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STUCKAGAIN HEIGHTS BLK 2 LT 6A
tuckagain Heights Block 2 Lot 6A #041-021-69 Was Lot 7 before Replat Municipality of AnchorageI,v` Development Services Department $ (" Building Safety DM$Ion °➢1 On -Site Water and Wastewater Program, 4700 S. Bragew St. P.O. Box 198850 Anchorage, AK 99519-8650 Page of I www.d.androrage.ek.us (907)343.7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO40200 PID Number: 041-021-09 RrM. Karl Bohlin Wastewater System: ❑ New El Upgrade 9701 Basher Dr. ABSORPTION FIELD Psora: 33s-zsos wnne°rorasemwm: 3 13 Dee, Trench© shetaw Trena,❑ew pMauw ❑pm°,; LEGAL DESCRIPTION Sall Ratlnp:TabIMM, from odainal graft: ak>ek: Lae sul,aMelan: DPWFe Dopa, to p4e Uotlafrom pn edpinal goods:cmel 8.0 F. d" beneath Townehb: Rerpx 8eetlon: FlII addedoee w aaaiml paaa: 91M BnvM Lenptlr. Ft. Well: EXis+i�❑NeW ❑ Upgrade U 1.3 Ft. c°•""w 40 F. Numbed of DaMncw,eM.en mee: CM°eM�alb^ (PMats. A S. C} TotalOwth: cued b: 5.0 FY. Taal absorption am: 1 NA FL PIM Material: (� R. FL 395 Flt ASTM D3034 clear. DOW pew: etatleWWr LavM: Mission CMM CMM Construction Insisted:. FL 7-6-04 TNkI: Pa^v aM at Csein `W"`d Above po,rm0: DPM a. FL TANK SEPARATION DISTANCES Oseptic ❑Holding ❑S.T.E.P.❑Other: To Septic Absorption Lift Holding twxwPrivate a^ °11e^ May From Tank Field Station Tank I sewerune Premier 1000 Dal, won 155 200 NA NA 100 Mebrad: HDPE "°m" 7`° p°"^"°' 2 -was, 100+ 100+ NA NA LIFT STATION LAX Law 50+ 50+^ NA NA NA . ursn („1. Fcuedebon 50+ 50+ NA NA Tu^p mr. W"l M: 'Pump air keel n: HehacteralmmaC hl CutaIn pas, NA NA NA NA Pump Make a Model Electrical Impactions pertonmtl by. P« arks Old septic system abandoned in place. BENCHMARK Location MW Dsealptbn: bottom of septic tank Awsoned lwsilim 93.78 FL Engineer's Stamp Inspections performed by: Cindy W. Ellis, P.E. Dates: tM 7-05-04 49TH y 2 n 7-12-04 Developme ;* -' t Services Department Approval- Cf ... Y W. Reviewed viand approved by: Date: Ia/ Ellis CE 10677 �FSSIONAL cNs' 0 I50 ft well radius Vii'vewa9 -CO AB 0� p o `�G OF. A �'� 4p .. D I 69.0 28.9 DCO2 76.0 82.0 STI 80.3 89.3 ST2 82.1 92.3 MT1 78.7 89.6 DC03 129.5 151.0 COI 128.4 155.3 MT2 124.8 151.6 CO2 88.4 119.6 MT3 88.0 119.5 4" foam insulation o dine under driveway. i FP)K 03 ®- TH 1bIT2 k 01 _ _ __ MTl Class C 11 \\ Proposed lot liinne \\ Existing lot line \\ DCO1 A FCO "i - Parking Parking �B i IExisting 3 BR House Existing lot line Stuckagain Heights, Blk 2, Lot 7 Septic Upgrade Record Drawing Karl Bohiin Watkins Engineering, Inc. 0� p o `�G OF. A �'� 4p .. Parcel ID: 041-021-09 oo�� y;' D 'Y TH D ° • 49 — .. DO Permit No. SW040200 , 0 l(/�...JI DQ : DY W. ELLISPO. D•. CE -July D�t CindyW. Ellis, RE 28, 2004 Box 110443 Scale 1 inch - 30 ft Anchorage, Alaska 99511-0443 9 Z Phone: (907) 349-1851, Fax (907) 349-1934 FINAL GRADE FCO DCO 102.01 MTl 97.95 97.20 1000 GALLON HDPE SEPTIC TANK 96.96 MT for Tank Bottom 93.84 N.T.S. CO1 MT2 MT3 FINAL GRADE = 99.09 - 99.97 r 4"0 PIPE I FILTER FABRIC,,- 95_05 CO2 NOTE: I ORIGINAL GRADE _ 97.92 - 98.70 West I I I SEWER ROCK 11 1 East 90.70 91.60 40.0 NOTE: TRENCH Relative Depth of Bottom of Test Hole: 84.70 N.T.S. No water. 91.19 AS -BUILT Stuckagain Heights, Bik 2, Lot 7 0000000000 Record Drawing of Septic Upgrade ��C..�F•A..•..ION Karl hlin Parcel ID: 041-021-09W atkins Engineering, ,in gineerin g Inck. ao p ��P49 70, �� Permit No. SWO40200 p.:......CI W. Eius :. o° dp4:.`•. E • 10577 Cindy W. Ellis, RE P.O. Box 110443 1, 2004 ���40000Q0000 No scale Phoner(907) 349-1851, Fax (907) 349-1934 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw, Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SWO40200 Legal Description: VUgajn jjpt htsyt3(GCiC2Lot*' Design Engineer: 0844 Watkins Engineering, Inc Owner Name: Karl Bohlin Owner Address: 9701 Basher Drive Anchorage , A 99507 - Ll I 5ZTD Date Issued: Jun 17, 2004 Expiration Date: Jun 17, 2005 Parcel ID: 041-021-09 Site Address: 9701 Basher Drive Lot Size: 86684 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit Is for the construction of: ❑✓ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. Al 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: (- - Z-( -O c( Issued By: Date: G �� Municipality of Anchorage • Development Services Department Building Safety Division em On -Site Water and Wastewater Program s 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW Property owner(s) KA 4 L_ go Nr_ i w Day phone 333 -:2 6Q Mailing address (1) 9 7Q 1 ?2fh-' Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _ kd> �` 7 S?/ Ce A -C-. e fj It -TS Legal description (Section, Township & Range) Lot Size 2A-c.2F:-5, Acres/Sq.Ft. Number of Bedrooms 7' THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made fora Single Family Dwelling and is in accordance with applicable Municipal Codes. P (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: [n — OZ{ Date of Payment: Receipt Number: 3 5 7,�-��teceipt Number: (Rev. 12/00) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 041-021-09 Permit Number SW Properly owner(s) Karl & Kathleen Bohlin Day phone 333-2606 Mailing address (1) 9701 Basher Drive, Mailing address (2) Anchorage, AK Zip Code 99507 Legal description (Lot, Block & Sub'd.) Stuckagain Heights, Block 2, Lot 7 Legal description (Section, Township & Range) Lot Size 86,684 Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑� THIS PROPERTY CONTAINS: Hot Tub E3 Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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 of property oylner or authorized agent) Permit Fees: Date of Payment: Receipt Number. (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: Watkins Engineering, Inc PA Box 110443, Anchorage, AK 99511 (907)349-1851 fax 349-1934 June 10, 2004 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Stuckagain Weights, Blk 2, Lot 7 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation for upgrading the septic system for the existing 3 bedroom house on the referenced lot. This lot is currently proposed for replatting, moving the east lot line (Petition S11232-1). Both the existing and proposed lot lines are shown on the attached site plan. A well located on Lot 7 is a Class C well, serving both lots 6 and 7. The existing septic system is located within the 150 ft protective radius for the Class C well, and is proposed to be abandoned. The tank was installed in 1996 and is proposed to be moved and used in the new location, if it is found to be competent under inspection. The proposed drainfield design is based upon a test hole dug on May 13, 2004. It was dug to a total depth of 14 ft with no water encountered while digging or after 7 days of monitoring. A percolation test was run between 4.5 ft and 5.0 ft. The rate was less than one minute per inch, and it is proposed to utilize the native sand as a sand filter. The soil Jog is attached. Proposed Soil Absorption System: 3 Bedrooms x 150 GPD/BR = Application rate: 450 GPD / 1.2 gpd/ft2 = System Type: Maximum Depth: Effective Depth: Length Required = Proposed Length: 450 GPD 1.2 gpd/ftx 375 sq. ft required shallow trench (5 -wide) 8.0 ft 4.0 ft 375 sq. ft/5ft•0.5 = 37.5 ft 40 ft Sewer Upgrade Pennit Application for Stuckagain Heights, Blk Z Lot 7 Watkins Engineering, Inc.; June 10, 2004; page 2 There are no surface waters or private wells within 100 ft of the proposed septic system. The Class C serving lots 6 and 7 is more than 150 ft away. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, CindyW. lis, P.E. Municipality of Anchorage - jENGIN b, Development Services Department k 9TFI Building Safety Division yr On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519650 �.. Cin y W. Ellis www.muni.org/onsits (907) 343-7904 CE -10577 i Solis Log - Percolation Test _ I`` Performed For. Karl Bohlin Date Performed: May 13, 2004 Legal Description: Stuckagain Heights, Blk 2, Lot 7 Township, Range, Section: Depth 1.2 (Feet) Organics 1_ M1l 0'33 Lixtn 2- 1 Dean Ark. lora W K SaNIJ w/graoek 4- wbbles She Plan WAS GROUND WATER ENCOUNTERED? NO 8 IF YES, AT WHAT DEPTH? — L Depth to Water or • / P Monitoring?/�Inne E Date: 5-20 -64 el PERCOLATION RATE 4 1 (mmte Inch) FERC HOLE DIAMETER in TEST RUN BETWEEN ;F.5 FT AND 5. FT COMMENTS Pere hole took S gallons of water as fast as it was Poured In _ PERFORMED BY: Cindy W. Ellis, P.E. I �'J�� CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDE#1NES IN EFFECT ON THIS DATE. DATE: S-2,9 - 0 Any portion of the line from the house to the septic tank which lies under the driveway shall be insulated with 4" foam insulation. / Lot 8 Undeveloped j\ Existing sept' sy e►p \ �� on Lot 7 \ to be ab oned. � proposed lot ' e Class Wel 150 ft well radius Septic tank (inspected and moved Current locati n of septic tairjC from previous location) - 1250 gallons,, ` Existing FC� No wells within 730'TH of septic Sys radius Lot 7 CO3, Mrs Driveway to be moved. RR R p01Nj OR. Proposed lot lh Exis / Q hank este �� 4 1 Lot 6 Existing lot line Distance from house to tank is 115 ft. CO installed within 100 ft run g crib and septic I Lot 6 to be inspected, and documented. Lot 5 Undeveloped Stuckagain Heights, Block 2, Lot 7 0 OF A C S Op Proposed Septic Upgrade Karl Bohlin Watkins Engineering, Inc o Q o rO.." 49TH 0 �0 Parcel ID: 041-021-09 0••••' •.•••••• ;,p,`�" .... �S D Cindy W. Ellis, RE P.O. Box 110443 00 �; ''• b� c �iosn s• June 7, _ Anchorage� Alaska O��p�>,'' t Scale 1 inch =100 ft Inch Phone: (907) 349-1851,99511-0443 Fa (907) 349-1934 ••........ od�o ��000000�d� I DESIGN DETAILS I 3 BR, 450 GPD Proposed lot line \ 1.2 gpd/ft2 Class C Well ' Requires 375 ft2 Shallow Trench \ 4 ft Effective Depth Reduction Factor = 0.5 Length Required = 37.5 Maximum Depth 8 ft Existing lot line Any portion of the line from the house to the septic tank which lies under the driveway shall be insulated with 150 ft well 4" foam insulation. radius / Existing septic drainfield on Lot 7 to be abandoned. Current location of septic tank 0 Distance from house to tank is 115 ft. CO installed within 100 ft run CO3 veWzY DCO i i FP X i Se ' tank (inspected and moved i' from pr 'ous location) - 1250 gallo i I Proposed Trench: I COl 5 ft wide, 40 ft long ® TH Parking 4 ft effective depth, �� 4 ft to 8 ft. TI �� slope 10% MT2 Existing 3 BR House Existing lot line Stuckagain Heights, Blk 2, Lot 7 0 OF A Proposed Septic Upgrade Karl Bohlin Watkins Engineering, Inc o�P.•' �.oD ' Parcel ID: 041-021-09 Do co J9 TH •.7 D Dp p••••• ••• cw W. ELLIS Cindy W. Ellis, RE P.O. Box 110443 0�•; `.• c toss o0 June7 - Alaska 1 Scale1 Inch 30 ft Phone. (907) 3491 51,Fax: (907) 349-1934 .06/17/04 TSU 18:55 FAX 9073491994 06/01/2004/'09:56 /9072472081 Gdd � /cit Municipality 7upi7 of Anchorage January25, 2004 goblin Kad A. & Kathleen 9701 Basher Drive Anchorage, AK 99507 Dear Applicant Watkins Ener FP.FD KALATKA & ASSO 4700 S liumaw Street Anchorage, Alaska 995194650 Telephonw (Wn 343-79W Fax (907)343 -IMT httpJhw w.eLanchorsge.ak.us A4ayor Afar* Begkh DEPARTMENT OF PLANNING On Monday, January 19.20D4. the Platting Authority acted on your pstlGon S11232.1.3tuckagain Heights. The pemon was APPROVED. Special Conditions. th addition to diose of Title 21. attached by the Platting Authority are on the enclosed Summary of action. H you have any questions on these conddions at changes. please Call our oflics at 343-4267. PRELIMINARY APPROVAL IS VALID ONLY FOR 18 MONTHS or as otherwise stated In the Summary of Action. Within thst time, you must 000 mplish the following to fluaraA your request II001 PAGE 01 1. Negotiate a subdivision agreement with the Department of Pubic Works. 9 required. 2. Meet the conditions specified by fie Plating Authority which are inNudsd In the attached Summery of Action in addition to those of Tina 21 of the AMC. 3. Comply wish a5 applicable provisions of the Murdolpal land Subdivision Regulations. 4. In the case of subdM". submit to the Department of Planning s property executed tlnel plat ready forNng. If you wish to appeal this decision or any of the eondliati, we will furnish copies of our appeal procedures. Please note that all appeals must be made wtthin fifteen (15) days of the Pladng Board's vJinn Sincerely; DEPARTMENT OF PLANNING Zoning and Platting Section ca Fred Walatka 4 Associates Fred walatka 3107 W. 29th Ave. Anchorage, AK 0517 I ,09/17/04 THU 16:36 PAZ 9073491934 Watkins EnBr 06/81/2004 89:56 9872432001 FRED WALAVA a Asso owti Piet S w"wy JSD=W 19, 2004 Page 2 of 2 / f n or plat otes 6-11232 Mpkagain Igdghts Subdivision Return for redesign and modification to Address the ranowing: I. YJtfiity ea9ca'►eeats. 2: Resolving with On -Site Water & wastewater program that the disposal. systems servimg these properties meet Municipal standards, u they have not been permitted nor approved by the Municipality. 3. Providing an as -buff! survey to Zoning Code Compliance to ensure compliance with yard setbacks with rcgards to the new lot eonfiguxadorL 4. Configuring the proposed lots to make proposed Lot 7A more usable. S. Ensuring that the lot configurations do not necessitate any Zoning ' variances. 6. Resohdug the need for a aide yard variance foo• the side yard on proporcd . . Lot 7A. Q002 PAGE 02 Uu SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 745 Peet. DRtt-L-E6 ATZFHE-RA3-E-OF--------------42LER-FOOT. PROPERTY OWNER ehb LOCATION OF WELL SITE Stuckaq.auz l( h,f' o-% jec.6, T7212 R20 S.Li. Gt.6&7 ,S E-:)4.5 Ey+ NLO4 fVE4 Sec(,l TIZL?VlR 016,M, QLDGv7� DRILLER Bean.te Czu4 o4 Rollp-2t D& LLi.n.q. WELL LOG: C7 0-----=-76, Sdtidy, gAaue.L faith jm.at)- bou tdeA4. 209;0'c4 � r CIS 76------58' Si) -til. c lack-35%gAa.ue-C.={ Z rn 58------96' Ctean dine n w.ve t ._. Cn 96-----775' S i t t.y. gAaveL-20's c.Lav 6'- `775----779' 715 ---- 719'Clean Ova to t bea/LLaq. gh.oue t -oh.owifw, a. y ie td o.,' 9q. p.m.. 779----745' Bed tock. -/t 4ed i -,Ten,taet tock.-1Le cuott. 85 fit. off'. mate t 4ttand. 4� � D Crl COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. Wf2iiE-E1tom SijM-A THANK YOU YOU VERY MUCH. BEE CLAUS OF RAMPART DRILLING WORKS DATE liov, 75, 7977 SERVICE CHARGE 0F t;;% PER MONTH WILL BE ASSESSED ON PAST DUE ACCOUNTS, STATE OF ALASKA 617 , DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING, LAND & WATER r " l Alaska Hydrologic Survey \ . WATER WELL LOG revised Dort 312016 Drillina Started: / ! Completed: 11 / 15 / 1971 Pump Install City/Borough Subdivision Block Lot Property Owner Name & Address KARL B O H L I N, Anchorage STUCKAGAIN HEIGHTS B2 L 0 6 Well location: Latitude Longitude Meridian S Township 012N Range 002W Section 6 1 SE 1/4 of SE 1/4 of NW 1/4 of NE 1/4 BOREHOLE DATA: (from ground surface) Drilling method: it rotary, Dable tool,QOther Suggest T.M. Hanna's hydrogeologic classification system' Well use:❑Public supply,❑Domestic,OReinjection,❑Hydrofracking https://my.ngwa.org/NC Product?id=a185000000BYub3AAD ❑Commerciai,QObservation/Monitoring,OTest/Exploratory,OCooling, ❑Irrigation/Agriculture, Grounding,❑Recharge/Aquifer Storage, Q Heating,OGeothermal Exploration,E]Other Fluids used: Depth From To sandy gravel with small boulders, 20% clay 0.0 16.0 silty clay - 35% 16.0 58.0 Depth of hole: 145 ft Casing stickup: ft Casing type: Casing thickness: inches Casing diameter: inches Casing depth: ft Liner type: Depth: ft Diameter: inches Note: gravel clean fine gravel 58.0 96.0 silty gravel - 20% clay 96.0 115.0 clean water bearing gravel showing a yield of 9 GPM 115.0 119.0 bedrock - sedimentary 119.0 145.0 Well intake opening type:.. Open end, .Open hole,' Other Screen type: , Screen mesh size: Screen start: ft, Screen stop: ft, PerforatedOYes 0 No Perforation description: Perf from: ft, Perf to: ft, Perf from: ft. Perf to: ft Gravel packedOYes Q No Gravel start: ft , Gravel stop: ft Note: Static water (from top of casing): ft on-/-/ Artesian well Pumping level & yield: feet after hours at gpm Method of testing: Development method: Duration: Recovery rate: gpm Grout type: Volume Depth: From ft, To ft Include description or sketch of well location (include road names, buildings, etc.): Final pump intake depth: ft Model: Pump size: hp Brand name: Was well disinfected upon completion? H Yes No Method of disinfection: Was water quality tested?Yes ONo Water quality parameters tested: Welldriller name: ................. ................................................................ Company name: .MMPART .DRIL.LING. ............................................................... Mailingaddress: .................................................................................... City: State: AK Zip: Phone number: �) AS 41.08.020(b)(4) and AAC 11 AAC 93.140(a) require that a copy of the well log be submitted to the Department of Natural Driiler's signature: Resources within 45 days of well completion. Well logs may be submitted using the online well log reporting system available at: Date: Anchorage Municipal Code 15.55.060(1) and North Pole Ordinance 13.32.030(D) require that a copy of this well log be submitted to the Development Services Department/City https://dnr.alaska.gov/welts/ within 30 days of well completion. OR email electronic well logs to City Permit Number: Dale of Issue: dnr.water. reports (d)alaska.gov Parcel Identification Number: 'Guide for Using the Hydrogeoloaic Classification System for Logging Water Well Boreholes by Thomas M. Hanna NGWA Press Municipality of Anchorage = On -Site Water and Wastewater Program =" (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D.041-021-69 Expiration Date: 1. GENERAL INFORMATION: Complete legal description STUCKAGAIN HEIGHTS: BLOCK 2, LOT 6A Location (site address) 9701 Basher Drive *Anchorage Current Property owner(s) Karl & Kathleen Bohlin Day phone 280-9207 Mailing address Real Estate Agent 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well M Individual M Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ . Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment 21�g 0 0 1 Date of Payment Receipt Number (95.1526 Receipt Number - - COSA # OSC211064 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: �4 1 2�-1 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. 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, � d o ` r Ste)% Lo .....+.r . ....R........... ..1..y.�c ....J ���s ,11/CE 795 AI , i vv��p�� f es sio��oo #AECC884 `g ON-SITE WATFn� AND m with the follovuzctsti�tl�l�r_ SII'' m Pprit-r`A .. n _SERVIG�S�`\\. Original Certificate Date: Z ' Z -2-1 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: STUCKAGAIN HEIGHTS; BLOCK 2', LOT 6A If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑Q Well log is filed with Onsite (or attached) Date drilled 1971 Total depth 145 ft Cased to *119 ft Al Sanitary seal is functioning correctly FE -1 Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 2/11/21 Static water level at beginning of test 48.8 ft. Comments *ASSUMED CASED TO BEDROCK B. TANK DATA Age of tank(s) 16.5 years Tank type/material 'EPTIGHOPE Measured operating fluid level in septic tank *39„ ®❑ Standpipes/foundation cleanout per record drawing Date of pumping 2/15/20 Parcel ID: 041-021-69 Structure served by this system Well production at time of test 6.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes X No FW Coliform bacteria is Negative Nitrate 6.00 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Al Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 2/2/21 C. LIFT STATION ❑ Required maintenance comp] Age of lift>materi s Lift statio Commen D. ABSORPTION FIELD DATA TRENCH Which system tested (date installed) 7/12/04Adequacy test date 2/11/21 © ALL standpipes present per record drawing Results Z Pass For 3 bedrooms Total measured depth from grade 9.0 ft (max) Fluid depth prior to test 2/0 in Measured depth to pipe invert from grade 3.83 ft (min) Water added 770 gal ❑ N/A — pressurized field 10/4 New depth in ®❑ Monitor tubes go to bottom of effective. If not, state " 120 Elapsed time min depth into effective 72Code-requiredsoil cover over field Final fluid depth 4/1 in 7NAbsorption System presoaked rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced 2,051 galions If yes, enter date N/A Comments/Deficiencies: 'PRE-SOAKED ON 2/10/21 "MT'S EXTEND 4.25-4.83' BELOW THE CLEANOUT ELEVATION COSA Checklist yellow sheet NONE E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' F✓ Yes if No ft Private Sewer/Septic Line > 25'✓1 Yes if No Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ✓0 Yes if No Neighboring Absorption Fields > 100' If septic tank is under driveway comment below Animal Containment > 50' Q Yes if No Q Yes if No ft ft ft ft ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F71 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less'than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' [71 Yes if No ft Private Wells > 100' F71 Yes if No. Water Main > 10' ✓M Yes if No ft Community Wells > 200' Q Yes if No_ Water Service Line > 10' Q 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' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' F71 Yes if No ft Wells on Adjacent Lots: Water Main > 10' R Yes if No ft Private Wells > 100'�]✓ Yes if No Water Service Line > 10' R� Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' [] Yes if No ft F. ENGINEER'S COMMENTS WATER AND SEWER SERVICES LINES MAY CROSS EACH OTHER DRAINFIELD LATERAL LINES MAY BE OUT OF LEVEL BY AS MUCH AS 4 INCHES G. ENGINEER'S CERTIFICATION l certify that l 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. COSA Checklist yellow sheet 4 JfH -vim v0 ...........I. .... .�....D i .Jeff ( Carness.- Q� Q 9 (tY`-795• �O�aProfess''oO #AECC884 ft ft ft ft I1ditrate Advisory Certificate of On -Site Systems Approval # OSC211064 Subdivision: Stuckagain Heights, Block: 2, Lot: 6A A water sample revealed a nitrate concentration of 6.00 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Pleasesee the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Ma�hng Address P O Box 196650. *Anchorage, Araska 99519 6650 * www muni org ^j LO Ss9 S �Y _... _... __ CO vl . I t., 30 30 'I I f2� 3�5 K .i W O 1z. .I . '' r =g 1i BY EQ� Cues � M V 'ell RR `��L�z LL LL