HomeMy WebLinkAboutPREUSS #4 BLK 8 LT 3Preuss #4 Block 8 Lot 3 #050-572-47 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221427 PID Number: 050-572-47 Dwelling: V Single Family (SF) E] with ADU E] Duplex (D) E] Two Single Family Project: W New F-1 Upgrade Name Jeffrev Kiecker ABSORPTION FIELD El Deep Trench 2 Wide Trench Fl Bed El Mound Site Address 10209 Ronald PI El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 6.0 GPDISF 3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.96 Ft. Gravel depth beneath pipe 1.04 Ft. Subdivision Block Lot Preuss #4 8 3 Fill added above original grade 0.23-0.88 Ft Gravel length 18 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft SEPARATION DISTANCES To; Septic Absorption 1 Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank I Line 102 Ft2 1 Ft - Well 66'* 86'* 25+ TANK El Septic El S.T.E.P. El Holding [Z Other Advantex FAP Manufacturer Greer Capacity 150OGal, Su rface Water 100+ 100+ Material Number of compartments Lot Line 10+ 10+ NA Plastic Foundation 10+ 10+ _�ATIO N Manufacture Capa ity Remarks *Advantex system Gal Alarm location Elect��� ric tied bv Installer PIPE MATERIAL House to tank Tank to D3034 drainfield D3034 JR's Drainfield DSO-T4' CO/MT D3 1 034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection dates: 8/7/23 2 d 8 /7/2 3 Location and description 31d 8/8/23 4 th 8/11/23 Bottom corner of house door frame ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF Conditional Approval: Date Aw 493h Septic System Approved Date ZW5 /ts. KENNET4'm FIFLIS �!ip CE 7� I*— IN 4w Note: this approval does not include well permit requireme �Kev uo/uz/its) AS —BUILT SYSTEM DETAILS/SITE PLAN Permit OSP221427 PREUSS #4 BLOCK 8, LOT 3 PID# 050-572-47 •n i w Fp \ a �i:D cRza � DECOMMISSIONED r A—C=13.9' B—C=37.4' A—D=30.0' B—D=48.9' A—E=28.9' e B—E=48.9' A—F=41.4' o B—F=63.4' A—G=41.0' E B—G=63.4' Eo am CXIS rING Nauss. E. sy -- Fd 1 ' SCALE- 1 Lu ia, I 89.s4 Hen enz. Ln 44 SCALEt NTS v OF.AW ....... PREPARED FOR: �Q E' pp ® `� � JEFFREY KIECKER m.' 10209 RONALD PL " g * -L� TH �, * �! EAGLE RIVER, AK a � r KENNEPH D I FIELD BOOKS co►putm: z c-7116� BOUNDARY N A °RAY' KSD z ,� °' ^ / a` f A r' AMIRLT: JLS Dew 8 29 23 `' •...� ��s 1��' 4 EFESSIO .p Dwc. FILE GRID: N WOQ56 '�► ,1' ACAD RIE FILE 108 N" 22135 �FR K. 9957i'g1�6 � w _n 0 J z ry O O o z_N Q .. W M w0-) O � w <L O m O 00 O 0 O 2 5' WELL S89°59'38"W 164.02' (S89-59'00"E 163.33' R) SEPTIC VENT (typ) r\ WELL GRAVEL C D /W F'P CAN 24 LOT 3 GC BLK 8 oUSEc N1 VAULTO MH ® 24.0- C;� S89°56'57"E 163.43' (S89°59'00" 163.33' R) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: PRIEUSS SUBDIVISION UNIT No4 LOT 3 BLOCK 8 PLAT 72-6 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, Under no circumstance shout+ 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. NOV 14, 2023 1 1 "=30' schullerOak.net 2 3 -116 DRAWN BY: CHECKED eY GRID NVMBEN; BOOK AGE: JLS NW0056 1 230348 © = FND 518" REBAR . of ALkk 01 . 49TH p JgHN L. SCHULLER, o 1�Nr LS-10408 a �I.4.,.. . ' ®e.°fessionai V A w !-n o Cf)Lw 00 O U 00 0 P -� O O 1= z O � z �o 1SURV 5 rn n n 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221427 Work Type: Septic Upgrade Tax Code Number: 05057247000 Site Legal Address: PREUSS #4 BLK 8 LT 3 G:0056 Site Mailing Address: 10209 RONALD PL, Eagle River Owner: KIECKER JEFFREY T Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date: Expiration Date »cnt G �f' _ I- J � Department Lot Size in Sq Ft: Total Bedrooms: 2/9/2023 2/9/2024 19600 Q Disposal Field Q 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 3 Special Provisions: The extent of the seepage pit is to be located and sewer rock removed if it will be within 12' of the proposed trench. Received By: Issued By: Date: Date: Lo Z3 MUNICIPALITY OF ANCHORAGE Ar EEEMNZ� 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. 050-572-47 Property owner(s) Jeffrey Kiecker Day phone Mailing address _ 10209 Ronald Pl. Eagle River, AK Site address 10209 Ronald Pl. Eagle River, AK Legal description (Sub'd., Block & Lot) Preuss #4 Block 8 Lot 3 Legal description (Township, Range & Section) Lot Size 19,600 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑ (w/wo AD U) Septic Tank ❑X Upgrade X pg ❑ (D) El Holding Tank ❑ Renewal 1-1Duplex Multiple Dwellings ❑ Privy ❑ (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. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: '�Sl S Date of Payment: lol 1d22 C;,., - Receipt Receipt Number: 0 51 a0 Permit No. --),a IL4d_1 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221427, Curtis Townsend, 02/09/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221427, Curtis Townsend, 02/09/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221427, Curtis Townsend, 02/09/23 MUNICIPALITY OF ANCHORAGE THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this .L Day ofLla!t!lw!! ,, � of 20�, by and between !%!/ i��'y /,'eclt! er- , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex located at (legal description) Preuss #4 Blk 8 Lot 3 -10209 Ronald Place, Eagle River 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Al-K—Throughout the term of this Agreement, the Owner shall enter into a service agreement V -- with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. gjv--<3wwner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page I of 3 AX -Owner acknowledges that the Municipality may request records of maintenance and L7 - repairs from the manufacturer's representative or maintenance provider. Aff?(_Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. ATX Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. wner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. ,_A�wner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: T (signature) , ,%/ K• -eCk! J (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) Date: The foregoing instrument was acknowledged before me this day of R , 209�_, by COSTO NOT PUBLIC FOR ALASKA � P•'''•�'' �' My Commission expires: 10 ODS ; J�r o�W'/ sNON ` i y•i P& Co z i STATE OF 0%��`. MUNICIPALITY • ,II' 11 s 1110 By: �� (signature) (print name) Date: ( l Title: (rev. 05/18/2018) Page 3 of 3 GRE.;: ;ER ANCHORAGE AREA BOf UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME &Ake �'�'rti 6 MAILING ADDRESS 3 ey Jay � f PHONE X79( LOCATION / �p'{�'f� �`' LEGAL DESCRIPTION v"� -*� f I•n e4 SEPTIC TANK: DISTANCE NUMBER OF FROM WELL MANUFACTURER � MATERIAL ��� COMPARTMENTS f INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY le& GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER -7V OR WIDTH_, LENGTH—, DEPTH l9' LINING MATERIAL CRIB SIZE: DIAMETER 0 DEPTH 691 DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) (J� SQ. FT. ADDITIONAL ABSORPTION WELL - TYPE —CONSTRUCTION DEPTH DEPTH BUILDING J7� FOUNDATION CESSPOOL APPROVED DISTANCES: NEAREST LOT LINE OTHER SOURCES DISAPPROVED DISTANCE FROM: NEAREST SEPTIC 8 SEEPAGE SEWER LINE TANK_, SYSTEM REMAR Form No. EQ -031 DIAGRAM OF SYSTEM 73 /117/,(APPROVED 16V r 4 e4` R -e= IV INSTALLED BY: PIPE MATERIAL: &" LOT SLOPE: RE/M-ARKS: DATE Form No. EQ -031 DIAGRAM OF SYSTEM 73 /117/,(APPROVED 16V r 4 e4` a �` GREA—(ER ANCHORAGE AREA BOROUGH / DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. l 3500 TUDOR ROAD POUCH 6.650 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT Eeltyl�, (9""/,' MAILING ADDRESS 11a7��T'✓' PHONE ZZ - / INSTALLATION LOCATION LEGAL DESCRIPTION I y �VVY INSTALLATION OF: TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE A NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /c/poo TYPE "e"-� E;PAG'EE EA. SIZE " : TYPE MI 4ST*N C 9 ST R El 0 U T - ( WOO` V� IAGRAM OF SYSTEM // FOUNDATION TO SEPTIC TANK '^ I I OUNDATION TO SEEPAGE PIT 2W . DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /5-1 SEPTIC TANK —c_, SEEPAGE PIT DRAIN FIELD _ TO NEAREST LOT LINE. WELL TO SEPTIC TANK 100 SEEPAGE PIT DRAIN FIELD WATER MAIN TO SEPTIC TANK ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD / �} SEPTIC TANK, v r SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OIIT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. CAST IRON SIPHON PIPES ON SEPTIC TAN FITTED WITH AIRTIGHT REMOVABLE CAPS. VEL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORITY OR LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. d72 q DATE 'APPLICANT'S SIGNATURE/, 0 & E EI v GI NEERI NG & DEVEL &MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 Russell Oyster Earl Ellis 694-2774 333-5240 Civil Engineering Surveying Soils & Foundations Land Development SOIL LOG Performed for: Name: ''�737� Tel. No.' -;-5.4.4 `W'Wp Mailing Address: Legal Description: i -Or -0,3' �N�- e.Us4 Depth (feet) Soil Characteristics 0 2 3 4 'Y ���Vw� V� ,-rH 6 7 ®�s C' ►�. � � i�tiv. �, tea, � f ie� A 8 9 10 11 cTC-cb M �T Ground Water Encountered: Yes- No If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments:1Z'-A\°Z' �� Aa � `'► �'�,�4s W"2 , C VZ-6LXVy Performed by:Date: \\ v H M -W DRILLING, Inc. P. O. Box 4-1224 - 1310C International Airport Road (907)274-4611 - ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner Use of Well [Tcfm Lo:ation ddress of�Township, Range Sectia ow, or 44 ce main roa�1 Size of casing---� Depth of Hole -214 --feet Cased to---2L-----feet Static water levet 7 ft. (above) (below) land surface. Finish of well (check one) open end (.x ); Screen ( ); Perforator.( Describe screen or perforation Well pumping test at-.,: gallons per fhour..) (minute) for hours with of drawdown from static level. Date of completion P-17, 7 9 ( WELL LOG . Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness �' TO '; '�r�a�anic•, r ,I TO `R 71.1 4•5F L"rn%4cl P. /1c,.., TO 3-CONTR/ / M -W DRILLING, Inc. P. O. Box 4-1224 a 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner - -- I,o:ation address Township, Range, S e owrl; or y�i take main of Well Size of casing -__:__Depth of Hole_'"' feet Cased to_�"' feet Static water level.--- ----ft. (above) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated_( Describe screen or perforation_ Well pumping test at --gallons per (hour) (minute) for hours wither `` j` ft, of drawdown from static level, Date of completion_-__ WELL LOG _ Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness mn TO TO ._ TO---'— 1O_-- i—^---` — MUNIaPAUTY OF ANex+t�on -- ``OOP HEALTH & ENVIRONMENTAL PROTECTION TO-- _ _ MAY 1 91996 TO-- — -- --E-C 3 — CONTR Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-572-47 1. GENERAL INFORMATION Complete legal description Location (site address) COSA# OSC�la.iaal Expiration Date:�- Preuss #4 SO, Block 8, Lot 3 10209 Ronald Place, Eagle River, AK 99577 Current Property owner(s) Steven and Lana Anderson Day phone 694-2319 Mailing address Same as above Lending agency Day. phone Mailing address Real Estate Agent Audrey Mason, ReMax of Eagle River Day phone 622-3344 Mailing Address 10525 Old Glenn Hwy., Eagle River, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: - -n ivldual Well - — _ - - Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 Douglas T. Kenley, P.E. Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer's Printed Name Douglas T. 5. DSD SIATURE S✓/ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the Phone (907)746-1073 DateJ Wn__ 131 U rL z OFT � COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By Original Certificate Dater (Rev. 11/0.5) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program a 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Preuss a4 S/D, Block 8, Lot 3 Patel ID: 050-572-47 LS'I1�S>!llZ�t•1 Well type fd" t9 Date completed 2/6/76 Total depth 94 ft. Date of test Static water level If A, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to 32 ft. FROM WELL LOG 2/6/76 75 ft. Well production 0.5 g.p.m. WATER SAMPLE RESULTS: Coliform Negative colonies/100 mL Nitrate 2.03 mg/L Arsenic: ND ug/L date of sample: 4124/12 B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1000 gal. Number of Compartments 1 Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) 12 in. AT INSPECTION 5/22/2012 73.8 ft 3.2 g.p.m. Collected by: F. Kenley Date installed 8/23173 Cleanouts (Y/N) Y Foundation cleanout (YM) Y Depression over tank (Y/N) N High water alarm (Y/N) NIA Date of pumping 4/20/12 Pumper JR5 Pumping C. ABSORPTION FIELD DATA Date installed 8/23173 Soil rating (g.p.d./ftz or ft2/bdrm) 150 System type Seepage Pit Length Unknown ft Width Unknown ft, Gravel below pipe 6 ft. Total depth 10 ft. Eff. absorption area UK ftz Monitoring tube Y Depression over field N Date of adequacy test 5/24/12 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 32 in. Water added lsoo gal. New depth 49 in. Elapsed Time:215 min. Final fluid depth 45'112 in. Absorption rate >= 450 Any rejuvenation treatment (past 12 mo.) (YIN & type) Y If yes, give date Y* D. LIFT STATION "Pump on" level at _ in. Size in gallons Cycles tested Manhole/Access (Y/N) Meets alarm level at in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 70 ft. On adjacent lots 100+ft' Absorption field on lot 1 OO+ft. On adjacent lots 100+ft. Public sewer main NA Public sewer manhole/cleanout NA Sewer /septic service line 25+f . Holding tank NA Animal containment areas 50+fL Manurelanimal excrete storage areas 100+ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ft. Property line 10+ft• Absorption field 5+It. Water main NA Water service line 10+ft. Surface water 100+ft. Wells on adjacent lots 100+ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ft• Building foundation 90+ft• Water main NA Water Service line 10+11t. Surface water 100+ft. Drivewa rkin 5.n y pa glvehide storage Curtain drain None known Wells on adjacent lots F. COMMENTS _ G. ENGINEER'S CERTIFICATION �`,'` ' N1 I certify that I have determined through field inspections and >k •�49 IH v`' review of Municipal records that the above systems are in + conformance with MOA COSA guidelines in effect on this date. •03 ' -. � c ^s P Douglas T. Kenley P.E. ' Engineer's Printed Name '•� OEM'd� KOM Date �•rw.- 136 'La ('tom �.� COSA Fee Date of Payment Receipt Number ��0q (Rev. 4110) Waiver Fee $ Date of Payment Receipt Number Cy 0 0 0 Cl' < L.Lj Chi C)) 0 V) L_J < 0 M 0 00 0 0 0 0 z 25' WELL 0 1R4 n?' Cy 0 0 d • o LO 0 CO 0 000 0 00 0 00 71' 0 �':)Ozj izi UU ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: PREUSS SUBDIVISION UNIT No4 LOT 3 BLOCK 8 PLAT 72-6 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the 2__ improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoU14 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: DATE: sckE; E—MAIL.• JUNE 17, 2022 1 =30' schuller0ok.net 22-063 DRAWN BY. ICHECKED BY: GRID NUMBER: BOtitC AGE JLS NW0056 220234 10j.jj M) * == FND 5/8" REBAR 0 4 NX 0� A W At W_ ej 11P 49TH ?.......... .. ... A •� rr^�� Z ............. *j N L. SCHULLER: 7\� . / 4 . LS -10408 A0 1.831 Talkeetna Street ANW Anchorage, Alaska 99508 6 0 'O \ 'Aw f \ essjon6 10' (907) 227-1455 office (907) 274-4992 fax P"Mo r➢P.IWID FLOOREI£V. (ASSUMED) PROPOSED B NG CgtNER fl V. (A MW) ZONING DISTMCT FRONT BUILDING SETBACK 5DE BVIILp10 SETBACK REAR WWNG SETBACK( 251 2 I 163.33' S890 59' 00"E W GRAVEL W°LL U .... DRIVE ... _ . a 23.9 0 `0 26.0 2117 z EXISTING N Q HOUSE F— 85.5 26.0 OLU 23 9 a 0 I= LU n/ 0 0 LL N00 I p O O C. .s I 0 I I N890 59'00"W 163.33' 4 UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING, REPRODUCTION MAY CAUSE ERRORS IN SCALE. LOT SURVEY SURVEY TYPE ❑ FOUNDATION AS -BUILT SYMBOLS ❑ FINAL STRUCTURE AS -BUILT SET REBAR DRAINAGE ASPHALT El PLOT PLAN ... AS -BUILT ...LOT SURVEY ... TOPOGRAPHY HY FOUND REBAR ':^';': ' 9'�9 WOOD FENCE I� CONCRETE IN AS -BUILT ... NO CORNERS SET RECERnFlCATON AS -BUILT ... NO CORNERS SET 00 ff ASSUMED ELEV. v METAL FENCE ® WOOD DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE SIDEWALKS, DRIVEWAYS, ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION •••�" .••�E OF, i,, i Prepared by Robert E. Johns, Jr. & Assoc. PLOT PLAN Um rot ora.. ana am..eea ... ana that L "°""""°""°"°""°y"""° raaaa > ..tmNhm aK °r +ne Lee ����P. ..... �1 '''�. Professional Land Surveyors Qea coma. s .n°.n an me qan ane to th. B.M a my - ,.• / 77 1700 Brink Drive. ANCHORAGE. mahwaase and aelltha& an Orn.n.wn. na< n.an m. noa w° and ea,reet. • ALASKA 99504 Scale: 1 LL _ 3�L Rea. Lot S.F. Rea. Plat File No. FOUNDATION Ar '•••• AS -BUILT L. Rol E Bohn.. Jr.. harehy.1ty mat �••• e• ... ........... .0 Dote Surveyed: Ye 6/18/12 Drawn by. REJ Checked b M1en perbnnh m A.-9vYt wlrw at N. Wndmlan an We Dat d mat oath. ........ ,...........� • ,''•,o •, enn and hr .Ikn a..hmm haven "y°, °"foodl'"'ro w't N. . BERT : S, MK Date Drawn: 6I1 8112 Grid: W N �56 W.O. 12-186 ,'he°,wetnwd . � ;. �� FINAL STRUCTURE AS -BUILT s ''. '4 .' Ae-I ''•., ' "' Legal Description: I, Rcbxt E b5n5 w., hrtly artly that fe ,. ���� Z he.. perTa,ned an A._B°It .any a m. eaaaw.. anae KM >.a mat al hm od d P •..............• a� . Lot 3 Block 8 aM we ma n° a a�"aa`a,'0mnti .wt edm w�°aamim X11 'ofes sionol L•�� 4�....•• PREUSS #4 Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 June 11, 2012 Municipality of Anchorage On -Site Services 4700 South Bragaw Anchorage, Alaska Re: Steven Anderson, Owner Preuss#4 S/D, Block 8, Lot 3 10209 Ronald Place Eagle River, Alaska COMMENT FOR COSA CHECKLIST This is in reference to the double asterics (**) shown on the tan form (F) Comments section. Lot 2's well was drilled on 8/10/02 subsequent to the installation of the seepage pit on Lot 3 in August of 1973. During an adequacy test on Lot 3, measurement was made from the well on Lot 2 to the seepage pit on Lot 3. It measured 100 feet from the well to the stand pipe coming out of the seepage pit, which means that the 100 foot radius of the well encroaches upon the seepage pit area. This was brought to the attention of both Jay and Jeff at MOA Onsite Services and they contacted Michael Anderson, the engineer in charge of the installation of Lot 2's well and septic system. I was informed that Michael Anderson has recently applied for a waiver. If you have any questions, please call me at (907) 746-1073 or 243-5372. Sincerely, Douglas T. Kenley, P.E. PE #8176 Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 June 11, 2012 Municipality of Anchorage On -Site Services 4700 South Bragaw Anchorage, Alaska Re: Steven Anderson, Owner Preuss #4 S/D, Block 8, Lot 3 10209 Ronald Place Eagle River, Alaska 99577 COMMENT FOR COSA CHECKLIST This is in reference to the double asteric items shown on the tan form (F) comments section. Lot 2's well was drilled on 8/10/02 subsequent to the installation of the seepage pit on Lot 3 in August of 1973. During an adequacy test on Lot 3, measurement was made from the well on Lot 2 to the seepage pit on Lot 3. It measured right at 100 feet from the well to the stand pipe coming out of the seepage pit, which means that the 100 foot radius of the well encroaches upon the seepage pit area. This was brought to the attention of both Jay and Jeff at MOA Onsite Services and they contacted Michael Anderson, the engineer in charge of the installation of Lot 2's well and septic system. I was informed that Michael Anderson has recently applied for a waiver. If you have any questions, please call me at (907) 746-1073 or 243-5372. Sincerely, Douglas T. Kenley, P.E. PE #8176 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1,9-06 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) I _ z-,:�P) -?o„9;5-c slf�1 Location (address or directions) (b) Applicant Name L--Al`tf- IacKS7 r3 a N Telephone: Home t0M` Z3kcl Business .(4t`I - TAct to Applicant Address 5e3 5 S )3 6"Lr A?(Ve--' Ad (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder V; Buyer ❑ ;Other ❑ (explain); (d) Lending Institution � 1114 rn o C-Cy k6A_ Telephone Address ' � K (e) Real Estate Company and Agent N Address Telephone (f) Mail the HAA to the following address: EAGLE RIVERr AK 99577 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Number of Bedrooms 3. WATER SUPPLY Other Individual Well IJ-' Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite E�- Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page t of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 0 As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation of this Health Authority Approval 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S I: 1r1AjEt.rm Gam_ _— Telephone Address air Date EAGLE RIVER, AK 995.77 MAY 17 Ig% DHEP APPROVAL 031) Approved for edrooms by ApprovedDisapprove Terms of Conditional Approval Conditional dh20 CAUTION 1, ^ __r 1'NTC 1p - V z, p A $%, 1OFF'swk The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 A. WELL DATA Well Classification �i MUNICIPALITY OF ANCHORAGE (MO I MUNICIPALITY VE tORITY APPROVAL (HAA) DEPT. OF [0jff ENVIRONMENTAL PRI IST - FEBRUARY 1984 264-4720 AY 19 1986 Legal Description: L 3 C/3 RECEIVED r, If A, B, C, D.E.C. Approved (Y/N) Well Log Presenter Date Completed Z "&" %(a, Yield Total Depth Cased to 3 Depth of Grouting Static Water Level 7S Pump Set At Casing Height Above Ground — Electrical Wiring in Conduit(Y//m l'7 // Y Sanitary Seal on Casing (cm — Depression Around Wellhead (Y Separation Distances from Well: To Septic/Holding Tank on Lot 7a ;On Adjoining Lots i To Nearest Edge of Absorption Field on Lot !o ;On Adjoining Lots — ..iJ,a To Nearest Public Sewer Line To Nearest Public Sewer t/M hole To Nearest Sewer Service Line on Lot CU / -e 3O ` Cleanou an _ Water Sample Collected by SVCS C�6i�'/���b ; Date ' 12 ' g� Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed 8-23-73 size /00,0 No. of Compartments Standpipes ll N) Depression over Tank Air -tight Caps&N) Foundation Cleanout k Date Last Pumped Is-' / ` (_ Pumping/Maintenance Contract on File (Y/N) ;for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: 9._ To Water -Supply Well 7V I _)� To Building Foundation To Property Line Zy r 4- To Disposal Field To Water Main/Service Line �'� } To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of SyTt Design cZ �Prt9F. Date Installed "Z 3 �7 " ! 3 Length of Field 41 Width of Field ; UDepth of Field /a 14 Square Feet of Absorption Area Gravel Bed Thickness N3 z Standpipes Present (SCiDB� Depression over Field WX& Date of Last Adequacy Test Results of Last Adequacy Test I iY,qze v Separation Distance from Absorption Field: To Water -Supply Well /UU To Building Foundation L S- ,I. Lot 4/1 To Water Main/Service Line 1+ To Stream/Pond/Lake/or Major Drainage Course To Property Line To Existing or Abandoned System on y On Adjoining Lots xz� / To Cutbank (if present) x't To Driveway, Parking Area, or Vehicle Storage Area 00/ - Comments 6 �11knrt ire I—f� D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedS & S ENGINEERING Date MAY 1 7 1986 Compa� 196 MOA No. �r J Cts 3 EAGLE RIVER, AIS 99577 Receipt No. �3`�L��� Date of Payment S "' I d 1 --+� Amount: $ (<)S C, Page 2 of 2 72-026 (11/84)