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CHANDELLE ACRES LT 27
Chandelle Acres Lot 27 #051-822-06 U10MYTA Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211142 PID Number: 051-822-06 Dwelling: N Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New K Upgrade Name BRENT HAMMILL r0E1 <DeTrench IELD Site Address ❑Wide Trench ❑Bed ound 23847 CHANDELLE DRIVE, CHUGIAK, AK 99567other Phone Number of Bedrooms Soil Rating Total depth fr original grade 854-1054 3 /sF Ft. LEGAL DESCRIPTION Depth to pipe invert from origins avel depth beneath pipe Subdivision Block Lot EXISTING CHANDELLE ACRES - 27rut,Ft. Fill added above original g JGnh Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Dist a between lines SEPARATION DISTANCES Ft. Ft. To Septic AbsorptionHolding Sewer Total orption area Number of trenches Dist. between ches From Tank Field Lift Station Tank Line Ftz Well 1 QQ'+ EXIST. - - 25'+ TANK 9Septic ElS.T.E.P. ElHolding ElOther Manufacturer Capacity Surface Water 100'+ EXIST. - _ GREER TANK 1000 Gal. Material Number of compartments Lot Line 5'+ EXIST. - - NA HDPE PLASTIC 2 Foundation 101+ EXIST. - _ LIFT STATION Man er Capacity Remarks Gal. Alarm location installed by PIPE MATERIAL House to tank 03034 Tank to D3034 Installer drainfield ARM SEPTIC SERVICES, LLC Drainfield EXIST. CO/MTD3034 Inspector GEG CONSULTANT, JODY MAUS BENCH MARK (Assumed elevation) 100.00 It Inspection 15` 5/21/2021 2�a Location and description 3rd 4th BOTTOM OF SIDING AT POINT "B" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp _0�0 F�q `0004 Conditions! Approval: Date o ��• "" . I 95,0 0 4 ../...... ........ D .... _ .o Septic System �O �, .�effir ey A. Gayness oQ /%� C 953 �� p Approved C��� ��/' Date 3 Iy0122 Q s� �c4 44�e~ed �a? �. • o\ hod Note: this approval does not include well permit requirements. Op �o Hess ooa II #AECC884 ��OQp00 (Rev 05/02/18) 0�19 I PERMIT NUMBER: RECORD DRAWING I N O PARCEL ID NUMBER: I OS P211142 051-822-06 NOTE: OLD STEEL SEPTIC TANK WAS DECOMMISSIONED PER THE UPC CODE PER CONTRACTOR, INSTALLED DOUBLE CLEANOUTS (DBL1 & DBL2) NEW 1000 -GALLON GREER PLASTIC SEPTIC TANK.— NEW FCO. / PLUMBING / REROUTED IN / CRAWLSPACE / 1 i r r t t t t I I I I ATB V FCO 6.0 1 33.1 MH 23.1 24.7 ST1 25.2 20.2 DBL1 26.6 18.7 DBL2 27.0 18.0 SUMP1 31.4 43.4 C01 102.7 64.5 MT1 100.5 62.4 l 1 1 V V 1 \ NOTE: PIPE LOCATIONS ARE \\ SHOWN PER GEG SHOTS \ TAKEN WITH LEICA DISTO \ S910 LASER DISTANCE \\ METER. SWING -TIES TO \ HOUSE CORNERS WERE \\ GENERATED IN AUTOCAD. 1 EXISTING m X WELL /�. SCALE: i 1"=30' GARNESS ENGINEERING GROUP, Ltd ..... .. ... .. p Cl6L ENVIRONMENTAL ENGINEERS . �:s ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE: w .games gheering wm ... ... .......... Aw PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ 10 �Jeffrey•• •, arness •C• �/ BRENT HAMMILL 854-1054 2 OF 3 ♦# J, ;••• CE -7 53 PROJECT/LEGAL DESCRIPTION: DRAWN BY: ♦ ��. e �► CHANDELLE ACRES S/D; LOT 27 J.L.M. �1 �...;�®®' TYPE OF WORK:DAT R ��®®Cj��` RECORD DRAWING OF SEPTIC TANK UPGRADE 6/15/2021 LICENSE ®r —EXISTING DRAINFIELD. PASSED SEPTIC ADEQUACY TEST ON 5!7/2021 EXISTING m X WELL /�. SCALE: i 1"=30' GARNESS ENGINEERING GROUP, Ltd ..... .. ... .. p Cl6L ENVIRONMENTAL ENGINEERS . �:s ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE: w .games gheering wm ... ... .......... Aw PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ♦ 10 �Jeffrey•• •, arness •C• �/ BRENT HAMMILL 854-1054 2 OF 3 ♦# J, ;••• CE -7 53 PROJECT/LEGAL DESCRIPTION: DRAWN BY: ♦ ��. e �► CHANDELLE ACRES S/D; LOT 27 J.L.M. �1 �...;�®®' TYPE OF WORK:DAT R ��®®Cj��` RECORD DRAWING OF SEPTIC TANK UPGRADE 6/15/2021 LICENSE ®r PERMIT NUMBER: RECORD D RAW I N G PARCEL ID NUMBER: I OS P211142051-822-06 FINAL GRADE Ltd CIVIL & ENVIRONMENTAL ENGINEERS , is ... . ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE: -games gimeernrg.mm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRENT HAMMILL 1 854-1054 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: CHANDELLE ACRES; LOT 27 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING FOR SEPTIC TANK UPGRADE 6/15/2021 ATION 4CTOR) Ll f.� +.....�. ..........� ♦ ea c Q w c� ess jw• • • LICENSE ����� #AECC884 R UP Lot 27 54,762 S.F. 70 MANHOLE—''' N ` 170.00' 8.3'x12.3' SHED--,/� J�`/J 0 a )TIC PIPES—" J �s 2.0`x5.2' .-ti f*1 CANT �52� '�• o a w �¢ 38.0' Lot 26 2.Vx11.7' CANT WOODEN CHAIN—LINK FENCE WALKWAY j' 4.0'x6.6' CANT IR�105 ti00 PR0,1EC1�VE WELL ro z 10' UTILITY / EASEMENT / NOTE: DUE TO SNOW & ICE COVER, THE DRIVEWAY IS APPROXIMATE. Lot 2$ —L=26.72' R=200.00' PLOT PLAN AS BUILT x_ SCALE _ 1"�= 60 GRID — N_W_ 1560 Project No.22-083 Al ��}} Associates, � 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & H S S o C i a t e S inc. (907) 522-6476 Phone (907) 522-4625 Fax aF Agbj�� Professional Land Surveyors ken0longsurvey.com jonathon*langsurvey.com �� I hereby certify that i have surveyed the following described property: LOT 27, CHANDELLE ACRES SUBDIVISION (PLAT No. 79-190) 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 sold property except as Indicated hereon. Dated this the __ ' — — 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 plot. 49TH* .................. . .......:... kkENNET •IAN �t V� �FESStONAL �� AECC963 MUNICIPALITY K]FANCHORAGE On -Site Water & Wastewater Program POBox 1B665 400Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 On -Site Wastewater Disposal SystemPermit Permit Number: OSP211142 Work Type: SopboTankUpgnsde Tax Code Number: 05182206000 Site Legal Address: CHANDELLE ACRES LT 27 G1560 Site Mailing Address: 23847CHANDELLE DR, Chugiak Owner: HA@M|LLBRENTT Design Engineer: GARNESGENGINEERING GROUP LTD This permit iofor the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 5/13/2021 5/13/2022 [] Disposal Field 0 Septic Tank [] Holding Tank 0 Privy [] Private Well 0Water Storage 3 All construction shall heinaccordance 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 VVaa|owobar Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC8O) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Provide notification bycalling (907)343'79O4(24/7). - -4. From October 15 to April 15, a subsurface soil absorption system -under construction during fhezinQYYeetershall be either: '----� m. Opened and Closed onthe same day, or b. Covered, sealed, and heated bxprevent freezingOW Special Provisions: ** For decks thirty inches or less above grade, the septic tank shall not be located under an associated deck support. Receive( Date: Date: MUNICIPALITY OF ANCHORAGE �l Develop ment'Services Department y Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-822-06 Property owner(s) BRENT HAMMILL Day phone 854-1054 Mailing address 23847 CHANDELLE DRIVE, CHUGIAK, AK 99567 Site address 23847 CHANDELLE DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) CHANDELLE ACRES; LOT 27 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Q Septic Tank 0 Upgrade. 0 (w/wo ADU) (D) ❑ Holding Tank ❑ RenewalDuplex ❑ 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: ,022.5 Waiver Fees: Date of Payment: ��h "I Date of Payment: Receipt Number. 017an G Receipt Number: Permit No. DJP 21 11 W 2, Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211142, Deb Wockenfuss, 05/13/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211142, Deb Wockenfuss, 05/13/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211142, Deb Wockenfuss, 05/13/21 / MUNICIPALITY OF ANCHORAGE • ' • 1 t j _ ► ( 1 \ / \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME��f y�PHONE .3e'-1•-) k�ft'f /* C1a. 5102--43Z1 KNEW UPGRADE MAILING ADDRESS 7.--1 Iii C , '3 "L_Ic-A rDirz , . , et 8 LEGAL DESCRIPTION / LL/ T- 2-1 e'1- t a../6-r-_,-/L--S LOCATION NO. OF BEDROOMS F ZManufacturer w4 rn DISTANCE TO: Well - I ki Absorption area 1 Dwelling It C—r— ) PERMIT NO. ._c— ( I �iKc"Er2 - Mat�rjal �� j1� -l— No. of compartments -7_, Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth 0 z D ZH Q 2 DISTANCE TO: Well y � Dwelling PERMIT NO. Manufacturer A Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well t.....)-6,-)--1 N Foundation ( I Nearest lot line' t, CD -1' PER ( S No. of lines Length of each,lineTotal (Ql� length of lies t Trench w' th !JC% inches Distance between lines �/A Top of tile to finish grade it—`Material beneath tile Co -0 inches Total effective absorptio area I Q SEEPAGE PIT Length Width Depth PERMIT NO. Type of crib Crib diameter fl._) Crib depth Total effective absorption area DISTANCE TO: Well A Building foundation Nearest lot line —I w Class ' �� epth S I 1 0.......1 �`� ,JC Driller • Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER •. PIPE MATERIALS� �/ ii '-" p,-,;-1 '-0-3,-)- c 3` -)_SOIL SOILTEST RATING .5gel-i DP/,,,,, 1 pri. INSTAL ER REMARKS / - T W dab411* + F QC 3 0 • A,•�! :,w Gam.. t� A-? e . ..~< ... ,:.. r Baa.- 0 11 r, « R*Isert A. Shafer ; (t` t--1 iNi. v),. Na. 1457-E APPROVED , 4y DATE LEGAL 4a %f�1�. e r :7,':';',..7-,f1 fie. tz ' ��� ��J loi 1 72-013 (Rev. 3/78) OWNER OF LAND ADDRESS LEGAL DESCRIPTI DATE - Started — PERMIT NUMBER KIND OF FORMATION: From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft.. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: En-IfingUf a by DOC Co. dba =15 TP2112 P.O. BOX 272, CHUG IAK, ALASKA 99567 o TELEPHONE 688-2759 Ended DEPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING From Ft. to lAL' 11ClAAi f fy ����, c7F , ,. , _ CHORAGE From E1 -4Y1 r,cnL f; Ft. to f I�tlE1.1 6TR � c.Tiary From Ft. to.bti. From a Ft. to Ft. From Ft. to '' 4t V From .f Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft I�:il� 1L11 �lii.Y►Gl3L�1 . q T !NA 1=1 5='11q1 ..... ... !ETE. DEPARTMENT OF HEALTH AND EMVIROMMENTAL PROTECTION 825 L S[REE|, l.NCHOHE, AK 99501 264-472; PERMIT Nt.)� DATE ISSUED: BERNARD KRUEGFR 2121 E. 37TH ANCHORAGE, AK CONTACT PHONE: 562-4329 LOT SIZE: MAX BEDROONS: SUBDIVISlON: CHANDELLE SECTION1W .4762 (SO.FT. OR ACES) Listed below are the options available to you in dssigning your sopLic system. Choose the option that best DEPTH TO PIPE BOTTOM (FT.) GRAVEL DEPTH (FT.) TOTAL DEPTH (FT.) GRAVEL WIDTH GRAVEL LENGTH (FT.) GRAVEL VOLUME (CU.YDS.) TANK SIZE (G)LS) SOIL RATING (SQ.FT./BR> 349 ** GRAVEL LFNGTP > 7F, FT RFgUTRES MULTIPLE RUNS (MO/ Ex��EUI� ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS �.V G I certify that: 1. I familiar with the for on -siLe sewers and wells as se� {crth !Dy tho Municipality of Anchorage <MO:> and the State o[ Alas�a. I will install the MOA codes and regulations, and in compliance with the design criteria o{ this permi�. I will adhere to all MOA and State o{ Alaska requireme/`ts {or the se� bac!� �is��nces rrom any existing wsll, wastewatcr disposal syste� or p�b]ic sewerage sysLem on this or any adjacent or nearby lo�. 4. I ��derstand that this valid for a maximum o[ 3 bsdroo�s asd any enl.argeent will require a: additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED DIN!E CODES, THEN (1) AM ELECTRICAL PERMIT AND INSPECTION MUST BE OBT:YINED; WILL NOT BE APPROVED WTHOUT AN ELECTRICAL INSPECTION REPORAKD (3) THL: ELECTRICAL NORK M! 3T BE DONE BY A LICE]SED ELECT�I[:AN. = �~�`�.~~_~�^- _ ______~_-~___'___-__- -__�-_ -'_-_�� -- SIGNED 20.3131q, DATE: nARD KRUE�ER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: £d,21OE /lam"(}XG.1E#C LEGAL DESCRIPTION: DEPTH (FGA ) 1- 2 -', iS\A 4 7 -4p),. GAA 9 it 10 11 -f DATE PERFORMED: L r / t , 1 -109/•14)i—[ -LF /7L',4g5 SLOPE *9 20 - COMMENTS /en WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? ❑ SOILS LOG PERCOLATION TEST 7-a20 SITE PLAN 1 V S L 0 P E 30. 1r Y f L A - 1 Reading Date. Gross Time Net Time: Depth to Water Net Drop / /7%2E4. I ; o a / ht /»3� "36 3 „,• Z , 3 11.(1/4)A- .-1`) ,3/z �z 4 Y ) j i ,• - A • jo 3'/ i `f r �j AL" -0%r • i© yi4, r PERCOLATION RATE TEST RUN BETWEEN VIGIVIEERING RB ALASIv% 2V10 CERTIFIED B PERFORMED BY: 72-008 (6/79) 4D (minutes/inch) 7' FT AND FT DAT Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel ID. on -822-o6 COSA # Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 27 Chandelle Acres Location (site address) 21847 Chandelle Drive, Chugiak, AK 99x67 g-21-03 Current Property owner(s) Peter McCole Day phone Mailing address P.O. Box 7004, Syracuse, NY 13261 Lending agency Day phone Mailing address Real Estate Agent Charlie Whitlock/CB-Fortune Mailing Address 3000 C St., Ste 101, Anchorage, AK ggsoi Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 Day phone 265-g16s TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. 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, 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 Pannone Engineering Services, LLC Address P.O. Box 1o29Sa Anchorage, AK gq' io Engineer's Printed Name Steven R. Pannone, P.E. Engineers Comments: In conducting an adequacy test, 1 attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and :arc/ satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit 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 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Phone 272-8218 Date ogosiS ° OF 4 By: • t �c�iH .iA •j :IP • • • j AkSteven R Ponnone? • is •�c ilk. No CE 8149�r( f��` 44aa�3F59Q::• iucr, • ON SITE t-WACTE1AWATER AND . • m= • PROGRAM • °ck•'••....• ••C Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev 11 Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other / lti• <77t_ Original Certificate Date: S/- / /0 8 /1 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 APPROVAL CHECKLIST Legal Description: lot 27 Chandelle Acres A. WELL DATA Well type E If A, B, or C provide PW SID # Date completed 6/1c/1gSq Sanitary seal (Y/N) y Parcel ID: 051-822-06 Well Log (Y/N) Y Wires properly protected (WN) Y Total depth 201 ft. Cased to 201 ft. Casing height (above ground) 12+ In. FROM WELL LOG Date of test 6hs/1485 Static water level 170 ft. Well production 15 g.p.m. WATER SAMPLE RESULTS: Coliform `C colonies/100 mL Arsenic: Mb mg/I B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel Septic Tank size loop , gal. Number of Compartments; Foundation cleanout (YM) V Depression over tank (YIN) Date of pumping 8hlzoo7 Pumper JR's Pumping AT INSPECTION 8/6/2007 147 S.0 ft. g.p.m. Nitrate 1 •(AOmg/L Other bacteria--C.;—'colonies/100 mL Date of sample: 5/16/08 Collected by: Mike Wehr Date installed 6/15/1885 Cleanouts (Y/N) Y 1 High water alarm (Y/N) N/A C. ABSORPTION FIELD DATA Date Installed 6/st/so8s Soil rating (g.p.d./ft2 or ft2/bdrm) a4g Length sot ft. Width 2.s ft. System type Deep Trench Gravel below pipe Total depth 8.8 ft. Eff. absorption area;oco ft2 Monitoring tube Y Depression over field 1t Date of adequacy test 81612o07 Results (Pass/Fail) Pass For g bedrooms Fluid depth In absorption field before test;_o in. Water added466 gal. Elapsed Time:;44o min. Final fluid depth la In. Absorption rate >= bso+ ft. New depths In. g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date Installed Si n gajion' Manhole/Access (Y/N) Tump on" level at _ in. Pump o =1 at _ In. High water alarm level at Datum Cycles Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot zoo+ Absorption field on lot soo+ Public sewer main 100+ On adjacent lots loo+ On adjacent lots zoo+ in. Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas loo+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ao+ Water main aoo+ Wells on adjacent lots aoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line io+ Absorption field t+ Water service line ac+ Surface water aoo+ Property line 20+ Building foundation 10+ Water main aoo+ Water Service line 2 + Surface water loo+ Driveway, parking/vehicle storage to+ Curtain drain None Observed Wells on adjacent lots zoo+ F. COMMENTS RecertiHing August. 2007 COSA with new bacteria and nitrate samples. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems am in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P,E. Date COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11/05) SGS Ref. #: 1082080 Client Name: Pannone Engineering Project Name: Chandelle Acres, L27 Client Sample ID: Chandelle Acres, L27 Matrix: Drinking Water PWSID Sample Remarks: SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AIC 99518 Tel: (907) 562-2343 Fax (907) 561-5301 All dates/times are Alaska Standard Time Printed Date/Time: 05/19/08 16:50 Collected Date/Time: 05/15/08 9:48 Received Date/Time: 05/16/08 8:00 Technical Director. �8teph� Release Parameter Colony Count Total Coliform Count Fecal Coliform Count Allowable Prep Results POL Units Method Limits Date 0.00 9222B 0.00 92228 0.00 92228 05/16/08 05/16/08 05/16/08 Nitrate 1.66 0.10 mg/t. EPA 300.0 10.00 05/16/08 Analysis Date Ink 05/16/08 dIc 05/16/08 dlc 05/16/08 dlc 05/16/08 tcp } Municipality of Anchorage cgz Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FORA SINGLE FAMILY DWELLING Parcel I.D. 05/- 8A2- 1. XL 1. GENERAL INFORMATION Complete legal description Lot 27 Chandelle Acres COSA# bq-033O Expiration Date: / / — 2 9 - 0 7 Location (site address) 23847 Chandelle Drive, Chuqiak, AK 99567 Current Property owner(s) Peter McCole Mailing address 23847 Chandelle Drive, Chuqiak, AK 99567 Lending agency Mailing address Day phone 688-3047 Day phone Real Estate Agent Charlie Shftiock/CB-Fortune Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Day phone 265-9165 TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ Individual Holding Tank 0 ❑ Community On-site 0 ❑ Public Sewer 0 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 SY 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 Pannone Engineering Services, LLC Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Phone 272-8218 Date 8/15/07 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of thc system in accordance with MOA DSD Guidelines & Regulations. The reported results describe thc 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 soil condition, ground water ��•.� CF' as *., levels that may fluctuate during thc year, and the water usage of the family being served by the system. p. • • These conditions are outside the control of the evaluator of this system. All systems eventually fail and a c satisfactory test results do not guarantee future performance of the system, nor do they guarantee that e t there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit 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 Ste- Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: - • • • • • 1/4kk 01 J = ON-SITE • yam: WATER AND; r^" : WASTEWATER ; - JCA• 1/2)))))1M),- ENi1\\l`\� Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: g " a 9 -0 7 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 1 (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 27 Chandelle Acres A. WELL DATA Parcel ID: OS/- 32 2 - Well type P If A, 8, or C provide PWSID # _ Well Log (Y/N) Y Date completed 8/1511985 Sanitary seal (Y/N) y Wires properly protected (Y/N) V Total depth 201 ft. Cased to 201 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 6/15/1985 8/6/2007 Static water level 170 ft 147 ft. Well production 15 g.p.m. 5.0 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml Nitrate f • 9I fig" Other bacteria 1 colonies/100 mL Arsenic: N b mgA Date of sample: 816107 Collected by: Laura Pannone B. SEPTIC/HOLDING TANK DATA Tank Type/Material Steel/Septic Date installed 6/15(1985 Tank size 1000 gal. Number of Compartments j Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) fi High water alarm (Y/N) NIA Date of pumping 8/312007 Pumper JR's C. ABSORPTION FIELD DATA Date installed 6/15/1985 Sod rating (g.p.d./ft2 or ft2/ drm) 349 System type Deco Trench Length 105 ft Width 23 ft. Gravel below pipe 5 ft. Totalel behe Eff. absorption area RQS ft Monitoring tube Y Depression over field H Date of adequacy test 8/6/2007 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 19 in. Water added4¢¢ gal. New depthfl in. Elapsed Time: a min. Final fluid depth 14 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Ng If yes, give date D. LIFT STATION Date installed Size in g 'Pump on" level at _ in. "Pump off Datum Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/llft station on lot 100+ Absorption field on lot 100+ Public sewer main 100+ Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ in. Public sewer manhole/cleanout 100+ Sewer /septic service Una 25+ Holding tank 100+ Animal containment areas 100+ Manure/animal excrete storage areas 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ Water main 100+ Property line _te Water service line 25+ Absorption field 5+ Surface water 100+ Wells on adjacent Tots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 100+ Water Service line 25+ Surface water 100+ Curtain drain None Observed Wells on adjacent Tots 100+ F. COMMENTS Driveway, paridnglvehide storage 50+ G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems am in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone. P1. Date .��4s•• ssssss c2 \Fp !4 7„ Ss s}�1• • - �1�a i • j Steven R. Pannone n i •1•d CE.8149 i/J \i 6�i a E55' COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) 0fq 989ag Waiver Fee $ Date of Payment Receipt Number SGS SGS Refit Client Name Project Name/tl Client Sample ID Matrix PWSID 1073921001 Pannone Eng. Srv. Lot 27 Chandell Acres Lot 27 Chandell Acres Drinking Water 0 All Dates/Times are Alaska Standard Time Printed Date/Time Collected Date/Time Received Date/Time Technical Director 08/15/2007 16:24 08/052007 13:00 08/06/2007 10:20 Stephen C. Ede Sample Remarks: Parameter Results PQL Units Method Allowable Prep Analysis Container ID Limits Date Date Init Metals by_ICP/M3 Arsenic Waters Department Total Nitrate/Nitrite-N Microbiology Laboratory ND 5.00 ug/L EP200.8 C (<10) 08/13/07 08/14/07 11/4111 08/09/07 JDS 1.81 0.100 mg/L SM20 4500NO3-F B (<10) Total Coliform 1 OB. No Coli col/100mL SM20 9222B A (<1) 08/06/07 SDP Municipality of Anchorage Development Services bepaiiment Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 wwW.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.,r%5l ea. -04 06 HAA# NAo2o/92 Expiration Date: 8/13/02. 1. GENERALINFORMATION . Complete legal description '•• Lor 2g-; C# -4A/De e- Ldcation (site address or directions) Z 3tt4V- (f-Aa�f DEur- biz-. LF+- 1.2 -6t 411 -- .. Orient Property owner(s) ?meet . O.W/D S"i in"I • Mailing address ': • ., Day phone 6-M- Lending agebcr Day phone Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. ,doe 23f>C.c—,z..S Day phone 338- I-8 e) 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System cgi 3 2 S— r(/ 3/0 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certifidtates 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 dale shown below, I verify that my Investigation, based on procedures outlined In the Health Authority 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) h compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm 5 ENG I N K -2.t QC -- Address /7-034 C--Address/7-034 /A/. erka.Le. iv'Ex.ta» Ira .y r Engineer's Printed Name 2Z3 T �. 4 isf-7.1 5. DSD SIGNATURE ?( Approved for Disapproved. Conditional approval for 3 bedrooms. Phone 6094 - 29'x-9 Date S/'i/a - .%� •. ▪ QS ., kI , It ii.6%/t.NGINErc4f9N.V111 ;del t,) t �7AM6'�1 lit 0 ` ROBERT C. COWAN I`!41 �eG"•/� CE •8801 4". ( Vl``• •.. r••.•..•• , ` a bedrooms, with the following stipulations: Additional Comments \,id\kof t<l7 Y OF/ G'•• .2 •• O•S 0= �W0�S1TE •:r R Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: Otzt4v 4.7t - (11.r, t:N01 ; W,ASTE AND 0E. WArn c • PROG TER • cr Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: .03/°2 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL. CHECKLIST Legal Description: 1/2r2'? CH-ftdDeLtir A«a A. WELL DATA Well type YTL t v47! If A, B, or C provide PWSID # Date completed ✓ Sanitary seal (Y/N)__Y_ Total depth%n • 4 ft. Cased to 40 +ft. FROM WELL LOG Date of test L SS Static water level I q% Well production 1 WATER SAMPLE RESULTS: Coliform Q colonies/100 ml. Date of sample: 5 / 1 /0 Z Parcel ID: C/ til CZ Well Log (Y/N) 7 Wires properly protected (Y/N) V a Casing height (above ground) 18 r in. AT INSPECTION 5/1/02 ft. /'� g ft. g.p.m. 4. 3 g.p.m. Nitrate 1U mg.A. Other bacteria V colonies/100 mi. Collected by: 5't 6.JG t v Cyt./ 'd er B. SEPTIC/HOLESH TANK DATA Tank Type/Material &' LPT ft, S Ttvc- Tank siie 1000 gal. Number of Compartments, ?r y Foundation cleanout (Y/N) Depression over tank (Y/N) N Date of pumping if U'f a 1/ Pumper C/)2 t S C. ABSORPTION FIELD DATA Date installed (, I i S f s S Cleanouts (Y/N) High water alarm (Y/N) 14 /n Date installed t: 1$IR( (g.p.d./112 rating (g.p.d.' ordm) 741 Length I O S I ft. Width 1.6 ft. Total depth 4 ft. Eff. absorption area IDSA ft' Monitoring tube Date of adequacy test S';/0L Results (Pass/FalirP 14 Fluid depth in absorption field bl►►((efore test ',,,Y,L in. Q Water added Elapsed Time: min. Final fluid depth 40 in. Absorption rate n 45U g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ,./Orate k. wow r/ If yes, give date System type / Meat //- Gravel tGravel beiow pipe 5 ft. 1 Depression over field For bedrooms gal. New depth 4 in. D. LIFT STATION Date installed `Pump on" level at / in. Datum tI A Size in gallons "Pump oW level at in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/M sl2g; on lot 1 00 -.- Absorption field on lot (00' + Public sewer main "4 /A /septic service line 1 & '4 Manhole/Access (YM) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent Tots in. , 00 ' - Public sewer manhole/deanout N/I" Holding tank A7 SEPARATION DISTANCES FROM SEPTIC/HGLt7(NG TANK ON LOT TO: 5 ' 4 Property line I0 it - Building foundation Water main /A Wells on adjacent Tots 100' Absorption field Water service line Surface water / 00 1 1 - SEPARATION SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I 0 1.4- Building foundation � I t — Water main Water Service s� Bine Or i Surface water I OQL ' . Driveway, parldng/vehicle storage / 0 It - Curtain d`Curtain dram 4Dkit YaiChi,J Wells on adjacent lots IO'.j" F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name g0 ©LR! C. C3414r0 Date rE OG AasommitC.��.hl .•711 t't+•y HAA Fee $ 3 7 S. • ° Date of Payment S` / `f l0 Receipt Number (Rev. 12/00) Waiver Fee $ \la% naleeregesess Date of Payment Receipt Number CT&E Refit Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Remarks: CT&E Environmental Services Inc. 1022303001 S & S Engineering Chandelle Arces Lot 27 Drinking Water 0 All Dates/Times are Alaska Standard Time Printed Date/rime 05/06/2002 12:33 Collected Date/Time 05/01/2002 14:10 Received Date/Time 05/02/2002 11:15 Technical Director StephetyC)J de Released By Parameter Results PQL Units Method Allowable Limits Prep Date Analysis Date Init Waters Department Nitrate -N Microbiology Laboratory Total Coliform 0.20013 0.200 mp/L EPA 300.0 (<10) 05/02/02 IDT 0 co1/100mL SM18922213 (<1) 05/02/02 SBII N 90°00'00.E 170.00' 28 4/30/02 A: DATE NOTES: Easement: plat are not shows provided by client. or builder, prior t< building grade relc connections, and I easements, coven< appear on the rec Elevations based c indicated, and bea LOT 27, CHANDELLE ACA PLAT NO. 79-190 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 HAA# ffi1cA Parcel I.D. # ne--) \ - nLo 1. GENERAL INFORMATION Complete legal description Lot 27; Chande e,e. Acnes Location (site address or directions) 23847 Chandette Dnive_ Property owner Mailing address Lending agency Mailing address Chug.iaiz, AK 99567 Bennand & Lonnaine. Knuegen Day phone 23847 Chandeile. D'4fve Chug-iak, AK 99567 688-2633 Seatte.v. Montgpge Day phone 562-5626 560 E. 34.th, Swi..e 100, Anchorage, AK 99503 Agent Lynn Ki e.e/ Tange t Reatty Day phone 694-2388 Address 17034 Fagfe Rive -n loop Eagle. Rivet, AK 99577 Unless otherwise requested, HAA will be held for pickup. 3 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXX NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer XXX NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 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. l 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 'I; 5 ENGINEERING '117.'34 Eagle River Loop Road No. 204 Address aivrr, Alaska 99577 Phone Engineer's signature Date 4 Ze - 9 6. DHHS SIGNATURE _CZ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By 44...cf. 44, N -"No+ el .111 *JO • sue ic4t! :o J. HAFER R .4f .^ 4t r o n ••fir(,, ng F,,, "44�,p•e o t p., •na • R� +IPP Additional Comments 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 lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lor 21 LA Parcel I D A. WELL DATAp Well type t'�‘,\I— If A, B, or C, attach ADEC letter. ADEC water system number Log present&N) Y Date completed e=6- Total S Total depth 2' o, �~ Sanitary seal &N) Date of test Static water level Well flow Pump level ‘( Driller JwAAIac-S. Cased to Zoo g`" Casing height Wires properly protectedOY N) FROM WELL LOG to -8S 11t:7t J�— gpm AT INSPECTION rn 8:2>+ p m ITI w SEPARATION DISTANCES FROM WELL TO: \ - Septic/holding tank on lot \ C> ; On adjacent lots \or oa Absorption field on lot \ \I''\ ; On adjacent lots \ (t) Public sewer main ill Public sewer manhole/cleanout kA, Sewer service line '?- Petroleum tank ZS + WATER SAMPLE RESULTS: Coliform CSI W\ A} S, Nitrate -15-93 Date of sample: D.'1D.c1 k44C1t Q • Other bacteria ►�o,J r B. SEPTIC/HOLDING TANK DATA Date installed S & S ENGINEERING Collected by• 1702 Fagle River Loop Road No. 204 Eagle River, Alaska 99577 Tank size \moo Compartments 2 CleanoutsYN) i Foundation cleanout,V#N) \ Depression (Ye High water alarm (Y0 Alarm tested (Y/N) Date of pumping 4 — \ 1 —" Pumper L SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: k-'• Well(s) on lot \ o D ` On adjacent lots \ o D Foundation � u, Ok SI o0 - To property line \. O Absorption field Water main/service line Surface water/drainage \ ov- 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N) "Pump on" level at .mp off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y SEPARAT STANCE FROM LIFT STATION TO: ell on lot D. ABSORPTION FIELD DATA Date installed - 1 s -55- On adjacent lots Surface water Soil rating 349 4iex- System type I Length \ 05' Width 30 Gravel thickness - Total depth Total absorption area Depression over field (Y, Results ail) P7 S Peroxide treatment (past 12 months) (Y Cleanouts presentrtyN) Date of adequacy test for 'r:e\e- - C3� i104 o s If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot k\-2,\ On adjacent lots To building foundation 20 4' "2;014- On adjacent lots Cutbank h" Water main/service line b Surface water ' ll° Driveway, parking/vehicle storage area Curtain drain 4- \c‘ -°l3 bed rooms Property line To xisting or abandoned system on lot fy- E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on thedate of this inspection. ` S & S ENGINEERING `` " OF • A.qs, ACT 17034 Eagle River Loop Road No. 204 CQ;•• ▪ •x%4 Signature Eagle River, Alaska 99577 �e49111 • •%1? (/, :M••00e800000••N•Neesi•• 0 0 Engineer's Name -20-ata Date • abe®ewwwee iM1li�•ee�e %11; ROGER J. S AFER :44,0 VI C ; No. 8215 J �/ s 4`1®AROFESS\D• �▪ P+®� HAA Fee $ 170. 2/--2- 9.3 ,Z1/6/6 (777.) Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee. $ Date of Payment Receipt Number 15: CTE EN1:! I RONMENTAL LAB SERI) I CES Ha 364 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & CNGINCCRING CO. �ATORY 5633 8 STREET ANCHORAGE, ALASKA 99519 TELEPHONE (967) 562.-2343 FAX: (907) 581.5301 Chealab Ref,t :93.1631-3 Client Sample ID :L27 CHANDELLE ACRES Matrix : WATER Client Name Ordered By Project Name Projects PWSTD :5 & 5 E$OJNEERING :R. SHAFER :UA Sample ROUTINE SAMPLE COLLECTED BY: RAY. Remarks: QC Parameter Results Qual, NITRATE -N REPORT of ANALYSIS Units Method 0.96 mq/1 EPA 353,2/300.0 Collected Received WORE Order Report Completed Technical Director Released Ey : Allowable Limits :04/15/93 f 15:00 hre :04/16/93 l 16:30 hrs :65056 :04/19/93 :STEPHEN,C. EDE Extract Analysis Date Date Init 10 04/19/93 LLN ' See Special Instructions Above • See Sample Remark' Above U • Undetected, Reported value is the prectirel quantification limit. D • Secondary dilution. UA - Unavailable NA - Not Analyzed LT - Leas Than GT - Greater Then 101211:2113 Member of the SGS Group (Societe Generale de Sur•.eillance) 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 Application Date 0 -ZS-" 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) r LoT 2.1 i�1,?1 Location (address or directions) 5g 3 -Bc4. It 0l04`vhl01' ba :tut e t.a,8ta k, K qq5 j (b) Applicant Name .BeR-tvd2d Kea:-ftli.k. Telephone: Home <ciCS -2(c3-3% Business 5amE. Applicant Address x I 10 $ �,/C h t aIC (c) Applicant is (check one): Lending Institution 0 ; Owner/builder ll; Buyer 0 ; Other 0 (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Telephone� I�tai+ (1) -the HAA to the following address: SRB 196X 435.6 P. 167/ 2. TYPE OF RESIDENCE Single -Family Lld/Multi-Family 0 Other Number of Bedrooms 3 bed, 1s 3. WATER SUPPLY—/ Individual Well Imo'" Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conserva attesting to the legality and status. SEWAGE DISPOSAL Onsite [52K Public 0 Community 0 Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conserva attesting to the legality and status. Page 1 of 2 12-025 5. ENGINEERING FIRM PROVIDIh.a INSPECTIONS, TESTS, FILE SEARCH, ph AA AND INFORMATION' 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 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. 1 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 Address Date Telephone 6. DHEP APPROV +A, Approved for V edro Approved Disapproved Terms of Conditional Approval CAUTION 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 lendti g.,,. k institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections 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 (11/84) MUNICIPALITY OF ANCHORAGE (MOAN HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: MUNICIPALITY OF ANCHORAGE. DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION A. WELL DATA ii 0 3 198 RECEIVED G � N Well Classification S�• If A, B, C, D.E.C. Approved (Y/N) it1/4 Well Log Present at'N) Total Depth 2va 0 Static Water Level Date Completed (O rte. Yield Cased to Za71 Depth of Grouting 1"7 a' Pump Set At C=sPhl Casing Height Above Ground "aa" Sanitary Seal on Casing ON) Electrical Wiring in Conduit 69N) Depression Around Wellhead (Y,(SP Separation Distances from Well: To Septic/Heidrrg• iTank on Lot v ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot Jp To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results It - ; On Adjoining Lots To Nearest Public Sewer Vanes a.p •1r To Nearest Sewer Service Line on Lot S4 6 e:rv15..«..)645:e2.4 ; Date tr3-28 -86'- Comments B. SEPT! C1(W61'TANK DATA Date Installed Lip. -15 -131S --Size \ 4.0‘› No. of Compartments 7. - Standpipes Standpipes CaN) Air -tight Caps4IPPN) Foundation Cleanout ON) Depression over Tank (WISP Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/I•41444g Tank: �o t To Water -Supply Well Ip n7/A 4 - To Property Line To Water Main/Service Course Comments Line .o Temporary Holding Tank Permit (Y/N) /^ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage S` Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design �xrW Date Installed ' iS $s- Length of Field t.0S Width of Field ~ Depth of Field CI I t Sltow J t c,ia�u LVL, A'3 i Square Feet of Absorption Area L,b5-4-1P Gravel Bed Thickness Standpipes Present(PN) Depression over Field (Ye) gate of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well IIS ' To Property Line l b To Building Foundation Zo .t To Existing or Abandoned System on i Lot n ; On Adjoining Lots 3a 4 To Water Main/Service Line 1.a t k To Cutbank (if present) "s J,s To Stream/Pond/Lake/or Major Drainage Course '' 61 l To Driveway, Parking Area, or Vehicle Storage Area SC) Comments D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at A Vent (Y/N) Tested for !� Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 8 & e SWIMMING Signed SRS 196X Date 8/sc)/8S an LE AMR, ALASKA '8957T Conk p y pit 694.29T$ MOA No ` DO.3 Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) 9-3-a5 WS ; No. 1457h r :• `, DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: PWS To Whom it May Concern: According to records on file in this office the Water Regulations 1 BILL SHEFFIELD, GOVERNOR Telephone: (9071 Address: 274-2533 Water System is in compliance -with the State Drinking ALASKA ei)UIROnFTCnTAL COfTROL S RUICCS, Inc Engineering & enuironmentol Studies February 16, 1982 !Nr. Robert F. Ort 125 W. Fireweed Anchorage, Alaska 99503 Dear Mr. Ort: MUNICIPALITY OF ANCHORAGE LNVI. n i3s RECEIVED We have drilled and performed percolation tests on lots 16, 20, 21, 23 and 26 of Chandelle Acres. In general, the soils are uniform throughout the subdivision, silts and silty gravels. Our test showed water at -9ft on lot 21 and at a distance of 150 ft from Chandelle Drive and 180 ft from the east lot line. We did not hit water on any other testhole. As lot 21 has a frontage of over 300 feet I would advise that sewer system be placed high on the lot, along the street and that the well be placed along the opposite lot line on the back (low part) of the lot. In my opinion this area will support a zero lot line homes (duplexes) if there is only one septic tank and one trench on each lot. There is adequate separation if the wells are grouped along adjacent lot lines. If you have any questions please let me know. Sincerely, Leroy C.•eid Jr.,PhD, -7 President S6] 1220 West 25th Auenue • Anchorage, Alaska 99503 • (907) 276-1361 7 APR -7 1982 . 4 MUNICIPALITY OF ANCHORAGE OF HEALTH & ENVIRONMENTAL PROTECTION HEALTH CASE REVIEW WORK SHEET • DEPARTMENT ENVIRONMENTAL El PLATTING BOARD ❑ PLANNING & ZONING CASE NUMBER S-6153 NAME Lots 21A - 26B Chandelle Acres Subdivision DATE RECEIVED February 24, 1982 COMMENT TO PLANNING BY March 26, 1982 FOR MEETING OF CASE OF ❑ PUBLIC WATER NOT AVAILABLE TO PETITION AREA ❑ PUBLIC SEWER NOT AVAILABLE TO PETITION AREA REVIEWER'S COMMENTS: Q(Jll&ea( 6153 - Lots 21A -26B, Chandelle Acres Subdivision Va liked .5 i ..1?,(A 40, a- Impart C -13c Agreements: MUNICIPALITY OF ANCHORAGE D'?T. VVIR ENP,ii=lair" V F lECEIVE�D \N y Points not addressed. 1. Is money set aside in escrow? (Septic system maintenance.) 2. Is liability to both owners if overflow occurs? . Who has the authority for repairs to be inst ituted? 4. Who has the authority for maintenance (order pumping,dispersement of funds?) 5. In the event of an upgrade of system required by seller of one side what is cost sharing responsibility of the other resident? 41 --S - 11 - �'Z-- (9L/6) PLO -LL - T!'"7 :9N11133NIDN3 1VIN3WN0HIAN3 .=q0171#1M_ 111 'V31:IV N011113d 33IAH3S 01 318V1IVAV ION 1:13M3S 3118 d r FT sase0 10 318V1IVAV ION H31VM O1l8nd :NOI±V11NVS 1VINRWNOHIAN3 :SIN3WWOO dO ONI133W HOd 6L61 'TZ ga3 J.8 DNINNVId 011N31/111/11O3 6L61 ' Z &zenzga3 03A1303831V0 NOISInla8f1938 NOIlb'OVA NOIld3OX3 IVI03dS DNINOZ38 HOd NO11113d uoTsTA pgns sazoV aTTapuugm do 8SOS-S 8381/11f1N 3SVO M3IA31j 3SV3 DNINOZ aNV DNINNVId !i0 DNIl1Vld NOII3310Hd 1V1N3INNOHIAN3 aNV HI1V3H 3O 1N3WIHVd3a buTuoz puts buTuuttld xansaM iCxxar :op mcIPIER 4sTTuToadS Ia;uatuuo1Teua uur2 'M ugor ' ATexaouTS 'OZLV-P9Z 472 aoT333 BPI; ;ZE;uoo aseald 'suoT;aanb xaq.xn; Au8 eav axat ;I •putt oTlnuxpXtt buTpTnoxd i q A4Tsuap sTgl q;Tt sTTos 30 A;TITqudso uoT;dxosqu sqq dTeu IITA ;doouoo sTtty •sa;rax uoT;e1ooxed mots tt;Ttn ego' auq uT gouax; uoT;dxosgv deep u s€ paufTsep eq uaxg goual apt; spuai ooax pup '6I puv 0T sgo'I uo s;sa; uoT;ulooxad putt stTos ;senbax ;uaur;xsdap sTgL 'J4Fsuap ;oT xad saxo8 +- ssoxb TpZ'T 144Tm sa;vx uoTaalooxad FIS ;o pap ;sa; (5) eAT; art; 3o (z) ots; uo sgseq uoT;nnooaed pup s-Tos ago spu'F; pup 'Peggp:qns sv uoTsTATPq'ns ;oocgns ag; pemaTaax surf 4uam4avdop sTuj, stt;ieW •O.'I saw Z uoT;ue44v uo;sTnTpgrs soapy eTTapuvt3 xoT NaTAOH uoT4vTooxad pup SIToS s;oecgnS T0S66 uxsslV 'abuxogou, T e;TnS '49924S H OOL sxaauTbu3 buT;Insuo3 uvoTaomv ue,j 6L61 'ST Aaveugr AMENDMENT NO. 2 TO PROTECTIVE COVENANTS, CONDITIONS AND RESTRICTIONS FOR CHANDELLE ACRES Whereas BLUE MAX DEVELOPMENT CORPORATION, an Alaskan corporation, executed those certain Protective Covenants, Conditions and Restrictions for Chandelle Acres, dated November 15, 1979 and recorded in the office of the Anchorage Recording District, Third Judicial District, State of Alaska, in Volume 453, pages 0580 through 0593, inclusive, and whereas these Protective Covenants, Conditions and Restrictions were amended on the 16th day of January, 1981, and recorded January , 1981, in the Office of the Anchorage Recording District, Third Judicial District, State of Alaska, Volume , pages through inclusive, and Whereas Blue Max Development Corporation desires to further amend said Protective Covenants, Conditions and Restrictions for Chandelle Acres to assure the continued development of Chandelle Acres, NOW, THEREFORE Blue Max Development Corporation hereby amends those certain Protective Covenants, Conditions and Restrictions for Chandelle Acres to read as follows: PART C. RESIDENTIAL/RECREATIONAL AREA COVENANTS. C -la. LAND USE AND BUILDING TYPE. Lots 21 through 26, inclusive, are being re -platted and re -designated 21a and 21b, 22a and 22b, 23a and 23b, 24a and 24b, 25a and 25b, 26a and 26b for the specific purpose of permitting the construction of "Zero Lot Line", two-family dwellings on each of the aforementioned lots as previously designated, with their sale as two individual units in each building. C-2. DWELLING COST, QUALITY AND SIZE. No "Zero Lot Line" structure shall be permitted that provides less than 1200 square feet of living space for each family unit. Additionally each unit shall provide an enclosed garage•. Each individual living unit shall have a maximum of 2 bedrooms. Architecture for the "Zero Lot Line" units shall be of distinctive architecture, acceptable to the Architectural Control Committee. Each individual family unit shall have a minimum appraised value of $110,000 including land and improvements. C -4a. Lots 21a and b, 22a and b, 23a and b, 24a and b, 25a and b, and 26a and b may build up to the interior lot line between the "a" and "b" lot, adjoining the two structures as a two family structure. All other setback requirements shall apply. C-13. WATER AND SEWAGE. Developers shall provide on-site water and sewage as indicated below. C -13a. WATER. Class C public water systems serving two or more households in strict conformance with Alaska Statute, TITLE 18, CHAPTER 80, Drinking Water. C -13b. SEWAGE. Single on-site sewage systems shall be installed for each "Zero Lot Line" structure serving both dwellings in strict conformance with Tite 18, Chapter 80, of the Alaska Statutes and guidance provided by the Department of Environmental Quality, Municipality of Anchorage. Separation standards outlined in Table A, Title 18, Chapter 80. A.S., shall be strictly adhered to. Septic tanks shall be a minimum size of 2000 U.S. gallons. Leaching fields will be so located as to provide for an alternate field on the property in the event of a later failure. Leaching areas may overlap both lots serving an individual building or be located entirely on one lot provided all separation standards are met. C -13c. AGREEMENTS. Builders shall provide apppropri agreements between the several parties utilizing common facilities which shall provide adequately for maintenance, or replacement if necessary, of wells, sewage systems, party walls, beneficial easements, and any other common facilities. The agreements of necessity will require pre -coordination with the appropriate lending institution for the lender. This agreement will be acknowledged by the appropriate buyers and recorded. As a minimum, the agreements will address and affix responsibilities and procedures as follows: a. Establish monthly escrow deposits from each party to adequately provide for septic and well maintenance. Such escrows should be adequate to completely replace a septic system within a six-year period. Once the escrow account reaches that level, it can be adjusted as necessary. b. Specifically establish equal, mutual responsibility to both owners in the event septic overflow occurs. c. Specifically establish authority to the senior owner, by virtue of date of recorded purchase, to institute repairs, pumping, or replacement. Such authority shall specifically provide authority to disperse funds from the escrow account for such repairs or replacement, as well as assess the appropriate owners as may be required, in the event escrow accounts should prove inadequate to meet specific requirements. d. In the event upgrade of a system, either well or septic, is required through normal usage, the cost sharing responsibility shall be equal except in the event upgrading is necessitated as a result of a pending sale of interest by one or the other party's desire to sell his interest in the property. In such event, the party selling his property shall be required to contribute one-third of the total upgrading cost to the escrow fund with the remainder of the upgrading costs being shared equally by both parties. PART D. AIRFIELD OPERATIONS. D -3a. Owners of "Zero Lot Line" units on lots 21 through 26a shall have full use of the airstrip at Chandelle Acres. If they own an aircraft, they may be assigned a "tie -down" spot on Tract B on an "as available" basis. In such case, they will be charged a tie -down charge of $10.00 per month in addition to their normal homeowner's fee. This tie -down fee will be payable to the Chandelle Acrs Homeowner's Association. All other terms and conditions of the Protective Covenants, Conditions and Restrictions for Chandelle Acres as recorded on November 15, 1979, in Volume 453, Pages 0580 through 1593, inclusive, and as amended on January 16, 1981, in Volume , Pages , through , shall remain in full force and effect. Dated this day of , 1982. BLUE MAX DEVELOPMENT CORPORATION BY BY Claude G. Rick, President Russel A. Carter Secretary/Treasurer