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Home My WebLink AboutTONJESS ESTATES BLK 2 LT 18ATonjess Estates Block 2 Lot 18A #051 - 832 - 27 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://wvvw.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231049 Work Type: SepticTank Upgrade Tax Code Number: 05183227000 Site Legal Address: TONJESS ESTATES BLK 2 LT 18A G:1462 Site Mailing Address: 25440 SCHAFF DR, Chugiak Owner: MASTERMAN ROBERT D Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date: Expiration Date U f� VOW DeI)at-tment Lot Size in Sq Ft: Total Bedrooms: 4/6/2023 4/5/2024 59791 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a-.—Opened-and-Closed-on-the-same-day,—or b. Covered, sealed, and heated to prevent freezing Received By: (5 5vli D '(b A (t -r— Tf, W Date: Issued By: Date: Z 3 MUNICIPALITY OF ANCHORAGE P+ifr Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION 2 Parcel I.D. 051-837-27 Property owner(s) Rober Masterman Day phone Mailing address 25440 Schaff Dr. Chugiak, AK Site address 25440 Schaff Dr. Chugiak, AK Legal description (Sub'd., Block & Lot) Tongjess Estates Block 2 Lot 18A Legal description (Township, Range & Section) Lot Size 59,791 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: (N all that apply) Absorption Field ❑ Initial ❑ Septic Tank ❑X Upgrade X❑ Holding Tank ❑ Renewal ❑ Privy E-1— Private Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: TYPE OF DWELLING: Single Family (SF) X❑ (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF—and/or-D) Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: 225 Waiver Fees: Date of Payment: '-1/3 A Date of Payment: Receipt Number: Ou0li76 Receipt Number: Permit No. Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231049, Curtis Townsend, 04/06/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231049, Curtis Townsend, 04/06/23 ' Municipality of Anchorage Page _Lot/ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SIA -1 q SO 36,9 PID Number C)•5/3 -P-'-'2 ' Name'(�- Wastewater System: .New 0 Upgrade Address: ,/ i/3 ABSORPTION FIELD Phone: 376 40 Sop No. of Bedrooms: 3 ❑ Deep Trench t9'Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating. en GPD/Sq Ft Total Dept romoriginalgrade: -7---* Lot. Block: ' Subdivision: /0 - n 7;-_,I!55 GS74.7ZS Depth 10 pipe bottom from original grade: y 1- Ft Gravel depth beneath pipe Ft Township: Range: Section: Fill added above original grade: Ft Gravel length: 6.1 Ft WELL: 0 New 0 Upgrade LTi/I•-•Fj Gravel width: 'S Ft Number of lines: / Distance between lines: %./i4• Ft Classification (Private, A,B.C): Pe. i I/47a Total Depth.* CV Ft. Cased To: 2.g.. FI. Total absorption area: /..".<3 4/,.. SO Ft Pipe material: PV Driller: f./ra Dei .L.. ! 44`' Date Drilled. it 4/t5 83 Static Water Level:Installer: !.9 FL �.ttr^Lv'S ate...L.a/Dd Date Installed: 3 t17-0)3 yield: Pump Set at: Casing Height Above Ground: y, 7 GPM I /1,../e/../,04.,.7-1 Ft / p— Ft. TANK SEPARATION DISTANCES kSeptic ❑Holding ❑S.T.E.P. To From Septic Tank Absorption Field Litt Station Holding Tank Pubtic/Pnvate Sewer Lines Manufacturer: �a,e e•2 Capacity in gallons: (l pc,0 Well /70 5) /4 /4- /-0 N/4 Material: s7E_E. t_ Number of Compartments: 2 - Surface Water PAI/'`�� LIFT STATION Lot S'o /0 /_/.Q/� is C S'" $2C'i lions: "Pump on" level Pump Make 8 Manufacturer: at: Electrical "• •' " le .. Inspections performed High water alarm at: by. Foundation Curtain Drain Remarks: BENCH MARK l �ewl/ }i t Loc.. Location and Description: 24,-./ ' o..r Por, -''7 //"./ 11on//C57Coo ?o4'7 Assumed Elevation: /OL9 - Ft ENGIIU g, EAL Di- r�cqJy -it. 4t a 'wf �YY...47 Nk Alir ' 7 . 1 Ce (lir fer' or 4 Y'�'" �� il'� Y M �+v�: ,... ...� C S Fbwurd C. Holton :g. 46 iP 4 INo 3od3 E Y' 4 u d�,F9''�Y... ••°((...r ��`' aA��okesNA II4**�' Inspections performed by: '- 14 4e4 _L Dates' 1s 4? 7v g3 2nd e.) 4'1 Department of Heal 1 and uman�S�errvices approval Reviewed and approved by: S' ��% Date //23— f3 72-013 (Rev. 9/91) MOA 25 16 100' WELL RADIUS PROJECT BENCHMARK \RANDOM POINT 11 ASSUMED ELEV. .. I00 10' UTILITY PO ESMT 0 45109 © • 0. WELL \ . sem, Oma, '9 CURVE DATA R=50' L=77.57' 2 R=45' L=29.08 t.41%® v ". •rs.0 :tt.4 ALI • : Y N — i 74 g o A z 0 n z .io z .IHS' 1MM'J BID. HOUSX 1a • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930369 DESIGN ENGINEER:ACUMETRIX CORPORATION OWNER NAME:FRANK LINDA G 50% & OWNER ADDRESS:20433 LUCAS AVE. EAGLE RIVER, AK 99577 PARCEL ID:05183227 LEGAL DESCRIPTION: TONJESS ESTATES BLK 2 LT 18 A LOT SIZE: 59791 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 9/16/93 EXPIRATION DATE: 9/16/94 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE SEPTIC TANK FOR THIS SYSTEM SHALL BE A STEEL TANK CONSTRUCTED BY A MUNICIPALITY OF ANCHORAGE APPROVED MANU- FACTURER. RECEIVED BY: ISSUED BY: /%1_0(/, ,� leOi ebele) DATE: DATE: 100' RADIUS FROM ADJ. SEPTIC —� — — ` 100' WELL PROTECTION RADIUS �. N 89'03'55 E II �• .�. I. 1 14700/ • • •• T ;' 1 SA . ' I PROPOSED . 1—STORY rzs.zz :� 4•e . , WOOD . FRAME HOUSE ' . .•.;,ee7�: .7 5j./791•S.'F.•,:'FF m Q 96.30 • �\ J •o4®"�OF `t1 OF cov '4 t a 1. `i 41 E` : Howard C. Holton �,✓ ®o 1/4,011 1r No. 3063-E ; 2 Q PROF SIZN.ti CURVE DATA R=50' L-77.57' 22 R-45' L=29.08 NOTE: 162.54 EXISTING SPOT ELEV. (TVP) SITE' PLAN SCALE: 1" a 60' 159.46 N 00'10'30" 173.76 ENT I OF Z ALL BEARINGS AND DISTANCES SHOWN ARE RECORD, UNLESS NOTED OTHERWISE. LOT: 7 C914BLOCK:E SUBDIVISION: TONJESS EST.4 TES IP CUM CORPORATION 4900 PALLIER-WASUJ.A HWY.. SUI1E 3 WA9LLA. AK .99654 (907) 376-6600 FAX (907) 376-9629 APPD: DAIS: JGB NUMBER: 93-09.04 DESIGN BY: R.M. S.Er.PTIC PLA V (MIlWCJPALITY OF ANCNOR.4C21) SCALE; NOTED DRAWN: epf CHECKED: ppm ' 0 81 o11 Al epi A P � ,e 15 At I, r^ Z i C1 4 i 5 yam r CI IA h b Y NO ; o� i k A 4 G 3n 111Z C 3-11 n t NEW J MO. NOOSE A8 �b 9 8 1 1 1 QR Fromi: Enuirolab at 0373-1113 07-23-93 06:10 am ..To: Acumetrix at 0376-9629 001 of 002 ENVIROLAB Environmental Assessment Laboratories of AK,Inc. P.O.Box 872988, Wasilia. AK 99687-2988 Ph.(907)373-4143 FAX 376-8016 REPORT ON DRINKING WATER ANALYSIS SATISFACTORY 93-09.04 Acumetrix 4900 Palmer/Wasilla Hiway #3 Wasilia, AK 99654 Sample collected: 7/21/93 1730 RM Sample received: 7/22/93 1204 Sample type:Routine Water Treatment: None TEST NAME: Presence/Absence of Total Coliforms Results:0/100 mis, number of positives w/100 mis inoculated. Normals: 0 positives per 100 mis. Reported: 7/23/93 1200.' Report sent to AKDEC: N/A Comments: L18A B2 Tonjess Est. Thank you, Richard Hope, Envirolab V!.l 1». i( ENVIROLAB Environmental Assessment Laboratories of AK,Inc. P.O.Box 872988, WasiLla, AK 99687-2988 Ph.(907)373-4143; FAX 376-8016 July 20,. 1993 WATER SAMPLE ANALYSIS Nitrate Sample Collected: 7/14/93 Sample Received by Northern Test: Lab: 7/14/93 Northern Test Lab Lab #: Sample ID: Lot 18A Block 2 Tonjess Est. DETECTION PARAMETER SAMPLE METHOD Nitrate EPA 353.3 DETECTION LLMIT 0.10 SAMPLE EPA RESULT LIMIT 3.5 10 Results expressed as mg/1 unless otherwise noted. ND = none detected at or above the detection limit listed THIS TEST WAS DONE BY NORTHERN ITESTING LABORATORIES Original report on file. Thank you, Richard Hope. Envirolab PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST Key ✓3a.rif rt/cro ?t'roi-Je. '-re/ LEGAL. DESCRIPTION: hole /4f. azif.. TN 1 %.✓jell tS,. /vpt4J / Or>r4r.,.,c P) s�.,� �.�.e ✓ re 1•. /* p„ • ••) ow* .r••P 10- 11- 12- 15 • (se) 16 • t • -."4"-‘\1 17 - i�0��' 0 ••°° 0.4�11,/1 /* j• +: 4 r4✓e / WAS GROUND WATER ENCOUNTERED? NO 18-49 .49L . it 1 �. N:wee. .y..w N..N..f••, -*•.NS ..... ..... ......moi .. 19 • o•Louis A. Butero : �/f 20-��J'J'.�. CE 6736 ••'� �4% of Jest /%/e 44`, COMMENTS p .S./t 1/4/.r> /ty e r PERFORMED Br 4.4,6.!• (ENGINEER'S SEAL) DATE PERFORMED: i/.. $/9 Township, Range, Section: j''S'N K' /w sec SLOPE IF YES, AT WHAT DEPTH? Depth le Wale: pler l Monlloring? ^« (214/1 kit 08'zi/ 93 s L 0 P E SITE PLAN N Rrf Fi Fe Tr' No i} Reading DateGross Time Ne Time Depth ter Drop SDAFr 5-/..) 1, / •' 1:rs;..._ Ao.-...., 6'-J%.' s/..` 2 " /:.6 /u ...... e'- 2 ,.." ri/6.. 7 g -:3t /o...•.:1 6-3'.• 11/4.• i/ " g: 47) /o•...:. 6-3 j" r1/4r PERCOLATION RATE /d/ Iminutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4'r FT dti•' Rete G...t/e11,r �<Q 7' jroG S'yCfC.•. ,„•;.c /2 - ASHrP</.4.- 6 I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72.008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST /fey /3aak /Vcp P.o/,e• t,e, LEGAL DESCRIPTION: Jot I//T 2 ro'/je'1 est (ENGINEERS SEAL) DATE PERFORMED: -t /. /q Township, Range, Section: T/SN /el& Sec tP H' r/fie2 1 10 11 12 S.'///3 S•c•�d3 �.ure/ l3ri• i� /Pied De -we SLOPE WAS GROUND WATER Q Si % Ssr j Gti-Gi ENCOUNTERED/ No _v 13 14 `1_1'�\\, 15 i�P,�E,O• F.q�gil�.. ' • r' ••s+� I�I 16 of* !49TN-� S ••:•••••••••—..i... 0 ••.•.......... ...........• •••• r4172- Louis A. Sutera : 18 •4 s'., ..."444:040 CE -6736 41,\ lioFESS1O tdu?' �lboiaa♦'• 17 19 20 COMMENTS /ere' �1e !''' IF YES, AT WHAT DEPTH/ Depth b Weser Aller Monitoring? Ai9 GWj_ Dale. O2//q SITE PLAN s L O P E N Or Ha• 17" / • 7.7" 90 u• Reading Date Gross Time Net Time Depth to Water Net Drop 3-.+Y+ /1 S/.. o,_ 1 G:1T•..., ,o.-...:, ,c -'—ie "// /s4i.. Z .' 6: Y,: be .-s..:, ter'_ io " / J/iim 4-/ 7:01 /o ....:i S L9'%. / 3//s • 7 ., 7: y?. /o ....;, r' -9'''r.. / W. PERCOLATION RATE !' 4' (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN s FT AND 6 FT PERFORMED BY. CERTIFY THAT THIS TEST WAS PERFORMED IN 1?//9 3 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE 72.008 (Rev. 4/85) LOCATION OF WELL WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 8 Geophysicol Surveys dj Ptyrit" �,o. (n D��u-x na Permi1 tt Atl-CI 11°31 ' • ,, N (Nem complete either r la, Ib or Ice) WL A.D.L. No. la. Borough Anra. Subdivision Tnni, rr Lot 1F Block P Ib. 1/40r.. —of_of—of — Section No. Township N 0 s0 Range E • WO Meridlon le. DISTANCE ANO DIRECTION FROM ROAD INTERSECTIONS Street Address and Area of W.lI Location 3. OWNER OF WELL: J. :.'t iI:CC/' • Schaff 2412 W. 29th Ave. Address: ; f r chor1' :Cy Al:'.._nl:r-. 99500 2. WELL LOG Fest Blow Surface _ 4. WELL DEPTH: (final) e''.4 S. DATE OF COMPLETION C — 25 — 83 It. M olerlol Type Top Bottom '."i-r,ni C: :>r(:;in c+.'ior rnd. c .l't• 0 4 6. 0Coble tool 0 R ory 0 Driven ❑Dug ii].: Lr;:( `-n ':;: ry ,.:.rd with 4 69 ❑Auger ❑Jetted ❑Bored ❑ Other : 1rr(;E boulders. 7. USE: ❑ Domestic 0 Public Supply ❑ Industry r;:ld n.:_c. ' revel : .Ljs. ;:: t brown 69 71 O Irrigation O Recharge ❑ Commerical .ith yr.:ter: 2? F. t. rl. III Teat well ❑Other: 5o_.?:: C : :-2.(7: r^.Ct hrrd 7.:E'_h 71 S0 S. CASING: 0 Threaded Q Welded water: 8 F. ;I.)a. dime. 6 in. to l2 ft. Depth Weight 17 lbs./ft. i.; ^. ro C':: )"re`). :'n:. hrrd. 6U ' et: diem. In. to It. Depth Stickup It. 9. FINISH OF WELL: o j' l:n nolo Type: Diameter: Slot/Mesh SU*: Length: Set between ft. and ft. Bockfilling Grovel pock 69 V pp 10. STATIC WATER LEVEL: ft. t'5» - - Date 1B.low -- D Above or lond surface sand line EOulpm.nt used: 11. PUMPING LEVEL below lopd surface and YIEL sa t i ft. after r' hrs. pumping 1' g.p.m. ft. after hrs. pumping g.p.m. A Ott " E/ Om. 12.6ROUTING Well Grouted: *0 Yes 0 No O Material: ❑ Neat Cement O Other: 1. turn'. ( T 13. PUMP: (It available) HP ,, p Length of Drop Pipe 11. capocity g.p.m. OI L Q, 0 Subm. ❑ Jet ❑ C.ntrillcal ❑ Other IL REMARKS: v 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature ❑ F ❑ C _a This well was dei Ilea under my jurisdiction and this report Is True to the best of my knowledge and belief; I'Orly Pril7.inr. f.A -IS E, Regi d Business Name Contract License Number f!!::2 :;oma. '(�) J i.orta;'oo.:::, r':-. Ct:uL;ir:'kf ria::: i..lr Address: Signed: Dote: Authorised Rep live Form 02•WWR (11/81) Copy Distribution: WHITE- State DOGS, PINK -Driller, CANARY -Customer •oN Ilm, ses(1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW940047 DESIGN ENGINEER:ACUMETRIX CORPORATION OWNER NAME:LINDGREN JOHN A & BARBARA E OWNER ADDRESS:P.O. BOX 672312 CHUGIAK AK 99567 PARCEL ID:05183227 LEGAL DESCRIPTION: TONJESS ESTATES BLK 2 LT 18 A LOT SIZE: 59791 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 3/07/94 EXPIRATION DATE: 3/07/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: PERMIT IS ISSUED FOR A WELL THAT WAS DRILLED WITHOUT A PERMIT IN 1982/1983. RECEIVED BY: i%vinum%/ 4r �� ly 3 DATE: ' a/.,/ ISSUED BY: JAS IT? -f' DATE: 47/4¢ Ii�tO� 14. cm 16 17 / ,1� 100' WELL PROTECTION /s l RADIUS• — ` ( I `J N 89'03'55 E 1 PROJECT BENCHMARK \RANDOM PEW/1 ASSUMED REV. - 100 • q 10' UTILITY 40 ESMT. o ide o. WELL n v 2 5.99 • 1 • __ 1 LOT 18A 59,791 S.F. • • \.. S S GRAVEL a . CURVE DATA \. R=50' 0 LK.77.57' 0 R=45' L=29.08 0 .......... •'CS00 "r 9 ,. 3" gv so* :d Y :;r S 1• t•, co • Howard C. • Holtan ; �,m .12% • No. 3063-E i •o. • " F� .aI �kFOPR0FESS(0". ' 19 NOTE: c/o VENTS c/o c/D's7�° 100' RADIUS FROM ADJ. SEPTIC >-STORY FOOD PRAA(E HOUSE /'P - 155 RECOVERED /5 REBAR (TYP) N 00'10'30" W, A 5'— 9UILT SITU PLAN SCALE: 1" = 60' SHT f OF 2 ALL BEARINGS. AND DISTANCES SHOWN ARE RECORD, UNLESS NOTED OTHERWISE. LOT: BLOCK: > 8A 2 SUBDIVISION: TONJE'SS ESTATES CORPORATION '-'"411.1 4900 PALLIER-WASILLA HWY.. SUITE 3 WASILLA. AK 99654 (937) 376-8800 FAX (907) 376-9629 PERMIT NO. SW 930369 DATE: JOB NUMBER: 93-09.04 DESIGN 8Y: R.M. AS.�'PTIC PLAN (d1UNzCIPALZTY OF ANCHOR -4 C6f SCALE: NOTED DRAWN: epf CHECKED: EPIRAIE 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 Parcel I.D. 051-832-27 1. GENERAL INFORMATION Expiration Date: i — / Ll- z -©e-0 Complete legal description TonjesS Estates B2 Ll 8A Location (site address) 25440 Schaff Drive, Current property owner(s) Capo=i J M Living Trust Mailing address Day phone Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Fx� Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: i Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6,56 Waiver Fee $ Date of Payment 10/1/19 Date of Payment Receipt Number Receipt Receipt Number COSA # OSCI q «& 2 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE 22 System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 745-8200 Date /eofoC) OF Al_qsk�� Steven R. r'onrene 1�911 . CE 8149 Conditional approval for bedrooms, with the following stipulations: S11 M Vq ZIP o r ��l)iis)t11� By: 0ylti 1 Original Certificate Date: © �4 —`� 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 Advisor d Other Legal Description: Tonjess Estates B2 L18A If more than 9 septic system on lot: COSA Checklist # of A. WELL DATA 9 Well log is filed with Onsite (or attached) Date drilled 06125!83 Total depth 284 ft Cased to 22 ft U Sanitary seal is functioning correctly FE -1 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA '9115119 Static water level at beginning of test 71 ft. Comments B. TANK DATA Age of tank(s) 26 years Tank type/material Steel Measured operating fluid level in septic tank 50 OR Standpipes/foundation cleanout per record drawing Date of pumping 8/30/2019 - D. ABSORPTION FIELD DATA Which system tested (date installed) 9/20/1993 © ALL standpipes present per record drawing Total measured depth from grade 7.4 ft (max) Measured depth to pipe invert from grade 4.5 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 0 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: 051-837-27 Structure served by this system _ Well production at time of test 1.8 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑✓ No © Coliform bacteria is Negative Nitrate mg/L On Nitrate less than MRL (ND) Arsenic ug/L W Arsenic less than MRL (ND) Collected by PES Date of Sample 0912/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8115!7993 Results ,✓❑ Pass For 3 bedrooms Fluid depth prior to test -0 in Water added 500 gal New depth 24 in Elapsed time 60 min Final fluid depth DRY in Absorption rate 500+ gpd Any rejuvenation treatment (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 Septic Tank/Lift Station on Lot > 100' [✓ Yes if No Community Sewer Manhole/Cleanout > 100' ✓M Yes if No ft Q Yes if No ft Neighboring Tank > 100'✓] Yes if No ft Private Sewer/Septic Line > 250 Yes if No ft Absorption Field on Lot > 100' M✓ Yes if No ft Holding Tank > 100' M Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' El Yes if No ft Q✓ Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q✓ Yes if No ft ❑✓ 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' QYes if No ft Property Line > 5' ✓0 Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' ✓l Yes if No ft Community Wells > 200' Fv� 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓l Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. / P30 COSA Checklist yellow sheet "w k .'ko It - A... vs... ... Ste n .R. Pannone C` 8149 �- U %�ESS, v DocuSign Envelope ID: 2CE60401-30E5-4A5A-8DF2-2A6383750604 MUNICIPALITY ANCHORAGE r� DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section / www.muni.org/onsite DocuSigned by: Signature of buyer o 9 596174MBF542C... Septic Wank Advisory Certificate of On -Site Systems Approval#OSC191462 Subdivision: Tonjess Estates B2 L18A 907-343-7904 Fax: 343-7997 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 26 years old. Typical replacement costs range from $8,000 to $11,000. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. M d�ss�Oo3 6650 g c "or ge a+ a,991 9-665 mu '�corg+' . N.M. +s�� LEGEND: MEASURED DATA 12,5' RECORD DATA N 90'00'00" W 100' WELL RADIUS �'>', LOT 17A oy�� N89°03'55 E 215.99' / !V O 50' o P� R=50.60` J LOT 8a L=77.6 owELL 59,791 Sq.Ft. N m ' sq ��P �°y L=29.01' y9� ONE STORY 8.3'x20.3' �GD \'� tissa WOOD HOUSE h�� /SHED O� S/P 30 F:P4 S/Po io° ' . o . }/+ TRACT B O LOT 19 NOTES 1. ALL BEARINGS, DISTANCES AND AREAS SHOWN ARE RECORD, UNLESS NOTED OTHERWISE. 2. THIS SURVEY IS PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE SURVEY STANDARDS. 3. THIS REPRESENTS A RECERTIFICATION OF AN MORTGAGE SURVEY DONE BY THIS COMPANY, DATED 5/5/06. EXCLUSION NOTE: IT IS THE RESPONSIBILTY OF THE OWNERS TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDRY OR FENCE LINES. MORTGAGE SURVEY CERTIFICATE: I HEREBY CERTIFY THAT I, OR SOMEONE UNDER MY DIRECT SUPERVISION, HAVE PERFORMED A MORTGAGEE`S INSPECTION ON THE FOLLOWING DESCRIBED PROPERTY: LOT 18A BLOCK 2 TONJESS ESTATES LOTS 17A AND 18A, BLK 2 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. t ` 49th? , =,Ter L. Nicodemus'o; .a �® �FFSSIONP�V��`� aaaam�4a. E/MrA GEOMATICS LLC r/ `Q DATE: JOB No: F.B. No: .91c? 119 93-09.04 93JIM 14 SCALE: DRAWN: CHECKED 1" = 60' TAN TLN MORTGAGE SURVE 2 TONJESS ESTATES SEWARD MERIDIAN 'LAT No. 83-520 GRID No. RECORDING DISTRICT PALMER NW146 'REPARED FOR: SANDRA MACMILLIAN 25440 SCHAFF RD., EAGLE RIVER, AK 99577 lion A 1 V ' WATER WELLS Drilling • Piling • Pumps P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Pannone Engineering Gene Capozzi 25440 Schaff Drive Chugiak, AK 99567 Flow Test Report: Total Depth: 284' Pump at 260' Well Yield: 1.8 GPM Date: 8-6-19 Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panenpak.com 11 October 2019 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: TONIESS ESTATES B2 L18A Tank Operating Condition COSA Number: OSC191462 Ladies and Gentlemen: On 110CT2019 we received a comment in response to a COSA Submittal that stated "...The fluid level was 46.5" which would indicate the tank may be leaking. Please address." When the tank levels were checked and recorded at the time of the adequacy test, and again today, on 110CT2019 we measured the fluid levels in both compartments of the tank and found that the tank is well within operational limits and is functioning as it should. There is no indication of leakage from the tank. As previously discussed, attempting to measure the fluids in a tank from the bottom of the tank to the fluid level is a dubious and inaccurate method of determining depth. The existence of solids and other material that has settled to the bottom of the tank makes this ineffective, as it is not possible to determine if the measurement is actually from the bottom of the tank. A more prudent method is to measure from the top down (i.e. top of tank to fluid level) as all are known standards and easily determined. Please contact me if you have any comments or concerns. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Anchc. Fge :viailing. P.O. Box 100217, Anchorage, AIC 99510-0217 Palmer N9ailing• P.O. Box 1807, Falmer, ;`,l< 99645 Telephone: (907) 745-3200 FAX: (907) 745-8201 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 05/-83 z -,a7 S 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address COSA# oto ot7q Expiration Date: 2 -/ 7 -063 TONJESS EST. 5/0; LOT 18A, BLOCK 2, 25440 SCHAFF DRIVE * CHUGIAK , AK 99567 BARBARA LINDGREN Day phone P.O. BOX 672312 * CHUGIAK, AK 99567 Day phone C/O AGENT LYNN SWANSON w/PRUDENTIAL J.W. Day phone 242-2212 16635 CENTERFIELD DR. EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 0 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer 0 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 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, 1 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 Nes 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 GARNESS ENGINEERING GROUP. Ltd. 3701 E. TUDOR ROAD. SUITE 101 * ANCHORAGE. AIC 99507 Address 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 & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usago of the family being served by the system. Those 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 11 confer any legal right whatsoever. 5. DSD SIGNATURE 17' Approved for 3 bedrooms. Disapproved. Conditional approval for Phone 337-6179 Date 0 arness. 0 CE— 953 :'`SO • Sst Pro f esiotte bedrooms, with the Mowing stipulations: `ltt nn/OF/ r�ii� cci at/ `GQpON-SITE•c �: WATER AND ; I^_ . WASTEWATER : = PROGRAM Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: Arsenic Advisory )10)»ffll0 Maintenance Agreements Supplemental Engineer's Reort Other Aire 11.151 Original Certificate Date: 3-- /7 -406 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TONJESS EST. S/D; LOT 18A, BLOCK 2, Parcel ID: 0 57- « 3 a-0 7 A. WELL DATA wen type PRIVATE If A, B, or C provide PWSIDVI N/A Well Log (Y/N) YES Date completed 5/2/1997 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 284 ft. Cased to 71 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 5/2/1997 5/3/2006 Static water level 234 ft. 75 ft. Wen production 1.5 g p m 1.65 gpm WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate I mg./L. Other bacteria 0 colonies/100 ml. Arsenic: ND ug./L. Date of sample: 5/3/2006 Collected by GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size 1000 gel SEPTIC/STEEL Date installed 9/20/1993 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (WN) NO Date of pumping 5/8/2006 Pumper C. ABSORPTION FIELD DATA Date installed 9/20/1993 Soil rating Length 68 ft. Width High water alarm (Y/N) JR'S PUMPING N/A 71�v^7a�111:I•Z 4r,J� r fttbdrm) 0_8 5 ft. System type SHALLOW TRENCH Gravel below pipe 3 ft, Total depth 7.5 ft. Eff. absorption area 586 ft' Monitoring tube YES Date of adequacy test 5/3/2006 Results (Pass/Fail) PASS Fluid depth in absorption field before test14 in. Water added 455 gal. Elapsed Time' 240 min. Final fluid depth 18.5 in Any rejuvenation treatment (past 12 mo.) (YIN & type) Depression over field NO For 3 bedrooms New depth 20 in. 450+ g.p.d. Absorption rate >= NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/ "Pump on" level at in. "Pump off"- - High water alarm level at in. Datu Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic tanklfl t station on lot Absorption field on lot Public sewer main 100'+ N/A Sewer /septic service line Animal containment areas 25'+ 50'+ On adjacent lots On adjacent lots 100'+ 100'+ Public sewer manhole/deanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ 100'+ Water main N/A Water service line • 10'+ Surface water Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 10'+ Building foundation 10'+ Water main N/A Water service line • 10'+ Surface water 100'+ Curtain drain NONE KNOWN F. COMMENTS • PER 1993 HM Wells on adjacent lots 1001+ Driveway, parking/vehicle storage 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 guidelnes in effect on this date. Engineer's Printed Name Date JEFFREY A. GARNESS 10'+ COSA Fee $ LIP / 514 �0� Date of Payment Receipt Number (Rev. 11/05) )7151 i1 Waiver Fee $ Date of Payment Receipt Number 05-05-06 14:40 FROM-Pudential Jack White Eagle River 9016896499 T-931 P.002/002 F-I1T LEGEND: MEASURED DMA 12.5' RECORD DATA' 14 90'00'00` W RECOVERED %6' REBAR O • 1 miry- tutus `� tu v LOT 17 / Pp `° O 41 e JSP • .3 ,pcv O Xsz• o`O,�O' ,;3. /to \ // 4/6:‘ LOT 19 NOTE t4 cv LOT 18A 5,791 Sq.Ft. THIS REPRESENt5 A RECERTIFICATION OF AN ASBUILt DONE BY THE ACUMETRIX CORPORATION DATED 10/5/93. NOTE $ ALL ISEARNGS, DISTANCES AND AREAS SHOWN ARE RECORD, UNLESS NOTED OTHERI.IISE. EXCLUSION NOTE: M .0£,01.00 N IT 15 THE RESPONSIBILITY. OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTICN5 WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCtR1STANCEB SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. MORTGAGE SURVEY CERTIFICATE: I HEREBY CERTIFY tHAT I, OR SOMEONE UNDER MY DICT SUPERVISION, HAVE PERFORMED A MORTGAGEE'S INSPECTION ON THE FOLLOWING DESCRIBED PROPERTYr r,i $ govt. ha CI / to 7 TAI ICAO. VAT&TCA 1 HEREBY CERTIFY THAT I, OR SOMEONE UNDER MY DIRECT SUPERVIbION, HAvt ?-tITI-UN w A MORTGAGEE'S INSPECTION ON THE FOLLOWING DESCRIBED PROPERTY+ 21 LOT LOT IBA, BLOCK 2, TCNJESS ESTATES AND THAT NO ENCRDACHh1ENT5 EXIST EXCEPT A5 INDICATED. ri4 ityc, 49th! �' on • .a L �uwl ‚1Ton\L Ntcodemue gira^" No.9106—S /!# SP:sit stie .;'tss� .r . ' 18A xaoc, 2 TONJESS ESTATES eccnat 2 Tatar EN Rant tw SEWARD roaouw KAT "°* 83-520 ANCHORAGE con* Diem= aattek company us blur now tor_ runt nu tat& AK owsl-aver (WM 17* -1a0 FAY Or)$fl-yrs 4WL alY .V OA@ 5I5/t() 93-09.04 ra testa S3JRM.14 SCALE: I" a 60' Mat TAN on= TLN MAP NG. GRID NW 1462 MORTGAGE SURVEY Mar.16. 2006 3:16PM Gayness Engineering Group, Ltd. ( M -W DRILLING, Inc. P.O. Box 110370 *10330 Old Seward Highway - 0907) 349.8536 AN « «r . . _ . 99611 wen ci ner LINDGREN, JOHN DUWNG LOO No•3169 P. 1 Use of WeU DOMESTIC Location (address of: Township, Range, Section, if known; or distance main road LOT 1SA, BLOCK 2. TONPESS ESTATES: 25440 SCHAFF CHUGTAR, ALASKA • Size of easing 6^ nepth of Hole284' feet Cased to71 Co—al—feet Static water level 2 14 ft. Sawn ( ); Perforated A_ :. Describe street or perfoeit1tst +i+ 1a •T' • i:..' is •1''.' t WELL LOO ) land surface. Finish of well (check one) open end ( X 3.N/A WeU pumping test a of drawdown from static bate of eoaopletiru97 MAY 1 ), ) (minute) for 1 hours with 100% ft, Depth in feet from ground surface o ,nj84 —8glrn 98 ST0?84 TO Tn TO TO TO.— To of lormadons penetrated, size of material, color and hardness )WRITE FRACTURES, QUARTZ LENSES ,As RK GREY, WHITE LENSES, SMALL WATER SEAPS f>=,, 4 r _ St SPORADIC FRACTURES • o,xv4. .y 1—CUSTOMER Parcel I D # 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 5/e,3 2,7-7 1. GENERAL INFORMATION Complete legal description 4O7- /S - A HAA # •e145S `-\ fl'1 ?-)D1DiDS Location (site address or directions) Z5wo0 .449,,+E s7'1_..4;› Property owner dge4.4 F•s Day phone 37e- -5/ 2 C� Mailing address 119 1 U'L.n �La,,, /--i&, / Sre. /0` - Lending agency f- 02cv'GS r Day phone 7 4' - y75O Mailing address 2550 •c ' 4.d L, • Agent • g°(-�- 1-4"-7"-1,, // Day phone 7c.. 84-41,4 Address // 73 �� 7L.11,e; Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water G'i't - 3•5O v 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 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. v 72-025 (Rev. 1/91) Front MOA 121 eA 1t3• :. STATEMENT OF INSPECT] ON 3Y 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 ,4,_ vvt E72 1 s Phone ''g8 o O Address lic/Ov 2 %d I LJ,, c_ MA" y Engineer's signature 6. DHHS SIGNATURE iC Approved for bedrooms. Date A Ors. Ot.• / 414# v •,• .• ri. G • o-� s 6c, No. cors -e 4®� ROfESS104Z7 Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: /Z)-----1— Date %%-//%'c/3 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. 72025 (Rem 1/91) Back MOA 121 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L 27 >6-A- •S•74- "TE -S A. WELL DATA Well type 1:', ✓'47E If A, B, or C, attach ADEC letter. Log present (Y/N) YLas Total depth W Sanitary seal (Y/N) • YES Parcel I D 05/ 43 32 ADEC water system number Date completed 6./±5/63 Driller 6.z-° Cased to D- Casing height / •O FROM WELL LOG Date of test G105/5 3 Static water level Well flow Pump level Gg L/rKr+owi� SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /70 Absorption field on lot /00 Public sewer main Sewer service line N /q Wires properly protected (Y/N) yes gpm 1.1 )4- Pllublic sewer manhole/cleanout /-1/4 2:21z.,tc. r. X167 AT INSPECTION ``s -12:;•c -7/13P;3 1.o 9 G U g m 'i4 uNk!-1bw,-1 ij c au. ,''4, 1}. .61 C' Q Oy ; On adjacent lots ; On adjacent Tots /00 4 /00 WATER SAMPLE RESULTS: Coliform 0 Nitrate 3.5 Date of sample: 741//'S3 fi 114/ h3 B. SEPTIC/HOLDING TANK DATA Date installed 41.170/3 Cleanouts (Y/N) 1z5 High water alarm (Y/N) J4 Date of pumping /4 Petroleum tank 'P,5* {" Collected by Tank size /000 Other bacteria e, t,s ,4.t_e_ Foundation cleanout (Y/N) YFS Compartments 2. Depression (Y/N) Alarm tested (Y/N) Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 170 ' On adjacent lots /d0 To property line 'O Absorption field /0 Surface water/drainage /`//4 72-026 (Rev. 7/91) Front 1-10 Foundation /0 Water main/service line N14' • CONTINUED ON BACK PAGE C. LIFT STATION ',VA Date Installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ' / zO ) et 3 Soil rating d•/�`%System type.544 s..4.04., 7� Length Width S Gravel thickness 3 — Total depth Total absorption area 6, L.N. 1T. Cleanouts present (Y/N) las Depression over field (Y/N) O Date of adequacy test 7Jl4 Results (pass/fail) /-' 6O0J571 for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) /4-)/42- If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /S O On adjacent lots /00 -I- To To building foundation /O On adjacent lots /DD t Property line G8 To existing or abandoned system on lot %✓1 Cutbank /`I /4 Water main/service line hi b4 Surface water f-//4 Driveway, parking/vehicle storage area 3E Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines In effect oa.fhEreatiltroilhis inspection. Signature ..••• �.... Engineer's Name /4-'44.° C. Wog -74 �r Date ,�� •.• •:....'�.�� p $ Howard C. Kollar • 1. ✓� 1f� s • til,RO.'�TSJ� ' HAA Fee $ Date of Payment lO—a'_�3 Date of Payment Receipt Number �`' .%-f) .40 253 a Receipt Number Waiver Fee. $ 72-026 (Rev. 3/91) Back MOA 21 From: Enuirolab at 1373-1193 07-23-33 06:10 an To: Acnnetrix at 1376-3629 001 of 002 ENVIROLAB Environmental Assessment Laboratories of AK,Inc. P.O.Box 872988, Wasilla, AK 99687-2988 Ph.(907)373-4143 FAX 376-8016 REPORT ON DRINKING WATER ANALYSIS SATISFACTORY 93-09.04 Acumetrix 4900 Palmer/Wasilla Hiway #3 Wasilla, AK 99654 Sample collected: 7/21/93 1730 RM Sample received: 7/22/93 1204 Sample type:Routine Water Treatment: None TEST NAME: Presence/Absence of Total Coliforms Results:0/100 mis, number of positives w/100 mis inoculated. Normals: 0 positives per 100 mis. Reported: 7/23/93 1200. Report sent to AKDEC: N/A Comments: L18A B2 Tonjess Est. Thank you, Richard Hope, Envirolab EN V Z F DLAI3 Environmental Assessment Laboratories of AK,Inc. P.O.Box 872988, Wasilla, AK 99687-2988 Ph.(907)373-4143 FAX 376-8016 August 2, 1993 WATER SAMPLE ANALYSIS Nitrate Sample Collected: 7/14/93 1145 RM Sample Received by Northern Test Lab: 7/16/93 Northern Test Lab Lab *: A1247932 Sample ID: Acumetrix L18 B2 Tonjess Estates DETECTION PARAMETER SAMPLE METHOD Nitrate—N EPA 353.3 DETECTION SAMPLE LIMIT(MDL) RESULT 2.50 DATE ANALYZED 3.5 7/20/93 MDL= Method Detection Limit Results expressed as mg/1 unless otherwise noted. THIS TEST WAS DONE BY NORTHERN TESTING LABORATORIES Original report on file. Thank you, Richard Hope, Envirolab ACCORPORATIONUfflEC iX Date WELL FLOW TEST 7=1.3-3. ::::::::. Well Depth gy (ft.) Costing Above Ground /9 (ft.) Project *. Loco t ion Loi 18A, 13io.L 2, To ^1,J5� Static Water Level: G 9 = (ft.) (M.osur.d from top of casting) Time Water Level (ft.) Volume (gal.) Cum. Volume (gal.) Meter Reading 9a14 Flor ( m) 9P Comments 9.10b9' 92.53 9 es S• o 915 6 9 s zS 92 50 d1 50 9•zo 70 050 9z, S89 25- .. D 905 no 7S 9 2, G l y _TwcizFASED pi...,. 930 7_c -.2 1z5 9Z GG y So /0 0 935 78 -° 175 gZ, 7/ y , s /0'0 g ya g o _ zzy$ 9z,744/ -^o `� �O—O 9ys Q0. 80 ZS z7 92, Sly 5.O 0tcPffe.`rz)trZow 9 50 300 9z, 839 z� 955 �z5 9z, 8c, ti o ' lobe 3So 9z, 889 S• O IO:o5 375- `9l Z, 91 y ZO /o./0 395' 92, �13� 5�0 to �� 10: 90 5i5 93 0$y Zo y o /I: /o 6,35- 93 17'y/.o )1 i/ . yo 75.E 9 -i zq y a y,b 12:/a 87S g3 y1Y 120 y.6 1z:g0 99.E 93,53y y,G /:/o IZO 1,//S 93,45'5 80-e RECOVERY COMMENTS I: �o 92 AVERAGE FLOW RATE % 7 (gpm) REVIEWED BY: Underground conditions ore subject to change over the course of time