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HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 3 LT 15 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: _.%1,¢ ~25' 0 II I PID Number: ~/- ¢2/"t ;~;'~ /~ N~m~: ~¢6 ~¢~415~5 /W~ Wastewater System: ~ New U Upgrade Address:~5~/~ ~ ~ ¢~5~ ABSORPTION FIELD Phone: ~/~' of B corns; -- ~ ~. ~? /~ ~ Deep Trench ~Shallow Trench ~ Bed ~ Mound ~ Other Soil Rating:,~ Y GPD/Sq. Ft. Total%Depths/from_ 5°ri"inal' grade: LEGAL DESCRIPTI 0 N ~ot: /5~BI°cK: ~/~ ~/~ ~ST ~,~ ~ Ft. ~' Ft. '~ownship: / ~ ~ llRang~: / ~ Section: ~ Fill added above original grade: Gravel length: WELL: B New Q Upgrade Gravel~ ~/D¢~ Number of lines: Oistancebelweenlines: ~lassification (Private. A.B.C): Total Deplh: . Cae~7 Total absorption area: ; Pipe material: ~riller: ~// Oate Drilled: Slatic Waler Level: Installer: Date installed: -- ~ield: ~/ '[~ump Se, al: Casing Height Above Ground: TAN K : _/"~ GPM / F' Ft. SEPARATION DISTANCES ~s~.uo u ~o,di.~ u S.T.~... From Tank Field Station T~nk Sewer Lines ~ w., ¢~ ¢¢0~ N/~ ~//~ ¢/~0~ ~.r~.,~5%¢¢~ W.t~r ~/~ ,~/~ ~/~ ¢/d ///d LIFT STATION Lot / Size in gallons: Manufacturer: .,.. /¢ Curtain ~' Drain ///~ ~//~ ~//~ ~//~ ~/~ Pump Mak~ &~d¢'l"Electrica, InspecUons ~;rformed by: Remarks: BENCH MARK ~uh,ed Elevation: ENG!~EER'S SEA~ inspections performed by:_¢/1~/~/~ E.~,d,S Dates: 1st ~/~ ¢/¢¢ :""~.': ?'" '~ Department of Hea~ and Humag. Services approval ~,,,~,, ~ .,.~.,,: ,~ ' %.,,, Reviewed and approved by. ' _ 2~-¢~ '~:':"* '"'.- - 72 013 {1/§1} MOA 25 Permit No, SW 94-0111 Page 2 ot 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343~4744 On-Site Wastewater Disposal System and/or Well Inspection Report Knik View Estates Lot 15, Block 3 051-043-17 Legal Description: PID No.: LOT 16 / KEYBOX VACANT LOT i4 / ~- C / VACANT 1500 GAL i / ~/ /~¢~ ¢ / B - c = 33.0 .-~?/ ~0~/ J B - F = 26.3 / / / I B J = 733 "', ' // / D - J = 38.8 k % / / / B - ~= 78,4 ~ ~ + - KEYBOX D - L : 54,8 ~ EASEMENT SCALE 1" = 50' ELEVATIEINS <NIgT 11] SCALE) CRt,IR REBAR e LBT 14/16/15 INTER, ACIUAL EL~V = 16a.00' ADDED FILL ~,/GRI]UND ~ rD 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 PAGE 1 OF 1 PERMIT NUMBER:SW940111 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:WALDEC ENTERPRISES INC OWNER ADDRESS:6208 STADEM ANCHORAGE, ALASKA 99504 DATE ISSUED: 5/04/94 EXPIRATION DATE: 5/04/95 PARCEL ID:05104317 LEGAL DESCRIPTION: KNIK VIEW ESTATES BLK 15 3 LT LOT SIZE: 34554 (SQ. FT.) N~ER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: o o THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 A.ND THE STATE OF ALASKA WASTEWATER DISPOSAL~ REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED BY: ~~ DATE: DATE: Louis Butera, P.E, Registered Civil Engineer April 20, 1994 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Knik View Estates Lot 15, Block 3 Narrative Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent proPerties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. Adjacent lots are all vacant. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in Our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \C:\WPWIN60\WPDOCS\1994\94-010A.NAR PO Rnx' 77.q2~)4 · F. aolo Rivor Al~kn qq577 , Tolm',hnno ~qfl71 ~q4-~lq5 , Fa'., Iq~71 c~q~L29q7 SPECII~CATIONS FOR ON-.SITE SEPTIC SYSTEM LEGAL: LOT 15, BLK 3 KNIK VIEW ESTATES GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. DRAINFIELD 1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield bottom. 2. The bottom of the drainfield shall be level, plus or minus 1.5". 3. The total depth of the drainfield excavation is not to exceed 7' at any point. 4. The drainfield gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded to prevent ponding of surface water runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 7 ' GRAVEL DEPTH = 3.5' DRAINFIELD LENGTH = 81' DRAINFIELD WIDTH = 5' SOIL RATING = 0.8 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK = 1,250 GALLONS Twenty-four (24) hours notice required for all inspections. / /~~~ // ~ TEST HOLE · MONITOR TUBE NO WELLS OR SEPTICS +100' o SEWER CLEANOUT NO SURFACE WATER +100' + KEYBOX ',',mmx~- PROPOSED LEACHFIELD NO KNOWN CURTAIN DRAINS ~ ~- EASEMENT LEOAL: LOT 15 BLK 3 KNIK VIEW ESTATES OWNER: WAL~C ~m~,,,lS~S. ,,C. ~~~ '.. CONTRACTOR: GOLD STAR EXCAVATING uo~ ¢ ~4-0'~01-~,TS: 04/~/¢4I-sc,us ~" : ~.0, ~.~>~-~ "f EA~S~ RIVER ~]N~R]Ng ~ERVIC~ tA uou~s A. ~UT~A ,~ P.O. So~ ~F3224 EA~LE RIVER, AK. 99577 EAGLE RIVER ENGINEERING SERVICES P.O, Box 773294 EAGLE RIVER, AK 99577 (907) 694-5195 JoB Knik View Estates Lot 15~ Block 3 SHEET NO.. OF. M.N. 04/19/94 CALCULATED BY DATE L.B. 04/20/94 CHECKED BY DA'[E SCALE Single Fmnily Residence 4 Bedrooms x 150 GPD = 600 gpd Soil absorption rate = 0.8 gpd/ft2 600gpd + 0.8 = 750ft2 750 ft2 x 0.54 (reduction factor) = 405 fF 405ft2 + 5' = 81' Recommended Drainfield Dimensions: Gravel Depth = 3.5' Gravel Length = 81' Gravel Width = 5' \C:\WPWIN60\WPDOCS\1994\94-010A.CAL Munlclpellly of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Streel, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PEFIFORMED FOR:, ,~¢, ('~_~C ~,.~'f. ~,--,¢ LEGAL DESCRIPTION: Township, Range, Section: 77~-1 1 2 3 4 5 6 7 8 g 10 11 12 13 14 15 16 17 18 19 20 ,~E E rL _/._~ ~/~? .¢.-., // 0/'.~'.;'0 I ~, '~'. ~' ' WAS G[1OUND ~ ENCOUNTERE , -, , DEPTH? g~l]lh Io Waist Aller Monitoring? ' Reading / i PERCOLA'DOI SLOPE SITE PLAN Gross Net Depth to Net Reading Data Time Time Water Drop / " /;ZJ / ~ /~ m,'. ~ '~ ~" /~//~" lEST RUN BETWEEN __ (minules/inch) PERC HOLE DIAMETER ' l AND d FT ACCORDANCE WITH ALL STAle AND MUNICIPAL OUIDELINES mN EFFECT ON THIS DATE. DAle: 4,85) PERFORMED FOR: 7// LEGAL DESCRIPTION: TH ~- ! 2 3 4 6 7 8 9 10 11 12 t3 14 15 16 18 lg 20 MuOclpallly of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE Township, Range, Section: SLOPE SITE PLAN WAS GRO! 'ER ENCOUNTERED? __ ~, ~ Ir YES, AT WHAr ~1. O DEPTH? e.,,/,,¢, P E Dfeplh lo Waler Aller /.-//I ?/~ ¥ Monilerlng? I~,/A . Dale:. Reading Date Gros~ Net DePU~ to Net Time Time Water Drop / " /~ .¢,~ /o~,~ ~' '~," 1%" ~ ., /~: ~ ) 3'~:_ / ', / ,, COMMENTS z?--,/~3'-~ ./1"~/- ~ ~ ACCORDANCE WHH ALL S~ATE AND MUNICIPAL GUIDELINES IN EFFECT ON1HIS DATE. DATE: 72-008 (Rev 4;85) PERCOLA]ION RA/'E // Iminules/inch) PERC HOLE DIAMEIER __ 1EST RUN BETWEEN 4/'Y~ FT AND ~')"'" FT CERIIFY THAI THIS TEST WAS PERFORMED IN AuguSt 3, lg94 Mr, Judd Walker Waldec EnterpI1~e~ 6L:~ Staedam Drive Anchorage, AK 99504 RE; (9o7) ~t 15, Bloc~ 3 Krttk View EStates 8ubdMslon. Compliance Wtth State Ddnklng Wst~r Fle0uletto~m, IO']tk vIpw E~e$ Water l~ystem, Class "A" Publt~ Water 8yate;Tt PWSID NO. 218409; ADEC Pre flor Nos. 95~.1-DW-215.016. , ' .- This let;er Is tn response to th. request rec~tved in this office August 11 I~94, concernin{] compllmlce of thl~ w~ter ~ ~st~m w~th Slate r.)rinklng Water Reguletloma (18 AAC 80}. ^ review of thl,s oflice'~ flies concert trig the monitming Stmue of thil) water system h~ been completed: 1. ~h.e I,ast $.atl,~fa(.,tory Tot~ Coliform i~aoteda result~ w~re submitted to tills uepar~ment oh July 98, 1.994. Thio doan meet the provi~lon~ Of10 AAO 80.200(a). 2. The ~8,t Inorganic L hen,uc~l Conta ~unanm {?m]~ple re~utls were eubrn~ to th~8 Department oh April 19, 1994. Trois doea meet the provlg[ons of '18 AA(; .t, T~m i~t Organic Chemical Contaminante/'Volatile Organl~ Chel~'~ical (VOC) were ~ubmitted to !!'lis Department on Apdl t8, 1994, This doe~ meet tile provisions of ~$ ~C O0.~O, (.), · : 3rhe above well iS a new C~ass "A" public water syatem, in addition to meeti~lg the c"orld~on8 granting Intedm approval, icontinued compliance will require that routine water cormlstJng of t~artedy samfillng for t~te] coliform baoteda and annuPJ amnpllng of tnorg~nlcs for nitrate b~ conducted, WIm:r~ there are more than 25 people or 13 bedroorr~ aerved by this w~ter Syetem this office will ~'taed to be hOUnd to adjust the required routine raw water sampling. _T?ank y.ou for your coop,e.r~on witi] thfs Depm'tment, if there are any queatj'ons regarding the et)eve please do not hesitat:~ to Mlehe. e~ Lu, Environmen~l Engineer ~TrATE OF AL,A~KA APPROVAL OF ON.SITE RIE~IDENTIAE' WATER AND SEWER I~EM8 PROPERTY DL~ORII~ION a "A' PWSZD no,2184Q9 This approval dc'el Ilot constttLlla e gUara.tSS Of ar~y kind, explicit or Implied, as to tile performellee of Ihs water supply and w~stewater disposal systems,' WATER SUPPLY A recen! water sample was re,tOd and found ~O meet Dep. arlmenf of Environmental OOn~erv~tlon drink- ing wa~tsr standar~ for total ~olitorm bacteria, an(~ nitrate. WASTEWATER ~SPOSAL In~t~W the ~epa~ment of Envlr~menlal ~e~sllon and found t~n e~pllan~ with eppll~ble~anta of In~ct~ Installed ~y a an~ that tl~. ,y,tem ~le ~p--I I, valle 1~ el.ia family ~ multi-la..th, .tS of .--_.room,. k'NIUMCFAUT OF �o -, o l �% Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051-043-17 z'�HC IOI AGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION 678gZ10 b n JUN132019. Phone: 9 `- 3-17 Fax: 907-343-7997 Expiration Date: N J )UO Complete legal description Knik View Estates Lot 15, Block 3 Location (site address) 21841 Rebecca Circle, Chugiak, AK 99567 Current property owner(s) Holly Morris Day phone (907) 301-0473 Mailing address Real estate agent PO Box 671085, Chugiak, Alaska 99567 Kathy Geraci 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone (907) 242-5276 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic R Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System El Public Sewer ❑ Waiver request for: Not Applicable q Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ "J76-6 Date of Payment (43k? Receipt Number Uh t1912D-- COSA# 0&L Ig l;R33 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 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 Michael L. Foster & Associates Phone 696-6200 Address 13135 Old Glenn Hwy, Suite 200, Eagle River, AK 99577 Engineer's Printed Name Gordon Seversen Date 5/17/19 6. DSD SIGNATURE OF System #1 Approved for 4bedroomsCE System #2 Approved for bedrooms @%' 7656 Disapproved�4��FD/�"��``��AV Conditional approval for bedrooms, with the following stipulations: �lttt(t(ff(/ /fir ON-SITE yup WATER AND M MACTR o PROGRAM cj BY:.6ZL, j) _ _ (�CZ uad Original Certificate Date: 0 % 5 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other *Tri k L�W i S c- t X (.J" COSA checklist Nue sheet Legal Description: KnU\View Estates Lot 15, Block Ifmore than 1septic system onlot: CDGAChecklist #pf A.WELL DATA [] Well log is filed with Onsite (or attached) Date drilled Total depth _ft Casodto_ft r-1 Sanitary seal is functioning correctly FlWires are properly protected Casing height (above ground) ______in. Date offlow test for CO8A Static water level atbeginning oftest ft. Comments Served b»community well -nowell onsite B.TANK DATA Age ufhank(a) 25 years Tanktype/meteha| Steel Measured operating fluid level inseptic tank 51" HStandpipes/foundation cleanout per record drawing Date of pumping 2017 O. ABSORPTION FIELD DATA 5/1885/17/1@,As-Builts Parcel ID: 051-043-17 Structure served by this system Well production adtime oftest _____gpm Water storage tank vo|ume____gallons Well disinfected for coliform test? R Yes No RColiform bacteria ioNegative Nitrate _____mg/L Nitrate less than MRL (ND) Aroenic_____ug/L Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION RRequired maintenance completed Age oflift station yeara Lift station mahahe| Comments: _- 51291945/16119Wh�a��m�a�d�a����� ����___ RALL standpipes present per record drawing Results ED Pass For bedrooms Total measured depth from grade 8.2 ft (max) Fluid depth prior totest O in Measured depth bopipe invert from grade ft (min) Water added 750 gal RN/A—pnassuhzedfia|d New depth 9.5 in MRMonitor tubes gotobottom ofeffective. |fnot, state Elapsed time 205 min depth into effective ---- Code -required soil cover over �e|d 5 Fina|�uiddnpth in System Absorption rate 8O0+Qpd (Required ifvacant for greater than 30days prior to Any rejuvenation treatment (past 12months) NO date oftest) Gallons introducedgallons|fyeo.ent*rdobs ---- Comnnenb/Deficiennieo: Pipe invert depth not obtainable: measured um"m/depth was ^.7feet. Final fluid depth measured was ~,1/wominutes elapsed time after water added. COSAChecklist yellow sham From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic TankfLift Station on Lot > 100' Yes if No Community Sewer Manhole/Cleanout > 100' 17 Yes if No ft r7 Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25'17-1 Yes if No ft Absorption Field on Lot> 100' F1 Yes if No ft Holding Tank> 100' D Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' F] Yes if No ft [:] Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 1771 Yes if No ft D Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Yes if No ft Surface Water > 100' [aYes if No ft Property Line —> 5' Yes if No ft Wells on Adjacent Lots: ft Private Wells > 100' n Yes if No ft Absorption Field > 5' Q Yes if No _ ft Private Wells> 100' Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' r-1 Yes if No ft Private Wells > 100' n Yes if No ft Water Service Line > 10' F/I Yes if No ft Community Wells > 200' n/ Yes if No ft Surface Water> 100' lZI Yes if No ft F. ENGINEER'S COMMENTS Absorption rate well exceeded required 600 gpd. 10 A certify that I have determined through field inspections and review Ar C:Pde 0 N of Municipal records that the above systems are in conformance with Av MOA COSA guidelines in effect on this date. p 49th , lvvGOM01, F- sevesdi, so CE -7656 tNtzl 0 Z�FESSOI, COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Septic Tank Advisory Certificate of On-Site Systems Approval # OSC191233 Subdivision: Knik View Estates Block:3, Lot: 15 The septic tank for this property is 25 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. S 8102'03" 1 Loi 9 4 / /, 243 13' SEPTIC r.� •--.�``" PIPES / 0. SEPTIC PIPES caj ASPHALT DRIVEWAY. 0 vat/ / • cc -.r _ 88.9' / "~ SEE HOUSE / ro DETAIL / Q Low s. �'�� / Cr z / CC HOUSE DETAIL c 10' T&E EASEMENT / / Scale: 1" = 30' / 0 0� PORCH lit 2.0'x4.6' S0, s R4*50.00' CANT 2 STORY S" RESIDENCE .r• oFc� 400, 2.0' CANT NOTE: THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM 50 PLOT PLAN AS BUILT X SCALE 1" _ .3{f" GRID NW 1558 Project No. 19-434/R1 ,�, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 La & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors ken langsurvey.com jonothan®langsurvey.com I hereby certify that I have surveyed the following described property: LOT 15, BLOCK 3, KNIK VIEW ESTATES (PLAT No. 86-113) X �qTb �* �G Anchorage Recording District, Alaska, and }hat the improvements situated ;•hereon 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 Z1 Day of '£` 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 plot. 'A�,¢ KENNY•�G. IAN it ,rc e � ' y�,:�;,G AECC963 Ownywor OAK 24451 MST tw- TT TT Or SOP oil, Tiny W Twhv= Permit No SW 94-0111 F02- L-Fz,--mss' MoL?Lz! 17h�"f °al ib 4- 5tt^7t t,-) Page _ 2 of 2 Municipality of • age DEPARTMENT OF HEALTH AND c` SERVICES ENVIRONMENTAL P.O. Box 196650 a Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Repol Knik View Estates Legal Description:. Lot 15, Block 3 PID No.: 051-043-17 h1.00 P-rk : 157c*A4- FO -,Le- 6,1=.j I• �!!-rito -1= ge2 AAJ Nt3 L5 I KEYBOXa°oiforar l ; 's is>Z'r LOT 16 / - v VACANT LOT 14 VACANT �tJ / B FND REBAR A �� LOT 151aer�cfr �Yo ✓ I500 GAL sr.�%3 - _-`F �W / � g SEPTIC TANK ,I©�a'�-—'---DRIVEWAYr--^-� co P- HOUSE L / / U qtr e��g z. goo � SWING TIES B = 3M B - C-'= 33.0 b C - D = 27.0 A - E . = 17.8 11 +7 t>F-y i.�-' B - E = 26.0 A - F = 18.3 3:415P ;"y�° 4, B - F.= 26.3 g1 rft? r r H 16.6 `a ��'� _ D- H= 810 0 B - I = 71.6 D - I - 36.9 q,6 L- 2a yt t g. b? G Pu - 75b G,kE, B - J = 73.3 Q p 6. Z0 / � q � � D - J = 38.8 sy 9.D:�% B - K = 78.4 MONITOR TUBE D - K = 44.6 - SEWER CLEANOUT B - L. = 87.1 pI t� -it) - KEYBOX D - L: = 54,2 est R I� 4(101. — — - EASEMENT SCALE t" = 50' 4`k,56i LL E A 101\J CR14R REDAR 2 LOT 14/16/15 WIER. (NOT TO SCALE' ACIVAL ELEV = 162.00' r*ti N _ S 0 ADDED FILL �/ GROUND OPIGL O 1 LEVEL e 159.9 2' f 3.3' ce-�r,4 2' 35PSI INSULATION NOGWT ON WEST END 1 ANK 146.9 157.0 '156.6 \156.3 156.3 FIELD 7 n�i r ni-. a 9+, (AOA 75 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 34;3-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# O~1- C)~'~- J% 1. GENERAL INFORMATION Complete legal description OCT 1:5 1997 RECEIVED Location (site address or directions) Property owner Mailing address Day phone __ Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~O(~ v TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng 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 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/orwastewater disposal system issafe, 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, of this inspection. Phone ordinances, and regulations in effect on the date Name of Firm ,'.-~--.' ......... ,.-¢:¢'/'k 6 ;'o~k~)'d 9 e/~ r. Address ./ ,,,,r:~:i~../~,K'~-~4 /./ Engineer's signature DHHS SIGNATURE ~' Approved for ~ bedrooms. Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 'f:1,"llL'ii 'Th~ Municipality of Anchorage Dep~r~men~ of H~l~h ~nd Human $~rvi¢~s (DHH$) issues t-I~lth Authodb/ ApproYal C~rHfi¢~t~s b~s~d only upon th~ r~pr~$~n~tions gi¥~ i~ paragraph ~ abo¥~ by an i~d~p~d~t p~ofession~l ~gin~r ~gis~er~d m th~ $~at~ of Alaska. Th~ DHH$ do~s this ~$ ~ ¢our~$¥ to purchasers of hom~s ~nd their I~ding i~s~itutions in o~der to satisfy ¢~r~in federal ~nd stat~ r~quir~m~ts. Employ~s of DHH$ do not ¢o~duct inspections or ~nalyz~ d~t~ b~for~ ~ ¢~r~ificat~ is issued. The Municipality of Anchor~g~ is not mspon~ibl~ for ~rors o~ orni~sions in th~ professional ~ngi~er's world. 72K)25 (Rev. 1/91) Back MOA #21 MUNIGIPA~.iTY OF ANCHOlU~b Municipality of Anchorage ENviRON~ENfAL SERVICES DEPARTMENT OF HEALTH & HUMAN SERVICES oct l ;~ ]99? Environmental Services Division ' 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 34~-~E ~V E Health Authority Approval Checklist Legal Description: ~..~'T/Gt I~/-.-J~'~ ! ~./LJlJg.. ///~.l,t/ ~57', Parcel I,D.:__ A. WELL DATA Welltype ~O~,~ I~B. crC, attachADEC lo,er. ADEC water system number ~J~O~ Log present (Y/N) j~//~- Date completed Total depth ~/~ Cased to /U/,,~ _ Casing height (above ground) Sanitary seal (Y/N) A')//~ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test ~//~- Al/,4 Static water level Well production g.p.rn. WATER SAMPLE RESULTS: Coliform ~///'{- Nitrate /~///g- Other bacteria Date of sample: /U//~ Collected by: /'['///~ : El. SEPTIC/HOLDING TANK DATA Date installed ~J~%[ct'-[ Tank size._~OO~[Number of Compartments ~-.-. Cleanouts ~) ~ _ Foundation cleanout ~N) ~ Depression (~/~5 High water alarm (y/N~ /¢/~ Date of Pumping (0(~ Pumper ~.¢. ~ '~,~G C. ABSORPTION FIELD DATA Date installed ~'~ So.lrating (g~'orff'/bdrm) O,~ _Systemtype W,~ ~'~. Length 8%' Width ~( Gravel thickness below pipe ~,5' Total depth. ~l Effective absorption area ~8 ~ Monitoring Tube present ~N) ~ Depression overfield (Y/~ ~o Date of adequacy test JO/O~ I*~ Results(Pass/Fail) ~ For ~g~ bedrooms Fluid depth in absorBtion field before test (in.~/0' I (' Immediately after ][~ gal. water ad'ed (in.): ~'/g 16'/z" - ~S~ .... Fluid dept~ ~0 ~ .g.p.d. (ins) Minutes later: [~O ~}~ Absorption rate ='" '/ ~7 Peroxide treatment (past 12 months) (Ye ~¢ ~¢~ If yes, give date ~ LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested "Pump on" level at* *Datum Size in gallons SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main /%//~ Sewer/septic service line //~//'¢" Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ ~ 4- Property line / O Water main/service line /O'+' Surface water/drainage. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 I ~gfl. ~S'6¢103 Building foundation /O '~- [o0' 4- Surface water Curtain drain On adjacent lots On adjacent lots F. ENGINEER'S CERTIFICATION Public sewer manhole/cteanout "Pump off" level at* Absorption field ~ ~ Wells on adjacent lots c~O0 % Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots I certify thatl/~ave determi~e~ thru field ir~spections and review of Municipal records that~lt~e~above systems are inconform~w~ithMOA~/~Ag~d~!n~z,!~.~ffectonthisdate. ~'~ OF Signatur¢~. / V(~ a~' .... Engined Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Parcel I.D. # 1. 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 051-043-17 GENERAL INFORMATION Complete legal description HAA # 'H ~f ~ f-~LO ~' / ',~...-.' Knik View Estates, Lot 15, Block 3 Location (site address or directions) N'HN Rebecca Circle, Chug±ak Property owner Waldec F~te~rises, Inc. Mailing address ~,~chora~ge, AK Lending agency Mailing address Agent Address 99504 Prem]ier Mortgage/Jan Endicott Day phone 563-7736 Day phone ~ 3000 A Street:, Suite 102, Anchorage, AK 99503 Alpha Group/f~2~ Day phone 563-3242 999 E Tudor Road, Suite 205, Anchorage, ~< 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. 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. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site x , Holding tank Community on-site : Public sewer 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 ~121 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, lfurtherverifythat 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?~-~,,- ~r~-.,, *¢.,- ,~,~,.... Name of Firm ma9~ R~'~r~¥' Rnoin~ring ,q~l"~zi~e.~ Phone 694-5195 Engineer's signature bedrooms, DHHS SIGNATURE ~ Approved for 4 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Se~ices (DHHS) issues Health Authorit~ 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 satisf~ certain federal and state req uirements. Employees of DHH$ do not conduct inspections or analyze data before ~ certificate is issued. The Municipalit~ of Anchorage is not responsible Ior errors or omissions in the professional engineer's work. 72~)25 (Rev 1191) 8ack MOA ~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: /¢/v/~' ///£//¢ ~¢5-r. Lo-r/C, CLEZ ParcelI.D. ~51 [2q5 /'? A. Well Data Well type /~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C. attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height FROM WELL LOG Wires properly protected (Y/N) ATINSPECl Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL T( g.p.m, Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMF RESULTS: Nitrate Other bacteria pie: Collected by: B. SEPTIC/I-14~=BtNG TANK DATA Date installed Cleanouts (Y/N) )/£5 High water alarm (Y/N) Date of pumping Tank size /:DD Compartments ; ¢-~ Foundation cleanout (Y/N) )/¢? 5 Depression (Y/N) /,//4 Alarm tested (Y/N) /-1/,4 /V//k~ /VE/,v' Pumper /v//~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line Surface water/drainage On adjacent lots h ~OO / Foundation 1'~- / Absorption field ~.d- / Water main/service line ,,~ /¢ "' 72-026 (3/93)' Front CONTINUED ON BACK PAGE C, LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level ~ Meets MOA electrical codes (Y/N~-~'~,'~ SEPARATION DIST E~T~~FROM LIFT STATION TO: Welt 0~¢¢'~'~ On adjacent lots Manufacturer ~ Ma~ ~ "Pump off" Level at Cycles tested D. ABSORPTION FIELD DATA Surface water Date installed Length ,¢.~ / Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) 05./'~/ Soil rating (GPD/Ft2) O. o° Width ~ ~ Gravel thickness Cleanout present (Y/N) Results (pass/fail) Depression over field (Y/N) for After test /V/,4 If yes, give date System type Total depth Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation ~/~ On adjacent lots ¢- ,..,2~ ' Sudace water /',//,4 Curtain drain On adjacent lots /'-,2--/~,I~/ Property line To existing or abandoned system on lot Cutbank ,'vi,4 Water main/service line ¢,'z~ / Driveway, parking/vehicle storage area ¢-,'z, / E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. EngineeCs Name /'.¢¢-, ~.,'-~ /¢¢,/~-,-~ Date HAA Fee $ Receipt Number Waiver Fee $ Date of Payment Receipt Number