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Home My WebLink AboutVALLI VUE ESTATES #1 BLK 1 LT 5LoT' Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221470 PID Number: 015-311-060 Dwelling: N Single Family (SF) [:1 with ADU D Duplex (D) [I Two Single Family Project: ] New M Upgrade �Name CAIN ALASKA COMMUNITY PROPERTY ABSORPTION FIELD N Deep Trench 0 Wide Trench [I Bed EJ Mound [] Other Soil Rating Total depth from original grade 1.2 GPD/SF 10 Ft. Depth to pipe invert from original grade Gravel depth beneath pipe 4.0 Ft. 6.0 Ft. —grade Site Address — 6815 DOUBLE TREE CT Phone Number of Bedrooms 14 LEGAL DESCRIPTION Subdivision stock Lot VALLI VUE ESTATES # 1 BLK 1 LT 5 Fill added above original 0 Gravel length vel len Township Range Section Gravel width 2 Ft. Total absorption a area 'Number 504 Ft-' Beds: Number of Lines 0 of trenches 1Ft, Distance between- lines Ft. Dist. between trenches SEPARATION To From DISTANCES n Septic Absorption Lift Station Holding Sewer Tank Field Tank Line well NA NA* TANK 19 Septic [I S.T.E.P. 0 Holding 0 Other Manufacturer 'Capacity ANCH TANK 1250 Gal. ��Surfac;ewwater 1001+ - 1001+ Material PLASTIC 12 Number of compartments Lot Line 10'+ 104 NA Foundation **8 81+ LIFT STATION Manufacturer Capacity Remarks *COMM. WATER Gal, OUTSIDE FOOTING BEARING AREA Alarm location Electrical installedby Installer MIKE ANDERSON PIPE MATERIAL House to tank 3034 Tankto drainfield 3034 Drainfield TOi� CO/MT 3034 Inspector MIKE ANDERSON PE. BENCH MARK (Assumed elevation) 102.8 It Ins dates: ction I st 3/15123 2"d 3/16/23 d 3rd 41h Location and description TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date •-ftw 4 0 F A 49TH . # . 0 -.0 # # ;0a �?,S-- MICHAEL , CE - 9469 A'- Septic System Sy Approved Date Note ot - is approval does not include well permit requirements. (Rev 05102/18) LI -1 F. B . Permit No. OSP221470 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: VALLI VILE ESTATES # 1 BLK 1 LT 5 PID No.: 015-311-06 BLDG FOUNDATION TANK LID 8 p„ 1250 PLASTIC TANK 45% SLOPE 1 NEW LEACH FIELD SOIL BEARING FORFOUNDATION i ASBUILT SCALE: 1"=5' �•�P••E ............ .'<S♦�i AV • ... ...I.I ... ... ... ........0 .MICHAEL N. ANDERSON. � �I��S °o• No. CE 9469 Ar �. '•.•8-2-25 �.�� i ♦♦♦♦I�ESS;�� Municipality of Anchorage A P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * Waiver#: OSV261007 COSA#-. OSC251425 Permit#: OSP221470 PID#: 015-311-06 Legal Description: Valli Vue Estates #1 Block 1 Lot 5 Engineer: Mike N. Anderson Your request for a waiver of the required 10 feet horizontal separation from the septic tank to the foundation has been approved. The approved separation distance is 8.0 feet. Your request for a waiver of the required 10 feet horizontal separation from the disposal field to the foundation has been approved. The approved separation is 8 feet. This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: Approved by: ame Reviewer **** VARIAN C E/WAIVER REVIEW **** Feb. 9, 2026 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: 8’ waiver to tank and field Legal: VALLI VUE ESTATES #1 BLK 1 LT 5 To whom it may concern: This is a request for a septic waiver of 8 feet from the tank and field to the foundation. My justification is the granting of this waiver will not impact any of the surrounding neighbors and we have 80 percent of the required 10-foot separation. The granting of this waiver is necessary for a better system. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221470 Work Type: Septic Upgrade Tax Code Number: 01531106000 Site Legal Address: VALLI VUE ESTATES #1 BLK 1 LT 5 G:2539 Site Mailing Address: 6815 DOUBLE TREE CT, Anchorage Owner: CAIN ALASKA COMMUNITY PROPERTY Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: tl�cnt. o� llepartIII cnt 3/20/2023 3/19/2024 20352 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing AWer-son Date: Issued By: Date: ZC��Z 4 MUNICIPALITY OF ANCHORAGE Development Services Department �`' Phone: 907-343-7904 On -Site Water & Wastewater Section 'ry- Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-311-06 Property owner(s) CAIN ALASKA COMMUNITY PROPERTY Mailing address 6815 DOUBLE TREE CT, ANCH, AK Site address SAME Day phone Legal description (Sub'd., Block & Lot) VALLI VUE ESTATES #1 Legal description (Township, Range & Section) Lot Size 20352 Sq. Ft. Number of Bedrooms 4 BLK 1 LT 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 Septic Tank El Upgrade 0 (w/wo ADU) Duplex (D) ElHolding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (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: It 15 -96 - Date of Payment: ll(o [aa Receipt Number: () l & t &7 Permit No. Q Sp2;Z1Ll?n Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Bui[ding Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Dec. 1, 2022 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic system permit Legal: VALLI VUE ESTATES #1 BLK 1 LT 5 To whom it may concern: This is a request for a septic permit on the above referenced lot. A single test hole was excavated to 17 feet. The soils consisted of poorly graded sand (SP) for the entire depth. Water as observed at 17 feet and stabilized at 16 feet after the 7-day monitoring period. The lot is serviced by a community water system. A simple deep trench has been designed with a gravity flow 1250 gallon plastic tank. The slope around the field is flat where the field is located then slopes at about 10 percent towards the north. This new system will not impact any of the neighbors or encroach on any wells, septic or open water issues. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221470, Deb Wockenfuss, 03/20/23 SEPTIC FIELD SECTION DESIGN CRITERIA: 6.0' EFFECTIVE 4 BDRM X 150 = 600 GPD SOILS = 600/1.2 = 500 GPD 500 GA/12 = 42' 2.0' WIDE 42' LONG (1) TRENCH 10.0' DEEP 17 (TH#1) 1.0 SP ORG 1.0'2.0' -10.0 -4.0 MOUND OVER FILTER FABRIC SEWER ROCK 3,3( GRADE 1"=100' PROPERTY LINE EXISTING DRAINAGE FIELD EXISTING HOUSE -E TREE DR--DOUBLE TR E E C T - OPEN GREEN SPACE SCALE: DJRDRAWN: DATE: VALLI VUE EST #1, BLOCK 1, LOT 5 Anchorage, Alaska CAIN TRUST 11/3/2022 H2O@16' OCT 2022 WATER SERVICE NOTE: NO WELLS WITHIN 100' OF PROPOSED SEPTIC AREA, COMM. WATER SERVICE FOR ENTIRE SUBD. LOCATED OVER 1000 YDS TO THE NORTHWEST Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221470, Deb Wockenfuss, 03/20/23 F.B.1"=50' EXISTING HOUSE -DOUBLE TR E E C T - NOTE: ALL LOTS ARE SERVICED BY COMM. WATER VALLI VUE ESTATES #1 BLOCK 1, LOT 6 VALLI VUE ESTATES #1 BLOCK 1, LOT 4 VALLI VUE ESTATES #1 BLOCK 1, LOT 17 VALLI VUE ESTATES #1 BLOCK 1, LOT 18 VALLI VUE ESTATES #1 TRACT A SCALE: DJRDRAWN: DATE: VALLI VUE EST #1, BLOCK 1, LOT 5 Anchorage, Alaska CAIN TRUST 11/3/2022 PROPERTY LINE 10' DRAINAGE EASEMENT 10' UTILITY E A S E M E N T NEW 1250 GALLON PLASTIC TANK, MAINTAIN 10' FROM FOUNDATION, INSULATE UNDER DRIVEWAY W/ 2" TYP. TH#1 CO CO MT FCO CO OLD TANK & SEEPAGE PIT TO BE DECOMM. PER THE UPC COMM. WATER SERVICE LINEMAXSLOPE7-10%DCO NOTE: ALL LOTS ARE SERVICED BY COMM. WATER WELL LOCATED OVER 1000 YDS TO THE NW. APPROX. SHOULDER OF 9' ELEVATION CHANGE, MAINTAIN 20' FROM SHOULDER, SEE CROSS SECTIONMAXSLOPE 7-10%NOTE: 10' MIN. FROM FIELD TO FOUNDATION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221470, Deb Wockenfuss, 03/20/23 1"=20' EXISTING BUILDING EDGE SCALE: DJRDRAWN: DATE: VALLI VUE EST #1, BLOCK 1, LOT 5 Anchorage, Alaska CAIN TRUST 11/3/20229.0'PROPOSED NEW LEACH FIELD APPROXIMATE LOCATION OF THE SHOULDER AND SLOPE > THAN 25%. 20.0' 10.0'10.0'1: 1 SLOPE LINE FROM FOUNDATION 4 TO 1 SLOPE LINE MEASURED 2' ABOVE PROPOSED DRAIN PIPE BUILDING ROOF 6.0'41 NATURAL 36% SLOPE WHICH IS GREATER THAN 25% Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221470, Deb Wockenfuss, 03/20/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221470, Deb Wockenfuss, 03/20/23 DOC/BL E- 0000�OO�O o �C� OF A 7 0 0�oi°NSHANE A. HOLT el �DO Qn LS -6914 C6��0 �ofessionax ��DOOoo�� THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. Mul'?TT THE SURVEY DATA AND MEASUREMENTS HEREON ARE PREPARED FOR THE OWNER OF RECORD AS OF THE DATE OF THIS SURVEY. ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. AS-BU/L T SURVEY 1" =20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HA VE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT5 BLOCK 1 VALLI VUEESTATES1 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VIS/BL E IMPRO VEMENTS S1 TUA TED THEREON ARE WI THIN THE PROPER TYLINESANONO VISISL E ENCROA CHMEN TS EXIST OTHER THAN NOTED. DATED A T ANCHORAGE,ALASKA THIS 8TH DA Y OF SEPTEMBER , 2022 15615 227-11 HOL T LAND SURVEYING 9309 GRO VER DRIVE ANCHORAGE,AK 99507 223 8615 3759 GCI.NET GRE?r i. ER ANCHORAGE AREA BOF" ,UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME G-'~),(;q (2 LOCATION MAILING ADDRESS ~) /~'O~-~ PHONE-27</''~~'~-c3) ¢~ SEPTIC TANK: DISTANCE FROM WELL(~'Y"~//?3, MANUFACTURER ~(~/~.~2L~- INSIDE LENGTH ~ INSIDE WIDTH NUMBER OF MATERIAL /~{~'~ COMPARTMENTS / LIQUID DEPTH "~- LIQUID CAPACITY /00~> GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER ~-- OR WIDTH /~/ LINING MATERIAL0f~T~;~ ~','J,'~4('~'~RIB SIZE: DIAMETER BUILDING FOUNDATION :2.~ NEAREST LOT LINE ADDITIONAL ABSORPTION LENGtH~/, DEPTH DEPTH "~ DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ..~ O'"/ SQ. FT. WELL: TYPE BUILDING FOUNDATION CONSTRUCTION NEAREST LOT LINE CESSPOOL APPROVED OTHER SOURCES DISAPPROVED NEAREST SEWER LINE DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: Form NO, EQ-031 DIAGRAM OF SYSTEM DATE ,,~/C~) ~, /~7~/ APPROVED /~b~'¢¢'2~L- ~. G.A.A.B. GREATER ANCHORAGE AREA BorOUGH SEWAGE DISPOSAL SYSTEM M APPLICATION AND PERMIT PERMIT NO. NA.E APPL'OANT INSTALlATiON LO.AT,ON INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF PACiLITY TO BE SERVED SOIL TEST RESULTS COMPLETION DATE ANT~C~ATEDd'O/'~ SEEPAGE PIT , DRAIN FIELD . OTHER. TO BE INSTALLED BY ~/' ~1~'- W ~ NO~= !THI~ P~RMI~ IS ~OT VAEID WITHOUT ~O1~ FINAL [NSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WAL£ SEPTIC TANK SEEPAGE PIT TO NEAREST LOT LINE, WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, SEEPAGE PIT TO RIVER, LAKE, STREAM. SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM , DRAIN FIELD SEEPAGE PiT ALSO CONS[DER AREA WELLS. SEEPAGE PIT DRAIN FIELD. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION ~ PEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. GREATER ANCHORAGE ArEA BorouGH SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of APPLICANT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT ~ , DRAIN FIELD. , OTHER SOIL TEST RESULTS ~'*~//"-~'/~'~' NOTE.' THIS PERMIT IS NOT VALID WITHOUT SOIL TSST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEEPAGE PIT 4~'~ DRAIN FIELD SEPTIC TANk TO SEEPAGE Pit WaLL Y~'~ , DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT ~/~ / SEPTIC TANK. J~ SEEPAGE PIT /~<~) DRAIN FIELD '--- TO RIVER. LAKE. STREAM. CAST ~RON INTO AND OUT OF SEPTIC TANK AND lETO CRIB CROSSING GAP OF EXCAVATION 5 fEET INTO UNDISTURBED SOIL. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT IAM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE J APPLICANT'S SIGNATURE Performed Legal This For Description: corm Re~orts "One tcs~ is worth a ~h~sand o?'n'ons Glacier Excavating Date Performed 10/26/74 Lot ~ Block i Subdivision Valley View Add. Soils LDO Percolation Test_ Peoth Feet Soil Characteristics Silt, ML ottom Te, t hole Was Ground Water Encountered? I~ Yes, At What Depth? I Readinq Date Gross Time Net Time Depth to H20 Net Drop I ! Percolation Rate .llnute Proposed Inst~on: Seenace Pit Drain Field Den. th of Inlet Depth To Bottom Of Pit Or Trench area requigecl per b~clroom so±ls. No b~clrock or water table to minus 16 ft. Test Performed By Jim Mack Data Certified BY:Construction Test Lab na+~ 10/26/7~ MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251425 Parcel ID 015 -311-06 Expiration Date: 1/22/2027 Legal description VALLI VUE ESTATES #1 BLK 1 LT 5 Site address 6815 DOUBLE TREE CT Current propertyowner(s) CAIN ALASKA COMMUNITY PROPERTY X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 2/17/2026 This C ificafe of On -Site Systems Approval (COSA) is intended to demonstrate the subject Sys m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, D velopment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department _" '7 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-311-06 Complete legal description VALLI VUE ESTATES # 1 BLK 1 LT 5 Location (site address) 6815 DOUBLE TREE CT, Current property owner(s) CAIN 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: F-1 Private Well serving # dwelling units ❑ Other Non-public well as regulated by MOA E] Water Storage FK Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: � Private Septic ❑ Private Septic serving 2 dwelling units F] Holding Tank F-1 Community Septic or Public Sewer 5. SEPTIC TANK: F1 Steel � Plastic F-1 Concrete R Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: F-1 AWWTS F] Bed � Deep Trench ❑ Wide Trench El Seepage Pit Waiver request for: Expedited review requested: F-1 Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 2510 Date of Payment _qfl&12S' COSA # OZ25/ ytf Waiver Fee $ Date of Payment I-V I / /X V Waiver # 0 -IS G I 0CF-71 COSA Application_Apr2025,doc Ill...ubA LoneCK isi Legal Description: VALLI VUE ESTATES # 1 BLK 1 LT 5 Parcel ID: 015-311-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA wvcu ivy Io IwU VV vi,anc w, ouoin icy/ Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. volt v, uwv icai wi �.v.�ry Static water level at beginning of test ft. Comments COMM. WATER WELL B. TANK DATA Measured operatina fluid level in septic tank 44 Date of pumping 1/22/26 ❑ Required maintenance completed, if AWWTS Comments: D. DISPOSAL FIELD DATA Which syste.m tested (date installed) 3/15/23 0 ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade j --ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 11 fi,hcc. nn 11 hnftnm of pfi"+"a If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) Yam.! 6a,� Comments/Deficiencies: waN �necKllsi_iviayZUZD.Docx rron Niv�wu�i, amnc vi iwi y�+,ii 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) vvuc�.�c� �y Date C. LIFT STATION [l Required maintenance completed Age of lift station _ years Lift station material Comments: Adeauacv test date 1/26/26 Results ✓❑ Pass Fluid depth prior to test 2 in Water added 600 gal New fluid depth 4 in Elapsed time 1440 min Final f1mA rfcnth 2 m Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 2 in Effective depth remaining 70 in L. JLrI11\f111V1\ VIJIf\I\VLJ From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' Yes if No_ ft Neighboring Tank > 100' ❑ Yes if No _ ft u sposal rleo on Lot v IUO LJ Tes IT IVO n Sewer Manhole/Cleanout > 100' ❑ Yes if No _ ft Sewer Service/Septic Line > 25'❑ Yes if No _ ft r owing I anK n I OUU Yes li Ivo _ ft Neighboring Disposal Fields > 100' Animal Containment > 50' [:]Yes if No _ ft ❑ Yes if No _ ft Manure/Animal Excreta Storage > 100' Sewer Line/Main > 100' ❑ Yes if No _ ft ❑ Yes if No _ ft ❑✓ N/A — Served by Community Well (not on lot) or Public Water I Vw .acNusn wwwy 1 ann anu JwNJaa� Ic��ta/ un Lua w. tr iccac ."m, warm iuw a icaa a ci icywicui Tank to Foundation > 10' ❑ Yes if No 8 ft Surface Water > 100' ❑✓ Yes if No _ ft Field to Foundation > 10' ❑ Yes if No 8 ft Wells on Adjacent Lots: Tank to Property Line > 5' ❑✓ Yes if No _ ft Wells > 100' ❑✓ Yes if No _ ft Field to Property Line > 10' ❑✓ Yes if No _ ft Water Main/Service Line > 10' LI Yes if No _ ft F. ENGINEER'S COMMENTS OUTSIDE FOOTING BEARING Community Wells > 200' ✓❑ Yes if No _ ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. KAIVI= AAIr1GRCrl\) Engineer's Printed Name SAME COSA Checklist_May2025.docx 797-RR64 �'ituilc — Date 1/27/26 ' q0 OF�: i Etl° • 1 ••• ... . . ........ �A MICHAEL N. AND[RSCH 9 69 o � _o OF A h 49 0 0�oi°NSHANE A. HOLT � 000 Q� LS -6914 �ofessiona\ �'od ��DOOoo�� THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. C ?ux?T THE SURVEY DATA AND MEASUREMENTS HEREON ARE PREPARED FOR THE OWNER OF RECORD AS OF THE DATE OF THIS SURVEY. ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. AS-BU/L T SURVEY 1" =20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HA VE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT5 BLOCK 1 VALLI VUEESTATESI ANCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE VIS/BL E IMPRO VEMENTS S1 TUA TED THEREON ARE WI THIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED A T ANCHORAGE,ALASKA THIS 30TH DA Y OF MARCH 2023 15615 227-11 230-74 HOL T LAND SURVEYING 9309 GRO VER DRIVE ANCHORAGE,AK 99507 223 8615 3759 GCI.NET