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Home My WebLink AboutEAGLE CREST #1 TR A LT 11AEagle Crest #1 Tract A Lot 11A #050 - 303 - 41 Municipality of Anchorage On-Site Water and Wastewater Section ° (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211068 PID Number: 050-303-41 Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New K Upgrade Name Jordan and Toni Johns ABSORPTION FIELD El Deep Trench [:1 Wide Trench ❑Bed ound Site Address 10311 Crestview Lane Eagle River ❑ Other Phone Number of Bedrooms Soil Rating Total depth fr original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from originalgrade Ft. I§ravel depth beneath pipe Ft. Subdivision Block Lot Eagle Crest #1 Tract A 11A Fill added above original gra Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer b r Total aption area Number of trenches Dist. between trenches From Tank Field Tank Line FO Ft. Well >100' NA NA NA NA TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water >100' NA NA NA Material Number of compartments Lot Line >5' NA NA NA NA plastic 2 Foundation >1 0' NA NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield JRs Septic Drainfield Co/MT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspection ection 1-14/7/2021 2°d 4/15/2021 Location and description 3" 4111 top of concrete deck footing ON-SITE WATER AND WASTEWATER SECTION APPROVAL EEggs k.tamp Conditional Approval: Date ®L'�•�.• • • TH i� V" c ......./ .... ..... .. rtis L To nse c1 !rt �qq Date ? •:` e s' No.0 11904 •'ca.y Septic S Ste Y APPro Date -Z%,-Z I �pROFESS1r�"`\� �C+r = k� Note: this approval does not include well permit requirements. kI\GV VJIVLI I V) LOT 10 DRI VEWA Y SEPTIC AREA wq rE \SDI US �_Q r9 1--------- _ LOT 9 -------� LOT 7, 8 --LOT 11A IS SERVED BY AWWU AND- _ _ - THERE ARE NO WELLS WITHIN 200'. ��_Al NSG __44 ---------_ EXISTING 48' x 6' DECK >,30' l`1 EFFEC TI VE DEP TH 3 BEDROOM TRENCH , HOUSE BM TA I ~ CO MT W--W--W THIRD STREET SCOPE OF WORK 1. EXISTING SEPTIC TANK WAS ABANDONED AND BACKFILLED AS IT WAS LOCATED UNDER THE DECK. 2. PLACED NEW 1,000 GALLON PLASTIC SEPTIC TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH MINIMUM 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. TANK IS LOCATED A MINIMUM OF 5' AWAY FROM DECK SUPPORTS AND 5' AWAY FROM EXISTING TRENCH. DOUBLE CLEANOUTS WERE PROVIDED BEFORE AND AFTER THE TANK. 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. Tank Record Drawing Prepared for ROCK RETAINING WALL LOT 29 Jordan and Toni Johns 10311 Crestview Lane, Eagle River Alaska 99577 EAGLE CREST #1 TRACT A LOT 11A OSP211068 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 406-1058 4/20/2021 CLT SCALE: 1" = 40' PID: 050-303-41 SHEET 2 OF 3 LOT 13 LOT 28 Q ry J Q U_ UJ W W U) W LOT 10 DRI VEWA Y SEPTIC AREA wq rE \SDI US �_Q r9 1--------- _ LOT 9 -------� LOT 7, 8 --LOT 11A IS SERVED BY AWWU AND- _ _ - THERE ARE NO WELLS WITHIN 200'. ��_Al NSG __44 ---------_ EXISTING 48' x 6' DECK >,30' l`1 EFFEC TI VE DEP TH 3 BEDROOM TRENCH , HOUSE BM TA I ~ CO MT W--W--W THIRD STREET SCOPE OF WORK 1. EXISTING SEPTIC TANK WAS ABANDONED AND BACKFILLED AS IT WAS LOCATED UNDER THE DECK. 2. PLACED NEW 1,000 GALLON PLASTIC SEPTIC TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH MINIMUM 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. TANK IS LOCATED A MINIMUM OF 5' AWAY FROM DECK SUPPORTS AND 5' AWAY FROM EXISTING TRENCH. DOUBLE CLEANOUTS WERE PROVIDED BEFORE AND AFTER THE TANK. 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. Tank Record Drawing Prepared for ROCK RETAINING WALL LOT 29 Jordan and Toni Johns 10311 Crestview Lane, Eagle River Alaska 99577 EAGLE CREST #1 TRACT A LOT 11A OSP211068 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 406-1058 4/20/2021 CLT SCALE: 1" = 40' PID: 050-303-41 SHEET 2 OF 3 LOT 13 LOT 28 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211068 Work Type: SepticTank Upgrade Tax Code Number: 05030341000 Site Legal Address: EAGLE CREST #1 TR A LT 11A G:0055 Site Mailing Address: 19231 THIRD ST, Eagle River Owner: JOHNS JORDAN D & TONI R Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: ent �Delpa1'fI11ent 3/22/2021 3/22/2022 ❑ 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: Issued By: tyl__ Date: Date:ZZ Z 0 MUNICIPALITY CHG AGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 050-303-41 Property owner(s) JOHNS JORDAN & TONI Mailing address 10311 Crestview Lane Eagle River Day phone AK 99577 Site address 10311 Crestview Lane Eagle River AK 99577 Legal description (Sub'd., Block & Lot) EAGLE CREST #1 Legal description (Township, Range & Section) Lot Size 28,794 Sq. Ft. Number of Bedrooms 3 TR ALT 11A APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field E] Initial ElSingle Frrril(S\F) E] (wf�o A Septic Tank El Upgrade U X ❑ (D) F-1Renewal Holding Tank El Renewal❑ 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 odes. (Signature of property owner or authorized (agent) Permit/Rush Fees: _"$Z25 Waiver Fees: Date of Payment: 31 7- Z/ Date of Payment: Receipt Number: (,9 C17 Receipt Number: Permit No. 0-C-5102 11061 9 Waiver No. GADevelopment Services\Building Safety\On Site Water and Was tewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211068, Deb Wockenfuss, 03/22/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211068, Deb Wockenfuss, 03/22/21 · ~ .... ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health DiviNon 825 "L" Street, Anchorage, Alaska 99502. Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name ~::~ Vl~_~.~ ~V~ ~:~ G DISTANCES ~,m ~ ~ SEPTIC ABSORP110N ~ TANK FIELD WELL ~,~ ~ WELL ~°'T~ ~' I~ ~~t FOUNDATION TANKS , N TYPE OF SYSTEM ~ '~ ~RENCH D BED D W. DRAIN D OTHER ~ ~. ~,,~ ~. ,.-~ ~" '~'/ ~' ~'"~ ~"~"~ ~/A -' WELLS ~ PRIVATE ~THER ~l~nflfv~ ~ ~ FT REMARKS: ~ ~ ~,~ ~ ~' ~, He,~ Oe~.~nt ~ov,l: Date: 72-013 M U N I C I P A L I T Y 0 F A N C H 0 R A G E Department of Health & Human Services 825 L Street; Anchorage, Alaska 99501 545-4720 Permit Number: Date Issued: ON-SITE 890255 Upgrade 10/51/89 Engineer SEWER Designed PERMIT Owner Address: BYRON MORRIS 421 JUDY LANE JUNEAU, AK 99801 Day Phone: 694-2979 Parcel Id: Lot Legal: Lot Size Max Bedrooms: 050-505-20 Section: 7 Township: 14N Range: 1W HOUSE IS ON LOT 12. 11070 (sq.~t. or acres) This Permit: 5 Total Capacity: ~ SEPTIC TANK: Minimum total septic ta~k capacity: 1,000 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 ~eet requires insulation over tank(s). PERMIT EXPIRES DECEMBER 51, 1989. NOTIFY DHHS OF INSPECTIONS AT 545-4744, OR 545-4681. ~OPEN AND CLOSE EXCAVATION ON SAME DAY, OR HEAT EXCAVATION. ENGINEER MUST VERIFY INTEGRITY OF EXISTING SEPTIC TANK. ENGI?EER TO VERIFY CpNTINUITY OF SOILS DURING INSTALLATION. I CERTI~ THAT: 1. I am ~amiliar with therequirements lop on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State o~ Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 5. I will adhere to all MOA and State of Alaska requirements ~or the set back distances ~rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid ~or a maximum o~ 5 bedrooms. I also understand that the capacity of the total system is 5 bedrooms and additional permit. any enlargement will require an Signed: ..... j_~__~_ ~ DATE: (Owner) BYRON MO~T~IS ~ Issued By: ~ ~_ DATE: COPt. OF HEALTH & ~' C'/.'.~C' ,~,~Z~-**_'rZ,~I: .... I /~ Munlclpality of Anchorage ~.;~.--~.;.~ I .. _.~/ 0~T -~ ~ l~PARTMENT825 '-"- OF HEALTH & HUMAN SERVICES /~~ J ~ L Street, Anchorage, Alaska 99502-0650 ~~ J~ J ~ kECEIV E~°~s ~o~--.~.co~T~O. z~sm O ~ / SLOPE , SlTE'PLAN J 2 3 4 5 6- 7- 8- 9- 10- 11- 12= 13- 14- 15- 16- 17- 18- 19- WAS GROUND WATER ENCOUNTERED? ~-p ,FYES. ATW.AT O~.f/~O /~ DEPTH? Monitoring? E 20- PERCOLATION RATE ~ (m,nuteshnch) PERC HOLE DIAMETER TEST RUN [~ETWEEN ~-~ FTAND, ~ FT COMME.TS /f//. 'Z':.. ~-~/~.s' 72-006 (Rev. 4/65) CERTIFy THAT THIS T~ST WAS PERFORM. ED IN ANCHORAGE AREA BO£'" H Department of Environmental Quality~' ., ~ 3330 C Street Anchorage, Alaska 90503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL ~'~'~-, NUMBER OF COMPARTMENTS LIQUID DEPTH I IQUID CAPACITY / O~ GALLONS. SEEPAGE PIT: NUMBER OF PITS [ DIAMETER ~701 OR WIDTH LENGTH__, DEPTH LINING MATERIAL ~ CRIB SIZE: DIAMETER t~ DEPTH ~1 DISTANCE FROM: WELL U - ~f0t TOTAL EFFECTIVE BUILDING FOUNDATION ~l!, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) ~O ADDITIONAL ABSORPTION. WELL: TYPE CONSTRUCTION. . DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK __ SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARK5 DISTANCES: INSTALLED BY: ~l( PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE APPROVED/~,/"//1.~ ~,, · .A.A.B. ENGINEERING ~ DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 Russell Oyster Civil Engineering Soils & Foundations Perfomed for: 2 3 4 5 6 7 8 9 10 11 12 ~OIL LOG Name: ~X,\~- ~ -~0~ ~t~W~.~ Mailing Address: ~\ ~_ ~ ~ Legal Description: ~--cs~ \\~t ~'-~ Depth (feet) 1 0 - ~.~' ~ --~ ~.~_~ ~ Earl Ellis 333-5240 Surveying Land Development Soil Characteristics Ground Water Encountered: Yes No Proposed Installation: Seepage Pit Comments: If yes, what depth Drain Field Date: MUNMPAUTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approva Parcel I.D. 050-303-41 1. GENERAL INFORMATION Expiration Date: Z -2! �'-Z,7A Complete legal description EAGLE CREST #1 TR ALT 11A Location (site address) 10311 Crestview Lane Eagle River AK 99577 Current property owner(s) JOHNS JORDAN & TONI Day phone Mailing address Real estate agent 10311 Crestview Lane Eagle River AK 99577 Wendy Bringhurst 2. TYPE OF DWELLING: 0 Single Family (w �DU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 907.854.1236 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5�� Waiver Fee $ Date of Payment y 5 a o 1 Date of Payment Receipt Number "7 g �i Z p Receipt Number COSA # O 3 C a 1 I V73 3 Waiver # STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Engineering, LLC Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE 6. DSD SIGNATURE System #1 Approved for 0!:L— bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Phone 907.406.1058 Date fco ...�j sL'T se d....• Date-L2wa ��FC/ •..No.0 11 h .'vr 1N. PROFESS\ P = bedrooms, with the following stipulations: 11))1),,, ,��.�• �- B Original Certificate Date: IV- 2-:S -.z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: EAGLE CREST#1 TR ALT 11A Parcel ID: 050-303-41 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow testfor Static wat vel at beginning of test ft. ments public water B. TANK DATA Age of tank(s) 1 years Tank type/material septic plastic Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping installed April 2021 D. ABSORPTION FIELD DATA Well production at time of test gpm Water storage tank v e gallons Well disinf for coliform test? ❑ Yes ❑ No oliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance Age of lift station Lift station material Comment Which system tested (date installed) 1989 Adequacy test date 212512121 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms Total measured depth from grade 10 ft (max) Fluid depth prior to test 60 in Measured depth to pipe invert from grade 4 ft (min) Water added 476 gal ❑ N/A — pressurized field New depth 65 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective FE-11Code-requiredsoil cover over field Final fluid depth 59 in ❑ System presoaked Absorption rate ' 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced gallons If yes, enter date Comm ents/Deficiencies: surveyor didn't capture first trench clean out. Engineer verified that this clean out is present. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 2✓ Yes Community Sewer Manhole/Cleanout > 10 ' ® Yes if No ft s if No ft Neighboring Tank? 100' ❑ Yes if No ft��a�ee ',Q is Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft 100' ❑Yes if No ft Neighboring Absorption Fields > 100' ® Yes if No ft Water Main > 10' Animal Containment > 50' ❑ Yes if No ft M es if No ft Q,Q Yes if No ft Water Service Line > 10' / Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Communitty,Sev rv��Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10'�j✓ 2✓ Yes if No ft Surface Water > 100' F Yes if No ft Property Line > 5' Yes Yes if No ft Wells on Adjacent Lots: Cj✓ Absorption Field > 5' Rl Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' Q,Q Yes if No ft Water Service Line > 10' Q Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 2✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Cj✓ Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' FV� Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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. COSA Checklist yellow sheet ENGINEER'S <3,; *,'� 'j, <eo®> a 0 0> sYCI Lvansend 'r per• Do-t11e Gi`�rF No1.,0=; . • .M1. 0 g/i Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel1.D. 050-303-41 Expiration Date: / .2 -/'O - / 1. GENERAL INFORMATION Complete legal description EAGLE CREST #1, TRACT A, LOT 11A Location (site address) 10311 CRESTVIEW LANE, EAGLE RIVER, AK 99577 Current Property owner(s) RICHARD & VICKI BLACK Day phone Mailing address 10311 CRESTVIEW LANE, EAGLE RIVER, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Distance: Received by: d - COSA to be released tothe ngineer,un� t equested by the engineer. Date: 9-/0 /Sv COSA Fee $ 52.(O - Waiver Fee $ Date of Payment th-S%1 S (yam Date of Payment Receipt Number 6358 Receipt Number COSA # ChCi6 ty 1p ` Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Phone 868-3791 8124/15 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future ' r �, AL occupants or can ArcTerra guarantee that no unseen y encroachments, deficiencies or discrepancies exist. / � "�, 6. DSD SIGNATURE / ? KENNETH M. nV k / System #1 Approved for 3 bedrooms.Aar System #2 Approved for bedrooms. s Disapproved. By: Conditional approval for bedrooms, with the following stipulations: otill((((((rffr r. \Q�\(Y OFgNC ir ? ON-SITE �c �`_ WATER AND 111- z1 PROGRAM Off` �O. )/))SE)��\\\N• Original Certificate Date: 1-1 0 -Ar The IVunic��'dy ''1.rorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independentprofessional civil engineer registered in the State of Alaska.. The Municipality of Anchorage is notresponsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.dae 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: EAGLE CREST #1, TRACT A, LOT 11A Parcel ID: 050-303.41 A. WELL DATA — PUBLIC Well type If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) Y Wires properly protected (Y/N) Total depth ft. Cased to _ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate _ mg/L Arsenic: ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC /STEEL Date installed 11.7.1989 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping t�-2G-/4 Pumper fig S JRS C. ABSORPTION FIELD DATA Date installed 11-7-1989 Soil rating (g.p.d./ft2 or ft2/bdrm) 190 System type DEEP TRENCH Length 48 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 10 ft. Eff. absorption area 576ft2 Monitoring tube Y Depression over field N Date of adequacy test 814/2015 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 27 in. Water added 450 gal. New depth 42 in. Elapsed Time: 1350 min.' `' ' ' 'final fluid depth 27 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatrner'rt,(past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at _ in. "Pump off' level at _ in. Datum Cycles tested Manhole/Access (YIN) High water alarm level at Meets alarm & circuit requirements? in. E. SEPARATION DISTANCES - PUBLIC WATER WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5'+ Absorption field 54 Water main 10'+ Water service line 10'+ Surface water 1001+ Wells on adjacent lots 200'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 2001+ F. COMMENTS 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 ih effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 8/2412015 COSA canary sheet_2-6-15.doc c-rdr »'eW G ye ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: szt c&EX'iC G49rr/4.fll /c7741,, rT f • AND THAT NO ENCROACHMENTS EXIST aCEPT 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 SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SEWARD & ASSOCIATES. LAND SURVEYING 694-0829 SCALE: / >JC -DATE 7/4W GRID: FB: x,38--17 DRAWN: .t1, tsib. 4.SISK 0!. A[ 4vitt o*/ /`1 1 �' 4- -R r Cn ,• T Duane Mark Dewar f�•. LS -591h, crektukxCEk " MUNICIPALITY OF ANCHORAGE Department of Health & Human Se~lces DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # t'~- "~'?-,-~-~f~ HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot. block, subdivision, section, township, range) Lo,~ 11; T~.ct "A" E~tg~.~. C~.e6t #I Location (address or directions) Th~,~E g: Cre6t vZem. I~11 (b) Property owner Bq¢o~ Mailing A(~dress 421 Ju~q Telephone': (home) Alz. 99801 Business (c) Lending Iqstitution . Telephone Mailing Addre.~s · (d) Real Estate ~ompany and AgeNt EE/I*,{AX OF EAGLE ~.ZVEE / Eu~z Lo'.eft Address 16600 Ce~z~.,t~_Z~_d l?,,t.. #~0! Eaa_~e RZu~,~_. Ak. 99577 ."~?'" !-,-.: Telephone 694-4200 ' ' (e) Mail the HAA to the following address: (or check her~, if hold for picR up.) 6' ' ~i~t contact per, on and day ~hone number bolow: 5?. '. S & $ ENGINEERING I/uJ4 ~-agfe Rivet' LOop Road No. 204 Eagle Rtver~ Alaska ~577 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3. WATER SUPPLY Individual Well i'-I Community [] Public Dc Note: If community well system, must have written confirmatiop from the State Department of Environmental · ~Conservation attesting t~ th legality and status. "' 4~ SEWAGE DISPOSAL ' On-site EX Public I'1 Community D Holding Tank [] Note: If community well syste~, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status, 72-~25 (Re~. 7~68) Page I of 2 5. ENGINEERING FIRM PROVIDING INSPECTI~3NS, TESTS, FILE SEARCH, DATA AND INFORMATION" As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of thi~ Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. ' Name of Firm $ & $ ENGINEERING Telephone ~4'~;,'c"~-F~*/ 17034 Eagle River Loop Road No. 204 Address Eagle PJver, AlasEa 99577 Date Approved for -_3~' ' ' bedrooms by APproved.~ ~ '__~ Disapproved Conditional 'Terms of Conditionai'Approval "7~'; ;. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered In the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Insti.tufions 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. ~.o.~ (,,,. 7~) e,=k Page 2 of 2 CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: Date Completed Depth of Grouting A. WELL DATA Well Classification Well Log Pre~ent (Y/N) Total Depth ' Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: If A, B, C, D.E.C. Approved (Y/N). Yield ' Pump Set At Sanitary Seal on ~asing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank o'r~ Lot To Nearest Edge of .Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results [ Comments~Jl~ ~.--~IP'./>.L.. · ~ .~r.l~:~ ~ t..{... ; On Adjoining Lots "'/..~:~ I Jr' ; On Adjoining Lots. To Nearest Public Sewer Cleanout/Manhole , Date B. SEPTIC/HOLDING TANK DATA Date Installed [I-"/-~ Size ~, ~ No. of Compartments 'Z--- Standpipes (~N) 1 Air-tight Caps ~N) ~' Foundation Cleanout::~ZN) Depression over Tank (Y.~ r"T Date,Lastvl__, Pumped Pumping/Maintenance Contact on File (Y/N) / /-'~' ; for Holding Tank High-Water Alarm (Y/N) ~//* Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: . ~ -. "; ..... '"' '" ~+ To Water-Supply Well -' "- ~ To Building Foundation To Property Line - ' '. ,', r TO Disposal Field To W, ater. Main/Service LI,ne'~, .... . .... . : ,~ To Strea~, Po~d, Lake Or Major Drainage Course t ~ co; n ents - .... ~=-o~(,~,. ~/~) F,o,,, Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~ ~ ~"~'.~ ~ Type of. System Design Date Installed [ ~ ~ ~ - ~ Length of Field · .~ Width of Field Depth of Field Square Feet of Absortion Area Depression over Field (Y/~S]:~ Resuits of Last Adequacy Test Gravel Bed Thickness t~ f ' ~ '"'~ ['~ "~f= Statndpipes Present ~:~N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot '"'"" [~;" To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments , To Property Line To Existing or Abandoned System on ; On Adjoining Lots '"'3~,=-' ~ ~ I t'~'~ To Cutback (if present) .. D~,~.~alled ' ' Size in ~, "Pump On" Lev~ Dimensions Manhole/Access (Y/N) ~ ' ' ';Pump'Off" Level' at ' High Water Alarm Level at ~ Tested for Meets MOA Electrical Codes (Y/N) Comments Vent (Y/N) ~~es during Adequacy Test. **Check Permitted Bedroom Rating Against HAP, Request*' I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING 17034 Jr..agio Kivcr L~I~ Road I~o. 204 Company F=31. g;var: Alaska ~9577 Date MOA No. Date of Payment //'-/3 -,~ ~ " Amount: $ /7~). ~ Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 MUNICIPALITY OF ANCHORAG~F_, ~._~-~ [~_~n DEPARTM~'. OF HEALTH AND ENVlRONME~ L PROTECTION 825' L Street, Anchorage. Alasxa 99501 264-4720 Date Received: Februar~ 2, 1978 ~1: Time Date ~2: Time I :~f~D~h #3: Date ~-ff:-l(~ (7%J~,~%. Insp ~ Time Date In sp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Peoples Bank and Trust Mailing Address: Pouch 7-QQ7 99510 Phone: 2. Property Owner: Dennis R./Barbara Camobell Mailing Address: Box 141 Crest View Lane Phone: 694-9~6~ 3. Legal Description: Lot 11 and 1~ Trac~ ~ Eaole Crest 4: Single Family Residence: (x) Number of Bedrooms: Two Multiple Family Residence: ( ) Number of Bedrooms: Well System: Permit fl Construction Individual well (x) Community/Public System ( ) Depth of Well ~ Well Log on File Bacterial Analysis ( ) 6. Sewage Disposal System: On-site System (x) Public%Utility Permit 9 Installed Installer/ Septic Tank Size /OOO Manufacturer ~ Absorption Area Soils Rate /~ Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line ( ) Nearest Lot line Absorption Area to Nearest Lot Line ''Page. Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 11 and 12 Tract A Eagle Crest subdivision Comments: (~Ou~uOlluG ~ ' I Affadavit Attached: Approved: /'~/.C - Disapproved: Letter Attached: Date: Date: Department Worksheet: