HomeMy WebLinkAboutT12N R3W SEC 22 LT 28 M250'Onsite File
T12N R3W Sec 22
Lot 28 M250'
#015-521-32
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241387 PID Number: 015-521-32
Dwelling: ■❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade
Name
Sally Donaldson Trust
ABSORPTION FIELD
El Deep Trench Wide Trench El Bed [I Mound
Site Address
11020 Totem Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
4
1.2 GPD/SF
JTotal
9.6 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5.1 Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
28 M250
Fill added above original grade
0.6 Ft.
Gravel length
51 Ft.
Township Range Section
12N 3W 22
Gravel width
5 Ft.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
1
Dist. between trenches
N/A
From
Tank
Field
Tank
Line
500 Ftz
Ft.
Well
>100'
>100'
N/A
N/A
>25
TANK ❑� Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1250 Gal.
Surface Water
>100'
>1 00'
N/A
N/A
Material
Plastic
Number of compartments
Two(2)
Lot Line
>5'
>10'
N/A
N/A
NA
Foundation
>1 0'
>10,
N/A
N/A
LIFT STATION
rCapacity
Gal.
Remarks Deep burial tank
Alarm location I installed by
PIPE MATERIAL House to tank D3034 drainfield Tank to
D3034
Installer
GLW Enterprises
Drainfield D3034 CO/MTD3034
Inspector M. Jakubisin
BENCH MARK (Assumed elevation) 100 ft
Inspdection 1 12/9/24 12/10/24
Location and description
2�d
Bottom of Siding @ Point A
3rd 4"'
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
O
Conditional Approval: Date
A.. �
�til��Q'
i
raJ.• 9 ��
49 TH
..............
Septic S stenl�
Approved L Dater j L�
Pjj Benjamin Schiller :4
Ilf�,ci�F CE 12524
J' 92
12/16/24
,lkF, PROFESS *
Note: this approval does not include well permit requireme s.
rtt
\\\\\�1�4
(Rev 057*r8)
x
x x x x x x x x x x x x x x x x x x
x
Benjamin Schiller
CE 12592
R
E
G
ISTEREDPROFE S S I O N A L E N GINEER
1"=50'
NEW 51' LONG x 5' WIDE,
4' EFFECTIVE DEPTH
ABSORPTION TRENCH
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
PERMIT # OSP241387 PID # 015-521-32
T12N R3W SECTION 22, LOT 28 M250'
A B
FCO2 23.4
MH 54.6
SV 53.6
A
B
2CO 53.0
CO1 46.0
MT1 43.8
CO2 30.7
20.9
26.6
29.5
30.9
31.9
30.6
65.9FEET
0 50 100
FCO2
TO
T
E
M
R
O
A
D
3-B
D
R
M
H
O
M
E
PLAN AS-BUILT
12/30/24
CA
B
I
N
33' ROADWAY AND PUBLIC
UTILITY PATENT RESERVATION
NEW 1250 GAL
SEPTIC TANK
FCO1
535530
540
525
520
SHED
MT2
MT1
CO1
CO2
TH#1
MHSV
2CO
MT2 29.265.2
FCO1 18.94.7
C
D
C D
PROFILE AS-BUILT
(NO SCALE)
91.0
86.0
91.6
96.0
FC
O
MH
SV
PERMIT # OSP241387 PID # 015-521-32
T12N R3W SECTION 22, LOT 28 M250'
1250 GAL
SEPTIC TANK
96.7 FINISH GRADE
51'
DRAINFIELD ROCK
MT
1
TH
#
1
NO GROUNDWATER 12/4/24
86.5
91.0
CO
1
CO
2
80.1
86.5
91.0
96.1 ORIGINAL GRADE MT
2
2C
O
90.8
Benjamin Schiller
CE 12592
R
E
GISTEREDPROFE S S I O N A L E N GINEER
12/16/24
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: OSP241387
Work Type: Septic Upgrade
Tax Code Number: 01552132000
Site Legal Address: T1 2N R3W SEC 22 LT 28 M250' G:2637
Site Mailing Address: 11010 TOTEM RD, Anchorage
Owner: DONALDSON SALLY TRUST
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms
11/26/2024
11/26/2025
84525
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 (18A Water Regulations (18AAC80)
3. The wastewater code requires ins ns during the installa The engineer shall notify the Development
Services Department per AM .65. Provide notification by calli (907 ,
4. From Octob ubsurface soil absorption sys m -u icon truction during freeze ther
shall be e�
a. Op ed and Closed on the same day, ar
b. efi�, sealed, and heated to prevent free ing
Fecial Provisions:
1. Prior to construction, locate the existing field in order to ensure that the required separations will be met.
2. Show the existing field on the Record Drawing.
4
3. A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to
niirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation
ate. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require
VVzra design change, construction shall stop pending approval of a change order. Please submit results with
the inspection report (or change order, if required).
�e9f hole- com�JAcJl . acs , , Aan�c,
�/ r
-Retied-By: 5 5 &tej 'f-0 Date:
Issued By: Date:
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-521-32
Property owner(s) Diane Miller
Mailing address P.O. Box 201962, Anchorage, Alk 99520
Site address 11020 Totem Rd, Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) _
Legal description (Township, Range & Section)
Day phone 907-277-8016
T12N R3W SEC 22 L28 M250
Lot Size - 84,525 —Sq. Ft. Number of Bedroomsx H
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(E all that apply)
Absorption Field
rX-1
Initial EJ
Single Family (SF)
R
(w/wo ADU)
Septic Tank
FK
Upgrade RX
Duplex
EJ
(D)
Holding Tank
0
Renewal D
Multiple Dwellings
0
Privy
D
(SF and/or D)
Private Well
El
Water Storage
El
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: S Z Waiver Fees:
Date of Payment: I Z I I / 2 O 2 y Date of Payment:
Receipt Number:
Permit No. -SP _Z_ L i
Permit App_'-'- '- ,
Receipt Number:
Waiver No.
Wnidoity of Anchorage
On-site Water and Wastewater
OSP241387, Deb KboketAtm, 1 V26:
November 25, 2024
E E R I N G
PO BOX 240773
ANCHORAGE, AK 99524
522.7773
677.7766 (FAX)
FORGECIVIL.COM
MOA Development Services, On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: T12N R3W SEC 22 L28 M250 - 11020 Totem Rd
Septic System Replacement
Dear On -Site Services Engineer:
The home at 11020 Totem Road is being sold, but it does not have a documented septic system
and cannot be tested for a COSA. We are submitting this permit application for a new system. The
property currently has a home, a cabin with a bathroom, a well, and several septic pipes in the back
yard. We are unable to detennine from these pipes the layout of the existing septic disposal field.
The new system will accommodate the 3 -bedroom home in addition to the cabin.
The ground surface on the lot slopes down toward the northwest corner of the lot between 5-8%
slopes. There are no slopes greater than 25% within 50 feet downslope of the system. Drainage
arrows are shown on the site plan showing the grade and direction of flow. Stormwater drainage
will not impact this septic system. The new trenches will be constructed parallel to the slope as
much as possible.
Due to the time constraints with the home being for sale, we are proposing to use adjacent test hole
information for the design and dig a confirmation test hole before installation. We have collected
test hole information for all of the surrounding lots, compiled into the following table. The
percolation rates varied, but were consistently more than 15 min/in, with the longest rates over 40
and 50 min/in. Our proposed design assumes a percolation rate between 30-60 min/in. Almost
every test hole documented no groundwater with the exception of a test hole on Rons Lot 2, which
indicated groundwater at "10+ feet". This seems to be, not an actual measured level, but instead
documentation that the subsequent trench design had "at least" enough separation to meet code.
We will be digging a confirmation test hole on-site prior to installation. Our trench section assumes
that in this new test hole we will confirm a groundwater reading of at least 12' to the seasonal high,
and 14' to bedrock/impermeable layers.
C.haarier
�c5C.an attie.-b neu.>
�01�5 i\✓l�p . ��
LeLyal
Date
Soil Perk min/in
Groundwater
Boyd L3
7/7/95
SM/ML, Silty sand to silt
3.2
None to 18.5'
Rons L1
8/6/90
GM, Sand w/ gravel, trace silt
21
None to 16'
Rons L2
11/12/86
ML/SM, Silt w/ silty sand
14.7
None to 13'
10/27/86
GM, Silty sandy gravel (ML below)
41.7
10+'
T12 ... L29 N132
2/1.5/89
ML, Sandy silt w/ little rock
10
None to 18'
T12 ... L29 5132
1/12/22
ML, Sandy silt w/ cobbles
16
None to 19'
1/12/22
ML, Sandy silt w/ cobbles
26.6
Perk only
T12 ... L27 S2
2/4/94
GM/SM, Silty sandy gravel
40
None to 14'
2/4/94
SMISP, Silty sand
27
None to 14'
T12 ... L28 Less N375
10/8/24
SM/ML
54
None to 16'
T12 ... L28 N125
6/21/01
GM Light gray to brown
48
None to 18'
As the site pian specifies the confirmation test hole prior to installation, we ask that these design
criteria be accepted in lieu of a stamped perk test for design and permitting purposes only.
The new septic system will be a minimum of 100' from all wells and surface water. Please refer
to the attached plan and profile for the septic design. If this design is followed, there will be no
adverse impacts to adjacent properties.
Sincerely,
m ..4.r
Benjamin Schiller, PE
T1 2N R3W SECTION 22 LOT 28 M250'
THE NORTH 125 FEET OF LOT 28
ABANDON IN PLACE EXISTING
ABSORPTION TRENCH
EXISTING TANK TO BE LOCATED
AND DECOMMISSIONED PER UPC
NEW 1256GAL
SEPTIC TANK
--FG0
2C0. I -------------------
FC&SHEb-�
> s'
10, 0
V,J
H#1
--j
CO.... ..
ALTERNATE SITE
NEW 50' LONG x 5'
WIDE, 4' EFFECTIVE
DEPTH ABSORPTION 33' ROADWAY AND PUBLIC
TRENCH UTILITY PATENT RESERVATION
LOCATE EXISTING 7"
ABSORPTION
TRENCH & ENSURE
-j SEPARATION
NOTE: CURRENT ROUTING OF PLUMBING/SEPTIC, UNKNOWN
DETERMINE ROUTING AND INSTALL F&6-8 AT BOH HOME AND CABIN
0
SOUTH 250 OF THE NORTH m I
375 FEET OF LOT 28
0
LOT 28 LESS THE NORTH 375 FEET
G � i i
LEGEND
AW. CO - CLEANOUT
j*ANW,
2CO - DOUBLE CLEANOUT
Ar: 49...SEPTIC PLAN FCO - FOUNDATION CLEANOUT
41
FS -FLOW SPLITTER VALVE
i
Benja Schiller '00' MH - MANHOLE
0 50 100
CE 2592 W MT - MONITORING TUBE
j is 1214/24
.W FEET SV - SEPTIC VENT
1"=50' TH - TEST HOLE
T12N R3W SECTION 22 LOT 28 M250' Com
DESIGN FACTORS:
600 GPD PEAK FLOW
PERK RATE: 2.4 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
5 -WIDE TRENCH SYSTEM
1250 -GAL SEPTIC TANK
600 GPD / 1.2 GPD/SF / 5' WIDE * 0.5 RED FACTOR [4' DEEP] = 50 LF TRENCH REQUIRED
(50 LF SPECIFIED)
BOTTOM OF TRENCH: 8.0' BELOW GRADE
FLOW LINE ELEVATION: 4.0' BELOW GRADE
^"'DE ADDITIONAL FILL TO
JNT FOR SETTLEMENT
'EXTILE FABRIC
RFORATED PVC (HOLES DOWN)
INFIELD ROCK
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE SOF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
E N G ' NEER , " G
M
..........
' • • Benja • ' Schiller
(���c�fP • CEv /2492
�`���� PROfESSIONa�y"�
SOILS LOG AND PERCOLATION TEST
E N G I N E E R I N G
LEGAL DESCRIPTION: T12N R3W SEC 22 L28 M250
PERFORMEDFOR: JENNIFER ZIMMERMAN
DATE: 11/27/24 PARCEL ID#: 015-521-32
DEPTH TEST HOLE 1
(feet)
1
1
NO WAS WATER ENCOUNTERED?
- IF YES @ WHAT DEPTH?
DRY DEPTH TO WATER AFTER MONITORING
12/4/24 DATE OF MONITORING
DATE
READING
START TIME
NET TIME
(MINUTES)
WATER
(INCHES)
NET DROP
(INCHES)
11/27
1
10:24
18
10
716
>61-1
2
10:47
10
1 ,s
616
5 6-
3
10:57
10
1 16
5 16
4 is
4
11:08
10
1 0
5A
46
5
11:18
10
1 0
56
416
6
11:28
10
1 116
516
416
PERCOLATION RATE: 2.4 (MIN/INCH)
COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
SITE PLAN
TECHNICIAN: M. JAKUBISIN
Lot 2
N
Ln
O
0
0
0
O
N I
I
SEPTIC PIPES-- �
2.0' CANT J V-2.9'
HOUSE DETAIL
Scale: 1 " = 30'
THE NORTH 125 FEET OF
LOT 28 _
EAST 329.50'
HOUSE
I JI
1
X
NOTE: GROUND LEVEL IMPROVEMENT
LOCATIONS ARE APPROXIMATE DUE
TO SNOW COVER.
6%]W
)ADWAY AND PUBLIC
'ATENT RESERVATION
SOUTH 250 OF
THE NORTH 375 FEET
OF LOT 28
93,908 s -f. (MOA)
WEST 329.50'
LOT 28
LESS THE NORTH 375 FEET
PLOT PLAN ___ AS BUILT _X_ SCALE _ 1= 50__ GRID _ SW 2637 Project No. J24 -2961A1
P.O. Box 210005
Lang & Associates, inc. Anchorage, Alaska 99521-0005
(907) 522-6476 o OF A
Professional Land Surveyors jonathanolangsurvey.com oG4
ken®langsurvey.com
I hereby certify that I have surveyed the following described property:
SOUTH 250 OF THE NORTH 375 FEET OF LOT 28, SECTION 22, T12N, R32, SM, ALASKA
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said pm perty except as indicated hereon.
Dated this the _ f- Day of t'10J6M P� __, _�s2� at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
>A JO N C. LANG ar
440.LS-9944. • •'
�o
gJO
a • . �4' OFZSSIONAA- -o
004000��
State of Alaska AECC963
8.2' x 16.0' OPEN STORAGE
^�
6.3' x 8.2' SHED
83' N
0, 3.
1.0' CANT ...
o
o
24.3' 2.0' CANT
ASPHALT
_ PAVEMENT':
Ld
W W
O
8.3' x 13.3' CANT * 0 Q M
d (n_0 W d
m
Of F_=- PORCH
13.6' 4.7'
SEPTIC PIPES-- �
2.0' CANT J V-2.9'
HOUSE DETAIL
Scale: 1 " = 30'
THE NORTH 125 FEET OF
LOT 28 _
EAST 329.50'
HOUSE
I JI
1
X
NOTE: GROUND LEVEL IMPROVEMENT
LOCATIONS ARE APPROXIMATE DUE
TO SNOW COVER.
6%]W
)ADWAY AND PUBLIC
'ATENT RESERVATION
SOUTH 250 OF
THE NORTH 375 FEET
OF LOT 28
93,908 s -f. (MOA)
WEST 329.50'
LOT 28
LESS THE NORTH 375 FEET
PLOT PLAN ___ AS BUILT _X_ SCALE _ 1= 50__ GRID _ SW 2637 Project No. J24 -2961A1
P.O. Box 210005
Lang & Associates, inc. Anchorage, Alaska 99521-0005
(907) 522-6476 o OF A
Professional Land Surveyors jonathanolangsurvey.com oG4
ken®langsurvey.com
I hereby certify that I have surveyed the following described property:
SOUTH 250 OF THE NORTH 375 FEET OF LOT 28, SECTION 22, T12N, R32, SM, ALASKA
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said pm perty except as indicated hereon.
Dated this the _ f- Day of t'10J6M P� __, _�s2� at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
>A JO N C. LANG ar
440.LS-9944. • •'
�o
gJO
a • . �4' OFZSSIONAA- -o
004000��
State of Alaska AECC963
~'r~. * . / ' ~ , '+ .~ ,' :. ~ ~ ,'~
-]~:~.[?;'- ' ~ -feet of dr~on f~m s~tic lev~'l · .~ * ,... ~.~
~pt~foe~ from ~0 do%~tls Of 'fo~%ions pono~r~%o~, si~o of ~%ori~l~ color.
to
to
to
to
WELL
DRILLERS
Size of Casing ~ ,t ..
.Depth of Hole /~ feet. Cased to .~ feet.
Static'water level /~ feet (above)(~w) land surface. Finish of well (check
';[~'~,: one) Open end (~; Screen ( ); Perforated ( ).
Describe screen or perforations
~ell p~mping test a~. /~ ga]lens per (hour) (minute) for
~.~¥?' ~ '~' ~ '"~ re6% of drawdo~ from static level'.
Re~rks
WEI~ LOG .
~epth in feet from Give details of formations penetrated, size of material, color,
sround surface
hardness
to
to
to
to
' " "'to
to
to
to
to
tO
to
to
to
'~~')'~ i'~'~' '~ ' D GRE.ATER.ANCHORAG~ AREA BOROUG_H
~~ ~ .... epar~:men~ of E~Vironmental Q~a/ity
teet, Anchorage, Alaska 99503 274-4561
~X~ ~u "C" S r
Date Received ~ne623~ 197_24_76 6 _ .
Tim~ , o~, Inspection
, Dat~'%?inspecti°
REQUEST FOR APPROVAL OF .
INDIVIDUAL SEWER & WATER FACILITIES
l. Approval requested by: Alaska Mutual Savings Bank
Mailing Address: Ph0~e:
2. Property Owner: Joseph E & Yvonne F. Clauson
Phone: 344-1672
Mailing Address: Star Route A Box 17.18L 99507
Legal Description: T12N R3W Section 22 Lot 28
[0cati0n: Mile 2.5 up O'Malley to Totem, turn right 3rd mailbox on the
right
Type of facility to be, inspected Single Family No. of bedrooms 3
6. Well Data: Individual
A. Type B. Depth 78'
C. Construction D. Bacterial Analysis
7. Sewage Disposal System: On-ste system ~
A. Installed B. Installer
C. Septic Tank: 1. Size ' 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Materi~l
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank
Nearest lot line ~°O
,'Absorption area
Other contamination
Sewer Lines ~0,
B. Foundation to septic tank
Absorption area
C, Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pa~es - Rer"qst for Approval of Individual.~er· & Water Facilities
Legal ,Descr~pti0n T12N R3W Section 22 Lot 28
Approved ~./~_ ~ Disapproved Date ~/~,/~/7~
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true af~d
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ,034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTS/lENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner:
Mailing Address~
3. Name of Buyer:
Mailing Address:
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent:
FHA CONV /-~'
Day Phone: ~%- 1~-7 ~
Day Phone:
Phone:
Mailing Address:
Legal Description:
Location:
Phone:
·
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
No. Bdrms.
Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System:
If Individual, date of installation
Public Utility
Individual (on-site)
72-003(3/76)
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC241525
Parcel ID 015 -521-32 Expiration Date:
Legal description T1 2N R3W SEC 22 LT 28 M250'
Site address 11010 TOTEM RD
Current property owner(s) DONALDSON SALLY TRUST
X The On-site system(s) is/are approved for 4 bedrooms
By:
11/22/2025
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
Original Certificate Date: 12/31/2024
This Ce/rtificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
systeni(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
irSdependent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X
Absorption Field Advisory
Tank Age Advisory
Other
Well Flow Advisory X
Nitrate Advisory X
Arsenic Advisory
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-521-32
Complete legal description
T12N R3W Section 22 Lot 28 M250
Location (site address) 11020 Totem Road, Anchorage, AK 99516
Current property owner(s) Sally Donaldson Trust Day phone (907) 277-8016
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL:❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel *Plastic ❑ Concrete ❑ Fiberglass
Age NEW - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ I ( Waiver Fee $
Date of Payment C? Date of Payment
COSA # (C '2- Waiver #
COSA Application—June 2022
N/A N/A
N/A
(907) 522-7773
Benjamin Schiller, P.E.12/31/2024
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
On -Site water and wastewater Section
1�V
www.muni.org/onsite ��
Well Water Advisory
Certificate of On -Site Systems Approval # .410SC241525
Subdivision: T12N R3W SECTION 22, Block: , Lot: 28 m250'
907-343-7904
Fax: 343-7997
This well's productivity was determined to be 0.7 gallons per minute. The
recommended well productivity under (AMC 15.55) for a 4 -bedroom residence is
.41 gallons per minute or 150 gallons per day per bedroom. Although the subject
well currently exceeds this minimum recommendation, the production capacity
can fluctuate and may be insufficient to meet your needs.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC241525
Subdivision: T12N R3W SECTION 22, Block: , Lot: 28 m250'
907-343-7904
Fax: 343-7997
A water sample revealed a nitrate concentration of 9.49 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.
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 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.
Lot 1
:.
2.0' CANT--"' V-2.9'
HOUSE DETAIL
Scale: 1 " = 30'
THE NORTH 125 FEET OF
LOT 28
CHAIN—LINK FENCE ri
EAST 329.50' ---
SEPTIC
SEPTIC MANHOLE N /
Ui / ABIN
SEPTIC PIPES
ASPHALT
SEE :. PAVEMENT'
HOUSE
107.1' D ETAI L
NOTE: GROUND LEVEL IMPROVEMENT
LOCATIONS ARE APPROXIMATE DUE
TO SNOW COVER.
53.2
1
)ADWAY AND PUBLIC
ATENT RESERVATION
i�
SOUTH 250 OF
THE NORTH 375 FEET
OF LOT 28
93,908 s.f. (MOA)
WEST 329.50'
LOT 28
LESS THE NORTH 375 FEET
I
PLOT PLAN ___ AS BUILT _X_ SCALE _1=_=50__ GRID _ SW 2637Project No. J24-296163
P.O. Box 210005
Lang & Associates, i n c. Anchorage, Alaska 99521-0005 0000Op��o ZZ4�
Professional Land Surveyors onatjonat 522-6476 �� F q p�
han®langsurvey.com ov,� • • • ... q Q
I hereby certify that I have surveyed the following described property:
SOUTH 250 OF THE NORTH 375 FEET OF LOT 28, SECTION 22, T12N, R32, SM, ALASKA P Q
Anchorage Recording District, Alaska, and that the improvements situated thereon are'4'. • • •......�
within the property lines and do not encroach onto the property adjacent thereto, that Q
no improvements on the property lying adjacent thereto encroach on the surveyed (7'A JON C. LANG o
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
3 rr+ Da of _ ��� Z� Q �Fo .LS -9944.••' S5
Dated this the
Day at Anchorage, Alaska Q Q04ao 0 RCFESSIONA� ao
It is the responsibility of the owner to determine the existence of any easements, �OQppoo�
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
x 16.0' OPEN STORAGE
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6.3' x 8.2' SHED
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1.0' CANT.
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24.3' 2.0' CANT
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PAVEMENT
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8.3' x 13.3' CANT
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Of PORCH
13.5' a a
2.0' CANT--"' V-2.9'
HOUSE DETAIL
Scale: 1 " = 30'
THE NORTH 125 FEET OF
LOT 28
CHAIN—LINK FENCE ri
EAST 329.50' ---
SEPTIC
SEPTIC MANHOLE N /
Ui / ABIN
SEPTIC PIPES
ASPHALT
SEE :. PAVEMENT'
HOUSE
107.1' D ETAI L
NOTE: GROUND LEVEL IMPROVEMENT
LOCATIONS ARE APPROXIMATE DUE
TO SNOW COVER.
53.2
1
)ADWAY AND PUBLIC
ATENT RESERVATION
i�
SOUTH 250 OF
THE NORTH 375 FEET
OF LOT 28
93,908 s.f. (MOA)
WEST 329.50'
LOT 28
LESS THE NORTH 375 FEET
I
PLOT PLAN ___ AS BUILT _X_ SCALE _1=_=50__ GRID _ SW 2637Project No. J24-296163
P.O. Box 210005
Lang & Associates, i n c. Anchorage, Alaska 99521-0005 0000Op��o ZZ4�
Professional Land Surveyors onatjonat 522-6476 �� F q p�
han®langsurvey.com ov,� • • • ... q Q
I hereby certify that I have surveyed the following described property:
SOUTH 250 OF THE NORTH 375 FEET OF LOT 28, SECTION 22, T12N, R32, SM, ALASKA P Q
Anchorage Recording District, Alaska, and that the improvements situated thereon are'4'. • • •......�
within the property lines and do not encroach onto the property adjacent thereto, that Q
no improvements on the property lying adjacent thereto encroach on the surveyed (7'A JON C. LANG o
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
3 rr+ Da of _ ��� Z� Q �Fo .LS -9944.••' S5
Dated this the
Day at Anchorage, Alaska Q Q04ao 0 RCFESSIONA� ao
It is the responsibility of the owner to determine the existence of any easements, �OQppoo�
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
