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HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 3 LT 19KnI*k View Estates Block 3 Lot 19 #051-043-21 'Municipality of Anchorage Page 1 of 3 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. SW ti -7 sem PID Number. oSia ¢3 za Name: Draldec Enterprises Inc. Wastewater System: New O Upgrade Address: ABSORPTION FIELD 9210 Vanguard Drive Phone: 399-5678 No.Fof Bedrooms: our eeP Trench •O Shallow Trench O Bed O Mound O Other LEGAL DESCRIPTION sal w°"° Total Depth inalg 15; .SIS- pD Ft Lot: Block: SubdlvWon: Depth to pipe bottom from original grade: Growl depth beneath pipe 3 /%C VA�W .F_�575. MA>< 15,97 Ft to Ft Township: Range: Secflon: Fill added above original grade &J-- 5 Gravel length: 70 Ft Ft WELL p eve ❑Upgrade Gravel width: 21 O Number of lines: Deism be! to 1111M Z Fj Ft Classifr ovate. ".C): Total Depth: Cased To: Total absorption area: 400 Pipe material: S7t_l Ft. FL 7 Ft F—'Die Omler. Date Dirtied: Static war" UvN: Insalter. Y7 1 llOr'IF.s Date stalled: -7 1 �2 -i Ft.f Yield: Pump Set at: CasingH"mADO"Gramd: TANK GPM Ft FC SEPARATION DISTANCES optic 0Holding 0S.T.E.P. To Septic Absorption uh holding 4 Manufacturer. a`.. +� Tw ��^ Capacity In gallons: 1 Z From Tank FkAd aMlg Tank S~ Lines Welt, > / F 0 Material, NumberCompartments: Surface iee / >Z'a°f LIFT STATION eco' LineFoundation �I Sat /� Size In gallons: Manufacturer.lint �•,/ r✓' / Pumpon'levelat 'Pump o level at igh water alarm atcurtain i//� Pump Makes ModM I Inspections performed W. Drain x Remarks: A/ �t<!t(i' r1Ytr/ fee-A/.1& A3 BENCH MARK r.e. n o wT.11�� Location and Oa> pilon: rte. S I r— / /L. 4 =A . • Assumed Elevation: ENGINEER'S SEAL , Inspections performed by: Dates:l 2nSr 3rd 9/1 /97 Department of Health and Uumarervlces approvalA-31 Reviewed and approved by: Date: L-17-'77 Mrrre ,2-013 (nsr. e/et) MOA 25 Pannit No. SW970153 Page Z of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 19, Blk. 3, Knik View EStS. PID No; 05109321 JSP2 11"noNQLEGENDSeptic Pump, compartment 1 « 2 Clean Out Monitor Tube A L ••Yj C3 4 - Pi} die, Permit No. -70 I Page 3 of 3 Municipality of Anchorage 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 Legal Description: Lot 19, Blk, 3, Knik View Ests. LEGEND SP1 Septic Pump, compartment 1 SP2 • 2 i C Clean Out MT Monitor Tube U Elevation Plan AS -BLT 1" = 10' ,03 . gec�ctwli fab,-1� . -7B�-LU . kl PID No.: 05104321 East Trench �iV 'Ov'o 3 S IVIG • �cG•T� 1�.t7 ee e / • •i n „ • o e • re • ' . e eo u . � !.•.;A m West Trench t�o' a • s V O• D �. o e " o East Trench �iV 'Ov'o 3 S IVIG • �cG•T� 1�.t7 ee e / • •i n „ • o e • re • ' . e eo u . � !.•.;A m West Trench t�o' Wu of Anchorage OF HEA DEPARTMENT OF HEALTH 3 HUMAN SERVICES B25 `L' Street Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: e'�Iga.U, �] •r - S DATE LEGALDE RIPTION: L' ,%'�� 3 c<��K VIP.�f'ownshlp, Range, Section: Qe► GSTS, S��• Sr--�SLOPET—Y r 3- 4- 5- 7- 10- 5 7 10- ; it 12- 13- 14- 2 13 1a o 15 X? �GIgSG' v b 16. 17- 18- 19 7 18 19 b. 20- COMMENTS 0 COMMENTS j WASGROUNDWATER ENCOUNTERED? IFYES.ATWHAT J - DEPTH? Deo to wer am MerAN"? Wee ' � N,. a �) `N • J FA PERCOLATION RATE (mmuuvmM) PERC HOLE DIAMETER TEST RUN BETWEENFT AND FT PERFORMED BY: t T] 1 /Y•I`•tA—AJ— � TIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �r ! L•��J7 JOB SHEET NO. O► • CALCULATEOby DATE 9-h5hY7 CHECKEOIV DATE v SCALE q1qmME ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 563-7155 563-5389 FAX MEMORANDUM DATE: October 17, 1997 TO: Dan Roth FR01I: Mike Anderson, P.E. SUBJECT: Lot 19, Block 3, Knik View Estates Subdivision Certificate of Health Authority Approval The end of the easternmost absorption trench on Lot 19, Block 3, Knik View Estates Subdivision falls within 10' of the house foundation. At this point, however, the perforated pipe is between 7' and 8' below the ground surface. The house footing is only 3.5' below the footing making it impossible for septic effluent to daylight in the crawlspace of the house. It must also be noted the soils are fairly tight on this lot and migration of effluent towards the house is highly unlikely. I therefore recommend the trench be allowed to be within 10' from the house foundation. The exact dimension is 7.5' from the foundation. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970153 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:WALDEC ENTERPRISES INC OWNER ADDRESS:9210 VANGUARD DRIVE ANCHORAGE, ALASKA 99507 PARCEL ID:05104321 LEGAL DESCRIPTION: KNIK VIEW ESTATES BLK 3 LT 19 LOT SIZE: 22247 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: �'. x_\' c' r� PAGE 1 OF 1 DATE ISSUED: 6/26/97 EXPIRATION DATE: 6/26/98 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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. S P on °I - ►Lo S1 ('NQ, Y% q-lg-a,7 12- SPECIAL 2 SPECIAL PROVISIONS: f)T rlr+E of fv,vSriPulTIUN EA6r,vrER s<.Att PA-`Rre,Pr Ar HOvir,uaAc sviaf rF_sr ro R m ,/mw N VLr r-, Or /B TO V RiAY Nv Bi0 Rvck, E LI i RECEIVED BY:C`�i'{ DATE ISSUED BY: .VCL-1W �' �Pr_� DATE: c/—• 2 !,. — 57 ANDERSON ENGINEERING ; P.O.':,80X ; 4077.3. ANCHORAGEii iAiC 99524 563-7155 663 -6389 -(FAX)! MEMORANDUM DATE: July 1, 1997 RECEIVED TO: Dan Roth 711 EAa. JUL , 1997 SUBJECT: FROM: Mike Anderson, P.E. Lot 19, Block 3, Knik View Subdivision Dept.uHealth�& Human Sen9lces Septic System Design Permit No. SW970153 On Friday, June 27, 1997, Testhole No. I was deepened to 24' to check for groundwater and bedrock. Neither condition was found. A monitor tube was placed in the hole and checked periodically. As of Monday, June 30, no water was found in the tube. The purpose of the testhole was to determine if the total depth of the system could be lowered to 16' to provide additional separation from the steep slope fronting the lot. With the absence of both groundwater and bedrock we are requesting the total depth of the system be 16' as opposed to the 13' shown on our initial design. If the total depth is 16' we will be able to maintain more than 50' separation from any 25% break in grade. We will continue to monitor the groundwater over the next two weeks, but based on the steep terrain in the area we are confident no water will materialize. Please review this testhole data and revise the design to allow a total depth of 16' for the new absorption trenches. (EiiGINEER5SEAL) °a A1t�ffp MluNdpe ty o1 Anchomga 4 �'2:. i t•' -1 rY. DEPARTMENT OF HEALTH 3 HUMAN SERVICES i `a+•• �'°• "`�` 825 `L' Street Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST1 - cat e PERFORMED FOR: :5�pl"iC�L-L- LEGAL DESCRIPTIONIJ 5?, r/oC- 1..., 2 0 3 '�' 0 (��I 4 � 7 I Gbli• hoµt• � '►� 3 8- 12- 121314 13- 14- /L is- 5 is is- 17 - 77 c / gcr0.h Irl t. is 600SCK. 19 20 Eemtm L COMMENTS l FSY"t c CD 7'0 CS DATE PERFORMI (lA Township, Range. Section: �. SLOPE SITE WAS GROUND WATER p ENCOUNTERED? IF YES, AT WNAT DEPTH? fto III w'M=w7"r_ Itae G 30L PERCOLATION RATE ( WW11) PERC HOLE DIAMETER 57" TEST RUN BETWEEN FT ANMD_ L FT /�dex /«� trier iv Aw1r11 4 PERFORMED BY , 1 ' • "`f-� THAT HI/$ ^TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 72 -008(A" A I ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 563-7155 563-5389 (FAX) MEMORANDUM DATE: June 26, 1997 TO: Dan Roth FROM: Mike Anderson, P.E.�� SUBJECT: Lot 19, Block 3, Knik View Subdivision Septic System Design Permit Application The owner of Lot 19, Block 3, Knik View has relocated the proposed house to within 15' of the south property line and moved it back nearly 25'. This will allow sufficient room to place the septic system in the front of the house. The attached site plan shows the location of the new system. We have also redesigned the trench to accomodate the percolation rate of the soil found in Testhole No. 1. The trench will have an effective depth of 10' with a total length of 74'. A splitter valve will be placed between the trenches. Substantial grading has already been completed on the lot with a 79' bench constructed for placement of the house and septic system. The slope to the front of the lot will be flattened as much as possible during construction of the system. It is our opinion the system will function adequately in this new location. Please review the attached information and advise if you have any problems. We are confident the construction permit can now be issued. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 563-7155 563-5389 FAX June 11, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 19, Block 3, Knik View Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to construct a new septic system on Lot 19, Block 3, Knik View Subdivision. The attached Site Plan and backup documentation identify the size and location of the new absorption trenches to be constructed on the lot. The subdivision is served by community water and all required separation distances are easily met. No conflicts exist with other septic systems in the area. Testholes performed on the property revealed silty gravels which percolated at 27 minutes per inch. We have designed the absorption trenches for an absorption rate of .6 gallons per day per square foot. Total depth of the system will be 10'. No groundwater was encountered during excavation for the testholes nor was any noted during the monitoring period. The surface of the lot slopes from east to the west at grades varying from 6% to 10%. The surface of the ground in the area of the absorption trench is fairly flat. If the system is constructed as designed the following statements can be made: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The subdivision is currently served by a community water system. Lot 19, Block 3, Knik View Subdivision June 11, 1997 Page Two 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments % Joe . B 3 fv✓iK 1lit�'✓ ijs. Su,Bo AREA MAP SHEET NO OF CALCULATED BY DATE SCALE 1"-= 100' CHECKED BY DATE M SCALE JUDD Circle NS9•S6'J1' 95915 -r' � N h 46 179.92 ST o. � tip � ••�r0`' I JOr. \ 04,1.1 20 r"°JJJ I •�� 11 " \ �..tf` b I •O ry \ / / J wmv � ne.00 Is � p " 11 10 . 1 / ?J •A 9 L r�• y IV ti • O Jy r O .. rA / be...«Odv •y �. 193 f3/fir f14 `°•. /• v / \BOSS' / 1F�:4 r���4a/•t �Oi G�'.rr: MR 15 � •" tea. '��: •,;:,. s. !.- .14.✓/zz ✓14W Es TS. JOB SHEET NO. 0/ CALCULATED EY DATE �I%7 •:§+ '� P • (_'•'�i CNECKE0IY DATE '41 wL-YM• e'Y'• \� III I YII ! r i i Iii I N OL 01 �_ J - D--- m; ''nn r0 2 Mz:Iii 'rll I I I I— I I,•�; i l I I I 1 I i I i I I... ,cao i—i ! I I919r I I I I It I I ! I I II I III Iii illl-:I�II - Dol jl SYSTEM PLAN III NO SCALE I 1,250 GALLON SEPTIC TANK PROPERTY LINE - Dol jl III I 1,250 GALLON SEPTIC TANK I 7 PARKING AREA/DRIVEWAY, I LOT 19, BLOCK 3, KNIK VIEW SUBDIVISION DESIGN FACTORS: Four Bedroom Home Perc. Rate: 44 Min./Inch Application Rate: .45 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gallon Septic Tank 10' Drainfield Rock 4 Bedrooms X 150 GPD / .45 GPD/SF = 1334 SF of Absorption Area 1,334 SF/20 SF/LF (Sidewall Area) = 77 LF Trench Length Therefore: Construct a Deep Absorption Trench With Two Laterals. One must be 25' in Length and the Other 45'. Distribution Pipe in Trench Placed at 3' Below the Original Ground Surface. Place Trenches 20' Apart With a Flow Splitter Valve Between. 6enrGxri LC FAabc- Dtt.Ai.l F icL4 Ro CA'— "Z& TYPICAL WIDE TRENCH SECTION' IP -N (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Mlle --j E / po+ w �G&i - r ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 19, BLOCK 3, KNIK VIEW SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank and the construction of a total of 74' long X 10' effective depth absorption trench. Two laterals, one 25' in length and the other 42' will be required. A splitter valve must be placed between the trenches. The trenches must be 20' apart. Flatterning of the slope west of the trenches will be required. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. Munidpa0ty of Anchorage DEPARTMENT OF HEALTH 3 HUMAN SERVICES 825'L' Street, Anchorage, Alaska 99502.0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 5p14 LL - LEGAL DESCRIPTION:Lj l�✓� 2- 4- 2 1314 15 16 17- IS- 19- 20- 17181920 COMMENTS COMMENTS wee.4. II. 7f� I Esq, DATE PERFORM D, Range. Section: SLOPE SITE 4` WAS GROUND WATER p ENCOUNTERED? \ / IFYES.ATWHAT DEPTH? Dots to NwAffig7�-Aln� aft r �(,.(EJiGWEER55EAll �3c4td E Mm wml LS51•E 6 7- 9 9- 10- 10it 11 / 12- 13- 14- 15- Is- 17- IS- 19- 20- 17181920 COMMENTS COMMENTS wee.4. II. 7f� I Esq, DATE PERFORM D, Range. Section: SLOPE SITE 4` WAS GROUND WATER p ENCOUNTERED? \ / IFYES.ATWHAT DEPTH? Dots to NwAffig7�-Aln� aft r �(,.(EJiGWEER55EAll �3c4td E Mm wml LS51•E PERCOLATION RATE�(mt=wwAZ) PERC HOLE DIAMETER E TEST RUN BETWEEN 7r FT ANDS L FT 71'ar� PERFORMED B'V' 1 TI THAT THII; ;TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE E DATr 7 7 724= fAev. �rE3 ■����rz>���v�s�s PERCOLATION RATE�(mt=wwAZ) PERC HOLE DIAMETER E TEST RUN BETWEEN 7r FT ANDS L FT 71'ar� PERFORMED B'V' 1 TI THAT THII; ;TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE E DATr 7 7 724= fAev. �rE3 (FEr� 14& . SS '_IPGINEERSSEALI;,, Munldpa of Anchorage ty fi 63 •fi t S •,I as •i�Z%i ."A 4. .. DEPARTMENT OF HEALTH 6 HUMAN SERVICES 1 sem• •,«,.-«e«- jar/}_� �.' ✓ 825 •L" Street, Anchorage, Alaska 89502 -MO «—"�•xsr-� SOILS LOG— PERCOLATION TEST '"tisM°`�aA"�"•" atFy`v' . 6 PERFORMED SPCA CLL. DlarvlES1 ��Y.0 � .�� mow• DATE PERFORMED: FOR: LEGAL OESCRIPTJON:L—��_ 1!:>s K � F -J K V�Township, Range, Section: or (FEr� 14& COMMENTS EZ3: SLOPE WAS GROUND WATER (/ ENCOUNTERED? IFYES.ATWHAT DEPTH? oniawow m Yoape017 _Z— 9 Qut -� J PERCOLATION RATE Ll tmwndwvidi) PERC HOLE DIAMETER ? >, TEST RUN BETWEEN FT AND FT san, A --j Ailer 74- 'i`"r PERFORMED BY: " • - 1 rl 5� `"Ot—CMNFY THAT TH/JJS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �� "• 7 72-008 Acv uss 2- 3 4 3- 4- 5 5 CC 6 nco �SM 8 / _�e55Jou�5P. 9 0 0 10 c/ 11 12 13 14- 415 is- 16- 1817 17- 18- 1&1920 19 - 20 COMMENTS EZ3: SLOPE WAS GROUND WATER (/ ENCOUNTERED? IFYES.ATWHAT DEPTH? oniawow m Yoape017 _Z— 9 Qut -� J PERCOLATION RATE Ll tmwndwvidi) PERC HOLE DIAMETER ? >, TEST RUN BETWEEN FT AND FT san, A --j Ailer 74- 'i`"r PERFORMED BY: " • - 1 rl 5� `"Ot—CMNFY THAT TH/JJS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �� "• 7 72-008 Acv uss Ntunidp of AHUM t ' DEPARTMENT OF HEALTH & HUMAN b AN SERVICES M "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: :5pM1fiLL 140M6S DATE LEGAL DESCRIPTIONkWCrn 104 M y b 1 7 to 8- 10- 11 10,1 i ,2 13 / 14 e 15 16 17 -�3 ,6 ,9 20 w a ►u :acid E.. ��: �✓v+� COMMENTS 4-s7l WAS GROUND WATER A / ENCOUNTERED? v IFYES.ATWHAT DEPTH? gob to witar ON UwAffi ip? tWt NEEMOR • MEMS EMENOmm OEM NERENE MWENEENEEN 9 PERCOLATION RATE 33 (rt utwwch) PERC HOLE DIAMETER 1i=i FEST RUN BETWEEN 5 FT AND "o FT RUN PERFORMED 6Y: , 1 ' " ""44tt /"" ed— `'^'IFY THAT TH/I�5 TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE G/I Q 7 72-= IR". USS) Municipality ®i Anchorage On -Site Water and Wastewater Program (907) 343-7904 CL Certificate of On -Site Systems App 6),51 Parcel I.Q,&t6-043-21 1. GENERAL INFORMATION: Complete legal description Knick View Estates; Block 3, Lot 19 Location (site address) 22613 Judd Drive *Chuqiak, AK 99567 Current Property owner(s) Mailing address Expiration Date: Day phone Real Estate Agent Tate Rodgers Day phone 907-302-6262 — 2. TYPE OF DWELLING: Z Single Family (w1wo 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 z Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ I I -R. Date of Payment <'3 f ioZ loir!J(�_ Receipt Number COSA # Date: Waiver Fee. $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: c l p Zv In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE O System #1 Approved for L( bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, #AECC884 _ with the folla`vg IG -SIT[.! Gtr' W . �ry PRGGRA,,;: _� R By: - f = Original Certificate Date:�13 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other` I Aa -P 2 ®`t COSA Checklist Legal Description: KNIK VIEW ESTATES; BLOCK 3, LOT 19 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly >Wiresare operly protectedabove gro in. t OSAel at beginning of test Parcel ID: 015-043-21 Structure served by this system 1 e Well production at ' of test gpm Water sto a tank volume gallons disinfected for coliform test? E] Yes XNo ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic/ ug/L ❑ Arsenic less than MRL (ND) Collected by "/,.a, Date of Sample ft. AWWLI WATER B. TANK DATA Age of tank(s) 23 years Tank type/material SEPTI -TEE Measured operating fluid level in septic tank 50 ❑■ Standpipes/foundation cleanout per record drawing Date of pumping Akwc, —a ;r �—O D. ABSORPTION FIELD DATA DUAL TRENCH - WEST/EAST Which system tested (date installed) 9/18/97 Al ALL standpipes present per record drawing Total measured depth from grade 16.5/17.8 ft (max) Measured depth to pipe invert from grade 5.6/8.1 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ■❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced N/A gallons Comments/Deficiencies: TESTED WEST TRENCH ONLY COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Adequacy test date 2/11/20 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 6/0 in Water added *860 gal New depth 13/0 in Elapsed time 120 min Final fluid depth 8/0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date N/A NONE 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 > 10 ' ❑ Yes if No ft s if No ft Neighboring Tank > 100' ❑Yes if No ft Pri� a Sewer/S Ine > 25' ❑Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft �c� in Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' El Yes if No ft I No ft �75'0 Manure/Animal Excreta Storage > 100' Community Sewe n > 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' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' ED Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No 7.5 ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots Water Main > 10'✓❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' ✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *ASSUMED **ASSUMED - SEE AWWU CONNECT CARD DRAINFIELD IS 16' AWAY FROM 40% SLOPE ti�-jL►C+� �Lr Z3�►�-z�1 G. ENGINEER'S CERTIFICATION �QnF oov,_ l 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. COSA Checklist yellow sheet #AECC884 0 MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE: (907)564-2762 BLOCK/LOTITRACT BLK 3 LT 19 3r C'C) -I- 2_ WATER CONNECT PERMIT 97 - 5114 DATE OF APPLICATION 06/24/97 SCHEDULED COMPLETION DATE 12/31/97 SUBDIVISION KN1K VIEW ESTATES TAX CODE 5104321 GRID NW1558 AS -BUILT STREET ADDRESS 22613 JUDD DRIVE OWNER WALDEC ENTERPRISES INC MAIL ADDRESS 6208 STAEDEM DR ANCHORAGE, AK 99504 U SINGLE FAMILY MULTI -DWELLING No. APTS COMMERCIAL PHONE CONTRACTOR SPINELL HOMES ASSESSMENTS 11 Repair Existing Service Main Line Extension IXi On Property Only City Tap O Have Been Levied --�e�— Hydrant Only n 50' or Longer To Be Levied Main Tap - To Property Line Only Comments: Main Tap & On Property Connect Row No. _ Disconnect R & R - Main Tap Only OwnerIStaff —' CONNECT SIZE 1" ISSUED sparr PAID CASH INSPECTION FEE $ 103.00 PERMIT FEE $ 45.20 ❑ CHECK # $ 0.00 F] OTHER DEPOSIT $ 0.00 INSPE TED BY— REIMBURSABLE TOTAL $ 148.20 NUMBER _-- DATE REMARKS PERMITTEE (Please Print) MAIL ADDRESS , SIGNATURE PHONE POST IN A CONSPICUOUS PLACE AT THE JOB SITE AWWU INSPECTOR Original DATE SCHEDULED TIME INSPECTOR SUBDIVISION KNIK VIEW ESTATES BLOCK/LOT/TRACTBLK 3 LT 19 INDICATE NORTH I -C I I � I I I I o o� I INSPECTION REPORT I �a I I 1 YLINE BLOWN OUT Z I INSPECTOR ❑ K.B. &_T.W. - OK AFTER BACK -FILL SIZE CONN 1" ❑ OPEN BORE FLUSH CORP. STOP / CURB STOP C TO C ❑ 200 LB. TEST FTOPPER PIPE 114" R 2" KEY BOX ❑ MAIN CHLORINATED THAW -WIRE THAW-PLATE/NUT ❑ CHLORINE FLUSHED KEARNY CONNECTOR I OTHER ❑ DOMESTIC ONLY ❑ BOTH FIRE & DOMESTIC ❑ FIRE LINE ONLY ❑ FIRE HYDRANT ONLY DATE OF TAPE / / BY SIZE MAIN ❑ ALLEY ❑ STREET ❑ EASEMENT TYPE MAIN E CAVATOR DISCONNECTS ❑ YES NO SIZE OF DISCONNECT COMMENTS KEY BOX LOCATION_;�_.�'��-t,_. --- INSPECTION REPORT YLINE BLOWN OUT I I ❑ INSULATED INSPECTOR ❑ K.B. &_T.W. - OK AFTER BACK -FILL DATE � / ❑ OPEN BORE FLUSH I / COMMENTS ❑ 200 LB. TEST ❑ MAIN CHLORINATED ❑ CHLORINE FLUSHED - OK TO TURN -ON ❑ DO NOT TURN -ON Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC201082 Subdivision: Knik View Estates BLK 3 Lot 19 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $8,000 to $11,000. 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. Ma�Gng Address SP�Ct Box 196650 �Anchorage; Alaska 99519 6x650 *wwwis t muni org Municipality of Anchorage Development Services Department Building Safety Division' Onsite Water and Wastewater Program .. I T. 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.o.o;sT-04?)- zi COSA# ogco,;t' Expiration Date: a — a 5'_ 0 9 1. GENERAL INFORMATION Complete legal description Lot 19: Block 3; Knik View Estates Location (site address) 22613 Judd Dr. Chuglak, AK 99567 Current Property owner(s) Joe & Pam Pawloski Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑� Day phone 244'8059 Day phone Day phone Z/X 3 K 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 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. 1 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 S a S Engineedng •.�) Phone 694-2979 Address 16861 S. Birchwood Loop ougfiWAK Engineer's Printed Name 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Date bedrooms, with the following stipulations: A.:kdd 14$7-2 Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: �/ Ltd, Original Certificate Date: -a- _a 6-- D8 (P.. „jos) Municipality of Anchorage ••, '-° Development Services Department , / Building Safety Division , • , „ On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: � � wj.) 557-, Parcel ID: 05-1— 10 43-2 I A. WELL DATA Well type' ` a IC Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE Coliform ug/L If A, B, or C provide PWSID # 21 Sq6q Well Log (YO1Qii o Sanitary seal (YIN) _ Cased to ft. FROM WELL LOG mL ' Nitrate mg/L date of sample: _ B. SEPTICIHOLDING TANK DATA TankTypelMateriat lC. Wires properly protected (YIN) Casing height Uyl Other bacteria colonies/100 mL Collected by: Tank size _1260 gal``'' Number of Compartments - Foundation cleanou (©N) lEg Depression over tank (Y®_Q___C> Date of pumping _4� Pumper `t f �,S'PV11 C. ABSORPTION FIELD DATA Cleanoutsvi ) _u High water alarm 00 vix�G Date installed i A `� Soil rating(g.p.d.e r ft2fbdrm) �5 System type bEFeyr >-Lxti r Length .7b r ft. Width 3 ft. Gravel below pipe /D It. r Total depth ft. Eft. absorption area `(L_ftZ Monitoring tube Depression over field _V_0 Date of adequacy test .91-7/ob Result(Pas / ail) For _�__ bedrooms it 1, Fluid depth in absorption field before test 19' In. Water added gal. New depth in. Elapsed Time: Ioa min. Final fluid depth a tn. Absorption rate >_ &CO t g.p.d. Any rejuvenation treatment (past 12 mo.) (Y& type) No If yes, give date r D. LIFT STATION N/A Date installed 'Pump on' level at _ in. Datum Size in gallons in. High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES UBUc SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service On adjacent lots Public sewer manhole/cleanout Holding tank areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: rI Building foundation M Property line _� Absorption field � Water main 070 r Water service line ROr Surface water /00 -r Wells on adjacent lots 9Q0 -+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line !D + Building foundationD + Water main /b -F r / t Water Service line /0 4 Surface water hGV " /' Driveway, parking/vehicle storage o2 r Curtain drain 1,>��t7i. JPaVW0 Wells on adjacent lots aW -4- F. COMMENTS G. ENGINEER'S CERTIFICATION r y�pi1F;. • " 1 1 certify that I have determined ugh held inspecti sand r* review of Municipal records that a above s ysle4 are conformance with MOA COS gu' lines n lafect t s dal . r� ska.. Engineer's Printed Name �' ��', '�• A- ward Date ti COSA Fee $ 41'30 - Waiver Fee $ _ Date of Payment 2,/ 0-0 /0 2p, Date of Payment Receipt Number O0550D Receipt Number. (Rev. 11105) I MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services TMW On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY. APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# 05104321✓ HAA# V\E\�`1C��did� 1. GENERAL INFORMATION Complete legal description Lot 19 Block 3, Knik View Estates Location (site address or directions) Property owner Waldec Enterprises Inc. Day phone 344-5678 Mailing address r Vangliard T)rivp Anchorage, Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone 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 XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. n4M (R". L91) Front MOA121 S. 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 Anderson EngineeringPhone 563-7155 Address P.Q. Box 240773 Anchorage, AK 99524 Engineer's signature mat.aL � ^— Date 9/19/97 6. DHHS SIGNATURE _X Approved for 4- bedrooms. Disapproved. •°':c+' ��. Conditional approval for bedrooms, with the following stipulations: Additional Comments a N 4tITIC M Date lO-/7-y7 The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in Order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. non (AW. 1/91) Swk MOA 921 A_D :p - r .. ~cn CD x p So. a .r O I an 03 '^ • m , J• v ♦ w � - M o M o 'p • 9 i �' V � D CA n (� • c ��77 • • • • - '• 'a • P - lot o • a • • • •�`4 �` �iIto'By t•ti QR N � • 'L •1 � w. o • s � A � \ I A � j i g •p o i r� a i \ • u • a - a -• fJ S •It } � '�♦ :* f1 C7 �a C q. CD r� : x,12 :�� �`� 6 •�. } b. P ? : iT Z?• Oz �.� •yam ' � t�"�' �♦• 1 A' <Mr♦♦ O X QED rrl V yr -M 1 'n o • O � s w c�ii AO �F Municipality of Anchorage - DEPARTMENT OF HEALTH & HUMAN SERVICE84CIPAITM of ANCHO Environmental Services Division ENv,,Ow,NTAL,,,v,a1 D 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) SEP343A7,d 1997 Health Authority Approval Checklist RECEIVED Legal Description: Lot 19, Block 3, Knik View Est -Parcel l.D.: 015104321 A. WELL DATA Well type PWS If A, B, or C, attach ADEC letter. ADEC water system number 218409 Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (YM) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Public Water System Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Date installed 7/1/97 Tank size 1 , 250 Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YM) Y Depression (Y/N) N ;High water alarm (Y/N) N Date of Pumping New Pumper Construction C. ABSORPTION FIELD DATA Date installed 7 / 1 , 2 / 97 Soil rating (g.p.dJftz or ft2/bdrm) -45 System type Deep Trench Length 70' Width 3Gravel thickness below pipe 10' Total depth 15' Effective absorption area 1 , 4100 SF Monitoring Tube present (YM) Y Depression over field (YM) N Date of adequacy test New Const. Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test (in.); Immediately after_ gal. water added (in.): _ Fluid depth (Ins) Minutes later. Absorption rate = a.p.d. Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)' If yes, give date D. LIFT STATION None -on Lot Date Installed Manhole/Access (Y/N) _ High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size In gallons "Pump on" level at* 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer /septic service line ,r "Pump off" level at* Public Water System On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 211 Property line 50' Absorption field 1 n' Water main/service line 20' Surface water/drainage > 1 00' Wells on adjacent lots > 70n' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line >10, Building foundation >10, Water main/service line > 10 Surface water >100, Driveway, parking/vehicle storage area 2' Curtain drain None on T.o Wells on adjacent lots > 700' F. ENGINEER'S CERTIFICATION )'s VeTs I certify that I have determined thru Geld Inspections and review of Municipal recorris'tliat fhe ahove'Syst@ms are in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name Mi t, 1 F- And rcnn, per, Date 9/19/97 HAA Fee $ '�i n O _") Waiver Fee $ Date of Payment 0 ..n n �CV) Date of Payment Receipt Number �.�—k �Ol U Receipt Number 72-026 (Rev. 3(96)'