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Home My WebLink AboutBROADWATER HEIGHTS TR A LT 2Broadwater Heights Tr A Lot 2 #050-131-38 Inspection Report_'I-1-12!ddcl/ Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141349 PID Number: 050-131-38 ❑✓ New ❑ Upgrade Name: ABSORPTION FIELD David Stevenson [—]Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 18207 Stillwater Drive Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPDfSF 6.4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.4 Ft. Gravel depth beneath pipe 4-OFt. Subdivision Block Lot Broadwater Heights Tract A 2 Fill added above original grade 1-2 Ft. Gravel length 54 Ft. Township Range Section Gravel width 5Ft. Beds: Number of Lines I Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 540 Ftpi One Fl Well >100' >100, >100' >75' >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250Ga1. Surface Water >100' >100' >100' >100' Material Steel Number of compartments Two Lot Line >5' >10' N/A N/A NA Foundation >5' >10' NIA N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks in. in. in. Pump make and model Electrical Inspections performed by PIPEMATERIAL Housetotank D3034 Tankto D3034 drainfield Installer Guaranteed Services Drainfield F810 GOIMT D3034 Inspector W Roberts BENCH MARK (Assumed elevation) 100.Oft Inspection 1St 10/8/14 10/8/14 Location and description dates: _ 2 Top of Furthest East Sono Tube Foundation. 3" 8/15/15 a COMMUNITY DEVELOPMENT DEPARTMENT APPROVALOrSW .. �• • Conditional Approval: Date �� 49 TH !... ; * o.... ... 00 �:� �1ra MICHAEL E. ANDERSON ♦ :� CE -4381 ,,IfF'�Fp3•� ;; r••'�F��'i ko/// Approved 411V _.�( Date q--1 -1,57 11; w �?��' Inspection Report_'I-1-12!ddcl/ DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 PID No.: 050-131-38 Pan. 7 of 2 Permit Number: OSP141349- — — — — — — BROADWATER HEIGHTS SUBDIVISION TRACT A, LOT 2 \\29,749 SF JAMIE DRIVE —_ 1 1 I I I I f 1 TRACT A-1 N87.13'50"E 180.26 10' I Utility Easement — — I � Well O��ewo1, I LOT 4A i Four Bedroom , Home , B FCO ' S1 re0 Shed Alternate Slte 1 I Septic I 3C5 �0 I LEGEND: TH — Test Hole 11CO — Clean Out— MT — MonW Tube Oo� FSV —,F15w Splitter Valyl p SV y Septic Vent F9d — Flow Diverter Valve \ A e TRACT A -3A \` S1 10.1' 23.5' / S2 13.0' 26.1' / C4 23.8' 54.5' / C5 49.5 45.1' / M 1 24.7' 54.8' / f o++� OF "off .��...........qGq aaa ♦1�� I EXWell 49th �-(� ................ .................... ICHAEL E. A .%...No. CE 43818 �= SITE PLA N 4TH.. -f -�S,,.. •' �1� ` \ aaaa40 E... ... ++ SCALE 1" = 40' i TRACT A-1 N87.13'50"E 180.26 10' I Utility Easement — — I � Well O��ewo1, I LOT 4A i Four Bedroom , Home , B FCO ' S1 re0 Shed Alternate Slte 1 I Septic I 3C5 �0 I LEGEND: TH — Test Hole 11CO — Clean Out— MT — MonW Tube Oo� FSV —,F15w Splitter Valyl p SV y Septic Vent F9d — Flow Diverter Valve \ A e TRACT A -3A \` S1 10.1' 23.5' / S2 13.0' 26.1' / C4 23.8' 54.5' / C5 49.5 45.1' / M 1 24.7' 54.8' / f o++� OF "off .��...........qGq aaa ♦1�� I EXWell 49th �-(� ................ .................... ICHAEL E. A .%...No. CE 43818 �= SITE PLA N 4TH.. -f -�S,,.. •' �1� ` \ aaaa40 E... ... ++ SCALE 1" = 40' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141349 31 W Existing Ground No Groundwater 8-15-14 U �100.7 U UU 1,250 Gallo Septic Tank 96.45 �p 98.0 97.0 Drainfield Rock ,/— 82.0 54' (Trench Length) PROFILE AS -BUILT No Scale Page 3 of 3 PID No. 050-131-38 U tsty .r7.;•- •t9� mac• 49th •...0 MICHAEL E. ANDERSON Wheaton Water Well, Inc. 1190 N. Wasilla-Fishhook Road Wasilla, AK 99654 Nance: Del -fart Construction i Address: P.O. sox 940304 City: Houston State: K Zip Code: 99694 Well Site: Broadwater Heights Lot: 2 Block: Tr. A Additional: Nell Depth: 305ft. iIFrom: Tat. Formation: Below Ground: 303 ft.9 9 fill Above Ground: 2 ft' 9 58 silt, gavel 58 62 damp silty gravel 3aUMin: 1 62 66 silt itatic Level: 251 ft 66 113 graveL silty water using: 144` of 6" ID Steel 11' 120 fine silty sand water 120 124 silt Irger pipe: none= 124 132 wet silt, gravel acreeued: non 132 139 gravel 139 154 soft bedrock ?erFcirated: 105, to 710 ryl 154 189 hard bedrock. little water 3routede BenonIIB, 89 214 softhedrock Depth: 201+214 305 hard bedrock Develop. Method: �i Else of Well: Residential , Drilling Method: Rotary] Fluids Used: none; Pump Installed: non `--- — — Ben Mattson _....-.� Bene Drilled: 9-18-2014 Driller: Development Services Department Building Safety Division R, on -Site Water & Wastewater Program 4700 Elmore Ruad O, Bax 196654 _s r , -y Marts Begich Anchorage, AK 99507 Mayor wyry':� (gor, m3--1904 Pump Installation Log Well Drilling Permit Number. SW osP14130 Date offSsue: 8-&2014 Pnrr.•3 Frlenti iention Number:05013138000 L1e20g1aA vy ••. •'••,•• V•,••• Mvid ne Lot 2 D'If a. Eagle River 5T] Ea91e ftvs AK 09577 Pump Installation Date: ]_1.2015 I Pump Intake Depth Below Top of Well Casing: 212 feet Pump Manufacturer's Name: Gourds 7mmO hp Pitless Adapter Burial Depth: is feet Pitless Adapter Manufacturer's Name: £amaeu Pitless Adapter Installer: Others Well Disinfected Upon Completion? 0 Yes Li Na Method of Disinfection: CNm3nelrsblc e Comments: Name: Wheaton Water Well, Inc I 190 N. WasAI.Flshlmak Road MO.. RK 99654 Attention: The pump installer shalt provide a pump installation log to the DST) within 30 days of pump installation. On -Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141349 Tax Code Number: 05013138000 Work Type: WellSeptic Initial Permit Effective Dates: September 05, 2014 to September 05, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: BROADWATER HEIGHTS Site Legal Address: BROADWATER HEIGHTS TR A LT 2 G:0253 Owner/Address: STEVENSON DAVID 18207 STILLWATER DR EAGLE RIVER AK 995770000 Site Mailing Address: 12011 W SKYLINE DR, Eagle River This permit is for the construction of: Lot Size in Sq Ft: 29749 Total Bedrooms: 4 Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By By: tet/ Date: Date: MUNICIPALI'T'Y OF /ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-131-38 Property owner(s) David R. Stevenson Mailing address 18207 Stillwater Drive Eagle River, AK 99577 Site address 18221 Stillwater Drive Eagle River, AK 99577 Day phone Legal description (Sub'd., Block & Lot) Broadwater Heights, Tract A, Lot 2 Legal description (Township, Range & Section) Lot Size 29,749 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: 10 all that apply) Absorption Field Q Septic Tank El Holding Tank ❑ Privy ❑ Private Well El Water Storage ❑ APPLICATION IS AN: Initial F] Upgrade ❑ Renewal ❑ TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings I(��rD) Sup L AUG 2 0 2014 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. 1 further certify that this is in accordance with applicable Municipal Codes. >Y.t� Z at,,J� (Signature of property owner or authorized agent) Permit/Rush Fees: 551,619' 21S" : "189- Date of Payment: ? l2tl Iq Receipt Number: 0"14g( i'it Permit No. 05 P1` -\ 13`iq Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. x❑ e August 20, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 2, Tract A, Broadwater Heights Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The developer of Lot 2, Tract A, Broadwater Heights Subdivision intends to construct a four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a well and septic system to accommodate the four-bedroom home proposed for the lot. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system and alternate site. Also identified on the plans are the locations of the proposed well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot indicated Silty Gravel with Sand (GM). The percolation rate was determined to be less than 5 minutes per inch. We have designed the new trench with an application rate of 1.2 gallons per date per square foot. We are proposing to place a 1,250 gallon septic tank and a 50' long trench by 5' wide with a 4' effective depth. The total depth of the system will be 7' with the distribution line at 3' below the existing surface. The ground surface on the lot slopes to the south in the area of the absorption trench. The trench will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells Lot 2, Tract A, Broadwater Heights August 20, 2014 Page Two in the area or those to be constructed in the future. 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 reserve 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, �L� Michael E. Anderson, P.E. Attachments BROADWATER HEIGHTS SUBDIVISION TRACT A, LOT 2 29,749 SF i JAMIE DOPE 1 1 I I I 1 I TRACT A-1 .' 49th MICHAEL E. ANDERSON NOTE: 0 N87'13'5O"E 180.26' Utility Easement — O0" -V - I I Proposed Well Four Bedroom Home LOT 4A I re I 1,250 Gallon / Septic Tank 'Co 2CO f Sv SV* / MT ! / CO ®TM1 _ CO 50' Long x 5' Wide / � o x 4' Effective Degth / Alternote gate Absorption Trench. i Septic LEGEND: Shed TH – Test Hole CO– Clean Oyd \ O MT – MonW Tube FSV –4o1 Splitter Voly� o- SV y Septic Vent c\ F V' – Flow Diverter Valve \ 90.80 ,' TRACT A -3A ` / No Excessive Slopes or Breaks in Topography Within 50' of the Proposed Wastewater Systems. W No Surface Water Within 100' of the Proposed-q�tewater System. 1 ST/` If %j q�n I Existinc C 1 Well " SITE PLAN SCALE 1" = 40' ` `� X TRACT A-1 .' 49th MICHAEL E. ANDERSON NOTE: 0 N87'13'5O"E 180.26' Utility Easement — O0" -V - I I Proposed Well Four Bedroom Home LOT 4A I re I 1,250 Gallon / Septic Tank 'Co 2CO f Sv SV* / MT ! / CO ®TM1 _ CO 50' Long x 5' Wide / � o x 4' Effective Degth / Alternote gate Absorption Trench. i Septic LEGEND: Shed TH – Test Hole CO– Clean Oyd \ O MT – MonW Tube FSV –4o1 Splitter Voly� o- SV y Septic Vent c\ F V' – Flow Diverter Valve \ 90.80 ,' TRACT A -3A ` / No Excessive Slopes or Breaks in Topography Within 50' of the Proposed Wastewater Systems. W No Surface Water Within 100' of the Proposed-q�tewater System. 1 ST/` If %j q�n I Existinc C 1 Well " SITE PLAN SCALE 1" = 40' ` `� LOT 2, TRACT A, BROADWATER HEIGHTS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: <5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.2 GPD/SF/5 SF (Width) *.50 (Red. Factor)= 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trenches Flow Line Elevation in Trenches to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 3' Cover Over Absorption Trenches and 4' Cover Over Septic Tank. 2-6- 6" 1 .O 4' 5' Geotextile Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) o. NOTE: Grade Area Over Trench to Drain Away, Minimum 6' Separation From Bedrock. ...... Minimum 4' Separation From Groundwater. Is..A Minimum 100' Separation From Private Wells in the Area. 0�& Minimum 100' Separation From Surface Water or Streams: ♦# 49th 'a MICHAEL E. ANDERSON No. CE -4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 DEPTH (feet) 1- 2 3 4 5 6 7 8 9 - SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 2, TRACT A, BROADWATER HEIGHTS PERFORMED FOR: GREG DEHART DATE: 7/29/14 PROJECT No.: PARCEL ID#: TECHNICIAN: JKB TEST HOLE 1 OG/OL SI OPF Silty Gravel w/Sand GM N 0 10 WAS GROUND WATER ENCOUNTERED? No IF YES n WHAT DI DEPTH OF WATER AFTER MON[TORMG:G:None 0 2% 11 DATE OF MONITORING: 8115/14 -� - 13 15 Bottom Hole @ 15' 16- 17- 18- 19— DATE 6171819 y� c 49th MICHAEL E. ANDERSON No. CE -4381 .< DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) WgTER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 7/29 1 10:09/10:19 10 1.25^/7.50^ 6.25" 2 10:20/10:30 10 1.50'/7.75" 6.25" 3 10:31/10:41 10 1.25'/7.50" 6.25" 4 10:42/10:52 10 1.38"/7.63" 6.25" 5 10:53/11:03 10 1.50"/7.75" 6.25" 6 11:04/11:14 10 1.38"/7.63" 6.25" PERCOLATION RATE: 1.66 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGfNEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 9/26/12 MUNICIPALITY OF ANCHORAGE o Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 050-131-38 Certificate of On -Site Systems Approval Expiration Date: /3- 0, 2 3 Legal description BROADWATER HEIGHTS TR -A LOT 2 Site address 12011 W Skyline Dr. Eagle River Current property owner(s) Ted Petersen X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 2/17/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLiune 2022 „UIIPALITY •Fr CHE SII Development Services DepartmentF Phone: 907-343-7904 On -Site Water & Wastewater Section —� Fax. 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-131-38 Complete legal description Broadwater Heights Tr A Lot 2 Location (site address) 12011 W Skyline Drive, Eagle River, AK 99577 Current property owner(s) Ted Petersen 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑i Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 9yrs - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5Y6 Waiver Fee $ Date of Payment 1.1134a 2 3 COSA # asr-X3/6-- 3 � 0 goq g ID Date of Payment Waiver # COSA Application—June 2022 Broadwater Heights Tr A Lot 2 050-131-38 3.7 09/18/2014 305 144 3.62 24+ 02/06/2023 Forge Engineering 210 01/25/23 50" 2/8/23 10/8/2014 6.4 2.7 N/A > 600 48 Benjamin Schiller, P.E.2/10/23 (907) 522-7773 MUNICIPALITY OF ANCHORAGE ® Ad Development Services Department 4 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-131-38 1. GENERAL INFORMATION Expiration Date: re b 02 0 Complete legal description BROADWATER HEIGHTS TRACT A LOT 2 Location (site address) 12011 W SKYLINE DRIVE EAGLE RIV%AK 99577 Current property owner(s) SEC. OF VETERANS AFFAIRS... Day phone Mailing address Real estate agent 3401 W END AVENUE STE. 760W, NASHVILLE, TN 37203 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 $ 1L/5 Date of Payment b �J9 Receipt NumberU'(f?q()p COSA # 05C l `3n 1594 b 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4661 NATRONA AVENUE, ANCHORAGE, AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 11/20/2019 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, V 1�� 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 they law3 system and maintenance. The operational life of all well and septic systems are subject toj,-' ' 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 FWC5 and Anderson Construction & Engineering. JOCHAn J4 K- -. No. C8 4i6li 6. DSD SIGNATURE 11/20/191 ' 141 System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipula p§(((((((f(( y OF WATER AND �' q By: 7 Original Certificate Date: i:� 0, 1 1 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other COSA Checklist Legal Description: BROADWATER HEIGHTS TRACT A, LOT 2 Parcel ID: 050-131-38 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 9/18/2014 Total depth 303 ft Cased to 144 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 7/6/2018 Static water level at beginning of test 228 ft. Well production at time of test 1.7+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.91 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 10/3/2019 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 5 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50” Standpipes/foundation cleanout per record drawing Date of pumping 7/6/2018 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: House has been vacant for 18+ months. D. ABSORPTION FIELD DATA Which system tested (date installed) 10/8/2014 ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 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 2,000 gallons Adequacy test date 7/6/2018 Results Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 7 in Elapsed time 170 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No *5’+ ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If 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 ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *Per code at install. 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. 11/20/19 E.•gE BV •- t ! Municipality of Anchorage• °�P i_ o On-Site Water and Wastewater Program ` •` 1J (907) 343-7904 SA ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-131-38 Expiration Date: 0C+ 1 3) < C' 1 g 1. GENERAL INFORMATION Complete legal description BROADWATER HEIGHTS TRACT A,LOT 2 Location (site address) 12011 W SKYLINE DRIVE,EAGLE RIVER,AK 99577 Current Property owner(s) CHARLES &JOANNE EUNICE Day phone Mailing address 6117 CENTER HILL DRIVE,BLACKSHEAR,GA 31516 Real Estate Agent Day phone 134SS , 2. TYPE OF DWELLING: <4' . �'";99 ® Single Family (w/wo ADU) /, ' `�o ❑ Duplex •:c. u' 6, �, , ❑ Multiple Dwellings (Single Family and/or Duplex) (2.y N 3. NUMBER OF BEDROOMS: 4 6g 4a 9 S 7 EZ \ 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank 0 Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 Waiver/Variance request for: Distance: Received by. - Date: 7/i 3//e COSA to be released t• : e•.: 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 ANDERSON CONSTRUCTION &ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 07/07/2018 <o< o° F o 0 0 0$01.<OD O< O o J p n • 0 ......p 0 0 0 0 0 6. DSD SIGNATURE s� MICHAEL'N. ANDERSON ,'4:-;•s v/ System #1 Approved for 4/ bedrooms. ('(‘')'.•• System#2 Approved for bedrooms. .,;, ,'t,. `•...;" Disapproved. Conditional approval for bedrooms, with the following stipulations: Li Q� <, E OOC/‘'P 4 `moi,-<>� nFlr•�t' ' By: 7 . l Q 77/12 Cch/uod Original Certificate Date: )(L 13) 0018 J The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist#_of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: BROADWATER HEIGHTS TRACT A,LOT 2 Parcel ID: 050-131-38 A. WELL DATA Well type Private If A, B, or C provide PWSID #_ Well Log (Y/N) Y Date completed 911 812 01 4 Sanitary seal (Y/N)Y Wires properly protected (Y/N)Y Total depth 303 ft. Cased to 144 ft. Casing height(above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 9/18/2014 7/6/2018 Static water level 251 ft. 228 ft. Well production 1 g.p.m. 1.7+ g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate 12,bet mg/L Arsenic: ND ug/L Date of sample: 7/6/2018 Collected by: FIRST WATER CONSULTING B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/8/2014 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y _ Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/6/2018 Pumper ONE STOP C. ABSORPTION FIELD DATA Date installed 10/8/2014 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type 5-WIDE TRENCH Length 54 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.5 ft. Eff. absorption area 540 ft2 Monitoring tube Y Depression over field N Date of adequacy test 716/2018 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 7 in. Elapsed Time: 170 min. Final fluid depth . 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in.High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES 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 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ _ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 10'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'__ Building foundation 10'+ Water main 10'+ Water Service line.__10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+___ F. COMMENTS Vacant system presoaked per code prior to testing. G. ENGINEER'S CERTIFICATION c Or• �1[4f' I certify that I have determined through field inspections and -'•. �► �•'•� � review of Municipal records that the above systems are in 1*:4 9TH '�r conformance with MOA COSA guidelines in effect on this date. 1444- `! Engineer's Printed Name MICHAEL N.ANDERSON,PE MICHAEL N. ANDLRSCN: Z s CE Date 07/07/2018 rpt�f�,• rLQ//(��[�/ •:j J✓ .• • •LC•• '• Sys qk • GEE` ' COSA canary sheet 2-6-15.doc t Parcel LD 050-131-38 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 ,I Certificate of On -Site Systems Approval Expiration 1. GENERAL INFORMATION SI P G 1 2415 Complete legal description Broadwater Heights, Tract A, Lo 5�f Location (site address) 12011 W. Skyline Drive Eagle River, 57 a` r:nrrPnt PmnPrfv nwnP.rfsl Christopher DeHart Dav phone Mailing address Real Estate Agent P.O. Box 940304 Houston, AK 99694 2. TYPE OF DWELLING: (] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four Day phone t9--;-tC 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well i] Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: �—�" ` Date: 1- Z ^<S' COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ (cq 7 q1 9`d � 111_4p Waiver Fee $ Date of Payment ��l'' �S Date of Payment Receipt Number O� 27 ul Receipt Number COSA# 0'ic(5]y7 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 Anderson Engineering I. ' P,.00 -B 73 Ah ox 2407ncora e, AK 99524 Addfess.`g Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE _ System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Phone 522-7773 Date 9/1/2015 bedrooms, with the following 49 ra� tas AFL E. ANDERSON CE -4381 By: Original Certificate Date: The M icq yrage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue MMI - If more than 1 septic system is on the lot: COSA Checklist # _ _of Structure served by this system Certificate of On -Site Systems Approval Checklist Broadwater Heights, Tract A, Lot 2 Legal Description: A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 9118/14 Sanitary seal (Y/N) Y Total depth 203 ft Cased to 144 ft FROM WELL LOG 9/18/14 Date of test Static water level 251 ft. 1 Well production 9 -P.M. WATER SAMPLE RESULTS: Coliform 0 coloniesll00 mL Nitrate 2.44 mg/L Arsenic /J D ug/L Date of sample: 8/26/15 B. SEPTICIHOLDING TANK DATA Parcel ID: 050-131-38 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION ft. Collected by: And. Engineering Tank Type/Material Septic/Steel Date installed 10/8/14 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping New Const. pumper C. ABSORPTION FIELD DATA Date installed 10/8/14 Soil rating (g.p.d./fe or ft2/bdrm) 1.2 GPDISF System type 5' Aide Length 54 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.5-8 ft. Eff. absorption area 540 if Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons _ "Pump on" level at in. "Pump off" level at Datum Cycles tested _ Manhole/Access(Y/N) in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES 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 %75' Public sewer manhole/cleanout >100' Sewer /septic service line Holding tank >75 Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: r Building foundation >50 Property line Absorption field >5 r Water main >10Water service line Surface water >1 00 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >1 Or Building foundation > 10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 9/1/2015 COSA brown sheet 10-10-12.doc Water main N/A Driveway, parking/vehicle storage >10, in. MEL E. ANDERSON.:,,*; CE -4381 .9./_fit �,•E�'�� 9'°+y0fES5lONp ��® DETAIL NOT TO SCALE NE CORNER OF LOT 2 NW CORNER OF LOT 4 RECOVERED__,,- I o 5/8" REBAR n S yLINE DR' - — POWER �} (P� )�---•--_' N87'73'50"E 180.26(R) T N87"15'41"E 180.25'(0)— m. LOT 1 4" PLASTIC RISER (TYP.) 0 t5 O"' ,--NAT. GAS �y zz.o• 40.3•- S �'.• ro� 1 20UTILITY n O 4jb�L EASEMENT Crj o 2�ho SHED 4 PLASTID ti�h 36 13 h' y.qy; µ d';" _.. NO FND . PIPE z L Lu 1 4.pMU (MLE)=MEASURED DATA 29,749 S.F, (R)=RECORD DATA PER PL ohe=OVERHEAD ELEC. �rrn c u COVERED DECK w W/STAIRS O 40.1' 9. .. 24. I . DWELLING RECOVERED 5/8" REBAR (SEE DETAIL) z z 10' UTILITY EASEMENT N�Np." ..._ �(o \ LOT 4 RECOVERED -0 ^..,,,.,w --5/8" REBAR FND= PI OUNDATON M TYCAL L=90.80•(8) (TYP.) CO. = CLEAN OUT L=90.9P(M) SATELLITE \ `q DISH 1"-a0' NOTES: 1. EXCEPTING FOR GROSS NEGLIGENCE, THE UABILRY FOR THIS SURVEY SHALL NOT EXCEED THE COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS & CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY SUBSTANTIALLY COMPLIES WITH ASPLS MORTGAGE STANDARDS. 5, THIS SURVEY PERFORMED FOR DeHART CONSTRUCTION, IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION, REUSE THIS DRAWING FOR ANY PURPOSE NOT STATED ABOVE WITHOUT THE EXPRESS WRITTEN CONSENT OF ALASKA RIM ENGINEERING, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS. OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. RECERT S4cjTH* ..;9.. ........s.. E.nrllneers: Planners: �'R0• RT U FARMER1;o — Orsi •• 10615—S •,' I HEREBY CERTIFY TH ��fd;•••••.•••••"p�sJ UNDER MY DIRECTION R4�ESSIDNAL �' BROADWATER HEIGHTa i PLAT No. 71-73, ANC ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE RD., SUITE 1 PALMER, ALASKA 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: 0krim0alaskarim.com : WEB: www.alaskarim.com WO: 1400659 GRID: NW0253 PAGE: 1 of 1 oyors SCALE: 1" = 50' 1 FILE: 1400659RC A MORTGAGE INSPECTION WAS PERFORMED I THE FOLLOWING DESCRIBED PROPERTY: JBDIVISION "TRACT A", LOT 2, AGE RECORDING DISTRICT, ANCHORAGE. ALASKA. OF JUNE. 2014. @2014