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HomeMy WebLinkAboutT12N R4W SEC 9 SW4SW4NW4SW4 PTNTI R4W eC. SW4$W4NW4$W4 PTN 011 - 262 -22 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP111114 PID Number: 011-262-22 Page 1 of 3 Dwelling: 9 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 0 New ❑ Upgrade Name: GHM Trust ABSORPTION FIELD 8726 Jodhpur St Phone r or rseorooms 4 LEGAL DESCRIPTION Subdivision Block Lot SW4SW4NW4SW4 PTN TownshiT12Np Range�,"' Section PR BIW SEC 9 SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Well >100' >100' N/A N/A >25' Surface water >100' >100' N/A N/A NA Lot Line >5' >10' N/A N/A Foundation >10' >10' N/A N/A Number of trenches Curtain Drain Nonel Noted >10 Ft. Remarks Both the primary and alternate sites were constructed and connected with a flow diverter. Trenches follow North / South labels. ❑ Deep Trench W Shallow Trench ❑ Bed ❑ Mound ❑ Other Soil Rating Total depth from original grade 1.2 GPD/SF 8.0/8.0 Ft. Depth to pipe invert from original grade Gravel depth beneath pipe 4.0/4.0 Ft 4.0/4.0 Ft. -ill added above original grade Gravel length 1.0-7.3/1.5-9.4 Ft. 50/50 Ft. 3ravel width Beds: Number of Lines Distance between lines 5/5 Ft. N/A N/A Ft. notal absorption area Number of trenches Dist. between trenches 500/500 Ft2 2 >10 Ft. TANK R] Septic ❑ S.T.E.P. ❑ Holding ❑ Other Vlanufacturer Capacity Greer 1 1,250 Gal. Material Number of compartments Steel Two blikX STATION on level at IPumM%JLtevel at IHigh water alarm at in. I i . make and model lElectrical Inspectio rformed by PIPE MATERIAL House to tank D3034 Tank Installer drainfieid D3034 WM Construction Drainfield D3034 CO/MT Inspector AH Inspection dates: BENCH MARK (Assumed elevation) 100 ft 1" 6/22/11 2nd 6/23/11 Location and description 3'd 6/25/11 4m 6/26/11 Lower level finish floor COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL I Engineer's Stamp nditional Approval: Approved inspection Report_9-1-12.doc Date Date 2 OF Al .TH � Benjamin Schiller CE 12592 /J 5/24/24 ..� PROF, is T12N R4W SEC 9 SW4SW4NW4SW4 PTN - 8726 JODHPUR RD PERMIT # OSP1 11114 PID # 011-262-22 TH Benja i Schiller CE 2592 5127124 AV PLAN AS -BUILT 0 50 100 kM M M j FEET 1.0=50' A tj FCO 32.8 9.2 SVI 57.5 36.6 SV2 66.8 43.5 2CO 69.4 45.2 FD 74.8 49.8 C4 80.7 52.5 C5 125.5 93.0 Ml 124.9 92.2 C6 83.7 62—.9 C7 122.9 93.7 120.3 91.3 WTI —112N R4W SEC 9 W2SW4SW4 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE T12N R4W SEC 9 SW4SW4NW4SW4 PTN - 8726 JODHPUR RD PERMIT # OSP1 11114 PID # 011-262-22 93.2 FINISH GRADE 99.5 FINISH GRADE ,— 92.2 ORIGINAL GRADE 88.2 84.2 (o 95.1 -- - ------------------ 81.7 — DRAINFIELD ROCK Me DRAINFIELD ROCK 77.7 50' NO GROUNDWATER 8/15/2011 67.7 Lo 11 r 88.2 84.2 1 N r- 85.7 ORIGINAL GRADE 2i 0 n n -,-- 87.2 PROFILE AS -BUILT (NO SCALE) 77.7 81.7 �QF ..... k.41! TH •;10 .. ... ........ ? Be la 'n Schiller ..% AW 592 8/22 3 Alpine Drilling & Enterprises Permit Number: #SWOSP 111114 Date of Issue: 6-22-11 Parcel Identifleation Number: 01 12622200,t Date Started: 7-12-11 Date Completed: Z -L3-11 Is well located at approved permit location? x esn 0 Legal Description: T12N-R4W Sec 9 SW4SW4NW$SW4 PIN G 2322 Property Owner Name & Address: GHM Trust 400 W International Airport Road Anchorage, Alaska 99518 Borehole Data: Depth - 71 ; -- Method of Drilling x air rotary [I cable tool Soil Type, Thickness & Water Strata From TO fj� Pump: Intake Depth_ feet Pump size - hp Brand Name Well Disinfected Upon Completion? x Yes No Method of Disinfection: chlorine tablets Comments: omments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 Casing type: steel Stick-up 0 2 Wall Thickness:.250 inches silt 2 13 Diameter: 6 inches Depth: 350 feet gravelly silt 13 16 . Liner -.Type..' silty gravel 16 Diameter: - inches Depth: feet . 35 Casing stickup above ground: 2 feet silty sand 35 44 Staticwater level from ground level): 243 feet silty gravel 44 48 Pumpinglevel: 350 feetafter gravel 48 116 2 hours pumping 20+ gpm sandy silt 116 141 Recovery Rate: 20+ gpm Method ®f Testing: air sally gravel 141 160 Well Intake Opening Type: salty sand 160 239 x Open End 0 Open Hole sandy silt wet 239 342 ❑ Screened Start feet Stopped feet silty sandy gravel 342 350 Perforations Start feet Stopped feet Grnivt Tvne- bent -an granules Volume: I Pump: Intake Depth_ feet Pump size - hp Brand Name Well Disinfected Upon Completion? x Yes No Method of Disinfection: chlorine tablets Comments: omments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 rn 9 Z a i ti O s ti O o O� C d, Q � Q�o m of R �__� O Z O k LZ O O �0O Q lV J mv� 2 ------------------------- ----- �3� 99'L_ IZ HlbON-- --- �+z - 1N3lN3SV3,u1711n.OT N £6LTZM„£Z,OODON O 1 N3V3SV3 A1171117,0T '�NM3i}/.'10 73LIVUD W Wi O Ji o � 0.I rrl ¢ i y C ry r CL ¢� 2 t i --- -- 073-0005M„£Z,0000N! - i £Z39Vd 9fL N0091V 030XOD3H Y,iN53'J373.0T 1, ZIOZ'SZ 'O-T6Z9£O-ZTO2'IV 03GY003Y 1,YVS3 SVD,OT 073H 96'BOZ M „££ , ibO 00 N Q 2 � ¢ J ro ------------ --------- ----- ----- QO US �h O W W m W -------------------------- O 1/ 7 v=iti wF�”ZE u 0 O�! o 0 W Wi O Ji o � 0.I rrl ¢ i y C ry r CL ¢� 2 t i --- -- 073-0005M„£Z,0000N! - i £Z39Vd 9fL N0091V 030XOD3H Y,iN53'J373.0T 1, ZIOZ'SZ 'O-T6Z9£O-ZTO2'IV 03GY003Y 1,YVS3 SVD,OT 073H 96'BOZ M „££ , ibO 00 N Q 2 � ¢ J ro ------------ --------- ----- ----- QO US �h O W W m W -------------------------- r V/ v=iti wF�”ZE u O�! o 0 t= -z ~ 01 l¢i W ¢ W 3 h r I 1 1 1 O 1 I 2y ~O v g� Z i t r� w i Q Q O r; _ ----------------- ? �,� 3wo Daze Q>� sAoO Jo J`i ozQ ^4k `�Q WQ¢< O 2W 2�0 0 = v �- w���o Z¢a oho? oz¢ m� ui N Q o vice r 3bb r a � j 1 S Y/ 11- d ao1 m IN Z6 £9Z 3 „9D , £P OO N ------- o 'J3Y 96 Z9Z M ,ZO 00 N §1 V y MVry� rW YJ NN �j� LU v=iti wF�”ZE u o 0 t= -z ~ > l¢i W ¢ W 3 (WQ7 �=-3� Q Ln O Q�trttl 5i�o(Z 2y ~O v g� Z OwV r� w d Q Q O �p X002 zw.W� k� e"A ? �,� 3wo Daze Q>� sAoO Jo J`i ozQ ^4k `�Q WQ¢< O 2W 2�0 0 = v �- w���o Z¢a oho? oz¢ m� ui N Q zv� oNzx ac” z o� �Zaz$Qoz W 0.. QFm ¢o aS CJ =ZzOz h5 2 2w 203 a O Ix i; i; W W W J W S c�+W�02JZ U > I-- O�OWZw�j z�,��owa4 W W H H z Y �uZLu 073H 00'OZ£M „£Z,00 DO N 1 S Y/ 11- d ao1 m IN Z6 £9Z 3 „9D , £P OO N ------- o 'J3Y 96 Z9Z M ,ZO 00 N §1 V y MVry� rW YJ W � z c, aCLxQz,j wo4oWg zwo�`�Wo VmCJZcc� tiOVa�WO m QZOy�uW 2000) W 0 a w NN �j� LU t= -z j�Q 11) > aHz o (WQ7 �=-3� Q Ln O Q�trttl 5i�o(Z OwV d Q Q O J V o ZrneN O W ui N Q Lli ui w W 0.. QFm >a U > I-- = m H H z Y H w H In Q BVI Q V1 QF-Q-zt F=-0 zzvlz W m >tD H W W U N of z ' H H O>. -i=0 ti W K d F z -i U L K Q N O LL W H W 2 ] I< - m Q Q w O O LU W K J w aLn wF=- W 2H W u z H 2 d HO W d>i-w0 W � z c, aCLxQz,j wo4oWg zwo�`�Wo VmCJZcc� tiOVa�WO m QZOy�uW 2000) W 0 a w On-Site Water & Wastewater System OSPl11114 01126222000 WellSeptic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: Tax Code Number: Work Type: Initial Permit Effective Dates: June 22, 2011 to Design Engineer: ANDERSON ENGINEERING Subdivision: T12N R4W SEC 9 June 21,2012 Permit Site Legal Address: T12N R4W SEC 9 SW4SW4NW4SW4 PTN G:2322 Owner/Address: GHM TRUST 400 W INTERNATIONAL AIRPORT RD ANCHORAGE AK 995181103 Site Mailing Address: Lot Size in Sq Ft: 88800 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y SepticTank N Holding Tank N Privy Y 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: Date: UNICIPALITY Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan OF ANCHORAGE ~ Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ~1/-~.6~-?-?_. Property owner(s) ~::~a_, r~ ~- £-~' ~ '~ ~-~'~,~.-- Day phone Mailing address Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size ~, ~k::::)O Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial ~ Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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 property owner or authorized agent) Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522.7773 677-7766 (FAX) June 16,2011 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: T12N, R4W, Section 9, SW4, SW4, NW4, SW4, PTN Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of the subject lot intends to construct a new four-bedroom home on the property. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. No existing wells or septic systems are closer than 100' from the proposed well or septic system. The proposed house location is at the end of an existing road with no development in all directions. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the tract in the area of the absorption trench and alternate site indicated well graded sand with silt (SW/SM). The percolation rate of the soil was determined to be between 1 and 5 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. An application rate of 1.2 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250-gallon septic tank and a 50' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 8'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the absorption trench slopes to the southeast at a grade approximating 5%. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal T12N, R4W, Section 9, SW4, SW4, NW4, SW4, PTN June 16, 2011 Page Two requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' from the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments VACANT~, ,Iq, = VACANT 'T' 13.- o S89'58'22"E 209.79' Proposed \ ~ ~o~77~ ~~co '.Long x 5' Wide ~-~~//~~ ~ x 4' Effective Depth LEGEND: FCO - Foundetion Cleen Out CO - Cleen Out MT - Monitor Tube TH - Test Hole ~ - SepUc Vent StTE PLAN SCALE 1" = 50' VACANT T12N, R4W, SECTION 9 SW4, SW4, NW4, SW4, PTN DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area 500 SF/5 SF/LF*.50 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct an AbsorptionTrench 50' Long x 5' Wide x 4' Effective Depth. Flow Line Elevation in Trench to be 4.0' Below Original Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trenches. '6" Natural Backfill © Geotextile Fabric 4" Perforated PVC (Holes Down) -- Drainfield Rock f TYPICAL 5' WIDE TRENCH SECTION .?.?~...,,, -- - .... - tAerreoar St rea ms.- t_EGAL DESCRi PERFORMED d%%~0R~Z, aK. ~'~ ' PI"K)~ (g~7)~-0176 ' r~ (~ - ~ [SOIL LOG - PERCO~TiON TEST] Tt2N, R4W, SEC 9; GOVERNMENT LOT 5, W2~', 5370' )R: ERIC & EILEEN BEHR DATE: ORGANICS ITEST HOLE #1[ 17 19 2C SC.! S CONIMENTS: __ SW-SM OW . ;.->a , GP ML .'",~ .': GC OL ""~-¥~,' ', !~ SP CH DEPTH TO GROUNDWATER DATE DRY 3/8/2011 . ~ oo' W~[L~ - RADIUS L~ONS I DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) _ 5/8/2011 ~ 1:30 - 6- _ I 2 1:36 6 0" 6" 3 1:36 -- 6- _ 4 1:45 9 O" I 5 1:45 - 6- _ 6 1:5,5 10 3,/8" 5 5/8" 7 1:55 - 6- _ 8 2:0,.5 10 1/2' 5 1>2" 9 2:05 - 6- _ t0 2:15 10 1/2" 5 1/2" ........ '11 2:i5 - 6- _ 12 2:25 10 1/2" 5 1/2" J TEST RUN BF fWEEN 6.0 F':. AND 7.0 FT, A FOUR HOUR PRESOAK WAS PERFORHED: [] YES ~ NO ROB CAMPBELL PERCOL,aT~CN FESi PERFORPiED BY: ANDREW GRAY 3Y GEG, Ltd. l, JEFFREY A. GARNESS, CERTIPf THAT THIS WAS P[ER~ORMED IN ACCORDANCE ,,TE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ~/H/II, PERFORMED WITH ALL ST LEGAL DESCRt PERFORMED DEPTH (feet) S(~-~OG - PERCO~TION TEST] ORg~NICS [TEST HOLE SW-SM SOIL CLA.SSIFICATIONS_ ';~]~'¢",.~ GW ~ ORG GP ~ ML GM ~ CL GC ~ OL SP ~ CH ~f,4/~ ~4 oH sc DEPTH TO GROUNDWATER D/YFE DRY 3/8/2011_ 10 11 17 t8-- 1 20-- ~;(' ,, R LOGGi COMMENTS: PERFORMED WITH ALL ST DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) .3/8/2011 1 1:30 - 6" - 2 1:57 6 O" ~ 5 8 10 tl 1:37 1:47 1:47 i:57 t:57 2:07 2:07 2:17 2:17 2:27 10 12 10 lO '10 10 FER'COLATION RATE 2 (h N.II~,iCH) TEST RUt.; BET'-AEON 6.0 FT. AND A FOUR HOUR PRESOAK WAS PERFORMED: ROB CAMPBELL 1/2" 6" PERCOLA'i ON TEST PERFORMED BY: 5 1/2" 5" 7.0 FT. ~ ¥~s ~ NO ANDREW GRAY 3Y GEG, Ltd. t, JEFF,R, EY A. GARNESS, CERTIFY THAT THIS WA~ P~ERFORMED IN ACCORDANCE ~TE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE' ~.~/1t h It r - C) G) G) ry0-)) ('') C'7 I,- ti O C) CD CD LU C ca � O LL V � I.L. O 2 U Z LL �q 01 J ,O CE: CO Vca L Q a) Z o� U 06 Cc C N O Q Q U) N A N U) C O 4— O N m U 4= O WA LO N O N il- C-0 6 cu C O cu .Q x W O O O I N N i N O N O 0 a) U m a_ d. jN O m CO Z Q N O L O � U C d7 Q w U) U a - Z o N_ 0 O c ti o 00 Q N U U U _0 7070 M J CO U O 0 O 0 X w C O N Q N O) C 0 0 L 3 U 0 O () Aw d O Mn cu L- 0 0 U) c m E 0 A It O N O N r O ai cu a) U a) U c 0 0 U o a o m A• CL Q Q O N s ~ O ~ m U -0 Ci CD 0 O O ^W N W L Q .� Q co o U)N Q v JT cn O 3 d Q > c Q. O d 0- .Q Q cL C N V V E ca A Q O O 0 CL O> d O +�+ C 0 Ln 0 0 R U) C U E 0 U) N t 0 �+ r Q X X 0 U) Ln Y> U N Q Uo a) OL Q z cn o Y a) w O ca m U Q O 2 U H H Q ",;I- TTr— TCS VTJ VJ Vl CA? I? r— I- C) CD CJS 07 a) c) CL 00 Z O N N CN O N L Z O a o LU Z C) w O 0- V Z Y Q /�JU z U) U) Q Z � CO i d- O U) � N C: r-- 0 co Q U O U) 0 a) � N O 0 a � O U U r. MM M 6� E S1 m m LL — 0 O M O U 0 U N O m � •C L �- y..1 N O d a) W O N = CO (� a) L) a) O a U) > N CO U _Q _T 0 -- 0 Q U Cl) a) >, ❑ (n c O C: > E❑ W Q' O cn L a- O U U cu c ❑ ❑ c a) o a) 0 LL v C U ~ m a o ❑ > _0 a) � N O O a) C O UT- N cz W > > 0 ■❑ ❑ O U (B f a) m Q O m CL m O y--' J ❑ L a) " a) ❑ CL > UU O L O N ++ d O cn m O El Elca_ a_ U)�; o LL El ¢ W J a) N d W 1 .0 c0 -1p U) a (D > ❑ a) U) U) C/) 0 m a a) W a) w 0 >, v w Z — U)Y �- a a L � L V cn z a O U 4° > CU cn w w O °) >' n. a a) >, O ��- Q Q > CLa) N M 4 wi 6 � W m +O+ MM M 6� E S1 m m LL — 0 O M O U 0 U N O m COSA Checklist Legal Description: T12N, R4W, SEC 9 SW4SW4NW4SW4 PTN Parcel ID: 011-262-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 7/13/11 Total depth 350 ft Cased to 350 ft X Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 5/13/24 Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes No N Coliform bacteria is Negative Nitrate mg/L X Nitrate less than MRL (ND) Arsenic 39.7 ug/L ❑ Arsenic less than MRL (ND) Collected by , MNA Static water level at beginning of test 243 ft. Date 5/13/24 Comments NO PUMP INSTALL LOG AVAILABLE FROM AAROW PUMP AND WELL B. TANK DATA Measured operating fluid level in septic tank 48 Date of pumping 6/7/24 ❑ Required maintenance completed, ifAWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 6/26/11 A ALL standpipes present per record drawing Total measured depth from grade 8/8 ft (max) Measured depth to pipe invert from grade 4/4 ft (min) ❑ N/A — pressurized field. 0 Per record drawings, field is insulated. Q 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 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/17/24 Results Q Pass Fluid depth prior to test 2 in Water added 600+ gal New fluid depth 2 in Elapsed time 1440 min Final fluid depth 2 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) *48 in Effective depth used 2 in Effective depth remaining 46 in Comments/Deficiencies: ` SOUTH TRENCH TESTED, NORTH DRY COSA Checklist June 2022 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' Qi Yes if No _ ft Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100' [E Yes if No ft Community Sewer Manhole/Cleanout > 100' ❑E Yes if No _ It Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' QYes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft Di Yes if No _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑� Yes f No _ ft Q 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' Q Yes if No—ft Surface Water > 100' []Yes if No *50 ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' 0 Yes if No _ ft ❑� Yes if No _ ft FElYes ifNo_ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ❑� Yes if No It Q Yes if No _ ft Water Service Line > 10' Yes if No _ ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS LANDSCAPING POND < 50' FROM SYSTEM. POND HAS A LINER. POND IS DRAINED DURING THE WINTER TIME. SEE ABUILT SURVEY 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 Ml h.o t�L /4*1d, eV Sr A �i $ Engineer's Printed Name 6 uyl. , COSA Checklist -June 2022 Phone 727-8864 Date �._7VI, 4m *s .•..• .• . . ..� �. .... ...... '.. MICHAEL N. ANDERSON .�<r r�+ 469 June 11, 2024 Municipalities of Anchorage Development Services Dept. On-Site Water & Wastewater Section Anchorage, Alaska 99519 Phone 343-7904 Re: 6’& 30’ Waiver to open water Legal: T12N, R4W, SEC 9 SW4SW4NW4SW4 PTN To Whom it may concern: This is a request for a separation waiver of 6 feet and 30 feet between the landscaping pond and the existing septic system (tank and field). The justification for the waiver is, the two small landscaping ponds (see the attached survey) are both lined with a water-tight membrane and drained each winter. The ponds do not impact any of the septic system design requirements and do not have any out-fall and or overflow system. The granting of this waiver will not impact any of the surrounding neighbors or the existing septic system. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 • w Cl cn r CN N U U) 01Q U) 0 U N N N CO N r O ❑ @I a) N U 0 C: .N m g7 70 0 Cl Q it yT T LU W w C) UJ wC .z G U H a V) a 41 LIJ Ln a) W 41 U, u v w Ln $ o F NO E +, c s }, Coca Ln N L Q m °' o O E in C >, O O +- E a a� Q) -0 N aJ UD ai O s > Er N u Ln Ol v — v Ln > O L E � U d ^ L -0 �1 }' M ++ j M N t]A M O O i O M � —' O aJ a1 N � c a 0 S° L- w � z O 0 m cv L s LU O ro 0 t4-- . N In � >, .-, M O 4 '7 N C wu Q O O O w Ln c w O U a Q C O � O 0 u bn- E > aCJ1 4� 0 u Qu o O u V)a � ° _0 Q N f° o �0 0 v o a) 4� s � s E u O u cv cn u O _ ( � u a1 cp cn E u -0 o a� c o ao >v }, a� o O aC c °' M a O CaJ C N E a) � O `n C O > V) c 3 V .7 > ate-' C ro ate-+ �" N ccz s o > o H U cn Q u Q s �