Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
SCENIC MEADOWS BLK 2 LT 1
Scenic Meadows Block 2 Lot 1 #051-064-80 Municipality of Anchorage Community Development Department Page/ of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 65P/210 6 % PID Number: QS/- o6y- LC '%New ❑ Upgrade Name: ABSORPTION FIELD 9PDeep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 7 v 94x._2� ( ❑ Other Phone p Number of Bedrooms Soil Rating Total depth from original grade 2 2 % " 4/ ! 6c I? GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3, .5 Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade( ode Ft. Gravel length ' / "J / Ft. �,�J Z Township Range Section Gravel width S Ft. Beds: Number of Lines — Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorpt�� Number of trenches Dist_ between trenches I From Tank Field Tank Line a FQ — Ft. Well — .-. ,� TANK septic ElS.T.E.P. E]Holding E] Other Manufacturer .--� asr& CCn Capacity "(9 Gal. Surface Water Q;1��, f ,.. Material V ' S T'6C4 Number of compartments 0 Lot Line /Q f (f _ _ t7 NA Foundation 5-1f Q rf _ LIFT STATION Manufacturer Capacity Gal. Curtain Drain .— — — Pump on level al Pump off level at High er alarm at Remarks in. in. Pum ake and model rec4Inspections performed by PIPEMATERIAL House to tank�WC'.j%? Tankto Orainfield rr Installer n �^ A � cz,%A es- 4- Drainfield PVC_ COlMT PVC_ Inspector F BENCHMARK (Assumed elevation) 16(o ft r r n Inspection �� �,L Location and description !icer S ct f CCG1w C_: e. ( 6 dates: �z. 2n0 / /� 3rtl 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date'sse®.,�omE'®v m� --A fid."�1i��n Approved (k4z IAJ 1� Date$'(®r/2 bC� fT}`lry Inspection RepoiC 1 -T -12.0c sa ' o GBi. CD y 3CD Fo x Q A 3 m 3 N N 0 N S 71 -NIIP � 3 O n n = W 0 0 O fU 3 td D N S Q 0 o 0 m D s N 0 1 h O 3 n / Z 3 n S :3 n n .+ O O N � � —i -i n nc�0 00 ro� W W W ro o-, LA (71 cn ro0 CAM v W ro I--• 00 W ro .' Q t+ ro i 7Z bd O x 0_s m rt < zo ZO A F CO T p 7COA 3 a y X z O D 1+ ° V o O T�T ID 3 �N Z ` N p � �p m O A ei �ro - o MD < 3 S O 3 LTI OD h II O A h � N 3 A N � I �h 3 NO 0 � M c n ro N 0 tj n z m m n m N N N < < A Lt c z i fTl 3 ❑ O O tj A U II II Q < I I N A N O �D tD 0 G m - O N (Il t0 IHT 6 Q � CII (A H I i fp 0 ` h it `_ i7 < 0 � A N W 3 O ti c oor tCJ (n N cF Tl -q I O 0 0 S N N n z s h h h 7- H O F c n n i N FO A I 3 m 0 1y( S v N N m D 3 1 O O fJ 3 ° n X —In 0 a A 0 p — 0 I n (� cS O I0 In r+ N 1O+ d 0 3 CIl O (/) —9I N —I S O A 3 rp O Ip O 3 c n W + S S❑ILS LOG — PERC❑LATI❑N TEST Performed For: Mike Quinn Date Performed) 6/14/12 Legal Description: Scenic Meadows Subdivision, Block 2, Lot 1 DEPTH (FEET) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - Organic GP Sandy Gravel T.H. Location: See Attached Design SP Groundwater? No Depth Sand Water Depth w/ Gravel After Mnnitorinn.None Date, # Date Gross Time Net Time Depth Net Drop 1 6/14 0 -- 23" -- 2 6/14 9 9 min, 29" 6" 3 6/14 30 -- 23" -- 4 6/14 39 9 min. 29" 6" 5 6/14 70 -- 23" -- 6 6/14 79 9 min 29" 6" 21 - i Percolation Rate 1.5 min./inch Perc Hole Diameter 6" Test Run Between 4' and 5' Comments: PrPsnakPd More than RO/ sand Performed By NorthRim Eng, I�� CERTIFY THAT THIS TEST WAS Performed in Accordance with Allstate/Municipal Guidelines in Effect ON THIS DATE, DATES 6/14/12 NORTHRIM ENGINEERING PO Box 770724 Eagle Rl e , Alaska 99577 907.694.7028 49m TESTH❑LE LOG T. H. 1 GE❑TECHNICAL D*'a 6/14/12 2 of 2 On -Site Water & Wastewater System Permit 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: OSP121057 Tax Code Number: 05106480000 Work Type: WellSeptic Initial Permit Effective Dates: April 20, 2012 to April 20, 2013 Design Engineer: NORTH RIM ENGINEERING Subdivision: SCENIC MEADOWS Site Legal Address: SCENIC MEADOWS BLK 2 LT 1 G:1460 Owner/Address: QUINN MICHAEL PO BOX 772641 EAGLE RIVER AK 995772641 Site Mailing Address: 23240 BLUE SKIES CIR, Chugiak Lot Size in Sq Ft: 40652 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. Receivec Issued B Z MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan ON-SITE FOR A SINGLE FAMILY DWELLING r ,r Property « jl' Day phone Legal description (SuWd., Blo& & Lot) e ---,a^ t r s Legal description (Township, Range & Section) Lot Size �,Sq. Ft Number of Bedrooms THIS APPLICATION IS FOR: THIS APPLICATION IS AN: i , Absorption Meld Initial �1 �` Septic Tank -JE� Upgrade ❑ Holding Tank ❑ Renewal El Privy Private Well Water Storage Q THIS APPLICATION INCLUDES A VARIANCE t 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 des. Permit/Rush Fees: $5936 • tq Waiver Fees: Date of Payment: 4.1tj 112 Date of Payment: Receipt Number: Q2 C Receipt Number: Permit No. (jSP 0 k�l I Waiver No. QASulldft\0n SiteTomtsVierd Fbn tslPemft App 01041 t.doc (Rev. 1/1 1) Date: 4/6/12 To: MOA On -Site Services MEMO Steve Eng, PE, PH (907) 694-7028 tel NorthRimEng@aol.com Subject: Scenic Meadows S/D, Block 2, Lot 1 Number of Pages: 7 A lot is being developed. The soil test reveals excellent soil & no groundwater. Public water serves the subdivision. The neighboring subdivision lots have been developed by the same builder. This site should not negatively impact any of the other area lots. The lot slopes to the south and is relatively flat. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks -Steve NEERING Scenic Meadows S/D, Lot 1, Block 2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 3 -bedroom, single family home. Most of the neighboring lots are developed. The subdivision test hole is being used for soil design basis & groundwater monitor. These lots are large and are served by public water. No adverse impacts are expected from development. No conflicts to the other lots will take place by this septic system construction. The neighboring lots easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with gravel. An application rate o2 GPD/FTz with 0.5 reduction factor for utilizing a 5' wide trench. Trench Length 3 FTI/5'x.5 reduction factor = 37.5'; 1 line @ 38'.-XOb@dF@*kw*s- groundwat9was encountered in the soil test. e(3, S` Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil cover. /^i• � -,% O'rreZ 'C. aver, 1'-- Z "' t n r jec� ., • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock. • Drain rock to be''/z inch to 2'/z inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • Backfill over drain rock must not be less than 36". • The finish grade must be mounded to promote drainage away from the trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal) C. o O O o � d > A � N Pa £ O M S T Q Ln E N U O ��L L c � U - U ryj N N 0 JOT L i _ O UTL Ovi UJ L > m U Q (D N (D > O q) Cn 75 4/ Z L = cn z5 to N I LU (--� r N ro d- VA C. 0 d L: f o O O L > A � N Pa £ O M S 0 d L: f i Q ` N U O ��L 0 L i + Ovi v s a > > L Ln to N I c C N E N 0 W a 0 O M fr7 V 4- O Q o Q 0 N Q J LJ U Y N U LJ E:I J M� Z W H i U 3 (� w IHH\ LJ Lj / 3 Q LJ U J � Z � n Q n�o lJ Q m �z o�� O� moo Z ohm ZW aq W N Ou 0 fq J N OOi Q (� y LAW o �W uM II o >_ U N (D QJ U d'I�y Q Wp T LTJ N d N Psa LO U wo E v z +C+ u N H E C) .E po Q \ LJ W J LTJ 3 Q am \ N N L Y O C L d ~ N J O T w O cu UI L O- m a ° ° > U1 co O N Z 0 C " S Ul O N * N C7 �O y U1 N O W 0 N M N Ou 0 fq J U N m a N y 0 Y N N u W J N L \ \ MS Y M \ O Q W J Q N OOi Q (� y LAW o �W uM II aq U 00 p QJ U d'I�y Q Wp LTJ d N Psa U wo v,¢ v z u N H U Q W po Q \ LJ W J LTJ 3 Q am \ N N L Y U N m a N y 0 Y N N u W J N L \ \ MS Y M \ O Q W J Q o OOi Q (� y LAW o �W em II aq ZW 00 QJ ti Q LTJ U U wo U J v z H U Q W z Q Q LJ V / LTJ 3 Q V OOi Q (� y LAW n C �W em cj� aq ZW w° � u ) CD \ / F- L ® ` = e b © ± c / / { 7 g ® d ?El w ! I / lu / % / j_{ ® & u ® 9 t 2S oj s ED \ ° u q R ! f u ( } � 2 2 / A 2 LLJ c \ Ld 0 \ 3 s « ? G / f C 0) f:::) L } ) G / § ) 2 g c \ < 2 75 2 E 0 ® 2 e ® & $ / « / \ j \ ®LA Q b % ; @! &e L ® 2 j / / { \ \ j -P G > g L m f C5 ) \$ e{ U) a- wo® / \ �g o= u >=o�®$�\ -�: m� L_0) Eaj % ItK s£ j) -8 l \\ j-: e°� �0Qj 0 %f/. , u L 020 k ai 0) u \ §\\\\��\\ 22,( $ §0\2®}\\ƒ �\$j` -C -Y L % U3 OL 0i ®\\�\ f mom/®/>42& / N -4e Cl) ¥wJ /z(L N Cu 0 N Y U O w L d i Q a v 4; aj ajd 0 L i 3 N L� L O U7 d 3 � a -N S d p +' F > 0- v N i J Q ai U L) cU L 3 O h E S Z L U Z d f N LO L C4 W p _;cum L L N d c O L 4' _N U d N U Q L � N 6 � 0 Q J � L Q LO W w C(i ' u Y ; L � Y U ZU W O (U U J \ a A N P21 v N zzo O O -0 d aj d t0 m O_H N s CL a u 3 = LJ U J i Ol w � W W ~ Go75 oO- M i-' C3 DO ELLJ d N W 06 F O (� a 3 �I L Q s d in O L 3 {a N l� V1 i O xY\ O 3 oj O O N S i 0 L Z0. S LLJ W U1 L L N d 3 L d _N U 0 Or .20 2004 12:26PM Garness knsineerios Groue, Ltd- GARNESS ENGIN GROUP, Ltd. PERCOLATION TEST LECA. DESCRIPTION: WE CMTES SUBDMSIo►1; PROPOSED tOT 4, PERFORMED FOR: aR« GONFrwicno/1 DATE: 4/12/2004 ORC3TIa ITEST laA FILL / DISTURBED CLASSIFICAMONS SONS (FROZEN) =— CIO ORO lRllllllML IJhjjWpGM%//%CL OMGCNNAOL unllnMH sill.CH I. u OY OH '-1 SC GM/SIA to SM SILTY SANDS AND GRAVEL'S W/ SILT MIXTURES No•5816 P. 5 ... •. as s — •....... DATE READING CLOCK TIME NET TIME WATER LEVEL NET DROP (MINUTES) READING (INCHES) 4/13/20041 1 744 6• 2 1 734 10 0' 6• 3 7:54 1 1 I a 1 0:v4 1 — 1 6" 1 •• 1 I_ I 1 / I 0:14 1 — I 6' 1 — 1 1 I 1 IF 1 0a4 1 — 1 s- 1 — I 1 I 1 II 1 "4 1 — 1 6' 1 — 1 191 1 PERCOLATION RATE 1.7 (MW./INCH) FERC. HOLE DIA, B (INCHES) TEST RUN BETWEEN 6.0 T. AND 6.5 FT. 20 A FOLK HOUR PRESOAK WAS PERFORMED: X YES ❑ NO SOILS LOGGED BY: JODY MtAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN COMMENTS: LOTS 4. 5, 6, 6 7, SHOULD BE GRADED SO THAT SNOW MELT WILL NOT POND PERFORMED BY GEG, Ltd. 1, JEFFREY A. GARNESS. CERTIFY THAT THISWASg&-- E ORMED IN ACCORDANCE WITH ALL STATE AND MUNOPAL GUIDELINES IN EFFECT ON THIS DATE: 2% • • f,� Municipality of Anchorage 5 6 8 9 i On-Site Water&Wastewater Program .y'' (907)343-7904 E T Y JUC l 0 ?01911 c. CERTIFICATE OF ON-SITE SYSTEMS APPRo`L 6tL B 5 Parcel I.D. 051-064-80 Expiration Date: 1-1 (117 o 1. GENERAL INFORMATION Complete legal description SCENIC MEADOW S/D; BLOCK 2, LOT 1 Location (site address) 23240 BLUE SKIES CIRCLE, CHUGIAK,AK 99567 Current Property owner(s) TRAVIS&SARAH JOHNSON Day phone 529-1124 Mailing address 23240 BLUE SKIES CIRCLE, CHUGIAK,AK 99567 Real Estate Agent SABRA GILLILAND Day phone 341-3720 2. TYPE OF DWELLING: I. Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well n Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System U Public Sewer WaiverNariance request for: N/A Distance: - Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ 550-0 V Waiver Fee$ Date of Payment 1liz 2DIol Date of Payment Receipt Number 0 35 I g Receipt Number COSA# O s&t9 13 OD 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. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK,99507 I Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date iii) )141 Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the 31011SSIII■1 guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the •4.•� OF .4., . condition of the systems on the date/s of the evaluation.Separation distances were measured to readily identifiable features. 1.P."•..... .. Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic t�. � systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These tia,M1 1\ %*••. conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the 9 / system/s;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. 0GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the ' • • current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the •�: off•: • Games- :•••�•N information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not ♦ 0 = 4r m ♦ / CE-7V53 ..--as authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. �Js•• V • 6. DSD SIGNATURE '4 PROFESS\�Pi 4 LICENSE �#1 1�" " `I , #AECC884 /\, System #1 Approved for bedrooms. \\\,olll TY((f I r�fr System #2 Approved for bedrooms. J�G�P� tic tilf: /' Disapproved.Disapproved. �l1/_Sr'TE yam% Q E Conditional approval for bedrooms, with the following stipt OnsWAS R'9MD m r- PRoGb,TER z • `1/ SFRVICs s\`>> ))t• 1 r By:-- �1 '^"- Original Certificate Date: -7-1 (.0 -/9 The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations 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. ATTCHMENTS: COSA Checklist j Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12/12) COSA Checklist Legal Description: SCENIC MEADOWS; BLOCK 2, LOT 1 Parcel ID: 051-064-80 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA SERVED BY PUBLIC WATER ❑Gseklog is filed with Onsite (or attached) Well production at time of test gor Date drilled --_--___ Water storage tank volume gallons Total depth ft ..,,- - Well disinfected for_col orm test? ❑ Yes ❑ No Cased to ft ❑ Coli •- •acteria is Negative ❑ Sanitary seal is functioning correctly 'itrate mg/L ❑ Nitrate less than MRL (ND) ❑Wires are properly protected •rsenic ug/L [' Arsenic less than MRL (ND) Casing height(above ground) Collec -• • Date of flow test for COSA --- Date of Sample Static water leve eginning of test ft. Comm_o, f`\ B. TANK DATA C. T STATION Age of tank(s) 7 years ❑ Required---maintenance completed Tank type/material STEEL Age of lift station ye- Measured operating fluid level in septic tank 49.5 Lift station material ❑■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 7/8/2019 _- D. ABSORPTION FIELD DATA 5-WIDE DRAINFIELD Which system tested (date installed) s-"2012 Adequacy test date 7/2/2019 • ALL standpipes present per record drawing Results E Pass For 3 bedrooms Total measured depth from grade 8.8 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4.7 ft(min) Water added 520 gal ❑ N/A—pressurized field New depth 5 in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 325 min depth into effective ❑■ Code-required soil cover over field Final fluid depth 0 in Absorption rate 450+ d ❑ System presoaked p gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies:"HOUSE VACANT ON MAY 31,2019 PER OWNER.ADEQUACY TEST PERFORMED 32 DAYS AFTER VACANCY. PRESOAK REQUIREMENT WAS WAIVED BASED ON THE ADEQUACY TESTING RESULTS PER 7/10/2019 PHONE CONVERSATION WITH TIM EKLUND AT THE MOA ONSITE DEPARTMENT. COSA Checklist yellow sheet E. SEPARATION DISTANCES SERVED BY PUBLIC WATER From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic k • Station on Lot> 100' Community Sewer Manhole/Cleanou _ ❑yes if No ft --- Yes if No ft Neighboring Tank> 100' ❑i- if No ft Private S- eptic Line >25' ❑Yes if No ft Absorption Field on Lot> 100' ❑Yes if No Holding Tank> 100' ❑Yes if No ft Neighboring Absorption Fields> 10.0' Ani - •ntainment> 50' ❑ Yes if No ft —==fl Yes if No ft -=- Manure/Animal Excreta--Storage > 100' Commu wer Main > 75' ❑Yes if No ft —HD Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) ------, Building Foundations > 10' E Yes if No *5+ ft Surface Water> 100' E✓ Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' E Yes if No ft Private Wells > 100' r❑ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells >200' ✓❑ Yes if No ft Water Service Line > 10' El 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' 1:1 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' E Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' E Yes if No ft Community Wells > 200' CI Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *5'+ (MET CODE AT TIME OF INSTALLATION). ,o�000.„ G. ENGINEER'S CERTIFICATION : OF A k�44 I certify that I have determined through field inspections and review $' P.•• •. Z 1 of Municipal records that the above systems are in conformance with i 4 6', �)\ •.-5�p MOA COSA guidelines in effect on this date. i .. �0 f . Gar ess. 0 "P • ;O0 q COSA Checklist yellow sheet 10a Pro f esS ..z � #AECC884 4��� °� .p.Oa • • Municipality of Anchorage 5 6 7 8 o. �• } .i_ On-Site Water&Wastewater Program % :�: (907)343-7904 %naL, : •'•'•:'_'K,';?` a 1 Ey JUL I 2015 CERTIFICATE OF ON-SITE SYSTEMS APPR1t' L '66.L951 Parcel I.D. 051-064-80 Expiration Date: 1-1 (a-7-6 6 1. GENERAL INFORMATION Complete legal description SCENIC MEADOW S/D; BLOCK 2,LOT 1 Location (site address) 23240 BLUE SKIES CIRCLE,CHUGIAK,AK 99567 Current Property owner(s) TRAVIS&SARAH JOHNSON Day phone 529-1124 Mailing address 23240 BLUE SKIES CIRCLE, CHUGIAK,AK 99567 Real Estate Agent SABRA GILLILAND Day phone 341-3720 2. TYPE OF DWELLING: • Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site U Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System • Public Sewer ❑ WaiverNariancerequest for.. N/A Distance: - • Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ 550'0 0 Waiver Fee$ Date of Payment 1 f 1212419 Date of Payment Receipt NumberC 0 35 18'ci Receipt Number COSA# 0SCA9(3OD Waiver# 4 COSA Checklist Legal Description: SCENIC MEADOWS; BLOCK 2, LOT 1 Parcel ID: 051-064-80 If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1 A. WELL DATA SERVED BY PUBLIC WATER ■ '': og is filed with Onsite (or attached) Well production at time of test .fp- Date ••Date drilled Water storage tank volume gallons Total depth ft Well disinfected fo ,. orm test? ❑ Yes ❑ No Cased to ft ❑ Coil .• .acteria is Negative ❑ Sanitary seal is functioning correctly 'itrate mg/L ❑ Nitrate less than MRL (ND) ❑Wires are properly protected •rsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) • Collec • Date of flow test for COSA Date of Sample Static water leve .eginning of test ft. Corn .- B. TANK DATA C. - T STATION Age of tank(s) 7 years ❑ Require. ••-intenance completed Tank type/material STEEL Age of lift station ye- : Measured operating fluid level in septic tank 49.5 Lift station material El Standpipes/foundation cleanout per record drawing Comments: Date of pumping 7/8/2019 D. ABSORPTION FIELD DATA 5-WIDE DRAINFIELD Which system tested (date installed) s-7/2012 Adequacy test date 7/2/2019 ❑� ALL standpipes present per record drawing Results E Pass For 3 bedrooms Total measured depth from grade 8.8 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert,from grade 4.7 ft(min) Water added 520 gal ❑ N/A—.pressurized field New depth 5 in Monitor tubes go to bottom of effective. If not, state depth into effective Elapsed time 325 min [' Code-required soil cover over field Final fluid depth 0 in ❑ System presoaked I l Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies:-HOUSE VACANT ON MAY 31,2019 PER OWNER.ADEQUACY TEST PERFORMED 32 DAYS AFTER VACANCY. PRESOAK REQUIREMENT WAS WAIVED BASED ON THE ADEQUACY TESTING RESULTS PER 7/10/2019 PHONE CONVERSATION WITH TIM EKLUND AT THE MOA ONSITE DEPARTMENT. COSA Checklist yellow sheet Municipality of Anchorage 1l;F • Development Services Department Building Safety Division u p z On -Site Water and Wastewater Program S n E , y' n 4700 Bragaw 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 Parcel I.D. 051-064-80 COSA# ®ey(' / %mcl Expiration Date: ?' e 1. GENERAL INFORMATION Complete legal description Scenic Meadows Block 2 Lot 1 Location (site address) 23240 Blue Skies, Peters Creek, AK 99567 Current Property owner(s) Quinn Michael Day phone 229-4966 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address same Day phone Dee Quinn Day phone 229-4966 RE/MAX Eagle River Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF � TYPE -OF -WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System 3 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (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 NorthRim Engineering Phone 694-7028 Address PO Box 770724 Eagle River Engineer's Printed Name Steve Eng Date 7/25/2012 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all subject to these various and dynamic characteristics and are outside the control of t evaluator of the well and septic system. 5. DSD SIGNATURE Approved for .3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other WATER AND By: / Original Certificate Date: " % (Rev. 11/0.5) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program a 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Scenic Meadows, Block 2, Lot 1 Parcel ID: 051-064-80 A. WELL DATA - Public Water Well type na If A, B, or C provide PWSID # Well Log (Y/N) na Date completed na Sanitary seal (YIN) na Wires properly protected (YIN) na Total depth na ft. Cased to na ft. FROM WELL LOG Date of test na Static water level na ft. Well production na 9 - p.m -WATER SAMPLE RESULTS: Coliform NA colonies/100mL Nitrate NA mg/L Arsenic: na mg/l Date of sample: na Collected by: NA B. SEPTIC/HOLDING TANK DATA Casing height (above ground) na in. AT INSPECTION na na ft. na g. p.rn. Tank Type/Material Septic/Steel Date installed 6/13/12 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA Date installed 6/13/12 Soil rating (g.p.d./ftz or ft2/bdrm)1_2 System type Trench Length 41 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 7.5 ft. Eff. absorption area 410 fe Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) NEW For 3 bedrooms Fluid depth in absorption field before test in.. Water added_ gal, New depth -- in. Elapsed Time: = min. Final fluid depth - in. Absorption rate g g.,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date = D. LIFT STATION Date installed na Size in gallons na Manhole/Access (Y/N) na "Pump on" level at na in. "Pump off level at na in. High water alarm level at na in. Datum na Cycles tested na Meets alarm & circuit requirements? na E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot na Absorption field on lot Public sewer main On adjacent lots na On adjacent lots na Public sewer manhole/cleanout Sewer /septic service line na Holding tank na Animal containment areas na Manure/animal excrete storage areas na SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 10'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water. 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain (None Known) Wells on adjacent lots 200'+ F. COMMENTS f, ell G. ENGINEER'S CERTIFICATION A� a °•°°•'"'•�S'� I certify that t have determined through field inspections and 90 -e STH e review of Municipal records that the above systems are in"°°"'"" °°•°' °•'•^"° conformance with MOA COSA guidelines in effect on this date. _ a C ............>. Engineer's Printed Name Steve Eng Steven W. EngPE Q56 •,'�;y; Date 7/26/2012ESS;p'''V COSA Fee $49&. -OT iOJr• L6 Date of Payment Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number _ `0 J U) 0 O J M O J 0 0 O J 0 O J 0 O J PLOT PLAN AS BUILT X SCALE 1* = 40' GRID NW 1460 Project No. 12-039A2 Lang & Associates, Inc . 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone oa�pp0 Registered Land Surveyors (907) 522-4625 Fax �'40 kenOlong survey.com / fonathanOlangsurvey.eom d,��,pF•A•C/S4� I hereby certify that I have surveyed the following described property: LOT 1, BLOCK 2, SCENIC MEADOWS SUBDIVISION (Plat No. 2006-49) 491- � v Anchorage Recording District, Alaska, and that the Improvements situated thereon aro t°A •••• ....:.tr�o within the property Imes and do not encroach onto the properiy adjacent thereto, that Q no Improvements on the property lying adjacent thereto encroach an the surveyed 17 premises and that there are no roadways, transmission Imes or other visible QOA.:........................�� easements on said property except as Indicated hereon. ar-, KENNETH G. LANG oO d LS -5202 oo Doted this the ^''A"' 7 J,., Day of v��`ti 'L�t,�• at Anchorage, Alaska (f�Fgb fir%© It is the responsibility of the owner to determine the existence of any easements, �4p0ssloNA�ab� covenants, or restrictions which do net appear on the recorded subdivision plot.