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MOUNTAIN PARK ESTATES #2 BLK 3 LT 22
Mountain Park states lock Lot 017-022 -34 Municipality sof Anchorage On-Stte Water and Wastewatei Program •(907) 343-7904 Page or ON-SITE WASTEWATER INSPECTION REPORT Permit Number OSP/811.76 PID Number 017-0U:34 Dwelling: 0 Single Family(SF) (i Duplex(D) 0 Muhipie(SF and/or 0) Project. ❑New IN Upgrade Narrri; ABSORPTION FIELD - EXISTING RICHARD M SCHROEt ER — AQdres* ❑ Deep Trench 0 Shallow trench 0 Bed ❑ Mound 12841 FOSTER ROAD, ANCHORAGE, AK 0 Other . Phone, 'Nurtber o4 Bedroom; Soc Rat g —17depik from ongsnal gi.ute.._.. 4 i PC,.:;.Fk Fl _ > LEGAL DESCRIPTION Depth Pe pipe<nvcr from qt+�IisireGlove!al grade Glove!davbeneathMit beath OIPa StibeBiun ...,.. . .._ ikir.A Lai i t x Ft. MOUNTAIN PARK EST. S2 3 22 Filr added'above original grade Drawl eingth Inwnzhip Give Seciloit Ft. Fl Gravel width Beds.N n 1.er at!inns Distance between Roes SEPARATION DISTANCES -._ -- Ft 7o soot Aoson llan,Lm statorHolding ` swan Teta,al:aeration ration area Number al trenches Dist.between trenches 1' _ -10111 ' PI+ C! ; Tara Line Ft' — __ rt _._. _.._... ` , Writ 100+ - ._ NA .. TANK s- S.T E-P Q Ho 11%. 1 1 Other - Menuteritoor Capacity :Klltat:e vv.,ter 100'+ . .. ._.-._ NA Anchorage Tank - 1250 cai. l hiaoiNtai Number of c arnpartnrerrtn UK Lire . 5'+ - - NA Steel 2 Pounttlaran 11Y+ § .,,_._._... . NA LIFT STATION �. A1amoheturer Capacity Curtain Drain , NA NA NA Gai. (tentacles Existing ST decommissioned per code. p.m on I "�at oft ,iweii al HO wale!'Wenn at tft:: in ori Ptrrrtp mst€e sett rnogal Forbit l inspecxian,parlurrnr4 try AIMIIRIM mvPIPE MATERIAL HouseIelank 3034Taskto 30 trnslaatier A+ _ E Ytitfieid CcWT 3034 Instw for ARCTERRA BENCH MARK _sttrnte orsosuoni 100 ti tnsrtacrr n - r1 L:n�tian antf Oesolplic+l dimes t /13J'IB a..7r94/ t8 F." 4° Garage Floor COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL r. *II' �' .444. Ilk.,," 1.41111. Conditional Approval: ��.__.._._.__._. Date _ �,\*.r `�� -„ 1'�4 f . SII r Pritir F icW<L;ti{Rr k 4, A- •i< j.:nry' Approved I� Date -ZS-IT k ,� tm ,0 7. („: _.__. ” r plat' s ears Stam Its eillors Repo.! 9 . 12,j„t_ AS—BUIL_ I SYS I LM DETAILS/SITE PLAN Per~‘it OSP1t81176 I M0'UNtTAIN PARK ESTATE,S SUBDIVISWN Not L22 83 PID 0170 —34 NB9'56'06"W 183.06' (183.00' R) f x 4...4 ' cap r`- ' " ` `, f 8 few 150.- CA 1—'7k fi- " I 41 C� Qu sr. rir :c. LxJ Ic CI "' a ,. CO I CO FC('i 0. aq 't allm 7tacIt C? w fq x r lcISr ,,,, 1 to x 70' N8947 4 "W 1:2, .. " (N89'56'06"W 183.00' R) I ti SCALE. 1' we 30' 1 A—C=34.O' s 1 \I 1 i $ A—D=38.8' .I �'�° FINAL GRADE lV— . . _ — I td4 SEPTIC �� 1 AP4t £.X S P4G FIELD i .` e.e. -...1.. OF A �. SCALE+ NTS k itss Ill P!1PARE1a PURI 1Z03.41. FOSTER ROAD It* * : r * ANCHORAGE., AK 99'316 t• , i,. ,' t‘ a:‘, E ! Cl;-7t1ti-.•- ` 411101F au;fiaurr.�A nom:: 0� I4,141 .° ., >� ��'' ... ,., .•e 11 .1 N/A «,eckrn KAtp s rai.F. 18141 AK.9077' ""'Y MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program yS • F3 PO Box 196650 4700 Elmore Road •• ; 4'.• 'A Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 y "" http://www.muni.org/onsite I)cl,aruncnt �h�HONP'0 On-Site Wastewater Disposal System Permit Permit Number: OSP181176 Effective Date: 7/6/2018 Work Type: SepticTank Upgrade Expiration Date: 7/6/2019 Tax Code Number: 01702234000 Site Legal Address: MOUNTAIN PARK ESTATES#2 BLK 3 LT 22 G:2839 Site Mailing Address: 12841 FOSTER RD, Anchorage Owner: SCHROEDER RICHARD M Lot Size in Sq Ft: 20130 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing •-'ter �� /! Received By:. ' Date: Issued By: R �� t fel Date: N 8 MUNICIPALITY OF ANCHORAGE (--:"'''c". ' - Community Development Departmen Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water&Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-022-34 Property owner(s) RICHARD M. SCHROEDER Day phone 223-7394 Mailing address 12841 FOSTER ROAD, ANCHORAGE, AK 99516 Site address 12841 FOSTER ROAD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) MOUNTAIN PARK EST. #2 B3, L22 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field [1 Initial ❑ Single Family (SF) U (w/wo ADU) Septic Tank Upgrade Oti Duplex (D) ❑ Holding Tank [ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage [I THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Sign-etre—o roperty owner or authorized agent) Permit/Rush Fees: 216.00 Waiver Fees: Date of Payment: 1151201.g Date of Payment: Receipt Number: 032—ICQ D Receipt Number: Permit No. OS 191.g1 11(, Waiver No. Permit App_9-1-12.doc •4 ARcTERR,y \ ARCT ERRA I • CONSULTING, INC ........c3 4 •. Si : 212 E.51st Ave,Anchorage,AK.99503 • C1,"�T. d Office(907)868-3791,Fax(907)868-3793 t�'�O� 4tR atITtoHG•�m-41 June 27, 2018 Municipality of Anchorage Development Services Department On-Site Water&Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject SEPTIC TANK UPGRADE PERMIT MOUNTAIN PARK EST. #2,B3,L22 The owner has requested we proceed forward to obtain a septic permit to upgrade the failed septic tank. We propose to decommission the existing 1000- gallon septic tank per code and install a new 1250-gallon tank in the same location to serve the existing 4-bedroom house. The adjacent lots are served by private water. There is no surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 868-3791 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting,Inc. Kenneth M. 11 f .s, P.E. Attachments: On-Site Sewer Application 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736• PH(907)868-3791 • PAX(907)868-3793 WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN MOUNTAIN PARK ESTATES SUBDIVISION No2 L22 B3 N89'56'06"W 183.06' (183.00' R) 30' N DECOMMISSION EXISTING 5.T.t rn INSTALL NEW 1250-GAL IN •A `D. THE SAME LOCATION S.T. W/ POST TANK COs & CONNECT 10.2' 'X---� i.►. Z TO EXISTING SYST. 23.0' X iauIt O Z �.zr„� 0 0 R ,1 a • CSI -. co,CO CO w i\ LX2 -P: q. CO '-10' N DECK B.3' c'i • CTI Ori FCO �r� PP & s ' 4 3.0' 3.151 • oo = x - t- � 0- o • Al. 5 OT au) — 1s,2• co _ N w i xi �1 i To ®F w 39.4' I • . MT No N W a 37.0' . . - —. - N89'47'41"W 182. ' (N89'56'06' W 183.00' R) (q i FLAG PROPERTY LINES so:1(El 1'= 30' WELL RADII & EASEMENTS PAGE 1 OF 1 PRIOR TO CONSTRUCTION iNO PUBLIC WELLS WITHIN 200' CF DESIGN DETAILS PROPOSED SYSTEM. 2O0' OF o PR PPOSEDTE SY T EXCEPTYELLSNAS NOTED. 1. INSTALL NEW 1250 GAL S.T. & INSULATE TANK IF <4' COVER. O NO SEPTIC SYSTEMS WITHIN 200' OF .� PROPOSED WELL EXCEPT AS NOTED, INSTALL POST TANK & FOUNDATION CLEANOUTS. 4 3, CONTRACTOR WILL ENSURE MINIMUM 27. SLOPE INT❑ SEPTIC TANK, 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS EASEMENTS, PROPERTY LINES, ETC.,. F � Az \ R . PREPARED F❑ g.CTEi �� ' + RICHARD M. SCHR❑ADER . �� ..... -* .�7 12841 FOSTER ROAD �()•t'(1.114 iiA� kr a *'A, L 11 ”" *y ANCHORAGE, AK 99516 �� /` 907-223-7394 0. FlELD BOOKS COMPUTDD: Z I X • tH �, i, 1-. S i 11 k. C: •' , BOUNDARY:N/A DRAMN: BMW RM• ti.R.,1 N { y . 4zc ,• . sTAMMN/A CHECKED: KMD , .� % j ` mow I ,/ cY� Z/' I� AS ULT: SLS DATE: 6/27/2018 .`' p E 1 • �. \ Fis3I0*� DWG.FILE: Cap' 2839 cqE coy l�yG`�11 E \v`�� ACAD FILE ao9 Na .ALF,,' LILTING •,36 FILE 18-141 AK.99571 (~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ' ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE / I~NEW MAI LING ADDRESS LEGAL DESCRIPTION '-- ~m ~ LOCATION i NO, OF BEDROOMS ~' DISTANCE TO: IWell ~O / Absorption area Dwelling PERMIT~oq ~ ~ Manufacturer ~¢~ Mat~a~[ [ No. of compartments kiq. c~ci~allons IF HOMfi~DE: Inside lenflth ~idth LiquiO Oepth ~ ~ DISTA~C[ TO: Well D~ellinfl P[~MIT ~0. 0 ~ ~ Manu[acturer Material Liquid capaciW in ~allons ~ ~ell Foundation ~earest lot lin~ ~[8~11 ~0. ~ ~ ~ No. of lines Le gt or.ch line Total length of lines Trenc Distance between lines ~ ~ ~ inches ~ ~ Top of tile to finish grade Material beneath tile ~' Total effective~ti~area ~ inches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well I Budding foundatmn Nearest lot line ¢ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(si OTHER PIPE MATERIALS INSTALLER ~'¢ ~ ~ REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) PE.~?i t T NO. FIF'F'L I CFtN T L. O C P, T I C N T l ."1 STE[..IFhr4.:T l: DNST E 4:2Ei I,I ILL 'I NFt!4 FIJ,.,'E. F'i'E TER [:,F..L L, 22 E:3: H"r. F'RRK ESTFt'f'E$ S,..'D L. OT SIZE 'T'T'F'E' OF SE~ I L F!BSORF'T I ON S"r'E;TEH 'J: S: TRENCH 3 32:-:E:E;E:4, 'I.6E~E~E9 'Hr:;C!URF.:E FEET PtRXZP1.H Nt MEF2F.' OF E:EDRCff.'FIS = ~$ SOIL RFiTING ':5.:.'! FT,-."BR::,= '!FJ5 THF-' ..... RECK IE'FE, SiZE OF THE L--,.,O:[L F,.':iBSZF..PF_JN~ ~. ' ~r . :B'¢STEH IRE;: TNE L_EN(3TN E:,iHENSION IS TNE LENGTH ,::IN FEET) OF THE TRENCH OR DRRtNFIELD. THE DEF'TH OF R TRENCH OR F'IT IS THE DZSTRNCE 8ETF!EEN THE SI..IRFRCE OF THE GROUND RND THE BOTTOM OF THE EXCB',,,'RTZON (IN FEET). THERE !S NO SET NIDTH FOR TRENCHES. THE GRRVEL. DEPTH ZS THE HINIHUH D, EPTFf OF GRW,,,'EL BETktEEN THE OLFf'FRLL. PIPE RND THE BOTTOH OF:' THE EXCRVRT!ON (IN FEET). BRCKFiLLING OF FIN'¢ '_:;'.r"STEH NZTHD_T FZNR. L INSF'EZTI'-.'.~. RND RPF'F, tO',,,'RL E,'¢ THIS DEF'RF."THE':HT t.,-!~.LL E-'E SLBJECT T_- PROSECUTION. MIN!MI..IH DISTRNCE BET[qEEh! R F!E!._L RND RN"? ON-.SITE SENRGE DISPOSRL 'L::'¢S]"EM i25 · _I_E~E~ FEET FOR R PRIVRTE ~%~EL.L OR :tSEl TO RE,.E1 FEET FROH R PUBLIC 14ELL DEF'ENDING LIPON TNE T'.?PE OF PUBL.!C [,.!ELL HINIMUH DiS'!'RNCE FROH R F'RI',,,'RTE HELL TO FI PRI'--,,'R]"E SEi4ER LINE IS 25 FEET RND TO R COHP'!UNIT'¢ SENEF.! LINE IS 75 FEET. O]"HEF.: RE&]UIREHENTS HFtL?' RPPL.'¢. SF'ECIFICRT!ONE; RND CONSTRUCTION DIRGRRHS RRE R',,,'RILRBL. E TO INE;UF..'E PROPER INE;TRLLRTION. ~'- c:_F-~:.]-1% T' E::_: >-C ~:- :E F:EE':-:; E:,EE~:Z:EEE-1E;EF..: -_E-: ::L .., ! CERTIF'¢ THRT :t: I RH FF!HIL_TRR NiTH ]"HE REQUIREHENTS FOR ON-.SITE '_=;.,EklEF.'.S RND klELLS RE; SET FOF-.!TH B"r' THE HUNICiPRL!'T'-? OF RNE::.~4ORRGE. 2: ! !,.!ILL. !NSTRLL TFIE S'¢:"¥TEH iN RCCORDFfNCE 1.4ITH THE CODES. 3: I UNDER:.r:.;TRND THRT THE ON-SITE SEklER S"r'E;TEH HR"r' RELqLliRE ENLRRGEHE:NI' If:' THE: RESIDENCE IS REHODELED TO INCLUDE HORE THRN 4 BEE"ROOf'iS. S I GNED' _._.~~ .................................. RF'PL I CRNT TOM STE!4RF.:T ': MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST E~"'~O ILS LOG~ ~,.-. ...... ~ '~"'~PE RCO LATI ON TEST L-,'~ LEGAL DESCRIPTION: ~(-' ~ ' t SITE PLAN 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER S ENCOUNTERED? .... Y L O IF YES, ATWHAT E DEPTH? J k\ ~'T' Gross Net :~ Depth to Net Reading Date Time Time ~';, Water Drop ? ^'~ / ,TEST RUN BY:'' ': ~- ' PERCOLATION RATE BETWEEN 72-008 (6/79) i. This well is producing _~allons of water per hour. s.~, ~ox ~, ~OG~D ~. PALM~R, ALASKA 99645 [ Set pump ~:~ feet. CASIN FORMATION APPLV--'NT FILLS OUT UPPER HA''~''~ ONLY ..,~..~ . ~"~- Phone Address "' ~ Zip Code . ~ Phone Address Zip Code Type of Resi~nce ~. Single .mily Multiple Family No. of Bedroo~ ~ Other ..... Water Supply / ~ Individual ~ ~ ~ A~ACH WE~L LOG. A w~l log is required for all wells drilled since June 1975. ~ Community , / ~ .: ~; ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Disposal Individual Year Individual Installed: Public ~ility When Connected to Public ~ti~it~ ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector MuJ ,IICIPALITY OF AN'CHORAGE Field Notes: t J DFPT @~ HE"LT'J P-. S E P ~ G 1982 RECEIVED ( ) CONDITIONAL APPROVAL' Soils Rating Date ~wer installed Well To Absorption Area Well Log Received ~,.9 Septic ,~k Size 72-023 (3182) MU W C � P A U GI L'l ® l! ANCHORAGE Development Services Department f Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 017-022-34 iwewkI4�_10Vlize7N►�_r#[6P►I Expiration Date: QLT I , 1� D � I Complete legal description MOUNTAIN PARK ESTATES #2 BLOCK 3, LOT 22 Location (site address) 12841 FOSTER ROAD, ANCHORAGE, AK 99516 Current property owner(s) AMANDA FISHER Mailing address Real estate agent Day phone FOSTER ROAD, ANCHORAGE, AK 99516 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: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment 6,11 r] 90 �2 1 Receipt Number TD 7 1 g y Waiver Fee $ Date of Payment Receipt Number COSA # 03CZ-1 133 1 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWH . 6. DSD SIGNATURE System #1 Approved for A— bedrooms System #2 Approved for bedrooms Disapproved Date 6/1512021 o �• z • • ' Curtis Huffman CE 128991••4�c` A OF ss N��ti��" 0- Conditional approval for bedrooms, with the following stipulations: . .11 '0o 11 U, -Y-7-, ri `S ON -SIT -E WATER AND m^ By: 116u,rj0vz,1ze0 Original Certificate Date: 7 42 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 Checklist Legal Description: MOUNTAIN PARK ESTATES #2 BLOCK 3, LOT 22 Parcel ID: 017-022-34 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 8/27/1981 Total depth 310 ft Cased to 81 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 6/3/2021 Static water level at beginning of test 38 ft. Well production at time of test 1+ gpm Water storage tank volume 500 gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.802 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample 6/14/2021 Comments WATER RECOVERY MEASURED ACOUSTICALLY IN CASING INDICATES 1++ GPM. WATER SAMPLE TAKEN AT SPIGOT. B. TANK DATA Age of tank(s) 3 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49” Standpipes/foundation cleanout per record drawing Date of pumping 6/3/2021 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/21/1981 ALL standpipes present per record drawing Total measured depth from grade 8.4 ft (max) Measured depth to pipe invert from grade 5.7 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 6/3/2021 Results Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 900 gal New depth 6 in Elapsed time 1400 min Final fluid depth 0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: MT PIPE CLEARED OF DEBRIS – 2’ED MEASUREABLE. The field has been partially under the driveway since installed in 1981 with no know issues and many changes in ownership. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S 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. 6/25/21 y678910 MUNICIPALITY OF ANCHORAGE, �Awe, ., { *.,_a la MAR 2 6 2019 Development Services Department `' P 7Z7-343-7z904 On-Site Water & Wastewater Section • 7-33399% O1 6 8 L 3c Certificate of On-Site Systems Approval Parcel I.D. 017-022-34 Expiration Date: b 1. GENERAL INFORMATION Complete legal description Mountain Park Estates #2 Block 3 Lot 22 Location (site address) 12841 Foster Road, Anchorage, AK 99516 Current property owner(s) Jaime & Travis Mason Day phone 208-631-8245 Mailing address 12841 Foster Road, Anchorage, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Ix I Private Septic Water Storage I I Holding Tank ❑ Community Well ❑ Community I—I Public Water System I I Public Sewer I I Waiver request for: Distance: Received by: Date: COSA to be released to the engineer. unless otherwise requested by the engineer. COSA Fee $ 556 Waiver Fee $ Date of Payment 3/a7119 Date of Payment Receipt Number OC96/55D Receipt Number COSA# 66c lq 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/20/19 .roolor911q41R! w d 49th N". 6. DSD SIGNATURE :T �: :. - ' �'..»., • r/" System #1 Approved for bedrooms 1.11CHAEL E. ANDERSON r II/ �\ No. cE-43a1 System#2 Approved for bedrooms • -f,o N/20/19 .csc :�f$'.• .410 Disapproved . Ma440 a.�� Conditional approval for bedrooms, with the following stipulations: JLVI iv 7 L S� O Oeqa /OpA�r rc S� Original Certificate Date: . " 2 ?-I? 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 Checklist blue sheet • COSA Checklist Legal Description: Mountain Park Estates#2 Block 3 Lot 22 Parcel ID: 017-022-34 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Well production at time of test .29 gpm Date drilled 8/27/81 Water storage tank volume 500 gallons Total depth 310 ft Well disinfected for coliform test? ❑ Yes ❑� No Cased to 81 ft 0 Coliform bacteria is Negative Sanitary seal is functioning correctly Nitrate mg/L 0 Nitrate less than MRL(ND) 0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND) Casing height(above ground) 24 in. Collected by Forge Engineering Date of flow test for COSA 4/23/18 Date of Sample 3/11/19 Static water level at beginning of test 98 ft. Comments Well flow rate taken from previous COSA done 4/23/2018 done by Arcterra B. TANK DATA C. LIFT STATION Age of tank(s) <1 years ❑ Required maintenance completed Tank type/material $'ist"' � Age of lift station years /Q Measured operating fluid level in septic tank l _ Lift station material DI Standpipes/foundation cleanout per record drawing Comments: Date of pumping New tank<1 yr old D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 9/21/81 Adequacy test date 3/13/19 0 ALL standpipes present per record drawing Results ❑Pass For 4 bedrooms Total measured depth from grade 7 ft (max) Fluid depth prior to test 1 in Measured depth to pipe invert from grade 5.8 ft(min) Water added 728 gal ❑ N/A—pressurized field New depth 11 in ❑ Monitor tubes go to bottom of effective. If not, state 1440 depth into effective 1.2 Elapsed time min [' Code-required soil cover over field Final fluid depth 3 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) None date of test) If yes, enter date Gallons introduced _gallons Com ments/Deficiencies: COSA Checklist yellow sheet • E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft 9 Yes if No ft Neighboring Tank> 100' 9 Yes if No ft Private Sewer/Septic Line >25' I Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' p✓ Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 9 Yes if No ft Surface Water> 100' 9 Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' El Yes if No ft Community Wells> 200' 0 Yes if No ft Water Service Line > 10' 9 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' 9 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' ✓l Yes if No ft Private Wells > 100' 9 Yes if No ft Water Service Line > 10' ElYes if No ft Community Wells >200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS ff �/ f G. ENGINEER'S CERTIFICATION 40►.44.7 /� + .... a�."'w:. ,�.. • •. 11'.. .1 I certify that I have determined through field inspections and review AT �,•• �1,.- • of Municipal records that the above systems are in conformance with I .11 4/ 49th 1\ MOA COSA guidelines in effect on this date. /. i. . 111111111111/111••• .� j l/.....%aN.U.....uO..aaofaOuaa 1aMaa:.3 h WO MICHAEL E. ANDERSON i.7;a ♦ , . �v Ar C.�1111. No. CE—4381 .��.••c_� � • .s•.• 3!20/19 .• � COSA Checklist yellow sheet • eo •,p•*,"�a11""•aaa� P*' 41 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • r (" "i2 907-343-7904 On-Site Water and Wastewater Section � j Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # OSC191086 Subdivision: Mountain Park Estates #2, Block: 3, Lot: 22 This well's productivity was determined to be .29 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4-bedroom residence is .41 gallons per minute or 150 gallons per day per bedroom. The production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org • •-,:� 01",, Pa \ ' Municipality of Anchorage ° On-Site Water and Wastewater Program 4- e1 (907) 343-7904 5A ETY CERTIFICATE OF ON—SITE SYSTEMS APPROVAL Parcel I.D. 017-022-34 Expiration Date: I © --O- 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK ESTATES#2 BLOCK 3,LOT 22 Location (site address) 12841 FOSTER ROAD,.ANCHORAGE,AK 99516 Current Property owner(s) RICHARD M.SCHROEDER Day phone • Mailing address 12841 FOSTER ROAD,ANCHORAGE,AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class_Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: ' Received by: iad,flyit-ea/ Date: 7"�l0 —1 camAto be releasedtct the engineer,unless oty the.engineer... COSA Fee $ 5 L Waiver Fee $ . Date of Payment `2 ( ( Date of Payment Receipt Number OS' .5-2g 1J Receipt Number COSA# OS C (�( Z (( 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 6/20/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. 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 thefamily 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 ... .4..:`►-\ encroachments,deficiencies or discrepancies exist. • .‹ OF ��1 Air '* 49TH " * f 6. DSD SIGNATURE Aligrfa System#1 Approved for q . bedrooms. • + -P Ken W. 11 , .. „, System#2 Approved for bedrooms. 3, �16 i Disapproved. 1 u\ -..Fsss o N'' Conditional approval for bedrooms, with the following stipulations: . \\\y OF ANL jyC, R P = NIAlE Is- • ` OGP cpR ./W,-,t0-1-C By: �••----,(.--- , Original Certificate Date: 7-2- �- L 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•erf ineer 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 . ._ x - Septic System Advisory Arsenic Advisory Welt Flow Advisory ? Other . • • • COSA blue'sheet_10-10•12.doc 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: MOUNTAIN PARK ESTATES#2 BLOCK 3, LOT 22 Parcel ID: 017.022.34 A. WELL DATA Well type PRVT If A, B, or C provide PWSID#—_ Well Log (Y/N) Y Date completed 08/2711981 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 310 ft. Cased to 81 ft. Casing height(above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8/27/1981 4/23/2018 Static water level -- ft. 98 ft. Well production -- g.p.m. 0.29 g.p.m. WATER SAMPLE RESULTS: Coliform ,V colonies/100 mL Nitrate / • L(3 mg/L Arsenic: N p ug/L Date of sample: 6/19/2018 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed-9221t1§81 7-14- t' Tank size 1250 gal. 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 4/23/2018 Pumper ONE STOP C. ABSORPTION FIELD DATA Date installed 9/21/1981 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 System type SHALLOW TRENCH Length 70 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 7.25 ft. (Measured 4/2318) Eff. absorption area 500 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10.19-16 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption.field before test 0 in. Water added 600 gal. New depth 4 in. Elapsed Time: 1230 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation.t vejatrent(past 12 mo.) (Y/N &type) N 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 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 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 stotage 10'+ Curtain drain 50'+(NONE KNOWN)_ Wells on adjacent lots 100'+ F. COMMENTS • 500-GALLON WATER STORAGE. Steel tank is past average life expectancy. G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance -41..._ with MOA COSA guidelines in effect on this date. � OF ALS 1 !A Engineer's Printed Name KENNETH M.DUFFUS A,� � T Date 6120/2018 ,r ! H i , COSA canary sheet_2-6-15.doc / KENNETH M. te,v, kAir • s 1DR MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • •0_,tj `t 907-343-7904 On-Site Water and Wastewater Section / Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # OSC181284 Subdivision: Mountain Park Estates #2, Block: 3, Lot: 22 This well's productivity was determined to be .29 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4-bedroom residence is .41 gallons per minute or 150 gallons per day per bedroom. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org ---"Elf4 I' LOT 3 N00'20'24"E 109.93' ® (N00'03'45"W 110.00' R) X x—x—x vU ILITIc EA MEI T x x x x—x—x—x—x F x x I x x I b I �x____T WELL X to 14.2' 0 I 26.9' 5-5SHE° 1 LOT 22 � O Co H BLK 3 Doo N w 10.3' E"{ o 0 '— ` 0 4.0. 18.0' tF O DECK ' 19. 13.2' " 3' ��N U7 0 11� CO . 00 O, Z 00 32.8 'i133' z x-x-x o "' . a 0) N EXISTING g 00HOUSE Z 24.4' 9.7 0 23.p• �-,� 32.7• • N 20.2' COVERED ENTRY SEPTIC • VENTSCONCRETE (T�) i DEW • (i}� - N00'10'10"E 109.48' (N00'03'45"W 110.00' R) 0 to FOSTER ROAD 0 N) I ANCHORAGE RECORDING DISTRICT,ALASKA AS-BUILT OF: MOUNTAIN PARK ESTATES SUBD NO 2 O =FND 5/8"REBAR LOT 22 BLK 3 PLAT P-561 `__`\\\\ SURVEY CERTIFICATE:I,John L.Schuller,Have conducted a 'gill'. OF A��� y�' LANDR-•k physical survey of this property as shown on this drawing and that the / • •.� 11 4• ti0 p f improvements situated hereon are within the property lines and no /Of c�.' ` ' *.t,'# y4c�� �n�✓� enchroachments exist other than noted.Under no circumstance should 0 .• 49TH i\ ,� a �0 anyinformation on this drawingbe used for construction of fences, CI structures,improvements,or for stablishing boundary lines. x a . r EXCLUSION NOTES:It is the owners responsibility to determine I , ../ •, OHN L. SCHULLER: °/ 1 ' •1 the existence of any easements,covenants,or restrictions which /s LS-10408 1,c,./ • •....„....,..-- do not appear on the recorded subdivision plat. �� .• AO 1831 Talkeetna Street WORK ORDER NUMBER: DArM SCAM E-u�u 1411%o .••Z'Id'it• a`'�� Anchorage, Alaska 99508 18-040 DRAM SY:CHECKED Br GRID HAMM BOOK/PAM \A\t°Zession0\ .'• ? (907) 227-1455 office JLS SW2839 180170 '\\\272 (907) 274-4992 fax 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DVVELLING Parcel I.D. 017-022-34 = GENE~L INFORMATION Complete legal description COSA# I~)j~ ~_.-'/.f~ / '~-q Expiration Date: MOUNTAIN PARK ESTATES #2 BLOCK 3, LOT 22 Location (site address) 12841 FOSTER ROAD, ANCHORAGE, AK 99516 Current Property owner(s) |OHN ALFRED CAFMEYER Day phone Mailing address 7200 STAMPS CIRCLE, ANCHORAGE, AK 99507 Lending agency Day phone Mailing address Real Estate Agent THE RAMSEY TEAM Day phone 261-7552 Mailing Address 3111 C STREET STE. 100, ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class __ Well Public Water System TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [~ [] Individual Holding Tank [--] [] Community On-site E~ [] Public Sewer k-'-] 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 (ara) 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(ara) 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 868-3792 Address 20441 PTARMIGAN BLVD.e EAGLE RIVER~ AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 11/05/2010 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 ara 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. bedrooms. DSD SIGNATURE /-" Approved for '! Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (Rev. 11/05) Original Certificate Date:_ //-/o --/o Municipality of Anchorage Development . iceS Department Building Safety Division On-Site Water & Wastewater program 470'0 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MOUNTAIN PARK ESTATES #2 BLOCK 3f LOT.22 A. WELL DATA ~il tyPe V~AT~ ifA;'8,'; or'C provide ,PWS~D # Well: Log ~/N) ~ Date completed e8/'27/1981 SanitmY seal (Y/N) X Total depth 31e IL Cased to 81 It. FROM WELL LOG Date of test 8[27/81 ' Static water level na It. Well prOdUction na WATER SAMPLE RESULTS: Parcel ID: 017-022-34 Wires properly protected (Y/N) Y__ Casing height (above ground) 24 in. AT INSPECTION 1/2/2010 47 'It. g.p.m. * 0.44 g.p.m. Coliform NEC colonies/100mL Nitrate ** 20.5 mg/L Arsenic: ND .mg/I Date of sample: 10/29/10 Collected by: ArcTerra SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/21/3.981. Tank size 1250 gal. 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 9/15/10 Pumper A+ C. ABSORPTION FIELD DATA Date installed 9/21/$1 Soil rating (g.p.d./ff2 or ff2/bdrm) 125 System type Trench Length 70 ff. Width _5 ff. 'Gravel below pipe 2_~ff. Total depth 6_ ft. Depression over field N Results (Pass/Fail) Pass For 4 bedrooms in. Water added 1170 gal. NeW depth 4 in. in. Absorption rate >= 600+ g,P.d. Eft: absorption area 500ff2 Monitoring tube Y Date of adequacy test 11/02/2010 Fluid depth in absorption field before test __ Elapsed Time: 75 min. Final flUid depth __ Any rejuvenation treatment (past 12' mo.) (YIN & type) N__If yes, give date --- 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.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On-Site Systems Approval # 101291 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 22 of Mountain Park Estates #2 subdivision. This inspection revealed a nitrate concentration of 20.5 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. 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. ci. anchorage, ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # 101291 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 22 of Mountain Park Estates #2 subdivision, the well's productivity was determined to be 0.44 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 4-bedroom residence is 0.42 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Ref.# 1105848001 Client Name ArcTerra Engineering and Surveying Printed Date/Time 11/05/2010 8:17 Project Name/# Mountain Park Est #2 B3,L22 Collected Date/Time 10/29/2010 13:40 Client Sample ID Mountain Park Est #2 B3,L22 Received Date/Time 10/29/2010 14:35 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 11/02/10 11/03/10 KDC Waters Department Total Nitrate/Nitrite-N 20.5 * 0.100 mg/L SM20 4500NO3-F B (<10) 10/29/10 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 10/29/10 DLC Total Coliform Negative 1 100mL SM20 9223B A 10/29/10 DLC Aarow Pump & Well Service LLC (907) 346-9355 Inspection Report Lot 22, Block 3 Mountain Park Estates #2 Well has perforations from 44'-47'. Perforations are dry at this point in time on 11/8/2010. No perforations above 40' were found. Brian R. Wille Aarow Pump & Well Service LLC MOUNTAIN PARK ESTATES/$2 BLOCK 3, LOT 22 - 500 GALLON WATER STORAGE LOT 3 26.9' NOO'20'24"E 109.93' (NOO'O3'45"W 110.00' 10' UTILITY EASEMENT LOT 22 BLK 3 SEP'nC · ~ I VENTS (T~) --~ · GRAVEL · D/W NOO"IO'IO"E 109.48' (NOO'OS'45"W 110.00' R) FOSTER ROAD RECORDING DISTRICT, ALASKA AS-BUILT OF: MOUNTAIN PARK ESTATES SUBD NO 2 LOT 22 BLK 3 PLAT P-561 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Und~ no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. 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. WORK ORDER NUMBER: 0A'rE: JNOV 4, 2010 J 1"=30' I kndeng~k, net 1 O-- 0 71 I~ I IJ's / 2~3g I 100364 1~ = FND 5/8" REBAR LAND 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office. (907) 274-4992 fax'