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Home My WebLink AboutMINDYER MANORS BLK 2 LT 3 Onsite File Mindyer Manors Block 2 Lot 3 ##020 - 091 - 70 Swale/berm to remain in place for future COSH approvals . • Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151395 PID Number: 020-091-70 Dwelling: ❑ Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑■ New ❑ Upgrade Name: KAYLA YOUNG ABSORPTION FIELD Address [' Deep Trench El Shallow Trench ❑ Bed [' Mound El Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 9.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3,0 Ft. 6.0 Ft. MINDYER MANORS B2, LOT 3 Fill added above original grade Gravel length Township Range Section 2.0 Ft. 42 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 2.0 Ft. Ft. To Septic Absorption ' Holding Sewer Total absorption area Number of trenches Dist.between trenches Tank Field Lift Station Tank Line z From 504 Ft 1.0 Ft. Well 100'+ 100'+ 50'+ TANK 0 Septic 1]S.T.E.P. ElHolding ElOther Manufacturer Capacity Surface Water 70' 60' ANCH TANK 1500 Gal. Material Number of compartments Lot Line 9' 10' STEEL 2.0 NA Foundation I 10' 10' LIFT STATION Manufacturer Capacity Curtain Drain NA NA ANCH TANK 1500 Gal. Pump on level at Pump off level at High water alarm at Remarks waiver required for tank and field to open water culvert (tank 60', field 70) 30 in. 24 in. 36 in. Pump make and model Electrical Inspections performed by PS - 2o be( ok/ PIPE MATERIAL House to tank 3034 Tan to 3034 Installer drainfield GLACIER MASONRY Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation)94.3 ft Inspection 141 6-12-16 2nd 6-12-16 Location and description da3,d 4th GARAGE SLAB COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer5 Stamp Iii Conditional Approval: Date ... P�• • •••�r�4 ei * :49TH '...* ft? / A�� r..MICHAEL N. ANDERSCN .yrs < 1 f. CE-9469 :` ;'' iefes•. Approved ) ljj/ Date 2-76//8 ' 0 p R �•�aa`-u Inspection Report_9-1-12.doc Permit No. OSP151395 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: MINDYER MANORS BLK 2, LOT 3 PID No.: 020-091-70 MARK A / C Cot 40 /SEPTIC) _ I TC01 )1V332 �——— \�-- ITCO2 37 -�- MT 5 48 �// //-- -N. / N / \ / \I \ii _ / N • I • 1 I\ /— ` I \ / 50. 0,<'Coln. 0 y / \ /''."... \ / \� r�� / \\ // I _ _ _ - 1 CREEK CENTER LINE / I 1 / N -� / BENCH AT GARAGE DOOR I Do G,<I a1s<t I I // / • / l / \ ( \ / ( EP116 \ / • NEW 1 00 GALLON STEP TANK N._ T d IN1 i•rt. \ W s• . \ 12" SWALE Fe' SEPTIC SPILLAGE x PRIMARY TRENCH N N. w W SECONDARY SYSTEM 18" EXISTING CU VERT--- I o II L _ _ __I0 60' WAIVER REQUESTED FOR TANK 10 ,.1.. a El.o Easement 70' WAIVER REQUESTED FOR LEACH 1CREEK CENTER LINE ASBUILT SCALE: 1"=100' r co, Tc01 .♦♦\\\\IIr t,, I( MT 100 ‘1,,'Z.)2 1 ORG GRADE ♦- 4444, C ' -1/13 r� FINISH GRADE 1� Fbis GRADE 1 4:16V>.:...`. �� 1 (/r♦♦ v �- �Ih \ MIK _� .0 1 ORG IMMvr. l 1.25'PIPE 1I/fICiER FA8RIC I '•T J,* •♦I • s — { , •:;i4g T 1 ...•....•.. , qD� 1.500 GALLON SIECI SOP.x• GM 0 .ir.,t_ e c STEP TANK • �'I�%�" ` 4: �• \';MICHAEL N. ANDERSON/ke5 ae.l_i maw \88.5 \97 ),.. *. •No. 'E 469 ( i 8200 85 MAY 2016 ••♦♦, I�`o•.. /d/4... C :. SEPTIC SECTION 82 ♦ (=.\'- N.T.S. f,11'AC t`* _ ♦♦ e"'""' , Municipality of Anchorage Development Services Department P.O. Box 196650-4700 Elmore Road Anchorage,Alaska 99519-6650 ,` Info and Help: (907)343-8211 ''' CNo«pVE INSPECTIONS: Voice: (907)343-8300 Fax: (907)249-7777 2/10/2017 Inspection Report License/AP#: E15-2335 Parent AP#: R15-2685 Inspection#: 443915 Type: RES Status: Issued Address: 4700 Virgo AVE Parcel: 02009170000 Inspector: M.Green Project: Resp Party: Descr: 2883 SQ FT OF LIVING AREA; 676 SQ FT OF GARAGE AEEXEMPT: REVIEWED BY REVIEWING PROFESSIONALS MICHAEL ANDERSON AND TRAVIS JULIUSSEN. Inspection ElecFin (Final Electrical) Evaluation: Approved Result Notes: Items from 2/9/2017 resolved. Electrical final approved. inspection Item Item Description Evaluation 2/9/2017 Correct Below Corrected Code Ref: Location: Septic controller. Notes: Liquidtight needs bonding bushing. 2/9/2017 Correct Below Corrected * Code Ref: Location: Septic controller Notes: Liquidtight needs grounding bushing. 2/9/2017 Correct Below Corrected * Code Ref: Location: HRV unit in bed room closet. M-W trilling, Inc. *P.O. Box 110389*Anchorage, AK 99511♦ ♦907-345-4000 ♦ 907-345-3287 Fax* Job No. 16-116 Anch Permit No:08P 151395 Amended To Reflect The Additional Casing&Change on Depths GROUNDWATER WELL LOG Well Owner: Kayla Youngs Use of Well: Domestic Legal Description: 4700 Virgo Ave Anchorage,AK 99516 Mind Yer Manors, Block 1, Lot 3 CONSTRUCTION Drill Method: Air Rotary Hole Size: 6" Hole Depth: 213' Casing Size: 6" Cased to: 47.23' Material: A53B Wall: .250 Well Completion: Open end X Screen Perforated Method: Screen/Perforation description: Bed Rock Grout Notes: Dry Grout with (2)sacks of Bentonite Well Development: Air surge Well Disinfected: No Method: airlift Yield test at 1.5 GPM for 4 Days hour(s)with 100% of drawdown(DD)from static level(SWL). Method: Air surge Static Water Level (SWL): 35.2' Start Date: 4/27/2016 Completion Date: 04/29/2016 _ Yield test Date: 01/04/2017 Final Pump Install Date: 09/16/2016 WELL LOG Depth in feet from top Details of formations penetrated,size of material,color and miscellaneous details. of casing. 0 TO 3 Casing Stick Up 3 TO 47 Sandy Silty Gravel 47 TO 48 Weathered Bedrock 48 TO 107 Bedrock: dry, grey siltstone argillite 107 TO 112 Bedrock: fractured water seeps 112 TO 197 Bedrock: dry, grey siltstone argillite 197 TO 203 Bedrock: fractured water seeps 203 TO 213 Bedrock: dry, grey siltstone argillite TO TO TO --- TO _.___.---.-.-.--.-.---._-._WA ToWAYNE E. WESTBERG iroNfonn OUg Coot400 lL President,M-W Driiling,Tnc. TO Nitrates i flgf1. NGWACertlfMGr -- TO ..................____ kms AkGevted aster Contr Lic NooundweF 1000 Development Services Department Building Safety Division • On-Site Water & Wastewater Program 4700 Elmore Street r a P.O. Box 196650 Z Anchorage, AK 99519-6650 �. Mark Begich 9 s A A E T Y Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: OSP /57395' Date of Issue: - Parcel Identification Number: OBD -09I/ 0 006 Legal Description Block Lot Property Owner Name & Address: 4444 ytt #1045 .B / 3 k,fYL/ Yfi* Pump Installation Date: 09-- /G -20/G Pump Intake Depth Below Top of Well Casing: /91k. feet Pump Manufacturer's Name (fid,* Pump Model: 5 606-4/ L Pump Size A hp Pitless Adapter Burial Depth: 17 feet Pitless Adapter Manufacturer's Name: lies_ fiftxo Pitless Adapter Installer: AP-W J//U/4/ Well Disinfected Upon Com leti/on? X Yes J No Method of Disinfection: CMG/ L' I9 6 0i# j Comments: Pump Installer Name: -W Company: —(/V Mailing Address: /4, I/ 99L�l City: #4.- State: /5 Zip: /`� Attention: The pump installer shall provide a pump installation log to DSD within 30 days of pump installation. Permit Number: Tax Code Number: Work Type: Permit Effective Dates: Design Engineer: Subdivision: Site Legal Address: Owner/Address: On-Site Water & Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 OSP151395 02009170000 WellSeptic Initial January 27,2016 to January 26, 2017 ANDERSON CONSTRUCTION & ENGIIX MINDYER MANORS MINDYER MANORS BLK 2 LT 3 G:3336 YOUNGS KAYLA 50% & YOUNGS TODD 50% 481 OCEAN POINT DR ANCHORAGE AK 995150000 epar trnent Site Mailing Address: 4700 VIRGO AVE, Anchorage Lot Size in Sq Ft: Total Bedrooms: 66449 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: .~.~~ Issued By: /~-~ ~~~..~---- Date: Date, MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. (O ~. Property owner(s) Mailing address Day phone Site address Legal description (Sub'd.,'Block & Lot) ¢¢(¢ r~t~_.~ Legal description (Township, Range & Section) LotSize (,/(.~c~t'~ Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: ([~ all that apply) Absorption Field E~ Initial E~ Single Family (SF) (w/wo ABU) Septic Tank [] Upgrade [] Duplex (D) Holding Tank [] Renewal [] Multiple Dwellings Privy [] (SF and/or D) Private Well [~ Water Storage [] 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: ~'~J¢~¢1 ,-~{~' ~ '-~(Waiver Fees: Date of Payment: (~'~/~/~/~' ~"~ODate of Payment: Receipt Number: ~;~'~/¢~ Receipt Number: Permit No. ~)¢J 51 ;2-~,~- Waiver No. 'Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Jan 27, 2016 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Legal: Well and Septic System (revisions) Mindyer Manors Subd., Blk 2, Lot 3 To Whom it may concern: This is a request for a new well and septic system on the above referenced lot. A second test was completed to a depth of 18 feet which showed silty gravels for the entire depth. No water was observed in the test hole during the excavation or after the 7 day monitoring period. A new simple deep trench was designed with 6 feet of effective depth. The pert rate was 3 minutes per inch with an application rate of 1.2 GPD/SF which means the length of trench is 43 feet. The lot slopes at about 24% to the west with the proposed new septic area located on a semi-flat spot south ofthe house. The small creek on the south side of the lot is contained in a partially cover 18 inch culvert, which will be covered during the excavation of the new system. Any standing water on the west side of the lot will also be covered with fill. The new well will be 25 feet minimum from the creek per the old Title 21 code. This new system and well will not impact any of the neighboring lots. Please call me if you have any questions. Sincerely ~x, Michael N. Anderson, P.E. DESIGN CRITERIA: ~MOUND OVER OHiO OH~2) ~.- 4 BDRM X 150 = 600 GPB ORO \ / SOILS = 600/1.2 = 500 GPD 1.o_ 2.o __ ~ ~.FIL...TE~,R FABRIC ---- ---' ~1.25:~ PIPE , 600 GA/12 42' OM -2.0- ~ 0.25e HOLES I GM ~SEWER ROCK (1) TRENCH ' 8.0' DEEP 6.0' EFFECTIVE -s.o-- 2.0, w,DE 12.o, I / 42' LONG 17_ 48_ SEPnC mELD SECllON ~ ~' --dk? ..... ' ~ PROPOSED x ,, '-- ~ ~ ' ~ t BE C~RED~ , ~ ~i ~ ~ -. ~ rnuruocu ~ CO~AINED mN ~ ~///A ,, '- I' ~LON ~P TANK a,.D*ER ~.ORS CUL~, ~D ~ ~ '~ i B~ 2 LOT 1 12" OF SOIL ~. ~ '~ ., ~ER CUL~~ ~l~k~ ~ ~ I~ PROPE~ BNE KAYLA YOUNG . ~, ............ MINDYER MANORS, BLK 2 LOT 3 ,- · ~ · --~- ........ Anchorage, Alaska ~ .~ .. ~.~.,-..,~ .......................... ,..~.~ Michael N. Andermn,P.E. DATE: 1/20/2016 ~MICHAEL,2¢~%. No.~EN' ~469ANBERSON:~ 4601 NATRONA AVE DRAWN: D JR ANCHO~GE, A~ 99516 (907) 727-88~/F~: (907) 345-1391 SGALE: 1"=100' . -~ ~ ~ ~--~7" / I I / /_/ I . ~'"' ...~ / I IZ'//'//"~~ ..... 'A -'~ ~s ..............~ ~ /I ~ ~ ~, ~ ~ -~'?~---~-~- .... CUL~m~ ~ :~ / ~ ~ ii / ~, m . ~ biZ I I >, ,/ ',', ~~ -__ ~ / , / , ,, ,, , .__._.. : / / >,.. ,, ~ '--,---x_/ // / .::~.___~_.--'~ KAYLA YOUNG ~ ~. ............... MINDYER MANORS, BLK2 LOT3 Anchorage, Alaska ~....., .............................. &.....~ ~.dEzz~.~ ..................... ~.~.~ Michael N. Ande~on, P.E. DATE: 1/20/2016 ~.~MICHAEL N. ANDERSON~m ANCHO~GE, A~ 99516 (907) 727-88~ / F~: (907) 345-1391 SCALE: 1"=30' Municipality of Anchorage Development Se~ices Depa~ment Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. BOX 196650 Anchorage, AK 99507 (907) 343-7904 Softs Log - Percolabon Test Peaormed For: ~u~l~ LegalDescripgoq: ~¢ ~¢ ~ ~ ~ Township, Ran~a, 8oction: 4- 5- 6- 7- 8- 9- 10- 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? L O Depth to Water After ~ p Monitoring? ~ E Date: .L~' Reading Date Gross Time Net Time Depth to Water Net Drop · ' i f, / PERCOLATION RATE ~ ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~'~ FT AND ~ FT PERFORMED BY: ~'-~/~ ~[j{~ J CERTIFY THAT THIS TESTjYVA,~ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ /r :' 49~_~,H ~ ;'~' ~w.ci.anchomqe.ak. U8 (907) 343-7904 SOils Log - Percolation Test ' ~' ....... Date Pe¢ormed: Township, Range, Section: Municipality of Anchorage Development Services Department Building Safety Division ' On-Site Water and Wastewater Program 4700 Elmore Road , ./ LegalDescription: /k[(.~..(,.?~' ~/~14t/~'~, ~)'~[' ~)~ Slope 1- O¢cf , 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 20- Site Plan WAS GROUND WATER ~.t ENCOUNTERED? S IF YES, AT WHAT DEPTH? L O Depth to Water After p Monitoring? ~ E Reading Date Gross Time Net Time Depth to Water Net Drop ,/,,/,,, (,,, PERCOLATION RATE ~11 ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ ET AND ~ FT PERFORMED BY: ¢~./11'~,~/{.'~ I ,CERTIFY THAT THIS TES~I' WA~ PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~,/'~ ?~//' ~ Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-091-70 1. GENERAL INFORMATION Expiration Date: Complete legal description MINDYER MANORS BLOCK 2, LOT 3 Location (site address) 4700 VIRGO AVENUE, ANCHORAGE, AK 99516 Current property owner(s) KAYLA & TODD YOUNGS Day phone Mailing address Real estate agent 4700 VIRGO AVENUE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 5 O Date of Payment 5/.27 Receipt Number 1 1 r% 2 COSA# OSC �L 11 a �9 Date: 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN PE Date 5/2612021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the • l well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q: • • • „� �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting &FAGS . • TH ......... 6. DSD SIGNATUREiii ' • Curtis Huffman System #1 Approved for I bedrooms•CE 128991 /'RO ESS NP��..� System #2 Approved for bedrooms ��ROFESS.,�.m Disapproved Conditional approval for bedrooms, with the following stipulations: .. , •`',y0 Obi -SITE _ WAJ rp, nr.n STIE--VATER PROGRAM \� J By: ;%2�� Original Certificate Date: ( 1,2 Fldo.')g 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 Legal Description: MINDYER MANORS BLOCK 2, LOT 3 Parcel ID: 020-091-70 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 4/29/2016 Total depth 213 ft Cased to 47 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/25/2021 Static water level at beginning of test 35 ft. Well production at time of test 1.2 gpm Water storage tank volume 250 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 5/25/2021 Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) 5 years Tank type/material STEP / STEEL Measured operating fluid level in septic tank * Standpipes/foundation cleanout per record drawing Date of pumping 5/20/21 C. LIFT STATION Required maintenance completed Age of lift station 5 years Lift station material STEEL Comments: *FLOAT LEVELS (SEE MAINT. REPORT) D. ABSORPTION FIELD DATA Which system tested (date installed) 6/12/16 ALL standpipes present per record drawing Total measured depth from grade 9.8 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective ASSUMED PER MOA REC. DOCS Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date 5/25/2021 Results Pass For 4 bedrooms Fluid depth prior to test 1 in Water added 600 gal New depth 21 in Elapsed time 45 min Final fluid depth 5 in Absorption rate 600. gpd Any rejuvenation treatment (past 12 months) N If yes, enter date Comments/Deficiencies: E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Property Line > 5’ Yes if No ft Absorption Field > 5’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *60 ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 Property Line > 10’ Yes if No *9 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *70 ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No F. ENGINEER’S COMMENTS *MOA WAIVERS ISSUED PREVIOUSLY. REQUIRED SWALE RECENTLY REPAIRED BY N. EX. 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. 6/19/21 MUNICIPALITY'OF ANCHORAGE r. Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Owner Septic Tank: *Sludge level inches I ift ctntinn - Lift Station/Pump Vault Maintenance Log Street Address V"', t - o Pumping: required es no •Pumping completedCygs no *Pump basket cleaned no *Control floats cleaned no Operation satisfactory es no Alarm System: *Effluent filter cleaned es'. no •Proper float settings confirmed esu no •Dedicated electrical alarm circuit es no *Audible and visual alarm inside dwelling Ves no •Alarm system operation satisfacto' not satisfactory Manhole Riser •Ground water intrusion at riser to tank connection es •Ground water intrusion around pipe penetrations esrgn*Weep hole functionales no •Manhole lid: Functional (ges no Insulated es' no Properly Secured(y es no Other *All manufacturer required inspections and maintenance completed yes no C'nmmantc- Qualified Maintenance Provider: Technician ko\,v,�s4 D ate of maintenance - Company ^ • Lc� Signature Date • GE. .db Municipality of Anchorage r • r On-Site Water and Wastewater Program (907) 343-7904 s n r r.T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-091-70 Expiration Date: 5//3/17 1. GENERAL INFORMATION Complete legal description MINDYER MANORS B2,LOT 3 Location (site address) 4700 VIRGO DR ANCH,AK Current Property owner(s) KAYLA YOUNG Day phone 7NS - 1038 Mailing address 4700 VIRGO DR ANCH,AK Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: WAIVER FOR TANK AND TRENCH Distance:_60' & 70' Received by: !OA— Date: Z(/07__ COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ ( •$o Waiver Fee $ 159 Date of Payment // - 1( - Date of Payment 1l01(oP Receipt Number G orQ Receipt Number ddrl q9D COSA# O (1 /U as Waiver# QJ' V 1'f f 005 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm MIKE N ANDERSON,P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 01/24/17 • tieil.�. 49 L! -r ° S'; iii r, 6. DSD SIGNATURE �'• 44A f, <; X [ �' �tr70,,�MICHAEL N. AhDERSCV e�-System #1 Approved for y CE 94 9 r bedrooms. liJf-. J •°' ;_ System #2 Approved for 1cp !l 1• , ..�o Disapproved. p bedrooms. ��v��;v X' Conditional approval for 9 bedrooms, with the following stipulations: e,• ( .. .- . ✓ . be_ f'n_straflej S r-iln Y OF - +C —S-- S �� !� IPJ SITE m WATER AND IC WASTEWAI I.R . . . e _ ! . ►i 0,4 / By: /110, '�/ �� ca� - Original CertifiN! �/1 7 The Municipality of Anchorag- •evelopment Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10.10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: MINDYER MANORS B2, LOT 3 Parcel ID: 020-091-70 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed / 2T1t Co Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth_ft.21 3, Cased to_ft. `1 7 2 3 Casing height(above ground) 24"+ FROM WELL LOG AT INSPECTION Date of testy�7/s't_t 'y,? s_'i— '�� -./. i Static water level 3 S. e- ft. ft. Well production s g.p.m. g.p.m. /► _ WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L Date of sample: 5/1912016 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Date installed 6-12.16 Tank size 1500 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout (Y/N)Y Depression over tank (Y/N) N High water alarm (YIN) ST, >1 Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA—1985 SYSTEM TESTED Date installed 6-12.16 Soil rating (g.p.d./ft2) 1.2 System type DEEP TRENCH Length 42 ft. Width 2 ft. Gravel below pipe 6.0 ft. Total depth 9.0 ft. Eff. absorption area 504 ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results(Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test NEW in. Water added NEW gal. New depth NEW in. Elapsed Time: NEW min. Final fluid depth NEW in. Absorption rate >= NEW g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) UNKNOWN If yes, give date D. LIFT STATION Date installed 6-12-16 Size in gallons 1500 Manhole/Access (Y/N) Y "Pump on" level at 30 in. "Pump off' level at 24 in. High water alarm level at 36 in. Datum BOTTOM Cycles tested 3 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 50'+ Holding tank 100'+ Animal containment areas 100'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 101+ Absorption field 5'+ Water main 100'+ Water service line 10'+ Surface water 60'+* Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 9'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 70'+* Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. COMMENTS *WAIVER(60'&70')FOR TANK AND FIELD REQUIRED G. ENGINEER'S CERTIFICATION .f:15,_ • tom ?, I certify that I have determined through field inspections and '' •' "r l review of Municipal records that the above systems are in ,IJ "r' • � conformance with MOA COSA guidelines in effect on this date. d ...... r,I %'• � : Engineer's Printed Name MIKE N. ANDERSON,PE / MICHAEL N. ANDERSON Date 0112412017 1 ✓'• CE-9469 .• . �00�s1^• COSA canary sheet_2-6-15.doc Michael N. Anderson, P.E. Civil/Structural Engineering&Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Jan. 24,2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 V Re: Septic System Waivers Legal: Mindyer Manors Subd., Blk 2, Lot 3 To Whom it may concern: This is a request for a waiver of 60 feet from the septic tank and 70 feet from the leach field to open water. Originally the existing culvert was going to be extended and covered but then the size and length was questioned by the MOA water shed department. Due to time constraints it was decided to get a waiver and not disturb the culvert. The water sample is good and we really don't have any other area to install the system without impacting the other large stream, see the site plan. For this reason we are requesting the granting of the waivers. We are also requesting a lot line waiver from the leach field to the property line of 9feet. e 4, 44— ►.( 419) 1PirG '\ 32 ' ger e es.? , These waivers will not impact any of the neighboring lots. Please call me if you have any questions. Sincerely Michael N. Anderson, P.E. Municipality ®f Anchorage llrir, ��• P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 I (907) 343-7904 • Fax(907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV171005 COSA#: OSC171022 Permit#: OSP151395 PID#: 020-091-70 Legal Description: Mindyer Manors BIk 2 Lt 3 Engineer: Mike N. Anderson Applicant: Kayla Youngs 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 9.0 feet. In addition, the tank is approved to be 60 feet and the field 70 feet to surface water. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 2.--/6// Approved by: .1� Name of Reviewer **** VARIANCE/WAIVER REVIEW *'k** 0 1— H // / \ o U' \ NOO°04'05"W 195.51 / / \ 10' Tele. & Elec. Easement N080ct-, �.E r / - J 292.83 p II 1 7157 II v al S?° a m IVO I I c?' II rn_ co In I I Zii ("Ds 1 a° m — � . cn I `D o _ szo I \`1�4 .4�'=��16.0 `IIIIIIIIII \ I o. oi :3, 1 v �' 3 Sto Frame House Grke/dna ~ I 1 m � m CD / o o ewII I / 1 .x 43.5 I i I _ . c, m20.5 0 \ zzs. — ~ ` — _ ._ } 3 .-- CO N 0��V0'Je� \ 1 i _, �e°e��2 1 I I .0).4)°. „,o <;:=11 � � .1/ I 1 � n \ I 71 10' Tele. & Elec. Easement 1 \ NOO°04'05"W 433.47 0 84.00 ` I o 0 \ m r —_``\ I- -1 co OF AL \ BOBBY F. B URNETT X N 3i �,'” � .�,1, 2941 Carriage Drive > ..1-- _ .� Anchorage, Alaska 99507 /* 49TH /\ * (907) 350-5541 `, _ I Date Scale Legal Description / / 7/29/16 1' = 40' I hereby certify that the property described hereon has been survey! BOBBY F. BURNETT .1, Grid Grid Lot 3 Block 2 by me, or at my direction, and that the improvements situated therec LS-5464-5464 are within the property lines and do not overlap or encroach on the 4‘.';'- 2c-/-7^6 AS—BUILT SW 3336 MINDYER MANNERS property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the sS[oN1 / Drawn by Field Book SUBDIVISION premises in question and that there are no roadways, transmission BFB ASB2016 PLAT # '78-294 lines or other easements on said property except as shown. ‘111h...\."40".