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HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 4 LT 7Knik View Estates Lot 7 Block 4 #051-043-38 Municipality of Anchorage Page 1 of_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 345-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SWO00030 PID Number: 051--043--38 N°me:LARRY AND TERRY GALL Wastewater System: · New [] Upgrade Address: P.O. BOX 671705 CHUGIAK, AK 99567 ABSORPTION FIELD No. of Bedrooms: Ph°ne:(907~ 6B8-24,~5 nDeep Trench ~Shallow Trench DBed DMound DOther LEGAL DESCRIPTION o.8 ~/~.. ~ 6.5 - 7.0 7 4 KNIK VIEW ESTATES 2.5 - 5.0 ~ 4.0 - - - 1.5 - 2.0 ~ 63  Grovel wide: Number of WELL: ~ New ~ Upgrade 5 ~ 1~ - F~. ~ .~4/F RI~ ~ ~ ~. s~. ~ ~-~-~---- - SEPA~TION DISTANCES a Septic ~ Holding D S.T.E.P. To Septic Absorption Uft Holding Pub]io/P~vot~ From Tenk Reid Stetion monk s,w.~ u.. ANCHORAGE TANK 1000 Well 200'+ 200'+ - - - STEEL 2 SudaCewater 100'+ 100'+ -- - -- LIFT STAT/,O~ Lot 5'+ 10'+ - - - ~ ~ ' Line Foundefion 5'+ 10'+ - - - Drein - NONE KNOWN I I R~mo~s: BENCH MARK TOP OF CONCR~E S~B AT BACK DOOR Isumed ~eveflo.: 97.08 Inspections pedormedby:. AWWC, INC. Dates: 1st 4/27/2000 ,~XXJ;~ 3rd 9/25/2ooo ~ .epa.ment of Health and Human Se~ices approval '0~:"... .......... Reviewed and ~ ~ Date: approved b~/~ ~. /0 PERMIT NUMBER: AS BUILT D~WING P^ROEL ID NUMBER: SW000030 ' 05 i -04-3-38 NEW 1000 GALLON SEPTIC TANK~ ~c°2 NEW / / ~ 5 BEDROOM / / m ~ HOUSE ~ A B - // , co ' ~ , / / ~L2 24.9 24.5 ~ I/ / C01 55.0 20.9 ~ Z / MT1 51.2 23.1 ~ ~ // / C02 27.1 61.3 ~ ~/~/ MT2 27.4 58.5 ~ ~_ ~ / / / / ~..~. , ~j'...:~.....'%~ J.L.M. AI,ASICA WATER & WASTEWATER ..... CONSULTANTS, INC., ,, ~REPARED FOR: PHONE NUMBER: PAGE NUMBER: LARRY AND TERRY GALL (907) 688-24.15 2 OF J[OAL DESCRIPTION: KNIK VIEW ESTATES S/D; LOT 7, BLOCK 4 PfPE OF WORK: AS-BUILT OF SEPTIC SYSTEM A B FCO .35.1 9.7 IST1 55.6 16.2 ;ST2 28.2 20.9 DBL1 26.5 22.9 DBL2 24.9 24.5 C01 5,.3.0 20.9 MT1 51.2 23.1 C02 27.1 61.5 MT2 27.4 58.,,3 PE*,T R...E* AS--BUlLY DRAWING SWO00030 051-043-38 ~P~C T~K ~ / · g~,O-~,O / AI,AS~ ~VATER & ~VASTE~VATER J.L.M. ,.,, CONSULTANTS, INC. ' 1" ~RRY AND TERRY GALL ([907) 688-24~5 ~ O[ ~ PROFILE ~S-~ILI OF SEPII~ SYSTEM MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Mar 08, 2000 Expiration Date: Mar 08, 2001 Permit Number: SW000030 Legal Description: KNIK VIEW ESTATES BLK 4 LT 7 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Larry & Terry Gall Owner Address: PO Box 671703 Chugiak, AK 99567- Parcel ID: 051-043-38 Site Address: Lot Size: 21990 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [~ Disposal Field [~ SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: t. 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 Wa!er Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inCpection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: I Issued By: ' Date: Date: ALASI WATER & WASTEWATER RECEIVED March 1, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 MAR 03 200O MuNiCIPALiTY OF ANCHORAGE ,m,,~klMENTAL SERVICES DIV!e' Reft Septic System Design for Lot 7, Block 4, Knik View Estates Subdivision To whom it may concern: The proposed 3 bedroom house will be served by a community water system and a private septic system. Test holes were excavated on the property. The proposed septic system will be designed around the 30 foot radii of test hole #1 and #2. We are proposing that a 1000 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and the percolation test results. The soils below the organic layers are a GW/SW material to a depth of 5 feet in both test holes and th~n transitions to a GM/SM material to a depth of 15 feet (bottom of test holes). No groundwater was encountered during the excavation of the test holes. Percolation tests were performed in each test hole between the depth 0£6.0 feet to 6.5 feet which had a percolation rates of 7.5 minute/inch and 13.3 minutes/inch. It is our opinion that due to the overall appearance of the soils, a application rate of 0.8 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: 7.5 & 13.3 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/fi2 c. NumberofBedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 563 ft2 f. Total Depth: 8 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.5 i. Minimum Length: 60 feet long j Effective absorption area = 600 ft2 6901 Debarr Road, Suite 2B - Anchorage, AK 99504 N Pr: (907)337-6179 - Fax: (907)338-3246 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPItY: As can be seen on the attached design, the average topography of this property mostly flat in the area of the proposed septic system; in short, there are no slope concerns. The trench is to be installed parallel to slope contours. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. ~ ~erf~nAt~arnes~P.E, M.S. NOTE: Attached is a site plan drawing, a design drawing, two soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B N Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246 NOTE: ALL PROPERTIES SHOWN ARE OR WILL i BE SERVED BY A COMMUNITY WATER SYSTEM AND PRIVATE SEPTIC SYSTEMS. LOT 2, BLOCK 4, KNIK VIE ESTATES UNSUBDIVIDED ALTER~TE SITE~ KLh~KT VS~E~BL~KTAT4E'S LOT 9. BLOCK 4, LOT 8. BLOCK 4. T.#~: ..... -~TH#2 mnT z. nmnr'K 4 \ / KNIK VIE~V ESTATES KNIK V1EW ESTATES ......... K~lV~ ~jE~'~S~TATE'S // (SEE DESIGN, PAGE 2 OF 2) [- ~ / / ~ ./~/// '~ ~~~~Y ./~OT 20. B~OOK '~'~'~'~ ~';~~~/// / /~IK ~ ESTATES ~ ~ LOT 10, BLOCK 5, / '-.~ ~-~/~ / -~~ _ / '--~ /~/ ~AS~ WATER ~ WASTEWATER CONS~T~S, ~C. ~:~-~ OF/i)/' PHONE: (907) 337-6179/F~: (907) 338-3246 4--~ ' ~'~~;~ ~' ' ~" KU~K V~EW ESTATES SU~mWS~OU: LOT 7, ~LOCK ~, ~'P':'" ........................ ~ ,'V' '~ SITE P~N FOR SEPTIC SYSTEM ~' · 'REP~ED FOR: PHONE NUMBER: ~ '/~m. .~ ,. ~S~'. ~% '~1 .E 7953 .' TERRY GALL (907) 688-24~5 i ~ ~- .' ~RRY AND ,h~ '- · J.LM. 1 = 100' 1 Of 2 ~ :ALTERNATE SITE ~~. P R 0 P OsSI~pDTI Cl OTOAON KGALLO N "~'~_#~"~ ~~ / IS 8 FEET DEEP MAXIMUM J / BY 5 FEET WIDE BY 60 / PROPOSED / FEET LONG. ADD 4- FEET /~ -- 5 BEDROOM / OF CLEAN, WASHED SEWER ~[ r' HOUSE / DRAINROCK. INSTALL TRENCH / PARALLEL TO SLOPE CONTOURS. "% LO/,_ ~ / ~ / ~ED PRIOR TO INSTALLATION ALASKA WATER AND WASTEWATER CONSULTANTS, INC. ~ OF~..~' ~,. DESIGN Of PROPOSED SEPTIC SYSTEM ~Je J.L.M. 1 = 30' 2 OF 2 ,'~.~,,~ PHONE (907) 337-6179 * FAX (907) 558-5246 iso,L .DC - PE.oo..T,o. =s l ~::.:,.. ~...~,, .......... :....,~ PERFORMED FOR: ~RRY AND TERRY GALL ~ ~ ~ ........ DATE PERFORMED: 2/25/2000 /~]/"'. ] I TEST HOLE ~1 DEPTH F ~ ~E ORGANICS  ~.':~ooo ~ c ~.~oOo, SOIL C~SSIFICATIONS ;. ~<~, 6W/SW ~I~ ~L  ~;:~;~° ° ' ~ GC , .?:oo%, i GM EL 5 ' ~ SP CH sYs~u ~ SM / ~ OH ~FII~ ~ ISC 7 DEPTH TO ~ ff~-- ~-~/// / 8 ~ DRY 2/23/2000 - 11 ~' DATE READING CLOCK NET TIME WATER LEVEL NET DROP ~] HI[' '~ TIHE (MINUTES) READING (INCHES) IIFII~ ; ~ 2 9;38 ~ MIN. 2" 4" 15~I~H~ ;a 4 10:08 50 MIN. 2" I B.O.H. 5 10:08 6" 16 6 10:38 50 MIN. 2" 19 PERCOLATION RATE 7.5 (MIN./INCH~ERC. HOLE DIA. 6'~(]NCHES) 20 TEST RUN BETWEEN. 6.0 FT. ~ FT. COMMENTS: PERFORMED BY A~SKA WATER ~ WASTEWATER I. [ j~C~~ , CERTI~ THAT THIS WAS PERFO~E, IN ACCORDANCE WITH ALL ST=~,~UNI~UIDELINES IN EFFECT ON THIS ~AT~. ~ATS: //~= DEPTH TO DATE GROUNDWATER DRY 2/25/2000 DRY 5/1/2000 LEGAL DESCRIPTION: KNIK VIEW ESTATES S/D; LOT 7, BLOCK 4,~.~.,. , /.' /r'--'-... PERFORMED FOR: DATE PERFORMED: 2/23/2000 ¢' ' ~" I TEST HOLE #21 ............. DEPTH F feet) ( f .... : ORGANICS 2 ,¢~E*,ooo { SOIL CLASSIFICATIONS ALTER~ATE S~E 3 '4'::I°°°' Ge/se ~ GP rT~T~ ML k / ~[~m~j] ...... ROPOSED LEVEL NET DROP 1 ~ TIME (MINUTES) READING (INCHES) 12~', ',', 2/24/2o~)o - PREEOAKED PERF CAVI~ 4+ HO JR PRIOR TO TE~T I.H. ~ 5 10:07 6" 18 19 PERCOLATION RATE 13.5 (MIN./INCH) ~PERC. HOLE DIA. 6" (INCHES) 20 TEST RUN BETWEEN~~, A~ [ 1.5 FT. DATE. DA~E: DEPTH TO DATE GROUNDWATER DRY 2/25/2000 DRY 3/1/~000 MUNICIPALITY OF ANCHORAGE Development Services Department v Phone. 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-043-38 Certificate of On -Site Systems Approval Expiration Date: Legal description KNIK VIEW ESTATES BLK 4 LT 7 Site address 21701 KNIK VISTA CT Chugiak AK 99567 Current property owner(s) BEAN AARON W & PAOLA A X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: 7/14/24 bedrooms, with the following stipulations: By: //U� Original Certificate Date: 7/14/23 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory X Arsenic Advisory Other COSA Approval—June 2022 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 Application 1. GENERAL INFORMATION Parcel I.D. 051-043 Complete legal description KNIK VIEW ESTATES BLOCK 4 LOT 7 Location (site address) 21701 KNIK VISTA COURT CHUGIAK, AK 99567 Current property owner(s) AARON & PAOLA BEAN Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units Z Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 23 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 $ 5 5 Waiver Fee $ Date of Payment 5J-2-92 �3 Date of Payment COSA # ©S C 2 3 2 'L�f Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: KNIK VISTA ESTATES B4, L7 Parcel ID: 051-043-38 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” 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 NA 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 50” Date of pumping 6/19/23 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 4/28/2000 ALL standpipes present per record drawing Total measured depth from grade 8.8 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) 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) N If yes, enter date Adequacy test date 6/19/23 Results Pass Fluid depth prior to test 35 in Water added 450 gal New fluid depth 39 in Elapsed time 720 min Final fluid depth 34 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 34 in Effective depth remaining 14 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximately with 4’+ ED. E. SEPARATION DISTANCES COSA Checklist.docx From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/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 Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 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 > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private 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 *Septic tank installed per code at time of construction with 5’+ separation to foundation. 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 6/27/2023 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 & 6/27/23 DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Wank Advisory Certificate of On -Site Systems Approval # OSC231224 Subdivision: Knik View Estates Block:4, Lot: 7 907-343-7904 Fax: 343-7997 The septic tank for this property is 23 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. MaiUng Address P O Box 196650 * Anchorage, AlaskaX99519 6650 *www{muni org s b �1 -- -off • • Municipality of Anchor. A 7 '4.019 • - On-Site Water and Wastewater Progra • (907) 343-7904 c> w ` ' s CERTIFICATE OF ON-SITE SYSTEMS AP' "• Parcel I.D. 051-043-38 _. Expiration Date: (c 1. GENERAL INFORMATION Complete legal description Knik View Estates BIk 4 Lot 7 Location (site address) 21701 Knik Vista Ct, Chugiak Current Property owner(s) Nathan & Alexandria Goffena Day phone Mailing address 21701 Knik Vista Ct, Chugiak, AK Real Estate Agent _ Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) Duplex Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well I Holding Tank ❑ Individual Water Storage I I Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System Waiver/Variance request for: Distance: Received by: _ Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 555 Waiver Fee $ Date of Payment 4fics t9 Date of Payment Receipt Number 4704 Receipt Number COSA# 05C1Q/a Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 6.96-6111 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/7/2019 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use. local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future +�`\ occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. �)� ��\ 1 * a_ T i f Y,t 6. DSD SIGNATURE 1S i�i�— System #1 Approved for bedrooms. 4 . KENNETH `I. r,e; 4711E •( Ar System #2 Approved for bedrooms. ' \rr> 4/0 ii F4' Disapproved. )'/"!E,: to�\� Conditional approval for bedrooms, with the following stipulations: `kill( (10(04 W ON�S/TE �4T t---5.1 --- ------ ----- - STE Np m o RoGPgM?,% R Boz; 7-) )IJ))SERVICE N\N .' 135/7.-------- ---- – (:::' Original Certificate Date: 10 fry / l The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10-10-12 doc COSA Checklist Legal Description: Knik View Estates Block 4 Lot 7 Parcel ID: 051-043-38 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test gpm Date drilled Water storage tank volume gallons Total depth ft Well disinfected for coliform test? ❑ Yes II No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height(above ground) in. Collected by Date of flow test for COSA Date of Sample Static water level at beginning of test ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 18 years ❑ Required maintenance completed Tank type/material Septic/SteelAge of lift station years 52"Measured operating fluid level in septic tank Lift station material ▪ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 6/5/19 D. ABSORPTION FIELD DATA Which system tested (date installed)4/28/2000 Adequacy test date 6/6/19 El ALL standpipes present per record drawing Results D Pass For32 bedrooms Total measured depth from grade 8.1 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 4.0 ft(min) Water added37 gal El N/A–pressurized field New depth in II Monitor tubes go to bottom of effective. If not, state Elapsed time 80 min depth into effective32 Final fluid depth in • Code-required soil cover over field 45 —+ Absorption rate gpd ❑ System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) If yes, enter date Gallons introduced gallons Com ments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout> 100' ❑Yes if No ft n Yes if No ft Neighboring Tank > 100' ❑Yes if No ft Private Sewer/Septic Line > 25' ❑Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment> 50' 0 Yes if No ft ❑Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft ❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 0 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' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells >200' 0 Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION sem',-10"4"441.` 444. I certify that I have determined through field inspections and review • fir'• •e • ♦ of Municipal records that the above systems are in conformance with w 4t:• a 9 i* ♦t MOA COSA guidelines in effect on this date. %. •.KENiNE . Fus/ . ♦♦i�>: CE: 7t f -. COSA Checklist yellow sheet f-� assss.• SrO1897671a • •� Municipality of Anchorage �4 - On-Site Water and Wastewater Program ti K ,A (907) 343-7904 E J U N 21 tp, E Certificate of On-Site Systems Approval z .•„,c-- . 8 L Parcel I.D. 051-043-38 Expiration Date: (9 1. GENERAL INFORMATION Complete legal description Knik View Estates Block 4 Lot 7 Location (site address) 21701 Knik Vista Ct Current Property owner(s) Thomas & Jann Vanderhoof Day phone Mailing address 1842 Green Valley Rd Cibolo, TX 78108 Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 111 Public Sewer ❑ WaiverNariance request for: Distance: Received b • JOAI l% IL. )A1 I_ Date: (.0/(2.0// COSA to be released to the engineer,unless otherwise requested by the -ngi eer. COSA Fee $ Waiver Fee $ Date of Payment (0[9-1111 Date of Payment Receipt Number 01613,6\ Receipt Number COSA# brl �2-Mg 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and 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 ttti 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 there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 6/20/2017 �44‘ OF A� kt ,4 , ..eco.. ..r 6. DSD SIGNATURE ""•" % `I� • . System#1 Approved for 3 bedrooms r •S{even R. Pannone• ' a. CE-8149 ,�• System #2 Approved for bedrooms Tti4s •• i Disapproved ��1� `5=`�y� Conditional approval for bedrooms, with the following stipulations: .4 ON-SITE r, WATER AND rn ' WASTEWATER z PROGRAM 7.,r t. • Original Certificate Date: n L� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r - • ,. If more than 1 septic system is on the lot: COSA Checklist # 1 of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Knik View Estates Block 4 Lot 7 Parcel ID: 051-043-38 A. WELL DATA Well type Public If A. B, or C provide PWSID# Well Log (YIN) Date completed Sanitary seal (YIN) Wires properly protected (YIN) 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 Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 4/27-28/2000 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) N Date of pumping 6/1/2017 Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 4i27-28/2000 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 GPD/SF System type Shallow Trench Length 63 ft. Width 5 ft. Gravel below pipe 4 ft. l otal depth *8-9 ft. Eff. absorption area 630 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/6/2017 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 23 in. Water added 450 gal. New depth 30 in. Elapsed Time: 1440 min. Final fluid depth 23 in. Absorption rate >= 450+ g.p.d. N Any rejuvenation treatment (past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS *Below existing grade. Survey on file. G. ENGINEER'S CERTIFICATION +� OF A4-4k`, I certify that t have determined through field inspections and �tij.• review of Municipal records that the above systems are in 0*:49 TH %\ *��/ conformance with MOA COSA guidelines in effect on this date. •••• ' • Engineer's Printed Name Steven Pannone ":� evert'R. Pannone• % 6/20/2017 � 9 CE-8149 ' Date r COSA canary sheet_2-6-15.doc Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 051-043-58 1. GENERAL INFORMATION Complete legal description KNIK ViEW ESTATES S./D: LOT 7. BLOCK Location (site address or directions) 22701 KNIK VISTA COURT CHUGIAK. AK Property owner Mailing address Lending agency Mailing address lARRY AND TERRY GALL P.O. BOX 671705 CHU$1AK, AK 99567 Day phone (907) 688-2455 Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC lng to the legality and s~a~us of system. 72A)25 (Rev. 1/91) Front MOA #21 Computer Version 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation of this Health Authority Approval application shows that the on-site water supply and/er wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy 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 and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Address 6901 DEBARR Engineer's Sig In conducting this evaluation, system in accordance with ADEC and MOA CONSULTANTS Phone (907) 337-6179 gg 04 Date /b conscientious engineering analysis of the Guidelines & Regulations. The reported results described 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 soils 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. 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. 6. DHHS SIGNATURE Y Approved for "~ bedrooms Disapproved Conditional approval for. bedrooms, with the following stipulations: Additional Comments By: ~_....~/~_.-..~/ ~/C I, ?/--" 'c~/-~ Date / <D - (' © ~ 0 cD The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements· Employees of DHHS do not conduct inspections or analyze data before a cer[ificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Sack MOA #21 Computer Version Municipality of Anchorage R E C E I V E,I DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services DiVision 825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-47~CT 0 (~ ?000 MUNICIPALITY 0FANCHORAGE Health Authority Approval Checklis{"NWRONMENTAL SERVICES DIVISION Legal Description: KNIK VIEW ESTATES S/D; LOT 7, BLOCK 4 Parcel I.D.: 051-043-38 A. WELL DATA Well Type PUBLIC Log present (Y/N) Total depth If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) Date of test Static water level Well production FROM WELL LOG AT INSPECTION ~ g.p.m~ g.p.m. WATER SAMPLE RESULTS: Coliform. Date of sample: _ B. SEPTIClI-IOLDING TANK DATA Date installed 4/27-28,/00 Tank size Foundation cleanout (Y/N) YES Nitrate Collected by: 1000 Number of Compartments 2 Cleanouts (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) N,/A Date of Pumping NEW Pumper - C. ABSORPTION FIELD DATA ,~ ~>~ Lo~J ~.~j~.~. ~,~O~S Date installed 4/27-28/00 Soil rating ~or ft2/bdrm) 0.8 . System type TRENCH Length 63' Width 5' Gravel thickness below pipe 4' Total depth 8' - 9' ~e Effective absorption area 630 SQ.FT. Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO Date of adequacy test NEW Results (Pass/Fail) - For. 3 Bedrooms Fluid depth in absorption field before test (in.); - Immediately after - gal. water added (in.): - Fluid depth - (ins) Minutes latar:" - Absorption rate = - Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Computer Version - If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" ~ff" levei at* .~~ ~ ~lum _ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: PUBLIC Septic/holding tank on lot Absorption field on lot Public sewer main On adjacent lots ~Public sewer manhole/cleanout Liffstation SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation _ 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 10% Surface water/drainage 100'+ .Wells on adjacent lots. 200'~ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line. 10'+ Building foundation Surface water 100'+ Curtain drain. NONE KNOWN F. ENGINEER'S CERTIFI~ I certify that/h~ ~t~r~ of Municipal re/bo/~ with MOA HA~ gu Signature Enginear'sNamel ! '~/ Date field inspections and review systems are in conformance on this date. JEFFREY A. GARNESS 10'+ Water main/service line 1 Driveway, parking/vehicle storage area 5o'+ Wells on adjacent lots 200'+ OF HAA Fee $ '-'~ · Date of Payment Receipt Numbar 72-026 (Rev. 3/96)* Cornputer Version Waiver Fee $ Date of Payment Receipt Number