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HomeMy WebLinkAboutBROADWATER HEIGHTS BLK 2 LT 3Broadwater Block 2 Lot 3 #050-081-26 MUNICIPALITY OF ANCHORAGE A DEPARTMENT 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 PHONE ❑ NEW UPGRADE MAILING AADRESS . t�. (3c)x �i �"� _ G i --Er r -v' <A --I S -1 -1 LEGAL DESCRIPTION 2- LOCATION NO. OF BEDROOMS " Well Absorption are a Dwelling ) PERMIT NO. U DISTANCE TO: � + ! 5- e3i _Y a. ZG Manufacturer `� Ma i= No, of compartments Z w f 1^ Liq,C.Vity i gallons IF HOMEMADE: Inside length Width Liquid depth _ , ❑ Y DISTANCE TO: Well Dwelling PERMIT NO. Juz 02< 2 Manufacturer Material Liquid capacity in gallons ❑ DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. LU = J LL Z No. of lines Length of each line Total length of lines Trench width Distance between lines Z W P: inches l� Top of tile to finish grade Material beneath tile Total effective absorption area ❑ inches w Length i Width y D pthl` .� C PER � � � , iZ 45 Type of crib "" — Crib diameter Crib depth Total effective absorption a ea i i 6 i y DISTANCE TO: Well f Building_touna�tipn •-C '5 LC Nearest lot line I J Classy Dept Driller Distance to lot line PERMIT NO. J ` �h� w � DISTANCE TO: Building fou dation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 16 r A SOIL TEST RATING j 7 j �V V~ INSTALLER 6- -q( C' REMARKS .s V1 04 4.404G •r o• ;-'*,*461 -7n �-; �;T'v ® �'. IVq. 1457-E f -h �. _Ft APPROVED., (. i'i(VERP ALA5KA V0511 DATE LEGAL pit. 44-2= ) q� )// Z �rJ7 vV 72-013 (Rev. 3/78) I jJ PERMIT NO: DATE ISSUED: ' APPLICANT: ADDRESS: CONTACT PHONE P-1 LJ KI I C.'� I F="aff-N L -rNe (3 44 1%J (::" " C3 F_ -Z onh�E� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 4--] PA -_E3 I -T- En E3 EO hJ FEEZ FR F-FLE F,� M I-� 850408 abuc+�A^~'` 07/11/85 �' w�l V' % S&S ENGINEERING GIBB8 EXCAVATING ' SRB 196-X EAGLE RIVER, AK 99577 . 694-2979 LEGAL DESCRIP: SUBDIVISION: BROADWATER r.�� ° LOT: 3 BLOCK: 2 SECTION: 1 TOWNSHIP: 15N RANGE: 1W LOT SIZE: 20019 (SQ.FT. OR ACRES) MAX BEDROOMS: 4 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. --------------------------- "TFr4EF_:UqK-- t -i ~----------- (E�l G���� � ��~ ro�z�4][�vDEPTH TO PIPE BOTTOM (FT.) 5°0 6.0 5.0 GRAVEL DEPTH (FT.) 3.0 0.5 3.0 TOTAL DEPTH (FT.) 8,0 6.5 8.0 GRAVEL WIDTH (FT.) 2.5 20.0 5.0 GRAVEL LENGTH (FT.) 84.0 ** 38.0 59.0 GRAVEL VOLUME (CU.YDS.) 27.3 28.2 38.3 TANK SIZE (GALS) 1�250.0 ** 1,250.0 ** 1,250.0** SOIL RATING (SQ.FT./BR) 125 125 125 ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT. EACH) ** TANK MUST' HAVE AT LEAST - - - - - - - - - - - - - - TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. Iam familiar with the requirements for on-site sewer& and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the -set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is Qalid for a maximum of 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTG WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. ` SIGNED DATE: �ZIBB ����f�--i APPLICANT: % S&S �"GINi�RING S EX�AVATING�� � ' ISSUED BY DATE: J� _____________________________________ ~~ ' �ATER ANCHORAGE ARE� 8OROL DEPARTMENT OF ENVIRONMENTAL OyALlTY CASE # 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For Leqal D8SCrintiOD: Lot Block 2 Subdivision'�-2toc2Aw3;�l—olrl—!�-T-T-- This FUr0 Rennrts Soils Log Percolation Test q8nth Feet 5Ofl Characteristics 2 --' —Ta t ej Gross Time U3' Net Dron! 5 � 6 0010)3lE(]ElVEI�--- 7 -__- A.0 0~� /w'� /� y __. umwB« ne/, op ewvmuwMcWIAL�AL��10 Was Ground Water Encountered? no If Y25, At what Depth? R e a d i n q —Ta t ej Gross Time Net Time Depth to H2O Net Dron! yerCO|atlOn KOte Ili nute Proposed Installation: SePnaoe Pit Drain Field De�)th of Inlet D Of Pit 0 CDM.�'ENTS� Test Performed By --- Pata Certified By: Oate: xSOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST Com, PERFORMED FOR: � tiR�i�S �.XG DATE PERFORMED: � "� 1 LEGAL DESCRIPTION: qT I SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PERFORMED,BY: 72-008 (6/79) WAS GROUND WATER ` S ENCOUNTERED? j� L Depth to Water Net Drop P E IF YES, AT WHAT DEPTH? 1 Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE N (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DAT / b�J� WATER WELL RECORD t:...,. _ STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys LOCATION OF WELL (Please complete either la, Ib or Ic.) la. B�Aorough Subdivision Lof Block Ib. I/4 qt re. ncb—of_of_of Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS Street Address and Area of Well Location 2. WELL LOG Material Type °;F, na f gravel y silt Gray and bloc h. rock Cray and green rocs. pa rage Drilling Permit No. A, D. L. No. ffp Range E❑ Meridian WO WELL: lgr,y Osgood (Steveand J Address: Box 771327 Eagle River, Ake 99577 Feet Below Surface 4, WELL DEPTH: (final) 5, DATE OF COMPLETION Top Bottom !nR —ft• lfl _ ) —• 8", 0 6. ❑ Cable tool `iq Rotary ❑ Driven ❑ Dug ❑ Auger ❑ Jetted ❑ Bored ❑ Other f ❑ Domestic ❑ Public Supply ❑ Industry i , ❑ Irrigation Recharge ❑Commerical ❑ Test Well Other: 8. CASING: ❑Threaded %Q Welded f) diem. In. to �� ft. Depth Weight l7 Ibs./ft. dtam, In. to ft, Depth Stickup ft, 9, FINISH OF WELL: Type: Diameter: SIof�Mesh Size: Length: Set between ft. and ft, Backfilling Gravel pack 10. STATIC WATER LEVEL: ft, ❑ Above or Below land surface Date Equipment used: II . PUMPING LEVEL below land surface and YIELD ft, after hrs, pumping q,p,m, ft, after hrs. pumping q,p,m, 12.GROUTING Well Grouted: ❑ Yes ❑ No Material: ❑ Neat Cement ❑ Other: 13. PUMP: (If available) HP Length of Drop Pipe ft, capacity 9 -p -m ❑ Subm. E] Jet Centrifical Other 14. REMARKS: .Production o:r 30 GPFI 16. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temperature a This 10 V well was drille(t under1.mry jurisdiction and this report Is true to the best of my knowledge and belief; r n.ucry .:ac .. A. 'i ?,!3 Registered Business Name • Contract License Number Address: i? (: }}tl�'' �i,. 1 Signed Authorized Representative Date: 0.0 LForm 02-WWR (11/81) Copy Distribution: WHITE -State DGGS. PINK -Driller- ❑ F ❑ C Municipality of Anchorage1W I Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 18, 1992 Ted Johnson, P. E. Criterium Alaska Engineers PO Box 111790 Anchorage, Alsaka 99511-1790 Subject: Waiver Request for Lots 3/4 Block 2 Broadwater Heights Waiver Request #WR920006, PID #050-081-26, HA920088 Dear Mr. Johnson: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 99 feet from well to septic tank. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, z9a7�f Daniel J. Roth Civil Engineer On-site Services ljm:#6 Con ur: u�V J hn Sm i , P.E., rogram anager On-site Services IN MUNICIPALITY OF ANCHORAC Department of Health and Human Services On-site Services Section WR# WR920005 PID# Waiver Review Worksheet 050-081-26 Date Received: Feb 10, 1992 HA# HA920088 Permit # Legal Description: Lots 3/4 Block 2 Broadwater Heights S/D Engineer: Ted Johnson, P.E., Criterium Alaska Engineers PO Box 111790 Anchorage, Alaska 99511-1790 Applicant: Stephen Osgood Waiver Requested: Well to septic tank - 99 feet Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: 7t Waiver is NOT Granted: List Conditions or Reasons for above: Date: _3 — 0- 92- By Rec #: 23436/669 Amount: $ 410.00 v Date Paid: Feb 10, 1992 i! 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(! -- -- --------- 2f a¢ ` ro T ---- -- --- -1-7, -- - -- i i. March 14. 1992 From: Stephen R. Osgood 1165 Edinboro Dr. Boulder, Co 80303 (303) 494-4631 RECEIVED MAR 16 1992 To: Dan Roth Mun;c.,,,.;+ ;,, of Aochurage On Site Inspection Dept. Health & Human Services Health Department Municipality of Anchorage Regarding: Chronological listing of drilling and placement of wells on lots 3 & 4 , Block 2 Broadwater Subdivision. Dear Sir: The following is a description of the timing and the placement of wells on the lots described above according to my records and recollection. The lots were purchased in August, 1971. Building commenced the summer of 1972. It should be noted that this house was a pay as you go operation. Consequently, the date of finished construction and occupancy are later than in a normal commercial housing situation. The first well drilled is located in front of the house on lot 3. It was drilled during the summer of 1974, by Sam Cotton Sr. The rig used a pounding method to drill the well. It took 3 weeks and went down a depth of 200 ft. My wife, son and myself occupied the partially completed house February, 1975. This well never had much capacity and by the spring of 1983 it became apparent that it could no longer supply the needs of my family. Bill Magnuson, a well driller in the Eagle River area, was contacted in the summer of 1983, to drill a new well. This time a hydraulic drill rig was used and the resulting well went to a depth of 600 ft. The drilling was completed in the early fall of 1983. This. well is the one that is the furthest south of the two on lot 4. A line to the house from the well was placed and a pump was lowered into the well, The pump could only be lowered 150 ft due to some obstruction. Attempts were made to pluck out what was causing the obstruction and when this failed the rig was brought back in and the obstruction was drilled through. However, upon attempting to place the pump blockage was found to have occurred at the same point. It should be noted that there have been at least two wells which have collapsed on lots close to or adjacent to mine. This well was abandoned and it was decided to move the rig and to drill a new well, which is 608 ft in depth. Four inch white FVC pipe was used to line the well and keep any collapsed rock from impeding the placement of the pump, which worked, The well was connected to the house in the f all of 1983 and the line from the old well to the house was disconnected, at that time. This August, after talking to the state hydrologist, I decided to have this well hydro -fractured to increase the flow. This was done by Anchorage Well/Pump Service with satisfactory results. I hope this answers any questions you may have. Enclosed is a copy of the water well record Magnuson filed with the state. I assumed that this took care of any reporting requirements. Sincerely, Stephen R. Osgood Municipality of Anchorage Department of Health and Human Services d1 -1h5 Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 March 7, 1992 Ted Johnson, P.E. Criterium Alaska Engineers P.O. Box 111790 Anchorage, Alaska 99511-1790 Re: Waiver for Lots 3 & 4 Block Broadwater Heights, Waiver Number WR920005, P.I.D. 050-081-26 Dear Mr. Johnson: This office is unable to process your waiver request at this time for the required 100 feet separation distance between the septic tank on Lot 3 and the well on Lot 4 until the following information is submitted to this office: 1. Our records indicate that there is only one well on Lot 4 serving the dwelling on Lot 3. The house was constructed in 1976 according to the municipal tax records. You submitted with your waiver package a log for a well which was drilled in 1983 without a permit from this department. A well log for the other well should be submitted at this time or verification of casing depth, total depth, static water level and water production. 2. A surveyed site plan was submitted in the waiver package that shows all the standpipes on the wastewater disposal system corresponding to our as -built document. The site plan, however, shows both wells exceed the required 100 foot horizontal separation distance from the septic tank. If a waiver is in fact required then the surveyed site plan, performed by Robert Johnson, L.S., must be corrected. 3. You must determine if the well not in use at this time has any production capabilities. If it does then the property owner may keep the well provided it is temporarily abandoned in accordance with A.M.C. 15.55.060(K.1). If the well has no production capabilities then it must be abandoned in accordance with 11 AAC 93.140. Call me if you have any questions of the above. Sincerel Daniel J. Roth Civil Engineer On -Site Services 0 8 8 1 0 7 Co currence G"t-/t J hn Sm' h, P.E. rogram Manager On -Site Services A L S AEWG I NEER S February 9, 1992 Subj: Separation Waiver, L3 & 14, B2, Broadwater Subd. CAE Job No. 91177 Municipality of Anchorage Department of Health & Human Services PO Box 196650 Anchorage, AK 99519-6650 P.O. BOX 111790 ANCHORAGE AK 99511-1790 TEL 907 349-1003 IN AK 800478- 1 003 FAX 907 349-1003 MOBILE 907 229-8453 RECEIVED FEB 10 1992 Municipality of Anchorage Dept. Health & Human Services Application is hereby made for the granting of a separation distance waiver according to Anchorage Municipal Code, Chapter 15.65.140. 1. Description of separation distances for which waiver is requested. When measured, the separation distance between the nearest septic tank inspection port and the well in use on the property was one foot short of that required by 18 AAC 72.015. The measured distance was 99 feet instead of the 100 feet required. A waiver is requested for the one foot deficiency. The well is located approximately at the center of Lot 4. The septic tank, house and drainfield are all on Lot 3 with the house near the southeast corner and the septic and drainfield to the west. The well is 99 feet southeast of the septic tank. 2. Information on soils and topography. The ground generally slopes to the southwest at approximately 22% slope. There is a more gentle rise, of approximately 10%, towards the southeast from the septic tank to the well. The ground to the northwest on the north side of McCrary Road, rises at about a 30% slope. The bedrock profile appears to be at a steeper gradient than the surface profile. Adjacent well logs show bedrock at depths of 10' to the northeast (Lot 6, Block 1, Broadwater); 30' on the subject site; and 19 to 20 feet on the lots adjacent to the southwest (Lots 6 & 7, Block 2, Broadwater). The general slope of the bedrock appears to be South -Southeast. The soils above the bedrock are classified as sandy -gravels (GW and GP) silty -sandy gravels (GM) and gravelly sand (SP) on the various soil logs and test pits on adjacent lots. Generally, it appears the surface soils are relatively free draining under the surface mat of silty topsoil with organics. Based on the slopes found and the soil profiles determined from the available soils information, the septic tank is about level with the bedrock at the well location. The well is cased 30' to bedrock. The static water level at the start of the 4 hour flow test was 106'. After drawdown the level was at 260', which was apparently the pump depth, recovering to 220'. The fracture from which the well is drawing water is below the septic tank, but is also on the upslope side of the bedrock structure. The drainfield is outsid allowed separation distance. REGISTERED PROFESSIONAL ENGINEERS BUILDING INSPECTIONS INVESTIGATIVE ENGINEERING LITIGATION SUPPORT CONSTRUCTION MANAGEMENT 3. Proposed mitigating measures. The present separation distance is within one foot of the allowed distance. There are no effective mitigating measures proposed for this small a distance waiver. 4. Statement of all positive and negative impacts associated with granting waiver. The positive effect will be to legitimize an existing condition that was apparently created strictly by oversight. The as -built survey shows a scaled distance of 108'. The actual field measured distance is 99'. This documentation of that error will provide a more accurate record of the actual conditions. A functioning, albeit low flowing, well is in operation in a bedrock structure. The probability of locating another well in this structure is slim. Redrilling for the sake of one foot of separation does not appear to be a reasonable alternative. No negative impacts are known or foreseen. The information represented in this application for waiver is a true and accurate representation of the conditions found in the field at the time of my inspection. The Municipality of Anchorage records were researched as well as other known available records to ascertain to the fullest extent possible, the impacts of the requested waiver. To the best of my knowledge and belief, granting of this waiver will not harm or affect the subject or adjoining properties. Sincerely, Theodore. A. Linson, P. L.S y WATER LINE EASEMENT KNOW ALL MEN BY THESE PRESENTS, that Stephen R. Osgood, a single person, as owner of Lot Four (4), (� Block Two (2), Broadwater Heights Subdivision, more fully described below, (hereinafter referred to as "Grantor") for the sum of Ten and 00/100 Dollars (10.00) and other good and valuable consideration in hand paid, the receipt and sufficiency of which is acknowledged, does hereby grant, convey and warrant unto Stephen R. Osgood, a single person, as owner of Lot p Three (3), Block Two (2), Broadwater Heights Subdivision, more T)U fully described below, (hereina€ter referred to as "Grantee"), (A o t� and to his successors and assigns, an easement and right of way U in perpetuity, with the right, privilege and authority to the S Grantee, to operate, maintain and repair a water line for the purposes of supplying water from a well located on Lot Four (4), -v �- Block Two (2) to the residence located on Lot Three (3), Block ' S d Two (2) through, across and under the following described lands 41 w -05 within the Anchorage Recording District, Third Judicial District, State of Alaska, and more particularly described as Nfollows: GI -- Lots Three (3) and Four (4), Block Two (2), BROADWATER HEIGHTS SUBDIVISION, Section 1, Township 14 North, Range 2 West, Seward 1 Meridian, Anchorage Recording District, Third Judicial District, State of Alaska. Said easement is set forth in Exhibit "A", attached hereto. Together with the right to the Grantee, his successors and assigns, to maintain, inspect, and repair water lines across, through and under the above-described premises, and to do anything necessary, useful or convenient for the enjoyment of the easement herein granted, also, the privilege of removing at any time of all of said improvements erected upon, over and under said lands. It is agreed by the Grantee that such debris and waste materials as are caused by such operation, maintenance and NCO a ROM repair will be removed from the premises, and that the premises o,ct- )N will be left as nearly as possible in the same condition as they N CN now are. UU: a � All improvements laced on the remises p p p pursuant to � b o� this easement are the property of the Grantee. The failure of 0 the Grantee to exercise any of its rights granted herein shall U a � not be construed as a waiver or abandonment of the right. Grantor covenants that he is the owner of the above- described premises. 8K 022414Pc746 This easement shall be a covenant running with the land and shall be binding and inure to the benefit of the parties hereto, their heirs, executors, administrators and assigns forever. IN WITNESS WHEREOF, the Grantor has hereunto set his hand and seal this i C1 day of f- } ;, �, r� , �! , 1992. r StepheA R. Osgood "Grantor" STATE OF COLORADO ) ss. County of VuQC ) THIS IS TO CERTIFY that on this _]a-_ day of -, 1992, before me, the undersigned, a Notary. Public in and foiJColorado, personally appeared Stephen R. Osgood, to. me known and known to me to be the individual named in and who executed the foregoing instrument and he acknowledged to me that he signed the same freely and voluntarily for the uses and purposes therein stated. WITNESS my hand and official seal the day and year in this certificate first above written. -2- NOTARY PUBLIC in and for Colorado My Commission Expires:, cJ !7/�ja< •� � N M N�, ••'•... i7 .. •'•• N u: 4Da 30�b'` OL c� i d` -2- 0 � - t3- i z- , . N 9 H', AS -BUILT -7 I hereby certify that I ha� surveyecl th�011owing' described property: L,,-7'• -,r & fArY AnchorageRecording Precinct, Alaska, and that,the improve- ments situated thereon are within the property lines and o not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premi.sep in question and that there are no roadways, transmission lines or other visible easements on said prolle't-tv except as indicated hereon. Dated at Eagle River, Alaska this 7- day of__jG c ROBERT C. JOHNSON —/Q,9�> 1 2 SCRegistered Land Sueyor No. 6 ALE: Surveyor - I" Box 77-0456, Eagle River, Alaska 99577 Phone (1407) 694-2543 rm EXHIBIT PPAPP ��— 008611 1 E,ORAGE REO Nri t DISTRICT UQUESTED RYR- '92 FEB 28 RC1 10 9B Lor' 3 %/V -0. CAs,� �ir•N ;' , N' r� i ,r r' L oT 4�- F M aT-,F5 Al JP g04,/"Lj5 vim' r� wJE L4. BASS is -,Vi' LocATED Ohj "T, 9�-:eaG c 2 �r�.a DwhT,ER Hi�Is Fcf2 ' LaT. 3 j. 6'_�-aC hE Z1 Brea f? 'icy �1.� HEIr,-P75 . : GoMMGN:.trV6 A7' 7'H�E' AIvRTK6f?N G.ISi \ .,GDICMfa.F� �i►-7'�''L�i:.:fJ"�o7'S '3 ANG !�' 6-O ' ,.Sav�'N zs•(/�2.a"wES7' �4LdNd• 7'H� l.ar LlNI' 4710 rO&r 7'a r✓ t- BSG-tNN�nI .�� o�= TMts E,d'S.C"CeU r 7 Ht---AJcr r� 5pu-rH 4.8 • EAST. �4,'D1fTA"CE 0F' +5-.a Per r. 7" 7ro ,A .Pare�T -rHaXICE &a SavTM, ZI` w6ti7- A prs7',a.NCF vs- 2 -*,0 F!'i9X•T -'r4O ' A POlOTJ7`ffEtVCF -o NoR H .ef.8a wEsT`:A P/s'7`AiVGF:' G[; k?, i6 FEET :7'o A P,>lNr oN TYKE 46-r L_lN�-rHx"ec. ":Wo t` OA, r t z6°/t'Zu"CAsT A Pj5T:4!,A'C.E o�= ANb 7'•Ne 'rF'orrV; �GF'�-NDtrVs��cF '7f -,l$ 'C.OA—AINS 1033 SQLjARES 9=6E'r, 1 • ( • U - ') Municipality of Anchorage 4pG t} zr o•;.iiti` ur a On-Site Water and Wastewater Program .': • (907) 343-7904 SA EETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-081-26 Expiration Date: i, } () I -1 1. GENERAL INFORMATION Complete legal description BROADWATER HEIGHTS BLOCK 2, LOTS 3 &4 Location (site address) 18336 MCCRARY ROAD, EAGLE RIVER,AK 99577 Current Property owner(s) MATTHEW&SUSAN WILSON Day phone Mailing address 18336 MCCRARY ROAD, EAGLE RIVER,AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (wlwo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: Date: .i/a//i7 COSA to be released to the engineer,unless of erwise requested by the engineer. COSA Fee $ ,I�5Z(o Waiver Fee $ Date of Payment Y`Zof`? Date of Payment Receipt Number 'ctf6513 Receipt Number COSA# [ � 'l Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 4/13/2017 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen +-‘►\ encroachments,deficiencies or discrepancies exist. -"-‹? ALS Ae 4• TiI * # 6. DSD SIGNATURE j System #1 Approved for 3 bedrooms. s. 4rflinFAM . UWE! ! r Al System #2 Approved for bedrooms. + cry 7� s (�SwAlf AirDisapproved. Ess Conditional approval for bedrooms, with the following stipulations: Q� ��{ OF�41e17(") ON-SITE a WATER AND o� WASTEWATER pROGRAM CZ Ajn'p-lr rQ`1C4G, T�, By: 164-t(itc, Original Certificate Date: Li/2$ ( 7 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory X. Other • COSA blue sheet 10.10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: BROADWATER HEIGHTS BLOCK 2, LOTS 3 &4 Parcel ID_ 050-081-26 A. WELL DATA Well type PRVT If A, B, or C provide PWSID#_ Well Log (YIN) Y Date completed 10/1983 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 608 ft. Cased to 20 ft. Casing height (above ground) 24+ _ in. FROM WELL LOG AT INSPECTION Date of test 1011011983 4/13/2017 Static water level -- ft. 147 ft. Well production 30 g.p.h. _0.65 g.p.m. WATER SAMPLE RESULTS: 2.11 Coliform SING. _colonies/100 mL Nitrate Dos mg/L Arsenic: NA ug/L Date of sample: _4113117 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 711211985 Tank size 1250 gal. Number of Compartments 2 Cleanouts(YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping "t J2'1 11 Pumper j'��, C. ABSORPTION FIELD DATA Date installed 7112/1985 Soil rating (g.p.d./ft2 or ft2/bdrm) 125 System type BED Length 32 ft. Width 24 _ ft. Gravel below pipe 0.5 _ ft. Total depth 4 ft. Eff. absorption area 768 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/13117 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth_3 in. Elapsed Time: 75 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum _ Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: b )4V i L1-Cd) Septic tank/lift station on lot 125 �T �( W ' vt • On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 1001+ Sewer/septic service line 25'+ Holding tank _100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 99'(WAIVER ISSUED) ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 99'IWAIVER ISSUED) F. COMMENTS 3-year vacant system presoaked per code prior to testing. G. ENGINEER'S CERTIFICATION I certify that 1 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. OF \1. ` Engineer's Printed Name KENNETH M. DUFFUSOr �4�� w Date 4113117 * • * tineWiril COSA canary sheet_2-6-15.doc +1�� ht.Nnr.T,p !,�, �I 4� Municipality of Anchorage • t�` Development Services Department Building Safety Division 1 � l� 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 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # OSC 171149 During a recent COSA on-site inspection and test of the potable water supply well on Block 2, Lot 3 & 4 of Broadwater Heights subdivision, the well's productivity was determined to be 0.65 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. COSA# olm06 Expiration Date: I I— 1-3—e-7 GENERAL INFORMATION Q ��� Complete legal description rU{� �% 'fer Rs` ,6 , I{t,c,(4 Z, Location (site address) J (j Current Property owner(s) h Kj7_- Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone �„/�o,� Day phone Zuy—Q347 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3� TYPE OF WASTEWATER DISPOSAL: Individual On-site rE3`- 0 Individual Holding Tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm Address Engineer's Printed Name Phone 6*W-7QZcF Date �f9✓07 :�.OF OR "T'... .... .A ash 0 Vit.+, ;'• 9! QTR - TN rd........> ..- ............... 5. DSD SIGNATURE do :P'; Steven w. Env iD •. PE 6255 e ✓ Approved for 3 bedrooms. IQlFgF ••,,••� ��• Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory X Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. vim• Original Certificate Date:— 1 3 — O7 (Rev. I IM5) Municipality of Anchorage •. Development Services Department Building Safety Division On-Sne water 6 Wastewater Program s • " 4700 Bragaw Street P.O. Box 196850 Anchorage, AK 995198650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST L.egalDescriptlon&Z,._J.y #P.t 1,$/„ , Zo— Parcel ID: 0 A. WELL DATA wen type -f— If A, B, or C provide PWSID # _ Well Log (YM) Date completed 3 Sanitary seal (YM) Wires properly protected (Y/N) Total depth A0 —eft. Cased to Z0 fl. Casing height (above ground) 2 % in. FROM WELL LOG AT INSPECTION Date of test ���/y�� 3 412,67 Static water levet ft. 2 9 % ft. Well production 3d g•p.k 0.00 g•p.m. WATER SAMPLE RESULTS: Coliform _cotonies/100 mL Nitrate ° P mg1L Other bacteria Q— colonies/100 mL Arsenic: Lar6gA Date of sample:�%3 67 Collected by B. SEPTIC/HOLDING TANK DATA Tank Type/Material (.. �EG/�Date installed Tank size AZ 52 gal. Number of Compartments Z Cleanouts (Y/N) _T Foundation cleanout (YM) Depression over tank (YM) Al High water alarm (YM) Al Date of pumping -�`hl Cj:2— Pumper ,! C. ABSORPTION FIELD DATA Data Installed214?a-r Son rating W4) di or fe/bdrm) /Z S System type Sed Length Width Ztl ft. Gravel below pipe d • S fl. Total depth t ft. Eff. absorption area %68 fe Monitoring tube -,X— Depression over field Al Date of adequacy test its O Results (Pass/Fag) J014LUS For -3 bedrooms Fluid depth in absorption field before test In. Water added -S!.' -t- gal. New depth -3 in. Elapsed Time:[,<Q min. Final fluid depth / in. Absorption rate >= ,S'a o g.p.d. Any rejuvenation treatment (past 12 mo.) (YM &type) !.f- IZ If yes, give date D. LIFT STATION *JI,4 Date installed 'Pump on' level at In. Datum E. SEPARATIO DISTANCES Size in gallons 'Pump ofP level _ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/kft station on lot_ Absorption field on lot Public sewer main Sewer /septic service line N1/f Animal containment areas ri t'd0 Manhote/Access Y/N) High water a18fm level at Meets alarm 8 circuit requirements? On adjacent lots - / f On adjacent kits /OQ r'e- Public sewer manhole/cleanout 44�,/. f Holding tank 6214 Manure/animal excrete storage areas /o o "I" SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r Building foundation s ,'' Property line -Z!2 f Absorption field /0 Water main Water service fine - /O r'r• Surface water /o s fl. - Wells on adjacent lots 99 , SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line /D t Building foundation 40 rf Water main X19 Water Service line Z S r Surface water /a a r*' Driveway. parkiNowhicle storage O 14 - Curtain drain U-4 /�, Wells on adjacent lots /(90 /r• F. COMMENTS G. ENGINEER'S CERTIFICATION -:'f, OF q�4,Z, I certify that I have determined through field inspections and 44.00* V $) review of Municipal records that the above systems are in �00 ; 49TH ••.. } *� conformance with MOA COSH guidelines In effect on this date. _ Engineer's Printed Name S f 0%/E 4�G A t ........ w Sreren W. Eng i J •, PE 6256 •��� • Date COSA Fee $ q�o 75 "4) 4) Date of Payment � n Receipt Number _ 5 q % / 7 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number >aD sx ` P. k 1- \IKi Lo7' 3 Y v c -J r As -BUILT �S, o0 I herebycertify that 1 hav sury e�77tI the ollowing described property �-o%S 'z F 4-, / OG Z 1 pr -41a?. wad �7— Fhe.io Anchorage Recording precinct, Alaska, and that the improve. A ,c0 `7 ments situated thereon are within the property lines and do not OF OF /. B overlap or encroach on the property lying adjacent thereto, that �. p •.•• ••t.S'f-Qe no improvements on property Iadjacent thereto encroach on the premises in question and at there are no roadways, a 1* 9 transmission lines or other visible easements on said property except as indicated hereon. Dated at Ea le River, Alaska 4 0 Robert C. 7o hnson t: this y D day oL_%H� �,® may NO, 880.5 ,•+i.7 ROBERT C.IOIINSON LV SCALE: Registered Land Surveyor 14o. 1 - LI -O/ Phone (907) 6941e53TLver, Alaska 99577 Municipality of Anchorage Development Services Department I =y„ Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Nater Well Advisory Health Authority Approval # 070305 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 2, Lot 3&4 of Broadwater Heights subdivision, the well's productivity was determined to be 0.8 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.3 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES M Division of Environmental Services M On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# 050-081-26 HAA# HA920088 1. GENERAL INFORMATION Complete legal description Lots 3/4 Block 2 Broadwater Heights Subdivision Location (site address or directions) 18 2a Mc Crary Road, Eagle River, Alaska Property owner Stephen R. Osgood Day phone 303-494-4631 Mailing address 1165 Edinboro Drive, Boulder, Colorado 80303 Lending agency Mailing address Day phone Agent John Blaine Day phone 561-2488 Address Coldwell Banker 4105 Tudor Centre Drive, Anchorage 99508 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Three (3 ) 3. TYPE OF WATER SUPPLY: Individual well xxxxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxxxxxx Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Criterium Alaska Engineers Phone Address PO Box 111790, Anchorage, Alaska 99511-1790 Engineer's signature 6. DHHS SIGNATURE X Approved for Disapproved. By: 3 bedrooms. Conditional approval for Additional Comments Date bedrooms, with the following stipulations: Date 7-2.7 - 92 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L3&4, B2, Broadwater Heights Parcel I.D. 050-081-26 A. WELL DATA Well type Privai e If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Yes Date completed 10/83 Driller Magnuson L Total depth 608 feet Cased to 20 Casing height 32" Sanitary seal (Y/N) Yes, Wires properly protected (Y/N) Yes Date of test Static water level Well flow Pump level FROM WELL LOG 10/10/83 30 g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot NA Absorption field on lot NA Public sewer main Public sewer service line NA WATER SAMPLE RESULTS: Coliform Negative Nitrate Date of sample: 1/3/92 B. SEPTIC/HOLDING TANK DATA AT INSPECTION 1/3/92 r 220 stable -n O z n rM rT' 9 r 2.6 m. 260 f A o w a n in OLD N o O On adjacent lots 99 0 "' On adjacent lots 110 Public sewer manhole/cleanout NA Petroleum tank NA 0 Collected by — Other bacteria Theodore A. Johnson Date installed 7/12/85 Tank size 1250 Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Yes Depression (Y/N) No High water alarm (;Y/N) N/A Alarm tested (Y/N) NA Date of pumping 12/26/91 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot NA On adjacent lots 99 Foundation 25 To property line 55 Absorption field 5 Water main/service line - Surface water/drainage — NA 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed NA Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot - On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ Date installed 7/12/85 Soil rating GP System type Bed Length 32' Width 24' Gravel thickness 61 Total depth 6' Total absorption area - 768 Cleanouts present (Y/N) NV Depression over field (Y/N) NV Date of adequacy test 1/3,/92 Results (pass/fail) P for t h -p@@ (3) bedrooms Peroxide treatment (past 12 months) (Y/N) No If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation 35 On adjacent lots Property line 28 To existing or abandoned system on lot Unk On adjacent lots Cutbank NA Water main/service line Da Surface water NA Driveway, parking/vehicle storage area 100, Curtain drain NA E. ENGINEER'S CERTIFICATION I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. AW � Signatur o AO '• �'� moi• • Engineer's Name The ore A. Johnson, P.E. 00.•.. ' i1 .,.. ii •..•� Date 2/9/92 0 [ami . •s,� ts ' • .' m . .• �`Amp HAA Fee $ i Z Waiver Fee: $ Date of Payment —/o �Z Receipt Number •�- 3 3�O rt �'� 72-026 (Rev. 3/91) Back MOA 21 Date of Payment Receipt Numbers 5. STATEMENT OF INSPt%;TION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Criterium Alaska Engineers Phone 349-1003 Address _PO Box 111790 Anchorage, Alaska 99511-1790 Engineer's signature 6. DHHS SIGNATURE Approved for __ bedrooms. Disapproved. xxx Conditional approval for three (3 ) Date bedrooms, with the following stipulations: Money is placed in escrow to accomplish the abandonment of the two specified wlls no later than June 1, 1992. Additional Comments The well serving this home appears to experience seasonal fluctuations for production between 63 qpm to 2.6 qpm Water conservation practices may be necessary during low period. PMWAWAVVIP�M Date April 1, 1992 e The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1%91) Back MOA #21 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Criteri= Alaska Engineers Phone (907)349-1003 Address Engineer's signature 6. DHHS SIGNATURE By: Approved for Disapproved. _X_ Conditional approval for Date February 10, 1992 OF Awl `��•'�� .y9 Alt Theo Johnson ; �0�s�•. CE 5191 ; c��d bedrooms. 3 bedrooms, with the following stipulations: RONF- '/-' IS PL ACE D /N E SrRO w 7'0 olt('0 't,oL ISH A9.4A,,00Wet&4v, OF THE Two SPECIPlE41 wF[L No TUNE ,r.v A DDI &&W w ELL r.4N Pi a /Y us i DE TAkEN QEFORE )-k A,6 /, 1Y112. ; Additional Comments W FLL SFR ttIN6 i}ilS #a.Atc geemou %'D r_ yPFR/Fd/cF X95yA,#L F ue n4 a TIONS FOR PRODuCT/ON BR T ►vEEl1/ . 63 G. P, Iy, To 2. 6 6. A /9. WATER CouSERVAT/aai PINCT/CES /yAy DE NECESSARY OWRwd Low allTlr Pr+R�op Date 3 — 1,9- 72- The 2 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Beck MOA k21 FROM : Cr i ter i um -A t a e ka EIw g s nmer s ewe', A L "I 3 Ell E E R S P.O. snx 111790 ANOHOAA&F AK OOG1 f•179D W? 349-1003 zJuris 80, 1998 ��aa M 1003 91LE 607 229.453 Linda Wileon Northland Mortgage 2806 Denali Anchorage, AK 99508 Re: Re•inspectioon M 18958 McarNuy jou Nwasr: 91177 Dear Me. Wi1WX �4 At your request, An inspection Of thlg above propertywas ptrfonned on dura 80, 1092. The report, that Mime has boon prepared based on that inspection. The purP01116 inspection and this repar't is to verily the deiicicnoies rioted in our previous report had been correotod, Thin irk«peotion was pay -formed by anI'1 rept written by Theodore A. Johnson, p,B, of Critorlurn-Alaeka Engineers, PRODUCTION Aa you roquo6tod, this evalttoatior, i1I limited it scope, f0o11Aing on the liNtod dON4110i4s 0*, Thio inspoctiotx report is Jihad to observations mode Dram visual evidence, NO destructive or invaeivo tebtxaig W#v pot'furm>o'd The report is not to be considered a guarantee of o+iJmdrtian end no wali"ranty is implied, As professional 'fl;nginsers, it is our romponsibility to evaluate availNble evidence relevant to tho purpose of this inspection. V7rs are not, however, respmoible ibr uouditions that could not bs sear or wsro not within the scope of our sorvice lit the taigas or the f nepection, ACTIONS TAKV 1, The two abandoned avelle havo bhen 11419faotOrily sealad, coNOLUSION a0tion hike been ta'kon and IT, aonotueicxi, we are satiefl ed that the approp risW coins-ectivs youany ort bo thecae d>sf havef tho opportunity ityeto of fr,ol feet to call ug for o aritic Thank , plecrice iiiNyrectipri, please afdolkit+alloe to you.1%N'tXW%� ndorl A, JQhmVW A,ri IlHerslrrnw OUILDIN0 INSAGOTION6 INVIDTIOATIVC ENaINGKAINO LITGAT10N aUPPOPT oUNVAUCTION MAm#,01MFNT NORTHLAND MTG CO ER TEL:6947292 EEDNO THLAND MORTGAGE MEN COMPANY March 16, 1992 Mar 19,92 12:42 No.004 P.02 IM 11421 Old Glenn Mi Eagle River, Alaska 99! (907) 6947872 / FAX (907) 6947 Municipality of Anchorage On Site well and Septic Approval ATTENTION: DAN ROTH RE: Lots 3 and 4, Block 2, BROADWATUR HEIGHTS SUBDIVISION OSGOOD To PRINZ Funds bald in escrow for completion of abandonment of wells Dear Dan, We will be holding $1,687.50 in our trust account for the completion of abandonment of the wells on the subject property. The funds will not be released until the work is complete and we have an unconditional DEC in file. If you need further information please do not hesitate to calx me at the number listed above. Sincerely, a Wilson Loan Closer kef\ . LABORATORY I TELEPHONE (907) 562-2343 5633 B Street Ve S.1 Anchorage, Alaska 99516 1—,-,fAAD Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY.WATER SUPPLIER TO BE COMPLETED BY LABORATORY/Il " ❑ PUBLIC WATER SYSTEM I.D. # X PRIVATE WATER SYSTEM Analysis shows this Water SAMPLE to be: s CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. . CV-\-rt=Ktj if -o( - A t`A%Y'VCA ` lI:N c, I NV- -Ks Name Phone No. (D.O.°°3 Mailing Address Awl c.%Eavt A.\c- Apr - / 9 Cay State Zip Code SAMPLE DATE: d Mo. Day SAMPLE TYPE: 1?� Routine ❑ Check Sample (for routine sample with lab ref. no. ja Special Purpose Year ❑ Treated Water ❑ Untreated Water SAMPLE Time Collected No. LOCATION Collected By 21 J 4 1 I 5 A.D.E.C. 1-62-92�H Membrane Filter: Direct Count / 6) z cnuf^rmlinn mi READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received 3 / Z— Time Received 1C_e Analytical Method: Membrane Filter ' No. of colonies/100 ml. Lab Ref. No. Result* Analyst I �V 82.0035 © m J (� rm W BACTERIOLOGICAL WATER ANALYSIS RECORD Verification: LSB ' e a( r -'e BGB Ve 2 -ar t Fecal Coliform Confirmation//t d Final Membrane Fllte esuits 4 Coliform/100 ml Reported By '�'"� �� Date TNTC = Too Numerous To Count Time: a.m. Held For Confirmation��� p.m. OB - Other Bacteria !. CHEMICAL & GEOLOGICAL LABORATORY °E A DIVISION OF COMMERCIAL TESTING & ,ENGINEERING CO. �F v TELEPHONE (907) 562-2343 Anchorag ,Street LAeoRAtOR♦ rafle, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D. 0 '0 PRIVATE WATER SYSTEM Phone No. Name Mailing Addrou Cey State Zip Codi ME] = SAMPLE DATE: Year Mo. Day SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample with lab ref. no. } ❑Treated Water special Purpose Untreated Water SAMPLE Time Collected No. LOCATION Collected B 2 3 I " 4 5 l READ INSTRUCTIONS BEFORE COLLECTING SAMPLE TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: * Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery! mail. Date Received 1,191 Time Received tD�o' Analytical Method: Membrane Filter ' No. of colonies/100 ml. Lab Ref. No. Result" Ana yet 202112-- iWI BACTERIOLOGICAL WATER, 'ANALYSIS RECORD Collform/100 ml Membrane Fitter: Direct Count Verification: LSS Fecal Collform Confirmation BG9 Final Membrane Filter Resu 1* Coliform/100 mi �� i Det* - Reported By t Time: e TNTC = Too Numerous To Count OB : Other Bacteria ANCHORAGE WELL & PUMP SERVICE 6901 Tanaina Drive ANCHORAGE, ALASKA 99502 �' { 43.0740 To _ 1_J JOB ESTIMATE 10 NE DATEkO/LOCATJWL -r _ ie., Z �A4 V� � JOB DESCRIPTION: ,'j W r' [r i�, )JA.1 t) dw rn,c.. adv r� 0 L)� U SIs Q C�c)fT L r, 5 �-C lT ff ti e c) uru asv (3 Gam' r kc)pLlrL.#Z_c IT 1 r "b6.ed k)?ctz,., Cur o�� C Av,6 d -41,,f ?�mb he/'lAjp04V Oro &,god THIS ESTIMATE IS FOR COMPLETING THE JOB AS DESCRIBED ABOVE. IT IS BASED ON OUR EVALUATION AND DOES NOT IN- CLUDE MATERIAL PRICE INCREASES OR ADDITIONAL LABOR AND MATERIALS WHICH MAY BE REOUIREO SHOULD UNFORESEEN PROBLEMS OR ADVERSE WEATHER CONDITIONS ARISE AFTER THE WORK HAS STARTED, ESTIMATED JOB COST ESTIMA BY 00 MATUE 1 1 :1 1 McCL INTO C:K: Lam:—ER ENG I NEER F' . 0 1 To: John Blame Coldwell Banker Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 694-5195 FAX 694-3297 Date: March 10, 1992 563-441$ Re: Broadwater Heights Lots 3 & 4, Block 2 Message: Our quote for abandoning two wells on the above referenced properties is $1,025.00 and does not include recovering water pumps. Work to be completed after break up. Sincerely, cz— Louis Butera, P.E. Total number of pages 1 including this cover sheet. If you have any questions or if you are missing any pages please call us at 694-5195. ... MAR -10-104 TUE 15:39 IDIS&S ENGINEERING TEL N0:617 694 1211 #803 P02 TWEED EXCAVATING AND CONSTRUCTION 17034 EAGLE RIVER LOOP RD., SUITE Me EAGLE RIVER, ALASKA 00677 FMONI; 901109+2919 or 40+1318 a PAX., 094-1211 Psse No. of Paps UTl UaMITTED VO RHONE DATE '?A VITT, aTATit; AND (zip COOL: DATE OF PANS i I We hereby submit specifications and estimates for: LOCATION kJ&, ) e—oor— GSI" :may ,{�.+--• y'�y1 % "f' 1 F1� I 'F.s " ` &4, ' Z .� 14vf- 14e -L. J M-11! �11d We propose hereby to fur�nis'hh material and —laboorr -complete In accordance with above specifications, for the sum of: Payment to be mode tis follows: Y 1 material Is guarant"d to be as spaNfled, An work to be completed In a work. Authoriz nuke manner morping to standard practices. Any elteratlon o► devlatlon from Signature i apaoltloatlons involvinE axtre Od#ts will be eMeautatl only upon written orders, e will baaama an eat►■ eharae over antl ieeva the Mllmata. All agreements can. tI at upon atrlkes, aeeldents or tlalays beyond our Control. owner to Carry fin, Note: This proposal may to wit dra n and other naoeeaary Insurance. Our workers ere Ivlly covered by Wvrk• lf�eel's tbinpansetlon Insurance. by us If not accepted within days, OfgcWry 8"ANOEThe above prices, specifications and conditions are Signature and are hereby accepted. You are authorized to do the as swifled. Payment will be made es outlined above. pajrtt of Aceaptanee. Signature IIOSTIMATE Rephen R, Osgood 1165 Edinboro Dr, Boulder, Colorado - -_ -- "(303)-494-4631 John Blaine Coldwell Banker Area, Inc. Realtors -1105 Tudor Centre Drive Anchorage, Alaska 99508 Dear John. The hydro-fracing has been completed. The flow test, done byr S & S Engineering, showed a flow rate of 38 gallons per hour, It's not trer-nendous but I believe sufficient . The original rate was 30 gal/hr. Enclosed is all the paper work we went over along with a copy of the well log and the Anchorage Tax Assessment. A copy of the house key can be obtained Ruth Doherty 694-5023. I have neighbors looking after the house and using the bath .and laundry rooms, as they are in the middle of construction of their own home. There should be no difficulty showing the house during the day. After 6 P.M, and on weekends you might give them a call to inform them of your coming. Bill and Sanda Putnam b94-4054, Please give me a call or write if you have any questions or concerns or if anything needs to be done to enhance the property. I'm Sorry about the delay and I do realize there isn't that much good time for selling the property. V� Sincerely, �. Stephen R. Osgood V.- A. R 4 � E4 `'�E RIVER. AS�,P HEALTH AUTHORITY APPROVALS MiL. Steve Osgood 1165 Ed.inbon.o Boutden, CoZorado 80303 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 August 19, 1991 FAX 694.1211 QA/ -,j 4 P'mf 2 SEWER &WATER REFERENCE: Lot 3; Btock 2; Bnoadwa-teA Heights Subdivision; MAIN EXTENSIONS Dear Mn. Osgood, At your request a 6tow test was performed on the. weU serving .the SEWER &WATER reberenced pnopenty on August 17, 1991. Prior to this 6tow testing INSPECTION the wet was Hydro-Sractured by Anchorage weft 9 Pump Senv.ice on August 9, 1991. The static waters teve.2 was measured .in the wet at 212 6t. beeow the ENGINEERING STUDIES top o6 the casing. A meter was connected p4 i.on to the pressure tank AND REPORTS and the stow turned on jjutt. Ater two hours and � ive minutes the water Levee was drawn down to the pump. The pump was then shut o66 and the water teve.e was mowed to recover 6or appnox.i.matei'y 20 minutes. At that time the pump was turned on again and the water WELL INSPECTION tev °pdrawn back down to the pump white the water quantity was & FLOW TEST metered. This process was repeated 5 times with consistent nebuetts. From this test we have found the we.ete to eurrentty pnoduee approx.cmate.ey 38 ga tons pen hour (GPH) . This 6tow rate .is not guaranteed to remain constant, subsequent vani.at.ions can occurs. SITE PLANS I j we may be o6 burther senv.ice, ptease contact u,s. S.ineerety, ROAD DESIGN n SOILTEST ROGER J. SHAFER, P.E. RLS/gm PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 1 17014 FAGLE RIVER LOOP. SUITF 204, EAGLE RIVFR, AI ASKA 99577