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Home My WebLink AboutNORTH WOODS BLK 3 LT 31Onsite File North Woods Block 3 Lot 31 #051-731-51 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201026 PID Number: 051-731-51 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New K Upgrade Name Megan N. & Steven T. Garwood ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 22743 Northwoods Dr. Chugiak, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 870-799-9342 3 EXISTING GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot North Woods 3 31 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line I Ft2 Ft. Well >100' N/A N/A N/A >25' TANK ❑ Septic X S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Greer 1250 Gal. Surface Water >100' N/A N/A N/A Material Number of compartments Lot Line >5' N/A N/A N/A NA Plastic 2 Foundation >1 Q' N/A N/A N/A LIFT STATION Manufacturer Greer Capacity 250 Gal. Remarks Tank only permit. Tank is insulated and is at least 5' from any deck support post. Alarm location Middle of NW wall inside house. Electrical installed by Existing PIPE MATERIAL House to tank D3034 drainfield Tank to D1785 Installer Wilco Contractors Drainfield Existing CO/MT D3034 Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspection 151 2/25/20 Location and description da 2" Threshold of back door. 3rd 4h ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp , .'•�E F Conditional Approval: Date ••�P,.•••'"' ••:qS ♦s 49th +..... *. ...... ...... .. ... .h.....0 ........... ... .+ 0................. • f_�on ; MICHAEL E. ANDERSON 14Y&Septic st� Sy Approved t �``� Date • ��®'sem'•.., NO. CE-4381 •,••�_= Note: *�� pRO�e•• ,eFESSIONA�e�a�v� this approval does not include well permit requirements. tKev uwuui a/ NORTH WOODS, BLOCK 3 LOT 31 PERMIT # OSP201026 PID # 051-731-51 \ \ LOT 12 / \ LOT 23 \\\ LOT 11 / \\\ \\. \ / \ LOT 29 LOT 10 \ \ \ / LOT 30 \ EXISTING BED TO LOT 31 \ \ REMAIN IN SERVICE. NEW 1,250 -GAL S.T.E.P. TANK w/ / \ O TWO 20" MANWAY RISERS. / \ MH2 / \ O °° H1 LOT 9 / p / / EXISTING SEPTIC TANK AND / LIFT STATION PER ABANDONED IN PLACE AND FILLED WITH �h O / \ CONCRETE �O \ \ LOT 32 / �Al' LOT 33 A B C MH1 14.5 9.7 11.5 MH2 17.8 13.1 9.9 MT 18.5 11.9 7.7 ENGINEERING •.••••,OF q��++ LEGEND C f ` CO - CLEANOUT PLAN AS -BUILT 2CO - DOUBLE CLEANOUT 49th FCO FOUND MICHAEL E. ANDERSON •'•. No. CE -4381 `pA '•? ♦,�+,t pROFES51si•�• MEL--= FEET i..=50' ATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://wwv,,.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201026 Work Type: SepticTank Upgrade Tax Code Number: 05173151000 Site Legal Address: NORTH WOODS BLK 3 LT 31 G:1459 Site Mailing Address: 22743 NORTHWOODS DR, Chugiak Owner: GARWOOD STEVEN T & MEGAN N Design Engineer: FORGE ENGINEERING This permit is for the construction of: ❑ Disposal Field C Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date 1)eparrIII CIIt 2/18/2020 2/17/2021 Lot Size in Sq Ft: 20046 Total Bedrooms: 3 ❑ Private Well ❑ Vater 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, seated, and heated to prevent freezing Received By: �� 1 Issued By: a_'q't..,t Date: t % ) :�o' Date:. 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. 051-731-51 Property owner(s) Megan N. & Steven T. Garwood Mailing address 22743 Northwoods Drive Chugiak AK 99567 Site address Same Day phone 870-799-9342 Legal description (Sub'd., Block & Lot) North Woods, Block 3, Lot 31 Legal description (Township, Range & Section) Lot Size 20,046 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade ❑X (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) El ❑ Multiple Dwellings ElPrivy (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: i 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: ;ZS Waiver Fees: Date of Payment: _ %l g f a2U 6 Date of Payment: Receipt Number: 0'S7914'D Receipt Number: Permit No. 0 S PAW= o Waiver No. Permit App_-'-: • :'-.,:c; PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) February 18, 2020 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: North Woods Block 3 Lot 31 – 22743 Northwoods Drive Septic System Design Dear On-Site Services Engineer: The owner of the above lot has a 3-bedroom home with a septic tank more than 30-years old that is nearing the end of its life expectancy. We are submitting this design and permit application for the installation of a new 1,250-gallon S.T.E.P. tank to replace the existing 1,000-gallon septic tank and 500-gallon lift station. The existing tank and lift station will be decommissioned in accordance with Municipal Code. The attached site plan identifies the location of the home along with the new and existing septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. This subdivision is served by a community water system and now wells exists within 100’ of the subject property lines. The new tank will be a minimum of 100’ from all surface water, at least 10’ away from the building foundation, and more than 5’ away from any deck post or property line. Please refer to the attached plan page for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 2/18/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201026, Rebecca Carroll, 02/18/20 DocuSign Envelope ID: ODA6F192-4941-4491-BD66-BCC5819ABD18 DS ASSUILT SEt,IARD & ASSOCIATES LAID I HERESY CERTIFY .THAT I HAVE SURVEYED THE SCALE=,.V ,V_1 DATE- f AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE MCISTENCE OF ANY GRID= EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB- ANY DATA HEREUN BE USED FOR -CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND-D12AII�N= ARY LINES_ _ 694-0 0 —. �rslDuano me 4ward ~ // // // // // // //10050 0 FEET 1"=50' INSTALL NEW 1,250-GAL S.T.E.P. TANK w/ TWO 20" MANWAY RISERS.3-BDRM HOMENOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM NO EXISTING WELLS - PROPERTIES ARE ON A COMMUNITY WELL SYSTEM CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MH NORTH WOODS, BLOCK 3 LOT 31 N ORTHWOODS DR2/18/20 S H E D 15' UTILITY EASEMENTDECOMMISSION EXISTING SEPTIC TANK AND LIFT STATION PER MOA CODE. EXISTING BED TO REMAIN IN SERVICE. MH CONNECT TO EXISTING 2" ABS PRESSURE SERVICE LINE. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201026, Rebecca Carroll, 02/18/20 MUNICIPALITY OF ANCHORAGE D[~, /RTMENT OF HEALTH AND HUMAN SER,,_j~ES ~{ ~'"~ '" - Environmental Health Division ~ ' 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address __% T0 SEPTIC ABSORPTION ~U~ ~ ~ TANK FIELD WELL Phone(st J P.~~ ~NO. of Bedrooms WELL J~.OCkx iLEGAL DESCRIPTION LOT LINE z ~/~ Lot Subdivision Township, Range, Section ~/ ~ [ ~t ~' ~ AS-BUILT DIAGRAM (Show Iocat,on of well, septic system, property l,nes, founder,or driveway, water bodies, etd) TYPE OF SYSTEM ~P ~ ~ TRENCH ~BED ~ W. DRAIN ~ OTHER ~eplhtoplpebottom/rOmonginalgrade Total deplh ,rom orlglnal grade I oxlglnal grade Gravel depth beneath p~pe added above Gravel lengJb , GraveT w~dth - Totalabsorphonarea Distance between lines ~/ ' , % Number ol hnes / Sod rahng Pipe material .~ ~ ~ Installer Date Installed ~ [~ ;/ ~__PRIVATE ~ZSl'lju& ~OTHER (Identify) ~'a, ~A ,, 5~ & Eagle17034and StateRlYer~EagleAjasEaRiVer [~E~sd N~ ~:[~_. cedily thai ~this inspection~ was peHormed accordiflg lo all f Health Depa~ment Approval: Dale: ,~%~.~ ((, ~, ~. 7 /5' UTILITy · ~CALE c Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST LEGAL DESCRIPTION: ,¢~3/ ~B Nor~uJ~o~¢ Township, Range, Section: O ~. -- ~ ~f SLOPE SITE PLAN 4 5 6 7 8 9 10 11 12 13- 14 15 16 17 18 19- 20- / / I N WAS GROUND WATER ENCOUNTERED? / ~"--~' S IF YES, AT WHAT ! OL DEPTH? & p E Depth to Water After~ / Monitoring;' Date: '~- ~- ~:~"~ Reading Date Gross Net Depth to Net Time Time Water Drop z/"'¢-~7 II; z.~ , ¢-" _ ',,o',, ,o PERCOLATION RATE 2-"~) (minutes/inch) PERC HOLE DIAMETER - ~ TEST RUN BET FEN .~ FT AND ~ FT COMMENTS ./Z~.¢ ~¢t ~'~ /;~ ~.~.J .~ ~,:, ,4 / eL e" PERFORMED BY: 1~0~ E.~Ie ~]ver L~ ~ N~: ~~~ CERTIFY THA~ T~S TEST WAS PERFORMED IN ACC R Ea.leRiv~,Alaska 995~ ~ DATE: ~/~/¢ 7 o aANCE W~T. AfL STATE AND UUN~C~PAL 6U~EUmS ~ EFFECT ON TH~S DATE. 72-008 (Rev. 4/85) ~ / / t , 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 Liq./ga~aci~j ~. ~all°ns IF HOME.DE: Inside length Width Liquid depth ~ ~ DISTANCE TO: Well ~ ] / // Dwelling PERMITNO. 0 ~ ~ Manufacturer / ~ --~ /; Material Liquid capacity in gallons ~ Top of tile to finish grade I / '~ Mat, r~, ~.eneatb ,i~ ,,-~ ~ inches ~ -- DZ:__~ .~2,~ S~,, ~5.~ches Total effective a.orption area Length Wid(h ' PERMIT NO, ~'"~ Typeofcrib Cr,bdiame~//~ Cribdepth Total effect,ve absorption area -- / -- ~ DISTANCE TO: Well - ¢ Building foundation Nearest lot line ~ Class Depth Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS /g b/' , .- SOIL TEST RATING / REMARKS/ ,~. , ".-,'.~. ~:~ ',4 :-~..t: //, //; FERJIIT NO. RF'PLICRNT · GEl_ WILMOTH -..~';"-' a.* S'fL 21'1 LOCRTION HILLSIDE LEGRL L 3:2L B '~: NORTH WOODS LOT SIZE TYPE OF SOIL RBSORF'TION S'¢STEM IS: TRENr:H MR?:;IMLIM NUMBER OF EEE,R}OM'5 = _--.'. 20000 SL.]UARE FEET SOIL RRTING (SQ FT,.'E,F...' ' "' = 2!0 THE REi::!UIRED SIZE 0F THE SOIL RBSORF'TION S'¢STEM IS: ~-.FF'TFt= ." - .... LEf-t,3TH= .'- ~ GF-:R%."EL [)EPTH= 4-. == THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND ]'HE BOTTOM OF THE E~CRVATION (IN FEET). ,THERE iS NO SET WIDTH FOR TRENCHES. TFIE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). PERMIT RF'PLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY ~ELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. TI-iCi ,:: '-'~' .':. :I i'-.~SF'~i-:T I Cit'-.~5-. RF-:E F-:E,_--::! LI I F-:E£:, BRC:KFiLLING OF RN'¢ --'" ' -,~=,TEfl WITHOUT FINRL INSPECTION RND RPPROVRL B'¢ THIS DEPRR]'MENT WILL BE SLIBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL RND RN9 ON-SITE SEWRGE DISPOSAL SYSTEM IS · 00 FEET FOR R PRIVATE WELL OR '150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON ]'HE T~PE OF PUBLIC WELL MINIMUM DISTRNCE FROM R PRIVATE WELL TO A PRIVBTE SEWER LINE IS 25 FEET RND 'FO R COMMUNIT9 SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MA9 RPPL9. SPECIFICRTIONS AND CONSTRUCTION DIAGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F'EF,]-:I~'I I T E.--..,F I.F.~'E:S [:,EC:EI"IBER _--<.J_.. I CERTIF9 THRT · 1: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH B~ THE MLINICIPRLIT9 OF RNCHORAGE. 2: I WILL INSTRLL THE SVSTEM IN RCCORDANCE WITH THE CODES. ~: I UNDERSTBND THAT THE ON-SITE SEWER SYSTEM MA9 REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. S I GNE[:, · RF'PL I CRNT C~ W I LHO]"H ISSUED B'¢__~~_____dCZ~? [)RTE -7 -//-fP V4. 0 PERMIT NO. < RPPL I CRNT ~¢-zbv"'5 e- LOCRT I CIN LEGRL ~ 3 ( F~. ~ ,-,oM .-, STREET., RNCHORRGE, RK. ,~,~r ~ RI"-4C, i-lP4--S T Ti SEI--4ER F'E~:hl T T ) ;l? c~ _700:.93 LL]T SIZE ~C> o6 (b SIi!URRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: MR>::IMUM NUMBER OF BEDROOMS = ,~ SOIL RRTING (SQ FT,/BR)= ,:~f (5 THE REQUIRED SIZE OF THE SOIL RBqO~'PTION _,¢.:,TEM IS: B, EPTH= { I ~/ L E 1'-4,3 T H = gO I~-~ R 8 '-l-' E b [:,EF' TH-- THE LENGTH DIMENSION IS THE LENGTH ,:;IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF Ft TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND FIND THE BOTTOM OF THE EXCFI'¢FITION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRR',?EL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE FII'4D THE BOTTOM OF THE EHCRVRTION (IN FEET). REQm_I I RED SEF'T I C TRI"Wi-::: "=, I ZE= [ ~) L') L--] ;3RLLEII'--IS PERMIT RPPLICFH'4T HI=IS THE RESPONSIBILIT'?' TO INFORM THIS DEPFIRTMENT DLIRIr.,IG THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROF'ERTY AND THE NUMBER OF RESIDENCES THRT THE 14ELL WILL SERVE. TI---IC~ ( 2 ) I 1'4_~,PECT I 01"4_c, f-IRE R E 1_--4LI I RE[-', BFtCKFILLING OF RH'?' S'?'STEM WITHOUT FINRL INSPECTION RND RPPROVRL Bb' THIS DEPRRTMENT WILL BE SUBJECT TO PROSECLTI]N. MINIMUM DISTFINCE BETWEEN R WELL FIND RNY ON-SITE SEWFlGE DISPOSRL SYSTEM IS 10~ FEET FOR Fl F'RIVI-]TE WELL OR 150 TO 200 FEET FROM FI PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM FI PRIVRTE WELL TO FI PRIVRTE SEWER LINE IS '25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED FIND MUST BE RETURr-,IED TO THE DEPRRTMENT WITHIN _-<0 OF THE WELL COMPLETION. OTHER REQUIREMENTS I"IRY RPPLY. SF'ECIFICRTIONS RND CONSTRUCTION DIRGRFlMS 'RRE RVFIILFIBLE TO INSURE PROPER INSTF~LLFlTION. 'PERi'-1 I T E.*--=:F' I F-rES [)EL-:Ei--1E:ER 31.. I'Z~- :BO I CERTIFY THRT 1: I FIM FRMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS FlS SET FORTH BY THE MUNICIPRLIT'¢ OF RNCHORRGE. 2: I WILL INSTFILL-THE S'?'STEM IN 8CCORDFINCE WITH THE CODES. .9.?: I UNDERSTFIND THFlT THE ON-SITE SEWER SYSTEM MR9 REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 3: BEDROOMS. RPPL I CRNT \ ISSUED ~, ? ...... /~ ....... [:.,RTE ..... PERFORMED FOR= 212 E, INTErJeCTIONAL A.I~PORT ROAD AN c H~,~G E, A L~AS KAl g9502 PUO N E .,2//~ (~--~/Nr~'-~:~';~z ...... DATE PERFORMED: ,,~ SOILS LOG · ,~ PERCOLATION TEST SLOPE SITE PLAN WAS GROUND'WATER .~,,~;'lj~/.'~ ENCOUNTERED? ' S L IF YES, AT WHAT /~z~l DEPTH? Gross Net Depth to Net Reading Date Time Time Water· . , ' Drop ?~ '~' % c~ ~3 ~' ~.~ PERCOLATION RATE ~ ~/~" ' -~ /,/J (minutes/inch) TEST RUN BETWEEN '~---'~. 'FT AND (~'- . FT 1X 196650 un c pa-hty ANCHORAGE, ALASKA 99519-6650 O~ (907) 264~t2:X 4 ? 4 4 AncO°rage MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES January 23, 1987 Mark and Nancy Langley SR 3 Box 7562 Chugiak, Alaska 99567 Subject: Lot 31 Block 3 North Woods Subdivision The Department of Health and Human Services wishes to take this opportunity to thank you for your cooperation and assistance with the septic system related problems facing the North Woods area. With your help we have been able to ascertain which areas of Phase I are most likely to have a shallow groundwater problem. Our next step in this process is to determine to what extent the shallow groundwater has affected your neighbors throughout North Woods Phases II through V, as well as the surrounding area. We will then proceed along a similar course in those areas where groundwater contamination is a definite possibility. After reviewing the specific tests and the results provided by our engineering consultant relating to your lot, we have drawn the following conclusion: your septic system is discharging into the groundwater and will require immediate attention. Therefore, you will need to contact this department to obtain a permit for the upgrading of your system as soon as possible. Our office is located at 825 L Street, Room 502; our phone number is 264-4744. It is our sincere hope that we will be able to insure a clean and safe community in which you and your neighbors can live. To this end we wish to once again express our gratitude for your under- standing and unselfish cooperation. Si~erely, ~' Dan Bolles Engineering Tech On-site Services '6PCniA6 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section -' Fax: 907-343-7997 Parcel I.D. 051-731-51 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: Complete legal description North Woods, Block 3, Lot 31 Location (site address) 22743 Northwoods Drive, Chugiak, AK 99567 Current property owner(s) Steven & Megan Garwood Day phone 970-799-9342 Mailing address 22743 Northwoods Drive, Chugiak, AK 99567 Real estate agent 2. TYPE OF DWELLING: Fm� Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic ❑■ Water Storage ❑ Holding Tank. ❑ Community Well ❑■ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COS- A -Fee-$ _ern Waiver -Fee-$ Date of Payment o-/ Ig Date of Payment Receipt Number Q )(Q aa4:) Receipt Number COSA# QSCo2d 10&b 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 Forge Civil Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE -4— System #1 Approved for M System #2 Approved for Disapproved Conditional approval for bedrooms Phone 907-522-7773 Date 2/19/20 LE j 49th MICHAEL E. ANDERSON %No. CE -4387 ,•` bedrooms $0 `'•..• 2/19/20 <'ss ®� lsa7iea��,+�84� _ bedrooms, with the following stipulations: Original Certificate Date: Z-2-1- z f] The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: North Woods, Block 3, Lot 31 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments Class A Well - Community Water System B. TANK DATA Age of tank(s) <1 years Tank type/material STEP/PLASTIC Measured operating fluid level in septic tank New V Standpipes/foundation cleanout per record drawing Date of pumping New Construction D. ABSORPTION FIELD DATA Absorption Bed Parcel ID: 051-731-51 of Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station <1 years Lift station material Comments: New Construction Which system tested (date installed) 4/16/87 Adequacy test date 2/11/20 7 ALL standpipes present per record drawing Results Q✓ Pass For 3 bedrooms Total -measured -depth -from -grade 3-6—ft-(max)— Fluid-depth-prior-to-test---O---in– Measured luid-depth-prior-to-test 0--inMeasured depth to pipe invert from grade ft (min) Water added 563 gal ❑ N/A – pressurized field New depth 3 in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min 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 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 N/A if No ft Community Sewer Manhole/Cleanout > 100' N/A ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No N/A ft Private Sewer/Septic Line > 25' ❑ Yes if No N/A ft Absorption Field on Lot > 100' ❑ Yes if No N/A ft Holding Tank > 100' ❑ Yes if No N/A ft Neighboring Absorption Fields > 100' N/AAnimal Containment > 50' ElYes if No N/A ft F-1Yes if No ft if No ft Community Sewer Main > 75' El Yes if No N/A ft Manure/Animal Excreta Storage > 100' ❑ Yes if No N/A ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10'✓❑ ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ✓❑ Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' ❑✓ 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'✓❑ 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 F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF N . 49th+BI .......................... ....................� F MICHAEL E. ANDERSON •Zw J, No. CE -4381 s 2/18/20 •.. • °• C' w • . �� a4"ROFES,wo'o® oil \o \ ( \ oil ki \ /Z - -\ $ / \ - ( \ / - -\ % s - G \ \ j § lip \3i(\ 2\ MUNICIPALITY OF ANCHORAGE DIVISIOM OF E~rVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND EN~;IRONblENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, townshi~, range) Location (address or directions) ~l~ (b) Applicants Name~///~L-b~-/~'~,/z/~.~/JyTelephone - Home Business Applicants Address ~. ~ (c) Applicant is (check one) Lending Institution ~ ; Owner/builder ~ ; Buyer [122; Othe [122 ( xplain); (d) Lending Institution ~~.~ / ~/~r_~. ~--~'7~ .~..~ Telephone (e) · Address '~'~'~/~,1.4V ~.~. Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms 3. Water Supply Multi-Fami!y~ Other (describe) e Note: If community well system, must have written cor~firmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage Disposal Onsite ~ Public ~-~ Community ~ Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providing Inspections, Tests, File Search~ Data and Information 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 shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone Approved. ~ Disapproved ~ Condition~ Te~s of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMEIff OF HEALTH AND Eh~qIRO~NTAL PROTECTION (DHEP) ISSUES H~ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TiE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN ~ PROFESSIONAL ENGINEER'S WORK. (DHEP SmLL) RR4/ej/D18 [Page 2 of 2] 7-19-84 Well Classification Well Log P~esent (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~c~ Well: To Septic/Holding Tarzk on Lot ~k~ MUNICIPALITY OF ANCHORAGE (M(~iCiPAtlT¥ OF HEALTH ~O~TY ~PROV~ (~l~.c,-~:~~'.~ C~LI~ - F~RU~Y 1984 If A, B, ~ C~ D.E.C~ ~p~oved(Y~) Date ~leted Yield ~pth of G~outing_ ~ ~t At Sanitary Seal on Casing (Y/N) Depression A~ound Wellhead (Y/N) ; On Adjoining Lots ~ To Nearest Edge of Absorption Field on Lot ~/~ f-- ; On Adjoining Lots To Nearest Public Sewer Line C leanout/Manhole Water Sample Collected By Water Sample Test Results ~ Cc~rents /~/~ To Nearest Public Sewer To Nearest Sewe~ Service Line on Lot ; Date / B~ SEPTIC/HOLDING TANK DATA NO. of Cc~[~3a~tments ~ Date Installg~ ~ ~'~ Size ~Standpipes (~?/~-~ ~ _Ai~-tight ~epression ove~ Tank (~ Date Last Pumping/Maintenance Contract on File (Y/N) Foundation Cleanout (Y~) fo~ Holding Tank High-Water Alal~m (Y/N)/~}/p~ Toltl~2a'~y HoldirxJ Tank Perlr~t Sepa~at'ion Distances f~om Septic/~ank: ! To Water-Supply Well ~ To Property Line ./~ To Water M~.-i~/Service Line Course Comuents To Building Foundation /~ To Disposal Field ~/ To S~t~gam~ Pond, Leke~ c~ Majo~ D~aina~e [Page 1 of 2] 2~15-84 Ce De ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed r~.~/~ ~z3 / /Length of Field Width of Field ~L~ /( Depth of Field ~ 7~ / Results of Separation Distan~ To ~te~-sup~ly ~11 To Building Foundation ' Date Installed Size in Gallons "PLtmp On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) //~"~ump Off" Level at VC)- Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Counts ** Check Permitted Bedroom Rating A~ainst HAA Request I certify that I have checked, verified, o~ confor~ed to all M~)~ 'HAA ~G~Qes on the date of this inspection. Company KB1/d5/s [Page 2 of 2] 2-15-84 r D/(TE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF iff;'--'.:&i ! & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO[~[VIRONMENTAL ;';'OfF-CTION 825 L Street - Anchorage, Alaska 99501 I 980 ENVIRONMENTAL SANITATION DIVISION ' Telephone 264-4720 DIRECTIONS: Complete all ~arts on ~e~e ~. Incomplete requests will not he processed. Please allow ten (~01 devs for ~roeessin~. MAILING A D~D~ ESS PROPERTY RESIDE~(If different from above) PHONE MAILING ADDRESS 3. LENDING INSTITUTION(~<~ ~x~Q.~I~-~ ['~ PHONE 4. REALTOR/AGEN~ J PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four E~ SINGLE FAMILY [] Two [] 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.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY BI ONE [] THREE F-I FIVE [~3 OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified. INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line 1 WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ¢ OVED FOR. BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~~2 DATE BY 72-010 (Rev. 6/79) Time x _,. ;'ne Time x. ~, Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size / d~D ~,~.. (~) Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner /~ ~ ~-~ Mailing Address ~-~ ~~ ~/~/~' ~ ~--~7 ~~?/ Buyer Lending Institution ~ '~ ' ~ ,: ' ~ ~ Add ress '--y:):~_~ ~ Address Legal Description ~'~/ ~ ~ /~2~~' ~'~. L~I~~1~/~ ~ Street Location ~W~~ ~//~ ~: ~ Typ~ Residence : ~ ~ Single Family ~ ~ Multiple Family No, of Bedrooms ~ Other Water Supply ~lndividual A~ACH WELL LOG. A well Icg is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach Icg if ~ Public Utility available.) Se~ Disposal ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank : .NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.