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HomeMy WebLinkAboutT15N R1W SEC 18 LT 179ATI5N RIW ction 18 Lot 179A #051-23-284 LOT 1 PLAT J2022-68 'e 40 ....� 30' UTILITY ESMT. imp MINIM LOT 169 SEC.18 T15N R1W F � RICHNER RD .F (S 89-54 52" W 144-37') ._ 24.21 ELEC. 28.2' FENCEwl 4V GARAGE�N GAS M'TR. a 1eelel t ,x 47.29f L7 9 A�95f / — ,r ;4*3/ ,Q5 01 LOT 178 SE .18 T1 N RlW E. ASPLS MORTGAGE LOCATION SURVEY NOTES: NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE MAY DE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. laimm C) RECORD DATA PER PLAT 95-25 FOUND 3.25" ALUM. CAP EDGE OF ASPHALT —' -- FENCE -- E OVERHEAD UTILITIES pp -& POWER. POLE Q SEPTIC PIPE QQ WELL yx SEPTIC TANK LID DECK CONCRETE 01 1 (lltfxl7") Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241284 PID Number: 051-232-84 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) El Two Single Family Project: R New Upgrade Name THOMAS ANDERSON C/O ARM SEPTIC SERVICES ABSORPTION FIELD E] Deep Trench IMN Wide Trench El Bed Mound Site Address 19118 RICHNER ROAD, CHUGIAK, AK [I Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-688-9433 (ARM SEPTIC SRV.) 4 1.2 GPD/SF 9.45'MAX. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 4 Ft. Subdivision Block Lot 179A Fill added above original grade SEE DWG. Ft. Gravel length 50 Ft, Township Range Section T15N RIW 18 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 500 FF. I - Ft. Well 100,+ 100'+ — - 25'+ TANK N Septic 0 S.T.E.P. [I Holding El Other Manufacturer INFILTRATOR SYSTEMS, Capacity IM-1530 Gal. Surface Water 100,+ 100+ — - Material Number of compartments Lot Line 5'+ 10'+ - - NA PLASTIC 2 Foundation 10'+ 10'+ - - LATION Capacity IManufacturer Remarks OLD TANK DISPOSED OFFSITE. Gal, Alarm location 'o ec ailed by Ehol�. Installer __ PIPE MATERIAL House to tank D3034 d Tank to D3034 rainfield ARM SEPTIC SERVICES Drainfield D3034 CO/MT D3034 Inspector GEG BENCHMARK (Assumed elevation) 100.69 ft Inspdates:ection 15' 10/7/2024 10/8/2024 Location and description 2' 31" 10/912024 4111 TOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp 4=1 OF C %� Conditional Approval: Date I 4 .......... .. .... ............. I ' * * * * : .... Septic System Approved Date zo e r E 79�.3ness., Note: this approval does not include well permit requirements, 'A �Profess!O IffAECC884 Rev 05/02118) PERMIT NUMBER: RECORD DRAWING V Y I N G PARCEL ID NUMBER: OSP241284051-232-84 --�--- /----�----------------�---- 100' WELL RADII GENE / / GENERAL LOCATION 1 RICHNER ROAD I yi EXISTING % I/ 1 I f 4-BEDROOM Ile I rj HOUSE: EXISTING c GARAGE ' / A O / / / Q/ 4 / / / �o/ / q--- B NEW IM-1530 ,\ ; j �' MH 46.0 57.2 INFILTRATOR / �a• / / ST1 53.7 62.6 , PLASTIC _cat Q /. V / / DBL1 57.1 65.4 SEPTIC TANK i MT1 `, j Q- // DBL2 57.9 66.1 4` FD 60.7 68.0 DOUBLE /' C01 38.8 42.3 CLEANOUTS �i '//'� �/ �MT1 38.8 41.1 (DBL1 & DBL2) -' l' CO2 86.3 87,6 c0 ,' �'�------- / MT2 87.1 88.7 POLYLOK FLOW NOTE: PIP LOCATIONS ARE DIRECTOR (FD) MT ' / SHOWN PER GEG SHOTS V TAKEN WITH LEICA DISTO MT r I 2 Q GEG TEST HOLE #1 S910 LASER DISTANCE /� METER. SWING -TIES TO / �/ HOUSE CORNERS WERE EXISTING % GENERATED IN AUTOCAD, DRAINFIELD NEW DRAINFIELD LOUIS A BUTERA, P.E. / 1994 TEST HOLE NOTE: RESERVE SITE FOR / 4-BEDROOM HOUSE SHALL / CONSIST OF REBUILDING THIS EASEMENT UTILITYSEMENT/ NEW DRAINFIELD N / � � NOTE: THE EXISTING HOUSE HAS A PUMP STATION LOCATED INSIDE THE RESIDENCE PER SCALE: ARM SEPTIC SERVICES V, . 40' AV .�� e•�� ♦� �a�a i r�r� I� Ili Ltd �. 4 .ui.... m. ... uui...uuu....*... - ENGINEERING, SALES CONSULTING ����� ����� �M � .� ��• 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, ALASKA • PHONE (907) 337.6179 • WEBSITE: www.gamessengineefing.com , •• •• ...• .••.•••.•...i. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 1n ; e G mess � Q C/O ARM SEPTIC SERVICES 907-688-9433 2 OF 3 ♦j-� ' CE-79 •' `�`'' PROJECT/LEGAL DESCRIPTION: DRAWN BY: �♦ •. I%� ® .•.40 T15N, R1 W, SECTION 18; LOT 179A J.L.M. ♦ FD ''••••••... �, • TYPE OF WORK: DATE: LICEN�'',���5;����• RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 10/30/2024 #AECC884 PERMIT NUMBER: PARCEL ID NUMBER: OSP241284 RECORD DRAWING 051-232-84 TOP OF MANHOLE FINAL GRADE LID = 100.69 ST1 100.49-100.76 0 TOP OF TANK @ INLET = 96.84 - INVERT OF PIPE @ INLET = 96.25 — PER THE CONTRACTOR, THE TANK WAS INSULATED WITH 2" OF RIGID INSULATION 1530 2-COMPARTMENT INFILTRATOR SEPTIC TANK ORIGINAL GRADE @ HIGHEST POINT = 100.! WALL -FINAL GRADE = 100.14-100.86 FILTER FABRIC INVERT OF PIPE = 95.47 BOTTOM OF TRENCH = 91.47 I t RELATIVE BOTTOM OF GEG TH#1 = 83.42 (NO GROUNDWATER ON 1017/2024) U ENGINEERING SALES -CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, ALASKA - PHONE (907) 337.6179' WEBSITE: www.gamewengineefing.eom PREPARED FOR: PHONE NUMBER: PAGE NUMBER: C/O ARM SEPTIC SERVICES 907-688-9433 3 � OF 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: T15N, R1 W, SECTION 18; LOT 179A J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 10/30/2024 fOP OF TANK @ OUTLET = 96.86 WERT OF PIPE @ OUTLET = 96.04 LICENSe,' ♦.V ESS\���� #AECC884 r",�• FA 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241284 Work Type: Septic Upgrade Tax Code Number: 05123284000 Site Legal Address: T15N R1 W SEC 18 LT 179A G:1054 Site Mailing Address: 19118 RICHNER RD, Chugiak Owner: ANDERSON THOMAS JOHNSON & ANN Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 9/19/2024 9/19/2025 23353 0 Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: , Date: Issued By: Date: �' _ 4 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-23-284 Property owner(s) THOMAS ANDERSON C/O ARM SEPTIC SERVICES Day phone 907-688-9433 Mailing address 19118 RICHNER ROAD, CHUGIAK, AK Site address 19118 RICHNER ROAD, CHUGIAK, AK Legal description (Sub'd., Block & Lot) 179A — Legal description (Township, Range & Section) T15N, R1W, SECTION 18 Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (JR all that apply) Absorption Field 0Initial M Single Family (SF) MX (w/wo ADU) Septic Tank MR Upgrade M Duplex (D) ❑ Holding Tank M Renewal M Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. 22 ILL/ Waiver No. GMevelopment ServicesGuilding Safety\On Site Water and WastewaterlForrns\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241284, Curtis Townsend, 09/19/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241284, Curtis Townsend, 09/19/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241284, Curtis Townsend, 09/19/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241284, Curtis Townsend, 09/19/24 LOT 169 CIO SEC.18 T15N R1W ER RD 1.5 (S 89"54 52t) W 1441.371p) L �6 24 2 19.6' ELEC. 28.2' MTR, CID 3 STORY cil C) Co RESIDENCE Q> G GARAGE AS 0 MTR. 0c.. 23.7 GAS 3 Of 3.Of 28.2' cn 47.2 c:) 1 00'WELL RADIUS LOT 179A PLAT #95-25 C CD D ADf Qr 0 CD CA cyl 4. LOT I PLAT #2022 —68 30' UTILITY ES MT. FOUND BENT ALUM POST W1 MISSING CA* AX-k A LOT 178 SEC.18 T15N RIW 15' P.U.E. ASPLS MORTGAGE LOCATION SURVEY NOTES: NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT, ONE m � ( ) RECORD DATA PER PLAT #95-25 5� FOUND 3.25" ALUM. CAP EDGE OF ASPHALT FENCE E E —OVERHEAD UTILITIES pp POWER POLE SEPTIC PIPE WELL DECK 71 Lj CONCRETE of 3 Of 60' SCALE: F'= 30 FEET 01 fix 1711) OF A� IdAww ANW 491-H � s Ryan G. Johnson 9C* C No. 12159 NZ �Z�712024 - c��N AMW S10*0 I Good morning Mairah, After looking at the Plat of record 95-25, MOA Right of Way does not have permitting authority in the 30'Electric, Telcom, and Gas Easement. This is utility specific, so MOA ROW cannot issue permits. I would suggest reaching out to MEA, MTA, ACS, GCI & Enstar for letters of non -objection. If you have questions, feel free to give me a call. Michael S Walters Senior Plan Reviewer Right of Way Section michael.watters@�anchora o __ ge" -V Office:907-343-8226 Cell: 907-727-7637 Fax: 907-249-7910 -----Original Message ----- From: ARM Septic Services, LLC <armservices flmok.com> Sent: Tuesday, September 3, 2024 1:52 PM To: Walters, Michael S. <michaelwaLters_ Ca�_ancjior, ageak g of > Subject: ROW application-1 9118 Richner Road [EXTERNAL EMAIL] Hello Mike, Please see attached application, I will also attached Garness Engineerings drawings so you can see where proposed drainfield is going to go. Also I do apologize I may have not filled out this application right, it seems Like once a year I have to fill it out. <image001.png> :4 -M E* A MATANUSKA ELECTRIC ASSOCIATION MATANUSKA ELECTRIC ASSOCIATION, INC. LETTER OF NON -OBJECTION Date: September 18, 2024 Thomas and Ann Anderson 12110 Business Blvd Suite 6 PMB 404 Eagle River, AK 99 Re: Letter of Non -objection for a septic system partially located within the 30 ft Utility Easement on Lot 179A, Plat No. 95-25, Section 18, Township 15 N, Range 1 W, S.M., Anchorage Recording District Dear Thomas and Ann Anderson, MEA has no objection to the proposed septic system partially located within the platted Utility Easement on Lot 179A, Plat No. 95-25, Section 18, Township 15 N, Range 1 W, S.M., as it pertains to MEA's use of the easement and is subject to the underlying landowner's approval, as shown in the drawing dated Septemebr 3, 2024, on page 2, subject to the following conditions: 1 _ The improvement will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the easement for any and all utility purposes that it presently enjoys under the easement. 2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any person or property that may result from the existing and future use of the easement by MEA, its contractors, or assigns. 3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use of the easement by others under a Letter of Non -Objection. 4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the easement. 5. The landowner will be responsible for any special construction costs incurred by MEA due to the improvement in the easement. 6. The landowner will assure compliance with all applicable safety codes relating to the improvement in the easement. 7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these conditions. 8. Alteration of these conditions shall invalidate this letter. 9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of the referenced property is changed from the above -named landowner. Sincerely, Sarah Brandt Land Services Manager STATE OF ALASKA) SS - THIS IS TO CERTIFY that on this & day of 2024, be€ore me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Sarah Brandt, Land Services Manager . Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument and acknowledged to me that helshelthey signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written STATE OF'ALASKA f NOTARY PUBLIC Notary Public in and of AJaska My commission expires =HULA S. BRAULT JNM24.2M Return to; MEA, PO Box 2929, Palmer, AK 99645 MATANUSKA ELECTR C ASS"TION, INC. • P.O. Sa 2929 • Pairrer, Alaska 99645 • t 907-N&M • f 907.761.9368 • wwwnmcoop Docusign Envelope ID: 6C9F2705-FCFB-4FEE-84C3-942488570766 September 5, 2024 Tom Anderson 19118 Richner Rd Chugiak, AK 99567 To whom it may concern, Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the leach field encroachment into existing 30' TELECOMMUNICATION, ELECTRIC and GAS easements located within Section 18, T15N, R1 W in Seward Meridian LOT 179A, also known as 19118 Richner Rd, city grid ERNW1054, GCI WO# 24-0002-33. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also, any additional and extraordinary costs incurred during any future required construction, repair, or reconstruction of GCI's facilities to accommodate any or all the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now, and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. , Sincerely, DocuS;gned by: Signature 9/9/24 S".61 019DEE3BDD07489... Date ALEX SLAVENS GCI I OSP Design Data Management Delivery Engineering 907-868-1049 Anchorage Water & Wastewater Utility Engineering Division Thomas Johnson & Ann Anderson 19118 Richner Rd. Eagle River, AK Re: Request for Letter of to Encroachment ofT15N.R1W,Sec. 1ELLot 1794 (Tax {[#O51-232-84) Grid NVV1O54.Plat 19S5-O25. Anchorage Water & Wastewater Utility ) received a request from yNahoh Combellwith ARM Septic Services, LLC on Aug. 14. 2024 regarding a proposed septic drain field encroaching into a 30'utilfty easement abutting the south east property line of T15N, R1W, Sec 18, Lot 179A). AVVVVU is currently not using thha3D' utility easement along S. Birchwood Loop Rd. and has no objection to the encroachment. A\88/VU hereby issues this letter with stipulations to allow the encroachment ofthe proposed drainage field within the 30' utility easement. The property owner(s) agrees to the following: 1. /VJVVVUwW| be held horm/heso, now and forever, for any damages orinjury hoanyperaon resulting from the encroachment. 2. The property > shall call for utility locates before excavation inthe easement. 3 All applicable codes and regulations will be observed and maintained within the easement. 4. This letter will innoway preclude /VWWUfrom full use and enjoyment ofitohghbavvithin any portion ofthe easement. b. The property owner(s) ahoU pay any additional and/or extraordinary costs incurred to mcoonnnnodehe the encroachment during any future required maintenance am:ene, oonstruution, or reconstruction of /4WWU infrastructure or facilities and, if nacemmary, reimbursement mf/YNJVVDtime and materials toremove the encroachment. Replacement ofencroaching fin±umewwill also baat the expense nfthe property oxvnar(s). O. /VJVVVU'o non -objection does not imply other approvals that may be required for this encroachment. 7. AWVVU doom not provide a position for any other penza( or uU|hv impacted by the encroachment. Shouldyou have arly-questions, please call the AVVVVUPlanning Section et(QO7)5G4-273Q. Sincerel avidd Duke Engineering Technician III Planning and Engineering Div. Anchorage Water & Wastewater Utility Clearly EO ]uVo8n�cBouhmo�~ Phone 907-S64-2774° Fax 907-S62-082*"xwwmwwu.biz - - ENSTAR Natural Gas Company, LLC Engineering Department, Right of Way Section 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907) 277-5551 FAX (907) 334-7798 September 3, 2024 Tom Anderson 19118 Richner Road Chugiak, AK 99567 Subject: Letter of Non -Objection — Septic Encroachment Lot 179A— Sec. 18, T15N, RIW, S.M. To whom it may concern: ENSTAR Natural Gas Company, LLC (ENSTAR) has no objection to the existing septic encroachment located within a thirty foot (30FT) wide utility easement located within Lot 179A, SECTION 18, T15N, Rl W, S.M. according to the official plat thereof, filed under Plat No. 95-25, in the records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. This service is free of charge. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the land owner. • All applicable safety code regulations will be observed and maintained. • This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. If you have any questions, please feel free to contact me at 334-7944 or by email at j ames.christopher@enstarnaturalgas.com. Sincerely, James Christopher Right of Way Agent ENSTAR Natural Gas Company, LLC NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT By this document Matanuska Telecom Association, Inc. (MTA) declares that it has no objection to the existing and proposed septic encroachments located within the platted utility easement ofT15N R1W SEC18 Lot 179A,19118 Rich ner Road, filed as Plat Number 95-25 in the Anchorage Recording District, State of Alaska, as shown on the attached as -built dated 06/27/24, Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the encroachment as a result of utility construction will be borne by the property owner of record. This document does not authorize the placement of any additional encroachments within the easement area. Property owners are required to obtain utility locates before doing any kind of work in the utility easements and will be liable for any damages caused by their construction work in the easements. This document is in no way an aareement to vacate any portion of the utility easement and should not be interpreted as such. Issued for Matanuska Telecom Association, Inc. this 181h day of August, 2024 by -�° Jessica Burnett, Right of Way Manager Matanuska Telecom Association, Inc. · Municipality of Anchorage Page / of 2'' DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAl_ SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well inspection Report Permit Number: Gv'') cz~I~[d')C)'~"~' ' - -""-~ PID Number: ¢l%~Z.l~ ~rn~: FIr. ST H ~ll0*'l&t, r¢:~,t"l ~1~ OL&~ Wastewater System: ~ New ~ Upgrade *dd'"~D F~¢x {007¢0/AIq~AK d elSlO ABSORPTION FIELD :No. of Bedrooms Ph°ne: ~52J 'S¢~) ¢~6~ ~ Deep Trench ~ Shallow Trench dSed UMound ~Other Total Depth fron origma[grade: LEGAL DESCRIPTION so~,~.~i.~: 1.0 o~/s,.~, __~_ ] ~1~r~ge~ ................... t ¢ Fill added abovel%l/~°rigina' grede: Ft. Grave[ length: Ft Grove]d~ th: Ft, Numbero~l~of~ines:IIDistancebetweenlines: WELL: ~ New ~ Upgrade w~fl~ ~' Ft C~essific~Pon (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe materiah Date Drilled: Static Water Level:h~staller: ' , FAsriu .H Date installed: Ft SEPARATION DISTANCES ~so,ti~¢¢.'~.~.~ ~ HolOm~ Su,.~. ~od ................... LIFT STATION -- Curtain ~/g ~ Pump Make & Model Electrical Inspections performed by: Drain LocaPon and DescdpJ~gn ~ Assumed Elevat~om Od ENGINEER'S,SEAL Inspections performed by: 4~¢-I:t/E~.¢5 Dates: 1st (~ ¢¢,,,',¢~,~ " ~" ....... " 2nd. s/Iq/flt'l '% n ~ . .~epar~memolHeal u a -. Reviewed and approved by Date: ~ ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Le al Description: LcFIqfl,,TI6~! ~.1~ Sl~ PID No.: ~63,93 W (Ni]I lEI SC:Al E) 33' PATEN'I RD\¥ EASEHEN'[ SCALE 1" = 60' EASEMENT WALT~~I~ J, HICKbL, GOVERNOR ANCHORAGE DISTRICT OFFICE 800 E, DIMOND BLVD,, SUITE 8-470 ANCHOFtAGE, ALASKA 99515 (907) 349"7755 June 21, 1994 Mr. Curt Hollm' E~gte River EngtneertnC[ Servioes P.O. I~ox 7732~4 Eagle River, AK ~kS?T RE: Lot I79, T15N R1W ~' ~ec. IB 19'118 Rlchner Rd.; Well Abandonment ADEC Projt-x~t No. 9421-DW-167~I64 Dea~ Mr. [,loller: This letter ks in reference to the materials received in this [;ffice JL~ne 18, 1994, ~.~eking approval fo~ ~n al[create method of well 8ban~nme~l~, The Dep~rtment h~ comple[~ ks review of the proposed me~oc~ ef ~b~donmenl ou~ined in the subm~ted I~er, B~sed upon this revi~, the prepaid method indited as aeon A mee~ the ~n~rn~ of this ~padme~; "Fill majority of well with pea gravel or 3/4' minus material to just above stat:lc w~ter level ef 24'. Fill §' ~4th clssn sand. Chlorinate gravel and send mt 2' intervals. Fill rer~aining 15' with bentonite grout, level with casing top." Therefore, in aooordanoe with State Drlnktng Water Regulations (18 AAC 80.015(d)(3)) approval for ~bandonrne~ of an exi~fin§ well using the above attemate metllod is granted. Thaek you for your cooperation with this Dept~rb~ent, if there ~e any quaetion[~ regarding the nb(~ve please do not hesitate to call. Sincerely, ( erlifie rilltng by SULLIVAN WATER WELLS P.O. BOX 570272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION DATE · Started _ PERMIT NUMBER Ended STATIC LEVEL OF WATER I:F DRAW DOWN GALS. PER HR ~ 0 KIND OF' CASING KIND OF FORMATION From D Ft. to ~'''~ " '~ ~ ~-~7:~_~::_~f'~ j~ · ' Ft. { .~'~'~'* ~ From Ft.' to' Ft.: From. _ FI to Ft.. ~F'rm~ ' Ft. Io Ft From Ft. to Fl, From Ft. ~o Ft. From __Ft, h,. Fl From Ft. Io . Fl Frm'n Ft. to Ft. From Fl. I~L From FL to From Ft. lo Ft. From Ft.'to Ft. From Fi. to Ft From Ft: to Ft. From Ft,~to Ft._ From Ft. to ' Ft. From Ft, to Ft. From Ft. to From Ft. ~o_ From__ Ft. to From F/.[o From Ft to Ft. JUL 2 5 1994 Munic pality of Anchorage O~ ........... H'Jr~ ap Rnrvln~n_ Ft. From Ft. to Ft From _Ft. to Fl MISCL. INFORMATION: DRILLER'S NAME "?~ ,/'"l,,.f'~*"~-g" .... PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940059 DESIGN ENGINEER:EAGLE RIVER ENGINEERING OWNER NAME:FIRST NATIONAL BA~K OF ANCH OWNER ADDRESS:P.O. BOX 720 ANCHORAGE, AK 99510-0720 DATE ISSUED: 3/29/94 SERVICES EXPIRATION DATE: 3/29/95 PARCEL ID:0.5123218 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 179 LOT SIZE: 43560 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM 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 (iSAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ,~ DATE: DATE: Louis Butera, P.E. Registered Civil Engineer March 25, 1994 John Smith, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 179, T15N R1W Section 18 Narrative Dear Mr. Smith: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: 1. The area has large lots allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \E:\WPDO CS\ 1994k94-001A.NAR P.O. Box 773294 · Eagle River, Alaska 99577 · Telephone (907) 6944195 · Fax (907) 694-3297 ~,~- - - -~~==-~ -7 - - -~- -7 PRESSURE - ~ ~ ~~ / ........ 7/ ~/ / ~0~ // ~ / / / , / F~ S~C~ // ~ / ~ 6,' ~ ~~~ ~ ~y ~7/ ~ - c = ~.~, , ~ ~ ~ ,/~ / ~/ ~ ~ /~ / / ~' ~ ./Z ~' / / ~/ , // // ~ - TEST HOLE · - MONITOR TUBE o - SEWER CL~OUT NO SURFACE WATER +1OO' + - WELL i ~- PROPOSED L~CHFIELD NO KNOWN CURTAIN DRAINS ~SEMENT s ~ P T~C S~T E P .~. ~_--~-~,,,,, LEGAL: LOT 179 T15N RIW SEC.18 CONTRACTOR: N/A JOB ~ 94-001A1 DATE: 04/19/94J SCALE 1" = 50' A EAOLE RIVER ENGINEERING SERVICES EAGLE RIVER, AK. 99577'~tt~ss~ (907) 694-519S tAX: (907) 694-3~97 Munlclpallly of Anchorage DEPARTMENT OF HEAL1H & HUMAN SERVICES 825 "L" Sheel, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGINEER'S SEAL) LEGAL DESCRIPTION: [~']- ~-'/~::~ , Township, Range, Section: ~'1~1~ I'~1 ~ $~C Iq 1 2 3 4 5 6 7 8 9 10 11 t2 13 14 15 16 17 18 19 20 COMMENTS WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN s IF YES, ATWttAT OL -- ' ~qof~ltorlng? ~F--}'F D,IO: 5'l~.qH " I.O H,r,I TEST RUN BETWEEN ~ FT AND ~ FT PERFORMED BY: ~-~{~I~E ~ ~5 I ~ CERTIFY THAI THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL SLATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DALE, DATE; 72-008 {Rev. 4/85) LEGAL: 1. 2. 3. 4. 5. 6. 7. 8. 9. Be SPECIFICATIONS FOR ON-SITE SYSTEM Lot 179, T15N R1W Section 18 Richner Road, Chugiak General The well and septic plan are for a single family residence only. The drawing and/or site plan shall be a part of this specification. All materials and workmanship shall meet the Anchorage Department of Health (MOA- DHHS) requirements. All soil tests are advisory to the design and are to verified or modified in the field by the Engineer. All excavations and depths are advisory and are to be verified in the field by the Contractor to meet MOA-DHHS requirements. It is the responsibility of the Owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. It is the responsibility of the Contractor to secure all utility locates prior to construction. The excavation is to be exactly in the area shown on the site plan, any deviation requires Engineer approval. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. Septic Tank The existing septic tank and inlet pipe shall be uncovered and the 4" inlet pipe replaced and reinstalled with proper bedding back to the pressure line connection, located in an assumed position on the site plan. The Engineer shall be consulted after uncovering the line. 2. 3. 4. 5. 6. 7. 8. Trench Abandon existing seepage pit by removing steel tank of filling in place. Move existing shed to outside trench construction area and relevel on similar foundation. The bottom of the trench shall be level, plus or minus 1.5". The total depth of the trench excavation is not to exceed 11' at any point. The effluent line is to replace the existing sewer line that leads to the existing leaching system. The trench gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachfield. The area over the trench is to be finish graded to prevent ponding of surface water runoff. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200' to any community well. \E:\WPDOCS\1994\94-001A.SPC 1 RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 11' GRAVEL DEPTH ~ 3.~' TRENCH LENGTH - 49' TRENCH WIDTH -~ 5? SOIL RATING = 1.0 gpd/ft2 BEDROOM CAPACITY = 3 SEPTIC TANK SIZE = 1,250 gallons (existing) Twenty-four (24) hours notice required for all inspections \E:\WPDOC$\1994\94-001A.SPC 2 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK 99577 (907) 694.5195 JOB SHEETNO CALCULATEDBY ~ /*~ DATE CHECKEDBY DATE Single Family Dwelling - Three Bedrooms 3BR x 150 gpd = 450 gpd Soil absorption rate = 1.0 gpd/ft2 450 + 1.0 = 450 S1~ required area Trench Dimensions: Total Depth = 11' (maximum) Gravel depth = 3.5' Width = 5' Length = 49' \E:\WPDOCS\1994\94-001 A.CA1. oGRE '"ER ANCHORAGE AREA BO~'~UGH Department of Environmental Quality 3330 C Street Anchorage, Alask~ 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS LOCATION /~ ~~ LEGAL ~ESCmPT,ON_~/7~ SEPTIC TANK: DISTANCE INSIDE LENGTH_ INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS lIQUID CAPACITY /~/~ GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER CRIB SIZE: BUILDING FOUNDATION OR WIDTH DIAMETER NEAREST LOT LINE ADDITIONAL ABSORPTION DEPTH ~! DISTANCE FROM: WELl TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~ SQ. FT. WELL: TYPE '~'/L'/- ~]~ CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE_ CESSPOOL OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM _ DISTANCES: 'NSTALLED ~y: /-/~e~ ~'~'~ LOT SLOPE: ~.'EL REMARKS: Form NO, EQ-031 DIAGRAM OF SYSTEM DATE ~/q/ ~/~,A,A,B. G~eAtEr ANChORage A'reA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT InSTALLaTIoN OF: SEPTIC TANK TYPE AND SIZE OF FACIL,TY TO BE SERVED Il NOTE=.THIS PERMIT IS NOT VALID WITHOUT SOIL T~ST COMPLETION DATE ANTICIPATED __ ~ ~ " ~ ~ FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL iNSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE. //~ TYPE ~'~/ ~/~ SEEPAGE AREA SIZE ~ TYPE~_//~~ MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGe pIT __ SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK __ SEEPAGE PIT TO NEAREST LOT LINE. ? DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN field TO RIVER. LAkE~ STREAM. . DRAIN FIELD SEEPAGE PIT ALSO CONS]DER AREA WELLS. SEEPAGE PIT ..,, CAST ]RON ]NTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF ~ExCAVATION 5 FEET INTO UNDISTURBED 4 I. NCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKF'ILL CONFORM TO BOROU~ROU ~GULATIONS~.~REGARDiNG INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE ~JE~CRIBED SYSTEM I~ IN ACCORDANCE WITH SAID ~ODE. MUNICIPALITY OF ANCHORAGE Is - Development Services Department V, Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC241491 Parcel ID 051-232-84 Expiration Date: (� 2- S Legal description T15N R1 W SEC 18 LT 179A Site address 19118 RICHNER RD Current property owner(s) ANDERSON THOMAS JOHNSON & ANN X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Z This system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-23_ - Jy Complete legal description T15N, R1W, SECTION 18, LOT 179A___ Location (site address) 19118 RICHNER ROAD, CHUGIAK, AK Current property owner(s) THOMAS & ANN ANDERSON C/O ARM SEPTIC SERVICES Day phone 907-688-9433 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: * Private Well F71 Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: FE-1 Private Septic F-1 Private Septic serving 2 dwelling units M Holding Tank M Community Septic or Public Sewer 5. SEPTIC TANK: R Steel RN Plastic R Concrete R Fiberglass Age NEW _ See advisory if steel older than 20 years 6. ABSORPTION FIELD: [:1 AWWTS F-1 Bed ❑ Deep Trench Al Wide Trench E] Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $_ Waiver Fee $ Date of Payment t Date of Payment COSA # Waiver # COSA Applicationjune 2022 COSA Checklist Legal Description: T15N, R1 W, SECTION 18, LOT 179A Parcel ID: 051-23-584 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 4/1994 Total depth 84 ft Cased to 81 ft 9 Sanitary seal is functioning correctly n Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/24/2024 Static water level at beginning of test 21.8 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/7-9/24 IN ALL standpipes present per record drawing Total measured depth from grade 9.4 ft (max) Measured depth to pipe invert from grade 4.7 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. 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/A If yes, enter date Comments/Deficiencies: Well production at time of test 0.8+ gpm Water storage tank volume 500 gallons Well disinfected for coliform test? 93'Yes MNo PColiform bacteria is Negative Nitrate mg/L 03"kitrgite less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, LTD..v�S Date 10/24/2024 T STATION ❑ Require t� Age of lift station Lift station materlai ce compl Adequacy test date NEW Results Q Pass Fluid depth prior to test NEW in Water added gal New fluid depth 0 in Elapsed time NEW min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 0 in Effective depth remaining 48 in COSA Checklist June 2022 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' Community Sewer Manhole/Cleanout > 100' ©Yes if No ft ❑a Yes if No ft Neighboring Tank > 100' © Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot _> 100' [E Yes if No ft Holding Tank > 100' RlYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' FNJ Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft ril 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' Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' 0 Yes if No ft M Yes if No ft Q Yes if No ft Q Yes if No ft M Yes if No ft Surface Water > 100' Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' 0 Yes if No ft Yes if No ft Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *NEW DRAINFIELD IN EASEMENT - LETTERS OF NON -OBJECTION GRANTED FROM UTILITY COMPANIES 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 Garness Engineering Group, LTD. (GEG) Engineer's Printed Name Jeffrey A. Garness Phone 907-337-6179 Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist_June 2022 �QOo0O��4 oa�P 4 T v4�0 �...:.... ... ............:.tr. i i Q ey C. rness;' G �QOs, ' , CE 795 c�5�1O� 11 e,, c°jo UCENSE4K00'Pr o f e s sio0aQo #AECcam �D0000�c' 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. 051.23-21~ Expiration Date: 1. GENERAL INFORMATION Complete lega! description ,~Lot 179, T15H, RlW, SEC18 Location (site address o~' directions) '19~18 RICHNER RD., CHUGIAK, AK 99567 Current Property owner(s) CHARLES WRIGHT Day phone 688-0270 Mailing address (SAME AS ABOVE) Lending agency Dayphone Mailing address Real Estate Agent LES BAILEY. PRUDENTIAL VISTA Day phone 689-6451 Mailing Address 16635 CENTERFIELD DR., EAGLE RIVER, AK 99577 Unless otherwise requested, HA.A will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WAS I ~.WATER DISPOSAL: [] Individual On-site C~ [] Individual Holding tank I'-I [] 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 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of flue (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 pdvate 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 vedfy 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 ali applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND En§ineerinq Address 20441 Ptarmigan Blvd. Ea§le River, AK, 99577 Engineer's Printed Name Kenneth M. Duffus 5. DSD SIGNATURE ~ Approved for Disapproved. Conditional approval for Phone. 696-6111 Date 12/27/01 bedrooms, with the following stipulations: Additional Comments · ~.'.' ,,, · . .,~ .....'' ,?,~. · . *. ~. ~" ON-SITE '~ : WASTEWATER : .. Attachments: HM Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: / ~ -.."D~ '7- ~ / Legal Dsacdption: A. WELL DATA Well type nflvate Date completed 4/1994 Total depth ~ ft. Municipality of Anchorage Development Services Department Building Safety Division On-Bite Water & Wastewater Program 4700 South Bmgaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lot 1~?TI fN. RIW. 6ECt8. SM Parcel ID: 05t-~2~ If A, B, or C provide PWSID # Sanitary seal (Y/N) y casedto ~T ft. FROM WELL LOG Date of test 4/1~H Static water level ~Q ft. Wall production I g.p.m WATER SAMPLE RESULTS: Coliform 9 colonies/100 mi. N;~,a~[e 0.2 rog./1. Date of sample: ~ Collected by: KND Enolneedno B. SEPTIC/HOLDING TANK DATA Tank Type/Material An~horaae Tank I Steel Date installed Integrity veflfted 5/18/1994 Tank size 1250 gal. Cleanoute L Foundation dsanout y Date of pumping 12/10/0t C. ABSORPTION RELD DATA Date installed 5ttgf1994 Soil rating (9.p.d./ff Length ~ ft. Width ~ ft. Gravel below pipe 3.5 Well Log (Y/N) y wires pmpedy protected (Y/N) Casing height (above ground) AT INSPECTION t2/1010t ~ ft. t.-q3 g.p.m. Other bacteria_J)_ colonies/10Oml Number of Compartments 2 · Deprasslon over tank Id_High water alarm NA Pumper System type Shallow Trench fl. Total depth 9.5 ft. Eft. absorption ama 431 ft2 Monitoring tube Y Depression over field 14 Date of adequacy test t2/t0/01 Results (Pass/Fall) Pass For ~._ bedrooms Fluid depth in absorption field before test 14.5 in. Water added 450 gal. New depth 22 in. Elapsed Time: g0 min. Final fluid depth 14,9 in. Absorption rate >= 4~Q g.p.d. Any rajuvenaflon treatment (past 12 mo.) (WN & type) NA If yes, give date D. UFT STATION Date installed NA, 'Pump on' level at __ in. Datum E. SEPARATION DISTANCES Size In gallons. Manhole/Access (Y/N). 'Pump off' level at __ in. High water alarm level at Cycles tested Meets alarm & circuit requirements? On adjacent Iota 100'* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot tQQ'* Absorption field on lot 1QQ'* Public sewer main ~;'+ Sewer/septic sewice line 2[;'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: On adjacent Iota 100'+ Public sewer manhole/cleanout Holding tank tQQ'+ Building foundation ~'+ Property line ~'+ Water main 10'+ Water service line Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation lQ'+ Surface water 1QQ'+ Walls on adjacent lots t00'+ Property line lQ'+ Water Servtce line Curtain drain J0'+ F. COMMENTS f00"l' · Absorption field ~'+ Sur~ce water tQQ'+ Water main Driveway, parking/vehicle storage in. Water system includes a 600-oallon water storaee tank. Set~c sv~em in~,d~ an interior sewage artnder oumo. The exted0rs of ENGINEER'S CERTIFICATION review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Enotnee s P,nted Nama HAA Fee Date of Payment 12/l~101 Rec. ipt Number Waiver Fee $ Date of Payment Receipt Number Parcel I.D. # 1. MUNICIPALITY OF ANCHORAGE :~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 343-4744 99519-6650 CERTIFICATE OF HEALTH AU?HORITY APPROVAL FOR A SINGLE FAMILY DWELLING Currently 051-232-3.8 HAA# H~q~O~- GENERAL INFORMATION Complete legal description Lot 179 to be known as Lot 179A, T15N R1W Section 18 Location (site address or a rections) Richner Road, Chugiak Property owner_ .~A / susan Ga_rcett Mailing address P'.'o. Box 7?0548, Eaqle River. Lending agency Mailing address ' ' N/A Agent ' ' - ·. Address Day phone 694-2103 99577 Unless otherwise reouested HAA ~,ill b- 2. NUMBER OF BEDROOMS: ::. ,'~3 · 3. TYPE OF WATER SUPPLY: Individual well X Day phone Community wel 4, TYPE OF WASTEWATER DISPOSAL: Day_ phone · Individual on-site Holding tank' ''~ :'!' ' ' , Community on-site Public sewer NOTE: Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legaiitY'a~fstatus of system. ~ ~, .,' If community wastewater system, provide written confirmation from State ADEC atte,tin~ to the le~ali~ and status of system. ' ' 72-025{Rev, I/91] Front MOA#21 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 dis0osal 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 mves.ti..qation 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. Phone Name of Firm Eagle River Engineering Services Address P.O. Box 773294, Eagle River, AK Engineer's signature ~ 694-5 195 99577 Date ; 6~~;~ DHHS SIGNATURE 'bedrooms. '' ~i~Additlona Comments Date Health and Human Services [DHHS) issues Health Auth~ority / upon the representations given in paragraph 5 above by an independent istered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes Hn order to satisfy certain federal and state requirements, Employees of DHHS do not or analyze data before a certificate is issued. The Mun~icipality of Anchorage is not - ra~ponsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type /~/2/b/,,~ 'T-~ If A, B, or C, attach ADEC letter. ADEC water system number ,,~//~ Log present (Y/N) y~ Date completed /~ t4/9~' Driller .SI) LA. )1//3/-./ ~-~,/ J Total depth ~'/"'/ ' Cased to ]2~J~O/Z~/"~/~ ..~-~ Casing height Sanitary seal (Y/N) )/~F~ Wires properly protected (Y/N) I~ ~ FROM WELL LOG AT INSPECTION Date of test r) z.//CN ~5/~2 ~ - Oz// Static water level ~ / ~ / Well flow /' ~ g.p.m. /, ~ Pump level1 [2~]~j ~ /~_ / SEPARATION DISTANCES FROM WELL TO: Septic/~ tank on lot /~-~ / ; On adjacent lots Absorption field on lot / ~ ~ I ; On adjacent lots Public sewer main ~/~ Public sewer manhole/cleanout Sewer se~ice line ~ / Petroleum tank ~ WATER SAMPLE RESULTS: o 7 ,79s Coliform ~ Date of sample: ~. - S, - ,? 5- Nitrate '~ ~ ~/~,/~ * Collected by: B. SEPTIC/HOLDING TANK DATA Other bacteria 05/_~/~ c~ Date installed ~Tank s ze / ~ ~/~ Compartments Cleanouts (Y/N) ~ ~ Foundation cleanout (Y/N) YC7S Depression (Y/N) High water alarm (Y/N) ./'//-~' Alarm tested (Y/N) .,/,//~ Date of pumping ~c~//~,/~b/ Pumper ~T-.,/~. SEPARATION DISTANCES FROM SEPTIC/I=I~EEHNG TANK TO: Well(s) on lot /~ To property line Surface water/drainage On adjacent lots '/'/~(~2 I Foundation ~/~ ~-' / Absorption field /c/' Water ma~/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer ~ Manh°l~at ..-~"~Cycles tested Meets MOA electrical codes (Y/N) / SEPARATiO~FT STATION TO: Well o~..gDJo~ On adjacent lots D. ABSORPTION FIELD DATA Date installed~,~//¢?/ Length ~0 / Width Total absorption area Surface water Soil rating (GPD/Ft2) /,~ Systemtype ,?~./~D~ ?')~ &'/,./C_ /-/ .~ / Gravel thickness ,~, ~J Total depth 9. 5 / Cleanout present (Y/N) ~/~ ~ Depression over field (Y/N) ,,~ Results (pass/fail) /D~) S ~ for -.;~ ,/V~/,A After test .,~! / ~ /'~/~ If yes, give date /'~//,-~ Bedrooms Date of adequacy test /k/IA Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water ,/'-/ Curtain drain On adjacent lots 7~/~ / Property line ~.~ ~ ~ To existing or abandoned system on lot Cutbank /~?~ Water ~/service line_ Driveway, parking/vehicle storage area 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 Engineer's Name Date HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number. 72-026 (3/93)* Back MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services / On-Site Services Section P.O. Box 196650 Anchorage,343_4744 Alaska 99519-6650 /~,~, Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING (151-232-1R HAA # ¥.~ 1. GENERALINFORMATION Complete legal description Lot 179, T15N R1W Section 18 Location (site address or directions) Richner Road, Chugiak Property owner FNBA / Marty Miller P.O. Box 100720, Anchorage, AK Mailing address Day phone 99510-0?20 265-3500 Lending agency N/A Day phone Mailing address Agent N/A Day phone Address 2. NUMBER OF BEDROOMS: 3, TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 3 NOTE: Individual well X Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. Individual on-site X Holding tank Community on-site Public sower NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: 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 Eagle River Engineering Serives Address P.O. Box 773294, Eagle River, AK Engineer's signature Phone 694-5195 99577 DHHS SIGNATURE //~_ Approved for / Disapproved, Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 th is 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. 72~25 {Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Z~7' /?~ 7'~Sfv /2/~,~ Sg~ I~ Parcel I.D. A. Well Data Well type ~P£1v,~ T£ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~.~ Date completed Oz~ / ?~ Driller Total depth ~ Cased to p~PFO~T~ ~?- S Casing height Sanita~ seal (Y/N) ~5 Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test ~/j ?L/ /75//~ ~ ~ ~,yJ ~/ Static water level z/0 ' .~ / Well flow ./. D g.p.m. /. O .g.p.m. Pump level1 ///,I~/VD~ /',7 ,~p/~,-o ~. ~ / SEPARATION DISTANCES FROM WELL TO: Septic/heldir~g tank on lot / ~ ~ Absorption field on lot / L/ ~ ' Public sewer main /',~ / A Sewer service line '~ D ' ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank /V~/V£ WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: 0']//,y/~,z./ Collected by: Other bacteria B. SEPTIC/H(~=BtNG TANK DATA Date installed Cleanouts (Y/N) ~/~ ~) High water alarm (Y/N) Date of pumping Tank size / Z ~0 Compartments Foundation cleanout (Y/N) Y~ 5 Depression (Y/N) /V/F~ Alarm tested (Y/N) 0~ ? ~/~] ~ Pumper SEPARATION DISTANCES FROM SEPTIC/N~L,~If, tG TANK TO: Well(s) on lot / ~. To property line /(~ Surlace water/drainage On adjacent lots Absorption field Foundation Water r~/service line 72-026 (3/93)° Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons "Pump on" level at Vent (Y/N) High water alarm level /Cycles tested Meets MOA electrical codes (Y/N).~/ SEPARATION DIS~ LIFT STATION TO: W,,~.~/L. On adjacent lots Manufacturer / Manhole/~ / "Pump off" Level at Sudace water Date installed Length '~O~ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) D. ABSORPTION FIELD DATA Width Soil rating (GPD/Ft '~ J Gravel thickness Cleanout present (Y/N) ,,VEZ, O Results (pass/fail) .System type ?,e~L~ ,~. '~' Totaldepth Depression over field (Y/N) for Nter test ~/~ yes, give date. Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot To building foundation On adjacent lots Surface water Curtain drain On adjacent lots ¢' / DO / Property line To existing or abandoned system on lot Cutbank ,,,w/,fl Water mei~service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA , of this inspection. Signature ~ Engineer's Name ff.. - HAA Fee $ Date of Payment Receipt Number 72-026 (3/93)* Sack Waiver Fee $ Date of Payment Receipt Number