HomeMy WebLinkAboutT12N R3W SEC 27 (BLM LTS) LT 60AOnsite File i MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221331 PID Number: 018-092-62 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MAPSTON DAVID & LADONNA LIVING TRUST ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 13900 MULLIGAN RD, ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. LT 60A Township Range Section T12N R3W SEC 27 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well *98.2' __ 25',+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface water 100'+ -- Material HDPE Number of compartments 2 Lot Line 5'+ -- NA Foundation 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks *MOA WAIVER OF 97' FOR NEW HDPE SEPTIC TANK & EXISTING SEPTIC TANK... Alarm location Electrical installed by Installer � RS PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection fisc 9/22/22Location dates: 2"d 9123/22 and description 3'd 4`h TOP OF MH RISER HDPE TANK ON-SITE WATER AND WASTEWATER SECTION APPROVAL "�"•'' Conditional Approval: Date .t�� TH ........��� . ... • • ` • • • . Septic System ' Curtis Huffman A roved - Date LO��t �'�`• CE 128991 ��`��►� •. 10/1/22 .•�C�s �k , OpROFESSIONW� Note: this approval does not include well permit requirements. �'Il��,,��.,`.s_ tnev 05/02/ 8) P I D: 0 18-092-62 PERMIT: OSP221331 ( 89°50'27"E 135.07' R) 2.0' 10' T&E ESMT N A—C=36,5' B—C=9.8' A—D=47.3' B—D=21,4' A—E=52,4' B—E=26.4' A—F=56.5' B—F=30,5' I— 93.41 93.24 ED 1250 -GAL w WELL CONCRETE IS TANK CLEAN PIPE .0' 12.0' TO EXISTING x o q W CONCRETE N-' TANK X ALL BUILDINGS `N -'0]0 'pphF TO BE O AON — k> SKIDS MT WOOD FOUNDATIONS. Is G AVEL x C❑NC D/W I SHED L&' �cFN EXISTING x L CONCRETE TANKS GRN D Ix HSE co 1250 -GAL PAVED x F MbCO TANK D/W n r E D MH 1pp, x DFCO C C--) DESOMM&SIN ALL NIEWNG i�S 27,8' 1000—GAL HDP SEPTIC TANK i WITH NEW D 0 & DCO �x BEFORE & A R TANK. BM: TOP NEW MH Cl1 I LD z Lj ° DRAWING IS BASED OF MOA RECORD � (/� o DOCUMENTS, VISU L OBSERVATIONS m pq m 1 EXCAVATION & RE NT ASB SURVEY. d H Lr) E3 sI l w IAH H CO M DCO DCO 00 0: �FlNAL GRADE STING 93.41 93.24 1250 -GAL 1,000 -GALLON CONCRETE HDPE TANK TANK CLEAN PIPE TO EXISTING 1250 -GAL CONCRETE BM: MH TOP TANK SEPTIC SECTION SCALE, NTS T12N R3W SEC 27 (BLM LTS) LT 60A PREPARED FOR: DAVID MAPSTON & LADONNA LIVING 13900 MULLIGAN RD ANCHORAGE, AK 99516 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmail.com EXISTING FIELD O 00 In CU PER AVAILABLE INFORMATION - MOA WAIVER TO EXISTING FIELD & CONCRETE SEPTIC TANK & NEW HDPE SEPTIC TANK SUPPORT@ SERVICES: OF .A.L�[WES� C * 9 TH DATE: 10/1/22 tis Huffman SURVEY: JLS CE 128991 w DRAWN: FWCS 4' SCALE: 1" = 30' p1�0_/1/20 �� -, "� �ssl0 Municipality of Anchorage P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV 221066 COSA OSC221487 Permit#: OSP221331 PI D#: 018-092-62 Legal Description: T12N R3W Sec 27 lot 60A Engineer: First Water Consulting Applicant: Mapston Your request for a waiver of the required 100 feet horizontal separation from the Septic tank & drain field to the Well has been approved. The approved separation distance is 96' & 97' . This waiver approval applies to the Existing Septic tank &Trench only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 -day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: l _l l �� Approved by: Name of Rei fewer **** VARIAN C E/WAIVER REVIEW **** y! F�rs[ Wder CONSULTING .. IN , Al E 13021 Montego Circle, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com October 1, 2022 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: T12N R3W SEC 27 LOT 60A – WELL TO FIELD & SEPTIC TANKS WAIVER Per the attached as -built survey by John L. Schuller September 30, 2022, and previous discussions with MOA staff and available information —the assumed closest portion of the existing trench was measured at approximately 97.4' to the adjacent property's well on Lot 59. The existing concrete tank also encroached the subject property's well and the newly installed improved HDPE tank does too and was measured at approximately 98.2' to the well on Lot 60A. We are therefore requesting a waiver to 96' between the referenced well on Lot 59 and assumed property's septic field and 97' from the new HDPE septic tank and existing 1250 concrete septic tank be granted at this time. Granting of this waiver is justified in the fact that the attached CAN water samples show little nitrate influence, the newly installed HDPE tank is of higher material quality than the decommissioned old steel septic tank and that this field and concrete tank – septic system has been in operation for around 40+ years with no known side effects. Granting of this waiver will not adversely impact any of the neighboring properties. Please contact us if you have any questions. Respectfully, Curtis Huffman, P.E. Attachments: As -Built Survey i3l]�J1S Slnda I X—x-- (?� ,OL'69Z) ,8L'69Z M„00,1.0e0N Q' I a O r, y N N F- Oi 2oA 0-5 b� w a[C]3H]S z V r- W -O 'o 0•ZL O O U H W � ^II z v1 � to � ° ^•. A ,0 •C A• � Q, � a A i�•l W Q N ° 10,01Lo �® O 00 0-) (n 00 m N = L'6£ z w o _ Z n o = N � � dOHS 6 1,0 U� Z —x—x ~ Z a ,Ny A°io '' ZoCo N I 0 3 �aM n N 0 3snOH ONIISIX3 .0'6ti Oj ,0L'LZ� ,0-01 ,0'0l i -x—x—x—x—x—x-x1 00'" iWS3 03-13 Cl ��\C I O co LLC N to V N 1� O) w w Y O Go co CSI O gtOM J ^ I- (d WCQ 7 E� CO 11 O W J SS y co v rn O �Q 00 Ao M O O o coy m VZ OP i 4 NIA :vl .Q �p ��; . �-•� . •' •etyma® I y N N a Oi 2oA 0-5 b� V M .° O o a x -O 'o LO O H H O o ^II z v1 Q to � ° ^•. A ,0 •C A• � Q, � a A i�•l W Q ° O O m o � � N 0 F - 00 Z —x—x 0 COD ,Ny A°io '' ZoCo LLC N to V N 1� O) w w Y O Go co CSI O gtOM J ^ I- (d WCQ 7 E� CO 11 O W J SS y co v rn O �Q 00 Ao M O O o coy m VZ OP i 4 NIA :vl .Q �p ��; . �-•� . •' •etyma® y N N a 2oA 0-5 b� V M .° O o a x -O 'o d- LO H H O o ^II z v1 Q to � ° ^•. A ,0 •C A• � Q, � o A i�•l cn 0. ° N A bUcs ti 0 m o � � N 0 F - 0 COD ,Ny A°io '' ZoCo N I 0 3 �aM U aAi Z t O co o W a> 0- un v¢ O V N >,U O"..^ .5 �C �Q 0 w N h V) %5. - ,v° 3 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program Pa 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: OSP221331 Work Type: SepticTank Upgrade Tax Code Number: 01809262000 Site Legal Address: T12N R3W SEC 27 (BLM LTS) LT 60A G:2936 Site Mailing Address: 4551 DE ARMOUN RD, Anchorage Owner: MAPSTON DAVID & LADONNA LIVING Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: en r u � - v L)epartmen t Lot Size in Sq Ft: Total Bedrooms: 8/26/2023 37686 ❑ Disposal Field 0 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 (2417). 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: 1. For a future COSA, a waiver will be required for the first concrete tank to the well on 1_60A. 2. For a future COSA, a waiver will be required for the field, and possibly tank, to the well on L59. 3. The COSA will have to address the second concrete tank under the structures. Received By: Date: 8/26/2022 Issued By: Date: 7— Z_ 5 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. 018-092-62 Property owner(s) DAVID & LADONNA MAPSTOPN Day phone _ Mailing address 13900 MULLIGAN ROAD, ANCHORAGE, AK 99516 Site address 13900 MULLIGAN ROAD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 2N R3W SEC 27 LOT 60A Lot Size 37,686 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade 0 (D) E] Holding Tank ElRenewal ElDuplex 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. nature or property owner or autnorized agent) Permit/Rush Fees: AZ-2-5- Date Z-2SDate of Payment: Z)//r6A22 Receipt Number: 5Ig) q'3 Permit No. O S1a22 1'33 1 Waiver Fees: Date of Payment: Receipt Number: 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 August 18, 2022 Municipality of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: T12N R3W SEC 27 LOT 60A 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 after the existing 1250-gallon concrete tank per MOA documents to serve the existing 5-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties and it is proposed to maintain and/or amend the waiver to the existing concrete tank. 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 OSP221331, Deb Wockenfuss, 08/26/22 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK EXCEPT AS NOTED. T12N R3W SEC 27 (BLM LTS) LT 60A DESIGN DETAILS: VERIFY EXISTING S.T.s & STAKE ALL WELL RADII PRIOR TO CONSTRUCTION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221331, Deb Wockenfuss, 08/26/22 889*55'47"E 135-06' (N89°50'27"E 135.071 R) A -A -A -A -A -A -A -A -A -j- X� 0' T &-'L-- E S M T 20.0' 0SHED 1 WELL 16.0'12.0' N 0 SEPTIC •0 12.0' AVEL X VENT CONC D/W SHED (t yp) X X-1 X EI PAVED X 16.0' D/W GRN HSE M ry #MH X Lli CD 1 27.8' 0') In X F 32.0' CL C"4 or) x :2 V) < I Of X - Z Lj 0o > 0 C C� X < (3i At 0 .14- X 2: wL0 N X 00 STORAGE CN12.5' 0 -o 7.5' 28. X 0 F_ Li X 12.0' X DECK 0o V_ o CD 0 CD X X LOT 60A V) 0 X LLJ < X Q)* < X N89*49'00E 115.17 (115.11' R) DEARMOUN ROAD i ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 60A T12N R3W Sec27 S.M. AK PLAT 93-24 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 shoul( 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 any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE. SC&E;E-MAIL P1 xxx xx, 2022 1 =40' schuller0ok.net 22— xxx DRAWN BY: CHECKED BY. GRID NUMBER: BOOK/PAGE I JLS NW1 255 2201 xx FND SURVEY MONUMENT FND 5/8" REBAR law SUR 4 V Adw OF L L A V 0011- 407 or 4 STH d t'r ....................... . ...... k.t t ................ .. ?A t 6 J - N L. SCHULLER.- 0 (L LS -10408 1831 Talkeetna Street or ov • 8. 4. . 6Anchorage, Alaska 99508 AAW AMW 0 f Llnc\ AAW (907) 227-1455 office N V�l ssio 1 (907) 274-4992 fax  MUNICIPALITY OF ANCHORAGE ~"~'~ _,\\ DEPARTMENT OF HEAL'FH & ENVIRONMENI'AL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION  825 L Street - Anc~ora.qe, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT [] NEW ADDRESS LOCATION Well / Absorption area . ~ M - Matorial I- Z Menu f~cturer ~ ~ Liq. capacity in gallons Inside length Width Liquid depth PERMIT NO. -I'Z~ ' DISTANCE TO: Well Dwelling O ~ ~ Manufacturer Material Liquid capacity in gallons ~ ~ Weli . I Foundation / Nearest lot line ~ PERMIT NO. ~'~ No~ C~':~) Lengtbofeachline¢.~} ~oa ,ength'oflines*-,~ Trench width Distance?~ Length Width ~,/.~_.1~ f ~ D0pth PERMITNO. ~ ~ Type of crib Crib dismeter ~rib depth Total effective absorption aroa ~ Well Building foundation Nearest lot line ~ DISTANCE TO: MUNICIPALITY OF ANC MUNICIPALITY OF ANCHO}qABV Department ~ Health and Environmenta~ ~rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ ~_~[3~-t? ~'%E't~'R. ON-SITE SFWER PERMIT-L-L(~% Location: ~" ~0 ~.~,~ ~,.~7-'T'~/%4- R ~'(x) Phone Number: Descrmption. Legal '' ' Type of soil Absorption System Is: Trench: /~ Drainfield: Seepage Bed: Lot Size: Holding Tank: Maximum Number of Bedrooms: ~' Soil Rating(sq.ft/br) ~--- ..~ The Required Size of the soil Absorption System Is: / DEPTH _ .~ LENGTH /~ 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 minimtun depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /'~ 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. * * * PF_RMIT EXPIRES DECEMBER 31, 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 enlar~ment if the residence is remodeled to include' more tha~t<~bedrooms.//~ Signe~: /~ !F~Issued by Applicant Date: 7.3 SWP/024(1/81) 7t25 Old Seward HWt/.' An~h0rage, ~a~ka .~9,~02 · T SOILS LOG - PERCOLATION TES ]';'; .' {',Lg' SO~LS LoG i~ER{~O LATIO f~ TEfiT LEGAL D P , ?,'% ~ qq ,qA', :,2 / .l~,.'A,2,~Ol ~. ~ ~ ,~.-L.i , ,'. SI1 E PLAN O'-LO' O~,CtAAJIC_ ~iI.T Of SLOPE :L Y 28 !)83 317 !:fi:, )i\, I~ .;:; Li2_h; };3W 5FC'LIIN 27 BLOCI(-O I,.',"-"', .,. 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I iq'_:H'f:II...L.FI'I" I Obi. ]; E:[:i:l:,;fl'.iF:"r~ 'THFIT ::1: :[ Fib1 r:'l::ll"l];k]:lal~: I.q;[Ttl TII[:~ I:;i'.[i;I]:!I..I:[Fi:P:]"II~;I'.CI".--.', F'O[;[: (3N--S; :[ "[E SEI,.IE[~:S I~I'qD klEL[.S I:::IS I::'OI;~:-IH B"r' THE hll..IN I C: :[ F'F~I.. :[ Th~ I]IF I::INC:HO[i:FIGE. 2: ]: I.'lII..l_. iI",IS;TFILI.. THE: S"r'STI}::FI IN FIC:COIT[:'F:IhlCE 1.4ITII THE CO[:'ES. AF:'I::'L. ]: CF:INT I]:q:l"," ]: [:' P'IOF'S TCIN '" ~:'. ............ ~ ~''~' ~ .......... : :: ~: ....... :~X ....................... ].......I._1[...[. [ , .......... ~.~...,...~ .............. lilt[ ]PLOT PLAN: NG Z NE!ERS, GRID: ;~;~):, ORAWN B'f /',4(]C: .:,-~LCK{:~; tz' ZNC THAT I HAVE SURVEYEO THE FOLLOWING DESCRIBED PROPERTY. ~g¢. 2.']¢ ~'I~.N, R~VX/ANCHORAGE RECOROIWG OiCJTR[CI. AK SI'fUATEO THEREON ARE WITHIN file PROPILRTY LINE.r~ ON THE PROPERTY LYING AOJACENT fHERETO T~IAf NO LYIN$ ADJACEN~ THERETO ENCROACH ON I'HE PREMISES THERE ARE NO ROADWAYS, ~RANSNISS~I)N L.TNES ()fi OTHER ON SAID PROPERTY EXCEPT AS INDICATED HEREOh; OAY OF RUG., t90~, ANCHORAGE, At ASKA B~LI~Y,OF 'THE OWNER OR BUILDER, PRIOR ~0 CONS1RdCT:[ON. RELATIVE TO FINISH GRAD6 AND UT~LI'fY ;.'T0 DETERMINE THE EX]S'fENCE OF ANY EASEMENTS. COVENANTS :..I~,H:ICH DO.NOT APPEAR ON THE RECOROEO SUBDIVISION PLAT. .\nchor i hone Ancl,orage ~ '~k. September, ~979 ',; LL LOG D. ,V. r,aiaot on S.',..'~. ~.~ox 317 Anchorage~ Att. 0 .................. 18 ft. ~ $ .................... 3a ft. 32_ ................... 5~ ~t. .51 ................. lO2 ft. 102 ................. 1 32 1 32 ................. 143 ~rown :)and Clay ~: Gravel Brown Sand ft. ,.;ilt h water ft. ',.;rave]. '~ Water !"ailed 12 Gl ]~ l0 ft. water in well Certificate of On -Site Systems Approval Parcel I. D. 018-092-62 Legal description T1 2N R3W Sec. 27 lot 60A Site address 13900 Mulligan Rd. Anchorage, Ak Current property owner(s) David & Ladonaa Mapston Expiration Date: 1-11-2023 X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: BY Original Certificate Date: I L This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 018-092-62 Complete legal description T12N R3W SEC 27 LOT 60A Location (site address) 13900 MULLIGAN ROAD, ANCHORAGE AK (4551 DE ARMOUN) Current property owner(s) DAVID & LADONAA MAPSTON LIVING TRUST Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 1 NEW HDPE & 2 CONCRETE AT 40+ YEARS - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: L59 WELL TO SEPTIC FIELD & L60A WELL TO SEPTIC TANKS Distance: 96'&971 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 $ l�y� Date of Payment 2 2 Date of Payment 2 2 COSA # Waiver # ©LS l :Z COSA Application—July 2022 copy 2.doc Legal Description: T12N R3W SEC 27 (BLM LTS) LOT 60A Parcel ID: 018-092-62 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 9/1979 Total depth 143 ft Cased to UNKNOWN ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/9/22 Static water level at beginning of test 88 ft. Well production at time of test 6+ gpm Comments B. TANK DATA Measured operating fluid level in septic tank 50" Date of pumping NA — NEW HDPE / 8-9-22... ❑ Required maintenance completed, if AWWTS Comments: One Stop Pumped Existing Tank & so did JRs when installing new HDPE tank. D. ABSORPTION FIELD DATA Which system tested (date installed) 10125/1983 ® ALL standpipes present per record drawing Total measured depth from grade 8_8 ft (max) Measured depth to pipe invert from grade 5_3 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 3.5' of 4'ED ❑ 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 Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 3.44. mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Fir Date 8/9/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/9/22 Results M Pass Fluid depth prior to test 0_5 in Water added 1040 gal New fluid depth 5 in Elapsed time 45 min Final fluid depth 0_5 in (OR LESS / WET) Absorption rate 750 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 42 in Effective depth used 6_5 in Effective depth remaining 35.5 in Comments/Deficiencies: MT/CO DEPTH AT GRADE. NO LATERAL JUST FIELD SUMP/MT WITH PERF. ASSUMED 3.5' EFFECTIVE DEPTH (ED). PER OBSERVATIONS OF GOOD MATERIAL, CLEAN PIPE... WITH MOA STAFF ON SITE EXISTING 2ND CONCRETE TANK WAS NOT PUMPED & DEEMED SATISFACTORY AS IS WITH VOLUME WITH THE 2 PRIOR SEPTIC TANKS BEING ADEQUATE FOR 5 BEDROOMS. COSA Checklist—July 2022 - MULLIGAN RD.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' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No *97+ ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No ft ❑ 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 5'+ ft Surface Water >' 100 _ ®Yes if No ft Tank to Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ® Yes if No ft Private Wells > 100' ❑ Yes if No *96+ ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft F. ENGINEER'S COMMENTS If tank or field is under driveway comment below ''MOA WAIVERS TO EXISTING FIELD / TANK & NEW HDPE SEPTIC TANK. EXISTING CONCRETE TANK WAS 5'+ TO FOUNDATION PER CODE AT TIME OF INSTALLATION. 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 10/1/22 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 & FW2 COSA Checklist July 2022 - MULLIGAN RD.docx 4 2n . -49 TH ... ....... . Curtis Huffman % CE 128991 .• �� �S� 10/1/22 . •��� �k pROFE$SIONP , � MUNICIPALITY OF ANCIqORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SFRVICES CERTIFICATE OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, townsh~.P..,range) Location (address or directions) (b) PronertvOwner/~/'~'~/~ Telephone:l~.ome 3 ~//'-~ -//~'-~ Business ,=.~"~ "-~'=~/~' (c) Lending Institution/~'~t~/~-"~"~-'Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the followino address: or: Check here~, if hold for pick up List contact person and day phone number below. ~ S & S ENGINEERING ~/034 ~agie kiver Loop Road No. 204 I'~gle River~ Alaska 99577 _ TYPE OF RESIDENCE Single-Family.~ Number of Bedrooms WATER SUPPLY Individual Well/~ Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite,[2{ Public [] Community [] Holding Tank [] Note: If community well system, must I~ave written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72 025 fRev 8/861 Front 5. ENGINEERING FIRM PROVIDING iNSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date showr~ below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date i~l~lle River, Aias~(a 99577 Telephone DHHS APPROVAL Approved for '/¢~'~'¢'- ~¢'.'~_ bedrooms by ~'~: '''~' '"~ Approved /'~ Disapproved Conditional Terms of Conditional Approval /¢~,¢~; ~t/~._+¢--,_ ~// ~'~ /¢,~,-¢',=,,,E' ,',~ CAUTION The Municipality of Anchorage Department of Health and Human Services fDHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72 825 IRev 8/861 Back MONI(.I?A[IT¥ O~ ANCHO2AG E~ViRONMCN1AL SCP, VICES DIVISION ~U~IOIPALITY OF ANOMORAQE ,'--'lUFf t t ~u.~,G~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 RECEtV .D Legal Desorip~ion: _~ WELL DATA Well Classification Well Log Present ~¢'¢~N) Total Depth _ / c/,~ r Static Water Level - Casing Height Above Ground Electrical Wiring in Condui~0~N) Separation Distances from Well: To Septic/Holding Tank on Lot _ Cas? to /~ z- // If A, B, C, D.E.C. Approved (Y/N) Date Completed '¢/~_ Yield . Depth of Grouting Pump Set At Sanitary Seal on Casing ~'~/N) Depression Around Wellhead (Y/~t,~ /(~() ' ; On Adjoining Lots / ~ ''/ To Nearest Edge of Absorption Field on Lot _ To Nearest Public Sewer Line z"///:~ _ To Nearest Public Sewer Cleanout/Manhole ~//~ To Nearest Sewer Service Line on Lot/ ~ <~ /~' Water Sample Collected by ~"~ t,"-,c.>-c:~ ,"~,"~"c;.~'-7¢-/'''z c~ ; Date _ ~/'~//~/',~_ Water Sample Test Results _~'%/-17 Comments .~_z--/~z- /~z~,~,r B. SEPTIC/HOLDING TANK DATA Date Standpipes C/N) . Depression over Tank (Y~-) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Size"J'~5'¢-)¢ ~/~'¢~"~ No. of Compartments Air-tight Caps~/~/N) . Foundation Clean~o/ut (Y/~ Date Last Pumped --'-///~/~ ~'///~ ;for Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holdieg Tank: To Water-Supply Well To Property Line ~v To Water Main/Service Line Course To Building Foundation ~ / ~/ To Disposal Field ? /.~/ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~/~'/z¢/,~ Width of Field Square Feet of Absorption Area _ Depression over Field (Y/~:~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line / c> '-/ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ '~.)p~..o,/204~.~ Type of System Design Length of Field Depth of Field _ Gravel Bed Thickness Standpipes Present (iON) Date of Last Adequacy Test To Property Line. 't/'/5/ To Existing or Abandoned System on ; On Adjoining Lots ~c>/'~' To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M CA and HAA guidelines in effect on the date of this inspection. Signed $ & $ ENGINEERING Date 11034 Eagle RlYer Loop Road No. 26'4 Compa~.agle~t,-er; .&lnslr.~,g¢.~/- MOA No. Receipt No. ¢:~ - ~ (~ ./-- <¢' 0 CD / Date of Payment __.~.~ ¢ ~//~ 0¢' Amount: $ ,,,/ ~ 0 ~ Page 2 of 2 72 026 (Rev 8/86/ 8ack ENCROACHMENT PERMIT THIS AGREEMENT, made this /~? day of 198_~_, between MUNICIPALITY OF ANCHORAGE, Grhn%or, and David MaDstQ~ ~. , Grantee, WITNESS~rH: The Grantor does hereby grant an Encroach- ment Permit in the following described Public Right-of-Way or Easement Area to Wit: ~LM Lot 60 _.__~ated w~th~n SW 1/4 of Section 27~ T12N, R3W, ~.,M. Grid 2936 The encroachment hereby authorized is described as and limited the following: Well encroaches 15 feet into Dav~ S~r~-I- ~igk~of~Way as per ATTACHMENT "A" to In consideration for this permit, the Grantee agrees that he will indemnify and hold harmless the Grantor against any and all claims which may a' 'e or'be caused by the construction, alteration or maintenan existence of the above described encroachment or for es whatsoever arising out of the granting of this ~ ~ The c ~ ~/ 'he right to revoke this permit upon twenty ~ notice to the Grantee. The Grantee, ag~ ~' of revocation, to immediately remove said easement, street or public right-of-way. ~ refuse or fail to comply with said written n~ ~or, may without further notice to the Grantee, re~, .e to be removed the encroachment, and the Grantee here~ ~s to reimburse the Grantor for all cost incidental to the .oval thereof. The Grantee hereby agrees to pay an annual fee of $ 10~00 IN WITNESS ~HEREOF, the parties hereto have hereunto set their hands and seals the day and year first above written. Grantee.' ~/~~ ..... Grantor: ANCHORAGE ~ Municipal Engineer STATE OF ALASKA ) ) SS. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this'~_~7~-- day of , 198_~_, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissi~ned and sworn as such, personally appeared ~/~ ~7~ J. David Norton, known to me to be the Municipal Engineer for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said cor- poration for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the da'{~ and year first above written. ~/~e~. ~ ~~ NOTARY PUBLIC i~ and or Alaska STATE OF ALAS~ ) ~ S/AY5 0~A~S~ ) ss. J ~0TARY ~UBLIC THIRD JUDICIAL DISTRICT ) ~ LESLIE J. JORDAN ~ ~ 19~ ~ beffo~e me~ the unde~gned~ a Nota~y Pubizc ~n and fo~ ~he S~a~e o~ Alaska~ du~ oo~n~ss~oned and suo~n a~ such, personally appea~ed~.~ ~g~ , known ~o me to be ~he ~nd~v~dual named herein who exe~uEed ~he foregoing infO.u- merit, and s/he acknowledged that s/he d~d ~o f[eely and volun- tarily fo~ ~he use8 and purposes the~e~n men~ioned, and on oath sta~ed ~hat s/he wa~ authorized ~o exeou~e sa~d ~nstrumenE. WITNESS my hand and official seal the day and year in this certificate first above written. bp/ep 2 NOTARY PUBLIC in and~for Alaska My Commission Expires:.~ 06-10'87 5.78.4 *lO, g0