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HomeMy WebLinkAboutUS SURVEY 3042 LT 100 E2S2Onsite File US Survey 3042 Lot 100 E2S2 #075-093-09 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 221281 PID Number: 075-093-09 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name Jacob Ohms ABSORPTION FIELD ❑ Deep Trench A Wide Trench ❑ Bed ❑ Mound Site Address PO BOX 425, Girdwood, AK 99587 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)748-6294 4 5.0 GPD/SF 6.2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.2 Ft. Gravel depth beneath pipe 3.0* Ft. Subdivision Block Lot US Survey 3042 LT 100 E2S2 Fill added above original grade 1.3 Ft. Gravel length 22 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches 1 Dist. between trenches From Tank Field Tank Line 174 Ft2 n/a Ft. Well >100' >1 00' N/A N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding M Other Manufacturer Orenco/Advantex Capacity 1500 Gal. Surface Water >100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' 0' > 1 0' N/A N/A LIFT STATION Manufacturer Orenco Capacity - Gal. Remarks *Gravel depth confirmed during installation. Final measurements revealed MT's had been knocked up Alarm location Inside garage Electrical installed by Sims Electric LLC or filled by several inches. Refer to profile Installer PIPE MATERIAL House to tank D3034Tank to D3034 drainfield Spartan Earthworks Drainfield D3034 CO/MTD3034 Inspector L. Tidwell / B. Schiller BENCH MARK (Assumed elevation) 100 ft Inspeection 151 11/22/22 1/25/23 Location and description 2�a Bottom of siding @ SW Corner 3'' 4w ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp oo®\� �1_zOF Conditional Approval: Date ' ' ' • . S,fil� ,W��Q'• ...... Benjar0 r Schiller �� �'c<�,•, CE 12592 • �``��� Septic System Approved / Date�?' Z8 s1F • , 3/20/23 , •'�C�,� PROFESSIONP Note: this approval,k� do not include well permit requirements. \�® ®®�1d (Rev uoiufiiti) Benjamin Schiller CE 12592R E GISTEREDPROFE S S I O N A LENGINEER1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT VV - VAULT VENT MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND CO2 TH#1 PERMIT # OSP 221281 PID # 075-093-09 US SURVEY 3042, LOT 100 EAST 1/2 SOUTH 1/2 A B MH 17.4 VV 19.1 2CO 18.9 A B C C 58.1CO1 56.4MT1 56.8 65.0 63.8 73.9 MT2 58.3 74.7 31.8 37.2 43.3 FEET 0 50 100 HO T T E N T O T M I N E R O A D 4-BDRM H O M E 3/20/2023 EXISTING WELL w/ 50' RADIUS NEW WELL EXISTING WELL w/ 100' RADIUS 22' LONG x 5' WIDE, 3' EFFECTIVE DEPTH ABSORPTION TRENCH CO1 MT1 2CO FCO 1500 GAL ADVANTEX FAP TANK NEIGHBORING SEPTIC AREA APPROX OUTHOUSE LOCATION, PRIOR TO DRILLING WELL VERIFY 100' SEPARATION PLAN AS-BUILT CO2 MHVV MT2 FCO 20.58.5 100' RADIUS 50' RADIUS PROFILE AS-BUILT (NO SCALE) 97.7FCO MH88.8 FINISH GRADE 22' DRAINFIELD ROCKMT TH#1NO GROUNDWATER 7/15/22 81.6 84.3 COCO76.5 81.6 84.3 87.5 ORIGINAL GRADE MT2COBenjamin Schiller CE 12592 R E GISTEREDPROFES S I O N A LENGINEER1500 GAL ADVANTEX FAP 2.0 TANK AX-20 FILTER POD PERMIT # OSP 221281 PID # 075-093-09 US SURVEY 3042, LOT 100 EAST 1/2 SOUTH 1/2 3/8/2023 81.3 93.8 88.7 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Well Log Permit Number: #__________ Date of Issue: ________ Parcel Identification Number: __________________ Date Started: _________ Date Completed: _________ Is well located at approved permit location? Yes No Legal Description:_________________________________________________________________________ Property Owner Name & Address: _______________________________________ _______________________________________ _______________________________________ Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Method of Drilling air rotary cable tool Casing type: _________ Wall Thickness: inches Diameter: inches Depth: feet Liner Type: _________ Diameter: inches Depth: feet Casing stickup above ground: feet Static water level (from ground level): feet Pumping level: feet after hours pumping gpm Recovery Rate: gpm Method of Testing: _________ Well Intake Opening Type: Open End Open Hole Screened Start feet Stopped feet Perforations Start feet Stopped feet Grout Type: _________ Volume: _________ Depth: _________ Start feet Stopped feet Well Disinfected Upon Completion? Yes No Method of Disinfection: Comments: Well Driller: _____________________________ Company: _____________________________ Mailing Address: _____________________________ Water Sample Results: Arsenic: _________ ug/L Nitrates: _________ mg/L Total Coliform Bacteria:_________ colonies/100mL Attention: The well driller shall provide a well log to the On-site Water and Wastewater Section within 30 days of completion. Development Services Department Building Safety Division • On -Site Water & Wastewater Program o ' a 4700 Elmore Road Z. P.O. Box 196650 s S A F E T Y MarkBegich Anchorage, AK 99507 Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: Date of Issue: 9- 3 -2a Parcel Identification Number: Legal Description A- �5 S��v ��K�, l a uv 2,S)'- ,S Property Owner Name & Address: -6U0b Pump Pump Installation Date: Ll _ LA _ Pump Intake Depth Below Top of Well Casing: Ila feet Pump Manufacturer's Name: f= 'P S Pump Model: 1 u G f v -n 1OV, -2 w. Pump Size P/�, hp Pitless Adapter Burial Depth: a feet Pitless Adapter Manufacturer's Name: Ce hnlp�l "�0 Pitless Adapter Installer: N Well Disinfected Upon Completion? EyYes ❑ No Method of Disinfection: I+ 4 �/� Comments: Pump Installer Name: Johnny Kay Hefty Drilling, Inc. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. W} of Lot 100 TREATMENT POD PIPES / EJ of NJ of Lot 100 F of lot S ?g 7'3885 SOQ / F SEPTIC--,, PIP MANHOLE Of n 2 N 'Y S Y cE s.o. 32 2' n o gAICONy - ?� 1 23 \ PORCPORC Lot C WELL I� Sp. \ pR0 rF�r f I Rqa LS Z HoTTF19To �\ T M�NF R0. Ina:. NOTE: DUE TO SNOW & ICE COVER, SOME SURFACE LEVEL FEATURES ARE APPROXIMATE. PLOT PLAN ___ AS BUILT _X SCALE __1___4a__ GRID _ SE 4912Project No. ____23_0811A1--__ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone kenOlongsurvey.com �? ` Professional Land Surveyors jonothanOlangsurvey.com �OF•At,9 it fravisOlangsurvey.com ANW, t t,. I hereby certify that I have surveyed the following described property: E} of S1 of LOT 100, US SURVEY 3042 Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. �'t' Dated this the ? ___ Day of _ L1 ��� _______I _`_ _ J , at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. *.449TH *� g KENNETH G. LANG F 1 F9Fa �' I� z AW 3. s� lt,`ROEESSZN';� State of Alaska AECC963 h ai 7 / EJ of NJ of Lot 100 F of lot S ?g 7'3885 SOQ / F SEPTIC--,, PIP MANHOLE Of n 2 N 'Y S Y cE s.o. 32 2' n o gAICONy - ?� 1 23 \ PORCPORC Lot C WELL I� Sp. \ pR0 rF�r f I Rqa LS Z HoTTF19To �\ T M�NF R0. Ina:. NOTE: DUE TO SNOW & ICE COVER, SOME SURFACE LEVEL FEATURES ARE APPROXIMATE. PLOT PLAN ___ AS BUILT _X SCALE __1___4a__ GRID _ SE 4912Project No. ____23_0811A1--__ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone kenOlongsurvey.com �? ` Professional Land Surveyors jonothanOlangsurvey.com �OF•At,9 it fravisOlangsurvey.com ANW, t t,. I hereby certify that I have surveyed the following described property: E} of S1 of LOT 100, US SURVEY 3042 Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. �'t' Dated this the ? ___ Day of _ L1 ��� _______I _`_ _ J , at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. *.449TH *� g KENNETH G. LANG F 1 F9Fa �' I� z AW 3. s� lt,`ROEESSZN';� State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP221281 Work Type: WellSeptic Initial Tax Code Number: 07509309000 Site Legal Address: US SURVEY 3042 LT 100 E2S2 G:4912 Site Mailing Address: 278 HOTTENTOT MINE RD, Girdwood Owner: OHMS JACOB Design Engineer: FORGE ENGINEERING This permit -is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: trent rNo%� S v Department 8/3/2022 8/3/2023 13860 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction shall be in accordance with: I. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing C V _4c) C a V1q a +0 �YLIGIn 1 X � 1/i �"Bvn , 12./ 2. ZZ-- .J ( I Veronica Pope GE 2022.08.03 Received'By: 21:34:04 -05'00' Issued By: Date: Date: g/ 2Z 4 December 21, 2022 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: US Survey 3042 L100 E2S2 - 278 Hottentot Mine Rd Septic system design Dear On -Site Services Engineer: The owner of the above lot intends to build a 4 -bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes mildly under 20% to the southwest. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Elevations are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new category II system will be a minimum of 50' from all wells and surface water, and more than 5' away from the septic tank. The alternate site is located more than 6' away. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE US SURVEY 3042, LOT 100 EAST 1/2 SOUTH 1/21 Co -?Ft NEIGHBORING SEPTIC AREA / I EXISTING WELL // ® APPROX PRIOR SE W/ 100' RADIUS –�� LOCATION, TO DRILLING W L VERIFY 100' / SEPARATION/ _/- LOT 1WE2N2 / (PUBLIC SEWERS LOT WEST 1/2 FAIRFIELD LOT C ,PROPOSED WELL W/,50',& 100' RADIUS /\ \ �L y� 'LOT 100 -282 105 � / FCO EXJSTING WELL / • • 4 -BID H �' / w/ 50' RADIUS / 2C TH#1 Co ` I / � FAIRFIELD LOT B / (�PBLIC SEWER) � � J T�\ / / 1530 -GAL QUANICS / CAT II SYSTEM / MAINTAIN 10' FROM / FOUNDATION TION / NS -500 -AC AEROCELII POD / 24' LONG x 5' WIRE, 3' / EFFECTIVE DEPTH ABSORPTION TREE CH / MAINTAIN 5' I,FFTM PROPERTY LINE & TA K / 95 CO ALTERNATE SITE — / M \ , �/ , \ "�-eNGINel0.1NG NOTES NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 50' OF THE PROPOSED SEPTIC SYSTEM TH•• *+�� ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS • • • • • PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC . ........... .. SYSTEMS. Benja i Schiller 0 50 100 �F••, CE 2592 • �/ 6,' 17/2,112022,.�jFEET 1`�` ROFESSIONP�� 111=50' LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE US SURVEY 3042, LOT 100 EAST 1/2 SOUTH 1/2 DESIGN FACTORS: 600 GPD PEAK FLOW PERK RATE: 15 MIN/IN APPLICATION RATE: 3.0 GPD/SF SYSTEM REQUIREMENTS: SHALLOW 5 -WIDE TRENCH SYSTEM 1530 -GAL QUANICS CAT II SYSTEM 600 GPD / 3.0 GPD/SF /5' WIDE * 0.58 RED FACTOR (3' EFF DEPTH) = 23.3 LF TRENCH REQUIRED (24 LF SPECIFIED) BOTTOM OF TRENCH: 6-6" BELOW GRADE FLOW LINE ELEVATION: 4'-6" BELOW GRADE TOP OF TRENCH: 6" ABOVE GRADE 5' TYPICAL TRENCH SECTION (NO SCALE) EOTEXTILE FABRIC 'PERFORATED PVC TOLES DOWN) RAINFIELD ROCK NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY LEM of Aj­ . • ' • . Benja. in SchillerCE .......... ' Dec 212 092 ' •���� llij`o PROFESSIONP��.�'r MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 075-093-09 Property owner(s) Jacob Ohms Day phone 907-748-6294 Mailing address PO BOX 425, GIRDWOOD, AK 99587 Site address 278 Hottentot Mine Rd Legal description (Sub's., Block & Lot) US SURVEY 3042 LT 100 E2S2 Legal description (Township, Range & Section) Lot Size 13,860 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X Septic Tank 0Upgrade ❑ (w/wo AD U) (D) ❑ Holding Tank El Renewal Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 1� ��� Waiver Fees: Date of Payment: D I'll 11092 Date of Payment: Receipt Number: 065 5 1 D Receipt Number: Permit No. OS �'� 1 a R 1 Waiver No. Permit App_::- : .'-.,:c: LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 15 7/15/22 1 2 3 GP/GW (COARSE SANDY GRAVEL) Professional Engineers Stamp: no US Survey 3042 L100 E2S2 7/8/2022 075-093-09 Jacob Ohms 2:201 2 3 4 0 16 2:51 3:22 OB 30 Benjamin Schiller CE 12592R EGISTEREDPROFE S S I O N ALENGINEERMay 5, 2021 PERC TEST LOCATION TECHNICIAN: J. Millette 6 4 16 NONE 7/15/22 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN 2 4 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 4 0 1630 6 0 16 2 0 16 4 0 1630 6 0 16 2 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221281, Deb Wockenfuss, 08/03/22 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT T13IS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and �a q entered into as of this •• 'IDay of j0\ of 20,),1, by and between J0.£v 6 U 1'✓) , herein the "ONYNNER," and the Municipality of Anchorage, herein the "MUNNKCIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced vVastewater Treatment System (AWWTS), described as Advantex Waste Water Treatment System located at (legal description) US Survey 3042 L100 EAST 1/2 SOUTH 1/2 2. Maintenance, Repairs and Alterations. (Oxvner is required to read, understand and initial each section) Jb Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWIVTS shall be maintained in a satisfactory condition capable of performing as designed and producing,treated septic effluent in accordance with the equipment's approval for operation in. the Municipality. J© It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or`the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. JD Owner acknowledges that regular maintenance of an AWRV'I'S reduces the potential failure of the system, which could include sewage backup and costly repairs ter drainfreld replacement. (rev. 05/18/2018) Page 1 of 3 Ja Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new D Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. 1onwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Lase. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The Iaws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Wage 2 of, 3 OWNER: By: � S _(signature) Date: -71(q Jcup 066) (print name) STATE OF ALASKA ) ----- ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was achowledged before me this IC( day of 202=2=, by A CA4v O VlUrAR'' PYJ I FOR ALASKA Ste o fAlwka My Conunission expires: O f o zi NOTARY PUBLIC Bessie O,Ryan Carpio Mjp 2 MUNICIPALITY: (signature) (print name) (rev. 05/18/2018) Date: U Z zZ Title: Page 3 of 3 MMMUPA UTY OF AHC HO AGE Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 075-093-09 Complete legal description US Survey 3042 Lot 100 E2S2 Location (site address) 278 Hottentot Mine Rd, Girdwood, AK 99587 Current property owner(s) Last Frontier Contracting, LLC Day phone (907) 748-6294 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age < 1 yr - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS [-]Bed ❑ Deep Trench ®❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: BN Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ ' 2 0 Waiver Fee $ Date of Payment /Z I ,Z- 3 Date of Payment COSA # 0 �c -2,3110 Waiver # COSA Application—June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department :sem Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 075-093-09 Expiration Date: Legal description US SURVEY 3042 LT 100 E2S2 Site address 278 HOTTENTOT MINE RD Current property owner(s) LAST FRONTIER CONTRACTING LLC 7/28/23 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By:. Original Certificate Date: 4/28/23 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory X Other COSA ApprovMjune 2022 US Survey 3042 Lot 100 E2S2 075-093-09 30 10/26/22 138 138 24 13.1 10/26/22 Hefty Drilling 59 4/4/23 & 4/24/23 N/A N/A 1/25/23 7.2 4.5 N/A N/A N/A New Construction > System is a Cat III Advanced Treatment System with a reduced separation distance to wells and surface water (907) 522-7773 Benjamin Schiller, P.E.4/26/23 Arsenic Advisory Certificate of On -Site Systems Approval # OSC231104 Subdivision: US Survey 3042, Block: , Lot: 100 E2S2 A water sample revealed an arsenic concentration of 13.1 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box196650 * Anchorage, Alaska�99S19 6650 *www muni org