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HomeMy WebLinkAboutKNIK VIEW BLK 2 LT 2 Municipality of Anchorage Page I of. :2 DEPARTMENT OF HEALTH AND HUMAN SFRVICES 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: 5~ ff~ o~qs PID Number: OS Io,Di ~,~ Name: L~o~ A~ ~A~ Wastewater System: ~ New D Upgrade Address: ~ o, ~ox ~ oo~5 c.~,~, ~.%~ ABSORPTION FIELD I No. of Bedrooms:. · Phone: ~ -- ~ O~ ~ D Deep Trench ~Shallow Trench D Bed ~ Mound D Other Total Depth from original grade: LEGAL DESCRIPTION Soil Rating: J, ~GPD/Sq. Ft. ~ ¢~' SubdivBion: Depth to pips boltom from original grade: Gravel depth beneath pipe Township: Range: Section: Fill added above original grade: Gravel length:  Number of lines: Distance between lines: WELL: ~'u~ New D Upg Gravelwidth: ~ Ft. J ~ Ft. ~lassificetion (Private, A,B,C): ~ Cased To: Total absorption area: Pipe material: ~l O Date Drilled: S[aticWaterLevel: ~ Date installed: ;ield:~ Pump Set at: Casing Height Above Ground: TAN K ~~ G PM Ft. Ft, SEPARATION DISTANCES ~ Septic D Holding D S.T.E,P. To Septic Absorption Lift Holding Public/Private Manufacturer: CapaciW in gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~RO~ ~ ) Well' ~O~1+ ~O0~ --" ~5~ Material: ~ Number of Compadments: Sudace ~ Water Ioo . ~oo'+ ~ _ ~ LIFT STATION Foundation ~ ~l I ~ "Pump on" level at: ~ off" level at: High water alarm InsPections Cu~ain performed by: Drain Remarks: BENCH MARK Location and Description: Assumed Elevation: J Oo.o ~i, ENGIN~L Inspections performed ov:~ ....... ~ .............. uates 1st Deparlmenl of He~llhand Human 8ervi~ee approval ~:, <-. ...',.,'~' Permit No. SW950595 Page 2 _of 2 Municipality of Anchorage 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 LegalDescription: LOT 2, BLOCK 2, KNIK VIEW S~D PIDNo.: 0510,315,3 / ST1 ST2 HT ~C04 ;99.4' /~, ?[NAL GRADI~ "'%% 99.2'~..~.  NEW ~ ~ 93,2' (roi 1006 GAL SEP' [C .6' TANI' 89.Y'/ ] / NO WAf'E~ ~OUND J 1-14~95 &'/ LT. ~ITE ' ' / / / NEW 1000 GAL. --~Lr~ i -- ~ A B C ,, ST2 41' 32' i~ II ¢*~. C01 42' 58' ~ I I ,~v~ ..... C02 42.5' 59' [b ~ ~,'~' -./~ C03 50' 47' ~ '~ /'='~'~ ..... C0415' 31' 41' ~~ ~ ........ " ......................... ~ <~ J.~-, ..... ...'... ..-~ / / 72-013 A (Rev. 9191) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950395 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SCHMELZER FAMILY TRUST OWNER ADDRESS:P.O. BOX 670045 CHUGIAK, AK 99567 PARCEL ID:05103133 PAGE 1 OF DATE ISSUED:il/29/95 EXPIRATION DATE:il/29/96 LEGAL DESCRIPTION: KNIK VIEW BLK 2 LT LOT SIZE: 22013 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED BY: .... · ', ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. November 15, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W/~STEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2, Block 2, Knik View Subdivision Request you issue a permit to install a septic system to serve the proposed three bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring 'tube was found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. This property is served by a Community Water System. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 SITE PLAN DESION SCALE ':;U b.., ~O 0 ZC)--4 F'q C '-0 El-nco .-< C) KNIK 10' UTILIW ESMT. VISTA DRIVE .... r- 5m m~Z zo~© .-q o~O ~ ~ rq 0 0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 2 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- DATE PERFORM[DF' .. .' .... , ,-~A~ ~k[ ~g~J Township, Range, Section: '-:: WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~t oL DEPTH? A p E Deplh to Waler After Moniforing? '~"~ Date: ~ SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ~-~ ~,~ ~'~[~t~ ~ ~ 'l ~ ~,o ~ q'/q~ ~" PERCOt. ATION RATE __ TEST RUN BETWEEN I ~ [mmutes/~nch) PERC HOLE DIAMFTER __ "~ FTAND ~ '/L- FT COMMENTS PERFORMED BY: ~I?03~ E=~= ~V~Y L~ ~==~ ~ ~o~ CERTIFY THAT THIS TEST WAS PERFORMED IN I ~ r 7 72-008 (Rev1 4~85) ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORIT'( APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER ~NSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN REFERENCE: Lot 2, Block 2, Knik View Subdivision November 15, 1995 GENERAL: 1. The scope of this project includes the installation of a 1000 gallon septic tank and a five foot wide drainfield to serve 'the proposed three bedroom residence for the referenced property. Construction shall be in accordance with 'the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank xs to be constructed by a certified septic tank manufacturer. Construction shall include · two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded 'to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of :[2 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 o EAGLE RIVER, ALASKA 99577 Page Two Lot 2, Block 2, Knik View Subdivision November 15, 1995 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed~-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Grave]. is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less 'than twenty-four (24) inches. Insulation must be installed when 'the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 2, Block 2, Knik View Subdivision November 15, 1995 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform 'to current M.O.A. or D.E.C. requirements. Page Four Lot 2, Block 2, Knik View Subdivision November 15, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspec'tions required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2e The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation~ but before the placement of any other backfill. The final inspection is to occur upon final gradJ.ng of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc0 Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the con'tractor to perform 'the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and wi].l inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of 'the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engine.ring's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER O (3) r- I -- C") cy') � � 0- 0 O > u) N C Ww N O N ti m M C O cu Q x w 0 0 O 1 M M 1 O 1 r LO O U ti LO rn rn a co 0) N � N ~ U) J < m U) w > > Y Y Y Y o c N O N U) U In N _0 _0 ca J (n WE RII ii c O N m C 0 0 a� ui 0 0 N �L O N O .N 0 E O :lk N O N N O T- M 13 m o 0 0 U) Q• -a Q. O 3 .� +' U •� N V N L 0 •a C O N O H 0m U L = 00 aa) _c N v = N a) C R _L p, cn > ` o a' o Q '> -0 > _0 N E N �+ C a U a `"(n— ° 0 °' CO a) CO O 3 c a .N �:za U aiL E .r = N •E > i Q. -0 O o M 0 C L Q O �__ E m x x 0 c4 (n MO w. N+' >% Ui r +c >, .O a) 0 ) ,Q cnNE�o Q� O _ Q > CL N a) cn N O UI > 4- O d > CL L +' m LL 'O +; _ = U 0) V N0 N �- Q LO Z U) ) Y 0 ns «s = U Q O U N v V Q a) CL 00 0 a) LL a) co ►� m a - O a) N 0 a) i " _MY J aa)i U E a) c li 4 0 O O U � U U n d•+ C W ^LL ^D LL 0) L O O U) ❑ U Q •V L O U _ CL >, N O +_, � Q `O 07 a� cn a Q a) C 0 0) - — N cm E E ® �cn a) cn cn > O a Y u0i Q E N V E u) Ll fn EN N Cn U) J U OJ m W W Ho Q cO O W > El — a) i `� a? m ca o O > a J C O O a) U �►= 'tf C)o Z O_ H W Z J W M C r Lo o WCL > Y Y o N Q L) a`�i Fa 0 a)a a) Y Z c o M m o Zm W W `-a. C o O m �� O® LL N U) y W F- cn a a a LL O W > a El cu ❑ O a. fA o w W a LL O W w C7 a o U L) U z O a ~ a H r N M 0 a) LL a) co ►� m a - O a) N 0 a) i " _MY J aa)i U E a) c li 4 0 O O U � U d•+ W W ^LL L O U) ❑ U Q •V L O U _ CL a) CO a O E E u) ® a O U) •O ❑U a) C IL V C ❑ CL f- � N N C �U. N A ❑ O O U _ > ❑ U C) °� o m C Q. ElN ❑ L A � U i N y :2~ L a o r ❑ Q �° Ems_ Elm a, C O CO OU N J a) a) ® > W � LL Q) R Z o L • Z � O (1) 0 u ~a" t U co� C •� r �+ 0 a) -o a a) cn N Q Q > aai cQv d > X L6 cc W m 0 a) LL a) co ►� m a - O a) N 0 a) i " _MY J aa)i U E a) c li 4 0 O O U � U COSA Checklist copy.docx COSA Checklist Legal Description: KNIK VIEW BLOCK 2 LOT 2 Parcel ID: 051-031-33 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 51” Date of pumping 9/17/24 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) 1/10/1996 ALL standpipes present per record drawing Total measured depth from grade 8.9 ft (max) Measured depth to pipe invert from grade 5.3 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 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 9/17/24 Results Pass Fluid depth prior to test 0 in Water added 610 gal New fluid depth 9 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 42 in (MOA 3.5’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth remaining 42 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA 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 ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 09/20/2024 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 & 09/20/24 Lij V a O i V Z a LL 4.v ai +� -� J i Z a 0 W � � u N — Z a v 0 3 aj O Lr) r -j N w U m a) > 3 t a �' m U tA uj c v c o f 0 bwo aJ M N L OU a-+ aj C: Z w +�+ �_ i QJ U U :3 7 N aJ C m N O a 0 E u m L u >- H L W N 3 � Ln O _ O 0 o 3 Ki, fB O L- CL CL Q Q aJ N N 4.v ai +� -� O N Q N CO E L O 0 � O ca L C O -P.- }O O O OJ O Lr) r -j O 4s N v a �' m U O^l Q) hA Q) f>O N i ~ aJ M N L OU a-+ aj C: � N L_ aJ 4- C: i QJ U U :3 7 N aJ m c -I NO u O > O Q N O Ln � N u m L u >- H L +' O b3 C: � Ln O _ O Q Ln E a ,m N Q) cJ) O U O 3 a) Y Q O L Q N t 4� L O Y T O N n Y c m 4N U Q a) L � bA L Qj bA v U m � cB aJ -0 V) =3 E O cu U O N 4+ U Q � N ate -+ N c _0 _� U C L ON > _0 N U V) I— OU CO I— fB O L- CL CL Q Q aJ N N 67g 970, GE g4 ®Municipality of anchorage AUS= On -Site Water and Wastewater Program �— (907)343-7904 5a ETY ti Certificate of On -Site Systems Approval 0` 6 9 L 9 Parcel I.D. 051-031-33 Expiration Date: O _ 12- -20LO 1. GENERAL INFORMATION: Complete legal description Knik View: Block 2. Lott Location (site address) 22700 Knik Vista Street *Chugiak, AK 99567 Current Property owner(s) Julie Anderson Day phone 310-8993 Mailing address Real Estate Agent 22700 Knik Vista Street *Chugiak, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: ce 120 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with th #AECC884 SOF441 �g ON-SITE WATER AND R` PROGRAM ��^ Original Certificate Date: q — 5 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 Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12.doc Nitrate Advisory Arsenic Advisory Other s—alvk AQ - p /��.1, j i'U�/ Legal Description: Knik View; Block 2, Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for CO Static water.at beginning of test ft. B. TANK DATA Age of tank(s) 23 years Tank type/material septiclsteel Measured operating fluid level in septic tank 50 FOR Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) 1996 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.3 ft (max) Measured depth to pipe invert from grade 4.8+ 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 n/a gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-031-33 Structure served by this system Well production at time of test Water storage tank volume gallons Well disinfected oliform test? F-1 Yes ❑ No ❑ C " m bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station year Lift station material Commen Adequacy test date 8/12/19 Results 21 Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 495 gal New depth 9 in Elapsed time 90 min Final fluid depth 0 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date n/a litW E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes Community Sewer Manhole/ out > 100' ft ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft P ewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Field _ Water Main > 10'✓❑ Animal Containment > 50' ❑ Yes if No ft if No ❑ Yes if No ft ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below C nity Sewer Main > 75' ❑ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓❑ if No Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS *Met code at time of installation G. ENGINEER'S CERTIFICATION o OF ��44 1 certify that 1 have determined through field inspections and review �� Q • ' /r of Municipal records that the above systems are in conformance with p 9TH *I MOA COSA guidelines in effect on this date. ... ... . . ...... ./. ........... .J f r A. arne s•- V ° —7953 6�Ao COSA Checklist yellow sheet �Q ro f essio0oo� #AECC884 400000�0� 0 (A i - I- r J Q OF Q ~ � Q G= Y Z I- 0 O O u0d3 p O' d w� Q{ I-Ep LL 0 TS co LL ' V II V LLJ i t r I I Z w C' �� II N� Uwwo0 ori m0L0� rwl�Mun rf�v _ 0 (A i - I- r J Q OF Q ~ � Q G= Y Z I- 0 O O u0d3 p O' d w� Q{ I-Ep LL E"I0 V) CD 0- LLJ i t r I I Z w C' �� II N� Uwwo0 ori m0L0� rwl�Mun rf�v _ n NOIS34 VZSIA XINX NVId HIS ,0S = „L �2c _5 deo �6 �� z aO ang >-.-2 D] W p L _ w >- O O > in N W N w Z raz W o ui tYZJ L� =00 1— 0 Z z E 0:1 � � co ;4 oz zE� Ord w 0a� CL, a � O N IFrontier Surveys, LLC Project No: 19-334 LO ered By: Anita Bates Scale 1" = 60' / / / / / Lot 2, Sfack2 Knik Yew Subdivision 22,013 Net Sq. Ft. +/- 38,075 Gmss Sq. FE +f 22IDa WM' KYa Oaro S S(ory WwaFnm, Heuse `tJ1 GrGrn�s N89.3034'W 122.26 ARR / R.O. W. / / / / / / / LOT4 / Date:08/26/2019 Plat: 85-162 / / / / / / / / / / LOT1 .20'5'°2 SHED y e\ y, Grid: N/A q o NOTE: T COAhUNITYMJSIRR WELL I N j LOT3 --_ i i �/-�—�INLET VISTA DRIVE 1. Electric Meter/Outside Power `'0.a Telephone Pole , Tel. Ped. y Gas Meter ® aeck •a- Fence Se Elec. Ped. t (S; Septic © Water Valve ��Maiiboz -o+u-Overhead Utility General Notes: 0 30 60 120 1. This document Is created for the purpose of a single property transactionand is subject to Federal Ccpydght La'r+s. 2. Excepting for gross negligence, the Ilabil ly for this survey shall not exceed the cost of preparing this survey. 3. All measurements!setbacks are to the visuaVapparent building footprint. Scale in Feet 4. All d;mensions to property lines are plustminue 0.1 ft. "%*�N%tttt tit This survey complieth the ASPLS.Viortgaga Location Standards. The survey represents visible mp mots oand OF ( till - ondils wi ions at the time of the survey. This document does not constitute a bounds surveyand is subject to any P( .. qs tit Inaccuracies that a subsequent boundary survey may reveal. It is the responsibility .(the Chvnar to defemvne the •� / xistence of any easements, covenants, or restriction which do no appear on the record pial m Under no bircuslanaes should this document be aced for construction .1 for estoblishng a boundary or fence Fre. JJ 09TH '• As -Built Survey of., Lot 2, Block 2 Knik View Subdivision iP �� cr.a.nc W. LS.Aa<6 O � I, Fre tleric Wagner, hereby certify that this Mortgage Inspection.Survey was performed by me, or J//cT••' 8/26/2019 �e under my direct supervision on August 19th,2019. /yr ecgf . •.•'S Frontier Survys, LLC /fttit Xxt S ONA`�.��~ 650 W. 58th Ave.eSuite E Anchorage, Alaska 99518 Stu'Ove S•.�r Rf 907.460.1686- info@frontiersurveys.com PROFESSIONAL SEAL wwnv.frontiersurveys.com Septic Tank Advisory Certificate of On -Site Systems Approval #OSC191410 Subdivision: Knik View B 2 Lot 2 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 23 years old. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE ° DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section it P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # i ' `' 3 / ' 3 3 1. GENERAL INFORMATION Complete legal description Lot 2; Bl.ock 2; Knik View Subdivision Location (site address or directions) NHN Knik, Vista Drive iak, AK Property owner Leroy Alderman Day phone _ 688-3403 Mailing address P.o. Box 670045 Chuaiak, AK 99567 Lending agency — Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well LY.`; Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 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 S & S ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address Eagle Rive-.Als-ka 99P9 Engineer's signature 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments By: al1TIC Date -7 616 bedrooms, with the following stipulations: Date :2-1— ?6 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 (1411. 1191) Beck MOA x21 Municipality of Anchorage DEPARTMENT OF HEAL-rH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 1 44UNICIPALI'I Y Of ANCI•I()R,'tt;� ENVIRONMENI.SERVICES DtVlgl( Health Authority Approval Checklist `1 `�i'� � � 1J�G Legal Description: L� Z (fji Z (L,Si \j � Ohl �lo Parcel LD.: O S I - 0 3 I - 3 3 A. WELL DATA Well type ry Log present (Y/N) _ Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE P Coliform Date of sample: IP A, B. or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG B. SEPTIC/HOLDING TANK DATA Nitrate __ Casing height (above ground) Wires properly pi•otectec ) (INSPECTION Collected by: Other bacteria g. p. Ill, Date installed ,-kgL- t° Tank size 1Ue-o Number of Compartments _ -L- _ Cleanouts (Y)N)_-V_ Foundation cleanout (DN)—q_—,—_ Depression (Y/�i?j High water alarm (Y/N) Date of Pumping �p, 1 l4L Pumper C. ABSORPTION FIELD DATA Date installed _t� 1 b -`j V Soil rating (g.p.d./W or ft`/bdrnt) /,Z System type SiI A-I'Lo'y ,T, 4'jr.W Length 4S1 _Width S Gravel thickness below pipe ?,,s Total depth Effective absorption area 5// 7 Monitoring Tube present(PN) Depression over field (Y/Q�/ _ Date of adequacy test 4A' - AJir-,tJ Results (Pass/Fail) — For _bedrooms Fluid depth in absorption field before test (in.); _ � Iiumediately Lifter=gal. dater added (in.): Fluid depth —(ins.) Minutes later:_ Absorption rate = _ g.p,d. Peroxide treatment (past 12 months) (YIN) _ If yes. give date _ D. LIFT STATION Date installed Manhole/Access (YIN) High water alarm level E. SEPARATION DISTANCES Size in gallons „Pump on'. *Datum SEPARATION DISTANCES FROM WELL ON LOT TO! "Pump off' level at* Septic/holding talik on lot ; On adjacent lots Absorption field on lot cent lots Public sewer main Public sewer manhole/cleanout Se% septic service line Lift station SEPARATION DISTANCES FROM fiPTIC HOLDING TANK ON LOT TO: Building foundation 13 I Property line Sa I Absorption field Water main4-/service line /v Surface water/drainage / 10 `a - Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation /A . Water main/scrvice line Surface water ! o O t Driveway. parking/vehicle storage area ` Curtain drain 'J%4- Wells on adjacent lots zOQ Property line / 2 F. ENGINEER'S CERTIFICATION 1 certify that /hove determined thru field inspections and review ofAtunicipal records 1lfi tt oyr-jS- S1Mns are in conformance with A1100 12M guide!n in effect on this date. Signature i Jl'1✓'�" /t (3�L2T 1'1&,rll gS l e?eEngineer's NameC� �✓�"�x,. Date / �X y /q (, HAA Fee $ 3erb , ory Date of Payment Receipt Number � ! e 744 Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number ROBERT C. COWAN CE - 8801