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Home My WebLink AboutKIRK LT 1 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251188 PID Number: 05058127000 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Martin ABSORPTION FIELD ❑E Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4477 Panther, Eagle River, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.8 GPD/sFJ 10.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.8 Ft.7 Gravel depth beneath pipe Ft. Subdivision Block Lot Kirk Lot 1 Fill added above original grade 0.5 Ft. Gravel length 54 Ft. Township Range Section Gravel width 2 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 750 Ft2 1 Ft. Well +1 QQ +100 NA NA +25 TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water +1 QQ + 1 00 NA NA Material Poly Number of compartments 2 Lot Line +10 +10 NA NA NA Foundation +10 +10 NA NA LIFT STATION Manufacturer Capacity Remarks Old tank was hauled offsite for disposal. Gal. Entire drain field effective area was installed Alarm location Electrical installed by in SM/SW soil strata. PIPE MATERIAL House to tank PVC Tank to PVC drainfield Installer Northern Lights Construction and Engineering Drainfield PVC CO/MTPVC Inspector Matthew Balzarini BENCH MARK (Assumed elevation)100 ft 1s` 6/20/2025 6/22/2025 Inspect Location and description 2nd sn Septic Tank Manhole 3`d 6/23/202 4`, 6/24/202 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date i•�P y TH /* 49— */ Septic System MATTHEW P. BALZARINI /�+ �kc CE118893 Approved Date - , ��'�:Fq°8/8/202q�� FOPROFESSIO*gg4- Note: this approval does not include well permit requiremen s. (Kev ub/uzi 16) 54' LONG DEEP TRENCH WITH 7' EFF. ' �l * 49 * I , WELL MAFT�T,HEW PBA�LZAR�IN�I CID O �§CE118893 ��' /SHED/ �w /31/20 MT PROFESSO/ TH-1 �� 4 BR HOUSE I I A I I BII �' I 100' WELL % --�� I MT RADIUS I I CO / ABANDONED DRAIN FIELD TH—S&S / Item Bev/Depth Note Tank Manhole Lid 100 Benchmark �� : �, SwINGTIES Tank Inlet 95.4 Invert `� - A B H DESCIRIPiION Tank Outlet 94.7 Invert D -----_____ c 73.4 71.6 TANKMANHOLE F D 72.6 74.5 TANKCLEANOUT BTMTank 89.8 E O C DOUBLE E 71.5 75.9 CLEANOUT Final Grade at Tank 100.0 Cos F 70.2 75.7 CLEANOUT Cover Over Tank 4 Depth G 48.9 97.7 CLEANOUT Cover Over Field 4 Depth H 47.7 97 MONITORTUBE I 59.1 - 44.5 MONITORIUBE D st E� pe I nvert 93.5 J 61.9 - 50.3 CLE�,NOUr BTMofAleld 86.5 KIRK LOT 1 Final Grade at Field 97.8 1250 GAL GREER Elf ecti ve Depth 7.0 Depth POLY TANK Ori g Grade 97.3 BTM TH 80.5 Ground Water NONE 6/25/2025 Fill Added 0.5 Depth EX Depth atReld 10.8 Depth PLAN — SC : 1" = 30' TANK LID FILTER FABRIC INAL ONITOR TUBE FINAL GRADE AT TANK BM GRADE INISHED GRADE TESTHOLE 1 FIELD ORIG. GRADE COVER TANK INLET TANK IST PIPE SEPTIC TANK OUTLET INVERT BTM--3 FIELD 4'b DISTRIBUTION PI FIELD NO GWT SEE TABLE FOR 0.5' EFFECTIVE SEWER ROCK DEPTHS AND ELEVATIONS SCHEMATIC PROFILE VIEW SHOWS ELEVATIONS OF INSPECTED ELEMENTS BUT DOES NOT DEPICT SYSTEM IN ITS ENTIRETY. BTM INSPECTION FOR GENERAL CONFORMANCE TO DESIGN AND MOA TESTHOLE REQUIREMENTS ONLY. SCHEMATIC ELEVATION — SCALE: NTS LEGAL DESCRIPTION: KIRK SUBDIVISION LOT 1 NORTHERN LIGHTS CONSTRUCTION OWNER: MARTIN DATE:7/31/25 1 REV:O 1 DRAWR7 M REF: AND ENGINEERING 907-854-5244 SEPTIC RECORD DRAWINGS 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: OSP251188 Work Type: Septic Upgrade Tax Code Number: 05058127000 Site Legal Address: KIRK LT 1 G:0703 Site Mailing Address: 4477 PANTHER DR, Eagle River Owner: MARTIN JANE Y & JOSEPH A Design Engineer: Northern Lights Construction and Engineering This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/18/2025 6/18/2026 123812 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Special Provisions: New test hole dug to verify soil information for this proposed trench. Groundwater study was not completed. 7 day groundwater monitoring is required. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. .- Received By: Date: Issued By: Date: � MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05058127000 Property owner(s) JOSEPH & JANE MARTIN Day phone Mailing address 4477 PANTHER DR, EAGLE RIVER, AK 99577 Site address 4477 PANTHER DR, EAGLE RIVER AK 99577 Legal description KIRK LT1 Number of Bedrooms 4 Engineering Firm NORTHERN LIGHTS CONSTRUCTION AND ENGINEERING Building Permit Number Not Applicable X APPLICATION IS FOR: APPLICATION IS AN: (N all that apply) Disposal Field R Initial ❑ Septic Tank F] Upgrade El Holding Tank 0 Renewal El Privy El Well El Water Storage D THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: S 9f Waiver Fees: Date of Payment: Date of Payment: Permit No. 0�p Waiver No. May 2025 NORTHERN LIGHTS CONSTRUCTION AND ENGINEERING Ph: 907-854-5244 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System for KIRK SUBDIVISION LOT 1 Dear Reviewer, The above referenced property is currently served by an older failing septic system. Our review of available documentation and field investigation show that this project will not adversely impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, or drainage flowing onto and off of the subject property. The old system will be replaced with a new tank of MOA approved construction and a deep trench disposal field. The existing drain field may be abandoned in place or connected to the new tank with a diverter valve at the option of the owner. The disposal field will be located horizontally a minimum of two times the depth of gravel below the distribution pipe invert from the edge of the existing drain field. The new system will meet all MOA required separation distances as shown on the plans. The proposed system will be located on a slope greater than 25%, but less than 46% and will meet MOA requirements for deep slope disposal fields as shown on the plans. • Vertical separation distances will be measured from the up-gradient side of the trench. • The trench will be less than 60” wide. • Vegetation on the down-gradient side of the trench will remain undisturbed. • The distribution pipe invert will be a minimum of 36” below the natural organic surface measured from the down-gradient side of the trench. The tank and field shall be covered with a minimum of 2” moa approved insulation and 3’ of cover or a minimum of 4’ of cover without insulation. The design is based on the testhole and perc test logged by S&S Engineering in 1990 to a depth of 13’ below grade. Review of available data for neighboring test holes shows that soils in the area are generally SM, GM, or SP. Shallow groundwater or impermeable layers were not reported at adjacent lots down- gradient from the proposed site. Based on this, it is not expected that conditions found at this site will vary substantially from those reported in the S&S testhole. Prior to construction, a new testhole will be dug in the vicinity of the proposed trench as shown on the plans. The testhole will be located on the uphill side of the proposed trench and will be dug to a depth at least 6’ below the bottom of the proposed trench. This testhole will be dug in the presence of the Engineer and will be used to confirm soil data, percolation rate, groundwater levels, and absence of impermeable layers before construction starts. If changed conditions are encountered at the new testhole, a design revision and change order request will be submitted to the MOA to ensure the proposed system meets MOA requirements. Upon completion of the installation, a record drawing will be submitted showing the location of the new tank, leach field, well, and other applicable features. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251188, Curtis Townsend, 06/18/25 Following replacement of the septic, we will be seeking a COSA. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5244 or by email mpbalzarini@gmail.com with any questions or concerns. Sincerely, Matthew Balzarini, PE 5/28/2025 Revised 6/13/25 6/13/2025 Residence: Kirk Subdivision Lot 1 number of bedrooms 4 br Water usage/bedroom 150 gpd/br Water Usage 600 gpd system type: Conventional type: Deep Trench Application Rate 0.8 gpd/sqft required absorption area 750 sqft trench width (W) 2 ft MIN gravel depth (D) 7 ft Min Required Length: 54 ft Groundwater Depth: dry Testhole Depth: 17 ft Max Excavation: 11 ft Calc By: MPB Date: 5/28/2025 Revised: 6/13/2025 Northern Lights Construction and Engineering 907-854-5244 Septic Design Calculations RESIDENCE/LOT INFO DRAINFIELD REFER TO PLANS FOR DETAILS OF CONSTRUCTION 6/13/2025 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251188, Curtis Townsend, 06/18/25 6/13/2025 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251188, Curtis Townsend, 06/18/25 6/13/2025 38.3' 2 0.3' 38.3' 2 0.3' C A R P O R T G A R A G E SHED 12'x14' LEGEND EDGE OF GRAVEL DRIVEWAY DECK RECORD DATA PER PLAT #86-210 SEPTIC PIPE WELL RESIDENCE 28.3' 16.0'4.1' 6.8' 4.1' 6.5' 5.4' 3 . 8 ' 12.3'3.8' 5.4' 12.0' 28.3' 59.0' 2.0' CANT. 2.0' CANT. 2.0' CANT. 2.0' CANT. CANT. ELEC. GAS RESIDENCE TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.072 SCALE: 1" = 50 FEET DATE: 4/16/2025 SHEET: 1 of 1 MOA GRID: SE0703 SCALE: 1" = 50 FEET(11"x17") 50'0' 100' AS-BUILT OF: ADDRESS: 4477 PANTHER DR, EAGLE RIVER, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 1KIRK SUBDIVISIONPLAT #86-210 RESIDENCE DETAIL 1" = 20 FEET MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~ ~ ~'~ ~ Tn SEPTIC ABSORPTION ~d~FROM~ TANK FIELD WELL LEGAL DESCRIPTION LOT LINE P/o / ~/~ / ~" ' LotI Block Subdivision / I ~/~ ~' ~ ~ ~, FOUNDATION ~ ~ ' Township, Range, Section AS-BUILT DIAGRA~ (Show Iooation of well, sepbc system, ~ropedy lines, loundation, ~/~ ~ ~ / ~ ~ ~, ~ driveway, water bodies, etc.) TANKS ~ ~ Manufacturer Capacity in ~allons M~eri~l No. of Comp~men~s ~ ~ ~ TYPE OF SYSTEM ~ TRENCH G BED W. DRA N OTHER Depth tO pipe bottom from Total depth from original grade ~ ~ original grade ~ FT ? FT ~ X Fill added above original grade Gravel depth beneath pipe Gravellength Gravel width ~ ~ Total absorption area Distance between lines X Number of lines Soilrating~ J~ SQ FT Pipe material~r~ 'o' ' ; ~'/' / / ~ WELLS ~ ~ Lr? ~ PRIVATE ~ ~ OTHER (Identifv) -..x ~ / / Eagle River AK 99577 ~~ caddy thai Ih~s ~nspe~ on was pedorme~ according to all Municipal and Slate guidelin, in elfect onthis date: ~ ~ ~ ~ Health Depadment Approval: 72-013 (3/85} ~ ( J bJi' i E:) P .) ~qunicipa~ity of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FORi LEGAL DESCRIPTION: 6 7 8 9 10 11 12 13 Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth Io Water Alter .onitoring? 14 15 16 17 18- 19- 20- Gross Net Depth to Net Reading Date Time Time Water Drop ~;¢J7~ ~o ~ ~ ~ t,l~ TEST RUN BETWEEN ~ T AND ~ FT ' I' I ka 99577 72-008 {Rev. 4/85) unicipality of Anchorage Department of Health and Human Services " 825 "L" Street Tom Fin~, Mayor P.O. BOX 196650 Anc..horage, Alaska 99519-6650 343-4744 January 9, 1989 Kasey Correia PO Box 771658 Eagle River, Alaska 99577 Subject: Lot 1 Kirk Subdivision Permit #880157, P.I.D. ~050-581-27 A permit issued,by~this Department ~'or an individual well and/or on-site sewer system has expired as of December 31, 1988. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. ~ If a private engineer inspected the installation of the on-site sewer system, the orginal as-built inspection report (three-part form) must be sent to this office for review and approval, and for documentation. When applying for a new permit, the fees are: $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. Sincerely, Daniel J. Roth Acting Program Manager On-site Services Section DJR/ljw enc: Copy of Permit M U N I C I P A L I T Y 0 F A N C H 0 R A G E Depar'tment c~f Healt:h & Human Sepv.ices 825 L St~eet, Anc:hopage, Alaska 99501 .]143-47R0 CIN--SI'I"E SEWER & SEP'T'IC "FANI< & WELL. F:'EF:,"MIT Pep.mit Number': ,.c38C~15'7 Date Engineer' Designed O~,,.~nep Name.· KASEY CORREIA Ortner' Addpess: PO BOX 771658 EAGLE RIVER, Al< 99577 Papcel Id,: 050-.581-27 Lot. L..ega].: Subdivision: KIRK L.o{: 1 Block: Sect.:Lan~ :32 ]"c~wr~ship: 14N Range Lo'L Size 12'.Z~812 (sq. ~t,. o~' acpes) Hax Bedr'ooms; This F'er. mit,: 3 Tot. al Capac:ity~ Day 696-0846 INSTALL F'ER ENGINEERS DESIGN A TRIENCH 'TYPE: ABSI]RPTION SYSTEM. LENGTH: 42'; GRAVEL DEF'TH: 5'; MAXIMUM DIEF:'TH: 9' T'HIS PERMI]" I!.:~ ISSt.JED FOR A 3 BEDROOM SINGLE F'AMIL. Y RESI'DENCE [)NL..Y AND'EXI::'IF~ES :L2/31/88. IqOT]:F'Y DHHS PF;'.IC)R TO ALL INSF'EC'TIONS I CERT'II='Y THA'T: 1. I am familiar' with 'Lhe reciui?ement, s fop on-.sit, e sewer's and wells as set ¢o~'f..h by the Mun:LciPali-Ly o¢ Ant:borage (MOA) and t. he State c)f A].as!-::a, ,: .... I will inst. all t. he systef il"l acccmdance with ali MOA cc)des and r'egulat.:i.c)ns, and in compliar~c:e with the des:i, gn cpi'Ler'ia o~' this pepmil:,, 3. I w:L].], ac:lher'e 't'..c) all MOA and State (:)f Alaska pe(::tuir'emer~ts ¢(::m t. he set back d:i.s'Lances f'r'om any ex:i. st:i. ng we].l, wsst. ewa'Ler' disposal system op public ~ewer'age system on 'Lhis ot" any adjacent (::)P neapby lot. I unde~*~'Land tha'L t. his per'mi'L :i.s valid f'cg~' a maximum of 3 bedrooms,, I also under'star'~d t. hat the capacity of' the t. otal system is 3 bedr. ooms and any enlar'gement will r'equipe:, an addit, ional pe~*mJ.t. Issued Bv SEPTIC TANK: Minimum total septic tank c:apacit, y: 1,000 gallons. Each septic t. ank must have a'L least. 2 compar'tment, s. Dep'Lh 'Lo t.c)p of' septic t. ank(s) < 4,,0 ¢ee.t pE, cjt..tir'es inst..tla{~or') ovep WELL: Leg riit..t~t, b(f~ ~iLiblll¢.t.t. ed t.o Mur'~:i. cipal:Lt.y of Anc:hor. age Depar.{ment of Igealt. h ~).l]d Hu. liiaFI Sepvic:es w&thin 5()days of well comple'Lion. SCALE . PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE Township, Range, Section: SLOPE SITE - / WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth 1o Water After Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ((2-~7 '-~(minutes/inch) PERC HOLE DIAMETER If) g TEST RUN BETWEEN ~ T AND ~ FT $ & S ENGINEERIN~ 72-008 (Rev. 4/85) 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 OSC251314 Parcel ID 050-581-27 Expiration Date: Legal description KIRK LT 1 Site address 4477 PANTHER DR Current property owner(s) MARTIN JANE Y & JOSEPH A X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development 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 Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory 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. 05058127000 Complete legal description Location (site address) Kirk Lot 1 4477 Panther Drive, Eagle River AK 99577 Current property owner(s) Joseph & Jane Martin 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: X Private Well serving #_1 Day phone 907-229-1722 dwelling units F-1 Other Non-public well as regulated by MOA El Water Storage f_j Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: RE Private Septic E] Private Septic serving 2 dwelling units F-1 Holding Tank Fl Community Septic or Public Sewer 5. SEPTIC TANK: R Steel OR Plastic R Concrete R Fiberglass Age new - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: [:] AWWTS R Bed � Deep Trench F Wide Trench 0 Seepage Pit Waiver request for: Expedited review requested: n Distance: 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 $ 2-k Waiver Fee $ Date of Payment L Date of Payment COSA # OK 2-5t 31� Waiver # COSA Applicafion_AW025.doc COSA Checklist Legal Description: Kirk Lot 1 Parcel ID: 05058127000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 8/1988 Total depth 133 ft Cased to 133 ft ❑ Sanitary seal is functioning correctly FE-1 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 6/16/2025 Static water level at beginning of test 80 ft. Comments B. TANK DATA Measured operating fluid level in septic tank N/A Date of pumping N/A ❑ Required maintenance completed, if AWWTS Comments: Tank is New D. DISPOSAL FIELD DATA Which system tested (date installed) 2025 0 ALL standpipes present per record drawing Total measured depth from grade 11.3 ft (max) Measured depth to pipe invert from grade 4.3 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑E Monitor tubes go to bottom of effective. 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) If yes, enter date Well production at time of test +7 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes R No F0 Coliform bacteria is Negative Nitrate 0.719 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Matthew Balzarini Date 8/04/2025 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date N/A Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 84 in Effective depth used 0 in Effective depth remaining 84 in Comments/Deficiencies: New system, adequacy testing not required COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' 2 Yes if No ft Neighboring Tank > 100' Q✓ Yes if No ft Disposal Field on Lot > 100' M Yes if No ft Neighboring Disposal Fields > 100' 0 Yes if No ft Sewer Line/Main > 100' QYes if No ft Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft Sewer Service/Septic Line > 25'F71 Yes if No ft Holding Tank > 100' M✓ Yes if No ft Animal Containment > 50' 2 Yes if No ft Manure/Animal Excreta Storage > 100' r✓ 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' F Yes if No ft Surface Water > 100' Q✓ Yes if No Field to Foundation > 10' ❑✓ Yes Tank to Property Line > 5' P7 Yes Field to Property Line > 10' [D Yes Water Main/Service Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: if No ft Wells > 100' if No ft if No ft F. ENGINEER'S COMMENTS New tank and field installed 6/2025. Community Wells > 200' I, R] Yes if No ft FZ Yes if No ft If tank or field is under driveway comment below 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 Northern Lights Construction and Engineering Engineer's Printed Name Matthew Balzarini COSA Checklist_May2025.docx Phone 907-854-5244 Date 7/31 /2025 =_ of At gsAW tl ;,4s TM MATTHEW P. BALZARINI 19Fc CE118893�� 120 38.3' 2 0.3' 38.3' 2 0.3' C A R P O R T G A R A G E SHED 12'x14' LEGEND EDGE OF GRAVEL DRIVEWAY DECK RECORD DATA PER PLAT #86-210 SEPTIC PIPE WELL RESIDENCE SEPTIC TANK LID SHED 10'x12' 28.3' 16.0'4.1' 6.8' 4.1' 6.5' 5.4' 3 . 8 ' 12.3'3.8' 5.4' 12.0' 28.3' 59.0' 2.0' CANT. 2.0' CANT. 2.0' CANT. 2.0' CANT. CANT. ELEC. GAS RESIDENCE TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.072 SCALE: 1" = 50 FEET DATE: 7/18/2025 SHEET: 1 of 1 MOA GRID: SE0703 SCALE: 1" = 50 FEET(11"x17") 50'0' 100' AS-BUILT OF: ADDRESS: 4477 PANTHER DR, EAGLE RIVER, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 1KIRK SUBDIVISIONPLAT #86-210 RESIDENCE DETAIL 1" = 20 FEET