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HomeMy WebLinkAboutT12N R3W SEC 33 LT 111AOnsite File sk M "h3 W EC 3 *4 IZN R wv %W fR•�i�iT1 The 1981 absorption field may not be tested for a 4 bedroom C• Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221000 PID Number: 018-252-29 Dwelling: IWE Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 9 Upgrade Name THERESA BRIGMAN ABSORPTION FIELD Q Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 2700 NUGGET LANE *ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-244-6017 4 0.8 GPD/SF 11 & 11 (MAX) Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 6.02 & 6.02 Ft. Subdivision Block Lot Fill added above original grade SEE DWG. Ft. Gravel length 40 & 40 Ft. Township Range Section T1 2N R3W SECTION 33 LOT 111 A Gravel width 2.5 & 2.5 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 960 Ft 2 2 12+ Ft. Well 100'+ 1 ��'-I- 25'+ TANK � •Septic ElS.T.E.P. ❑ Holding El Other Manufacturer Capacity GREER TANK 1250 Gal. Surface Water 100'+ 100'+ Material Number of compartments Lot Line 10'+ 10'+ NA PLASTIC 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity 1 Remarks OLD TANK DECOMMISSIONED PER UPC PER CONTRACTOR Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tankto D3034 A+ HOME SERVICES Drainfield D3034 CO/MTD3034 Inspector GEG AND MOA BENCH MARK (Assumed elevation) 103.18 ft Inspection ection 151 6/8/2022 2nd 6/9/22 Location and description 3'' 6/9/22 4`' 6/10/22 TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Itamp 00600 Conditional Approval: Date " 0.......J....................�� .-- .. f ,J............. Septic Syste Approved Date � A ffrfe" A. arne Q G 0 �`� p Q S • { c.-��� �o� Qp ��,. �1-. -��•�-�'•"��o � _ 44 No : this approval does not include well permit requiremen . 7 ed /' - nab o avEccaa4000000� trtev c;:)iuu/ray 0 PERMIT NUMBER: esP221000 RECORD DRAW(NG NUGGET LANE X90 S C04 7547 130,2 MT4 155.6 131.2 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN ITOCAD. ASSUMED LOCATION OF 1981 TRENCH PER SUMP LOCATION AND NEW C/O AT EAST END OF FIELD \ I NEW DRAINFIELDS %, .O: W ' g W � T< GL c H o PARCEL ID NUMBER: 018-252-29 EXISTING 4 ' BEDROOM HOUSE GENERAL LOCATION OF 100' / WELL RADIUS; FLAGGED BY PLS / DURING CONSTRUCTION J / m 182 +/ RESERVE SITE r__T.N.#1 � MT Tl 2N R3W SECTION 33 LOT 111 S99' / \ 1 m V = 40' ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101' ANCHORAGE, AK 99507 -PHONE (907) 337.6179' FAX (907) 339-3246' WEBSITE: w�w� ya.messmy�neerny mm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: THERESA BRIGMAN 907-244-6017 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: T12N R3W SECTION 33 LOT 111A D.J.G. TYPE OF WORK: DATE: -,._ SEPTIC SYSTEM RECORD DRAWINGS 6/29/2022 n" PERMIT NUMBER: PARCEL ID NUMBER: OSP221000 RECORD DRAWING 018-252-29 TH TOP OF TANK AT INTLET = 95.49 INVERT OF BUNG AT INLET = SOUTH ORIGINAL GRADE AT HIGHEST POINT = 97.56 6.02 FEET TOP OF MH = 103.18 FINAL GRADE = 102.11-102.96 ST2 NEW 1250 GALLON H.D.P.E. GREER SEPTIC TANK FINAL GRADE = 96.90-97.50 FILTER FABRIC INVERT OF PIPE = 92.58 BOTTOM OF TRENCH = 86.56 — RELATIVE ELEVATION AT BOTTOM OF T.H. = 80.06 (RELATIVE ELEVATION OF G.W. AT 80.23 ON 618/2022) TOP OF TANK AT OUTLET = 95.46 INVERT OF BUNG AT OUTLET = 94.66 NORTH ORIGINAL GRADE AT HIGHEST POINT = 98.7 6.02 FEET FINAL GRADE = 97.53-99.52 TH FILTER FABRIC INVERT OF PIPE = 93.79 BOTTOM OF TRENCH = 87.77 RELATIVE ELEVATION AT BOTTOM OF T.H. = 81.27 (RELEVATIVE ELEVATION OF G.W. AT 81.44 ON 6/8/20 .....1 - ,..w ui i = iu i - ANn NU w t:, AK 99Ju/ - PHONE (907) 337.6179' FAX (907) 338-3246 • WEBSITE: v .gamessengine PREPARED FOR: PHONE NUMBER: PAGE NUMBER: THERESA BRIGMAN 907-244-6017 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: T12N R3W SECTION 33 LOT 111A D.J.G. TYPE OF WORK: DATE: ASEPTIC SYSTEM PROFILE RECORD DRAWING 6/29/2022 OF, ,' 0�® ®®�P...., ..,®®® �� f®®0 �........ .. .... .,1.w..c.::.....0 Je rey A. Garness -'g7 m, `m f C -79 3 •�AV AV 40, ®®m pROFESSI�P®®o LICENSE®�8�®���`® #AECC884 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program pOBox 19oono *700 Elmore Road Anchorage, Alaska oe51e'ssnu Phone: 343-7904 Fax: (oor)0007yur xop://m*nwmuni.ow/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221OOO ' o�c Effective Date: Work Type: Septic Upgrade Expiration Date: Tax Code Number: 01825229000 Site Legal Address: TI 2N R3W SEC 33 LT 11 1A G:3034 Site Mailing Address: 27UUNUGGET LN, Anchorage Owner: BR/GMANNICHOLAS VV&THERESA J Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: ' Disposal Field 0Septic Tank [] Holding Tank [] Privy 1/13/2022 1/13/2023 Lot Size inSqFt: 37125 Total Bedrooms: 4 ' []Private Well [lWater Storage All construction shall bainaccordance with: 1. The attached approved design. 2. All requirements specifiedi Anchorage Municipal codChapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (I 8AAC72) and Drinking Water Regulations (1 8AAC80) — 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 1GtoApril 16.asubsurface soil absorption system undoruonotrucUonduhngfn*ezngwnaUher shall beeither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing Received Issued By: Date: — / / /,-'3 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Ethan Berkowitz On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 018-252-29 Property owner(s) THERESA BRIGMAN Day phone 907-244-6017 Mailing address 2700 NUGGET LANE *ANCHORAGE, AK 99516 Site address 2700 NUGGET LANE *ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) T12N R3W SECTION 33 LOT 111A Legal description (Township, Section & Range) _ Lot Size Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms_ _ 4 APPLICATION IS AN: Initial ❑ Upgrade 19 Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: S ? 5 Waiver Fees: Date of Payment: Date of Payment: Receipt Number:0517 ? �iG Receipt Number: Permit No. 0 s`0 °2 16 0 0 Waiver No. (Rev. 01/11) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221000, Deb Wockenfuss, 01/13/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221000, Deb Wockenfuss, 01/13/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221000, Deb Wockenfuss, 01/13/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221000, Deb Wockenfuss, 01/13/22 Q) K N_ ml 00'961 9.00,90 oOOS CIO 4K t, 416*1 6Zo7k 1-• 6 - LA. o o Jl 4n (^ Z V) LLJ LL 0 4k CL cti (1) co + (1) Z 0- r_ -A) LL C/) 00 CV) �o ri cr" '4 tj ct� U, Mo'd J-N3pv3sv3 Ainun,ok co OHU—OHU OHU _1OHU OH 00*961 M,00 OoOON W ek107 4a 0. _lK dOHS uj C'OE N, CN Lry Q N LGA rN14 0 z Z C6 4) 0 m loo 0. 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C 7 3 s N C D ro mCL 0 ro D (Do O N Cn 0�Q�� ora° to 0 D C 00 B 2 2 c o (D m m 0.33 (D 00 C O m v < N 3 (D O U) a O 7 5 O o a p O v;0 v N 0 ? a CT a m c 00 a m m i Q N N v CD N p Q N a o a a m ro _: v Z,:2 0 0 0 a ? < N o m o m m (DK v O� m cm a� Q : O m 0 m CL rn o ma 0 m 83o.m 3 m v CD � in w Q -P W N -' 0 D D m -I � X (D s X I ma a° O O v m O m N o o ^ n NO 3 N (D v X- O 3 N m :3 (D a CO O N N N N N rt SD CD v.ar n �ro o D v o �o v mmSD' v s n 'ro0 � _= a (D XX fm -r E m v 0 (D CD. F 0 7 :. NOO' 06'00"W 198.00 :P (D O ro 'In U T c o (D (D (D o mo C) a h 74� co = 10' UTILITY EASEMENT o ro v -. _. X .00L � O i w E a (D N (D n U N O ID CC G 0 0 CD (D 0 0 (D a �m •. F n O � C (D N C+7 Cn n Q (D W 5• O m D LOT 112 / N :. NOO' 06'00"W 198.00 II , a• >' , :•' •, s' ° .. Ho nHo /IHO /WO -OHO 10' UTILITY EASEMENT _ rn •. N O ro '7 , i� - �1� m03 r 9.0 o cor- O co n \cN z1 15.6 0 (°03 a < IR Zp r A a I 3 m 14.9 N o m co _ Q j ry�, \�n \ OJ A MB G) !n ^GCa y W p N A rn y V N v N Ka ooWn b \4_11.5 Q� v \�\ � rn n N 30.3m� `14.6y m y sm �ti f roq. } N \s cn m h,> m I 42.7 ' \ ().0 127,9 127,9 w O 10.5 co N I � -r � CD 00 33' 0 S00°06'00"E 198.00 R.O.W. v 0 I isi LOT 111-8 I NAME MUNICIPALII'Y OF ANCHORAGE DEPARTMENT OF ItEALTN & ENVI;~ONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM /A~i~lili~l~l~iil;;L INSPECTION REPORT PHONE -- EW NO. OF BEDROOMS Driller Distance to lot line Absorption area(s) OTHER PIPE IVlATERIA LS SOIL TEST RATING APPROVED DATE LEGAL PERH ~[ '!" ~;]F:PL ][ I]:F~l",! l L .OCF:I"I' I EI!',I [ E(]iF![. J I:::IIC C Of,IS T'[;?.IJ C T I Ed"! !RI:::IEI~?,IT CI';.:[!]EK SMI::'ILL L ;:1.,:1i1::1 I:';'.t:::IE~;~IT C:I'~'.. SM. TR. S,.'"D CH I I.,.I-( FIT CT, EFI(.~I.E I:;?.I',,,'EF?. I._0"[' S I ZE 'f"¢F'IE OF S(] )i t.. I::It~:SOIRF'T I 01'.,! S'.?S'I'EM I S: 'T'RIEIqC:H I'"IFi',:':',IP'IUM NL.IME:E]:;?. OF E:IZ[:,ROOMS = iii: '.E;O I [... RI::I"I" I NG ( S(;! F F,.'"E:R 1:, .... 22~;i!~ TIqE I;?E~:!LI I [~'E[:, S 12% iii[-- THE fi;O I L F:IBSORP-I" I ON S'¢'.~;'I~EM I '~i;: I'FIE I...ENGTH [:,Ii"IEt'.,!'ii;ION IS 'FI-..IE LENGTH (I1",1 FEET) OF' :f'HE "['I:,~:E!",ICH EIR [)RFIIi",IF'IEL.[) TI..IIZ t}EF'T'I~I OF' FI 'I'I[.'.ENCI4 OR F']:T Z~; THE [:,:['_'a;TFIt'.,ICE 8ETI,IEEN TI..'l[i~ SLIIi:FFICE OF THE GIROI.)I'..f[) FII",ID THE IBOT"I'OM OF THE Ei:.::CFI',,,'FITION (IN FEET::,. "FI-IERE IS NI:] SE'T t,II[:,-[H I::'OR 'I-REI'.,ICHES. I'HE GRI:::tVEL DEPTH IS ['HE t','IINIMUi"I [:,E:PT'FI OF' GRFIVEI.. E~IE"I'HEEN THE OUTFFII..L. F'iPE FIND ]'HE BCFI'TCIM OF THIE EXCFIVlaTIC~N (It'.,I FEEl"). I::'ERI"IlT I::IPPt..ICFINT I'.ll::l'ii: 'I'I.~E F,~:E:i];I:::'Cd",ISIE~ILIT"r' '['0 iNFORM ]HIS [>I~]::'F:II:,~fI'I"IEI'qT [:,URI!',!G THE ZI",IS'f'FII.L.FITZON IN'J'~;PECTIONS CIF;' f::It',l"r~ I,IEL.I..S R[:,.]'F~CEN'I' TO '[l-II'J~ F:'ROPE]?T"¢ FIND TFIE I'.,II.fM[?,EF;: 01:: RE'.~i;IDIE!".ICE:~i; 'I'HFtT THE I.,.IE[..I_ I.,.IILL ................ "]I'" I1 ,,-~ EiZ~ ,CZ J~:i: ]:" ]E iP.,,!I ~:~; E:::" EE ICi: '~"' ::E ~.::;:;~ ~'",,-~ ::E~!; !Fit ~::;ii: F,E[; ]:;;~1: l[iE; ~.:~ L.t % I1::~: il'i;~ iE> ................ BF:ICI<F i LL I NG OF' I:'INV %'-¢S'1'1~]"1 14 ]' THOI...IT I'::' I NFIL i t'.,ISI':'ECT 101'.,I F:I[',!I} F:IPF'I:;~:CI',?FII... B'¢ 'tH I S t}EPF:fRTP1EI'.,t'I" filL. l_.. 8E ~Jlj[.~IJ'ECT TO PI~'.OSECU'TIC~N. I"11[ N I I"IUM D :l. EIE~ FEE] I_IP(]I'..! THE 'F"¢f::'E OF F:'IJE',LIC I,.IELL. M!NIi"ll..fM [:,IS'['FINC:E FRCIM FI PRIVFI"FE HELL TCI I::1 PRIYFI]'E CiEI,.IER I..INE I::2 25 F:!EET I:::11",![:, l'O FI COI"IMUNI'F'¢ '-:';EI.,.![E[;;[ LII",IE IS 75 FEET. O"I"HEf;?. IRE([!I..I I I:REi'flENT':i:J; MF:I"? FIPF'L% SF'EC I I::' I (}FIT' I OI",IS FII",I[:, C. ON:[!;TRIJCT I ON D I FIGRFIMS F:tRE FI~,?t:::I ]] L F:IEILE TO Z i'.,I'.E;I...II:,~'.E I:'I;~(]F'EF';: '[ PlSTFILLFI-i- I EIN. 1f: CEIRT I F"¢ THI::I-r' ::1..: ! F:Ii'"I FI::IMILIFIR HiTH TI-lIE [;~:E(;!I..IIREMENTS FOR OI',I-SITI:Z SENERS FINE:, I,.IEL.I__S I:::1~:~; FORTH B'~" THE MUNZCZPF:ILI'I"'¢ [)F F:INCIIORFIGE. 2: Z t.,.IILL ZN?'f'FILL THE S'.r':E;]'EI'I :I:N I::ICCORDFINCE 14ZTH THE C:ODIES. :i:: I IJhI[:,EP. STFaN[:, THFIT THE (]N..-.SITIE SEI.qER S"r'STEM I"IF!"," RIE(;g. JIRE E},ILFII:;:GEP!E~:NT IF' I'I'IE RE'.EiI[:,E]",IC:E ZiE; I:REMO[)[EL.E[:' -I-0 INCLUI}E MORE THFIN ]: PERFORMED FOR: LEGAL DESCRIPTION: JA/4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST (.~ (2 ~L) ~- DATE PEREORMED: PERCOLATION TEST 1 2 3- 4- 5- 6- 7- 8- 9 SLOPE 10 11 12 13 ENCOUNTERED? · pO IF YES, AT WHAT E DEPTH? 14 15 16 17 18 19 20- COMMENTS ., -, ~Reaaln~, Data Gross Net Deplh Io Nat Time Time Water Dxop PERCOLATION RATE ~d-~3 (minutes/inch) TEST RUN BETWEEN ~£- FTAND "~ FT zzo s,(, ,//5 PERFORMED BY: CERTIFIED BY: 72-00B [6/79) Parcel I.D. 018-252-29 Certificate of On -Site Systems Approval Expiration Date: 8/8/2025 Legal description T12N R3W SEC 33 LT 111A Site address 2700 NUGGET LN Anchorage AK 99516 Current property owner(s) BRIGMAN 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: 9/9/2024 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. COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA ApprovMjune 2022 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ANCHORAGE'2\():5 Phone- 907-343-7904 Fax- 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D.018-252-29 Complete legal description Location (site address) T1 2N R3W SEC 33 LT 11 1A 2700 NUGGET LN ANCH AK Current property owner(s) i 0.1 Sol Eel &A W, L 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: FN� Private Well [:] Private Well serving 2 dwelling units 0 Private Well serving 3+ dwelling units [] Community Well or Public R Water Storage 4. TYPE OF WASTEWATER DISPOSAL: F-01 Private Septic ❑ Private Septic serving 2 dwelling units 0 Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: [] Steel OR Plastic R Concrete 0 Fiberglass Age 2 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: E] AWWTS n Bed nE Deep Trench n Wide Trench El 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 $--560 Waiver Fee $ Date of Payment (Pa4o e Date of Payment COSA # 05C221-t 12-q Waiver # COSA Applicationjune 2022 COSA Checklist Legal Description: T12N R3W SECTION 33 LOT 111A Parcel ID: 018- 252- 29 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 `1960's Total depth '56 ft Cased to >40' ft ❑� Sanitary seal is functioning correctly ❑� Wires are properly protected Casing height (above ground) 30 in. Date of flow test for COSA 7/23124 Well production at time of test 3+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes 0 No 0 Coliform bacteria is Negative Nitrate 7.52 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by MNA Static water level at beginning of test 32 ft. Date 8/8/24 & 8/20/24 Comments FROM MOA FILE. WELL CASING IS 30" ABOVE THE CONCRETE BASEMENT SLAB W/ SUMP IN THE CONCRETE SLAB ABOUIT 6' AWAY B. TANK DATA Measured operating fluid level in septic tank 5.2' Date of pumping 9/3/24 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 6/10/22 0 ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 5 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 Comments/Deficiencies: NORTH TRENCH TESTED. COSA Checklist June 2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 818124 Results Q Pass Fluid depth prior to test 4 in Water added 600+ gal Newfluiddepth 13 in Elapsed time 1440 min Final fluid depth 4 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 4 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' 7n Yes if No _ ft Neighboring Tank > 100' Q Yes if No _ ft Absorption Field on Lot > 100' 0 Yes if No ft Community Sewer Manhole/Cleanout > 100' ❑C Yes if No Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100'❑ Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' QYes if No ft F Yes if No _ ft Manure/Animal Excreta Storage��> -1I00' Community Sewer Main > 75' s❑ Yes if No _ ft L I 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' Q Yes if No _ ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' ❑i Yes if No _ ft Wells on Adjacent Lots: Field to Property Line > 10'❑ Yes if No _ ft Private Wells > 100' Q Yes if No- ft Water Main > 10' R Yes if No _ ft Water Service Line > 10' ❑� Yes if No ft F. ENGINEER'S COMMENTS Community Wells > 200' 9 Yes if No _ ft If tank or field is under driveway comment below 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 M AL Lq , i-e f4f)h P, IF — Phone 727-8864 Engineer's Printed Name Ci4-n, P Date 9 gE OF Atgl1, �1V1-•••••••.• O V-• MICHAEL N. ANDERSCN i•. CE-9469 •'~� COSA Checklist —June 2022 V � 1 ,wOANCHORAGE DEVELOPMENT SERVICES DEPA T ME#�4 3 ` i.�\ � 907-343- 9 On -Size Water and 47` aster ad ter Se C)n �') Eax: 343-7997 www.ri"'uni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC241292 Subdivision: T12N R3W SEC 33, Block: , Lot: 111A A water sample revealed a nitrate concentration of 7.52 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice 20241979 Bill To: Michael Anderson, PE 4661 Natrona Ave Anchorage, AK 99516 Ship To: Michael Anderson, PE JOB: 2700 Nugget Lane Anchorage, AK 99516 SALESPERSON RIDGWAY, TYLER S YOUR NO. 39137 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 9/5/2024 PG. 1 QTY.ITEM NO.DESCRIPTION PRICE DISC %EXTENDED PRICE TX. We appreciate your business. Thank you!SALE AMT. FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE 1 Service Call CAMERA WELL FOR ALL DETAILS 1 FIELD SERVICES 09/04/24 - Open well seal, camera well. Static water level 27' and total well depth 56'. Customer requests casing depth measurement and general condition report. Casing appears to extend full 56' depth of well. No damage or openings noted during camera survey. $258.00 $258.00 1 ST5-Tyler Service Tech 1 ST19-Dennis Service Tech Helper 1 CAMERA WELL CAMERA $400.00 $400.00 $658.00 $0.00 $0.00 $658.00 $0.00 $658.00 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMEN];AL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date. ~-.7~--9~:~ ._ (a) Legal Description (include lot, block, subdivision, section, township, range) Location (addrees or dij~e~tions)/ , Business (C) Applicant is (check one) Lending Institution ~ ; Owner/builder Buyer ~ ; Other F-~ (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address (f) ~ezepaone .~- . Mail the HAA to the following address: 2. Type of Residence Single-Family.~ Number of Bedrooms Multi-.Family~-~ Other (describe) 3. Water Supply- Note: If community well sysuem, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ~ 4. Sewage Disposal Onsite~ Public ~ Community ~ Holding Tank~--~ .'i' Note: If community well system~ muse have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] e Engineering_Firm Providing Inspections, Tests i. File Search,~ Data andInformation As certified by my seal ~.ffixed hereto and as 'of.the validation da'tei'sh6w~{'.bi~lo;~,' I verify that my investigation of this Health Authority Approval shows that',the on-site water supply a,nd/or was*ewater disposal system is safe, functional and adequate', for the number of ~edrooms 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 codas, ordinances, and regula- tions in effect on the date of this inspection. , , .~.. Name of Firm~-~-~_~ ~.~f.~_~ ~'~ ~/~_~ Telephone' Approved for *A~bedrooms B~~'~' ~ Date Approved / ~ Disproved .---- Con~ion~---- Te~s of Conditional ~pproval CAUTION THE M~JNICIPALITY OF ANCHORAGE DEPAR%I~ENT OF H~ALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY A2PROVAL CERTIFICATES BASED SOLELY_ UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL :ENGINDER REGISTERED IN THE STATE OF AI~SKA. THE DHEP DOES THIS.: AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MCNICIPALITY OF ANCHORAGE IS,..NOT ,RESPONSIBLE ,FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINDER'S wORK. RR4/eJ/Di8 [Page 2 of 2] (DHEP SEAL) 7-19-84 : ~ MUNICIPALITY OF ANCHORAG~ MUNICIPALITY OF ANCHORAGE (MOAI DI]PT. OF HEALTH & HEALTH AUTHORITY APPROVAL (ItAA) ENVIRONMENTAL PROTECTION CHECKLIST- FEBRUARY 1084 F'E8 0 ? 1§86 264-4720 Legal Description: .-.-.-.-.-.-.-.-.-c~'~7 WELL DATA Well Classification ~Z>//.~/~ JT.~/..~/2~__ If A, B, C, D,E.C. Applro~ved (Y/N) Well Log Present (Y~ Date Complet~ed. ,?~r/~b'.¢ ?¢;/~c, ,~' Yield Total Depth UF~/,~%'6~J Cased to O~ILIO0t.0M Depth of Grouting ~ Static Water Level .~-,¢¢ / Pump Set At '¢~C/'GI~'"0r~ / Casing Height Above Ground .-~'~"~'"' Sanitary Seal on CasingS) Electrical Wiring in Conduit (Y/N) /dA Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field o,n/~, t To Nearest Public Sewer Line _ /~/.~/~.'¢ . To Nearest Public SSwer Cleanout/Manhole ~'¢~'~.~;'¢' _ To Nearest Sewer ServiCe Line on Water Sample Collected by "/Y~x"//'~/~d Water Sample Test Results - / Comments '~e~-~ A~A¢,te~ ~',,?~1~ SEPTIC/HOLDING TANK DATA Date Installed ~' -/~ '"~ Size /~ No, of Compartm~nt~ Standpipe/~j'N) Air-tight Cap.~N) Foundation Cleanout Tank~N) Date Last pumped Depression over Pumping/Maintenance Contract on File (Y/N) -- ; for .~- Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line Temporary Holding Tank Permit (Y/N) To Building Fouhdation .~-~'~/ : : To Disposal Field To Water Main/Service Line .~Z. ~ ' To Stream, Pond, Lake, or Major Drainage Course Comments ~%~ ~Ac~(~ {N~b~'l~ ~&~O~~ I ~ ~;~ ~ ~J~ ) ~0~"~) Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata J~¢ Date installed ~/;' -/'¢ - ,~'¢./ Length of Field 4g Width of Field VNl~/vou, Jid Depth of Field Square Feet of Absorption Area Depression over Field~ Results of Last Adequacy Test Separation Distance from Absorption Field:/ To Water-Supply Well /r/~ To Building Foun/dation ~£~'% /'~-- To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area L~T STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level al Tested for Electrical Codes (Y/N) Comments Gravel Bed Thickness ~ / FibTf) i¢-fCu~,tqc¢ Stand pipes Presen~i'~) Date of Last Adequacy Test / To Property Line To Existin/g. or Abandoned System on ; On Adjoining Lots ~-~ '7/- To Cut ban k~(if p_~esent) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** 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. Date MOA No. Signed Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 n 1/84) N unicipalitYo Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES, MA YO R DEPARTMENT OF HEALTH & HUMAN SERVICES February 12, 1986 Carey S. Meyer, P.E. Besse, Epps, and Potts 2220 East 88th Avenue Anchorage, Alaska 99507 Subject: Lot iliA Rabbit Creek Small Tracts Subdivision Waiver Request, WR86-106 Dear Mr. Meyer: This Department bas reveiwed your request for a waiver of the minimum separation distance required between the septic tank and well on the subject lot. The 100 foot separation distance stipulated in 18 AAC 72.021 has been waived to 96 feet in this case. This waiver is valid for a three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION Environmental Sanllation Division 825 L Street · Anchorage, Alaska 99501 · Telephone 264.4720 CERTIFICATE OF INSPECTION SEWER AND WATER FACILITIES 1. Property Owner Mailing Address 2. Legal Description Mike Brittain NH~I Nugget Lane Lot lllA Rabbit Creek Small Tracts 3. Type of Dwelling 5. Sewage Disposal C~ingle Family X Individual [] Multiple Family Public Utility [] Other Holding Tenk 4. Wa, ter Supply ~ individual © Community [] Public APPROVAL FOR three BEDROOMS [] CONDITIONAL ~ DISAPPROVAL This Approval not valid Without Departmental Seal ~BESSE, EPPb & POTTS TIME-~7~R D ~ MO~ TUE WED THU FRI 9AT SUN ~AME (~inted~ / C~PUTER JOB DESCRIPTION: MON:~ WED: THU: ~6¢~BY: I EMCLOy~IGN~RE: Lcx~tion: BESSE, EPPS & POTTS 2220 EdkST 88 AV~2~UE AN(~{ORA~, AK 99507 (907) 349-6451 W;LTER ~ELL TF~ST Client's Na~: Address: Tester: Initial Reading ~q Meter: MUN]CII~AI)TY OF ANCHORAGE DEPT. OF HEAL'tH & .......... MENTAL PROTECTION ,-i: t~ 0 '?/986 RLCEIVIED GPM ~ VOLUME TOTAL VOLUME .~'r/~o,,~,/~. / Pr~bic/tJon R:te: d/,?/ GPM 2'l-flour Ca[×~city _~C~llcn~ February 10, 1986 ii Municipality of Anchorage Depart~nent of Health and Environmental Protection 825 "L" Street Anchorage, ~< 99501 Attention: Susan Oswald Re: Horizontal Separation Variance Request Lot iliA, Subdivision of BLM Small Tract Gentlemen: This is to request a variance to the require[~nt that the well be 100 feet from the septic tank on the above.-referenced lot. The existing well is 96 feet from t~m existing septic tank. Attached is a drawing of the lot reflecting the location of the improvements° The 6-inch well is 56 feet deep and the casing has been visually inspected to 40 feet. Attached are satisfactory water sample test results. Considering the fact that the septic tank and leachfield are down hill of the well, that the well is only 4 feet closer than the required 100 feet, that the well has provided satisfactory water quality during the four years since the tank was installed, and that the on-site septic system was approved when installed in 1982, it is my professional opinion that the lesser separation distance is justified and reasonable in this situation. Very truly yours, smh Attachr~ents ENGINEERING, PLANNING, SURVEYING ?;:20 E. 88th A ye. / Anchorage, Alaska 99507 / ?blephone g07-349-645I / 344-13a2 "Providing a quality personalized service to those building Alaska's future" NME ,~~ TIME :TIME DAT '~~ ~E ' DATE I: MUNICIPALITY OF ANCNORAGE / I-~ ~ MUNIOIPALITY OF ANCHORAGE DEPT. OF II:ANH & l~~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~NMENhXL S:~ ,IEC'I'ION bE0 9 1980 ~NVlRONMENTAL 8ANITATIO~ Telephone 264-4720 RECEIVE REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FAClLI~[~ 1, PROPERTY OWneR PHONE MAll A SS 3, LENDING INSTITUTION PHONE '~-. ~'L E G A~6~$ c R I PT I O N sTREET LOCATION 6. TYPE OF RESIDENCE ~l~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ~ T~rree [1 Six Other 7. WATER SUPPLY ~ INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wells drilled [] COMMUNITY since June 1975, For wells dr'illed prior to that date, give well [] PUBLIC UTI LITY depth (attach log if availabio.) 8: SEWAGE DISPOSAL SYSTEM ~ l, : ,x~ INDIVIDUAL/ON-SITE*~ (' YEAR ON,SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MuST ACCOMPANY EAcH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SiX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank S ze . If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS /APPROVED FOR ~ONDITIONAL APPROVAL (letter m~st accompany certificate) 72-010 (Rev, 6/79) 825 "L" STREET ANCHORAGE, ALASKA 99501 {907) 264 4.111 GEORGE M. SULLIVAN, MAYOR L)EPAR [MEN I OF }IEALTH ANf) ENVHtONt,4EN'FA[. PI{OTECTION ,]auuary 6, 1981 Mike Brittain % Nancy Doner Century 21 - Sleeper, Inc. 8050 Old Seward Highway Anchorage, Alaska 99502 Subject: T12N R3W Section 33 Lot lllA The adequacy test on the above subject property has failed. Therefore, before we may grant an approval, an upgrade will be necessary. Prior to the upgrade a soils test wii1 need to be performed so that a permit may be issued. The existing cesspool will need to be caved in and filled with dirt. Also, the well for the property needs to be iocated for our inspection. If the well casing is buried, raise it twelve(12) inches above ground level. The ].ocation of the well should be determined prior to the upgrade of the sewer system. If there are any furhher questions, please call this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate c. ' ' ~,peclallst RCP/1 jw cc: Alaska~ Bank of Commerce 3230 C Street 99503 ~0 hereby certify that a survey of Lot ltl A , ~ ~ ,~ ~ that the improvements skuated thereon are within the prooerty lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said properly except as indicated hereon. Dated at Anchorage, Alaska, this [ -~ ~_1-,.. ~ day o[ ~ ~. C.. CONSTRUCTING ENGINEERS, INC. SRA Box 60, Anchorage, Alaska 99507 :M4~)817 Phone 34.4-6968 December 26, 1980 Municipality of Anchorage Dept. o£ HeaIth& Environmental Protection 825 L Street Anchorage, Alaska 99501 Attn: Mr. Robert Pratt Re~': On site sewer adequacy test for Mike Brittai~ located Nugget Lane. Lot IliA, Sect.33, !I!12N~ R4W, S.M. on Dear Mr. Pratt: Attached is one copy of our test report regarding ~he referenced project. Please call if you should have any questions regarding the data. Very truly yours~ Cortland A. Broberg MUNICIPALITY OF ANCHORAGE December 26, 1980 ~EPr. o~ .,~;& Dear Mr. Brittain: R[CEIV/ D Ref: House on Nugget Lane, Lot lllA, Sect. 33, TZ2N, R3W, S.M. Adequacy best For existing on site sewage disposal system. Our preliminary check of your sewage disposal system indicated that it might not be capable of handling a 300 gallon surcharge per municipality requirements for a 2~ bedroom house. Since cold weather would hamper the operation which required metering water from a supply truck we proceeded to run a modified test using the domestic water supply which furnished water at an average rate o£ 4.3 to 2.8 g.p.m. After injecting 190 gallons o:C water into the cesspool over a one hour 'time period it was noted that the liquid level was entering the vent pipe. Water application was discontinued and we recorded measurements as shown on the attached inspection report. A copy of this report will be furnished to D[[E]~. They will notify you on what action is required. Very truly yours, Corl;]an~] A. Broberg © 0 0 0 0 hereby certify that a survey of Lot Ill ~ , ~ ~' .~ ..~ ~n was made on ~'C I~I~0 and that the improvements ~Nuated thereon are within the pro~y lines and do not overlap or encroach on the prope~y lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska, his_ _l.~l'[~ _day of ~E'__, CONSTRUCTING ENGINEERS, INC. $RA Box 60, Anchorage, Alaska 99507 ~4~817 AS-BUILT SURVEY, '' .' December 15, 1980 Mike Bri'ttain ' % Nancy Doner Century 21 - Sleeper, Inc. 8050 Old Seward Highway Anchorage, Alaska 99502 Subject: T12N R3W Section 33 Lot lllA Before this department can make an evaluation of the on-site sewer and water facilities serving the subject property we will need the following items completed: (1) Locate the well and expose for our inspection. (2) Install c]_eanouts to all components of the sewer system. (3) Locate and expose 'the standpipe to the sewer system serving the house directly south and across the street from the subject property, (4) The water facilities were not on at the time of the inspection. Please make arrangements for another appointment with this department. Robert C. Pratt, R.S. Associate Specialist If there are any further questions, please call this at 264- 4720. RCP/ljw cc: Alaska Bank of Conmlerce 3230 C Street 99503 office