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Home My WebLink AboutT12N R3W SEC 25 N2SE4SW4NW4NE4 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP221413 Work Type: WellSeptic Initial Tax Code Number: 01741106000 Site Legal Address: T12N R3W SEC 25 N2SE4SW4NW4NE4 G:2841 Site Mailing Address: 12740 GINAMI ST, Anchorage Owner: SANDSTROM LINDA GRACE Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 1�Zent � n V Depal-talent 11/29/2022 11/29/2023 54450 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1. To divide the effluent between the fields, a flow splitter is required. 2. The existing septic system is to be decommissioned. R,gGeiv,- : I S5,uej -f"r') P 5 Issued By: Date: Date:�1? a/Z- - ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-Y1 1-06 Property owner(s) Linda Sandstrom Mailing address Site address 12740 Ginami Street Day phone Legal description (Sub's., Block & Lot) T1 2N R3W SEC 25 N2SE4SW4NW4NE4 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (IR all that apply) Absorption Field X❑ Initial 0 Single Family (SF) X❑ Septic Tank X❑. Upgrade 1:1Duplex (w/wo ADU) (D) E]Holding Tank El Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: '112 ay Waiver Fees: _ Date of Payment: /6/4P'a;�, Date of Payment: Receipt Number: 68o5-16 Receipt Number: Permit No. 6'se g /,-/ l.3 Waiver No. .� zz s r��.�e� ��v w�l ►� Permit App_:- :- . .,:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221413, Deb Wockenfuss, 11/29/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221413, Deb Wockenfuss, 11/29/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221413, Deb Wockenfuss, 11/29/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221413, Deb Wockenfuss, 11/29/22 GREATEr ANCHORAGE AReA BOROUGH SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT PERMIT NO. ~ ~ ~ OTHER INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD SOIL TEST RESULTS FINAL ~NSPECTION: 24 HOUR NOT~CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC: TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEEPAGE Pit /~d DRAIN FIELD DIAGRAM OF SYSTEM SEPTIC TANK TO SEEPAGE SEPTIC TANK ., SEEPAGE PIT TO NEAREST LOT LINE. DRA[N FIELD /'~/~ ~ SEEPAGE P~T ?/~ /~ WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT /~U ~ , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND ~NTO CRIB C~;{OSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST [EON SIPHON P]PE~ ~EPT[C TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED ]e~ ESIG N E~F~ CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREa BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DA ~ APPLICANT'S SIGNATURE /. v - GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska. 99507 279-8686 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL INDIVIDUAL SEWER & WATER FACILITIRS FOR Approval Requested BI/: (~ //~ ~--~ Type of Facility to b~ Znspect~d.~~¢ Numbe~ o¢ Bed~ooms: -~ Well Data:~ ~. A. Type B. Depth C. Construction 7. -Sewage Dts.6osal System: · A. Installed ~ -Septic Tank: 1. Size D. Seepage Pit: 1. size E. Disposal F~eld: 8. Distances: A. Well To: , Nearest Lot Line B. Foundation to Septic Tank Bacterial Analysis· B. Installer 2. Manufacturer- 2~ Materia! Total Length of Lin6's Septic Tank , AbsorCtion Area ,, Sewer Lines , Other Coh'tamination "> Ab§orption Area C. Absorption Area to Nearest Lot Line_ Requect for Approval of" .vidua] Sewer & Water Faciliti, : Pag~ Two ' 9. Comments: Apnroved Disapproved Date Ap~rova~ Valid for One Year F~om Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this re~ and accurate representation of the sub.~ect a true Signed Date MUNICIPALITY OF ANCHORAGE Development Services DepartmentPhone: 907-343-7904 =T On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-411-06 Certificate of On -Site Systems Approval Expiration Date. 2/28/23 Legal description T12N R3W SEC 25 N2SE4SW4NW4NE4 Site address Current property owner(s) Linda Sandstrom X The On -sites stems Y () is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Existing wastewater system to be decommissioned. New permit applied for. By. Original Certificate Date: 11/28/22 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 AdvisoryNitrate Advisory Tank Age Advisory Arsenic Advisory Other Well Waiver COSA Approval June 2022 U CIPALI Y OF ANCHOR -AGE O Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-411-06 Complete legal description TI 2N R3W Sec25 N2S4SW4NW4NE4 Location (site address) NHN Ginami Current property owner(s) Linda Sandstrom Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: D 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: M Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. 0 COSAApplication June 2022 COSA Checklist Legal Description: %,i I4 WG`- EPacei ID: 017-411-06 If more than I well andtor septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/1973 Total depth 120 ft Cased to 120 ft ❑ Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA AWPS 8/23/22 Static water level at beginning of test MY ? ft. Comments well flow done by AWPS 8/23/22 Measured operating fluid level in septic tank — Date of pumping ❑ Required maintenance com Comments: D. ABSORPTION FIELD DATA if AWWTS 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 introducedr gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 5.3 gpm Water storage tank volume na gallons Well disinfected for coliform test? ❑ Yes n No Coliform bacteria is Negative Nitrate t,%) mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Z Arsenic less than MRL (ND) Collected by AWPS Date 11/3/22 C. LIFT -STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: 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) Effective depth used in Effective depth remaining in in Comments/Deficiencies: System is undocumented and there is a permit OSP221413 in place to upgrade tank and field COSA was never obtained at time of sale. COSA Checklist June 2022 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' _90x Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ❑ Yes if No _90* ft Private Sewer/Septic Line > 25' ® Yes if No ft Field to Property Line > 10' ❑ Yes if No ft Absorption Field on Lot > 100' F-1 Yes if No _9d ft Holding Tank _ 100' Q Yes if No ft Neighboring Absorption Fields > 100' —90 Animal Containment > 50' ® Yes — if No ft ❑ Yes if No ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100` Community Sewer Main > 75' QYes if No ft DYes 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' F-1 Yes if No ft Surface Water > 100' -- ❑ Yes if No ft Tank to Property Line > 5' ❑ Yes if No ft Wells on Adjacent Cots: Field to Property Line > 10' ❑ Yes if No ft r ' �-Pfivate Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No := ff Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑Yes jf-tato y ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS septic system undocumented for this lot. Distances irrelevant as new system being installed. Neighboring system is also approximate based on MOA data on file at Onsite. Well was installed in June 73 prior to code change in October 1973 requiring an increased separation distance from 50ft to 100 ft. 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 l=irm Pannone Engineering Services E'n'-ineer's Printed Name Steven R Pannone P.E., F. ASCE COSA Checklist—June 2022 Phone 907-745-8200 Date 1 %a C. - !v TH ; s-= C: "E S i;< Municipality of Anchorage Uepartmenr P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proqram * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: PSV221078 PID#: 017-411-06 COSA#:OSC221533 Permit#: Legal Description: T12N R3W SEC 25 N2SE4SW4NW4NE4 Engineer: Pannone Engineerinq Services Your request for a waiver of the required 100 feet horizontal separation from the absorption field on T12N R3W SEC 25 S2SE4SW4NW4NE4 to the private well on T12N R3W SEC 25 N2SE4SW4NW4NE4 has been approved. The approved separation distance is 90.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 1 ZZ Approved by: ................................................N:2me ofRe.i:w..................� **** VARIANCE/WAIVER REVIEW **** Steven R.Pannone, Principal Registered Professional Engineer November 15,ZO2J Subject: T12NR3VVSec JSNJ5E4SVV4NVV4NE4 Request for Well Waiver This is a request for a separation distance waiver for an existing well on the subject property to the existing septic field on the neighboring lot to the south T12N R3W SEC 25 S2SE4SW4NW4NE4. 1. Waivers: This well on the subject property was installed in June of 1973 prior to the installation of the septic onthe neighboring lot. The Engineer for T12NR3VVSEC 25SZSE43VV4NVV4ME4indicated that the distance tothe well onthe subject property was 1O8ft. The distance has been determined tobeapproximately gOft.VVetherefore request aseparation distance waiver of9Dft. Both wells have atotal depth mf120'tnthe bottom ofthe casing. The well onthe subject property has a static water level of9' Both wells at grade are atthe same approximate elevation. The test hole performed onthe subject property had noground water toadepth of1l'below grade. The elevation atgrade for the test hole ia 1Z7Ofeet and the elevation atgrade for the well is13Z5feet. To have the static level of the well at 9' below grade and no water in the test hole indicates that there is a confining layer at a depth preventing cross contamination from the surface to the water table. The same concept will apply for the septic systems found at the same elevation as the wells. Granting this waiver will not affect the future development of the surrounding nrexisting lots. |fyou have any questions orconcerns, please contact nneat7S4'8200. Sincerely, OF Steven R. Pannone CE 8149 AV Ap Steven R. Pannone, P.E. Ovvner/[ivi|En8ineer Klai|ing- P.[}, Box 18Q7,P@|rnmr, K09645 Phy5ica|:477ONDoty[|r Te|ephone:'9O7)7�5'B2DO RAI: (9O7)745-Q2G1 TOPOGRAPHIC SURVEY OF: SCALE: GRID No: WORK ORDER No. DRAWN:CHECKED: DATE: FB BOOK/PAGE: Nov. 21, 2022 1"=40' ROLJLA SW2841 160/42 N 1/2, SE 1/2, SW 1/4, NW 1/4, NE 1/4, Sec. 25, T. 12 N., R. 13 W., Anchorage, AlaskaSERVINGALASKASI N CE1982EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the Plat used for this survey. NOTE: Under no circumstances should any data hereon be used for construction or for the establishing of property lines. SURVEY CERTIFICATION: FARPOINT has conducted a physical survey of the subject property, the improvements situated thereon are within the property lines as shown. Found Rebar/IP Septic Vent Power pole PREPARED FOR: Linda Sandstrom PO Box 111171 Anchorage, AK 99511 1.Bearings and distances are record per the Official BLM Plat for T. 12 N., R. 3 W., Accepted July 12, 1951 unless otherwise noted. 2.Sufficient boundary evidence was recovered to establish the subject parcel on the ground. Not all controlling evidence is shown hereon. ZONING: R9 Test Pit Found Spike Robert O. Lumpkin No. 10459 SHEET 1 of 2