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HomeMy WebLinkAboutKNIK HEIGHTS BLK J LT 2Knik Heights Block J Lot 2 0 1 8�232�2 Not eligible for Certif e of Health Authority�A until fee wastewater 'I f,,dispos system to well A- wIxTn;x T aiver paid. 3'� Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241253 PID Number: 018-232-27 Dwelling: 2 Single Family (SF) El with ADU El Duplex (D) El Two Single Family Project: El New 0 Upgrade Name HAGARMAN CORAL A TRUST ABSORPTION FIELD - EXISTING El Deep Trench F-1 Wide Trench El Bed El Mound Site Address 13301 RIDGEWOOD CIRCLE, ANCHORAGE ❑El Other Phone Bedrooms Soil Rating Total depth from original grade 7 " 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. KNIK HEIGHTS J 2 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic I Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+! 25'+ TANK Septic El Holding Holding 171 Other EQ Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ Material HDPE Number of compartments 2 Lot Line 10'+ NA Foundation 101+ LIFT STATION Manufacturer Capacity Gal. Remarks *MOA waiver #WR040071 & fee paid w/ this submittal. Deep burial HDPE tank installed. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank todrainfield 3034 Installer PCN Drainfield CO/MT Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection I5'8/27/2024 nd 8/28/24 Location and description dates: 2 3 rd 4 th ITOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date AW / *�� TH ? . .... .... . I . ......... .......... .. , k Septic System Curtis Huffman Approved - CE128991 AW Date_8/30/24 V PROFEWO Note: this approval does not include well permit requirements. (Rev 05/02/18) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: KNIK HEIGHTS LOT 2 BLOCK J PLAT P-452B SURVEY CERTIFICATE: I, John L. Schuller, Have 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 enchroachments exist other than noted. Under no circumstance shouli any information on this drawing be used for construction of fences, 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 do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DAM SCALE: E—MAIL AUG 30, 2024 1 "=30' schullerakftmail.com 2 4 — 0 9 7 — 2 DRAYM BY. (NECKED BY GRID NUMBER: BOOK AGE: JLS SW2936 240324 1"=30' / moo. / OO = FND 5/8" REBAR OF L N T� / �.. 4 9TH •. � / . .. .. ..... ' � .� L) ... ... ......................i ./ •. OHN L. SCHULLER.•: s LS-10408Z4 la AW \pro f e a� \�s sslon �. ��\n���� 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax PID:018-232-27 PERMIT:OSP241253 FIRST WATER CONSULTING KNIK HEIGHTS BLOCK J LOT 2 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 Permit Number: OSP241253 Work Type: SepticTank Upgrade Tax Code Number: 01823227000 Site Legal Address: KNIK HEIGHTS BLK J LT 2 G:2936 Site Mailing Address: 13301 RIDGEWOOD CIR, Anchorage Owner: HAGARMAN CAROL A TRUST Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: Dcpartmcnt 8/23/2024 8/23/2025 28800 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: �✓�% A,o Issued By: Date: r Date: 4 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 018-232-27 ANCHORAGE ON -SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) CAROL HAGARMAN Day phone Mailinq address PO BOX 670964, CHUGIAK, AK 99567 Site address 13301 RIDGEWOOD CIRCLE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) KNIK HEIGHTS BLOCK J LOT 2 Legal description (Township, Range & Section) Lot Size 28,800 Sq. Ft. Number of Bedrooms 4 Phone: 907-343-7904 Fax- 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) C@ (w/wo, AD U) Septic Tank Gi Upgrade IN Duplex (D) D Holding Tank El Renewal D Multiple Dwellings D Privy El (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: V �`� 'i ill POr— to I'- (:-L' I 015'L y / S S - i f� L-- 4 ( LC_ ?- Distance: ��' � I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (SigpatCwei of property -owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: � I , I � 0 Date of Payment: Receipt Number: Waiver No. �v GAIDevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! August 15, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: KNIK HEIGHTS BLOCK J, LOT 2 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE deep burial septic tank per the attached design to serve the existing 4-bedroom residence. We would recommend a 1500-gallon HDPE tank be installed for current functionality and future consideration or flexibility. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank or other actions may be required. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. 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 OSP241253, Curtis Townsend, 08/23/24 Minicipality of Andiorage On -site Water and Wastewater 0: F first Waler C O N S U L T I N G 13030 Sues Way Anchorage, AK 99516 907-350-9566 / FirstWaterAK@g ail.com August 22, 2024 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road (2— 14 PEVIEMD FOP CODE COMPUANCI OSP241253, Curtis TOWMYxl, M3/ Anchorage, AK 99507 1 RE: KNIK HEIGHTS BLOCK J, LOT 2 — MOA-WAIVER WR#040460 - NITRATES Per our investigation of the well located on Kn' Heights Block K, Lot 6A and the referenced septic system, we request continued issuance of waiver WR4"4 The continuance of this waiver of the 85.7' separation between the well on Lot 6A and the septic absorption field on Lot 2 is justified because of the information provided in the initial waiver request, site observations and investigation of available information. The well is uphill from the septic system and the septic field area gradient slopes away with any potential surface or subsurface effluent flowing away from the well. The silty soils act as a confining layer, per the well log the well is 244' deep with a static water level of 223', the soil sorption, permeability and gradient indicate acceptable protection. It is our professional engineering opinion that the referenced septic system is not specifically contributing to higher nitrate levels, but that the general neighborhood and areas increasing density and natural characteristics is contributing to the higher nitrate levels. It is also proposed that the referenced property will have a HDPE septic tank installed that with this higher -quality material will potentially assist with nitrate levels. We did review and look at adjacent available MOA files and sites pertaining to water quality and to ascertain possible and visible contamination such as soils, agriculture, animals, septic, etc. We could not see any possible contamination to abate. The well and surrounding wells show confining soils above the bottom of the wells or water producing zones. The soils appear to adequately protect the well and aquifer from surface or shallow water flow. We have also attached the waiver fee as requested in the MOA documents. Please contact us if you have any questions. Respectfully, Curtis Huffman, P.E. Attachment: MOA Waiver Fee S/ 2 3/2oZ� FIRST WATER CONSULTING KNIK HEIGHTS BLOCK J LOT 2 DESIGN DETAILS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241253, Curtis Townsend, 08/23/24 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: KNIK HEIGHTS LOT BLOCK PLAT P-452B SURVEY CERTIFICATE: 1, John L. Schuller, Have 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 enchroachments exist other than noted. Under no circumstance shout( any information on this drawing be used for construction of fences, structures, improvements. or for establishing boundary Iiiies. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E-MAJU =-, AUG 14, 2024 1 3 0schullerakOgmail.com 24-097 DRAIIII BY, ICHECKED BY C111D NUMBER: .- _6_0_0_K7PAGE: JLS SW2936 240310 1 30 1 00010 ".00000, "'Z * = FND 5/8" REBAR 4W low O.F L A 46 AWN, Alp f 4 NTH 00,' C, , • �j Li ?A . . . . . . . . . . . . . . . . . . . . . ?A f ............................ JOHN L. SCHULLER., LS-10408 1831 Talkeetna Street z+ Anchorage, Alaska 99508 `ADOf 0 n,3\ AM \1 W (907) 227-1455 office essi _410W (907) 274-4992 fax Municipality ofAnchoraae P.O. I)os 19riri50 - Anchom9c, Alaska V 519.66,50 - Telephone (]07) 343-&901 - rar ((X)7), 4700 Ompw Street - Anchom9e, Alaska 90.;07 s • s r . Mayor Mark Begich "VM111nl.org Building* Safety Division September 23, 2004 Carol Ann Hagarman Property Owner 13301 Ridgewood Circle Anchorage, Alaska 99516 Re: Wastewater Disposal System Encroachment to Water Well Knik IIeights Subdivision Block J Lot 2 Parcel ID: 018-232-27 Dear Ms. Hagarmann, A private sector engineer recently performed an evaluation of the wastewater system and water well on Knik Heights Subdivision Block K Lot 6A. It was discovered during this evaluation that the water well serving the home on this property is being encroached on by the wastewater system serving the home on Knik Heights Subdivision Block J Lot 2. According to our records you are the owner of Block J Lot 2. The separation distance is approximately 80 feet. The minimum separation distance from a private .well to a wastewater system is 100 feet. This is a violation of Anchorage Municipality Code 15.65.060. The water well on Block K Lot 6A was constructed on November 28, 1978 and the wastewater system on Block J Lot 2 was constructed on August 13, 1992. Because the well on Block K Lot 6A was in place at the time the wastewater system on Block K Lot 2 was constructed, it is the responsibility of the property owner of Block J Lot 2 to resolve this encroachment matter. Be advised that Knik Heights Subdivision Block J Lot 2 is not eligible for a Certificate of Health Authority Approval from this office at this time. The result will be the inability of the owner to transfer title of the property at the time of sale until the separation encroachment matter is resolved. If you have questions regarding this letter, please contact me at 343-7906. Sincerely, +JuieMakela, P.E. Civil Engineer II On -Site Water and Wastewater Program Coil? ntzality, Security, Prosperity ■ Complete harm 1. 2, and 3. Aleo complete hem 4 It Restricted Delivery Is deeked. • Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailplece, or on the front if space pam ns. 1. Article a, Om 2T � 13:31 �E, &ACz �`�' X576 O Agent C. Date of Delivery D. R d*IIv4Ffesese aaweO from sem» Oyes U YES. enter dsevery address below: O No Km /Ci Certified Mail O &,press Mall O Ragwomd O Relum Receipt to Merchandlee ' O Immed kw O C.O.D. 4. Reelected Degveryl pfre Fee) O Yea c 2. Ankle Number ^� /� /� /� /� p� _ (t-mwcan awvk-bb4 ! QW I D -7V QQ�� DSD 1 PS Form 3811, August 2001 Dornestk Return Receipt 102595-02-W540 m Ir N Pottage m ea r Ceedu Fee pftt . m nwn P4 apt Fee Hen G (Enoonemant ReguaeM O nsamn,d Dau wv Fee O (Enoananen Hsg-"M Gr irotw PoAa" a F. $ rAr O r C taro frP ■ Complete harm 1. 2, and 3. Aleo complete hem 4 It Restricted Delivery Is deeked. • Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailplece, or on the front if space pam ns. 1. Article a, Om 2T � 13:31 �E, &ACz �`�' X576 O Agent C. Date of Delivery D. R d*IIv4Ffesese aaweO from sem» Oyes U YES. enter dsevery address below: O No Km /Ci Certified Mail O &,press Mall O Ragwomd O Relum Receipt to Merchandlee ' O Immed kw O C.O.D. 4. Reelected Degveryl pfre Fee) O Yea c 2. Ankle Number ^� /� /� /� /� p� _ (t-mwcan awvk-bb4 ! QW I D -7V QQ�� DSD 1 PS Form 3811, August 2001 Dornestk Return Receipt 102595-02-W540 .� Municipality of P.O. aoc 19WZO • Anchorage, Alaska 99519,6650 • Telephone (907) M-&101 • Fax (9(r/) 343.82W 4700 Dmgaw Sheer • Anchorage, Alaska 99507 Mayor Mark Begich %' W.munl.org Building Safety Division 10/8/2004 KND Engineering, Inc. 10441 Ptarmigan Blvd. Eagle River, Alaska 99577-8736 Subject: Waiver Request for Knik Heights, Block K, Lot 6A Waiver Request #WR040071 Parcel ID #018-232-35 HAM HAO40460 Dear KND Engineering, Inc.: - Your request for a waiver of the required 100 feet horizontal separation from the absorption field to private well has been approved. The approved separation distance is 85.7 feet. This waiveris granted for. the encroachment of the' absorption field on Knik Height, Block J, Lot 2 to the water well located on Knik Heights, Block K, Lot 6A. This waiver approval applies to ' the existing absorption field to private well separation only. Any future upgrade to the`on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Apr 13 22 12:36a Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Date of Issue: -_-_ Parcel Identification Number: 018 232 27 Legal Description KNIK HEIGHTS Block Lot 2 Property Owner Name & Address: HAGARMAN CAROL A TRUST HAGARMAN CAROL A7RUSTEE 13301 RIDGEWOOD CIRCLE ANCHORAGE, AK 99516 Pump Installation Date: 04 - 11 -2022 Pump Intake Depth Below Top of Well Casing: 400 feet RED JACKET Pump Manufacturer's Name: Pump Model: 8S2 1.0 Pump Size: hp Pitless Adapter Burial Depth: 15 feet Pitless Adapter Manufacturer's Name: MARTINSON Pitless Adapter Installer: Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: PELLETS I Comments: Pump Installer Name: Company: Mailing Address: ATTN: WARRANTY DEPT AMTROL INC 1400 DIVISION RD WEST WARWICK, RI 02893-9977 State: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. / / Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: Q l=`J'r'=?'''; - Name: Wastewater System: New ❑ Upgrade 1 UST Address: ABSORPTION FIELD 1312/1L / Phone: I No. of Bedrooms: Eh/Deep Trench El Shallow Trench ❑Bed ❑Mound C1 Other � LEGAL DESCRIPTION Soil Rating: � Total Depth from original grade: �� +` c GPD/Sq. . Ft. Lot: Block:r Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe "/ �\ /t��I "� is l� lii/ ' y FL 6 Ft. _ Township: Range: Section: Fill added above original grade: Gravel length: ell/ Ft. ❑Upgrade FL Gravel depth:wrdiG / Number of lines: Distance between lines: WELL; ErNew� _--" — Ft. / Ft. Classification (Private, A,B,C): Total)Depth: Cased 1'o: Total absorption area: Pipe material: ^ / ,/i�f�T�-- 7� S Ft. I lq 3 Ft. 7[IO SQ. Ft. 0 > +1 Driller: Date Drilled: Static Waler Level: Installer: Date Installed: Yield: Pump Set at: Casing Height Above Ground: TANK j GPM /t/0I /mil. Ft. 3' Ft. SEPARATION DISTANCES ���� ler5eptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lilt Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Linesi Well ///J //�i/ /Y%//.r� Material: ;�!'z / Number of Compartments: 7, ;,�5 /i�0+ Surfac %/ 'O hllll A///i /J/iLIS LIFT STATION Water /OCJ+ Lot+ Line 5 V �9 3 s V/�`/ �i =� irl/!_f• Size in gallons: Manufacturer: "Pump on" level at: "Pump off' level at: High water alarm at: Foundation Curtain Pump Make &Model Electrical Inspections performed by: Drain BENCH MARK Remarks: Location and Description: _ Assumed Elevation: EN9,INEER'S SEAL P n t It]n Inspections performed by:`i,.//=A/ Dates: 1st 2nd _1,,- C -I +ArtV rs On I -C Department of Health and Human Services approval Date: / 9Z Reviewed and approved by: 72-013 (1/91) MOA 25 Permit No. 92 0 2y / 7 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.U. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Leaal Description: LZ OL �J KN 1 1< P F_-1 fi N7�5 PID No.: e \nIELL _13 72-013 A (2/91) MOA 25 I LOT 2 BL. J KNIK HEIGHTS STATE OF ALASKA DEPARTMENT OP NATURAL RESOURdHM DIVISION OF GEOLOGICAL AND GEOPHYSICAL SURV&YS WATER WELL RECORD LOCATION nm WO.T.T. BOROUGH SUBDIVISION j6� LOT BLOCK SECTION QTRS TOWNSHIP S RANGE E W MERIDIAN DIRECTIONS: ti WELL OWNER:CQ .� �.. WELL DEPTH: Depth of hole: 4/`d V ft Depth of casing: 1 ¢ eft Or DATE OF COMPLETION: MEASURING POINT:top of casing [] ground surface 59other: BOREHOLE DATA: Depth STATIC WATER LEVEL; ft. Date ter a Metype anco or From To -_= 0 Z METHOD OF DRILLING: Pair rotary ❑cable tool. Elother: f USE OF WELL: 'g domestic ❑ irrigation ® monitor []public supply [] other: g CASING: Stick-up ft. Diam: 46 in WELL INTAKE: Li open end ❑ screened © perforated open hole Depths of openings: to ft ry� / J��[• SCREEN TYPE: _ Diam: in Slot/Mesh Size r Longth: £t Set Between and ft ` Sr_�p+■1_ GRAVEL PACK TYP ' Volume used:_ Uept:h tv top: ------------- 0 /f© GROUT TYPE;__ _Volumo: Depth: from �t to ft R DEVELOPMENT METHOD:_ �a Duration; REMARKS. DEC 7 19 2 Pl. He p h & Of �lncfiUrra�e dept Health & lillnl{1(7 SerVicDs CONTRACTOR INFORMATION: /27 PUMPING LEVEL AND YIELD: ft after._2__hrs pumping_.1_gpm PUMP INTAKE DEPTH: -ft Horsepower: Date Pump Installed _ -__- WATER CHEMISTRY SAMPLE TAKEN? Elyes Ono Well disinfected u on completion? n ves Flno R4gvte—red Business Na �-� w � Signature of Authorizeqo4epresentative Date PLEASE MAIL WHITE COPY OF LOG WITHIN 45 DAYS TO: DGGS PO BOX 77-2116 EAGLE RIVER, Arc. 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON—SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920217 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HILDA BYNUM TRUST OWNER ADDRESS:13245 RIDGEWOOD DR ANCHORAGE AK 99516-2940 PARCEL ID:01823227 LEGAL DESCRIPTION: KNIK HEIGHTS BLK J LT 2 LOT SIZE: 28800 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 PAGE 1 OF 1 DATE ISSUED: 8/11/92 EXPIRATION DATE: 8/11/93 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND TETE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: -Jc)l-rw ")'mm DATE: �f/ // 2e7 2_ DATE :&3z/(/q Z-- ON SITE SYSTEM IMPACT L 2 BL J - Knik Heights Subd. Installation of an on site wastewater system and well for this lot should have little if any impact on the surrounding properties due to: 1. The lot has plenty of room for water and wastewater systems plus reserve septic system. 2. Installation of on site systems will not effect the lot drainage or drainage in the area due to the excellent soils in the area and local topography. If you have any questions please contact me at 34'4-4551. Yours Truly, M. L4�k6ul Michael E. Anderson, P.E. "n Fsql, .aF ° aea yoo Irl?�yyo,,)F� 4i o � d �0fl oa p��.pnwoa °o_°en ilfl ne a � n1:Michael I:. Anderson �p 4`P•o^ 4381 -E '� v H Ur w �4 i4 r� D� tt c N _Z - =o � raca .Oopj¶AhrCc °P[SOn 0 <//. A � Michael F. And. n,D DAA \! \ U (.A (A r. (A A S Z _b M D R1 b V' �+ P ri, in A ZI n \ U (.A (A r. (A A S Z _b M D R1 b V' =_ in N BY G(/�YJ —_ ©ATE _CLIENT �C S /�zR/:> / t/ f(�0�� SHEET CHKD. BY -_--- DESCRIPTION LOT p7I -T- jos NQ �S �D F=T 0. l3 A OF .— T��� I� q Bo 7- T-00 F F 1 J e =.hhicliael P.ncicrson . 1 s FE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825"L" Street. Anchorage. Alaska 99502-0650 SOILS LOG ® PERCOLATION TEST PERFORMED FOR: J/,�/C /L/$ � /A/ 1/i/ C�C)6 DATE P`ll'��0, v Kkko: OMth to Water Net Oroo LEGAL DESCRIPTION: IT, Township. Range, Section: DEPTH SLOPE SITE PLAN (FEET1 1 UL PEDD/SM S-177- I I I I I 4 1 I1 1 11 P/(,-/I'i 3 c_ - ai'nvl.c, 5 s 6FF- C_ AnipyI- N.' 10 11 12 13 14 15 16 17 16 19 20 ---- 13o0 7y I WAS GROUND WATER ENCOUNTERED? %I/(7 IF YES. AT WHAT DEPTH? t. wa,r AW 7Z92- 11 FA Reading Date I Grow lY) ^1 rme Net hl I Time OMth to Water Net Oroo zC I I PERCOLATION RATE lminutmincnl PERC HOLE DIAMETER .s TEST RUN BETWEEN FT AND 1, FT COMMENTS /, - ������/,n /A^ (�j}� PERFORMED BY: V°'�" R%bS A&,FAii.1)i� J I - ` �G'° =CERTIFY THAT THIS T T WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: e� �� LEGAL DESCRIPTION:_2 6L Township, Range, Section: DEPTH ��1J J /� /-i� /4 /lT.r SLOPE !® SITE PLAN (FEET) --q 77 I I 1 OL RE�p1`,i! SrL7 `> 2- 6- P 3 %IN1J y 4 Grp,AvF(_ 10 I I WAS GROUND WATER ENCOUNTERED? SIO 11 S IF YES. AT WHAT L 0 12 DEPTH? s P E 13 Duma a water Alar Mxwwr,q? No WA�}jfj p„r `7 z 7z 14 15 16 17 1a 19 20 SON Reading Date Grou Tiros N'I,� Nn Tiros Deoth to Water Not Drag c oa i Municipality of Anchorage au e'r� via DEPARTMENT OF HEALTH & HUMAN SERVICES 82.5 "L" Street, Anchorage, Alaska 99502-0650 ,•' Cjc I°� �� a4+ oAoo+,u' lj SOILS LOG PERCOLATION TEST e ,+4 zoo r •a q //, �,ichoel nla,.,o, ` „ `/ +1 l /7, i� i,I'�°• PERFORMED FOR: I2.E5 I LM S /M L/ 0 0 L PE�FORtit�PJ"` —DATE • v. LEGAL DESCRIPTION:_2 6L Township, Range, Section: DEPTH ��1J J /� /-i� /4 /lT.r SLOPE !® SITE PLAN (FEET) --q 77 I I 1 OL RE�p1`,i! SrL7 `> 2- 6- P 3 %IN1J y 4 Grp,AvF(_ 10 I I WAS GROUND WATER ENCOUNTERED? SIO 11 S IF YES. AT WHAT L 0 12 DEPTH? s P E 13 Duma a water Alar Mxwwr,q? No WA�}jfj p„r `7 z 7z 14 15 16 17 1a 19 20 SON Reading Date Grou Tiros N'I,� Nn Tiros Deoth to Water Not Drag 3 //, 6.0 /6 „ „ `/ a /7, i� Cn•4/7'• - 2z. I PERCOLATION RATE (O Immutearincnl PERC HOLE DIAMETER TEST RUN BETWEEN L' 0 FT AND _ �� FT COMMENTS //OL!" Pfe E_. • (,) A }'1_..t�'+ _ PERFORMED BY: �,r X40 jsfip cli I W-kCAkf- !�"' %_(CERT]T"HAT THIS /(TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: �? l C% '�,,_�® MuI" iciptyP.C. )x 196650 ANCHORAGE, ALASKA 99519 6650 fNIT '� �` (907) 264-4111 TONY KNO WLES. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 9, 1987 Hilda Bynum 8400 Hartzell Road Anchorage, Alaska 99507 Subject: Lot 2 Block J Knik Heights Subdivision On-site Sewer & Well Permit #860206 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1986. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report (three part form) must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4744. Sincerely, L R.W. Robinson Program Manager On-site Services RWR/ljw enc: copy of permit PERMlT NO" DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS: ���X If.. -1 '1 W; H.. X -V-4wo 113107 14 TWO 1 ���M1,4 R� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 �E. �:� 0 '� 860206 07/02/86 HILDA 8YNUM 8400 HARTZELL ROAD ANCHORAGE� AK 99507 344-0501 SUBDIVISION: KNIK HEIGHTS SECTION: 27 TOWNSHIP: 32000 (SQ.FT` OR ACRES) 4 Listed below are the options available to system^ Choose the option that best f,its JERIs: 13 DEPTH TO PIPE BOTTOM (FT 4.0 GRAVEL DEPTH (FT.) 0"5 TOTAL DEPTH (FT.) 4.5 GRAVEL WIDTH G, -1 122^0 GRAVEL LENGTH (FT") 4�,0 GRAVEL VOLUME (CU"YDS.) 34"3 TANK SIZE (GALS) 1250"0 ** SOIL RATING (SCI AIT. /BR> 152 w'nfz�(. / ^" C�^1,7(-o'' .~�� 6-c / U�� e�;,fr -74C-�` LOT: 2 BLOCK: J 12N RANGE: 3W YOU in designing your septic your site. ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certify thaL: 1. I am f,ami]iar with the requirements for on~site sewers and wells as set trip LA by the Municipality o[ Anchorage (MOA} and the State of Alaska. 2, I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit, 3. I will adhere to all MOA and State of Alaska requirements hip the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" 4" I understand that this permit is valid for a maximum o[ 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) ASAUILTS WILL NOT 8E APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3> THE ELECTRICAL W BE A LICENSED ELECTRICIAN" SIGNED DATE: ' ..... ..... -~~-~~~--��~- APPLlCANT: HIL�� BYNUM /y ^p 1SSUED BY ��� ~�/ DATE: ��_��~��6 ----~�~^~^`^^-^�.~~^�^~��~~~^�--~~~~� ~~^--~`~ 9 SOILS LOG - MUNICIPALITY OF ANCHORAGE e se- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ES /er 8ctmgarcdnet- Rer ax Heal DATE PERFORMED:— -5-1 /% /r9�- LEGAL DESCRIPTION: 1-0 Z Block J ��hlIT U/ -v P DEPTH SLOPE SITE PLAN p ]_ Ol- Ree(e- " 03«/lc Sllf 2 3 4 6-1` It( rr 5 S r l F/ $ira d j, Grave l 6 Dr/ 7 8 C % 61ravPll% S( f 9 10 11 12 13 14- 15 16- 17 s► 18- 0 19- CIL 9 CILP-C,,t,dy 6�raue / WAS GROUND WATER S 125 L3';1t3D81-r ENCOUNTERED? NQ L D7 IF YES, AT WHAT E DEPTH? S F' 6ia-awe(y San 6C his R •49TH a ����V •. THEODORE F. MOORED 4� � •.,, CE - 3589 �..• �,® eading Date Gross Time Net Time [Min) Depth to Water (ir) Net Drop (SnJ So.x k 6 / xI 3 5TH F' rl all pr- Sti ez k thp cekso, Sdr;C j 1 It : 06 (, ; 1`8 I 27 s/6 6: re as "i/c 2 it G Zb iQ t9 7 3/e 3 z'y ; Z 3/6 X 11 '//{ J' ,': N6 -7 .(' a �� .� rr t r� �mr /%rG I 20 clk"Profess-loal @� PERCOLATION RATE _ SEf (minutes/7incch) mTEST RUN BETWEEN// G f% FT AND --ILL FT o% COMMENTS %¢nGfj Px 7oiraq J r ori Hr k� 110 /1 C" /,$ Z r7'laa,t7 ,h 2' frJ 12,5- >a'/0drrn u�v�tlpnF �o �� I 2- a`/Bcfr+, 12 6 R' rn7I?-t &r 3a,4nr . `ir^enck teno'lt ^ 4t3 r PERFORMED BY: rIG bGg 'Tedlaiced S@t-y*ec!1 CERTIFIED BY:y�.c_ �J: DATE: 72-008 (6/79) kluttOP Technic -(Tl Services 14530 Echo Street Anchorage, Alaska 995.1 BLOC K T i i PROPas�12 s e r• roc. z" YSTE M r� AGO ` 91 P 6 G �O SG �^ 2 e �eeeeee •Beee� 1 91 P 6 G fa 1' T -f c e �eeeeee •Beee� fa 1' T -f c FLATTOP TECHNICAL SERVICES CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 June 19, 1986 MUNICIPALITY OF ANCHORAGE DEPT, OF HEALTH & Susan Oswalt ENVIRONMENTAL PROTECTION M.O.A. Dept of Health and Human Services 'JUN 2X 19816 P.O. Box 6-650 Anchorage, AK 99502 RECEIVE® Dear Ms. Oswalt: V This is to confirm our discussion of this afternoon with Robbie Robinson regarding Lot 2, Block J, of Knik Heights S/D. Due to my inadvertent lack of knowledge of current Health Department requirements, no monitor tube was installed at the time of a soil test on this lot on May 19. Since there has not been a documented groundwater problem in this immediate area, you agreed that a permit could be issued on the condition that groundwater be monitored for 7 days at the time of construction, and that certification of the necessary vertical separation be provided on the as -built. Sincerely, Ted Moore, P.E. cc. Jim Allison Multiple Listing Service, Inc. © Rev. 6/65 0 4 EARNEST MONEY RECEIPT AND AGREEMENT TO PURCHASE This is a legally binding contract. Head both page 1 and 2 carefully before signing. Data ��`/7`'S,�' sLOPhone do SO Phone Listing Office -_aA,� z�����/�1$ Agent ,STH�� h' U1i f C� �� r? ��n(� f� Selling Office _�51 LS C' 1_'Al f _t -f_. ZL Agent _- LC RECEIVED FROM ��iP//d>C�Gf�f�?L��anl✓f5%2l/<<[yS SSN The sutn of Dollars in the form of check for $—�0�_, cash for $—_ , other --__ _ note for $ _, due no later than _ to be hold in Trust by: 1. //- y L Etil7f2IrtiY as earnest money on and part payment for the real property and improvements situated in lho — Recording District, State of Alaska, described as: and all fixtures and equipment attached to and a part of the above-described property. DOWN PAYMENT (including earnest money shown above) ..............................$ _ BUYER shall apply for a A /AI iivur+d _ 0,aV. i 2L1_�c i z)o q _ loan in the approximate amount of ............... BUYER shall assume Seller's _ loan of approximately ....................$ _ BUYER to execute a Deed of Trust and note in the approximate amount of ....... ........$ __ payable at $ _, or more, per month including _% interest per annum for , years payable to -- TOTAL PURCHASE PRICE ............... ........................... ............. $_ L coo COSTS: The costs designated below shall be paid as indicated by Buyer (B) or Seller (S): 0 o ITCAA R S ITEM R S ITEM B S I 1 Glyl Bank Service Fee v v Doc. Prep. Fee Assumption Fee Smoke Detectors Commitment Fee Recording Fee Assump. Transfer Foo NOA Transfer Feos Credit Report Owner Title Ina. s Bank Sol—Up Fee Well Flow Test MIP/PMI ALTA Title Ins. Annual Escrow Foo VA Funding Fee Appraisal Warehouse Fee Escrow Closing Fee Brokerage Fee Survey Discount Points Assessments 711 Other Est./Replace Reserves Tax Registration ___ Well/Sep. Inspect. Fee Other /l5�rSstIL4L 7S i�Eu.a. Aar_ r-1TAI"IS rr � T�l 6£ •;f c, �- �'r ��� r'� 1. CLOSING/POSSESSION. This sale shall be closed on or before (.t ,- 3 19 > .Possession shall be given to Buyer: 0 On closing ❑ Before closing under attached occupanc agreement. 2. FINANCING. Buyer agrees to apply in good faith for any necessary loan or assumption withindays of Seller's acceptance and provide all information, pay all fees and satisfy all conditions required by the lending institution for processing of loan and/or assumption application. Broker has made no representations as to availability of any loans or the interest rates. In the event Buyer fails to obtain a loan commitment, through no fault ofhisiherown, within days from the date of this Agreement, the earnest money will be refunded, except for direct cost incurred in processing the application. When a commitment is obtained, IL additional days are allowed for closing. If purchase is not completed within .specified time, earnest money shall be forfeited by Buyer. 3. BROKER INFORMATION. Buyer and Seller authorize any lender to furnish Broker and Agents with closing statements or other information upon request. Buyer and Seller authorize all lenders, escrow agents, and appraisers to furnish to the Listing and/or. Selling Agents on request any and all information and copies of documents concerning the status, progress and final disposition of loans, credit, appraisal, closing, conveyance and any other matter related to this sale. 4. DUE ON SALE. If any existing loan contains an acceleration or "due on sale" clause, the lender will demand full payment of the entire loan balance as a result of this transaction. 5. CLOSING DOCUMENTS. Buyer and Seller agree to sign all necessary closing documents and perform the conditions required by the closing agent and/or any financing institution. (� / Pagel of 2 _l_— Buyer Seller EARNEST MONEY RECEIPT AND AGREEMENT TO PURCHASE Regarding property described as _. Z e -)L 6. EARNEST MONEY—DISPOSITION. If either Buyer or Seller fails to comply with paragraph 5, above, than the other party may terminate this agreement and, as applicable: Buyer or Seller may forfeit the earnest money and/or proceed in any other legal manner. ft In the event that the Broker Is unable to determine to his/her satisfaction which party Is responsible for failing to perform the oyer requirements of the contract, the Broker shall request the parties to execute an agreement for release of earnest money to one or the other or both parties. Broker need not disburse earnest money until an agreement is signed. Alternatively, Broker may: (a) with Buyer's and Seller's consent, submit the matter to arbitration by the Conflict Resolution Center or other agreed arbitrator; or (b) alar Interplead the earnest money with the cou No for date rail nation of who is entitled to the earnest money.The Broke r shall be a Milled to an award, from the earnest money, of reasonable attorney's fees and costs for Interpleading the earnest money. 7. PROPERTY CONDITION. Buyer offers to purchase the property in its present condition, or on terms itemized and made a pan of this Agreement. Buyer understands that Broker is unable to independently verify the condition of any aspect of Seller's property, Bu er including well and/or sewage system. Any representations about the condition of property are based upon Seller's reprosonta- /�CJ- tions and Seller's attached property information sheet. Both Seller and Buyer hold Broker harmless from representations contained in this Agreement or leading to sale. Seller In the event any improvements on the property are destroyed or materially damaged prior to closing, this contract shall, at Buyer's election, Immediately become null and void and earnest money shall be returned to Buyer on demand. 6. TITLE. Seller shall convey title by statutory warranty deed, and will provide proof of marketable title at time of closing by a preliminary commitment to Issue title insurance.I itleshall beclear of encumbrances except conditions, restrictions, reservations and rights-of-way, easements and covenants of record. 0. PRORATION. Taxes, interest, Insurance and prepaid rents and Home Owner's Association lees, if applicable, will be pro -rated as of the date of closing. Security deposits shall be transferred to Buyer. 10. ASSIGNABILITY.Seller's acceptance of this Agreement is based upon Buyer's apparent ability to qualify for this purchase within the agreed time and according to the agreed terms. This Agreement is not assignable without the express written consent of Seller. 11. BROKER, it is mutually agreed by all parties that the Brokers shall not be held liable in any manner whatsoever for damages arising from defaults or acts by or upon the part of either party to this agreement. Buyer acknowledges that the Broker represents only the Seller, and not the Buyer. 12, SQUARE FOOTAGE. Broker makes no representations sale the square footage of the improvements or land. If this is important to the Buyer, the Buyer must Independently verify or measure the square footage. 13. CODE SAFETY COMPLIANCE. Broker makes no representations that house or other improvements meet current building code safety or other requirements. Broker shall not be liable for the cost of any work necessary for Building Code requirements. 14. ENTIRE AGREEMENT. This document and the referenced attachments if any consisting of __1:�_ pages contain the entire Agreement between the parties. It may not be modified except in writing and signed by the parties. 15. PERIOD EXTE{�, ION. Time is the essence of this contract but either Broker may, with written notice, extend for a period not to exceed T Com_ days the time for the performance of any act hereunder except the time for the acceptance hereof by Seller. NAME OF SELLING OFFICE ­- f 1-4 AGENTSIGNATURE ' ` ` 4,4 WE .LrL F TIME 119-1 7 AGENT PHONE _-3 `L',2 ` �_- IM/e agree to purchase and pay for the above described property on the terms and conditions herein stated. Receipt of a copy of this Agreement is hereby ackn wledged. I/We understand this is a legally binding contract. Said gent is granted the exclusive and Irrevocable rlgWor __4__ days (I m date to obtain an acceptance of t -Soffer falling ch earne`stt money/oposit shall be returned. ( ) ; / /1 O/- N / BUYER 4kV44e1 Print nam9a be on closing lLJf :w- ! A/ 7S PHONE: Home ° ti _42 fl Office SELLER ACCEPTANCE, IIWe accept the foregoing offer and agree to sell and convey the property described on the terms and conditions herein stated. IM/e understand this Is a legally binding contract. If the Salo is not completed, I/We agree to pay for preliminary title report. Seller's Disclosure: Seller certifies that there are no known problems with: the well, if applicable; the foundation or basement walls; the roof; the septi: system or sewerage system; the healing or plumbing; drainage in the yard; the fireplace; water in file crawl space; or other except as noted herein. TAX ADVICE. Seller acknowledges he/she has been advised to seek counsel of a tax attorney or Certified Public Accountant for income tax consequences of this transaction. COMMISSION. IM/o agree to pay forthwith at closing to the above named Broker a commission of $ _ ���� for services in this transaction. In the event of a forfeiture of the deposit as above provided, the said deposit she I be paid to or retained by the real estate firm to the extent of the agreed upon commission with residue to the Seller. I/We authorize said real estate firm to pay out of the cash proceeds of Sale the expense of furnishing evidence of title, of recording fees, if any, as well as any encumbrances on said premises payable by me/us atlor before closing. IM/e acknowledge receipt of opy of t is earnest money receipt bearing my/our signature(s) and that of the Buyer(s) no ed above („ Q ) CLOSING AGENT, I/We hereby appoint and lawful attorney, to have prepared on my/our behalf all legal documents necessary to complete this transaction. r DATE IME ;d'11Y?S"-�j111', / SELLER r r _ /�T-_ 2f /u�ELLER _ Print names as to be on deed: ADD ESS ez f��a_ 1 x� PHONE: Home — 3 `/ � t) Ak1161KLt — VV<'ic..y Office DELIVERY TO BUYER OF COPY OF ACCEPTED OFFER BUYER RECEIPT: TA undersigne Buyer(s) acknowledges receipt of a fully signed e" py of the foregoing oement. DATE 10 TIME M. BUYER U ' BU Page 2 of 2 MUNICIPALITY OF ANCHORAGE Development Services Department ' / Phone: 907-343-7904 On -Site Water & Wastewater Section —' Fax. 907-343-7997 Parcel 1. D. 018-232-27 Certificate of On -Site Systems Approval Expiration Date: 8/1 /2024 Legal description KNIK HEIGHTS BLK J LT 2 Site address 13301 RIDGEWOOD CIR Anchorage AK Current property owner(s) HAGARMAN X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 9/3/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE F? u 5q imagism 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. 018-232-27 Complete legal description KNIK HEIGHTS BLOCK J LOT 2 Location (site address) 13301 RIDGEWOOD CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) CAROL HAGARMAN Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: Z Private Well R Private Well serving 2 dwelling units F] Private Well serving 3+ dwelling units R Community Well or Public F-1 Water Storage 4. TYPE OF WASTEWATER DISPOSAL: E Private Septic E] Private Septic serving 2 dwelling units 0 Holding Tank R Community Septic or Public Sewer 5. SEPTIC TANK: El Steel Z Plastic F-1 Concrete R Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: El AWWTS El Bed Z Deep Trench 0 Wide Trench 0 Seepage Pit Waiver request for: Expedited review requested: Z 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$ � 30 Waiver Fee $ Date of Payment COSA# ;,_�)D - Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: KNIK HEIGHTS BLOCK J LOT 2 Parcel ID: 018-232-27 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 8/15/92 Total depth 428 ft Cased to 183 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 40 in. Date of flow test for COSA 8/6/24 Static water level at beginning of test 205 ft. Well production at time of test 4+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 4.75 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 8/1/24 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/14/92 ALL standpipes present per record drawing Total measured depth from existing grade 11.8 ft (max) Measured depth to pipe invert from grade 7.1 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 4.9’ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 8/5/24 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 8/6/24 Results Pass Fluid depth prior to test 3 in Water added 600 gal New fluid depth 5 in Elapsed time 1440 min Final fluid depth 0 in. (Missing 13” ED) Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 72 in (MOA 6’ ED) Effective depth used 13 in (Missing ED & Final Fluid Depth) Effective depth (ED) remaining 59 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate with 4.9’ ED with 13” or 1.1’ ED missing. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *85.7 ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *WR040071. MOA waiver fee paid with this submittal. G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 8/30/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 8/30/24 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services ik On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # O 1823 ZZ 7 1. GENERAL INFORMATION HAA# WQ9PmL14 Complete legal description LOT* Z C -3L 7 K SII K H E 16 HTs Location (site address or directions) 15301 RIDGE 1n 0n4D O I l2�(' LE. Propertyowner _1414DA OPIUM i2usT Day phone 3q5 -2855 -- Mailing address 13Zq5 R 1D6E IAloo o C 19 C -LE - 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. 1191) Front MOA 021 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. Name of Firm- Aagmsoi E�Gin1GwLiN6 Phone 3�� `� Address P,0, gox ZV077.�; �rvf.r¢ AL- !F95� Engineer's signature C5 Date Leo 4 Z. 6. 7s SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments By: bedrooms. OF®�0 a0N e.•0 �•i { 0 ,Y C.• =4040 p000 6 \/{/� ogee ay.Y0Y4..... •` ib ?I -.Michael E. Anderson G 4381-E p `niss0- 41�_prnFG��1oNP.� bedrooms, with the following stipulations: Date �.z - / -/'`' 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. 72-025 (Rev. 1/91) Beck MOA x21 Municipality of Anchorage [department of Health & Human Services M}�r HEALTH AUTHORITY APPROVAL CHECKLIST f Legal Description: L07- Z 8L S KN I K Parcel I.D. — 019 Z3 Z Z 7 A. WELL DATA Well type ,F If A, B, or C, attach ADEC letter. AD/EC water system number Log present (Y/N) —7 Date completed �!/� 9Z p ,�s_ Driller Total depth Cased to /8 3 Casing height Sanitary seal (Y/N)�e� Wires properly protected (Y/N) X w FROM WELL LOG AT INSPECTION Date of test /.2 9Z Static water level /79' Well flow 3 g,p,m, 3, S g,p Pump level — Nor t r" 12ETEfZ01INED yr -7 0 0 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /"95./ Z5 ; On adjacent lots .— >Ioo Absorption field on lot / 5�0' ; On adjacent lots ® > i601 Public sewer main IW" -ES —Public sewer manhole/cleanout - MILES Public sewer service line 2221 LES Petroleum tank — > 160' WATER SAMPLE RESULTS: i Coliform �' / Nitrate �I__/'� Date of sample: 1- A11c) � Collected by: B. SEPTIC/HOLDING TANK DATA Other bacteria 0) Date installed 16113172- Tank size 12,:50 Compartments 2 Cleanouts (Y/N)Foundation cleanout (Y/N) v Depression (Y/N) til High water alarm (Y/N) N1,41 Alarm tested (Y/N) Date of pumping &1Z - /n/17_/.4L QCcL2P�qNCy rXPC"OTEFo i//s/93 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /7 S r On adjacent lots > BOO' Foundation /D' To property line`2�__Absorption field—? Water main/service line Surface water/drainage > fop 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ Date installed 8�13/g2 Soil rating System type L 7WELA Cf-/ U Length 6° 5 Width 3 Gravel thickness Total depth Total absorption area 790 Cleanouts present (Y/N) Depression over field (Y/N) N Date of adequacy test Results (pass/fail) PASS for bedrooms Peroxide treatment (Past 12 months) (Y/N) N — If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot / ` 0 On adjacent lots > /00 —Property line z 3 s To building foundation 22 To existing or abandoned system on lot NONE ON LoT On adjacent lots > /Oc>Cutbank > /00/ Water main/service line Surface water > ioo' Curtain drain > 160' E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ' Engineer's Name Mt u1At`L L= 4 ,r!?SD.J Date 0Z� HAA Fee $ 1-2 U Waiver Fee: $ Date of Payment /,�_ Date of Payment Receipt Number _ Receipt Number 72-026 (Rev. 3/91) Back MOA 21