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SKYVIEW ESTATES LT 5
kyview Estates Lot 5 #015-531-58 (j GREA R ANCHORAGE AREA BOR 'GH Department of Environment Quality �f�'Ytl 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /M%&&I P_WAJ?6-t1 _ MAILING ADDRESS 504 /7y9a PHONE LOCATION 0%�',{- N c� © _ LEGAL DESCRIPTION �` �G J 'Amz L' . 50=C TANK: DISTANCE NUMBER OF FROM WELL i00 a" MANU17ACTUREFZ MATERIAL 5keP-6_COMPARTMENTS INSIDE LENGTH_ —INSIDE WIDTH LIQUID DEPTH .—LIQUID CAPACITY20� GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL FOU NUMBER OF LINES ABSORPTION DEPTH: TOP OF TILE TO FINISH GRADE WDLL: isC,yb �Gv1rG�a TOTAL LENGTH REST LOT LINE._ _OF LINES BETWEEN LINES —_-�--TRENCH WIDTH— IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE_ IN. TYPE _CONSTRUCTION -d -.,-ed Z /14 kq, .DEPTH — BUILDING NEAREST NEAREST SEPTIC i SEEPAGE FOUNDATION , LOT LINE �, SEWER LINE_ TANK A, SYSTEM ` CESSPOOL �2 d 'ti/ _, OTHER SOURCES APPROVED_ _DISAPPROVED— REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS:0-ap 00 Roue de- Gz `-y�"I Form PW�027 DIAGRAM OF SYSTEM IL? weYk/- i2tW{ir5.a.-T G - Cess��azL �z WCLLIV o� �YGS T/N� tG � iR�.LuL Lo+ Li vie, DISTANCE FROM: DATE ,23/L73APPROVED_&7G,dt - 664ZL-Z— G.A.A.B. I / rff A- R ANCHORAGE AREA BOR.,.tJGH Ol _ DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 Tu ooR ROAD COUCH 0-650 V A:dC HO RAC C. ALASKA 99502 T[;.[TRon[ 279.3606 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT —�Q�R / Z3/Jl-te—/,�----- MAILING ADDRESS �R� / � ------ -- PHONE _ INSTALLATION LOCATION ` �!/4y /�------- LEGAL DESCRIPTION - k , y �C�5�/�' �S— �`�•1 ��' V-- INSTALLATION OF: SEPTIC TANK _�� //�J SEEPAGE PIT__—o __, DRAIN FIELD. _. OTHER TYPE AND SIZE OF FACILITY TO BE SERVED �! ' TO BE INSTALLED BY �,V� soLL TesT REsu LTs-E/vo//YG- NOTE. THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED — _ _P.ERMIT VALID -D F HAg��� FINAL INSPECTION, 24 HOUR NOTICE: REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL ,,��,t) H�E ,SUBJECT TOPROSECUTION. SEPTIC TANK SIZE -pts TYPEIisrs..ru�e�Cnrx_eleSEEPAGE AREA SIZE TYPE -- MINIMUM DISTANCES, R[:QUIREMENTS ,��. ir-r.r /Ji -��I` / �� 7x DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANKj�C-X� FOUNDATION TO SEEPAGE PIT 20 ft, . DRAIN FIELD 1.0 ft. SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK 5 ft, SEEPAGE_ ..�2Q ft. , DRAIN FIELD TQ ft. TO NEAREST LOT LINE. SO/ .77- l WELL T0.8HE-PJTiE TANK/ G C� .SEEPAGE PI-i-YI 2' DRAIN FIELD(-f� 'L11� J ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK 10 ft • SEEPAGE PIT — 10 ft, DRAIN FIELD ZO ft, SEPTIC TANK. 25 ft,, SEEPAGE PIT 100ft, . DRAIN FIELD �Lft- TO RIVER. LAKE. STREAM. P; •.E i �� �0 r" CA51 IR011 SINIOR srP11C PIPC KITII AIRTIGOT CRIB CAST 11'r - —� welS LA 51 INL1 mlm sn'r.BED SOIL `II Il11:U:I - IIIIIIIdUl1 L I realli rctl elmncvcr Ilnc crosses vNcr Jriec.oy. I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GR DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. DATE 3L) 7 APPLICANT'S SIGNATURE 4RAYEL BACKI'II Lam' . "00" CRIB. (ABLE) 14' HIRINDII ABGCE NATER A IIIGI SEIIER LIR[. -- OPIIS10fR IT F. CAVATI sr D'A 0E Til F.SCAYL11011 RASED 011 gflla• 5011. TEST. Gr4Ge: i'.per !CO' or 1/A" A r Poo' except 10' preuedi IIOUSE - tenk 6 t64. ,Hou1J not acted 7%. 6` Pcr 100 ,. flat CAST IEOrI. q �� .SEPTICferrel.,. I'ITL 5' TAIM 111To 1!!I- I'-__� a IHOI ...... G �) CAST IRGI! SINI0R PIPE SDIL ; \ �SEEPAGE PIT :J JJ—CRIB t_IG� GRAVEL DACKFILL HIHIMIR4 UGH ORDINANCE NO. ILl P! Ili "FILL Qf: (s CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF - EXCAVATION 9 FEET INTO UNDISTURBED SOIL, ". Il i'.-- Sol 10 PIT- 100' 1. SLEER L1HE- 10 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT ® r I11_OI.IC FITTED WITH AIRTIGHT REMOVABLE CAPS.10 QC- GO- LD `I.Yp AO GRAVEL BACKFILL C�[If(�y/ys'�� !ILI opL'r `J CONFORM TO BOROUGH REGULATIO/1/S REGARDING INSTALLA REGARDING1'W III I'It - e�TOHFiITY II — nI.'I'll SnI1TCE III H .=i�1:9mTI0n OR LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GR DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. DATE 3L) 7 APPLICANT'S SIGNATURE 4RAYEL BACKI'II Lam' . "00" CRIB. (ABLE) 14' HIRINDII ABGCE NATER A IIIGI SEIIER LIR[. -- OPIIS10fR IT F. CAVATI sr D'A 0E Til F.SCAYL11011 RASED 011 gflla• 5011. TEST. Gr4Ge: i'.per !CO' or 1/A" A r Poo' except 10' preuedi IIOUSE - tenk 6 t64. ,Hou1J not acted 7%. 6` Pcr 100 ,. flat CAST IEOrI. q �� .SEPTICferrel.,. I'ITL 5' TAIM 111To 1!!I- I'-__� a IHOI ...... G �) CAST IRGI! SINI0R PIPE SDIL ; \ �SEEPAGE PIT :J JJ—CRIB t_IG� GRAVEL DACKFILL HIHIMIR4 UGH ORDINANCE NO. 26.68 AM/ THATTHE ABOVE C ons. Ovation ge_4t Za,% "One test is worth a thousand opinions" 5629 TU OR ROAD. ANCHORAGE., ALASKA 99507 O TELEPHONE 333.8472 ,�✓ .7 Performed For z/° t^A'f Date Performed Legal Oescrintion: Lot t) Block SubdivisionV, This Form Renorts Soils Log�j I� — PerCO�Test— -- Tenth ��ll Feet Soil Characteristics pk,-- 1 n Was Ground Water Encountered? " If Yes, At what Depth? '— L_i i i i Reading Date Gross Time Net Time Depth to H?0 I Net Drop - it '— L_i i i i Reading Date Gross Time Net Time Depth to H?0 I Net Drop Percolation Rate Minute Proposed Installation: Seenaae Pit Drain Field Deoth of Inlet Depth To ottom Of Pit Or Trench / rnMVENT.S: Lll /�✓/J C" Test Performed By�% /fC�/_'--- Data Certified By:(�Yvi��� m -/l i"/7i /v/�C/f.'r- Date:^ February 25, 1973 Mr. Rubert E. barker SRA pox 1749-1 1, Anchorage, Alaska 9950L subject: Lot 5, Skyview Estates Subdivision Tho"K you for respunuinq to or. Lee's letter of Nbruary 23. 190. We K,Vc a xLended your Sewer" pc:rrrit, and I'vew e:ncluse6 your Copy for your recorus. Please note the three i,tcos which have been CnanUcd, in GumpliunCe with Lou Whe of Alaska t_1lrjunuy SoWa9L u'ispusai Act: 1) Distance fruit: well to septic tank is 100 f'o t. 2) uistancps from well to nu paqu .area is 110 Feet.. 3) The septic tank size must be 1,000 U011.0"s or Ureater. Any var'ii.= Un W above jai` LoucLs KuSt: hu obtain" from from KylC Cherry, &tilt, Uf Alaska, oup6rLmant of I: Viron- henLal CO"SOVvitiGn iind must he sub"tud to our offs" in writinu. Prior to isCLU61 installation, you Mit nowu a soli "S" a copy of which roust be submitted to our office. Pruvidiny the test: is within approver.! limits, you will be allowed Lo pru-. coati with the upgrade. in any event, your system wast r.;r.ut applicable requirements by ,July 1, 1173. sin ccrely , Susan L. uickerson sanitarian kt tic insure Certified Jo, 67065ej o SENDER: Be sure to follow instructions oCHECKEDside BLOCK(S) rn;particle INDICATEDBYCE(S)charges Tegaired for Giese servicedDeIIVer ONLY te and address RECEIPT Received the numbered artiele deserlbed below F— -��7i SI D 1 OF ADD SEE (ASu�se'aUs b� A aNSURE C W ATE K GREATER ANCHORAGE AREA BOROUGH DEPT, OF ENVIRONMENTAL QUALITY RFCEIf T FOR CERTIFIFR MAII_-30(` (T, SENT TO STREET AND N0, P.O., STATE AND ZIP CODE OPTIONAL LSERVICES who, aAUDITI0 do FEES flEYURN Wilh Delivery to addressee Only d 85q RECEIPT g, Shores to whom, dale and rvhere delivered .. 35C SERVICES With dehVely to addressee only 50 SPECIAL DELIVERY (axlra Eao rogorta----""" 3000 NO INSURANCE FOR OEINTF.RNATIONAL COVERAGE PROVIDED— FarmMNL> aeoeB.,. mo."se Nov. 1971 -- 1-S ) C ij t- P GREATER ANCHORAGE AREA BOROUGH DEPT, OF ENVIRONMENTAL QUALITY RFCEIf T FOR CERTIFIFR MAII_-30(` (T, SENT TO STREET AND N0, P.O., STATE AND ZIP CODE OPTIONAL LSERVICES who, aAUDITI0 do FEES flEYURN Wilh Delivery to addressee Only d 85q RECEIPT g, Shores to whom, dale and rvhere delivered .. 35C SERVICES With dehVely to addressee only 50 SPECIAL DELIVERY (axlra Eao rogorta----""" 3000 NO INSURANCE FOR OEINTF.RNATIONAL COVERAGE PROVIDED— FarmMNL> aeoeB.,. mo."se Nov. 1971 -- February 26, 1973 � u' �� f;J 1? leu ue l"ti t.. Orr i1 Nildred F. Imle-r .,A uUA 174 9-1, neer Ar; nn ,U'wer sys Lew curraacly io 11511 UH cnn +'iUbWI; fOl. s an anuourovou uasspaul. l.'S517Vo Is as 0 mt?LI d OF sewdiU(: Uisposal are l lle'gal in tHu Grunter Amchora4e Area 8orouyh "nu wu wust r'O(Iuust thaL an dpprovou sIoptic sysL:'n bu, installeu on or befure July 1, 157::x. If yUUr all is Lu also Serve I_UL A. GM bedrest Sower Ifni! nusL bU 4U VoL iron Lou Mll,thu OcaVUSC =t" Prior tiro, :,ii ice, anu Lnu nvAresc iaepR hit. IN Foot, Prior 46 installdLion, a perwiL will to re{iiiro. ana ions$ OQ uI Lpinuu fr'Uiii Luis deparLliiLrlL Within thirty (aO) r!irys. -'your CoUperdtion is requ cSLud. A ncurely, J 12 John ii. Lee Lnvironmental Servicas : upurvisur KC Lurtlfiud filo. 151595 (i�C�IP� F9�t eI,e .i 4r fvirili,�ps; (plNs postage) . POSTMARK OR DATE - SENT TO _� STREET AND N0. 1 T7 -- ,—i P.O., STATE AND ZIP CODEOPTIONAL I ' (.i — 1 _ERVICES F9R —ADDITIONAL FEE ¢ whom and tlatc dclivere0 - fi5C RETURN With delivery 10 addressee only nECEIPT p. Shows m vh¢m, Gate and �!nere delivered ,. 851 SERVICES With Iellvery to no only DELIVER TO ADDRESSEE ONLY - --" -- e �SI'ECIAl, DELIVERY (extra f roquired) IID INSDRANCE COVERAGE PROVIDED— PS Form 3800 saPo¢¢o odor side) APc. )9V) 1707 FOR HITF.HlIA-11ORAL MAIL SENDER: Be sure to follow Instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Additional charges required for LAeee services) ❑Show to whom, date and address Deliver ONLY where delivered 91 to addressee RECEIPT Recelved the numbered article described below REGISTEREDNO. SIGNATURE OR ME-` ADDRESSEE(dlll9t atrvage be filled in) L ee 1 ll CERTIFIED N0. 1515 E . 5 SIGN TORE 0 ADDRESSE S AGENT, I 80 `xv Insu NOW FLsI DATE DELIVER D S O HERE DEL ERED (C >Vjf jgjyNd,pso i incllude ZIP Code) F 3 M�ad ',a C) ,J GREATER ANCHORAGE AREA BOROUGH 4P,po�annaE�gf 3500 TUDOR ROAD z�.°� rl n90o ANCHORAGE, ALASKA 99507 DEPARTMENT OF ENVIRONMENTAL QUALITY 1ry�j EuO JP11 December 5, 1972 Robert E. Barkers°v St. Rt. A, Box 1749-A Anchorage, Alaska 99507 a Tq $PIP0 Subject: Permit to install sewer system Dear Sir: A permit was issued to you by this Department for the installation of an on-site sewer system and at this time we have no record of this system having been installed. Please complete this form and return it to this Department at your earliest convenience. yes no I� 1. The system has been installed. 2. The system will be installed later this year. -3. Void my permit; the system will not be installed. 4. The system will be constructed during the next construction season. Your cooperation is requested as we have a great number of outstanding permits for 1972 and we would like to clear our permit files out as much as possible. Thank you, 5;4 1? �I �o ohn R. Lee, R.S. Environmental Services Supervisor Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 6 16_ 53('58 COSH# (%05°13 1. GENERAL INFORMATION Expiration Date: 3 _a 1— O 7 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SKYVIEW ESTATES: LOT 5 2641 JEFF CIRCLE " ANCHORAGE AK 99516 SHELLY BRYANT Day phone 373-2036 4950 E. JOHN—JOHN COURT * WASILLA AK 99654 Day phone F S R O Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑ ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site 0 Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my --4 investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Gufdelineslor4his application, shows that the on-site watersupply and/or wastewater disposal system is (are) safe, functional and adequate., for the number of bedrooms and type of structure indicated herein. 1 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. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ✓ Approved for 1+ bedrooms. Disapproved. Phone 337-6179 Date 12 Zo o6 M • yf y.e,-yarness.• o iV1 CE -7953 add Conditional approval for bedrooms, with the filowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other ON-SITE WATER AND WASTEWATER PROGRAM �••••••.LS .. By:— Original Certificate Date: — 0Z — 0 td (Rw. 11M) Municipality of Anchorage .• • Development Services Department Building Safety Division :. .. On -Site Water 6 Wastewater Program 4700 Bragsw Street P.O. Box 196850 Anchorage. AK 99519-660 www.muni.mg/onsits (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SK)MEW ESTATES: LOT 5 Parcel ID: A. WELL DATA Well type PRIVATEN A If A. B, or C provide PWSID# � Well Log (YM) NO Date completed PRE 1973 Sanitary seal (YIN) YES Wires prop" protected (YM) YES Total depth 81 It. Cased to 72 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1/17/2006 4 Static water level ft. 36 ft. NO Well production g.p.m. 10 g.p.m. WATER SAMPLE RESULTS: p. / 9 qct Coliform _t) colonies/100 ml. Nitrate �m ./L. Other bacteria colonies/100 ml. Arsenic: te• t%gJL. Date of sample: l2 12 2006 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER Tank Type/Material Data installed _ Tank size gal. Number of Compartments anouts Foundation cleanout (YM) Date C. ABSORPTION FIELD DATA Pumper tank (YIN) _ High water alarm (Y/N) PUBLIC SEWER Date installed Soil rating (g•P•d./ft'or ft'/bdrm) _ System type _ Length ft. Width ft. Grav Pipe ft. Total depth ft. Eff. absorption area _ fl' Monttori Depression over field Date of adequacy test Res ass/Fail) For bedrooms Fluid depth in absorption field be _ in. Water added _gal. New depth _in. Elapsed Time: Pint fluid depth _ in. Absorption rate >= 9•Rd• halloo treatment (past 12 mo.) (YM & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _in. Size In gallons High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A Absorption Heid on lot - N/A Public sewer main *50' Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent kits 100'+ Public sewer manhole/cleanout •50' Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: PUBLIC SEWER Building foundation Property line Water main Water serviraline' Surface water Wells SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: PUBLIC SEWER Property line Building foundation Water main Water service line Surface Driveway, parking/vehide storage Wells on adjacent lots F. COMMENTS WAIVER #12818 G. ENGINEER'S CERTIFICATION I certify that l have determined through field krspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date I'Z/zo/06 COSA Fee $ YY3c) f / %S h?I.c Cl, Date of Payment %.2QA, 6 Receipt Number. 3 %Yd 9 (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number SGS ReEN 1007237001 All Dales/Times are Alaska Standard Time Client Name Gamcss Engineering Group, Ltd. Printed Datelfime 12/19/2006 17:02 Project Nsme/p Skyvicw Est Lot 5 Collected Datelfime 12/12/2006 10:35 Client Sample ID Skyvicw Est Lot 5 Received Date/time 12/122006 14:28 Matrix Drinking Watcr Technical Director Stephen C. Ede P%N SID 0 Samplc Remarks: Allowable Prep Analysts o...__.... Results . PQL Units Method Container ID Limits Date Date Init Metals by ICP/M9 Arsenic 6.48 Waters Department Nitrate -N 0.185 Microbiology Laboratory Total Coliform 1 OD. No Coli 5.06 ug/L EP200.8 0.100 mg/L EPA 353.2 C (<10) 12113/0612/18/06 TK D (<10) coUl00mL SM209222D A (<I) 12/13/06 ALR 12/12/06 DPT JHN-11—"Laab a'L :•+`� YM KGL.LIGS.UNL 1 ML IV • .� ..�..,+.. /o' carie . �►.rnr. wwo 70 A A c►♦v f.. yar opt aaaa E.e/jr on •t� l'IA.•C 7 IL+•may �'•If:: :.{, l[QAb• f �� I JE (.,i♦7^� r�y%OX iS�♦ Nor"' J dor p` /o 9g 2 f �YaM psc�s ' 0 Q C a \1 �i UI•DER NO CYICUWSTANM3 SK= AN AS-UAT K USIM rM CONST)UCfad Oa ran CSTAgulwo /WNCMY OR ro= L&, '�•C fJrKYCR T"m RCSIN asiilTU rO! TN[ II mak TRANSACTm ONLY ANO AiTU1K] FNMlCI& LIASC.TY ONLY COR TMC COST Or TN( SURKY. LISTED 04ST06a1 PREVAIL OAR SWING. ROMODUCTION WAY CALL= CMM N SCALE SURVEY TYPE SY480L5 nuc+uc .s_"T KT RLSAR,� WDRANAOC •.t' ruw .. .s.w,.T • SafncT ... YaorlAw{r O FOUND RE1AR roan rDa t—!'1- cometur —•-da• — cab t' (' ® AWYm CM urr4 rnC rT77-7I .wn...... M -CA 00 NOT APPEAR SURVEY CERTIFICATIO+ >r .F /rl M M pw� yY.Y �.n..rwwrw YrNww. VtiMM•I w� Y•. w .w— .ID.� •l -W47 L 1MVC:IY:E 4-4LILT .nt �.I. �•. �h M1 {w. H M.w•.OY Y r.� ..� w�'M wVww-Yy Y• Ar 4 Of E UOMS• 4121—S 10 ONLY THOS[ W*0% IK WOW. mom %be I!K CTC., AR[ WOW N NS MAY PRCV04T SOY[ RT. ALL DISTANCE! A Robert E. SONO ns, Jr. & Assoc. .Land Surveyors RK. Yl S/. VK. n0{ rl1 MG " � 3D{ tORld 7T-1 nt LOT i. SKYVIEW ESTATES SUBDIVISION Y.c�Jir. Municipality of Anchorage l j, D velopment Services Department =• \ Building Safely Division Onsite Water 6 Wastewater Program a 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 15' 5 31 -5-9 COSA# 0660 :3 3 1. GENERAL INFORMATION Expiration Date: S— / 0 Complete legal description SKYVIEW ESTATES: LOT 5. Location (site address or directions) 2641 JEFF CIRCLE " ANCHORAGE. AK 99516 Current Property owner(s) BILL MAXIM Day phone 907-344-0077 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 2641 JEFF CIRCLE * ANCHORAGE. AK 99516 GREG ERKIN w/ EMAIL REAL ESTATE Day phone Dayphone 907-562-3382 3820 LAKE OTIS PARKWAY ANCHORAGE, AK 99508 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ]♦ Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer N The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal andior water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 onsite water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 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 CARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. CARNESS, P.E. Date (� 7 Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may auduato during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sore benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE 1� Approved for 4 bedrooms. Disapproved. J ff4y mess 7953 Qs„ '•I.'..��J Conditional approval for bedrooms, with the filowing stipulations: Attachments: COSA Checklist l/ Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Manitenance Agreements Supplemental Engineer's Reort Other WATER AND r VVASfi€WATfR = PROGRAM By; Original Certificate Date: — (R". /7101) D. LIFT STATION Data installed "Pump on" level at _in. Datum E. SEPARATION DISTANCES Size in gallons High water alar level at Cycles tested Meets alar 8 circuit requirements?. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/Oft station on lot N/A On adjacent lots Absorption field on lot N/A On adjacent lots 100'+ Public sewer main *50 Public sewer manhole/cleanout '50' Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Wells on Property Water Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: PUBLIC SEWER Property line Water service fine Curtai F. COMMENTS WAIVER #'12818 G. ENGINEER'S Budding foundation Water Weds on adjacent lots parking/vehicle storage I certify that I have determined through field inspections and review of Municipal records that the above systems are in """' ' ' ' "" "". • """ �rmance with MOA COSA guidelines in effect on this ............ date. ......... ..... f eY nese: Engineers Printed No -1a JEFFREY A. GARNESS C Date 11,1 04 • ''t �. � ! pb�� ` COSA Fee E f' a) Waiver Fee $ Date of Payment Z H 10(, Date of Payment Receipt Number �� Receipt Number (Rev. 12/01) Municipality of Anchorage a e, • Development Services Department Building Safety Division ` On -Site Water & Wastewater Program ' { 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SKYVIEW ESTATES: LOT 5, Parcel ID: 01-6--531-S'9 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Date completed PRE 1973 Sanitary seal (YIN) YES Total depth 81 ft. Cased to 72 ft. FROM WELL LOG Date of test ef Static water level ft. Well production 9.p -m. WATER SAMPLE RESULTS: Well Log (Y/N) NO Wires property protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 1/17/2006 11 10 g.p.m. Coliform 0 colonies/100 ml. Nitrate 0.1 mg./L. Other bacteria 3 colonies/100 ml. Arsenic: <5.0 ug./L. Date of sample: 1/17/2006 Collected by: GEG Ltd. B. SEPTIC/HOLDINGTANK DATA PUBLIC SEWER Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (Y/N) _ D over tank (YIN) Date Pumper Date installed (YIN) High water alarm (Y/N) C. ABSORPTION FIELD DATA PUBLIC SEWER Date installed Soil rating (g.p.dJft'or ft'/bdrm)_ System type Length ft. Width ft. Gray i pipe ft. Total depth ft. Eff. absorption area _ ft' Monit� Depression over field Date of adequacy test Res ass/Fail) For bedrooms Fluid depth in absorption Heid be _ in. Water added _gal. New depth _in. Elapsed Time: Final fluid depth _ in. Absorption rate >= g.p.d. treatment (past 12 mo.) (YIN 8 type) If yes, give date SGS/CT&E ENVIRONMENTAL SERVICES -S %.�— . : nn (;Z� nn Drinking Water Analysis Re READ INSTRUCTIONS ON REVERSE SIDE SEFOR4 MUST BE COMPLETED BY WATER SUPPLIER - -- - [3 PUBUC WATER SYSTEM IDS ❑ PRIVATER SYSTEM Send Re sults ❑. Send"Vote SAMPLE COLLECTION: Date: F FTJ 'I LS�].[l-iLiJ wn W r— 200 W. POTTER DRIVE ANCHORAGE, ALASKA 99518 Tel: 907.5e2-2343, Fax 907.5515301 lab Ret Na ' 10602ryu�7ggYYpHIIIp6ppmml�own 1 0 Send Renih 08and Irwoke SAMPLE TYPE R Routine ❑ Treated Wator ❑ Repeat Sample E3 Untreated Water (refer to lab no. 1 ❑ Special Purpose TransvoAed (� . to lab e)r.. MoSame as collector Other - TO BE COMPLETED BY LABORATORY ' Sample Recetvina• / / 6 0S8mPMaw30lnuso1d. ❑ RUSH SAMPLE Reach mey be onraeable Temp: Delivery Method: Received By. L G Cornmerds: ss Hour Wsivar , F'tione #: /For It m teneons t A .............................................................................................................................................. Bacteriological Water Analysis Record: SerM IO ADEC: MMO•MUO (P1A) RESULTS: ANC FBK .NN Analysis Began: / /716 /730 Tont Collftsm IDstafrinne- Analyst 7� Analytical Method: Membrane Fitter MMO-MUG (PIA) Reported By. —� t&prgare E Cd[ _ SerM 10 CderR MEMBRANE FILTER RESULTS: Phoned 0 Faxed Direct Count IPA Coonbs1100ML DaterTbne- VermcalINT 1✓4 SDoks with, wror. • LTB. . BCB• � Satisfactory ,..,.. { EC Unsatisfactory D 1MTC �T.s Nw.rweY e»e1 DatelTlme: "A/ Crl w.grn..e»w Form R FW 0053 12/17103 1Wsesinas0l%AN Group0ata\Public\DOCUMENTIFORMSIapprovedlCoI Form 121703xis SCS Retia 1060276001 Client Name Gamcss Enginccring Group, Ltd. Project lamel# Skyvicw Est Lot 5 Client Sample ID Skyvicw Est Lot 5 Matrix Drinking Watcr Sample Remarks: All Datesfl7mes are Alaska Standard Time Printed Date/Time 0123/2006 14:46 Collected Datefrime 01/172006 13.15 Recehed Date/Time 01/172006 13:40 Technical Director Stephen C. Ede Parameter Results PQL Units Method Allowable Container ID Limits Prep Date Analysis Date Init Nitratc-N 0.100 U 0.100 m8/L EPA 353.2 D (<=10) 01/17/06 AZS Metals by ICP/MS Arsenic 5.00 U Microbiology Laboratory Total Colirorm 3 OD. No Coli 5.00 u8/L EP200.8 C co1/100mL SM20922211 A (al) 01/17/06 0123/06 SCL 01/17/06 TLF aMAN-26-2006 10:57 AM KELLIES.UNLIMITD 907 522 0088 ■ Jan 26,2006 To Whom It May Concern: The well located at Lot 5 ew Estates has been vidcocd down to 72 Ft. No perforations where cafe . Total Well Depth Is V FtO Inchey Brian Willie Manger Aarow pump Well Service P.01 JAN -11-2006 02:49 PM KELLIES.UNLIMITD 907 522 0088 P.02 q AA.'MM 1Pfr •• • • • • M N) ! It r Iv 7 nan n•vr.. • • O � 4' ) -f♦ t t I��.•t ): �', ,.••i{;_ -,a , VZ7ne� • �lt\� Glsnoyi I C atiQy I ;\ � C JE F,C I o L Koybox is 6' tiBr• s.7' .s croen ffe )0" io v'.0 p Coo rflty - G VNOER No CKW>rtTAMCES ZP+WID AN �S-MMT RUlan /Oil I '.•f A'tiRKTCR TABS RCS►oNaoRAM . ►pl ►RETMC "%#4' ]SACTId ONLY µ40YltuC11W d I01 bTAOEt�1u0 80UMOARY OR FU CC L&CL USTCO dSTAMgS YA4 OVQ SOAlDIF. ROROpOC}p1�yAY'T� UOAL V My AOR TN[ CM Or Os."Oft= IN TM SURKr, u,c� c.,o.•.-RlT SURVEY TYPE "Ou f'.uCMt .f -.yet • 1CT 40M r- •.C' RAM.. ,V-waT... wln ... 7ofq�NR 0 fowa F43L#X 'L L_'�?'� AWMALT °LG PUNS k l ® AL.R101 LIEU. y.y� W rmcf oONd1[1C * Is Yrc RcsvoNs�luTt or "O0p oEeR 'ONSTRUCTON, OR owatm To VERIry ►RWOSC -AOR To oNLY TNofl( YVRo�da .O .IM,SMCC CRAor AMO u7jurr CONNE OLMUN O 21 RLLArK »AMOK OROyNO AMO NLO�E MULL INC +'E EAST 'rC ne "'- -_ CTla.t AYQ to n...�..-,. w '•_ �+OEL *CLL& lfsne ., ....,..� S'.1RVEv CCRrncAroN )T PLM ALL OffJTANO" Aar RCCOR V- 1[LOT O NLCSfJl8-nO OTf.[R[NwIANCSC NOTYC.CALO. repore y Robert E. Johns, Jr. & Assoc. ProfeSSiond Land Surveyors 841 E 11 AML AMOCR04L MA&A ft&M MII� M *:3C'1 -71-105 RK l.t L. R«. r•w n...e. -1� ]OAfe �. LO -.2I _05 O•�w�l. O�.nw AX LOT 5, SKYYIEW ESTATES SUBDIVISION ....... ... .. ... ...... 77: romill SEWER IMPROVEMENTS 4 SKYVIEW ESTATES L.I.D. NO. 175 Es 2 7 2634 Y-1- 5440 USED AND USEvUL OCTOBER 29, 1981 JUNWU Was 9486-4891-3524 0y STAMP :PE( ......... .FOR . .. . .. .... ........ .. ... ... . 290 .......... . ......... .. . . . . . . . . . . . . . . ........ ...... . . . . . . . . . . . . . . . . . . . . . . . . . . . .:,285........ . . . . . . . . . i ....... -1 . . . . . . . . . ...... . ...... .... .. ... ......... ...... . ....... . ....... ...... . ........ ...... .. .. .... .... ........ .. . ..... I .. - + . ....... . .. ftm =.T.. 7.7 t—'L: ...... = .. . ....... . .. ........ j. .................... :: ....... .... .. .. ... .... .... "IN Y_. ....... ... .. ... ...... 77: romill SEWER IMPROVEMENTS 4 SKYVIEW ESTATES L.I.D. NO. 175 Es 2 7 2634 Y-1- 5440 USED AND USEvUL OCTOBER 29, 1981 JUNWU Was 9486-4891-3524 0y 1> llWPMG0VrRA0* STEVE CO Nr� DCJ�T. OF FNVERON,"ENTAL CONSERVATION 437 E274-2533 Street FACILITYCONSTRUCTION AND OPERATION Suite 200 May 13, 1987 :Tec 1. aanara.Bryan, Assistant Administrator ,T ' nical'Services j'Aii Waterfand Wastewater Utility cgeic 390ohoArct:Boulevard Y A -1c oraqe.`AK-;99503-3898 ..RE. Final Plans and 'Well Specifications Regulation Waivers Der mat ver 56-7 ADEC,Project N_ 0 S..,.Bryan.. le.1final -.'plans and ;Jor'. e :referenced Of .CO er" to Approval given Othou 12818 specifications and Project have been Department. This on this same date. Anchorage, AK 99501 AWWu ' 8. MAY 141987 Technical SPrvi_,.! requested well/sewer re distance 4 viewed and are approved for-�77- .written approval confirms 'My ,-,ine;referenced LIDproject will consist of furnishing and installing roxiarateI 64*lfnear feet Of 12 -inch ductile Jf iron sewer Pipe approximately ar. eet:b -Inch ductile iron sewer Pig. 7 type 'A' ,approximately "sewer les,'11 -unitary:sewer service connection ) n.1 ta to property line d 'related te nces-" 11 Of this construction is grant eligible work un lt�pa rd for reimbursement Purposes,Ms r the ADEC de 'Lynda Barber's engineering report that requested waiver approvals to_ ltsin'ind:;6perite the Skyview Estates LID No. 17S sanitary sewer cloier me ,Private drinking water Source and two (2) Class C ees'than Yillcwed by the State Wastewater Disposal Regulations, 16public water - AAC .72. OnSideredr'.CoMplete. -The report, along with the final contract documents,.. fded;the:physfcal factors and proposed Mitigation measures needed to pro- theserdri nking water Sources. We find the project design and its required 7 I Mt. Sandra Bryan-A80 .,.,May 13„1981.• Page Two special provisions in the contract documents to apply heat shrink tubing to the pipeline Joints and eementitious manhole waterproofing to the manholes within the, protective well radii will allow or Justify the lesser separation distances. ':Therefore, in accordance with 18 AAC 72,021(c), the following ^regulation waivers are granted. Lot'27, Block 5, Bruin Park Subdivision: .Approximately 57 feet between private well and Manhole 05; approximately 25 feet of sewer pipe within the protective well radius of private well with the closest edge of pipeline being } ,'approximately 53 feet from well. Lots'6 and 6, Skyvfew Estates Subdivision: Approximately 50 feet between Class C public well on lot 5 and Manhole 17 (terminal) and approximately 100 feet between Class C public well on lot 6 and Manhole /7 (terminal); Approximately feet of Class Public wwell ao lott5iwith thn the en clo est edgeotective wellof Pipeline being approximately 52 feet from well. The sewerllne�crosses over an existing 24-inch waterline at two locations, One ,pis at the entrance of Jeff Circle and the other is at the intersection of 112th Avenue and Lake Otfs Road. The designed plans show both to have greater separa ;.tion than'the minimum 18 inches. However, during construction at these eros slogs, the owners inspectors must verify construction compliance. :Please forward.copies of the bid tabulations; executed (signed) construction i lwntract;and notice-to-proceed with construction when available, it 1i 4 , Sincerely. -:29eery'ypn�l�I j'' / V 'GM.bk,. Construction Grants Engineer s 1 1 s S raaxxars® . -