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HomeMy WebLinkAboutCALKINS LT 5Onsite File Calkins Lot 5 PID# 050-211-16 Prior to any future COSA approval, the encroachment of the disposal field needs to be addressed. Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251227 PID Number: 050-211-16 Dwelling: [OR Single Family (SF) El with ADU F-1 Duplex (D) E] Two Single Family Project: n New nN Upgrade Name Kassondra & Kyle Cline A ORPTION FIELD ❑ De Trench n Wide Trench F] Bed n Mound Site Address Other Phone Number of Bedrooms Soil Rating depth from original grade 1 3 ITotal Ft. LEGAL DESCRIPTION Depth to pipe invert from original g e Ft. Gravel depth beneath pipe -�, Ft. Subdivision Block Lot Calkins 5 Fill added above original grade Ft. Gra I length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dista between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t From Tank Field Tank Line Ft2 Well >95,* N/A N/A N/A >25 TANK R] Septic El S.T.E.P. 171 Holding [I Other Manufacturer Anchorage Tank Capacity 1250** Gal. Surface Water >1 oo, N/A N/A N/A Material Plastic Number of compartments 2 Lot Line >5, N/A N/A N/A NA Foundation >1 o, N/A N/A N/A qEE§TATION Manufacturer Capacity Remarks *Amended waiver WR86-123 Gal. **Oversized tank installed at owner's request Alarm location Electric lied by PIPE MATERIAL House totank D3034 drainfield Tankto D3034 Installer Territory North Drainfield D3034 CO/MT D3034 Inspector Justin Earls BENCH MARK (Assumed elevation) 100 ft Inspection 7/22/25 Location and description dates: 2 nd th Ledger over dog door are 4 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date Aw 7 TH ;4111 Septic System _-Z / Approved Date D1 �Benjamin Sc-hiller _ o - - 7/30/25 Aw CE 12592 �IkPROFESSO�, Note: this approval does not include well permit requiremets. ,, (Kev ub/uzi 1 t3) Benjamin Schiller CE 12592R E GISTEREDPROFES S I O N A L E N GINEER 1"=40' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP251227 PID # 050-211-16 CALKINS, LOT 5 FEET 0 40 80 SEPTIC PLAN 7/30/25 3-BDRM HOME 1250-GAL SEPTIC TANK (DEEP BURIAL) EXISTING TRENCH (8' OF COVER) 2CO C R E S T V I E W L A N E ALL NEIGHBORING WELLS SHOWN w/ 100' RADIUS SVMH A B 2CO 50.3 SV 49.9 MH 49.2 57.9 55.7 51.3 A B BENCHMARK LOCATION PIPE LOCATION CORRECTED BY SURVEYOR - SEE FINAL ASB PROFILE AS-BUILT (NO SCALE) 90.4 85.2 90.9 99.5 FC O MH SV CALKINS, LOT 5 1250 GAL SEPTIC TANK 2C O 90.1 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 7/30/25 PERMIT # OSP251227 PID # 050-211-16 CALKI N S SUBD I V I S I O N CR E S T V I E W L A N E Taylor L. Dosch No. 189892 R E GISTEREDPROFESSIO N A L L A N D S U R VEYOR 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: OSP251227 Work Type: SepticTank Upgrade Tax Code Number: 05021116000 Site Legal Address: CALKINS LT 5 G:0055 Site Mailing Address: 10535 CREST VIEW LN, Eagle River Owner: CLINE KASSONDRA & KYLE LYNN Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 7/3/2026 20663 ❑ 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 Special Provisions: Prior to any future COSA approval, the encroachment of the disposal field needs to be addressed. Recei Issue Date: 7/3/2025 Date: 7/3/2025 3 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-211-16 Property owner(s) Kassondra & Kyle Cline Day phone Mailing address 10535 Crestview Ln, Eagle River, AK 99577 Site address Same Legal description Calkins, Lot 5 Number of Bedrooms 3 Engineering Firm Forge Engineering Building Permit Number Not Applicable F0_1 APPLICATION IS FOR: APPLICATION IS AN: all that apply) Absorption Field F] Initial ❑ Septic Tank Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: Q25-00 Waiver Fees: Date of Payment: 713 io? .� Date of Payment: Permit No. 0SPOIS—W11 Waiver No. July 1, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Calkins, Lot 5 – 10535 Crest View Ln Septic system design Dear On-Site Services Engineer: The owner of the above lot has a 3-bedroom home on the property. The old septic tank has been confirmed to be leaking so we are submitting this permit application for the installation of a new tank. The attached site plan identifies the location of the home as well as the proposed location of the new. While the old tank and trench are within 100’ of the well on lot 6, the new tank can be installed outside of this radius and any others nearby. Please refer to the attached plan page for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE UYE E E R I N G July 21, 2025 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIF..COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Calkins, Lot 5 -10535 Crest View Ln Well waiver request Dear On -Site Services Engineer: We have been in close touch with the installer on this project. Our initial measurements indicated that the septic tank and absorption trench are both very deep, around 8' of cover, so we noted to the contractor the importance of checking elevations and slopes before fully excavating the tank. The current tank is more than 100' from the well on this lot, but is about 85' from the neighboring well. The contractor exposed portions of the pipes and took laser measurements. He discovered that there isn't enough of an elevation difference to place the tank outside the closer well radius and still achieve fall to the trench. We would like to place the tank in line with the existing pipes, but further from the well. This would be an improvement from the existing situation, which has been in place since the installation in 1976, with no adverse consequences for the well. We believe that we can achieve 95' separation from the well. Since this is an improvement over the current tank location, and we cannot place the tank outside the radius and get gravity flow, we request approval for a waiver to place the tank 95' from the well on Lot 6. Sincerely, Benjamin Schiller, PE 1-5 -TV 5 i 1 F 1 4; v V 2,0 z S- C-,-, PI tv n, 3 ; ,, r3 TH •:* Benja i Schiller �Fc CE 2592 i iflF . &26n5 . • •�VA: ,t lli� PROFESSIONP�.�.:"� SEPTIC PLAN 0 40 80 FEET 1"=40' LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE . GREA.cR ANCHORAGE AREA BOR GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME %ZP � ��a L� /"MAILING ADDRESS 2 r 5 � f ` Lf % PHONE LOCATION LEGAL DESCRIPTION `t COL -LA L1 -:)S SEPTIC TANK: DISTANCE��TJ— NUMBER OF FROM WELL ' -4� MANUFACTURER � e� MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY Zo-�GALLONS. TILE DRAIN FIELD: � TOTAL LENGTH l/p� DISTANCE FROM WELL :EFOUNDATION NEAREST LOT LINE L OF LINES NUMBER OF LINES 1�DISTANCE BETWEEN LINES TRENCH WIDTH 3 IN. TOTAL EFFECTIVE mob: ABSORPTION AREA � SQ. FT. LENGTH OF EACH LINE r�C• I , DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE 2e' MATERIAL BENEATH TILE IN. ABOVE TILE IN. WELL: TYPECONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM_ CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED DISTANCES! INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS:����I REMARKS DIAGRAM OF SYSTEM . lcf Akttl� 44,4V r-,-44 ' ! I'Gy DATE C '� APPROVED _ F 0. �' v ,1,Jw Q rYrt-' cdi'�% / G.A.A.B. Form EQ -032 U apo I - ti C��e t trd "Drittinby �r A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694.2588 OWNER OF LAND W4f#vc" or2ous .vEA-4 DEPTH OF WELL /�� ee ADDRESS ISTATIC LEVEL OF WATER FT. �`✓� LEGAL DESCRIPTION—i <� (�14oi_K IPJJ Sudo DRAW DOWN FT. 1c), DATE - Started10 Z_'*Ended _� _� GALS. PER HR 300 PERMIT NUMBER 7L�G KIND OF CASING 6 -T ori KIND OF FORMATION: From 0 Ft. to-2—Ft. J From Ft. to Ft. From r? to - Ft. _/ r From Ft. to Ft. FromFt. to?S_ Ft. 6 0 1''ZtC47ef Q 4 From Ft. to Ft. From34�_ Ft. to--LO—Ft. Yd^ f) J;" C'P�✓�`� From—Ft. to Ft From ^ 2 Ft. to -L3 -5 --Ft. e4 .*l r t;e/1 `e4yeo(44.0ex_ :rom FL to Ft From /35' Ft. to _L9 -Eft Ft. 5_01`0'T 6404✓-" Froin—Ft. to Ft. From_ H F Ft. to /LD Ft. 6,6 j""` 6Q.-f✓e4c From Ft. to Ft. FromIeFZ) Ft. to a l 8 Ft. SAVO 1"li �'J�< From Ft. to Ft. From a, Ft. to 0230 Ft. %/ CH i S4/ tj 4 From Ft. to Ft. From a Ft. to 0 3 5' Ft. 4!f4r4Y 6dq,t-"L *B0cJ4,'0t -tom Ft.to Ft. a From��Ft. to�—Ft. 5.4.,ao l44l 4'+E c From Ft. to Ft. From�gLFt. to 5"0 Ft. ­519"U10From Ft. to Ft. FromFt. to 2frFt. l7/�4,y; ,.vD 64Wa_=l_ W-L?Je 6jQec4 From Ft. to Ft. From 2b Ft. to 3I4.Ft. I From Ft. to Ft. From -?/17, Ft. to 315 (Ft. .S`4—,O 61M,4:FG +Y `JA%%A From Ft. to Ft. From 3/S=LFt. tot_ -(-FL d004AaLM4 From Ft. to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: to 4F" 7'o i3c✓r►7PrlO J�JT r�/$TE or` 5ft'rn f�rrP To 4 SFi 30 76/0 ar= C,Qsiw< DRILLERS NAME 2-9? f t'1 L.1t-J I C,I t= FAL I T•,r• 07F At.�CHt_tR1�GE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR, RD.., ANCHORAGE, AK. 99507 / 276-2221 Z'o t%IEL_L_ AttilC i0M—S I TE SEL4e:FZ F=EFSt-y I 'T - PERMIT PERMIT NO. { • 76285 ) `�o �� G^ ✓ 1 \ APPLICANT M.K.E. CORP. 4263 MINNESOTA DRIVE /� 277-1443 V LOCATION CRESTVIEW LANE LEGAL L5 CALKINS SUBD LOT SIZE 20663 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C�EPTH= 11 LEhtGTH= 4-c=. C3FZRkfEL_ E>EF=l'TH= 5,5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRE14CH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). FZE=lD_U I FZE:E> SEPT I C3 -rnNF: S I ZE:E_ :3 -C -i093- C3nL-lL0"_gl_ BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT I-IITHI14 30 DAYS OF THE WELL COMPLETION. --- SPECIFICATIONS AND CONSTRUCTION -DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. P'EFZM I T Vf=lL_ I C? FOFZ QNE: VF_= IFZ FFZIDM I SSUFEE 1 CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR Ott -SITE SEWERS AND WELLS.AS.SET FORTH SY,THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT"IF THE RESIDENCE IS REMODELED TO INCLUDE MORE -THAN 3 BEDROOMS. SIGNED: --I -------------------- . APPL I CANT M. K. E. CORP. - JISSUED B4'_ )RTE------ �- r, haobS L.�Guutcf'�nC� GREATER ANCHORAGL• ARL'A BOROUGH Department of Environmental Quality k�' 3330 "C" Street Anchorage, Alaska 99903 MI• hMM• • Performed for h/a_1ne. Legal Description: Le This form reports: SOILS I,O(j - PERMATION THST Date Perfonied� S -log ro-- - Percolation tes Depth Feet - 5,ity 60.+d 66-6cvntlr/ 4?e61YUu/ moi/ ,Ceddjsh %6APOWn 2 - 54. d ep"d 6.%!y dO�C/ [dP-6M) 3 - COn+r1v' '10y'a. gaavels Low Mu%afuQe_ ton 4- 5rity 5- 6- 7 [6w) . 2u�,dn,ti., Gvb6/e5 ,., 9 Lahb/e cLn/1 lf2tcv�/ �Rlat�F�c�n 10 - �uhtmqu/u2o'6c/b2ou�Jec( 11 - 12 - 13 - 14 - GOT OtA a t= ZFrxcavar-JorJ 1 e4E6TV/EW /JorvE Was ground water encountered?, If yes, at what depth?- ; -- Reading Date Gross Time Net Time Depth to Water Net Drop Percolation rate minute. -Proposed installat of n: Seepage Pit Drain Field Depth of Inlet Depth to bottom 5Y pit or trench COMMENTS: /1='=4 of- B5 114Z. a Lo1."b,4ad ail, rlafe oe- Howe✓e2 dve v'O Mine2 6;H- cfQGGftUr) r� afh� /owe,;: 64i'/6_ un'�cf• Q/Iaie /SD /� �['o m�nr./P.� Lh„p /ZoGi%/t��•/ �-y.�i/� . .�t�� d�f�Jurr���l. Performed BY: -( r _Certified 4y: ! a_,n ri, !Date:1��1. F Municipality of Anchorage August 25, 1986 • P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 5 Calkins Subdivision Waiver Request, WR86-123 Dear Mr. Shafer: Your request for a waiver of the 100 foot separation required between the septic system on the subject lot and the well on the adjacent lot (Lot 6) has been granted. This waiver is valid for the existing septic system only. Any enlargements of the existing three bedroom single family septic system will void this waiver. Sincerely, Q. S tap lenS. Morris Civil Engineer On-site Services SSM/ljw T` �XtS�1ri, Waiver is Se e' cW veS l �at� OtOL/ J_vctib l 3 / 2 0 12 Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 June 13;2012. Municipality of Anchorage On -Site Services 4700 South Brame Anchorage, AiasKa- Re- James Whitecavage, Owner Calkins SID, Lot 5 10535 Crest View Lane Eag(e River, Alaska 99577 REQUEST FOR AMENDED WAIVER A waiver dated August 1986 is on file at the M.0-A.negarding Lot 5. The waiver was requested by S & S Engineering for Lot 5's septic tank and leach field to be within 85' & 96' on neighboring Lot 6. At that time, S & S stated the distance from the well to the tank on Lot 5 to be 100'; however; it is shown as 94' on the asbuit survey & field measurements. SGS water sample report dated 5/18/12 shows the following: Arsenic (ND) Total Nitrate/Nitrite-N (ND) E. Coli (Negative) Total Coliform (Negative) 1 am requesting an Amended Waiver to the existing Waiver mentioned above. It could easily have been done in the existing Waiver. S & S's drawing showed that the tank was 100' from the well. This was done during an adequacy test, but at that time the M.O.A. was not requiring surveyor asbuilts, which contributed to the signing off and approval. In conversation with staff at the M.O.A., it was stated that they will not charge for this Amended Waiver. If you have any questions, please call me at (907) 746-1073 or 243-5372. Sinncce�reellyy,, U � Douglas T, Kenley, E. PE #8176 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251325 Parcel ID 050-211-16 Legal description CALKINS LT 5 site address 10535 CREST VIEW LN Expiration Date: � �- ,� 2-41 2-' Current property owner(s) CLINE KASSONDRA & KYLE LYNN X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: This 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 Service 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 submittal. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory X Well Flow Advisory Nitrate Advisory Arsenic Advisory Other 1. GENERAL INFORMATION Parcel I.D. 050-211-16 Complete legal description Calkins, Lot 5 Location (site address) 10535 Crestview Ln, Eagle River, AK 99577 Current property owner(s) Kassondra & Kyle Cline Day phone 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: Fn� Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel n Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed Fm� 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 $o� ��j Waiver Fee $ Date of Payment �/! 3 t 1 a Date of Payment COSA # 32- Waiver # COSA Application_AK2025.doc COSA Checklist Legal Description: Calkins, Lot 5 Parcel ID: 050-211-16 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 9/17/76 Total depth 315.5 ft Cased to 315.5 ft 0 Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA 5/29/25 Static water level at beginning of test 280 ft. Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 1976 Fm-1 ALL standpipes present per record drawing Total measured depth from grade 11.5 ft (max) Measured depth to pipe invert from grade 6.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. no Monitor tubes go to bottom of effective. If not, state depth into effective IWE Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 1440 gallons 5/29/25 date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Well production at time of test 4.2 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑E Nc X Coliform bacteria is Negative Nitrate mg/L FN-1 Nitrate less than MRL (ND) Arsenic 0.546 ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 5/29/25 C. LIFT STATION L-J1ReqL1fred maintenance completed Age of lift station �yea...Lift station material�''�� Comments: Adequacy test date 5/29/25 Results I.1 Pass Fluid depth prior to test 0 in Water added 560 gal New fluid depth 9 in Elapsed time 15 min Final fluid depth 0 in Absorption rate >450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 60 in Effective depth used 0 in Effective depth remaining 60 in Comments/Deficiencies: Presoak talcs: 48'x5'x2 (error) = 4800.4 = 192x7.5 = 1440 gal Presoak should have been 2000 gallons. See attached justification COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' © Yes if No ft rol Yes if No ft Neighboring Tank > 100' ❑i Yes if No ft Private Sewer/Septic Line > 25' © Yes if No ft Absorption Field on Lot > 100' E Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' © Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft Q Yes if No ft ❑ 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' R Yes if No ft Surface Water > 100' ❑■ Yes if No ft Tank to Property Line > 5' ❑i Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' [E Yes if No ft Private Wells > 100' ❑ Yes if No >95 ft Water Main > 10' ❑■ Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' M Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *Ammended waiver WR86-123 7/24/25 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 Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist —June 2022 Phone (907) 522-7773 Date 7/30/25 AW TH Beniarr rt'Schiller ��`•. CE 12592 `4Ode �lIk PROFESSO" August 13, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Calkins, Lot 5 – 10535 Crest View Ln Adequacy test absorption justification Dear On-Site Services Engineer: The trench at this property has been vacant for over 30 days prior to COSA testing, so it required a presoak. When we arrived for the test, we confirmed that the trench (effective depth of 5’) had no standing liquid in it at all. We had arranged for a 2000-gallon water haul for the presoak and test, and all of that water was injected into the trench and absorbed in less than 45 minutes. Our calculations for the presoak amount included an error we discovered on final review- the amount of water we counted for the presoak was the equivalent of a 2’ wide trench, not a 3’ wide trench. Therefore, we counted 1440 gallons of the water haul for the pre-soak, and 560 gallons as the septic test. In actuality, the presoak should have been a full 2000 gallons. The purpose of the presoak is to ensure that an underused trench has an adequate test. In reality, most of the time the presoak causes better results, because a trench that is unused for a period of time will have liquid levels in lower layers of the trench that are biomatted up and don’t absorb water. The water level usually needs to be brought up to higher levels of the trench where the absorption rate is better. In this case, there does not seem to be any biomatting. The trench levels never rose above the first few inches, and that was primarily because of the speed at which the 2000 gallons were introduced. Within 15 minutes of ending the haul the trench had absorbed all of the water. It is clear that the absorption rate of the trench is much greater than the required 450 gallons in 24 hours. We request that the reduced amount of water for the presoak be accepted as adequate for this testing. Sincerely, Benjamin Schiller, PE EPu}uS MUNICIPALITY OF ANCHORAGE Development Services Department , Phone: 907-343-7904 On -Site Water &Wastewater Section - Fax: 907-343-7997 Parcel I.D. 050-211-16 Certificate of On -Site Systems Approval Expiration Date: 1. GENERAL INFORMATION Complete legal description CALKINS LT 5 Location (site address) 10535 Crestview Ln Eagle River 99577 Current property owner(s) LEVOY LAURA L Mailing address Real estate agent same as site address Pete Carpenter 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System Day phone Day phone 907.854.8404 TYPE OF WASTEWATER DISPOSAL: 0 Private Septic 0 ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer % ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J`J� Waiver Fee $ Date of Payment Date of Payment Receipt Number 03(1-316 Receipt Number COSA # ®5 C Z 100 Waiver # I 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 Eklutna Engineering, LLC Phone 907.355.9820 Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE/2020 L� Curhs L send .... '/ 6. DSD SIGNATURE !A �'., Date ? 9 7o?rt•Q No. CE fl System #1 Approved for bedrooms Fy �tI��PROFESSIONP� d System #2 Approved for bedroomsa�;.,�,,��"� Disapproved Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of.,Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA Checklist blue sheet Nitrate Advisory Arsenic Advisory Other Legal Description: CALKINS LT 5 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1976 Total depth 315.5 ft Cased to 315.5 ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA 2i10/2020 Static water level at beginning of test 288 ft. Comments B. TANK DATA Age of tank(s) 44 years Tank type/material septic p18StIC Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping Feb 3, 2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 1976 ❑ ALL standpipes present per record drawing Total measured depth from grade 14 ft (max) Measured depth to pipe invert from grade 9 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 2000 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050-211-16-000 Structure served by this system _ Well production at time of test 3 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ N ❑ Coliform bacteria is Negative Nitrate 0.255 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Curtis Townsend, PE Date of Sample 2/1012020 C. LIFT STATION ❑ Required maintenance co Age of lift station yea Lift station mat lal Adequacy test date 2'2r"2' Results 0 Pass For 3 bedrooms Fluid depth prior to test 11 in Water added 450 gal New depth 23 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 4au gpd Any rejuvenation treatment (past 12 months) no If yes, enter date 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' 94 ft Community Sewer Manhole/Cleanout > 100' F-1Yesif No ft ❑✓ Yes if No ft Neighboring Tank > 100' R� Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields > 100' ❑ Yes if No 85 ft Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' Manure/Animal Excreta Storage > 100' if No Community Sewer Main > 75' 0Yes if No ft M Yes if No _ _ _ 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' ❑Q Yes if No ft Property Line > 5'✓❑ if No Yes if No ft Wells on Adjacent Lots: Yes if No Absorption Field > 5' Q Yes if No ft Private Wells > 100' ❑ Yes if No 85 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' 121 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 96 ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' i❑ Yes if No ft F. ENGINEER'S COMMENTS foundation cleanout in downstairs bathroom waiver WR86-123 was amended by MOA on-site June 19, 2012 septic tank material was confirmed by camera inspection Feb 2020 by JRs Septic G. ENGINEER'S CERTIFICATION l certify that I 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 49 TH Curfis L ovm �en0 il Oate 2 0 2 I��`��'iJ;. No. E11 .or ��®��pROFESS1D�tp�'-a ENGINES R'S Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEms APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-211-16 1. GENERAL INFORMATION Complete legal description Calkins S/D, Lot 5 COSA # 0509 11 I Expiration Date: Cl — / q l Location (site address) 10535 Crestview Lane, Eagle River, Alaska 99577 Current Property owner(S) James wnitecavage Mailing address Lending agency Mailing address Real Estate Agent Advantage Mortgage 100 W. 38th Ave., Ste. 100, Anchorage, AK Mark Soquet, Soquet Realty Day phone 694-93351H. 360-3302/C Day phone 257-0145 (Lisa) Day phone 727-1616 Mailing. Address 4155 Tudor Center Dr., Ste. 208, Anchorage, AK 99508✓ (� Unless otherwise requested, COSA will be held by DSD for pickup. 0 K -R t_ � PtCX (iP 0641q�Y 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well✓❑ Individual On-site ❑✓ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class 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 wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a 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 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 Douglas T. Kenley, P.E. Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer's Printed Name Douglas T. Kenley 5. DSD SIGNATURE Approved for _3 bedrooms. Disapproved. Phone (907) 746-1073 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Byr Original Certificate Date- (aev nrosl Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program ` 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Calkins SM, Lot 5 Parcel ID: 050-211-16 A. WELL DATA Well type amare Date completed X17 Total depth 315.5 It. Date of test Static water level Well production if A, B, or C provide PWSID # _ Sanitary seal (Y/N) Y Cased to 315.5 ft FROM WELL LOG 9/10/76 292 ft 5 g.p.m. WATER SAMPLE RESULTS: Coliform Negatn'e colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L date of sample: 5/16112 B. SEPTI:/HOLDING TANK DATA Tank Type/Material Septic/Plastic Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 16 in. AT INSPECTION 9/28/10 288.3 ft. 3.5 g.p.m. Collected by. F. Kenley Date installed 6/14176 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y" Depression over tank (Y/N) N High water alarm (Y/N) N/A Date of pumping 617/12 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 6/14/76 Soil rating (g.p.d./W or fe/bdnn) 150 System type Trench Length 48 ft. Width 3 ft Gravel below pipe 5 ft. Total depth74 ft. Eff. absorption area 480 ftz Monitoring tube Y Depression over field N Date of adequacy test 9/28/2010 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 6-1/2 in. Water added 467 gal. New depth 6-1/6 in. Elapsed Time: 115 min. Final fluid depth sin in. Absorption rate >= 450 g,p.d_ Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date W D. LIFT STATION installed Size in gallons Manhole/Access (Y/N) "Pump on" level at — in. u in. High water alarm level of in. Datum Cycles tested Meets alarm & circuit regw E. :SEPARATION DISTANCES SEPARATION DISTANCES FRQM)NELL ON LOT TO: Septic tank/lift station on lot 160* ft- On adjacent lots 100+ fl;. Absorption field on lot 100+ ft. On adjacent lots 100+ ft. Public sewer main NIP` Public sewer manhole/cleanout N/A Sewer /septic service line 25+ ft. Holding tank N/A Animal containment areas 50+ ft. Manure/animal excrete storage areas 100+ ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ ft. Property line t0+ ft. Absorption field 5+ ft. Water main NSA Water service line 10+ ft. Surface water 100+ ft. Wells on adjacent lots See commerds SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 10+ ft. Water main N/A Water Service line 10+ ft. Surface water 100+ ft. Driveway, parkingtvehide storage 5+k Curtain drain None Known Wells on adjacent lots $` c " F. COMMENTS ix«isrra„e4•vdvoso�+�✓rc vlq G. ENGINEER'S CERTIFICATION I certify that I 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. Engineer's Printed Name Douglas T. Kenley P.E. Date % ! I,%/ I -L" COSA Fee $ Date of Payment Receipt Number (Rev, 4/10) Waiver Fee $ _ Date of Payment Receipt Number_ Y • 4 k�5 _ ►ZS,ZQ l 1, { { e N rtt-cs o �. O � •._. � v�NTS 8 1 7 to Q �'. / �r s. C'tar�s•�` � v s,s� ttauk i � '0 AS-BViLT _ I hereby certify that. I. have surveyed the following AtUCtKS. _ described proPertS Stamm :7� „a sx tea T 14 N R 5 hA +^ onrt Anchorage Recording Precut Alaska5 and thst hhe:' + ��. " "' "�'^ timpron ovements situated there' ar'i` within the property ' ` •" , "" hnes and do Mot overlap�r encroach on the' propierty thh y lying- adjacent thereto, at nb....uunnppr�ovements 'o�ti;P td l • it �� £ ertyt lying adjacent thereto enctoach on the preinrsed' question and that there axe no roadv3Ys, tranarncept' v lines or other vjsible easements on SAI Property except as indicated hereon. repeataF Dated at Eagle River, Alaska r °. ;•�Fi `NC. ULc7:-i /�ul _,� ��� SY'fr •�4t•b Me a�.xx yip/ this—_:.'iay Of APS. 19_-""--- r ROBERT C_SOIINSOM SCALE:Registered Land Surveyor 1'a - 36' Boz 455, Eagle River, Alaska Phone 694-3543 r'_50 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. # HAA # UQ01 I CY'1t�;!Zk 1. GENERAL INFORMATION Complete legal description Lot 5; Ca2Funa Su6diviaion ''' Location (site address or directions) 10535 Cne.atv.iew Lane Eag.2e Rim. AK Property owner Jin Wh tecavage Day phone 694-9335 Mailing address 10535 Cne4tv.i,ew Lane Eagte Rim. AK 99577 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XXX Community well ' Public water NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev.1/91) Front MOA 421 k7m 6. By 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 furtherverify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address 17034 Eagle Engineer's signature DHHS SIGNATURE Approved for Disapproved. No.204 3 bedrooms. Conditional approval for Additional Comments Phone Date Aoaon '7-2 ' " 7 `n2 bedrooms, with the following stipulations: The Municipality of Anchorage 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. 72-C25 (Rev. 1/91) Back MOA $21 Municipality of Anchorage Alk Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: "-rs- Lra�t,�S s`o Parcel I.D. A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present N) Date completed OA La Driller L— D, -,L. k i b Total depth 3\7 I (, Cased to Sts L.Casing height tZ1tl- Sanitary seal O/N) Wires properly protected (*/N) FROM WELL LOG AT INSPECTION Date of test °1 11 110 I Z - 3 a _ 9 3 a MUNICIPALITY OF ANCHORAGE Static water level ?f1 2 �/ 6 1 FnntIRONMENTAL SERVICES DIVISION Well flow g.p.m. S, / gTA —4 1994 Pump levell 3 0 ` U 14- LSEPARATION RECEIVED SEPARATIONDISTANCES FROM WELL TO: Septic/holding tank on lot 1 L> of ; On adjacent lots Absorption field on lot 1117 I ; On adjacent lots vo I Public sewer main `a Public sewer manhole/cleanout '� A Sewer service line ZS 1� Petroleum tank WATER SAMPLE RESULTS: Coliformy Nitratey A 0 Other bacteria O Date of sample: 17, - t V - 93 Collected by: 5 �, S E,,5 c,, ,� 5,6Rl ALu B. SEPTIC/HOLDING TANK DATA Date installed _ L+ - ► `1 ��1 !, Tank size I two o Compartments Z Cleanouts (Y -)N) T/ Foundation cleanout (YIQ ,, -Depression (Y/19) tl High water alarm (Y& Alarm tested (YM) A& Date of pumping I - 3 j7 3 Pumper ��•' !:Ess'/� a SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / o On adjacent lots %� 8 S Foundation 3 3 7 To property line / `' r Absorption field / Water main/service line / D S Surface water/drainage konJ S - 7-5-- 72-028 (3193)' Front ° CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTAWCE FROM LIFT STATION TO: lot D. ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) at tested On adjacent lots Surface water Date installed Soil rating (GPD/Ft2)1 So`�lbL System type �i:fu1 i Length mgr Width 3� Gravel thickness *s� Total depth Total absorption area BD; Cleanout present6/N) Depression over field (Y4 "J Date of adequacy test---! ' 3 0— ry 9 Resultsas ail) 6 s for 3 Bedrooms .. Water level in absorption field before test (� 3 After test Peroxide treatment (past 12 months) (Y& ���� ILS° r.f�( If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: i Well on lot '! / S"' On adjacent lots -k 9 G r Property line / To building foundation S t ( To exi;ting or abandoned system on lot "Ilii On adjacent lots 3 o r J-Cutbank �` .� Water main/service line I,L e0 r+ Surface water 100 Driveway, parking/vehicle storage area \I' Curtain drain E. ENGINEER'S 4 -ZS -13(. CERTIFICATION I certify that I have checked, verified, or conformed t OA and HAA guidelines in effect on the.date is inspection. �.Y.i '••.n� n y OW J Signature S & S ENGINEERI 17034 Eagle Riv P Ro No. 204 Engineer's Namff Date r,�'% •.....>....� . HAA Fee $ ',� Q O e� Date of Payment Receipt Number o?SS�/ C/7 Ski 72.026 (3193)' Back Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1-270'd6(0 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 1-vt S of tLtN_-�s Location (address or directions) (b) Applicant Namel�&r"\,�Ad2LG � Telephone: Home Business ssz— Applicant Address 12 Z; 3S 4*6'r* V I C -w L.A. - r3WA V4 ymytok'T�L. �G577 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builderO-. Buyer ❑ ; Other ❑ (explain); (d) Lending Institution SAOX!!L 49f 'O'F lt—keTelephone Address a.,6.41 (e) Real Estate Company and Agent f�nJ - Address Telephone (f) Mail the HAA r jhE inl b jnaarl U6 55 55 EEIIVVSS��1IINYEEEERRIIIIVV SR B I 96X �• CF. ACTt r AK 99577 2. TYPE OF RESIDENCE Single-Familo* Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual WeII� Community ❑ Public ❑ . 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 72-025111184) S. ENGINEERING FIRM PROVIDIhu INSPECTIONS, TESTS, FILE SEARCH, Dr. @ A AND INFORMATION 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 that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING Telephone 95��?17,� Address SR B 196X Date EAGLE RIVER, AK 99577 8 ZL �6 6. DHEP APPROVAL Approved for �ti''« bedrooms by �'�'"�� Date Approved Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an Independent professional engineer registered In the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) r? ' CHECKLIST - FEBRUARY 1984 264-4720 rn _, 9 p o 4! 1 IVJ4 Legal Description: A. WELL DATA y; r r Well Classification S •�• If A, 8, C, D.E.C. Approved (Y/N) /b Well Log PresentCYN) Date Completed +1 Yield Q•S &F -f-44 Total Depth �sK 10 Cased to 315 6 Depth of Grouting Static Water Level 2'1'I� r Pump Set At V VG Casing Height Above Ground 110" Sanitary Seal on Casing (VN) Electrical Wiring in Conduit &N) Separation Distances from Well: Depression Around Wellhead (Y/10 To Septic/fJolding Tank on Lot I od r ; On Adjoining Lots t oo I� To Nearest Edge of Absorption Field on Lo( So' ; On Adjoining Lots L mo t To Nearest Public Sewer Line a /S To Nearest Public Sewer t Cleanout/Manhole a P To Nearest Sewer Service Line on Lot Water Sample Collected by S s_*�4 ; Date 6-1-66 Water Sample Test Results =5. f! Comments %436u- S(1 &.4> ::1%6T Jr-11e4W=Q Ar=2'? D.S G-,!'a/�. B. SEPTIC/HCti7I1aG TANK DATA Date Installed A.P_-J4_-_7 6 Size 1 dspo No. of Compartments Z Standpipes (7/N) Air -tight Caps ®/N) Foundation Cleanout (Y(1P Depression over Tank (YAW a Date Last Pumped 5(e Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) P Temporary Holding Tank Permit (Y/N) a Separation Distances from Septic/Heidi, g Tank: To Water -Supply Well d d r To Building Foundation To Property Line 1't'• To Disposal Field fin To Water Main/Service Line %0, A- To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026111/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Sd 62- Type of System Design 'relµ Date Installed V ' ( +'"7 Length of Field L4 Width of Field 3 • Depth of Field i Gravel Bed Thickness s Square Feet of Absorption Area L4 130 Standpipes Present®N) Depression over Field (Y(fj�ij Date of Last Adequacy Test Results of Last Adequacy Test t5e=m S rjo,- &.&I r 3 F -- Separation Distance from Absorption Field: To Water -Supply Well k \ S , To Property Line To Building Foundation S To Existing or Abandoned System on Lot ala ; On Adjoining Lots 3� 0 a b To Water Main/Service Line To Cut�JA ank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ep .-t Comments ��y3p" V -Z — 'R�rJ E -'7•f Ta t�V., vJ amu_ e,J L -C ' to . D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Leve) at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments •' Check Permitted Bedroom Rating Against HAA Request •• 1 certify that I have checked verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. BI S & S ENGINEtNG Signed DateUln 96X � Compan MOA No. LE RIVER, AK 99S77 At Receipt No. OO.0 .+P���.... .C4 %1 s .o 77 Date of Payment o a b ,r = 00%17 Amount: $ �5o •� . 9 .. ...Set Page 2 of 2 72-026 (11i84) bb.rt 3tyf.r i i ROFES w� Municipality of Anchorage August 25, 1986 n P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Robert A. Shafer, P.E. S & S Engineering SRB 196X Eagle River, Alaska 99577 Subject: Lot 5 Calkins Subdivision Waiver Request, WR86-123 Dear Mr. Shafer: Your request for a waiver of the 100 foot separation required between the septic system on the subject lot and the well on the adjacent lot (Lot 6) has been granted. This waiver is valid for the existing septic system only. Any enlargements of the existing three bedroom single family septic system will void this waiver. Sincerely, Stelpen S. Morris Civil Engineer On—site Services SSM/ljw • �'+�;,tli�ilj�, r A A .S E,ClF RIVFR.PS�P HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSALSYSTEM DESIGN August 22, 1986 Mun.icipat.ity of Anchonage Depattment ob Hea.Pth and Human Setv.tces 825 L Stkeet Anchonage, Ataska 99501 ATTENTION: Steve Mott.ia REFERENCE: Lot 5; Catkins Subdivision Dean Steve, ROBERTA.SHAFER CIVIL ENGINEER 694.2979 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 'AUG 2 2 06 RECEIVED Request you approve the attached Heatth Authokity Apptovat appt.ication 'and .Lbdue a a>Iai.vet 'to' -the hontiontat bepanatLon dietancea between the! on -6,i to wa.6tewatet d.ispozat system and the ne.ighboni.ng weft Located on Lot 6; Catkins Subdivision. Attached bon yours %ev.iew .in addition to the tegmitement6 Joh an HAA ate the 6ottowing documents: A. Wa,ivet review work sheet B. Letter of acceptance o6 the wai.ven conditions by the owner of Lot 6. C. A copy o6 the wet tog, coti6otm bactet.fa anatysts, and n,i tAate anaty6.i,6 Jon the weft on Lot 6. D. Site pian showing the ketation6h.ip ob the on-site wastew tet dispo6at system to the netghbot.ing weft. In accordance with the t.iak anaty6.i6 nun by this o6b.ice it .is out opinion that the hokizontat 6epatation distances ptactibed by 18AAC72.021 ate not tequited .in this case. be o6 Jutthet 6etvice, ptease contact us. , P. E. SRB 196X EAGLE RIVER, ALASKA 99577 ('I MUNICIP&LITY GF A.NC60k.10E DEPARTMENT OF HEALTH. AND NU:!AN SERVICES WAIVER RE'," E ^'ORKSHELT DATE RECEIVED: LEGAL: ENCINEER: e e ei ,E 11N5 - SR B 196X EAGLE R1V@R, AK .717 APPLICANT. T/>an - WAIVER REQUESTED: 1::) ►3�--(W<��L,E� s.�- b —rU 5v—�1L �t'a-•� 1c.� o� Ler S � SSS _ —ra I—�—.tet-1 X11=s--� CRITERIA: 1) Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: 0,c) _ s.S Z.o TOTAL: l7,3 2) Special Conditions:V6-f::p_ kepiIrf& -. N.i� 44w ifp„�avtjs 0 - 3) Other: �_�_VWL- -- WAIVER IS: granted, with condtticns listed beluw: not granted :or reasons iisr.ed beluw: w DATE: PY: Lau ¢ a a� •� « 1 4t 1p9 -r...... ..........1^'Yv+..w..�.a............ ........w I ' Eagi. River Area GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 n�-°ani v _ �✓ QQQ111 Date Received .February 17, 1977 Time of Inspection 11:00 4111 Date of Inspection--J77�p�. REQUEST FOR APPROVAL OF tII�tUU INDIVIDUAL SEWER & WATER FACILITIES FOR u� Conv. qo 0111. 1. Approval requested by: Alaska National Bank E. Disposal Field: Total length of lines B. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Mailing Address: Pouch 7-010, Calais II Phone: 278-4581 2. Property Owner: Wayne Cousineau Phone: 694-2140 Mailing Address: NHN Crestview Street 3. Legal Description: Lot 5 Calkins Subdivision 4. Location: NHN Crestview Drive 5. Type of facility to be inspected _Single Family No. of bedrooms 4 6. Well Data: A. Type Individual B. Depth 330' C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system A. Installed B. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Absorption Area _ 2. Material E. Disposal Field: Total length of lines B. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages GREATER ANCHORAGE ARL-!, BOROUGH ENyj oE''T• Department of Environmental Quality NA1FNrAtpROrc�„vtV 3330 "C” St., Anchorage, Alaska 99503 - 274-45UA R REQUEST SEWER &PWATTERLRECEIVED FACILITIES 1. Type of Inspection:• CMRO VA FHA CONV xx 2. Property Owner: Wayne Cousineau ; Mailing Address • NHN Crestview Street Day Phone 694-2140 3. Name of Buyer: MADDOX, Ronald E. & Gail K. Mailing Address: 2151 Chandalar Drive Day Phone Work:279-9441 . 4. Name of Lending Institution: Alaska National Bank Mailing Address • 3301 C Street Phone 278-4581 Ext. 274 5. Name of - Realtor or Agent: Gary Deardorff Smiley's Realty Mailing Address: PO Box 1086 Eagle River phone 694-2114 6. Legal Description: Lot 5, Calkins Subdivision Location: NHN Crestview Street Eagle River, Alaska 7. Type of Facility to be inspected: Single Family No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual X If Individual, number of dwellings presently served 1 If Individual, depth of well 330' 9. Sewage Disposal -System Type -of System: Public Utility Individual (on-site) x If Individual, date of installation unknown MUNICIP GREATER ANCHORAGE ARLI, BOROUGH ofa tlryop Department of Environmental Quality EM'IRpN . Of yfANCyO Lu 3330 60 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 MfNrgt�cF 9 DoTECTio FEa 1 � N REQUEST FOR APPROVAL OF 19?1 INDIVIDUAL SEWER & WATER. FACILITIES RE�F/VE D 1. Type of Inspection:' CMRO VA FHA CONY XX 2. Property Owner: Wayne Cousineau Home Phone 694-2140 7 Mailing Address: NHN Crestview Street Day Phone ' -Lagle - , " asit 3. Name of Buyer: MADDOX, Ronald E. & Gail K. Mailing Address: 2151 Chandalar Drive DaJ pis hnehO g9-9441 4. Name of Lending Institution: Alaska National Bank Mailing Address: Pouch 7-010 Calais II Phone 278-4581 5. Name of -Realtor or Agent: Listing Agent: Gary Deardorff of Smiley's Realty Mailing Address: PO Box 1086 Phone 694-2114 Eagle Mer, Alaska 6. Legal Description. Lot 5, Calkins Subdivision Location: NHN Crestview Drive Eagle River, Alaska 7. Type of Facility to be inspected: Single Family Res. No. Bdrms. 2 & 2 Unfir 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served If Individual, depth of well 330' 9. Sewage Disposal -System 4 Type -of System: Public Utility Individual (on-site) X ` If Individual, date of installation1RfallYOFANCHORAGE EWJRONMENTAL PROTECTION FEB 1?1977 RECENO r.r•..n n. N.. w. rw••...NrN NY.nr•.....!r.. n.....r..rwrryr.�r.♦gqwvrrN.wr—aYwyy..or ..M.Y'rrrl r. l Y ,_ '.,J'Y I.s rr. v .r .. 1 .. .. _ __ Page 2 of two pages - Rec ^t for Approval of Individual S'r"1- & Water Facilities Legal bescription Lot 5 Calkins Subdivision Comments VD l-5.1 D.i Dat' 717 Approval;Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date