HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #3A BLK 6 LT 6Thunderbird Heights #3A Block 6 Lot 6 #051-582-51 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221085 PID Number: 051-582-51 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name TANYA &ANTHONY CHRISTIANSON ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24744 TEAL LOOP, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot THUNDERBIRD HTS. #3A 6 6 Fill added above original grade Ft. Gravel length FL Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' Ft. Well 200'+ -- . .... 25,+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other - Manufacturer GREER Capacity 1000 Gal. Surface water 100'+ -- Material HDPE Number of compartments 2 Lot Line 5'+ -- NA Foundation 10'+ ILIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank 3034. Tank to 3034 drainfield Installer JRS Drainfield CO/MT 3034. Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 1" 5/1/2022 5/1/2022 Location and description 2nd 3'd 4th BOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL 1��\\ � Awl A1. Conditional Approval: Date ' •:t�1 �r••.L L•:9�� $0 �.. Curtis Huffman• • edstem Apptic roved PPDate / 2 .:� Z� ���'s1 ' • .Cs %28991• • ..����/ � F,pF'0 Note: this approval does not include well ..... 'N AM • ll� PROFEWONP permit requirements. (Kev uoiuunu) PID: 051-582-51 PERMIT: OSP221085 15' MTA & MEA EASEMENT POST & RAIL FENCE DECOMMISSIONED EXISTING S.T. & INSTALLED NEW 1000 -GAL HDPE SEPTIC TANK WITH NEW DCO. JUST EAST OF EXISTING S.T. 5'+ TO PL' & 10'+ TO FOUNDATION. BM: BOTTOM OF SIDING' WOODEN FENCES A—C=47.8' B—C=15.2' A—D=43.0' B—D=17.9' A—E=40.1' B—E=19.0' BM: 100' AT BOTTOM OF SIDING SEPTIC SECTION SCALE: NTS THUNDERBIRD HTS. #3A, B6, L6 PREPARED FOR: TANYA & ANTHONY CHRISTIANSON 24744 TEAL LOOP CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com SUPPORTIIISERVICES: -do OF AL4, � c * 9 TI 0 (N DATE: 5/5/22 0� rtis Huffman wx SURVEY: KGL DRAWN: FWCS 5�5�2291�® SCALE: 1" = 30' PAGE: 1 OF 1 Lot 22 0 �o. \ `Oar IVO -9 15' MTA & MEA RS. u •OOc� EASEMENT \ POST & RAIL FENCE Lot 5 SEPTIC MANHOI WOODEN FENCE - PIPES A \ X00. ASPHALT ....PAVEMENT'. � BB, + RES 7'ORY IDEIVC,�1 2.5' x 6.1' CANT AEcK Lof 6 /o 22,214 s.f. C9 10.2' x 11.7 �V VSs SHED .7O 05' CHAIN-LINK FENCE / Lot 21 /C0 I BLOCK RETAINING WALLS 2.5' x 5.0' CANT 1.2' x 3.8' CANT Lot 7 PLOT PLAN AS BUILT X SCALE 1" = 40' GRID NW 1865 Project No. 22-232GA2 ,' Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & f\ s S o C i a t e S y i nc® (907) 522-6476 Phone (907) 522-4625 Fax oc> () F A Professional Land Surveyors ken®langsurvey.com v jonathan®langsurvey.com I hereby certify that I have surveyed the following described property: 0 LOT 6, BLOCK 6, THUNDERBIRD HEIGHTS, ADD NO. 3A (Plat No. 82-332) 0 * . 49TH 0� Anchorage Recording District, Alaska, and that the improvements situated thereon are •"""" "' . ............ within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed •� •• • • • • premises and that there are no roadways, transmission lines or other visible Q KENN easements on sold property except as indicated hereon. LS -5202. • yJ0© Dated this the Day of at Anchorage, Alaska �4FoA �O 4�Q, O,`ESSiONAL 4a It is the responsibility of the owner to determine the existence of any easements, O�OVodd�' covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNIG,11PAILITY OF ANCHORAGE On -Site 1 Tatar & Wa$tewatef Protgram PO Box 19W50 4700 Drnwe Reed Awhmgtg , Alas%a 99519-6650 Phone: (907) 343-7904 Fax; X907) 343-7907 hV;)dAvwAr.muni .aWans4l On -Site Wastewater Disposal System Permit Perm it Number- 09 P221065 Work Type. 5epticTank Upgrade Effective Date - Expiration ante: Ta c C -ode Number= 0515$2:51(l0o Site Legal Address: THUNDERSIRI) HEIQHTS #M BILK 6 LT 6 01665 Site Mailing Address: 24744 TEAL LOOP, Dhugiak Owner, CH RI$TMSON TANYA L & Design Engtnaer; FIRST WATER CONSLULTING This parmit is fortha conStrUaon of - ,N%5 F] s rL clrar[rliulYf 4)2$!2022 Q28d21)23 Lot Size in Sy Ft: 22214 Total Dcdraorns-_ 3 ❑ aispoSei Field ® Septic Tsrrk Q Holding Tarek ❑ Priory G Prig to Well L Waier 5lorage All construction Shall be in accordance with. 1. The attached approved design - 2. All requirements spWfled in Anchorage MUnlolprif code Chapters 15.55 and 15.55 zLnd the Make of Alaske VV@stewi9ter Disposal RegUIations (f 8AAC72) and Drinking ~!~Tater Regulations (1 5AAC80) 3. The wastewater node requires Jnspecticns during litre inslallatiorr- The engineer shalt notify the Development Services Department per AMC 15.65, Proyide notili eon by calling (907) 343-7504 (2417)- 4. From October 15 to April 15, a subsu rFaca Seal absorption system Under construction duFingfreezing weather shall be either: a- Opened and Closed on the same day, or b- Covered, sealed, aed heated to prevent freezing Received E3 Issued By - , Date: Date: q17_ e/;?, 7 MUNICIPALITY OF ANCHORAGE Development Services Department r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-582-51 Property owner(s) TANYA & ANTHONY CHRISTIANSON Day phone Mailing address 24744 TEAL LOOP, CHUGIAK, AK 99567 Site address 24744 TEAL LOOP, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) THUNDERBIRD HTS. #3A B6, L6 Legal description (Township, Range & Section) Lot Size 22,214 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank El Upgrade El (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ . (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 't a ? 5 Waiver Fees: Date of Payment:l/q,Z-- Date of Payment: Receipt Number: 50919 y Receipt Number: Permit No. O S 0 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com April 21, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: THUNDERBIRD HEIGHTS #3 BLOCK 6, LOT 6 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. The lot and area are served by public water and the waterline will me marked prior to tank installation. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221085, Deb Wockenfuss, 04/28/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221085, Deb Wockenfuss, 04/28/22 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION - ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 0**0 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONEEW ❑ UPGRADE MAILING ADDRESS 6,6x- LEGAL DESCRIPTION 1,7-6 4 a ` O LOCATION NO. OF BEDRMS 2y DISTANCE TO: Well &31 � Absorption area 15' Dwelling Now PERMIT NO. WQ h Manufacturer Material No. of compartments N Liq. cyp, asci do gallons IF HOMEMADE: Inside length Width Liquid depth Y JVZ DISTANCE TO: Well Dwelling PERMIT NO. = z FQ- Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. u z z w —R No. of lines ' Length of each line Total length of line � Trench width / (I inches Distance betw a nes ' h p Top of rile to finish grade 1 ">` Material beneath rile ( ­7 inches Total effective a sorption area L at Length Width Depth PERMIT NO. IF w ° Type of crib Crib diameter Crib depth Total effective absorption area m DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIA S .[ J(fJ SOIL TEST RA ING / 1 INSTALLER REMARKS 5 L 1 , APPROVED DATE LEGAL 3 —;_7e 72-013(Rev.3/78) TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATINdG (SQ FT/BR)= 100 THE REQUIRED SIZE OF THE SOUL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANdCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO _ET 14IDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCASIATIONa (IN FEET). T 1=1"6 < I Z-! E_ = -:2!5r--J eZ� 1=16_ 6. CH r-4 PERMIT APPLICANT HAS THE RE=PON=IBILITY TO INdFORM THIS DEPARTMENT DURING THE INdSTALLATION IN'_PECTIONdS OF ANY WELLS ADJACENT TO THI_ PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. — — -- -r& -A &D a::_ ` :=a I r -d F= 6= ! T I CH P-4 t� 6=" 0= 6�_ f=1 --e U I C_• — — BACKFILLING OF ANY SYSTEM WITHOUT FINdAL IN=FECTION AND APPROVAL BY THI= DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H 14ELL AND ANY CN—SITE _SEWAGE DISPOSAL SY_ TEM IS 100 FEET FOR A PRIG+HTE WELL OR 159 TO 200 FEET FROM A PUBLIC: HELL. DEPENdDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SENDER LINE IS. 25 FEET AND TO H COMMUNdITY =EWER LINE I= 75 FEET. OTHER REQUIREMENTS HAY APPLY. SPECIFICATIONS AND CON•dSTRUCTION DIAGRAMS ARE A'•.•AILABLE TO INSURE PROPER INSTALLATION. F� E: F;; -'r-1 I 71'- a o4 F= 16=° En ° c_a E—= e__ t= 6'•-66=: E: 6 -RI' f7 -4:E -- I 7 -4 -= I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _. I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:__(__X. ��_` -------------------- APF'LICANdT ST tir'EN+I L StRGGS ISSUED BY------�,----------=—_C:HTE ------ —V4.0 11 U PA 10 I E2 Fl I. I T' -e-' C16" F1 t -A 0- HFJp F- F=1 Cj I=— =DEPARTMEN•dT DEPARTMENT 'HEALTH AND ENVIRONMENTAL' OTECTION 25 'L" STREET, ANCHORAGE, AK. 99b0l 264-4720 Co PA —'__* I T 6= _.1= L-A E_ 1--Z F` E_ F? t`1 I T PERMIT NO. 8.301-:_a APPLICANT STEVEN L _KAGGS, PG BOX D CHUGIRK 99567 688-2831 iN LOCATION LEGAL LGBG THUNDERBIRD HTS LOT SIZE 999999 _QUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATINdG (SQ FT/BR)= 100 THE REQUIRED SIZE OF THE SOUL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANdCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO _ET 14IDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCASIATIONa (IN FEET). T 1=1"6 < I Z-! E_ = -:2!5r--J eZ� 1=16_ 6. CH r-4 PERMIT APPLICANT HAS THE RE=PON=IBILITY TO INdFORM THIS DEPARTMENT DURING THE INdSTALLATION IN'_PECTIONdS OF ANY WELLS ADJACENT TO THI_ PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. — — -- -r& -A &D a::_ ` :=a I r -d F= 6= ! T I CH P-4 t� 6=" 0= 6�_ f=1 --e U I C_• — — BACKFILLING OF ANY SYSTEM WITHOUT FINdAL IN=FECTION AND APPROVAL BY THI= DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H 14ELL AND ANY CN—SITE _SEWAGE DISPOSAL SY_ TEM IS 100 FEET FOR A PRIG+HTE WELL OR 159 TO 200 FEET FROM A PUBLIC: HELL. DEPENdDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SENDER LINE IS. 25 FEET AND TO H COMMUNdITY =EWER LINE I= 75 FEET. OTHER REQUIREMENTS HAY APPLY. SPECIFICATIONS AND CON•dSTRUCTION DIAGRAMS ARE A'•.•AILABLE TO INSURE PROPER INSTALLATION. F� E: F;; -'r-1 I 71'- a o4 F= 16=° En ° c_a E—= e__ t= 6'•-66=: E: 6 -RI' f7 -4:E -- I 7 -4 -= I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. _. I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:__(__X. ��_` -------------------- APF'LICANdT ST tir'EN+I L StRGGS ISSUED BY------�,----------=—_C:HTE ------ —V4.0 O & E ENGAEERING & DEVELOr i�AENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performedfor: Name: 5%E/✓G/✓ �. s1<'44;4�s Tel. N0.6ff-Zff �5 f Mailing Address: %, ® {.adK �/� CJ/{U //¢K, /4<<.%�/j % Legal Description: /-"r 6,, 15LOC14 �9 / %ifU v�� 2r�ii2v //775, SUi3�. Depth (feet) Soil Characteristics 0 1 Ml— -::511-r Tom' Sa/G_ /2AvF,vs L�o� - - 2 .25' 3 gyp! 4 5 s 7 8 s 10 — PLOT PLAN l.%o .sC'f'IGE 11 12 PERC. TEST 13 /25/%3./L. 14U7 -7-0-`t ©F Pii 15 16 T Ground Water Encountered: Yes No r/ If yes, what depth �6or.„',:° ac.cac^c'' mac o`•= Proposed Installation: Seepage Pit Drain Field �.p = Earl P. Ellis P iz Comments: NO. 7745E t 4��o RO�E[SS1� i' Performed by: l(sc t i sC>CGt� Date:— 5 Time APPLFANT FILLS OUT UPPER HA 'ONLY Prdperly Owner G5K (',OriStamYdti Otl Phone Mailing Address Zip Code ' 45-2553 Buyer Address Zip Code Lending Institution - Phone Address Zip Code Realty Co. &Agent iWVMAX os. Eagle River, Inc. (Jim Montague) Phone Inspector Field Notes: 694-4200 Address PO Box 843 Eavle River AK Zip Codec o5 77 Legal Description Lot 6, Block 6, Thunderbird- Heights Subdivision Street Location N TIN Raven j Type of Residence it Single Family 4 - ❑ Multiple Family No. of Bedrooms + O Other Water Supply O Individual - ( ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. js7 Community ?q fie. For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal - 19 R 3 k Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank BY: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date - Date Inspector Inspector Inspector Inspector Field Notes: ^e OF ANCHORAGE ��i 1 �, C1 Low j S -e, I MUNICIPALITY IDEPT. OF N`ALTII F: PROTECTION ENVIRO\MLNTAL OCT 1 2 1982 RECEIVED ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) COND IONAL APPRO a DATE BY: I X:5 Soils Rating Date Sewer InstalledQ� Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72 023131&1 Time APPLIt ,NT FILLS OUT UPPER HA. ONLY Property Owner GS Construction Time Phone Mailing Address Date Zip Code 745-2553 Buyer Judy Munday €c Lvelyn ;filler Date rr�� rteI �)'.—e, -> Inspector Address 2900 Columbia, Anchorage, AK Zip Code 99502 Inspector Lending Institution Alaska Pacific- Field Notes: Phone 61 5 ko t L@ lew— to ,1 t 101 Benson, PO Box 420, Anchorage, AK ZipCode99510 265-0203 Address DEPT. OF HEALTH P: —� rte,. Realty Co. & AgentPhone RP/ffAX of eagle river, Inc, (Jim I+ioncaguej Qij'c Low )sem,A' Address PO Box £343, Pagle River, AX zip Code 99577 694-4200 Legal Description Lot 6, Block 6, Thunderbird Heights Subdivision (� APPROVED BEDROOMS Street Location HH11 Teal Loop Road ( ) DISAPPROVED ( ) CO DITIONAL APPROVAL' Type of Residence s Z % —90!6 IN Single Family DATE ❑ Multiple Family No. of Bedrooms ❑ Other Soils Rating Date Sewer Installed Well To Absorption Area Water Supply ''�ll /Ov ' V-` Well to Tank ❑ Individual Septic Tank Size ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. 9 Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: 1983 , ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date rr�� rteI �)'.—e, -> Inspector Inspector - Inspector Inspector Field Notes: L p I[ V;'34 1%,Q+ —T,1J 61 5 ko t L@ lew— to ,1 t MUNICIPALITY OF ANCHORAGE _r DEPT. OF HEALTH P: —� rte,. ENVIROi N:NTAL PROTECTION Qij'c Low )sem,A' SEP i4t`� t RCEIVED (� APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CO DITIONAL APPROVAL' s Z % —90!6 DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received ''�ll /Ov ' V-` Well to Tank Septic Tank Size 72 023 (X82) APPLI'` :NT FILLS OUT UPPER HA'ONLY -Property Owner Time Phone Mailing Address k Zip code 116' C 'r -? S 7 / Y � Buyer Date �'- Address Zip Code Lending Institution - Phone Address Zip Code Realty Co. & Agent Phone Address Zip Code (� APPROVED BEDROOMS Legal Description (UC��, j _� ( ) CONDITIONAL APPROVAL - Street Location rf vtJf' DATE Type esidence BY: - Single Family Soils Rating ❑ Multiple Family No. of Bedrooms Well To Absorption Area ❑ Other Water Supply ❑ I vidual 1 Well to Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer sposal / /' E /_C�_i—/� r �%t 4-Us,1s� Intlivitlual Year Individual Installed: l �•• ❑ Public Utility - When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date �'- Inspector Inspector Inspector Inspector Field Notes: MAY 2 51983 "MU!"IM 'i nnh - ," (� APPROVED BEDROOMS 'CONDITIONS OF Af M9V.Agf Heui;h & ( ) DISAPPROVED Environmenfai PrG;tcnflgn" ( ) CONDITIONAL APPROVAL - DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received J( 11 1 Well to Tank Septic Tank Size ®® O 72 023 Time APPLICANT FILLS OUT UPPER HAr ONLY Property Owner C S. K. Construction Phone Date SRA Box 6105—A� Palmer, Alaska Zip code 99645 745-2553 Mailing Address Inspector Inspector Inspector - Inspector Buyer- Kenneth N. Barber P. 0. Box 322 Address Qij ak Alahka Zip Code Gor6 ( ) DISAPPROVED gi Lending Institution Alaska Pacific Bank Phone '" `'1 — P. 0. Box 420 DATE o Address Zip Code 276-3110 Realty Co. R Agent Totem Realty, Inc. — William Schlegel Phone Well Log Received 724 E. 15th Avenue Anchorage, AK Zip Code 99501 272-0571 Address Well to Tank Legal Description - Lot 8, Block 6 Thunderbird Heights Street Location Rairpniri Type of Residence X Single Family - ❑ Multiple Family No. of Bedrooms 4 ❑ Other Water Supply —] ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. a Community - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal 1982 IR Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Tim / Date Date Date Date Inspector Inspector Inspector - Inspector Field Notes: ( - APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' '" `'1 — DATE o BY. Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size f l � I — r1 �` Well to Tank 72 023 MUNICIPALITY OF ANCHORAGE Development Services Department f i Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 051-582-51 1. GENERAL INFORMATION Expiration Date: L(— l 9 r 2Z 2- l/ Complete legal description THUNDERBIRD HEIGHTS #3A BLOCK 6 LOT 6 Location (site address) 24744 TEAL LOOP, CHUGIAK, AK 99567 Current property owner(s) TANYA & ANTHONY CHRISTIANSON Day phone Mailing address Real estate agent 24744 TEAL LOOP, CHUGIAK, AK 99567 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: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -50 Date of Payment — .-- Receipt Number 7 r 5- ('9 3 COSA # SSG -Z 1186 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 5/3/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q: •' for current or future occupants or guarantee that no unseen encroachments, deficiencies or fig•• '9 �� discrepancies exist can be given by First Water Consulting449& % *: 7H '. k FWH' .. ........ 6. DSD SIGNATURE �• "" "''_ • ' • Curtis Huffman System #1 Approved for bedrooms ����F��s•• CE 128991 10e System #2 Approved for bedrooms t1,F�PROFEWQ0 Disapproved Conditional approval for bedrooms, with the following stipulW%w(((ffff(( opt 6,,VVA �/ M 1n1� R ANo R; V r, PRO - qT&R JJ iO � ! J f By: Original Certificate Date: S L 2— 02? The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: THUNDERBIRD HEIGHTS #3A BLOCK 6 LOT 6 Parcel ID: 051-582-51 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA – PUBLIC WATER ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to _ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) _in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA Age of tank(s) 0 – NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid levei in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Which system tested (date installed) 3/24/1983 ® ALL standpipes present per record drawing Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 4/18/2022 Results E Pass For 3 bedrooms Total measured depth from grade 8_8 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 2.8 ft (min) Water added 600 gal ❑ N/A – pressurized field New depth 0 in ❑ Monitor tubes go to bottom of effective. If not, state depth into effective MO IR TED - SHOTS SHOW WED Elapsed time <10 min depth 0 in Code -required soil cover over field Final fluid d— ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: MT/ST+ AT GRADE & SHOTS TAKEN AT TESTING. APPEARS TO BE MISSING 1'ED FWE 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' If absorption field is under driveway comment below ❑ Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No. Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' F. ENGINEER'S COMMENTS Animal Containment > 50' ❑ Yes if No ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E] Yes if No ft ❑ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION ��"°' `!��low ,� 1 I certify that I have determined through field inspections and review owe, : •'` • of Municipal records that the above systems are in conformance •"� �� with MOA COSA guidelines in effect on this date. e/ , iii . , ..': • Curtis Huffman F� •. CE 128991 �� sj�R. • 515/20�2•'F��'.� PROFESSO -� ft ft ft ft ft ft ft ft Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-582-51 Expiration Date:G���� 1 f� 1. GENERAL INFORMATION Complete legal description Thunderbird Heights #3A Block 6 Lot 6 Location (site address) 24744 Teat Loop, Chugiak, AK Current Property owner(s) Hernandez Day phone 907-947-8990 Mailing address same Real Estate Agent Rebecca Baker Day phone 907-947-8990 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) OlS Fnr a9eA4- -1-v yak ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) ✓ 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ® Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52(12 Date of Payment Receipt Number COSA# 05C16t 102 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. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 6. DSD SIGNATURE --Iz_ System #1 Approved for System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following Steven W. V4 3 '27�/S ' ITY Z,J oN do = M VV.4 RANn mr m i Original Certificate Date:- of Anchorage Devlopment 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 notresponsiblefor errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the tot: COSA Checklist Structure served by this, system Certificate of On -Site Systems Approval Checklist Legal Description: % .S "�?A 0!96 ZC Parcel ID: d ,51-5 S� A. WELL DATA A1,4 1 c' Well type If A, B, or C provide PWS ID # 2 1' Well Log (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test. Static water level ft. Well production 9.p -m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate Arsenic ug/L Date of sample: mg/L Collected by: ft. 9 -P.M. B. SEPTIC/HQLDING TANK DATA Tank Type/Material 5 S7 F& Date installed Tank size 1(20 gal. Number of Compartments Z Cleanouts(YIN) Foundation cleariout(Y/N) --y Depression over tank (YIN) AZ- High water alarm (YIN) Date of pumping -� Pumper C. ABSORPTION FIELD DATA Date installed 3 c^ 0soil rating (g.p.d./ftZ or felbdrm) �O System type-ri.4&y Length 3!Z ft. Width 3 ft. Gravel below pipe % ft. Total depth 1L ft. Eff. absorption area q-%�f? Monitoring tube —Y-- Deptession'over field AL Date of adequacy test Results (Pass/Fail) For -S bedrooms Fluid depth in absorption field before test (n in. Water added O gala, New depth� i in. Elapsed Time:- .30 mina Final fluid depth t� in. Absorption rate >-= 41s-0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) t,1A(R If yes, give date D. LIFT STATION NA Date installed Size in gallons _ "Pump on" level at - in. "Pump off' level at Datum Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: ^1A Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line _ ril Manhole/Access(Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 1— Property line /D ,+ Absorption field S r� Water maim Water service line /D �f Surface water O D Wells on adjacent lots JJQ6 `'I - ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main /O 7' r Water Service line Surface water /oD �- Driveway, parking/vehicle storage � Curtain drain i/iUte_' Wells on adjacent lots /Dd f- F. COMMENTS in. G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems- are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed NameS f F✓E Ems" G' Date /01 Zl COSAyellow sheet 2-5-15.doc Municipality of Anchorage • Development Services Department z �' Building Safety Division E;,x 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 Parcel I.D. 051-582-51 COSA # ( —5c— 1 Expiration Date: 7- 1. _1. GENERAL INFORMATION Complete legal description Thunderbird Heights Subdivision #3A Block 6 Lot 6 Location (site address) 24744 Teal Loop, Chugiak, AK 99567 Current Property owner(s) Marian Devoll Day phone 688-0531 Mailing address Lending agency Mailing address 24744 Teal Loop, Chugiak, AK 99567 Day phone Real Estate Agent Keller William/Dan Wolfs Team Day phone 865-6512 Mailing Address ,Unless otherwise, requested, COSA will be held by DSD for pickup. 2 :' NUMBER. OF BEDROOMS: 3 3.' TYPEOF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual .Nell' ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® 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 On -Site 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 engineer's 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 7/18/2011 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. '-"1&' lk The operational life of all wells and septic systems depend on the local soil condition, ground water ���� DF ��4 4% levels that may fluctuate during the year, and the water usage of the family being served by the system. ��� �. `P .,•........... These conditions are outside the control of the evaluator of this system. All systems eventually fail and J �?,.•'•�• ��� satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future ••••• •••• • •••• •••••• •••. 00 performance nor give any estimate of how long the system will continue to meet the operational ............••• ..... „•..... • •• 0 requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed j _81 ;Steven R. Pannone: AN AV above. Any reliance upon or use of this report by any other person or party is not authorized nor will it •I0�P°•.,.• No. CE 8149 •.':AV Ar confer any legal right whatsoever. ��•.., .••°'�� 5. DSD SIGNATURE Approved for pp bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory WASTEWATER Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other BY Original Certificate Date:.- (Rev. 11/0 f Municipality of Anchorage *AE Development Services DepartmentBuilding Safety Division On -Site Water & 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 CHECKLIST Legal Description: Thunderbird Heights Subdivision #3A Block 6 Lot 6 Parcel ID: 051.582-51-000 A. WELL DATA Well type AWWU If A, B, or C provide PWSID # Date completed Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOG Date -o est Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Coliform colonies/100 mL Nitrate mg/L —OftLtacterl Arsenic: ug/1 Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA ft. g.p.m. colonies/100 mL Tank Type/Material Greer/Steel Date installed 3-24.83 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) y Foundation cleanout (Y/N) y Depression over tank (Y/N) n High water alarm (Y/N) na Date of pumping August 26.2010 Pumper JlTs Septic Pumping C. ABSORPTION FIELD DATA Date installed 3.24.83 Soil rating (g.p.d./ft2 or ft2/bdrm)100 System type Trench Length 34 ft. Width 3.0 ft. rGravel below pipe/_Z_ft. Total depth 11 ft. Eff. absorption area 476 ft2 Monitoring tube y Depression over field n Date of adequacy test 711'112011 Results (Pass/Fail)ap ss For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 12 in. Elapsed Time: 90 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 ins a Size in gallons "Pump on" level at in. "Pump off' level at Manhole/Access (Y/N) _ High-water alarm level at Datum Cycles tested Meets alarm & circuit E. SEPARATION DISTANCES TION DISTANCES FROM WELL ON LOT TO: Septic tank/lift Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots On adjacent lots Pu Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 10+ Absorption field 5+ Water main 25+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 25+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 25+ Curtain drain 25+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and Jam. 49rH°• review of Municipal records that the above systems are in �.....a .. conformance with MOA COSA guidelines in effect on this date. �....:..... ............. Engineer's Printed Name Steven R. Pannone, P.E.•Steven R. Pannone •��� •'o•• No. CE 8149 4� Date 711812011 eeeje, •••'••••..........\ .••'� :_•� � l q COSA Fee $ —I l 0' Waiver Fee $ Date of Payment -� I d-,t-� 1 I 1 Date of Payment Receipt Number 0154q 1 Receipt Number (Rev. 11/05) in. s4 s if 7 Com, ` F 1, 0 AS -BUILT I hereby certify that I have surveyed the following described property: L p 7— r Anchorage Recording Precinct, Alaska, and that the improve- rnents situated thereon are within. the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska this 3 r�r( day afi ! a 29 t`F 0 R013ERT C. JOHNSON 1.1 SCALE; Registered Land Surveyor No. 880 -LS jV, = `" Box 456, Eagle River, Alaska I Phone (D07) 694-2543 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 Parcel l.D.051-582-51 COSA# Y_>C1Q1U-3e Expiration Date: -5-- / I — U_ 1. GENERAL INFORMATION Complete legal description Thunderbird Heights Subdivision #3A Block 6 Lot 6 Location (site address) 24744 Teal Loop, Chugiak AK 99567 Current Property owner(s) Marian Devoll Day phone 688-0531 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 24744 Teal Loop, Chugiak AK 99567 Day phone Keller William/Dan Wolfs Team Day phone 865.6512 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ED TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 On -Site 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 engineer's 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 Pannone Engineering Services, LLC Phone 272-8218 Address P.O.Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 3-9-2009 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. ••„a The operational life of all wells and septic systems depend on the local soil condition, ground water •.•� aaa4 levels that may fluctuate during the year, and the water usage of the family being served by the system. per..••„” ..:Qp�4j� Thesc conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that c'( 49rH there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational ..0 „„„- „: requirements or the MOA DSD. The content of this report is for the sole benefit of the owner listed 0- pi Steen R Ponno�e above. Any reliance upon or use of this report by any other person or party is not authorized nor will it # , ;_ r r 8143 confer any legal right whatsoever. # D CT • 5. DSD SIGNATURE�414 Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: J — ,/ C) (Rev. I IAS) Municipality of Anchorage • Development Services Department ° j' Building Safety Division ' On -Site Water & 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 CHECKLIST Legal Description: Thunderbird Heights Subdivision #3A Block 6 Lot 6 Parcel ID: 051.582.51.000 A. WELL DATA Well type AWWU If A, B, or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL Arsenic: u Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Greer/Steel Date installed 3.24.83 Tank size :1000 gal. Number of Compartments 2 Cleanouts (YM) y Foundation cleanout (YIN) y Depression over tank (Y/N) n High water alarm (Y/N) na Date of pumping August 26, 2009 Pumper JR's Septic Pumping C. ABSORPTION FIELD DATA Date installed -23 4.83 Soil rating (g.p.d./fe or fe/bdnn)100 System type Trench Length 34 ft. Width 3.0 ft. Gravel below pipe 5 ft. Total depth 11 ft. Eff. absorption area 476 fe Monitoring tube y Depression over field n Date of adequacy test 3-3.09 Results (Pass/Fail)aD ss For 3 bedrooms Fluid depth in absorption field before lest 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 100 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 `Pump on" level at _ in. P p Datum Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM Septic tank/lift station on lot _s Absorption field on lot Public sewer main Sewer /septic sery Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? adjacent lots Ona cent lots Public sew 2 Holding tank _ Animal containmefit areas Manure/animal excrete3torage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 10+ Absorption field 5+ Water main 25+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 25+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 25+ Curtain drain 25+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 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. Engineer's Printed Name Steven R. Pannone, P.E. Date 3.9.2009 JAI COSA Fee $ U Date of Payment ✓� .�7 / Receipt Number (Rev. 11/05) .70 tv - '?fil/ r -N Ik Waiver Fee $ Date of Payment Receipt Number, ..... . ?;• y 114 Municipality of Anchorage • -tel 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 'a Parcel I.D. 051-582-51 COSA # �it{ Expiration Date: 3-31-10 1. GENERAL INFORMATION Complete legal description _Thunderbird Heights Subdivision #3A Block 6 Lot 6 Location (site address) _24744 Teal Loop, Chugiak, AK 99567 Current Property owner(s) Marian Devoll Day phone 688-0531 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 24744 Teal Loop, Chugiak AK 99567 Day phone D.� Wo�GK�11�r�.J;11�.Ms Day phone SS65-6510 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site 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 On -Site 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 engineer's 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. 0. Name of Firm Pannone Engineering Services LLC Phone 272-8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 3-9-2009 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory lest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PGS can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE _(z� Approved for _1 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rw IM) i Municipality of Anchorage • Development Services Department Building Safety Division ° -- On -Site Water & 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 CHECKLIST Legal Description: Thunderbird Heights Subdivision 0A Block 6 Lot 6 Parcel ID: 051.582.51.000 A. WELL'DATA Well type AWWU Date completed Total depth ft. Date of test Static water level If A, B, or C provide PWSID M Sanitary seal (YM) _ Cased to ft. FROM WELL LOG ft. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Well production g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Other bacteria Arsenic: _ ugA Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA ft. colonies/100 mL Tank Type/Material Greer/Steel Date Installed 3.24.83 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) v Foundation cleanout (Y/N) y Depression over tank (Y/N) r High water alarm (Y/N) na Date of pumping August 13, 2008 Pumper JR's Septic Pumping C. ABSORPTION FIELD DATA' Date installed 3.24.83 Soil rating (g.p.d./V or ftz bdrm) 100 System type Trench Length 34 ft. Width 3.0 ft. Gravel below pipe 5 ft. Total depth 11 ft. Eff. absorption area 476 fe Monitoring tube y Depression over field r Date of adequacy testi 3.09 Results (Pass/Fail)aD ss For 3 bedrooms Fluid depth in absorption field before test 0 in. Elapsed Time: 100 min. Final fluid depth 0 In. Water added 450 gal. New 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 Date Installed "Pump on" level at _ in. E. SEPARATION DISTANCES Size in "Pump off"level at _ in. DISTANCES FROM WELL ON LOT TO: Septic tank/lift station o -r "k Absorption field on lot Public sewer main Sewer/septic servi 3ftE Anlm containment areas Manhole/Access (Y/N) High Meets alarm & circuit requireme On adjacent lots On ad'a Public se nhole/cleanout Holding tank Manure/animal excrete storage areas _ in. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ` Building foundation 5+ Property line 10+ Absorption field 5+ Water main 25+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 25+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 25+ Curtain drain 25+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and " review of Municipal records that the above systems are In ; , 0 conformance with MOA COSA guidelines In effect on this date. i ;$ Engineer's Printed Name Steven R. Pannone. P.E. �� c;s3�"en R. PCnnone p� ♦ `��%�s, �p� �C� 8349 �`w� Date 3.9.2009 �eeei•�' COSA Fee $ % O Date of Payment 3 — a 6 0 / Receipt Number 3 / 3 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number • MUNICIPALITY OF ANCHORAGE Department of Health & Human Services gowd-z"I DIVISION OF ENVIRONMENTAL SERVICES 343-4744 on - CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # nz) 1 - �- 23 HAA # Qin tai 19'q 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 6 Btoch 6 • Thundutb i+cd Heights # 3A Location (address or directions) 24744 Teat (b) Property owner Evefun Mif feL Telephone: (home) 688-43gusiness Mailing Address HC 79 Bax 120 Teaf Loop Chua.iah Massa 99567 (c) Lending Institution Mailing Address Telephone (d) Real Estate Company and Agent Re/Max a{ Eagte R.iveA ATTN: Vikginia KuhR_4ietd Address 16600 Cewtek4ietd Dn,Cve Suite 201 Eagte Rives Ak. 99577 Telephone 694-4200 (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: 5 & 5 ENGINEERING 17034 Eagle River Loop Road No 204 - - .— Eagle River, Alaska 99577 - 2. TYPE OF RESIDENCE Single -Family 61 Number of bedrooms 3 V 3. WATER SUPPLY Individual Well ❑ Community Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ❑XX Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 12-025 (Rev. 1/88) Pagel of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 S EN,='--•' _G Telephone 17034 Eagle ;ei"" Loop . Oa _ o. 204 Address Eagle Rive{ `:..'=^,3 995.77 Date 6. DHHS APPROVAL Approved for bedrooms by Approved —/_-- Disapproved Terms of Conditiona Approval 0 A r// i/ Date ZL 7 Conditional �fi lVP �'V .4 1 J,A .,::A y i.i, Yr l lft� i 1,_,I{a , ,V.i,,j�.VrNMTCUIV+1 PI iWh 4111.1E i5 i! t r�.i�e ,1FG.: I! The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. ]158) Rice Page 2 of 2 A. WELL DATA Well Classification Well Log Present (Y/N) MUNICIPALITY OF ANCHORAGE (MOA) PAUTY O)Hgal(oAk thority Approval (HAA) A MENTAL SEAY9A55K' Tv FEBRUARY 1984 im 343-4744 N11 AN 2 :3 1930 M Date Completed Legal Description: �/ (� 6 ': / Ii IenP tf73 Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: If A, B, C, D.E.C. Approved ON) Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot f� ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by To Nearest Public Sewer Cleanout/Manhole Water Sample Test Results Comments ; Date B. SEPTIC/HOLDING �A � D2ATp3 Date Installed 3 83 Size E2:� No. of Compartments Standpipes (VN) Air -tight Caps[P7N) Foundation Cleanout (tel) Depression over Tank (YJ!g> Date Last Pumped Pumping/Maintenance Contact on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) rA Temporary Holding Tank Permit (Y/N) 014 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well To Building Foundation To Property Line o�� To Disposal Field 1 To Water Main/Service Line k To Stream, Pond, Lake or Major Drainage Course �/( ''r Comments �IS 6�Ss&E2,-- 11,11ay"ic 72-026 (Rev. 7/88) Front Page 1 of 2 moi-/ C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata . frog%L Type of System Design G4 Date Installed Length of Field Width of Field Square Feet of Absortion Area Depression over Field (YOP -•¢ Depth of Field Gravel Bed Thickness Statndpipes Present(LVN) Y Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well f� To Property Line i To Building Foundat nP o To Existing or Abandoned System on Lot ; On Adjoining Lots r� To Water Main/Service Line � o /� To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course / CSO /_/_ To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Datestalled Size in Gs "Pump On" Level a High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent(Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines inn�,f inspection. F 4 S & S ENGINEERING v .•••• ° 17034 _ag on -Road No. 2U4 Signed Company F1gla Rive(, laska 99577 ���� �k > >°•.> Date MOA No. C /% �l'rJ,i iJ `` � Receipt No. O> �' l 2 Receipt No. Date of Payment Waiver Fee: $ Amount: $ ����;�I �� Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 the date of this 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 Ile Lit 5. [T♦ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.051-582-51 COSA# DSC101U38' Expiration Date: 5__ / q — ff 1. GENERAL INFORMATION Complete legal description Thunderbird Heights Subdivision #3A Block 6 Lot 6 Location (site address) 24744 Teal Loop, Chugiak, AK 99567 Current Property owner(s) Marian Devoll Day phone 688-0531 Mailing address 24744 Teal Loop, Chugiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Keller William/Dan Wolfs Team Day phone 865-6512 Mailing Address Unless othenvise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® 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 On -Site 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 engineer's 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 Pannone Engineering Services LLC Phone 272.8218 Address P.O. Box 102954 Anchorage AK 99510 Engineer's Printed Name Steven R Pannone P.E. Date 3-9-2009 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the perfomtance of the system under the conditions encountered at the time of the test, and separation distances measured to readily idcntiriable features. The operational life of all wells and septic systems depend on the local soil condition, ground water•••,` OI- A qga,g�a levels that may fluctuate during the year, and the water usage of the family being served by the system. �•-�P,••"'"'"""'•'•.,Ui These conditions arc outside the control of the evaluator of this system All systems eventually fail and � �•• � satisfactory test results do not guarantee future performance of the system, nor do they guarantee that �' ' rm49LH yl } 0 there are no hidden defects or encroachments. PES can therefore not provide any warranty for future :- "i performance nor give any estimate of how long the system will continue to meet the operational «.rte__... ._ ... requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed ♦ tH�Steven R Po«none above. Any reliance upon or use of this report by any other person or party is not authorized nor will it 00 a`v, N r 14�x�.: confer any legal right whatsoever. �2e•O 5. DSD SIGNATURE �e4404 � •• _LL� Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: / Al, ,�� Original Certificate Date: (Rev. 11N5) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & 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 CHECKLIST Legal Description: Thunderbird Heights Subdivision #3A Block 6 Lot 6 Parcel ID: 051.562.51-000 A. WELL DATA Well type AWWU If A. B, or C provide PWSID # Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. 9.p -m. . WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL Arsenio: ___0/1 Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Greer/Steel Date Installed 3.24.83 Tank size 1000 gal. Number of Compartments 3 Cieanouts (Y/N) v Foundation cleanout (YM) y Depression over tank (Y/N) n High water alarm (YIN) na Date of pumping August 26, 2009 Pumper JR's Septic Pumping C. ABSORPTION FIELD DATA Date installed 3.2483 Soil rating (g.p.d./ft2 or ft2/bdnn)100 System type Trench Length 34 ft. Width 3.0 ft. Gravel below pipe 5 ft. Total depth 11 ft. Eff. absorption area 476 fe Monitoring tube y Depression over field n Date of adequacy test 3.3.09 Results (Pass/Fail)aD ss For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 100 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