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HomeMy WebLinkAboutMINDYER MANORS BLK 1 LT 5MI*ndyer Manors Block 1 Lot 5 #020-091-66 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231266 PID Number: 020-091-66 Dwelling: FOR Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ®❑ Upgrade Name Josh & Joelle Nadel) A ORPTION FIELD ElD Trench ❑ Wide Trench El Bed ❑ Mound Site Address 4821 Virgo Ave Other Phone 907-382-5342 Number of Bedrooms 4 Soil Rating Total depth from original grade /SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original a Gravel depth beneath pipe Ft. Subdivision Block Lot Mindyer Manors 1 5 Fill added above original grade Ft. Gr length N11, Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dista between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between tr hes From Tank Field Tank Line Ftz t. Well >100' >1 00' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >1 00' > 1 00' N/A NIA Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation > 10' > 10' N/A N/A L ATION Manufacturer Capacity Remarks Insulation placed over tank and new pipe. Gal. Additional fill placed over field where needed Alarm location Electric d by Installer PIPE MATERIAL House to tank D3034 dTankto rainfie ld D3034 Beek's Contracting, Inc Drainfield D3034 CO/MTD3034 Inspector B Schiller BENCH MARK (Assumed elevation) 100 ft Inspection 151 9/26/23 2nd 9/27/23 Location and description• 31d Garage slab 41h ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ����- ' ' • • `9cSa,���� ..• .. .. ...... �•• • Benjarr" chiller �� •. CE 12592 • i�`� s�'' Septic System a (ItAIV Approved Date t i Z; 'srF • . 11/2/23 . • •�C Note: ��� ROFESSt4N�. this approval does not include well permit requirements. // // // // // // // // // // // FCO CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP231266 PID # 020-091-66 A B FCO 24.8 MH 61.0 SV 66.2 A B 2CO 72.8 CO1 82.4 MT1 81.3 CO2 89.8 39.9 74.3 79.3 82.1 88.3 97.0 105.5 1"=50' 4 - B D R M H O M E MINDYER MANORS, BLOCK 1 LOT 5 FEET 0 50 100Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N G INEER V I R G O A V E N U E 11/1/23 AS-BUILT PLAN 10 ' T & E E A S E M E N T EXISTING ABSORPTION BED TO REMAIN IN SERVICE.NEW 1,250 GALLON SEPTIC TANK 2CO CO3 93.9 MT2 100.9 CO4 93.6 MT3 59.4 97.1 93.3 83.3 76.1 CO1 MT1CO2 CO3 MT2 CO4 MT3 EXISTING WELL BENCHMARK PROFILE AS-BUILT (NO SCALE) 90.4 85.4 90.9 94.9 FC O MH SV 1250 GAL SEPTIC TANK 2C O 90.2 Benjamin Schiller CE 12592 R E GISTEREDPROFES S I O N A L E N GINEER 11/1/23 PERMIT # OSP231266 PID # 020-091-66 MINDYER MANORS, BLOCK 1 LOT 5 INSULATION 30� G �G, y (J rn� o 1 II \ 3 i i I r 250 H Street Anchorage, Alaska 99501 Lr Survey Department Phone 562-5291 Inc Mainline Phone 243-8985 AECC668 ORDERED BY: JOSHUA NADELL LOT 4 LEGAL DESCRIPTION: LOT 5, BLOCK 1, MINDYER MANORS DRAWN DATE: 10/06/2023 DRAWN BY: ADS CHECKED BY: GMG SCALE: 1.1 = 50' WORK ORDER: 23019 PLAT: 78-294 GRID: SW3336 REF:13L072 W N890 56' 00"E 392.67' NEIGHBORS DRIVEWAY AS -BUILT ` Gravel LEGEND: Concrete CLEAN OUT O WELL OverhanE FENCE - X ,Wood Dec .2' j o Z O w O �Q �W V J _> w p 06 CD LOT 2 Lu d J O LU F- O o p Z BUILDING DETAIL lit =30' NOTE 1) HIS MORTGAGE LOCATION SURVEY (AS -BUILT) WAS PREPARED F RJOSHUA NADELL. IT SHOULD ONLY BE USED FOR A SINGLE ROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE RIGINAL CLIENT OR BY OTHERS FOR ADDITIONAL USES LATER WITHOUT THE EXPRESS WRITTEN CONSENT OF LCG LANTECH, INC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. 2) THE LIABILITY EXTENT OF LCG LANTECH, INC. SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION FORTHIS PRODUCT, UN LESS GROSS NEGLIGENCE IS DISCOVERED. 3) THIS MORTGAGE LOCATION SURVEY (AS -BUILT) IS A REPRESENTATION OF THE CONDITIONS THAT WERE FOUND AT THE TIME THIS SURVEY WAS PERORMED. THIS AS -BUILT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4) THE INFORMATION CONTAINED ON THIS DRAWING SHOULD NOT BE USED IN SUPPORT OF ANY NEW CONSTRUCTION. 5) THIS AS -BUILT ONLY SHOWS EASEMENTS THAT WERE ON THE ORIGINAL PLAT. IT IS THE PROPERTY OWNER'S RESPONSIBILITY TO DETERMINE IF THERE ARE OTHER EASEMENTS, COVENANTS, RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF RECORD NOT SHOWN ON THE ORIGINAL PLAT. ADDRESS: 4821 VIRGO AVENUE PARCEL #: 020-091-66-000 MUNICIPALITY OF ANCHORAGE � �\llenC On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road %- Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 J� http://www.muni.org/onsite � I ___� tic 7artn�ent On -Site Wastewater Disposal System Permit Permit Number: OSP231266 Effective Date: 8/31/2023 Work Type: SepticTank Upgrade Expiration Date: 8/30/2024 Tax Code Number: 02009166000 Site Legal Address: MINDYER MANORS BLK 1 LT 5 G:3336 Site Mailing Address: 4821 VIRGO AVE, Anchorage Owner: NADELL JOSHUA R & JOELLE G Lot Size in Sq Ft: 62492 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ 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 (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: • Find and repair missing standpipes in the field and add additional cover to meet code. F_eceived-fy_ 5-5 ct �C, Issued By: , i Date: Date: 8 3 Z MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-091-66 Property owner(s) Joelle Nadell Mailing address 4821 Virgo Ave, Anchorage, AK 99516 Site address 4821 Virgo Ave Day phone (907) 382-5342 Legal description (Sub'd., Block & Lot) Mindyer Manors Block 1 Lot 5 Legal description (Township, Range & Section) Lot Size 62,492 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) IN (w/wo ADU) Septic Tank ❑X Upgrade❑X Duplex (D) El 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: 225/ Waiver Fees: Date of Payment: / / 6/ Z,,) '13 Date of Payment: Receipt Number: Receipt Number: Permit No. 05P2-31 264 Waiver No. Permit App_'- :: -.,:c August 15, 2023 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Mindyer Manors Block 1 Lot 5 - 4821 Virgo Ave Septic Tank Replacement Dear On-Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, so we are submitting this permit application for its replacement. The attached site plan identifies the location of the home as well as the wells and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing the septic tank with the same size designed for 4 bedrooms. At the time of installation the missing pipes on the existing system will be repaired or replaced as needed, and cover will be added to the field to ensure minimum 2’ of soil over the insulation covering the laterals. The new septic tank will be a minimum of 100’ from all wells and surface water. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231266, Deb Wockenfuss, 08/31/23 // // // // // // // // // // // FCO CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 1"=50' 4 - B D R M H O M E MINDYER MANORS, BLOCK 1 LOT 5 FEET 0 50 100Benjamin Schiller CE 12592REGISTEREDPROFESSIONA L E N GINEER V I R G O A V E N U E 8/12/23 SEPTIC PLAN 10 ' T & E E A S E M E N T DECOMMISSION EXISTING SEPTIC TANK PER UPC EXISTING ABSORPTION BED TO REMAIN IN SERVICE. FIND AND REPAIR MISSING PIPES, AND ADD ADDITIONAL 1' COVER TO MEET MIN REQUIREMENTS NEW 1,250 GALLON SEPTIC TANK 2CO Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231266, Deb Wockenfuss, 08/31/23 Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 9 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: f2i 9301516 PID Number: 07 -Do AI f ✓� Name: eleer 5u 6hew� Wastewater System: W�ew ❑ Upgrade Address: ABSORPTION FIELD Phone: No. of Bedrooms:'' ElDeep"Trench ❑Shallow Trench Bed I] Mound 11 Other LEGAL DESCRIPTION Soil Rating: Total Depth from original ! 'S GPD/Sq. Ft. .S— Lot: �� Block: yr' '"� Subdivisio Depth to pipe bottom from original grade: Gravel depth beneath pipe / � ,.; — -5/Ft. .7 Ft. Township: Range: - Section: Fill added above original grade: Gravel length: Ft. Ft. • WELL New ❑ Upgrade Gravel depth: Numberoflines: Distance between lines: Ft. %ir Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Awrt r, --o#34 , ?-q7 Ft. t-51 Ft. yam• S t SC. Ft. F - iii Drillelt Dat Dr'lied: Static 7�3 93 Water Level: Insta r Dat installed: IAVW /iLr Ft. �� 9 Yield: ! r aqf Pump Set at: Casing Height Above Ground: TANK 7 GPM i Ft. 2 Ft. SEPARATION. DISTANCES eptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Private Manu acturer:Capacit�y in gallons: From Tank Field Station Tank Sewer Lines 11-549 Well, %1051 IIS, , 40 materialL Number of J Ware t e >IQt 'Ila' - -Iao' LIFT STATION Lot Line �'J� �,. �! Size in gallons: Manufacturer: - Foundation 7�' 70' / "Pump on" level at: "Pu 'level at: High water alarm at: Curtain Drain 'I H� / Illy/ IT 101Pump Make 8 Mo Electrical Inspections performed by: y Remarks: 1 BENCH MARK Location and Description: e Assumed Elevation: p0 ,4®L AtSEAL 0� r g peeO %Fl aee ��� �c9 'ea • e P ee ,,}y e ®0 g ° AlAPO Inspections performed by:iti� Dates: 1s L3 ®cacocase csse..e e, .. _ ®e a tr.A . 2nd 611 9 4 Michael E. Anderson a � X `ea 4361- E ,j � ® Department of Healp ldH In ervices approval � ® Reviewed p FES and approved Date: 72-013 (1/91) MOA 25 Permit No. <OL 9.301 S(e Paye of 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 d >� �- mm(A y Z- m XZ0 > coo to O N CP Ln,§ A O p C W 0 < O 0 cm m C� to :O < N N N r NN Z Z m 1 A W � � (n Z }I Z 3� m o rn CO C4 Z U) m cn C ml Z' r. co i Z 0 O �1 m N D C: CO Q m n C A v O Oz Z =x N O ° r < 0 n]c E m ° w m a38 mST n 5 J a° n O° J a 0- .05 a J y n S o m Qm 3"➢ S 2 3Z"un1 m �- F °on N ° r,o1 ][i C� a� o N S cm a o m ]am J q onC7 on'm" °ac Z Z o TC - 3> u N C 4 -' S C m m b T O J -.O i° ° o mO� 3"»3. 00 _OZA pa°n T=2 C a m " NnOiry �w'G m] " �a co N 3 :'_ ••'•OO� 0." `co �O O4�d4poo , 0r: o vl w CD C� o� O O rn -6719 Z9�� N U I I- N 4s .9•- �c A,R�rC 1WS3 3 V 1 ,OLS 09[ '3 "00,ti0.00 S M"012 N OF WEtt T 1 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURM DIVISION OF WATER WATER WELL RECORD `�i CK REGION GT" RECTION TOWNONPI (tAOE OOM WELL OWNER: ground surface WELL DEPTH: , GATE OF 00MP16TI"i Depth of hole:ft Depth Depth of casing eft J / From To F DEATH TO STATIC WATER LEVEL "+ C 7 i0/,- ft below 9 top of casing 0 ground avi lsog r` Date: 1. 1ki� METHOD OF DRILLING: ;I air rotary 17 cabin W. ff a cft » Other USE OF WELL: V domestic 17 irrigstlon . IJ moil W ' 41 C] public supplY Q other CASINO STICK•U:_ it. Dism: 6 In. J$ WELL INTAKE OPENING TYPE: D open end 1110et"nWil O perfofated )b open hole Depths of openings: to ft SCREEN TYPE: Dism: Slot/Mash Size: Length: t GRAVEL PACK TYPE: - Volume used: Depth to top: GROUT TYPE: Volume: Depth: from ft to `}{ DEVELOPMENT METHOD: Health & Hum n Servfc s PUMPING LEVEL AND YIELD: � i) ft after / hrs.pumPing PUMP INTAKE DEPTH: it Horsep'ower:l: WELL DISINFECTED UPON COMPLETIONt ©:Y REMARKS: z PLEASE MAIL WHITE COPY OP. DNR/DIVISION OF WATER PO BOX 772118 EAGLE RIVER AK 99577.2116 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930156 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:SUITER CHESTER E & ADELE E OWNER ADDRESS:4821 VIRGO AVE ANCHORAGE, ALASKA 99516 PARCEL ID:02009166 LEGAL DESCRIPTION: MINDYER MANORS BLK LOT SIZE: 62492 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 1 LT 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 6/16/93 EXPIRATION DATE: 6/16/94 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: 693 C/ 2 /'v-& DATE : oz— / a / ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 June 2, 1993 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 5, Block 1, Mindyer Manors Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The subject lot slopes at a rate of "`1$ n east to west direction. The slope is fairly uniform and will preventany any ponding at or near the proposed elevated bed system. Groundwater was encountered at shallow depths during initial testhole exploration. A subsurface drain was installed along the eastern property line which appeared to lower the groundwater level at the location of the proposed system. If the system is constructed as planned the following statements can be made: 1. The system, if constructed as designed, will have no adverse impact on the wells currently in use or to be placed in the future on lots in the area. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have �����verse impact on drainage patterns in the area. a''oF A114% Sincerely, e 1 VIP e AW,&L.t E 04. Michael E. Anderson, P.E. ei E. Anderwn 4381•E - AP— A MAP /if /PQ` j, , JOB LOT r7fC211, MIKt2ft hAMO cSL} 0 SHEET NO. OF CALCULATED BY - z0f DATE 5/LS/9°5 PAGUGGi2Ga�1131npkSMb13[d�11P+JhA1(A�/aDa.GioWo,Nw.GNit.io WbIPXGXEtOLLiFEEt-0OU115G30 - - iPA000f$011 poles w00i'1(pg*j� MMc. GMM, M"011/1. ie0 �e-r-A ILS SKEET Ko. OF tom! /� hi CALCULATED Sv Me14 DATE G /0 43 CHECKED BV DATE NIDUrJQ S JtLrNli PCsmc.0L4170,j P—A7 MON. /%NC I 4 Oris -4 Glb f 8D2M - $ APo A*rc - 750 Fr L /8 x 45 �DN 1rorL TdE CoeT}a .Our_ - \ _ 0 NlUNIrok /V oc I,ZC0 6A&L0,J SEvrIG TA..d� 0 0 cl Z �LS7rM -?LatJ 141o,jim M Z' thro+4 fr. emaFj Ai40 Z bp„J 4 L /NdULA710 DR 3' dATUkAL $AGWIU. Ar1b NO :WSULArt04. 3 6PARSE_ 5AaD Fik. (M w) - (lxnnoJ� ALL Wfir P�ArURAI._ .L�A,cvab Arvp Dr24ANICS ®®OFti� TPIGAL f4OUND S� LrIOAI 90®6 B a aou eG0 e9.P .. a Michael E. Anderson Geo,-E,RFAC Fner�Ia PA(t.ttgl�f IS+WtSwW ASt lvgi0 laGYli I[.4rc4 WY YIIII.IOpMYl,1Mt ICLLMEI�TlSa1p PERK LEGAI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PERFORMED BY: � I P1494610 el..V.La��Y THAT TNI T SSTpWAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ���7J 72-008 (Rev. 4/85) �JJ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: DATE �®' LEGAL DESCRIPTION:�� ��NV) t%il� Township, Range, Section: 2 �Oe 3 4WAr 4 / 0. 5 6- 7 p i 8 4'no-°h. •0,o 9 10 11 12 13 14 I TLS 15Z 16- 17- 18- 19- 20-4 61?181920 COMMENTS WAS GROUND WATER ENCOUNTERED? No IF YES, AT WHAT DEPTH? Depth to Water After IAanitorillp? +e, Bale: 11 ®®mmm �®' PERCOLATION RATE 3 (minuteS/inch) PERC HOLE DIAMETER '_II, - TEST RUN BETWEEN FT AND _3 FT _ �� 1 PERFORMED BY: _ I NY4r / °=�� THAT T/HI/$ T T WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 0/ 3if3 72-M (Rev. 4/86) tttttA sa w Q SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 1-) PERCOLATION T . � TEST 825 L. StrMt. And_r&M Ahaa ==501 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Ilin(c keit(S%i eA _ DATE PERFORMED: /22/87 LEGAL DESCRIPTION: L.oFy1 QiOC k 1 !"f18� y[I' Na�o�t S /D 7' (FEET) 1 2 if 03(ac- ovgAicr) 3 4 • 6, ns. (gl� c1aY;X. rllE) s Si/Sr! �grou� t�(!� tand, 7 E 9 10 WAS GROUND WATER 11 ENCOUNTTERED7 [S O P 12 E IF YES, AT WHAT. 4r0 Bs,L DEPTH? 13 .+. F/tf /B7 is ' PSE OF•A(�s�t • R 16- s .,9 17 J THEODORE F. MOORE ; CE -3589 c+ ( 19 +! �AtU(•ei5�� � 20 7 PERCOLATION RATE (minutnlinchl -r d• J TEST RUN BETWEEN FT AND FT COMMENTS RI f' a iieL�r fer ow -sr ILC deiOalu� TW57-µ064..s '03 PDO- tWIJ SUR M M AL- PERFORMEDBY:,r%EF/O4 iecAAical Service/ CERTIFIEDBY: mmmmmm mmmmmm mmmmmm mmmmmm 20 7 PERCOLATION RATE (minutnlinchl -r d• J TEST RUN BETWEEN FT AND FT COMMENTS RI f' a iieL�r fer ow -sr ILC deiOalu� TW57-µ064..s '03 PDO- tWIJ SUR M M AL- PERFORMEDBY:,r%EF/O4 iecAAical Service/ CERTIFIEDBY: • .. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 89502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: // DATE � 7 LEGAL DESCRIPTION: Lbj I N� lIQVi rv�L, GIC Township, Range, Section: COMMENTS SLOPE SITE (ENGINEER'S SEN.) FAP, WAS GROUNDWATER 4 'p"�'1"`� ENCOUNTERED? S IF YES, AT WHAT I r L DEPTH? 3 k 'v I, E koLb la wmr AIW Maailoriap7 .49' Brlt PERCOLATION RATE' 3 (mmutwinm) PERC HOLE DIAMETER `'? TEST RUN BETWEEN � FT AND SFT PERFORMED BY: 1 r'ig����%+=-, G^�9nQTIIfY THAT TNI TEST WAS PERFORMED IN . ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS-DATEDATL 41zlq.7 72-008 (Rev. V85) 2 e3 jo u n 1 �YY 1 4 .Ov *00 5 . 6 7-. 8 4p 11 le 9- t011to - 11 12- 13- 14- 5 15- 16- is17is1s20 17- 18- 19- 20 COMMENTS SLOPE SITE (ENGINEER'S SEN.) FAP, WAS GROUNDWATER 4 'p"�'1"`� ENCOUNTERED? S IF YES, AT WHAT I r L DEPTH? 3 k 'v I, E koLb la wmr AIW Maailoriap7 .49' Brlt PERCOLATION RATE' 3 (mmutwinm) PERC HOLE DIAMETER `'? TEST RUN BETWEEN � FT AND SFT PERFORMED BY: 1 r'ig����%+=-, G^�9nQTIIfY THAT TNI TEST WAS PERFORMED IN . ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS-DATEDATL 41zlq.7 72-008 (Rev. V85) PERF LEGA COMMENTS PERFORMED BY: A. I �' T"'a^-��TI THAT THIS TEST]j WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE )Z /93 72-008 (Rev. 4/85) ~� ����I C�������� �� *' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION S25 L STREET, ANCHORAGE, AK 99501 264~4720 C) VA_�I 'I'EE E3 Ew hJ EE: F4Z F� FE F;� Irl I -T- PERMIT NO: 870145 ENGINEERED DESIGN DATE ISSUED: 06/22/87 APPLICANT, TUCK-FDELSTFEN ADDRESS: J100 SUMMIT AVENUE, EAST ' JEATLE, WA 98102 CONTACT PHONE: (206)382-0460 LEGAL DESCRIP: SUBDIVISION: MINDYER LOT: 5�' � BLOCK;� 1 ,` , °~ ^ SECTION: 3 TOWNSHIP: 11N RANGE: 3W LOT SIZE: 63000 (SQ"FT" OR ACRES) I certify that: 1" I am familiar with the requirements for on-site sewers and wells as set / forth by the Municipality of Anchorage (MOA) andthe State of Alaska. 2^ I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" 3" I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING cDDF9, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-8UILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED APPLI EDELSTEEN DATE : 0 - ISSUED 9YDATE: "�~. 22 -97 ~~(19A;f7ocr peR �� �$ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501264.4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR:f ciai 11 47A • SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 - 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Tt e -k Eo. irSIYPn DATE PERFORMED: SI Z2/ & 7 LEGAL DESCRIPTION: /-O7 F, B IDGlc -1 m (neer "cc nors S/40 7-H #2 FD—EPT-H-1 SLOPE - SITE PLAN F* 1 2 -I 3 GU/ CG/eun Sandr c/rave0 4 SS O'/adrrm 5 6- 7 - — ff:a seeps s 9 B. H. 10- 11 12 13 Date Gross Time 14 Depth to Water Net Drop 15 O....F At 16- `,�� •.�0. 0* 94 4JT" 17 1 ...................:: 1$ .0. .... ....... ....... ® THEODORE F. MORE ; •'•. CE . 3589 'Q1f�ta 19. '••..... ••'Gt\Ao1 WAS GROUND WATERS ENCOUNTERED? Yes L O P IF YES, AT WHAT Hta eF ul da'Af DEPTH? eRca✓uflon H -LO scf 9.47'on S/ef/ Reading Date Gross Time Net Time Depth to Water Net Drop e B 20PERCOLATION RATE (minutes/inch) TN z TEST RUN BETWEEN FT AND FT COMMENTS SuiI o[irSor 02 )tan btGr C '!/ rGaul a 2' SaAa .91Wer ?' H #t 2 A - 20' fv so"* con il'rmce.P ca�nl-ra ui /y aoc rmaf-o-i4tl PERFORMEDBY: rr=1a�� ,o TeCkg( Se✓+J /- d%c CERTIFIEDBY: J. .-f 141� DATE: 6IrlB7 72-008 (6/79) • 0 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 -264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Tf.SGT e i Steer) DATE PERFORMED: 5 % / zzI B LEGAL DESCRIPTION: 1'01' Stock 1 11(44ye( lYaoorx DEPTH SLOPE - SITE PLAN �� PP ( Froreif PH-c�� r 1 2- 3- 4- 5- 6- 7- s- 9- 10 - -10• 11 - 12- 13- 14- 15- 16• 17 - GP sIntitrr s.l y yrave) Rzo Saiuru�ic•�i B. W.. •<<G OF.. A` qct # kY.e 49TH • �9* 1 .... .................... I 18 "..THEODORE F. MOOS a CE - 3589 ,• ea�professim�a\ V. Sr WAS GROUND WATER ENCOUNTERED? Yes IF YES, AT WHAT 2.%of SY2%/87 DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 20 I I PERCOLATION RATE (minutes/inch) T. Ham• #J� TEST RUN BETWEEN FT AND FT COMMENTS __ SO(I GCJ.Cor02)1-e0,7 SVS1E-C/ry oOrcc(n a -AX /or GoRC cftorl ar" moctn,o( srs�rm. "aFertal a sut;4ubl,- der rererr✓e a(rc� PERFORMED BY:FIIXF%. TCc Aaccaf S2rve'Ceimf S2rye'Cy CERTIFIED BY: �J . /�'aK, DATE: 6 4.J A97 72-008 (6/79) AC-SE(i�E ABE/�: S�opE EliAFupTIOF(: The 66 slopes generally 4v t/+e uesP of LoT3 Flattop Tech.nicaI Services 14530 Echo Street Anchorage, Alaska 9951P AdfOgrnom Lo T y 1 $ WCl.4 HSS too PKoP L�OTS \` --- \\ Aa rPROPt. LH xSEmJ hit 04 7-144 ???J� T. x. of ztW NO' �PRtnRRY ARaA (, o T 6 ( (/ACAIVT) The Primary arca s� OE.q<-.® is a low gravel ` P'N •, '�jc rvat�e arpeox. m � v of ...... f................:...� m at land 0.rr .:. c. {w{ m CtQ ht ly �# { �• THEODORE F. MOORE A iol'%e wesI•.• CE -3589 •` R% +4�� m0�Pf..CS... *a\ 004 L3j 82 WaoO R H D61 AQSoRrT7oe � TRGNcN /- lj 82 S {ro PHR N LOT S� l3�lr �� N{ND rFR rrAmaRs S!D SCA4 E : l ° x [00 ' DptE ' 6!6/67 DwN SY: TFrf Nore. -T{i,',s ,s not- a sur ver ed lolaf, All locaF,ons 0 -re cellar, A,.•, a Fe 0 CIVIL. & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 WASTEWATER DISPOSAL SYSTEM LOT 5, BLOCK 1, MINDYER MANORS SUBDIVISION Site Characteristics: The lot is generally poorly drained and is characterized by a high water table. Drainage in the reserve area shown on the Site Plan could be improved by construction of a curtain drain along its east and north sides. The lot slopes generally to the west at 5 - 15%. The primary wastewater disposal area is a low gravel ridge approximately 10 feet higher than the land to the west. Because of highly permeable soils overlying the water table, a 2' sand filter will be required. Construction in the reserve area will probably require a "mound type" system. System Sizing: Using a sand filter rating of 125 sq. ft. per bedroom, a 4 bedroom system will require 500 sq. ft., which with a 1.5 safety factor required for beds equals 750 square feet. Due to the shape of the primary area, the bed should be 15 feet wide by 50 feet long, as shown below. Continuity of materials and depth to water table throughout the bed area should be verified at time of construction. A 1250 gallon septic tank will be required. All construction shall be in compliance with M.O.A. requirements. so' —i- (TYo) e f, 4r Monrdur ra6t K" Perf Pre CTye) S.o' 2S' PIAN (/ICI(/ A A o 1250 Ga/ Sepf.. Tank 0 2" Rr9 rni Tnswlah.a Cover Hat'/ 2' Nedcam Saar( rn'Srjct G -ravel 56C -TION rA-A° OF A4 4 4�- .*( 0. ...................... ............ �.... THEODORE F. MOORE ; l �@��eo� . CE -3589 rQ' Certificate of On -Site Systems Approval Parcel I.D. 020-091-66 Legal description MINDYER MANORS BLK 1 LT 5 Site address 4821 VIRGO AVE Anchorage AK Current property owner(s) NADELL Expiration Date: `1 'Zo L X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: t/� By:.Original Certificate Date: 11 /14/2023 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 MUMC AUYYof nLl HCHOFA�Gr rt 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. 020-091-66 Complete legal description Mindyer Manors Block 1 Lot 5 Location (site address) 4821 Virgo Ave, Anchorage, AK 99516 Current property owner(s) Josh & Joelle Nadell Day phone (907) 382-5342 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: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age < 1 yr - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS A 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 $ 5 6D Waiver Fee $ Date of Payment COSA # 0.5 G 7 1 t 39 Date of Payment Waiver # COSA Application —June 2022 Mindyer Manors Block 1 Lot 5 020-091-66 4.3 7/3/93 247 24 15+ 7/31/23 Forge Engineering 9.5 10/31/23 N/A N/A New Installation 6/25/93 N/A N/A N/A 7/31/23 0/0 1013 5/0 1440 0/0 >600 6 0 6 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' Community Sewer Manhole/Cleanout > 100' MYes if No ft MYes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft ❑ Yes if No ❑ 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' g Yes if No ft Surface Water > 100' Yes if No Tank to Property Line > 5' n Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' n Yes if No ft Private Wells > 100' 0 Yes if No Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No _ Water Service Line > 10' n Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft ft ft 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 Forge Engineering Engineer's Printed Naine Benjamin Schiller, P.E. COSA Checklist —June 2022 Phone (907) 522-7773 Date 10/27/23 AL,q49��� TH . .. • • .. • `• Benja • ' • chiller ��C�`n��`�l%F • • CE 12592 • 0 C���®®�pROFESSIONP�'�.All' Municipality of'Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-091-66 Expiration Date: — 7 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent MINDYER MANORS S/D; BLOCK 1 LOT 5 4821 VIRGO AVENUE * ANCHORAGE AK * 99516 DAVE & ANGELA HIGBIE Day phone 345-0398 4821 VIRGO AVENUE * ANCHORAGE, AK * 99516 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: Day Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site M Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ Received by: �' �i Date:Y�i COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA # I a t 3 6 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. 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. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for 0 bedrooms. 337-6179 Date 1 Z2-1(9 bedrooms, with the following stipulations: �r6ar{ess:' CE -7953 �..! ZzJ� McAdoo Pr o f e s sio�°oo OPA/V C� YON -SITE WATER AND WASTEWATER �. PROGRAM Original Certificate Date: a— 13 The Wnicipalityk/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 of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTCHMENTS: COSA Checklist / Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11/05) 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 S/D; BLOCK 1, LOT 5 Parcel ID: 020-091-66 A. WELL DATA *BEDROCK AT 18'. Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 7/3/1993 Sanitary seal (Y/N) YES Total depth 225 ft. Cased to *24 ft. FROM WELL LOG Date of test 7/3/1993 Static water level 14 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/13/2012 10 ft, Well production 7 g.p.m. 3.8+ —9 p.m. WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrate 0 • ( 4"mg./L. Collected by: GEG. Ltd. Arsenic: 1- Qg./L. Date of sample: 5/15/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 6/23-25/1993 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/11/13 Pumper MCDONALDS PUMPING SERVICE C. ABSORPTION FIELD DATA Date installed 6/23-25/93 Soil rating (g.p.d./ft2or /bdrm 0_8 System type BED Length 45 ft. Width 19 ft. Gravel below pipe 0.5 ft. Total depth *2.6 ft. Eff. absorption area 810 ft' Monitoring tube **YES Depression over field NO Date of adequacy test 6/13/2012 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test** 1 in. Water added 775 gal. New depth *** 19 in. Elapsed Time: 300 min. Final fluid depth ***166 in. Absorption rate >= 600+ g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date **NORTH MT NOT FUNCTIONAL. USED SOUTH MT FOR TEST. MT EXTENDS 1.1' PAST EFFECTIVE INTO FILTER SAND. APPROVED PER JEFF POET FOR USE IN ADEQUACY TEST. ***100% FULL AT THIS POINT. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level at_i . High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main Sewer/septic service line On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank 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 N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that t 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. Engineer's Printed Name JEFFREY A. GARNESS Date 0z7-/13 (Rev. 11/05) Municipality of Anchorage Development Services Department ¢° Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street i P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite I/ (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 020-091-66 COSA# 1. GENERAL INFORMATION Expiration Date: - l - Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MINDYER MANORS S/D; BLOCK 1, LOT 5 4821 VIRGO AVENUE * ANCHORAGE, AK * 99516 DAVE &' ANGELA HIGBIE Day phone 4821 VIRGO AVENUE * ANCHORAGE, AK * 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 Day phone Day phone 345-0398 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 samples. (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, t 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. 1 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. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may Fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Attachments: t/ COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory 337-6179 Date S'21 hZ bedrooms, with the following stipulations: Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other pN-S4TE WATER AND WASTEWATER By: Original Certificate Date: j3—,21 -12 (Rev. 11105) Municipality of Anchorage g • o:i::;::;;�< 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: MINDYER MANORS S/D; BLOCK 1, LOT 5 ParcellD: 020-091-66 A. WELL DATA *BEDROCK AT 18'. Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 7/3/1993 Sanitary seal (YIN) YES Total depth 225 ft. Date of test Static water level Well production Cased to *24 ft. FROM WELL LOG 7/3/1993 14 7 9.p -m. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 6/13/2012 10 ft, 3.8+ 9.p -m. WATER SAMPLE RESULTS: Coliform �O colonies/100 ml. Nitrate (��y/�/ �mg./L. Collected by: GEG, Ltd. Arsenic: r O ug./L. Date of sample: 6/8/2012 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 6/23-25/1993 Foundation cleanout (YIN) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/16/2012 C. ABSORPTION FIELD DATA ,+,ttzr►f_1111001111111all IT, lN!mtcl Date installed 6/23-25/93 Soil rating .p.d./ or ft�/bdrm) 0_8 System type BED Length 45 ft. Width 19 ft. Gravel below pipe 0.5 ft. Total depth *2.6 ft. Eff. absorption area 8100 ft2 Monitoring tube **YES • Depression over field NO Date of adequacy test 6/13/2012 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test ** 1 in. Water added 775 gal. New depth ***19 in. Elapsed Time: 300 min. Final fluid depth***16 in. Absorption rate >= 600+ g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **NORTH MT NOT FUNCTIONAL. USED SOUTH MT FOR TEST. MT EXTENDS 1.1' PAST EFFECTIVE INTO FILTER SAND. APPROVED PER JEFF POET FOR USE IN ADEQUACY TEST. ***100% FULL AT THIS POINT. D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN "Pump on" level at in. "Pump off' level High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS . G. ENGINEER'S CERTIFICATION I certify that f 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. Engineer's Printed Name JEFFREY A. GARNESS Date $ I2t1 j2' COSA Fee $ LIQO ` Date of Payment ?-I a'1 1)a Receipt Number OyOJba Cn (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number to W I r I pr oz 0 EA S N 0 w C rq X a Z O O C u, (Am C .0-4%r- p m I'' 0 Ul j 1WS33v1,ot ,00'091 3 ,OO,VO.00 S JNI15� 3 mI An�rmO D•I•� > m Z vD N Ao 0 r P I y I x jI n p\ v r2 N A 2 n U . ,. x s y.Z ,s z o, •g ec O � a 28 p90 m x z m ,^ uxnrx d] !1 Z A O � � G U+ 8 - SN CrN N j 1WS33v1,ot ,00'091 3 ,OO,VO.00 S JNI15� 3 mI An�rmO D•I•� > m Z vD N Ao 0 r P I y I x jI n p\ v r2 N A 2 n U . ,. x s y.Z ,s z o, •g ec O � a 28 p90 m x z m ,^ uxnrx d] !1 Z A U+ CD N CrN N �0' o so �eNs CD w � ap E �ac W 1 �. (n n co cl O t] 41 0 m A 34 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0Z_&0 9/6 ro 1. GENERAL INFORMATION Complete legal description LS, g� M'✓�� ✓`~� Location (site address or directions) Property owner njCS-, tn1L 17 -OL Day phone Mailing address Pn &t Q� k\ q(41a.'� Lending agency Mailing address Agent Address Unless otherwise requested, NAA will be held for pickup. 2. NUMBER OF BEDROOMS: —� 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone row NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Fronl MOA #21 S. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate forthe 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm kjoei ori 6Nomjznaun16 Phone f,/y- `155-j Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments 0 bedrooms. Date i0 4 U Michael E. Anderson 4381-E x)10 bedrooms, with the following stipulations: Date LA The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1191) Sack MOA 021 Municipality of Anchorage am O Department of Health and Human Services ms HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LS #/ Parcel I.D. 0 0 9/64 A. Well Data Well type If A, B, or C, attach ADEC letter. DEC water system number A114 -- Log present (Y/N) Date completed 73 f'3 Driller�14�� ,,�ir�/ica Total depth -,7!f Cased to z f Casing height 2 - Sanitary Sanitary seal(Y/N) Date of test Static water level Well flow properly protected (Y/N) )' FROM WELL LOG AT INSPECTION 7 g.p.m. Pump levell SEPARATION DISTANCES FROM WELL TO: Septic/gsidk%,.tank on lot > 1175" ; On adjacent lots 2t 1151 Absorption field on lot '— //8 , On adjacent lots � 1'0 Public sewer main > / m+ l/ Public sewer manhole/cleanout > Sewer service line % Go Petroleum tank /to �a� MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION OCT 2 9 1993 ECE(VED WATER SAMPLE RESULTS: Coliform o Nitrate «/a nc.y /L Other bacteria e Date of sample: /Q A-0* Collected by: ,4 !fes/a B. SEPTIC/ANK DATA Date installed G Z3— Tank size /Zso Compartments Cleanouts (Y/N) Foundation cleanout (Y/N) Depressior High water alar (Y/N) _ tested (Y/N) W14 Date of pumping Pumper SEPARATION DISTANCES FROM SEPTICS TANK TO: Well(s) on lot /176 On adjacent lots % Zoo Foundation ,I-- (Y/N) (Y/N) /✓ To properly line i/z Absorption field Watermairr/service line % $o Surface water/drainage > 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in Vent(Y/N) High water alarm level Meets MOA electrical codes "Pump on" level at SEPARATION DISTANCE FROM LIFT STATION TO: D. ABSORPTION FIELD DATA "Pump off" Level at tested adjacent lots Surface water Date installed 44_3-1-Ye63 Soil rating (GPD/Ft2) -S System type !x� Length S Width AS Gravel thickness 40 Total depth y -rA FA. 1 Total absorption area Cleanout present(Y/N) Depression over field (Y/N) Date of adequacy test (pass/fail) for `f Bedrooms Water level in absorption field before test 1 -� After test Peroxide treatment (past 12 months) (Y/N) �— �— If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot //B / On adjacent lots Property line 2a r To building foundation %pTo existing or abandoned system on lot On adjacent lots /ZS / Cutbank Waterservice line Surface water >//O/ Driveway, parking/vehicle storage area S r Curtain drain 6_1 //Sr E. ENGINEER'S CERTIFICATION 1 certify that t have checked, verified, or conformed to all MOA and HAA guidelines fie i9 , , of this inspection. /� ®n or e^e Signature /®u ea.e •..e wu • •.i e.• Engineer's Name /'1i&mAc1... aC Alaouer% 0 :6". 4361 - E �® Date/0 ®+00og 9F HAA Fee $ '50O Waiver Fee $ Date of Payment Date of Payment Receipt Number 5O �O 89�> Receipt Number. 72-026 (3/93)' Back