Loading...
HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS BLK 3 LT 13Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221034 PID Number: 051-721-24 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: [3 New © Upgrade Name ABSORPTION FIELD Melissa Motta ❑ Deep Trench FZI Wide Trench El Bed ❑Mound Site Address 27306 Goshawk Court ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 3 1.2 GPD/SF JTotal 8.71 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.21 Ft. Gravel depth beneath pipe 3.5 Ft. Subdivision Block Lot Thunderbird Heights 3 13 Fill added above original grade 0.00-0.64 Ft. Gravel length 41 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field I Lift Station Tank Line 379 Ftz 1 Ft. Well 1001+ 1001+ I I TANK 2 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal, Surface water 100'+ I 100'+ Material Plastic Number of compartments 2 Lot Line 101+ ! 101+ NA Foundation 101+. 10'+ I TATION Manufacturer Capacity Gal. Remarks Alarm location Elects Iled by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer JR's Drainfield D3034 CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection 1�Location 3/31/22 3/31/22 and description dates: 2nd 1 3`d 4/4/22 4th 4/5/22 Bottom of siding ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp g!� OF+f1 ��.♦ Conditional Approval: Date ���� i i i _ AW tic �2 2 % CE 7116/•• Ar App �-- _-�l� Date �.p�. �iI iG�+• Note: this approval does not include well permit requirements.+� �111111 ESS1��� (Rev 05/02/18) AS—BUILT SYSTEM DETAILS/SITE PLAN Permit OSP221034 THUNDERBIRD HEIGHTS BLOCK 3 LOT 13 PID# 051-721-24 7 M a—c=18.o' x B—C=39.4' a A—D=19.9' B—D=41.1' A—E=21.4' B—E=42.4' o A—F=22.2' B—F=43.1' A—G=32.4' 2 B-6=40.5' o A—H=33.5' m B—H=40.8' a A—I=31.8' B—I=14.3' cy A—J=32,7' B—J=15,8' MT H G CO T im 1, 0 7 1000 GAL — y SEPTIC TANK 3—BEDROOM HOUSE FCO Mir.19 CO's Ft \ NEW 1000 CAL. TANK W F SCALES i' =. 20' PREPARED FOR; MELISSA MOTTA 27306 GOSHAWK COURT CHUGIAK, AK 99567 FELD BOOKS EWNDARY: N /A STMNO: N /A Aseu" WALATk DWG. FlIF: AcAD FSE: FILE 84.00 u¢v�nvzz 41' COMPUTED: DRAWN: KSD CHECFD:D' KMD DATE: 4/15/ GMD: NW18f " No' 21100 SCALES NTS Z W � JJJJ 0 ti 1, 0 7 1000 GAL — y SEPTIC TANK 3—BEDROOM HOUSE FCO Mir.19 CO's Ft \ NEW 1000 CAL. TANK W F SCALES i' =. 20' PREPARED FOR; MELISSA MOTTA 27306 GOSHAWK COURT CHUGIAK, AK 99567 FELD BOOKS EWNDARY: N /A STMNO: N /A Aseu" WALATk DWG. FlIF: AcAD FSE: FILE 84.00 u¢v�nvzz 41' COMPUTED: DRAWN: KSD CHECFD:D' KMD DATE: 4/15/ GMD: NW18f " No' 21100 SCALES NTS y r q�� !D tD p or, ` 1 1. ' `••� is 1't 111LZ A CONSULTING, INC u = 20441 Ptarmigan, Eagle River,AK 99577CQ9 T1 j " t Office (907) 696-6111, Fax (907) 868-3793 TING j KENNETH R SOILS PERCOLATION TEST Performed for: Melssa_Motta Date Performed:___ 03 31 2022 Project: Thunderbird Heights Block -3 Lot -_13 _ _____PERC #2 _ TEST HOLE # _TH 22-2_ Depth (Feet) ORG 0'- 0.5' SEE ATTACHED SITE PLAN I- FOR HOLE LOCATION SM/GM 0.5'-3' w rocks 1" 1J- 16- 17- 18- 19- GW/SP 6- 17- 18- 19- GW/SP 3'-15' with rocks Y-6" B.O.H. 15' PERC RATE BASED ON PRIOR TH Was Ground water encountered? NO What depth? Depth to water after monitoring? 0'0" Date 3/31/22 (Depth below grade) Reading Date Gross Time Net Time Depth to Water Net Drop I 2 3 4 5 6 7 8 9 10 11 12 * Water Added Percolation Rate 1.5 (min/in) Perc Hole Diameter 6" Test Run Between 3.5 feet and 4.0 feet I, Kenneth M. Duffus, certify that this test was perforated in accordance with all State. and Municipal guidelines in effect on this date. 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: OSP221034 Work Type: Septic Upgrade Tax Code Number: 05172124000 Site Legal Address: THUNDERBIRD HEIGHTS BLK 3 LT 13 G:1865 Site Mailing Address: 27306 GOSHAWK CT, Chugiak Owner: ROSS JOHN J & Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: El Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: ll�»1Cllt . }r r• f- il I)eparrinent 3/10/2022 3/10/2023 23178 ❑ 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: Issued By: Date: Date: 4ZoZ 3 MUNICIPALITY OF ANCHORAGE rr: Li:, tea' Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcell.D. 051-721-24 Property owner(s) Melissa Motta Mailing address 27306 Goshawk Court, ChuLiak, AK Day phone Site address 27306 Goshawk Court, Chugiak, AK Legal description (Sub'd., Block & Lot) Thunderbird Heights Block 3 Lot 13 Legal description (Township, Range & Section) Lot Size 23,178 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field 0 Initial ❑ Single Family (SF) FAI (w/wo AD U) Septic Tank E Upgrade x Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees:. S911�5' Waiver Fees: Date of Payment: Receipt Number: Permit No. 05 PZZ / 0"�(-I Date of Payment: Receipt Number: 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 OSP221034, Deb Wockenfuss, 03/09/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221034, Deb Wockenfuss, 03/09/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221034, Deb Wockenfuss, 03/09/22 LOCATION �jf 111 " CONNECTION MADE BY 31-058 (12177) EXCAVATOR APPOINTMENT TIME: TIME READY: INSPECTED BY ❑ IMP. DIST. ❑ EXT. AGREEMENT MUNICIPALITY OF ANCHORAGE ^^�� WATER CONNECTION — Location Record ACCT. NO. tee. rr�� ADDRESS d v— L Ik NAME LOT �.3 BLOCK ADDITION Lt E DATE MADE Jn�Z 3' �7 NEW CONN. REPLACEMENT CONN. SIZE CONN. LOCATION: ALLEY 0 STREET CZ TYPE OF MAIN I } SHOW SKETCH ON REVERSE SPERMIT NO. CORPSTOP THAW PLATE KEARNY WIRE CONNECTOR W CURB STOP C TOC CONN. CURB STOP C TO I OTHER: I NSP. CORP CONNECTOR PERMIT COUPLING C TO I TOTAL X BRASS BUSHING GALVANIZED BUSHING COMMENTS: BROKEN MAIN, EXT. CONNECTION, EXTRA PIPE X CASING, DELAYS, ETC. FT. C� 2 PART UNION PI LA 3 PART UNION ❑ PAID PREY_ SERVICE CLAMP X ❑ W.M. # COPPER PIPE PAID CASH i 7/4" KEY BOX ❑ SUB AGREEMENT 2" KEY BOX ALT. THAW WIRE DISCONNECTS LOCATION �jf 111 " CONNECTION MADE BY 31-058 (12177) EXCAVATOR APPOINTMENT TIME: TIME READY: INSPECTED BY ❑ IMP. DIST. ❑ EXT. AGREEMENT KEY BOX AND SERVICE LINE LOCATION BY SKETCH INDICATE I NORTH STREET ALLEY 31-058 (12/77) -�huhd Cif 1�1 Y8- 1,�>Y MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME v PHONE W Ct c T t ,c1 7Y ' ❑ UPGRADE MAILING ADDRESS r -3 l LEGAL DESCRIPTION LOCATION % NO. OF BEDROOMS �~ 4t" U _ Y DISTANCE TO: I Absorption ar Dwelling PERMIT ` � ©[ a- Q Manufacturer Mate ' No. of corry�rtments LU I.- p�� ti Liq.capaci in galons IF HOMEMADE: Inside length Width Liquid depth zDISTANCE TO: Well Dwelling PERMIT NO. _j 0 2 Z Manufacturer Material Liquid capacity in gallons 0 W = DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. _j Z w No. of lin a� Length Length of ac ine Total length af� Trench widtfj, Distance bet a ry(ines ¢ l � Inches C,(, Top of tile to finish grade Material beneath tile y--� Total effective abs � inekes C f - ®a Lu Length Width Depth PERMIT NO. 0 CL ~a w Type of crib Crib diameter Crib depth Total effective absorption area ti DISTANCE TO: Well Building foundation Nearest lot line .j Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 30 e SOI L TEST RATING d c INSTALLER _ c REMARKS Jn F ` LD& LA c sT w4 is 5 � mss D �n Y 5 rn APPROVED DATE LEGAL _ �v �Cis /Z -u16 Uiev. 3//6) 1 / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION �0* ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME El NEW FIUPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE TO: Well !a Dwelling PERMIT NO. UY I— z 0- < Manufacturer Material No. of compartments WF Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling PERMIT NO. _j a 2 02< Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. Uj U _j w z No. of lines Length of each line Total lien th5�s f lines Trench I Distance between lines PZW inches Top of tile to finish grade 14 E5 Material beneath tile Total effective absorption area O I R S= inches Length Width Depth PERMIT NO. W <I- a. Wa: Type of crib Crib diameter Crib depth Total effective absorption area W Cn DISTANCE TO: Well Building foundation Nearest lot line _j Class Depth Driller Distance to lot line PERMIT NO. _j W 3: 1 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIR--,MATERIAM SOIL TEST RATING INSTALLER REMARKS( A15. AJAJ -4 AA -Ie-A U10 IZushaii L Uyve, 4 1 WrT7.3 LYA� rikiAL-- j N 0455 -4 AQ4 n 1-10 APPROVED DATE LEGAL 01111.17/- 1 72-013 (Rev. 3/78) r-l�_H P-4 I CD- I F' F -H III_][ - CO F=" f? DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, HK. 99501 — 264-4720 K0 hl --00 1-F E= Al E= 90-9 E: F-_' F"E= F-"_1�1-1 I -� PERMIT NO. ( 800101 ) APPLICANT G.S.K CONST. SRH 6105 H-] PALMER 745-2551: LOCATION THUNDERBIRD DR LEGAL LOT 13 BLK] THUNDERBIRD HTS. LOT SIZE 21780 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 109 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ������= "E." �����IF �= to to ���N? EE L_ �����= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD` THE DEPTH OF H TRENCH 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). �F=- 9-7-9 L-9 I F;; -'E= E> co Em 7'"IF I a::-- IF 1=1 T41 02 "Ey I .70=7 Il to AD CA Fi L_ L_ CD 44� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. �94 CH < ;a" ---- T PA On F" Eo CD -7- 1 C9 F=9 F_ E- F-_' E= IQ U I F! 9-- C-- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. �K Fy? 1-1 1 IF K b< $=" 3: F-"- C_- E= ED E7 P1 E3 E7 FQ 77 "1" AL <0 E3 CC -11 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED:___ _--- �ZAJ_c� ________ HP��ICHNTOG�S.K CONST. Appiliall? �������� ISSUED BYj/-���l�����������-�l_-DHTE Y4.0 / ` MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-721-24 Certificate of On -Site Systems Approval Expiration Date: 3/20/2025 Legal description THUNDERBIRD HEIGHTS BLK 3 LT 13 Site address 27306 GOSHAWK CT Current property owner(s) KENDLE JORDAN SCOTT & JENNIFER XThe On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: U Original Certificate Date: 4/1/2024 IV 13 e -Y, C&j5er 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 Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovWjune 2022 1 IPALITY OF ©evelopnierit Services Department On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application I. GENERAL INFORMATION Parcel I.D. 051-721-24 Complete legal description THUNDERBIRD HEIGHTS; BLOCK 3, LOT 13 Location (site address) 27306 GOSHAWK COURT, CHUGIAK, AK 99567 Current property owner(s) SCOTT & JENNIFER KENDLE Day phone 1-281-733-8639 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units Al Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age 2 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench Q 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 $ -6--G-O Date of Payment 3 Z 2 y COSA # '05C2,'1 107.6 Waiver Fee $ Date of Payment Waiver # COSA Application_June 2022 COSA Checklist Legal Description: THUNDERBIRD HEIGHTS; BLOCK 3, LOT 13 Parcel ID: 051-721-24 Ifmore than 1well and/or septic system mnlot, provide separate checklist. Structure served 6ythis system 1 LL DATA �n El Well log I with Onsite (or attached) depth ft Date drilled Cased to ft—� ElSanitary seal iofunctioning correctly Elwires are properly protected Casing height (above ground) Date nfflow test for COS J�~�°� Static waterjpePffbeginning of test t B. TANK DATA Measured operating fluid level inseptic tank 47-5 Date of pumping RRequired maintenance completed, ifAVVWT8 Comments: D. ABSORPTION FIELD DATA Which system tested (date installed)415122 XALL standpipes present per record drawing Total measured depth from grade (max) Measured depth topipe invert from grade (min) ElN/A - pressurized field.El Per record drawings, field is insulated. [-1 Monitor tubes go to bottom of effective. Ifnot, state depth into effective 3�-3* F-1Presoaked required if (Required ifhouse vacant urfield not used for more than 3Odays prior todate oftest) Gallons introduced _gallons date Any rejuvenation treatment (past 12months) N/A If yes, enter date Well production at time of te�s gPm Water storage tan a gallons Well dip =edfor coliform test? n Yes No Coliform bacteria ioNegative abnmg/L �[� �Nitrate|esmtha MRL (ND) ug/L 'M Arsenic less than MRL (ND) enic Collected by Date STATION � [� �Requird&� Age oflift station Lift station nsaW Adequacy test 3/15/2024� ' [�l --- R��� cupaso Fluid depth prior bztest _ Water added 484 gal New fluid depth » in Elapsed time D min O in Final fluid depth 8 in Absorption rate 450+ gpd FIELD STATUS -POST RECOVERY Effective depth (per record drawings) 42 in Effective depth used O in Effective depth remaining 42 in Comments/Deficiencies: NOTE: SOUTH GO HAS I" OF STANDING LIQUID LEVEL (LL) AND DOUBLE GO'S HAVE 1 TO 1.25" OF LL STANDING IN IT. COSAChecklist-June 2022 E. SEPARATION DISTANCES rivate Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Li on Lot > 100' Community Sewer Manhole/ > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes I ft Pr' ewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ing Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > Animal Contain > 50' [] Yes if No ft Yes if No ft Manure/Animal Excreta Storage > Co Sewer Main > 75' ❑ Yes if No ft Q Yes l ft Al N/A — Served by Community Well (not on lot) or Public Water From SepticlHolding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' FEC Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 7 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *PER 4/16/2022 KENNETH DUFFUS, P.E. RECORD DRAWINGS, WATER SERVICE LINE IS 10'+ FROM SEPTIC TANK AND DRAINFIELD. G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Gayness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. OF...4 UIQ �! • • . Is, H A;Garnes:' 9• h'E--79az e� Q NSE W�, pyo f CS 5io'�O_G COSA Checklist June 2022 #AECC884 TGE @G • Municipality of Anchorage ° r � On -Site Water and Wastewater Program a (907) 343-7904 5 a E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-721-24 1. GENERAL INFORMATION Expiration Date: _ _7 z oZY Complete legal description Thunderbird Heights Block 3 Lot 1.3__ Location (site address) 27306 Goshawk Court, Chugiak, AK 99567 Current Property owner(s) Melissa Motta Day phone _ _ Mailing address Real Estate -Agent 27306 Goshawk Court, Chugiak, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _ Well Public Water System Waiver/Variance request for: Day phone-- 3 hone- 3 TYPE OF WASTEWATER DISPOSAL: Individual ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Q ?7) Date of Payment Receipt Number 03 COSA# 0SCa a 11 H (0 Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING-,, INC. Phone 696-6111__ Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS DateXk�z Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future 4+�.�►\ occupants or can ArcTerra guarantee that no unseen encroachments, deflcieiiCias or disciepaincies exist. 6. DSD SIGNATURE System #1 Approved for ,3 bedrooms. System #2 Approved for Disapproved. bedrooms. '1 9 TH� r� KENNETH M. Dul.- I / ,ems^ 7t V ., `F� G s Conditional approval for .-._ bedrooms, with the followingVtsOFAn��/i�� J WATER ANg m% IASTI- TER PROO - - RM``ff^^ ti-•.! __ - __ Original Certificate Dater Z 2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other — COSA blue sheet 10-10-12.doc Legal Legal Description: Thunderbird Heights Block 3 Lot 13 Parcel ID: dW a �1- 72_ 1 -2_1 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) New years Tank type/material Septic/Plastic Measured operating fluid level in septic tank 0 Standpipes/foundation cleanout per record drawing Date of pumping New Install 3/31/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 4/4!22 ALL standpipes present per record drawing Total measured depth from grade 9.64 ft (max) Measured depth to pipe invert from grade 5.95 ft (min) ❑ N/A — pressurized field IN Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) nic ug/L ❑Arsenic less than MRL (ND) Collected Date of Sample C. LIFT STATION ired maintenance completed Age of lift stair _ years Lift station material Comments: Adequacy test date New Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min 11 Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) SI✓pt:ac,Za�nk/Lift Station on Lot >'0' ® Yes Community Sewer Manhole/Cleanout > 100' `•-...�` ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' �'�`es�, if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No C Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Yes Animal Co taut t > 50' ❑ Yes if No ft ❑ Yes if No ft ® Yes if No ft Water Main > 10' Yes Manure/Animal Excreta Storage _ Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes ii 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' Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet 83110' 2p J b, _w 387 0 4 cc�:' �' :4 2'35„ / 0 E ? 64 `f-~ R-225 QO -g RECERTIFIED 4-06-22 .� "".NXXX X AS -BUILT NO CORNERS SET THIS DATE � 1 hereby certify that I have performed a Mortgagee's inspection W Q• ' • ,0 # in accordance with ASPLS Standards of the following ,�CO• + described property: LOT 13 BLOCK 3 �?' 9th i THUNDERBIRD HEIGHTS SUBDIVISION %'f / • • Anchorage Recording Precinct, Alaska, and that the •:.� �:Fr. i • : �prmA improvements situated thereon are within the property lines and do not overlap or encroach on the property lying . £ljzabeth L. Woiotko . sa' adjacent thereto, that no improvements on the property lying AF • • 8036 - LS « • J4�e adjacent thereto encroach on the premises in question and P e4Fo • . • o .d that there are no roadways, transmission lines or other SCALE: V= 40' d0ss10140-•�.r® hvisible ereon easements on said property except as indicated 1�4® Dated at Anchorage, Alaska this 22nd day of MARCH , 2007. THOSE SHOWNN ON THE RECORDED pg EASEMENTS RECORD, OTHER THAN FB 21-7 49-50 FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON Recert 3-28-17 BE Engineers and Surveyors UNLESS OTHERWISE NOTED. JKD, FB 07-1, pg 49 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka Is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. 10, U -no - 9.87 I ZI I 35. 2.O OH 210 e deck (/ deck 11.0 40 O / M 2 Story o i O Frame Q / House i MLOTIaten 13 N I rnI I _W I f 0,.,. -Manhole t� I d /-Chain link fenc H / 1- -wood fence t. LOT 12 b I o eptic Vent -—�Watervalve I 30 Nis°54,?6. 6.35 LOT 14 RECERTIFIED 4-06-22 .� "".NXXX X AS -BUILT NO CORNERS SET THIS DATE � 1 hereby certify that I have performed a Mortgagee's inspection W Q• ' • ,0 # in accordance with ASPLS Standards of the following ,�CO• + described property: LOT 13 BLOCK 3 �?' 9th i THUNDERBIRD HEIGHTS SUBDIVISION %'f / • • Anchorage Recording Precinct, Alaska, and that the •:.� �:Fr. i • : �prmA improvements situated thereon are within the property lines and do not overlap or encroach on the property lying . £ljzabeth L. Woiotko . sa' adjacent thereto, that no improvements on the property lying AF • • 8036 - LS « • J4�e adjacent thereto encroach on the premises in question and P e4Fo • . • o .d that there are no roadways, transmission lines or other SCALE: V= 40' d0ss10140-•�.r® hvisible ereon easements on said property except as indicated 1�4® Dated at Anchorage, Alaska this 22nd day of MARCH , 2007. THOSE SHOWNN ON THE RECORDED pg EASEMENTS RECORD, OTHER THAN FB 21-7 49-50 FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON Recert 3-28-17 BE Engineers and Surveyors UNLESS OTHERWISE NOTED. JKD, FB 07-1, pg 49 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka Is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. INSPECTION APPOINTMENTS DATE RECEIV TIMETIME / TIME DATE , ECTOR INSPECTO / INSPECTOR � C, MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIkW]RONMENTAL PP,OTECTION 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION OCT 13 1980 Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE 0U/V Pc lO n) PHO d2�� 3 MAI LING ADDRESS �n 6 /0 - - 2- �d2 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE �? L MAILING ADDRESS YL/ `%�t 3. LENDING INSTITUTION PHONE �El�);��dLs�z2 SGS 3 7Yo- MAILING ADDRESS 4. REALTOR/AGENT PHONE r�LZ2 i 1— Z5 X7.2 vS 7) MAILING ADDRESS 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED _ INSTALLER ❑Septic Tank or ❑ Holding Tank Size: I If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS T ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE \ BY n 72-010 (Rev. 6/79)