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Home My WebLink AboutSKYLINE VIEW LT 1`Skyline View Lot 1 #051-192-06 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Upgrade Permit Number: SW990304 Legal Description: SKYLINE VIEW 056LOT 1 Design Engineer: 0000 None Required Owner Name: Charles Engel Owner Address: PO BOX 672381 Chugiak , AK 99567-2381 Date Issued: Aug 27, 1999 Expiration Date: Aug 26, 2000 Parcel ID: 051-192-06 Site Address: 019423 WILDWOOD DR Lot Size: 43560 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑✓ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. 1) The water storage system shall conform to the standards of AMC 15.55 and have a minimum capacity of 1000 gallons. 2) The existing well cannot be used as the water source for this residence. The water source is to be soley the water storage system to receive a Certificate of Health Authorty Approval. Received By: Issued By: Date: 9 a �^ Date: 7 / \\ ("'� MUNICIPALITY OF ANCHORAGE DEPARIMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 2644720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONEC"AR PSNEW Li S N - L- g- / ❑UPGRADE MAILING ADDRESS SO 1 0 7 C H T7 LEGAL DESCRIPTION LOCATION SKI rN5 VsEw HuGrAK NO. OF BEDROOMS 44 OY Well h Absorpton area DISTANCE TO: Ib } f Dwelling /+ 3 PERMIT NO. Sao eq D, o. Q Z- Manufacturer /'� � Material No. of compartments H F `} �� 2 ^ oC Liq, capaZcity lOn gallons IF HOMEMADE: Inside length � Width � Liquid depth 6 DISTANCE TO: Well Dwelling PERMIT NO. _? H Manufacturer isMaterial - Liquid capacity in gallons D J= W 11+ DISTANCE TO: 1;iRIH Foundation 5/f Nearest lo[ line /t .7 PERMIT NO. ^ pl Hw W No. of lines ( /� Total length o tnej Trench width oS Distance between lines ¢ t * Inches A C H Top of rile to knish grade / +, Material beneath the Total effective abs rption -a "o Inches W Length Width Depth PERMIT NO. U d f Wd Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J CI Depth Driller Distance to lot linePERMIT NO. J W N DISTANCE TO: Building foundation Sewer line Septic tank Absorption steals) OTHER PIPE MATERIAL ASlizori 6'VG SOIL TEST RATING !Q� 2 INSTALLER S �•xc � v. REMARKS �y -�OFAL Q(E I WT;- .. ,. v W •s^,, Ro6er1 A. Sh• r 4OFES;10�^+ �.4 Al r . A HO D' DATE -LEGAL - E':JGINEE$Ii.G uEE1 10SIX n. nm 2 13 (Rev. 3178) MUt+I I C IFiL I TY OF FiI,ICI-�c�RF�GE r DEPARTMENT HEALTH AND ENVIRONMENTAL "OTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 L4E:L.L nr4E> (D" -S I TE SEWER PERM I T PERMIT NO. (.820892 ) APPLICANT CHARLES ENGSR1 BOX 1157 CHUGIAK 99567 683-9153 LOCATION s16 rvAAA I LEGAL L1 B2 SKYLINE VIEW LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS 3 SOIL RATING CSO FT/BR)= 1Q0 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E>EPTH= 3 2 L.EFJGTH= 1.3 GRF3YEL I>EF:''TH= S THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET 14IDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). REGOU I REO SEPTI C -rnNK S I ZE= 1000 GF L -L-01 FS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TWQ <2> I "SPECT I ODFVS nRE REQIJ I REI7 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXPIRES E>ECEMF3ER 31. 1 SS2 I CERTIFY THAT 1: I AM FAMILIAR. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: ISSUED BY CHARLES V4. 0 O & E EN( ,NEERING & DEVELG.MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOIL LOG Performed for. Name: ��• L�AjA..E' —Tel. Nol Mailing Address: '!:—, JLO 1-t- i -1/1 7 . e4_,gyr.1.� Legal Description: 1, ---.) K`> C_I *J 1/fEul S Depth (fast) Soil Characteristics 0 2 3 ____�,4 5- 6- 7— t 6 .� s Earl Ellis 688-2280 10 _ PLOT PLAN 11 12 13 — PERC. TEST 14_ 15- 16i /� .- OF AL �{�lOYTO/Y) os6 1T �` .......... S l Ground Water Encountered: Yes N0_2L/_ yes, what depth �" ••':�9�0 Proposed Installation: Seepage Pit_ Drain Field Nt . 42J6-- E f "•F 0 3 10 _ PLOT PLAN 11 12 13 — PERC. TEST 14_ 15- 16i /� .- OF AL �{�lOYTO/Y) os6 1T �` .......... S l Ground Water Encountered: Yes N0_2L/_ yes, what depth �" ••':�9�0 Proposed Installation: Seepage Pit_ Drain Field Nt . 42J6-- E f "•F LOCATION Of WELL (PI•460 06.01010 either Is. le 61 la.l WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES. Division of Geological a Geophysical Surveys Or11Lna Per.lt No. ' la. Borough Anch 163aedlvislaa o- I Bloat la 1/e gin. section No. To.nehipN ^"ange^e•EQ Meridian .OL/Z�blo !<•IiNP f EefNl=etNE6bN /6 /S sQ ! w = SM `/y92Gss/ le. D13TANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: Mr: Charles Engel•... atro•1 SR # 1 jqx4j dX:/t9 Address end Arae of Well Location 2.. WELL i LOGFoot eel:.. Bar foea• WELL DEPTH: ((tool) S. DATE OF,COMPLETION • McNrlal Type Top Bottom __7b—ff. .,�_ �, �O •._. p,,: -+kH•� Gravel - 0 "15 B. y Q OdeCoale tool Ralar � -00,l.-. Qg.r S3u11 boulders 15 20 Q Ar '" :L ❑n.d'•❑sanll T ❑Ota.r, Grb4vel 20 30 T.USEXEI DO.aella; Q Public supply • Q Industry . Sand 0 35 Q Irri gatlen. - ..Q Recharge % Q Colnmerl0el . Gravel 35 50 Q Test WH . .Q Other: Sand wet 50 60 s. CASINO: Q Threaded r,w•Ieed ma..�_In. fa�_'u. �`.0`,h w.lghl l7 tes.�n. Gravel with water 60 76 . —Ft. Depth , ; 311ehup ft.. B. FINISH OF WELL:. ''! ..••.. :..';u ) . .. . ,.:6u. . /� Type: "Yen Hole. almost*,, Slot/Mesh Stn• Length• r $a but. sea It. ane It. Backbiting Gravel peck ' _ 10. STATIC WATER LEVEL: -" ' ft. 0 Ali*, 0410 F Eguipiat.a0ed: - ' - - 7 S —AA ' G 11. PUMPING LEVEL Delo. land Surface and YIELD n.' ':Ft0. ":.:: ors. pumping ... g.o. m. It. 'Offer krs. pass Ing G w ' O cj) _ 12.GROUTING Well Created: Q ri• ONO : Material: 0 N041 C0.ee1 0 Gills J ' .. .. " _ p < CV 13. Pump: 11t arallaabl . Hp Length of Drop Plpe 11. capacity g. p... c ; ' n. :•, - � � Q Sua.. -.`Q dei 7.0 Cenlrillcal +, ••Q OIMr • % .. i.: Ie. REMARKS;".• - • ,r 1 a 7'1: '• K., h .rq �:?.� Bail tested:at 10 GPM 'IB. WATER WELL CONTRACTORS CERTIFICATION: „ . .. ...'IS. ,.� WaIvTemperalu is❑F'f} Y:�t❑C,,:'�'•'t - Tal all e a Imhakuon'pe: tole (•pori �i s brf°tY�b9 Is Ira: to fn• heat at ` f kno.pOg: q u p:� n.t�~ f • . `r AA 5385 1 �'� i':�':. y its livered Bu.lne•s Nam• .z. ,_• P.g: Boz 504 Eagle River, I. ;C. Qonlracl (ffsnse Numgey Ak; i Aildross' r� - „ j ; .' Dlgn•d. t/� /`.'01' y0 �'r 1r!q�.r �:1 aleJuaeil j . 9 :: t . A61Mrind Re►reuMatlr a��[ 1` •' y{� - ! j(1 �'{��$�� r Farm 02'WWR II/11) - ( •: .--��Co►YDI•Irieelun.� WHITE -Slap DGGS .PINK aDrllbr Co. e...l.. 7V ` APPLIC^NT FILLS OUT UPPER HAI"'' ONLY Time Property Own&@ lanr/rs .1 F 6 Pe -ca /v� Phone Mailing k/� ddress �F � Box I/S7 r`(!r/ Zip Code S�iJ D Buyer _Poep —A 7 Address Zip Code Date -le Lending Institution e: Phone Address f Zip Code Inspector Realty Co. d Agent Field Notes: ��l/ "-+1 "�✓-*'HCl ni Phone ��— , j16L�- d1�1/ l rL�6 DLLLv i- 12 3f Address Zip Code Legal Description �C,PE Q j` # SyJ I,/v& Street Location IlWa 1 /Op Typeof R sidence Ingle Family ❑ Multiple Family No. of Bedroom ( ) CONDIy' L APPROVAL' DATE '' - J ❑ Other Water Supply ^ r� yYrndividual is c� IYl�pf ATTACH WELL LOG. A well tog Is required for all wells drilled since June 1975. ❑ Community n U For wells drilled prior to that dale. give well depth (attach log If available). ❑ Public Utility Well To Absorption Area Sewer Disposal �dividual Year Individual Installed: /2- 14-0 0 Public Utility ❑ Holding Tank Q �. [J Q When Connected to Public Utility: I Well to Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date _Poep —A 7 Date Date -le o� Inspector Inspector Inspector Inspector Field Notes: ��l/ "-+1 "�✓-*'HCl ni ntr.1 d ,�c L4 , j16L�- d1�1/ l rL�6 DLLLv i- 12 3f ( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDIy' L APPROVAL' DATE '' - J Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received XELX 14-0 1 4Q—/ / —'r v I Well to Tank Septic Tank Size /Yid 72vn n GE $p 0 p..bw • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 5a =T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-192-06 Expiration Date: &_Z 46 1. GENERAL INFORMATION Complete legal description SKYLINE Location (site address) 19423 WILDWOOD DRIVE CHUGIAK AK 99567 Current Property owner(s) DAVID & REGINA JOHNSTON Day phone Mailing address Real Estate Agent 19423 WILDWOOD DRIVE CHUGIAK AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: -Received by: COSA to be released to the engineer, unless .-Date: COSA Fee $ � 2 C Waiver Fee $ Date of Payment Date of Payment Receipt Number U 91 l T D Receipt Number COSA# 6SC I (otogZ 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 ARCTERRA CONSULTING INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD. EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 4/1412016 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen r OI, AL® encroachments, deficiencies or discrepancies exist. v `�s Ar Ar 0*149Tlt' v 1 6. DSD SIGNATURE B_ System #1 Approved for bedrooms. xs"vETH ITS d y s� vis 2�1 / System #2 Approved for bedrooms. FE. SI0 n��1' Disapproved. Conditional approval for bedrooms, with the following stipulations: OF WATER A Kin By: -- -" �-i� �'� Original Certificate -Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10-12.dw If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: SKYLINE VIEW LOT 1 Parcel ID: 051.192.06 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # _ Date completed 6/18/1982 Sanitary seal (Y/N) Y Total depth 76 ft. Cased to 76 ft. FROM WELL LOG Date of test 6118/1982 Static water level ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 11.1 mg/L Arsenic: ND ug/L Date of sample: 2/24/2016 B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC / STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 2.5.2016 Pumper C. ABSORPTION FIELD DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 2.5.2016 65 ft. 6.6 g.p.m. Collected by: ARCTERRA Date installed 9/11/1982 Cleanouts (Y/N) High water alarm (YIN) N Date installed 9/11/1982 Soil rating (g.p.d./ft2 or fe/bdrm)100' System type DEEP TRENCH Length 34 ft. Width 2.5 ft Gravel below pipe 6 Total depth 10_75 ft. (measured 216/16) Eff. absorption area 408 fl? -Monitoring tube Y 'Depression over field N Date of adequacy test 4.12.2016 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 41 in. Elapsed Tune; 1200 min. Final fluid depth 40 in. Any rejuvenation treatment (past 12 mo) (YIN & type) _ Water added 600 gal. New depth 70 in. Absorption rate >= 600 g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons "Pump dW level at' in. Cycles tested Septic tank/lift station on lot 11001+ Absorption field on lot 1001+ Public sewer main 751+ Sewer /septic service line 251+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: ManholelAccess (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout 1004 Holding tank 1001+ Manure/animal excrete storage areas 1001+ Building foundation 51+ Property line 51+ Absorption field 5'+ Water main 101+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 104 Water Service line 101+ Surface water 1001+ Driveway, parkingivehicle storage 104 Curtain drain 504 (NONE KNOWN) Wells on adjacent lots 1001+ F. COMMENTS SYSTEM OPERATING IN THE TOP ONE-THIRD OF THE 6' EFFECTIVE DEPTH, G. ENGINEER'S CERTIFICATION I certify that l 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 KENNETFLM.RUFFUS '00,�� Date 41412016 * Qt %V COSAcanary sheel2-6-15.doo - --. KRNNN. of s`Onw I)i Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.o4onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # osc161087 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Skyline View subdivision. This inspection revealed a nitrate concentration of 11.1 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. N00'01'00"W 132.19' WILDWOOD DRIVE ANCHORAGE RECORDING DISTRICT AS BUILT OF: 0 'Ft'1D �`� n SKYLINE VIEW SUBDIVISION ACRE LOT 1 PLAT P-508 vOD LAft SURVEY CERTIFICATION: 1, John L. Schuller, have conducted a J OFyt0 physical survey ofthis property as shown on this drawing and that the .... ..., q improvements situated thereon are within the property lines and no S enchmechments exist other that noted. EXCLUSION NOTES: It is the owners msponsibility to determinethe % / / / // a an [" existence ofeasements, covenants, a restrictions which do not t . ...4.1/��...1/rVl/.r.^^^.---.---.---.eexc. ('0 appear on the recorded subdivision plat. Under an circumstance should'.r L. sC[iuLiER.' m ' any information on this drawing be used for construction offences, sirncmres,improvements, or for establishing bounder lines.1831 Talkeetna Street WORK ORDER NUMBER: wrE: SeMF: reasbnd �.�! Anchorage, Alaska 99508 MAR 25, 2016 hqN (907) 227-1455 office 1 6 — 01 9 9sAwx sr arrxro a wN aaasra:^ 601 Ace JLS NW7159 160122 1 (907) 274-4992 fax 33' SECTION LINE ESMT 44� I ACRE LOT 1 �K—LNP1N 1JNM FENCE i tR.O /t /x x g ax ml oI x/x/ o i ®� .sr i o ' e.o • Ow) i9. DECK 16.0 I OEM 67.Y i IEXISTING TUNDRA JEWEL RANCH .R HOOSE -s ACRE LOT 2 LOT 3A F 60' m r I pEtK TNIb-1 W I PA4E0 w � p oiw m A 0 rn m z m I z I I I YELL I I PtroucEn COPY S �NT` N00'01'00"W 132.19' (132.0 R)�- 0 n WILDWOOD DRIVE ANCHORAGE RECORDING DISTRICT AS BUILT OF: 0 'Ft'1D �`� n SKYLINE VIEW SUBDIVISION ACRE LOT 1 PLAT P-508 vOD LAft SURVEY CERTIFICATION: 1, John L. Schuller, have conducted a J OFyt0 physical survey ofthis property as shown on this drawing and that the .... ..., q improvements situated thereon are within the property lines and no S enchmechments exist other that noted. EXCLUSION NOTES: It is the owners msponsibility to determinethe % / / / // a an [" existence ofeasements, covenants, a restrictions which do not t . ...4.1/��...1/rVl/.r.^^^.---.---.---.eexc. ('0 appear on the recorded subdivision plat. Under an circumstance should'.r L. sC[iuLiER.' m ' any information on this drawing be used for construction offences, sirncmres,improvements, or for establishing bounder lines.1831 Talkeetna Street WORK ORDER NUMBER: wrE: SeMF: reasbnd �.�! Anchorage, Alaska 99508 MAR 25, 2016 hqN (907) 227-1455 office 1 6 — 01 9 9sAwx sr arrxro a wN aaasra:^ 601 Ace JLS NW7159 160122 1 (907) 274-4992 fax �RCTERRq - � OF \ � \ ARC 1m ERRA �� L�1'� � 1 '~ CONSULTING INC y "+.. $ f 212 E. 51" Ave, Anchorage, AK. 99503 4 TH °ws Ip e Office (907) 868-3791, Fax (907) 868-3793 TING 'P KENNETH K li / SOILS PERCOLATION TEST Performed for: David & Regina Johnston Date Performed: 4112/16 `� st°`t, op Project: SKYLINE VIEW LOT 1 TEST HOLE # TH 16-1 Depth Feet SEE ATTACHED SITE PLAN 1- Org/OL FOR HOLE LOCATION SP/gp-gm-sm mod dense, trace of silt, w/ cobbles to 1' B.O.H. 16 - LOCATION NOTED ON 17- ATTACHED AS -BUILT 18 - HOLE PRE-SOAKED 19- PRIOR TO TEST 20 - Was Ground water encountered? NO What depth? NA Depth to water after monitoring? NO Date? 4/15/16 Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/12/16 1:00 6" 2 1:10 10 min 5/16" 5 11/16" 3 * 1:11 6" 4 1:21 1 10 min 4/16" 1 5 12/16" 5 * 1:22 6" - 6 1:32 10 min 4/16" 5 12/16" 7 * 1:33 6" 8 1:43 10 min 5/16" 5 11/16" 9 * 1:44 6" - 10 1 1:54 10 min 6/16" 510/161, 11 * 1:55 6" - 12 2:05 10 min 6/16" 5 10/16" * Water Added Percolation Rate 1_7 (min/in) Pere Hole Diameter 6" Test Run Between 4 feet and 5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. • '� Municipality of Anchorage i On -Site Water and Wastewater Program UBMI (907) 343-7904 3 MAR 2 ' s . , E r CERTIFICATE OF ON-SITE SYSTEMS APPRO9AWtChen Stuller Parcel I.D. 051-192-06 1. GENERAL INFORMATION Complete legal description SKYLINE VIEW LOT 1 Expiration Date: (2 19 rt b Location (site address) 19423 WILDWOOD DRIVE CHUGIAK AK 99567 Current Property owner(s) DAVID & REGINA JOHNSTON Day phone Mailing address Real Estate Agent _19423 WILDWOOD DRIVE CHUGIAK AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _ Well Public Water System Waiver/Variance request for: Received by: 4=z COSA to be released to the engineer, COSA Fee Date of Payment 31211 jt Receipt Number aJggJ� COSA# 3 Day phone TYPE OF WASTEWATER DISPOSAL: ® Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Date: a79 requested by the engineer. Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name _KENNETH M. DUFFUS Date 2/29/16 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. OF � L \ X �4g— `; r !a Ttt moi, 6. DSD SIGNATURE -T ?� 'H Af. "US System #1 Approved for bedrooms. , � System #2 Approved for bedrooms. .. Disapproved. Conditional approval for bedrooms, with the following stipulations: r�TSERVIG�� By: W"\\ (� Original Certificate Date: a P 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. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory _ Well Flow Advisory Other COSA blue sheat -10-1 0-12.dm If more than 1 septic system Is on the lot: COSA Checklist # of _ Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: SKYLINE VIEW LOT 1 Parcel ID- 051.192.06 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # _ Date completed 6118/1982 Sanitary seal (Y/N) Y Total depth 76 ft. Cased to 76 ft. FROM WELL LOG Date of test 611811982 Static water level ft. Well production 10 9.p -m. WATER SAMPLE RESULTS: Coliform _ w colonies/100 mL Nitrate Il. 4 mg/L Arsenic: nro ug/L Date of sample: 212412016 B. SEPTICIHOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (YIN) N Date of pumping 2.5.2016 Pumper JRs Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 2.5.2016 ft. 9 -13 -m - Collected by: ARCTERRA Date installed 911111982 Cleanouts (Y/N) Y High water alar (Y/N) N C. ABSORPTION FIELD DATA Date installed 911111982 Soil rating (g.p.d./ft2 or ft2/bdrm) 100 System type DEEP TRENCH Length 34 ft. Width 2.5 ft. Gravel below pipe 6 ft. Total depth 10.75 ft. (Measured 2!5!16) Eff. absorption area 408 ft2 Monitoring tube Y Depression over field N Date of adequacy test 25.2016 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test 48 in. Water added 500 gal. New depth 69 in. Elapsed Time: 1025 min. Final fluid depth 48 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at —in. Datum Size in gallons "Pump off' level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1004 Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 25'+ Manhole/Access (Y/N) High water alarm level Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 1004 Public sewer manhole/cleanout 1004 Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5+ Water main 10'+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main 101+ Water Service line 101+ Surface water 1001+ Driveway, parking/vehicle storage 104 Curtaindrain 50'+(NONEKNOWN) Wells on adjacent lots 100'+ F. COMMENTS SYSTEM OPERATING IN THE TOP ONE-THIRD OF THE 6' EFFECTIVE DEPTH G. ENGINEER'S CERTIFICATION I certify that t 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. ' OF Al, ^� Engineer's Printed Name KENNETH M. DUFFUS � Date 2129116 H COSAcanary sheet_2-6-15.doc - - KENN - M. DUF- ag�Alf in. Municipality of Anchorage Development Services Department ' Building Safety Division 4S A On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # osc161087 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Skyline View subdivision. This inspection revealed a nitrate concentration of 11.1 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. TUNDRA JEWEL RANC LOT 3A �ro ACRE LOT 2 WILDWOOD DRIVE ANCIIORAGE RECORDING DISTRICT AS BUILT OF: SKYLINE VIEW SUBDIVISION ACRE LOT 1 PLAT P-508 SURVEY CERTIFICATION: I, John L. Schuller, have conducted a physical survey of this property as shown on this drawing and that the improvements situated thereon are within the property lines and no enchro�hments exist other that noted. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear) on the recorded subdivision plat. Under no circumstance should any information on this drawing be used for construction of fences, structu4es, improvements, or for establishing boundary lines. WORK 9RDER NUMBER: DAtE: scA�E: JE -MAIL' MAR 25, 2016 1"=30' CSI - 01 9 DRAWN BN CHECKED B GRID NUMBER; I BODK A_M JLS NW1159 1 160122 o ? SF' . O A• 111 \1l') ��• cSl� i ... .. ................ m ••jo L. SCHULLER:• o` imr LS -10408 0 M 0 M �5O ADL NDR��'�f In ti 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax Municipality of Anchorage .. Development Services Department z: Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street �� H P.O.Box . AK 9 6650 Anchorage, AK 99519519 -6650 www.muni.org/onsite (907) 343-7904 �j CERTIFICATE OF ON-SITE SYSTEMS APPROVAL" FOR A SINGLE FAMILY DWELLING Parcell.D. 1)57I-192-Q_� COSA# I)W) 1°f 1. GENERAL INFORMATION Expiration Date: 9 - 6 — d ro Complete legal description SKYLINE VIEW ._- , SUBDIVISION: LOT 1, Location (site address) 19423 WILDWOOD DRIVE • CHUGIAK, AK 99567 Current Property owner(s) JAMES do CORINNA GEBEL Day phone 688-9153 Mailing address 19423 WILDWOOD DRIVE • CHUGIAK, AK 99567 Lending agency Day phone Mailing address Real Estate Agent ELENA NOVITSKY w/ PRUDENTIAL VISTA Day phone 240-4369 Mailing address 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite 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 fV my saq/ afflxpd)4�eto and as of the validation date shown below, I verify that my Investigationased on procedure's outlined in the Certificate of On -Site System's Approval Guidelines for this application, shows that th o*A**ovater'suppfy and/or wastewater disposal system is (are) gefe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verily that based on the information obtained from the Municipality of Anchorage riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system !slate) 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. Engineer's Comments: In conducting this evaluation, GEG, LtD. 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 test, 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 benefit 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 I/ Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory L�� Phone 337-6179 Date bedrooms, with the Mowing stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other �.,.....•��ry0 is '•'Pym nN-S1TE • : m- WATER AND _ 1��fl�STFWATER PROGRAM By: Original Certificate Date: CP d �o INr HM\ Municipality of Anchorage ' Development Services Department Building Safety Division Onsite Water 8 Wastewater Program 4710 Bragaw Street P.O. Box 196850 Anchorage, AK 99519.6850 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SKYLINE VIEW = SUBDIVISION% LOT 1, Parcel ID: Q A. WELL DATA Web type SATE H A, B, or C provide PWSID# N/A Data completed 6/18/1982 Sanitary seal (Y/N) YES Total depth 76 ft. Date of test Static water level Web produetlon Cased to 76 ft. FROM WELL LOG 6/18/1982 WATER SAMPLE RESULTS: 1 CdNorm _0 colonies/100 mi. Arsenic: NO ugJL. B. SEPTICfHOLDING TANK DATA Well Log (YM) YES Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 5/26/2006 66 ft, g.p.m. 6.2 g.p.m. Nitrate 11.9 mg./L. Other bacteria 0 colonies/100 ml. 5/26/2006 Date of sample. 5/10/2006 Collected by: KND ENG./GEG. Ltd. TankType/Material STEEL Date installed 9/11/1982 Tank size 1250 gal. Number of Compartments 3 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alar (Y/N) N/A Date of pumping 5/8/2006 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Date installed 9/11/1982 Soil rating (g•P•d./fti)r4j§j�D 1100 System type TRENCH Length 34 ft. Width 2.5 ft. Gravel below pipe 6 ft. Total depth 010.75 ft. Efl. absorption area 408 fe Monitoring tube YES Depression over field NO Date of adequacy test "5/26/2006 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test40 k1. Water added 601 gal. New depth 47.5 in. Elapsed Time: 17 min. Final fluid depth 45 i1. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date "SEPTIC TESTED BY KND ENGINEERING ON 5/10/2006 AND PASSED. DATA SHOWN IS FOR GEG TEST ON 5/26/2006. D. LIFT STATION Date installed Size in gallons Manholel "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic lonkAifi station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING 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, parkinghrehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 ced fy that 1 have determined through held inspections and review of Municipal records that the above systems are in conformance wAh MOA COSA guideBnes in effect on this date. Engineers Printed Name JEFFREY A. GARNESS Date S t l ko (- ''• KILO- COSA Fee 00 ' Waiver Fee $ Date of Payment 4P & f ko Date of Payment Receipt Number 3 Receipt Number (Rev.1 1/05) I ey A. Gorness.: CE -79;3 OS -25-O6 14:47 FR014-Pudential Jack White Eagle River 9076896429 T-444 P-002/008 F-624 ' • S • _ • _ A I • .� _ 41 r. 0. ASBUILT. • • " _ •,' ' f hereby c6tL&�.thatl have surveyed theaoIIowG z-dearrlDed: .. • '�=. ' .: --. ..r�{S�xrr.22•'Vi:�.ii'"f"s);�{r'y'�f .. u.: _� •;':'.-�'r-�G'1� r• suers`'hfsii'1••Gi'a'7V{;�z:fLt3:1'xl%.f' :: •..•;" Aaphora¢e 8ecmdlgg!PiecSnrr.ATeska,and that 'thc inprcva., •w,. :1, .iai ._�{, " 'f" .talnta.6:tllated. n-zn tbe;m th0' Prope�ey Ilam end do » •l A tano or cnvenirl�itaottEi °auoD4ty 7vtrlY adjacent4 there=:iimrepprrpq Property lying adiaoeat4 . eaerQ4ch oa• $he-yremises.ia ¢umtion and that there are.J30 •oroadways; traaemreslan 1inm.or other vlatble eseemenfaOa %Y.Yio «. -^ • pld Property except as indlea4pd hereon: _ ' ; Ml R6tri'C ri d^n': j ' Dated a��,{1Es61e; Elver' Aleskn•.�t ROH T:G JOHMON1';T SCALE. Re'[iatartd JBeadSuzvesor No: BWLS. v 7.� : rr. 1•.�•lfpr :' . 3ox4sd;F�gla'R1vai:Ahtela. . :Phone (907) 894-26i9::•i: • ' f Municipality of Anchorage • Development Services Department Building Safety Division -� On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 060219 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Skyline View subdivision. This inspection revealed a nitrate concentration of 11.9 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. N-1-2006 06:18A FROM: Y TO: 3383246 Aarow Pomp & Well Service L.L.C. (907) 346-9355 Well Work Regarding high nitrate levels at 19423 Wildwood Drive. Well camera was sant down to 50 feet with no broken welds or perforadons. Piths depth Is 10 feet below top of casing. We were only able to drive our grouting pipe to a depth of 15 feet due to larga rocks. We tried four diftent spots and that was the deepest we were able to go due to the amount of rooks. We pumped In excess of 140 gallons of grout slurry with none coming to the surface. It is my belief that R then was a surface water problem with this well it Is not any longer. Brian R. Wille Arrow Pump and wall Service 05-25-06 14:41 FROM-Pudentlal Jack White Eaale River 9016896499 KND ENGIINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER AK 99577-6736 696.8111 May 22, 2006 C/O. Elena Novitsky James Gebel Prudential jack White 16635 Centerfield 103 Eagle River, AK 99577 T-444 P.003/008 F-624 1 J RE: SKYLINE VIEW SUBDIVISION, LOT 1-19423 WILDWOOD DR. Septic Symern Adequaa & Well Flow Test Test Procedure & Results: The well was pumped at a constant rate while an acoustic sounder monitored the draw down. At the beginning of the test, the static water level was measured at 60' below top of casing. At a pumpin; rate of 4.33 gallons per minute, the water level dropped only 4' to 64' and remained in the range of 63-64' for the duration of the test, recovering within minutes after the flow was stopped. Water samples were taken and found satisfactory with the exception of high nitrates (see attached). The Municipality of Anchorage requirement for well flow is 150 gallons of water per bedroom per day. This well exceeds this requirement. JR's pumped the 1,250 gallon septic tank prior to testing. At the beginning of the septic adequary test, 3.7' of standing fluid was present in the monitoring tube. A total of 600 gallons were added to the on-site wastewater absorption trench and the fluid levels rose 025'. Within minutes after adding the water, fluid levels returned to the pre-test level. The Municipality of Anchorage regwires an absorption rate of 150 gallons of water per bedroom per day. This septic system meets this requirement. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in the land use, water usage and other factors. 05-25-06 I4:47 FROM-Pudential Jack White Eagle River 9016896/99 T-ddd P.004/008 F-621 Skyline View Lot I May 22, 2006 T Peee2 ort If you have any questions regarding the referenced property's on-site water and wastewater system or testing procedures, please contact me at 696-6111/FAX 696-8111. Respectfully, ICM Engineering, Inc. Attachments: SGS Water Analysis Note: The operational life of all septic systems depends on the local soil conditions, 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 this septic system. Therefore we can not give any estimate of how long this system will function satisfactory for current or future occupants. All septic systems ultimately fail. Some systems last 15-20 years or longer, while others fail after less than 5 years. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH S HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING nILC. C(,KO fiY ; Parcel l.D. # W I —1 y7 'oco HAA # O Q035 0 LI l S 1. GENERAL INFORMATION ACAC Complete legal description ' Lot 1, Skyline View Subdivision Location (site address or directions) 19423 Wildwood rip. s;s:.y�•� Drive t!'•,Propertyownee•'Charles Engel POA bike Engel Dayphone688-9513 ........ Mailing *address 79.423 Wildwood Drive, Chugiak, AK 99567 ----Lending agency _ Day phone 'Mailing address' Agent Polar/Elena Novitsky Day phone 349-7681 ..... Address1101 E. 76th , Anchorage, AK 99518 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX - Community well Public water 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 XXX 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-M (R,v. 1N1) Front MOA /21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Phone 6`t `1';�ti ? 4 Eagle River Loop Road No. 204 Address Eagle River, Alaska "s77 , Engineer's signature 6. DHHS SIGNATURE M Approved for LHW bedrooms. Disapproved. Conditional approval for Additional Comments Date 'Y/1-7 A9 OF f•\ ROBERT C COWAN , bedrooms, with the following stipulations: 0,4 ,, V %� 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. 724250%W.1/911 B� MOAR21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 a Anchorage, Alaska 99501 • RECEIVE AUG 17 wA"IQFAUTY OF Health Authority Approval Checklist '-R.'E Legal Description: T -PKSY411VEylC S'1D Parcel I.D.: OSI - 1 9 2 -O 6 A. WELL DATA Well type1Z/ ,*7Z-- It A, B, or C, attach ADEC letter. ADEC water system number ` Log present yi4 Date completed G 41466 Total depth�lo''� Cased to 6 Casing height (above ground) Sanitary seal _ 7L -S Wires properly protecte6M S FROM WELL LOG Date of test Static water level Well productiong.p.m. g.p.m. WATER SAMPLE RESULTS: PV,L T o N I I it r 4 S E x ca ,Go, t /o ny/e � w f �� 91J6r,.,-.• UtG (4•.ccr.t�c 4i 4...,..di..G,) t1.+4 1000 4./c.f-•...5 CF SraRAGtE 64.DAo•.r �...,ran•,..� Coliform Nitrate / Other bacteria Date of sample: Collected by: 1n16f2el-VkC— d S ENGINEERING B. SEPTIWHOLDING TANK DATA 17034 Eagle River Loop Road No. 204 Eagle River leak& 99577 Date installed Tank size /ZSaG Number of Compartments Cleanouts<M'j�-s Foundation cleanout&r /meq ES Depres�si^on o19f f �f [0 High water alarm (Y/N) N� Date of Pumpingl"T Pumpery 5' C. ABSORMON FIELD DATA '. Date installed Soil rating (g.p•d./ffr ft'/bd System type 14fw if Length . - 3-4 Width 20 Gravel thickness below pipe tea- Total depth Effective absorption area Monitoring Tube prssenlODepression over field 020-A/2 Date of adequacy test,!9�99 Resultslilt 1155 For itJL/�2 bedrooms ' 11 Fluid depth in absorption field before test (in.); Immedlateiy afteco/knal, water added (in.): z3 Fluid depth Z �7 (ins) Minutes later. Absorption rate = G27 f p.d. Peroodds treatment (past 12 months) (YM) 491IKAM JGI/ If yes, give date 72-026 (Rev. 3196)' D. LIFT STATION Date installed ir< Size In gallons Manhole/Aocess (Y/N) "Pum el ae4 t' High water alarm level at" Cycles E. SEPARATION DISTANCES 'Datum SEPARATION DISTANCES FROM WELL ON LOT TO: "Pump Oft" level at' Septic/holding tank on lot /00/14 - On adjacent lots /09 /,f - Absorption field on lot /eq0 lee - On adjacent lots lee7 /7e - Public sewer main NZA Public sewer manhole/cleanout N Sewer /septic service line ZS �� Lift station Al SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line M /� Absorption field S it Water maim rvice line /D Surface water/drainage/� Wells on adjacent lots 14X SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line O /� g / Buildin foundation �� ><' Water maiNservice line Surface water '//OD 1f' Driveway, parldng/vehide storage area 4 Curtain drain 01V& i�IV061%/� Wells on adjacent lots /00 /f' F. ENGINEER'S I cerfHy that I have determined thru Held inspections and review o/ Municipal 1C8iG are in conformance with MOA HAA guidelines in effect on this date. 4,?. ,S% Signature y/ 2 lrf *! Engineer's Name Cni ocy _ Data X 17 / di q E. 2 HAA Fee E 0 r'D Date of Payment 8 1/ -7 ? Receipt Number JAS `� /�� J 72-0213 (Rev. 3198)• Waiver Fee $ Date of Payment Receipt Number