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Home My WebLink AboutT15N R1W SEC 9 LT 79T15N RIW SEC 9 Lot 79 #051-103-26 Inspection Report_1-1-1. Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • hftp:/AwAv.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: SW980312 PID Number: 051-103-26 ❑✓ New ❑ Upgrade Name: ABSORPTION FIELD Dan Delucia ❑ Deep Trench 21 Shallow Trench ❑ Bed ❑ Mound Address 1614 Post Road Anchorage, AK 99501 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 12 FL LEGAL DESCRIPTION Depth to pipe invert from original grade 8 Ft. Gravel depth beneath pipe 4.0 Ft. Subdivision Blodc Lot Fill added above original grade 0-1 Ft, Gravel length 40 Ft. 79 Township Range Section Gravel width SFt. Beds: Number of Lines Distance between lines Ft. 15N 1W 9 SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches Tank Field Lift Station Tank Line 400 Ftp One Ft. From Well >100, >100' N/A N/A >25' TANK ❑+ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Tank Capacity I 1,250Ga1. SurfaceWater >100' >100' N/A N/A Material Steel Number of compartments Two Lot Line >5' >10' N/A N/A NA LIFT STATIONManufacturer Foundation >5' >10' NIA N/A Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Owner Installed Drainfield HDPE caMr D3034 Inspector BENCH MARK (Assumed elevation) 100.0ft MEA Inspection., 9/15/98 9/16/98 Location and description dates: 2- Northwest Corner of Exterior Deck. 3,a— 4, COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL lEStnt .:! �•.vr•i.: • •• S 0 •��• Conditional Approval: Date * ; 49� � f, NfIAiAS 6 ANDetSON . ��, s� �• CE o 4381 .. 4_ �! pROrfS510Rp'� Approved Date—EA Inspection Report_1-1-1. Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit No.: SW980312 PID No. 051-103-26 T15N R1W SECTION 9 LOT 79 29,621 S.F. n 3g. N O9 0(7s e 0 2sg a wellvs, 0 N Yl O o Gravel Driveway I u1 Unfinished GS rage Three Bedroom / House / FCO / / S1 i / S2 ---_— C2 C3 M1 TH1 Alt. C4 Site n11 *981' O� ' ,0 3' k 8' 2' 9' LEGEND M1 — Monitor Tube FCO — Foundation Clean Out TH — Test Hole C4 — Clean Out ��aaaarp .•��E � y��i 49th..° �.....:' ........................ ::.... 10 ............. I... ......�yy. PLAN AS-BUILT •� ♦ C MICHAEL E ANDERSINtl •'y: i� No. CE-4381 SCALE 1" = 50' ♦♦��'PFpw� `�.i� Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW980312 v 98.7 Page 3 of 3 IUIH,PXfl.11Q11191P i IT U 40' (Trench Length) PROFILE AS -BUILT - No Scale 92.5 E &' ®:VW -T, - 8le .Drives RC 33 �:� p� crs FI6 X654 :a cis 3w- eaumm GN�4rug�25 177 17 �j�fsv .229 22 GffArs�F3S �__... sm Oamine my Owoww son"" D&Tft £amn To n &eaSrai?a: TVw sd rmC -e--C v D 3 " L'<„c. en — 6-eAvtL d'IK,--- tty sem•-cY—�l=y. -WKIK�i - I1,/Ec0 6,Gpv £ CTOR INFOMMTMN: $OA Dmkr, Fes. ear R W. walor tiyhoioge 9ez.aq MwzAoesti-r gwL And OOV AKgMI--3577 7/5/✓ AIJS�'C,7 >mm ago > Oil QE Qs Ehv veetOWNM S� Lcs-e oRmjw comnzm= vest oeme Dqau of �To SCO-iL t �.1'w MM-- --s -_if bftw (a Cep d Won" sm"Oo MMM OF OLS Q air mrarr ❑ c*k Coo! ❑ Wer ! DISE OF YiEI t. ® p i Q !; Q vL*ft sa+ota p • CONTRA e, 01 steresee' Mnm ignature o Author¢ esrrttatwe te slant WFAKE Q BMG Trm O vel evenimie Dep&s Of �— im SbtA� laa9�.�—�— 7t S®c .x,..r (iCOf7CTTPfe�— Dever lwm�— Pumma tEVM Alp TieLD- .. jn67,itae®r__ — VL �eleiA[E18iit C REMARKS: p py •-- �QL--x--I MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Permit Number: SW040318 Legal Description: D'15N R1 W SEC -9 LT:79 ) Design Engineer: 0000 None Required Date Issued: Aug 05, 2004 Expiration Date: Aug 05, 2005 Parcel ID: 051-103-26 Site Address: Owner Name: JOHN & PAMELA SMELCER Lot Size: 29621 SO. FT. Owner Address: 22722 CHAMBER LANE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567 - This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements 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. 5. The following special provisions. -WHEN THE WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. (olkg~y./)-Cv61NFceZ S2Z-777-? -THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55. PLEASE SEETHE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM". IF THERE ARE ANY QUESTIIONS PLEASE CALL THE MUNICIPAL ON SITE WATER AND WASTEWATER PROGRAM AT 907-13-7904. \ , Received By. Date: k// /Py v Issued By. Date: � S ° \ 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.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. b S I— 16 3 —a t, Permit Number SW Property owner(s) D!))0,vS lea Y1tiP Mailing address (1) ) , 'taPY' �G YYO CQ tr' Day phone 6 as — 4 a 6S L, -",— Mailing address (2) Zip Code (Rq 56-7 Legal description (Lot, Block & Sub'd.) T p N R W SELF% LoT �� Legal description (Section, Township & Range) Lot Size '4 &`j Acres/Sq.Ft. Number of Bedrooms 3 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 ❑ certify that the above information is correct. I further certify that this application is being made for a Singja,Family Dwelling and is in accordance with applicable Municipal Codes. of property owner or authorized agent) Date of Payment: Date of Payment: Receipt Number: rJ 1 ofl tA 1 107 Receipt Number: (Rev. 12100) i Zf J r— C}LLj L Lt! C>: a _J._....._ .._.. rLU L tl C `y � t LLI pAo � `av, r- '. N tt1 CC co (- U 1� • • LLIQ g L u S? Q t' J i r z fes` g / i Zf J r— C}LLj L Lt! C>: a _J._....._ .._.. i L } X � t LLI d � < J V C (- U 1� LLIQ g L u o z m ISN too ori I E. i 02' elev. TZ LN R=- �2 r J / N 101' ele`v. ILE F I Municipality of Anchorage Department of Health and Human Services 825 1" Street Mayor rom Rick y, P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ei.anchorage.ak.us July 8, 1999 Anthony Delucia PO BOX 671591 Chugiak, AK 995671591 Subject: T15NRIWSEC 9LT 79 Permit # SW980312 PID # 051-103-26 The subject permit, issued 8/19/98 by this office for a single family well and/or on-site wastewater system, is due to expire as of 8/19/99. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Sincerely JameVross, PE Program Manager On-site Services enc: Copy of Permit 9 n, 0A Gel° MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW980312 Date Issued: Aug 19, 1998 Expiration Date: Aug 19, 1999 Parcel ID: 051-103-26 Legal Description: T1 5N RI SEC 9 LT 79 Design Engineer: 1ff {4_A -y-, p_ncsy,\ �tyLX-\n_c(@t@w4ddress: Owner Name: Dan Delucia Lot Size: 29621 SQ. FT. Owner Address: 1614 Post Road Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99501 - This permit is for the construction of: ZDisposal Field ❑✓ Septic Tank ❑ Holding Tank E]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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: 0l1-1lb Issued By: f/��/I ' Al • Date: August 8, 1998 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: BLM Lot 79, Section 9, T14N, R1W, S.M. Septic System Design Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of BLM Lot 79 intends to construct a three bedroom home on the lot. We therefore request a permit to place a new well and septic system to serve the new house. The attached site plan and backup documentation identify the size and location of the new absorption trench designed to serve the house. It also shows the location of the new well and the neighboring well and their respective 100' protective radii. Two testholes were placed on the lot at the locations shown. Poorly graded sand with gravel was found under the organic material. This material percolated at a rate faster than 1 minute per inch. The majority of the material, however, passes the No. 4 seive so a sand filter is not required. No groundwater was encountered nor was any measured during the monitoring period. We are therefore proposing to construct a 5' wide trench system with 4' effective depth. Total length will be 38' with the distribution piping at 4' below the existing ground surface. The total depth of the system will be 8' below the existing ground surface. The surface of the lot is fairly flat in the area of the new absorption trench with a slight 3% slope from east to west. The lot adjoins the Glenn Highway and has a steep nearly 30% slope near the northern boundary. This is an upward slope, however, and will not affect the absorption trench. No wells or septic systems in the area conflict with the new systems. BLM Lot 79 August 8, 1998 Page Two If the system is constructed as designed the following statements apply: 1. 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 reserved 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` Off 'b m 1 Vlir001 Michael E. Anderson, P.E. Attachments UNAEP' 0 Well cy9�eFR \ <qHR 1,000 Gallon Septic Tank TIH1 38 X 4' Absc A1�I� TH2 5' WidE ive Der Trench NOTE: No conflicts with wells or septic systems ZZ in the area SITE PLAN SCALE Y" = 40' e gq 491r x Three Bedroom Home Foundation Cleanout 011,000 Gallon Septic Tank 2 Post Tank Cleanouts Monitor Tube Cleanout Each End 38' Long X 5' Wide X 4' Effective Depth Absorption Trench SYSTEM PLAN NO SCALE DESIGN FACTORS: Three Bedroom Home Perc: Rate: LT .1 Min./inch Application Rate: 1.2 GPD/SF LOT 79 SYSTEM REQUIREMENTS: 5' Wide Trench System 1,000 Gallon STEP Tank 4' Drainfield Rock 3 Bedrooms X 150 GPD / 1.2 GPD/SF = 375 SF of Absorption Area 375 SF/5 LF (Width) X .5 (Red. Factor) = 38 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench System With OneLateral 38' in Length with 4' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed 3.5' Below Original Ground. 11 5•'0" ! i TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. OF,A-g °\I6 �P • ° w. 4 AA �� MICHAEL 4381•E �. ld PpricrrcuitJP�'-- BAucFtLA— � GEar-sxrrc,c l., 11 5•'0" ! i TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. OF,A-g °\I6 �P • ° w. 4 AA �� MICHAEL 4381•E �. ld PpricrrcuitJP�'-- Municipality of Anchorage DEPARTMENT OF HEALTH &HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99602-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Dan Del nci a DATE PE LEGAL DESCRIPTION: BLM Lot 79 Township, Range, Section: T1 nr/vL- 1 2) -IC— E Ill o, a 3 ae Net rime Depth to Water • 0� 4 . 5 1 �'• 6 � a _ 0' 3t�L 7 s $j Ar OI u * SP w rrt4 41, GIZA VCL 9 �! o , 10 a .O 11 12 d 3 13- 14- 141516 is - 16 O 17 I` 18 e 19 20 5DTr om o =- SLOPE E WAS GROUND WATER ENCOUNTERED? No S IF YES, AT WHAT L DEPTH? O P E Oepm to Water Atter Mobring7 None Italt 8/8/98 U110iAE. E A�1 1W,SecUion 9 Reading Date Gross Time Net rime Depth to Water Not Drop fk �: u a 3t�L L s $j Ar OI u * ; z1 41, �D PERCOLATION RATE < 1 (mmutevinch) PERC HOLE DIAMETER 6m �I TEST RUN BETWEEN 4 FT AND q FT COMMENTS MnrP Than 50% of Material PaSSPS No 4 4iP a Nn Sand r'n is Dor„�.•�..7 PERFORMED BY: A . Hara l.a I Tv n� _V CJ IFY THAT TIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE 72 -OM (Rev. 4/&5) Municipality Anchorage DEPARTMENT OF HEALTH �8t HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Dan llel LGi a DATE LEGAL Prlo L T5TJ404, : /kl0. Z SP w t„+ (! (zA.rC-L. 14f C, 1s dt�t�c 16- 17 18 19 20 Section: T15N,R1W,Secti6n 9 WAS GROUND WATER NO ENCOUNTERED? it IF YES. AT WHAT DEPTH? DePN In Wau After Mmimring7 None 0jte 8/8/98 Reading Dam Grass Net 'rim Time Depth to Wam Net if 4-9 I& 4 rkL 03 � nt�� yr 1A." 0-14 •� Z2. 14 195 4 erL L: L7 S Section: T15N,R1W,Secti6n 9 WAS GROUND WATER NO ENCOUNTERED? it IF YES. AT WHAT DEPTH? DePN In Wau After Mmimring7 None 0jte 8/8/98 Reading Dam Grass Net 'rim Time Depth to Wam Net l 7 7-5 I& rkL 03 :I S L:IG nt�� yr 1A." 0-14 •� Z2. t 4 erL L: L7 S nlo.tct ya PERCOLATION RATE < 1 (mmutwinch) PERO HOLE DIAMETER 610 u TEST RUN BETWEEN 4 FT AND r FT COMMENTS Mira Than 50% of Mai-eri Al Passos No 4 4i PVP No Rpnrl r i -s Romti rcA PERFORMED BY: A • Harala I ng'. -o` cf/tdO LL&J 7)'Y THAT TFFFyy)S TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE: 72-008 (Rev. 4188) • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-103-26 1. GENERAL INFORMATION Complete legal description Ree f G § v e - Expiration Date: 2 - �; - / T1 5N R1 W Section 9 Lot 79 Location (site address) 22722 Chamber Lane Chugiak, AK 99567 Current Property owner(s) Phillip and Kathy Geracl Day phone Mailing address 11411 Old Glenn Highway Eagle River, AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: COSA Fee Date of Payment Receipt Number COSA# .12 13 2 Date: ' ( unless otherwise requested by the engineer. Waiver Fee $ Date of Payment Receipt Number Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed he-reto'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 effectat the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer'sPrinted Name Michael E. Anderson, P.E. 6. DSD SIGNATURE . . System #1 Approved for System #2 Approved for Disapproved Conditional approval for 3— bedrooms bedrooms Phone 522-7773 Date 11/6/2013 0 9T p ® ? �e c ici�.164PA.NDEA , CE -4381 bedrooms, with the following By: ��jLl Original Certificate Date: The Municipalityo 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 Septic System Advisory Well Flow Advisory COSA blue sheet ( 7. '.i c X Nitrate Advisory Arsenic Advisory Other Parcell.D. 10 Municipality of Anchorage Development Services Department Building Safety Division On -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 051-103-26 1. GENERAL INFORMATION Complete legal description T15N R1 W Section 9 Lot 79 Location (site address) 22722 Chamber Lane Chugiak, AK 99567 COSA # OSC Q,13Fs `-f Expiration Date: 1 .1 _ L4 Z - Current Property owner(s) Phillip J. and Kathy Geraci Day phone Mailing address 11411 Old Glenn Highway Eagle River, AK 99577 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: Individual Well ❑✓ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL Individual On-site ❑✓ Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 ! : MICHAEL B AF MON CE*4381 .�Za 5. DSD SIGNATURE F •.��a�� 1/ Approved for _ bedrooms. X14 pOFfS51�Nt®vis Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date:_.' 1 (Reu 11/05) Municipality of Anchorage �• Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: T15N R1 W Section 9 Lot 79 Parcel ID: 051-103-26 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 7120/92 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 165 ft. Cased to 165 ft. Casing height (above ground) >18 in. FROM WELL LOG AT INSPECTION Date of test 7120/92 7/20/2012 Static water level 75 ft. 138.3 ft. Well production 15 g.p.m. 6.0 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 2.83 mg/L Arsenic: N/D ug/1 Date of sample: 8/7/2012 Collected by: JKB B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/92 Tank size 1,250 gal. Number of Compartments Two Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 6/1/2012 Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 9/15-16/98 Soil rating (g.p.d./ftz or ft2/bdrm)1.2 GPDISF System type 5' Wide Trench Length 40 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 72 ft. Eff. absorption area 400 ftZ Monitoring tube Y Depression over field N Date of adequacy test 818112 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 4 in Elapsed Time: 60 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Size in gallons "Pump off" level at Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: F. Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main N/A Sewer /septic service line >25' Animal containment areas >50' in. Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout Holding tank N/A N/A Manure/animal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption feel Water main N/A Water service line >10' Surface water Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' >5- >100' >IV 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/24/2012 COSA Fee $ Wtb Date of Payment Receipt Number cD t a-5 8 Q% (Rev. 11/05) x,`17;•' :�� :�-V i Waiver Fee $ _ Date of Payment Receipt Number in. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) DATE: September 2, 2012 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 79, T15N, R1W, Section 9 COSA 1. The septic system was constructed on the subject lot in 1998 by the owner of the lot before the house, driveway or any other features were in place. A the time the slope of the lot was relatively flat and the difference in elevation from one end of the trench to the other was less than 1'. The ground surface of the lot remains the same today with a slight slope in a northeast to southwest direction. The absorption trench was constructed entirely in the soil layer designated. Placement of the trench at 90 degrees from the design location has not adversely affected the absorptive characteristics of the system as evidenced by the past 14 years of service. 2. The surveyor as built was apparently not to scale when originally submitted. The attached survey shows the well at 104' from the first septic tank cleanout. The edge of the tank is at least 102' from the well according to the surveyor as built.