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HomeMy WebLinkAboutVALLI VUE ESTATES #1 BLK 1 LT 11Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251074 PID Number: 015-311-12 Dwelling: E Single Family (SF) M with ADU R Duplex (D) R Two Single Family Project: [:1 New 0 Upgrade Name PETERSON-BOHN FAMILY ABSORPTION FIELD - EXISTING ❑ Deep Trench [:J Wide Trench El Bed R Mound Site Address 6707 DOUBLE TREE COURT, Anchorage E] Other Phone Number of Bedrooms Soil Rating depth from original grade 1 4 GPD/SF ITotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot VALLI VUE ESTATES #1 1 11 Fill added above original grade Ft. Gravel length Ft. 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 Tank From Field Tank Line Ft2 Ft. Well 200 TANK G] Septic [I S.T.E.P. E] Holding ❑ Other Manufacturer IM -INFILTRATOR Capacity 1530 Gal. I Surface Water 100'+1 Material PLASTIC Number of compartments 2 Lot Line10'+ NA Foundation 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated & any deck supports Win 5' of tank was installed to bottom of tank elevation. Alarm location Electrical installed by Tankto PIPE MATERIAL House to tank 3034 drainfield 3034 Installer NORTHERN EXCAVATION Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 1" 6/12/25 d 6/13/25 Location and description dates; 2 3`d 41t' TOP OF MANHOLE MH) ON-SITE WATER AND WASTEWATER SECTION APPROVAL A 4 Conditional Approval: Date X . ...... -- ------ - -49 -Sk IL p- Setic Approve Cuts Huffman CE 128991 Date 1 /20/26. . Aw PROFESSO ZNote: this approval does not include well permit requirem nt?s. (r 05/02/18) PID:015-311-12 PERMIT:OSP251074 FIRST WATER CONSULTING VALLI VUE ESTATES #1 BLOCK 1, LOT 11 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: OSP251074 Work Type: SepticTank Upgrade Tax Code Number: 01531112000 Site Legal Address: VALLI VUE ESTATES #1 BILK 1 LT 11 G:2539 Site Mailing Address: 6707 DOUBLE TREE CT, Anchorage Owner: PETERSON-BOHN FAMILY TRUST Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 4/8/2025 4/8/2026 25081 ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. Locate and mark the water service line prior to construction. 2. If the 5' separation to the deck support can not be met, the support needs to be brought to the same depth as the bottom of the tank. Received By: J Date: Issued By: Date: 4 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 015-311-12 ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) PETERSON-BOHN FAMILY TRUST Day phone Mailing address 6707 DOUBLE TREE COURT ANCHORAGE, ALASKA 99507 Site address 6707 DOUBLE TREE COURT ANCHORAGE, ALASKA 99507 Legal description VALLI VUE ESTATES #1 BLOCK 1 LOT 11 Number of Bedrooms 4 Engineering Firm FIRST WATER CONSULTING Building Permit Number APPLICATION IS FOR: (® all that apply) Absorption Field ❑ El Septic Tank Holding Tank Privy Well Not Applicable ❑■ APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: OSP - �� 0 Date of Payment: Permit No. L Waiver Fees: Date of Payment: Waiver No. Phone: 907-343-7904 Distance: $: first Water N 8 U L T I N 6 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com April 1, 2025 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: VALLI VUE ESTATES #1 BLOCK 1, LOT 11 Municipality of Andwage On-site Water and Wastewater OSP251074, Ben Cogger, 04108125 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 1250 -gallon HDPE tank per the attached design to serve the existing 4 -bedroom residence. Aside in/out Infiltrator IM -1530 may be considered if deemed more appropriate. No groundwater was noted in the MOA on-site file and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank upgrade, an epoxy coated steel septic tank or other action may be required. An existing deck greater than 30" high is close the existing septic tank and any deck supports within 5' of, the tank will be installed to the same elevation of the bottom of the new tank. The lot and area are served by public water and any encroaching wells, easements, ... must be staked prior to construction. The water line in the front yard must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Fr s I W d Lm e. 1111 PMWNG FIRST WATER CONSULTING VALLI VUE ESTATES #1 BLOCK 1, LOT 11 DESIGN DETAILS: SERVED BY PUBLIC CLASS A WATER W/ NO WELLS WITHIN 200' OF PROPOSED SEPTIC TANK. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251074, Ben Cogger, 04/08/25 ..~. ~ MUNICIPALITY OF ANCHORAGE ~'~ D[ RTMENT OF HEALTH AND HUMAN SER :ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name J~( DISTANCES ^dd'essJ~ l:~ ,,~, ~ ~ SEPTIC ABSORPTION ~/2 ~ ~ ~ ~O ~/' ~ ~' ~ AS-BUILT DIAGRAM (Show Iocat,on of well, septic system, property hnes. foundat,on. TANKS N ~ SEPTIC ~ HOLDING Material No. of Compa~men[s TYPE OF SYSTEM ~TRENCH ~ BED ~ W. DRAIN ~OTHER Depth to p~pe bottom from Total depth from odginal grade or,ginal grade ~' '~- FT ~ FT F,II added above odg,nal 9rade Gravel depth beneath p, pe ~ / T°talabsorph°narea ~ S" ET Oistance between fines -- FT ~ C ~' ~ P~WATE ~ OTHE~ ~denU~v~ Cl~ssIhcahon (A,B,C) ~ ~,o~pg' Cased ~0 ~EMA~KS: Scale: ; ENGINEER'S SEAL InspecSons PeHormeO by: ~unicipalandSlateg ' einesi cl t' dale: : ~ , '] t ~ ~ ~, Health Depadment Approval: ~ Date: 72-013 (3/85) L[:i. GAI.. DI ]SCF,' i F:' ~ SL!BD ][ V I S I [iN ~ VALI.. ~ VUE L,O]' ~ SI~!:CTION: :i4 TOWNSHIP: :!.2N RANGE: 3W !.Of S:i:ZiL;: :i.~ ()A (liQ,, !'::i ,,OR ACRES) fc)t'!.i'i by 'i:.l]~::, MLUi;ic:i.l:iality c:,F Anc:i'!oi-'~':ge (MOA) arid the State of A:l.a~M.::a~ :2.,: ! z4;i,]], ;i.n.i::i'l:aJ.J. 'l:.h~ syst.~:z,m in a(:::c:cipdaric:e I~:i.'LJ] ail I1CIA :2,,. :i: ,..~:i,J.]. a(::il'i(~",e:~ Lo ali MOA a!'i(::l S'La'L~,) c:~i' ~:l][at~i[::a p~::~qLl:[l~eii!~;}:~i']'L[[~ i'l::ir' 'i:.h~]! ~[i~i~'.)t. bac:k dJs'Lanc(:~s Fr'om any (-:~x:i.s'LinEt ~,~e].:!., wastewa'Lep d:i. spc:,sa], system oP public I. ,: ~ ~,l...u.c,[/. ~ ~,~ AREA ~-d'~ COVIEF/ED MOA BU :I:I._D i NG ,~::~'~ (]) Ai,! ~I.I~],:IFercAI.. ! .. Il. ~ .... ....... [,CllL,,~ rh.~:~l FF' l,)~",,1 ..hI. NI:::.L~ (;Z) ~,.~ .... I.l. LI .... ........... ¢¢.! ...... 4..,! Ah.! ,..~..c:.~.,!l,,.I.E,(!.... ..,N,siI.L,[.i.~,m r~l::.t-Lh.t!i (,.qL, (;~) II~E :::[ J::' '~:; ]:(..~(~i.. ~'i'!c:'~''' "" "-' '"-'~'. ....... -.. -._h::~ ~ BIE DDNIE :(:;:Y~:1 I...I ~.Jr:.N.:::~,:::D El, [:]2'I i::;: 'I' [; T [:.N .. - .................................................................,.. . !. ~. ~ .::. 0 DATE ~ .::,::., ..... . ,-~ -. !. !.., .[ i,~-.fi4 I ~ . P.O. SOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 January 10, 1986 TO: Permit Applicant Subject: Permit # 850463 Lot 1i Block 1Valli Vue Estates Subdivision #1 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to t~is Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as-built inspection report(three part form) must be sent to this office for review and approval,and for documentation~ If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw eno: Copy of Permit DEF:'ARTMENT GF HEALTH AND ENVIRONMENTAL PROTECTION $25 L STREET, ANCHORAGE, Al< 99501 264-4720 C.~ ~"'.l --. L_=i ]E 'T F] S E l¢,J E. ~'-.. F' E] F~ li'~J 3: F:'ERM I T NG: G~¢t:~4.6.:, DA'I-E I SSIJEI): (_1 7/..], .~/8~., APPLICAN F: ADDRESS: CONTAC I' F'HONE:: C/O GEOLAB CHUCK CROf¢ 1131 :-:' 76TH ~101 ANCHORAGE, ~AK 99518 .... 44 8 .. 4,= L. EGAL DESCRIP: SUBDIVISION.- VALL. IVUE ESTATES ~1 LOT: SECTION: t4 TOWNSHIP: 12N RANGE: 5W L..GT SIZE: lA (GQ.FT. [IR ACRES) MAX BEDROOMS: 4 BLOCK: i Lis'Led below ape the options available to you system. Choos'e the option tha'L best Fits your in designing your septic site. -F'REI'4C~-~ ]FJED W. Dr";.'A I I~[ DEPTH "FI: PIPE BOTI-OM (FT.) 5.0 ~'~ 4.5 5.0 GRAVEl._ DEPTH (FT.) 6.0 0.5 3.0 TGTAL DEPTH (FT.) 9.0 5.0 8.0 GRAVEL WIDTH (FI-.) 2.5 :[6.0 5.0 GRAVEL LENGTH (FT,) 55.0 32.0 40.0 GRAVE:[ VOLUME (CU.YDS.) 19.9 19.0 26.0 ]'ANK SIZE (GAl_S) 1,250.0 ** 1,250~0 *~ 1,250.0 **' SOIL RATING (SQ. FT. /BR) 99 85 85 ~ DEF'TH -I"0 F'IPE BOTTOM 4...'~'.,J=' FT. R='QUIRES_ . . INSULATION ~ DEPTH TO PIPE BOTTOM <' 4.() FT. MAY REQUIRE A LIFT S'f'ATION -~ 'f'ANK MUST NAVE AT LEAST TWO COMPARTMENTS certiIv that: t.. I am Familiar.with the requirements for on-site sewer, s and wells as ses. For'th by the Municipality oI Anchorage (MOA) and the ~C~tate oI AIaska. 2.. I will install the system in accordance wi'Lh all MGA codes ano regulations, and in compliance with the design criteria of th:is permit. :~. I wil] adhere to all MOA and State of Alaska requirements For the se~. back distances From any existing well,, wastewater disposal system of public sewerage system od this or any acjacent or nearby Lot. 4. I under, stand tha'[ this permit, is va].id For a maximum o¢ 4 bedrooms and any enlargement will require an additional per'mit. IF: A I"HEN WILl.. EELE[;TRI CAL ,.~ 1GNED AF'PL I CANT: ISSUED BY LIF:'T STATION IS INSTAL. LED IN AN AREA COVERED BY MOA BUII._DING CODES, (1) AN ELECTRICAt. PERMIT AND INSF'ECTION MUST BE OBTAINED; (2) AG-BOILTS NOT BE '~PPROVED WITNOLJT AN EI_ECTRICAI_ INSPECTION REPORT; AND (3) TNE WORI.::] dUST BE DONE BY A _ICENSED ELECTRICIAN. ~~ .......................................... DATE.: 0 /'~ /~ C/O GEOLAB C~IUCI< CROFi LEGAL DESCRIPTION: OL 1 3 4 5 6 '7 8- 9- 10. 11 13- 14- 15 16 17 18 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST .j/4/~,~ ~/~/~./frownship, Range, SLOPE WAS GROUND WATER ~-~.¢~ //c~ ENCOUNTERED? IF YES, AT WHAT ~- Depth lo Water ADer Monitoring? Dale: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop~ PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER __ .G PiO~J'A B, Inc. - l131.E.' ?6%h Ave. Anchorage, Alaska 344-8042 SOIl_ LOG PERCOLATION TEST PERCOLATION TEST -~- BEDROOMS PERFORMED FOR;__, LEGAL DESCRIPTION: 5 6 ? 8 9 JOB NUMBER: SLOPE SITE PLAN /~,~ ~/3,~ w ff~e' ZZ. /' .. ~WAS GROUND WATER ~/ ~. ~ a¢~e ........... ~7 ................................ ~_~ .................. .......................... {m;nulestinch) TEST RUN BETWEEN . ._~ ___ FTAND_ ./¢:__ -- Ff ';' ' PERFORMED BY: <~~- : ...... CERTIFIED BY: ......................... Z_.' ...... DATE: ALASKA eildRODmeDTAL CODTROL $ RuIC S, IDC. ~ncline~rin~ $ Enuironmenlol Sluclies SPECIFICATIONS FOR BED WASTEWATER TREATMEN: SYSTEM LEGAL DESCRIPTION! VtLTEv VUE ~TA~S BLOCK 1, LOT ~I 2 . 0 ~N~RA~ ~ 1 TBe drawings, sheets ! throug! 4, shall be part )f this spe. cifioatJon. 1,2 1,4 2,0 2.1 2.2 2.3 2.4 2,5 All materials and workmanship shall meet the requirements of 'tile ,'4unicipai~t~ of Anchorage, Deparlment of Health & Human Services (DHHS), tile conditions of the permit, and all applicable rules and regulations currently in effect. All excava[5oas and depths are advisory, and are to be verified or ,nodt~,~ed in tile field by the Engineer or inspecting agency. It is the responsibility of 'tile owner or installer to adhere 'to approved design for the installation, to maintain the specified separation distances and 'to have the appropriate inspections. If the installation is not inspected by an AECS engineer, AECS wii] not be responsible for the instal]ed syetem. An engineer al: AECS should be consulted prior to construction, to determine tile number of inspections that will be requiz'ed and. to explain what these inspections will involve. Septic T,.n:. The existing septic tank may be used, if it meets the capacit,V requirement for the residence aim tile approval of DHHS. if not, thenspecie' '~'1 Ca ~'t, lnns 2.~ througl 2.8 apply, The septic tank shall he a UPC Approved two compartment tank, constructed of 12-gauge steel with hitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of ~ feet or less, it must be insulated with an overlying layer of 2 inch burial type po]ystyreue rigid board insulation. The septic tank shall be a minimum of 5 feet from the house foundation, and a minJnlum of 5 feet from the absorption area, The septic tank and bed shall be a minimum of 100 feet from any private well or body of water, 150 feet from Class C wet]s, and 200 feet from Cla~ A or B wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by DHHS or Alaska Department of Enviranmenhat Conservation (ADEC). Piping shall be fitted with a mechanical watertight calder coupling on the outlet e. nd in]et of the septic task. The ]ids nmst be sealed and watertight. Piping shall be 4-inch solid PVC ASTM D3034 or cast iron, siaped a mintmum of i/4 inch per lineal foot. If the pipin~ is buried a~ a depth of 4 feet or !ess, Jt must be insulated w~th an overlyin~ layer of 2 2.6 3.0 3.2 3.3 3.4 3.5 3.7 3.8 inch burial type polyshrene rigid board inenlal-[on. Cieanouts shall be imsta!!ed as designated and capped with air-tight rain caps (Ji!n caps or equivalent), and extend a minimum of I foot above ground level. Seepage Bed The sand shall have an effective size of 0.4 to 0.6 MM and a uniformity coefficent of not more tban ~. The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less tha~ 8% Dassiag ~200 sieve residual. All substitutes must have prior DHHS approval. The bottom of tbe excavation shall be level and raked with the backhoe blade to insure that the bottom has not been compacLed during excavation. The distribution pipe shall be perforated 4-inch rigid PVC witb a minimam crush strength of 1500 pouads and shall meet the approval of DHHS for use as drainfield pipe. Ail pipes shall be !aid level, sad spaced according to the drawings, bIonitor sLaudpipes simll be placed as shown in the drawings. They shall be 4-inch rigid PVC ASTM D 8084, or cast iron. The section shows with holes may be either drilled 0.5 inch boles on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe may be clamped to tbe solid section with a no-hub coupling or solvent joint. Perforated section shall be located in gravel only. The portion of pipe above the sewer rock shall be soiJd. A rubber raincap (Jim Cap or equivaleat) shall be placed over the top of the pipe, If the final grade over the bed Js less than 4 feet above the gravol, insulation is required, usiag burial type potystene rigid board insulation. There shall be 1 inch of imsulation for every foot of soil less than the required 4 feet of cover, but there must be at least 2a inches of soil even though insulation is used. The solid pipe extending from the septic task to the drainfieid shall also have 4 feet of cover or an equivaicmt layer of insulation combined with soil, If insulation is not necessary, then the gravel must be covered with a layer of a nonwoven fabric (such as Mirafai, FibreLex 200 grade, Poly Filter X, or eqniva]ent). The top and sides of the bed shall be planted mith a white clover and red fescue m~x or blue grass. 4,0 Inspections This bed wilt ~eqaire a minimum of three inspectioas. The first inspection will be of the open excavation, to assure that the systei~ is installed in hhe proper soil strata, correct depth and meet i~inimum specified design parameters. 4.2 The :~econd inspection will be performed after sand fill is installed, but pti. or to placement of gravel and distribution pipes. This inspection will verify that the :filler is properly installed, that it meets specifications and that it fulfills the intention of the design. 4,3 The [hird inspection will be after placement of gravel, standpipes, and dJstributiou pipe, to verify proper installation and position of pipes prior to backfill. 4.4 The inspection of the septic tank iastaliation can be incorporated with aa¥ one of the above listed inspections. ALASKA ENVIRONMENTAL JOb /../I gl Va/~, l'"'~ ~'r/.~ ~ / CONTROL SERVICF~,INC. /,,~, ,/, 1200 West 33rd Avenue. SUite B SHEETNO.* ' OF ANCHORAGE, ALASKA 99503 CALCULATED BY ~' ~'~'~' '~ DATE (907) 561-5040 CHECKED BY DATE SCALE ALASKA ENVIRONMENTAL Jos /-// (~ / CONTROL SERVICF~ INC. 1200 West 33rd Avem, Suite B SHEETNO. ANCHORAGE, ALASKA 99503 CALCULATED BY. (907) 561-5040 CHECKED BY. SCALE / "/-- ~ ! DATE UNIFIED SYSTEM ASTM D-2487 06/04/87 VALLI VUE #1 BLOCK 1 LOT 11 SAMPLE IDENTITY 5-9 FT PASSING #200 SIEVE: 7.06% RETAINED: PASSING # 40 SIEVE: 20.23% RETAINED: PASSING # 10 SIEVE: 45.14% RETAINED: PASSING # 4 SIEVE: 58.10% RETAINED: PASSING 1/2 IN SIEVE: 74.16% RETAINED: PASSING 3/4 IN SIEVE: 82,00% RETAINED: PASSING 1 INCH SIEVE: 90.56% RETAINED: PASSING 2 INCH SIEVE: 100.00% RETAINED: PASSING 3 INCH SIEVE: 100.00% RETAINED: D10 IS 0.17 MM. D30 IS 0.90 MM. D60 IS 5.50 MM. TtlE LIQUID LIMIT IS UNKNOWN THE PLASTIC LIMIT IS UNKNOWN THE PLASTICITY INDEX IS UNKNOWN CU = 32.35 CC = 0.866 13.17% 24.91% 12.96% 16.06% 7.84% 8.56% 9.44% 0.00% 0.00% THE SOILS ARE COARSE GRAINED SANDY SOILS BORDERLINE SOILS THE SOILS ARE POORLY GRADED SAND.(SP) MUNICIPALITY OF DEPT. OF HEALTH & ENVIRONMENTAl. PROTECTION RECEIVED ' ALASKA r-~U RonmenTAL cOnTROL SeP=~ICeS, IllC ~n~ineerin~ I; ~nuir~menlal Studies TE7 HOLE NO. Date Legal Description Sample Depth ~--,? Reported to Plotted /,.&~J Checked by. .App ~oved by I SIEVE ANALYSIS SIZE OF OPENING IN INCHES I NUMBER OF MESH PER INCH U.S. STANDARD Oc)o IO0 ~ ~ ~ ~ ' -- -- - k ~ - I ' zo~ ~l ...... ~ ~- ~ -- GRAIN SIZE IN MILLIMETE~ COBB~S SAND 1200 [U~sl 33r~ Au~nu* SuiI¢ ~, An&oraq* Ahsb 99503.[907) 561-5040 May 27, 1987 Jo Ann V Crem hereby grants Judy M Lamb authority to sign for an on-sight sewer (septic) system located on Lot 11, Block 1 of Valli Vue Estates. 7 Jo Ann V Crom ~ Jud~ M Lamb STATE OF ALASKA ) ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 27th day of May, 1987, before me, the undersigned, a Notary~ubtic in and for the State of Alaska, personally appeared~ ~. ~ , know to me to be the individuals named in the fore~ing'instrument, and ~ acknowledged to me that~z~ executed the foregoing instrument as a free act and deed for the uses and purposes therein stated. WITNESS my hand and official seal the day and year in this certificated.. first above written. NOTARY PUBLIC in and for A as a My commission expires:~~/~~'. ~I~)~OH~NV JO AJ. I1Vdl31NII~ Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261012 Parcel ID 015 -311-12 Expiration Date: Legal description VALLI VUE ESTATES #1 BLK 1 LT 11 Site address 6707 DOUBLE TREE CT 6/13/2026 Current property owner(s) PETERSON -BONN FAMILY TRUST X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By:✓ Original Certificate Date: 1/21/2026 This C ificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject sys (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, evelopment 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 COSA Checklist_May2025 copy 2.docx COSA Checklist Legal Description: VALLI VUE ESTATES #1 BLOCK 1 LOT 11 Parcel ID: 015-311-12 If more than 1 well and/or septic system on lot, provide separate checklist. 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. 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 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 6/10/1987 ALL standpipes present per record drawing Total measured depth from grade 7.8 ft (max) Measured depth to pipe invert from grade 4.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective 3.3 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) N If yes, enter date Adequacy test date 3/10/25 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 4 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 42 in (MOA 3.5’ ED) Effective depth used 2 in (ED Missing + Final Fluid Depth) Effective depth remaining 40 in Comments/Deficiencies: COSA Checklist_May2025 copy 2.docx E. SEPARATION DISTANCES 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 Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 01/20/2026 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 or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 01/20/26 \ Tract A 10' UTILITY \ EASEMENTS \ Lot 29ryry +� + Lot 11 \ 25,081 s.f. P Lot 10 00 \ SEPTIC PIPES 4.3' CANT \ SEPTIC MANHOLE�gYi RFS STS 2.0' ,'p�' \ \ 5' STREET LIGHT EASEMENT \\ a� ; Fti Opp, 3.8' PORCH04- \ ASP AL / PAVEMENT O ', L=23.16' c/ \ \ R=100.00' / + CHAIN-LINK FENCE t - - L=26.24' / Lot 28\\\\\\ N '524 yy 11 09 R=50.00' ` DOUBLE D9 \ TREE �\ Lot 12 i\ COURT NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. THIS PROPERTY IS SERVED BY A COMMUNIYT WATER SYSTEM. DATE OF SURVEY: 22 AUGUST 2025 PLOT PLAN AS BUILT X SCALE 1" = 40 GRID SW 2539 Project No J25 -073/A2 Lang & Associates, inc P.O. Anchorage, Alaska • Anchora e, Alaska 99521-0005 (907) 522-6476 0� OF A �oopa Professional Land Surveyors survey@langsurvey.com d���.... q SpA I hereby certify that I have surveyed the following described property: LOT 11, BLOCK 1, VALLI VUE ESTATES UNIT No. 1 (Plat No. 71-217) 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 easements on said property except as indicated hereon. Dated this the Day of AU6-U 9 T z425 — at Anchorage, Alaska It Is the responsibillty of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. /JO... - .C..... ..,.� G 40oROFESSIONA� �a D�ODOo�� State of Alaska AECC963 / / L~T I~ %. responsibility of the owner or prior to construction, to verify the proposed building grade relative to finished g~ade and utility cormcctians and to determine the existence of any easements, covenants, or restrictions which do not appear on the ~x)rded subdivision pht ' '~-Z.~8"l