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HomeMy WebLinkAboutKNIK HEIGHTS BLK J LT 3 1/24/2020 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251034 PID Number: 018-232-26 Dwelling: Single Family (SF) with ADU Duplex (D) Two Single Family Project: New Upgrade Name REBECCA A POWELL ABSORPTION FIELD Site Address 13245 RIDGEWOOD CIRCLE, Anchorage Deep Trench Wide Trench Bed Mound Other Phone Number of Bedrooms 4 Soil Rating Total depth from original grade 1.2 GPD/SF *12.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision KNIK HEIGHTS Block J Lot 3 6 Ft. 6 Ft. Fill added above original grade Gravel length Township Range Section 3.09’ – 3.49 Ft. 42 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2 Ft.Ft. From To Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area Number of trenches Dist. between trenches 720 Ft2 2 12 Ft. Well 100’+ 100’+ -- -- 25’+ TANK Septic S.T.E.P. Holding Other Manufacturer Capacity Surface Water 100’+ 100’+ -- -- NA GREER 1250 Gal. Material Number of compartments Lot Line 10’+ 10’+ -- -- HDPE – DEEP BURIAL TANK 2 Foundation 10’+ **0’ -- -- LIFT STATION Manufacturer Capacity Gal. Remarks *Noted on drawing, due to elevations, separations, excavated at construction to verify soils/groundwater & installed to the same elevation of the existing field, which has had Alarm location Electrical installed by no known previous issues. **#OSV251010 (1984 absorption field). Installer PCN PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Drainfield 3034 CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation)100 ft Inspection dates:1st 6/5/25 2nd 6/7/25 Location and description 3rd 6/10/25 4th TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date Septic System Approved - ____________________________ Date Note: this approval does not include well permit requirements. (Rev 05/02/18) 09/17/25 10/10/2025 FIRST WATER CONSULTING PID:018-232-26 PERMIT:OSP251034 KNIK HEIGHTS BLOCK J LOT 3 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: OSP251034 Work Type: Septic Upgrade Tax Code Number: 01823226000 Site Legal Address: KNIK HEIGHTS BLK J LT 3 G:2936 Site Mailing Address: 13245 RIDGEWOOD CIR, Anchorage Owner: POWELL REBECCA A Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: Dc[)aI•tnncnt 3/11/2025 3/11/2026 Q 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 Special Provisions: �' v d--- • Prior to construction, locate the existing trench in at least two areas in order to ensure that the required r separations will be met to the new tank and fields. • The inactive well on the lot is to be decommissioned. A Well Decommissioning Log is to be submitted prior to IR approval. ,Reesi�ve444y:- �Si Gce r� +-o -/- rC%t Fey Cons, 1 '101 Date: Issued By: ,y o Date: 311 5 G Mun'dpaflty of Anchorage U.pn tmc nr `;. P.O. Box 196650 a 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite DevelopmentICes Divisi On-Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV251010 COSA#: Permit#:OSP251034 PID#: 018-232-26 Legal Description: KNIK HEIGHTS BILK J LT 3 Engineer: First Water Consulting Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: // S Approved by: ki/;— Name of Reviewer **** VARIANCEMAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE J J� Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 018-232-26 Property owner(s) REBECCA A POWELL Day phone Mailing address 13245 RIDGEWOOD CIRCLE ANCHORAGE, ALASKA 99516 Site address 13245 RIDGEWOOD CIRCLE ANCHORAGE, ALASKA 99516 Legal description KNIK HEIGHTS BLOCK J LOT 3 Number of Bedrooms 4 Engineering Firm FIRST WATER CONSULTING Building Permit Number Not Applicable A] APPLICATION IS FOR: APPLICATION IS AN: (Z all that apply) Absorption Field FX1 Initial D Septic Tank N Upgrade El Holding Tank El Renewal E] Privy El Well n THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: 'k_G7q5 Date of Payment: 2 Lz C Z-4 Permit No. 25P2,5203LI Distance: Waiver Fees: -0'-2 Z -6- Date of Payment: Waiver No. O_S11251010 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com March 4, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT WITH WAIVER LEGAL: KNIK HEIGHTS BLOCK J, LOT 3 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install two deep trenches and 1250 -gallon deep- burial HDPE septic tank to serve the existing 4-bedroom residence. A 1500-gallon septic tank may be considered for current functionality and future consideration or flexibility. The design is based on the recent test hole conducted on February 12, 2025. No groundwater was observed at test hole excavation or monitoring. Groundwater was not noted in the Municipality of Anchorage (MOA) on-site file and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank or system upgrade, an epoxy coated steel septic tank or other action may be required. An existing deck greater than 30” high is partially over the existing septic tank. No deck supports can be within 5’ of the new tank unless deck supports are installed to the same depth of the bottom of the tank. The locations of the existing & proposed fields will be verified & maintained between the fields and the new tank. The slopes are moderate at 7-14% at the proposed upgrade location. However, there is a slight raised hill or rise between the septic area and the driveway with steeper slopes along the drive. The elevations of these driveway slopes or grade are at or below the proposed laterals with no potential day lighting. Please see design notes. Per the review of existing MOA records & recent survey, it appears the existing field is approximately 1’ from property line and therefore respectfully request a field to lot line waiver of 0’ be granted at this time. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251034, Deb Wockenfuss, 03/11/25 March 4, 2025 Knik Heights Block J, Lot 3 Page 2 of 2 ! Granting of this waiver is justified since the existing field has been in operation since 198 4 with no known issues or ill effects to the adjacent property and it is anticipated that the field will not impact the neighboring property. The separation distance to the adjacent property absorption field located on Lot 2, Block J is approximately 30’+ away. Please see the proposed design. The lot has a non-active well that will be decommissioned with submittal of the inspection report. The lot and area are served by private water and any encroaching wells, easements, property lines… 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. FIRST WATER CONSULTING DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC SYSTEM KNIK HEIGHTS BLOCK J LOT 3 NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD UNLESS NOTED - PLEASE SEE DESIGN COMMENTS. TO ACCOMMODATE DRIVE THERE MAY BE A SMALL CUT OF >25% ALONG THE DRIVE SIDE, BUT SLOPES ARE MAINLY <25% & QUICKLY LESSEN W/ DRIVE. THE PROPOSED TRENCH LATERALS ARE AT OR BELOW THESE SIDE SLOPES & THE SOILS, HILL BARRIER / SEPARATION, SUBSEQUENT LOW SLOPES, GRADE DIRECTION WOULD INDICATE NO POTENTIAL EFFLUENT DAY LIGHTING. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251034, Deb Wockenfuss, 03/11/25 FIRST WATER CONSULTING KNIK HEIGHTS BLOCK J LOT 3 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251034, Deb Wockenfuss, 03/11/25 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : KNIK HEIGHTS BLOCK J LOT 3 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2/20/2025 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 SM/sp 7 8 9 10 11 12 13 14 15 16 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 2/12/25 10 min 6” 2 13 /16” “ 6” 2 13 /16” “ 6” 2 11/16” “ 6” 2 9/16” “ 6” 2 9/16” “ 6” 2 9/16” PERCOLATION RATE 4 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 2/20/2025 TESTHOLE # 25-1 DATE PERFORMED: 2/12/2025 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: REBECCA A POWELL 02/20/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251034, Deb Wockenfuss, 03/11/25 L �O ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: KNIK HEIGHTS LOT 3 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 shoulc 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: DATE: SCALE: E—MAIL: FEB 1, 2025 1 "=30' schullerakOgmail.com 25-005 DRAWN BY: CHECKED BY GRID NUMBER: BOOK/PAGE: JLS SW2936 250106 © = FND 5/8" REBAR - ® 10%w® ®®® ®..O F o ®00 �........A� ® '�).•' 49M �•.�' ............. ......... . ... ® .. 1 co •.JO . L. SCHULLER.• o 0 LS -10408 10' ®pr O� ® Ofe ck SSIOCI �. p_�4D SUR L A N D 0 ,✓'''�_� �� G �' lir. c 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax ~~--~l -,~"1~ M UNIClPALITYOFANCHORAGE¢ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I,~.~ Elto, ~)) ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ='~A ~ PHONE ~ ~W ~MX~ ~ '~ . __ ~-~'~ ~ UPGRADE MAI LING ADDRESS ~EGAL DESCRIPTION LOCATION NO. OF BEDROOMS JWell Absorntin,] area 2 ~ DISTANCE TO: I ~0G /--/~. ~ / Dwelling ~ / PERMIT~~NO. ~ ~ Manufacturer Material No, of co tments Liq. capacityl~in gallons Inside leng~ IF HOMEMADE: /~ Width Liquid depth ~ ~ DISTANCE TO: Well . . /. Dwelling PERMITNO, O ~ ~ Manufacturer -~- ~; -- ~ Material Liquid capacity in gallons ~ Well / Foundation Nearest lot line / PERMIT NO. ~ DISTANCE TO: ~,~ .~ ~.~ / Length ofeachline Total length ofli~es Trench width q Distance bet~een lines ~ N°' °f lines ~ .~t '~ inches ~/~ ~ ~ ~ Top of tile to finish grade M~teria~~ ' beneath tile Total effective absorption area Length I Width D~pth ~p ~}¢t'Y OF~tt,i .Kt[ tC,~?/%~ ~N Type of crib Crib diameter Crib depth Total effective abso'pt o~ ar~¢,,,,.~. '¢~'/ n,~¢~ ~ m DISTANCE TO: Well Bulling foundation Nearest lot line ~ Class .1/. Depth Driller Distance to lot line PERM T ~0. ~ DISTANCE TO: ~uildin, foundation Sewer line Septic tank Absor,~:~,~,~,~,~: ~ ~/ ~: OTHER PIPE MATER IA~S SOIL TEST RATING ~ST,~E~ ~ %~/ ~ b R EMAR KS ) - APPROVED DATE LEGAL - 72-013 (Rev. 3/78) f.)EF':'I=IFFFHli!::NT OF:' HEI=ILTH FIN[) ENV]iF;?.CII',,JhtENTFIL. F:'Iqff,)TIECTi[ON CEF~'.T :I: I:::'",' 'TI'II:::IT ' :L. :i: I:1t"1 FF::IH:[L.]:Fif~: I.'.I:[TH TI4[!: Fi:!iii:~;!i..l:t:!:;::.,f~:l"l~£1",l"l"S; FnF' Cfi",I""'.:ii; :[ TIE SEI.,.IEF~'.S I:~t",11:::' I,.!EL.L:!!; FiE; SET F::'C. IF:iTH . THE I"11...11",1 :[ C: ]: F::'i=II... ]: Th" OF::' i::II',IC:H(:)Fi:I::I(:iE (MCII:::I ::' FIND THE STFtTE: OF I::ILFIE;I'(I:::I. ;:'L .1: I'.I~LL ]:I",I'.:.;TF:IM_ TI"IE: S'~".BTEH :[1",1 I=ICC:CIF::[:'I:::Ii",IC:E 14]:TH FILl.... 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MUNICIPALITY OF ANCHORAGE DEPARTM[-'NT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, A~aska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: /"~t- .JO" ~,C~ - LEGAL DESCRIPTION: Lo L) 1 (6?) 2 3 4 5 ( 6 7 8 9 10 11 12 13 Lot' SLOPE WAS GROUND WATER S L ENCOUNTERED? )'~() 0 P E IF YES, ATWHAT DEPTH? 'SITE PLAN 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-008 (6/79) Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED BY: ~ DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST '~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 3 ~ 4 8 9 10 12 13 14 15 16 17 18 19 20 SLOPE / Lbo.5 WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT DEPTH? Reading Date Gross Net Depth to Net Time 'Fime Water rop PERCOLATION RATE (minutes/inch) 72-008 (6/79) WELL LOG Date Drilled: ~ a-:w~ Static Water Level ohs feet Draw Down ~I'~ feet Gallons Per Minute Total Feet of Casing_ !,.¥ ) 1 !~i ?ype Material Drilled: 0 feet to to to to Hefty Drilling S.R.A. Box 1553 H Anchorage, Alaska 99507 10- 6-04; 5:1SPM; ;907 5515301 K CT&E Ref. #: 1046348002 Client Name: KND Engineering Project Name: Knik Heights Client Sample ID: Knik Hts, Block J, Lot 3 Matrix: Water PWSID n/a Remarks: ME Environmental Services 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 All dates/times are Alaska Standard Time Printed Date rime: 10/06/04 17:00 Collected Date/time: 09/27/04 10:40 Received Date(fime: 09/27/04 Technical Director: ,11:05 Stenhen FAP Released Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date ]nit Nitrate 3.35 1 mg/L EPA 6010E 09/28/04 Date:9/25/25 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 Brent Western First Water Consulting Services RE: 13245 Ridgewood, Anchorage Well Camera Inspection The well is steel cased beyond 60’ with a 2’ Stickup. All welded joints look good with no leaks. The Casing is in good condition with no holes, cracks or leaks. The pitless area appears to be sealed and in good condition. There is no indication of surface water contamination. Development Services Department On-Site Water & Wastewater Section Phone: (907)343-7904 Fax: (907)343-7997 MUNICIPALITY OF ANCHORAGE 018 -232-26 KNIK HEIGHTS BLK J LT 3 Expiration Date: Parcel ID Legal description Site address 13245 RIDGEWOOD CIR Current property owner(s) POWELL REBECCA A X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments By:Original Certificate Date: 10/10/2025 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 Absorption Field Advisory Tank Age Advisory Other Well Flow Advisory Nitrate Advisory Arsenic Advisory Certificate of On-Site Systems Approval X OSC251437 X X 6/20/2026 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. 018-232-26 Complete legal description KNIK HEIGHTS BLOCK J LOT 3 Location (site address) 13245 RIDGEWOOD CIRCLE ANCHORAGE, ALASKA 99516 Current property owner(s) POWELL REBECCA A Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: FN_J Private Well serving # 1 dwelling units [:1 Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: FE -1 Private Septic ❑ Private Septic serving 2 dwelling units E] Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel FNIl Plastic R Concrete R Fiberglass Age NEW _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: E] AWWTS 0 Bed � Deep Trench ❑ Wide Trench E] 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 $ 2-0 Date of Payment COSA# 062111'W Waiver Fee $ Date of Payment Waiver # COSA Application—Apr2025.doc COSA Checklist.docx COSA Checklist Legal Description: KNIK HEIGHTS BLOCK J LOT 3 Parcel ID: 018-232-26 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 5/4/1984 Total depth *375 ft Cased to 205 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/20/25 Static water level at beginning of test 195 ft. Well production at time of test 0.82 gpm Water storage tank volume 300 gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 9.60 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 6/20/25 Comments *MOA docs state well may have been deepened to 557’ along with a water storage tank, low water use devices that were installed previously. Well was scoped. The other non-use well was decommissioned. See attached Sullivan letters. B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) NA – NEW FIELD ALL standpipes present per record drawing Total measured depth from grade 16 ft (max) Measured depth to pipe invert from grade 9.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NA – NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – NEW FIELD Effective depth (per record drawings) 72 in Effective depth used 0 in Effective depth remaining 72 in Comments/Deficiencies: COSA Checklist.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *0 ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MOA WAIVER# OSV251010 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 10/09/2025 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 & 10/09/25 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Nitrate Advisory Certificate of On-Site Systems Approval # OSC251437 Subdivision: KNIK HEIGHTS , Block: J , Lot: 3 A water sample revealed a nitrate concentration of 9.60 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Well Water Advisory Certificate of On-Site Systems Approval # OSC251437 Subdivision: KNIK HEIGHTS, Block: J , Lot: 3 This well’s productivity was determined to be 0.82 gallons per minute. The recommended well productivity under (AMC 15.55) for a 4-bedroom residence is 0.4 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum recommendation, the production capacity can fluctuate and may be insufficient to meet your needs. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING --~ ~, -- 2__./~ HAA# ~ ~0~ ~ ~"~ ¢",¢')( 1. GENERAL INFORMATION Complete legal description Lot 3; Block J; Knik Height~ Location (site address or directions) 13245 Ridg6~ood Property owner Mailing address David and Carol Hag~rman Day phone C/O Coldwell Banker/ Aaron or John Blaine 4105 Tudor Centre Lending agency Anchorage, AK 99508 Day phone Mailing address Agent Aaron or John Blaine/Coldwell Banker Address 4105 Tudor Ce~re Anchorage, AK 99508 Day phone 561-2488 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1191) Front MOA 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 Address Engineer's signature __ ~ & 3 ~NGINEERING Phone ~ ¢/-/~2_.¢' ~ ? Date DHHS SIGNATURE ~Approved'for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: / / ~ .... / 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'¢ work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~:¢t'% ¢2W.~ %- ~--,._k~z_ ~-¢5 Parcel I.D. A. Well Data Well type ~¢.-,4~,¢,,r'~ Log present~/N) ~ Total depth "~'1 5'~ Sanitary seal ~.Y~N) If A, B, or C, attach ADEC letter. ADEC water system number FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Date completed ~-' ¢ ~ -o04 Driller Cased to '7.--~ 5' ~ Casing height Wires properly protected ,~/N) AT INSPECTION 1J¢ Septic/holding tank on lot Absorption field on lot Public sewer main ~- Sewer service line ~ ~ .V- ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform O Date of sample: ~ - "5~ ~ B. SEPTIC/HOLDING TANK DATA Date installed '~ '5 ~ Cleanouts (~N) q High water alarm (Y/~ Date of pumping Nitrate /--/, ~2~ Collected by: Tank size \ Foundation cleanout (_~N) Other bacteria (-~ ~?o34 5~tc~ l~tl,/er LoOp Road No. 204 ~agte River~ AJaska 99577 Compartments ,,-/ Depression Alarm tested (Y/N) ~'//~ Pumper ~k+ ~--~ ~,~... SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \ok¢~ On adjacent lots To property line /o ~ '~- Absorption field Surface water/drainage ! ~ o Foundation Water main/service line 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump High water alarm level Meets MOA electrical codes (Y/N) SEPA~M LIFT STATION TO: ~4t~on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed \ % ~ z~ Length ~"~' ' Total absorption area Date of adequacy test Width Water level in absorption field before test Peroxide treatment (past 12 months) (Y~ Soil rating (GPD/FF) [,~b~ '7-~~ Gravel thickness Cleanout present t~¢'N) ',/ / Results.__~[~ail) ~P/~ % System type ,~/,~ be Total depth /,2 ...~ ' Depression over field (Y~ for ¢ Bedrooms After test l \ '~/~t ~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ) Id To building foundation On adjacent lots '~ On adjacent lots / o o / "- Property line / To existing or abandoned system on lot Cutbank ~--~ I A Water main/service line Surface water \ o o ~- Driveway, parking/vehicle storage area '~ ~ ¥ Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to ali MOA and HAA guidelines in effect on the date of this inspect/on. Signature HAA Fee $ ///~ ¢ / '¢'~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number WATER .WELL ADVISQRY HEALTH AUTHORITY APPROVAL NO. ~%0500 During a recent Health Authority Approval on-site inspection and test of the pota. ble water supply well on Lot ~__ Block ~ of ~NI~ ~/~-~ Subdivision, the well's productivity was determined to be ~,~ gallons per minute. The minimum well productivity required by this department (AMC 15.55) for a ~ bedroom residence is 0,~[ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing cars and watering lawns and gardens may be required. This advisory mu~t be attached to all.'copies of the subject Health Authority Approval. 1. General Info~nation Application Date (a) Legal Descz:iptiQn (i~elude lot, block, subdivis~op, sec.t~icn, tc~¢nship, range) · ~- .~, ;'~'~ ,~ . .. ~.= ~ ~ l/ .... ~. ' Loca~h '(add~es~ or di~ctiot~) (b) Applicants ~~ ~ lephc~ Applicants Ad.ess (c) Applicsnt i~ (~he~ 0~) Buyer ~ ; ~h~t+~ (e~plain); (d) lending Institution ~ .... : ....... _ ..... ~._~_ (e) Real Estate Co, & Agent ._ Ad'ess Te le phone 2. ~ of ~esidence Si ngle.-F~md, ly ~z~/~. Multi--Family of Bedrccms __kSp Numte~ OU~e~ (describe) 3. water ~ IndividuD]. %~11 ~. Conmlunity Public Note: If ce~Nrunity well system, must have %¢~itten confir,mticn from the State Depart~rent of EnviroPzfe. ntal Conservation attesting to the legality ~d status. Is the ~11 adequate for the ntumber of bedroQns specified in this ~kr-~ (Y/N)~ 4. ~,.e/_~a._oj~ Dispgsal Onsite ~'<~ublic F----[ Co~nunity ~-_'~; Holding Tank Is the wastewater disposal system adequate fc~ tile r:umber of [Page 1 of 2] 5. Engineerin_q Firm f%'ovidincL I~n~j_.ctions, 7bsts, Data and infcrmaticn I ~K~ify ~a~I have c~cked, verified, or ccnfor~d to all ~,DA Hk~ ~i~li~s in 6 .pjlIEP ._~pproval Approved for Disapproved Conditional %~ne Municipality of Anchorage Department of Health and Envirop~enta] Protection does not guarantee the ccntinued satisfactory ~erformnce of tt~ water supply and/or the wastewate~ disposal system. This approval indicates that., as ol t..~ validat~cc date shcwn above, bated on the data and information furnished by an engirzeer registered in the State of Alaska, the ;cater supply and wastewater disposal system is safe and func- tional fcr the ntm~0er of tedrccms and type of str¼cture indicated. ( DiiEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Pa~qe 2 cf 2] 2~.].5-84 July 5, 1984 Municipality of Anchorage Department of Health and Environmental Protection 825 "L" Street Anchorage, AK 99501 Attn: Keith Brandt MUNICIPALITY Of: ANCHORAGE DEP'I-, OF I4EALTH & ENVIRONMENTAL PROTECrlON R[ CEIVI D Re: Knik Heights Block J, Lot 3 As-Built Ins[)ection Report of Water Saver Devices Dear klr. Brandt~ Today I inspected the above mentioned property and here is the report: Low volume flush toilets, 3 1/2 gallons Ex-Low volume washer cycle Low water s~]bguard protection on submersible water pump 300 gallon capacity storage tank in garage Small orifice shower heads (].ow volume ) These devices are installed° Reference: June 18, 1984 letter. Sincerely, Dale R. ~4errell, P.E. Bob Wessels Engineer sw/ls ENGINEERING, PLANNING, SURVEYING 2220 E. 88th ,Ave. / Anchorage, A/as/fa 99507 / ? ¢!ephonc 90?-?,49-645 i /,¢44- i3",J2 "Providing a quality personalized service to those building Alaska's future" MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AtrI~ORITY APPROVAL (HAA) CHECK'LIST - FEBRUARY 1984 Well Classification ~l/ucv~-. F/,~I/I/ If A, B, c~ C, D.E.C. Approved(Y/N) Well LO~ P~esent (Y/N) ~' ~}i~H~,~--Date Completed ~/~/~/ Yield Total Depth '~"7~.~ Cased to ~v.~ ~ . ~m~ . Depth of Grouting. Static Water Level .2Z~.~- lha~p Set At --- Casing Height Above Ground /~ /' Sanitary Seal on Casing (Y/N) Electrical Wi=lng in Conduit .(~Y/N) /~ Depression A~ound Wellhead _(.Y/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot I~' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ; On Adjoining Lots To Nearest Public Sewer Line N/~ To Nearest Public Cleanout/Manhole N/~, To Nearest Sewer Service Line on Lot Water Sample Collected By ~ . fi t~gT~ ; Date Wate= Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed ~/~d/ Size /~l~ No. of Compartments Standpipes (Y/N) /y / Air-tight Caps (Y/N) y~F°undati°n Cleanout (_~Y./N_). Dep=ession ove~ Tank (Y/N) AI Date Last Pumped Pumping/Maintenance Cont]zact on File (Y/N) ; for Holding Tank High-Water Alarm (Y_~/N.) AI//~ Temporary Holding Tank Permit Separation Distances f~cm Septic/Holding Tank: To Water-Supply Well ~6~/ To Building Fc~ndation To P~operty Line ~ ~'+ ! To Disposal Field To Water Main/Service Line ~///~ To Stream, Pond, Lake, c~ Major D~ainage Course Comnents, ~<J/4TI S ~. Ac'r O ~ V / [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Stzata _/~o ~L~/Ab~A4. Date Installed ~//~/~/q Length of Field Type of System Design Width of Field · / -/ Square Feet of Absorption A~ea Depression over Field (Y/N) //. Depth of Field /~ Gravel Bed Thickness t,2. '! Standpipes Present (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test ~///~ Separation Distanc~ frc~ Absorption Field: To ~ate~-Supply Well ~'//~ ! To Property Line To Building Foundation ~' /~ / To Existing/or Abandoned System cn Lot /V/~ ; On Adjoining Lots To Wate~ Main/Se~vic~ Line To Cutbank(if present) Stream/Pond/Lake/c~ Majo~ Drainage Course To To Driveway, Parking A~ea, o~ Vehicle Storage A~ea D. ~z~f--~V-%~Ob~- ~ Date Installed Size in Gallons "Pump O~" Level at High Water Ala~ Level at Tested for Electrical Codes (Y/N) Dim~ ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles d~ing Adequacy Test. N~ets MOA Co~.~'cents ** Check Permitted Bedrocm Rating Against HAA l~equest I ~rtify that I have checked, verified, or confo~n~d to all MOA HAA Guidelines in effect on the date of this inspection. Signed Date Company MOA No. [Pa~ 2 of 2] 2-15-84 June 18, .[984 Municipality of Anchorage Department of Health Environmental .Protection 825 "L" Street Anchorage, AK 99501 Attn: Keith Bran~ t Re: MOA ar~ HAA Approval -- Knik Heights, Lot 3, Bleak J Dear Mr o Bra~ t, Based on the attached a~--builts an] water well prcr]uction t~t information, I recommend MOA and HAA approval of the above mentioned lot. ~bwever, because of the relatively low re- charge rate arr] prcduction capacity on the water well, ar~] as per our June 14, 1984 telephone convemsation, the following water saver devices shall be i~%statle.] on the property: o Low Volume Fl~sh Toilet o Low Volume Washer o Low Water Shut Off Switch on Pump (either n~.chanicai) float, mercury switch probe, or amperage n]easurement acceptable ) o 100 Gallon Minimum Capacity Storage Tan~ o Low Volume Shower He~s Our office wil[ inspect an] verify that these devic~ have ~n -fact i:een i~mtalled on property art] will forward our ~.nspec- tion as-built of the devices. Sincerely, Dale R. Me~[rell ikob Wessels Engineer ENGINEERING, PLANNING, SURVEYING 2220 E. 8$th A ye, / Anchorage, Alask¢~ 99507 / "Providing a quality personalized service to those building Alaska's future"