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HomeMy WebLinkAboutT12N R3W SEC 33 LT 111AOnsite File
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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�®
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�� f®®0
�........ .. .... .,1.w..c.::.....0
Je rey A. Garness -'g7 m,
`m f C -79 3 •�AV
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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
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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
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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
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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