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CHICKADEE SLOPES TR A LT 1B
Chickadee Slopes Tract A Lot 16 #015-231-84 O Municipality of Anchorage ,, 4E:7' Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT C✓ Sp Permit Number: E1l101260 PID Number: 015-231-84 714: 1 of 2 Name: Mark Luiten Wastewater System: ❑ New 1/ Upgrade Address: 12301 Rock Ridge Drive. 99516-2434 ABSORPTION FIELD Phone: Number of Bedrooms: 3 ❑ Deep Trench 0 Shallow Trench 0 Bed 0 Mound ® Other: Tank LEGAL DESCRIPTION Soil Rating: GPD/Ft2 Total Depth from original grade: Ft. Block: Lot: Subdivision: 1B Chickadee Slopes Tract A Depth to pipe bottom from original grade: Ft. Gravel depth beneath pipe: Ft. Township: Range: Section: Fill added above original grade: Ft. Gravel Length: Ft. Well: ❑ New ❑ Upgrade Gravel width: Ft. Number of lines: Distance between lines: Ft. Classification (Private, A, B, C): Exist'g Private Total Depth: Ft. Cased to: Ft. Total absorption area: Ft2 Pipe Material: ABS Driller: Date Drilled: Static Water Level: Ft. Installer: Beek Construction Date Installed: 11/6/2010 Yield: GPM Pump Set at: Ft. Casing Height Above Ground: Ft. TANK SEPARATION DISTANCES 4 Septic ■ Holding ■ S.T.E.P. • Other: To From Septic Tank Absorption Field Lift Station Holding Tank 'ublic/Private Sewer Line Manufacturer: Anchorage Tank Capacity: 1250 Gal. Well100 107.1 100+ Material: Steel Number of Compartments: 2 Surface Water 100+ 100+ LIFT STATION Lot Line 21.7 1 Size: Gal. Manufacturer: Foundation 5.4 10+ "Pump on" level at: in. "Pump off' level at: in. High water alarm at: in. Curtain Drain 50+ 50+ Pump Make & Model Electrical Inspections performed by: Remarks: Septic Tank replacement only. Exist;g tank abandoned per code in BENCH MARK place. Request lot line waiver for drainfield to north lot line. Location and Description: Garage Finish Floor Granting this waiver will not pose a health issue or prevent future Assumed Elevation: 100.0 Ft. development of the surrounding lots. Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1st 11/6/2010 Engineer's Stamp ��ovoakuli%4� ��P��"�••••••.,• �. arc-).." ' . .../r- :� : ♦♦ % ? 49TH /\ °: ♦0/ IINA 2nd 11/6/2010 Development Services Department Approval p PPII Conditional Approval Date: f%Steven •R. Pannone; t 1♦ 0 p:. No. CE 8149 ' c� . t • ' 417 S.••• � ♦ 4 ./, / L / 7-1/' Reviewed and approved by: ` �- ��� - ✓ Date: (Rev. 04/06) s' ., Z CO A 8 T1 18.3 23. T2 11.3 31. 0 ROCKRIDGE LOT UNDEVELOPED ^ NO WELL OR SEPTIC L WITHIN 200' A LETTER OF NON—OBJECTION WILL BE OBTAINED — GAS 10' Util Esmt ss ABANDONED EXIST'G TANK PER CODE INSTALLED FCO NEW 1250g SEPTIC TANK INSTALLED DCO CONNECTED TO EXIST'G FIELD D/W T2 GA t3` 1- < 0 z Z Q D W 0 11 I- I- I- 0 0 WD J OJ Z Z J J of 0 0 00 104.7- 'l 99.0 98.81 W 1250 SEPTIC TANK CONNECT TO EXISTING FIELD 98.6 97.6 EXISTING FIELD PROFILE PROFILE T1 ✓' A —5.4 B \ EXISTING \3BR HOUSE M 1 B W WELL (E) WELL (E)\ HUFFMAN RD NOTES: RECORD DRAWING PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 PLAN CHICKADEE SLOPES TRACT A, LOT 1 MARK & JUDY LUITEN 12301 ROCKRIDGE DRIVE ANCHORAGE, AK 99516 Agkk j * • 49TH i� *V Steven R. Pannone V1) •. %CE 8149 • l�ROFESS1otJP�� Date 11/09/10 Scale 1"=50' P.I.D. NO 015-231-84 PERMIT NO. 0SP101260 Sheet 1 OF 1 MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division March 8, 2011 Mark and Judy Luiten 12301 Rockridge Drive Anchorage, AK 99516 Mayor Dan Sullivan RE: Encroachment: Septic System in 10' Utility Easement Chickadee Slopes Subdivision, Tract A, Lot 1B, Grid 2739, 12301 Rockridge Drive Right of Way Section Phone: 907-343-8240 Fax: 907-343-8250 The Right of Way Division has reviewed a request for a letter of non -objection to a proposed septic system, which will encroach approximately 3' into the 10' Utility Easement. On the plan and profile plans prepared by Pannone Engineering and dated November 2, 2010, submitted with the request, the petitioner has shown the proposed septic system. This letter of non -objection is issued with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Maintain letters of non -objection from the following utilities: ❑ Anchorage Water & Wastewater Utility ❑ Chugach Electric Association, Inc. ❑ Matanuska Electric Association, Inc. ❑ Municipal Light & Power ❑ Eyecom (Girdwood Cable TV) ® Alaska Communications Systems ❑ Matanuska Telephone Association • Enstar Natural Gas Company ® GCI Cable of Alaska ❑ No letters required All letters of non -objection should be retained in your permanent files. If you have any questions, please call me at 343-8240. Sincerely, /-,,ylack L. Frost, Jr. Right of Way Supervisor Concur Property Owner(s) Mailing Address: P.O. Box 196650 • Anchorage, Alaska 99519-6650 • http://www.muni.org Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Department On -Site Water and Wastewater Program Department **** VARIANCE/WAIVER REVIEW **** WR#: osp111026 HA#: Permit#: osp101260 PID#: 015-231-84 Legal Description: Chickadee Slopes Tr- A Lt -1 B Engineer: PES Applicant: Mark & Judv Luiten Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: Date: 4/14/2011 X Waiver is not Granted: Approved by: Rec#: 3 'Amount: 2 0 d Date Paid: 3—// V l/ e • - eviewer **** VARIANCE/WAIVER REVIEW **** On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP101260 Tax Code Number: 01523184000 Work Type: Septic Upgrade Permit Effective Dates: November 02, 2010 to November 02, 2011 Design Engineer: Subdivision: CHICKADEE SLOPES Site Legal Address: CHICKADEE SLOPES TR A LT 1B G:2739 PANNONE ENGINEERING SERVICE Owner/Address: LUITEN MARK E & JUDY MAY 12301 ROCKRIDGE DRIVE ANCHORAGE AK 995162434 Site Mailing Address: 12301 ROCKRIDGE DR, Anchorage Lot Size in Sq Ft: 37796 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The Final Inspection Report will not be approved until all letters of non -objection are received for the trench in the utility easement. 1 Received By: � jiiV /10 Date:( L Y Issued By: l( G OrA-v im . - Date: ////-/O Parcel ID. D. 015-231-84 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s) Mark & Judy Luiten Mailing address 12301 Rockridge Drive, Anchorage, AK Site address 12301 Rockridge Drive, Anchorage, AK Day phone 6 3 Z - Li 7..00k Zip Code 99516 Legal description (Sub'd., Block & Lot) Chickadee Slopes, Tract A, Lot 1B Zip Code 99516 Legal description (Township, Range & Section) Lot Size 37,796 Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN: Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage ❑ Initial ❑ 0 Upgrade 0 ❑ Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Sing Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property •wner or authorized agent) Permit/Rush Fees: 2,00 Waiver Fees: Date of Payment: Receipt Number: 065070 (Rev. 11/05) Date of Payment: Receipt Number: Pannone Engineering Services iic Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(cr�panengak.com November 2, 2010 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Chickadee Slopes S/D, Tract A, Lot 1B Emergency Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1000 gallon Septic tank be issued for this lot. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a three-bedroom house and is operating adequately for three bedrooms. The existing outlet end of the tank has collapsed causing backup. The homeowner is pumping the tank weekly to keep it from spilling onto the ground. The existing tank will be filled with clean gravel and abandoned per code. The surrounding lots are served by private water systems and there are no wells within 200 feet of the proposed septic tank. This lot is served by private well. PES will verify all required separation distances at time of installation. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 1B is approximately flat. The proposed installation will be located in the north -central portion of the lot next to the existing septic tank and absorption system. 17, Ancht"%rag :Physical: 6.:5 East 2_.' Ave, Cuite B6, An ="i e e shone: (907) 272-821.8 FAX: (90? Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, ■ g^ THS, ■ ■ Steven R. Pannone • CE 8149 •� 1•■■■■.••• t tic? Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Main„ P.O.Box . ; 2 a.7, Anchorage,,, AK 615 East 82..'t Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX:: (907) 272-8211 TRUE NORTH z� 0 Q D z Z Q �w O 0 CLEAN OUT CLEAN OUT 0 ROCKRIDGE LU 0 J z mQ 0 - 0 LOT UNDEVELOPED ^ NO WELL OR SEPTIC L WITHIN 200' A LETTER OF NON -OBJECTION WILL BE OBTAINED 10' Util Esmt ss D/W ABANDON EXISTING TANK PER CODE INSTALL FCO NEW 1000g SEPTIC TANK INSTALL DCO CONNECT TO EXISTING FIELD EXISTING 3BR HOUSE CONNECT TO EXISTING FIELD NEW 1000 SEPTIC TANK EXISTING FIELD PROFILE PROFILE W WELL (E) HUFFMAN RD NOTES: FOR CONSTRUCTION PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 PLAN CHICKADEE SLOPES TRACT A, LOT 1B MARK & JUDY LUITEN 12301 ROCKRIDGE DRIVE ANCHORAGE, AK 99516 ``SOF q� �c. . qs% kh /.��•�P !f'9O+ Steven R. Pannone j f, +�, CE 8149/ `l\ - Date 11/02/10 PERMIT NO. OSP101260 Sheet 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ���iIiii 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME/ `� ��% ��% t-- A- `� �� 4e- I `_� PHONE/ 3'iL� 4, EW li PGRADE ^2 MAILING ADDRE G jPi'•J5.� LEGAL 6ESCRIPTION ` 0407- / 6 C�r .i _042 e� S 6�i�- -- LOCATION NO. OF BETBRQOMS SEPTIC TANK TO: Well�f_�? (( Absorption area '7�'+' Dwelling PERJ li-. N� of,, ,::2_.e7) I�r/� CJ` Man uf!tiir�2 Materice �e.� •�J No. of compartments Liq. caCCpa't in al ons IF HOMEMADE: Inside length Width Liquid depth JaZ 2 � FQ- DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well :y••fjj, - Foundation � Nearest lot,/ PERMIT NO?//....2 d No. of lines Lengt f ea h I' Total len pts ( Trench wi inches1� Distance bet ei s Topof tile to finish grade Material eneath tile � inches Total ective absorption area ���p SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J J w Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) OTHER v l PIPE MATERIALS t 36 ,I' ' ' SOIL TEST RATING !r=s # El Elwin in ■■■■■■I■■■■■ 1 INSTALLER [mo i e nizte- REMARKS REMARKS ,IIIllhIOIIII Ig APPROVED DATE q % LEGAL • .. 11 k 0 1. c I A A A A 1.. 1 Sk 72-013 (Rev. 3/78) �������� OF- ������� DEPARTMENT HEALTH AND ENVIRONMENTAL 1]TECTION / ~ - 825 � STREET, ANCHORAGE, HK 9!..7.J01///ov/`/��°�°� ' 264-4720 WEELA___ nr.m. falr.4_s=im sE7. R.F.9.1I-1- PERMIT Na ( 810120 ) /:' '� ~ �� ' /c -/'J -q/ APPLICANT LARRY SMITHWICK SRA BOX 7:9%."-ZA 995A7 349-4082 LOCATION HILLSIDE/HUFFMHN ROADS [�J_LOr LEGAL L 18 TRACT A CHICKADEE SLOPES LOT SIZE 54000SQUHRE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH vkue_°L) MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 100 —//S ---Xl` THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: c. CnEFM-1= �FCFIVEL �EFD'Irt-l= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F:1711_,IF:EC) TRIFAK S7 I2TE= IL -10E110 laIFIL-L-Cl���� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE ___ -TWO IC:27> IINIF"ECTIONS: BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEEL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETIOR OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT E::-4PIRES DECEMBER I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: % UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED. APPLICANT LARRY SMITHWICK 0 duoi ISSUED BY DHTE__�L����� Y40 -MUNICIPALITY OF ANCHORAGE , Department f Health and Environmenta Protection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT Applicant: LQ rr y X77; cj / e k Mailing Address: 6 e /q j 5 2 3 ' Location: 511 4c. J Phone Number: .3y —</6�':� /3y5 -37y/ Legal Description:Lt?/1 T,', 14' e/7,(taclee 54,-ejLot Size: /Yy- GZCr Type of Soil Absorption System Is: Trench: t/ Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) /060 The Required Size of the Soil Absorption System Is: DEPTH rI LENGTH O GRAVEL DEPTH 3 WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /000 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * # * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: Issued by : Applic SWP/024 (1/81) 35 FT G7a 3 J. Date: c/ ,/ r oe„ , MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVHY)NMENTAL PROTECTION � Pouch 84550, Anchorage, Alaska 49602 276-2221 r t • SOILS LOG -- PERCOLATION TEST F 01 t.C)£; 1.3 PERCOLATION TEST. 1w/54/4/ 4g.5 DATE PERFORMED: d►rgam;e3 .5),r /0000 : /1 1 • 0" 4ceD \ 1 1,0 -4H -e ,LJ d_ou/5-yi (LA n c\, r1(\_ct_ - _ /c/ 1(c) 7 7 /0 (3P C CD cpL LoLu fielp („c- >Co .,t52.1ice% w e aanormag a/ :31V0 ri 7 (6L/9) 800-ZL .l8 031A1a03a3d / �7 Id ONV ld - N33M138 Nfla 1S31 (yaul/salnulw) J k.. ,1.j / •-.? Ssa7 3IVH NOILV1O 083d 0.0 "1 2 o C ?-.0 (2 0 zj'O 6/'o Z 2 h o /s ' a o 0 zf'o SQ'O Z 2 -Zr. -0 /h'9 0 a _A-4/ i doia laN ,alert o141daj awll laN aw)1 sswo °lea 6u!pea)j -�T 1 eS 4'10D7 1 f,.,r 14 NV1d 311S 3 d 0 1 S 5J -Z. d'hI„ S -bn 4 1 J T 1,07 eJ /baan/ 5//trr7 LHld30• / yw' ' q IVHMIV'S3.1di d1Q/5 J.o 7Sn2-race f .'why( "C/ O3a31N(1O3N3 .a,t /iv/ 1.-2...f4ld31VM ON(lO8D SVM � fps/ f 3z�/fa t w//pe -,r�•�.tor� p/^vy ?9/-//. I$ 0/% 00 pp 4111' l7/A V/ -(1,1 /I?rD.V ',/?'d•494a 9 ' ss)l )41 3d01S 1S31 NOIIV10083d DO1 S1IOS ❑ »d'/S � ao z / / b/ /zj_� ti 7 :G3LAIHO3!!3d 31VO SIN3WW00 - OZ -61 - 81 - L1 -91 - 91 - 171 - 21 - Zl - 11 - 01 - 6 - 8 - L - 9 - 9 - ti - Z (133d) HId30 :NOIldf1:10S30 1V031 I /� 0 S/ lir.1 1S31 NOIIV1O31:13d — 9O1 S1IOS OZLb-179Z L0966 eiseIV 'e6eJo113ud 'lea. % '1 9Z8 NOI13310Hd 1V1N3INNOHIAN3 aNV Hl11/3H dO IN3IN1HVd3O 39V8OH3NV AO J1111VdI3INf1W :1j0d 031/VEOdH3d BLW�taILiana watt= $343x 1369, STAR ROUTE A ANCHORAGE. AL.ASIKA 99502 344-7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF "'ff'21' O( PER FOOT. PROPERTY OWNER I 6 0 • LOCATION OF WELL SITE �• yf� f ?}vac k f3 e.)it-Le Ctaa.3 o r° L ? ? alr.t Jn i,L! ing o' i -i . C'l� C � �� r ! 0 D �I r� ✓ . DRILLER WELL LOG: 0----18' Couit4ep a,ve-L vr-Wt 20;x; i t irca t-e4,%cL1 . 18---33' �C Baru'. (LCI -P,7 t Lt, Ui .1ti l.)(,i c t1.tl . ---45' 0alcdp.arz. ii ceimen ted. gpzccvet. 4C--160' 8P.Ci ock. ^•c_' I.-ClILP,!"i.t-a}7 i J.C3C-y-. b'ate,t p, oduct-LorL o . 1.5 to po.syiitr1Jf 2 gm. FaL'tLL. fa—t lt,ecove ip. 0el .. may. a-140 -trivie.uise with. case. /J en g.i.e td com i.ru� owt of. a. q -u pe )t..ock. 7. %olt- t pee- at tri th. oyel. 700 1?ee t o1 tvate4. 4-twLC-irLl. U ccr4 -4. 7/2 hoe 4u brnerz4-Ute pump. 4h.owLd (re 4.17.4 ta,Lted 10 -, ee t o f bottom.. 1 57_7,00 - ;13 60. 00 COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF THANK YOU VERY MUCH. 33360.00 BERNIE CLAUS OF RAMPART DRILLING WORKS 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. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 51eA G Location (address or directions) l�► L ' Cf (Li +E 41W FFwt :t (b) Applicant Name M ` ^V -Ce Telephone: Home 345 --41-4`35 Business 276 —1 F.c!..1% Applicant Address 4 Z �C \ V't3c.=+G-gI UCS A- cCK .ir£ , AL 9' j I C (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder? Buyer ❑ ; Other 0 (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 4t- 2. TYPE OF RESIDENCE Single -Family' Multi -Family 0 Other Number of Bedrooms .3 3. WATER SUPPLY Individual Well Community 0 Public 0 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 Onsit 7 Public 0 Community 0 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 1 of 2 72-025 (11i84) 5. ENGINEERING FIRM PROVID INSPECTIONS, TESTS, FILE SEARCH, L .4 AND INFORMATION 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 44.1 "" eft- < }'�'t� Telephone 45-7 Address � � tvQO CAN CIE ISD P}NC_tlt tc / At_ 7757 4. Date 5/61(T -A 6. DHEP APPROVAL C Approved for t—e--bedrooms by 7OF At'44 �oeQ� Ark , ••t.;® • 7ft 10; q !�• THOM A. FISCHER �0t•.. CE -6793 +¢t0 Engineer's Seal ate Approved Disapprove Conditional Terms of Conditio al Approval CAUTION 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 72-025 (11/84) A. WELL DATA MUNICIPALITY OF ANCHORAGE (MO, -.1 MUNICIPAL! 1eAWeORITY APPROVAL (HAA) DEPT. EAL ENVIRONMENTAL"ST - FEBRUARY 1984 264-4720 Legal Description. C3D-1— -E A MAY G 819986 RECEIVED Well Classification AJ - Well Log Present (Y/N) Total Depth 1 6o r Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) `( Separation Distances from Well: To Septic/Holding Tank on Lot I To Nearest Edge of Absorption Field on Lot t ©° If A, B, C, JPD,E g Approved (Y/N) Date Completed '/ '/ 1 Yield 5. 4 Cr -P" Depth of Grouting i•t)oot GI' Pump Set At Z6 Sanitary Seal on Casing (Y/N) 00 Depression Around Wellhead (Y/N) N� To Nearest Public Sewer Line 1 P Cleanout/Manhole / IAC --T_ A , F zi ; On Adjoining Lots ISO r at ; On Adjoining Lots [E rt To Nearest Public Sewer To Nearest Sewer Service Line on ; Date /8C-' Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed I ©/ 491 Size No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) YQ Foundation Cleanou (Y/N) ;z7 N hq Z Depression over Tank (Y/N) ►.144 Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) 14 Separation Distances from Septic/Holding Tank: ,CDC To Water -Supply Well To Property Line To Water Main/Service Line Course I"lP} Comments Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field L -r To Stream, Pond, Lake, or Major Drainage N114 Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata () ; 0 Date Installed 1 x/14 /'a f Width of Field Type of System Design (1t Length of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area 5 74z) Standpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test 5/6/(:. Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well To Building Foundation Lot 1`31 To Water Main/Service Line e'er- 131S .. To Property Line 2,5- (-1- ; On Adjoining Lots To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area 1O( To Existing or Abandoned System on To Cutbank (if present) N l� ZST-t-' Comments D. LIFT STATION Date Installed Dimensions Size in Gallons ,/,•-"'--Th Manhole/Access (Y/N) .' "Pump On" Level at } "Pump Off" Level at f'7 High Water Alarm Level at Vent (Y/N) Tested for Pumping Qycles 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. Signed => ^^ I�} ._J�'� rn-' Date -51.&(--. Company i..-'rnMs-ittnz- 'rZ G'"ireMOA No Receipt No Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) n;1. ` -. %j :i.,,4•:•.. o ... ♦+ Engineer's Seal r�"%.4 _ THOM A. FISCHER CE - 6793 •• �a';� X4.0• •• . �Q �,%k;®tOfess „..••i APPLIC - NT FILLS OUT UPPER HAI - ONLY Time Phone ( ' i Property Owner ,,. k , Mailing Address ,, ( /l ' A Zip Code Buyer i Address "' 1. -' Zip Code q ` 0; Date Lending Institutionj•- Address i . n Zip Code '-{ (Th Phone i! Ph �n Realty Co. & Agent Address yl. 0 - (--- Zip Code � Legal Description �_i LB -re A Ch f. L c t c e S t op -.L„' Street Location - (AA (ll -\ r,.; \ i'<0C- . Y i c`l (` -- Type of Residence Ingle Family --2 Family No. of Bedrooms .,J Field Notes: MUNICIPALITY OF ANCHORAGE t, 1'EPT. OF i Hi. LT: i ENVIRO;',,1_N1 AL P 3 ECf1ON RECEIVED Multiple ❑ Other Water Supply g/Individual Community ❑ Public Utility ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available). Sewer isposal ilIIndividual ❑ Public Utility ❑ Holding Tank Year Individual Installed: When Connected to Public Utility: Date Sewer Installed /0-1K-1( NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date is -10t- h)16h Inspector Inspector Inspector Inspector( -_l _10- �``s . m Field Notes: MUNICIPALITY OF ANCHORAGE t, 1'EPT. OF i Hi. LT: i ENVIRO;',,1_N1 AL P 3 ECf1ON RECEIVED ( APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITI AL APPROVAL* DATE *CONDITIONS OF APPROVAL 8--- i/ Soils Rating ( S / Date Sewer Installed /0-1K-1( Well To Absorption Area i� i-.., Well to Tank / 5-6 (4- Well Log Received Septic Tank Size / 'Z S 72-023 (3/8Q) M -W DRILLING INC. P.O. BOX 10-378 ANCHORAGE, ALASKA 99511 PHONE 349-8535 NAME k ADDRESS C ITY LEGAL DESCRIPTION TR I L&r 1 B C�-.i�Rc�+✓ES� LEGAL OWNERS EANK OR LENDING INSTITUTIONS CURRENTLY HOLDING DEED OF TRUST !-TOME PH:C;!,tE WORK PHONE INVOICE j Non 2 4 0 0 DATE %k/ 1/ F3 3 OTY. MATERIALS UNIT PRICE AMOUNT TOTAL MATERIALS WELL NUMBER DIAMETER DEPTH PUMP MAKE HP STATIC LEVEL 90 �T GPM DRAWDOWN SETTING VOLTS PHASE AMP RATE SERIAL NUMBER MODEL SCREEN LENGTH SLOT SIZE LINER/SCREEN DESCRIPTION OF WORK DATES C1 Vit 1 "Co R yl�c� 17 � �u� \nls L1 (zi!, TE 04- tpc,pm 57 o j7� s>vJ�ow F.\• /•IF L czc-c-U�►CQC.c c2 r• -•2.s �7 �T�R�f,• A// charges shall be paid in full within ten days unless other arrangements are made prior to drilling. The customer shall pay in- rerest at the rate of 1 Y2% per month on any amount not paid within ten days. Failure to pay may result in a lien against the property WORKMAN DATE IN OUT LABOR HOURS 2 RATE So /00 QS 121 I loon t boo MATERIALS (FROM AECVEI OTHER CHARGES CUSTOMER SIGNATURE PAY THIS AMOUNT -i December 21, 1963 Larry Smithwick SRA 3523A Anchorage, AK 995 Subject: Lot 1L, Tract A, Chickadee Slopes Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: ° The septic tank pumped with a receipt submitted to this department. Please notify tnis Department tor a reinspection when the noted discrepancies have been corrected. It there are any further questions, please call this office at 2b4-4720. Sincerely, Jim Roberts Associate Environmental Specialist JR13/ej/E1 ''Date Date 7 4, d / �Daatee /./Ce) -7/f / , S' Inspector Inspector Inspector Comments Conditional Approval / l9-0 J ril r- c-- _V1 fNVIv}+�- ,, (t., to ifil 1-3:141'._- o vc)ccimoir 3 . ,.ra° Date Sewer Installed Cd .- Permit No. Septic Tank Size / ,SZi Holding Tank Size Soils Rating Well To Absorption Area Well to Tank Well Log Received /14.TL, ..p APPLICANT FILLS OUT LOWER HALF ONLY Property Owner i4 /Pi'/ S tI it / 6.3 1 CX Mailing Address S /1 a 33 Co 4041 ,1k 9 95-o 7 , Phone 395_ 4°.8sa Buyer m7pev SQ-t/%#60(Ce Address 5494 23 3c. 9?so7 C1----)�y� �� Lending Institution /1/45474 5171 .LP�> r�pd �. 0 F ott/A/`apc e c. ----C Address Phone Realty Co. & Agent Address �j, / Phone y� Legal Description C41 c/� odee 3/ ,D Y /� TS 1A( 11 L o /T /n Street Location e-inVA)e,<' a e" qtj 4 -4 -fin OU ie©ciA9/,U6Z f TypResidence Single Family ❑ Multiple Family No. ❑ Other of Bedrooms Watc,Supply A. Individual ATTACH WELL LOG. A well log is required for all wells drilled since June E Community 1975. For wells drilled prior to that date, give well depth (attach log if ❑ Public Utility available.) Sew Disposal Individual Year Individual ❑ Public Utility When ❑ Holding Tank ' /Q 8 Installed: Connected to Public Utility NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 6"15 57p) S • • •(A`'(l( '-� Municipality of Anchorage On-Site Water and Wastewater Program < (907) 343-7904 SAF E ,. Certificate of On-Site Systems Approval Parcel I.D. 015-231-84 Expiration Date: 1. GENERAL INFORMATION Complete legal description Chickadee Slopes Tr-A Lot 1 B Location (site address) 12301 Rockridge Dr. Current Property owner(s) Daniel Esler & Jennifer Kormendy Day phone Mailing address PO Box 12 Point Roberts, WA 98281 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: a f Received byk ' 1 � Date: 1 C� COSA to be released to e eng .. othe '•se equ g-d by the engineer. COSA Fee $ 52(0 Waiver Fee $ Date of Payment L tlItg Date of Payment Receipt Number -1 tog I t Receipt Number COSA# 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 andlor 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the lime of the test. and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date 9/10/2018 qF �'k , •• 6. DSD SIGNATURE 410 System#1 Approved for bedrooms Svonn�n-'e CE-8149 System#2 Approved for bedrooms4 . ii Disapproved FR Ot .� • Conditional approval for bedrooms, with the following stipulations: o 1.1, °N.s• cz GF �F4� ,Q off- By: 1 Original Certificate Date: q---ao 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 blue sheet f '- c • • If more than 1 septic system is on the lot: COSA Checklist# + of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Chickadee Slopes Tr-A Lot 1B Parcel ID: 015-231-84 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y Date completed 6/6/1981 Sanitary seal (YIN) y Wires properly protected (Y/N) Y Total depth 160 ft. Cased to 160 ft Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test 6/6/1981 9/4/2018 Static water level Unknown ft. 39. • 8 ft. Well production 1 .5 g.p.m. 3.6 g.p.m. WATER SAMPLE RESULTS: Coliform Ike colonies/100 mL Nitrate •(1 01 mg/L Arsenic ug/L Date of sample: 914&1112018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 11/6/2010 Tank size 1,250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank(YIN) N High water alarm (Y/N) N/A Date of pumping 71`-ll Pumper /-1 —1 \--\jM ,a1ACOS I , C. ABSORPTION FIELD DATA Date installed 10/14/1981 Soil rating (gi i 115 SF/BR ytypeShallow Trench .p.d./ft or ft /bdrm) System Length 68 ft. Width 36 ft. Gravel below pipe 3 ft. Total depth 5ft. Eff. absorption area 345 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/4/2018 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ 100+ Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 1* Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway,parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS * WR #OSP111026 - Utility Easement Enchorachment Permit on File G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in 0 • � *' conformance with MOA COSA guidelines in effect on this date. .• • ' l� 1 Engineer's Printed Name Steven R. Pannone g •Steven R. Ijannone • Date 9/10/2018 � � • CE-8149 COSA brown sheet 10-10-12.doc i s G s SGS Ref.# 1184923001 Client Name Pannone Eng.Srv. Printed Date/time 09/11/2018 12:31 Project Name/# 12301 Rockridge Drive Collected Date/Time 09/04/2018 11:00 Client Sample ID 12301 Rockridge Drive Received Date/Time 09/04/2018 11:42 Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Mit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.$ C (<10) 09/06/18 09/09/18 VDL Waters Department Total Nitrate/Nitrite-N 0.901 0.100 mg/L SM2I 4500NO3-P B (<10) 09/04/18 AYC Microbiology Laboratory E.Coli Negative 1 I00mL SM21 9223B A 09/04/18 K.W Total Coliform Positive 1 100mL SM21 9223B A 09/04/18 K.W i ,.V _,.. ._i..._... SGS Ref.# 1185297001 Client Name Pannone Eng.Srv. Printed Date/Time 09/20/2018 8:52 Project Name/# 12301 Rockridge Dr. Collected Date/Time 09/17/2018 15:42 Client Sample ID 12301 Rockridge Dr. Received Date/Time 09/18/2018 8:28 Matrix Drinking Water Technical Director Stephen C.Ede Sample Remarks: Allowable Prcp Analysis Parameter Results LOQ Units Method Container ID Limits Date Date !nit Microbiology Laboratory E.Coli Negative I 100mL SM21 9223B A 09/18/18 K.W Total Coliform Negative I 100mL SM21 922313 A 09/18/18 K.W 30.0' 1 1 LOT 2 I ( S 89'54'35"E 134.90' Ai__._r--SEPiIC ---- - F NCFD _GLEt�NQ'JTS GARDEN--.�� —1 \ 'n� EA1 0' MUlan'NT J EASEAIEN7 '32.0' ....c.—,,_..---• \ • I -N 3� \ Z Aspwe_T ' 2 spur RIVEV&Y• ^. LEVEL A5.5' .i. RES. rn r \ r r: ;0.00' ;iyi a, ''^ �1 WINDOW BOX \ I� rt —t-COVERE/PORCH . 'n 3.2 \ / 2' CANT r 32.3' 33.4' \\:-2' l Xi o DECK CANTCANToz 1 / 27.0' --- (") 25.5' N O ( 1 POST & WELD N RAIL NCE 1 I v `T " C) I rri I.3 QLOT 1 —B .... b LOT 1-A/ C., \ 37,796 S.F. ,., 0 /o N 'o / 7 _.-- I —,D Im1rY c.SDAL YT N 89'58.00"W 134.66` — —— — — — 0 S — — — i — — i HUFFMAN RD PLOT PLAN ____ AS BUILT _1 SCALE 1" �., 50' GRID SW 2739 Project No. 18-449/R1 11500 Daryl Avenue, Anchorage, AlaWka 99515-3049 Lang & Associatesi n c . (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenOlangsurvey.com A‘?'‘ Op jonathanOiangsurvey.com P� '' 'Q ' I hereby certify that I have surveyed the following described property: d LOT 1—B, CHICKADEE SLOPES SUBDIVISION (PLAT No. 80-185) f* 49TH •.17�,% 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, tr•ansmistion lines or other visible KENNETH( easements on said property except as Indicated hereon. Q�� � ttu Dated this the Dayof 1 "••,i"- � '� ' . 52Oz.••' , at Anchorage, Alaska Q o kN,%p'sSIDNAL It Is the responsibility of the owner to determine the existence of any easements, DO covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 015-231-84 Expiration Date: 1. GENERAL INFORMATION Complete legal description Chickadee Slopes, Tr -A, Lot 1B Location (site address) 12301 Rockridge Dr. Current Property owner(s) Brian & Jody Malta Day phone 12301 Rockridge Rd. Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: H Single Family (w/wo ADU) LJ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 x n_ FAITTAL )( .i A TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank rnm rnunifv Public Sewer n u WaiverNariance requept fo Distance: Received by: ` 1vti: L.t ./ Date: I ' P%,% it f LI I COSA to be released to the en ineer, unless otherwise requested by the engineer. i COSA Fee $ 62Jo — Waiver Fee $ Date of Payment ICA IL{ IIL( ('a– Date of Payment Receipt Number If g0 Receipt Number COSA# f–N l y 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of at wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Phone (907) 272-8218 Date 10/2/2014 .e (P' OF A�,gskl) %i�.• tit 1%*�t� 6. DSD SIGNATURELy, System #1 Approved for 3 bedrooms % r ; Steven.0,;nnane : j .. CE -8149 • �5 System #2 Approved for bedrooms f s., Disapproved �ji ftitt Conditional approval for bedrooms, with the following stipulations: ssA‘{ OF AVc37); ON-SITE • WAIEKAND % wASTEwATER n, tit P OGRAiv4 j SMI + ) in, By: ,, //12, Original Certificate Date: The _ unicipzl ty of Analage 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 blue sheet_c If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Chickadee Slopes, Tr -A, Lot 1B Parcel ID: 015-231-84 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 6/6/1981 Sanitary seal (Y/N) Total depth 160 ft Date of test Static water level Unknown ft. Well production 1.5 g.p.m. Well Log (Y/N) Y Wires properly protected (Y/N) Cased to 160 ft. Casing height (above ground) 18+ FROM WELL LOG 6/6/1981 WATER SAMPLE RESULTS: Coliform 'vim colonies/100 mL Arsenic /V N1 ug/L Nitrate a• SS (o mg/L Date of sample: 10/1/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Depression over tank (Y/N) Date of pumping 5/27/2014 AT INSPECTION 10/1/2014 37 4.1+ Collected by: PES ft. g.p.m. in. Date installed 11/6/2010 Cleanouts (Y/N) High water alarm (Y/N) N Pumper Denali Sewer & Drain C. ABSORPTION FIELD DATA 10/14/1981 115 SF/BR Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) Length 68 ft. Width 3 ft. Total depth 5 ft. Date of adequacy test Fluid depth in absorpt Elapsed Time: 170 Eff. absorption area 345 ft2 System type Shallow Trench Gravel below pipe 3 ft. Depression over field N Monitoring tube Y 10/1/2014 Results (Pass/Fail) Pass For 3 bedrooms ion field before test 14 in. Water added 481 gal. New depth 21 in. Final fluid depth 14 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date min. D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Manhole/Access (Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout Holding tank 100+ 100+ Manure/animal excrete storage areas 100+ 5+ Property line 5+ Absorption field 5+ Water main 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Water service line 10+ Surface water 100+ Property line 1* Building foundation 10± Water Service line 10± Curtain drain 50+ Surface water 100+ Wells on adjacent lots 100+ Water main 10+ Driveway, parking/vehicle storage 10+ F. COMMENTS * WR #OSP111026 - Utility Easement Enchorachment Permit on File G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformancewith MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 10/4/2014 COSA brown sheet 10-10-12.doc diP top Stever •:'':nne:" nof Tte CE -8149 • ,fr int LOT 2 S 89'54'35"E 134.90 SEPTIC - FENCED OSS GARDEN—�� F 4 a 30.00' 62:0 n ASPPULT <DRIVEWAY ROCKRIDGE DR Z O 4 0 COVERED' PORCI I 2' CANT 10' UTILITY EASEMENT 38.2 SPLIT LEVEL RES. G S^ 3.2' 32.3' 6.5' 1' WI 33.4' 316'1 I _o MEI ro 2• C o DECK O 27.0' `-10' UTILITY EASEMENT 25.6' HELL \\ LOT 1—B 37,796 S.F. W BOX S 00'01'52"W N 89'58'00"W 134.66' HUFFMAN RD PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 2739 LOT 1-A/ / ` Project No. 14-184 Lang& Associates,Inc. 11500 Daryl Avenue, Anchorage, (907) 52.2-6476 Phone Registered Land Surveyors (907) 522-4625 Fax kglanglsOalaska.net / jclangls*alaska.net I hereby certify that I have surveyed the following described property: LOT 1-8, CHICKADEE SLOPES SUB. (PLAT 80-185) 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 \O ' Day of oc..-rtzb 't- , Ut !-, 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. Alaska 99515-3049 .c(); 4913 s Y KENNETH G. LS -5202 r % •' 1u(em tis-••• %,trss t 4 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING conA# (3g c )21025 Expiration Date: c5 — /0 — % a. Parcel I.D. 015-231-84 1. GENERAL INFORMATION Complete legal description Chickadee Slopes, Tract A, Lot iB Location (site address) 12301 Rockridge Drive Current Property owner(s) Mark & Jody Luiten Day phone Mailing address 12301 Rockridge Drive, Anchorage, AK g9516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBE7 OF BEDROOMS: . TYPE OF INAT4R SUPPLY: individual Welly IndviEival,Water Storage Community Class Well Public Water System rsi ❑. 3 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer 0 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. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services. LLC Address P 0 Box 100217 Anchorage AK ggsao Engineer's Printed Name Steven R. Pannone. P.E. Phone 272-8218 Date /2.0( Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE i/ Approved for . bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: (Rev. 11105) 44* P"� ........ „qwq� �r4A rG'"G, o.h :Steven R. Pannone,// -;;a ‚zay .i''oCy CJ Z aa,: ON-SITE •',l WATER AND m- t WASTEWATER : • PROGRAM •. Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other )790Original Certificate Date: 0,2,— / 0 - l2— Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Chickadee Slopes, Tract A, Lot iB Parcel ID: o51-211-84 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 6/6/1981 Sanitary seal (Y/N) v_ Total depth 26o ft. Cased to 26o ft. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 6/6/1881 1/24/2012 Static water level UNK ft. 18 ft. Well production 1.5+ g.p.m. 3.2 g.p.m. WATER SAMPLE RESULTS: Coliform 4/Eer colonies/100 mL Nitrate 0.6gymg/L r Arsenic: 4/0 ug/I Date of sample: I f ui7Z Collected by: P.Cr S • B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic / Steel Date installed11/6/aolo Tank size 125o gal. Foundation cleanout (Y/N) Y Date of pumping 1/24/2012 Number of Compartments z Cleanouts (Y/N) Y C. ABSORPTION FIELD DATA Depression over tank (Y/N) N High water alarm (Y/N) Pumper One Stop Services 4' Date installed 10/14/1981 Soil rating (g.p.d./ft2 or ft2/bdrm) 215 SF/BR System type Deep Trench Length 68 Total depth 6 ft. ft. Width . ft. Gravel below pipe 3 ft. Eff. absorption area 408 ftMonitoring tube Y Depression over field N Date of adequacy test 1/24/2012 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test o in. Elapsed Time: 220 min. Final fluid depth o in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Water added r gal. New depth ° in. Absorption rate >= 4co+ g.p.d. If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _ in. "Pump off' level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot too+ Absorption field on lot too+ Public sewer main 75+ Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots too+ in. On adjacent lots too+ Public sewer manhole/cleanout too+ Sewer /septic service line 25+ Holding tank Animal containment areas ;o+ too+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Water main to+ Wells on adjacent lots too+ Property line to+ Water service line 25+ Absorption field c+ Surface water too+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 2!* Building foundation 10+ Water Service line to+ Surface water too+ Curtain drain 5o+ Wells on adjacent lots too+ F. COMMENTS * Lot line waiver WR#: OSPnlo26 - Utility Easement Enchorachment Permit on file. Water main 75+ Driveway, parking/vehicle storage 10+ 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. Engineer's Printed Name Steven R. Pannone. P.E. Date 4,(-)4.0 OPE OF A�gS�.4 TH i c �� i • i••� Steven R. Pannone, i No. CE 8149'•x= 40 FESS •*** COSA Fee $ -i`i O , U) Waiver Fee $ Date of Payment a tri -10 Date of Payment Receipt Number 0 3 5g.2,6 Receipt Number (Rev. 11/05)