Loading...
HomeMy WebLinkAboutFIRE LAKE #2 BLK 2 LT 2Onsite File x Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 181107 PID Number: 051-351-22 Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) El Multiple (SF and/or D) Project: El New I Upgrade Name: BLANCHE STRUEMKE ABSORPTION FIELD Address ❑Q Deep Trench ❑ Shallow Trench El Bed El Mound ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 1.2 GPD/SF 10.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.0 Ft. 7.0 Ft. FIRE LAKE #2 2 2 Fill added above original grade Gravel length Township Range Section 0.5 Ft. 40 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES ,) �4 2.0 Ft. Ft. To: Septic ;Absorption LHolding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 560 Ft2 1.0 Ft. Well 100'{. 100'{. 50'+ TANK ❑ Septic 0 S.T.E.P. ❑Holding 0 Other Manufacturer Capacity Surface Water 100'+ 100'+ Gal. Material Number of compartments Lot Line 10'+ 10'+ NA Foundation 101+ j 101+ LIFT STATION _ Manufacturer Capacity Curtain Drain UN UN ANCH TANK 1500 Gal. Pump on level at Pump off level at High water alarm at Remarks 36 in. 24 in. 40 in. Pump make and model Electrical Inspections performed by STANDARD PREMIER ELECTRIC PIPE MATERIAL House to tank 3034Tank to 3034 Installer drainfield MIKE ANDERSON Drainfield 3034 CO/MT 3034 Inspector MIKE ANDERSON, P.E. BENCH MARK (Assumed elevation)96.8 ft InspectionLocation and description dates: 1` 8-22-18 2 8-22-18 3'1 Ott' BACK DOOR PAD COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Erik .ita p Conditional Approval: Date '`�'•• :s��? del •*: 49TH •.* lit %I MAN S4 — s // _• MICHAEL N. ANDERSON •,' .'s �•. CE 46 s '; ii •.V/11//.`4,:c:;'.1,..-' Approve t.% Date X27-1 P Inspection Report_9-1-12.doc • OSP181107 Page 2 of 2 Permit No. 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: FIRE LAKE #2 BLK 2, LOT 2 PID No.: 051-351-22 MARK Ai / B ,11 �\ / \ TC01 711 I 35 \ I // • I \I CO2 7 30 �\\\\1\ \1 // MT1 45 X / 1 MT2 5 53 \\ / 1 1 / I _ I I ® va�ou� I ail OLD SYSTEM DECOMMISSIONED%c�P v 1 p e.) 1 I \ / \ / N \ --- / �\ \I \ 1 \ / / N \ DRIVE ' / '}'"-- \ \ • N / BENCH // �\ • \1 . / \ \\ r El 1 / \ / I / \ / 11 / C X I I /1 1500 GALL N STEP ITAIN C II I J I X /� 1 I X /// I �r XISTING WELL\\- CO1 //� MT H / / 1 / \ RESERVE AREA 8,— /IC 11\ / LJ—'1-- Cb 11 / \\ / I • I TC r l \ / \ Nil / / I /-',- �4SQUI T' I SEPTIC SCALE: '1''50' > , roof 1-002 i TCO1 Ler 5 A 2 T/ ii 2. .iaakr\•1t.44 2 �NH �� .•••��•O- !1/ A/• 7111E .0 070 / i• • ,•�/ FILM FABRI0— : 49 /1 •♦1� TH ` 9, / '500 GALLON sn�a won ( • •• /%� • , STEEL STEP faux 97 • Y • 90 / MICHAEL N. ANDERSON; ;� 04�% No. C 99 •�� •• Vf7?7I SEPTIC SECTION it/JD ea — .� \ vim. v,44 N.T.S. pi O 7?71"i ,1I1\1»�11' • Municipality of Anchorage !�.'1"ECa'S• A?,s _-� Development Services Department r (1.• ••;o- 0 On-Site Water and Wastewater Section /0 . •4 9 T ',T'� �� 4700 Elmore St. �..•, • • d 1 •11 c:141° P.O. Box 196650 Anchorage.AK 99519-6650 ••'°''••• •••. c\.-.4%. . www.rnuni.orq/onsite �• • .. . / (907)343-7904 MICHAEL N. ANDERSON :4'4..7. 4 ,d r"----.__._.--- ti "'.1-r./.... CE-9469 .; � • Soils Log - Percolation Test �I�-PF••• . ••,.,`>' - Performed For: (9W ,n 1P t.1"/ �Z4( �V✓'. Date Performed: \� Legal Description: F., r G L v kc_, qe Z Township,Range,Section: I- J_ Slope Site Plan .r. 2, L v Depth • (Feet) • 1-_ 2- `J 'C e_i_ 3- 17/ -re-- • 4- 0A14 5- 6 r n/\ . 7- 8- e-ii Ay WAS GROUND WATER 9- (:7V-Ove( ENCOUNTERED? 0 S 10- IF YES.AT WHAT DEPTH? L o . Depth to Water After P 1 1- Monitoring? VE . 12- D.,te Z7// 13- 14- Reading D to Gross Time Net Time Depth to Water Ne;Drop 15- 51/7/47 IONS/ V V17 ---- 16- 1(/I 1,4( S 17- v ‘1.44/4/0 ,/ Yr r _ 171,5- 18- 1 [I 6c .. - 19- 20- PERCOLATION RATE 2, (minulesiinchi PERC HOLE DIAMETER te TEST RUN BETWEEN 3 FT AND Cp FT COMMENTS --i- ht (2 erwl"..�. tr .• /, 40//444is PERFORMED BY: 1 )\i./!` I CERTIFY THAT THIS TEST AS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1/ Z. MUNICIPALITY OF ANCHORAGE On -Site Water& Wastewater Program POBox 1966n 470mElmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 Permit Number: OSP181187 Work Type: Septic Upgrade Tax Code Number: 05135122000 Site Legal Address: FIRE LAKE #2BLK 2 L 2 G:0454 Site Mailing Address: 13Q13SAVAGE DR, Eagle River Ovvnac Stnuomke8|annhe Design Engineer: ANDERSON ENGINEERING This permit infor the construction of: ZDisposal Field 10Septic Tank DHolding Tank [] Privy A-IFTY4AT419- =.- Lot Size in Sq Ft Total Bedrooms: 5/2y/2O18 5/20CZ01Q El Private Well 11 Water Storage All construction shall beinaccordance 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 (1 8AAC72) and Drinking Water Regulations (1 8AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.S5.Provide notification bycalling (QO7)343-7QO4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing 19 -- �r`�t1 � R"!o-- i' ' ' OT e) & ce_ ] 0o- � '+~ �/{Lr� {�»/l-l~ ^ -^ / y I- 2) -e-°L hu/r y `,/ /�y0/4`4m%4c - - rr,v ^ J �o -L� y�\r`� o4 -7` ��/ l �r ` / .^ ~~"~�' / /" �/uc/ y re I o o�i' Received By: 41 Date: 9%* MUNICIPALITY 0-F ANCHORAGE � 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. 051-351-22 Property owner(s) BLANCHE STRUEMKE Mailing address 628 LEMON ST N, HUDSON, WI 54016 Site address 13913 SAVAGE DR, EAGLE RIVER Day phone Legal description (Sub'd., Block & Lot) FIRE LAKE #2 BLK 2 LT 2 Legal description (Township, Range & Section) Lot Size 49658 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 0 Upgrade 0 Duplex _., ❑ (D);" Holding Tank ❑ Renewal ❑S. - - Dwelling ❑ iltip(e Privy ❑ Q (SF and/qE, . Private Well ❑ �� ^: Water Storage ❑ o rv^ 3 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: 8 c.o _ �a -1-11, UQ J +0 I,T 7£Z� Distance: 0.O � , I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of owner or authorized agent) Permit/Rush Fees: $ 916 .q6 Date of Payment: Receipt Number:a��J �( g Permit No. 015p12116 Waiver Fees: 0 21.E Date of Payment: 7 g Receipt Number: 5 Waiver No. OSy 1 g O GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Waiver#: OSVI81063 COSA#: Permit#: OSPI81107 PID#: 051-351-22 Legal Description: Fire Lake #2 Block 2 Lot 2 Engineer: Mike N. Anderson Applicant: Richard & Susan Westlund Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the �7, on-site wastewater disposal system will require all separation distances be met or another approval from this department. a 2 2 M a a a a a a 2 x a a M a a a 2 a M a 0 a M a a a a a a M M a x a a a a 2 2 0 M a M 8 a a a M M a M a a a a M a H a a a a 0 z 2 M a a 0 a x a a 0 a M I Waiver is Granted: x Waiver is not Granted: Date: S/f 7/1 g Approved by: Name of Reviewer a a a a 0 a a a K a a z 0 0 0 M M a a a a a M M a U 2 a a 0 1 MITUIV, MITI I I I F /\u' 17. 2018 K4Lill icipu|hicaofAnchorage Departments ofHealth and HumanServices P.O. Box 196650 /\nchora�c,/\|usko995l9'665U Fax 249-7847 Re: ChmmeOrder for New Septic Permit (OSP 1Nll07AND To Whom it may concern: This isurcques for a change order for the CUrrent septic permit upgrade oil the above referenced lot. &ncw test hole was excavated and found OMand GYVgravels and nowater. The system hn/numoved duetothe better soils and open space. The lot slopes 5tm |Opercent near the new location for the leach field, see the site plan, then flattens out to less than 5 percent. This change order will not impact any of the nei0liborini, properties due tothe lot |ayou1. /~ We are also roquemLiugo lot line vvuivctdueVothe existing well radius, see the site plan. Please call me if VOLI have anv qUestions. Sincerely Michael N. Anderson, P.E. 4661 Natrona Aoch,/\k9y5l6 Ph 727-8864 DESIGN CRITERIA:, MOUND OVER (TH11) GRADE o GRADE 4 BDRM X 150 = 600 GPD SOILS = 600/1.2 = 500 GPD 1.0 ORG FILTER FABRIC ' & INSULATION 500 GA/12 = 42' -2.0 1.25"0 PIPE GM/GW (1) TRENCH SEWER ROCK . 8.0' DEEP :?,a ' EFFECTIVE 2.0' WIDE 19 12.0' O'LONG I SEPTIC FIELD SECTION /0 r --------- ------ -BARNES AVE- _ — — — — — — — — / \\�_S PTIC EXISTING HOUSE ��' \ ---/ PROPERTY LINE PROPOSED I� DRAINAGE FIELD\ \ WELL I Ii i EXISTING WELL �� 100' RADIUS > ' ` 1 S PTI �SECONDARY SYSTEM, TEST } I HOLE REQUIRED i Septic Design Prepared for BLANCHE STRUEMKE ��`P.•... "' qS®, FIRE LAKE #2, BLOCK 2, LOT 2AF 000 Eagle River, Alaska ..... Iff 49 TH �•.................... I................ . . Mic �� •MICHAEL N. ANDERSON DATE: 8/12/2018 '!0 No. C 9 9 ' 4601 NATRONA AVE AV DRAWN: DJR AV ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1 "=200' ��r4�-E i I FIRE LAKE I LOT 3, TRACT 6h \�� � ` yj I Z / EXISTING ti I / ( i ( Lu 2 !f HOUSE �t� / 1 w Ixy �� I w I I Izi I I I Io 1 ( ! ! I 1 ! MAPS SHOW l� I FIRE LAKE P2 PROPERTY LINE EXISTING WELL STREAM, WHICH LOCK 2, LOT 1 / 100' RADIUS GOES UNDERGROUND FIRE LAKE 42 i' / '`.� LOCK 2, LOT 2 BARN I SHED ��\ 5-10% \ W\ <t j LOT LINE I / { WAIVER I x-' XI w Ii REQUESTED �' I ,I' ARENA 111 ( a WELL EXISTING I I < 1 2-4% HOUSE x MT 'COl EXISTING TANK/SYSTEM TO BE DECOMMISSIONED PER UPC MT /G/ t 1500 STEP TANK SECONDARY SYSTEM YSTEM FOR NEW 4 BEDROOM, TEST HOLE REQUIRED/ t Septic Design Prepared for �'0 BLANCHE STRUEMKEOC �p •,•• qs FIRE LAKE #2 BLOCK 2 LOT 2 Ar Eagle River, Alaska mr 49 TH .......... ...................... 0 ............................................ m Michael;MICHAEL N. ANDERSON,�/u � N. p • DATE: 8/12/2018 0, 0 No. E46 DRAWN: DJR 4601 NATRONA AVE `� '' r � r ANCHORAGE ALASKA 99516 V. (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1 -50' Municipality of Anchorage I V1' Development Services Department On -Site Water and Wastewater Section 4700 Elmore St. TH ? 49 4 I P.O. Box 196650 Anchorage, AK 99519-6650 wLw_w.muni.orq/onsite 14 (907) 343-7904 1- h4lCHAEL N. ANDERSON CE 9469 Soils Loa - Percolation Test Performed For: U ✓ —Date Performed: Legal Description: Pt T %.,I— P fti '? VS 7- LU- Township, Range, Section: Slope 1 7-1 F_ 1 oucl 2- Date Gross Time 3- Depth to Water Net Drop 4- 5- 6- 7- 8- 9- G LAJ 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- leelffillifflaiwL WAS GROUND WATER ENCOUNTERED? r4 s IF YES, AT WHAT DEPTH? L Depth to Water After 0P Monitoring? d E Date:t Site Plan Z�m Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutesdncii) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND 4-f FT PERFORMED BY: MNA I CERTIFY THAT THIS TEST NAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: (°- ..3o .. N89`56'00"W 300.00 NN !-� Di Qi • dJ Lr) i GRAVELr-r) DRIVEWAY ~ z WI / \P w CO (Yjo i w / • w > SIO / } CO I LA I �" • .l. H U w oJ J 0CO CO WELL =Ir QIQ oZ NLL C O - : >-m wU -6 Cio lQ co • Qz Q / O (n' \ , 03m \ ! 0 \ / 0 8.3 z • PET PENS \ CO \\100' WELL RADI CO 0 M • 30 . 134.98 N89°56'00"W 300.00 :‘:•` <5�•. -` 4s 1 i ,A,.*'.. ;4• v. *+ v v 1..: GRAPHIC SCALE: 1 Inch = 40 Feet ® � FB ® ,` ���. r r. euoarr. • / BobbyF. Burnett a ° , ,mss 2941 -carriage Drive r 11 I F �/? ' Anchorage, 350-5541 899507 20 0 20 40 80 �\ V , ,ssiox►Li Date Scale Legal Description 5/9/2018 1 = 40 I hereby certify that the property described hereon has been surveyed Lot 2 Block 2 by me, or at my direction, and that the improvements situated thereon Grid AS BUILT are within the property lines and do not overlap or encroach on the NW 0454 property lying adjacent thereto unless otherwise shown. That no Drawn byField Book FIRE LAKE SUBDIVISION#2 improvements on the property lying adjacent thereto encroach on the PLAT # P 515 premites in question and that there are no roadways, transmission BFB ASB-2018 lines or other easements on said property except as shown. • Li co- • Municipality of Anchorage !) On-Site Water and Wastewater Program ,.�� l t (907) 343-7904 $A r r T. CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-351-22 Expiration Date: j i -2.7-11? _ 1. GENERAL INFORMATION Complete legal description _FIRE LAKE #2 BLK 2 LT 2 Location (site address) _13913 SAVAGE DR, EAGLE RIVER AK Current Property owner(s) _BLANCHE STRUEMKE Day phone Mailing address _623 LEMON ST N, HUDSON, WI 54016 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: LA Date: •Ir COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 9767 Waiver Fee $ Date of Payment S /Z2/ / Date of Payment Receipt Number 2 Z 5) cel Receipt Number COSA# 2s( ) ') 22_0 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 MIKE N ANDERSON,P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 8/22/18 CTI" 4 • V, l? • S . dro:tea,. -, 4':-- 9714 Tr' 9: U. n t U 0 . 0 0 0 P f/4, 6. DSD SIGNATURE t tt< <t°° .<°,.°°°°, .; x o fJ.ICHAEL N. ANDERSON o fQ System #1 Approved for bedrooms. e ✓� C`- 99 �r� • System #2 Approved for bedrooms. ZFD • ••"° "`��� Disapproved. Conditional approval for bedrooms, with the following stipulations: �V Jz ON SITE .. WATER AND WASTEWATER PROGRAM By: ` Original Certificate Date: 2-2-7—I The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: FIRE LAKE #2 BLK 2 LT 2 Parcel ID: 051-351-22 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 1976 * Sanitary seal (Y/N)Y Wires properly protected (YIN)Y Total depth 95 ft. Cased to 95 ft. Casing height(above ground) 24"+ FROM WELL LOG AT INSPECTION Date of test 1976' 5-4-2018 Static water level UK ft. 60 ft. Well production UK g.p.m. 4.0+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 1.22 mg/L Arsenic: ND ug/L Date of sample: 5-4.18 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/ 51—EP Date installed 8.22.18 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA— 1985 SYSTEM TESTED Date installed 8-22-18 Soil rating (GPD/SF) 1.2 System type DEEP TRENCH Length 40 ft. Width 2.0 ft. Gravel below pipe 7.0 ft. Total depth 10.5 ft. Eff. absorption area 560 ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) NEW-PASS For 4 bedrooms Fluid depth in absorption field before test in. Water added gal. new depth in. Elapsed Time:_min. Final fluid depth_in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N & type) N - If yes, give date D. LIFT STATION Date installed 8-22-18 Size in gallons 1500 Manhole/Access (YIN) Y "Pump on" level at 36 in. "Pump off" level at 24 in. High water alarm level at 40 in. Datum BOTTOM Cycles tested NEW Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 104 Property line 10'+ Absorption field 10' Water main 100'+ Water service line 50'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 100'+ Water Service line 25'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. COMMENTS •.' `�•• Se�� *NO WELL LOG BUT WELL WAS DEEPEDED AND WE HAVE THAT LOG. /* ;49TH ••: d/� G. ENGINEER'S CERTIFICATION %'"• • �!• MICHAEL . ANDERSON ;Z 1 certify that l have determined through field inspections and �+ •�•'• CE 94 9 '�� review of Municipal records that the above systems are in 9Fo 5•?7."p•\*,�-- conformance with MOA COSA guidelines in effect on this date. ‘1; orEssta ,. Engineer's Printed Name MIKE N. ANDERSON, PE Date 8122/2018 COSA canary sheet_2-6-15.doc I 30 N89°56'00"W 300.00 I N N ai ai 1 I .. 1 c0 ° LC) CO CtI0 t al 0 NO s' 00 CD,O WELL° �� 0 >1 0 oow CO O CIz o3 • O • o 0 2g� _ • r z 0— Lai N m m d 0 ci • 30 134.98 N89°56'00"W 300.004.-0,-,6-1k (S. CIF ALgs "*. .,1-- k GRAPHIC SCALE: 1 Inch = 40 Feet ® FB® /` .`. F. sew= % BobbF. Burnett q ° IS—5444 j 2941 'Carriage Drive e 4 ,..2_,./:.... - Anchorage, Alaska 99507 k., moi (907) 350-5541 20 0 20 40 80 \ ssiorw���� Date Scale Legal Description 5/9/2018 1" — 40' I hereby certify that the property described hereon has been surveyed Lot 2 Block 2 by me, or at my direction, and that the improvements situated thereon Grid AS BUILT I are within the property lines and do not overlap or encroach on the NW 0454 property lying adjacent thereto unless otherwise shown. That no \ ,...Drawn byField Book FIRE LAKE SUBDIVISION#2 improvements on the property lying adjacent thereto encroach on the PLAT# P-515 premies in question and that there are no roadways, transmission BFB ASB-2018 lines or other easements on said property except as shown. 0,0N -T\ • • .� Municipality of Anchora: 1 • J On-Site Water and Wastewater Program t d' (907) 343-7904 •'�11�: CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-351-22 Expiration Date: c.kca— `j1 .20 16 1. GENERAL INFORMATION Complete legal description _FIRE LAKE #2 BLK 2 LT 2 Location (site address) _13913 SAVAGE DR, EAGLE RIVER AK Current Property owner(s) _BLANCHE STRUEMKE Day phone Mailing address _628 LEMON STN, HUDSON, WI 54016 Real Estate Agent Day phone PM 1 2 3 2. TYPE OF DWELLING: s" ® Single Family (w/wo ADU) 74 Duplex s , ❑ Multiple Dwellings (Single Family and/or Duplex) o o '� 9 c� ti a 3. NUMBER OF BEDROOMS: 3 Sy E z i. Wd 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ gn. Waiver Fee $ Date of Payment ur/a2111 Date of Payment Receipt Number A2.67(4 Receipt Number COSA# 0502/9•026 Waiver# 5. STAii 3F INS : TION BY ENGINEER As certified s ` ed hereto and as of the validation date shown below, I verify that my investigation, based on:,pfoce• .ed in the Certificate of On-Site Systems Approval Guidelines for this application, shows that it on-si er supply and/or wastewater disposal system is (are) safe, functional and adequate for the number f 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 MIKE N ANDERSON,P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 5/22/18 o ` 9 i i c o 0 0 o c oor��/!� 1 � 6. DSD SIGNATURE r C" •.JS 4� C.J System #1 Approved for bedrooms. _°f= •`-' `2 System #2 Approved for bedrooms. • Disapproved. XConditional approval for bedrooms, with the following stipulations: Nem= sus- � -\-o be co tAc1l-ec\ osd ,�rni-� (Aosc e b� June ts`1 X018, `,,tp Ai'ChG DN"SV ND � " \f‘111•1 p,(E Q F <e- 0A'// nIT sr-P\t' By: i\-1, ce-ik. QQO Original Certificate Date: 5/2.1/1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10-12.cloc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: FIRE LAKE #2 BLK 2 LT 2 Parcel ID:_051-351-22 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 1976 * Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 95 ft. Cased to 95 ft. Casing height(above ground) 24"+ FROM WELL LOG AT INSPECTION Date of test 1976* 5.4-2018 Static water level UK ft. 60 ft. Well production UK g.p.m. 4.0+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 1.22 mg/L Arsenic: ND ug/L Date of sample: 5-4-18 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 1976 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N)Y Foundation cleanout(Y/N)Y Depression over tank (YIN) N High water alarm (Y/N) V).1. Date of pumping Pumper CONDITIONAL C. ABSORPTION FIELD DATA- Date installed 7-5.77 Soil rating (SF/BEDROOM) 180 System type EXIS —hM KKr L1. ITV TV ft. Width 4 Gravel below pipe -;*0 ft. Total depth 11&ft. Eff. absorption area 560 ft2 Monitoring tube Y Depression over field N Date of adequacy test CONDITIONAL Results (Pass/Fail) UPGRADE For 4 bedrooms Fluid depth in absorption field before test in. Water added gal. new depth in. Elapsed Time:_min. Final fluid depth _in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in.High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: 474-1-he-% win%f (( 'f P�J A-'Y 6. • Septic tank/lift station on lot 4484 '-'4.01/1- - 4"- On adjacent lots 100'+ Absorption field on lot 100'+ ettti. 4(0' ,_Or k On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 10'+ Absorption field 10' Water main 100'+ Water service line /- Surface water 1004 Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 100'+ Water Service line 25'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. COMMENTS •: OF A / 11k1 NO WELL LOG BUT WELL WAS DEEPEDED AND WE HAVE THAT LOG. I • ::!,ft . or -44--4--44--4- �� 4-ir `Toho 4- �,e (Z .S. /V o' 1r.lova ,tocClTH ` •; G. ENGINEER'S CERTIFICATION 5 ' c 4 P9vit174 000000000000 (0 / • /A• MICHAEL N. ANDERSON 'et. I certify that I have determined through field inspections and 1 i•. C -94A9 review of Municipal records that the above systems are in (4�'. • `; conformance with MOA COSA guidelines in effect on this date. 1"�Fp' ••• U.*' E,`' Engineer's Printed Name MIKE N. ANDERSON,PE Date 5122/2018 COSA canary sheet 2-6-15.doc Proposal Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 727-8864 Fax 345-1391 May 27, 2018 BLANCHE STRUEMKE 13937 SAVAGE DR, Eagle River AK 99567 Re: Septic replacement and Conditional COSA Legal: FIRE LAKE #2 BLK 2 LT 2 Descriptions of Engineering & Excavation services Provided: 1. Engineering and design for a new 4 bedroom septic system with STEP tank. 2. Excavation and perc for new system design. 3. MOA permits for the construction and Certification of On-Site Approval (COSA). 4. Installation and excavation for the new 4 bedroom system. 5. New survey asbuilt for the COSA. 6. Well flow and lab testing for the COSA. 7. Electrical for new septic lift station (STEP) 8. Final grading for best fit contours. Total Proposal $21,000.00 I received your email with the Michael Anderson proposal for the Septic Work, Stewart Title of Alaska will hold one and a half times the proposal for Escrow funds. We will need a copy of the Conditional COSA in our office prior to recording, and work will need to be completed by July 30, 2018. Lito Talbert Escrow Officer 4F,kit.-. Stewart Title of Alaska \4414‘ 480 E.36th Avenue Anchorage,AK 99503 0(907)777-0508 I M(907)274-2562 I F(866)458-1756 Iito.talbert@stewart.com Jayme Lembke Escrow Processor (907)777-0517 jayme.lembkestewart.com Stewart title Real partners. Real possibilities.'"" NTSE:STC **Be aware! Online banking fraud is on the rise. If you receive an email containing WIRE TRANSFER INSTRUCTIONS call your escrow officer immediately to verify the information prior to sending funds.** 2 MUNICIPALITY OF ANCHORAGE Hea ] and Environmental Protec ion Fourth Floor West 825 L Street Anchorage, Alaska 9950]_ 279-2511, x 224, 225 SEEPAGE PIT: LOg Crib Rings___ BuiLD NG FOUNDAI'ION '~'~' ~'! INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM DISTANCEI , .~ ~ NUMBER OF / ~ I ~ TOTAL EENGTH . , DIBTANCE~ FROM . ~ ; '~ _ _ ............... LOr LINE. .......... 1 .......... :; ~}~0~ ~es ~ DISTANCE ~E'IWECN LINES TRKNCH WIDTH IN. TOTAL EFFrEC~ IVE ~B~ORPTION AREA ~.~_~ ........ SQ. ~T. t E~TH OF EACH lINE ...... ~_/ ' ' ~ L)EP~It OF I ILTt R OEp'i"II: TOP OF TiLE IO FINISIt (.;HA[)~ MA[EI~IAI_ BEN[ATtt llLE IN. ABOVE TiLE DIAMETER ..... OR WIDTIi ...... LENGTH___, OEP'IH Crib Size: DIAMETER ...... DE ,tH .... DISTANCE FROM: WELL 1OTAE EFFECTIVE NEAREST EOf t INE .... AI%K)RPTION AREA (WALL AREA) !iWel$ii ' iClaS~:,/~/~, Depth: iWell:'Dist~nce To: Lot Line ilBldg:' , 'Sewer Line: --'- 'i ipe,Materlals: "~ of 'Bedrooms: !Insta'ller= 'iRemarlks:~~ [ DA! L~.~w-__~_ APPROVE[ ~'.,i.::i:::'F:[i.;;'t i'il:::l.,i 'i t..ti:;:'[:::li 'I'H F:ff.,tl': t..: !-,I ,,, I I": i IF,dql... F.i t Hl '1 i !"i::!i[":'!' '!' [ i1",! '\['7z-'''2 ,1¢tt ' ...ti ........... :.:::;; "il "'ii" il:i::: :?;: !t::::7 !i..,,.lt IF:i:: Ii::;;" I~::::::" Il:ii:::: li:;;;i" Ii '" i! "1,: '"'ii "~ ~ "~ "~ ~.J r~. ,: ;::,.;::,,::l..::;il:::l .:, ,~._j ~(~·/. ':::;t:::11 I '.¢ I':1:.:11 I t:::lb.ll::l~.r~ I:::',1')::.=', 't::1 ;::;'~:::; Ii:l;:: I';ii t:::' I:;;I ]' . I: l:::;',;::',;::::....?'::;I ;:.'l;.:, I I I:::' F:' I:::; t:;;' I:::'' I :::i: I:::;::::' I IF:'l:::'l:::'i;;' i:::' T Fi'F:' I F:II';:'I:::: ':::;I I::: I .I'TT' :!!i; ;t: ;;::'l:i: '.i': ;:: I::!H::: I:::1 ':::;l::ll 1:::!!:;i:t:i: O ~ E GEO', .'CHNICAL 6r DEVEL 3MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 088-2280 Soils E~ Foundations Land Development Performed for: Legal Description: Depth (feet) Name: ~,~"x-~G ~-~--'~..,.w__ ~,v.~_~..v Tel. No.~ Mailing Address: ~'~o~. \\'2-~_ ~%c.~_~_-~t~ .~x~,~v.~, ~¢k'~')7 Soil Characteristics 0 1 2 Ground Water Encountered: Yes /No__ If yes, what depth Proposed Installation: Seepage Pit__ Drain Field Comments: ' ~-~,-< ~..~-~..v,~.~,~ ~,~' ~ ,~ ~.~ Performed by:~ Date: PHONE 694.~g81 SAM COTTEN, OWNER Sam Cotten Drilling Co. 672c/ 7otoi c/~ar~)es - $520, O0 {3acJ~ rio e 60, O0 $ 5~,'o. oo q O0 , O0 80. O0 - [3alance due. ': THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED - :, INSPECTION APPOINTMENTS ' ~ TIME ~ TIME '~lMi= DATE ' ~' DATE DATE ' ' INSPECTOR i INSPECTOR INSPECTOR DIRECTIONS: ' ' ' 1. TYPE O~ RESIDENCE NUMBER OF BEDROOMB ' [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY' [] TWO [] FOUR [] SlX - 2. WATER ~uPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] CQMMUNITY ~ DATE DRILLED [] PUBLIC UTILITY Col!nect]on Verified LOG RECEIVED 3. SEWAG~ DISPOSAL SYSTEM PERMIT NUMBER r-IINDIVI~UALTON -SITE, DATE INSTALLED []PUBL,C UT,L,TY Connection V~rifiad INSTALLER r-'lSeptic._~,.Ta~k or [] Holding Tank Size:~~ If Tank is homemade_ SOILS RATING ' give dimensions: TYPE OF TANK ANUFA TOTAL ABSORPTION AREA MATERIAL WELL TO:, , Absorption Area to nearest Lot Line 5~ COMMENTS' ~ [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION ~ ' ' _ - 72-010 [Rev, 3/78) 4649 BUSINESS PARK BLVD. P.O. BOX 4-1276 ANCHORAGE, ALASKA 9-2509 TELEPHONE (~,97) 27B~014 Orin!<ing Water Analysis Report for Total Col[form TO BE CO~4PLETED BY WATER SUPPLIER i.D. NO. Public W~tc, r System N~ml City Slate ~o, D~y Ye~F Zip Code SAMPLE TYPE: F] RoDtine I~ Check Sample (for routine sample with lab ref. no. . _ ) ELSpeclal Purpose /_.,~M-Ar Treated Water Untreated Water SAMPLE NO. 1 2 3 4 5 Time LOCATION Collected Collected By TO BE COMPLETED BY ILAE, ORATORY LABORATORY: CltEM & GEO I_ABS OF AK., INC. NAME 4649 BUS]NESS PARK BI_VD, ADDRESS ANCIt CR~.E, AL AS._KA CITY Date Received Time Received ,_~ :O0~¢¢. Analytical Method: Ferment8tion Tube Membrane Filter Lab Ref. No. Result* Analyst J .... I ......... J READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No, 18-310(3-78) 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 DaleCo ected 9-26-78 24 Houri WATER ANAl,. S Mail Report ' ) · Name Legal Address~f Property: Lot Block Explain: WATER SYSTEM Suspected Hour Date J~/~ / ~ U.S. Survey # 1. Well Type Depth 2. Surface Water: 3. Number of Homes Served 4. Treatment: /~/1. Water Approval for Building Permit. / / 2. Routine lmalysis. ./. / 3. Special: Check Specific Items for Analysis. PURPOSE OF ANALYSIS Gallons per Minute Temporary /~/ Permanent /~'"~- (Column 1) (Column~ 1 and 2) (Columns 1, 2 and 3) (1) Analysis Limits (2) Analysis Limits I_[on (Fe~. ~o O~ O. 3 Fluoride (F) O.~ 1.5 Chloride (el) p_ 250 ~ho---sphate (PO4) .0~ good ~(p'~ 30 poor Total Hardness 50 soft ~- ~00 hard .De t.e r~en ts ~5 ,0 , ~I1 6.5 - Speci'fic ,Conductance /~/ , . SANITARIANS COMMENTS; ~agnesium 125 (~g) Calcium 300 Ca) Turbidity 5 Color 15 Bicarbon- 25 goo¢ ate !500 poo~ (HCO~) Carbona te. , [ }50 Alkalin_ityl 150 , . Total Dis- 500 olved ~olids , * Re~.tr~,~ Speel~l Container (3.) Analysis Limits Sodium (N,a) .... 2_0_0 Potassium (K) Sulfate (SO4) ,, 250 Sulfite ,(SO3)~ 5.0 Nitrate (NO3) 10. Suspended Solids 0,01 Arsenic (As) C o__~j2~e r (Cu) 1.0 ~Cy aq idle_ (Ch)_ 0.01. Phenols 0.001 Zinc (Zq) .... 5.0 Barium (Ba) 1.0__ 'Ca~mi~--um (Cd) 0. O1 Le--ad (Pb) ....... 0.0~ S il v~e.r (Ag) 0.05 Ma__nganes~ (Mn .. _ 0.05 GREATER ANCHORAGE AREA BOROUGH Department of ~nvtronmente] Quality 3500 Tudor Road, Anchorage. Alaska 9950'7 279-8686 Date Received july 3~, 1973 Time of Inspection Date of Inspection REQU£ST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Conventional Aoproval Requested By: gene's Realty Address. 635 '~' St. Anchorage 99501 Barbara tlil 1 Phone: 272-6494 Pronertv Owner James Arnold Phone, Legal Description: Lot 2, Block 2, Fire Lake Subdivision #2, Locat'ion: Savage Drive Type of Facility to be Inspected: Number of Bedrooms: 4 Single Family Dwelling Well Data: A. Type Drilled B. Depth~ 7~' ~, C. Construction D. Bacteria] Analysis Satisfactory Sewage Disoosal System: · 1967 (ap~rox) A. Insta[led Gerhard P~euss B. Installer Gerhard Preums C. Septic Tank: 1. Size 300 gal 2. Manufacturer__ D. Seepage Pit: 1. Size 12'x12' 2. Material Lo[J crib Disposal F~eld: Total Length of Lines +ieach field Distances: A. We].) To: Septic Tank 73'__ , Nearest Lot Line Fnundatton to Septic Tank Absorption Area to Nearest Lot Line Absorptton Area 100' · Other Contamination Absorption Area , Sewer Lines [%equ~st for Approval Page Two 9. Comments: Disapproved AprJroved Approval Valid for One Year From Date S~gned Gr~atar Anchorage Area Borough, DeF, artment of Environmental Quality DIAGRAM OF SYSTF~M Date Augu,,s~. 1 ~ 1373 I certify that the information contained in this request for approval to be a true and accurate representatt, on of the subject sewer and water facilities located at: Signed Dale