HomeMy WebLinkAboutBENITO BLK 1 LT 8
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE694-2588
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ADDRESS
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MISCL. INFORMATION:
DRILLER'S NAME
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC251489
Parcel ID 050 -271-38 Expiration Date: 11/4/2026
Legal description BENITO BLK 1 LT 8
Site address 10243 GENORA ST
Current property owner(s) NORMAN E R FAMILY TRUST THE
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: ''' Original Certificate Date: 11/7/2025
This Ceftificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sy m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
evelopment Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department;,'; Phone; 9+J7-343-7904
On-Site Water 1fVasteater erection Fax: 9?-343-7997
Certificate of On-Site Systems Approval Application
1, GENERAL INFORMATION
Parcel I.D. 050-271-3$
Complete legal description BENITO BLOCK 1 LOT 8
Location (site address) 10243 GENORASTREET EAGLE RIVER, AK 99577
Current property owner(s) NORMAN E R FAMILY TRUST Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: F0 Private Well serving # 1 dwelling units
❑ Other Non-public well as regulated by MOA ❑ Water Storage
Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units
Holding Tank X Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench' ❑ Wide Trench ❑ Seepage Pit
Waiver request for: Distance:
Expedited review requested: ❑
By applying for this entitlement, this property is subject to inspection by municipal On-site staff'
to verify the accuracy of the information provided.
COSA Fee $' _ Waiver Fee $
Date of Payment 101 A �� � Date of Payment
COSA'# ocb c'?G1"4 M Waiver #
CO5A Application-Ap2025.doc
COSA Checklist_May2025.docx
COSA Checklist
Legal Description: BENITO BLOCK 1 LOT 8 Parcel ID: 050-271-38
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 1976 Total depth 142 ft
Cased to 142 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18 in.
Date of flow test for COSA 10/23/25
Static water level at beginning of test 95 ft.
Well production at time of test 5 gpm
Water storage tank volume None gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 0.437 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by & Sullivan Date 10/23 & 11/4/2025
Comments __________________________________________________________________________________
B. TANK DATA – PUBLIC SEWER
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. DISPOSAL FIELD DATA – PUBLIC SEWER
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) If
yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_May2025.docx
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Disposal Field on Lot > 100’ Yes if No ft
Neighboring Disposal Fields > 100’
Yes if No ft
Sewer Line/Main > 100’ Yes if No *85 ft
Sewer Manhole/Cleanout > 100’
Yes if No *86 ft
Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10’ Yes if No ft
Field to Foundation > 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/Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
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
*MET CODE AT TIME OF WELL INSTALL WITH APPROXIMATE SEPARATIONS. **MET CODE AT TIME OF WELL
INSTALL, IS UNKNOWN BUT APPEARS TO BE 25’+.
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 11/06/2025
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 &
11/06/25
2 5 .1'
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.
3'
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4 6 .3 '
2
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.
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4 6 .3 '
6 .1 '
1 .0 ' C A N T .
RESIDENCE
LEGEND
EDGE OF GRAVEL DRIVEWAY
DECK
CONCRETE
FENCE
RECORD DATA PER PLAT #67-44
WELL
TIMBERLINE SURVEYING AND MAPPING
17035 BARONOFF AVE
EAGLE RIVER, AK 99577
907-242-5320
ryan@timberlinealaska.com
FILE NO.: 25.242
SCALE: 1" = 20 FEET
DATE: 11/3/2025
SHEET: 1 of 1
MOA GRID: NW0052
SCALE: 1" = 20 FEET(11"x17")
20'0' 40'
AS-BUILT OF:
ADDRESS: 10243 GENORA ST, EAGLE RIVER, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
LOT 8, BLOCK 1BENITO SUBDIVISIONPLAT #67-44