The URL can be used to link to this page

Home My WebLink AboutPREUSS #2 BLK 1 LT 15Preuss #2 Block 1 Lot 15 #050-571-13 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221492 PID Number: 050-571-13 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name THORTON GALLIMORE & ANNA GENTRY ABSORPTION FIELD ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 20130 DAVID AVENUE, EAGLE RIVER ❑ Other Phone7Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 1 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot PREUSS #2 1 15 Fill added above original grade VARIES 2.04'— 2.3 Ft. Gravel length 100 2 X 50' Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 500 Ft2 2 10 Ft. Well 1001+ 1001+ 25'+ TANK ® Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 100'+ 100'+ Material EPDXY STEEL Number of compartments 2 Lot Line 5'+ 10'+ NA Foundation 10'+ 10'+ LIFT STATION Manufacturer ORENCO / ANCH TANK Capacity 1500 Gal. Remarks Existing tank decommissioned & field abandoned. New fields insulated w/ 2' MOA sand below ED. Alarm location FIRST FLOOR Electrical installed by DRS Installer QRS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection 15t 7/18/23 2nd 7/19/23 Location and description 3`d 7/20/23 4'h 7/21/23 TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL 0`�\\ OF A Conditional Approval: Date '•,ts,� H " " " " " " " Curtis Huffman Septic System Appr ed Date / ��1�F�� • CE 128991 . �, *' [ lF • . A 19 K 8/28/23 . • '�v_IdEw • approval Note: t does not Include well permit requirements. tmev uoiuzriu/ PID:050-571-13 PERMIT:OSP221492 FIRST WATER CONSULTING PREUSS #2 BLOCK 1, LOT 15 i HOUSE DETAIL / Scale: 1"=20' / o ADDITION ON ji;�5.0' PILINGS 5 —L1 2 1' 4 \ • 'n DAVID AVENUE L4 0 S 89'59'E 134.30' rWELLS 10'x10' WATER WELL USE AGREEMENT °cGRAVES(BK. 3436, PG. 442) 'DRIVEWAY 2.0'x5.1 CANT 1 8.8' ASO T 24.3' PORCH 40. > p _ 9 iA o > RRESIDENCE 2z.a' I WOODEN n FENCE Z rn 39.3' N / O SEE DETAIL tlb:�O 24.3 22.8' I Q 0DECKECK 1 g•5 0 / Lot 16 4.5x6.5 SHED 22.0' 00 Lot 1 MANHOLES 00 1 / SEPTIC l A / PIPES � O 6.5'x9.5' SHED �)/ Lot 15 8.2'x8.2' SHED 10' UTILITY 25,181 S. F. EASEMENTS N 89'59'W 134.30' Lot 3 Lot 4 Lot 5 I I PLOT PLAN ___ AS BUILT _X_ SCALE __1,� —49' GRID _ NW 0056Project No. ___ 22 -769/A2 ---- 11500 2_76/A2____11500 Daryl Avenue, Anchorage, Alaska 99515-3049 La n g & Associates, inc. (907) 522-6476 Phone ken0langsurvey.com Professional Land Surveyor s jonathan®longsurvey.com ! OF At tk�� lrovis®langsurvey.com � I hereby certify that I have surveyed the following described property: RC2 LOT 15, BLOCK 1, PREUSS SUBDIVISION — UNIT No. 2 (PLAT No. 70-42);of*: 48 TH Anchorage Recording District, Alaska, and that the improvements situated thereon are • • • • • • • • • • • • • • • t/ within the property lines and do not encroach onto the property adjacent thereto, that kid no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible • ' • • . . • KENNETH G. LANG All• easements on said property except as indicated hereon.``c, • No. 5202 Dated this the __ �t _ Day of � , 282 "' at Anchorage, Alaska rrpie xt, .3 P -r" 1` E5514NA � It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 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: OSP221492 Work Type: Septic Upgrade Tax Code Number: 05057113000 Site Legal Address: PREUSS #2 BLK 1 LT 15 G:0056 Site Mailing Address: 20130 DAVID AVE, Eagle River Owner: GALLIMORE THORNTON M & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnr J Dc I al'tin nt 1/4/2023 1/4/2024 25181 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage 4 All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska - Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: jDeIA"test hole is required prior to construction of the absorption field, in the location shown on the site plan, to confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation rate. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). GD l De5,V\ C hc� c A. -o 4�et � R.emKted=3_r, 1 5tneCA +11 rs �f%a�Pr� Date: Issued By: lam/ Date: ��iA2�a Development Services Department j Phone: 907-343-7904 On -Site Water & Wastewater Section \ Y' Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-571-13 Property owner(s) THORNTON GALLIMORE & ANA GENTR� Day phone Mailina address 4250 THUNDERBOLT DRIVE, SCOTT AFB, IL 62225 Site address 20130 DAVID AVENUE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) PREUSS #2 B1, L15 Legal description (Township, Range & Section) Lot Size 25,181 Sq. Ft. Number of Bedroomso L( APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) . Absorption Field - _ Q ._— Initial ❑ Single Family SF g y (w/wo ADU) Septic Tank Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: D'a2Ll Permit No. 63Rd :2 / L1 9 2 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc u First Water CONSULTING �,. '✓% VIA Sic1'l:iTER 511PPGRT &PLAI; HING 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com June 1, 2023 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT — DESIGN CHANGE LEGAL: PREUSS #2 BLOCK 1, LOT 15 The attached test hole with seasonal high -groundwater monitoring was recently conducted and a design change order is required due to shallow unanticipated groundwater. Per the attached design we - propose to -excavate_ 3' from original grade, install -_2'_ of MOA - - --- approved sand, install two 50' long pressurized trenches and an anchored 1500 -gallon epoxy steel STEP to serve the existing 3 -bedroom residence plus an assumed 113R additional bedroom per MOA MLS search. All other previously and approved design information has remained the same. The design change will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, r Curtis Huffman, P.E. i�'Wa�� CONI[Tito s_r{VICES -� Yi f.IfA/VNA PIAN NH SIG „' 3li PP07IL ING 0 4BR DESIGN: 4BR X 150 GPD = 600 GPD 600 GPD/1.2 GPD/SF = 500 SF SAS 500 SF / 5'W X 0.5 'ED = 100 FT. TRENCH USE 2 TRENCHES - 50'(L) X 5'(W) X 0.5'(ED) NO SLOPES >25% WITHIN 50' TOTAL MAX DEPTH FROM EXISTING GRADE: -1' OF PROPOSED FIELD. EXCAVATE -3' FROM GRADE & INSTALL 2' OF MOA SAND FOLLOWED BY 0.5' ED WITH FABRIC/COVER. N❑TESI STAKE PROPERTY LINE & WELL RADII PRIOR TO C❑NSTRUCTI❑N 100 LF 1 1/4" PVC WITH 3/16" HOLES @ 3' SPACING (17 TERAL) M 0 0 0 � m M 0 APPROX. SEPTIC AREA Lot 16 10' UTILITY EASEMENTS INSTALL SEPTIC FIELD PARALEL TO SLOPES NRNL W. V / .tee - NRNL TMO 6J OdL %eTr%OlT ED b `o-m_c ,ans _ tTJe, FxrwvATc To -r Rene To aa' m • NRNL Y YM AR'RMD EUD. SEPTIC AREA Lot 3 /NO PRIVATE WELLS WITHIN 100' OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 100' OF PROPOSED WELL EXCEPT AS NOTED. PREUSS #2 BLOCK 1, LOT 15 PREPARED FOR: THORNTON GALLIMORE & ANA GENTRY 20130 DAVID AVENUE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmail.com DAVI �lUE — 0 I9'59'E 134.30' 10'x10' WATER WELL & USE AGREEMENT GRAVEL (BK. 3436, PG. 442) DRNEWAY WELLS NT RL. N uz10 Lt{ PFR 5F1 M vavm • °.p ORCH ew,yµ o�C 40.1 3-4BR c ESIDENCE 22.0 - -—WooDEN `?cy - ---- -- N FENCE VQQl -� 0 22.0CK ' R CK � 8.5 DE 22.0 m ,va ma �nL Rir nFm..s90 tiNn SEPTIC AREA —/-T O MT n swan a ,m STJ SL.=e &int MT b K+> AMWPA KN W PL TT H MTX Lot 15 Lot 1 a 25.181 S.F. ,C 1m FSYT. Lot 4 Lot 5 SEPTIC AREA SEPTIC AREA 4BR RESERVE: REMOVE & REPLACE PROPOSED SEPTIC SYSTEM OR SHOW CAT III RESERVE SITE APPROPRIATE SDW315ER MOA CODE. SUPPORT®SERVICES: rwr. s 411�C DATE: 6/1/23 SURVEY: KGL DRAWN: FWCS SCALE: 1" = 60' PAGE: 1 OF 2 OF At , ® 9TIi *� rus Huffman CE 128991 I� N6/1/2023 e ®-,ftFuSSI010 Ed I DESIGN DETAILS: INSTALL NEW ANCHORED 1500—GAL EPDXY STEEL STEP TANK. MAINTAIN 10'+ FROM FOUNDATION, 100' TO PRIVATE WELLS, 200' TO PUBLIC WELLS, 100' TO SURFACE WATER, 5' TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR INSULATION. INSTALL 4BR SEPTIC WITH TWO 501 X 5'W X 0.5 'ED FIELDS —1'OG PER AMC 15.65, 15.55, & MASS ... TANK BEDDING, SEPARATIONS, MATERIALS,... EXCAVATE —3' & INSTALL 2' MOA SAND PRIOR TO 0.5' ED. "-10'x10' WATEF & USE AGREE GRAVEL (BK. 3436, P( DRIVEWAY WELLS 2.0'x5.1' CANT if 8.8' WELL IN USE VERIFIED & 24.3' 1' ry N SCOPED BYPORCH SULLIVAN 40. 41 3-4BR cD RESIDENCE 22.0 39.3' 0o E0 c 22.8' 1p- I DECK 18.5 22 iSTAKE 100' WELL RADIUS of \8^ DECOMMISSION FIELD T SUMP/MT - 2" STEEL 0 FLAT j T -10'- STAKE FLAT '0 6'+ SEPARATION MINPL- SHED SKID M 0 EXCAVATE TO -3 PRIOR TO 0.5' ED & TH23-1 INSTALL 2' MOA APPROVED SAND. '%, pis 10' UTIL ESMT. s N 89°59'W 134.30 PREUSS #2 BLOCK 1, LOT 15 PREPARED FOR: THORNTON GALLIMORE & ANA GENTRY 20130 DAVID AVENUE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING MT MI S EDS ON WOOD o SKIDS - NO FOUNDATIONS OR PILINGS Lot 15 25,181 S.F. \ 11� WOODEN FENCE O O O 00 F WELL SERVES L14 PER SULLIVAN 00 / UT O DESIGN BASED ON 1975 SUBJECT SOILS & ADJ TEST HOLE DATA. Lot 14 SUPPORTISERVICES: ®®®® ® OF AL�, � C F 5 ®*��qt DATE: 24.3' rtHuffman wx O SURVEY: DRAWN: KGL FWCS rv, CE 128991 �w 6/1/23® 0 OD INSTALL NEW DFCO- 1" = 30' DECOMMISSION 907-350-9566 FirstWaterAK@gmail.com EXISTING SEPTIC SYSTEM ®MI -' & INSTALL NEW 00 ANCHORED 1500 -GAL ®MH �l EPDXY-STEEL STEP TANK O & NEW FIELDS. 1.25" PVC - CO sy s��oo MT f 16 0��° / MT 4BR - INSTALL TWO 50'LX5'WX0.5'ED 'I 0-5� FIELDS - 1'OG. o 0o E0 c 22.8' 1p- I DECK 18.5 22 iSTAKE 100' WELL RADIUS of \8^ DECOMMISSION FIELD T SUMP/MT - 2" STEEL 0 FLAT j T -10'- STAKE FLAT '0 6'+ SEPARATION MINPL- SHED SKID M 0 EXCAVATE TO -3 PRIOR TO 0.5' ED & TH23-1 INSTALL 2' MOA APPROVED SAND. '%, pis 10' UTIL ESMT. s N 89°59'W 134.30 PREUSS #2 BLOCK 1, LOT 15 PREPARED FOR: THORNTON GALLIMORE & ANA GENTRY 20130 DAVID AVENUE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING MT MI S EDS ON WOOD o SKIDS - NO FOUNDATIONS OR PILINGS Lot 15 25,181 S.F. \ 11� WOODEN FENCE O O O 00 F WELL SERVES L14 PER SULLIVAN 00 / UT O DESIGN BASED ON 1975 SUBJECT SOILS & ADJ TEST HOLE DATA. Lot 14 SUPPORTISERVICES: ®®®® ® OF AL�, � C F 5 ®*��qt DATE: 6/1/2023 rtHuffman wx 13030 SUES WAY SURVEY: DRAWN: KGL FWCS rv, CE 128991 �w 6/1/23® 0 ANCHORAGE, AK 99516 SCALE: 1" = 30' ®sstolz�' 907-350-9566 FirstWaterAK@gmail.com PAGE: 2 OF 1 ®®®®� a Fpvrst Water N NG SA ER/xASITEWAT R S UP PO R T F. PL AN N I NG x: 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@szmail.com - SOILS LOG -PERCOLATION TEST LEGAL:— PREUSS #2 B1, L15 DEPTH FEET 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SOILS ORG/OL GM/sm • • Curtis Huffman I��'�``cs,,• • •CE 128991 • ��'�� PERFORMED FOR: GALLIMORE & GENTRY TESTHOLE # 23-1 DATE PERFORMED: 4/26/2023 1 GROUNDWATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 10' DEPTH TO WATER AT MONITORING: 5' DATE: 5/22/23 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION Reading Date Gross Net Time Depth to Time Water Net Drop 5/10/23 10 min 6" 3 12/16" " 6" 313/16" " 6" 311/16" " 6" 310/16" " 6" 3 11/16" " 6" 311/16" PERCOLATION RATE 2.8 (MIN / INCH) TEST RUN BEWTWEEN 2.5 & 3.5 FT PERC HOLE DIAMETER 6" PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE I/ 16TH PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5/23/2023 m rn 0 m Lot 16 10'UTILITY EASEMENTS / DAVID AVENUE S 89.5 'GRAVEL DRIVEWAY D 2 STORY w > u RESIDENCE 001 DECK A DECK 1 4.5'x6.5' SHED \ 22.0 00 �\ SEPTIC PIPES--- O 6.5'x9.5' SHED Y, 8.2'x8.2' SHED Lot 15 25,181 S.F. HOUSE DETAIL Scale: 1 "=20' rn m b ADDITION ON o 5.0' PILINGS 5.0' n ? o i2.1' o 0 0 T — — — — 2�--10'x10' WATER WELL & USE AGREEMENT (BK. 3436, PG. 442) WELLS NOTE: DUE TO SNOW & ICE COVER, SOME SURFACE LEVEL FEATURES ARE APPROXIMATE. Lot 3 Lot 4 Lot 5 I I PLOT PLAN ___ AS BUILT _x_ SCALE _1" =_40__ GRID _ NW 0056__ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone ken®longsurvey.com Professional Land Surveyors jonothanolangsurvey.com � OF travis*langsurvey.com ,r -, I hereby certify that I have surveyed the following described property: LOT 15, BLOCK 1, PREUSS SUBDIVISION — UNIT No. 2 (PLAT No. 70-42) Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the __ 1't__ Day of at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. y KENNETH G. (LANG S,- ' Fc�fF No.202 .QJ1�33A Illi, Rz�tis��. Paoy State of Alaska AECC963 . GREA''m4'R ANCHORAGE AREA BORC`GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME��// C�;uS �/- MAILING ADDRESS PHONE 533'10 LOCATION r_4265 �yC2 QFC' a'/_"PLEGAL DESCRIPTION/4 T /�6 C r /AGG$$ SEPTIC TANK: DISTANCE jl d5 G NUMBER OF FROM WELL MANUFACTURER S9�%Sc% MATERIAL r ��/J ��COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY O� GALLONS. TILE DRAIN FIELD: $yr'VST91/`/� ay 74,,v / ``,,v uyP<-,e404,kNDo TOTAL LENGT�I DISTANCE FROM WELL -FOUNDATION�NEAREST LOT LINE Zo OF LINES /YL�0 NUMBER OF LINES—1 DISTANCE BETWEEN LINES N�/f TRENCH WIDTH?e IN. TOTAL EFFECTIVE ABSORPTION AREA 60 SQ. FT. LENGTH OF EACH LINE ' DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE _6L_ 1MATERIAL BENEATH TILE WELL: 120 7' rN57—,4 /eO !}i %i�c IN. ABOVE TILE IN. TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM 7'X2,',V ff = �O INSTALLED BY: �/ UcPrr/ = 9 SEWER LINE DEPTH: PIPE MATERIAL: OED '�tr` LOT SLOPE: (� REMARKS- 5re / - l S /7� Q6( _ / 2 DATE l6 3 7SAPPROVED ^ Form EQ -032 A W tddd'LLL'AAAIII pApA��99� Q iG �f NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GREA :R ANCHORAGE AREA BOF'*'JGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 •'C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 W, SEWAGE DISPOSAL SYSTEM Q-�,�- APPLICATION AND PERMIT f� CoNSTr INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACIL FINANCED THROUGH _ SOIL TEST RESULTS / I�,MAILING ADDRESS pQJ DRAIN FIELD TO BE INSTALLED BY PERMIT NO. OTHER NOTE1 THIS PERMIT IS NOT VALID WITHOUT SOIL COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK S1ZE J GLD� TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL DRAIN FIEI SEPTIC TANK SEEPAGE PIT DRAT TO NEAREST LOT LINE. WELL TO SEPTIC TANK , SEEPAGE PIT _ DRAIN FIELD 66-1- n ALSO CONSIDE WATER MAIN TO SEPTIC TANK SEEPAGE P DRAIN FIELD SEPTIC TANK, _,J_SL_LL, SEEPAGE PIT �`�`�' DRAI TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRI EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TAI FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALL/ G.A.A. OR L NSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE / v • APPLICANT'S SIGNATURE FORM NO. EO.016 SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM 0 Et E GEOTECHNICAL & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Mis 694.2774 688-2280 Soils & Foundations Land Development SOIL LOG Performed for: Name:(s0 Tel. No. p Mailing Address: Legal Description:r )-45;.-sc-v, Depth (feet) Soil Characteristics 0 2 n� G-�Vf.t_%,�.T.� G� f t , V8 4� ray 9 10 11 12 Ground Water Encountered: Yes No If yes, what depth 7%-5.331 Proposed Installation: Seepage Pit Drain Field Comments: (� sw� �n �c f�,c� Marp4,,� x ��I Performed by:'—,,,,, e.J Date: LOG OF DRV.I NG by A & L DRI LLI % G COMPANY OWNER OP LAND.. ....'........... <... ........... * ........ . ..... ADDRESS .......... ............... .. .......... ....... WELL SITE ........ 61X ...... I ...... �D.r ........... DATE -STARTED DATE -ENDED .... KIND OF FORMATION: DEPTH OF WELL...... ...... STATIC LEVEL OF WATER FT...... .................... . DRAWDOWN FT. ........................................................ GALS. PER HR. ...... ......................... . ................... KIND OF CASING ... ..................................... ,lp FROM ........ ja .......... FT. TO ...... !� ............. FT ....... FROM....:...................FT. TO ........................ FT. FROM...... 3.:...........FT. TO .... is� ......... RO ........................FT. TO.. --•---................FT............................... -/,T ............ FT. TO ..... 1-1 .......... FT ...... Af ..................... FT. TO ........................ FT ............................... OM7FROM. FROM .... 2.1 ............ FT. TO ...... V .......... frROM ........................ FT. TO ........................ FT ........................ ..... FROM ..... <- I ............... FT. TO.52 ............ m--ril .................. FROM ........................ FT. TO ........................ FT ............................... FROM... �........ FT. TO..... ?j ........ FT ......0l....' �!� FROM........................FT. TO ........................FT .... .......................... 77 .1 FROM ......9.4 OF3 , 6 /'v A%` ........................FT. To ........................ FT ............................... FROM........................FT. TO ........................ FT ............................... FROM ........................ FT. TO ........................ FT MISCL. INFORMATION - 4 '04, 1, DRILLER'S NAME ....i." ... . ............................................................... MUNICPAUTY OF ANCHORAGE f lit s�� 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. 050-571-13-000 Legal description PREUSS #2 BLK 1 LT 15 Site address 4250 THUNDERBOLT DR Expiration Date: 4/18/23 Current property owner(s) GALLIMORE THORNTON M & GENTRY ANA MARIA, Q/4W 'jot4t'ul X The On-site system(s) is/are approved for _ bedrooms X Conditional approval for 4 bedrooms, with the following stipulations: Comments or advisories: The septic system is to be upgraded per OSP221492 by June 15th for a non -conditional approval. � �,� IA,nII nn /L /--In1Ir17)r 1� By: Original Certificate Date: 1/18/23 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 X Tank Age Advisory Arsenic Advisory Other COSA ApprovaLJune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 FINAL COSA APPLICATION.doc Certificate of On-Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-571-13 Complete legal description PREUSS #2 BLOCK 1, LOT 15 Location (site address) 20130 DAVID AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) THORNTON GALLIMRE & ANA GENTRY Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: Private Well Private Well serving 2 dwelling units Private Well serving 3+ dwelling units Community Well or Public Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Private Septic Private Septic serving 2 dwelling units Holding Tank Community Septic or Public Sewer 5. SEPTIC TANK: Steel Plastic Concrete Fiberglass Age __0_ - See advisory if steel older than 20 years 6. ABSORPTION FIELD: AWWTS Bed Deep Trench Wide Trench Seepage Pit Waiver request for: Distance: Expedited review requested: 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 $ Waiver Fee $ Date of Payment Date of Payment COSA # Waiver # FINAL COSA CHECKLIST.docx COSA Checklist Legal Description: PREUSS #2 BLOCK 1, LOT 15 Parcel ID: 050-571-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 11/20/1975 Total depth 82.3 ft Cased to 82.3 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/06/22 Static water level at beginning of test 43 ft. Well production at time of test 4+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 13.9 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 12/06/2022 Comments: FLOW OBSERVATIONS INDICATED WELL ON SITE WAS CONNECTED TO RESIDENCE. SULLIVAN VERIFIED SEE SULLIVAN LETTER. WELL CASING SCOPED WITH NO OBSERVATIONS OR ACTIONS REQUIRED FOR HIGH NITRATES , WHICH ARE COMMON IN THE AREA – SEE SULLIVAN LETTER. B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW 1500 STEP Required maintenance completed, if AWWTS Comments: 4” INSULATION PER 2023 IR C. LIFT STATION Required maintenance completed Age of lift station 0 years Lift station material EPOXY STEEL Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NA - NEW ALL standpipes present per record drawing Total measured depth from grade 3.3 ft (max) Measured depth to pipe invert from grade NA ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NA–NEW Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) NA in Effective depth used NA in Effective depth remaining NA in Comments/Deficiencies: FINAL COSA CHECKLIST.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 08/28/2023 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 08/28/23 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. 050-571-13-000 Legal description PREUSS #2 BLK 1 LT 15 Site address 4250 THUNDERBOLT DR Expiration Date: 4/18/23 Current property owner(s) GALLIMORE THORNTON M & GENTRY ANA MARIA, The On-site system(s) is/are approved for bedrooms X Conditional approval for 4 bedrooms, with the following stipulations: Comments or advisories: The septic system is to be upgraded per OSP221492 by June 15th for a non -conditional approval. BY /VOriginal Certificate Date: 1/18/23 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 x Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUHICIPALITY OF Development Services Department On -Site Water & Wastewater Section - Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-571-13 Complete legal description PREUSS #2 BLOCK 1, LOT 15 Location (site address) 20130 DAVID AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) THORNTON GALLIMRE & ANA GENTRY Day phone 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 ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NA PENDING -See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS [:]Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 4 5`76 Date of Payment 12 1.x®1,.029- COSA # 652 of o_ l J :7S Waiver Fee $ Date of Payment Waiver # COSA Applicalion 2022.doc COSA Checklist PENDING INSTALL.docx COSA Checklist Legal Description: PREUSS #2 BLOCK 1, LOT 15 Parcel ID: 050-571-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 11/20/1975 Total depth 82.3 ft Cased to 82.3 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/06/22 Static water level at beginning of test 43 ft. Well production at time of test 4+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 13.9 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 12/06/2022 Comments FLOW OBSERVATIONS INDICATED WELL ON SITE WAS CONNECTED TO RESIDENCE. SULLIVAN VERIFIED – SEE SULLIVAN LETTER. WELL CASING SCOPED WITH NO OBSERVATIONS OR ACTIONS REQUIRED FOR HIGH NITRATES , WHICH ARE COMMON IN THE AREA – SEE SULLIVAN LETTER. B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NA – PENDING NEW INSTALL Required maintenance completed, if AWWTS Comments: S.T. PUMPED FOR TEST (12/6/22) C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NA - PENDING ALL standpipes present per record drawing Total measured depth from grade PENDING NEW ft (max) Measured depth to pipe invert from grade NA ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NA–NEW PENDING Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) NA in Effective depth used NA in Effective depth remaining NA in Comments/Deficiencies: NA – PENDING NEW INSTALL IN 2023 PER MOA PERMITTED DESIGN AND MOA CONDITIONAL COSA REQUIREMENTS. NEW TESTHOLE(S) TO BE PERFORMED PRIOR TO ANY SEPTIC INSTALLATION & MOA CHANGE ORDER & APPROVAL IF NECESSARY. COSA Checklist PENDING INSTALL.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *98 ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MOA Waiver & previous COSA to existing absorption field that is to be decommissioned with septic upgrade. 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 12/28/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 12/28/22 lfitrate Advisory Certificate of On -Site Systems Approval # OSC221575 Subdivision: Preuss #2, Block: 1, Lot: 15 A water sample revealed a nitrate concentration of 13.9 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com December 28, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: CONDITIONAL COSA - CCOSA LEGAL: PREUSS #2 BLOCK 1, LOT 15 Due to unprecedented events contributing to material and labor shortages, we are requesting a Conditional COSA for the above referenced property. The pending permitted 4-bedroom septic system upgrade has been impeded due these conditions and other factors with no known date on when the septic system components or conducive install weather window may be available. The system will be installed once the components become available and the weather conditions are favorable for installation. The system has been working for the occupants and granting of this Conditional COSA (CCOSA) will not impact any of the neighboring properties or pose a public health risk. Attached are three septic upgrade estimates and escrow letter from title for the pending installation. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. 13021 Montego Circle, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com January 11, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: EXISTING WELL NITRATE MITIGATION – PREUSS #2 B1, L15 Per the well log, a letter from a well professional stating his testing and opinion, along with our letter indicating positive drainage away from the well along with our review stating our professional engineering opinion and evaluation – we believe that the referenced well is not in question of contributing to higher nitrate levels, but that the general neighborhood is contributing to the higher nitrate levels and respectfully request issuance of the COSA. Per the well log and well professional scoping, the casing was adequate with no apparent action needed and no perforations noted with the water producing zone at the bottom of this shallow, vacant well. There were discussions about the increasing nitrate levels of this vacant well and general area. The area in general has some increasing nitrates which could be contributed to increased density, lawn fertilizer, roads, drainage improvements, animal waste, …. We recommended periodic nitrate testing in the future of this currently vacant property. This property has been vacant for about 9 months, and it is hoped that nitrate levels may decrease with normal water usage. We are planning to install a new improved septic system on the lot and abandon the current septic absorption field that has an existing waiver. We did review and look at adjacent available MOA files and sites pertaining to and to ascertain possible and visible contamination such as soils, agriculture, animals, septic, etc. We could not see any possible contamination to abate. The well and surrounding wells show confining soils of some silt/clay sands and hard pan with some gravel above the bottom of the wells or water producing zones. The soils appear to adequately protect the well and aquifer from surface or shallow water flow. As does the positive drainage around the wellhead. Our goal has always been to conservatively approach sites and provide the necessary information the first time to avoid having to go back to the client with more required testing and additional costs. Based on this professional review, we request issuance of the COSA for the pending closing. Please contact us if you have any questions. Respectfully, Curtis Huffman, P.E. Date: 12/16/22 P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Brent Western 20130 David Ave Eagle River, AK 99577 Well Camera Inspection Well camera inspection was ordered due to concern of high nitrates. Upon inspection we found the pitless area, at 12 feet, to be slightly damp but not necessarily leaking. This area is the most corroded and decomposed area in the casing that was inspected. There is not enough evidence of surface water contamination in the pitless area to justify any further action. The remainder of the inspection down to 45 feet, where the static water level is, yielded no cracks, holes, or leaks that would otherwise contribute to surface water contamination, leading to increased nitrate levels. Determined that the well closest to the house is well in use. • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Parcel I.D. 050-571-13 n _ Certificate of On -Site Systems Approval !s � 1 � 5 U Expiration Date: { 1. GENERAL INFORMATION Complete legal description Preuss #2, Block 1, Lot 15 Location (site address) 20130 David Avenue Eagle River, AK 99577 Current Property Owner(s) Paul & Sharon Bullock Day phone 694-0114 Mailing address 20130 David Avenue Eagle River, AK 99577 Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 4. TYPE OF WATER SUPPLY: Individual Well TYPE OF WASTEWATER DISPOSAL: individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:We � — � i�(:i.� ✓'1°� � Distance:__ Received by: n �.r.-.�Co C s Date: C'S COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ _r2 4 Waiver Fee $ Date of Payment � Date of Payment Receipt Number d / b Receipt Number COSA# 04G Waiver# OW /S_10{L1 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Phone 522-7773 Date 3/17/2015 41" OF A4 k4o i/ System #1 Approved for bedroomsF , Icr f tkt`IDEUONa �® #4 s: CE -4381a System #2 Approved for _ bedrooms d . ®® 3 . Disapproved 690��RO�FEESS \'® Conditional approval for bedrooms, with the following stipulation. Original Certificate Date: o ` Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only v 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_! - If more than 1 septic system Is on the lot: ` COSA Checklist # _of _ ;Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Preuss #2, Block 1, Lot 15 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 11/20/75 Sanitary seal (Y/N) Y Total depth 82.3 ft. Cased to. 82.3 ft. FROM WELL LOG 11/20175 Date of test Static water level 59 ft• Well production 20 9•P•m• WATER SAMPLE RESULTS: Parcel ID: 050-571-13 Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) >18 in. AT INSPECTION 7/30/14 42.5 ft 2.5 g.p.m. Coliform O colonies/100 mL Nitrate 8.94 mg/L Arsenic ND ug/L " Date of sample: 3/12/15 Collected by: Anderson Engrg. B. SEPTICIHOLDING TANK DATA Tank Type/Matedal Septic/Steel bate Installed 10/13/75 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) N Depression over tank (YIN) N High water alarm (Y/N) N Date of pumping 8/12/14 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA t50SFIBDRM Date installed 10113!75 Soil rating (g.p.d./ftz or ftz/bdrm) System typeDeep Trench. Length 60 ft. _ ,., Width t 2, ft. Gravel below pipe 5 ft. Total depth 9 ft. Eff. absorption area 600 fe Monitoring tube . Y Depression over field N Dateof adequacy test 7/30/14 Results (Pass/Fail) PBSs For 3 bedrooms Fluid depth in absorption field before test 35 in. Water added 450 gal.. New depth 48 in. Elapsed Time: 1,440 min. Final fluid depth 35 in. Absorption rate >= 450 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" evel at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL.ON LOT TO: Septic tank/lift station on lot Absorption field on tot Public sewer main >100' 98'** N/A Sewer /septic service line >25' Animal containment areas >50' On adjacent lots >1 00' On adjacent lots >1 00' Public sewer manhole/cleanout NIA Holding tank N/A Manure/animal excrete storage areas >100' SEPTICIHOLDING TANK ON LOT TO: >5 >& Property line Building foundation >5� Absorption field >100' Water main >10' Water service line >10, Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' Buildin foundation >10' Water main N/A Property Ione g > 10 ' >100' Driveway, storage >10 Water Service line Surface water None Noted Wells on adjacent lots >100' Curtain drain j F. COMMENTS The well is located off the lot. Agreements are in place allowing the location and use of the well in its current location. ** See well to absorption trench waiver. G. ENGINEER'S CERTIFICATION I certify that t 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 Michael E. Anderson, P.E. Date 4/6/15 COSA brown sheet_10.10.12.doc 491fl AEL E. ANDERSON CE -4381 14 -1 r Municipality of Anchorage of Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 141408 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 15 of Preuss #2 subdivision. This inspection revealed a nitrate concentration of 8.94 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. April 6, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 15, Block 1, Preuss Subdivision No. 2 Septic System Absorption Trench to Well Waiver Dear Onsite Services Engineer: The existing septic system absorption trench on Lot 15, Block 1, Preuss Subdivision No. 2 is located 98' from the existing well on the lot. A recent surveyor as built completed during the testing of the septic system revealed the discrepancy. A waiver is therefore required to allow the trench to remain in its current location less than 100' from the well. The septic system was originally constructed in October of 1975 prior to the installation of the well. The trench is 60' in length with only the easterly 10' less than 100' from the well. Underlying soils on the lot are sandy gravel with some silt (GW) based on documentation completed during construction of the septic system. The well and septic system have been tested and certified twice in the past showing the well more than 100' from the absorption trench. The well log indicates a total depth of 83' with a measured static water at 42' surface indicating a head pressure of 41'. The log further indicates a clay and layer from 34' to 78' below the surface to further protect the aquifer. We recommend that the waiver allowing the existing absorption trench to remain the well be granted. Sincerely, Michael E. Anderson, P.E. below the hard pan therefore 98' from Municipality of Anchorage Development Services Division Onsite Water and Wastewater Program Dent S '10 P Wepaitment va **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV151014 COSA#:OSC141408 Permit#: PID#: 050-57143 Legal Description: Preuss #2. Block 1. Lot 15 Engineer: Anderson Engineering Applicant: Paul & Sharon Bullock Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved.. The approved separation distance is 98.0 feet. This waiver approval applies to the existing 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 affectedadjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ 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. ........................................................ ..................... Waiver is Granted: X Waiver is not Granted: Date: Approved by: '.ame of Reviewer .........:.r.....• ................ ....................-R a...............-....... 1 DAVID AVENUE M M S89059'00"E 134.30 %A I !qw\ o Gravel driveway \ ]ante \ 19. ,74.0 deck Goge 40.0 N 0 I 0 o 'co,, 2 Story g Frame House 22.00 .00 j39.3 U') -' 10.1 . off o Lot 16 c~D 19. 24.0 :o a s.om °d 22.7 . . r 72.z deck deck �a O 4 �.-... co roe ' . Septic vent Compost Lot 15 0 z Wood fence (typ) -----------'=fir -- 10' Utility Easement S89°59'00"E 134.30 Lot 3 Lot 4 Notes: 1. The distance from the center of the well to the septic vent is 99.91t. 2. There exists a Water Well & Use Easement Agreement recorded 3-09-99, Book 3436, Page 442. Aw cg.. 49tH •9 01 0000, ,.Fred Walatko. ff/ ", s 3255 — S , • �� EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 15-2, pg49-50 BE 8411Z ° X10' x 10' Water Well & Use Easement Agreement 4Z a� r $ct C3 Lot 14 LO G 00 r C3 0 I_ 50 C3 SCALE: I"= 40' 0 Z Lot 5 AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's Inspection of the following described property: LOT 15. BLOCK 1. PREUSS SUBDIVISION. UNIT No. 2 Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property limes and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property tying adjacent thereto encroach on the premises In question and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated at Anchorage, Alaska this tat day of Agdl .2015. FRED WALATKA & ASSOCIATES (907.248-1858) Engineers and Surveyors Parcel I.D. 050-571-13 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date:_ _/ /- / 8 -/ q- Complete legal description Preuss #2, Block 1, Lot 15 Location (site address) 20130 David Avenue Eagle River, AK 99577 Current Property owner(s) Paul & Sharon Bullock Day phone 694-0114 Mailing address 20130 David Avenue Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water Sstem System r1 LJ Public c_, er f1 r uu l .�cvv ci U WaiverNariance request Received by: � y(`- z a,_� Date: 9 417 - 19 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 a (0 Waiver Fee $ Date of Payment 8 I U Date of Payment Receipt Number C ga/ qC Receipt Number COSA# Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 49� �• 6. DSD SIGNATURE �,�; ,•,� „„;1 �� e.... t00 __L��System #1 Approved for bedroomsd c;Mfctfaa E nNr> sorv: �� M ®®�s� CE -43$1 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: By: al r0hghral Certificate Date: o g V T M Hitt Itq.oi Apl age 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet t c If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Preuss #2, Block 1, Lot 15 A. WELL DATA Well type Private If A. B, or C provide PWSID # Date completed 11/20/75 Sanitary seal (YIN) Y Total depth 82.3 ft. Cased to 82.3 ft. FROM WELL LOG Date of test 11/20/75 Static water level 59 ft. Well production 20 WATER SAMPLE RESULTS: 9.p -m. Coliform 0 colonies/100 mL Nitrate 1.07 mg/L Arsenic ND ug/L Date of sample: 7/30/14 B. SEPTICIHOLDING TANK DATA Parcel ID: 050-571-13 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 7/30/14 42.5 ft, 2.5 Collected by: Anderson Engrg. Tank Type/Material Septic/Steel Date installed 10/13/75 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) N Depression over tank (Y/N) N High water alarm (Y/N) _ Dateofpumping 8/12/14 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA rn Date installed 10/13/75 Soil rating (g.p.d./ft2 or ftZ/bdrm) 150 SF/BDRM System type Deep Trench Length 60 ft. Width 2 ft. Gravel below pipe 5 ft. Total depth 9 ft. Eff. absorption area 600 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/30/14 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 35 in. Water added 450 gal. New depth 48 in. Elapsed Time: 1,440 min. Final fluid depth 35 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed Size in gallons _ "Pump on" level at in. "Pump off' level at Datum Cycles tested _ 1 NIRIA91cL11111 M�P]FIV_1V181*I WELL ON LOT TO: Manhole/Access(Y/N) in. High water alarm level at Meets alarm & circuit requirements? Septic tank/lift station on lot > 100' On adjacent lots > 100' Absorption field on lot >100' On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout NIA Sewer /septic service line 5 Holding tank N/A Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main >10 Water service line >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10, Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' Absorption field >5' Surface water > 100' Water main N/A Driveway, parking/vehicle storage >10,_ F. COMMENTS The well is located off the lot. Agreements are in place allowing the location and use of the well in its current location. E�ailell.t=1=1APSi=1 A IIa10C1111 I rey 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8112/14 COSA brown sheet 10-10-12.doc rr=v - . . & ILHA9. E. ANDERSON • �4, CE -4381 : e` �o •; Iz ; y''```6. �� A MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 050-571-13 HAA # 1. GENERAL INFORMATION Complete legal description Lot 15 Block 1 ; Preuss Subdivision #2 Location (site address or directions) 20130 David Avenue Eagle River, AK Property owner Dorothy Jones Day phone Mailing address C/O REMAX OF EAGLE RIVER 16600 Centerfield Dr Eagle River, Alask Lending agency Day phone Mailing address Agent Audrey Mason/ Remax Eagle River Day phone 694-4200 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well XX 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 XX 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(P v.1/91) Front MOA121 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compli nce with all Municipal and State codes, ordinances, and regulations in effect on the date of tAIA inspection. , / Name of Firm AL.AsKA WATER & wgrEyk Phone 2VE72 Address Engineer's signature Alaska Water & Wastewater Consultants Mr. Shall be PAID $ 375 ss� or prior to, closing for the '?&� Engineering Services Provided. 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Date 0" 0FE=-S�O�`� Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date 3 " 17— T`? CAUTION 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 tending 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-M(PAV M) e.ck k10Am _........._.,.._......_..,_.._ _...._ _ _. .................._.......... _. RECEIVED Municipality of Anchorage MAR 10 1999 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALITY OF ANCHO 825 L Street, Room 502 • Anchorage, Alaska 99501 • ( fffft§FvrcEs ° N Health Authority Approval Checklist Legal Description: Pk Euss S�� 4.-r I5of gi Parcel I.D.: OS O - 571 - 13 A. WELL DATA Well type pokO A?E If A, B, or C, attach ADEC letter. ADEC water system number n1 A Log present (!DN) iPEs Date completed 11 12 O 7 5 Total depth S2' 4 Cased to S Z ' `f 1' Casing height (above ground) !8 If + Sanitary seal (ON) Date of test Static water level Well production FROM WELL LOG 11120175 .5°I ZO Wires properly protected OYN) YEr AT INSPECTION I /11L419 94 g.p.m. 4.6+ g.p.m. o. WATER SAMPLE RESULTS: � Coliform -{f- Nitrate Other bacteria 5 Date of sample: a 9 9 Collected by: /¢ �✓ �C �h�. 3 TANK DATA Date installed 10 Tank size 1000 Number of Compartments Cleanoutseq) Yes Z lA J - Foundation cleanout ('A Ic Depression (Ve 00 High water alarm IVA& NO " Date of Pumping! Ll 1411 Pumper JR 9vM91PJln C. ABSORPTION FIELD DATA Date installed 10 3 7S Soil rating , o /bdrm bS 0 System type � II� r Length Width 2 Gravel thickness below pipe 5 Total depth:Z1 Effective absorption area 600 Monitoring Tube present &M -As; Depression over field MO No Date of adequacy test 7 9`t Results (Pass/Fain PAs S For 3 bedrooms ?Fluid luid depth in absorption field before test (in.); �Immediately after -18 gal. water added (in.): 15,1 depth 'n Qp (ins) Minutes later. 1 D-� Absorption rate = 450-r c.p.d. Peroxide treatment (past 12 months) >VAV Pegg KMCWAJ If yes, give date k 72-026 (Rev. ares)• S � "to 9 S� � S. P oavy Exp -SPS ISB6"o'j INvEA-c— of AQ�aP�PE . D. LIFT STATION Manhole/Access (Y/N) High water alar level "Datum Size in gallons "Pump oft" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: SepticlhelclOg.tank on lot 10014- On adjacent lots 10614. Absorption field on lot 1001+ On adjacent lots 100 r f Public sewer main ?5'+ Public sewer manhole/cleanout ) Do 1+' Sewer /septic service line 25 -f Lift station 1001+ SEPARATION DISTANCES FROM SEPTICA11115MUSTANK ON LOTTO: i 1 Foundation 64 Property line 5 ♦ Absorption field b { Water main/service line 101+ Surface water/drainage loo lt Wells on adjacent lots foo I+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line • 1 of 11- Building foundation 10t+ Water main/service line 101 Surface water I001t Driveway, parking/vehicle storage area 50� Curtain drain 0604r< VA0,-J -' I Wells on adjacent lots 1001 } F. ENGINEER'S tify CERTIFl ;,i I certhat / h e e fie inspections and review of Muniapaljati •• kms are in conforman Ardeli es in effect on this date. ! ► . • /l ••. Engineer's Name Date 3/ HAA Fee $ - vp Waiver Fee $ Date of Payment Date of Payment Receipt Number d ,-� �5`—��3 Receipt Number 72-026 (Rev. W96)• Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Rd Suite 28 — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338.3246 March 8, 1999 Municipality of Anchorage Department of Health & Human Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 15; Block 1; Preuss Subdivision #2 Health Authority Approval submittal We are submitting for a Health Authority Approval on the referenced property. A new asbuilt survey was done by Shane Holt, Land Surveyor on January 18, 1999. It has been determined that the subject well is located off the property and is actually located on Lot 14; Block 1; Preuss Subdivision #2. A water well & use easement agreement is attached. If you require additional information or have questions, please contact us at 337-6179. P.E., M.S. From t hoB To: JEFF GARNESS Date: 111 V99 Time: 2.05 06 PM -- — -— -—-—- -- QAVIQaxME�—-— -— - —- —-- N D-.. 11 IT Pepe 2 of 2 N 69059'W. 134.30 Ar-BULT CUrZVEY THE NFORVATION HEREON IS FOR THE USE OF LENDM INSTITUTIONS SPECIFICALLY TO SHOW EAISTINO STRUCTURES AND PLATTED LOT LINES OR EA.•,ELIEN-5 AND IS NOT TO BE LC.ED FOR 1 STAUI( PES OR FENCELINES. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT.ARE NOT SHOWN HEREON. NOTE: ANY FENCELNES SHCNMARE LOCATED APPRCXWATELY AVD ARE NOT TO BE USED TO DETERNNE PRCF•ERTY OR LOCATE STRUCTURES. 1 S. BLOCK 1, PREJSS SUS. UNI- 2 J STRICT, ALASKA AND THAT iTED TMaAV ARE WITH RJ THE VIS.BLE=NC:OACMMEN'3 eX13T ED AT A'J Ce4x:.CE ALAS✓A'Hb 18TH OF ANVARY 13S3i �— 6ANjo SUR,/EVrZ- •31TF3'T9•ei 3-4e-ee13 6Pc 2 . 4 G WATER WELL & USE EASEMENT AGREEMENT THIS EASEMENT GRANT is made between Peter J. Panarese and Susan F. Panarese (hereafter collectively "Grantors") and Dorothy M. Jones (hereafter "Granted'). The following recitals of fact are a material part of this instrument: A. The Grantors are the owners of a lot described as follows: Lot 14, Block 1, Preuss Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska (hereafter "Lot 14"). B. The Grantee is the owner of a lot described as follows: Lot 15, Block 1,Preuss Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska (hereafter "Lot IS"). C. The Grantors wish to grant and the Grantee wishes to receive an casement on Lot 14 for the use and maintenance of the water well located on Lot 14 (hereafter "Water Well Easement"). The Water Well Easement is described as follows: Beginning at the northwesterly corner of Lot 14, thence cast 10 feet along the north boundary of Lot 14, thence south 10 feet and parallel to west boundary of Lot 14, thence west 10 feet and parallel to the north boundary of Lot 14, thence north 10 feet along the west boundary of Lot 14 to the point of beginning. NOW, THEREFORE, in consideration of Ten Dollars ($10.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the following grants, agreements, covenants and restrictions are made: palmiselwatereas.0291ft 1 nrPGM 1. Recitals. Each and every one of the foregoing recitals are made a part of this Agreement and incorporated by referenced as if more fully set forth. This Agreement shall be construed in light thereof. 2. Grant of Easement. The Grantors hereby grant to the Grantee, her successors and assigns, an easement over and across the northwest comer of Lot 14 as described above and known as the Water Well Easement. 3. Purpose. Tbc purpose of the Water Well Easement is to create an easement for the continual use of a water well and connecting lines located on Lot 14 by the Grantee and the subsequent owners of Lot 15. 4. Maintenance. The Grantee and the subsequent owners of Lot 15 shall repair and maintain in a reasonable manner the water well and connecting line within the Water Well Easement. The cost of the repairs and maintenance of the water well and connecting line shall be paid by the Grantee and the subsequent owners of Lot 15. 5. Conditions. The Grantee and the subsequent owners of Lot 15 shall have the right to take reasonable quantities of water from the water well, shall follow all applicable state, federal and municipal laws and regulations, and shall take all steps necessary to insure that no liens or encumbrances of any kind arise against Lot 14 from their use of the water well and connecting line. The Grantee and subsequent owners of Lot 15 shall indemnify and hold harmless Grantors and subsequent owners of Lot 14 against any and all claims. losses, expenses, costs, obligations, and liabilities incurred by reason of the breach of or failure to perform any their commitments in this agreement. 6. Running ofBenefits and Burdens. All provisions of this instrument, including benefits and burdens, run with the land and are binding upon and inure to the heirs, assigns, successors, and personal representatives of the parties hereto. 7. Duration. This Water Well Easement shall terminate only at such time as a public utility supplies water to Lot 15. 8. Construction. The rule of strict construction does not apply to this grant. This grant shall be given a reasonable construction to implement the intentions of the parties to confer a right of enjoyment to the continual use of the water well and connecting lines. palmisdwatereas.029/dk • - 1�K��6Pc444' DATED this 27TH day of FrngrIARV .1999. GRANTORS: GRANTEE: PTT -ER J. RANAAESE DOROTHY M. , ONES 9f, :;� VASea-j ".0— SUSAN F. PANARESE STATE OF ALASKA ) ) SS. THIRD JUDICIAL DISTRICT ) - THIS IS TO CERTIFY that on thio day o" me appeared PETER J. PANARESE and SUSAN F. PANARESE, to known to me to be the individuals named in and who execute the fol ltd acknowledged voluntarily signing and sealing the s 1 ;, t -•- ' : _ Rotatf Public d My Commis on xp u l�:• ST�"T'EtF'ALASKA ) SS. THIRD JUDICIAL DISTRICT ' THIS IS TO t:' OTIFY that on thi I � day of me appeared DOROTH•Y.M. JONES; to me known and I:klmyn V me named in and who executed the'foregoing instrumeri ackn wled `signing and sealing the same. " r•. 1999, before wn and instrument, for Alaska ares: 8 -i0 bbd 1999, before e individual Notary Puiali n and for Alaska 11113�� My Commis on Expires: %A a 3 iC palmisawitereas•929M. 0626�< 1999 MR -9 AM 9: 33 ANCHORAGE RED ESTER Y RECORDING DISTRICTA �� Dryi4l� y Untied States of America} State of Alaska THIS IS TO CERTIFY that the foregoing is a full. true and correct copy of the documerN as it appears in the records and hies of my office. IN THE WITNESS WHERLOF. 1 have hereunto set my hand and have affixed affixed my official seal at ANCHORAGE. Alaska. n� This, `1"� ��y"Yrp�19.9 sy, Rmorder N f MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 1. GENERAL INFORMATION (a) Legal Description (include lot, block, Location (address or directions) //8/-- /zy 1 Application Date November 24, 1986 section, township, range) T14N R1W Sec. 8 Rag] a River (b) Applicant Name Audrey Mason Telephone: Home 694-9568 Business 694-4200 Applicant Address —P.O. Box 772849 Eagle River, Alaska 99577 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder) ;Buyer O ;Other O (explain); (d) Lending Institution G.M.A.C. Telephone 276-3949 Address 307 E. Northern Lights Suite 201 Anchorage, Ak 99503 (e) Real Estate Company and Agent N i x Address N/A Telephone ,NSA (f) Mail the HAA to the following address: in ek"D by engineer i it 2. TYPE OF RESIDENCE Single -Family ® Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public ❑ Community O Holding Tank O Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025111/84) 5. ENGINEERING FIRM PROVIDINU INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION Q 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 shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm EAGLE RIVER EKf:IN=ERIP!n, SERVICF_S Telephone Address EAGLE RIVER, AK 99577 Date y1/r I.;-.eG94-8145 DHEP APPROVAo It L' //, Approved for ' ' '• ` bedrooms by 14; ate Approved X `' 'Disapproved Conditional Terms of Conditional Approval W W CAUTION so 000loi Louis A. Mora •• CE -6736 o a Imp The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11184) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Lor IT ,64-1k_7 J%u f,E/ SNQp, T /-1 N R 1 4./ Sem, 8 A. WELL DATA Well Classification l%%�• ><c If A, B, C, D.E.C. Approved (Y/N) N/A Well Log Present (YIN) y Date Completed l ll20 l 7-F Yield �'S4^ Tcj e,� t ��zt/y 6 Total Depth 83 Cased to k43 Depth of Grouting t'A Static Water Level B. t'. t•g Pump Set At 6')Cy"'' Casing Height Above Ground ) y ' "`ti °° Sanitary Seal on Casing (YIN) Y Electrical Wiring in Conduit (YIN) Y Depression Around Wellhead (YIN) N Separation Distances from Well: To Septic/Holding Tank on Lot /2S *,{ ; On Adjoining Lots boa f To Nearest Edge of Absorption Field on Lot �`/L �—` ; On Adjoining Lots /0p To Nearest Public Sewer Line Z�IA To Nearest Public Sewer Cleanout/Manhole '`'14 To Nearest Sewer Service Line on Lot Water Sample Collected by L^O ; .� r ; Date Water Sample Test Results S.4;1RJK I Comments B. SEPTIC/HOLDING TANK DATA Date Installed % 7T Size 1,960 No. of Compartments Standpipes (YIN) Y Air -tight Caps (YIN) % Foundation Cleanout (YIN) N Depression over Tank (YIN) X1 Date Last Pumped 12-2-86 Pumping/Maintenance Contract on File (YIN) Nv1A ;for Holding Tank High -Water Alarm (YIN) Temporary Holding Tank Permit (YIN) Separation Distances from Septic/Holding Tank: To Water -Supply Well /1 d- "-' To Building Foundation j0 To Property Line �� + To Disposal Field u"kA'� n To Water Main/Service Line /O ~ To Stream, Pond, Lake, or Major Drainage Course N=.'r- Comments MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & pWIRONMENUL PROTECTION Page 1 of 2 r 2 ri C v G ow RECEIVED 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �`�O Type of System Design TRE.�c if Date Installed % 7T Length of Field 60 u i Width of Field 2 `/ Depth of Field 9 Gravel Bed Thickness Square Feet of Absorption Area Dov Standpipes Present (Y/N) Depression over Field (Y/N) 00 Date of Last Adequacy Test Results of Last Adequacy Test S. �', t' 7�vr 3 Q erc. °`s e4Gx, Separation Distance from Absorption Field: To Water -Supply Well 7y2 To Property Line o + To Building Foundation �° + To Existing or Abandoned System on Lot ".1A ; On Adjoining Lots 11-30 . NIA To Water Main/Service Line )°+ To Cutbank (if present) IA To Stream/Pond/Lake/or Major Drainage Course NZA To Driveway, Parking Area, or Vehicle Storage Area /0' Comments i D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at •° Check Permitted Bedroom Rating Against HAA Request •• Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that IIhhave checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. ST 2 6S Receipt No. Z ooh !9 D6 S Date of Payment Amount: $ 4� O?J c/. EngtneeEaSeai S � c. �.� : Eagle River Engineering Services Y` •e".c,71t P. 0. Box 773294 ! •�a> ia.a..w...S.-� Eagle 69v44.5 99577 � 9� ......... .w .. Page 2 of 2 , lois A. Cutcra 72-028 (11/84( �( J ••, CE -6736 t a � s• ��F .p.•'. o s •»,o°°° Felty ...,,�...F.. .--+r."..... »......-iv.»..vwr...err,.......:+.+...,w..+-.....r.-... ......-.-....+r +y�.......N. ..ru-.1.x-n.,..�....•vn�r+.......wr..•.•.•--+.. .-.�. ... •.. ........ .0 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 /pL t o p. Y,i? 1,G Date Received February 13, 1976 Time of Inspection I[):{)O Ar�-\ Date of Inspectiioon� % L. 214- r)t,, REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Conv. Alaska Mutual Savings Bank Mailing Address: Post Office Box 1120, 2. Property Owner: Ralph Hettinga 99510 Mailing Address: Star Route Box 5205, Eagle River Phone: 274-3561 x 235 Phone: 4+a--9- .g.7 Loq'A - %Ll� 3. Legal Description: Lot 15 Block 1 Preuss Subdivision 4. Location: NHN David Street 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type '0 f. i/i< U C. Construction S T rtt').) 9� u• B. Depth C� / D. Bacterial Analysis 54 i%SFegogy 7. Sewage Disposal System:On-site system. A. Installed 1611317 s B. Installer rU.OU — C. Septic Tank: 1. Size 4600 2. Manufacturer S D. Seepage Pit: 1. Absorption Area /,,Dn p� 2. Material !�'riv�L��it�'.1✓c/ i E. Disposal Field: Total length of lines Zo 'i 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area 3� C. Abs4tion area to nearest lot line 2 d EQ -034 (1/74) Page 1 of two pages .. r MI it .'\.• .n!^`i.✓^.RI�•r ury.r�Y r.w �-r rv1 �n•.w .. a.. H.. r .. •t `l: 1 i M•'T'� • e .. r r r • r •.. � 1 � •� an. Y .• rr�.. .. .. .. •. Page 2 pf two pages - Re(;'st for Approval of Individual FO"Ier & Water Facilities -Legal Description Lot 15 Block 1 Preuss Subdivision Comments Approved I� Disapproved Date 3/z/x , Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating sgistac_torik,-" SIGNED EQ -034 tI/Iw) Date 05-1,76 i ,�� .. - 4 r'', / � e. d MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274.4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV XXX 2. Property Owner: Rnlnh 1lettinZa Mailing Address: _SR 5205 Eagle River, Ak Day Phone # 333-9707 3. Name of Buyer: Robert and Dorothv Jones Mailing Address: _c/o 800 A. St. Anchorage, Al-. 9950JDay Phone 265-5401 4. Name of Lending Institution: _Alaska Mutual Savings Banlc Mailing Address: P.O. Box 1120 Anchorage, Ak 9W-61he 274-3561 X235 5. Name of Realtor or Agent: Mailing Address: Phone 6. Legal Description: L 15 B 1 Pruess S/D Location: THIN David St. Eagle River, Ak 99577 7. Type of Facility to be inspected: Single Farnily Home No. Bdrms. Three 8. Water Supply Type of Supply: Public Utility Individual Xx` If Individual, number of dwellings presently served One If Individual, depth of well Unknown 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) RRX If Individual, date of installation Unknown (1975) EQ -037 (1/74) j?y SY 3 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Conv. 1. Approval requested by: Alaska 2Sutual Savings Bank Mailing Address: Post Office Box 1120, 99510 Phone: 274-3561 x 235 2. Property Owner: Ralph Hettinga Phone: =='i'7-" L0q'j-�`�'�� Mailing Address: Star Route Box 5205, Eagle River 3. Legal Description: Lot 15 Block 1 Preuss Subdivision 4. Location: NHN David Street 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type B. Depth C. Construction S Totv,.> 14 U, D. Bacterial Analysis 5f} i/S FlIe7o4 y . 7. Sewage Disposal System: On-site system. A. Installed /6.//,3/7 5 • B. Installer /3tLAV - u NDe.A' 6-t40V&._- C. Septic Tank: 1. Size -DOG 2. Manufacturer S 1 A-? — 1 714 sT� D. Seepage Pit: 1. Absorption Area Zn D p'e 2. Material %, <z�f%G' - n�✓c/ E. Disposal Field: +x 8. Distances: Total length of lines 0 6 A. Well to: Septic tank Absorption area , Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area 3U� C. Absorption area to nearest lot line Z b "0" Date Received February 13, 1976 Ll Time of Inspection If-1M Date of Inspection ` 1 ,�� - I REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Alaska 2Sutual Savings Bank Mailing Address: Post Office Box 1120, 99510 Phone: 274-3561 x 235 2. Property Owner: Ralph Hettinga Phone: =='i'7-" L0q'j-�`�'�� Mailing Address: Star Route Box 5205, Eagle River 3. Legal Description: Lot 15 Block 1 Preuss Subdivision 4. Location: NHN David Street 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: Individual A. Type B. Depth C. Construction S Totv,.> 14 U, D. Bacterial Analysis 5f} i/S FlIe7o4 y . 7. Sewage Disposal System: On-site system. A. Installed /6.//,3/7 5 • B. Installer /3tLAV - u NDe.A' 6-t40V&._- C. Septic Tank: 1. Size -DOG 2. Manufacturer S 1 A-? — 1 714 sT� D. Seepage Pit: 1. Absorption Area Zn D p'e 2. Material %, <z�f%G' - n�✓c/ E. Disposal Field: +x 8. Distances: Total length of lines 0 6 A. Well to: Septic tank Absorption area , Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank Absorption area 3U� C. Absorption area to nearest lot line Z b "0"