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Home My WebLink AboutNORTH SLOPE #2 BLK 4 LT 15 tnev voruZ( 10) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201306 PID Number: 05051137 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Upgrade Name JONES ROBIN ABSORPTION FIELD Wide Trench ❑ Bed ❑ Mound Site Address 31054 SAGWON AVE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 227-6495 3 0.8 GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Ft. 4 Ft. Subdivision Block Lot2 NORTH SLOPE # 2 BLK 4 LT 15 Fill added above original grade (Gravel length 2 Ft,f 57 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist, between trenches From Tank Field Lift Station Tank Line Ft= 1 - Ft. Well 100'+ i 100 + na na na �] septic ❑ S.T.E.P. El Holding El Other Manufacturer Manufacturer Greer Capacity 1000 Gal. � Surface Water 1100'+100'+ i na I na Material Number of compartments Lot Line 101+ 101+ na na NA Plastic 2 Foundation i10,+ '+ 10 na na LIFT STATION Manufacturer Capacity Remarks Gal. Harm location Electrical installed by PIPE MATERIAL House to tank D3034 drainfiel'J Tank to D3034 Installer Dean Construction Drainfield D3034 CO/MTD3034 Insf,ector NorthRim Eng. BENCH MARK (Assumed elevation) 100 (t Inspection. 9!21120 9/22/20 dates: Location and description 2 " Deck 34" ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date++��A,OF *,kXk 144 Ar Arc.:) iAr � :49�� •. *ft Septic System s• •: • • • • • • . • . i 'f`+Steve Approve t� I Js Date 3 2 &C- ` 5s ± 4p 5 IT/' 2Y Note: this approval does not inc�de well permit requirements. tnev voruZ( 10) AS-BUILTS A B Ti 62 47 T2 65 51 DCO 69 55 DV 71 58 MT/C01 74 62 MT/CD2 124 112 Sagwon Ave 0 Lot 14 Well 0 /15-25% Slop Driveway /15-25% Slope 3 Bdrm / /15-25% Slope 0 / co / 15- % Slop Lot 16 Well \ / / New 1000 Gallon 12 .5 \ Septic Tank w/DCO's G<ti Decommissioned Old Septic Tank EYP \ \ PER UPC -25% Slope � \b /15-25% Slope \ \ �ot 3 Septic /15- 5% is-2sz Stop \ Lot 2 Septic \` _ NOR THRIM ++�rw►wtp 1N so' OFA- #Z ENGINEERING SteveEng.com f* 9m � �P: BLOCK 4 LOT 15 REC❑RD PO Box 770724 ' ....; . s Fxp.... "Al Eagle River, Alaska 99577 f+ �- _ LAYOUT = WASTEWATER an -7 �c�Q 7ngsz ##w /'30 '2,0 +_ 1 IDr_DnT)E- '�`CDTTf'` Date., -- -- - _ O rr^^ mm Q y/ ''I �o@Z� � DD o (D�� X0 rill V C v Noel o Z �,ot�+� apgq N R) �a C:) a Ar44pMM��,w�.®� U M D H H /TJ z LTJ -CD = oM z 1�;u3--0 d F I H (Tl < QQ _ Q �Q O o W Z ro 1 jF— EDCD C) E-1 ID o � � E-1FTI cn n V I F),) o` -n - m IM m --q A Z C+ O O :� Ln O 3 c Q C+ n SQ C+ .< 0,3 C+tD S \ N .S o ro \ :5o n S rel Q LA m m < Q < Lt Q o m < f sy o Q C+ Ul 0 O J ro c_� W < O _-5 jC+ -9 -1 (LD- :5 < W 3 I.- < <oo Q -0 D p !± C+ O Q Q O :5O:3 "D �< w 9- m m m < Q C+ 0 ro 0 N 0o or ro m 3 X P Ln h ,+ n :3- 0 M -9< O Q 900 rLn < o O -P ` -1 -0 O Q c C+ Q O Q < Q < I ro <L=� Q< < < < c -F < Z o-9 70 c d� cQ UC+ ro 6- n:3 n: < Qo 0Q C 0 Ln !C+ Q X- C -) - n Q O c C+ Ln M `<° ro Q < h P o ED -:5 o 3� fio Ln f0 0 v cD .D Un w Cil < Q 0 c - C+ Ln ld < C+ < < 0 < C+ < n S ► or ro m 3 X P Ln h ,+ n :3- 0 M -9< O Q 900 rLn < o O -P ` -1 -0 O Q c C+ Q O Q < Q < I ro <L=� Q< < < < c -F < Z o-9 70 c d� cQ UC+ ro 6- n:3 n: < Qo 0Q C 0 Ln !C+ Q X- C -) - n Q O c C+ Ln M `<° ro Q < h P o ED -:5 o 3� fio Ln f0 0 v cD .D Un w Cil < Q 0 c - C+ Ln ld < C+ < < 0 < C+ < n S 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 I http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201306 Work Type: Septic Upgrade Tax Code Number: 05051137000 Site Legal Address: NORTH SLOPE #2 BLK 4 LT 15 G:0703 Site Mailing Address: 31054 SAGWON AVE, Eagle River Owner: JONES ROBIN S & BRIAN L Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date Expiration Date ��»int c Ct•�F I U r, f DCpa]-tmell t Lot Size in Sq Ft: Total Bedrooms: 8/28/2020 8/28/2021 55926 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (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: *** If, the old crib is found during construction of the field, construction of the system will stop pending On-site review and approval. Received By: Date: Issued By: (/v Date: g MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section - Parcel I.D. 050-511-37 ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) Jones Mailing address 31054 Sagwon Ave Site address same Phone: 907-343-7904 Fax: 907-343-7997 Day phone 694-0825 Legal description (Sub'd., Block & Lot) North Slope #2 B4 L15 Legal description (Township, Range & Section) 'Lot Size 55929 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade Q Duplex (D) F-1Holding Tank ElRenewal El Multiple Dwellings El ❑ (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. (Signature of property owner or authorized agent) Permit/Rush Fees: y 6.7-5- COULP Waiver Fees: Date of Payment: $ 2 ®% Q Date of Payment: Receipt Number: C3 -b Receipt Number: Permit No. (7SPZ0 1306 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 8/6/20 Number of Pages: To: MOA On-Site Services Subject: North Slope #2 B4 L15 Septic System Upgrade During a tank pump it was discovered that all the drain-field cleanouts had standing water, indicating failure. A new design is submitted to mitigate this damage. A previous soil test reveals GM w/Sand and no groundwater; no bedrock at depth. The design calls for a new trench and a new septic tank. The existing trench to be connected via diverter valve. Slopes and easements are depicted on the drawing. The terrain is generally sloped at the trench site, and the remainder of the area. The system design size is a single family at 3 bedrooms. Please review the wastewater system design for the existing single family home. I have included design plans & specs, design guidelines, & soil test. If there is need for additional information or clarification please give me a call. Thanks-Steve Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201306, Deb Wockenfuss, 08/28/20 SteveEng.com North Slope #2 B4 L15 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom, single family home, in a developed subdivision. This is a very large lot with no conflicts. A new trench is planned + new 1000 gallon septic tank. The existing trench to be connected via diverter valve. No adverse impacts are expected from trench/tank upgrade. No conflicts to the other lots will take place by this septic system construction upgrade. A previous soil test reveals GM w/Sand. An application rate of 0.8 GPD/FT². Trench Length = 562.5 FT²/5x .5 = 57 trench, 4 effective. A new 1000 gallon septic tank will be installed; Decommission old tank per UPC. Measure well radius prior to construction. Previous Tank-Well Waiver in effect. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  Two compartment, New 1000 gallon septic tank. Install Double Cleanouts. Decommission old tank per UPC. MOA-Spec Material Under Tank.  10 minimum between the tank trench, tank to house. 10 to property lines,  3 of cover or insulation is required for trench; 2 Minimum thickness for insulation can substitute for 1 cover.  Tank & solid pipe must be set on well compacted, stable soil.  4 inch diameter cleanouts with airtight caps are required 1 to 4 from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 from the tank positioned to provide cleanout access towards the tank and towards the absorption field.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Trench to be placed level, minimum of 4 to groundwater, 6 to bedrock from drain- rock.  Drain rock to be ½ inch to 2 inch screened. Drain rock to be distributed uniformly throughout the trench.  Perforated pipe to be installed level with perforations down.  Silt barrier (filter fabric) to be installed above the drain rock.  Smeared trench sides must be raked or scarified before drain rock placement.  The finish grade must be mounded to promote drainage away from trench.  Insulation must be placed over any pipe installed under driveways or parking areas.  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661,  Sewer Service Line is minimum 2% slope.  Septic Tank to be pumped every two years or when required.  Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201306, Deb Wockenfuss, 08/28/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201306, Deb Wockenfuss, 08/28/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201306, Deb Wockenfuss, 08/28/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201306, Deb Wockenfuss, 08/28/20 A,6bUiLT-NO CORNERS SET THIS DATE. SEWARD & ASSOCIATES LAND SURVEYING 694-0829 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE. , FOLLOWING DESCRIBED PROPERTY �� ,,.•�'''�a��'�� v r-s�s�a.�Esoh�19dd�ya, z DATE AP OF • : A AND THAT NO ENCROACHMENTS EXIST EXCEPT AS�j ,a �e�,•'•• •• s INDICATED. IT IS THE RESPONSIBILITY OF THE rH%"� Y OWNER TO DETERMINE THE EXISTENCE OF ANY GRID:,••• •••••••• ••1 EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- �• "' I S ISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: Duane MaSeward 1 � •.• �s— e .NY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND - DRAWN: ARY LINES. i~ 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 LOCATION~~ t~ ~~ NO' OF BEDROOMS DISTANCE TO: ~ ~ Material No, of compartments ~ Z Manufacturer ~ ~ Liq, capacity in gallons IF HOME.DE: inside length Width Liquid depth Well Dwelling PERMIT NO. 9~ DISTANCE TO: Q ~ Manufacturer Material Liquid capa~it~ in gallons Nearest '°t Hne ~ = DISTANCE TO: ~ ~ ~ No. of lines / Length of ea~in~ Total length o~ Trench wid~ ~,nches Distance between~lines ~ Top of tile to finish grade .~ Material beneath tile & ~ ~. Total effective a~r~¢;a Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ 61ass Depth Driller Distance to lot line PERMIT NO. m Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER O SOIL TEST RATING INSTALLER co APPROVED ~ 5Cr~ U~d~ DATE LEGAL (Rev, 3/78) Russell Oyster 694-2774 Performed for: O &'E EN~NEERING & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Legal Description: L~7'-- /~ ~g-"~;~//-L- /-L'// JO~z"~'~l Depth (feet) SOIL LOG Mailing Add ress~D~'-- Soil Characteristics 5 7__ Earl Ellis 688-2280 Tel. N0. 10-- 11__ 12__ 13-- 14__ 15__ PLOT PLAN PERC. TEST 16__ Ground Water Encountered: Yes Proposed Installation: Seepage Pit__ No ~ yes, what depth Drain Field ~ Comments: JVJ-W DRILLING, Inc. P, O, Box 4-1728 e 2811 Dawson A C 907-279-1741 ANCHORAGE, ALASKA 99509 DRILLING LOG Well Owner____ Dave Wi~war Use o£ Well. Dom ? Location (address of: Township, Range, Section, if known; or distance main road Size of casing Static water level Screen ( ); Describe screen or perforation_ Well pumping test at__~P___gallons per (~) of drawdown from static level. Date of completion 18 Oct __Depth of Hole Perforated ( 87 _feet Cased to 87 feet (below) land surface. Finish of well (check one) ). Non~ open end ( (minute) for___l_ __.hours with WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO__ 1 Silty_ Gr~vel Fill TO .... _5 .... __f__TO. .TO___7.5 .TO _TO._ ........ TO ..... TO .... TO TO _TO_ ........ TO ....... TO_ ___ x ); ft. 1 -- CUSTOMER MUNICIPALITY OF ANCHORAGE Development Services Department ��= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-511-37-000 Expiration Date: 1/31/2024 Legal description NORTH SLOPE #2 BLK 4 LT 15 Site address 31054 SAGWON AVE Eagle River AK 99577 Current property owner(s) MAPES CASEY &LOONEY ADAM X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 10/31/2023 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 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 050-5 Complete legal description NORTH SLOPE #2 BLOCK 4, LOT 15 Location (site address) 31054 SAGWON AVENUE, EAGLE RIVER, AK 99577 Current property owner(s) CASEY MAPES & ADAM LOONEY Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age 3 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ -5 �50 Date of Payment/ �6�Z3 COSA # 05r 231 L(0:3 Waiver Fee $ Date of Payment Waiver # COSA Applicalion.doc COSA Checklist.docx COSA Checklist Legal Description: NORTH SLOPE #2 BLOCK 4, LOT 15 Parcel ID: 050-511-37 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 10/18/1973 Total depth 87 ft Cased to 87 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 10/13/2023 Static water level at beginning of test 66 ft. Well production at time of test 6.4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.979 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 10/12/23 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 10/10/23 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/22/2020 ALL standpipes present per record drawing Total measured depth from grade 7.6 ft (max) Measured depth to pipe invert from grade 3.5 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 3.7’ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 10/12/23 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/13/23 Results Pass Fluid depth prior to test 2 in Water added 500 gal New fluid depth 10 in Elapsed time 1080 min Final fluid depth 1 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4’ ED) Effective depth used 5 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 43 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximately 0.3’ or 4” of ED is missing. Also, 1’+ of additional fill/cover over field added. 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 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 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 ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 10/28/2023 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. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 10/28/23 MUNICIPALITY OF ANCHORAGE 0 A -me Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 05051137 1. Certificate of On -Site Systems Approval Expiration Date: GENERAL INFORMATION Complete legal description NORTH SLOPE # 2 BLK 4 LT 15 Location (site address) 31054 SAGWON AVE Current property owner(s) JONES ROBIN Day phone 227-6495 Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: F-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic FX_1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment __�" 1 -7- 20 Z, 2 Date of Payment Receipt Number 00 6 2.0 I? Receipt Number COSA # 0 S C 2 a 1 0 9 v� 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 NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 10/30/21 6. DSD SIGNATURE System #1 Approved for bedrooms System.#2 Approved for. bedrooms Disapproved Conditional approval for + �1 AV'qS��+ s TH j•• ;4, Steve Eng f CE -62562 t bedrooms, with the following stipulations: WATER AND Te PROGRAM c Original Certificate Date: 3 ZQ " 2e> 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 Ctccklist bluo shcct • Legal Description: NORTH SLOPE # 2 BLK 4 LT 15 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 111173 Total depth 87 ft Cased to 87 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 3,15/22 Static water level at beginning of test 69 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material Sptcplstc Measured operating fluid level in septic tank na ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA 9/22/20 Which system tested (date installed) na OR ALL standpipes present per record drawing Total measured depth from grade 8 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 05051137 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 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 NRimEng Date of Sample . 3/15/22 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 3115122 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes if No ft Community Sewer Manhole/Cleanout > 100, [0 Yes if No ft Ga Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' Yes if No f Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Yes if No f1 Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ayes if No f1 R1 Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [j2 Yes if No ft &a Yes if No fi From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations, > 10' Yes if No ft Surface Water > 100' Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Water Main > 10* Water Service Line > 10'CJ R Yes if No It [a 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 if No Yes if No ft R Yes if No It [a 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 If absorption field is under driveway comment below Property Line > 10' Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' Yes if No ft G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are if 7 conformance with MOA COSA guidelines in effect on this date. pr - !C,) .. ........ Steve Eng em CE -6256 ASBUILT-NO CORNERS SET THIS DATE. SEWARD &,ASSOCIATES LAND I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE'. 4-0821 FOLLOWING DESCRIBED PROPERTY a4q DATE=� , ...... ,4 AND THAT NO ENCROACHMENTS EXIST EXCEPT AS �~• INDICATED. IT IS THE RESPONSIBILITY OF THE ,0 * q IH *- � OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: 0 • • - • • • • • • • - - . d EASEMENTS, COVENANTS, OR RESTRI CTI ONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- •, .' • ' .' • • r m s Duens Meek wsrd : � VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' 4 �M tS_8 wkly ANY DATA HEREON BE USED FOR CONSTRUCTION � t'�" • % '. cp Ar OF FENCE LIN OR �.... ,� ARY LINES. ' FOR ESTABLISHING BOUND- DRAWN '%wr --: *" 1-01-e---sl- � '� 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.# O5~O - k--I/--~ 1. GENERAL INFORMATION Complete legal description Lot 15; HAA# ~'~ '~c~ ~ Block 4~ North Slope Subdivision .Lpcatien,(site address or directions) Sagwon Mailing addie'.~S "C/O Remax Eaqle River · Lending agency .. · Mailing addreSsl Day phone 16600 Centerfield Dr. Eagle. RZu~: Day phone e "Agent- Vi'r~inia Kohfield/ Remax of Eagle River Day phone AK 99577 NOTE: 694-4200 Address 16600 Ce~e~tfi~.~d D,t.<~ve Eaqle River, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well XXX Z~- C:3 <2> '< Community well I-1'1 Public water If community well system, provide written confirmation from Sti~A~'EC a __ lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: XXX Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legafity and status of system. 72-025 (Rev. 1/91) Front MOA ¢21 99577 Legal Description: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist A. WELL DATA Well type ~2¢ Log present ~N) Total depth Sanitary seal Date of test Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG Casing height(above ground) Wires properly protected(~N) AT INSPECTION L.J~J WATER SAMPLE RESULTS: Coliform ~ Date ofsample: Nitrate B. SEPTIC/HOLDING TANK DATA C0 0,4 Collected by: Date installed ~c~q~ Tank size FoundatiOn dl~an0u( (~,.~ ~ Depression (Y~i) Datbof'[/umping ¢~°~'5' ' Pumper A'~So~rios ~'IgbD DATA Length "'bi -~ Width Effective abs0~ti0n ~ea %'~Gd~ ~ Date of adequacy test · ¢ ~ 4 ~ Other bacteria ~ S & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Number of Compartments L)~-- Cleanouts(~q) ,,~ High water alarm (Y/N) ~ I~, Soil rating (g.p.d./fl2 or fi2/bdrm) [ ~5c3 ~v~fSe. System type '-~g~>~ ct& Gravel thickness below pipe ~71.'~0~ Total depth ~ ~ Monitoring Tube present(~ ,,/ Depression over field (Y/~) t~ Results ~7Fail) ~4~5 For ~ bedrooms Fluid depth in absorption field before test (in.); 5~5'- Inunediately after57>2, gal. water added (in.): __ Fluiddepth /0/ Minutes later: &O# ~¢ (ih.) Absorption rate = g.p.d. Peroxide treatment (past 12 inonths) (Y~) ~o~J£ /<'~/o~JIfyes, give date 7/ # D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* High water alarm level at* .~,.--~-----'- *Datum level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~ La I ~[~ fit'/"/; On adjacent lots \q>o ~ 4- ; On adjacent lots ~').k, Public sewer manhole/cleanout 'g-%'- 1 ,k Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Absorption field on lot Public sewer main Sewer/septic service line Foundation ,~> Water main/service line Property line \,c>~k- Absorption field .Surface water/drainage \ o c> ~4- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Surface water Curtain drain Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots F. ENGINEER'S CERTIFICATION I ce~ t~ that 1 h "~[ ~- · fy ave determined thru field inspections and review of~¥tunicipal r~ %.~ns are in conformance with MOA I-IAA ~zuideline,t.~effect on this date. ff ~/ .,-l~. ., .~'~ ~ ~ ~ ' d O / , ', '2 .? '..,.-:., ............................................................................... _ HAA Fee $ ~'~. ~C~ Waiver Fee $ Date of Payment ~O65~/~/~~'- Date of Payment Receipt Number ,///~:Z ~y~//~/O/ Receipt Number Rev. 8~95 OSS: haa.wk,doc APPLI( . NT FILLS OUT UPPER HAL-....,.)NLY P~opertyO~ner ~.<~'~ j.j~t~_gooc,~ ---/"{&o~_. ~ t..JT"L,~P~. Phone (orst~{ MailingAddress .~,17,~, i7::o¥ '>'_~_-NSz'L5 ~.../~' ~_~'i~.. 5-/~6,-~- ~_t~,5~< ~ ~t< ZipCode c_'T~,-~, --?..~ 2~-?~z'--¢~T'li Buyer Address- Zip Code Lending Institution ~Z_ c_ ~., .~' ~-~-~ ,0 r% .,:::, < Phone Address Zip Code Realty Co. & Agent ~._ o ~ 4:' ir~ ~ ~-St,z, ~ ;-~ '-r'% Phone Address ~ ~t,~oz ~x/~ Zip Code ] LegalDescription Lorn ~ ~ ........ q _ ~,-~ .... r,c 0~_ 5 ..... %~o ..... ~,~ ,w~ ~.~.2~~/ ~ ...... ~,~ ,~ ~treet Locat ~ ~. ~ .... Type of Resi~nce ~ Single Family ~ ~ Other ~..._.~ ,~', ( ~ ,~ - / i '-. A WELL LOG, A ~1 Icg is required for all wells drilled since June 1975, ~ Individual ~ ~ Community For wells drilled~prior to that date, give well depth (attach log if available). Sewer Disposal /~ ~ ? ~ Individual Year Individual Installed: · ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ~ ( ..~) APPROVED BEDROOM8 "CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received ~ //~) / 7~7 Well to Tank Septic Tank Size /,.~ ~'~ 72.023 (3182) Time, Date Date Date InspeCtor Inspector Inspector Comments Conditional Approval Date Se~er Ins~ ~,~5r-- ~ r~rm~~ Septic Tank siz; Soils Rating Well To Absorption A~ea Well Log Received Well to Tank APPLICANT FILLS OUT LOWER.HALF ONLY Property Owner 11~ ~, ~a-~ ~a]lCaS~e~ I Phone Mailing Address S~-:~. 2360 ~agle ~ver, AK 99577~694_3575 Buyer She ~ood Cuttle~ Address Lending Institution Fdderal Alaska Credit Union Phone Aadress 75~ I Street ~chorage~ AK 276-~011 Phone aealtyCo. &Agent Commonwealth AR~A~ Inc. Realtors Address P.O. BOX 249, ~agle River, AK 9~577 694-9555 Legal Description North Slope Subd. Lot t5, Block 4 Street Location Sa~on Ave. ~ Eagle ~iver~ AK 99577 Ty~of Residence -~ Single Family ~ Multiple Family No. of Bedrooms ~ Other - Wa~r Supply -~ Individual A~ACH WELL LOG. A well log is required for a~l wells drilled since June ~ Community 1975. For wells drilled prior to that date, give well depth (attach log if Se~ge Disposal ~0/26/79 -~ Individual Year Individual Installed: ~ PuSli, c UtiNty When Connected to Public Utility: ~ Holdiag Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 July 28, 1982 MUNICIPALITY OF ANCHORAGE D~-P'I'. OF I:E,"L;'H r. ENVI~., il.',:~'..A. I ~OEr i'l'. J Marian Wood SR Box 1469 Eagle River, Alaska Dear Mrs. Wood, Reference: Lot 15; 99577 Block 4; North Slope Subdivision A ~ewer ~ystem adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow of water over a period of 48 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the two bedroom residence is currently functioning adequately. However the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call. ~S/~:ea ~mmon. ealth .ealty ATT}~TION: Maureen Clayton Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA MUNICIPALITY OF ANCHORAGE ~/~UNIcIPA[.ITy OF ANC PAGE ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOI~ 825 L Street - Anchorage, Alaska 99501 ·:J'/ ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) davs for processing, 1. PROPERTYOWNER I PHONE David W. WiswarJ 694-9639 MAILING ADDRESS St. Rt. Box 1460, Eagle River, AK 99577 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAI LiNG ADDRESS 3. LENDINGN/A INSTITUTION~,.~,.)~ ~¥..~+ y~(~ ~,T~,I[ PHONE MAILING ADDRESS 4. REALTOR/AGENT I PHONE Myrna Johnston, AREA, Inc. RealtorsI 694-9555 MAILING ADDRESS P. O. BOX 249, Eagle Riverr AK 99577 5. LEGAL DESCRIPTION North Slope #2, Blk 4, Lot 15 TREET LOCATION Sagwon Avenue 6. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four ~ Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) log attached 8, SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY If [ndlwdual/on-site, give installation date 1973 If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 025 L Street · Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 2644720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete ell parts on page 1. Incomplete reque~t~ will not be processed. Please allow ten (10) days for processing, I. PROPERTY OWNER t PHONE David W. WiswarI 694-9639 MAILING ADDRESS St. Rt. Box 1460, Eagle River, AK 99577 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3, LENDING I~STt.~TI~ . PHONE MAIWG AD D ~,,~SS ,~"'2~ 4. REALTOR/AGENT~ ] PRONE Myrna Johnston, AREA~ Inc. RealtorsI 694-9555 MAILING ADDRESS P. O. Box 249t Eagle Riverr AK 99577 5. LEGAL DESCRIPTION North Slope #2, Blk 4, Lot 15 STREET LOCATION Sagwon Avenue 6, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four {~ SINGLE FAMILY :~ Two I--1 Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL" [] COMMUNITY [] PUBLIC UTILITY · ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) log attached 8, SEWAGE DISPOSAL SYSTEM ''If individual/on-site, give installation date 19 73 ~] INDIVIDUAL/ON-SITE" ' If system is over two (2) years old an adequacy test is required [] PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) October 2, 1979 Department of Health & Social Services Environmental Health Section ATTN: Mr. Kyle Cherry 338 Denali, Room 1206 Anchorage, AK 99501 RE: North Slope Subd Addn #2, Block 4, Lot 15 Eagle River, Alaska Dear Mr. Cherry: Attached is data supporting a request for waiver of the State requirement stipulating a minimum distance of 100 feet from an individual on-site well to a septic system. The septic system on .referenced property was installed in 1973 without Municipal inspections or approval. It consists of a 1,000 gallon septic tank and a log crib. According to Mr. Robert Pratt of the Municipal Department of Health and Environmental Protection, the log crib is 82 feet from the on-site well. A water well log, water analysis report, soil test and sketch of neighboring wells is attached for your review. Request a waiver of the minimum distance requirement be granted on subject property. Thank You, David W. Wiswar Property Owner by: Myrh~ John~n, ~ssociate Broker ARE~ Inc.~Realtors Encl a/s ~Y To: Robert Pratt October 16, 1979 ~yle Cherry State of Alaska Environmental Conservation 33~ Denali Street 5~ackay Building Anchorage~ Alaska 99501 Subject: Lot 15 Block 4 North Slope S~dlvision ~2 The sewer system on the subject lot was installed illegally in 1973. ~ inspection of the property along with a soils test indicates that a 100 foot separation is possibl~. ~ would reco~.~m~nd the requested ~aiver be denied. If there are any further questions~ please contact this office at 264~4720o Sincerely, Robert C. Pratt~ Associata Specialist c /ljw cc: Well log Soils test Water analysis Letter from ~yrna Johnston DEPT. OF ENVIRONMENTAL CONSERVATION : SOUTHCENTRAL I:IE.~IONAL OFFICE October 30, 1979 338 Denali Street. MacKay Bldg., Room 1206 Anchorage, Alaska 99501 (907) 274-5527 P.O. Box 1207 [] Soldotna, Alaska 99669 (907) 262-5210 P.O. Box 1064 [] Wasilla, Alaska 99687 (907) 376-5038 · MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Ms. Myrna Johnson, Assiciate Broker Area, Inc. Realtors Parkgate Professional Building . Eagle River, Alaska 99577 r'.]ov ]. 1979 RECEIVfiD Subject: Lot 15, Block 4, North Slope. Subdivision Addition #2. Dear Ms. Johnson: I have reviewed all pertinent material submitted to this depart- ment regarding the proposed waiver o£ the required 100 foot dis- tance from the well to the septic tank and,.soil .abserption system. This department has no objection to the septic tank being located at least fifty (50) feet from the well, but will require that the soil absorption system be located one hundred (100) feet from the well. If there are any further questions please call on me. Sincerely, ~herry Regional Environmental Supervisor cc: AM-DHEP bl 18-06LH