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Home My WebLink AboutTHUNDERBRUSH LT 1Thund rbru h Lot 1 015-142 -70 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 0SP231379 PID Number: 015-142-70 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name AMY HAN ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑Bedound Site Address 11400 BIRCH ROAD *ANCHORAGE, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-252-0811 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot THUNDERBRUSH; LOT 1 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total orption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ 25'+ TANK El Septic 0 S.T.E.P. El Holding [I Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 100'+ Material Number of compartments Lot Line 5'+ NA EPDXY COATED STEEL 2 Foundation 101+ LIFT STATION Manufacturer Capacity Remarks PER CONTRACTOR OLD TANK WAS HAULED OFFSITE ANCHORAGE TANK *500 Gal. *SECOND COMPARTMENT OF STEP TANK Alarm location 11 G010,�; Electrical installed by � s 0 -q, PIPE MATERIAL House to tank D3034Tank to D1785 drainfield Installer A+ HOME SERVICES Drainrield D3034/EXISTING CO/MTD3034 Inspector GEG BENCH MARK (Assumed elevation) 100.00 ft Inspection1s' 6/11/2024 - Location and description es: 2�a BACK DOOR THRESHOLD 3rd - 4t _ ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp oo6op�0 o� OF q �°pop Conditional Approval: Date 4TH ... ....�� Q Jeffrey A- Garrtess;" QO 9 v. VCE-7953 eQ� Septic System / , 1 Approved Date N te• is approval does not include well permit requiremen s. 4��°00000�� #necc (Kev Ub/UL/1S) / PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER: OSP231379 015-142-70 A B MH1 49.5 62.2 \I MH2 1 56.2 67.7 \ NOTE: PIPE LOCATIONS ARE \ SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER, SWING -TIES TO \ HOUSE CORNERS WERE APPROXIMATE 100' WELL RADIUS GENERATED IN AUTOCAD. \ T12N R3W SECTION 22 LOT 40A \ EXISTING CULVERT WITH LID. A BALL VALVE IS LOCATED ON EACH PRESSURE LINE TO DIVERT FLOW TO EACH FIELD � /-NEW 1500 GALLON STEP TANK THUNDERBRUSH; I LOT 5 APP THUNDERBRUSH; LOT 41 - -1 _/ — f� — 100' WELL RADIUS THUNDERBRUSH; LO 22 I EXISTING 3 BEDROOM y• HOUSE DRIVEWAY r GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907) 337-6179 • FAX (907) 338-3246 • WEBSITE:-gamessengineering.cam PREPARED FOR: PHONE NUMBER: PAGE NUMBER: AMY HAN 907-252-0811 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: THUNDERBRUSH; LOT 1 D.J.G. TYPE OF WORK: DATE: �_ SEPTIC TANK RECORD DRAWINGS 6/21/2024 N SCALE: 1"=40' w\�\\�'1\ /♦ :/etfrey A, Gayness �♦�� CE -7953 =��: LICENSE 1 ROFESS #AECC884 It ylI`is� P` NUMBER: OSP231379 RECORD DRAWING OSP231379 TOP OF MH#1 = 98.62 –n/ --FINAL GRADE = 98.06-98.23 TOP OF TANK AT INLET = 93.12 INVERT OF BUNG AT INLET = 92.48 NEW 1500 GALLON EPDXY COATED STEEL STEP TANK PER CONTRACTOR - NO GROUNDWATER WAS ENCOUNTERED IN THE TANK HOLE TOP OF MH#2 = 98.66 GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK 99507' PHONE (907) 337-6179 - FA%(907) 338-3245 -WEBS ITE: wvrw.garnessengineei in g.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: AMY HAN 907-252-0811 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: THUNDERBRUSH; LOT 1 D.J.G. TYPE OF WORK: DATE: i,_ STEP TANK PROFILE 6/17/2024 PARCEL ID NUMBER: 015-142-70 — TOP OF TANK AT OUTLET = 93.09 vi OF 40, AW `9 # AV IAF 0 ................. .......... � .' r / .. . .................................. 0 0 �� : Jeffrey A. Garness 'AiAr = # C## 7953 ••'�F�i� • LICENSE• PROFESS�uz mow* #AECC884 1111,11\\* / 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 Permit Number: OSP231379 Work Type: SepticTank Upgrade Tax Code Number: 01514270000 Site Legal Address: THUNDERBRUSH LT 1 G:2637 Site Mailing Address: 11400 BIRCH RD, Anchorage Owner: HAN WHEE AMY Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: C ll j- �0 fi S', f. c� De paI-t4ntell t 11/14/2023 11 /13/2024 32756 ❑ 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: -� 7-j C E Issued By: L �— Date: Date: I t / `1 0 Z- 3 3 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. 015-142-70 Property owner(s) MINA HAN (BUYER) Mailing address 11400 BIRCH ROAD *ANCHORAGE, AK Site address 11400 BIRCH ROAD *ANCHORAGE, AK Day phone 907-252-0811 Legal description (Sub'd., Block & Lot) THUNDERBRUSH; LOT 1 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial [ ] Single Family (SF) Septic Tank ElUpgrade (w/wo ADU) Holding Tank ElRenewal ❑ Duplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (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: 2 Z Waiver Fees: Date of Payment: It Z Zo Z Date of Payment: Receipt Number: Permit No. 0 S P Z 3/ 3 ?5 Receipt Number: Waiver No. G.\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231379, Curtis Townsend, 11/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231379, Curtis Townsend, 11/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231379, Curtis Townsend, 11/14/23 FNt? REBAR N 14 27' E27' FiVG? 3"BRASS SAP / crane r rvu jDj rrcn r-ncrrrn®r THE INFORMA TION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALL Y TO SHOANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLA TTED L OT LINES ANDOR EASEMENTS,- AND IS NOT TO BE USED FOR POST TIONING ADDITIONAL S TRUCTURES, IMPRO VEMENTS, OR FEN 'ELINE : EASEMENTS OF RECORD, OTHER THAN THOSE A PPEA RING ON THE RECORD PLA T, ARE NOT SHOWN HEREON ( UNLESS INDICA TED) NOTE- FENCEINES THA T ILIA YAPPEAR ON THIS DRA WINO ARE NOT TO BE USED TO DETERMNE PROPERTY L INES OR POSI TION ADDI TIONAL IMPROVEMENT, ANY PA VING SHO WN HEREON MA Y BEAPPROXIMA TE DUE TO EXCESSI VE SNOW AND/OR ICE. OF THE FOL L OWING DESCRIBED PROPERTY ANCHORAGE RECORDING DISTRICT ALASKA, AND THA T THE VISIBLE IMPROVEMEIt!TS S1 TUA TED THEREON ARE WITHIN THE PROPERTY L INES AND NO VISIBL E ENCROA CHMENTS EXIST O THER THAN NO TELL DA TED A T ANCHORAGE, ALASKA THIS 14 TH DA Y OF SEPTEMBER , 2023 HOL T LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 223-8615 /'"% MUNICIPALITY OF ANCHORAGE DE, .,,~TMENT OF HEALTH AND HUMAN SER¥...ES '~' '"~' Environmental Health Division · '.'"~ ' 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name CNA~L~ s GA~ ~ ~D!STANCES Address ~ TO . SEPTIC ABSORPTION il ~ ~ t~ ~ ~,FRO~ ~ ~TANK FIELD WELL Phone(s) ] Perm,t No. .. iND. of Be~room, WELL ~E~L oEsc.,.,,o. LOT LINE I Lot TM ON~ ~O~ ~ FOUNDATION m . Urlveway. water bodies, etc.) ' TANKS N ~ SEPTIC ~ HOLDING Manulacturer Capaoty m gallons I Material = No. of Compa~ments TYPE OF SYSTEM ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER ~pthtop~pebottomlrom~ - ~otalOepthlromong~nalgra~e ~ ~ Fdl aeeed above original grade Gravel oepth ~neath p~pe Gravel leng~ ~ravel w~dlh ~ Total absorptmn area ~ D~stance between hnes , '~umber of hnes J 50,I rat,nD j P,pe material FI: Installer Date Installed I I, WELLS ~ ' ~ PRIVATE ~ OTHER {Identify) ClasslhCatlon (A.B,C~ 3oral Depth ~1 Cased to c '~, .'..' ~; :~ ~ ~ ~,~'~ FT FT F;2' Installe~ Date Installed, ', REMARKS: Inspecbons Pedo~mea ' ~ ~ ~ ~,-~", ....... ~f.~,>;. Da e. - .... I cedily ~at this inspe~ion was pedormed according Municipal and Slate ~delines in e ~ ~; e~¢ ' Health DepadmentAppr~val:.. -~/- -- Date;~~ 72-013 (3/85) PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT. PHONE: ~-tlUI~ I C T F~('aL Z TY I~ICi--i~--~AGE DEPARTMENT ~. OF A HEALTH AND ENVIRONMENTAL , .,OTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 OI~--S I TE SEL~JER F'ER~ I T 86£ ~7 ENGINEERED DESIGN 09/05/86 GAUSE/SF'URKLAND 203 WEST 15TH. AVE. ANCHORAGE, AK 99501 279-5916 LEGAL DESCRIP: LOT SIZE: SUBDIVISION: THUNDERBRUSH SECTION: o~) · ~.~- TOWNSH I F': .75A (SQ. FT. OR ACRES) LOT: 1 BLOCK: NA 12N RANGE: 3W I certi;'y that: 1. 1 am £amiliar with'the requirements £or on-site sewers and wells as set F'orth by the Municipality o~ Anchorage (MOA) and the State o( Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria o~ this permit. 3. I will adhere to all MOA and State o£ Alaska requirements (or the set back \ distances £rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2)' AS-BUILTS WILL NOT BE APPROVED WITHOUT APl ELECTRICAL INSPECTION REPORT; AND (5) THE ELECTRICIAN. DATE: ELECTRICAL WORK MUST BE DONE BY/~ LICENSED SIGNED -~, ~ DATE: p/nE. VeL Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR,.T,ON: 1 3 5 10 11 12 13 14 15 16 17 18 19. 20 COMMENTS 31,2..- ~ ~. (~ERG~EEEI'S,$EAL) _.'. ',,~" "- '. 4'-'~ · '"~7.:% ' ,, f, i -. JUNE 25. t97! .'. gATE PERFORMED:: ' SLOPE -- ~;IT"E P~L-AN' ! - WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH? ~ O P E Depth to Water Alter Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop 0,,,~. R //?.t~[. o 0 7 //~" 0 ~ , 8 fl~]~ o 0 A.. ~. PERCOLATION RATE.Z~/~__ . (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~;/'~- FT AND ~-~' FT i PERFORMED BY; D.t ~/CICA/ , ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. ?2-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: REA- ER iANCHORAGE AREA BOROb 'H Department of Environmental Quality 3330 C Street Anchorage, Alaska 995'03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCAT).o,N MAILING ADDRESS g (:3/~ /(03-"0 PHONE. ~-~ Z/~/-O ~7'~)0 LEGAL DESCRIPTION g--~5"~'I ~'H-U~t~l~2-['~l~O-.(4/~"tz4 SEPTIC TANK: DISTANCE' FROM wELL INSIDE LENGTH MANUFACTURER ~.~ t~-~_t~ MATERIAL INSIDE WIDTH .LIQUID DEPTH NUMBER OF S4~..~.. / COMPARTMENTS '~- ,LIQUID CAPACITY / OC~ O GALLONS. SEEPAGE PI"I: tr NUMBER !OF PITS ~ DIAMETER LINING MATERIAL CRIB SIZE: OR WIDTH ~, LENGTH , DEPTH DIAMETER DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTIONIAREA (WALL AREA) ~(/~' P SQ. FT. BUILDING i FOUNDATION ~ ADDITIONAL ABSORPTION NEAREST LOT LINE WELL: TYPE BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER 5OURCE5 DISAPPROVED DEPTH DISTANCE FROM: NEAREST SEPTIC 'SEEPAGE SEWER LINE , TANK __ , SYSTEM REMARKS DISTANCES: INSTALLED BY: i ~ ~~ CO ~ ~ LOT SLOPE: REMARKS: Form No. LQ-031 DIAGRAM OF SYSTEM DATE APPROVED f~' ~I~ G,A,A,B, ,Rz,-)'/,*.6 [..z--v,,.-- ~. :2 P r:, -/)nAo /5- 6.]?.~. PERMIT NO. :r.lt/,,..,r,:.,:.; -. .. ,, .~ , -. ,...,, ..: ........ ., .: .... ./'. ,,.., , APPLICANT REGINALD .. v,-, ~-. .~'.:- .' BOX' "'16~0 SRA ANCHORAGE ~'4'--097'0 LOCATION LEGAL L1 ~HUNDERBRUSH'SUBD .!, !".,,:-.,'::::LF -t'~ .... "' ' '-" -' - LOT~'StZE:'' -: _~2756'"_~.OA~E FEET .... ' . TYPE OF SOIL ABSORBTION SYSTEM IS:';TRENCH"'-~';.-- ./',-....' .; ~.,., MAXIMUM NUMBER OF BEDROOMS = g SOIL RATING (SQ ~/BR>= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: F--~EPTH= 7 L E t~l G T H =~\..,5 7 GRFi%.'EL DEF"I-H= '~:~ THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS :THE DISTANCE BETHEEN THE SURFACE- OF _THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>, " THERE IS NO SET HIDTH FOR TRENCH, ES. THE GRAVEL DEPTH IS THE ftlNIMUrt DEPTH OF GRAVEL BETHEEN THE OUTFRLL 'PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. F-:Em;!U I AEC, SEPT I C TRr~K S I ZE: 10m3m,-3 GRLLmDrqS BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT HILL BE SUBJECT TO PROSECUTIO~'' r; . :- MINIMUM DISTANCE BETHEEN A NELL RND~ ANY ON-SITE',:~EHRGE DISPOSRL'"~YSTEM IS J · 0~ FEET FOR R PRIVATE HELL OR 2~EET~FOR~.R PUBL ' '" I C HELL.~ .... HELL LOGS ARE REQUIRED RND HUST.BE~RETURNED TO 'THE 'DEPRRTHENT NITHIN ~ DRYS OF THE HELL COHPLETION. ~.' . ............................ SPECIFICATIONS AND CONS~LIC~-ION"DIRGRRMS ,ARE AVAILABLE TO INSURE PROPER I NSTRLLRT I ON. ~: ~"' '" F'ERr-IIT "..~RLIE~ F~DR OraL. '~ERR FRCmrl I SSI_IL I CERTIFY THAT l: I AM FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AND NELLS AS SET 'FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCORDANCE HITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEHER SYSTEM MAY REQUIRE ENLARGEMENT IF .THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. A"choratle, A I aslca 9g'.,U3 ~ ,(~.;tl'lioM I,(~; .. I'I~IIOI,A'I'If~N 'I'I';:{T .Pc~'~° rmcd for uescr~pc]on: Lo~ 1 S~ 1/4 g~z'), ~ _ . ...... J)ate Perfonmzd ,. ~ z b:is" --- ' form reports: S~Fs-~j--~--,~,z..=~._~.2~= 22, T12~,. =z,.. =~, --~-~~ Percolation te~Y'--~ ......... - z.7 - z,:' (~9) Was ground water encountered? ..U.m. ......... 'If yes, at what depth? Reading Date Gross Time___.___ __j~.~'e~t _T.i__me i.)eptl) tO Writer Net Drop .............................. 2 ........ LL]" .--:_' .................... ' ........ / ....... ~ , ........ , .... -'" '." · . . utc _ .2Z m~nutea · - ........................ 'J ........~ ........ · ' " · I rdlll ! 1Cid . · MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section—' Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-142-70-000 Expiration Date: Legal description THUNDERBRUSH LT 1 Site address 11400 BIRCH RD Anchorage AK 99516 Current property owner(s) HAN WHEE AMY 11/15/2024 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: WE Original Certificate Date: 10/15/2024 ThKCertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject tem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE Development Services De \ _,T � Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-142-70 Complete legal description THUNDERBRUSH; LOT 1 Location (site address) 11400 BIRCH ROAD *ANCHORAGE, AK Current property owner(s) AMY HAN 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-252-0811 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: F Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS X Bed X Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $_-5_60 Date of Payment g1 -z- 7/2 `-i COSA # 0S CZ" 13a 5 Waiver Fee $ Date of Payment Waiver # COSAApplicaUon_June 2022 Legal Description: THUNDERBRUSH; LOT 1 Parcel ID: 015-142-70 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 9/1976 Total depth 146 ft Cased to UNK ft F0 Sanitary seal is functioning correctly FM Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/16/2023 Static water level at beginning of test 121.5 ft Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: *NEW SEPTIC TANK D. ABSORPTION FIELD DATA Which system tested (date installed) 1986 A ALL standpipes present per record drawing Total measured depth from grade 5.5 ft (max) Measured depth to pipe invert from grade - ft (min) ❑■ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. vF* If not, state depth into effective X Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced *1060 gallons 10/19/2023 date Any rejuvenation treatment (past 12 months) UNK If yes, enter date N/A Well production at time of test 5.4+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑■ No R Coliform bacteria is Negative Nitrate 2.09 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by UCu Date 9/20/2023 C. LIFT STATION FN Required maintenance completed Age of lift station NEW years Lift station material STEEL Comments: Adequacy test date 10/20/2023 Results Q Pass Fluid depth prior to test Water added 462 gal 3 in New fluid depth 6 in Elapsed time 240 min Final fluid depth 3 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 3 in Effective depth remaining 3 in Comments/Deficiencies: *SYSTEM FILLED TO 100% (6.5" IN EACH MT) DURING PRE-SOAK. TWO NEW MTS WERE INSTALLED IN BED. **BOTTOM OFA MTS ARE AT (OR NEAR) THE SAME ELEVATION. CONDITION OF 1976 TRENCH WAS NOT EVALUATED L COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' FE] Yes if No ft Neighboring Tank > 100' [E Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Neighboring Absorption Fields > 100' [ji Yes if No ft Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Holding Tank > 100' Animal Containment > 50' NlYes if No ft Q Yes if No ft Community Sewer Main > 75' ❑■ Yes if No ft Manure/Animal Excreta Storage > 100' Q 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' ❑i Yes if No ft Surface Water > 100' ❑■ Yes if No ft Tank to Property Line > 5' [n Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' FE Yes if No ft Water Main > 10' n Yes if No ft Water Service Line > 10' 9 Yes if No ft F. ENGINEER'S COMMENTS Community Wells > 200' Q Yes if No ft If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Gayness Engineerinq Group LTD (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG 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 results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; 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 can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. I.VJA l:neCKIWS June 2022 0, 4 TH �* ff e A.�Garness, E-79 3 , TENSE ,pro f e s s1o"°oma' #AECC884 9 FND. RERAR N 14 27E 2.7 <,vnnn rnAAD1 mc -n onCITlnA/ FND. 3" BRASS CAP OF. A C0 49 TH � �D SHANE A. HOLT .'� � �a LS-6914cb � O °tessiona\ ��OOooO� THE INFORMA TION HEREON IS FOR THE USE OF L ENDING INS TI TU TIONS SPECIFI CA L L Y TO SHO W A N Y CONFL IC TS BETWEEN EXIS TING S TR UC TURES A NO PLA T TED L 0 T L INES A ND/OR EA SEMEN TS,- A NO IS NO T TO BE USED FOR POSI TIONING A DDI T/ONA L S TRUC TURES, IMPRO VEMEN TS, OR FENCEL INES. EASEMENTS OF RECORD, 0 THER THAN THOSE APPEARING ON THE RECORD PLA T , ARE NO T SHOWN HEREON ( UNLESS INDICA TED) NO TE:- FENCEL INES THA T MA Y A PPEA R ON THIS DRA WING A RE NO T TO BE USED TO DETERMNE PROPER TK L INES OR POS/ TION A DDI TIONA L IMPRO VEMEN TS. ANY PA VING SHOWN HEREON MA Y BEAPPROXIMA TE DUE TO EXCESS/ VE SNOW AND/OR ICE. / HE HE H Y UE H / l- Y / HA / / HA VE PERFORMED A SUR VEY OF THE FOL L OWING DESCRIBED PROPER T Y L 0 T 1 THUNDERBRUSH SUB. A NCHORA GE RECORDING DIS TRIC T A L A SKA, A ND THA T THE VISISL E IMPRO VEMEN TS SI TUA TED THEREON ARE WI THIN THE PROPERTY L INES AND NO VISIBL E ENCROA CHMENTS EXIS T 0 THER THAN NO TED. DA TED A T A NCHORA GEA LA SKA THIS 17 TH DA Y OF JUNE 2024 15926 234-20 237-56 v m HOL T L% ND SURVEYING 9309 GRO VER DRIVE ANCHORAGE,AK 99507 223-8615 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to sUbmittal) (a) Legal Description (include Iht, block, subdivisiOn, section, township, range) LoT! '; ': : ;'MUNICIPALITY OFA~IcHORAGE: ' : ~ ~' Department of Health & Human Services ' DIVISlON OF ENVIRONMENTAL SERVICES : CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Location (address or directions) (b) Property owner (c) Mailing Address Lending Institution It H o-c=, ~. Telephone: (home) ._~usiness Telephone Mailing Address (d) Real Estate Company and Agent Address (e) Telephone ~-T&, - ~_-~"~'~ ! Mail the HAA to the follOwing address: (or check here~~' if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE ~' Number of bedrooms Single-Family 3. WATER SUPPLY Individual Well'l~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental ConservatiOn"attesting to th legality and 'Status'. 4. SEWAGE DISPOSAL , ; ~ Public[] ' Community[] ' Holding Tank[] Note: I~/ community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) 'Page 1 o~ 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND.INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the .on'site water supply, and/or wasteWater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection.. Address Date Engineer's Seal 6. DHHS APPROVAL _Approved for ,.. -,:~ edrooms by Approved ~ Disapproved Terms of Conditional ,~,pproval Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent prOfessional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees oi DHHS do nOt conduCt inspeCtions or anal~:ze data'before a'certifiCate is issued. Th:e Municipality of Anchorage is not reSponsible fOr errors or omissions in the professional engineer's work. ' ' 72-025 (Rev. 7/88) 8acl( Page 2, ,of 2 ,...: ,:: [..*--~__~.~ ..... .Health Authority Approval (HAA) , .MAR ]989' - A.'WELL DATA Total Depth ~/$~ Oasedto)/~ Depth of Grouting . Static Water Level. I ~ Casin~ .eight ~bo~ ~[o~n0 ... filectrical Widng~in Conduit {Y/~) ~ SEPARATION DISTANCES FROM WELE: ',",~; To Septic/~ Tank.on Lot - I ~,".. To Nearest Edge of Absorption Field on Lot ..... ]~ ~ ; On Adjoining Lots To Nearest'Public Sewer Line ~/~ To Nearest Public S~wer Cleanout/Manhole Pump Set At :Sanitary Seal on Casing'{Y)N)". Depression Around. Wellhead (Y/N). To Nearest'Sewer Service Line on Lot -i~//A ' - ' Water Sample Collected by -. ,.-¢,~..S ;Date ~.'~l~. ~':~ ' Water Sample Test Results ' '.' .~."~' ~.o///,~" . ' Oi ~,/..//t4,4 .~//~ Comments ~" ; b. SEPTIC/I'I~I~i;~:RG TANK DATA .... ' .... Date Installed "I~rT~.--- :Size I~ No. of Compartments .... "~ Standpipes (Y/N) T'~'O ' Air-tight Caps'(Y/N) 7 F°undati°rz'Ctean°ut?¢/~ e,,~o/~' "' Depression oVer Tank (Y/N) ~ ..... Date Last pUmP Pumping/Maintenance Contact on File (Y/N) ~/t~ ; for ~. -.' '' '' ,i. ; ~..I ".' ::" -. ;::: 'J . ' ' ;~.' ~ ' " Holding Tank High-Water Alarm (Y/N) ~ TemporarY ,Holding Tan? Permit (y/N) ;"~:,'.,.~j,:. ,. o'.:. :.~-~ . SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: 'TO Buildin~F0undatioh t./~ · To .Water-Supply Well ] "~C) ~' .... ~ ' To Water Main/Service Line _'~ ! O To Stream, Pond, Lake or Major Drainage Course Comments ..... "' 72-026 (Rev. 7/88) Front Page 1.0_f 2- Soils Rating in Absorption Strata ir'~'l ~, ~ ::': ';: ~': TYPe*of System:Design Date Installed "I:'gt'~' ~ ~~':--';Length 0f~i~' · ~,LWidth.of:Field~ i:-c ~ ~ ....... ', Depth of Field ~ .::,, ;~.'. </,, '~,",: ','/ ~: J: 3 ~Gravel Bed Thickness ~" Square Feet of Abs°rti;~ A~ea ~ ~'~ ~ Statndpipes Pre';h{' (~ .1. pepre~sion 9var F~eld (Y/N), ~__. ~e~f~ AdequacYTe;t' ~/Io 18~ ' ' Resultsof Last Adequacy Test ' ' ~ , ~ SEPARAtiON ~ISTANCE ~ROM ABSORPT;ON FI~C&~ , .... To Water-Supply Well ...... ~:~ / ~:~ '~ "" ':~ TO" Properly ':~: ~;';~ Line '~ ' To Building Foundation ........ ~ ~: ' :: -* TdE~isting or Abandoned SY~te~ on Lot- ~' ''' ~ .... r;~.... ::~:: :'~,~..,: "OnAdjo~mngLotsl,; ,,~:~:~. .... ~ , . ... .' To Water ~in/Service ;Line !.: ' "P/c-c:': ~: :. To Stream, Pond, Lake, or Major Drainage Course _..To riveWay;' _Pa. rking Area,!or!Vehic!e,.St0,rage Area Comments To Cutl~ack (if Present);' D. LIFT STATION ""' ..... Date Installed · Size in Gallons- ' ~.-'.'5'o-c> '::: :; ....... :!Pump On"-Level at ... High.Water. Alarm Level at ri' ~ ' Tested for / Meets MOA Electrical Codes (Y/N) Comments · · .'.. Dimensions ' ,5'°'¢~ Manhole/Access (Y/N)' "Pump Off" Level at ~ ~ ' ',: Vent (Y/N) ~/ Pumping Cycles during Adequacy Test. Check Permitted B~droom Rating Against HA~ ReqUest*,* .... I certify that l have checked, verified, or conformed to all MOA a'n~' HAA ~l~idelines in'~fiect ~' :' ';' :~ '"':~' on the'd~te 5f this inspection: Company I Date ~~ '~ ~ ~ ~ Q ~. :~T~ ~..~ ~r,.' Engineer%Seal -~ . ~-~ ~1 ~, ' '. ~% .. ' .... [;.'/J, . ...... ., . ,),~ , ,, .... . . . ~ ' ' : MOANo. __ ,~, ~.' ~"~'. JUNE 2S. ~971 .'./~ ............. 7 ,~ _ · ~...(~...,~.., ,' , - ..,.~, . : . · . ' . Rece,pt No. Receipt No. Date of Payment ~/~/ Waiver Fee: $ 72~26 (Rev. 7/88) Back P~ge 2'°f 2 . 203 W. 15th AVE "C" SUITE 203 ANCHORAGE. ALASKA 99501 TELEPHONE: (907) 279-3916 LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM ADEQUACY TEST Lot 1, Thunderbrush 11400 Birch Road Charles Gause Single Family, Three'Bedrooms On Site SEPTIC SYSTEM: DATE OF LAST PUMPING: FROM MUNICIPAL RECORDS: 3-Bedroom System TANK: Greer Steel, 1000 gal, 2 Comp. ABSORPTION SYSTEM: Pressurized Bed ABSORPTION AREA:..- 1408 sq. ft. SOIL RATING: 312 sq. ft. per bedroom INSTALLATION DATE: November 1986 March 9, 1989. Marx DATE OF TEST: March 10, 1989 TEST PROCEDURE: System was inspected and measured. Tank was found with 5 feet of cover, monitor tubes to bed had 3 and 8 inches of liquid. System had been pumped on Feb. 24, and the bed had dried out by March 3. Approximately 700 gallons of clean water were added to the absorption field while the water levels in the monitoring tubes were monitored. The water level rose one inch per 360 gallOns. The absorption was monitored for 2.5 hours. The water level dropped .25 inches during this period, indicating that approximately 60 gallons were absorbed. This is the same as 575 gallons per 24 hours. TEST RESULT: This system meets the code requirements of the Health and Social Services Department of the Municipality of Anchorage. NOTE The operational life of all septic systems depends on the local soil conditions, groundwater 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 septic system. We can therefore not give any estimate of how long this system will function satisfactory for current or future occupants. This system is designed for a water usage of not more than 450 gallons per day. A higher water usage will cause the the system to overload and a period of no use will be required to restore the system. 17034 Eagle River Loop Road Eagle River, Alaska 99577 ~---~7 _ DATE OF TEST: '~"~:::'~"¥- DRILLER: ROBERT A. SHAFER PROJECT: '[:~~~ ' "~::::::'O~ LOCATION OF WELL (Legal Description): WELL DEPTH: ~,~'~"'~'-- ~ FT. CASING: __ DATE DRILLING COMPLETED: STATIC WATER LEVEL (Top of Casing): ~. "7-~--"°1 CIVIL ENGINEER 694-2979 SCREEN; CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWNI PUMPING TIME PUMPING STARTED/ STOPPED, MIN. WATER, FT. RECOVERY RATE, GPM REMARKS I % 25 30 35 40 45 50 10 15 20 25 30 ~ 35 \ Comments: ~)~..~ ~.~j~.~ ,~ ~ )~ ~ ~0~ -- ~, ~ ~. Flow is not Guaranteed Subsequent Variations Can Occur. ;-' ,,' : i *' ' . ' ', iMUN CIP/~Llff 07 ANCHORAG ,' - : ~ : r MUNICIPALITY OF ANCHORAGE '! .... I .... '~' '*^ ; O ' ~"~'-. ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL~ ' ~-I] ~[ ~ ' 825 L Street- Anchorage, Alaska 99501 ; .............. ~' .... ~. .... ~'Y" fl ~ ~ ~ ~' ,' , ~' '.~ I ' ~ .:~ ~~ ~ ~ ,' Telephone264~720 . .'~ r'~t": ~. ~ ; '~. REQUEST FOR APPROVAL OF INDIVIDUAL WATER ~ND S~~CI[~ da~s for pr~cessing.~: DIRECTIONS: complete all pa~s on page 1. Incomplete reques~ will not be processed. Ple~s 1. PROPERTY OWNER ~ ;, · ~, ]~,; ~ [ PHONE :~' : HUCKEY, [Reginald ~d"Linda '~. ~ ~:!~'. 3'44-0970 MAILING ADDRESS , "' ~' ' :' i SRA ~ox~[650, ~c~ra~e, A~as~a 99507 ' ;~.. :. PROPERTY RESIDENT (If different from abo~) 2. BUYER , '- ~ l '~ ~RUC~,~ Thomas .E~. ~' ;. ~; 279'661 ' 500 Wes~ Internati6nal Airport' Road. : , Security National~Ba~k- ~Ac~{e t~~. _. ~!:~ ~; ~I 276-6~80 2525 C Street, AnChorage, Alaska 99503 t, . ~ ~; :, 4. REALTOR/AGENT ~ ~',, ' ,I :1~'. Larry Eaton '~" :' I :~. ~ 2 8- MAILING ADDRESS ~ ;' ' J~j ~ ~. SRA Box~ i651 // 5300 C Street STREET LOCATION 4/10 mile South of:~ O~'Malle'y on West side o L'ot 1, ThunderbruBh 'Sub Birch Rolad 6. TYPE OF RESIDENCE {-i" " NUMBER OF One 1[X SINGLE FAMILY I'I ' [] Two [] MULTIPLE FAMILY ~ :I ~ Three * ATTACH WELL LOG. A ~ since June 1975. For wells depth (attach log if availab! 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY **If individual/on-site, give !r 'If system is over two (2) ~ by this Department. 8. SEWAGE DISPOSAL SYSTEM ~ INDIVI DUAL/ON'SI'lIE~:* [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST, ACCOMPANY EACH REQUEST BEF~ 72q310{3/78) BEDROOMS Fou 'Ii[] Five !:[] Six [] Other, ell Idg is r, equireiJ for all wells drilled drillb~l prior to that date, give well e.l',...'1 ~ t ~ ars oki an adequacy test is required ;)REPROCESSING CAN BE II~ITIATED. THIS SIDE FOR OFFICIAL USE ONL~ ~ ',~ I INSPECTION APPOINTMENTS TIME ;[ I~!!'~,, I i: ' '~ ; !!, · ~ TIME ,~ TIMEi DATE [~; ~ ~. 'r , : : DATE I DATE INSPECTOR I [~ ,11! ' . i I. INSPECTOR INSPECTOR I' 1. TY E OF RESIDENCE! [] : SINGLE FAMILY. [] MULTIPLE FAMILY 2. WATE SUPPLY [] INDI~/~DUAL [] COMMUNITY : [] PUBLIC UTILITY Connection Verified 3. SEWAGE. DI~;~OSAL SYSTEM [] IN DIVi DU~,'E/ON -SITE~ []PUBLIC O'i'i'L~IT~Y Connecti0=n:v~rified ~Sept~ ~{~k ~ ~Holding Tank Size: ~P ~;! ifTankis'homem~d gave dlmensl~qS~ ~ ~ TOTAL ABSORPTION AREA ", ~ 4, DISTANCES ;~ : ~ t ~ELLTO: Absorption Area to nearest Lot Line DATE RECEIVED DIRECTIONS: !~. NUMBEd OF,BEDROOMS [] THREE [] 'ONE [] Two [] FOUR " i[] FIVE s,x 'l [] .!'OTHER DATE DRILLED., DATE INSTALLED INSTALLER I. J MATERIAL:,i Septic/Holding SOILS RATING Tank .IAbsorption Area J l'!jJSewerlLine .... Nearest Lot Line I DATE BEDROOMS LEGAL DESCRIPTION 72-010 (Rev.