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HomeMy WebLinkAboutRIVERVIEW ESTATES BLK 10 LT 7 Municipality of Anchorage Page I of 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: ~'(.,a ~7~ ~ PID Number: O'~O - ~--&'O~ Name: 04~..~ ~--~.~s~ Wastewater System: ~New ~ Upgrade Address: ~ qeS~W ABSORPTION FIELD Phone: ~_:~ No. of Bedro~s: gDeepTrench DShallowTrenoh DBed.. ~Mound ~Other Total Depth from orig~al grade: LEGAL DESCRIPTION Soil Rating: ~.~ ~PD/Sq. Ft. Township: ~ange: I Section: Fill added above o~g~a~ra~e: Gravel length: ~ . ~ Ft. Ft. Nu;~er oi lines: Distance [;lween fi,es: WELL: ~New ~ Upgrade Gravelwidth: ~ -% ' Ft. ,_ I ~ Ft. Classification (Private. A.B,C): Total Depth~ Cased To: Total absorCtion ¢ Pipe material: Date illed: Static Water Level: installer: Date instalie~./~. ~7 Driller: Pump Set at: Casing Height Above Ground: TAN K SEPARATION DISTANCES ~Septic D Holding G S.T.E.P. "To Septic Absorption Lift Holding =ublic/Private Manufacturer: ~ ¢ ~ Capacity in gallo~:s FFO~ Tank Field Station Ta.k S .... La,es ~ {4 · 1 Material: Number of Co~rtments: s,rf~oe jO¢~ )O0't.~ ~ LIFT STATION Water . ~ , . , Lot JO ~ ~O I~ ~ .~ Size in gallons: I Manufacturer: Line '" ~ High ' ' " " t: water alarm at: Foundation )~ ~P J O i~ ~ ~ ~ "Pump on" level at: CurtainDrain ~-- ~)¢ ~A)O~~ ~ Put, Electrical Inspections perf°rmed bY:. Remarks: BENCH MARK Location ~nd Descriptio~P ~ ~ ' ' Assumed Elevation: Department of Health And Humah Services appreval/ %~.;,,:F~(;~ evi ,edanda oved ,' . ' /~ '- . ~ -, [ , 72-013 (Rev 9/91) MOA 25 PERMIT NO. SW970032 PAGE 2 OF 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Ataska 99519-6650 * Telephone; 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 7, BLOCK 10, RIVERVIEW ESTATES P.I.D. NO. 050-801-06 ALT. SITE \ THA =---3 co NEW TRENCH NEW 1000 GAL. DBU SEPTIC TANK ST2 o ST1 ST1 ST2 0 FCO FINAL GRADE EW 78.72' 12 GAL 77. 91 S.T. FINAL G MT,,nI I to.( \ \ 02 = 79.5' C01 = 75.4' CO2 = 75.4' NO WATER FOUND 62.9' B.O.H. %WELL SCALE 1" = 40' ­:_." .­­_ --row'n­iio ' -A\ ROBERT C. COWAN f 0�" % CE - 81 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE- Started PERMIT NUMBER DOC ¢o, aba SULLIVAN WATER WELLS P.O. POX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688,2759 St.xTIc LEVELOF waTER Fr ~ '/ KIND OF FORMATION: From ~') Ft. lo c~ FL Ft. Io Fl. From !¢ Fi. to 30 Ft. ~&~ ¢ ~HOE4 erom~.rt, to_,~Ft, From .Ft. to Fl From FI. to.~ From Ft. to Ft From~Ft. to From Ft. to Ft. From.~Ft. to~.F~ ~om~Ft. to Fl. From ~FI- to ~Ft. Fro~l Ft, to Fl. From Ft. to Ft. Frj~ ~_.~.Ft. to Ft. MISCL INFORMATION: JUL 28 1997 Municipality of Anchorage Dept. Health & Human Servicea DRILLER'S NAME MUNICIPALITY OF DEPARTMENT OF HEALTH ~D HU~ SERVICES P.O. BOX 196650, 825 "L" STREET~ ROOM 502 ~CHO~GE~ ALAS[~ 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970032 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DALE JOHNSON OWNER ADDRESS:21766 CHANDELLE DR. CHUGIAK~ AK. 99567 DATE ISSUED: 3/10/97 EXPIRATION DATE: 3/10/98 PARCEL ID:05080106 LEGAL DESCRIPTION: RIVERVIEW ESTATES BLK t0 LT LOT SIZE: 41457 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18A3kC72) AND DRINKING WATER REGULATIONS (18A_AC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ISSUED BY: DATE: DATE: February 28, 1997 ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOiL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SIYE W,~ST EWATER DISPOSAL SYSTEM DESIGN (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 7, Block 10, Riverview Estates S/D Request you issue a permit to drill a well and install a septic system %o serve the proposed four bedroom house on %he referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring tube was found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 ~ALE F %ITE PI AN i' DESIGN F o r~ O ~m ..--iA :1>O 7,7.0 8GALE %ITF' PI AN DE.SION F 0 zo ~o ~> Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- (EN G_..[~,~, SEAL) ~'. .... h" ~ ~ ROBERT C. C~WnU ~ ~,- ,~ ~x~ CE-8801 DATE PERFORM ~g · .~-- ~' ~ ~ ~'' ' ,~-, '*bL"g ..... :'%-. '.," Township, Range, Seotion: ~,¢.- SLOPE SITE PLAN WAS GROUND WATER [ t'---' ENCOUNTERED? s IF YES, AT WHAT r.~/ L DEPTH? -,A pO E Depth to Water After Monitoring? '~-~[ Date: ~1, ~7..o "~,b'" Gross Net Depth to Net Reading Date Time Time Water Drop q s-' PERCOLATION RATE I (mmutes/mch) PERC HOLE DIAMETER L~ TEST RUN BETWEEN '~ FT AND fl FT COMMENTS S & $ ENGINEERING ....... · *,.-I ~,~ ~,'~A'~,~ ~,~ ,,,.5 'l~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY; 'J7034 Eagle N, lver ~,aop I~,oag;! re~, ,~k.we · ACCORDANCE WITH AL~[~"i~TIEj~,,ND~[~¥~I'~I~J~t~IDELINES IN EFFECT ON THIS DATE. DATE: ~ ~ i ~ ~ 72-008 (Rev. 4/85) 0 rn CD CD ,- r � It CY) Ce) I,- I— CD O (9) CY) LL.I o cL r n O LL V � Q O 2 U Z Q LL F— J a - � U a) u(')) Z U 06 U c >� E o_ 0 > Cl) C)O ca 0 Q 0- U) U) N U) CO C O 4- 0 cu U W �` LO N O N LO G) a� m 0 C O Q x W O O O 0 i T11 - C) C) 00 O O N co d ti LO OD H Q J i C) > J m W W a � H U U Y W w W Lu �NN / L1 Lo o Q N U N U)) 70 co J (� W z J U 06 W m U CO Z J O 0- 0 Q) C O a) Q O n c U Ci O 0 a) O CL 0- m (1) m M N ch T O c O Q) x vi C 0 CL N O) C 0 O a) _c_- 3: U 0 0 70 a) .o A E O A It N O N C'7 N ai cu D a) ca U It a) U c I 0 0 0 m a ,>1 O c E O a) U Ci a) O �O C O N C Q — � Q E o N E N Cl)t O Q U E > C CL O M 0 � Q .a Q a7 0 2 0 c N +' O � U) cn �+ U)in -� CO N E O ° o ° > N O i N M c �j E o v°) N L Q. k cn Q L X x 0 O Y > L) 4) Q U o a) Q Q Z U) 0 � W O m = U Q O U H f— a 0 CD 0) CJJ I�t �t CY) M ti f -L CD CD 0-) CY) 0 a� LL > m co 0 0 a a 0 U rz U � R w -f+ � N C d d 7 � CD cm N U) � (6 C a� O O O ❑ U O. 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B L O U N c CL ❑ E a� U) ` .Q s= �_ O O � V E ❑ Q' U ui c ❑ � U • O a) c �, Y LL V �a a ❑ C� C (D N -a U)❑ ® N d O U > ❑ U o o m L]N C 0 Q m ❑ CL O U ` T) U H w E O ++ O El Q ❑ (A El a5 ,� a� oo w ° in J N O v ® > w_ = N LL O �m U O u> m a , ct til • _U H N O N % �+ a o� m L • :- CL a >-CL > ui co mx i>> w >% in 0 a� LL > m co 0 0 a a 0 U COSA Checklist.docx COSA Checklist Legal Description: RIVERVIEW ESTATES B10 L7 Parcel ID: 050-801-06 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 April 1997 Total depth 300 ft Cased to 33.3 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 9/5/24 Static water level at beginning of test 35 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 0.268 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 9/5/24 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 48” Date of pumping 9/5/24 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/7/97 ALL standpipes present per record drawing Total measured depth from existing grade 9.5 ft (max) Measured depth to pipe invert from grade 3.7 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 9/5/24 Results Pass Fluid depth prior to test 0 in Water added 650 gal New fluid depth 1 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 78 in (MOA 6.5’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 78 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS Also, like the 2022 COSA comment, the two northernmost pipes were not seen, and it is unknown what these two northernmost pipes are on the as-built survey. 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 9/9/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 09/09/24 �LAJ v Y. O 2 V Z a LL O F— J a F- r a zo w �u V - � L Zw m 0 3 N � w N LL, N C O H to WD z L L cw +v+ �_ G C J 4 LU 3 0 o 3 v °J t Q N M M O E � O O 0 o [0 v1 c O L} O 0 Q p Lr) O Ln Q) � m U Lf 1 m t ~ m7 Ln N U aj 41 L- Qj ) bA C:QJ L U u N m N N O u co O Q Q Q 4-+ V Q) N I� a-+ u O m Vf LU 3 aJ -0 O i ^ N 4� � Q N � 4- O U Q) — ° L H M A r N Ile c m U Q Q O 5 bA CU j bA L v O N Q O —_ cB O 0 44� v 4� 0a O Q) > cr-I4- ru� CL N r- bD E T O cu m i E O VI +- U Q N N a '0 ON i m N U V) H 00 v c F- • '-� Municipality of Anchorage rGEg` On -Site Water and Wastewater Program (907) 343-7904 s a E T Y Certificate of On -Site Systems Approval Parcel I.D. 050-801-06 Expiration Date: 7-2—q ^ z Z 1. GENERAL INFORMATION: Complete legal description RIVERVIEW ESTATES; BLOCK 10 LOT 7 Location (site address) 7415 River Park Circle *Eagle River Current Property owner(s) Pete Komar Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 570-854-6561 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for. Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment MZ6 A z Receipt Number 776 COSA # 0,5G 2 i l 6 t7 Date: Waiver Fee $ Date of Payment Receipt Number. Waiver # ci. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: _Gamess Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: - 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 7 -- In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the dates of the �(r evaluation. Separation distances were measured to readily identifiable features. Hidden defects or ©• L �� encroachments may exist that were not identified during the evaluation" The operational life of all wells O• S� and septic systems depend upon a variety of variables, including but not limited to, soil conditions, � �Al �: �-� —F � y, •,(] groundwater levels (that may Fluctuate during the year), quality of construction (materials and �i J workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are butside the coniroi of GEG. Saiisiacioiy iesi resuiis do not guarantee future performance of iile systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of i • • • the well or septic system. GEG makes no representation whether an alternative well or septic system�� l =l �" =� J •5�.' can be installed on the property in the event either of the current systems fail to perforin adequately in CE-- the future. The content of this report is for the sole benefit of the person/party that retained GEG to `f perform the evaluation. Reliance upon the information provided in this report by any other person or 4�i� F party (including subsequent property purchasers) is not authorized, nor will it confer any legal right 0 ssionoo`� #AECC884 . 6:. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the pF��i���� `� �,�,�t Dngw /_ o�F G r �— Original Certificate Date: -y The Municipality of Anchorage Development Services Division (DSD) issues Certificates of Onsite 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 _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other CS4,:02( Legal Description: RIVERVIEW ESTATES; BLOCK 10, LOT 7 Parcel ID: 050-801-06 If more than 9 septic system on lot: COSA Checklist # of Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/97 Total depth 300 ft Cased to 33.33 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/11/22 Static water level at beginning of test 34.7 ft Comments B. TANK DATA Age of tank(s) 25 years Tank type/material �"r's� Measured operating fluid level in septic tank 50" ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA DEEP TRENCH Well production at time of test 2.5+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes Ro No oliform bacteria is Negative Nitrate U . �-a i mg/L ❑ Nitrate less than MRL (ND) Arsenic • I3 ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 4/11/22 C. LIFT STATION ❑ Required maintenance Age of lift station Lift station materi Commen . Which system tested (date installed) 7/7/97 Adequacy test date 4/11/22 ❑ ALL standpipes present per record drawing Results R Pass For 3 bedrooms Total measured depth from grade 9.58 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4.25 ft (min) Water added 708 gal ❑ N/A — pressurized field 4 ❑ Monitor tubes go to bottom of effective. If not, state New depth in 45 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NONE date of test) Gallons introduced N/A gallons !f yes, enter date N/A Com ments/Deficiencies: COSA Checklist yellow sheet q_1 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' [a Yes if No ft [] Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' []✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' []✓ Yes if No ft Q 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' Q Yes if No ft Property Line > 5' QQ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' [) Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' [] Yes if No ft If septic tank is under driveway comment below From Abs—rp>ig�, FtLe�d �[t Lpt k�; (Ple a eskerd�ts �r cis if less than_r�qu, j�„�j ._- Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' [j Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS 1 j (li � t:,•w N LTJ 1--��-' T �Yi Z� , v t; C12'�-�--.J'?,v ,M t� S � � i ���,� f L'1� ti i• -S }�: /( G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF ............ v—.. . QO f A. Gar ess,- CEr' 79 3 o�G 44�Preo 1' �J t 2, o0 rofessir oq #AECC884 4����Od�c' LOT 6 0 (a SEPTIC 0 0 0 e a 0 rr�� %0. . � °°e F� 9� \ ME LL ��/�i �'riT TO• � , �9 sF d nir A g "l\ AV 'Nag TW o® x009 •e•• •••a•ee•i•••® • ••• 40•0e40•e09e:0ee� 0 A c KEVIN M. SMITH ®�J'AN0 Na. LS-9234 q�•{ V e ��•/ v b A I �✓0 F sslWN' L®> %Taxe�lo I HEREBY CERTIFY THAT I HAVE SURVEYED LOT 7 BLOCK 10 RIVERVIEW ESTATES SUBD. SHOWN ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTANCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS VlHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. 4 1p lz `�9, LOT 4 LOT S ASBUILT LOT 7 BLOCK 10 RIVERVIEW ESTATES SUED. SENTEC Inc. 4141 Ingra Street, Suite #201 Anchorage, Alaska 99503 Phone: (907) 562-9966 Fax: (907) 562-9924 Drawn Grid Scale W.O. # KMS SW358 1"=50' 97-455 Checked Date C. Fila # F R. — Pe. 10 07—As;�; www.muni.org/onsite Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC 221160 Subdivision: Riverview Estates Block 10 lot 7 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for this COSA / property is 25 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Mailing Address P Box 196650 *Anchorage, Alaska 99519 6650 *www muni org . `, 189 7O • Municipality of Anchora On-Site Water and Wastewater Progra (907) 343-7904 E` OCT 09 2017 ,1'lJ c r y CERTIFICATE OF ON-SITE SYSTEMS ' °° •ROVAL CJI) Parcel I.D. 050-801-06 Expiration Date: /— I 7-- t g 1. GENERAL INFORMATION Complete legal description RIVERVIEW ESTATES BLOCK 10, LOT 7 Location (site address) 7415 RIVER PARK CIRCLE, EAGLE RIVER,AK 99577 Current Property owner(s) BRIAN &VICKI MEYERS Day phone Mailing address 7415 RIVER PARK CIRCLE, EAGLE RIVER,AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: 1,014 �/ Date: /D//y / COSA to be released to the engineer, urges/it/ ise requested by the engineer. COSA Fee $ 5aL. Waiver Fee $ Date of Payment 1Ou!0007- Date of Payment Receipt Number Q 303--9b Receipt Number COSA# 05(14174/ Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/3/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use. local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ��\vik encroachments,deficiencies or discrepancies exist. OF i-1Lx7 X tS -: 4. T11*, I�x. # 6. DSD SIGNATURE System #1 Approved for `( bedrooms. b1:171\111.111.11.1.0 System #2 Approved for bedrooms. , ffFrfF I,l,C I Ir.��� G � Disapproved. t ' ,'F,'9:f0%N Conditional approval for _ bedrooms, with the following stipulations: 4[[l[�ttrt;,t \--tri{ OF,44/6 -�- ON-SITE WATER AND WASTEWATER o rn [ PROGRAM : �-- &VTSON ' Original Certificate Date: / Q-1 71 7 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 COSA blue sheet-10-10.12.d oc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: RIVERVIEW ESTATES BLOCK 10, LOT 7 Parcel ID: 050.801-06 A. WELL DATA Well type PRVT If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 4/1997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 300 ft. Cased to 33.3 ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 4/1997 9/20/2017 Static water level 30 _ ft. 32 ft. Well production 1.5 g.p.m. 2.75 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.456 mgIL Arsenic: 5.99 ug/L Date of sample: 9/20/2017 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 5/1911997 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N_ Date of pumping 9/20/2017 Pumper ONE STOP C. ABSORPTION FIELD DATA Date installed 5/19/1997 Soil rating (g.p.d /ft2 or ft2/bdrm) 1.2 System type DEEP TRENCH_ Length 45 ft. Width 2.5 ft. Gravel below pipe 6.5 ft. Total depth 10.25 ft. (Measured 9/20/17) Eff. absorption area 585 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9.20.2017 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 630 gal. New depth 3 in. Elapsed Time: 10 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons _ Manhole/Access (Y/N) _ "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+___ Absorption field on lot 100'+ _ On adjacent lots 100'+_ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 1001+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line _10'+ Building foundation 10'+ Water main 10'+ Water Service line _10'+ Surface water 100'+ _ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'__+____ F. COMMENTS rev Ey/STS G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformanceNik with MOA COSA guidelines in effect on this date. OF fiI Engineer's Printed Name KENNETH M.DUFFUS �Air �� f��1 Date 1013/2017 ' *''49 TH* COSA canary sheet_2-6-15.doc '` / _ f 4.r� KENNETH . DUFFU / ��0 71 6 �y tiAsr FY7j. ; Air orf MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _~ ~-O - ,~O / - O ~ RECEIVED JUL 211997 Mu, c,pality of Anchorage Oapt. Health & Human Seryices 1. GENERAL INFORMATION Complete legal description Lot 7; Block 10; Riverview Estates Location (site address or directions) Riverpark ~" ," · · Eag]~ River~ Dale Johnson .':'~,F~.r0perty owner ,Mailing add[ess 2~766 Ohandelle Drive Chuq~ak, Day phone AK 99567 688-7095 Lending agency Mailing address Day phone Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: xxx If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on=site Holding tank Community on-site NOTE: xxx 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) Front 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/orwastewaterdisposal 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. $&$ENGINEERiNG Phone ~ cf ~.[ - ,~ ~l -2 ~ Name of Firm 17034 Eagle River Loop I~oad NO. 204 Address Eagle River, Alaska 99577 Engineer's signature '"~/./~.¢~Z ~ Date '7 ~:~, /97 DHHS SIGNATURE ~,/~'"Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 MUNICIPALITY OF ANCHORAGE: Municipality of Anchorage ENVIRONMENTAL SERVI /~jj~j~ON DEPARTMENT OF HEALTH & HUMAN SERVICES JUL 2 1 Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 343-~ E IV Legal Description: A, WELL DATA Well type Log present) Total depth Sanitary seal (~) Date of test Static water level Well production FROM WELL LOG WATER SAMPLE RESULTS: Health Authority Approval Checklist Parcel I.D.: 6'~o - ~o ~ -od, If A, B, or C, attach ADEC letter, ADEC water system number '-"-~---- Date completed Cased to _.~.~ / Casing height (above ground) Wires properly protected AT INSPECTION l,% Coliform (~ Nitrate Dateofsample:7/7/~7 '~ 7/'~'/c/7 B. SEPTIC/HOLDING TANK DATA Date installed ~'~' ~' '7 Foundation cleanout ~"-"~1) Date of Pbm'ping": ~//~-' 'c~ C. ABSORPTION FIELD DATA: . Da!e installed ~' ~/~'~ '~ . g.p.m. g,p,m. ° ~ ~ Other bacteria / Collected by: Tanksize /~O Number of Compartments Depression (Y/~) '"C')O High water alarm (Y/~ A) 0 Pumper Soil rating (g.p.d,/fF or fF/bdrm) /,¢'~ System type Length /-/5' Width 2.:~' / Gravel thickness below pipe ~ .z~ I . Tota depth ~ Effective absorption area ~"~,.~,,~ Monitoring Tube present~N)_.~'~ Depression overfield (Y~__~) ~ Date of adequacy test f/////~:c~ Result9 (Pass/Fail) For ~ bedrooms Fluid depth in absorption field before test (in,); Fluid depth ~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Immediately after - 9al, water added (in.): Absorption rate = If yes, give date .g.p.d. D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /~ 0 ~" Absorption field on lot t Public sewer main Sewer/septic service line Size in gallons ~ "Pump off" level at*. *Datum /OO P /OO On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /~ '-F Property line /0 Absorption field / Water main/service line /0 It Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 'lo ~ ~-' /o ~ /o Building foundation Water main/service line /00 ~ /-- Driveway, parking/vehicle storage area .~'~9 ~,~ /,'~' /('~/~,'0,.,.~/t~ Wells on adjacent lots Property line Surface water Curtain drain F, ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformance with tCOA .I-IAA g~idelines in effect on this date. Signature '~fi/_~J~. -~.~ Date '~ /~'/ /q ~ HAA Fee $ 3 Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number LOT 6 o ~ SEP~C --~ o o o LOT 4 I HEREBY CERTIFY THAT i HAVE SURVEYED LOT 7 BLOCK 10 RIVERVIEW ESTATES SUBD. SHOWN ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTANOE OF ANY EASEMENTS, COVENANTS, OR RESTRIO]]ONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, OR FOR ESTABLISHINC BOUNDARY OR FENCE LINES. LOT 8 Checked ASBUILT LOT 7 BLOCK 10 RIVERVIEW ESTATES SUBD. SENTEC Inc. 4141 Ingra Street, Suite #201 Anchorage, Alaskm 99505 Phone: (907) 562-9966 Fax: (907) 562-9924 j Grid Scole W.O. # KMS SW558 F.B. 1"=50' Date C. File # KMS 7/18/97 TFB Pg. 19 97-455 97-455