HomeMy WebLinkAboutEKLUND #1 BLK 4 LT 6050 53 /6 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW Date of Issue Parcel Identification Number: Legal Description Property Owner Name & Address Eklund #1 Block 4 Lot 6 Brian Busby 4249 Lower Kogru Drive Eagle River, AK 99577 Pump Installation Date: 9-30-20 Pump Intake Depth Below Top of Well Casing: 230 feet Pump manufacturer’s Name: F&W Pump Model: 4F07P07301S Pump Size: 3/4 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Unknown Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 72-013 (Rev: 3/78) G, MUNICIPALITY OF ANCHORAGE w 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 NAME PHONE❑NEW �f— 69�� _6q� PGRADE MAIL NG ADDRES 6 c4Jp� LEGAL DESCRIPTION LOCATION N0. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. O DISTANCE TO: 05 r Y PZ Manufacturer C, Material No. of compartments wF N Liq. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth 6 Y DISTANCE TO: Well Dwelling PERMIT NO. Jt7Z _ zF Manufa, r Material Liquid capacity in ga ons w= DISTANCE TO: Well f� Foundation , Nearest lot line �- (,) PERMIT /0 Q6 W u- U w No. of lines Length of e h ne g Total length of I' es g � Trench wi�dt�hJ� / Distance Int n lines � V inches // _ II- Top of tile to finish grade f Material beneath tile �T Total effect- bggr� on area 0 —3 4r�ebes Length'Width Depth PERMIT NO. Lu C7 Q F Type of crib Crib diameter Crib depth otal effective bsorptio - wE w rn We g foundation Nearest lot line DISTANCE TO: J o Depth Drillers L Distance to lot line PERMIT NO. J /`Y w Building foundation Sewer line Septic tank Absor tion rea(,,ssI e p DISTANCE TO: G® OTHER PIPE MATERIALS 1 1 i Pa -5 -re c, %�e_ ,�� SOI L TEST RATING goo INSTALLER REMARKS{i( r (v�vU r d w e APPROVED f-� � DATE LEGAL .- / f & ) L— 72-013 (Rev: 3/78) G, TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)---m 200 THE REQUIRED SIZE OF THE SOIL. ABSURPT Or' SYSTOEll IS THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). 'THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F;.,' EF Q U I F;po t= F=� -F 1 0 -F " N K "—= _=r .joF==: 117-100 O"L-1 C-INf-3 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. Q U I F-- r -A — — — DEPARTMENT r, HEALTH `L` AND ENVIRONMENTAL. I 99501 jTECTION U-0, 01 a. 825 STREET., ANCHORA13E.� AK. L L 1-d 264-4720 PERMIT NO. 8:10-3-00 APPLICANT KAREN &MARTIN MALL P. O. BOX. CHUG. NON �; LOCATION KOGRU DR. LEGAL LOT 6 BLK 4 EKLAND SUB LOT SIZE 43560 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)---m 200 THE REQUIRED SIZE OF THE SOIL. ABSURPT Or' SYSTOEll IS THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). 'THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F;.,' EF Q U I F;po t= F=� -F 1 0 -F " N K "—= _=r .joF==: 117-100 O"L-1 C-INf-3 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. MINIMUM DISTANCE BETWEEN A WELL. FIND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 1.00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS rlff-r' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=I=FZM I -r F=XF=m 1 2`3 -- A -!E-74 OHI 1. I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAI' THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. ol r SIGNED ATAALL A 11F L I N T FK A 'EN - M A R TI 009A 4z -------- ---- DATE_ ISSUED BY V4. 0 ID Q U I F-- r -A — — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL. FIND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 1.00 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS rlff-r' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=I=FZM I -r F=XF=m 1 2`3 -- A -!E-74 OHI 1. I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAI' THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. ol r SIGNED ATAALL A 11F L I N T FK A 'EN - M A R TI 009A 4z -------- ---- DATE_ ISSUED BY V4. 0 ID Pi U VA 1 1::- 11 ---o L_ I "T`-e k---# F=" �r-A 91-- " p"__ff F`- C-M F:7-- / / DEPARTMENT [��,HEALTH AND ENV IRONMENTHL r�QTECTION 825 'L' REET/ ANCHORAGE/ AK. 9950� ^ 264-4720 --� T -T-E�. PERMIT NO. ( 8102ZO0 ) DATE OF ISSUE 50881 u�0oK�n� *** WARNING - DUE TO CHANGING REQUIREMENTS THIS PRINTOUT MAY NOT BE AN EXACT * * *** COPY OF THE ORIGIONAL PERMIT APPLICANT KAREN &MARTIN MAI L P.O. BOX. CHUG. NOME LOCATION KOQRd DR. LEGAL LOT 6 BLK 4 EKLHND SOB LOT SIZE 43560 SQUARE FEET TYPE OF SOIL 8BSQRBTIQN SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/8R)= 200 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: EN r=- f-' -I- " = 1 -1 L-FEr-40-r"�= 3:,C_-1 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELQ. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). �AE 12"! 19 1 Fr-, FE r_H _._~ ���RD T PA "—=. F-ft F= 1:��l aZa r-4 #E7 F:l F." E F2 E-E. 101 U 11 F;;?. FEE C-A BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL/ OR 150 TO 200 FEET FOR A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM A PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO 8 COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY - SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION F::" EE lz,: V1 I -F FE:­40 F=:o I IR EF ����E r-1 0- F-r P-.a --7-- -1 090�z. I I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED: ----------------------------------------- APPLICANT KAREN 8MARTIN MALL. ISSUED _~..-_..[)ATE_~___--~__-__~_ INSPECTION HISTORY ~ SEWER 1 0 SEWER 2 0 WELL INSP 0 WELL LOG DATE 0 DRILLER GRE"ER ANCHORAGE AREA BOP 'IGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME4-440i-4 kOO 4Z- MAILING ADDRESS,6c'X fyt2f'115Ir Altlr0e PHONE LOCATION 64C ///r e Idl LEGAL DESCRIPTION 1,17- V yvr0% ON il c i� SEPTIC TANK: DISTANCE C FROM WELL MANUFACTURER INSIDE LENGTH INSIDE WIDTH ,x NUMBER OF C °� S'{ MATERIAL/f/r C- COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY /0-e-7 GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH LENGTHIL_q DEPTH / LINING MATERIAL �� !Y V � IB SIZE: DIAMETER DEPTH DISTANCE FROM: WELL .le t TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINES . ABSORPTION AREA (WALL AREA) O SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED DISTANCES: INSTALLED BY: _CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED PIPEMATERIAL: g f'�, REMARKS: Form No. EQ -031 NEAREST SEWER LINE , REMAR DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM i r-6 f c ?`Wl F DISTANCE FROM: SEEPAGE SYSTEM APPR F -rle e -N c k e.' Wilting Cog ,,q by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694.2588 OWNER OF LAND jY�F�C. DEPTH OF WELL0 ADDRESS STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION/ -j lCi Q L /� 4/ �i�/aYi �/ RAW DOWN FT. 3o CS>� Jy� DATE - Started �' Ended u GALS. PER HR / iv PERMIT NUMBER KIND OF CASING KIND OF FORMATION: From 0 Ft. to Ft. ! 1 From Ft, to Ft. From � Ft. to_�70_Ft. c. Zdf/ _t From Ft. to Ft. From ��Ft. to _� S Ft. Yl W00 �i"/ �PlQtt�L From Ft. to Ft. FromFt. to --Ft'. From Ft. to Ft _L-75 From Ft. to -1_`+ Ft. � From Ft. to Ft From Ft. to U_ Ft. &vl`t1FIZ /� F Ft. to Ft. From_ J�—Ft. to_14c Ft. c-14 �e�6%CJe:C From -Ft. to Ft. � Fromt��}}j_Ft. tom 3 ,L.Ft.%3hL% Qb C k' From Ft. to Ft. From_Ft. to=_Ft. ��i�zTtJ��l� �� 1`� From Ft. to Ft. �e From >> 1_C Ft. to.St-LQ Ft '6)c le From Ft. to Ft. From Ft. to Ft. From Ft. to—Ft- o Ft.From Ft: to Ft. From—Ft. ` From Ft. to—Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From - Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft, to Ft. From Ft. to Ft. From Ft. to Ft MISCL. INFORMATION: DRILLER'S NAME — _ a h .> � :; .� „, , . _, " GR NGFO AREA BO DEPARTMENT OF ENVIRONMENTAL QU.QL 3330 "C" STREET ANCHORAGE, ALASKA TELEPHONE 274-45 1 ASEWAGE DI 0 AL SYSTEM - APPLICATIO 1ItOdl -- NAME OF APPLICANT INSTALLATION LOCATION;9'40 p� � LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SEEPAGE PIT ESS FINANCED THROUGH TO BE INSTALLED BY N SOIL TEST RESULT9?O® ���f NOTE: THIS COMPLETION DATE ANTICIPATED N DRAIN FIELD 0,0 PHONE w 7 IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEEPAGE AREA SIZE 114 TYPE SEPTIC TANK SEEPAGE PIT . DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK � SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT p DRAIN FIELD '�Jyj/�✓� /� SEPTIC TANK, 70449 `-. SEEPAGE PIT�'�` DRAIN FIELD`/ TO RIVER, LAKE, STREAM. CAST'IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REG�Ay//RJ/,,�Qj�ING. INSTALLL,JATION. 0 G.A.A.B. OR IC NSED D-ESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF. GREATER ANCHORAGE D`lESCCpjBED SYSTEEM°,1 IS IN ACCORDANCE WITH SAID CODE. WT -� tel" �-�" APPLICANTS SIGNATURE FORM NO. EQ -016 i t'. DIAGRAM OF SYSTEM Y- .i i J } ♦ r 0 Ft E GEOTECHNICAL & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster s< 694-2774 Soils 8 Foundations SOIL LOG Earl Ellis 688-2280 Land Development Performed for: Name: 13oozell S Ale lz E Tel. No. 6 �'¢- Mailing Address: 130 /�cz, 9!'j'e7 Legal Description: 1-07 6, 16Gf-c 4, e'f 4eJAI-4> SV�� Apr�nr'♦ �. Depth (feet) Soil Characteristics 0 1 2 �3 4 6 7--------------- - 8 9 514AIV V C121405�L- Sew 511-7- 1A11 7-// 1-7- oA117-H d.�5P, ht 10 11 �sTTD,Lt m f iT 12 Ground Water Encountered: Yes No t-� If yes, what depth Proposed Installation: Seepage Pit Drain Field k-� Comments:yP�/z�E� TE1� P//9F 7-0 f3 G�in Performed by:Date:_ 7J s kk d s0 U[NimpAA,L Y OCA NC HORAG Development Services Department tib` ('� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050 531 16 1. GENERAL INFORMATION Complete legal description EKLUND#1 L6 134 Location (site address) 4249 LOWER KOGRU Current property owner(s) Mailing address Real estate agent 2. TYPE OF DWELLING: M- Inge Family w wo ADU) __..... _ ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex). 3. NUMBER OF BEDROOMS: 3 Expiration Date: ^7— 21 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic El Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 8 u Date of Payment 3 h a 0� ) Receipt Number 0� 30 3 COSA # 75621 l()5_9 Waiver Fee $ Date of Payment Receipt Number 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 2/28/2021 6. DSD SIGNATURE _ X System #1 Approved for 3 System #2 Approved for Disapproved Conditional approval for SJ OF A�qs�� 8 p *: 49 TH . ; ....... bedrooms CHARLES G BALZARINI D � ��� CE -13854 bedrooms . I��� ��F�F� PROFES SIONA�'�% A bedrooms, with the following stipulations: i GC(r /I NO C -T`! ',Tvrrrrr�i., m= /JJJJ�1 SERVICES�1``�� Original Certificate Date:q-7-2,1 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 COSA Checklist blue sheet COSA Checklis-i Legal Description: EKLUND #1 L6 B4 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA A Well log is filed with Onsite (or attached) Date drilled 1976 Total depth 240 ft Cased to 145 ft FIC Sanitary seal is functioning correctly FE -1 Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 2/12/21 Static water level at beginning of test 123 ft. Comments B. TANK DATA Age of tank(s) 45 years Tank type/material PLASTIC septic Measured operating fluid level in septic tank 48 ❑Q Standpipes/foundation cleanout per record drawing Date of pumping 4/3/21 D. ABSORPTION FIELD DATA trench Which system tested (date installed) 1981 FIE ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 3 ft (min) 01 N/A — pressurized field ❑® Monitor tubes go to bottom of effective. If not, state depth into effective ❑M Code -required soil cover over field ® System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 050 531 16 Structure served by this system 1 Well production at time of test +4.2 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes 0 No FEM Coliform bacteria is Negative Nitrate 12.6 mg/L ❑ Nitrate less than MRL (ND) Arsenic 1.19 ug/L F-1Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 3/24/2' C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 2/12/21 Results ❑ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 15 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date NA W 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 5 Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' P/1 Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Water Main > 10' ✓❑ Animal Containment > 50' ❑✓ Yes if No ft ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Manure/Animal Excreta Storage > 100' comment below Community Sewer Main > 75' [E Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required Building Foundations > 10' ❑ Yes if No 5 ft Surface Water > 100' ® Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Water Service Line > 10' Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' 0 Yes if No ft 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 3 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 Water Service Line > 10' 21 Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS Request conditional cosy to repair damaged distribution pipe in drain field and add MT to second trench. Drain field partly under driveway G. ENGINEER'S CERTIFICATION l certify that l 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. 2/2/21 COSA Checklist yellow sheet OF At, .s mom : 49 TH '• �, CHARLES G BALZARN F6, , CE -13854 PROf:ESStON ft ft Ecklund, Timothy J From: Sent: To: Subject: Attachments: Oops, that would be for this COSA CHARLES Balzarini <cgbalzarini@gmail.com> Tuesday, July 27, 2021 8:46 AM Ecklund, Timothy J Re: Approved Eklund Conditional COSA attached doc17808020210407150113.pdf On Fri, Jul 23, 2021 at 1:00 PM Ecklund, Timothy J <timothy.ecl<lund@anchorageak.gov> wrote: Sorry there was nothing attached. Tim Ecklund Onsite Water and Wastewater Municipality of Anchorage 907-343-7905 timothy.ecl<lund@anchorageak.gov From: CHARLES Balzarini <cgbalzarini@gmail.com> Sent: Friday, July 23, 20219:04 AM To: Ecklund, Timothy J <timothy.ecklund@anchorageal<.gov> Subject: Re: Approved Eklund Conditional COSA attached [EXTERNAL EMAIL] Hey Tim, The repairs have been completed and inspected on this one. Any chance you can release the condition on th COSA? 1 Cv,-t� � c C d �;� MUNICIPALITY.OFANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 056 531 16 Expiration Date: 1. GENERAL INFORMATION Complete legal description EKLUND#1 L6 B4 Location (site address) 4249 LOWER KOGRU Current property owner(s) Mailing address Real estate agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well FLI Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 HO Date of Payment 3 `, a D, Receipt Number 0q 30 3 1�$ Waiver Fee $ Date of Payment Receipt Number COSA # rX)G2 I I Q '� 5 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 2/28/2021 6. DSD SIGNATURE System #1 Approved for . bedrooms System #2 Approved for bedrooms Disapproved ?? Conditional approval for OF A/-. 49 TH �• .� rJJ • CHARLES G BALZARINI •% CE -13854 PROFE55O� bedrooms, with the following stipulations: Original Certificate Date:q-7-2-1 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 CN— Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet r Legal Description: EKLUND #1 L6 B4 Parcel ID: 050 531 16 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1976 Total depth 240 ft Cased to 145 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 2/12/21 Static water level at beginning of test 123 ft. Comments B. TANK DATA Age of tank(s) 45 years Tank type/material P`AST'c septic Measured operating fluid level in septic tank 48 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 4/3/21 , D. ABSORPTION FIELD DATA trench Which system tested (date installed) 1981 ❑ ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 3 ft (min) OR N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective OR Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 2000 gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test +4.2 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ No OR Coliform bacteria is Negative Nitrate 12.6 mg/L ❑ Nitrate less than MRL (ND) Arsenic 1.19 ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 3/24/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 2/12/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 15 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) NA If yes, enter date NA 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 5 Community Sewer Manhole/Cleanout > 100' ✓❑ Yes if No ft M Yes if No ft Neighboring Tank > 100' M✓ Yes if No ft Private Sewer/Septic Line > 25' E] Yes if No ft Absorption Field on Lot > 100' M✓ Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft ft If septic tank is under driveway comment below From Absorption Field on Lotto: (Please enter distances if less than required) Manure/Animal Excreta Storage > 100' Building Foundation > 10' Community Sewer Main > 75' 0✓ Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5 ft Surface Water > 100' Q✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'✓❑ Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' 0✓ Yes if No ft Water Service Line > 10' FV -1 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lotto: (Please enter distances if less than required) Building Foundation > 10' El Yes if No 3 ft If absorption field is under driveway comment below Property Line > 10' 17,71 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' F/� Yes if No ft Community Wells > 200' 121 Yes if No ft Surface Water > 100'v� Yes if No ft F. ENGINEER'S COMMENTS Request conditional cosy to repair damaged distribution pipe in drain field and add MT to second trench. Drain field partly under driveway G. ENGINEER'S CERTIFICATION l certify that l 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. 2/2/21 COSA Checklist yellow sheet OFA 41P-1 ,®co 49TH.. ... ... CHARLES G BALZARIU1 CE -13854 � �F�PROFEW6' Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Cosa for Eklund#1 L6 B4 Dear Reviewer, This letter provides supplemental information for the COSA for Eklund#1 L6 B4 We are requesting conditional approval of a COSA for the above referenced property. During our inspection, it was noted that the drain field pipes were damaged and needed repair. Due to the mountainous location and frozen ground conditions we are requesting that the repairs allowed to be made after the ground thaws. Repairs will be completed by 7/01/2021. The system is located partially under the driveway. Insulation and compacted granular fill will be placed in front of the garage to protect from freezing. Up to (4) 4x4 posts will be embedded as bollards at the direction of the engineer to keep vehicle traffic off of the distribution pipe. The Engineer will observe these repairs and will coordinate with the installer on the extents of bollards, insulation and additional pipe repairs as necessary. A copy of this letter will be sent to the contractors upon issuance of the conditional cosa. Thank you for your time in reviewing this request. Please do not hesitate to contact me at 907-854-5558 or by email cgbalzarini(c�gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 4/5/21 Ors�Cr�P� �•p $1 X. .. . ....... p CHARLES G BALZARINI CE -13854 ��j�o PR0FESSIONP� RESIDENTIAL MORTGAGE, LLC NMLS #167729 100 Calais Drive Anchorage, Alaska 99503-4049 (907) 222-8800 phone (907) 222-8801 fax 1-888-357-2707 toll free www.residentiaimtg.com March 10, 2021 Municipality of Anchorage On -Site Water & Wastewater Section 4700 Elmore Road Anchorage, AK 99519 Re: Lot 6, Block 4, Eklund Subdivision Addition #1 4249 Lower Kogru, Eagle River, AK To Whom It May Concern: Residential Mortgage will be holding an escrow for repair of damaged septic pipe in the amount of $8,000.00 This is an escrow of 2.0 times the $4,000 bid from Northern Excavation & Construction, dated 3/8/2021. No additional funds will be released without MOA approval. Required completion date of the work is 9/10/2021. Sincerely, Denise J. Long Sr. Vice President (907)222-8812 longd@residentialmtg.com 1. PROJECT: 3. CONTRACTOR: 4.PROJECT NO, 5. REQUEST NO Charles Balzarini Silver Swan Industries 21005 1 2. ADDRESS: 6. CE DESCRIPTION: 7, PROPOSAL DATE 4249 Lower Kogru Eagle River Repair Sanitary 3/15/2021 AK 99577 COSTSUMMARY WORK DIRECTLY PERFORMED BY THE UNDERSIGNED CONTRACTOR 1A. SSI Direct Labor $3,210 2A. SSI Self Work Materials $785 Subcontractor Proposal $0 3A. SSI Self Work Equipment $0 3B. Specialties 4.TOTAL OF WORK VALUE (Sum of 1 - 3) $3,995 The intent of this proposal is to include the excavation of 701f of trench to repair 40 total If of sanitary pipe and add 1 monitor tube and backfill. It is assumed free and clear access to the work locations will be maintained through the duration of project. Assumptions of extent of damage and limits of work were based on drawings provided and final invoice will be based on work performed. Description Exclusions Customer Name Customer Signature Date JR's Septic Pumping and Excavation PO Box 773415 Eagle River, AK 99577-3415 I Name/Address I Charles Balzarini 4249 Lower Kogru Eagle River, AK 99577 Date Estimate # 3/5/2021 39 Signature Phone # E-mail 9076946454 jrsseptic@ginail.com gmail.com Project Description Qty Rate Total Replace crushed line in septic field. 8 hours at $225/hr. Locates and materials for septic field repair. 60' of pipe, plus the steel monitoring tube, and private locating services.. 8 1 225.00 650.00 1,800.00 650.00 Total $2.450.00 Signature Phone # E-mail 9076946454 jrsseptic@ginail.com gmail.com Northern Excavation and Construction, LLC 15861 South Birchwood Loop Road Chugiak, AK 99567 (907)694-1373 Northern Excavation@Gmail.com ADDRESS EKLUND #1 BLK-4 LOT -6 4249 LOWER KOGUR ESTIMATE # i DATE 1786 03/08/2021 Services EKLUND #1 BLK-4 LOT6 4249 LOWER KOGRU Thank you for the opportunity to provide you with this estimate. - Changes which increase the specific tasks of machine/labor time spent of this contract, will be submitted in writing by the owner and accepted by the contractor and the contract modified accordingly. Payment to the Contractor for modifications to this contract which increase the work will be charged. All agreements are contingent upon accidents, design changes, or delays beyond our control. Northern Excavation & Construction, (NEC) shall not be held liable for the affects that may occur to the property during and after the install. Affects such as damage and structural integrity of decks or deck supports in or close by the work zone, trees left in close proximity of where machine work takes place or having to stock displaced excavated material around trees to be retrieved, damage and structural integrity of retaining walls that may need to be partially removed or traveled close too, disturbance to driveways, disturbance to any landscaping, etc. All methods and materials shall be in accordance with MOA regulation. Payment in full is due upon completion of backfill. Payments received after 30 days of completion shall be charged a 1.5% monthly fee on unpaid balances. DESCRIPTION: Removed portion of existing fence as needed. Excavation and backfill for approximately 20' of damaged pipe in existing trenches. Install monitoring tube in 35' long trench. INCLUSIONS: Pipe/Supplies. Drain rock. Pumping. Machine/labor time. Re -surface existing driveway w/ D-1. EXCLUSIONS: Re -landscaping or seeding. Re -installing or replacing fence. Re -placing asphalt, if existing._ Please note that a 48 hour notice to start digging is required by the State of Alaska for utility locates. `Northern Excavation and Construction, LLC is not liable for any utility lines not located by 811 public utility locate e.g., any lines running to detached structures. Please notify contractor of any power/gas/communications lines, prior to starting the job, so private locate services can be called. An extra charge will be incurred for private locate services. Accepted By TOTAL Accepted Date Please note that a 48 hour notice to start digging is required by the State of Alaska for utility locates. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC211085 Subdivision: Eklund #1, Block: 4, Lot: 6 A water sample revealed a nitrate concentration of 12..6 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. Iameg , 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. � � � MailmgAddress PFO Box 196650 ��►nchorage, Alaska 99519 6+350 * �tww muni org�� '� �. REF REF 1-0S PIP[ REF I-ok INS, I - RE N01 THE ABL ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: A4 DATE- ...... AND THAT NO ENCRO S EXIST b(CEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE MCISTENCE OF ANY GRIDs EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- 0 VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS ANY DATA HEREON BE USED FOR CON!XTRUGTION OF FENCE LINES, OR FOR ESTABLISHING BOUND-, ARY LINE DRAWN= -110�r ASBUILT _ SE14ARD & ASSOCTAT.ES LW SURVEMG 6AL—nR-7Q I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE �33� J FOLLOWING DESCRIBED PROPERTY= OF A4'%# DATE_ ,���s �y AND THAT NO EN CROACHME0 EX7�5T EXCEPT AS • p INDICATED. IT IS THE RESPONSIBILITY OF THE� AL GRID= OWNER TO DETERMINE THE E:CISTENC.E OF ANY EASEMENT$, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI— VISION PLAT. !UNDER NO CIRCUMSTANCES SHOULD #$ oma... biarS s.v a. � ���; •, ts- � F� ANY DATA HEREON BE USED FOR CONSTRUCTION /3g �S/ ft� !��S'��z - - OF FENCE LIPS OR FOR ESTABLISHING'3 BOUND- DRAWN: . - � �s t'rsirfi�� w ARY LINES. xw� Municipality of Anchorage •• On-Site Water and Wastewater Program (907) 343-7904 S: Tv CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-531-16 Expiration Date: JCul 0.� (20! 3 1. GENERAL INFORMATION Complete legal description Eklund #1 Block 4 Lot 6 Location (site address) 4249 Lower Kogru Dr Current Property owner(s) Miller Day phone 440-7257 Mailing address same Real Estate Agent RE/MAX, Raney Day phone 440-7257 678970 2. TYPE OF DWELLING: 'bvl "', . ® Single Family (w/wo ADU) ❑ Duplex SEP 2 6 2018 ❑ Multiple Dwellings (Single Family and/or Duplex) t6 c °I 6 8 Ls'� 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received by: 7 ,(i_ Date: /6/2//f COSA to be released to the engineer,unless otherw' e requested by the engineer. COSA Fee $ ��((p ' Date: Date of Payment q lots Date of Payment Receipt Number ( j (ag Receipt Number COSA# O'SC 1510 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724,Eagle River Engineer's Printed Name Steve Eng Date 9/26/2018 • • 6. DSD SIGNATURE 4 V System #1 Approved for 3 bedrooms. z eo oc 'r System #2 Approved for bedrooms. ,w s� u aLo� s1 Disapproved. • . 70—e Conditional approval for bedrooms, with the following stipulations:.;;,2,- `I' ONSITE �', WATER AND WASTONATER = PROGRAM O fop �\Gti� NT SER By: l{ r- i-jur-, Original Certificate Date: /0/008 The Municipality of Anchorage Devlopment 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 . . COSA blue sheet 9-1-12.doc < If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description:fleL.e// f6 l'/ .84 LC Parcel ID: a5-OS3J/6 A. WELL DATA Well type P If A, B, or C provide PWSID# Well Log (YIN) y Date completed 5(15/74. Sanitary seal (Y/N) Wires properly protected (Y/N) s y y Total dept1- #0 ft. Cased to/ / ft. Casing height (above ground) �CP in. FROM WELL LOG AT INSPECTION Date of test 61017 6 91/I?At Static water level /2 L ft. // . .5 ft. Well production 3 g.p.m. T `f g.p.m. WATER SAMPLE RESULTS: Coliform ��/0 colonies/100 mL Nitrate AiU mg/L Arsenic /YD ug/L Date of sample: /WM Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material 6-6/5%IC./ .PL 4J'71C.. Date installed 7/2//�7e( Tank size /Ode) gal. Number of Compartments 2 Cleanouts (Y/N) ' Foundation cleanout(YIN) \< Depression over tank(Y/N) A. High water alarm (YIN) ( A) Date of pumping 717?/t't Pumper Sc,0!*(3.7 P ,,yf C. ABSORPTION FIELD DATA Date installed,5-1304 4/ Soil rating (g.p.d./ft2 or ft2/T btu) tad System type l a"c-4 Length /2 C) ft. Width ft. Gravel below pipe 47//� 1 ft. Int Total depth F Tft. Eff. absorption area ft2 Monitoring tube Depression over field N n Date of adequacy test 7/I f/� Results (Pass/Fail) yo. For 3 bedrooms Fluid depth in absorption field before test 6 in. Water added 4/5"a gal. New depth a in. Elapsed Time: 3() min. Final fluid depth 0 in. Absorption rate >_ �Sd g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) t>it/l' If yes, give date /Yl7 D,Lv 6c M it " 'CL -7- /iS7-4-L4 - / lV V �QOeP -- Qoo.Z,t p� '7-f4_4 t D. LIFT STATION ,JA Date installed Size in gallons Manhole/Access (Y/N) _ "Pump on" level at _ in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot /'Q �� On adjacent lots /o'd r'f Absorption field on lot lQQ f On adjacent lots /a6T- Y Public sewer main /�G `'f Public sewer manhole/cleanout fdO ('f" Sewer/septic service line 2.5 '- Holding tank /oQ Cf' Animal containment areas 5 O Manure/animal excrete storage areas /00 f SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 t Property line /61 "f Absorption field 5 14 . s Water main lQ /-f- Water service line /6 14' Surface water /dcr /1--- Wells 'tWells on adjacent lots /6 a ,r ABSORPTION FIELD ON LOT TO: Property line �Q i Building foundation , Water main /6 !-/— Water Water Service line / 1`f Surface water /dQ 1" Driveway, parking/vehicle storage Cr Curtain drain (`/t/iG Wells on adjacent lots 4a 6 /74 F. COMMENTS ' '/ 'Al I oil r= 0.4 /. _At- 1 P " 4ve: -croJ,Ji .s ,)rc-��ee_ G. ENGINEER'S CERTIFICATION I certify that I 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. `,' : '. Engineer's PrintedN me_____ ��� f�ALC . — Date /2-(' if r7 .,41-,' . .: COSA yellow sheet_2-6-15.doc a �i Yob h� • V\ •....vzy. I ti I . iir„,,F7' . ---), N4 t i y / ti / r..,.r t‘i )•.. V .$1. k i I / / -4 k Ai j 794 _ �� 1 34,-.....: lkd3 v/ I . ` / f • • \ .01.y.01 v . . //f • ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-082g I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALEj'.j 1 .��•vx\ FOLLOWING DESCRIBED PROPERTY: �_.. �� 3F a j� � AND THAT NO NMOAO EI EXIST ECM AS fZe�� �,••• s1- , INDICATED. IT IS THE RESPONSIBILITY OF THE . . ; 49 ..• OWNER TO DETERMINE THE EXISTENCE OF ANY GRID' 0- pa.Gf.: EASEMENTS, COVENANTS, OR RESTRICTIONS fP6ot WHICH DO NOT APPEAR ON THE RECORDED SUBDI- ij t0� CTATGMFAIT (1C IAICD=i`TIf1A1 DV CAIn IAICCM -•SMR If more than 1 septic system is on the lot: COSAChecklist#of_ Structure served by this system J_ Certificate of ®n -Site Systems Approval Checklist Legal Description: 'Kwl7�#jl�l� i (;pT v Parcel ID: ©SO S A. WELL DATA 7 Well type 1 5��7� If A, B, or C provide PWSID # NfA- Well Log Date completed tt Sanitary seal ®'N)_ Wires properly protected A) Total depth �qo ft. Cased to J-15—ft. Casing height (above ground) (a in. FROM. WELL LOG AT INSPECTION Date of test: VI'D/V�l Static water level t� Well production 3 g.p.m. f g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate &' 0L mg/L L j Arsenic 00 ug/L Date of sample: / /t � Collected by: (—botf GS &[7,&/'i h r B. SEPTIC/HOLDING TANK DATA Tank TypeWaterial �i'E Ir` 7x $rtzz/ Date Iliaa�f�##fed 16f -16 Tank size (boo gal. Number of Compartments � Cleano0 ! y ` Foundation cleanout jq/N)) /� Depression over tankk ((Y& A/a High water al (Y61 N0 Date of pumping S Pumper J` s G. ABSORPTION FIELD DATA Date installed Wj/ li 16 Soil rating (44dIOoV&WA) Q�2S4 Fr�j P system type TIZEVog Length oft,, Width 313 ft. Gravel below pipe Ll f S � ft. A Total dept 11 Eff. absorption area 1Y7Z ft2 Monitoring tube 1 L Depression over field NO Date ofisd YgQacy t (tD%(z Results as /Fail) For' bedrooms Fluid depth ie al porption field t%fore test2I 5, 3 in YFs ftr added 45d gal. New depth36 71 in. Elapsed.Time.~ fluid depth in. Absorption rate >= W 5© g.p.o. Any rejuvenation treatment (past 12 mo.) (YAT& type) A�Wir A t9P% l If yes, give date N/%i– D. LIFT STATION Nd Gd r r Date installed �4i/il`- Size in gallons Manhole/Access (YIN) A//A "Pump on" level at `�4 in. "Pump off" level at in. High water alarm level at IV16 in. Datum lUliY Cycles tested Meets alarm & circuit requirements?IVIA- E. SEPARATION DISTANCES WELL ON LOT TO: Septic t ank/lift station on lot t On adjacent lots j V Absorption field on lot ®mom On adjacent lots Public sewer main - fw Public sewer manhole/cleanout (dw Sewer /septic service line f �,� Holding tank -t1.0a Animal containment areas f (90 Manure/animal excrete storage areas Lm� SEPTIC/HOLDING TANK ON LOT TO: r. Building foundation `E5 / Property line fl� Absorption field 4 S Water main ELS Water service line fo Surface water Wells on adjacent lots Goon ABSORPTION FIELD ON LOT TO: . Property line Building foundation_ Water main 'FID Water Service line 1(0 Surface water 4 1,6 Driveway, parking/vehicle storage f Curtain drain Se. Wells on adjacent lotsf+ 0s F. COMMENTS 3E SEtW/}ly�P JZEOL)r-s?" jig LEALH YELb TC! L�A2Rl�C NiAT�C9RN - 6021FR5 TNSTA-I•LEi> 7-0 P2EV0A'T VE4tt2r, �-S<Oyo�I Se -Mite. * 5Y57 -AOI[ W45 PR €CHARaO WZ7 H R Le To 7-e57.' G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in �F •. qS�/♦ conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name L�/}R $M1 ` * : 7 4 „•... .. /c1a9lfo. Date I i ...... s ♦ 9 •Charles G. .0 t ��i��Rq•. �t1/1h ' COSA yellow sheet_2-6-15.doc Ullt It,,Wt , i I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALE FOLLOWING DESCRIBED PROPERTY= OF A 4. °a1 DATE - AND THAT NO El�ii'i EX T EXCEPT AS �r a /� S �t INDICATED. IT IS THE RESPONSIBILITY OF THE'4� s... ::... OWNER TO DETERMINE THE EXISTENCE OF ANY GRID= ...... .... ,� � EASEMENTS, COVENANTS, OR RESRICTIONS�„ WHICH DO NOT APPEAR ON THE SUBDI- ;¢ D.�. ryeA %.wt � M VISION PLAT. UNDER NO CIRCUMSTANCES SHOD! FIS t LS- I ANY DATA HEREON BE USED FOR CONtvMCTION OF PENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN V16104OMunicipality ®f Anchor o`f't .tPL I' P.O. Box 196650 ® 4700 Elmore RoadR Anchorage Alaska 99519-6650 ®(9071 343-7904 o Fax (9071 343-7997 ry I Department http://www.muni.oEg/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver-#: OSV161040 COSAM OSC161131 Permit#: PID#: 050-531-16 Legal Description: Eklund BL 4 Lot 6 Engineer: C&M Engineering_ Applicant: Schoonmaker Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the foundation has been approved. The approved separation distance is 3 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. X Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: 5 a' I Approved by: Name of Reviewer ............................................................................... C&M ENGINEERING SERVICES Ph: 907.8545558 Re: Eklund#1 Block 4, Lot 6 Dear Reviewer, We are requesting a waiver for the above referenced property in support of a COSA. The home is currently served by a functional septic system that was installed in the 1980s. We are requesting a waiver from the each drain fields, to the garage foundation, from the required 10 feet, to 3 feet. Each leg of the leach field was excavated for cleanout repair, and the leach field distribution pipe was observed to be below the foundation. The garage slab configuration makes it unlikely that a failed leach field could flood the garage. The leach fields have been encroaching on the garage for approximately 30 years, with no apparent negative impacts. Additionally, one of the laterals was installed in the driveway, directly in front of the garage doors, the other was installed along the edge of the driveway between the garage and the house. 4x4 timbers were installed to prevent vehicles from driving over the fields. Thank you for your time in reviewing these requests. Please do not hesitate to contact me via phone 907-854-5558, or at cbalzarinit�amaii.com, if you have any questions or concerns. Sincerely, Charles Balzarini, PE �cs5 �a &IZA07', f r APPLIC-`!T FILLS OUT UPPER HAL'" )NLY Time r r Property UWner �'7", ��!` , 194 $6W T- 614&e5lAl- � v� t4 t F69� A- t?r Mailing Address O� '3 3 / F (� j pfd' Zip Code 7 Date � � Buyer Address Zip Code Date Lending Institution /� 5. Phone Zip Code Address . r�^^ Realty Co. & Agent Gr=,v-�.i�y 1 /96r'i�!�.` (�EOk'�i; ..SH,�u/ Phone / +` + d4,f '��N del/G Zip Code -Z' Address Legal Description e, 77 C_ �1—�'�P"'/C!' ( ` rAPPROVED BEDROOMS 3 Street Location ;, L. 'CONDITIONS OF APPROVAL Type of Residence 4Single Family ( ) CONDITIONAL APPROVAL' ❑ Multiple Family No. of Bedrooms ❑ Other Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. 1>5 ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Well Log Received Septic Tank Size,,, Sewer Disposal Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date � � Date Date Date Inspector - Inspector Inspector Inspector Field Notes: / W r'� ( ` rAPPROVED BEDROOMS 3 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size,,, Well to Tank rL-UL'J (Jim) 'j , U 5. LEGAL DESCRIPTION T77 ZL MUNICIPALITY OF A4CHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTA"ICIpALITY OF ANCHORAGE ST EET LOCATION 825 L Street - Anchorage, Alaska 99501 DEPT. OF HEALTH 8, ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 1981 6. TYPE OFRE IDENCE Telephone -264-4720 MAR 2 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW rMVTD DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (1.0) day's for piocesebn9--' 1. PROPERTY OWNER ® Two ❑ Five ONE eA 7. WATER SUPPLY 0-c INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled MAILING AD KESS since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY J Lar PHONE PROPERTY RESIDE T (If dif eren f o r e f/ �.i . **If individual/on-site, give installation date . .. PHONE 2. BUYER A C/e ❑ PUBLIC UTILITY MAILINGADD S INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. NOTE: THE //ii /i 3. LENDING INSTITUTION PHONE JVKA MAILING ADDRESS lima— 0!2 4. REALTOR/AGENT PHONE oaj�ltli 0K MAIL]NG ADDRESS U 5. LEGAL DESCRIPTION ST EET LOCATION 6. TYPE OFRE IDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other ❑ SINGLE FA ILY ® Two ❑ Five MULTIPLE FAMILY Ilk Three ❑ Six 7. WATER SUPPLY 0-c INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date . ,1!nh INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. NOTE: THE 72-01013/781 1- 93 DAVID A. SLENKAMP ROBERT A. SHAFER t, I CHANICAL ENGINEE CIVIL ENGINEER 694-9055 694-297 i� rch 12, 19S MUNICIPALITY OF ANCHORAGE FgC�E RIVEftP pSKP DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAR 17 1981 Martin Maul c/o Sun Realty RECEIVED ATTENTION: Darlene Nicholaysell P.O. Box 1201 Eagle River, Alaska 99577 Dear Mr. Maul, Reference: Lot 6; Block 4; Eklund Subdivision A sewer system adequacy test was performed on the system located on the referenced property as requested by'Sun Realty. The septic tank was pumped and verified to have a capacity of 1000 .gallons. The absorption trench was tested by a continuous flow of water over a period of 48 hours. In the first 24 hours, 514 gallons of water was added irhile the elevation of the water in the sump came up two inches. During the next 24 hours approximately )AI gallons of water was added to the system with no additional measurable rise in the water level in the sump. It can be concluded from this test that the septic tank is adequate for your three bedroom residence. However, I regret to inform you that the absorption trench is only adequate for two bedrooms. It will be necessary for you to upgrade the system. If we may be of further service to you in arranging for your permit or upgrading of your system, please do not hesitate to contact us. Sinc'proly, %Z 7 �' ROBERT A. SHAFER� P.E. RASlss cc: The First National Bank of Anchorage ATTENTION: Mr. Bennet Municipality of Anchorage Department of Health and Enviornmental Protection SRS 196X EAGLE RIVER, ALASKA 825 "U' SIRE CT ANCHORAGE, At..ASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR OF HEALTH AND E.NVIRONNICN I Ai.. PROTECTION March 4, 1-981LP]�LPP6n Lq S J L-�' 4() LlS Va.IJ-4110. Martin/Karen Mall Box 465 Chugiak, Alaska 991567 Subject: Lot 6 Block 4 Eklund Sibdivision Approval. for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The wat ' er analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our review. �(2) The septic tank. pumped with a receipt-, submitted to c this office. VLA (3) An adequacy test needs to be 'performed on the existing leaching area. This test will determine if the SYStcM is adequate accordii.-ig to National Standards. A listing of private firi-tis performing the t.( -,St is enclosed. This report needs to be submittied to this department for our review. If there are any further questions, please call t1l.,is office at 264--4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist- RCP/ljw cc: Darlene Nicolaysen First National Bank of Anchorage % Sun Realty post office Box 4-2090 99509 Post office Box 1201 99577 m MUNICIPALITY OF'��iORAGE MEMORANDUM Date Signed