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Home My WebLink AboutPARADISE VALLEY BLK 5 LT 2 & 3Par'adi Vail Y Block 5 Lot 2 #020-412-09 Mar 29 22 04:52p Anchorage Well & Pump Ser MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Pump Install Well Drilling Permit Number: Parcel Identification Number: 020_41225 9072430742 p.1 NCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 n Log Date of Issue: Legal Description Block Lot I Property Owner Name & Address: ADICKES, WILLIAM & CARIN SELLAR PARADISE VALLEY 5 2&3 1401 EDG CLIMB DRIVE SITKA, A 99835 Pump Installation Date: 03 - 25 - 2022 Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name: Pump Model: 50C211 BERKELEY Pump Size: •50 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: MARTINSON Pitless Adapter Installer: Well Disinfected Upon Completion? XYes ❑ No Method of Disinfection: PELLETS Comments: feet Pump Installer Name:. ANCHORAGE WELL &PUMP SERVICE Company: 7640 KING STREET ANCHORAGE, AK 99518 Mailing Address: 907-243-0740 City: State: Zip: Attention: The pump installer shall provide a pump installation log to 0 -site within 30 days of pump installation. Municipality of Anchorage :.:s~..'~ ,' g,~.-, Development Services Department :~ ~1~' B uild'mg Safety Division On-Site Water and W~te'water Program. 4700 $. Emgaw St. P.O. Box 196650 ~c~orage, AK 99519-6650 ,. Page of w~v.ci.anc~orage.akus (907) O N-SITE WASTEWATER DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~"~k/0 ~--0~-- 7-~- LEGAL DESCRIPTION ~... P~~ ~fl~ '~ ~: ' ~ Welt: ; [] N~W . ~'~ Upgrade SEPARATION DISTANCES Septic Absorption Lift Hold~g Tank Field Station Tank WastewaterSystem: ~ New ~ Upgrade ABSORPTION FIELD ~ ,,. ~ ,,. TANK ~Septic ~ Holding I'-I S.T,E.P. t"i Other. LIFT STATION BENCH MARK Inspections performed by:,~. S ;'"'~/'~/~ D.~te$: ~" ~'-~-?'--~I Development Se~ices Depa~ent Approval Englneer's Stamp SW020274 AS BUILT PLAN 52' x6.3' Effective absorption Field -.~LOT 13 LOT 1 ¢~/ . ! / LOT 2 LOT 3 Gal ST FROM TO DIST. A STCO I 57.4 C STCOI 20.8 A COl 51.6 C COl 54.9 A REVCO 73.5 C REVCO 38.6 LOT 12 (UNDEVELOPED) LOT 10 JAMES SIZEMORE & ASSOCIATES CIVIL ENGINEERS & SURVEYORS" SW020274 AS BUILT D~TAILS JAMES SIZEMORE & ASSOCIATES CIVIL ENGINEERS & SURVEYORS James Sizemore & Associates Civil Engineers & Surveyors 6410 Switzerland Drive (907) 345-1572 Anchorage. AK 99516 Mr. James Cross, P.E. Manager On-Site Water and Wastewater Pwgram Municipality of Anchorage Building Safety Division Reference: Permit SW020274 Dear Mr. Cross: I am requesting that this system be up-graded to a 5 bedroom system. I made a mistake when I applied for the permit in 2001 that I did not apply for a five bedroom permit. The as built ofthe system is enclosed with this letter & I can furnish any additional information that you require. Sincerely yours,~, /9 J~nes F. S~zemore P.E. Anchorage Municipality of .Anshorage i ii. America Ci~ George 15 tVuerch, ~ll(,gor 2002 8/29/2002 James Sizemore PE Sizemore & Associates 6410 Switzerland Dr. Anchorage, AK 995 ! 6 Subject: Waiver Request for Paradise Valley Block 5 Lot 2 Waiver Request #WR020066 Parcel ID #020-412-09 HA020432 Dear Mr. Sizemore: Your request for a waiver of the required 100 feet horizontal separation from the septic tank to private well has been approved. The approved separation distance is 97.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Civil Engineer On-Site Water & Wnstewater Program P.O. Pmx l(,X~50 "Anchorage, Alaska 99519-6650 * Tclcphonc: (,907) ~3-8B01 * Fttx: (907) 8~3-8200 ~7~ ~)uth Bragaw Strcct * z%chomgc, Alaska ~507 h t t p://~xax~v.cl.anch oragc.ak,us Municipality of Anchorage Development Services Department Building Saf~.ly Division On-Sil¢ Water and Waste'water Program 4700 Br'agaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www,ci.anchorage.ak.u$ (907) 343-7904 Waiver Review Worksheet WR$: WR020066 PID0:020-412-09 HAS: Permit#: Date Received: 8127/02 Legal Description: Paradise Vaflev Block $ Lot 2 Engineer. Jame~ $tzemore Pi[ ,O Applicant: ~lame$ $izemore Waiver Requested: 98 feet from well to eel)tlc tank Criteria: Geology A. Water Tabte B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: 7.~ 2.4 ~.~ 2.~ 2~. Z. Waiver is Granted: ~ Waiver is not Granted: Ust Conditions or Reasons for above: ~JEE' Date: ~'/~. ~'/~- By: ~$l,/ Name o~ Revi~r Rec$: 24770 Amount: 800.00 Date Paid: 8/2912002 $. o~ A. O. E. ¢.~. D. w. G..£o,- S.~. R. O. Zo. 2 .;:.,...,,..- ,. ; ,,'. 6410 Switzerland Drive (907) 345-1572 James Sizemore & Associates Civil Engineers & Surveyors Anchorage, AK 99516 Municipality of Anchorage On-Site Water and Wastewater 4700 S Bragaw Street Attn Dan Roth Reference: Waiver Request, Well to Septic Tank, L2B5 Paradise valley Subdivision Dear Mr. Roth: I request a waiver ofthe separation distance between the well & septic tank. I remeasured the well & septic last evening (August 26) & I measured 101.1 ft. between the well & the Septic Tank eleanout. This still leaves a comer of the tank that is between 98.6 & 100 ft. from the well. " The septic tank is located downslope from the well. I have not found the well log for my well. I had a new pump installed about one moth ago & the pump is se at 224 ft. beneath the top ofthe well casing. I have well logs from four surrounding lots: Lot 11BI5 0mmediately South of lot. Well is 291 ft. deep & shows clay layers over bedrock. Lot 1. BI5 ~Vest of Lot) Well is 165 ft. deep Lot 9B16 (North of Lot) Well is 377 ft. deep. Ot 5BI5 (East ol~Lot) Well is 152 ft. deep. I will obtain any further information required to process this request. amies F.~Sizemore P.E. MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Waslewater Program 4700 South Bragaw Street P.O. Box 195650, Anchorage, AK 99519-6650 (go7) 343-7904 ON-SITE WASTEINATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Aug 06, 2002 Expiration Date: Aug 06, 2003 Permit Number: SW020274 Legal Description: PARADISE VALLEY BLK 5 LT 2 Design Engineer: 0027 James Sizemore & Associates Owner Name: Mr. & Mrs. James Sizemore Owner Address: 6410 SWITZERLAND DR ANCHORAGE, AK 99516-6028 Parcel ID: 020-412-09 Site Address: Lot Size: 22547 SQ. FT, Total Bedrooms: 4 Permit Bedrooms: 4 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. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 643-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Issued By: ~~,-~ ~ Date: ~-'~"-" ~'"~'-' ~' Date: Municipality of Anchorage Development Sen/ices Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancherage.ak.us (907) 343-7904 ON-SITE SEWERJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING ..O Permit Number SW Proper[yowner(s) ,,..1~-~"~,,~'~"~.-..~"~2/ ~'~'-~-:~:~'~(~Y'L~Dayphone Mailing address (1) Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size '7_~--. Acres/Sq. Ft. / THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub [] Swimming Pool [] Therapy Pool [] Well Only [] Water Storage [] Jacuzzi [] Water Softening Unit [] I certify that the above information is correct. I fudher certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes, {~n~t~re of propedy owner or~ Date of Payment: Receipt Number: (Rev. 1~00) Waiver Fees: Date of Payment: Receipt Number: MUNICIPALITY OF ANCHORAGE Development Services Depa~rnent On-Site Water & Wastewater Program 4700 Sou~h Bragaw Strae~ P.O. Box 190650, Anchorage, AK 9951g-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 03, 2001 Expiration Date: Aug 03, 2002 Permit Number: SW010296 Legal Description: PARADISE VALLEY BLK 5 LT 2 Design Engineer: 0027 James Sizemora & Associates Owner Name: Mr. & Mrs. James Sizemore Owner Address: 6410 SWITZERLAND DR ANCHORAGE, AK 99516-6028 Parcel ID: 020-412-09 Site Address: Lot Size: 22547 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www,ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLI'NG Parcel LO. O ~,~ "¢-/7_.- Permit Number _SW {)] 0~' Property owner(s}/~r~.;~ J/~j"~.-~/3'~..~ ~:,,~--~'/~/'~-- Day phone -~'--,/~ Mailing address (1) G~ 5W~~/~ ~ ~ Mailing address (2) ~[0~/~[~ ~/~/ Zip Code ~.S/~ Legal description (Lot, Block & Sub'd.) ~ ~ ~ ~ ~/;~ ~//~Y Legal description (Section, Township & Range) ~I~ ~/I ~} ~ ~ ~/ Lot Si~ ~5~ A~/Sq. Ft. N~mb~or~d~oo~s ~ THIS APPLICATION IS FOR: Sewer Only [] Well Only [] Sewer and Well [] Water Storage Sewer Upgrade ,~ THIS PROPERTY CONTAINS: Hot Tub [] Jacuzzi [] Swimming Pool [] Water Softening Unit [] Therapy Pool [] I certify that the above information is correct. I fudher cedify that this application is being made for a Single Family Dw~applicable Municipal Codes. ~rty owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 1~00) Waiver Fees: Date of Payment: Receipt Number: 5' x 50' x 8' deep (4' effective) absorption Field ~., / ~'x=s~=ng ~eepage Remove top, Fill unclassified / LOT 2 BLOCK 5 PARADISE VALLEY SUBD. PROPOSED SEPTIC SYSTEM UPGRADE SITE PLAN JAMES SIZEMORE & ASSOCIATES CIVIL ENGINEERS & SURVEYORS TEL. 907-345-1572 FAX-345-9669 (ENGINEER'S SEAL) Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ ~ SLOPE ~ SITE PLAN N Pr 9- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water AJte 14 - Reading ,~_,~ -__~, ~,~.' +(ore ~, t~ }} 17- 18- 19- Date Time Time Water Drop 20- _ PERCOLATION RATE ~'~ 72~ (R~. 4/~) WASTEWATER DISPOSAL SYSTEM LOT 2, BL. 5, PARADISE VALLEY SUBDIVISION 0.0 GENERAL 0.1 The scope of this project consists of removal of the existing 1250 Gallon Septic tank and the installation ora new 1250 gallon Septic Tank and a five foot wide by 50 foot long absorption trench containing 4.0 feet &sewer rock. The existing timber crib absorption pit shall have the top removed and shall be backfilled with unclassified material. 0.2 Construction shall be as shown on the approved site plan and design drawings. Deviations from the approved design drawings shall be coordinated and approved by the engineer conducting the inspections. 0.3 All construction procedures and material used to construct the system shall comply with Municipal and State regulations. 0.4 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading areas after the system is constructed and soll is compacted and mounded over the wide trench disposal field and the Septic Tank. 1.0 SEPTIC TANK 1.1 The ! 250 Gallon septic tank shall have two compartments and shall comply with Municipality of Anchorage Requirements. 1.2 The septic tank shall be set level and shall be bedded as necessary to prevent settling or shifting of thc tank. 1.3 All pipe connections to the septic tank shall be made with waterproof mechanical couplings. A double cleanout shall be installed downstream, within 5 feet of the septic tank. 2.0 SOIL ABSORPTION DRAINFIELD 2.1 The soil absorption drainfield shall consist ora 5 ft. wide by 8 fi. deep by 50 foot long drainfield containing a total of 4.5 feet &sewer rock, 4.0 ft. beneath the perforated drain pipe. 2.2 The bottom oflhe excavated trench shall be level within +/- 2". And compacted or smeared surfaces shall be raked to allow for proper infiltration of effluent. This includes both the sides and bottom of the trench. 2.3 Sewer rock shall be 0.5 - 2.5", screened gravel with less than 3% passing the # 200 sieve. 2.4 Cleanout pipes and monitor tubes shall be 4" diameter and installed as shown on the plans. The portion ofthe monitor tube extending through the sewer rock shall be perforated. All monitor tubes and cleanout pipes shall have waterproof caps conforming to Municipality of Anchorage Specifications. 3.0 ENGINEERING INSPECTIONS 3.1 A minimum of four engineering inspections will be required during construction ofthe system. One after the septic tank is set prior to its backfill, one after excavation of the absorption trench prior to placement of sewer rock, one after placement of the sewer rock and the distribution piping, cleanouts and monitoring tubes are in place. The final inspection shall be after filter fabric is placed, the trench and the final grading are complete. 3.2 The contractor shall coordinate with the engineer at least 24 hours prior to start ofconstruction, lfthe contractor desires, a site visit with the engineer prior to start of construction can be arranged. PROBABLE IMPACTS TO ADJACENT PROPERTIES A) WELLS The proposed wastewater disposal system is designed in accordance with current Municipal Wastewater Disposal Regulations. The proposed 5' x 50' Absorption Trench is greater than ! 00 t~. from wells on this and surrounding lots. Therefore, there should be no adverse impacts on wells from this system. The construction of absorption system will not preclude construction of systems on adjoining lots. B) WASTEWATER SYSTEMS The system is designed in accordance with current Municipal Regulations, and construction will comply with current regulations~ There should be no adverse impact of adjacent disposal systems. C) RESERVED SPACE/SURFACE AND SUBSURFACE There is adequate space on the lot for a replacement disposal system, and still maintain the protective radiuses around wells. The placement of the septic system on this lot should not preclude building replacement systems on adjacent lots. D) DRAINAGE The topography on this lot and the surrounding lots is sloping varying fiom 5 % to 15 %. The area disturbed during construction of the system will be graded to prevent ponding of water. Construction ofthis system should not adversely affect drainage. ANCHORAGE AREA r tOUGH Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL/g2Z2 INSIDE LENGTH MAN U FACTU R E R -~<-~-'-/~'~ J'~Z. MATERIAL NUMBER OF COMPARTMENTS . NSIDE WIDTH ..LIQUID DEPTH .LIQUID CAPACITY /ZJ'~ GALLONS. SEEPAGE PIT: .,f~ ..~/.,./~.~×~ ~' / NUMBER OF PITS / DIAMETER _--OR WIDTH LENGTH , DEPTH /-~-/ LINING MATERIAL ~/~-~' CRIB SIZE: DIAMETERC~ DEPTH ~ DISTANCE FROM: WELL r TOTAL EFFECTIVE BUILDING FOUNDATION ~<~' ~ NEAREST LOT LINE °'~'~ /. ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING ~/6 NEAREST FOUNDATION LOT LINE CESSPOOL /V~/c/~'-- OTHER SOURCES /~ ~2.~-- ,~ DISTANCE FROM: CONSTRUCTION ,-'~/~,/~-/:':':':':"~/-~';'~/~ ~/~r'//(./~ DEPTH NEAREST ~ SEPTIC / SEEPAGE //,~ / SEWER LINE z/~ TANK /~ .,. SYSTEM ' APPROVED DISAPPROVED REMARKS INSTAL_ED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form PW-026 DIAGRAM OF SYSTEM r /~-,.,~.~'7/~,-,~" DATE APPROVED G.A.A.B. G~;iI,.~,(ER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-6510 ANCHORAGe, ALASKA 995102 TELEPHONE 279-8686 PERMIT NO. 2175 NAMe OF APPLICANT INSTALLATION OF: SEPTIC TANK SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT ~EEPAGE PIT X DRAIN FIEL , OTHer ~OIL TE~T R~SULT5 Ote~ Hl~ PEH~IT I~ NOT VALID ~ITHOUT SOIL TE FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK .%-/-- ;20 ~ FOUNDATION tO seEPAGe PIT , DRAIN FIELD . ! SEPTIC TANK TO SEEPAGE PIT WALL /~ , BeEPAGE PIT. ., DRAIN FIELD bEPTIC TANK TO NEABEST LOT LINE. WeLL TO SEPTIC TANK DRAIN FIELD seePAGe PIT also CONSIDER AREA WELLS. seePAGe PIT //~ F' WATer MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, ~i/~/~I~-/~ ~' , seePAGe PIT/~/~/~/~/' , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST iRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF eXCAVATION § FEET INTO UNDISTURBED BOIL. 4 INCH DIAMeter CAST IRO~LSIPHON PIPES ON SEPTIC TANK AND seePAGe Pit FITTED WITH AIRTIGHT REMOVABLe CAPS. GRAVEL BACKFILL CONFORM TO BOROU~H~C~EGULATIONS ReGARDiNG INSTALLATION. ,./// HeaLTh g..THORITY LICeNSeD DESIGNER i CERTIFY THAT i am familiar WITH THe ReQUIREMeNTb OF GReater ANCHORAGE AREA BOI~6JgH ORDINANCE NO. 28-68 AND that THe above DeSCRIbED SYSTEM IS IN ACCORDANCe With said CODE ~'/'/~-~ ~ )~ ~ ~ MUNMWAUTY OF ANCHORAGE 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. 020-412-25 1. GENERAL INFORMATION Expiration Date: Complete legal description PARADISE VALLEY BLOCK 5, LOTS 2 & 3 Location (site address) 6410 SWITZERLAND DRIVE, ANCHORAGE, AK 99516 Current property owner(s) ALLEN L SR & KATHLEEN KIRBY Day phone Mailing address Real estate agent 6410 SWITZERLAND DRIVE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 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: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55 Q Waiver Fee $ Date of Payment 5 o2 Date of Payment Receipt Number g 15 Z 13 Receipt Number COSA # 05C 2 110 �_) Ll 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 1/25/2021 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, +` A 9f• •[ 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 'a-rg,..!i�,9 �I for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWfs ' *� ... .. . .... ... V.~:: 6. DSD SIGNATURE Curtis Huffman ' System #1 Approved for bedrooms r��,6" .CE 128991•..��` �l F9F�PROF S ONPX. System #2 Approved for bedrooms 1��1� Disapproved Conditional approval for bedrooms, with the following g' ion�F��y�%r,� �o f)N-RITF WATER AND m -V lzrxo PR F\ AM . By: i.v. Original Certificate Date: 2-2--2 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 a,wl( ►Civ; ion 0 I r2I Legal Description: PARADISE VALLEY BLOCK 5 LOTS 2 & 3 Parcel ID: 020-412-25 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) Water storage tank volume NA gallons Date drilled CIRCA 1972 Well disinfected for coliform test? ❑ Yes ® No Total depth 240 ft ® Coliform bacteria is Negative Cased to 50 ft Nitrate 12.8 mg/L ❑ Nitrate less than MRL (ND) ® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND) ® Wires are properly protected Fw=csFS Casing height (above ground) 18+ in. Collected by Date of flow test for COSA 1/22/2021 Static water level at beginning of test 92 ft. Date of Sample 1/19/2021 Well production at time of test 2.2 gpm Comments NO WELL LOG — SEE SULLIVAN SCOPING LETTER. B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 51" ® Standpipes/foundation cleanout per record drawing Date of pumping 1/18/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/30/2001 -- ® ALL standpipes present per record drawing Total measured depth from grade 13.6 ft ("nx) Measured depth to pipe invert from grade *6.4 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective *6.31+ ED C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 1/23/2021 Results Z Pass For 5 bedrooms Fluid depth prior to test 30 in Water added 900 gal New depth 60 in Elapsed time 1400 min ® fluid depth 27 in Code -required soil cover over field Final System presoaked Absorption rate 750+ 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 2000 gallons Comments/Deficiencies: *Elevation differences between MT and ST DCO. Pipes at end of field appear to be both monitoring tubes. FkS 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' IN Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ Yes if No *98+ 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 M ® Yes if No ft Property Line > 5 IN Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells >' 100 _ ®Yes if No Water Main > 10' ® 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 *MOA Waiver. G. ENGINEER'S CERTIFICATION l certify that / 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. kko.� rob. TM $¢� .......�/ Curtis Huffman �'' i �Fc •. CE 128991 � p OFESsloo ft TI www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 211024 Subdivision: Paradise Valley Block 5 Lot 2&3 A water sample revealed a nitrate concentration of 12.8 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. If nitrates continue to rise future work may be required. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P 'O Box 196650 *anchorage, Alaska 99519 6650 *www muni org WE I 45 TIT `*.-< c., DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic 'Tank Advisory Certificate of On -Site Systems Approval # OSC211024 Subdivision: Paradise Valley Block:2, Lot: 2&3 907-343-7904 Fax: 343-7997 The septic tank for this property is 20 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $7,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. Mail�rig Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Brent Western 6410 Switzerland Dr. Anchorage, AK 99516 Camera Inspection Report Welds to 77' look good and no signs of leaking. Casing to bedrock is 77'. Static is at 87'. Pitless looked good, no signs of leaking. Date: 1-28-21 LLC co C� a3 0 N89`14'40"E 2' V] j 0 LLC 0 c`"10' DRAINAGE & UTILITY ESMT ' m co c-, C12 io-ul V olo 0 M— Lo ASW ':t (6 Aw 0 �.-, "IV .* . ". .. �D 00 -- P p- I .. : ": X 0 0 VA : 0 -4d. c LJ o o t.j co so 0-. E- o) 10 0– 0 C,O c" 10. v 0 I cq 'co Q) of 18I 1 0, C IS co o 0 co F) o -a to C, 7Ei Fs A Pia N5.'6 cn 0 clo = = c LZ==8 o 5 -> ;> )o 00 Cl) a 0 9 -j A m 0 C-4 0* C) -Z, > LT, 0 3A 0 5 0 N fn U jz Z o z CD0 �a , cl t2l�D m w I > 0 o r U Z ms� MuniciPality 'of ;A_nchorage ' : .! ..... ' , ~'i'" ';';"' 0~-i-;,- .. Dev, elopment Services Department ,. , ,' ,:. :z .I ~:" .,Building Safety Division" '~ :,' '" "' ' . :- · ,. r*',,.;:;On~SiteWat~randWastewaterProgram .':.,? - - ...-.-'..:' .'-:,]....;. 47008(~QthBragawSL'., .. ~.;,.,. "' P.O. Box 1966 0 'An~:h6'ra~e.~AK 99519-6650 . .' . .., ,.., .~.., ,,.-,-.,,.. ,;,,.,, - ,. HA APPR '" ~1~, '" CERTIFICATE OF HEALT UTHORITY OVAL-. ':,: '"' ' : FORA,SINGLE FAMILY DWELLING .. . _ ..,:....: .... '- Expiration Dat~: :. '1 J i ;,,-,-,-,-,-,-,-,-,~.t~ .:0 ~,,. :' "-' ENE ']NFORM^t ON.'" ' :'.' " Lendin(~.ageqcy" · .. : ;,._Day_phone .. .' -,.' · ' "" Mailing address -,: ' · ReaI Estate Agent - Dayphon ,. ", - · ~' '. ' : " 'i '':: ,..~,` 7: , Mailing Address .... Unless otherwise requested, HAA will be held by DSD for pickup. _... i ..:. ,-...;.L ' .... . ' 2. NUMBER _..~ ,. ....... ; :' 3. TYPEOFWATERSUPPL¥::.:--':!-: - '--:'~ :- J' .Ty~PEOFWASIEINATERDISPOSAL: ': ~ . nd vdua We , .- . - ........ ~L. ,,,. IndividualOn-site ,: .. '~ ,~; . ~ -. Community Ckis* Well .......[] '~.- Public Water System ............... [] i ......... Public Se~er ................ [] ..... The Municipality of Anchorage Devek~pment Services Department (DSD)'Iss~es Certificates of Health Authority Approval (HAA) based only upon the representations given'in paragraph 4 by an Independent professisnal civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required fcr the ffansfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system· DSD aisc issues HAAs upon request to homeowners· Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private er Class C well and may be reissued with new water sample results. (Certificates may be reissued for a pedod 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 ol'.the validation date shown below, I veri~ t~at my investigation. based on procedures outlined in the Health Authority Approval Guidelines for this application, sh~ws that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate f~r,.L~ ~umber of bedrooms and type of structure Indicated herein. I further verify that based on the information ~'t~.~o~ the Municipalityj~k~Anchorage files and from my investigation .and inspection, the on-site wate_r ~u~I] t~j~c~er~ wastew~,.e~(~sal system Is(are) in compliance with all applicable Muhicipal and State codes and ro~.u~dl~ rn effect at the time of installation.... Engineer's Printed Name ...~/~/~.e- F, g/'~//'/(~9/,'~---' Date_ A ~,G'. Z. / 5. DSD SIGNATURE ~"'"' Approved for Disapproved. Conditional approval for bedrooms. bedrooms with the following stipulations: ' Additional Comments Note: The well for this property meets existin~ State and Municipal Codes. There are nitrates present. It is suggested that periodic te~ting be perle?mc, dee insure the wells continued suitability. Current nitrate concentration i~ 7.2~ mg/l. EPA maximum concentration i~ 10.0 mgm_ information on nitrates is available from the On-Site Services Program, at 343-7904. Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Mnnicipnlity of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Souffi Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA wa, type Total depth'?.,,~ Date of test Static water level Well production IfA, B, or C provide PWSID Sanitary seal ~/N) Cased to .,;~2 ft. FROM WELL LOG g.p.m. Wall Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) ~__in. AT INSPECTION ~----' 0 g.p.m. WATER SAMPLE RESULTS: Coliform (~ colonies/100 mi. Arsenic: mg./I. .,,.te '7, Date of sample:~--/~'~7-. Other bacteria ~ colonias/100 mi. e. SEPTIC/HOI nlN6 TANK DATA TankTypaa~latertal .~c ~:~ e / Tank size ~ gal. Number of Compartments Foundation cieanout (Y/N) ~ . Depression over tank (Y/N) Ce · Date of adequacy test ~-- I 7 '--~::) ~ ' Results (Pass/Fall) ~ Fluid depth in absorption field before test ~' in. Water added "~-',~al. Elapsed Time:~::)nin. Final fluid depth ._~ in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (YIN & type) ABSO~ON FIE~ OAT~ ;' .;'-' . , ... ~, ., .~; :; .: . ~ . . Date .s~.~°~- ~.mfi~ (g.p.d.~ or ~ l/~.~ Sys~m ~ ~ ~ TOtal de~ ~,0 It Eft. ,~fion a.a~ M~n~fiog m~ V Depression ~er flel~ For ~ New depth ~'~'~. '~X'O g.p.d. If yes, give date D. UFT STATION Date installed Size in gallons *Pump on" level at ""'~'lm--_....~_ump~l~...levef~ __ Datum ,_..----~""'"'"'~C ~ ~s tested Eo SEPARATION DISTANCES in. Manhole/Access (Y/N) High water alan'n level at SEPARATION DISTANCES FROM WELL ON LOT TO: ~ep,c ten~ =tion on ~ o~e~k~' ~'c-~) "~S:~' 'i Absorption field on lot J Public sewer main /k~/A sewer/septic service line t~ F_--)/' On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING T~AN~( ON LOT TO: Building foundation "~-O ( Property line ,'~"~ Absorption field Wate, main ~J,//~ Wate, se.ice,ne ~~ Su.~cewater Wells on adja~nt ~ ~ ~ ~ / SEP~TION DIST~E FROM ~SORPTION FIELD ON LOT TO: Prope~ line [ ~ Building ~undefion + ~ ~ Wa.r main Wamr Se~ line ~ ~ ( Curlain drain F. COMMENTS Surface water /~0~::' Driveway, paddngNehicle storage Wells on adjacent Iot~ ~/.._.~r ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal record~ that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date HAA Fee $ ,'~'"/~'-*"'t Da. o~ P,~ent Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number L_O t 2.J~r.~., .'BIo c k ...~z_ ' Anchorage Recording Precinct, Alaska. LOT SURVEY CERTIFICATION I hereby certify that I hove surveyed the property shown and described hereon~ and thai the improvements sltuofed thereat ore within the property lines and do not overrun or encroach on adjacent property an~ that no improvements on adjacent property overlap orencrooch on fha premises in question ond lhot there ore no roodwoys~ utility lines or other.visible easements on said property except os indicated hereon. Prepay"e# ~y: Dole.. By: ~' ' LEGEND Brass COp Monumenl I~on Piee Steel Survey H~ Tack REVISIONS DATE BY