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HomeMy WebLinkAboutKNIK VIEW BLK 2 LT 8Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241354 PID Number: 051-031-39
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
TRACI LYNN HARTZ
ABSORPTION FIELD
❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound
Site Address
22510 INLET VISTA DRIVE, CHUGIAK
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SF
7 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5 Ft.
Gravel depth beneath pipe
2 Ft.
Subdivision Block Lot
KNIK VIEW 2 8
Fill added above original grade
VARIES 1.02'— 2.6 Ft.
Gravel length
53 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To' Septic Absorption Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
From Tank Field Lift Station Tank Line
375 Ft2
1
Ft.
i
Well 100 + :i 1 QQ'+ 25'+
TANK ® Septic EDS.T.E.P. ❑ Holding [:1Other
Manufacturer
GREER
Capacity
1000 Gal.
Surface Water 100 + 100 +
Material
HDPE
Number of compartments
2
Lot Line 5'+ 10'+Nq
FoundationLIFT
1 0 + 1 0 + !
STATION
Manufacturer
Capacity
Gal.
Remarks Existing septic tank decommissioned.
Deep-burial tank installed.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer WILCO
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspecction tion 15` 11/06/24 2„d 11/07/24
Location and description
3`d 11/08/24 41' 11/08/24
MANHOLE TOP
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Conditional Approval: Date
tb
TH
Septic Syste
Approved - U
.
�'�`••, CurtisHuffman ,•���
�� ��stF
Date - -� (j
• . ,l 1/ 14/24, . •'�C�i
this include
ROFESSIO
ote: approval does not well permit requireme ts.
(Rev 05/2/18)
PID:051-031-39 PERMIT:OSP241354
FIRST WATER CONSULTING
KNIK VIEW BLOCK 2, LOT 8
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: OSP241354
Work Type: Septic Upgrade
Tax Code Number: 05103139000
Site Legal Address: KNIK VIEW BLK 2 LT 8 G:1557
Site Mailing Address: 22510 INLET VISTA DR, Chugiak
Owner: HARTZ TRACI LYNN
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
10/24/2024
10/24/2025
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
Received By: 5 S �--� F w C- Date:
Issued By: L„� Date: W'z i -a 2 r
3
ON -SITE SEPTICMELL PERMIT APPLICATION
Parcel I.D. 051-031-39
Property owner(s) TRACI LYNN HARTZ Day phone
Mailing address 22510 INLET VISTA DRIVE, CHUGIAK, AK 99567
Site address 22510 INLET VISTA DRIVE, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) KNIK VIEW BLOCK 2 LOT 8
Legal description (Township, Range & Section)
Lot Size 20,000
Sq. Ft.
Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(Z all that apply)
Absorption Field
Initial ❑
Single Family (SF)
(w/wo ADU)
Septic Tank
Upgrade
Duplex (D)
❑
Holding Tank
❑
Renewal
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature - of 0000,17ty owner or authorized agent)
Permit/Rush Fees: *5q5
Date of Payment: t
Receipt Number:
Permit No. Q,5P2 -A135q
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
October 14, 2024
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: KNIK VIEW BLOCK 2, LOT 8
The property owner has requested we obtain a permit to upgrade the failed septic system of the
above referenced lot. We propose to install one shallow trench and 1000-gallon HDPE deep-
burial septic tank to serve the existing 3-bedroom residence. The design is based on existing
MOA records with testhole data. No groundwater was observed at testhole excavation or
monitoring.
The slopes are moderate to flat at 0-5% at the proposed upgrade location. The lot and area are
served by public water. The design will not impact any of the neighboring properties. Please
contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241354, Curtis Townsend, 10/24/24
FIRST WATER CONSULTING
KNIK VIEW BLOCK 2, LOT 8
DESIGN CALCS:
NO WELLS WITHIN 200' OF PROPOSED
SEPTIC SYSTEM. AREA SERVICED BY
PUBLIC WATER.
NO SLOPES >25% WITHIN 50'
OF PROPOSED FIELD.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241354, Curtis Townsend, 10/24/24
FIRST WATER CONSULTING
DESIGN DETAILS:
KNIK VIEW BLOCK 2, LOT 8
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241354, Curtis Townsend, 10/24/24
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: ~N'v'qs-°~'~b") PID Number: 0'.5(o~1
Name:
~-~_t) %Cft~L,~e'rz~ Wastewater System: ~ New D Upgrade
Address:
~.o.~ ~qq ~ys,,,~, ~. q~o ABSORPTION FIELD
Phone: [ No. of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench D Bed D Mound D Other
I
LEGAL
DESCRIPTION
~, ~ GPD/Sq. Ft.
Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Towaship: Range: ~ Section: ._ Fill added aboveo ,~ ~ original grade: Fl. Gravel length: ~ ~ ~ Ft~
WELL: Q New Q Upgrade Gravelwidth: ~¢ Numberoflines: Oistancebelweenlines:
Classification (PrivateS,C): Total Depth: Cased To: Total absorption area: Pipe material:
Ft. Ft. , ~/~ SQ. Ft.
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: Pump Set at: Casing Height Above Ground:
~.~ .~. .,. TANK
SEPARATION DISTANCES ~ Septic D Holding ~ S.T.E.P.
TO Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~ ~0~ ~' ~
Well' ~o ~ ~oo~- Material: Number of Compartments:
Surface ~~ LIFT STATION
Water I Co '+ ~ ~.
Lot ~ ~ ~. ~ize in gallons: Manufacturer:
Line ~ ~O ~
Foundation ~ ¢ ~ r ~ ~ ~ "Pump on" level at: ~ "Pump 9~: High water alarm at:
=ump Make Electrical Inspections performed by:
Curtain ~ ~ ~~ ~,~
Drain
Remarks: BENCH MARK
Location and Description:
Assumed Elevation:
Inspectionsperformed~34EagleRiverL°°pR°"al~'¢ ?°~ates: 1st II-~-q¢ ~'"~'~¢~/'"'":
: ~ //x/~.// ~_.~_~
alt~ '~ "A" '"'~'
Department of Hex -~,-- Hu rvices approval '~,~,.-,', ....... ." '*'
Reviewed and approved bye, , . , ~ Date//,~ /~/'~ ':" '<x-~*~
72 013 (Rev. 9/91) MOA 25
Permit No.
SW950257 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 Wel~ Inspection Report
_ LOT 8, BLOCK 2, KNIK VIEW SUBD. 05103139
Legal uescription:_ PID No ·
94'~~ NEW
tO00 GAL ~94.7_' 94'2'~/ R
SEPTIC
FCO 58 5
ST1 ~9 9'
% ST2 41 16'
EW ] ~ENCH CO5 60 30'
CO4 27 40'
~NEW
1000 GAL j~/
72-013 A (Rev. 9/91) 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:SW950237
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:SCHMELZER FAMILY TRUST
OWNER ADDRESS:P.O. BOX 799
MARYSVILLE, WASHINGTON 98270
PARCEL ID:05103139
PAGE 1 OF 1
DATE ISSUED: 8/23/95
EXPIRATION DATE: 8/23/96
LEGAL DESCRIPTION:
KNIK VIEW BLK 2 LT
LOT SIZE: 20000 (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 (18AA072) AND DRINKING WATER REGULATIONS (iSAACS0) .
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 FOhLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ROBERTC. COWAN, RE.
ROBERT A. SHAFER, RE.
HEALTH AUTHORITY
APPROVALS
SEWER&WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW T EST
SITE PLANS
ROAD OESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
August 17, 1995
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Departmen't of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 8, Block 2, Knik View S/D
Request you issue a permit to install a septic system to
serve the three bedroom house on the referenced property.
A test hole was excavated and a 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.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/gk
Enclosure
17034 NORTH EAGL[: RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577
1" = 4.0' SITE
F
PLAN __l DESIGN
z
0
~©
0~o~0
.--t
~$~
©
(FNGINEER'S SEAL)
Municipality of Anchorage .~K,~¢''~ .... °.~' ..,"I..~Z'3~
DEPARTMENT OF HEALTH & HUMAN SERVICES ~ -~'~ /~ '",.J
825 "L" Street, Anchorage. Alaska 99502-0650 '%//~,~ ~',':-~
SOILS LOG -- PERCOLATION TEST /~¢./¢~ff ¢ ~.,/, ~¢~_
LEGAL DESCRIPTION: U~ ~ ~; ~'x~ Township, Range, Section: -~~
5
6
7
8
9
10
11 ~"1[2 ~'F
12
13
14 --
15
16
17
18
19
20-
WAS GROUND WATER
ENCOUNTERED?
iF YES, AT WRAT
DEPTFI?
Depth 10 Water Alter
Monitoring?
S
L
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE \ "~'~ tm,nutes/,nch) PERC HOLE DIAMETER
TEST RUN BETWEEN ¢{ __ FTAND
COMMENTS
PERFORMED BY: S & S ENGINEERING
17034 Eagle River Loop Road NO720~ U¢~ Sc) CER'IIFY THAT THiS TEST WAS PERFORMED IN
ACCORDANCE WI7~,~~ GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, RE.
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
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
CIVIL ENGINEFRS
(907) 694-2979
FAX (907) 694-1211
REFERENCE: Lot 8, Block 2, Knik View S/D
August 17, 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 is 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 12 inches above final grade.
17034 NORTH EAGLE RIVER LOOP ' SUITE 204 . EAGLE RIVER, ALASKA 99577
Page Two
Lot 8, Block 2, Knik View S/D
August 17, 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:
0
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.
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 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 8, Block 2, Knik View S/D
August 17, 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 extr~lded 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
grave], layer and the native soil backfill.
All 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 8, Block 2, Knik View S/D
August 17, 1995
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
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.
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 grading 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, etc. 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
activities0
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permJ, t. There will be no contractual
arrangement existing between the contractor and
S & S Engineering. S & S Engineering shall be the owner's
representative and wJ. ll 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 liabili'ty to the owner or to
others for acts or omissions of the con'tractor 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
MUNICIPALITY O NCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section '—' Far.: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-031-39-000
Expiration Date:
Legal description KNIK VIEW BLK 2 LT 8
Site address 22510 INLET VISTA DR Chugiak AK 99567
Current property owner(s) HARTZ TRACI LYNN
11/8/2025
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 11/18/2024
his Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval June 2022
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COSA Checklist.docx
COSA Checklist
Legal Description: KNIK VIEW BLOCK 2 LOT 8 Parcel ID: 051-031-39
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 – NEW TANK
Measured operating fluid level in septic tank NA
Date of pumping NA - NEW TANK
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) NEW
ALL standpipes present per record drawing
Total measured depth from grade 9.6 ft (max)
Measured depth to pipe invert from grade 6.02 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 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 – NOT TESTED
Effective depth (per record drawings) 24 in
Effective depth used 0 in
Effective depth remaining 24 in
Comments/Deficiencies: Approximate total measured depths from existing grade.
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 11/14/2024
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 &
11/14/24
M Lot 18
DECK
2.1' CAP
9.9' x 11.7' SHED
unI icr nrrA I
30.01
PLOT PLAN AS BUILT _X SCALE _1- 50' GRID _ NW 1557 Project No. J24-306 Al
P.O. Box 210005 N
Lang & Associates, inc. Anchorage, Alaska 99521-0005
(907) 522-6476
522-6476 0�p
Professional Land Surveyors jonothanolongsurvey.com v • o F q 4 p
kenOlangsurvey.com a0'`� ' '9s�o
I hereby certify that I have surveyed the following described property:
LOT 8, BLOCK 2, KNIK VIEW SUBDIVISION (Plat No. 85-162)
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
Dated this the Day of /�y%�—, _� , at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
9Z'
,A AT C. LANG o
�'PFo • . LS -9944. • •' yJ�
4pW9� tESS100--
State of Alaska AECC963
a 9 70 17 O
/ • Municipality of Anchorage ,6
2A
On-Site Water&Wastewater Program .# 4, 2::
(907)343-7904 2.p�o r r r
ti" AUL
w
CERTIFICATE OF ON—SITE SYSTEMS APP';•, ► 6 Q 1'
Parcel I.D. 051-031-39 Expiration Date: (9 02 3 -17
1. GENERAL INFORMATION
Complete legal description KNIK VIEW S/D; BLOCK 2, LOT 8
Location (site address) 22510 INLET VISTA DRIVE, CHUGIAK,AK 99567
Current Property owner(s) MARC&DENITA CORRERA Day phone 884-3073 (C/O TODD)
Mailing address 7633 N. MILLIRON ROAD, CHEYENNE,WY 82009-8339
884-3073
Real Estate Agent TODD&TRACY OBANION Day phone 727-3073
2. TYPE OF DWELLING:
El Single Family(w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual On-site 111
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System I Public Sewer ❑
WaiverNariance request for. N/A Distance: -
Received by: / Date:
7/08
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$ g(P`(-7) Waiver Fee$
Date of Payment 1/3/W 18 Date of Payment
Receipt Number 6v (-3 Receipt Number
COSA# 3Ci )3/I 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.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD, SUITE 101 'ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A.GARNESS,P.E. Date 7 Ian
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 1,16'1S1111\ r
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the 444� OF i k44
condition of the systems on the date/s of the evaluation.Separation distances were measured to readily identifiable features. •• \ 4 f 1tr
Hidden defects or encroachments may exist that were not identified during the evaluatron.The operational life of all wells and septic = ••.,• .
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during C',>••
�•••' ) t;
the year),quality of construction(materials and workmanship),and the water usage of the famity utilizing the system/s.These t 'K ,.,Iii
. /t ,.I \ •'..*♦..
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the Il '' 0
system/s; •therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. 0 0
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the c. „ , •
current systems fail.The content of this report is for the sole benefit of the person/parry who retained GEG.Reliance upon the •�n= J -r:i A. ,,• e s s
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ ,71 `" 4cr•
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. .d>••• CE-7953 D\=
6. DSD SIGNATURE ♦♦�'4��•AR FEF \CO's 4.
a�
LICENSE '1 PRO
1'il1�OF
2 \*\ �iivLA,
System#1 Approved for J bedrooms. �Q
System#2 Approved for bedrooms. ON-SITE C,
WATER AND �`
Disapproved. -o WASTEWATER o
z.Conditional approval for bedrooms, with the following stipulations: PROGRAM
n �-,2 eccVS J
v ( r� /I/A r---p l�r'G
( �r �J t' c l'e1� c-e�'�l LlC �' S� l 2_© v4S L% Li-
to,
y: „----r--;--„A4 v---4.7 Original Certificate Date: ��--L
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist —XL _ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10/12112)
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: KNIK VIEW S/D; BLOCK 2, LOT 8 Parcel ID: 051-031-39
A. WELL DATA
1- t pe PUBLIC If A, B, or C provide PWSID# Well Log (Y/N)
Date comple -. Sanitary seal (Y/N) Wires properly protected
Total depth ft. Cased to ft. Casing height ..ove ground) in.
FROM W OG A i PECTION
Date of test
Static water level ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RES :
Coliform colonies/100 ml. Nitrate mg./L. Collected by:
A . - Ic: ug./L. Date of sample:
B. SEPTIC/HOLDING TANK DATA NOTE: 23 YEAR OLD SEPTIC TANK MAY BE
APPROACHING THE END OF ITS USEFUL LIFE.
Tank Type/Material SEPTIC/STEEL Date installed 11/7/1995
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) NO
Date of pumping 6/25/2018 Pumper ONE STOP PUMPING
C. ABSORPTION FIELD DATA •BELOW EXISTING GRADE AT MONITORING TUBE
Date installed 11/7/1995 Soil rating kp.d./ t'or ft2/bdrm) 1.2 System type 5-WIDE
Length 45 ft. Width 5 ft. Gravel below pipe 3.5 ft.
Total depth *8.4 ft. Eff. absorption area 416 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 6/19/2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 25 in. Water added 765 gal. New depth 36 in.
Elapsed Time: 320 min. Final fluid depth 27.25 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) NO If yes, give date -
D. LIFT STATION
Date installed Size in gallons Manhole/Acce
"Pump on" level at in. "Pump off' le - . -. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit req - .•
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: PUBLIC WATER
Sep i • 'ft station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main " • is sewer manhole/cleanout
Sewer/septic service lin- Holding tank I
As'.•. •ntainment areas Manure/animal excrete storage areas _
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation '5'+ Property line 5'+ Absorption field 6+ (ASSUMED)
Water main 10'+ Water service line 10'+ Surface water 100'+
100'+PVT./
Wells on adjacent lots 200'+COMM.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ _ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
100'+PVT./
Curtain drain NONE KNOWN Wells on adjacent lots 200'+COMM.
F. COMMENTS
*MET SEPARATION DISTANCE AT TIME OF INSTALLATION
G. ENGINEER'S CERTIFICATION 41,1„1.<\x, _ OF.. •�F' •...4 1.
I I '1 .. ' ..0
/certify that I have determined through field inspections and % *'' 4' �'• ��_ .�'. �/
review of Municipal records that the above systems are in • �� . . ;
conformance with MOA COSA guidelines in effect on this
date. �� • Game -
Engineer's Printe N me JEFFREY A. GARNESS 0. 5) .. C —7 �•.•....:_j
•
Date 7 Z-1 IS *1,c`p'Iii ....�P\, •
LICENSE 1.III�"S`****4.
#AECC884
(Rev.10/12/12)
0 84740
d-
co
opo o^ Q, 4/63, Lot 7
/ /
BLM Lot 18 '' �a`� ,--,9,,,6'%
Alaska Railroad47
/
PI
Se 25668 / /
01h •:�' /
�
`ti a c, `tl',./ RO,4c� 4
iii(�I /
o / •/7 . /
�m� / U a% himney rh `
N ,,� / �°' 4 , : , 30
/ N
/ 2.00 a7 0 >•.
N e ;
60 6 Op NIrood fence/ Septic vent ' o ooe 20 t7 pre\t r`.
h/ CQ/ �6.1 v //� ^ lij/
2 / \j--.. 1.6 off /4. t.N Q/
N.
` �-,-, Lot 8 //v o,
N6o 10 o / o N . /
r • •
6.7•49,E a�na9e I•'.':. 2v
id
Lot 9 Easy /
?59.46 n76,--
*46
--- /
/' 30
• AS-BUILT NO CORNERS SET THIS DATE
����X. X II 1 thereby certify that I have performed a Mortgagee's inspection
•:":,\c...,.. .OF 'A� 1 �SM ` / of the KNIKaV EW SUBDIVISION rty: LOT 8, BLOCK 2,
_ ,Air
`P. ' ' '_ /
' 49th ") *�O Anchorage Recording District,Alaska,and that the
improvements situated thereon are within the property lines
�� � ' and do not overlap or encroach on the property lying
•• �i.�i:`+�4. adjacent thereto,that no improvements on the property lying
izobeth L. Walotko.I / adjacent thereto encroach on the premises in question and
SCALE: 1"= 40' % ••, •gp _ ,• ar that there are no roadways,transmission lines or other
f �., . yo — visible easements on said property except as indicated
1 <p • . . • • ' .tao hereon.
I oFEssi oN�u S� Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN %`"`.% this 14th day of JUNE ,2018.
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON. CO• .2-2--IE) FRED WALATKA&ASSOCIATES,L.L.C.
UNLESS OTHERWISE NOTED S&S, FB 18-3, pg 43 BE 907-248-1666 Engineers and Surveyors
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
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # ~Db--/ DZ/ ,.7 ~
1, GENERAL INFORMATION
Complete legal description
Lot 8; Block 2; Knik Vi2w Subdivision
Location (site address or directions)
NHN Inl¢.t V~'.~a D~iv¢.
Chugdak, AK
Property owner Ted Schm¢.~zer
Mailing address C/O M2C1 Inc. P,0. Box 670045
Day phone
Chu¢ia/z, AK 99567
Lending agency
Mailing address
Day phone
Agent
Address
Day phone__
Un/ess otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well
Community well X×X
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. 1/91) Fronl MOA #21
S;TATEMENT 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
S & S ENGINEERING
17034 Eagl~~afl~f{o. 284
Eagle River, Alaslca ?9577
Phone
Date
DHHS SIGNATURE
~. Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date
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~)25 (Re','. 1/91) Bsck MOA #21
Municipality of AnchOrage i
DEPARTMENT OF HEALTH & HUMAN SEP, VICES
Environmental Services Division
825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Health Authority ApProval Checklisl
Legal Description: %-o~- ~ ~..~..~'Z-- ~d-~,W q ~ Parcel I.D.;
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanita~ seal (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE~:
'-'Date of sa~
B. SEPTIC/HOLDING TANK DATA
Date installed II- '7 - ~J ~ Tank size
Fouudation clcanout,.(~q~ __/t/
Date of Pumping
C. ABSORIrPION FIELD DATA
Date iuslalled [ [~ 7~ ~ 5--
Length ~5- / Width
IfA, B, or C, attach ADEC letter. ADEC water system nambor
___Cased 'o. Casiag height (ab°~A'
__ ~ ~ Wires prop~(ected (Y~)
FROM WELL LOG / AT INSPECTION
~ g.p.m.
Nitrate
Collected by:
Other bacteria
[ o o o Number of Compartmeuts 2-- . Clean0uts 1~) ,7/
Del)ression (Y/~-'~ /J High water alarm (Y~)
Pumper ~[/~
Soil rating (g.p.d./ft2 or flZ/bdrm)
,5- Gravel thickness below pipe
Effective absorption area 5//6, Monitoriug Tabe preseutl]~N)
Date of adequacy test ~Jff4" ~/,¢;,J Results (Pass/Fail)
Fhfid depth in absorption field before test (in.);
Fhfid del)th ~-'--~[i Minutes later:
Peroxide tmatmeut (past 12 utonths) (Y/N)
hmnediately after__
Abs°rption rate =
/, 3 System type J~,4z.4~,M
'~ ."¢-- Total depth
DepressiOn over field (Y~
For ~ bedrooms
gal. water added
: g.p.d,
If yes, give date
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access (Y/N) "Pump on" level at*
/-
~ig~ *Datunl
.Cygles tested
ofF' level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
On adjacent lots
.._...-/ P~nmuhole/cleanoat
S~ Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building fotmdation 7 ! Property. line z/d ~ Absorption field
Water main/service line /o t P Surface water/drainage loot & Wells on adjacent lots
ff-i q"
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation ,,~
Sttfface water 40
Curtain drain
tY
Water mai~ffservice line / o
Driveway, parking/vehicle storage area .~o
Wells on adjacent lots ~ o t /" Property line
ENGINEER'S CERTIFICATION
in conJbrmance with MOA I. MA guidelines Jrt efJkct on this date.
Siglmture '~/~ ~
Eugineer'sName ~O~.~ ~" ~¢~
1 cert!/? that I have dete,'mined thru field inspections and review of Municipal records ,.~.c~.~"~ek?lj~D,~'.~v~Its are
, x?' c>¥."
HAA Fee $ ,~ ~0 Waiver Fee $
Date of Payment /-- I (5>'-9 ,~
Rev. 8~95 aSS: haa.wk.doc
Date of Payment
Receipt Number