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Home My WebLink AboutGATEWAY TO THE PARK BLK 1 LT 9Gate Way To The Pcirk Block 1 Lot 9 #067 - 601 - 06 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 Parcel I.D. 067-601-06 Legal description Expiration Date: 7/2/2025 GATEWAY TOTHE PARK BILK 1 LT 9 Site address 2016 MOUNT KILIAK CIR Current property owner(s) NOSICH ERIK J & AMANDA X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 7/17/2024 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 Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section RU5 �+ ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 067-601-06 Complete legal description GATEWAY TO THE PARK BLOCK 1 LOT 9 Location (site address) 2016 MOUNT KILIAK CIRCLE EAGLE RIVER AK 99577 Current property owner(s) ERIK & AMANDA NOSICH Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ 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 3 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ® AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: 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 $ -5g0 Date of Payment COSA# OJ' GZyIZ �O Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist NEW.docx COSA Checklist Legal Description: GATEWAY TO THE PARK BLOCK 1 LOT 9 Parcel ID: 067-601-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 8/30/83 Total depth 58 ft Cased to 58 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 7/2/24 Static water level at beginning of test 37 ft. Well production at time of test 5+ gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.605 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 7/2/24 Comments B. TANK DATA Measured operating fluid level in septic tank *NA Date of pumping *NA – 7/15/2024 Required maintenance completed, if AWWTS Comments: *NA - See Maintenance Report C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 5/21/2021 ALL standpipes present per record drawing Total measured depth from grade 5.5 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 7/2/2024 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 2 in Elapsed time <20 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY – NOT TESTED Effective depth (per record drawings) 18 in (MOA 1.5 ED) Effective depth used 0 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 18 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist NEW.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ 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 *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. 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 7/15/2024 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 & 7/15/24 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of t of 20- by and between herein the "OWNER." and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AN ADVANTEX SYSTEM located at (legal description) GATEWAY TO THE PARK BLOCK 1, LOT 9 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This 1"7 includes an annual maintenance fee (typically 5400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev, 05/18/2018) Page I of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from (lie manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing KI guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the Aww'rS approval, 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof, 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. 'rhe laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of'3 QWNER- By: .-r_s7. �' �-=' �-� _._.�... � (sigmature) Date:._.., (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) Tip foreeoin g instrument .vas a knowledged before me this Mfg day of 20 by N ` tl Y P B FOR My Commission expires: = `• �' OF MUNICIPALITY: By: —�� — (signature) Date: (print name) Title: (rev. 05/18/2018) Page 3 of 3 ■■ ■■ ■■ ■ moss■ 1. ■■ ■ ■ ■ ■E■ IIIIi� ■ ■■■ ■■■ ■ ONE 462 570 ■■ s NINE ■ ■ *vanTwe Field Maintenance Report Annual Inspection ■ ■ ■■■ I on on on AnchorageTE 907-272-3; nk Property Ownerfrracking # pH (6 9) Operator Previous Erik & Amanda Nosich Previous A+ Home Services Tech 2nd Compartment Site Address Previous Contact Phone Previous 2016 Mt. Kiliak Circle, Eagle River AK 99577 Riser/Lid (907) 748-0000 Splice Box AX Site ID # County ID # Pod # RTU #NL # D'ate of Last Inspection AX -153221 436900 RTU 144946 10/12/2022 Retrieve O&M Into Daily flow Recirc ratio _ Timer settings: Perform Field Sampling/Observations NTU (15 t NTUs) pH (6 9) DO (2-6) Previous Cu/r�rtht tl p' Previous Odor of Sample Typical ❑ MustyEarthy ❑ Moldy Non -typical ❑ Sulfide ❑ Cabb a ❑Decay Oily film in PVU ❑ Yes ,�.,�o Foam in tank El Yes LAG No Check Control Panel RAmps Discharge Amps Rirc 1�c It Audible and visual alarms EVOK Dial tone (telemetry only) ❑ Yes ❑ No Inspect/Clean Pump System Ins ect Clean Riser/Lid ..................... Splice Box ................... . Float Cords ................... Floats ........................ Pump........................ Biotube® Filter ................. Biotube Pump Vault ............ Recirculating Splitter Valve...... . Ej Comments Signature Measure Sludge/Scum Sludge scum 1st Compartment Pyrrent Previous Cu/r�rtht tl p' Previous Biomat:ormal 2nd Compartment Current Previous Current Previous Inspect/Clean AdvanTex Filter Odor. ormal ❑ Pungent Biomat:ormal ❑ Excessive Bridging/Ponding: (lone/Minor ❑ Excessive Inspect/Clean Discharge Pump System Insp t Riser/Lid Splice Box Float cords Ins ct clfo Laterals/Orifices Pod Bottom Intake Vent Ins It Floats Pump Inspect/Service Other System Components Inspect Clean Inspect thea Disinfection Equipment ❑ ❑ Dispersal Laterals/Orifices ❑ ❑ Observations ({" Additional Services Rendered ❑ Cleaned textile sheets? ❑ Replaced UV items? ❑ Replaced/Used other items? Parts Used: W = Warranty, B = Billable (✓ appropriate selection) W B Item Number Description Fin/Safety Inspection YSV reinstalled pQ Manifold reconnected; flush valves closed Suitt ry/Recommendations //System performing; no fuf#her action needed ❑ Call fpr service Yf/ Date I 'I-) " Fax completed form to 1-866-384-7404 gL-I�I{ds bolted on L� Cantrol panel reactivated ❑ Tank needs pumping ❑ Other? Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211117 PID Number: 067-601-06 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name WILLIAM & WENDY SOUTHARD ABSORPTION FIELD - ADVANTEX ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 2016 MOUNT KILIAK CIRCLE, EAGLE RIVER ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 2 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.5 Ft. Gravel depth beneath pipe 1.5 Ft. Subdivision Block Lot GATEWAY TO THE PARK 1 9 Fill added above original grade VARIES 1.28 — 1.35 Ft. Gravel length 50 Ft. Township Range Section Gravel width 5 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 320 FtZ 1 NA Ft. Well 50'+ 50'+ 25'x., TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 50'+ 50'+ Material STEEL Number of compartments 2 Lot Line 10'+ 10'+ NA Foundation 10'+ 10'+ LIFT STATION Manufacturer ORENCO Capacity 1500 Gal. Remarks EXISTING SYSTEM DECOMMISSIONED 4BR FIELD INSTALLED W/ 4BR RESERVE Alarm location GARAGE Electrical installed by PLC Tank t PIPE MATERIAL House to tank 3034 dra nfield 3034 Installer NORTHERN EXCAVATION Drainfield 3034 Co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection15` 5/19/21 5/20/21 Location and description dates: 2nd Td 5/20/21 4 1 5/21/21 TOP OF AX20 POD ON-SITE WATER AND WASTEWATER SECTION APPROVAL .a\l1.r • Conditional Approval: Date r�Q ' ' •:}Q,f, TH .. .. ....•:.. " "" """""' Septic System Approved�'•, Curtis Huffman Date J��1F��0 C5 2528991.��/ ll1 pROFES5I�N,�-�- Note: this approval does include not well permit requirements. (Kev uoiuzii t5) »7►II11111=01010PAaM 20' DRAINAGE EASEMENT \' A -C=103,9' B -C=81.0' A -D=111.6' B -D=88.2' A -E=173.2' B -E=163.9' A -F=175.1' B -F=165,7' A -G=196.7' B -G=172.3' A -H=193,9' B -H=169.8' A -I=188.5' B -I=167.5' PID: 067-601-06 STAKED 50' STREAM SETBACKS FCO CO AX20 POD 1500 -GAL STEEL ADVANTEX TANK Loi' 9 55,570 S.F. DCO CO CO INSULATION CO MT FINAL GRADE FILTER FABRIC 74.84 SEWER ROCK SEPTIC SECTION SCALE: NTS GATEWAY TO THE PARK 131, L9 PREPARED FOR: WILLIAM & WENDY SOUTHARD 2016 MOUNT KILIAK CIRCLE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING 13030 Sues Way SURVEY: Anchorage, Alaska 99516 DRAWN: (907)350-9566 SCALE: FirstWaterAK©gmail.com SUPPORT®SERVICES: WE. 5 05/27/21 KGL FWCS 1" = 40' ORIGINAL GRADE/-� TH21-1 2.5' ORG/OL GM GRND.WIR. 0 7' 4/29/21 ® 9, 5/20/21 11' 66.34 BOH 04 9TH 0 uk��o rtis Huffman. - CE 128991. 5/.27/21'Air sstor�AtiAV � RETAINING 6.3'x14.5' LEAN-TO �j WALL 6' N EDGE OF ROAD ` p t�• `" 8.2'x 12.8' STREAM / / CANT.' vy Lot 10 / / P ? LT 11 x14.2' WOOD 6.2'xSHED FC Fyt�J 26.5` • . .� �. 20' DRAINAGE/ y�6� i 9 ' EASEMENT / �/ � • • ,.?s�• ,yb• . \ / RETAINING WALL SEPTIC PIPES SEPTIC MANHOLES -�_:: 00 r \19 1O0 \ \ % TREATMENT POD-J ` f0 0 8.2'x8.2' O 0 \ SHED i- \ M Lot 9 s, \ 55,570 S.F. o, 25 0' 20' DRAINAGES ' EASEMENT 5 l/ LSTREAM I-WELL (APPROX.) ® \ �� \ Lot 8 / SCREENING EASEMENT 15' T&E EASEMENT MORTGAGE SURVEY X SCALE 1" = 50' GRID SE 0905 Project No. 21-186/A2 9' Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & S S O c i a t e S n C® (907) 522-6476 Phone (907) 522-4625 Fax mac" OF �O�Q� Professional Land Surveyors ken®langsurvey.com d •. �,q �4 jonathan®langsurvey.com Qoo�P •.. S,�4pp I hereby certify that 1 have surveyed the following described property: LOT 9, BLOCK 1, GATEWAY TO THE PARK SUBDIVISION (PLAT No. 82-251) 49TH v* �� Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a """"' """"""'0 representation of the conditions that were found on the date the survey was performed. Q This survey does not constitute a boundary survey and is subject to any inaccuracies KENNETIi G. LAN k-.Q that a subsequent boundary survey may disclose. The information contained hereon shall d not be used to establish any fence, structure, or other improvements. UQ t-rl(--i �- p�`Po . .LS-5202.••' J�� Dated this the '�} Day of t�t� �"`'` at Anchorage, Alaska ,cV ` ��'SSIONA� It is the responsibility of the owner to determine the existence of any easements, Opppo covenants, or restrictions which do not appear on the recorded subdivision plot. AECC963 MUNICIPALITY OF ANCHORAGE On -S `rte Water & Wa stewater Pro g ram PG BOJ 1966W 4700 Elmore RMd ArschareW, Alaske 9951M650 Phanec 7) 343-7904 Fax: {007j 3.43-7997 1h1tp:?A w -rrwr9,org�onsr1e On -Site Wastewa#er Disposal System Permit Parmlt Number- C)SP211117 Work Type: Seplic Upgrade Tax Godo NLrmb&T- 46760100000 SIis Laval Address GATEWAY TO THE PALM{ BLK 1 LT 9 0,0$45 Site Mailing Address: 2016 IVIOUNT KIL1AK CIR, EagLa River Owner, .50UTHARD WILLIAM R &WENDY R Design Engineer, FIRST VVATER CONSULTING This perm it is fo r the 00 nStructic n of: E lfe cti ae Date Expiration Dalb. Lot Size in Sq Ft: Total Sedr ms; :L C L_ ujr),arr[hch[ 5)62021 5��2022 55570 0 Dsp 9 Field 0 Septic Tank ❑ Hcfding Tank ❑ Privy ❑ Private Well M Water Storage All ccnstructictr shall! be in accordance with; 1. The attached approved design, 2. All requiraments specified in Anchorage Municipal coda Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1 BAAG72) and Drinking Water Regulations (1 USO) 5. The WasttWater code requires inspections during the installation. The engineer shall n(ytify the D-ovolhopiueiil Services Departn*nt per ASIC 15.65. Provide notification by calling (907):343-7904 (2417)- 4, From October 15 to Apell 16, a subsurface soil absorption system~ under construction during teezing weather shall t)e either_ a. Opened and Closed on the sarn-o day, or b. Covered, sealed. and heated to prevent freezing Received 83 Issued Dy: IVIIJA mate: �r'2 3 MUNICIPALITY CHS Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 067-601-06 Property owner(s) WILLIAM & WENDY SOUTHARD Day phone Mailina address 2016 MOUNT KILIAK CIRCLE, EAGLE RIVER, AK 99577 Site address 2016 MOUNT KILIAK CIRCLE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) GATEWAY TO THE PARK B1, L9 Legal description (Township, Range & Section) Lot Size 55,570 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade Duplex (D) ❑ Holding Tank ElRenewal ElMultiple 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. of property owner or authorized agent) Permit/Rush Fees: � 5 � 5 Waiver Fees: Date of Payment: 2 9 Z 2 Date of Payment: Receipt Number: %q 9 2 ~& q Receipt Number: Permit No. OSP 11 /l �/ 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 29, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: GATEWAY TO THE PARK BLOCK 1, LOT 9 The septic field has been found failed and the owner has requested we proceed with a septic permit to upgrade the system on the above referenced lot. We propose to install one shallow trench with an Advantex system to serve the existing 3-bedroom residence. The design is based on the recent test hole conducted on April 22, 2021. The slopes are moderate at 13-18% at the proposed upgrade location. The lot and area are served by private water and Ken Lang has picked up the location of two streams as noted on the design. 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 OSP211117, Rebecca Carroll, 05/05/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211117, Rebecca Carroll, 05/05/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211117, Rebecca Carroll, 05/05/21 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL: GATEWAY TO THE PARK B1, L9 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4/29/2021 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 GM 5 6 7 8 9 10 11 BOH 12 13 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 4/23/21 30 min 6 6 30 min 6 5 15/16 30 min 6 5 15/16 PERCOLATION RATE 5 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 7.5 DEPTH TO WATER AT MONITORING: 7 DATE: 4/29/2021 TESTHOLE # 21-1 DATE PERFORMED: 4/22/21 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: WILLIAM SOUTHARD 4/29/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211117, Rebecca Carroll, 05/05/21 20' DRAINAGE EASEMENT I � j I / rRETAI WALL OF ROAD 0 J r 5 w D E RP rn T WELL O n O p I /� 8.2'x8.2' O SHED r lq / 125• �I c --T 20' DRAINAGE � I I I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 1, GATEWAY TO THE PARK SUBDIVISION (PLAT No. 82-251) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any Inaccuracies that a subsequent boundary survey may disclose. The Information contained hereon shall not be used to establish any fence, structure, or other Improvements. til Dated this the _ �� ___ Day of __- �LL;_-�--________- - Zz _, at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49?H*& ¢l �.. KENNETH .!: .o 9 s� `. 4�2c9121 �OFPFo' ..LS -5202. SSG 04� OF£SSIONAD �o AECC963 L EASEMENT STREAM' WELL (APPROX.) / / / Lot 8 / \V" 20' SCREENING EASEMENT / \ 15' T&E EASEMENT MORTGAGE SURVEY _X_ SCALE _ 1=_= 50'- GRID __SE 0905-- Project No. Lang & Associates, 11500 Daryl Avenue, Anchorage, inc. (907) 522-6476 Phone Alaska 99515-3049 Professional (907) 522-4625 Pax Land Surveyors kenOlangsurvey.com �ooDODOO oo / 4�0 o .. . OF A .`9 4 jonothan®langsurvey.com I hereby certify that I have surveyed the following described property: LOT 9, BLOCK 1, GATEWAY TO THE PARK SUBDIVISION (PLAT No. 82-251) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any Inaccuracies that a subsequent boundary survey may disclose. The Information contained hereon shall not be used to establish any fence, structure, or other Improvements. til Dated this the _ �� ___ Day of __- �LL;_-�--________- - Zz _, at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49?H*& ¢l �.. KENNETH .!: .o 9 s� `. 4�2c9121 �OFPFo' ..LS -5202. SSG 04� OF£SSIONAD �o AECC963 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this -30 Day of of 20 _Lk , by and between i 11 iaM R . r WIn . S �, herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AN ADVANTEX SYSTEM located at (legal description) GATEWAY TO THE PARK BLOCK 1, LOT 9 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. 124- Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. n� Owner agrees that any sale or transfer of title of the property will not occur without a new U)� Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: C (signature) Date W n y . c�i7/Ao-,rd (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) q -3U -z( The foregoing instt:�iment s acknowledged before me this 3b day of 202, b, J D v ARY LI R ALAS CA [ . My Commission expires: % Z3 :. OFFICIALS �— D. SCOTT BTROUD �► MUNICIPALITY: By: (signature) (print name) 'NOTARY PUBLIC -STATE OF ALASKA NW'Comm. EVhs Augus119 3 - Date: Z Title: (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES 0 10006 Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name Address ,4Hc'' 1I 1';S /nG'/..3 /' / c a /7y o i)"NG.�.-ate ? YSS/o Phone(s) 'Permit No. �9y-Si5S i,el �7-0-65 LEGAL DESCINPTION No. of Bedrooms 3 FROM TO DISTANCES SEPTIC ABSORPTION TANK FIELD WELL Lot / 'Block / Subdivision �G fe way T The /o •-sf WELL LOT LINE /do' 9G/ 8o'* 4 Township, Range, Section T/3/v /.e Sec, FOUNDATION //o / TANKS AS -BUILT DIAGRAM (Show location of well. septic system. property lines, foundation, driveway, water bodies. etc.) mTS . 1$ SEPTIC 0 HOLDING Manufacturer GREE' Capacity in gallons /000 6e /, Material STee/ No. 01 Compartments TYPE OF SYSTEM HSE 1 ❑ W. DRAIN ❑ OTHER r Total depth from original grade ems'+ - �.a. FT 5-6 FT ,\!: Fill added above original grade Gravel depth beneath pipe a ' FT 1 FT f y�� Gravel length Gravel width % Lf S FT 5' FT Total absorption area t Distance between lines �i/6 SQ FT /0 FT Ss Number of lines Soil rating Pipe material 3 / 3e5 -SO FT As%fin 3 3y /f Sive? Installer Date Installed 4 C/A EH 'e.-perr , z /o/s.7 - /°�'%? r WELLS 13' ❑ TRENCH 0 BED Depth to pipe bottom from original grade 0 PRIVATE 0 OTHER (Identitvl 1 /00/ 1 N... 4;4.: as' • WELL Classification (A,B,C) pre I ✓.t re Total Depth SFr FT Cased to SI" FT Installer .Sy/e c N Date Installed: /30/cr 3 REMARKS: r / 7 -..'�4 (Asr) Has Gpar vc/ dde1.0 of 4'J$ 544 Sw,�s fes Ore s/oP ,/,rfe.rce_ 1 O- CLAW 0y7 - • - /f90 r✓/TeR f '4 L Ey►c/, w4' F Wa te,- lo -+o.,/: ter 4 t t/.., e o-,' /,.,s t // N.,. G 7- /36 fN4 Y2r �e!•Y7. S)er,"Ss eft, /tree! 0/4 r,r, r ♦../s 13//. Y..,•/ one e/..er.te.i t , S 'b Scale intent a cnpa Vika Services P O. Boy 7732,34 Date: Eagle River, AK 99577 694-5195 a1'y//. Municipal and Stas geidelines in deism this dale: estily that this inspection was performed warding 1 all /6/3#/&7 Health Deprinranl Approval '• `^^'•'� Date' V -B/81- e Or •}•••••••••4M•••H•••••:•• c •4 9St rn ; Lours A. Butera / •a CE -6736 � � •'`+ Qui `kk�eROFESS0N4.4' NlCIPALlTY OF ANCHORAGE Department of Health & Human Services Street, 4nrhoraoe, Alaska 9950i 343-4720 Upprade \)a.ie EnD_i.:eer Designed FINANCE ess: PNU. 8Ox 10102' ANcHORAGE, AK 9951ti PERMI1- Day Phone: LotLega1:iiiiiiiii0�cx� � Sg3ST•c. Section: 9 /oNnsnzp: 1:1N xange; 18 !'o| Sizssq.lt. acres� Nat iKatiru',ws: this Permit: 3 Total Capacity: 3 SEP7IL TAN|(; MLnimum total septic tank capacity: 1,000 oallons. Each septic tank n''si ha"e at ]east 2 compartmenis. Depth to top of septic tank(s) < 4.0 �eet 'eq:jres insuatio: nver tank(s). Y00 FOOT SEPARATION BETWEEN SURFACE WATER AND SEPTIC SYSTEM HAS 8EEN TO B5 FEET. PUMP EXISTING SEPTIC TANK AND ABANDON IN PLACE. INSTALL NEW lANK TO MEET 85 FOOT SEPARATION RFQ||lRFnrNT. MEA8UKE WATER TABLE AT TIME OF INSTALLATION TO VERIFY FOUR FOOT SFP*RATIOH TO WAlER TABLE. PROVIDE THIS INFO UN AS -BUILT. rth the Municipality of anchoraqe (MOA, and the State of Alaska. l w,il instail tGe syetem iG accordance with all MOA codes and requlatiohs, en: .n compliance desipn criteria of this permit. 4. 3 onoerssnd that this permit is valid lor a maximum of 3 bedrooms. DP[E: --~�._��~~--��-�---�~----�----------- --�11 (•j< HOUSING FINANT1E d( 0\ o cD 100' �O. r NT EXISTING LEACH FIELD ane.— NEV LEACH FIELD CLEANOUT -• SCALE' 1' = 50' WELL AND SEPTIC SITE PLAN LEGAL: LOT 9, BLOCK 1, GATEWAY TO THE PARK OWNER: ALASKA H❑USING FINANCE CORP. CONTRACTOR: N/A EAGLE RIVER ENGINEERING SERVICES P❑ BX 773294 EAGLE RIVER, AK. 99577 694-5195 OF ASt 411 •• ,43 p- * `�H 4 , * ro...• •• 11.11..:°.. 170S;° Louis A. Butera • i IJ� � •• CE -6736 • �� tea' ,°•. ' �� 4 %eRoFESS10N�P�v EVO��a�• PERFORMED FOR: Lc'rr MUNICIIDEPRL O R ENVIRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST SEP p2R5083171ON TEST RECEIVED DATE PERFORMED: LEGAL DESCRIPTION: G A r E WA y To % HG PAR K Lot 7 SLOPE p 1 2- ;D O_ O 3 0 ;Z0. 4- O 5 - t0 _ s • b 8 • -- 10 •_ 11 • - _ To/°rv/t 14-.6 ,-GrA'S a.,i 01,- C- Y -A e ✓e I 138 4b /4!t ' 9/asg7 v Yin/s7 /30)1 15 - �...1�� E0F4 '% 16 - ;,SP1 ..••......• FIs, 14. � Or Gs. • •••.,y•II 17 -% * "49TH . * ♦ 18 ... .• / Ie 3t: Lows A. Butero :• or 19 - r �P.'. CE -6736 �a* 20 - b\ PR.0FES5 °.Nom 41.41. COMMENTS -SCE /9ES/GN M (At WAS GROUND WATER YES ENCOUNTERED? IF YES, AT WHAT DEPTH? 7/6/5• 7 Q/H/ / /3N/ i'/E Sec, SITE PLAN S L 0 P E / 7 o AY. 7.67 . re r 7 H' 3 c .6 Reading Date Gross Time Net Time Depth to Water Net Drop So A K 9//7/47 S.,..3 4• 3%L,. Q/: 30 /d..,,;, .5----/ 3%y• 3/6 •. ? =/b„ y /.. SZo /o.,.'.v S=3514 PERCOLATION RATE TEST RUN BETWEEN .E'ecc S 7 (minutes/inch) _ /3* 46/Tie FT AND 4 FT PERFORMED BY: Eagle River Engineering Services P. 0. Box 773294 CERTIFIED BY: Eagle River, AK 99577 694-5195 �� i� DATE: 7X-2.-5-/,?? MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION (�k�� - ENVIRONMENTAL ENGINEERING DIVISION \\\\�\�'F�%/�/J/// 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME(/�,� VP -0C- 11Os= `-C,+NcCQ E'er— Corel �iZ PHONE Z%(c- 51,8 Irgt4 y M UPGRADE MAILING ADDAEJS o G 1 131-,5 E_XC_ LEGAL DESCRIPTION Gl S k L--o-r 11. K . 1 *�'r-€ w :=••-P -pp . p Pv P_ -IC n LOCATION ,� /a Se-cl 9 NO. OF 'BEDROOMS SEPTIC TANK 73A/ Well �� f DISTANCE T Absorption Dwelling ry//d'PERMIT NO. /./k anufacturern � � � Manufacturer(.. Mat ialc. �� No. of compartments Liq. capacity in gallons IF HOMEMADE:,C- Inside length Width Liquid depth / h ") 16 Y JC%Z 2 F DISTANCE TO: Well i /�[ Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well Fo ndation Nearest lot line PERMIT NO. No. of lines Length of each line Af o length of lines Trench width inches Distance between lines Top of tile to finish grade aerial beneath tile inches Total effective absorption area SEEPAGE i3 E P Length �/ `."1c Width Z. _ ( 5 Dep} �h LJ �t Det t' U to S 12.0r'u PERMIT NO. / Type of crib Crib diameter Crib depth Total effective absorption area ...3.i 17t DISTANCE TO: Well / / /D:1 Building fol n Nearest lot line �Q i.,�. 0- J W Class Depth/ / /f� %n/Jfy�r Distance to lot line PERMIT NO. 66" rr6 Y V Jdi o dat' n l Se r line Septic tank Absorption weals) / DISTANCE TO: OTHER • PIPE MATERIA AVL SOI L TEST RATING t�� INSTALLER �i X3635 CYC, REMARKS CAM v 6'. 4C .f=.. .ai iia- 14 ' - \ v'J, !._�- 1457-c(.7 s_^AIN' '.;.. .. . fa ( i CO .7"")..11.....7 n �1SOCS�P' ....11.0.1, MU: APPR ED �i��, ?-7 V DATE LEGAL" ^`'""--- - SRB ALASKA 99577 PH. 694-2979 ,� MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection -1825 L Street, Anchorage, AK. 99501 264-4720 \ + ;h./• HANDWR I TTEN PERMIT ` ` Permit t93&--1LIc.i WELL AND/OR ON-SITE SEWER PERMIT Applicant: C nsnf�eLLd Io . cf ,t Mailing Address: `i// -f -7c ! 4. zr4Vocation:j..-kq c71c- 1 ��{ t_PA Phone Number: 27(,- G'8 L401 Description: t 131u 11tE Kgc_ ? Lot Size: ___ Y TEipe of Soil Absorption System Is: Trench: Drainfield: Seepage Beds Holding Tanks Maximum Number of Bedrooms: .3 Soil Rating(sq. ft/br) JS ; The Required Size of the Soil Absorption System Is: DEPTH 7.-S` LENGTH - 1/(' GRAVEL DEPTH 3 i WIDTH The length dimension is the iength(in feet) of the trench or draiafield_ el depth of a trench or pit is the distance between the surface of the grouad-i the bottom of the excavation (in feet) . There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe ami the bottom of the excavation(in feet). ` ' REQUIRED SEPTIC(HOLDING) TANK SIZE = 100-0 GALLONS * * Permit applicant has the responsibility to inform this .�deitartssent_during. t - - -- i installationinspections of any weds adjacent to this property and the num of residences that the well will serve. ' * *# TWO(2) INSPECTIONS ARE REQUIRED ` ` + Backfilling of any systema without final inspection and approval by this depas will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 186 -for a private weld er I50 to 200 feet from a public wellldepending upon the t __of public well. Minimum distance from a private well to a private sewer liter is 25 feet and to a community sewer line is 75 feet. Nell loge are mined- and must be returned to this department within 30 days of the well completiel Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * ` PERMIT EXPIRES DECEMBER 31, 1 9 3 3 * * * I certify that: .(1) t am familiar with the requirements For on-site sealers and wells as set forth by the Municipality of Anchorage. J(2) I will install the system in accordance with codes. . '(3) I understand that the on-site sewer system may require enlargement I the eeidence is remodeled to include more that 3 bedrooms. Signe$: /'1 � Issued by:. Z A. Date: W5/g3 plicant tort SWP/024(1/81) l..< ZU. d ' i . a Permit # Applicant: Location: MUNICIPALITY OF ANCHORAGE Department/ -f Health and Environmentarotection 825 Street, Anchorage, AK. _3501 264-4720 * HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT COnS+eucroc_ c s Mailing Address: //-E L 141 Ga w,a 1-o tkE Lnt9 6lork I Phone Number: 7'7- i&'8(o Pa�� 5rS'U/ Legal Description: 7-13/U p/F Spr 7 Lot Size: 56O- ? Type of Soil Absorption System Is: Trench: Drainfield: ,/ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) A26-14 The Required Size of the Soil Absorption System Is: DEPTH 7. LENGTH '5'(/ GRAVEL DEPTH 3WIDTH 6 The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /n70 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31) 1 9 u 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signed: Issued by: „Z.7%7L(19Y-,27 Applicant Date: rOau . SWP/024 (1/81) i-,. 3 e�4-0T-1 btp _ .s ?A/83 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: S/Y74 ►' EXC4 v / *LS LEGAL DESCRIPTION: v7- , ' l v c4E 2 c$ Me44 . , SLOPE 15 pF 4!:41h1 49M�ri• p 17 •se• .:••• • j 18 ft , : 2225-E 'Al; JUNE 25,1971 ••t,,,/• 19 .��F ••�\ - S:• .. 20 ilt�Osa SOILS LOG ❑ PERCOLATION TEST DATE PERFORMED: y /7) 17F.3 742) I SITE PLAN 1 z Cc ess c WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? yes O Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE _ TEST RUN BETWEEN COMMENTS NO i r614. -71'A% S.ire of j -es FT AND (minutes/inch) FT PERFORMED BY: 1. 84 r C vQ 72-008 (6/79) CERTIFIED BY: DATE: t 5zr DAILY DRILLING LOG thA'te7,a41 TD 7kE biELSYREN BROS. DRILLING, INC. 2701 Eagle Street Anchorage, Alaska 99503 274.6437 OWNER OF LAND Lou Butera DEPTH OF WELL. 58 feet f , g,1 912 E. 15th Avenue 30 feet f,g,l, ADDRESS STATIC LEVEL OF WATER FT. WELL—SITE Mile 14 Eagle River Road DRAW DOWN FT DATE—STARTED 8/30/83 GALS. PER mi 9 gal/min, DATE—ENDED 8/30/83 KIND OF CASING 6" A53 Grd B Steel KIND OF FORMATION: FROM 0 E. TO 14 F,1, f 111 FROM FT. TO FT 14 37 clay/gravel FROM FT. TO FT FROM FT. TO FT 37 50 damp clay/gravel FROM FT. TO FT FROM FT. TO FT FROM 50 FT. TO 58 FT gravel/water FROM FT. TO FT FROM FT. TO FT. FROM FT. TO FT. FROM FT. TO FT FROM FT. TO FT FROM FT. TO FT. FROM FT. TO FT. FROM FT. TO FT FROM FT. TO FT FROM FT. TO FT FROM FT. TO FT FROM FT. TO FT. FROM FT. TO FT FROM FT. TO FT FROM FT. TO F'r. FROM FT. TO FT FROM FT. TO FT MISCL. INFORMATION: Stephen .D, Syren DRILLER'S NAME Russ [1UMO01PU7V OF °; GMOHOO IRAOC A KPI Development Services Department ;' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 067-601-06 Expiration Date: 7 1. GENERAL INFORMATION Complete legal description GATEWAY TO THE PARK BLOCK 1, LOT 9 Location (site address) 2016 MOUNT KILIAK CIRCLE, EAGLE RIVER, AK 99577 Current property owner(s) DEREK & TRACI ESPELAND Day phone Mailing address Real estate agent 2016 MOUNT KILIAK CIRCLE. EAGLE RIVER. AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 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: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 2 SD + lo'3 OWSH) Waiver Fee $ Date of Payment 'Jr -2- y -a/ 5/.29/a 1 Date of Payment 5182.?2 Receipt Number. 5 / L 2 /3 Receipt Number COSA # 0 5 C �2,1 1'I'1 �0 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. 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 5/22/2021 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 g�Q: • • • • • :1,9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or _ J discrepancies exist can be given by First Water Consulting& FWCS ' * • TH , , , , ;* r 6. DSD SIGNATURE r Curtis Huffman System #1 Approved for L bedrooms r�� 6,� CE 128991 S .•�� Y pP �l�c�•..�/22(4021�,— System #2 Approved for bedrooms iikFEFop SS0 Disapproved Conditional approval for bedrooms, with the following stipulations: OF pN_ VVA R �WT AQ ,- ASD m r PROD V IA TER r B Original Certificate Date: 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: GATEWAY TO THE PARK BLOCK 1 LOT 9 Parcel ID: 067-601-06 If more than 1 septic system on lot: COSA Checklist # _of ` Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8/30/1983 Total depth 58 ft Cased to 58 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/15/2021 Static water level at beginning of test 34 ft. Well production at time of test 5.5 gpm Comments B. TANK DATA Age of tank(s) NEW TANK years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping * D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ® ALL standpipes present per record drawing Total measured depth from grade 5.4 ft (max) Measured depth to pipe invert from grade 3.9 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.704 mg/L Arsenic ug/L FWES Collected by Date of Sample ® Arsenic less than MRL (ND) 4/29/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: "NEW SYSTEM Adequacy test date NEW SYSTEM Results ❑ Pass For bedrooms Fluid depth prior to test _ in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) N If yes, enter date WES 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' ® 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' Surface Water > 100' ❑ Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No ft ft ft ft 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' ❑ Yes if No *50+ ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ❑ Yes if No *50+ ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft 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 *50+ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ❑ Yes if No *50+ ft F. ENGINEER'S COMMENTS *MEETS CAT III SYSTEM CODE SEPARATION REQUIREMENTS. G. ENGINEER'S CERTIFICATION / 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. TH .. ....... ' Curtis Huffman CE 128991 .• i`4i �� cR' • 5124/2921'�Q�� F�PROFESSIONA� MUNICIPALITY OF ANCHORAGE ADVANCED '!WASTEWATER TREATMENT SYSTEM MAINTENANCE ANM REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of of 20 , by and between it 1c`C17 , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as AN ADVANTEX SYSTEM located at (legal description) GATEWAY TO THE PARK BLOCK 1, LOT 9 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) t5�/ Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of perfonning as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. b4li-t shall be the responsibility of the Owner during the tern of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Pagel of 3 <) Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Jullowner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. r% Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. '- Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 0 z attire) STATE OF ALASKA ) . ss. THIRD JUDICIAL DISTRICT ) name) Date: . J11— The foregoing instrument was acknowledged before me this day of 20 d( , by Notary Public NC)tAkY PUBLIC FOR ALASKA CYNTHIA K. DIXON My Commission expires: State ofAhgska � my CGn9tYli2VOon l_XVliras Jurta 18, 2022 MUNICIPALITY: By: (signature) (print name) Date: S--^ 2c( l Title: (rev. 05/18/2018) Page 3 of 3 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 ('NR3t (494 -Al Parcel I.D. D/01 -(0 DI -Oln COSA# 0 O 4 Expiration Date: 7- 02- " O R 1. GENERAL INFORMATION Complete legal description 447ctj41 Tv TH-6 PA-R.K. Lvt t et -k 1 Location (site address) 2016 +1LKTL:A-K cxP. Current Property owner(s) MAR' 4 At na &t r it` El Day phone Mailing address 201 t; rnT. kttr,4rc. at2 - Lending agency _ Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3• 0 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer 0 0 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 E*1'4GE QT,rtria attic- rye -5 Address Po 130X 77; G64/ 8fi2,04K 9q S 77 Engineer's Printed Name C It2t57 yfIft-2 R_ tJoob Date'4 /O4d Phone 69q- Sig 5- 5. 5. DSD SIGNATURE Approved for R bedrooms. Disapproved. Conditional approval for 'r - *: o - d, x, i cli SIOPH:R R WOOD ; CE11397 , . 'Fssia :a 146 -frabedrooms, with the following stipulations: , \Q(e1O t. yO C� = • ON-SITE -rot:, WATER AND ; m= WAST€WAT€R PROGRAM : • X1111111.0) Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11105) Original Certificate Date: - .2- 1- 0 O 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: C 4TE1JAi TO T1t1 PARI K. LIT °t $LK t Parcel ID: O67 - 0I— 0 6 j - A. WELL DATA r' Well type KRA-1C . If A, B, or C provide PWSID # _ Well Log ON) YE, Date completed Sanitary seal 67N) 7K Wires properly protected &N) `/6 i Total depth 5$ ft. Cased to 5 '' ft. Casing height (above ground) orof< in. FROM WELL LOG AT INSPECTION 12 cc...), Date of test , 'b/T/433 `i/Zo /2w7 Static water level 3o ft. 3 5 ft. Well, production 1 g.p.m. •'t S g P -m - WATER SAMPLE RESULTS: - Coliform Q colonies/100 mL - Nitrate 0.5— mg/L Other bacteria _17 colonies/100 mL •• Arsenic: 1.7f mg/I Dateofsample: 3/2//O$ Collected by.(!i`�i7«...F�'e/ B. SEPTIC/H0t3tNG TANK DATA Tank Type/Material 5 blit -C- EL. . Date installed /0/30 / 19 57 Tank size I1 wo gal. Number of Compartments 2 Cleanouts ON) Ye 5 Foundation cleanout ION) ,i/-75 Depression over tank (YIN) WO High water alarm (YI, » 0-0 Date of pumping 9 ittl /14 Pumper 3 R'S C. ABSORPTION FIELD DATA is Date installed /0/30111157 Soil rating (g.p.d442 or ft2/bdrm) 13 9 ' System:type Deck/Fret b. Length LI r • ft. Width S ft. • Gravel below pipe 3. S ft. Total depth 7-4 ft. : Eff. absorption area '1(6 ft2 Monitoring tube It, Depression over field Aro Date of adequacy test `H?D/07 , Results (Pass/Feil) P4 SS For 3 bedrooms Fluid depth in absorption field before test 46 in. Water added 450 gal. New depth 2.y In. Elapsed Time:114pmin. Final fluid depth $ in. Absorption rate >= I50 g.p.d. Any rejuvenation treatment (past 12 mo.) (WN & type) Noo.rt: K•wv✓) If yes, give date a(9 D. LIFT STATION Date installed - -- Size in gallons - - - • - - • --- i `Pump on level at _ in. `Pump ofti l hFl , in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot 't'Ioo I Absorption field on lot 'I'IOo Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots /00 I On adjacent Tots 4 f too Public sewer main •t• Iu0 I Public sewer manhole/cleanout Hoe 1 Sewer /septic service line 1-Z5• ' Holding tank t 7 S ' t, Animal containment areas 't'rod ( Manure/animal excrete storage areas He.° f SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1- r r Water main fro 1 1 Property line # 5 Absorption field 7`.5 Water service line # 10 Surface water ' 4 S Welts on adjacent Tots 'Hoc I SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 'f' fO • I Water Service line 170' Building foundation #1O 1 Surface water ' ' , 5 1 Water main o Driveway, parking/vehicle storage Sr, Curtain drain f- i O * Wells on adjacent lots +/or) / F. COMMENTS af- Lvh--robe 4Mint) I e7 Fat %s' wR's7-O5 i G. ENGINEER'S CERTIFICATION I certify that I 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 C lit rS'ttp*'-4t Q.. l,roudi Date tile /0 c6 ' 'CHR'STOrHER R. WOOD CE: Ojj X0 - - Waiver$ ' Itss COSA Fee $ Fee Date of Payment Wil/o8 Date of Payment Receipt Number 669% Receipt Number (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On -Site Systems Approval /1 080094 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 9 of Gateway to the Park Subdivision. This inspection revealed an arsenic concentration of 47.9 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.ore/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. CV)el; 1<.••r Ie—ZR—A7 7 63 791^L No C4 a...mss .gl4%'1 ''(/7F2,4t. 1. c-��_ AS -BUILT 1 hereby certifythat1 have surveyed the following described property. L O ( Vii . P Je c -k ( ,• Sn.J ..t•y ±e �`6� t", -fr raj e/ Sirrioar lriil,713 IARIE ySet,/ Anchorage Recording Precinct,. Alaska, and that the improve- ments situated thereon are within the pmperty lines and do not Overlap or encroach on the property lyu+g adjacent thereto, that no improvements on property Tying 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_ • �-r- .day of__M a!- 19fl ROBERT C. JOHNSON a'1 c - SCALE: Registered Land Surveyor No. 880 -LS 1" • 5'O • Bax 77-0456, Eagle River, Alaska 99577 Phone (907) 694-2343 - -. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. Oh760/Dto GENERAL INFORMATION ,Complete legal description qetieWa, 77u_ 7'zk., ,g /, 9 HAA # (7l -(O L3 Expiration Date: 9 - z - 0 4t - Location (site address or directions) .-2O/1' ` 217L• 'Liu, Circe Current Property owners) o/u,rt I- 6.7 ti'i ii -u 1�r.av4.4 ?t Day phone • (oily - 7'31 T26 r30u 112.% J ,i2. . Mailing address °r.. Lending'agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address /04.z/ Si/.t Phone 694 —5/`�S t/f?'u Jw . :2 /' Engineer's Printed Name Gftlea-roPHEi€ R"- h/oob Date 5. DSD SIGNATURE X Approved for 3 bedrooms. Disapproved. By: Conditional approval for bedrooms, with the following stipulations: Additional Comments tt tYOF <<cccrrrr(rri J2: ON-SITE . Gs WATER AND rn WASTEWATER PtM PROG • • . •• Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements • Supplemental Engineer's Report Other (Rev. 01102) Original Certificate Date: Cc Z - d Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WELL DATA' Well type1JATt~ Date completed TS0 Total depth ' qg ft. If A, B, or C provide PWSID #1? ; vw - Well Log 6/N) y Sanitary seal /N) Wires properly protectedl&N) Y -(4 - Cased to 55 ft. Casing height (above ground) - in. FROM WELL LOG 4%3 o/eti3 30 9 g.p.m.. Static water level 1, Well production I WATER SAMPLE RESULTS: Coliform 1' Io colonies/100 ml. Ir Arsenic: iNik mg./I. B. SEPTIC/HOLDING TANK DATA Tank Type/Mate . r F � Tank size' I, ��1U 'gal. •, Number of Compartments c2- oundation cleanout N :' Date 'of pum ing 1) / O/ Q 3 Pumper .J K'5 'i (d m 1p ,1,' C. ABSORPTION FIELD DATA Date installed'/0•-x,29 87 Soil rating (g.p.d./ft2 or ft2/bdrm) l3$ /e.System type ',vide- ira-f :ad 1 t{ i Length tis ft Width 5 ft. Gravel below pipe 3 Va-. ft. li' AT INSPECTION• +' S-ao-off 35 l ft. 5- O I °' g.p.m. Nitrate; 0.27'& mg./I. Other bacteria C7 colonies/100 mi Date of sample: S'=a0-0' - Collected by: "' _ _ _ Date installed Cleanouts &Y%N) • F ((Y�) Depression over tank (Y �'jn , High water; alarm (YY � � v I: Total depth 5'' (o eft. Eff. absorption area 4/(e ft2 Date of adequacy test 5-61-0-0 Fluid depth, in absorption field before test 4-3 in. Monitoring tube 43 ) Depression over field A/0 Results (?/Fail) Pa434 _` Water added `/50gai. Elapsed Timeo?.3(_ min. Final fluid depth_ a 3 r in: Any rejuvenation treatment (past 12 mo.) (Y&& type) 410 Absorption rate For 3 bedrooms New depth 41 in. '/ SO g.p.d. If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum in. Size in gallons f j f Manhole/Access (Y/N) "Pump off–lei/el at in. High water alarm level at Cycles tested Meets alarm & circuit requirements? 1 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septi c tank/lift station on lot 100 / On adjacent Tots On adjacent lots in. Absorption field on lot /00 1 - Public Public sewer main nkc4- /00- ' Public sewer manhole/cleanout Sewer /septic service line g4 -L51 Holding tank /00+ SEPARATION DISTANCES FROM SEPTIC/HAL-DING TANK ON LOT TO: 1 +- Building foundation $S Property line -I 0— Absorption' field / Water main 100 Water service line 1' 2 S Surface water Wells on adjacent lots /DOf, SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line go / _t Building foundation //0 / Water main t till :4-1M s It g Water Service line ' /O f' Surface water 2S N Driveway, parking/vehicle storage ' l ' ! l;, Curtain drain ,''3 i ` 85 ., ' Wells on adjacent Tots /00 1 { i til ' 5 F. COMMENTS c.//4i0 YZ %) 1.27 Fok w5 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name CH,2./STVPHER__ R. WOOD Date 5— —.Oif- HAA Fee $ Li30 Date of Payment 2–) , 0 `'I Date'of Payment Receipt Number c-77_ OSS S Receipt Number (Rev. 12/01) Waiver Fee $ E � j I ! I MAY -27-2004 13:39 RESIDENTIAL MTG 6948802 P.02/02 tr 0,4 NN L't \ x•'.41 I .._..,. • 1 €ks • R..2 4. ;p.c. a 4 ' �• 2. . ;5441441."••••4 41.••• �. eil. rat, ..1%.4.11' r '\ AS•BUILT • 1 hereby certify that I haveurve ed the following described property. i t� 1'`. � �ld G l er.dataAv'tfl(-r-k T✓4 Sa 1�is4r Ir t 7/3 Nj R I E 5,(14, Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in queshon 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 2"1" --day of H.-,Y� ' 19 ?Z • " ROBERT C. JOHNSON g& - SCALE: Registered Land Surveyor No. MO -LS 1" — 5 0' Box 77.0456, Eagle River,•Alaska 99577 . Phone (907) 694-2543 TOTAL P.02 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I D # OL. -1 -100\ -LLD 1. GENERAL INFORMATION Complete legal description HAA # t,14Ziq Lot 9; Back 1; Gateway .to the Park Subdiv.iAion Location (site address or directions) M.t. latiak Cuccle Property owner Bead Chastain Day phone 696-3538 Mailing address HC 83 Box 2431 Eagle Rit/eA Road Eagle Riven, Ak. 99577 Lending agency Day phone Mailing address Agent 2001 REALTY Day phone 276-2001 2600 Dena i. Addreg,$ttee Denati. Towan 4th Hoot Anchorage, ALa4ka 99503-2785 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 V XX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 021 • r. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone S & S ENGINEERING 17n/d Ea* River Leap Read Ale_ 211¢ Address Eagle River, Alaska 99577 Engineer's signature Date 6i -21- i 6. DHHS SIGNATURE Approved for By. Disapproved. Conditional approval for bedrooms. AP TI • ,o.. ._e, 1A i Aq. o. °It 14 11440•41.• el IMA d ROG[hi : `iHAFER : ` 44,�� J"eq No. 115 .1k.,-ROFFFsso` `a' bedrooms, with the following stipulations: Additional Comments Date f CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska, The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Beck MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: I -c -r &)DRse-N.4.e..i 1Z. Parcel I D 1'rkE A.{1- ►L A. WELL DATA Well type C714\11'cC- If A, B, or C, attach ADEC letter. ADEC water system number � Ik Log present &N) Date completed S 3 Driller DPn�.� Total depth 5a t Cased to yS Casing height 1 _elA- Sanitary seal Y N) Wires properly protected r(DN) Date of test Static water level Well flow Pump level FROM WELL LOG S-3fl-63 30' 9.0 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 1 bC> Absorption field on lot Public sewer main Sewer service line gpm ?Alp, 2S'} AT INSPECTION ` -8? 5:2-0 -83 7 p. f ri -. 4 Ls 38' 9 P•< CD vli—N0 f� CO N C7 o� F.- o Z ; On adjacent lots ; On adjacent lots 1 dO "k oo �} Public sewer manhole/cleanout b6.- WATER a WATER SAMPLE RESULTS: Coliform O 4-o"t 00 mi Petroleum tank Z S 14- Nitrate } Nitrate 0.31 Alti-. Other bacteria It.J Date of sample: 51- iS'9Z Collected by S & S ENGINEERING 17034 aegis itivier Loop Regi No. 204 Eagle River, Alaska 99577 B. SEPTIC/HOLDING TANK DATA Date installed IO -30 -81 Tank size 1000 AM. Compartments Z- Cleanouts P/N) V Foundation cleanout (SIN) N/ Depression (Y/Q a/ High water alarm (Y6) A Alarm tested (Y/N) il Date of pumping S -ZD -92 Pumper T, K. Le -SS P o o L. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1 o o ' On adjacent lots o,o 1} Foundation es' To property line 901 Absorption field 171 Water main/service line /0. / 4 - Surface water/drainage 'BSS , 14.4, 4fL4-,-17-E4 /0-2 -87 72-026 (Rev. 7/91) Front - `'CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at Pump off' level at High water alarm level Cycles tested Meets MOA electrical codes Y SEPARATIO II on lot ANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA Date installed l -?i - S'f On adjacent lots Surface water 1 Length 45ToTAti Width Total absorption area 41 is Depression over field (Y Soil rating 135416,- System type 130..6.4-,FIE404 1 1' ASSJME S- Gravel thickness 3 11- Total depth 45j" to I -401 - Cleanouts present (�D/N) Date of adequacy test Results (efail) (NCI for ()) bedrooms Peroxide treatment (past 12 months) (Yf /� 14/4,,-1A) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot DO On adjacent lots ao Ik Property line 001 To buildingfoundation 1 t/ O ' To existing or abandoned system on lot So On adjacent lots 3' } Cutbank �+- Water main/service line lo 1 Surface water 136wPl\L 4*c 1D-7-89Driveway, parking/vehicle storage area ePOI {- Curtain drain SS I E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Engineer's Name x ' St 12 - Date HAA Fee $ Date of Payment 2-i Receipt Number *-►� _ �x 0 SI. n Waiver Fee. $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I D # cS\ -Oi \ - cD HAA # IPA 1��(� 1 1 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 9; Mock 1; Gateway To The Path Location (address or directions) (b) Property owner Thadi.ub Ktot i.cfii. Telephone : (home) Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent TARGET, INC. Rea.Q.tot4 ATTN: Dick Btown Address 17034 Eag.2e Rivet Loop Road, EagLe Rivet, Ah. 99577 Telephone 694-2388 (e) Mail the HAA to the following address: (or check here a if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 1701A Ea* Rwer Loop Road No 9O4 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single -Family Number of bedrooms .3 3. WATER SUPPLY Individual WeII.B. Community 0 Public 0 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 EXX Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 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 Address Date $ & 5 ENGINEERINO 17034 Eagle River Loop Road No. 204 Eagle giver, AI..kd 995 Telephone S--Zi-j0 . ILL ..4r a yy s .. w • 4 rt A. Shea• , ° Ne. 1457•£ ... ,bKs7 O •°°;°°,a wwna°O' V 6. DHHS APPROVAL '- � oi Approved for 3 bedrooms by A0�/' Date r'/Zi /f1�y 0 Approved �— Disapproved Conditional �� Terms of Conditional Approval CAUTION 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 a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 A. WELL DATA Well Classification 6/ rk) % F Mi L1 MUNICIPALITY OF ANCHORAGE (MOA) F ,NCHth Authority Approval (HAA) SERVICES D(yNKLIST - FEBRUARY 1984 343-4744 MAR 3 0 1990 Legal Description* Lc't `7) £/or (( -1- _.-4,411,0A-4 _.-4Atww-4 T the Pi r /( 5. �. If A, B, C, D.E.C. Approved (Y/N) 044 RECEIVED Well Log Present (Y/N) Li Date Completed 8 -30 - S3 Yield 10. t i IP �o` Total Depth_ Cased to S Depth of Grouting j Static Water Level 3 `8 i Casing Height Above Ground 3Z 11 Electrical Wiring in Conduit (Y/N) I SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot / 00 If" To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Pump Set At Ul( Sanitary Seal on Casing (Y/N) 9 Depression Around Wellhead (Y/N) post • On Adjoining Lots 001 ; On Adjoining Lots / OO it - To Nearest Public Sewer Cleanout/Manhole N//R Water Sample Collected by S S EN iNee$1.46 • Date 3 - 9 0 ►� Water Sample Test Results �A t / �tAC f ft/- AAGterir# ANL /JifQdF IeS Comments B. SEPTIC/HOLDING-3 TANK DATA d Date Installed 7-r' Size / 000 No. of Compartments Z Standpipes (Y/N) 1 Depression over Tank (Y/N) Air -tight Caps (Y/N) h Foundation Cleanout (Y/N) y iNJ Pumping/Maintenance Contact on File (Y/N) /3/A Holding Tank High -Water Alarm (Y/N) N/04 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: Date Last Pumped 3—.z4 —40 ; for N/L4 Temporary Holding Tank Permit (Y/N) To Water -Supply Well To Property Line i et To Building Foundation To Water Main/Service Line 1 �t g� To Disposal Field I To Stream, Pond, Lake or Major Drainage Course Comments .�f ic-�t..K Po fitpe.ci SS '*U)Altier if, jeci6A111 O }-iesfii)lo-z-81 -1 os Cesspool PO &pinli 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata / 3 S `9'/i317 Type of System Design 1A); de LIA-11Jf e.id Date Installed (o - -2_9 - 8 -7 Length of Field Al S ' tufo, / 1 Width of Field Depth of Field . , �s5UN '-ltiwls��Pri 3 Y Gravel Bed Thickness z Square Feet of Absortion Area '/ l (o " Statndpipes Present (Y/N) (1 Depression over Field (Y/N) /0 Date of Last Adequacy Test 3 - / - 9 D Results of Last Adequacy Test _ A ! , S / wC / S (/y 3 QI r eD0 M SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well / Od (t To Property Line 80 ' r To Building Foundation I/ 0 i To Existing or Abandoned System on Lot A JA- ; On Adjoining Lots 30 't To Water Main/Service Line (b / t To Cutback (if present) A/A To Stream, Pond, Lake, or Major Drainage Course E - 8 ,3 (Nl t;v1,10 ) To Driveway, P rking Area, or Vehicle Storage Area / 0 t Comments A /-10V3/ 1 17A CJS G/-4 (-5/-FE W) l -tl-I --D--A 15 3J6D / / - If - e7 . ri j, 41Z1,49/n16 AS R -Er J 1S-0 15 E -1A -A CII - 4-61) Ai7F � Tc. tfr�✓L, R �e-1 a -erg D. LIFT STATION k1 ""' A 2.M. 71 L.&2 r /4 Sd 9 I1 c..-1 c J�fooi r3.-"!:r-ii1D:Z DU` I-rkfr<, G.J/z-R 5r-te2 C-01/150---. Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at N Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effec A G � fiat r.' inspection. Signed S & S ENGINEERING Company 17034 Eagle River Loop Road No. 204 Date Eagle River, Alaska 99577 .:57 y MOA No. C Receipt No. o7 )% a/C / Date of Payment X% - Amount $ /7Z) 72-026 (Rev. 7/88) Back Receipt No Waiver Fee. $ Date of Payment Rfate of this L4 .1‘114- 4•.,,jrN tom/ A. SA.#er No. 145741 .. Poim I kROFESSk h1,��p► Page 2 of 2 MUNICIPALITY OF ANCHORAGE '1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION d 8 toll 06 DIVISION OF ENVIRONMENTAL HEALTH 2 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL g 8-1-.0632 OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) LOT 9, BLOCK 1, GATEWAY ID THE PARK T13N, R1E, SECTION 9 Location (address or directions) MT. KILIAK CIRCLE, EAGLE RIVER AK (b) Applicant Name LORIE CROWDER Telephone: Home NA Business 694-5500 Applicant Address 10928 OLD GLENN HIGHWAY, EAGT F RIVER AK 99577 (c) Applicant is (check one): Lending Institution 0 ; Owner/builder ❑ ; Buyer 0 ; Other Rig (explain) REALTOR (d) Lending Institution THE FIRST NATIONAL BANK OF AN(lephone 694-2103 Address P.O. BOX 770548, EAGLE RIVER AK 99577 ATIN: LITA FIGON (e) Real Estate Company and Agent JACK WHITE COMPANY, =Address-- 1092R OLD GT FNN HTC TWAY, Telephone 694-5500 •_;' (f)Mail_ the HAA to the following address: •FIR PTCKTIP 1W FAGT.F. RTVF.R ENGINEERING SF.RVT('F: . "TYPE OF RESIDENCE Single -Family Multi -Family❑ its moi.= : ,,Number bf Bedrooms ' 3 3._ .WATER SUPPLY Individual Well cm Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite EK 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. 72025 (11/84) Page 1 of 2 a ENGINEERING FIRM PROVIDING 3PECTIONS, TESTS, FILE SEARCH, DAT :ND 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 EAGLE RIVER ENGINEERING SERVICES Telephone 694-5195 Address P.O. BOX 773294, EAGLE RIVER, AK 99577 Date J/ 3/5'7 • 0c')i= - Ettginec�rs`Se`a?'9 so 4H • - -•••O\M•.I •, • �ort LouisA.Butera ?,� s:"... CE -6736 � "MV tJ •. `4%ROFsSOsPk • 6. DHEP APPROVAL` Approved for` / " 3) bedrooms by Approved 4� Disapproved Conditional Terms of Conditional Approval A./O fG /488. CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025111/841 A. WELL DATA yy PF ANCHORAGE (MOA) N,GtPPIIIH y'Rt JTHORITY APPROVAL (HAA) 1P3EN`ftROvPPc 3 1HE�KLIS264-4 20T - UARY 1984 N DLegal Description: �c "/ l ` RECE�v E 7.; rAe- ' If T/34, / s-ec Well Classification #i " / "- t If A, B, C, D.E.C. Approved (Y/N) 't'�`E Well Log Present (Y/N) YIS Date Completed '/ 367/,9- 3 Yield -S --5- o1'.7 TES r60 9/FYI 7 Total Depth S8' ' Cased to 5-8 / Depth of Grouting /i//4 37 ' •9-o-, 7-0- 47F C s' s Pump Set At 4-'r'^ Casing Height Above Ground 3 ca. " Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) /L Separation Distances from Well: To Septic/Holding Tank on Lot /Go ; On Adjoining Lots tloo To Nearest Edge of Absorption Field on Lot 7 -/co / ; On Adjoining Lots ticd' To Nearest Public Sewer Line ilJA To Nearest Public Sewer Cleanout/Manhole ivA To Nearest Sewer Service Line on Lot lei ' Static Water Level Water Sample Collected by —^5,• -veer Water Sample Test Results CO /,' Comments ; Date C..1 7 ^'%. B. SEPTIC/HOLDING TANK DATA Date Installed /5' 7 Standpipes (Y/N) Y Size lot'v 5` / No. of Compartments Air -tight Caps (Y/N) Foundation Cleanout (Y/N) 7 Depression over Tank (Y/N) /✓ Date Last Pumped .f%'^' lv,,s y-� Pumping/Maintenance Contract on File (Y/N) N/' • for N� Holding Tank High -Water Alarm (Y/N) Ni` Temporary Holding Tank Permit (Y/N) ;VA Separation Distances from Septic/Holding Tank: / To Water -Supply Well /6767 / To Building Foundation ,?5 To Property Line % / ' To Disposal Field / 7 To Water Main/Service Line *fo ' To Stream, Pond, Lake, or Major Drainage 8s' bt[s: v''v igna...tsiL (WR8j-058) ic'/+-/8¢ --5.M Course Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 133 4//ssr Date Installed /9S7 Skc Ocfrd 29 Width of Field '- Type of System Design Length of Field Depth of Field S 6 T.d. Gravel Bed Thickness .O.-4 , ,?5 P4./ 7 f / 3% Square Feet of Absorption Area4,46 Standpipes Present (Y/N) Depression over Field (Y/N) /✓ Date of Last Adequacy Test �/c Results of Last Adequacy Test New CC, 'VS , c_fie'' — /14 7es / Separation Distance from Absorption Field: To Water -Supply Well /�O To Property Line Po'' To Building Foundation //6' To Existing or Abandoned System on o/ Lot � � On Adjoining Lots To Water Main/Service Line 7"/0 ' To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course 8 S — 3 [i. , t i To Driveway, Parking Area, or Vehicle Storage Area /1' Comments L.." n)/4 /..✓,rpt//e../ Ay Co.+lsnc%''..- oa.rf..// f. XGA✓rs "err w,/I r.ii's.row, )i. },/visit ,-�a.(c S..»......�. of `t"S c, e,r.s.cecph 64 D. LIFT STATION AA Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments `• Check Permitted Bedroom Rating Against HAA Request ** I certify that I have the ed, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed - Date /47/3 % 7 Company /=/e✓`s -06/-O o/ MOA No / .2 ‘_s -- Receipt S"Receipt No. T Date of Payment /.//3/1 7 Amount: $ ,o g� � Page 2 of 2 72-026 (11/84) Eagle River Engineering Services P. 0. Box 773294 Eagle River, AK 99577 694-5195 ....'"‘VV11%%Vti E` f Ark rineeri S9ar.;- 3, .:-� •.T` *:49TN /_. • ••s••...--1.•-•.� Tf p Louis A. Bufera 4/ ,� 6,c•• CE -6736 1,(7.74/ If1'TFO �••.•.••'�tc�_� Municipaity of Anchorage October 2, 1987 P.O. BC'196650 ANCHORAGE, ALASKA 99519-6650 (907) 343-4200 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Lou Butera, P.E. Eagle River Engineering Services P.O. Box 773294 Eagle River, Alaska 99577 Subject: Lot 9 Block 1 Gateway to the Park Subdivision Waiver Request WR87-058 Dear Mr. Butera: Your request for a waiver of the 100 foot separation required between surface water and the septic system on the subject property has been granted. The required setback to the two streams coursing along the approximate north and south boundaries of the subject lot has been waived to 85 feet. The existing septic tank and absorption field must be relocated from their present positions to meet this 85 foot setback requirement. Your waiver application indicated that due to the location of streams along both property lines, it is not possible to locate a septic system on the lot and meet the 100 foot setback to both streams. A field visit by department staff confirmed that a setback of 85 feet is the maximum distance that can be practically achieved between a septic system and surface water on this lot. This waiver is valid for the existing three bedroom single family dwelling only. This waiver does not apply to future upgrades of the septic system. Sincerely, Step en S. Morris Civil Engineer On-site Services cc Gus Andress, P.E., Manager, On-site/Water Quality EAGLE RIVER ENGINEERING SERVICES Iou Buten, P.H. P.O. Box 773294 Eagle River, Alaska 99577 Telephone (907) 994-5195 September 25, 1987 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 REF: Lot 9, Block 1, Gateway to Dear Mr. Morris: the Park MUNKIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION SEP 2 51987 RECEIVED On behalf of my client, Mrs. Lorie Crowder, I am submitting the information necessary for your determination of a waiver of separation distance, surface water to septic leachfield and tank to 85' and 56' distance respectively. The prospective site for the leachfield has been explored and is located on the attached plot plan. A test hole excavated to 14' depth has shown a soil rating of 138 sq.ft./B.R. which is uniform thru the depth of the test hole. We are proposing a series of trenches located across the slope, as the site topography is unsuitable for bed or drainfield type systems. The proposed trenches would contain a gravel depth of 6' and would be positioned at 7' total depth insulated and covered. Two trenches would be required, each 17.25' long. This would allow the leachfield to be located 86' from the closest point of creek. . 446* 1�.. a /.s�cafe a by R . 4. P. the lot and the original septic As there is existing use system installation was we are faced with obtaining the best compromise solution that is also cost effective for the owner. For this reason we are also asking that the septic tank be allowed to remain in place with the stipulation that the tank be uncovered and couplings be checked and tank lids be sealed. It is my opinion that destroying the tank the would lead to a greater chance polluting the creek during destruction process. Please incorporate in to your decision our phone discussion and field notes taken during your site inspection. If there are any contact me at 694-5195. Sincerely, Louis Butera, P.E. LAB:bls Attachments concerns or questions, please feel free to ` LJA ! /i 1 1 tirl C 00 (SYN SPECIFICATIONS FOR ON-SITE SEPTIC -,YSTEM LEGAL: LOT 9, BLOCK 1, GATEWAY TO THE PARK A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department Of Environmental Conservation require- ments. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified or modified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 7. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. B. TRENCH 1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. 2. The bottom of the trench shall be level, plus or minus 1.5". 3. The total depth of the trench excavation is not to exceed 7' at any point. 4. The sewer line is to replace the existing sewer line that leads to the existing bed. 5. The trench gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachfield. 7. The area over the trench is to be finish graded to prevent ponding of surface water runoff. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = 7' GRAVEL DEPTH = 6' TRENCH LENGTH = 35' TRENCH WIDTH = 30" Soil Rating = 138 Bedroom Capacity = 3 Septic Tank Size = 1000 EXISTING NOTE: SEPTIC SYSTEM TOTAL DEPTH REQUIRES 2" INSULATION OVER TRENCHES AND SEWER LINES WITH 2' SOIL COVER. HORIZONTAL MEASUREMENTS TO CLOSEST POINT OF CREEKS SHOULD BE GREATER THAN 85' DISTANCE. SEPTIC TANK MANHOLES WILL HAVE TO BE UNCOVERED AND SEALED AND CONNECTIONS VERIFIED AT INLET AND OUTLET OF TANK. APPLIC"IT FILLS OUT UPPER HALA ONLY Property Owner (�'' ,�.,-F� 1.1ailing Address` - E \i (1 Z, r: 15 T1llE v: TE2Oftip Code Q" SQ/ Phone 07 • -€5.5k, Buyer trR`-( Na- M i T,f--e- Z / Tem 6E2 C-7 I Cit 2 Zip Code Address C/Q Q 17._ �- . (-..- ie. Lending InstitutionPhone e40&----,-).7-- !//✓/OIJ Zip Code 17 7C--6 sY 3 �. ,FED. Q1kc ,90 Address /.3'A, (--d - Realty Co. & Agent %1(e- 6c.„, H',,7-&-- CU , ‘, y "ZAi Address F+- Code Phone 0777-, fs3 /4 40 -At Legal Description [ 0 / ,GLOC.C� / ,?/f_' �✓ T T/i 4iip.0 Street Locatim "LJfp-E /%ic;LO /iti 77 (S .°P1 f& Type of Residence Single Family 2 ❑ Multiple Family No. of Bedrooms/l (APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE 1 - 3 t - 1 D Other Water Supply ja.Jpdividual ❑ Community ❑ Public Utility ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal ^-?t ❑ Public Utility ❑ Holding Tank Year Individual Installed: i /Q a"" When Comected to Public Utility: Well To Absorption Area (/ 13' Well to Tank / 0 O NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date i` 444 e 0 Inspector (L� Inspector Inspector Inspector'' - r\ , �lllr� l /_ �� Field Notes: C) • U ,11 V - Ls cs-f r1 CJ (APPROVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE 1 - 3 t - 1 'CONDITIONS OF APPROVAL BY: C-3.-4--\ L -C)52.-.-.17-..- Soils Rating 1.)-S Date Sewer Installed i- - 07 3 Well To Absorption Area (/ 13' Well to Tank / 0 O Well Log Received /.�1+&'t—F" t Septic Tank Size 1 0 , O