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Home My WebLink AboutALPINE WOODS BLK 6 LT 4's Alpine Woods Block 6 Lot 4 #015-234-44 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161008 PID Number: 015-234-44 Dwelling:* Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name MARK CAYLOR ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 12210 KENLIEN CIR, ANCH AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot APLINE WOODS BLK 6, LOT 4 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'+ 50r+ TANK ❑ Septic ❑ S.T.E.P. E3 Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1000 Gal. Surface Water 100'+ I Material Number of compartments Lot Line I10'+ NA STEEL 2 Foundation 5'+ LIFT STATION Manufacturer Capacity Remarks HOLDING TANK FOR SHOP ONLY Gal. NO BEDROOMS IN GARAGE Alarm location Electrical installed by PIPE MATERIAL Nouse to tank 3034 Tank to Installer drainfield MIKE N ANDERSON, P.E. Drainfield CO/MT inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection151 2/3/16 Location and description na GARAGE SLAB 3rd 4'" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 3 mo-,. F•. t. o � J_,�1 Conditional Approval: Date d �- -. �1F • 447`1 io . .. .• .......... ti MICHAEL N. ANDERSCN•;�' � ¢ `�'•, c� 94 9 ,•:.% Septic System (/ Z6 Approves I -- Date Zt.,5�? Note: this approval does not include well permit requirements.��»�� k,uv UUIU4110) Permit No. OSP161008 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ALPINE WOODS BILK 6 LT 4 MARK FCO Col TC01 TCO2 TC03 A B 5 2 / 5 2 8 2 11 / 13 3 / / I / 'DRIVEWAY / T TC 002 NEW 7000 G \ TANK LOT / I I / SEPTIC AREA \i ° BENCH, GARAGE SHB I / PID No.: 015-234-44 Li 0 SMA OCK AIG -WALL -S-- SA BUILT SCALL 1 "=30' SEPTIC SECTION N.T.S. 200' COMM. WELL RADIUS Ar AW ®®�P�................ �qs®� a49TH '• �...if ...moi. �..11...tl...�....i..� MICHAEL N. ANDERSON*.i�6MINF No. CE 9469•• 5-25-21 On -Site Water and/or 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: OSP161008 Tax Code Number: 01523444000 Work Type: SepticTank Initial Permit Effective Dates: January20, 2016 to January 19, 2017 Design Engineer: ANDERSON CONSTRUCTION & ENGIN Subdivision: ALPINE WOODS Site Legal Address: ALPINE WOODS BILK 6 LT 4 G:2738 Owner/Address: CAYLOR MARK T & TONYA L 12210 KINLIEN CIR ANCHORAGE AK 995162469 Site Mailing Address: 12210 KINLIEN CIR, Anchorage Lot Size in Sq Ft: 36070 Total Bedrooms: 6 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N 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. Receive( Issued B Municipality of Anchorage P.O. 80x 1 6650' .4700 Elmore Road - Anchorage. Alaska-99619-6650 • {907) 343-7904 • Fax (907) 343-7997 http;ffim,munl.oralonsite Devehoement. °Servicbs Division MUNICIPALITY OF Community Development. Department Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel l.D. Property owner(s) Murk. C w y l t9✓ Mailing address (7 2 /O .t r h Day phone Site address lae rn�/ Legal description (Sub'd., Block &Lot) _ R\ f -me- co VS (p L L4 Legal description (Township, Range & Section) Lot Size 3 b09 0 Sq. Ft. Number of Bedrooms qVV LC' on ivl o 5t-ap -C() APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field E] Initial Single Family (SF) ADU) W/�./,�,C� ild Septic Tank Upgrade F](w/wo Duplex (D) ❑ $�(�/1 Holding Tank Renewal ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ i Water Storage ❑ l_ - A /6 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: cl P� 1101^ 40tv'k Distance: * 1 certify that the above information is correct. I further certify that this is in accordance witTi applicable Municipal Codes. (Signature property owner or authorized Permit/Rush Fees: o9! -I - % Waiver Fees: 'W)5-4 '* o�-I Date of Payment: _' I�( C'09-3sDate of Payment: ( o Receipt Number: Q Receipt Number: Permit No. MOO (o � ON Waiver No. (!l6w (41 o.3 Permit App_::- ::-..:c: Jan. 20, 2016 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Holding Tank Permit Legal: Alpine Woods S/D, Blk 6, Lot 4 (Waiver request) To Whom it may concern: This is a request for a waiver to install a 1000 gallon holding tank on the above referenced lot. As previously stated the garage has no bedrooms just a single toilet for the shop. The following are my comments concerning AMC 15.65.070. A -K. A. Public sewer is not available. B. The holding tank will meet all of the required separation distances. C. A 2000 gallon tank is the min. size but that is for a house NOT a shop with single toilet. The code does not cover this type of situation. D. The tank will be accessible by pumper truck, see site plan. E. Floatation is not a issue on this lot, we have no water table at the elevation the tank will be installed. F. The tank openings will have the correct 6" openings. G. The tank will have water tight lids. H. The tank will be insulated. I. The tank will have a high level alarm. J. The tank will meet the corrosion protection per the UPC. This waiver and holding tank permit will not impact any of the neighboring properties or violate any MOA codes. Please call me if you have any questions. Sincerely Michael N. Anderson, P.E. 4661 Natrona Ave. Anch, Ak 99516 727-8864 Jan. 14, 201f LP Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Holding Tank Legal: Alpine Woods S/D, Blk 6, Lot 4 To Whom it may concern: This is a request for a holding tank permit on the above referenced lot. The owner has built a small garage with a single toilet for minor usage. The lot is serviced by a functioning on-site system with community water but due to the topography a STEP tank would be required which is expensive therefore the hold tank option was chosen. The lot slopes to the west at about 20 percent, see the drawing. This holding tank will not impact any of the neighboring properties. Please call me if you have any questions. Sincerely 44—f t Michael N. Anderson, P.E. 4661 Natrona Ave. Anch, Ak 99516 727-8864 ALPINE WOODS BLOCK 6, LOT 2 ALPINE WOODS BLOCK 6, LOT 3 PROPERTY LINE If II \ ALPINE WOODS SHOP W/ TOILET / cl / COMM. WATER BLOCK 6, LOT 8 u ¢ LINE EXISTING 7 BEDROOM PROPERTY LINE HOUSE \ EXISTING SEPTIC \ ALPINE WOODS TRACK B ALPINE V BLOCK 6, V / EXISTING CLASS EXISTING CLASS A WELL 200' A WELL FOR RADIUS ALPINE WOODS ALPINE WOODS BLOCK 6, LOT 6 SUB. I I Septic Design Prepared for MARK CAYLOR ALPINE WOODS, BLOCK 6, LOT 4 Anchorage, Alaska T ichael N. Anderson, P.E. DATE: 1/14/2016 1NATRONA AVE DRAWN: DJR ANCHORAGE, ALASKA 99516 SCALE: 1"=100' (907) 727-8864 / FAX: (907) 345-1391 ALPINE WOODS BLOCK 6, LOT 7 MICHAEL N. Al No. E R., PROPERTY / " y1040 / 14 u L O J 1 sr� / TCO ITC AM NO WELL, LOT SERVICED BY COMM. WELL EXISTING ` l HOUSE i ly WtG/ 4.-SEPTIC`PANK LJ SEPTIC '0/ 0 EMENT T&E FAS 100'+ FROM / r r J / r .. TANK HOLDING TANK SHOP r / / " y1040 / 14 u L O J 1 sr� / TCO ITC AM NO WELL, LOT SERVICED BY COMM. WELL EXISTING ` l HOUSE i ly WtG/ 4.-SEPTIC`PANK LJ SEPTIC '0/ 0 EMENT T&E FAS 100'+ FROM NEW CREEK TO TANK HOLDING TANK SHOP Septic Design Prepared for MARK CAYLOR ALPINE WOODS, BLOCK 6, LOT 4 Anchorage, Alaska Michael N. Anderson, P.E. DATE: 4601 NATRONA AVE DRAWN: ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: PROPERTY LINE ALPINE WOODS BLOCK 6, LOT 5 1000 GALLON HOLDING FOR SINGLE TOILET IN 1/14/2016 8A1CT 1.=30' Municipality of Anchorage Page of ,3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: �� Dd "2� PID Number: �/� ` a 3 /- y/ Name: Wastewater System: ❑ New ❑ Upgrade Address: Id,?10 /e,,VIL/C,41 C-1 R_ C- I— ABSORPTION FIELD 1.9 9,51(P Phone: No. of Bedrooms: is Deep Deep Trench C3 Shallow Trench ❑Bed E3 Mound ID Other LEGAL DESCRIPTION Soil Rat! Total Depth from original grade: GPD/Sq. Ft. �c� Lot: Block:/ Subdivision: 6 Depth to pipe bottom from original grade: Z/, Gravel depth beneath pipe L Ait -. 0 o S _� Ft. 1 .S Ft. Township: Range: Section: Fill added above original grade: Gt`% ravel length: / v O's Q - G), .5 Ft. O & /P s /I Ft. L: El New El Upgrade Gravel width: Number of lines: Distance between lines: /f 13 Ft. Ft. Classification (Pri Total Depth: Cased To: Total absorption area: Pipe material: Ft. Ft. / j W SQ. Ft. IAS r d 0 Driller: Date Drilled: Static Water Level: Installer:_ _rt.J Cx Date installed: Ft. Cj u l/0/-+ Yield:Pump Set at: Casi eight Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: A 'f4, -k1 Capacity in gallons: From Tank Field Station Tank Sewer Lines / . jgA 6 U Well- n� t �00 Material: CrL Number of Compartments: IP - Surface Water /00 � /00�t �" `— LIFT STATION Lot / / Size in gallons: Manufacturer: Line Foundation / lA ` J �_ "Pump on" level at: "P ff" level at: High water alarm at: Curtain Pump Mak odel I Electrical Inspections performed by: Drain Remarks: �� it , , S pvM��e�� BENCH MARK n �I Location and Description: 8 \ _ -f0A 00,V lc- Shco�n ;R/c.. cW ./t L. C4ie,9 17U/I- i S1c CJESI Sicp� 0+/,/Ovsc, Assumed Elevation: Ft - ENGINEER'S SEAL -110 Ar .� S & S ENGINEERING Inspections performed by47 tes: 1st -��"9�•»•` •• 4 •»«~.,.»•'•..� Eagle River, Alaska 99577 2nd S' a i' 98 y.« ° ' •� -a ROBERT C. COWAN �@ Department of Health and Human Services approval�`'�;�� cF"8s°1 Reviewed and approved by: -'0:14/ �f P Date: G� z3�*0 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW970221 PAGE 2 OF 3 MunicipaUt of Anchora e DEPARTMENT OF HEALTH AND HUKAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT4, BLOCK 6, ALPINE WOODS P.I.D. NO. 015-234-44 LOT 3 I FLOW DIVIDER (FD) j (NO CLEANOUT) I C01 -� MT1 I q / II � / I I I i TH /NEW TRENCHES #1 W DBL DBL 1 CO3 MT2I I TOM® MT3 I A CON( I C0 STEP � II II ,, T I I I MT` ��, � C04 TH #2 EXISTING TRENCH _ —E�iT � UTIY E LITA 10 S L NEW 0 2000 GAL. Z�L —Ofw N0Cn —mD LOT 4 B�FC ST1 SEPTIC TANK 200' COMMUNITY WELL RADIUS SCALE 1" - 40' OF Alt -"N �r„(iael/-�;:'�al�aw. esre r.:rc+.c.ca"amao. LOT 5 �f � 3 ROBERT C. COWAN �it C"', .. CE - 8801All PERMIT NO. SW970221 PAGE 3 OF 3 Municipalit of Anchora e DEPARTMENT OF HEATH AND HUKAN SERVICES ENVIRONMENTAL SERVICES DIVISION R0, Bax 196650 • Anchorage, Ataska 99519-6650 • TeL hone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WPELL INSPECTION REPORT LEGAL LOT 4. BLOCK 6. ALPINE WOODS P.I.D. NO. 015-234-44 ST1 ST2 100.1' NEW 94.2 1250 GAL SEPTIC TANK MTI C01 CO3 MT2 CO2 MT3 C01 = 95.8' C04 CO3= 97' H � /-0O2 = 98.9' H H /-004 = 97.4' COl = 92.4'CO3 = 93' w CO2 = 92.4' SR C04 = 93.2' MTI = 84.9' MT2 = 84.9' MT3 = 85.3' ♦ TH#1 ♦ TH#2 NO WATER FOUND NO WATER FOUND 799' B.O.H. 79.3' B.O.H. 10/23/96 5/21/98 S FINAL GRADE d SCALE 1' = 40' A B C FCO aa 6' ST1__ 10.5' 27' ST2 72' 13' 40.5' DBL1 71.5' 14.5' 42.5 D B L2 71.5' 15' 43.5 DV 71' 16.5' 44.5' FD 75' 52' C01 46' 83.5' CO2 73.5' 1 56' MT1 47' 79.5' MT2 70' 57.5' CO3 86.5' 76.5' C04 106' 73' MT3 88.5' 76.5' MT 89' 57' CO 84' 1 20' 41.5 P.I.D. NO. 015-234-44 ST1 ST2 100.1' NEW 94.2 1250 GAL SEPTIC TANK MTI C01 CO3 MT2 CO2 MT3 C01 = 95.8' C04 CO3= 97' H � /-0O2 = 98.9' H H /-004 = 97.4' COl = 92.4'CO3 = 93' w CO2 = 92.4' SR C04 = 93.2' MTI = 84.9' MT2 = 84.9' MT3 = 85.3' ♦ TH#1 ♦ TH#2 NO WATER FOUND NO WATER FOUND 799' B.O.H. 79.3' B.O.H. 10/23/96 5/21/98 S FINAL GRADE d SCALE 1' = 40' Municipality of Anchorage . �• .� DEPARTMENT OF HEALTH & HUMAN SERVICES' 4 ••!,'% �.. Mf •• 11 HLN1 ♦IfINlNlIMNl.! 825 "L" Street, Anchorage, Alaska 99502-0650 XL— SOILS LOG — PERCOLATION TEST r'• (� -Y3 C. COWAN j,'• '• PERFORMED FOR: F� A ST UV r DATE PERFORME[1f° LEGAL DESCRIPTION: "11 'V ,S W 00 0 ,•S SAb Township, Range, Section: DEPTH 7- #- S) fid L4 ./ a SLOPE SITE PLAN (FEET) L� � i 23 �- 4qa, c Sd• S, ,�, � 2 ;. 4 5 - 6 5-4 7 �• `'' �s S «,T- G o2q„ 16, � 8 -�: 9 v �G 10 ~� WAS GROUND WATER J ENCOUNTERED? N l S 11 ` L IF YES, AT WHAT 0 DEPTH? P 12 t` ` E 13 a Depth to Water After .1 Monitoring? Date: S 14 �t 15 re 16- 17 6 17 4 18 19 mmmmuawmmm ■■■MORM■■■ ®®®® • Water.. 20 -� I PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER cul TEST RUN BETWEEN FT AND FT COMMENTS � S 1/'ZA SgnvA r of .e- i /fq n/ , + t a. 7-6/e 'V H L S Hu w N C a./ tG S T HO L E- At I S1011- J S3 y&�7ti S ENGINEERING PERFORMED f1act I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANC1EA11110 AY-M-MOE%pKOfSUICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / Z .l' /9 72-008 (Rev. 4/85) e0-\ Nell C PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970221 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:STOUT FRED L & DOROTHY A OWNER ADDRESS:12210 KINLIEN CIR ANCHORAGE, AK 99516 PARCEL ID:01523444 LEGAL DESCRIPTION: ALPINE WOODS BLK 6 LT 4 LOT SIZE: 36070 (SQ. FT.) NUMBER OF BEDROOMS: 7 THIS PERMIT: 7 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 7/29/97 EXPIRATION DATE: 7/29/98 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: "��✓� DATE: 7/ )-q / -7-7 ISSUED BY: ` DATE: Z 9� S&S� 7IneeRInG HEALTH AUTHORITY APPROVALS July 2, 1997 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER&WATER MAIN EXTENSIONS REFERENCE: Lot 4, Block 6, Alpine Woods Subdivision SEWER&WATER Request you issue a permit to upgrade the septic system INSPECTION serving the existing seven bedroom house on the referenced property. A test hole was excavated and a percolation test performed. ENGINEERING STUDIES The approximate location of the test hole is located on the ANDREPORTS attached site plan. The monitoring tube within the test hole has been checked and found to by dry. WELL INSPECTION & FLOW TEST This property is served by a Community Water System. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the SITE PLANS installation of the proposed septic system. If you require additional information, please contact us. ROAD DESIGN Sincerely, SOILTESf' Robert C. Cowan, P.E. RCC/mg PERCOLATION Enclosure TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 0 ON, adz na 0 ?4WD rn c; i2 SOH -3 z 1" = 60' r O a 01 DESIGN �oRA/Nq�F � co�RSF SITE—PLAN 5 mx Dnz�� 1 c z 1 on m0-` 1 o�x Z� -- 1 = 00 - S 1 mm 1 c 1 1 oll 1 o y ° EXISTING r O Z mC) D O p 7 BDRM a y �— N 1° HOUSE 0) z m H r r a =Wc„ 1 a P D 1 -gy' 11 r0 y �r r � r o a mDo�iV <Z.nZp \ a rri a z _ux m o L Z `n x7 U <u'g� m Z myul< ylm�< nrjo nodi z" Z r O H lSEPTIC AREA DESIGN �oRA/Nq�F � co�RSF SITE—PLAN 5 mx Dnz�� 1 c z 1 on m0-` 1 o�x Z� -- 1 = 00 - S 1 mm 1 c 1 1 oll 1 o y N Lo -P W 1 N`y O O -I d � 1 0 LTi Cn ONo -Izmmm II r 0-0 O II Z m II Oo C� 1e�j W Q m t�7 -o > � O c ey ? _ 0.O O Z 2 , NyN « Dec �nAm -I NZ, r cc�o� O H, O_zm a ZDDN=E�=tn Z A O . M, oNF z z r ;m,zy� mm -I( i.M-jm cnvMO'* 0 -mnZ �o A A Z = p0o / D Zm O� / z z 0 Z N / KINLIEN CIRCLE ° EXISTING O �P Hl! Z mC) D O p 7 BDRM a y W ° 0 xn 1° HOUSE o z 10 ty H r r a =Wc„ 1 a P o-ml7� G- n b 1 -gy' 11 r0 y �r r Z > C) � o o a mDo�iV <Z.nZp \ a AA a z _ux m o L ai `n x7 U N Lo -P W 1 N`y O O -I d � 1 0 LTi Cn ONo -Izmmm II r 0-0 O II Z m II Oo C� 1e�j W Q m t�7 -o > � O c ey ? _ 0.O O Z 2 , NyN « Dec �nAm -I NZ, r cc�o� O H, O_zm a ZDDN=E�=tn Z A O . M, oNF z z r ;m,zy� mm -I( i.M-jm cnvMO'* 0 -mnZ �o A A Z = p0o / D Zm O� / z z 0 Z N / KINLIEN CIRCLE r ° O �P Hl! Z mC) D O p z �O W ° 0 xn O�Cdm V1 z o � N Lo -P W 1 N`y O O -I d � 1 0 LTi Cn ONo -Izmmm II r 0-0 O II Z m II Oo C� 1e�j W Q m t�7 -o > � O c ey ? _ 0.O O Z 2 , NyN « Dec �nAm -I NZ, r cc�o� O H, O_zm a ZDDN=E�=tn Z A O . M, oNF z z r ;m,zy� mm -I( i.M-jm cnvMO'* 0 -mnZ �o A A Z = p0o / D Zm O� / z z 0 Z N / KINLIEN CIRCLE 0 v D m I� O �P Hl! b ;01) --1 nF0 O�Cdm V1 z z H H Dyrlp rr 'dCx =�V)m H[q�O " Z a z o �x�:j �C az 0 v D m I� 0 PERFORMED FOR Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST r9if-0 S -TO v 7` t 0 T- q /32-uC k C LEGAL DESCRIPTION: DEPTH (FEET) 1 � D 2 r � c. 126 4 ,v , C 1 c} Z 3- 4- 4 PC4A 14Aa/ 5 `a it M S w/ (.AA,/OC .lVP t �M) �y, •}fie{/�/J�ti I�PJ�O••J�J itcl.ii [' -n ROBERT C. COWAN f CE 8801 Av DATE PERFORMED: '`/.t,.3 w'w r'3ii 0w -F�> Township, Range, Section: 7 oa 8 `r F Q 9- 10- 11 10 11 12 13- 14 3 14 15 16- 17 6 17 d - 18- 19 M L S'r'L T WAS GROUND WATER ENCOUNTERED? SLOPE S 5i - r Ly 1/yr�y IF YES, AT WHAT �. p DEPTH? P N2 S /S -/g7 E Depth to Water Alter y //1 1'7 Monitoring) DEQ Y Date: SITE PLAN Reading Date Gross Time Net Depth to Net Time Water Drop 2ffuAK'r" • tl G 0 G 18,. 4 S` L M ., �.�3 20 u« PERCOLATION RATE _2_. (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 7 FT AND FT COMMENTS S & S ENGINEERING PERFORMED BY:vercepRoaNa. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WIlFFP0?-A rvd4A* 18R§371�AL GUIDELINES IN EFFECT ON THIS DATE. DATE: / Z 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN s&sN 71neeR1nG ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 4, Block 6, Alpine Woods Subdivision July 2, 1997 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 GENERAL: 1. The scope of this project includes the installation of a 2000 gallon septic tank and two leachfeild trenches to serve the ey isting seven bedroom residence located on the referenced property. The existing septic tank is to be excavated, pumped, crushed, and abandoned completely. The existing leachfield is to be abandoned such that it may be used in the future. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 4, Block 6, Alpine Woods Subdivision July 2, 1997 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Five Lot 4, Block 6, Alpine Woods Subdivision July 2, 1997 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER 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 IPHONE [] UPGRADE LOCATION ~ ~ NO. O~...~EDROOMS 1~ /1¢~/~ Absorption area ~ Dwelling ~ PERMITNO. ~ Manufacturer ~ Mat Liq. ca~1¢,~ i~a~jons IF HOMEMADE: Inside length__ Width Liqui~L~ O Z <~ M~ ~ ...... Material Liquid capacity i 12 Well , ~ ,, ,~ Foundation t Nearest Iotl~e//.~ ! PERMIT NO. ~u..z_,,, No. of I~) ~_~ Length of ea~)n'~-/ Total length of ~_'~/lines' Trench width .~ '~'s Distance ,~y~ ~- ~ ~ Top of tile to :~inish grade ,~ Material beneath tile Total ef fect'ive .~bs~r. Et i o n area Length Width Depth PERMIT NO. ~: I- Type of crib Crib diameter Crib depth Total effective absorption area '" Well Building foundation Nearest lot tine u~ DISTANCE TO: /~lass --~-- Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: ilding foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS' SOIL TEST RATING APPROVED _~/~ ~'~~ DATE LEGAL 72-013 ~,~78) Permit MUNICIPALITY OF ANCHORAGE f Health and Environmenta' Applicant: Deloar tment 825 ~ Street, Anchorage, AK. .9501 264-4720 * * * HANDWRITTEN PERMIT * * * ~.F-9~I~ ON-SITE SEWER PERMIT Protection Mailing Address Location: TI.A~ ~' ~c. 23 Phone Number: ~ ~g-lO ~'~ Legal Description: Lot~ ~/oC~ ~ ~,~ ~ SO~ee/~ Lot Size: ~] O,?O Type of Soil Absorption System Is: Trench: Drainfield: / Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~&~ The Required Size of the Soil Absorption System Is: DEPTH ~' LENGTH _ .'~/~ ~ ' . GRAVEL DEPTH ~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and 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 outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~.$-~: GALLONS.* * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as (2) (3) Applicant set forth by the Municipality of Anchorage. I will install the system in accordance with code~. I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Issued by: Date: SWP/024 (1/81) MUNICIPALITY OF ANCHORAGE Ut-PARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: 4 5 6 7 8 9 SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER ~ S ENCOUNTERED? ~J o L O IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ....... C. Reid, Jr. No. 2251-E PERCOLATION RATE {minutes/inch) COMMENTS ~n;t '~'rC~z (' ~ TEST RUN BETWEEN FT AND FT PERFORMED BY: -~ a'~. CERTIFIED BY: DATE: 72-008 (6/79) M.UMMPAUTY OF ANCHORAGE 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. 015-234-44 Expiration Date: V - Z Z.` Z3 1. GENERAL INFORMATION Complete legal description ALPINE WOOD BLOCK 6, LOT 4 Location (site address) 12210 KINLIEN CIRCLE, ANCHORAGE, AK 9951 Current property owner(s) MARK & TONYA CAYLOR Day phone Mailing address 12210 KINLIEN CIRCLE, ANCHORAGE, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 7 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: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 55 D Waiver Fee $ Date of Payment 7 7 0 Date of Payment Receipt Number 907 90 Receipt Number COSA # OS C � 11 a 0 1'f 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 4/2312021 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 i . • • ' • •,^151�,C.`,j well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q.' • • :1,9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting& FWGS ' *' 49 TH •'* �r ... �:- DSD SIGNATURE %r Curtis Huffman System #1 Approved for bedrooms �� Fc�s•, CE 128991 -7- �� Te�* • •4/23/29 •`F�..r System #2 Approved for bedrooms `li 19PROFESSO Disapproved Conditional approval for bedrooms, with the following stipulations: Original Certificate Date ,5 '2L - 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 Se -t av,. - AqP Aof,1,S,ey l Legal Description: ALPINE WOODS BLOCK 6 LOT 4 Parcel ID: 015-234-44 If more than 1 septic system on lot: COSA Checklist # _of __ Structure served by this system _ A. WELL DATA - CLASS A ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) _in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA Age of tank(s) 23 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49 ® Standpipes/foundation cleanout per record drawing Date of pumping 4/22/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 5/21/1998 ® ALL standpipes present per record drawing Total measured depth from grade 10.5 ft (max) Measured depth to pipe invert from grade 3 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 4/22/2021 Results M Pass For 7 bedrooms Fluid depth prior to test 33 / 0 in E / W TRENCHES Water added 1050 gal New depth 46 / 19 in Elapsed time 1400 min ® Code -required soil cover over field Final fluid depth 31 / 0 in El System presoaked Absorption rate 1050 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date NES 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 Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ 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' Surface Water > 100' ® Yes 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' ft ft ft ft W ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® 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' ® 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 1 have determined through field inspections and review �,re.�Q`.:•' • • '•i�� of Municipal records that the above systems are in conformance •:"� �� with MOA COSA guidelines in effect on this date., 7H • • . •': .. .... ......... '. Curtis Huffman �¢ �'F•• CE 128991 • ,4wAV' eo -..4/26/21..- ��pROFESSIONP ..'� M MAJ DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 211204 Subdivision: Alpine Wood Block 6 Lot 4 907-343-7904 Fax: 343-7997 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. MailingAddress P O Box 196650 *Anchorage, Alaska 99519 6650 * www munL org TM zD-mD (i} ]`1 2A.0 r--� n 2` W �- "--- m cn1M m U)Dm:z D M N � om=z mzom M 0 CD 3�m cin' Qo�3> 1'CCOWCL (D 0G 00oap M cn -iz0 _ O Nd�mCD?omm Zmaa D c)rn M vm� 03'CD m'L 5oozm II 0) �� ';mmO� CD D C-o-0�; O mzm0 P o Rmm 0 0 o N.o C�o� 0 F. I zzmx O 0 CD IV N D � CD m � 0 Om CO O= o Q< 3 .(� 0� q m ci (QM mm o 030`°(-' o�� C� ooxm mm (D o ID °'�'�a o; N`D �O <W°iID ®r z a m � m -n m I'I'I -n G) 7 O (D to O U) 00 3 O 3 0 m 3 �I Q'< c a Q a s z' j _ 0 Q C 2 0 _ 0CD(D � N CN �• a� �i ETC2 O _ ran' j Q N ((D LS' D r C V a. O= .CD _ O. D7 Q1 N z x (D s a X O N (0 O m Cil A. 3. c r�i- 3 w = _ ... - X N -. 77 N13°p2, 30„ N13- 02,33 „E �4 . g (R) Tele. & Ede 3 (M) C 1 0 p — — CD \ A 48.0 0 2 Story G ara9e N �M � 5z 48.0 0 o ' < n O m s c 3' O O O N 23- to —� � (n O CD 6? Cn rn ®® t®�®®� NCD 01 N �' cn o0 o��ys• • . ST 0 6, u, t ° 0 CD CD C-0 LTI ® A : o �• :O �o a' r ` •TI® (fl M� N00AW 001 sG�• n•: � � ��m ]`1 2A.0 10.0 10.00 0 2` W 03 622.00 M N � Cn 0 a CD 3�m cin' Qo�3> 1'CCOWCL (D 0G 00oap 0 0 a o _ O Nd�mCD?omm Zmaa D c)rn M vm� 03'CD m'L C 0) �� ';mmO� CD D C-o-0�; O o Rmm 0 0 o N.o C�o� 0 F. I " o�0�ca SD 0m o m 0 0=3 0�5v C D— CD IV N D � CD Ujr�a Om CO O= o Q< 3 .(� 0� or- ci (QM mm o 030`°(-' o�� C� 'O 0` (D o ID °'�'�a M D C7 `43-a3�cD <W°iID CO I hCDW@-:0CA0No'(j) 3 ; cm 0.m0 c roo,� 3 0oZT OC -0 �I z >cf) a' vs(Da CD C) O _ O '� Cn (D '< 'a D) CA N a. O C 0 « (O O (D m� m SCD D a� O �_ o N m �. cn a CD (D r n N 0 deck 10.00 56.0 0 i CO N N) 3 Story Frame House o 2A.0 10.0 10.00 0 2` O N 622.00 N N � Cn 0 a CO 0G 00oap o O p :., .W -a CD -c O l O I CD IV N p CO W O N N) 3 Story Frame House o 2A.0 10.0 10.00 0 2` O N 622.00 N N � Cn 0 a O D O o :., (C'�n -a L'41 5p ` 10'T & E R'Sp.00 Co32` Easement L=27.56 Sp p0 R=375.00 n, (R) �iKINLIEN CIRCLE 71 °24'35-- 98. 812'08',59,, W 98 .92 w (M) � Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 0 c r. SA [TY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ^C�15- �.�-�� COSA #_ 1. GENERAL INFORMATION Expiration Date: Complete legal description Lot 4; Block 6; Alpine Woods S/D Location. (site address) 12210 Kinlien Circle -Anchorage, Ak,99508 Current'Property owner(s) Dottie smith 345-0085 Day phone Mailing; ddress Lending agency Mailing address Real Estate Agent Mailing Address 12210 Kinlien Circle -Anchorage, Ak,99508 Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual - Well ❑ Individual On-site ❑✓ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class A 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 sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm S & S Engineering Phone 694-2979 Address 15861 S. Birchwood Lp. Rd: Chugiak, Ak. 99567 Engineer's Printed Name Robert A. Shafer Date 1-4-08 �a , ,.y9.A • 7A 1� � :• � _T? � -: == `- �, 1. •R j ; Bert R Sh W �� 14�; 5. DSD SIGNATURE % & ,�$+* Approved for _� bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory OFr''�� AN �j : ON- �� •yyATFR AND VVASTEWAT ATE _ r�----------- Attachments: n Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: / --7-09 (Rev. 11/05) Municipality of Anchorage *AE Development Services DepartmentBuilding Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 j CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: __ LoT '7 ; /,)(cOC� ''(p ; �( j�/,�j � S ParceClD. O -2,3f� A. WELL DATASS Well type If A. B, or C provide PWSID # Wefll Log (Y/N) Date completed P Sanitary seal (Y/N) Wires properly pro (Y/N) l Total depth ft. Cased to ft. Casin right (above ground) in. FROM WELL LOG AT INSPECiTION j Date of testi Static water level ft. ft. Well production g.p.m. g.'p.m. WATER SAMPLE �RLTS: l Coliform colonies/100 mL Nitrate mg/L Other.bacteria colonies/100 mL Ars c: ug/L date of sample: Collected by: j B. SEPTIC/HOLDING TANK DATA Tank Type/Material sr m c- i to Date installed Tank size ZOO gal. Number of CompartmentsC2 Cleanout65) `IES I: Foundation cleanout) Depression over tank (� High water alarm Oa Date of pumping o Pumper A} n� IC. ABSORPTION FI LD DATA Date installed 1'S 2 Q) Soil rating (g.p.d./ft or ftz /bdrm) 8 System type a �� 86 3 Length Width Width 3 r ft. ' Gravel below pipe ft. i Total depth ft. Eff. absorption area /ft2 Monito ' tube`s Depression over field .� Date of adequacy test i2 I q O f Resu s (Pas ail) For I bedrooms Fluid depth in absorption field before test P P in. Water added al New depth o� in. Elapsed Time: min. Final fluid depth in. Absorption rate >_ lOSC7 g p d Any rejuvenation treatment(P mo. ast 12 13 type ) YP) If yes, give date i ------------ i - - D. LIFT STATION 1J In Date installed "Pump on" level at in. Datum Size in gallons "Pump off" leve_ tested Manhole/Access High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: e'N L -OT' Septic tank/lift station on lot On adjacent lots Absorption field on lot Public sewer main Sewer /septic service On Public sewer manhole/cleanout Holding tank IO Animal ment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING ANK ON LOT TO: / Building foundation yr l� Property line t Absorption field -E- y � Water main Water service line %D l4- Surface water too I Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line l 3 f Building foundation Water main / Water Service line f0 l� Surface water BOO Driveway, parking/vehicle storage lG Curtain drain .AWE A�"M Wells on adjacent lots F. COMMENTS P G. ENGINEER'S CERTIFICATION l I certify that I have determined through field inspections and sells . 0 • review of Municipal records that the above systems are in !, ' conformance with MOA CPP elfin s i effe this ate.,, r� Engineer's Printed Name/ Date7 77 I COSA Fee $ Waiver Fee $ Date of Payment f © Date of Payment Receipt Number d55� 3� Receipt Number (Rev. 11/05) I: M N M 00 N31 Nl � � N e6-86 91-96 ti0 Z ° lS Z. 00.09=�j 00. 99'12=1 g90 -e J 1 m CO 1 Q 1 1 1 1 ..26. to .vW ppb =1 c6 LO LO asnoH awej-q tiojS `V N W O~ tiZ 0'99 �0 Ol 1 LO -i e- 43ep > • 1 G t�co fl, CA c j � Acc 2 NCO C � .. N CV) N N > o W W W cv CN 1 v G N '.. 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LU 4LU ui z w~i Z LL Z HOZ Wu)w � w Q F- 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 264-472O Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name~-~~''"~''~-O ~ Telephone: Home ~ Business Applicant Address l~0 k~NLel~ ~ (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 Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Other Number of Bedrooms -- ~' - WATER SUPPLY individual Well [] Community ~ Public[] Note: If community well system, must have written confirmation from the State Departmeht of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL OnsiteJ~, 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. 72-025 (11/84) Page 1 of 2 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 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 ~-7_~ ~::'~/~ ~ ~PO-~'T'~ Telephone ~'~- ~ ~/ Address ~ ~. ~ ~ Date Approved /,~ Disapproved Gonditionad Terms of Conditional Approval Date CAUTION 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) Ao MUNICIPALITY OF AN DEl>T, OF HEALTH & I~I~NICIPALITY OF ANCHORAGE (MOLl ENVIRONMENTAL PltOTECTIC~IEALTH AUTHORITY APPROVAL (HAA) MAY 9, 8 RECEIVED WELL DATA Well Classification'~a=;~==jmae- Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line CHECKLIST- FEBRUARY 1984 264-4720 Legal Descrip~on: L"C:)~ '~ ~ \ ~ '~ If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To i~learest Sewer Service Line on Lot ; Date PFC ~ oF B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) '"{ ~- ~ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service Line .-~ Course Size ' \'~.~'C~ No. of Compartments Air-tight Caps (Y/N) ~ ~--~ Foundation Cleanout (Y/N) Date Last Pumped ~, [!'~, Temporary Holding Tank Permit (Y/N) /~J/A To Building Foundation 7...f~' ~ I To Disposal Field ~.(:::~ Ic-~-l.~:;)~- To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ ~~-~'~ Width of Field ~; Square Feet of Absorption Area Depression over Field (Y/N) I',.L (O Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~/~ To Water Main/Service Line Type of System Design-'~ ~ ~ ~', ~-~[c:L. Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line "[" '~t To Existing or Abandoned System on ; On Adjoining Lots "~ ~,(~:::~ 4r-~ I~ "~ [o~..~t.~)o'v, TO Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION ~J/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, vej:j, fied, or conformed t0.._all MOA and HAA guidelines in effect on the date of this inspection. Signed ~ ~I~.~ Date ~ -'Z"L~ ~ Company ~/~---'~ ~ t°o'"r7~5 MOA No. Receipt No. Date of Payment ~'"/~' ~::'/~ Amount: $ ~ Page 2 of 2 72-026 (11/84) '~ INVOICEk i~ 013882 "~ ¢~ "]~ CLEANING SERVICE P.O. BOX 112688 PHONE 345-2513 ANCHORAGE, ALASKA 99511-2688 Job Address ROTOR ROOTER SERVICE CALL HRS STEAM THAWING HRS. TRIP CHARGE HRS, OVERTIME CHARGE HRS. ADDITIONAL LABOR CHARGE HRS PUMPING SERVICE 1 ~,~.~[ IGAL)HRS HYDRO-JET SERVICE HRS PLEASE PAY FROM THIS INVOICE TOTAL TOTAL FOOTAGE CLEANED OR THAWED__ BLADES USED "'" PROBABLE CAUSE OF STOPPAGE . LINE CLEANED L~:. - ~ JOB NOT GUARANTEED ~OR FOLLOWING RE~ON. WORK ACCEPTED BY __J~ , ';" DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA g9501 BILL SHEFFIELD,. GOVERNOR Telephone: (907) Address: 274-~533 To Whom it May Concern: According to records on file in this office the //~ff/'/~ '~,'Y/'¢// Water System is in compliance with the State Drinking Water Regulations Si nce rely, Michael P. Lewis Environmental Engineer MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROV;~L CERTIFICATE 1. General Information Application Date (a) Legal D~scription ( include~ot_, block, .subdivision, section, township, range Lo-r z; BCoc tIL' tAI£ WOODS ._qORb. Location (adck~ess or directions) .~t~H/~ K;/~LgtA3 _CZkCC~' (b) Applicants Name 'R ,~_~]~ ~, C/~&~5~)/~ ........ Telephone3~9-~.OS'~ Applicants Address ~ (~. BO~< IlO~o._~ / (c)Applicant is (ched~ one) Lending Institution ~; Owner/builder .~ Buyer ~; Other ~ (explain); (e) l~al Estate Co. r~ A~ent N/~ Address Te le phor~ 2. Type of B~sidence Single-Family ~ Number of Bedrooms 3. Wate= Supply Individual Well ~ Multi-Family Othe'~' (describe) Cc~nunity~ Public~ Note: If conmunity w~ll system, must have w~itten confirmation frcm the State Department of Environn~ntal Conservation attesting to the legality and status. Is the ~11 adequate fo= the number of bedrooms specified in this HAA (Y/N) ~_~ 4. SewaGe Disposal Onsite ~ Public ~ Con~nunity ~ Holding Tank ~-~ Is the wastewater disposal system adequate fc~. the number of b~drocms .(Y/N) [Page 1 of 2] 2-15-84 5..Engineerin~ Firm Providin~ Insi)ections, Tests, Data and Information I certify that I have checked, verified, c~ conformed to all MOA HAA (tlid~li~s in effect on the date of this inspection. Signed by Date 6. DHEP Approval Approved for .J (ENGINEER SEAL) Approved ~ Disapproved ~ Temps of Conditional Approval Conditional F--~ The Municipality of Anchorage Department of H~alth and Envircrm~ntal Pre not guarantee the continued satisfactory performance of the water suppl5 wastewate~ disposal system. This approval indicates that, as of the va shown above, based on the data and information furnished by an engineer the State of Alaska, the water supply and wastewater disposal system is tional for the number of bedrocks and type of structure indicated. tect ion dces and/ct the :idatiop. Ckate registe.. ~ed in safe and fun.c- (DHEP SEAL) 7. Mail the HAA to the followihg add~ess: KB2/d5/s [Page 2 of 2] 2-15-8~ L..F__.Cr~L - LOT' "~ R '3 ~ c~E.c'T'7 oAJ ~_.s MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION BARg ~oc)A A. WELL DATA RECEIVED A Well Classification Well Log P~esent (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~cm Well: To Septic/Holding Tank on Lot To Nea~st Edge of Absc~ption Field on Lot To Nearest Public Sewe= Line Cleancut/Manhole Wate= Sample Collected By Water Sample Test Results Cc~m~nts -/~' ~ A-'77'/~_-H ~ ~) If A, B, C~ C, Date Completed Pump Set At D.~..c. ~pmovea(Y/N) ~ Yield Depth of Grouting. Sanitary Seal on Casing (Y/N) Depression A~ound Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date sE~zC/~OmZ~ TA~ DA~A Date Installed ~,/~/~,3~ Size I~_~C) G,i~L.'~ NO. ~ C~t~nts ~ Statics (Y~) ~ ~ Airtight ~ ~ F~ndation Cleanout ~ / ~ession o~ Ta~ (Y~.) ~O ~te ~st P~d ~ S~T~ __ P~ing~intenan~ ~n~a~ ~ File ~; fo~ Holding Ta~ High-Wate~ Ala~ (Y~) ~O ~a~y H~ldi~ Tank ~t (.y~)~/~ ~p~ation Distan~s ~ ~ptie~olding Ta~: To Water-Supply ~ll~JO~ ~OW~To ~ildi~ F~ndati~ ~ ~O~ ~ To ~rty Li~ .~J.O/ ~ To Dis~al Field ~, O ~ I TO ~ter ~i~vi~ Li~ ~O ~ ~6~o S~e~, ~, ~e, ~ ~jor ~aina~ co~ ¢-~OOz [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA De Soils Rating in Absorption Strata Date Installed ~/~//~_ 3 Length of Field Depth of Field ....... Grave 1 Bed Thickness Square Feet of Absorption A~ea .~ S ,.,~ ~ Depression over Field (,Y/N) NO,. Date of Last Adequacy Test Results of Last Adequacy Test SeParation Distance f~cm Absc~ption Field: To Water-Supply Wsll ~,lOr'l-O KaY Eox~ To P~operty Line "~'1 O' To Building Foundation ~-30, (/~.' To Existing c~ Abandoned System cn Lot ~-.30/ ; On Adjoining~ots ~-'~,0z' . TO Water Main/Service Line q-~O%~6~0~'~o Cutbank(if present) ~//~ To Stream/Pond/Lake/c~ Major D~ainage Cou=se ~ To D~iveway, Parking A~ea, c~ Vehicle Stc~age Area q- %Oz C nts i A~$7~5 C T'lO A,] Standpipe~ P~esent (y/N) x/~ SITE ST, TZON "bOSS O'F A-?pLy' Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du=ing Adequacy Test. Meets MOA Elect=ical Codes (y/N) cc~nents ** Che~k Permitted Bedrocm Rating' Against HAA Request ** I certify that I have checked, verified, c~ confc~m~d to all MOA HAA Guidelines on the date of this inspection. Signed ~/~~--~ Date ~/~/~ KB1/d5/s [Page 2 of 2] in effect 34 DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR ~lephone:(90~ 274-2533 Address: 437 E. Street Suite 200 Anchorage, AK 99501 March 8, 1984 PWS I.D. #213598 To Whom It May Concern: According to records on file at this office the Alpine Woods Water System is in compliance with the State Drinking Water Regulation. Sincerely, Environmental Field Officer MM/msm STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE for PUBLIC WATER SYSTEMS A. APPROVAL TO CONSTRUCT Plans for the construction or modification of by 'T'RY'clc [] approved. . _ public water system located Alaska, submitted in accordance with 18 AAC 80.100 Y~ have been reviewed and are conditionally approved (see attached conditions). Additional pump tests be on--ed o~f wells #3 and #4 to show draw down and recovery rate. If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order no. or descriptive reference) Approved by Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. The construction of the .~L P~Z~I~)~- ~ OOJ~ ~ ./~,7~T~J~ .~'~ ~ public water system was completed on rc_~lo, f,~ ! ~ !~¢~/-/. (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY TITLE DATE As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed the s~stem was constructed according to the approved plans. The system is hereby granted final approval to o,~te. TITLE CATE 18-0407 (Rev. 11t83) DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete Section C) 3. PINK - ENGINEER/MUNI.BOROUGH (Complete Section C) 4, GOLDENROD - MUNI-BOROUGH (Complete Section A)