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LAKE RIDGE TERRACE BLK 9 LT 2
MUNICIPALITY OF ANCHORAGE DEPA~qMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS PHONE ~UPGRADE LEGAL DESCRIPTION LOCATION o_ ~ DISTANCE TO: l-~.,~z Manufacturer ~- Lq.c DISTANCE TO: Manufacturer DISTANCE TO: Wel I No. of lines Top of tile t o ,~i.~sh ~/~de/ Length Width inside length NO. OF BEDRO~¢S I Dweling / ~- IPERNIITNO. . Material co parl~[Ze ts Dwelling PERMIT NO. Depth Width Material Nearest lot J, ine inches inches Liquid depth~ Liquid capacity in gallons PER~.~ .~).~_~;/~T.[~../_ - ~)_ Total effactlv~e~a_bsorD.l~bn area PERMIT NO. Type of crib Crib diameter Well DISTANCE TO: Class depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Septic tank Sewer line Absorption area(s} OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER ~RKS__ ~ '2 ; AP DATE LEGAL L.(]T '= ? TM F-' .... [:,EL- ¥ Fi :< '[ MIJM i'..tMF:EF.' (}F .......... 5~;Fj¢,.:'.!E~ SQt. JF!F;;:E F'EE]" SO I L. RFFF ! NG ,' ?;Q FT/E:R ;: .... 2:'"! ;i) TFIE F:EQUIF.:E[:, SIZE OF THE SOIL .:tE':_:OPP'I"I(]N S'-?E;TE]"I );'F.;- THE L. ENGTH DiMENSiON IS THE L.E:NG'TH ,.':IN FEET) OF: TFIE TRENF':H OF.: [:,RF!INFZELD. TFIF.'. DEPTH OF R TRENCH OR PIT I:.:; THE DiSTRNE:E BETHEEN THE SURF'FIE:E OF' THE GROUNC', RNE:, THE BOTTOM OF THE E::-:;E:RV'R]"I(}N ,:;ihi FEET). THEF.:E ZS NO SET H!DTH FOF.: TRENCHEi;. THE GRFIVEL DEPTh! IS THE HINIHUM DEPTF! r"iF GRFF,,'EL BE]'HEEN THE OU]'.'FF','L.L PIPE F!ND THE E:OTTOH OF' THE E::.:',E:RVFiTION -':Z IN FEET). F-'.' EE ~]:~ ~.....~ % ~: i;~-._; C',, :'~; E E::~ T' % ~Z:: -~C F.4. P-,,il ~---.:'." '~EE; % ;Z: ~Z == :!. ,~2E~ ~E~ ~:;E~ 03 F:::~ L_ L_ C-~ ,..E'_=,,-r; b,_-, ~ R,_l.~z . -., "FO.. ............ 'r.i'. F- F?f.I 'T'.L~T'E; r':,FpF F.'THENI" [,JR'tH3 "FHE F'ERMI'F FIPF'L. tE:RNT FIRS THE -,---c,,- ,.-~ ,.,, .,T, ..... i H'S]"FI!_LiBT I ON l NSPECT IONS ] F' RN"r' ..,.!ELi S .Ri',ZrF,'Z:E~'~T TO TH ! S F'RCIF:'ER"F'T' FIl'q[) THE '. ~ !I,'IP',EF? OF RES ~ DENCES -~ "~' T ....... :,E. *. ,,, E.. ..... t,IH. THE HELL. F 'r"~ ..... '"'- E'~RCKF i LL. I NG CtF FIN'.¢ S?~-~ TFH .,J T TF '/_ T F i*-.,F~[.. :£ NSPEE:!" i ON RblP RPF'ROVF~IL. E:'¢ 'FH l S F.,E F'F:IF.:": MENT ~ ..... ! LL S JD .)'ECT TO PF.:O'S,r-iFX:iJ]' i Oi',! M !' N l MUM D ! :iS'TFH'-4C'E F3E'FHEEEN f::l HELL. RND FtN'.¢ ON-S I "FE E;EHF!GE [> I S;F'OSF4L S'T'S'?'EM I S :I. Ei~23 FEET F'OR R PF.:!',,,'FITE HE:L..L OR !SO TO 2Et(~i FEE:T FROM R F'UBLIC HELL [:,EPENDZNG UPON TF!E T')F'E OF F'LIBL. IE: HEL. L.. MINIMUM DIE;TF~NCE FROM R F'RIVRTE HELL TO ~ F:'RIVRTE SEHEF.: LiNE !S 2.5 FEET Ri',!D TO !:~ CCi!','iMLJNZT'¢ SEHER L..iNE !S '?5 FEET. OTHER REQUZP. EHENTS MR'¢ RF'F'L'¢. E;PEE:~FiE:RTZONS ~ND CONST'RLIE:TZON E:,ZRGRRMS RRE RMF~ZLRBLE TO ZNSLIRE F'ROPER ZNS"FF~LLRT!ON. i CERTtFY 'TI"iRT :L: I FIM FF!MI.L. IFiF:: HITH THE REQUIREMENI"S F:'OF.'. ON--.SiTE :SEI-,.!ERS FIN[:, HELL.S FIS SET FOF.:TH B') THE MUNIE:!PF:iLii"')OF RNCFIORRGE. 2: i i.,.!iL.L iN!;T'RLL THE S'¢STEH iN RCCORDRNCE I,.!iTFI THE CODES. 2:: I L.INE:,ERSTRND T'HRT THE ON-SI'I"E E;EHER S'¢S'TEH h'IR'.¢ REQLIIRE ENL..RRGEMENT IF' THE F.:E:SIi}ENCE IS REMODELED TO ]:NCL.I.J!)E MI'.]F.:E THRN ]: E:EDROOMS. F!F'F'L., I CF~NT PFF!"'T'Y LEE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST SLOPE 5 6 ~. 7 10 11 12 13 WAS GROUND WATER ENCOUNTERED7 IF YES, AT WHAT DEPTH? 14 15 16 17 18 : 19 20 COMMENTS [] SOILS LOG PERCOLATION TEST SITE PLAN Gross Net Depth to Net Reading Date Time Time ~' Drop PERCOLATION RATE ~ (minutes/inch) TEST RUN BETWEEN ~ FTAND~ FT G~'~.,~,TER ANCHORAGE AREA BORO!'~,.'H HEALTH DEPARTMENT 327 ~AGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~ LOCATION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY ./~) ~--~(-~ .GALLONS. NUMBER OF / MATERIAL C~- ~- ~/~C'~/~-~--~ COMPARTMENTS INSIDE LENGTH ~ INSIDE WIDTH LIQUID ~ .. DEPTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER ~ OR WIDTH /? LINING MATERIAL ~/~-¢~ ~/'~'~"--~ . DISTANCE FROM WELl NEAREST LOT LINE :~>~- ~-) / ~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH /~/ , DEPTH BUILDING FO UNDATIO N-'-,~ r,-~-~/~ SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL ' ~-~'~, FOUNDATION ~. NEAREST LOT LINE ~,~~ , NUMBER OF LINES ///~'~ DISTANCE BETWEEN LINES ~ TRENCH WIDTH _//~ IN. TOTAL~FFECTIVE E~PTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER M~'~RIAL BENEATH TILE IN. ABOVE TILE__ WELL: TYPE~-/~ , DEPTH ~-~ / DISTANCE FROM ////) ~_.~ \WATER , BUILDING FOUNDATION.k/~~ .~'~- C,~SAMPLE , NEAREST NEAREST / SEPTIC ~"~'D ( SEEPAGE /,//~ ~ LOT LINE /'~ '/7~ SEWER LINE , TANK , SYSTEM CESSPOOL ~- OTHER . , , SOURCES DISTANCES: ~_~e_~. DIAGRAM OF SYSTEM . ~'~i-.~_:'.!i;;. .~ ~ i. ili.':.i: ~..:J. : . ,.-..:, i..i.i, i .i. - ,,~, ~ : : ; :. ~. . ,. ~ . ...,. } ~ ..... : ~ . - ........ :, .. · ~ ~ : ' : : : : E : ~ ~ : : ~ ~ ~ : : .~.-... ~ , ~ :. _ .-..f : : :' . -.: ~-: ~ : ~ .._. f.,-:,-., : · ~.~ ~ ~ - ~. 't~": ' ~ ':: - ~'~ :''' .... :":';"~' '~ ......... ~ .... ~ :' '~':'"~ : ...... .....~, ~ ~ ~'" ~ .: '- . .~ ~:'-~ . - , . : ....... - . .: ..... : . . .......... .... t~. /: ~ ....... ~ : ~ ...... ...... ; .... ~ .... ~ .... ..~ ........ : , ~. - ~/~,-; : '..: ~:.: .;. ; ~ :. .~;... U. ,.E.' .- .~ ..~ : ..~ ........ ~ :.,~ / ' ~ :.... ~ ;.~ :. ~ :. :..~ ~ .... ~ ..... ;.. ..... :'- ' '~;~ ? :"~": ~ .";'-'-~"':' '"f~;":'Z'q~ ~ ; ' ~ ~ ; ;- : I ~ . . , ~ff~ ..... ~ .-~ ~- ,> ; -,~ ; : v ; , . -. · : ,. ....... ~ .. - :7 .....~ : ~ ~ .- . ~ . :- . . ; - -- ' ·' - . . _ . : '-.' .. ~ ' : . ~...~ ~ -~-~,~ .., .~_ ' ~ · . ~ ~ GREATEI, ANCHORAGE AREA )ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 Case No../~'?z/' SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT ~--¢-~ /~~ MAILING ADDRESS ~' ,~-/'c ,- ,/-?/C . PHONE RESIDENCE ADDRESS ~-~'--~' .,/~ LOCATION OF INSTALLATION ~//-~'~--~~-'~'~' LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS THIS IS TO SERVE AS ,S/~EPAGE PiT .~-'~, DRAIN FIELD ,OTHER TO BE INSTALLED BY.~'~::Z'~-~"'~"~ ,~~''z~' ANTICIPATED DA'I~OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ~,-,~-~ AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED SEEPAGE AREA · SEPTIC TANK SIZE ,/,~ TYPE DIAGRAM OF SYSTEM TYPE DISTANCES: Health Authority , I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. nATI: APPLICANTS SIGNATURE Depth Fe.e t , ,/'"~!., ANCHORAGE, ALASKA 99501 ', Performed For 3~l'"d~ PO~ ~D"~;<P ' ' ~ Lot ~ Block ~. _Subdlv~slon Legal Description: _~ . This Form RepoPts a: So~ls Log ~ / · - -Percolatmon TesZ ..... ~"~ s Location Sketch Soil Char=~.e, ~ .... c Was Ground Water Encountered?~ ..... If Yes, At l~,~bat Depth~ ~ Net Time Depth To H20 .n .... l.,.a,._,~o,,: Seepage Pit L/ Drain Field Depth Of Test Performed By: Data Certified By: 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 Parcel I.D. 051-323-13 1. GENERAL INFORMATION Expiration Date: 7 _-a q ZZ Complete legal description LAKE RIDGE TERRACE BLOCK 9, LOT 2 Location (site address) 14206 HAROLD LOOP, EAGLE RIVER, AK 99577 Current property owner(s) GISELA ANAYA & ELVIN MEJIAS Day phone Mailing address Real estate agent 14206 HAROLD LOOP, EAGLE RIVER, AK 99577 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: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 5 5 0 Waiver Fee $ Date of Payment 3%2�7�22 Receipt Number C/p5-f Z03 COSA# 0SC0.? fl 13 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 3/25/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices I 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 r 0 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 ��Q: • • • - • :1 for current or future occupants or guarantee that no unseen encroachments, deficiencies or j g-• •9 �1 discrepancies exist can be given by First Water Consulting & fG . % *� 9 TH ••* �� 6. DSD IGNATURE �� � • • • • • • • •'v'~ ' / • • Curtis Huffman System #1 Approved for bedrooms r+c�s•,• CE 128991��� �� lF9 • .115122 . • System #2 Approved for bedrooms iI�F�PROFESSIQ0 Disapproved Conditional approval for bedrooms, with the following stipulations: okd hD_Qv, I c c4vvl VOL AIC eV -1 �elcase NlAc Ad u t_� �o re q a- rd f�'t4 14446!� A ,9 A s rn a � -�� nJ 13 Jar `"rVII Cer I I Fate: ZZr Zz �lJ��� CES DLL��111 The Municipality of Anchorage Development Services Division (DSD) issues Certificates)bp6))-S�fe 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 Checklist Legal Description: LAKE RIDGE TERRACE BLOCK 9, LOT 2 Parcel ID: 051-323-13 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) Well production at time of test 4.1 gpm Date drilled CIRCA <1970 Water storage tank volume NA gallons Total depth 53+ ft (PER MOA DOCS) Well disinfected for coliform test? ❑ Yes ® No Cased to UNKNOWN ft ® Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate 8.42 mg/L ❑ Nitrate less than MRL (ND) ® Wires are properly protected Arsenic u /L g ®Arsenic less than MRL (ND) Casing height (above ground) 18 in. FS Date of flow test for COSA 3/24/2022 Collected b Static water level at beginning of test 18 ft. Date of Sample 3/24/2022 Comments SIMILAR TO 2019 COSA / TEST. WELL UNDER DECK W/ WAIVER TO CONCRETE S.T B. TANK DATA Age of tank(s) 41.5 years Tank type/material SEPTIC/CONCRETE Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 3/24/2022 — AK QUALITY D. ABSORPTION FIELD DATA Which system tested (date installed) 1982 TRENCH ® ALL standpipes present per record drawing Total measured depth from grade *10.4 ft (max) Measured depth to pipe invert from grade *7.7 ft (min) ❑ N/A — pressurized field C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 4/21/22 Results M Pass For 3 bedrooms Fluid depth prior to test 30 in Water added 450 gal New depth 36 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective *JRS NEW MT — IR SHOWS 31ED h 30 in El d fluept ®Code -required soil cover over field Final❑ 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) — Gallons introduced gallons If yes, enter date Comments/Deficiencies: CO/MT AT GRADE W/ FILL. 2020 COSA APPEARS TO SHOW MOA IR & TO TEST CO IR. 2022 TEST & CO ELEVATIONS SHOW 7.7' TD OF INVERT & 10.4' BOTTOM OF MT. JRS INSTALLED NEW MT 6' FROM EXISTING FIELD CO. NO FLUID OBSERVED IN DCO OR FIELD CO. SYSTEM WORKING IN TOP PORTION OF ED AND IS 90% SATURATED. BUYER SHOULD EXPECT NEW SEPTIC SOON. ADJ. PROPERTIES HAVE ADVANCED WASTEWATER / PRESSURIZED SYSTEMS. MOA SEPTIC ADVISORY. FRES 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 *50 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' Yes if No Animal Containment > 50' ® Yes if No ® Yes if No ft ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No Manure/Animal Excreta Storage > 100' Community Wells > 200' ® Yes if No 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 W ft ft ft ft ft If, . ..._ _.ater 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 *MOA EXISTING WAIVER ST TO WELL. SEE 2020 COSA AND MOA DOCS. DOCS PER MOA 2020 COSA / ASB. 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. �4Q "A 'Ape 7'H .. ....... .. .... ......... Curtis Huffman �� �c�cs.• CE 128991 •, n� lF�' • .4122/2;. • •� ��I�010ROFEi$ 00 -v P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Brent Western 14206 Harold Loop Camera Inspection Report Date: 4-27-22 Although the casing seems to be very rusty and degraded we could not see any visible breaches to 45'. Nitrate Advisory Certificate of On -Site Systems Approval # OSC221113 Subdivision: Lake Ridge Terrace Block 9 lot2 A water -sample revealed a-rritrate concentration of 8.42 milligrams per liter-(mg/L) The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information.and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water' treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box 196650 *;Anchorage, Alaska 99519 6650 * www muni org Municipality ®f Anchorage ,*G R Development Services Department r ............. Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci . anchorage. ak. us (907) 343-7904 Septic System Advisory Certificate of On -Site Systems Approval # OSC221113 -`,Duri:ng-,a -recent adequacy test on the septic system for Block 9, Lot 2 of Lake Ridge Terrace subdivision, 30 inches of standing water was observed in the absorption field. This indicates that approximately 90% of the absorption area is inundated. Although this system passed the adequacy test, the remaininLy life expectancy may be limited. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval i �UdHM „ UT Y Oo FNCHO N OE Development Services Department:- -� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-323-13 1. GENERAL INFORMATION Expiration Date: d 5 0 D Complete legal description Lot 2, Block 9, Lake Ridge Terrace Location (site address) 14206 Harold Loop, Eagle River, Alaska 99577 Current property owner(s) Breckenridge Prop. Fund Day phone ( 907) 390-0256 Mailing address 2015 Manhattan Beach Blvd, #100, Redondo Beach, CA 90278 Real estate agent Kylie MacDougall Day phone ( 907) 390-0256 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 [3 Private Septic 13 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 $ 6-5-6 Date of Payment 9-1-11 1p -az Receipt Number e993157 COSA # C 5 C P.4 l®(!(10 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 Pinard Encgineerinq Phone ( 907) 232-1347 Address PO Box 871347 Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 2/7/20 6. DSD SIGNATURE© J System #1 Approved for \3 bedrooms Paul E. Pinard �c System #2 Approved for bedrooms om® CE -14793 Q® Disapproved Coe®o P��EF 1% ROFESSIO� ,� Conditional approval for bedrooms, with the following stipulations -Q_;� Zt� g \�Y OFA,r+ `StT WATER AND m" WASTF, 'ITER o J �p�g11 hh 6By: /gym �� tc� Original Certificate Date: c�, J5 aXp� a 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 Checklist blue sheet COSA Checklist. Legal Description: Lot 2, Block 9, Lake Ridge Terrace Parcel ID: 051-323-13 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Prior to 1970 Total depth 53 ft Cased to ft ER Sanitary seal is functioning correctly [R Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA _ _8_/ 21 /19 Static water level at beginning of test 10.1 ft. Comments Structure served by this system Well production at time of test 4 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes [:*No ® Coliform bacteria is Negative Nitrate 6. 17mg/L ❑ Nitrate less than MRL (ND) Arsenic ND ug/L ❑X Arsenic less than MRL (ND) Collected by Pinard Engineering Date of Sample Inital 8/19/19 Update 1/28/20 B. TANK DATA C. LIFT STATION NA Age of tank(s) 39 years ❑ Required maintenance completed Tank type/material Concrete Age.of lift station years Measured operating fluid level in septic tank 50" Lift station material [Standpipes/foundation cleanout per record drawing Comments: Date of pumping Measured 0.0" for scum & sludge Pumping is not needed Home has been vacant D. ABSORPTION FIELD DATA Which system tested (date installed) Shallow Trench Adequacy test date 8/21/19 [JALL standpipes present per record drawing Results [Pass For 3 bedrooms Total measured depth from grade 6 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft (min) Water added 960 gal ❑ N/A —pressurized field New depth 0 in [](Monitor tubes go to bottom of effective. If not, state Elapsed time 240 min depth into effective [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 960gallons If yes, enter date Comments/Deficiencies: Drainfield presoaked with 2000 gallons prior to testing. Boulders to be placed to prevent vehicle traffic over the septic tank and the drainfield. COSA Checklist yellow sheet 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' 50[Yes Community Sewer Manhole/Cleanout > 100' []Yes if No -9Q ft [2 Yes if No ft Neighboring Tank > 100' [JCYes if No ft Private Sewer/Septic Line > 25' [X—] Yes if No ft Absorption Field on Lot > 100' ® Xes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' ® Yes Animal Containment > 50' ® Yes if No ft Yes if No ft ® Yes if No ft 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' Q Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: 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' 50[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' [R Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' [R Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS placing boulders to restrict vehicle access. 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. COSA Checklist yellow sheet 6=1 00000000 - 10 0® ° o(i Thi 4 I 0 00 00 00 0©©00 0 00 oc G `1 o© 000GOODO 00000000000 o Paul E. Pinard oO 0� o oCE-11,793 o o ��ez '3A�'OFCSSIQ a 0C i s 008,10M MURAMID Nitrate Advisory Certificate of On -Site Systems Approval # OSC201046 Subdivision: Lake Ridge Terrace, Block: 9, Lot: 2 A water sample revealed a nitrate concentration of 6.17 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. �Vlaihng Address PCO Box 196650 *���i�nchorage;�plaska 99519 6650 * inrwuv muni org � � �� y � � �9.�w_.4 Ccs PINARD ENGINEERING a P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) 0 ADEQUACY TEST LOCATION: Lot 2, Block 9, Lake Ridge Terrace APPLICANT: Breckenridge Property Fund 2016 2015 Manhattan Beach Blvd, #100 Redondo Beach, California 90278 SEPTIC TANK TYPE/SIZE: Concrete/1000 Gallons, based on MOA Records ABSORPTION SYSTEM: Trench, based on MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAL/BR = 450 gallons TEST DATA Irii 1 JOB NUMBER: 19-156 DATE OF TEST: 8/21/19 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.0' SLUDGE: 0.0' NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes No XX Time Flow Rate Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System Comments AM (GPM) (GALs) (GALs) Liquid Level * A Level Monitor Tube 1* A SAS Level Monitor Tube 3* A SAS Level 8:05 4.0 - - 4.2' - 0.0' - Start Flow- Meter 673280 8:35 4.0 120 120 4.2' 0.1' 0.0' 0.0' 673400 9:05 4.0 120 240 4.2' 0.0' 0.0' 0.0' 673520 9:35 4.0 120 360 4.2' 0.0' 0.0' 0.0' 673640 10:05 4.0 120 480 4.2' 0.0' 0.0' 0.0' 673760 10:35 4.0 120 600 4.2' 0.0' 0.0' 0.0' 673880 11:05 4.0 120 720 4.2' 0.0' 0.0' 0.0' 674000 11:35 4.0 120 840 4.2' 0.0' 0.0' 0.0' 674120 12:05 - 120 960 4.2' 0.0' 0.0' 0.0' Stop Test - 674240 RECOVERY Date I Time I SAS *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: This system was found to be operating satisfactorily. There was no measurable liquid in the SAS MT prior to or at any time during the test. The drainfield was presoaked with 2000 gallons of water immediately prior to this test. Reviewed by: Paul Pinard Date: 8/26/19 LOCATION: Lot 2, Block 9, Lake Ridge Terrace DRILLER: Unknown DATE WELL COMPLETED: Unknown WELL DEPTH: 53' STATIC WATER LEVEL (top of casing): 10.1' PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) WELL FLOW TEST JOB NUMBER: 19-156 DATE OF TEST: 8121/19 FIELD STAFF: PJ Pinard LJ Time Elapsed Time (Minutes) Static Water Level Flow Rate (gpm) Cumulative Gallons Pumped Remarks 8:05 AM ---- 10.1' 4.0 --- Start Test - Meter 673280 8:20 15 23.4' 4.0 60 673340 8:35 30 22.9' 4.0 120 673400 8:50 45 24.6' 4.0 180 673460 9:05 60 23.0' 4.0 240 673520 9:20 75 24.0' 4.0 300 673580 9:35 90 24.3' 4.0 360 673640 9:50 105 25.5' 4.0 420 673700 10:05 120 23.7' 4.0 480 673760 10:20 135 24.8' 4.0 540 673820 10:35 150 24.6' 4.0 600 673880 10:50 165 26.2' 4.0 660 673940 11:05 180 26.6' 4.0 720 674000 11:20 195 26.3' 4.0 780 674060 11:35 210 26.8' 4.0 840 674120 11:50 225 28.2' 4.0 900 674180 12:05 PM 240 27.1' - 960 Stop Test - 674240 RECOVERY No need for recovery measurements. All well protection features were found to be satisfactorv. Average Flow Rate: 4.0 gpm Comments: DURING THIS TEST, THIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 4.0 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE. Reviewed by: Paul Pinard, Date: 8/26/19 at=Su Test Lab; I Water® Quality Testing 9131 E Frontage Rd, Ste 15 Palmer, AK 99645 (907) 745-3005 matsutestlab.office@gmail.com Name: Pinard Engineering Lab ID#: M200069 Mailing Address: PO Box 871347 Date Sampled: 01/28/2020 TNTplus 835/836 Hach 10206 Wasilla, AK 99687 Time Sampled: 1055 Legal Description: Lot 2 Block 9 Lake Ridge Terrace Sampled By: PJ Pinard Date Received: 01/28/2020 Sample Site Location: Outside Bose Bib Time Received: 1127 Total Nitrate Parameter Method Result Unit MRL MCL Date Nitrate — N TNTplus 835/836 Hach 10206 6.17 mg/L 0.200 10.0 01/31/2020 Method Reporting Limit (MRL): the lowest concentration that can be reported reliably Maximum Contaminant Level (MCL): highest acceptable level in public water systems as set by EPA nig/L: milligrams per liter; 1/10001' of a gram Results Reported By: Patience Lyne Laboratory Analyst Reviewed By: Signature: 6721 W07,1/qtr Jen Williams (Feb 3, 2020) Email: matsutestlab.office@gmail.com aimsu Test P=mlb, Wal er Qualley ` agggg 9131 E Frontage Rd, Ste 15 Palmer, AK 99645 (907)745-3005 matsutestiob.office@omaii.com Name: Pinard Engineering MailingAddress: P.O. Box 871347 Wasilla, AK 99687 Legal Description: Lot 2 Block 9 Lake Ridge Terrace Sample Site Location: Kitchen Sink Health Guard I Lab ID#: M190723 Date Sampled: 08/19/2019 Time Sampled: 1445 Sampled By: PJ Pinard Date Received: 08/19/2019 Time Received.• 1533 Parameter Method Result Unit MRL MCL Date Total Coliforms Colilert A --- --- --- 08/20/2019 SM 9223B Ea . coli Colilert A --- --- --- 08/20/2019 SM 9223E Total Nitrate - N TNTplus 835/836 5.37 mg/L 0.200 10.0 08/23/2019 Hach 10206 Arsenic Arsenic by ASV <MRL µg/L 1.000 10 08/20/2019 Metrohm AB 416/3 Method Reporting Limit (MRL): the lowest concentration that can be reported reliably M(Winum Contaminant Level (MCL): highest acceptable level in public water systems as set by EPA ns. -/L: milligrams per liter; 1/1000"' of a gram pg/L: micrograms per liter, 1/1,000,000" of a gram Absent (A): none of this type of bacteria was detected Present (P): one or more bacterial cells or this type were detected Results Reported By: Pa& Patience Lynch Laboratory Analyst Reviewed By: Signature: ( Aw GUIalG Tftr Jen Williams (tug 2i, 2019) Email: matsutestlab.office@gmail.com wren L, 0 MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way- Section epartin-ent THIS AGREEMENT, -made this '24th day of February, 2020, by and between BRECKENRIDGE PROPERTY FUND 20-16,: LLC and their heirs, administrators, and assigns hereinafter balled "PERMITTEEO', and the Municipality of Anchorage, a municipal corporation organized and existing -under its Charter and the laws of the State* of Alaska, he'reinafier'- called the "PERMITTER". WITNESSETIff.. WHEREAS, PERMITTEE is the owner of the following described real, property: LAKE RIDGE. TERRACE, BLOCK 9,. LOT 2-, according 'to the official records thereof; on. file in the office of the District. Recorder, Anchorage Recording. District, Alaska, aftd.,, WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The' MENTY.P00T UTILITY EASEMENT,. immediately along the cast boundary Of S PERMITTEE_ ' ' property as shown -on Plat. No. P-5.49, on file in the office'dthe. Vistri6tRecordet., Anchorage Recording Distiictj Alaska, and; WHEREAS, PERNUIT, M- has -placed a absorption. system. Pipe upon the ;referenced real property which encroaches I 1.04e% UPOA the PFJWITTFFL'S 20 -.0 -feet Utility Easerriebt NOW, THEREFORE,. it ' mutually agreed between.tho is parties hereto that: The PERMITTER, -acting through the Director of Development Services. Department, hereby grants to thd .PERMITTEE the privilege of allowing ' vi wing an absorption system pipc:tbencroach. j.l.o- febtupon. the'' PERMITTEWS 20.0 -feet Utility Easement-, as shown on "Attachment A,y' included hefeWith. 2. The PERMITTEE agrees. forever to; :indemnify, defend,. save And hold harmless, the;Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs arid expenses- incident 'thereto., arising wholly or -in part from or in connection with the existence of, alterations, maintenance, repair,. renewal,. reconstruction, operation, use or removal of the encroaching absorption system pipe, as placed upon the PERMITTER'S 20.0 -feet -Utility Easement. 3. The PERMITTEE. shall not assign or transfer any of the rights granted herein to another individual or companyWithout first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 20.0 -feet Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTERa one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of $315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTOR: MUNICIPALITY OF ANCHORAGE �y-20 Breckenridger16, LLC. jroack L. Frost, Jr. Owner Right of Way Supervisor STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 1,Z5•'Jtld-ay of February, 2020, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. JpiA F F. ,o _- Q. ,y ►,� O ARY P in and for A aska Uv' 40TgR �I-) �4, My Commission Expires: !42 a4ya Q STATE OF AL THIRD JUDICIAL) ss. DIST ) THIS IS TO CERTIFY that this day of , 2020, before me, the undersigned, a Notary Public in a for the State of Alaska, duly commissioned and sworn as such, personally appeared known to me to be the individual(s) named herein who executed the forego' instrument, and (s)he acknowledged that (s)he did so freely and voluntarily for the used and purposes rein mentioned, and on oath stated that (s) he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year firs-akpve written. NOTARY PUBLIC in and for Alaska My Commission Expires: A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of the document. State of California County of Los Angeles On _1^ bytAbi N 25, 2-0 20 before me, E.J. Lopez a Notary Public, personally appeared Gregory L. Geiser , who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal *my E. I LOPEZ Notary Public • California t.os Mgeles County Commission ° 2301362 Signature (Seal) Comm. Expires Sep 9, 2023 y My Commission Exu-s:. September 9, 2023 POST IN A CONSPICUOUS PLACE 1 e n r ALL WORK MUST BE INSPECTED No Field Inspection Request required 2 working days in advance of starting work and 2 working ¢. days in advance for final InspQciton. Call (907) 343-8206 (voice'recorder) for scheduling. Permit.ls notvalld without the call-in and also must include the one -call ticket (utility. locate) number. MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION � ep a i• tm en t 4700 ELMORE ROAD TELEPHONE (907),343-8240 FAX (907).343-8250 RIGHT OF WAY PERMIT R201131 Type: EncrchmntGrid: Status :.: `,Issu _ NWt)553 ed;= Date Applied: 02/24/2020Date tasy d:.;.:;:;..02/2.4/202{) '`Issued,f3y: ctaudia.pinard :..- Construction Start DaWt _..:. _. sEsst`tJ dated: 02/24/2020List U dated.,_: clal�d'ia:p(nard Permittee: 131RECKENRID6E`PROI'ERTY FUND.,,;;::°>�:;::�,__-,-_�:_ Work Order.: " -=Utiit ty: Contact tt t Petsv i PJ Pinard (907) 232; 59.62 Primaryr tnsp eciot-Jon Sauertrrey AddresslLi c:. 1:!4206 HAROLD. LOOP, Eagle River = @ l+i Fi N.a(Cery Road Legal Descgiptlon`' LAKE RIDGE TERRACE idLK g LT 2'G 1 $1 Total Fees: $1 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the teriTrs and cdndiUons;: and I certify that all:work will comply with federal, state, and munlapaIC regulati and the provisions of this permit Authorized agent for: Signature:ri Breckenrid a Pro erty Fund 2016, LLC Date: 02/25/2020 WRITTEN CONSENT OF THE SOLE MEMBER OF BRECKENRIDGE PROPERTY FUND 2016, LLC IN LIEU OF A MEETING November 16, 2018 The undersigned, constituting the sole member (the "Member") of Breckenridge Property Fund 2016, LLC, a Delaware limited liability company (the "Company"), in lieu of holding a meeting, hereby consent to the following actions and adopt the following resolutions with the same force and effect as if they had been unanimously adopted at a duly convened meeting and direct that this consent be filed with the minutes of the proceedings of the Company: WHEREAS, the Company desires to confirm that each of the following persons acting in his capacity as an officer of Wedgewood, LLC, the manager of the Company, as set forth below, has the authority to execute documentation on behalf of and bind the Company; Gregory Geiser President David Wehrly Executive Vice President Darin Puhl Executive Vice President Wade Brandenberger Vice President James Helfrich Senior Vice President Gary McCarthy Senior Vice President WHEREAS the Member deems it to be in the best interests of the Company that the Company confirm their status as authorized signers; NOW THEREFORE BE IT RESOLVED, that the negotiation, authorization, execution, of any documentation by the Company and the consummation of the transactions contemplated thereby are hereby authorized and approved; BE IT FURTHER RESOLVED, that each of Gregory Geiser, David Wehrly, Darin Puhl, Wade Brandenberger, James Helfrich, and Gary McCarthy, acting alone, in his capacity an officer of the manager of the Company is hereby authorized to execute such documents or certificates as it deems necessary or appropriate to effectuate the intent of the foregoing resolution, its signatures thereon to be conclusive evidence of the authority granted hereby; and BE IT FURTHER RESOLVED, that all prior action taken by any member, manager, officer or employee of the Company in connection with the foregoing is hereby ratified and affirmed for all purposes. IN WITNESS WHEREOF, the undersigned have executed this Written Consent as of the date first written above. Neighborhood Stabilization Holdings I, LLC, Member By: W , President ASBUILT A� "-� I HEREBY CEt2TIFy THAT 1 HAVE SURVEM THE sem'FOUDWING DESCMBED OF PROP. i m�®a� r dTZi''R9 DATE- » ��C•,....,,�q�M AND THAT No ENCROACHME &IST EXCEPT AS INDICATED; 1T IS THERE5PONSISIUTY OF THE MNER To DEfE'RMtNE THE EMSTENCE OF ANY ORD • • • : • • • • • ••:••: „� EASMMrSr OR RESTRICTIONSWHM NOT APPEAR ON THE REO MED SM- VISION PLAT. UNDER NO CIRCUMSMCES SHOUTA F& 3 4�� ES -6 s � ANY DATA HMMN BE USED FOR CONSTRUCTION ' # '` '• OF FENCE LINES, OR FOR ES'TABLtSFUNS BOUND- ARY LINES. DMWNi f k�" sem.► MATANUSKA ELECTRIC ASSOCIATION, INC. LETTER OF NON -OBJECTION February 22, 2020 Breckenridge Property Fund c/o PJ Pinard PO Box 871347 Wasilla, Alaska 99687 Re: Lot 2, Block 9, Lake Ridge Terrace Subdivision, Plat 1960-P-549, Anchorage Recording District Dear Mr. Pinard, et al, MEA has no objection to the encroachment of a septic pipe and related within a twenty feet wide (20 ft) utility easement lying along the east property boundary line, subject to the following conditions: 1. The improvement will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the easement for any and all utility purposes that it presently enjoys under the easement. 2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any person or property that may result from the existing and future use of the easement by MEA, its contractors, or assigns. 3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use of the easement by others under a Letter of Non -Objection. 4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the easement. 5. The landowner will be responsible for any special construction costs incurred by MEA due to the improvement in the easement. 6. The landowner will assure compliance with all applicable safety codes relating to the improvement in the easement. 7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these conditions. 8. Alteration of these conditions shall invalidate this letter. 9. This lettpr is not effective unless it is recorded/in the Anchorage Recording District before ownership of the refekeN erty is changed from the bove-named landowner. Sincerelx, Manny Lope , R Land Services Man e STATE OF ALASKA) SS - THIS IS TO CERTIFY that on this 2 day February, 2020, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Merced M Lopez, SR/WA, MEA Land Services Manager Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument and acknowledged to me that he/she/they signed and NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT By this document Matanuska Telephone Association, Inc. (MTA) declares. that it has no objection to the encroachment of the septic system in the platted 20' utility easement of Lot 2, Block 9 of Lake Ridge Terrace Subdivision, Plat Number P-549, filed in the Anchorage Recording District, State of Alaska. Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the encroachment as a result of utility construction will be borne by the property owner of record. This document does not authorize the placement of any additional encroachments within the easement area. Property owners are required to obtain utility locates before doing any kind of work in the utility easements and will be liable for any damages caused by their construction work in the easements. This document is in no way an agreement to vacate any_portion of the utility easement and should not be interpreted as such. Issued for Matanuska Telephone Association, Inc. this 18'h day of February 2020, by,. Cliff Burris, OSP Construction & Maintenance Manager THIS IS TO CERTIFY, that on this 1.801 day of February, 2020, before me the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Cliff Burris known to me and to me known to be the individual named in and who executed the foregoing instrument and acknowledged to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS, WHEREOF, I have hereunto set my hand and official seal the day and year first above written. OFFKMLSM Now Spomra No Pu lie in and for Alaska Notary RNOSW orAWa My commission expires: R 1 P.Q. Box 3550 Palmer, Alaska 99645 I mtasolutions.com 1 907.761.2510 February 21, 2020 Breckenridge Property Fund 2016, LLC 2015 Manhattan Beach Blvd., Suite 100 Redondo Beach, CA 90278 Re: Utility Easement Encroachment To whom it may concern: ENSTAR Natural Gas Company A DIVISION OF SEMCO ENERGY Engineering Department Right of Way Section 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907)277-5551 FAX (907) 334-7798 ENSTAR Natural Gas Company has no objection to the septic pipe encroachment within the twenty foot (20FT) wide utility easement adjacent to the East property line of Lot 2, Block 9, Lake Ridge Terrace Subdivision, according to Plat No. P-549, Records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. This service is free of charge. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the land owner. • All applicable safety code regulations will be observed and maintained. • This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, zv� Andrew Fraiser Supervisor of ROW & Permitting ENSTAR Natural Gas Company tDATE II'~CTOR INSPECTION APPOINTMENTS 1 TIME DATE INSPECTOR MUNICIPALITY OF ANCHORAGE RECEIVED TIME DATE INSPECTOR DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO~I~iALITY OF ANCHORAGE 825 L Street-Anchorage, Alaska 99501 r>EPT. OF H'~,L~H ,C ~NVIRONMSN1AL pROTECTION ENVIRONMENTAL SANITATION DIVISION DIRECTIONS: Comptete a I parts on [)age 1, h-momp;e~m requests will not be processed. Pteas~, allow t~n. (10) days for processing. 1. PROPERTY OWNER PHONE T~-~[ L~-~--~?,7~~ .................................... P¢~OPERTY RESIDENT {If differen~ f~om ;tt)(ivet ! 2. BUYER PHONE PttONE 3. LENDING INSTITUTION f PHONE MAILING ADDRESS 4. REALTOR/AGENT MAI LING ADDRESS 5. LEGAL DESCRIPTION *TREETLOCATION ,~**O~Z LOO ,~ 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [~ One [~ Four ~ SINGLE FAMILY ~ Two U~ Five ~ MULTIPLE FAMILY [] Three ~ Six [] Other 7. WATER SUPPLY INDIVIDUAL* COMMUNITY PUBLIC UTILITY ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SVS1-EM I~ INDIVIDUAL/ON.S!T E*~ PUBLIC UTI I._! TY YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITI/~/FE~. 72 010 (Rev. 6/79) 'fills SI[.',~-; FOR OFFICIAL USE ONLY 1, TYFF. OF RESIDEI',,ICE NU~,IBER OF BEDROOMG ~] SINGt E FAMILY [~] ONE [--J -I'I~HEE F~ FIVE (S} OTHER [~1 MULTIPLE FAMILY ELi; fWO {~J FOUR ~J SIX E. ] INI)IVIDUAL. I)EF'TH OF WELL COMMUNITY ~ATF DHILLED ~()q lection k/o~ f(d ............. LOG RFCi:IVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [":l II"f)IVIi')UAI/Ol,I~'-ol I ,: .... F.'IP Ifil_lC UTI LITY Cmmecdon Verified .... [ 'IS ~plic 'rank or [~]ltolding Tank Size: ._./~2~?._ _ ~f ]~,,,k flive dimensions: TYP[ OF l-/qgK MAN ~A' I'UHER [~A~H(.~V [ D FOR .......... {tEDROOMS ~ONI}IT!OFIAI. APPB[)V/X!. (letter rnust accoml)a~W certificate) 6[) UISAPPROVED December 9, 1981 Jacqueline Lynch ~e~,~ral Delivery Eaqie River, AK 9957'! . ~@rra~e Subject: Lot 2, Block 9, Lakeridge '~ ~ Harold Loor~ Dear Mr. Lynch: A%7'[~roval for the individual sewer and water facilities cannot be-granted until the following items have been completed: The top of the well casing sealed with a sanitary seal so that it is ~,~ater tight. o The water analysis report needs to be submitted to this ~ ~ the Chem Lab, 5633 B Street~ for our review. .}I ~ J. ce from o The adequacy test performed on your sewer system reveals the system is ~aiting and an upgrade i~itl be necessary. Prior to the upgade a soils test will be necessary se that a permit may be issued. Please notify this department for a reinspection when the Roted discrepancies have been corrected. If there are any f~rther questions~ please call this office at. 264~4720. S incere!y, P. obcrt C. Pratt Associate Environmental Specialist EXCAVATION ROBERT A. SHAFER Century 21, Metropolitan ATTENTION: Lorraine Minor P.O. Box 677 -.Eagle River, Alaska 99577 · ''Dear Mrs. Minor, WORK CIVIL ENGINEER 694-2979 November 29, 1981 A4UNIcIPALITY OF ANCHORAGE DEPT. OF HEALT ] & F--4~VIRONMENTAL p,.Z, OTEC-HON RECE! ED Reference: Lot 2: Block 9~ Lakeridge Terrace Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 900 gallons of fresh wate~ ~ndafter a period of 24 hours all _t'~ _~a~er_wh~Qh had-bee~h~ed, t~ cfi~m~i-ned-~ri~-h~i/~--t~ seepage pit. It can be concluded from this test that the septic tank is adequate for a three bedroom residence. However, I regre~ 5o_info~m_yo_u that the seepage pit has failed %~'-~r~0i~-~-~h-adequate amount of .water a~Yd~i~ii~require~gr~d~n-gv ............ - ................... If we may be of further service, please do not hesitate to call. Sinc~ely, ?i ~ ~ ,:::- ' F s/ss // ' cc: City Deposit Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA