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Home My WebLink AboutNORTH SLOPE #1 BLK 3 LT 8 I ' Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-SiteWastewater Disposal System and/or Well Inspection Report Permit Number: ?,'~,~ ~3'000/ PID Number: O,ff(2-x'~'//'-l/ Name: , /_o ~/~ ~2/~/?~5 Wastewater System: ~ New D Upgrade Address: 30 '~ ~ ~ ~ ~. E~SZ¢ ~¢~x AK ~¢~'~ ABSORPTION FIELD Phone: ~¢~¢¢~ No. of~drooms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other LE GAL D ES C R I PTI O N soi~ Rating:~, ~ GPD/Sq. Ft. Total Depth fr~ ~riginai grade: ~ Subdiv~ion: Depth to pips boffom from original grade: Gravel depth beneath pipe Township: Range: Section: Fill added above origi0ai grade: Gravel length: WELL: ~ New ~ Upgrade Gravel width: Number of lines: lDistance baleen lines: Classification~/~-(Private' A,B,C): Total/~Depth: Ft. Cased/~/To: Ft. Total absorption. ~oarea: ~SQ. Ft. Pipe~.~material:~O~ Driller: Date Drilled: Static Water Level: I~staller: Date installed~_ Yield: Pump Set at: Casing Height Above Ground: ~ GPM ~(~2/0 ~ ~ Ft. ~ Ft. TANK SEPARATION DISTANCES Ss~pt~c u Holding D S.T.E.P. To Septic Absorption Lift Holding Public/PrivateManufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines , ~/~c~ O~a ?~ ~A~ / Material: Number of Compa~ments: we~ /~ /o~F ~ '~ ~j ~ s~Cg~ Sudace w~e~ /0~ ~ / ~0 ~ ~ ~~LIFT STATION LineL°t ~ / ~ / ~ ~ Size in gallons: Manufact~~ Remarks: ~ ~v,~ ~.w~P BENCH MARK ~oc..o..n~c~..on: ~g~ ~ ~ ~,'d,~q ~ "~". I Assumed Elevation: ENGINe'S SEAL ........ Inspections pedormed by: t ~ !~1'~!~ Da~s: ~st &-g - ~~~--' ........ Department of Healt~ and Hu~an~e~ices approval '~2~, ~eviewed and approved by: Date: ~ ~- ~ "~.~.'?'~'<"~ ~ ~ ~ 72-013 (Rev. 9191) MOA 25 P~.~ No. SW98000 ~ P,G~ 2 OF 5 , M_un_i_.cip.o,_.Li~y_o.-F' Anchor'ac~e DEPARTMEN/ Ol- HI-AL/H AND HUNTAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ~.~Anchoro~ge, Ato. sko. 99519-6650 · Tetephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOT 8, BLOCK 3, NORTH SLOPE #1 P.I.D. No. 050-511-11 LOT 9 NEW & TH \ \ \ \\ \\ DBL3 -INSULATION WELL NEW 1000 GAL. SEPTIC TANK-- SCAL]~ 1' = 40' LOT 8 LOT ROBERT C. CE -880l PERMIT NO. SW980001 PAGe. .~ OF ~ · M_.uQi~ip..~iC.y_o.f' AnchoeaQe DEPARTMENI uh HIzAL/H AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.B. Box 196650 eAnchorage, Atask~ 99519-6650eTetephone. 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEH AND/OR WELL INSPECTION REPORT ~.EOAL LOT 8, BLOCK 3, NORTH SLOPE P.I.D. NO. 050-511-11 A B FCO 22.5' 2.0' 201 44.0' 49.5' DBL1 57.0' 60.5' 3BL2 59.0' 62.0' ST1 61.0' 65.5' ST2 67.0' 69.5' DBL5 69.0' 72.0' DBL4 70.5' 75.5' C02 68.5' 65.5' MT1 72,5' 70,0' C03 121,0' 125.0' MT2 118,5' 121.0' ST1 ST2 MT1 = 84.9'_. MTZ = 84.8' MT1 C02 MT2 C03 CO~ = C03 = 92.8' C02 = 89.1' C03 = 89.1' · NO WATER FOUND 78.8' B.O.H. by SULLIVAN WELLS P,O. BOX 670272, CHUGtAK; ALASKA 99567 · I'ELEPHONE ,--"" BORE HOLE DATA OWNER OF LAND __..,~3 .~ 7t,,=4~, ~ ~,,4,~, ........ DEPTH ADDRESS I,.EGAL DESCRIPTION pERMIT ~UMBER_.?~OJ3D_!. Date of IssueJ_~.- '~ ~' ~0~_ TAX'INDENTIFICATION NUMBER ~ ~ ~ I I .: ........ IS W~ll. Io~ated at approved permit location? ~ ~ No Me[hod Qf Drilling: ~ota~ ~ ca'ble t00[ Depth of well: C~s~ng Type ~E Q Wall Thicknes~., ~ ~O _inches Diameter_ ~ inches, depth~ ~ feet Ca~ing Stickup Above Ground: ~ feet 8.tati¢ Water Level (from ground level): ~~ feet Pumping level: ...... ~eet afle~hm, pumping ~gpm Recover Rate: ~gpm Method of Test rig: ..... ~..I We~l intake Opening Type: ~End O Open Hole ~.'Screened; Sta~ feet. Stopped ........ ~eet ~ Perforations Sta~ ~~ Stopped feet Depth: from~ ~ .feet, to ~ feet Pump Intake Depth: Pump Size~ hp Brand Name Wel~Disinfected Upon Completion? ~ ~ No CO~3rhents; :Z Driller's Name ,/.~?~.~/.~ ' '...' ... A~711EN.T ON: It is the responsibility of the property owner to submit a copy of the well log to the pmpe~ authod~, MuN~',ipality :ol~;Anc.,horage Department of Health & Human Service3 and/or Department of Environmental conseNati(~n. MatSu B0rotJ~gh:' D~l~ar{rn~nt of Envlronmentai Conservation, ' ? -.. · :.'..!:. ..... :. ' Rick Mystrom, Mayor Mmdcipal ity of Anchor e Department of Health and Human Services 825 'L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us August 10, 1998 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 8 Block 3 North Slope #1 Waiver Request #WR980038, PID #050-511-11, HA980188 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 5 feet f~om the leachfield to the northwest property line. ~ ~. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site-- wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljw #7 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR#105Qq~f~'~ '~ PID~ 050-511-11 HA~ ~Q~/~/~ Date Received: July 20, 1998 Legal Description: Lot 8 Block 3 North Slope #1 Engineer: Robert C. Cowan, P.E., S & S Engineering Permit ~ SW980001 17034 Eagle River Loop Road, Suite 204, Eagle River, Alaska 99577 Applicant: Lorie Dzingle Waiver Requested: Lot line waiver of 5 feet from the leachfield to the NW property line. Criteria: 1. Geology: Points: A. Water Table Bo Soil Sorption C. Permeability ~ D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: Rec #: 03785/ Amount: $ 115.00 Name of Reviewer Date Paid: July 20, 1998 HEALTH AUT HORI'D/ APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. MUNICIPALITY OF ANCHORAGE Depamuent of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 July 16, 1998 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 i ECEIVED JUL 20 1998 MUNICIPALITY DP ANCHORAGE ~-NVIRONMENTAL SERVICES DIVISION REFERENCE: Lot 8; Block 3; Northslope S/D #1 Request you issue a Health Authoriq, Approval on the referenced property and grant a"for the horizontal separation distance between the leachfield and the property line at 5 feet. We do not anticipate any adverse effect on the adjacent property. The adjacent property is undeveloped. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jsf 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980001 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DISOTELL CARL A OWNER ADDRESS:PO BOX 770210 PARCEL ID:05051111 DATE ISSUED: 1/07/98 EXPIRATION DATE: 1/07/9~ LEGAL DESCRIPTION: NORTH SLOPE #1 BLK 3 LT 8 LOT SIZE: 43260 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT} 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: ROBERT C. COWAN, P.E. HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN $OILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTE*WATER DISPOSAL SYSTEM DESIGN December 23, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 8, Block 3, Northslope S/D #1 Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no groundwater was encountered and after seven day groundwater monitoring, the monitoring tube was found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. There are no points of contamination within the proposed well radius which can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jm Enclosure ' v'IRONMENTAL SE~VI(ZI~$ DIVI$IO~ RECEIVED 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 '.~1" = 60' SCALE I SITE PLAN I DESIGN I ~zmm~ ~ II ~ ~ 0 ~ ~' 0 0 0 L~0 F 0~0 z~ z~ ~ 0~ ~z~ ~om~ z '-~ z~ ZO ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: '~-,,, ~. 0 LEGAL DESCRIPTION: t 'Township, Range, Section: 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18- 19- 20- COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES. AT WHAT ~ O DEPTH? p E Depth to Water Alter jl,d v Monitoring? ~'-/ Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAME%ER __ FT AND ~ FT :;' '.. PERFORMED BY: ]~-~.~ ~.~1(:~,v~, ................... ~u~. st.au ,.~..~tl . .. , CERTIFY THAT T~IS TE~T WAS PERFORMED ACCORDANCE Wl~a[~ ~E~~AL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVALS ~'~VER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE W.~STEWATER DISPOSAL SYSTEM DESIGN ROBERT C. COWAN, P.E. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 8, Block 3, Northslope S/D #1 December 23, 1997 GENERAL: The scope of this project includes the installation of a 1000 gallon septic tank and a five foot wide drainfield to serve the proposed three bedroom residence for the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 8, Block 3, Northslope S/D #1 December 23, 1997 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These 'cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away fi:om the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the £mal gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Lot 8, Block 3, Northslope S/D #1 December 23, 1997 The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast kon Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Page Four Lot 8, Block 3, Northslope S/D #1 December 23, 1997 Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sm~d filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER MUWCPAUTYQ F (0 �{ Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 050-511-11 Expiration Date: -/ —3 C) �Z I 1. GENERAL INFORMATION Complete legal description NORTH SLOPE #1 BLOCK 3, LOT 8 Location (site address) 30736 KUPARUK AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) MCKENZIE SELLMAN & RICHARD ALEXANDER Day phone Mailing address 30736 KUPARUK AVENUE, EAGLE RIVER, AK 99577 Real estate agent 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: 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 $ JT S Waiver Fee $ Date of Payment 0-71 Date of Payment Receipt Number Bod �o J Receipt Number COSA # 0�21 133'-I 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 Date 6/16/2021 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 g�Q: • • • . :1,9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWN ' * . TM .....•. . ..1�.�... ... V�.~.'. . 6. DSD SIGNATURE Curtis Huffman / System #1 Approved for 3 bedrooms r��Fc�sf . .CE 128991 FQ F/16/21 System #2 Approved for bedrooms \\\"�F�PROFESSIONA1� Disapproved Conditional approval for bedrooms, with the following stipul; iV1,R'(((((((q(( OF,q�yc((i � A! -SITE _ WATER AND WAS -V\, 0 PR9rRAM ,c �SEFN !�►�, —e—tl Original Certificate Date: C5, -S d — 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 Advisor Well Flow Advisory Other S`i$2 tk- P l dviS; Legal Description: NORTH SLOPE #1 BLOCK 3 LOT 8 Parcel ID: 050-511-11 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 6/18/1998 Total depth 122 ft Cased to 121 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 6/7/2021 Static water level at beginning of test 73 ft. Well production at time of test 3.9+ gpm Comments B. TANK DATA Age of tank(s) 23 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 6/7/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/4/1998 ® ALL standpipes present per record drawing* Total measured depth from grade 8.3 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 0.726 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FG1'E Date of Sample 6/7/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 6/7/2021 Results 2 Pass For 3 bedrooms Fluid depth prior to test 31 in Water added 470 gal New depth 38 in Elapsed time 1410 min ® Code -required soil cover over field Final fluid depth 31 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: Second int. CO between house/tank not found. Field operating in the top 1/3 of the 4' ED NES 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 Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS 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 with MOA COSA guidelines in effect on this date. .... ....t...... . Curtis Huffman �� FFG' •. CE 128991 .• c'w4,®' • x6125/21. •'��,d F�pROFEWONP� ft ft ft ft ft ft ft ft Septic Tank Advisory Certificate of On -Site Systems Approval #OSC211334 Subdivision: North Slope #1 Block 3 Lot 8 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. S ` ; � Ma�lmg Address �P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org � MUNICIPALITY OF i5 (� Development Services Department On -Site Water & Wastewater Section Parcel I.D. 050-511-11 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: O —/ ( y Complete legal description NORTH SLOPE #1 BLOCK 3, LOT 8 Location (site address) 30736 KUPARUK AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) JAMES & CYNTHIA RUTH Day phone Mailing address 99577 Real estate agent PO BOX 110650, ANCHORAGE, AK 9951130736 KUPARUK AVENUE, EAGLE RIVER, AK 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: 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 $ 515,6/ Waiver Fee $ /� Date of Payment gla.gl ig Date of Payment Receipt Number Qq� 11 C) Receipt Number COSA # 6 5 C Ig / 1 231 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE, ANCHORAGE, AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 4/22/2019 i r*49TH " * 6. DSD' SIGNATURE ` X�/ System #1 Approved for .MICHAEL N. ANDERSON. bedrooms ` ��, No. CE 9489 System #2 Approved for bedrooms 4•/22/19•.. •� 40 Disapproved PSS1Ot9'ti i Ilk __41P. Conditional approval for bedrooms, with the following stipulations: OF ANA(r tyyO,//mss ON-SITE WATER AND --o z WASTEWATER o PROGRAM Jam' 0440, o By: J Original Certificate Date: S--1 _1 7 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: NORTH SLOPE#1 BLOCK 3, LOT 8 Parcel ID: 050-511-11 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) Well production at time of test 3.4+ gpm Date drilled 6/18/1998 Water storage tank volume NA gallons Total depth 122 ft Well disinfected for coliform test? ❑ Yes ® No Cased to 121 ft Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate 0.68 mg/L ❑ Nitrate less than MRL (ND) ® Wires are properly protected Arsenic ug/L 2 Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by FWCS Date of flow test for COSA 3/7/2019 Date of Sample 4/18/2019 Static water level at beginning of test 73 ft. Comments B. TANK DATA— 6/4/1998 - 1000-gal C. LIFT STATION -NA Age of tank(s) 21 years ❑ Required maintenance completed Tank type/material STEEL Age of lift station years Measured operating fluid level in septic tank 50 Lift station material ® Standpipes/foundation cleanout per record drawing Comments: Date of pumping 10/1/2018 D. ABSORPTION FIELD DATA—57'L x 5'W x 4'ED — 0.8 GPD/SF = 570 SF Which system tested (date installed) 6/4/1998 Adequacy test date 3/7/2019 ® *ALL standpipes present per record drawing Results El Pass For 3 bedrooms Total measured depth from grade 9 ft (max) Fluid depth prior to test 29 in Measured depth to pipe invert from grade 5 ft(min) Water added 480 gal ❑ N/A— pressurized field New depth 38 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 1400 min depth into effective ® Code-required soil cover over field Final fluid depth 29 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: Second intermediate CO between house and tank not found. System operating in the upper half of the 4' effective depth. COSA Checklist.docx 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' Z Yes if No ft Z Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' Z Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft Z Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® 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' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Absorption Field > 5' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below Surface Water> 100' ® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No * 5 ft Wells on Adjacent Lots: Water Main > 10' Z Yes if No ft Private Wells > 100' ® Yes if No _ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *1998 waiver field to lot line. Arr G. ENGINEER'S CERTIFICATION Ir ��.OF ` . I certify that 1 have determined through field inspections and review j\ .� TAof Municipal records that the above systems are in conformance ..,,-..4.9TH * •r with MOA COSA guidelines in effect on this date. / .4 • r MICHAEL N. ANDERSON: �i'r No. CE 9489 ....."410 j COSA Checklist.docx t 0 ••4/.22/19' e/ \ PESSIOTlt''' `__4°P DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC191123 Subdivision: North Slope #1 Block 3 Lot 8 907-343-7904 Fax: 343-7997 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. Mailing Address P O� Box 196650 *, Anchorage, Alaska 99519 6650 * www`mum`org Frontier Surveys, LLC Project No: 19-089 Date: 04/09/2019 Ordered By: Morgan Michelsohn Plat: 70-110 Grid: N/A Scale 1"=40' FocFOFfq��`\\w\ FiyFN cr $ / c o' L LOT ^° e ti I iso 'l.. N 0 r5: Lot 8, Block 3 cRA`F<A SHED North Slope Subdivision ATti Addition No. 1 43,260 Sq. Ft. +/- To 8..0 'ss ° 30736 Kuperuk Avenue o \ 3 Story Wood Frame House \ \ With Attached 2 Car Garage \ \ LOT 7 H \ 3g F Za .00 \ \ LOT \ \ \ \ \ Legend: y Electric Meter/Outside Power 10i Telephone Pole � � Tel. Ped. LOT 5 y Gas Meter ® Deck Fence E_j L Elec.Ped. ` ) Septic . W; Water-Well �� Satellite Dish —nu— Overhead Utility General Notes: 0 20 40 80 t. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. Scale In Feet 3. All measurements/setbacks are to the visuallapparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and �,yML QF Q conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the �P �'� {sI �j existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances Lj* *y-9� should this document be used for construction or for establishing a boundary or fence line. .w pTH #t *.r 47-- s* As-Built Survey of: ~#` Lot 8, Block 3 North Slope Subdivision Addn. No. 1 � i ♦Msi{♦moi N 4i W`1si� � Frederi<W. r O t ;a M L.S.-9946 ne `� �� I, Frederic Wagner, hereby certify that this Mortgage Inspection Survey was performed by me, or 4 9/2019 �� J�� under my direct supervision on April 4th, 2019. Frontier Surveys, LLC if FYINONTIM. fi#�f4f,;ffi��SSION4�f,� 650 W.58th A e. Suite E Anchorage, Alaska 99518 907.460.1686-info@frontiersurveys.com PROFESSIONAL SEAL www.frontiersurveys.com Division of 'Environmental Services 1. GENERAL INFORMATION Complete legal description On-Site Services Section P.O. Box 196650 --. Anchorage. Alaska :.99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Locatioa~(~S!f~i~88ress or directions) P¢olSertyoWher .. .\~ Mailing address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup· NUIVIBER OF DEDROOIVIS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE oF WASTEWATER DISPOSAL: Individual on-site Holding tank . Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 ~Rev. 1/91) Front MOA#21 5. STATEIgtENT OF INSPECTION BY ENGINEER As cer[ified by my seal affixed hereto and as of the validation date shown below, I veri.fy that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verifythat 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 ~n compliance with all Municipal and State codes, ordinances, and regulations n effect on the date of this inspection. S & $ ENGINEERING Name of Firm eli ' p-E A~ dress Eagle Eiver~ Alasl(a 99577 Engineer's signature ~'~/Z Phone Date )/! '7 ~/~'g' DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The MUnicipality of AnChorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the state of Alaska. The DHHS does this as a courtesyto purchasers of hemes and their lending institutions in order to satisfY Certain federal and State requ rements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The MuniciPality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICI~L 2 0 1998 Environmental Services Division ~,~[NtCfPALIT¥ OF ANCHORAGE 825 L Street, Room 502 · Anchorage, Alaska 99501~iv,{~)~/~!-~s DWlS[ON Health Authority Approval Checklist Legal Description: L~-~'- ~ i~,0D~;:¢ )x'J0PCJ"h~[z-2~ ~'J Parcel I.D.: A. WELL DATA Well type Log present, i) Total depth / ~-~-~/ Sanitary sea (~) ~',/(~ If A, B, or C, attach ADEC letter. ADEC water system humber ~z'~ Date completed ~ II ~ ~ / Cased to i '2~ ~ Casing height (above ground) ~'~ i~"~) Wires properly protected~N) L~ ~,~ FROM WELL LOG AT INSPECTION ,-.f+ ,, iB.> ~'~' g.p.m. .~ g.p.m. Date of test Static water level Well production WATER SAMPLE RESULTS: O. r~lO~ Other bacteria Number of Compartments ~-~ Cleanouts~/N) ~[~ ~1 ~) High water alarm (Y/~ f~ (D System type Gravel thickness below pipe , Total depth -E.70~ T(-'~.'~ Monitoring Tube present ("?/~J'q) ~i~;'~ Depression over field (Y~I~ J~' t'~ L,~J Results (Pass/Fail) ~ For '7'P)/.~- bedrooms Coliform O Nitrate Date of sample: ~/,-~)/~ .~ Collected by: B. SEPTIC/HOLDING,/,,,TAI~IK DATA Date installed ~/~:/"?~ Tank size Foundation cleanout ~) ~'~<-~ Depression (Y/~B Date of Pumpin~j': i .~'ii~(~ ' Pumper '~----' C. ABSORPTION FIELD DATA Datein~talled ~'1~'/~{' : Soilrating (g.p.d./fForfF/bdrm) (~,~ ,' / I _/ - Length ..' '~-~ Width ,/~ Effective absorption area Date of adequacy test Fluid depth in absorption field before test (in.); ~ Immediately after-~ gal. water added (in.): Fluid depth '~ (ins) Minutes later: '~ Absorption rate = --- - .g.p.d. If yes, give date Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* LIF Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons ~*Datum % Cycles tested E. SEPARATION DISTANCES "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot I L)~ / ~' Absorption field on lot I I'~fb Public sewer main Sewer/septic service line On adjacent lots 1 6o "~ On adjacent lots [ E) O ¢ ~ Public sewer manhole/cleanout ~//'~ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: ! Foundation ~ Property line 5 Absorption field Water main/service line i 0 Surface water/drainage tO0 Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line __¢ Building foundation I Water main/service line Surface water ¢ 00~ j¢ Driveway, parking/vehicle storage area Curtain drain r,) ¢¢J ¢7 ~ ~,)o~d Wells on adjacent lots ( ENGINEER'S CERTIFICATION HAA Fee $ Date of Payment Receipt Number I certify that I have determined thru field inspections and review of Municipal reco~stems 'ate in conformance with MOA IdAA auideli~es in effect on this date. 5' 4, .. Waiver $ Date of Payment '7~0/<~ C Receipt Number 0 ~ -'~C~ 72-026 (Rev. 3/96)*