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Home My WebLink AboutT15N R1W SEC 19 LT 31B A 1CM I I I T Onviluw AZOMIRIBb WUND buKVh-YllN6 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: At LoT DATE. AND THAT W6ENCROACHMENTS EXIST EXCEPT AS INDICATED. ITIS THE RESPONSIBILITY OF THE LH OWNER TO DETERMINE THE. EXISTENCE OF ANY GRID. EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON T.HE RECORDED SUBDI- 7- Duan Merk Saward VISION PLAT. UNDER NO' CIRCUMSTANCES SHOULD FB: Ls - _V 13 _w ANY DATA HEREON BE USED FOR CONs,rRUCTION-0 �, lo, K�ll OF FENCE LINES, OR FOR ESTABLISHING BOUND- : ARY LINES. DRAWN /Z.J1 NKA ad, 5 A 1CM I I I T Onviluw AZOMIRIBb WUND buKVh-YllN6 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: At LoT DATE. AND THAT W6ENCROACHMENTS EXIST EXCEPT AS INDICATED. ITIS THE RESPONSIBILITY OF THE LH OWNER TO DETERMINE THE. EXISTENCE OF ANY GRID. EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON T.HE RECORDED SUBDI- 7- Duan Merk Saward VISION PLAT. UNDER NO' CIRCUMSTANCES SHOULD FB: Ls - _V 13 _w ANY DATA HEREON BE USED FOR CONs,rRUCTION-0 �, lo, K�ll OF FENCE LINES, OR FOR ESTABLISHING BOUND- : ARY LINES. DRAWN MUNICIPALITY OF ANCHORAGE 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 PHONE [~N EW Z~,/~/~:~/~/ ~.-~-~'/~%,¢~ ~ ~-'~ ~ UPGRADE I Well I Absor0tion area Dwelli~/~ PERMIT NO, I ~ DISTANCE TO: /~0 I /~ ~-~) IF HOME.DE; ~ ~ DISTANCE TO: Well /0~1 ~/~ ~;O ~ 7~(r~ "Z '7 OTHER I SOIL TEST RATING ' ~ ~o~'Es s~~ APPROVED~ ~~ DATE LEGAL 72-013 3/78) t. IELL PERMIT NO. ( 788477 ) APPLICANT .B,~. ENTERPRISES LOCATION KLONDIKE STREET LEGAL DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRu~ECTION d~...., STREET, ANCHORAGE.. AK. ~DP~A~ ~64-4 t ~ P.O. BO},' 413.: EAGLE RIVER '9.9577 b,-,,:, L 218 SEC: :1.9 T~LSN R~W SI'1 LOT _.I,-E -<24f4~ S~)LARE FEE'[' TYPE OF SOIL RBSORBTION =, 'r ,: TEi'l I=.. TRENCH MAXIMUM NUMBER OF BEDR]OMS = 4 SOIL RATING (SQ FTdBR)= THE REQUIRED SIZE OF TH~ SOIL ABSORPTION SYSTE~le/IS: [:'EF'TH= t..~TH= ,"EL THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE E~CAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F~:E _F~qJ I ~'EC. SEF'T I E: TRr-,IK '_~ I ZE--~ :.'L2---:_;£-i LE~FIL_ L.,]~-.]"----~, BI_IR I t I~J THE PERMIT RPPLICRNT HAS THE RESF'ONSIBILITY TO INFORM THIS DEPARTMENT ' " INSTALLATION INSPECTIONS OF 8NY WELLS ADJRE:ENT TO THIS PROPERTY AND ~rHE -.ER ~ E. NUMBER OF RESIDENCES THAT tHE WELL WILL '= '"' TtqO c' 2 ::' I F~PE _.T I Or-~S RF4E R EL---!IJ I RE[) BRCKflLLING OF RNY _-.~_.TEM WITHOUT FINRL INSPECTION RND APPRO',,,'RL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECIJTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL.. SYSTEM IS ~00 FEET FOR A PRIVATE WELB OR · 50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS WRY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT l: I RM FAMILIAR WITA THE REQUIREMENTS FOR ON-SITE SEWERS 8ND 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 I~EMODELED TO.INCLUDE MORE THAN 4 BEDROOMS. RPPI. ICRNT B. ~. ENTERF'RISE5 / ISSUED _DFITE ',/.~. 2 O 8- E GEO"I_CHNICAL ~ DEVEL~C. 'MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Ear/Ellis 694-2774 SOTL LOG 688-2280 Soils Et Foundations Land Developmerit Sol1 Characteristics yes, what depth ,,. Perfomed for: Name: Hat 1 tng Address: Legal Description: , , Depth (feet) 0 2__ 5~ 7 10 12 Ground Water Encountered: Yes__No Proposed Installation: Seepage Ptt_~Drain Field~_ Comments:_ , Tel. NO,~ Performed by: ,~. Date: Certificate of On -Site Systems Approval Parcel I.D. 051-241-44-000 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: q I 1y Complete legal description T1 5N R1 W Section 19, Lot 31 B Location (site address) 19369 Klondike Street Current property owner(s) Kenneth & Jennifer McLeod Day phone 281-703-2613 Mailing address PO Box 771757, Eagle River, AK 99577 Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone �y 6 1 8 9 7o ! 7 AUG 01 2019 1- /\j ti 3. NUMBER OF BEDROOMS: 3 �68 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the. engineer. Date: COSA Fee $ 0U Waiver Fee $ Date of Payment 11 Date of Payment Receipt Number q H 1 Receipt Number COSA # (SC 1ql 357 Waiver # h 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Pioneer Engineering LLC Phone 907-863-2455 Address 16547 E Smith Road, Palmer, AK 99645 Engineer's Printed Name William Klebesadel Date 7-30-19 r :....::...........---`' •fir 6. DSD SIGNATURE d System #1 Approved for bedrooms ......... System #2 Approved for bedrooms �t •. X30-19. � Disapproved Conditional approval for bedrooms, with the following stipulations: c (j By: Original Certificate Date: �`— 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 Legal Description: T15N R1 W Section 19, Lot 31B If more than 1 septic system on lot: COSA Checklist # of Parcel ID: 051-241-44-000 Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 7.3 gpm Date drilled Water storage tank volume gallons Total depth 60 ft Well disinfected for coliform test? ❑ Yes ❑ N Cased to ? ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 38 in. Collected by Sullivan Water Wells Date of flow test for COSA 7/18/19 Date of Sample Static water level at beginning of test 36 ft. Comments No electricity to well currently. Wires are inside the well casing. B. TANK DATA Age of tank(s) 41 years Tank type/material Fiberglass Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Deep trench Which system tested (date installed) 1978 ❑ ALL standpipes present per record drawing Total measured depth from grade 16 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 2000 gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7/18/19 Results EDPass For 3 bedrooms Fluid depth prior to test 0 in Water added 634 gal New depth 0 in Elapsed time 76 min Final fluid depth 0 in Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date None 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' Fl� Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft 7 Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' F/� Yes if No ft Holding Tank > 100' F� Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No F71 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 7 Yes if No ft Surface Water > 100' ft ft ft ft ft F✓ Yes if No ft Property Line > 5' Fl� Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ✓0 Yes if No. Water Main > 10' El Yes if No ft Community Wells > 200' 0 Yes if No Water Service Line > 10' 0 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' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' F71 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓� Yes if No ft Private Wells > 100' ®✓ Yes if No Water Service Line > 10' F/� Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / 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 ft ft ft ft ee t , rt 1 ft ft ft ft VIPULLIVAN WAI USIVULb P.O. Box 670269. Chugiak, AK 99567 688-2759 TO:Clearview Investments LLC Jonathan Wiese Dolot79@gmaii.com TERMS: 1 YS % interest per month on unpaid balance L31 ORDER TAKEN BY I CUSTOMER ORDER NO. ❑DAY WORK ❑ CONTRACT ❑ EXTRA JOB NAMEMUMBER JOB LOCATION 19369 Klondike JOB PHONE STARTING DATE 8-29-18 QTY. DESCRIPTION OF WORK PRICE AMOUNT 1 Flow Test 1 Water Samples 1 Disinfect TOTAL: $1,180.00 Resting Static: 36.5' Total well depth: 60' Well makes 10+ GPM Currently there is a 2 wire pump on galvanized drop pipe No discounts will apply if invoice is not paid within 30 days. If paying with credit card please add a 3.75% credit card fee. If invoice is not paid within 90 days a lien will be placed on the property. Thank you, Bill & Cole Sullivan DATE COMPLETED: 8-29-18 WORK ORDERED BY: SIGNATURE 1 HEREBY ACKNOWLEDGE THE SATISFACTORY COMPLETION OF THE ABOVE DESCRIBED WORK. SGS Ref.# 1184862001 Client Name Sullivan Water Wells Project Name/# 19369 Klondike Client Sample ID { 19369 Klondike "Wellhead" Matrix Drinking Water Sample Remarks: Printed Date/Time 09/04/2018 8:52 Collected Date/Time 08/29/2018 16:30 Received Date/Time 08/30/2018 11:12 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/Dm ug/L Arsenic ND Waters Department 08/30/18 08/31/18 Total Nitrate/Nitrite-N 3.26 Microbiology Laboratory SM21450ONO3-F B E. Coli Negative Total Coliform Negative 5.00 ug/L EP200.8 C (<10) 08/30/18 08/31/18 DSK 0.100 mg/L SM21450ONO3-F B (<10) 08/30/18 AYC 100mL SM219223B A 100mL SM219223B A 08/30/18 K.W 08/30/18 K.W 2of5