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HomeMy WebLinkAboutT15N R1W SEC 8 LT 97T15N R1W Section 8 Lot 97 #051-151-27 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211423 PID Number: 051-151-27 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name CAROLE J. ESTEP ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 20320 OLD CRANBERRY DR., CHUGIAK El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SFJ Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. 97 Township Range Section 15N 1W $ Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft' Ft. Well 100'+ -- 25'+ TANK ® Septic ElS.T.E.P. El Holding El Other Manufacturer GREER Capacity 1250 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks Tank insulated. 3BR HOUSE — 4BR SYSTEM. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 3034 Installer DENALI EXCAVATION d a of eld Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection1st 12/8/21 �d 12/8/21 Location and description 3rd 12/13/21 41h BOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF A Conditional Approval: Date i ' -!W, *: 490 I ....•:* "" "" r� Curtis Huffman / Septic System �- i p t Date 2/ Z� �'F•• CE 128991'`vim/W ��sr�• . 12/20/21 ���,..�" IiFF� PROFESSIONP�'-� Note: this approval does not include well permit requirements. (Kev Ub/U2/16) PERMIT: OSP211423 PID: 051-151-27 60.2' EXISTING i) GARAGE 60.2' A—C=39.9' B—C=60.5' A—D=43,3' B—D=66.1' A—E=46.9' B—E=71,1' A—F=50.3' B—F=71,9' SUMP 12/20/21 EXISTING JLS DRAWN: FWCS SCALE: 10.0' PERREMOA DOCS p 0 F-1 SHED _ co DECOMMISSIONED EXISTING S.T. & INSTALLED NEW 1250 -GAL HDPE SEPTIC TANK W/ DCO & DFCO. 01 STAKED 100' WELL RADIUS PRIOR TO CONST. LOT 97 T15N R1 W Sec8 SA GRAVEL D/W SEPTIC SECTION SCALE, NTS Tl 5N R1 W SEC 8 LOT 97 PREPARED FOR: CAROLE ESTEP 20320 OLD CRANBERRY DRIVE CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK©gmail.com SUPPORT SERVICE C WE. 5 DATE: 12/20/21 SURVEY: JLS DRAWN: FWCS SCALE: 1 " = 30' PAGE: 1 OF 1 NN IN AV OF� 9 TI rtis Huffman wx CE 128991. i� 12/20/21 Aw '141Z vssio0z N89°56'56"W 330.12' (N90'00'00"W 330.00' R) 50' PATENT ROW RESERVE BK 174 PG 225 r—X—X—x—x—x—X—x—x—x—x—x—x—x—x— — x i I LOT 97 i T1 5N R1W Sec8 SM i� O 0 SEPTIC + n M VENT M (trp) 10.01 10.01d _o r 5� <, to O SHED UD 63.2' SHED O Q 60.2' 0 O O EXISTING In GRAVEL Z O n GARAGE M a D%W77 '62.0' 60.2' MH 00 d to N89°55'58"W 329.94' (N89°58'30"W 329.97' R) ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 97 T15N Rl W Sec8 S.M. AK BLM PLAT: MAY 13, 1955 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enebroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: FJLS scAtE E—NNL , 2021 1"=50' echjllwOok.net 21-139-2 CHECKED BY MD NUMOER: �. 800KIPAC£ NW1256 220106 V 0 701' WELL I ICFW— AWF OF �... ...fit F 49TH �. %JOjHN L. SCHULLER.: LS -10408 c ' fessiono–'a.. U) W w z z 0 I- Q LU M 0 ,pa, LAIVII) 4% V, C ? 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On-SIte Water & Wastewater Program RO Bcu 195650 4700 Elrrari- Road Arimorage, Alaska 9951 X6650 Phone: (007) 343-7204 Fax: �90i} 363-7!:P97 httpfwww.munl-argr-DnVe 0n -Site Wastewater DIspo!saI System Permit Permit Number: OSP211423 Work Type: SepticTank U pg rado T.qx Code Number_ 08115127000 Sito Le-yal A(Ildre$S: T15N R1W SEC 8 LT 97 G:12560 Site Mailing Address: 20320 OLD CRANBERRY DR, Chugiak Owner: ESTE P CAROL E J Die &ign EngIriei�r, FIRST WATER CON UI-7IN This Permit is for the construction of: Effective Date: Ex pI ratt*ti Date: Loft Slize in -Sq Ft: Total Bedrooms= viLnr { r. I u1 irrmcnI 1D02021 1 OV2022 198900 ❑ Disposal Fleld 10 W!r-Tank ❑ Holding Tank ❑ Privy ❑ Privale vVell © Woter Storage All construction shall be In aceordlarice with: 1. The attached appTaved design. 2. All requirements specified in Anchorage Municipal code �apters 15,55 and 1:5.3:5 and the State of Alaska Wastewater Disposal Regulatlo ns (1 SAAC72) and Drin king Water Ragul alioas (I SAAC80) 3. The wa&iewatar Godo requires inopeotions during the instaltaiion. The engineer shall nntlfy ine Development �aruirp-� np�r-nr[rnFnt rqr AKAC. 15.85. P rivi lip nQti fi-7 atiQn Ery c2I1ing (407) 3,13-794{1 f2417). 4. From October 15 to April 15, a subsurNee soil aNmrptiorr syslerrl under oorl8truction during freezing weather shall be erther: a. Opened and Closed on the same day, or b. Covered, sealed, and healed to prevent freezing spealal Rrovwons; 1- Locate the beginolog of the field to confirm that the 5' separation belween th-e lank and field will be Arai, 2- Repair the d-eanoo at lho beginning of the trench per the 1978 Inspection Roport- Received By: Issuod By,. M08/2021 Date: � 3 MUNICIPALITY OF ANCHORAGE Development Services Department°= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 051-151-27 Property owner(s) CAROLE ESTEP Day phone _ Mailing address PO BOX 670867, CHUGIAK, AK 99567 Site address 20320 OLD CRANBERRY DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 8 LOT 97 Lot Size 108900 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank E Upgrade Q (D) El Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: $22-5- Date 225Date of Payment:/ / Receipt Number: 2111�:R Permit No. OS PZ ) 1 LI 2 ?, Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com October 1, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: T15N R1W SEC 8 LOT 97 (20320 OLD CRANBERRY DRIVE, CHUGIAK) The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence (4BR septic system). The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211423, Deb Wockenfuss, 10/08/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211423, Deb Wockenfuss, 10/08/21 PO a00 �0 Ln o 0� 00 00 z0 z I ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF. BLM LOT 97 T15N R1W Sec8 S.M. AK. BLM PLAT: MAY 13,1955 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachrnents exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E—MAIL. SEPT 19, 2021 1 "=50' schuller0ak.net 21-139 DRAWN BY: CHECKED BY GRID PLUMBER: BOOK/PAGE JLS N W1256 210319 LOT 97 T15N R1 W Sec8 S.M ,i, , ..... ,A�.L LANs 491H- • ♦ . s • . • . . . . . . • . • . . . • • . . • . • . • . . .� �o ..........•.•..•......••........R •,BHN L. SCHULLER.• ? '• LS -10408 % •�. • . . • • �� / 1831 Talkeetna Street o C� qty • ' •� • : •� V/.: • Anchorage, Alaska 99548 �1 Of a, L .., (947) 227-1455 office �, s s lo��,`.a.. (947) 274--4992 fax 'NAME ~UNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT EW UPGRADE LOCATION DISTANCE TO: I Well ~ Absorption area Manufacturer t NO, OF BEDROOMS Dwe,,,,,, PERM,T NO. 'l Material .~T¢~.~ / No of compartments 'l~dth~{:~ Liquiddepth d.~ IF HOMEMADE: DISTANCE TO: Well ~/U,( (j.'.'.'.'.'.'.'.'.~ ~ ~' Manufacturer DISTANCE TO: No. of line~/~ ¢ Well Length of each lin Top of tile to finish grade Inside length Dwelling Well Foundation Total length of ~sCt,~ Material beneath tile PERMIT NO, Nearest lot ]i,m i ~,, inches Liquid capa i~. in gallons PERM TNO. 9 '05qS =r~ abso ' are NO, Type of crib Crib c~Lamete~r Crib de, t~. Total ef fe.ctive.___~a_bsorption area Building foundation Nearest lot line DISTANCE TO: 31ass Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area{s) OTHER PIPE MATERIALS SOIL TEST RATING" INSTALLER REMARKS APPROVED 72-013 (Rev, LEGAL DATE PERHI]' Fff:'F'L ): C:RNT.]'OHN :i!: T[}:[.::B'.~" 1 _ O C R T ~ O NC R: FI I",1B E F: R L. EEiRL. I..277' S8 "r:Lsl'.,I B 0 ,',:', 52:.':'1. SM I_.OT Si]:ZE T"r'PE: OF SOIl... I':IF.~SOfRBT]:Oi'4 SYSTEM :]?:5: I'RENC:H Hl:::h'.'.',llgJH i'..It..IH[:'~El? OF:' B'E[:,I'~'.OOMS ,-= .7: SO ]i [. Fi:FIT I iqdi ,:: S6! FT?I~:[;?, ) = :L.q. 8 THE R[:::QUIF~:E:I) SI2E OF' -rl.IE %O];I... FIB::.i;O[~'.i::'TIOi'.~ SP'r'S'T'E:f'I THE L..EN(':iTH [:, ]: i'lEN2; I ON :[ S TI4E LEi",tG'I'H ,:.' I N FEET :) OF 'fI"IE TRI~5'qC:H OR C,F~:I::I:r. i'.!1::' :1: ITL. f::,. TFIE [)EF'TH Of;:' ¢::l TRE'I'.,IC:H OR F'IT ]:S 'FFI[E [)I:SrFCqi:SE E:E'I"I.qEEN TI-Iii!i: '.'~};I...II'('.FF'ii::;:[::*. (::iF' 'I-HIE ISiF?.OLIN[::, Fll'.,I[:, THE [XKrTCII',i OF:' THE f!i:,'.',CF:lYla-I"IOl'.,I ,:.' ]:1",1 I::IEET::,. 'TH[~:[~E ]:~:; NO :SET P.K[I)T,Ul F'CiF: "I'REfq(::HE5;. "f'l. lE I.}[;~[I::IYEI... DfEF'TH :['.'S THE i'd :I: i'.,! :[ HUH DEF'TH Cfi:' £~i~,[:F:I',,,'EL. E.~[!;TI-,.IE[.ZI'.,I TI.lIE oI. rI"F:Fi[.L. PZF'IZ FIN[) 'l'Hr~: BO"f'TIDbl OF THE: E,'.',',CI::I',,,'FI'f']:CIN ,::]:i'.,I FEIET). PEF.;tHIT FIPF'L.:[CI::INT ;lf::lS 'rile F.-.'ESF'OIqSIBiLtT'.r' TO INI'-:OP.M TFI!'S [:,EF>I:'IR'f'i'"IE:NT [:)LI[4'.II',I(!i TI'Il:!: ]:N':':71'f:ILLF'tTZON ZNSI:'[:::C:TION21; OF' FIN"r' P.IEL.L.S I:-ID.]'FIE:[}~NT TO TIII'.:ii; F'F:OF'EF~:T"r' FIND NUME:E:;:;?. OF RES;[DENC:EtE; THFIT '1'1'-I[-'~ I-,.IELL [4:[I..1_ SER',?IT... BRCKf:':I:[..L :1: NG [:IF:' FIN"? S'r'5;TEf"I 141 THOIJT F I ?,IFIL I NSF'EC'f' I IZl["4 FIN[) FII::'F:'F.:O'¢FII.. B'.r' 'l"l'l:[ 5; I)EF'FIF,'.THENT I.,.I:[LL BE :'SLtBJECT TO h'l ): N ]: i',llJp1 [):[ STF~i"4C:E F.~ETIqEEN FI !.,.IEL.L. FIND FIN"r' ON-E; I 1"[~: '-;!!;[.::I, IFIGE D ::i. OO FEET I::'"1;' R FR.. t(E !-'.IEL[..~ -'F' :I..SE~ '1'O 288 FEET F'ROH FI F'LIE~[.IC WELL. t]'EF'Ei'4DZI",tdi UF'Cfl",I THE T'¢F'E CIf:: F'I...IE',t..ZC OTHEI';?. F.'.[':'.QU :[ P. EPiENT%-, PIFI"? RF'f:'L'¢. ~'.:,F'EI::: ]: I::' :[ E:I':IT :[ Cd"4% FIND C:ONS:,'f'P~:UE:'r' 1' ON [:, :( FIC!ifF:'.l:::lf,'l:!2; I::I[;~:E [;:IVI::I]:LI::IEI[.F: TO ]:NSUR:E PR:OPER INSTlaLLRTI Oi'4. F" EE ~::;-:: Ir"-It % 'lr' ~E: ;:*¢ f::* ]i: f~: IE %E; tr.:::, EE C: E: lh,ll Il!E." E:iE IF;L" Z~: £J ..... ::::L ."E;" ';:::" ::~E= :L: FORTH E:~'r' THE MUM l C I I::'FII_. I T~'r' [:IF:' FII"4CI-IO[~:RGE. 2: I P.IlLL. ]:NS;TFILL THE: '.:~.:,"r'S'f'EH ]:N RCCO[;'.Df:Ii"~CE WITH THE "':': ]: IJNI)I.Z[;?.STFINC, "f'FIFI-F THF.: uN-.:::,1 I E '/.SE!.4ER ..,T.-, fell ["1F:!¥ RE6:!LIZI;i:E E:r.,IL. FIR:(:iEr,'IEI'.4T ]:F:' II.IE :~E:E; I [;:,E'i',!IZ:E//~. ~~:[:Ei [:::[EH~].~"'~O :~.,IC:L.I..I[)E I"IO[;~:E THf:lhl 2:: F'F:'L ]: IZ:FINTJ'OHi",! 'S TE[:'E '~" .............. .................. ............ .'_ .................................. ,.,:?. 12:EFKF t I::"Y I*I-.IFIT I lam [::I::Ir,'I:[L:[RF: WITH "I"HE I:;i:EQLIIF:EMENTS [::'O[,?. O[.,I-..~!;:['I'L~: SE],.IEI:e.~!; f::li'.4[::, WEI..I..% F't::_:; :SET MUNICIPALITY OF ANCIIORAGE Depart~T f Health and Environmental ~ ction SOILS ]LOG ,10 12 14 Date Net Time 16 Depth Net Drop Percolation Ra t~_~___ _minute ~i'"llll.,._llIP'dl % I..~ 3[i II::'i~::~ IL.._ 3~i U' D Ei:"H F~'. '[ P ff£i"JT 1_0'1 ~i; ;[ Z[:. '_1;OOOOO !-~;6!I_.II::II:,~:E: F:'EET .: ..... E:,I'::F'FI':-;FIL _~,r ,[[i'1 {",1 .[ IgLIi'"l E:' ]J :, i h r'4 .L E:',E I HEE. I",I FI L,.IEFJL. L... I'-IN[:' FIF,I"r' 131'q--:(; ] FIE ,[:1'.1 - -:E - ~ '~" ..... ' ,:~ i::I~EI FOF:: I':l F'I~::L'v'F~'I~:~: I.'.IELI- 'F? 2~1Z10 FEE] FOI(: t:1 f:'ll[J:L)](.:: HELL i HI: I.,.I[:.L.L C:OHF'L E I J ~ t:l.~.i Jl-'~ IHFtt' .I F'IPI [::I::ff"IZL. JFI[~: !.,3.L I'l-'l 'IF.II:_ h::lH I:,' THE_ FII_INZE:J.F:'f:IL].-I'r' OF: -'',I_.F .... l' J i,I:[UL. :lCi",l:~i;I I:II...L ~IF'It::~ ':-,"dE; I[C ' ~[i",1 FIC:E:EIF:'.I..:~F:Ihh2E: I,l:[ Ik'l I FIE ~IP 22 ~1 ! 16:00 REP 23 91 S iI~4B CHEMICAL & GEOLOGICAL LABORATORY A DIVIS{ON OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA99518 'TELEPHONE (907) 562.2343 FAX:(907) 561-5301 AHALY$I$ BBPO~? BI 3A~PLS io~ BU3Ho~ds~! 36597 B,q ! kllo~abls Pazar~te~ Te~ted ~afult Unitm Method [,imltm Sa~lm BO~IMZ SABLE COLL{CYED BI; ~l. Hot kr~lyzed L~-Leos Yhan, OY-O~eatsI Tl~n ~ ~'~J~ ~lember of the SGS Group (SocJ{t~ OOn~rale de SuweJllance) CHEMI~A...,L & GEOLOGICAL LABORATORY :__=~ D, v,..., o.___oj o oM~__~.o,A~ TEST, NG ~ EN_~~__.~ ~,-'.,.==~ % = ----: 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-S301 Date Report Printed: NiP ll 91 @ 16:14 Client Ea~plo ID:Lg? SEC S T15N PWSID Collected SEP 9 91 @ 16:45 h~. Rocoivad HEP 10 91 ~ 14:26 P~oaa~vod ~lth :AS REQUIRED Client Acct :SNEEHGP BPO { PO ~ NONE RECEIVED Oxdezed By :R. 8HA~ER Analysis Co~npletod :SEP 1i 91 Hand Beports to: Laboratory Eupax~ ~..~_~_.,L$I_~EEP~EN C. EDE 1)8 & S ENGINEERING Chemlab Rof {: 914715 Lab 8mpl ID: 3 Matrix: WATER Allowable ParemoteK TeNted ~osult Un~t{i Method Lli~lt8 NI~BATE-N 9.0 lng/1 EPA 353.2 10 Sample BOdYINg ShMPLE COLLECIED BY: NAY. I Yoot~ Porfm:med ' See Sponlal In0truetlom Above UA,,Unayallablo ND= None Da@acted "Soo Sample Rem~k~ Above NA- Not Analyzed LI-Loss Ihan, §T-Greater ~han Member of the SSS Group (Sooi~t~ G6n6rale de Su~voillanoe) MUNICIPALITY OF ANCHORAGE 01 4 Development Services Department ff Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-151-27 1. GENERAL INFORMATION Complete Complete legal description T15N R1W SEC 8 L0T 97 Expiration Date: 3 -�' ~ Z O Z 2 - Location (site address) 20320 OLD CRANBERRY DRIVE, CHUGIAK AK 99567 Current property owner(s) CAROLE J. ESTEP Day phone Mailing address Real estate agent PO BOX 670867, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Dista Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 550 Waiver Fee $ Date of Payment 12 % Date of Payment Receipt Number 51 M 5 3 Receipt Number COSA # 0 S L 2117 a 3 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 12/17/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FWf.5 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for _ bedrooms Disapproved Conditional approval for bedrooms, with the fol� P �1i ON-SITE�.AJATVER AN `g m� WAST'I—'VATER Z PR JJ. Original Certificate Date:_— 2) -2 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 Legal Description: T15N R1W SEC 8 LOT 97 Parcel ID: 051-151-27 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9-1977 (PER MOA DOCS)* Total depth *108 ft Cased to *90 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9/15/2021 Static water level at beginning of test 51 ft. Comments B. TANK DATA Age of tank(s) NA – NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA Well production at time of test 5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 6.25 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Date of Sample 10/5/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Which system tested (date installed) 7-17-1978 Adequacy test date 9/15/2021 ® ALL standpipes present per record drawing Results 0 Pass For 4 bedrooms Total measured depth from grade 6.3 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 2.3 ft (min) Water added 1000 gal ❑ N/A – pressurized field New depth 16 in ® Monitor tubes go to bottom of effective. If not, state depth into effective 4' INTO THE 7'ED Elapsed time 5 min ❑ depth 0 in Code -required soil cover over field Final fluid — ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: NO KNOWN FROST ISSUES. 150 GALLONS BROUGHT FLUID UP TO MEASUREABLE LEVEL FW'i;5 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Manure/Animal Excreta Storage > 100' Building Foundation > 10' Community Sewer Main > 75' ®Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below :Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / 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. * t. TH�� jj Curtis Huffman P' F$ �'c<`�•, CE 128991i0`�0 .2120/2 OFESSI4 J NA��� R ., ft ft ft ft ft ft ft ft Nitrate Advisory Certificate of On -Site Systems Approval # OSC211723 Subdivision: T15N R1W Sec 8 lot 97 A water sample revealed a nitrate concentration of 6.25 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. 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. MaiUng Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org* 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. Ma�hng Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SEFIVICES Oivision of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AU'I'HORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 97; Section 8~ ~15N~ RIW; S.M. . ---~- ...... Locati0R.(site.address or di~'ections) 20320 Old Cranberry Road Property Owner Mailing address Day phone Lending agency NORTHLAND MORTGAGE Day phone Mailing address_ Ea~l~ River, Alas~ ' Agent Be~ FieZd/PTARMINGAN REALTY Day phone ~4-2321 Address j_2j~1 Old Gl¢.,. H~y¢ SuJt~. 9: Ea~iv¢~A~a 9957~ Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: individual well Co. mmunity well Public water NOTE: __ XXX__ If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. XXX TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If comrnunity wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA ¢21 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 of this Health Authority Approval application 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. Name of Firm S & S ENGINEERING Address ... 17034 Ea?Je RiYer Loop Eagle River, Alaska 99577 Engineer's signature Phone Date DHHS SIGNATURE _~'~ Approved for Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments /Note: Thc_ well for this property meets existing state and Municipal Codes. There are nitrates present° It is ~~ that = ' ' continued suitability. Nitrate concentration is 9.4 mg/1. EPA ma ........................ ~ 10 0. ~/~ By: Date . The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage Ps not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1/91) 88ck MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHFCKLIST Legal Description: ~.-o-r '~-] A. WELL DATA Well type Log present (Y(~ Total depth_ Sanitary seal ~N) Date of test Static water level Well flow Pump level __ If A, B, or C, attach ADEC letter. ,U Date completed Cased to_ ~ O ~ FROM WELL LOG ¢~,1-- g.p.m. ADEC water system number c~ .~ Driller __Casing height ~,'7- Wires properly protected (~N) MUNICIPALITY OF ANCHORAGE AT INSPEOTIOI~vJRONMENTAL SERVICES DIVISION S£P 2 $ 1991 _I .CEIVEI) SEPARATION DISTANCES FROM WELL '1'O: Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESLILTS: Coliform O Date of sample: et B, SEPTIC/HOLDINC- TANK DATA Date installed Cleanouts ~N) _ High water alarm (Y(~) Nitrate ~,O ¢~¢ Other S & S ENGINEERING Collected by: ~ ~7~ ~a~e River L~p Road Eagle River, Alaska 99577 Date of pumping _ Compartments Depression (Y,(~ _ Alarm tested (Y/N) ,,4 ) SEF ARATION DISTANCES FROM SEPTIC/HOLDING TANK 'TO: Well(s) on lot \oc~ ~ '~'' To property line ~ Surface water/drainage On adjacent lots _Absorption field Foundation ~" ~ Water main/service line ~,O ~ '~' 72-026 (Rev. 3/91)Fron[ MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) ~ Vent (Y/N) "Pump on" level at ~evel" at High water alarm level .~'"~"~- Cycles tested Meets MOA electrical codes~ SEPA~NCE FROM LIFT STATION TO: ~-efl'-o n lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length '~L¢' Width Total absorption area Depression over field (Y~ /d Results ~[~/f ail) Peroxide treatment (past 12 months) (Y~ Soil rating ~c~ ~ System type Gravel thickness '~ ' Total depth Cleanouts presentdC~/N) Date of adequacy test o~ . for ~ ~-¢- ~ ~E ~o ~ If yes, give date . bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot !ct~~ On adjacent lots ~ c~ c:, 14.- Property line To building foundation ~"~ ' To existing or abandoned system on lot On adjacent lots .~c~ 4- Cutbank ,4~, Water main/service line Surface water ~,C~c~ ~ ¥ . Driveway, parking/vehicle storage area Curtain drain r'~l/~ E. ENGiNEER's CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature S & S ENGINEERING 17034 Eagle River Loop Road NO. Engineer's Na~I° River, Alaska 9¢577 HAA Fees / '~ ~ 0 Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number ENVIRONMENTAL ENGINEERING D,v~sloNJAN '[ 5 1979 Telephone 264-4720 MUNICIPALITY OF ANCNORAG~'4UN{Cip^U~ OF ^NCHOP, AGH DEPARTMENT OP HEALTH & ENVIRONrvlENTAL P~OT~P3f}or~F {{HA[TH & 825 L Street - Anchorage, Alaska 9gE01~ ~r/[RONMENTAL P~,O/ECfION DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please anew ten {~ 01 de Is for processi~g. ,~' JPHONE 1. PROPERTY OWNER MAILING ADDRESS PROPERTY RESIDENT (If different from above) 2. BUYER MAILING ADDRESS PHONE 3. LENrHNG INSTITUTION MAILING ADDRESS PHONE 4, REALTOR/AGENT MAILING ADDRESS '~. 'LEOAL DEBCRIPTION STREET LOCATION ~_~H~tZ~/ /st o~.~-~T ~GINGLE FAMILY ~ MULTIPLE FAMILY NUMBER OF BEDROOMS [] One I-~ Four [] T~Wo BI Five []~'"'~Th ree E] Six Other 7. WATER SUI~LY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY ~. SEWAGE DISP~.OSAL SYSTEM ATTACH WELL LOG. A well log is required for all wells dri lec ;race June 1975. For wells drilled or{or to that date, g~ve well oeoth (attach log if available.) ~ NDIVI DUAL ~ON-SI'FE** [] PUBLIC UTI LITY "f individual/on-site, give installation date .[~ .. If system's over zwo (2) years old an adeouacv test IS required Dy this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH HEQUI-'ST BEFORE PROCESSING CAN BE INITIATED. '~,010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED iNSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSP ECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTR OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []PUBLICE:] INDIVIDUAL/ONuTi LITY -SITE DATE INSTALLED ~) ~ ' 'h ~ Connection Verified iNSTALLER [:]Septic Tank or [] HoJding Tank Size: ~c~--~~'13 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACT[I~R~I~ TOTAL ABSORPTION AREA MATERIAL' 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~ APPROVED FOR ~"' BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BYe( LEGAL DESCRIPTION 72-010 (Rev. 3/78)