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Home My WebLink AboutEAGLE CREST #1 TR A LT 40Eagle Crest #! Lot 40 Tract A #050-303-31 Municipality of Anchorage Page ~- o! DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 · On-Site Wastewater Disposal System and/or Well Inspection Report Peimit Number: ~3Z:~<~$~(~II~ PID Number: .arno: ~7, E'[,'o~' C./~,,- J,e..,.-,/,~ Wastewater System: 13 New ~,,Upgrade ^d*,..: ABSORPTION FIELD Phone: ~ ~ v.~ -'e~d~g' '~ I NO. O~edrooms: ~Oeep'Trench t-I Shallow Trench r'l Bed t'l Mound f'l Other LEGAL DESCRIPTION /./2- Gpo,sq F, ! ~- ' Classificat:on {Pnvale, A.B.C): ~Fl Cased TO: Fl Total absorptionz.~..area: $0 Ft 7/'~- ~¢~"~'~.i Yle~,._lCl~: GPM IPUmp Set at: ' F,.Ica'~"g "'';n' A~°" G'°''r~:Ft. TANK SEPARATION DISTANCES ~2/s · ptic n Holding n S,T.E-P. Remarks:~rt ~'// fl~ =v*- BENCH MARK ENGINEER'S SEAL Inspections performed by: ~Rg~ Dates: 1st ~-~ ~.~ Reviewed and approved by: ~~ ~. ~ Date: ~ ~- ~ Z- o ~ Permit No. 8W980144 Page. 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage. Naska 99519-6650 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Eagle Crest Lot 40 Tract A No.: 05030331 Neg'56'0'W e 82.0' 67 -- ~lO' utility .stat J SwinqTies A-C - 27.8' ~~% e-c- '~7.2' A-D - 52,5' e-o - 47.1' LOT 40 ,bed I N89'58'0'W 82.0' (NOT TO SCALE) Scale 1" =30' 6/15/98 HUNICIP~LIT¥ OF RNCHOR8OE DEPRRT~IENT OF HERLTH AND ENYIRONMENTRL PROTECTION · 825 L STREET, ~NCHOR8OE~ RK ~501 264-4720 ON--SITE ~£LL PERMIT PERHIT NO: DRTE ISSUED: 840~43 05715784 RPPLICRNT: RDDRESS:. CONTRCT PHONE: LEGRL DESCRIP: LOT SIZE: JRMES W. FROCE P.O, BOX 875021 ERGLE RIVER 376-8566 RK 99687 SUBDIVISION: ERGLECR~$T SECTION: ? TOWNSHIP: i4N i1070 (SQ. FT. OR RCRES> LOT: 40 TRRCT BLOCK: RRNGE; iW NR CERTIFV THRT: I RH FRMILIRR WITH THE REOUIREHENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BV THE HUNICIPRLITV OF RNCHORRGE (MOR) RND THE STRTE OF RLRSKR. I WILL INSTRLL THE SVSTEM IN RCCORDRNCE WITH RLL MOR CODES RND REGULRTIONS, RND IN COMPLIRNCE WITH TH~ DESIGN CRITERIR OF THIS PERHIT. I WILL RDHERE TO RLL HOR RND STRTE OF RLRSKR REQUIREMENTS FOR THE.~ET BRCK DISTRNCES'FROM RNV EXISTING WELL, WRSTEWRTER DISPOSRL SYSTEM OR PUBLIC SEWERRGE SV~TEM ON THIS OR RNV R~JRCENT OR NERRBY LOT. !.SIGNED ~~__~~ ........ DRTE; RPPL I CRN~.~=~J%E~ ~ROCE · Rick Mystrom. Mayor Municipality of Anchorage Department of Health and Human Services 825 'L" Street P.O. Box 196650 Anchorage. Alaska 99519-6650 htlp://www.ci.a nchorage.ak.us April 3, 2000 Eliot Chamberlin 10200 Hillcrest Lane Eagle River, AK 99577 Subject: Eagle Crest #1, Tract A, Lot 40 SW990118 ParcelID: 050-303-31 The subject permit #SW990118 issued by this office for a single family well and/or on- site wastewater system, is due to expire 365 days after it's issuance on June 2, 1999. If this is a well permit and you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If this is an on-site wastewater system and' a licensed Professional Engineer has inspected the installation, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Sincerely, Program Manager On-site Services enc: Copy of Permit MUNICIPALITY OF ANCHORAGE Department of Health and Human Sen/ices On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Renewal Date Issued: Jun 02, 1999 Expiration Date: Jun 01, 2000 Permit Number:. SW990118 Legal Description: EAGLE CREST #1 TR ALT 40 Design Engineer:. 0024 Eagle River Engineering Services Owner Name: J. Eliot Chamberiin Owner Address: 10200 Hillcrest Lane Eagle River, AK 99577-8450 Parcel ID: 050-303-31 Site Address: 010200 HILLCREST LN Lot Size: 11070 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either:. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing, MUNICIPALITY OF ANC~0RAGE DEPARTMENT OF HEALTH AND IUJMAN SERVICES P.O. BOX 196650, 825 #L" STREET, ROOM 502 2~NC~ORAGE, ALASKA 99519-6650 ~ ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER: SW980144 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:CHA~BERLIN J ELIOT OWNER ADDRESS:10200 HILLCP~EST LN EAGLE RIVER, AK DATE ISSUED: 6/01/98 EXPIRATION DATE: 6/01/99 PARCEL ID:05030331 LEGAL DESCRIPTION: EAGLE CREST TR ALT 40 LOT SIZE: 11070 (SQ. FT.) I~UMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHEDAPPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ILNC~0RAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF AI~ASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DH~S AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS } . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO A~RIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALEDAND ]{EATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: · ... Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-$294 (907) 694-3297 fax May 19, 1998 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 RECEIVED ~t~¥ 20 1998 ~,ad~t.,~Akll¥ OF ANCHORA~,E Eagle Crest, Tract A, Lot 40 Narrative & Permit Application Dear Mr. Cross: We are requesting a permit to allow the upgrade of an existing home occupied since 1974 with an existing wastewater system. The proposed septic upgrade will be partially located in a fill area, the fill consisting of a good quality gravel soil and having been in place +7 years. The system will be constructed in both the natural soil and the fill layer. We have completed 2 test holes within the 30' radius of the trench pete. testing both layers. No credit will be given for the original topsoil layer, and a weighted application rate is used to calculate the required absorption area. Using this criteria, a trench 20' in length, with a total depth of 12' from the existing ground surface will provide sufficient absorption area. Additional fill will be added after construction to provide the necessary 3' earth cover. Further details can be seen on the attached site plan. Drainage is not expected to be a problem due to the natural land contours, and also the fact that fill will be added above the proposed septic system to improve drainage and insulation. There will be no onsite well on this proper%', a 1000 gallon water storage system xvill be used. The layout of this lot and the surrounding lots limit the area available for septic upgrade. It is imperative that our design produce the shortest trench design possible. The design presented has the .least impact on the subject lot and the surrounding lots. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. [1998\98-014-~AR.DOC Neighbor / ~~~'"~'~' _- , . . ,~ I' ~1~ ~'~ ~- // ~n Pri~ I, · ~ ~COND' . - ?~,.o~ · -- MONITO~ TUBE o - 5~ER C~O~ + - W~L ~EMENT · NO SURFACE WATER ~- PROPPED L~HF)ELD NO KNOWN CURTNN D~INS I-- EXIS~NG ~HFIELD WELL/SEPTIC SITE PLAN LEGAL: Lot 40 Eoglecrest Tract A ~..'""~"~0~ CO~IR~ClOR: .... ............... ~o~ ~s-o~4 ~,[: s/~4/,s I sc~t[ ~" = 30' ... P.O. Bo~ 778~4 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax LEGAL: A. I. 2. 3. 4. $. 6. 7. 8. 9. SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM Eagle Crest. Tract A Lot 40 5/5/98 GENERAL The well and septic plan are for a single family residence only. The drawing and or site plan shall be a part of thls specification. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. All soil tests are advisory to the design and are to be 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 Municipality of Anchorage, Department of Environmental Conservation requirements. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 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 Any remaining open test hole excavations shall be filled. B. WATER STORAGE FACILITY SPECIFICATIONS Specifications and requirements for water storage tanks interior application is as follows: I. Water storage tanks shall have National Sanitation Foundation (NSF) approval. 2. Water storage tank materials and coating used in construction shall be either U.S. Food and Drug Administration (FDA) or NSF approved food grade. 3. All components of water storage facilities shall comply wlth the latest adopted edition of the Uniform Plumbing Code as amended. 4. Water storage tank shall have a minimum capacity of 1,000 gallons. 5. An extarior or easily accessible fill point shall be provlded. 6. Access or fill point to water storage tanks shall be clearly and permanently marked "potable water~. 7. A water pressure system shall be installed to provide a 5 gpm water flow to the house at a minimum pressure of 20 psi. A captive air bladder type pressure tank to be proved that will limit pump cycle time to I minute or more. C. SEPTIC TANK 1. Septic tank shall have a mlnlmum capacity of 1000 gallons and be of MOA approved design. \1997~98-014-spc.doc D. 1. 2. 3. 4. 5. TRENCH The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. The bottom of the trench shall be level, plus or minus 1.5". The total depth of the trench excavation is not to exceed 12' below orlgonal ground at any point. The effluent line within the trench shall be lald level within 0.0Y. : The trench gravel is to be covered with typar fabric material. Soil or combination of soll and extruded board insulation to a depth of 3' or equivalent is to be piaced over the leachfield. The area over the trench is to be finish graded to prevent pondlng 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 feet to any community well. ~,ECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH '= 12' GRAVEL DEPTH = 10' under pipe, 2" over pipe TRENCH LENGTH = 20' TRENCH WIDTH -- 3' SOIL RATING ,' 1.12 GPD/ft2 BEDROOM CAPACITY = 3 SEPTICTANK ,= 1000 gallons Twenty-four (24) hours notice required for all inspections. ~1997~98-014-spc.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 98-014 Calculated By: LB Date: 5/20/98 Legal: Eagle Crest lot 40 tract A Single Family 3 Bedroom Dwelling TEST HOLE Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 2 minutes perinch Wastewater application rate = 1.12 gallons per day per square foot Required absorption area = 402 square feet Trench width (W) = 3 feet Graveldepth (D) = 10 feet Required length = Required absorption area 12 / D Required length = 402 I 2 Required length = 20 feet Total Excavation Dept = 12.0 feet I 10 See attached for weighted application rates. 98-014-cal.xls 9:31 AM5/20198 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L' Street. Anchorage. Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST PERFORMED FOR= D^TE PERFORMEO: LEGAL DESCRIPTION: ~f,/< (~-/~'~?' '~'q~/'~,-c~,,~ TOWnShip. Range. Section: SLOPE SITE PLAN ,c-,'//t Gw-d,v 4- 5- 6- 7- 8- 9- 10- 12- 14- 15- 16 18 19 20 I lll IIII I,-'.'1 I I I IIII I1.111111 I I WAS GROUND WATER ENCOUNTERED? Gross Net DePth to Net Reading Dete Time Time Water Drop Z ! [Yo'"'"' lO ~.',, 7 ? rl/~ / q tr:f~' lo ,...,,'., *) ? rl,~ i PERCOLATION RATE ~" ~:~ {m.nutes,'mch) PERC HOLE DIAMETER TEST RUN BETWEEN '~ FT AND ~/~ FT COMMENTS PERFORMED BY: ~'~fr'''~'-''- f I ~~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE; 72-008 (Rev. PERFORMED FOR: LEGAL DESCRIPTION: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street. Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: ~._,,~.~.c?~, Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? DEPTH? Depth to Water After I~ni~in;? I I N Gross Net Depth to Net Reading Date Time Time Water Drop ~ I~: v? 11-7 ' ( I~ ; ~? /~ If'll'/vz' COMMENTS PERCOLATION RATE ~-' ~' (m~nute~'mch) PEflC HOLE DIAMETER TEST RUN RETWEEN I/ FTAND 1o~ FT PERFORMED ny: ~'E'J' ~ ,/-~~ CERT,FY T,AT T,,S TEST WAS PERFORMED ,N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK 99577 (907) 694.5195 ..................................................................... ~ . ~ , , ~ ~ ~ . ........................................................... : ...................... . , ~ · '" Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax June 1, 1998 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Eagle Crest, Tract A, Lot 40 Narrative & Permit Application Dear Mr. Cross: I consider the fill material noted on our soil logs for the above referenced lot to be suitable material for a leachfield system. The material was visually inspected and perc tested utilizing 2 test holes. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. ~ 1998\98-014 B-NAR.DOC MUNICIPALITY 4 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-303-31 1. GENERAL INFORMATION Expiration Date: (—' I - Z. OZ Z. Complete legal description EAGLE CREST #1, TRACT A, LOT 40 Location (site address) 10200 HILLCREST LN EAGLE RIVER, AK 99577 Current property owner(s) SEAN GLOVER & LEIGH ROBIN/ TRUSTEES Day phone Mailing address Real estate agent 10200 HILLCREST LN EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY:. TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 5 5 Waiver Fee $ Date of Payment a O Q 9 Date of Payment Receipt Number 19 Receipt Number COSA # 0 5 Ca -I) f 0 7 D Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 3/4/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q: • .. for current or future occupants or guarantee that no unseen encroachments, deficiencies or /rg•' '.9 �� discrepancies exist can be given by First Water Consulting & 49 TH -•* 6. DSD SIGNATURE ,, "'�". / • • Curtis Huffman System #1 Approved for bedrooms %��F��•• CE 128991�� ,' • 4/4/2 . - F� System #2 Approved for bedrooms iI,F�PROFESSIONP�4 Disapproved Conditional approval for bedrooms, with the following stipulations: A Ki- r�0 O fir//moi \NP� I..��P�ER o� Jo ROG` P o �l))))))))W)�1 ) Original Certificate Date: �" ,� ZQZZ 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 Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Other i'awt k I4ct�i s[or7 Legal Description: EAGLE CREST #1 LOT 40 TRACT A Parcel ID: 050-303-31 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UNKNOWN — SEE 2011 COSA Total depth 310 ft Cased to 310 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 2/7/2022 Static water level at beginning of test 282 ft. Well production at time of test 2.7 gpm Comments B. TANK DATA Age of tank(s) 24 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout.per record drawing Date of pumping 2/2/2022 - ONE STOP D. ABSORPTION FIELD DATA Structure served by this system _ Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 2.96 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) NES Collected by - Date of Sample 02/04/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station ___ years Lift station material Comments: N Which system tested (date installed) 6/5/1998 Adequacy test date 2/7/2022 ® ALL standpipes present per record drawing Results 0 Pass For 3 bedrooms Total measured depth from grade *15.8 ft (max) Fluid depth prior to test 28 in Measured depth to pipe invert from grade *7.8 ft (min) Water added 450 gal ❑ N/A — pressurized field New depth 29 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 165 min depth into effective ELEVATIONS SHOW 9.8' NOT 1WED ® Code -required soil cover over field Final fluid depth 28 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: *RAW DATA AT MT/DCO F E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ft ft ft ft ft ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' y Yes if No ft Community Wells > 200' Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No _ ft. Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that l 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. OF *; —49 TH •, _ Curtis Huffman 9 . CE 128991 •�``w� OFESSION�`L��,,�� ft it Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221070 Subdivision: Eagle Crest #1 Tract A lot 40 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / pfoperty is 24 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Mad�ng Address P O Box 196650* Anchora e, Alaska 99519 6650 * www muni or �R MunicipalitY of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-30331 ~ GENERAL INFORMATION ~.~- Complete legal!descr{ption ~,,,. Location (site address) 10220 Hillcrest Lane, Eagle River, Alaska '~:,Current Property ~er(s) S~ne, eui~ders ':~.;Malllng..:. addre~Ss, 2601 Kona Lane, ~cho~e, AK 99517 Expiration Date: Lot 40, Tract A, Eagle Crest Subdivision #1 Day phone (907)441-2232 Lending agency Unknown Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBEROF BEDROOMS: 3 TYPE OF WATER SUPPLY:' Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System ri' 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 pdvate or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown bel°w, 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 vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Alaska Rim Engineering, Inc. Address P,O. Box 2749, Palmer, AK 99645 Engineer's Pdnted Name Ronald E. Godden DSD SIGNATURE ~ Approved for -~ Disapproved. Conditional approval for bedrooms. Phone 907-242~0755 Date J I(Z./IJ bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory y2/~Advis°ry B . (Rev. 11/05) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Repod Other Original'Certificate Date: /~/~ ~'/// ' f / Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/0nsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 40, Tract A, Eagle Crest Subdivision #1 Parcel ID: 050-30331 A. WELL DATA Private Well type . .. Date completed Total depth 31 IfA, B, or C provide PWSID #~ Sanitary seal (Y/N) Y Cased to 310 ft. Date oftest FROM WELL LOG UNK ' Static water level g.p.m. Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 1.90 mg/L Arsenic: ~0 ~'~'('~ . ug/L date of sample: Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 18 AT INSPECTION 10/20/2009 271 ff. 10 g.p.m. in. Collected by: Robin GabeI-Dammann B. SEPTIC/HOLDING TANK DATA Tank Type/Material Anchorage Tank, Steel Date installed 06~05~98 ,~,,,6:f'' + ' ~ze 1~259"gal. Number of Compartments 2 Cleanouts (Y/N) Y .~ndation cleanout ~.J~, ~ Depression over tank (Y/N) N High water alarm (Y/N) NA .~:~e of pdmping .09107t.1.1 Denal~ Sewer & Drain Pumper ~,.. ABSORPTION FIELD DATA ""''" ~;':'~ ''~ 0(;/05J9~8{~"i!' System type ':~%~.i t~ installed , . Soil rating (g.p.d./ff2 or ft2/bdrm) ,.2~¢,,, Deep Trench Le'~gt~ 20 ft. Width 3 ft. Gravel below pipe t0.0 Total d6pth' 17' ff. Eft, absorption area 402 fF Monitoring tube Y Depression over field N Date of adequacy test 06/17/11 Results (Pass/Fail) P Fluid depth in absorption field before test 0 in. Water added 590 gal. Elapsed Time: 30 min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) _Unknown For .....3.. bedrooms New depth 26 in. Absorption rate >= 450 g.p:d. If yes, give date NA LIFT STATION Date installed NA "Pump on" level at NA in. Datum NA Size in gallons NA "Pump off" level at NA in. Cycles tested'Nm Manhole/Access (Y/N) NA High water alarm level at NA Meets alarm & circuit requirements? NA in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 105 Absorption field on lot 115 Public sewer main NA Sewer/septic service line 105' Animalcontainment areas +50' On adjacent lots + 100 On adjacent I°ts -F 100 Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas +100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation +10 ft Property line +10 ft Water main NA " Water service line +25 ft Wells on adjacent lots + 100 SEPARATION DISTANCE FROM ABSORPTION FIELD oN LOT TO: Property line +10 ft Building foundation +10 ft Water Service line +25 ft ' Surface water + 100 ft Curtain drain None observed Wells on adjacent lots +100 F. COMMENTS Absorption field + 10 ft +100 ft Surface water Water main NA Driveway, parking/vehicle storage -t-10 ft Engineer's Pdnted Name Ronald E. Godden Date ,, ~ ~ II '~. I~' .~ COSAFee $ '~ 7~ ~WaiverFee$ Receipt Number / ~ ~ ~ Receipt Number (Rev. 4/10) EAGLE PLAT NOo 63-70 CEEST SUBDIVISION LOT 40, TRACT A 11,070 S.F. S 89"56'00"E 82,00' 10' UTiL. ESbrr. 22.1' 19.8' '~'~, S 8g'~56'OO"E 82.00' ~ . %, 2ND STREET %, ,,Em£ A.C, PA~N,(~ 50' A S -B"U I'"L T ,, .E.~-,~' c~' *~T, .~ ~.~ ~E , PROPERTY DEPICTED ABOVE: ~D ~T NO ~1 ~D ~C~HM~ ~1~ ~C~ ~ INDI~, SURVEYING, LLC ~ IS ~E RE~O~BI~ OF ~E O~ER ~ JE~ k ~1, R. LS. D~INE ~E ~I~NCE OF ~ ~EM~ 2~ E ~ ~., ~ 8 CO~ OR ~I~ONS WHICH ~ N~ ~CH~ ~ 9g~7 ~ ~ ~E RE~ ~BD~SI~ P~T. PHONE 2~-5~4 UNDER NO CI~UM~C~ ~OU~ ~ DATA GRID ~TE H~ON BE US~ ~R CON~U~ ~ ~R ~0055 7/27/2011 ~USHING BOUN~ OR ~CE UN~. " ANCHO~E RECORDING Ol~l~, ~ F.B. JOB NO. 11-03 E~A NOTE: NO C~NERS SET THIS DATE. rvlunicipal ty Anchorage POUt... ~' 6-650 ANCHORAGE. ALASKA 99502-0650 (907) ,264-4111 TOMY KNOWLE$ MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840343 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 40 Tract B]0ck NA Eaglecrest Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as-built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Si.ncerely, Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057