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HomeMy WebLinkAboutKNIK VIEW BLK 2 LT 3 Municipality of Anchorage Page 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: ~ ~4'"/O'~'L~Jf PID Number: 0~1 '~ ()~l - ~: ~'~ Wastewater System: ~ New ~ Upgrade Address: ~. ~-~ ~'~oo~ C~l~c~A~ ~'/ ABSORPTION FIELD Phone: No. of B~rooms: -- ~OO D Deep Trench ~ Shallow Trench OBed DMound DOther LEGAL DESCRIPTION Soil Rating: I . '~ GPD/Sq. Ft. Total Depthfro~o~iginal grade: Township: ~ Range: Section: ~-- Fill added above ~riginal grade: Gravel length: WELL: ~,&~,~New D Upgrade ~ Gravelwidth: ~1 Number of lines: Distcncebe~eenlines: Ft. i '~ Ft. ~assification (Private, A,B,C): Total D~ ~ed To: Total absorption area: . , Pipe material: ~ ~ ~'~ /~ Ft. Ft. ~0~ ~ SQ. Ft. A~'r~ O~oy?, I ~ri[ler: ~/ Date Dri[led: StaticWater~evel: Installer: Date installed: / ~eld: ~GpM Pump Set at: Ft. Casing Height Above_ Ground:Ft. TANK SEPARATION DISTANCES ~Septic D Holding 0 S.T.E.P. TO Septic Absorption Li~ Ho]ding Public/Private Man,act?er: Capacity in gallons: From Tank Field ~tation Tank Sewer Lines ~,~0~ ~ ~ ~ I Material: · Number of Compa~ments: Su~ace Water IOOle i00{+ ~ ~ -- LIFT STATION Line . ~ Foundation J 01 J O i "Pump on" level at: ["Pump off" I~~h water alarm at: Cu~ain - ~j o~ ~ J~ ~ ~ N .... ectrical Inspections pedorm~d by: Drain ~ Remarks: ~ ~ ~G ~lo~ m. BENCH MARK Location and Description: A~umed Elcvatiom I00, o ft, Inspections pedormed by: s& S ~N61N~INIi Dates: 1st I ~/S/~'~ ~"-~,,~'~' .... :"/'"'/':'~"'~.. ~ ..... ........... - ,,?,.-~:'"'"~ 17034 Eagle River Loop Road, No. 204 2nd ti/,5'/~w ~'~e ', ROBERT C. COWAN Depa~ment of mea.n ana~uman ~e~ces approvm Reviewed and approved by: ~J ~ ('- // Date: ~' [¢'¢~ ' / 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW970524 PAOE 2 0~' 2 Municipo, ti±v oF Anchoro, ae DEPARTMENT OF HEALTH AND NUH'AN SERVICES ENVIRONMENTAL SERVICES · P,O. ]3ox 196650 e~Anchor<l§e, AIGska 99519-6650 eTelephone: 343-4744 ON-SOTE WASTEWATER UISPOSAL SYSTEM ANg/OR WELL INSPECTION REPORT LEGAL LOT ,5, BLOCK 2, KNIK VIEW SUBDIVISION P.LD. NO. 051-031--34 SITE NEW 12.~0 GAL. SEPTIC TANK WATER LIN E..--~ (APPROX. LOC,)~ / DRAINFIE-LD ATHll GRAVEL DRIVE STI ST2 / 99.1' [~_ FINAL 1500 GAL SEPTIC .1' TANK WATER KEYBOX GRADE-~ CO1 = 93.3' CO2 = INLET VISTA DRIVE MT1 = 89.4' MT2 = 89.4: MT1 C01 MT2 COg = 98.8', C02 98.2 NO WA.T, ER FOUND 81.4 B.O.H. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 PERFORMED FOR: LEGAL DESCRIPTION: SOILS LOG -- PERCOLATION TEST ' ~ ~O ~ ~ ~ Township, Range, Section: - 5 6 7 8 9 10 11 12 13 14 15- 16- 17 18 19- 20- ~_.~ ~,~ ~ ~ ~J t~.~ i,~ ~.. ~,.1. ~. t~_,~ SLOPE SITE PLAN WAS GROUND WATER . \ ENCOUNTERED? N (~) IF YES, AT WHAT / DEPTH? Depth to Water Alter -- ~ Monitoring? Date: Gross Net Depth to Net Reading Date Time Time Water Drop 5_ ~:~ c '/~" I" PERCOLATION RATE (minutes/tach) PERC HOLE DIAMETER ~'~ TEST RUN BETWEEN ~ FT AND ~2~ FT COMMENTS PERFORMED BY: I;'0~,,,~. -'";..~e :~ivu, L~p ~uaci [~o. 2~ I /" _ , , CERTIFY THAT T~IS TEST WAS PERFORMED ACCORDANCE ~I~L~i~I~PAL GUIDELINES IN EFFECT ON THIS DATE. DATE: % //~ / ~ ~/ 72-008 (Rev. 4/85} ROBERT O. COWAN, P.E. ROBERT A. SHAFER, RE. APPROVALS SEWER&WATER MAIN EXT ENSION8 .SEWER&WATER ENGINEERING SI'UDIES AND REPORTS WELL iNSPECTION & FLOWTEST SITE pLANS ROAD DESIGN DaEe~ CIVIL ENGINEERS (907) 094-2979 FAX (907) 694-12! 1 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED NOV 2 0 1997 D Municipality of Anchorage ept, Health & Human Services The septic inspeqtions for th~eferenced property were performed on //7~/q7 and ///~/~ . Prior to submitting the On-site Wastewater DisPosai'DVstem and/or Well Inspection '' ~ ~ --I ' 0 e Report we are wa~tlng for the ~£r~y~r3 /.¢-~,~ t b completed. If we may be of further service please contact us. Sincerely, Robert C. 'Cowan, PoE. SOILTEST PERCOLATION [ESr $IRUCTURAL& MECHANICAL INSPECTIONS ONSIIE DISPOSAL SYSTEM 17034 NORTIt EAGLE RIVER LOOP "SUII-E 204. EAGLE RIVER, ALASKA 99577 PAGE 1 OF 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:SW970324 DESIGN ENGINEER:S & S ENGINEERING OWNER NIkME:SCHMELZER FAMILY TRUST OWNER ADDRESS:P.O. BOX 670045 CHUGIAK, ALASKA 99567 DATE ISSUED: 9/18/97 EXPIRATION DATE: 9/18/98 PARCEL ID:05103134 LEGAL DESCRIPTION: KNIK VIEW BLK 2 LT 3 4 LOT SIZE: 24680 (SQ. ~T.) NUMBER OF BEDROOMS:4~/THIS PERMIT: /~ 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 (18AJ~C80) . 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 SA_ME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: ROBERT C, COWAN, P,E. October 14, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANO REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 3, Block 2, Knik View Estates Request you re-issue a permit to install a septic system to serve the proposed four bedroom house on the referenced property. The existing permit (#SW970324) was for a three bedroom house. Attached is a revised design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jlm Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 ROBERT C. COWAN, P.E. September 5, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS S EWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION &FLOWTEST SITE PLANS ROAD DESIGN SOiLTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE W,~STEWATE R DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 3, Block 2, ICnik View Subdivision Request you issue a permit to install a septic syste~n to serve the proposed three bedroom house ou the referenced property. A test hole was excavated and percolation test pe~'onned. The approximate location of the test hole is located on the attached site plan. The mmfitofing tube within tile test hole have been checked and found to be dry. This property is se~. ed by a (,ormnumty Water System. This prope~ty has enough area fol' 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 tile ,nstallatlon ~f ,he proposed septtc system. If'you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/jlm Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 I 1" = 50' ~ ! ~o~ 0 / ~' ~ / z~ 0{:2 F z ~ ~,,._ = ~o~o SITE PLAN mO '-0(j) ~m O0 c-m (.~q DESIGN mo - - '~:d oo Fq"O ZO rILI~ ESMT, IC~ KNIK VISTA DRIVE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 625 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~'' 2 3 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTFI? Depth to Water A~[[[,,,~ · Monitoring7 .-~,¢~%.v~,, Date: / Gross Net Depth to Net Reading Date Time Time Water Drop / PERCOt. ATION RATE ~ (mmutes/~nch) PERC HOLE DIAMFTER ~ TEST RUN BETWEEN'4~ ~"'- FT AND__--~' ~ FT 17034 Eagle River Loop Road No. 204/u - ' " DATE: ACCORDANCE WlTI-~F"i~'~/~ ~;~,t~ GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) PERFORMEDIN ROBERT C, COWAN, P.E, CIVIL ENGINEERS HEALTH AUTHORITY A2PROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SiTE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WAS [EWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUC~FION PRACTICES and MATERIAL SPECIFICATIONS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 3, Block 2, Ktfilc View Subdivision September 5, 1997 GENERAL: 'The scope of tiffs 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 prope~W. 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 othel~vise, the property owner shall be responsible for final grading m'eas subsequently depressed fi'om 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 fi'om the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tani~ shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a rrfinimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER, ALASKA 99577 Page Two Lot 3, Block 2, Iinik View Subdivision September 5, 1997 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 tanl~ and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tanlc). These cleanouts shall be located on undisturbed soil not more than 10 ft. fi'om the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean towm'd 'the septic tank. Final grading over the septic tank shall be such that a positive slope e',¢~sts away fi'om the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dhnensions shown on the design. The bottom of the excavation shall be witbh~ 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 pe~i'orations faced downward. Gravel 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 baclcfill. Ensure the silt barrier covers the entire gravel surface befo,'e 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 tln'ough the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the e:f[~ctive 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 ttfirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation ora depression at[er settling. IVI1NIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed ibr installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Lot 3, Block 2, Knik View Subdivision September 5, 1997 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pip_e_ Pe~5'orated Solid Cast h'on Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use ora type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chenfical Company Styrofoam I-II or equal). 4. Septic tank inlets and outle'ts shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt battier (Typar 3401, Mirafi 140N, or equal) must be installed betaYeen the final leachfield gravel layer and the native soil baclcfill. 6. All leacl~eld gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements~ which ever applies. INSPECTIONS: Typically there will be a minimum of thi'ee (3) inspections required during the installalion of the wastewater disposal system. These inspections will occur as follows: I. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds a~d before the installation of any gravel. A septic tank may be set ha place, but may not be baclaSIied before 'this inspection. 2. The second inspection must be conducted after the placement of the silt ban'ier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other bacld]ll. 3. The final inspection is to occur upon final grading of the property. Page Four Lot 3, Block 2, Knik View Subdivision September 5, 1997 Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a construction meeting will take place on-site. The inspecting engineer will not coordinate, dkect or control in any way the contractors activities. The owner shall contract with the contractor to per£o~n the work outlined in these specifications and plans and in accordance with the attached MO.A. permit. There will be no contractual an'angement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will 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 perlbrming work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, teclmiques, sequence, procedures or the safety precautions incident to tiffs project. CONTRACTOR/OWNER MUNICIPALITY OF ANCHORAGE AMe Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251098 Parcel ID 051 -031-34 Legal description KNIK VIEW BLK 2 LT 3 Site address 22640 KNIK VISTA ST Expiration Date: 3/12/2026 Current property owner(s) WRIGHT LLOYD & JENNIFER 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 Original Certificate Date: 3/27/2025 T fs Cert ficate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE rr Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-031-34 Complete legal description KNIK VIEW BLOCK 2 LOT 3 Location (site address) 22640 KNIK VISTA STREET CHUGIAK, ALASKA 99567 Current property owner(s) LLOYD & JENNIFER WRIGHT Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ® Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 27 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ 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 $ Date of Payment 3 y 2 COSA #S Waiver Fee $ Date of Payment Waiver # COSA Applicalion.doc COSA Checklist.docx COSA Checklist Legal Description: KNIK VIEW BLOCK 2 LOT 3 Parcel ID: 051-031-34 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 50” Date of pumping 03/12/2025 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) 2/25/98 ALL standpipes present per record drawing Total measured depth from grade 9.7 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 3.8' 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 3/10/25 Results Pass Fluid depth prior to test 7 in Water added 615 gal New fluid depth 8 in Elapsed time 30 min Final fluid depth 7 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4’ ED) Effective depth used 9 in (Missing ED + Final Fluid Depth) Effective depth remaining 39 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximately 0.2’ or 2” ED is missing – not measurable. 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) - 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 03/21/2025 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 & 03/21/25 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC251098 Subdivision: Knik View Block:2, Lot: 3 907-343-7904 Fax: 343-7997 The septic tank for this property is 28 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more, not including engineering, surveying, MOA permitting fees or site restoration. 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 30 year old steel tank MAY look like. MUNICIPALITY OF ANCHORAGE Development Services Department j' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems ,Approval Parcel I.D. 051-031-34 1. GENERAL INFORMATION Expiration Date: _� r _-Z © Z I- Complete legal description KNIK VIEW BLK 2 LT 3 Location (site address) 22640 KNIK VISTA ST, EAGLE RIVER AK Current property owner(s) RIBLETT Mailing address Real estate agent SAME 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well I] Private Septic Z Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550,Waiver Fee $ Date of Payment 3 L'�' I a 0 a Date of Payment Receipt Number 0a I a 3 Receipt Number COSA # O S C -? ;� 1 O '� � Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 3114122 6. DSD SIGNATURE System #1 Approved for 4 System #2 Approved for Disapproved Conditional approval for "o 't;4 9TH' ..,.... bedrooms • • ....... MMICHAEL N. AnCtRS;,iJ . , f � bedrooms!,^... CE 44 +� 7.?Z_•1 �s�*:` _ bedrooms, with the following stipulations:b�. pro._ �0FIAn'IrK16 `g UN- -- = WATER AN m' m WAST'_ 'ATER �� I 01 SER\l "J)))))))))))7711 �- 22 By: �^'" Original Certificate Date: =7 - Z Z -Z2 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisor Well Flow Advisory Other y�1 ' vy A-4. //�/�COSA Cheddist blue sheet '_ `'\)r� t Oa — —eo/ Legal Description: KNIK VIEW LOT 3, BLK 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 COSA Static water level at beginning of test ft. Comments COMM. WATER SYSTEM, CLASS A WELL B. TANK DATA Age of tank(s) 24 years Tank type/material�GSrEE Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 3/1/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 1115197 ❑ ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 4 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 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-031-34 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform 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 years Lift station material Comments: Adequacy test date 3/1/22 Results ✓7 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 5 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community welt) Septic Tank/Lift Station on Lot > 100' Building Foundation> 10' Yes Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tanis on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'✓l Building Foundation> 10' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100' Yes if No ft -" •-V'dater Main > 10' - n Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation> 10' Yes if No ft if absorption field is under driveway comment below Property Line > 10' Q✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' F/ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS COSA Checklist yellow sheets *LUT HAS COMM. WATER SYTEM G. ENGINEER'S CERTIFICATION �"�,t- . • • • ° : `- " a mac„ •' ', " I certify that I have determined through field inspections and review -9 !L' of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. . • • e a • • • • . v s �,I / �•� MICHAEL N. ANO RSC:ii 4%•. CE -9 9 ; COSA Checklist yellow sheets e: �•"a" www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221098 Subdivision: Knik View Block 2 Lot 3 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 24 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. £960334 d b 1yN01SS��P V©^ �'ZOzS—s1'��°,��QO ONVI H13NN3X }old uolslAlpgns papJOOeJ 841 uo JDeddD ;ou op 40!4M suOHDIJIM Jo 's}uouanoD 'SjuaweSDe Auo ;o oDua}slxg 944 aulwaelap o{ JaumO 044 }o Ailllglsuodsoi e41 sl 11 D7jSDly '960J040uy }D '-77— '------ ��< -- }o AoCl 044 s141 p9100 t •uoeae4 poloolpul sD 4deoxe ApedoJd plos uo s}uewasoo elglSIA J8440 Jo scull uo1ss1wsuDJ4 'sADMpDOJ ou 8 -JD GJ041 }04} puD seslweJd padanans 044 uO 40DOJOUD 049J041 }usODjpD 6ulAl ApedoJd e44 uo sjuewaAoJdwl ou }D4} 'o}eJe4} {ueoojpo Apedoid 041 o{uO 4000JDua 40u op puD scull ApedoJd e41 u!4}IM a.JD uoaJa4j pe}Dn}Is S}uewenoJdwl 944 ID41 puD 'D)ISDId '101Jls!(l 6uIpJOOGN 86DJ040uy (Z91-58 'ON 1V'ld) NOISIAiaens M31A NINA 'Z N0018 '£ 101 :A{JedoJd peglJosep 6ulm011o} a41 poAoAJns aAD4 I P41 Lblpeo AgaJa4 I t�J woo -A9 Jns6uOl0UO4}ouoj woo-AeAJns6uol®us)i Sa O A 8 Aa n S p u DJ (C) u o I S s e j Oa d xDJ sz9v—zzs (L06) ` au04d 9Lv9—ZZS (L06) o U( ISE) E) I r) 10 os S `v �� u ID -1 6v0£—S 1566 D)IsOIy a6aJo4Duy anueAd IdJoa OOg L ----L?J 8 L L—ZZ 'ON 4Oa oJd —'LSS L MN 01 10,0£ _ --- u � — 31t/0S j(— 111(18 Sy --- N`v''id 1014 ,0£=„ L :31VOS Emm 661 OOL OS SL OL 0 'Z 101 OlNO S3HOy08ON3 03HS 3H1 (2 W31SJlS 2JRVVM kLiNnvgNoo y AH 03A83S SI 101 3H1 (Z •31yWIXONdd`d 388 S32iniv33 13A31 3ovi8nS 3HOS '83AOO 301 V MONS Ol 3f10 ( L :S310N z 101 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 "'~" '" - '~ '; ~-'~' "- _3 ~\ ~,~(~-~,'-'/ r , ': ~" ~' -- '" HAA # '~ 1. GENERAL INFORMATION Complete legal description Lot 3, Block 2 Knik View Subdivision Location (site address or directions) Property owner Mailing address_ P O R~× ¢,7¢~n4~, ¢'h~g'iak~ AY 99~7 Lending agency Mailing address_ Agent Address Lerc¥' Alderman (M2C1 Construction) Day phone Day phone Day phone 223-8100 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well 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: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Fronl MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify thai my investigation of this Health Authority Approval application shows that the on-site water supply and/orwastewaterdisposalsystem is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverifythatbased 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 £ & 2 ."NC-iNEEMN,., Phone 17034 Ea~le R~er Loop~oad No, 204 Address Eagle Eiver~;A[¢sf~ 99~7 Engineer's signature ~/-~¢~-- Date DHHS SIGNATURE b/ Approved for ~[~'f~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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'8 work. 72~)25 (Rev 1/91) Back MOA ~21 LegalDesodption: L~ ¢~ I~IVl~¢~- ~/1~~ MLINIClP4 t I T Y 0i~ ~1 ~I6'tlORA Municipality of Anchorage I~A~ -, '/~1~ DEPARTMENT OF HEALTH & HUMAN SERVICES "6 ( 1998 Environmental Se~ices Division ~r,~... 825 L Street, Room 502. Anchorage, Alaska 99501. (907)"~~*~ Health Authority Approval Checklist _ Parcel I,D.: 0~/ - c/~ - 5+ A. WELL DATA Well type ~.UAGO R Log p[~esent (Y/N) Total depth~'~,.~ Date completed Cased to If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) L g.p.m, Sanitary seal (Y/N) Date of test FROIgh-VV .~..~ELL LOG AT INSPECTION Static water level Well production WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: Collected by: .. SEPT C/.O'D . TAN .ATA Date installed tlJ5'/C~ ~. _ Tank size Foundation oleanout (~_N) L11~4~ Date of Pumping ~ [J;,~,,) 1 2~¢JO Number of Compartments ~¢/ Cleanouts(~l) . Depression(Y~ I'~0 High water alarm (tl~ . I~[~ Pumper ~ System type ~¢/-Z¢)~ TTCS¢~P, Total dePth 9 Monitoring Tube presentCN) ~$ Depression over field (Y(~ f~'O Results (Pass/Fail) ~-' For ~ bedrooms C. ABSORPTION FIE,D DATA Date installed III ~'/c~;/' Length ~O r Width Effective absorption area ~ .~ '2. Date of adequacy test Ik~ t'~J---VO I, Soil rating ~r fF/bdrm) 'Z Gravel thickness below pipe Fluid depth in absorption field before test (in,); ~-"-' Immediately after--' gal. water added (in.): '--' Fluid depth =--~ (ins) Minutes later: ~- ~ Absorption rate = ~ .g.p.d. Peroxide treatment (past 12 months) (Y/N) "~ If yes, give date 72-026 (Rev. 3/96)* : Septic/holding tank on lot __ Absorption field on lot Public sewer main Sewer/septic service line Date installed ~ Size in gallons Manhole/Access (Y/N) ~ "Pump on" level at* High water alarm level at* ~"--,~atum Cycles tested SEPARATION DISTANCES SEPARATION DISTANG~M WELL ON LOT TO: On adjacent lots ~h°lLi ft station ~/clean°ut SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ! ~ Property line ~ ' Absorption field Water main/service line "Pump off" level at* Surface water/drainage !~/'~)_" _/L Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Surface water Curtain drain ! Building foundation lO Water main/service line Driveway, parking/vehicle storage area ~¢ow) r~ Wells on adjacent lots ~;7.~O / ENGINEER'S CERTIFICATION ,:; .. , "¢2~'- ~ A I certify that l have determined thru field inspections and review of Municipal reco[~m,~ ~'~ ......... ~}~¢~,tems,~ are in conformance with MOA HA~uidelines in effect on this date. ~ ¢, / .... - ~ Signature Engineer's Name ~/¢~ ( . ~ ¢~//~ ~ '/ HAA Fee $ ,'~00 ~ (~ 0 Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)*