HomeMy WebLinkAboutFIRE LAKE #2 BLK 2 LT 2Onsite File
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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
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// _• MICHAEL N. ANDERSON •,' .'s
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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 �\ / \
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SCALE: '1''50' > ,
roof 1-002 i TCO1 Ler 5 A 2 T/ ii 2. .iaakr\•1t.44 2 �NH �� .•••��•O- !1/ A/•
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FILM FABRI0— : 49 /1 •♦1�
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STEEL STEP faux 97 •
Y •
90 / MICHAEL N. ANDERSON; ;�
04�% No. C 99 •��
•• Vf7?7I
SEPTIC SECTION it/JD ea — .� \ vim.
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N.T.S. pi O 7?71"i ,1I1\1»�11'
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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.
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"'.1-r./.... CE-9469 .; �
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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
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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
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1 ( !
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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:
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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.
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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
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dro:tea,. -, 4':--
9714 Tr'
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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
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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