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SAND LAKE #2 BLK 2 LT 18
Sand Lake #2 Block 2 Lot 18 #011-133-07 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211438 PID Number: 011-133-07 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New g Y J ®Upgrade Name NICHOLAS A BRANCHE ABSORPTION FIELD Site Address 8100 WILCOX STREET, ANCHORAGE ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Phone El Other Number of Bedrooms Soil Rating Total depth from original grade 2 0.8 GPD/SF 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot SAND LAKE #2 2 1 g 7 Ft. 4 Ft. Fill added above original grade Gravel length Township :Range Section VARIES - 0.1 — 0.1 Ft. 38 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. To Ft. Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station From Tank Line 380 Ft' 1 -- Ft. Well -- 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water -- 100'+ EXISTING Gal. Material Number of compartments Lot Line -- *51+ NA Foundation -- 10'+ LIFT STATION Manufacturer Capacity Remarks *MOA WAIVER. Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer NORTHERN EXCAVATION drainfield Drainfield 3034 Co/MT 3034 Inspector ion BENCH MARK (Assumed elevation) 100 ft Inspection 1�` 11/11/21 Location and description dates: 2nd 11/11/21 Td 11/12/21 4`h 11/15/21 BOTTOM OF SIDING--- ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: D�- .ig Date .� .. TH Septic System ....• Curtis Approved - �•, Huffman Date f j 9 .ZD �s . • . CE 128991 • • ..�c4,�r® Not 2 �kfipFvP'Rd t6/ * * Note: this approval does not include well permit requirements. k FESS (Rev 05/02/18) PID: 011-133-07 PERMIT: OSP211438 APPROX. 100' WELL RADIUS LOT 19 � N 9 °00' 0" 135.00' 0 CO EXIST. —x X X X O DIV. S. T. O O MT D I A ' 34.4 o O LnC • N Ln I 8.0' CD � W I NEW X z CK D 0"H o 1-- O o v BLOCK WALK o w W FIELD X wZ U) = 0>1 OI LLI X Y w 24.0' o O O O X 1982 LOT 18 0-j M BM N m I EMT TH So.o O OI X F B .• B LK 2 m e BLOCK Ox O Z CID r 20.6' Z N90°00'00"E 00' SHED ON WOOD SKIDS LOT 17 APPROX. 100' WELL RADIUS A -C=9.3' B - C = 3 5.1' FCO Co jDCO / CO MT MT CO A - D = 3 4.0' f CO / DIV 96.28 FINAL GRADE 96.46 96.36 B -D=32.7' ORIGINAL GRADE ORG/OL A - E = 4 2.3' FILTER FABRIC 2, B - E =1.2'O A - F = 4 6 7' EXISTING 1STEELGTANKN 89.36 89.36 SEWER ROCK ML B -F=5 6' 85.36 85.36 DRY -7/9/1982 TESTHOLE 1982 14' SEPTIC SECTION 8236 BOH PER AREA SOILS NO GROUNDWATER SCALE NTS �W/ OBSERVED 17'+. PER PERMITTED DESIGN. SAND LAKE #2 BLOCK 2, LOT 18 SUPPORTsSERVICES: - F\\ PREPARED FOR: ���� AZ4,� 1 NICHOLAS BRANCHE /� - 1� 8100 WILCOX STREET ANCHORAGE, AK 99502 C �* 9 TH /` � Huffman FIRST WATER CONSULTING DATE: 11/17/2021 rtis � 04 13030 SUES WAY SURVEY: JLS DRAWN: FWCS 1 04 CE 128991 w 11 /17/21 ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK©gmail.com SCALE: 1" = 20'FESSIo'o 1 AVti \\\__� LOT 19 LOT 17 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: SAND LAKE SUBDIVISION ADD Not LOT 18 BLOCK 2 PLAT P-176 SURVEY CERTIFICATE: I, John L. Schuller. Have conducted a 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 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCAM: E--MAit; NOV 16, 2021 1 "-30' schullerOak.net 21-149 DRAWN BY: I CHECKED BY GRID NUMBER: BOOK/PAGE JLS SW2224 210361 30' CD 0 0 W C w 0 C a 0 z LJ w ry X 0 C) * = FND 518" REBAR 30 2 A-- �' 1\ AW 10 r � 1 0. 49TH '•�'o� ,A� / ..... ........ ............. .Y •.J HN L. SCHULLER.• 0/ = . • . LS --10408 ':• . . • . , •�! • , ,��. • ���/ 1831 Talkeetna Street 1 a ,,�,► Anchorage, Alaska 99508 ° f no� �a'�' {907} 227-1455 office essia ��g, ��.'�'�'' (907) 274--4992 fax 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 Wastewater Disposal System Permit cnt S Q 1 L)epar-tin ent Permit Number: OSP211438 Effective Date: Work Type: Septic Upgrade Expiration Date: Tax Code Number: 01113307000 Site Legal Address: SAND LAKE #2 BLK 2 LT 18 G:2224 Site Mailing Address: 8100 WILCOX ST, Anchorage Owner: BRANCHE NICHOLAS A Lot Size in Sq Ft: Design Engineer: FIRST WATER CONSULTING Total Bedrooms: This permit is for the construction of: 10/19/2021 10/19/2022 6750 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Received By: Date: Issued By: Date: / Z 2 Municipality of Anchorage k '.�� Ur��:n•tment P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV211083 COSA#: Permit#:OSP211438 PID#: 011-133-07 Legal Description: Sand Lake #2 Blk 2 Lt 18 Engineer: First Water Consulting Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing and proposed absorption field. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date:ZI Approved by: fit/ Name of Revie r **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Development Services Department �` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 011-133-07 Property owner(s) NICHOLAS A BRANCHE Day phone Mailing address 8100 WILCOX STREET, ANCHORAGE, AK 99502 Site address 8100 WILCOX STREET, ANCHORAGE, AK 99502 Legal description (Sub'd., Block & Lot) Scw\A L m,k, # 8� k 2 Lf- 12 Legal description (Township, Range & Section) Lot Size 6,750 Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx_1 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ❑ Upgrade 0 (D) El 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: 45 q q Date of Payment:O1AZZ Receipt Number: 2-12 1q -L Permit No. 0_!) I 1 Ll �B Waiver Fees: (_)5U21 1(g3 Date of Payment: Receipt Number: Waiver No. =9 GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com October 18, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: SAND LAKE #2 BLOCK 2, LOT 18 We recently conducted a site visit to perform a septic adequacy test and assumed the test would go smoothly based on the adequacy test performed 3 years ago. However, it was discovered at our inspection that the field was saturated and after taking elevations approximately 3 of the 6 effective depth was not measureable in the monitoring tube. We had a site meeting with the property owner and MOA On-Site staff Tim Ecklund. The frustrated, but understanding property owner has requested we obtain a permit to upgrade the failed septic field of the above referenced lot. We propose to install either a deep trench or rebuild the existing field, which is 13 from the existing grade to serve the existing 2-bedroom residence. The 1982 inspection report states that the existing field had a total depth of 10.5 after construction, so perhaps there is some fill above original grade that was spread over the site since that time. The design is based on the uniform soils and groundwater monitoring of the lot, the adjacent lots and the Sand Lake subdivision in general. Attached are the soils logs of the adjacent Lot 17 and also Lot 16 with total depths respectively of 18 and 22.5, which show no groundwater or impervious rated soils to 20+. The adjacent Lot 17 groundwater monitoring was conducted at a seasonal high in May 1996. Based on this information along with the existing fields depth, there seems to be sufficient data and design has the same total depth of the existing field at 13 from current grade. Based on historical data in the file, which originally noted the need of a waiver and approved by the MOA it appears there should have been a lot line waiver granted initially and/or subsequently (Original IR or 2018 COSA) for the field to property line and we therefore request an official waiver to lot line of 5 be granted with this upgrade and will be noted with the inspection report after construction. The proposed design Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211438, Deb Wockenfuss, 10/19/21 October 18, 2021 Sand Lake #2, B2, L18 Page 1 of 2 maintains 5 to property lines and will not adversely affect the neighboring properties. The adjacent lots and lots of this subdivision in general have existing or should have field to lot line waivers of 5+/-. Granting this waiver officially and continuance of this encroachment is justified since no known issues have been observed or noted between the adjacent lots for approximately 40 years, it will not impact existing or future septic systems of the neighboring properties, and any potential effluent transference or interaction between the fields will be marginal or nonexistence due to soil types. As noted on the design, the slopes are flat at the proposed upgrade location and the surrounding area of the adjacent lots have moderate slopes of 0-5%. There are no slope issues within 50+ of the proposed field. The lot and area are served by private individual and shared water wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Attachments: As Noted Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211438, Deb Wockenfuss, 10/19/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211438, Deb Wockenfuss, 10/19/21 Municipality of Anchorage Community Development Department Page 1 of 2 On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181289 PID Number: 011-133-07 ❑ New 0 Upgrade Name: ROBERT&ASHLEY SOENNICHSEN ABSORPTION FIELD Address El Deep Trench ❑ Shallow Trench ❑ Bed El Mound 8100 WILCOX ST, ANCHORAGE AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 2 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel dept. :. eath pipe Subdivision Block Lot Ft. Ft. SAND LAKE#2 2 18 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Holding Sewer Total a.•.rption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line Ft2 Ft. Well 135.7 N/A N/A N/A 100+ TANK O Septic ❑S.T.E.P. Q Holding 0 Other Manufacturer Capacity Surface Water 100+ N/A N/A N/A GREER 1000Ga1. Material Number of compartments Lot Line 8.5 N/A N/A ' N/A I STEEL 2 NA Foundation 7.0 N/A ! N/A j N/A LIFT STATION I Manufacturer Capacity Curtain Drain 50+ N/A N/A N/A 1 Gal. Pump on level at Pump off le < . High water alarm at Remarks TANK LOCATION APPROVED BY T.EKLUND DURING SITE VISIT 08/31/2018 n. in. in. Pump mak- . . model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield GRAY'S Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 133tt Inspection i=, 31AUG18 Location and description dates: 2' 03SEP18 3,0 4v, BOTTOM TRIM HOUSE COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp •"•` OF AC‘�� Conditional Approval: Date P�G• ..,9 + 0 S€e___ W A Iif-er' id ir 4- k /410-V Kak_fl/k-1 vim, jfren . onnteorae r--' Y++�g���8149 `�.��1 Approved ( t �f / Date Cr" 7—(e l‘,;,aii —1 1\\\\�..-- Inspection Report_1-1-12.doc fiz b •• M I • Q0 0 0 0 ZW .. f. ..� ._W mZJL. �.0 UW U O / O U `: \. * - __ OG/FG 133.0- '" ' • 2 2 ^,�' **** EL: 124.4 I��r:.1G 1000 GAL \EL: 124.2 COMMUNITY RUE NORTH may, SCALE : �'= 50' PROFILE TANK(N) \CLASS C /�✓J SCALE:NTS w 0 / I \ ! • 1! / 201, 135.7 �. �.. --_.- 3 6 ; / I 1911 I ! /' REMOVED 1000. SEPTIC 7".'-'\.„C_C INSTALLED 1000. SEPTIC TANK N TANK E) PER MOA CODE CL W DCO AFTER CONNECT TO 1 / 11. (E) 1 �� -.O7.0 (LOCN APPVD BY END OF DRAIN FIELD 8 5 ' 0 /_ DRAIN FIELD E \—(�' T.EKLUND 8/31/2018) — 'NJI WM � .- � I WALKWAY IRMA 11�� 't; ,a; I X E SFD /� O SHED/ f'cam 132 U '`i , 9t , J ir--- 133 M 8J 134--' __, -3 . - - . I r ` - \• \ A'` V 11 135.3 �_ W 17 \ D - - ll 9 I / . • COMMUNITY 1 6 A B - FC 7.4 7.2 ABBREVIATIONS T1 8.3 9.5 i TH TEST HOLE T2 14.4 16.4 ! (P) PROPOSED 15 i (E) EXISTING —w --w —.WATER..LINE-../.._ ------I--------- - CO CLEAN OUT NO. WELL RADIUS 1 MT MONITOR TUBE NO. —ss —ss — NEW SEPTIC TYP TYPICAL 11 NOTES: PANNONE ENG SVC, LLCDote RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 P•• ��:9� 09/04/2018 PHONE (907) 272-8218 FAX (907) 272-8211 • Scole - *:•• • /N :* 1.. = 50' Iiiiii•\ •1p ••• P.I.D. NO - SAND LAKE #2 B2 L18 �• •• 11-133-07 ACP ROBERT & ASHLEY SOENNICHSEN �� CE 8149� �• 'PERMIT NO. DRAWN :; 0SP181289 8100 WILCOX ST. • SITE PLAN ANCHORAGE, AK 99502 � ':�i iii, Sheet 2 OF 2 Municipality fiTf Anchorage ,���,�,�� S� }�1 t � � � L ,•f�i�iJ�( Y �• �. j P.O. Box 196650 ® 4700 Elmore Road libio : f Anchorage. Alaska 99519 6650 ® (907) 343-7904 ® Fax (907) 343-7997 _ � Department http:/lwww.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV181069 COSA#: Permit#: OSP181289 PID#: 011-133-07 Legal Description: Sand Lake #2 B 2 Lot 18 Engineer: PES Applicant: Robert Soennichsen Your request for a waiver of the required 10 feet horizontal separation from the Tank to Foundation has been approved. The approved separation distance is 7 feet. This waiver approval applies to the Existing �e10 Lc. , - - - . only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. H The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. , Waiver is Granted: X Waiver is not Granted: Date: Approved Name of Reviewer en 0(et Pannone Engineering Services ac Steven R. Pannone, Principal Registered Professional Engineer E-mail:steve@panengak.com September 7, 2018 Subject: Sand Lake No. 2, Block 2, Lot 18 Waiver Request Tank to Foundation I am writing to request a waiver to the new code requirements that a tank be located 10 feet from a building foundation. The new tank was installed on September 1, 2018 seven feet from the building foundation. This tank replaced a 36 year old tank that was located five feet from the foundation.The house has a tall crawlspace, measured to be five and a half feet tall (5.5'). The bottom of the footing was measured to have an elevation of 127.3'. the bottom of the new tank has an elevation of 120.1 feet. The assumed load path from the bottom of the footing intersects the new septic tank six inches (6") up from the bottom of the tank. See the attached drawing. The tank installation as installed, will not cause a health problem and the structural integrity of the tank will not be adversely influenced by the load from the strip footing. The lateral load at that depth will be insignificant and the load applied six inches above the bottom of the tank will not cause the tank to bend and collapse. This is further proved by the fact that a steel tank was located two feet closer at the same depth for 36 years and did not collapse due to the footing load (Note:the tank was replaced due to corrosion in the upper portion of the tank at the water line. Tanks typically fail due to corrosion at the water line and collapse downward, and not from excessive lateral loads due to footing pressure.) This waiver will not adversely affect public health and safety of the property. If you have any questions or concerns, please contact me at 907.745.8200. Sincerely, .4.7c oE 44444 • •F"%Steven R. Donnore? i •�% No.CE 8149 wwww� ++• ;; .. II Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 1807 Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 g 7t `A - -c P . { A J F 1 U'1 r \0.. \ \ . 1.1Jo w p (� -c t 4 V Z d ., N 2. (w 0 Z C2i4W . S PAcel Pannone Engineering Service, LLC JOB TITLE e3`eff) r( CI, NO. P.O. Box 102954 SUBJECT " L IkAlle--/Z) N- j -(3.G77,e7/J Anchorage AK 99510 n f Phone 907-272-8218 • FAX 907-272-8211 BY s . CHECKED DATE 7t Wt 0 SHEET / OF Fri MUNICIPALITY OF ANCHORAGE � On-Site Water&Wastewater Program •S.; ® , PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ~'R� http://www.muni.org/onsite _ I)chirtIII( ft 4 ORRG� On-Site Wastewater Disposal System Permit Permit Number: OSP181289 Effective Date: 8/24/2018 Work Type: SepticTank Upgrade Expiration Date: 8/24/2019 Tax Code Number: 01113307000 Site Legal Address: SAND LAKE #2 BLK 2 LT 18 G:2224 Site Mailing Address: 8100 WILCOX ST, Anchorage Owner: SOENNICHSEN ROBERT&ASHLEY B Lot Size in Sq Ft: 6750 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 2 This permit is for the construction of: ❑ Disposal Field E Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Received By:( r� �(X Date: r 27 i Issued By: ALyt Date: ��� EPurtia MUNICIPALITY OF AmmuRAGE Community Development Department ;" y—' Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICA1c1045 228936 48/22/18 i11:58Pl1 434 Well/Septic Systems $215.00 Parcel I.D. 011-133-07 Property owner(s) ROBERT &ASHLEY SOENNICHSEN Day phone Mailing address 8100 WILCOX ST. ANCHORAGE, AK Site address 8100 WILCOX ST. ANCHORAGE, AK Legal description(Sub'd., Block& Lot) SAND LAKE #2 B2 L18 Legal description(Township, Range & Section) Lot Size 6,750 Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family(SF) ❑X (w/wo ADU) Septic Tank Upgrade ❑x Duplex(D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Dis tance: 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: cal‘ Waiver Fees: Date of Payment: 4991117 Date of Payment: Receipt Number: � Receipt Number: OJ Permit No. 66121 12 Waiver No. Permit App_::•._. c: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181289, Rebecca Carroll, 08/24/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181289, Rebecca Carroll, 08/24/18 MUNICIPALITY OF ANCHORAGE 771 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 0* ENVIRONMENTAL ENGINEERING DIVISION ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �5t_f_'lJ e- �_•�- l Y h6 PHONE 3 -'2 'F� NEW ❑UPGRADE MAILINGADDRESS y ,{ k LEGAL DESCRIPTION Z . )v/>: --A I -t 'T/P LOCATION ° ��� llJld.,G9� I�LrjO11C�� ��'f'N AJYtJ .,��uta NO. OF BEDROOMS DISTANCE TO: Well Absorption area Dwelling �a 7- Jim PER T NO. j Z? 0'7 0.F Z Manufacturer Material No. of com artments Liq. capacity in gallons ,� IF HOMEMADE: Inside length Width .-- Liquid depth O z DISTANCE TO: Well Dwelling PERMIT NO. SManufacturer Material Liquid capacity in gallons w = DISTANCE TO: Well //, r YN Foundation °1io 3- i/v Nearest lot line - �J° PERMIT NO. fl 7 J LL z P:z L No. of lines ` Length of each line q� Total length of lines ey >f Trench width 6 inches Distance between lines Q Top of tile to finish grade l2 Material beneath tile Z inches Total effective absorption area LU a Length Width Depth PERMIT NO. i H w ° Type of crib Crib diameter Crib depth Total effective absorption area w 0 DISTANCE TO: Well Building foundation Nearest lot line J W Class Depth Driller Distance to lot line PERMIT N0. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER °ti e C) PIPE MATERIALS P V .P C SOIL TEST RATING /so fd FF tJ 17 1� /`/A VJ INSTALLER 6 / G REMARKS i /tel U a r?s t= T LV d I V= ,_ 0 Ai Lo ! APPROVED DATE LEGAL /c7--7_7-9 G4'- fi?.� F3 72-013 (Rev. 3/78) TYPE OF SOIL HBSORPTION SYSTEM TRENCH MHXIMUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ J. THE REQUIRED SIZE OF THE SQIL HBSORPTION SYSTEM IS� 1-2 10, Fog -7- F-1 17U Q FEE N Ch 0- 11-111% 14. 15 oil V 0=1 V 1=7 U, �EDX=:�g����' � THE LENGTH DIMENSION Fog����� KDF- Rgr-�� OR DRHIHFIE.LD ^ ` DEPHRTMENT,/�� 825 HEHLTH HND ENVIRONMENTHL/�ROTECTION GROUND «� ^ STREET, HNCHORHGE, HK. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE 264'~4720 HND THE BOTTOM OF THE PERMIT �������� N(], 152 FEZ 611 ���� ������. HPPLICHNT STEVE CHRLSON 7801 HRLENE HNCHORHGE ~ �6] 245] LOCHTION LEGHL L18 82 SAND LAKE S/D #2 LOT SQUARE FEET TYPE OF SOIL HBSORPTION SYSTEM TRENCH MHXIMUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ J. THE REQUIRED SIZE OF THE SQIL HBSORPTION SYSTEM IS� 1-2 10, Fog -7- F-1 17U Q FEE N Ch 0- 11-111% 14. 15 oil V 0=1 V 1=7 U, �EDX=:�g����' � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THEE. TRENCH OR DRHIHFIE.LD THE DEPTH OF H TRENCH OR PIT I� THE DISTHNCE BETWEEN THE SURFHCE OF THE GROUND wND T�E BOTTOM OF THE FEET). THE�E IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCHYHTION (IN FEET). 152 FEZ 611 U 1 1-1 IE- Koo :0 W F::1 7 IF C! -T- RE` - PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE INSTALLATION INSPECTIONS OF HNY NELLS HDJHCENT TO THIS PROPERTY HND THE Cm WZ 11, so ��SEE" 19E.7- 1:1 -V 1 411) P -A. �E.-E" W Q C;'� U 1: FR. E:. lo-� —�~ BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVf8. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTHNCE BETWEEN H WELL HND HHY I-)PI�EWHGE DISIPOSHL SYSTEM IS 100 FEET FOR H PRI;HTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVATE WELL TO H PRIYHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY HPPLY, SPECIFICATIONS HND CONSTRUCTION L)IHG�HMS HRE PlVHILHBLE TO INSURE PROPER INSTHLLHTION KE .. xn 1 W KV W Fol jEw EFE- F;�! ... ��3!� I CERTIFY THHT 1 I HM FHMILI HIE xEuuIREPIE@/S FOR UN -SITE SEWERS HND WELLS AS SET FORTH BYTY OF 12: I WILL E S DHNCE WITH T�� CODES ]� I �N�ERSTH TH S R SYST�M �HY REQUIRE.ENLHRGEMENT IF THE F,IE.5-IDENICE 15 "F DEU gel 1PICLI&Q-11JORE THAN 1 BEDROOMS. SIGNED: SO vV " DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: key K1 Lau'3, I()n CumDijQ1j DATE PERFORMED: -1 11' W__ LEGAL DESCRIPTION: .nand L�.l�p �2 f)U �B bcR 2- I LAS I 1, c —.10 11 12 13 14 15 16 17 18 19 20 PERFORMED BY: Gry—e,YI CERTIFIED B 72-008 !6/791 DATE -Z �d Z- APPLIC' NT OUT UPPER HAI' `ONLY -FILLS Properly Owner -:5-/e U' �.) /��-5Cl"I 5 ,� I f'}') ._C�� 1 i�l -�-- Phone Ce3— 2053 Mailing Address d� fJ�Z/) L �)�S Zip Code Time Buyer Address Zip Code Lending Institution EA - Phone Address Zip Code f a7b-)132-- Realty Co. & Agent 21 I / Phone Address'] -p . - .Zip Code % i - /tom ` /3S Legal Description LoT /0':' t?CoG Z - Street Location ail Cl 01 - Type of Residence Single Family Z Inspector ❑ Multiple Family No. of Bedrooms Inspector ❑ Other Inspector Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. X Community - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal VIndividual 9,Q n-1 ��, Year Individual Installed: CI, 2 1 1932 C1 Public Utility / When Connected to Public Utility: ❑ Holding Tank (t:§-1 Pl d O's- - NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ( APPROVED BEDROOMS CfL` MTV Time Time Time Time n ISL_ (Z M� Date Date Date Date �^ \(c)-r.`a.-qa "Y� Inspector Inspector Inspector Inspector (��) Field Notes: ( MUNICIPALITY OF ANCHORAGE DFPT Or T'' 1. ENVIRu( v,,! --t .A...: .0 , -C -NON CI, 2 1 1932 REG I,VLD ( APPROVED BEDROOMS 'CONDITIONS OF APPROVAL DISAPPROVED ( ) CONDITIONAL APPROVAL - DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank ]2023(3/82) C) G) rn rn tir- (Y) CIO O O (3) 0') m x W o co ♦n o LL V � Na LL O i U Z a J � —.0 (D a O U C) L) Z 0 MU U O- O � a) cn ❑O LO N O N N N r- 0 O M 0- x x W O O O O A M r O ❑ U f6 N O LO (7) 0) c Y r J O N Y O JM U W It F— LU U) Y X Q O Z U) O O c � O CO Q � `v U) U � a) -p a)' J U) u Sig ff III A U O O a a) N m O 4-- 70- 0 O OL a co co c O 0 Ii E O A . q. L) 0 0 0 a) a � a 'a CL O 3 =O C E t N O H X CD O L O O O 0 C 'N d -a C iC N O Q � > oo _a •E Q Q > N E Cl) Q N 0 Q ( U =goo ��� z Q p U i m E a +, .N >i Q 'a O O m .Q O Q C Q L O CL CL E N N v O E O X C L cn (n O F+ m v, E -a O Q ' O = O. O _ > L- Q. U) d u O U) a) > O N> Q L U m� IL Q N O _ Q V • � Q � L _ {H ^i � 1 W 0 O O,c o (� + E O = ca O U Q I— O U= cOA U N H v) Q Q Q N N Q 0 U V I O O t7 O O E U o V cu C b ti O O O7 O U W 0 L a O +� Q O O t7 E U o V cu Q � A.- z c6 U O U U a) C-6 U L E Q O 00 T ° C O SZ - CL Q M W IMM V ° ° LL CJ t7 a) cu :r1 64 U )y O Z O U C O UCL += 00 N a J W C a) O ca T — CL c O r >, Nd U Q ° El 0 C:U = E N Q o Q O >, C D O O N E V N O cu ® W CL <n w O U N N m ❑ ❑ 0) 3 > M a) ❑ N U 0) ° ° N 0 El coo >+•- U)N ON O C L : m ?� ® ❑ U c mi a d L o c� m � Q m a) U) J El � EIL O L CL N L(6 2!�U u N a d O u o ❑ ® ❑ T ai 1 c o LLO 0o J ElQ ❑ w N a win- �' ❑ -o E N O w S Q a) 0a) ... 2 w® 0 w N c i z �' u r a LU li u. H G~.. (1)(D d LU w H O W >+ O w m > H H U)Q Q � N M d to co >� > Q w m -W V ° ° LL CJ t7 a) cu :r1 64 LL O O U co D O UCL 00 t7 a) cu :r1 64 LL O O U co D O UCL COSA Checklist.docx COSA Checklist Legal Description: SAND LAKE #2 BLOCK 2 LOT 18 Parcel ID: 011-133-07 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PRIVATE SHARED WELL (CLASS “C” WATER) - WELL LOCATED ON LOT 21 Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 54.7 ug/L Arsenic less than MRL (ND) Collected by Date 7/22/24 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 7/22/24 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/15/21 ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 6.8 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). 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) N If yes, enter date Adequacy test date 7/22/24 Results Pass Fluid depth prior to test 12 in Water added 450 gal New fluid depth 22 in Elapsed time 1440 min Final fluid depth 12 in Absorption rate 300 gpd (2BR SEPTIC) FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4 ED) Effective depth used 12 in (Final Fluid Depth) Effective depth remaining 36 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft 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 *7+ ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No **5 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *WAIVER OSV181069. **WAIVER #OSV211083. NO DECK SUPPORTS OVER TANK & DECK <30” HIGH. 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 8/5/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 8/5/24 z D r IN I - L Z O UJ •} H v wco o �: w *' U V) �w w r_ u c o bn " z L LU .1 o O ate{ E J i7i 3: O 0 3: v E v tw-0 ; C: pi c += 4-j cn N L 3 aU x v Q m O O v�E E 0 + O E a� � — v ai !O -0 N �-+ O s > c° O- c /) O U Ln C CYl U N > O i E m m m O M aJ 'It U n N 3 Ln M 4- 4 a1 tiA L a) Era aJ (O 4- -Y 'O }' - O O ° N Ln N bn O d < m M V) O d +' U U a bD '— C:v- ,� N >, w > O O Ln O N Q O O aJ O Q .E c O .� fB 4- U C J boA -0 N E G� > U O N ro Q N Q) v N O > O E o Q U ca O O � O aj O aJ LCn O }, s a1 N Q) v � ai 0 a' ro U D 0 o a) v E n c E In J L1 O O V) � N C: O — bA =3 -a w ra ca d O E aJ E L m Lnc > 4� ate.., Q N cv bz C: > E Ln iw o U Ln Q U Q s Certificate of On -Site Systems Approval Parcel I.D. 011-133-07 1. GENERAL INFORMATION Expiration Date: R,� Complete legal description SAND LAKE #2 BLOCK 2 LOT 18 Location (site address) 8100 WILCOX STREET ANCHORAGE AK 99502 Current property owner(s) NICHOLAS A. BRANCHE Day phone Mailing address Real estate agent 8100 WILCOX STREET ANCHORAGE AK 99502 2. TYPE OF DWELLING: ® . Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well (SHARED) ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 02 Waiver Fee $ Date of Payment 11 15 , 01 Date of Payment Receipt Number 51 5 1 `7 Y Receipt Number COSA # 0 SC.;Z... 116,6 7 Waiver # Distance: 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Date 11/12/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the ,�(i ^�•,Q l` well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q; • • • • • �� �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWr . tk; • 7H • •• �� .. . 6. DSD SIGNATURE • • • • • • .... . r • Curtis Huffman / J System #1 Approved for c� bedrooms�F67 . CE 128991 �� �F9•• 11�12lza•��� System #2 Approved for bedrooms �l�F©pROFEssto�a Disapproved Conditional approval for _ bedrooms, with the following stipulations: 11111((((((( NATER ER z pGEAM .S N1 By: Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory x Well Flow Advisory Other COSA Checklist Legal Description: SAND LAKE #2 BLOCK 2, LOT 18 Parcel ID: 011-133-07 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA – PRIVATE SHARED WELL LOCATED ON LOT 21 Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 54.6 ug/L Arsenic less than MRL (ND) Collected by Date of Sample 10/12/21 & 10/15/21 (COLI RESAMPLE) Comment B. TANK DATA Age of tank(s) 3 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50” Standpipes/foundation cleanout per record drawing Date of pumping 6/15/2021 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW - 11/11/21 ALL standpipes present per record drawing Total measured depth from grade 11.1 ft (max) Measured depth to pipe invert from grade 7.1 ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date NEW FIELD Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) NO WELL ON LOT Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No *7+ ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10’ Yes if No ft Property Line > 10’ Yes if No **5 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *PER MOA INSPECTION REPORT. **MOA WAIVER. NO DECK SUPPORTS OVER TANK & DECK <30” HIGH. G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 11/16/2021 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Arsenic Advisory Certificate of On‐Site Systems Approval # OSC211667 Subdivision: Sand Lake #2, Block: 2, Lot: 18 A water sample revealed an arsenic concentration of 54.6 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. F_PLitlfms RW • �� Municipality of Anchorage ° `'`0aislt On-Site Water and Wastewater Program (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 011-133-07 Expiration Date: 11) — 7 i 1. GENERAL INFORMATION Complete legal description Sand Lake #2 Block 2 Lot 18 Location (site address) 8100 Wilcox St. Current Property owner(s) Robert & Ashley Soennichsen Day phone Mailing address 8100 Wilcox St. Anchorage, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: CI Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received 1j6,2;,: Date: 11011`U COSA to be released to the engineer,unless othe requested b. a engineer. COSA Fee $ �4 (•w Waiver Fee $ Q / Date of Payment -1 (5 it& Date of Payment Receipt Number Receipt Number COSA# OC-IS?/(463 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are)in compliance with all applicable Municipal and State codes, ordinances,and regulations in effect at the time of installation. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and 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 satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance,nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date 9/5/2018 AMP'' •°F4 �t 4 j*•:4g.•- i\—,•.* l 6. D7SIGNATURE /•• - • •• ••r System#1 Approved for —bedrooms " :Steven c •. Pannone: CE-8149 System#2 Approved for bedrooms 9a9 ,r Disapproved �ll �OFESS� �' Conditional approval for bedrooms, with the following stipulations: 0N-s\-At t. WHTER 1\N° 1 \,Np,STF JF VER c`: pROGRANI BY I Z-t SPIA4 Original Certificate Date: — ( le The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheeti' '- Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSC181463,Tm Eck fund,09/07/18 If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Sand Lake #2 Block 2 Lot 18 Parcel ID:011-133-07 A. WELL DATA Well type Private/Class C If A, B, or C provide PWSID# 214772 Well Log(YIN) Date completed Sanitary seal (Y/N) Wires properly protected(Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform NEC' colonies/100 mL Nitrate ND mg/L Arsenic 54.3 ug/L Date of sample: 8/7/2018 Collected by: PES B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/31/2018 Tank size 1000 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm(Y/N) N/A Date of pumping NEW Pumper N/A C. ABSORPTION FIELD DATA Date installed 10/29/1982 Soil rating2 2 180 SF/BDRM 5-Wide (g.p.d./ft or ft/bdrm) System type Length 46 ft. Width 5 ft. Gravel below pipe 6 ft. Total depth 10-11 ft. Eff. absorption area 552 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/10/2018 Results(Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 12 in. Water added 300 gal. New depth 18 in. Elapsed Time: 180 min. Final fluid depth 12 in. Absorption rate >= 300+ g.p.d. N Any rejuvenation treatment(past 12 mo.)(YIN&type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) "Pump on"level at in. "Pump off'level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer/septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 71* Property line 0+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway,parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and y' • review of Municipal records that the above systems are in *I sla TM `` conformance with MOA COSA guidelines in effect on this date. IPt'N Steven Pannone Ieven fk.-annorae Engineer's Printed Name CE 8149 .;•�.• Date 9/5/2018 J.��• .1 . COSA canary sheel_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT i' a �t' �� 907-343-7904 On-Site Water and Wastewater Section � j' Fax: 343-7997 www.muni.org/onsite Arsenic Advisory Certificate of On-Site Systems Approval # OSC181463 Subdivision: Sand Lake #2, Block, 2 Lot 18 A water sample revealed an arsenic concentration of 54.3 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.Box 196650*Anchorage,Alaska 99519-6650*www.muni.org //?q.,--'.S' ...cc . /.?.5: O ,C `' ik 010119,:, 1 NI n Ni i. -,. ii r \ ' h1I 1g 1 i�• 'b ���%� . �vi 'c � '� ��y ��!1.' i. _. ! _ I__ , - )., M \)` o •cX11 , 0 0 -.! �� Iv, �_—_ �¢� I - gt ,-74-,=---, • ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-082.9 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:,� ��caEryaq I FOLLOWING DESCRIBED PROPERTY: _ ,7'-4--__.-74df- A 1 'N f,�/�//47-(-:::'-..2---e-- -?://O /�,'.l,?-:I" DATE. •••LP 4 AND THAT NO NCROACHMEW' S EXIST EXCEPT AS � .• '� ÷ INDICATED. IT IS THE RESPONSIBILITY OF THE • o ; 4` ' , OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: ' I EASEMENTS, COVENANTS., OR RESTRICTIONS z,�2'/ v _ - . .. 0.WHICH DO NOT APPEAR ON THE RECORDED SUBDI- Duene Mtrt Seward ~ a VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS' is :.. i.7„,7/ ->' ' ANY DATA HEREON BE USED FOR CONSTRUCTION tv�` t,',?,..,,,41 .-. ,,`2 * i 4. OF FENCE LINES, OR FOR ESTABLISHING BOUND- ' ' 'h 't"e:,;kx;;• Q' ARY LINES. DR-AWN: j .,.•�"' Parcel I.D. 011-133-07 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: /5 Complete legal description Sand Lake #2, Block 2, Lot 18 Location (site address) 8100 Wilcox Street Anchorage, AK 99515 Current Property owner(s) George C. Shelton 0 Day phone 230-6939 Mailing address Real Estate Agent 205 E. Dimond #125 Anchorage, AK 99515 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: TWO 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class C Well Public Water System WaiverNariance request Received COSA to be Day phone TYPE OF WASTEWATER DISPOSAL: ❑ .Individual 0 ❑ Holding Tank ❑ E Community ❑ ❑ Public Sewer ❑ requested by the engineer. Date: 5� I 3 COSA Fee .$ 5a� r Waiver Fee $ Date of Payment Date Date of Payment Receipt Number 02e)5LIn) Receipt Number COSA # Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 4/712015 e4:1" OF q4Q An, gyp:•' .S;_ ®. rrjTH . r 6. DSD SIGNATURE w Val. ERSON ✓ System #1 Approved for �_ bedrooms m 4 t CH.4381 : s` System#2 Approved for _ bedrooms ��•r�"��+.,�!-'7-�40.•���o �olll peorisso o®o Disapproved 1n�®4®q®o Conditional approval for bedrooms, with the following stipulations. By: Original Certificate Date: The Municipality of Anchorage velopment Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered In the Slate of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's vrork. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue shed I f- 1, 0 If more than 1 septic system is on the lot: COSA Checklist # _of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Sand Lake #2, Block 2, Lot 18 Parcel ID: 011-133-07 A. WELL DATA Well type Class C Date completed _ Total depth ft. Date of test Static water level Well production If A, B, or C provide PWSID # 214772 Well Log (YIN) Sanitary seal (Y/N)_ Wires properly protected (Y/N) Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Iri9_\ICIZ&fL1LVJI,MA:U &III%V ft. Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic 58.4 ug/L Date of sample: 3/16/15 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tanksize 1,000 gal. ft. g.p.m. Collected by: Anderson Engrg. Date installed 10/29/82 Number of Compartments 2 Cleanouts (Y/N) u Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 3/11/15 Pumper Alaska Sewer and Drain C. ABSORPTION FIELD DATA - Date installed 10/29/82 Soil rating (g.p.d./ftz or ftz/bdrm) 180 SF/BERM System type Deep Trench Length 46 ft. Width 5 ft. Gravel below pipe 6 ft. Total depth 10-11 ft Eff. absorption area 552 ftp Monitoring tube Y Depression over field N _ _Date of adequacy test 3/11115 � .Results (Pass/Fail) Pass For 2_bedrooms Fluid depth in absorption field before test 14 in. Water added 650 gal. New depth 29.5 in. Elapsed Time:. 1'0 min. Final fluid depth 21 in. Absorption rate >= 300 g.p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed Size in gallons _ "Pump on" level at in. "Pump off' level at Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout _ Holding tank Manure/animal excrete storage areas Water main >10' Water service line >10' Wells on adjacent lots >100'** ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line _ > 10' Surface water >100' Curtain drain None Noted wells on adjacent lots >100' Absorption field >5' Surface water >100' Water main N/A Driveway, parking/vehicle storage >10' F. COMMENTS System is acceptable for two bedrooms only. Tank is nearly 33 years old. Class C Well separation distance waived to 100'- 10111/82. G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 4/7/2015 COSA brown sheet_10-10-12.doc III C14AEL E. ANDERSON., z�o; o F .4381 ItVwL%*-"�� Municipality of Anchorage s PQ v. p Community Development Department ° Development Services Division '.E. On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Arsenic Advisory Certificate of On -Site Systems Approval # OSC151125 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 18 of Sand Lake #2 Subdivision. This inspection revealed an arsenic concentration of 58.4 micrograms per liter (ug/L) for the property's well water sample. 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/onsit ) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) May 10, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 18, Block 4, Sand Lake Subdivision No. 2 Certification of Septic System for Two Bedroom Home Dear Onsite Services Engineer: In recently inspected the residence at 8100 Wilcox Street along with Kevin Taylor, the realtor marketing the property. I verified that only two bedrooms are in the residence. Records further indicate that the house was originally constructed with only two bedrooms. Sincerely, Michael E. Anderson. P.E. IWC) � 9. �D 49th MICHAEL E. ANDERSON April 21, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 18, Block 4, Sand Lake Subdivision No. 2 Certification of Septic System for Two Bedroom Home Dear Onsite Services Engineer: The existing house on Lot 18, Block 4, Sand Lake Subdivision No. 2 was constructed in 1982 with two bedrooms. It is currently functioning as a two bedroom home. The septic system serving the house was designed for a three bedroom home and also constructed in 1982. A recent adequacy test of the absorption trench indicated it is capable of absorbing slightly more than 300 gallons per day. The absorption trench is capable of meeting the design requirements for a two bedroom home but not a three bedroom home as it was originally designed. We therefore request a waiver to Municipal Code allowing the septic system to continue to serve the two bedroom home currently on the lot and not the three bedroom septic system as originally designed. Sincerely, n Michael E. Anderson, P.E. 133b�1S X007/M 2 W LL o > HHV T � H3E 2 0 a aao N Ow N zu n o z g w w m wa �tim Q aOm H in 11 w p V=1 u > 2 Hao G~ UUU ��' Sima HHZ Y'i M H J VI H Vl m R'a Y H1/1Z, H o z n v z r¢ i-0vai zzozw 0 H W W QUQ 7 N LL 2 N M W F H 3 YOU O J i F m w O U W K T u W W JO wmi wm i U o m W M W S a QW 7 WWm 1J y'OaU m U s V I w H H E H O a> H w p z aOv 0 maq 0m O Z OW z wW F W J W LL Q Q K O Oh wn OOaW aZ�m NQ O ww �F i� �w my O z w wz mw O� Qw �m mF 00 z mo Fo ti O n o ' d9', w - iP � m t D aOv 0 maq 0m O Z OW z wW F W J W LL Q Q K O Oh wn OOaW aZ�m NQ O ww �F i� �w my O z w wz mw O� Qw �m mF 00 z mo Fo ti O n ,.: lrl4. 0 so Q.' g1joa CONSTRUCTION AND OPERATION CER ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT y Plans for the construction of <.4d d Or =4 S(n tt 1) S• f LO { s IV 11 c1 61 to ► (l( << / f/xz f-f'a�!- /F.S)blic water system located in A Nc Alaska, submitted in accordance with 18 AAC 80.100 . by �1r�tiPt� f �rt v SO -t- have been reviewed and are 14 approved. 0 conditionally approved (see attached conditions). c � DATF y� — rt Y rriuvlt�ct� rr �08H ✓!' L�^i� yr T If construction has not started within two years of the approval date, this certificate Is void and new plans and specifications must be submitted for review and approval before construction. APPROVED CHANGE ORDERS Change (contractorder Po. or descriptive reference) Approved by Date ' ' The "APPROVAL TO OPERATE" section must.be'completed before any water is made available to - the public. APPROVAL TO OPERATE ' The construction of the 5�tct r . RUL 11 R�r� ' public water system was completed on �O h - jdate). The system is hereby gtanted interim approval to operate for 90 days following the cpmpletion date. er,.t,,,.�. DAT€ TITLE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. I TTLE DATE By J• , r �nn I SYM DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGENESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: PWS I.D.# ,2- 4 77Z BILL SHEFFIELD, GOVERNOR Telephone: (9071 Address: 274-2533 To Whom it May Concern: {� According to records on file in this office the J ✓^1r/ 4 A G 4 Water 5yst.em is in compliance with the State Drnkg Water Regulations Sincerely,