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HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 5 LT 40 &nIK View Estates Block 5 Lot 4 #051-043-44 Municipality ofAhchorage �'' '• Development Services Department Building Safety bivision • • • • . On -Site Water and Wastewater Program, 4700 S. Bragaw St. / P.O. Box 196650 Anchorage, AK 99519-6650 Page I Of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: :5 1-03605Y PID Number. 051' 0gS—g5/ Name:/ erO 4 el Q ermAddress Wastewater System: W New [I Upgrade Bo><177(` S 4/1z(4;4 ke q5Y7 ABSORPTION FIELD Phone: ZD 3 — bl /11 mDeepNumber of Bedroor pp(( a U N pTrench 13 Shallow Trench O Bad D Mound 0 Other. aSaR7 LEGAL DESCRIPTION Ralk- I. Total Depth from original grade: p ,� ,Sp Block Lot SubrSvislon:. /�! / �/ / •1 L• Depth to pipe bottom from or �pa5 Gravel depth beneath Ope: K Ft. 16 FL Township• Range: SacboK Fill added above original grade: Gravel Length: '3L1 Ft. FI. Well ❑ New ❑ Upgrade Gravel widM f Number of Mea: I Dlslance between lines: .—�'- Ft. FL �cl ssirication (Private, & B, Total Depth: cased to: ier Told absorption area p �Q PI MetOdal: _ �/� D Q man Uri I Ft O FP JCrJ" Draler. O ed. Slake Water Level: in nor. uftiFork- Date Initialled: t[11 7��-03 Ft Yield: Pump Set at: Casag ' Move Gram, TANK GPM Ft. FL SEPARATION DISTANCES IBJ Septic I] Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PultindPrivale M aceasr �— capacity From Tank Field Station Tank SewerUne 000 Gat Weer loo �— est Material: / /�e Number of CompartmaMa: {, Surface Water 100 t©o It LIFT STATION Lot Line��O ^ I t ' D Sao, MaraAaGurar. Foundation I t I -Pump on' level at 'Pump o High water darm at „ h Pump Make 8 Elecbical Inspections performed by: Curtdn Drain ^n �Qwn Remarks, BENCH MARK Location and Desrnpbon: /l t tlT10� S� in t It (J it "t'sunwid d D 111 Ft 12 N �tAq a 't1 '- .:' t S St S ENGINEERING Inspections by: 17034 Eagle River Loop Road, No. i,t 7'/ _� 3 performed : ; 2nd -�-03 0j -1 % ROBERT C. COWAN "O,,\ bevelopiTleh $ Nices bepartnietltApproval tf CE -8801 ;ttj Revie*ed and approved by: Date: 31 °S Fes::•::•"; ri•... (Rev. 17.90) ♦,t .,i•'_,v� PERMIT NO. SW030054 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEA�.TH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 eAnchorage, Alaska 99519-6650 • Te�l�ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4, BLOCK 5, KNIK VIEW ESTATES P.I.D. NO. 051-043-44 1 I I I I I I I I I i I I I I I I I LOT 5 I i I I I I I I I I HEyI CO CO2 C01 NEW 1000 CALLON T1 SEPTIC TANK OBLI k OBL2 H w l 01 I 1 m ECoST2 TO ST I 7 .TN 1 r H O a O 4 Z (0 ISI 3irv`'i 1 z Zmi " N 101 n N m Z ;I > I DRIVEWAY NI f'1 I �-3 m L J I KEYBOX SCALE: 1- . 40' I a t yL�i 1 1 LOT 3 oe.�..��...� r` I _... 0-,,o. t ROBERT C COVIAN i C: - 8801 r I I PERMIT No. SW030054 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650Te�l�ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4, BLOCK 5, KNIK VIEW ESTATES P.I.D. No. 051-043-44 ST1 S 99.1' FINAL GRADE 95.6' NEW 1000 95.4' GALLON SEPTIC TANK A B FCO * 1 .0 3.0 ST1 44.5 22.5 ST2 49.5 28.5 DBL1 52.0 31.0 DBL2 53.0 32.0 col —98.8, C01 53.0 22.5 CO2=99.1' I CO2 -1-7 —5.5 54.0 MT1 1 54.0 26.0 ' OFFSET FROM HOUSE FINAL GRADE C01=95.4' SR CO2=95.4' MT1=89.5' w'Cp�.''• '•.,.–, +a 04 V- NO WATER FOUND �•-»^• .......... ROBERT C. COWA4 Iti 83.0 B.O.H. CE nl •2\. L.:1�• tir w MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW030054 ,'Legal Description: knik view estates bltt k 3 L. " / Design Engineer: 0003 S & S Engineering Owner Name: leroy alderman Owner Address: p.o. box 670045 anchorage , AK 99567 - 3-z�-o3 @ C4- .1 D a Date Issued: Mar 24, 2003 Expiration Date: Mar 23, 2004 Parcel ID: 051-043-44 Site Address: p.o. box 670045 Lot Size: 21866 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field Q Septic Tank ❑ 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: Date: 3/2 43 Issued By: J., Date: 3 tqc3 Municipality of Anchorage • --r 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 SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel 1. D. OS i - bc( 3 - Y- Z Permit Number SW Property YO Day phone OZ�3— 491'00 Mailing address (1) 10.0. 8 A 6 700` 5 - Mailing Mailing address (2) C ii V (,-c 14 K Q t< Zip Code 9'%q_5-6-7 Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size^'a 1 SGS Acre /Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 3 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. 1 further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. & S ENGINEERING 1a e-1&22 zlj2 --- 17034 Eagle River Loop Road N 204 Eagle River, Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: y o J Waiver Fees: Date of Payment: 1O% 3 Date of Payment: Receipt Number: O 3 ;t 7 S5— An Receipt Number: (Rev. 12/00) 116 ROBERTC. COWAN, PE ROBERTA. SHAFER PE CIVILENGINEERS (907) 694-2979 FAX(907)694.1211 March 19, 2003 'iHOPoTM APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWERBWATER AWN DRENSIDNS REFERENCE: Lot 4, Block 5, Knik View Estates MMPECTAIONA� It is requested that you issue a permit to install a septic system to serve the proposed three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test was performed. The approximate location �REPo� srLolEs of the test hole is located on the attached site plan. At the time of excavation 3/6/03, water was not found. After monitoring, no ground water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WELLRISPECTION AFLOW TEST areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PLAra If you require additional information, please contact us. Sincerely, ROAD DESIGN 1*2 6 SMTEST Robert C. Cowan, P.E. RCC/bj j Enclosure PERCOLATION TEST B1ilUCTli1ALA MECHANICAL WSPECRONS CNSITE WASTEWATER ' blS 0&kSrsTW DESM 17034 NORTH EAGLE hnR LOOP SURE 204 • EAGLE RIVER ALASKA 99577 , tij ~Q � I � A n UO O r-� 1" = 40' r" a r= - DESIGN SITE—PLAN _ ,p� P i oma, � Xro ^ l 1 'SCAI K � m W W 0) to d n •N•~,l �v�,�, .x. renin yl'frA a�0 ` Q C m r non YP9A C'q? yH g ► y � rrl ZQTIm ��-yy lti Nva n om�s f � __._--.___-____—_..--_____,—_-__^_—_Gl-mM 1. I O. W CNK /1" V i "� �'•y'N..�pW 0-3 �t ZRr2IZS "VLLSIII MINM d 1N31V3SV3 3Nil N01103S .£ — 1N3W3SV3 W003131 V 01ii10313 .0l — — A V) c ----------- ---— — ---..------ A C---- tn0 W V O 4 1 0 N O 4 Monod v I l w ,, O r £ 0o O �' ` 43SOd0Nd 90 ti m 3S()O" fin �N � 0 y o X ni D CID H3tlOd H334 y: '^• s o A NO O / 1 n ®� �Dcz� loopDm C� p m mei D=-1 n C7 O i(" tij ~Q � I � A n UO O r-� m � r" a r= - =o 1..� N m ^ l 1 0-4 K � m ••,•'' �� n •N•~,l �v�,�, rn non x g ► y W 1• i \ J f � 1. I O. W /1" V i 0-3 DAWO Z r y yM3 ti D y � m ••,•'' �� •N•~,l �v�,�, rn non b1- O J ► y s 1c 1• i \ J r 0 m ••,•'' �� •N•~,l �v�,�, rn h V' 03 03 1• i Ndarmed Por: Legal bescription: mu"1 0611Ey 81 Aliblit rdgo h3old(Ttttbtil tbNlcbs beOddhiehl buMind Wely blvlslon bd-Slle Walel 9nd Wdsle*aler hrogranl 4700 SoUlh brage A sl. h.d. box 196650 Anchotage. Akins I g-wo un"oraae.9 liq (907) 3907134 J—•7804 861k Lid - aoirrbkliciii tact OF �� f J✓"NGINEEts,� S2i�L�7 j :: .__. Vii•, .'�; ROBERT C. COWAN f , C5-8801 •� f �fJ / pE`••.......... ••'�.�'� h. Fn"�ruD• .� INAs COUNTIERtb fat: t:FlCOUlJfERLb't bepth it yLs. At 0lAt bkbth? i- (feel) tJ A �. e . ;i. bale: 3- O . 5- ° • 7- G g- O i o. iz- ®' INAs COUNTIERtb fat: t:FlCOUlJfERLb't bale it yLs. At 0lAt bkbth? —� S � L beblhtot!Jdle4ANet ° Montloringt DAY t bale: - ib- • V� i �- i e- is- . COMMEMS heddind bale Gloss Bine Nel time bepth to Water Not trop PERCOATIONRATE, (mnxesm") r•tr�G ntnt u,nmeren tbsthUlJbLtJLu_kt ANbkt ! E-- hPhFohl�Eb ItY: / %/G6I-/�d"c.• <J C.[.li��G`' I `�/•�� c---� �7w'�-�:SRtIPY fNAt'FFIIS tb5 WA hEhPOhlAtb IN ACCOribANCE YAM ALL STAtE AND MUAICIhAL C LINES IN EPPECt ON Tills bAtb. I)AM i / c I i & A Weep kq R, PEROBERTA. SHAPER, G CIVIL ENGINEERS ALAWA (907) 694-2979 FAX (907) 694A211 W-WHAIRNoRITY ON-SITE WASTEWATER DISPOSAL SYSTEM APPROVALS CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS SEWERS WATER MAINEXTENSK" REFERENCE: Lot 4, Block 5, Knik View Estates Subdivision March 19, 2003 SEWER 6 WATER MPECTfa+ GENERAL: 1. The scope of this project includes the installation of a 1000 gallon minimum. tNCNEERNGSTLVES HDPE septic tank and' installation of a trench to serve the proposed three AHOREPORTS bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design YfLLWECTION drawings, Municipal permit with any special provisions or conditions, and all aR.CW TEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground glTEMMS utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROAD DESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their SOIL TEST own systems must also receive prior approval from the Municipal Health Department. TEST SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. StRXIMA L Construction shall include two 4" cleanouts for pumping access. flEaw+�:At '"T1ON3 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. oia SITE WASTEWATER OISPOSALSYSTEM OEsroN 17034 NORTH EAGLE RNER LOOP 4 SUITE 204 � EAGLE RIVER, ALASKA 99577 • Page 2 Lot 4, Block 3, Knik View Estates Subdivision March 1g, 2003 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 4, Block 5, Knik View Estates Subdivision March 19, 2003 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 4, Block S, Knik View Estates Subdivision March 19, 2003 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to cavy out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER ® Municipality of Anchorage r4 On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051.-043-44 1. GENERAL INFORMATION Complete legal description Knik View Estates Block 5 Lot 4 Expiration Date:�- � — Z Location (site address) 22435 Knik _Vista St. Chugiak,. AK 99567 Current Property owner(s) Herman & Julide Staschke Day phone Mailing address 22435 Knik Vista St. Chugiak,__AK_99567 _ Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ❑ Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _Well ❑ Public Sewer ❑ Public Water System Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S S O Waiver Fee $ Date of Payment a a Date of Payment I Receipt Number 6's (09(� �j Receipt Number COSA # OS C.a 11'700 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. Name of Firm ARCTERRA CONSULTING, INC. Phone 696 -61,11 - Address 20441 PTARMIGAN BLVD„ EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS _ Date I j__ -- Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future 4+�\ Nk occupants or can ArcTerra guarantee that no unseen OF Al \ encroachments, deficiencies or discrepancies exist. - - ��: .:Q`ti, 1 10, TFI 6. DSD SIGNATURE U System #1 Approved for bedrooms. KENNETH M. C T • 8 716 System #2 Approved for bedrooms. h0b7 gS1 ~�, AwlDisapproved. "*, Conditional approval for bedrooms, with the following sti k(((((((//(� j ON-SITE AN- - --- o �n►A��v1_'ATER o PROGF,AM Original Certificate Date: 2 r —2,&) z/ The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other ____ COSA blue sheet -10-10-12 doc • Legal Description: Knik View Estates Block 5 Lot 4 Parcel ID: 051-043-44 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA is filed with Onsite (or attached) Date dri Total depth ft �``�•� Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 18 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49" Standpipes/foundation cleanout per record drawing Date of pumping 11/5/21 D. ABSORPTION FIELD DATA Which system tested (date installed) 4/2/03 ALL standpipes present per record drawing Total measured depth from grade 9.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) A? .._ ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION uired maintenance completed Age of lift s years Lift station material Comments: Adequacy test date 11/23/21 Results Q Pass For 3 bedrooms Fluid depth prior to test 1 in Water added 450 gal New depth 3 in Elapsed time 30 min Final fluid depth 1 in Absorption rate 450+ gpd Any rejuvenation treatmOnt (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Sep /Lift Station on Lot > 100' '`"• ® Yes if No ft Community Sewer Manhole/Cleanout > 100' �,,,,� ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' if No Animal Con t> 50' ❑ Yes if No ft ❑ Yes if No ft Yes if No ft Manure/Animal Excreta Storage_44q;� Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes ice_ ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' 10 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 ft Water Main > 10' Yes if No ft Community Wells > 200' ® Yes if No ft 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 ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet Municipality of anchorage Development Services Department \ Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519519 -6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. !4:3 - 4 COSA# 090 1(0 S 1. GENERAL INFORMATION Expiration Date: G_/1_/0 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address KNIK VIEW ESTATES, BLOCK 5, LOT 4 22435 KNIK VISTA STREET * CHUGIAK. AK 99567 KENNETH do LINDA HOLMES Day phone 240-9683 • PO BOX 770572 • EAGLE RIVER, AK 99577 Day phone DONNA ALDERMAN w/PRUDENTIAL VISTA Day phone 16635 CENTERFIELD DRIVE • EAGLE RIVER, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 689-6468 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class_A Well ■ Community On-site ❑ Public Water System ❑ 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 wastewpter 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 private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,, shows that the on-site water supply and/or wastewater disposal system, is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd, Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines B Regulations. The reported results described the performance of the system under the conditions encountered at the Lime of the test, and separation distances measured to readily identiLiable features. The operational lite of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE L/ Approved for—3 bedrooms. Disapproved. Phone 337-6179 Date 6 0 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory y Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rm 11NS) \\\1 OF�gN \t Y err ON-SITE ••••:�� WATER AND ; M: WASTEWATER . :off'• PROGRAM • �,\`` Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ._4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: KNIK VIEW ESTATES, BLOCK 5, LOT 4 Parcel ID: 0_4�/- 0'-13-q A. WELL DATA Well type "A" COMMUNITY WATER If A. B, or C provide PWSID# 218409 Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Date completed Sanita Y/N_� Tot t ft. Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production -9 -P.M. WATER SAMPLE RESULTS: Coliform colonies/100 mi. Nitrate r Domp B. SEPTIC/HOLDING TANK DATA Collected by: ft. g.p.m. 00 mi. Tank Type/Material SEPTIC/STEEL Date Installed 4/2/2003 Tank size 1000 gal. Number of Compartments 3 Cleanouts (Y/N) YES I Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) N/A Date of pumping' 5/19/2009 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA ELGw EXISTING GRADE Date installed 4/2/2003 Soil rating .p.d./ r ft'/bdrm) 1_2 System type TRENCH Length 34 ft. Width 4 ft. Gravel below pipe 6 ft. I Total depth *9.42 ft. Eff. absorption area 408 ft' Monitoring tube YES Depression over field NO Date of adequacy test 6/3/2009 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test DRY in. - Water added 640 gal. New depth DRY in, Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p.d, Any rejuvenation treatment (past 12 mo.) (Y/N 8 type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size In gallons Manhole/Access (Y/N 'Pump on' level at in. 'Pump off leve High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES COMMUNITY WATER SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent Absorption field on lot On Public sewer main Sewer /septic service areas Public sewer manholelcleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service tine 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections andp e 4 review of Municipal records that the above systems are in I"""' conformance with MOA COSA guidelines in effect on this Q date. f Engineer's Printed Name JEFFREY A. GARNESS �Q a Date 6I Li 'e COSA Fee S 1 9 O Date of Payment V517 A �' 1 _ Receipt Number ti I (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number CE -79— All Municipality of Anchorage PZE g4 • �. Development Services Department Building Safety Division On -Site Water and Wastewater Program 5A T E T Y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.qk.us (90T) 343-7904 ,ERTirICA I E O!= SAL 1 i -i %ilJ I rtOh{i I Y HPi✓RUiJAL FOR A SINGLE FAMILY LIWELL.ING i Parcel I.D. X051-043-44 Expiration Date: 11. GENERAL INFORMATION Complete legal description _ Lot 4; Block 5; Knik View Estates__ Location site address or directions z N_ 1� nik Vista St. - Current Property owner "'Leroy Alderman ,^_ Day phone._ 223-8100 Mailing address Lending agency Mailing address. Real Estate Agent Mailing Address PO Box 670045 Chugiak_,AK 99567 Unless otherwise requested, HAA will be held by DSD for,oickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Ek Individual Holding tank ❑ Community On-site ❑ Public Sewer L, r The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastevrater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private 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 below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water. supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from, the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Fir r;) S & S Engineering- -- 694-2979 !'i IGIIC _ Address 17034 N. Eagle River Loop Ste. 204 Eagle River,- AK 99577 Engineer's Printed Name Robert C Cowan Date S6-:�,/ 3 . OF zeM r 5. DSD SIGNATURE ROBERT C. COWAN I I, - CE - 8801 , -CE -8801 Approved for �� bedrooms. wtkka%ki Disapproved. I Conditional approval for bedrooms, with the following stipulations: Ittrr_rrr Additional Comments a: ON-SITE Z:E'Z: WATER AND .; : WA9T€W4F=R PROGRAM y w . • � Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: �� Original Certificate Date: 9 --2 —03 (Rev. 07!02) D. 'LIFT STATION Date installedNIA Size in gallons Manhole/Access;(Y/N) "Pump on" level at in. "Pump 'off' level at _ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES %G(CjC/ 61 SEPARATION DISTANCES FROMW LL ON LOT TO: Septic tank%lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/c anout Sewer /septic service lin Holding tank SEPARATION DISTANCES FROM SEPTICIHGH3.1 d TANK ON LOT TO: Building foundation S r f Property line 4-7Absorption field ''E' • r Water main ( D r+ Water service line Surface water log) 7 - Wells Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ,ON LOTTO: rr Property line Building foundation f'.�. f Water main / d Water Service line �y Surface water (00 f ` Driveway, parking/vehicle storage Curtain drain/VON6*404 Wells on adjacent lots li F. COMMENTS �a OF i;J G. ENGINEER'S CERTIFICATION'. I ceray that !have determ`ned through field inspections and re vi e'^o, Municipal records than tnc abo-..a systems are in conrorma ice with MOA HAA guidelines in effect on this date. p ROBERT C.'-COWAN Engineer's Printed Name ,C a 06 ccr_ C ' co W41-1 ftFyw:t �' Date 3�\ r. 41� a/o HAA Fee. $ ,7 r', v J / Waiver,Fee $ Date of Payment '/ a 2 A Date of Payment Receipt Number 0.140 s 7 Receipt Number (Rev. 12101) o 3A O aoi a�'i o c o v � 0 co co cu 3E0& oo `o p to Lf) Lf)43 yo_o v oo Y � Q q, 41) +�'i t, U �" _T w e +d+ L .-3 C O LO .► �o_=oN3 0) �•••� C •••.•�iT c O C> V d t 0' E u CFI.0 12 UJ AW qqio-�O* com J J W z3. •• OhAoC�fr 0�O w ON'- pa fi 14 : ; AL 7- E =1 =00cli N= m O G 0 . C14 a, VI MO = a, v� o < C�L AV gl (A e4Wc o ¢ ��v. {te9\t 4w r� a=i0 C: 41 V> m ui Eno�vo�= o° xU) �- a Ao �i o UW o T,-,, O W C 'o U.0 0 a+ 0 C O CLu 'O m 3 Z M a -a 0 E p ov z v a co A F.. '� .-5 c N co M 2 G. 0. 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