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HomeMy WebLinkAboutMOUNTAIN SHADOWS BLK 1 LT 111 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241074 PID Number: 017-401-07 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name DAMES &LEE CLOUD ABSORPTION FIELD — ADVANTEX FAP 2.0 ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 8301 EAST 130TH AVENUE, ANCHORAGE _7_u� ❑ Other Phone Phone Number of Bedrooms Soil Rating Total depth from original grade 4 2 GPD/SF +0.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +1 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot MOUNTAIN SHADOWS 1 11 Fill added above original grade VARIES 4.04' — 4.3 Ft. Gravel length 2 30' 60 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between line's Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Pump Basin Tank Line 300 Ft2 2 6 Ft. Well 50'+ 50'+ 50'+ 25'.+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX Manufacturer ORENCO / ANCH. TANK Capacity 1500 Gal. Surface Water 50'+ 50'+ 50'+ Material EPDXY STEEL Number of compartments 2 Lot Line 5'+ 51+ 5'+ NA Foundation 10'+ 10'+ 7'+ LIFT STATION Manufacturer ORENCO Capacity 75+ Gal. Remarks Decommissioned old septic tank & installed new Steel S.T. w/ AX Pod, pump basin & field. Any biomat removed & w/ 2' type II Alarm location FIRST FLOOR Electrical installed by BRICKWELL & 2' MOA sand per design. MOA On -Site Staff on site: Ben Cogger. PIPE MATERIAL House to tank 3034 drainfk ld 3034 Installer MIKE N ANDERSON, PE (MNA) Drainfie►d 3034 CO/MT 3034 Inspector MNA & FWC BENCH MARK (Assumed elevation) 100 ft Inspdection 19' 6/6/24 2Id 6/10/24 Location and description 3'd 6/11/24 41" 6/12/24 TOP OF MANHOLE — PUMP BASIN MH ON -SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date �; Q�`•'• *J" 7H .. .. . ......... vim..—. 01 Curtis Huffman Septic System Approved - 'F# �`��is,. CE 128991 Date 2� Z ..�,•+' � F,pSl pRQEESSIq ��'4, Aw ESS10'"` Note: this approval does not include well permit requirements. `�\\ (Rev 05/02/18) N89"56'43"'E 150.001 E. 130TH AVE OEM"* 400� ANCHORAGE RECORDING DISTRICT, ALASKA AS —BUILT OF: MOUNTAIN SHADOWS SUBDIVISION LOT 11 BLOCK I PLAT 71-168 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul( any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lilies. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E-MAIL- JUNE 24, 2024 1 1$ =30' schullerakOgmail.com 24-029-2 DRAWN BY. ICHECKED BY. GRID NUMBER: BOOK/PAGE: JLS SW2841 240215 0* = FND 5/8" REBAR SURAW AGM AW Ile, 49TH ?A ... .... ................. -JOHN L. SCHULLER: ' (P for LS-10408 1831 Talkeetna Street Anchorage, Alaska 99508 Ar ��►ofeo3k (907) 227-1455 office�l n (907) 274-4992 fax FIRST WATER CONSULTING MOUNTAIN SHADOWS B1, L11 PUMP BASIN TO FOUNDATION PID:017-401-07PERMIT:OSP241074 FIRST WATER CONSULTING MOUNTAIN SHADOWS B1, L11 3030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : MOUNTAIN SHADOWS B1, L11 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/10/24 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 GM/SM 7 8 9 10 11 12 13 BOH 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE NA (MIN / INCH) TEST RUN BEWTWEEN NA & NA FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: 10’ IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 10’ DATE: 6/8/24 TESTHOLE # 24-1 DATE PERFORMED: 6/1/24 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: GROUNDWATER MONITORING ONLY – SIMILAR SILTY SOILS PER ORIGINAL TESTHOLE. PERFORMED FOR: JAMES CLOUD 6/10/24 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: OSP241074 Work Type: Septic Upgrade Tax Code Number: 01740107000 Site Legal Address: MOUNTAIN SHADOWS BLK 1 LT 11 G:2841 Site Mailing Address: 8301 E 130TH AVE, Anchorage Owner: CLOUD JAMES L & D LEE Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft Total Bedrooms: I)epart111Cnt 5/9/2024 5/9/2025 19947 Q Disposal Field ❑✓ 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 (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to confirm minimum separation to impermeable soil and seasonal high groundwater. Engineer may perform a percolation test to see if more favorable absorption rate is found than what was previously tested. Construction may proceed at your own risk prior to 7-day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). Received By:� Date: Issued By: Date: 5 �''L_ M 11NICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax- 907-343-7997 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-401-07 Property owner(s) JAMES & LEE CLOUD Mailing address PO BOX 110742, ANCHORGE, AK 99511 Site address 8301 E 130TH AVE, ANCHORAGE, AK 99516 Day phone Legal description (Sub'd., Block & Lot) MOUNTAIN SHADOWS 131, L11 Legal description (Township, Range & Section) Lot Size 19,947 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 1fl Septic Tank x❑ Upgrade ❑x (w/wo ADU) Holding Tank El Renewal❑ (D) ElRenewal Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ignature of property owner or authorized agent) Permit/Rush Fees: 459.5- Waiver Fees: Date of Payment: L11, A Date of Payment: Receipt Number: { 110 Z ( Receipt Number: Permit No. CL5P2 ut L 07y Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! May 3, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: MOUNTAIN SHADOWS BLOCK 1, LOT 11 The septic system has been found failed and will be completely decommissioned and per the owner we request a septic permit to upgrade the existing septic system on the above referenced lot. This will be a total removal of bio matted material and subsequently adding 2’+ of Type II soils, 2’ of MOA sand followed by both the primary and reserve 4-bedroom fields. We propose to install 2 shallow trenches elevated 2 ’ above existing field elevation with an Advantex system to serve the 4- bedroom residence per the attached design. The design is based on the 1983 test hole conducted & the attached letter from Leroy C Reid, JR Phd, P. The MOA inspection report was not entirely clear of actual install depths, but water was shown at 4.5’ from grade after 5 days. We will conduct verification as noted on the design to confirm groundwater depths prior to construction and install of this Advantex system will be above groundwater per code & as proposed 2’ elevated above the existing field. The slopes of this deep mound are moderate at 7-12% at the proposed upgrade location. The lot and area are served by private water with no known private wells within 50’ of the proposed septic system. Based on visual observations and review of available information, the design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241074, Curtis Townsend, 05/09/24 FIRST WATER CONSULTING MOUNTAIN SHADOWS BLOCK 1, LOT 11 DESIGN CALCS: NO PRIVATE WELLS WITHIN 50' OF PROPOSED ADVANTEX SEPTIC SYSTEM NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241074, Curtis Townsend, 05/09/24 FIRST WATER CONSULTING DESIGN DETAILS: MOUNTAIN SHADOWS BLOCK 1, LOT 11 NO PRIVATE WELLS WITHIN 50' OF PROPOSED ADVANTEX SEPTIC SYSTEM Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241074, Curtis Townsend, 05/09/24 �V66 -a 3�y N 89 "56' 43"E 150. 001 #I 0 to ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN SHADOWS SUBDIVISION LOT 11 BLOCK 1 PLAT 71-168 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoulc any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lilies. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E—MAIL APRIL 27, 2024 1 =30' schuilerok®gmcii 2 4 - 0 2 9 DRAWN BY. CHECKED BY GRID NUMSM: BOAC AGE JLS SW2841 240136 E. 130TH AVE © — FND 5/8" REBAR su)? AW O.F 4,4 LAN5 j 4 9M �..................... ........� r FA .01 10'-•.J HN L. SCHULLER•• o % ' % LS-10408 v�� ':• ' �t .� � ' �w.4 � �� • • . • 2�. • ��/ 1831 Talkeetna Street ecy ` 4 - ��� ��, Anchorage, Alaska 99508 o fe o� \. ,. A (907) 227--1455 office (907) 274--4992 fax  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE <~/ ,~NEW MAILING ~DD~ESS LEGAL DESCRIPTION ' /)o ~ ~ ~ Manufacturer~ ~ ~ [~ e Material~-~/ No. of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth ~ IF HOMEMADE:__. ~ ~ Well Dwelling PERMIT NO. DISTANCE TO: ~ ~ Manufacturer Material Liquid capac[tg in ~allons ~ DISTANCETO: Well /~ 7 ........, 1' ' Foundation~ ~ ~:~--~ No, of I]nes~- Length ofeachJin~/ TotaJlength of~7 ~ ~ Top of tile to finish grade z Material beneath tile -- Total effective absorption area ...... ~.~ngth Width Depth PERMIT NO. ~ I- ~ype of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth ~}i~er " J Distance to lot line ~ PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ..... SOIk I~ST ~ATI~G ~J / - APPROVED DATE LEGAL 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE / Department f Health and Environmenta ?rotection 825 ~, Street, Anchorage, AK. 49501 264-4720 ~ HANDWRITTEN PERMIT * * * Permit #~ - ~- - .... '/:~,~ I WELL AND%~t~ ON-SITE SEWER PERMIT Applican,t: _,~7;/~2d AJ ~/O &/~g~ Mailing Address:/~,// Location :~:N,~ ,,j)~, ~-/ ~'~t~ -- Phone Muter: Legal Description: %~(L ,~$--~/~- /~&~ Lot Size: ./~, Type of Soil ~sorption System Is:__~//~>4'~"~z~ ~ ~,,(///]~ot.~ Trench: Drainfield: Seepage Bed: Holding Tank Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) The Required S~ze o~ the Soil Absorption System Is: The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enla~rgement if the~e~idence is remod~d to include more th~ bedroo~// Sign e~~~.~~~~, _~~ s s u e d by :~~/.~~_~ ~ SWP/024(1/81) ALASKA ENVIRONI~eNTAL CONTROL SERVIC; INC. 1220 West 25th Avenue 'Suite B ANCHORAGE, ALASKA 99503 276-1361 279-2917 SHEET NO CALCULATED BY CHECKED BY SCALE OF OATE 0ATE 3/5 ALASKA , iaUIROnm fTrAL COFITROL $ ,,tUIC S, ~nqirJ~rimt $ {nuironm~nloJ ~lu(lics May 2, 1983 Paul Palmer 411E 36th Avenue Anchorage, Alaska 99503 Dear Mr. Palmer: Mountain Shadows Subdivision Lot 9, 10, 11. All 3 lot's did not percolate at an intermediate depth which would be required for a septic system of a trench design. Test holes were redone with a post hole digger 1 foot below the OL layer on Lot's 9, 10, and 11. The percolation tests were done at these depths because original test holes showed increasing tightness of silt and gravel with depth, and did not perc. These lots can accept a septic system but it must be of a shallow surface design (mound system.) This letter and drawing are rough draft of a conventional trench system and that of a mound system on each lot. They are not the ~inal engineered design but a draft to use for cost estimates of mound versus trench. Pete S~pala Civil Engineer ~2oo LiJ~s~ 33rd ~uenu¢. ~uife ~ o J~nchoroc~¢, Aloska 99503 o (907) 276-1361 ALASKA CMuidnWTAL COnTROL eRU,GCS, IN. C'mineerinq f Cnuirort nenlal Studies Department of Health & 825 L. Street Anchorage, Alaska 99501 Attn: Gary Willia Dear Gory: January 11, 1984 Envi-ronmental Protection bI UN,C1 P' tO 3' - . < ENVlQQ,�Ll I-'O �PnU��'E� IEer.'e are the copies of the porculati-on %eats we did on lots 10 and 11, black 1, Of Mountain Shadows Subdivision. Lot 9 had a visual soils rating of 150 sq.ft./bedroom in the excavated area. Lot 11 had been over excavated so we perced the bottom of the bed and then had 3 ft of sand brought in to bring the bed to 4 feet above groundwater. The way the lots were cleared made it appear that we were deeper than planned. however, we found that the excavator used building excavation dirt to fill around the holes, The soils were much better than what c.re fo6nd earlier with the augers. T hope this anawers your questions. Sincerely, Leroy Reid Jr. !,Pt� , PEPresidl nt ALASKA e~,,JlROllmellTAL COI1TROL $~hdiC~S, IllC. ~n~lin~rinq E- ~nuironm~nl~l $1u~i~s /~I O A PERCOLATION .T..EST, DATA SHEET ZIP CODELC/~.,~' ~,,/- LEGAL LOCATION ~o~tll/ BI~aJ~ i.,,Z~I~...~t,~,d~,w.~ .~,,I,~f;,,,'.,,:.~,,?'I2N,~R3~,$e:~','~,, TOTAL DEPTH OF HOLE. ~./Z+ ft, ZONE TESTED ~1~ ft TO __ '~ ft TH:~I READING # CLOCK TIME NET TIME DEPTH TO NET DROP RATE (min/in) · DATUM .... i ~. ~, ~ - _ ..... ~ ~+ ~FINAL ~E:RCOLATION RATE. (min/in) fERFORMED BY =~r/.*,~n . ALASKA eI~ulROFImE~IqTAL COFITROL SE!Ro~Ce$, inc. PERCOLATION TEST DATA SHEET ADDRESS ZIP CODE LEGAL LOCATION__ ~v~_o[jnt-O!n ,_cihC{C.t(~LL}~ ,~Lpbd.I_~i~'lCJ,'l TOTAL DEPTH OF HOLE ~. ZONE TESTED ~ ft TO ~/2_ ~ft / ~ao"P ~zo~.~; OL ~,x~'~ READING # CLOCK TIMI-' NET TIME DEPTH TO NET DROP RATE (min/in) DATUM -Pti2.0 .: /© ~'~,n. · ~ · 05- FINAL PERCOLATION RATE PERFORMED BY . 1200 ~esl 33r~ Au~u~. Su~,Z,~, Anc~or~. Alosko 99503 * (907) 276-1361 DEPARTMI. OF HEALTH AND ENVIRONMENTAL PR, 825 g Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST CTION / PERCOLATION TEST LEGAL DESCRIPTION:_ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18t 19- d/~:~, A' / / ~//t SLOPE SITE PLAN / / ¢'~,1Y/ ENCOUNTERED? . SL o P IF YES, AT WHAT E' DEPTH? ¢?~ " Reading Date Gross Net Depth to Net Time Time Water Drop /~ , '~o i/.'/q , &.~ /./.' ~ ~ , ~ 20 -/-//,¢ O ' -' · '" P ER CO~I~TIO N RATE '~'-"')f'/~'~'~~¥~.' ~ ~.,~.~. %~.a ~' %f: ~ ~ ~' ~1%~{~S~ifl~ ' ~ ....I~1~ ~/ ~/~ ~'"~ ~' ,'- ' ~' ' PE R FORMED BY: / , ,. ',..~ , .~ .~c~.~ .:' ...... 72-008 (6/79) ~,. , ' h~~ ~' rv1-W DRILLING, Inc. P.O, Box 10-378 · 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner C©!Tff~)!'.! ~,~.~;I,F!~' .Use of Well ~¢z:¥~,~t'ic. ........ _ Location (address of: 'township, Range, Section, if known; or distance main road ~ ~a(,~.~ ..~)~ion Size of casing 6" Depth of Hole Static water level ~J. ft. Screen ( ); Perforated ( Z~5' feet Cased to ~5'· 5' feet (below) ]and surface. Finish of well (check one) open end ). Describe screen or perforation ,. Well pumping test at )'£ gallons per of drawdown from static level. (minute) for ] hours with-- '! :::')'~i Date of completion Jul', WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness "'" ,TO :it Cas:[~R st:icku~:, ____.TO. ii TO TO .TO.__ TO.__ ~TO.__ TO _ TO ____TO _ TO.__ ____TO ____ TO__ __TO _ 0r~'anics 3-- CONTRACTOR APPLIC NT FILLS OUT UPPER HAl ONLY Prope~t-y Owner Phone Gordon Wolfe M~dingAddress ]241 Fr:iRndly I,a~n~ ~,'1.: Anchorage ZipCode 995(~4. 337--4,984 Buyer James L. & Lee Cloud Address Zip Code Lending Institution Phone National Bank Alaska Address C ST. & Northern Lights Zip Code 276--1132 Realty Co. & Agent Phone llOne Address Zip Code Legal Description LO~ 11~ B 1, Mt. Shadows Sub. Street Locatio,~ Type of Residence  Single Family Multiple Family No. of Bedrooms 3 ~ Other Water Supply ~1~ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility ,~ Individual Year Individual Installed:---:~9 8 3 ~ Public Utility When Connected 1o Public Utilily: ~(~]~ ., ,-.,,-,...-, ~J~f,..H old i n g Tank NOTE: THE INSPECTION FFE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector ~.L-~,~'t~,. MUNICIPALITY OF ANCItORAGf~ (~) :~PROVE~ 8EOROO~S 'CON~mONS OF APFROVAL ( ) D~SAPPROVED Soils Ratinq . Date ~wer installed Well To Absorption Area / / ~ / Well Log Received ~ 72 023 ¢182) ALASKA eI dlRODmE DTAL CODTROL SE RuIC( $, tDC. ~nqineerinq 6 ~nuironmenlol Studies October 27, 1983 Municipality of Anchorage Department of Health & Environmental Protection 825 L. Street Anchorage, Ak. 99501 Re: Health Authority On October 24, 1983 our company collected a water sample from the house located on Lot 11 Block 1 Mountain Shadow Subdivision. The property owner is Ken Boyer. The water analysis was satisfactory. A copy of the report is attached. The well is located 94 feet from the septic tank and 100+ feet from the leach field. The electrical wires are encased in conduit. All the standpipes are capped. The well casing stands over 1 foot above ground and has a sanitary seal. 1200 ~est 33r'd Auenue, ~uile ~ · Anchoro§¢, Alusku 99503 · [907) 276 ~361 ALASKA FI ,i OFImeF1TAL COFITBOL IFlC. ~nqincerlnq 8 ~nuironrncr, lal $1udics January 11, 1984 Department of Health & Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attn: Cory Willis Dear Cory: Here are the copies of the percolation tests we did on lots 10 and 11, block 1, o1! Mountain Shado~¢s Subdivision. Lot 9 had a visual soils rating of 150 sq.ft./bedroom in the excavated area. Lot 11 had been over excavated so we perced the bottom of the bed and then had 3 ft of sand bronght in to bring the bed to 4 feet above groundwatez~. The xcay the lots v~ere cleared nmde it appear that we were deeper than planned. However, we found that the excavator used huilding excavation dirt to fill around the holes. The soils were much better than what ~,~e fo&nd earlier with the augers. I hope this answers your questions. Sincerely, Le~.'oy ~. Reid Jr. ~/,P~, PE Pres~ 1200 LUes! 33rd A,¢n,~. SuH¢ B · A,chora§~. Alaska 99503, {907} 276-1361 Parcel I.D. 017-401-07 Certificate of On -Site Systems Approval Expiration Date: 4/10/2025 Legal description MOUNTAIN SHADOWS BLK 1 LT 11 Site address 8301 E 130TH AVE Anchorage AK Current property owner(s) CLOUD X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/27/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 Em Development Services Department On -Site Water & Wastewater Section MUNICIPALITY OF 1.NCHOR1GER054i 4)] Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-401-07 Complete legal description MOUNTAIN SHADOWS BLOCK 1, LOT 11 Location (site address) 8301 E 130TH AVENUE, ANCHORAGE, AK 99516 Current property owner(s) JAMES & LEE CLOUD —Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well E] Private Well serving 2 dwelling units F-1 Private Well serving 3+ dwelling units E] Community Well or Public F1 Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Z Private SepticE] Private Septic serving 2 dwelling units El Holding Tank r_1 Community Septic or Public Sewer 5. SEPTIC TANK: [9 Steel i Plastic F1 Concrete n Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: Z AWWTS 0 Bed E] Deep Trench Z Wide Trench R Seepage Pit Waiver request for: Expedited review requested: E 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 $ LN 3 Waiver Fee $ Date of Payment COSA # 0_'5C 2�-1 122-6 Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: MOUNTAIN SHADOWS BLOCK 1, LOT 11 Parcel ID: 017-401-07 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 7/18/1983 Total depth 245 ft Cased to 25.5 ft (INTO BEDROCK) Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/10/2024 Static water level at beginning of test 31 ft. Well production at time of test 0.25 gpm Water storage tank volume 250 gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.99 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 4/10/2024 Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NA – ADVANTEX <1YR Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: NEW ADVANTEX SYSTEM D. ABSORPTION FIELD DATA Which system tested (date installed) 6/12/2024 ALL standpipes present per record drawing Total measured depth from grade 4.3 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ 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 N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/24/24 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 well and septic system. 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