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EKLUTNA WEST LT 12
,] MUNICIPALITY OF ANCHORAG~J~,r ~th and Environmental Pro1 ~ion Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME~{ -~ ¢ LOCAT,ON 7)" = LEGAL DE. SCRIPT ON _~---~ ~f--/r..~ /~-":-'/C',~ ~--' 7'/~..'~ '/'" (--~2~ .-~ '-'~':~')' '~''' SEPTIC TANK: ' ¢':m :"-~'¢' ~'-- ~: OISTANC~ ~ FROM WELE ~ ~ ~'~ FACTURER INSIDE LENGTH INSIDE WIDTH f NUMBER OF ,MATERIAL ~/" '"' / COMPARTMENTS LIQUID DEPTH t LIQUID CAPACITY / -'?"r~'.GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL # of Lines ABSORPTION AREA DEPTIt: TOP OF TILE TO FINISti GRADE FOUNDATION DISTANCE BETWEEN LINES NEAREST LOT LINE. TOTAL LENGTH OF LINE , TRENCH WIDTH__ IN. FT. LENGTH OF EACH LINE DEPTH OF FILTER TOTAL EFFECTIVE MATERIAL BENEATH TILE. IN. ABOVE TILE IN, SEEPAGE'P~T: '~¢~ .::/ ' 2 DIAMETER --OR WIDTH_-~ , LENGTH , DEPTH , 'i Log Crib __Rings__ Crib Size: DIAMETER___DEPTH . DISTANCE FROM: WELL ,~ ~- ,, ~ , TOTAL EFFECTIVE BUILDING FOUNDATION ¢, ¢ NEAREST LOT LINE '" · ABSORPTION AREA (WALL AREA) ,SQ. FT; Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: j3 Installer: -/)i~/( f~, Remarks: PERMIT NO. ON--S I TE ( 781868 > APPLICANT LOCATION LEGAL I'ILIN I C I PAL I T'-r' OF Rt-ICHORRGE DEPARTMENT ~="xHERLTH AND ENVIRONMENTAL r~OTECTION 825 ~L STREET.. ANCHORAGE, AK. 99~ l ~4-47~8 SEWER PERtl I T FRED OLINGER TINR DR L12 EKLUTNR WEST SUBD 1470 TINA STREET 658-22~6 LOT SIZE 2~952 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 8 SOIL RATING (SQ FT?BR>= THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 14 LENGTH= 57 GRR'..~EL DEPTH= THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCFt OR DRRINFIELD. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND 8ND THE BOTTOM OF THE EXCAVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE 8ND THE BOTTOM OF THE EXCAVATION <IN FEET>. REQU I RED SEPT I C TANK 5 I ZE= 225e I]RLL~]r~S PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE, TWO ( 2 ) INSPECT IONS ARE RE~-'~..LI I REE-. BACKFILLING OF 8NY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR 8 PRIVATE WELL~ OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ,)~ ~ PERMIT EXPIRES DEC:E~IBER ~l~ ~' I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~ I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 8 BEDROOMS. ~I~NED._- APPLICANT FRED OLINuE~R ISSUED BY ........... DATE--- 2_ V~.2 PERMIT NO. ~-'11 L# ~'*,lt ]E Cz iE DEPFIRTMENT OF t-iERLTH RND EN'v'IRF'INMENTRL PNOTEE:TION 825 "L." S'I"REET., FINCHORFIGE., 264-4'720 () Il'-,! .... S; ]E T' E S; E 1...1 E~': F: F" ES F'.'--': !Pl I -If" ,:.' '7S0060 ) I::IF'PL I C:Fli'.,tT LOCFITION L. EGI::IL TINR DR Lt2 EKLUTNFI 1.4ES;T SUE: :'L470 "['II'.4Ft ST CHUGIFIK Al<: LOT SIZE "t"'¢PE OF 2:;OIL I~E:SORBTION S'¢STEM IS: TRENCH MFIXIML.IM NUME:ER OF' BEDROOMS = 8 688 2226 29952 SQURRE FEET SOIL RRTING THE REQLIIRED SIZE 01:: THE SOIL FIBSORPTION SYS'f'EM IS: [:, E~: F' -r ta = :_iL .,$ L_ E t'.,I IS -T H = :_~i ]::-' nS R R '...' E L_ [:* E F' ""IF' ~--] = :JL CZu ]"HE LENGTH DIMENSION IS 'T'HE LENGTH (IN FEET) OF' THE TRENCH OR DRFIINFIELD. THE DEF'I"H OF" R TRENCH OR PIT IS; THE DISTRNCE BETI.,.IEEN ]'HE SURFFIC:E OF' THE GI'-~:OUND FIN[;.., THE BOTTOM OF THE EXCFIVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRFI',,,'EL DEPTH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETI,.IEEN 'THE OUTFI:::ILL PIPE I::11'4[;.', THE BOTTOM OF THE EXCR',,,'RTION (IN FEET). ................................ F' R C: I-::: Ft E_~ E P IL_ !::t FI PFIE:KFIGE PLRNT MFI'¢ BE INS;TFILLED Fi'r THE PERMITTEE'"S OPTION SUBJECT TO THE FOLLOI.,.IING CClI'.dDI TIONS: :L. EITHER R CLFISS I OR II NSF RPPROVED PLFINT MR"r' BE INS'I"FILL~ED. 2. FI C.'ONTINUOUS MFIINTENFINCE FIGREEMENT IS REQLIIRED. IF FI MRINTENRNCE RGREEMENT IS NOT KEPT CURRENT YOU MFI"r' BE REQUIRED TO ENLFIRGE THE SOIL FIBSORPTION S"r'STEM RND?OR "r'OU MFI'¢ BE SUBJECT TO PROSECUTION. .................. -F t..-I El ( 2 ]:, I l--.I ':_=; It---' E C: 'T I C~ t'-.~ "_-S; I:-:'t IR E R E: (=':..~ U Z ~:;.'.': E_-i] C, 8FICKFILLING OF FIN'-r' S'¢STEM WITI-~OUT FINFIL INSPECTION FIND Ftt::'F"RO",CFIL E:'~¢ THIS DEPFtRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTFINCE BETWEEN R WELL RND RN'¢ ON-SITE SEWFIGE DISPOSRL S'¢STEM IS ±00 FEET FOR FI PRI',,,'FITE WELL. OR 200 FEET FOR FI PUBLIC WELL O"I"HER REQU I R. EMENTS MR'¢ FIF'F'L"r'. SF'EC: I F t CRT IONS RND C:ONS'I"F.'.uc'r I ON [:, I FtGRFIMS FiRE fi~',,,'F~ILFIBLE TO INSURE PROPEF'. INSTRLLF~TION. I C:ER'I"IFr¥ THFW .:,EWEF..:, FIND WELLS FLS SET ::L' I FIM FFIMILIF~R WITH .THE REQUIREMENTS FOR ON-SITE FOF.:TH B'¢ THE MUNICIPFILI'I"'¢ OF FINCHORFIQE. 22: I WILL INS'TI:ILL THE S'¢STEM IN FICCOF.'DRNCE P.IITH THE CODES. - '-'"="- F.'E.] IF.-'E ENLHI'.=EMENI IF 'rile 3:: I UNDERSTFIN[:, THFYr ]"HE: Fff.4-':-]ITE SEI.4ER =,f_,IEfl MFt'¢ ._ . ' .... ; .... ' '" F.'.ES!DENCF IS REMO[:,ELED TO INC:LU[:,E MORE THFIN 8 BEDROOMS. FIF'F'L I CFII'4T F'I:;,:EE:, OL I NCi~'. Y]:. 0 EXCAVATION WORK Mary Ann Koehler ROBERT A. SHAFER CIVIL ENGINEER MUIvICIPALiT, 694-2979 September 28 Dear Mary Ann, Reference: Lot 12t Eklutna West Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you"requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The absorption trench was tested by a continuous flow through the seepage pit for a period of 72 hours without any adverse effect on this system. It can be concluded from this test that the waste water disposal system serving the three bedroom modular home located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. If we may be of further service, please do not hesitate to call. ~T A. SHAF~R, P.E. / cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 2644111 (;EOil(;t M. SUL.LIVAN, OEPt'~R fN'IEN i' OF tltAl 'l'lt ANt) t::NVli?ONMENTA[. Pi~()TEOTION December 31, 1979 Fred Olinger 1470 Tina Street Chugiak, Alaska 99567 Permit ~ 781060 (Extended Permit for 1979) Subject: Lot 12 Eklutna West Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer has inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please contact this office at 264-4720. Sincerely, LNB/ljw enc: Copy of Permit Development Services Department On -Site Water & Wastewater Section Certificate of On -Site Systems Approval Parcel I. D. 051-062-45 1. GENERAL INFORMATION Complete legal description EKLUTNA WEST LOT 12 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 5 z `1 — Z©ZC� Location (site address) 21536 TINA STREET, CHUGIAK, AK 99567 Current property owner(s) MAVERICK YABUT Day phone Mailing address Real estate agent 21536 TINA STREET. CHUGIAK. AK 99567 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ® Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 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. COSA Fee $ 5 / Waiver Fee $ Date of Payment Date of Payment Receipt Number qb 10-7 5 Receipt Number COSA # 05G 2125) 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/31/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the\\ system and maintenance. The operational life of all well and septic systems are subject to r~AJ �`�� these various and dynamic characteristics and are outside the control of the evaluator of the r •� ` well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q.' or for current or future occupants or guarantee that no unseen encroachments, deficiencies or J discrepancies exist can be given by First Water Consulting & fWCS ' *• 9 TH ••* �r / . ... .. ........• / 6. DSD SIGNATURE % •Curtis Huffman j System #1 Approved for bedrooms r�+�F61 CE 128991 ..\7��r �ilES �NP�,O�... System #2 Approved for bedrooms �t\\ F9F�pR0ESSO1� Disapproved Conditional approval for bedrooms, with the following stipula`��"Poa{twt,,(e 11�V, �QP``TY OFq� �<< WA �t IA.,ER AND m P =V'AT R z^ RA JJJ JJJ SEng RV ICEII\��� By: Original Certificate Date: (::7 ZZ 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 !S`f-M� J�/�SiOt\/ 4+Oc�u 4 i Legal Description: EKLUTNA WEST LOT 12 Parcel ID: 051-062-45 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA — COMMUNITY WATER CLASS A - #211431 ❑ 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 B. TANK DATA Age of tank(s) 25 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 5/25/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 9/15/1997 ® ALL standpipes present per record drawing Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 5/24/2022 Results 0 Pass For 4 bedrooms Total measured depth from grade 15.9 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 6_8 ft (min) Water added 600 gal ❑ N/A —pressurized field New depth 25 in ® Monitor tubes go to bottom of effective. If not, state Elapsed time 1400 min depth into effective ADEC & SHOTS SHOW 10'ED ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FkS Comments/Deficiencies: NE MT/CO AT GRADE & SHOTS. _' k. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ❑ Yes if No ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft ❑ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100' ft ft ft ft ft ® 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 Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *CODE AT ST INSTALL. PROPERTY SERVED BY DAWN WATER. 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. .. ......... . Curtis Huffman ��¢ ?'FG,/•,• CE 128991 �\R��� '0 ROFESS ON���4 ft ft DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic 'Tank Advisory Certificate of On -Site Systems Approval #OSC 221251 Subdivision: Eklutna West lot 12 907-343-7904 Fax: 343-7997 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 $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. Mailing Address P O Box 196650 * Anchorage, Alaska99519- 66,50 .,,,WWwmuni org: -- o • Municipality of Anchorager�=°` ;_° ` _.. On-Site Water&Wastewater Program �c . (907)343-7904 5. Err CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-062-45 Expiration Date: 7 2- 1. 1. GENERAL INFORMATION Complete legal description EKLUTNA WEST S/D; LOT 12 Location (site address) 21536 TINA STREET, CHUGIAK,AK 99567 Current Property owner(s) ANTHONY"TONY" DADDATO Day phone 907-715-8896 Mailing address 21536 TINA STREET,CHUGIAK,AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: ❑ Single Family(w/wo ADU) 1111 Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well • Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. N/A Distance:31/6 Received by: fes-, Date: Y// COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ 5-4Z Waiver Fee$ Date of Payment g/9//3 Date of Payment Receipt Number 61/5D(o6 Receipt Number COSA# I' 35Ci 'f3Q Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, i verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E.TUDOR ROAD,SUITE 101 *ANCHORAGE,AK,99507 g' JEFFREY A. GARNESS, P.E. )r // B Engineer's Printed Name Date Engineer's Comments: In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the ***SII t 11 guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the �� OF �♦ condition of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features. 4p•P . �; (1.�♦ Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic ♦ \ Yt • systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during � '•••• •��\7 the year),quality of construction(materials and workmanship),and the water usage of the(amity utilizing the system/s.These 4/\49 1‘ \**•�, conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the 1i system's;therefore,GEG makes no warranty(express or implied)regarding the Mum performance of the well or septic system. • be I GEG makes no representation whether an aitemative well or septic system can be installed on the property in the event either of the ',„l, ,r current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the % vpry�A, Ga meds i information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not . C E 953 authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. SJ 1J 6. DSD SIGNATURE �44 pRc •• r�OFESS\ #AECC884 System#1 Approved for bedrooms. LICENSE '� „`,l�� System#2 Approved for bedrooms. Disapproved. \p!.\o I .O/: , Conditional approval for bedrooms, with the following stiptal`tions:ON.. c 'y C) wgTF SITE .,R 14/As R qND c ,pry p fFWq • l OGM n-qm \c>,c p pn1�r Original Certificate Date: � 13 The Municipality or Anchorage Develop,emt 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. ATTCHMENTS: . COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10112112) 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: EKLUNTA WEST S/D; LOT 12 Parcel ID: 051-062-45 A. WELL DATA ►.: type COMMUNITY If A, B, or C provide PWSID#211431 Well Log (Y/N) Date comp - :• Sanitary seal (Y/N) Wires properly protected Total depth ft. Cased to ft. Casing height -:.ve ground) in. FROM W . LOG AT PECTION Date of test Static water level ft ft. Well production g.p.m. g.p.m. WATER SAMPLE RESU : Coliform colonies/100 ml. Nitrate mg./L. Collected by: Ar - ic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA 21 YEAR OLD STEEL SEPTIC TANK MAY BE APPROACHING THE END OF ITS USEFUL LIFE. TANK APPEARED TO BE AT NORMAL OPERATING LEVELS DURING SEPTIC ADEQUACY TEST. Tank Type/Material SEPTIC/STEEL Date installed 8/2-9/15/1997 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) YES Depression over tank(Y/N) NO High water alarm (Y/N) NO Date of pumping 7/10/2018 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA -BELOW EXISITNG GRADE Date installed 8/2-9/15/1997 Soil rating ip.d./ 'or ft2/bdrm) 0.6 System type DEEP TRENCH Length 50 ft. Width UNSPECIFIED ft. Gravel below pipe 10 ft. Total depth *14.4-16.3 ft. Eff. absorption area 1000 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/27/2018 Results (Pass/Fail) PASS For 4 bedrooms **4.5/ **32/ Fluid depth in absorption field before test 22.25 in. Water added 900 gal. New depth 34 in. **8.25/ Elapsed Time: 180 min. Final fluid depth 22.25 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) NONE KNOWN If yes, give date - **WEST MONITORING TUBE/EAST MONITORING TUBE.MONITORING TUBES DO NOT APPEAR TO BE AT THE SAME ELEVATION. SEE COPY OF ADEC DOCUMENTATION ON FILE AT MOA ONSITE OF SEPTIC SYSTEM BY MIKE ANDERSON IN 1997. D. LIFT STATION Date ins . -. Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off' leve . High water alarm level at in. Datum Cycles tested Meets alarm & circuit req - 2 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY WATER SYSTEM e. '- -• lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main •.• is sewer manhole/cleanout Sewer/septic service line Holding tank Animal c.• ent areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation *5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ 100'+TO PVT./ Wells on adjacent lots 200'TO COMM. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ 100'+TO PVT./ Curtain drain NONE KNOWN Wells on adjacent lots 200'TO COMM. F. COMMENTS *MET CODE SEPARATION DISTANCE AT TIME OF INSTALLATION. NOTE: SERVED BY DAWN WATER SYSTEM.WELL IS AT CORNER OF HOMESTEAD ROAD AND SPARKLE DRIVE, PER A.D.E.C. POINT OF CONTACT. lookssa•vi 444 /4„4 G. ENGINEER'S CERTIFICATION 4 PSE ' • I certify that l have determined through field inspections and • *° 4 'I• *♦�� review of Municipal records that the above systems are in • • conformance with MOA COSA guidelines in effect on this : date. t. ♦� , f Gar � ssw: a Engineer's Printed N me JEFFREY A. GARNESS ♦� j, CE-79 •:° �o' Date `vl .eo 14�;ROFESS• �• LICENSE �IR"%I #AECC884 (Rev.10/12/12) MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT I • Fl � 907-343-7904 On-Site Water and Wastewater Section 1` Fax: 343-7997 www.muni.org/onsite Septic Tank Advisory Certificate of On-Site Systems Approval # OSC181398 Subdivision: Eklutna West, Lot: 12 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this property is 21 years old. As of May 1St 2019 Coal Tar Septic Tanks cannot be sold or installed. At a point of leakage or failure this tank will need to be upgraded and replaced. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 20 year old steel tank MAY look like. • •: 7. 010 A Ajar* Att .r fi •r'= .., _.'• L4wcillwr7L+21. Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org