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Home My WebLink AboutNORTH WOODS UNIT 4 BLK 16 LT 17Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191330 PID Number: 051-064-32 Dwelling: R-11 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Dwayne and Linda Ray ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21430 Snowflower Lp Chugiak ❑ Other Phone Number of Bedrooms Soil Rating Total depth fro,j.onginal grade 719.482.5689 4 GPD/5F Ft. LEGAL DESCRIPTION Depth to pipe invert from ongiin1l-gAade r Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot North Woods Unit 4 16 17 Fill added`�aboveorigPndf grd6 "I Ft. Gravel length Ft. Township Range Section Gravel widt Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic (Absorption Lift Station Holding Sewer Total apsorption area Number of trenches Dist. between trenches From Tank Field Tank i Line FtZ Ft. Well + NA NA I NA NA NA TANK A Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water 100 NA ( NA (�q j Material plastic Number of compartments 2 Lot Line 11(Y NA I NA NA j NA Foundation110' NA I NA NA I LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Territory North Constructors Drainfield NA Co1MT D3034 Inspector Curtis Townsend, PE BENCHMARK (Assumed elevation) 100 ft Inspection 1 817/19 nd 8/10/19 Location and description dates:2 3`d 8/10/19 41 8/12/19 top of deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date,ts-.�� DaW � �� 's�F taa.c� 1904 Septic S stem��Fc' Se p Y ��% ��z Approved i� CJ' Date •.. •'� . Note: this approval does not include well permit requirements. (Rev 05/02/18) NEW 1250 GAL SEPTIC TANK— MARK A B FCO 9'-3" 5'-4" SVl 15'—B" 12'-2" SV2 19'-4" 16'-5" DC1 22'-7" 20'-0" DC2 23'-5" 21'-1 " THERE ARE NO STEEP SLOPES WITHIN 50' OF THE PROPOSED TANK. THIS PROPERTY IS SERVED BY AWWU AND THERE ARE NO WELLS WITHIN 200' OF THE SEPTIC SYSTEM. NEI BORING SEPTIC X APPROXIMATELY,,. 29' FROM PROPERTY LINE i RESERVE SEPTIC AREA SCOPE OF WORK 1. EXISTING SEPTIC TANK REMOVED. 2. NEW 1,250 GALLON PLASTIC SEPTIC TANK PLACED AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WITH MINIMUM 20" 0 MANWAY RISER SERVING THE FIRST COMPARTMENT. A TANK MONITORING TUBE WAS PROVIDED NEXT TO THE TANK 3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. As—built of Tank Replacement Prepared for DWAYNE AND LINDA RAY 21430 Snowflower Loop Chugiak, Alaska 99567 NORTHWOODS UNIT 4 BLOCK 16 LOT 17 OSP191330 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 355-9820 DATE: DRAWN: 8/13/2019 CLT SCALE: 1 " = 40' PID: 051-064-32 SHEET 1 OF 2 .��*��`1L►vjFil OF C ; • •'' �i ' 9TH �. ........................................... �. ............................ �.................. ..� 0, CURTIS TOWNSEND ' �a �♦�i�: No. E 1904 �• i AV SS\iw� �1kimm Z F O_ � O ~ ~ Q O O Z Z Z Q O D Li Z Z W ro OU Z W Z W � m Q Q J Q J D [.I ... As—built of Tank Replacement Prepared for EXISTING 60' x 30' BED, 6" ED SOIL RATING 290 SF/BR DWAYNE AND LINDA RAY 21430 Snowflower Loop Chugiak, Alaska 99567 NORTHWOODS UNIT 4 BLOCK 16 LOT 17 OSP191330 EKLUTNA ENGINEERING, LLC I DATE: 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 355-9820 DRAWN: 8/13/2019 CLT SCALE: 1" = 10' PID: 051-064-32 SHEET 2 OF 2 NOTES: 1. () RECORD DIMENSIONS PER PLAT 83-333 ARD. 2. UTILITIES OTHER THAN THOSE SHOWN MAY EXIST. 3. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY DATA SHOWN BE USED TO ESTABLISH ANY FENCE, STRUCTURE OR ANY OTHER IMPROVEMENTS. 4. ALL VISIBLE ABOVE GROUND FEATURES OF THE EXISTING SEPTIC SYSTEM WERE LOCATED AT THE TIME OF SURVEY AND ARE SHOWN HEREON. \ iG-) 49TH '.* r �� • ' Dayna M. Rumfelt �r • • No LS 13322 dW �f 1l ESSIONA P ASBUILT — NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF LOT 17, BLOCK 16, NORTH WOODS SUBDIVISION UNIT 4, PLAT NO. 83-333, ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE IMPROVEMENTS AS DEPICTED HEREON EXIST AS SHOWN IN RELATION TO THE PROPERTY LINES. EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON RECORDED PLAT No. 83-333 ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. DATE: 8/13/2019 FB: 2019-2 GRID: NW 1460 DRAWN: DMR C•7 SCALE: 1" = 40' I FILE: 19-040AB LOT 18 OO `9K •Oo �ss, \ NORTH WOODS SUBDIVISION UNIT IV I- s PLAT 83-333 LOT 17 BLOCK 16co rp s °� 0 SCALE 1" = 40' �o SHED /o o°°J O� s �s �OGyT�o J 68��'A 0, °3 \ i ASPHALT °> BLOCK PAHO f� / SGP is. 4,� LOT 16 DRIVEWAY / c� T.LL PME LEGEND O ks , A LES L._ F L J r1P LrMB FOUND REBAR SEPTIC VENT WATER VALVE STREET SIGN CABLE PEDESTAL ELECTRIC PEDESTAL TELEPHONE PEDESTAL ELECTRIC TRANSFORMER MAILBOX C N DER \ SURVEY & MAPPING 2890 S. BARNYARD CIR., WASILLA, AK 99654 DAYNA RUMFELT (907)301-5177 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP191330 Work Type: SepticTank Upgrade Tax Code Number: 05106432000 Site Legal Address: NORTH WOODS UNIT 4 BLK 16 LT 17 G:1460 Site Mailing Address: 21430 SNOWFLOWER LOOP, Chugiak Owner: RAY DWAYNE & LINDA FAMILY Design Engineer: TOWNSEND CURTIS This permit is for the construction of: ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: 8/8/2019 8/7/2020 21810 ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B� Issued By: Date: Date: 4 11111M P.O. � r @ C� � P.O. Box 196650 ® 4700 Elmore Road Anchorage Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section manr 1.)ep11rrFF}h111L-nt * * * * VARIANCE/WAIVED. REVIEW * * * * Waiver#: OSV191063 COSA#: Permit#:OSP191330 PID#: 051-064-32 Legal Description: North Woods Unit 4 Block 16 Lot 17 Engineer: Curtis Townsend Applicant: Dwayne and Linda RaV Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 8.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing absorption field only. Any fixture upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. :...............................................■.............................I Waiver is Granted: X Waiver is not Granted: (�vV�iopqDate: 0 I Approved by: 6JJ( Name of Reviewer ............................................... ■ ............................. ■ 1 **** VARIANCEMAIVER REVIEW **** EpLNNS MUNICIPALITY OF ANCHORAGE Development Services Department ,rl; Phone: 907-343-7904 On -Site Water & Wastewater Section '� Fax: 907-343-7997 ON-SITE SEPTIC[WELL PERMIT APPLICATION Parcel I.D. 051-064-32 Property owner(s) Dwayne and Linda Ray Mailing address 21430 Snowflower Loop Site address same Day phone 719.482.5689 Legal description (Sub'd., Block & Lot) NORTH WOODS UNIT 4 Legal description (Township, Range & Section) Lot Size 21,810 Sq. Ft. Number of Bedrooms 4 BLK 16 LT 17 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial El Single Family (SF) (w/wo ADU) Septic Tank El Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Lot line to field Distance: 8' I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature 6f property owner or authorized agent) Permit/Rush Fees: 0 P-5 Date of Payment: 3131 111 Receipt Number: 00 D Permit No. 65P191336 Waiver Fees: 2,2 -5 - Date of Payment: U3_ -ILI9 Receipt Number: 66 __�__7LUD Waiver No. (3311 1 G GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191330, Rebecca Carroll, 08/08/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191330, Rebecca Carroll, 08/08/19 . MUNICIPALITY OF ANCHORAGE ~ il :O 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 ~.~'~ ~'~'~.~ .~ ~¢; '~Ow, lPHONE I~NEW · ~ ~ UPGRADE MAI LING ADDRESS LEGAL DESCRIPTION LQCATION Well Absorption area Dwelling PERMIT NO. ~ ~._ ~) ~ DISTANCE TO: ~D GA~/I / ~ ~ . ~ ~ Man ufacturer ~ ~ ~,~ ~ Material ~"~¢ ~ / No. of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth ~ ~. ~-~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. aZ ~ Manufacturer =--~ Material Liquid capacity in gallons D Well Foundation Nearest lot line , PERMI~ NO. --~m~'~ No, oflJnes ~.~ ~/~kenath°feachJ~e'~/~'-y Total length ~lTe~. ~ Trench~idth.3c.~ inches Distance between lines ~ h ~ ~ Top of tile to finish grade/ ~ ¢/; ~ ~ Material beneath tile Total effective~bsorption are~ .... ~ ~ ~ ~ ~r'~- ~ inches /~OO ~ Length Width - Depth PERMIT NO. < P Type of crib Crib diameter ~ ~ Crib depth Total effective absorption area m ~ DISTANCE TO: Well Building foundation Nearest lot line m Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ~ ~, ~/~, ~ PiPE MATERIALS ~ ~ ~o SOIL TEST RATING , ~- ~ REMARKS ~J~ ~t~~ ~" / I APPROVED DATE LEGAL ~K '~, . OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ' ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~---~,5'~;( ~'/~"o'3 ~ ~- '~;'C,.'i -- ~ UPGRADE MAI LING ADDRESS LOCATION NO. OF BEDROOMS J Well Absorption area DweWing PERMIT NO. ~STANC~TO: ~ ~/~ / t / ~ 3 ~: Manufacturer ~, ~Or~:,~ ~ Material :. ~,,' / NO. Of compartments Liq. capacity in gaWons Inside length Width Liquid depth / ~. ~-O IF HOMEMADE: ~o ~ DISTANCE TO: Well DweWing PERMIT NO. ~ ~ ~ Manufacturer Material Liquid capacity in gallons ~ WeW Foundation Nearest lot line PERMI~.NO. No. of lines . Lenqth of each [be . Total length ~ Ice~ Trench .lOth Distance between lines ~ ~ Top of tile to finish gradeZ ~ ~ ~ -- Material beneath tile Total effectivegbsorption are¢ Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS APPROVED DATE LEGAL ~[ b' ' ' - gal L..f,~ I .... ).:)ATE!: 'r L.(:] T ,.. J. ,_..::. ,, MAX o':n ',hr' ,~' . L "T:. 17 [3L.,{]{:::l<: 16 ::[ ANPF", .~ ..:: , 11,4 DEF'TH 'TO F':!:F:'E B[YT'TOM (F:3":) G R A VIi!!:L DEi:F:'T H (F::'T 'I"OTAL DEi:F:'TH (F:"T'.) GRAVEL.. ~4 ].' ).')TH (F:']", GRAVEL V~3L.U!"!E (CU,, ]"ANK SIZE (GAL. S) SOIL FRAT:[NE~ (Sg)~F:'T., /BR TANK MUST ~...~z~ ~ .... L. EAST ::....,:::...,h~..CAL ":".' ..... ~'"" ¥ ....... ~", ........ " ' ' ......... ~"~ ................ ~ ............. I ..................... ~ .................................................. : I :i.q ii{T) :~ F:' F:> L. t C A N T: ALASKA ENVIRONIW~ITAL CONTROL SERVICL , INC. 12OO West 33rd Avenue. Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO CALCULATED CHECKED BY SCALF ~*~ OF DATE Il-- ~-~.~ DATE ALASK IUIRORmeRTAL CORTROL November 6, 19 Department of Health & Human Services 825 L. Street Anchorage, Alaska 99501 Dear Susan: This is in regards to Northwoods Subdivision p 16, Lots 16 & 17. In the spring of 1985, I performed soils tests'on each of these lots. There also had been a testhole done in February 1984 on lot 16 to 13 feet that was dry. On May 17, 1985, I inspected septic systems installed on both lots. On Lot 16 they installed a deep trench and on Lot 17 a shallow bed. Both systems were bone dry. These soil logs and inspection reports are enclosed. Recently, however, there have been some groundwater problems with various lots in Northwoods. So, before granting final approval for the Health Authority Approval on these lots, the MOA requested that testholes be dug near the septic systems in order to determine whether or not groundwater had come up in this area subsequent to the inspection. Therefore, four testholes were performed, with monitor tubes installed in all. A drawing is attached showing the location of these testholes. On Lot 17, two test holes were performed. One was done about 20 feet south of the bed, towards the road. This test hole was dug to 12 feet on 10/22/85 and originally was dry. On ~ 10/29 the water had seeped in to a depth of 7.5 feet, and on 11/6/85 it was stabilized at 7.5 feet. This testhole was done near the shallowest corner of the bed, where the original depth of the bed was only about 3 feet (See inspection report -- top of tile to finish grade was only 2 feet here°) Further, groundlevel at the monitor test location is about a ~l~. ~n'~' foot lower than at the bed, so even if the 7.5 foot water table were continuous laterally, it would be 4.5 feet below ~.~ ~! the base of the bed. However, a second testhole was done near this bed to the east, 16 feet from the bed, and here seeps that were at 14.8 feet on 10/29 stabilized at 11.7 feet on 11/6, well below the level of the bed. Therefore, it does not appear that groundwater is in any danger of being contaminated by the bed on Lot 17. The standpipes in the bed also proved to have no water in them. On Lot 16, a trench I1 feet deep was dug for the septic system. A testhole was dug about 40 feet south of this trench, in which some seeps from 8 to 12 5 feet were observed n · yo 10/22 which were at 9 feet on 10/29 and 8.7 feet on 11/6. However, 40 feet is really quite far away from the septic system, so a second test hole was dug only 10 feet from the 1200 LUesl 33r¢1 Aucnu¢, $uii¢ I~- Anchorage, Alaska 99503 ,(907) 561-5040 ALASKA t DUIRODITII DTAL CODTROL SI RUICI S, IDC. ~n§in¢¢rin§ 6 ~nuironrnentol StucJies November 6, 1985 Department of Health & Human Services · 825 L. Street Anchorage~ Alaska 99501 Dear Susan: This is in regards to Northwoods Subdivision Phase IV, Block 16, Lots 16 & 17. In the spring of 1985, I performed soils tests on each of these lots. There also had been a testhole done in February 1984 on lot 16 to 13 feet that was dry. On May 17, 1985, I inspected septic systems installed on both lots. On Lot 16 they installed a deep trench and on Lot 17 a shallow bed. Both systems were bone dry. These soil logs and inspection reports are enclosed. Recently, however, there have been some groundwater problems with various lots in Northwoods. So, before granting final approval for the Health Authority Approval on these lots, the MOA requested that testholes be dug near the septic systems in order to determine whether or not groundwater had come up in this area subsequent to the inspection. Therefore, four testholes were performed, with monitor tubes installed in all. A drawing is attached showing the location of these testholes. On Lot 17, two test holes were performed. One was done about 20 feet south of the bed, towards the road. This test hole was dug to 12 feet on 10/22/85 and originally was dry. On 10/29 the water had seeped in to a depth of 7.5 feet, and on 11/6/85 it was stabilized at 7.5 feet. This testhole was done near the shallowest corner of the bed, where the original depth of the bed was only about 3 feet (See inspection report -- top of tile to finish grade was only 2 feet here.) Further, groundlevel at the monitor test location is about a foot lower than at the bed, so even if the 7.5 foo~ water table were continuous laterally, it would be 4.5 feet below the base of the bed. However, a second testhole was done near this bed to the east, 16 feet from the bed, and here seeps that were at 14.8 feet on 10/29 stabilized at 11.7 feet on 11/6, well below the level of the bed. Therefore, it does not appear that groundwater is in any danger of being contaminated by the bed on Lot 17. The standpipes ~n the bed also proved to have no water in them. ~ On Lot 16, a trench 11 feet deep was dug for the septic ~F system. A testhole was dug about 40 feet south of this ~!~t trench, in which some seeps from 8 to 12.5 feet were observed ~h./~on 10/22 which were at 9 feet on 10/29 and 8.7 feet on 11/6. ~.?/ However, 40 feet is really quite far away from the septic .~ system, so a second test hole was dug only 10 feet from the 1200 LLJesl 33r~1 ~uenu¢, $uii¢ J~, ~nchor~§e, Alaska 99s03 ,/907) 561-50z10 trench, and it was dry to a depth of 15 feet on 10/29 and still dry on 11/6. The standpipe in the trench also is dry. Therefore, it appears that groundwater on Lot 16 also is in no danger of being contaminated by the septic system° Now, you may have noticed by the drawing that Test Hole ~4~ with water stabilized at 11.7 feet, is only 22 feet from this ll-foot deep trench° However, this is no cause for alarm. It is obvious that Test Hole #4 does not represent the true, laterially continuous water table; otherwise, one would certainly expect to find groundwater also around 11 feet at Test Hole #3, which is only about 30 feet away and downhill. Yet Test Hole #3 is dry to 15 feet. It appears that an isolated seep, possibly a misplaced pocket of water, was encountered at Test Hole #4 which does not go anywhere near the septic systems. Therefore, since the original soils tests were dry, the original inspections were,,~ry, and the recently dug test holes show groundwater to be at least 4 feet below the bottom of either septic system, we feel there is now no reason to withhold final approval of the Health Authority Approval for either of these two lots. If you have any questions please feel free to call. Sincerely~ Darcy ~/ev en s Engineering Geologist MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST · E~7 SOILS. LOG ~....~ PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 5 6 7 8 9 10 11 12 13 14 15, 16 17 18 19 20- COMMENTS SLOPE PERFORMED BY: ~.-~.r'~v~ 2-008 SITE PLAN WAS GROUND WATER S ENCOUNTER ED? ~O L O P IF YES, AT WHAT E DEPTH? '~ Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE /'~ { ,'~ % · TEST RUN BETWEEN ~ F.T AND ~' ¢ FT / 6i (minutes/inch) DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST S~)I LS' LOG f PERCOLATION TEST PERFORMED FOR: ~-~ LEGAL DESCRIPTION: DATE PER~:ORMED: SLOPE SITE PLAN TH I O EyTI ([ EE'f I 2 3 4 8 12 17 20 PERFORMED BY: ~.~.t'~t-1 ~/72-008 (6/79) WAS GROUND WATER S ENCOUNTERED? F~O L , E IF YES, AT WHAT ~ DEPTH? ¢ Reading Date Gross Net Depth to Net Time Time Water Drop 2 i o~ '~ .Y"I · O ~ (minutes/inch) PERCOLATION RATE TEST RUN BETWEEN FT AND L~. ~;' FT DATE: Use EPLANS MUNICIPALITY OF ANCHORAGE Development Services Department l' Phone: 907-343-79.04 On -Site Water & Wastewater Section -,_ Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-064-32-000 1 Expiration Date: 7/18/21 GENERAL, INFORMATION Complete legal description North Woods Unit 4 B16 L17 Location (site address) 21430 Snowflower Lp. Current property owner(s) Dwayne & Linda Ray Day phone 719-482-5689 Mailing address 21430 Snowflower Lp., 'Chugiak, AK 99567 Real estate agent: 2. TYPE OF DWELLING: n Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well Public Water System 0 Day phone 251-7587 TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic x❑ ❑ Holding Tank ❑ Fi Community ❑ N-1LMC' Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ w Date of Payment B O Receipt Number COSA # 05C 1913 ?a 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Eklutna Eng. LLC Phone 355-9820 Address 19162 Mountain Rd., Chugiak, AK 99567 Engineer's Printed Name Curtis Townsend, PE Date 8/12/19 6. DSD SIGNATURE ZLrEs t 7'oyvnsend System #1 Approved for bedrooms ��;• oaie >_;..5 r ; 2 . too, System #2 Approved for bedrooms FEss1` Disapproved Conditional approval for bedrooms, with the following stipulations: ON-SITE AND m TER z PROGRAM SE l By:poj�wA 66"." W� Original Certificate Date: R//5// 9 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 Legal Description: North Woods Unit 4 B16 L17 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) <1 years Tank type/material septic/piastic Measured operating fluid level in septic tank n/a 0 Standpipes/foundation cleanout per record drawing Date of pumping n/a D. ABSORPTION FIELD DATA Which system tested (date installed) 5/7185 ❑® ALL standpipes present per record drawing c Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ NIA — pressurized field 0 Monitor tubes go to bottom of effective. If not, state depth into effective Parcel ID: 051-064-32 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample ,�-b I C- Oa -i A- ( ( W U) M - C. LIFT STATION ❑ Required maintenance complet Age of lift station ,ye r"s Lift station material Comments: Adequacy test date 7/18/19 Results [7 Pass For 4 bedrooms Fluid depth prior to test 2.5/0 in Water added 630 gal New depth 4/1 in Elapsed time 1385 min ® Code -required soil cover over field Final fluid depth 2/0 in ❑ System presoaked Absorption rate 630 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) If es, anter date Gallons introduced gallons y Comments/Deficiencies: Final fluid numbers indicate the fluid change in the Northerly and Southerly most monitoring tubes. Checklist yellow sheet v G1 .A- 7 (', /�/ 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' Q Yes Community Sewer Manh_o1a6Gieanout > 100' r7 Yes if No ft'`�p ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if Na ftnvate Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if o ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields _ 00' Private Wells > 100' ❑✓ Yes if No ft Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Community Wells? 200' F/I Yes if No ft � ❑✓ Yes Manure/Animal Excreta Storage > 100' ft Community Sewer Main > 75' ❑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' Q Yes if No fit Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells? 200' F/I 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 ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 8 ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' E1 Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' M Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS See separation distances waiver (OSV191063) for the teach field to property line variance. 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. TH Cutts Tavms nd i '-�f�.• CaitC � 1 � N0. CE 11 �4 PROFESsioA COSA Checklist yellow sheet -)& IT y r N VT rl, 0)e, MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR ~ALTH AUTHORITY APPROVAL CERTIFICATE t. ,General Information Application Date -~/3o/~' %' (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) _ 3n o~ ~/,~ ~ ~ Applicants Name C3 K ~s~-{~, Telephone - Home Business is (check one) Le~!ng Institution ~ ; ~er/builder ~; Buyer ~; Other ~ (~plain)~ (d) Le~ding Institution ~ ~'~f~ '~.,~}'~]~iC Telephone .D~,~ -~,/~ (e) Real Estate Co. & Agent Address ./3~7-a Telephone~ ~ (f) Mail the HAA to the following address: 2. T_~of Residence Single-Family~ Number of Bedrooms 3. Water Sup 1~ Multi-Family~ Other (describe) Individual Well ~-~ Community ~ Public ~-~ Note: If community well system, must have written confirmation from the S~ata Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Note: If community well 'system~ must have written confirmation from ~he S~a=e Department of Environmen~al Conservation attesting to the legality and status. [Page 1 of 2] i; ~n$ineerin~ Firm Providin~ Inspections? Tests~ File Search? Data and Inform,~tion certified by my seal affixed hereto and as of the validation date shown below, that my investigation of' this Hem/th Authority Approval shows that the iwater supply ann/or wastewater disposal system is safe, functional and adequate for n~mber of bedrooms and type of structure indicated herein.. I further verify i'based on the information obtained from the Municipality of Anchorage files and from investigation and inspection, the on-site water supply ann/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and reg~la- in effect om ~he date of this inspection. Approval Approved\2or_~_~_bedrooms Approved~ Disapproved., Telephone Terms of Conditional Approval ~ M'O~tICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMgNTAL P~OTECTION (DHEI~) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ' ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENq)ENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DREP DOES THIS AS A COURTESY TO PUP. CHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN 0RDER TO SATISFY CEKTAIN FEDERAL AND STATE REQULRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN ~ PROFESSIONAL ENGINEER'S WORK. RR4/ej/D18 [Page 2 of 2] (DHEP SEAL) 7-19-84 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA)"UNI;'IPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) DEPT. OF HEALTH & CHECKLI ST- FEBRUARY 1984 ENVIRONMENTAL PROTECTION 264-4720 Legal Description: r r vrD Well Classification ~ If A. B, C, D.E.C. Approved (~N) ~V~N) Date Corn pleted Yield ~Static Water Level ~' -~-ump Sit At __ ICasing Heigh~ ~~ JEl~g in Conduit (Y/N) - Depression Around Wellhead (Y/N)~ Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sam pie Test Results ~'^ Comments : On Adjoining Lots ~-'-'¢ ~ ; On Adjoinin~ Lots To Nearest Public Sewer To Nearest Sewer Service Line on ; Date SEPTIC/HOLDING TANK DATA Date Installed Standpipes (~) Air-tight Caps Depression over Tank (Y/~:~ Pumping/Maintenance Contract on File (Y/N)- Holding Tank High-Water Alarm (Y/N) ~'~ Separation Distances from Septic/Holding Tank: 3-/'7'/'~5~ Size /~O No. of Compartments Foundation Cleanout ~/N) Date Last Pumpea ,/,-m ; for Temporary Holding Tank Permit (Y/N) ,Z Go --+- To Water-Supply Well To Property Line To Water Main/Service Line Course To Building Foundation '~ ' To Disposal Field To Stream. Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 5-/';, / ~, Width of Field ,~O Square Feet of Absorption Area Depresmon over Field (Y/~. Results of Last Adequacy Test ~ Type of System Design Length of Field .. (o ' Depth of Field ~ .¢-~ Gravel Bed Thickness / Standpipes Present ~/N) Date of Last Adequacy Test SeparationDistance from Absorption Field: To Water-Supply Well lo='--, To Building Foundation ~. ~' ' Lot /v~ To Water Main/Service Line /o I~ To Stream/Pond/Lake/or Major Drainage Course To Driye.~way, Parking Area, or Vehicle Storage Area Comments To Proper~y Line To Existing or Abandoned System on : On Adjoining Lots ~,, To Cutbank (if present) LIFT STATION Dallied Dimensions ~ , Size in Gallons'~"'"'--.~~ Manhole/Access (Y/N, ~ 'Pump On" Level at ~tn"( High Water Alarm Level at ~ ~ Ve Y/N) rested for . ~ Electrical Codes (y/N) ~..../~d~y Test. Meets MCI "' Check Permitted Bedroom Rating Against HAA Reques! ** I certify that I have checkea verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed . ~4.-,~.~. ~ Date Company /'fcc $ MOA No. Receipt No. ,3,_~ P3 70 Date of Payment Amount: $ Page 2 of 2 72-026 {11/84 ST ~ ~- oy AS-BUILT I hereby certify that I have surveyed the fo/lowing described Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the l~mperty lines and do not overlap or encroach on the property lylng adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, excepttransmissi°nas indicatedlines Orhereon.Other visible easements on said property Dated at Eagle River, Alaska ROBERT C. JOHNSON SCALE: Registered Land Surveyor No. 880-LS - 1" ,= ~ ~ Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694-~543 DEPT. OF EN%'IRON MENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR Telephone: (907} Address: 274-2533 Pws To Whom it May Concern: According to records on file in this office ~LY~L~IL~Yt_y Water System is in compliance with the State Drinking Water Regulations Sincerely,