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HomeMy WebLinkAboutKNOLL ON THE WOLD BLK 1 LT 1Knoll wool "04 1 Ikk Lot i #041-031-56 Municipality of Anchorage Development Services Department - Building Safety Division °•++*+ On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page ' of www.cl.anchorage.ek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO40214 PID Number: 041-031-56 N°m`' Judith Anderson Wastewater System: ❑ New El Upgrade Y P9 A'dr"` 9130 Teri Circle Anch. 99507 ABSORPTION FIELD per: 338-1921 Number of Bedrooms: 3 I] Ota TranM ❑ ShalbW Trench seri Mound Othar. p ❑ Wit Rating: Total Depth troin original graft: LEGAL DESCRIPTION 0.8 GPDIFe 10.8-11.0 Ft. Block: Lot: Subdivision: Depth b pip. WRom from original grade: Gravel depth beneath Alpe: 1 1 Knoll on the Wold 3,0 Ft. 6.0 Ft. Twmship: Range: Section: Fill added above original grade: Gravel Length: 0.5-1.0 Fl, 36 Ft, Well: ❑ New ❑ Upgrade Gravel Mikan: 2.5 NI of lines: 1 Diatarxe between lines: NA Ft Ft. Classipcetion (Priv . C): Tote) Depth:Cased b: Total absorpWn area: Pipe Material: Qf IV Ft. Ft. 576 Fe I ASTM D30341 F810 Driller, fled: Static Water Level: Installer: A+Home Services Data Metalled: 7/21/04 Ft. Yield: Pump Set at Casing Hag Ground: i TANK GPM Ft. SEPARATION DISTANCES O Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding lublbPrivate Man adurer: Anchorage Tank apadty: 1000 From Tank Field Station Tank Sewer Line Gal. Matenal: Number of Compartments: wall 118 150+ NA NA 100+ steel 2 surfaw Water 100+ 100+ NA NA LIFT STATION Lolllne 25 25 NA NA Ulm: an ...... NA 'Pump ori level al: 'Pump off lava High water alarm at: Foundation 5 100+ NA NA In. In. Pump Make E Model Elactncal inspections perfomred by Curtain Drain NA I NA NA NA R°n°'""BENCH Old tank removed and buried on site. Old MARK drainfield retained, and diverter valve installed. `°`°b°nand Desc pion: Top of deck at support beam at SW corner A.­­d Elwah.n: New tank insulated w/4" rigid foam. Bottom of tank = 90.91 Ft. 100.00 Engineer's Stamp '(Fn ...S2.F...A� �P' q Cindy W. Ellis Dates: 1`t 7/20/°4 �t 49TH Inspections performed by: .2nd 7/21 /04 �f f�� «...: Developm t Services Department Approval N__G.Y. .... Cl y W. Ellis Reviewed and approved by: Date: CE • 10577 �' (Rev. iypp) � N,•1 ' I4 I ®C�I TERM----� \ 4- s�o N Lot 2-100ft \ @\\ _ i 32'Sp„w well radius o °- 1 A\ Old septic tank removed NI I I T1 O WELL T2 ST2 of I / 1000 gal steel D 1 q` Septic Tank & DCO \ Existing trenches retained. / Lot 2 / / r \ \ Lot 1 111�P1 SU SUMP�L' ' / Z �� O h Q CO2 —__ N O 4Li// O ON Q, tD N m/ N. P03 p , MT MT1 / C04 / , / , / / OO D (0 Knoll on the Wold, Blk 1, Lot 1-97- Watkins En ineerin Inc. WatkinsEngineering, A I B I C D STI 23.4 15.1 P.E. P.O. Box 110443 Cindy W. Ellis,u — ST2 22.6 17.9 — - DCO 1 23.7 1 19.2 — — DV 22.4 21.6 — — COI 30.1 16.3 •- - sumPI 67.3 52.7 sumP2 75.7 51.4 — - 0O2 — -- 17.7 205 CO3 — -- 111.3 142.4 MT1 — — 111.5 140.1 C04 — -- 110.3 117.4 MT2 -• 106.9 120.7 CO2 —__ N O 4Li// O ON Q, tD N m/ N. P03 p , MT MT1 / C04 / , / , / / OO D (0 Knoll on the Wold, Blk 1, Lot 1-97- Watkins En ineerin Inc. WatkinsEngineering, 0 �F Acq,v •"... Proposed Septic Upgrade �Q� S 0 �dn Richard Brodsky & Judith Anderson 49 THS Parcel ID: 041-031-56 „. . . W .... 0 CIN W. ";us �us o P.E. P.O. Box 110443 Cindy W. Ellis,u August 20, 2004 Anchorage, Alaska 99511-0443 �0'•, Q�D'JQ''oG�� �4 Scale 1 inch = 50 ft Phone: (907) 349-1851, Fax: (907) 349-1934 , e ��: \,,• . FINAL GRADE Diverter . 98'7 0 99'66 FCOValve 95-68 4" rigid foam —� I insulation 95.19 1000 GALLON STEEL SEPTIC TANK 94.98 To old drainfield N.T.S. C04 -_ � MT2 MT1 CO3 FINAL GRADE = 93.1 - 96.6 NOTE: ORIGINAL GRADE _ 92.54 - 92.68 4"0 PIPE FILTER FABRIC SEWER ROCK 81.72 81.50 36.0 TRENCH N.T.S. NOTE RELATIVE DEPTH OF TEST HOLE = 72.68 90.07 81.79 AS -BUILT Knoll on the Wold, Blk 1, Lot 1 Record Drawing of Septic Upgrade Judith Anderson Watkins Engineering Inc. °� 49TH . vD Parcel ID: 041-031-56 SW040214 ,.`:•:• Permit No. ' CIN W. ELLIS 10577 Cindy W. Ellis, P.E• P.O. Box 110443 .�?�•-09 August 23, 2004 Anchorage, Alaska 99511-0443 Phone: (907) 349-1851, Fax: (907) 349-1934 �p�Od No Scale \ \ L AtCi � N FAee \ E9 j1HO�f MAOUBE g O FPAME v E ofOf e i NONFNONDR Ir N DWELL / K/,/ m47 O/ N / 3 % 0000004pp0 P,�E.OF- 4'4 9�4p00 e 9MANE A. HOLT: / QO� i?'•, LS -6914 ,pyG O o00 / Fo �pRDa[•nCNH'dp� �4op0000 / NO CORNERS SET NO CORNERS SET THIS DATE SCALE : 1 ' a 50' V / 1 HEREBY CERTIFY THAT I HAVE PERFORMED A / MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. �O. LOT 1, BLOCK 1, KNOLL ON THE WOLD SUB. V ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXISTING STRUCTURES AND PUTTED LOT LINES OR EASEMENTS AND IS NOT TO BE STRUCTURES OR FENCELINES. USED FOR POSITIONING ADDITIONAL OTHER THAN NOTED. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREON. I DATE ) AT ANCHORAGE, ALASKA THIS 26TH— 'AO 6TH_ DAY OF JULY 2006 NOTE: ANY FENCEUNES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES HOLT LA D SURVEYI�N .—$354, FUiT3-4 OR LOCATE STRUCTURES. TEL. 346-6613 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw, Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number. SWO40214 Legal Description: Z10MD [THE.WOLD 6LK Design Engineer: 0844 Watkins Engineering, Inc Owner Name: RICHARD BRODSKY & JUDITH ANDER Owner Address: PO BOX 21-0052 ANCHORAGE, AK 99521-0052 W 140b 'qI>'/oq Is 3a Date Issued: Jun 22, 2004 Expiration Date: Jun 22, 2005 Parcel ID: 041-031-56 Site Address: 009130 TERI CIR Lot Size: 50575 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 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 (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 6 - 7.3 -G4 Date: 2 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Parcel I.D. 041-031-56 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Number SW Property owner(s) Richard Brodsky & Judith Anderson Day phone 338-1921 Mailing address (1) 9130 Teri Cir Mailing address (2) Anchorage, AK Zip Code 99507 Legal description (Lot, Block & Sub'd.) 1<04L%- OV 79E w01.0 CL. I Legal description (Section, Township & Range) Lot Size 50,575 Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub 13 Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of propeify owner or authorized agent) Permit Fees: L-1 to O Waiver Fees: Date of Payment: — % 7 - O 1-F Date of Payment: Receipt Number. 3 ecelpt Number: (Rev. 12/00) Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 fax 349-1934 June 15, 2004 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Knoll on the Wold, Blk 1, Lot 1 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation for upgrading the septic system for the referenced 3 bedroom house. The existing septic system was installed in 1984 and has failed. It is proposed to install a new 1000 gal. septic tank and a deep trench drainfield. The proposed design is based upon a test hole dug on June 2, 2004. Two test holes were dug, with TH#1 containing an impermeable layer of silt at 2 ft from surface. No water was encountered in either test hole. Test hole 92 was dug to a total depth of 18 ft and encountered silt with some sand stringers. A percolation test was run between 6.25 and 6.75 ft, with results of 5.9 minutes per inch. The soil logs are attached. Proposed Soil Absorption System: 3 Bedrooms x 150 GPD/BR = Application rate: 450 GPD / 0.8 gpd/ft2 System Type: Maximum Depth: Effective Depth: Length Required = Proposed Length: 450 GPD 0.8 gpd/ft2 563 sq. ft required deep trench 12 ft 8 f 563sq.ft/8ft/2 = 35.2ft 36 ft The current septic tank will be abandoned in place, and the existing drainfield will be retained for future use, with a diverter valve installed. Sewer Upgrade Permit Application for Knoll on the Wold, alk 1, Got 1 Watkins Engineering, Inc.; June 15, 2004; page 2 There are no surface waters or private wells within 100 ft of the proposed septic system. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, CindyyVG. Ellis, P.E. 7 6 P 8 5 UNDEVELOPED / 1 I I I Knoll on the Wold, Blk 1 Lot 1 Proposed Septic Upgrade Site Pian 000000p0 0 0P A 4 �pp4 ,q�' O� - Richard Brodsky & Judith Anderson Watkins Engineering, Inc ooP� A' 'f ID: 0 �r' 49 TH y, 0 Parcel 041-031-56 15108 p....:. ... ............. . ' DD p....:....... .......p 0� g '• CIIN �p Cindy W. Ellis, P.E. P.O. Box 110443 ,Y S86 -42-35"E NR _ _ - - Phone: (907) 349-1851 Fax (907) 349-1934 m ��; ono6Qo �400 A, A ' \ I WELL ° nda WELL \¢� \ WELL o / I n . 1 i BRACT B i 2 WELL �PSN�R 1 I I I Knoll on the Wold, Blk 1 Lot 1 Proposed Septic Upgrade Site Pian 000000p0 0 0P A 4 �pp4 ,q�' O� - Richard Brodsky & Judith Anderson Watkins Engineering, Inc ooP� A' 'f ID: 0 �r' 49 TH y, 0 Parcel 041-031-56 p....:. ... ............. . ' DD p....:....... .......p 0� g '• CIIN �p Cindy W. Ellis, P.E. P.O. Box 110443 June 7, 2004 Anchorage, AK 99511-0443 �4poo4 Scale 1" -100' Phone: (907) 349-1851 Fax (907) 349-1934 ��; ono6Qo Lot2-1 Qft well radius \ \ a� n / / / Ene McNrNQNuq 7 50.00, ` Lot 3 -100 ft well radius 5 minimum I Existing Septic Tank to be NI I Abandoned in Place. I WELL f I Install/1000 gal steel Set* Tank & DC / P p D \ Existing trenches to be retained for future use. / Lot 2 \ \\ Lot 1 \\ Install CO. �,—;\,_ Q/ 47 \ Maximum/ at suitable 0 40 3 SR, 450 GPD 0.8 gpd/ft2 Requires 563 ft2 Deep Trench 8 ft effective 36 ft long Max 12 ft deep \ 100 ft rurl N s / for geptic system �Q,/ development' \ I TEST / O o/ D \ \ HOLE #1 A \ /� ON 30 ft radius r m/ 47 \\ /� MT1� \� / C01 \ i °TEST I / Proposed Deep Trench: t HOLE �2 , 36 ft long x 8 ft effective \� MT2 / / i / / OO / (00, v Knoll on the Wold, Blk 1, Lot i Watkins Engineering, Inc 0000� vp�p AF A (q�Qo Proposed Septic Upgrade o �� Richard Brodsky & Judith Anderson a �? 1 �p -.7,��D Parcel ID: 041-031-56 y' 49THW O �. •.. CIN WLIS ;' O Cindy W. Ellis, RE P.O. Box 110443 June 7, 2004 Anchorage, Alaska 99511-0443 4� ; .. 0577: vo Scale 1 Inch s 50 ft Phone: (907) 349-1851, Fax (907) 349-1934 Municipality of Anchorage 9 Development Services Department Building Safety Division y/7 •---... y� On-Site Water and Wastewater Program µ •• _... 4700 South Bragaw St. CI Y W. Ellis P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite CE -10577 (907) 343-7904' Soils Log - Percolation Test Performed For. Judith Anderson TH#1 Date Performed: 5-25-04 Legal Description: Knoll on the Wold, Blk 1, Lot 1 Township, Range, Section: Slope Site Plan Depth Qarr. (Feet) Orjah iCs � ML RAd 1-04,WL 2.0 3- 4- Ph L S i /1L WIsame. Y- 5- 5 aMaC + ov 6- 9 rowel. 7- 8- (��^-WAS GROUND WATER 9- 1 ENCOUNTERED? No ,o- I S r"at IF VES. AT WHAT DEPTH? — O q Depth to Water After P 11- WQ/YVI� Monitoring? DRY E 12- - 7I1 Date: 6-9-04 13- 14- 15- 16- 17- 18Le" 19 20 Zo, o UAW &141 Reading Date Gross Time Net Time Depth to Water Net Drop 1/2 5-25-04 17:33/17:43 0/10 6/1.625 4.375 3/4 17:44/17:54 0/10 6/2.75 3.25 5/6 17:55/18:05 0/10 6/3.0 3.0 7/8 18:06/18:16 0/10 6/3.125 2.875 9/10 18:17/18:27 0/10 6/3.125 2.875 11/12 18:28/18:38 0/10 6/3.125 2.875 PERCOLATION RATE 3.5 (minubMndQ PERC HOLE DIAMETER s TEST RUN BETWEEN t FT AND 1.5 FT COMMENTS PERFORMED BY: Bart Stewart l Cindy Ellis I f ItZ1.0 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEy ES IN EFFECT ON THIS DATE. DATE: 10L=L40L Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995196650 www. muni.orglonsite (907)343-7904 Soils Log - Percolation Test Performed For. Judith Anderson TH#1 Date Performed: 5-25-04 Legal Description: Knoll on the Wold, Blk 1, Lot 1 Township, Range, Section: 11 1 1 1 1 1 Depth (Feet) Organics 0,5 ML &d Loavn 2.0 Si I+ al/same 04 L 5"td- + 5rad - uttw W/ Y RM Site Plan WAS GROUND WATER ENCOUNTERED? NO S IF YES, AT WHAT DEPTH? L Depth to Water After 0P Monitoring?i A( _ E Dale: -D f N L,fwcr Bar" Reading I Date Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE (mx-naaMch) PERC HOLE DIAMETER in TEST RUN BETWEEN Aq 1FT AND (p.Q FT COMMENTS Would not pert. PERFORMED BY: Bart Stewart / Cindy Ellis I PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL ` CERTIFY THAT THIS T�T AS LI S IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Building Safety Division a1 On -See Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-8650 www.muni.org/onshe (907)343.7904 Soils Log - Percolation Test Performed For. Judith Anderson TH#2 Date Legal Description: Knoll on the Wold, Elk 1, Lot 1 Township, Range, Section: Performed: 6-2-04 IS Data — Depths Depth to Water (Feet) Or j 4n j45 1 a 1.0 2 IF YES, AT WHAT DEPTH? — L 3- s M Stri vt5ErS . 4 6 P 511+ t Sa vl.of. 5_ Date: 6-9-04 g W(gra�d(Y2� IS �� 1$.0 Site Plan 7 (5 Reading Data WAS GROUND WATER 9- Depth to Water ENCOUNTERED7 NO 1 6-2-04 a to- 6 IF YES, AT WHAT DEPTH? — L 2 Depth to Water After O 11 -Monitoring? 4.19 DRY E 12- Date: 6-9-04 �� 1$.0 Site Plan 7 (5 Reading Data Gross Time Net Time Depth to Water Net Drop 1 6-2-04 15:00 0 6 2 15:10 10 4.19 1.81 3 15:11/15:21 0/10 6/4.19 1.81 4 15:22/15:32 0/10 6/4.19 1.61 5 15:33/ 15:43 0/10 6/4.25 1.75 6 15:44/15:54 0/10 6/4.31 1.69 7 15:55/18:05 0/10 6/4.31 1.69 PERCOLATION RATE 5.9 (minuteanrl) PERC HOLE DIAMETER s TEST RUN BETWEEN 5.25 FT AND 6.75 FT COMMENTS 4 hr presoak prior to test. PERFORMED BY: Bart Stewart ( CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S IN EFFECT ON THIS DATE. DATE: 6 - q 6,f MUNICIPALITY OF ANCHORAGE \\ nr:PARTMFNT OF HFAI TH R FN1/IRONMFNTAI_ PROTECTION ENVIRONMENTAL ENGINEERING ON y C) Y �\\Q\'\�c�;�•/�//// 825 LStreet -Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAM PHONE NEW I " d . 6k,/ ❑ UPGRADE MAILING ADDRESS +tiAve,r\ebo rme N K qq5c)� LEGAL DESCRIPTION Kr�oe_ Wold 5ub Loll zioli LOCATION NO. OF BEDROOM LIMP 11 Uy DISTANCE TO: Well f Absorption area I Dwell in O�- PERMIT NO. b z Manufacturer Material No. of compartments W I p co Liq. capacity in gallonsInside IF HOMEMADE: length Width Liquid depth onb y DISTANCE TO: Well Dwelling PERMIT NO. JUZ O Z Q S H Manufacturer Material Liquid capacity in gallons Well I ;- Fow dation Nearest lot line f PERMIT NO w DISTANCE TO: j - �� a 2- No. of linesLength of each 4ine Total length of lines I Trench width Distance between lines K' I Z W 2, y - inches 1^� Top the to finish Material beneath tile Total effective absorption ar a ap of grade I o %y inches v Length Width Depth PERMIT NO. W U Q I- Type of crib Crib diameter Crib depth Total effective absorption area M a. W W Well Building foundation Nearest lot line DISTANCE TO: d Class Depth Driller Distance to lot line PERMIT NO. J W Building foundation Sewer line Septic tank MUNI �AjMt�Fo15'a�CsM012/lGE DISTANCE TO: rPr. O - ENVIRON10ENf PROTECTIO OTHER PIPE MATERIALS�. \\ /I �V� j SOILTESTRATING S DOM C INSTALLER ar AA^ vv rw k E 84-2-1 G REMARKS 1 II / >e ✓/ d t AtCD PICUjInd�i'TO No 71' Moml� k � o p L APPROVED DATE LEGAL �/ /'% Ma Knoll � ), 1� A �-co� � E3lock I l bL on 72-013 (Rev. 3/78) P K ...,M \ Division of Gaelogical and Geophysical Surveys (DGGS) 3001 PorCuPine Drive (Telephone: 277-6615) Anchorage, Alaska 99501 WATER WELL RE -CORD Drilling Company wa. Foss Drilling LOCIIT ION OF HELL Please complete either la, ib, or It. U.S.G.S. Local No. Drilling Permit No. A.D.L. No. +11f* STATE OF ALASKA DEPARTMENT Of NATURAL RESOURCES I&. Borough AnCh. IM12oft two Wold I Lot 1 R7ock 1 76. Fraction / / / Section No. Township N/s Range E/W Meridian It. Distance and Direction free Road Intersections Street Address and Area of Well Location 3. OWNER OF WELL 'Richard Brodsky Address: 7349 E. 17th Ave. Anch., Ake 99504 2. WELL LOG Material Type Feet Below Surface Top Bottom 4. WELL DEPTH: (completed) 107 ft. I Surface Elevation Daae of C le Ion 5%9/84 'Alluvium: light brown color 0 20 5, EC.bl.. tool ❑Rot.ry 13 Or i van 13 Dug Jetted Bored ae'°r ❑other: ❑❑❑ and soft. Till: re color and hard. 20 4 6. USE: f1Opnmstio ❑Publ lc Supply ❑ IMus try ❑Irrigation ❑Reche rile ❑Colmerc ial []Test Well ❑Other: Alluvium• li ht brown color 4 55 and soft. Sand & Gravel: light brows and tedium hardness. 7, CaE1Nc., ❑ Threaded Welded 6 In. 'i8 1cr PL•.'iWpON' Weight 17 bs/ft. —1 n. to ft. Depth Silt: brown color, water beau j in and heaving. Silt & Sand: brown color, witl 105 watergrim. E. FINISH OF WELL: open end Type: Diameter: Slat/Mash Size: Length: Set between ft. and ft. Fitting.: S d: brown color with water 10 107 10 Rpm. 9. STATIC WATER LEVEL: 87 ft. ❑ Above fleelcm, land surface Type of Measuramant: sand line 10. PUMPING LEVEL below land surface 9 ft. after � 4 hrs. pumping 10 g.p.m. ft. after hrs. pumping g.p.m. t 11. WELL HEAD COMPLETION: ❑ In Approved Pit ❑ Pltless Adapter 1 s inches above grade 12. GROUTING: Well Grouted: INYes 13 No material: 1311"t Cement ❑ Other: natural 13. PUMP: (If available) HP Length of Drop Pipe ft, capacity g.p. Type: ❑ Submersible ❑Reel prow t l ng ❑Jet ❑Other; 74. REMARKS: 15, WATER WELL CONTRACTOR'S CERTIFICATION: This wall was drilled under my Jurisdiction and this report is true to the best of my knro ledge and belief: Foss Drilling AA 758 ttei6a'6us� ness a�T——�Eontract :CaZ' nsmT+u3er Address: S c S 0 Signed: Date: Authorized Representative iorn.02-WMR Copy Distribution: WHITE - State DOGS, PINK - Driller, CANARY - Customer PERMIT NO: DATE ISSUED APPLICANT: ADDRESS: CONTACT PHONE LEGAL DESCRIP LOT SIZE: HAX BEDROOMS: rlUl" 1 0 1 FunL- I -Fowu Co F:7 F-1 r-4 #--"H IZ:l Fe n 13 DEPARTMENT OF HEALTH AND EtT-ilRONIIENTAL PROTECTION 25 L. STREET., ANCHORAGE., AK 99501 264-4720 84024-4 04/24e,'84 RICHARD BRODSKY 7349 E. 17TH, A -,-E ANCHORAGE.- ffl%". 99504 33]:-5652 SUBDIVISION: KNOLL ON THE HOLD SECTION: 6 TOWNSHIP: 12N 58575 t.SQ.F*r. OR ACRES) 31 F=' U Fe 11 1 _r LOT: :1 BLOCK: :1 RANGE: '.3W LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR — SITE. — — — — — — — — — — — — — — — — — — — — -- — — -- — -- -- — — — — — — — — — — — "T- F:F— i'-.9 rH — E= -.E= --r--, L4. I:.". Fe F-1 11"-4 DEPTH TO PIPE BOTTOM f.FT. 4. 0 4. 0 4.0 GRAVEL DEPTH (FT.) 6. 0 4-0 0.5 3. 5 TOTAL DEPTH ';FT. 10. 0 4.5 7.5 GRAVEL WIDTH (FT. 2. 5 25.0 5.0 GRAVEL LENGTH (FT. al. o 49.0 105. 0 GRAVEL VOLUME (CU. `r'DS. 48. 7 45. 3 77. 7 TANK SIZE (GALS) 1.,000. 0 1., 000. (3 1, 000. 0 SOIL. RATING r*.Sf-..!. FT. .,-BR) 2 2 4 270 324 GRAVEL LENGTH D, 75 FT. REQUIRE'S MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) TANK MUST HAVE AT LEAST TI -10 COMPARTM04TS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - I CERTIFY THAT: 1. 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA. 2. 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AN[,., REGULATIONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS' PERMIT. 3. 1 WILL ADHERE TO ALL 110A AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK. DISTANCES FROM ANY EXISTING, WELL, 14ASTEWATER DISPOSAL SYSTEM OR PUBLIC SE14ERAGE SYSTEll ON THIS OR ANY ADJACENT OR NEARBY LOT. 4. 1 UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUll OF 3. BEDROOMS AND ANY ENLARGEMENT WILL REC-4UIRE AN ADDITIONAL PERMIT. IF A LIFT STATION is INSTALLED IN AN AREA COVERED BY MOA BUILDING CODE-: THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED., (2) AS—BBILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORTj AND () THE ELECTRICAL 14ORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED ---------------------------------------- DATE: . ---- -------- APPLICANT: RICHARD BRODSKY ISSUED BYDATE: ---------------------- N [1-:11 I. Mj :1 �fA D 'I Ut L �'T'6- .. . .. ..... .. .. ..... co ue- C " Ob AK zo L X SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Ti I(I n 'R r) 11 Gi L DATE PERFORMED: c5 -- I � - F>'<-1 LEGAL DESCRIPTION: (it' F� I )'; ne-) I1 on theI. )n IX L.�, —p7<)---Q'L�_- — -- SLOPE SITE PLAN (FIEEWY. —' 1 2 3 4 5 6 7 8 9 11 12 13 14 1= ncl 15 T-4 I 16 17 18- 19 20 COMMENTS jfn� ;l U Ccs S i ovw� L Cobb l e, 1 WAS GROUND WATER S n?6 ENCOUNTERED? L o r a P E IF YES, AT WHAT -- DEPTH? n . n 11 Reading Date Gross Time Net Time Depth to Water Net Drop a : 3LI � In L L PERCOLATION RATE S (F> /,II (`minutes/inch) TEST RUN BETWEEN � moi, FT AND FT 1:7 ` Rn A rnn nn /%/ PERFORMED BY: 6 (�-��P C CERTIFIED BY: m O (� -,-r- d y - C? �4 72-008 (6/79) DATE: r j L-A V. -J, J".,�����~��� DEPRRTM�NT F1TH HND ENVIRONME_"'NTHL /./OTECTION 825 LSTREET/ HNCHORHGE/ HK99501 264�47�0 EE���� PERMIT NO. HPPLICHNT DESIGN CONCEPT INC]908 LOIS DRIVE 9950] 56]~Z586 LOCHTION LEGAL. LOT i BLDCK 1 KNOLL OF THEWOLD LOT SIZE 45000 SQUARE FEET TYPE OF SOIL HBSORPTION SYSTEM ISRHINFIELD Mi RATING 75 THE F:EDQI i.[RED 1_1F THE SOIL 'IS� / ������ �!!R6 �_ �= ����� ����� ���- ������22- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD� THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM 1Df7 THE EXCHYHTION (IN FEET). � �li,� -d C_ H-11 ��C."T 0-0 �� ��. ���� �E-H, ICE -T. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE HND THE' THE (Al,-� FEET). IF���������7 k CH PA� PERMIT HPPLICHNT HHS THE RESPONSIBILITY TOINFORM THIS DEPHRTMENT DURING THE INSTALLATION INSPECTIONS OF HNY WEI HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THHT THE WELL WILL SERVE 7- � ..A ���PA "E-:; LJ _1 LIU BFICKFILLING OF HNY Sli` STEM WITHOUT f INHL AhlD HPPRCYVF1L BY 'THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MlNIMUM DISTHNCE BETWEEN H WELL HND HNY DISP( SHL SYSTEM IS J.00 FEET FOR H PRIVHTE WELL OR i50 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVHTE WELL TO H PRI YHTE SEWER LINE IS 25 FEET HND TO R COMMUNITY SEWER LINE IS 75 FEET. kIELL LOGS ARE REQUIRED HND MUST BE RETURNED TO THI.::. DEPHRTI,IENT WITHIN ]0 C THE WELL COMPLETJ.ON. OTHER REQUIREMENTS MHY FIPPLY. SPECIFICHTIONS HND CONSTRUCTION FIRE HVHILHBLE TO INSURE PROPER INSTALLATION. F7 -E`7 FA -1 1. -If"' �R'­ 'r. E'.- F-_U�EE if;_" 0 ".7,� � CERTIFY 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS HS SET �ORTH BY THE OF' HNCHORHGE 2� I WILL ���THLL T�� SYSTEM If -,I HCCORDHNCE WITH THE CODES. ]� I UNDERSTHND THHT THE SYSTEM MHY REQUIRE ENLHRGEMENT IF THE RESI�ENCE IS REMODELED TO INCLUDE MORE THHN ] BEDROOMS. . N^ SIGNED� -����=��''48111 the event that alift Station hS InotaKIC HPPLICHNT DESIGN CONCEPT INC. »-~ electrical Permit and i lapwCUon mLIa«hbe/nnU. Ao'hui|bocannot be opprQveCfiUthoo/nctrice/ inapncU0n is received, Thm n/ooih | n nnrmod bys/�omA »�/�`�'` /»«»r'm�' ./��n�`socdr/nion., i^ SOILS LOG -_ MUNICIPALITY OF ANCHORAGE +� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: k1chw/d (.i(���i �, �j DATE PERFORMED:_ LEGAL DESCRIPTION: KYio ' Y Wo dkyxl V) oc, SLOPE SITE PLAN 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 (BVI I—) CY(,1V���1 f>YOW'r1 1 6 t'1s e WAS GROUND WATER jy), (\t bU,P�tFNCOUNTERED? COMMENTS PERFORMED BY: i'ti?O�t 72-008 (6/79) IF YES, AT WHAT DEPTH? 2,1- 3 3 S Alt) L - O P E Reading Date Gross Time Net Time Depth to Water Net Drop I r/, 0 '2/2,2/23 q r C iI-/a b l2: 09 ry"J _, ioKy,o y- 2.: � p l S Alt) L - O P E Reading Date Gross Time Net Time Depth to Water Net Drop I r/, 0 '2/2,2/23 q r C iI-/a b l2: 09 ry"J _, ioKy,o y- 2.: � — 6 '7/ PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN -.ems FT AND FT CERTIFIED BY: S'-/ ee-1 4 ?'-', DATE: ALASKA LAIROMPTAL COnTROL SCkuICCS, IN. Fnyneerinq v Enuironmenlal Studies Supplemental Soils Information. Subdivision ���I h( �I��(,I Plock LOT I LOT LOT LOT TH L TH 3 TH TH 1 2 3 4 5 6 7 8 9 10 11 1; 1� 1! 1� 1 1 1 2 MI) j �JYOIt)nsi�+ __ 1 wl-N �cu5icnul cobbles�5ra��S 2 `xx�10 Si11� 2 4' 3 5— M�i hYown Si Ir 6 - 00f a _ plab�r✓ 9 - >ti1 L) 10 - -oxn 11 Yr t2 1� 13 14 15 9 16 17 18 11 19 20 L) I\ 1 DEPTH (FEET) i \O ((1M) 1 `xx�10 Si11� 2 3 y� Sj X419 4 5 11111 6 Yr 7 8 9 10 11 12 13- 31415 14- 15 16- 17 1a 19 i 20 1200 ales( 33rd Auenue. Suite B • Anehoroge Alaska 99503 • 901) 2761361 5-4,0e�-7jy 1 2 3 4 5 6 7 e 9 10 11 12 i 13 14 15 16� 17 — 18- 19- 20— DEPTH 0— DEPTH (FEET) ALASKA HUIROnmcnTAL COnTROL SCRUICCS, Inc. Engineering & 6nuironmental Studies PERCOLATION TEST DATA SHEET CLIENT RLhQrCA �%�(%�a5k\� DATE ADDRESS ZIP CODE LEGAL LOCATION TOTAL DEPTH OF HOLE ft. ZONE TESTEDy?_ ft TO ft TH # �) �� I/l/l,l1l'Iif)dr-�n,117, j READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) H7-0 1 I+HZ�;tC):LfI 3i lu yr Il�1'1V) .ru3 b-7 — — 1GFm;�i �t�z D --- ?� 0(v +NZU s_ 1`1: it IL rni�70 GCc ' z��ty. II .ZI i� 31 �pyv�tn. i (JU FINAL PERCOLATION RATE (min/in ) PERFORMED BY Cd 1--'I Qi17 " A /0 � !f,/� ej" 07 S'%ia //lilt b-e�cl( C'%— 6r'P— 5-) s>e.w )Ie -s krl. Peep ye, /r arm 1200 West 33rd Auenue, Scor ,P* Anchorage, .Alaska 99503 • (907) 276-1361 MUNICIPALITY o1� ;_ al�' Development Services Department On -Site Water & Wastewater Section Parcel I.D. 041-031-56 Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: lJ'�c7 zr 1. GENERAL INFORMATION Complete legal description KNOLL ON THE WOLD BLOCK 1, LOT 1 Location (site address) 9130 TER] CIRCLE, ANCHORAGE, AK 99507 Current property owner(s) LONNIE & DENISE BROWN Day phone Mailing address 9939 MIDDLEROCK ROAD, ANCHORAGE, AK 99507 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 7 %,?,, 5 0 40 V lb - 11 Waiver Fee $ Date of Payment i0/6�z4 Date of Payment Receipt Number 2 16 17Z Receipt Number COSA # o S C'_� O f 5(o I Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY. ANCHORAGE. AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 10/14/2020 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 ofOF A[ �l, construction (workmanship &materials), the water usage of the family being served by the t, i • . \ 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 g ' •;� [J well and septic system. Therefore, any estimate of how long a system will function satisfactory * ; •49 TM ••7k ((rJ for current or future occupants or guarantee that no unseen encroachments, deficiencies or .. .. ....... discrepancies exist can be given by First Water Consulting & Fb cs • • • • • • lir- DSD SIGNATURE r✓� �••• Curtis Huffman 0 c, CE 128991 System #1 Approved for 3 bedrooms ��is�F,�FOP ol14/2o,7JX� System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: V ' OWSITE WATERTER oz ^� pROGF pit J/JJO0. �. Original Certificate Date: 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 Legal Description: KNOLL ON THE WOLD BLOCK 1 LOT 1 Parcel ID: 041-031-56 If more than 1 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 5/10/1984 Total depth 107 ft Cased to 107 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 1/29/2020 Static water level at beginning of test 89 ft. Well production at time of test 5.2 gpm Comments B. TANK DATA Age of tank(s) 16 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 10/7/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/20/2004 ® ALL standpipes present per record drawing Total measured depth from grade 11.8 ft (max) Measured depth to pipe invert from grade 3_8 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 2.41 & mg/L❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FWES Date of Sample 1/29/20 & 10/06/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 1/29/2020 Results M Pass For 3 bedrooms Fluid depth prior to test 51 in Water adde d New depth Elapsed time 510 gal 70 in 1320 min ® Code -required soil cover over field Final fluid depth 48 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons NES Comments/Deficiencies: II 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No . ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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. - k. AW wrI TM •,�r �� .... .. . ...... .. ... ....� .... . Curtis Huffman f �'c9 •, CE 128991 • iw 19/2 0/2 QqG ft ft ft ft ft ft ft ft E P('164ju Ill: MUNICIPALITY GF ANCHORAGE Development Services Department j Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 041-031-56 1. GENERAL INFORMATION Expiration Date: � j­_20..-ZC% Complete legal description KNOLL ON THE WOLD BLOCK 1 LOT 1 Location (site address) 9130 TERI CIRCLE ANCHORAGE AK 99507 Current property owner(s) JUDITH L ANDERSON Day phone Mailing address Real estate agent 9130 TERI CIRCLE ANCHORAGE AK 99507 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ V Un—b Date of Payment o��3io2yo2�_ Receipt Number 03�{ COSA # 6,5C gj 1635 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below,, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN,PE Date 2/1/2020 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 .r, \� 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 �� •• ,.A system and maintenance. The operational life of all well and septic systems are subject to wc ` 'ATM •, these various and dynamic characteristics and are outside the control of the evaluator of the �/, L� well and septic system. Therefore, any 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 & FWfS • • • • • • • • • ���..• Curtis Huffman F CE 128991 6. DSD SIGNATURE } �i�J'• 2/1/2020 ,.•�� i System #1 Approved for bedrooms �ll`FDPROEESS16t System #2 Approved for bedrooms Disapproved Conditional aDDroval for bedrooms, with the following stipulatioqR-(((((((t,,._ �itJl)))11ti� Original Certificate Date: Z` I (` Z0? -0 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 Legal Description: KNOLL ON THE WOLD BLOCK 1 LOT 1 Parcel ID: 041-031-56 If more than 1 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 5/10/1984 Total depth 107 ft Cased to 107 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA 1/29/2020 Static water level at beginning of test 89 ft. Well production at time of test 5.2 gpm Comments B. TANK DATA Age of tank(s) 16 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 51" ® Standpipes/foundation cleanout per record drawing Date of pumping 9/23/2019 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/20/2004 ® ALL standpipes present per record drawing Total measured depth from grade 11.8 ft (max) Measured depth to pipe invert from grade 3.8 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FRcs-> Date of Sample 1/29/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 1/29/2020 Results Z Pass For 3 bedrooms Fluid depth prior to test 51 in Water added 510 gal New depth 70 in Elapsed time 1320 min ® Code -required soil cover over field Final fluid depth 48 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FW1,S Comments/Deficiencies: 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® 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' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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. Aw �•'�• TH '•�¢� :• • Curtis Huffman >� �¢ ?'F'••. CE 125991 C�`t'l�.' • . 2/3/200. • .�-\7 Aw k��PROFESS10�4.� ��la- ' XUNI,CIPALITY OF ANCHORAGE DIVISION 01 ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE I. General InformationApplicatlon. Date (a) Legal Description (i.nclude lot, block, subdivision, section, township, :range) Location (address or directions) Tele hone Home Busine , (b) Applicants Name Applicants Address ,` ) (c) Applicant is (check one) Lending Institution Owner/bui.lder. ; Buyer 1:: ; Other FLI (explain); (d) Lending Institution .r_iclE ce_ e'' c' Telephone Address � .�.,.;.._ � ,_;'� ,_:c�'•r (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. ape of Residence Single—Family Number. of Bedrooms 3. [dater Supply Individual Well Mu1ti-•Family IT Commuii:i.ty Other (describe PubIJ.c E --I Note: If community well system, must: have �rri.tten confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage isp Disposal OnsiL'e C__h Public ._ Community � Holding Tank r �1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. J' [Page 1 of 21 5. 6 ' 1 Engineering Firm Tggy�iding Inspections, Tests, File Search Data and l tpj As certified by my `sail affixed hereto and as of the validation date shown belt I verify that my investigation of this Health Authority Approval shows that the water supply and/,or wastewater disposal system .is safe, functional and adequat,. �,,�. ` =', the number of bedroom] and type of. structure indicated herein. I further verily based on the information obtained from the Municipality of Anchorage files and investigation and inspection, the on --site water supply and/or wastewater disposal system is in complianc:Z with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. : c Name of Firm l-, Add r:esa Date DHEP Approval. I (ENGINEER SEAL) Approved for l� bedrooms Approved Disapproved Terms of Conditional Approval p. N�3 ✓y ,� 't.�h fa�Jy L✓' eq ilii �l v� cel a troy C. Raid, J p No. ` i (FP ajo � CAU'CION Conditional. THE MUNICIPALITY OF I4XnORACE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGi2APH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF AI.ASKY. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF [TOMES IND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF.DAEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED, THE MUNICIPALITY OF ANCLORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. � Y RR4/ej/D18 [Page 2 of 2] I (DHEP SEAL) 7-19-84 MUNICIPALITY C` A4JCKNACc DEPT. CF HEi LTJ CNVIRONii[NTi,.L Pa��i.CiIC�J MUNICIPALITY OF ANCHORAGE (MOA) SEV 2 71984 HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 IR CE I �f Fb Legal Description: A. WELL DATAr r J 13(ont. I K= III vvi 44ni U3o0 Well Classification pe-(oc�t t� If A, B, cc C, D.E.C. Approved(YM) AJ14 Well Log Present AM) Date Completed ,S1101kc( Yield QED of Total Depth /'D% Cased to /� 7' Depth of GroutingNycm Static Water Level 8`7 Pump Set At AIC4- no, W_r'f ( to � r Casing Height Above Ground Sanitary Seal on Casing & N) Electrical Wiring in Conduit N) Depression Around Wellhead (Y Separation Distances from Well: To Septic/Holding Tank on Lot /S' © On Adjoining Lots 3tf3 lot To Nearest Edge of Absorption Field on Lot /iAd f ° e/o; On Adjoining Lots ;3(1 30 To Nearest Public Sewer Line w1k To Nearest Public Sewer Cleanout/Manhole JOU To Nearest Sewer Service Line on Lot )()IA_ Water Sample Collected By t')aPs.42 Date `?/2q�gc� Water Sample Test 'Results x>C?c �ac�iP Ccatme nts�n n� ff_& FC B. SEPTIC/HOLDING TANK DATA Date Installed '5.117 -2 Size /Ooo No. of Compartments :2 - Standpipes Standpipes &) - Air -tight Caps ((&) — Foundation Cleanout Depression over Tank (Y Date Last Pumped �LYA Pumping/Maintenance Contract on File (Y/N) for N�'+ Holding Tank High -Water Alarm (YM) 'UTA- Temporary Holding. Tank Permit (Y/N)'!MA Separation Distances from Septic/Holding Tank: To Water -Supply Vbll /,2, ® To Building Foundation //'' '0 To Property Linen" To Disposal Field (o� To Water Main/Service Line '�)/Ar To Stream, Pond, Lake, or Major Drainage Course >100 Comnentss 2rn�.��u� �Qu c.� c lor.�i� �y�Pc C 4-o s+c-, JQ,o s [Page 1 of 21 IV I r7 2-15-84 �— 1 0, e—VLOt f a,214a. WDtc!- C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata J'. Type of System Design Date Installed -5-// 7 le L( Length of Field Width of Field Depth of Field 75"� Gravel Bed Thickness Square Feet of Absorption Area Standpipes Present � /N) Depression over Field (Y y Date of Last Adequacy Test 4)(a Results of Last Adequacy est (A Separation Distance from Absorption Field: To Water -Supply Well //2 �� C6To Property Line 163 ✓ To Building Foundation �; y� ` +410(00 To Existing or Abandoned System on Lot N to ; On Adjoining Lots To Water Main/Service Line tUTA— To Cutbank(if present) &)tA- To Stream/Pond/Lake/or Major Drainage Course >/00" To Driveway, Parking Area, or Vehicle Storage Area ! /0 10 4CLOeCLc�' comments e. )0&m-J,',,- D. 0&m- ,',,- D. LIFT STATION Date Installed IkJ/* Dimensions WV Size in Gallons N(,A- Manhole/Access (Y/N) YU%A "Pump On" Level at 'UTA- "Pump Off" Level at 06 High Water Alarm Level at 'V(A Vent. (YM) MIA Tested for 10 (A.-_ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N) W(A- Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection • <:e�x:`t+;� ems+ � i�_ Signe W,4Date lam_ 1101 Como pany FC MOA No. if�-U�� �yprr,� RS f( ���p �, e'FY KB1/d5/rJ •. . �.°.�f'ni°.°o. roy C, n9 4, ���,�; No.t�tii•� i [Page 2 of 21 % WEM 'ba 2-15-84