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Home My WebLink AboutUPLANDS LT 1Uplands Lot 1 #050-472-88 Municipality of Anchorage Page I of? DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: �w9YOZ9ly PID Number: OSbY72PP Name: �• %�H/�cs�C Wastewater System: JKNew ❑ Upgrade calrYn+ /�Edolz.o><t Address: ABSORPTION FIELD P.O. /Ron 733(05' pie; P7 No. of Bedrooms: I j• Deep Trench D Shallow Trench D Bed ❑ Mound D Other [VASI&I—A A 99 LEGAL DESCRIPTION Soil Rating: ? Total Depth from originggrade: GPD/S.Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe S —� 0P44AJQS G Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: - 75' -- 0 - ?. 3— Ft. Ft. Gravel width: Number of lines: Distance between lines: WELL:❑New ❑Upgrade • 2.SFt. / Ft. Classification (Private, A,B,C): EX76 T. Total Depth: Cased To: Total absorption area: Pipe material: FF/U Pe'_ F• Z>30JN /�•V•�-• C61wrrt U.tJ79' Ft. Ft. 76'0 SQ. Ft. 149T,r,k Driller: Date Drilled: Static Water Level: Installer: �C.)le Date installed: Ft. OGO.uY Yield:Pump Set at Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES .septic D Holding D S.T.E.P. TO Septic Absorption Lift Holding Public/Private Manufacturer: A.V�HdR�-GG WI-- Capacity in gallons: I /z5n From Tank Field Station Tank Sewer Lines / Well, 2(Z1 200 rt 2S -f- Material: -S%-ECL Number of Compartments: 2— SurfaceLIFT /00 rf STATION Water /00 1- LotSize in gallons: Manufacturer: Line /D r ! /0 r -- "Pump on" level at: "Pump off" at: High water alarm at: Foundation ! S' ' 371 Curtain /JO.UE oWAJ Pump MakeB Electrical Inspections performed by: Drain Remarks: Ft) BENCH MARK Z.7G/ Location and Description: /31s —M % OF FOUtJ7�RT/O Cl "fj" Assumed Elevation: /QU .00D Ft EN_glNF�ES3�S SEAL e S" S ENGINEERI 17034 Eagle River Loop Road, No. 204 ; Inspections performed by: EaglaRlIvarAlaska 99177 Dates: 1st 2nd Ilk), 1467 5 Department of Healp and Human Services approval Reviewed and approved by: Date: 72-013 (Rev. 9/91) MOA 25 Permit NoSW940296 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal DescriptiorPLANDS SUBDIVISION; LOT 1 PID No.: 05047288 72-013 A (1/93)' 94.3' 5' 97r (MT2&I& O1 98 6' 02 C04)) FINAL' GRADE NEW 04.9' GAL.4' S 250 3& N.T.S. 4) .. ....... _._... ......... ..._....... .... ._..... 85.3 ..... .......... ................... (MT1& MT2) - _ ♦ 78.3' NO WATER FOUND A B FCO 1:4.5 28.0 C01 21.0 32.0 CO2 97.0 37.0 CO3 38.5 55.0 C04 113.0 126.5 �_........ MTl 38..0 55,5-.. ..._ ..___._._ ._._.... ._ MT2 1.12.5 126.0 N .NEW 1250 GAL. :SEPTIC TANK ......................c... oa ................................. ......................... ............. ................................. ...... .................... ............... ............. MT iC 2 COS 0 01 _-W1 °BL: 4 BDRM co 0o HOUSE NEW=TRENCH A ENGINEE,�S SEAL PROPERTY SERVED BY COMMUNITY WATER SYSTEM. NO WELLS WITHIN 1 '-- 200' OF SEPTIC SYSTEMA. s `* a / SCALE 1 — 40' i /1 t i 3 1 t T !^L• 72-013 A (1/93)' August 31, 1994 ROBERT SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Depanbneni oU Hea th and Human Serv.iee6 Attn: Jim Cross P.O. Box 196650 SEWER&WATER Anchorage, AK 99519 MAIN EXTENSIONS REFERENCE: Lot 1; Uptand6 Subdivision Dean Mr. Cross, SEWER & WATER INSPECTION Attached is a revized site plan and a soil tog which changes the toeation ob the proposed septic system permitted undm pekm.it # Sw940296. ENGINEERING STUDIES The site tocatc.on was changed as a r� esutt 0 erenees eXpressed b ANDREPORTS the proposed homeowner. Site conditi.onsa.re re�retativetythe same however .the proposed area is stightZy downslope Brom the onig.ina2 design tocation. Wojtk wiU be proceeding on the .in6tattation ob this WELL INSPECTION system within .the next bew days. & FLOW TEST Ib we may be o$ buntheA service, ptease contact U Stinc y, SITE PLANS ROAD DESIGN BE T A. SHAFER, P.E. RA /gh ENCLOSURES SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 0 v�C' �r z 3 ,i a V•t� � Z �.xfjo Q ~ z Fl W Y Q n 3 0 0 - a o ` a LL \ O / x I M I � ro Z O N LJ ? O Oz i q 00 V)wU0O \ W N �Mp Q�QF IOLk� \ �i [if 0 o a 0 c4i � o pa l o �ozUNO_ i wwx z = o Jn 'mw�-�z � g F oQz>li0 Q oz3O� o aQ= a vi (f) Z JVIa wI ¢ o o �n wwY Mm o 7 0 O1 Vj win �Q �^wd D Q W S JoM J W O NE- K ��o WQQ ,,o v N JJ \ aF rn > wZ�Q }N~ \ Op,cl W �� ti Y F-OmN ZF U �0QO to wzZ \ W VINQ F-�U CJ Q O q �\ a z a a o z \ �! WF .. U3w Q 3 H aLL S c7 Ir ago zr J q \ WI (7 p VI W Z N a� W W �Ur >Ww wwa 4�41n1 z ws3o r>� 11 Qw�F wKC) dR W moo F a n v� Sao W U WQ 31tl05 NV�d ILIS A5 = „-! 1* PERFORMED LEGAL DESCRIPTION:/..J DEgXH n� EET) UIw COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PEACOLATION TEST !—/(—, t/TVC-V1 DATE 1 9,16) Township, Range, Section: St�TI Cq"ny 6r"Vs-St� W/ i:bW Q.emse SANo L-Fju65S 7)Pwu6A90u3 WAS GROUND WATER ENCOUNTERED? O IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? PERCOLATION RATE TEST RUN BETWEEN 77034 Eagle River Loop Road No. PERFORMED BY: age Iver, a5 a 577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDI 72-008 (Rev. 4/85) +nutes/inch) PERC HOLE DIAMETER AND FT CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: Depth to Water PERCOLATION RATE TEST RUN BETWEEN 77034 Eagle River Loop Road No. PERFORMED BY: age Iver, a5 a 577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDI 72-008 (Rev. 4/85) +nutes/inch) PERC HOLE DIAMETER AND FT CERTIFY THAT THIS TEST WAS PERFORMED IN ON THIS DATE. DATE: PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE ,I DEPARTMENT OF HEALTH AND HUMAN SERVICES �d16�,1J P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 (&1- ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940296 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:TANDESKE DEBORAH L & WILLIAM OWNER ADDRESS:P.O.873365 WASILLA, AK 99687-3365 PARCEL ID:05047288 LEGAL DESCRIPTION: UPLANDS LT 1 LOT SIZE: 43560 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 8/17/94 EXPIRATION DATE: 8/17/95 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PR RECEIVED B ISSUED BY: DATE: DATE: /e 1691-ol S 1 D v <f'v 0 eA �v�� °��'o�'ol �f ro July 28, 1994 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVILENGINEERS (907) 694-2979 FAX 694-1211 HEALTHAUTHORITY L/ TEST APPROVALS Municipality of Anchorage MECHANICAL DEPARTMENT OF HEALTH AND HUMAN SERVICES INSPECTIONS 825 'L' Street P.O. Box 196650 SEWER &WATER Anchorage, Alaska 99519-6650 MAIN EXTENSIONS REFERENCE: Uplands Subdivision; Lot 1 SEWER & WATER INSPECTION Request you issue a permit to install a septic system to serve the proposed four bedroom house on the referenced property. ENGINEERING STUDIES ANDREPORTS Test holes were excavated and percolation tests performed. The approximate locations of the test holes are located on the attached site plan. The monitoring tubes within the test holes have been WELL INSPECTION checked and found to be dry. & FLOW TEST This property is served by a Community Water system. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. SITE PLANS This property has enough area for a future septic upgrade which can be seen on the attached site plan. ROAD DESIGN If you have any questions, or require additional information for your review, please act us. SOILTEST Z Shafer, P.E. PERCOLATION L/ TEST RAS �jk STRUCTURAL& MECHANICAL INSPECTIONS ONSITE I / WASTE WATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 9 a� of oEi�° °� g C° CY<Q grLL " 3 e�� Ox foo pIN® , Il9 A i Jw N ism 190 �9 .T.. O F asp a z z a Qy w Z�0 J 4 z O m 0 U V O d �r d yin �i a x N z � 1 E F O Oz a N zz aao I�l~Il to I xo Z<O I ll Q C aN oaf 0 0(4w pUNa 1 I' �a p.qN U Q ..Z w W u dl 4 Il W o P. n, r o'a Z>w» LL � 0z3O-00 I H o 0 40o p v N 5�>�� 1- W WI � z -'via > W mo ww W 7 Z yZ� c U N wN�Q zwa z N J —4 Q WNN dw� ix Ci n NZ H F -j W W Q 0 F Ox w Z�Q K}V1~ W NEI �OmF-Wla.wU O INF�U� W V ]a V �oaC -N>FZ 1 Opp, �SZ x000 Y P,lWi1 NNQ F -OV n Z 77�\ Oof �\ Z w Fx � H 0 J z O 3 w a 3 \ E oa"• if] mov~ W Q \ 00� HW Z� C) 000N � l J .0 V 1 J 16 w W r� �N onn<. NNW �N0 mNnC .+ 0Q00 > H YNtp R�iN mQ 31tl05 Ndld 311S ,OS = „L e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: / l/'L DATI LEGAL DESCRIPTION:`�V 1 �'T S��`+' +Township, Range, Section:' PTH /1A, I SLOPE r—T 1 2- 34 3- 4 O �O 5- 6- 7 67 s 9,— ` 10. R • 11 i </ o / 12 .f r7 / 13- 14- 15 3 14 15 16- 17 18- 19- 20- COMMENTS 81920 COMMENTS 11 0 WAS GROUND WATER ENCOUNTERED? 'D IF YES, AT WHAT DEPTH? Depth to Waler�lleJ� , Man,Gale: � 0 1�,�-q2 iloring7 _'�-. `�.— i PERCOLATION RATE _L(�1 (minutes/inch) PERG HOLE DIAMETER — TEST RUN BETWEEN FT AND 7 FT PERFORMED BY: S & S ENGINEERING\�'I' CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Roado. ACCORDANCE WITH tbbl%ToiwPw"ktilgOWGUIDELINES IN EFFECT ON THIS DATE. DATE: 79 -MR (Pov d/A5l e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 / SOILS LOG—/PERCOLATION TEST PERFORMED FOR:_�JO,� 3jj"�L//FLL^ L/�IJ�1 " DATE PERFORMED: LEGAL DESCRIPTION: M7 11"1 I''1 G%V'I l'� Township Range, Section:--�L`-hJ, ~ .1,H 1)/9, l�' IIA SLOPE SITE PLAN^PTH � 1 �- I I I_ 1 2- 3 3 4 .. ... nn 5 /. "" � M 6 p 7 ro� 8- 9 9 �' (t C ` 10 rP 12 p 13- 14 15 16 17 18 19 WAS GROUND WATER ` ENCOUNTERED? T O IF YES, AT WHAT DEPTH? Depth to Water Alter Monitoring? � \— Date: S L O P E Reading Date Gross Time Net Time Depth to Water Net Drop E> D 21k3 " 5 2. 2:53 N y ti3 1 a 20 I_� y PERCOLATION RATE� (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN A FT AND FT COMMENTS S & S ENGINEERING PERFORMED BY: I —� CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road No. 2nA ACCORDANCE WITFE&bIeSarVtAAQAWVV#)y GUIDELINE IN EFFECT ON THIS DATE. DATE: �� 1 72-008 (Rev. 4/85) ON—SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Uplands Subdivision; Lot 1 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. Page Two Uplands Subdivision; Lot 1 July 28, 1994 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATEPJAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. Page Three Uplands Subdivision; Lot 1 July 28, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0:5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. Page Four Uplands Subdivision; Lot 1 July 28, 1994 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER G� 6 Municipality of anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-472-88 1. GENERAL INFORMATION: Complete legal description UPLANDS: LOT 1 Expiration Date: -5-- 2S —2. o2� Location (site address) 10400 STEWART DRIVE, EAGLE RIVER, AK 99577 Current Property owner(s) FREEDMAN REVOCABLE TRUST Day phone 907-726-1514 Mailing address Real Estate Agent 10400 STEWART DRIVE, EAGLE RIVER AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA # 0 S C a 9, 1 a (o �, 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: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for q bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, #AECC884 OF 0rR 'Qy/iii Z 0�`1_S1TE G'� D with the following ulall&iE, PER o W R M �, oROGF`A .� J J CIV 1 6r_X , IS 1^--� Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA blue sheet_10-10-12.doc Nitrate Advisory Arsenic Advisory Other tvi qe Rdt) �t�v� KI Legal Description: UPLANDS; LOT 1 If more than 1 septic system on lot: COSA Checklist # 1 of 1 . LL DATA I ❑ Well log d with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) Date of flow test for CO Static waterf beginning of test ft. B. TANK DATA Age of tank(s) <28 years Tank type/material STEEL Measured operating fluid level in septic tank 9 ❑ Standpipes/foundation cleanout per record drawing Date of pumping �N1A�� D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 9/1994 ❑ ALL standpipes present per record drawing Total measured depth from grade 11.6 ft (max) Measured depth to pipe invert from grade 3.9 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 050-472-88 Structure served by this system 1 Well production at time of test m Water storage tank volu gallons Well disinfect coliform test? ❑ Yes ❑ No L rm bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Ar ug/L ❑ Arsenic less than MRL (ND) Collected by EG,LTD. Date of Sample STATION ❑ RequRrb&waintenance Age of lift station Lift station material Comments Adequacy test date 5/26/22 Results �✓ Pass For 4 bedrooms Fluid depth prior to test 35.25 in Water added 777 gal New depth 42.5 in Elapsed time 198 min ❑ Code -required soil cover over field Final fluid depth 36.5 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NIA date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES rivate Well on Lot to: (Please enter distances if less than required or if community well) 0 Yes Septic Tank/Lift n Lot > 100' Wells on Adjacent Lots: Absorption Field > 5' Community Sewer Man eanout > 100' if No Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if o ft. e Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if ft Tank > 100' ❑ Yes if No ft Neighboring Absorption Fie _ 0' if No ft Animal Containme ❑ Yes if No ft ❑ Yes if No ft _ Manure/Animal Excreta Storage > 1 C nity Sewer Main > 75' F1 Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' B Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Cj Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' (]✓ Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *MET SEPARATION DISTANCE AT TIME OF INSTALLATION. G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet #AECC884 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221266 Subdivision: Uplands lotl Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 28 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. Ma�lmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni 0rg ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY., AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT 1S THE RESPONSIBILITY OF THE OWNER TO DETERMINE TH^ E.CISTENCE OF ANY EASEMENTS, COVENANTS, OR REF;TRICTIONS WH16N DO NOT APPEAR ON THE RECORDED SUB01- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONUTRUCTION 0= FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SEt,ARD & ASSOCIATES LAND SURb'EYIt;G 694- SCALEt arc....... 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GENERAL INFORMATION Expiration Date: 7-1-7-0 9 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address UPLANDS: LOT 1 10400 STEWART DRIVE *EAGLE RIVER AK 99577 WILLIAM do DEBORAH TANDESKE Day phone 862-1107 10400 STEWART DRIVE *EAGLE RIVER AK 99577 Day phone BARBARA CRITTENDEN W/ PRUDENTIAL Day phone 242-2227 16635 CENTERFIELD DRIVE *EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site N ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal axed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 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 GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefil of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for —I)L bedrooms. Disapproved. 337-6179 Date IC- bS Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory C.� Arsenic Advisory Maintenance Agreements Supplemental Engineers Reort Nitrate Advisory tOther By: (Rev 111M( WASTEWATER PROGRAM Original Certificate Date: :7—/7-08 Municipality of Anchorage Development Services Department Building Safety Division , On -Site Water& Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVALCHECKLIST Legal Description: UPLANDS- LOT 1 Parcel ID:05'0 - I/7.Z-ro/� A. WELL DATA Well type PUBLIC Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE Coliform ug./L. If A, B, or C provide PWSID# _ Sanitary seal (Y/Ni— Cased to ft. FROM WELL LOG B. SEPTIC/HOLDING TANK DATA Well Log (YIN) - Wires properly protected Casing height (abo r AT IN TION ft. ft. g.p.m. 9— p.m-mi . Nitrate mg./L. Other bacteria colonies/100 ml. Date of sample: Collected by: Tank Type/Material STEEL/SEPTIC Date installed 9/2/94 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping /9/08 Pumper JR'S Pumping C. ABSORPTION FIELD DATA Be ow EXISTING Gaao Date installed ' 9/2/94 Soil rating (g.p.d./WorqGd 0_8 System type TRENCH Length 75 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth +11.6 ft. Eff. absorption area250 f? Monitoring tube YES ' Depression over field NO Date of adequacy test 7/8/08 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 118 in. Water added 1060gal. New depth 33 in. Elapsed Time: 120 min. Final fluid depth27 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access "Pump on" level at in. "Pump off" E. SEPARATION DISTANCES water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service areas PUBLIC WATER On adjacent On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined rough field inspections stems ars and 4P�3 review of Municial records that the above s stems are in conformance with MOA COSA uidelines in effect on this date.,Je frEngineer's Printed Name JEFFREY A. GARNESS �O ' Date�� da COSA Fee $ -I so • O O Date of Payment 1 S/y R Receipt Number_ �$(D (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE TH' E"ISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR. ON THE RECORDED SUB01- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSUTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SEI;ARD 6 ASSOCIAIE5 LP\U 5URVEYINIi b94 SCALE: OF At DATE - GRID i FS: is DRAWN MUNICIPALITYOFANCHORAGE1 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 Parcell.D.# 0s'01V7;Lge HAA# 9!E 051-7 1. GENERAL INFORMATION Complete legal description Lot 1 U lands Subdllision Location (site address or directions) Stem)tt Dative Ea to Riv AK Property owner Dl i e-2i.am 9 Deboaah Tandu ke Day phone 258-8878 Mailing address P.O. Box 873365 Oa6itta, AK 99687 Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water xxx Day phone Day phone 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 XXX 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-M(Rev.1/91) Front MOA#21 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 compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. 5 & 5 ENGINEERING q I ^ l� r Name of Firm 17024 E -g) c I p Read Na 104 Phone (J Eagle River, Alaska 99577 Address Engineer's signature Date _ E OFA �+ = ROBERT C. COWAN CE_ 807 4`Q? �fi!i'F�p " ^"""••r`�G�� 6. DHHS SIGNATURE SIG Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto 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 7Z=�(Pw1/91) .Back MOAM Sj ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LT- 1 op+—oo�r>S Parcel I.D. O S- o y 7 a 13 8 A. Well Data Well type M 0,6% If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Date completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) ' FROM WELL LOG Date of test Static water level Well flow Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot tT Wires properly protected (Y/N) AT INSPECTION M 0 n g.p.m. g.p.m. r r7 V m co n � m � y H 0 On adjacent lots z Absorption field on lot 20 01� ; On adjacent lots Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Nitrate sewer manhole/cleanout Petroleum tank Date of sample: Collected by: S. SEPTIC/HOLDING TANK DATA Other bacteria Date installed `� —A -9 Tank size 1 7-50 Compartments Z Cleanouts &N)Foundation cleanout ON) Depression (Y/Q High water alarm (Y� I Alarm tested (Y/N) Date of pumping //k — l�� Pumper _� a SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot -Z�� t�- On adjacent lots '3 ,4 Foundation Js To property line /0 y Absorption field / o Water main/service line / o J Surface water/drainage I o,r> r i - 72-026(3W)•F=t CONTINUED ON BACK PAGE C Z n 0 Z z i 0 9 V7 C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION Well on lot D. ABSORPTION FIELD DATA tested LIFT STATION TO: 7R On adjacent lots Surface water Date installed q -9 —9� Soil rating (GPD/Ftz) 8 System type Length 75- Width Z.s Gravel thickness 1137 Total depth Total absorption area 75 a Cleanout present QJ) Depression over fie d (Y @ zJ Date of adequacy test /v/ - 14,„-1 Results (pass/ ail) 1 for - r Bedrooms //JJ r Water level in absorption field before test �� a After test rt Peroxide treatment (past 12 months) (YQ If yes, give date u SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot Zoo (+- On adjacent lots /V/4- Property line �0 F To building foundation 37 f To exi ting or abandoned system on lot On adjacent lots 30 Cutbank y a Water main/service line Surface water o n / Driveway, parking/vehicle storage area , 5-6 f Curtain drain E. ENGINEER'S CERTIFICATION 1 cerfify that l have checked, verified, or conformed to all MOA and HAA guidelines in effect pjt ava'at� gf this inspection. Signature Engineer's Name t 4 �`L.2 r C, Co i✓ gi✓!%RO6ERT[C. CON AN /�j r` /V f CE -f3801 Date \ C�?bh. ,nJ'• HAA Fee $ 0 0 __ � Date of Payment � 0 — V Receipt Number /\ S 72-026 (3/93)' Back U — 60 36 Waiver Fee $ Date of Payment Receipt Number