z Approved for bedrooms. Disapproved. E.�,r.•A�.4�18 clr = ti••;r�i�� CE 7116 41PRO. I-ESSION�•a Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: /� A 0&<if Original Certificate Date:61,11, (Rw. 1L00) Municipality of Anchorage ' • Development Services Department Building Safety Division On -Site Water 8 Wastewater Program •� 4700 South Bragaw St. 1 P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST I! Legal Description: Glenn View West Block 2. LM 24 Parcel ID: 051.799.20 A. WELL DATA well type PUBLIC it A, B, or C provide PWSID # _ Well Log (Y/N) Date completed _ Sanitary seal (YIN) _ Wires property protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test Static water level Well production 9 -p.m g,p,m_ WATER SAMPLE RESULTS: Coliform —colonies/100 ml. Nitrate mg.A. Other bacteria oolonies/100ml Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material _ Anch. Tank I steel Date installed 5118f01 Tank size 1250 gal. Number of Compartments 3 Cleanouts y_Foundation cleanout -y—Depression over tank [_High water alarm gg Date of pumping n;nnew tank Pumper C. ABSORPTION FIELD DATA Date Installed 5H812001 Soil rating (g.p.dAY or ft2lbdrn) U System type shallow trench Length 97 ft. Wkfth 5 ft. Gravel below pipe 2.51_ ft. Total depth U ft. Eft. absorption area 7I$fe Monitoring tube Y Depression over field n Date of adequacy test n"aw system Results (Pass(Fail) pass For L bedrooms Fluid depth In absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ In. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) If yes, give date D. LIFT STATION Date Installed na "Pump on" level at _ in. Datum Size in gallons Manhole/Access (Y/N) "Pump off' level at _ in.High water alarm level at Cydes tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/IIR station on lot On adjacent lots Absorption Heid on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line'�'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parkingtvehide storage '+ Curtain drain 50'+ Wells on adjacent lots '+ F. COMMENTS G. ENGINEER'S CERTIFICATION i1Nt. "`' % ��• I certify that I have determined through field inspections and review of Municipal records that the above systems are in • • • as••o#-.•• Otto %.• conformance with MOA HAA guidelines in effect on this date. T :1. pv .• t iy Engineer's Printed Name Kenneth M. Duffus % » to Date 11112101 /t1�\ ROfESSIONP�+�� HAA Fee $300 Date of Payment 11/13/01 Receipt Number (Rev. 12W) Waiver Fee $ Date of Payment Receipt Number In.