Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SKYWAY PARK ESTATES BLK 4 LT 6A
Skyway Park Lot 6A #019-141-26 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251240 PID Number: 019-141-26 Dwelling: Z Single Family (SF) El with ADU El Duplex (D) n Two Single Family Project: [1 New Z Upgrade Name TERRY & MARTHA WASCHKE ABSORPTION FIELD - EXISTING El Deep Trench n Wide Trench n Bed El Mound Site Address 11901 TOY DRIVE, ANCHORAGE E] Other Phone Number of Bedrooms Soil Rating depth from original grade 1 4 GPD/SF ITotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SKYWAY PARK ESTATES 4 6A Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft Ft. Well *77+ *77'+ 25'+ TANK E Septic 0 S.T.E.P. El Holding [3 Other Manufacturer ANCHORAGE TANK Capacity (1 500-gal total) 1250 Gal. Surface Water 100'+ 100'+ Material EPDXY STEEL Number of compartments 2 Lot Line 5'+ 5'+ NA Foundation 10'+ 10'+ LIFT STATION ORENCO Capacity 250 Gal. IManufacturer Remarks Anchored epoxy steel STEP (1 500-gal total). *Amend existing waiver to 77'from interior well to STEP. Alarm location SW SIDE ROOM Electrical installed by BRICKWELL Installer MIKE N ANDERSON, PE (MNA) Tankto PIPE MATERIAL House to tank 3034 drainfield 3034 Drainfield CO/MT 3034 Inspector MNA & FWCS BENCH MARK (Assumed elevation) 100 It Inspdatesn ectio15' 8/13/2025 2 nd 8/14/25 : Location and description 3'd 10/15/21 4 th ITOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL �kk OF Ak_'N Conditional Approval: Date &4# TH 4. Curtis Huffman Septic Syste Approved - Date CE 128991 t\�q Awl' Note: this does include Aw 91/06/26. *�\\� k�, OPROFiSWW�� approval not well permit requirements. (Rev 05/02/18) P I D: 0 19-141-26 PERMIT: OSP251240 I LOT 313 A-C=30.2' B-C=56,5' A-D=31.5' B-D=58.3' A-E=38.0' B-E=65.5' 110 u 7 �J%j 'j f 330.45 - — — — — — — — — — I — *�N I C4 WALk-ky SH D FENCE FIRE LOT 0 /A MICHAEL N AND SON. PE SAID STEP WAS I IN THE SAME LOCATION OF E 9 PREVIOUSLY EN G TANK & REQUEST E REVIOUS WELL AMENDED TO OM WELL TO ppRo"v L JVG OCA MH 2,o WELL 9 r- IT BLOCK PATIO POWER * POLE WOOD PATIO L -J[- VERI & MAINTAINED E 7 np LD TO STEP 0 URIVEWA INSTALLED 77.r FROM DECOMMISSIONED EXISTING WELL & REQUEST SEPTIC TANK & LIFT STATION PREVIOUS WAIVER BE AMENDED TO 7r D INSTALLED NEW ANCHORED 1500-GAL ioo, EPDXY STEEL TANK 3 AND RECONNECTED 444 N, TO EXISTING SYSTEM, APPROX i WELL RAE SEPTIC SECTION SCALE, NTS SKYWAY PARK ESTATES BLOCK 4 LOT 6A PREPARED FOR: TERRY & MARTHA WASCHKE 11901 TOY DR ANCHORAGE, AK 99515 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmail.com SHED I Z'uI-FuK StKvlutti: OF A44 'OF Of NTH Fj* DATE: 01/06/2026 0 ZtAisj Huffman SURVEY: HOLT CE , 128991 DRAWN: FWCS 01 /06/26 SCALE: 1" = 30' PAGE: 1 OF 1 0 F-vrsl CONSULTING 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com February 9, 2026 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: AMDENDENT TO WELL TO STEP SEPTIC TANK WAIVER LEGAL: SKYWAY PARK ESTATES BLOCK 4, LOT 6A Per previous request and information provided, we are requesting the existing DEC waiver 8521- WA-016 be amended or issued by the MOA to 77'. Amendment of the existing waiver is justified because the well is protected inside of the residence, the area gradient slopes away from the well and any effluent surfacing from the septic tank (STEP) would not reach the well with any path of surface contamination flowing westward towards Toy Drive away from the well. The STEP tank is visible, and any surfacing effluent would be readily visible and corrected if noticed. The STEP tank is of one unit as compared to the previous 2 components (tank & a separate lift station). The new STEP tank material is of higher quality with epoxy coated 10-gauge steel. Nitrate levels of this Lot 4 in 1988 were 1.8 mg/L and 2.7 mg/L in 1992. The recent nitrate results of 01/30/2026 show 2.39 mg/L, which is less than the previous one taken approximately 34 years ago. This recent result indicates that nitrate levels are stagnant or similar and further demonstrates that this encroachment is justified. From record documents, site & area investigation with new water analysis, the amendment and continuance of this waiver will not impact any of the neighboring properties. Amending or granting of this waiver of 77' from the STEP septic tank to the well is warranted per these justifications & request a 77' waiver from the on -site STEP septic tank & the well be issued. Please contact us if you have any questions. Sincerely, v�— Curtis Huffman, P.E. FirI W d l'11 k. 4 A41[11 FA t,I1F „HNI'!B O OF.A CO 4g LH `9 h'Ae�— s SHANE A. HOLT �� G LS-6914 ,\,°fessiona� �-Qo POND ---- BLOCKRET. WALL FENCE • SEWER SYSTEM P/PE THESURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE OWNER OFRECORD AS OF THEDATE OF THIS SURVEY. ANY USEOF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOD/ ANY CONFLICTS BETNEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES- EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOYN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWNG ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHONN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNON AND/OR ICE. AS-BU/L T SURVEY f " = 30' NO CORNERS SET THIS DATE / HEREBY CERTIFY THA T / HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT6A BLOCK 4 SKYWAYPARKESTATES (PLAT77-87) A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLEIMPROVEMENIS SITUATED THEREON ARE WITHIN THE PROPERTYLINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATEDATANCHORAGE,ALASKA THIS 25TH DAYOF AUGUST 2025 1536 242-19 244-5 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 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: OSP251240 Work Type: SepticTank Upgrade Tax Code Number: 01914126000 Site Legal Address: SKYWAY PARK ESTATES BLK 4 LT 6A G:2729 Site Mailing Address: 11901 TOY DR, Anchorage Owner: WASCHKE TERRY & MARTHA JOINT Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 2,0 r s;. 10 f t?eparet��ent 7/23/2025 7/23/2026 46257 ❑ 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: Issued to FWCS Date: 7/23/2025 Issued By: _ &!;e' [ Date: 4 MUNICIPALITY OF ANCHORAGE At Development Services Department -343-7904 Phone: 907-343-7904 On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 019-141-26 Property owner(s) TERRY & MARTHA WASCHKE Mailing address 11901 TOY DRIVE, ANCHORAGE, AK 99515 Site address 11901 TOY DRIVE, ANCHORAGE, AK 99515 Day phone Legal description SKYWAY PARK ESTATES BLOCK 4, LOT 6A Number of Bedrooms 4 Engineering Firm FIRST WATER CONSULTING Building Permit Number APPLICATION IS FOR: (Z all that apply) Disposal Field ❑ 91 El D R 1-1 Septic Tank Holding Tank Privy Well Water Storage Not Applicable X APPLICATION IS AN: Initial D Upgrade nx Renewal 1-1 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: 01?� Date of Payment: 711(01'2- Permit No. 05P2512't6; May 2025 Waiver Fees: Date of Payment: Waiver No. Distance: 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! July 16, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SKYWAY PARK ESTATES BLOCK 4, LOT 6A The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon epoxy steel STEP septic tank per the attached design to serve the existing 4-bedroom residence. An existing waiver of 84’ to the current tank exists and due to the field area, etc…this separation is to maintained. The 84’ well radius is to be staked prior to installation. Groundwater was noted in the MOA on-site file, but if shallow groundwater is encountered during installation the tank may need to be anchored or other action may be required. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. 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 OSP251240, Ben Cogger, 07/23/25 24.1 7.0 8. 0 30.2 47 .8 8.1 26. 2 35.5 14 . 2 1.9 11 . 9 2.0 7. 7 6.7 15 . 5 8.0 12 . 1 7.9 12. 6 9.5 11.3 FIRST WATER CONSULTING SKYWAY PARK ESTATES BLOCK 4 LOT 6A DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251240, Ben Cogger, 07/23/25 ,~ ~ MUNICIPALITY OF ANCHORAGE /~/ · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION '-~-/- ~ L~ 825 L street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS EGAL DESCRIPTION LOCATION PHONE [~N EW ,~/~ - C~;~'~' [] UPGRADE NO, OF BEDROOMS Well z Absorption area ]Liq capac ty n ga ons ] _ ] Inside length /~ ~0 IF HOMEMADu: DISTANCE TO:~ell /Dw "ir'g ] DISTAN Well Foundation/ Length Width Depth DISTANCE TO: g DISTANCE TO Building foundation Sewer Fine IDwelllng ~c~ / Materia]~/O z Nearest lot line Trench widt~c9 inches inches ¥ No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Total effective absorption area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line J PERMITPERMIT NO, Septic tank ~o~ ~rea(s) I OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED DATE LEGAL 72-013 (Rev, 3/78) PERM]:T' NO. FIF'F'I... ): _'" FIHT E:ETT'.r' J CHFINB, LER F'O E, .. =. 4:J.~.... FINCI'"IORFIGE 5~:95'E::1. _'..44-.~,...,~:,..., L. 0 C FI T I 0 I",1 LEGFtL L..E;FI E4 '..:.,K"r'i..IFl"r' F'K E::,] "II'E:.', L. OT :,Ia.l: '/~ ::;k:~ '3 'S ::.: $6!IJFIRE E'EET '1 rFE OF' :,uIL RE_uFJ lION _.,~_lEli .[ .... :'HE LENGTH [:,IMENSION IE; THE LENGTH '.':IN FEET) OF THE TRENC:H OR [:,RRINFIEL.[:,. THE [:,EPTFI OF R TRENCH OR PIT I:5 THE DiSTI:~NCE BE:TWEE:N "tHE ~;(iI~F'RC:E OF :'FIE GROUND RND TI-IE BOTTOH OF THE EXCR',,,'RTZON ,:;ZN FEIET). THERE Z5 NO E;ET P.IIDTN FOR TRENCNES. THE GFrRVEL DEP'FH I~5 THE MINIMUM DEPTN OF GRFIVEL BETWEEN 'THE OUTI::'RL.I_ PIPE RND THE BOTTOH OF' THE EXCRVFITZON/(ZN' FEET). F'ERMIT I:tPF'LZE:F:II"~T HFI~S "FHE ;'""¢ '- ': ........... . ","r F.. E ~ F - ~ ~.:", 11 .~ ]. L i F 'r '[' 0 I N F 0 R 1'"1 ] ~ ] .[ .:, [:, E F' FI R TM E N T E:' I..I R Z N G T H E ......... '=' '" -' " " '-' rFIZ_, F RUFERT~ Rf.,IE:, THE Z P~: T LLr. PI I Z. N Z [ L ~ EL.: Z JN., ElF Fllq'¢ I JELL:, RD.J'I:II:}EI",KF TCl '' '= :' ' - ' - '" ' .' NUHE:ER OF I..E...,ZEENLE.. THFIT THE WELL. P.IZLL SERVE. ............... -~' ~r'"'~ ~=~ ":" ,=:: H'" :E I; .L._.II:-. E.L- If % r",t'-P'::; ti-liE:J:: F."l.:-?.E;';!lt..lt ][ II~'.'EEIIZ:: E, PI L.I-...I- I L L I i 4 b 0 F Fl[',,l'.r' .., ~ _, T [: i' I 141 T H 0 IJ 1" F ~ I II- L I I' I... F E .. ]' 1 _ i ,t FIN E:, P F F t~. _, M L E:'.r' 1 I I I ... [:,EPRRTHENT P.IIL. I.. EE ::,UE,..'IE...."I TO FF.L.:,EL.I...IFIuI,I. HINIPIUH [)]:2;TRNCE'.' E:ETI,.IEEN FI I.,IE:L.L (:IN[:, I=ll'.,l'-r' ON-SiTE :F.';EI.,IRC~E [:,ISPOSRL S.';"r'STEH IE; ::L00 FEET' FOR FI PRI',,,'FITE I-,~EL.I_ OR :1.50 TO ;?.00 FEET FROM FI PUE,'LIC WELL [:'EF:'EI",IDINL"{ LIPCd",I THE T"r'F'E OF F'UE~L. IC NELl.... HINIMLIM [:'ISTFINCIE I::'F.:OH FI PRI',,,'RTE I.,-!ELL 'FO R PRI',,,'R~rE ':SEI,.IEF;.: LINE: IS 25 FLEET FIND TO FI COI','IHIJNIT'.r' SEI,.IER LINE IS 75 FEET. OTHER REE~UIIrf:EMEI'.,I]"S HFI"r' FIPF'L'¥'. SPE;CIFICI:IT]:OI",IS FIND CONSTF;:UC]'ION [:,IFIGRI::IM'.'7, FII'~'.E FIVRILFIli~LE "FO INSIJRE F'F. zOPEF.: II",ISTFILLR'FION. i CERTIP"'T' TI'"IFIT :L: I RH F'I::IHILIFiR I.,.IITI-I THE REQI. r. IIREHENTL:; I::'OR ON-SITIE SEWERS RF,IE) WELLS IRS SE'T FORTH B'¥' THE MLINZCZF'RLIT'¢ OF' RNCHORRGE. 2: I WII_L. INtS'T'RI.L THIE S'¢STEM IN RCCORDRf',ICE FILTH :"HE CODES. ]:: I LII'.,I[:,ERSTRND THRT THE ON-SITE SEWER S"r'STEM MFI"r' RE:QUIRE ENLRRGEIdE;I",IT IF TFIE REBII}ENCE IS REMOC'E[.ED 'TO IIqCLU[:,E MORE THEIN 4 BEDROEd'"tS. : F: F L I I]:F NT/ BIETT'¢ .T_- FIRHE,I_ER... '7 ' : . : .. '/F'~/ .... ' ¢).' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMEN'FAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION ]'EST SOILS LOG PERCOLATION TEST LEGAL DESCRIPTION: )PE SITE PLAN WAS GROUND WATER ENCOUNTERED? DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~/~:~ o -~TT, 5~/- ~). L. cf ~ ~ I~,'1~ ~,L~q (minutes/inch) ~ FT AND PERFORMED BY: 72-008 (6/79) 20 PERCOLATION RATE TESTRUN BETWEEN TO: Alaska Environmentla Control Service, Inc. 1200 West 33rd Avenue Suite B Anchorage, Alaska 99503 FROM: Bruce E. Eirckson District Engineer DATE: August 1, 1984 FILE NO: TELEPHONE NO: SUBJECT: Waive Horrizontal Separation Between a Private Well and Septic Tank on Lot 6 A, Block 4, Skyway Park Estates 8521-WA-016 The Department has reviewed the subject waiver request and hereby waives the horrizontal separation on the subject property to 84 feet between the well and septic tank. nv� n U'le TO T A /\, /�- 02-001A(Rev. 10/79) MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water &Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261163 Parcel ID 019 -141-26 Expiration Date: Legal description SKYWAY PARK ESTATES BLK 4 LT 6A Site address 11901 TOY DR 1/30/2027 Current property owner(s) WASCHKE TERRY & MARTHA JOINT X The On-site system(s) is/are approved for 4 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 6/4/2026 This�C ificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sy m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, evelopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 019-141-26 Complete legal description SKYWAY PARK ESTATES BLOCK 4, LOT 6A Location (site address) 11901 TOY DRIVE, ANCHORAGE, AK 99515 Current property owner(s) 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: M Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ■❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ■❑ Wide Trench ❑ Seepage Pit Waiver request for: FIELD TO PROPERTY LINE Expedited review requested: ❑ Distance: 0.5'+ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ lJ Date of Payment S 1 COSA# 1;SC-Zb�� Date of Payment Waiver # VZ_ C_ COSAApplication Apr2025.doc COSA Checklist.docx COSA Checklist Legal Description: SKYWAY PARK ESTATES BLOCK 4 LOT 6A Parcel ID: 019-141-26 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Unknown Total depth Unknown ft Cased to Unknown ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 5/21/26 Static water level at beginning of test 30 ft. Well production at time of test 4+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.39 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 1/30/26 Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW S.T.E.P. TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station NEW TANK years Lift station material EPOXY STEEL Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 6/21/1983 ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade 2.5 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 5/21/26 Results Pass Fluid depth prior to test 4 in Water added 620 gal New fluid depth 10 in Elapsed time 1440 min Final fluid depth 4 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 12 in (MOA 1’ ED) Effective depth (ED) used 4 in (Final Fluid Depth) Effective depth remaining 8 in Comments/Deficiencies: Approximate total measured depths from existing grade & owner has not had any freezing issues. COSA Checklist.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No *77 ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *0.5 ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: 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 *WAIVERS 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 05/30/2026 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 & 05/30/26 Municipality of Anchorage _''° ►► P.O. Box 196650.4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV261019 COSA#:OSC261163 Permit#: PID#: 019-141-26 Legal Description: Skyway Park Blockl 4 Lot 6A Engineer: First Water Consulting Your request for a waiver of the required 10 feet horizontal separation from the disposal field to the property line has been approved. The approved separation distance is 0.5 feet. This waiver approval applies to the existing disposal field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Grante Date: / Approved by/ ` Namd of fReviewer **** VARIAN C E/WAIVER REVIEW **** 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com May 30, 2026 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SKYWAY PARK ESTATES BLOCK 4, LOT 6A – FIELD TO LOT LINE WAIVER There are existing mature trees along the area of the septic field encroachment along the property line along with MOA records and it appears the existing field is approximately 1’ from property line. The field is adjacent to the Toy Drive ROW, does not affect any adjacent fields / properties, has had no known issues for the past 4+ decades and therefore respectfully request a field to lot line waiver of 0.5’ be granted at this time. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel i.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~,L:~,\ - ,C~[z3 HAA # GENERAL INFORMATION Complete legal description Location (site address or directions) I I BO i ~ ¢_~ Property owner Mailing address t. ending agency Mailing address Day phone ,-~i) a y phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: c// TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from Stale 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 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/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 ~::~ ~' ~,' ~'~'-- ~ v'-'¢/ I~'~-' Phone Address ~% ~ 1~ Engineer's signature ~~~~ Date ~' ~' ~ ~ f DHHS SIGNATURE /~' Approved for / - Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: 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 engineeCs work. 72~25(Rev, 1/91) Bsck MOA#21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WE L DATA Lo Well type_ ~ Log present (Y/N) Total depth Sanitary seal (Y/N) Parcel I.D. If A, B, or C, attach ADEC letter. / ADEC water system number Date completed J%.[o~- !~c~V~ Driller Cased to l'~,~ Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow g.p.m. Pump level SEPARATION DISTANCES FROM WELL TO: ( , Septic/holding tank on lot ~' ~ ~'¢,~ t.,~¢4.~) Absorption field on lot [ O ~ Public sewer main ['~,,~ Sewer service line ~"¢;¢._5 AT INSPECTION I//'?//~J ~' t,~NtClPAu'rY OF ANCHORA(~E ?~ ~, ,~NVIP, oNMENTAL SERVICES DIVISION RECEIVED ; On adjacent lots ; On adjacent lots I 6o Public sewer' manhole/cleanout Petroleum tank I~///_~, WATER SAMPLE RESULTS: Coliform (~ Nitrate _ t Date of sample: ~/1'7 l~ ¢- Other bacteria · Collected by: B. SEPTIC/HOLDING ~TfNK DATA Date installed ~/~//~ '5 Tank size J~?'- ,~O Compartments Cleanouts (Y/N) ~_ _ Foundation cleanout (Y/N) ~.. Depression (Y/N) High water alarm (Y/N) fh//~k- Alarm tested (Y/N) t¥'/'A Date of pumping '/'5'"/~ ~ Pumper /Jr ~d E4 C-¢..~ ~ / SEPARATION DISTANCES FROM SF_PTIC/HOLDING TANK TO: Well(s) on lot f~¢ On adjacent lots To property line ¢:¢--~ 'j- Absorption field '/~) Surface water/drainage Foundation_ Water main/service line 72-026 {Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Dateinsta,ed Size in gallons ~ ~ Vent (Y/N) '~' "Pump on" level at High water alarm level ~ O Meets MOA electrical codes (Y/N) y Manufacturer 'k Manhole/Access (Y/N) "7/ "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot ~' On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed (P/¢" J/~ Length c~ t~ Width ~ Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating I ~ Gravel thickness Cleanouts present (Y/N) System type ~"/~/'~' Total depth Date of adequacy test for ¢ If yes, give date '/,71q bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /0 ~ TO building foundation On adjacent lots ,'~ ~) Surface water Curtain drain On adjacent lots /~t2 Property line ,/~) ~' - To existing or abandoned system on lot Cutbank b4,/~.~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on thedate of this inspection. Signature '~,,~ ,~ EngJneer'sNam ~,~-'~ Date I l,;z_O [ q Z- ' HAA Fees / j~ _o~ Date of Payment /-,~/- ~ '-~--' ,~ Receipt Number o?.~.'~ ~;/-- ~"-? 72-028 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number 205 NEST ~5¥H, AVENUE SUITE 206 ANCUOAABE, ALASKA 99502-3904 SEPTIC SYSTEM ADEQUACY TEST LEGAL: I_OCATION: J. ]. 9(]) J. Toy B1 vc:l ,, QWNER: RES I DENCE: S:L ngle Fami I y ~ 4 Bedr'c)c.n?, WELL: F'r'iva{'.e~ On Site SEPTIC SYSTEM: FROM MLJNII]IPAL RE(3[)RDS: 4 Bedroom .c/iystem TANK: Anc:hc~rage ]"ank 1250 Gal. Two Compacts,, ABSEIRF:'T I ON SYSTEM~ Wide SOIL. RAJ' ]] J~JG ~ I NSTAi..L. AT I ON DA'I' E :: 6-21-83 DATE OF LAST PUMF~IN6: Anch,, Cess Foc,.I. Jan :1.5 :l. 99'2 [)ATE OF TEST: January :1.7~ 1992 ]'ESi' PROCEDURE: System was :i. ni~pec'i".ed and measured. Tank was · l:ound with :];.5 Tee'ti of c::c)ver and wi tll a liquid level (:)~: 37 :i. nch water' levels :in the tank and 'Lhe monitor tubK~ LqE:')K'~;:~ IllOFliJ,'[=C)rc~d. TI]cc) water ].(:~ve]. in the tank cl~d not change~ wl"l i ]. (-:, 2,5 ~nc:hes o.J: water TE~T ~I_T: This ~ys'[:g~ tl~e~t~; thee L:od~ r'(;~CJL.til-'~tT~eFIt~?, 0'~ the Health and Soc:i. al Services NOTE The oi:)el"ational l:i.~Fe c)~: a].l septic systems dependr~ on the lc)ca], so:i. 1 c:om"~ditiom'ls~ groundwatel'" levels that may f].Ll(Zl:Llat:~e c:h.u":[ rig 't.'.l'~a yc:~ar' ,~ and 'l".he t,~a~'l:~r' t..t~:~][a by thce system. ']'l'lese conditions are c:Jutside the con'J:rol o'F the evalua'l:or' c:)~ '[:his s(6:~p'[::i.c: system, J-ge can tl'~ere'Fol'e riot give any (,:z,~:~t:~mat(~ of ho~ lorlg tl~is system will c::urr'er'r~: o~' '~Cutur'c:, 203 WEST 151H, AYENUE SUITE 206 ANBIOAAGE~ ALASKA 99502-5904 (907) 27%5916 RESIDENTIAL ~JELI_ INSPECTION LEGAl_: LOCATION: OWNER: TYPE] OF WELL: WELL. LOG AVAILABLE: I',lc~ INSTALLATION REQUIREMENTS MET:~Yes WELL YIELD FRSM WELL LOG: PUMP YIELD FROM TEST': 6 Gallons per" Minute DATE OF INSPECTION: January :[7~ 1992 TEST PROCEDURE: We].l was p~ul~pecl at a constant r'ate while the pr'c)be. At t. he I]eg:i.r~r~J. ng o.~: the test. wa'her :l. evel was -Found ai-. 30,,5 '~eet bel~:)~ t. op of casing. At a pumping ratca o.F 6 gallons per ~li iqute till? J.~a'~]E~l"' ]. eve]. dr"opped 6 ii. i]c:h(~)~kB, a '~:c)t:al (::)~ 900 I.:lal 1 ohs TEST FOR E.COLI AND TOTAL NITROGEN: Water' ~.~as testecl -for E,,Cc~l:[ ar'id reit. al r'li'hrc)ge)n on Januar'y :1.8~ 1992 IE.Col± C). Tot:'.al Nitr'o{4en 2.7 mfj/1. Ma,x. allowab].e 'To'hal Nitl"oger'l ],0 mci/1. TEST RESULTS: -Fl"~i t; wel 1 m(,:,~,.)ts t. he rc.!qui r"emen'Es c)~ Lhf~ Hunil:::J. pal:i, ty o'~ Anchorage. ]'FILS WELL WILl_ PRODUCE MORE .THAN 3 GALLONS PEER MINUTE FOR MORE THAN FOUR HOURS ]"he MunJc:i. pal r'~;;qu:[r'ement ~or" well fZI. ow is 150 ga]lons of wa'her" per" bedroom per" clay. This well exc:e6~d t:his requir"emerrt:., I'he ~:u~isossment o'f the conclit:i, on o4: the wl{;¢l I appl:i.e:,s on].y to the c:ond:[t:i, orls as of the clay tested. The fio~g F-,'.¥be fil~:ty C:]'~4Al]ge (:It.re '['.o and char~ges in aqLLi f (~r MUNICIPALITY OF ANCHORAGE DEPARTMENT OF liEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAl.) (a) Legal DescriJ]t,~)~(inc de|et, block, subdivision, section, township, range) Lecati~n} (address or~ (b) ~Propedy Owner ~ t ~ . cTelephone: Ho~e .. ~ Business (c)--.,~.,--- ~.-.L~t~tiO~.'>~'~'~? . - Telephone _ Mail~/~res~..4 ~t~' ~ ~' (d) Real Estate 8~pany and Agent ~5~ ~K~¢, Address Telephone ~- 1~17 (e) Mail the HAA to the followino address: or: Check here ,[~if hold for pick up. List contact person and dsy phone number below· TYPE OF RESIDENCE Single-Family'~. Number of Bedrooms WATER SUPPLY Individual Well~ Community [] Public [] No(e: If community well system, must have written confirmation from the State Department of Environmental Conservation attestihg to the legality and status. SEWAGE DISPOSAL Onsite'~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation aitesting to the legality and status. Page 1 of 2 72-025 fray 8/861 Front leUO!SSejoJd eq~ u! sue!ss!u Jo Jo sJo~Ja Joj elq!Suodse~ ~ou s! e6aJoqouv jo Al!led!o!un~ sql 'penss! s! e~eofj!peo e eJojeq e~sp ezAieus Jo suo!~oedsu! ~onpuoo ~ou op SHHQ jo saaAolduJ3 's~ueLua~[nbeJ e~e)s pus Icj@psi u!epao Ajsi~es o~ Jap Jo u! suo!~m.!~su! 5u!puel J!eql pus sauJoq jo sJeseqaJnd oh AselJno9 a se s!ql seep SHHQ eqJ. 'e~SSlV jo el~S eq~ u! paJais!6eJ Jesu!Sue leUO!SSato~d luapuedapu! us Aq e^oqs S qds~ea~ed u! UaA!8 suo!le~uaseJdeJ aql uodn /~luo peseq se~eafjipeo le^o~ddv ~poqln¥ q~leeH sanss! ($HHQ) seo!^~aS ueuJnH pus q~lSeH Jo ~ueLupedaQ ees~oqou¥ Jo ,g,!led!a!un~ eqJ. NOI,.LnVO le^oJdd¥ leUO!l!puoo Jo SLUJe/ leUO!$!puoo panoJddes!a '~x~ peAoJdd¥ '9 uJJ!:f jo euJeN ~7~ ~.~-~ / ~)~ auoqdele/ ff~('/'uo!loodsu ! uo lOalle u! suo!~8lneaJ pus 'saoueu!pJo 's@poo al8~S pus led!o!unv~ lie q JiM eoUs!ldUJOO u! s! LUaIS,~S lesOdsfp JaleM@~SeM Jo/pus Xlddns Ja~BM al!S-uo aql 'uo!loadsu! pus uo!lee!lsa^u! ALU LUOJj pus saul e6eJoqouv jo Aliledio!unR aql uJoJj pauie~qo UO!~eLUJOJU! aqi UO paseq leqj/~J!Je^ JeLllJnj I 'u!eAeq pa~Bo!pu! eJnjonJls Jo adXl pus suJooJp@q jo JaqLunu alii menbepe pus leUOfiOunj 'a~es s! UJalS,~s lesods!p JeleMelSeM Jo/pus ~lddns ~aleM al!s-uo aq~ jeql SMOqS IS^oJddv A~poqlnv q~lsaH s!qJ Jo uo!lee!isa^u!/~uJ l~ql X~pa^ I 'MOlaq UMOqS alBp uoilep!le^ aql lo se pus oJaJeq pex!Jle leaS,~uJ NOIJ.¥INblOSNI aNY ¥/¥a 'FlObl¥3$ ~-IIJ 'S.L$~.L '$NOIJ. O=I~ISNI 9NlalAOI:Id JNbllJ !DNII~:I~NIeN~ .g r~/,,I.~ClCIPALITY OF ANCHORAGE (MOA) *UT.O.,TY APP.OVAL CHECKLIST - FEBRUARY 1984 264-4720 Well Classification Legal Description: Z_~P'f · .r/~./.) ~ ~-.~. If A, B, C, D.E.C. Approved (Y/N) ,'t///,~ Well Log Preseni (YL/N~. Total Depth )~t- ~-/ Static Water Level ¢~ ,~?' ;~ Casing Height Above Ground Electrical Wiring in Conduit (Yc~ Separation Distances from Well: Date Completed ¢/z/'z',,V:¢~ J,¢' Yield ~.¢~ _ Cased to ,~,-.e-~z'r Depth of Grouting ."J//"~ Pump Set At Sanitary Seal on Casing(~N) Depression Around Wellhead (Y~ To Septic/Holding Tank on Lot ('~ ~¢ / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot~:) /~' ~ / ; On Adjoining Lots To Nearest Public Sewer Line _ ,'t)Z/4 To Nearest Public Sewer Cleanout/Manhole /J,/,d To Nearest Sewer Service Line on LOt Water Sample Collected by /¢/'~'~'¢ /'~' /¢J)~'-~/ Date Water Sample Test Results Z~.'/¢d~ ~ ""'~'-- "~//~'~"'¢¢~'~' /° Comments ~ ¢J~/'-¢' /~/-~J "~7" B. SEPTIC/HOLDING TANK DATA Date Installed ~ ~?~'/~ Standpipes(~N) Depression over Tank (Y~'4~) Pumping/Maintenance Contract on File CY/N) / Holding Tank High-Water Alarm (Y/N) _ /J/ccc Separation Distances from Septic/Holding Tank: To Water-Supply Well 5¢'¢// Size /'~-c~ No. of Compartments Air-tign! Cans~.~N) __ __ Foundation Cleanou (~N) Date Last Pumeed ~27~¢?~'¢'~ Temporary Holding Tank Permit (Y/N) _ To Building Foundation 3'o Propel:ty ~.ine · ,~d Water Ma b]Serv ce Line To Disposal Field '¢" 'Fo Stream. Pond. Lake, or Major Drainage 72-026[11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~' ~/ Width of Field :%' Square Feet of Absorption Area Depression over Field (Y~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present(~N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) .,,J//4 Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for ~/,'~' Electrical CoO~s.~.N) Comments A"/?~--~ Dimensions / Manhole/Access(~)N) "Pump Off" Level at ~'"~ ~ Vent Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Bating Against HAA Request ** I certify that I hav..9.~eC'~d,.vej'ifi.~d, or conformed to all ~OA and HAA guidelines in effec[ on the date of this inspection. Signed ~ ~' ,~'~//""'"'~ Date '~" /'~/ Company /~¢~' MOA No. O~--/ Receipt No, Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) "(]:{E-E-,'CECTRiC DOCTOR, INC. /~)/,)/ JOB INVOICE "We IViake House Calff," ~'~ ANCHORAGE, ALASKA 99503 MECHANICS HELPERS "O8 IH N. 'l'r(. o755 are held and [irmly bound unto the 0 ..... ), lawqJI money of ~he Uni(ed L bind ours(pves, our heirs, executors, ;en ts. ~bove bounden principal has or is about to ontractingin the State olAaska in accor. nd contributio']s due the State and poliUcal ~d is written shall not exceed the sum anti shall be continuous un. 'artment of Commerce and Economic ff cancellation to the Department of J shall apoly to all liens and bond is app:icable under law, even it nd or the liabilities are enforced after ir hands and seals this SURETY _ I~ns~u_r.a~n.c_. ~.__Com~ua_n_y- ~ Car,'ol 1~-"~/~ ,~enter ~09. Anchorage, AK 9951~ ~¥ ~OT~ PR~ROI?AL AND Note: Surety's Power of Attorney must bo attached if not already in vour file with the Division of Occupational i i::ensillfl' Pouch D.LIC, .hJneau, Alaska 99811. 11:111 (REV C. W. Gustafson. ' (Su rety'~eal) r: .-~..FFH!2 ,i" ~LASKA , R.,. I,,,SU~ ANCIi ..., ,,, 1 ,i 1988 Alpine Drilling & Enterprises Domestic -- Commercial Pump & Water Systems P.O Box 110496 I Job Name~'~.ocatlon chorage, Alaska 99511 INVOICE No_ 2486 DATE QUANTITY DESCRIPTION AMOUNT ..~~-, Thank You SIGNATURE (I Hereby Acknowledge Ihe Satisfactory Completion of the Above Described Work.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL DE CHARGED ON OVERDUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL t~]ALTH DEPARTME..NI' OF I~AI.TH AND ENVIRONMENTAL PROTECTION APPLICATION FOR ImM,TH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date __~-~Z~' (a) Legal Description (include lot, block, subdivision, sectioa, township, range) Location (addr.?.ss or directions) Applicants address.~(~_~.~- ~ / g Buyer [~ ; Other ~2 (explain); (d) Lending Institution ~ Tele~!~ Address (e) Address Telephone (f) Mail the HAA to the following address: 2. T_2~i~e_.of Residence Number of Bedrooms ____~-_~_ 3. Wat~er Su_~.l__~ - Individual Well ~.~ Community [_---__] Public 2~[ Note: If community well system, must have w~itten confirmation from the State Department of Enviro~ental Conservation attesting to the legality and status. 4. Sewage I)is.~osal Ousite [~ Public [~ Community ~[:~ tlolding Tank ~"-X Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legaIity and status. [Page 1 of 2] 5. En~ineerin~ Firm Providing__.__. Inspections. -- ~ Tests~ File ....... Search, Data and Information 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 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 informatien obtained from the M~nicipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or w~stewater disposal system is in compliance %~th all Municipal[ and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm_~_~_~k ~L~k_~ Telephone ~// DHEP Al~r oval , Approved for Approv~d~_~ ~ Disapproved ~__ ConditionaI Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCItORAGE DEPARTMENT OF ~ALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES }~ALTH AUTHORITY A~]?ROVAL CERTIFICATES BASED §O__L.~!?_f UFON THE REPRESENT~ ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INI~PEN~:N~I' PROFESSIORAL ENGINEER REGISTERED IN TIlE STATE OF ALASKA. THE I~EP DOES Tills AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAl, AND STATE REQUIRE~i MENTS. EMPLOYEES 0F'DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN T}~ PROFESSIONAL ENGINEER'S WORK. (DIIEP SEA1,) RR4/ej/D18 [Page 2 of 2] 7'-19-84. WELL DATA Well Classification ~ O~T~' Well Log P~esent (_Y.~ Total D~pth ~2~.~;~ Cased to MUNICIPALI~"f OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL CHECKLIST - FEBRUARY 1984 If A, B, C~ C, D.E.C. ApprOved.(Y/N) ~//~. Date Cc~pleted ~ff~v~/w7 Yield ~//~/~ Depth of Grouting Static Water Level Casing Height Above Ground Electrical wiring in Conduit .(Y~ Separation Distances f~om ~ll: To F~pti~/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public ~wer Line _ ~/~ Sanitary Seal on Casing De[~ession Around Wellhead (Y~ ; On AdjOining Lots ~<)u~, ; On Adjoining Lots~$6 _ To Nearest Public Hew~..r Cleanout/Manhole~ ~.//~ To Nearest Sewer Service Lir~.~ on ~t ~3/D Water S~ple Colleoted By ~)~ ~ ~ ; ~te ~/~ ~ , __ Water S~le Test l~sults ~%-~o~f B. SEI~£IC/HOLDING TANK DATA Date Installed _~_/~,/~ 5 . Siz~ ! %q O No. of Ccr~pa~ta~.nts ~ Standpi~s ~) /__ Ai~'-tight Caps ~) __ Foundaticn Cleanout =~) P~.%ng~alntenan~ Con~a~ c~ File (Y~ ~' for ~~ C~oc F~6 Holding Ta~ High-Wate~ Ala~ (.[~) ~/~ Tem~ra~y Holding Tank ~r~t (Y/N) ~ ~p~ation Dlstan~s ~ ~ptic~olding Tank: To Water-Supply Well_'~-- To Property Line .~ To Water Main/Service Line Cou~ ~/~ . Counts . ~ ~5~. /$q-~-~e'~. To Building Foundation __ To Disposal Field To S~aam, Pond, Lake, c~ Major D~ainage [Page 1 o~= 2] 2-15-84 C. ABSORPTION FIELD ~TA Soils RatinG in Absorption Strata Date Installed Width of Field Square Feet of Absorption A~ea Depression over Field (Y~ Results of Lest Adequacy Test Type of System Design Length of Field Q O ' Depth of Field ~ ~ Gravel Bed Thickness ~ ~ ~; ! Standpipes P~esent ~/N) Date of Lest Adequacy Test /3/~ Separation Distanae from Absorption Field: To Water-Supply Wall J O To Buildin~ Foun~tion Lot ~3ol ~ ; TO Wate~ Main/~vi~ Line ~/~ To ~t~(if ~e~nt) To St~e~ond~ke/~ Majo~ ~ai~ C~se To ~iveway, Pa~ki~ ~ea, ~ Vehicle St~a~ ~ea D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at Dimensions ~9~ ~.~'~'~- High Water ~ ~1 at ~,~' Vent ~) Tested fo~ ~/~ ~ing Cycles ~ing Adequa~ ~st. Electrical Co~) Meets MOA ** Check Permitted Bedroom Rating Against HAA l~quest I oe~tify that. I have checked, verified, o~ confo~msd to ali. MOA on the date of this inspe~ticn. KB1/dL/s [Page 2 of 2] HAA ~G~4~_ ~s in effect Date MOA No. 2-15-84 ALASKA el dlROrlmellTAL COIITROL SeI uICI S, IllC. ~nqin¢¢rinq $ ~nuir0nmenlal Slu~ics August 8, 1984 Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Attention: Keith Bandt Subject: Skyway park Estates, Block 4, ~ot. 6A ])ear Keith: On June 19, 1984, this officer performed a well flow test on the subject property's well. The well flow rate was 1.0 gpm ~u]d was sustained throughout the 3 hour pumping phases of the test. Static water level was at 29.56 feet, with a maximum drawdown to 29.6]. feet (maximum of 0.05 feet). Total recovery occurred within 10 minutes. Although the flow rate should have been increased, this test is representative of the productivity of the well. The minor amount of drawdown, combined with the quick recovery indicates that the well is adequate for the 4 bedroom residence. If this office can be of further assistance, please do not hesitate to contact us at 561-5040. Sincerely, Larry MontgomCZy. ~'~//~ Envirom~ental Eag~n~-er L~4/caj 1200 LDesl 33r~J Aucnu¢. Suil¢ ~,Anchoro(l¢. Alosk~ 99503,t907) 561-50z10 APPLI( Property Owner --Mailing Address h ~X ~ ~/~' /~/-/, fl/~ Buyer . .. Address NT FILLS OUT UPPEFI HA' "ONLY Zip Code ~'~4'~/ ZIp Code Lending Institulion /, . ~ ~ Phone t?/ i~ > ',~ :~.- /1 ,:~: ~. ('~>. ~:/vh~/ Address Zip Code Realty Co. & Agent Phone Address Zip Code Type of Residence ~ Single Family [] Multiple Family No. of Bedrooms [] Olher Water Supply ~ Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. ~] Community For wells drilled prior to that date, give well depth (attach Icg if available). Sewer Disposal ~ Individual Year Individual Installed:_ [~ Public Utility When Connected to Public Utility: [~ Holding 'rank NOTE: THE INSPECTION PEE MUST ACCOMPANY EACH REC~JEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Ti~ k~ Date Date Date Date Insp~lor Insp~tor Insp~tor Insp~h~{ , ~ d ' ~ . ~ ~ dn¢f~l~J¢~. '"'/ '- RECEIVED ( ~( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVe" ,Soils Rating Date ~wer Installed Well TO Absorption Area Well Log Received Well to Tank Septic T~k Size ApUi' ].2, 1983 Approval loc tha~ individual sower and u~.l..(c,(; 'lluom the 31w,1 Lab, 5633 B Uti:eel;, (ou our review. size of the septic tank. ,~3oi. 1 test ha:: beeu }?~.,rforuaed and sulm~itttM to this office~ '2he ieachin(l area ilas been relocated at; lei~s'i; 1.00' f~om any weJ 1 ~ 'iq~,ts Iii, eld will need to be dJ. sconlleCtecl v/hen Ule upglTo, dc has been colapleted, May 30, 1979 Beryl E. Gilbert % Bowden C. Realtors 301 East Fireweed Lane Anchorage, Alaska 99503 Subject: Lot 6A~l~k~Skyway Park Subdivision Bett~andler~roperty Approval for the individual well and sewer facilities will not be granted until the following items have been completed: (1) Expose the well for our inspection to determine proper construction, also, to insure the minimum distance requirements are met between the well and sewer system. (2) A water sample needs to be taken for bacterial analysJ, s, this office was unable to get the sample on May 25, 1979 due to the dog in the yard. (3) A four(4) inch cast iron cleanout be installed to the septic tank or leaching area. The standpipes to the septic tank and leaching area were not accessible for inspection. Notify this office for a re-inspection when descrepancies have been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Alaska Mutual Savings Bank Mortgage Loan Department Post Office Box 1120 99510 June 12, 1979 Deryl Gilb<.~rt % ~3o'wden Con~pany Realtors 30.3. East Fireweod Lan~ A~lchorage, Alaska 99503 Lot"d~-]'~lock 4 Sk~,ay Park ~ubJe~t: ...... Subdivision ?he on-~slt(~ sewer and w~ll on ~e subJe~t property can ;~ot be approved ~.~'~t~l tho following descr~panGies have bean (1) The well casing is raised twelve(12) inches above level. (2) The well ]lead is sealed with a sanitary seal. (3) The w¢.~].l floor is sealed with four(4) tnch(~s of cement;. Expose th{~ septio tank to verify its e~istence. If there. is a tank, it must b{0 at least fifty(50) feat away from any well. It must b¢~ pumped {~o verify its capa~ity. It must be at least 1,250 gallons. If thc; standpipe in the front yard serves a Gesspool~ it is only sixty.-four(64) feet from th~ w(~lt, It ¥~ill need to be abandoned and caved in. A new' l~aohing araa willnneed, to bo installed ono-hundre(l(100) feet from any (6) If the l~a~hing ar(3a is in another location, it will to be exposed so that we Gan determine if it n{e~.~ts the proper distance requiremsnts. Jun~; 11, 1979 (7) If. it is on~-hundre, d(100) f~et away from any well~ you will need te haw~ an adequacy '~un~. performed. It i'~ ~loes not pa.~]s the adequac~ tent a new loacRing area will be require[l. (8) i~.f an upgrad~ of the synt(~m in nec~ssary, a p~rxait n~ust b~ insued by this department. A soils '~e~st will be required if the leaching area neod. s to be upgraded. If t:her.'e ar~ any further q~stions, pleaso contact this office at 264-~4720 o Since:rely, Robert C. Pre'bt, R.S. Associate Specialist. cc, ~ Alaska ~utual Savings Bank Igort.qa(3e Loan .Do}?artment Post Office ]3ox 1120 99510 ,2 i!i7g ENVIRONMENTAL ENGINEERING DIVISION MAY ~ ~, Telephone 264-4720 DJ~F l~l~ ~ r r~, REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SI:W~I~F~.I¥I~"~') MUNICIPAL ~', Of' /'~NCHORAG~/ MUNICIPALITY OF ANCHORAGE DEPT. c% [.~ ~, / DEPARTMENT aP HEALTH & ENVIRONMENTAL PROTECTIO.N/IR©t N1.,,. h.O~ .CT[ON 825 L Street - Anchorage, Alaska 99501 DIRECTIONS: Complete ali parts on page 1. lecomptete requests will not be processed, Please allow ten (10) days for processing. 1. PROPER OWNER MAILING ADDR ES~' PHONE PROPERTY RESIDENT (if d fferent from above) I1,~ ~ o / ,sw / ~ ..% .,~... ~,..,'o ,.~ ~ ~ ~ , /~ 2. BUYER PHONE PHONE MALLING ADDRESS 3, .ENDING INSTITUTION PHONE MAILING ADDFIESS MAI Lll~ ADDRESS 5. LEGAl. DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [~ =our ~. SINGLE FAMILY [] Two [] Five [] MULTIPLEFAMtLY [] Three [] Six 7, WATER SUPPLY ~Z~ INDIVI DUAL* ' ATTACH WELL LOG. A well Icg is required for ell wells drilled [] COMMUNITY since June t975, For wells drilled prior to that aate, give wel [] PUBLIC UTI LI TY depth {attach Icg if available.) ,~/~'~ ' Other_ "~'. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE" [] PUBLIC UTILITY ** f individual/on-site, give installation dete / ¢~] b~- . If svstem is over ~wo (2) years old an adequacy test is reouired Dy this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BI=FORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INsPECTIoN APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR I NSP ECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [~ MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DR I LLE D [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] I NDIVI DUAL/ON -SITE DATE INSTALLED [Z/PUBLIC UTILITY Connection Verified INSTALLER E~Sep~ or []Holding Tank Size: ~7~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Lb]e [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany.~ertificate) ¢>'-DISAPPROVED DATE ~ BY (Title~.~ LEGAL DESCRIPTION 72-010 (Rev, 3/78)