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Home My WebLink AboutCOHOE LT 11Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231220 PID Number: 015- 051-24 Dwelling: Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Upgrade pgrade Name ❑ ATKINS ABSORPTION FIELD Site Address 9215 STRUTZ AVE, ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Phone ❑ Other Number of Bedrooms Soil Rating Iota! depth from original grade 4 LEGAL DESCRIPTION Subdivision COHOE LT 11 Township Range Depth to pipe invert from original grade Gravel depth beneath pipe Lot Ft. added above original grade Ft. Gravel width Beds: Number SEPARATION DISTANCES Ft. To Septic Absorption . Holding Sewer Total absorption area Number of tren From Tank Field Lift Station Tank Line Ftz Well *135'+ 50'+ TANK N Septic ❑ S.T.E.P. ❑ He Manufacturer Surface Water 100'+ GREER/ANCH TANK Lot Line 1 0'+ Foundation 10'+ Remarks * CLASS A WELL W/ WAIVER NA PLASTIC LIFT STATION Manufacturer location length Distance between lines Ft. Dist. between trenches Other 1250 Vumber of compartments 2 pacity I installed by Gal. Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield MIKE N ANDERSON, P.E. Drainfield corMT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection 1s' 11/4/23 Location dates: 2nd and description p 3id 41h TOP OF MANHOLE 100 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Enjiqetr:s stamp conditional Approval Date �' y • i /, _ _.. /{.• ... �• .......... s'7 � • MJCHAEL N. f _; •, Septic System Approved •. ' Date : .. 3riCE S Zvi•.•', > ii Note: this approval does not include well permit requirements. ev 05102/18) Permit No. OSP231220 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On —Site Wastewater Disposal System and/or Well Inspection Report Legal Description: COHOE LT 11 C01 5 22 T 01— — _ 13 15 C 102 16 12 CO2 19 15 CO3 20 16 CLASS A LOCATED I GARA I I SEPIC SEC71ON N.T.S. \ I APPORX. 135 C\ SS A WELL RADIUS W� PEC WAIVER I I 1 I 1 B I IST1N 0 TC01 A e TCO2 I CO /CO T I B0 I I I FXIS h / I / 1 OLD T N / / I ASBUILT / SCALE: 1 "=50' i i i PID No.: 015-051-24 K. 200' CLASS A RADIUS TANK TO FIELD IS >6' TYP. TOP OF MH MT/CO PUMPED & FILLED IN —PLACE F Al i i � 49 TH MICHAEL N. ANDERSON6 No. CE 9469 / �j1-15-23 �11 '�O ••'•... ...•.•• •• W j W Q o�P��.�F At o�D 49 TH E �O N SHANE A. HOLT oOp� LS-6914 0� 4a a o ssiona\ �o�T 0 0 0 0 LLJ 0 CD 0 0 M AS-BUIL T SURVEY SC% L E 1 " = 20 ' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 11 COHOESUS THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES• THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT ARE NOT SHOWN EXIST OTHER THAN NOTED. HEREON C UNLESS INDICATED) 10TH NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE DATED AT ANCHORAGE,ALASKA THIS DAY OF PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS• NOVEMBER , 2023 ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. ONLY VISIBLE IMPROVEMENTS ARE SHOWN HEREON 9337 111-67 235-38 HOL T LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 907-223-8615 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231220 Work Type: SepticTank Upgrade Tax Code Number: 01505124000 Site Legal Address: COHOE LT 11 G:2437 Site Mailing Address: 9215 STRUTZ AVE, Anchorage Owner: JABAAY DERRICK Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: l�epartnieuC 11/6/2023 11/5/2024 14008 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • Prior to construction, the field is to be located in order to ensure that the required separation will be met. Received -By (_i3 S C4 erj 4c, Hkl� Issued By: Date: Date: 4 MUMUPAUTY OF IL3�HCHO PRA GE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section %-V Fax. 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-051-24 Property owner(s) ATKINS Mailing address 9215 STRUTZ AVE ANCH AK Site address SAME Legal description (Sub'd., Block & Lot) COHOE LOT 11 Legal description (Township, Range & Section) Day phone Lot Size Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank X ❑ Upgrade X ❑ (D) ❑ Holding Tank ❑ Renewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 11-1 Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: > b 0 Waiver Fees: Date of Payment: '�� .Z 3 Date of Payment: Receipt Number: O.2 0(i 9 Receipt Number: Permit No. to '�, I Z Z O Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc July 14, 2023 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic tank permit Legal: COHOE LOT 11 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The tank will be decommissioned per the Uniform Plumbing Code (UPC). Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231220, Deb Wockenfuss, 11/06/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231220, Deb Wockenfuss, 11/06/23 1 Department of Environmental Conservation DIVISION OF ENVIRONMENTAL HEALTH Drinking Water Program 555 Cordova Street Anchorage, Alaska 99501 Main: 907.269.7623 Fax: 907.269.7650 dec.alaska.gov October 27, 2023 Derrick Jabaay DEC Project ID 18640 Homeowner File: Cohoe Subdiv. L11 P.O. Box 231295 PWSID: AK2212924 Anchorage, AK 99523 Class: Community Source: Groundwater Re: Lot 11 Cohoe Subdivision - Separation Distance Waiver Dear Derrick Jabaay, On September 15, 2023, this office received a submittal from Michael Anderson, P.E. requesting a Separation Distance Waiver for a new polyethylene septic tank to an existing public water system well located in Anchorage, AK. This letter issues a Separation Distance Waiver as detailed in the submittal outlined below and separation distances listed in Table 1. Project Description This project will replace an existing 1250-gallon steel septic tank with a new 1250-gallon polyethylene septic tank from Anchorage Tank, approved for installation within the Municipality of Anchorage. The aging septic tank, installed in 1993, collects wastewater from an existing 4-bedroom single family residence on Lot 11, Cohoe Subdivision located at 9215 Strutz Ave. A separation distance waiver was granted in 1993 for both the onsite septic tank and soil absorption trench at distances of 135 feet and 137 feet, respectively, to the public water system well on Lot 1 of Cohoe Subdivision (PWSID#2212924). The proposed upgraded 1250-gallon polyethylene tank will be 130-ft from the well, which is a 4% reduction in the existing 135-ft separation distance. The existing soil absorption trench (72-ft long, with an effective depth of 7-ft of gravel under the distribution pipe) is reportedly functioning as designed and will remain untouched. The existing public water system well (PWSID#2212924) serves eleven single-family homes, including Lot 11, in Cohoe Subdivision and has a daily population of 36 residents. The well is located on Lot 1, directly across Strutz Avenue to the west of Lot 11. This well does not have a well log according to a sanitary survey dated 10/27/87 and a submittal dated 11/02/87 from the previous well owner, Richard Strutz. Well information was verified by Alaska Now-Well-Vern’s Drilling and Enterprises on 10/28/87 as having a total well depth of 260-ft, static water level is 205-ft, and a 3-hp pump set at 241-ft. Lot 11, Cohoe Sub. Waiver October 27, 2023 231027_Lot 11, Cohoe Subdivision_212924_WA.docx 2 Separation Distance Waiver The department finds that the information, justification, and endorsement of the submitting engineer adequately supports a waiver of the minimum distances required in 18 AAC 80.020. The following conditions were taken into consideration as part of this waiver: 1. Configuration and system design requirements prohibited the wastewater system from being installed so that it meets the minimum separation requirements; 2. Test holes in the area had the presence of very dense gravelly silt and silt layers; 3. The new polyethylene septic tank will be placed in approximately the same location as the existing steel septic tank. Based on an evaluation of the available information and in accordance with the State's Drinking Water Regulations, 18 AAC 80, a Separation Distance Waiver for the wastewater system encroachments detailed above is issued. Please submit a copy of the as-built after construction. Limitations and Appeal Process This waiver is limited to this project and its current site conditions. Any changes, constructed or natural, that affect the conditions to which this waiver was granted may void this waiver and components may be required to be relocated to meet separation distance requirements. Approval of this waiver does not obligate the department to approve future waiver requests proposing the same design, is not an approval of omissions or oversights, and does not guarantee correctness of the functional design or waive the owner’s responsibility for continued compliance with state, federal, and local regulations. A person authorized under a provision of 18 AAC 15 may request an informal review of a contested decision by the Division Director in accordance with 18 AAC 15.185 and/or an adjudicatory hearing in accordance with 18 AAC 15.195 – 18 AAC 15.340. See DEC’s “Appeal a DEC Decision” web page https://dec.alaska.gov/commish/review-guidance/ for access to the required forms and guidance on the appeal process. Please provide a courtesy copy of the adjudicatory hearing request in an electronic format to the parties required to be served under 18 AAC 15.200. Requests must be submitted no later than the deadline specified in 18 AAC 15. If you have any questions regarding this plan review, please do not hesitate to contact me at 907-269- 7632 or michael.gerard@alaska.gov. Table 1: Separation Distance Encroachments PWS Water Source Potential Contaminant Horizontal Separation Distance Notes 6-inch well casing (Lot 1) New 1250-gallon Polyethylene Septic Tank (Lot 11) 130 ft. Existing Leach Field (Lot 11) 137 ft. Existing Waiver (ADEC Project 9321-WA-020) Lot 11, Cohoe Sub. Waiver October 27, 2023 231027_Lot 11, Cohoe Subdivision_212924_WA.docx 3 Sincerely, Michael Gerard Engineer Assistant II, DEC Cc: Michael Anderson, P.E., mnanderson58@gmail.com Chris Jackson, DEC-DW EPT, chris.jackson@alaska.gov Jordan Ebert, DEC EPS, jordan.ebert@alaska.gov Cohoe Subdivision PWS212924, kedmondson@gci.net Bill Rieth, DEC WW, bill.rieth@alaska.gov MOA On-site, deborah.wockenfuss@anchorageak.gov . Municipality of Anchorage 'Page I 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: ~l,V' cj~ 00(~(o PID Number: O 1,5'O,5'12- ~ Name: Wastewater System: [] New ~"Upgrade D/IN IEL ~vL~UREL Address: ~15 5T~UTZ A¢~ , A~Cfl,, ff950~ ABSORPTION FIELD Phone: ~ No. of Bedrooms: ~'~I ~ ~DeepTrench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION so, Bating: Total Depth from ori~inai grade: O. ~ GPD/Sq. Ft. 13 ' Lot: Block: Subdivision: Depth to pipe boltom from original grade: Gravel depth beneath pipe I i -- Co HoE 5.~ Ft. 7. ~ F~. Township: ~ % Nii Range: ~ ~II Section: J ~ Fill added abovel, originaIo grade: Ft. Gravel~ F~E(length:T I ~ ~ Ft. WELL: ~t5 ~ D New D Upgrade Gravel width: Number of lines: ] Distance between lines: Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~'* Driller: Date Drilled: Static Water LevehFt. Installer:~L,~ ~AC~TI~ DateinsT~:/~ SEPARATION DISTANCES ~Septic D Holding ~ S.T.E.P. TO Septic Absorption Lill Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~C~O~ A~ I~ 50 ~ Number of Compartments: Surface , Water ~/~' ~/oo _ ~ 7/~o' LIFT STATION LineL°t ~D / ~0~ ~ ~ ~0~ Size in gallons: I Manufacturer: I Foundation ~1 iO~ ~ -- 0, '"Pump on" level at: ~ "Pump °fl" level at: I High water alarm at: Curtain Pump Make & Model ~ Electrical Inspections performed by: Drain -- ~ ~ ~ I Remarks: ~c~ ~a~ ~ ~co~~of BENCH MARK ~ ~ ~ ~ ~ ~ ~ ~ ~~ Location and Description: ~ ~ ~e~ ~e~o~, ~ ~p~n, ~t r~o ~ ~ ~ ,'"' ':EN~INEERSSEAL'. "'* Health~ Department O~ Reviewed and approved by: ~- ate: 72-013 (Rev. 9/91) MOA 25 Permit No. ,S[,v' '~%oo(~(o Page ~- of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-47'~~,':':':' On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: ~OT It ¢ COHoE Pld No.: ':~o-~ HOUSE bECK C.o. "C" Io' 3~' C.O. b ~3 37 ,, ~. TA ~ , , C , '-' 9.S 2o Pl..A- N 72-013 A (2/81) MOA 25 ..FlattOp' Technical Services ":: 14530 Echo Street Anchorage, Alaska 99,~ Permit No. S Iv' cj 300 (o/o Page of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anc.horage, Alaska 99519-6650 · Telephone: 343-47~,~;:'": :" ':' On-Site Wastewater Dmposal System and/or Well Inspection Report LegalDescription: LOT II, COHOi~ PIDNo.: Ol.-,c'O.5'l::Z~ ! ioo 1250 GAL SF--. PTIc_ "TANk J ~"~/. J T.~.I~. ~VIN, bOk/ SILL I00.0 ~,¥ STAIRS To bECl~ 72-013 A (2/91) MOA 25 GRou~,% ELEVATioN BY 1.t.t ? t So'r'T~ oF 'rRE~tc~ p R O F' I L F~ VIE. t4,~ V~-RT'. .~C,fl A'fE ' 1"--,5't-O'' I~1o H-oRIZ. E/a/top Technical Services 14530 Echo Street ~nchorage, Alaska 9951.6 -I DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 WALTER J. HICKE-L, GOV£RNOR May 11, 1993 Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Lot 11 Cohoe Subdivision, Anchorage, Alaska, Class A Public Water System, PWSID Number 212924, ADEC Project 9321-WV-020, Review Dear Mr. Moore: This letter is in response to your submittal, received in this office on April 15, 1993. You have requested that the Department waive the Separation distance from 200 feet to approximately 135 feet between a Class A Public Water System Source Well serving Cohoe Subdivision and a wastewater disposal system in which only the soil absorption system located on Lot 11 Cohoe Subdivision is to be replaced. I have completed my review of the submitted information, this office's file on Cohoe Subdivision which covers a waiver that was issued in August 1985 for the existing septic tank and the failed soil absorption system, and other pertinent information. Based on the results of this review, I have the following comments. The monitoring data tends to indicate that the aquifer and source well are not being directly influenced by improperly treated wastewater from the wastewater disposal system in question, nor from the other systems that are located within the 200 foot protective radius of the existing Class A Public Water System Source Well. Thus, it appears that there is existing evidence in support of the requested waiver without all the information required in 18 AAC 80.030 (b) being provided to this office. Therefore, in accordance with the provisions of 18 AAC. 80.030, the following separation distances have been granted: Between the existing Class A Public Water System Source Well and Septic tank from 200 feet to 135 feet. This waiver will also include the septic tank if it needs to be replaced. Ted Moore 2 May 11, 1993 Between the existing Class A Public Water System Source Well and Soil Absorption System from 200 feet to 137 feet. This covers the effluent line from the septic tank to the soil absorption system and the proposed soil absorption system. This waiver will remain valid until the wastewater disposal system on Lot 11, Cohoe Subdivision again requires upgrading, is modified, or the operator(s)/owner(s) of the Public Water System object to this waiver. At that time, either existing separation distances will need to be met or another waiver request will need to be submitted to this office. This approval does not imply granting of any additional authorizations, nor obligate any state, federal or local regulatory body to grant required authorizations. Thank you for your cooperation with this Department. To close out this project, please submit a copy of your April 15, 1993 letter sealed with your Professional Engineer's stamp. If you have any questions, please do not hesitate to contact me. Sincerely, ,4 Keven K Kleweno, P.E. District Engineer KKK/cf cc: John Smith, MOA, DHHS, On-Lot Services PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930066 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:BULL DANIEL J & LAUREL J OWNER ADDRESS: 9215 STRUTZ AVE. ANCHORAGE, AK. 99507 DATE ISSUED: 4/22/93 EXPIRATION DATE: 4/22/94 PARCEL ID:01505124 LEGAL DESCRIPTION: COHOE LT 11 LOT SIZE: 14008 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: DATE: CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 April15,1993 14530 ECHO ST. ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 11, Cohoe S/D, located at 9215 Strutz Avenue. The existing soil absorption trench is no longer able to handle the wastewater load from the residence. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole #s 1 and 2. As can be seen from the soil log, the native material below 2.5 feet is a uniform silty sandy gravel with a measured perc rate of 22 minutes per inch. Using the soil application rate of 0.6 gpd/square foot specified in the wastewater ordinance, this 4 bedroom residence requires a total absorption area of (4 x 150)/0.6 = 1000 square feet. The proposed 72 foot long trench with 7 feet of sewer gravel beneath the distribution pipe has a total absorption area of 1008 square feet. In order to obtain the required absorption area we have had to design the trench with the bottom of the sewer gravel 4 feet above the bottom of the test holes. Our groundwater monitoring has been conducted during breakup, so there should be no concern about a seasonal high groundwater table. To assuage possible concern about the required 6 foot separation from an impermeable stratum or bedrock, we refer you to the enclosed soil log prepared by S & S engineering in November of 1990. Their hole was drilled to a depth of 22 feet at a location approximately 55 feet south of om' proposed trench, and their log reports uniform GM material all the way down to that depth. This residence is served by a Class "A" community water system, and there is a DEC waiver allowing the present septic system on Lot 11 to be 135 feet from the community well. Concurrent with this permit request being submitted to your office we are also requesting DEC renewal of their waiver to encompass the proposed upgrade. We will forward a copy of the DEC approval to your office prior to start of construction. According to Carl of Carl's Excavating, who dug down to the outlet end of the septic tank a few weeks ago, the existing tank is a 1250 gallon septic tank and appears to be in good condition. As part of this project we have specified that the engineer is to reinspect the condition of the tank, and that if any problems are found the tank is to be replaced. The topography of the lot slopes from the east towards the west at approximately 2%. The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface, or on c~ainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. N I_oT ~" l~ ~ u' tF D R l U, E: -4 LOT il; 51FE CO HO~ PI-,A hi NoT'E': 'I'HtJ ~J mOT PLA N ~ P~RF PIP~ 5 F:.C TIO N II I = 5' Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 LOT i1,, Co HOE .5 /D 5o11., PI. AN AE,5OR?TIoN Tr~ENCH ~ CRO.gE-5~CTION Flattop Technical Serv~ces 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 11, Cohoe S/D 9215 Strutz Avenue Wastewater disposal system Specifications upgrade 1.0 General: 1.1 The scope of the project consists of construction of 72 lineal feet of soil absorption trench with 7.5 feet of sewer gravel between 6.5 and 14 feet below the original ground level. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buffed utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settiement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing 1250 gallon septic tank may be retained in service only if it's structural integrity has been verified by the engineer, and if it has functional cleanout pipes with airtight caps, allowing pumping access to each compartment. 2.2 A replacement septic tank (if required) shall be a 1250 gallon Municipally approved tank, and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption trench shall be constructed by excavating a 72 foot long trench to a depth of 14 feet below the original ground level in the vicinity of test hole #1. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 7.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 7.0 above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel prior to backfill with unclassified soil. The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.6 After the backfill has stabilized, all lawn areas disturbed by the construction shall be covered with 4 inches of topsoil and seeded with grass seed to promote rapid revegetation. The work in this section shall be the responsibility of the property owner. 4.0 Inspections: 4.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (4) after final backfill and grading is complete. The septic tank replacement (if applicable) requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 995]~ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN ,SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST TEST HoAE ¢g ~ IIx Co~oE PERFORMED FOR:_. LEGAL DESCRIPTION: 1 2 3 4 5 6 7 d:l'~ 8 9 10 11 12 13 Gr~v e l 14 ~-~ beco~ej 15 ~or~ew h,~t 17 ~9 20 COMMENTS 50 i I DA'rE PERFORMED: ~ /'~ ~'~_~ Township, Range, Section: ~e.c SLOPE WAS GROUND WATER ENCOUNTER Et:)? S IF YES, AT WHAT L 0 DEPTH? p E Depth lo Waler Alter ~' T. ~r/~ Moniloring? ............. Date: ~_~/J ,,5-/c).,,~ SITE PLAN Date Gross Net Depth to Net ................... ................. Time Time (~'f;o) Water Drop __q_l~_ ........ ? :?_J 4~ ~ ? ............... ~o :~ ~ .... ........ ~o: ~ .................... a~ ~/a .......... I~ : ~ ~ 3 u · 37 ~ ZZ 'aA~ Reading · + PERCOLATION RATE ~ ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 7, 7..~' FT AND 8, ~,,~' FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: '~ // /.5-- / ~" 3 PERFORMED FOR: LEGAL DESCRIPTION: PF 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 1~ ¢,.~. 19 20 ~.~. ~ COMMENTS Flattop Technical Services ]4530 Echo Street Anchorage, Alaska 995]R Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST T"esF Hole Cf' ~ ~roy 5~,~y ~rave / DATE PERFORMED: Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH7 p E Depth Io Water Alter J~l. T'. Moniloring? d~Y_ Dale: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (mmuteshnch) PERC HOLE DIAMETER FT AND ~ FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC~ ON THIS DA~E, 72-008 (Rev. 4/85) CER]IFY THAT THIS TEST WAS PERFORMED IN DATE: __~?/"¢ / % /~)~3 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST oD1 COMMENTS $ & $ F_NGINEF-R!NG 17034 F. agie River Loop PERFORMED BY:Eagl. e ~.[.;~_.% ~.las~a ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 4/85) .~..~EL~I~,~ SEAL) .- , ~' ~,~. .~ ~ ~ . ~ -' ~; 'c '.~,,"" ~ ' , Township, Range, Section: ~ A); I~ ~ j ~ ~ ~ SLOPE SITE PLAN _ / WAS GROUND WATER ENCOUNTERED? ,/~ C) S L IF YES, AT WHAT O DEPTH? p E. Monitoring? Oale: l l- Gross Net Depth to Net Reading Date Time Time Water Drop "] PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN *'~- _/T AND __ FT / I, .,//'"/_/.~ ~ ~'~RTIFY THAT THIS TEST WAS PERFORMED IN GUIDELINE ON THIS DATE. DATE: CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. ''F"A~'r;I 15, 1993 14530 ECHO' ST, PH: (907) 345-1355 ANCHORAGE, ALASKPt, 99516 Keven Klaweno ADEC Anchorage District Office 800 East Dimond Blvd., Suite 3-470 Anchorage, AK 99515 RE: Cohoe S/D Class "A" Community Water System - PWSID # 212924 Dear Mr. Klaweno: As we discussed over the telephone on April 9, I am in the process of designing an upgrade to the wastewater disposal system serving the existing 4 bedroom single family residence on Lot 11 of Cohoe S/D, located at 9215 Stmtz Avenue in Anchorage. The existing soil absorption trench is no longer able to handle the wastewater load coming from the house. Since the existing septic system is permitted by waiver (8621-WA-039)to be 135 feet from the Class "A" well, and the proposed replacement trench will also be less than 200 feet from the well, we are requesting that you amend the waiver as necessary to allow for construction of the replacement system. Copies of our soils logs, perc test results, site plan, design drawings, specifications and narrative are enclosed to assist you in your review. The proposed upgrade trench will be 150 feet from the well which is approximately the same distance as the existing trench. We propose to leave the existing 1250 gallon septic tank in service, provided an engineering inspection indicates that it is still in sound condition. If it is found to be not in sound condition, it will be properly abandoned and a new tank installed in a location slightly further from the well. From our telephone conversation I understand that the Class"A" well is cased to 260 feet and has a reported static water level at 205 feet below the top of the casing. The required water quality monitoring has been kept up to date by the water system operator with no parameters in excess of standards. The nitrate level was 0.19 mg/l in 1986 and 0.3 mg/l in 1990, indicating no appreciable increase. This, coupled with the_ facts that (1) the shallow soils encountered in our test holes are sufficiently silty to provide good filtration, and (2) the static water level at 205 feet provides an extensive zone of non- saturated soil for the effluent to pass through, indicates that there should not be a public health concern associated with amending the waiver to include the proposed upgrade. The homeowners are anxious to upgrade their presently failing system within the next few weeks. After the installation is complete, we will provide your office with a copy of the as-built inspection report to document the compliance of the construction for your records. Thank you for your timely assistance, and please give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. WALTER J. HICKEL, GOVERNOR DEPT. 01~ ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 May 11, 1993 . CEIVED MAY 1 4 199~ ....::~, :y ~,i Anchorage . ::,t H~alth & Human Services Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Lot 11 Cohoe Subdivision, Anchorage, Alaska, Class A Public Water System, PWSID Number 212924, ADEC Project 9321-WV-020, Review Dear Mr. Moore: This letter is in response to your submittal, received in this office on April 15, 1993. You have requested that the Department waive the Separation distance from 200 feet to approximately 135 feet between a Class A Public Water System Source Well serving Cohoe Subdivision and a wastewater disposal system in which only the soil absorption system located on Lot 11 Cohoe Subdivision is to be replaced. I have completed my review of the submitted information, this office's file on Cohoe Subdivision which covers a waiver that was issued in August 1985 for the existing septic tank and the failed soil absorption system, and other pertinent information. Based on the results of this review, I have the following comments. The monitoring data tends to indicate that the aquifer and source well are not being directly influenced by improperly treated wastewater from the wastewater disposal system in question, nor from the other systems that are located within the 200 foot protective radius of the existing Class A Public Water System Source Well. Thus, it appears that there is existing evidence in support of the requested waiver without all the information required in 18 AAC 80.030 (b) being provided to this office. Therefore, in accordance with the provisions of 18 AAC. 80.030, the following separation distances have been granted: Between the existing Class A Public Water System Source Well and Septic tank from 200 feet to 135 feet. This waiver will also include the septic tank if it needs to be replaced. Ted Moore 2 May 11, 1993 Between the existing Class A Public Water System Source Well and Soil Absorption System from 200 feet to 137 feet. This covers the effluent line from the septic tank to the soil absorption system and the proposed soil absorption system. This waiver will remain valid until the wastewater disposal system on Lot 11, Cohoe Subdivision again requires upgrading, is modified, or the operator(s)/owner(s) of the Public Water System object to this waiver. At that time, either existing separation distances will need to be met or another waiver request will need to be submitted to this office. This approval does not imply granting of any additional authorizations, nor obligate any state, federal or local regulatory body to grant required authorizations. Thank you for your cooperation with this Department. To close out this project, please submit a copy of your April 15, 1993 letter sealed with your Professional Engineer's stamp. If you have any questions, please do not hesitate to contact me. Sincerely, ~4 Keven K Kleweno, ¢.E. District Engineer KKK/cf cc: John Smith, MOA, DHHS, On-Lot Services GREA,ER ANCHORAGE AREA BORudGH Department of EnvironmentsI Quality 3330 C Street Anchorage, Aleska ggS03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~ .~ MAILING ADDRESS ~/'C~J'~'- ~--~ Cg--ks~ PHONE SEPTIC TANK: DISTANCE ~ / ,~'/~ · _ FROM WEL~~ ~ANUF^CTURER MATER~AL INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY__ GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE FOUNDATION NEAREST LOT LINE DISTANCE BETWEEN LINES __ TRENCH WIDTH SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH,,~ OF LINES IN. TOTAL EFFECTIVE __ IN. ABOVE TILE IN. WELL: TYPE _ BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION _ DEPTH NEAREST NEAREST SEPTIC SEEPAGE LOT LINE__ SEWER LINE TANK__, SYSTEM OTHER SOURCES DISAPPROVED REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATE RIALS' LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM G.A.A.B. Form EQ-032 GreaTer ANCHORAGe AReA BOROUGH ~/ls~' DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~ SEEP FINANCED THROUGH TO BE INSTALLED BY DRAIN FIELD SOIL TEST RESULTS NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED AL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE PARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE Pit WALl SEPTIC TANK , SEEPAGE Pit TO NEAREST LOT LINE. WELL TO SEPtiC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT TO RIVER, LAKE, STREAM. DRAIN FIELD ., DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD sEEpAGE AREA SIZE TYPE ~T ~.1 OF 2- 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. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, DATE APPLICANT'S SIGNATURE FOF:~M NO. EQ-016 )RAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE il! MUNICIPALITY OF ANCHORAGE Development Services Department p P Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-051-24 Legal description COHOE LT 11 Site address 9215 STRUTZ AVE Anchorage AK Current property owner(s) JABAAY Expiration Date: X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 11 /21 /2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 5-0) lil'lf1UHMP A U TV OF !' HCHORZAGE Development Services Department r' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-051-24 Complete legal description COHOE LOT 11 Location (site address) 9215 STRUTZ AVE ANCH AK Current property owner(s) DERRICK JABAAY 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units X Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑■ Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ 50 / ) Waiver Fee $ Date of Payment , / /' J 1 UZ3 Date of Payment COSA # n,5C L{ Waiver # COSA Application —June 2022 COSA Checklist Legal Description: COHOE LT 11 Parcel ID: 015-051-24 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA 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 Static water level at beginning of test ft. Date Comments COMM. CLASS A WELL WITH DEC WAIVER B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: NEW PLASTIC TANK INSTALLED D. ABSORPTION FIELD DATA Which system tested (date installed) 5/20/93 RN ALL standpipes present per record drawing Total measured depth from grade 14 ft (max) Measured depth to pipe invert from grade 7A ft (min) ❑ N/A— pressurized field. ❑ Per record drawings, field is insulated. FN Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date COSA Checklist June 2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 7/24/23 Results Q Pass Fluid depth prior to test 4 Water added 600 gal New fluid depth 12 in Elapsed time 1440 min Final fluid depth 4 in in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 88.8 in Effective depth used 4 in Effective depth remaining 84.8 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No _ ft Neighboring Tank > 100' ❑ Yes if No _ ft Absorption Field on Lot > 100' ❑ 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 Neighboring Absorption Fields > 100' 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 X 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' ❑E Yes if No _ ft Surface Water > 100'❑ Yes if No _ ft Tank to Property Line > 5' ❑i Yes if No _ ft Wells on Adjacent Lots: Field to Property Line > 10' ❑E Yes if No _ ft Private Wells > 100' IS] Yes if No _ ft Water Main > 10' ❑e Yes if No _ ft Community Wells > 200' ❑ Yes if No *135 ft Water Service Line > 10' Z Yes if No _ ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS * CLASS A WELL ACROSS THE STREET IN THE GARAGE, SEE ADEC WAIVER 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 JVILe Ci /l( •4,1lGV4VN �/ f Engineer's Printed Name ery wee COSA Checklist —June 2022 Phone 727-8864 Date III?1/1Q. 1�• •�♦ { ••n♦ n i' :"`'• MICtfAEL N. ANVER:CH i. t' C 9 9 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) Legal Description (include tot, block, subdivision, section, township, range) Location (address or directions) (c) Telephone: Home '-~'~,_~. 'i--7 ~L'~ 7Business ....... ~-~,~:]~ Applicant Address '~_Z'~-,¢~O C ~f"J~"C~/L~£. ~?_~_~:~_~i~¢r~_--- ~c: Applicant is (check one): Lending Institution I-] . Owner/builder.,~l~; Buyer [] ' Other [] (explain); (d) Lending institution Telephone Address (e) Real Estate Company and Agent Address (f) Telephone Mail the HAA to the following address: TYPE OF RESIDENCE Single-Familyz~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well [] Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [~' Public [] Community [] Holding Tank [] Note: If community well system, rnust have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (1 1,U4) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm __ ~'~ Engineer's Seal DHEPAPPROVAL ~ ~~D Approved for __...~___ bedrooms by _ ate _ Approved Disapproved __ Conditional,, CAUTION Tile Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. ]-he Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 WELL DATA Well Classification Well Log Present (Y/N). Total Depth ~ Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer L~ne Cleano~t/Manhole Water Sample Collected by Water Sample Test Results Comments MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~------"'~ ~ ~"~'~'~' k If A, B, C, D.E.C. Approved (Y/N) Date Corn plated Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer., To Nearest Sewer Service Lithe on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed t~CN~,~,~ . Standpipes (Y/N) .~ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) {~ I Sepa ration Distances from Septic/Holding Tank: TO Water-Supply Well I ~-'/,. ~" TO Property Line I ~'-I' To Water Main/Service Line ~.'5' t ""J" Course ~,~ J ~ Size .~ ~ NO. of Compartments Air-tight Caps (Y/N) y~ Foundation Cleanout (Y/N) Date Last Pumped 'for Temporary Holding Tank Permit (Y/N) To Building Foundation /1~.!,../ To Disposal Fielc~ To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA ' Soils Rating in AbsorptioQ Strata Date Installed Width of Field Type of System Design Length of Field / ' Depth of Field '7 Gravel Bed Thickness .~ "1~ ~"" Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test / Separation Distance from Absorption Field: To Water-Supply Well ~ ~'{~ To Building Foundation J (:~ Lot J'~ To Water Main/Service Line Standpipes Present (Y/N) Date of Last Adequacy Test ~'/~'/~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Existing or Abandoned System on ; On Adjoining Lots ~.-~C)'"~-' To Cutbank (if present) ~/'J~ Comments LIFT STATION Date Installed Size in Gallons ~,~nhole/Access (Y/N) _ "Pump On" Level at / "Pump Off" Level at _ High Water Alarm Level at / Vent (Y/N) _ Tested for / Pumping Cycles during Adequacy Test. Meets MOA Ecl;C: ri::~ t:°des (Y/N, ** Check Permitted Bedroom Rating Against HAA Request ** Signedl certify t h~hec~k d~ed,~ -"-'-~" '"'- or conformedDate~/'7/~I~'~ 't° al lM CA and HAA guidelines in effect on the date of this inspection. Company ('~[4,1,'r~',~ ~ c~,~ No. Receipt No. '~ Date of Payment Amount: $ /~-L ~' ~ C;:(~ Engineer's Seal Page 2 of 2 72-026 [11/84) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 August 8, 1985 Mr. Charles Gold 9215 Strutz Avenue Anchorage, Alaska 99503 SUBJECT: Waiver Horizontal Separation between ~ell and Septic Tank,(8621_t,,~A_O39iLot 11 ~Subdivision, Anchorage, Alaska Dear l,lr. Gold: The Department has reviewed the subject waiver request and hereby condi- tionally waives the horizontal separation between the well and septic systems as follows: 1. 87 ft. from well to septic tank on Lot 1 2. 125 ft. from well to drain field trench on Lot 1 3. 164 ft. from well to septic system on Lot 2 4. 135 ft. from well to septic system on Lot 11 The waiver is conditionally approved upon receipt of the following infor- mation from the engineer or the owner: 1. A plat of the subdivision showing accurately engineered drawn septic system locations, specifically that of lots 2 and 11. 2. A current primary inorganic and bacteriological water tests. Fulfillment and acceptance of these conditions must be met before full approval may be given. If you have any questions, please contact me at 274-2533. Sincerely, Michael P. Lewis Environmental Engineer MPL/msm MEMORANDUM (Brief commu nic, ations) State of ~.laska TO: FROM: SUBJ.: Name. ~ Dept./Div./Sect. 02-001C (12180) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEAL'¥H AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472O Application Date GENERAL iNFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 11 Block 1 Coho Subdivision Location (address or directions) 9215 Strutz (b) Applicant Name Chuck Gold__ . _ Telephone: Home __'~,49-Z65.Z ..... Business Appiicant Address 2450 Cinnabar Loop 99507 (c) Applicant is (check one): Lending Institution [] ' Owner/builder'~:l' Buyer []; Other [] (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family ~z~ Multi-Family [] Number of Bedrooms (4) Four Other WATER SUPPLY Individual Well [] Community:[~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public[] Community[] Holding Tank[] Note: If community well system, must have written confirmation from tile State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 ~-0~,~ ENGINEERING FIRM PROVIDINg, ,¢ISPECTIONS, TESTS, FILE SEARCH, DA',.. AND INFORMATION As certified by my seai affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approva~ shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposat system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Address Date This Department has received written confirmation from the State DEC office that all conditions have been met, Therefore the subject property meets all MOA requirements. Engineer's Seal Approved 2 .................. DisapproVed// '-- ~/ - Conditio'f'raf, Terms of Cor~c,~o~'.a~ Approval ........... CAUTION The Munc~paht/ of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval cedificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered ,r, the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in otter to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certihcate is issued The Municipality of Anchorage is not responsible for errors or omissions in the professiona! er~gmeer s work. Page 2 of 2 72-O25 ! 11 ,~;4. 3330 GREATER ANCHORAGE ARL/, BOROUGH Department of Environmental Quality "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES · l. Type of InspectiOn: ' CMRO 2, Property Owner; ~/b~l~)~ Mailing Address: ~ il. I(~ 3. Name of Buyer; C~lx~(b~Lx Mailing Address: c~/~~- 4. Name of Lending Institution: Mailing Address: Phone FHA CONV X . Phone Phone 5. Name of Realtor or Agent: Mailing Address: Phone Legal Description': /_oF' Location: ?~'~'~ .Type of Facility to be inspected: ~?~s~ ~cU No. Bdrms. ~m Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served If Individual, depth of well ~Jm Sewage Disposal'System Type ,of S~stem: Public Utility Individual (on-site) If Individual, date of i.nstallation /~6~ GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ;/~--~/I 3330~"C" Street, Anchorage, Alaska 99503 274-4561 '/i[.~/~ iii~ (~ ~'/~ ~ ~'ii it~ !~ ~ ' i~ Date Received ~ - /7 - 7~- [ :.~ Time of Inspection , Date of Inspection i REQUEST FOR APPROVAL OF 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3.. Legal Description: ,~-~ // .4. Location: ' .,~,~/,.q' 5. Type of facility to be inspected ~~ No. of bedrooms 6. Well Data. ~, ~.~_.~ J,~ 0 / A. Type B. Depth o~o C. Construction D. BaCterial Analysis 7. Sewage Disposal System: A. Installed ~-f/ /~.~ B. Installer .~-~I~'~,~_~_ - C. Septic Tank' ~1 Size /-~0 2. Manufacturer ~ · . D. Seepage Pit: 1. Absorption Area - ~}L ~.~/dMaterial E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank ., Absorption area //~-/, Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank ~ , Absorption area C. Absorption area to nearest lot line "~ EQ-034 (1/74) Page 1 of two pages Lo-/- i'1 CoH o~ ~,,~o ,z.~ oo $ ¢ ¢ Page 2 of two pages - R L~gal Description :st for Approval of Individual ~er & Water Facilities Comments Approved ~,"'~ ~"~'~"'~ Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74)