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ALPINE TERRACE BLK 1 LT 7
MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251451 Parcel ID 015 -243-31 Expiration Date: 10/31/2025 Legal description ALPINE TERRACE BLK 1 LT 7 Site address 11851 NEBESNA DR Current property owner(s) HORTON WENDY & ROSS _ The On-site system(s) is/are approved for bedrooms X Conditional approval for 4 bedrooms, with the following stipulations: By: Comments or conditions: Disposal field upgrade to be completed on or before 10/31/2025 and permit OSP251321 to be closed out. Original Certificate Date: 10/14/2025 This Cer ' cate of On -Site Systems Approval (COSA) is intended to demonstrate the subject syste (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, De elopment Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other j� CONDITIONAL COSA AGREEMENT COSA NO. SUBDIVISION: Alpine Terrace LOT. ! The buyer of the above referenced property agrees to complete all the conditions required on the Conditional Certificate of On -Site Systems Approval (CCOSA) issued by the Municipality of Anchorage (MOA) by the above referenced date. Failure to do so will result in a daily fine of up to $300 every day after the expiration of the Conditional COSA (see AMC 14.60.030). Additional fees will be assessed for inspector's time associate with violations at $145 per hour (minimum one hour). The buyer, once owner, shall be responsible for all violations on the property. I, Gregory M. Naylor, (BUYER) have carefully read this agreement, understand its contents, and acknowledge I am responsible for compliance wit�h- Municipal Law. GAG C jt i-1- 1�1i�-r �, u� , be �; k2 c�2?v�� rr Signature: Date: � 2- q / `2,v 9 Buyer Name (Printed): Gregory M. Naylor, by Kelvin Sonnekson, as attorney in fact STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT The foregoing in nt was acknowledged before me this �,,7 by NOTARY PUBLIC FOR ALASKA My Commission expires: ,,I yle � �1 Page 1 of 1 h day of September , 2025, (Sof Alaska NOTARY PUBLIC Breanna A. Bovey My Commission Expires Jun 22, 2029 MUNICIPALITY OF ANCHORAGE Development Services Department \, / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-243-31 Complete legal description Alpine Terrace, Block 1 Lot 7 Location (site address) 11851 Nebesna Dr Current property owner(s) Wendy & ROSS Horton Day phone (318) 366-2138 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: FO -1 Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: Fm� Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 2 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑E Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ bKU Waiver Fee $ Date of Payment I01�lg Date of Payment COSA # 05 625tg5( Waiver # COSA Applicalion_Apr2025.doc 700 W 41st ave Suite 201 Anchorage, AK 99503 (907) 345-1890 info@aplusak.com Estimate ESTIMATE#1075396791 DATE 09/22/2025 PO# CUSTOMER Justin Milette 11851 Nebesna Dr Anchorage Alaska 99507-8028 (907) 306-9436 SERVICE LOCATION Justin Milette 11851 Nebesna Dr Anchorage Alaska 99507-8028 (907) 306-9436 DESCRIPTION To install one trench that is 70' long X 5' wide X 2.0' effective and to meet ALL engineer specifications per design dated 09-04-2025. *WE WILL MATCH COMPETITOR PRICING WITH COMPARABLE INCLUSIONS/EXCLUSIONS* Inclusions: Pipe & Fittings Fabric Sewer Rock Insulation Well Radius and Property Line Survey Bull Run Valve Machine & Labor Price of required pumping *50% deposit required prior to the start of commencement of work, remaining balance to be paid upon job completion. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. We are responsible for calling in utility locates. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. This estimate is only valid for 30 days. If acceptance does not occur within the 30-day period, it will need to be revised to reflect current market price increases. A 5% per handling fee will be charged if paying by credit card (we accept all major credit cards), and a monthly 3% finance charge will be added to all past due invoices. Tank & Drainfield Description Rate Total CUSTOMER MESSAGE * Please note that 50% is due upon acceptance to secure a scheduled slot * This estimate is based on the current design only * Any work outside of this scope will need to be reapproved by the owner prior to continuing work. * We are not responsible for any damage to driveways, fences, walkways, and or pavement. * Estimate does not account for any ground water problems if they occur. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. New construction or loose soils may cause settlement. We are not liable for regrades or repairs due to frost jacking, settlement or natural causes. Estimate Total:$19,541.00 PRE-WORK SIGNATURE Signed By: EXCAVATION CONTRACT * Please note that 50% is due upon acceptance to secure a scheduled slot * This estimate is based on the current design only * Any work outside of this scope will need to be reapproved by the owner prior to continuing work. * We are not responsible for any damage to driveways, fences, walkways, and or pavement. * Estimate does not account for any ground water problems if they occur. **In the event that ground water is encountered during excavation, in order to maintain integrity of the tank and prevent damage or "floating", Tank Ballasting will be required. This will incur an additional charge to cover the required ballasting materials and labor, based on engineer/code requirements and/or manufacturer suggested method.** We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. If locates indicate utilities are in close proximity or cross the excavation site and require additional caution and labor to hand dig in the area, an additional charge will incur based upon labor hours and difficulty. Pricing is subject to change in the event of unforeseen circumstances such as, but not limited to, unearthing unexpected items such as undocumented tanks or old cribs, ground water influx gravel and or sandy soils causing the hole to collapse or any event causing less than ideal work conditions. If one of these events occur the customer will be notified and charged an hourly rate of $250 until event is remedied. In the circumstance in which a special provision is needed in order to remove a fence, tree, deck, stairs, shed or other obstruction near the excavation site, additional charges for contractors as well an administrative fee will be added. A+ Home Services is responsible for contacting the needed contractors unless otherwise specified in a written agreement with the homeowner. We will do our best to coordinate their schedule with the needs of our company and work with the homeowner for any scheduling conflicts, however, this may not always be possible, dependent upon specific job needs. We reserve the right to discontinue work if change orders are not approved in a timely manner. If work is discontinued or delayed for any reason, we may charge additional fees until delay is resolved. **THIS IS ONLY AN ESTIMATE** Job pricing may change upon completion due to price increases from vendors or change of scope on the project. We will do our best to keep in communication as changes occur. A 5% per handling fee will be charged if paying by credit card (we accept all major credit cards), and a monthly 3% finance charge will be added to all past due invoices. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. E S T I M AT E GLW Enterprises, LLC PO Box 2100 53 Anch orage, AK 9952 1-0 053 glwalaska@m e.com +1 (90 7 ) 33 3 -6 9 82 Bil l t o Ross and Wen dy Horton 118 51 Nebesna Dr. Anchorage, AK 99507 Estimate details Estimate no.: 305 4 Estimate date: 0 9/24/2025 #Product or service Description Qty Rate Amou nt 1.Excav ation Ex cav ate for tes t hole (comp leted )$745.00 $745.00 2.Excav ation - M ob ilize and s tage eq uip ment - E x cav ate and ins tall new ab s orp tion field as p er Forge Engineer ing d es ign in comp liance with all M OA s tand ard s and r egulations . - Prov id e p ip e, fittings , rock and ins ulation - Coord inate with engineer for all ins p ections - Ins tall d iv erter v alv e to s av e exis ting b ed for later us e - B ackfill as req uired - E x p or t ap p r ox 3 load s of was te material with d ump fees - Clean up s ite and d emob ilize eq uip ment NOTE : - GLW is not res p ons ib le for any s ettling that might tak e p lace d ue to cold er temp er atures or wor k b eing p er formed in winter months , final land s cap ing includ ing top s oil, gr as s or hy d r o s eed , water mitigation, s ur v ey ing, engineer ing, contaminated s oils , s wp p p . - Should exces s material b e ab le to r emain ons ite GLW will p as s that s av ings on to cus tomer. 1 $15,900.00 $15,900.00 Total $16,645.00 To: Ross and Wendy Horton Date: 9/26/25 Re: 11851 Nebesna Dr. B.C. Excavating, LLC. Proposes to provide the equipment, labor and materials necessary to perform the civil site work for the above referenced project, as detailed below. Pricing based on rough plans from Forge Engineering on 9/12/25. Price to include the following: o Mobe o F&I new diverter valve o Install 4” pipe to new 70’ x 5’ infiltration trench to MOA Standards/ Forge design o Import drain rock and additional material for backfill o Backfill and re-grade with existing materials Assumptions: Access is adequate for 8’ wide machine, no conflicts with any other utilities , septic tank is pumped before work, schedule is mutually agreed upon Estimate Total $17,575.00 Exclusions: Jetting of septic lines, re-seed/ landscaping, survey, concrete, asphalt, permits, SWPPP plan, engineering, quality control testing, winter conditions, any items not specifically stated in inclusions above. B.C. Excavating requires a 50% (Fifty Percent) deposit before work begins on all residential projects. No credit cards accepted. This proposal shall be incorporated by reference or attached to and made part of the contract documents. All work contingent upon mutually acceptable schedule. Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. Any work items not specifically stated in the inclusions above are not included in our pricing. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, wind, earthquake and other necessary insurance upon above work. Owner to locate any lines not located by the “Locate Call Center.” Invoices are Net 0. Not responsible for delays/complications due to COVID-19. Respectfully submitted, Scott Franz Project Manager October 1, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Alpine Terrace, Block 1 Lot 7 – 11851 Nebesna Dr Conditional COSA request Dear On-Site Services Engineer: The owners of this lot reached out to us early-August to test this system for a COSA. At the beginning of the test it was noted that the existing bed was very close to failure, 5” out of 6” used. We decided to try the test hoping the bed would still accept the required amount of water. It did not. The existing bed is at capacity and we deemed it failed. At this point we moved forward with a drain field replacement permit and were able to get approval mid-November. While the current drain field is nearing the end of its useful life, the system has not backed up into the tank, there are no smells in the yard or soft spots in the soil, and there has been no daylighting of effluent. The water sample from the well had minimal nitrates in the water. For the time being there is no confirmed contamination from the system and it continues to be operational for the occupants. However, the sellers had hoped to close at the beginning of September and have had to push that date back in order to organize getting everything required for a conditional COSA. They would like to be able to close as soon as possible but at this point in the season, most contractors are at least a few weeks out. The buyers have collected 3 estimates and the attached letter noting that 150% of the highest bid is placed in escrow with 50% authorized to be released prior to the start of work as a deposit and the rest to be released when the project has been installed. We request a Conditional COSA be issued to allow for the sale of the home, with the work done as soon as can be scheduled with a contractor. Thank you, Benjamin Schiller, PE COSA Checklist Legal Description: Alpine Terrace, Block 1 Lot 7 Parcel ID: 015-243-31 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled C. 1973 Total depth Unknown ft Cased to 42+ ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 8/12/25 Static water level at beginning of test 14 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 55 Date of pumping 10/6/25 ❑ Required maintenance completed, if AWWTS Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) NEW* ALL standpipes present per record drawing Total easured depth from grade ft (max) Measured pth to pipe invert from grade ft (min) ❑ N/A — p ssurized field. ❑ Per record wings, field is insulated. ❑ Monitor tubes go to tom of effective. If not, state depth into eff ive ❑ Presoaked required if (Required if house vacant or field t used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 4.0 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 8.36 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by Forge Engineering Date 8/6/25 C.=STATION❑ R Age of lift station Lift station material Comments: ance completed equacy test date sults ❑ Pass Fluid th prior to test Water add gal New fluid dept in Elapsed time min Final fluid depth in Absorption rate g d FIELD STATUS — POST RE Effective depth (per record d Effective depth used Effective depth remaining _ in DVERY a *ngs) in in in Comments/Deficiencies: *Conditional COSA requested with active drainfield upgrade permit COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' 0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Disposal Field on Lot > 100' ❑■ Yes if No ft Neighboring Disposal Fields > 100' R Yes if No ft Sewer Line/Main > 100' R Yes if No ft Sewer Manhole/Cleanout > 100' ❑� Yes if No Sewer Service/Septic Line > 25'[E Yes if No Holding Tank > 100' Yes if No Animal Containment > 50' Yes if No Manure/Animal Excreta Storage > 100' ❑■ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' 0 Yes if No ft Surface Water > 100' 9 Yes if No Field to Foundation > 10' ❑■ Yes if No Tank to Property Line > 5' R Yes if No Field to Property Line > 10' ❑� Yes if No Water Main/Service Line > 10' ❑E Yes if No F. ENGINEER'S COMMENTS ft Wells on Adjacent Lots: ft Wells > 100' ❑� Yes if No _ ft Community Wells > 200' ❑� Yes if No _ ft If tank or field is under driveway comment below ft ft ft ft ft ft ft ft 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 ofFirm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist_May2025.docx Phone (907) 522-7773 Date 10/1/25 .' SOF A�q�ll �* •'qg TH .. .. .. ... ........ J� '. • Benja. ' . chiller ����F�;l , CE 12592 • .������ 1 tl`F�pROFESSI4N�t.� � FirstAmerican Title Insurance Company 1400 W Benson Blvd, Ste 250 Anchorage, AK 99503 crican Il Firs t Am rit, e Phn - (907)561-1844 Fax - (907)561-1948 To: MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT ON-SITE WATER & WASTEWATER SECTION In reference to the attached AGREEMENT AND INSTRUCTIONS TO HOLD FUNDS IN ESCROW -MUTUAL RELEASE - WEATHER DELAY First American Title will verify that the money shall be held in escrow until such time as final unconditional Certificate of On -Site Systems Approval is issued by the On -Site Water & Wastewater Section. First American Title Insurance Company Authentisign ID: FB8B8B2A-859E-F01 1-8E61-002248330080 .0 A e First American Title Insurance Company 1400 W Benson Blvd, Ste 250 VA Anchorage, AK 99503 401ril T, tic! F stAm can (907)786-9540 Fax: (907)561-1948 To: First American Title Insurance Company ("Settlement Agent") File No.: 0201-4292054 (CW) Charity Wilkinson, Escrow Officer Date: September 29, 2025 Re: 11851 Nebesna Drive, Anchorage, AK 99507 ("Property") "Buyer": Gregory M. Naylor "Seller": Ross Horton and Wendy Horton (Individually, a "Party" and collectively the "Parties") AGREEMENT AND INSTRUCTIONS TO HOLD FUNDS IN ESCROW - MUTUAL RELEASE - WEATHER DELAY This Agreement and Instruction is to be used when the Parties agree to hold funds for improvements, repairs or other agreed upon items due to weather considerations. It constitutes authorized instructions to the Settlement Agent and may not contain terms for the Parties. The Parties agree and instruct Settlement Agent to hold funds in the amount of $29,311.50 (the "Escrowed Funds") pursuant to this agreement and the instructions contained herein. Purpose of Withheld Funds: Funds are being held for Well & Septic work. The money shall be held in escrow until such time as a final unconditional Certificate of On -Site Systems Approval is issued by the On -Site Water & Wastewater Section. First American Title is authorized to release a 50% deposit required prior to the start of commencement of work, remaining balance to be paid upon job completion.. Party responsible for ordering work: [ ] Buyer [ x ] Seller Estimated Completion date: 10/31/2025 Mutual Instructions: Escrowed Funds are to be released pursuant to and upon receipt by the Settlement Agent of mutual written instructions from the Parties concerning disposition of the Escrowed Funds. If Settlement Agent has not received written mutual instructions from the Parties concerning disposition of the Escrowed Funds, or written notice of a dispute from one of the Parties, by the date that is three (3) months after receipt of the Escrowed Funds or the Estimated Completion Date if listed above, whichever is later, Settlement Agent has the right, but not the obligation, at any time thereafter to issue one check in the amount of remaining Escrowed Funds to the Party that delivered the Escrowed Funds to Settlement Agent without additional notice to or instructions from the Parties. Modification in Writing: Any modification of the Agreement and Instructions shall be given mutually by the Parties in writing. A modification regarding any matter other than the disbursement of Escrowed Funds will be of no force or effect unless agreed to and accepted by the Settlement Agent. Non -Interest -Bearing Account: Escrowed Funds will not be placed in an interest-bearing account. If Escrowed Funds, or any portion thereof, are to be held in an interest-bearing account, separate instructions that are accepted by Settlement Agent and a $ fee will be required for opening and maintaining the interest-bearing account. An interest-bearing account will not be opened for funds that will be held for less than thirty (30) days. Page 1 of 2 Authentisign IDVBIJ8 I& JA2�48 r n Ur"&?Company File No.: 0201-4292054 (CW) Interpleader Action: Any time after the date that is three (3) months after Settlement Agent's receipt of the Escrowed Funds or the Estimated Completion Date listed above, whichever is later, in the event no mutual instructions to release the Escrowed Funds is received by the Settlement Agent, Settlement Agent may, AT ITS SOLE DISCRETION, file an action in interpleader, or any other appropriate and necessary action, and deposit the Escrowed Funds held with the clerk of the court. The Parties agree that all costs, fees and expenses including attorney's fees incurred by the Settlement Agent by filing an action may be deducted from the Escrowed Funds held prior to or upon depositing any of the remaining Escrowed Funds with the clerk of the court. Upon filing of an action in interpleader, or other appropriate and necessary action, the Settlement Agent will be deemed fully released and discharged from any obligations, duties or requirements imposed by these instructions. State Escheatment Requirements: Settlement Agent will forward any remaining balance of the Escrowed Funds held to the applicable state agency or department requiring the disposition or handling of unclaimed property pursuant to the applicable state's unclaimed property act or administrative rules. Once any remaining balance of Escrowed Funds held has been escheated to the State, it may be necessary for the Parties to file a claim with the State in order to receive any of the Escrowed Funds deposited with the applicable state agency or unclaimed property department. Indemnity, Hold Harmless and Limit of Liability: The Parties agree to indemnify and hold Settlement Agent harmless from any loss or damage arising from or pertaining to the Parties' conduct, requirements, action or inaction regarding the matters addressed herein or for any other loss or damage that is not caused by Settlement Agent. The Parties acknowledge and agree that Settlement Agent's sole responsibility arises under the instructions given to Settlement Agent. The Parties further expressly waive any special, incidental, punitive or consequential damages arising out of or in connection with these instructions to Settlement Agent and that Settlement Agent's liability is limited to and cannot exceed the amount of Escrowed Funds held. Authentisicim' kofd oetoh ss Horton Authentisic,,\! Wetidy ortoh Wendy Horton bre Authenti��ic,-m3orfor y /0- Nay Gregory M. Naylor Page 2 of 2 CONDITIONAL COSA AGREEMENT COSA NO. SUBDIVISION: Alpine Terrace LOT. 7 The buyer of the above referenced property agrees to complete all the conditions required on the Conditional Certificate of On -Site Systems Approval (CCOSA) issued by the Municipality of Anchorage (MOA) by the above referenced date. Failure to do so will result in a daily fine of up to $300 every day after the expiration of the Conditional COSA (see AMC 14.60.030). Additional fees will be assessed for inspector's time associate with violations at $145 per hour (minimum one hour). The buyer, once owner, shall be responsible for all violations on the property. Buyer Name (Printed): STATE OF ALASKA Gregory M. Naylor, by Kelvin Sonnekson, as attorney in fact )ss. THIRD JUDICIAL DISTRICT The foregoing in, -uffient was acknowledged before me this day of September, 2025, by NOTARY PUBLIC FOR ALASKA My Commission expires: Page 1 of 1 kky"av,vi At aSKa NOTARY PUBLIC Breanna A. Bovey I L My Commission Expires Jun 22, 2029, 1 September 5, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Alpine Terrace B1 L7 - 11851 Nebesna Dr Septic system design Dear On-Site Services Engineer: The owner of the above lot owns a 4-bedroom home on the property. The septic absorption trench serving the home has reached the end of its useful life, so we are submitting this permit application for the construction of a new one. The attached site plan identifies the location of the home as well as the proposed trench locations. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot has a mild slope of around 10%-15% from the southeast to the northwest. There are no slopes greater than 25% within 50 feet downslope of the proposed trenches. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251321, Isatou Njie, 09/12/25 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND ALPINE TERRACE, BLOCK 1 LOT 7 FEET 0 50 100 SEPTIC PLAN 9/4/25 N E B E S N A D R I V E CIRCLE DRIVE SO L D O T N A D R I V E 950 945 940 935 70' LONG X 5' WIDE, 2.0' EFFECTIVE DEPTH TRENCH INSTALL DIVERTER VALVE TO SAVE EXISTING BED FOR LATER USE CO MT MT CO EXISTING TANK TO REMAIN IN SERVICE EXISTING WELL 4-BDRM HOME EXISTING WELL EXISTING WELL 100' RADIUS NEIGHBORING WELLS BEYOND 100' NEIGHBORING WELLS BEYOND 100' TH#1 1973 SEEPAGE PIT, ENSURE 12' SEPARATION TO NEW TRENCH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251321, Isatou Njie, 09/12/25 ALPINE TERRACE, BLOCK 1 LOT 7 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5' WIDE TRENCH SYSTEM EXISTING 1500-GAL SEPTIC TANK BOTTOM OF TRENCH: 4.5' BELOW GRADE (5' MAX) FLOW LINE ELEVATION: 2.5' BELOW GRADE 600 GPD / 1.2 GPD/SF / 5' WIDE * 0.7 RED FACTOR [2.0' DEEP] = 70.0 LF TRENCH REQUIRED (70.0 LF SPECIFIED) GEOTEXTILE FABRIC w/ 2" INSULATION 9/3/25 2' 5' 2' 6" PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 6" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251321, Isatou Njie, 09/12/25 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING DEPTH TO WATER AFTER MONITORING <1 8/27/25 1 2 3 4 5 6 SW-SM (WELL-GRADED SAND w/ SILT AND GRAVEL) Professional Engineers Stamp: ALPINE TERRACE, BLOCK 1 LOT 7 8/27/25 015-243-31 ROSS HORTON 53 8 16 OB 00:20 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: JARED EARLS 59 8 16 10.0' 9/3/25 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION DETERMINED BY LAB ANALYSIS. 9/3/25 MOISTURE NOTED AT TIME OF DIGGING?NO 00:23 00:25 00:23 00:25 00:25 53 8 16 59 8 16 6 0 16 53 8 16 59 8 16 6 0 16 53 8 16 59 8 16 6 0 16 53 8 16 59 8 16 6 0 16 53 8 16 59 8 16 6 0 16 ML (SANDY SILT) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251321, Isatou Njie, 09/12/25 Report No: MAT:25-1465-1Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sierra GrayReviewed By:9/3/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com 683/8in 59¼in 53No.4 74½in 1001½in 84¾in % PassingSieve Size Limits 13No.60 8No.100 5.4No.200 18No.40 37No.10 26No.20 Drying By:OvenDate Tested:9/3/2025 0' - 9.5' Sample Details 25-1465-1Sample ID Alpine Terrace, B1 L7Location8/28/2025Date Sampled Atterberg Limit: Liquid Limit:Plastic Limit:Plasticity Index:Linear Shrinkage (%): Sample Description: Grading: Not Obtainable NP (Non-Plastic) NP (Non-Plastic) 20.1520D85:6.5323D60:3.9691D50:1.1584D30:0.3099D15:0.1816D10:35.97Cu:1.13Cc: ASTM C136 Tested By:Amir Mack Particle Size Distribution Page 1 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1465-1 mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (47%) COARSE 16.4% FINE 30.3% SAND (48%) COARSE 15.9% MEDIUM 19.0% FINE 13.0% SILT/CLAY 5% Diameter mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (47%) COARSE 16.4% FINE 30.3% SAND (48%) COARSE 15.9% MEDIUM 19.0% FINE 13.0% SILT/CLAY 5% 0 10 20 30 40 50 60 70 80 90 100 Perce ntage Pass i ng (by mass ) Report No: MAT:25-1465-1Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sierra GrayReviewed By:9/3/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com Sample Details Not Obtainable9/3/2025Nic CropperWell-graded sand with silt and gravelSW-SMPaul Santillana8/28/20255A1.1335.97 0' - 9.5' 25-1465-1Sample ID Alpine Terrace, B1 L7Location8/28/2025Date Sampled ResultCuASTM D2487 Other Test Results MethodDescription Limits CcProcedure ASTM C117Water Content (%)ASTM D2216Date TestedTested ByGroup Code ASTM D2487Group NameTested ByDate TestedLiquid Limit ASTM D4318 NP (Non-Plastic)Plastic Limit NP (Non-Plastic)Plasticity Index Nic CropperTested By 9/2/2025Date Tested Page 2 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1465-1 Comments Report No: MAT:25-1465-2Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sierra GrayReviewed By:9/3/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com 923/8in 88¼in 85No.4 95½in 1001½in 97¾in % PassingSieve Size Limits 67No.60 62No.100 54No.200 70No.40 79No.10 74No.20 Drying By:OvenDate Tested:9/2/2025 Sample Details 25-1465-2Sample ID 9.5' - 15'Alpine Terrace, B1 L7Location Atterberg Limit: Liquid Limit:Plastic Limit:Plasticity Index:Linear Shrinkage (%): Sample Description: Grading: Not Obtainable NP (Non-Plastic) NP (Non-Plastic) 4.5556D85:0.1242D60:N/AD50:N/AD30:N/AD15:N/AD10:N/ACu:N/ACc: ASTM C136 Tested By:Amir Mack Particle Size Distribution Page 1 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1465-2 mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (15%) COARSE 2.5% FINE 12.2% SAND (31%) COARSE 6.0% MEDIUM 9.0% FINE 16.1% SILT/CLAY 54% Diameter mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (15%) COARSE 2.5% FINE 12.2% SAND (31%) COARSE 6.0% MEDIUM 9.0% FINE 16.1% SILT/CLAY 54% 0 10 20 30 40 50 60 70 80 90 100 Perce ntage Pass i ng (by mass ) Report No: MAT:25-1465-2Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sierra GrayReviewed By:9/3/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com Sample Details Not Obtainable9/3/2025Nic CropperSandy siltMLPaul Santillana8/28/202511.3A 25-1465-2Sample ID 9.5' - 15'Alpine Terrace, B1 L7Location ResultCuASTM D2487 Other Test Results MethodDescription Limits CcProcedure ASTM C117Water Content (%)ASTM D2216Date TestedTested ByGroup Code ASTM D2487Group NameTested ByDate TestedLiquid Limit ASTM D4318 NP (Non-Plastic)Plastic Limit NP (Non-Plastic)Plasticity Index Nic CropperTested By 9/3/2025Date Tested Page 2 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1465-2 Comments Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231075 PID Number: 015-243-31 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name LOUIS & JANICE CAMPBELL ABSORPTION FIELD — EXISTING BED ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11851 NEBESNA DRIVE, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot ALPINE TERRACE 1 7 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ __ 25,+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 100'+ __ Material EPDXY STEEL Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated, anchored & 2 MH risers, but gravity fed to existing field. Alarm location Electrical installed by Installer DENALI EXCAVATION PIPE MATERIAL House to tank 3034 drainfie d nk3034 Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspeection 15' 6/13/23 2rd 6/14/23 Location and description 3'd 4 th TOP OF MH — 1ST RISER ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date � • / %�F'•F�C.utis Huffman Septic Syste �CE128991 ,W Date 7/7/2023 •��6r FO ... � x pROFESSIONA 'ir -� Note: this approval does not include well permit requirements. \ROFESA kf uv VJ/VL! 10) PID:015-243-31 PERMIT:OSP231075 FIRST WATER CONSULTING ALPINE TERRACE BLOCK 1, LOT 7 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: OSP231075 Work Type: SepticTank Upgrade Tax Code Number: 01524331000 Site Legal Address: ALPINE TERRACE BLK 1 LT 7 G:2740 Site Mailing Address: 11851 NEBESNA DR, Anchorage Owner: CAMPBELL LOUIS D & JANICE C Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: ni Department 5/1/2023 4/30/2024 51200 ❑ 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 Received By: I S 5� O �/ G Date: Issued By: (,�,� , �- Date: r -zo z 4 MUNICIPALITY L.ITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-243-31 ON-SITE SEPTICIWELL PERMIT APPLICATION Property owner(s) LOUIS & JANICE CAMPBELL Day phone Mailinq address 11851 NEBESNA DRIVE, ANCHORAGE, AK 99507 Site address 11851 NEBESNA DRIVE, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) ALPINE TERRACE BLOCK 1, LOT 7 Legal description (Township, Range & Section) Lot Size 51,200 Sq. Ft. Number of Bedrooms 4 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field p ❑ Initial 0 Single Family (SF) X❑ (w/wo ADU) Septic Tank 21Upgrade ElDuplex (D) ElHolding Tank ElRenewal ElMultiple 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. .......... . (Signature of property owner or authorized agent) Permit/Rush Fees: 2 Z Date of Payment: !X Z_q�23 Receipt Number: 950L(Z Y5 Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 10' UTILITY EASEMENTS ��•- 5'x30' UTILITY �� EASEMENMENTS I. 49.70' Lot 8 SEPTIC Lot 6 S 89'50' Lot 7 49,809 S.F.(COMPUTED) 51.200 S.F.(M.O.A.) VA rjySHEDS II�JJ / � �S0 0 30.0' CIRCLE DRIVE � Q �Ov \-s, 44'58'00"W 25.00' R=25.00' PLOT PLAN AS BUILT —2L SCALE 1" = 60' GRID SW 2740 Project No. 23-135/A2 p y 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & A S S O C i a t e S, inc. (907) 522-6476 Phone _"` kenOlangsurvey.com `�'►OF A``\�l Professional Land Survey ors jonothanOlangsurvey.com troviaOlangsurvey.com �r�P'�� q i�� I hereby certify that I have surveyed the following described property: ng.' LOT 7, BLOCK 1, ALPINE TERRACE SUBDIVISION (PLAT No. 64-63-1)*: 48TH *�� 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 R % no Improvements on the property lying adjacent thereto encroach on the surveyed • • • • • • • • • • • • • premises and that there are no roadways, transmission lines or other visible (tr KENNETH G. LANG QMo easements on said properly except as indicated hereon. F��. 0 202 rAW— Dated Dated this the 2ca Day of duh" "°i 1a at Anchorage, Alaska �11 ? � ESS O If is the responsibility of the owner to determine the existence of any easements, �\\k�keetw covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! April 24, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: ALPINE TERRACE BLOCK 1, LOT 7 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install an anchored 1500-gallon epoxy coated steel septic tank per the attached design to serve the existing 4-bedroom residence. Shallow groundwater was noted in the MOA on-site file and an anchored epoxy coated steel septic tank is required. The lot and area are served by private water as shown on the design. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231075, Curtis Townsend, 05/01/23 FIRST WATER CONSULTING ALPINE TERRACE BLOCK 1, LOT 7 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231075, Curtis Townsend, 05/01/23 i;i 10' UTILITY EASEMENTS 5'x30' UTILITY EASEMENTS N 00'02'00"W 49.70' Lot 8 SEPTIC Lot 6 Lot 7 49,809 S.F.(COMPUTED) 51,200 S.F.(M.O.A.) O I 03ESIDEN C 3 M C,,i \ X4.20 PPJ�� BO . 00 'z AS°q0, 00 O,Az` . NOTE: DUE TO SNOW & ICE COVER, SOME SURFACE LEVEL FEATURES ARE APPROXIMATE. 30.0' o � 0 0 SHEDS N O O — —rq CIRCLE DRIVE W \ 9.6' i -WELL ^ / Cc I q � ii O/ Ov 5 / `S 44'58'00"W 25.00' ,-L=39.27' R=25.00' PLOT PLAN ___ AS BUILT _X_ SCALE -11_= 60__ GRID _ SW 2740__ Project No. ____23=135fA1____ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone \\ kenOlongsurvey.com �� \\kl Professional Land Surveyors jonathanolongsurvey.com E OF. Atq`il� travisOlangsurvey.com A.—W .. sL , I hereby certify that I have surveyed the following described property:/C-39 LOT 7, BLOCK 1, ALPINE TERRACE SUBDIVISION (PLAT No. 64-63-1)*; 49TH Anchorage Recording District, Alaska, and that the improvements situated thereon are •• 0, within the property lines and do not encroach onto the property adjacent thereto, that ;W40 ... . . • • • • • no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible 90 9 • KENNETH G. LANG -,•o easements on said property except as indicated hereon. �+ cNo. 202 Dated this the --- Day Day of ___1 " _______, _---'__, at Anchorage, Alaska ,l �lFgF�PQ�2o�2�,,�Dsp�� 1` ROfESSIONP��P � 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. State of Alaska AECC963 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: ,.~ h2 ~ ~.O/~ ~ PID Number: ~/~ - ~ ~ - ~ / N,~,: Wastewater System: D New ~pgrade Address: ABSORPTION FIELD s oo ~ D Deep Trench D Shallow Trench ~Bed D Mound D Other LEGAL DESCRIPTION so. Rating: O, ~ GPD/Sq. Ft, Total /.Depth~'fr°m original grade: Lot: ~ Block: Subdivision: Depth to pipe bottom from original grade: Gravel Gep[h ~,ea~h pi~ )~' ]Range: ~W' ]Section: ~ FIll added above original grade: Gravel length: Township: ~-F F,. WELL: D New Gravel ~h: ~,~ / ~ Ft. ~ I ~ Ft. Classifi~tion (Private. A,B.C): ~h: Cased To: Totalabsorption area: Pipe material: Driller: ~ Date Drilled: Static Water Level: Installer: Date in~// Yield: ~pM IPump Set at: Ft. I~sing Height A~ve Ge°and:Ft. TANK ~ SEPARATION DISTANCES ~septic ~ Holding ~ S.T.E.P. From Tank Field Station Tank Sewer Lines ~ ~ ~ 4 ~ Material: Numar of Co~psr[mei~lS: Sudace W.~.r N/A LIFT STATION Lot i , ' s'ze 'n ga"°ns: I Manufacturer Foundation ~6' ~' N/~ ,,Pump on,, level at: ~" level at: Cu~ain ' P~I Drain ~/~ Pun El~trical Inspections pedormed by: Remarks: BENCH MARK Location and Description: Assum~ Elevatipn~ Inspections performed by: ~l~~ Dates: ls~ =n, Department of Health and Human Services approval ,.vi.w., an, a,,rov., 72..013 (1/91) MOA 25 Permit No. ~"~"~ ~"~/~ ~ Page of Municipality of Anchorage 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 Legal Description: ~-~7:' /9 z:~'//,/-/'/ //-/,/~/,~,c' ~"~,rr',,c~5._ PID No.: 91.9' 196,8~ 30' 18' N 89°50~40' W LOT7 BLK1 NEW 1250 GAL, TANK; HOUSE WELL 100,00' ~ R-25,00' ELEVATIONS L=39,27 (NOT TO SCALE) ~ BOTTOM Dr S]O]N~ NV CORNER ~ ASSUMED ELrV = t00,OO' GRND ~ S.EN]] 94,9' GRND ~ N.END 93,7' ~ GRND. ,96.1' [ [ TEST HOL SCALE' 14=50, ~¥/[NG TIES A-C=35,7' A-D=41,7' A-E=45.8' A-F=50,5' A-G=54,0' A-H=84,5' A-1=80.8' B-C=2B,6' B-D=36,7'i B-E=41,6' B-F=48.7' B-G=51.P' B-H=69.6' B-I=64.4' B-J=66,5' ~ -- TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT + - WELLi .-EN(~iNI~Eq!s SEAL. ~-.'~ L~'~ '~,~: , ':-::' 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE ~ ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. 196650. "L" STREET. ROOM 502 ANCHORAGE, ALASKA 99519-6650 ---- ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920169 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:CAMPBELL LOUIS D & OWNER ADDRESS:il851 NEBESNA DR ANCHORAGE, AK. 99516 DATE ISSUED: 7/02/92 EXPIRATION DATE: 7/02/93 PARCEL ID:01524331 LEGAL DESCRIPTION: ALPINE TERRACE BLK 1 LT 7 LOT SIZE: 51200 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE BED MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIGN DATED 6/26/92. THE ORGANICS MUST BE EXCAVA TED TO A DEPTH OF APPROXIMATELY 1.5 FT. BELOW GROUND LEVEL. A MINIMUM OF 2 FEET OF SAND FILTER MUST THEN BE INSTALLED PRIOR TO PLACING THE SEPTIC ROCK. THE EXISTING SEPTIC TANK AND DRAINFIELD MUST BE PROPERLY ABANDONED. / DATE: DATE: Louis Butera, P.E. Registered Civil Engineer June 29, 1992 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 7, Block 1, Alpine Terrace Narrative Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be altered, and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 694-5195 · Fax (907) 694-3297 LEGAL: SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LOT 7, BLOCK 1, ALPINE TERRACE Ae GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. BED 1. 2. 3. 4. 5. 6. 7. 8. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. The bottom of the bed shall be level, plus or minus 1.5". The total depth of the bed gravel layer is not to exceed 4.3' below the top of monitor tube #1 at any point. The sewer line is to replace the existing sewer line that leads to the existing tank and pit. The bed gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. The area over the bed is to be finish graded to prevent ponding of surface water runoff. The septic tank and leachfleld must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 1.4' at test hole #2 GRAVEL DEPTH = 6" below pipe BED LENGTH = 48' BED WIDTH = 18' 7~:~: SOIL RATING = 0.7 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK SIZE = 1,250 NOTE: Abandon both existing tank and pit to code. Overexcavate and place 2' sand filter layer below leach gravel. Twenty-four (24) hours notice required for all inspections. EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 JOB A'I pine SHEET NO. CALCULATED BY CHECKED BY SCALE Terrace, Lot 7, Blk 1 92-098 OF L.B. 06/26/92 DATE DATE CalCUlation for FOur BedroOm Single F~y DWelii.g: ~ B~ ~ ~ GPD Soil Rating = 0:7 Z + 10 0',~,~/~ 30' ND PRIVATE WELLS +100' 6 VACANT LOT 196,83 N 89d50'40' W LOT7 BLK1 ExEXIS NB SURFACE WATER CBURSE NO KNOWN CURTAIN DRAINS T.H,~2 ~ 48' NEW T,H,~I · g 18' ]XISTING TANK GAL, TANK HDUSE WELL lO0,O0' ,-.z ~ " PS,00' WITHI~ L=N 100' 30' / [] - TEST HOLE · - MONITOR TUBE o - SEWER CLEANOUT + - WELL :Xxll:~:l- PROPOSED LEACHFIELD EASEMENT SEPTIC SITE PLAN LEGAL: ALPINE TERRACE LOT 7 BLK. 1 OWNER' LOU CAMPBELL CONTRACTOR: N/A JOB # 92-0981 DATE' 06/24/92 SCALE 1" = 50' A EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) I~ERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: >~7~- 7 ,~/,'~'/ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 2O Township, Range, Section: ~'/~ ~/ ~ 3' /.~ ~'~¢ ~' SLOPE SITE PLAN O' · D WAS ~ ENCO~ IF YE= - PER~ GROUND WATER :OUNTERED? 7 S L · AT WHAT /,'7 ~ / 0 P E W,ler After , /~ '-//9 ~ g? '7, ~. Date:. ~ Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~//~ / '/ /~: ~,~ ,,r,--- z.~ / .3 ~ ~" J I' ll;l~ ~'-5~" ~ / ~/. PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER FT AND ~Y' FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 iRev. 4/85~ CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) PERFORMED FOR: /~P" ~'~'~"~,,~ ~ ~// DATE PERFORMED: LEGAL DESCRIPTION: ~-~'-;2 ¢~:::'/,,/-¢/ *~o,~ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Township, Range, Section: 7'/~ ,~ ~ 3 ~) x'~¢ .~' SLOPE SITE PLAN .-" 5.~ ENC~ IF Y~ DEP' R PER, GROUND WATER TERED? ;, AT WHAT 'H? dh to Water Alter b~ ~' Gross Net Depth to Net Reading Date Time Time Water Drop ~ ~, //; 5~ ~/-~" 7,~~ ~ '~ ~ " //;¢~ 3~ 30" 3.~' &" 3.~,~,, _- ~, ~ 3OLATION RATE __ {minutes/inch) PERC HOLE DIAMETER ( '''/ TEST RUN BETWEEN '~ FT AND z/' FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN GREf-'~R ANCHORAGE AREA BOP"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME //~/0X /~tV6'7l)~°z MAILING ADDRESS · OCAT,ON LEGAL PHONE SEPTIC TANK: DISTANCE FROM WELL/~~ MANUFACTURER ~/~ ~----~-' M AT E R I A L ~? ,/¥£/~' ~:~_ NUMBER OF COMPARTMENTS ~"~ INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /.~.-)'C~ GALLONS. SEEPAGE PIT: t NUMBER OF PITS I DIAMETER __ OR WIDTH /,~, LINING MATERIAL AOf/~* (2 CRIB SIZE: DIAMETER BUILDING FOUNDATION 3C"~, NEAREST LOT LINE~C ADDITIONAL ABSORPTION ~//~ / LENGTH /~, DEPTH ~/~ "~3E PTH DISTANCE FROM: WELL/(~'~ ~ ~ TOTAL EFFECTIVE . ~:;7~ ABSORPTION AREA (WALL AREA) ~ ~/~ISQ. FT. WELL: 'tYpE P^~, //~ BUILDING FOUNDATION CESSPOOL APPROVED , OTHER SOU DISAPPROVED REMARKS SEEPAGE __ , SYSTEM DISTANCE FROM: DISTANCES: INSTALLED BY: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM APPROVED " ~., ZATER ANCHnRAGE ARE& BOROU . DEPARTMENT OF ENVIRONI!ENTAL QUALITY ., 3500 TUDOR ROAD ~)~~¼~%-~,~-----'~0--', ANCHORAGE, ALASKA 99502 Performed For ~3 ~i ~.S;[~¢ ~. Leeal Descrintion: Lot ¢ Block This Form Re~orts Soils Log ~ qepth Feet CASE # Date Performed ?Subdivision Percolation Test Soil Characteristics m m Was Ground Water Encountered? IF Yes, At what Depth?_ I.~/ Readin~ Date Grmss Time Net Time [ Denth to H20 I Net Dropl I Percolation Rate Minute Proposed Installation- SeeDaqe Pit Drain Field De~th of Inlet Denth To Bottom Of Pit Or Trench CnU~ENTS' Test Performed !By Pata Certified By: Date' GRE^'r R ^NCHOR^Gr A EA BOROUGH DEP^RTMENT OF EN¥1'RONHENT^L 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For_ 1}} f II~ ~', i~ ~¢ ~ Dated Performed Legal Description: Lot ? Block_ ILl,Subdivision This Form Reports Soils Log_ ~ Percolation Test ,, - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Soil Characteristics Depth Feet 2~ 3~ 4~ 5~ 6~ 7~ 8~ 9~ 10-- 11~ 13-- 14~ Was Ground Water Encountered? If Yes, At What Depth? ,,/F~ ~ Reading Date Gross Time Net Time Depth to H20 Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench COMMENTS: Test Performed BY. ~)~::::~'~-~- Date Certified BY: Date ' · GREATER ANCHORAGE AREA BOROUGH .- DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For ~o_~z ~--~(~c~a~X Dated Performed (o/~77~ Legal Description: Lot ~f'~ Block -S~"/' Subdivision ~/~;.~_ ~r~/ This Form Reports Soils Log Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet 2~ 3~ 4~ 5~ 6-- 7-- Soil Characteristics m 9~ 10~ 11~ 12-- 13~ 14-- Was Ground Water Encountered? If Yes, At What Depth? Reading Date Gross Time I Net Time Depth to H20 Net Drop! I Percolation Rate Minus_ Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench COMMENTS: / Test Performed BY /~_ ~$?'~_~/ Date Certified BY: Date: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 ~ Date Received July ~~ ~/.~/ Time of Inspection ~u~/.~_~/~j ~ a 0.~ Date of Inspection a/~ ! INDIVIDUAL SEWER & WATER FACILITIES FOR 7~ 1976 1:30 7-8-76 Conv, 1. Approval requested by: National Bank of Alaska Mailing Address: Post Office Box 600, 99510 Phone: 2. Property Owner: Robert Leidiq Phone: Mailing Address: Star Route A Box 394-J, 99507 (house is vacant) 3. Legal Description: Lot 7 Block 1 Alpine Terrace Subdivision 4. Location: Off of Hillside Drive 5. Type of facility to be inspected 6. Well Data: Individual A. Type C. Construction Single Family No. of bedrooms 4 7. Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: 8. Distances: On-site system 1. Size 1. Absorption Area Total length of lines B. Depth 200' D. Bacterial Analysis B. Installer 2. Manufacturer 2. Material , Sewer Lines A. Well to: Septic tank ?0 + , Absorption area /d Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages ~ge 2 of two pages - Re'--st for Approval of Individual f er & Water Facilities L~gal Description Lot 7 Block 1 Alpine Terrace Subdivision Comments Approved ~. ~/~ Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. Date SIGNED EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO 2. Property Owner:. J~~'e~¢ Mailing Address: -~'' ~'~ 3. Name of Buyer: r~--~"~ Mailing Address: ~'/~:~ VA FHA CONV ~ Day Phone: 4. Name of Lending Institution: Mailing Address:~~ / Phone: 5. Name of Realtor or Agent: '"~-~ ~' ~ ~~- Mailing Address: ,~)~,~ O / ~ ,~'~'~- Phone: Legal Description: ~'~ O '/~' /~. ~--- ~/, .~.~g ~ %e~_.~j~_ ~_=_ Location:~~, 7. Type of Facility to be Inspected' No. Bdrms. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served ~ '~' If Individual, depth of well. Sewage Disposal System Type of System: Public Utility If Individual, date of installation ~,~V ~/~ ~-~ A.J Individual (on-site) 72-OO3(3/76) YENNEY'S CONSTRUCTION CO. 9100 Lake Otis Pkwy. ANCHORAGE, ALASKA 99507 Phone 349-2242 Page No. Pages PROPOSAL SUBMITTED TO STREET ARCHITECT ,~ [ DATE OF PLANS and eshm We hereby submit specifications ' : PHONE I DATE JOB NAME IJOB PHONE I[ ~le ~Iropose hereby to fur~sh rr~ri~labor -- complete in accordance with above specifications, for the sum of: ~ ~ .' ~ollars ($ )' Pay~nt to b~de as f~llo~ : All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above specifica- tions involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. Authorized Signature Note: This proposal may be withdrawn by us if not accepted within days. Arreptanre of lroposal--The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: Signature Signature FORM 118-3 COPYRIGHT 1960 ' Avaitable from t't4D~} Inc.. Townsend, Mass. 01469 Development Services Department t Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 015-243-31-000 Expiration Date: Legal description ALPINE TERRACE BLK 1 LT 7 Site address 11851 NEBESNA DR Anchorage AK 99507 Current property owner(s) ESTATE OF CAMPBELL LOUIS D & J 11/1/2023 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By, Original Certificate Date: 8/1/2023 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 Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-243-31 Complete legal description ALPINE TERRACE BLOCK 1, LOT 7 Location (site address) 11851 NEBESNA DRIVE, ANCHORAGE, AK 99507 Current property owner(s) LOUIS & JANICE CAMPBELL Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years. 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ --150 Date of Payment 2 cZ3 COSA # D5c-23 ► 2 Waiver Fee $ Date of Payment Waiver # COSA Application 2022.doc COSA Checklist copy.docx COSA Checklist Legal Description: ALPINE TERRACE BLOCK 1, LOT 7 Parcel ID: 015-243-31 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 CIRCA 1973 Total depth 200+/- ft Cased to UNKNOWN ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/17/2023 Static water level at beginning of test 20 ft. Well production at time of test 4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 7.46 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 4/17/2023 Comments _New sanitary seal, conduit & scoped by Sullivan – see Sullivan letter. B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/11/1992 ALL standpipes present per record drawing Total measured depth from grade 5.3 ft (max) Measured depth to pipe invert from grade 3.4 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 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 4/16/23 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 4/17/20223 Results Pass Fluid depth prior to test 0 in Water added 620 gal New fluid depth 4 in Elapsed time 240 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (0.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist copy.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 7/7/2023 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 & 7/7/23 Date: 7/19/23 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259. TO: First Water Consulting Services Cap and conduit repair has been completed. The well was scoped for high nitrates and logging. No issues were found that would lead to elevated nitrate levels. Well was logged to 42 feet where pump sits. Without pulling the pump the total depth of the well could not be determined, but it is likely not deeper than 50 feet. Casing Stickup : 18” Pitless depth : 11’ Static: 14’ Pump intake: 43’ Total Depth: NA Steel cased : to 42’+ www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC231255 Subdivision: Alpine Terrace, Block: 1, Lot: 7 A water sample revealed a nitrate concentration of 7.46 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Ma�lmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.