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CHICKADEE SLOPES TR A LT 4A
heckadee Slopes Tract A Lot 4A #015-231-85 Municipality of Anchorage Page 1 of 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: 5 a/ 17by 1 5 1 PID Number: 015 — 0,3 1 — 925 Name: Wastewater System: O New ❑ Upgrade Address: i k ABSORPTION FIELD , (. l Phone: o. of Be r oms: Deep Trench [I Shallow Trench ❑Bed El Mound 11 Other LEGAL DESCRIPTION Soil Rating: j• 2 Total Depth fro rjgjnal grade: GPD/ Lot: Block- Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe �_C r ii/H C 14 1 t! L A p JE k S L s —13 Ft. Ft. Township: Range: Section: Fill added above originalgrade: Gravel length: _ f Ft. 6 Ft. WELL: fg/New El Upgrade Gravel width: Number of lines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: FP M V%'E rG D & Ft. e '_5 Ft. SC. Ft. F LY / V Driller: /� 1 )� AL -P / h-. Date Drilled: -Z Static Water Level: If Ft. Installer: Date installed: i1 -�� Yield: Pump Set��at/: 8F Casing Height Above Ground: TANK GPM ry�0&14 Ft. Ft. SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer:_ 1 Capacity in gallons: From Tank Field Station Tank Sewer Lines AN 1-// % N 0 Well- J t. ' Material: S %1FC L Number ofCompa ents: %Q;2 I,4 Surface Water N � 1�. � LIFT STATION Lot ► / Size in gallons: Manufacturer: Line Foundation FJ J 2 • X/ "Pump on" level at: "Pump off' level at: High water alarm at: CurtainL� f_ Pump Make & Model Electrical Inspections performed by: Drain 0 T-1 BENCH MARK Remarks: % �-0 Location and Description: �I �!i>cr/ l+td-CX �yf''�c: t%� !.' �t .Lir[8�at ✓j / 1l3� 162 Assumed Elevation: �y /0(1 — Ep►g 9-SF„ALL Inspections performed by:� Dates: 1st -7/s/ r. a .c.s. •..moi.. Tob` :u+'<' -rd r CE -2225 .f Department of HeallM and Human Services approval 8• Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 I I I I I - - - -- - = I I •4;, SWING TIES: DECK,'�' I AB 32 FT I AC 28 TANK CO BC 40 AD 44.5 BD 50 DOUBLE CO BENC MARK A£ 32.5 TRENCH CO BE 34 AF 76.5 A 8 �- BF 66.5 TRENCH CO AC 69 BG 60 MT 1250 GAL SEPTIC TANK C REPLACEMENT TRENCH _ PRIMARY TRENCH LENGTH 45 FT DEPTH 9 FT ROCK DEPTH 6 FT F TH 7-1e•9�. • .. . q ......... . I AV 9 I �..49th I ,•�.......... ........... ......� � TOB EN•SPURKLAND f= F�j •••..........••••''� �•• •,4111 FESS •••• • I I I I 25 0 25 50 75 100 125 150 SCALE, I' = 50 FT I I I I I I I TOBBEN SPURKLAND P.E. CHICKADEE SLOPES LOT 4A SEPTIC SYSTEM AS, BUILT 203 W 15TH. AVENUE DATE: JULY 28, 1996 A N C H. A K. 99501 12200 ROCKRIDGE DRIVE ,_ __. ___ __. _ MIKE BRAIN SHEET: 2/3 GRID: 2739 REPLACEMENT TRENCH Standard Trenches 2' Wide 45' Long 9' Deep 6,0' Sewer rock 3' Cover PRIMARY TRENCH O Moni for Clean Out 1E 94.0 Mir a Fi 140 6,0 Ft of Septic Double Clean Outs / Foundation Clean out 12+ FT. 0-0- O O 1250 gal Septic tank Clean Out WIMIWMAN BENCH MARK, FIN. FLOOR BASEMENT I ASSUMED ELEV, 1DD.00 Fr TOBBEN SPURKLAND P.E. LOT 4A CHICKADEE SLOPES SEPT1C SYSTEM AS BUILT 203 W15th Ave MIKE BRAIN DATE; JULY 28, 1996 Anchorage Ak 99501 SHEET: 3 3 GRID 2739 070_�aic 12200 ROCKRIDGE DRIVE 11 e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: N (C I—i/4 lE`y DATE PERFORM t� av J ro LEGAL DESCRIPTION: LO7A C�Ac.Township, Range, Section: DEPTH SLOPE SITE PLAN F E 6F) k p N 2 3 ; 4 5 6 T 7 8- 9 9 r 10 j 11 12 13 Y m v 14 N 15- 16 5 16 E' J 17 18- 19- 20- COMMENTS 81920COMMENTS so"L X f3c W No �� WAS GROUND WATERj ENCOUNTERED? KI IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Dale: ■11■11■■11 Reading Date Pit. k Gross Time Net Time Depth -w of Water Net Drop iS 9tv 30 A % L !O i 2 a 3iZ 3 73 z — � 4 3 -7 1/9— L/ — + _ 3 16 3 3 2 rl PERCOLATION RATE tminutes/inch) PERC HOLE DIAMETER rr / TEST RUN BETWEEN R FT AND 8 J FT et avL�t� `T j4 PtRFORMED BY: s I rS _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) LOCATION OF WELL BOROUGH 8U plVl 10 LOT BLOCK LOCATION/SKETCH: STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD SECTION QTRS WELL OWNER: r. 6@CTIOry I TOWN61-1IA I RANOE MERIDIAN ON DE El OW 0 DEPTHS MEASURED FROM:Ocising tort ❑ground surface WELL DEPTH:� DATE OF COMPLETION BOREHOLE DATA; Depth of hole: 49� ft Dept#i Depth of casing:ft ��l, Material Type and Color From TO --'IN A - DEPTH TO STATIC W N 11 13 RECEIVED JUL 31 1996 iMunicipal"Y t HI►cnvl Rot. Health & Hutnan & CONTRACTOR INFORMATION: ATER LEVEL: . S ft below top of casing ❑ ground surface 37 Date: _ METHOD OF DRILLING: .air rotary O cable tool ❑ other USE OF WELL: 19 domestic ❑ irrigation ❑ monitory d 0 public supply ❑ other CASING STICK• P: ft. Oiam: 0 in. to Wlft Casing type; in. to �' t WELL INTAKE OPENING TYPE: ❑ open end © screened ❑ perforated Kopen hole Depths of openings: � to ft SCREEN TYPE: Diam: in, Slot/Mesh Size; Length: ft GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE:_ Volume: Depth: from ft to ft DEVELOPMENT METHOD: Duration: PUMPING LEVEL AND YIELD: ft after- hrs pumping gprT� PUMP INTAKE DEPTH; ft Horsepower: _ WELL DISINFECTED UPON COMPLETION? S.YES Q NO REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: > DNR/DIVISION OF MINING & WATER MGMT 3001 C St, Suite 800 ANCHORAGE AK 99503-5935, Phone (907)269.6639, Fax (907)562-1384 1 SSI - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES` P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960159 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:BRAIN MICHAEL A & NANCY OWNER ADDRESS:12200 ROCK RIDGE DR ANCHORAGE, ALASKA 99516 PARCEL ID:01523185 LEGAL DESCRIPTION: CHICKADEE SLOPES TR A LT 4A LOT SIZE: 49508 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 ! r%,(.� C;io f� LV iSl1 DATE ISSUED: 6/26/96 EXPIRATION DATE: 6/26/97 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: ENGINEER.3HAJwL..P. AN . DI ' Q ., �'ER�07����QN; T��5,.. ., E VICINITY OF THE ROP ED ABSORPTION.. ,TPZNC I ' Sim Ru RESULTS TO FIC W H THE AS - BUILT/INSPECTIgN,4 �. R 'raz. RECEIVED BY. DATE : ISSUED BY: 1 �� DATE: ��(C' 4 6, T.SPURKLANID P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907)279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 4A CHICKDEE SLOPES MIKE BRAIN No Ground Water or Impervious Layer to 15ft. Use Standard Trench Soil Rating. 5 min/in = Use 1.2 gal per sq.ft/day No. of Bedrooms 4 Required Area per Bedroom: 15011.2 = 125 sq.ft.. Total area required: 4 x 125 = 500 sq. ft. Finish Floor Elevation 104.00 Ground Elevation at Absorption Field 95+- Testhole Total Depth 15 ft Rock depth 6ft. Length of trench 500/ 12= 41.7 ft SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 45 FT TOTAL WIDTH 2 FT TOTAL DEPTH 9 FT ROCK DEPTH 6 FT COVER 3 FT SEPTIC TANK 1250 GAL The installation of this septic system will not prevent wells from be installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUN 18 1996 RECEIVED (ENGINEER'S SEAL) Municipality of Anchorage w DEPARTMENT OF HEALTH & HUMAN SERVlr =S 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: "I -e - V X-ck-t Yi DATE PERFORMED: V9 ` q & LEGAL DESCRIPTION: L bT 4 A C L-� ICAID IE L Township, Range, Section: SLv Pte$ SLOPE SITE PLAN 1 l 1 L vee trot r 1� rr� wyt 2- 3- 4- 5- 6- 7- 8- 9- 10- 11 - 12- 13• 14- 15- 16• 17- 18• 19• 20 COMMENTS S 1 l I) So"A- c 0 WAS GROUND WATER 1■111■■■■■ ENEENEENNE IMMENEEMEN, IF YES, AT WHATNEENNEEMEN DEPTH? Depth to Water Alter Monitoring? �a- Date: Reading Date Gross Time Net Time Depth to Water Not Drop >�i ! l S• 9.4 (o � iZ E S /41L 0 n-ti•t v _ .1i1_v_ ©.ic 2-0 4 0 y% 3 M r 1t D 0, f o Li t 3. > I'= oto 4'0•lw a -t v PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER h) TEST RUN BETWEEN FT AND FT PERFORMED BY: - f S ,-_ I - ll J CERTIFY TH T THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATF DATE: 72-008 (Rev. 4/85) 174 (ENGINEER'S SEAL) Municipality of Anchorage K DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: l Q rco 101 ---DATE PERFORMED: LEGAL DESCRIPTION: LA '/A Township, Range, Sction; SLOPE-_� SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER a 1 O ENCOUNTERED? 1� S IF YES, AT WHAT L O DEPTH? P E Depth to Water Alter 6120A / 1 Monitoring? C r Date: , Gross Dgth to Time istis, I I PERCOLATION RATE L '= (minutes/inc�-h)) PERC HOLE DIAMETER tt__JJ A' TESTI RUN BETWEEN FT AND ( FT COMMENTS "" r_ F -C PERFORMED BY: _ T- s. S __ CERTIFY THAT THIS TEST WAS PERFORMED IN / e e ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:. DATE: 1 ��� ! � � 3 "L b 72-008 (Rev. 4/85) e re- ©v► lam/ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST (ENGINEER'S SEAL). PERFORMED FOR: 1 4.1 'kk DATE PERFORMED: /9t 9% LEGAL DESCRIPTION: -LOT 4A C jt,'( i� e.e Township, Range, Section: iPl 7 to P -e S SLOPE SITE PLAN a +'r! t 2 3-,�jS, t I, Sac � 4 5- 6 7 8 9 'i ley SgKd% 10 11 12 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? 133o�K� y' j Depth to Water Aller 1 1 [30 -14•tiµ .4 14, 'e Monitoring? _ 14- 15- 16- 17 4151617 18- 19 20 COMMENTS ■■.■■■■■■■I ■■■E■■■■■■ MEN MEN 9eading Date Gross Time Net Time Depth to Water Net Drop I'LL -`1114& Eke S DAV- �{ Z 10 4 3 , 6,5 l7 10 �o L o2 P.r.-RCOLATION RATE �_ (minutes/inch) PERC HOLE DIAMETER ___ .r _ t TEST RUN BETWEEN FT AND T PERFORMED BY: 7-114 I - T—, S — CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) H (ENGINEER'S SEAL). Municipallty of Anchorage .r DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: H; k •e -c-m i 4 , DATE PERFORMED:'-' LEGAL DESCRIPTION: _ G 7A r C fel. r G 6,de �0_ Township, Range, Section: 1 P w S �O p -e S SLOPE SITE PLAN E') 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER �1V ENCOUNTERED] S IF YES, AT WHAT L DEPTH? O P E DepthMonitoring? to Water Alter v� Monitar;np? � �._ Date: Reading Date Gross Net Depth to DNot rop Time Time Water PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER r TEST RU BETWEEN FT AND FT PERFORMED BY: � 0/ S CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) i o TRACT A-] i S I I, I, I I � I I, 0 I 0 50 100 150 200 250 3DD SCALE- I' = 100 FT — — — — — — — — — — — — — — — — — — T 3 _ I VACANT ISI � LOT 4A / I v I I I LOTS I -- -- �--�-— I I VACANT I CJ LOT 2 Well I I I q I LOT 4B VACANT I LOT 4 9T IA TOBBEN SPURKLAND P.E. CHICKADEE SLOPES LOT 4A SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE DATE: JUNE 16, 1996 A N C H. AK. 99501 12200 ROCKRIDGE DRIVE ,a,,,% „70—Ml r MIKE BRAIN SHEET: 1/3 GRID: 2739 I I I I I F-- — — — — — — — — — — — — — —— - -- - - Well I 3.5 MIN/IN DECK ND PERC . . I I I � I 1250 GAL SEPTIC TANK © #3 I I I I REPLACEMENT TRENCH PRIMARY TRENCH LENGTH 45 FT 547 DEPTH9 FT I RACK DEPTH 6 FT W F AV mf 49th. ..... 10 %... � ..... .. .......... .. ' ...0 0.. .. ... .� �'� TO BEN�SPURKLAND�.� . J� �.• Ar No, CE-2225AV I I I I q 25 0 25 50 75 100 125 150 W I I SCALE, 1' = 50 FT Q) I I I I TOBBEN SPURKLAND P.E. CHICKADEE SLOPES LOT 4A SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE DATE: JUNE 16, 1996 A N C H. AK. 99501 12200 ROCKRIDGE DRIVE (or) -7) '�70_:0ia MIKE BRAIN SHEET: 213 GRID: 2739 REPLACEMENT TRENCH Standard Trenches: 2' Wide 45' Long 9' Deep 6,0' Sewer rock 3' Cover PRIMARY TRENCH Monitor Clean Out Mlro Fi 140 6,0 Ft of Septic Double Clean Outs / Foundation Clean out 12+ FT. 0-0- O O 1250 gal Septic tank Clean Out OF ♦��P�� ........ �♦, 49th TgBBEN SPURKLANN C No. CE -2225 �.���• AV NOSCAL E•.......... ••NPS ♦♦ FESS ivu JC HLL BENCH MARK, ASSUMED ELEV, 203 W15th SPURKeAND P.E. LOT 4A CHICKADEE SLOPES SEPTIC SYSTEM DESIGN 203 Anchorage Ave MIKE BRAIN DATE: JUNE 16, 1996 Anchorage Ak 99501 a74-�4u 12200 ROCKRIDGE DRIVE SHEET: ,3/,3 GRID 2739 JUN 15 2( I laity of anchorage :r and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval f Parcel I.D. 015-231-85 Expiration Date: 1. GENERAL INFORMATION Complete legal description CHICKADEE SLOPES; TRACT A, LOT 4A Location (site address) 12200 Rockridge Drive *Anchorage 99516 Current Property owner(s) Frank Monfrey Day phone 360-2524 Mailing address Real Estate Agent Gene Fitzgerald Day phone 351-9606 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: N/A Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. * g- Z 6 .0 a 143/x• Ga1�_' COSA Fee $ 97�- Date of Payment 6-15`16 —16 Receipt Number QZ.C932 COSA# e05C1G/Z-33 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179 Address 3701 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date' iS G In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail. The content of this report is for the sole benefit of the person/party who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved OFA F �rt�yO Conditional approval for bedrooms, with the follow rUg stiKQi j�ti-n E s `J4fATERAND rn. Original Certificate Date: ro _(S '-/ (,, 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 blue sheet 9.1-12.doc Nitrate Advisory Arsenic Advisory Other 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: CHICKADEE SLOPES; TRACT A, LOT 4A Parcel ID: 015-231-85 A. WELL DATA Well type PRVATE If A, B, or C provide PWSID# N/A Date completed 6/28/1996 Sanitary seal (Y/N) YES Total depth 206 ft. Cased to 83 ft. FROM WELL LOG Date of test 6/28/1996 Static water level 51 ft, Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/2/16 6-1161 Well production 8.0 9,p -m. 4.0+ g,p,m, WATER SAMPLE RESULTS: Coliform 0 colonles/100 ml. Nitrate 6.06 mg./L. Collected by: (EG. Ltd. Arsenic: NO ug./L. Date of sample: 6/2,/2016 B. SEPTIC/HOLDING TANK DATA TankTYPa/Material SEPTIC/STEEL 199(, ENDateinstalled/1hi Tank size 1250 gal. Number of Compartments E Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Cleanouts (Y/N) YES High water alarm (Y/N) N/A Date of pumping 6/29/15 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA PBELOW EXISTING GRADE Date installed/15-is%1996Soil rating .p.dJ or ft'/bdnn) 1.2 System type DEEP TRENCH Length 45 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth *13 ft. Eff. absorption area 540 fe Monitoring tube YES Depression over field NO Date of adequacy test 6/2/16 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 17 in. Water added 685 gal. New depth 41 in. Elapsed Time: 1120 min. Final fluid depth 33 in. Absorption rate >= 600+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump oTi" level High water alarm level Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100,+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manholeicleanout 100'+ Sewer /septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ •.Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 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 do d Name JEFFREY A. GARNESS Date 6 f q/ b (Rev. 11105) Municipality of Anchorage Development Services Department u, Building Safety Division S=" r On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # osc161233 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block A, Lot 4A of Chickadee Slopes subdivision. This inspection revealed a nitrate concentration of 6.06 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. g i3 d W �w� gggggg QY� 3AIdG 30(118A008 OZ W q a¢ N u�l w n VO M �'Z c�1Q� iW S 00'01'35" E 165.02' flu txg UP 2 o¢-¢ £ H c -_.. �3y o N 170' 17.0' sY..:. tO 41.3' ® w =o \ �` to U Y O cm O F- I d1 O z 0 N h C �O J �I 3 0 rl o � Q) 0000 2 Q W �bW fi mI-- � 3 a ZF O Lu MOW UJ oz¢ U m L---- L--- U W 10' UTILITY EASEMENT N 00'02'00" W 165.03' ¢ 0 5 Q y a Y Municipality of Anchorage �. v 4pe� 6v • Development Services Department s Building Safety Division r On -Site Water and Wastewater Program s A E T 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. o15-2-�i-85 COSA# O'S,06l,' 166 Expiration Date: I 6j- - 1. GENERAL INFORMATION Complete legal description Chickadee Slopes, Tract A, Lot 4A Location (site address) 122oo Rockridpe Drive Current Property owner(s) Michael and Nancy Brain Day phone Mailing address 122oo Rockridpe Drive, Anchorage, AK Lending agency Day phone Mailing address Real Estate Agent Careen Muir/ Keller Williams Realty Day phone 727-228g Mailing Address 1o1 W. Benson #So -4, Anchorage, AK gg5o3 Unless -otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank Community Class Well ❑ Community On-site 1-1 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 100217, Anchorage, AK ggSzo Engineer's Printed Name Steven R. Pannone, P.E. Date 8/g/2ozo Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water ..,6„"1LjkI, ��OF....4� Ito levels that may fluctuate during the year, and the water usage of the family being served by the system. • .��P •.•• ' ' "'•••gSjT �1# These conditions are outside the control of the evaluator of this system. All systems eventually fail and �..'�� �'':,# 9 # satisfactory test results do not guarantee future performance of the system, nor do they guarantee that 49TH °•••••� there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 00••••• •• •••• • ••• performance nor give any estimate of how long the system will continue to meet the operational 0 requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed ip\ :Steven R. Ponnone .' i ����J �: above. Any reliance upon or use of this report by any other person or party is not authorized nor will it No. CE 8149 = confer any legal right whatsoever.••. •P�F� X4414k_Z 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 >< es PROGRAM Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ILI Original Certificate Date: (Rev. 11/05) Munidpa ty of Anchorage Development Services Department ° u x x Building Safety Division " On -Site Water & Wastewater Program 5 A Y 4700 Bragaw Street . P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Chickadee Slopes, Tract A. Lot 4A Parcel ID: 03.5-233.-85 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 6/28/igo A Sanitary seal (Y/N) Y_ Wires properly protected (Y/N) Y Total depth 2o6 ft. Cased to 83_ft. FROM WELL LOG Date of test 6128/3.996 Static water level 52. ft. Well production 8 g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 mL Nitrate 6.82 mg/L Casing height (above ground) 24 in. AT INSPECTION 8/6/203.0 45 ft• 5.4 g.p.m. Other bacteria ND colonies/100 mL Arsenic: ND ug/I Date of sample: 2 2oio Collected by: Dan Moran B. SEPTIC/HOLDING TALK DATA Tank Type/Material Steel Date installed 7/16/996 Tank size 3.25o gal. Foundation cleanout (Y/M) Y Number of Compartments 2 Depression over tank (Y/N) N Date of pumping 7/2o/2oio ' Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 7I3.61z996 Soil rating (g.p.d./ft2 or ft2/bdrm) 3..2 Cleanouts (Y/N) Y High water alarm (Y/N) N System type Deep Trench Length 45 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth 3.2a ft. Eff. absorption area S�ft2 Monitoring tube 1 Depression over field N Date of adequacy test 816/2o3.o Results (Pass/Fail) Pass For 6 bedrooms Fluid depth in absorption field before test n in. Water addedZSo gal. New depth29 in. Elapsed Time: 3.2o min. Final fluid depth 1 in. Absorption rate >= 75o g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed t "Pump on" level at Datum in. Size in gallons "Pump off" level at in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 102'+ Absorption field on lot 102'+ Public sewer main 75'+ Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots zoo'+ On adjacent lots 1oo'+ Public sewer manhole/cleanout 1oo'+ Sealer /septic service line 25'+ Holding tank zoo'+ Animal containment areas zoo'+ Manure/animal excrete storage areas zoo'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 28' Property line _3o'+ Absorption field 51+ Water main 75'+ Water service line 25'+ Surface water 1oo'+ Wells on adjacent lots 1oo'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1o' Building foundation 3o' Water main 75'+ Water Service line 25'+ Surface water zoo'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Well's on adjacent lots ioo'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 4�OF .�.`P�E.... I certify that I have determined through field inspections and JAV review of Municipal records that the above systems are in n� conformance with MOA COSA guidelines in effect on this date. `K Engineer's Printed Name Steven R. Pannone. P.E. ��, ;Steven R. Panno !n s_ No. CE 8149 Date 8/g/2oio •��•�•ESS�•C COSA Fee $ z4qv Date of Payment Sr/[Wo Receipt Numbier ,6— 0 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number El Municipality of Anchorage • "� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 101166 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 4A Tract A of Chickadee Slopes subdivision. This inspection revealed a nitrate concentration of 6.82 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. MAY. 24. 2010 3:47PM FIRST ASI TITLE NO. 3970—P. 2 W c r= 0 cn b d � m cn �t O O z wn z�:CC 7 AK VF=•r�+1'1 � &sl -0Twp O m ..a� �'yT nn ^moa a �_A 7t0�7'A Xy a ZZ C �% h nr om+w acn O yy3QQ n No `°JM g yC Z m n 4' w A .Daof- ze -J, C� o °•a °'off 0 ,Zljro5 0gae�� �Gvm mwc: Zoe r C p m a n e m a .y 0 M „OO,ZQ.)0 N GI D {� _ 1 r r iN3V43Sd ---- ' 3 .�llllitl ---__-`......._�.. .. J.._ ,pl IL---------«-__ ------------ 1 t r a � i w. s rri N s D Z 4 1 1 1 (A ?f x ' $0 r - 0 M „OO,ZQ.)0 N GI D {� _ 1 r r iN3V43Sd ---- ' 3 .�llllitl ---__-`......._�.. .. J.._ D �06; fy` 0 o'r'7•W 00 3ni�a 30aid>j'ood 00 IR D Xo-s9t M „OO,ZQ.)0 N _ 1 r r iN3V43Sd ---- ' 3 .�llllitl ---__-`......._�.. .. J.._ ,pl IL---------«-__ ------------ 1 t r F � i w. s rri N s D Z 4 1 1 1 (A ?f x 1 1 i 1 00 I 1 IR r � o a ; f �l t r 1 � D ; 1 i tQ F r O iC+ r --1 U Im F D r � 1 �rn 1 z N ; co to i zo i «•.. to ® ® � Cl t n .0'4t N z N 1 ®� 0.06 u f a G F 28.5 , � co pv 1 =Y ANb e Pj K , zo ss c ..ss. to.oa s fy` 0 o'r'7•W 00 3ni�a 30aid>j'ood 00 IR D SGS SGS Ref.# Client Name Project Name/# Client Sample ID Matrix Sample Remarks: 1103723001 Pannone Eng. Srv. Chickadee S/D Lot 4A Chickadee S/D Lot 4A Drinking Water Printed Date/Time Collected Date/Time Received Date/Time Technical Director 08/03/2010 16:04 07/29/2010 10:00 07/29/2010 11:00 Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 275 5.00 mg/L SM20 2340B C 07/29/10 07/30/10 NRB Waters Department Total Nitrate/Nitrite-N 6.82 0.100 mg/L SM20 450ONO3-F B 07/29/10 AYC Microbiology Laboratory E. Coli Negative I 100mL SM20 9223B A 07/29/10 DLC Total Coliform Negative 1 100mL SM20 9223B A 07/29/10 DLC Private Individual Analysis Alkalinity 185 10.0 mg/L SM20 2320B D 07/30/10 LP Aluminum ND 20.0 ug/L EP200.8 C 07/29/10 07/30/10 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 07/29/10 07/30/10 NRB Arsenic ND 5.00 ug/L EP200.8 C (<10) 07/29/10 07/30/10 NRB Barium 52.0 3.00 ug/L EP200.8 C (<2000) 07/29/10 07/30/10 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 07/29/10 07/30/10 NRB Calcium 90100 500 ug/L EP200.8 C 07/29/10 07/30/10 NRB Chloride 53.0 0.500 mg/L EPA 300.0 D (<250) 08/02/10 08/02/10 SDP Chromium ND 2.00 ug/L EP200.8 C (<100) 07/29/10 07/30/10 NRB CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 07/30/10 LP Conductivity 602 1.00 umhos/cm SM20 2510B D 07/30/10 LP Copper 10.8 1.00 ug/L EP200.8 C (<1300) 07/29/10 07/30/10 NRB Fluoride ND 0.100 mg/L EPA 300.0 D (<2) 08/02/10 08/02/10 SDP HCO3 Alkalinity 185 10.0 mg/L SM20 2320B D 07/30/10 LP Iron ND 250 ug/L EP200.8 C (<300) 07/29/10 07/30/10 NRB 08-15-'10 12:58 FROM-kellerWilliamsPealty 9078656565 / Li 11 Uniform Residential ADDfaisal Rdtnnrt T-864 P0001/0001 F-921 here are 10 comparable ro Ales 0umem offered for sale in the subject nelchborhood fanning In price from $ 595,00o n V to $ 650,00o here are 39 comparable sales In ells subject net htromood wwn the past twelve months r In In sale Ace from S 560 0110 to S 659 000 fEATIJRE SUBJECT COMPARABLE SALE # 1 COMPARABLE SALE # 2 COMPARABLE SALE # 3 ddress 12200 Rockridge Drive 5031 Manytell Avenue 13301 CireaMew DGae 11950 Ginami Drive Anchors AK 99516-2317 1011 Forest Ridgea/d Mountain Perk Estates 1411 Woodboume roxdmi to%bject 2.06 milesSouthwest 0.97 miles Scuthwemt D. 4 miles Eastale Price S 609 500 S 640 000 S 600 000 S 659 500 JA, ale Pace/Gross LIV. Area 249,08s .h. S 23105 s ,ft- S 277,52 s .h, S 200.09 sab Source 6 AMDS MLS 286 da on mkt AMDS Unknown mkl UrneFsb AMDS MLS 31 da s on market erification Source s MOA MOA M A LUE ADJUSTMENTS DESCRIPTION DESCRIPTION + - SAdbslment DESCRIPTION t • SAd strtem DESCRIPTION + - SAdiuslmert ales ornnaindng Conv None Conv None Convomosalons Clsd 512010 Clsd 6/2010 Chid 1012009 DaleofSalamn F 4/2010 EM 3/2011"1 EM 912009 Location SuburbardAv SuburbaNa Suburbs Av aubuMan/Aya Leaseholo/FeeSlinple Fee Sim le Fee Simple Fee Simple Fee Slm la .Site 49,508 78 386lS -15 000 33 600/lnfedor +20.000 84.206/Sur)•20 000 Yew Average I-nr I Average Mins Avera a Intoes InletIclt Ad'abv Design is Two Story Two Sto TWO Story lvro Story OdillyofConalruction Avera o + Avera a + Avera a+ Avars n + Actual Age 199618E 1999110E 200214E -24 000 199616E -12 200 Condition Avera 8 + Avera e + Average + Avera " Above Grade Tata) Bdmts. earns Tota edfms. Balla Taal Bhma Baths Tp151 Bdrms BaQis Room Count =8: 4 2.5 JO 1 4 3.6 -5 000 6 3 2.5 6 4 1 3 -3.800 Gross LWIng Area 2.447 s .h. 2770 s ,D, 12,900 2162 5 .h. +11400 3296 s .h. 34 000 Basement8 Rnlshed 1,184 Sq.Ft. 1308 Finished -3,700 1140 Finished +1,300 975 Pinxshed +6,300 Rooms Below Grade 97% 2.0-1 3-0-1 2-1-1 1-D-0 +5 000 FunctionalUif Average Avera a Averacia Avera e HiatiniiiCooling GHWBB GFA Radiant -2 00 GFA ' EWgy Efficient hems Standard Starxlard Standard SIaMArd Garage/Carpolf Garage 3 Garage 3 tans +4,000 Garage 3 Garage 2/shop +5000 PorcbRallo/Deck CE L Dk shed CovEnt L De CE Ok shd +3.00 CE. La Dank +500 • SeCS RIVac 9' coil RVDGM VC+ RVDGM VC+ +6.000 RVDGM VC++ RVOG VC++ +4,000 1F 1 a iSty 1 Fre lace 1 Flre lace 1 Fireplace AMD t S -26600 + K—_9 700 t S -50400 . NdAdjusbnetd obimerossAdi- A09ed Sale FleeNet Adj. 4.2 % Net Adj. 1.e % Not Adj. 7.6% ECom aratdes 7.3 % S 613 400 Gmss Ad'_ 10.3 % S 609 700 Gross Ad . 13.9% S 809.100 1 add did not research Are sale or transfer hl5toky of ars r)ubioc property and com aWe sales. h not ex lain M research Fl did R did not reveal any prior sales or transfers of the subject property for the three years pdor to the effective dale of IIIIS appraisal. Data SourC s MOA .MLS research ndid g did not reveal any prior sales or transfers of the comparabieswes for the ear prior to Btc direct sale of the comparable sate. Data Solaces MO MLS Report the resues of the research and ane sls of the Prior sale or transfer history of hie sub ect proDwertv and comal-111(report additional pdor sales on ome 3). ITEM SUBJECT COMPARABLE SALE #1 1 COMPARABLE SALE #2 COMPARABLE SALE #3 Date of PriorSale/Transfer None fotmd None found None found None found Pelee of Prior SalelTransfsr Data Sources MOA MLS MOA MLS MOA MLS MO MLS Date 01 Data Sources 8/2010 8/2010 812010 812010 ArMSIS 01 Vilor sale or transfer history of the sub'ecl r0 and comparable sales No sale of the subject in the nrinr three ears and no sale of trip comparable safes in the stet year, No sales of the sales in the past 12 months. Summay of Sales Com adson Approach Three sales of similar design two story homes with basements As IrnCated in the same hillside area of the d'W were used for comparison, The sales bracket the sub'ecA in size and amenities and are all homes wht h wound be directly competitive in IEAecilve this market- Land value ad ustmeni5 are needed MAI Cnrac all rfun 19dKerences in the site values which Is attnhuha-d to;: and view differences between (he sates and not strict due to view or size. Adjustments are relatitgy fewmain) for a aim and ament variances and all ad'ustmonts are well within the recommended guidelines. A narrow range in value is developed front the sales and that range uhctudes the P-er4ing sales price of the subject property which is $609.500. That price la therefore considered to be well support das a confusion of value fnr the a rl , IrdoatedValueby Sales Comparison roach S 610,001) Indicated Value by. Sales Comparison App mach S 610-000 Cost A roach (if developed) S 599,495 Income Approach if developed) S NIA Sales compansw a roach is iven reateel wei ht as h best reflects the drat reaedon or bu ershellem In themarketplace. Cost 2�qyroach not t 'owl used D the .market bur In this case supports the market approach. Income alViroach Is not applicable due (crack of relavenl rental data as well as Na fact Ihst home- of this are not rchwed for dhefr income elm potential Itype This appraisal Is made 'as IS', subjeel W completion per plans and specifications on the basis of a hypodldical condhlon drat the Improvements have been completed, ❑ subject to the following repairs or anerarlons on the basis of a hypothetical condition that the repair or ahastiorls have been completed, or ❑ subject b the following required inspection based 01) the extraordinary assumption mal are conaMon or dellclency does not require attention or realr Based on a complete visual Inorpeclion o1 the Interior and exterior areas of the subjeeh groperty, defined scope of work, statement dl assumptions and limiting conditions, and appfabeps ceMillcallon, my (oud opinion of the market value, es defined, of the real prop/ Ay That Is the subject of this repos is S 610.000 as of August 10 1010 which Is the dale of Ins ion and The effective date of this appraisal. Freddle Mac Form 70 March 2005 Page 2 of 6 Form 1004 — VKOTAL• appralaal a0hw81`e by a la mods, Inc. —1.800•ALAMODE Fannie Mae Fomt 1004 March 2005 It FU',lrycJ A,+RON/lE SERVICES INC. 7 55 0 1 J 4.0th Avep-we Anchorage, Alaska 99516 345-1890 INVOICE Pt `Gallons Seritic Leach Area Holding Tank Standpipes Time F❑I PROBLEM AREA — CALL FOR MORE INFORMATION El NEEDS TO BE DONE. AGAIN IN 6 MONTHS Good Shape Ej Sludge bufldup on bottom 011 Floater, on -top ❑ Jim cap missing or, D Cut standpipe to 1' above ground 0 Needs Septictrine needs,, repacing MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 015—A31-05 HAA # 1. GENERAL INFORMATION P'A x-1'4 Complete legal description T VIAL < A` CkAi CV—A D F_S LO p GiS Location (site address or directions) ! Z20 t� Rdcl�r►"c��2 Property owner 13RA1 �4 ,. m 1 C14 A I✓ L Day phone Mailing address Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 I o Lb e vl p v r Ica �oK t� Phone ZW - 3 91,6 Address Engineer's signature X20 3 6. DHHS SIGNATURE _ __%1_ Approved for bedrooms. Disapproved. Conditional approval for Date I I r b! Q b LWy i-✓ Ja ie03 � l 1 �j�] 1 1 ''�10 DOi f say 'a9a3flG 059..000 Yom, J' bedrooms, with the following stipulations: Additional Commentgote: The well for this property meets existing State and Municipal Codes. There are nitrates present. It is continued suitabi�ijy. /Nitrate [oncentration is 5.47 mg/1. EPA _flrx� FA 1111 MITIC The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/91) Beck MOA #21 MUNA-WALITY Lir AIY-HUKAVt ENVIRONMENTAL SERVICES DIVISION �- Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES NOV 1 X99 Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343 -PEC E I `1 I E DIA Health Authority Approval Checklist Legal Description: j R&I A C 41 x -14 l D E L S Lo Pr= arcel I.D.: D 15-1— A. WELL DATA Well type 'e- If A, B, or C, attach ADEC letter. ADEC water system number Log present (YIN) ___Iy_ Date completed �S; � 1/ 4 1 b Total depth .206, _ Cased to 83 Casing height (above ground) Sanitary seal (YIN) FROM WELL LOG Date of test Static water level Well production g•p•m- Wires properly protected (Y/N) AT INSPECTION 9— p.m- WATER SAMPLE RESULTS: , `I 1, Other bacteria � j Coliform Nitrate �u :,� � / ' L, Date of sample: I / r f b Collected by: B. SEPTICIHOLDING TANK DATA Date installed k, Tank size 1 a2 60 Number of Compartments_ Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (YIN) N High water alarm (YIN) Date of Pumping 12 Pumper N/0- N F—VU C. ABSORPTION FEELD DATA Date installed -7//,S- I9b Soil rating (g.p.d./ftZ orf mt) 1. System type 1 %L4IV6# 11 r t Length 115'; Width _ Gravel thickness below pipe (o Total depth Z Effective absorption area 5416 Monitoring Tube present(YIN)—Y— Depression over field (Y/N) Date of adequacy test NIP— Results (Pass/Fail) 'Pve For 7 bedrooms Fluid depth in absorption field before test (in.); Fluid depth 1/ (ins.) Minutes later:_ Peroxide treatment (past 12 months) (Y/N) Immediately after ✓gal. water added (in.): _ Absorption rate = g.p.d. If yes, give date L/ D. LIFT STATION N © N � Date installed Manhole/Access (YIN) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum -Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: r i Septic/holding tank on lot 10 a ; On adjacent lots i � C.0 t Absorption field on lot 102 ; On adjacent lots 1 �� Public sewer main o o e— Public sewer manhole/cleanout No ll e— Sewer /septic service line �, ° 5 Lift station 0 N != SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation o28 _ Property line 3 © Absorption field i rJ 1 p Water main/service line i,25 Surface water/drainage Nlyv/ ?- Wells on adjacent lots > 1 o SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 60 1 Water main/service line > t2 Surface water N n O •e- Driveway, parking/vehicle storage area Curtain drain o v1 .t? _ Wells on adjacent lots > 10-0 Property line F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Signature Engineer's Name 66 •e ait v r V� �tQ� .En veering $e1 Hefe L _ Date - � �w ---------------------------------------------------------------------------------- ----=� �:~: -' �'_- , ------------ HAA Fee $ 119/0 - CTE) Date of Payment Receipt Number 5 yJ Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number RE�Efv � ptC 0?_ 19g6 CT&E Environmental Services Inc.'ZtL h®rag® Laboratory Division ►oiiii///�//�/�'////�'�// Dept. Health &Hum Drinking Water Analysis Report for Total Coliform Bacteria 2001. Potter Drive Anchorage, AK 99518-1605 READ INSTR UCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Tel: (907) 562-2343 Fax (907) 561-5301 MUST BE COMPLETED BY WATER SUPPLIER o PUBLIC WATER SYSTEM I.D. # X PRIVATE WATER SYSTEM ❑ SendResultt 0 ❑ Sendlnvoice „ ,tv Srssem N�m ampanYNamt0 t2,K�.N D ons Hunt one umoef li. umber .M—ng AdNaS Month Day ,.y D Dee DoteMFG-- O Send Results O Send Invoice ompmy ante =namc Ma, tng Aaa — iry tate p Doc TO BE COMPLETED BY LABOKA 1 UK alysis shows this Water SAMPLE to be: Satisfactory ❑ Unsatisfactory ❑ Sample over 30 hours old, results may be unreliable ❑ Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received l� Z� Q Time Received �- Analysis Began la — Analytical Method: /i Membrane Filter ❑ MMO-MUG Number of colonies/100 ml. - Result* Analyst M - ® RN SAMPLE DATE: Year 9'70T� � . � 148 Month Day SAMPLE TYPE: ❑ ❑ Routine O Treated Water ch Fbics Jun Fazed Repeat Sample (for routine sample X Untreated Water with lab ref. no. ) Date: Time: — o Special Purpose Client notified of unsatisfactory results: Time Collected SAMPLE LOCATION Collected By �. ❑ Phoned Spoke with El Faxed � D ate: Time: Plesse Print BACTERIOLOGICAL WATER A`tALYSIS RECORD MMO-MUG Result: Total Coliform E. Coli Membrane Filter: Direct Count O Colonies/100 ml TNTC -r.' lyu-crus To c'-1 Verification: LTB BGB COLIFIRM OB Other Bacteria Fecal Colifo Confirmation Final Membr n Filter a Coliform/100 ml ao Reported B ate Time hrs Comments: r®: s 3s Member of the SGS Group (Socidt6 G6n6rale de Surveillance) v cnt�non,... c..-.. .. .... ._.-.. ,.. ...eva r•a''cr'onnA a noinA 11 1-1110 —0— .,.., .—.. .-_,.-.. .,-- ...-......r,.-..1,. CT&E Environmental Services Inc. ' ML ® CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Parameter Nitrate -N Total Coliform 11 966075001 Tobben Spurkland P.E. Tract 4A Chickadee Slopes Potable Drinking Water Client PO# Printed DatelTime 11/15/96 11:26 Collected Date/Time 11/07/96 15:15 Received Date/Time 11/13/96 15:50 Technical Director: Stephen C. Ede Released By 2h9r1-- C LrL/ Allowable Prep Analysis Results POL Units Method Limits Date Date Init 5.47 1.00 mg/L SM18 4500-NO3F 10 max 11/14/96 WEP 0 0 col/100mL SM18 92228 11/13/96 TAV 19 OB W/O COLI PARCEL: 015-231-85-000-97 CARD: 01 OF 01 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: - - - - 1 ------------------------------------------------------------------------------ MICHELSOHN & DAUGHTER CHICKADEE SLOPES CONSTRUCTION INC TR A LT 4A 750 W DIMOND BLVD #100 0 ANCHORAGE AK 99515 1515 SITE 12200 ROCK RIDGE DR ------------------------------------------------------------------------------ LOT SIZE: 49,508 ---DATE CHANGED--- ----DEED CHANGED ---- ZONE : R6 OWNER : 07/23/96 BOOK : 2951 PAGE: 0152 TAX DIST: 002 ADDRESS: / / DATE : 07/16/96 GRID . 2739 HRA # 000000 PLAT : 820192 NOTES ----------------------------------ASSESSMENT HISTORY -------------------------- --- LAND-- --BUILDING- ---TOTAL--- FINAL VALUE 1994: 32,300 0 32,300 FINAL VALUE 1995: 32,300 0 32,300 --EXEMPTION--- FINAL VALUE 1996: 42,400 0 42,400 -----TYPE----- EXEMPT VALUE 1996: 0 0 0 STATE EXEMPT 1996: 0 -COMM COUNCIL - FINAL VALUE 1996: 42,400 MID -HILLSIDE GREP-XF-a- ANCHORAGE AREA BOROUGH DEPAR OF ENVIRONMENTAL QUALCASE 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For Date Performed -71 Legal Description: Lot+Btar-k /4 Subdivision1c — 5ill - This Form Reports Sails 0 9 -r 7 - 4ttn Test - 11) Depth Feet i 1�� 2 Soil Characteristics 3- 4 5 -St-_ I 5— clay _; A , ,,tL I-dIT F___I 6 7 8 9 10 Water Encountered? Was oun � Lf—V s, At What Depth? (2tQV.-II UA C k 4111.j lif _T( 7 16 &,-r7cw, 01 " J Reading I Date I Gross Time Net Time IDepth to H2O 1 Net Dro vercoiation Kaye- 1 n u t e Proposed Inst .page Pit Drain Field Depth Of Inl,,,,,-0.,'Depth To Bottom Of Pit Or TrencW_ COMMENTS: - Law- Fertormed a------ wIt Data Certified By: Date: 4p