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COHOE LT 6
Cohoe Lot 6 #015-051-18 Municipality of Anchorage Community Development Department Page 1 of 3 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: OSP141253 PID Number: 015-051-18 ❑ New ❑✓ Upgrade Name: RICKY THOMPSON ABSORPTION FIELD ❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 9361 STRUTZ AVE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.6GPD/SF 12 Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 9Ft. Subdivision Block Lot COHOE 6 Fill added above original grade 0.5 Ft. Gravel length 60 Ft. Township Range Section Gravel width 3Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 108OFel Fl 18 Ft. Well 205.7+ 104.7 205.7 N/A N/A TANK ❑ Septic Z S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1250Gal. Surface Water 100+ 100+ 100+ N/A Material Number of compartments Lot Line 28.4 17.5 28.4 N/A STEEL 2 NA Foundation 12.5+ 20.9 12.5 N/A LIFT STATION Manufacturer Capacity Curtain Drain N/A I N/A I N/A N/A ORENCO 250 Gal. RemarksCONTINUOUS LINE FROM LIFT STATION TO Pump on level at 40in. Pump off level at 36in. High water alarm at 45 in. TEE. LINE INSULATED UNDER DRIVEWAY. Pump make and model P2005-1 Electrical Inspections performed by 7) e 6/', "tt Installer PIPE MATERIAL Housetotank Tankto drainfeld 3034 A -PLUS HOME SERVICES Drainfield 3034 CO/MT 3034 Inspector PANNONE ENGINEERING SERVICES BENCH MARK (Assumed elevation) 100111 Inspection 1e'7121/2014 dates: 2" a 7/22/2014 Location and description V 7/23/2014 0 HOUSE FINISHED FLOOR COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Date 3�C3F !4L1 . �,�►���� y,,,r�P� PIP ..tateven { onnorae Approved Date 7-12- w `r ' .► Inspection Report_1-1 .doc IV COHOE L T A I B I C E DC01 22.401 13.80 EASEMENT DCO2 22.90 13.20 T1 26.10 14.60 0F3 T2 34.00 22.30 MH 35.50 24.00 M1 22 45.20 M2 44.70 62.50 M3 61.60 40.90 64.80 M4 58.10 79.60 3 10A 0 W W/ , �/ ,W G APPROXIMATE LOCATION OF WATER SERVICE LINE (E) MAINTAINAI0' HORIZONTAL SEPARATION TO DRAIN FIELD , AND 36 -INCHES VERTICAL SEPARATION MT. FROM PRESSURE DISTRIBUTION LINE/ &—M UPGRADED SEPTIC SYSTEM (2EA) 3OLF x 3'W x 9.0'ED x 12.0'TD _ e >MT4 y A \SEPTIC AREA (E)V 1 TH-1 17 104.7 _ WELL (E)' NOTES: RECORD DRAWING PLAN 134.4 PANNONE ENG P.O. BOX 100217 ANCHOR) PHONE (907) 272-8218 FAX • , ' DRIVEWAY \ LO 6 10, MIN \ JG 1250g SEPTIC TANK REMOVED 1500 GAL S.T.E.P TANK L-. SEPTIC AREA (E) SEPTIC AREA (E) 1 rIII +I J DRAIN FIELD (E) �,-�..,,� IN FAILURE SHED 11 REUSE AS RESERb <v 9 r 2`�> E MT2 10' UTILITY EASEMENT 10' U� EASEMENT \PIPE CAPPED \I SEPTIC AREA (E) I z z) w•w MP r! J I ffi b LLC 272-8211 COHOE, LOT 6 RICKY THOMPSON 9361 Z AVENUE ANCHORAGE, v AK 99507 Date OF ACq�I� 7/24/2014 .s9il� Scale •*��P.I.D. NO 015-051-16 n • Pannorie� PERMIT N0. CE 8149 OSP141253 ���� ���' Sheet "� 2 0F3 Date OF ACq�I� 7/24/2014 .s9il� Scale •*��P.I.D. NO 015-051-16 n • Pannorie� PERMIT N0. CE 8149 OSP141253 ���� ���' Sheet "� 2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 3. SCOPE OF WORK: REPLACED EXISTING 1250 GAL SEPTIC TANK WITH 1500 GAL TANK, INSTALLED NEW 500g LIFT STATION. AND INSTALLED SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18 FEET. FILTER FABRIC3.0 Id _c. l_9'7S'r.. 36 -INCHES MIN TER SERVICE .DRAIN ROCK 10' 10' 1 Y4" 0 PERF PIPE W/ 74" HOLES DRILLED 18" O.C. 3 DRAIN ROCK 6" ABOVE PIPE INV 1F— 3 1 1 S (� 93.58 )�3 TH-1 DIP -0.5 OR (W) 96.53- TH (W) 93.5 FC GM/ T# SM C# (W) 84.5 M# -16.0 r RIGID INSULATION wo DOUBLE CLEAN OUT mz 0 o OU z BFG BELOW FINISH GRADE 3. � 89.18 RIGID INSULATION 3 6.0 1500 g S.T.E.P 3.0 TANK (E) PROFILE FILTER FABRIC3.0 Id _c. l_9'7S'r.. 36 -INCHES MIN TER SERVICE .DRAIN ROCK 10' 10' 1 Y4" 0 PERF PIPE W/ 74" HOLES DRILLED 18" O.C. 3 DRAIN ROCK 6" ABOVE PIPE INV 1F— 3 1 1 S (� 93.58 )�3 LEGEND W WATERLINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: RECORD DRAWINGS I DESIGN DETAILS DESIGN PARAMETERS RESERVE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 29.4 MPI SOIL RATING: 0.6 GPD/SF AREA RQD: 1000 SF SYS. TYPE: DEEP TRENCH WED MIN LENGTH: 55.6 LF USE: (2EA) 30LF x 3'W x 9.0'ED x 12.0'TD TOTAL AREA: 1,080 SF PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 COHOE, LOT 6 RICKY THOMPSON 9361 STRUTZ AVENUE ANCHORAGE, AK 99507 CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS 9'0 BFG BELOW FINISH GRADE OG � FG DRAIN ROCK 3 6.0 18.0—I 3.0 (E) 84.58 SECTION w m z FILTER FABRIC w o x 1 Ya" 0 PERF PIPE W/Ya° HOLES � F z � DRILLED 18` O.C. DRAIN ROCK 6" ABOVE PIPE INV 5 2"RIGID INSULATION UNDER DRIVEWAY � ;�# LEGEND W WATERLINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: RECORD DRAWINGS I DESIGN DETAILS DESIGN PARAMETERS RESERVE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 29.4 MPI SOIL RATING: 0.6 GPD/SF AREA RQD: 1000 SF SYS. TYPE: DEEP TRENCH WED MIN LENGTH: 55.6 LF USE: (2EA) 30LF x 3'W x 9.0'ED x 12.0'TD TOTAL AREA: 1,080 SF PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 COHOE, LOT 6 RICKY THOMPSON 9361 STRUTZ AVENUE ANCHORAGE, AK 99507 CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE ate bF ^lq,kil 177/24/2014 * ••:*I, NTS .... ... .. ...,. �. .I.D. NO 015-051-18 •StevenR. •Pannone• PERMIT N0. �P,n •. CE 8149 .•,Eta „�,,, ,,.,�, 3 OF Municipality of Anchorage Community° Development Department Development Services Division P.O. Box 196650 - 4700 Elmore Road Anchorage, Alasla 99519-6650 Info and Help: (907) 343-8211 INSPECTION: Voice: (907) 343-8300 Fax (907) 249-7777 Inspection Report 7/24/2014 License/AP--: RETROE141372 Parent AN Inspection #: 311406 Type: RETRO Status: Issued Address: 9361 STRUTZ AVE Parcel: 01505118000 Inspector: Mike Green Project: Resp Party: Desc: Retro6tunrp Power controls san lift sta hp Me - Address:Anchorage, AK, 99507 Inspection Item Item Description Evaluation Originally Cited Code Description Electrical Electrical Inspection Approved Result Notes: Septic electrical rough, underground and final. On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141253 Tax Code Number: 01505118000 Work Type: Septic Upgrade Permit Effective Dates: July 17, 2014 to July 17, 2015 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: COHOE Site Legal Address: COHOE LT 6 G:2437 Owner/Address: THOMPSON RICKY R & VANDERWERF MARY H 9361 STRUTZ AVE ANCHORAGE AK 995074349 Site Mailing Address: 9361 STRUTZ AVE, Anchorage Lot Size in Sq Ft: 19000 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By By: Date: { r ol v Date: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program RUSH ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-051-18 RUSH Property owner(s) Ricky Thompson & Mary Vanderwerf Day phone Mailing address 9361 Strutz Avenue, Anchorage, AK 99507 Site address 9361 Strutz Avenue Legal description (Sub'd., Block & Lot) Cohoe, Lot 6 Legal description (Township, Range & Section) Lot Size 19,000 Sq. Ft. Number of Bedrooms 4 RUSx APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Single Family ❑X Absorption Field FX] Initial ❑ (SF) (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) ❑ Holding Tank ❑ Ree I _ in Al Mu(SFaltiple Dnd/olrinDjs ❑ Privy ❑ S�,%I'IT Private Well ❑ JUL 1 6 2014 Water Storage ❑ __ RUSH THIS APPLICATION INCLUDES A VARIANCE! WAIVER REQUEST FOR: RUSH 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: I �.�a ' 0110,40 Waiver Fees: Date of Payment: l n t4 Date of Payment: Receipt Number: 0CA92A Receipt Number: Permit No. OWN 2-5.3 Waiver No. _ RUSH 1� Permit App_' :L.,",R y SH RUSH Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(coanengak.com July 16, 2014 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 Subject: Cohoe, Lot 6 Septic System Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to install a new septic system be issued for this property. The proposed systems will serve a existing four (4) bedroom house. Currently the existing field is in failure. The existing 1250G septic tank will be decommissioned per code and a 1250g S.T.E.P. tank will be installed. This lot is served by a Class'A' water system. The surrounding lots to the north and west are served by this same water system. There are no Class 'A'wells within 200' of this system. The lots to the east and south are served by private wells. There are no private wells within 100' of this system. Soils. PES performed one test hole on this lot in July of 2014, and groundwater was monitored for seven days. Ground water was NOT observed below the ground elevation in the test hole monitor tube. It is my opinion, based on the results of the soils tests, the use of a conventional system and overall soils appearance; an application rate of 0.6 gallons/day/square feet should be used for a conventional wastewater system. 1. Soil Absorption System Design. a. See Sheet 2 of the design package. 2. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: The proposed drain field is located on the flat top of a knoll. The surrounding topography radiates away from the field from 5% to the east to 20% to the northwest and south. There are no steep slopes in the vicinity. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 4. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 i Q OHSD V w � z a W VJ, SEPTIC AREA (E) SEPTIC AREA (E) VERIFIED 1250g SEPTIC TANK (E) ON 7/17/14 DRAIN FIELD (E) ADD 500g LIFT STATION (P) IN FAILURE APPROXIMATE LOCATION OF ��y STIED REUSE AS RESERVE WATER SERVICE LINE (E) DRIVEWAY SHED 10' HORIZONTAL SEPARATION TO DRAIN FIELD I AND 36 -INCHES VERTICAL SEPARATION kk, S PTIC AREA (E) FROM PRESSURE DISTRIBUTION LINE _-_ DRAIN FIELD (P) (2EA) 30LF x 3'W x 9.0'ED x 12. 'TD ' �Q' a LII o o M yy �) M SEPTIC AREA (E)� . TH-1 I — ' 19.1 7 10' UTILITY EASEMENT 10 7UTILITY EAST , 108.2 EMENT �- WELL (E) \I �� ��� uate NOTES: PANNONE ENG SVC, LLC SOFA/,., � 7/17/2014 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 r '� .S PHONE (907) 272-8218 FAX (907) 272-8211 /g�p �yt) scale *, TH 1•=50• �... .. .. . ...... P.I.D. NO COHOE, LOT 6 / / 015-051-18 RICKY THOMPSON / Steven R. Pannone PERMIT NO. PF.•, CE 8149 OSP141253 9361 STRUTZ AVENUE+�s. r PLAN ANCHORAGE, AK 99507 �il� PROFES sheet t��ROFES 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 3. SCOPE OF WORK: INSTALL NEW 500g LIFT STATION. INSTALL SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 18 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 18 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. TH-1 'ILTER FABRIC 1 Ya" 0 PERF PIPE W1 IV HOLES DRILLED 1 B" O.C. -DRAIN ROCK 6" ABOVE PIPE INV 1250 g SEPTIC I �; �5 TANK(E) WATER 10' 10' PROFILE SECTION 8.0 M FILTER FABRIC o, o o f 1 Yn" 0 PERF PIPE W/)6" HOLES a o z TEST HOLE DRILLED 18" O.C. fff zz D iS u z� m a DRAIN ROCK 6" ABOVE PIPE INV 20 11 A 11 1250 g SEPTIC I �; �5 TANK(E) WATER 10' 10' PROFILE CU COPPER DESIGN PARAMETERS DIP DUCTILE IRON PIPE RESERVE SEPTIC SYSTEM TH TEST HOLE LEGEND NO. BEDROOM: 4 (600 gpd) FC FOUNDATION CLEAN OUT W WATER LINE/ TANK SIZE: 12508 S.T.E.P. T# TANK CLEAN OUT NO. WELL RADIUS PERC RATE = 29.4 MPI C# CLEAN OUT N0. SOIL RATING: 0.6 GPD/SF M# MONITOR TUBE NO. AREA ROD: 1000 SF SS NEW SEPTIC SYS. TYPE: DEEP TRENCH 9'ED R.I. RIGID INSULATION MIN LENGTH: 55.6 LF DCO DOUBLE CLEAN OUT DV DIVERTER VALVE USE: FS FLOW SPLITTER (2EA) 3OLF x 3'W x 9.0'ED x 12.0'TD BFG BELOW FINISH GRADE TOTAL AREA: 1,080 SF OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL & VEGETATE NOTES: FOR CONSTRUCTION DESIGN DETAILS PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 COHOE, LOT 6 RICKY THOMPSON 9361 STRUTZ AVENUE ANCHORAGE, AK 99507 OF A4;jk1, 17/17/2014 *.,.�TH l�►T :*��/ P.. D.T INO l�V % 015-051-18 Steve e � PERMIT NO. CE 8149 OSP141253 Sheet2 OF 3 SOILS LOG - PERCOLATION TEST TEST HOLE 1 OR ORGANICS SLOPE \N ,NJ SI DRIVEWAY SHED SHED 2LO 6 3— 4— 6X aJ TH 7 8 TH- GM/ SANDY 10' UTILITY . EASEMENT 10 SIM GRAVEL WITH ry�10 UTILITY EASEMENT SOME SILT 12 77 13 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 IF YES, AT WHAT TH 16 DEPTH? DRY X 17 DEPTH TO WATER AFTER MONITORING? DRY 18 DATE: 7/16/2014 1 BOH 19 CLOCK WATER READING DATE TIME NET TIME LEVEL NET DROP 20 READING 1 7/9/2014 10:50 - 5.72 2 11:20 30 MIN 6.75 1.03 DATE PERFORMED: 7/9/14 3 11:20 - 5.72 - 4 11:50 30 MIN 6.74 1.02 5 11:60 5.72 - 6 12:20 30 MIN 6.74 1.02 PEROLATION RATE 29.4 (min/inch) PERO HOLE DIAMETER 6 inches TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS: Test hole excavated by A+ HOME SERVICES. Perc hole was presoaked. Test was run for at least one hour. Last three readings reported. PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: I& Date PAMONE ENG SVC, LLC /1 7/17/2014 FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ............ 4 Scale PHONE (907) 272-8218 FAX (907) 272-8211 NTS ... ... ... P.I.D. NO COHOE, LOT 6 015-051-18 RICKY THOMPSON meven R. annone _R CE 8149 /PERMIT NO 9361 STRUTZ AVENUE az OSP141253 Sheet SOILS LOG ANCHORAGE, AK 99507 iN � - -, k)ll 3 OF 3 Register 163, July 2002 ENVIRONMENTAL CONSERVATION (A) the site of the proposed system is remote from a community with access to professional engineering services; and that the resulting cost of bringing a registered engineer to the site would be overly burdensome; and (B) public health, public and private water systems, and the environment are adequately protected without this requirement, (2) justify the lesser distance and explain how the lesser distance does not threaten public health, public and private water systems, or the environment; (3) describe soil classifications, groundwater conditions, surface topography, geology, and other environmental conditions that would assist the department in establishing a lesser separation distance; and (4) include a set of plans, consisting of (A) record drawings if the department determines them necessary to evaluate the request; (B) an accurate description, including the location, of potential sources of contamination, surface water, groundwater, and existing or potential drinking water sources in the area; and (C) the details of the system design that (i) address the physical and environmental conditions in (3) of this subsection; and (ii) will prevent contamination of the surface water, groundwater, or drinking water sources identified in (B) of this paragraph at the lesser distance; and (D) other information the department determines to be necessary to assess the effect of a lesser distance upon public health, public and private water systems, and the environment. (f) In accordance with 18 AAC 72.060, the department will approve a waiver of the separation distance required by (b) or (c) of this section if the department finds, after review of the report submitted under (e) of this section, that a lesser separation distance does not threaten public health or the environment and protects surface water, groundwater, and existing or potential drinking water sources. As necessary to protect public health and the environment, and to protect surface water, groundwater, and existing or potential drinking water sources, the department will require changes to system design as a condition of approval, including increased depth of grout and changes to the pipe material, pipe bedding, joints, and pipe strength. (g) A person may not install 0 Register 163, July 2002 ENVIRONMENTAL CONSERVATION (1) a septic tank or soil absorption system directly above or below a water line at any distance, or within 10 horizontal feet of a water line; or (2) a sewer line directly above or below at any distance, or within 10 horizontal feet of a water line, unless (A) the required location or separation distance cannot be met because of the site configuration, the system design, or the presence of other obstacles that have regulated separation distance requirements; (B) the sewer line is designed and constructed in a manner equivalent to the requirements for a potable water pipe, and (i) is pressure tested to ensure watertightness; or (ii) is enclosed in a carrier pipe of similar strength and rating as the actual pipe, or of a strength and rating approved by the department as protective of public health, public and private water systems; and the environment; (C) the sewer line is in a separate trench from the water line; and (D) at locations where sewer and water lines must cross, (i) the sewer line is installed below the water line to the maximum length possible until existing appurtenances, elevations, or depth -of -cover requirements prohibit such installation; (ii) the sewer line uses a bedding that is specially designed to protect the integrity of the sewer line in places where the elevation of a water line is below a sewer line; joints; and (iii) the sewer line joints are at least nine feet from the water line (iv) the sewer line is at least 18 vertical inches from a water line. (h) Upon determining that a waiver will not threaten public health, public and private water systems, or the environment, the department will waive the requirements of (g) of this section in accordance with 18 AAC 72.060 (1) for a utilidor, if the water line is above the sewer line, and (A) for an above -ground utilidor, the utilidor will not flood if pipe failure occurs; or MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 0 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name % DISTANCES SEPTIC ABSORPTION Address FROM TANK FIELD WELL WELL r� f Phones) Permit No. No. of Bedrooms -Gc % Z�Q -3447970,035 ! LEGAL RIPTIGN 7 LOT LINE ,��' � i c71 Lot Block Subd��i rr++� iio�on,, CEJ FOUNDATION zoo Township, Range, Section /� ����, r AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, 7ZZIL&/� 7 driveway, water bodies, etc.) T KS a D ,I� - x �� _ .fit SEPTIC ❑ HOLDING I4' r t 41 Manufacturer Capacity in gallons (Jf 2 5Q Mat rial/��7o. of Compartments L Ar 1 $.3 TYPE af SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from original grade FT Total depth from original grade FT Fill added above original grade 0__/ FT Gravel depth beneath ipe f FT Gravel length �� FT Gravel width r/ FT Total absorption area • f 419— SOFT Distance between lines /UIA FT Number of lines Soil rating 0 IFT /25�Q Pipe material f ! l (fs Installer Dale Installed Q 2 G49 WELLS ❑ PRIVATE ❑ OTHER (Identiliv) Classification (A,B,C) Installer Aat Total Depth Cased to FT FT I tall d: REMARKS: ra t � � Scale: c• AUS 9 eiuo r n yin ep. - kirt lo.Pi�l, �►'Fi�rn ections Pel Date: 117-1 a0 I N certi( that this inspection was performed according to all Municipal and State guidelines in effect on this date: L t �� /A Health Department Approval: Date: — V71 / A 0 -013 (3/13b) It a I IENGIVlE€R'S SEAL MUNICIPALITY OF ANCHORAGE Department of Health & Human Services 825 L Street, Anchorage, Alaska 99501 343-4720 ON-SITE SEWER PERMIT Permit Number: 900357 Upgrade Date Issued: 11/02/90 Engineer Designed Owner Name: LLOYD BELLAMY Day Phone: Owner Address: 9361 STRUTZ AVENUE 279-8866 ANCHORAGE, AK 99507 Parcel Id: 015-051-18 Lot Legal: Subdivision: COHOE SUBDIVISION Lot: 6 Block: - Section: 15 Township: 12N Range: 3W Lot Size 19000 (sq.{t. or acres} Max Bedrooms: This Permit: 4 Total Capacity: 4 ` SEPTIC TANK: Minimum total septic tank capacity: 1,250 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 feet requires insulation over tank(s),, TIKE PERMIT EXPIRES 12/31/90 AND VALID FOR A SINGLE FAMILY HOME. CONSIRUCT PER ENGINEER'S ATTACHED DESIGN. lNFORM D.H.H"S° A MINIMUM OF 2 HOURS PRIOR TO INSPECTIONS BY ENGINEER, IF AFTER OFFICE HOURS, CALL 343-4681 AND LEAVE A MESSAGE. I CERTIFY THAT: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. J. I will adhere to all MOA and State of Alaska requirements {or the set back distances from any existing well, wastewater disposal system or public sewerage on thi or any adjacent or nearby lot. 4. I understanc AM 3ormit is valid for a maximum of 4 bedrooms. I also unde that capacity of the total system is 4 bedrooms and j&,wiljAeiquire an additional permit,, Signed: Issued By: VC AMY TE: WASTEWATER NARRATIVE FOR LOT 6, COME SUBDIVISION The location of the wastewater disposal system on the subject property should have no negative affects to the adjacent properties or the environment for the following reasons: WELLS There are no adjoining wells and the community well for this property is properly separated from the planned wastewater extension by at least 300 ft. WASTEWATER SYSTEM The wastewater system proposed for this property has been located so that there will be no effects to any surrounding properties. All setback distances have been satisfied as required. Further the soils are of such a nature that treatment will be assured over a long term period. RESERVED SPACE The wastewater system on this property have no effect in taking away reserve area set aside on other adjacent lots. SURFACE AND SUBSURFACE DRAINAGE The wastewater system will have no impact to surface water drainage due to the location and the fact that the contours will remain unchanged. Subsurface drainage will be unaffected since treatment of wastewater is assured before it reaches groundwater tables. M - . ���Wtla 1 �� 1.5P,wer Sewer✓' !�'S� � I Loi` fJnVew S{►e� E1u3{.125 uc�n1,—�° .o, 'T,µ,*2 r---- 4, Mem i f6ir Slop4a.(e.a to°6f 2, esqj d Q Dc Art 5%SLP 7 g /ver te�� Flat- �� cawc�-� �1-1 rim k /SO = l000 / Z �o 0,8 1�z 751 75'�z �2, Y `ldf r -117 2-07-6 r8o � Lc2�r�t fi �dtSu�ei�td-t ��t�6i7� Q ,Okn eixt;t4. lh sbw Ave Cll—lwm tot� 0 11 �/L 4 ! Se,Ctf2% �t`G�t elr�✓ S' J'7�pdr� r7 NOTE: All Dimensions And Locations Must Be Field Verified Prior To Construction SEWER. SYSTEM •LOCATION -PLAN e E1 x�X' C 56 YdsCI ,. 's", SECTION/TOWHSI HtP/RAN SCALE$ >%c/ �. DRAWN BYx. NORTH ;ems avcwswwcv.. - COiC NOTES ; The Accuracy OC Location OC Exisiting And Proposed Property Corners, Wells, and Septic Systems Indicated 16 -Not Exact. Dimensions Indicated Have Seen Determined By Urc.Or Cloth Tape and/or Municipal Records, And Hot By Surveying Techniques PREPARED FORo ls���-ale Ger DATE, jD/J/1 l SHEET OF municipa(ity,of Anchorage DEPARTMENT OF HEALTH & HUMAN SERI 825 "L" Street. Anchorage. Alaska 99502-0( SOILS LOG — PERCOLATION T9 0 F or,: 1:546 6� v C- f-, r- 0 R M, C Township. Range. Section: LEGAL 0CSCR(pT(0N:—,, SLOPE oEPTH 2 3 4 5 6 7 10- 11 12- 13- 14- is - 16, 17 18 19 20 COMMENTS a W1, 5: � 0 � 15c1A f C silt' " - 5911,5114 5~ f /f %vASGROUNDWATER ENCOUNTIEREO? IF YES, AT WHAT 0EPTI-l? cept to W&r fexa:toriau? ��Otic C,! V cgv '"I ORKED--, SITE PLAN 0/ 1 1&e4e-r PERCOLATION RATE "3 (minuteviach) PERC HOLE DIAMETER --(92— -7' SE<f' �r'ftrzc�i TEST RUN BETWEEN --- *9— FT AND FT PERFORMED 8y: ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 41851 TIFY THAT THIS TEST AS PERFORMED IN THIS DATE- DATE: . - � 2�, i �1 - - 4OPM 0/ 1 1&e4e-r PERCOLATION RATE "3 (minuteviach) PERC HOLE DIAMETER --(92— -7' SE<f' �r'ftrzc�i TEST RUN BETWEEN --- *9— FT AND FT PERFORMED 8y: ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 41851 TIFY THAT THIS TEST AS PERFORMED IN THIS DATE- DATE: . - � 2�, i �1 - - ocorwin & associates,inc. Consulting Engineers 1000 E. Dimond Blvd. • Suite 205 • Anchorage, Alaska 99515 • (907) 522.1311 PERCOLATION TEST DATA SHEET DATE CLIENT S1qA ADDRESS l "� J ZIP CODE LEGAL DESCRIPTION TOTAL DEPTH OF HOLE J�4��FT. TO 7�g FTZONE TESTED READING CLOCK NET TIME DEPTH NET DROP TIME TO DATUM FINAL PERCOLATION RATE }/ ' (min./in. ) �`,""�°a� �►�,�,� , PERFORMED BY L em F!' es+�t,mw'Ca v JAA It "win 1. s. �" ,, aos,►w,r A' ,y 'tii PERFORr,;EO FOR: Municipality. of Anchorage DEPARTMENT OF HEALTH & HUMAN SE 825 "(_" Street• Anchorage. Alaska 99502• SOILS LOG PERCOLATION T LEGAL OESCRIPTION: �/ (FEET) v�- 2 3 l b 4 6 7i / Township, Range. Section: SLOPE WAS GROUND WATER % fO 10 I I ENCOUNTERED? S L 11 IF YES, AT WHAT O ' DEPTH? E 12 �Li1 (A Ylxtct Atkr 13 F,,oaitxi 7 tktc la I • � S��l� � _ Is - 16 s 16 17 18 19 PERCOLATION RATE _S.-3-3 (minutevj;icj PERC HOLE OIAMETER / TEST RUN BETWEEN -3 IFT AND FT COMMENTS Of 7 //" V&RTIFY THAT T H!q T WAS PERFORMED III PERFORMED BY: I / i /ate ACCORDANCE 1ALL ST T� NO MUNICIPAL GU(OELI NES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 41 1 • - �■��r� PERCOLATION RATE _S.-3-3 (minutevj;icj PERC HOLE OIAMETER / TEST RUN BETWEEN -3 IFT AND FT COMMENTS Of 7 //" V&RTIFY THAT T H!q T WAS PERFORMED III PERFORMED BY: I / i /ate ACCORDANCE 1ALL ST T� NO MUNICIPAL GU(OELI NES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 41 1 o O & associates,inc. Consulting Engineers c, 1000 E. Dimond Blvd. • Suite 205 • Anchorage, Alaska 99515 • (907) 522+1°a^•.� N� ''66 �IYEYy\iiK{n�,;;l.yi'.'CtF> i PERCOLATION TEST DATA SHEET CLIENT �jG�/�� �/%/f DATE C` D ADDRESS LO 7L !Z1� ZIP CODE LEGAL DESCRIPTION Z TOTAL DEPTH OF HOLE FT, r ZONE TESTED FT. TO FT. s�l�,r�7dr READING CLOCK TIME NET TIME DEPTH TO DATUM NET DROP ©. ¢i 2oXA 3 7 lj, Zc> o,3c� 1444114 0 FINAL PERCOLATION RA PERFORMED BY (min./in. ) November3-�, 197J �3i.)] StruLz Avenue Aj"icnuragu, SubjiccL: Lot 6, CjNoe SUL)divisi011 Dear -Ir. tialtio. Tids office approv;-,u tkp: ins".-allai-Iloo uf a SLptic Lank oil au:jj'LCL r1'0- pem-N. ho.qt!ver, wo crave 11c, ififorkiiation on Via appamnt installa-itioil of a uct� lul.-�Lrs 1-0 yUU Oil JUj Uary I ail ' gdjh J ill 0-1�6)Lr, aria. office 6 1 I �.a k -- ififorilatioil ol-I tiie outs tantifivj ienyiit. T;ie most recti 6 I!, LL Le r was no is In ord,�r to aliprovo Lyiu existin-j permit, we will require L,,,,u fullu,Anj. R-Cuij)L for gravel lvacicfill. i,,(cJpt for criij mati:rial. GumpleLe dia-gram of so:page area. for al I Ape used. J) i ncuvar fc)jr (4) corners of a'UsorVJL-ium arLd dUvi,') to gravel bacrIflil. J unL u L,,,� r .j iii Lei, (lea} days fel liuilrig rLCCipL of Liiis Failure:. L -o coiiply will r aril is in legal aCI.Jur'. Sincerely, Susan L. i0icki.,rson. Sardtariaii RECEIPT FOR CERTIFIED MAIL -3041 (plus postage) - SENT TO POSTMARK OR DATE i STREET AND NO. 00 co P.O., STATE AND ZIP CODE OPTIONAL SERVICES FOR ADDITIONAL FEES ' RETURN 1 • Shows to whom and date delivered ........... With delivery to addressee only ............ 15¢ 65¢ RECEIPT 2. Shows to whom, date and where delivered .. 35¢ SERVICES With delivery to addressee only ............ 85¢ --t[- -- ----- VER TO ADDRESSEE ONLY ..................................................... 50d Q SPECIAL DELIVERY (extra fee required) .................................... , Z PS Form3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Apr. 1971 NOT FOR INTERNATIONAL MAIL n GPO :1972 O - 480-T43 GREATER ANCHORAGE AREA BOROUGH o .$ DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 f TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT 0 NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION L"' I, / INSTALLATION OF: SEPTIC TANK L/ TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH PERMIT NO. %.3 � l 5 fdyfiz '41-0 17�� - %� 2 MAILING ADDRESS PHONE r4 1c(7f E PIT_ DRAIN FlEy OTHER / / --fes+' / / 7 TO BE INSTALLED BY SOIL TEST RESULTS —~ ��YIO rtil NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE_ ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT T/g PRfjSEC TION. bi SCi // —/Ql'—e > h&Vfir/ i r/ SEPTIC TANK SIZE V TYPE ••�� SEEPAGE AREA S MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT Z a DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL — SEPTIC TANK _ , SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK`o-1 0q�.e EPAGE PIT —. DRAIN FIELD _ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK / tJ SEEPAGE PIT DRAIN FIELD� r0 --• SEPTIC TANK, 11_111 SEEPAGE PIT .lam_. DRAIN FIELD/D 0 f TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 7 r /✓ �.._.. G.A.A.B. U OR Z713LICENS D DESIGNER To 0bf�t /)I ERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE �PE DIAGRAM OF SYSTEM I G DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE ) / 7 3 APPLICANT'S SIGNATURE FORM NO. EQ -016 i A NAME OF APPLICANT _ GREA I ER ANCHORAGE AREA BOkJUGH PARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-65-0 ANCHORAGE, ALASKA 99502 TELEPHONE 279-8686 AGE DISPOSAL SYSTEM — APPLICATION AND PERMIT PERMIT NO. j 4.I�C lel, II\raI%\ MAILING ADDRESS C, 3(C S`f IZIY G' ly�y - PHONE INSTALLATION LOCATION :S - ^ Z--i4L)C LEGAL DESCRIPTIONLi- G �'����t� �i�Vl INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED 3c'�'tz, 111.?; I ly�l -4 -- - FINANCED THROUGH 7 {/ TO BE INSTALLED BY -7 E I F-" f FL, SOIL TEST RESULTS NOTES THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. ' SEPTIC TANK SIZE � TYPE ��Y�\'t-L- �' S }tABEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK �r . SEEPAGE PIT �el / , DRAIN FIELD TO NEAREST LOT LINE. r WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK rte' DRAIN FIELD SEEPAGE PIT l6elcj ALSO CONSIDER AREA WELLS. f —, SEEPAGE PIT / 10 SEPTIC TANK, G !) SEEPAGE PIT DRAIN FIELD , TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETE AST N SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEALTH AUTHORIT OR LICENSED DESI ER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. - DATE APPLICANT'S SIGNATURE January 19, 1971 ldr. William Waldo 7800 iicBarr Road Anchorage, Alaska 99504 SUBJECT: Permit and Application for Sewage Disposal System, Lot G, Cohoe Subdivision Uear Mr. Waldo: August 10, 1970, you obtained a permit from this Department for the installation of a sewage disposal system. As of this date, the permit is still outstanding. Please advise this Department if you have installed, or still intend to install, a sewer system on the subject property and wish your permit kept pending in our files. Sincerely, Lynn S. Coad Sanitarian rn GARB -HD -2 GREATET 1NCHORAGE AREA )ROUGH Case No. g; HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM — APPLICATION & PERMIT NAME OF APPLICANT % - �( '; t �� MAILING ADDRESS 79040 � �--PHONE NO�`3`__P40 RESIDENCE ADDRESS LOCATION OF INSTALLATION �%7�[.t 7?_ LEGAL DESCRIPTION ' �� APPLICATION TO INSTALL: SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY 11-D T 1 FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETIO ✓ Ivelf BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS �� ( PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE ew E SERVED�� . SEPTIC TANK SIZE UD TYPESEEPAGE AREA TYPE DIAGRAM OF SYSTEM DISTANCES: I. d C HEALTH AUTHORITY I� I I 1 I 1 1 1 I 1 I IOR I LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ord' ance No. 28-68 and that the above described system is in accordance with said code. rI/©i'- f/©1 �/.P��!a+ DATE G' �� !� APPLICANTS SIGNATURE-r"-�"` I Ell 3 &U,je,l ha -C 006 W -O, -K- 1 Ccrl+arl� W141. S0 eA Ma44* C -am Oc-cup- ( rL powlxrt�+,,or) 4�0$1 p,cA<e,ff, and I e--'!, COVI(c,h WO oaf U-)MI,px 44le ape C'oMpOC_�4PA and consir.6vii- Water Encountered?_ Aa —. -2�� — — - — -------------- 170 140t t", cl pit nlet Of lZM ........... Test Performed w I c MUNICIPALITY OF ANCHORAG 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. 015-051-18 Legal description COHOE LT 6 Site address 9361 STRUTZ AVE Expiration Date: Current property owner(s) CHRISTIE ERIKA & AARON REID 6/12/2025 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: A% Original Certificate Date: 31-2-01-,7 1-1 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. Fit Ifi[�:IiT [4V1t&113 COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 III :: 1 p qi ;Iiri III III Development Services Department - Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-051-18 Complete legal description COHOE LOT 6 Location (site address) 9361 STRUTZ AVENUE ANCHORAGE, AK 99507 Current property owner(s) CHRISTIE ERIKA & AARON REID - Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well F-1 Private Well serving 2 dwelling units R Private Well serving 3+ dwelling units Z Community Well or Public F-1 Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Z Private Septic F] Private Septic serving 2 dwelling units [-I Holding Tank FI Community Septic or Public Sewer 5. SEPTIC TANK: Z Steel F1 Plastic F-1 Concrete F-1 Fiberglass to Age � - See advisory if steel older than 20 years 6. ABSORPTION FIELD: 0 AWWTS r_1 Bed H Deep Trench r_1 Wide Trench El Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. I COSA Fee $ 0 Date of Payment ai�t67 COSA# 0-c-2G2'41?_6J Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: COHOE LOT 6 Parcel ID: 015-051-18 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER 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. Well production at time of test gpm Water storage tank volume NA 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 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank *NA Date of pumping 6/12/24 Required maintenance completed, if AWWTS Comments: *STEP FLOATS C. LIFT STATION Required maintenance completed Age of lift station 10 years Lift station material STEEL Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/23/14 ALL standpipes present per record drawing Total measured depth from grade 13.9 ft (max) Measured depth to pipe invert from grade N/A ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective 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) N If yes, enter date Adequacy test date 6/13/2024 Results Pass (North / South Trenches) Fluid depth prior to test 31 / 20 in Water added 650 gal New fluid depth 47 / 33 in Elapsed time 1440 min Final fluid depth 31 / 20 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 108 in (MOA 9’ ED) Effective depth used 31 / 20 in (Final Fluid Depth) Effective depth remaining 77 / 88 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per measured shots, visual observations, MOA docs & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 7/12/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 7/12/24 MUNICIPALITY OF ANCHORAGE All Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Owner Septic Tank: *Sludge level oinches Lift station: Lift Station/Pump Vault Maintenance Log Street Address 9361 Si r -Pumping: required &no ,Pump basket cleaned es no *Control floats cleaned <& no -Operation satisfactory es no Alarm System: tZ' -Pumping completed es no -Effluent filter cleaned es no -Proper float settings confirmed es no ��ry� .2y *Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling es o -Alarm system operation satisfacto not satisfacto Manhole Riser ,Groundwater intrusion at riser to tank connection es ,Ground water intrusion around pipe penetrations yes &Manhole lid: Functions e no Insulated es no Other -Weep hole functional 40 no Properly Secured es no -All manufacturer required inspections and maintenance completed Comments: Qualified Maintenance Provider: Technician 1,0-,c' ,�� Company Signature Date of mainteiiamce D L) ne Date o iu,_!L � pati H • '� Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. -� jS 0 -� 1 ] 8 Expiration Date: :z 1. GENERAL INFORMATION Complete legal description COhoe, Lot 6 Location (site address) 9361 Strutz Ave. Current Property owner(s) Ricky Thompson & Mary Vanderwerf Day phone Mailing address 9361 Strutz Ave. Anchorage, AK 99507 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ 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 F] Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public tnrater System m El Public Sewer j_1 u WaiverNariance request for: Received by, Date. , COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number CosA # _ ° S G- / q 13 ,* Waiver Fee $ _ Date of Payment Receipt Number, 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 Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 7L12014 OF A(q�l�'9lrl 6. DSD SIGNATURE j *" .. 8� System #1 Approved for bedrooms t : Sleven R. Pannone System #2 Approved for bedrooms �� *�y . CE -8149N. Disapproved ��� Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: :7 ' / The u ici® ity of nchorage 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 r c If more than 1 septic system is on the lot: COSA Checklist # !_of 1 Structure served by this system + Certificate of On -Site Systems Approval Checklist Legal Description: COhOe, Lot 6 Parcel ID: 015-051-18 A. WELL DATA Well type Public If A, B, or C provide PWSID # AWWU Well Log (Y/N) Date completed Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S•T•E•P/Steel Tank size 1,500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (YIN) N Date of pumping New Pumper Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. Collected by: Date installed 7/23/2014 Cleanouts (Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed 7/23/2014 Soil rating (g.p.d./ft2 or ftz/bdrm) 0.6 GPD/SF System type Deep Trench Length 60 ft. Width 3 ft. Gravel below pipe 9 ft. Total depth 12 ft. Eff. absorption area 1080 ftZ Monitoring tube Y Depression over field N Date of adequacy test New Results (Pass/Fail) PBSS For 4 bedrooms Fluid depth in absorption field before test New in. Water added New gal. New depth NeW in. Elapsed Time: New min. Final fluid depth New in. Absorption rate , 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed 7/23/2014 "Pump on" level at 40 in. Datum Bottom of Tank E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Size in gallons 500 "Pump off' level at 36 in. Cycles tested New Manhole/Access (YIN) Y High water alarm level at 45 Meets alarm & circuit requirements? Yes On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Animal containment areas Manure/animal excrete storage areas 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+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Curtain drain 50+ F. COMMENTS G. ENGINEER'S CERTIFICATION Surface water 100+ Wells on adjacent lots 200+ I 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 Steven R. Pannone Date 7(26/2014 COSA brown sheet 10-10-12.doc Water main 10+ Driveway, parking/vehicle storage 110+ in. 25' Found 5/8" Rebar 1' Below Ground Level Wood Rail Fence 3 O ° LOT 5 00 o I- b Lo 0 z Lee Knrnbelni No. 3143-S uf Riser Pipes (TYp-) 10' Utility Easement Wood Fence (Typ.) LOT 11 LOT 7 33.0 o in i� 118.1 -�- Bi—Level Wood Wood .2" y>° Uh.,�. .4. ' Residence Wood alb a o Fence Asphalt Drive (TYp-) 10.4' 3\ � Lift - . 82 21.4' Station LOT 6 ?y moo.. Wood Inspection PVC O• I �.... Porch Pipe w w 0 0 > M. . ^o LOT 7 Concrete qs :w 00 Wood Deck Retaining in & Stairs Wall 2�fjay f 0 I oa Bi—Level Wood Wood y>° Frame?� Shed Residence Wood alb a o Fence (TYp-) 3\ � oa 82 ?y moo.. Wood O• I �.... Porch 167.07' 589'55'58"W r, LOT 12 N I I hereby certify that an accurate survey of the following described property: COHOE SUBDIVISION (70-169) 1� LOT 6 was made on July 29, 2014 and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on low the premises in question and that there are no roadways, transmission lines or other visible easements on said property except r as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 31st day of July 2014. SCALE : 1 " = 20' 0' 10' 20' 40'