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Home My WebLink AboutBENBECCA BLK 1 LT 3ABlock 1 Lot 3A #051-052-65 Municipality of Anchorage On -Site Water and Wastewater Program - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181382 PID Number: 051-052-65 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: SHAWN ROBERTS ABSORPTION FIELD -EXISTING ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound Address 22626 LAKE HILL DRIVE, CHUGIAK, AK ❑ 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 BEN BECCA 1 3A 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 -- Fe -- Ft. Well 100'+ -- __ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1 1250 Gal. Surface Water 100'+ -- -- __ Material STEEL Number of compartments 2 Lot Line 10'+ __ __ __ NA Foundation 10'+ __ __ __ LIFT STATION Manufacturer Capacity Curtain Drain NA -- NA ----------------- Gal. RemarksExisting septic tank decommissioned Pump on level at in. Pump off level at in. High water alarm at in. per code. New tank placed in same location & connected to system. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 drainfield Tank to D3034 Installer RPC Drainfield -- CO/MT D3034 Inspector ARCTERRA BENCHMARK (Assumed elevation) 100 ft Inspection I51 10/26/18 11/5/18 Location and description 2nd 3rd 4d Bottom of Siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Nk Conditional Approval: Date 19 U, 'P, '^ Xy'i3METIi V DU S "116 CE ApproDate Inspection Report ST copy 3.doc AS—BUILT SYSTEM DETAILS/SITE PLAN BENBECCA SUBDIVISI❑N LOT 3A BLOCK 1 N89°54'37"E w A—C=20.5' B—C=33.2' A—D=27.6' N =B—D=37,6' 0 J Y. CD m U H • LOT 3A BLK 1 Permit ❑SP181382 PID# 051-052-65 o� ;um D z Z C7 2 O r -X X X x CONNECTED TO EXISTING SYST. 1 CO CO _0 B 36.0' N N 0 E N 20.0' I� rn E m MN _� FCO c: cn 491 x COS D/ C DEQ x NEW 1250—GAL SEPTIC TANK k� k� X x o LEANTO SHED o 15.3' 12.0' X N89°52'55"E w 5 `1 \1 1W¢1<W U uJ _ n \. \n nn FINAL GRADE f 0 o' o J 1250—GAL CONNECTED TO EXISTING SYSTEM N 7 SEPTIC : ' / I TANK EL uj w �� OF AZ4 CD / M ° * : 9TH O N KENNE S., Air E \ FES Ip11AS' PREPARED F❑RI SHAWN ROBERTS 22626 LAKE HILL DRIVE CHLIGIAK, AK 99567 FIELD BOOKS BOUNDARY: N /A STAKING: NSTAKING: N /A ASBUILT. SLS DWG. FILE ACAD FILE: FILE COMPUTED: DRAWN: BMW CHECKED: K M D DATE: 11DATE: 11 /5� GRID: NW15E 'IDB No-: 18199 SCALE, 1' = 30' I U'_ C14 0 "' SCALEI NTS 24 00 CD 8� 1 0 - ?�. x 0.0 c m C Z y O JQ 2Z; o�� N'=s�o� �� n O GRACE STREET zg rs O v� t3 •� W O R N p fp „a oo N89'54'37"E 314.71' x 30' I 30' O ti N w CD m O C.AOY z 0 t 00 w Z SRI ZO tz ^gym ° OD s i9 y o c °'+ r—X—X—X ° W a NN 36.0'CD x o_ W 0 20. 0' 60 ci- x yPD N cnZM �i i x �' t7 b u•i C" O / • 10.0'ITI *71 O OJ t> k\ X—X FLE�NJTOE137HED26.0'o W 12.0' 0 0 W12. 6? 15.3' 100.6' ;1' z x N89'S2'S5'E 314.70' sC PULL x o W13�4 sa'f x NS�y Mz, - Pr�CD yi t co CA ra co 01 ov N W OCD c -I J x Jrrt��t�3�� U 1 1 �� N,„'”""'Y MUNICIPALITY OF ANCHORAGE 4' ,i On-Site Water&Wastewater Program �o ,; ,.-..:.\,..,--,,:,.. S ,,K; PO Box 196650 4700 Elmore Road • ';Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 --Nj http://www.muni.orgionsite I)t.parlinen I 4N<H OR pot On-Site Wastewater Disposal System Permit Permit Number: OSP181382 Effective Date: 10/23/2018 Work Type: SepticTank Upgrade Expiration Date: 10/23/2019 Tax Code Number: 05105265000 Site Legal Address: BENBECCA BLK 1 LT 3A G:1561 Site Mailing Address: 22626 LAKE HILL DR, Chugiak Owner: ROBERTS SHAWN ADELE Lot Size in Sq Ft: 40107 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 G Received By: Date: 5/i V Issued By: -( X,Uk Cavt Date: I d/2 3/Q01? MUNICIPALITY OF ANCHORAGE Community Development Department W., Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-052-65 Shawn Adele Roberts 440-6450 Property owner(s) Day phone Mailing address 22626 Lake Hill Drive, Chugiak, AK 99567 Site address 22626 Lake Hill Drive, Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) BENBECCA BLOCK 1 , LOT 3A Legal description (Township, Range & Section) Lot Size 40,107 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial Single Family (SF) [l (w/wo ADU) Septic Tank (>i Upgrade > Duplex (D) Holding Tank Renewal Multiple Dwellings Privy (i (SF and/or D) Private Well n Water Storage I 1 THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Munici•al Codes. (Signatu - of %ro erty owner or authorized agent) l Per - i -ush Fees; /IS.Od Waiver Fees: Date of Payment: IOJ2'J f 1B Date of Payment: Receipt Number: Receipt Number: Permit No. o.Sp181382 Waiver No. Permit App_9-1-12.doc -` RcTeRR4 �' ARC'I ERRA I CONSULTING, INC '. % 212 E.51st Ave,Anchorage,AK.99503 Office(907)868-3791,Fax(907)868-3793 October 18,2018 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage,AK 99519-6650 Subject: Septic Tank Upgrade Permit-Benbecca Block 1,Lot 3A The owner has requested we proceed forward to obtain a septic permit to upgrade the septic tank on the subject lot. The proposed upgrade will serve the existing 4-bedroom house. The adjacent lots are served by private water as noted on the design. There are no wells or surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions,please contact me at 868-3792/FAX 868-3793. Respectfully submitted, ArcTerra Consulting,Inc. Kenneth . P.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan 20441 PTARMIGAN BLVD •EAGLE RIVER,AK 99577-8736 PH(907)868-3791 • FAX(907)868-3793 I 1 N WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN BENBECCA BLOCK 1 LOT 3A CO / EXISTING 4 B D R M 1250 S,T, SFD co f2Q,_ _ I ' INSTALL NEW FCO "� ' 1250-GAL S.T. / a) IN SAME LOC, M T / a, co LOT 3A Scale: i'= 30' PAGE 1 OF 1 DESIGN DETAILS DECOMMISSION EXISTING SEPTIC TANK PER CODE INSTALL NEW 1250-GALLON SEPTIC 10'+ FROM FOUNDATION, 5'+ TO FIELD, 100'+ TO WELLS & CONNECT TO EXISTING SYSTEM NO PUBLIC VELLS VITHDI 200.OF PROPOSED SYSTEM. NOTES1 NO PRIVATE VTUS VITHIN ear O: PROPOSED SYSTEM EXCEPT AS NOTES'. NO SEPTIC SYSTEMS VITHIN 200 Os 1. INSULATE TANK IF <4' COVER. PROPOSED VELE EXCEPT AS NDTE1 2. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK. 3. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS & SEPTICS. '4°' ) OF /16 PREPARED FORT ��' • PAUL & BETH LAIRD RCTER �. �C� 4218 UPPER KOGRU DRIVE y r* :49TH /\ * V` EAGLE RIVER, AK 99577 `•° • \,\ -c, ,/• KENNF.I'H M, pUTFUs or FIELD BOOKS COMPUTED: i I 4 } cs�f4fe �v4 e°u+0""Y.BOUNDARY °R""": QMW •� � ' \ ✓t ` b h, o STAK.4O STAKING cNEoau KMD 1 ` Sfi y ` / �� /� / A58�ALT: JAG DATE' 10/18/18 \o ` 11"60,1111060:411... Esst0P _ �_ 4►'s 1� � OW.rw MC, NYJ1561 Rid Mr • e AcAO TILE:FILE 0013 Na. 1 8199 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 6W %&Z80 PID Number: n51 -0'5Z—&:5 Name: Wastewater System: f New ❑ Upgrade Address: - "b E ABSORPTION FIELD Phone: No. of Bedrooms: Ll ❑ Deep Trench Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: J z Total Depthrom ori-ginal fade: 5. /� GPD/Sq. Ft. -' ✓1" Lot: 2 Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe de, • L Ft. Z. 9 Ft. Township: Range: Section: Fill added above original grade: Gravel length: Ft. Ft. WELL: New ❑ Upgrade Gravel width: Number of lines: Distance between lines: Ft. CC YCwtar F . Classification (Private/, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Fg(L'j {/ 1 (✓�� Z Ft. Z Ft. SQ. Ft. D Driller: Date Drilled: Static Water Level: Installer: Date installed: 2`L? 7 Dr -1, I /45Ft. Yield: `25 IPump t at: Casing Height Above Ground: TANK GPM LA -r Ft. Z Ft. SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: / From Tank Field Station Tank Sewer Lines ` t L �✓ O Material: Number of Compartments: SurfaceLIFT t� -�- STATION Wter at a � — r --- Fnga Manufacturer: Line -E +Foundation lU+ IU+ — — __at: "Pu level at: High water alarm at: Curtain /� t� f Pump Make & Mo Electrical Inspections performed by: Drain /D,\�+ v Remarks: am ;� BENCH MARK /'14 'o1 Location and Description: Ye,l)e j a ,0,1 a 0 r, U.56. 0 OxjC o // ✓ �� w�✓ w Assumed Elevation: /DD c r4{.;.. L 1f" • V - tqiHl�j OA Inspections performed by: Dates: 1s .. • ..... ... •••• . all, • •..•s,,, ..,.., ...!4 21d 9�9 Kenneth el. :ut ,IJ'•• // Department Health Human Services l CE/711 .'�� of and ap�wo� O'�✓.`: 1111Q10FESSO Reviewed and approved by: °4— 0. Date: 72-013 (Rev. 9/91) MOA 25 AS --BUILT SYSTEM DETAILS/SITE PLAN Permitil, SW960280 BENBCCCA S/D BLNCK 1, 1-111 30 PID#051-052-65 314.86 Co 4 145.16 SI-- �� O FII1197-1 LFT 3 Q� 1 RENCH 1 f 1P50 S.T, co MT C C❑ O o, MT oN rr A—C=33.1' CP E B—C=20,1' A—D— 3 /.4' TI -I 1196-2 B—D=27,7' A—E-87.6' B—E=76.1'Ga�l� _ A--F-86./I' Proposed ll vew� B—F-92,9' A A—E-132.7' B-5=128.6' IH 1196-30 o WLLL 98,10 LJ I-7 S >- lY ISI v. r l F -I J - 1250 GAI_ E:l nl SEPI [C TANK 93,14 SCALE' NTS OF AZ4 Aar I Is pf TI I / KENNETH M. ll S / ` CE -7116 / 1 � \ "RCFESSIOP, AV LOT 4 FINAL GRADE FILTER fA11RIC\ SEWER R❑CK TRENCH i "Al - FINAL GRADE SCALE 1" - 50' R, z o � VARIES 92,30 _ 85,60 82.20 B.1 x FILTER / 1NSULATIDN FAllRIC VARIF_S - — I T.s 92.16 92,21 SEWFR R❑CK 2.91 1 RENCI I 2 89,27 - — 66' I -- PREPARED FOR: JEFF SIMPS❑N '('1 -501A LEMON STREET I_I_ME:ND❑RF, ALASKA 9952(, KND ENGINEERING 204/11 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-0111 ITE:10/6/97 rev.10/21/97 URA'WING 11 KALE AS NOTED I 96059 -SI ➢1]H FC❑ , _ TH 1196-1 I3 R •� Proposed ll vew� IH 1196-30 o WLLL FINAL GRADE FILTER fA11RIC\ SEWER R❑CK TRENCH i "Al - FINAL GRADE SCALE 1" - 50' R, z o � VARIES 92,30 _ 85,60 82.20 B.1 x FILTER / 1NSULATIDN FAllRIC VARIF_S - — I T.s 92.16 92,21 SEWFR R❑CK 2.91 1 RENCI I 2 89,27 - — 66' I -- PREPARED FOR: JEFF SIMPS❑N '('1 -501A LEMON STREET I_I_ME:ND❑RF, ALASKA 9952(, KND ENGINEERING 204/11 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-0111 ITE:10/6/97 rev.10/21/97 URA'WING 11 KALE AS NOTED I 96059 -SI ➢1]H SEP -30-1997 09:46 BELL HOMES 0116 in,c). Box 110378. 1o33o Old Seward Highway (907)549.8536 kIr-Ut-iMAr.r- ALASKA 99511 RECEIVED JUN 1 $ w - DRILLING LOG P.01 Well Owner BELL HOMES - SIM)SON Use of Well Dn CPST T Location (address of: Township, Range, Section, if known; or distance main road LOT 3, BLOCK 1 , BENBEQQA-5-U3DJ-US IQN* T,AKE H NORTH PETERS CREE(L _ALASKA Size of casing—EL—Depth of Hole 2 : A L ---feet Cased to.239-.72--ieet Static water level -IA] ---ft- fakV . py"' (below) land surface, Finish of well (check one) open end x Screen Perforated Describe screen or perforati Well pumping test at '35 (minute) hours of drawdown from static leVeL:- Date of completion 05 JUN: 1,19 7-Y-', WELL LOG I X1 Depth in feet from Give I* Llround surface is of formations penetrated, size of material, color 2To 3 6 SMALL 1 IL: � I'Li--KAV Z L _ • --a�—TO-1Q- --ko--TO-52- --L9 TO 80- 80.—TO 0 80 To 1 00 Dept. Health & Human : �'- 200 216 GR&Ivit-': 'STLTy- ANDY'DAMP TO 216 HEAVING SANDY, DIRTYc 3-5 GPM _TO_.�3 4 GRAVEL :-S ILTY";" 2_34 TO -11-0— _TO- -To posfltTffl brand fax transmittal memo 7671,V of Pages * 2- .-t 6r A. Certif, 973' CUSTOMER TOTAL P.01 Municipality of Anchorage •2d� t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 1 :Ar' .-Ai /' ROFESSI� Jell,— PERFORMED FOR' .� e l S��SOr� DATE PERFORMED: LEGAL DESCRIPTION: �o��A ��ad«CQ Township, Range, Section: �� 9 7_ / SLOPE SITE PLAN DEPTH �M J (FEET)✓/GS %!b�%LG/ I 2 G111 3 iflGG�. dGri.�Y fr! at, ~;34 t "Wei 5 6 7 8 -�� NlLISP lrn.3e,3 9 10 11 12 13 14 15 i I I I I WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT rr DEPTH? �yy,G,pr. NLOlS `v 161 {_ 15.. Q„f# I 17 Mi ice Depth to Water Atter Monitoring? Dale: S L 0 P E Gross Time Depth to Water �L'14 FOR M. 20 l� PERCOLATION RATE _8O . (minutes/inch) PERC HOLE DIAMETER `� TEST RUN BETWEEN 9 FT AND _ FT COMMENTS JLk� �'�� iO� -Q V- In j' -S t PERFORMED BY: w 1 ,� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STAT AND MUNICIP GUIDELINES IN EFFECT ON THIS DATE DATE: <1112�/�, 72.008 (Rev. 4/85) $77 ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 t (907)696-6111/FAX (907)696-8111 September 10, 1997 Mr. James Cross, P.E. Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: SW960280- Lot 3, Block 1, Benbecca Subdivision Construction Extension Dear Jim: We are requesting a time extension of two weeks for the completion of the referenced permit. The subject well and septic permit was issued on 9/5/96. The contractor started work on the septic system in June of this year and did not call us for an inspection until he had dug the trench to deep and ran into problems. Jim Williams inspected the site and issued a transmittal sheet requiring additional soil tests in an attempt to rectify the problem. Subsequent to that time the contractor pulled off of the job and the owner has now retained another contractor to complete the necessary work. The well has been drilled and the foundation is installed. Bob Hamann is scheduled to install the septic September 4 - 12, and we anticipate having the inspection report and as -built completed shortly thereafter. If you have any questions about this request, please contact me at 696-6111/FAX 696- 8111. Respectfully submitted, JX D Engineering Kenneth M. Duffus, P.E. cc Jeff Simpson PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE pre- i/ ort, DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 3 �C�C ANCHORAGE, ALASKA 99519-6650 3 _2e-9_7 a 5 l;9 kr � 6 /too pan ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960280 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:KING BONNIE & DAVID A OWNER ADDRESS:PO BOX 77-1064 EAGLE RIVER, AK 99577 PARCEL ID:05105265 LEGAL DESCRIPTION: BENBECCA BLK 1 LT 3A LOT SIZE: 40107 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/05/96 EXPIRATION DATE: 9/05/97 P tN , -t1-`Z1 cy\ C\-CA-q_� 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5, THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: DATE: S ISSUED BY: DATE: i WASTEWATER ABS❑RPTI❑N SYSTEM DETAILS & SITE PLAN LOT 3, BLOCK 1, BENBECCA S/D LOT 1 314.84 31 h� BENBECCA SUB BLOCK 2 o PROPOSED WELL 3 PROPOSED WELL LOCATIONS VACANT LOT 2 D WELLV PROPOSEDWELL' 0 ° END LOCA i IDN 0 0 PROPOSE WELL PROPOSED WELL VACANT SEPTIC AREA O WELL LOT 2 VACANT Q T. H. 40,145.16 SF —5-7 LOT 3 P,o osld d11—y —.5-79. Ie90 ST. _. 5-7 E c C B T.M YI i o LOT 4 VACANT 0 T.H. SEPTIC AREA 12 SEPTIC �9 AREA N SEPTIC AREA 35 e1r¢ o FROPEISED WELL 60' 36 SEPTIC AREA NO WELL WITHIN 100' OF PROPOSED SEPTIC SYSTEM, DESIGN DETAILS NO SEWER WITHIN 100' OF PROPOSED WELL, 4 BDRM X 150 GPD = 600 GPD 600 GPD/ 1,2 GPD PER SQ, FT. = 500 SQ. FT, 500 SQ. FT./5 X .54 Reduction (3.5' GRAVEL) = 54' LENGTH TOTAL DEPTH OF SYSTEM IS 4.0 OF AL\ � .. �,� 1, 'NOTES: C-) �� 1. Install new 1250 gallon steel tank. 1 2. Insulate all lines with less than 3' of cover, *,A9 TH Insulate field if it has less than 4 feet of cover. L .. *.,./ 3. Contractor to insure 2% grade from house. KENNETH I US CE -711 0 PREPARED FNR1 1� w Af Scott Peppers Peppers Construction \ h'0PESS10 / P.O. Box 77-1064 'k 1%:11b --W Eagle River, 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 ATE.8/15/96/rev8/29/96 DRAWING # SCALE: 1' = 100' 96059-S1 IN Baa 4.,'O AV�54e- C4:! ?W i?45. 7-:57 doop �XGr�GIa �� +�•�. lr�,f s�o w.� ate, 7" es aCAAc �� ✓10./ �sitse 7A !s ar� �4 Xggr6 ! �r��i. �uirl(i ;7'A te44 �/o ,green/ w • � 41V 46 �.4WX,.,, , , V � cis"m f ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 miT 3� �� MIT. (907)696-6111/FAX (907)696-8111 August 15, 1996 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot 3, Block 1, Benbecca Subdivision On July 31, 1996, two testholes were excavated on the above lot in addition to our previous hole dated 5/7/94. The results are attached. We have designed a single shallow trench to serve the proposed 4 bedroom dwelling. There is also adequate space for the reserve area which is indicated on the proposed site plan. This lot is served by individual well. We have identified 2 potential well sites pending a decision from the owner as to what will best meet his needs. There are no sewer systems that will encroach into either proposed well site and there are no public wells within 200' nor private wells within 100' of the proposed septic site. There are also no known curtain drains within 50' or any surface water within 100'. The installation will have no adverse effect on neighboring lots. The lot slopes gently from east to west and there are no steep slopes, standing water or drainage problems in the area. We have designed the system utilizing the top soils strata. Computations for soil absorption was based on the rate of 3.2 minutes an inch. Based on the above we are requesting that a permit be issued for the sewer system and well. If you have any questions about this application, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IKHD Engineering Kenneth M. Duf us, P.E. attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Logs (3) WASTEWATER ABS❑RPTI❑N SYSTEM DETAILS & SITE PLAN LOT �, BLOCK 1, BENBECCA S /1D LOT 1 rl W 314.84 1� 31 BENBECCA SUB BLOCK 2 o PROPOSED WELL PROPOSED WELL LOCATIONS VACANT LOT 2 D WELLPROPOSE WLLU 0 0 2ND LOC TION 0 0 PROPOSE WELL PROPOSED WELL VACANT O WELL LOT SIZES 40,155 LESS HOUSE FOOTPRINT: 2919 LESS OTHER IMPACTS: 33,205 TOTAL AREA AVAIL,: 9,869 LOT 4 VACANT Q T.H. 80' SEPTIC AREA SEPTIC AREA 38 12 SEPTIC AREA NO WELL WITHIN 100' OF PROPOSED SEPTIC SYSTEM. DESIGN DETAILS NO SEWER WITHIN 100' OF PROPOSED WELL. 4 BDRM X 150 GPD = 600 GPD 600 GPD/ 1.2 GPD PER SQ. FT. = 500 SQ. FT. 500 SQ. FT,/5 X 5 Reduction = 50' LENGTH —_`` TOTAL DEPTH OF SYSTEM IS 5' IAWOF ALS \ 4� ,1 NOTES: 1, Install new 1250 gallon steel tank, `� 2. Insulate all lines with less than 3' of cover, * 4� TH * Insulate field if it has less than 4 feet of cover. L....,.,... ./ 3. Contractor to insure 2% grade from house, 0 1,41-, - KENNETH M. S ` CE-711647� PREPARED FOR: Scott Peppers Peppers Construction \ d 1'ROFESS1010'1 Aw P,❑, Box 77-1064 Eagle River, 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE: 8/15/96 DRAWING it SCALE; 1° = 100' 1 96059—S1 SEPTIC AREA LOT 2 VACANT O T. H. 0 31486 ~i w SEPTIC AREA 40,145,116 SF —5-7 P�ro.•.a n�w...y LOT 3 Pma 0 35 � 8 —5-7 Y T. H, II C1 c 1250 S.i. Praposetl Orivesu CO „ 5-7% — .0 PROPOSED WEL LOT 4 VACANT Q T.H. 80' SEPTIC AREA SEPTIC AREA 38 12 SEPTIC AREA NO WELL WITHIN 100' OF PROPOSED SEPTIC SYSTEM. DESIGN DETAILS NO SEWER WITHIN 100' OF PROPOSED WELL. 4 BDRM X 150 GPD = 600 GPD 600 GPD/ 1.2 GPD PER SQ. FT. = 500 SQ. FT. 500 SQ. FT,/5 X 5 Reduction = 50' LENGTH —_`` TOTAL DEPTH OF SYSTEM IS 5' IAWOF ALS \ 4� ,1 NOTES: 1, Install new 1250 gallon steel tank, `� 2. Insulate all lines with less than 3' of cover, * 4� TH * Insulate field if it has less than 4 feet of cover. L....,.,... ./ 3. Contractor to insure 2% grade from house, 0 1,41-, - KENNETH M. S ` CE-711647� PREPARED FOR: Scott Peppers Peppers Construction \ d 1'ROFESS1010'1 Aw P,❑, Box 77-1064 Eagle River, 99577 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE: 8/15/96 DRAWING it SCALE; 1° = 100' 1 96059—S1 Municipality of Anchorage A 9h.••,�/, DEPARTMENT OF HEALTH & HUMAN SERVICES 0000jo ..............•......:... 825 "L" Street, Anchorage, Alaska 99502-0650 / .. SOILS LOG — PERCOLATION TEST a% ; Kenneth M. D ; CE 7116 PERFORMED FOR:DeF/R�S DATE PER FO x�\� LEGAL DESCRIPTION: +-7 3A 131vck- / Township, Range, Section: DA —,� r6 e-" �`-Gd--- SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Wr4Cn/104 3 �a �l lv,> Zr re d oQ"aA , �1 � rv1L , Gv i-Gh �� Gv inti WAS GROUND WATER �ff ,ENCOUNTERED? !V!� r e- Q it-" p(F,,b�(t` S 1 IF YES, AT WHAT L O DEPTH? P E Depth to Water Atter Monitoring? _p_ Date: & o0D 4 Reading Date Gross Time Net Time Depth to Water Net Drop /7-7-1/ Ild" < & a8 Ta g 4 /i- c7-- Jr d d a38 C�- r` C�L [� 1fv t 1Co 20 -{ � 1.1-44 � w`//8 / '/ K U PERCOLATION RATEJ.? tminutesnnch) PERC HOLE DIAMETER (c� l 1/ TEST RUN BETWEEN 212- FT AND /� FT COMMENTS PERFORMED BY:/ I �w CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Aft .•V� e Municipality of AnchorageOp .•49L 0. DEPARTMENT OF HEALTH & HUMAN SERVICES••• �, .;.. •• ••• ••' 825 "L" Street, Anchorage, Alaska 99502-0650 io e • ! •• Kenneth M. Duf •%•4� SOILS LOG — PERCOLATION TEST AA. c et 7116 :o-* �o f f �� 2 r5 PERFORMED FOR: P� DATE PERFOR%M LEGAL DESCRIPTION: L4 3A, glve—k / &,Mke,c.jOWnship, Range, Section: nEr arN� SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 01,14-1 54'nd WAS GROUND WATER ENCOUNTERED? 61014 . S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? —0— Date: U 7 9 ReadingDate Gross Time Net Time Depth to Water Net Drop a lao� l 7� 8 T79 '✓ 1' d o s 1 '7 l�.-. 8 /eLlJev /.�fl8 8' ilo 0iti 9 /dill l f6 �< tuPERCOLATION RATE (minutes/inch)) PERC HOLE DIAMETER TEST RUN BETWEEN 3 /'�` FT AND FT COMMENTS��Jr¢ dchtzil�_r� ; %Qccled D✓v�rrt«;tif PERFORMED BY: sol'e') �Ny �" t I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: &Z–J-g 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES - 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Bonnie Kin _ OC_ 0 � n°00000a e°,^ LrNGINE L) o G &,e49 YH °. 06 •ems• oeoNa.o•...ot0000ee.T .+ Q � / 4♦ •..•o•••� •uee i. er�.a e.o+ Kenneth M. Did' � a Vie•° CE 711y Qo°° ROFE DATE PERFORMED: LEGAL DESCRIPTION: Prop. Lot 3, Blk 1 Township, Range, Section. NE'/4 > , T15N R)lr� DEPTH Benbecca S D SLOPE SITE PLAN (FEET) 1 10 II li �I 2 3 4 J�/ PO2. 14DLL EL -EV. 5 6 5ar,1� sll� 7 8 9 10 11 12 13 14 15 16 17 18 19 20 z i, 5/1 6/-9+ WAS GROUND WATER / ENCOUNTERED? Nd `= ML// S 14f�v>7-vPtvA IF YES, AT WHAT E DEPTH? P E 4-67. Depth In Water Atter / Monitoring? f 4 Date: _ COMMENTS ._ Hole presoaked. PERCC LeATION RATEa z'C(mutes7ncn)�ERC' U DIAMETER gl TESL RUN BETWEEN -3 1 Z FT AND 4 —F1 PERFORMED BY _ KMS Kenneth fids —_ CE 11IFY THAI THIS TE6J WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL G010[IJNE-S IN FFF FCi ON THIS PAiF- DATE Depth to Water 1 � 2 • • PERCC LeATION RATEa z'C(mutes7ncn)�ERC' U DIAMETER gl TESL RUN BETWEEN -3 1 Z FT AND 4 —F1 PERFORMED BY _ KMS Kenneth fids —_ CE 11IFY THAI THIS TE6J WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL G010[IJNE-S IN FFF FCi ON THIS PAiF- DATE MUMMPAU U 7Y OF %HCHORQGEE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section F_ax__90.7_343-7.9.9.7 Certificate of On -Site Systems Approval Parcel I.D. 051-052-65 1. GENERAL INFORMATION Expiration Date: -,t/b a 0� Complete legal description Benbecca Block 1 Lot 3A Location (site address) 22626 Lake Hill Drive, Chugiak, AK 99567 Current property owners) Wayne Baker Day phone Mailing address 22626 Lake Hill Drive, Chugiak, AK 99567 Real estate agent Alisa Parrent 2. TYPE OF DWELLING: 9 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907)250-3154 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑■ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -5_"")_0 Date of Payment i 1 1�2 a 021 Receipt Number 67.3'1 � D COSA # 0SC 2 f 16 76 Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 compliance wifh all app Ica a Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering - Phone (907-) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. (M.J.) Date 11/16/21 TH 4 6. DSD SIGNATURE �- System #1 Approved for 4 ..T.. / bedrooms �.� Benjarrl>D/Schiller ..� j System #2 Approved for bedrooms F��s•, CE 12/21 AEW �1%' .. /16/21 P`�*v�� Disapproved 1 ll ``ROFESSION Conditional approval for bedrooms, with the following stipulations: .i II I(i Mif, By: Original Certificate Date: g X20 % 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 Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Benbecca Block 1 Lot 3A 051-052-65 ■4.5 6/1997 240 240 ■ ■ 18 Forge Engineering 11/15/21 186 11/9/21 2 Septic/Steel 48 ■ JR's Septic Pumping 11/15/21 Shallow Trench 9/1997 11/15/21 ■4 5.2 0 2.3* 661 0 ■ 0 2.9 0 >600 *Insulation present over trench ✔ COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to:(Please enter distances if less than required or if community well) 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 From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’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 septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft 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 If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I 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. 11/24/21 ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Upper (eastern) trench had 55" of effluent in trench at the time of testing (Effective depth 80"). Test completed using "primary" trench (western). ✔ LOT 2A 10' TEL.. & ELEC. EASEMENT EDGE OF PAVEMENT G R A V E L D R I V E W A Y Lot 3A, Block 1 Benbecca Subdivision 40,107 Sq. Ft. +/- 22626 Lake HIll Drive 2 Story Wood Frame House With Attached 2 Car Garage S0° 13' 50"E 127.52'N89° 54' 37"E 314.71'N89° 52' 55"E 314.70'21.4 26.320.1 18.622.236.341.5 14.0 8.3 ℄ LAKE HILL DRIVE S T T LOT 4A PAVED SIDEWALK PAVER RET. WALL 12.212.112.310.2 WOOD DECK TYP. 8.3 COVERED STORAGE SHED 8.972.330.7 32.9 100.318.6 SHED TEE CULVERT TYP.30' R.O.W.W 1 0 0 ' W ELL RADIUSG E S SS SS SS S S N0° 13' 33"W 127.36'145.310.16.06.0FRENCHDRAINPROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. November 9th, 2021. Legend: Scale 1" = 50' Electric Meter Telephone Pole E Lot 3A, Block 1 Benbecca Subdivision General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Alissa Parrent 21-823 11/10/2021 95-123 1561 E Elec. Pedestal Tel. Pedestal STA T E O F ALA S K A49 TH ROYEVRUSDNALLANOISSEFORP DERE T S IGER Pierre M. Stragier NO. LS-9812 11/10/2021 T Wood Deck FenceGGas Meter Over Head Utilities Septic Water WellWS Guide Wire �'&1897p�i ti r 5t • Municipality of Anchor e �a OCT 18 209 On -Site Water and Wastewater Progra"" (907) 343-7904 A� 5A F E T YA CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 051-052-65 1. GENERAL INFORMATION Complete legal description BENBECCA 61, L3A Expiration Date: rlUb q Location (site address) 22626 LAKE HILL DRIVE, CHUGIAK, AK 99567 Current Property owner(s) SHAWN ADELE ROBERTS Day phone 231-5656 Mailing address 22626 LAKE HILL DRIVE, CHUGIAK, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: �/2/" Date: 01 h COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5s0 • dc) Date of Payment 1019-4-119 Receipt Number 244 2_�0('=' COSA# 0_CcmS(:)G Waiver Fee $ Date of Payment Receipt Number 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. Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/21/19 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. s. 6. DSD IGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: KUTY pF��i�� ru ,d C A �mVV PRO Ot- TFR JJ . J/ �1 SFRViCeSv,\\\. By:U'u.&7UU0 Original Certificate Date: I 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 10-10-12.doc Legal Description: COSA Checklist Benbecca Blockl Lot 3A Parcel ID: 051-052-65 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 6/97 Total depth 240 ft Cased to 240 ft Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/4/18 Static water level at beginning of test 185 ft. Comments B. TANK DATA Age of tank(s) 1 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49 ® Standpipes/foundation cleanout per record drawing Date of pumping 10/24/18 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/1997 ® ALL standpipes present per record drawing Total measured depth from grade 5'5 ft (max) Measured depth to pipe invert from grade 2'24 ft (min) ❑ N/A — pressurized field Q Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system 1 Well production at time of test 4.7 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® Nc [Qf Coliform bacteria is Negative Nitrate /V_ mg/L Nitrate less than MRL (ND) Arsenic /� ug/L [Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 10/21/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/24/18 Results Q Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 1030 gal New depth 12 in Elapsed time 1140 min Fi 0 Code -required soil cover over field nal flid dth 0 uepin N System presoaked Absorption rate 600+ 1H (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced 2000 gallons If yes, enter date Comments/Deficiencies: aUon present over irencn COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 250 Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS Vacant system presoaked per code prior to testing Upper (eastern) trench #1 had 40" of fluid. (All fluid levels verified 10/21/19) G. ENGINEER'S CERTIFICATION 1 certify that I 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. COSA Checklist yellow sheet 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ArcTerra Consulting, Inc. Phone 8683792 Address _20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 09/08/2009 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational rife 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 ArcTerra can o give any septicsystem. of how long a "� OF t % system will function satisfactory for current or future •�P�;.••""'"'••+ 1� occupants or can ArcTerra guarantee that no unseen i h .• •. y encroachments, deficiencies or discrepancies exist / * f48In A%, * � 5. DSD SIGNATURE Approved for L bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: (ew. nAs) 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: BENBECCA BLOCK 1, LOT 3A Parcel ID: _051-052-65 A- WELL DATA Well type PRIVATE Date completed 6/1997 Total depth _ 240 ft. If A, B, or C provide PWSID # Well Log (YIN) Y Sanitary seal (Y/N) Y Cased to 240 ft. FROM WELL LOG Date of test 611997 Static water level 180 ft. Well production 25 g.p.m. WATER SAMPLE RESULTS: Wires properly protected (Y/N) Y Casing height (above ground) _min. AT INSPECTION 8/28/2009 184 ft. 5.97+ 9.p -m. Coliform 0 colonies/100mL Nitrate LID mg/L Other bacteria 0 colonies/100 mL Arsenic: ND mgn Date of sample: 8128/09 Collected by: ArcTerra B. SEPTICIHOLDING TANK DATA Tank Type/Material SeotWSteel Date Installed 9/1997 Tank size 1250 gal. Number of Compartments a Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N_Date of pumping 8129109 PumperJRs C. ABSORPTION FIELD DATA Date Installed jINL Soil rating (g.p.dJft2 or ft2/bdrm) 1.2 System type Shallow Trench — 7re4d a Length Aft. , Width 5 ft.' Gavel below pipe 2_9 ft. Total depth 5.14-5.5 ft.Tre n CA z eit ?//104 cue Eff. absorption,area w fe /'Monitoring tube Y Depression over field N Date of adequacy test 8129/09 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 16 In. Water added 639 gat. New depth 22.6 in. Elapsed Time: 1440 min. Final fluid depth 15 In. Absorption rate >= 650+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) _If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) '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 SEPARATION DISTANCES FROM WELL ON LOTTO: Septic tank/lift station on lot 100'+ Absorption field on lot 1001+ Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 51+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation _10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ b Curtain drain '50'+ Wells on adjacent lots 100'+ F. COMMENTS �I r 'System presoaked prior to test %iaad j 7 hQs 3, 9 of !'cyr✓ �it! 9%/ �O� G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections andi 4g [, I0;+,� it review of Municipal records that the above systems are in •' •�•� •••' conformance with MOA COSA guidelines in effect on this date. ... `'^ ...}.. « •90 Knmph .� u• i Im Engineer's Printed Name KENNETH M. DUFFUS Date 09108/2009 COSA Fee $490.00 Date of Payment, • Receipt Number Z (Rev. 11/05) Waiver Fee S Date of Payment Receipt Number 1 MMM -t937 69: x..0 SELL Ww;; 0116 P.01 } 1s E , N wuarw ,:r.ir x i - k-- - IOi.4L9WE N 4wirisft Mir l t..q Mme, Mt w M m x3 TDTiL P.81 T'd SL22-889-LOS WdL2:2 8002 ST daS MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 MOM MUNIC:INALITY OF ANC;HUKAut: ENVIRONMENTAL SERVICES DIVISION OCT 10 1997 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING RECEIVED Parcel I.D. # 051— 05Z — L5 HAA # 1. GENERAL INFORMATION Complete legal description Lc,� 3 A -i L 1 M� Location (site address or directions) oda L-oJ1,,-_ 4t, 11 Dy -I V� Property owner -1e--r _-S vM�)nor) Day phone Mailing address 21-51)1 A L(Wta7q S�. EA -63 AK, Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site_ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5 STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. KNr Engineering Phone Name of Firm Address ':aje River, AK 99577-8736 Engineer' 6. DHHS SIGNATURE Approved for �'y2 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date fi "tel The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-M (Rev. 1/91) Back MOA 821 Municipality. of Anchorage MUM�wAUTY of ANGHU DEPARTMENT OF HEALTH & HUMAN SERVId ONM'NrALSERVICEs'( Environmental Services Division Cp 1997 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-474 Health Authority Approval Checklist RECEIVED Legal Description: Lo� 3A -5(KLam' eh 6ecca_ Parcel I.D.: 051- A. S1 A. WELL DATA p // Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) !` Date completed!09 7 Total depth Zyv Cased to ZZ/0 Casing height (above ground) 2 Sanitary seal (Y/N) ( Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test �. 9 i Static water level �3 D Well production g.p.m. ti• WATER SAMPLE RESULTS: Coliform CU Nitrate '40-10 mgi Other bacteria Date of sample: �Z �97 Collected by: Aldo 6t -7 e r� B. SEPTIC/HOLDING TANK DATA Date installed 9 1 b7 _Tanksize_/Z5D Number of Compartments Z Cleanouts (Y/N)_� Foundation cleanout (Y/N) - Depression (Y/N) /V High water alarm (Y/N) Date of Pumping — Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) /. 2 System type 54.J(0LJ lreoick Length (aWidth Gravel thickness below pipe 2, 9 Total depth Effective absorption area 25 7 Monitoring Tube present (Y/N)--,/ - Depression over field (Y/N) Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.); — Immediately after — gal. water added (in.): Fluid depth (ins) Minutes later: Absorption rate = g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* ��h l�-� STI IiL�P►l Date installed Manhole/Access (Y/N) _ High water alarm level at* Cycles tested E. SEPARATION DISTANCES F Size in gallons "Pump on" level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: ump off" level at* i Septic/holding tank on lot l co r `f" On adjacent lots Absorption field on lot /00 f On adjacent lots -Ino Public sewer main /V14 Public sewer manhole/cleanout N Sewer /septic service line 2 -t Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation /D Property line Absorption field /U f r , Water main/service line 25 4- Surface water/drainage /DU + Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Jt� Building foundation 4- Water main/service line 25 f Surface water ILI) 0 �f Driveway, parking/vehicle storage area /OQ Curtain drain * M6 i� Wells on adjacent lots *Wpne- ENGINEER'S CERTIFICATION nF A 1 certify that I have determined thru field inspections and review of Municipal in conformance with OA HAA guidelines in effect on this date. Signature Engineer's Nameehh�T�u�uS Date /ee,r-VA7 � OI �`AROFESSIO` HAA Fee $ -30,.;D Date of Payment / a b a h -�' Receipt Number�3 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number