HomeMy WebLinkAboutBIRCH HILLS ESTATES #1 BLK 1 LT 1Birch Hills
Estate # 1
Block 1
Lot 1
#050-081-10
Municipality of Anchorage
On-Site Water and Wastewater Section •(907)343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191169 PID Number: 050-081-10
Dwelling: N Single Family(SF) ❑with ADU ❑ Duplex(D) ❑Two Single Family Project: ❑ New ❑■ Upgrade
Name ABSORPTION FIELD
Ann Stone
Site Address ❑ Deep Trench ❑Wide Trench 0 :•: 0 Mound
11930 Lugene Ln Eagle River AK ❑ Other
Phone Number of Bedrooms Soil Rating ( Total••pth from original grade
907.488.3027 4 QPq/Sk Ft.
LEGAL DESCRIPTION Depth to pipe invert frofn(!iq irie r ade Gravel depth beneath pipe
Subdivision Block Lot \ Ft. Ft.
Birch Hills Estates# Block 1 Lot 1 Fill added abyvkoniin. grade Gravel length
Township Range Section .- Ft. Ft.
GravelScIth Beds:Number of Lines Distance between lines
SEPARATION DISTANCES Ft. Ft.
ToSeptic Absorption Lift Station Holding Sewer Total. orption area Number of trenches Dist.between trenches
From Tank Field Tank Line Ft2 Ft.
Well 63'/65' NA NA NA NA TANK ®Septic ❑S.T.E.P. 0 Holding 0 Other
Manufacturer Capacity
Surface water >100
NA NA 1 NA Greer 1250 Gal.
Material Number of compartments
Lot Line >10' NA NA NA NA polyethylene 2
i I LIFT STATION
Foundation 1 0' NA NA I NA
I Manufacturer Capacity
Remarks Gal.
Alarm location Electrical installed by
PIPE MATERIAL House to tank 3034Tank to 3034
Installer drainfield
Curt Whitters Excavation Drainfield original CO/MT 3034
Inspector Curtis Townsend, PE BENCH MARK(Assumed elevation) 100 ft
Inspectio
1" 5/27/19 2 d 5/28/19 Location and description
dates
3id 5/29/19 4i" 6/1/19 concrete sidewalk at bottom of step
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp
Conditional Approval: Date v Q. 1S.4-1‘100
Al*: Y i l‘....*:*.
g.-.1-_::. 0
,/
Septic System �_— /�1�`°C••D N0.CE / A"'
Appro t"---( Date �/ ^�! Ilk ROfESS\
Note: this approval does not include well permit requirements.
(Rev 05/02/18)
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/ / 100'
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/ 0' DECK_INE I• „ i 100'
's SV1 BM \\ i
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/ 1 SV2 \
/ DC* ) ., \`'J1' 7 WE L
/ 1 '/5' DPP' \
NEW 1250 GAL PLASTIC ' \ \
SEPTIC TANK i //
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y / ASPHALT \ // \
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c`I\ \ ss 1984`WELL ' -. // Q I /
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4 L' ` TRENCH //
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MARK A B SCOPE OF WORK
1. REMOVED EXISTING SEPTIC TANK.
SV1 17'-0” 14'-9" 2. PLACED NEW 1,250 GALLON PLASTIC SEPTIC TANK AND
TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS
SV2 20'-1" 18'-5" PROVIDED WITH A 20" 0 MANWAY RISER SERVING THE
DC1 21'-2" 19'-7" FIRST COMPARTMENT.
3. ALL CONSTRUCTION IN ACCORDANCE WITH ALL
DC2 22'-4" 20'-7" REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE
CHAPTERS 15.55 AND 15.65.
Tank Replacement As Built Prepared fo, '.',t"11*,,,,
Ann Stone ••' '• ��'QS�4i�
11930 Lugene Lane Eagle River, Alaska 99577 .7c-3/.
• OO
• • 49 TH '. } t
BIRCH HILLS ESTATES #1 BLOCK 1 LOT 1
OSP191169 0 "�,�':� •
ti •
EKLUTNA ENGINEERING, LLC DATE: 6/3/2019 ;�:;CUR� TOWNSENDii,, :
19162 MOUNTAIN ROAD 4 No. E 11904 ° i
DRAWN: CLT .N..6 , . a,
CHUGIAK, ALASKA 99567 3 r�''• '•�%•:
(907) 355-9820 SCALE: 1"= 30' 4tSS\C,-•
1 •
PID: 050-081-10 SHEET 1 OF 2 'llisssiis*
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a O 0z
OZ
zQ a
1.° 1-0..
YQ `l< 00
'--U.. HU • 1
i -- , mi•MminirAmmE... 41
•11:1' .. AIN
1,250 G
.PLASTIC TANK
L,.,
SEP11C SECnON
SCALE 1. .. 10' i o
.
EXISTING 52' x 4' ED TRENCH
SOIL RATING 100 SF/BR
I
Tank Replacement As Built Prepared for
Ann Stone i
11930 Lugene Lane Eagle River, Alaska 99577 �... --,.7
��.
BIRCH HILLS ESTATES #1 BLOCK 1 LOT 1 % . %
OSP191169
•
EKLUTNA ENGINEERING, LLC DATE: 6/14/2019 JO-c_\)'1,CURTIS TOWN SEN Di
19162 MOUNTAIN ROAD DRAWN: CLT �.: ' No. E 1 904 .-..
CHUGIAK, ALASKA 99567 SCALE: 1" = 10' ��► , ... ..../�,.••• •,
;907) 355-9820 PID: 050-081-10 SHEET 2 OF 2 ,♦,1 � s� 4••
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Pax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP191169
Work Type: SepticTank Upgrade
Tax Code Number: 05008110000
Site Legal Address: BIRCH HILLS ESTATES #1 BLK 1 LT 1 G:0153
Site Mailing Address: 11930 LUGENE LN, Eagle River
Owner: STONE ANN
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
Deparrment
5/17/2019
5/16/2020
24394
❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. Although the proposed tank size does not meet the requirements of the subdivision plat note #8, it is being
approved in accordance with the tank size requirements of AMC 15.65 and what has been approved in the
subdivision historically.
2. An insulated, 20" diameter (minimum) manway riser is required on the first compartment of the septic tank, in
accordance with 15.65.205F.1
Received Br
Issued By:
Date:
Date:
4
Municipality of Anchorage
P.O. Box 196650 a 4700 Elmore Road
Anchorage. Alaska 99519-6650 a (907) 343-7904 e Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
S -i'a eC
Department
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV191025 COSA#: Permit#:OSP191169
PID#: 050-081-10
Legal Description: Birch Hills Estates #1 Block 1 Lot 1
Engineer: Curtis Townsend, P.E.
Applicant: Ann Stone
Your request to renew and amend the waiver of the required 100 feet horizontal separation from
the septic tank to the private wells on this lot has been approved. The approved separation
distances are 70.0 feet to the 1977 well and 67.0 feet to the 1984 well. See engineer's waiver
request for justifications.
This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
............................................... ■ ............................. ■ 1
Waiver is Granted: X Waiver is not Granted:
q 1a;
Date: 5 � I Approved by: t�tA CSUUa_
Name of Reviewer
............................................... ■ ............................. ■ 1
**** VARIANCE/WAIVER REVIEW ****
S
MUNICIPALITY OF ANCHORAGE
Development Services Department ���.:� _ Phone, 907-343-7904
On -Site Water & Wastewater Section '- -' Fax; 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-081-10
Property owner(s) Ann Stone
Mailing address 7290 Richardson Hwy Salcha AK 99714
Site address 11930 Lugene Lane Eagle River AK 99577
Day phone 907.488.3027
Legal description (Sub'd., Block & Lot) Birch Hills Estates #1 Block 1 Lot 1
Legal description (Township, Range & Section)
Lot Size 24,394 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) �]
(w/wo ADU)
Septic Tank
Q
Upgrade 0
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Renewal of WR86-034; well to septic tank. Distance: 68'
I certi that the above information is correct. I further certify that this is in accordance with
applic le unicipal Codes.
(Signaturd of property owner or authorizedagent)
Permit/Rush Fees: 01016 -
Date of Payment:5/a[�9
Receipt Number: 5-ib
Permit No. -� e Q ito
Waiver Fees: _1,
Date of Payment:
Receipt Number: )J
/� .,e
Waiver No. WV IQ 1 d GJ
GADevelopment ServicesNBuilding Safety\On Site Water and Wastewatefforms\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191169, Rebecca Carroll, 05/17/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191169, Rebecca Carroll, 05/17/19
Name: Eklutna Engineering Lab ID#: M190325
Mailing Address: 19162 Mountain Rd Date Sampled: 04/17/2019
Chugiak, AK 99567 Time Sampled: 1830
Legal Description: Birch Hill Estates #1 Block 1 Lot 1 Sampled By: CLT
Date Received: 04/18/2019
Sample Site Location: Bathroom Sink Time Received: 1550
Health Guard I
Parameter Method Result Unit MRL MCL Date
Total Coliforms Colilert
(SM 9223B) A --- --- --- 04/19/2019
E. coli Colilert
(SM 9223B) A --- --- --- 04/19/2019
Total Nitrate - N TNTplus 835/836
(Hach 10206) 0.759 mg/L 0.200 10.0 04/22/2019
Arsenic Arsenic by ASV
EPA 7063 < MRL µg/L 1.000 10 04/19/2019
Method Reporting Limit (MRL): the lowest concentration that can be reported reliably
Maximum Contaminant Level (MCL): highest acceptable level in public water systems as set by EPA
mg/L: milligrams per liter; 1/1000th of a gram
µg/L: micrograms per liter; 1/1,000,000th of a gram Absent (A): none of this type of bacteria was detected
Present (P): one or more bacterial cells of this type were detected
Results Reported By:
_____________________________
Anne Gleason
Laboratory Analyst
Reviewed By:
9131 E Frontage Rd, Ste 15
Palmer, AK 99645
(907)745-3005
matsutestlab.office@gmail.com
Signature:
Email:
Jen Williams (Apr 22, 2019)
Jen Williams
matsutestlab.office@gmail.com
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191169, Rebecca Carroll, 05/17/19
r -I
LOT 10 /
.v�
71 w
0
,S,
Lor z
LZ\ ENDER
SURVEY & MAPPING
2890 S BARNYARD CIR., WASILLA, AK 99654
677), DAYNA RUMFELT (907)301-5177
vJ CONCRETE
CONCRETE RETAINING WALL
RETAINING WALL
ti /
C
47.8 i
3 -STORY FRAME
HOUSE
3.8'
C Us I
BIRCH HILLS ESTA TES
UNIT #1
PLAT 69-186
LOT 1
BLOCK 1
y
�O v�
�0,�
NOTES
1. DIMENSIONS ARE
RECORD PER
PLAT 69-186.
UTILITIES OTHER THAN
THOSE SHOWN MAY EXIST.
THIS SURVEY DOES NOT
CONSTITUTE A BOUNDARY
SURVEY AND IS SUBJECT TO
ANY INACCURACIES THAT A
SUBSEQUENT BOUNDARY SURVEY
MAY DISCLOSE. UNDER NO
CIRCUMSTANCES SHOULD ANY DATA
SHOWN BE USED TO ESTABLISH ANY
FENCE, STRUCTURE OR ANY OTHER
IMPROVEMENTS.
24.0'
n, LEGEND
oma. O FOUND REBAR/
IRON POST
24.0' �2 STREET SIGN
POWER POLE
I // L J
' / GUY WIRE
SEPTIC VENT
f W
CW -)WELL
OVERHEAD UTILITY
UNDERGROUND
ASPHALT // GAS UNE
DRIVEWAY
OF A
cv
<5 j 49
Dayna M. Rumfeit /
iil v ��� • • No. LS 13322 • . a i
Awl
`� ll ROfESSIONAI`,`.�.
0
� ASBUILT - NO CORNERS SET THIS DATE
.� 1 HEREBY CERTIFY THAT I HAVE PERFORMED
A SURVEY OF
SCALE 1" = 30'
ALL VISIBLE ABOVE GROUND FEATURES OF
THE EXISTING SEPTIC SYSTEM WERE LOCATED
AT THE TIME OF SURVEY AND SHOWN HERE ON.
LOT 1, BLOCK 1, BIRCH HILLS ESTATES UNIT
#1, PLAT NO. 69-186, ANCHORAGE
RECORDING DISTRICT, ALASKA,
AND THAT THE IMPROVEMENTS AS DEPICTED
HEREON EXIST AS SHOWN IN RELATION TO
THE PROPERTY LINES. EASEMENTS OF
RECORD OTHER THAN THOSE SHOWN ON
RECORDED PLAT No. 69-186 ARE NOT
SHOWN HEREON UNLESS OTHERWISE NOTED.
LrJ- DATE: 4/28/2019 FB: 201812019
,GRID: NW 253 DRAWN: DMR
SCALE: 1" = 30' FILE: 19-012AB
MUNICIPALITY OF ANCHORAGE
Ilezo�� and Environmental Protelo"-�'on
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME _lLV jr l -✓' `
<1"%tel
LOCATION
SEPTIC TANK:
DISTANCE
FROM WCLL
INSIDE LENGTH
TILE DRAIN FIELD:
DISTANCE FROM WELL
# of Lines
_ MAILING
C• r p.G
LEGAL DESCRIPTION A07`�
a,
NUMBER OF p�
MANUFACTURER S�li �t'�_ MATERIAL�COMPARTMENTS_
INSIDE WIDTHLIQUID DEPTH __ LIQUID CAPACITI/AsVGALLONS.
TOTAL LENGTH
_FOUNDATION _NEAREST LOT LINE--.,---. -OF LINE
DISTANCE BETWEEN LINES TRENCH WIDTH_— IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE �1 IN. ABOVE TILE _xie^ IN.
SEEPAGE ffP•:
DIAMETER_ORYIDTI� LENC-r-Air ��-mc`
Log Crib _Rings_ Crib Size: DIAMETER_UEPTH_ DISTANCE FROM: WELL
- TOTAL EFFECTIVE
BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT.
Well
Class: Depth:
Well Distance To: Lot Line
Bldg: Sewer Line:
Pipe Materials:/1
# of Bedrooms: y
Installer: P9M[%Td N%rd v
Remarks:
DATE ___ APPROVED
I l�
I
-
I-
-�-
FT,
Tyl
-1
DATE ___ APPROVED
�1
a
DEPARTMENT l HEALTH AND ENVIRONMENTAL / j 1 EL.1 lOfl
825 L' STREET, ANCHORAGE, AK. 77OU7
264-4r'20
i+L [[=1_ L r1 M IJ u 1"V — � 1 1 C � L.. 1-V L. ►�: t— i- tt: l' 1 1. 1
PERHi I NO. l 77954 J
APPLICANT WI'I VI -I p - _ Y. U. GUTS 534 E. R. :7577 t+`94-960
LOCATION VEE ON 0 LUGtNE VR
LEGAL L1 G1 UPPER CIRT..HHILL EST LUT SIZE 66824 SQUARE FEET
TYPE OF SOIL ABSORGTION SYSTEM 1S
MAXIMUM NUMBER VY BEDROOMS = 4
TRENCH
SOIL RATING (SQ FT/ER)= 100
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM 15:
Ll C►'�' 1 H= ~ LI-L`+1U 1 H=
t51 Uphi%% EL L_ VEL=' 1 Lti= -4-
THE
+
THE LENGTH 01HENSION 15 THE LENGTH 0N FEE) OF THE TRENCH OR VRRINF1ELV.
THE DEPTH OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE 1S NO SET WIDTH FOR TRENCHES.
HE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
L=:1=1-!iJ 11<:�1�• :E;t=1 1 11:7,Hf iL� =. 1 LL= 1C k� L7HLI�IJM�
— — — — — — — 1 LJ 1= 1 1 tlf-.1---------
6 PACKAGE PLANT HAY BE INSTALLED AT THE YERHITTEE'S OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
Y. EITHER A CLASS 1 OR 11 NSF APPROVED PLANT HAY BE INSTALLED.
2. A CONTINUOUS Hi I N T ENRNCE AGREEMENT IS REQUIRED. REV. 1 F A HA I N T ENt1NCE
h GREEHENT 1S NOT KEPT CURRENT YOU HAY BE REQUIRED TO ENLARGE THE SOIL
h eSORPTION SYSTEM AND/OR YOU HAY BE SUBJECT TO PROSECUTION.
------ — 1 V.L 4J t C 1• 1 el on V" L= C! 1 1 1J V4 "" FA � Q C K L= C? IJ .L PQ LE E>
GiCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION FIND APPROVAL BY THIS
UEFiRTHEN1 WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 1S
190 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LUGS ARE REQUIRED AND MUST BE RETURNED TO THE VEPHRTHENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS HAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
t� i=F<i'1 1 1 i= >:; t= 1. fct=_• IJ iE:C_ Ei-iGL=F<: :-f.ys :11�!! f
1 CERTIFY THAT
:L: 1 hN FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL. INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
_. 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM HAY REQUIRE EHLHROEHENT IF THE
RESIDENCE 15 REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED:_ joirvyym Y (j. n ,
APPLICANT I 411'T VHNBRUN T
-.VH I E______________i YS. rl
r//;,VIILTdl✓
` 0 £t E GEC` ECHNI CAL Ft DEVEL .PMENT CO.
• Box 90, Davis St., Eagle River, Alaska 99577
6942774 or 668-2280
Russell Oyster fed Ellis
6942774 SOIL LOG 668-2280
Soils 6 Foundations Land Development
Performed for: Name: VA 9P—t)A-/7- Tel. No.
Mailing Address:
Legal Description: Lor / , F'i�,��� /JPPr2 QircilNiG� EsT.grCS
Depth (feet) Soil Characteristics
0
1
3
4
5 5P, CSP �rCq✓Ec5 �.9N0S/ Si4NDS /`/ED. Ta nn
6 C'a�CSc lc'Aitl��� CGEq.✓, !'o�t'!�'S -d�c Q.
6 .,
7
8
9
10
ML
11
13 int/ ofT
15 �Eo encx
16
Ground Water Encountered: Yes No ✓ If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
e-1
r^
e;
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
325 'L' STREET, ANCHORAGE, AK. 99501
264-4720
LJCLL 1='C1=:M I T
PERMIT NO. ( 770959 )
APPLICANT ERWIN DUGIN SR2 BOX 233 E.R.99577 694-3099
LOCATION LUGENE LHNE
LEGAL L 1 B 1 BIRCH HILL EST LOT SIZE 32670 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
t� t=Ft_tl I T L:�I=' I 2E �EGEI`1E:LF-�1 s 1 -C=A r r
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED
APPLICANT ERWIN DUGIN
ISSUED BY��-dc�r_-------DATE-/e--/g- —---� V3. 0
Sscno�/ A -A'
I
n
Z�T 2
LoT / BPRCN 01LLS
AMR"
acop6
oP 68DAmr-K
DAIT.<M Ileo
EAGLE R,vER
ENGINEERING SERVICES INC.
P. O. Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694-5195
CHECKED BY DATE-.
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EPIAAJS
MUNICIPALITY OF ANCHORAGE Rassio
(74
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. 050-081-10 Expiration Date: q- f O 1
1. GENERAL INFORMATION
Complete legal description Birch Hills Estates #1 Block 1 Lot 1
Location (site address) 11930 Lugene Lane Eagle River AK
Current property owner(s) Ann Stone Day phone 907.488.3027
Mailing address 7290 Richardson Hwy Salcha AK 999714
Real estate agent Drew Jones Day phone 907.330.9477
2. TYPE OF DWELLING:
E Single Family (w/wo ADU) RUSH
❑ Duplex
E. Multiple Dwellings (Single Family and/or Duplex) siMIlmommumb
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well U Private Septic l�
Water Storage ❑ Holding Tank ❑
Community Well Community n
Public Water System ❑ Public Sewer
Waiver request for:waivers in place for wells to tank Distance: 67' / 70'
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ `ir�B Waiver Fee $
Date of Payment 6 l3 /19 Date of Payment
Receipt Number 6769-465 Receipt Number
COSA# 05(161109 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 Eklutna Engineering, LLC Phone 907.355.9820
Address 19162 Mountain Road Chugiak AK
Engineer's Printed Name Curtis Townsend, PE Date June 1, 2019
6. DSD SIGNATURE , / /•••°t ,. ��R'S r,
(` System #1 Approved for `�I bedrooms 1 • • .1. • •' ,y: f
• pate •
System #2 Approved for bedrooms �+F�/s•..No.ce1tsoa..10•,
Disapproved +�1�\o���a-m0`
Conditional approval for bedrooms, with the following stipulations:
.1/4t., tOF<<r`t,.
O
ON-SITE VS:-
WA I t
�o WASTFWATER 6
...,_3PROGRAM
i47SER\1\C
")))1))11)11
By: IN �— Original Certificate Date: Co—1 O -i?
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
COSA Checklist
Legal Description: Birch Hills Estates#1 Block 1 Lot 1 Parcel ID: 050-081-10
If more than 1 septic system on lot: COSA Checklist# I of Structure served by this system
A. WELL DATA
['Well log is filed with Onsite(or attached) Well production at time of test 0.41 gpm
Date drilled 1977 Water storage tank volume 450 gallons
Total depth 425 ft Well disinfected for coliform test? [' Yes ❑■ No
Cased to 16 ft ❑t Coliform bacteria is Negative
❑■ Sanitary seal is functioning correctly Nitrate mg/L ❑t Nitrate less than MRL (ND)
❑■ Wires are properly protected Arsenic ug/L ID Arsenic less than MRL(ND)
Casing height(above ground) 30 in. Collected by Curtis Townsend, PE
Date of flow test for COSA 6/619 Date of Sample 6/9/19
Static water level at beginning of test 260 ft.
Comments There are two wells on this property. This well was drilled in 1977.
B. TANK DATA C. LIFT STATION
Age of tank(s) <1 years ❑ Required maintenance completed
Tank type/material plastic septic Age of lift station years
Measured operating fluid level in septic tank 58„ Lift station material
❑t Standpipes/foundation cleanout per record drawing Comments:
Date of pumping new tank May 2019
D. ABSORPTION FIELD DATA
Which system tested(date installed) 1977 Adequacy test date 4/27/19
t❑ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms
Total measured depth from grade 7 ft(max) Fluid depth prior to test 0 in
Measured depth to pipe invert from grade ft(min) Water added 602 gal
❑ N/A—pressurized field New depth 24 in
❑ Monitor tubes go to bottom of effective. If not, state 150
depth into effective 2.5 Elapsed time min
Q Code-required soil cover over field Final fluid depth 0 in
❑ System presoaked Absorption rate 600 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) no
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
COSA Checklist
Legal Description: Birch Hills Estates#1 Block 1 Lot 1 Parcel ID: 050-081-10
If more than 1 septic system on lot: COSA Checklist# Z of 2- Structure served by this system
A. WELL DATA
❑Well log is filed with Onsite(or attached) Well production at time of test 4.0 gpm
Date drilled 1984 Water storage tank volume 450 gallons
Total depth 355 ft Well disinfected for coliform test? ❑ Yes ❑■ No
Cased to 21 ft 0 Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate 0.759 mg/L 0 Nitrate less than MRL(ND)
0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL(ND)
Casing height(above ground) 36 in. Collected by Curtis Townsend, PE
Date of flow test for COSA 4127"6 Date of Sample 417"9
Static water level at beginning of test 22 ft.
Comments There are two wells on this property. This well was drilled in 1984
B. TANK DATA C. LIFTS ON
Age of tank(s) years equired maintenance completed
Tank type/material Age of lift station years
Measured operating fluid level ins tic ank Lift station material
❑ Standpipes/foundati -cleanout per record drawing Comments:
Date of pum
D. ABSORPTION FIELD DATA
Which system tested(date installed) Adequacy test date
❑ ALL standpipes present per record drawing Results s For bedrooms
Total measured depth from grade ft(max) Fluid e th prior to test in
Measured depth to pipe invert from grade ft(min) ater added gal
0 N/A—pressurized field New depth in
❑ Monitor tubes go to bottom of effective. If not, s - e Elapsed time min
depth into effective
0 Code-required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater an 30 days prior to Any rejuvenation treatment(past 12 months)
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficie les:
COSA Checklist yellow sheet
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' Community Sewer Manhole/Cleanout> 100'
0 Yes if No 63765' ft 0 Yes if No ft
Neighboring Tank> 100' 0 Yes if No ft Private Sewer/Septic Line >25'1 Yes if No ft
Absorption Field on Lot> 100' ❑Yes if No 64197' ft Holding Tank > 100' 0 Yes if No ft
Neighboring Absorption Fields> 100' Animal Containment> 50' 0 Yes if No ft
—❑✓ Yes if No ft
Manure/Animal Excreta Storage> 100'
Community Sewer Main> 75' 0 Yes if No ft E Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations> 10' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft
Property Line> 5' 0 Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' 0 Yes if No ft Private Wells 100' 0 Yes if No ft
Water Main > 10' 0 Yes if No ft Community Wells>200' 0 Yes if No ft
Water Service Line> 10' 0 Yes if No ft If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation> 10' 0 Yes if No ft If absorption field is under driveway comment below
Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots:
Water Main> 10' 0 Yes if No ft Private Wells> 100' D Yes if No ft
Water Service Line> 10' 0✓ Yes if No ft Community Wells>200' 0 Yes if No ft
Surface Water> 100' 0 Yes if No ft
F. ENGINEER'S COMMENTS
Waiver OSV191025 previously granted for septic tank to well separation.
The tank had to be moved from previously permitted location to accomodate
bedrock that was found when excavating.
G. ENGINEER'S CERTIFICATION
1 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
���P��of a 444
— • TM I\ ¢r
•
�jig ..:. 1
COSA Checklist yellow sheet Curls L T.
/����,• Date ly �/��
c�l�•No.CE 11904•. 5
1,1‘,f-,oROFEsstONP�4...
•
Eklutna Engineering, LLC
curtistownsend@gmail.com
June 17, 2019
Subject: Birch Hills Estates Unit#1 Block 1 Lot 1
Permit 0SP191169
This property is served by two wells. These wells are both on individual circuits.When I performed my
well testing in April 2019,the 1984 well was turned on, and the 1977 well was turned off. I was
monitoring the water level in the storage tank throughout my test. It maintained a consistent height
throughout my test, as fast as I was draining it out,the well was filling it up.The well produced 602
gallons in 2.5 hours, this is a calculated flow rate of 4.0 gpm.
Samples of the water from the 1984 well were tested in April 2019.The test results show that Coliform
is absent, Nitrate is 0.759 mg/L and Arsenic is<MRL.
Prior to well testing in June, I turned the 1984 well off and turned the 1977 well on. I then drained the
450 gallon storage tank. I conducted my well flow testing two days later.The 1977 well produced water
at 2.7 gallons per minute. It was able to maintain this flow for 250 gallons.At this time,the level in the
storage tank started to drop.The well was not able to keep up with the demand and the water level in
the storage tank was decreasing. I continued to draw water from the storage tank till the level was at
150 gallons. Within 12 hours (the next morning),the volume in the tank was at 450 gallons. The well
provided 300 gallons in less than 12 hours.This works out to 0.41 gpm. It very well could be a higher
flow rate,the level in the tank could have filled completely sometime in the night, no one was around to
verify. I am going to use 0.41 gpm as the maximum flow rate this well could produce without drawing
down the water storage tank volume.
Samples of the water from the 1977 well were tested in June 2019.The test results show that Coliform
is absent, Nitrate and Arsenic were both<MRL.
Sincerely,
Curtis L.Townsend, P.E.
AXU
• s�V!•L.45k
er
• Curtis L,Tow,send
�'• Date _ 1 c 4
9;�'fT4.No. .CE 1f • •
r ';1 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
2644720
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot. block, subdivision, section, township, range)
Lot 1 Block 1, Birch Hills Estates N1 T14N R1W_Sec. 1
Location (address or directions)
LuYene Ln.
(b) Applicant Name Ann Stone Telephone: Home 488-3027 BusinessN/A
Applicant Address PO Box4548 Eielson AFB, Fairbanks, AK 99702
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder:] ; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution N/A Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(I) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Familyn Multi -Family❑ Other
Number of Bedrooms 4
3. WATER SUPPLY
Individual Well ® Community ❑ Public ❑
Note: If communitywell system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ❑ Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72.025 (11,84)
5. ENGINEERING FIRM PROVIDIr"tNSPECTIONS, TESTS, FILE SEARCH, Dr AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this Inspection. *with approval of separation distance waviers, well—septic.
Name of Firm
Address EAGLE RIVER ENGINEERRIG SERVICES
//o s` L RIVER, A 99577
Date � � Rd. UOX-7T3294
694.5195
6. DHEP APPROVAL
Approved for
Approved
Telephone
� 4 •�e CE1T.i6 t,�•. i
J ;] /
L,
bedrooms by 4L_1ae-1 '4 * 2j'/ " "Date
Disapproved
Terms of Conditional Approval
Conditional
n
CAUTION
3 — Z.?- —9'(,
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineers work.
Page 2 of 2
72-025 a Veo
MUNICIPALITY OF ANCHORAGE (MOA,
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
"MlaPAUM OF AMCHORAW
DMMIL�PROOTS.
EalON
MAR 171986
284-4720
Legal Description: �� � ,ASCEMD
A. WELL DATA
Well Classification 11�74/'/AT,- (..� ) If A, B. C. D.E.C. Approved (Y/N) y1A
Well Log Present (Y/N) e f Date Completed rte» — ZZF4" Yield Kdov )
Total Depth -0 7524ased to I�Depth of Grouting yA
Static Water Level zOS'/ ( .SS/r Pump Set At
Casing Height Above Ground Civ" b �� Sanitary Seal on Casing (Y/N) - Y7• %Y�
Electrical Wiring in Conduit (Y/N) y 11 (y Depression Around Wellhead (Y/N) N1, C�:%Z
Separation Distances from Well
To Septic/Holding Tank on Lot..K•7 (A' 9 � ;On Adjoining Lots
To Nearest Edge of Absorption Field on Lot 97 o ;On Adjoining Lots
To Nearest Public Sewer Line "c To Nearest Public Sewer 1
Cleanout/Manhole To Nearest Sewer Service Line on Lot ras' �'a1'7l
Water Sample Collected by C`S 'e" r ^S' ;Date
Water Sample Test Results S4 f r
Comments ON* 70 %"e c o c c! �6e ' ^ roti r F �/r r t i Y
PC-
B. SEPTIC/HOLDING TANK DATA
Date Installed Oc t H 7 7 Size /a 5-0 No. of Compartments
Standpipes (Y/N) X Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) y Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) �� ; for
Holding Tank High -Water Alarm (Y/N) __�4 Temporary Holding Tank Permit (Y/N) —y_
Separation Distances from Septic/Holding Tank:
76y�
To Water -Supply Well � To Building Foundation �
To Property Line Cf c To Disposal Field r '5/S
To Water Main/Service Line *�� To Stream, Pond, Lake, or Major Drainage
Course �Vlft - 4-27'^ /""
Comments
Page 1 of 2
72-02601/641
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ADO �!d'/C. Type of System Design %re-^ c A
Date Installed Oc. ;,, /5 7
Length of Field S
Width of Field 3 Depth of Field 7
Gravel Bed Thickness �, /
Square Feet of Absorption Area G Standpipes Present (Y/N) 1131,
Depression over Field (Y/N) Date of Last Adequacy Test &Af J6
Results of Last Adequacy Test Sc J` s . ia�� VSs or ), f -- "A! 7zr Jr- dPc/r r c.,c,
Separation Distance from Absorption Field:
To Water -Supply Well 97
To Building Foundation E3/
To Property Line
Id
Lot /7,/9 ti -le- ; On Adjoining Lots
To Existing or Abandoned System on
r.3D
To Water Main/Service Line t/o I To Cutbank (if present) 10 /1e
To Stream/Pond/Lake/or Major Drainage Course y' • "Zz•' iuo '
To Driveway, Parking Area, or Vehicle Storage Area s-,
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at —
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
•• Check Permitted Bedroom Rating Against HAA Request ••
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspectipn.
Signed Date ?I/`'�Fe
Company IFS, MOA No.
Receipt No. 3'1 �,-7 '5�
Date of Payment 3
Amount: $ t.=,�
Page 2 of 2
72-02611 I,841
i
• • %.•, V &gineer's Seal
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Louis A. flutes
CE -6736
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Municipality p. 0×1966 9
ANCHORAGE, ALASKA 99519-6650
O~~ (907) 264-4111
Anchorage TONYKNOWI. ES.
MA
DEPARTMENT OF HEALTH & HUMAN SERVICES
April i, 1986
Lou Butera, P.E.
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Subject: Lot 1 Block 1 Birch Hills Estates Subdivision #1
Waiver Request, WR86-034
Dear Mr. Butera:
This department has reviewed your request for waivers of the horizontal
separation distances stipulated in 18 AAC 72.021 for the subject property.
A risk analysis was performed that showed that the affected wells on the
subject lot are almost sure to be free of contaminatiDn resulting from the
septic system on that lot.
The following waivers have been granted:
(1) 1977 well to septic tank distance waived to 67 feet.
(2) 1977 well to leach trench distance waived to 97 feet.
(3) 1984 well to septic tank distance waived to 69 feet.
(4) 1984 well to leach trench distance waived to 60 feet.
These waivers are valid for the existing four bedroom single family dwel]ing
only.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
EAGLE RIVER ENGINEERING SERVICES
Lou Buten P.E.
P.O. Box
Eagle River, Alaskalaska 9 9
9577
Telephone(907)694-5195
3/10/86
Mr. Steve �t „ qe
Municipalityty of of Anchorage
Department of Health and Human Services �A6
825 "L" Street AMP
Anchorage, Alaska 995020650 w 1•
Ref:Lot 1, Block 1, Birch Hills Estates M1
Dear Mr. Morris; YY
On behalf of my client, Mrs. Ann Stone, I am applying for
a wavier of separation distance for two wells located on the
above referenced lot. The waviers of horizontal separation dist-
ance are as follows:
1. 1977 well to septic tank distance 67'.
2. 1977 well to leach trench distance 97'•
3. 1984 well to septic tank distance 69'•
4. 1984 well to leach trench distance 60'.
The 1977 well was drilled on March 19,1977 prior to the
septic installation. This is vertified by septic permit dated
10/14/77 and by excavators reciept dated 10/31/77. The septic
system installation was inspected by the Municipality and ap
parently the well location was overlooked as approval was granted.
The 1977 well has a 425' total depth. Bedrock was encountered
from 16-295' as noted in the well log. At the 295' level and
again at the 390' water was encountered rising in the casing
to a static level of 105' . The 1984 well has a total depth of
355' and draws water from a depth of 285-289'. Bedrock also
protects the aquifer from 21-285'. The 1977 well was tested
at a recovery rate of 517 GPD and the 1984 well produces 600
CPD. The two wells are needed to support a 4 bedroom home usage.
Topography of the lot is such that the wellheads are located
21 vertical feet above the septic leach field. This would act
to direct leachate away from the well locations. Both wellheads
are located at the same elevation with the septic tank outlets
approximately 4' lower in relative elevation to both wells.
The soil log included shows that the septic leach field is located
in SP -GP soil rated at 100 sq. ft. per bedroom. This soil layer
is directly underlain by an ML soil type which should be consider-
ed in the evaluation. The leach field is 7' total depth with
4' of gravel added. The leach field was tested as adequate for
4 bedroom usage. A survey plot plan is included for your informa-
tion.
cont'd
Page 2. L1, B1, BirQ Hill Est. M1
In evaluating of this wavier we ask that you consider the
relative elevations separating aquifer and septic system, the
confining bedrock layer, favorable surface topography and soil
layer located directly under the leach trench (ML).
If there are any questions or concerns please call me at
my office 694-5195.
Sincerely,
Lou Butera P.E.
MUNICI►AUTY O/ AMCM04AGI
WYI D WAWAL P M 4
Rf1TECTlgy
MAR 1 I S%
RECEIVED
