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HomeMy WebLinkAboutT15N R1W SEC 19 LT 16T15N R1W Sec. 19 Lot 16 #051 - 241 - 09 Aih� Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 261037 PID Number: 051-241-09 Dwelling: X Single Family (SF) [3 with ADU El Duplex (D) ❑ Two Single Family Project: 0 New X Upgrade Name HUFFAKER ABSORPTION FIELD W Deep Trench R Wide Trench F1 Bed E] Mound Site Address 19399 KLONDIKE ST, Chugialk E] Other Phone Number of Bedrooms Soil Rating depth from original grade 13 0.8GPDISF JTotal 7.5 Ft. LEGAL DESCRIPTION Depth to pipe invert . from original grade 1.5 Ft. — Gravel depth beneath pipe 6 Ft. Subdivision Block Lot T1 5N RI W SEC 19 LT 16 Fill added above original grade 1.5-2 Ft. Gravel length 48 Township Range Section Ft. Gravel width 2.0 Bed -s: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption LiftStation Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 576 Ft2 1.0 Ft. Well 100 100 50 TANK M Septic [I S.T.E,P. C0:31 H [ding [3 Other Manufacturer GREER/ANCH, DEEP BURIAL Capacity 1000 Gal. Surface Water 100 100 Material Number of compartments I Lot Line 10 i 10 NA PLASTIC 2 Foundation 10 10 LIFT STATION -1 Manufacturer Capacity Remarks OLD TANK DECOM. Gal. Alarm location Electrical installed by Installer to PIPE MATERIAL House to Tank grainfield3034 MIKE ANDERSON Drainfield 3034 CO/MT3034— Inspector MIKE ANDERSON BENCH MARK (Assumed elevation) 102.5 ft Inspection i st 4/14126 dates: 2w 4/15/26 Location and description — 3"d 4 th TOP OF MH LID ON-SITE WATER AND WASTEWATER SECTION APPROVAL E.Wel'sStamp Conditional Approval: Date 47 4 9 L4i J4�'. 1 0. ...... i,:r) • MICHAEL N. ANDERSON C Septic System Approved-�`""�- Date 4/23/2026 9 9 Note: this approval does not include well permit requirements, C" S SVV. Aih� Permit No. OSP261037 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER AND WASTEWATER SECTION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-7904 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: T15N R1 W SEC 19 LT 16 PID No.: 051-241-09 50' R.O.W. RESERVE MARK A B C01 75.1 87.1 TC01 82.7 95.4 TCO2 87.1 99.4 CO2 90.8 103.4 CO3 92.2 105.1 BE qCH, TOP OF MH C04 118 133 MT 119.5 134 C05 97.1 104 i _ x—x 'CO CO2, TCO2 o TCO1 Nn& PLASTIC TANK i \\ C01 OLD SYSTEM DECOM. / QHAIN \ INK x \ g \ I I \ V� ASBUILT I LE: 1"=50' \ EXISTING FCO TC01. BENCH TCO2 CO2 CO3 C05 MT1 C04 ��•,""r,�, OF,r.ir. �C�S�+�i fl .4 �P••' C�) FNi5F1 GRADE FlLL •• 4 . FlLTER FABRIC 6 INSUUI �G I SULATION % •• TH -.� ..49 - - .... ........ 1.000 GALLON / PLASTIC TAM( Sm •;4MICHAEL N. ANDERSON' � ♦�� No. CE 9469 � �.' %44-17-26 •.• 40 •44440• � ppp ......... WA �\ ..�� SIR SECTION TER O 87.25 APRIL 202 ♦ ' SPRUCE CREST DRIVE _ 50R,O.W. RESERVE GARAGE 32.6' ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 16 SURVEY CERTIFICATE: 1. John L. Schuller, [lave conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachnients exist other than noted, Under no circumstance should anv information on this drawing be used for construction of fences. 49TH -.7 structures, improvements, or for establishing boundary lines. ...... . . . ..... EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which OHN L. SCHULLER.: 0 do not appear on the recorded subdivision plat, LS -10408 WORK ORDER NUMBER: DA7----- SCALE: E-MAIL: APR 16, 2026 1"=50' sehullerokOgmall.com 4) 26-030 - AM Ofession 1831 TmUc etoa Street co ' ~ `~ -- ss,nc _ wx� ko � CD n -0 uo - 00 CD 0 Zu z 00=ORAVEL LINK WELL Uj GARAGE 32.6' ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 16 SURVEY CERTIFICATE: 1. John L. Schuller, [lave conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachnients exist other than noted, Under no circumstance should anv information on this drawing be used for construction of fences. 49TH -.7 structures, improvements, or for establishing boundary lines. ...... . . . ..... EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which OHN L. SCHULLER.: 0 do not appear on the recorded subdivision plat, LS -10408 WORK ORDER NUMBER: DA7----- SCALE: E-MAIL: APR 16, 2026 1"=50' sehullerokOgmall.com 4) 26-030 - AM Ofession 1831 TmUc etoa Street Permit Number:OSP261037 Tax Code Number:05124109000 Work Type:Septic Upgrade Effective Date: Design Engineer: Site Legal Address:T15N R1W SEC 19 LT 16 G:0955 Owner:HUFFAKER GERALD & CHRISTINE Site Mailing Address:19399 KLONDIKE ST, Chugiak Lot Size in Sq Ft:54450 Total Bedrooms:3 This permit is for the construction of: Disposal Field Septic Tank Holding Tank Privy Non-Public Water 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. Coodinate with On-Site staff regarding preferred method. 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 4/10/2026 4/10/2027 FIRST WATER CONSULTING Expiration Date: þ þ ¨¨¨¨ Issued To: Issued By: Date: Date: 4/10/2026 4/10/2026 FIRST WATER CONSULTING Isatou B Njie 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 http://www.muni.org/onsite On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE • Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 051-241-09 Property owner(s) GERALD & CHRISTINE HUFFAKER Day phone Mailing address PO BOX 670346, CHUGIAK, AK 99567 Site address 19399 KLONDIKE STREET, CHUGIAK, AK 99567 Legal description T1 5N R1 W SEC 19 LOT 16 Number of Bedrooms 3 Engineering Firm FIRST WATER CONSULTING Building Permit Number Not Applicable APPLICATION IS FOR: APPLICATION IS AN: (Z all that apply) Disposal Field nx Initial ❑ Septic Tank nx Upgrade nx Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: S-9 Date of Payment: 115 Permit No. Z_ May 2025 Waiver Fees: Date of Payment: Waiver No. Distance: 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! April 8, 2026 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: T15N R1W SEC 19 LOT 16 – 19399 KLONDIKE STREET, CHUGIAK The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one deep trench and 1000-gallon HDPE deep septic tank to serve the existing 3 -bedroom residence. We would recommend installing a 1500-gallon septic tank for current functionality and future flexibility. The design is based on the recent test hole conducted on March 14, 2026, by Mike N Anderson, PE. Groundwater was observed at test hole excavation and subsequently at recent monitoring per the attached. The slopes are moderate at 8-13 % at the proposed upgrade location, but steeper slopes exist downgradient and a 50’+ separation will be maintained. The lot and area are served by private water. 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 OSP261037, Isatou Njie, 04/10/26 FIRST WATER CONSULTING T15N R1W SEC 19 LOT 16 DESIGN CALCS: NO SLOPES >25% WITHIN 50'+ OF PROPOSED FIELD STAKE PROPERTY LINES, WELL RADII, ESMTS, OR OTHER SEPARATIONS... PRIOR TO CONST. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261037, Isatou Njie, 04/10/26 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK OR FIELD. DESIGN DETAILS: T15N R1W SEC 19 LOT 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261037, Isatou Njie, 04/10/26 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP261037, Isatou Njie, 04/10/26 Mark Begich Men Development Service: Department Building Safety Division On -Site Water a Wastewater Program 4700 Brogaw Street P.O. Box 196650 Anchorage. AK 99519-6650 acomuntatthnslin (907) 343-7904 Pump Installation Log Well Drilling Permit Number: Parcel Identiflcatlon Number:051 -$ -0 — 000 Date of Issue: Legal Description T/SN (e, SEG 19 Block Lot /6 ._ 7 N, uyfakct (Iqg a q q kLonc//kt Sf Chli3 aka Ak 995-47 6759 - Pump Installation Date: 04 - O - log Casing: 37 feet Pump Intake Depth Below Top of Well Pump Manufacturer's Name Ay /"/UbrI n a a Pump Model: a-3o5oksH / Pump Size by feet - A Fides* Adapter Burial Depth: Nin PItlen Adapter Manufacturer's Name: Pities, Adapter Installer: N� N Well Disinfected Upon Co nt X Y Method of Disinfection: L SP' hO p' 0 No to t3°,1 Comments: Pump Installer Name: il)L° S L rey P a gnen Comms: l.4et-4 S'njetpris es Matting Address: PO. &'X 77/236 c ity:Eta5LG lam).- stat: /4k zip: 9957? Attention: The pump installer shall provide a pump installation log to DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE •, -i �'y?�- "'• DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME . - , �/� /q /� { //9n �'// A #7 -r � , / I_ lin/�! PH (�j(,E ,p��(,q (l g—1 ou+ ❑NEW UPGRADE MAILING ADDRES _0 /j S 4s /OH0 2 11 a LEGAL DESCRIPTION r/ 4 Sec l 9 TKA./ RI& LOCATION // ti/C4ke NO. OF BEDROOMS SEPTIC I TANK Well 7o / DISTANCE TO: Absorpti�orea JJ Dwelling 29 / t Material PERM ITr I .i r 7//�� MLT I J i No. of c artments Manufacturer1167-NtI Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid o Y J 0 2 0�F DISTANCE TO: Well N Dwelling PERMIT NO. Manufacturer SAY" • Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well /d 2 . f,� Foundatione#7, Nearest lot line !t ,� PER 1�(�I Ij ! 26 3 No. of lines .Z / Lantly1 e 1,61,1.4 Total lenJh%f iF es„1 Trenc widthrr 0 inches Distance between lines --.. Top of tile to finishgrade/ f 4 m5 - Material beneath tile f! . LdCr A'dLT 14,1`.--3inches Total effec iv a.;nrppti area / /&o 6 SEEPAGE PIT Length Width Dep)e/S71/06-^ lath J/ PERMIT NO. Type of crib Crib diameter Crib epthd Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line w Class Depth - Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER Gry t) PIPE MATERIALS 0 f' C3 SOIL TEST RATING Q �' 2S1 / � 54 INSTALLER 6/ 4 6- `'t, 12-3 / �c cp REMARKS /%/ / y-��f ��/ Sr'(:)S/c 7 k saris c �. t 8/L NI ti S41 t /J r '� r rt.ICeUrile •f.1j1 N re , ' s .epi( a fer At ;.4 APPR$ ED /J/�///�/ DATE /_L/�LEEEGAL OS 72 017IR bv: 3/78) , MILNINLIFC "Fs ire C)FE Fmncl-tc Br::DCFLE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 /L' STREET/ ANCHORAGE. 99501 264-1720 clivA �MTIFIE JENEEF:IN1TEr PERMIT NO. ( 790263 ) APPLICANT ALLEN M WILLIAMS LOCATION KLONDIKE ST LEGAL LOT 16 SEC 19 T15N R1W BOX 185 KLONDIKE ST. CHUGIHK 688-2638 LOT SIZE 55000 SQUARE FEET TYPE OF SOIL HBSORBTlON SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 289 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: �����H— n IFE[GuilKiEFH= EIEI FP EVE = THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). srEr-ric �Fltrmittc: sramE= fLoora onLonir-A--,; PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. 1-0,4 COI ��)1 I F,WEE IT I 0:MN; FED RAE: gIa FnEI 115i - GHCKFILLI NG OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IF 100 FEET FORH PRIVATE WELL/ OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND C[MTRLICTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F° Efl DRI7LP11 I If EE Ds Ei ND FE CI: EIC E3 PEE P.! !r.731�� I CERTIFY THAT 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SlGMED:_ HPPLICHNT AL LEN M WILA_ IEMS ISSUED BY -DHTE __- V3.2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-2221 PERFORMED FOR:4I/Grl bI SOILS LOG — PERCOLATION TEST ialtans DATE PERFORMED: 1 SOILS LOG ❑ PERCOLATION TEST S chat/ 77 LEGAL DESCRIPTION: Zo riZ tie / 9, r /.s "`i * / u SLOE SITE PLAN 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (FEET) •,V 014 `La i —171, Top / Lary ANo i GCe,tzwS 2 Z p5ec0Ls7/o?U `%&'s Ct )k767 C,e g Sm/n / 27s"-3da ��f� f�rdh /o 7-rro/14 I/0 IS COMMENTS WAS GROUND WATER Ow % ° S ENCOUNTERED? L' IF YES, AT WHAT DEPTH? -- Reading Date Gross Time Net Time Depth to Water Net Drop / 31079 J"; 3a (r SME _____ — lir s(as ti ■ 30cit/dl 62`/ 1 " /1 6,J8 iathto 62 7yt /� ,/r `3 174 if g;20( /0AY/ b Cz'/ /At 6-' 1, 6 30 /ocai;o 02.3' /„ te citt ft t WAS GROUND WATER Ow % ° S ENCOUNTERED? L' IF YES, AT WHAT DEPTH? -- Reading Date Gross Time Net Time Depth to Water Net Drop / 31079 J"; 3a (r ' I" _____ — 2 ti 6 eop 30cit/dl 62`/ 1 " /1 6,J8 iathto 62 7yt /� ,/r `3 174 if g;20( /0AY/ b Cz'/ /At 6-' 1, 6 30 /ocai;o 02.3' /„ te PERCOLATION RATE 40 (minutes/inch) T RUN BETWEEN r FT AND --4-- FT 1 T /"5 /N nFr PERFORMED BY: -5d /Afl.-/44"V% Pe 72-000 (7/76) r4 k 1 2597 c Be Mine e Fxis ri.JvC- see/ sf CERTIFIE DATE:I iff-71 3330 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality Street, Anchorage, Alaska. 99503 274-4561 Date Received July 15, 1976 t_doDLn. Time of Inspection 1:,30 P,TYL (lam/ Date of inspection71c2=--Oa ./ �o al REQUEST FOR APPROVAL OF NDIVIDUAL SEWER & WATER FACILITIES FOR Pay ,D4 Ami Approval requested by: ,lose : ,LA Mailing Address: - Phone: bi I 0 P LA Olt Property Owner: Ronald L. Coleman, Jr. Phone`. 688-2030 .;Mailing Address: Legal Description: T15N R1W Section 19 Lot 16 4. Location: Klondike Court off South Birchwood Loop Road 5. Type of facility to be inspected No. of bedrooms 6. Well Data: Individual A. Type B. Depth 40' C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank (J 3 , Absorption area /6 3 , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area tonearestlot line EQ -034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE. GREATER ANCHORAGE AREA BOROUGH DEPT. OF HEALTH & Department of Environmental Quality ENVIRONMENTAL PROTECTION 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 159976 REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL SEWER & WATER FACILITIES L V L 1. Type of Inspection: CMRO VA FHA CONV 2. Property Owner: 6'on41cQ L Colevnak Jr. Mailing Address: Day Phone 4 88 x.0 3 0 3 Name of Buyer: noel .� E 4 P. SAlidli4frws Mailing Address: Day Phone 4. Name of Lending Institution: O nem -lvionce-ck Mailing Address: Phone 5. Name of Realtor or Agent: crtfe 1i��nme I 8 3232 /1 r_4yI• Mailing Address : 7 o Box Io 6s Phone 6 99- 9521 0. 6. Legal Description: T/5 Al /3 I a1 Sec. 1 9 Lot- /6 Location: Klov,e Ke c --c So- 13.1 Awoocx loop 7. Type of Facility to be inspected: No. Bdrms. 8. Water Supply Type of Supply: Public Utility . Individual X If Individual, number of dwellings presently served 2 If Individual, depth of well Y,21 9. Sewage Disposal System Type :of System: Public Utility Individual (on-site) X If Individual, date of installation cel. ° ppa. Low ` ` " e)“,, x Page 2 of two pages - Req t for Approval of Individual S(r & Water Facilities .egal`Description Lot 16 Section 19 T15N R1 W Comments Approved Disapprove Ar _Date 'Approval ;Valid for one ye r 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 - areoperating satisfactorily. SIGNED. EQ -034 (1/74) Date S&S ENGINEERING MECHANICAL ENGINEER JCIIANICAL ENGINEERS CIVIL ENGINEER DAVID SLtNKAMP CIVIL ENGINEERS ROBERT A. SHAFER ' 694-9055f SRB 196X Eagle River, Alaska 99577 694-2979 MUNICIPALITY O: ANCHORAGE DEPT. 0: •. . ENVIRONMLNTAL �'ZCTION RECEIVED Allen M. and Roberta -J. Williams 185 Klondike Street Chugiak, Alaska 99567 June 5, 1979 REF: Government Lot 16, Sec 19, T15N, R1W Per your request, a sewer system adequacy test was attempted for the referenced property on May 31, 1979. The septic tank was pumped and found to have a capacity in excess of 1,000 gallons. - The seepage pit was completely full of water and there were signs of percolation through the ground to the surface. As a result of this inspection and the pumping of the septic tank, it can be concluded, that the septic tank is adequate for the three bedroom residence; however, I regret to inform you that the seepage pit has failed. Also, per attached) necessary system in 2 Inca as your request, a soil test (copy attached) and a permit (copy for upgrading the system has been obtained. It willnow be for you to arrange with a local contractor to upgrade the accordance with. permit specifications. ��R BERT A. 'SHAPE'/ P.E. CF: Dynamic Realty, 501 W. Northern ights Blvd, ATTN: Valda Drake, Anchorage, AK 99503 Alaska USA Federal Credit Union, ATTN: Diana Gibbs, 777 Juneau Street, Anchorage, AK 99501 Municipality of Anchorage, Dept of Health $ Env Prot (')LUhS �-air-i9 MUNICIPALITY OF ANCHORAGE MUNICIPALITY •- DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT L Street - Anchorage, Alaska 99501 tiWJRONt OF ANCHORAGE G 'SIT -; & ENTAL . _ ..--CTION 1 v:y?0 [[ II ,/, C6TI_t i 0 /825 • " f 11 ENVIRONMENTAL ENGINEERING DIVISION MAY Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days fo processing...' 1. PROPERLY OWNER / iN /4- / /// 4" 4iS P//HONEn"(, (l MAILINGADRESS/ / I -S iC..e-> LALI '`"te6, PROPERTY RESIDENT (If different from above) �cY/G�`-'7'7---C� PHONE 2. BUYER irea IO&k PHONE 333- 74.L A6 MAILING DRESS 3. LENDING IN TITUTION /� /fir--- /� -c ).--7-7/A) g-te,e- � PHONE 2-76- /as MAILING ADDRESS 4. REALTOR/ ENT (J - PHONE igt-c-67. //4116,67,--, MAILING ADDRE /C &---14--4-/: .y fYtraUg 7 / /q/, % /��.-c_ 5. LEGAL DESCRIPTION �/ �6/Le... . A /la a � c/ �/ As --4/ „e /W STREET LOCATION / ,,Cz-71--'� 3 MX) c . .4) • 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS • One • Four • Other SINGLE FAMILY • Two ■ Five O MULTIPLE FAMILY rig Three ■ Six 7. WATER SUPPLY Q7- INDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled 0 COMMUNITY since June 1975. For wells drilled prior to that date, give well 0 PUBLIC UTILITY depth (attach log if available.) 8. SEWAGEGE/DISPOSAL SYSTEM C INDIVIDUAL/ON-SITE** **If individual/on-site, give If system is over two (2) installation date ti D. c ears old an equac t 666 E PROC SSING CA st is reed • PUBLIC UTILITY Department. by this NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST Bf`F I T i 2J79 4721 =2 4e i.� AGO e i THIS SIDE FOR OFFICIAL USE ONLI INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE • SINGLE FAMILY O MULTIPLE FAMILY NUMBER OF BEDROOMS • ONE ■ THREE 0 FIVE ■ OTHER • TWO • FOUR • SIX 2. WATER SUPPLY OINDIVIDUAL O COMMUNITY ■ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL Lin DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM OINDIVIDUAL/ON -SITE ■PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INj$T,)ALLED ( X1( �-,t_L3r- (A Lori" n� nn� -1,1 ---1 ex I �tz� INSTALLER • Septic Tank or • Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank - Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest L Line Q Q �a 5. COMMENTS pp t ry)t n A I nn p N\ trw� �1m1ll ci- ci -1 co- t r...,, P f cC� . t-c, kL a C l ‘ �CLfl 1 j 1 4 ,1FF. P (n fl r kA - I 11dAkk_A LY, 9 St r.� S)0 1/t 9 o� U.5. Lett 1..,J-d�•l Li_sei1.v°II -� 0 y�to �o -\ (.� e r c A n4 d� 4 4 G r M P . W 1 4/�' s S) Q..0 #pJ' me em-Qtr./ — ytu 4 -'--- tJ Lf 6 r llV// -_- /r (1 GI APPROYED_EO.R-------BEfettrO S---- )( O CONDITIONAL APPROVAL (letter must acc�y certifi. &I— DISAPPROVED � 4�� K /�- _.- , , r A DATE G -I BY (Title) --Cittd7 0 V LEGAL DESCRIPTION-0 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE fi Development Services Department �`" Phone: (907)343-7904 On-Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261096 Parcel ID 051 -241-09 Expiration Date: " U 2 Legal description T1 5N R1 W SEC 19 LT 16 Site address 19399 KLONDIKE ST Current property owner(s) HUFFAKER GERALD & CHRISTINE X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: Isatou B Njie Original Certificate Date: 4/23/2026 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 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 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. 051-24-109 Complete legal description T15N R1 W SEC 19 LT 16 Location (site address) 19399 KLONDIKE ST, Chugiak Current property owner(s) HUFFAKER GERALD & CHRISTINE Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 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: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 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 $ 2 �' ' ` Waiver Fee $ _ Date of Payment Lf COSA # Date of Payment Waiver # COSA Application_Apr2025.doc �~��*��& ����W���&~U~m�� ------- -'----~`~~~~~~ Legal Description: T15NR1VVSEC 19LT16 Parcel ID: 051-241-09 If more than I well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA [] Well log iofiled with Onsite (or attached) Date drilled UN Totaldepth >40 ft Cased to UN ft �� Sanitary seal is functioning correctly UNIWires are properly protected Casing height (above ground) 12 in. Date offlow test for CC`SA 3/20/26 Static water level atbeginning oftest 21 *. Comments B. TANK DATA Measured operating fluid level inseptic tank NEW Date ofpumping NEW [] Required maintenance completed, ifAVVVVTS Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 4/14/26 ALL standpipes present per record drawing Total measured depth from grade 9.5 ft (max) Measured depth bopipe invert from grade 35 ft (min) FlN/A _ pressurized field. ----- Fl Per record draxvingm, field is insulated. Monitor tubes gotnbottom ofeffective. If not, state depth into effective ElPresoaked required if (Required ifhouse vacant orfield not used for more than 30days prior todate oftest) Gallons introduced _gallons date Any rejuvenationtreatment (past 12months) If yes, enter date . ----------- Well production *t time oftest 2.6 °pm Water storage tank volume O gallons Well disinfected for coliform test? F-1YesNo H Coliform bacteria is Negative Nitrate 1.87 rnQ/L 0 Nitrate less than MRL (NO) Amenicug/L ��Arsenic less than MRL (ND) Collected by K8NA Date 9/12/246 C. LIFT STATION FlRequired maintenance completed Age oflift station yeaxn Lift station rnatadm| Comments: Adequacy test data NEW Results ZPoas Fluid depth prior totest in Water added ____gal New fluid depth _in Elapsed time nnin Final fluid depth in Absorption rate 0pd F|EL8STATUS-POST RECOVERY Effective depth (per record drawings) 72 in EffectiveOd�pthus�d in Effective depth remaining L2 in E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' "Q Yes if No ft Neighboring Tank > 100' F71 Yes if No ft Disposal Field on Lot > 100' 2] Yes if No ft Neighboring Disposal Fields > 100' R] Yes if No ft Sewer Line/Main > 100' RV Yes if No ft Sewer Manhole/Cleanout > 100' R� Yes if No ft Sewer Service/Septic Line > 25TV-1 Yes if No ft Holding Tank > 100' n Yes if No ft Animal Containment > 50' n Yes if No ft Manure/Animal Excreta Storage > 100' M Yes if No It M 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' [Z] Yes if No It Surface Water> 100' R1 Yes if No ft Field to Foundation > 10' � Yes if No ft Tank to Property Line > 5' F71 Yes if No ft Field to Property Line > 10' [Z]Yes if No ft Water Main/Service Line > 10' FE Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Wells > 100' Yes if No Community Wells > 200' Yes if No If tank or field is under driveway comment below 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 of Firm MIKE ANDERSON Phone 727-8864 Engineer's Printed Name SAME Date 4/20/26 rr ';r 49TH l'!?,* MICHAEL N. ANDLRSCN CE 94 9 COSA Checklist—May2025.docx