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HomeMy WebLinkAboutDIGEL LT 2t)I'* 9 e I Lot 2 #051-042-96 Municipality of Anchorage Page i or Z DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: OS/ - Ove -2j�- Name: Aaaresl: Wastewater System: pr O Upgrade . ABSORPTION FIELD Phone: No. of Bedrooms: 4O` - `� 3 O Deep Trench (Shallow Trench O Bed ❑ Mound O Other LEGAL DESCRIPTION Soil Hating_ Tot al Depth lrom original grade: Lot: Range: WELL: JZI New ❑ Upgrade Total Depth: Caned To: �/ Ft. Ft. Date Drilled: Static Weler Level: q/'y /7 Fr in to PIP$ bottom from original grade: ,9 added above original grade: vel daprh:s✓nv�,y !I absorption area: Gravel depth beneath pipe .3 Gravel length: Pipe materiel: F - Z, Date installed Assumed LReviewed rmed by: � P. c Dates: 1st ` 103.1&1 2nd jb /cy CHRMTOPHEaR. A% CEM nt of Health and Human Services a 4 pproval proved by 1,J,T i" �`�s Wa Date: "�` 72-013 (1N1) MOA 25 GPM , Ft. z Ft. TANK SEPARATION DISTANCES jaSeptic ❑Holding ❑S.T.E.P. To From Septic Tank Abewpllon Field Lift Stenon Holding Tank blb/PMete Manufacturer. Capacity In gallon!: Well v / sewer Unna 7 $ r [' Materiel: Number of Companments: Surface e ware` 7<.°0' LIFT STATION Lot Line y' �� ' / / �O r Size In gallons: Manufacturer. Foundation �) v 3/ v / / O "Pump on" level at: "Pump otr lev to High water alarm at: CDrainn •.v f� ' ><�O r 'SSD I Pump MekeB M tIecMcel Inspections performed by: Remarks: BENCH MARK Loeetion and Description: Assumed LReviewed rmed by: � P. c Dates: 1st ` 103.1&1 2nd jb /cy CHRMTOPHEaR. A% CEM nt of Health and Human Services a 4 pproval proved by 1,J,T i" �`�s Wa Date: "�` 72-013 (1N1) MOA 25 Permit No. SWO30454 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: DIGEL SUBDIVISION, LOT 2 PID No.- 051-049—can S 89'56'30' E JJ 299.90' CLEAN Y OUT. Tl'P. WELL N SEPBC I 30' •7 TANK ,p N 0 GARAGE~ ow 3 BR HOUSE w SPLITTER A W b a � __,�'aLD ® E w q• .16I E �• n ~ o • a �in co @ I I : N lJ COD a A • d K 00 1 ° O • o 09 . P = a' 3 ® o o to TH1 30' (ABANDONED) S 89'57'40' E 299.88' G - SEWER CLEAN OUT DQ - WATER KEYBOX SWING TIES _ - WELL - PROPOSED LEACH nELD A D EASEMENT ��- EXISTING LEACH HELD C 87' 66' Q� - DIVERTER VALVE ©- DRIVEWAY ® - TEST HOLE • - MONITOR TUBE U 79' 69' E 99' 81' SCALE: 1'-50' 11/16/04 ELEVATIONS & GARAGE DOOR SLAB ENGINEER'S SEAL 000000 (NOT TO SCALE) ASSUMED TEV _ 100.00• o OF ORIGINAL GROUND G V 96.6' LEVEL 95.6. TEST o�[�Q'' 9 '••.'f'�p0 HOLE >re O Q *90.0- 3.6' Q CAL 0 CHRISTOPHER w000 O TR t: 92.7 QO CE -10387 p� 94• TR 2: 69.6. 92.7' 2: 89.627 X80.65.2• �404�;'.•�'�o•'„� o Nov -19-04 03:36A Certifteb -.311.1rRing log by we oo. as SULLIVAN WATER WELLS P.O1 P.0.150)(87027 CHUQlAK, ALASKA 90607 • _... Jowfu c O Y,O E c�BOW OWNER OF LM>1T L ? HOLE DM DEPTH. ADDRESS: Fnw m LEGAL DESCFM7TX Nh- '0 -6Et s'uhd in T .l- O l,.IC � Wl� Hili sJ oaTE _ T%v�oy SIA-7*r SArJO SI-GAAfSk. PSWNtiMBM 0a 9Dab ciI=* cl--2,,\9t WX - 16 TAX MENTFICATM NUMBER: Qs'I -A4 IS well localed at approved permit location? a -*s CSI No Method of Drlti V 4P* rotary Ci cable loot .$ 19• +d fir �f-i sit. L Dxmofoat S) LJ.4T�Z Casing Type zErE .-Wal Thiclatess � �' inctnas Dianeler�M+d+�.tfeplh 3�f and Liar Type: O) DW 9E Casing Stickup Above Oax- : feet static V"M LM* _ fd - bet Recover Rete �, 7 WM Method of Tesb As 0, wee intake OpervrV Type: *Cfen aro O open tole J Somero , Stat Tees Stopped bet Perfaratiorts Startbet vped feet Grout •ry"j E..r TO••r • !r t d .s Depth: 6om O feet. to A D feat Wall D sinfeded Upon Comptd bn? 64tC O No McMmI of Dlsir%dior> CNa s w . ,.r d SD [�f /✓) Oonrtrertls Driier`s Triafte M9111ON: It IS the responsibility of the propeAy owner to submit a copy of the wet log to tt►e proper authm*. MunicipMI N AnchmWec Department of Health & Human Services anNor Deparhnent of Environmental Conservation. MatSu Son" )sparime t of Emdrorwroantal Correenation. 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.orglonsite (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Eagle River Engineering Services Legal description: Rigel Subdivision Lot 2 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ calculation error In design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ❑ Topographic Information missing or Inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission In narrative. ❑ Insufficient fill over tank or field._ ® Other. On-site wastewater disposal systern must be installed by an Name of reviewer. Julie Makela. P.E. Date: 3/30/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of Anchorage 6 �, tffar \ iT t'.11. Nix MAN) • .tnchomgc, Alaska 9.619.666 ) • Telephone (lN17) 33 —KY)l • rax MJ7) .*A3. slNl 37(N) Bragaw Slrccl a rtnchomgc, rtlaska <,M6707 ��im munf.org Mayor Mark Bcgich Building Safety Division October 19, 2004 Kenneth & Loydale McDonald P.O. Box 670947 Chugiak, AK 99567 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW010454 Legal Description: Digel Lot 2 Dear Mr. & Mrs McDonald: An On -Site Water/Wastewater Permit, number S W030454, issued by this office for a single-family system, will expire on October 21, 2004. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $115.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, Daniel J. Roth Program Manager On -Site Water and Wastewater Program Enc: Copy of permit Community, Security, Prosperity MUNICIPALITYOFANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW030454 Date Issued: Oct 22, 2003 Expiration Date: Oct 21, 2004 Parcel ID: 051-042-96 Legal Description: Pj(2! L "DIVISION LOT 2! Design Engineer: 0848 Eagle River Engineering Services Site Address: NHN MAYTAG STREET Owner Name: KENNETH & LOYDALE McDONALD Lot Size: 49559 SQ. FT. Owner Address: PO BOX 670947 Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK . A 99567-0947 This permit is for the construction of: Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specked 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: Issued By. Date: 'ok-3103 Date: /D 2 2 O 09/03/03 11:27 FAX 9073438437 HOA LAND.USE ENFORCEMENT Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw SL 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 t/m Parcel I.D. 0510 Li Z 9 & Permit Number SW 0 30 04 Property owner(s)_kQPUFTfi k 1&1D41/' MchaJAtI Dayphone 6,K -294q Mailing address (1) Po MN 47n147 Mailing address (2) C A U4Ts4/ A K `i J S A 7 Zip Code , 99 s 67 Legal description (Lot, Block & Sub'd.) DT H Ct Un7- 2 Legal description (Section, Township & Range) SGG N T 1111 R I t / Lot Sizeq9., S q Acre q.FL THIS APPLICATION IS FOR: Number of Bedrooms 3 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 for a Single Fa oly Dwelling and is it Accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number:ur%� Receipt Number (f%v.12100) Eagle River Engineering ,Services Louis Butera, P.I;. Christopher R. Wood, P.1~. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 995773294 (907) 694-3297 fax October 13, 2003 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Digel Subdivision Lot 2 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, and underlying soils are adequate for a future replacement drainfield, if necessary. 4. Drainage will not be affected and is not a major consideration in our design. This well and septic system will have little impact on adjacent lots, due to the large lot sizes. Neighboring wells and septic systems have been located and identified. Impact to future wells and reserved spaces will be minimal, or none. Drainage will not be affected by this design. The percolation rate for the two ERES test holes is rather slow, in the 31-60 minutes per inch application rate category, despite a faster percolation rate for the old S&S test hole in the vicinity. The old S&S soils report has been included for your information. If you have any questions please call our office at 694-5195. Sin/cer1%0 � //4 /'Cw Christopher R. Wood, P.E. Senior Engineer \1997\03-051 HARMOC PROPOSED SEPTICS +30' 1 f PROPOSED WELL +100' N M 1�; N ,o / \ \ / EXISTING I \ / WELL + 120' TO SEPTIC S 8P'56-30- E 299.90'/ \ I PROPOSED WELL ' \ \\ 10' OLD TH 21\ A \ 4' vvt + 30' TO SEPTIC + 200' TO WELL I + 30' TO SEPTIC + 200' TO WELL' 30' { 30' / N 66 N F in PROPOSED HOUSE N I w 36..• / •� I W w •. W J • ,n / n U / I N W I s� INSTALL 1000 CAL T2}{ ® SEPTIC TANK TH1 IU' (ABANDONED) S 89'57'40' E 1. NO SURFACE WATER OR NO KNOWN CURTAIN DRAINS WELL SEPTIC SITE LEGAL: LOT 2, DIGEL SUBDIVISION 299.88' PLAN PROPOSED RIVE Q ,n 30' OWNER: DARRELL MCDONALD CONTRACTOR: N/A JOB 03-051WS DATE: 10 02 03 SCALE 1" = 50' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX.' (907) 694-3295 — TEST HOLE • — MONITOR TUBE o — SEWER CLEAN OUT — WELL — — — EASEMENT — — — PROPOSED LEACH FIELD — EXISTING LEACH FIELD ©— DRIVEWAY OWNER: DARRELL MCDONALD CONTRACTOR: N/A JOB 03-051WS DATE: 10 02 03 SCALE 1" = 50' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX.' (907) 694-3295 Eagle River Engineering Services Louie Butcra, P.'[. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694.3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Digel Subdivision Lot 2 October 13,2003 A. GENERAL 1. The well and septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or casements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — 1% minimum and insulated with 2" of burial foam if shallower than 3 11., with 2 R. minimum. 2. Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or place with 4' of soil cover, min. C. DRAINFIELD 1. The drainfield is to be placed as shown on the site plan. Contractor shall take extreme care ensure that I5'separtation distance is maintained between trenches, and 10' from the lot line. 2. The bottom of the drainfield excavation shall be level, plus or minus 1.5", prior to placing gravel. 3. The total depth of the drainfield excavation shall not exceed 6 ft. at any point in relation to natural ground surface. 4. The drainfield gravel shall be covered with typar fabric material. 5. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfield is to be finish graded or mounded to prevent ponding of surface water or runoff. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACIIFIELD DIMENSIONS: TOTAL DEPTIi - 6' GRAVEL DEPTI I — 2.5' under pipe, 2" over pipe (3' total) DRAINFIELD LENGTH = 2 X 65' DRAINFIELD WIDTH = 5' SOIL RATING= 0.45 GPD1W BEDROOM CAPACITY= 3 total SEPTIC TANK - 1,000 gallons min. Twenty-four (24) hours notice required for all inspections. \\Eres\DOCS\WPDOCS\2003\03-051drainfield- spec.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 6945195 ERES Project No.: 03-051 Calculated By: CW Date: 10/13/2003 Legal: Digel Sub. Lot 2 TEST HOLE 2 f 3 Single Family 3 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Percolation rate - Wastewater application rate = Required absorption area = Trench width (W) = Gravel depth (D) = 450 C— vi inutes per inch 0. gallons per day per square foot 1000 square feet 5 feet 2.5 feet Required length = Shallow trench factor • Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor = 0.64 Total Excavation Depth = 6.0 feet Required length = 127 feet y h i:,, •. Lhi .•.. �(is l•l.yfi;tri 03-051 Caic.xls 11:17 AM10/13/2003 i • �, Municipality of Anchorage DEPARTMENT OF HEALTH 6 HUMAN 825'L' Street, Anchorage, Alaska 995 SOILS LOG — PERCOLATION PERFORMED FOR: Ti A0QI/c'� DATEPERFORMED: 1010cl03 LEGAL DESCRIPTION:_ (A L ci(A (I, % h1 Z Township Range Section: 'ri 05 DEPTH 0s&A"res SLOPE SITE PLAN 1 T11tJ Lt ayes 51t.i 2 SC 3 U.Owol 6 7 88 AI'�rR 10 — •11 12 13 14 0 0 15 16 17 S -I -r,/ rD�' WAS GROUNDWATER GOil 18 , 19 20 PERCOLATIA147E s(minutes/inch) PERC HOLE DIAMETER b _ TESTRUNBETWEEN L4 FTAND FT COMMENTS VOLI.fkIE.L - I A'r– ,f.). r - {� ^ ori -� 7 MaT '(2G PERFORMED BY: �f{nJ R,FF2 I /' CERTIFY/,.THAT THIS TEST WAS PERFORMED ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE /( J/i� ��03 72-008 (Rev. 4/e5) NMI PERCOLATIA147E s(minutes/inch) PERC HOLE DIAMETER b _ TESTRUNBETWEEN L4 FTAND FT COMMENTS VOLI.fkIE.L - I A'r– ,f.). r - {� ^ ori -� 7 MaT '(2G PERFORMED BY: �f{nJ R,FF2 I /' CERTIFY/,.THAT THIS TEST WAS PERFORMED ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE /( J/i� ��03 72-008 (Rev. 4/e5) • �, Municipality of Anchora{ DEPARTMENT OF HEALTH & HUM, 82S "L" Street, Anchorage, Alaska SOILS LOG — PERCOLATI, PERFORMED FOR: �A�Rr" 1 Y}�r 000AL b LEGAL DESCRIPTION: D L GF / �n [`i, LU-( Z Township, Pt:4 ,t U COMMENTS O 12 AA; r>j— [ 5 TAM 61 h /t / L l -t' 51 ST1-1./_ 5AP GM- CRA. -Y. srcr/- 5Amby GPA��L WAS GROUND WATER ENCOUNTERED? Section: 7 IF YES, AT WHATL � DEPTH? OAJ O P E Depth to Waer Aner . Monitoring? Date, PLAN -CSo.AtEd (0 lies ��-� 6 PERCOLATION RATE S 7� (mmutevincS) PERC HOLE DIAMETER TEST RUN BETWEEN L4FTAND -S FT FtlTd�f.A�T. AP/A e. TAI SM LA'IrV APPj,AP — 61CIA hPrRir, FA -IC r/ATA lTe() A PERFORMEDBY: _(/ AFI T VJn(q% I rl RTIFY THAT THIS TEST WAS PERFORMED it ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE -- �� / I N /D i 72-008 (Rev. 4185) o�07JUM s��,a�a�■r.»mss -CSo.AtEd (0 lies ��-� 6 PERCOLATION RATE S 7� (mmutevincS) PERC HOLE DIAMETER TEST RUN BETWEEN L4FTAND -S FT FtlTd�f.A�T. AP/A e. TAI SM LA'IrV APPj,AP — 61CIA hPrRir, FA -IC r/ATA lTe() A PERFORMEDBY: _(/ AFI T VJn(q% I rl RTIFY THAT THIS TEST WAS PERFORMED it ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE -- �� / I N /D i 72-008 (Rev. 4185) ❑ SOILS LOG -� 114 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIONERCOLATION TEST 825 L Street, Anchorage, Alaska 99601 2641720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: RCtc .L]i t.F L DATE PERFORMED: 3`,2z-tlY LEGAL DESCRIPTION: U T Ot T &0--r Y GEs. S10 I. 2- 3, 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 PERFORMED 72-006 (6/79( C) Q•to A -M 1 L SITE PLAN WAS GROUND WATER ENCOUNTERED) IF YES, AT WHAT O� 0, DEPTH) mmm1momprim mommmmmommmm .■■.■■.■■■ Reading Deis Groes Time Net Time Depth to Water Net Drop 4 at PERCOLATION RATE �J (minutes/inch) TEST RUN BETWEEN �_ FT AN6J sr FT DATE. '2.1 MUNICIPALITY OF, MMMOMMMOMMM Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051 042 96 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description D I G E L LOT 2 Location (site address) 22112 MAYTAG ST Current property owner(s) KNUTSON Mailing address Real estate agent 2. TYPE OF DWELLING: F Single Family (w/ADU) F-1 Duplex 1771 Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: ­7 ju. - - Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ED Private Septic FX Water Storage F Holding Tank F Community Well F Community F Public Water System F Public Sewer El Waiver request for: NO N E Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. 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 C&M ENGINEERING Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Phone 8545558 Date 6/15/21 of : 49 TH i ;101 ,... System #1 Approved for bedrooms �� >rHARLES G BALZARNf System #2 Approved for bedrooms �¢F��� . SCE -13854 Disapproved Conditional approval for bedrooms, with the following stipulations: .,,kW(((f(w1" �� WAST`=v='ATER z J� FAM Original Certificate Date: —7-7— The --7— The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet SA ec ist Legal Description: DIGEL LOT 2 Parcel ID: 051 042 96 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 5/29/00 Total depth 51 ft Cased to 51 ft ❑ Sanitary seal is functioning correctly Al Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 6/10/21 Static water level at beginning of test 13 ft. Comments B. TANK DATA Age of tank(s) 16 years Tank type/material SEPTIC STEEL Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 6/28/21 D. ABSORPTION FIELD DATA SHALLOW TRENCHES Well production at time of test +5.6 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ N OR Coliform bacteria is Negative Nitrate 0.233 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 01 Arsenic less than MRL (ND) Collected by C&M ENGINEERING Date of Sample 6/29/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 2004 Adequacy test date 6/10/21 ❑ ALL standpipes present per record drawing Results R✓ Pass For 3 bedrooms Total measured depth from grade 6.5 ft (max) Fluid depth prior to test 11 in Measured depth to pipe invert from grade 3.5 ft (min) Water added 450 gal ❑ N/A — p1i2d-ffeid— New depth 17 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective RMCode-requiredsoil cover over field Final fluid depth 11 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NA date of test) Gallons introduced gallons If yes, enter date NA Comments/Deficiencies: LEACHFIELD CLEANOUTS AND MTS WERE SEPARATED. PIPES REPAIRED AND DIRT REMOVED COSA Checklist yellow sheet --_E -- -SEPARATION- DISTANC 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 if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Fv-1 Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' Z Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No Z Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft Fv Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft F✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' 0 Yes if No ft Community Wells > 200' M Yes if No. Water Service Line > 10' 0 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' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' Rl Yes if No ft Private Wells > 100' Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Surface Water > 100' F/I Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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. 6/28/21 COSA Checklist yellow sheet ft ft 0 Yes if No ft 21 Yes if No ft OF A1,4 49 m '• ,� ... ...... ... C HARLES G BALZ CE -13854 (f>e Sctila�, Municipality of Anchorage -� Development Services Department 4--w Building Safety DivisionOn-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 05I -01.49-0(n COSA# 0101a Expiration Date: 10 — 2S- 0 % 1. GENERAL INFORMATION Complete legal description 1) 018 P.l I T 2 Location (site address) 7 7 11 7 /Aa j'nt o C-1 Current Property owner(s) Re nnet an 1 L%fiale, M ctbrialA Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ED Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site $i Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ G The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm E[1.o 1P_ R j V % F'M i neQ 668 Sef i cpSPhone 6`9y"5/9.f Address fogt t V t w P�d. S,4X L Zo l 611 4L,! 99S77. Engineer's Printed Name C:Vtr�icnh V1 r . (, )n[ A_ Date JZ�2 310 5. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: 510 7 (Rev 11105) Municipality of Anchorage • Development Services Department Building Safety Division On -She Water & Wastewater Program 4710 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: D I Q P d L n+ % Parcel ID: 05'/ - O Y:;k,- 9 6 14 A. WELL DATA Well If A, B, or C provide PW SID # _ Well Log ON) Ye -C, Date completedqJJq/QH Sanitary seal &N) YES Wires properly protected &N) Ye"s Total depth -1—ft. Cased to _t, I ft. Casing height (above ground) Z_in. FROM WELL LOG AT INSPECTION Date of test 5/2 a/oy 7/0/2n07 Static water level 17 ft. -2S ft. Well production i 5 g.p.m. . 8 g.p.m. WATER SAMPLE RESULTS: Coliform _or__colonies/100 mL Nitrate L2 2 mg/L Other bacteria _0colonies/100 mL Arsenic: mg/I Date of sample: IZ-0/07 Collected by. c krLr lt?S Bo -1-7r1 0117/ B. SEPTIC/HOLDING TANK DATA Tank Type/Material L< zsia�aI Date installed g/bA�Ki Tank size IOD o gal. Number of Compartments 2 Cleanouts (?/N) Yew Foundation cleanout ON) Ye Depression over tank (Y() RQ High water alarm (Y8 N 0 Date of pumping Ji/Pumper C. ABSORPTION FIELD DATA Date installed W-5/0ri Soil rating (g.p.d./ t2 orfl3 v ) 0. 'q System type _ IIr, I Itni-) I-e-Y1GbeS Length 4� b/6_, ft. Width -r)/-r) ft. Gravel below pipe 3 ft. Total depth 6�6 ft. Eff. absorption area na0ft2 Monitoring tube YLDepression over field MLL Date of adequacy test2(L9ZZQ07 Results Fail) iPa SS For, bedrooms Fluid depth in absorption field before test = j in. Water added tE, Qgal. New depth. Elapsed Time: Lq-qQmin. , Final fluid depth � in. Absorption rate >= L41;0 g.p.d. Any rejuvenation treatment (past 12 mo.) (YA(& type) KI torte. K rv7rJ n If yes, give date NA D. LIFT STATION Size in gallons `Pump on" level at _ tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot + I00, Absorption field on lot + 110' Public sewer main 4 -IM' Sewer /septic service line 'f' r Animal containment areas + 100` Manhole/Access (YIN) level at Meets alarm & circuit On adjacent lots + 100 On adjacent lots + I o O ` Public sewer manhole/cleanout + 10 0' Holding lank Manure/animal excrete storage areas + 100` SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation + 5 r Property line + Absorption field +5r Water main + I Or Water service line 4-10 ` Surface water + 10 Or r Wells on adjacent lots +)00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 ` Building foundation + I ` Water main + 10` Water Service line + j 0' Surface water + I 0 0 ` Driveway, parking/vehicle storage 2 Qr Curtain drain + 5 0 ` Wells on adjacent lots + 1001 F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and ' review of Municipal records that the above systems are in ' conformance with MOA COSA guidelines in effect on this date. '; CIICSZOP}IEItR Engineer's Printed Name C -b c i St77'l b r R. W iciod Date i /7 3 /0 7 COSA Fee $ :L34 ' Date of Payment 7/2--rp Receipt Number CrZ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number in. 1L epR 86.. . ASBUILT SI3lARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: ds� tti�Cor L, AND THAT NO ENCROACHMENTS EXIST EXCEPT AS SCALE: DATE: P14%,41 - INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- i FB: ANY DATA HEREON BE USED FOR CONSTRUCTION �sy� IF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN •:RY LINES. y�J 6 - .• • c'• ,, - �E ASBUILT SI3lARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: ds� tti�Cor L, AND THAT NO ENCROACHMENTS EXIST EXCEPT AS SCALE: DATE: P14%,41 - INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ANY DATA HEREON BE USED FOR CONSTRUCTION �sy� IF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN •:RY LINES. y�J r