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TIMBER RIDGE BLK 2 LT 2
Timber Ridge BlOrk 2 Lot 2 #050-321-20 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221074 PID Number: 050-321-20 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MATTHEW TOMTER ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 19341 UPPER SKYLINE DRIVE, EAGLE RIVER __T� ❑ Other Phone Phone Number of Bedrooms Soil Rating depth from original grade 4 JTotal GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot TIMBER RIDGE 2 2 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line FtZ Ft. well 100 + __ � 25'+ TANK ® Septic ElS.T.E.P: ❑Holding El Other = — -- Manufacturer GREER Capacity 1250 Gal. Surface water 100'+ -- Material HDPE Number of compartments 2 Lot Line 51+ __ NA Foundation ILL LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. 3BR HOUSE — 4BR SYSTEM. Alarm location Electrical installed by Installer QRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection ection s1 1 4/18/22 9nd 4/19/22 Location and description 3'd 41h TOP OF RISER / MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date • .'rH .....•... tri..-. �.. ..! •••• •••••••;••� Septic System A t '• Curtis Huffman i` roved - -�n�.--��' Date _ ���i�j'•,• 4E 228991 •,��,�,�s�,r�' /22 FP ..... • Asti ROFEWQN .� Note: this approval does not include well permit requirements. �'�,�.,�,�-,�,` k1\ VV/VL/ 101 PID: 050-321-20 PERMIT: OSP221074 LOCATED 100' / WELL PRIOR TO CONST. A -C=9,0' B -C=14,5' A -D=16.6' B -D=22.0' A -E=20.7' B -E=25,3' A -F=23.7' B -F=27.6' A -G=24,7' B-6=18.9' *BM TOP OF MH A COeE I F DECOMMISSION EXISTING S.T. WITH CONCRETE UNDER DECK & INSTALLED NEW 1250 -GAL HDPE SEPTIC TANK WITH NEW FCO & DCO. EXISTING 4BR FIELD 4BR SINGLE FAMILY RESIDENCE 0 EX TING S.T. .0 MMISSIONED IN LACE W/ 0 0 LOCATED 100' WELL PRIOR TO CONST. TIMBER RIDGE B2, L2 PREPARED FOR: MATTHEW TOMTER 19341 UPPER SKYLINE DRIVE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING PER SHOT AT S.T. INSTALL SEPTIC SECTION = 5,85' ED FROM S.T. OUTLET SCALE, NTS 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK©gmail.com SUPPORT@ SERVICES: OF ADI& • ��`3' C * TI DATE: 4/22/2022 SURVEY. HOLT tis Huffman Ay 04 DRAWN: FWCS CE 128991 SCALE: V, = 30' 4/22/22 ' PAGE: 1 OF 1 ssiogAy � S9% > G 16% § Z: ( / z » >'K3 @ « )/\\ e / 6\Dm g / > < / \ )\}� (y § § q \ J°?; )}\� / << w ;\<$ <»§ LU zu m y� \/\\ ((\ \� L}� m •' &32 5$\ 1-4 \ \\a\ \ §(k°/ CL0 ®,/(\ ere: V) m //%Q,Q J %Pm/\§\ LU Iu J53 2 / 'axeeaew II < �$> ®. ru m±g //2 f@ ru rij ooh 'o �@ � euu F-I®qo3&% c auu m $E2 x �z \x 0E�0 o :&0 ®0C 3EE�% \ �® §2 &55$5 3 \�` 7 j S/�%? \ Cq� LU \\\ � \§3\ j u m <00< �c ui ?5~\gj m m ( \ aKM:X< 22 eC6u <>euo� 2 § Z: ( >'K3 @ « )/\\ e / 6\Dm g / >\p< : / R % (y 2y%« «,} ;\<$ <»§ y� \/\\ ((\ •' \ \\a\ \ §(k°/ ®,/(\ ere: //%Q,Q J %Pm/\§\ 'axeeaew Q, ~^® ooh 'o 29 x �z \x o :&0 / )O\ / ¥®:{/ ZU) 3 \�` 7 = ® z MUNICIPALITY OF ANCHORAGE On -Site Watsr & Wastewater Prolymm Flo 549 196650 4700 Flm4re Road Aneficr,rge,Alasks 99S19.RM Phone: (907} Ud -MG 4 Fax: {WnW-79UT On -Site Wastewater Disposal System Permit Permit Num ban OSP21 074 Wnrk Typ*: Sep17r;7ank Upgrad, Tax Cock Number 0503212x000 Site Logal Address: TIMBFR RIDG E BL 2 LT 2 6x:0255 Site Ma tIling Address: 19341 U PP E R SKYLINE DR, Eagle River Owner: 70WER MATTHEW D-Esign Engineer: Fl RS7 WATER DONS UL71MG This permit is Fflr theeanstructian of; EffectIve Qatc; Expiration Date: Lot SLI* In Zq rt: Total Bedrooms: Ipcnr JL r' 1 el7;rr r rrici3 t 4MM02-2 4}i V2023 X6386 C nisposal Field 0 Septic Tank ❑ Holding Tank ❑ prig ❑ Private Well ❑ Wakeir Storage All 0¢nS-tructilan shall ba ih accordancewith: 1. The attached approved design, 2. All requirements spec fled in Anchorage Mun6eipal Code C hapters 15.55 and 15.65 and the State of Alaska Wa5tewater Disposal! Reigulatiens (18AAM) o nd Drinking Wao r Regulations. (I S AC80) 'JTho wantowatcr a:*14 r�yur rasa iropecllon p GIu11 nq U18 111Uallariu L. TI ie -wi igin ltlr 911al4 Wl1Y (Me DeV814ment Ser vicas Deparlmeni per AMC 15.65_ Provide natificatisrl by calring (907) 343-79N (24R). 4. FF -Dm Gatpber 15 to April 15, a subsurface sail absoro-on eystem under Construdion during freezi rmg weather shall be either; e. Opened and OIosed on the same day, or b. Covered, SEM&ed. and heated to pevent fre>ozing Speolal Provi$ion5; It a :STEP tank is installed, a high waW alarm that regiPAaf$ both visually and audrbMy shall be Iiislalled insid the dmmAln� oratteehed garage, Received By: I��aed By. este: Date: 1 3 ON-SITE SEPTIC/VVELL PERMIT APPLICATION Parcel I.D. 050-321-20 Property owner(s) MATTHEW TOMTER Day phone Mailing address 19341 UPPER SKYLINE DRIVE, EAGLE RIVER, AK 99577 Site address 19341 UPPER SKYLINE DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) TIMBER RIDGE B2, L2 Legal description (Township, Range & Section) Lot Size 38396 - Sq. Ft. Number of Bedrooms- 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial El Single Family (SF) M (w/wo ADU) Septic Tank El Upgrade RX Duplex (D) E] Holding Tank El Renewal El . Multiple Dwellings El Privy ❑ (SF and/or D) Private Well ❑ Water Storage El THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: a 5 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: '70,7 0'? R Receipt Number: Permit No. Q'S 0 D, 10 7 'j Waiver No. GAIDevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com April 6, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: TIMBER RIDGE B2, L2 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. A 1250-gallon steel tank serves the current lot. The area is served by private wells. The existing tank will be filled with concrete under the deck and the contractor may decide to install an Infiltrator tank if it fits better with separations and elevations. If not, the tank may need a lift station to make MOA required separations. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221074, Rebecca Carroll, 04/13/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221074, Rebecca Carroll, 04/13/22 r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE EW ❑ UPGRADE MAI LI GAD0 1 LEGAL DESCRIPTION LOCATION G�r�J- NO. OF BEDROOMS 2x DISTANCE TO: Well Absorption r a i Dwelling ` / t PERMIT NO. c� Q� l �O a Q w I— Manufacturer Mater No. of compartrrts �i Cn Liq. cmt�iCC11(��JJ nfgalions Inside length IF HOMEMADE: � Width Liquid depth._ x J � Z DISTANCE TO: Well PERMIT NO. Manufacturer enal capacity in gallons w= DISTANCE TO: Well i Foundation Nearest lot line PERMIT NO L LL Z F Z w No. of lines Q e, Length of each line Total length of Ines Trench width Distance between lin sem_ t inches HTop p of tile to finish grade f Material beneath tile Total effective ayhS:��or.p.,tion area inches 1 VQ w C7 Length Width Depth PERMIT NO. a H wa Type of crib iameter Crib depthcUve absorption area CAI Well g oundation ANCE TO: Nearest lot line J J Cla Depth Driller Distance to lot line PERMIT NO. w Building foundation Sewer line DISTANCE TO: Septic tankt, Absorption areas) l O OTHER PIPE MATERIALS SOIL TEST RATING V INSTALLER R MARKS 0 VV6� (fir APPROVED DATE LEGAL d- 72-013 (Rev. 3/p) rlU"A 1 C; 1 FLY 1=1 L_Z������to T:_�: r DEPHRTMENT G RLTH H�D ENYIRONMENT9L ECTION -~~ � .. ~ ,^ 825 'L �S/REE7. ANCHORAGE, HK. 99517. 264-4720 `------�' J ^ ��z �R- 1��� T�PvT—����� IN En � FEE F? ����1 T �1��/�/ PERMIT NO. ( 790207 > HPPLICHNT HARRY M%KE� LOCATION SKYLINE DR |LEOHL L2 B2 TIMBER RIDGE S/D /0A /1101 /1 '//-l9 ST RT BOX 1175 CHUGIHK 688 2813 iTYPE OF SOIL HBSORBTION SYSTEM IS. TRENCH LOT SIZE 127S6 SQURPE FEET 1MHXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)- iO3 ITHE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: { i2wE1=1�0-1= E3 L "'! 11= 1153 cli Fit F"w"v" FE: L. E3 FE 404 0- 1-0= -0 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIRLD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE �ROCND HND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFHLL PTPE AND THE BOTTOM OF THE EXCHYRTION (IN FEET) T"? lEz sit LA 1: rNo EE E> 13 lF3F low P44 v< A5 1: SE! EYE= 11- 1 5� PERMIT APPLICANT HHS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURINS THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND T0E NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- -1- 14 C3 V 0?: ::::i �01 YET 120 EE C; 7- l.: FZ FE F& FE CA L 1 1: vv�ERE 12, --- BACKFILLING OF ANY SYSTEM WITHOLT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. XMINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEN IS 180 FEET FOR H PRIVATE WELL/ OR 150 TO 208 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS ARE REQUIRED FIND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 D%Y OF THE WELL COMPLETION. OTHER REQUIREMENTS NAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE UAVAILABLE TO INSURE PROPER INSTHLLHTION- ����1 _T_ EE: 4: Fol 1: 047 E? OF �pi_::�:: P. -.-Y, F'-, ��ll I CERTIFY TH9T �: I HM !`!::4111 LIAR WITH THE REQUIREMENTS FOR ON-SITE SENERS AND WELLS RS RE -F FORTH BY THE MUNICIPALITY OF HNCHORHGE. 2: I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLHPGEMENT IF T KRESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS� SIGNED:/x4 'Y4 ISSUED BY ______DHTE__����_.��'_��_-/ • OONSTRUCTION TEST LAB "One Test is worth a Thousand Opinions" 2204 Cleveland Anchorage, Alaska 99503 277-0231 Performed for C6Ck.LKeA Date Performed 6 Legal Description: Lot_ Block Subdivision /R�►aL���ic/ This Fora reports: SOILS TEST PERCOLATION TEST 1 Depth Soil Characteristics Feet �ll�I /J leco 59 l� d may.. Was Ground Water Encountered42� j If YES, What depth? �/ 2 Reading I Date i Gross Tune ENNERSEEN 00 ■EMOSMOMEEEE • EEEEMN&C-MEEE EEEEEEmmm\mm EEEEEE mE Md Net Time I Depth to H2O f Net Drainage Percolation Rate Minute Proposed Installation: SEEPAGE PIT Depth of_Inlet Depth to DRAIN FIELD Rn -Ft -nm n -F Vii- nr Troneih w. Drilled by: Harry A. Mackey Well Log: Lot 2, Blk 2, Timberidge Sud. Ski Line Drive Eagle River, Alaska 0-4 Top Soil 5-8 Sand going more to gravel 8-20 Sand heavy with gravel 21-28 Sand and some clay 28 Some boulders 29-53 Conglomerate -little water at 53' 54-63 More fine sand - little more water at 63' 63-66 Brown clay 67-80 Clay 81-84 Sand, clay, conglomerate - more water at 84' 34_ Large boulder 85-112 Conglomerate 112-126 Large boulders 120 Bedrock Cased to 120 Drilled to 230 ' in bedrock - Water at 7 gal per min. Static Level; Comes up 60 6• well MUNICIPALITY OF ANCHORAGE ca;( dK . I:Cz 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. 050-321-20 1. GENERAL INFORMATION Complete legal description TIMBER RIDGE BLOCK 2, LOT 2 Expiration Date: Location (site address) 19341 UPPER SKYLINE DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) MATTHEW TOMTER Day phone Mailing address 19341 UPPER SKYLINE DRIVE, EAGLE RIVER, AK 99577 Real estate agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment Receipt Number COSA # O S c a,2 1 15O 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name Of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 4/18/2022 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 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 & FIAH 6. DSD SIGNATURE System #1 Approved for bedrooms By: System #2 Approved for bedrooms Disapproved .0P49 TM . ....... Curtis Huffman ��t��Fc�sl • CE 128991 .,.0ANW,/ PROFESSIONP� Conditional approval for bedrooms, with the follow`Ily�{�i4����(�r ON-SITE n Original Certificate Date: !�_— 7 —2072_Z 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 Legal Description: TIMBER RIDGE BLOCK 2 LOT 2 Parcel ID: 050-321-20 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 1979 Total depth 230 ft Cased to 120 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/6/2022 Static water level at beginning of test 117 ft. Comments B. TANK DATA Age of tank(s) NA — NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid level in sep is tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA Which system tested (date installed) 6/11/1979 ® ALL standpipes present per record drawing Total measured depth from grade 11.9 ft (max) Measured depth to pipe invert from grade 6.2 ft (min) ❑ N/A — pressurized field Structure served by this system Well production at time of test 3.8 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 5.29 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FWC Date of Sample 4/25/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 4/6/2022 Results 2 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 0 in ® Monitor tubes go to bottom of effective. If not, state depth into effective MOA IR SHOWS 51ED Elapsed time <5 min ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: CO/MT AT GRADE. AT TEST SUMP / INVERT SHOWED 11.9' TD & INVERT AT 6.21 =5.5'+/ -ED. FWE5 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' -M Yes if No Community Sewer Manhole/Cleanout > 100' If absorption field is under driveway comment below ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No 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 Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main >.10' _ ® Yes if No ft Community WPlls > 9n' _ _0_ Z Yes if No _ Water Service Line > 10' 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' -M Yes if No ft If absorption field is under driveway comment below Property Line ? 10' '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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. r� TH ,e ................... .. .... ....t...... Curtis Huffman CE 128991 .•��,o+� .1122/2�..���� � PROFESSIONP ft ft ft ft ft ft ft ft § DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 221150 Subdivision: Timber Ridge Block 2 Lot 2 907-343-7904 Fax: 343-7997 Awater samplerevea-led'a ni rate concentration of 5.29 milligrams per liter (rr]g/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing healthinformation and can herefore be .used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P fJ Box 196650 *Anchorage, Alaska 99519 6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has-been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. 'TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not -readily remove nitrate. The best method for limiting nitrate in well water is source control. 'This can _include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. ': ; Ma�Urg Address P °O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org Municipality of Ancho- Cage • '� Development Services Department Building Safety Division On -Site Water &Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage AK 99519-6650 www.muni.org/onsite i S 5 t,_ck fz C (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-321-20 COSA# D S G 1 (� f 1. GENERAL INFORMATION Expiration Date: — 3 O Complete legal description TIMBER RIDGE LOT 2, BLOCK 2 Location (site address) 19341 UPPER SKYLINE DRIVE * EAGLE RIVER, AK 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address THOMAS AND SUSAN MORGAN Day phone 694-4020 19341 UPPER SKYLINE DRIVE * EAGLE RIVER, AK 99577 Day phone RUTH BARNDT W/PRUDENTIAL Day phone Unless otherwise requested, COSH will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 227-8040 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 onsite wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90days 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, f 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. l 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. Phone 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 iife 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 DSD. 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 V Approved for bedrooms. Disapproved. 337-6179 Date 30 f2 Y ...... ......... e A. 9 C7-793 �� 3o (� 4��Aa profwssion�� 00 Conditional approval for bedrooms, with the following stipulations: Attachments: / COSA Checklist (/ Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory Other By: 61 (Rev. 11/05) Original Certificate Date: :"3 - 3 0-12- Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak,us (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TIMBER RIDGE, LOT 2, BLOCK 2 Parcel ID: 050-321-20 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N A Date completed 1979 Sanitary seal (Y/N) YES Total depth 230 ft. Cased to 120' ft, FROM WELL LOG Date of test 1979 Static water level 170 ft, Well Log (Y/N) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 4/25/11 ills] Well production 7 g.p.m. 4.7 g,p,m, WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrate 5. q)- mg./L. Arsenic: N_ug./L. Date of sample: 3/28/12 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments 2 Date installed 6/11/1979 Cleanouts(Y/N) YES Foundation cleanout (Y/N) NO Depression over tank (Y/N)No High water alarm (Y/N) N/A Date of pumping 5/4/2011 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA I *BELOW EXISTING GRADE Date installed 6/11/1979 Soil rating.p.d./ orft2/bdrm)100 System type TRENCH Length 40 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth *10.83 ft. Eft. absorption area 400 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/25/2011 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 920 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d- Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed - Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off"level High water alarm level at in. Date Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingfvehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I ce that I have determined through field ins pections and ;'9 H. review of Municipal records that the above systems are in p """' "' . ""' """"*' conformance with MOA COSH guidelines in effect on this . .... ......... date. Q - e y A. Garness; Engineer's Printed Name JEFFREY A. GARNESSI CE 795 ¢� Date 31.30/!2 0 �e�e''••/.�J,O.!A�pO COSA Fee Date of Payment Receipt Number (Rev. 11/05) Waiver Fee Date of Payment Receipt Number Municipality of Anchorage s Community Development Department :k Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval 4 111141 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 2 of Timber Ridge subdivision. This inspection revealed a nitrate concentration of 5.92 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SGS- SGSRef.# 1120950001 Client Name Garness Engineering Group, Ltd Project Name/# "Timber Ridge SD B2 L2 Client Sample ID Timber Ridge SD B2 L2 Matrix Drinking Water Printed Date/Time Collected Datefrime Received Date/rime Technical Director 03/30/2012 12:01 03/28/2012 8:33 03/28/2012 11:20 Stephen C. Ede Sample Remarks: 4500NO3-F - Total Nitrate/Nitrite - MS reeoveiT is outside of QC criteria. Refer to the LCS for accuracy information. Total Nitrate/Nitrite-N 5.92 Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS E. Coli Negative t 100mL SM21 9223B A Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/28/12 03/29/12 ACF Waters Department Total Nitrate/Nitrite-N 5.92 010o mg/L SM21 4500NO3-F B (<10) 03/29/12 AYC Microbiology Laboratory E. Coli Negative t 100mL SM21 9223B A 03/28/12 DLC Total Coliform Negative 1 100mL SM21 9223B A 03/28/12 DLC Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.G. 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. 05032120 COSA# Q ��� III 1. GENERAL INFORMATION Expiration Date: ' Complete legal description TIMBER RIDGE LOT 2, BLOCK 2 Location (site address) 19341 UPPER SKYLINE DRIVE -* EAGLE RIVER, AK 99577 Current Property owner(s) THOMAS AND SUSAN MORGAN Day phone Mailing address Lending agency Mailing address Real Estate Agent 694-4020 19341 UPPER SKYLINE DRIVE * EAGLE RIVER, AK 99577 Day phone BETH SIMPSON W/KELLER WILLIAMS Day phone 865-6556 Mailing address 101 W BENSON BLVD. SUITE 503 * ANCHORAGE, AK 99503 Unless otherwise. requested, COSA will be held by DSD for pickup. `2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water 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 imy 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,vr 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 r Mali I fro th.. FA. ... ...... l:1 f /1 ',,','as rrd from i investigation and iris eotion L1 e inl0("!rlatiGn vutarnEu uvii the ,vru,nu,Na,rty° ofAnchorage ,,,eS a, .. , v„e r;"ry p.,.,b on-site water supply anal/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. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. 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 DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of tttjs 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 9 -.Jeff Ny` � Garpess: Conditional approval for bedrooms, with the following stipulations: Attache bents: _,OS A Checklist Septic System Advisory Well Flow Advisory N"It.CtC Advisory y Arsenic Adviso 1l Maintenance Agreements Supplemental Engineer's Report Other /q. p,ofessior0\ o �o���tcltilt/f(/ ON-SITE c • WATER AND : m= WASTEWATER PROGRAM '..... By: '� � Original Certificate Date:`6 _f (Rev. 11/05) Municipality of Anchorage 4E B� • Development Services Department Building Safety Division On -Site Water & Wastewater Program 5 A 6 T Y 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: TIMBER RIDGE, LOT 2, BLOCK 2 Parcel ID:O 5032120 IAIA=1R417_Nl_1 Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 1979 Sanitary seal (Y/N) YES Wires properly protected (Y/N)`' Total depth 230 ft. Cased to 120' ft. Casing height (above ground) 12+ in. Date of test Static water level Well production FROM WELL LOG 1979 170 ft. 7 g.p.m. WATER SAMPLE RESULTS: Coliformy colonies/100 ml. Nitrate b • J mg./L. AT INSPECTION 4/25/11 110 ft. 4.7 9— p.m- Arsenic: ug./L. Date of sample: 4/22/11 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material a SEPTIC/STEEL Date installed 6/11/1979 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) NO Depression over tank (Y/N) NO High water alarm (Y/N) N/A SIgl a o t l Date of pumping' 47"2+7z261i1 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA I *BELOW EXISTING GRADE Date installed. 6/11/1979 Soil rating g.p.d./ or ft2/bdrm) 100 System type TRENCH Length 40 ft. Width 3 ft. Gravel below pipe 5 ft. Total depth *10.83 ft. Eff. absorption area 400 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 4/25/2011 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. Water added 920 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & 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' level 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 100'+ On adjacent lots 100'+ Absorption field on lot Public sewer main 100'+ On adjacent lots 100'+ N/A Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank N/A 100 Animal containment areas 50'+ Manure/animal excrete storage areas ,+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field Water main N/A Water service line 10'+ Surface water. Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 5'+ 100'+ Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS �o6oOp � G. ENGINEER'S CERTIFICATION o �F I certify that I have determined through field inspections and * 49 review of Municipal records that the above systems are in 0 conformance with MOA COSA guidelines in effect on this O date. Q f A Gar ess. Engineer's Printed Name JEFFREY A. GARNESS QO E-7 vI411 dd Q'°s '••.•' tic�rJ Date -Prof essio�°o� COSA Fee Waiver Fee $ Date of Payment 51t 0I Date of Payment Receipt Number to 1a !' Receipt Number (Rev. 11/05) Municipality of Anchorage • �'� Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC111141 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 2 of Timber Ridge subdivision. This inspection revealed a nitrate concentration of 6.54 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. SGS Ref.# 1111524001 Client Name Garness Engineering Group, Ltd ProJectName/# TIMBER RIDGE B2 L2 Client Sample ID Timber Ridge B2 L2 Matrix Drinking Water PWSID 0 Printed Date/Time 04/29/2011 15:11 Collected Date/Time 04/22/2011 13:30 Received Date/Time 04/22/2011 14:15 Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 04/25/11 04/26/11 NRB Waters Department Total Nitrate/Nitrite-N 6.54 0.100 mg/L SM20 450ONO3-F B (<10) 04/28/11 AYC Microbiology Laboratory E. Coli Negative 1 100ml- SM20 9223B A 04/22/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 04/22/11 DI,C 0.qt_�q� SHANE A. HOLT LS -6914 I ea a ���n�°teasfona\ ��c THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON (UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCE55IVE SNOW AND/OR ICE. AS -BUILT SURVEY 1" =30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 2, BLOCK 2, TIMBER RIDGE SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS _27TH DAY OF APRIL , 2011. HOLT LAND SURVEYING 600 HIGHVIEW DRIVE 11537, FB 145-26 ,53 ANCHORAGE,AK 99515 345-5513 Page 1 of 1 Poet, Jeff W. From: Sonja Blewett [Sonja@garnessengineering.com] Sent: Tuesday, May 17, 2011 10:54 AM To: Poet, Jeff W. Cc: Poet, Jeff W. Subject: Foundation clean out Hi jell, below is the email from JR's regarding the foundation cleanout on 19341 Upper Skyline Drive (Timber Ridge B2 1-2). Please contact me if you need anything else. Thanks Sonja Blewett On Tue, May 17, 2011 at 10:27 AM , merodavid@gci.net wrote: Tom after some investigation we were unable to find a outside foundation clean out. But their is one inside of the foundation wall with in Five feet of where the Septic pipe goes through the wall to the Septic Tank. This should meet the M.O.A code. Sincerely Dave J is 5/17/2011 • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ';)Z-2 7/ 8 (,/ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, townsNp, range) I— . Location (address or directions) (b) Applicant Name—�+���^� Telephone: Home C(i�� Business Applicant Address c 2242 w o.t (c) ..Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other (explain); (d) Lending Institution Telephone Address (e) Real Estate,Company and Agent Address Telephone (f GMaWthe HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WgTER SUPPLY Individual Well l, Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. - Page 1 of 2 72-025 (11/64) 5. ENGINEERING FIRM PROVIDO INSPECTIONS, TESTS, FILE SEARCH, I* AND INFORMATION 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 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address SRB 196x Date Eagle River, Alaska 99579 1 •+• OF .4 �► AW 1 by •ewe a•oa..aio • M • �. F:s Yw AFF • %obM A. s�°•°• No. 1457-1 `�: r ••Y• • ••SLY �` � 6. DHEP APPROVAL y� Approved for ¢�^�y bedrooms by �`''' '��/°�''"O Date Approved Disapproved Terms of Conditional Approval Conditional CAUTION .3-/0-196 The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) MUNlOPALITY OF ANCHOMCe DEPT. OF HEALTH 8& MUNICIPALITY OF ANCHORAGE (MO IVIRUNMENTA� PROTEMON HEALTH AUTHORITY APPROVAL (HAA) Q 5 Qffi CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Z v T _ ' - EC I V • A. WELL DATA Well Classification _ hA.-r If A, B, C, D.E.C. Approved (Y/N) [Ar Well Log Present(yx Date Completed /%79 Yield S r &4t�iA/A( Total Depth z'Jy Cased to Z 0' Depth of Grouting Static Water Level 176' Pump Set At L4 , Casing Height Above Ground IZr Sanitary Seal on Casing 011 Electrical Wiring in Conduit 6x Depression Around Wellhead (NA Separation Distances from Well: To Septic/Holding Tank on Lot On Adjoining Lots To Nearest Edge of Absorption Field on Lo� r7Z ; On Adjoining Lots To Nearest Public Sewer Line ) To Nearest Public Sewer Cleanout/Manhole l To Nearest Sewer Service Line on Lot Water Sample Collected by S' ; Date 3'Z—cc 6 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed �G%%9 Size 1004) No. of Compartments Z Standpipes O j Air -tight Cap5o(4ky Foundation Cleanoutam, Depression over Tank.4N{6) / Date Last Pumped •3'� Pumping/Maintenance Contract on File (Y/N) �(� ; for Holding Tank High -Water Alarm (Y/N) �'� Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line, r A t To Disposal Field To Water Ib4fti�r/Service Line Course Comments Page 1 of 2 72-026(11/84) /& It To Stream, Pond, Lake, or Major Drainage M C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ra, Type of System Design Date Installed Length of Field ya ` .r Width of Field 3` Depth of Field Gravel Bed Thickness bre Square Feet of Absorption Area 1" I& Standpipes Presento4w Depression over Field (Yw� Results of Last Adequacy Test Separation Distance from Absorption Field Date of Last Adequacy Test / -Z—CV—.5Y r�Gti��e y /C77i/f- OIY To Water -Supply Well r To Property Line O/ d' To Building Foundation Z To Existing or Abandoned System on Lot ~/�' ; On Adjoining Lots To Water Main/Service Line �V / r To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 0 Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection Signed S & S Engineering Date .?" -1/--- v 6 SRB 19" Companyiior, AL laske 99MMOA No. 0_-., + �+`?� Receipt No. °� �J�� D ,,,�•�'re �asspBl.S. 0 Date of Payment Or .� c !► a4;� i' - tie aN t?* ;:19�: Amount: $ L- osi_ Page 2 of 2 72-026 (11/84) I 1457-13 •' �` �j •°� •l s �jrrg�;``� 6 MUNICIPALITY OF ANCHORAGE a DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 2 Block 2 Timberidq.e Subdivision Location (address or directions) (b) Applicants Name Tom Morgan Telephone - Home Business Applicants Address SR Box 7349 Eagle River, 99577 (c) Applicant is (check one) Lending Institution ; Owner/builder ; Buyer ; Other (explain); (d) Lending Institution F rountier Mortage Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single -Family xx Multi -Family Other (describe) Number of Bedrooms three (3 ) 3. Water Supply Individual Well r-x-x—T Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite xx Public Community ,Holding Tank Note: If community well system, muJ t,written confirmation from the State Department of Environmental Conservatia 1 lvftesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information 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 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 further verify that, based on the information obtained from the Municipality of Anchorage files and from n-; investigation and inspection, the onsite water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Address Date 6. DEEP Approval Approved for three bedrooms Approved xx (ENGINEER SEAL) Telephone The engineer(S&S Engineering) has provided written confirmation of the conditionals have been met as per MOA requirements. This property is now fully approved. By Date Disapproved Conditional Terms of Conditional Approval January 1, 1985 THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERr"D IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HONES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (IDHEP SEAL) RR4/ej/D18 I ( 1 1 i [Page 2 of 21 7-19-84 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE I. General Information Application Date Z1,3 (a) Legal Descri tion (include lot, bloc , subdivis on, section, township, range) Location (address or directions) 2 (b) Applicants Name-�&_lgo rc Applicants Address J (�: 68,x -7-3 Telephone' - 2 e L Business (c) Applicant is (check one) Lending Institution Owner/builder ; Buyer [:::I ; Other E::l (explain); (d) Lending Institution / 4: �06u1^j���_/_— Address (e) Real Estate Co. & Agent Address Telephone z (f) the HAA to the following address: I`:VGINEERINGA SRB 196X 5E;, .. 014 SZ0A_'Dt70 2. Type of Residence Single -Family Multi -Family Other (describe) Number of Bedrooms 3. Water Supply Individual Well Community E:] Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite �4 Public =i Community 1=1 Holding Tank = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] S• Engineeri 0 Firm Providin 11 Inj_ pections, Tests, File Search Data and Information 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 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 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Address Firm Telephone f Date 7 �5 T Pr / • e • • • •`iw t c% � f ~ (ENGINEER SEAL) 6. DHEPaFP. Approval .y.-.c._.r-�.. ' -Approved for �-' a • � lrlr -_.. r " bed rooms By l,!., c .0 rz..� f Dam Approved. Disapproved Conditional !(_ Terms of Conditional Approval W g"L L W reL-� CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH S ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MQA HEALTH AU'MRITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 A. WELL DATA Legal Description: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION DEC n V"'A`6-� CLEIVED Well Classification S If A, B, or C, D.E.C. Approved(Y/N) ---� Well Log Present(Y ) Date Cmpleted /V7 Yie Total Depth Z So Cased to lZv Depth of Grouting Static Water Level 170 Pump Set At Gt, vc Casing Height Above Ground Sanitary Seal on Casing ( ) Electrical Wiring. in Conduit (Y' Depression Around Wellhead Separation Distances from Well: To. Septic/"Id rig Tank on Lot /Q Z - ; On Adjoining Lots `[SLS To Nearest Edge . of Absorption Field on Lot /D 2 �� on Adjoining Lots /mo �-,F- To Nearest Public Sewer Line To Nearest.Public Sewer Cleanout/Manhole PT -1i7- To Nearest Sewer Service Line on Lot 3o f Water Sample Collected By I S •eel Date 2 Water Sample Test Results T Camments N 10 i -J c B. SEPTIC/UgEBEW TANK DATA Date Instal d l9% % Size 490-o No. of Canpartments Z Standpipes ( Air -tight Caps ( Foundation Cleanout Depression over Tank t Date Last Pumped /zoo 3 B `F Pumping/Maintenance Contract on File (YMV/10- ; for Holding Tank High -Water Alarm (Y 4- Temporary Holding Tank Permit (Ya `4 Separation Distances fran Septic/1t7te ng -Tank: To Water -Supply Well /C)2, To Building Foundation mS To Property Line L 7 To Disposal Field 6 To Water Me a/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Receipt # 31 SSL Date Paid: j;L- ko-Sq Amount: (-LS ,C>D- (Page 1 of 2 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _ �Q Type of System Design ,at: `! Date .Installed C��•7 ! � Length of Field � Width of Field 3 Depth of Field Gravel Bed Thickness 6040. Square Feet of Absorption Area Standpipes Present Depression over Field (YAQ Date of Last_acY ! Z O Results of Last Adequacy 'lest .!5/} 7 jr--no Separation Distance from Abiscrption Field: To Water -Supply ill `D 2 �-�- To Property Line To Building Foundation 20 �- To Existing cr Abandoned System cn Lot /3 0 0.1 r-� On Adjoining Lots /G7o To Water 4a&pAervice Line _ rt To Cutbank(if present) ti 0 nI1_= To Stream/Pond/Lake/or Major Drainage Course /V O I" F To Driveway, Parking Area, cr Vehicle Storage Area �O f Gents /ls Q w .T D. LIFT STATION Date Installed Di nsions Size in Gallons ole/Access (Y/N) "Pump On" Level at Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Zest. Meets MOA Electrical Codes(Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, cr confcrmed to all MOA HAA Guidelines in effect on the date of this inspection. AkSigned NQ1W Date 2 �j "LE MVM AMKA ZW Company PH.'s94.2g73 MOA No. RBl/d5/s [Page 2 of 21 '��' °F..4�''�e ftbort A. Shafe, J • No. 1457-E r 44.0 �9F •�� 1f ''40 2-15-84 5. LEGAL DESCRIPTION MUNICIPALITY OF ANCHORAGE , Timberidge Subdiv. Eagle River, Ak. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 1- ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 p ���s id R tr C E I V E a 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proce 1. PROPERTYOWNER Harry A and Madeline M Mackey ❑ MULTIPLE FAMILY PHONE 688-2813 MAILING ADDRESS St. Rt. Box # 1175, Chugiak, Alaska 99567 PROPERTY RESIDENT (If different from above) *.ATTACH WELL LOG. A well log is required for all wells drilled PHONE New construction ❑ PUBLIC UTILITY depth (attach log if available.) 2. BUYER PHONE Chris and Donna Outlaw F-1 PUBLIC If system is over two (2) years old an adequacy test is required MAILING ADDRESS Mariner Drive, Anchorage, Alaska by this Department. 3. LENDING INSTITUTION Spokane Mortgage PHONE MAILING ADDRESS will be picked up by Madeline Mackey at Health office ) 4. REALTOR/AGENTPHONE Dick Brown - Target Realtors MAILING ADDRESS 5. LEGAL DESCRIPTION Lot 2, Blk 2 , Timberidge Subdiv. Eagle River, Ak. STREET LOCATION Skyline Drive 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ICl SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY EX Three ❑ Six 7. WATER SUPPLY X7 INDIVIDUAL* *.ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date F-1 PUBLIC If system is over two (2) years old an adequacy test is required UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) 4 w THIS SIDE FOR OFFICIAL USE ONLYS INSPECTION APPOINTMENTS DATE RECEIVED y TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ " SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: Se If Tank is homemade give dimensions: SOILS RATING �v TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 6 --APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE / BY (Title) LEGAL DESCRIPTION iz-uiu trsev. sits)
