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Municipality of Anchorage Page --..~--- of
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
Permit Number: /4/f/ ~'42,3...?.~ PIn Number:
Name: ~
/,~ ~'<~,e Wastewater System: ~New D Upgrade
Address:
~ ~ ?~1~,~,1~ ~"~c ~ ¢~; ABSORPTION FIELD
Phone: NO. of~edrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION so, Rating: Total Depth from originalgrade:
~ ~ GPD/Sq. Ft. //. ~ ~
Lot: ~ 8lock: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Range: Section:' Fill added above original grade: Gravel length:
Ft.
WELL: ~ New D U pg Fade Gravel width: Number of lines: Distance between lines:
Classification (Private, A,8.C): Total Depth: Cased To: Tolal absorption area: Pipe material:
Driller.~ Date Drilled: Static Waler Level: Installer: ~ Date installed:
Yield: Pump Set al: Casing Hefghl Above Ground:
SEPARATION DISTANCES ~Septic U Holding ~ S.T.E.P.
To Sepbc Absorption Lift Hold~ng Public/PrivateManufacturer: Capacity in gallons:
¢ Material: Number of Compadments:
Surface
w~to~ ~ ,- LIFT STATION
Drain ~ ~ ~ . ...... : performed by:
Remarks: ~T~ ~'---'/ ~ ~:~-¢~ BENCH MARK
Loc~tion 8nd Description:
Assumed Elevation:
Inspections performed by: ~E~ Dates: 1st ~-2~ ~~~~ .
Department of Heal. and Human Services approval ~t~.,.
Reviewed and approved by: _ Date: ~-/~- ~
Permit No. SW970273 Page 2 of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVlGES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 545-4744
On-Site Wastewater DispOsal System and/or Well Inspection Report
Legal Description: Ptarmigan Lot 1
PID No.: 05036234
R=£O,O0'
L=3L$O'
100,.
,~E
ELEVATIDNS ~ ToP ~F ~ELL c~sI.o
(NflT TD SCALE) ~
.... [ .... " ' 803
SWING TIES
A-C= 129.8'
B-C= 138.8' ·
A-D= 125.3'
B-D= 105.7'
A-~= 1 I0.0'
B-E= 90.7'
e - DIVERSION VAVLE
[] - TEST HOLE
· - MONITOR TUBE
o - SEWER CLEANOUT
+ - WELL
LEACHFIELD
EASEMENT
SCALE 1"=60'
4/17/98
ENGINEER'S SEAL
, ~..-' 49 T~H~ '..?~
MOA
PAGE 1 OF
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:SW970273
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:THOM_AS & HOLLY BEBEE
OWNER ADDRESS:18530 WALRUS CIRCLE
EAGLE RIVER, ALASKA 99577
DATE ISSUED: 8/25/97
EXPIRATION DATE:
PARCEL ID:05036234
LEGAL DESCRIPTION:
PTARMIGAN LT 1
LOT SIZE: 48352 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
THE ATTACHED APPROVED DESIGN.
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).
THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
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
THE FOLLOWING SPECIAL PROVISIONS.
8/25/98
SPECIAL PROVISIONS:
RECEIVED BY:
DATE:
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
December 4, 1997
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re;
Ptarmigan Subdivision Lot 1
Permit revision to well site
Dear Mr. Cross:
We are requesting a revision to the well location as previously permitted to the
East side of the lot to match the well radius of lot 2 and to allow the waterline to be installed in
an area where there is less danger of freezing. The revised location will not subect the well to
any contaminate dangers and will improve the lot layout. Attached are 2 site plans.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\ 1997\97-057B-NAR
Septic
.Vent
PTARMIG, BLVD ~
PROPDSEO
WELL
./
DRIVE
LOT 1
44'
PROP T~H2 N
HOUSE° ~
PROP ~ .5' FF=99, O'
HOUSE ~"~t;~ ~ GARAGE 30.5'
~ 27' ~o~~
~3X4~' TRENCH IBSO
_ TANK
RESERVE AREA ~ ~
~ ~L ~ Lo~ ~
~LL
~+10o
THIS PLAN IS TO REVISE THE WELL LOCATION
FOR LOT 1 THERE ARE NO OTHER CONTAMINATES WITHIN 200'.
NO SURFACE WATER
NO KNOWN CURTAIN DRAINS
WELL LOCATION
LEGAL: PTARMIGAN LOT
OWNER: Beebe
CONTRACTOR:
N A
JOB~ 96-034 DATE: 12/4/97 [ SCALE 1" = 60'
A EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 604-3297
REVISION
M - TEST HOLE
· - MONITOR TUBE
o - SEWER CLEANOUT
+ - WELL
EASEMENT
PROPOSED LEACHFIELD
mm- EXISTING LEACHFIELO
" t
S 89'35;56' W 137.60
P~OP O~/P_
Prop
Well
5ire
CHILD~'~N5
PLAYHOUSe..
GAL
- } 110.92 I~ - TEST HOLE
WE.EL/SEPTIC S~TE PLAN
LEGAL. Ptormigen Io~ 1 -
CONTRACTOR: N/A I
. EAGLE RIVER E~G[~EERi~G SERWCES I
~ P,O. Box ?73294 I ~ ,...~-ST3~....~=
~ EACLERIVER,A~ 99577 I
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
August 13, 1997
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
MUNICIPALITy OF ANCHoRAG&
ENVIRONMENTAL .SERVICEs DIVISION
RECEIVED
Re: Ptarmigan Subdivision Lot 1
Narrative & Permit Application
Dear Mr. Cross:
The proposed septic upgrade/well and septic system will have very limited impact on adjacent
properties for the following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2.Immediate neighboring septic systems are all +30' distance.
Reserve space is adequate, due to absorption capacity.
4. Drainage will not be affected and is not a major consideration in our design.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1997\97-057-NAR.DOC
,, .. Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Ptamrigan Lot 1
8/13/97
A. GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval,
8. It is always recommended that a surveyor locate the nearest lot line position and the location of any
easements.
Any remaining open test hole excavations shall be filled.
SEPTIC TANK
Septic tank shall have a tninimum capacity of 1250 gallons and be of MOA approved design..
TRENCH
The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom.
The bottom of the trench shall be level, plus or minus 1.5".
The total depth of the trench excavation is not to exceed 11' at any point.
.The effluent line within the trench shall be laid level within 0.0Y.
The trench gravel is to be covered with typar fabric material.
Soil or combination of soil and extruded board insulation to a depth of Y or equivalent is to be placed
over the leachfield.
The area over the trench is to be finish graded to prevent ponding of surface water runoff.
The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any
Class "C" well, or 200 feet to any community well.
B.
1.
C.
1.
2.
3.
4.
5.
6.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 11' GRAVEL DEPTH = 6' under pipe, 2" over pipe
TRENCH LENGTH = 42' TRENCH WIDTH = 3'
SOIL RATING = 1.2 GPD/ft5 BEDROOM CAPACITY = 4
SEPTIC TANK = 1250 gallons
Twenty-four (24) hours notice required for all inspections.
\1997\97-057-spc
P~YHOUSE
I~/I Prop~3x4~ Trench~
} 116.92 U - TEST HOLE
S 89'55'56" W · - MONITOR TUBE
o - SEWER CLEANOUT
4- - WELL
WELL +100' N
NO SURFACE WATER SEPTIC +30'N EASEMENT
NO KNOWN CURTAIN DRAINS PROPOSED LEACHFIELD
i- EXISTING LEACHFIELD
WELL/SEPTiC SiTE PLAN
LEGAL: Pt~rmiqan lot 1
OWNER' Bebee ~ ."'
CONTRACTOR:
N A ~.749 TH ~
" '
JOBff 97-057 DATE: 8/14/97 I SCALE 1 - 50
P.O. Boz 7?3294 v.-~
EACtE RIVER, AK. 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG --,PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCR,PTION=
Lo~- I
'r-% - or3..
2
3
4
5
6-
7
¢
10
11
12
13
14-
15
16
17
18
19
20-
COMMENTS
DATE PERFORMED:
WAS GROUND WATERt/V~/O
ENCOUNTERED?
Township, Range, Section:
SITE PLAN
SLOPE
S
IF YES, AT WHAT
DEPTH? //V'/~ 0
P
E
Depth lo Water Alter
Moniloring? ~"'?' Oat~
Reading Date Gross Net Depth to Net
Time Time Water Drop
I e~~-q? ~ .,2'! 3 '~" ,,
~ .~ ~ ';Z~ ,. ,,
PERCOLATION RATE
TEST RUN BETWEEN
-- (minutes/inch) PERC HOLE DIAMETER __
__ FTAND FI
PERFORMED BY: ~'/~ ~J' I -~ -~-~----~_ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: ~" ~ ~'~ ~' ~
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904 F
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 067-311-02
1. GENERAL INFORMATION
Complete legal description Ptarmigan Lot 1
Location (site address) 9535 Wren Cir. Eagle River, AK
Expiration Date: 1 ®—U —ZZ—
Current Property owner(s) Thomas & Holly Beebe Day phone
Mailing address 9535 Wren Cir. Eagle River, AK
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
Waiver/Variance request for:
Received by:
4
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 550
Date of Payment 1 c20122
Receipt Number I 10 G
COSA # OS C)W 3'13
Date:
Waiver Fee $
Date of Payment
Receipt Number,
Waiver #
stance:
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AI< 99577
Engineer's Printed Name KENNETH M. DUFFUS Date
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future �► '�� , +y,
occupants or can ArcTerra guarantee that no unseen ♦♦4\OF
••,,,.,,•,••i["�ix l+�
encroachments, deficiencies or discrepancies exist.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
llllttttt(�f
ON-SITE
WATER AND
By: Original Certificate Date:
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
Septic System Advisory
Well Flow Advisory
COSA blue sheet- 10-10-12.doc
X Nitrate Advisory
Arsenic Advisor
Other
pfd vt•s � �►�/ .� .����
Legal Description: Ptarmigan Lot 1 Parcel ID: 067-311-02
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 3/12/98
Total depth 61 ft
Cased to 61 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 16 in.
Date of flow test for COSA 6/2/22
Static water level at beginning of test 45 ft.
Comments
B. TANK DATA
Age of tank(s) 25 years
Tank type/material Septic/Steel
Measured operating fluid level in septic tank 49"
IN Standpipes/foundation cleanout per record drawing
Date of pumping 6/6/22
D. ABSORPTION FIELD DATA
Which system tested (date installed) L2/2/98
11 ALL standpipes present per record drawing
Total measured depth from grade 12.9 ft (max)
Measured depth to pipe invert from grade 6.9 ft (min)
❑ N/A — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Structure served by this system
Well production at time of test 7.9 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes E No
Coliform bacteria is Negative
Nitrate 8.34 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L 10 Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date of Sample 6/9122
STATION
❑ Requlr aint�
Age of lift station
Lift station material
Comments:
completed
years
Adequacy test date 6/2/22
Results Q Pass For 4 bedrooms
Fluid depth prior to test 32 in
Water added 600 gal
New depth 45 in
Elapsed time 60 min
11 Code -required soil cover over field Final fluid depth 32 in
❑ System presoaked Absorption rate 600+ and
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
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
Wells on Adjacent Lots:
Community Sewer Manhole/Cleanout > 100'
0 Yes
if No
ft
[0 Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 260 Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
Surface Water > 100'
Yes
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No 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'
0 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
i 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
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC221313
Subdivision: Ptarmigan Lot 1
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this COSA / property is 25 years old. A leaking septic tank may be a source of contamination
to the aquifer. Typical replacement costs range from $10,000 to $15,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of a 16 -year-old septic tank in failure and should be replaced.
Mailing Address P `O Box 196650 *Anchorage, Alaska 99519=6650 *www muni org
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 221313
Subdivision: Ptarmigan lot 1
A water sample revealed a nitrate concentration of 8.34 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mallirng Address P b Box,°196650 *Anchorage, Alaska 99519 6650 *www muni org
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