HomeMy WebLinkAboutKASILOF HILLS BLK 4 LT 23 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water&Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650•http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191166 PID Number: 015-131-09 ❑ New •Upgrade Name: NINJA HOGENBIRK ABSORPTION FIELD Address: 0 Deep Trench 0 Shallow Trench 0 Bed 0 Mound 10701 VOSIKOF PLACE*ANCHORAGE,AK 99516 0 Other Phone: No.of Bedrooms: Soil Rating: Total Depth from original grade: 907-947-9063 3 GP 8a.R. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: R. Ft. Subdivision: Block: Lot: Fdi added above original grade: Grave gth: KASILOF HILLS 4 23 G Ft. I ownship: - Range: - Section: - Gravel width: ��I(...\S'' Beds Number of Ynes: Distance between Ines: Ft. Ft. SEPARATION DISTANCES Tot:iabem901 Number of trenches Dist.between trenches: To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines 8G.R. Ft. Well 100'+ _ - 25+ TANK M Septic 0 S.T.E.P. ❑Holding 0 Other 0 Manufacturer Capacity: Surface Water *43' Z - - INFILTRATOR 1060 Gal • I^ Material: Number of compartments: Lot Line 5'+ N/A • X HDPE 2 Foundation 10'+ IJJ - - LIFT STATION Curtain Drain 10'+ _ _ - Manufacturer D Gal Remarks: *OSP191166 "Pump on"level at: 'Pump off level at: High water alarm at: 'PER CONTRACTOR,THE OLD TANK WAS FILLED WITH CONCRETE Pump Make&Model Electrical Inspections performed by: PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES Drainfield EXISTING CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Location and Description. Dates: 1st 5/22/19 2nd 3rd 4th TOP OF GARAGE SLAB ENGINEER'S'••L Community Development Department Approval ooQoO',',O 7 C -- . ' • qsA Conditional approval: Date: KR- / . i_ •..1 1 / D Q • y A. •• ess.: QO, • CE 79 .• 1%o' Approved: 1- Date: b ^� ( LICENSE44oOO fesO000�� #AECC884 DOO Inspection Report_1-1-12.doc PERMIT NUMBERL PARCEL ID NUMBER. OSP191166 RECORD DRAWING 015-131-09 A B PER THE ATTACHED AS-BUILT SURVEY BY DBL1 50.1 34.8 ELIZABTH WALATKA,PLS;THE WELL IS LOCATED O �� ' DBL2 51.1 35.4 160'EAST OF THE EAST LOT LINE;IN SHORT,THE MH 53.2 36.5 WELL RADIUS DOES NOT ENCROACH UPON THE ST1 52.5 32.4 NEW SEPTIC TANK -------- O DBL3 52.4 30.7 `\ _ DBL4 52.5 30.1 ARM SERVICES RETAINED ONE-STOP Pc, v FS 52.5 29.5 SERVICES TO LOCATE THE WATER SERVICE ♦ CO1 63.3 42.6 LINE.MOA EMPLOYEE TIM ECKLUND WAS ONSITE TO CONFIRM THE SEPARATION DISTANCE BETWEEN THE SERVICE LINE AND NEIGHBORING DRAINFIELDS ON LOT 21.GEG, EXISTING DRAINFIELD LTD.DID NOT CONFIRM THAT THE WATER '. • SERVICE LINE IS LOCATED WITHIN THE CATCH BASIN PER .,s.'.• GRANTED EASEMENT. AS-BUILT SURVEY ,.•• ': 1 I ';i. .4 ;: :'ti'.i•.: 1 0 1 C 1 -1 r... 1 r I c'`. •DRIVEWAY '`.• A' :• ,' GARAGE i v KASILOF HILLS; BLOCK 4.LOT 21 /// CULVERT FROM 1 m SURVEY ' : -••• i ? 0 EXISTING 3 l tt CO�'. ` BEDROOM HOMEI ' 1 1 l -II' u))_ t ..':::.........7A...... A*/ A 1 F 43'WAIVER APPROVE it '. : r•� SEWER LINE UNDER DRIVEWAY Ur / INSULATED WITH 4"THICK 4'WIDE ON a CO1 H .�'••..'i CENTER CATCH BASIN PER •` • l AS-BUILT SURVEY 1 1 ` 43'WAIVERAPPROVED DBL1&2 1 NEW 1060 INFILTRATOR SEPTIC TANK 1 O �� 'nIt APPROXIMATE LOCATION OF SWALE 1 i -0 PER GEG INSPECTION ON 12/12/2018 1 1 r 1 I 'I 'Pe., 1 i v. ' PER THE CONTRACTOR, j BOTH DRAINFIELDS WERE I I m EXPOSED ON THE PROPERTY CATCH BASIN PER j TO CONFIRM THE NEW TANK AS-BUILT SURVEY lit i MET 5'SEPARATION. I ; In1 1 V i , KASILOF HILLS:BLOCK 4,LOT 24A SCALE. 1"=40' • ar ARNE ENGINEERING GROUP, Ltd ` 9 `�*�°.. •GARNESS G . • ENGINEERING SALES CONSULTING �\ ` % 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507-PHONE(907)337-6179-FAX(907)338-3246.1AEBSITE.www garnesseng veering corn F:e...4J�• '. 011 1:C, PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .cll 1. . A. ess : Cc//- NINJA HOGENBIRK 907-947-9063 2 OF 3 .���J,�: E-79531• '�-�� PROJECT/LEGAL DESCRIPTION: DRAWN BY: ..(�'''••• 3„11.8.<e' :•jj.3f j • KASILOF HILLS; BLOCK 4, LOT 23 D.J.G. . �o p�FESS��P„,4 4. TYPE OF WORK DATE: LICENSE 1�1�"`? 4 SEPTIC SYSTEM RECORD DRAWING 5/31/19 #AECC884 C PERMIT NUMBER: PARCEL ID NUMBER: ` OSP191166 RECORD DRAWING 015-131-09 FINAL GRADE=97.72-98.57 MH lo ST1 2"HIGH DENSITY INSULATION PER CONTRACTOR TOP OF TANK AT INLET=94.48 TOP OF TANK AT OUTLET=94.96 aWI c c INVERT OF INLET BUNG=94.44 INVERT OF OUTLET BUNG=94.12 1060 GALLON TWO-COMPARTMENT HDPE INFILTRATOR SEPTIC TANK • GARNESS ENGINEERING GROUP, Ltd *•' 4 `�* vo ENGINEERING•SALES•CONSULTING 0 3701 E TUDOR ROAD,SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)338-3246'1AEBSITE www.ymssamymerivcam •/ PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 rn• rrr r= A. G- ess : - NINJA HOGENBIRK 907-947-9063 3 OF 3 46' ;r Cl-7913 •'4 PROJECT/LEGAL DESCRIPTION: DRAWN BY: . i,". ?( I.,ti••(`7� KASILOF HILLS; BLOCK 4, LOT 23 D.J.G. 1♦ •• P�, �4p TYPE OF WORK: DATE: 41•PRO FESS\Ce ** PROFILE DRAWING 5/31/2019 -#LICENSE 4 11�imslis��• P ��N�"- `r.' 0 MUNICIPALITY OF ANCHORAGE l,lcnt / On-Site Water&Wastewater Program �° 'S'; PO Box 196650 4700 Elmore Road /- Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:l/www.muni.org/onsite III Ifalifill' cHoap Gt On-Site Wastewater Disposal System Permit Permit Number: OSP191166 Effective Date: 5/16/2019 Work Type: SepticTank Upgrade Expiration Date: 5/15/2020 Tax Code Number: 01513109000 Site Legal Address: KASILOF HILLS BLK 4 LT 23 G:2541 Site Mailing Address: 10701 VOSIKOF PL, Anchorage Owner: NCH TRUST Lot Size in Sq Ft: 49593 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Prior to Inspection Report approval, the water line is to be located to confirm that it meets all separation requirements, especially to Lot 21's septic field. Relocation of the water line or waivers may be required. A new Ingress/Egress Easement may be required. Received By: dr 111111110f Date: 10- ( 9 Issued By: /(9,„45- 1 .11661 Date: Municipality of Anchorage a'° I>r.parrmrnr P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 s Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW *** Waiver#: Amendment of HA950054 Which was amended for a 2006 COSA Permit#: OSP191166 PID#: 015-131-09 Legal Description: Kasilof Hills BIk 4 Lt 23 Engineer: Garness Engineering Group Applicant: Ninja Hogenbirk Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the surface water has been approved. The approved separation distance is 43 feet. This waiver approval applies to the existing field and proposed tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: —5X6M Approved by: Name of Revie r **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE . ,rte Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-131-09 Property owner(s) NINJA HOGENBIRK Day phone 907-947-9063 Mailing address 10701 VOSIKOF PLACE *ANCHORAGE, AK 99507 Site address 10701 VOSIKOF PLACE *ANCHORAGE, AK 99507 Legal description (Sub'd, Block& Lot ) KASILOF HILLS: BLOCK 4, LOT 23 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial ❑ Single Family (SF) Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade Duplex (D) Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy I 1 (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 02 a� Waiver Fees: Date of Payment: 6MM0�� 19 _ Date of Payment: la� Receipt Number: 0/11614 Receipt Number: Permit No. 65 P/9111g(, Waiver No. (Rev.01/11) a Quanics GARNESS ENGINEERING GROUP, Ltd AdvancedTreatment System ENGINEERING SALES CONSULTING . Dealer January 23`d, 2019 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Kasilof Hills; Block 4, Lot 23 To whom it may concern: The existing 3-bedroom house is served by a private well and septic system. Per MOA records, the existing septic tank is steel and approximately 34 years old. Per MOA memorandum, the septic tank must be exposed and inspected. In addition, the septic tank is located under the driveway. Given the age of the steel septic tank and its location, we are proposing to replace the septic tank. We are proposing to decommission the existing septic tank per UPC and install a new 1060-gallon two compartment Infiltrator septic tank. Waivers: Per GEG inspection on 12/12/2018 there was no observable surface waters (snow on ground) to the north and south of the existing drainfield (see attached pictures and MOA records). However, there was observable surface waters to the west (see attached image). An existing waiver is on file with the MOA for the drainfield to surface waters down to 43 feet and tank to surface waters down to 70 feet. In addition to the surface waters, there appears to be a swale south & southwest where water may pond or be present seasonally (see attached photos). Based upon this fact, we are requesting you amend the existing waiver to include the proposed tank and waive the separation distance from the septic tank to surface water from 100 feet down to 43 feet. Justification for granting this waiver is as follows: • The existing septic tank has encroached upon the surface waters for approximately 34 years (installed in 1984 per MOA records). • The area between the proposed tank and drainfield is vegetated. • We are proposing an HDPE Infiltrator septic tank. • The existing tank is located underneath the driveway. In order to move the tank outside of the driveway, this waiver must be amended. We are unaware of any adverse impacts this installation or waivers would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. It is our understanding the homeowner is installing the system. Si. erely, J-e r_, • r.a nes., P.E., M.S. Pre ,•- t 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com GEG,Ltd.HAS A 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN.TO OBTAIN A COPY OF THE LETTER CONTACT PER THE ATTACHED AS-BUILT SURVEY BY GEG.BY PROCEEDING FORWARD WITH THIS ELIZABTH WALATKA,PLS;THE WELL IS LOCATED ��O' INSTALLATION,THE ENGINEER,WELL DRILLER, 160'EAST OF THE EAST LOT LINE;IN SHORT,THE CONTRACTOR AND PROPERTY OWNER AGREE WELL RADAII DOES NOT ENCHROACH UPON THE THAT THEY HAVE READ THESE PROPOSED SEPTIC TANK __ O SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. 0 'NN.''''''"N„..N.N...s PSS ASSUMED LOCATION OF EXISTING TRENCHES PER • , CLEANOUT LOCATION AND RECORDS IN MOA 1 CATCH BASIN PER .'.•'.•• 1 AS-BUILT SURVEY 4.• •4 .. .. :. 1 j'� 1 G KASILOF HILLS;BLOCK 4,LOT 21 1 •t; 4.. •: s'.• ' .....••.:, ... • ((DRIVEWAY tt .',••`/' x.// iy • GARAGE 1 m CULVERT FROM • ' ' . • -• ,• 1 ''i 1 m SURVEY .1, 6- ?'.• plir'1, aill'illi APPROXIMATE LOCATION OF EXTING TANK PER MOA ' /�'/ TANK TO BE DECOMMISSIONED PER UPC 0 al1 43'WAIVER REQUESTS �`,��'•. '.,: SEWER LINE UNDER DRIVEWAY TO BE 1 C W� ,• ,. 1 3 a M .mow• ;"':. INSULATED 4"THICK 4'WIDE ON CENTER • I '77. ^ CATCH BASIN PER `+:, v) AS-BUILT SURVEY •'•• -4•.• INSTALL FLOW SPLITTER AND SEWER PIPE AS REQUIRED TO OBTAIN GRAVITY FLOW TO BOTH TRENCHES \111111443'WAIVER REQUEST i I O PROPOSED 1060 INFILTRATOR SEPTIC TANK;INSTALL DOUBLE CLEANOUTS 1 BEFORE AND AFTER TANK;DO NOT INSTALL TANK UNDER DRIVEWAY; T INSTALL MH RISER ON FIRST COMPARTMENT OF SEPTIC TANK I APPROXIMATE LOCATION OF SWALE ; 1 13 PER GEG INSPECTION ON 12/12/2018 1 t r I I0 1 1 1 1 m CATCH BASIN PER 1 AS-BUILT SURVEY 1 lit 1 1 I 1 I ill i I. KASILOF HILLS;BLOCK 4,LOT 24A SCALE: 1"=40' IL ad . (graJ01 'i GARNLSS ENGINEERING GROUP, Ltd - •• ENGINEERING•SALES CONSULTING •� i • f �••• • 3701 E.TUDOR ROAD.SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)338-3246'WEBSITE:www.gamessengineerirg.com , • . PREPARED FOR: PHONE NUMBER: PAGE NUMBER: A % •• y A. - ess NINJA HOGENBIRK 907-947-9063 1 OF 1 •�0J,•'; C -7913 •' m PROJECT/LEGAL DESCRIPTION: DRAWN BY: ..4 .4 4(141.4. -4.• � KASILOF HILLS; BLOCK 4, LOT 23 D.J.G. •�FO•"*p•�•p�•l,1,��• •••••••• P\, �• TYPE OF WORK: DATE: LICENSE 44' T "` ,44 SEPTIC SYSTEM DESIGN UPGRADE 5/14/2019 #AECC884 NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~",,~?' MAILING ADDRESS LEGAL DESCRIPTION LOCATION VO,~" .l~J"~'~- ~ /~/r~-~ 1' (4 NO. OF BEDROOMS 3 Well _ Absorpt on area Dwelling PERMIT NO. Ov DISTANCE TO: I ~O'~ 1~ [ ~b ¢/'4 PZ I Manufacturer . Material ~O ~ ~ ] ~ /I ¢~ cr-~ ~ NO. of compartments ~ ILiq. capacity in gal ons I Inside lengt ~ Width ~ ,~ 'Z~ [0~ IF HOMEMADE Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, ~ ~ ~ Manufacturer ~ ' Material Liquid capacity in gallons -- ~ Well . Foundation -- · Nearest lot line ~ ~ I DISTANCE TO: [ /~O'~/~ ~O~ f~ '' - , ~l ~ N ' ' ~Z~ I o, of hnes ~ ILengthof each hne Total lengthof)znes Trench width Distance between lines ~R Top of t le to f nis~ grade __ Material beneath tile -- [ Length Width ~ O~pth ~ [ Total effective absorption arePERMITa NO. ~ ~ [ Type of omb Orib diameter Grib depth / } Nearest lot line ~ DISTANCE TO Well Building foundation ~ j/Class ~0~' ~ ~ ~ Depth Driller Distance to lot line ~ERMIT NO. / ~ ~ DISTANCETO Buildinq foundation Sewer line I Septic tank ] Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS IAPPROVED DATE LEGAL DEPARTMENT OF NATURAL HESOURES Oivi,l~on of Geological 8, GeophyslcoI lur~.~y~ WELL LOG Top 4 WELL D[pTH: (final) ,,. BI AIIovI of [~ BIlo. lantt lU~'fll¢l P2 OROUTINO Well O~outed' ~'~ Yem WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geologicol 8 Geophysical Surveys LOCATION OF WELL ~c~/ DI3'FANCE AND DIrElY'ION' F (Please complete either la, lb or lc.) Drilling Permit No, A.D.L, No, :OM/ROAD?INTERSECTIONS 3. OWNER OF WELL: ¢."1 ',,:' 6. ~ Coble to01 C] Rotory E] Oriven C~Dug ": '' ."';¢" Bi Auger E]dolled ~Bored ~ Other: .... :', L ? 7. USE: ~' OomesHc ~ Public Supply ~ Industry ~ Tesl Well ~ Other: ............... 8. CA~ING: ~ Threoded ~ Welded 9. FINISH OF WELL: Slol/Me:~h Size: [.englh; Bockfilling Grovel pock _ - Above or ~ Below [and surface Equipment used: ..... ~UN[C~pALi.~ ()~ ~0~ ,~ II. PUMPING LEVEL below Idnd surface and YIELD, ~F.~AL~H ~ ~:~/' ft. after hrs. pumping' :":*.~ g.p.m. ~i~QNMENIAL pRo~ECT 9N ~ ff. otter ~hrs. pumping~ ~g.p.m. Well Grouted: ~ Yes ~ NO 14.REMARKS: 15. Water Temperolure ~o ~ F ~ C Materiel Type __ ,.'.:'-':.. : 16. WATER WEI L CONT'RACTOR'S , ,, .., Form O2-WWR (11/81) llEE:t~ INII ....... tED ]E '"'ii'" EE F:'ERM I'l" NO.' 840594 D A T E I S S LJIE D ,: 07 / 20 / 84 AF'I='L. I [',ANT: ADDRESS: CONTAC1" F.'IqDNE: FI']EJ E!3 DEVEL.OPMIEIxlT F'. 0. BOX ANCNORAGE, Al'",', 99511 .349-8011 LEGAL. DESCF;: I I::': L..OT SIZE: IdAX BEDR[]OMS: SUBDIVISION: KASII,...OF HILLE; SECTION: 1324 TOWNSHIP: 12N 45420 (SQ.FT. (]F~ ACRES) 3 LOT: 23 RANGE: 3W BLOCI<: 4 Lis't.,ecl below ape 'Lhe options available 'Lo you in designing yOLtP sep'L:Lc: sys'Lem. Choose 'Lhe op{ian tha'L best f.i,t.~ your' site. DEPTH TO PIPE BOT'T'OM (F'I'.) 5. () 6,, 0 5,, 0 GRAVEl_ DEPTH (Fl'.) 3.0 0.5 2,,0 TOTAL DIEF"TH (FT.) 8,, 0 6.5 7. () GRAVEL WID'I'H (F:'T.) 2.5 17.0 5.0 GRAVEL LENGTH (F'T.) 63.0 34,, 0 5:5,, 0 . GRAVIEL VOLLJME (CLJ.YDS.) 20,,4, 21,,4 24.5 TANI< 81ZE (GALS) 1,000.0 '~,~' 1,000.0 '~'~' 1~ 000.0 .~'.~. SOIL. RATING (SQ.FT. /BR) 125 125 125 · .-.~ "I"AI',II< MUST HAVE AT LEAST TWO COMPARTI'IENTS I c:er"L:tfy that: 1. I am familiar' with the requipements for on-si'Le seweps and wells as~ set for'th by 'Lhe Municipali'Ly ar Anchor'age (MOA) and the State aJ' Alaska. 2. I w:i. ll ins'Lall the system in ac:c:opdance w:i.'Lh all MOA codes and p~2gulatians, and in compliance with the design cr'itepia of th:i.s per'mit. 3,, I will adhene to all MOA ancl State oF Alasl.::a r'equirements For the set back distartces ¢pom any ex:i. sting well, wastewa'Lep disposal sy, stem ap public sewepage system on this or any ad.jac:ent on near'by lot. 4. I under's'kand 'Lhat:, 'Lhis per'mit is valid fop a maximum oF 3 bedpooms and any en'.Lapgemer]t will pequir(;~ an additional pepmit,, IF A L,,IFrT' STA"FION IS INS'I"AI_I_ED :[N AN ARIEA COVERED BY MOA BUII..DING CODES, THEN (1) AN ELECTRICAL F:'EIRMt"F AND INSPEC~I[IN MUS'I' BE OBTAINED; (2) AS-BUIL. TS WILL. N[]'F BE AF'PROVED WITHOLJT AN EL. ECTRICAL iNSF:'E[',TION REF'ORT; AND C!.) THE EL..EC'TRICAL.. WORK MUST BE D[INE BY A LICENSED ELECTIRIC'IAN. SIGNED ~~.~,.~ AF'PL. I CAI',IT :~S/~ ISSLIIED :3Y ~Z/ DATE,', ~E~I_OI:: ME']N'¢/ DEF'ARTIqENT OF HEALTH AND' ENVIRONME:]qTAI_ F'IROTECTION 825 L S'f'IREET, ANCHORAGI'Z, Al":: 99501 2AZl.-4720 PERMIT NO:: DATE ISSUED: 840551 07/06184 AF:'PL I CANT: ADDRESS ,', CONTACT' PI.,,IONE: FE:JES DEVELOPMENT P G BOX .t t-R009 ANCHORAGE, Al< 99511 '.~::49-8011 I_E:GAL DIESCR I F': L.OT SIZE.' MAX BEDROOMS,', SUBDIV]:SION: I.:::ASILOF HILLS SECTION: 1324 TOWNSHIP: 12N 454.'.?0 ' (SQ.IZT. OR ACI:~E'.S) 3 LOT: 23 RANGE: 3W BLOCK: 4 Listed be].ew ape the op'Li~ns available 'Lei y~u in designing your, septic system,, Choose {he optic~n tha'f, best fits your' site,, ' DEF:'TH TI] F'IPE BOT'TOM (FT.) 4.0 4,,0 GFr~AVEI_ DEF'-'"FH (FT.) 4.0 0,, D TC)TAL DEPTH (FT.) 8,,0 4.5 GRAVEl- WIDTI4' (FT.) 2.5 25.0 GRAVEL. LENGTH (FT.) t22,, 0 '~"~' 4.¢:?,, 0 GF;'.AVEI_ VOLUME (CU. YDS. ) 50.8 45,, 3 TANK SIZE (GALS) 1,000.0 '~'~' 1,()00,,0 SOIL. RATING (SQ.F:]". /BR) 324 270 4.0 3.5 '7.5 5.0 105.0 *'~, '77.7 000.0 '~"~' ~ GRAVE:I_ I,,.ENGTH > 75 FT. RE(;~UIRES MUL. TIF'L.IE RLINS (NOT' EXCEE:DING 75 F:'T'., EACH) ~'~ TANK MUST HAVE AT I_EAST TWO C[)MF'ARTMENTS I cer"Lify that.: 1. I am {'¢~milian wJ.'Lh the r'equil-ement, s fop on-site sewer's and we].:L~ as set for'th by the Idunicipality o¢ (Anc:l'~or'age (MOA) and t,l~e State el' Alaska. 2. I w:i. ll ins{all the syst, em in ac:col'danc:e with all MOA cc}cles and r'egulat, ions, and in compliance with the design [niter'ia of this pea*mit,, 3,, I will adher'e to all MGA and Stat. e c)f Alask,a p64cluil-mmerd;s ¢of the ~set. back distarlces fi-om Ar'fy existing well, wastewat, ep disposal system or' public sewe~-age syst. em on t.h L~B el" any ad.j acer]t r31" near'by lot.. 4. I under'st, ar~d that this per'mit. :i.s valid ¢c)p a maximum of 3 bedr'oc)m~ and any enlangement will pequiPe an additienal pepmit. IF A 'T'HEN W I IELEC, TRI[',AL WORI.:: .MU,ST. BE DONE BY A L. ICENSED IZLFC]"F~ICIAN. ,. (4F:'PI..,,ICANT: FEJES DEVIEI_OF:'ME~ L. IFT STATION IS INSTAI_L. ED IN AN AREA BOVEF4ED BY MOA BUIL..DtNG CODES, (l) AN EL. EC]"RICAL F'ERMIT AI'4D II'4SF:'ECTIOI~I MLISI' BE (]BTAINliED.~ (2) AS-BUll. TS NOT BE AF'I:"*I'ROVFD WITHOUT AN E'LECTFRIE',AI.,. INSPECTION IRIEI:"DR'T'; AND .(3) THE I,),.:>LJb. D BY ]DA'r'E: SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION-TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1't- 2 3 4 7 10 13 ~v~ L SITE PLAN SLOPE 14 15 16 17 18 19 2O WAS GROUND WATER N --o s ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) COMMENTS PERFORMED BY: 72-008 (6/79) TEST RUN BETWEEN ~ ,'~,~/~y FT AND FT DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19. 20- COMMENTS 72-o08 (6/79) WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ./ . . '~ '/~,'/~ ' t~ ~ ~' .~. (~- JO.', ', , ~J~' · PERCOLATION RATE ____ fi~utes/inch) dUN BETWEEN ANO CERTIFIED B'~ 50' _CERTIFICATE, I HEREBY CERTIFY THAT I HAVE SURVEYED'THE FOLLOWING I~[SCRIB~ D PROPERTY, I.Or z5 ~LOCI( 4 K-,~ S I L, OF:: HILLS '' AND THAT NO ENCROACHMENTS 'EXIST EXCEPT AS INDICATED. NOTE, E:dc IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE · RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD 'ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE ' LINES. % C. FUGLESTAD a SONS, INC. LOT ~3 BLOCK 4 BOX 210767 -" ~- ~_,c*_,~, ". ,.' -.'~'...'' I c~',,~'~~ ..... AS'BUILT 01111 • • •fit�'� Municipality of Anchorage ti3 L5 ": es `�. On-Site Water and Wastewater Program !� (907) 343-7904 • 4.Pc.� d t Pit Certificate of On-Site Systems-7904 • 4 '41 + 3 o _ Parcel I.D. 015-131-09 Expiration Date: , . ., c� 1. GENERAL INFORMATION: Complete legal description KASILOF HILLS: BLOCK 4, LOT 23 Location (site address) 10701 VOSIKOF PLACE*ANCHORAGE,AK 99507 Current Property owner(s) NINJA HOGENBIRK Day phone 947-9063 Mailing address 10701 VOSIKOF PLACE*ANCHORAGE,AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: Z 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 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: _ Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5 Waiver Fee $ Date of Payment 60/3`/g Date of Payment Receipt Number Receipt Number COSA# 65C14 i a4 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 (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road,Suite 101-Anchorage.Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: .513)/i q In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system •gOF 0044 in accordance with the guidelines and regulations established by the Municipality of Anchorage and c..•'.... �S�Q industry practices. The reported results describe the condition of the system/s on the date/s of the p P ••• Q evaluation. Separation distances were measured to readily identifiable features. Hidden defects or Q� �';� n encroachments may exist that were not identified during the evaluation. The operational life of all wells y*VO and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 4 '•' Q groundwater levels (that may fluctuate during the year), quality of construction (materials andVA Ci workmanship), and the water usage of the family utilizing the system/s. These conditions can vary,and 0 .. . Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the 0e f ey A. ness, Q system/s; therefore, GEG makes no warranty(express or implied)regarding the future performance of O 9 C —7 53 boQ� the well or septic system. GEG makes no representation whether an alternative well or sept W((( r can be installed on the property in the event either of the current systems fail to perform -. olrFy � t 3 •si.�I• �cA� the future. The content of this report is for the sole benefit of the person/party that r. . .:.`+ to `.•P ) �O' � � rofess‘o�a perform the evaluation. Reliance upon the information provided in this report by art, . person or ggqqqod party (including subsequent property purchasers) is not authorized. nor will it cor • y legal() 'SO whatsoever. Q W s IV. /rE r Cy #AECC884 6. DSD SIGNATURE J p TRO 6q AND m System #1 Approved for bedrooms � GRAM System #2 Approved for bedrooms //1/TS �S� \�, Disapproved ��)))))) )�C111)' Conditional approval for bedrooms, with thefollowingstipulations: L _' . P c ioW `4-25`�V�c/ 1 S VcLw �A vvvt ` W�-Qwi�c�V' �,I, 1,1/ G4 Y ,6ov� ��h �N f N t l (/'A, o l S f GI.QW! LAA-0 r t l 1a20( 4-0 b P ��aw\ 4-o L wAev -� Original Certificate Date: (�' /9" 4� Pev. til 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 7 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-70-12 Soc COSA Checklist Legal Description: KASILOF HILLS; BLOCK 4, LOT 23 Parcel ID: 015-131-09 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA `S l�uL�� 6.-1 1 S e g--, lel&-( /; yd LZ/ •Well log is filed with Onsite (or attached) 1�1 Well production at time of test 0.87 gpm Date drilled 9120184 . NI Water storage tank volume N/A gallons V 0 Total depth 50 ft Well disinfected for coliform test? ❑ Yes ❑i No Cased to 37 ft ({ U ❑■ Coliformbacteria is Negative ❑■ Sanitary seal is functioning correctly Q I/ M �I rt ate 15 mg/L El less than MRL (ND) 0Wires are properly protected 1 (`,\G' Arsenic ug/L ❑■ Arsenic less than MRL (ND) Casing height(above ground) 12+ in. V\ Collected by GEG, LTD. Date of flow test for COSA 12"0'18 Date of Sample 5/14/19 Static water level at beginning of test 30.3 ft Comments B. TANK DATA C. LIFT STATION -- Age of tank(s) NEW years ❑ Required maintenance completed Tank type/material HDPE Age of lift station years Measured operating fluid level in septic tank NEW Lift station material ■❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 1984 Adequacy test date 12/0"8 ■❑ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade *7.8+ ft (max) Fluid depth prior to test 26 in Measured depth to pipe invert from grade 4.2 ft(min) Water added 500 gal ❑ N/A—pressurized field 37 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 240 depth into effective .. Elapsed time min ❑■ Code-required soil cover over field Final fluid depth 32 in Absorption rate 450+ gpd ❑ System presoaked NO (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) - Gallons introduced - gallons If yes, enter date Comments/Deficiencies:TESTED WEST TRENCH NLY'E T TRENCH APPEARS TO BE SURCHARGED."SEE 2016 COSA REGARDING MT DEPTHS 'AT WEST TR CELL. COSA Checklist yellow sheet Ll(-) 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' Community Sewer Manhole/Cleanout > 100' El Yes if No ft 1 Yes if No ft Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line >25' 0 Yes if No ft Absorption Field on Lot > 100' El Yes if No ft Holding Tank> 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' El Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water> 100' ❑Yes if No *43 ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' El Yes if No ft Water Main > 10' El Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' El 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' El Yes if No ft ** Water Service Line > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water> 100' ❑ Yes if No *43 ft F. ENGINEER'S COMMENTS *WAIVER APPROVED OSP191166 **SEE 5/2019 RECORD DRAWING EAST TRENCH APPEARED TO BE SURCHARGED AND WEST TRENCH WAS 60% FULL PRIOR TO START OF TEST. 00600\,I, G. ENGINEER'S CERTIFICATION o OF 4 ��N I certify that I have determined through field inspections and review P •' O of Municipal records that the above systems are in conformance with ,,..,1"/, -. ( ). A 9 H 0'\ • 0 MOA COSA guidelines in effect on this date. �� �' • * a D A I VA Q io . :f r• A. Come- . I Q % CE �O 09 'j116%,. ...:513.4 7 , //\ 00 COSA Checklist yellow sheet 44� ro f ess1o�a #AECC884���Opoo�6 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • 907-343-7904 On-Site Water and Wastewater Section \ � Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC191209 Subdivision: Kasilof Hills, Block: 4, Lot: 23 A water sample revealed a nitrate concentration of 15 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • ` 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # OSC191209 Subdivision: Kasilof Hills, Block: 4, Lot: 23 This well's productivity was determined to be .87 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. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org i t \ GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING May 31, 2019 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Section 4700 Elmore Road Anchorage, Alaska 99507 Attn: Tim Ecklund Ref: Kasilof Hills, B4, L23— Elevated Nitrate Levels in Drinking Water Well Mr. Ecklund: Recent water sampling (5/14/2019) indicated the Nitrate level in this well to be 15 mg/L, which is above the EPA limit of 10 mg/L. Earlier sampling performed on 6/22/2016 indicated a Nitrate level of 8.23 mg/L. In short, there has been a significant spike in the Nitrate level. The well on the subject property was drilled in September of 1984. It was drilled on the neighboring property, Kasilof Hills, B4, L21. Per the drilling log (Alpine Drilling — Dave Harper) the well is 50 feet deep and cased into bedrock at a depth of 37 feet. Furthermore, the drilling log indicates that from a depth of approximately 2 feet to 37 feet (copy of drilling log is poor quality and difficult to read) below grade "weathered bedrock" was encountered. I am familiar with the weathered bedrock on at least one lot in this general area. Based upon my experience, the weathered bedrock is very loose/fractured, and can be excavated with a backhoe. See the attached soil logs for two lots that are immediately uphill (Kasilof Hills, B4, Lots 16 & 17). As can be seen, both lots are underlain by shallow fractured bedrock over bedrock. The upgradient lots also have elevated Nitrate levels. The Nitrate issue is likely due to a combination of factors, such conventional septic systems (or IDSF systems) installed in (or in close proximity) to fractured bedrock or shallow bedrock, as well as poorly constructed wells (improperly grouted) throughout the area. Correcting the Nitrate issue in this area will likely require a multifaceted approach. The property owner has just replaced the old steel septic tank on her property with a new Infiltrator septic tank. She was also required (by the MOA) to document that the water service line from her home to the well (located on B4, L21) does not encroach upon the septic system located on B4, L21. My client has likely spent in excess of $10,000 for this work, in addition to the engineering services associated with her COSA. In short, she has made a significant"contribution"to the environment and public health by correcting the problem of a failed septic tank and has formerly documented the separation distance between her water service line (35 years old?) and the well on Kasilof Hills, B4, L21. In the near future, the OSTRB is planning to re-write the "Water Well" code, and it is anticipated that they will codify formal requirements/procedures to address/correct poor or improper well construction. Until that process is formally codified, it only seems fair to continue the current longstanding COSA 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com Page 2 of 2 policy of issuing an "Advisory Notice" regarding elevated Nitrate levels and allowing for residents to address water quality concerns by installing point-of-use or point-of-entry drinking water treatment systems. It is understood that if an obvious well deficiency is identified, like a leaking pitless adapter, or cracked casing, that corrective action/s would be required. To the best of my knowledge, a camera inspection has not been performed on the subject well. Please call or email if you have any questions. Sinc-rel - yarn_ s, '.E., M.S. Pre de` 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax:(907) 338-3246*Website:www.garnessengineering.com 84411 / / pF i O� 05\� SQ)' n s`s6° Lot 22 1 `C`' /„ „<'• S30 S-� o ;re \----- V _---— well 1 30 asphalt ,��i�4,. lP 9are �� 160.0-1t--0 CM OH � . Culvert �A Catch basin - N �0 1 I e,. 2 story 1 �/ Septic Vent ' ♦psi rye. frame 1 W P (tYP}-�.•�`. :-..!ii���.0 house 1 0 ® Ic N C r--) \ z 1 E cr-- Curtain drainT 1 m Lot 21 C°0 <:, I m 1\0etch basin T % n o ao� 11 5- o v _ 1 0 n1 -.\ - 1 0 m osyl I NLOT 23 Catch basin II I I I I N 87°14'29” E 205.94 I Lot 24 I I RECERTIFIED 5-28-19L) REVISED 8-01-16 ``�\\\�, AS-BUILT NO CORNERS SET THIS DATE /\c_ OF •A• L 1 1, I hereby certify that I have performed a Mortgagee's inspection Q' .,•., :.S , of the following described property: LOT 23 BLOCK 4 my ' •t•9 #• , KASII OF HII I S SI IBfIVISION 'Iffiv �� � CO. 4 th i� 00d•►/,.•. •> /, '..• 0, Anchorage Recording Precinct,Alaska,and that the ••• d---.0 �I improvements situated thereon are within theproperty lines and do not overlap or encroach on the property lying ik .Elizabeth L. Walatka:ff / adjacent thereto,that no Improvements on the property lying ,,qtr,,,•• 8036 - LS ••Je-- adjacent thereto encroach on the premises in question and • • 5 that there are no roadways,transmission lines or other ho Aft.;' • • • • •0,d visible easements on said property except as Indicated hereon. SCALE: 1"= 50' ,' ' ,X I.v•-•• Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN -13-217)- this 28th day of July ,2016 THOSE SHOWN ON THE RECORDEFRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON FB 19-3 pg 36 Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 16-7 pg 34 BE 907-248-1666 • • 21/Loyal-kii' 1,zaraamq 1201 RR1ORR 99515 ANCHORAGE, ALASKA 344-7714 SIX INCH WATER WELL DRILLED OUT TO THE DEPTH OF2�Dp .. DRILLED AT THE RATE OF PER FOOT. PROPERTY OWNER ' & (/LLi. (f n..t4 & I1ZLm.L} R3aA,i.,an 338-0503 LOCATION OF WELL SITE 18 NI. • xa.4.1.14 ILi.L1d Star. DRILLER Benn.Le-_Calm O. Ram .t Dit,11,ting WELL LOG: 0-.--16' R wet 4andg geauet. 35% cia4. btndee. &token bedrock rate tta.L 4ont. 12 .fit. 16-�38' Weatheeed bedeock. Cao. n (4 L) dntuen .to equoa,L at 38 .feet, 38---51' Sem bedeock with mtn ma).. amoun 4 4 wata4 oield 4haw.ing at 51 4. 51--146' ifaitd 4edime4 ta.tz Mack, w A. flame grianutat type watee beaeing /tack at 146 It. 146-152' Thi4 a'ea 4haw4 good pate tial .flan watch 71oi0u4 type nock yie.Lddng a. ,ateg 44w 4 watch. RWa 'tM4 atea 4hauLd break ,in atAanget with u ee a.4. Je.LL. 152-203' Thin anew o 4 wa.teit y ie d eow hou t. MiMrna,L anwun t4, lwweue t, cvaabity good po.tenA a.L. Water 4ttpp,L.r}. 4.4 pumped clean, with eecauee back up within 20 4 a� 4U4ace.. The quality ttt d.4 good. Quan4,4 o e wat.e2 4upp 4 ao 800 to 1000 ga. ort. ee- coveey 1n a 24 haunt tine Pane. Thd o WeLL 'Amid aLao inctecwe with u.e .xtppitio 1.6 gallon4 wate4 pee 4 an caadng. Ouee 275 gation4 4 wate t in eeae rve af.te4 �wLt necaveitti.. tnae wateA. ra needed -44 •futwte use .thvJ WrU can. be d.eepp..AM L tt.4 -Li.l t.Le .incarwen t eiu R 3/4 Hoe4e S �t..�,J.a 'Pump fhau,ld JJe .iry taLttd tv., . o �'''�p�},^,,�,,^, y� ' 1 ALITY Or L it a# bottom.. ENV/RONMENFAHEPP TH CACt pIECTIoN r r ° U1986 COST INCLUDES ALL LABOR AND MATERIAL FO CTil LVE0 OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF - THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE 11144444t 20th, 19854S-6 4-1.."-Nr- - SERVICE . .N+SERVICE CHARGE 0 F 1''/% PER MONTH WILL BE ASSESSE ON PAST DUE AC OUNTS. WELL LUG Rik. 4 Lot 16 Date Drilledt -17-n[ Kasi?of. Subd. Static Water Level 1S feet Gallons Per Minute 1 Draw Down feet Total Feet of L`asing_ 2° MUNICIPALITY OF ANCHORAGE CEPT. CF HEALTH & ENVIRONVMENT2.L PROTECTION Tyne Material Drilled: DEC 3 1986 0 feet to 1 1.2 feet to 4^" Redroc!c to Producin' 1 q.n.m, noir bottom. to to to 1-r,R.2 , h = V02 5,1(4' 3.3 ii /3371t1 " :4 9-18 = 3fr Hefty Drilling ,111/11-e ibr3 S.R.A. Box 1553 H6c)� A nchorage,Alaska 99507 • /V SOILS LOG . •. MUNICIPALITY OF ANCHORAGE •- . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION TEST `� 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR:___( iiC/(/•e4.!______L____ DATE PERFORMED.0a/C LEGAL DESCRIPTION: Z----< 6 ,8 LI r//o ,C L //< L r S/� SLOPE t SITE PLAN DEPTH ' ( -6E/1") r {Y,k , I 1 = 4 f fr7 / C m(1R / 2 - ', 6 r Ss/Z \ 1.---. ..--\-- 3 ti � `/Z/J`� f49, - 0 4 - G, l,' G1 5 - �p 6 - 6 6,- A-7 V 4- 7 - , G /2d C.Gl / 6-,e( de-- C _ I, /2-s- ,6/dA- 7cI4, 8 - 9 ,.- J , 8 E.6, ' - 1010 - WAS GROUND WATER Q S 11 – ENCOUNTERED? L 0 P – 12 IF YES,AT WHAT �– E f DEPTH? 13 – �;`e.'c: ,.. , 1 cn r r r i1 .r.: Y 4l ¢-s�; + Gross Net Depth to Net 14 – ,•v-.,". 5,` (,Reading Date�,,A ..i, {5'.•, Time Time Water Drop 07 C1, '!' "'�. gi b• Y It24.497/vf."-: ,,,....,: :••••'; 140" 4 ,;if 16 — 's 10 1.. lEvbori A. Shafer , Ili.sr 17 - r iJ,,.,,, No. 1457-E s,: , 8 18 – /rn_ � 4VI(e/10fr �� �`r -- — 19– 20– // ).-- PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 6113 196' a it.i �1 a% ALAS q1,,57t PERFORMED BY:" h�L 69442+$79 CERTIFIED rip00.7 DATE: 00/e-f--- 72-008 (6/79) ..;,, Qi` Ai, ,,dt S( C(7(7 ,ti. 1.E1-Sas A ' e" C0� r 4it.' 6 �t5p • : _ b ��1't • • . Municipality of Anchorage ' ....4"1,".,;"/";', �� .^••^x ••il i DEPARTMENT OF HEALTH & HUMAN SERVICES '• ;-'%„•,,,,•••••7047: 825"L"Street, Anchorage, Alaska 99502-0650 'O ` d', 9 Robert A. ShMtav i ". No. 1457-E •:`�v SOILS LOG — PERCOLATION TEST � s�••• •,••i.10 A117617° ,16.7. #743 C O 2 '. e4:� •0j.•FEa• •••ary ro c /nom y� r .R7p� ,�� . PERFORMED FOR: , .0 • Q 1 d/ DATE PERFORMED: /7,7 .S� LEGAL DESCRIPTION: Z._17 g AyieLop TioA,pip, Range, Section: 7��2/v R J r^ T`!i _ //rig SLOPE SITZ# rIE.ET) C'/7a'n l L' ■■NII■IIII■PI■ 11101111111MEME 4._ \ ' ZWINEENIIMMIll 3 - vC o 11/1111111111111111111111111111 —''�1 _ a n '11111111■■■■■ d o 7C2r9 c-Tlr2�' , — � ,'y■■■■■1111■■ - ��CPC- . 11•111111111111111111M1 -6 - at r G s/L '' le111■ 1111■■■■ -7 _ o t ` `svf'` ©e ■■■■■■■■■■ v ` ` 111111111111111111.1111111 a c IIIIINIIIIIIIIIIINMIM .11.1111111•11111111111'--�9 - o c 1 WAS GROUND WATER o Qec( l�C--4 N0 ENCOUNTERED? 11 - S IF YES,AT WHAT L O DEPTH? -- 12 - P - E --- /C Depth to Water Alter / 13 - Monitoring? - Dale: ----- 14 -14 Reading Date Gross Net Depth to Net Time Time Water Drop 15 - 16 - 17 - /7)- 18 19- 20- PERCOLATION RATE ,(minus sigh) PERC HOLE DIAMETER TEST RUN BETWEEN v//FTFT COMMENTS 91°.S'?/ZGt C 7 Ike Q /Q U e91 G 4_42E4 - : �ti a ,t :'-I 1 _ PERFORMED BY: S fXq�Kft X9 7 I u/." ' CERTIFY THAT THIS TEST WAS PERFORMED IN •�,1 I 91RtlZM IPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / gc� ACCORDANCE WITH ALL ST Y• -_» 7 �/ 72-008(Rev 4/85) /J „-,f Vi,.0':•?' ',NrIrk.04,37Nfa.W4 i •st'i474,t,..*: •:.4.qvitir•Ve.,00 4:illy;fig-4.-t..1.. -:•)4.*.v1/4;ic,;Wx,:04,.,;,.!;,: -,, :)..1.t , , • • ”, •X ''.';•.:•7i I: t, ;s , STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD LOCATION OF WELL S /970269 BOROUGH SUBDIVISION LOT BLOCK SECTION CTRS SECTION TOWNSHIP RANGE MERIDIAN kit' / 1 ON OE Jim 14:5 /7 II Os Ow -... LOCATION/SKETCH: WELL OWNER: PO,. PDX 0-1 Z 0 3? f95-03 17.15/4..c t -e • DEPTHS MEASURED FROM:Ocasing top Oground surface WELL DEPTH:' . • DATE OF COMPLETION Depth of hole: . ft BOREHOLE DATA: DepthDepth of casing: ft /6) //6 /97' Material Type and Color From To 0 DEPTH TO STATIC WATER LEVEL: gft below X top of casing 0 ground surface Date: /42 /_4___/ 97 __ 9 .2.25, moETotHhOeUr OF DRILLING: J 'air rotary 0 cable tool • 11Z1/04 USE OF WELL: p•-domestic 0 irrigation 0 monitor 0 public supply 0 other CASING STICK-UP: • ft. Diam: . in. to.t&.3ft Casing type: in. to:1,42ft s WELL INTAKE OPENING TYPE: 0 open end 0 screened . 0 perforated ig open hole . - -- Depths of openings: to • ft SCREEN TYPE: Diam: in. Slot/Mesh Size: Length: ft • GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE: 4,.. . tho• I 'ine: . - .• -- Depth: from ft to ft -- Rra= DEVELOPMENT. MET D: i2( NOV ' Duration: • • . . NOV 7 1997 PUMPING EVEL AND YIELD: fultinitpalliy of Aficherage , - - . - — • '•'. . ft after 7L.• hrs pumping 3 gpm , Oopt.Health&Human Services PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? jsz YES 0 NO .._ CONTRACTOR INFORMATION: s., _ ._____ --• - --REMARKS: -9 . .. • 1I ,_ ./, . ./.. --e. -A ...e ,- Reg-idtered : siness 1.- e __ _ _ _ , — " " ,s , 0 , LEASE MAIL WHITE COPY OF LOG TO: ' - .s. a 72-af-1- 2-•.-A i 713 DNR/DIVISION OF MINING &WATER MGMT ....? Signature of Author ea espre ntative ate 3601 C St, Suite 800 .. . _- • ANCHORAGE AK 99503-5935 - •. Phone (907)762-2538,Fax (907)562-1384 Parcel I.D. # ¢'~\~" 1. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P,O. Box196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ( ~'-~ HAA # ',,-~"~c'~C :~Lc ~,£ GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Day phone_~¢'-?-~- Z~_ ( [ Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system, TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Front MOAIt21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address '~ ;~ ~-0 Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date . 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 (Rev. 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Dcscriptioa: Lo-r 2. ht Parcol I.D,: A. WELL DATA Well type 'T~I Log present (Y/N) y Total depth Sanita~' seal (Y~ If A. B, or C. attach ADEC letter. ADEC water system number Date completed ~9~- g0-q¢ Cased to '~ '7 /~'F Casing height (above groand) 5L /vT Wires properly protected (Y/N) __ Date of test Static water level Well production FROM WELL LOG oq- 2. z- ;LO FT AT INSPECTION d..-~ g.p.m. 19. q& . g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate 4 ~' -1o'1~/,~ Other bacteria tV/~/E /V~TED Collected by: A'~- "~AM t ggE ~ B. SEPTIC/HOLDING TANK DATA Dateinstalled ~97,,_~]-I~4 rmtksize /)O00Ja/NumberofCotnpartments ~ Cleanouts(Y/N) Foundation cleanout (Y/N) ~ Depressioo (Y/N) /%/ High water alarm (Y/N) tX] Date of Pamping.~/0-q,~" Pumper'~Et0ALI ~E~/Et~ ? "~l~AttO C. ABSORPTION FIELD DATA Date installed ~/~t--/ Soilrating (~.flfl~ftT,/~/ft2/bdnn) /,,~,~ _System.type _ ?) qs~:'r Dq FT Length 2) 30 ~T Width 2) q ~T Gravel thickness below pipe Effective absoCtion area ~O ~ Monitoring Tube present(Y~) ~ Date of adequacy test _Oq - 02 - qS' Results (Pass/Fail) 51-1r"ILLo~ d ~T Total depth ~ 15.6. . Depression over field (Y/N) For t_"~ bedrooms .~fid depth in 3bsorption field before test (in.): Y- I/Zq hnmcdiateh, afterS~]gal, added 3~/Z5. =E water ~c~ I /?~cH ~ ' ' ' SEE TABLE Fluid depth OO Minutes later: Z3.S/Zq (in.) Absomtion rate = qOO g.p.d. Peroxide tmammnt (past 12 months) (Y~) ~ If yes, give date Date installed Manhole/Access (Y/N) High water alarm level at* Size m gallons "Pump off' level at* *Datum "Pump off" level at* Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank oil lot Absorption field on lot Public sewer main /~/]t Sewer/septic service line 51PE O~ : On adjacent lots ~ I00 FT · On adjacent lots Public sewer manhole/clem~out Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 1'7.14 F:T Property line ~ ~'/' Absorption field ~ Water main/service line 7,~..q ~"[ Surface water/drainage ~/z]-'~Wells oil adjacent lots SEP~A~ON DISTANCE FROM ABSOR~ON FIELD ON LOT TO: Bnildingfoundation ~ [~.~ ~T Water mai~se~ice line ~z.q Surface water ~9 ~~ ~' Drive,vay, parkinWvehicle storage area Curare drain ~0 FT Wells on adjacent lots ~ 1.00 -- -- ', C" ' .... [ certify that ] h~e determined thrufield inspections and review of~VIunicipalo~bdeds'~hat the in co~)or,,,ance w~th xloA .~ guiaetines in efJact on this date. ,'7:' :-:. :'~ Date 0~/- 13-~'ff' HAA Fee $ 3 Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Rick Mystrom, Mayor Mumcipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 October 16, 1995 Deborah S. Allen, P.E. ARH Consultants 8250 Country Woods Drive Anchorage, Alaska 99502 Subject: Waiver Request for Lot 23 Block 4 Kasilof Hills Waiver Request ~WR950054, PID #015-131-09, HA950366 Dear Ms. Allen: Your request for a waiver(s) of the required 100 foot horizontal separation of a septic system to the surface water has been approved. The approved separation distance(s) are the septic tank to the surface water of 85 feet and the leachfield to the surface water of 60 feet. This waiver approval applies to the existing septic system to surface water separation only. Any future upgrade to the septic system will require all separation distances be met or another approval from this department. Should the operation of the subject wastewater disposal system cause any contamination or degradation of the subject surface water, this waiver will become void. ~Sincere~, 4- James P. Willzams Civil Engineer On-site Services Concur: Program Manager On-site Services/Water Quality JPW/ljm#5 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~[33~q._~/ PID~ 015-131-09 HA# HA950366 Permit # Date Received: October 10, 1995 Legal Description: Lot 23 Blcok 4 Kasilof Hills Subdivision Engineer: Deborah Sue Allen, P.E., ARH Consultants 8250 Country Woods Drive, Anchorage, Alaska 99502 Applicant: Jon Fugelstad Waiver Requested: Septic tank, leachfield to surface water of 6~6~,~5'~,~ / Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient ~Points :) E. Horizontal Separation ,/ TOTAL: 2. Special Conditions: W~iver is gr~nted: _ ~ Waiver is NOT Granted: List Conditions or ~easons for above: g=~ ~,~ ~a~ o~ Rev~'e~'er Rec ~: ~01377/3521 Amount: $920.00 Date Paid: 10-10-95 October 15, 1995 Mr. Jim Cross Municipality of Anchorage Department of Health of Human Services Division of Environmental Services, On-Site Services P.O. Box 196650 Anchorage, AK 99519-6650 8250 Country Woods Drive Anchorage, AK 99502 (907)344-0893 RECE:IVF D OCT '/6 1995 ,,,., . , .... :~;'Jh y of A .... ,m, ~ervloo~ Health Authority Approval Application Lot 23, Block 4, KasilofHills Subdivision Leachfield and Septic Tank to Surface Water Waiver Application (Revised) Jon and Che~3,1 Fuglestad, Owners ARH Project No. 002-01 Dear Jim: Per your ~equest. the owner of the subject property has constructed a protective piping system in an area which violates tile requirement fei' a minimum of 100 feet of separation between a leachfield and surface water. Based on our conversation last week, the outlet of the pipe has been e×tended to approximately 3 to 4 feet from the existing road culvert, and a wye and stub has been i,~.stai!ed to cat'ch the flow from the driveway culvert. The driveway culvert stub was extend to approximatel? 3 to 4 feet from the outlet of the driveway culvert During construction, two other seeps were observed to be flowing into the area from the south. Two additional wyes and catch basi:ns were installed to intercept this flow. As built drawings which show the location of the pi?e: catch basins, and other pertinent features including the distance to the septic tank and !e~.,~ht'm!d are attached to this letter. Please replace the previously submitted as-builts with the a':txci'~ed. As shown on the drawings, 6-inch diameter corrugated polyethylene pipe with a cover depth of twelve inches was used for construction of the drain. Based on our observations of the floxv at t~',is lime of year, tbis size of pipe should be adequate to handle the anticipated flow during x,.,ea'.,her events. Approximately 3" minus clean gravel was placed at the entrance and exit points cfi' the pipe to minimize erosion Alter pipe placement, the trench was backfilled with native material. If natural vegetation does not adequately reestablish, the trench area will be re-seeded with all Alaska grass mix next year, since seeding at this late date will likely be ineffective. Department of Health and Human Services October 15, 1995 Page 2 Based on the attached as-built drawings, distances. we [ ECEIVED 001' 1 6 1995 ~er~,u??~a!ity of Anchorage pt. rmalth & Human Services request waivers for the following separation Septic Tank to Surface Water Leachfield to Surface Water 85 feet 60 feet To justify the waiver, we offer the following comments. Catch Basin No. 1 is installed at a location a minimum of 10 feet in elevation above the elevation of the top of the septic tank. It is highly unlikely that any contamination from the on site sewer system would infiltrate this upper area. · Catch Basin No. 2 is located at approximately the same elevation as the lower end of the leachfield. However, any possible leachate from the on site system which reached the ground surface would flow downhill to the west. Since Catch Basin No. 2 is located south of the leachfield, any contamination of surface water in this area is unlikely. The catch basin was located to intercept a seep, and could therefore not be located any further from the pipe. Catch Basin No. 3 intercepts flow from the driveway culvert which is normally dry except during spring breakup and rainy periods. The inlet to the drain is at an elevation above that of the lower leachfield after which the flow in cased in the piping making any possible contamination unlikely. · Catch Basin No. 4 and 5 are downgradient of the leachfield and intercept small seeps which were observed during construction. The basins are greater than 65 feet downgradient of the leach field and contamination is unlikely. · Catch Basin No. 6 is the termination of the pipe after which any flow in the system immediately enters the roadway culvert. This basin is located more than 80 feet fi'om the estimated location of the leachfield. Please refer to the project as-built drawings for a graphical representation of the above narrative. Drainage arrows have been added to the drawings to indicate the approximate drainage runoff path.. The topography of the area is relatively steep fiom the edge of the driveway to the leachfield, becoming moderate to fiat as the property approaches the road. IN addition, the area has been regr.~ated and filled as required to eliminate any standing water. Department of Health and Human Services October 15, 1995 Page 3 REC[!IVED OOT 1 6 1995 i"~d,~:',';,i),3!i.',~, Of Anchorage Health & Human Services If you have any questions or comments regarding the enclosed, or if you need any additional information, please call at your convenience· Sincerely, ARH Consultants Deborah S. Allen, P.E. Project Manager DHHSI015.95 DS~'mtf ~'Z. D'-O r_.O[I&ITF,.Y WhO'Ibc--, q 0--/- 544- 0 Rq 3 RECEIVED PER AS- ~tE~ FIPE ' DF b" PER~ PiPE ~LID~M~T D~ '~ ~e~O OF P~PE · -- -ff~ D ~F &~L~ ::';~ .,:..-.e .- ,. :~ . ~ ~; . :(:.,' ' )5 :hbrage ~ Servioes O PL/q~ NIf~TL ~ TO E×isTI~JO- TYhLAL TI~EfLEM £EF_._TIDA3 _].oo'- fi2 ~/o NAME / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS PHONE jz/¢ ~o// ~ NEw UPGRADE LEGAL DESCRIPTION TION V~" J~c> '3I~ ~ /~'¢.~ ,' [~ ~ Well __ Absorption area Dwelling . PERMIT NO Manufacturer - - Mater a ~ No ofcomnartments Liq, capacity in gallons I Inside length Width Liquid depth /0~ I IF HOME~D.: ao~i DISTANCE TO' IWell IDweuing PERM,T NO. Manufacturer I Material Liquid capacity in gallons IDISTANCE TO: Iwell ~0 '~,'~ F°undat'°;O~ ,~ IN~.r..t,ot,,n. ~ ~ PER~T~¢ I No. of~in.~~ Length of each line Total length of~nes I Trench width Distance between line~ r ~--~ 7 ' ~ I ~ inches I Top af tile to finish grade ' Material beneath tile /¢ ..... ~ ~ ¢ -- -- ~otat e~c~ve ~)s~tjon area I = o. ] Type of cr,b Cr,b d~ameter Crib depth Total effective absorption area DISTANCE TO Well Building foundation Nearest lot line ]Class ~ ~ ~ Depth · Driller Distance to lot line PERMITNO DISTANCE TO Building foundation Sewer line Septic tank Absorption area(s) OTHER PiPE MATERIALS p I/'~___ C f SOIL TEST RATING INSTALLER REMARKS / APPROVED DATE LEGAL ?-si-F: ih'Ils ?: 72-013 (Rev, 3/78) ' "',L_o T CERTIFICATE, I HEREBY CERTIFY THAT I HAVE SURVEYED'THE FOLLOWING D~SCRII~D PROPERTY, LOT Z5 BtcOCK 4 K-.A. 51L.. C:, F: HILLS AND THAT NO ENCROACHYENT$ EXIST EXCEPT AS INDICATED. :)ATE T. C. FUGLESTAD ~ SONS, INC. [~OX 210767 ANCHORAGE, ALASKA 99521 SCALEr I'~,, ',~D~ CHK'D~ . ' ' HoU~ ErI~R NOTE, IT IS THE RESPONSIBILITY'OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD 'ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE ' LINES. LOT ~.5 BLOCK 4 K'ASiLOF HILLS AS'-BUILT `°_i'�....�,M--rc.''�,'.':--d'a..s''-1.,.;:',"'k•�r^,4s3=y2'Y�^rfi�.—i�%:=:C; jj � �I 1QOK 1 7 6 1 j RAVE 0707 I MW OFFICIO OF WILLIAM L. MCNALL fora W[OT THIRD Ave, SUITR too ANC340F AOX A1.ASXA 99301-1917 19071 276.2835 EASEMENT THIS INDENTURE, made this ae� day of June, 3988, by and between RUSSELL C. DOIG and ELLEN L. DOIG, of 10700 Rexauor Circle, Anchorage, Alaska, hereinafter referred to as the Grantors, and JON FUGELSTAD, of X070 1 _, Anchorage, Alaska, hereinafter referred to as EEee Grantee, W I T N E S S E T H: WHEREAS, the Grantors are the owners of that certain real property situate in the Anchorage Recording District, Third Judicial District, State of Alaska, more particularly described as follows: Lot Twenty-one (21), Block Four (4), KASILOF HILLS SUBDIVISION, Plat No. 66-96, Anchorage Recording District, Third -Judicial District, State of Alaska; and WHEREAS, the Grantee is the owner of that certain real property situate in the Anchorage Recording District, Third Judicial District, State of Alaska, more particularly described as follows: Lot Twenty-three (23), Block Four (4), KASILOF HILLS SUBDIVISION, Plat No. 66-96, Anchorage Recording District, Third Judicial District, State of Alaska; and WHEREAS, the well located on such Lot Twenty-three (23) was constructed by inadvertence so that its water line is constructed on such Lot Twenty-one (21). NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows: 1. Grantors do hereby grant, bargain and sell unto the Grantee, his successors and assigns, forever, a permanent access and maintenance easement over and across such Lot Twenty-one (21) as follows: A strip of land, for the purpose of egress and ingress for maintenance of the existing water -1- line for the purpose of serving the well located on Lot Twenty --three (23), Block Four (4), KASILOF BILLS SUBDIVISION, Plat No. 66-96 as filed in the Third Judicial District, Anchorage, Alaska, 10 feet wide, the center line of which is described as follows: Beginning at the NW corner of Lot 21, Block 4, Kasilof Bills Subdivision, Plat No. 66-96 as filed in the Third Judicial District, Anchorage, Alaska, S 80 25' 218 E 9.001 to the true point of beginning, thence N 840 001 248 E 165.151 to the Easterly border of said lot. The side lines of said strip to be shortened or lengthened to terminate at the Westerly and Easterly boundaries of said lot. 2. The cost of maintenance allowed by the easement granted herein shall be at Grantee's and Grantee's successors' and assigns' sole cost and expense. 3. The easement granted herein shall be utilized in such a manner as to not interfere with Grantors' use of the water line and well on Lot Twenty-one (21). 4. Grantee or any successor or assignee of Grantee whose acts pursuant to this easement disturb the condition of Lot Twenty-one (21) shall be personally and solely responsible for the cost and expense of returning Lot Twenty-one (21) to the condition it was in prior to such acts. IN WITNESS WHEREOF, the Grantors have hereunto set their hands and seals the day and year first hereinabove written. Russell C. Doig r Apt _BM=, so. '. .-.a.R.4...� -2- L%W OFFIC20 OF WILLIAM L. MCNALL 1020 W22Y THIRD AV[. OutTC 300 Al1CHORAP2, ALA2KA 991501-1917 (907) 276 -ROSS rrrrr 'AW DpIllQB DP WILLIAM I-. MCMA go,, WLOT THIRD A ""ITY IDD ...RADE. ALAI 99E01 -19f7 (907) 276•2W fY.tA A � R TATE OF ALASKA ss: -BIRD JUDICIAL DISTRICT 1988, THIS IS TO CERTIFY that on the � � day of June, the and S )efore mer the undersignedd,a Notary RUSSELL lic in and ELL&t1for hL.DOIG, of Alaska, personally app =wn to me and to me known to be the identical individual name Ln and who executed the foregoing the same freely and hey acknowledged to me that they executed voluntarily for the uses and purposes therein stated. WITNESS my hand and notarial seal the day and year first above written. >" STATE OF ALASKA THIRD JUDICIAL DISTRICT Notary rup My cammias } ss: Fuge K: Cs OF • • �� antee _ day of July, 1988, THIS IS TO CERTIFY that anNotary Public in and for the State before me, the undersigned, known to me and to of Alaska, personally appeared SON dualFUGEnamed who e me known to be the identicand�helacknowledged to me that he cuted the foregoing instrument, ily for the uses and purposes executed the same freely and voluntar therein stated. OFFICIAL SEAL fE�-_btA,*S rst Bove WITNESS my hand and not seal the aY NOTARY PUBLIC dACKIE.Z MPAN written. �yc�,,�,-• A. ja&ry Public 'n a for Alaska RcC,- Commissia Expires:/9L--- $- � `$$ —s— RETURN of iEWARI TITLE j of Bank of AlasRa 1 r U !i Y _ . 101 },V. Sanson 95" Anchorage, AK rE. KA 3 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Member of the SGS Group (SociCt~ G~.&rale de Surveillance) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH ALJTHORITY APPROVAL OF ON-SITE SEWER AN[) WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name "4¢,4/'~//~,,g~ ,/¢,/~,,~¢ Telephone: Homo Business Applicant is (check one): Lending Institution~; Owner/builder []; Buyer []; Other El (explain); (d) Lendinglnstitution ~//~'¢¢ .,¢./~.../'~/'//¢-'?,.~',~¢' Telephone Address //?/ ~, ~ ~ (e) Real Estate COmpany and Agent Address ~ ~O', ~ ~ Telephone ~2~ (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single~Family,[~' Multi-Family [] Number of Bedrooms -~ Other WATER SUPPLY Individual WellJ[~' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation attestin9 to the legality and status. SEWAGE DISPOSAL Onsite,~J, Public E] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025{'~1/84) F"NGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage flies and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ,,~'~,~/'/ '~ ~ ~. Telephone Address --~ ~ //~ ~ ~ ~? ~ ~// Date //~- ,~ Approved for ' - bedrooms by Approved ~ ' ' Disapproved Conditional 'l'erms of Conditional Appi'oval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (I 1/84) WELL DATA MUNICIPALITY OF ANCHORAGe: DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 26,.,,4, RECEIVED Legal Description: '.'4/o/'~ Well Classification Well Log Present (Y/N) If A, B, C, D.E.C. Approved (Y/N) _ Date Completed ~/~-..~¢'2~--,,p.¢~ Yield Total Depth -~ / Cased to -'5'*;;;~ / Static Water Level ../.;~--~' ~-~/~-.., o.p. Casing Height Above Ground Zo /' Electrical Wiring in Conduit (Y/N) Y' Depth of Grouting Pump Set At '~i-'~" Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /V ~-'~?"5¢' / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~'~-"~ / ; On Adjoining Lots /¢ ¢ /'~ To Nearest Public Sewer Line "~'//~.-'¢ To Nearest Public Sewer Cleanout/Manhole /v,///¢:, To Nearest Sewer Service Line on Lot Water Sample Collected by _.,'/~.¢"'~/ '~"~'~"~-.-~ ; Date //-- Water Sample Test Results ~',~¢'-' ;;~ ~'"?~ / Comments Z~,~/'/ /~ ~_/' /,_ff ,//(.~" _,Z"'~/ -7'"~a,'~'~ ¢,,-'~'/'/ ,,,fl~;'~-~/' 0,~) B. SEPTIC/HOLDING TANK DATA Date Installed ~.;.-F/. Standpipes (Y/N) Depression over Tank (Y/N) AY' Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well 2:~J'd.~" To Property Line /"-~ '/ To Water Main/Service Line Course Size .~o~ No. of Compartments Air-tight Caps (Y/N) ,/v Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) ~--~.-'~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 Of 2 72 026 fRev 8/861 Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~-'-~/'~ ¢¢"¢~ Width of Field ~"~/~o Square Feet of Absorption Area ,,~'"'-..5" Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~1..'/~ To Water Main/Service Line /u'///~. To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ S~ / ~/~'~'/,/"/2~,,./ .~..~ Type of System Design Length of Field / Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ,/~ To Existing or Abandoned System on ; On Adjoining Lots .//~ ~ To Cutbank (if present) /t/'~'/.~ z / -.._ LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checke¢, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ,¢~'~'-~~~ Date Co m pany./~-~/--//~.r~'l¢'. ---¢.-,,~ ,~'" MOA No. Receipt No. Date of , ayn2nt Amount: Page 2 of 2 72 026 IRev 8'861 Back M[~IICIPALITY OF ANCtlORAGE DIVISION OF ENVIRONI4ENTAL H'EJJ~TH DEPARTMENT OF gEALTH AND ENVIRO~.~ENTAL PROTECTION kPPLICAT%ON FOR I~JkLTH AUTHORITY APPROVAL CERTIFICA%~ 1o General Infozqnation Application Date (a) Legal Description (include lot'~ bloe[%/s~fl)divisio~,.sactlon~ range) Location (address or directions) Applicants Address Business (c) Applicant Other Buyer ~ (d) Lending Institution Telephone Address A¢ld~ess (f) Telephone the HAA to the follm.rlng addres.~: ~'jf~e of Residence S ±=tie--Family ~ Number of Bedrooms Water S}LP3~Y- ~ Individual Well ~:~ Other (describe) ~7ote: If community well .%wstem, must have '~:igten corlfJ, t7~latfon from the State Department of Env~ron~,~e ....... ~t Consel~atlon attesting to the le~'ality and status° 4. Se'¢¢age D.is~.sal Note: If com~,nunity :.reli r?'stam, ~mst have ~ritte. n cou.fJ.~atT~n from ~he Depart~]ent of ~ ~ · · anv,~ron~,e~5~;.. Conservation attesting i'.o the 7e:~ality and status, [Page 3. of~°~ ~n~ineering ............. Firm Providing ~In~ectiot]s,~ ....... Test-~,.~,__File. Sea?:c~. ........Da~a and Informati~on As certified by my seal affixed hereto and as of the validation date shown below, verify I~'hat my investigation of this Health Authority Approval shows that the on-site water supply and/or ~rastewater disposal system is safe, functional and adequate fo~ the number of bedrooms and type of structure _ndicated herein~- I further verify based on t~e lnformagion obtainexi from the Municipality of Anchorage files and from ~,~y investigation and inspection, the on-site vmter supply and/or waste~ater disposal system is in compliance ~rith all Municipal and State codes, ordinances~ and regula- tions in ef~ect on the date of this inspection° Name of ~ ir .... ~U2.~/~jT<~ .... _i,~'~.~,~t~52f ~ Yele >hone .~ ~ Approved for ...... ~(. bedrooms By ~t~A~.~' 7 Approved b-- Disapproved Cond. i~ion~, Terms of Oonditional Appreval CAUTION THE MUi~ICIPALT. TY OF ANCEORAG~ DEPARTMENT (~' lDL{3_2['H AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES tIEALTR AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TIDg REPRESENT~ ATIONS GIVEN IN PARAGR~_PH 5 ABOVE BY A_N INDEPENDEWf PROFESSION&L ENGIN~qER PdgGISTERED IN TI~E STATE OF ALA.SKAo THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF I{OMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTSo EMPLOYEES OF DHEP DO NOT CONDUCT IMSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICAT]!; IS ISSUED° %7tE I.[0R{ICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN %]tE PROFESSIONAL ENGINEER'S WORK~ (DHEP SE/~L ) RR4/ej/D18 [Page 2 of 2] 7-19-84 DEPT, 0~: i~: ~ q:~O qME;' i'/,',. ....... I MUNICIPALITY OF ANCHORAGE (MOA) JAil 2 8 '/985 HEALTH AETI~ORITY APPROVAL (HAA) Legal Description: Well Log P~esent (~N) Date C~L~leted ~:/~.:2~. ~c/- Yield Static Water ~1 ~ ~ ~t At ~~~ ~9 Casing ~ight A~ Gr~nd ~,Q ~ Sanit~. ~al on'Casing ~) Elec~i~al Wi~in~ in ~nduit ~) ~ession ~ound ~l~ead ~Y~ ~p~ation Distan~s f~ ~11: t To ~ptic~olding Ta~ ~ ~t ~-~ ; ~ ~joining Lots //~ To ~a~st ~ge of ~so~tion Field on ~t ~ 5~; ~ Adjoining ~ts .... To Newest ~blic ~ Lin~ ~3~ To ~est ~blic Wate~ S~le Colle~ed By ~M~ ~. _; ~te /- ~ /~-~ ~ Wate~ S~le Test ~sults B. SEPTIC/HOLDING TANK ~ATA Date Installed 7- ~f - ~'y Size /~.O0 No. of Ccmpa~tm~nts ~ Stan~i~s~) Ai~-tight ~aps ~)~ Foundation Cleanout~) ~ession o~ Ta~ ~Y~ ~te ~st P~d_ ' ~ P~ing~intenan~ Con~a~ on File (Y~),~ ; fo~ ~ Holding Ta~ High-Wate~ Ala~ (Y~) ~ q~a~y Holdil~ Tank Pe~t ~Y~~ Sep~ation Distan~s ~ ~ptie~olding Tank: To Water-Supply W~ll To Property Line !o'.4 To Water Main/Service Lira Course To Building Foundation /~ To Disposal Field [~Q' (-~ TO Stream, Pond, I~ke, c~ Maj6r D~ainage Receipt Date Paid: ; Amount: ~1 ~-~c~'~ -- [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date .Installed 7~$ f_ ~ c~ Width of Field 4! Square Feet of Absorption Amea Dep=ession over Field (Y~ Results of Last Adequacy Test /2%- z~,~ tO Type of System Design __ / f). Length of Field . 7~- CO Depth of Field .. ~ ! Gravel Bed Thickness ~-O~ Standpipes Present ~/N) Date of Last Adequacy Test Separation Distance from Absor~Dtion Field: To Water-Supply Well /' 67~ ~ ~ To Property Line To Building Foundation ~o~ ~ To Existing or' Abandoned System cn Lot ~ ; On Adjoining Lots ~ To Wate~ Main/Service Line /~ To Cutbank(if pr~segt) To Stream/Pond/Lake/or Majo~ D~ainage Course To D=iveway, Parking Area, c~ Vehicle Storage Area _ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) ComTents ~nt (Y/N) du~ing Adequacy Test. Dimensions J Manhole/Access (Y/N) J Meets MOA ** Check Permitted Bedroc~ Rating A~ainst HAA Request I certify that I have checked, verified, or. conformed to all MOA HAA Guidelines on the date of this inspection. Signed ...~/~-_ ~), ~ Date KB1/dL/s [Page 2 of 2] in effect 2-15-84