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KNIK VIEW BLK 2 LT 8
Municipality 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 oop-uoll-liddy Vs00 #aanleM luawAed 10 aled $ aa3 aanleM ,2 S # VS00 luawAed to alea 9 1-21-2 $ aad `dSOO 'papinoid uollewaolul ay; jo Ammw ay; /4iaan o} gels alls-uo ledlolunw Aq uol;oadsul of pofgns sl A:padoid s143 `;uawal}ljuo sly} aol 6uIAIdde A8 :aouelsla ® :polsanbaa Malnaa pallpadx3 :joj lsanbai aanleM lld a6edaaS ❑ youaal aplM ® youaal daaa ❑ pa8 ❑ S1MMb' ❑ :a-1313 NOIldMOSSV '9 saeGA OZ ueyl aaplo Iaals dl AJOSlnpe aaS - M3N a6y ssel6aag13 ❑ alaaouoO ❑ ollseld ® IaalS ❑ NNVI 0I1d3S 'S aam@S ollgnd ao o1ldeS A1lunwwoo ❑ duel 6uiPIoH ❑ shun bulllamp Z bulnaas olldaS alenlad ❑ o1ldeS alen!ad ® :-1VSOdSIa N31dM31SVM 30 3dA1 'ti a6eaolS aaleM ❑ oilgnd JO IIaM Al!unwwoo ® shun 6u1IIaMp +£ 6ulnaas IIaM alen!ad ❑ shun 6ulllaMp Z 6ulnaas IIaM alen!ad ❑ IIaM alenlad ❑ :A-Iddf1S 2131VM 30 3dA1 '£ SW002Ja38 £ 2103 a3ZIS SW3ISAS 311S -NO 'Z auoyd Aea ZIMVH NNA-1 IOb211 (s)aauMo Alaadoid lua.uno L9966 VNSV IV mvi9nHO 3ARla VISIA 13-1N1 06SZZ (ssaJppe a}Is) u011e00 1 810"1 Z )10018 M31A NINA uo1ldlaosep lebal aloldwoo 6£-6£0-M '(TIlaoaed NOIIVWNO3NIIVION3J I uoi}eoilddy Jenoaddy swE)IsAS aj!S-up jo ajeoigpoo L66L-C-b0-L06 :xe3 uoiloaS aalennalseM'8 aaleM alis -u0 1,06L-Ct,C-L06 auoyd luawlaedaQ saolnaeS luowdolanaa 30VNOH3NV :JO A.LIIddIOINnw 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