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Home My WebLink AboutOVERLOOK ESTATES BLK 2 LT 2Overlook Estates Block 2 Lot 2 #068-041-08 Municipality of Anchorage .., Development Services Department Building Safety Division; j Onsite Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO10281 PID Number. 068-041-08 Name: JOHN THOMPSON Wastewater System: ■ New O Upgrade Address: 7343 SANTA MARIA DRIVE • EAGLE RIVER, AK 99577 I ABSORPTION FIELD Phone: No. of Bedrooms: (907) 240-2020 3 O Dee Trench ■ Shallow Trench O Bed O Mound 0Other p 1 LEGAL DESCRIPTION so "` 1.2 TOW Depth nwa 1I 9.0 MAX DPD/4 rL R Lot, Block: Subdivision: Depth to Pip. ewmm from wipinai Pads Dwwi depth bwoM Pipe 2 2 OVERLOOK ESTATES 5.39 MAX R 1 3.61 R Township: Range: Section: n eda.d sew• wipbd Pees Gewl anplta — — — 0.75-1.0 R I 45 R ■ New D Upgrade Gent eldtie 5 Mwiw of irr 1 Oates.. e.te..n 1.WELL: — pL R cbilbotim Prw1.. Ae.D . Totel Depth: ca..d TO: Tom w.e PipeD 3034/ F-810 PRIVATE 460 rL 101 R 425 so. R Drew: WELLS Dat. plead: 8/2/2001 Stade wales twwt: 150 ertailen GUARANTEED SERVICES Dot. e.tae.¢ i 11/29/01-12/3/01 SULLIVAN WATER R P w" so Aa 1 oft"11� low" raowte TANK � 1.3 cPu UNKNOWN rL 2+ R SEPARATION DISTANCES ■Septic 0Holding 0S.T.EP., I C11 Other To Septic conk Ab "*n Field Uft station Holding Tank /PrIM. sww Mn.. M.1 Oocbxen ANCHORAGE TANK aapaety In 9` 1000 From Well 100'+ 1001+ — — 25'+ STEEL w e� 2 Surface Water 100'+ 100'+ - - - LIFT STATION Lot Une 5'+ 10'+ — — — sue in "ewes 7� Foundation 5'+ 100+ — — — an twwl ad ad teDh ear olwm ad ►wep ace. tn.v.ctiore tr Curtain Drain NONE KNOW BENCH MARK Remarks: Locv a end Dw.riptwa . THRESHOLD OF MAN DOOR A.w...d o.Mbn: QO.00 R CNGINEER3 eFJ1L 4�OFj o � Inspections erformedb : AWWC, INC. Dates: 11/29/2001 P P y 0 4 . .�.. ... y... 0 2nd 12/3/2001 3rd 12/3/2001 f G ess' of and Human/Services approval 4p�444s�P 953��o�p RevDwed and approved byartment . 2 S� (Rw. 12/00) 4 rOfee etOtt p � 40poo� PERMrrSWO NUMBER: AS—BUILT DRAWING Pb' 8` 041 08'1 SW010281 \ \ ALTERNATE A I B STI 56.4 28.5 ST2 54.6 32.1 DBL1 54.6 33.4 DBL2 54.5 35.3 C01 61.8 52.0 Wrl 61.0 52.6 CO2 34.7 57.1 ATf2 35.2 60.2 NEW 1�Q \ ALASKA WATER & WASTE, WATER CONSULTANTS, INC. wont hFRAW engin C111TF ?A . AWNnYlnF !R 4"M • FNONF (001851!110 • FAX l901133A-3?4e \ GALLON\ \ TANK NEW DRAINFIELD \ C.J.G. 1"=40' PREPARED FOR: PHONE NUMBER: rA LNUMtlm JOHN THOMPSON (907) 240-2020 2 OF 3 OVERLOOK ESTATES, LOT 2, BLOCK 2 E OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE r-: e79&53 .... . ..J f .•' `.•''' foo �OQdPro f e s slo"& �DD��OOo PERMIT NUMBER: AS-BUILT DRAWING PARCEL m NUMBER: SW010281 068-041-08 FINAL GRADE - 100.84 TOP OF TANK AT—\ TOP OF TANK AT INLET - 94.27 OUTLET - 94.27 NEW 1000 GALLON INVERT OF BUNG SEPTIC TANK AINVERT OF BUNG AT T INLET - 93.73 OUTLET - 93.50 FINAL GRADE ORIGINAL GRADE - 97.80 98.34 (AVO.) (HIGHEST POINT) FILTER FABRIC INSULATION Te 3.61' INVERT OF PIPE 9221 (AVG.) 1� I-"--5'� BOTTOM of TRENCH 88.80 (AVG.) DATE: oop6o00 1/25/20020,11 0! 0 DRAWN BY:9s�p� ALASKA WATER & WASTEWATER SCALE: C.J.G. �. v, � CONSULTANTS, INC. 6001 DFRARR ROAD SUITE. 2R . ANCHORAGF AK 9050(. • PHONF (407)W4170 • FAK (901)316-3246 N.T.S. PREPARED FOR PHONE NUMBER: PACE NUMBER: JOHN THOMPSON (907) 240-2020 3 OF 3 O of re A: ess.: LEGA. DESCRIPTION: Q 79553 k OVERLOOK ESTATES SUBDIVISION: LOT 2, BLOCK 2, TYPE OF WORK: 04 0'P 4p0000 PROFILE AS-BUILT OF SEPTIC SYSTEM �4�� 0 A by IOC co. ab. SULLIVAN WATER WELLS P.0.BOX 670272.CHUGIAK,ALASKA 99581 • TELEPHONE 688-2750 ATTENTION: It Is the responsibility of the property owner to Submit a copy of the well log to the proper authority. Municipality of Anchorage: Department. of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. 11/30� o / MUNICIPALITY OF ANCHORAGE Development Services Department��t'r") / 1/?� /0 On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jul 31, 2001 1 Expiration Date: Jul 31, 2002 I Permit Number: SWO10281 Parcel ID: 068-041-08 'Legal Description: OVERLOOK ESTATES BILK 2 LT 2 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Owner Name: John Thomson Lot Size: 44550 SQ. FT. Owner Address: 17343 Santa Maria Dr. Total Bedrooms: 3 Permit Bedrooms: 3 Eagle River , AK 99577 - This permit Is for the construction of: r,%; Disposal Field Q✓ Septic Tank Holding Tank ❑ Privy G 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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. Received By: Issued By: B. Covered, sealed, and heated to prevent freezing. Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0� g` 6q/ Permit Number Property owners) JOHN THOMSON Day phone 240-2020 Mailing address (1) 17343 SANTA MARIA DRNE " EAGLE RIVER. AK 99577 Mailing address (2) ZJp Code Legal description (Lot, Block & Sub'd.) LOT 2. BLOCK 2. OVERLOOK ESTATES SUBDMSION Legal description (Section, Township & Range) _N/A Lot Size y14 S55D Acres/Sq.FL Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only Sewer and Well m Water Storage Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ 01 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS, INC. nature of prope�.' owner or eu#�orized agent) - Permit Fees: 6 y tan. co Waiver Fees: Date of Payment 7! el Receipt Number. 75 to o? Date of Payment Receipt Number. ALASKA WATER & WASTEWATER CCrNSULTANTS, INC. July 19, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 Ref: Proposed Well .& Septic System Design for Lot 2, Block 2, Overlook Estates To whom it may concern: The proposed 3 bedroom house will be served by a private well septic system. Two test holes were excavated in the area of the proposed septic system. The proposed septic system will be designed around the 30 foot radii of these test holes. We are proposing that a 1000 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that the insitu soils should act as a sand filter and that an application rate of 1.2 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/R2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 37582 f. Total Depth: 9 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet L Reduction Factor: 0.50 j. Minimum Length: 40 feet long k Effective absorption area = 400 R2 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 6901 Debarr Road, Suite 2B' Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: akwwc.com i 4. TOPOGRAPHY: The area for the proposed septic system is 5% to 10% slope running northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your i., M.S. NOTE: Attached is a site plan drawing, a design drawing, two soils log, and a 17 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com OVERLOOK ESTATES LOT 1. BLOCK 2 i �1Tp) OVERLOOK ESTATES U LOT 3. BLOCK 1 FIELD VERIFY SEPOC LOCA' OVERLOOK ESTATES LOT 4, BLOCK 1 OVERLOOK ESTATES LOT 3. BLOCK 2 SEPTIC SYSTI (PACE 2 OF 1 I 1 1 \ RLOOK ESTATES T 4. BLOCK 2� rEXISTING SEPTIC \ 11 \� OVERLOOK ESTATES LOT 1. BLOCK 3 7/19/2001 DRAWN BY: AI.ASIL1 NNINI "R S WASTEWATER SSE C.J.G. CONSULTANTS. INC. , 6901 DFOARR ROAD, SUITE 29 • ANCHORAGE. AK 99504 ' PHONE (907)3374179 • FAX (907)336-3746 1 = 100' f ..... REPARED FOR PHONE NUMBER: PACE NUMBER: r JOHN THOMPSON 240-2020 1 OF 2 f` ....; of y .1 ess: :CAL DESCRIPTION: 4y41 C� E 79553 LOT 2, BLOCK 2; OVERLOOK ESTATES SUBDIVISION +�� ^''••,, I ,.: x.01 rPE OF WORK: +^v� SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM yv,^^�ee`lo'`�'� tie 1\ NOTE: THE CONTRACTOR SHALL HAVE THE \ NORTHWEST LOT UNE AND WELL RADII SHOWN FLAGGED BY A REGISTER LAND SURVEYOR PRIOR TO CONSTRUCTION OF THE SEPTIC SYSTEM. ' \ \ ALTERNATE SITE /O ITH 'I WTL1 I I r I \\ \V `. a V s t / 1 I / ROPOSEO NEW ORAINFIELD. E%CAVATE A TRENCH THAT IS 9 FEET DEEP MAX. BY S FEET WIDE BY 40 FEET LONG. I / ADD 4 FEET OF CLEAN. WASHED SEWER DRNNROCK. / \ INSTALL TRENCH PARALLEL \JO.SLOPE CONTOURS. \ I2� \ �INSTALL DOUBLE CLEANOUTS (DBL) \ A 1000 G C TANK No. •N'••.. f� P FESS1pN*�• Sr 'A \ o 7/19/2001 OFA add Y DRAWN BY: O AIASIC-1 NVA E'R d NVASTLNVAI'LR SCALE: CONSULTANTS. INC...... •. • .. ...• .....•. 001 DERARR ROAD. SUTE ER • AWHORAGE AR 99504 • R OHE (907)3374179 FM 9071338.3]46 EPARED FOR: PHONE NUMBER: PAGE NUMBER: ••� •••• JOHN THOMSON 240-2020 2 OF 2 Do a re Co s: :AL DESCRIPTION: OQ 4,; C 7953 J LOT 2. BLOCK 2 OVERLOOK ESTATES SUBDIVISION 00le.� ' 00 •......�••''Fp4ca DESIGN OF PROPOSED WELL AND SEPTIC SYSTEM 4�klOpllzv � o�' �F'�L°0o4 r v'<.." ••qt ALASKA «'ATER & WASTEWATL'R v��g CONSULTANTS. INC. O 201 wAOAD�-Unt 28 (007W7-6179 90 w • ok..aoom • SOIL LOG — PERCOLATION TEST 4 . LEGAL DESCRIPTION: OVERLOOK ESTATES S/D; LOT 2, BLOCK 2. OO A f .•A.! a ess: Q a PERFORMED FOR: JOHN THOMSON DATE: 7/12/01 QQ��•, -7I953 DEPTH ___ 4�•^�dp�ofseslo�°�� (feet) �3a=. ORGANICS TEST HOLE 1 °4Ov0000�� SOIL CLASSIFICATIONS f 1 2 GP ML 3 Q..c t GM CL q "o: GC OL SW MH j 5 4 ' • •• • SP CH Sm OH \� TH/1 THIS 6 Qi Sc + c \ OVERLOOK ESTATES 7 0; ,\ LOT 2. BLOCK 2 GW-GM 8RY o o' / t\. 9 I '\ Sf1E PLAN - - 1'=100' 10 DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 'o `< 12 14-15 o, 16 s.o.t1. 17 18 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 16" (INCHES) TEST RUM BETWEEN 5.0 FT. AND 5.5 FT. 20 COMMENTS: ENOUGH SILT BINDER SO THAT THE TEST HOLE WALLS DID NOT SLOUGH. PERK TEST WAS PERFORMED BY CALEB CALL I PERFORMED BY ALASKA WATER do WASTEWATER 1, JEFFREY A. GARNESS, CERTIFY THAT THIS RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: o ol GROUNDWATER DEPTH TO DATE DRY 7/12/01 TIME (MINUTES) READING (INCHES) oNs GpL�- c - 15— M Nv.�Es PE�G.OF �P ALASKA WATER &; WASTLWATKR CONSULTANTS. INC. LEGAL DESCRIPTION: OVERLOOK ESTATES S/0; LOT 2, BLOCK 2, VOQ a �e �ji PERFORMED FOR: JOHN THOMSON DATE: 7/12/01 DEPTH y_ QQ4nyplolea (reel) ORGANICS TEST HOLE #2211 1 1-:;A.I DEPTH TO DATE GROUNDWATER DRY 7/12/01 DRY 7/19/01 o CLOCK TIME SOIL CLASSIFICATIONS 2 ; / / I 1 NS gSpR�6 M\N�� G Nps SER �N P PER pF GW -- - -- ORG 3— cai 1 r�7 ... GP I ML � 1 GM CL g o` C� GC OL i o 10 OVERLOOK ESTATES LOT 2, BLOCK 2 SW MH 5110,' "SESPii CH SM ' : OH 60. SC DEPTH TO DATE GROUNDWATER DRY 7/12/01 DRY 7/19/01 I CLOCK TIME GW -GM 8— 1 1 / / I 1 NS gSpR�6 M\N�� G Nps SER �N P PER pF 1 � 1 � THJ i o 10 OVERLOOK ESTATES LOT 2, BLOCK 2 \ 0 12 -'- os 14'` o 15 0 `s B.OJL 16 17 16 19 DEPTH TO DATE GROUNDWATER DRY 7/12/01 DRY 7/19/01 DATE I CLOCK TIME i � I 1 1 / / I 1 NS gSpR�6 M\N�� G Nps SER �N P PER pF 1 � 1 � THJ OVERLOOK ESTATES LOT 2, BLOCK 2 \ `. -'- DATE READING CLOCK TIME NET TIME WATER LEVEL NET DROP (MINUTES) READING (INCHES) NS gSpR�6 M\N�� G Nps SER �N P PER pF PERCOLATION RATE <1 (MIN./INCH) PERC*HOLE DIA. 16' (INCHES) TEST RLN BETWEEN 5.0 FT. AND 5.5 FT. 20 ' COMMENTS: ENOUGH SILT BINDER SO THAT THE TEST HOLE WALLS DID NOT SLOUGH. PERK TEST WAS PERFORMED BY CALEB GALL. PERFORMED BY ALASKA WATER do WASTEWATER 1, JEFFREY A. GARNESS, CERTIFY THAT THIS W S P RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 20 MUNICIPALITY OF ANCHORAGE Development Services Department t Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 068041 08 1. GENERAL INFORMATION Expiration Date: 7-2q-2Z— Complete -2q2Z Complete legal description OVERLOOK ESTATES BLOCK 2 LOT 2 Location (site address) 6311 MAGNAVIEW Current property owner(s) Mailing address Real estate agent WILKENS 2. TYPE OF DWELLING: 0 Single Family (w/ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Fx] Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: N O N E Q Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55 U Waiver Fee $ Date of Payment q 11-1 �t 1 1P, Date of Payment Receipt Number d r] n6 -b Receipt Number COSA # 0 s C a a 1 1,33 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 4/1/22 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for OF Al_gsll 49 TH I •(,• 1 rJ . I;HARLES G BALZARIKI r�� F��J , • CE -13854 OPROFE SIC �� bedrooms, with the following stipulations: KOTY pFgAii�� vAT C-7 ER ANS m PROD ATER z BY Original Certificate Date: V2 Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advis ry Well Flow Advisory Other Ve v�I a COSA Checklist blue sheet A Legal Description: OVERLOOK EST L2 B2 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 8/2001 Total depth 460 ft Cased to 101 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 4/7/22 Static water level at beginning of test 174 ft. Comments B. TANK DATA Age of tank(s) 21 years Tank type/material septic STEEL Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 11/5/21 D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 2001 ❑ ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 3 ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced na gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 068 041 08 Structure served by this system 1 Well production at time of test +3 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes OR No ❑ Coliform bacteria is Negative Nitrate 0.458 mg/L ❑ Nitrate less than MRL (ND) Arsenic 2.241 ug/L ❑ Arsenic less than MRL (ND) Collected by C.BALZARINI Date of Sample C. LIFT STATION 4/10/22 ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 4/7/22 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) na If yes, enter date na E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0✓ Yes Community Sewer Manhole/Cleanout > 100' ✓7v Yes if No ft 0 Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' [Z] Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' 0✓ Yes if No ft Water. Main > 10'- __ Animal Containment > 50' Q Yes if No ft ✓Q Yes if No ft 0✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'✓Q Yes Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' if No Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water. Main > 10'- __ .✓❑ Yes if No ft Community Wells > 200' 0✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓Q Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 3/24/22 COSA Checklist yellow sheet Adw Aw P0 j*:49TM '•*�� .. .... .......r r... .......... . �j C HARLES G BALZARINI� j (�� c�s .. • CE -13854 lil PROFESSIONP -�. Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 2221133 Subdivision: Overlook Estates Block 2 lot 2 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for this COSA / property is 21 wears old A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. . 1 8 9 /0 • �� Municipality of Anchorage On-Site Water and Wastewater Program Lel. MAR (907) 343-7904 �� Certificate of On-Site Systems Approval 01 6 C'> Parcel I.D. 068-041-08 Expiration Date: to^ ^1 1. GENERAL INFORMATION Complete legal description Overlook Estates Block 2 Lot 2 Location (site address) 6311 Magnaview Drive Current Property owner(s) Katharine Curra-Spurger&Christopher Schwankl Day phone Mailing address 6311 Magnaview Drive.Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: �A 1 Received b • �. ►� L `'l�tj�►. ,�� Date:,*0 / COSA to be released to the engineer,unless otherwis: r:.uested by the engineer. COSA Fee $ '7 2-i ,— Waiver Fee $ Date of Payment J`t(o lf l r Date of Payment Receipt Number 064-S61 el Receipt Number COSA# (SSC CD?? 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 3/15/2018 6. DSD.SIGNATURE - •- System #1 Approved for E bedrooms S{even R. annone: SSystem #2 Approvedt♦ • CE-8149 �,�• y for bedrooms �$ Q • re Disapproved i� ,�1`�Ri'OFESSI � � Conditional approval for bedrooms, with the following stipulations: f.QP"'° OF,G „/r O ON-SITE 0 WATER AND r" GT, WASTEWATER o cccc, PROGRAM L sERvPF By: � `� ✓ Original Certificate Date: 3 / " / �f The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r '• .. c If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Overlook Estates Block 2 Lot 2 Parcel ID: 068-041-08 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/2/01 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 460 ft. Cased to 101 ftCasing height(above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 8/2/01 3/12/2018 Static water level 150 ft 148.9 ft. Well production 1 '3 g.p.m. 3'0 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.212 mg/L Arsenic NDug/L Date of sample: 3/12/18 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/SteelDate installed 11/29/01-12/3/01 Tank size 1000gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping 7/11/2017 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA 11129/01-12/3!0, 1.2 GPD/SF Shallow Trench Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length 45 ft. Width 5 ft. Gravel below pipe 3.6 ft. Total depth 8 ft. Eff. absorption area 425 ft2 Monitoring tube Y Depression over field N Date of adequacy test 3/12/2018 Results(Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 100+ 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 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Survey in file. G. ENGINEER'S CERTIFICATION ,��'�~pF A.i A Cq 1 I certify that I have determined through field inspections and r�''< • 1,-'•v# review of Municipal records that the above systems are in o*• , • "1-40. l, conformance with MOA COSA guidelines in effect on this date. ••, •• �� Engineer's Printed Name Steven R. Pannone •': }everi it.•0anriorie:• Date �_ 3/15/2018 61:.•• CE-8149 ., / COSA brown sheet 10-10-12.doc • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPRO�9,L APR `L 5 i \;\ 11)55- Parcel ug Parcel I.D. 068-041-08 Expiration Date: 1. GENERAL INFORMATION Complete legal description OVERLOOK ESTATES BLOCK 2 LOT 2 Location (site address) 6311 MAGNAVIEW DRIVE EAGLE RIVER AK 99577 Current Property owner(s) LEE & JAMIE STAAB Day phone Mailing address Real Estate Agent 6311 MAGNAVIEW DRIVE, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: x/-27-1fp COSA to be released tot e e eer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment �{�o2(Ol(% Date of Payment Receipt Number 047( LID Receipt Number COSA# 65U&//3s' 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, baVd on p;;[[,SS��cedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, sh ws tliat'i , Xon-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 4/18/2016 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 ' f OFAli Lr� occupants or can ArcTerra guarantee that no unseen i v " encroachments, deficiencies or discrepancies exist. 6. DSD SIGNATURE /- 9 KENNETH,D D ' F I System #1 Approved for bedrooms. 71e System #2 Approved forAw bedrooms. e ,is ,D Nti s Disapproved. Conditional approval for bedrooms, with the following stipulations: PROGRAM ^I/ By: wvt �� \ Original Certificate Date:�7'1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite 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: OVERLOOK ESTATES BLOCK 2, LOT 2 Parcel ID: 068.041.08 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 812/2001 Sanitary seal (Y/N) Y Total depth 460 ft. Cased to 101 ft. FROM WELL LOG Date of test 8/2/2001 Static water level 150 ft. Well production 1.3 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.2 mg/L Arsenic: ND ug/L Date of sample: 45-2016 B. SEPTIC(HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Tank size 1000 gal. Number of Compartments 2 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18 in. AT INSPECTION 415116 105 ft. 4.1 9 - p.m - Collected by: ARCTERRA Date installed 1.1/29/01-121312001 Cleanouts(Y/N) Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 4115/2015 Pumper Royal Flush C. ABSORPTION FIELD DATA Date installed 11129101-1213101 Soil rati (g.p.d./ ft?/bdrm) 1.2 System type SHALLOW TRENCH Length 45 ft. Width 5 ft. Gravel below pipe 3.6 ft. Total depth 8,9 ft. (Measured 4/5/16) Eff. absorption area 425 ft2 Monitoring tube Y ` Depression over field N Date of adequacy test 415116 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 470 gal. New depth 0 in. Elapsed Time: 1 min. Final fluid depth 0 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 Size in gallons Manhd(e/Access (Y/N) "Pump on" level at_ in. Datum "Pump dr level at_ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1001+ Absorption field on lot 1001+ Public sewer main 751+ Sewer /septic service line 251+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Higfrwateralarm level at irt:- --- Meats alarm & circuit requirements? On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 1001+ Building foundation 5'+ Property line 51+ Absorption field 51+ Water main 10'+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 104 Water main Water Service line 101+ Surface water 1001+ Driveway, parking/Vehicle storage 10'+ Curtain drain 50'+(NONE KNOwN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that) have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DVFFUS Date 411812016. COSAcanary sheet_2-6.15.doc - OF A.� 1 *.pgTFi KEN 710 �� S " V "W �S a1�� tll EP�4 �k x • '� Municipality of Anchorage r On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 068-041-08 1. GENERAL INFORMATION Complete legal description Overlook Est. B2, L2 Expiration Date: Location (site address) 6311 Magnavlew Dr. Current Property owner(s) Thomas & Marjorie Deakins Day phone Mailing address Real Estate Agent 6311 Magnaview Dr. 2. TYPE OF DWELLING: Fx-] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone - a -I3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Puhlir 1N.fo, c .fe t1 Pub!i Waiver/Variance Received by: COSA to be released to the unless otherwise requested by the engineer. COSA Fee $ p�o` Date of Payment(� Receipt Number o �a�y G� COSA# 0Sc--13�`la1 Date: 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Alk. 99510 Engineer's Printed Name Steven R Pannone Date *. 6. DSD SIGNATURE "' System #1 Approved for � bedrooms $leven $ 'PWone. "/ a System #2 Approved for bedrooms +, 0E-6149 �� Disapproved �! )) OAv�� Conditional approval for bedrooms, with the following stipulations: By: ////l/ • F a Original Certificate Date: �- The M- icipa" liry 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 7 c If more than 1 septic system is on the lot: COSA Checklist # _L_of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Overlook Est. 62, L2 Parcel ID: 068-041-08 A. WELL DATA Well type Private Date completed 8/2/01 Total depth 460 ft Date of test If A, B, or C provide PWSID # _ Sanitary seal (Y/N) Y Cased to 101 ft FROM WELL LOG 8/2/01 Static water level 150 ft. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18 in. AT INSPECTION 5/7/13 153 ft. Well production 1.3 g.p,m. 3.6 9 -P.M. WATER SAMPLE RESULTS: Coliform A%Q colonies/100 mL Nitrate mg/L tr Arsenic /S! I� ug/L Date of sample: 7/19 /13 Collected by: PJF S B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/29/01-12/3/01 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 10/1q/11 Pumper_ SGr�tai!I wln:r-e i C. ABSORPTION FIELD DATA Date installed 11'Zs'o,-Of Soil rating (g•P• d./fr orft) Y 2/bdrm 1.2 GPD/SF System type Shallow Trench Length 45 ft. Width 5 ft. Gravel below pipe 3.6 ft. Total depth 8 ft. Eff. absorption area 425 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/7/13 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 493 gal. New depth 0 in. Elapsed Time: 100 min. Final fluid depth 0 in. Absorption rate , 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum in. Size in gallons Manhole/Access (Y/N) "Pump off" level at in. High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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 Steven R. Pannone Date I -;(go i5, COSA brown sheet 10-10-12.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ in. n � �r� En'. 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 $W-100 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION COSA# U(LUH 1 d" Expiration Date: / / - C;2: 8 - O (o Complete legal description Lot 2 Block 2 Overlook Estates i Location (site address) 6311 Magnaview Drive, Eagle River, AK 99577 Current Property owner(s) Joshua & Bliss Halberg Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address _6311 Magnaview Drive, Eagle River, AK 99577 Day phone ss]ftLjer1 a,1 T 6�, Day phone 244-8584 Unless otherwise requested, COSA 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 ❑ Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name G. Scott Crowther. Date IQ31 ofp Engineers Comments: In conducting an adequacy tat, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational Tire oral) wells and septic systems depend on the local soil condition. ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions arc outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are n is or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of OFsA 111 continue to meet the operational requirements of the MOA DSD. The content of this report is for the sol 4.6'" ive. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer right w at c 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. K.P44q�,� 'Corr cuoKmr Conditional approval for bedrooms, with the followa Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory •�\,(�-•,•. •,,•IWC .� oN-slr •� •WAST AND : m= OG • RAM Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: OG (Rw. Ines) Municipality of Anchorage • Development Services Department Building Safety Division On-site Water & Wastewater Program 4700 Bragaw Street P.O. Box 198650 Anchorage, AK 99519.6650 www.muni.org/onstte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST A. WELL DATA Well type P It A. B, or C provide PWSID # _ Date completed 1112r ao2 1 Sanitary seal (Y/N) Y Total depth 1 _R Cased ID 101 ft. FROM WELL LOG Date of test 012 WI Static water level 150 ft. Well production 1.9 g.p.m. WATER SAMPLE RESULTS: ''''�� Coliform �colonies/100 mL Nitrate ►� mg/L Arsenic: IQ mgn Date of sample: 811 B. SEPTICIHOLDING TANK DATA w,'JAW;� Well Log (YM) Y Wires properly protected (YM) Casing height (above ground) 112 in. AT INSPECTION 8n7R008 158 ft. 1.5 g.p.m. i i Other bacteria's colonies/100 mL Collected by: Laura Pannone! Tank Type/Material Anchorage Tank Steel Data installed 11129=1 Tank size 1000 gal. Number of Compartments j Cleanouts (Y/N) Y Foundation deanout (YM) Depression over tank (Y/N) N High water alarm (YM) NIA i Date of pumping 8n81= Pumper X* Pumping C. ABSORPTION FIELD DATA Date installed 12DR001 Sail rating (g.p.d./fl2 or fte//bdrm)12 System type Shallow Trench i Length 45 ft. Width S ft. Gravel below pipe 3.81' fL Total depth 7.8 to 8.1 ft. EH. absorption area2�' fte Monitoring tube Y Depression over Heid tj Date of adequacy test 81178008 Results (Pass/Fall) Post For a bedrooms Fluid depth in absorption field before test Q in. Water added4a gal. New depth! in. Elapsed Time: $Q min. Final fluid depth Q in. Absorption rate >= 450+ I g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. UFT STATION Date installed 'Pump on' level at _ in. 'Pump Datum Cycjag E. SEPARATION SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank ift station on lot 100+ Absorption field on lot _ 100+ Public sewer main 100+ Sewer /septic service line 25+ Animal containmentareas 100+ Manhole/Access (YM) High water alarm level at & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manurelanimal excrete storage areas 100► SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Property line _W Absorption field 15+ Water main 100+ Water service line 25+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 100+ Water Service line 25+ Surface water 100+ Driveway. parkingNehide storage S Curtain drain None Observed Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I cer* that 1 have determined through field inspections and review of Mimidpal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name 0. Scott Crowther Data Siz-3/0(o COSA Fes S —1,20 * I7 5 RIk ? k Waiver Fee $ Date of Payment Receipt Number (Rev. 11/05) Date of Payment Receipt Number a 00011 cacwrm L CE .6491 in. Municipality,.of Anchorage • Developrrient Services Department ?r ' /Building Safety Division , On Site Water 8 Wastewater Progiam 4700 South Bragaw St. P.O. Box 196650 Anchorage AK 99519-6650 I www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL I FOR A SINGLE FAMILY DWELLING Parcel I.D.., 068-041=08 . .. ' HAA# 1. 'GENERAL INFORM ATION+ Expiration Dater ` ;k Complete legal description I LOT 2. BLOCK 2: OVERLOOK ESTATES SUBDMSION �. i Location (site address or directions) MAGNAMEW • DRNE• *-EAGLE, RrVER, AK -99577,:1 Current Property owners) JOHN THOMPSON Day phone 240—'2020". Mailing address' 17343 'SANTA MARIA DRrVE ' • EAGLE RIVER AK 99577 Lending agency, Day phone Mailing address: . Real Estate Agent Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 acid/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 samples. (Certificates maybe reissued for a period of up to one year withvalid 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. i Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S IIS01 at, orprior to closing for the engineering services provided. 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 Health Authority 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 typo of structure indicated herein. I further verify 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 is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER do WASTEWATER CONSULTANTS, INC. Phone Address 6901 DEBARR ROAD, SUITE 213 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. 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. AWWC, Inc. 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 solo 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 Approved for 3 Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory bedrooms. 337-6179 Date Zv 0'Z bedrooms, with the (Mowing stipulations: Manitenance Agreements Supplemental Engineer's Reort Other G•, •O ON-SITE WATER AND •; : WASTEWATER ; PROGRAM "�rrnl�f By�i�.. i • Original Certificate Date: 2 — 2 S " 0L c/— / (Re,. M-01) Municipality of Anchorage • Development Services Department Building Safety Division OnSfte Water & Wastewater Program 4700 South Sragaw St. P.O. Box 196650 Anchorage, AK 09519.6650 www.cLanchorage.sk.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LOT 2. BLOCK 2: OVERLOOK ESTATES S/D Parcel ID: 0681-041-08 A. WELL DATA Wag" VA11 If A, B, or C provide PWSIDff NIA Wen Log (YIN) YES i Date completed 8/2/2001 Sanitary seal (YM) YES Total depth 460 ft. Cased to 101 ft. FROM WELL LOG Date of test 8/2/2001 Static water level 150 ft. Well production 1.3 9— p.m- WATER SAMPLE RESULTS: Conform coloniea/100 ml. Nitrate ` S mgA. Arsenic: � A• m911. Date of sample: Z ! o B. SEPTIC(HOLDING TANK DATA Tank TypelMaterlal STEEL Tank size 1000 gal. Number of Compartments 2 Foundation deanout (YIN) YES Depression over tank (YM) NO Date of pumping NEW C. ABSORPTION FIELD DATA Wires properly protected (YIN) YES Casing height (above AT INSPECTION Date ktstaned 11/29-12/3/01 Son rating fj.p.d fllbdrn) 1_2 Length 45 ft. Width 5 ft. Total depth *9.74 ft. Elf. absorption area 425 fe Date of adequacy test NEW Other bacteria cotrJes/100 ml. I Collected by: AWWC, INC. Date installed 11/29-12/3/2001 I Cleanouts (YIN) YES High water alarm (Y/N) � i I System type TRENCH Gravel below pipe ! 3.61 ft. i Monitoring tube YES Depression over field NO Results (Pass/Fall) Fluid depth in absorption field before test = In. I For bedrooms I Water added=gal. New depth=in. Elapsed Time: = min. Final fluid depth = In. Any rejuvenation treatment (past 12 mo.) (YM & type) AbwgAon rate >= I g.p.d. I If yes, give della — 0. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A On adjacent lots 1009+ On adjacent lots 100'+ Public sewer menhole/deanout N/A Sewer /septic service fine 25'+ Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property Ane 5'+ Absorption field 5'+ Water main N/A Water service One 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, parkingtvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION �G Yr - I ceMy that I have determined through field inspections and t �-' '--y* review of Munldpal records that the above systems are In """ ' ' "" ""' """ conformance with MOA HAA guidelines in etfed on this date. Engineers Printed Nam JEFFREY A GARNESS pa ' , 7953 N4 �10 Data 2`22 tT r— •^�dPror..ab�d HAA Fee $ 375, 0 0 Date of Payment a - as - 0a Receipt Number O/ 1.0 3 7? (Rsv. 12101) Waiver Fee $ Date of Payment Receipt Number