HomeMy WebLinkAboutTALUS WEST #1 BLK 3 LT 23Talus West #1
Block 3
Lot 23
#015-202-08
17J L_ Cf flf
_V-i-I-VT1-AWF 4-1
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP251333 PID Number: 015-202-08
Dwelling: MN Single Family (SF) El with ADU 171 Duplex (D) El Two Single Family Project: 171 New 0 Upgrade
Name
MICHALE RATZLAFF
AORPTION RPTION FIELD
F
El F1 Wide Trench Wide Trench F! Bed C;�4ound
0
Site Address
4530 SNOWCUP CIRCLE, ANCHORAGE, AK
Z
Other
Phone
Number of Bedrooms
Soil Rating
depth f original grade
907-240-4478
1 3
F
1Total
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from ori -ravel depth beneath pipe
L__1 Ft.
Subdivision Block Lot
TALUS WEST #1 3 23
Fill added above original G I length
Ft. I Ft.
Township Range Section
Gravel width
>01000Ft.
Beds: Number of Lines
DisNbe
.�een lines
_" Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total orption area
Number of trenches
Dist between ches
From
Tank
Field
Tank
Line
Ft2
—
well
100'+
EXIST.
100'+
-
25'+
TANK Q Septic N &T.E.P. El Holding ❑ Other
Manufacturer
ANCHORAGE TANK
Capacity
1500 Gal.
Surface Water
100'+
EXIST.
100'+
-
Material
EPDXY COATED STEEL
Number of compartments
2
I
NA
Lot Line
5'+
EXIST.
5'+
-
Foundation
10'+
EXIST.
10'+
-
LIFT STATION
Manufacturer
Capacity
Remarks
ANCHORAGE TANK/ORENCO SYSTEMS
—500 (2ND CoMp.)Gal.
Alarm location
INDOOR I
Electrical installed by
PIPE MATERIAL House to tank D3034 d Tank to D2665
rainfield
Installer
'
ARM SEPTIC SERVICES
Drainfield D3034 CO/MT D3034
BENCH MARK (Assumed elevation) 100.00 ft
Inspector GARNESS ENGINEERING GROUP, LTD.
Inspection 1s, 10/16/2023
Location and description
dates: 2nd
31d 4,h
BOTTOM OF SIDING NEAR FCO
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
OF CoQ
Conditional Approval: Date
rp
-F
TH
....... ....a
Septic Syste
Approved Date/
y. Garn ss:
CE 7
No " is ap�roval does not include well permit requiremen S.
0(y P
ro f e'ss"10"O\
#AECC884
(Rev 05/02/18) /
PERMIT'NUMBER: PARCEL IDNUMIOSP251333 RECORD DRAWING 015-202-OBBER:
SNOWCUP C1R.
__ -t
, � 't
EXISTING
3-BDRM. j
HOUSE /
A I B
/ FCO 25.4 24.7
Mill 41.3 1 39.3
/ MH2 46.3 35.3
/ NOTE: PIPE LOCATIONS ARE
SHOWN PER GEG SHOTS
/ TAKEN WITH LEICA DISTO
/ S910 LASER DISTANCE
/ METER. SWING -TIES TO
HOUSE CORNERS WERE
GENERATED IN AUTOCAD.
i
/
NOTE: PER THE CONTRACTOR, THE OLD
/ SEPTIC TANK AND LIFT STATION WERE
DECOMMISSIONED IN PLACE PER UPC.
NEW 1500 -GALLON ANCHORAGE TANK
EPDXY COATED STEEL STEP TANK.
�i TANK RATED FOR 10 -FEET BURIAL.
r -
SHED r" a' ',�� �
\A gSomejo
EXISTING DRAINFIELD 1 • 11 er-°me 6 //
1
MONITORING TUBE
REPAIRED AND SET AT
THE CORRECT ELEVATIO
10' UTILITY EASEMENT
1 /
1
` 111/I' \ 1" = 30'
1
®y®\\\l®
♦' OF q�p
ENGINEERING SALES CONSULTING i
3791 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, ALASKA -PHONE (907) 337-6179' WEBSITE: w ..gamessengineering.mm • .•.•••• .•.••.•....•..... •.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ,I tin J ey . arness ; � R
MICHALE RAZLAFF 907-240-4478 2 OF 3 % l7t53 °��`
PROJECT/LEGAL DESCRIPTION: DRAWN BY: O 'TALUS WEST #1; BLOCK 3, LOT 23 J.L.M.p'�•1•�•.. (�P�, ++
TYPE OF WORK: DATE: LICENSE ?O ESS, `®®+
RECORD DRAWING OF STEP TANK UPGRADE 11/3/2025 #AECC884 ®`®i'�
BER
PERMIT NUMBER: PARCEL ID NUM
I OSP251333 RECORD DRAWING 015-202-08
TOP OF TANK (
INLET = 91.30
INVERT OF BUNG
@ INLET = 90.68
GALLON &OZ COATED ;TEP
TANK (RATED FOR 10' BURIAL)
W T
GARNESS ENGINJEJERIM43' td-ff-Wd-)`uP, Ltd
ENGINEERING - SALES - CONSULTING
3701 E. TUDOR ROAD, SURE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6179
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
MICHALE RAZLAFF 907-240-4478 30F3
PROJECT/LEGAL DESCRIPTION: DRAWN BY:
TALUS WEST #1; BLOCK 3, LOT 23 J.L.M.
TYPE OF WORK: DATE:
RECORD DRAWING OF STEP TANK UPGRADE 10/30/2025
0
ANrlULt=
101.74
P OF TANK @
)TLET = 91.26
OUTLET CAPPED
$74
953
4
4
LICENSE
AECC884
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251333, Isatou Njie, 09/23/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251333, Isatou Njie, 09/23/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251333, Isatou Njie, 09/23/25
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
A~,.~ ~ SEPTIC ABSORPTION
) Perm,t NO -- JNo. of Bedrooms WELL /~ / ~/~d2 /
Towosbip. Range, Sec,ion FOUNDATION
T/X ~/ ~ .~ ~-V, ~¢'~ Z ~ dr,veway.AS'BU' L~water" ,Abod,es.G RA M iShetc, ow ,ocat,on o, well. septic system, p operly ,,nes. ,our, 0at,on
/ TANKS
~ SEPTIC ~ HOLDING
~ TRENCH BED ~ W. DRAIN Q OTHER ~ ~(~
~ PRIVATE ~ OTHER (Identify) ~,~t
REMARKS: ~. ..
Pap!::el ]icj,",
Lot. Legal',: Sul::~d:i.v:i.s:i. on: TALUS WEST ~,1 Lot: 2~ Block:
Sec'L:i. on ~ ~?.2 I"c:n,,a'~ship:,, :[2hl Rar~gc~: 3W
l._ot S:i.~:e 24720 (sq. ft.., ch' att'es)
Max Bedr'ooms,,: ]"his l::'epmJ.'L: 3 'tl:~'La:[ Capaci't,y~ 3
.i.~ v~ ]., 000 galL ]cn'~!;~, Each ~-' .
Deptl"! ici tc, p c,¢ sept:Lc tarfl::
I;IqF[}RM I%H,,H,,S,, F::'R:[OR 'fi] :[iqSPE}:C'T]iOIqS BY ENGINEER~ !F AFTER
OI::F:ICI:~ I"IEHJRS, CALL, 343""46Ei:L AND L.EAViE A MESSAGE,,
CON!:;'IFdJC.'t F'ER ENf:{~]:NEEF~S ATT[~C;HIED AF:'F~R(]VED
THiS PIERPIII' EXP;[RE:]S :1.2/:},]./~]t9 AND VALID !:::E)R A SINGL..tE F'AMiLY HC)IdE,,
iElqEii i"¢EiEF? M!,JS'f SUBId t'l EL.EC;] F~ I C :[ ANS I NSF>EC'i' ]:ON OF L,.I FT S"i"A'i'I ON
ALONG W]]]'H
]. [:;EF;Y[ ]: FY THAI .:
]: am iarn:[],iar', ,,~!:L'~.h 'Lhe i"eClu:i.r'eman'(c, {'i:ip cHl'-'s:i.'La~ s6~,~er's and wc~].],% as s6'.t
· ¢cmtl"t by t. he~ l"h..tn:i, cipa].~ty c)f Aric:hor'ag~:~ (MOA) ar'id t.h~? Si:.a'[~;~ mf Alaska.
::.L I ~,~:i.:ll adl'lel'e 't.o a;l.]. MOA and S'l:.ate: cfi' A!asl.::a Pequif'emarrLs fen' '('.J"!~:] :4iet bacl.::
(:JJ.!~'li..f. Ci,::,;e~i {i"(:/til any ~)xJ. st;i. Fig Wa;,].].:, ~,,~ast0~nater, c:Ji[i~3posa! slyst, i.;.}m of pub[Lie
iE. EHa(..)r'a[JG¢ !i~y~i~'l;,i.~lfl (::)l'i 'LJ't~.~ii OP any ad.jacerit ch- r'lear'by Ici'L.
4,, :[ under's'Land tha'L 1'.hJ.~ pePm:Lt is valid for'
a].!BC) iil']d6?l'!i3't']&ll]Cj l'.ha'L 'LIIE, c:apac;:L'Ly of the 'Lo'La]. ~iys[~lfil :[!B iS J:lE,~di'EICiffl!~ and
any ~an].ar, oemc.;,rit L*,,:L]]. r'e;,qu:ir'e aa add:i.'Lioria].
~., ~..: ! ......
I,.~ I~AUI:::' I N
DATE
: i Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVI~
825 'L' St~:eet. Anchorage. Alaska 99502-06
SOILS LOG -- PERCOLATION TE,~
FOR: h!~ L
LEGAL DESCRIPTION: Lr)T ~_~ I~j ~ ,5 Township. Range. Section: ~-I?_
~" NE~- :4/~/:: j SLOPE SITE PLAN
3-
4
5
6
7-
10 '- WAS GROUND WATER .~ iq P ~/~TL~[
ENCOUNTERED?
I ES, AT WHAT
DEPTH2
IZ~ '
: ~ ~"' Z:~G /0~ ~ ~ ~ iZ'
18-
19
20
PERdiTION ~TE /~,~ (~n~i~l PBC HOLE DIAMETER ~"
'
- / kITH
I El FT STATION
~.L_ ~~ : I ~ ~N~TALL N.&~ ~PPEOVED '
~ [{ ~ J k,, L - I STATION UNIT
~ / ~o o oo
-~' ~ - -~,~-'~o ~ / > /
~ [N~TAEL ~00~1 HOA ApP~~'
LIFT ST&T 10 M
TANK ~ P~OPOSED ~EP. MAI~TAI~ ALL ~NGTEucTIOM TO MEET
I~' NELL ~EPA~TIOM M.o.A.
~ DLmensions ~8 ~ocations ~ust 8e ~iel8 Veri~ie8 Prior ~o Construction
-.SEWE 8YSTEM'LOOATION PLAN
............ MR. LA~NY MAUP
MUNICIPALITY OF ANCHOP, AGE
DEPT, OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
3500 EAST TUDOR ROAD
INSPECTIONS (907) 563-3464 INFORMATION (907) 786-8211
FOOTING [] ELEC. TEMP. __
FOUNDAT,ON_ [] ELEC. SE.V.CE, .
BOND BEAM __ [] ELEC. ROUGH
FRAMING [] ELEC. FINAL ~
INSULATION __ [] OTHER
SHEETROCK_ []
STRUCT. FINAL [] FIRE FINAL
OTHER [] ZONING
PLBG. UNOGR. []
PLBG. ROUGH __ []
GAS TEMP· []
GAS []
MECHANICAL __ []
MECH. FINAL []
PLBG. FINAL __ []
OTHER []
[] NO NONCOMPLIANCE OBSERVED
[] WILL REEXAMINE AT NEXT INSPECTION
[~] CORRECTIONS ESSENTIAL AS
EXPLAINED BELOW
[] DO NOT CONCEAL UNTIL REINSPECTED
COMMENTS
INSPECTOR DATE
WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION
84~902(Rev. 11/87)
DO NOT REMOVE THIS NOTICE
-®
GRE ,-,i!ER ANCHORAGE AREA BOk- UGH
Depsrtmenl of EnvironmentsI Quality
3330 C Street
Anchorage, Alaska 99503
NAME./~//~ '~/~' ~' '
SEPTIC TANK:
FROM WELL ~ MANUFACTURER
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
· · ' I ' MAILING ADDRESS ,/~.- ONE
NUMBER OF
COMPARTMENTS
INSIDE LENGTH
INSIDE WIDTH LIQUID DEPTH-~-~..- LIQUID CAPACITY GALLONS.
DISTANCE FROM WELL ,~/]~¢'~/--~)
N~MoBREpRTO~LINES~DISTANCE BETWEEN LINES /~h TRENCH WIDTH~ IN.
A S IO AREA ~(¢2 SQ. FT. LENGTH OF EACH ~ ~=
FOUNDATION '~(~ (" NEAREST LOT LINE ~ d~' '~_OF LINEsTOTAL LENGbHT~/H
DEPTH: TOP OF TILE TO FINISH GRADE
CONSTRUCTION
DEPTH OF FILTER
TOTAL EFFECTIVE
TILE
IN. ABOVE
BUILDING NEAREST ~)/ NEAREST
FOUNDATION LOT LINE
, SEWER LINE
CESSPOOL OTHER SOURCES ./~"~'~ /,
APPROVED ~/dlSAPPROVED REMARKS
IN.
DISTANCE FROM:
/
INSTALLED BY:
SEWER LINE DEPT~H:
PIPE MATERIAL:
LOT SLOPE: /~---~ -~ ~
Form EQ-032
DIAGRAM OF SYSTEM
G.A.A.B.
DRILLING, INC.
Well Owner
DRILLING LOG
Use of We]/ Dom.
Location (address of: Township, Range, Section, if known; or distance main road
Lot 23 Block 3 Talus '}lest
Size of casing.
Static water level
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at 6 gallons per
of drawdown from Static level.
Date of completion o / 3 / / 7
Depth of Hole 152 feet Casedto 151 feet
!00 ft. (~k}~) (below) land surface. Finish of well (check one) open end (
(minute) for ] hours with
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
'), .TO.
6 .TO. 22
22 .TO.
4A .TO_ 49
~9 .TO_' 59
5§ .TO_
$~ ~O_ ~24
124 .TO_
152 .TO_
TO
TO
TO
TO
.TO.
TO.
Silty sand
Silty gravel
Sandy graval ~' ~ ~ ,~"
Loose silty ~rave!
Sand:
Si!tv ~ravel
Sa~iv ~atar ~ravel
NV,.';V',, (',,?.:.Scj C--tractor
Cw.'tificnte No's. 814 e 973
2 -- STATE
F'EF?.M I T NEL
FtPF'L I C:F~Iq T
LOCFrT' I C I'.,!
I_EGRL
BL.IC:K H I EiH~T
II.ILL I=F,I,!IE=,:, LFINE
L2:3: I...,.~. TFIL c HE=, I
.:..../- .:, t-.:14
:].iE~E~EIEI :E;[;!LIFIRE F'EET
'f"¢PE OF '~ ...... c- :; '-
.:, ... ]. I : ..........
-IE,_,LI:..E, F].Ltq .~., r.: I Ell ] F. fLI
MFI;:'::IMIJM I",II...IHSER OF:' 1'3E::[:'I:;b]OMS = 3:
., ...... · ,::,_:;Q :--., ,.., ......
E;i::iL[L.. b.H[.Ei'lb I I. E,k. ,-., .
THE REI;:!IJ I RED '- '"':' '" OF ':;l']I I. : -": *' :' ' '
.:, ] ,:.l: . THE ...... I
THE L. ENEiTH DII'IEI",I':SION t'=E; THE LENGTH (IN I::'EET) OF' THE TRENCFt OR I)I;?.F::I!NFIEI..[:,.
'THE: DF-"F'TI"4 OF R TRENCH OF.'.' PIT ZE; THE E:,IS:TF4NC:E BE'THEEN THE L=;LIRFF~L-:E OF THE
GROIJN[) F~N[:, TI-E": E:O'TTOH OF' THE E',:-::CI:~'v'R]-ION '::IN FEET>.
THERE: I~ I'.,IO :E;ET HIDTH FOR TRENCHE'E;.
THE GRFF,,'EL DEPTH Z'.E; THE MINIHUM DEP]'FI OF: GRF:I',,,'EL. E:ETHEEN -I'HE: OUTF'FiL. L. P!F'E':
FIND THE BCiTTOM OF: THE E',:.::CFI'v'F]TIOIq ,::IN ISlSE'T'). ~
EZ]HLF.. FI L. LH.:,:, I OR :[Z i",l::i:;F FIPPRO',/E]) F'LRNT MIR"? E:E IIq?ITiL. LED.
R -:I"FF1X'.~JCdJ:E; I1HII~I'ENHi'.,I...E FKaREEHENT ]:..S F..Eb!LIiI:<[.E.. IF la MFIIN'FENFH',K::E
FIGREEMEN]" I5; NOT KEFq" C:LIRF.~EN]"_ YL]IJ I'"IR'¢ BE REQUIRE'[:, ]"O EMI-' r.dF,,,..--.-~[:: THE
E,_,UF..FI]..~N ......... . -': "1 "- '' -, ---' -
.:, .: I El i hll,ll... UR 'CF 1 I'"lFl"r' E,L.:,._ll:,...I EL. 1 ]'0 [' F.t.l.:,E....IJ r ! .. iq.
E -IL.I-,.F Z LL .[N..~ OF FIi",l"r' ':' '" .... '" '- "'" ]' '"
~:,]EM H:[THOLIT FZNFIL II",IE;F'EC:TICdq FIND HFFF~... HL -'1'.[.:,
E:,EF'FIRTi'IENT H I L..L IF_:E _ IJE.,J'r:.... I' ]"O F'ROSE~ ]:_ T t
MINIMUM DIS"FRNCE BETHEEN FI HELL. RF,II} RN'.r' ON-SITIE SEHRGE [.',I'_=,POE;RL S"r'S;"FEH I:E;
:LC~EI FEE:T FOR FI PRI',,,'F~TIE HELL OR 2EIC~ FEET FOR R PI.J[3LIC F.IEL. L..
HELL L.OCJS; RRE REQLIZRED RI',ID MUS;T 13E RETURNED TO THE DEF:'F:ff?.-J-HEN]- I.'.IITHZN
OF THE HEL. L COP'IPLETZON.
SF'ECZFICF~TIONS RND CONSTRUCTION DIFtGRFIMS laRE R","FIZLIRE:LE 'FO INSURE F:'ROF'ER
I I"E~;]"R[..LR T I ON.
I CER'f'IF'-? THFtT
±: I FIH FRHILIRR HITFI THE REQUIREHENTS FOR ON-S~TE 2;EI.qERS FIN[:, 1.4ELL.:S RS S;E]'
FORTH B'¢ THE HUNICIPRLIT'¢ OF FINCHORRGE.
2: I HILL INSTFILL THE S'-r'E;TEI¥1 ~-,j RCCORDFINCE HI]'H THE COE:,ES;.
Z: Z UNDERSTRND THRT ]"I4E ON-SI]]E SEHER S?r'~f:Etd MR¥ REQLltRE ENLRRGEI'1ENT IF THE
RESZDENCE :[% REHODEI~ED TO INCL. UDE HORE: THRN 3: BEDROOHS.
~'~':~ ..... E[,. E, [,HI [
Date
Insp
PL-:?AP, TI'IENL~_pF ~-IEALTI~I AND ENV~I~O~',~iENT;,...P~O'rECT~O;,i~
825 L Street, Anchorage, Alaska. 99501
279~-2511~ ext. 224 or 225
/~.~
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Date
Insp
Lending Institution Request: Alaska Mutual Savings Bsnk % Cheryl Smith
Mailing Address: Post Office Box 1120 Phone: 274-3561
2. ]Property Owner: Charles Hight, Sr.
~al. 13.ng Addre
Phone: 349-3494
]Legal Description: Lot 23 Block 3 Talus West Subdivision #2
4: Single Family Residence: (~
Multiple Family Residence: ( )
Number of Bedrooms: Three
Number of Bedrooms:
5. Well System: Individual Well (~ Co~mnunity/Pub].ic System ( )
3__~__~ . Depth of Well Well Log on ~li].e
Permit
~onstructlon ...... ~'~.~.~1~[. Bacterial Analysis
kx) Publ J_c Utility
Sewage Disposal System: On-site System
Permit tt Installed
Installer
Septic Tank Size
Manufacturer
Absorption Area
· Soils Rate
Material
'7.
Distances: Well to Septic
to Sewer Line
to Nearest Lot Line
Tank
Nearest Lot line
to Absorption Area
............. Absorp~.lOn Area
Department of Health and Environmental Protection
Request for Approval of Individual o ~
- oewer and Water Facilities
Legal Description: Lot 23 Block 3 Talus West Subdivision #2
kffadavi~. Attached: ( ) Letter Al'.tached: ( )
DisapprOved: -- Date:
Department Worksheet:
MUNICIPALITY OF ANCHORAGE
r�
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC251500
Parcel ID 015 -202-08 Expiration Date
Legal description TALUS WEST#1 BLK 3 LT 23
Site address 4530 SNOWCUP CIR
Current property owner(s) RATZLAFF MICHALE D
X The On-site system(s) is/are approved for 3 bedrooms
0
9/9/2026
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
Original Certificate Date:
11/12/2025
:his
C ificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
s m(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 Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
Certificate of On -Site Systems Appr
1. GENERAL INFORMATION
Parcel I.D. 015-202-08
Complete legal description TALUS WEST #1; BLOC
Location (site address) 4530 SNOWCUP CIRCLE,
Current property owner(s) MICHALE RATZLAFF
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
11 'rVOC f%C %A?A'rCO C1100t V. MM MA.. f- AA1_11 44 A
AK
5. SEPTIC TANK: ME Steel El Plastic ❑ Concrete ❑ Fiberglass
NEW EPDXY COATED STEEL
Age — See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑AWWTS ❑Bed ❑ Deep Trench F]Wide Trench ❑SeepagePit'
Waiver request for: Distance:
Expedited review requested: 0
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 $_ 15 Waiver Fee $
Date of Payment I I I � )� 6 Date of Payment
COSA # ot)ca6 1500 Waiver #
COSA ApplicationApr2025.doc
•
Legal Description: TALUS WEST #1; BLOCK 3, LOT 23
Parcel ID: 015-202-08
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
❑ Weil log is filed with Onsite (or attached)
Date drilled 6/8/1977 Total depth 152 ft
Cased to 151 ft
unitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 9/9/2025
Static water level at beginning of test 60 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NEW
❑ Required maintenance completed, if AWWTS
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) 11/20/1989
❑ ALL standpipes present per record drawing
Total measured depth from grade 4.9 ft (max)
Measured depth to pipe invert from grade 3.4 ft (min)
❑ NIA — pressurized field.
❑ Per record drawings, field is insulated.
Of Monitor tubes go to bottom of effective.
*
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N/A
If yes, enter date
Welf production at time of test 2.2+ gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L 0 Arsenic less than MRL (ND)
Collected by GARNESS ENGINEERING
Date 9/9/2025
C. LIFT STATION
❑ Required maintenance completed
Age of lift station NEW years
Lift station material *STEEL
Comments: *EPDXY COATED STEEL
Adequacy test date 10/27/2025
Results Q Pass
Fluid depth prior to test *0 in
Water added 511 gal
New fluid depth *1 in
Elapsed time 1175 min
Final fluid depth *0 in
Absorption rate 450+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 6 in
Effective depth used 0 in
Effective depth remaining 6 in
Comments/Deficiencies: *BASED UPON GEG ELEVATIONS, THE MT EXTENDS 6.5-7 INCHES BELOW INVERT OF CO'&
COSA Check] ist_May2D25.docx
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100'
2 Yes if No ft
Neighboring Tank > 100' Yes if No ft
Disposal Field on Lot> 100' ®Yes if No ft
Neighboring Disposal Fields > 100'
Q Yes if No ft
Sewer Line/Main > 100' 2/ Yes if No ft
Sewer Manhole/Cleanout > 100'
Q Yes
if No ft
Sewer Service/Septic Line > 25'21 Yes
if No ft
Holding Tank > 100' ® Yes
if No ft
Animal Containment > 50' Yes
if No ft
Manure/Animal Excreta Storage > 100'
2/ Yes if No
2 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'
2/ Yes
if No
ft
Surface Water > 100'
Q Yes if No
Field to Foundation > 10'
2/ Yes
if No
ft
Wells on Adjacent Lots:
Tank to Property Line > 5'
Fv� Yes
if No
ft
Wells > 100'
2✓ Yes if No
Field to Property Line > 10'
2✓ Yes
if No
ft
Community Wells > 200'
2/ Yes if No
Water Main/Service Line > 10'
21 Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
ft
ft
ft
ft
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
Engineer'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
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LOT 20 /
BLOCK 3 SNO WC UP CIR
/ R=50'
i
100'
WELL
RADIUS
LOT 24
BLOCK 3
LOT 5 I LOT 6 \
BLOCK 3 I BLOCK 3
LOT 7
BLOCK 3
ASPLS MORTGAGE LOCATION SURVEY NOTES:
NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE
RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS
MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS
MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE
CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES
NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT
A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN
THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR
OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY
EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED
FOR SERVICES IN PREPARATION OF THIS PRODUCT.
LEGEND
RECORD DATA PER PLAT ##80-40
EDGE OF ASPHALT
FENCE
SEPTIC PIPE
@
SEPTIC TANK LII)
LOT 9 (k�
WELL
BLOCK 3 1777
DECK
RICK PAVERS
LOT 8
it LO
o' 30' 60'
ml
SCALE: V = 30 FEET
(lllvxl7")
~� OF' A��Slil
*: 49TH
,Ryan G. Johnson,
No. 192159.,�a�/
�•10/30/2025 �AW
AW
ill �FESSIOt�A���s
~ ~ MUNICIPALITY OF ANCHORAG'~_~ W.U~-~icIrALH'~' ~
~ Department of Health and Environmental PrQ~/
//,~:: 825 L Street, Anchorage, Alaska 9~::'~[ ......
Mailing Address: Phone:
Mailing Address: Phone:
3. Lending Institution: A ~//~
Mailing Address:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Single Family Residence:~/~) Number of Bedrooms:
Multiple Famqly Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well ( ) Public/Community
If Individual Well, well depth /~
If Community System, name of system
System (
o
Sewage Disposal System:
If On-site System~ date
On-site System
of installation:
Public System ( )
*NOTE:
3/77
A well log
/
is required on ALL wells drilled since 6/75.