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PARADISE VALLEY BLK 5 LT 12
PARADISE VALLEY Block 5 Lot 12 #020-412-06 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 1 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231293 PID Number: 020-412-06 Dwelling: N Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: X New ❑ Upgrade Name TI BUILDING GROUP ABSORPTION FIELD Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address ❑ Other Phone FNumber of Bedrooms Soil Rating Total depth from original grade 1.2 GPDlSF 6.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.5 Ft. Gravel depth beneath pipe 5.5 Ft. Subdivision Block Lot PARADISE VALLEY BLK 5 LT 12 Fill added above original grade 2.5 Ft. Gravel length 46 Ft. Township Range Section Gravel width 2.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 506 Ftz Ft. Well 1 00'+ 100'+ 50'+ TANK X Septic ® S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity GREER/ANCH TANK. 1500 Gal. Surface water 100'+ 100'+ Material Number of compartments Lot Line 10'+ 1 0'+ NA PLASTIC 2 Foundation 101+ 101+ LIFT STATION Manufacturer Capacity Remarks GREER/ANCH TANK 1500 Gal. Alarm location NE CORNER Electrical installed by BRICKS ELECT. Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield MIKE N ANDERSON PE Drainfield 3034 CO/MT3034 Inspector MIKE N ANDERSON PE BENCH MARK (Assumed elevation) 103 ft Ins dates: ction 1sf 10/19/23 2"tl 10/23/23 Location and description 3'" 41h TOP OF EAST MH LID ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date r1it �......• . . MICHAEE N. A\DERSGN ca ` Septic System I , n / / Approved / `� Date 3/ - 44 9 :. Note: this approval does not include well permit requirements. ��� RF; FS��`•'`� kf uv uJ/uz/ 10) Permit No. OSP231293 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 Description: PARADISE VALLEY BILK 5 LT 12 MARK A B C01 13 45 TCO2 20 47 M T1 28 55 MT2 63 31 /I \ I/ l \ I \ I SEPTIC \ — 1 SEPTIC I _ TCa T1 I \ J • STEW 11 00 GALLON PLASTIC --,DMT2 / \ / \ CO \/ \ / B \ `\ BENb , TOR OF MH kLL \ \ 1 WELL SEPTIC � I l I WELL — _j / WELL/ � \\ \\ ASBUILT 1 �� — / \\ \\ SC 1"=501� PID No.: 020-412-06 SEPTIC SECTION DRY ® OCT 2023 N.T.S. �. �OFq 49 TH MICHAEL N. ANDERSON- ' No. CE 9469 1��� ,4-10-24 .•'' •• 46 ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: PARADISE VALLEY SUBDIVISION" O = FND 5/8" RE13AR. LOT 12 BLOCK 5 PLAT 01-16 ..�,�,� � � A N SURVEY CERTIFICATE, I, John L. Schuller, Have conducted a �' O F , .j� j y�, ' L D physical survey of this property as shown on this drawing and that the / �; improvements situated hereon are within the property lines and no �,.. • , �,,� �" enchroachments exist other than noted. Under no circumstance should % �•.' 4 9TH '• � � =-` any information on this drawing be used for construction of fences, 'Q` , ; , , , , , , , , , , , , , .... ...:.... �oj structures, improvements, or for establishing boundary lines. / : EXCLUSION NOTES: It is the owners responsibility to determine '�ci ' ' ' ' ' • ' ` ' ' ' ' ' ` • ` ` ` ` ` ` ` • •� CD •.JfIN L. SCHULLER.: the existence of any easements, covenants, or restrictionswhich �, • / 01 do not appear on the recorded subdivision lat. J�� �� LS-10408 • .• �; �,..,�..,,,,• pp p �r ' • , . ' ���/ 1831 Talkeetna Street WORK ORDER NUMBER: DATE: SCALE. „ , E-MAIL- � 0V ' '4 �. � �� � ,ter j nchorage, Alaska 99508 APRIL 9, 2024 1 =30 schu!lerck®gmail.c:am Ar 0 •A■/ 907 227—"1455 office DRAW Y. CHECKED BY GRID NUMBER: BOOK AGE: `` O f e $ n ck � �4--004 DRA B kx, s!o ��•.• (907) 274--4992 fax JLS SW3538 24013t� 0����►. 417i, 6 . , Development Services Department On -Site Water & Wastewater Section Pump Installation Log Well Drilling Permit Number: V')2 3 1,zq 3 Parcel Identification Number: Legal Description ?aro d;hc. VA 1tq 3W Pump Installation Date: Phone:907-343-7904 Fax:907-343-7997 Date of Issue: 6 Z - (37 - Z 3 Block Lot Property Owner Name & Address: ✓,L 5 I1- -C 1 g ld Gove Pump Intake Depth Below Top of Well Casing: 300 feet Pump Manufacturer's Name: ' l2 -y' e rc) Pump Model: �(� '� � �/ li • 2w Pump Size: �_hp Pitless Adapter Burial Depth: /0 feet Pitless Adapter Manufacturer's Name: C Ck.Vn j 1 1�,-1 0 Pitless Adapter Installer: `vf Well Disinfected Upon Completion? � Yes ❑ No Method of Disinfection: 10V I � C Comments: Pump Installer Name: !/l I � -t Company: ReL: por; 1 1c I VAC. Mailing Address: ��% IJJii I12,l30 State: Attention: The pump installer shall provide a pump installation log to On -site within 30 days of pump installation. d�dUV,,11U AU E ` OF ANCHOL AC Develo went Ser vices rvices Department „yi Phones 0 343 7904 On -Site Water & Wastewater Seciio Fax: 907-343 7997 Well Log Permit Number: # 231293 Date of Issue: 9-7-23 Parcel Identification Number: v 2 D °{ t 2 — 0 (p Date Started: 9-20-23 Date Completed: 9-22-23 Is well located at approved permit location? Yes © No ❑ Legal Description: Paradise Valley block Slot 12 G: 3538 Property Owner Name & Address: Taras Ilnitski Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To casing stick up 0 2 silty sand & gravel 2 54 boulder 54 56 silty sand & gravel 56 78 wet sand & gravel 78 85 clay (grey), sand & gravel 85 105 clay (grey) w/ gravel 105 130 wet clay (grey) w/ gravel 130 147 bedrock (hard) 147 400 LA-P 61.055389 LON:-149.762791 Water Sample Results: Arsenio: — ug/L Nitrates: __ mglL Total Coliform Bacteria: colonies/100mL Method of Drilling H air rotary ❑ cable tool Casing type: steel Wall Thickness:.250 inches Diameter 6 inches Depth: 147 feet Liner Type: Diameter: _inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 176 feet Pumping level: --feet after _hours pumping wpm Recovery Rate: !--Vm Method of Testing: airlift ❑ Open End Open Hole ❑ Screened Start 147 feet Stopped 400 feet ❑ Perforations Start _feet Stopped ___feet 20' Start 0 feet Stopped 20 Well Disinfected Upon Completion? QYes No Method of Disinfection: tabs Comments: Well Driller: "My Kay Company: Hefty Drilling, Inc. Mailing Address: po box 112130 Anc AK 99511 Attention: The well driller shall provide a well log to the On -site Water and Wastewater Section within 30 days of completion. 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 hftp://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP231293 Work Type: WellSeptic Initial Tax Code Number: 02041206000 Site Legal Address: PARADISE VALLEY BLK 5 LT 12 G:3538 Site Mailing Address: 18161 Norway DR, Anchorage Owner: ILNITSKI BOGDAN & VESNA Design Engineer: ANDERSON ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnr o� �S, o Department 9/7/2023 9/6/2024 17897 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: The mound over the trench is to have a 3:1 slope and have topsoil and be seeded. `Rssetved-By: � S Sc,�P �o �%t/Date: Issued By: Date: 4 h GE _ p ��� Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 020-412-06 Property owner(s) TI Building Group Mailing address 1120 HUFFMAN RD STE 24-797 ANCH AK Site address 18161 NORWAY DR Day phone Legal description (Sub'd., Block & Lot) PARADISE VALLEY BLK 5 LT 12 Legal description (Township, Range & Section) Lot Size 17897 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial 0 Single Family (SF) El Septic Tank 0 Upgrade ❑ (w/wo ADU) Holding Tank ElRenewal ElDuplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well 0 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: / 3 11 2— Waiver Fees: Date of Payment: /� 2� Z 3 Date of Payment: Receipt Number: (7 0 09 `"l Receipt Number: Permit No. QSP2 312cf :�2 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Oct. 15, 2023 Municipality of Anchorage Development Services Dept. On-Site Water & Wastewater Section Anchorage, Alaska 99519 Phone 343-7904 Re: Septic and well permit Legal: PARADISE VALLEY BLK 5 LT 12 To Whom it may concern: This is a request for a septic and well permit on the above referenced lot. Two tests holes were excavated and found silty gravel GM for the entire 12 foot depth. The perc rate was 3 minutes per inch for both test holes. Bedrock was discovered at the 12 foot level and no water during or after the 7-day monitoring period. The system has been revised with this new data. Additional fill has been added to the field which will not impact the drainage easement, see site plan. The slope at the leach field area is flat and has been field verified. On the west side its 5 to 10 percent with no cut banks or open water within 100 feet. This new septic and well design will not impact any of the surrounding properties. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSX231010, Deb Wockenfuss, 10/19/23 CO #2 SEPTIC FIELD SECTION DESIGN CRITERIA: 5.5' EFFECTIVE 4 BDRM X 150 = 600 GPD SOILS = 600/1.2 = 500 GPD 500 GA/11 = 46' 2.0' WIDE 46' LONG (1) TRENCH 6.0' DEEP 2. 0 ' 2.0' -6.0 -0.5 TOPSOIL & SEED FILTER FABRIC SEWER ROCK 3,3( GRADE 1"=200' PROPERTY LINE PROPOSED HOUSE PROPOSED DRAINAGE FIELD SCALE: DJRDRAWN: DATE: PARADISE VALLEY BLK 5 LT 12 Anchorage, Alaska TI Building Group 9/1/2023 -NOR W A Y DR- PROPOSED WELL & INSULATION +2/(6# Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSX231010, Deb Wockenfuss, 10/19/23 CO #1 1"=50' PROPOSED HOUSE PROPOSED WELL 100' RADIUS NEW 1,500 GALLON PLASTIC STEP SEPTIC TANK, SURVEY ALL EASEMENTS & WELL RADIUS SCALE: DJRDRAWN: DATE: PARADISE VALLEY BLK 5 LT 12 Anchorage, Alaska TI Building Group 9/1/2023 D R I V E W A Y 5-10% 5 -10% WELL SEPTIC, GM SOILS, PERC 7 MIN/ INCH SEPTIC, SP SOILS, PERC 1.9 MIN/ INCH SEPTIC, GP SOILS, PERC 2.3 MIN/ INCH CO CO FL A T NO SLO P E WELL WELL WELL WELL WELL SECONDARY FIELD, APPLICATION RATE 3 GPD/SF, 2'X5'X20' TH#1 TH#2 10' DRAINAGE EASEMENT ADDITION 2' OF COVER LIMITS OVER THE FIELD MAINTAIN 10' TANK TO HOUSE AND 5' FROM TANK TO FIELD Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSX231010, Deb Wockenfuss, 10/19/23 CO #1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSX231010, Deb Wockenfuss, 10/19/23 CO #1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSX231010, Deb Wockenfuss, 10/19/23 CO #1 MUNICIPALITY OF ANCHORAGE © Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-412-06 Legal description PARADISE VALLEY BLK 5 LT 12 Site address 18161 NORWAY DR Anchorage AK Current property owner(s) TI BUILDING GROUP LLC Expiration Date: 01 2 3 2p 2 y X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: C By: Original Certificate Date: 5/3/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approval —June 2022 Development Services Department On -Site Water & Wastewater Section /� R PHCHOR OE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-412-06 Complete legal description PARADISE VALLEY BLK 5 LT 12 Location (site address) 18161 NORWAY DR. ANCH AK Current property owner(s) ILNITSKI 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS .Day phone 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: N AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: FIE] 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 $ 120 Waiver Fee $ Date of Payment2 Zz Z `% Date of Payment COSA # ()�) G2 4 1 047 Waiver # COSA Application —June 2022 l"titrate Advisory Certificate of On -Site Systems Approval # OSC241097 Subdivision: PARADISE VALLEY, Block: 5, Lot: 12 A water sample revealed a nitrate concentration of 5.39 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Legal Description: COSA Checklist PARADISE VALLEY BLK 5 LT 12 Parcel ID: 020-412-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 9122/23 Total depth 400 ft Cased to 147 It 0 Sanitary seal is functioning correctly FS-1 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA NEW Static water level at beginning of test 176 It Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/19/23 70 ALL standpipes present per record drawing Total measured depth from grade 8.5 ft (max) Measured depth to pipe invert from grade ft (min) 0 N/A — pressurized field. 0 Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist —June 2022 Well production at time of test 2 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes No 0 Coliform bacteria is Negative Nitrate 5.39 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by Date 3/5/24 MNA C. LIFT STATION 0 Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: Adequacy test date NEW Results Q Pass Fluid depth prior to test _ in Water added _ gal New fluid depth _ in Elapsed time _ min Final fluid depth _ in Absorption rate _ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 66 in Effective depth used 0 in Effective depth remaining 66 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Fo Yes if No _ ft Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100' [j] Yes if No _ It Neighboring Absorption Fields > 100' Q Yes if No _ ft Community Sewer Main > 75' [EYes if No _ ft Community Sewer Manhole/Cleanout> 100' E Yes if No _ ft Private Sewer/Septic Line > 25' Q Yes if No _ It Holding Tank > 100' Q Yes if No _ ft Animal Containment > 50' Q Yes if No _ ft Manure/Animal Excreta Storage > 100' r2] Yes if No _ It ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑� Yes if No _ ft Surface Water > 100'❑ Yes if No _ ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Di Yes if No _ ft 0 Yes if No _ It Yes if No _ ft ❑� Yes if No _ ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' 0 Yes if No _ It Yes if No _ It If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm M I k cA-, "`r,-t ,t (P( e Phone 727-8864 Engineer's Printed Name 4_yvtd� Date 2v 2 •¢;• MICI-uEL N. AkV%.iSCN COSA Checklist June 2022