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HomeMy WebLinkAboutPROSPECT HEIGHTS #5 BLK 2 LT 6Prospect Heights #5 Block 2 Lot 6 #015-135-14 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: °I-1o1Ic,1 PID Number: 015 -'135 —1 Name: h ''K Pe-ra(z rl Geour AT-rill:M%Y-e B " Wastewater System: ❑ New ❑ Upgrade Address:# ANcH.t INK.ABSORPTION Sr,l-ra FIELD 3-87-o LAY -V- oris �PLOI. lay soa Phone: _ I I No, of Brooms: O Deep Trench L)(Shallow Trench 0 Bed 0 Mound 0 Other LEGAL DESCRIPTION Soil Rating: 'Z Total Depth from original grade: %1 - GPD/Sq. . Ft. Lot: Block: 6 Subdivision: 2 I' cSPEGC HGA #5 Depth to pipe bottom from original grade: r Ft. Gravel depth beneath pipe 41 Ft. Township: Range: --�- Section: Fill added above or pal grade: �� Gravel length: t --' Ft. .5D Ft. WELL: ®New ❑Upgrade ' Gravel width: Si Number of lines: l Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: 'S(-5 Cased To: Total absorption area: _L Pipe material: PKI -JA. -Ta Ft. 115 Ft. ter' 00 So. Ft. AST: 03e34 FS►o Driller: ALPIAE C)Rtt-Ll4G Date Drilled: '�-29-�� Static Water Level: 102 Ft. Installer: / KOCKID 'I• -< PK.C, Date installed: —y /'Z�'97 Yield: Pump Set at:. / Casing HeightAbove Ground: TANK 2 GPM Q r ft Ft. mac, Ft. SEPARATION DISTANCES 19 Septic 0 Holding 0 S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: _rAPM Capacity in gallons: From Tank Field Station Tank Sewer Lines acRoP,04GE Iz6o Welh lo014 fool' _ �5ti Material: ST E1— Number of Compartments: Z SurfaceLIFT 1* + STATION Water lcm 100 Lot -" '— Size in gallons: Manufacturer: Line 101.1- lata. Foundation+ "Pump on" level at: "P "level at: High water alarm at: 51 idtt Curtain ottE k�10 !J Pump Mak del I Electrical Inspections performed by: Drain BENCH MARK Remarks: Location and Description: TaP of cMv CLOSE n n o Po1Ar Assumed Elevation: IO O . OFt }M ••..N•• •iw•• L ; 11 1 A .. •.�, NJ • .�&$�fdVIN�@RIid3 �/—�T�(-97 Inspections performed by: 1St l+.w a..a• •,Hssu:rn.c 17034 Eagle OD Eagle River, Alaska 49577 2nd 9 . ROBERT C. COWAN �Q 3�d S -13-91 CE -8801 °�t�l Department of Health and Human Services approval PP � C �� q' 77 Reviewed and approved by: a- Date: z' 72-013 (Rev. 9/91) MOA 25 plapp NO.SW970161 PAGE 2 or 2 DEPARTMENT TH ANDhHURXN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT INGAI LOT 6, BLOCK 2, PROSPECT HEIGHTS NO. 5 P.I.D. N0. 015-135-14 / NEW 1250 GAL. SEPTIC TANK CO' oslz /I MT1/o/ 08L ALT. SITE-----___.� ♦ srz STI A o / TH / FCO O / 411 <// JPO �Pl % {1 8c02y B �O�Q ��J O��`��' WELL 3ZS ---- gra .Z ? 91J 6 $ `►f _e.. NEW TRENCH Orb -i yo �N3 S � 'd-3 L2 4+) 4 N__: M r 1 G., 7 S'/ SCALE 1" = 40' ST1 ST2 C01 99.2' MT1 CO2 "M__9 FINAL GRADE A'c��. 96.7'11,ccO.' = 96.9' .Y .. •..M .N....... NEW S20 GAL T14. SR COl = 88.3'... CO2 = 88.5' ?+ ROBERT C. COWAN l Q, `P�fs4 CE -8801 MT1 = 84.3'AL N NO WATER FOUND �c �Pjl ' ,�. 'g 73.3' B.O.H.a�. From : ALPINE DRILL 907 345 0202 Nov.12.1997 04:33 AM Pei LOCATION OF WELL STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD BPR suaDI I810N LOT BLOCK SECTION OTRs SECTION TOWNSHIP RANGE MERIDIAN t Ji' 4� a N ❑ E ❑S 0W LOCATION/SKETCH: WE WNER: DEPTHS MEASURED FROM:❑casing top ❑ground surface WELL DEPTH: DATE OF COMPLETION Depth of hole: 7 (t BOREHOLE DATA: Depth Depth of casino; 4Z_A�1— It J, 7 / Materiel Type and Color From To w DEPTH TO STATIC WATER LEVEL - V e, ft below$ Mop of casing 0 ground surface .. f (ry Date: '? 1`q1 METH00 OF DRILLING: "p -air rotary 0 cable tool At ❑ other n USE OF WELL; W2omastic ❑ irrigation ❑ monitor El public supply 0 other // �(f+ CASING -STICK •U It. Diam: In, to ft Casing type:.In. tot 0or -k / WELL INTAKE OPENING TYPE: I-) open end 0 screened U Z D perforated /, open hole Depths of openings: to It SCREEN TYPE: Diam: in. Slot/Mesh Size: Length; It GRAVEL PACK TYPE: Volume usod: Depth to top: _...-. - GROUT TYPE: me: ory Depth: from It to _ It DEVELOPMENT METHOD; Duration: NOV TT _1991 PU PlN!g LEVEL AND YIELD: It after 2— hrs pumping W' gpm Dept. Health & Human DervlcOS PUMP INTAKE DEPTH: _ It Horsepower: WELL DISINFECTED UPON COMPLETION? R YES 0 NO CONTRACTOR INFORMATION: REMARKS: PLEASE MAIL WHITE COPY Or LOG TO: DNR/DIVISION OF MINING 94 WATER MGMT 360a C 6t, Sujte 800 Anchorage, Ak 99503-5935 Ph14A717A9-961Q 1�nA /'2 p/t--- c oer /0-D pm 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:SW970161 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:PARK KEVIN B & JANET K OWNER ADDRESS:10101 SCHUSS RD ANCHORAGE, ALASKA 99516 PARCEL ID:01513514 LEGAL DESCRIPTION: PROSPECT HEIGHTS #5 BLK 2 LT 6 LOT SIZE: 100104 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 71;u' /R7 PAGE 1 OF 1 DATE ISSUED: 7/01/97 EXPIRATION DATE: 7/01/98 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: RECEIVED BY: DATE: ISSUED BY: DATE: 7-Z- �� HEALTH AUTHORITY APPROVALS SEWER& WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN June 9, 1997 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 6, Block 2 Prospect Heights No. 5 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Request you issue a permit to install a septic system to serve the proposed four bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and 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. If you require additional information, please contact us. Sincerely, 1/&Z Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 60' SCALE 0 y SITE -PLAN DESIGN Cd r o o 0-3 xW �a vahn yaoa°Yo a�°�' ^� ----______ 10_ UTILITY \ _EASyENT oN cn v t:l 0) ON .p O` O y � d m T o ` 0 o� n Q 0 0 NO WELLS/SEPTIC WITHIN 200'+ OF ` Q \2z� w �� o \ 17 d PRDPOSEp WELL & SEPTIC AREA Ol m d (,nNrn co-0Op j APPROXIMATE SHORE Ute COCO O pNp r� � `i � z am cif9 "d au�-im I O �KyAjmm o_IZnA Cij iZ� � ui F�a� mooK rim PROPERTY LINE AI APPR _X 14 • l� V p A W O Z D i y ` m X \ r0 A Yjr9 <�c D m A Ov'D \Z \ 0 O 00 '"''1 ZfT1n rrl -U NII `f�1 m d (,nNrn co-0Op j F COCO O pNp r� � `i � m m Fr p A W O Z D i y ` m X \ r0 A Yjr9 <�c D m A Ov'D \Z \ 0 O H8:4 Zmo rn ONO S-� T VZiy Cln wZ0 Szo C m 2 m Z C ON�m ti. m A ZDD�-r-I=VI O m N N m 3o c m D �ZN LUI mV0im-<mm O 0z ti A� A S N Z r -Cm ZDA mm-+ w wom < 6 m m 0 N O �o Nn Ami 02 � 0 0 z m QZ ZZ o oy Z A D m 0 `f�1 , tl j F COCO 1 11-1 L- 111` o 0 \ � `i tj Fr Cij H8:4 Zmo rn ONO S-� T VZiy Cln wZ0 Szo C m 2 m Z C ON�m ti. m A ZDD�-r-I=VI O m N N m 3o c m D �ZN LUI mV0im-<mm O 0z ti A� A S N Z r -Cm ZDA mm-+ w wom < 6 m m 0 N O �o Nn Ami 02 � 0 0 z m QZ ZZ o oy Z A D m 0 `f�1 , tl j F COCO 1 11-1 L- 111` o 0 \ � `i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: PSI bC,V C LEGAL DESCRIPTION: Lo T 13LoC K o�PTH� PAOJF/cc7 148t(—t4 rt 1 L 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 31 0A(-i1Nt G s S P GW/5W ( .'O- � r �6 ROBERT C. COWAN hC DATE PERFORMED: Township, Range, Section: S' SLOPE SITE PLAN SAn+� WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? p E I N cA jnJ n"t, Depth to Water After/ Monitoring? �Ry Date: 5 /a7 6 7 SAN✓ wt7-H Depth to 1) w -r# ==MM Water PERCOLATION RATE _ TEST RUN BETWEEN O rnnem CO LL✓z C7 f.6 a (minutes/inch) PERC HOLE DIAMETER FT AND FT l(' ' o /7' PERFORMED BY: 8{ S ENGINEERING CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River oop Ifia o.264 ACCORDANCE&OW R"T4kjFjsjaE99WCIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: r a-7 72-008 (Rev. 4/85) � 2 N O OL r a D ?� 7 Q CD m y u CD 0 � O 7 m m ori N 0 O O 3 0 �. O CD a O CD o N O an Percent Passing by Weight 0 0 0 0 0 0 0 0 0 0 -1-0 0 0 0 0 3" 2" 11/2„ 1" 3/4" 1/2" 3/8" Vo. 4 #8 No. 10 #16 Vo. 20 # 30 4o.40 # 50 No. 60 4100 Jo.200 .02mm Irl)- :: � v- b D' O CD Q o ON W 00 00 N J b () C) O CD n Cn H + b o C CIO o CD z zw O O CD O O O z 0 N N O O O O p w w z OZ oo N_ A_ �, �, N w ��• .� " O O Go a1 v, A w N .-• .- = N = ' M o O o 0 0 Cl 0 0 o rn 0 n J 00 00 lC \O O w II 0 0 � II n�i II O U7 VO H 0 z Irl)- :: � v- b D' O CD Q o ON W 00 00 N J b () C) O CD n Cn b o C CIO CD CD x CD a .. z 0 Irl)- :: � v- b D' O CD Q o ON W 00 00 N J Development Services Department { p P =' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-135-14-000 Expiration Date: 8/24/2023 Legal description PROSPECT HEIGHTS #5 BLK 2 LT 6 Site address 10101 SCHUSS DR Anchorage AK 99507 Current property owner(s) LANGLAND MARC & SANDRA L X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 5/24/2023 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 X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approva"une 2022 COSA Checklist.docx COSA Checklist Legal Description: PROSPECT HEIGHTS #5 BLOCK 2, LOT 6 Parcel ID: 015-135-14 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 7/29/1997 Total depth 365 ft Cased to 115 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 5/5/2023 Static water level at beginning of test 160 ft. Well production at time of test 0.8 gpm Water storage tank volume NA gallons per client. Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 1.83 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 5/1/2023 Comments SEE MOA WATER WELL ADVISORY. B. TANK DATA Measured operating fluid level in septic tank 48” Date of pumping 5/5/2023 Required maintenance completed, if AWWTS Comments: SEE MOA TANK ADVISORY C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/13/1997 ALL standpipes present per record drawing Total measured depth from grade 11.6 ft (max) Measured depth to pipe invert from grade 8.1 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 3.5’ of 4’ ED Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 5/5/2023 Results Pass Fluid depth prior to test 1 in (fluid & sludge) Water added 650 gal New fluid depth 3 in Elapsed time 1140 min Final fluid depth 1 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4’ ED) Effective depth used 7 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 41 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximately 0.5’ ED is missing. COSA Checklist.docx 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/11/2023 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 or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 5/11/23 �N 00.08'43"W r5e��- 15.76' RETAINING WALL Loi WOODEN GRAVEL ACCESS EASEMENT (Doc. No. 1997-035460-0) 1 PLANTER i Lot 7 \WELL 14.3'x16.4'I CABIN \ Lot 6 100,104 S.F. L _ / J ROOF OVERHANG / F VpQ� �1 Lot 4 631 / 1 I IEDGE OF PRIVATE LAKE 1 \ 0 10 25 50 100 SCALE: 1"=50' 10' T&E EASEMENT Lot 3 r, PER PLAT NOTE: OWNERS OF LOTS 3, 4, 6, 7 & 8, BLOCK 2, SHALL HAVE COMMON ACCESS TO THE ENTIRE LAKE SURFACE WITHIN THIS SUBDIVISION. THE COMMON ACCESS EASEMENT SHALL EXTEND TO THE SHORELINE OF THE LAKE. PLOT PLAN _ AS BUILT x_ SCALE 1 50 GRID _ SW 2540_ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang &7 522-6476 Phone Associates, inc. k90enOlangsurvey.com Professional Land Surveyors jonothanOlongsurvey.com ?t OF At l trovisOlangsurvey.com I hereby certify that I have surveyed the following described property: LOT 6, BLOCK 2, PROSPECT HEIGHTS SUBDIVISION — ADDN. No. 5 (PLAT No. 82-313) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the __i4K� _ Day of ___,1.02 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH *1 • ..... y KENNETH G. LANG , Q 0.5202 IIl�:R5.�2SQ-123PaQy i State of Alaska AECC963 / 3S0 / / 10' T&E EASEM EN PIPES_ SEPOTIC ^� CNCRETE WALKWAY J � I I �N 00.08'43"W r5e��- 15.76' RETAINING WALL Loi WOODEN GRAVEL ACCESS EASEMENT (Doc. No. 1997-035460-0) 1 PLANTER i Lot 7 \WELL 14.3'x16.4'I CABIN \ Lot 6 100,104 S.F. L _ / J ROOF OVERHANG / F VpQ� �1 Lot 4 631 / 1 I IEDGE OF PRIVATE LAKE 1 \ 0 10 25 50 100 SCALE: 1"=50' 10' T&E EASEMENT Lot 3 r, PER PLAT NOTE: OWNERS OF LOTS 3, 4, 6, 7 & 8, BLOCK 2, SHALL HAVE COMMON ACCESS TO THE ENTIRE LAKE SURFACE WITHIN THIS SUBDIVISION. THE COMMON ACCESS EASEMENT SHALL EXTEND TO THE SHORELINE OF THE LAKE. PLOT PLAN _ AS BUILT x_ SCALE 1 50 GRID _ SW 2540_ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang &7 522-6476 Phone Associates, inc. k90enOlangsurvey.com Professional Land Surveyors jonothanOlongsurvey.com ?t OF At l trovisOlangsurvey.com I hereby certify that I have surveyed the following described property: LOT 6, BLOCK 2, PROSPECT HEIGHTS SUBDIVISION — ADDN. No. 5 (PLAT No. 82-313) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the __i4K� _ Day of ___,1.02 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH *1 • ..... y KENNETH G. LANG , Q 0.5202 IIl�:R5.�2SQ-123PaQy i State of Alaska AECC963 Well Water Advisory Certificate of On -Site Systems Approval # OSC231128 Subdivision: Prospect Heights, Block: 2, Lot: 6 This well's productivity was determined to be 0.8 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 4 -bedroom residence is 0.41 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box X96650 *Anchorage, Alaska 99519 6650 *www muni org DEVELOPMENT SERVICES DEPARTMENT c On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231128 Subdivision: Prospect Heights #5 Block:2, Lot: 6 907-343-7904 Fax: 343-7997 The septic tank for this property is 26 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. 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 30 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# O1 - i36 — I HAA# 1. 2. 3. GENERAL INFORMATION Complete legal description Lot 6; Block 2; Prospect Heights 15 Location (site address or directions) NHN Schuess Drive Property owner The Petersen Group Day phone 562-1170 Mailing address 3820 Lake Otis Pkwv. Suite 204 Anchorage, AK 99508 Lending agency Mailing address Day phone Agent Mike Backus/ Petersen Group Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: 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. 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 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 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 c r e €bIGIN€EKING Phone __e� ay - -7 `I Address 17034 Earle River Loop Road No. 204 Engineer's signature 6. DHHS SIGNATURE _ Approved for ��<% bedrooms. Disapproved. Conditional approval for Additional Comments By: Date / / 1 2.1'q V ROBERT C. COWAN Cc -8801 A bedrooms, with the following stipulations: Date (' l4'%$ 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 courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. 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. 1/81) Back MOA #21 4RONMENTAL SERVICES DIViSIc.. Municipality of Anchorage 1A1 111111& DEPARTMENT OF HEALTH & HUMAN SERVICES R C 1 V E Environmental Services Division C 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: L-0 T 6 13 1--0 c cc I Parcel I.D.: 0 Pio s r,i rl rL I G.1-/ v f It '�- A. WELL DATA Well type E' 1\14 7 (L Log present (9/N) \/ C S Total depth I 1� S Sanitary seal e/N) 'Y ri S Date of test % Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number l Date completed 7 / D- 9 / `I 7 i Cased to / / Casing height (above ground) FROM WELL LOG /a E{/917 WATER SAMPLE RESULTS: Coliform to 4 O Nitrate Wires properly protected O/N) AT INSPECTION Y4 S g.p.m. / g.p.m. a,, j5 -It Other bacteria 0 Date of sample: 1 `i i `/ Collected by: S & S ENGINEERING 17034 Eagle River Loop Road No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 Date installed 7 /,j -f ( JJ`/ 7 Tank size ),I ' a Number of Compartments A Cleanouts(LWN) $'6-J Foundation cleanout &N) �7 f S Depression (Y/, ^' 0 High water alarm (YQN a Q Date of Pumping '`� `N� ^� Pumper C. ABSORPTION FIELD DATA Date installed Length r Width Soil rating g.p.d./ftor ft2/bdrm) System types✓� L a1 r Gravel thickness below pipe 1 Total depth Effective absorption area S-00 9 Monitoring Tube present (&N) Y f -(Depression over field (Y& PO Date of adequacy test N//+ — y' h v Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); Fluid depth Peroxide treatment 72-026 (Rev. 3/96)' (ins) Minutes (Y/N) redia ly-aftsf� gal. water added (in.): _ Absorption rate = g.p.d. If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level a' ,,Pump off' level at' High water alarm level at' *Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ; too U Septic/holding tank on lot t On adjacent lots / c On adjacent lots O0 -k Absorption field on lot Public sewer main t) Public sewer manhole/cleanout f Sewer /septic service line 5- 4 Lift station p.)( � SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ;ON LOTTO: Foundation IT i f Property line �� f Absorption field Water main/service line 10 4 Surface water/drainage IUO 4 Wells on adjacent lots iUU -� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: , � /0 -f- lU � t o Building foundation Water main/service line Property line � Surface water l 0 U t Driveway, parking/vehicle storage area 3O Curtain drain N Q i� Wells on adjacent lots /dd f F. ENGINEER'S CERTIFICATION q ° w of Municipal rec�' ms are I certify that I have determined thru field inspections and revieons xhXtire abbv�g in conformance with M H.V ui lines in effect on this date. S ♦ae' i.eH< Signature . 4 ril'v f 0 u�.v' a1 Fr'f . .. P.OBERT C. •COWAN...a Engineer's Name / fs Cr Date HAA Fee $ bo Waiver Fee $ Date of Payment I Date of Payment Receipt Number 681) Receipt Number 72-026 (Rev. 3/96)'°