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Home My WebLink AboutDEER HORN BLK 1 LT 1- PLAA � JOR to] Id A I 0 Lot 1 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241280 PID Number: 051-042-78 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade Name ANDREW CRAIG C/O ARM SEPTIC SERVICES ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench 0 Bed ❑ Mound Site Address 21964 DEER PARK DRIVE, CHUGIAK, AK ❑ other Phone Number of Bedrooms Soil Rating ITotal depth from original grade 907-688-9433 4 0.8 GPD/SF 2.19 (MAX.) Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot DEER HORN 1 1 Fill added above original grade SEE DWG. Ft. Gravel length 50 Ft. Township Range Section - - - Gravel width 15+ Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 750 Ft2 - - Ft. Well PUBLIC PUBLIC PUBLIC - 25'+. TANK ❑ Septic X S.T.E.P. ❑ Holding ❑ other Manufacturer INFILTRATOR SYTEMS Capacity 1530 Gal, Surface Water 100'+ 100'+ 10 0'+ - Material Number of compartments Lot Line 5'+ 10'+ rj'+ - NA PLASTIC 2 Foundation Q'+ Q'+ Q'+ _ LIFT STATION Manufacturer Capacity Remarks INFILTRATOR SYTEMS —500 (2ND COMP.)Gal. Alarm location INDOOR Electrical installed by Installer PIPE MATERIAL House to tank D3034Tank to D3034 drainfield D1785 ARM SEPTIC SERVICES Drainfield D3034 CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 100.00 ft Inspection 1m 9/25/2024 9/26/2024 Location and description 3'd 9/26/2024 4" 9/27/2024 BOTTOM OF SIDING NEAR FCO ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp oo6�Op� OF Conditional Approval: Date A, f '9S�lJ T �0 �....:.. ............. 00 ................... fr��y orness. Se tIC S Ste p Y Ci QO V CE79-3 �Q Approved -� Date U ��fP e' .lo� grz ��o co N : this approval does not include well permit requirem nts. �. #AEcces��a�Pr0000�� (Rev 05/02/18) ( 12 051-042-78 NUMBER: RECORD DRAWING - - - - - - - - KEY BOX LOCATION PER AS -BUILT �- R• KEY BOX LOCATION PER SURVEY AND ASSUMED WATER P P AWWU RECORD DRAWING LINE LOCATION / NEW IM -1530 INFILTRATOR STEP TANK r i FOX HILL; r GENERAL LOCATION BLOCK 3, LOT 2 r OF CURTAIN DRAIN 1 H ♦.1 1 SHED 1 EXISTING 4 -BEDROOM HOUSE 1 1 1 Z W 1 w 1 cn w W' 1 � 1 1 CONTRACTOR INSTALLED DIRT BLOCK IN OLD DRAINFIELD (SEE NOTE) i A I B C r PER MOA RECORDS r r r FOX HILL; BLOCK 3, LOT 1 NOTE: PER THE CONTRACTOR, THE OLD TANK WAS DECOMMISSIONED PER UPC. PER THE CONTRACTOR THE OLD DRAINFIELD NOT UNDER THE THE NEW DRAINFIELD WAS DECOMMSIONED IN PLACE AND A DIRT BLOCK WAS INSTALLED BETWEEN NEW DRAINFIELD AND OLD DRAINFIELD. FCO �"G 5.1 50.7 IV.J i P i CO , It 66.8 MH2 O x 24.2 -- w v LU 50.1 Mfia TH#1 67.0 C01 51.2 29.5 NEW DRAINFIELD---""' RAINFIELD �' --- - 56.3 34.4 RESERVED SITE (WILL REQUIRE AWWTS) SHED r i FOX HILL; r GENERAL LOCATION BLOCK 3, LOT 2 r OF CURTAIN DRAIN 1 H ♦.1 1 SHED 1 EXISTING 4 -BEDROOM HOUSE 1 1 1 Z W 1 w 1 cn w W' 1 � 1 1 CONTRACTOR INSTALLED DIRT BLOCK IN OLD DRAINFIELD (SEE NOTE) i A I B C r PER MOA RECORDS r r r FOX HILL; BLOCK 3, LOT 1 NOTE: PER THE CONTRACTOR, THE OLD TANK WAS DECOMMISSIONED PER UPC. PER THE CONTRACTOR THE OLD DRAINFIELD NOT UNDER THE THE NEW DRAINFIELD WAS DECOMMSIONED IN PLACE AND A DIRT BLOCK WAS INSTALLED BETWEEN NEW DRAINFIELD AND OLD DRAINFIELD. FCO 5.1 50.7 MH1 34.1 16.1 66.8 MH2 37.1 24.2 76.0 MTI 50.1 28.8 67.0 C01 51.2 29.5 66.2 CO2 56.3 34.4 67.8 CO3 61.5 39.4 69.8 MT2 63.1 41.1 70.9 MT3 68.0 60.5 110.2 C04 69.1 61.3 110.7 C05 73.1 63.9 111.8 C06 77.2 66.9 113.1 MT4 77.6 66.9 112.7 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO 5910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCADD. J OF MT Ltd 3 ENGINEERING & SALES -,5 CONSULTING �•.. 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, ALASKA- PHONE (907) 337.6179' WEBSITE. wmw.gamessengmeenng com / •• PREPARED FOR: ANDREW CRAIG PHONE NUMBER: PAGE NUMBER: •� Cin C/O ARM SEPTIC SERVICES 907-688-9433 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: DEER HORN; BLOCK 1, LOT 1 J.L.M. TYPE OF WORK: DATE: LICENSE RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 10/7/2024 #AECC884 Ia 0 1 2PARCEL ID NUMBER:OSP2480 RECORD DRAWING 051-042-78 TOP OF MH1 = 99.84 — TOP OF TANK @ INLET = 96.92 - INVERT OF INLET = 96.3 NEW 4" IM -1530 GALLON TWO COMPARTMENT INFILTRATOR TANK - NAL GRADES = 99.53-99.58 PER CONTRACTOR, 2" OF INSULATION 4" CO GRADE @ GEG TH#1 = 99. FINAL GRADES = 100.22-100.41� Ir4Vea-v ELEVATION OF DIST. LINES 0 /,0, n FOR DRAINFIELD = 97. BOTTOM OF SEWER DRAINROCK / TOP OF SAND FILTER ELEVATION= 96.93 TOP OF MH2 = 99.89 WEEP HOLE —TOP OF TANK / OUTLET = 96.90 TO DRA ,. PROPOSED PUMP TANK FLOAT SETTINGS INFILTRATOR TANK MODEL IM -1530 TOTAL CAPACITY_..... 1787 GALLONS W IN APA ITY 1638 GALLONS INLET INVERT 47" HIGH WATER FLOAT 33" '41" START FLOAT 32" '40" STOP FLOAT 32" '40" FLOAT LEVELS ARE FROM BOTTOM OF PUMP (-MEASUREMENT FROM BOTTOM OF TANK). NOTE: MEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES TO PIPING WITH A 3.5 INCH TETHER FROM PIPING TO FLOAT (PROVIDES 3" OPERATING RANGE). ALL FLOATS MUST BE NARROW ANGLE FLOATS. NEW 4" GEG TH#1 NEW 4" rPER CONTRACTOR, 2" OF INSULATION I r -FILTER FABRIC tltVHI WN Vh UKVUNL)WAI tK VN HIZb/ZUZ4 = `J7.43 L -EXCAVATED ALL CONTAMINATED MATERIAL FROM OLD BED AND INSTALL 3..41-3.98 FEET MOA FILTER SAND NOTE: AREA WAS GRADED SO THERE IS NO VISIBLE MOUNDED AREA OVER DRAINFIELD. INSTALLED G FOOT WIDE DIRT PLUG TOPSOIL AND SEEDING WAS DEEMED TO NOT BE BETWEEN OLD AND NEW DRAINFIELD REQUIRED. DISCUSSED WITH DEB WOCKENFUSS LIMITS OF EXCAVATION TO REMOVE ALL SEWER WITH MOA ONSITE DEPARTMENT ON 9/27/2024. DRAINROCK FROM OLD DRAINFIED = 92.95-93.52 mg a A *f: l49 /.............. .. ...............n ., r x ENGINEERING SALES-, CONSULTING 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, ALASKAPHONE (907) 337.6179' WEBSITE. www.gamesungineering.com o.. •••• • • • •••••u•• •...u••..� PREPARED FOR: ANDREW CRAIG PHONE NUMBER: PAGE NUMBER: to ; y A. r ess �' 4. C/O ARM SEPTIC SERVICES 907-688-9433 3 OF 3 �` J,'••. CE -7753 PROJECT/LEGAL DESCRIPTION: DRAWN BY: •�. (��••,� la��.•�� TMPD�E[�R HORN; BLOCK 1, LOT 1 DATE:J.L.M.M��t� p�'OFESSi�� RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 1017/2024 #AECCB 4 ,INTAlk�� 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: OSP241280 Work Type: Septic Upgrade Tax Code Number: 05104278000 Site Legal Address: DEER HORN BILK 1 LT 1 G:1558 Site Mailing Address: 21964 DEER PARK DR, Chugiak Owner: CRAIG ANDREW S 50% & Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: S' _" - "N Ur.Ixu'ti7ac�nt 9/23/2024 9/23/2025 30040 Q Disposal Field Q 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 -Recehred=By: S 5 e Date: Issued By: �Gt�� ,�— Date: z3 Z'— 4 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-042-78 Property owner(s) ANDREW CRAIG C/O ARM SEPTIC SERVICES Mailing address 21964 DEER PARK, CHUGIAK, AK 99567 Site address 21964 DEER PARK, CHUGIAK, AK 99567 Day phone 907-688-9433 Legal description (Sub'd., Block & Lot) DEER HORN; BLOCK 1, LOT 1 Legal description (Township, Range & Section) Lot Size Sq. Ft Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field FRI Initial ❑ Single Family (SF) FXJ Septic Tank QUpgrade (w/wo ADU) Holding Tank D Renewal Duplex (D) D EJ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage El 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:S qs Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 02-0716 Receipt Number: Permit No. - - 0 _c_, JJ 2, 1/ / ZS r) Waiver No. GAIDevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Perrnit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241280, Deb Wockenfuss, 09/23/24 LOT 3 BLOCK 2 LOT 2 BLOCK 1 LOT 2 BLOCK 2 I -- - 11, 111 IT _r- 2-1 TL I'%- DR LOT I BLOCK 2 1 � LOT 2 LOT I BLOCK 3 BLOCK 3 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 1-iAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SUFNEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCJ-OSE. THE INFORMATION CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPIRGVEMENTS. UNLESS GROSS NE13LIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES );OLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. mum RECORD DATA PER PLAT #84-179 @ FOUND 5/8" REBAR, PLASTIC CAP 0 FOUND 5/8" REBAR, NO CAP - -- GRAVEL DRIVE -WAY % EDGE OF ASPHALT 7K- FENCE E -- E— OVERHEAD UTELITIES PF, -0- POWER POLE m wil WATER VALVE @) SEPTIC PIPE F7711- L:�2j DECK/PORCH 3060' SCALE: I" -- 30 FEET MUNICIPALITY OF ANCHORAGE ; DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDR ESS//~ LEGAL DESCRIPTION LOCATION NO. OF BEDROOM~,~ No, of compa~tment$~., Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Total affectiv~ absorption area Nearest I°t lin~//O ,7~ Suildlng foundation Sewer line Septic tank OTHER PIPE MATERIALS SOl L TEST RATING REMARKS lot line PERMIT NO. Absorption area(s) APPROVED 724)13 (Rev. 3/78) MUN I I~ I PAL I TY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET~ ANCHORASE~ AK 9c~501 264-4720 ' ON--SITE SEWER PERMIT~ PERMIT NO: DATE ISSUED: 840544 HAND WRITTEN 05/07/84 APPLICANT: ADDRESS: CONTACT PHONE: CHUCK TANNER C/O S&S ENGINEERING SRB I~&X EAGLE RIVER, AK ~577 694-2979 LEGAL DESORIP: LOT SIZE: SUBDIVISION: DEER HORN LOT: 1 SECTION: 4 TOWNSHIP: 15N RANGE: 1W 2~&82 (SO.FT. OR ACRES) BLOCK~ 1 I certify that: 1. I am familiap with 2. the requirements for on-site sewers and wells as set fopth by the Municipality of Anchorage (MOA) and the State of Alaska. I will install the system in accordance with all MOA.codes and regulations, and in compliance with the design criteria of this permit. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing ~ell, wa~tewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~ THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT~ AND (5) THE ELECTRICAL WORK MUST LICENSED ELECTRICIAN. SIGNED ~' DATE:. ~7~ ~ -- ~r-~ APPLICANT:isSUED BY C~~NEERING. · °.~,~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [3 PERCOLATION 3'EST 825 L. Street, Anchorage. Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: I 3 m 12 13 14 15 16 18 19 20 fOWAS Gl ITERED? SLOPE SITE PLAN DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop TEST RUN BETWEEN COMMENTS /'~ 4~'1~'/~V~ PERFORMED BY: ~ 72-008 FT & Engineering LEGALDE$CRIPTION; L / ~ / 3 4 5 6 7 8 SLOPE P .5"//2 S.TE ..AN / ~_ ,.~-?7/ 10 11 13- 14- 15- 16 17 18 19 20 INAS GROUND WATER .//o /" ENCOUNTERED? y~ ~, IF YES. ATWHAT / ~ // DEPTH? [ "ct ,/2, Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~/*'//~ (minutes/inch) RUN BETWE N · ' ~TEST FT AND PH. C04 72-008 {6/79) DATE: ~-~-?~ ALASI A OI V[LOPJVII dT COP SULTAI TS, I dC. Engineers ? Surveyors Planners 5313 Arctic B vd., Suite 201 ' ~ i_P.O. Box 4-3187 Anchorage Ak. 99502 ,~?,~ ~'Anchorage, Ak. 99509 Office: (907) 561.1044 December 29, 1983 Municipality of Anchorage Department of Health & Environmental Protection 825 #L" Street Anchorage, Alaska 99501 Attn: Mr. John Linn Deer Horn Subdivision Curtain Drain. Case S-6787 Re: Dear Mr. Linn: ADC NO 83089 Pursuant to your verbal request of December 22, 1983, we have obtained As-built information from the Contractor for the curtain drain, which was constructed by Excavating Engineers for Deer Horn Subdivision. The Contractor stated that the construction was inspected (or observed) by Mr. Robert Robinson of your office. Eric Beckman of Excavating Engineers stated that the curtain drain was modified by the deletion of the fin pipe and substitution of a 4 inch perforated pipe with the trench backfilled with 2- to 4-inch washed rock as depicted on Attachment A. He stated this was verbally approved in the field by Mr. Robinson. The Contractor stated that, except for this modification, the curtain drain was constructed as shown on the Curtain Drain System drawing by S & S Engineers. The Contractor stated that the curtain drain was discharging a considerable amount of water at the time the installation was completed. A site inspection of the area on Wednesday December 28th indicated that the area disturbed for the installation of the curtain drain appeared to be where shown on the design drawing. One test pit was located on Lot 1, Block 1, however, no ice or other evidence of standing water was observed in the bottom. The pit had slbffed in and was only three feet deep at this time. Efforts to locate other test pits were unsuccessful. We investigated ~he test hole monitori~ program for Fox Hill · Subdivision which lies just south of Deer Horn Subdivision. Unfortunately the test holes which were monitored did not include those near the curtain drain, which could not be found. Monitoring reports by JML Laboratories, Inc., for July and November 1983 in Fox Hill are included for your information at Attachment B. Municipality of Anchorage December 29, 1983 Page -2- We are also enclosing the design drawing by S & S Engineers, dated 1/83 for installation of the Curtain Drain System at Attachment C. We trust that this information is sufficient to permit a favorable review. As I explained last week, the reason for the mis-understanding regarding your requirement for as-builting and monitoring of the curtain drain system was that the Staff Finding for Case S-6787 stated that "in review of new data and water table monitoring", your department was able to now support this proposed plat. We were unaware that satisfactory monitoring information was a condition. We understood that the Platting Board's condition of approval to resolve soils and sewage disposal with your department was satisfied after installation of the curtain drain when Mr. Robinson signed-off on this Condition of Approval. Should you have any questions or require further information, please do not hesitate to call. Very truly yours, ALASKA DEVELOPMENT CONSULTANTS, D. Shrader, P.E. Project Manager ' INC. SDS/mi XC: Ms. Barbra Jo Tanner 4134 Ingra Street Anchorage, Alaska 99503 I00 C,~C£1C ~'A T£~ I/lO~ll L OC~ T~O~I~ CUR TA llV Dt~A I~~ 270~ _~OCA T/ON bIAP tSCA/_E : I ~= I00' z' OI~IGIAIAL GI~£ 5ECT/ON A-A -) EBAR H ~ \ 2240-5 / -"': '"' ~ $ 89°§7'§.5'°C 129 8,5' TNH) · ~40 , , ~"10 2 142 SF. ~ 28,'770 $.F. ~Z 6 3 ~ 2 O0 S.F. ~ 38~939 S.F. ~ z 7' pro .'~ .O,F~ rEARZNG / WEST ' / / 115.00~-' S 89'f13'O4"N ~, iO0.O0 ~ 27,92t S.F. ~t BkOCK I , -~Z 28 S. . $go .00 659 TNH) . . .76' )PO. 59' GS) 2329.5t' 2 ~. t ' L ied oo :' (See Note 3) --- ~ -. ,~. I00' CREEK ~' ~....... ~. PROTECTION 4 -- ~ $ o1='o MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section �'— Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-042-78-000 Expiration Date: Legal description DEER HORN BLK 1 LT 1 Site address 21964 DEER PARK DR Chugiak AK 99567 9/26/2025 Current property owner(s) CRAIG ANDREW S 50% &CRAIG JAMES 50% X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: 2 Original Certificate Date: 10/16/2024 is Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approvaijune 2022 MUNICIPALITY C .A 0 \\ 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. 051-042-78 Complete legal description DEER HORN; BLOCK 1, LOT 1 Location (site address) 21964 DEER PARK DRIVE, CHUG IAK, AK Current property owner(s) ANDREW CRAIG 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 ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units FN_1 Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS 9 Bed ❑ Deep Trench ❑ Wide Trench ❑ 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 $ L y L Date of Payment 1 Uz`5-�z- COSA # 0 S ,r:- Z Waiver Fee $ Date of Payment Waiver # COSAApplicalioii June 2022 DEER BLOCK LOT Legal Description: ' Parcel ID: 051-042-78 If more than 1well and/or septic system on lot, provide separate checklist. Structure served by this system 1 9-,xVIA- BY PUBLIC WATER = with Onsite (or attache( Well log i with Onsite (or attached) 7"� Date drilled I depth ft ft Cased to ft F� Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) Date of flow test for CO Static water at beginning of test ft, ents B. TANK DATA Measured operating fluid level inseptic tank NEW Date ofpumping NEW 7Required maintenance completed, ifAVVVVTS Comments: C. ABSORPTION FIELD DATA Which system tested (date inotaUed) 9/26-27/2024 XALL standpipes present per record drawing Total measured depth from grade 35 ft (max) Measured depth topipe invert from grade 28 ft (min) F-1 NA\— pressurized field. RE -1 Per record drawings, field is insulated. ��Monitor tubes gutobottom ofeffective. If not, state depth into effective_____ F Presoaked required if (Required ifhouse vacant or field not used for more than 30days prior tndate oftest) Gallons introduced _gallons daka Any rejuvenation treatment (past 12months) N/A /fyes, enter date Comm ea: COSAChecklist—June2022 Well production at time of te§l,��gprn Water storage tan me_ gallons Well d' �'cted for coliform test? E] Yes ��Nc �]Co|�onnbaotehaiaNegative tra Nitrate less than MRL (ND) Anseni ug/L �lArsenio|eaothonKJRL(ND) Collected by Date C. LIFT STATION U� ==Requ/redmointenancocompJotnd Age ofU� lift NEWon ynora Lift station material PLASTIC Comments: Adequacy test date NEW nosuun 1E Pass Fluid depth prior to test NEW in Water added NEW gal New flNEWuiddapth in Elapsed time NEW min Final fluid depth NEW in Absorption rate 600+ Qpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used O in Effective depth remaining 8 in G in Fro ate Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift n Lot > 100' 0 Yes if No Community Sewer Manh anout > 100' Surface Water > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No -,ft e Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if ft Tank > 100' ❑Yes if No ft Neighboring Absorption Fie _ 0' Water Service Line > 10' a Yes Animal Containmeri _ E]Yes if No ft If tank or field is under driveway comment below ® Yes if No ft - Manure/Animal Excreta Storage > 1 Unityn ? 75' ❑Yes if No ft ® Yes if No ft A 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' 0 Yes if No ft Surface Water > 100' W Yes if No _ Tank to Property Line > 5' Di Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' R Yes if No ft Private Wells > 100' Q Yes if No Water Main > 10' Q Yes if No ft Community Wells > 200' Yes if No _ Water Service Line > 10' a Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft 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) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness 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 0 �..... ,q l fef . ey A. rness, vi+ lei 9- CE— 79.53 LICENSE �Qy pro f e, sio0 oc MECC884 i LOT 2 LOT 3 BLOCK 2 BLOCK 2 L0T 1 BLOCK 2 -DEER PARA," DR-- LOT 2 BLOCK 1 LOT 2 ' LOT 1 BLOCK 3 ' BLOCK 3 n 30' clJ 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. LEGEND ( } RECORD DATA PER PLAT #84-179 O FOUND 518" REBAR, PLASTIC CAP C FOUND 5/8" REBAR, NO CAP -- - -- —-— -GRAVEL DRIVEWAY EDGE OF ASPHALT FENCE E E OVERHEAD UTILITIES _& POWER POLE WATER VALVE SEPTIC PIPE MH SEPTIC TANK LID DECK/PORCH Of 3 0' 60' SCALE: V= 30 FEET (1 1 "x 1711 ) 14W OF At_4 odw & 0 0 0 0 , 0 k 491-H .... '•* 1j ',Ryan G. Johnson; 6-,) No. 192159 , oi ,10/2/202,4. AMW ill��fESSiONA� �� AS -BUILT OF : ..w?d 'rl. ,��V:6�p,/1';ar"e'� \ � � ♦ y. � _ d1 � d l'r .. 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I. i t y � f MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O~ Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ('%.~,\- ("~-, ~-'~-~ ~ 'NAA# ' k~,('Y~ ~-~-'~ 1. GENERAL INFORMATION Complete legal description Lot 1: Block 1: Deer Horn Subdivision Location (site address or directions) ~196Zl Deer Park Drive 15~'o, 1~%rt9 own6r" ~anOre~ Craiq · ?".~1~iling address .~196~ ~er Park D~ive :-~ending agency -.Mailing address ~ '~ ~ent Address .'' . AK Day phone Chuqiak, AK 99567 Day phone · Day phone 688-3995 2~" NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: Individual well Community ?ell ×xx Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site 'Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 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. S & $ ENGINEERING Nam~ of Firm 17034 Eagle R~ver Loo~ Road No. ~G4 Phone. 6 ~/¥. ~ 0 ? ~ E~jle River, Alaska 99577 Address Engineer's signature ~'~/~/'/. ,/~.._ Date ~2../~ (,/4 ~' DHHS SIGNATURE ~ Approved for -.~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of An~:~orage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Legal Description: A. WELL DATA Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501 Health Authority Approval Checklist R E ~_~ ~\ ~-/_ ~)t2~ ~!f') Parcel I.D.:. Well lype (Y/N) Sanitan/seal ,~ I_.A~(J tOI If A, B, or C, attach ADEC letter. ADEC water system number Ce Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: Date completed Cased to g.p.m. Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION Nitrate __ Other~ Collected by: ~ SEPTIC/HOLDING TANK DATA Date installed ;::~/~. )~' Tank size Foundation claano~N) ~. Date, o.f Pumping ,,. /(1~ NumberotCompellments ~ Claanoute{~}N) Depression (Y~) ~]O High water alarm (y~ ABSORPTION FIELD DATA. , Soil rating (g.p.dJ/ff o(~ ~"' System type ~ ~ Gravel mickness below pipe ~/I Total depth ~ ~ Effecth; absorption, sma~' ~'_ ~Z'MonitoringTube pmsent{~N)~)Depresalon over flald (Y~ Raid depth In absoq3~ion field before test (in.); ~ Immediately after.~ gal. water added (in.): .~ Fluid depth .~_t}(ins) Minutes later. '~':~ Absorpfion rate = .~-~'~ '/' q.p.d. / Peroxide treatment (past 12 months) (y/N) ~ If yes, give date .--.---- 72-026 (Rev. 3/96)* ate ~le~~~ Size in gallons Manhol~Access ~/N) ~" level at* __ 'Pump off level at' High water alarm level at' _ *~ SEPARATION DISTANCES FROM WELL ON LOT TO: :: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots t~/~ Public sewer manhole/cieanout ~'~ SEPARA~ON DIST~CES FROM SE~I~OLDING T~K ON LOT TO: Foundation P~pe~ line ~ )~ ~fio, field SEPA~TION DIST~CE FROM~SOR~ION FIELD ON LOTTO: Suda~ water 1 ~O ~ ~ D~y. p~ehicle ~omge ~ F. ENGINEER'S CERTIFICATION I cerSfy that I have deten~ined thru field inspections and review of Municipal in conformance with MC/A ~ guidelines in effect on this date. Signature ~Z. ~'- -. Date ..... HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)' Waiver Fee $ Date of Payment Receipt Number ML~I¢IPALITY OF ANCHOKACE DIVISION OF E~I~0~AL ~LT~ DEP~E~ OF ~Tll ~D Eh~IROh~AL PROTECTIO~ APPLICATION FOR ~LTll A~HORITY ~PROV~ ~RTIFICATE 1. ~neral Infoma~ton Application Date ~ (a) Legal Deserl~lon (lnelu~ lot, block, ~ubdIvI~lon, ~ec~ton, to~shlp, ra~e) Locagton (address or dlrecglo~) (b) Applicants Name~/~~ /~ O Telephone - florae Business (c) (d) Applicants Address Applicant is (check one) Lending Institution Buyer~-~; Other[~I (explain); Lending Institution ~--~ ; Owner/bullder~ ; Telephone Address (e) Real Estate Co. & Agent Address Telephone Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms 3. Water Supply Individual Well~ Multi-Family ~--~ Other (describe) Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite.~. 'Public~ '. Community~ Holding Tank~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. En~ineerin~ Firm Provtdin~ Inspections~ Tests~ File Search~ Data end Infor~ation ® As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows ~hat the on-site Water supply and/or wastewater disposal system is safe, functional and edequate 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 ~rater supply and/or wastewaCer disposal system is in compliance with all ~anicipal and State codes, ordinances, and resula- tions in effect on the date of this inspection. Name of Firm Address Telephone CAUTION THE I{UNICIPALITY OF ~NCHORAGE DEPARTMENT OF ILEALTH AND ENVIRONMEh~AL PROTECTION (DHEP) ISSUES.HtL%LTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY ~ INDEPENDENT PROFESSIO~%~ ENGINEER REGISTERED IN TI~ STATE OF ALASKA. THE DEEP DOES THIS AS A COURTESY TO PURCHASERS OF H~fES ~ND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL ~ND STATE P~QUIRE- I~NTS. EMPLOYEES OF DEEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE HUNICIPALITY OF ~NCHORA~E IS NOT RESPONSIBLE FOR ERRORS OR 0~ISSIONS IN THE PROFESSIOEAL ENGINEER'S ~0RK. (DHEP SEAL) RRt/eJ/D18 [Page 2 of 2] 7-19-84 Well Classification Well Log P~essnt (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wirirg in Conduit (Y/N) Separation Distances f~cm Wall: · TO Septlc~Holdirg Ta~k on Lot. ~(~0 '~- %:. TO N~est EdGe of Absorption Field on Lot~d;O '": T0 Nearest Public Sewer Li~e ' ~ Cleanout/Mar~le Water Samp{e Test Bssults MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL P~OTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: SEP $ 'Lg84 RECEIVED If A, B, c~ C, D.E.C. A[~proved(Y/N) Date C~,¥1eted Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression A~ound Wellhead (Y/N) ; On Adjoining Lots ~ : On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Servi~e Line on Lot · C~,~,ents SEPTIC/HOLDING TANK ~TA Pate Installed 7/~y/~ Size /~O Depression ove~ Tank (~N~ Date Last Pumped No. of Oa,~a~tments ~ Foundation Cleanout'~ PumpinG/Maintermnne Contract on File (Y/N~/;9~ ; fc~ ~ Holding Tank High-water Alarm (Y~)~ / ~ ~rary ~ldi~ Ta~ ~t (Y~/~ ~ati~ Dista~s ~ ~ptic~oldin~ Ta~: To ~ter-Su~ly ~11 ~ / To ~ildi~ F~n~ti~ ~ To ~rty U~ /~ ~ To Dis~al Field ~ To ~ter ~imJ~vi~ Li~ ~O To S~, ~, ~e, ~ ~jor ~ai~ Receipt # Date Paid:: Amount: ~, [Page 1 of 2] 2-15-84 ABSORPTION FIELD [I~TA /. Soils Rating in Absorpt~c~ Strata ~~ Type of System Design _~ Date Ir~talled ~' - "Ibr~th of Field Width of Field Depth of Field Square Feet of Absc~ption/fea Depression over Field Results of Last Adequacy Test Bed Thickness Date of Last Adequacy Test ,~ ~ ~" Separation Distanne f~cm Absorption Field: To Water-Supply Well ~-~ ~ To P~operty Line To Buildirg Foundation ~ (~ t To Existirg ~ Aban 'doned System Lot /--~ / ~ ; On Adjoining Lots -~ [D To Water ~Se~vice Line ..~O ~ To Cutback(if present) To Stream/Pond/Lake/c~ Majo~ Drainage Course To Drivaway, Pa~king Area, (~ Vehicle St(~ags Area ~ ~-- D. LIFT STATION Date Ir~ talled Si~ inGallons /~ ~_ "Ptm~ On" [e~l at High ~ter ~ ~1 at ~sted for. Ele~i~l ~s(Y~) Dim~ r~ io~ ' ' Maraole/Ac~$ (Y/N) "Pump Off" Level at %~nt (Y/N) Pumping Cycles du~ir~ Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating AGainst HAA Request I oertify th~f-~av? checke, d, verified, o~ oonfc~d to all MOA in effect on the dat,/of t~fis ir~gct~on. Sig~.ed ~ Date Cc~pan~' ~' Km/d5/s [Page 2 of 2]' 2-15-84