HomeMy WebLinkAboutMANN BLK 1 LT 3Mann
Block 1
Lot 3
#020-041-19
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name ¢per
DISTANCES
TO
FROM
SEPTIC
TANK
ABSORPTION
FIELD
WELL
Address
WELL
11-10,��
7
_
Phone(s""),,
Permit No.
No. of Bedrooms
LOT LINE
.....
7,�-
LEGAL DESCRIPTION
_
Lot Block ,Subdivision Iv� J
_ A(
FOUNDATION3/✓—
f
Township, Range, Section
_
7 //J
/
AS -BUILT DIAGRAM (Show location of well, septic system, properly lines, foundation,
_ 'Zod
driveway, water bodies, etc.)
TANKS
L� LL•
SEPTIC ❑ HOLDING
Manufacturery�(/
1
Capacily m gallons
Material
No. of Comparimants
H5 L
c
LL
TYPE OF SYSTEM
❑ TRENCH ❑ BED W. DRAIN ❑ OTHER
Depth to pipe bottom from_% Total depth from original grade
-
original grade / ,r Z�ss/'FT FT
-3' ,#
Fill added above original grade Gravel depth beneath pipe
9 ��
�.i FT 1— FT
Gravel length Gravel width
510 FT FT
Total absorption area Distance between lines
00,
SO FT FT
Number of lines Soil rating Pipe �0
material
! 41rSO FT b303�
/o
��
JJy
Installer. / _" --- _ J r Date InstalledIke
i
WELLS
PRIVATE ❑ OTHER (Identifv)
r
Classification (A,B,C) Total Depth Cased toM NIC
FT FT DPT. )F EAI H &
Installer Dale Installed:
•lO
REMARKS: p�� !A 2 3',1
�ilFq�� ,
s s�
Aloom�
Scale:
/V/0it #A/ yiia� 437A.L -D
/
ENGINEER'S SEAL
Ingspections Perf
Inspections
Date:
I _ — cerlily that this inspection was performed according to all
Municipal and Stale guidelines in elleot on this dale:
Health Department Approval: Date:'
_11�d�'
72-013 (3/85)
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MUNICIPALITY OF ANCHORAGE
cum�
Department of Health & Human Services _~
825 L Street, Anchorage, Alaska 99501 343~4720 ''-~--
DN~SITE SEWER F!ERMIT
Permit Number: 880158 EnlargeWent
Date Issued: 0B/11/88 Engineer Designed
Owner Name: REBECCA ZANK:I:E Day Phone:
Owner Address: 6001 ELIZABETH ST, 345�1578
ANCHORA8E, AK 99516
Parcel Id: 020~041~19
Lot Le�al: Subdivision: MANN Lot: 3 81ock: J.
Section: 2 Township: 111\1 Range: 3W
Lot Size 90000 (sq"ft. " or acres)
Max BedrooNs: This Permit: 1 Tot�,-Al Capity: 3
SEPTIC TANK: Minimum total septic tank capacity: 1,000 gallons. Each septic
tank must 1-1av9 at la,ast 2 compartmcwOts" Depth to top C:)[ 5eptic tran k(s> < 4,0
feet requires insulation over tank(s)"
INSTALL PER ENGINEERS DESIGN A WIDEDRAIN TYPE ABSDRPTION SYSTEM
WITH A DIVERSION VALVE TO THE ORIGINAL SYSTEM" LENGTH: 44'
GRAVEL DEPTH: 3'; GRAVEL WIDTH: 5/; MAXIMUM DEPTH: 4.4/.
THIS PERMlT [S ISSUED FOR A 3 BEDROOM GINGLE FAMILY DWELLING
ONLY AND EXPIRES 12/31/88. NOTIFY DHHS OF ALL INSPECTIONS"
I CERTIFY THAT:
1" I am |amiliar with the requirements f, i,. Co sewers and wells as set
�orth by 1. 110 Municipality of Anchoragco (MOA) and the State W Alaska"
2" I will install the in accordance with all MOA codes and 1,egu1ations;
and in compliance with the dczsign criteria of this permit"
3" I will adhere to all MOA and State o[ Alaska requirements for the set back
distances from any existing well, w�stcot water digposal system or public
sewerage system on this or any adjacent or nearby lot,
4, I undepstand that this permit is valid For �,-A mkXitrium o� 1 bedrooms. I
also understand th�t the capac:ity of, the total system is 3 bedrooms and
any will re i n additional pcormit"
Signed: DATE: ���
..... ..... ... .... ... ...... ..... .....
(Owner> REBECCA ZANKIE
�
[ssued By:DATE: �~'/��'�P
_��.~�_-~~_ ~�~~�~ ,._�~~.... .... ...._�~�~~
�e
E� ALASKA 0f1U1R0WWAL C0nTROL SRICCS, IN.
5
a 6ngmeerinq & 6nuironmental Studies
SPECIFICATIONS FOR +\ _ IVEQTD E WASTEWATER TREATMENT SYSTEM
LOT 3, BLOCK 1, MANN SUBDIVISiOii
1.0 GENERAL
1 ... The clrnw ings , sheets 1 through 4, shn l l be a part of this
specification.
1.2 All materials and workmanship shall meet the requirements of the
Municipality of Anchorage, Department. of Health & Human Services.
(DIMS), the conditions of the permit, and all applicable rules and
regulations currently in effect.
L3 All e.levutions and depths are advisory and are to be verified or
modified in the field by a DHHS approved inspector,
1.4 It is the responsibility of the installer to adhere to approved
designs for installation, maintain Lhe specified separation
distances, and have the appropriate inspections.
1,5 If the installation is not inspected by an AECS engineer, AECS will
not be responsible fol the installed system. An engineer a!AECS
should be consulted prior to construction, to determine the number of
inspections that will be required_ and to explain what these
inspections will. involve,
2.0 SEPTIC SYSTEM
2.1 The existing septic tank may be used, if .it meets the capacity
requirements for the residence and the approval of DHHS. Olrler•
systems mets need tank integrity verified. IS not, then ;specifications
2.2 through 2.6 apply.
2.2 The septic tank shall be a. UPC approved two --compartment tank,
constI"ucted of 12 -gauge steel with bi.tumastic coatiIlg, set level
on undisturbed soil. and insulated with overlying; layer of 2 inch
burial type_ polystyrene-..
2.3 The septic: tank shall be a minimum of 5 feel: from the house
foundation, and a minimum of 5 feet from the absorption area.
2.4 The septic tank and drainfleld shall he a minimum of 100 :Peet from
any private well or body of water, 150 feet from Class C wells, and.
200 feet from Class A or B wells, unless otherwise specified. Tess
than the required separation distance must have prior approval or
waiver by Alaska Department: of Environmental Conservation (ADBC).
2.5 Piping shall be fitted with a mechanical watertight cald.er c"uplin?
of the inlet and outlet of the septic lank. Piping ;hall he l inch
ASTM D3034 or cast iron, sloped a minimum of 1/4 .inch per foot from
1200 West 33rd Auenue, Suite B • Anchorage. Alaska 99503.(901) 561.5040
the house to the -tank and i%_ inch per root from o.he tante to the
trench,
2.6 c,]eWoaVS Shall be installed as designated, capped with Our-t.igllt
ricin caps (Jim caps or cquivalent=), and extend a minimum of 2 feet
abOVe ground 1eVU11 .
2.7 if a lilt_ s -[W on is Shown on the drawings it shall be Anchorage
Tank or MOA approved. equal. (See attached specification,)
3.0 DRAINEIELD SYSTEM
3.1 The gravel for the drainfield shall be 0.5 to 2.5 inch, screened rock
with less than 3% passim; the 1200 Sieve. All substitutes must have
prior DIMS approval.
3.2 The bottom and side of the excavation shall he raked with the backhoe
}Made to ensure that it has not been compacted during excavation.
The bottom elevation shall be level.
3.3 Monitor standpipe(s) shall be placed as shown in the drawings. and
shaAl be rigid PVC ASTM D3034, or 4 -inch cast :iron. The section
shown with holes may be drilled 0.5 inch holes on the G inch centers
on opposite sides of the pipe, or a regular section of perforated
sewer pipe. clamped to a solid section. with either a no -hub coupling
or a solvent. joint. A rubber rain cap (Jim Cap or equivalent) Shall
be placed over the top of the pipe.
3-i The distribution ripe ;hall be A -inch rigid PVC with a minimum crush
strength of 1500 lbs or equal. All distribution pipes shall be laid
level.
3.5 if the final grade of the drainfield is less than 4 Peet above the
gravel, insulation is required using Dow extruded 'blue styrofoam
board or equal. There shall be 1 inch or insulation for every fool_
of soil less than the required 4 feet of cover, but there must be at
least 18 inches of soil cover even though insulation is used. The
solid pipe extending from the septic_ tarda or li& station to the
drainfield shall also have 4 feet of cover or an equivalent layer of
insulation to prevent freezing of the line,
3.G If insulation is not necessary, the gravel shall he covered with a
layer of nonwoven engineering fabric.
3.7 It is recommended that,the area excavated and the area in the
vicinity of the drainfield shall be planted with a white clover, red
Fescue WN or Kentucky blue grass.
VO INSPECTIONS
JA A minimum of three inspections are required fop in_tall W on of the
trench. The first inspection will be of the excavation to verify
that the insWilation AM be in the proper soil
4.2 The second inspection will be after placement of the gravel, monitor
standpipe(s) and distribution pipe to verify proper installatinn
before backfill.
.�.5
The third inspection shall he after the drainf_eld is backfilled and
the ground graded,
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ALL PEWRD
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CnRTIFTCATION
I hereby certify that thr, f;allotrin den-
(.,ribql property has been survgyaj ',y rnri
or under my d3.rect super:•is!nn;
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ARobert M. Schwa mw ,4r
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t^°' :3 i1L!)(,;1; 1 MANN Str9111trIS'oN �,� �`,ic� �U��r. Y
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Anc!Drage Recording Pre-inct, A?asa �, and
that the Amprovements situated therean are
within the property line, and do nr•t over_ N
lap or eric-ca^h or, thct prr.Prtrty I:Ong ad. �__•__-_-- _ _ _ _
Jacent therF+to, that nc ttnprovrrvents )n the F
adjacent pronerty mcroach on the premiso if�[:C1I/.)I— ,Kt f:-) LANP'.V[=Y(�Rr�
In que*tion and that thF<•e am ro ro*kdwavr, ;
transmisciior, Knees or other v;si.blr ease- Zj>>>1 (=A 1 �()TH AVE NUE_
Tt�rt.i on aaid propn^t} ex,:ent ar in-'.i^at#-.-i AK1(I1- C)pA E
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CnRTIFTCATION
I hereby certify that thr, f;allotrin den-
(.,ribql property has been survgyaj ',y rnri
or under my d3.rect super:•is!nn;
•• %. ewta'••a•uNl�wsw .•'
ARobert M. Schwa mw ,4r
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9 Fon''••.••••• -ko .m
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b OFFSS1ONAt`perlrl
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t^°' :3 i1L!)(,;1; 1 MANN Str9111trIS'oN �,� �`,ic� �U��r. Y
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Anc!Drage Recording Pre-inct, A?asa �, and
that the Amprovements situated therean are
within the property line, and do nr•t over_ N
lap or eric-ca^h or, thct prr.Prtrty I:Ong ad. �__•__-_-- _ _ _ _
Jacent therF+to, that nc ttnprovrrvents )n the F
adjacent pronerty mcroach on the premiso if�[:C1I/.)I— ,Kt f:-) LANP'.V[=Y(�Rr�
In que*tion and that thF<•e am ro ro*kdwavr, ;
transmisciior, Knees or other v;si.blr ease- Zj>>>1 (=A 1 �()TH AVE NUE_
Tt�rt.i on aaid propn^t} ex,:ent ar in-'.i^at#-.-i AK1(I1- C)pA E
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ALASKA ENVIRONMENTAL ADB Jy1an S 6�/ its i OH / 3 4T/
CONTROL SERVICES, INC.
SHEET NO. z of
West 33rd Avenue,
ANCHORAGE, ALASKA 99503 CALCULATED BY /,fetd DATE ?/a be
(907) 561-5040
CHECKED BY DATE_
ALASKA ENVIRONMENTAL JOB Alan', '5u6cl, L3 d �
CONTROL SERVICES, INC. SHEET NO. 3 OF
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503 CALCULATED BY �e DATE
(907) 561-5040
CHECKED BY DATE
SCALE MTs' —
r F IN SEAL
�P o s/ >
s . Municipality of Anchorage '�*,• TH : S� 4
DEPARTMENT OF HEALTH & HUMAN SERVICES R••j• • ••••....•or.. ;:;.
825 "L" Street, Anchorage, Alaska 99502-0650 }so • ••••.••0•o••.• JR
SOILS LOG —PERCOLATION TEST }, ROY C225i R.
''`�
L h �n�I
{ PERFORMED FOR:. �jP cc �aF-r a DATE PERF
Ii1W718B�.QSS���g�'
a�'MMtr,�.
LEGAL DESCRIPTION: /y/6'hn Township, Range, Section: 77/N 3 ser{ 7 spy
zs
DEPTH SLOPE SITE PLAN
13
14
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
_ Ile -5-
13
.S
Depth to Water After
Monitoring? $• � Date: —2/6z".-
Reading
2%" 8
Reading Date
•I
Net
Time
Depth to Net
Water Drop
Aij
y
2
) • r
".
II ''JJ"'
.S�nd Y+lih 5�iyk�
0.67
3
4--7-7-77
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s,
e,
�. 6
7
r"
ac �
8
r
p
13
14
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
_ Ile -5-
13
.S
Depth to Water After
Monitoring? $• � Date: —2/6z".-
Reading
2%" 8
Reading Date
Gross
Time
Net
Time
Depth to Net
Water Drop
/Yvc iv,i
s^
0.67
PERCOLATION RATE °?'s tminutesiinch) PERC HOLE DIAMETER .,...ir�_
L // �" �/ TEST RUN BETWEEN 3 FT AND FT
:OMMENTS 1��e4 (a /"/un 7ext' r2 I0 Wert i Jq a 1/' /�" 4 e
PERFORMED BY: !. R¢- •rl I
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
GRED ' R ANCHORAGE AREA BOR 'GH
010 Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME �hc'i' _ , 2A E MAILING ADDRESS 930 LL' 1'E' t/))q PHONE
LOCATION LEGAL DESCRIPTIONh n� /�/�/uy���
SEPTIC TANK:
DISTANCE NUMBER OF /
FROM WELL 1493 MANUFACTURER MATERIAL A 74 __COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH____ LIQUID DEPTH LIQUID CAPACITY � GALLONS.
TILE DRAIN FIELD:
/ TOTAL LENGTH
DISTANCE FROM WELL /042)_� FOUNDATION _NEAREST LOT LINE .jC? /' OF LINES '
NUMBER OF LINES- DISTANCE BETWEEN LINES -_VA TRENCH WIDTI-I.?K IN. TOTAL EFFECTIVE
ABSORPTION AREA -?C SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE _MATERIAL BENEATH TILE SIN. ABOVE TILE ��_IN.
WELit,
por'roSeof
TYPE _ _CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL -
APPROVED
OTHER SOURCES
_ DISAPPROVED _
DISTANCES:
INSTALLED BY:
0akr
SEWER LINE DEPTH: 176
PIPE MATERIAL: 04*YM&A?C' -
LOT SLOPE: S 7 -
REMARKS: gs
Form EQ -032
NEAREST SEPTIC
SEWER LINE , TANK_
REMARKS
DEPTH - DISTANCE FROM:
SEEPAGE
SYSTEM_
DIAGRAM OF SYSTEM
DATE 917- :�Y_2JAPPROVED
G.A.A.B.
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.
fQ'V'Af-
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GREATER ANCHORAGE AREA BOROUGHPERMITNO,
DEPARTMENT OF ENVIRONMENTAL QUALITY
€3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
N,t[O 1[M,'
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT
INSTAL-LATION LOCATION ,--
,-(}j -3
LEGAL DESCRIPTION `l
MAILING ADDRESS °\�l ("nl'l\ PHONE
5 .
INSTALLATION OF: SEPTIC TANK .__L -c --)C)-_ SEEPAGE-AkT
1� I
TYPE AND SIZE OF FACILITY TO BE SERVED
DRAIN FIELD _ OTHER
FINANCED THROUGH /� _ TO BE INSTALLED BY _— —
SOIL TEST RESULTS !", c` L(s>avt- ��-, ---- NOTE: THIS PERMIT IS NOT VALID WITHOU'P SOIL. TEST
COMPLETION DATE ANTICIPATED
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.
�iCj l'i TYPE
SEPTIC TANK SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK —Q(
1
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC 'TANK TO SEEPAGE PIT WALL
SEPTIC TANK\ ( SEEPAGE PIT ��-�� ! DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
l 6 (,) (
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
o(
C.-� .t9 -III-` ,1YY- 1�
SEEPAGE 'XRJ-'A SIZE 3 �-y\'
SEEPAGE PIT/ o o —•
ALSO CONSIDER AREA WELLS.
—. SEEPAGE PIT 0 ( .
f
SEPTIC TANK, ` / p `� E1 . SEEPAGE PIT G � DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEETINTO 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 4DI G INSTALLATION.
7
G.A.A.B.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AR : BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE —1 -
FORM NO. EQ -016
■■■■■■
■
Ion
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AR : BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE —1 -
FORM NO. EQ -016
ice. FAIR ABAG
FAIRBANKS
CONSUL'I'ANTS, INC- JUNEAU
249 EAST SIST AVENUE • P.O. BOX 6087 • ANCHORAGE, ALASKA 99503 • 'TELEPHONE 907-279-0483 a TELEX 090-38419
I�IL�
March 20, 1975 R & M No. 562003
Peter Zankie
830 West 26th Avenue #4
Anchorage, Alaska 99503
Re: Test Hole 2. and Soil Log for Sanitary System, Lot 3, Block 1
Mann Subdivision
Dear Mr. Zankie:
In response to your request we have completed a second test hole
at the subject site. This second test hole was placed on a slightly
elevated bench located in the center portion of the lot. The
purpose in completing this second boring was to identify soil
conditions and to verify the present level of the perched ground
water table at this location. This investigation was performed
in accordance with your request of March 19, 1975, and those
procedures outlined in a letter dated December 19, 1974 by Mr.
Rolf Strickland of the Greater Anchorage Area Borough Department
of Environmental Quality.
The second test hole was put down within the center area of
Lot 3 for the purpose of defining general subsurface soil con-
ditions for the proposed sanitary system. Excavation was accom-
plished with an auger type drilling rig and the test hole was
extended to a total depth of 20 feet below ground surface. Samples
were recovered from various depths in the test hole and retained
for grain size analysis. The results of the sample analysis
are enclosed. The final log prepared for the test hole has been
included on Drawing A-02.
A perched groundwater table was encountered in the test hole
at a depth of 10 feet below existing ground surface.
We appreciate being given this opportunity to be of service
to you. Should you have any questions with regard to the above,
please do not hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
James W. Rooney
Vice President
JWR/nt
xc: GAAB
T <H. 2
3-19-75
^,j ORGANIC MATERIAL
0 0
pj
.Op _
0 0
o
O
0 0,
1
°ao SANDY GRAVEL, TRACE SILT (GW)
�' Brown
o�
0 0
o SCATTERED COBBLES FROM 5' to 9.5'
6
0•A
10.0' — o
W.D. 0 2
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e'a•
0� SANDY GRAVEL, SOME SILT (GW -GM)
0 oo Brown
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s
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,a
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S6.S. Refusal on cobble
0.0'
9.0'
20.0' T.D.
Log of Test Boring
Peter Zankie Property
Lot 3 Block 1 Mann Subd.
FZAnchorage, Alaska
Engineering & Geological Consultants Inc.
ANCHORAGE FAIRBANKS ALASKA JUNEAU
DATE 3-20-75 SCALE 1" = 31 DWN BY RFi CHKD BY JWR PROD. NO. 562003 )WO NO. A-02
42273
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3330 n[" SirccL
Anchorage, Alvsko 99�0J
S0O'3 1,0<| |`EROiJ\7lONTEIST
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Performed for )_/Zte,
Legal Description:
This form reports: SoilslO � PCrcOlat10n
Uepth �
[88t
7~ .
U~ '
9-
lU
]] ~
]4 -
Was ground water encountered? If yes, at wilalt depth? jo
- . - -- -rDa t
- - - - --_~ _�����- -
-adiny Date- Gross Time Net Time
Depth to Water | [let. UrOp
rate m1nVte.
�`'-`�~`�—
,Proposed Drain Fic�dr0pOSu� inSCJllat1on: �eupag8
Depth of {nle t � Depthtolbntt00 of Pi ur CrenC|/
COMMTS:
' `_-_--___-^^-_--'-~-.�-~--___�_~-�-__^--
-'� ifi�J Uv� J8���
PC7fVn��� �cr� , �
UQ-040 (6/74)
MUNICIPALITY OF ANCHORAGE
Development Services Department K
4n -Site Water &Was#ewater Section - Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-041-19
I. GENERAL INFORMATION
Expiration Date: (r,(j,(
Complete legal description MANN BLK 1 LT 3
Location (site address) 6001 E 162ND AVENUE, ANCH AK
Current property owners) COUGHLIN
Day phone
Mailing address SAME
Real estate agent
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
0
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 $ -550
Date of Payment 3 G�
Receipt Number d ��
COSA # O S
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 MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E. Date 3/14/22
6. DSD SIGNATURE
System #1 Approved for S
• •49TH a ...
bedrooms '
"J 0HAEL
System #2 Approved for bedrooms. rg cl - s 4 y
Disapproved
ti l
Conditional approval for bedrooms, with the following stipulations.
ll
ON -SI
:fr=R AND
STtv�'ATER o
pROGF" '
J
Q \\
BY
Original Certificate Date: q6a 0 _Pa
I
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist
Legal Description: MANN BLK 1 LT 3
If more than 1 septic system on lot: COSA Checklist # _of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled UN
Total depth >40+ ft
Cased to UN ft
Parcel ID: 020-041-19
Structure served by this system
Well production at time of test 4+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes No
❑� Coliform bacteria is Negative
0 Sanitary seal is functioning correctly Nitrate *10.2 mg/L ❑ Nitrate less than MRL (ND)
0 Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL (ND)
Casing height (above ground) 12 in. Collected by MNA
Date of flow test for COSA 2/23122
Static water level at beginning of test 11 ft.
Comments * well was checked with a camera with no issues..
B. TANK DATA
Age of tank(s) 47 years
Tank type/material STC ag
Measured operating fluid level in septic tank 48
0 Standpipes/foundation cleanout per record drawing
Date of pumping 3/21/22
D. ABSORPTION FIELD DATA
Which system tested (date installed) 197%1999
0 ALL standpipes present per record drawing
Total measured depth from grade .5.9 ft (max)
Measured depth to pipe invert from grade 3.9 ft (min)
❑ N/A — pressurized field
❑EI Monitor tubes go to bottom of effective. If not, state
depth into effective
❑� Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced 0 gallons
r.nmmPnf4/nPficienniAR'' 1988 SYSTEM TESTED
COSA Checklist yellow sheet
Date of Sample 2/23/22
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 2123122
Results ❑✓ Pass For 3 bedrooms
Fluid depth prior to test 5 in
Water added 450 gal
New depth S in
Elapsed time 1440 min
Final fluid depth 5 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
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'
M
Yes
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No
ft
Q Yes
if No _ ft
Neighboring Tank > 100' ❑v Yes
if No
_ ft
Private Sewer/Septic Line > 25' ❑✓ Yes
if No _ It
Absorption Field on Lot > 100'✓❑ Yes
if No
_ ft
Holding Tank > 100' Yes
if No _ ft
Neighboring Absorption Fields > 100'
❑Q Yes if No _ ft
Water Main > 10'
Animal Containment > 50' ❑✓ Yes
if No _ ft
❑v Yes
if No
ft
Yes if No _ ft
Water Service Line > 10'
Yes
_
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' 2] Yes
if No
_ ft
FZ] Yes
if No _ ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
M
Yes
if No _
ft
Surface Water > 100'
❑ Yes if No *65 ft
Property Line > 5'
v❑
Yes
if No _
ft
Wells on Adjacent Lots:
(]
Absorption Field > 5'
Q
Yes
if No _
ft
Private Wells > 100'
❑Q Yes if No _ ft
Water Main > 10'
❑v
Yes
if No _
ft
Community Wells > 200'✓❑
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 _
ft
Wells on Adjacent Lots:
Water Main > 10'
(]
Yes
if No _
ft
Private Wells > 100' ❑✓ Yes if No _ ft
Water Service Line > 10'
Yes
if No _
ft
Community Wells > 200' ❑✓ Yes if No _ ft
Surface Water > 100'
❑
Yes
if No *55
ft
F. ENGINEER'S COMMENTS
* SFF MOA WAIVFR
G. ENGINEER'S CERTIFICATION
1 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.
COSA Checklist yellow sheet
A!
49.... � v
E
.ca NUCAAR N. A\CLR'CI.J '6
t+�
C-
} G9
. �;•v
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Nitrate Advisory
Certificate of On‐Site Systems Approval # OSC221097
Subdivision: Mann, Block: 1, Lot: 3
A water sample revealed a nitrate concentration of 10.2 milligrams per liter (mg/L).
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.
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Nitrate Fact Sheet
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 medi a 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.
April 5, 2022
Municipalities of Anchorage
On-Site Water and Waste Water Section
4700 Elmore Rd
Anchorage, Alaska
Phone 343-7904
Re: Well repairs
Legal: MANN BLK 1 LT 3
To whom it may concern:
Per your request the existing well was excavated around the casing to a depth four
feet and a bentonite plug was installed around the casting. Due to the high nitrite
levels found recently in the water analysis this plug was done to better seal the well
from any contaminates due to animal feces or lawn fertilizer reaching the well water.
The existing soil around the well was also raised to prevent any surface water from
reaching the casing.
Sincerely
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
Hefty Drilling Inc. Date: 3-22-22
3540 Akula Dr. Anchorage, AK 99516
(907) 345-0593 Site:6001 E. 162nd Ave.
heftydrilling@aol.com - e-mail
www.heftydrilling.com - website
Well Camera Inspection Report
Well Cased 40’+ - only cased 28’
Casing breaks or leaks above 40’ – n/a
Well head stick up 18” - yes
Condition of well cap & conduit - good
Comments: being only cased to 28’ well could have influence from surface water.
Inspected by:
Johnny Kay
…………………………….
u Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
CERTIFICATE OF ON—SITE SYSTEMS
Parcel I.D. 020-041-19
1. GENERAL INFORMATION
Complete legal description MANN; BLOCK 1, LOT 3
Expiration Date:
Location (site address) 6001 E. 162 AVE. *ANCHORAGE, AK
Current Property owner(s) TOM & MICHELLE O'BRIANT Day phone (261)701-5256
Mailing address 6001 E. 162 AVE. *ANCHORAGE, AK
Real Estate Agent LEIF HERRINGTON Day phone 980-6248
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
Individual Water Storage
❑
Individual Holding tank
❑
Community ClassWell
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
WaiverNadance request troy. SEPTIC TAjNKK&& DRAINFIELD To SURFACE WATER, DRAINFIELD TO SLOPES >25%
Distance: 65'. 55% 0'
16,
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5I2- !O Waiver Fee $
Date of Payment UJ .[3111(4 Date of Payment
Receipt NumberU'' ``y�a'
I aI(-) Receipt Number G ®�d
COSA# �CAP lP6 Waiver# oroy11/7111 /
5. STATEMENT OF INSPECTION BY ENGINEER
As certified bMy_sea6:qfFixed 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, l 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
Address 3701 E. TUDOR ROAD, SUITE 101 "ANCHORAGE, AK, 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date
Engineers Comments:
In conducting this evaluation, GEG provided an engineering evaNalon ofthe we'lamdbrnplicsystem in aooNancewm the
guidelines and regulations established by the Munidpalif y of Anchorag a and industrypractices. The repotted results desWbe the
condition ofthe systeMs on the dafels oflhe evaluation. Separation dislances were measured to readgyidena5able features.
Hidden defects or encroachments may exist that were not identified during the evaluation. Theoperaficnallife Use wells andsepgc
systems depend on a vansfyofvanables including, but not limded to, sal conditions, gmundvefertevelsilhafmayauduale during
the yea), quality ofcondmctim (malenals and workmanship), and the waferusageoftha familyutilizing the systemrs. These
conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarenteekdurepedonmaceoflhe
syslem/s; therefore. GEG makes no wanumly (express orimplfed) regardng the fnumpedornance oflhe wa'I orseph'csyslem.
GEG makes no represenfefion whelheran affemative wellor septic system can be installedon the propertyinihe eventati erofthe
current systems fail. The content of this report is for sole benefit oflhepersoiVpanywhomfaaned GEG. Rdiano upon the
information provided in this report by any olherperson orparty, including hulnotlinBedlosubsequentprWgypurchwm is not
authorized.. In short, GEG disavows any legal duty to anyone otherlhm lheperso *adywhopa'dforthismpan.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
337-6179
System #2 Approved for bedrooms.
Disapproved.�\QQLA\( fOF41i,1
J y0"
Conditional approval for bedrooms, with the following stipul�ta s: ON-SITE S'
WATER ANn
WASTEWATER
Original Certificate Date: ro-2'S —
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 ofAfaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 10112112)
Nitrate Advisory
r
Arsenic Advisory
Other
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: MANN; BLOCK 1, LOT 3 ParoellD: 020-041-19
*PER AAROW PUMP & WELL SERVICE 2012 INSPECTION REPORT
A. WELL DATA *"PER SURROUNDING WELL LOGS, ASSUMED CASED TO BEDROCK
Well type PRIVATE If A, B, or C provide PWSID# N A
Date completed UNK Sanitary seal (Y/N) YES
Total depth *40+ ft, Cased to ** ft.
FROM WELL LOG
Date of test
Static water level YIE�� VOG ft.
Well production /NO —
g -p.m -WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml.
Arsenic: ND ug./L.
B. SEPTICIHOLDING TANK DATA
Nitrate ND mg./L.
Well Log (Y/N) NO
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
Date of sample: 4/28/2016
4/28/2016
4.7+ g.p.m.
Collected by: GEG. Ltd.
Tank Type/Material
SUNSET PLASTIC
Date installed
6/16/1975
Tank size 1000 gal.
Number of Compartments 1
Cleanouts (Y/N)
YES
'Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YM) N/A
Date of pumping 4/27/2016 Pumper AROUND THE CLOCK PUMPING
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE NORTH (1975)
6/16/1975 80 SOUTH (1988) TRENCH
Date installed 8/1$/1988 Soil rating (g.p.d./Wo bd 1125 System type WIDE TRENCH
45 3 3
Length 56 ft. Width 5 ft. Gravel below pipe 2 ft.
'5.1 270
Total depth .9 ft. Eff. absorption area 400 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 4/28/2016 Results (Pass/Fail) PASS
For E bedrooms
Fluid depth in absorption field before test **0 in.
Water added 706 gal
New depth
**7 in.
Elapsed Time: 30 min. Final fluid depth
**1 in. Absorption rate >=
450+
g,p,d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
TESTED NORTH (1975) TRENCH IN USE. SOUTH (1988) TRENCH WAS DRY UPON INSPECTION,
HOWEVER, ABSORPTION RATE IS UNKNOWN.
**NORTH (1975) TRENCH'S MT ONLY EXTENDS 1.43 FEET INTO EFFECTIVE, HOWEVER, THE LIQUID
LEVEL WAS BROUGHT 7 INCHES INTO THE MT AND DID NOT RISE FOR THE FINAL 418 GALLONS OF
THE TEST.
D. LIFT STATION
Date Installed Size in gallons
"Pump on" level at in. "Pump ofr
E. SEPARATION DISTANCES
Manhole/Access
water alarm level at in.
Cycles tested Meets alarm S circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilift station on lot 100'+
Absorption field on lot 100'+
Public sewer main
Sewer/septic service line za +
On adjacent Iota 100'+
On adjacent lots 100'+
Public sewer manhole/deanout 100'+
Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water *65'
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water *55' Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*SEE ATTACHED WAIVER REQUEST
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records drat the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Data l jig
(Ray.1IMM
30'
THREE Sri
_.._ _WOOD i
HOUSE
71.z•
WY
me 14
MANN
WACWY
J' 2s' CM Wal. SUBDIVISION;
PAD T
W L
I OT 3
4 A
Y
Smy t'
3rd 5]DkY '� �"'• 1 ' '
OGGK �
.�.4,y 4• •'•i ,
d �s
01 0 Ch '' PLAT 65-105)
5TANOfN4 WAM9
LEGEND
XX XX XX
MEASURED DATA
(XX XX XX)
RECORD DATA PER
O
PIAT 65-105
QBLOCK
NUMBER
0
14?'
osv
SEPTIC VENT '
Pon
WATER WELL
545r 300.00')
'blb'
AQ.rR'QA^c 000 co+
WY
me 14
MANN
WACWY
J' 2s' CM Wal. SUBDIVISION;
PAD T
W L
I OT 3
4 A
Y
Smy t'
3rd 5]DkY '� �"'• 1 ' '
OGGK �
.�.4,y 4• •'•i ,
d �s
01 0 Ch '' PLAT 65-105)
5TANOfN4 WAM9
;5'0
°
162nd STREP
------------
AS—BUILT
I hereby certify that I have, or someone under my supervision
has, inspected the property described as:
LOT 3, BLOCK 1
MANN SUBDIVISION
(PLAT No. 65-105)
Anchorage Recording District
The imyrovements situated thereon are within the property lines
and do not encroach or overlap onto adjacent properties, nor do
any Improvements from adjacent properties encroach or overlap
onto this property, except as Indicated hereon.
No lot aaners have been se/. The property di:aemlans th.,n oro from the r.cold
plat and ala mai neCeeaYYliy as H MY Flava nlaeYgd. N ilgvroeflent Ieeatlaae are - - opp%osienta .cd"nava home daterla ned d(y to the .atant that amgbles " to deter....
it there are any exreaehsents ,to or off of the let. crafting and rapraduotion
my and
no,
inconsistencies; therefore staking should not he attempted to
dow'" club. ainiesi.m. Tnid dravring is not adequate for addliionsi
Z construction or for determining too exact location of property line., city
...saints iron the recorded subdivision plot noted above are ehoen maroon and it is
the reaponslbl Rfy of tom
he en 10 deternime P .ny at her colonel., covenants, ar
restrictions .slot.
dmcllntaak Land.. --tem. Ins. fuel 9N1
0 25 _.. _y0- - 75._.. 100
5CAL.E
LEGEND
XX XX XX
MEASURED DATA
(XX XX XX)
RECORD DATA PER
O
PIAT 65-105
QBLOCK
NUMBER
0
ELECTRIC METER
;5'0
°
162nd STREP
------------
AS—BUILT
I hereby certify that I have, or someone under my supervision
has, inspected the property described as:
LOT 3, BLOCK 1
MANN SUBDIVISION
(PLAT No. 65-105)
Anchorage Recording District
The imyrovements situated thereon are within the property lines
and do not encroach or overlap onto adjacent properties, nor do
any Improvements from adjacent properties encroach or overlap
onto this property, except as Indicated hereon.
No lot aaners have been se/. The property di:aemlans th.,n oro from the r.cold
plat and ala mai neCeeaYYliy as H MY Flava nlaeYgd. N ilgvroeflent Ieeatlaae are - - opp%osienta .cd"nava home daterla ned d(y to the .atant that amgbles " to deter....
it there are any exreaehsents ,to or off of the let. crafting and rapraduotion
my and
no,
inconsistencies; therefore staking should not he attempted to
dow'" club. ainiesi.m. Tnid dravring is not adequate for addliionsi
Z construction or for determining too exact location of property line., city
...saints iron the recorded subdivision plot noted above are ehoen maroon and it is
the reaponslbl Rfy of tom
he en 10 deternime P .ny at her colonel., covenants, ar
restrictions .slot.
dmcllntaak Land.. --tem. Ins. fuel 9N1
0 25 _.. _y0- - 75._.. 100
5CAL.E
'4LEGEND
O
FOUND i' IRON PIPE
0
FOUND 5/8' REBAR
0
DIVERTER VALVE
osv
SEPTIC VENT '
Pon
WATER WELL
;5'0
°
162nd STREP
------------
AS—BUILT
I hereby certify that I have, or someone under my supervision
has, inspected the property described as:
LOT 3, BLOCK 1
MANN SUBDIVISION
(PLAT No. 65-105)
Anchorage Recording District
The imyrovements situated thereon are within the property lines
and do not encroach or overlap onto adjacent properties, nor do
any Improvements from adjacent properties encroach or overlap
onto this property, except as Indicated hereon.
No lot aaners have been se/. The property di:aemlans th.,n oro from the r.cold
plat and ala mai neCeeaYYliy as H MY Flava nlaeYgd. N ilgvroeflent Ieeatlaae are - - opp%osienta .cd"nava home daterla ned d(y to the .atant that amgbles " to deter....
it there are any exreaehsents ,to or off of the let. crafting and rapraduotion
my and
no,
inconsistencies; therefore staking should not he attempted to
dow'" club. ainiesi.m. Tnid dravring is not adequate for addliionsi
Z construction or for determining too exact location of property line., city
...saints iron the recorded subdivision plot noted above are ehoen maroon and it is
the reaponslbl Rfy of tom
he en 10 deternime P .ny at her colonel., covenants, ar
restrictions .slot.
dmcllntaak Land.. --tem. Ins. fuel 9N1
0 25 _.. _y0- - 75._.. 100
5CAL.E
Municipality of Anchorage
P.O. Box 196650 a 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 a Fax (907) 343-7997
http:11www.m u n i.org10nsite
Development Services Division
On -Site Water and Wastewater Program
��pcnr
�. Depau!III ell t r
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV161061 COSA#:OSC161204 Permit#:
PID#: 020-041-19
Legal Description: Mann, Block 1, Lot 3
Engineer: Garness Engineering Group
Applicant: Tom & Michelle O'Briant
The following separation distances are approved.
1. 55 feet between the drainfrelds and surface water.
2. 65 feet between the septic tank and surface water.
3. 0 feet between the drainfields and a 25% or greater slope.
This waiver approval applies to the existing septic system 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: (� a ( (� Approved by: Po Y, U -w•
ame of Reviewer
............................................... V ...............................
GARNESS ENGINEERING GROUP, Ltd
-- --- CIVIL& ENVIRONMENTAL ENGINEERS
June 2, 2016
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
.Ranks
Adla'11c0 J 0f vcvu S"AIM
o -
Ref: Mann; Block 1, Lot 3 -Waiver Request-Drainfield to Slope Greater than 25% and Drainfield
and Septic Tank to Surface Water
To whom it may concern:
The existing drainfield is approximately 60 feet from surface water and approximately 5 feet from
43% slopes. The existing septic tank is approximately 70 feet from surface water. We request that
your department issue a 55 foot variance from drainfield to surface water, a 65 foot variance from
tank to surface water, and a 0 foot variance from drainfield to 43% slopes. Justifications for
granting these waivers are as follows:
DRAINFIELD TO SURFACE WATER & SLOPES GREATER THAN 25%:
-The encroachment has existed for approximately 28 years.
-No daylighting was observed on 4/28/2016.
-The area between the drainfield and surface water is highly vegetated.
SEPTIC TANK TO SURFACE WATER:
-The encroachment has existed for approximately 41 years.
-Tank material is plastic (fiberglass).
-The area between the tank and surface water is highly vegetated.
There appears to be minimal risk in granting this waiver. We are unaware of any existing adverse
impacts associated with this encroachment. Please call or email if you have any questions.
3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
71.2'
�-) -) DRAINAGE
O
Z0
20 3' 28.6'
O 5U
3rd 5/OO'
DECK
l5 oas sok A (PLAT 65-105)
�o.
TANDING WATee
LEGEND
XX XX XX MEASURED DATA
LEGEND
FOUND 1" IRON PIPE
Municipality of
Anchorage
Development Services Departn
Building Safety Division
On -Site Water and Wastewater Program
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. 020-041-19 COSA #_ Is /c2/a C/9
1. GENERAL INFORMATION Expiration Date:
Complete legal description Mann S/D Block3. Lot 3
Location (site address) _6001 East 162nd Avenue Anchorage, AK gg516
Current Property owner(s) Ronald & Rebecca Cothren Day phone 345-1578
Mailing address
Lending agency
Mailing address
6001 East 162"d Avenue Anchorage AK ggs16
Day phone
Real Estate Agent Mary Cox/ReMax Day phone 2W-0112
— — -----Mailing Address marvcox(a)alaska.net
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: I
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
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 Pannone Engineering Services, LLC Phone 272-8218
Address P.O. Box 100217, Anchorage, AK gc)Sso
Engineer's Printed Name Steven R. Pannone, P.E. Date 8/sg/11
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water����� OF � 11
levels that may fluctuate during the year, and the water usage of the family being served by the system. ��P*�•^••••••• q
��gSO
These conditions are outside the control of the evaluator of this system. All systems eventually fail and . C, • '`C9
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that ,H
49— /V •2'� ��
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future �..... ••• ••••• ••••••••.....0
performance nor give any estimate of how long the system will continue to meet the operational 0 , ..
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed R. Pannone/
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it �1� No. CE 8149
confer any legal right whatsoever. ��., ,,.•'F'�
5. DSD SIGNATURE pe_ rrcc...
__LZ Approved for , 3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Ariacnmenls:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: `r s �� Z Original Certificate Date: 7 — a — IC2
(Rev. 1
e
Municipality of Anchorage °
Development Services Department
Building Safety Division
'On -Site Water & Wastewater Program
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: Mann SID Block i Lot z Parcel ID: 020.041-zg
A. WELL DATA
Well type P i
Date completed _:v-_19 g0
�(:Jbed �-o
Total depth )j_ft.
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to 4S+ ft.
Well Log (Y/N)
Wires properly protected (Y/N) Y
Casing height (above ground) min.
FROM WELL LOG AT INSPECTION
Date of test 8/i5hoiz
Static water level j� ft. 22.5 ft.
Well production r g.p.m. 1.7+ g.p.m.
WATER SAMPLE RESULTS:
Coliform I , colonies/100 mL Nitrate v�mg/L
Arsenic: +V VJug/1 Date of sample: aaaz Collected by: Laura Pannone
(9lr¢jj�z
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Sunset Plastic Date installed 6/16/297;
Tank size z000 gal. Number of Compartments i Cleanouts (Y/N)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) NIA
Date of pumping 8h312o11 Pumper Isaac's Pumping
C. ABSORPTION FIELD DATA (P` TCanLI\9-5)
Date installed b1 78 Soil rating (g.p.d./ft2 or fe/bdrm) t1
ro!Length ,6 -ft. Width 5 ft.
'S 3
Total depthISS.8S ft. Eff. absorption area ypo�p Monitoring tube i
Date of adequ�a{cy test 8115(5/2012 Results (Pass/Fail) Pass
Fluid depth in absorption field before test o in. Water added4so gal. New deptho in.
Absorption rate >= 45o+ g.p.d.
System type wide Trench
Gravel below pipe 2 ft.
3
Depression over field N
n/
For 3 bedrooms
Elapsed Time: o min. Final fluid depth o in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFT STATION
Date installed Siz '
"Pump on" level at _ in. "Pump
Datum r,"Ad
E. SEPARATION DISTANCES
Manhole/Access (YM)
at _ in. High water alarm level at
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot ioo+
Absorption field on lot zoo+
Public sewer main NIA
Sewer /septic service line z5+
Meets alarm & circuit requirements?
On adjacent lots ioo+
On adjacent lots zoo+
Public sewer manhole/cleanout NIA
Holding tank ioo+
Animal containment areas ioo+ Manure/animal excrete storage areas zoo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation io+ Property line io+
Absorption field s+
Water main N/A Water service line 25+ Surface water soo+
Wells on adjacent lots ioo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ao+ Building foundation io+ Water main NIA
Water Service line zc+ Surface water ioo+ Driveway, parking/vehicle storage io+
Curtain drain None Known Wells on adjacent lots zoo+
F. COMMENTS �p�(e� l4Sg'L`vewcl` �h u5E'
G. ENGINEER'S CERTIFICATION ••O��„OF, q�� ��♦
! certify that I have determined through field inspections and
review of Municipal records that the above systems are in X -v 49TH
conformance with MOA COSA guidelines in effect on this date.ry'
Engineer's Printed Name Steven R. Pannone, P.E.Imo' Steven R. P,
$IIQ��t •:,dJ�$onnonega9
Date
COSA Fee
Date of Payment _ ala
Receipt Number_ Ry t7
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Tiw
Aarow Pump & Well Service LLC
(907)346-9355
Inspection Report
I ran a camera 45' down the well at 6001 E. 162 Ave and did not find
any holes/ cracks in the casing or leaking around the pitless.
Beau Maxim