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KASILOF HILLS BLK 1 LT 9
Kasl'* I of Hills Block 1 Lot 9 #015-161-01 Municipality of Anchorage Page I 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: SW R�1015 PID Number: (3 1S — I G I - 01 Name: a r(-2 inn Wastewater System: ❑ New R Upgrade Address: 01 Sheball 'of 4v.e 1446,ti 99$16 ABSORPTION FIELD / (/ Phone:_ �� � No. of Bedrooms: 19Deep Trench O Shallow Trench ❑ Bed ❑ Mound O Other LEGAL DESCRIPTION Soil Rating: Q,.q Total Depth from original grade: r a GPD/Sq. Ft. Lot: Block: S7/uubdivisign_ ��// Depth to pipe bottom from original grade: Gravel depth beneath pipe �f/ // T.5 0 T1 S 4 Ft, 0 Ft. Township: Range: Section: Fill added above original grade Gravel Is the a®3a�ACi'l Ft. .fiya Ft. WELL • ' ❑New ❑Upgrade �( Gravel width: "I o S Ft. Number of lines: IX Distance between lines: I O Ft. Classification (Private, ,S,C): Total Depth: G1Crs�ir'� �f.Vol e Ft. Cased To: Ft. Total absorption area: 10 SC. Ft. P e mateMrial:� �y 71ST' ` 1,/3Ol?y FD �Q Driller: ate Drilled: Static Water Level: Installed Date installed Ft.e Yield: - mp Set at: Casing Height Above Ground: TANK PM Ft. Ft. SEPARATION DISTANCES I(Septic ❑ Holding O S.T.E.P. To septic Absorption Lift HoldingPublic/Private Manufacturer: PPervirel- Capacity in gallons' I 1300 From Tank Field Slalion Tank Sewer Lines WeIF' L (OU+ t Material: leve Number of Com Compartments: p ®i �1h Surface 100`1- 100' LIFT STATION Lot Size in gallons: Manufacturer: Line J Foundation jj 4 N \ "Pump on" level at: 11P 'level at: High water alarm at: Curtain4 © /''1 e k/ jkq Pump Mak el Electrical Inspections performed by: Drain - c Remarks: Wil. •i2 5i L,3 4E N`c 1,.r -b,2.67 BENCH MARK 1 A4--,� d7�kP ��r SC:iH ,trA d1' Location and Description: -7- 6 I® O'["'F C��0.Q� $ iD12g �4; 1LU 1'1t�Ntj/'. NC wry F•i, /2 - F.J., „r t) 'i s 14 �ia•r I gg Ib �� 0�1'TH Prr Nu+2t1� TtrU rr. AT Assumed Elevation: ` F� FL 04rasr f4d } a g r iy �7 o 51& 4o ENGINE ' EAL T lJ[i r�1iN i, lilt-) •, F iN fi 1.1/1Z.'E' �tG-il'u.'rs5 7'f 1i. /�t P��.. a...��1��� 17034 Eagle River Loop Road, No.2"* tagi0River, Alaska 7 a�`9� 44th Inspections performed by: 99577 Dates: 1st 2nd�'al"mac ... ✓... .._..�2 y, e0BERT C. COWAN t QQ CE-8801? Department of Health and Human Services approval :•�y�; Reviewed and approved by: Date: L `' 3ti,Z.z;_�� 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW9901 53 PAGE 2 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.11, Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 9, BLOCK 1, KASILOF HILLS S/D P.I.D. NO. I LOT 8 1 I I rsrna CO2f5dNT1 z IL—L— z n r s N°y CO' TH ST2 S1 I pO F'�w fP�rt�ks H➢HL1 S OHL2 'N ]300 GALLON YETH POLYLENESEPTIC — YETH TANK I I S H 015-161-01 / UNDEVELOPEIY UTILITY EASEMENT OLD SEPTIC TANK POOPED, CROSNE➢, AND ABANDONED H � I � CO EXISTING P� 3 BEDR001 HOUSE LOT 2 LOT 1 I RANIT AVE, LOT I A� l ROBERT C. COWAN f �! iG%,�• CE -8801 -i HG_' J � F_ J W � 3 � � a I o q Q D CD Q CL 3 m �m J ti W I z LOT 2 LOT 1 I RANIT AVE, LOT I A� l ROBERT C. COWAN f �! iG%,�• CE -8801 �I W 1 a I LOT 2 LOT 1 I RANIT AVE, LOT I A� l ROBERT C. COWAN f �! iG%,�• CE -8801 PERMIT NO. 015 53 PAGE 3 OF 3 MunicipaUt of Anchora e DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 •Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 9, BLOCK 1, KASILOF HILLS S/D P.I.D. NO. 015-161— FINAL GRADE MTI =86.2' STI TRENCH #1TRENCH #2 C01=98.4' CO3=96.7' nfl /_ CO2=98.4' /_ C04=96.7' C01=94.0' C04=92.4' CO2=94.2' SR MT2=84.4 AL GRADE 1 INSULATION 95.2'---/I NEW 1300 GAL, POLY. TANK 1 95.0' NO WATER FOUND 78.4' B.O.H. N. T. S. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW990153 Legal Description: KASILOF HILLS BILK 1 LT 9 Design Engineer: 0003 S & S Engineering Owner Name: Warren Penny Owner Address: 8901 SHEBANOF AVENUE ANCHORAGE, AK 99516-1285 p tt'� a "'d t 17yh Date Issued: Jun 18, 1999 Expiration Date: Jun 17, 2000 Parcel ID: 015-161-01 Site Address: 008910 SHEBANOF AVE Lot Size: 30785 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 7-21-y9 E&61mEER CI41.1-E0 ANO RE✓IS80 J7ES/6A/ %D 7'w0 rREArr",&$ wit HRVE QIFF1e"4LT/E6 144/NT/¢/A//N(, fEN/4I(+pjioy TO EafIST/NL DA'N/r+F/6Lp' 6f ?-me, I2E 4' u /IPE/i 20 WILL 8E lir oRl. 1 N< r? /6 ; Received By: Issued By: Date: 6 rZ z"— of / G Date: tnGrneeRrnG ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 June 7, 1999 HEALTHAuTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 SEWERBWATER Anchorage, AK. 99519 MAINEXTENSIONS REFERENCE: Lot 9, Block 1, Kasilof Hills Subdivision SEWERS WATER INSPECTION Request you issue a permit to install a septic system to serve the existing three bedroom dwelling on the referenced property. ENGINEERINGSTUDIES One test hole was excavated and percolation tests performed. The approximate location AND REPORTS of the test hole is located on the attached site plan. . At the time of excavation, 6-2-99 water was not found. After seven days of ground WELLINSPECTION - water monitoring the monitoring tube was dry. SFLOWTEST We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The SITE PLANS construction of this system will not prevent any future development on any of the adjacent properties. ROADDESIGN If you require additional information, please contact us. - SOILTEST nSincerely, /&17 6/Robeirt C. 'Cowan, P.E. PERCOLATION RCC/bjj TEST Enclosure STRUCTURALA MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP+ SURE 204 • EAGLE RIVER, ALASKA 99577 C = m' DEIGN SITE -PLAN SCALL ]m � w�-� SRR®± 6 » k§§� $ \§\)% §momTV � -u� ; t= , S w r— - - - - — - — - - — - A Z A NEIF ° DR',- -13 © I Via`° ~ TRENCH ►_/�{�I ( I / e | / ° , * �\ _ �< rtx n ¥§ fi n � ��� ° /�) < �z r;9©!v y ■ 100 WELL RAC; I ®® WELLRADIUS < - � I -------------- lgmqu #gEnoi F-9 r- ® ! r \\\ ; q !!, -Q, r ' � � .P.- Ln ! , %�(� �r Ln 2 m c oil 2 2 @ .� � Ln S. 2 . 00 0c ± ®mak \/ 99 m :G --4 ) \ � . 2 » 2 !% �c f ® \ W ° 2 r / / Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: WAILAErrj P4IJMY DATE PERK LEGAL DESCRIPTION: 1'O T I 13LOLK / Township, Range, Section: DEPTH Y� S I !- `v !'= J-�rC-L. S 8 f� SLOPE (FEET) 1 t•>> i eRG.RNi c.S 2{ S$` 3a,•A 4 ' ? -E.0 `t- 5 � r J '3 is 6 ` 7 P3 lO�� 8- i' 9 - • e 10 12- 13- 14- 2 13 14 •3 15 �y 16 17 18 19 20 COMMENTS &t ) WAS GROUND WATER N® ENCOUNTERED? S IF YES, AT WHAT L DEPTH? O P E Depth to Water Atter Monitoring? DRy Dale: 6 AA, °I Reading Date Gross Time Net Depth to Time Water Net Drop b 3 cti G n 40 y 2/1 •, ,r „ 9 o 104" PERCOLATION RATE_1 v (minutes/inch) PERC HOLE DIAMETER , TEST RUN BETWEEN 7i FT AND l '7t- FT S & S ENGINEERING PERFORMED BY: I� - �' n CERTIFY THAT TJiIS FEST WAS PERFORMED IN age ive• Loop Road No. 204'/ / ACCORDANCE WITH ftWRjfajkPAlV"Il�lM;1GUIDELINES IN EFFECT ON THIS DATE. DATE: g q 1q 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR990057 PID# 015-im-m HA# Permit # SW990453 Date Received: 8/13/99 Legal Description: Kasilof Hills. T,ot 9, Block t Engineer: S&S Engineering 17034 Eagle River Loon Road- No. 904 Eagle River, AK 99577 Applicant: Waiver Requested: 1 foot waiver bptwppn a�rianA an 9a� wa. tew - '' �-jys-tem. Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer Rec #: #or,I ao Amount: $ 115.00 Date Paid: 8/11/q9 Municipality of Anchorage Department of Health and Human Services�c 825 " L" Street Rick Mystrom. P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor httpl/www.ci_anchorage.ak.us S & S Engineering ATTN: Robert Cowan, PE 17034 Eagle River Loop Rd, #204 Eagle River, AK 99577 - January 17, 2000 Subject: Waiver Request for KASILOF HILLS BLK 1 LT 9 Waiver # WR990057 Lot Line Request for Parcel ID 015-161-01 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 1 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely����� Jeff Poet Engineering Technician III On -Site Water Quality Program Municipality of Anchorage OS- s • '� DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 AON-SITE SERVICES FEE DOCUMENTATION Date Paid: Permit Number: Name of Payer: (Name on Check) S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Receipt #: Mailing Address: (Off of check) Eagle River, as a heck #-. f� u i Legal Description (s) Type of Payment: (Indicate Amount Paid) — ✓% Health Authority: i E' Excavator Permit: _ Sewer & Well Permit: Engineer Permit: _ Well Permit: Pumper Permit: Sewer Permit: Well Driller Permit: _ Copy Request: Tank Manufacturer: _ (Waste Treatment) 72-034 (Rev. 10/87) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank: Well to Field Field to Surface Water Tank to Surface Water WHITE—MASTER FILE CANARY—PROGRAM FILE HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREFORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN August 12, 1999 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 i REFERENCE: Lot 9, B1ock.4,"KasilofHills Subdivision ROBERT C. COWAN CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 AUG i3 1999 MUNICIPALITY OF ANCHORAGE `.NVIRONMENTAL SERVICES DIV)S10, Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the west property line at I foot. We do not anticipate any adverse effect on the adjacent property since it is a right-of- way. If you require additional information, please contact us. Sincerely, E 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 Robert C. Cowan, P.E. RCC/skh E 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577 MUNICIPALITY 01= 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 �! PHO LAhEW Ue.l ptl `b3rf T2 �_0 3 6 -- --- ---- --- --- �5❑ UPGRADE -------------- ---- — MAI LING ADDRESS i00 Art c B]_vd , LEGAL DESCRIPTION - —`- lot. 9, BIA, 1, iGtsilof ili.lIF Sulxl, LOCATIONy Corner ula.za,nof an(' 3,feba,nof- NO. OF BEDROOMS 2y Well Absorption area DISTANCE TO: ___ Dwellinn PERMIT NO. F 2 Manufacturer rr ;reer Tan. _ Material -� - r, tc 1 No. of compartments 7 W F w Liq, t 7 4 G Ij1"_ ity in gallons y IF HOMEMADE: Inside len th Width --- - Liquid depth Y d DISTANCE 10: Wr 1 Dwelling - .T PERMIT NO. a� O 2 Z --------- --------IT ------ O e F - Manufacturer Material .� Liquid capacity in gallons O w y DISTANCE TO: Well 1 `;Q Foundation 25 11 15,lot line �T _ PERMff N0. E.amC J LL Z No. of lines Length o1 each line ,- Total length of lines 1rench vylr,I h O Distance between lines \A ' Q Oce — - - ---- - ------ --C --- � - -- - inches -_--"-" lotal effectiv..ahsorption area N Top u( tilt. to finish r tde grade Material beneath rile 1 �U 1,20 inches U11 f Length WidthDepth PERMIT NO. vi Type of crib Crib diameter a H p- Crib depth Total effective absorption area W ___ Lu DISTANCE TO: Well Buildingfoundation Nearest lot fine DrillerDistance to lot I;nh PERMIT NO. uj 1),fANCF T0: Absorption area(s) Building foundation Sewer line Septic tank OTHER A` PIPE MATERIALS J11. PVC - --- SOIL TEST RATING �— 1 `i0/lx1.rm, --- l� �. -- -"— ---- INSTALLE=R ' REMARKS l;Ut 111 Ttl3_CC OVB1" 4f1S01^Ci roc'c -,�it'1 pla5-tic. 7'rcnc%1 J>rohetiy - hack Fill '- ( — --- -- - --� - - - — --- k 4P' 1 cr- <� -. o onnnonnaen Ouonnanr�conopcndve ofq --i(AA .rt-p— .p ae9nte lVJfy o 0Nv1d J. Harman ivfU IC1 Lh- OF-RN- P) % NO. f 19Q. _ '' �---- DPT. OF H .ALTII & -- -- — .�RECEIVED78 `APPROVED //.^� `/ /` DATE LEGAL Ilavi.cl <J.' lla.rraarl to-6-78 TYPE OF SOIL HBSORBTION SYSTEM TRENCH MRXIMUM NUMBER OF BEDROOMS = ] SUlL 1011 1053 (SQ F[/8R15wi THE REQUIRED SIZE OF THE SOIL HB1-ORPTIO11 .1 SYSTEM IS: 11 1:i::: � 11 11 f= : 1. 02 �U 44113 - f- P.8� 1 & ms� C 11 Q f I %� I K I ��(I �i � , 11 !1 - 0= :�z " THE LENGTH DlMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELIn. THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEH THE SURFHCE OF THE GROUND RND THE BOTTOM OF THE EXCHVRTItoo (IN FEET) THERE lS NO SET WIDTH FOR TRENCHES THE GRHVB. DEPTH IS THE MINlMUM DEPTH OF GRAVEL BETWE[N THE OUTFHLL PlPE HND THE BOTTOM OF THE EXCHV8TION (lN FEET) TO 0 K 1 V P_ 0 ]: 0 Q Kh In> S& pz� 413 W_ : IF w 1; v 11001pof 15 : 1: � 1 F 1c- �1 , WTI C09 q oil 40 1 . L_CA PW I PERMIT HPPLICHNT HAS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTHLLHTION INSPECTIONS OF ANY WELLS HDJHCENT TO THIS PROPERTY HND THE 1 .41. 11,. 18ER OF RESIDEI'd CES IHT THE WELL |JICA L SERYE. V Up CA -f 2? !. K 7E 130051 y? 14 o In Q kh &T y 1, TY U TO BRCKFILLING OF HNY SYSTEM WITHOUT FINRL INSPECTICPA HND HPPROYHL BY THIS DEPHRTMENT NILL BE SUBJECT TO PROSECUTION. HM�71011011 I 1 1100,100" X lfw?U?� 10 47 T2 &� Q8E3 HVAQ : , I CERTIFY THHT i� I HM FHMILIHR 1,11 141 T|}E REQUIREMENTS FOR ONSITE SEWERS HHD WELLS HS SET FGRTH BY THE MUNICIPAL ITY OF HNCHORHGE. 2� I WlLL lNSFAL L THE SYSTEM IN OCCORDHNCE Hf 111 THE CO0ES ]� I UNDERSlHND THOT THE Off ~SlTE SEWER SYSTEM MRY REQUIRE ENLORGEMENT IF THE RESIDENCE IS�REMODELED 10 INCLUDE MORE IHN � BEDROUM!::::, 91 "5 2f9 4- 6. y zQSP.rr/cr/ /=LR- v -t9° 4u U , I i c:. \ rx m � i 14o— o 63 riLr-v r00 a \ I hereby certify that an accurate survey of the 91 "5 2f9 4- 6. y zQSP.rr/cr/ /=LR- v -t9° 4u U , I i c:. \ rx 20 c:. \ rx i 14o— o 63 riLr-v r00 /�py7 I hereby certify that an accurate survey of the Q following described property -- o, 00 0 F` L l.. - was made on_:'=fL_�_ and that the Improvements situated theron are within the S on the property lying adjacent thereto, that no , improvements on property lying adjacent there. - to encroach on the promises in question and that ,,,,..9 ,• ••»•- there are no roadways, transmission lines or Robert W. ` irns rr s J) as indicated hereon. ! � J � .a 20 I \ rx 'y o 63 riLr-v r00 I hereby certify that an accurate survey of the following described property -- 0 F` L l.. - was made on_:'=fL_�_ and that the Improvements situated theron are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no , improvements on property lying adjacent there. - to encroach on the promises in question and that ,,,,..9 ,• ••»•- there are no roadways, transmission lines or Robert W. ` irns rr s other visible easements on said property except as indicated hereon. ! � J � vAr' Dated at Anchorage, Alaska, this - day of PREPARED FOR JA t_�eC r o DE S.BYC?�(;r DA -1'E CNK. BY W.O. NO. SCALE /'/- ,p' SKNO. / OF/ F.B. N0, t� o ,-a ;, `r 2 L.+ C_ 7- j o r+ ROBERT W. BURNS REGISTERED LAND SURVEYOR No. 1232-„ 5303 No.Star Dr. Anch.,Ak.99502 !- "One :ea ti 22.04 Cleveland Anchorace, Alaska 99503 Performed For-___D_olph Roan Date Performed_ 7-20-78 Leaal Descrintion: Lot_9 Block _1 Subdivision K_aailof u;tis�hd vis en ----- This corm Renorts Soils Lon Yes __-_---_Percolation Test--- Yes_ -- tenth Feet = Soil Characteristics 2 — e3 4aBrown Silty Sandy Gravel -- te, 6 -- 8-- Brown Sandy Silt with occasional 10 -- Gravel 12 -- 14 _- 16- 18 6-18 _ Bottom of Test Hale 20 ---- Was 0 ---- Was C -round Water Encountered?_ No— If Yes, At what Depth? Readinq i Date _.7-20 7-21 7-9_i Gross Time tr'c:t Time -I AN-J--�- _� — -- -- - 10 10 min _—�_- - - 10 men � 44" - Percolation Rate - - I- --- A- L-� i -- Depth to fi20 I flet Dro __ Saturate Peri d _ __ - 10 min_ ___ 23'--- -- -__ -12_" 10 min----32'- -------------------- 10-min--� - ---381- - ---- - 611 - —--7-21 _� — -- -- - 10 10 min 10 men � 44" Percolation Rate 0.15" per Ili nute or 6.67 min/inch Prnnosed Installation: Seenaoe Pit Drain Field Depth of Inlet Depth To Bottom Of Pit Or Trench__-____-_ C r,V N r N T S : 150 S Ft .-draina e area—xe4uired._. er-_bedroom ------------------- ----- -- ---- — T e s t P e r f o r ;r. e d By David _ Paul ___-------.--__.-- _-- C a t a Certified B y:----____ _GT1 _ --- D a t e: 7-21-78-____-____ _-_ IB�Dm ISO% �BgrAm lRouvru A Awcw;lufamA(Gul9 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 450 Teet. DRILLED AT THE RATE OF 3188.00 PER FOOT, PROPERTY OWNER nUt.a�� 279-2882 LOCATION OF WELL SITE Bik. Suh. DRILLER BeAn Lp GtouA aP RampcvU j))z UA in.a Nwtk�. WELL, LOG: 32 Iiod&(jr.L A nnrl imenta&y. tcc _ Ro- 335---338' R caret r�cr o� t��inntrin�r nae�_�ha�r�i�r� �nmo_uxa�nla-pt�nritf��+rtn- — 338--.440'---- 440--•443' R Ao"m nick chow -4L 443--4501 SeMmera-ate nacF. -- Ta ta1, Oaten rytoduatt tart 4hau Ld Shaw 800�or .L4pe& dailye tci tr2 h an elatur i fh r tcoe to some wlzwt even a 7000 cwA4 aeA doav,. (1crva 400' _ate uro�ieh 4tand an cow4nao Gne ha)r4e Su h. Pump. 4hau td be, ta4tca U,ed 20 Peet aPP bo t%tor/a. S.tace 450 Peet tu'm &,&Uted, ;he-te wZU be a 75 Pont /lo Chaetae. Ato ao chwtge. Pali Wet t Sea.L. 7otal..f-ootaae cluvtaed: 375 Peet at 318000 pen Pot: 36750.00 /tt4o Zf- :th is GYe U p/tove-,j .jome what weak, R mnuVr t. w4,U dht Ut anathe t 200 Peel: at: aaotheA toca tai on. an lift. Paaa' 4 p toAe,z4 at, 910.00 lae�t Pooh.. COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 36750.00 THANK YOU VERY MUCH. BERN LAUS OF RAMPART DR[ LING WORKS DATE Coni 54-h _ 99 _ a - 1\ SERVICE CHARGE O F 1 %z% PER MONTH WILL BE ASSESSED ON PAST DUE; ACCOUNTS. — �� December 31, 1979 Patricia Roan Post O'EFLce Box 4--2835 Anchorage, Alaska 99509 Permit ; 790462. Subject: lot 9 Block 1 T,,isilof H1lls Su;JUJ_,J151On A permit issued by this department for well and/or sewer systel;I has expired. ermi.ts are issued on a calendar year, basis, as Stated on the permit, by authority of Municipal. ordinance. .If you have drilled the well, a well. log should be sent to th.is department to document the i.nstal.lai:ion date. If an engineer has inspected the installation of the On -•site sewer System, please have them Send us, the as-builts for our files. 'there are any further questions, ,Dlr_'ase contact i.his office at. 264.4 ,.c0. Sincerely, C %yes N. Buchh Senior Envi.r LNB/l. w kz-� YZa .� o1Z, R.S. ��� orimenta1 Spec ic-17st enc: Copy of Permit 1311 R _j two X (0:7»fly ���� o -l:- �::R P�lq 0 A rl":?. I"`� Cli� DEPHRTMENT ,F HERLTH HND ENVIRONMENTHL TECTION 825 'L' STREET/ 0NCHORRGE/ RK. 99501 264�4720 PERM1T NO. ( 790462 ) HPPLICHNT PATRICIA ROHN PO BOX 4-28]5 279 2882 LOCHTION SHEBHNOF HVE LEGRL 1 B1 KHSILOF HI[LIl; LOT SIZE ]4200 SQURRE FEET MINIMUM DISTANCE BETWEEN H WELL HND RNY ON~SITE SEW8GE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL/ OR 150 TO FEET FROM R PUBLIC WEL THE TYPE OF PUBLIC WELL WELL LOGS RRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY HPP IFICHTIONS HND CONSTRUCTION DIHGRHMS HRE RVHILHBLE TO INSURE PROPER INSTHLLHTION ������ ����IF E�i:_ III FEE �U 1-1 sit 14'. 1 1_ Sy I CERTIFY THAT 1� I RM FAMILIHR WITH THE REQUIREMENTS FOR ONPSITF SEWERS HND WFLLS RS SFT FO�TH rl!Y THE MUNICIPRLITY OF HNCHORH�E 2� I WILL INSTHLL THE SYSTEM �N RCC",TAkWITH THE LODES mumm ML.!ttiJ I ' T F- F:4 I -r'-r' CiF Rt -:H:=:F;:::FiCI E-= DEPARTME,,C OF HEALTH AND ENMIRONMENiAL PROTECTION '225 'L' STREET, ANCHORAGE., AK. 99501. 24-4 720 WELL .. " t om F-aF='m I T PERMIT 1-40. < //JJ AP'P'LICANT ! %�/� �C �� /`/• /C Gam* LOCATION he bivi el = 4u -t_ J LEGAL AoT-' 9 �j%� / /�� �; �C D �= [�, c L bS LOT SIZE 3 �©7�5 QUARE FEET TYPE OF SOIL ABSORSTION SYSTEM IS: MAXIMUM NUMBER OF BEDROOMS e SOIL RATING CSCE FT/BR"I THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C1Ei='TH= LEt-•I03TH= :=iF<_H'•:'EL CyEF'TH= THE LENGTH DIMENSION I S THE LENGTH CIN FEET? OF THE TRENCH CSR DR..A I NF I EL:D. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM, OF THE EXCA','ATICiN 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 E'CAVATION CIN FEET?. f:REi=!L.1 I F_:EC- EF'T I C_ TFRt-dnl_L_0P-.1'w. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY I -JELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE IJELL WILL SERVE. - --- TL-j��1 C: 2 ? I Y•.i F=m E:_ T I 0P-4 HF,'E F,EC!L! I F.:EC's — - BACKFILLING OF ANY SYSTEM 14ITHOUT FINAL INSPECTION AND APPROVAL BY THI DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I= 100 FEET FOR A PRIMATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 [NAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPEC: I F I CAT I DINS AND CONSTRUCT I CIN DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F'EFtt•� T T E�;F1 I F<~'E_• PES_ E t•1E:EF*: -:�_. I CERT I FY THAT 1: I AM FAMILIAR WITH THE RECUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE C:0DES. <: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ^ BEDRCIOMS. SIGNED; Applicant ISSUED B4' DATE----� _=:I ,-= •D AND WELLS AS SET ENLARGEMENT IF THE MUNICIPALITY OF ANCHORAGE 0 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. 015-161-01-000 Expiration Date: 1/18/2025 Legal description KASILOF HILLS BLK 1 LT 9 Site address 8901 SHEBANOF AVE Anchorage AK 99507 Current property owner(s) ROWE BENJAMIN X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: M bedrooms, with the following stipulations: Original Certificate Date: 1/31/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approva"une 2022 MUNICIPALITY OF ANCHORAGE Development Services Department `?rT Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-161-01 Complete legal description KASILOF HILLS BLOCK 1, LOT 9 Location (site address) 8901 SHEBANOF AVENUE, ANCHORAGE, AK 99507 Current property owner(s) BENJAMIN ROWE Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units -- -- -----— ------ –- -----[]]-Holding Tank--❑Community-Septic-or-Public-Sewer------ 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 25 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 114 6 - Date of Payment I ALL /z y COSA # 05C 2 9 1020 Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: KASILOF HILLS BLOCK 1, LOT 9 Parcel ID: 015-161-01 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 9/15/1979 Total depth 450 ft Cased to 32 ft (INTO BEDROCK PER MOA DOCS) Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 4/14/2022 Static water level at beginning of test 42 ft. Well production at time of test 0.6 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.502 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 01/18/2024 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 46” Date of pumping 1/24/2024 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/21/1999 ALL standpipes present per record drawing* Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 4/14/2022 Results Pass Fluid depth prior to test 0 in (WEST TRENCH) Water added 600 gal New fluid depth 22 in Elapsed time 1300 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 96 in (MOA 8’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 96 in Comments/Deficiencies: *Per past COSAs & recent digging SW & NE cleanouts could not be found in alders/snow/debris. Approximate total measured depths from existing grade with ED per elevation measured shots & appears approximate. FLUID LEVEL MEASUREMEENTS ON 1/23/2024 SHOWED WEST MT DRY & EAST MT WITH 11” OF FLUID DEPTH, WHICH IS BELOW PREVIOUS TESTING OBSERVATIONS OF 36” LESS THAN 2 YEARS AGO AS NOTED ON THE 4/2022 COSA. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No 1 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS WR#990057 – SEPTIC FIELD TO PROPERTY LINE / UTILITY EASEMENT. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 01/30/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 1/30/24 Well Water Advisory Certificate of On -Site Systems Approval # OSC241020 Subdivision: Kasilof Hills, Block: 1, Lot: 9 This well's productivity was determined to be .6 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. �MailingrAddress 'P O Box�196650`�~Anchorage,�Alaska99519$6650�www muni org MUNICIPALITYF 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. 015-161-01 1. GENERAL INFORMATION Complete legal description KASILOF HILLS BLOCK 1 LOT 9 Expiration Date: Location (site address) 8901 SHEBANOF AVENUE, ANCHORAGE, AK 99507 Current property owner(s) REBECCA & SAMUEL BEAL Day phone Mailing address Real estate agent 8901 SHEBANOF AVENUE, ANCHORAGE AK 99507 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 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: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 550 Waiver Fee $ Date of Payment 141 Date of Payment Receipt Number 009 ) yam, Receipt Number COSA # OS C,'12 !� 51 Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 4/18/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the W' OF well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q: • • • . for current or future occupants or guarantee that no unseen encroachments, deficiencies or fig•' '.9 lir discrepancies exist can be given by First Water Consulting & Fwr.5 % *� TM ....... f 6. DSD SIGNATURE `� • ' Curtis Huffman ' System #1 Approved for `J bedrooms 1� �• CE 128991 •. Q1_ ;01 ��F29 .4/18/�2•'F� System #2 Approved for bedrooms ill �PROFESS1oNP Disapproved Conditional approval for bedrooms, with the following stipulations: V _ON �QPLITY pF���i/i o WATER F � J _ 1 Z= M 141A rn �sERVICEs���`�� By: r Original Certificate Date: 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 C Other Legal Description: KASILOF HILLS BLOCK 1 LOT 9 Parcel ID: 015-161-01 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/15/1979 Total depth 450ft Cased to 32 ft (INTO BEDROCK PER MOA DOCS) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/14/2022 Static water level at beginning of test 42 ft. Comments B. TANK DATA Age of tank(s) 23 years Tank type/material SEPTIC / POLY Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 4/11/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/21/1999 ® ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert fromrq ade 4.2 ft (min) ❑ N/A — pressurized field Well production at time of test 0.6 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 2.11 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by F ES Date of Sample 4/1/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 4/14/2022 Results M Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 22 in ® Monitor tubes go to bottom of effective. If not, state depth into effective Elapsed time 1300 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 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 Comments/Deficiencies: *PER GEG 2016 COSA / ASB BUT SW CO NOT VISIBLE OR FOUND IN ALDERS & SNOW 36" OF FLUID MEASURED IN EAST MT. FW'i5 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 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' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft ft ft ft 111 ft ft Water Main >.1.0' Yes, if No ft Community Wells > 200' N Yes if No ft 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 1 ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100®Yes JfNo —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 WR#990057 — SEPTIC IN UTILITY EASEMENT PER ASB / WR. G. ENGINEER'S CERTIFICATION l certify that / 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. �AP OfA AQ k •• TH •• Curtis Huffman FFG, •. CE 128991 , • ii`�i Municipality o Anchorage o Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC221151 During a recent COSA on-site inspection and test of the potable water supply well on Block 1, Lot 9 of Kasilof Hills subdivision, the well's productivity was determined to be .6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ppc L� iP — -- s. `SSuC�r'1C�- Parcel I.D. 015-161-01 Expiration Date: 1. GENERAL INFORMATION Complete legal description KASILOF HILLS; BLOCK 1, LOT 9 Location (site address) 8901 SHEBANOF DRIVE *ANCHORAGE, AK Current Property owner(s) ERIN MEADE Day phone 260-0125 Mailing address 8901 SHEBANOF DRIVE *ANCHORAGE, AK Real Estate Agent EMMA SHIBE Day phone 250-0908 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ■ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ We,iverNanance request for. N/A Distance:= Received by:' Date: COSA to be released to the engine r niess .the e.qe requested b tthe engineer. COSA Fee $ 5_2_G Waiver Fee $ Date of Payment 7l 2J l � 5 Date of Payment Receipt Number 312-(o Receipt Number COSA # (7DS —1 ,�- ( 3 q ( 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. Address 3701 E. TUDOR ROAD, SUITE 101 `ANCHORAGE, AK, 99507 Engineer's Printed Name Engineers Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG provided an engineering evaluation of the well and/orseptk system in accordancewith the guidelines andregulafions established bythe MumcipalkyofAnchorage and indusfrypracfices. The reported rosAs describe the condition alike systemic on the date/s of the evaluation. Sepamtim distances were measured to readilydenlifiable features. Hidden defects orencroachments may exist that were not identified during the evaluation.The operationallire ofall wellsand septic systems depend on a vanetyof variables including, but not limited to, soi/conditions, groundmierlevels (that mayffuctuate during the year), qualkyof construction (materials and workmanship), and the waterusage oflhe fam iyufffizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory testresutls do not guarantee future performance of the systerNr therefore, GEG makes no warranty (express aimplied) regarding the future performance of the well or septic system. GEG makes no representation whotheran alternative well or septic system can be instafted on the prop edyin the a vent either of the cunenl systems fail. The content of this report is for the sok benefit of the persorupady who retained GEG. Refiance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, knot authorized. In short, GEG disavows any legal duty to anyone other than the persnnIpany who paid far this ration. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following Phone 337-6179 Date OFx ON-SITE PROGRAM I.() Original Certificate Date: The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory_ Other (Rev. 1011212) 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: KASILOF HILLS; BLOCK 1, LOT 9 ParcellD: 015-161-01 A. WELL DATA Well type PRIVATE **ASSUMED CASED TO BEDROCK If A, B, or C provide PWSID# N A Date completed 9/5/1979 Sanitary seal (Y/N) YES Total depth 450 ft. Cased to **32 ft. FROM WELL LOG Date of test 9/5/1979 Static water level <50 ft, Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION ***6/l/2016 Well production 0.55 g.p:m. 0.66 g,p,m, WATER SAMPLE RESULTS: ***WELL TEST PERFORMED BY AAROW PUMP & WELL SERVICE (SEE ATTACHED EMAIL) Coliform 0 colonies/100 ml. Nitrate 0.631 mg./L. Collected by: ARROW PUMP x WELL SERVICE *$!$I Arsenic: ND<5 ug./L. Date of sample: sI/2016 B. SEPTIC/HOLDING TANK DATA *SEE ATTACHED LETTER REGARDING TANK PUMPING Tank Type/Material SEPTIC/POLYETHYLENE Data installed 7/21/99 Tank size 1300 gal. Number of Compartments E Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping *5/11/2015 Pumper *A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 7/21/99 Soil rating <E/ >r ftlbdrm) 0.45 System type DEEP TRENCH Length 2 ® 32 � 64 ft, Width 2.5 ft. Gravel below pipe 8 ft. Total depth *1 +'ftEff. absorption area 1024 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 4/28/15 Results (Pass/Fail) PASS Forbedrooms Fluid depth ih absorption field before test **0 in. Water added **912 gal, New depth **9 in. Elapsed Time: *`1.95 min. Final fluid depth **0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If ye§; giVe,date — **TESTED WEST TRENCH ONLY; LIQUID LEVEL IN MT FOR EAST TRENCH REMAINED AT 31" THROUGHOUT TEST. CO2 ON INSPECTION REPORT COULD NOT BE LOCATED. D. LIFT STATION Date installed Size in gallons Manhole(Access (YIN) "Pump on" level at in. "Pump off" leve High water alarm level at in. Cycles tested Meats alar +& circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiftstation on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/deenout 100'+ Sewer/septic service lisle 25'+ Holding tank 75'+ Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property fine 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *11 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 *WR/)990057. SEPTIC SYSTEM IS IN UTILITY EASEMENT (SEE ATTACHED LETTERS OF NON—OBJECTION). G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and * T review of Munlcipai records that the above systems are in " .... ............ conformance with MOA COSA guidelines in effect t on this date. - G ness; ... Engineer's Printed Name JEFFREY A. GARNESS QQ a CE 79 Date 41e) lit. pp �ey f o QagnnprOfessiOna� 0Rev.11105) Municipality of Anchorage a Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC151391 During a recent COSA on-site inspection and test of the potable water supply well on Block 1, Lot 9 of Kasilof Hills subdivision, the well's productivity was determined to be .66 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage='$. 1 On -Site Water and Wastewater Program -- (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-161-01 1. GENERAL INFORMATION Expiration Date: Complete legal description KASILOF HILLS; BLOCK 1, LOT 9 Location (site address) 8901 SHEBANOF AVENUE `ANCHORAGE, AK Current Property owner(s) ERIN MEADE Day phone 360-0125 Mailing address 8901 SHEBANOF AVENUE "ANCHORAGE, AK 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: 4 _4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: N/A Distance: - Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 45tt 6 — Date of Payment 1 !. af(1 J'a., Receipt Number 03 j asP b COSA # OSCI S l 3A I Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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 Gayness Engineering Group, Ltd. Phone (907) 337-6179 Address 3701 E. Tudor Rd., Suite 101, Anchorage AK 99507-3246 Engineer's Printed Name Jeffrey A. Gayness Date 1 17IS— 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 oractices. The rovorted results describe the condition of the system/s on the dates 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 workmanshio), 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 quarantee future Derformance of the system/s; therefore, GEG makes no warranty (express or imniietl) regarding the future performance of the well or septic system. GEG makes no reoresentation whether an alternative well or septic system can be installed on the nroDerty in the event either of the current systems fail. The content of this report is for the sole benefit of the DersonInarty who retained GEG. Reliance upon the information provided in this report by any other person or Daily, including but not limited to subsequent vmoerty Durchasers, is not authorized. In short, GEG disavows any legal duty to anyone other than the Derson/party who oaid for this report 6. DSD SIGJdATURE ,✓/ System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for By: bedrooms bedrooms, with the following stipulations: ON-SITE WATER AND WASTEWATER PROGRAM Original Certificate The @I inicipfiTty�'of AlWorage Development Services Division (DSD) issues Certifcates 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 v Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 91-12,doc If more than 7 septic system is on the lot: COSA Checklist # of Structure served by this system, Certificate of On -Site Systems Approval Checklist Legal Description: KASILOF HILLS; BLOCK 1, LOT 9 ParcelID: 015-161-01 A. WELL DATA **ASSUMED CASED TO BEDROCK Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 9/5/1979 Sanitary seal (Y/N) YES Total depth 450 ft. Cased to **32 ft. FROM WELL LOG Date of test 9/5/1979 Static water level <50 ft. Well production 0.55 g.p.m. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION ***6/14/13 0.95 9 -13 -m - WATER SAMPLE RESULTS: ***WELL TEST PERFORMED BY ANCHORAGE WELL & PUMP SERVICE Coliform 0 oolonies/100 ml. Nitrate 3.67 mg./L. Collected by: GEG. Ltd. Arsenic: NO ug./L. Date of sample: 28/15 B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC/POLYETHYLENE Date installed 7/21/99 Tank size 1300 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping 15 I t�S Pumper f -+nrn r✓, ; . C C. ABSORPTION FIELD DATA *BELAW EXISTING GRAD Date installed 7/21/99 Soil rating .p.d./ orfelbdrm)0.45 Length 2 ® 32 = 64 ft. Width 2.5 ft. System type DEEP TRENCH Gravel below pipe 8 ft. Total depth-*12.33+ft. Eff. absorption area 1024 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/28/15 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test **0 in. Water added **912 gal. New depth **9 in. Elapsed Time: **195 min. Final fluid depth **0 in. Absorption rate >= 600+ ' `g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — **TESTED WEST TRENCH ONLY; LIQUID LEVEL IN MT FOR EAST TRENCH REMAINED AT 31" THROUGHOUT TEST. CO2 ON INSPECTION REPORT COULD NOT BE LOCATED. D. LIFT STATION Date installed Size In gallons Manhole/Access(YIN) "Pump on" level at n. "Pump ofr lev High water alar level at In. Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer marhole/cieanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas t o0'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *1' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WR#990057. SEPTIC SYSTEM IS IN UTILITY EASEMENT (SEE ATTACHED LETTERS OF NON -OBJECTION). G. ENGINEER'S CERTIFICATION 1 cer* that 1 have determined through flak inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Pd N me JEFFREY A. GARNESS Date %/ai 1I'r (Re liffi5) Municipality of Anchorage , Development Services Department = =� Building Safety Division a s On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 151391 During a recent COSA on-site inspection and test of the potable water supply well on Block 1, Lot 9 of Kasilof Hills subdivision, the well's productivity was determined to be 0.95 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. 30 Lot 8 I EAST 193.00 I Septic vents LLj >I 74.4--- � "12.0 p ' 72. •Septic vents LL CO 0 0 Osee I t0 N N 12.0 Z C r d i4ff � Septic vents I I .Asphalt ; / Z� O Z ;.:., Lot 9 i.',*r 30 SCALE: V= 40' 10' Utility Easement hain link fence 20.7 o Well 0 2 1/2 Story ' `c Frame House r 8416N Lot 2 13.J0 � "12.0 ' 72. 0 0 0 I t0 N N 12.0 C r d i4ff j d H Lot 1 0 OH I lL Z� z i.',*r N89058'18"W 173.01 SHEBANOF AVENUE — A4 I �/�•• Aw AV*: 49th 00 M.Fred Walatl:a;/ �� "rF• 3255—S� S i SSIONAI �♦ EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. JKD, FB 15-6, pg 20-21 BE 0 M AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 9. BLOCK 1. KASILOF HILLS SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th dayof JUNE ,2015. FRED WALATKA & ASSOCIATES (907-248-1886) Engineers and Surveyors Jun'11 ZB15 18.:59:81 899-Z94-5658 -> 9873383Z46 Merrill Lynch Page 084 Municipality of Anchorage Community Development Department On -Site Water anis Wastewater Program 4700 Elmore St. • P.O. Box 198650 Anchorage, AK 99519-6650 • http:/twvvw.muni.oFg/onsite • (907) 3437904 Well Decommissioning Log Legal Address: Subdivision _ Block �,_.. Lot _„- T R Section Lot On-ctte Water & Wastewater Program terrified Contractor performing the wen decomm9ssionin97 N :24 'c�q�f Signature: company,�,,�i vyell decommissioning date Method ordecommisstoning: AAMC 15.55.0600 a. ❑ b. ❑ c.� Location: Use the space below to provide a drawing of the property showing the Wowing teems; .....,�...,�.....,.,,...- ,. .�........__.,....�. • Nath arrow • Decommissioned wall, • OMherwater wells anthe property, Iwo separate swing.tie distanees for each well shown an the drawing. Note' The swing lie distances strep be measured from either permanent structures or the, property comers. l dr Please save torr your engineer. `Chis is needed for your COSA. G:lOommunity DevetopmenhDovetoPment So lces%Bulldlrg SafetpOn Site Water and WastewateAForms%Chent FemistVWI Docommlaonmg form.doc Dk - -, E: AND CASED OUT To T HE DEF,7H C.- DR€LLFD fh. 1,'4 RATE GO 'vEP 'TOOT. PRCRraTY Girr"ft its I�GG - . LOCATOf,r OF WELL srr /A- DR;LLER ?erg✓e Gita aj iam,2vt J.z JJ z�-; f WELL LOG; 'ts;.�.er��,FTnas�p„ u�rc _. _._i✓_ �k "ih_r. hno. — �hq,u o00 :r^J.a pe.=;a'c4..f1�••�.;f:_�/.%c�_.6rt, % tt�e -' eam� v a,t?.f�fh _.._._. hat ove,t ¢ 1000�ad—poet day. pint 400 chos hc'tr oe sub, _ _.. _._.aY mated 4%✓�{� !_n Pn 1 Pump �h.eu-Ld Lc _ 4etnlr..0 ed 20 j'eet o{�f:.bo•t-ton S4fLc 450 •Jzc tc Z U ifC a 75 �oo.t :no CJut tq ka.oa naes chdcge jag rt;ems Seal.. Ta to L dao teg.e fanged: 375 feet o f a 1c �0 ,rzet {oat: j 6%$0, 00 2Caa <� •tAt4 Eelt pRotre-�j dam2 ghat. rr��. :•'cm�n�t m {L d. oltio.FJt.et ?00 at anaFlra ocat an an (ivc. .'o Onr� p,Y.apr,'-0j at 910„00 pet raotw jr�.t COST INCLUDES ALL LABOR AND MATERfAL FOR COMPLETfON OF SAID DRILLfNG WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF,F�_ 5750_00 THANK YOU VERY MUCH, uERNF ...�LAUS DAT c. OP RAMPART DP,ILLIN<3 WORKS r• r\ tt 5ER4ICE CFi .RGE O �'r ; rEq M Oh7H WI;.L nr r,5SE55EDON rASr Du O LNTS ..._ u e (' jc t we - Jou 1181( GJae. �OMV r 44AA 5 was a"� G,GII Sk;1�� DA Page 1 of 1 Poet, Jeff W. From: Jeff Garness [Jeff@garnessengineering.com] Sent: Monday, August 10, 2015 8:37 PM To: Poet, Jeff W. Cc: Sonja Blewett; David Garness Subject: Kasilof Hills, Bk 1, L9 Mr Poet. I received your comment sheet dated 8/5/15. We are currently working on obtaining the ROW approval and will forward it to you once we receive it. In regards the well flow test, I am requesting that you accept the well flow test that was performed by Anchorage Well & Pump Service on 6/14/13. This is a low flow well 0.95 gpm (per the AWPS test results) and will receive an advisory notice from your department. We originally started on this job on 4/7/15, but delays in getting the inactive well decommissioned and obtaining letters of non -objection for the septic system encroachment into the utility easement delayed submittal to your apartment. Please call or email if you have any questions. Best Regards ........................jell Jeffrey A Garness, P.E., M.S. President Garness Engineering Group, Ltd 3701 East Tudor Road, Suite 101 Anchorage, Alaska 99507 Ph: (907) 337-6179 Cell: (907) 244-9612 Fax: (907)338-3246 Website: www.garnessengineering.com 8/11/2015 *."nompsew WATERWELL - TEST PUMP REPORT Conducted by Anchorage Well & Pump Service 330 E 76th Avenue, Anchorage AK 99516-2$40 Ph: (907) 243-0740 Fax: (907) 243-0742 Owner Information Owner: ERIN MEADE Address: 8901 SHEBANOF Well Location: Static Water Level: Max Drawdown: Air Line Depth: Average Discharge: PUMP ON PUMP OFF 30' 205' Time: 10:15 AM Date: 6/14/2013 Time: 3:00 PM Date: 6114/2013 Well Information Total Depth: Depth of Casing: Static Water Level: Casing Size: Screen Diameter: Screen Slot Screened From: Screened To: Remarks: ,..,.. r`nmmP-ntS ElapsedWater Level Ftowmerer rivw Urin -- - Time Feet Meters GALLOWS PUMPED PRIOR TO TEST=4160 6/7-618 847620 0 `. 10:00 30 s.v 10:20 46 i4.° 847642 --- 10:35 1 :3 1050 10:58 12:00 1:00 —200_ 3:00 — --- 117 �.. 35.7 175 205 62.5 _ 00 0.0 1 0.0 205 62.5 �— 7745 _ 7831 7874 J $104 — 5.7-- .710:58 19 -524.9 0.0 0.0 540.3 _ -540.3 -- OUT OF WATER OFF — — — OUT _— — 0.0 — —~ 0,0 ------ - — -- 0.0 — 0.0 0.0 —. 0.0_ °.0 o.o — — ONS PUMPED= E PUMPL'U= TEST YI LD= _ o.o 0.0 484 4 HR. .95 GPM -- — r——-- — �— —`�--_—J GALI Til — -- WE — — — o.o — 1203-24A Grid 2641 EN15010 015-161-01 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Erin Hall Meade (herein "Permittee"), whose address is 8901 Sehbanof Avenue, Anchorage, Alaska 99516. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Dedicated by the plat of the subdivision known as Kasilof Hills Subdivision, according to Plat Number 66-96, filed on the 0 day of August 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The North Ten Feet (N 10') of Lot Nine (9), Block One (1), Kasilof Hills Subdivision), according to Plat Number 66-96, filed on the 5a' day of August 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Nine (9), Block One (1), Kasilof Hills Subdivision, according to Plat Number 99-96, filed on the 4a` day of August 1966, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). 2. Encroachment. Permittee has constructed or purchased the following improvements on or within the real property subject to said Easement: Encroachment Permit - Page 1 of 4 Aseptic stand pipe that encroaches approximately One Foot (1') into the south side said Easement for a distance of approximately One Foot (1'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Running with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by anymeans to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. Encroachment Permit - Page 2 of 4 C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. PERMITTEE By B3� Shelly Schmitt, Senior Manager Erin Hall Meade Distribution Engineering � Date: Date: 0-e'l-0 8 lkils ` Encroachment Permit - Page 3 of 4 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this _rg? day of , 2015, by per(`-,,,, (-4\ w—�' (PRINT NAME(S) OF PERSON(S) SIGNING DOCUMENT) NOTARY PUBLIC TARA BUCHHOLOT STATE OF ALASKA My Commieelon Exp, April 13, 2019 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) Notary Public in and for the State of Alaska My commission expires: �i 1.�,(?®l� The foregoing instrument was acknowledged before me this day of ,2015, by Senior Manager, Distribution Engineering of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. Notary Public in and for the State of Alaska My commission expires: AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 Attn: Land Services Department Encroachment Permit - Page 4 of 4 Laska alas kacommunicati ans.cam June 19,2015 Erin Meade 8901 Shebanof Avenue Anchorage, Alaska 995007-6357 Alaska Communications has no objection to the septic system encroaching into the 10' Utility Easement located along the northern boundary of Lot 9, Block 1, of the Kasilof Hills Subdivision, otherwise known as 8901 Shebanof Avenue as depicted on the drawing submitted. Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 11 Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communications. 3. Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be bome by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way predude Alaska Communications from full use and enjoyment of its rights within any portion of this easement 6. Alaska Communications is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. PIeaCsign'ielow,yretati,",thi's%rtii;fOcynur�. se.andta'uralasignedco`pybacicto"JUaskaommtfnications cerely, La th, a 'En "ineering Foreman ka:C0 munications Outside Plant Engineering, MS#14 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: DATE: Grid OMWC 2641 June 15, 2015 Erin Hall Meade 8901 Shebanof Avenue Anchorage, Alaska 99507 Dear Erin Meade: Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the septic vent encroaching into the utility easement at the north property line of Lot 9, Block 1, Kasilof Hills, also known as 8901 Shebanof Avenue, city grid 2641. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any fixture required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. Sincerely, Acceptance Date David D Blelun OSP Design Manager GCI Communication Corp 5151 Fairbanks St. Anchorage, AK 99503 907-868-6769 Office 907-868-8580 Fax �NSTAR ® Natural Gas Company ENSTAR Natural Gas Company A DIVISION OF SEMCO ENERGY Engineering Department Right of Way Section 401 E. International Airport Road P. O. Boz 190288 Anchorage, Alaska 99519-0288 (907)277-5551 FAX (907) 334-7798 July 9, 2015 Erin FI. Meade 8901 Shebanof Ave. Anchorage, AK 99507 Grid: A2641 Re: Letter of Non -Objection To whom it may concern: ENSTAR Natural Gas Company has no objection to the septic vent encroaching into the 10' utility easement parallel and coincident with the North lot line ofKasilof Ifills Lot 9 Block 1, according to Plat 69-233, Records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1, Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, inc., (907) 278-3121 or 811 for fine locating two (2) business days prior to any related excavation. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be home by the land owner. • All applicable safety code regulations will be observed and maintained. • This Ietter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, Robin Leighty Right of Way and Permitting Agent ENSTAR Natural Gas Company � pent MUNICIPALITY OF ANCHORAGEsP Community Development Department � Right of Way Section Department ENCROACHMENT PERMIT R152245 THIS AGREEMENT, made this 25th day of August, 2015, by and between Erin Hall Meade and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: KASILOF HILLS, BLOCK 1, LOT 9, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The 10 FOOT UTILITY EASEMENT, located immediately to the north on PERMITTEES property as shown on Plat No. 66-0096, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a septic vent upon the referenced real property which encroaches entirely feet upon the PERMITTER'S 10 foot Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Community Development Department, hereby grants to the PERMITTEE the privilege of allowing a septic vent to encroach entirely upon the PERMITTER'S 10 foot Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching septic vent, as placed upon the PERMITTER'S 10 foot Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Community Development Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 10 foot Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $115.00. The PERMITTER hereby waives the annual fee of $300.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: Erin Hall Meade, owner GRANTOR: MUNICIPALITY OF ANCHORAGE ck L. Frost, Jr. fight of Way Supervisor STATE OF ALASKA ) S& THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 1� day of 59,0eM1to 2015, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. lNE.W Y,�T; �OTAR Y'•. Pwoc c: o i pyr. ti ; STATE OF ALASKA THIRD JUDICIAL DISTRICT NOTARY PUBLIC in and for Alaska My Commission Expires: Rb 1.1"1 ) ss. THIS IS TO CERTIFY that on this —9—h day of cx og4,4 yr 6,R r . 2015, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Erin Hall Meade, known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)he acknowledged that (s)he did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that (s)he was authorized to execute said instrument. WITNESS my hand and official seal onthe day and ear first w n. NOTARY PUBLI in and for Alaska OFFICIAL SEAL My Commission Expires: 1Q i tn5 SEAN P MCDONEU. NOTARY PUBt1C-0REfaON COMMISSION NO. 462553 W COMMISSION EXPIRES OCTOBER 11 2015 30 SCALE: 1"= 40' -ON I gat ' I Let z EAST 193.00 � 1€' Utility Easement Septicver;ts---�--------------, haln link lance ? 74.s.20.72 112 Story 0 Well a Lm om N89*58' a 8"W .73.131 :v1 SHEBAN€7F AVENUE OF A� C` Rl ,,• 49th dr o.Fred Wolatka:�s Eypq• 3255 - 5g ieO` �®� m AS-BLtLT NO CORNERS SET THIS DATE I hereby certify that f have performed a Mortgagee's in of the foUavlrxr described nronatty i 171T o RI r sPm Anctwraga t2etording Precinct. Alaska, and that the improvements actuated !hereon are within the property lines and do not overlap or encroach on the Mixtrly Wig adjacent thereto, that no irnprovemarrts on Use property tydlg adlacent %hereto encroach on the premises In 4uestton and that there are no roadways, transmission arses or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN this 11th day of JUNE 2015. THOSE SHOWN ON THE RECORDED FRED WAI.ATKA & ASSOCIATES PLAT ARE NOT SHOWN HEREON. JKD FB 15-6 2i}21 B£ Engineers and Surveyors _ Pg (9A7-248-i666j 3k RkkuhIY1wa w- 0 f !c 0 CD � Lot 1 !w O ! Z !is I ! 4 m AS-BLtLT NO CORNERS SET THIS DATE I hereby certify that f have performed a Mortgagee's in of the foUavlrxr described nronatty i 171T o RI r sPm Anctwraga t2etording Precinct. Alaska, and that the improvements actuated !hereon are within the property lines and do not overlap or encroach on the Mixtrly Wig adjacent thereto, that no irnprovemarrts on Use property tydlg adlacent %hereto encroach on the premises In 4uestton and that there are no roadways, transmission arses or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN this 11th day of JUNE 2015. THOSE SHOWN ON THE RECORDED FRED WAI.ATKA & ASSOCIATES PLAT ARE NOT SHOWN HEREON. JKD FB 15-6 2i}21 B£ Engineers and Surveyors _ Pg (9A7-248-i666j 3k RkkuhIY1wa w- POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspection. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE RIGHT OF WAY DIVISION See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this permit. Signature 1��v` Date: AO '�4/6� Parcel I.D. # 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 li.C✓, v Q0 vv' 1 7 �a u CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 015-161-01 HAA# 1. GENERAL INFORMATION Complete legal description Lot 9, Block 1, Kasilof Hills S/D Location (site address or directions) 8901 Shebanof Anchorage, AK Property owner Warren Penny Day phone — Mailing address 8901 Shebanof Ave., Anchorage, Ak 99516 Lending agency Mailing addre Agent " Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 - 3. TYPE OF WATER SUPPLY: Individual well XXX Community well Public water Day phone Day phone 346-3333 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: XXX 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 (Re. 1191) 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 furtherverifythat 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. S & S ENGINEERING G y- �-9 Name of FirmEagve.oopo. 1, Phone Address Eagle River, Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. 0 3 Conditional approval for Additional Comments Date ILi/00 O� , ...... g IV, N RoBFRT t. ZOWAN pacT:t' LE -809 1 f �.. F .. _. 1 f,t`o P� CfFJ5i0�*� bedrooms. bedrooms, with the following stipulations: Date / - / 7 - © o 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. 72-025(R..191) sack MOAM21 Municipality of Anchorage Jg1a„ DEPARTMENT OF HEALTH & HUMAN SEWPS %'?o1/' Ak Environmental Services Division',' seon, r�Q`a„ _. A 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) N1-4744.. Health Authority Approval Checklist Legal Description: Lo / 9 Q L oc. I 1<,+S i bQ it HI L f Parcel 1. D.: 0 1 S - / G A. WELL DATA Well type PLY47"IL If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y& N 0 Date completed /q-79 Total depth a a 7 , Cased to K 0 f Casing height (above ground) 1 -4- Sanitary }Sanitary seal &N) Y I Wires properly protected (9/N)yk i FROM WELL LOG Date of test Static water level J Well production g.p.m. WATER SAMPLE RESULTS: Coliform J Date of sample: 1/7/00 Nitrate /. 7/6 AT INSPECTION cd �io.�g 9 i 1{ H 0,6 Other bacteria rr am Collected by: S & S ENGINEERING i 7034 Eagle River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed l 41 / Q % Tank size 13 o G Number of Compartments A Cleanouts(&N) Ye -f Foundation cleanout&�N) Y4 -r S Depression (Y/® 'V c'' High water alarm (Y/_ /V a Date of Pumping /V/L} - N A�) Pumper C. ABSORPTION FIELD DATA Date installed T 1 C? Soil rating (g.p.d./ r ft2/bdnn) '� S System type _rA If L H E S Length G H / T oTAL Width "x Gravel thickness below pipe Total depth 3 ' Effective absorption area /0.1 y Monitoring Tube present (¢/N)y4J Depression over field (YO ti C Date of adequacy test` ' N / 4 - Results (Pass/Fail) For .5 bedrooms Fluid depth in absorption field before test (in.); Immediately after_ al. watetadded (in.): _ Fluid depth (ins) Minutes later, _ Absorption rate Peroxide treatme asr72 months) (YM) If yes, give date 72-026 (Rev. 3/96)` D. LIFT STATION Date installed Manhole/Access (YM) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: r Septic/holding tank on lot C! t On adjacent lots Absorption field on lot ) 0 0 -i-- On adjacent lots Public sewer main N Sewer /septic service line off' level at* /OD + lOo � Public sewer manhole/cleanout Lift station N /a ,A)l SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: r � Foundation Property line 33 Absorption field I Water main/service line % 0 t Surface water/drainage J u 0 '` Wells on adjacent lots / O o 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Aca.ks74i6 ) ' Property line I CN'41v44 Building foundation 6 0 Water main/service line Surface water J 0 0 '4- Driveway, parking/vehicle storage area _ Curtain drain N J 1' E k,v c w ;/ F. ENGINEER'S CERTIFICATION Wells on adjacent lots I certify that I have determined thru field inspections and review of Municipal records in conformance with MOA guidelines in effect on this date. Signature e n Engineer's Name Date / //J /C70 (6 � HAA Fee $ &D o • o� Date of Payment 1 Ill 100 r1 l Receipt Number 72-026 (Rev. 3(96)* Waiver Fee $ Date of Payment Receipt Number 0 r ao 4 4- 61%% 6e% ve)hwms are CE - 8801 MUNICIPALITY OF ANCHORAGE M E M O R A N D U M WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL N0. 0 0 O 0 /3 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Lot __J__Blocs _ of K 5 11,0F _� 1§11L LS Subdivision, the well's productivity was determined to be 0,6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 bedroom residence is () 31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the Production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. EV i--161'-01 Property owner Craig Schmidt Day phone 562-2334 Mailing address 721 Seasame Street, Suite 2B, Anchorage, Alaska 99503 - Lending agency Mailing address Day phone Agent Petie Strang % Re/Max Properties Day phone 257-0165 Address 2600 Cordova Street, Anchorage, Alaska 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: three (3) 1. GENERAL INFORMATION 3.,: TYPE OF WATER SUPPLY. I xxxxx Individual well. Complete legal description'Lot 9 Block 1' Kagilof Hills Subdivision 7 1 Public water NOTE: If community well system, provide written confirmation T 7 Location (site address or directions) 8901 Shebanof Avenue: - j TYPE OF WASTEWATER DISPOSAL: Individual on-site XXXXXXL: Holding tank Property owner Craig Schmidt Day phone 562-2334 Mailing address 721 Seasame Street, Suite 2B, Anchorage, Alaska 99503 - Lending agency Mailing address Day phone Agent Petie Strang % Re/Max Properties Day phone 257-0165 Address 2600 Cordova Street, Anchorage, Alaska 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: three (3) 3.,: TYPE OF WATER SUPPLY. I xxxxx Individual well. I Community Public water 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 XXXXXXL: Holding tank Community on-site Public sewer Yj V NOTE: If community' wastewater system, provide written confirmation from State ADEC�'.' attesting to the legality and status of system. 72-025(Rov.1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY,. -ENGINEER ,As certified bymy 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 t s and type of structure indicated herein. I further verify that based on the information obtained from N,. 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. 1 41 Name of Firm" Ted Moore, P. E. Flattop Technical Srvs Phone 345-1355 Address 14530 Echo Street, Anchorage, Alaska 99516 Engineers signature Date Disapproved. Conditional approval for .£ , tl � 1i 4 bedrooms, with the following stipulations: 1 MUNICIPALITY OF ANCHORAGE t Department of Health & Human Services �S DIVISION OF ENVIRONMENTAL SERVICES 343-4744• CERTIF=ICATE OF INSPECTION FOR HEALTH AUTHORITY. APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING - Parcel LD. # HAA # A I0L) 1. _GENERAL INFORMATION (Must'be completed prior to submittal) j (a) Legal Description (include lot, block, subdivision, section, township, range)` �o 9 >`e�.i,(OF,r(r Location (address or directions) 9901 She &cy)o Av-e (b) Property owner CM(1- SG�m�Telephone : (home) - Business 233q Mailing Address 7 21 Sesame S� Su��� 2!j ffnchoiP A-� 99533 (c) Lending Institution Telephone — Mailing Address _ (d) Real Estate Company and Agent IPe, ft&,x PeVrae(- f'�P PeA _ n4 Address cot -C C-0- S AAchorage 1-tc 995 U� Telephone S% (e) Mail the HAA to the following address: (or check here 9, if hold for pick up.) List contact person and day phone number below: ,. 2. TYPE OF RESIDENCE Single -Family ® Number of bedrooms 3 3. WATER SUPPLY Individual Well 9 Community ❑ Public ❑ Note: If..community.well system, must have written confirmation from the State Department, of Environmental,, Conservation attesting to th legality"and status. 4. SEWAGE DISPOSAL On-site 29 ' ` Public ❑ Community ❑ : Holding Tank Q Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. "" '` 72-025 (Rev. vee) Page 1 of 2 I 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION , As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this HealthAuthority 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 with all Municipal and State codes, ordinances; and regulations in effect on the date of this inspection. )4 Name of. .Firm '. Fla>`{a� Tectinlcuf Servri�� Telephone Address J'^! S 3U �c �+d .� �}n cG�arq� f}cr 99.5�1� Date t�tccv�h 29 1991 FFA A io a Cva� dilia� o� / upon a 6andonm e�+f ' d� 2naC use 11 o.� groper �.� ancC �requrr iltuctnee ,OC Sep6sraAon clrflunc( u�a"rv[r ae' OF AtAT 0� Engineer's Seal •...• •.....111. •.•.•••� .THEODORE F. PAOORE . g CE - 3589 �~ a Ilk mow er®� 6. DHHS APPROVAL Approved for bedrooms by Date 12 ///� Approved Disapproved Conditional SFE Qa v Terms of Conditional Approval /9jE Lei 0 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. Empioyees.of DHHS do not conduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors, or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2. of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) M j CHECKLIST - FEBRUARY 1984 343-4744 t Legal Description: 4'1x6F HILLS N,0191 A. WELL DATA Well Classification }' R t VAT E If A, B, C, D.E.0 r d (Y/N) N •A Well Log Present (Y/N) No Date Completed Total DepthP_ 2 7 Cased to VNK Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) I4" SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 8J To 'x ()7 ) _ Yield 0.grm mead 7/30 /90 Pump Set At c27' Sanitary Seal on Casing (Y/N) y Depression Around Wellhead (Y/N) On Adjoining Lots 7100 To Nearest Edge of Absorption Field on Lot 91 TO C-0- ; On Adjoining Lots 7/00 t To Nearest Public Sewer Line 7/00' To Nearest Public Sewer Cleanout/Manhole y100 To Nearest Sewer Service Line on Lot 67 Water Sample Collected by FLt4770P -FEC If SVCS ; Date —712Ltlqo 77 12-190 Water Sample Test Results= © Cp/c1s9✓m /re�Gm.Q, 1 ling� Q r!c%e%"lX Comments ly0("veYr�c/'e,( ._�o r cuell-yWl'i( Sy1l-em ComOU��nb, Gy�+��^GV r_�H�r�d d- .deer part! !l /9y90 waFc� �.rf rcrulh suh���-,��c �, B. SEPTIC/HOLDING TANK DATA Date Installed to /78 Size 1250 No. of Compartments Standpipes (Y/N) U 5 Air -tight Caps (Y/N) IES Foundation Cleanout (Y/N) _Ho Depression over Tank (Y/N)—moo Date Last Pumped _3 _^_4.3y9/ bY.�saac_r Pumping/Maintenance Contact on File (Y/N) N -A- ; for N.A Holding Tank High -Water Alarm (Y/N) R A_.A • Temporary Holding Tank Permit (Y/N) N•J)• SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well 21 FROM C.O . To Building Foundation � 1`R01`-' To Property Line ti So' To Water Main/Service Line ti Noy To Disposal Field _ 13 ' C.o To Stream, Pond, Lake or Major Drainage Course — - I Comments wave,- r -7 - see MC6 e_ 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating irVAbsorption Strata ISO O "RM Date InstallA I0/07S Type of System Design "f REncc tf Length of Field 30/ Width of,FieId Z.. 60 Depth of Field 18 Gravel Bed Thickness to r Sgij&re F�e ofCC���tion Area Soo A° PER 1c,178 INsP. REP,Statndpipes Present (Y/N) YES '�-ApresXn okeryield (Y/N) No Date of Last Adequacy Test '16 CJ? 0 �Results oftofAdequacyTest Ader"ac e ccGra,4Aa- role -ror 3 /jearr,o-nl SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well R1' F2oM C.o. To Property Line ^ SS r To Building Foundation 23' FROM C-0, To Existing or Abandoned System on Lot - q•R • ; On Adjoining Lots 5/00 To Water Main/Service Line /—� 83 To Cutback (if present) K•d To Stream, Pond, Lake, or Major Drainage Course . To Driveway, Parking Area, or Vehicle Storage Area Is Comments Waiver reT" suhmrff�� D. LIFT STATIONQ4, A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Check Permitted Bedroom Rating Against HAA Request's "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA gu,idglines in effect on the date of this inspection. it Signed F(cr7-e_c17nr S rutty Company ccd r Engineer's Seal Date 3� 29 J 9 /a!�`�`�^G�c— . �° o MOA No. 9a �Q�9 eovoyeaaca C-;- 9 Receipt No. �� 5 7 t l I Receipt No. Date of Payment .7 Amount: $ //0 °0 72-026 (Rev. 7/88) Back Waiver Fee: $ Date of Payment Page 2 of 2 Jolynne Howard 6901 Shebanof Avenue Anchorage, AK 99516 Mr. John Smith Program Manager, On -Site Services Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 RE. 8901 Shebanof Avenue, Lot 9, Block 1, Kasilof Hills Subdivision June 14, 1991 Dear Mr. Smith, RE(CF.Ii, ED k, ur,lc pacify of Anchorage Dopt. 1-1-0,91 h & i-lurnan Services Your department issued a conditional waiver in April of this year for the above referenced property. I be- lieve Dan Roth is familiar with our case. To refresh your memory, this is an improved property on a lot which has 2 wells. One well, which is hooked up to the house encroaches on the 100' radius from the septic system and required a waiver from your department for us to obtain financing. Your department is- sued a conditional waiver in April 1991 subject to the abandonment of the second well. Upon moving in to the house, we have found that the water supply from the operational well is less than adpquate to meet our needs. We have been unable to water our lawn and are very careful of our in- house water consumption. The second well, which you have asked us to abandon, is over 400' deep and has a static water level which is 9' below grade. Although this well does not produce at a rapid rate, it does offer tremendous storage. We would like to put a pump in this well and use it for maintaining our yard. When we have the money, we would like to examine the possibility of hooking it up to the house's water supply. We do not want to abandon this important source of water. Would your department issue a waiver to us If we put a pump in the second well ? We are working with Jim Ridgeway with Anchorage Well and Pump and with Ted Moore with Flattop Technical Services, but are hesitant to go ahead with installing a pump until we know if this will be ac- ceptable to you. I look forward to hearing from you at your earliest convenience. Thank you for any service you can offer. I can be reached at the address above, or by phone at 276-1851 during the day. Sincerely, Jolynne Howard Municipality ®f Anchorage _.. Department of Health and Human Services Cfrlrl5 825 "L" Street Tom Fink, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 April 12, 1991 Ted Moore, P. E. Flattop Technical. Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 9 Block 1 Kasilof Hills S/D Waiver Request WR900055, PTD #015-161-01 Dear Mr. Moore: Your request for a waiver of the required 100 foot separation of a septic system to a private well has been approved. The approved separation distance is 79 feet from a private well to septic tank and 90 from well to leachfield. This waiver is issued with the condition and understanding that the well casing located near the southeast corner of the subject lot will be abandoned in accordance with DNR requirements by June 1, 1991. This waiver approval applies to the existing septic well separation only. Any future all separation distances be met or department. Sincerely N�� ;. 4e Daniel J. Roth Civil Engineer On-site Services DJR/ljm:356 upgrade to either another approval Concur: ;C4 ohn Smi rogram Manager On-site Services system and will require from this CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 March 23, 1991 ANCHORAGE, ALASKA 99516 John Smith M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Mr. Smith: ` g v QUGH 1&0aul obvAogouv )o (Nedio;un;N Irm L 0 ddd UAHDI� This is in response to your letter dated December 5, 1990 which responded to my letter dated November 9 requesting a well -septic system separation distance waiver for Lot 9, Block 1, Kasilof Hills S/D. I understand that Jolymre Howard, the purchaser of the property, has recently discussed this matter with you. As you will recall, the primary issue affecting the granting of the waiver centers around the abandonment or placement into beneficial service of a second well on the property. In my previous submittal I inadvertently neglected to mention that we did arrange to measure the yield of the second (south) well last September and found it to be 0.13 gpm. Since that low of a yield would be sufficient for a one bedroom residence only, it would not be a feasible option to abandon the north well and utilize the south well only. The purchasers have decided to proceed with abandonment of the south well, which is one of the options you suggested. Unfortunately, the location of the property at the top of a steep icy hill, and now the imposition of load restrictions on the road, means that it will be impossible to bring a concrete truck up to the site to do a proper abandonment of the well until after breakup. In order to allow the sale to close in the near future, we are requesting that you issue a conditional Health Authority Approval certificate, with the condition being that the formal well abandonment be completed no later than June 30, 1991. Please give me a call if you have any questions on this request. Sincerely, Ted Moore, P.E. cc: Jolynne Howard (UAIVEIP RE G'uEs7' f0/3 LOT F 9Lk / w x�l v � r� a c� M aEr� �• r', 9oao.ss- /r19s/10f H14 3' X4(0 F. 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Box 196650 Anchorage, Alaska 99519-6650 December 5, 1990 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Re: Lot 9, Block 1, Kasilof Hills - Request for Waiver Dear Mr. Moore: This office has reviewed your request for waiver of the required 100 foot separation distance between a private well and a wastewater disposal system located on the subject lot. Based on our review, the requested waiver cannot be issued until a second well, also located on the subject lot, is either abandoned or placed in beneficial service. Your report indicates that there is a second well located near the southeast corner of the lot. Your report also indicates that this well has been in place for over eleven years and has never been placed in service. Your report does not indicate whether this well has been tested to determine its production capacity. Since the 100 foot protective radius of this second well does not encroach on any components of the existing wastewater disposal system, we suggest that this well be evaluated as a possible replacement of the well which currently, serves the residence and which does encroach on the wastewater disposal system. If it is determined that the second well is capable of supplying sufficient water for the residence, then it should be placed in service and. the well which encroaches should be properly abandoned. Should it be determined that the production capacity of the second well does not warrant placing it in service, then the second well should be properly abandoned. Kids Are Our Future December 5, 1990 Lot 9, Block 1, Kasilof Hills Page Two As a third alternative, your client may wish exercise the option of having both wells placed in service. Should you wish to pursue this alternative, the second well must be equipped with a pump and be plumbed to the existing water system. Water from the second well must be sampled and tested for bacteria and nitrate nitrogen. Please provide this office with a copy of all sample data and pump test results which document the production capacity and water quality of the second well. Also please advise as to which alternative your client wishes to pursue so that we can proceed with the final evaluation of your waiver request. Sincerely, Lu John Smith, P.E. rogram Manager, On-site Services oP�\c-, Na\Cc\��c\�p� 0 '. 0 "4 ATTOF to I J IO�t A CDC,YY� . TECHNICAL SERVICES L -LD 9 s CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE, T. MOORE, P.E. November 9, 1990 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 G'I.O.A. Dept of health and Human Services On-site Services Section P,0O Box 19-6650 Anchorage, AIS 941519 Dear gips: Bt means of this letter we are requesting waivers of the required 100 foot separation distance between 'the well and septic system components on Lot 9, Flock 1, Kasilof Hills. The: requested distances are 79 feet between the well and the septic tank and 90 feet between the well and the soil absorption trench. The fallowing is an analysis of pertinent factors relevant to the waiver. A site plan and copies of backup documents are enclosed. There are two wells on the lot, one of which (the southernmost one) has no pump and apparently has never served the residence. The north well is the one for which the waivers are needed. To ascertain which well the enclosed well log from the DHHS files applies to, we arranged for Dave Harper of Alpine Drilling to measure the total depth of each well on August 16. He reported that the north well, which presently serves the residence, has a total depth of approximately 227 feet, and the south well has a total depth of 446 feet. Accordingly, we believe the log applies to the south well. On July 30 we conducted a yield test of the north well. At the start of our test the static water level stood al. 44 feet below the top of the casing. Steady pumping of 290 gallons of water from the well caused the water level to be drawn down to the pump intake, at which time the water was turned off to allow the well to recharge. Based on measurements made over two drawdown and recovery cycles, we determined that the sustainable yield of the well is 0.8 gpm, which is adequate for this three bedroom residence. Water samples taken on July 24 were satisfactory, showing 0 coliform or other bacteria per .100 ml.. and LI mg/l of nitrate -N. A follow-up sample on November 2 again showed 0 coliform or other bacteria. The wastewater disposal system was installed in October of 1978 and according to the as -built inspection report consists of a 1250 gallon septic tank followed by 30 feet of soil absorption trench. There is a discrepancy between some of the information on the as - built inspection report and other documents in the file and field observations. The soils log reports the test hole to have been dug to a depth of 16 feet, and the sewer permit calls for a 26 foot trench with 9 feet of gravel and a total depth of 12 feet. The as -built inspection report states that the trench length is 30 feet and that the trench has 10 feet of server gravel with 8 feet of cover material. If so, this would be a most unusual type of construction, and for no apparent reason. A very large piece of equipment would have been needed to excavate an 18 foot deep trench. In an attempt to resolve this question we meaQured down to the end monitor tube and discovered the 4" diameter distribution line intersechng it at 3 feet below ground level. The bottom of the Monitor tube is now at i depth of 7 feet below ground .level. Both of these factors lead us to believe that the trench is much shallower than indicated on the as -built inspection report. We believe the 8 feet refered to on that form is the gravel depth beneath the pipe, and that the total de=pth of the system is 1 I to 12 feet. Cm ,July 30 we conducted an adequacy test of the wastewater disposal system. The residence was occupied at that time. The initial fluid level in the trench monitoring tube was approximately 1.25 feet below the level of the horizontal distribution pipe. The addition. of 290 gallons of water brought the fluid level up to the approximate level of the horizontal distribution pipe, after which time we measured the reabsorption rate, and the amount of water to refill the system two hours later. Based on our measurements we concluded that the trench is capable of accepting water at a rate of 0.5 gpm, when filled near to the level of the horizontal distribution pipe. This absorption rate is adequate for a three bedroom residence. "Che following is a discussion of each of the parameters to be considered under the DEC waiver analysis criteria, and an explanation of how we arrived at the points to be assigned to each. For the depth to the water table we used the measured static water level of 44 feet inside the casing of the subject well, which (when the casing stickup is subtracted) is 43 feet below ground level. It should be noted that the static water level in the south well is approximately 10 feet below ground level, however the log for that well clearly indicates that no water was encountered until a depth of 335 feet. Thus, we .feel that this water level reflects the pressure head on that deep aquifer, and is not relevant to the discussion at hand. As described above, the bottom of the soil absorption trench is approximately 11 feet below ground level. Thus the vertical separation from the water table is 32 feet, which results in a point assignment of 4.2. For the soil sorption category, we feel that the soil type most similar to the silty gravel with 3001t, clay binder described on the driller's log is silt, which results in a point assignment of 3.5. For the permeability category, we feel that the soil type most similar to the the silty gravel with 30% clay binder described on the driller's Jog is silt or sandy clay, which results in a point assignment of 2.0. For the water table gradient we have compared the 44 foot static water level in the subject well with the 40 feet static level reported on the enclosed log for the well on Lot 2, Block 1, which appears to have similar characteristics. This well is located approximately 200 feet ENE of the subject well and at a 20 foot higher elevation. Based on this analvsis we have concluded that the aquifer slopes to the west at 10%, which is away from the water source and results in a point assignment of 6.0 This conclusion j, stands to reason, as aquifers generally do tend to parallel the ground surface. For the horizontal separation category we have used 79 feet which corresponds to the assumed underground projection of the septic tank towards the well ( the standpipe is 81 feet from the well). The corresponding point assignment is 2.16. In summation the total point assignment is 4.2 + 3.5 + 2.0 + 6.0 + 2.16 = 17.86 which we feel should justify granting of the requested waiver without further mitigative measures. Please give me a call if you have any questions on this analysis. Sincerely, Ted Moore. P.E. I{0 SE — i�WELL LOT 2 &K 2 L.07 1 13 LK 2 VACANT NovSE LOT g VACANT. LOT 2 i w ti� 20 Ig3r l° _ a 1 Q i x LL I r00 0 57 � 3 aDRM x N Eu✓a� Novsr S%° o LOT I J U - I VACANT � I 5 7• DRlvE vj 11D LOT q QLK t�wE« 5aRvicE) I SNEBANO[" AVE _ LOT 1 ELK 5 '/�b L OT !O B7 -K S WELL NovSE WELL LOT 9 BLOCK I KASILO F HILLS SvBD. SITE PLAN 1 11 SCALE: I =50' )ATE:: 11/90 )WN BY: � NDTE. THis is NoT- A SURVEYED PLAT-' ALL. LOCATIONS AQr APppmeiMA-,"r • '� S��S��i����a.i�.9��.i� '�;;�1L`�3��1�iV d`+J' W �,:'���� .:::.::.. T3oX 1369, STntz l�oL•rF �i A�aaiouzao�a, Ar n�><cA 001502 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF.. 450 Tent. DRILLED AT THE RATE OF j78.00 PER FOOT. PROPERTY OWNER !' - _"OarL 279-2882 LOCATION OF WELL SITE Lt. 01'-. 5 O DRILLER Ljeltnie CCau.o a� j:ku curt J)AWA g WELL LOG: --------------•-nitslr�_.n.o_ -s=as-�ti„� To ta.0 lda telt p�tocltu:P Lon 44au Cdh,aiu () - 0 12-1-4- .�t��tv_v..e�td�rLtl f use to 'dome what ove,t a 1000 ._ - ga .-J��t _ dayo. oue zt 400- o fu Cn,e ho2�e Su &. Pump -ch.owLd be �.,L4 to t r eu 20 /ee t a�!' bo t ton. S fiu 450 4et Eva4 &? ,Wed, l (ed, .t1Le tc wZU. bc. a 75 ;aa -t /!o cha,tq.e. At -do n.o cl a&-ga /,at "L:c tC 5e" Total �ootaye chaff; 378 feet at i1c O0 pet /_aot: S675000 Rldo (� thLd lieLL ptovc.: game, uJhn,t. f,rcnC, :'antpa,tt: uw.i(t d"; -(.L alLothet 200 4et at anothet toca,t.ela on, lilt. oan.'o p,i.opc.t.ty. at ;10 00 pmt ,aa t® COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF __ _ -$67S0.00 THANK YOU VERY MUCH. E3ERNir=-CLAUS OP RAMPART DRII LING WORKS �77 ,� SERVICE CHARGE O E 1:,^; PER MONTH WILL F?C ASSESSED ON PAST DUE ACCOUN S. -Alok: %itis well (01 � i Tv uno� in *clls S"/p , We be/itµc if a/g/g/irYv e .fcouF(, cm SFJ or 4c , - S, TORIES TORIES CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC 5633 B STREET • ANCHORAGE, ALASKA 99518 • TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for. Work Order # 25822 Date Report Printed: JUL 28 90 @ 09:39 Client Sample ID:L9 Bi KASILOF HILLS S/D ' PWSID :UA Collected JUL 24 90 @ 11:00 his. Received JUL 24 90 @ 14:30 his. Preserved with :AS REQUIRED Analysis Completed :JUL 25 90 Laboratory Supervisor STEPHEN C. EDE Released By : G 'f Special Instruct: Chemlab Ref #: 902620 Lab Smpl ID: 3 Matrix: WATER Client Name FLATTOP TECHNICAL SRV Client Acct FLATTOT P.O.# NONE RECEIVED Req # Ordered By : TED MOORE Send Reports to: 1)FLATTOP TECHNICAL SRV 2) Allowable Parameter Tested Result Units Method Limits -------------------------------------------------------------------------------------------------------------- NITRATE-N 1.1 mg/1 EPA 353.2 10 Sample ROUTINE SAMPLE. SAMPLE COLLECTED BY CHRIS. Remarks: ' FRONT (SOUTH) HOSE BIB. I Tests Performed See Special Instructions Above UA -Unavailable ND-- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than 5. LEGAL DESCRIPTION Z �-V STREET LOCATION DATI RECEIVED 6. TYPE OF RESIDgNct INSPECTION APPOINTMENTS `SINGLE FAMILY TIME TIME TIME / .0 7. WATER SUPP INDIVIDUAL* DATE ❑ COMMUNITY DATE DATE I 8. SEWAGE DISPOSAL SYSTEM LAY' INDIVIDUAL/ON-SITE** INSPECTOR,/ ❑ PUBLIC UTILITY INSPECTOR INSPEC OI ..� - kFPF el- A' NC-! i"*QM5 MUNICIPALITY OF ANCHORAGE IVV�RRDCCEPT. OF I ALTH & pp�I�TI'ONNMEN17AL Fi:C%TECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC 825 L Street - Anchorage, Alaska 99501 J Al N 198 980 ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER - _ PHONE 1191 MAI LI NGADDRESS PROPERTY RESIDENT (If different from above) -- PHONE 2. BUYER �® - - PHONE MAILING ADDRESS 3. LENDING INSTITUTION — - PHONE MAILING ADDRESS -- 4. REALTOR/AGENT PHONES / MAILING ADDRESS 5. LEGAL DESCRIPTION Z STREET LOCATION 6. TYPE OF RESIDgNct NUMBER OF,BEDROOMS `SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ T� ❑ Five ❑ MULTIPLE FAMILY E4 --"Three ❑ Six 7. WATER SUPP INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM LAY' INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79)_ E-2_ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified - PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER - TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS rAPPROVED FOR . BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79)