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HomeMy WebLinkAboutCOTTONWOOD HEIGHTS BLK 1 LT 9wood N LL w LL° w w LL C7 N Col 4�1�►\l,� m a� O O 1 1 v� A r A•. .•`�) d ° ° _0 L n m ... r .'n. C7 CL -O n a> Fm U 45 iJ 00 ° E o 0 o N s ° ° co N O ' • _ N• Lll �w�o� El ❑ C9 v w m ca a a75 n • N z C:ani ° (7 C7 J 0 - c U E z U w C) C7 •• �� t? . •���rj� N LL LL F.. F c ° s ° ) o y• .� I . 1` T •r o O N N Wcn ; rn z o �I r d c;W , L p@ N m � w = E J5)° dr� W Oo mm o) z ui uC� OO m❑s ti Z c El W WcL p a) a) F -C: 0 WoZ Z —2- Z Q J Q yE_Z6 CD `�aIL Q) a) > 0 o El _ O a cm N a ca m Q�z o 0 ❑ � r ' � z� `° ��Ll- � w z � aQ ❑ ❑ � c LU W Q cn o IT c� F- H J� Q a p w CL j Q- J CV iii -U E c �/� ❑ Q] J v� Q �j ° coLU @ j i6 ❑ Q Y N E YW o = v C a)Q Z m r .0 N N C w w o 0 El m J ar N z O = U o Q m rl-z cn O LLI LUco U n o L O W J J Z O Z U) U- a a N CoW W _ — H 2 H -..-..._................. --- — U) CD z U a_ � O (n ° Y a� + O O + - + o m (y �' > w o H ai O m Z 0 pp 0 w O 6) M O O y P Cl) c - to Q O aN U)m m (n 3: ° o _ - .-. - -- ---- 0- U Z Q (n Z Z m J �— a a� a 0 co . 2 E ° CD � .2 MI)m = CL J ° a� 3 Em Lu �'o L W o O 3 U o w E o �, LL n o U CO LL 0 z -� in N a J cn r WlI I I I I N Cl ifl PID:051-431-22 PERMIT:OSP231374 FIRST WATER CONSULTING COTTONWOOD HEIGHTS B1, L9 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: OSP231374 Effective Date: Work Type: SepticTank Upgrade Expiration Date: Tax Code Number: 05143122000 Site Legal Address: COTTONWOOD HEIGHTS BLK 1 LT 9 G:0756 Site Mailing Address: 20108 KABOB CIR, Chugiak Owner: LEONHARD JERRY D & BONNIE J Lot Size in Sq Ft: Design Engineer: FIRST WATER CONSULTING Total Bedrooms: This permit is for the construction of: r� Department 11/8/2023 11/7/2024 64033 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • Prior to construction, the field is to be located to ensure that the required separation will be met. Receiv l r:SS�,ce� +C' .}'�iCl Date: Issued By: Date: 3 MUMCIPL' 0 TY OF"HC HOFRLGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section _- Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-431-22 Property owner(s) JERRY & BONNIE LEONHARD Day phone Mailing address PO BOX 671864, CHUGIAK, AK 99567 Site address 20108 KABOB CIRCLE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) COTTONWOOD HEIGHTS BLOCK 1, LOT 9 Legal description (Township, Range & Section) Lot Size 64,033 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 17 1 (w/wo ADU) Septic Tank El UpgradeX Duplex (D) El Holding Tank El Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ 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: — �� S Waiver Fees: Date of Payment: _ / Date of Payment: Receipt Number: 8 / / 3 Z Receipt Number: Permit No. D S P Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! October 31, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: COTTONWOOD HEIGHTS BLOCK 1, LOT 9 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. We would recommend a 1500-gallon HDPE tank be installed for current functionality and future consideration or flexibility. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank may be required. There is an existing decorative artificial lined pond that is downhill from the existing septic system on site. This lined pond is filled and drained periodically in the warmer months and is not a source of contamination for any potential groundwater, surface water or transference of effluent acceptance of the site or adjacent sites. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231374, Deb Wockenfuss, 11/08/23 FIRST WATER CONSULTING COTTONWOOD HEIGHTS BLOCK 1, LOT 9 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231374, Deb Wockenfuss, 11/08/23 m KABOB CIRCLE cli c FOUND 5/8"� REBAR (TYP) I I I UTILITY EASEME\NTI \I LOT 3 LOT 4 FOUND 5/8" REBAR IN CONCRETE LOT 5 NOTES I L=32.18' R=50.00' UTILITY PEDESTAL LOT 7 LOT 11 LOT 8 GUY I I I I I I Y -ULt— I ANCHOR 1 1. UTILITIES OTHER THAN THOSE SHOWN MAY EXIST ON THIS SITE. ONLY THOSE UTILITIES SEEN ON THE DATE OF SURVEY ARE SHOWN HEREON. 2. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. 3. THIS DRAWING WAS PREPARED IN ACCORDANCE WITH THE A.S.P.L.S. MORTGAGE SURVEY STANDARDS. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY DATA SHOWN BE USED TO CONSTRUCT ANY FUTURE STRUCTURE, FENCE, OR ANY OTHER IMPROVEMENTS. 4. ALL BEARINGS AND DISTANCES SHOWN ARE RECORD, UNLESS OTHERWISE NOTED. 5. THIS ASBUILT DRAWING CAN ONLY BE USED FOR ONE TRANSACTION & ONE YEAR FROM THE DATE OF SURVEY/REVISION. REUSE OF THIS ASBUILT WITHOUT CONSENT OF BULL MOOSE SURVEYING, LLC. IS A VIOLATION OF FEDERAL COPYRIGHT LAW. ASBUILT SURVEY ©BULL MOOSE SURVEYING 2023 LOT 9, BLOCK 1, COTTONWOOD HEIGHTS PALMER RECORDING DISTRICT, ALASKA RVIS44 I DATE YCERTIIFCATE: 'm ��.�F•A` q MORE GAGE SURVEY I HEREBY CERTIFY THAT I, OR BULL MOOSE SURVEYING LLC _�P.•' ••.•S - �j; SOMEONE UNDER MY DIRECT SUPERVISION, HAVE PERFORMED A • �' 49TH '.• 200 HYGRADE LANE, WASILLA, ALASKA 99654 MORTGAGEE'S INSPECTION ON THE •••• (907) 357-6957 office©bullmoosesurveying.com FOLLOWING DESCRIBED PROPERTY, o �,�_0 AND THAT NO ENCROACHMENTS ••••••••••••••...... VISIT US AT BULL MOOSE SURVEYING.COM EXIST EXCEPT AS INDICATED. OWEN THOMAS DICKS 0 ® o '••LS -184515 •' o� Ar ��® DRAWN BY: DATE OF SURVEY: PREPARED RSD 10/9/2023 FOR: JE SSo�al..La�a c��®® CHECKED BY: SECTION TWP. RANGE ALE: ORY DOCUMENT: TGC/OTD 29 15N 1W S.M. 1"=60' 1 PLAT #71-291 lk®V  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME IPHONE [] UPGRADE MAILINGADDRE~,/~-- ~ o~' ~' i~(.~//~/C~(¢-//V LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS ~ ~ DISTANCE TO: /~ Z /~ ~ Manufacturer Material No. of compartments Liq. capacity in gallons Inside length Width Liquid depth / [~ ~ ~ IF HOMEMADE: ~ DISTANCE TO: Well . ~welling PERMITNO. 0 ~ ~ Manufacturor Matorial Liquid ca~acitg in ~allons ~ ~oll /~ ~oundation m~ = DISTANCE TO: //Yr ~O ~ Nearestl°tline,~O 5 PERMITNO. __ ~, ~ Ne. of lines /n Length of ea~i~ ,_ Totallength~ine, / ~'~ ~ Top of tile to ish grade Material beneat~tile Total effective absorpt~n area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class ~e~t~_ Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATIN~ REMARKS . j  DATE LEGAL lev. 3~78) Permit ~ :/ Applicant: / .~//<~' Location: MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta Protection 825 L Street, Anchorage, AK. 99501 -- 264-4720 (? * * * HANDWRITTEN PERMIT * * * ~~"~~~ym. Yt~, WELL AND/OR ON-SITE SEWER PERMITC-;'-~ ( ~///7~X~ Mailing Addre s s~ 3 .~/~bF~/~., ,, Phone Number: Lot Size: Legal Description: Type of Soil Absorption System Is: Trench: .~_.~,, Drainfield: Maximum Number of Bedrooms:~-L~ DEPTH Seepage Bed: Holding Tank:~----/---- ~ Soil Rating (sq. ft/br) //~. , / z The Required Size of the Soil Absorption System Is: LENGTH ~ 3'--' GRAVEL DEPTH ~ WIDTH ~>~C> ~ The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(+~q~G) TANK SIZE = /O~j GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 $ 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I wi~nstall t~ system in accordance with codes. , (3) I ~hde~s~nd t~t the on-site sewer system may requ~i~e enla~e~ent if ~e, ,,:/~,//~~s~~s remodeled to include more th~ ~:rooms/, / ~ S igne~.(////~/~//~/~- Issued by: ~~~! / ~~ant L/ Date: ~~/C~ ~ SWP/024 (i/si) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST DATE PERFORMED: SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O COMMENTS WAS GROUND WATER Al ENCOUNTERED? / v ~ I~ O P E tF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) TEST RUN BETWEEN FT AND ~ FT CERTIFIED Robert A, Shofer S No, 1457-E P RME ~RB ~' P~, 694-2979 · 72-008 (6/79) LOCATION OF WELL (Please complete either to, Ib or Ic.) WATER.WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys Drilling Permit No. A.D.L. No. lo. Borough 1 Subdivision Lot Block Ib. I/ggirs• Section No. Township N11 Range E0 Meridian Anch ,ottomr�.od 9 1 —of—of—of Sp WO to DISTANCE AN D R CTION FROM ROAD INTERSECTIONS �i��is 3. OWNER OF WELLk -f Mr. Jerr;; Leonard i� Address: Box 65, 20 Grand Rd. Street Address and Area of Weil Location E ter R.1Ver 1ik. 995 77 2. WELL LOG Feet Solo w Surface 4.. WELL DEPTH: ( final) 5. DATE OF COMPLETION � fl. 6 _ 1 _ 7 Motariot Type Top Bottom _�_ 01 Q Gravel. sand, silt 6. 0 Coble tool 30 polory C] Driven 0 Dug ❑ Auger OJetted 0 Bored 0 Other: Gravel moist sand 60 80 ' GravelGravelq sandt, water incl 80 96 7. USE: IgOomeetic O Public Supply 0 Industry T C] Irrigation 0 Recharge C1 commerical ' p T.ef Well [D other: S. CAST G: Q Thnreoded Welded dlam, in, to a6 fl, Depth Welgbtii `� be,/ ft. diam. In, to ft. Depth Stickup It. i 9. FINISH OF WELL: I Type: Diameter'• Slol/Mesh Size: Length: Set between ft. and ft. Backfilling Gravel pack 10. STATIC WATER LEVEL: ft. Dote E] Above or 0 Below land surface Equipment used: II I. PUMPING LEVEL below land surface end YIELD - ft, after hn, pumping g. p, m. ft. after hrs. pumping g.p,m. 12.GROUTING Well Grouted: [] Yes 0 No Material: .Q Neat Cement 0 Other: ' 13. PUMP: (If available) HP Length all Drop Pipe ft. capacity g.p.m. G 0 Subm. O Jet 0 Centrifical 0 Other 14. REMARKS: i Lail tested at 5 GTT. 16. WATER WELL COQ : TRACTOR'S CERTIFICATION 15. Water Tamperafura ° 0 F 0 C I( This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; 1:u ;f r:ueon Drilling AA 5385 Registered Business Name Contract License Number Fox 504 Lagie River, „k. 99577 Address:F.o. Signed: / /r a► DoteJuritr 2, 1983 lAuthorized Representative Form 02-WWR (11/61) Copy Distribution: WHITE - State OGGS, PINK - Driller, CANARY- Customer C-Ctp1;6S io/Sb U i ��Uision� rg7 /3689 wee as ' FOm haus: DEPRF.:TMENT OF HERLTH RND ENVIRONI'tENTI'RL PROTECTION ::.:25 '"L"' STP..EET., RNCF.IOF:'.RGE.. RI.::; WI:,4-4,'.-'~ FtNCHORRGE ,'5 S, 4 .-. . ~ '1Z.': '1 · EFIGLE RIVER C,~"-.I ....... 5 I T'E L--~ELL F'E 'F-'"I'"I I T PE~:I'"I I T NO. :'~:]:iE~l RPPLICRNT: .TEF.:'R'-r' LEONFIRD PHONE: FIDDREZS: 20 GRFIND ROD EFIGLE F.: I',,.'ER., RK '_:'.?.56? LEGFIL DESCF.'.IPTIO~ SUDDI',,.'ISION: COTTONHOOD HTS BLOCK: :Z LOT: '_,9 LOT ~,IZE 0 S(;..'. FT TOHNSHIP: - RRNGE: -- SECTION: '- i CEF. ITI F~r' THFtT: '.L I RM FF'IMILIFtF:'. HITH THE REI;!UIF.'.EMENTS FOR ON-SITE SEHEF.'.S FIND HELLS FIS SET FORTH E:"r' THE MLINICIPFILIT"¢ OF' RNCHORRGE RN[:' THE STRTE OF RLRSKR. 2: I HILL_ tNSTRLL THE '"-;"¢STEM tN RCCOF.'.DRNCE HITH THE CODES FtND HFt',/E RECEIVE[:, R COPY OF THE CODE SUMMF'IF,::"r' FIN[:, DIFIGRFIM RTTFICHMENTS HHICH IS PFIF.'.T OF TI'"tI""4 PERM I T. ~:. I UN[:,ERSTFtN[:' 'T'HRT THE ON-SITE SEHER S'¢STEM MR'¢ F.'.E~UIF.:E ENLRD. GEMENT IF THE RESI[:'ENCE IS F.:EMODELED TO INCLUDE MORE THFIN 0 E:EDF.'.OOMS. PE'RMIT FtPPLICFINT I"'IF'IS THE F.:ESPONSIE:ILIT"¢ TO INFOF:'.M PERSONNEL [:,I. JF.".ING TFIE II"~STFILLRTION INSPECTIONS OF RN~r' HELLS R[:'JRCENT TO THIS. PROPED. T'¢ FIN[:' THE NUMBER OF RE'=;IDENCES THF'IT THE HELL HILL SED. VE. IF R LIFT STRTION IS INS'T'FILLED., RN ELECTF.'.ICI--IL PERMIT FIND INSPECTION MUST BE OE:TFIINE[:'. RS-E:UILTS CFtNNOT BE RPPF.:OVED HITHOUT FtN ELECTRICRL INSPECTION 'REPORT. THE ELECTF::ICRL 140F.:I< MUST E:E DONE B'¢ tR LICENSED EL. ECTD. ICIFIN: SIGNED: FfPF'LICFINT: JERF..'.'¢ LEO,"4FIRD ISSUED D',,': DRTE: MUNICIPALITY OF ANCHORAGE Department =. Health and Environmenta? ~rotection ~tOG., I 825 _ Street,264_4720Anchorage, AK. .3501 ,"~ /"~ * * * HANDWRITTEN PERMIT * * * Applicant: ~ Mailing Address: Location: Phone Number: Legal Description: ~~~ /,T~/~/ Lot Size: Type of Soil ~sorption System Is: ............ ~-~ S~d ~ Holdzn~ Maxim~ N~ber of Bedrooms: Soil Rating(sq.ft/br) DEPTH The Required Size of the Soil Absorption System Is: ~,,_~/~ - LE~CTH-~ GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width' for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE-~ GALL'ONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 51, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if t~residen~/~ ./ /7~ J,~-- -~-is remodeled to inCludeissuedmOre~~ SigneR: ~~~~ ,we. ~., by: _ ~pli~ant ~ ~-~~ Date: ~- SWP/024 (1/81) C) r- r- cY) c0 M C? I,- ti O o G) CF) CII O Q Q N N U) CO a) C O O a) N U W If O N N N cu 0 C O N a- x x W C] C) O N N i C`7 LO C] 0 a� cv a o� J r ~ Y Lo J CY) CO O) CO Y I— Q '2 � V W = U O 0� O/U) 00 O m H Y O co U _o c O 0 N Q u) U N U) Q) 0 a -a a M J Cl) W Z m 06 W Q Z O LUJ U a) C O Q O Q c Q) U N O 0 a) AM `O () > O Q a cu a� cu D U) O m U c O a) M E O N O N N N 00 O 0 m U Q) U c u N t 14 0 N a N U LL N C: Q cn U C. Q Z W0 -0 U Q 1— O 2 U Q F- F - "t ti CD O7 mAA Nt co M rl� ti O7 O7 T - O n. U U) m ^_Wl W a 0 U u O H run V ) � a `~ TO L �i V Z Vi LLQ r I a �o � U C C a) U) V � � L Q Z � � U L T - O n. U U) m ^_Wl W a 0 U u T a) LL m C I c m >, cu a 0 a) cu ❑ U ) `~ L Vi n~ LL 0U) V N 3 m O N d Q. _> C ❑ U i U C 0 C E N U 0) C/) a �, F .Q ❑ U _0 O a) w L O j E0 U ❑ U cn cm U En N ❑ ❑ 0 C) 0 '-.U-.. LL El VJ W U)Gn)' ❑ nnl� En O L O N ® N 'O a) O U c O O O N ® ❑ U L m W m '�"' ❑ Q) ElL o C. S MI > > Q O i (D U) O U U) NN 41 cu ~ s O ® ❑ ❑ aw U' L W-� ® O Q ❑ ,C aLU_ U) ❑ V5 d F" Q a) o "� cn N U) ( O a) J o d >, W F- El co LL N cc FW- F- in W 3:Q I O L *+ U)- a) 4 � W LL O LL O W /\ a. L 1� U Z w L i Za. a. IL (1)V ♦ L � Q. O H H � Q Q > M m` Q > N ori d ui co W m 0 T a) LL m C I c m >, cu a 0 a) cu ❑ COSA Checklist.docx COSA Checklist Legal Description: COTTONWOOD HEIGHTS BLOCK 1, LOT 9 Parcel ID: 051-431-22 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 6/1/1983 Total depth 96 ft Cased to 96 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 10/25/2023 Static water level at beginning of test 89 ft. Well production at time of test 7+ gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 2.34 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 5/21/2024 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/11/1983 ALL standpipes present per record drawing Total measured depth from grade 7.1 ft (max) Measured depth to pipe invert from grade 3.6 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 3.5’ 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 10/25/2023 Results Pass Fluid depth prior to test 8 in Water added 540 gal New fluid depth 10 in Elapsed time <15 min Final fluid depth 8 in (30” ED Missing – See note below) Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 72 in (MOA 6’ ED) Effective depth used 38 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 34 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per visual observations, measurements & appears approximately 2.5’ or 30” of ED is missing. 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) 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 8/5/2024 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 & 8/5/24 1. KABOB CIRCLE Rzz,50 .0 L 13:?. t C) LLJ LLJ 0 D 0 00 0 (0 /Y,--50.00 7-10 1 50' LOT 10 BLK 1 LOT 9 BLK 1 • SEPTIC PIPE (t yp GRAVEL D/W 4? MH tK 0 10' UTILITY ESMT S89*5'38"E 370.00 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: COTTONWOOD HEIGHTS LOT 9 BLOCK I PLAT 71-291 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shouk any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of anv easements, covenants, or restrictions which W do not appear on the recorded subdivision plat. WORKORDERNUMBER DATE: SCALE. E—MAJL: JULY 20, 2024 1 -,--.250' schullerakOgmail.com 24-076 DRAW BY. CHECKED BY; WD NUMBER: BOOK ACE: JLS NW0756 240250 * = FND 5/8" REBAR A%q1q1h4b1-1Q' 44 , SUR Aft -w", �440 ,a 0 F 4 AOW 0� W 'P 4 TH 9TH .......... ... ?A WA sir A..................... JOHN L. SCHULLER.-* OR LS -10408 1831 Talkeetna Street 6 Anchorage, Alaska 99508 A6W essiono, (907) 227-1455 office (907) 274-4992 fax ARTIFICIAL POND .01 1.5' x 8.5' BW CANT 104.5' 2'x8' 1�0_ 8.0' FP CANT 2x26' PLAY HOUSE WIRE QG CANT FENCE WELL 0 10' UTILITY ESMT S89*5'38"E 370.00 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: COTTONWOOD HEIGHTS LOT 9 BLOCK I PLAT 71-291 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shouk any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of anv easements, covenants, or restrictions which W do not appear on the recorded subdivision plat. WORKORDERNUMBER DATE: SCALE. E—MAJL: JULY 20, 2024 1 -,--.250' schullerakOgmail.com 24-076 DRAW BY. CHECKED BY; WD NUMBER: BOOK ACE: JLS NW0756 240250 * = FND 5/8" REBAR A%q1q1h4b1-1Q' 44 , SUR Aft -w", �440 ,a 0 F 4 AOW 0� W 'P 4 TH 9TH .......... ... ?A WA sir A..................... JOHN L. SCHULLER.-* OR LS -10408 1831 Talkeetna Street 6 Anchorage, Alaska 99508 A6W essiono, (907) 227-1455 office (907) 274-4992 fax