HomeMy WebLinkAboutKNIK HEIGHTS BLK K LT 8AKnik h
ight
lock K
Lot
8A
018-232
-36
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: OSP/oIZ.~2~ PID Number:
Name: ~O~i.'~ ~¢~e~ Wastewater System: ~ New ~ Upgrade
Address:
~Z~SO ~;'~oo~ ~{:c~ ABSORPTION FIELD
Phone: Number of Bedrooms: ~ ~DeepTren~ ~ Shallow Trench ~ Bed ~ Mound ~ Other:
Total Depth Eom original grade:
LEGAL DESCRIPTION ~o,.~: J'~ ~o~,~ t t~ ~ ~.
Block: Lot: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe:
Township: Range: Se~ion: Fill added above original grade: Gravel LenCh:
O - t ~. ~0 ~t.
Classifi~tio~ (Privy, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Driller: Date Drilled: Static Water Level: Installer: / Date Installed:
GPM Ft. Ft. TANK
SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. ~ Other:
T~ Septic Absorption Li~ Holding ~ubliCPrivate Manufa~urer: Capaci~:
Tank Field Station Tank Sewer Line ~}0~ ~1~% Ga,. [~
Well ~J~ /~1.~ ~/~ ~ ~5~Material: ] ~ Number°fC°mpaKments:
s.~w~,~,l~ + [OO'~ ~/A LIFT STATION
Lot Line ~[~ 1~.~ ~~ ~[~~SJze: Gal Man~a~ure~
ouno .,o t0;
in. in.
I P~p~~ ~ri~[ Inspections performed by:
Remarks:
g 'k .oA BENCHMARK
rg~'~~ ~ L°~c;~; i~ sc'7;~; l M ~' ~ Assumed Elevation:
Inspections performed by: ~ a Dates: 1st ~'~ ~ ~ :~3 ~::
Development Se~ices Depa~ment Approval
Reviewed and approved by:~ / ~ d Date: ~'-
~ Lo$ 9~ ~ / ~ 4.4, ~ \
,~ , / ~ Lo~ 8A / / SWlN6 TIES I '
. q~ ~ ~ / c 2a.0'50.5'
~ ~ ~ Ir~ pEN oeo NEOUINEWENIS ~ c~ ~ O 64.0' 87.0'
~ I/NSrALLEO BULL RUN reVERTER I I % ~ i I ~ ~~,
~ ~ ~ONNECTEO TO EXISTING TRENCH J INSTALLED 3-BEOROOM SEPTIC SYSTEM
~ ~ ~ 'Ru / / LENGTH 40 PP~
~ ~ ~ ' / ] ~IOTH Z5 FEET
~ ~ ~ ~ ROCK flEPTH 6.2 FEET
j APP~OX/MAm ~ ..........
- LA~S SP~LAN~ ~,~
BENCH ~ANK · 'A'
muoKmNO ENGINEERING ~IK HEIGHTS O~ K LOT 8J SEPTIC sYsIEO ~seu~Lr
208 · ISIH. AVENUE
ARCH. AK. 9950~ ROBIN NAWpWEYEN OAIE: dULY 2R 2011
(907) 279-3916 13250 PIOGEWOOD OIPOL~ AoOMOOAGE, AN 995~b SHEET: I/3 OglO: 2986
PEpMIT ~ DSpIOIp33 pI~ ~ OIE-p~p-26 KnikHeightsBKLE~I. dwg
A B'
C 28.0' 50.5'
O $$.5' 56.0'
E $5.5' 58.0'
F $6.5' 59.0'
G 64.0' 87.0'
H 82.0'105.0'
To ex/sting clr~/n £ield
0
O__
0
0 ~' I000 901 Septic tank
Stondord rrenc~¢
2,5~ Wide
.........
4~
Cover
~....~...;~;~,~.~..~..~...~.~.~....
ND SCALE
Monitor Cleo nou ~
ELEV.
~98~
4' Eover ~ /
[ES[ HOLE ./ ,_
6::2 ::
ELEK =S& O'
¢t oR Septic Rock
]flflfl g~l, septic f~nk
ELEK =79.6' NO 2¢~LE
~ENCN ~A~K BOTTO~ SiftiNG. ~SSUME~ ELEY~TION
SPURKLAND ENGINEERING KNIK HEIGHTS B~ K LOT 8A SEPTIC SYSTEN ASBUILT
~03 ~15kh Ave
AnchopcQe Ak 99501 ROBIN R~MPMEYER DATE: JULY ~5, ~011
PERMff ~ OSP1012JJ PARCEL ID ~ 018-2J2-J6 KnikHeightsBKLSADJ. d~g
On-Site Wastewater Disposal System Permit
OSP101233
01823236000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number:
Tax Code Number:
Work Type:
Permit Effective Dates: October 20, 2010 to
Design Engineer: SPURKLAND ENGINEERING
Subdivision: KNIK HEIGHTS
Upgrade
October 20, 2011
Site Legal Address: KNIK HEIGHTS BLK K LT 8A G:2936
Owner/Address: RAMPMEYER ROBIN J & KIMBERLY K
13250 RIDGEWOOD CIRCLE ANCHORAGE AK 995162939
Site Mailing Address: 13250 RIDGEWOOD CIR, Anchorage
Lot Size in Sq Ft: 39428
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: ~. "~"~', .
Issued By:
Date: ! ~/2.¢ZO/..~
Date:
Municipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road ~
Anchoraqe, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 ~epartment
http:llwww.muni.orqlOnsite
Development Services Department
On-Site Water and Wastewater Pro.qram
**** VARIANCE/WAIVER REVIEW ****
WaiverS: OSP101244 COSA#:~ Permit/C: OSP101233
PID#: 018-232-36
Legal Description: Knik Hei.qhts, Block K Lot 8A
Engineer: Spurkland Engineering
Applicant: Robin Rampmeyer
Your request for a waiver of the required 50' feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 35.0 feet.
This waiver approval applies to the proposed absorption field only. Any furore upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
Waiver is Granted: X Waiver is not Granted:
Date: /1~/~57~F_.) Approved by: ~ii .t~
Rec#: 064965 Amount: $200.00 Date Paid: 10/19/10
**** VARIANCE/WAIVER REVIEW ****
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
vvww. muni.org/onsite
(907) 343;7904
ON-SITE SEWER/WELL PERMIT APPLICATION
~.~, ¢~.~.c O~?lOl~H~ FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s)
Mailing address i3
J
Site address '-
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Lot Size .~cl, ffT..'~ Sq. Ft.
Day phone
Zip Code
Zip Code
Number of Bedrooms
THIS APPLICATION IS FOR, (J~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature"-""~of-~roJperty owner or authorized agent)
Permit/Rush Fees: ,_2~-.~ O Waiver Fees:
Date of Payment: / g ~ f///-- / O Date of Payment:
Receipt Number: 00 .~ ~.~ // ff Receipt Number:
(Rev. 11/05) -
Environmental Consulting and Design
I
SEPTIC SYSTEM DESIGN
Knik Heights Block K Lot 8A
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519
September 30, 2010
Subject:
Septic System Installation Permit
13250 Ridgewood Circle
Ladies and Gentlemen:
I am writing to request a permit to upgrade the septic system for the above referenced property.
The proposed system will serve a 3-bedroom single-family residence. The existing system was
installed in 1982 and did not meet COSA operation requirements. Soil logs, design calculations,
a site plan, design drawings and construction specifications are enclosed for your review.
Design Calcs:
No Groundwater observed to a depth of 18 feet below ground surface
(10/1/2010)
Soil Rating. From Testhole 9/24/2010
1 min/in = Maximum application rate 1.2 gal per sq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 150/1.2 gpd/sq.ft.= 125 sq.ft.
Total area required: 125 x 3 = 375 sq.ft.
System: We are proposing a 1000 gallon septic tank, and a deep trench absorption field. The
absorption field will be 40 feet long and 2.5 feet wide and contain 6 feet of sewer rock. This
provides 480 sq. feet. of effective absorption area.
Soils: A test hole was excavated on September 24, 2010. See the attached soil logs. Ground
water was monitored for through October 1, 2010. Ground water was not observed. A
percolation test was conducted at a depth of 5 feet in the limiting stata (1 min./in). The gravely
sand from 1-4 will perc at a faster rate. The drain field was sized using conservative application
rate of 1.0 g.p.d./sq.ft.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Surface Water:
system upgrade.
Environmental Consulting and Design
I
There are no surface waters within several hundred feet of the proposed septic
Topography: The lot slopes from the northeast to the south west at approximately 20-30%.
The existing trench has been located above this slope for 28 years and there is no indication of
effluent seeping out anywhere down grade of the trench. The entire area is heavily vegetated and
in our opinion the day lighting of septic system effluent is not a concern.
Waivers: Slope set back waiver 35 feet- drain field to slope greater than 25%.
The installation of this septic system will not prevent wells and septic systems from being
installed on the adjacent lots. The proposed septic system will not change the general slope of
the area. Ponding and/or concentration of surface runoff will not result from this installation.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
Lars Spurkland, P.E.
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
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NOTE: THIS IS NOT A SURVEYED P~T. ~ELL ~ SEPTIC J
DEPArTmENT DOCUMENTATION. A~ LOCATIONS SHO~N ARE ~,..~ .........
SPURKLAND ENGINEERING
KNIK HEIGHTS BLK K LOT 8A
SEPTIC SYSTEM DESIGN
DALE: SEPT. 30, 2010
SHEET: I/$ GRID: 29J6
20,3 W 15TH. A VENUE H
ANCH. Al{. 99501
~-J916
PERMIT # ~]$PiOXXX
ROBIN RAMPklEYER
15250 RIDGEWOOD CIRCLE, ANCHORAGE, AK 99516
Piti # 018-2..t2-36 Kn/kHe/gh ts£KL SD1, d~9
Lo~ ~
Lot 8A
IABANDON EXISTING SEPTIC
NK PER UPC REQUIREblENTS
INoSNNEcTALL BULL RUN DIVERTER I
T TO EXISTING TRENCHI
NOTE: THIS IS NOT A SURVEYED PLAT. ~¢ELL & SEPTIC
LOCATIONS TAKEN FRO~( ON-SITE WATER AND ICASTE IfATERI
DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOICN ARE
APPROXIMATE.
Lot 6A
INSTALL S-BEDROOM SEPTIC SYSTEM
1000 GALLON SEPTIC TANK
LENGTH 40 FEET
~¢IDTN 2.$ FEET
TOTAL DEPTH 10 FEET
ROCK DEPTH $ FEET
COVER 4.0 FEET
SPURKLAND ENGINEERING
205 W 15TH. AVENUE
ANCH. AK. 99501
~-$916
PE£MIT # SIWOBOXXX
KNIK HEIGHTS BLK K LOT 8A
ROBIN RAMPMEYER
15250 RIDGEWOOD CIRCLE, ANCHORAGE, AK 99516
Ep. YSTEkl DESIGN
T. $0, 2010
PID # 0~8-232-36 KnikHe/~gh tsBKL 8Dl, dwg
?o existin9 droin Field ~_ __
0
O:
0
O ~ 1000 9al Septic tank
Standard Trench:
2' Wide
40' Lan9
4' Cover ~.. f ~ -.
~ ~ 4~h ~ ~
ND 2CALE
/ Mom/tom
/ ~ Cleonouts
~ _
6,0 Pt oP Septic Rock --~ H
Effective lOOO ~ol. septic tank
ND SCALE
~03 ~5~h Ave
Anchorage Ak ~50~ ROBIN RA~P~EYER ~ATE, SEPTEMBER ~g, ~010
pTq_~tfi IJ250 RIDG~OOD CIRC~ ANCHO~GE, AK 99516 SHEET, J/J GRID~ 2936
PER~IT ~ OSPIOXXX PARCEL ID ~ 018-252-56 KnikHeighfsBKL8ADJ. dwg
Municipality of Anchorage
Development Services Department I
Building Safety Division
On-Site Water and Wastewater Program '
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchorage.ak, us
(907) 343-¢904
Soils Log - Percolation Test / ,~,.
Pedormed For: ~ ~.~ eT~ Date Pe~ormed:
Legal Description: I~[~( ~,e~[5 ~l~ ~ Lo[ ~ Township, Range, Section:
Slope Site Plan
2-
3-
4-
5-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT DEPTH? ~ L
O
Depth to Water After
P
E
Reading Date Gross Time Net Time Depth to Water Net Drop
5Vz. I~ lo'. 3Z ' %6 ,,,;,., ti ~/z
COMMENTS ~Def-r. Lo~,~a,¢,~ bJ¢ Ar,.,..A A¢.~ ;., i~
/
PERCOLATION RATE ~ (minutes/inch) 'DC !.~) PERC HOLE DIAMETER
TEST RUN BETWEEN .5' FT AND (¢ FT
PERFORMED BY: LO,,~ ~"~l)u~ IJ4 I / ¢"oC_~~'--~- CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL ~[.JIDEI~INES IN EFFECT ON THIS DATE. DATE: iO/i/ Z. otO
Environmental Consulting and Design
purklond Engineering
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
Subject Property:
Knik Heights Block K Lot 8A
Date: October 1, 2010
General:
]. The owner shall contract with a contractor to perform the work outlined in these
specifications and plans in accordance with the attached MOA permit. There is not
contractual arrangement between the contractor and the Engineer. The Engineer shall
be the owner's representative and will inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the MOA.
2. The scope of the project includes the procurement and installation of a 3-bedroom on-
site wastewater disposal system at the location depicted on the attached site plan
drawings. The scope of the work also includes the installation of a new 1000 gallon
septic tank, a drain field comprised of 1 trenches, 2.5-feet wide x 40-feet long, 10 feet
deep, with 6 feet of septic rock below the distribution piping. All components of the
proposed septic system must be constructed a minimum of 100 feet from any surface
water or water wells in the area. A minimum of 4 feet of earthen cover is required over
the septic tank and a minimum of two feet of cover is required over the drain field. ~[n
addition to the required earthen cover, 2-inch thick, 40 psi, direct bury board foam shall
be installed directly over all installed piping.
3. Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Municipality
of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
4. The contractor is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
5. The property owner shall be responsible for final grading any depressions formed from
settlement of backfill material. The property owner is also responsible for vegetation of
all areas disturbed by septic system installation activities.
6. Contractors installing wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from MOA DSD prior to system installation activities.
7. The contractor shall ensure that ALL materials being used are in compliance with the
most current guidelines established by the Municipality of Anchorage. Refer to
"Standards and Specifications for Component Parts and Materials Used in the
Construction of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by MOA DSD, On-site Water and Wastewater Program.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
purklond Engin¢¢ri
Environmental Consulting and Design
Septic Tank Znstallation:
1. A new septic tank, of the size specified in the design drawings, shall be procured from a
qualified manufacture/supplier if the existing septic tank is found to be defective.
Construction shall include two 4" diameter cleanouts for pumping access.
2. The burial rating of the tank shall be adequate for the actual burial depth encountered.
:3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank.
4. All standpipes on the tank shall extend a minimum of 12inches above the final grade.
5. Tanks installed with less than 4 feet of cover shall be insulated.
6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless
prior approval is obtained from the engineer.
?. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
8. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
9. A cleanout shall be installed 1 to 4 feet from the foundation.
10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to pressurized
lines.
11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank.
13. All holding tank and lift stations shall have an audible and visible alarm inside the residence
being served.
14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical
Code. A municipal electrical permit and inspections must be obtained where required by
the MOA.
15. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from any
residential water well, 150' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
16. The contractor shall remove or abandon the existing tank in compliance with the Uniform
Plumbing Code.
Drainfleld Construction:
1. The drain field shall be excavated to the dimensions outlined in the design drawings. If
any discrepancies are noted, contact the engineer immediately for clarification.
2. The drain field shall be installed parallel to slope contours.
3. The bottom of the drain field shall be within 2" of level. If the sidewalls or bottom of the
excavation become smeared, they must be raked or scarified prior to the placement of
filter sand or drain rock.
4. The drain field must be a minimum of 5 feet from the test hole excavation.
5. Distribution pipe is to be installed level with perforations facing downward, atop a level
bed of drain field rock. Septic rock shall then be placed atop the distribution piping to
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
",$purklond Engineering
~ r Environmental Consulting and Design
provide a minimum of ~" of cover, level across the entire width and length of the trench,
above the piping,
6. A silt barrier must be installed at between the final drain rock and the native soil backfill.
The silt barrier shall cover the entire drain rock surface.
?. Monitor tubes must be 4" in diameter, installed in the locations depicted on the design
drawings, and extend a minimum of 12" above final grade. The portion of the monitoring
tube below the septic rock must be perforated and the portion above the drain rock shall
be solid.
8. Backfill over the final gravel layer must not be less than 2 feet. Tnsulation must be
installed when the backfill depth is less than 3 feet.
9. Drain field back fill shall be mounded to prevent depressions from forming due to
subsequent settlement of backfill material.
10. The contractor shall verify that the drain field is a minimum of 100 feet from any
residential water well, 150' from any class 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
Inspections:
]. A minimum of two inspections are required by the Municipality of Anchorage. These
inspections must be conducted under the supervision of a Professional Engineer licensed
to practice in the State of Alaska.
2. The first inspection must be conducted after the excavation of the drain field and before the
placement of any gravel. The septic tank may be set in place, but may not be backfilled.
$. The second inspection must be conducted after the placement of the silt barrier, gravel,
distribution lines, stand pipes, cleanouts, and insulation, but before the placement of any
backfill.
4. The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use in preparing the record drawings.
5. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. Tf necessary, a preconstruction
meeting will be held on-site.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
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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
OSC251150
Parcel ID 018 -232-36 Expiration Date: 4/15/2026
Legal description KNIK HEIGHTS BLK K LT 8A
site address 13250 RIDGEWOOD CIR
Current property owner(s) CAIN STEVEN M & SUE A
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
M
Original Certificate Date:
6/16/2025
This Cet4ificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
syem(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 is
Tank Age Advisory Arsenic Advisory
Other
1. GENERAL INFORMATION
Parcel I.D. 018-232-36
Complete legal description
Location (site address)
KNIK HEIGHTS BLK K LT 8A
13250 RIDGEWOOD CIR
Current property owner(s)
CAIN
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: FN� Private Well serving #_1_ dwelling units
F-1 Other Non-public well as regulated by MOA F-1 Water Storage
Fj Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic F] Private Septic serving 2 dwelling units
El Holding Tank El Community Septic or Public Sewer
5. SEPTIC TANK: 0 Steel E] Plastic E] Concrete F] Fiberglass
Age 15 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: n AWWTS n Bed On Deep Trench E] Wide Trench El Seepage Pit
Waiver request for:
Expedited review requested: EJ
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment Date of Payment
COSA # Waiver #
COSA Application—Apr2025.doc
COSA Checklist
Legal Description: KNIK HEIGHTS BLK K LOT 8A
Parcel ID: 018-232-36
If more than t well and/or septic system on tot, provide separate checklist. Structure served by this system _
A. WELL DATA
H Well log is filed with Onsite (or attached)
Date drilled 12/13/82 Total depth 345 ft
Cased to 225 ft
® Sanitary seal is functioning correctly
❑� Wires are properly protected
Casing height (above ground) *0 in.
Well production at time of test 1.7 gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes X No
® Coliform bacteria is Negative
Nitrate 7.36 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L K Arsenic less than MRL (ND)
Date of flow test for COSA 4/15/25 Collected by
Static water level at beginning of test 210 ft. Date 4/15/25
Comments * WELL IS LOCATED BELOW GRADE IN COVERED LID WITH DRAIN
3a/c121.1075
Measured operating fluid level in septic tank 48
Date of pumping 4/15/25
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 11/5/2010
❑N ALL standpipes present per record drawing
Total measured depth from grade 11.7 ft (max)
Measured depth to pipe invert from grade 5.5 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
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)
If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 4/15/25
Results Q Pass
Fluid depth prior to test 64 in
Water added 450 gal
New fluid depth 72 in
Elapsed time 1440 min
Final fluid depth 64 in
Absorption rate 450 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 74 in
Effective depth used 64 in
Effective depth remaining 10 in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
Fi Yes if No _ ft
Neighboring Tank > 100' 0 Yes if No _ ft
Absorption Field on Lot > 100' N' Yes if No _ ft
Community Sewer Manhole/Cleanout > 100'
Q Yes if No _ It
Private Sewer/Septic Line > 25' 0 Yes if No _ ft
Holding Tank > 100' QYes if No _ ft
Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ ft
nm Yes if No _ ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' e❑ Yes if No _ ft R] Yes if No _ ft
❑ N/A - Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' on Yes if No _ ft Surface Water > 100' ❑� Yes if No _ ft
Tank to Property Line > 5'
n Yes
if No _ ft
Field to Property Line > 10'❑
Yes
if No _ ft
Water Main > 10'
n Yes
if No _ ft
Water Service Line > 10'
❑� Yes
if No _ ft
F. ENGINEER'S COMMENTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
❑' Yes if No _ ft
Yes if No _ ft
If tank or field is under driveway comment below
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 t&<1 h -e__ (t NtfpN Phone 7 rL 7 ^;e6G L4
Engineer's Printed Name .47 oft eE Date -lir �2s'
COSA Checklist—June 2022
dINEER
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MUNICIPALITY OF ANCHORAGE
t
DEVELOPMENT SERVICES DEPARTMENT / 907-343-7904
���
On -Site water and wastewater Section \ Irv_ . ;
/ Fax: 343-7997
www.muni.org/onsite —�
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC251150
Subdivision: Knik Heights, Block: K, Lot: 8A
A water sample revealed a nitrate concentration of 7.36 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
L,~t
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650 '
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
ComPlete legal deScription
Location (site address)
Current Property,owner(s),.
Mailing address ~'
,. -"~-~\ 2
COSA# (~,~ \\_'~:)
Expiration
Date: i/- F-i i
Day phone -'¢~ '- ~-:-;~, (
Lending agency
Day phone
Mailing address
Real,Estate Agen¥' :':~:~ ~:'50 ~,
'Mailing':Add[ess ~ '
unless, otherwise.requested, OOSA will be held by DSD for pickup.
NuM-BE~ 0F 'BEDROOMS:
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class ~
Public Water System
Well
Day phone
TYPE OF WASTEWATER DISPOSAL:
[~, Individual On-site
[] Individual Holding Tank
[] Community On-site
[] Public Sewer
I
The Municipality of Anchorage Development Services Depadment (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspeCtion, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm -~¢-i~,~,:~
Address ~o;~ W, i'5ik
Engineer's Printed Name
DSD SIGNATURE
'~/ Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
(Rev. 11/05)
Municipality of Anchorage
Development SerVices Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www. muni.org/onsite
(907) 343:7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Date completed I,~,3.1 ~7..
Totaldepth 3~$ ff.
Date of test
Static water level
Well production
Parcel ID: O1~-Z37--~
If A, B, or C provide PWSID #
Sanitary seal (Y/N) "~
Cased .to ~l.5 ft.
FROM WELL LOG
I'Zil31 ~'7_
~ ~ k~ ~ ft.
{,o g.p.m.
Well Log (WN)
Wires .properlY protected (Y/N)
· Casing height (above ground) + 1 '~ in.
AT INSPECTION
'z-to ff.
'?-- g.p.m.
WATER SAMPLE RESULTS:
Coliform A/'ec-- colonies/100mL Nitrate 5,~g rng/L
A~enic: ~V0 ug/L date of sempe:
SEPTIC/HOLDING TANK .DATA
Tank Type/Material .~['¢~.1 / ~r.~c~. ~'~.~
Tank size. ~ ~6o, o .,~,~ g~., Number of Compartments '7__
Foundatioo'cleanoUt (Y/N) ~,, ~Depression over tank (WN)
Date ~f, pumping A/~W .... ~ Pumper --'-
ABSORPTIONFIEL~ O D~TA'
Length. 'H0~ ff. Width 'Z,5 ff.
Total depth I~ f. Eft. absorptionlarea ~ ~ ft2 Monitoring tube
Date of adequacy test /~/(~V Results (Pass/Fail) --
Fluid depth in absorption ~f'~ld before test -- in. Water added --. gal.
Elapsed Time: ~ min. Final fluid depth -- in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
Date installed It)HI 2°~0
' Cleanouts (Y/N) ~/
Highr water alarm (Y/N)
systemtype O~.e? ~.~,
Gravel below pipe 6~,7__ ft.
Depression over tield/V"
For ~ bedrooms
New depth ~ in.
~ g.p.d.
If yes, give date ~
D. LIFT STATION
:E,
Date installed ,.
"Pump on" level at ~""~n.
Datum /
SEPARATION DISTANCES
Size in gallons ,~'q~nhole/Access (Y/N)
"Pump off" level at ~ High water alarm level at / in.
Cycles teste.~,'''~ Meets alarm& circuits?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on,lot ~oo
Absorption field on lot leo ~
Public sewer main /V/
Sewer/septic service line '7. 5
Animal containment areas 5o
On adjacent lots Ioo ~+
On adjacent lots i OD ~ +.
Public sewer manhole/cleanout /v
Holding tank A/I.A.
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation .~ i+ Property line ~ I+
Water service line
Water main
Wells on adjacent lots
Property line J
Water Service line
Curtain drain
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation t
Surface water lO0~
Wells on adjacent lots
Absorption field
Surface water
water main
Driveway, parking/vehicle storage
~F; COMMENTS
~ ...~.- ~,.-~,
I Certify that l have determined through field inspections and F ~'."~ m.r~~"
review of Municipal records that the above systems are in ·
co.~ormanc~ with MO~= COS~ =ui~elines in e~e~t on this ~ate. ','' 7' =..~.~~
, ~"" KLAND '
Engineer s Printed Name [_A~ ~'pu~.l~/
COSAFee $ C~---~- ~.~Sp~×[3)n'~, b.)J~ WaiverFee$
Date of Payment '-J.. J ~ I [I Date of Payment
Receipt Number (~ ~'~ c~L{ ~) Receipt Number
(Rev. 4/10)
Municipality of Anchorage
Community Development Department
Development Services Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
Nitrate Advisory
Certificate of On-Site Systems Approval # 111273
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block k, Lot 8A
of Knik Heights subdivision. This inspection revealed a nitrate concentration
of 5.78 milligrams per liter (mg/L) was reported for the property's well
water sample. The Environmental Protection Agency (EPA) has established
a maximum contaminant level (MCL) of 10.0 mg/L for public drinking
water systems. While private wells are not subject to this regulation, EPA
standards are based on existing health information and can therefore be used
to gauge the relative quality of water from private wells. Please see the
attached "Nitrate Fact Sheet" for important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-
Site Systems Approval.
SGS Ref.# 1112192001
Client Name Spurkland Engineering Printed Date/Time 06/07/2011 15:52
Project Name/# Knik Heights Blk K Lot 8 Collected Date/Time 05/31/2011 16:00
Client Sample ID Knik Heights Blk K Lot 8 Received Date/Time 06/01/2011 12:35
Matrix Drinking Water Technical Director Steohen C. Ede
PWSID 0
Samole Remarks:
Allowable Prep Analysis
Parameter Results LOQ Units Method Container ID Limits Date Date Init
Metals b~ ICP/MS
Arsenic
ND 5.00 ug/L EP200.8 C (<10) 06/01/11 06/06/11 NRB
Waters Department
Total Nitmte/Nitrite-N
5.78 0.100 mg/L SM204500NO3-F B (<10) 06/03/11 AYC
Microbiology Laborator~
E. Coli
Total Coliform
Negative 1 100mL SM20 9223B A 06/01/11 DLC
Negative 1 100mL SM20 9223B A 06/01/11 DLC
8361H
\
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ret. wall
2.0 ( b
LOT 9
\
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\
X
X
LOT 13
LOT 14
X
X
X
\
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\
¢..
'~._~
\
\
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3.0 Prow
LOT 8A
\
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x
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X
X
X
X
OH
under deck
10' UTILITY EASEMENT
N89°56'00"E 88.18
TRACT A
HILL-N-DALE SUBD.
LOT 6A
SCALE: 1"- 30'
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON.
Fb 11-5, pg 8-10
BE
AS-BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 8A. BLOCK K,
KNIK HEIGHTS SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property 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 Anchorage, Alaska
this 11th dayof JULY ,2011
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
(907-248-1666)