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HomeMy WebLinkAboutMOUNTAIN MANOR BLK 2 LT 12Municipality of Anchorage y On-Site Water and Wastewater Section • (907) 343-7904 . =1 of 3 ; ON-SITE WASTEWATER INSPECTION REPORT 050-671-11 NoV2 Permit Number: M201405 PID Number: fleo2® Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Upgrade Name SWARAN & DIANE SINGH ABSORPTION FIELD X Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11736 INSPIRATION DR. ANCHORAGE, AK 99577 ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 907-250-3524 4 1.2 GPD/SF JTotal 12.05 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.05 Ft. Gravel depth beneath pipe 8 Ft. Subdivision Block Lot MOUNTAIN MANOR 2 12 Fill added above original grade 0 Ft. Gravel length 63* Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1008 Ft2 1 N/A Ft. Well >100' >100' N/A N/A >25' TANK X Septic ❑ S.T.E.P. ❑ Holding [:]Other Manufacturer GREER Capacity 1,250 Gal. Surface Water >1 >1 00' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA PLASTIC 2 Foundation >1 0' >10' N/A N/A LIFT STATION Manufacturer Capacity Remarks *Existing Trench Extended 8' to meet Gal. requirements for a four bedroom home. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer NORTHERN EXCAVATION Drainfield D3034 cO/MTD3034 Inspector J.MILLETTE BENCH MARK (Assumed elevation) 100 ft Inspection 15` 10/12/20 11/17/20 Location and description 2�c Garage Slab. 3'° 4th ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF 44 Conditional Approval: Date :.QS #06,� „49�thj\ o ................�.................�...... ®... ��°titICHAEL E. ANDERSON Septic System r' No. ct-4381 o �_lu L-F'A°••.,,.11/18/20 Approv _ =CGC Date 112y-W 0, Note: this approval does not include well permit requirements. ®m®ROFESY3 ®®®®® tnev u=4/ -i u/ // // // // EXISTING WELL 2CO1 1"=50' 3-BDRM HOME CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MT1 TH1 PERMIT # OSP201405 PID # 050-671-11 MOUNTAIN MANOR, BLOCK 2, LOT 12 A B 2C02 28.6 MH1 29.2 SV1 31.9 A B 2CO2 32.5 CO1 35.7 CO2 54.0 MT1 56.5 11.6 13.9 19.1 20.9 27.6 60.8 62.311/24/2020 FEET 0 50 100 R O A D S E N D C I R C L E INSPIRATION DRIVE10' DRAINAGE EASEMENT63' LONG X 3' WIDE X 8' EFFECTIVE DEPTH ABSORPTION TRENCH . EXISTING TRENCH EXTENDED 8' UNDER THIS PERMIT. 1,250 GALLON SEPTIC TANK w/20" MANWAY. MH1 2CO2 SV1 EXISTING WELL CO1 WATER SERVICE LINE. 10' WATER SERVICE LINE SETBACK. ALTERNATE SITE: THE EXISTING TRENCH WILL BE DEMOLISHED IN ITS ENTIRETY AND THE ALTERNATE SITE CONSTRUCTED AT THE SAME LOCATION. 9 5 5 9 5 0 950C02 MT2 MT2 114.3114.5 PLAN AS-BUILT EXISTING ABSORPTION TRENCH. PERMIT # 201405 PID # 050-671-11 11/18/20 63' PROFILE AS-BUILT (NO SCALE) 93.8 88.7 94.4 99.35MH1 SV11250 GAL SEPTIC TANK MT1TH#1NO GROUNDWATER 10/21/20 85.5CO2 79.55 85.5 MT22CO293.6 DRAINFIELD ROCK 97.55 ORIGINAL GRADE/FINISH GRADE 93.5 2CO1MOUNTAIN MANOR, BLOCK 2, LOT 12 8'ABSORPTION TRENCH EXTENSION EXISTING TRENCH MUNICIPALITY ANCHORAGE Community Development Department` r Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-671-11 Property owner(s) Swaran & Diane Singh Day phone 250-3524 Mailing address 11736 Inspiration Drive Anchorage, AK 99577 Site address Same Legal description (Sub'd., Block & Lot) Mountain Manor, Block 2, Lot 12 Legal description (Township, Range & Section) Lot Size 57,145 Sq. Ft. Number of Bedrooms Fou -y- (`- APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank NUpgrade ❑X Duplex (D) ElHolding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) � Permit/Rush Fees: 6 t5.75 COUIP �- Waiveryyti ees:fZuSN _ Date of Payment: `� ��`(/a o 101420zpDate of Payment: Receipt Number: ©101`jD Receipt Number: Permit No. OS Waiver No. Permit App__- : .,:c Wells on this and adjacent lots are shown. The new trench will be a minimum of 100’ from all wells and surface water, and more than 10’ away from the existing well service line. The well service line was professionally located prior to the test hole being dug for the purpose of this design. Please refer to the attached test hole, plan, and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, P.E. Jim MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE.DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE El NEW O C C.lI PIQ - 2 GRADE MAILING ADDRESS . C✓ J // x �r /�-r LEGAL DESCRIPTION SSD -Je. ,� LOCATION , I yy ^^ D �I�J NO. OF BEDROOMS .DISTANCE TO: Well Absorption area Dwelling PERMIT NO. O _Y i ZQ Manufacturer / -Material No. of compartments wF w Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth d Z DISTANCE TO: Well w / Y Dwelling PERMIT NO. C7 O Z H Manufacturer Material Liquid capacity in gallons m= DISTANCE TO: Well57� f Foundation68 t Nearest lotli. P O T / j LL Z Z No. of lines Length of eaSd7Jjny - S / Total length of linea Trench wiy�, Distance tween lines /� P ¢ c3V inches A Q F G Top of tile to finish a e/ .... Material beneath the - inches Total of ctivg a tion area w Length Width- epth - PERMIT NO. U a F W0. Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well .. Building foundation Nearest lot line J Class _ Depth Dri er Distance to lot line PERMIT NO. J W 3 DI AN E TO: m ound tion er line Septic tank Absorption area(s) OTHER 117, PIPE MAT RIALS VC SOIL TE TRATING pq FJI"��—M�J INSTAL R - - CcC CnmZ: -REMARKS is' is J616 WAs X IVISUL4-'T-o W/ X Tr l3 a Ub.t+ A. Shoff i�a. : `' 'No. 1457E APPROVED ._ DATE; LE L SRB 796 111/ qT9 �i s ;1 RIVER ALASKA Z3s% a // ruts iRev. 3/78) f P • ❑ SOILS LOG ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION W'- PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: C-C,c �\i S- DATE PERFORMED: & •—(0 ` � / /w LEGAL DESCRIPTION: '- y � 1BL-4 - MOyar--,+w /�/�/l(Q/[_ '5(/1b PnSLOPE SITE PLAN E I O�f� A�-1 �L. it 1 -1 1 q Gross Time 2 ° art ,t, 3hafsr � 3 e 15 b� o ®°���0FEssro�a� .� 6 /D ,1 e v 'Z3 47 6 ;a 6 7 �k 'V o. o 9 � �6 10 G -x. 12 Date Gross Time 13 Depth to Water ° art ,t, 3hafsr � 4 14-11 -1157 {�/ e 15 o ®°���0FEssro�a� .� 16 17- 18 19 20 WAS GROUND WATER ENCOUNTERED? v;# IF YES, AT WHAT • An FUTUJ momms Room ■■■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop C b-6 8� 5z -4S- p-- S f �-- Z7 i 313 P o ff ifi u L S 3'�f dl a PERCOLATION RATE 7— / (minutes/inch) TEST RUN BETWEEN (0 FT AND 7 FT 72-008 (6/79) LOCATION SEPTIC TANK: GRAW ANCHORAGE AREA BOftH Department of Environmenta+@aality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS PHONE Il(06� LEGAL DESCRIPTION L Ia Rza Mt: MA4\o, DISTANCE_ i I QJ & I NUMBER OF FROM WELL -1 5 b MANUFACTURER yv�S>�.[ MATERIAL' L COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH J' `J LIQUID CAPACITYI�d GALLONS. DRAIN FIELD: I ^ - I I TOTAL S LENGTH �� I DISTANCE FROM WELL 1-70 FOUNDATION �`--�-I' NEAREST LOT LINE 2-5- 4- OF LINES NUMBER OF LINEDISTANCE �TWEEN LINES TRENCH IN. TOTAL EFFECTIVE ABSORPTION AREA �Q. FT`OLENGTH OF EACH LINE ` r DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE —3 MATERIAL BENEATH TILE10d IN. ABOVE TILE I✓ IN. WELDL/ 1- JA TYPE vJJyt CONSTRUCTION DEPTH ft DISTANCE FROM: BUILDING qq�^ C. NEAREST y I NEAREST 1701 SEPTIC lam- SEEPAGE 7 FOUNDATION -, LOT LINE / SEWER LINE., TANK � �0, SYSTEM / L O , CESSPOOL f , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: I SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Sol 13SK! Form EQ -032 DIAGRAM OF SYSTEM 13s X50 I APPROVED 6,W"w 100 ff p G.A.A.B. N ..._ - .. _ .a . e n n. .. a.. n n •..t r r -w a °n •....rte .__. r'-.. r—� n_'e �. DEPARTMENT ' HEHL...TH ti'5 '1 TREET HYdD F_Pd'•.'IR'OYdI'1EPd"fFl_ F?iTEC:TION ANCHORAGE, AK `_j� I //. /Y,- j - 't f 5 &-t- 279-2511. � / FA rJ E:r C304—f:3 I -FF-= = t` F M1F F: F=° F= F"° F •'F I -F�w PERMIT NO- t 77531�L[OS APPLICANT JOHN THOMAS BOX S=: E. R 694-9465 9.111). LOCATION INSPIRATION DRIVE LEGAL L._1.2 BI-' MT } MRNOR U=ST ;IEE 57000 SQUARE FEET I TYPE OF SOIL ABSORBTION SYSTEM IS I MAXIMUM NUMBER OF BEDROOMS = _ TRENCH SOIL.. RATING (SG! FT/BR)= 135 "EHE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: '=® F._. F=: v4 c3 WvA = - _ F.._ + i Fes' Y=4 V F L__. ➢_-° F- F=• -F UA == THE LENGTH DIMENSION I. THE LENGTH <IN FEET! OF THE: TRENCH OR DRAINFIEI_D, THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL_ BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2.-A CONTINUOUS MAINTENANCE_ AGREEMENT IS REQUIRED. IF H MAINTENANCE AGREEMENT IS. NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. --------------------------------------------- --- -F t4 ®-r r- -=1 I t F _= F=° 1= aL: T .7.. a `t F ° F=F F=' F= FT° F = C� F._Y I F Z F= C� BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL 'OR 200 FEET FOR A PUBLIC WELL. WELL LOBS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHJN .30 DAYS OF THE WELL COMPL..ETION. OTHER REQUIREMENTS- MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE. PROPER INSTALLATION. i=`FFR^F•T ]: -F �<.F=" I F=dF= ^=. LV..�e_:A�r•�F=aF= �° =�:� . _1_'E� - I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE_ WITH THE CODES. C. I UNDERSTAND THAT THE ON -;ITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IFTHE RESIDENCE IS RFMODE5E TO TwCQjE,;qPE THAN 3 BEDROOMS. SIGNED r i ISSUEDA'r'_..___._ ._ ..__------DATE___.__.--.---_ ................. 0 0 & E GEARCHNICAL & DEVE *MENT CO. "- - Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russel/ Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils & Foundations Land Development _—�- lS�- 95 1' � Performed for: Name:�� / FfPS�1�S Tel. No. Mailing Address:gox g$, 616.46 .:06C. 4x:� 995'77 Legal Description: Zai /2-, Bc.K 2, A110j1,17-A1,,v 4/, Vd'e Selao Depth (feet) Soil Characteristics 0 1 ML PGT vso �a�� Sao.'�fB,,e 2 3. 4 5 6 8 10 11 12 13c' ?Qty of 14 15 16 Ground Water Encountered: Yes No if If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: Performed by:� 72111 Date: f /3J Ike Russell Oyster 694-2774 Civil Engineering Soils Et Foundations .O & E ENNkEERING & DEVELOPONT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 333-5240 oma' %ou sc 'T �iQEnJc.1�r AjG Eat= .0 r°z D oe <l.J.AC-- i" ALL) n" Earl Ellis 333-5240 Surveying Land Development 1.5f lg78 #1: Time 9: Date 2 Insp AlffikMUNICIPALITY OF ANCHORA DEPART F HEALTH AND ENVIRON MEAPROTECTION 825 L Street, AnchoraaP, Alaska 99501 264-4720 Date Received: February 16, 1978 )� a . #2: Time #3: Time '-78 Friday Date / /Date :t Insp - u_ f J � �'Ansp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Bank of Commerce Mailing Address: Phone: 694-2021 2. Property Owner: John Thomas/Harry Davis Mailing Address: Post Office Box 88 99577 3 Phone: 694-9465 376-5925 Legal Description: Lot 12 Block 2 Mountain Manor Subdivision 4: Single Family Residence: (y) Multiple Family Residence: ( ) 5. Well System: Permit # Construction Number of Bedrooms: Three Number of Bedrooms: Individual Well (x) Community/Public System ( ) Depth of Well 153' Well Log on File (x) Bacterial Analysis 6. Sewage Disposal System: On-site System kx) Public Utility ( ) Permit # Installed 1977 Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page Two 0% 44 Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities I:egal Description: Lot 12 Block 2 Mountain Manor Subdivision Comments: f. I Af£adavit Attached: ( ) Letter Attached: ( ) Approv d: �, Date: Disapproved: J Date: Department Worksheet: =.o zaec: OdOv IIVW IVNCIIVNH31MI 601 ION 008£ IL61 "dV ON d Sd 'pm 'aqw aa51—03OIA084 39MA03 33NV80SNI ._._.............................. Ipa, lobo, aal a, 3><a) A83A1130 1V103ds _. .. .... ._ - Aluo 33SS3800V Di_ a3AII30 aos pS8 dluo aassaippe of F npp um S3 IMS ASE Paianpap alayN pue alep woyx. of sM,PyS L' AMU �S9 " dluo aaasa�ppe of R�aN lap yl!M Win DS[ "_' Palan9ap alae _Pue wo4M of swa45_L _. � �` S33d 'itlN011100tl tlOd S301AB35 1gN011d0 3000 dIZ ONV 3.WIS 0'd ('`} ON ONV 133815 31V0 8O 01 1N3S p8VW1SOd I (a$eisod snld) '0£—IIVW a31J11833 MOd 1d1333M ^UNICIPALITY OF ANCHORAAM Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 264-4720 \ �equest for Approval of Individual Sewer and Water Facilities 1. Property Owner: jc) n ) llr n cz5 M- iie rrt\ 6Cr 015 )4C alf �cu VtrS Mailing Address: pc, T�r,h Sy�jg ruer, Rla5ka_ Phone:(yy-<)y5 37 59 5 2. Name of Buyer: e ,, e \11a ti P__ k c Mailing Address: 2iutri Rk5kc Phone: n1,u/c?9577 3. Lending Institution: )95- 'cc f3on K (. l -c m/yr-rc e Mailing Address: 25c (, 10 Pf'(i erg (?)uskr•. Phone: 4. Realtor/Agent: -Kr ecu�i ueE04 l ncur.,�,c c 4- ed qq Mailing Address: ,JSr// aO�; /))rz/i }g,(' �9..5Q� Phone: ,276.2777 5. Legal Description: 4,71/,� /3rrkcka '\/X a,r7)run %%%anon Sia b, Street Location: _lr75�;'rcz 7�, c, rL 6. Single Family Residence: Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: *Individual Well �X) Public/Community System ( ) If Individual Well, well depth S,3 t If Community System, name of system 8. Sewage Disposal System: "On-site System ('X Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 MUNICIPALITY OF ANCHORAGE t�" Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-671-11 1. GENERAL INFORMATION Expiration Date: -a � - z D ZI Complete legal description Mountain Manor, Block 2, Lot 12 Location (site address) 11736 Inspiration Drive Eagle River Current property owner(s) SWaran & Diane Singh Day phone 250-3524 Mailing address 11736 Inspiration Drive Eagle River, AK 99557 Real estate agent Day phone 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) Y ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) g .� 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑■ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 3 3 Date of Payment CIA IN -19 11)4 202 Receipt Number © 3t COSA # O S C a 01(a 5S Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 11/23/20 �" 44;44 ' j �4 S®a G'.�'� ••' ®# 6. DSD SIGNATURE ®,.,,;; 49th •, zo ®�....... � ..��. q �..................L E. .............�..® System #1 Approved for bedrooms ���,'; MICHAEL E. ANDERSON : m No. CE -4381 System #2 Approved for bedrooms ��•.. 11/23/20 •.••'�Q Disapproved ®�o or' ROFESS�e"�®®®® Conditional approval for bedrooms, with the following stipulations: lll(t((((( 0 ANC, W PIER J ER o �a `N Pb J l/1/'i%))))))1111,1 Original Certificate Date: 11-2- q — 20 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 Legal Description: Mountain Manor Block 2 Lot 12 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled <1984* Total depth 140* ft Cased to 63+* ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 918/20 Static water level at beginning of test 105 ft Comments *Information from MOA files. B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic ** Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping **New Construction - 10/12/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/19/84 ❑ ALL standpipes present per record drawing Total measured depth from grade 10.5 ft (max) Measured depth to pipe invert from grade 2.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Comments/Deficiencies: 1COSA Checklist yellow sheet Parcel ID: 050-671-11 of Structure served by this system Well production at time of test 4.4 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 1.39 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 10/16/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Septic System is gravity flow. Ade uac test date 9/8/20 q y Results [D Pass For Fluid depth prior to test _ Water added 506 gal New depth 82 in Elapsed time 1440 min Final fluid depth 26 in 3 bedrooms Absorption rate '40u gpd Any rejuvenation treatment (past 12 months) None If yes, enter date Absorption trench extended 8' on 11/17/20 to meet requirements for four bedroom home. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' M Yes Community Sewer Manhole/Cleanout > 100' r,7/ Yes if No ft Q Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No 0 Yes if No ft *See Lot Line Waiver WR70023. Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [Z] Yes if No ft M Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' U Yes if No ft Property Line > 5' M Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' F,-/� 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' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 0.5* ft Wells on Adjacent Lots: Water Main > 10'✓® Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *See Lot Line Waiver WR70023. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review :P 'gyp;."'"` °'•.S',�� Of Municipal records that the above systems are in conformance with MOA MOA COSA guidelines in effect on this date. A 9tha ..•....y'....uu,a.ora...0°..uv.nu............ l� MICHAEL E. ANDERSON AWNo. CE -4381 ��TF,p °••. 11/24/20,.-' COSA Checklist yellow sheet �� pROFESS\ � +�nis; ft ft I / LOT 11 / 10' DRAINAGE EASEMENT---,/ F s62000 h of \�O h . \cC ov 60 oc .F LEGEND CURVE TABLE BUILDING CURVE RADIUS LENGTH DELTA CHORD BEARING CHORD LENGTH C1 150.00' 125.66' 48'00'00" S38'00'00"E 122.02' C2 20.00' 34.04' 97'30'03" S34'45'00"W 30.07' C3 125.00' 78.54' 36'00'00" N78'30'00"W 77.25' C4 425.00' 84.32' 11'22'00" S66'11'00"E 84.18' LEGEND NOIES 1. SURVEY CERTIFICATION: RODNEY P. KINNEY BUILDING ASSOCIATES INC. HAS CONDUCTED A PHYSICAL SURVEY OF THIS PROPERTY AS ------- BUILDING OVERHANG SHOWN ON THIS DRAWING AND THAT THE IMPROVEMENTS SITUATED THEREON ARE PROPERTY LINE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. — — — — ADJACENT PROPERTY LINE 2. EXCLUSION NOTES: IT IS THE OWNERS — — — — EASEMENT LINE RESPONSIBILITY TO DETERMINE THE EXISTENCE X — FENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE OSR SEPTIC RISER RECORDED SUBDIVISION PLAT. NOTE: UNDER NO CIRCUMSTANCES SHOULD ANY DATA ® FOUND 5/8' REBAR HEREON BE USED FOR THE CONSTRUCTION OR FOR THE ESTABLISHING OF PROPERTY LINES. �j GRAPHIC SCALE 50 0 25 50 1 inch = 50 feet OF sem.• •..��, 49TH Clark E. Kinney o LS-11760Aw ,a Ofessi0nal y0 —'" LOT 12, BLOCK 2, AS—BUILT �-Rodney I Kinney Associate,1 MOUNTAIN MANOR SUBDIVISION SURVEY Consulting Engineers a surveyors (PLAT 77-23) 11 /19/20 FIGURE 1 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 J www.ci.enchorage.ak.us ✓ (907) 343-7904 o 1-(0 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. — COSA# US G /2- 3 1. GENERAL INFORMATION Expiration Date: c? —2, 12 - Complete legal description MOUNTAIN MANOR S/D; BLOCK 2 LOT 12 Location (site address) 11736 INSPIRATION DRIVE * EAGLE RIVER AK * 99577 Current Property owner(s) SUSAN MALEKOS Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing address 244-1433 11736 INSPIRATION DRIVE * EAGLE RIVER, AK * 99577 Day phone KAY HANKS W/ PRUDENTIAL EAGLE RIVER Day phone 689-6464 16635 CENTERFIELD DRIVE * EAGLE RIVER AK * 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY; TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 samples. (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. t further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA - DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of thisreport by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist Septic System Advisory </ Phone 337-6179 Date !L _ \1YSOFfrrj (I �V gON-SITE WATER AND WASTEWATER bedrooms, with the following stipulations: PROGRAM Arsenic Advisory - N1aintenance Agreements - Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: (Rev. 11/05) Municipality of Anchorage • Development Services Department �v°= Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road . P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Q 71-11 Legal Legal Description: MOUNTAIN MANOR S/D; BLOCK 2, LOT 12 Parcel ID:, _ A. WELL DATA Well type PRIVATE *PER AAROW PUMP AND WELL INSPECTION. SEE ATTACHED. If A, B, or C provide PWSID# N/A Date completed PRE -1984 Sanitary seal (YIN) YES Total depth *140 ft. Cased to *63+ FROM WELL LOG Well Log (YIN) NO Wires properly protected (YIN) YES Casing height (above ground) 12+ in. AT INSPECTION Date of test 5/7/2010 Static water level �NPJp��Agft. 106 ft. Well production –9 P.M. 4.9 —9-p m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 1.26 mg./L. Collected by: GEG, Ltd. Arsenic: ND ug./L. Date of sample: 1/3/2012 B. SEPTIC/HOLDING TANK DATA *TANK ONLY HAS ONE CLEANOUT **INSIDE GARAGE Tank Type/Material SEPTIC/FIBERGLASS Date installed 8/2/1977 Tank size 1250 gal. Number of Compartments *2 Cleanouts (YIN) *YES Foundation cleanout (Y/N)**YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping Pumper JR'S PUMPING C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE Date installed 6/19/1984 Soil rating (g.p.ddftlor /bdrm268 System type TRENCH Length 51 ft. Width 2.5 ft. Gravel below pipe 8 ft. Total depth *10.5 ft. Eff. absorption area 816 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 5/5/2010 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 41 in. Water added 701 gal. New depth 69 in. Elapsed Time: 1196 min. Final fluid depth 56.5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date – NOTE: MT ONLY EXTENDS 83.5" INTO EFFECTIVE. TOTAL DEPTH AND LIQUID LEVELS ARE CALCULATED BASED UPON INVERT ELEVATION. TRENCH WAS INSULATED PER INSPECTION REPORT. 24" SOIL COVER SATISFIED. D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump of E. SEPARATION DISTANCES Manhole/Access water alar level at in. Cycles tested Meets alar & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Sewer /septic service line 25'+ Public sewer manhole/cleanout N/A Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *0.5'+ Building foundation 10'+ Water main N/A Water service line **10' Surface water 100'+ Driveway, paridng/vehide storage 1'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *PER EXISTING WAIVER #WR70023. **WATERLINE HAS BEEN RELOCATED (SEE ATTACHED LETTERS). G. ENGINEER'S CERTIFICATION 1 certiry that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date / 7' COSA Fee $ 7—�-10 - o o Waiver Fee $ Date of Payment l - 2 tf , /Z Receipt Number 0 7 Z G (Rev. 11105) Date of Payment Receipt Number Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program n,enr **** VARIANCE/WAIVER REVIEW **** Waiver#: osp 121011 COSA#: osc 211013 Permit#: PID#:050-671-11 Legal Description: Mountain Manor Block 2 Lot 12 Engineer: Garness Engineering Group Applicant: Susan Malekos Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0.5 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. F-1 Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ................................................................................ Waiver is Granted: r� X Waiver is not Granted: Date: / _ J �1 Approved by: am eviewer .................................................. ........................ Ree#: 00774G Amount: $200.00 Date Paid: 1-27-12 **** VARIANCE/WAIVER REVIEW **** January 27, 2012 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Lot Line Waiver Request for Mountain Manor; Block 2, Lot 12, To whom it may concern: We request that your department issue a 0.5 foot lot line waiver from the north property line to the existing drainfield. A road borders the north property line creating a significant separation distance between the subject drainfield and the nearest neighboring septic. We do not see any concerns with the granting of this waiver. We are unaware of any adverse impacts this waiver would have on adjacph wells or septic systems. If you have any questions, please contact us at 337-6179. Thanklypu fc r your assistance. P.E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessongineering.com 23 12 06:50a Dad AAROW PUMP & WER SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 333-8976 Eagle River: (907) 622-9335 CUSTOMER L 3388078 f 11 r v�©ZC "��a�ll No. 9257 2 JOB SITE IIJVOICE CryryhTE QUANTITY WELL EF TH SVA- p CHLORINATED PUMP DEPTH/ DESCRIPTION SALESPERSON PRICE AMOUNT PLABORHOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP. TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE (I Hereby Acknowledge the 5atisfaaory completior of the Above Described Work and agree that if above work is not paid for in 90 days I agree to alloy✓ Aarow Pump & Well Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. 07/03/2005 02:59 8883782215 EDWARD JONES PAGE 02/02 i 2 f .^ �� , 7rrff�.w�" �•�� Fr . 0'N'J>r el/ ' �, TMT i.. -i E 'f 1 S.es� �� caw. c•Fsr � .. J�a�seh%��bay�ecery�ap�e�q,° AS -BUILT I hereby certify that I have swveyed the following destclbed tproperty: 'i -o f Z; F/.c �... , Anchorage Recording Precinct, Alaska, and that the ` aprovements situated thereon ase within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises In question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle River, Alaska tlug % day ofP-e=-314 19 R.ORMT C. JOHNSON SCALE'. Registered band Surveyor No. 98D -LS r = 577 Box 458, Eagle River, Alas$e Phone 8942M 26/06 2012 08:08 FAX 907 694 1122 SOUTH FOR I COR zTRI 50EAGLE WVE-i. 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