Loading...
HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 15I I$ Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number- OSP221368 PID Number: 05173120000 Dwelling: K Single Family (SF) El with ADU n Duplex (D) n Two Single Family Project: n New nE Upgrade Name LIGGETT HERMAN ABSORPTION FIELD Deep Trench n Wide Trench n Bed n Mound Site Address 22649 MC MANUS DR El Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 406-9200 14 GPD1SF1 FL LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot NORTH WOODSBLK 4 LT 15 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds-, Number of Lines Distance between lines Ft. SEPARATION DISTANCES Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' FL Well + 100, na TANK N Septic 0 S.T.E.P. 0 Holding El Other Manufacturer GREER Capacity 1250 Gal. Surface Water 1, aterial Number of compartments Lot Line NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer Tankto PIPE MATERIAL House to tank D3034 drainfield D3034 Denali Excavating Drainfield C01MT D3034 InspectorNorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection im 10/28/22 10/28/22 Location and description L6� ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date 144 S, 4 9 UHL* AI CE—sm Ar Septic System Date JZ -J L7 22L Note: this approval does not include well permit requirements. I ,.~.~.~.I CL 0 a Va pq (Y) U) t!7 C) �f- ,d u C5 I I L -F' Ld ��0iN W cli o Q Nr W U >- I'll oiQe J pq p .-1 OJ p v�- �-v Q At)(11)A CL 0 a Va C) �f- u C5 I I L -F' I— O CL 0 a Va C) �f- M I I 4- lu cli o o Nr U >- I'll oiQe j 0, LO U O41 r I H N �ED WW ED 3 d- W In 3 q Li R f— U Q� 0 Q o3:Z F-1 ai z r� 3 \ do2 L7 c p c .. �.®awaaagM4 d Ut d pA� "iL1 CDf— Ut f— U i Q! CU_U E 0- _u p ! 3: a u a ff,,, • �,: zoQ0 � fy4q'�Smc. ` 00ZlW N W x O Nm J O Zw4itR �o � w �, y M O S U U � N N L L I— _ H L L In dS O p a 0 U Q ED o CL O Ld 3 d- _ V o E- - u --c- ED 1 ED `" z pq c m d o, W u I Q'I M H L, � o z caj o n u W C�- p d O LW O F' > C,N > W j Z N N Q � W W U F—I -P 0 n W z C3- � P N d O 01 O d ds��+gga c d L d p OL d �W'U iQ'' F-LLO W L F' o LLI 0- � ei IT 0 > .N -q 17 0 W LN O C5 QJ u t� V h 03 -.. m Z p N 0� ZWN 5 p �Z�`rn a m co LL- Z?ab FJN,CIPa1iJY0� MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite 9NCHORf•f'E On -Site Wastewater Disposal System Permit Permit Number: OSP221368 Effective Date Work Type: SepticTank Upgrade Tax Code Number: 05173120000 Site Legal Address: NORTH WOODS BLK 4 LT 15 G:1459 Site Mailing Address: 22649 MC MANUS DR, Chugiak Owner: LIGGETT HERMAN L & MARGARET K Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: c n t. "T""": ~ , llepartment 9/23/2022 Expiration Date: 9/23/2023 Lot Size in Sq Ft: 22015 Total Bedrooms: 4 ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • Locate field prior to install to ensure required tank to field separation. When field is located, we recommend installing a monitor tube/clean out so field location is known. • A Greer 1250 gallon plastic tank is not allowed to be buried deeper than V into groundwater. Received By: Issued By: 9/23/22 Date: Date: MUNICIPALITY OF AHCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05173120 Property owner(s) LEGGETT Mailing address 22649 MC MANUS DR Site address same Day phone 863-4484 Legal description (Sub'd., Block & Lot) NORTH WOODSBLK 4 LT 15 Legal description (Township, Range & Section) Lot Size 22,015 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Date of Payment: Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank El Upgrade (w/wo AD U) Holding Tank ❑ Renewal ❑ Duplex (D) E] Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: a&�5- ~ Waiver Fees: Date of Payment: q// a1a-? Date of Payment: Receipt Number: Q 214 qz Receipt Number: Permit No. 03i0,22 13&'8 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com North Woods B4 L15 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the seepage trench still functions. This lot is ½ acre and on public water. No adverse impacts are expected from tank replacement. Easements are present on the lot & depicted with dashed lines. The slope is indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  New 2- compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet.  5 minimum between the tank and trench. 5 to property lines & 10 to house.  4 of cover or insulation is required for tank; an equivalent of 1  insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil.  No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel.  4 diameter cleanouts with airtight caps are required 1  to 4 from foundation wall, prior to any 90 degree bend in 4 inch line, in 2 nd tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10  from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 st tank compartment.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Insulation must be placed over any pipe installed under driveways or parking areas.  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661,  Sewer Service Line is minimum 2% slope.  Septic Tank to be pumped every two years or when required.  Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221368, Curtis Townsend, 09/23/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221368, Curtis Townsend, 09/23/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221368, Curtis Townsend, 09/23/22 8504A Tract A 00 oma. Lot 16 Lot 1 O �S .o so 0boil* 000 Lot 15 �O 9� Wire fence (typ) 26 o o r\ o)' GO C00 a L r 1 a �� :� 0 � Q)* �e S 2s © o ay 60 00, ,�. 00 �Y Lot 14 h C� Note: Wire fence is in very poor condition. 2cS AS -BUILT NO CORNERS SET THIS DATE OF ' I hereby certify that I have performed a Mortgagees inspection ► .��• . • . �,� , in accordance with ASPLS Standards of the following �P• • • ,� ` described property: LOT 15. BLOCK 4, s 49th •GY NORTH WOODS SUBDIVISION . * 0� Anchorage Recording Precinct, Alaska, and that the oo • • • • • • • 0,4k • IN • • improvements situated thereon are within the property lines and do not overlap or encroach on the property lying Elizabeth L• Walotka • o to adjacent thereto, that no improvements on the property lying Iroon-'• •' adjacent thereto encroach on the premises in question and �.� 8036 — LSthat there are no roadways, transmission lines or other F J MW Y SCALE1 40� , �Fo • • • •�o visible easements on said property except as indicated • - A�oFESSIONA�- \.Y 4%0,hereon. ` Dated at Anchorage, Alaska this 1 st day of September, 2022. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED FRED WALATKA &ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON BEEngineers and Surveyors UNLESS OTHERWISE NOTED. DMS, FB 22-3, pg 50 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. "' MUNICIPALITY OF ANCHORAGE !f'= :' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION  ENVIRONIVIENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT N AM E,,¢.~. ~ON-E [] UPGRADE MAILING X~..~ ~1, ~ ! ~9 ~ LEGAL DESCRIPTION LOCATION ~ ~ NO. OF BEDROOMS "' DISTANCE TO: W~~ IAbsorptionarev,/ Dwelling ,~-- PER ~ ~ Manufacturer ~ ~e Mater~c .o. o~partmonts ~ ~ kiq. ~citg in ~allons I IF HOM~MADfi ~nside length ~iOth kiquid depth ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ Manufacturer Material Liquid capacity in gallons Well ~ Foundation/~t Nearest lot ,in~r PERMIT NO~/~ ~ ~ DISTANCE TO: L~o~ ~~ ~ ~ ~ N,. of li~ e Total len~A,s Tren~'e~ inches Distance between lines ~ D~ ~ Top of tile to finish ~rade ~ / ~ ~ Material beneath tile ~ inch.s Tot.l~ aBsor0tion are. Length ~idth' De0th P~MIT ~O. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m . Well Building foundation Nearest lot line ~ DISTANCE TO: j Class Depth Driller Distance to lot line PERMIT NO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: PIPE MATERIALS SOiLTESTRA~G~s q , ,~, /TJ ,,,,r 7, ,,, .... , R EMAR KS ~ ~ APPROVE~ DATE LEGAL 72-013 (Rev. ) PERMIT APPL.. I CANT t_OCFIT I ON LEGFIL. DEPARTMENT OF HEFILT'H FIND ENVIRONMENTAL. PROTECTION 825 "L" STREET., ANCHORAGE., AK. :.9950t 264-4720 .".~ ~-."Z ~--.,11EEZ ~.". F" EE ~]..' ~.1! ][. "T" F'RFINK BETHER. D PETE]F:!'" S CREEl-,:: L 15 B 4 NORTH WOODS SRFI 80H :t. 698K 995E!'? LOT SIZE ]:",: 4 .,.:, - ± E; :1..'='~ 27E~00 SQUFIRE FEET T"r'F:'E OF SOIL RBSORP'f'!CH"~. S"r'STEM IS: TRENCH i"tRX!MUM NUME, ER OF BEDROOMS = 4 SOIL RRTtNG '::SQ FT/BR)= :.[.75 THE REQUIRED SIZE: OF THE SOIl.... ABSORPTION Sb'STEM IS: THE L. ENGTH [)IMENE;ION IS 7.'HE LENG7.'H (tN FEEl") OF' THE TRENCH OR DRRINFIELD. THE DEPTH OF Ft "FRENCH OR PIT IS THE D:r. STFINCE BETWEEN THE SLIF:F'ACE OF THE GRC!L.IND AND THE BOTTOM OF THE EXCFIVATION (Il'.,! FEET). T'HERE IS NO SET. WIDTH FOR TRENCHES. 'THE GRAVEL., DEPTH IS TFIE MINII.IUM DEPTH OF GRAVEL BETWEEN THE OUTFFILL.. PII::'E AN[:, THE BOTTOM OF THE EXCAVATION (IN FEET). '.~.:.: E: ~;.". LJ~ ][ '.if;?.: EE E'.':, .-_':. E-_ i- 1F .]Ei-':._. T' ¢~ P-,,t! .~C .=."--' I: ¢_ E --- 21_,=:..,_, ~:- E]:.~ [¢:::t IL_ E_ KD~ P".~ .... '== F'ERMIT FIPPLICFINT HFIS THE ',-,-",' , ..... r ",, F.E.:,I: ..lq.:,IE, II.__] 'r ']"0 INFCRM THI""':'; [:,EF'RF.:TMENT [, F.'ING TAE INSTALLFI]"ION INSPECTIOi'4S OF' RN"r' WELLS FIDJFICENT TO THIS PROF'ERTb' AND THE NUMBER OF RESIDENCES THAT THE 1.4ELL HILL SERVE::. BFICKFILLiNG OF AN"r' S"r'STE:M 1.4ITNOU]" F]:I.',!FIL INSPECTIOI.',t AND RF'F:'ROVFIL. B"r' TFIIS DEPFIRTMENT HILL BE SUBJECT TO PROSECUTION. MINIMUM [)!S"['FtNCE BETI.,.tEEN R WELL. AND ANY ON-SITE SEWAGE DISPOSI"'qL. SYSTEM IS i00 F:'E:ET FOR FI PRIVFI]"E HELL OR ::L50 't'0 2E"~0 FEET FROM Fl PUBLIC HELL DEPEI'4DING UPON ]"FIE T'gF'E OF PUBI....IC WE:L.L. MINIMUM DISTRt",ICE FROM R PRIVATE WELL TO Fl F:'RIVRTE SEI.4ER LINE IS 25 FEET FIND '1"0 A COMMUNIT"r' SEWER [..:[NE IE; 75 FEET. OTHER REQUIREME:NTS MFI"r' RF'PI.2¢. SPECIF'ICFITIONS FIN[:' COI.',!STRUC]"IEff',I [:'IFIGRFIMS ARE AVAILABLE TO IN.S, lJF4.".E: PROPER INSTFILLFITtON. II:":' E:: F:.': D"l!. I 'T E"-.E ,%;: F" ][ F~ EE ~E:: [:." E'E C: E: ~"1 ES: EF] F;: ~: :'it. .... :IL ~ ~D ::;:IL I CERTIFV TF!F:rl' 1: I RM F'F1MIL. IFIR WiTH THE REQUIREMENTS FOR ON-SITE SEWERS RI,ID WELLS RS SET FORTH B"r' THE MLiNICIPFILIT'¢ OF FINCHORFIGE. 2: I HILL.. II..,ISTFILL THE S'-?S'TEM IN RCCOR[:,RNCE WITH THE CODES. 3: I UNDERSTFIND THAT THE ON-SITE SEWER S'gSTEM MFI'¢ REQUIRE ENLARGEMENT IF' THE RESIDENCE IS R~]"O INCLUDE MORE TH!:~N -4. BEDROOMS. ':-':; I G NEE:': ._T~~~~4~ ....~. PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6- 7- s' 12 '13- 14, 15 16 17¸ 19 20 COMMENTS PERFORMED BY.' I ' .~IUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENV! RONMENTAL PROTECTION Pouch 6-~50, Anchorage, Alaska 99502 276-222~ SOILS LOG PERCOLATION TEST SOILS LOG -- PERCOLATION TEST DATE PERFORMED; (=-/~ --~J SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? P E Gross . Net Oe~th to Net Reading Date Time Time Water Drop o o o PERCOLATION RATE ~ 5 ,(mlnutasltnch} TEST UN I)ETW'EE~J, DATE: \ I e UIROnml;FITAL COIqTROL $ 1 UIC1 $, April 6, 1982 Bethard Construction SRA Box 1698K Anchorage, Ak. 99507 Dear Mr. Bethard: On April 5, 1981, I checked to see if water was standing in the three homes in Block 4. Below are my com~nts: Lot 14- S~,~ pipe is dry. All standpipes are in place. Lot 15- Sun~ pipe. dry but standpipe broken off. Lot 17- Sump pipe dry but standpipe broken off. I also checked th~water level in the sump pipes on Lots 34 Block 3 and Lot l~°Ck 1. The water depth on Lot 34 was 34 inches down frc~ 41 inches on January 28, 1982. On Lot 16 the water level was 12 inches down frc~ 25 inches on January 28, 1982. It appears that the water traveling through the ground is dropping drastically. If there is no,increase during break up then it appears that the systems may he good. If you have any questions please let me know. Sincerely.5.-~ l_~ro¥ ~ Roid ,Jr., PhD~ PE president 1220 UJest 25th Auenue ,, Ar, cl~oraq¢. Aloska 99503 · [907) 276-1361 I ALASKA I~nUIROnmE~FITAL CONTROL $1~RUICI~S, II'lC. I~n§inee~in§ ~ I~nuironmental Studies May 24, 1982 Les Bucholz Municipality of Anchorage 825 L Street Anchorage, Alaska 99501 Dear Les: 'The broken pipes on Lot 15 and 17, Block 4 Northwoods Subdivision has been repaired, and now meet Municipal codes. If you have any questions please let me know. Sincerely, 1220 ~est 25th ~uenue · ~nchor~qe, ~1~ 99503 · {907) 276-1361 Time., Time Ime Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWERHALF ONLY Property Owner c~'/,,"'~w~:,¢---' c;~,.~,-,~7~.¢--~,-~,.~,¢..-,.v / ~, Phone UailingAddres~ ~0~ J~/ ~~, Buyer ~ ,~ ~/~~- ~ ~/ Address//~ ~/~ ~Q ~~. Lending Institution ~ Phone Address ~ ~, ~ ~~ ~. Realty Co. & Agent ~/~ ~~ ~ /~ Address ~o~ ~g~ ~, ~ ~ ~/, Legal Description ~ /~ / ~ ~ ~ ~' Street Location ~ ~/~ Ty~f Residence ~ Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Supply  Individual A~ACH WELL LOG. A well log is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach log if Public Utility available.) S~e Disposal ~ Individual Year Individual Installed: D Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 52 MUNICIPALITY OF ANCHORAG I i Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-731-20 Certificate of On -Site Systems Approval 1 ®/Z8'12oZ 3 Expiration Date: Legal description North Woods Block 4 lot 15 Site address 22649 McManus Dr Current property owner(s) Herman X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: S/� ?� CTEV 4 W c� �� �/� f►— %�z.pJ. 0 .I3-7* of S KP fig- ZY4,— t ` rS 7"I c -L 4- 0." By: Original Certificate Date: / 2- / G ' 22 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department '` r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 05173120000 Complete legal description NORTH WOODSBLK 4 LT 15 Location (site address) 22649 MC MANUS DR Current property owner(s) LIGGETT HERMAN 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 406-9200 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units X Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 556-eD Date of Payment r 1151 as COSA # Q S a a 15i'o_3 Waiver Fee $ Date of Payment Waiver # 0-4-11910 COSA Application—June 2022 • Legal Description: NORTH WOODSBLK 4 LT 15 Parcel ID: 05173120000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping NA ❑ Required maintenance completed, if AWWTS Comments: * new D. ABSORPTION FIELD DATA Which system tested (date installed) 10/16/81 ❑ ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 8/3/22 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/4/22 Results ❑ Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 6 in Elapsed time 60 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 0 in Effective depth remaining 48 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' 7- JYds if No ft. Yes if No ft Neighboring Tank > 100' F] Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' E] Yes if No ft Holding Tank > 100' F1 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F-1 Yes if No ft n Yes if No ft [:1 N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' [M Yes if No ft Surface Water> 100' W Yes if No ft Tank to Property Line > 5' FE] Yes Field to Property Line > 10' on Yes Water Main > 10' Yes Water Service Line > 10' Q Yes F. ENGINEER'S COMMENTS if No ft Wells on Adjacent Lots: if No ft Private Wells> 100' if No ft if No 11 Community Wells > 200' If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm NorthRim Engineering Illone 694-7028 Engineer's Printed Name Steve Eng Date 11/1/22 COSA ChecklistJune2022 Yes if No ft Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm NorthRim Engineering Illone 694-7028 Engineer's Printed Name Steve Eng Date 11/1/22 COSA ChecklistJune2022 1 Tract A Lot SCALE: V= 40' ,%:%, .®®�l>� OF 49th' 00 00 �,'. lizabeth L. • alatka ; a 00 �`P, • . 8036 - LS • Je�� AM ®�� �?0FfssIONA%-`��® EASEMENTS OF RECORD, OTHER THAN ZZC)1-2- THOSE SHOWN ON THE RECERTIFIED 11-08-22� AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following described property: LOT 15. BLOCK 4 NORTH WOODS SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 1st day of September, 2022, RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. DMS, FB 22-3, pq 50 BE 907-248-1666 FRED WALATKA & ASSOCIATES, L.L.C. Engineers and Surveyors This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.