HomeMy WebLinkAboutTHE TABLELANDS BLK 8 LT 12 Onsite File
The Tablelands
Block 8
Lot 12
#051 - 801 - 52
Municipality of Anchorage Page 1 of 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage,AK 99519-6650
www.ci.anchorage.ak.us (907)343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040363 PID Number: 051-801.52
Name. Wastewater System: New
S sine!! Homes
Address:
190
1900 W. Northern Lights, Ste. 200 Anch.,AK 99517 ABSORPTION FIELD
Phone: Number of Bedrooms: 5' Wide Trench
344-5678 Four 4)
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION .45 GPD/Ft2 6 Ft.
Block: Lot. Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
8 12 The Tablelands 2 Ft. 4 Ft.
Township Range: Section: Fill added above original grade: Gravel Length:
2-3 Ft. 134 Ft.
Gravel width. Number of lines Distance between lines:
Well: AWWU Water System 5 Ft. 2 10'
Classification(Private,A,B,C): Total Depth: Cased to: Total absorption area: Pipe Material:
Ft. Ft. 1,340 Ft' ASTM 3034 PVC
Driller: Date Drilled: Static Water Level: Installer: Date Installed:
Ft Pisano's Dirtworks 4/7-8/2005
Yield: Pump Set at: Casing I eight Above Ground: TANK
GPM Ft. Ft.
SEPARATION DISTANCES Septic
To Septic Absorption Lift Holding •ubliGPrivate Man rtaclurer. Capacity in Gallons
From Tank Field Station Tank Sewer Line Anchorage Tank 1,250
Material: Number of Compartments:
Well >200' >200' N/A N/A >25' Steel Two(2)
Surface Water >100' >100' N/A N/A LIFT STATION — NONE ON LOT
Size: Manufacturer:
Lot Line >5' >10' N/A N/A Gal.
'Pump on'level at: ''Pump off'level at: High water alarm at:
Foundation >5' >10' N/A N/A
in in. in.
Pump Make 8 Model Electrical Inspections performed by:
Curtain Drain None Noted
Remarks BENCH MARK
How Splitter Valve Placed to Assure Even How. Location and Uescnption.
Finished Floor.
Assumed Elevation:
100.0 Ft
Engineer's Stamp
�''�� `v��i
Inspections performed by: T. Kimbrough Dates: 1st 4/7/2005 % : '1 9 t o ��•�'� �0
2nd 4/8/2005 •
• `•MICHAEL E. •ANDERSON G W g
Department of Health and Human Services approval t6-3:.• .,. NO. CE-4381 �_�
Reviewed and approved by: k/Y)lr� �,z, Date: C�Z g ♦••4t,(Rev.10199) co .ROL ss ��:��•
.45e.. pro - i c----or 1-07 ,n,� efi c Iliszssits•
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW040363 PID No. 051-801-52
THE TABLELANDS SUBDIVISION
LOT 12, BLOCK 8
40,005 S.F.
s 72,52 37.4--
297.52,
co
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Home IO
cn
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C6 oi C7 GRAva DRNE I N CO
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I
A B S 81'03'42'E 256.21' I
S1 18.2 36.9
S2 23.7 37.5
SV 31.1 38.0
C4 32.9 55.4
C5 49.4 65.4 • s alii�/.,
M1 31.9 55.2 •••.-\_-.
M2 48.1 63.7 :• :..• ♦♦•••
C7 71.0 25.7
49th -. •`
PLAN AS - BUILT P•
� �
,, MICHAEL E. ANDERSQI' �
•1cr Na, cE-4381 tii
SCALE 1' = 50' ♦ ��.L-�;: •
•
•
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♦•• FESS1 •••
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Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655-343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW040363 PID No. 051-801-52
TBM = 100.0
7.78 6,43 6,08
[5.68
> > cu co
>
U c4 (4 U U
DECK
f 1,250 Gallon D
/ Septic Tank
91,0 90,9 _ 0,75 0,15
0,48
r,
v = I
U f H F U 96.55
- - 93.32/ - "-- /
1/
Geotextile Fabric =_—..
—/-- �
88.93
88,71
Dralnfleld Rock
In u x 77,2 f1/40 97.16
- - 92.15 - - - /
/ 85.07 /
Geotext le Fa r c
—
88.88-7 �89.09
Dralnfleld Rock
voisliolUilin
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4,87 84,86 A ° 49th :*•*t
A j1/i11eliti... f
P O F I L E AS 3 U I L T IN..MICHAEL E. ANDERSON
•♦ No. CE-4381 •1-
Scale: NONE ..- ..L-(7P''... :
I2004-25
THE TABLELA\ DS SURD VISIO \
. LOT 12 , 3LOC < 8
40,005 S.F.
S
25231.e
291.52.
in
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(Ni cN p
94 8,
PO
ti�°4 X6'0. /
'n S '2)1`�4,6, /
0
O GRAVEL DRIVE /
0 / ,'N /
Z ••• ^ / • /
SEPTIC SYSTEM / /
/ W p
EXISTING
Li c5
BUILDING II ,n O
I '' 30' ---iO
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• a> CO
GRAVEL DRIVEI N
1 "— 40 ' PoII
atiJ
_ h a
S 81'03'42"E 256.21' 119.7'
AS — BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE
GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO
•Ialiii•41 ENCROACHMENTS EXIST EXCEPT AS INDICATED.
... OF 4 N SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO
• Q ••""••.••.45, .� JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS,
;'� • 4726 WEST 88TH AVENUE COVENANTS OR RESTRICTIONS WHICH DO NOT
i *: 49TH •:* 1 ANCHORAGE, ALASKA 99502 APPEAR ON THE RECORDED SUBDIVISION PLAT.
• • PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA
• •. Jeffery a Gastoldi �► GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR
aO'O� t' Al ESTABLISHING BOUNDARY OR FENCE LINES.
•O'13.1; •. LS-609 1 s^1� ♦ NW 1559 7/8/2005
..Pap•.........•'6`' .• ANCHORAGE RECORDING DISTRICT, ALASKA
•/ 5
1
�walks' . FB 05-05 JoeTLo128 NOTE: NO CORNERS SET THIS DATE.
Permit Number: SW040363
MUNICIPALITY OF ANCHORAGE i 11 IV J�
Development Services Department
Onsite 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
Date Issued: Aug 26, 2004
Expiration Date: Aug 26, 2005
Parcel ID: 051-801-52
Legal Description: ,THE TABLELANDS SUBDIVISION BLOCK 8 LOT 12'
Design Engineer: 0014 Anderson Engineering Site Address: NHN SAMBAR LOOP
Owner Name: SPINELL HOMES, INC Lot Size: 40005 SO. FT.
Owner Address: NHN SAMBAR LOOP Total Bedrooms: 4 Permit Bedrooms: 4
EAGLE RIVER. AK 99577 -
This permit is for the construction of:
❑✓ Disposal Field ❑d 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.
5. The following special provisions.
Maximum depth of absorption trenches shall not exceed 7 feet below original grade.
Received By.
Issued By: '_
Date:
Municipality of Anchorage
• Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. m i' wx- 52- Permit Number SW
Property owner(s) Spinell Homes, Inc. Day phone 3445678
u�in address
Malting address
Legal description (Lot, Block & Sub'd.) _Lot 12, Block 8, Tablelands Subdivision
Legal description (Section, Township & Range)
Lot Size 40,005 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Code
Number of Bedrooms Four(4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
hi;If--j7.%IT t•T•7:yirJt:14
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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 owner or authorized agent)
Permit Fees: a Li (0 U Waiver Fees:
Date of Payment F)j t q 1Date of Payment
Receipt Number. 56g4tp �� p� Receipt Number.
(Rev. 12/00) c�.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
August 17, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 12, Block 8, Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 12, Block 8, Tablelands Subdivision intends to construct a new four-
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the new home. The subdivision is served
by a community water system and no conflicts exist with adjacent septic systems or
wells. The attached Site Plan and backup documentation identify the location and
configuration of the proposed septic system and alternate site. The water service line is
also shown. The current drainage pattern along with spot elevations are identified on
the Site Plan. The drainage pattern will be maintained after development of this lot is
complete.
A test hole recently placed on the lot indicated silty sand and gravel in the area of the
absorption trench. The accepting soils were tested and found to have a percolation
rate of 30 minutes per inch. No groundwater was found In the test holes during
placement and none was noted during the monitoring period. Our design includes the
placement of a new 1,250 -gallon septic tank along with 2 - 67' long by 5' wide by 4'
effective depth absorption trenches to collect and treat the sewage generated in the
house. The bottom of the trenches will be 6' below the surface. The distribution pipe
will be 2' below the surface. A minimum of 3' of cover will be placed atop the trenches
and a minimum of 4' of cover will be placed atop the new septic tank.
The ground surface on the lot slopes at shallow grades from east to west as shown on
the Site Plan. The absorption trenches will be constructed parallel with the slope of the
ground surface as much as possible in conformance with Municipal requirements. The
new septic system will be constructed a minimum of 10' from the water service
Lot 12, Block 8, Tablelands
August 17, 2004
Page Two
proposed for the lot and on adjacent lots. It will also be constructed a minimum of 100'
from any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
A
j"
Michael E. Anderson, P.E.
Attachments
W���Aam
WCHAEL E. ANDERSON
\. No. CE -4381 l
N 0(r07'59*W 172.65'
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LOT 12, BLOCK 8, TABLELANDS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House 5' Wide Trench System
Perc. Rate: 30-60 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .45 GPD/SF 4' Drainfield Rock
4 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,333.3 SF Absorption Area
1,333.3 SF/5 SF " .5 (Red. Factor) = 133.3 LF Trench Length
THEREFORE: Construct 2 - 67' Long x 5' Wide x 4' Effective Depth Absorption Trenches.
Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth to be
6' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Provide 2" of Insulation and 2' of Cover if Necessary. Place a
Flow Splitter Valve to Insure Even Flow to Each Trench.
1'6"
N.
4'0"
Natural
Backfill
5'
Geotextile
Fabric
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTIO"'
(NO SCALE)
NOTE:
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Services in the Area.
Minimum 100' Separation From Surface Water or Streams.
DEPTI I
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1
2
3
4
5
6
7
8
9
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1
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MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION. LOT 12, BLOCK 8, TABLELANDS S/D
PERFORMED FOR: SPINFI I
DATE; 8/3/2004 PROJECT No --M0466
PARCEL ID,/j TECHNICIAN: T. L. KIMBROUGH
TEST HOLE # 1
SILTY ORGANICS/OB SLOPE
SILTY—SANDY—GRAVELS
GM
ism
0%
SITE PLAN
CUpa KEY
1N2 TH1
0 0
WAS GROUND NATER ENCOUNTERED7 NO
IF YES (g WHAT DEPTH? D%.
DEPTH OF MATER AFTER MONITORING: NONE
DATE OF MONITORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
8:45
12.0°
CHARGE
2
9:15
30
10.75"
1.25"
3
9:15
12.0"
RECHARGE
4
9:45
30
11.125"
0.875"
5
9:45
12.0"
RECHARGE
6
10:15
30
11.25"
0.75"
PERCOLATION RATE:31 .3(AIIN/INCI I) FERC. HOLE DIA.6(INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORDIE-D BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
DEPTH
(kcp
1
2
3
4
5
6
7
8
9
1
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 12, BLOCK 8, TABLELANDS S/D
PERFORMED FOR: SPINFI I
DATE: 8/3/2004 PROJECT No M0466
PARCEL ID,y TECHNICIAN: T. L. KIMBROUGH
TEST HOLE # 2
P77=1 SILTY ORGANICS/OB SLOPE
POORLY GRADED
SILTY—SANDS
SP
SILTY—SANDY—GRAVELS
GM
[*em
0%
SITE PLAN
CURB KEv
TH2 TH1
0 0
Y
ti
SEE FUTUR^ AS1ULT
WAS GROIND NATER ENCOLNTE-RED? NO
IF YES Ei• WHAT DEPTH? O%
DEPTH OF WATER AFTER MONITORING: NONE
DATE OF MONITORING: P'I"�^^�•
DATE
READING
GJOSS TIME
MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER II
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
8:50
12.0"
CIIARGC
2
9:20
30
10.5"
1.5"
3
9:20
12.0"
RECHARGE
4
9:50
30
10.5"
1.5"
5
9:50
12.0"
RECHARGE
6
10:20
30
10.5"
1.5"
PERCOLATION RATE:20 (MIN/INCII) PERC. IIOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and_,5_5_FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
DEPTH
(15=0
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION. LOT 12, BLOCK 8, TABLELANDS S/D
PERFORMED FOR: SPINFII
DATE: 8/3/2004 PROJECT No= M0466
PARCEL ID,#• TECHNICIAN: T. L. KIM13ROUGH
TEST HOLE # 1
SILTY ORGANICS/OB SLOPE
COMMENTS:
SILTY—SANDY—GRAVELS
GM
9mi
SITE PLAN
CURB KEY
1H2 TH1
0 0
Y
WAS GROUND NATER ENCOUNTERED° NO
IF YES (�4 WHAT DEPTH' 0%
DEPTH OF HATER AFTER MONITORING: 13.5'
DATE OF MONITORING:
TEST HOLE PRE SOAKED
DATE
READING
G OSS TIME
MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
8:45
12.0"
CHARGE
2
9:15
30
10.75"
1.25"
3
9:15
12.0"
RECHARGE
4
9:45
30
11.125"
0.875"
5
9:45
12.0"
RECHARGE
6
1 10:15
1 30
1 11.25"10.75"
PERCOLATION RATE•31.3 (mmINCII) FERC. TOLE DIA. 6 INCIIES)
TEST RUN BET%VEEN: 4.5 FT. and -5 -5 -FT.
TO TEST.
TEST PERFORb1ED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
TI IIS WAS PERFORMED IN ACCORDANCE WITI I ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTIONS LOT 12, BLOCK 8, TABLELANDS S/D
PERFORMED FOR: SPINFII
DATE: 8/3/2004 PROJECT No -•M0466
PARCEL ID -u• TECHNICIAN: T. L. KIMBROUGH
DEPTH TEST HOLE # 2
(rap
I SILTY ORGANICS/OB SLOPE
2
3:`;': :
POORLY GRADED
NET TIME
(MINUTES)
Dy ATER F
(INCHES)
SILTY—SANDS
3
*` ::
SP
4
1
8:50
5
12.0°
CHARGE
6
2
7
30
10.5"
1.5"
SILTY—SANDY—GRAVELS
8
9:20
GM
9
RECHARGE
10
11
12
13
14
15
16
17
18
19
[*ON
O%
TE PLAN
CURa KEY
TH2 TH1
O 0
Y
S== FUTUR_ AS301-T
WAS GROUND NATER ENODUNTERED' NO
IF YES (a WHAT DEPTH^ 0%
DEPTH OF NATER AFTER MONITORING: NON[
DATE OF MONITORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
Dy ATER F
(INCHES)
NET DROP
I (INCHES)
9/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
8:50
12.0°
CHARGE
2
9:20
30
10.5"
1.5"
3
9:20
12.0"
RECHARGE
4
9:50
30
10.5"
1.5"
5
9:50
12.0"
RECHARGE.
6
10:20
30
10.5"
1.5"
PERCOLATION RATE 2�(N1I J/fNCII) FERC. HOLE DIA• 6 (NCEIES)
TEST RUN BETWEEN. 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR To TEST.
TEST PERFORMED BY VETECEI ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND A1UNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
MUNICIPALITY OF ANCHORAGE
Efwfmpqnfou!Tfswjdft!Efqbsunfou
Qipof;!!):18*454.8:15
Po.Tjuf!Xbufs!'!Xbtufxbufs!Tfdujpo
!!!!!Gby;!!):18*454.8::8
Dfsujgjdbuf!pg!Po.Tjuf!Tztufnt!Bqqspwbm
PTD372375
80803138
Parcel ID 162!.912.63 Expiration Date:
Legal description UIF!UBCMFMBOET!CML!9!MU!23
Site address
33635!TBNCBS!MPPQ
Current property owner(s) !IPINBOO!FSJD!S!'!NJDIFMMF
Y5
The On-site system(s) is/are approved for bedrooms
Conditional approval forbedrooms, with the following stipulations:
Comments or conditions:
Op!dpnnfout
tffubolbewjtpsz
Curtis Townsend
803403137
By:Original Certificate Date:
This Certificate of On-Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service 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 submittal.
ATTACHMENTS:
!!!!!!Y
COSA ChecklistWell Flow Advisory
Absorption Field AdvisoryNitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
COSA Application_Apr2025.doc
Certificate of On-Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D.
Complete legal description
Location (site address)
Current property owner(s) Day phone
2. ON-SITE SYSTEMS SIZED FOR BEDROOMS
3. TYPE OF WATER SUPPLY: Private Well serving # dwelling units
Other Non-public well as regulated by MOA Water Storage
Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: Private Septic Private Septic serving 2 dwelling units
Holding Tank Community Septic or Public Sewer
5. SEPTIC TANK: Steel Plastic Concrete Fiberglass
Age ______ - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: AWWTS Bed Deep Trench Wide Trench Seepage Pit
Waiver request for: Distance:
Expedited review requested:
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 $ Waiver Fee $
Date of Payment Date of Payment
COSA # Waiver #
COSA Checklist_May2025.docx
COSA Checklist
Legal Description: THE TABLELANDS BLOCK 8 LOT 12 Parcel ID: 051-801-52
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 7/7/26
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) 4/8/2005
ALL standpipes present per record drawing
Total measured depth from grade 11.6 ft (max)
Measured depth to pipe invert from grade 4.5 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective 3.8’
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 7/7/26
Results Pass East & West Trench
Fluid depth prior to test 27 / 0 in
Water added 600 gal
New fluid depth 27 / 5 in
Elapsed time 1440 min
Final fluid depth 27 / 0 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 48 in (MOA 4’ ED)
Effective depth used 27 / 3 in (Final Fluid Depth)
Effective depth (ED) remaining 21 / 45 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual
observations, MOA records & appears the West Trench is missing 3 inches of ED and East trench monitoring tube appears
to have 4’+ of ED. Injected 300 gallons into each trench.
COSA Checklist_May2025.docx
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Disposal Field on Lot > 100’ Yes if No ft
Neighboring Disposal Fields > 100’
Yes if No ft
Sewer Line/Main > 100’ Yes if No ft
Sewer Manhole/Cleanout > 100’
Yes if No ft
Sewer Service/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10’ Yes if No *5+ ft
Field to Foundation > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main/Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*Met code at time of install.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 07/20/2026
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
07/20/26
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org
Septic Tank Advisory
Certificate of On-Site Systems Approval # OSC261264
Subdivision: THE TABLELANDS Block:8, Lot: 12
The septic tank for this property is 21 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more,
not including engineering, surveying, MOA permitting fees or site restoration.
Steel septic tanks utilizing "Coal Tar Pitch" coatings are subject to corrosion as the
steel reacts to water and rusts. These tanks have a finite lifespan buried in the
ground. These tanks can become structurally compromised and pose a health risk.
They could collapse and/or leak untreated wastewater directly into groundwater.
In the interest of protecting public health and the environment, the Municipality of
Anchorage Development Services Department has issued Policy W.05 Standard of
Care Regarding the Inspection of Steel Septic Tanks when Performing COSA
Inspection. Please request a copy of this policy from the Department if interested.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.