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SCHROEDER LT 81
Schroeder Lot 81 #050-052-37 Environmental Consulting and Design Municipality of Anchorage July 7, 2009 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Strect Anchorage, Alaska 99519 Subject: Lot Line Waiver 12505 Iris Way Ladies and Gentlemen: I am writing to request a lot line waiver for the septic system absorption field at Lot 81 Schroeder. The septic system was installed on 5/31/1977. The inspection report stated that the existing trench was 30 feet from the nearest lot line. A surveyed property as -built located the trench sump 2 feet from the south property line. The property to the south is a municipal park. The system has operated in its current configuration for 33 years with no negative consequences to the neighboring property. The current configuration of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Si Sett Lars Spurkland, P.E. Civil Engineer 203 West 15'b Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 353-1597, Lspurkland@gci.nct t Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (9071343-7904 • Fax (9071343-7997 httg:ltwww.muni.org/Onsite Development Services Department On -Site Water and Wastewater Program �u n t n I)el�N **** VARIANCE/WAIVER REVIEW **** WR#: 090037 HA#:090211 Permit#: 09008 PID#: 050-052-37 Legal Description: Schroeder Lot 81 Engineer. Saurkland Engineering Applicant: Linda Monsarrat Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approval separation distance is 2.0 feet. This waiver approval applies to the existing absorption field to property line separation only. 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: 7/10/2009 Approved by: d��� N of Reviewer ................................................. . ........................... Rec#: 020454 Amount: $200.00 Date Paid: 717109 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 16, 2009 Expiration Date: Jun 16, 2010 Permit Number: SWO90087 Parcel ID: 050-052-37 Legal Description: SCHROEDER LT 81 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 12505 IRIS WAY Owner Name: LINDA MONSARRAT Lot Size: 47464 SO. FT. Owner Address: 12505 IRIS WAY Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. A 99577 - This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: 6 D Issued By. Date: Municipality of Anchorage --1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-05Z-37 Property owner(s) Un6T. Mon 5arrc,� Day phone Mailing Code Site address 17Se5 Zetg 1Js4j,�aWZ',js,, AK Zip Code 595_4_'� Legal description (Sub'd., Block & Lot) roe%e� i.0t 81 Legal description (Township, Range & Section) Lot Size L17146 K Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature owner or authorized agent) Date of Payment: Date of Payment: Receipt Number: 00.3 ? yU Receipt Number. (Rev. 11/05) Spuftknd Engomawoflg Environmental Consulting and Design June 8, 2009 Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Qragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION SCI IRODER LOT 81 Ladies and Gentlemen: We are submitting an application to upgrade the septic tank for this lot. The existing septic tank serving the above referenced property appears to be leaking. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. There are no wells within one hundred feet of the proposed replacement site. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, &er 0J&4zg Lars Spurk and, P.E. 203 West 151" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngugci.net DA VIS ST. I \ LOT 82 VACENT APPROX. WATER LINE OCAT/ON CITY WATER LOT 81 _l INSTALL NEW 1250 GAL. TEEL SEPTIC INSTALL DOUBLE CLEANOUTS ABANDON XISINC o zs so �s foo t2s tso. SEPTIC TANK SCALE, 1' = 50 FT. PUBLIC WATER & SEWER, WELLS >> 200' SCHREEDER PARK INSTALL DOUBLE CLEANOUTS CONNECTL EXIST DRAIN 4 FEET COVER A Jt'UMKLANU LNUINLLK/N(iI I SCHROEDER LOT 81 ANCH. AK. I ( SEPTIC SYSTEM DESIGN 203 W 1. 99501 TH. AVENUE LINDA MONSARRAT DATE. JUNE 8, 2009 • /9071 279-3916 12505 IRIS WAY, EAGLE RIVER. AK 99577 SHEET.1 �1 GR/D. NW 351 I PERMIT # SV0900XX PID x SCHROEDERLBIBLDVG Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: Deer Horn Block 2 Lot 4 Date: June 8, 2009 General: 1. The owner shall contract with a contractor to perform the work outlined In these specifications and plans in accordance with the attached MOA permit. There Is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the work Includes the installation of a new 1250 gallon septic tank. The location of the drain field is shown on the attached site plan drawings. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of 4 feet of earthen cover is required over the septic tank. If less than 4 feet of cover is available, 2 -inch thick, 40 psi, direct bury board foam shall be installed directly over the septic tank and all installed piping. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner Is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners Installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are In compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used In the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. 203 West 15 lb Avenue Suite 203, Anchorage, AIS 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland Cagci.net Environmental Consulting and Design Septic Tank Installation: 1. A new septic tank, of the size specified In the design drawings, shall be procured from a qualified manufacture/supplier if the existing septic tank Is found to be defective. Construction shall include two 4" diameter cleanouts for pumping access. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 12inches above the final grade. S. Tanks installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded In drain rock or the soil shall be sufficiently compacted to prevent future settlement of the soil. a. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. 9. A cleanout shall be installed 1 to 4 feet from the foundation. 10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from any residential water well, 150' from any class'C well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank In compliance with the Unform Plumbing Code. Inspections: 1. A minimum of one inspection Is required by the Municipality of Anchorage. These Inspections must be conducted under the supervision of a Professional Engineer licensed to practice In the State of Alaska. 2. The septic tank may be set In place, but may not be backfilled. 3. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use In preparing the record drawings. 4. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held onsite. 203 West 1516 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland(a�gci.net GREA, ER ANCHORAGE AREA BOk, JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMEIan/� C__.JJ////MAILING ADDRESS_ �_r� � l� %� �I �` PHONE 75 �l��y_ LOCATION bel7cfl-d k-061 / LEGAL DESCRIPT[ON d? �(DeCkIC- -11� SEPTIC TANK: DISTANCE NUMBER OF `) FROM WELL74MANUFACTURER MATERIAL �c COMPARTMENTS C_ INSIDE LENGTH _INSIDE WIDTH LIQUID DEPTH l _LIQUID CAPACITY LLONS./WY- TILE DRAIN FIELD: TOTAL LENG/T� DISTANCE FROM WELL FOUNDATION_�� -___NEAREST LOT LINE__, _-_OF LINES L�_'Z�-( / / 7 NUMBER OF LINES `- DISTANCE BETWEEN LINES _Vv / TRENCH WIDTH > N. TOTAL EFFECTIVE ABSORPTION AREA — `� SQ. FT. LENGTH OF EACH LINE _ /� DEPTH OF FILTER DEPTH_ TOP OF TILE TO FINISH GRADE / MATERIAL BENEATH TILE—_./ IN. ABOVE TILE WELL: lV� l' C n a-C�- c_y e_ri41Lx— TYPE CONSTRUCTION _ _ -DEPTH -_. DISTANCE FROM: BUILDING NEAREST FOUNDATION __ LOT LINE CESSPOOL __ OTHER SOURCES APPROVED_-- --DISAPPROVED-- DISTANCES: DISAPPROVED - DISTANCES: INSTALLED BY: SEWER LINE LINE DEPTH: -_ PIPE MAT ERIAL:-�� C LOT SLOPE:/�h` REMARKS: 5 /L� /J�J Form EQ -032 NEAREST SEPTIC SEEPAGE SEWER LINE—_TANK , SYSTEM_. REMARKS DIAGRAM OF SYSTEM !-�dretYl9 X y (C)OOFp Sept(r."'(aki lc w w vv DATE APPROVELC�-�c- G.A.A.B. TYPE OF SOIL HRSORBTlON SYSTEM IS� TRENCH MHXlMUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ FT/BR)� 1]5 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: 0,11 S�11 H E7 141 K3 - If I I — 10 &T �Hit lot ��11 . . R31 U 0" - F- H-1= v §.-.:: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF R TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFRCE OF THE GROUND HND THE BOTTOM OF THE EXCHVFI' ION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HND THE BOTTOM OF THE EXCHVRTION ():N FEET) ���11, _11 ::I[:: ��11' :JE (�.:: ril Vdl �ll::�� ::: H IcD, 1(%:�.If ����f��)f ill,F� ��� � ]1: 11 11 mi:, IF�E. F . �:: li � H_, 11", 11 ll:::: -Il IF- -i!! �11, � .11 : IF V ::11 BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPFAR OVFR. BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINlMUM DISTHNCE BETWEEN H WELL HND HNY ON^SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN OF THE WELL COMPLETION. SPECIFICHTIONS HND CONSTRUCTION DIFAIR HMS HRE HVRI1 -1:18LE TO INSURE PROPER INSTHLLHTION. ����11 - 11 11:: -H 0 p IF E IF:: IF-, 11:::D1 11111.4 F:�: �F-E:: ili:m!! 4:;:;;!! 11::,� )f y ., li I li -[I� N SOILS LOG MUNICIPALITY OF ANCHORAGE �/• DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 11 Pouch 6650, Anchorage, Alaska 99602 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: fvieaF 0ZrRfzFI % /,VG DATE PERFORMED:_ %z�2 LEGAL DESCRIPTION: L -0r_ –3/ _; H(2! n=LC- I Z01V/51QAf r iL-7aGLE 1 JD Ee H 51 /7y Sandy �a2fL(/C/s (GM) SLOPE- SITE PLAN — –� r—r--„-- ( ,LEG/d GLG.I JrQ/i ) ' I 2 3 a 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 !an�ly GP�t vel �G w ) G7zdv�l f lo6b/e ��ac�iorJ klell �oan�%c� to Sub - 1ZoC//�L%Cl /oav 0-i19is7`V.ee 6007�-07' WAS GROUND WATER S ENCOUNTERED? No L O P IF YES, AT WHAT E DEPTH? _ PZolioM oc 7XGgv. Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND __s FT COMMENTS DU.E +0 Mlnoe ally- 60n7LenoL GUE a, /22i1-)/1n6cm �!,¢ PERFORMED BY: Hou),-_, red , T. 6fzc CERTIFIED BY: DATE: /2 – &o – %6 (Rz 6rQC. ZnIG. 72-008 (7/76) O 2 V Municipality of Anchora q\` a° • ae 7 On -Site Water & Wastewater Program7 OCT 31 2015 (907) 343-7904 I ut E 9 � CERTIFICATE OF ON-SITE SYSTEMS APPR Parcel I.D. 050-052-37 Expiration Date: 1. GENERAL INFORMATION Complete legal description SCHROEDER; LOT 81 Location (site address) 12505 IRIS WAY "EAGLE RIVER Current Property owner(s) JILL BLOOMER Day phone Mailing address Real Estate Agent 11525 OLD GLENN HIGHWAY RANEY HARDMAN Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: 440-7257 TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System E Public Sewer ❑ WaiverNanance request for. Received by: COSA to be release to the otherwise requested by the engineer. COSA Fee $ S2 6 Date of Payment / / 1,111bl, Receipt Number Z— COSA # 0fC_1L,f)s--_ Date: 11 Waiver Fee $ _ Date of Payment Receipt Number Waiver # Distance: - L. a 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GES provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported msuns describe the condition of the systeMs on the deters of the evaluation. Separation distances were measured to madilyidentillable features. Hidden defects or encroachments may exist that were not Identified during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of constnrdion (materials and workmanship), and the water usage of the funny utlizing the sys(eW, These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems, therefore, GEG makes no warranty /express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system on be installed on the property in the event either of the current systems fail. The content of this report is for the sale benefit of the personrparty who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers is not authorized In short, GEG disavows any legal duty to anyone other than the person/parry who paid for this report. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. Conditional approval for 0 bedrooms. bedrooms. Phone 337-6179 • (^ I earn Ss W .��%T CE -79 V=�� 4k pROFESS\0N" LICENSE 1���\\\\\\\ #AECC884 bedrooms, with the following stipulations: �R YtOF", vt5T6lSC Vn.C�4✓' (ti)0e/C91. `_-`r-erAge or n C/ 1_1N -SITE Original Certificate Date: L WASTEWATER The Municipality or Anchorage Develop, emt 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. ATTCHMENTS COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112/12) I o 131 I(6 Date v`1 S . ♦•� 9 H * • (^ I earn Ss W .��%T CE -79 V=�� 4k pROFESS\0N" LICENSE 1���\\\\\\\ #AECC884 bedrooms, with the following stipulations: �R YtOF", vt5T6lSC Vn.C�4✓' (ti)0e/C91. `_-`r-erAge or n C/ 1_1N -SITE Original Certificate Date: L WASTEWATER The Municipality or Anchorage Develop, emt 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. ATTCHMENTS COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112/12) 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: SCHROEDER; LOT 81 Parcel ID: 050-052-37 PUBLIC ACCORDING TO MOA RECORDS, THE RESIDENCE USED TO BE SERVED BY A CLASS C WELL ON LOT 82; THE PROPERTY CONNECTED TO AWWU IN 2009 (SEE ATTACHED AWWU CONNECT CARD) A. WELL DATA Well type Date completed Total depth ft. Date of test Static water level Well production WATER SAMPLE If A, B, or C provide PWSID# Sanitary seal (Y/N) Cased to ft. FROM WELL LOG Well Log (Y/N) Wires properly protected (Y/N Casing :height (abo round) in. ATI CTION ft. g.p.m. Coliform _--� colonies/100 ml. Nitrate mg./L. Collected by: Vinic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA `NO INSPECTION REPORT WAS FOUND IN MOA RECORDS, INFORMATION ON TANK WAS WAS TAKEN FROM THE 2009 COSA. Tank Type/Material Tank size '1250 gal. *STE Date installed Number of Compartments'? Cleanouts (Y/N) '6/25/2009 'YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumping 9/7/2016 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA I •sELOW EXISTING GRADE Date installed 5/31/1977 Soil rating (g.p.d.Wo tbdr)) 135 System type DEEP TRENCH Length 48 ft. Width 3 ft. Gravel below pipe "8 ft. Total depth'.12.5+ ft.- Eff. absorption area 576 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 10/21/2016 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test"0 in. Water added 875 gal. New depth -22 in. Elapsed Time: min. Final fluid depth "'22 in. Absorption rate >= 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date THERE IS A 6" DIAMETER PIPE AT THE END OF THE DRAINFIELD THAT APPEARS TO HAVE BEEN USED AS A SUMP IN THE PAST, HOWEVER, NO INVERT WAS OBSERVED. THE MONITORING TUBE IS A 1.25" DIAMETER PVC PIPE AND IS LOCATED IMMEDIATELY BEFORE THE ASSUMED SUMP. WATER WAS INTRODUCED INTO THE SUMP THROUGHOUT THE TEST AND LIQUID LEVEL READINGS WERE ABLE TO BETAKEN IN THE MT. ALTHOUGH THE CONFIGURATION OF THE TRENCH IS UNCOMMON, THERE ARE POST TANK DOUBLE CLEANOUTS AND A FUNCTIONING MT. "`MT EXTENDS APPROXIMATELY 4.39 FEET INTO 6 FEET OF EFFECTIVE. "'173 GALLONS WERE INTRODUCED INTO THE DRAINFIELD, CAUSING THE LIQUID LEVEL TO RISE TO 22 INCHES IN MT. AN ADDITIONAL 702'GALLONS WERE ADDED (875 GALLONS TOTAL) CAUSING NO RISE IN LIQUID LEVEL.` D. LIFT STATION Date installed Size in "Pump on" level at in. "Pump off' level at in. Datum Cycles E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Manhole/Access (Y/N)— High water alarm level at Meets alarm & circui uir PUBLIC On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer erviceline Holding tank al containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 6+ Property line_ Water main 10'+ Water service 1 Wells on adjacent lots 100'+ 5'+ 10'+ Absorption field 54 (ASSUMED) Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line Z' Building foundation 101+ Water main 10'+ Water service line 10'+. Surface water 100'+ Driveway,.parking/vehicle storage Z(APPROx) Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WR#090037 OF •' G. ENGINEER'S CERTIFICATION • ............. (Rev. 10/12/12) * * 0 I certify that l have determined through field inspections and 4 ........ .. ...................... review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this: ••• • • ••••••••••.. ............ date. �� �:. Corn s; �= Engineer's Printed Name JEFFREY A. GARNESS ���fj CE -7 �i Date 10 )3//11" �o ••........... •.• ���: S\�� • ES � � LICENSErJ #AECC884 (Rev. 10/12/12) MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE:(907)564-2762 BLOCK/LOT/TRACT: LT 81 / SUBDIVISION: SCHROEDER TAX CODE: 05005237000 GRID: NW0351 STREET ADDRESS: 12505 IRIS WAY Eagle River, AK 99577 OWNER: MONSARRAT LINDA 50% & POLZIN MICHAEL 50% WATER CONNECT PERMIT W09W61' DATE OF APPLICATION: 08/11/2009 SCHEDULED COMPLETION DATE: 12/31/2009 MAIL ADDRESS: 4920 BYRD LANE ANCHORAGE, AK 995021350 ❑X SINGLE FAMILY ❑ MULTI -DWELLING No. APTS ❑ COMMERCIAL PHONE: CONTRACTOR Green Contracting ASSESSMENTS ❑ Repair Existing Service ❑ Main Line Extension Q On Property Only ❑ City TapX❑ Have Been Levied ❑ Hydrant Only ❑ To Be Levied ❑ Main Tap - To Property Line Only Comments: ❑ Main Tap & On Property Connect Row No. ❑ Disconnect ❑ R & R - Main Tap Only ner I Staff CONNECT SIZE 1 in ISSUED WWSAP INSPECTION FEE S 98.00 ❑PAID ❑ CASH PERMIT FEE 5 63. 00 ❑ CHECK # $ 0.00 i n OTHER Ct. REIMBURSABLE DEPOSIT $ 0.00 INSPECTED BY T Pi -17 !y NUMBER TOTAL $ 161.00 DATE X O REMARKS This lot is currently connected to the keybox on Lot 82 (12515 Iris Way) where the well was located. Must disconnect house from keybox on Lot 82 and run new service on this lot. co,yP/elter� g�jQ/pQ yNac�v PERMITEE (Please Print) C&T Construction MAIL ADDRESS 17343 Santa Maria Drive Eagle River, AK 99577 SIGNATURE =161MA POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY GATE -SCHEDULED 12/3112009 TIME 12.00 am INSPECTOR Z7—Z4_,t C'_�' SUBDIVISION SCHROEDER BLOCK/LOT/TRACT LT 81 / NAR T� Ia SOS_ N q � � EXrs7iNG 3/y a m �9� I K£y6ox--_R$ ��, A1W)0RoP 1 � GCRNER SIZE CONN: CORP STOP CURB STOP C TO C FT. COPPER PIPE 1 1/4" OR 2" KEY BOX FT, THAW -WIRE OTHER J/l LINE BLOWN OUT ❑ OPEN BORE FLUSH ❑ 150 / 200 LB. TEST ❑ MAIN CHLORINATED ❑ CHLORINE FLUSHED OK TO TURN -ON ❑ CONTINUITY ti3 � ©'DOMESTIC ONLY ❑ FIRE LINE ONLY DATE OF TAP SIZE MAIN TYPE MAIN DISCONNECTS E] YES COMMENTS KEY BOX LOCATION !6 F/ E or' / j,/ PRoF 0,4111s ❑ BOTH FIRE & DOMESTIC ❑ FIRE HYDRANT ONLY BY _ ❑ALLEY [-]STREET []EASEMENT EXCAVATOR ❑ NO SIZE OF DISCONNECT INSPECTION REPORT �y ❑ INSULATED INSPECTOR DATE C COMMENTS K13 ! o )-o7- 8( !S 7,,owed oN E �oPPE R T� 1 07 fir( IS {//SGOn//1/EcTF/J /}T e, 3 Po/I l o T S.2 - sjf (/d Tr' o/v 07"/? S -/,OF ❑ DO NOT TURN -ON OF Til/S /-2CRM/7 L,5 Municipality of Anchorage Development Services Department�Y _... e Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. 050-051-31 COSA # Qq0Q l I Expiration Date: 7-10-10 1. GENERAL INFORMATION Complete legal description s,.t,LSF sl Location (site address) .12505 Iris V41, Eng 1�I AV, 91516-1 Current 95b-1 Current Property owner(s) (, nX-A- Mon srur•rGk Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Sir. 1105JI Dayphone 3SO-648`1 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: I_ 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System fa TYPE OF WASTEWATER DISPOSAL: Individual On-site CK Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Sp4AAcQ &wineerinu Phone 249-391(0 Address 203 W. 15A1' Ave, sic. 207-. An, L,.4 e . AK 99501 Engineer's Printed Name 5. DSD SIGNATURE Approved for Disapproved. bedrooms. Date -4 -4 104_ SPURKL4NO.i 11 0 •��� 0/ SSt A� Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �, Original Certificate Date: 7— /0-0q (Rev t7.05) Municipality of Anchorage Development Services Department Building Safety Division - On -Site Water & Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST t - Legal Description: SrLroeAtr Lok $1 Parcel ID: OSy - 052.- 3_+ A. WELL DATA P0 -1;L W.4w Well type — Date completed = Total depth ft. Date of test Static water level Well production If A, B, or C provide PWSID # — Well Log (Y/N) Sanitary seal (Y/N)= Cased to — ft. FROM WELL LOG ft. WATER SAMPLE RESULTS: Coliform — colonies/100 mL Nitrate -- mg/L Arsenic: ug/L date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material Ar,.6nle- TAn1C) S4ce� Tank size 1250 gal. Number of Compartments �- Wires properly protected (Y/N) Casing height (above ground) — in. AT INSPECTION _ ft. g.p.m. Other bacteria — colonies/100 mL Collected by: Date installed b/-ts Jot Cleanouts (Y/N) Foundation cleanout (Y/N) _Y_ Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping Ale Pumper Al C. ABSORPTION FIELD DATA Date installed 5 3/ 3 Soil rating (g.p.ddfe o a d 115 System type Deed Tfx^jr, Length ft. Width 3 ft. Gravel below pipe (o ft. Total depthII I_3 ft. Eff. absorption area 536ft' Monitoring tube Depression over field AI Date of adequacy test 5 o Results (Pass/Fail) IL56 For I bedrooms Fluid depth in absorption field before test - in. Water added 10015 gal. New depth in. Elapsed Time: �0 min. Final fluid depth __0_ in. Absorption rate >= 6C / g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) male. KWyn If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level _ tn. 'Pump off" level at in. High water alarm level in. Datum Cycles tested Meets alarm & circ . requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: VJATC-P– Septic tank/lift station on lot — Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5rt Property line 5+ Absorption field 5 + 1 1 � Water main 10+ Water service line 104- Surface water /004 Wells on adjacent lots 7 WO SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 1 Property line 2 Building foundation 10+ Water main 10 t t Water Service line 10 1 't' Surface water t00' t Driveway. parking/vehicle storage Curtain drain IV. 0. Wells on adjacent lots `)WO 1 F. COMMENTS Ilk G. ENGINEER'S CERTIFICATION qE.�F.... 11+ � 1 I certify that I have determined through field inspections and review of Municipal records that the above systems are in/ gTH� conformance with MOA COSA guidelines in effect on this date. i " ` + r•• Engineer's Printed Name Lars S n 5 E: URKLAtvD:h� Rt Date --floy 111 �FAF . oq � COSA Fee $ Q50 Waiver Fee $ 40 u Date of Payment 2�6�!) Cf Date of Payment V rl Receipt Number Wo 7 Ti 1/ Receipt NumberCYd 7�y (Rev. 11/05) S� I 25 I -1 vOi m mNm Oi I zoo �" c Iz Noo I to 1< cn i ' 4 I N00002'00'W 157.02 m;vm Icn z 1O1nn 1 col 1� A 4". IRIS WAYtg — ,•c/j•Jl,.,.j �`� • , iy. ao.p I J +oo N 9 1 ferry /� eo I � J � • j � J m Enpy 1 J • AV 0 f A A 'dj. R1 I_ b l J �Tt Z� 1 •T 6.C, k' r I'=s r.. ' Z'17� to � j(p 1 O m a i I I J Ilii16 • _ . co s I o r J irii �'7f,�►Y+\tea I 1 J �° se r C 5 Lv O� Ham R w 4 b 17 � ( p XXX 1 J • o'g'a ii SaN�.. =Oc r FM 0 ma Z 1 vo (AM lb km N H N00002'40'W 114.34