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Home My WebLink AboutGLENN VIEW ESTATES LT 3Glenn View Estates Lot 3 #051-521-40 Municipality of Anchorage Page —/--of DEPARTMENT OF HEALTH AND HUMAN SE=RVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box '196650 • Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: &23G,% PID Number: —�— Name / �Y�,7il Wastewater System: ❑ New ❑ Upgrade Address: J �C _, jrj ABSORPTION FIELD Phone: / / -- No, of Bedrooms: ❑ Deep Trench X Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating Total Depth s/' from original rade: , GPD/Sq. . FL .1,e Lot: 3 Block: Su ivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe — Township: Range: Section: Fill added above original grade: Gravel length: JJ A Fl. c..)� Ft. WELL:New ❑ Upgrade Gravel width: / Number of lines: Distance between lines: 1 Ft. 1414 Ft. Classification nvate, q, B, C): Total Depth: Cased To: Total absorption area 7:� Pipe material: /%"5�1j� ,.,- t_� c'la` Ft. .iZ Ft. �11�_�_r_ SO. Ft. A",•yD Driller: I Date grill d: ( Static Water Level: /,7 J Ft. Installer: -, Date installed: Yield: Pump Set at: Casing Height Above Ground: `Z TANK 1120GPM G,L /J Ft. Ft. SEPARATION DISTANCES _ I Septic ❑Holding ❑S.T.E.P. — To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Man facture : -1 - Capacity in gallons: Well- / i Material: — / Number of Compartments: Surfac water �� /�� a r� m LIFT STATION Lot / Ih Manufacturer: Line �- /� Foundation / ' LSizeinllons: " level at: "Pf" level at: High water alarm at: curtain '/ i del Electrical Inspections performed by: Drain /YGl7Y / i Remarks: BENCH MARK — Location and Description:: ,s i Assumed Elevation: EN��QRL� ea •'`:'ids.• Inspections performed by: 1CWi S P11'4a ./ Dates: 1st go s.e •a. eu°..�® 2nd . Duff x f/ ren o Kenneth MCE 711 Department of Health and Human Services approval RA epW�gFo�.a�'.op.9�� Reviewed and approved by: � Date: 73"qg 72-013 (Rev. 9/91) MOA 25 AS—BUILT SYSTEM DETAILS/SITE PLAN Permit SW970362 GLENN VIEW S/D LET 3 PID#051-521-26 OTH #9 OT" /BDRM FD O T H 11R)ES WELL 0 -WE SWING TIES FIELD BOOKS 89.30 A -C=77.9' DRAWN: w STAKING: LANG CHECKED: B -C=83.7' ASHUILT: LANG DATE: 4/7/9 DWG FILE A -D=85.5' NW1360 o '0e No.: 97079 B -D=91.7' A -E=98.2' B -E=117,2' A o125o GA SEPTIC / TANK A-F=ll2.0' B-F=108.0' 84,16 #98-1 O PRI C ❑EE IT C 4 BDRM SFD 0 L11T 3 RY SYSTEM ❑ F OTH #97-2 OT 7-1 P/,),ISLD RESERVE 0 ww � UU U 86,64 FINISHED GRADE FILTER FABRIC\ 11 70.5' PREPARED FOR: REX TURNER ARCTIC DEVCO, INC. P.O. BOX 3489 PALMER, ALASKA 99645 FIELD BOOKS COMPUTED: DOUNDAR Y: LANG DRAWN: KfJID STAKING: LANG CHECKED: KMD ASHUILT: LANG DATE: 4/7/9 DWG FILE GRID NW1360 ACAD FILE: 97079.DWG '0e No.: 97079 INSULATION C SEWER ROCK C SCALE NTS SEPTIC K�� D LCJT VARIES 1 0.51T 2.15• 1 67.13' BON lkLA\l J19 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907696-6111/FAX (907)696-8111 w p��N 6 &oft ••o••N�r •••••'•NV n , Municipality of Anchorage ••� I . .� �; 497.x! DEPARTMENT OF HEALTH & HUMAN SERVICES �" ' •"'•••• '•••^ •• 825 "L" Street, Anchorage, Alaska 99502-0650 i ir.r••� ,,;, ,�•;, SOILS LOG — PERCOLATION TEST m ; Kenneth M. Duf J tt CE,7116 PERFORMED FOR QQ\'°kOFESS1�NPa► _DATE PERFORMED: LEGAL DESCRIPTION:—-F-G,�%j �G({f l fj Township, Range, SeCllOn. -0 -EP-T-H SLOPE SI FE PLAN f--� _ (FEET) I 1 �� j r-1 2 3j- 4 / 7 s 1 I -5ome Se�naf 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER , �_ ENCOUNTERED? A IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: S L O P E Reading Date Gross Time Net Time Depth to Water Net Drop 6 -I iv ; /0 7 s 1 I -5ome Se�naf 10 11 12 13 14 15 16 17 18 19 WAS GROUND WATER , �_ ENCOUNTERED? A IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Date: S L O P E Reading Date Gross Time Net Time Depth to Water Net Drop iv ; /0 Z /d;ZD /Orn 31�z" —5 TZ " 3 _ 7 _ / L13 -- - ZIQ 20 { uPERCOLATION HATE �' � (minutes/Inch) P RC HOLE DIAME TER TESTI RUN BETWEEN __ __. FT AND /FT COMMENTS—.��.5C1_.S/.S/_...�(-l�.CE_I/1Q-- PERFORMED BY. 1JKii ��J� ��,frll I -/iPnyu1�S CERTIFY THAII THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNRi AL GUIDELINES IN EFFECT ON THIS DATE DATE. 72.008 (Rm. 4185) U�u JUN 19 '98 1U:13AM NTL ANCHORAGE P. 1/1 KND Engineering 20441 Ptarmigan Blvd, NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 450.3116 • PAX 456-3135 6005 $CROON $TMEET ANCHORAGE, ALASKA 99518 (907) 349-1000 • FAX 349-1016 POUCH 340043 PRUDHOE BAY, ALASKA 99784 (907) 659-2145 - FAX 689-2146 DRINKING WATER ANALY618 REPORT FOR TOTAL COLIFORM BACTERIA Eagle River, AK 09577.3735 Phone Number: ( )606.6111 Fax Number: ( )698-8111 Collected by: KAY Sample Type: Routine Method of Analysis: Membrane Filtration (SM 9222 B) Date Received: 6/16/98 Date Analyzed: 6/17/06 Date Reported: 6/19/98 Next Sample Due: Comments Time Received: 16:25 Time Analyzed: 16:00 Time Reported: 10:41 S = Satisfactory U m Unsatisfactory POS = Positive Test Result ND = None Detected TNTC = Too Numerous To Count (>200 Colonies) CG = Confluent Growth HSM = Heavy Sediment Masking, Results May Not Be Reliable $A = Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Old = Sample Age >48 Hours, Too Old For Analysis Comments: R = Resample Required NT = No Test _ * # Colonies/100 ml # Colonies/ml Sample Sample Total* Fecal Other* HPC** Date Time Coliform Coliform Bacteria Result Labf# Location_ Comments 6/16/98 12:00 0 ND 0 NT ACS827 GLENVIEW LOT0 Satisfactory Sherri L. Trask Environmental Analyel 6110/95 Northern Testing Laboratories, Inc Anchorage, AK NO THIRN TESTING LABORATORILS, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 F -A 8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 • FAX 349-1016 POUCH 340043 PRUDHOE BAY, ALASKA 99734 (907) 659-2145 • FAX 659-2146 KND Engineering Report Date: 6/18/98 20441 Ptarmigan Blvd. Date Arrived: 6/16/98 Eagle River, AK 99577-3736 Sample Date: 6/16/98 Sample Time: 12:00 Attn: Collected By: Client ID: Glenview Lot 3 ** Legend ** Client Project #: MRL = Method Report Level Source: MCL = Max. Contaminant Level NTL Lab#: A155818 B = Present In Method Blank L' = Lstimated Value Sample Matrix: Nater M hlmrix Interference Comments:D it = Above MCL = Lost To Dilution Date Date LMchod Parameter — Units Result MRL Prepared Analyzed J SM 4500 NO3 E Nitrate -N nlg/L 2.12 0.50 6/17/98 Chemistry Supervisor IURNIR!TUIV�I:"�� r�Xy7V7Jr0J93JJ�'��"I I I I I I I I I I I 1' I V B TT1"158! 1111114IJ2211111111 :'OJ � �II I I I I I III I I I I I I I I I IH KO III . LJ �O •1.4 LL w o CD" - CU Ud R f- �' 0 X Dby �a SUL,L,I EVAN ATER' L Ia LLJ p.o. Box e70212; aNuoiAk; kARA i96A7 i TELE00611,1E ado! -069 a OMEk LAND f JA464 C _ ld ( BOhEHOLE DATA 0 ADDRESS LEGAL DESCRIPTION Aor _3 C4.C'4J J1ru1 PERMIT NUMBER03!7 Date of Isaue 0 is Well fdcated of approved permit location? es d No Method of Drilling:alr rotary C] cable tool Depth of well: %I_ Casing Type SrIFEt. Wall Thickness a1YOU inches Diameter ,_,inches, depth___LRA J feet Liner Type: kj Casing Slickup Above Ground: 0� feet Static Water Level (from ground level): — _ feet Pumping level: feet after hre. pumping gpm Recover Rate:._dtq _gpm Method of Testing: A I /Z Well Intake Opening Type: gjdpen End 17J Open Hole Q Screened; Start feet Stopped feet CJ, Perforations Start .. feet Stopped feet Grout Type: volume Depth: from 0 feet, to feet Pump Intake Depth: Pump Size - _,hp Brand Name Well Disinfected Upon Completion? hes 0 No Method of Disinfection: Comments: (141 1, P'l r. rc.rc JP ^� ®cJr^,°C rti.)efBr r sir, i `� 6rQ.la car?C� ; i J' -- pe 159 Y 1 Y 6Xt4jIXL (_JR Driller's Name ATTENTION: It Is the responsibility of the property owner to submit a copy of the well log fo the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conadrvation, Matsu Borough: Department of Environmental Conservation, iuA (_opq MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970362 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:ARCTIC DEVCO INC OWNER ADDRESS:P.O. BOX 3489 PALMER, AK 99645 PARCEL ID:05152126 LEGAL DESCRIPTION: T15N R1W SEC 10 SW COR NW4 LOT SIZE: 40238 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 2- PAGE 1 OF 1 ' DATE ISSUED:10/13/97 EXPIRATION DATE:10/13/98 c c� JI_p A 1 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: �. �u _ DATE: ISSUED BY: �� DATE: KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11/FAX (907)696-8111 September 30, 1997 Municipality of Anchorage Dept. of Health & Human Services On -Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Glenn View S/D, Lot 3 Gentlemen: On September 17, 1997, we excavated two new testholes for the subject property. There is one previous testhole which was dug during the preliminary plat process, however it was not suitably located for the four bedroom house which is proposed for this lot. The results of these tests and water monitoring are attached. We propose to install a 5' wide shallow trench. Although the testholes indicated no water, we have found some water in adjacent testholes in low areas. This combined with the area soils indicates the need for a shallow trench system. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. There are no public or private wells within 200' of our proposed system location except as noted. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111 /FAX 696-8111. Respectfully submitted, LK:FTU Engineering Kenneth M. Duffus, P. . MUNICIPALITY OF ANLHORAOU ENVIRONMENTAL SERVICES DIVISION attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test OCT 01 1997 RECEIVED WAS I I W I I R S Y S T I M BF-rn1 S/SI I C Pl nN I- 11 -13, hl -_ NN viLW LS 10 1 F -S, Si n i " L I TOS � 1 Ill J j(JIII lt9/-P ,� PPIIPHS1 1) RI -SE VE °i O N M1 — 1RLPIISLI) RISIRVE 111 119/- OI PRUI OSEO PRIMARY SYSIFMI,{1 III fl !-:' VACAN I _ LN 0 -, call FC A Il RM Ip GAL S.I. _ - 0 TII 119/-1 ti 0111 IIJR -S IP 141 _ 1 OSE9 PRIMARY \YS TI M CES - V cn Sl Pl lc IPM _9 WIII 1 u 'ROPE -ED W[ S j(I I_ N lilt I C C L = — PRMPNSE9 WLLI_ _ Z _ 5 . PRI I'I1S1. 1) 1.'1.1 \ \ 5(Opf TN!P s �VACAN r 1 y .EPl1G VACA i 1 SEPTIC � I a _-- r j LIJT 1�I iJll 1'1191 IC S/1 --LLS WITHIN PUO' 111- / I'RIII'NSI9 SYSTEM. I ❑T 1/0 Nil PRIVAll WII LS WIININ LOU, OI / I'ILIIPnSI U SYSIEtA EXCEPT AS NMI U. NIISIPiIC SYSTEMS WITHIN Poo' [II- II'RIIPIISI. I) WE[ E EXCEPI AS NOTES. M SIGN DI_ i 011_S i BDRM X IJO GPD = 600 11PI) 600 GPULP GPD PER SQ. ( I. -- `_)OU SQ, I 1 X (0.7' RE) W 0' GRIM 1) -_ /0 -1 . 1 RLNCH I o Lal depth of ;y ;tern 1 4.0' from original grade. I otal depth of gravel op(ovr di, lrlk)u Lion pipe I; P.0' Nil TES 1. USE IP_)O GAI_I_LIN Sf_PIIC TANK. INSLI AIE TANK 11 (1' CIIVI_R. P. INSULAII 1RENCHFS WJ111 i3' 1111 MflJ Al 1-110M 3. CON 1 RAC FUR WII I I NSIIR1 MOXIMUM PZ SLUPL IN I I I SF P 1 IC 1 FINK. 4. MAJ11IONAL PILL WII I 131 AIl1JLD 1 V R SYS II_M TO ACHII-VE MIN. 3' COVLR 11 RE(Jl11RCD, I(P_;NNL;'I'll IW DU'� ' CE ills w� PRI PARED I LIR. KND ENGINI_LRING S R1 X TURNER O l I' I ARMIGAN 131_ V 13 X19 DEVCU, INC. I Nil I RIVER, AK, `79, /'RoFCSSIM43'' AV P.O. MIX 31189 C907X>96-6111/Eax (90/)f>96-8111 '%®W)LMER, ALASKA 996/15 nn vclv9/ - - i — � � URhb. TNG It SCALb -100' 970/9 SI �.r Municipality of Anchorage Sys°0 oeaovpppeo Ope�e°a° vpp 'T DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650°" '•° ®m Kenne:n hi. D s ; SOILS LOG —PERCOLATION TEST ®®°p, CE 7110 • v° pp �ROFESSIO' � PERFORMED FOR:��L�ei%7 �O%�J`�y'//' LG/L %"/ DATE PERFORMED: LEGAL DESCRIPTION: VheLOCf'!" L�j7 Township, Range, SeCllOn:r�� DEPTH SLOPE SITE PLAN (FEET) �.�•�„ _t I Ci 1 1G1'� 2 r� . Z" N 3 Ca V, clea1I7 / 4 5 6 7 8 9 10 11 12 Sorrt 5�/ mo i s k-/ btarde✓ 13 Linde f n1 14 15 E 17 Y LVe� 0.-'i 18 20 COMMENTS WAS GROUND WATER Date Gross Time ENCOUNTERED? — S IF YES, AT WHAT L I DEPTH? -AO P E Depth to Water After Monitoring? Dq_ Date: �7 Reading Date Gross Time Net Time Depth to Water Net Drop 8 :z may„ �r PERCOLATION RATE ._.J•_/1,1Z(minutes/inch) PERC HOLE DIAMETER TEST RUN BETW�EN �' S FT AND _eLa FT PERFORMED BY: -� �i1 CERTIFY THAT TH S TEST WAS PERFORMED IN ACCORDANCE WITH ALL ST E AND 106,1 AL GUIDELINES IN EFFECT ON THIS DATE. DATE: d 72-008 (Rev. 4/85) Municipality of Anchorage A' X49m SO • 8.. oy Yoa .. ..• • . T DEPARTMENT OF HEALTH & HUMAN SERVICES io 825 "L" Street, Anchorage, Alaska 99502-0650 Kennc n ;al. : s'• SOILS LOG — PERCOLATION TEST d� •., CE 7116 •: 0 'F'•. amu, ,''�1 p OFE SNPS,,�, 4 PERFORMED FOR: % //le./, �(//"J`J7/' 6(.{'(O/'f DATE PERFORMED: / l` LEGAL DESCRIPTION:�If�L�i Township, Range, Section: DEPTH SLOPE SITE PLAN (FEET) 1 2 GP 3 4 6 s �,� h fE r /�/�o75 9 E 11 12 13 14 15 1 I / 16G��/J/ W/e f �-, LL7— "1h 17 4 18 3.0. R, oe cvc,J c r 19-- 20-- COMMENTS 9- 20COMMENTS E_ �'2C1 WAS GROUND WATER ENCOUNTERED? S /' L IF YES, AT WHAT O DEPTH? 'AF/�L-�-- P E Deplh to Water After Monitoring? 32✓� Oale: J X717 g PERCOLATION RATE ✓• (minutesnn`c1h) PERC HOLE DIAMETER TEST RUN RETW€EN 3, FT AND 7 • J FT PERFORMED BY: CERTIFY THAT THS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ST E AND M I AL GUIDELINES IN EFFECT ON THIS DATE. DATE: d 72-008 (Rev. 4/85) i r g PERCOLATION RATE ✓• (minutesnn`c1h) PERC HOLE DIAMETER TEST RUN RETW€EN 3, FT AND 7 • J FT PERFORMED BY: CERTIFY THAT THS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ST E AND M I AL GUIDELINES IN EFFECT ON THIS DATE. DATE: d 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE' Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-521-40 Expiration Date: l l " ( -2 �ZG� 1. GENERAL INFORMATION Complete legal description Glenn View Estates L3 Location (site address) 23241 Glenn Hill Circle Current property owner(s) Thorud Mailing address Real estate agent Cindy Wilson 2. TYPE OF DWELLING: F-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 244-1930 Day phone 244-1930 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ y f �, 5 (Cov)-b-LI) Date of Payment 7 bo,2o Receipt Number 3 � 21 1,0,b COSA # 0 5 C �) 013 Ls�o Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 7/17/20 �ltttttfrfr�, IS - ON -SITE IAIA 0 WASPEV11ATFR --, �m PROGRAM Jo )))))1111 By._�_� Original Certificate Dater Tho Municipality of Anchorage DavOloprrrent Services Division f.DSD) issues Certificates of On -Site Systoms Approval (COSA) fused only upon the representations given in paragraph 5 by an inclependent professional civil engineer registered In the State of Alaska. The `.tunlclpality of Anchorage Is not responsible for errors or ornissiorts in the professional engineer's mrk. 7. ATTACHMENTS: COSA Checklist x Nitrate Advisory Septic System Advisory Arsenic A ' pry Well Flow Advisory Other o Cosa L}Y.:$,ht t lug! XC') *;49�i :.A 6. DSD SIGNATURE $ ....; ....... s' ff System ,f1 Approved for bedrooms System :r2 Approved for bedrooms Disapproved Conditional approval for bedrooms, %vith the following stipulations: �ltttttfrfr�, IS - ON -SITE IAIA 0 WASPEV11ATFR --, �m PROGRAM Jo )))))1111 By._�_� Original Certificate Dater Tho Municipality of Anchorage DavOloprrrent Services Division f.DSD) issues Certificates of On -Site Systoms Approval (COSA) fused only upon the representations given in paragraph 5 by an inclependent professional civil engineer registered In the State of Alaska. The `.tunlclpality of Anchorage Is not responsible for errors or ornissiorts in the professional engineer's mrk. 7. ATTACHMENTS: COSA Checklist x Nitrate Advisory Septic System Advisory Arsenic A ' pry Well Flow Advisory Other o Cosa L}Y.:$,ht t lug! r Legal Description: Glenn View Estates L3 If more than 1 septic system on, lot: COSA Checklist # of A.. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 215198 Total depth 221 ft Cased to 221 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24+ in. Date of flow test for COSA '"4'20 Static water level at beginning of test 166 ft. Comments B. TANK DATA Age of tank(s) 22 years Tank type/material Measured operating fluid level in septic tank 49 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/4/20 D. ABSORPTION FIELD DATA 2/25/98 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade 2 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-521-40 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 2.21 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Al Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 7110/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date ,7114110 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 10 in Elapsed time 60 min Final fluid depth 5 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date From Private Well on, Lot to. (Please enter distances ff less than required or if community well) Septic Tank/Lift Station on Lot > 100' If absorption field is under driveway comment below Yes Community Sewer ManholeJCleanout > 100' E] Yes if No ft E Yes if No ft Neighboring Tank > 100' Mv Yes if No ft Private Sewer/Septic Line > 25'F --,l Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank> 1001 Yes if No ft Neighboring Absorption Fields > 100' nv Yes if No ft Water Main > 10' Animal Containment > 50' Yes if No ft Rv Yes if No ft 2] Yes if No ft Water Service Line > 10' 0 Yes if No ManuretAnimal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' P-1 Yes if No ft E Yes if No ft From Sept! c/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10" If absorption field is under driveway comment below Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5' Mv Yes if No ft Wells on Adjacent Lots: OF Absorption Field > 5' El Yes if No ft Private Wells > 100' nv Yes if No ft Water Main > 10' D Yes if No ft Community Wells > 200' 2] Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 21 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Ef, Yes if No ft Private Wells > 100' ID Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Rv Yes if No ft Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS OF Ar VOA- LHI G. ENGINEER'S CERTIFICATION VA tV% Steve Eng I certify tient I have determined through field inspections CE -6256 'AF iff and review 2 of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i-NG!i 4ER'S MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 201380 Subdivision: Glen View Estates Lot 3 907-343-7904 Fax: 343-7997 Starting at 20 years cf age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 22 years old. Typical replacement costs range from $8,000 to $11,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 20 -year-old steel tank MAY look like. � k Ma ling Address P O' Box 196650* Anchorage, Alaskar99519 6550 *www muni org, �P< Municipality of Anchorage -� Development Services Department a Building Safety Division a On -Site Water and Wastewater Program s. et. 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. t4D COSA # 7� Expiration Date: �� _ 02 L " 1 GENERAL INFORMATION Complete legal description (rn n U t rw 5 1A'�/rS a Location (site address) 7- Current 1 Current Property owners) /44c, fi h a. U i n Day phone( Mailing address 'Z 3 (Z 1-(( f n n Wit l Z" r. C h v. c a Ay, g� Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well _ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent, professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, f 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 Mi r(na r(j.(An �- t-rj. rrt Phone 72 7 - gr Ss (. U Address Gr M6,40"o Vr1 Engineer's Printed NameM t r (Ms4o (� �n S ,. 66� DateL3��i .®q OF 1� A. •�a ��• eo of °{ ?® 6r *. 4 _ I v %• MICHAEL N. ANDERSCN 5. DSD SIGNATURE �� c CE- as 1/ Approved for bedrooms. Disapproved; 0 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: (Rev 111051 Original Certificate Date: ca` �� Municipality of Anchorage • Development Services Department °R Building Safety Division Onsite Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: tYLeo.,yuesk-) Fie kokt s "+ 3 Parcel ID: O'F/— 501-; Lf Q A. WELL DATA Well type -PL%froA&� Date completed ��9X If A, B, or C provide PWSID # yj y, .1-(.i Well Log (Y/N) Y Sanitary seal (Y/N)- Total depth 22 Cased to 22 ( ft. FROM WELL LOG Date of test 2 Static water level 1-40 ft. Well production Z 0 9— p.m- WATER SAMPLE RESULTS: Wires properly protected (Y/N) '�( Casing height (above ground) Z % in. AT INSPE TION /70 ft. 4- g.p.m. Coliform _Q6—colonies/1100 mL Nitrate 2,q Zmg/L Collected by: P-v6*r 4-WPe/I, Arsenic: 4 ug/L date of sample:iAl B. SEPTIC/HOLDING TANK DATA l Tank Type/Material <il-e,.( Date installed Tank size I2 »0 gal. Number of Compartments Z Cleanouts (YIN) X Foundation cleanout (Y/N) Y Depression over tank (Y/N) , `_ High water alarm (Y/N) e Dateofpumping8' 12 Pumper_ 41r0.n14,V,_ Z'(rrA.r4r,d,44 C. ABSORPTION FIELD DATA Date installed il/ Soil rating (g.p.d./ft2 or ft2/bdrm) r ` System type S /w, d c - Length 7014; ft. Width U , O ft. Gravel below pipe2� ft. t Total depth z7� ft. Eff. absorption area 2Lp7 ft2 Monitoring tube _X_ Depression over Feld Date of adequacy test t ?/ Results (Pass/Fail) Pd s S For bedrooms Fluid depth in absorption field before test Z in. Water added 70 tal. New depth in. Elapsed Time: A414 Rhin. Final fluid depth% in. Absorption rate >= O 0 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date ._i D. LIFT STATION Date installed "Pump on" level at Size in gallons in. "Pump off' Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/J*Qbv ien on lot too 4 - Absorption field on lot t ao r f Public sewer main r Sewer /septic service line S D {— Animal containment areas / r9 il 1 � Manhole/Access High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots / coo r Public sewer manhole/cleanout t vd t �— Holding tank H Manure/animal excrete storage areas 00 (4— SEPARATION DISTANCES FROM SEPTIC/HQkftbiG TANK ON LOT TO: Building foundation 10 r� Property line /0 f / Absorption Feld /O r Water main Water service line SO Surfacewater /toy 1,4 Wells on adjacent lots t d o (YL SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1014-- Building foundation /D rw- Water main /� , 7 /00' Water Service line ! Cab /t Surface water / V 0 t Driveway, parking/vehicle storage IV O f� Curtain drain Ny1 k n dwo, Wells on adjacent lots !Vo t i4 - F. COMMENTS G. ENGINEER'S CERTIFICATION r �qG. ../6. I certify that I have determined through field inspections and review of Municipal records that the above systems are in oe 49TH conformance with MOA COSA guidelines in effect on this date. Engineer's Printed NameMI Y� r% /F dPt ✓f -, ° D ►� � ¢ � .MICHAEL N. AhDERSC'J „4 DateCE: 9459 4 COSA Fee $ 410 Date of Payment !1/2 Receipt Number (Rev. 4110) Waiver Fee $ Date of Payment Receipt Number C in. PLAT NO. 96-101 GLENN VIEW ESTATES SUBDIVISION LOT 3 40,000 S.F. GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWUNG RD., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRIDDATE NW1360 3/12/2012 F.B. J09 N0. GVELOT3 „Tc<lc I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. 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. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. 1