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TIMBER RIDGE #1 BLK 3 LT 10A-1
Timber Ridge #1 Block 3 Lot I OA - 1 #050-321-79 00'003 A s/s. Sie ppN t„_ -n V wRRCRJ JCI MID VAI L. SEWARD I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE' FOLLOWING DESCRIBED PROPERTY' � DATE' AND THAT NO ENCR04CHMENTS EXIST EXCEPT AS � INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID' EASEMENTS, COVENANTS, OR RESTRICTIONS Niv zss WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FBI ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN' _._ _ SSOCIATES LAND SURVEYING .� of q`ee st ' Cn� � ou Ixeh sn.d w � a h _._ _ SSOCIATES LAND SURVEYING .� of q`ee st ' Cn� � ou Ixeh sn.d OUSAWITT®' Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 DEC 1 WM14 of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141155 PID Number: 050-321-79 Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade Name: WALTER BLAJESKI B SORPTION FIELD ❑ Deep Trench N Shallow Trench ❑Bed E] Mound Address 19720 CANYON VIEW DR Other Phone Number of Bedrooms Soil Rating11 Total depth from original grade 2 / +W I r O` GPD/SF 7.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 3.5 Ft. Subdivision Block Lot TIMBER RIDGE#1 3 1OA-1 Fill added above original grade 2 Ft. Gravel length 32 Ft. Township Range Section Gravel width 5 Fd Beds: Number of Lines 1 Distance between lines 0 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line I," a 7S Ft2 1 0 Ft. Well +100 +100 N/A N/A +50' TANK & Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGETANK Capacity 1000 Gal. Surface water +100 +100 N/A N/A Material STEEL Number of compartments 2 Lot Line +5 +10 N/A NIA NA Foundation+5 +10 N/A N/A LIFT STATION Manufacturer N/A Capacity N/A Gal. Curtain Drain +50 +50 1 N/A N/A Remarks SLOPE SETBACK DISTANCE WAIVER Pump on level at N/A in. I Pump off level at N/A in, High water alarm at N/A in. APPROVED FOR 9' MIN, BETWEEN TOP OF STEEP SLOPE AND LEACHFIELD• &V Pump make and model N/A Electrical Inspections performed by N/A I"V tkAlbiJ t,1T Addt119NO1i j,`N P4,kC PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer guaranteed services Draintield 3034 COIMT3034 Inspector Charles balzarini BENCH MARK (Assumed elevation) 100 ft Inspdateg to 7/17/14 7/18/14 Location and desorption 2�d 3`" 0 TOP OF DECK NEAR SEPTIC TANK COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL V %St;1p Conditional Approval: Date s * ' #� rl �, $J ,, •.� ! Approved Date Inspection Report 9 s� p'�ci.�l ,��b�•' i *: TM .* i N .... .:.... ............ -------- - --- , ARLES G BALZARINr I, �F�• CE -13854 +lIiFRF�PR DRIVEWAY/P PARKING S �,0i�'� AREA _ A HOUSE DECK WELL FENCE SHED NEW GRAINFIELD SO�P�O P,GOE55 1pD n'et4 F TH-10 LOT 10-A D/US bo TOP OF STEEP SLOPE ph v / SWING TIES A C 38.1 28. D 27.3 28.2 E 36.8 46.6 / F 38.3 . G 39.8 21 21.66 H 226 \ / ALLSWISWINGTIES FROM HOUSE CO NEft TO STAND PIPE. ASBUILT PLAN - SCALE: 1"= 40' DOUBLE CLEANOUTS CLEANOUT +93.8 MONITOR TUBE +93.54 FINISHED GRADE TH-1 ORIGINAL GRADE +88.6 +88.2 +84.60 +84.60 NO GROUNDWATER +83.58 +81.1 +81.1 DISTRIBUTION PIPE 1000 GAL DRAINFIELD B.O.H TAvk wt5 SEPTIC TANK +75.1 SCHEMATIC SECTION - NOT TO SCALE LEGAL DESCRIPTION: TIMBER RIDGE #1 BLOCK 3 LOT 1OA-1 C&M ENGINEERING SERVICES OWNER: Walter Blajeski DATE: 12!08!14 REV: 1 DRAWN: CB REF: CM -13103 907-854-5558 INSPECTION REPORT On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141155 Tax Code Number: 05032179000 Work Type: Septic Upgrade Permit Effective Dates: June 11, 2014 to June 11, 2015 Design Engineer: BLAJESKI WALTER D & VALERIE E Subdivision: TIMBER RIDGE #1 Site Legal Address: TIMBER RIDGE #1 BILK 3 LT 10A-1 G:0255 Owner/Address: BLAJESKI WALTER D & VALERIE E 19720 CANYON VIEW DR EAGLE RIVER AK 995777927 Site Mailing Address: 19720 CANYON VIEW DR, Eagle River Lot Size in Sq Ft: 75004 Total Bedrooms: 2 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B) Issued By: Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.or_q/Onsite Development Services Division On -Site Water and Wastewater Program 1° F Department **** VARIANCEIWAIVER REVIEW **** Waiver#: OSP141187 COSA#: Permit#:OSPI41165 PID#:050-321-79 Legal Description: Timber Ridge #1, Block 3, lot 1OA-1 Engineer: Charles Balzarini, P.E. Applicant: Walter & Valerie Blaieski Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the 25% or steeper slope has been approved. The approved separation distance is 9.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this mIeu"Cam ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ................................................•.............................1 Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer ..............................................................................� MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION SUBMITTAL MAY 3 0 2014 Parcel I.D. 05-6 , 3a(•7-01 Gretchen Stuller Property owner(s) WA ^+ Ei'- }VAGER « Day phone Mailing address (y 7% CPW fo.,v VTC -w X75 7 Site address l `4 t7L) VM V I eU c br Legal description (Sub'd., Block & Lot) LLMhi /� � it7(� L9 d Legal description (Township, Range & Section) Lot Size 75,oy 4 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field ® Initial ❑ Single Family (SF) El Septic Tank ® Upgrade ® (w/wo ADU) Duplex (D) ElHolding Tank ElRenewal E]Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. of property owner or Permit/RushFees: �jP I Waiver Fees: sO(i� Date of Payment: Date of Payment: 6 Receipt Number:t0 Receipt Number: l`r Permit No. OLP1141<s,,7 Waiver No. &JYJ t 9a - Permit App_9-1-12.doc C&M ENGINEERING SERVICES Ph: 907.854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System for Timber Ridge #1 Block 3 Lot 10A-1 Dear Reviewer, C&M Engineering services was hired to design a new septic system for the above referenced property. One test hole was excavated on the lot, and a percolation test conducted. Groundwater was not encountered in the excavations, or after monitoring for 7 days. The Test hole indicated free draining brown sandy soils. The proposed septic system will have very limited impact on adjacent properties. The neighboring lots are either developed, or of large size with significant room for development. Drainage will not be significantly impacted by the installation of this replacement septic system. No surface water was identified within 100' of the proposed system during the May site investigation. A waiver of the 50' slope setback requirement is requested for the following reasons: Or O 'i6 CV`1S4 df slope, 11. The soils are free draining, reducing the risk of effluent traveling horizontally and escaping from the ground surface. 2. The existing septic system has been in service since the 1970s with no reported or observed effluent flowing from the slope. 3. The free draining soils down slope of the proposed septic are covered with an orgainic layer. The organic layer naturally acts as a "seal" to keep water or effluent contained in the soil column. 4. The amount of soil required to create the 35' separation distance as shown in the section drawing is relatively small. The excavation required and placement of the "soil wedge", would create a condition less effective at containing effluent than the natural organic layer. 5. Significant effort and added cost would be required to install the small "wedge of soil" required to create the 35' separation distance for minimal benefit. The steep slope would require a bench or other temporary access be created for the operation of excavating equipment. For these reasons, we request that the waiver request be approved without requiring additional fill be placed to create a 35' setback as shown in the attached cross section. Included with this letter is a permit application and design package, including plans, specifications, calculations, soil log, and slope waiver request. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email c FIs arini c tr aO cco_r; with any questions or concerns, or for additional information on the waiver request. Sincerely, Charles Balzarini, PE i C&M ENGINEERING SERVICES Ph: 907.854.5558 SPECIFICATIONS FOR ONSITE SEPTIC SYSTEM - MOA CERTIFIED INSTALLER LEGAL: Timber Ridge#1 Block 3 Lot 10A-1 May, 2014 A. GENERAL 1. The septic design is for a 2 bedroom, single family residence only. 2. The site plan and drawings shall be a part of this specification. 3. The Wastewater system shall be installed by a certified installer in accordance All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. In the event of an observed change in soil type, a field percolation test will be conducted, the design will be modified, and the department notified. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environment of Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. A licensed surveyor should locate all nearby lot lines, easements, exact 100' radius from the existing and neighboring on- site wells, and any nearby surface water. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed, after construction of the Drainfield. B. SEPTIC TANK 1. Septic tank shall be a fiberglass or steel, 1000 -gallon tank capacity of MOA approved construction. Installed to meet MOA requirements. 2. Install a foundation cleanout within 5' of the foundation. 3. Install 2 after tank cleanouts between the tank and drainfield. 4. 4' (minimum) of soil cover, or a combination of 3' soil (minimum) and 2" insulation shall be placed over the tank, to prevent ponding and promote drainage. Insulation shall be at a minimum 2" of direct burial polystyrene. Insulfoam R -Tech IV or moa approved equal shall be used. C. DRAINFIELD 1. The Drainfield is to be located as shown on the site plan. Notify Engineer of any changed site conditions. The total depth of the initial drainfield excavation is to be at maximum 7.5' deep. Bottom of excavation shall be level +/- 1.5" max. 2. In the event of over -excavation, a moa filter sand shall be used to maintain the 6' separation distance from the bottom of each trench to the bottom of the testhole excavation.The top of the sand layer shall be level, plus or minus 1.5", and raked, prior to placing sewer rock. Care shall be taken to not compact the sand. 3. A four foot (4') layer of sewer rock is to be placed in the trench. The 4" effluent piping is to be buried within the gravel layer with 2" of gravel cover over the piping, and 3'- 6" effective depth beneath the effluent pipe. 4. The Distribution pipe shall be 4" perforated pvc pipe conforming to ASTM D3034 5. The complete Drainfield gravel and piping is to be covered with a geotextile filter fabric. 6. Soil to a depth of 3.5' minimum is to be placed over the drainfield. Mounded side slopes shall not to exceed 3:1. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200' to any community well. Desiqn Summary Excavation Depth: 7.5' Gravel Depth: 3.5' under distribution pipe, 2" over pipe(4' total). Drainfield Length: 30' Drainfield Width: 5' Soil Rating: 1.2 gpd/sgft Cover 3.5' System Capacity: 2 Bedrooms ��E OF glll/ C&M ENGINEERING SERVICES ��P�•'''� jgS��j 907-854-5558 SeSeptic Design Calculations i• * 49?H p g i ��6- ; t narles G.Balzarini ' Residence: Timber Ridge #1 Blk 3 lot 10A-1 N F -13854 � RESIDENCE/LOT INFO I Fp''•..... rV• �1 number of bedrooms 2 br FESS`OO�n � Water usage/bedroom 150 gpd/br Water Usage 300 gpd Percolation Rate 1.2 min/inch AtTH-1 Water Depth None ft bgs SEPTIC TANK Min Tank Size 1000 gal Use Tank Size 1000 gal system class: Conventional type: shallow trench Application Rate 1.2 required absorption area 250 Test Hole Depth 13.5 ground water depth none K Excavation Depth 7.5 Absorption Area 250 trench width (W) 5 gravel depth (D) 3.5 Shallow trench factor 0.538461538 Min Required Length: 27 Use 30 gpd/sqft sgft ft ft sgfr ft ft below distribution pipe (W+2)/(W+1+2D) ft (Shallow trench factor * Required absorption area /W) ft Calc By: CGB Date: 5/21/2014 Design Summary System type: Conventional, Gravity Flow Tank: 1000 gal steel or fiberglass Drainfield: 5'x30'x3.5' shallow trench Effective depth 3.5' Total rock depth 4' Max Excavation Depth 7.5' Calc By: CGB Date: 5/21/2014 t N T- - - - < \ ABANDON EXISTING 15x15 SEEPAGE PIT IN PLACE - / HOUSE DECK e NEW 5k30' 10' DRAINFIELD c��' 5. TH-1 O A. TOP SLOPE DRIVEWAYS PARKING AREA FENCE jPOO�SS —K WELL � SHED PUMP AND DECOMISSION LOT 10-A EXISTING TANK IN ACCORDANCE WITH MOA CODE NEW 1000 GAL �- SEPTIC TANK SEE NOTE #3 PLACE FILL IN ON STEEP - SLOPE SEE SECTION A. °tip, � % • � _ ' . 0��� • CHARLES G BALZ CE -13854 ARINf �+,PF� •, 100, Rq ONUS LEGEND: 7 O CLEANOUT J• MONITOR TUBE / —(� WELL MOA4'CONTOURS / SHOWN FOR REFERENCE \ NOTES: ,� / 1. CONTRACTOR SHALT: RAVE 100' WELL RADIUS SURVEYED RIOR'IU'CCNSTRUCTION AND NOTIFY THE ENGINEER OF ANY UNFOSEEN IMPACTS TO THE DESIGN.. 2. BACKFILL TEST HOLE AND REMOVE MONITORING TUBES AFTER INSPECTIONS. MAINTAIN S MINIMUM SEPARATION BETWEEN NEW DRAINFIELD AND TEST HOLE EXCAVATIONS 3. LOCATE SEWER LINE FROM HOUSE AND INSTALL NEW FOUNDATION CLEANOUT W U w w U) 00 (D w Z_ 0' A WoD Z_ p Z W ri n �zt Z W u O ui � :- Q U Y Om w w m Y w ik w w (9J m _o w m w w O \ NOTES: ,� / 1. CONTRACTOR SHALT: RAVE 100' WELL RADIUS SURVEYED RIOR'IU'CCNSTRUCTION AND NOTIFY THE ENGINEER OF ANY UNFOSEEN IMPACTS TO THE DESIGN.. 2. BACKFILL TEST HOLE AND REMOVE MONITORING TUBES AFTER INSPECTIONS. MAINTAIN S MINIMUM SEPARATION BETWEEN NEW DRAINFIELD AND TEST HOLE EXCAVATIONS 3. LOCATE SEWER LINE FROM HOUSE AND INSTALL NEW FOUNDATION CLEANOUT W U w w U) 00 (D w Z_ 0' A WoD Z_ p Z W ri n V. HARLEES G BALZARMf I�I��srFgF "' E-138 j•� r ll`\ /'ROFESS�ON�+ m U Z 'S d O PT.1 EXISTING GROUND � J 2% 5% o o d o 2.5' Oso o 7.5' PT.2 z Q 6. 3.5' 0 00 U W U U PIPE INVERT _ 26% w w _OpF PROPOSED FILL =NE FREE DRAINING ly ` DRAINFIELD SANDS m Q 3 35' EXISTING �¢So �� Q W ORGANIC Lou LAYER m NOTE: PLACE FILL SUCH THAT AT NO POINT THE 25% SLOPE LINE w DAYLIGHTS BETWEEN PT.1 AND PT.2 AS SHOWN (D to cD to z� wLo w co wti zo C7 0 z w ca n 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. ci.anchoraoe.ak.us (907) 343-7904 Soils Log - Percolation Test I Performed For. WALDate Performed: 7t10-A Legal Description: ;��✓ Lf/ I Township, Range, Section: Depth r 2- Date Gross Time . 3- Net Drop 4_ t 6// ' f: oe, (9 '_ �� 6- r 7- .. 8- 3 6: 3 :os; o 0 9- 10- wy N (76S C r o� 11- 12 - 13- it � �'� — z WAS GROUND WATER /V0ENCOUNTERED? s IF YES, AT WHAT DEPTH? �J//-�'� L Depth to Water After a P Monitoring? /✓� e Date: I 49 TH f% les G. Balzand CE -13834 Reading Date Gross Time Net Time Depth to Water Net Drop 5/r,/ly t 6// ' f: oe, (9 '_ �� 011i'( � o� V 3 6: 3 :os; o 0 oN' 7 PERCOLATION RATE i., (mMW.sfi ch) PERC HOLE DIAMETER 16- TEST j`•TEST RUN BETWEEN FT AND FT COMMENTS -t6)V LYLAST 6 ft�/}7�,E.n/G$ Lii-fwN PERFORMED BY: Ll� f'}L�l--, Vf 1�L}Aa,ZNL I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5/; z/ GRF``'ER ANCHORAGE AREA BOr"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME MAILING ADDRESS PHONE LOCATION LEGAL DESCRIPTION Lo+ IOA el k s AOD 1 T;,r1IxR R;dge, &tb SEPTIC TANK: DISTANCE FROM WELL NO' INSIDE LENGTH SEEPAGE PIT: 'f NUMBER OF MANUFACTURER HmAi1LroA1 MATERIAL CC74C"#C COMPARTMENTS INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /boa GALLONS. NUMBER OF PITS I DIAMETER 60 OR WIDTH AS , LENGTH /E, DEPTH 6 LINING MATERIAL 60'h"V& CRIB SIZE: DIAMETER y DEPTH DISTANCE FROM: WELL 164 TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE? ABSORPTION AREA (WALL AREA) 360 SQ FT. ADDITIONAL ABSORPTION WELL: 04" 5ror Lolaled Lf cvcii. N/f driIld a/ 7/Kke o1' /nsNecldv� , / TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE SEWER LINE TANK -,SYSTEM CESSPOOL APPROVED DISTANCES: INSTALLED BY: ItAMILtON rcX , OTHER SOURCES DISAPPROVED PIPE MATERIAL: CAST tT-- roo 11 LOT SLOPE:EITREueL1f STrC f 14ILLCOVE REMARKS: 1qj, A,/larl((t''t // C/oep Wr-z.) Form No. EQ -031 REMARKS a o. 4 i 0 a 0 C1 C11 DATE /7,q lg77 APPROVED �" .A.A.B. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 IGS $ Sk E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-321-79 COSA # O�C16' 113 Expiration Date: / O 2 7- LO 1. GENERAL INFORMATION Complete legal description TIMBER RIDGE #1 BLOCK 3, LOT 1OA-1 Location (site address) 19720 CANYON VIEW DRIVE, EAGLE RIVER, AK 99577 Current Property owner(s) RUTH B TAYLOR Day phone_ Mailing address Lending agency Mailing address PO BOX 678 LIVINGSTON MNR, NY 12758. Day phone Real Estate Agent BUTCH JACQUES - KW Day phone 907-360-3576 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ 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. pSD 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 ARCTERRA CONSULTING, INC. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 07-15-2010 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 , occupants or can ArcTerra guarantee that no unseenOF. encroachments, deficiencies or discrepancies exist. I✓,?�_r� �*_ , 5. DSD SIGNATURE V� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: WATER AND mr ATER " DCN1r0AnA \1. Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: (9'(4-l" Original Certificate Date: 7 - (Rev. 11/05), -(Rev.11/05),d Municipality of Anchorage *::E Development Services DepartmentBuilding 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: TIMBER RIDGE #1 BLOCK 3 LOT 1OA-1 Parcel ID: 050-321-79 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # Date completed 9-20-1974 Sanitary seal (Y/N) Y Total depth 440 ft. Cased to 262 ft. FROM WELL LOG Date of test 9-20-1974 Static water level ft. Well production 0.33 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100ml- Nitrate 2.98 mg/L Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) *0 in. AT INSPECTION 07/02/2010 326 ft. 0.44 g.p.m. Arsenic: ND mg/I Date of sample: 7-2-2010 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Concrete Date installed 5-241974 Tank size 1000 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N)Y* Depression over tank (Y/N) N High water alarm (Y/N) 1V Date of pumping 7-2-2010 Pumper Sanitary C. ABSORPTION FIELD DATA Date installed 5-24-1974 Soil rating (g.p.d./ft2 or ft2/bdrm)146 System type Pit Length 15 ft. Width 15 ft. Gravel below pipe 6 ft. Total depth 9 ft. (Measured 7/2/10) Eff. absorption area 360 f:2 Monitoring tube Y Date of adequacy test 7/2/2010 Depression over field N Results (Pass/Fail) Pass For 2 bedrooms Fluid depth in absorption field before test 27.6 in. Water added 600 gal. New depth 70.8 in. Elapsed Time: 95 min. Final fluid depth 27.6 in. Absorption rate >= 300+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date = D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at _in. "Pump off" level at _in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 751+ Sewer /septic service line 251+ Animal containment areas 50'+ On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manhole/cleanout 1001+ Holding tank 100'+ Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 51+ Water main '10'+ Water service line 1('+ Surface water 1001+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 101+ Water main 101+ Water Service line 101+ Surface water 1001+ Driveway, parking/vehicle storage 101+ Curtain drain 50'+ (None Known) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I 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. Engineer's Printed Name KENNETH n DUFFUS Date 7-23-2010 COSA Fee $490.00 Waiver Fee $ — Date of Payment _ — l L-) Date of Payment Receipt Number r /a Q-7 Receipt Number. (Rev. 11/05) 01, Municipality of Anchorage • "'° Development Services Department ° 2 Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 101135 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 10A-1 of Timber Ridge #1 subdivision, the well's productivity was determined to be 0.44 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 2 -bedroom residence is, 0.2 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. MUNICIPALITY OF ANCHORAGE • z 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 l.D. #'. O Sol 3X/ 79 .\j HAA # 1. GENERAL INFORMATION Complete legal description %, ,dei /Q, ��t 1 Lo T /ori /31A- 3 Location (site address or directions) • �i'/t' Ki•✓�-r� Art Property owner Day phone &Mailing address r,,y/< R,-rcr Ak P'Ys'9i Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well 4A 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 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 (Rov.1/91) Front MOA 121 5. STATEMENT OF INSPECTION BY ENGINEER. As certified by my seal affixed hereto and as of the validation date shown below, l verify that my ,. investigation of this Health Authority Approval application shows that the on-site water supply andlorwastewater 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 a' :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. Eagle River Engineering Services _.Name of Firm P. a Box 773D4 Phone Eagle River, AK 99577 Address. s�e.5tgs Engineer's signature ��� Sri?� Date 6. DHHS SIGNATURE Approved for -T' w C bedrooms. Disapproved. Conditional approval for Additional Comments By tA// ___L> /.f/. d6-4� h •9 ti lose' 49 V".».�:; x �• ce Louis k!36rro Q_% CE -6736 bedrooms, with the following stipulations: Date 9— 2 --le 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 ofAlaska.The DHHS does this as a courtesyto purchasers of homes r: 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-= (Rev.1/91) Back MOA P21 Municipality of Anchorage AUG 2 41998 DEPARTMENT OF HEALTH & HUMAN SERVICEUNICIPALITY OF Environmental Services Division MRONMENTAL SERVI 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: T;.hw R,i/fe *1 L.•r/0,.� Pt 3 Parcel I.D.: Ofo 371 79 A. WELL DATA Well type i,-vrr< Log present (YM) %S Total depth 'He Sanitary seal (Y/N) Date of test Static water level Well production Yes If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG 9-2--01-?y c�. 33 WATER SAMPLE RESULTS: Collform fl Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA g.p.m. I-zo-9y '40�4 Casing height (above ground) i y 00 Wires properly protected (Y/N) rq-�S AT INSPECTION 7—/ V— 9 8 3;•if' ' RTC g.p.m. /, 5 '^ 6/4-/0.61 o'A Other bacteria 911 x Collected by: f-" S oN G e r Date installed $--11- 7V Tank size /01PO'Ir-o/Number of Compartments Cleanouts (Y/N) �<t Foundation cleanpNi(.Y/AI), 41V Depression (YM) lVa High water alarm (Y/N) �A Date of Putng��� i*�"'� " _ Pumper C. ABSORPTION FIELD DATA, Date installed �- zy - 95/ ,Moil rating (g.p.d./tt' or fN/bdrm) 1 N6 ��R System type P'7 - Length (S' Width 1 Gravel thickness below pipe 6(r«",✓) Total depth Effective absorption area 36oEr• ) Monitoring Tube present (Y/N) es Depression over field (Y/N) /1/0 Date of adequacy test �!"� y-� Results (Pass/Fail) FfS For Z �T "n) bedrooms Fluid depth in absorption field before test (in.V ;L 9 Immediately afterLal water added (in )• 3 J' 5- Fluid depth 3�� t (ins) Minutes later: 6 Peroodde treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)' 9• Absorption rate = Sy© g.p.d. .1W If yes, give date � /V4 W D. LIFT STATIONA Date installed Size in gallons Manhole/Acce . ) "Pump ori"_Jev "Pump off" level at' High water alarm level at' 'natum C ed E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / q O On adjacent lots + Absorption field on lot 6 On adjacent lots Public sewer main — N'4 Public sewer manholetcleanout Sewer /septic service line. f z s Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Property line t / S Absorption field Water main/service line 4/O Surface water/drainage /414 Wells on adjacent lots +!©v SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line S Building foundation t �L o Water rnnin/service line t ! V Surface water /V4 Driveway, parking/vehicle storage area f S—O Curtain drain /11-4 Wells on adjacent lots + 1 o v , F. ENGINEER'S CERTIFICATION I certify that / have determined thru field inspections and review of Municipal in conformance with MOA FAA guidelines in effect on this date. Signature _ - 4 Engineer's Name 1OH Q- '09 .4r" Date 72— / 7 — y -F HAA Fee $ ?0-b' lr-n Date of Payment Receipt Number /�Z- �7. 1 7) 72-026 (Rev. 3/96)' Waiver Fee $ Date of Payment Receipt Number �4 93 ms are ��wwiwNw.NE. Goulf �81d0iA ' �� L C f .....N� ?I . r MUPICIPALITY OF ANCHORAGE E M 0 R A N D U M W .TER WELL ADVISORY HEALTH AU_HORITY APPROVAL ITO. 14R 1$ 0.2 43 During a recent Health authority Approval on-site ins_ection and test of t:,e potable :rater supply well on Lot )OA Block _3 o=-j'MOEX 91 Subdivision, the ;,ell's productivity was determined to be 0,60 gallons ger minute. The mi:i-um well productivity required by this Department (A_MC 15.55) for a 2 bedroom residence is 0,21 gallons per although the subject well currently exceeds this minim. u- requirement, a'-_ parties ccncer:^.ed are advise that the production capacity of t^e e—!-- may fluctuate. Restriction of non-critical water -ses such as washing cars and watering lawns and gardens may he required. This advisory must be attached to all copies of the subject Healt:^. r.uthor'-tv Appro-: al. 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON-SITE DATEINSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ❑ OTHER 4. DISTANCES Septic/Holding Tank IAbsorption Area (Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS 2� APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certific to) 2 ' Z 1-�DISAPPROVED DATE t / L BY { \ 72010 (Rev. 6/79) r,. January 220 1982 Jake & Bess F)ohlwend P.O. Box 544 Eagle River, AK Subject: Lot 10A, BLock 3, Timber Ridge 01 Dear Mr. & Mrs. Hohlwend: Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. ` Expose the well for our inspection to determine proper construction, also to insure minimum distance requirements are met between the well and sewer system. ° The septic tank pumped with a receipt submitted to this department. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performit}g the test is enclosed. This report needs to be submitted to this office for our review. Please notify this department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Enclosure Sincerely, Robert C. Pratt Associate Environmental Specialist H N 1 1 N40 -Z A �..e 7 i A EXCAVATION WORK ROBERT A.SHAFER CIVIL ENGINEER 694.2979 March 21, 1984uNICIPALITY OF ANCHORAGE i' i C' HG'•CT'i A.- ENAR F'::U � ECT _';•� ?•r7n ,IA;, 21 1962 Totem Realty RECEIVED ATTENTION: Barbara Wagnitz r P.O. Box 911 Eagle River, Alaska 99577 Dear Ms. Wagnitz, Reference: Lot 10A: Block 3; Timberidge Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity in excess of 750 gallons, The seepage pit was tested by charging the system -with 400 gallons of water and after a period of 24 hours all the water added to the system had percolated out. It can be concluded from this test that the waste water disposal system serving the two bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. Sincerrely, O$ERT A/ 'SZAFER-�-�. E. /(r Sass % cc: USA Federal credit Union Municipality of Anchorage Department of Health and Environmental Protection SRB196X EAGLE RIVER, ALASKA