HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 1 LT 5Majestic Valley Block 1 Lot 5 #050-731-16 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 231108 PID Number: 050 731 16 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name DEVINE ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 25765 Eagle River Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.8 Ft. Gravel depth beneath pipe 4.2 Ft. Subdivision Block Lot MAJESTIC VALLEY ESTATES BLOCK 1 LOT 5 Fill added above original grade 1.24 Ft. Gravel length 40 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 400 Ftz 1 _ Ft. Well +100 +100 - _ +75 TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1250 Gal. Surface Water +100 +100 _ _ Material Number of compartments Lot Line +100 +10 - - NA POLY 2 Foundation -}-1 +10 _ _ LIFT STATION Manufacturer Capacity Remarks TESTHOLE RE-EXCAVATED TO 16' Gal. DIVERTER NOT INSTALLED. FCO VERIFIED. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank EXIST drainfield Tank to 3034 GUARANTEED SVCS Drainfield 3034 CO/MT3034 Inspector C.BALZARINI BENCH MARK (Assumed elevation) 100 ft Inspdection 151 6/6/23 2nd 6/7/23 Location and description 3rd 6/8/23 4'" TOP OF DECK ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp O� Conditional Approval: Date '4`gS,�i �� *�P 49 •iG.. •% rr . Septic System _ t;HARLES G BALZARINI ApprovedDate .•��`�r �� ��`7 CE-13854low Not . this approval does not include well permit requirem ts. �il �F�PROFEiV%O �.�Aft� �w.. 1 7 CHARLES G BALZARINI CE-13854R E G I S TEREDPROFE S S I O N A L E N GINEER 6/14/23 OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U O H U O H U O H U O H U OH U OHU OH U OHU OHU OHU OHU OH U OHU OHU OH U OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OH U OH U OH U OH U OH U OH U O H U O H U O H U O H U O H U O H U O H U O H U LO7  %LO&.   LO7 1 %LO&.   LO7  %LO&. 1 10 ℄ EA*L E R I 9 E R R O A D 7RA&7 1 0001  0  0 '  0  0 ' 00' LO7  %LO&. 1 0001 LO7  %LO&. 1 0001 10' U7IL ES07 0' U 7 I L  E S 0 7   ' U 7 I L  E S 0 7  ED*E O ) 3 A 9 E 0 E 1 7 E W SS S SSSS SC SS E N00° 20' 19"E 113.07 N 5 4 ° 2 0 ' 5 5 " E 5 8 . 0 0 S39 ° 4 0 ' 0 0 " E 2 0 0 . 0 0 S6 3 ° 4 2 ' 3 4 " E 6 7 . 0 0 S18° 3 1 ' 5 6 " W 2 8 0 . 6 5 L=57.00 R =50.00 L =7 5 .3 7 R =7 7 0 .0 0 L =9 5 .4 6 R =7 7 0 .0 0 10'[' A1&HOR ES07 3A9ERS SHED WOOD SHED G E             1    1  10 0               0   11 0   1 0 0 ' WELL RADIUS S18° 26 ' 2 8 " E 1 2 0 . 7 6 LRW  %ORFN 1 0DMHVWLF 9DOOH\ EVWDWHV SXEGLYLVLRQ  ST )W   EDJOH RLYHU RRDG  SWRU\ WRRG )UDPH HRXVH WLWK AWWDFKHG  &DU *DUDJH *RA9EL DRI9EWA< PREPARED BY: FRONTIER SURVEYS, LLC 650 W. 58th AVE. SUITE E, ANCHORAGE, AK 99518 907-460-1686 DRAWN BY: CHECKED BY: DATE: SCALE: DRAWING ID: SHEET 1 of 1 1.Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. Dimensions to property lines are plus/minus 0.1ft. 2.This document is created by Frontier Surveys for the purpose of an as-built survey for Vanessa Sayer, only. 3.This document is based on Plat No. 75-106, Anchorage Recording District. General Notes DisclaimerLegend 1. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. PS 1" = 40ft 06/12/2023 23-200KC Scale 1" = 40' AN AS-BUILT SURVEY OF LOT 5 BLOCK 1 MAJESTIC VALLEY ESTATES SUBDIVISION 25765 EAGLE RIVER ROAD CONTAINING: 55,798 Sq. Ft. +/- (RECORD) RECORD PLAT: 75-106 Gas Meter Electric Meter/Outside Power Deck Septic Telephone Pole Light Pole Overhead Utility E Elec. Pedestal Water Well Septic Tank M.H. Concrete Water Valve G E S W Culvert -XQ 1 0 R E GISTEREDPROFESSIO N A L L A N D S U RVEYORPierre M. Stragier No. L.S. - 9812 SC MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program . PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231108 Work Type: Septic Upgrade Tax Code Number: 05073116000 Site Legal Address: MAJESTIC VALLEY ESTATES BLK 1 LT 5 G:0363 Site Mailing Address: 25765 EAGLE RIVER RD, Eagle River Owner: DEVINE WILLIAM Z Design Engineer: C&M ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date v l Department Lot Size in Sq Ft Total Bedrooms: 5/30/2023 5/29/2024 51989 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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: An additional test hole is required to be done prior to the construction of the septic field to confirm vertical separation between sewer rock and seasonal high groundwater. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. Received By: S S CAl Date: Issued By: Date: 3-OZo 2_3 EMERGENCY TANK REPLACEMENT MUNICIPALITY C AGE Development Services Department; =' Phone- 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 050 731 16 Property owner(s) DEVINE Mailing address 25765 EAGLE RIVER RD Site address 25765 EAGLE RIVER RD Day phone Legal description (Sub'd., Block & Lot) MAJESTIC VALLEY ESTATES BLK 1 LT 5 Legal description (Township, Range & Section) Lot Size 51,989 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank 0 Upgrade Q (w/wo ADU) Holding Tank El Renewal Renewal ❑ (D) ❑ Privy El Multiple Multiple Dwellings ❑ and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: NONE Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C&M ENGINEERING (Signature of property owner or authorized agent) Permit/Rush Fees: _5q 57 Waiver Fees: Date of'Payment: _5 Z3 A3 Date of Payment: Receipt Number: (�)q6 3 1 r Receipt Number: Permit No. 0.3 11 () Waiver No: GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: New Septic System for Majestic Valley Estates Block 1 Lot 3 Dear Reviewer, The subject property is served by an aging septic system which is not able to pass an adequacy test. We are requesting a permit to construct a new leachfield and to install a new septic tank. A testhole was excavated and revealed favorable soils at the proposed location. Groundwater was not encountered. The testhole was excavated to a depth of 14-feet. The testhole used for the original construction was excavated deeper to a depth of 16-feet and is the basis for assuming depth to an impermeable layer. Impermeable was not encountered and we have assumed that it was likely within 30- feet of some portion of the proposed field, given the location of the existing trench. If required by the department, we will excavate a testhole during construction to a depth of 16-feet to confirm depth to impermeable. A deeper testhole requires a larger machine than was able to access the site at the time of testhole excavation. A percolation test revealed relatively free draining soils with a perc rate of 1.4 minutes per inch. The perc test was performed starting at a depth of 4-feet. The depth to water measurements were measured relative to the top of the PVC pipe tube used in the test. Our review of available documentation and field investigation show that this project will not adversely impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, or drainage flowing onto and off of the subject property. The work must be performed by a moa certified installer (or approved homeowner) in accordance with MOA requirements. Upon completion of the installation, a record drawing will be submitted showing the location of the new septic system components. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 5/17/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231108, Curtis Townsend, 05/30/23 CHARLES G BALZARINI CE-13854REGISTEREDPROFESSION A L E N GINEER 5/15/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231108, Curtis Townsend, 05/30/23 CHARLES G BALZARINI CE-13854REGISTEREDPROFESSION A L E N GINEER 5/15/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231108, Curtis Townsend, 05/30/23 Municipality of Anchorage Development Services Department On -Sire Water and Wastewater Section 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 WWW.mUnI.Or IOnSlte (907)343-7904 Soils Log - Percolation Test 7 4a tH �.J..,q................ i �CHARLESGBAtZARIMI; WOr No. CE -17854 °%10 o'ESSIO �v;rrrC Performed For: Date Performed: 1'� G Legal Description: iMk,� ✓�� L ! 5 Township, Range, Section, Cife Dhn NONE NOON NONE NOON EVEN NONE WAS GROUND WATER O ENCOUNTERED? s IF YES. AT WHAT DEPTH? ��( r 0 Depth to Water After A p P Monitoring? / // I E Dale 5� 1 Reading Depth Gross Time Net Time (Feet) / 10' I' t O W?— I S/q I Fl-- U, O ` 3- 3:�I L° 5- 1 6- ` 7- r 8- 9- i 10- u�O/fib 11- / L4'oZ 12- cu-�s� 13- 14- 15- 16- 17- 18- 19 - NONE NOON NONE NOON EVEN NONE WAS GROUND WATER O ENCOUNTERED? s IF YES. AT WHAT DEPTH? ��( r 0 Depth to Water After A p P Monitoring? / // I E Dale 5� 1 Reading Dale Gross Time Net Time Depth to Water Net Drop I S/q � 1.31 O r v/l;' z 3:�I L° u 0 u�O/fib 6 L4'oZ Lo cu-�s� PERCOLATION RATE j • L4 (mnulesrinch) PERC HOLE DIAMETER _ TEST RUN BETWEEN �FT ANDFT COMMENTS ��� M — 1A/0 PERFORMED BY: , �7�����`i I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL UiDELINES IN EFFECT ON THIS DATE. DATE: 7 SII Residence: MAJESTIC VALLEY ESTATES BLOCK 1 LOT 5 number of bedrooms 3 br Water usage/bedroom 150 gpd/br Water Usage 450 gpd system type: Conventional type: Shallow Trench Application Rate 1.2 gpd/sqft required absorption area 375 sqft trench width (W) 5 ft gravel depth (D) 4 ft Shallow trench factor 0.5 (W+2)/(W+1 Min Required Length: 38 ft Testhole Depth 16 ft Groundwater Depth None ft Monitored to 14' Design Excavation Depth 9 ft Calc By: CGB Date: 5/13/2023 C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations RESIDENCE/LOT INFO DRAINFIELD REFER TO PLANS FOR DETAILS OF CONSTRUCTION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231108, Curtis Townsend, 05/30/23 GREI -R ANCHORAGE AREA BOR )GH �`Qj jii,{If Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM y� NAME ° �/� MAILING ADDRESS�4/ ��Y �� � PHONE Z Z LOCATION ���� e75'y LEGAL DESCRIPTION b I �� ekoe- Il �pa�S�e SEPTIC TANK: DISTANCE (3ivuivibth ur FROM WELL MANUFACTURER MATERIAL �COMPARTMENTS f _ 5O INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY IZ GALLONS. TILE DRAIN FIELD: �a,�j TOTAL LENGTH DISTANCE FROM WELL FOUNDATION_l _NEAREST LOT LINE OF LINES _ NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA V1— SQ. FT. LENGTH OF EACH LINE l 0-;� 3 ` -- / DEPTH OF FILTER oe DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE 7—IN. ABOVE TILE IN. WELL: /V0 'T- .:Av8 1 A-1/cJ) OLT (/A -c' Ot= TYPE_.__ --CONSTRUCTION BUILDING NEAREST FOUNDATION_ LOT LINE , CESSPOOL OTHER SOURCES_ DEPTH NEAREST SEPTIC SEEPAGE SEWER LINE , TANK. , SYSTEM_ APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY SEWER LINE DEPTH: PIPE MATERIAL: CA -ST- P 1 Pte' LOT SLOPE: q REMARKS: Form EQ -032 DIAGRAM OF SYSTEM DISTANCE FROM: G.A.A. B. varti xrb Dritting i[og by A & L DRILLING,- COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 s TEI-EGHONE 694-2588 ,f OWNER OF LAND "/ f -S r' �`�iJ (_ �',�. ;.) 1 . DEPTH OF WELL �; r � •-. ADDRESS STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION ��' ._�!-' �"��� .fir .Ifs ��- DRAW DOWN FT. DATE - Started f `y �'_ Ended GALS. PER HR PERMIT NUMBER !�` �� a' KIND OF CASING KIND OF FORMATION: From—( ) —Ft. to � � Ft. �'� �f r From Ft. to— Ft. From From Ft. to Ft. From1 �� Ft. to r' - Ft _ ` ,tf,�i / „3- 1, hl�?a' From _Ft. to Ft. Ft. From . ' =` Ft. to _0 Ft.77T From Ft. to Ft. From From ' Ft. to r Ft.: %ru_/J iL-__',?From Ft. to _Ft. to— Ft, From Ft. to Ft. From—Ft. to Ft. From From Ft. to Ft. _Ft. Ft. to_ Ft. to_ From Ft. to Ft. From Ft. to Ft. Ft. Ft. Ft. From Ft. to Ft. Froin _Ft. -Ft. to From Ft. to Ft. From Ft. to Ft. Froin --Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: 1. i ;") From Ft. to— _Ft. From Ft. to Ft. From to Ft. From From _Ft. Ft. to_ Ft. to_ Ft. Ft. From Froin—Ft. Ft. to to _Ft. Ft. From From From Ft. to— Ft. to Ft. to Ft. Ft. Ft. From to_ Ft. Froin _Ft. -Ft. to Ft. From Ft. to Ft_ DRILLER'S NAME __ E D|]�HRTMENl0F ||EHLTH �ND ENVIRONMENTHLPRUTECTIQI'A 251Ell/DOR RD, H�CHORHGE, HK 99507 276-2221 PERMIT N0, (76046) R.6882�90 [(�HTIUN MI 675 ERRD LEGHL L5 8i MHJESTIC 11 1. EST SD LOT SIZE 55859 SQF[ YYPE UF SOlL HBSORPTION SYSTEMTRENCH NUMBER OF 150 THE REQUIRED SIZE OFTHE SOIL RBSORPTIUN SYSTEM ISDEPTH"! 12 LENGTH� T H OF GRHVEL 8ETWEEN THE OUTFHLL PIPE HND THE EMCHVHTION BOlTOM I� 7 FT THERE IS NO SB� WIDTH FOR TRENCHES� FOR DRHINFI�LDS�l�H� WlDT� IS ]FT TNE DEPTH OF TRENCH OR PIT IS THE DISTHNCE 8ETWE.EN THE GROUND SURFHCE HN I THE BUTTUM OF THE EXCHVHlION THG LENGTH DIMENSIUN IS THF L�NGTH UF EHCH SIDE FOR A S�EPHG� PIT �R THE LENGTH OF, THE TRENCH/ OR DRHINFIELD. THE R£QUlRr:D SEPTIC THNK SIZ£ IS i000 GHLLONS 8HCKFILLING OF HNY SYSTEM WITHUUT FIIAF-IL I1,41'r;P2C1I01.1 8Y THIS &EPHRTMENT WILL 8E SU8JECT TO PR0SECUTION MlNIMUM D]STHNCE FRUM WELL TO HNY �EPTIC THNK/PHCKHGE PLONT OR SOIL ONPTION SYSTEM IS 100 FTFUR H PRIVHTEWELL HND 200 FT FOR R PUHLIC WELL WB.L LOGS MUST 8E R2TURNED TU THL' I EPHRTMENl 1-11.TH1N ]@ WELL CUMPLETIUN. SPEClFICHTlUNS RN0 CONSTRUCTION DIAGRHMS HRE HVHILH17.LE TU INSURE PROPER lNSTHLLHTION l CERTIFY THHT I HM FHMlLIHR WITH THE REX UIREMENTS FUR HND WELLS HS SGTFORTH 6Y THE MUNICIPHLITY UF HNCN]�HGE 0QD WILL INST��L IN HC01 L,-' WITH THE C0DE SIGNED� � . . . . . . . . . . L -D �] « O £t E GEOTECHNICAL Et DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Soils Et Foundations SOIL LOG Earl Ellis 688-2280 Land Development Performed for: Name: kV41)E ZrVly4z"e5 . Tel. No. Mailing Address: Legal Description:-���- Depth (feet) 1 /0/,-- 2 0//,-- 2 3 4 5 6 7 6 9 10 11 Soil Characteristics 12. 41 be) 7-7v ei © F Ground Water Encountered: Yes— No ✓ � r �S Z,2. A���"�1 4P K'• gGoo q. ° q• e9g4,�[id • Jf/ �4 0. P. 9Qf4•il•. ..e• e• y� .��1a �Earl P. �Ilis �� NO. 1745-I: d :ate If yes, what depth4e��a••q.,,,q,..• 0s_po�FsstoNe Proposed Installation: Seepage Pit Drain Field, Comments: Performed by: Da >,/VZJi MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251064 Parcel ID 050 -731-16 Expiration Date: 6/7/2025 Legal description MAJESTIC VALLEY ESTATES BLK 1 LT 5 Site address 25765 EAGLE RIVER RD Current property owner(s) STAMATES LUCAS & X The On-site system(s) is/are approved for 3 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 3/4/2025 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 Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050 731 16 Complete legal description MAJESTIC VALLEY ESTATES BLOCK 1 LOT 5 Location (site address) 25765 EAGLE RIVER ROAD Current property owner(s) STAMATES 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 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 <2 - 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 $ X-6 Date of Payment COSA # 0 ( /.``Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping 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) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. 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) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 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 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 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 Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 6/14/23 2/22/25 MUNICIPALITY OF ANCHORAGE c �a(i •� 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. 050-731-16-000 Expiration Date: 9/20/2023 Legal description MAJESTIC VALLEY ESTATES BLK 1 LT 5 Site address 25765 EAGLE RIVER RD Eagle River AK 99577 Current property owner(s) DEVINE WILLIAM Z X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 6/20/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 Nquma L �� u V or - Development Services Department On -Site Water & Wastewater Section ti -CD) n2HCH0RA\GE R, V 5 Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050 731 16 , Complete legal description MAJESTIC VALLEY BLOCK 1 LOT 5 Location (site address) 25765 EAGLE RIVER ROAD Current property owner(s) DEVINE 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: 0 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 X Plastic ❑ Concrete ❑ Fiberglass Age 0 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: n 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 $ �-f U� Date of Payment I I Z 3 l COSA # �JG 2� 120 Waiver Fee $ Date of Payment Waiver # COSA Applicalionjune 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping 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) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. 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) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 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 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 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 Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 6/14/23 Municipality of Anc On -Site Water & Wastewater (907) 343-7904 9 30L 2 9 zm6 [� 6 8 L sy CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-731-16 Expiration Date: 1. GENERAL INFORMATION Complete legal description MAJESTIC VALLEY ESTATES SID; BLOCK 1, LOT 5 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 25765 EAGLE RIVER ROAD, EAGLE RIVER, AK 99577 JUDI SHAPIRO Day phone 317-6046 P.O. BOX 771254, EAGLE RIVER, AK 99577 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: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ COSA Fee $b y� d Waiver Fee $ Date of Payment �S' �� Date of Payment Receipt Number COSA # n -C /'4 Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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 JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG provided an engineering evatualion of the well aralm sepik system in accordance with the guidelines and regulations established by the Municipality of Anchorage and indusbypractices. The reported results describe the condition of the sysiemis on the dales of the evaluation. Separation distances were measured to readilyidenffiable features. Hidden defects arenctoachments maye>asf that were not identgied during the evaluafion.The operational lite of all wells andsepdc systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the yeaf, qualfyofconstruction (materials and workmanship), and the wafer usage of the family utilizing the sysleMs. These conditions can vary, and are outside the controlof GEG. Safsfaclorytest results do not guarantee future peal mane of the systeMs,; therefore, GEG makes no warranty (express or implied) regarding ills Mae pedomiance of the well orsepfc system. GEG makes no representation whefheran alternative allorsepiic system can be installed on the pmpertyin the event efherof the current systems fail. The content of this report is for the sole benefit of the persoruparty who retained GEG. Rerama upon the inlonnation provided in this report by any otherperson orparty, including but act limited to subsequentproperty purchasers, is not authorized.. In short GEG disavows any legal duty to anyone ofherthan thepersoepany who paid torthis mport. 6. DSD SIGNATURE System #1 Approved for _ bedrooms. System #2 Approved for bedrooms. Phone 337-6179 Date 71 /6 LICENSEfR0FESS\ j� #AECCaaa rI k YA�`�, >f Disapproved. ICY 0Fq Conditional approval for bedrooms, with the following stipulations ::=-\eF1CyO GN -SITE _ tA/A-rGo �nln Citi; Original Certificate Date: 2— l —1 LL 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 engineerregistered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist_ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other raa� ini2m2i 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: MAJESTIC VALLEY ESTATES S/D; BLOCK 1, LOT 5 Parcel ID: 050-731-16 A. WELL DATA W VSjz- {vR+wv.uG lir writ, Lbcr4 Well type PRIVATE If A, B, or C provide PWSID# NIA Well Log (Y/N) YES Date completed 511976 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 93 ft. Cased to* 40+ ft. Casing height (above ground) 18+ in. Date of test Static water level Well production FROM WELL LOG 5/6/1976 WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Arsenic: ND ug./L. g.p.m. Nitrate 1.63 mg./L. Date of sample: 7/131201.6 AT INSPECTION 7/5/2016 61 ft. 1.6 g.p.m. Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA 40 YEAR OLD STEEL TANK IS APPROACHING THE END OF ITS USEFUL LIFE. Tank Type/Material STEEL Date installed 5/3/1976 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) NIA Date of pumping 7/2511016 Pumper SANITARY PUMPERS C. ABSORPTION FIELD DATA rBELOW EXISTING GRADE Date installed 5/3/1976 Soil rating (g.p.dditbi- bdrm 150 System type DEEP TRENCH` Length 32 _ ft. VWdth 3 ft.: Gravel below pipe **7 ft. Total depth *10.6 _ft. Eff. absorption area 446 fe Monitoring tube YES Depression over field NO Date of adequacy test 7/5/2016 Results (Pass/Fall) PASS For 3 bedrooms Fluid dep4h m 6158orption field before test 15 in. Water added 510 gal. New depth 51.5 in. Elapsed Time: `` 10 min. Final fluid depth 15 in. Absorption rate > . 450+ g.p.d. Any rejuvenatjon treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **SUMP DOES NOT EXTEND TO BOTTOM OF TRENCH. ONLY MEASURING 6 FEET OF EFFECTIVE. STANDPIPE FOR SUMP HAS - 5 FOOTSECTION OF PERFORATED F810 WITH HOLES TAPED OVER JUST BELOW AND ABOVE GROUND SURFACE. PIPE APPEARS TO BE LIKE THIS FOR A LONG TIME AND THE SUMP HAS REMAINED FUNCTIONAL D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump otr E. SEPARATION DISTANCES level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAifi station on lot 1ar+ On adjacent lols 100'+ Absorption field on lot 101Y+ W+ adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100'+ Sewer /septic service line 25'+ Holding tank 75'+' Animal containment areas 504 Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 'S'+ Property line 5'+ Absorption field 51+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line : 104 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 "EDGE OF TANK IS APPROX.1 FOOT AWAY FROM NEW DECK PILE. SEE ATTACHED PILE LOG FOR PILE DEPTHS. >25% SLOPE EXISTS -10 FEET SOUTH OF SUMP. NO INDICATION OF DAYLIGHTING EFFLUENT ON SLOPE. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections s and review of Munidpal records that the above systems are in conformance with MOA COSA guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date 717,q.114 (Rev. 10/12/12) * 41a 4-- S 9* Municipality of Anchorage ' Development Services Department / Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 r d www.muni.org/onsfto f ( Ff H (907) 343-7904 41F jr v� CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 SD -7 3 / - I G COSA# n za_10/ 1. GENERAL INFORMATION Expiration Date: 7— / % —.Ly Complete legal description MAJESTIC VALLEY SUBDMSION, LOT 5, BLOCK 1. Location (site address) _25765 EAGLE RNER ROAD * EAGLE RIVE, AK 99577 Current Property owner(s) MARK & SAMANTHA SPINDLER Day phone 694-6275 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested, COSA will be held by DSO for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal axed 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 Finn GARNESS ENGINEERING GROUP, Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lest, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benerrt of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for ,�_ bedrooms. Disapproved. Phone 337-6179 Date U 1(,Oq >t -: Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other �Qr.•..... .'FC1 ON-SITE RAND WASTEWATER 1% PROGRAM By: t"/ _ /�//)� Original Certificate Date:^ (Rev 1185) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Boz 196650 Anchorage, AK 99519-6650 www.muni.org/onsits CERTIFICATE OF OWS2 Y79S4TEMS APPROVAL CHECKLIST Legal Description: MAJESTIC VALLEY SUBDIVISION, LOT 5. BLOCK 1, Parcel ID: 05'0' 7 31- / to A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 5/1976 Sanitary seal (WN)�fs �JN ' Wires properly protected (Y/N) Total depth 93 ft. Cased to 40+ ft, FROM WELL LOG Date of test 5/6/1976 Static water level 50 ft. Casing height (above ground) 12 in. AT INSPECTION 4/6/2007 60 ft, Well production 15 9.p -m. 1.8 g.p.m. WATER SAMPLE RESULTS: ,y( Coliform __0__ colonies/1 00 ml. Nitrate I • o tP mg./L. Other bacteria `Loolonies/100 ml. Arsenic: N 0 ug./L. Date of sample: 4/6/2007 Collected by: GEG, Ltd. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Data installed 5/3/1976 Tank size 1250 gal. Number of Compartments 3 Cteanouts (Y/N) YES Foundation cleanout (Y/N) YE5 Depression over tank (YM) NO High water alarm (YM) N/A Q22� Date of pumping 4 a 007 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 5/3/1976 Soil rating (g.p.d./feo Ibd 150 System typa DEEP TRENCH Length 32 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 10.6 ft. Eff. absorption area 446 ft' Monitoring tube YES Depression over field NO Date of adequacy test 4/6/2007 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DR' in. Water added 450 gal. New depth 17 in. Elapsed Time: 135 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed "Pump on" level at —in. E. SEPARATION DISTANCES Size in gallons "Pump off Manhole/Access water alarm level at Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ 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 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date LF�16�6 COSA Fee Date of Payment Receipt Number (Rw. 11/05) Waiver Fee $ Date of Payment Receipt Number G O LOUINDq NOTE: SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. 10' x 25' ANCHOR ESMT. onocwco er: EXCLUSION NOTES: It Is the owners' responsibility to determine B R.E N T WESTERN the esietence of any easements, covenants, or restrictions whit do not appear on the recorded subdivision plot. NOTE: with KND ENGINEERING, INC. Under no circumstances should any data hereon be used for WITZ IF III ME 164C- - -Well, pt I _0 M. or for establishing property lines. 440 WEST BENSON BLVD. # 103 ANCHORAGE, ALASKA 99503 WORK ORDER NUMBER: SCALE: FEB 12.. 2004 1'-50' 2004—L -36A •TAE Dw DMD —e� o'o A SW363 iB W/CAPD 5/8' RB O ALMON. 0 MONUMENT A TACK p _K_ x— DUKnT ULNIIHCAIIUN: LANTLCH has conducted a uvt101ANF - physical survey of this property as shown on this WOOD DECKS– drowing and that the Improvements situated there CONCRETE– F"— ,� :h on ore within the property lines and no encroach– ASPHALT– SPHALT– mans exlat oUer than noted. CRAVEL– AS—BUILT O F; LEGAL DESCRIPTION: SEPTIC STANDPIPES– WATER WEtL- (,U S—ENGINEERS -6626 �7) 7) 5662-5291 LOT 5, BLOCK 1, MAJESTIC VALLEY ESTATES SUBD. ,T eweq: "-106 ACL REF: 98L458 Municipality of Anchorage * Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 11-- rIwAl CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-7-31-16 HAA # (7) Expiration Date: Jr- / -7 - O 4- 1.` GENERAL INFORMATION Complete legal description Males tic Valley Fstatpsl Block 1. Int S Location (site address or directions)_ 25765 Fngle River Road,Fag RIye _*AK 9577 Current -Property owners) Mich _II _ Young Day phone 269-0710 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality" of Anchorage Development Services Department .Building Safety Division o On -Site Water & Wastewater Program :. CT. z . 4700 South Bragaw St., 'P.O. Box !196650 ; Anchorage, AK 99519-6650 www.ci.anchorage.ak.us f .'(907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST i Legal, ;Description':___ Majestic Valley Est 61';'r LS i Parcel ID: 050-731-16 A.' WELL!DATAIt s. Well'type_ If A, B, or C provide PWSID, # Well Log (Y/N) Y t Date completed 5/1976 Sanitary seal (Y/N)-,L Wires properly protected '(Y/N) Y Total depth 93 ft. i Cased to 40+ ft i Casing height (above ground) 2 FROM WE"LLLOG AT INSPECTION " •Date "of test i5/1 976' �1 _2/3/2004 Static water level " 50 69 ft. Well pr.o�duction f 1 .1 m, I 1 5 9 P t 2.56 g.p-m. 1:� j WATER SAMPLE RESULTS:' + �1 Coliform _colonies/100 ml.Nitrate,F 0.884 mg./I:Other bacteria _0 colonies/100 ml. a Arsenic:!!�� mgA. :Date of sample 2%3/04 i 9 � Collected by: KND Engineering B., SEPTIC/HOLDING TANK DATAfl .Tank Type/Material SEPTIC/STEEL:Date';installed 5/'1 97'6 Tank size 1250 gal. I, 'lig-. Ifp rF Numbelr:of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N)fY—Depression'over tank (Y/N)f�_High water alarm (Y/N) N Date of pumping_'2/3/04 }j1 Pumper SANITARY p C: ABSORPTION FIELD DATA I' 11 ¢ Date installed/1976 Soil ;'rating' i (g.p.d./ftz, or ft /bdrm) 1.150 System type _DEEP TRENCH Length 1'32. ft. Width 3 €+ `' 1 _' ft. Gravel below pipe 7 Total depth 12 ft. Eff. absorption' area'448'ft 11' for tube Y Depression over field N i f � j :I', Date of adequacy test 2/3/04 ' i ` Results (Pass/Fail), i PASS For bedrooms i ;3 ;.. Fluid depth' yin absorption field before test 0 (DRYI In Water 'added 460 gal. ; ` New depth 27 in. Elapsed Time: min. Final ;flufd depth 6 D in. r Absorption rate >= 450+ g.p.d. An re'uvenation treatment ':" = i Any (past 12 mo.) I',(Y%Ni &type) If,,yes, give date MUNICIPALITY OFANCFIORAGE n ° x DEPARTMENT OF HEALTH I & HUMAN SERVICES 4'` Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # HAA #-,1���i�,i 1 1 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner ' nYi.?�� '� ��//5� Day phonew�_ Mailing addressa, CI Lending agency Dav phone Mailing address Agent fir DOC,c UI _� Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYRE 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. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA N21 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 KND Engineering Phone ar+nigan Blvd. Address _ Eagle River AK,99577•8736 Engineer' 6. DHHS SIGNATURE 1Z Approved for Disapproved. _fE_ bedrooms. Conditional approval for Additional Comments Alk% R►Q��° OF •A �•�1Vr� � � .•• iso �� % 4 bedrooms, with the following stipulations: Date 59 - �/_ q 9 r CAtITInN" 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 orderto 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 SERVICESC t„ L- i V E L) Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907h-6Z4b98 Health Authority Approval Checklist MUNICIPAL11Y of ANCHORAGE I ,�, h(� \PVIRONMENTAL SERVICES DIVISIO" Legal Description: �Pi vt Aeu 6&/ Lo/5 �Parcel I.D.:_ A. WELL DATA Well type Z If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Date completed 5 Total depth 9.�_ Cased to yb �� Casing height (above ground) Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG -- 5 5 g. p. m. Wires properly protected (Y/N) AT INSPECTION 7 9— p.m- WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: %%% �I23 i6 Collected by: 1,2eeeo B. SEPTIC/HOLDING TANK DATA Date installed — Tank size Number of Compartments Cleanouts (Y/N)—Y_ Foundation cleanout (Y/N) _ Depression (Y/N) High water alarm (Y/N) Date of Pumping 7k3lfg Pumper �KS C. ABSORPTION FIELD DATA Date installed /� _ Soil rating (ggix * or! 2/bdrm 1-50 System type / l 1' i9G Length ✓�2 Width _ 3 Gravel thickness below pipe 7— Total depth /z Effective absorption area- y Monitoring Tube present (Y/N)—�— Depression over field (Y/N) Date of adequacy test _ 1 Z 3Ae Results (Pass/Fail) P S5 For _ 31 bedrooms Fluid depth in absorption field before test (in.); _� Immediately affer560 gal. water added (in.): _/_ Fluid depth (ins) Minutes later: Absorption rate = ZIIJD -?L g.p.d. Peroxide treatment (past 12 months) (Y/N) ^_+If yes, give date 72-026 (Rev. 3/96)" D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Pump off" level at* Septic/holding tank on lot /DD Y On adjacent lots ZDO �-/-- / Absorption field on lot 1614 f /d6 4 On adjacent lots / Public sewer main A114 Public sewer manhole/cleanout N A Sewer /septic service line I�J f Lift station Wp SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line A0 f Absorption field /U Water main/service line z ✓ 4 -surface water/drainage M4 Wells on adjacent lots /Qy f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 7'�Building foundation /LO � Water main/service line ZS k i Surface water Driveway, parking/vehicle storage area Curtain drain Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that t have determined thru field inspections and review of Municipal records.�t� �g4Ks,�s14�s are in conformance with MOA HAA guidelines in effect on this date. '` ;"•"°0•• °••'• ,s 8+ Signature // /0_••. •i_ •••• Q.•.••a"••60 Engineer's Name �i w2eff% �� �r� ?i t •' "'•" '• ':"' Kennet M Du s CE •• ���a Date 4 �'•. .•' ��!'� HAA Fee $ SGb.-cf-) Waiver Fee $ Date of Payment S'(o Date of Payment Receipt Number CD t i 3<�, 0, � Receipt Number 72-026 (Rev. 3/96)* \\ MUNICIPALITY OF ANCHORAGE EAGLE RIVER AREA DEPARTM. OF HEALTH AND ENVIRONMEi' L PROTECTION 825 L Street, Anchoraap.. Alaska 99501 264-4720 Date Received: _February 22, 1978__ #1: Timea 1� r ��, #2: Time #3: Time Date �- �]��,�nS Date Date InspInsp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: State of Alaska - Veteran's Affairs Mailing Address: 907 West Northern Lights Blvd. Phone: 274-7555 2. Property Owner: Robert/Phyllis Collier _ Phone: 694-3285 Mailing Address: Star Route 1 Box 1440 99577 3. Legal Description: Lot 5 Block 1 Majestic Valley Estates Subdivision _ 4: Single Family Residence: (x) Multiple Family Residence: ( ) 5. Well System Permit # Construction Number of Bedrooms: Three Number of Bedrooms: individual Well (x) Community/Public System ( ) Depth of Well 192' Well Log on File (x) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Permit # Installed 1976 Public Utility ( ) Installer Septic Tank Size 1a_<; ? Manufacturer Absorption Area L{4�? Soils Rate 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area Absorption Area l '-GIX_sf 0..,. . , I --vYc c1 .Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 5 Block 1 Majestic Valley Estates Subdivision Comments: Affadavit Attached: (A j Letter Attached: ( ) Approved: Disapproved: Department Worksheet: Date: Date: r 11 Aj 11 I IV lot 7,71r. ; ,t 4 �Y" AS-DUILT _ 6 z I hereby certify that I have surveyed the Momdng described property: Anchorage Recording Precinct, Ahwka, and that the improvements siAmted thereon are within the Y)k'01)c,'tY lines and do not overlap or encroach on the property lying adjacent (hereto, that 110 improvements on.prop- orty lying adjacent thereto eirer(Tach oil the premuses in question and that there are no rcia.-hvays, trawsrnsswn fines or other visible easements on said property except as indicated hereon. Dated nit Eagle River, Alask.� thi:: day of r-_.. --- -- -..- . . ., - - - , - I9—" - R0)3),:R'T C. JOILNSON ",-' qC,ALE: Registered Land IjUeVCyor e(). Dox 4.56, E.'agle River, Alaska Phone COMM �*4v, T{Al'AO3A4L PLLp poo... G Y n p'TLPLO IAiIUAIY A' GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received _July 13, 1976 Time of Inspection 1:30 p.m. Date of Inspection July 13, 1976 REQUEST FOR APPROVAL OF Neale INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Alaska Mutual Savings Bank o Chris Anderson Mailing Address: Phone: 2 3 Property Owner: Charles & Pogany DevelopmentPhone: 688-2390 Mailing Address: Box 323, Eagle River Legal Description: Lot 5 Block 1 Majestic Valley Subdivision 4. Location: 6.5 Miles up Eagle River Valley Road 5. Type of facility to be inspected singe Family No. of bedrooms 3 6. Well Data: Individual A. Type C. Construction B. Depth m D. Bacterial Analysis _ Satisfactory 7. Sewage Disposal System: On-site system A. Installed — 1976 B. Installer C. Septic Tank: 1. Size 1,250 gal. 2. Manufacturer Greer D. Seepage Pit: 1. Absorption Area 448 sq. E. Disposal Field: Total length of lines 8. Distances: 2. Material Steel A. Well to: Septic tank Absorption area Sewer Lines Nearest lot line — Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages I Page 2 of two pages - Re, st for Approvdl of Individual F 'er & Water Facilities Legal Description Lot 5 Block 1 Majestic Valley Comments Approved A,- Disapproved Date 7-13-76 Approval;Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM i certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date