HomeMy WebLinkAboutT12N R3W SEC 33 LT 127BT12N R3W
SEC 33
Lot 1276
#018-262-14
e Municipality of Anchorage ; :� ••.
Development Services Department r �I'1'':
•
Building Safety Division a•,�-
On-Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519.6650 Page ( of 'L
www.cLanchorage.ak.us (907) 343.7504
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 5 W v 3 0 o v St PID Number. CAV
Name. m.e (' i E 1 V a T 14 a
Wastewaters stem:% New Upgrade
Ada.aa:
C40ZZOry (, G.F LE,n.,
ABSORPTION FIELD
t 2q — ! V// WniraBatreotns:
�Aeap Tr DSbaa.Tra.. 1388 DAtu.N Dom e
LEGAL DESCRIPTION
SoilRaa4 19. 4V o 6i
Taal D.pd kana �:al ¢ad.:
//•O FI
Bktlt La: Tr SWdm'siarc
0•90. b&* Ewan k.r.l a5n4TIa:
Grnet deFN baraR. pip.:
TbwnalaV: /� Ranh: �1 Saetat
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FA amad ab" aipul O'ade:
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SEPARATION DISTANCES
gSepfic ❑Holding ❑S.T.E.P. ❑other,
To
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Absorption
Lift
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Inspections performed by: Dates: let 4111210'>
% *: 49TH"
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Develop t e ices Department Approval
y • MICHAEL N. AA.'DERSCN
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Reviewed and approved by: Date:fF•`�/2�UW,.��`eoY.e
69
�t
ROTESSiOK��—
Permit No. SW030008
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: LOT 1278, T12N, R3W, SEC 33 PID No.: 018-262-14
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0(9_' i MICHAEL N. ANDERSON:
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SINGLE FAMILY
FRAME HOUSE
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1�wiligh� Lane
R
THE INFORMATION REREON IS FOR TRE USE OF LENDNG NSMUTIOHS EPECNIGLLY TO BROW ANY CONFLICTS BETWEEN
"STING STRIICTLRES AMU RATTED LOT LINES OR EASEMENTS AND IS NOT TOM ABED FpR PONTKONNO ADpT10Ny,
STRUCTLRES OR FENCELNES
N
N
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N
EASEMENTS OF RECORD. OTHER THAN THOSE SHOT N ON THE RECORDED RAT. ARE HOT NIOMR HEREON,
NOTE: ANYFENCER SNIOMRARELOCATEDAPPROXIMATELYANDAREIDTTOEEUSEDTODETERMINEPROPERTYLINES
OR LOCATE STRUCTURES.
ANY PAVING 5HC;M%R MAY BE APPROV WTE OLE T09NOW COIDITION4.
o �OFA� 4�
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4c -W*
..............................
S�.4", f1Aeq4—
a SHANE A. HOLT.-
LB-6914
OLT.LB•6914
�I1.Fo _ O�G
AS -BUILT SURVEY
SCALE: l' -4a
I HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEES INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 1278. SECTION 31, T 12 N. R 3 W. S.M.
(PIAT NO. ")
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _"RD
DAV OF _MARCH 20)7 _
HOLT LAND SURVEYING 10/07, FB 12725
TEL 3155513
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S 89-57-A 1 "W /1 64.87'
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1�wiligh� Lane
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THE INFORMATION REREON IS FOR TRE USE OF LENDNG NSMUTIOHS EPECNIGLLY TO BROW ANY CONFLICTS BETWEEN
"STING STRIICTLRES AMU RATTED LOT LINES OR EASEMENTS AND IS NOT TOM ABED FpR PONTKONNO ADpT10Ny,
STRUCTLRES OR FENCELNES
N
N
r
m
N
EASEMENTS OF RECORD. OTHER THAN THOSE SHOT N ON THE RECORDED RAT. ARE HOT NIOMR HEREON,
NOTE: ANYFENCER SNIOMRARELOCATEDAPPROXIMATELYANDAREIDTTOEEUSEDTODETERMINEPROPERTYLINES
OR LOCATE STRUCTURES.
ANY PAVING 5HC;M%R MAY BE APPROV WTE OLE T09NOW COIDITION4.
o �OFA� 4�
•y
4c -W*
..............................
S�.4", f1Aeq4—
a SHANE A. HOLT.-
LB-6914
OLT.LB•6914
�I1.Fo _ O�G
AS -BUILT SURVEY
SCALE: l' -4a
I HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEES INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 1278. SECTION 31, T 12 N. R 3 W. S.M.
(PIAT NO. ")
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _"RD
DAV OF _MARCH 20)7 _
HOLT LAND SURVEYING 10/07, FB 12725
TEL 3155513
Rick Mystrom
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 'L' Street
P.O. Box 196650 Anchorage, Alaska 99519.6650
http://www. d. a nchornge.ak.us
Permit Number: #SW 030008 Date of Issue:! 3103 Parcel Identification Number: 018-262-14
Date Started: 3-7-03 Date Completed: 3-8-03 Is well located at approved permit location? ❑ Yes [3 -No
Legal Description: T12M R3W Sec ;13 Lt 127 8
Property Owner Name & Address: Paul Stivaletta
Twightlight Lane
Anchorage, Alaska 99516
Borehole Data:
Depth (ft)
Method of Drilling ®air rotary ❑cable tool
Soil Type, Thickness & Water Strata
From
To
Casing type: steer -
stick-up
0
2
Wall Thickness: M inches
organics & silt
2
3
Diameter: 6 inches Depth: 233 feet
gravelly sandy silt
3
42
Liner Type:
stilt
42
48
Diameter. inches Depth: feet
Casing stickup above ground: 2 feet
silty gravel
48
82
Static water level (from ground level): 105 feet
gravelly sandy silt wet 82 115
Pumping level: 260 feet after
silty gravel wet
115
120
2 hoursum in
P P g68Pm
Cobbly silty gravel
120
170
Recovery Rate: gpm
water sand & gravel silty
170
192
Method of Testing: a/rlif ,
gravelly silt
192
230
Well Intake Opening Type::
Bedrock
230
264
❑ Open End ® Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Startfeet Stopped feet
Grout Type: Bentonite #8 Volume: Lig
Depth eertQt+ot_itunnrA 7 f e
Pump: Intake Depth - feet
Pump size hp Brand Name -
Well Disinfected Upon Completion? ® Yea ❑ No
Method of Disinfection: chlorine tablets
RECEIVED
Comments:
Well Driller. Alpine Drilling & Enterprises
APR 2 5 2003
PO Boz 110496
Anchorage Alaska 99511
MUNICIPALIWCFANCHORAGE "r-'
:; :. t.:.` 4y t f. •._
ENVIRON61ENTAL SERVICES DIVISION
r ;:: �•"' i:. "t "� ° :'
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
y._ /2--0S
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SW030008
(Legal Description: T12N R3W SEC 33 LT 127B
Design Engineer. 0088 Anderson Construction & Eng'g
Owner Name: Prt{{ApU,� STIVALETTA
Owner Address: ,Nt�tiQTWILIGHT LANE
ANCHORAGE. AK 99516-
< L`0 /2:e4o
3 31co
Date Issued: Jan 13, 2003
Expiration Date: Jan 13, 2004
ParcelID: 018-262-14
Site Address:
Lot Size: 48989 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of.
0 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 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:
Issued By:
Date:
Date: 3 O.3
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. 0/8 — 2iv((2 " 14 I, Permit Number SW030008
Property owners) V�Lrld 1 5'j V a,� �1'Dayphone 3ti S-�4Ss~L-
Mailing address (1) NNIy TW/L /&HT LINE MememA6r. AK 993/6
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) yr — 12' 7 F>
Legal description (Section, Township & Range) ]"12 NN t3 W S e rioN .33
Lot Size4%%, k cres/ _.F Number of Bedrooms
THIS APPLI A�ION S 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
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: 1±7 S 0 Waiver Fees: _
Date of Payment: 2 t7 Date of Payment:
Receipt Number: O Z� $44 (\ Receipt Number:
(Rev. 12100)
Michael N. Anderson, P.E.
Civil/Structural Engineering
4640 Shoshoni Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
December 17, 2002
Municipality of Anchorage
Department of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re: BLM Lot 127B
To Whom it may concern:
This is a request for a new well and septic permit for the above residence. The test hole excavation
found silty Sand with some gravel pockets for the full depth of 18 feet. The perc test was done at
elevation 5 feet with a rate of 5.5 minutes per inch. No water was observed during the excavation or
after the 7 day waiting period. This new system will be a deep trench with 7 foot effective and 54 foot
length. The lots slopes gently to the northwest at about 2 percent. All the neighboring lots are
developed with functioning on-site systems. This new system will not encroach on any of the
neighboring systems or affect future development of their lots due to this upgrade.
If you have any question please call me at 345-3377
Sincerely
Mic acderson
DESIGN CRITERIA:
4 BDRM X 150 = 600 GPD
SOILS = 600/0.8 = 750 SO FT REO'D
750/14 = 54' TRENCH
(1) TRENCH
9' DEEP
7' EFFECTIVE
2.0' WIDE
54' LONG
EXISTING
100' WELL RADIUS
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1
1
1 I
EXISTING SEPTIC
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EXISTING
00' WELL RAE
US
BLM LQI 127A
PROPOSED
SEPTIC SYSTEM
/
PROPO
�ED HOUSE
O
J
I
ELM LOT 713
____,,FEXISTING 100'
WELL RADIUS
PROPOSED 100'
WELL RADIUS
Septic Design Prepared For
PAUL STIVALETTA
BLDI LOT 127B
Anchorage, Alaska
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SIIOSIIONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=200' JANUARY 13, 2003
OVER
3RIC
OF at `>><
9
*•49TH*• :A!
.00� MICHAEL N. ANDERSON 00
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,/--30' TEST HOLE
DIUS — TYP
NG WELL '--
RADIUS
DOUBLE CO—
TANK CO -
DOUBLE
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EXISTING WELL
100' RADIUS
RY SEPTIC SYSTEM
SEPTIC SYSTEM
-PROPOSED 1.250 GALLON
SEPTIC TANK
W
y -
A 9F -ORM NO�SC ````•
oPROPOSED
- T W I L I G H T L A N E -
M
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Septic Design Prepared For
PAUL STIVALETTA
BLM LOT 1278
Anchorage, Alaska
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SIIOSIIONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=30' JANUARY 13, 2003
WELL
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F MICHAEL N. ANDERSON : 'k- /
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�1.��r�� • 11 �/UTi.•:w��.:
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OF.q
a Municipality of Anchorage . y '•.� (r
DEPARTMENT OF HEALTH & HUMAN SERVICES
825-L' Street. Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
•� io!- MICHAEL N. ANDERSON ; ftr ,
(� U moi•, CE- 469
PERFORMED FOR: • �5�1 tl le "r0 � DATE PERFORM14?'� / e7'��••• SO\�
LEGAL DESCRIPTION: VLM 1.O4 (2 ;z B TOWnahlp, Range, Section:
r-D—EPT-H-1 SLOPE SITE PLAN
(FEET) 1Or''1 tU �-7-71 _
1
2
K1
4-
5--
5 e Y C
7 7uh/Ci CraYc(
6-
7-
8
8
9-
t011to -
11
12-
13-
14-
15-
16-
17-
16---
19-
20
213141516171920
COMMENTS
0t
WAS GROUND WATER —t
ENCOUNTERED? INC:,
S
T WHAT L
O
P
E
v Me
gam0 1 v
IF YES, A
DEPTH?
Depth to Wa
Monitoring?
®=mm
PERCOLATION RATE S, (minutesnmh) PERC HOLE DIAMETER
TEST RU//N BETWEEN FT AND Ml FT
e• r l (P T r r n^ ry. S y S
PERFORMED BY: </1.tJev4eyf I CERTIFY THAT THIS T/�ST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Zai L'
72-008 (Rev. 4ia5)
PERCOLATION RATE S, (minutesnmh) PERC HOLE DIAMETER
TEST RU//N BETWEEN FT AND Ml FT
e• r l (P T r r n^ ry. S y S
PERFORMED BY: </1.tJev4eyf I CERTIFY THAT THIS T/�ST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Zai L'
72-008 (Rev. 4ia5)
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 018 -262-14
Certificate of On -Site Systems Approval
OSC251387
Expiration Date: 7/8/2026
Legal description T1 2N R3W SEC 33 LT 127B
Site address 4051 TWILIGHT LN
Current property owner(s) HARBRIGE JOHN E &
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By:
Original Certificate Date: 10/1/2025
This riffrica f On -Site Systems Approval (COSA) is intended to demonstrate the subject
s em(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
evelopment 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:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory X Nitrate Advisory
Tank Age Advisory X Arsenic Advisory
Other
Certificate of On -Site Systems Approval Application
11. GENERAL INFORMATION
Parcel I.D. 018-262-14
Complete legal description T1 2N, R3W, SECTION 33, LOT 127B
Location (site address) 4051 TWILIGHT LANE, ANCHORAGE, AK
Current property owner(s) JOHN HARBRIDGEE
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: Ail Private Well serving #
Day phone 907-744-8124
dwelling units
1771 Other Non-public well as regulated by MOA F-1 Water Storage
171 Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: f0-il Private Septic ❑ Private Septic serving 2 dwelling units
1771 Holding Tank [I Community Septic or Public Sewer
5. SEPTIC TANK: Al Steel F71 Plastic F] Concrete E] Fiberglass
Age 22 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: 1771 AWWTS R Bed RN Deep Trench R Wide Trench El Seepage Pit
Waiver request for:
Expedited review requested: F71
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee Waiver Fee $
Date of Payment 7f
COSA# _W25IN7
Date of Payment
Waiver #
COSA Application_Apr2025.doc
COSACheckU^st
Legal Description: T12N.R3VV SECTION 33, LOT 127B
perum |D: 018'282-14
Ifmore than 1well and/or septic system on lot, provide separate checklist. Structure served by this system__
A. WELL DATA
X Well log is filed with Onsite (or attached)
Date drilled 3/8/20U3Total depth 264 ft
�
Cased to ft
��Sanitary seal infunctioning correctly
" FMWires are properly protected
Caoingheighd(above ground) 18+ in
.
^�
Date offlow test for COSA 7/8/2025
�
�
Static water level atbeginningofhaot 07� �
� �-
Comments
- B. TANK DATA
Well production odtime oftest 4.0+ ~pm
Water storage tank volume N/A gallons
Well disinfected for coliform test? E] Yes Al No
XColiform bacteria ioNegative
Nitrate ____.mg/L XNdrate less than MRL (NO)
Arsenic. _ug/L nNArsenic less than MRL (NO)
CoUectedby GARNESSENGINEERING GROUP,
Date 7/8/2025
STATION
��
Measured o��b fluid �v�i []
Required maintenance completed, if AWWTS Lift station rial
Comments: *BASED UPON GEGELEVATIONS, �m�
THE LIQUID LEVEL THEN THE INVERT O
BASED UPON THIS INFORMATION, THE TANK APPEARS TO BE AT NORMAL OPERATING LEVEL.
D. DISPOSAL FIELD DATA
Which system tested (date installed) 4/12/2003
Fol ALL standpipes present per record drawing
Total measured depth from grade 11.6 *(max)
Measured depth topipe invert from grade 4.2 ft (min)
FlN/A - pressurized field. �
F] Per record drawings, field is insulated.
FNI Monitor tubes gotobottom ofeffective.
|fnot, state depth into effective
____
r-1Presoaked required if
(Required ifhouse vacant orfield not used for more
than 3Odays prior todate oftest)
Gallons introduced gaUonu dato
Any rejuvenation treatment (past 12months) ____
If yes, enter date
Adequacy test date 7/21/2025
Results CqPoou
c�
Fluid depth ph*18
.75 .r5 �.in
Water added 683 go|
New fluid depth °82.5 in
Bopoedtimo 144 min
F/no|Ouiddapth °703 in
Absorption rate 450+ gpd
FIELDSTATWS-POSTRECOVERY
Effective depth (per record drawings) 84 in
Effective depth used 78-5 in
Effective depth remaining 4.5 in
Comments/Deficiencies: *TESTED NORTH TRENCH ONLY. FILLED TO JUST UNDER DISTRIBUTION LINE INVERT
FOR WEST END CLEANOUT (CO). EAST END CO IS -4.5" HIGHER IN ELEVATION THAN WEST CO FOR NORTH TRENCH.
NOTE: SOUTH TRENCH MAX DEPTH IS 11.8'DEEP AND PIPE INVERT IS 5.2'(MIN.). THERE IS A BULL RUN VALVE BETWEffN
TRENCHES. ON 7/8/2025, SOUTH TRENCH WAS FOUND SURCHARGED WITH BULL RUN VALVE DIRECTED TO SOUTH
TRENCH. OWNER SWITCHED FLOW T0NORTH TRENCH DN7/8/2025.ON7Q1/25,58'LIQUID LEVEL FOUND |NSOUTH
TRENCH MT FOOT BELOW WEST END OFCOFOR SOUTH TRENCH).
oOs^ohom,xxUwav2o2o.uvox
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' E1 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'
M 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 Surface Water > 100' ❑✓ Yes if No ft
Field to Foundation > 10' ❑✓ Yes if No ft
Tank to Property Line > 5' ❑✓ Yes if No ft
Field to Property Line > 10' [D Yes if No ft
Water Main/Service Line > 10' Q Yes if No ft
F. ENGINEER'S COMMENTS
*MET SEPARATION AT TIME OF INSTALL.
Wells on Adjacent Lots:
Wells > 100'
Community Wells > 200'
❑✓ Yes if No ft
✓0 Yes if No ft
If tank or field is under driveway comment below
•
NOTE: 2003 SEPTIC TANK IS LIKLEY NEAR THE END OF ITS USEFUL LIFE AND THE DRAINFIELD
IS NEAR THE END OF ITS USEFUL LIFE.
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 Garness Engineering Group, LTD. (GEG) Phone 907-337-6179
F,ngineer's Printed Name Jeffrey A. Gayness, P.E. Date
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments
may exist that were not identified during the evaluation. The operational life of all wells and septic systems
depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that
may fluctuate during the year), quality of construction (materials and workmanship), and the water usage
of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG.
Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no
warranty (express or implied) regarding the future performance of the well or septic system. GEG makes
no representation whether an alternative well or septic system can be installed on the property in the event
either of the current systems fail to perform adequately in the future. The content of this report is for the
sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the
information provided in this report by any other person or party (including subsequent property purchasers)
is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist_May2025.docx
Je, r y A:"`d,cLoess:
9. E 7953
LICENSED v�a pr o f e s ssonoo
#AECC884
10:39 iS i •1l 5G ;�__;x
ooo
September 30, 2025 at 10:39 AM
4051 Twilight
Tank test
Liquid level prior to adding water to
ST1
St1 LL 91.25"
ST2 LL 78.25"
10:28 started flow into ST1
Within 30 seconds, observed flow
through double pj.g rho, ,t .
Approximately 10 gallons of water
added.
Flow stopped in double
after -5 minutes. Tank levels same
as start of tank test. House appears
vacant now.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907-343-7904
On -Site water and wastewater Section Fax: 343-7997
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC251387
Subdivision: T12N R3W Block:Section 33, Lot: 127B
The septic tank for this property is 22 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.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT � � � '"� 907-343-7904
On -Site Water and Wastewater Section
www.muni.org/onsite
Septic System Disposal Field Advisory
Certificate of On -Site Systems Approval # OSC251387
Subdivision: T12N R3W, Block: Section 33, Lot: 127B
Prior to the disposal field adequacy test, 79.5 inches of standing water was
observed in the disposal field. This indicates approximately 95% of the disposal
field is inundated. Although this system passed the adequacy test, the remaining
life expectancy may be limited.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
® Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904.
Certificate of On -Site Systems Approval
Parcel I.D. Ul4S - 2(v2^ IL Expiration Date:
1. GENERAL INFORMATION
°r� t
SAFETY
-.2 0. -
/S -
Complete legal description T 'c'c- -5 fry 12�
Location (site address) �-rCJ S[ rw/rrt 4 V } L6(r� C,
Current Property owner(s) '54 n4wl n Day phone
Mailing address 1-10,5 0. I-Vi., 14 k N
Real Estate Agent
2. TYPE OF DWELLING:.
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
2L
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
[
Individual
Individual Wafer Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for:
Received by: /)�JmAn�_ Date: /
COSA to be released to the engineer, less otherwise requested by the engineer.
�a/�' t t ?W/s
COSA Fee $ S-2 Waiver Fee $ _
Date of Payment 1'3 S ( 9L115'1 Date of Payment
Receipt Number ' d / Receipt Number,
COSA-# ne'�c 51 O 1 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.
NameofFirm Mie r/ AfAilison Phone 727 -`651t -A(
Address H6b ( &4+fif t`ti A,e („J4I1-e
Engineer's Printed Name Ni%rt'oe Date 111k -111A;--
6.
1r'- /A;--
6. DSD SIGNATURE
System #1 Approved for _jL_ bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms
Fde
a a Nze � o
A9T ly a
� �a vc��ed
�bc s t �/a
�Atppl r1' -n '
with the following stipulat
By: �L� /N , h Original Certificate Date: I — .2, () _ (
The unlc all of Ap� age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) 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
CCSAWueeheetr - I. c
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: 1-12-14 (2 3 (10 -7m G T73 L v � ( Z �L 6 Parcel ID:_ Of f� — 7,
A. WELL DATA pp
Well type v a Fv If A, B, or C provide PWSID # Well Log (Y/N) Y_
Date completed / 1 3 G 5 Sanitary seal (Y/N) Wires properly protected (Y/N)_
Total depth 2(y ft. Cased to 7 5Oft. Casing height (above ground) Vlf in.
FROM WELL LOG
Date of test
Static water level
Well production ZT g.p.m.
AT INSPECTION
1 ?Z a iS
D (o ft.
_1 0 g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate ^4 P mg/L M J
Arsenic J4_ ug/L Date of sample:11-1-4Collected by:
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Ci � -P c Date installed I Z U
Tank size 1'r 4 Q gal. Number of Compartments 2 Cleanouts (Y/N)
Foundation Cleanout (Y/N) T Depression over tank (Y/N) High water alarm III iPl) o----_
Dateofpumping 5 /1% Pumper_S Ct,t
C. ABSORPTION FIELD DATA
Date installed ?h 3, Soil rating (g.p.d.M2 or ft2/bdrm) System type * W"t'
Length S (O ft. Width Z10 ft. Gravel below pipe ft.
Total depth ft. Eff. absorption area fe Monitoring tube Y Depression over field IV
Date of adequacy test Results (Pass/Fail) W v 4 For bedrooms
Fluid depth in absorption' field before test in. Water added 8 0 gal. New depth—/—' -L in.
Elapsed Time: I min. Final fluid depth in. Absorption rate >= Gt9 C2 Y- g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
Novi -v tv'?"('J 'e'1741
D. LIFT STATION
Date installed _
"Pump on° level at
Datum
in.
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size in gallons
Cycles tested
r
Septic tank/lift station on lot 100
Absorption field on lot too
Public sewer main N/
Sewer /septic service line ff rJ o
Animal containment areas too E
SEPTICIHOLDING TANK ON LOT TO:
in. High water alarm level at in.
Meets alarm & circuit requirements?
r
On adjacent lots f9 0
On adjacent lots toot d'
Public sewer manhole/cleanout r
Holding tank
Manure/animal excrete storage areas f t9o' r +
i r r
Building foundation 2 R f- Property line Z �'F Absorption field field --! :--"3 Y-
Water main Water service line t ✓0e •�- Surface water %0-0 14 -
Wells on adjacent lots l v 0 t F
ABSORPTION FIELD ON LOT TO:
Property line Z S l+ Building foundation 2 r
I r
Water Service line C fiD % Surface water rb 0
Curtain drain _d a Wells on adjacent lots —LO—0 t
F. COMMENTS
S ®Q `-rr TV e'Ae S
W Q
'F � )1', v �0 r c At 0 v -fel
y 4 A,eiry l Lv a ei T p�d-e 4 CA l'L4
G. ENGINEER'S CERTIFICATION MW
/ certify that I have determined through rreld 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 game . N4 t t'•V� @2( %l ok JT(!W
Date t / / S
COSA brown sheet_10-10-12.doc
Water main a It c
Driveway, parking/vehicle storage 90
u(v
Municipality of Anchorage
Development Services Department
/ Building Safety Division
on-site Water and Wastewater Program , A , 1,
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
Parcel I.D. cx `tti'— Zfo2r/H COSA#
Expiration Date: Z
GENERAL INFORMATION
Complete legal description L„ 4 12q 6 , T / pnr fL 15 L0 , Sri 33
Location (site address) i4DN �FW I u iT UI►
Current Property owners) PoU 74-v v a (r11gt Day phone R Z q- 2 d //
Mailing address
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:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
j� Individual On-site
❑ Individual Holding Tank
❑ Community On-site ❑
❑ Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 engineers 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 Onsite 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. l 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.
NameofFirm Mirk4r/ A(_AWrj r/ajN Phone
Address `l:/KU .4
Engineer's Printed Name M, r-% q, cf.r r 4, Date L a :Pt
5. DSD SIGNATURE
Approved for �_ bedrooms.
Disapproved.
/ MICHAEL N. ANND[RSCN�w.
Conditional approval for bedrooms, with the following stipulations:
Attacnments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By. Original Certificate Date:
(Rw. 1IMS)
A.
B.
C
Municipality of Anchorage
Development Services Department
Building Safety Division °
Onsite Water d Wastewater Program
4700 Bragaw Street
P.O. Box 198850
Anchorage, AK 99519.6850
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: /2 7'2l4 1� i W) �i e r t< 33 Parcel ID: �/ ii - 2 (0 2- /�/
WELL'DATA
Well type JPr r46:c/ If A, B, or C provide PWSID Well Log (Y/N) YC S .
Date completed JLVp 3 Sanitary seal (Y/N) -Y— Wires properly protected (Y/N)
Total depth 7 W ft. Cased to Casing height (above ground) Zi -D in.
FROM WELL LOG AT INSPECTION
Date of test ----414/0
State water level ft. / v 3 ft.
Well production ?• O g.p.m. S.o 9•P•m• L• •••� �s�
WATER SAMPLE RESULTS:
i
Coliform _P_coionhW100 mL Nitrate �_ M91L Other bacteria colonies/100 mL
Arsenic: /i) mgA Date of sample:/ Pi Collected by: M AJA .
SEP 110 HOLDING TANK DATA
Tank Type/Material 41 -cc Date installed Z
Tank size f? 49'0 gal Number of Compartments —2= Cleanouts (Y/N) Y
Foundation deanout MINI) Depression over tank (Y/N) rA High water alarm (YM) e
Date ( pumping 4-o Pumper 'v s ft -L Tic, cho t a' „r
ABSORPTION Fl DATA
Date kistalled Y&LO5- Soil rating (g.p.d.e or fe/bdrm) D.S{ System type 0teo- � ,th 1-7
I
Length TL ft. Width 2, D ft. Gravel below pipe . fl ft.
Total depth ._L ft. Eff. absorption area 22�_ft? Monitoring tube �_ Depression over field
Date of adequacy test 44 G 0 Results (Pass/Fall) PO4 For _ bedrooms
r�
Fluid depth in absorption field before test in. Water added Y W gal. New depthA in.
Eta Time: Time: 3 G O min. Final fluid depth * in. Absorption rate >= v o .p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date
D. LIFT STATION
Date installed
'Pump on" level at _ in.
E. SEPARATION DISTANCES
Size In gallons
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot /00
Absorption field on lot fled r+ -
Public sewer main
Sewer /septic service line / oy rqc-
Animal containment areas toe, (4.
High water alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots 10c) '4 -
On adjacent lots l o c?' -f.
Public sewer manhole/deanout t,
Holding tank - N a
Manurefanimal excrete storage areas /vy /oc
SEPARATION DISTANCES FROM SEPTiCkX%lgflG TANK ON LOT TO:
Building foundation ?,CF r 4- Property line 2 S �+� Absorption field—2 0 f -f
Water main Water service linet
/ V 0 ! Surface water, / u r t
Wells on adjacent lots /0 4.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line Z S Building foundation 2 5' /- Water main
Water Service line r v d r.f- Surface water ! 00 t4-
Driveway, parkingWehide storage SO ':-
Curtain drain N 44, Wells on adjacent lots /o a rA
F. COMMENTS
G. ENGINEER'S CERTIFICATION r p:�• • • •'
I certify that I have determined through field inspections and * 49TH 9+1�
review Of Municipal records that the above systems are in ••••
conformance with MOA COSA guidelines in effect on this date.
io
Engineer's Printed Name Mt (�a c % ;� ; MICHACt�N : /
CE 4
Date ii z q
COSA Fee S qDate of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
SCS ReEN
1071082001
Client Name
Mike N. Anderson. P.E.
Project Name/N
Lot 127B Sample
Client Sample ID
4051 Twilight Lanc
Marta
I Drinking Water
P\1'SID
Sample Remarks
A8 Datev Ilmes arc Alaska Standard Time
Printed Date/time
03/28/2007 14:01
Collected Date?Me
03/16/2007 8:00
Received Datefrime
03/16/2007 11:14
Technical Director
Stephen C. Ede
Allowable
Prep Analysis
Results
POL Unit.
Method
Conuina m
Limit.
Date Data
Ini1
Parameter
Metals by TCP/MS
ND
5.00 uS/L
EP200.8
C
(<10)
03/21/07 0322107
TK
Arsenic
Waters Department
TotalNitrat&itrito-N
ND
0.100 mg/L
EPA 353.2
D
(<10)
03/17/07
JDS
Hicrobioloav Laboratory
Tout Coli(otm
0
coV100mL
SM209222D
A
(<I)
03/16(07
DPT
011W 164.87'
as
4
Twiliolht Lane
in
N
t`
m
N
L%
N
iT
O
0
O
FA
THE IS FOR THE LISE OF LENDING INSTIIONS EXISTING STRTUCTURESEON AHD PLATTED LOT LINES OR EASEMENTS ANDS NOT TO BESPECIFICALLY USED FOR POSITIONING ADDITIONALEN
ST
STRUCTURES OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED RAT. ARE HOT SHOWN HEREON.
NOTE ANY FENCFLINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES
OR LOCATE STRUCTURES
ANY PAYING SHOWN MAY BE APPROXIMATE DUE TO SHOW CONDITIONS
OF A °OQ
v ............ 9�p�
C SHANE A. HOLT: y
LS -6914 4'�
ASEUILT SURVEY
SCALE: 1' • 40'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 1278. SECTION 33, T 12 N. R 3 W. S.M.
1 PLAT NO. 66-391
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _23RD_
DAY OF MARCH 2007
HOLT LAND SURVEYING 1040]. F8 127.25
TEL. 3455513
SINGLE FAMILY
FRAME HOUSE
r
m
N
DECK
\
1
3
i
0
'
In
a
I
�
O
O
Z
/
,BLOCK
\
I nET. WALL
/
\
1
\
\
/ / WELL
D
\ 9
9L
1 '• 1
S 89P57/3111W
/
164.871
I
�
Twiliolht Lane
in
N
t`
m
N
L%
N
iT
O
0
O
FA
THE IS FOR THE LISE OF LENDING INSTIIONS EXISTING STRTUCTURESEON AHD PLATTED LOT LINES OR EASEMENTS ANDS NOT TO BESPECIFICALLY USED FOR POSITIONING ADDITIONALEN
ST
STRUCTURES OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED RAT. ARE HOT SHOWN HEREON.
NOTE ANY FENCFLINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES
OR LOCATE STRUCTURES
ANY PAYING SHOWN MAY BE APPROXIMATE DUE TO SHOW CONDITIONS
OF A °OQ
v ............ 9�p�
C SHANE A. HOLT: y
LS -6914 4'�
ASEUILT SURVEY
SCALE: 1' • 40'
I HEREBY CERTIFY THAT 1 HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 1278. SECTION 33, T 12 N. R 3 W. S.M.
1 PLAT NO. 66-391
ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE
WITHIN THE PROPERTY LINES AND THAT NO VISIBLE
ENCROACHMENTS EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _23RD_
DAY OF MARCH 2007
HOLT LAND SURVEYING 1040]. F8 127.25
TEL. 3455513