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HomeMy WebLinkAboutPRATOR BLK 12A LT 7Prator Block 12A Lot 7 #017-093-15 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231247 PID Number: 017-093-15 Dwelling: Al Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name AMUNDSON ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 6741 MARQUEZ CIR ❑ Other Phone Number of Bedrooms Soil Rating Toial depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot PRATOR BLK 12A LT7 Ft Ft. Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Ft. Total absorption area Number of trenches Ft. Dist, between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ 50f+ TANK I] Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ ANCH TANK 1000 Gal. Material Number of compartments Lot Line 101+ NA PLASTIC 2 Foundation 10,+ LIFT STATION Manufacturer Capacity Remarks TANK DEMO PER UPC, Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank Tank to 3034 drainfield 3034 MIKE N ANDERSON, P.E. Drainfield CO/MT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed 100 elevation) ft Inspection 1� 9/3/23 dates: 2"° Location and description 3`° 4m TOP OF MANHOLE 100 ON-SITE WATER AND WASTEWATER SECTION APPROVAL . _'> amp Conditional Approval: Date L • iJ t .,. J • .. `, ? i3�•. Septic System Approved Date / 2� 20? ... Note: this approval does not include well permit requirements. `fit; `' r•. `� lRev 05/n9/1R1 Permit No. OSP231247 Page 2 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 Legal Description: LOT 7, BLK 12A PRATOR S/D PID No.: 017-093-15 1 MARK A B EXIS G 03 CO RED BY PAVE D IVEWAY EXIST G VAL a GLPLA1000 GPLA C CO2 01 TANK, Ly I BENC MARK EXISTING FCO I B — — I— i I � / I \ I � I � I I ASBUILT I SCA E: 1"=50' EXISTING FCO TC01 C01 CO2 EXISTING VALVE .../� OF /�1•. Air FINISH GRADE Y •' 49 TH ••' ♦� 1,000Ad Milo GALLON 95.2 ....... 4­011�, PLASTIC TANK;MICHAEL N. ANDERSON •♦1♦ 9-17-2369 SEanrci. E nON ♦#titNVASua TC01 40 25 TCO2 45 27 C01 47 30 CO2 49 31 CO3 73 37 1 MARK A B EXIS G 03 CO RED BY PAVE D IVEWAY EXIST G VAL a GLPLA1000 GPLA C CO2 01 TANK, Ly I BENC MARK EXISTING FCO I B — — I— i I � / I \ I � I � I I ASBUILT I SCA E: 1"=50' EXISTING FCO TC01 C01 CO2 EXISTING VALVE .../� OF /�1•. Air FINISH GRADE Y •' 49 TH ••' ♦� 1,000Ad Milo GALLON 95.2 ....... 4­011�, PLASTIC TANK;MICHAEL N. ANDERSON •♦1♦ 9-17-2369 SEanrci. E nON ♦#titNVASua MUNICIPALITY OF ANCHORAGE Ment S On -Site Water & Wastewater Program �o PO Box 196650 4700 Elmore Road .� Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite Department On -Site Wastewater Disposal System Permit Permit Number: OSP231247 Effective Date: 8/31/2023 Work Type: SepticTank Upgrade Expiration Date: 8/30/2024 Tax Code Number: 01709315000 Site Legal Address: PRATOR BLK 12A LT7 G:3039 Site Mailing Address: 6741 MARQUEZ CIR, Anchorage Owner: AMUNDSON AUDREY L & BRETT R Lot Size in Sq Ft: 55509 Design Engineer: ANDERSON MICHAEL Total Bedrooms: 3 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 Received By: `� 1 All I Date: Issued By: Date:'F/ 3i �Z hAUMUPAWTY OF AHCHOPPIAGE R?\�' UnD C3r,t i, Development Services Department 4 Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-093-15 Property owner(s) AMUNDSON Mailing address 6741 MARQUEZ CIR Site address SAME Legal description (Sub'd., Block & Lot) PRATOR BLK 12A LT7 Day phone Legal description (Township, Range & Section) Lot Size 55,509 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade Q (D) El Holding Tank ❑ RenewalDuplex ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 4�/ 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: 136 D Waiver Fees: Date of Payment: OA/A-73 Date of Payment: Receipt Number: OOg3l Z Receipt Number: Permit No. 0LP 27: 2L(7 Waiver No. G1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Aug 27, 2023 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic tank permit Legal: PRATORBLK 12A LT7 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The tank will be decommissioned per the Uniform Plumbing Code (UPC). Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231247, Curtis Townsend, 08/31/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231247, Curtis Townsend, 08/31/23 Municipality of Anchorage Community Development Department Page ( of On-Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: PID Number: Ot72 — Vq% —f 5' ❑ New [gUpgrade Name: ABSORPTION FIELD ❑ Deep Trench ❑Shallow Trench El Bed ❑Mound El Other Address &7q Phone Number of Bedrooms Soil Rating ) Total depth from original grade J cq• D GPD/SF 1 Zi Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade I, Ft. Gravel depth beneath ipe 7�, Ft. Subdivisif�n Block Lot 1-'ra v r ('j Fill added above original gradeGravel %/ Ft. length S ;7- Ft. Township Range Section Gravel widtheds: 2 Ft. Number of Lines Distance between lines / Ft. SEPARATION DISTANCES To From Septic Tank Absorption Field Lift Station Holding Tank Sewer Line Total absorption area (� Ftp Number of trenches Dist. between trenches Ft. WellSVD I (�Ut (./ A �h / �h l,� TANK El Septic ❑ S.T.E.P. El Holding El Other Manufacturer Ca Surface Water �Va f� (Vv r,� Gal. Material Number of compartments Lot Line �Y7 I� (� '� NA Foundation r.F ZJf� LIFT STATION Manufacturer Capacity Curtain Drain Gal. Remarks Pump on level at Pump off level atHigh in. water alarm at in. Pump make model Electrical Inspections performed by Installer ,J,II ,/( t � 1 n H�I C n ./`lYe vorur, P.E. PIPE MATERIAL House to tank rank to drainfield m3K Drainfield ,,E, CO/MT yp g Inspectorth r d c BENCHMARK (Assumed elevation) (VO R Inspection „ '/ dates: 1 Z a 6,2-2ntl p 3m 4m Location and description �l/��ire S u� COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date `p�,• "•°'' S no • 49TH01 00 00 •� • MICHAEL N. ANDERSON %.. CE-99 69 Approved Datey---/ PR jot -X inspection Report_t-t4egoc/1_11 Permit No. SW070217 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 7, BLK 12A PRATOR S/D PID No.: 017-093-15 MARK A B GRND. PIPE ELEV. ELEV. VALVE 32 68 99.5 96.7 C01 45 79 95.6 100. MT 73 103 100.6 CO2 92 116 100.7 95.6 ISTING TRENCH / 1 Co I I NEW VALVE / v C01 EXISTING TANK <o 0> I 1� BENCH, CONCRETE 48 � 1 \ A, \ \\ TEST HOLE ADIUS 1 \ 1 \ 1 ASBUIL \\ B 1 SCALE: 1"=30' VALK rc0. rMll X3.8 I FC04 / 9 I .r< .. . xwa D OflFANICS = .. M IXSVIAIgX WI&Rf AEVVIRfD FlLIER fABAK —V�5 SP � � • 4J9 TM Y 967 I��/..C.S:::...•.�.. W.0 ssm naR /.... •* .. .. u c.MICHAEL N. ANDERSON: SP L.n.•.. No. CE 9469 : SEPTIC SECTION N.T.S. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070217 Legal Description: PRATOR BLK 12A LT 7 Design Engineer: 0088 ANDERSON CONSTRUCTION & E Owner Name: DICK HUMPHREY Owner Address: 6741 MARQUEZ CIRCLE ANCHORAGE. AK 99516-4471 Date Issued: Aug 24, 2007 Expiration Date: Aug 23, 2008 Parcel ID: 017-093-15 Site Address: 006741 MARQUEZ CIR Lot Size: 55509 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑✓ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, seated, and heated to prevent freezing. 5. The following special provisions. THE EXISTING SYSTEM IS TO BE DOCUMENTED AT THE TIME OF CONSTRUCTION AND DOCUMENTATION SUBMITTED TO ONSITE WITH THE NEW ASBUILT. Received By: Date: ��� Date: z Issued By. vt/02_1 Date: Municipality of Anchorage - -:: ;. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 ° Anchorage, AK 99519-6650 www.muni.orglonsile J (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 4 17 09-5 - (S— ��11�� Ds hone Property owner(s) lU r e -k' ��' n h .f ✓t y p Mailing address btg4 Site address M Code Legal description (Sub'd, Block & Lot) aoT, ( -2"4. G u4 -7 Pro t o ✓ Legal description (Township, Section & Range) Lot Size --.5 5, 6 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms Code J THIS APPLICATION IS AN: Initial ❑ j Upgrade [� Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) PermitlRush Fees: 00 'L t'�W45 Waiver Fees: Date of Payment: pn/ay 10a Date of Payment: Receipt Number. `/ 1 �l Receipt Number: (Rev. W05) Michael N. Anderson, P.E. Civil/Structural Engineering & Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 August 24 2007 Municipalities of Anchorage Departments of Health and human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Blk 12A, Lot 7, Prator Subd. To Whom it may concern: This is a request for a new septic permit on the above lot. The lot size is large, 1.27 acres, typical for the area and the lot to the east is vacant. The test hole data is from the original engineer, Dee High, which shows silty sand and gravel for the full test hole depth of 20.5 feet, with no water observed after the 7 day monitoring period. Currently the existing trench system sits on a slight mound, thus the necessary depth of the existing system. The perc rate from Dee high was 2.1 minutes per inch, however a slower perc rate has been used for added life of this new system. All of the soils data will be verified during the new trench excavation. The data from second test hole has a slower perc rate of 24 minutes per inch but the test was run at elevation —4.3, the new system will be at least -6' below grade, similar to the perc rate of test hole # I, see soil log from Dee Iligh, attached. All of the lot have a gentle slope of about 2 to 3 percent from the southwest to the northeast, , as shown on the plan. There are no cut banks within 50 feet of the existing or proposed systems. Both roads, which border the property do not have a ditch line or steep drainage. The neighboring lots will not be impacted by the new addition due to the large lot size. If the existing system has not been asbuilted then I will add it to my asbuilt, per Dee high, the previous engineer. If you have any question please call me at 345-3377 ly Sin /r, 1/ 1A� Michael N. Anderson, P.E. DESIGN CRITERIA: 3 BDRM X 150 = 450 GPD SOILS = 450/0.8 = 562 GPD 562 GA/5X2 = 56' (1) TRENCH 14.0• DEEP 5.0' EFFECTIVE 2.0' WIDE 57' LONG -LOT 3 - OVER (THd1) o un'wc "0 ORG -3.5 SP FILTER FABF SM -9,0 4'0 PIPE -9.0 SEWER ROCK SP U 2.0• 2o.s ALL TEST HOLE DATA FROM DEE HIGH ORIGINAL TEST HOLE. VERIFICATION REQUIRED DURING INSTALLATION , ,J < 1 i 1` LOT, 1 < -LOT 2- 1 1 EXISTING DRAINFIELD - M A R 0 U E Z C IRC Lam- i rf -LOT 4- / / EXISTING SEPTIC TANK TO REMAIN ' I 1 �� 11 WELL I \ \\` WELL < -LOT 5- 1`�r -LOT 6- --- L —�tL N 11 I� 10 IA N 1-� 1� 11 1 1 EXISIb G 3 BI EXISTING WELL1 100_RADILJ§_ -3 J Septic Design Prepared For DICK IIUMPIIREY LOT 7, BLOCK 12A, PRATOR SUBDIVISION Anchorage, Alaska Prepared By MICIIAEL N. ANDERSON, P.E. 4640 SIIOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=100' AUGUST 24, 2007 DRAINFIELD LINE VACANT LAND HOUSE jr '9:" �! 49TH iAEL N. ANDEF No. CE 9469 R -MAROUE2 CIRCL�_PROPERTY LINE I 1 SMALL DRAINAG I _ EXISTING DR LD 1 -,-T.Q. BE- USED AS I 10 MIN. SE SYSTEM SEPARATIO5 0. PRO SED 1 TRENCH H�S i i �A IDRAI IELD 1 A Ajt BY D{:E HI la NEW VAL FOR ?� I �' i PE�iC RATE R.1 M /INCH Ts" i SW MING i / MT 1 1 I A 8 EN SYSTE EXISTING SEPTIC TANK TO BE SMALL DRAIN/iGE D H INSPECTED AND _ REPLACED IF I e 1 -t NECESSARY I - I I , 1 ro i I TH12 BY DEE d1 1 HIGH. PERC RATA I 24 MIN./INCH , 1 M j 1 1 1 EXISTING co \ 1 Lz�l ` 1 rn `� EXISTING 3 \\ 1 y N BEDROOM HOUSE I 1 1 r I \ 1 1 C 6 I WELL �` � I NOTE: ALL SOILS 1 I 1 WILL BE VERIFIED 11 ORAY IN THE FIELD 1 1 DURING 1 , INSTALLATION OF WELL I NEW TRENCH. I i i 1 -LOT 6- -LdT 7- i 1 Septic Design Prepared For DICK HUMPHREY ..���E .., ,,♦♦♦ LOT 7 BLOCK 12A PRATOR SUBDIVISION . Q ,.. Anchorage, Alaska♦♦ 49 R Prepared By ................. . c.....� MICHAEL N. ANDERSON, P.E. •••• 0 • 4640 SHOSHONI DRIVE ♦♦ :MICHAEL N. ANDERSON (907) 345-3377 / FAX (907) 345-1391 ♦♦♦ No. CE 9469 p ♦ • SCALE: 1"=30' AUGUST 24, 2007 ♦\ O Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 vwvw.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Michael N. Anderson Legal description: Prator. 612A L7 ®Permit OC.O.S.A. ❑Inspection Report ZD The attached paperwork has been reviewed and is being returned for the following reasons: 1. The existing system is not approved. The inspection report from the original engineer is required or the system must be documented. Prov srsn or. 2. Show all the easements. o K 3. The site plan shall have a description of the topography, areas of excessive slope, and extent of slopes and surface drainage patterns within 100 feet of any part of the system or portion of the lot intended for use for on-site wastewater disposal. AMC 15.65.030 D. Please provide this Information on the site plan. Is there a cutbank or ditch at the street that creates excessive slope? 01<4. Is the system parallel to the contours? O145. Exactly what size is the proposed trench? Name of reviewer. Deb Add P.ovis;on 7v Date: 8/24107 A,4+Al I h ex1'st,h7 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ri rt *f b DOC Co..Eba "SULUVAN.. WATER WELLS P_:O BOX 870272 CHUOIAK ALASKA 99557 • TELEPHONE 9892759 r ��r7.� s.••.ra..a OWNER OF LAND cx) .J TRA0-T-O/1$ _ DEPTH OF -WELL' to ADDRESS 0 •r1 �C* OF 9 RTICLEVELWATERFT LEGAL DESCRIPTIO ( in RAw DOwN FT' ; - s DATE Started Ended GALS PER HR ?O t] Ort+ as PERMIT NUMBER 1 4 KIND -OF -CASING v KIND OF FORMATION: * ,> t"" From 10 Ft.. toc—Ft. ^ Sr/C�J r From - Ft. to Ft. n1 r � �-, a •-. From,Z_Ft'toA_Ft .6 JF,(341 4 1Q�fC 7" FronL____Ft:to_Ff.i .L s ? V E [ From Ft to Fv FromFt toFt ' From_Ft to' 411 �- �" From Ff to QQ f0{ $ jli From Ft to— ! —Ft r� Lf 7 ^!l JCL From��t to Ft {� i FromFt toFt �A.t14 �rOA G W �! From Ft to Ft " FromFtSto�Ft C'L �}`r �/Q M� JtG L-' 1F m ':Ft u Frotn.�0_Ft to . i` iF�� Aru d =�kt/t Z ?' From Ft to FE - From Ft to�� Ft Tito-ar.T / From Ft to. Ft: j �p��I From n .:i Ft.jo�1-Ft. Q lct7Q PC -14 �_ `R From Ft. to_Ft. From Ft to Ft From Ft to- Ft- _ Ft. From FP to - � � �-Flom Ft to- Ft-` From Ft to—Ft From—Ft: to^ Ft. From Ft. to Ft. - - From Ft. to -Ft From - Ft. to .. Ft: From Ft. to Ft. "�� •"+ From Ft: to Ft: From Ft. to—Ft.'— From—Ft. oFt.'From Ft. to Ft. From—Fc-to—Ft. MISCL.INFORMATION: CAS 6 >� r �� 78 ro4AT2=D t � , TAL (, .. GAS iJ - ,4 DRILLERS NAME Z �J �� TX-Acipality of Anchorage Department of Health and Human. Services rte. 825 U' Street Pick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Nlayor 343-4744 November 14, 1994 Mr. William Marquez 6903 S.E. Riverside Drive, #18 Vancouver, WA 98663 Subject: Lot #7 Block #12A Prator Subdivision Permit #SW930347, Parcel ID #017-093-15 Dear Mr. Marquez: The subject permit, issued September 7, 1993 by this office for a single family well and/or on-site wastewater system, has expired as of September 7, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If the on-site wastewater system has been completed and a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerel, C James 1"-' rP.E. Program Manager On -Site Services JC/kb cc: Dee High, P.E. 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:SW930347 DESIGN ENGINEER:DEE HIGH ENGINEERING OWNER NAME:MARQUEZ WILLIAM F & OWNER ADDRESS:6903 SE RIVERSIDE DRIVE, #18 VANCOVER, WA 98663 PARCEL ID:01709315 LEGAL DESCRIPTION: PRATOR BLK 12A LT 7 LOT SIZE: 55509 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 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: 9/07/93 EXPIRATION DATE: 9/07/94 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 343-4744 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: a' ISSUED BY: DATE: ' 7 3 DATE: 9 /yj Perry It No. Page 1 of 8 W.O. 93072 Municipality of Anchorage Department of Health and Human Services Date 8-20-93 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION PID No. SITE NARRATIVE Lot 7 Block 12A Prator Subdivision is bordered by two lots. The lot to the west has a well and onsite septic system, while the lot to the south is also undeveloped. Lot 7 is undeveloped, and the septic system design is based on the proposed location of a three bedroom house as shown on the drawings. WELLS; The adjacent lot to the west has a 100' well radius that encroaches onto lot 7. The proposed well will be located on the west side of lot 7 and will overlap on the west side of lot 7 and will overlap the well radius on the adjacent lot. Neither well will affect placement of the proposed septic system as shown on the drawings. The proposed well radius will not encroach onto the undeveloped lot bordering to the south, so future development of this lot will be unaffected by the placement of the proposed well or septic system. SEPTIC SYSTEMS: The lot to the west has an existing onsite septic system which will not pose any restrictions on the proposed well location. The proposed septic system will not affect the future placement of a well on the lot to the south. DRAINAGE: The lot slopes from west to cast (from the well towards the septic system). All fills will be sloped to drain in the direction of natural drainage. The system will receive topsoil and seeding to prevent erosion. 72-013 A �2(Y�1 MM 25 G FAM 012C$BIU Permit. No. Page 2 of 8 Municipality of AnchorageW.O. 93072. Department of Health and Human Services Date 9-02-93 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 ° Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION PID No. BENCH MARK REBAR PROPERTY CORNER ELEV = 97.4 M A� CIRCLE / h RESERVE AREA TP 1 \TP 2,�'` PROPOSED I WELL LOCATION PROPOSED SYSTEM I / 77 4 10' PROPERjY UNE OFFSET 1 11 SCALE: 1 " = 50' C_ ne: 07_9920 rKerm+t Na. Page 3 of 8 Municipality of Anchorage W.O. 93072 Department of Health and Human Services Date 9-01 —93 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 4 Anchorage, AK 99519-6650 4 Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Deport Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION PID No. SYSTEM DESIGN CALCULATIONS 1. NO. BEDROOMS — 3 2. USE TRENCH SYSTEM 3. ABSORBTION AREA = (# BEDROOMS)(150 GPD/BR) TRENCH APPLICATION RATE = (3)(150) = 375 SF 1.2* 4. TRENCH AREA = (2)(DEPTH OF GRAVEL)(LENGTH) = 375 SF IF DEPTH OF GRAVEL = 5 THEN LENGTH OF TRENCH = 37.5' PERCOLATION RATE PIT & TRENCH APPLICATION RATE MIN/INCH GPD/SF 0-1 NOT SUITABLE 1-5 1.2 6-15 0.8 16-30 0.6 31-60 0.45 GREATER THAN 60 NOT SUITABLE FILTER LAYER 1.0 MOUND & BED ♦_'t`tT4 APPLICATION RATE �� OF44 X14 AP GPD/SF A % 040o�`O NOT SUITABLE TH *�0 0.8 04 • •04• •440000 as• 0*040 0.5 100004 o e 00000 0.4 `®eco $DENNIS DE H GH` ¢ s 0.3�S s4 CE 58 NOT SUITABLE®®®��prOfessio®fie` neTE T4810aaW C. Fn.. mvccn.'ui Permit No. Page 4 of 8 Municipality of Anchorage W.O. 93072 Department of Health and Human Services Date 9-02-93 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION PID No. M AROUEZ L- 1 e4 END OF TRENCH INVERT = 87.0 CLEANOUT \(TYP) MONITOR goo ` TUBE, / TP 1 _ BEGINNING OF TRENCH �`V` INVERT = 87.0 / m \ a 'r TANK OUTLET A, ' rq \ INVERT = 92.5 s9 \_ 0 -,�INSTALL 1000 GAL. J z \� SEPTIC TANK % SEE NOTE 2. 3 0 � o TANK INLET � TP 2 (T / o p INVERT = 92.6 ` / n m NINSTALL CO 2' / \ FROM BUILDING / �\ \ FOUNDATION 1' / z INVERT = 93.1 PROPOSED \ ` // •.•`�"R�a HOUSES OF 44,4144 99 LH�� g •� e 700 1 0*0 **DENNIS E IGHe S CE 58 SCALE: 1 " = 20' +�; profess.\o ��� l DATE �•a:•• C_ m.. 07205N.0 Permit No. Page 5 of 8 Municipality of Anchorage W.O. 93072 Department of Health and Human Services Date 9-02-93 ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, AK 99519-6650 • Tel: 343-4744 On—Site Wastewater Disposal System/Well Inspection Report Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION PID No. 4"0 MONITOR TUBE W/ AIRTIGHT CAP SLOPE FILL TO DRAIN SEE NOTES 15 & 16 BACKFILL EXISTING GRADE = 96.5t SEE NOTE 14----, SLOPE TRENCH WALLS AS 9 f REQUIRED TO MEET ALL COVER 6» LOCAL, STATE, AND GEOTEXTILE7RIC FEDERAL REGULATIONS SEE NOTE °g 4" 0 PERF. PVC PIPE °gam INVERT = 87.0 5'-0" GRAVEL BELOW SEWER ROCK PER °8° PIPE INVERT MINICIPAL SPECS o� ° SEE NOTE 10 BOTTOM OF GRAVEL = 82.0 f BOTTOM OF TEST PIT ELEV = 76.0 TYPICAL TRENCH SECTION SCALE: NTS Permit No, Legal Description: LOT 7 BLOCK 12A PRATOR SUBDIVISION NOTES: Page 6 of 8 W.O. 93072 Date 9-02-93 1 ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS OF THE MUNICIPAL CODE AS CURRENTLY AMENDED. 2 INSTALL NEW 1000 GAL SEPTIC TANK AS SHOWN ON THE DRAWINGS. RECORD INLET AND OUTLET ELEVATIONS OF THE TANK. TANK SHALL BE PLACED ON UNDISTURBED NATIVE SOIL. 3 SITE TOPOGRAPHIC SURVEY CONDUCTED BY DHI ON 8-17-93. EXISTING STRUCTURES, WELLS, SEPTIC SYSTEMS OBSERVED WITHIN 150 FT. OF PROPOSED SYSTEM SITE ARE SHOWN ON DESIGN DRAWINGS. 4 ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION INTO THE SYSTEM. 5 CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATER WAYS, SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM. CONTRACTOR TO STAKE PROPOSED SYSTEM PRIOR TO CONSTRUCTION, NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION. 6 CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRADE PRIOR TO PLACING THE SEWER ROCK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE AFTER THE WORK IS COMPLETED. 7 CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED -LINED, AS -BUILT DRAWINGS SHOWING ALL DATA AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN FIVE DAYS OF THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE AS-BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS, 8 ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN. 9 EXCAVATE THE ABSORPTION TRENCH. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 10 PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO f 1" PRIOR TO INSTALLING THE PERFORATED PIPE. 11 ALL PIPE SHALL BE PVC CONFORMING TO ASTM 03034 OR ENGINEER -APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FT OVER PIPES, 4 FT OVER THE SEPTIC TANK. 12 GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER -APPROVED EQUAL. LAP ALL JOINTS 2' MIN. 13 COVER THE DISTRIBUTION PIPE WITH MIN 2" SEWER ROCK, AND COVER WITH GEOTEXTILE BEFORE BACKFILLING. 14 MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 15 SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MIN. SLOPE, AND 3:1 MAX SLOPE, AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS. 16 RECORD THE FINISH GROUND ELEVATION AT BEGINNING, MIDDLE AND END OF TRENCH. 4. Rt mmwO Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 7 P 4 DATE PEP LEGAL DESCRIPTION: L -7 ✓ CA PWD2 S66 Township, Range, Section: SLOPE SITE PLAN DPW 09-QAN%C.S IT_, 4 Date 5 Net Time ('NLn1) Depth to Water Net Drop 6- ?-4-413 t:i o 7 7 8 it I'.2.4 to S o_ - 9 u 10i 11 12- 13- 14- 15- 21314 15 16- 17- 18- 19— 6171819 O G SAN04' 6,(GaJEL w� SIL.r SlL-Ty' S;P"ao wi 6AA%1CI— WAS GROUND WATER SANIVY Q#I!-A 1a— ENCOUNTERED? rN O WI C,0136t.r-S S TOVKr- S(L"r IF YES, AT WHAT �. L DEPTH? P E Depth to Water Aner Monitoring? t4Q"4 15— Date: 9 ZO-93 EMENNOMMEN Date Gross Time Net Time ('NLn1) Depth to Water Net Drop 9.s ?-4-413 t:i o EMMMENNNEE ti it I'.2.4 to S ' Y u MEMEMBEENE 4 )d75625." 12TUALLi u :M44V4,6-L �• S'� ZO.S/ V. 4-1 v 01 • 15 " 4•1 S Reading Date Gross Time Net Time ('NLn1) Depth to Water Net Drop 9.s ?-4-413 t:i o PERC HOLE DIAMETER ti it I'.2.4 to S ' Y u L :'1jCj 4 )d75625." 12TUALLi u :M44V4,6-L �• S'� ZO.S/ V. 4-1 v 01 • 15 " 4•1 S Si6,4 SYSTrim tt 1% 55 �%I1/ 9.15" 4.-7 11 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON T S DATE. DATE: u Z' 54 It .'15 It G. 2S" `t 3: oS it 9. t3ti 511 11 N 3 : L% tl 01.2-511 A--75 11 Gt.5" 1t 3:29 10 °1.251( 42511 20 U v2 � tt I Ert P TEST I. DL-� PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER ZO•rJI "7 i1 TEST RUN BETWEEN FT AND FT COMMENTS V 12TUALLi 6-PAEc. :M44V4,6-L �• S'� ZO.S/ 13yT- Srit Ey TD 4AY1= LF,SS SLLT PA.T �►' Si6,4 SYSTrim 69 9' M'PERFORMED BY: �%I1/ `��� I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON T S DATE. DATE: 72-000 (Rev. 4/85) x Municipality of Anchorage s , • �r `E via %307Z DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST a - PERFORMED FOR: TP LEGAL DESCRIPTION: L 7 6IZA 0fZ-4ANIGS 1 � o 2 o i 3 o 4 5 0 � i 6- 7 8- 10- 10 G 11 \ 12- 13- 14- C, 213 14G 15- 16- 17 5 16 17 O � 18- 191 8 Q'. 19 G D � I Q 20 COMMENTS DATE P Sub Township, Range, Section: SLOPE SAtoDY QAAklEL- WI SILT' S 1 LT`Y SA" O W I EiueAVCL L-t✓SS CW UC S Tf A I WAS GROUND WATER O ENCOUNTERED] IF YES, AT WHAT DEPTH? DepthIo Water Alter Monitoring? $�,q Monilorinp7 Balli: 3 L J 4- R 3 SITE PLAN MENNENER Date Gross Time Net ) Time �Y11Inl / Depth to Water Net Drop '�-4-q3 2=no 8g'cunt ■■..■■■M■■ ■■■■.■■■■. ■■■.■■■■■■ 3o c�.2 1. z ■■.©3©■.■■ .■■©M©©■■■ ■■■MME®.■■ ■■.■..■■M■ NEENEENNE MENNONNNNO ENEENNENNE ■■.■.■... Reading Date Gross Time Net ) Time �Y11Inl / Depth to Water Net Drop '�-4-q3 2=no 8g'cunt s"4111 3o c�.2 1. z r,tdD TEST t}oL-IZ PERCOLATION RATE 24 / �r � (minutes/inch) PERC HOLE DIAMETER l_ @ 2L), 5 TEST RUN BETWEEN 4'3 FT AND (0-3 FT Y PERFORMED BY: �'/t�i,i /4/vr i IiCERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DA E. DATE: r q3 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE a11Ll 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. 017-093-15 Expiration Date: 2' 2 91'2o 2 - Legal Legal description PRATOR BLK 12A LT7 Site address 6741 MARQUEZ CIR Anchorage AK Current property owner(s) AMUNDSON X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: a bedrooms, with the following stipulations: Original Certificate Date: 9/29/2023 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 MUHH U _77 OF" V�CHOR G -1, 4� Development Services Department r 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. Complete legal description PRATOR BLK 12A LT7 Location (site address) 6741 MARQ U EZ C I R, AN C H AK Current property owner(s) AMUNDSON 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: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age NEW - 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: FE -1 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 $ Waiver Fee $ Date of Payment C) 2 0 2 Date of Payment r t COSA # 05 G2 ---z, 1 2 % D Waiver # COSA Application—June 2022 COSA Checklist Legal Description: PRATOR BLK 12A LT7 Parcel ID: 017-093-15 If more than 7 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑NI Well log is filed with Onsite (or attached) Date drilled 10/93 Total depth 101 ft Cased to 101 ft ❑NI Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 6/9/23 Static water level at beginning of test 55 ft. Comments 1411111110111:11a73L1 Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: NEW PLASTIC TANK INSTALLED D. ABSORPTION FIELD DATA Which system tested (date installed) 8/28/07 a ALL standpipes present per record drawing Total measured depth from grade 9.2 ft (max) Measured depth to pipe invert from grade 3.4 ft (min) ❑ N/A —pressurized field. ❑ Per record drawings, field is insulated. 0 Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) _ If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 4+ gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes Q No 0 Coliform bacteria is Negative Nitrate mg/L N Nitrate less than MRL (ND) Arsenic ug/L N Arsenic less than MRL (ND) Collected by MNA Date 6/9/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 6/9/23 Results Q Pass Fluid depth prior to test 11 in Water added 450 gal New fluid depth 21 in Elapsed time 1440 min Final fluid depth 111 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 70 in Effective depth used 111 in Effective depth remaining 59 in 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' Fi Yes if No ft Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100' FE] Yes if No ft Community Sewer Manhole/Cleanout > 100' ❑� Yes if No _ It Private Sewer/Septic Line > 25' Q Yes if No ft Holding Tank > 100' ❑� Yes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ It Di Yes if No _ ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75'❑ Yes if No _ ft 0 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' ❑O Yes if No _ ft Surface Water > 100' ❑E Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS ❑e Yes if No _ ft ❑Q Yes if No _ ft E Yes if No _ ft El Yes if No _ ft Wells on Adjacent Lots: Private Wells > 100' Q Yes if No Community Wells > 200' Yes if No If tank or field is under driveway comment below 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 iycIt it, 4JA3q 4, evaeal Engineer's Printed Name —,7 C. with e-, COSA Checklist June 2022 Phone 727-8864 Date 24 y -Ji r. Cr r 41 A, A % MICHAEL N. ANDERSON `i••• CE -9469 1st •.- .'- ,:: sJ 4-2,111 • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcell.D. 017-093-15 1. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: ;�— 19 —/ Current Property owner(s) Dick Humphrey Day phone Mailing address Real Estate Agent 6471 Marquez Cir. ANCHORAGE, AIC 99516 2. TYPE OF DWELLING: ® 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: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver-Nariance request for: Dista Received by: .4746zn;t�- Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ iv Waiver Fee $ _ Date of Payment 9a (p(I Ck IMN Date of Payment Receipt Number 2 C>S[SJ J }o Receipt Number COSA# ©5q(,,I`(/lc) 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 S(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm MIKE NANDERSON P G Phone 727-3364 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON PG Date 09/1,5/16 10F 4 o A9TH d 6. DSD SIGNATURE System #1 Alcor for / p . MICHAEL N. ANDERSON ; �e Y Pp bedrooms. l i, CE -9,1 9 ti System #2 Approved for bedrooms. 6�d��fo •.9I l 5�%Sa•���� Disapproved. VlUlt�(i (r� Conditional approval for bedrooms, with the followi�ngQ�ijlfaQ6r�y/n�r�. l tnfnrro nK1n m� BY Original Certificate Date:" a �C 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 blue sheet 10-10-124oc 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: Prator S/D, BLK 12A, LOT 7 Parcel ID: 017-093-15 A. WELL DATA Well type Private If A, 3, or C provide PWSID # Date completed 10193 Sanitary seal (Y/N) Y Total depth 101 ft. Cased to 101, fit. FROM WELL LOG Date of test 1011193 Static water level 50 ft. Well production . 5 g. p. m. WATER SAMPLE RESULTS: Well Log (Y/N) Wires properly protected (Y/N) Y Casing height (above ground) 12 AT INSPECTION 812912016 46 ft. 5+ g. p. m. Coliform NEG colonies/100 mL Nitrate 4.71 ni Arsenic: ND ug/L Date of sample: 8124/2016 Collected by: Mike N. Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL ** Date installed 8120193 Tank size 1000 -:`gala._ , Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping, 81291201B-tPumper' Northland Pumping C. ABSORPTION FIELD DATA 1985 SYSTEM TESTED Date installed 8128107 *."* t "; _--Soil rating (g.p.d./ft2 r ft2/bdrm) 0.8 System type DEEP TRENCH (upgrade) Length 57. ft. Width 2.0 ft. Gravel below pipe 5.8 ft. Total depth 9_2 ft. `:'}Eff..absorption area 661 ft' Monitoring tube Y Depression over field N Date of adequacy test 813012016 Results (Pass/Fail) PASS ** For 3 bedrooms Fluid_deloth in absorption field before test 28 in. Water added 500+ gal. New depth 36 in, i�•" i Elapsed Time '360 •.mi'n `„+ Final fluid depth 30 in. Absorption rate >= 500+ g, p. d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons Manhole/Access (Y/N) in. "Pump off' level at in.High water alarm level at In. Cycles tested Meets alarm 8 circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main 75'+ Sewer /septic service line 50'+ Animal containment areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100' Manure/animal excrete storage areas 100'+ Building foundation 10+' Property line 50'+ Absorption field 10'+ Water main 100'+ Water service line 50'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line Building foundation 10'+ Water main Water Service line 25'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 100'+ (None Known) Wells on adjacent lots 100'+ F. COMMENTS Dee High system was permitted but no inspection report in the file. A /f p r p r,$, "Tank was inspected during 2007 system upgrade"* 2007 system was tested for this G. ENGINEER'S CERTIFICATION certify that 1 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 MIK. N. ANDERSON, PE Date 09115/2016 COSA canary sheet 2-6-15.doc zti� OF Al ......4 S•, MICHAEL N•.. ..ANDERSCN �•,`'�' O i C 69 �✓ i� Municipality of Anchorage Community Development Department On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 Well Decommissioning Log Legal Address: Subdivision PrG %r, l Block 12 Lot T R Section Lot On-site Water & Wastewater Program certified contractor performing the well decommissioning: Name: Signature: /t(dAeY "ii Company: ComPai 1j/% -r /_(,47 �Cy 2V' V �✓'-, Well decommissioning date Z04/099-9Method of decommissioning: AMC 15.55.060L1 a. ❑ b. ❑ C. Location: Use the space below to provide a drawing of the property showing the following items: • North arrow • Decommissioned well, • Other water wells on the property, Two separate swing -tie distances for each well shown on the drawing, Note: The swing -tie distances shall be measured from either permanent structures or the property corners. As�9u,cr, SUVTLpy 6,? y-e �� nrnC WoIt CU � v%F� �Uh�P` G:\Community Development\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Well Decommisioning form.doc N 00°38'20" - ' =5 Z A PRATOR_ o �- 9-01-2016 Lot 7 Block 12A SW3039 1 AS -BUILT ASB -2016 PRATOR SUBDIVISION PLAT #84-479 J a N ° W SEP T1C •C 1 i I Ii _- � 10 T & E EASEMENT 122 w 0 STREET -' Bobby E Burnett RLS 2 41 Carriage Drive Anchorage, Alaska 99507 (907) 350-5541 1 I 25 1 O N I OF14 AZ4. *49T �BOBBY F. BURNETT / L4-5484 / \ SSIONAl' � I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission / linea or other easements on said property except as shown. a 1• L i \ f 1 i I Ii _- � 10 T & E EASEMENT 122 w 0 STREET -' Bobby E Burnett RLS 2 41 Carriage Drive Anchorage, Alaska 99507 (907) 350-5541 1 I 25 1 O N I OF14 AZ4. *49T �BOBBY F. BURNETT / L4-5484 / \ SSIONAl' � I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto unless otherwise shown. That no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission / linea or other easements on said property except as shown. L=30.37' R=175.00' L=31.42' R=20.00' FND NO5 RBR TELECOM PED FND YPC FND NO5 RBR FND NO5 RBR GCI PED CATV PED ELEC PED SEPTIC MANHOLE N0 ° 3 8 ' 2 0 " W 30 4 . 8 9 ' S80° 02' 33 " W 99.55' N89° 59' 15"E 202.17' 3 2 . 2 ' 42.3' 3 2 . 2 ' 42.3' 24.7' 9 1 . 5 ' 94.6' 17 6 . 7 ' SINGLE FAMILY HOME LOT 7 BLOCK 12A 55,509 SQ. FT. 1.274 ACRES 1 0 0 . 0 ' PAVED DRIVE BARN G A R A G E S H E D 10' T&E ESMT. MARQUEZ CIR. R.O.W. P R A T O R S T . R . O . W . PAVED DRIVE DECK ROOF DECK TRANSFORMER SEPTIC LOT 6 BLOCK 12A LOT 6 BLOCK PRATOR SUB. LOT 8 BLOCK 1 ASPEN RIDGE SUB. LOT 6 BLOCK 1 ASPEN RIDGE SUB. N 9 ° 5 7 ' 2 7 " W 3 1 3 . 0 1 ' ASBUILT SURVEY LOT 7, BLOCK 12A PRATOR SUBDIVISION LOCATED IN NE 1/4, SEC. 35, T12N, R3W SEWARD MERIDIAN, ALASKA EXCLUSIONS IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENENTS,OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR ESTABLISHING BOUNDARY OR FENCE LINES. ASBUILT CERTIFICATION I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING PROPERTY, LOT 7, BLOCK 12, PRATOR SUBDIVISION, AND THAT NO ENCROACHMENTS EXIST, EXCEPT AS NOTED. Alaska Construction Surveys 907 E Dowling Rd, Suite 10 Anchorage, Alaska 99518 Office: (907) 344-5505 Fax: (907) 344-4775 Email: mcrow@akconstsurveys.com Site: Residential Address: 6741 Marquez Circle, Anchorage AK Field Survey Date: 09/08/23 Crew: B.B. Drawn by: F.C. Scale: 1" = 40' PREPARED FOR AMUNDSON AUDREY L & BRETT R ANCHORAGE, ALASKA 99516 ALASKA C CONSTRUCTION A SURVEYS S 18 Sep 2023