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Home My WebLink AboutT12N R3W SEC 25 S2NW4NW4NE4NW4 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221280 PID Number: 017-422-04 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ■❑ Upgrade Name Mosley, Deborah K ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 12441 Turks Turn St, Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms I Rating Total depth from original grade 907-223-3895 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe in from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot T1 2N R3W SEC25 S2NW4NW4NE4NW4 Fill added above original grade—'--_.Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lin Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. betty trenches From Tank Field Tank Line Ft2 t Well >100' >96'* N/A N/A >25' TANK ❑� Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water >1 00' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >1 0' >10' N/A N/A TATION Manufacturer Capacity Remarks *Waiver OSV#221060 Gal. Alarm location Electnc ailed by PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer A+ Home Services Drainfield D3034 CO/MT D3034 Inspector L.Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15, $/4/22 8/4/22 Location and description dates: 2 nd m th Back Door Threshold 3rd 4 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF k Conditional Approval: Date ��Q• ' '9c4,lfl� C2 *: 49 TH •. . Septic System Approve Date 3a- Z r Benja%Schiller �� F�, •, CE 12592 • �`�� %rF •�,C�® • . •8/16/22 . • �1�,� PROFESSlO.,� Note: this approval does not include well permit requirements. trtev uo/uu1u/ F- 7 I � 1-z0LU oLLI> W m o Qzw F- LU ow 01- �WQ w-w� ozmao�� < :D r C) �Mp��QOIL LLUUJ CV .,` ..._.... } m CV N C'7 4 Gh cocoC.010co k r fJ.oz�oo O 3GUpN Pv":l iw W W w Z n �r o ,It z r m d- f 3 w '. \ U) z Cl)Q NZ /� z C/) . // w O- z r (' w i J o t LO W ^^ U Q y W �2 o t\ U)a� %n 00 O Lu wF-fn m \ �-tnN m _N Q N M N ry U) ' O � �� • ® /� W Gr W CL- I:T-R1S NI jnl smn i r Cl1 CNQ • D T12N R3W SEC 25 S2NW4NW4NE4NW4 ENGIN!! RINC P I D # 017-422-04 M mr PROFILE AS -BUILT (NO SCALE) M • , ' • Benja. ' Schiller . •' C 92 F��O 8.6/22,�� \, ;wo-FESS10NP N 0 J 30' -;-a N N 0 (n O �i cp C W N n V) r O �- o N 30' a MIR Unsubdivided m S89'58'00"E 329.99' 30.6' 51.2' 21.0' 0) iA co ui co 4 (6 r- d 00 0) �j S89'58'00"E 329.99' Unsubdivided 57.0' 69.3' 0 O 117 (0 W in N 0 O U) v Q) -a 2 'v a V) C D Survey Certification: I hereby certify that a Mortgagee's As—built Inspection was performed on the described property. 124 E 7th Avenue Notes: It is the owner's responsibility to determine the Legal Description: Anchorage, Alaska 99501 existence of any easements, covenants, or restriction which (907) 306-8104 are not on the recorded subdivision plat. This as—built shall T 12N R3 W Sec. 25 mail@S4AK.com not be used for construction or for establishing property lines. > > > AEC# 173042 S1/2, NW 1/4, NW 1/4) Address: 12441 Turks Turn Street Parcel #: 01742204000 NE 1/4, NW 1/4 Checked by: SC Drawn by. AR Plat: BLM Grid: SW2840 Job: 2022-57 Scale: 1" = 40' Field Book: 110-68 Date: 8/24/2022 Ordered by. Deborah Mosley OF A '* 49TH ** .:..T...- .... �.?., STEVEN CALLA AN,- ' LS— .1/034 40�� fessiono� �'oo Legend: Rebar O Septic Standpipe o Septic Tank Access Lid Pavement Overhang Wood Deck Concrete Gravel 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 Wastewater Disposal System Permit Permit Number: OSP221280 Work Type: SepticTank Upgrade Tax Code Number: 01742204000 Site Legal Address: T12N R3W SEC 25 S2NW4NW4NE4NW4 G:2840 Site Mailing Address: 12439 TURKS TURN ST, Anchorage Owner: MOSLEY DEBORAH K Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: c n t lv Department 7/27/2022 7/27/2023 54450 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: The field may need a separation to well waiver at the time of Inspection Report approval. Received By: % Issued By: G'U Date: Date: 2 74-a- 4 MUHMp UTY OF Z%HCHO RAGE t{rr_ Community Development Department ` _ Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 017-422-04 Property owner(s) Mosley, Deborah K Day phone 907-223-3895 Mailing address 12441 Turks Turn St, Anchorage, AK 99516 Site address 12441 Turks Turn St Legal description (Sub's., Block & Lot) T12N R3W SEC 25 S2NW4NW4NE4NW4 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑x Septic Tank ❑x Upgrade ❑x (w/wo ADU) (D) El Holding Tank ❑ RenewalDuplex ❑ 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: 5 Date of Payment: Receipt Number: Permit No. S P,2 a 1 a� Permit App_'- : ._.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. July 18, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 25 S2NW4NW4NE4NW4- 12441 Turks Turn St Septic system design Dear On-Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, and we are submitting this permit application for its replacement. The attached site plan identifies the location of the home and existing septic location. No conflicts exist between this proposed system and any other wells or septic systems on adjacent lots. The original septic was designed for a 4-bedroom home. That home has been renovated and is now only a 2-bedroom home, but according to our site visit a second 2-bedroom ADU has been built and is tied into this system. So there are still 4 bedrooms on this septic system. The survey provided seems to show that the very end of the absorption trench encroaches slightly into the 100’ radius of the existing well. However, all existing paperwork, including the inspection report on file, indicates that actual separation is 100’. It is possible that the new survey may show this more accurately. In any case, the proposed scope of work does not include any adjustments to the absorption trench. The new septic tank will be a minimum of 100’ from neighboring wells and surface water, and more than 5’ away from the absorption field. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221280, Deb Wockenfuss, 07/27/22 EXISTING ABSORPTION TRENCH TO REMAIN IN SERVICE NOTE: NO SLOPES >25% ARE WITHIN 50' OF THE PROPOSED SEPTIC SYSTEM. NO SURFACE WATER WITHIN 100' OF THE SEPTIC SYSTEM. ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 1"=50'2-BDRM H O M E 1,250 GALLON SEPTIC TANK 20" MANWAY T12N R3W SEC 25 S2NW4NW4NE4NW4 FEET 0 50 100Benjamin Schiller CE 12592R EGISTEREDPROFESSIONA LENGINEER7/18/22 TURKS TURN STREET1160 1170 1180 1190 1200 1210 2-BDRM HOMEGARAGE 2CO 2CO DECOMMISSION EXISTING TANK PER U.P.C EXISTING WELL CONNECT BOTH LINES TO THE NEW SEPTIC TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221280, Deb Wockenfuss, 07/27/22 MUNICIPALITY OF ANCHORAGE ~,.~ ! · ~ ' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE [] NEW MAILING ADD~ESS LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS [ Well I AbsorPtidn'area PERMIT NO, ~ ~ Liq. capacity in gallons Inside length Width Liquid depth I ~ IF HOME.DE: , ~ Well Dwelling PERMIT NO, O ~ ~ Manufacturer Material Liquid capacity in 9aliGns ~ Well Foundation Nearest lot line PERMIT NO, N°' °f lines / ~ ~l '~ inches ~,~. ~ ~ ~,~ inches ~/~ ~'~ Class Depth Driller Distance to tot line PERMIT NO. OTHER PIPE MATERIALS ~ ~ ~ :~ ~/tN ,~STA.~. APPROVED ~ ~ .7'u~;~ DAT~ LEGAL ~ ~/~/~ ~UNICIPALITY 0F ANCHF~'~GE DEPARTMENT F4 ,~EALTH AND EN¢IRCNHENTAL _ . -..' '' 825 L STREET, ANCHORAGE, RE 995~i ' 264-4728 ~]~-I--SITE SEXIER:' pERMIT 'PERMIT NO: 840,~1i° -~' ~ ~~ [:,RTE ISSUED: 06~26,/,_,4 - (~/ ADDRESS: 2ee w 2:4TH ~255 ~ -' I- ' ~ - / '~ '- -- /* ~ --' Rf-&.HJRRuE, HK __5i6 ¢, . -- / ~. ~ , , , /~-. CONTACT PHONE: 56~:-5784 ~ ~~ LEGAL DESCRIP: SUBDIVISION: NB -- LOT: NB BLOCK,:.,, NR SECTION: 25 TOWNSHIP: Ti2N RANGE: LOT SIZE: 54450 (SQ. FT. OR ACRES) LOT LOCATION > --- S1/2NW1/4NWi/4NEi/4NW~¢' MAX BEDROOMS: 4 LISTED BELOW ARE THE OF'TIONS-"RVRILRBLE TO YOU _.~-_.TEM. CHOOSE"TH~:' OPTION THAT BE=.T FITS YOUR .~!T~. ~RE~4C:H DEPTH TO PIPE BOTTOM (FT..) 6.0 GRAVEL DEPTH (FT. ~ 8.0 TOTAL DEPTH (FT.) ±4.0 GRAVEL WIDTH (FT.) 2.5 GRAVEL LENGTH (FT.) ~2.0- GRAVEL VOLUME (CU. YDS. ) 25.~ TANK SIZE SOIL RATING (SQ. FT~/BR) IN DESIGNING YOUR _EPTIC 6.5 6.0 0.5 2.0 7.0 8.0 20.0 . 5.0 -?..8. 0 70. 0 28. ± ~2. 4 i25 12'5 · :~: TANK MUST HAVE RT LEA_T~ TWO COMPARTMENTS I CERTIFY THAT: i. I AM FAMI_IAR WITH THE REQUIREMENTS FOR ON=SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AND REQULRTIONS~ AND IN COMPLIANCE WITH THE DESIGN CRITERI~ OF THISeERMIT. 3. I WILL ADRERE TO ALL MOB AND'STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ONCTHIS OR ANY ADJACENT OR NEARBY LOT. 4. I UNDERSTAND THAT 9HIS PERMIT IS VALID FOR A MAXIMUM OF 4 BEDROOMS AND ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT. IF B LIFT STATION IS INSTALLED IN 8N AREA COVERED BY MOA BUILDING CODES,, _THEN (l) BN ELECTRICRL PERMIT AND INSPECTION MUST BE OBTBINED.~ (2) .,RS-BUILTS WILL NOT BE BF'F~,'OVED WITHOU~AN ELECTRICAL INSPECTION REPORT.~ AND ,..3:) THE ELECTRICAL WORK MUST BE D'ONE IBY A LI~iENSED ELECTRICIAN. _ .......................... '_~--'__ APPLICANT: ~HF¢~¢ -~ WARD MUNICIPALITY OF ANCHORAGE DEPARTIVlENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 ;264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PER.ORMED FOR: ¢,'ar Z DATE PERFORMED: 1 2 3- 4 5- 6- 7- 8- 9- 10- 11 · ~ot,$ott.. t~t~.I. (.o~.) p~-,4r 13- 14~ 15 16- 17- 18- 19- 20- SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross ,' 'N~t' ~ D6CJth to Net Reading Date TiMe Tithe . Wa~er Drop 10.0 2~ PERCOLATION RATE ~*..~ (minutes/inch) TEST RUN BETWEEN ~'*'~ , FT AND 7.0 FT CERTIFIED BY: ~ ~ DATE: 72-008 (6/79) Parcel I. D. 017-422-04 Certificate of On -Site Systems Approval Expiration Date: 11-25-22 Legal description T12N R3W Sec 25 S2NM4NW4NE4NW4 Site address 12441 Turks Turn St Anch. AK Current property owner(s) Deborah Mosley X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: -2 S� 2 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 MUHUPAUTY OF C, Development Services Department On -Site Water & Wastewater Section Z%HCHORAGE `K� V 5 N Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-422-04 Complete legal description T1 2N R3W Section 25 S2NW4NW4NE4NW4 Location (site address) 12441 Turks Turn St, Anchorage, AK 99516 Current property owner(s) Deborah Mode Day phone (907) 223-3895 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS & . , , , , �,, 14 I 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 0 Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass Age � 1 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ®❑ Deep Trench ❑ 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. COSA Fee $ 1530 Waiver Fee $ Date of Payment 5//0A_ -z Date of Payment COSA # 05G ZZlq Z I Waiver # COSA Applicationjune 2022 Legal Description: T12N R3W Section 25 S2NW4NW4NE4NW4 Parcel ID: 017-422-04 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 1961* Total depth 120* ft Cased to 30* ft FOR Sanitary seal is functioning correctly FOR Wires are properly protected Casing height (above ground) 16+ in. Date of flow test for COSA 5/15/22 Static water level at beginning of test 47 ft. Comments *Per MOA documentation B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: Installed 8/3/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/31/86 ❑Q ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 3.6 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. Fol Monitor tubes go to bottom of effective. If not, state depth into effective 8.8 ft ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 1.1 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ Nc ❑ Coliform bacteria is Negative Nitrate 1.45 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 6/29/22 C. LIFT STATION L3 -R -e fired maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/18/22 Results Fi-I Pass Fluid depth prior to test 28 in Water added 600 gal New fluid depth 58 in Elapsed time 1440 min Final fluid depth 23 in Absorption rate '600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 96 in Effective depth used 28 in Effective depth remaining 68 in 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 ft ❑ Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' FN-] Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *96 ft Holding Tank > 100' FE] Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft rj] Yes if No ❑ 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' FE -1 Yes if No ft Surface Water > 100'®❑ Yes if No _ Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' [-E] Yes if No ft Private Wells > 100' jQ Yes if No _ Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No _ Water Service Line > 10' Fu� Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *See waiver request. All previous physical measurements indicated 100' due to slopes on the lot. Recently required survey shows strict horizontal measurement of 98.5' to cleanout. ft ft ft W 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 Forge Engineering Phone (907) 522-7773 Engineer's Printed Name Benjamin Schiller, P. E: COSA Checklist—June 2022 Date 8/25/22 Aw • Fq�� 49 TH • " r• Benja chiller �� 'Fc •. CE 12592 ��hApROFESSI4NP . Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proqram Waiver#: OSV#221060 COSA # OSC221421 Permit#: OSP221280 PID#: 017-422-04 Legal Description: T1 2N R3W Sec 25 S2NW4NW4NE4NW4 Engineer: Forge Applicant: Deborah Mosley Your request for a waiver of the required 100 feet horizontal separation from the drain field to the well has been approved. The approved separation distance is 96. This waiver approval applies to the Existing Trench to well 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. mvvommaammmmvammmavamvmavmmveaemmvvamvaaamamaaamammaamvmvaaveavmamvaaavvmaavmv� Waiver is Granted: X Waiver is not Granted: Date:y� 2 2 2-- Approved by: Nam of Reviewer vavvvmcamavaeaavvvamvammaaKaaammvvaaaammmmamaaavmm■ mmmaaavaaammvaaaaavmveamva� August 25, 2022 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 25 S2NW4NW4NE4NW4- 12441 Turks Turn St Well waiver request Dear On -Site Services Engineer: A septic permit was issued for this lot on June 26, 1984, specifying the code -required minimum separation distances from the well to the absorption trench (100'). An inspection report for the installation was submitted and approved on October 31, 1986, with a sketch showing the 100' separation to the nearest end of the field. This was measured physically down the slope of the lot and was accepted. A Health Authority Approval was issued in 1986 confirming this separation, and the home was sold. The current homeowner has replaced the septic tank, and the subsequent survey shows that the strict horizontal separation to the cleanout is 98.5. We have taken a water sample from the well and found total nitrates under 10 mg/L (actual result 1.45) with no bacterial contamination. The location of the well is uphill from the septic trench, so there is no possibility that effluent could overflow the system and run toward the well. In addition, the system has existed for over 30 years with no adverse effects to the occupants. Based on this information, we hereby request a waiver be issued for the 96' separation between the well and absorption trench. Sincerely, Beira amin Schiller, PE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALs.I(~. ~ \O~ OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date IO / ~.,~/~' GENERAL INFORMATION (a) Legal Description (include rot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name (c) Telephonel Home ,5'~'! '~¥YO Business 'b-O~ -'-~?~' Applicant Address q,¢'~/ ~ 1.~ ~ A"~c/~'~',=ff5 /I-~ ?'25"03 Applicant is (check one): Lending Institution []; Owner/builder ~; Buyer []; Other [] (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent ~,A, ( ..~:~l,¢~. ~'v o~.~ner) /, - Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [] Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well [] Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite J~ Public [] Community [] Holding Tank [] Note: If commuaity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ~ As certified by my seal affixed hereto and as of the validation date shown 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 alt Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm' ~'(~ ~-'o~ '7~,~ ~"~! ~C~ Telephone ~ ~' Address Date ~0/~{ ~ Engineer's Seal Approved for ?~"O"'-'~_~"~~''~ bedrooms by~V'~/~ ~"~'~"'~-'t.-~ate Approved ,~,/'~ Disapproved __-- Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Well Classification t='¢'tv,~'~,~ ! If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) i~ Date Completed, ~ 1~6'! f4r o~,a¢,"' Yield Total Depth I ~O' Cased to ~. ~e,~,~,¢~ Depth of Grouting N,,~, Static Water Level 8 7 Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Pump Set At i I ~ ' Sanitary Seal on Casing (Y/N) ~' Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by 1'lc't/ Water Sample Test Results ~m~/~-'~¢J'~? Comments tO t ; On Adjoining Lots "~ too ' ~, 04~ ; On Adjoining Lots ~' ~oo ' To Nearest Public Sewer To Nearest Sewer Service Line on Lot ~1, ~. ; Date {o / ~ 17 / 06' B. SEPTIC/HOLDING TANK DATA Date Installed ? [P_t / Standpipes (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~o To Property Line Size ~.pO~'~,l No. of Compartments Air-tight Caps (Y/N) ~" Foundation Cleanout (Y/N) Date Last Pumped N, b. ; for N, .4. N,,~. Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field _~' To Water Main/Service Line Course To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 2910J RECEIVED 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/&l / ¢~t Width of Field ~'O Square Feet of Absorption Area Depression over Field (Y/N) K/8 Type of System Design Length of Field ' 3' ~ ¢ Depth of Field I/'f ~ Gravel Bed Thickness ~' ~ Standpipes Present (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test ~1~(-¢ Separation Distance from Absorption Field: To Water-Supply Well ~OO ' To Building Foundation ~-'7' ~¢~-~.~ c,~,, To Property Line ~" ' To Existing or Abandoned System on Lot _ $' To Water Main/Service Line N, To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments .~r,~ ¢, r~c~.~v, ; On Adjoining Lots h'.~ ' 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 MOA and HAA guidelines in effect on the date of this inspection. Signed ~ ,..~' ~ Date /O/' P-~ /' ~ ~' Page 2 of 2 72-026 (11184) Engineer's Seal MUNICI OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 017-422-04 Certificate of On -Site Systems Approval Expiration Date: Legal description T12N R3W Sec 25 S2NM4NW4NE4NW4 Site address 12441 Turks Turn St Anch. AK Current property owner(s) Deborah Mosley 11-25-22 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: _Z S� 2 10 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 ApprovaLJune 2022 n � � vu 5? Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section 6 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-422-04 Complete legal description T1 2N R3W Section 25 S2NW4NW4NE4NW4 Location (site address) 12441 Turks Turn St, Anchorage, AK 99516 Current property owner(s) Deborah Mosley/ Day phone (907) 223-3895 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS & . , , . , -,, .4 I 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 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ 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. COSA Fee $ - 50 13 30 Waiver Fee $ Date of Payment ��S/Z2 Date of Payment COSA # 05C, ZZ l y Z I Waiver # COSA Application—June 2022 Legal Description: T12N R3W Section 25 S2NW4NW4NE4NW4 Parcel ID: 017-422-04 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 1961* Total depth 120* ft Cased to 30* ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 16+ in. Date of flow test for COSA 5/15/22 Static water level at beginning of test 47 ft. Comments *Per MOA documentation B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: Installed 8/3/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 10/31/86 n ALL standpipes present per record drawing Total measured depth from grade 12.4 ft (max) Measured depth to pipe invert from grade 3.6 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 8.8 ft ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 1.1 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.45 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 6/29/22 C. LIFT STATION fired maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/18/22 Results Fm-]Pass— Fluid m-]PassFluid depth prior to test 28 in Water added 600 gal New fluid depth 58 in Elapsed time 1440 min Final fluid depth 23 in Absorption rate '600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 96 in Effective depth used 28 in Effective depth remaining 68 in 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' 0 Yes if No ft Community Sewer Manhole/Cleanout > 100' Yes if No ft ❑Q Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *96 ft Holding Tank > 100' Pm] Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft no Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' R Yes if No ft g 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' Fm -]Yes if No ft Surface Water > 100' g Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Field to Property Line > 10' Fm� Yes if No ft Water Main > 10' ❑® Yes if No ft Water Service Line > 10' E Yes if No ft Wells on Adjacent Lots: Private Wells > 100' E Yes if No ft Community Wells > 200' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *See waiver request. All previous physical measurements indicated 100' due to slopes on the lot. Recently required survey shows strict horizontal measurement of 98.5' to cleanout. 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 Forge Engineering Engineer's Printed Name Benjamin Schiller, P. E. COSA Checklist—June 2022 Phone (907) 522-7773 Date 8/25/22 - •' TH . • ' Ben'a • chiller • • • • . �Fc�d% CE12592 � ��F�PROFESS10Nf`��,� Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage Alaska 99519-6650 0 (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program Waiver#: OSV#221060 COSA # OSC221421 Permit#: OSP221280 PID#: 017-422-04 Legal Description: T12N R3W Sec 25 S2NW4NW4NE4NW4 Engineer: Forge Applicant: Deborah Mosley moment S� 1° n L eparnnent Your request for a waiver of the required 100 feet horizontal separation from the drain field to the well has been approved. The approved separation distance is 96. This waiver approval applies to the Existing Trench to well 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. mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm� Waiver is Granted: X Waiver is not Granted: Date: yr 2 2 2--- Approved by: Nam of Reviewer mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm■ mmmmmmmmmmmmmmmmmmmmmmmmmm. August 25, 2022 PO BOX 240773 ANCHORAGE, AK 99524 522.7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T12N R3W SEC 25 S2NW4NW4NE4NW4- 12441 Turks Turn St Well waiver request Dear On -Site Services Engineer: A septic permit was issued for this lot on June 26, 1984, specifying the code -required minimum separation distances from the well to the absorption trench (100'). An inspection report for the installation was submitted and approved on October 31, 1986, with a sketch showing the 100' separation to the nearest end of the field. This was measured physically down the slope of the lot and was accepted. A Health Authority Approval was issued in 1986 confirming this separation, and the home was sold. The current homeowner has replaced the septic tank, and the subsequent survey shows that the strict horizontal separation to the cleanout is 98.5'. We have taken a water sample from the well and found total nitrates under 10 mg/L (actual result 1.45) with no bacterial contamination. The location of the well is uphill from the septic trench, so there is no possibility that effluent could overflow the system and run toward the well. In addition, the system has existed for over 30 years with no adverse effects to the occupants. Based on this information, we hereby request a waiver be issued for the 96' separation between the well and absorption trench. Sincerely, Benjamin hiller, PE 30' +j N L (J-) 0 6 CO C L W CV � O L F 30' c m m M Unsubdivided S89°58'00"E 329.99' 30.6' 51.2' 21.0' a) h U? h d(6 000 rn N I It S89'58'00"E 329.99' Unsubdivided 57.0' 69.3' 0 0 L6 CO W in C1! 0 0 Survey Certification: I hereby certify that a Mortgagee's As—built 124E 7th Avenue Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the Legal Description: Anchorage, Alaska 99501 existence of any easements, covenants, or restriction which (907) 306-8104 are not on the recorded subdivision plat. This as—built shall T12N R3W Sec. 25 mail@S4AK.com not be used for construction or for establishing property lines. > > > AEC# 173042 S1/2, NW 1/44, NW 1/41 Address: 12441 Turks Turn Street Parcel #: 01742204000 NE 1/4, NW 1/4 Checked by: SC Drawn by. AR Plat: BLM Grid: SW2840 Job: 2022-57 Scale: 1" = 40' Field Book: 110-68 Date: 8/24/2022 Ordered by Deborah Mosley � .. °�....4-�soo '* 49TH *** ................................ . r.7.....-.....-. STEVEN CALLAGHAN.- 0LS 1 03A 'V �-aA ..•7.7.•- �OLJ 0�� fessiono� �oo Legend: Rebar O Septic Standpipe m Septic Tank Access Lid Pavement Overhang Wood Deck Concrete=:;'• Gravel