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HomeMy WebLinkAboutDENALY BLK 1 LT 16Densly Block 1 Lot 16 #067 - 041-22 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP241232 Work Type: Well Initial Tax Code Number: 06704122000 Site Legal Address: DENALY BLK 1 LT 16 G:0363 Site Mailing Address: 7022 KULCHAY CIR, Eagle River Owner: KIRKLAND JARED Design Engineer: This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: 7/31 /2024 7/31 /2025 46204 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well 2 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: ,LJ7 Issued By: Date: Date: 3, 2 " rd ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. Cy' Property owner(s) __)Orec� Day phone Mailing address 7C'-;'Z2 Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 9 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) 1.4 Absorption Field F-1 Initial CA Single Family (SF) (E9 (w/wo ADU) Septic Tank D Upgrade 0 Duplex (D) D Holding Tank D Renewal D Multiple Dwellings El Privy F-1 L__j (SF and/or D) Private Well ❑ Water Storage A I? 12Co 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. nature of property owner or authorized agent) ejol -7 -,?S� — Permit/Rush Fees:-# 05 Date of Payment: Y_ ! !� -1 L Receipt Number: 016q'B-6 Permit No. "r) S P z y I Z3L Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsCient FormsTermit Application.doc _SL. Municipality Anchorage r� y;tt 1- iv of ; Development Services Department 5 Building Safety Division ;',,, Onsite Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 Page www.cLanchorage.ak.us (907)343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW010216 PID Number. 067.041.22 of Name: The Petersen Group Wastewater System: 0 New ❑ Upgrade Address: 3820 Lake Otis Pkwy #204. Anchorage. AK 99508 ABSORPTION FIELD Number Bedrooms: tg71562.117Q ODeep Trench 8Shalow bench DBed OMound DOew. (y04 (90 LEGAL DESCRIPTION Sod Raing: 0.8 GPDIFI' Total Depth Iran angnm grade: 3.80 FI. Stock: Lot Swdmuon: 1 16 Denaly Depth to pipe bottom Iran orQnal grade: 0.6 Ft. Grave depth beneath pp: 3.20 FI. Townwp: Range: Secpan: Fa added above angnm grade: 2.75 Ft. Gravel Length: 94 FI. Well: 0 New CI Upgrade Gave amdet 5 FI. Mune ares: Drumm between ries: 1 NA Ft Clawhcabon (Peva. A. B. C): Private Total Depth: 145 FL Cased to: 145 FL 7O119 abrwpbon Sea: 810 Fr Pp Material: 03034 & F810 Dew: Harper Dee Drilled: 1011612001 slabs Water Leve: +2 FL Mums: Kincaid & Son Const., Inc Data Installed: 7/2512001 Yield. 4 GPM Pump Set at unknown Ft. C.samg height Above Grand: 1.5 FL TANK SEPARATION DISTANCES ® Septic 0 Holding • S.T.E.P. 0 Other. To From Septic Tank Absorption Feld Litt Station Holding Tank Public/Private Sewer Line Manufacture': Anchorage Tank Capitols. 1250 Gr. w« 1001+ 100'+ NA NA 25'+ Maternal: Steel Number of Dampe iemM. 2 Surtax Water 100'+ 100'+ NA NA LIFT STATION / La Line 5'+ 10'+ NA NA Sua. Gm. Manufacturer. Foadatbn 5'+ 1Q'+ NA NA •Pump chi level .t • 'Pumpotr . ac M. High wale mann at M. CotM Drain NA *501+ NA NA Pump 1i18Fs - "' Enamel Mepectiena pedemmed bs. Remarks: •noneknown BENCH MARK Location and Deaapbon. Door sill Assumed Lavation: 100 FL Engineer's Stamp a•CE OF 4--4 1 ....t.,'eeMee e�..e 1 „ 1. '%.911 j * f L y t * Po Sit eche =" •e 0 if Inspections performed by: KND Engineering Dates: 1M 7/2512001 2nd 7126101 Development Services Department ApprovT IZ/10/o( ,/ Reviewed and approved by: ii� �t cam/ Date: 12'/.1 - / �, Kenneth AL Du ir ,, j. -% CP 7116 cites% +49 t y +moose;...... ansa+sP law. )tido, AS -BUILT SYSTEM DETAILS/SITE PLAN Pernit SW010216 DENALY S/D, LOT 16, BLOCK 1 PID#067-041-22 I UJ Jr ARES v4. KND 6 46, 04 SF 1.06 ACRES A NT 99-21A GAL C TANK A -C= 29.6' B -C= 50.3' A -D= 31.6' B -D= 44.0' A-E= 52.4' B-E= 87.0' A -F= 75.4' B -F= 50.7' g �� G,',/ h' i SCALE, 1' = 50' VACANT FINAL GRADE ILK* 44441C\ 15 R0 074 1250 GAL _".. SEPTIC C TANK 11=11-11-II-tI-II �I I' I: SEWER ROCK Adres 9F 449S• i II—II—II—Ih11-11011— —1 11 11 !I—II—II—"-11-11 11-11—II—II—I 94' PREPARED FOR: PETERSON GROUP 3820 LAKE OTIS PKWY W204 ANCHORAGE, AK. 99508 (907) 562-1170 . KENN - H N. DU CE -7116 FIELD BOOKS eawrze . •,t bl'ESS10N1•‘' CASTALDI ACD` 01064.DWG KMD 11/21/01 °M1tr SW362 J08 01064 SCALE' NTS TEND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 FROM : ALPINE DRILLING FAX N0. : 907 345 0202 Dec. 11 2001 10:48AM P1 Municipality of Anchorage Department of Health and Human Services 825 V Street P.O. Box 198850 Anchorage, Alaska 99519-6650 Rick Mystrom httpJM+nw.ci anchorage.akus Mayor Permit Number. #SW 010365 Date of Issue: 9-11-01 Parcel Identification Number. 017-443-03 Date Started: 10-15-01 Date Completed: 10-16-01 Is well located at approved permit location? ® Yes ❑ No Legal Description: penaly Blk 1 Lot 16 Property Owner Name & Address: The Petersen Group 3820 Lake Otis Pkwy #204 Anchorage, Ak 99508 Borehole Data: Depth (ft) Soil Type. Thiclmess & Wata Strata From To stick-up gravelly cobbly silt w/bldrs silt gravelly silt H2O gravelly silt silty sandy gravel H2O gravelly silt silt 0 2 2 49 49 55 55 60 60 85 85 90 90 101 101 145 Method of DriIIing ® air rotary 0 cable tool Casing type: steel Wall Thickness:.025 inches Diameter: 6 inches Depth: 145 feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): + feet Pumping level: 100 feet after 2 hours pumping 4 gpm Recovery Rate: 4 gpm Method of Testing: airlift Well Intake Opening Type: ❑ Open End Open lick El Screened Start feet Stopped feet ® Perforations Start 85 feet Stopped 9Q feet Grout Type:ement Volume: ,►00 + gal Depth: Start Q feet Stopped 60 feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? (31 Yes 0 No Method of Disinfection: Clorine Tablets Comments: Well Driller. Alpine Dulling & Enterprises P O Box 110496 Anchorage AK 99511 Attention: The well drilla shall provide a well log to the property owner within 30 days of completion and the property owner or the. Anller Owl! n nine' In • well Inn to the f n.t of rr.elth b TT,nnen Pm/inn writhe. 4.1) dove of.n.nnla on MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 .-7/ZS-/D 7/2/i- $''�& ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW010216 r Legal Description: Denaly Block 1 Lot 16 Design Engineer: 0070 KND Engineering Owner Name: The Petersen Group Owner Address: 3820 Lake Otis Pkwy #204 Anchorage , AK 99508 - Date Issued: Jun 29, 2001 Expiration Date: Jun 29, 2002 Parcel ID: 067-041-22 Site Address: NHN Kulchay Cir Lot Size: 46269 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: Q✓ Disposal Field Q✓ Septic Tank ❑ Holding Tank ❑ Privy E✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. ' 1.) PRIOR TO CONSTRUCTING THE WATER WELL. THE WELL DRILLER SHALL SUBMIT A DRILLING PLAN • TO THIS OFFICE. THIS PLAN SHALL SHOW HOW THE WELL CONSRTUCTION WILL PREVENT ALL LEAKING ` THROUGH THE CASING ANNULUS FROM THE CONFINED AQUIFER. 2.) AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM AN ADDITIONAL PERCOLATION TEST AT THE WEST END OF THE PROPOSED ABSORPTION FIELDS. Received By: Issued By: L/ (r Date: (-2"-ol fdt>tr Date: 6- 2 9-0/ • Parcel I.D. 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Property owner(s) The Petersen Grow (Bob Petersen) Mailing address (1) 3820 Lake Otis Pkwy #204. Anchorage. AK 99508 Permit Number SW O / 02 /6 Day phone 562-1170 sac. Meiling -address (2) jJ t-&rJJ ku (k . 1 Legal description (Lot, Block & Sub'd.) Denaly S/D, B1. L16 Zip Code Legal description (Section, Township & Range) Lot Size 46,269 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Acres/Sq.Ft. Number of Bedrooms 4 Well Only Water Storage Jacuzzi Water Softening Unit 0 0 0 0 certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: WO Waiver Fees: Date of Payment: Receipt Number: Date of Payment: [96//3// Receipt Number: S5Z—t— (Rev.12/00) KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907) 696-6111/FAX (907) 696-8111 October 4, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Design Modification SW010216 — Denaly Lot 16, Block 1 Gentlemen: Per septic system modification discussions with DSD this past July 2001, please find the attached redesigned septic system as -built and corresponding soils. Due to topography of the proposed well location, the owner has requested that the proposed well be relocated. We do not expect there to be any adverse effect on adjacent Tots by the new proposed well location, as shown on the attached as -built. All other items on the previous request will remain the same. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, INND Engineering dale „op Kenneth M. Duffus, P.E. Attachments: As noted 103 .)r A AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW010216 DENALY S/D, LOT 16, BLOCK 1 PID11067-041-22 vi3/4 RES A -C= 29.6' B -C= 50.3' A -D= 31.6' B -D= 44.0' A-E= 52.4' B-E= 87.0' A -F= 75.4' B -F= 50.7' 9.65' govia zi 98.4 ILRK IAMK\ FINAL GRADE 15 RQ Q74 85 098.19 ri 11 YYKf 10250 GAL _ 111 is SEPTIC it.1i: �94.8� 94.8 LI II: TANK i ta SEVER ROCK 11-11-II—II-11-1 I: j 1 u 4110Mtai0 95.4J 91.64 t -8-1'-eg-8-u--u-8-8-8-.K-11=u=a-11-8. =i g-nii-il1�:� 084.0 ) ICH CE -7116 94' PREPARED FOR: PETERSON GROUP 3820 LAKE OTIS PKWY 11204 ANCHORAGE. AK. 99508 (907) 562-1170 SCALE: NTS FIELD BOOKS COWIRO: lawn.' GASTALDI DK -1 V8G PAK GASTALDI ocam K140 ABY: GASTALDI O.C. MU: OAR 10/4/01 IN ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 p°° SW362 Atha r" 01064.DWG JOB is.' 01064 • ................... (907)696-6111/FAX (907)696-8111 ]K ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Performed for. Project Depth SOILS PERCOLATION TEST Petersen Group I erect OFol Chi ..•3 .a•-• • . J'SCE 7116 legFo..•ti 4� 40' Date Performed: 07/18/01 Denaly S/D, Block 1, Lot 16 Org – soft, brown, moist loam - SP– brown gravely sand, moist, minute trace of silt 9--'— ' Seeps ML -wet, silty clay 10- ''Tt 11 r.. t t F.I B.O.H. 12- 13- 14- 15- 16- 17- 18- 19- 20- PRIOR TO TEST HOLE PRESOAKED TEST HOLE # 01-1 SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? YES Depth to water after monitoring? 8.5' What depth? 9' Date? 07/27/01 Reading Date Gross Time Net Time Depth to Water Net Drop 1 7/20/01 1:00 - 6" - 2 1:10 10 min 309/16" 27/16" 3• 1:11 - 6" - 4 1:21 10 min 312/16" 24/16" 5• 1:22 - 6" - 6 1:32 l0 min 315/16" 21/16" 7• 1:33 - 6" - 8 1:43 10 min 315/16" 21/16" 9 • 1:44 - 6" - 10 1:54 10 min 4" 2" 11• 1:55 - 6" - 12 2:05 10 min 4" 2" • Water Added Percolation Rate 5.0 (min/in) Perc Hole Diameter 6" Test Run Between 3 feet and 4 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. 1KbV D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AIC 99577-8736 OF AL i�8 /* /.. L e•..• •••.•w 0000000 ••• • ••N .t K•n.:o., M.......11V ( �4' t CE 7116 , est ' . .•• k..n ,f �• k►� pAOFESSI�00000 a�r_ Date Performed: 07/18/01 Vta��". Performed for: Project Depth 8- 9- 10- 11 r^` ' B.O.H. 12- 13- 14- 15- 16- 17- 18- 19 - HOLE PRESOAKED 20- PRIOR TO TEST SOILS PERCOLATION TEST Petersen Group Denaly S/D, Block 1, Lot 16 Org — soft, brown, moist loam - SP — gravely sand, dry, minute trace of silt, boulders to 2.5' seeps ML - wet, silty clay TEST HOLE # 01-2 SEE ATTACHED SITE PLAN FOR HOLE LOCATION LWas Ground water encountered? YES Depth to water after monitoring? DRY What depth? 9' Date? 07/27/01 Reading Date Gross Time Net Time Depth to Water Net Drop 1 7/20/01 1:15 - 68/16" - 2 1:25 10 min 312/16" 212/16" 3• 1:26 - 68/16" - 4 F36 10 min 314/16" 210/16" 5• 1:37 - 68/16" - 6 1:47 10 min 41/16" 27/16" 7• 1:48 - 68/16" - 8 1:58 10 min 45/16" 23/16" 9• 1:59 - 68/16" - 10 2:09 10 min 46/16" 22/16" 11• 210 - 68/16" - 12 2:20 10 min 46/16" 22/16" • Water Added Percolation Rate 4.71 , (min/in) Perc Hole Diameter 6" Test Run Between 2.5 feet and 3.5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 June 13, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: New sewer & well permit — Denaly S/D, Block 1, Lot 16 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On April 23, 1999 we dug one testhole for the proposed system. The results of this test are attached. The general slope of this lot is from northeast to southwest at a grade of approximately 8 - 15%. An individual well will serve the lot. We propose to install a 5' wide shallow trench for the proposed 4 -bedroom house. Water was not encountered during the excavation, but water was present and monitored at 13.5' on May 15, 1999. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, IKND Engineering Kenneth M. Duffus, P.E. Attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN DENALY S/D, LOT 16, BLOCK 1 8 D 42,17 163 S 0.97 ACR 11/sob1 og 11, • • L28 VACANT 14 60,692 SF 1.39 ACRES VACANT 15 59.924 SF 1.38 ACRES NO PUKIC YELLS VITHIN 200' IT PROPOSED SYSTEM. NO PRIVATE WELLS VITHIN 200' OF PRCPoSCD SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS VITHIN 200' K PRCPoSCD VELL EXCEPT AS MOTE& A, (SC' • • •.9L`?S / AP' . KENNETn w. L CE -7118 .41410 i'iti!'TSSIONNV DESIGN DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/.8 GPD PER SO. FT. (11.4 MIN/IN.)= 750 SO. FT (750/5'(W)) X .5(RF) (4.0' GRAVEL) = 75.0 FT. TRENCH USE 1 TRENCH - 75 CO X 5' (W) X 4.0'(D) Total depth of system is 7.0' From original grade. Total depth of gravel below distribution pipe is 4.0' NOTES: 1. CONTRACTOR TO USE 1250 GALLON SEPTIC TANK AND INSULATE TANK IF (4' COVER. 2. INSULATE TRENCH WITH 2' HD BURIAL FOAM. 3. CONTRACTOR WILL ENSURE MINIMUM 27. SLOPE INTO SEPTIC TANK. 4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE MIN. 3' COVER IF REQUIRED. 5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS 6 SEPTICS. PREPARED FOR: PETERSON GROUP 3820 LAKE OTIS PKWY *204 ANCHORAGE, AK. 99508 (907) 562-1170 Scale: 1'= 100' PAGE 1 OF 2 1IEL0 BOOKS COVPuTEO: IOiR'D"R" CASTALDI CASTALDI CASTALDI D.c ALL STAICMa A$&RT: AERO r"' 01064.OWC OAA.: VBG O" C31E° KMD DATA 6/13/01 DRO SW362 'DR nc" 01064 LEND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)698-8111/FAX (907)898-8111 WASTEWATER DISPOSAL SYSTEM DETAILS DENALY S/D, LOT 16, BLOCK 1 PROPOS SEPTIC TA #99-21A A 4'. 917.440 KENNETH M. DU ', CE -7116 E»PofESS1oN1woihh,Ncgi' PREPARED FOR: PETERSON GROUP 3820 LAKE OTIS PKWY 11204 ANCHORAGE, AK. 99508 (907) 562-1170 Scale: 1'= 20' PAGE 2 OF 2 ►nELO BOOKS ca+uao: sonar. GASTAI DI CRAM: VBG Soma GASTALDI Ocacco: KMD ASBua4 GASTALDI OAR: 6/13/01 LEND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 PC Mt uKe 5W362 A°'O'u` 01064.DWG J0B "" 01064 (907)696-6111/FAX (907)696-8111 • D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for. The Petersen Group Project: Denaly Block 1, Lot 16 SM - medium dense, brown, silty, gray, gravelly sand w/ cobbles, moist 20 - +�EOFA� 11 if ,,,.«e...e, qs, /l ice, ;91� 9L •••/ r .. ✓1• r NN e.M C• Kenneth M. Duffy id01 i CE 7116 4.44", lit .0 Date Performed: 4/23/99 TEST HOLE ft 99-21A SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? NO Depth to water after monitoring? 13S What depth? N/A Date? 5/15/99 Reading Date Gross Time Net Time Depth to Water Net Drop 1 4/27/99 4:00 - 8" - 2 4:30 30 min 5 1/16" 2 15/16" 3• 4:31 - 8" - 4 5:01 30 min 5 6/16" 210/16" 5• 5:32 - 8" - 6 5:33 30 min 5 6/16" 210/16" • Water Added Percolation Rate 11.4 (min/in Perc hole Diameter 6" Test Run Between 3.5 feet and 4.5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. FROM : REPINE DRILLING 10-7-01 Dan Roth MOA Development Services Department .7t4 -753i? Re: Denai Block I Lot 16 FAX NO. : 907 345 0202 Oct. 07 2001 08:22PM P1 Dan, this is in response to the permit requirement as to stoppage of the artesian effect of the wells in this particular subdivision and our construction method to prevent this. We propose the standard approach of dulling a larger diameter casing to the established silt layer and proceeding with the boring from that point to a depth of twenty feet into the silt layer open hole. At this . point the standard six inch well would then be started and completed • .The area bettweeathe six . inch and larger casing and borehole would then be grouted and the larger casing would be • permanently left in place. Also, the six inch well would be installed without the use of a standard driveshoe. In its place would be a shoe the same diameter of the well racing so as to not have an. annular space outside the casing. • . Please reply as to your thoughts and position on this approach. We have used this 0 times and it has served us well each time. David L. Harper Alpine Dnlhing & Enterprises PO Box 110496 ABcj»rage, Alaska 99511 $ Jaz 907-345-0202 VrMaid:dttiaFpern cOalaska-co lq- r` � m CII) cY) LU U C L V a_ 0 0 0 P� z LL0(y p;l F— � O O ®w1 U E U)® L L o� N U C6 •L > U) 00 -m© O Ln 2 cn Y _O > U LL 70 O C: Q U O m Q. Q Q L L Z (D O Y N w O � 2 U ¢ O LU r a 0 0 0 NCLO m CL 3 V N O rn LO N G ` N O cn O N O Q s C\jO d LO E 0 N U o L O m D � O = N >:3`% c0 U) O Q cuO 'a _ N O O Q N `�L. U N C rL Q O 7rZ"= O a) _Q O cu d U) � r—o U N CO 0 +'O+ N W LO E N +'^r VJ m 0')Qi .L a O / V/ C >+ J O U)O ++ � Q O 3 °' Q 'c; N U E ,_, N U O O M N O L O L p O O o rL CL d 0 CO E ca Q -0 Q Q O N O N W 0- U JCU Z N i O L 0)0 cuca N J i o O U m a Q U) } = W E > C) J U a a) O Q N c OZ r O Od w Y m o Q L d N cn c N O O > 4, O N o 4; cC p C O O ~ 0 NCD N ZZ � 0 L U ,� U O cu d o N N 4' Q U) N (n co I I N N v L v L a 0)/\ 0 m L N a i.i a cn v U -m© O Ln 2 cn Y _O > U LL 70 O C: Q U O m Q. Q Q L L Z (D O Y N w O � 2 U ¢ O LU r a LLI C: M Oil -C 0 z l< LL ui can= 0 0 C: = (1) L) E u(')) Im= - M Q) z Cu M C.) cz c 0 4 - co 0 O U) E (1) 4— U) U) U) (L 0 4- 0 z 0 0 LL z uj z A RIE 0 (n cn CU O LL L) C: 0 C) 0 U) cu F, 0 CO z 0— LU U) M, El 27!� ,IN O cn O m 6s a) N LL 0 0 rdw U) 0 0 0- 0 0) E O cn CN 0) U) 0 C: cz 2: IL QJ Li .0 m + 2: CO 5-- 0 0 LL Nui U) U) 2 LLI U) U) nL 0 cu .�: co L— IL Z Cl) w ul 2! U) —a) co U) (1) co U) 0 CL Wa III U) LLJ LL 0 LL 0 cn LLJ ui 0 CL a. F- N Ch .4 0 (n cn CU O LL L) C: 0 C) 0 U) cu F, 0 CO z 0— LU U) M, El 27!� ,IN O cn O m 6s a) N LL 0 0 rdw U) 0 0 COSA Checklist.docx COSA Checklist Legal Description: DENALY BLOCK 1, LOT 16 Parcel ID: 067-041-22 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 10/16/2001 Total depth 145 ft Cased to 145 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA *4/25/24 Static water level at beginning of test *0 ft. Well production at time of test *2.7 gpm Water storage tank volume *500+ gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.564 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 4/24/24 Comments *Sullivan installed artesian plug, inspected water storage system & conducted well flow – see report. B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 4/24/2024 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/25/2001 ALL standpipes present per record drawing Total measured depth from grade 7.3 ft (max) Measured depth to pipe invert from grade 4.1 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 4/25/2024 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 1 in Elapsed time <5 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 38 in (MOA 3.2’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 38 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.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 ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 5/1/2024 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 & 5/1/24 Date: 4/25/24 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259. Brent Western 7022 Kulchay Cir, Eagle River FLOW TEST REPORT Static: 0’ GPM: 2.7 DRAW-DOWN: 72.1’ KI O 0) Q ++ O c/ I Gi CC fu C O M M s- 0 xC c M O 4— O Q1 LL O O C) 4 ru PJA � U 4— aJ a) U OJ > p U a aJ 4� W aJ O E ms - Q •� N OmQ O U L Q a) L N •�r�S O 0 o m > m o O lD a Q O N N > w E r -I O O NU vii aJ _Ile CID © i a41 a -J j. U O in cn 4A _C CID"' =j Ln Nm t �' Ma) a) a) N +) LU U m v N O u S Lnw �LU 0 v � � v E F-@�;° o N i w O 410 0 U aO+ Ln a. mU 0 i F > C N a) U _0 fD > N a) +-Ln O O 3 U cn f— C F— Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 06V-041-22 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent DENALY; BLOCK 1, LOT 16 Expiration Date: Lp ! "( - / 3 7022 KULCHAY CIRCLE *CHUGIAK, AK 99567 DUSTIN & MICHELLE ENGELKEN Day phone 913-636-4332 GINGER GRAHAM W/ KELLER WILLIAMS 2. TYPE OF DWELLING: NI Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System • 4 Day phone 696-6625 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer Received by: COSA to he released to the engineer, unless otherwise requested by the engineer. Date: COSAFee$ gal Date of Payment shah 3 civa. 0-3-7 C\ Receipt Number CosA # CcvL 1316 °I Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, t 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E.Date Vold Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 6. DSD, ------- SD SIGNATURE l�/System #1 Approved for / bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: fir I A. -.. d0 7 Yrrofessiosoo Ass` tu•( OF tg ycWir ON-SITE g -R WATER AND zc: o WASTEWATER o; tet, :71::S: � o The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other Original Certificate'D`ate: 3 ! s/3 If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: DENALY; BLOCK 1, LOT 16 Parcel ID: 067-041-22 ARTESIAN WELL FLOWS BY GRAVITY TO BLADDER STORAGE TANK IN CRAWIL SPACE. A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 10/16/01 Sanitary seal (Y/N) YES Total depth 145 ft. Cased to 145 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 10/16/01 3////i 3 //�� Static water level 2+ ft /"v 4 c,5 i f v rZ. ft. Well production 4 g.p.m. 2 . 1 0 g.p.m. WATER SAMPLE RESULTS: LITESTED BY SULLIVANL WATER WELL. Coliform 0 colonies/100 ml. Nitrate 40 mg /L. Collected by: GEG Ltd. Arsenic: /Mt ug /L Date of sample: 2/28/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/25-12/10/01 Tank size 1250 gal Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 6/25/12 Pumper C. ABSORPTION FIELD DATA Date installed 7/25-12/10/01 Soil rating (g.p.d./ftio4/bdrL0.8 JRS PUMPING *BELOW EXISTING GRADE System type SHALLOW TRENCH Length 94 ft. Width 5 ft. Gravel below pipe 3.20 ft. Total depth *7.54 ft. Eff. absorption area 810 ft2 Monitoring tube YES Depression over field NO Date of adequacy test **3/5/13 Results (Pass/Fail) PASS Fluid depth in absorption field before test 0 in. Water added 640 gal For 4 bedrooms New depth 2 in. Elapsed Time: 1 170 min. Final fluid depth E in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date **PRE—SOAKED WITH 2005 GALLONS OF WATER ON 3/4/13. D. LIFT STATION Date installed "Pump on" level at Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Size in gallons in "Pump off' level Cycles tested Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line a5 't Animal containment areas 50'+ Manhole/Access (Y/N High water alarm level at in Meets alarm & circuit requirements? On adjacent lots loot On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line Water main N/A Wells on adjacent lots 100'+ Water service line 5'+ Absorption field 5'+ 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN F. COMMENTS Building foundation 10'+ Water main N/A Surface water 100'+ Wells on adjacent lots 100'+ Driveway, parking/vehicle storage 10'+ G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Pdn d ame JEFFREY A. GARNESS Date 3 /i I'3 (Rev. 11/05) C' ss' — yr iI •e caq 14-0 • „fie •e .ASBUILT HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED, IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SJBDI VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. 4 SEWARD & ASSOCIATES LAND SURVEYING 694-0829 SCALE: f✓ /Yo DATE 7✓3a�F� GRID; .rdir -Ski AWN Mar 11 13 01:57p Sullivan Water Wells 907 688 2759 p.2 Ogg H1LL 8c COLE V V PHONE DATE OF ORDER ULLIVANE WATER WELLS ORDER TAKEN BY CUSTOMER'S ORDER NO. P.O. Box 670269, Chugiak, AK 99567 688-2759 ( DAY WORK ( }CONTRACT ( EXTRA TO' ,C A0 5 c1„ fre:eA vt c GIC r rc 49 LTO JOB NAMEMUMBER 3101 6, ¶I ,or 5c IDI JOB LOCATION 7o �c / 1` C 'CJC TERMS: A v on c_ �-r/ q9 601 JOB PHONE STA9J QTY. DESCRIPTION OF WORK PRICE AMOUNT — 1 t\.6 Well 14 Ckc.-Y-- C rieV j 40 — W0.tef Peod Re'hA N. tiv lnou.5r 15 • (o GP» 16 c -k ek- --k,\5 }nu1-r — nvcc +ke wd d w&es�e�iyr j�uw� 'Apt-kr'Apt-kr+tr (9e'wtr p}rl,5;1 f , — 1,0 wt\k ftcookri ;s a,lo GRA'►, .- 5 « viv revyki ,,L i w %ifwL for 50in't k 1-6 Mat( Th5ffiv‘ ctJ, 11,cAAse 15c/ coert I L- cii ,----"2. Work ordered by e5 DATE COMPLETED e5._ 1 i _ 12, ' 1 / Signature I hereby acknowledge the satisfactory completion of the above described wodc. 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. I AP4-0-11- 29- 1. GENERAL INFORMATION Complete legal description DENALY, BLOCK 1, LOT 16 COSA# U 3 D U I cp C� Expiration Date: 3 - g - 0 1 Location (site address) 7022 KULCHAY CIRCLE • EAGLE RIVER, AK 99577 Current Property owner(s) ERIC ESPE Day phone 263-4163 Mailing address 7022 KULCHAY CIRCLE • EAGLE RIVER, AK 99577 Lending agency Day phone Mailing address Real Estate Agent BARBARA CRITTENDEN w/PRUDENTAIL JACK WHITE Day phone 689-1802 Mailing address 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: • Individual On-site ❑ Individual Holding tank ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER 5. 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 GARNESS ENGINEERING GROUP. Ltd. Address 3701 E. TUDOR ROAD. SUITE 101 $ ANCHORAGE, AI< 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the solo benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. Phone 337-6179 Date 12(3[0`3 00 0 ss; Q CE -79,53 F�� 08••'..q�o OrO •ssl000� 1�L,`t(WfoFf f/C,/���. ONSITE WATER AND : E WASTEWATER : bedrooms, with the fllowing stipulatiofi s: PRDGRAM:•�r ' • .. ...•.'• A1\ 1111)1))))))) Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other (Rn. 11,05 Original Certificate Date* A. 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.munl.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: DENALY, BLOCK 1, LOT 16 Parcel ID: n67- 04/-,22. WELL DATA Well type PRNATE Date completed 10/16/2001 Sanitary seal (YIN) YES Total depth 145 ft • Cased to 145 ft FROM WELL LOG AT INSPECTION Date of test 10/16/2001 6/25/2008 Static water level +2 ft +2 ft 4 g p m 2.14 g.p.m. If A, B, or C provide PWSID# N/A Well Log (YIN) Wires properly protected (YIN) Casing height (above ground) Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: NO ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 6/23/2008 Pumper Nitrate 0 37Eng./L. Date of sample: 11/19/08 C. ABSORPTION FIELD DATA Date installed 7/25/2001 Length 94 ft YES YES 36 in Other bacteria 0 colonies/100 ml. Collected by: Date installed GEG Ltd. 7/25/2001 Cleanouts (Y/N) High water alarm (Y/N) JR'S PUMPING YES N/A I'6ELOW EXISTING GRADE' Soil rating .d./ft r ft'/bdrm) 0_8 Width 5 ft Total depth •7.16 ft Eff. absorption area 810 ft2 Date of adequacy test 6/25/2008 System type 5—WIDE Gravel below pipe 3.20 ft. Monitoring tube YES Results (Pass/Fail) PASS Fluid depth in absorption field before test DRY in. Water added 600 gal. Elapsed Time: 0 min. Final fluid depth DRY in. Any rejuvenation treatment (past 12 mo.) (WN & type) Depression over field NO For 4 bedrooms New depth DRY in Absorption rate 600+ g p d. NONE KNOWN If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off" level Datu Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main 100'+ 100'+ N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Manhole/Access (Y/N High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent Tots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main N/A Property line 5'+ Water service line 10'+ Absorption field 5'+ Surface water 100'+ Wells on adjacent Tots - 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main Water service fine 10'+ Curtain drain NONE KNOWN F. COMMENTS G. ENGINEER'S CERTIFICATION N/A Surface water 100'+ Driveway, parking/vehicle storage 10'+ Wells on adjacent lots 100'+ 1 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 JEFFREY A. GARNESS Date 17-)11016 s000 0 vA y"A..JYarness. 0 CE -79 3 ta- •tZ/3.1o$'cA`v ed P ro l e aaioIN6 040000;� COSA Fee' I SOja Date of Payment 1 a I i' oz b elg83o'- Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number - - •� r CJSi., •-• r. ..7 F.6• • .44 ASBUILT ee Ve • 44.4 ee /, ri s J H SEWARD F4 ASSOCIATES LAND SURVEYING 694-0829 I HEP.EBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: a:rGf� f&4 co: / • AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT 1S THE RESPONSIBILITY OF THE OWNER. TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BDUND- ARY LINES. SCALE:, /C'so DATE. GRID: ;6f FB: //7z6 DRAWN: 0,:„..e..711.14. %, EOF A( ,;% • r � • •7 /! %. • ppxlnano. -S0 is . 18 •-..Er SG9 SGS WEN Client Name Project Name/ti Client Sample ID Matrix P%S SID 1086342001 Garness Engineering Group, Ltd. Denaly 131 L16 Denaly 131 L16 Drinking Water 0 Printed Date/Time Collected Date/Time Received Date/time Technical Director 12/032008 11:27 11/19/2008 8:50 11/19/2008 13:14 Stephen C. Ede Sample Remarks: Parameter Results PQL Units Mcthod Allowable Prep Analysis Container ID Limits Date Date Init Metals by ICP/ASS Arsenic Waters Department Total Nitmtc/Nitrite-N Microbiology Laboratory Colony Count Total Coliform Fecal Coliform ND 5.00 ug/L EP200.8 C (<10) 12/01/08 12/02/08 NRB 0.326 0.100 mg/1, Sh1204500NO3-F B (<10) 0 0 0 col/100mL SM20 92226 col/100mL SM20 922213 co1/100mL SM20 922213 A A A (<200) (<1) (<1) 11/20/08 1DZ 11/19/08 DS11 11/19/08 DS11 11/19/08 DS11 :2111 07/02/2008 12:14 9073449821 a••■ JRs Pumping PO Box 773415 Eagle River, AK 99577 (907)694-6454 [Billing Information Eric Espe 7022 Kuichay Circle Eagle River, AK 99577 (907) 6224390 Job Site Information JRS SEPTIC Job Description: 1250g P.O. Number. Terme: Net 30 Salesrap: Kadia Map Book: Cron Streets: Denania Drive Eric Job Comments: 7022 Kulchay Circle Eagle River, AK 99577 (907) 6224390 PAGE 01 Service Agreement Number. 026200 Order Date: 12 -Jun -2008 Service Date: 23 -Jun -2008 12:00 Technician: Mike Tax %: 0 Job Type Repeat Map Grid: t34- . Last Sery *07/15/2007• 1250g pumped & checked tank Additional Location Comments Diagram: 5 iDlaaramM10223 bmp Gray w/ white trim, its beside garage door- hard to see, steep dw Pipes 1 -by side of the house - Rest are back of Home Service Type Septic Service 15K Fuel Surcharge H e.. Qty Price Each 1 30.00 1 30.00 DM .t. Tax? No No Gallons Planned: 1250 Gal. Actual: Hose Length: 3.5 Double Tank: 0 Pump System: E Baffles Inlet: 0 Baffles Outlet 0 Extension Actual 30.00 30.00 Estimated Charges: Actual Charges: NonTaxable Total Taxable Total Tax Total Grand Total Customer agrees to Me twine end conditions shown. THIS ISA BINDING AGREEMENT. Signature and Dila or Customer Representative Date Accepted by JRs Pumping Data Accepted For your added convenience we accept: American Express. Dleover, Visa and Master Card payments over the phone. Amer 30 Days account will be tumed over to COLLECTIONS. 530.00 For NSF Checks Returned. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. (907) 343-7904 4.77/ P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us ��'""�i CERTIFICATE OF HEALTH AUTHORITY APPROVAL /VT / FOR A SINGLE FAMILY DWELLING HAA # 0/6 ‘3ln Expiration Date: 3 — / & - O2. Parcel I.D. 067-041-22 1. GENERAL INFORMATION Complete legal description DENALY SID,BLOCK 1. LOT 16 Location (site address or directions) NHN KULCHAY CIRCLE. EAGLE RIVER. AK 99577 Current Property owner(s) THE PETERSEN GROUP Day phone (9071562.1170 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 3820 LAKE OTIS PRKWY. ANCHORAGE. AK 99508 Day phone Day phone Unless otherwise requested, HAA 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 4 TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site 0 ❑ 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 5 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 less than 30 days old. (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 KND Engineering Address 20441 Ptarmigan Blvd. Eagle River. AK. 99577 Engineer's Printed Name Kennth M. Duffus 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. Phone 696-6111 Date 12/12/01 -Is OF 41 .40 111 •30 .4ATN / a co •.V tIGINEER S �: Kennm:vd.:J. i,- f, o �•°• d m • a 71 1 s ✓ r� � . e � d bedrooms, with the following stipulations: Additional Comments k�\qY OF 4g7 ��,�. SITE— : 'c ; WATER AND . YI'1J 1 L,,ll, 4d s ' PROGRAM _ • `z .., US ^= • • JS� "��j, ivi N 1S111���V Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other (Rev. 12/00) Original Certificate Date: / 2 - / a - 0 / 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: DENALY, BLOCK 1. LOT 16 Parcel ID: 067-041-22 A. WELL DATA Well type pfra If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 1011612001 Sanitary seal (Y/N) iL Wires properly protected (Y/N) Y Total depth 145 ft. Cased to 145 ft. Casing height (above ground) 1,5' FROM WELL LOG AT INSPECTION Date of test 10116101 Static water level + * ft ft. Well production 4 g.p.m g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 0,5 mg./1. Other bacteria 0 colonies/100m1 Date of sample: 12110101 Collected by: KND Enaineerina 13. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel 1 Anchorage Tank Date Installed 7125101 Tank size 1250 gal. Number of Compartments L Cleanouts ifoundation cleanout Y_Depression over tank N High water alarm HA Date of pumping NA - new tank Pumper C. ABSORPTION FIELD DATA Date installed 7125101 Soil rating (g.p.dJft° or ft2/bdrm) 0.8 System type Shallow Trench Length 94 ft. Width 5 ft. Gravel below pipe 3.2 ft. Total depth 3.8 ft. Eff. absorption area 810 ft2 Monitoring tube Y_ Depression over field N Date of adequacy test NA • new system Results (Pass/Fail) Dass For 4 bedrooms Fluid depth in absorption field before test _ In. Water added_ gal. New depth_ in. Elapsed Time: min. Final fluid depth _ In. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed NA Size In gallons -Pump on level at _ in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ 1001+ Absorption field on lot 100'+ Manhole/Access (Y/N) "Pump off" level at _ In.High water alarm level at in. Public sewer main 75'. Sewer /septic service line 25'+ On adjacent Tots On adjacent Tots 1001+ Public sewer manhole/cleanout 100'. Holding tank 100'. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Water main 10'+ Wells on adjacent Tots 00'+ Property line 5y+ Water service line Absorption field 5'+ 01+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water Service line 10'+ Surface water 1001+ Curtain drain 50'+ Wells on adjacent lots 100'+ F. COMMENTS 'Flowing artesian well G. ENGINEER'S CERTIFICATION I certify that l have determined through field Inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Kenneth M. Dufus Date 12/12101 Water main 10'+ Driveway, parking/vehicle storage 25'+ r _Kenneth M. Cuf; / f Z %;NCtdaf,3 S • �.1: e14ti;o`FESSO" .7 4.7s OF 4:43..•••" .....ti eD 1 *•4' T5 "� ':trB •� MN HM Fee $300 Date of Payment 12/12/01 Receipt Number /31/6Z (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number