HomeMy WebLinkAboutT12N R3W SEC 33 LT 148C Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241179 PID Number: 018-292-64 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MATTHEW &ANNA PERMAN ABSORPTION FIELD - EXISTING ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 15021 OLD SEWARD HWY, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. 148C Township Range Section T12N R3W 33 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To' Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft2 Ft. 100'+ 25'+ TANK ® Septic S.T.E.P. ❑ Holding ❑OtherWell Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ __ NA Foundation 101+ -- LIFT STATION Manufacturer Capacity Gal_ Remarks Deep -burial septic tank Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer PCN drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspdection 15` 7/31/2024 8/1/24 Location and description 2nd 3rd 4t MANHOLE TOP ON-SITE WATER AND WASTEWATER SECTION APPROVAL OF '9���1 Conditional Approval: Date Q., • • i 7H . 49 ................... Curtis Huffman Septic Syste Approved - �� CE 128991 •�� Date 1 /Note: ck 10/ '�0 , � F'0 • • • • NP���� ROFESSIO OFEW this approval does not include well permit requirements. .`-�- \ � (Rev 05/02/18) PID:018-292-64 PERMIT:OSP241179 FIRST WATER CONSULTING T12N R3W SEC 33 LOT 148C 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241179 Work Type: SepticTank Upgrade Tax Code Number: 01829264000 Site Legal Address: T12N R3W SEC 33 LT 148C G:3134 Site Mailing Address: 15021 OLD SEWARD HWY, Anchorage Owner: PERMAN MATTHEW & ANNA R Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: »enr I. Ucp� rtni<rtir 7/19/2024 7/19/2025 55612 ❑ 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 Received By: 1 '�> 15 "1 z-o i C-- Issued By: P L Date: Date: cy Z 4 ON -SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 018-292-64 Property owner(s) Matthew & Anna Perman Mailing address 350 E Peltier Acampo, ' CA 95220 Site address 15021 Old Seward Hwy Anchorage, AK 99516 Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N R3W SEC 33 LOT 148C Lot Size 55,612 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ER (w/wo ADU) Septic Tank Gi Upgrade ER Duplex (D) ❑ Holding Tank EJ Renewal ❑ Multiple Dwellings El Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable- Municipell _Codes. (Signature of property -owner or authorized agent) Permit/Rush Fees:Waiver Fees: Date of Payment: Z Date of Payment: Receipt Number: !j / 72 s Receipt Number: Permit No. LQ 19 -,,q 1179 Waiver No. GAIDevelopment Services\Building Safety\On Site Water and WastewaterTormsUient Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! July 1, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: T12N R3W SEC 33 LOT 148C The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon deep burial HDPE septic tank per the attached design to serve the existing residence. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank may be required and/or the tank may need to be anchored for buoyancy. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241179, Curtis Townsend, 07/19/24 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK T12N R3W SEC 33 LOT 148C DESIGN DETAILS: VACANT VACANT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241179, Curtis Townsend, 07/19/24 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · 'Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5OJ~qOH%~- PIDNumber: O1'~,~] ~: ~ ~ H ~T~o~ Wastewater System: D New ~' Upgrade Address: ~o~ ~eo ~V' A~.o~ A~. ABSORPTION FIELD Phone: ~-~ . . ~ No of Bedrooms: ~ ~DeepTrench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: ~ . ~ GPO/Sq. Ft. Ft. Ft  ~ Fill added above original grade: Gravel length: Township: [~ Range: ~¢i Section: ~ O-~ [ ' Ft. q~ Fb Driller: ~ Date Drilled: Stat[cWster Level: Installer: Date installed: SEPARATION DISTANCES ~Septic U Holding U S.T.E.P. To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons: From Tank Field Ste(ion Tank Sewer Lines Well- IO~' I~%~ ~ ~t- Material: ~ ~ N umber of Compartments: Surface Water [OO'-~ ~oo'. ~ ~ ~ LIFT STATION LineL°t ~ [[ ~ ~ ~ ~ Size in gallons: Manufacturer: Foundation ~¢ Drain ~.,, J Remarks: ~PT{~A~ ~%~ ~ BENCH MARK Location and DesCription: Assumed Emewt)on: Eagle RIver, Alaska~O~7~ 2nd i~-~ qfl g ; Department of Health and Human Services approval ~ <;;.,, ...... Reviewed and approved by: _ ~ Date: 7-/~ ' 7~ '-kx:-4 72 013 (Rev. 9/911 MOA 25 Permit No. SW940432 Page 2 of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 ° Telephone: 343°4744 On-Site Wastewater Disposal System and/or Well Inspection Report LO'F 1480, T12N R3W SEC 33 01829264 Legal Description: PID No.: MT CO COt CO2 G[~ADE NBW 1250 GAL S.T. SHED :)...GAL SEPTIC TANK FOO ST1 ST2 CO3 C04 MT1 LOT 1 4.BC EXISTING 4. 13DRM HOUSE ,~,B3. i' NO WATER FOUND NEW TRENCH .) [~-~/ EXISTING TRENCH I PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE ,~q It ~(q~ ~ ~ ;~oem DEPARYI~ENT OF HEALTH AND HUMAN~SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940432 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HITCHCOCK IRENE LOU OWNER ADDRESS:15021 OLD SEWARD HIGHWAY ANCHORAGE, ALASKA 99516 DATE ISSUED:il/15/94 EXPIRATION DATE:il/15/95 PARCEL ID:01829264 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 148C LOT SIZE: 35356 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MU-NICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASICA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: AT THE TIME OF CONSTRUCTION, ENGINEER SHALL PERFORM AN ADDITIONAL SOILS TEST TO A MINIMUM DEPTH OF 20 FEET TO VERIFY NO BEDROCK. RECEIVED BY: ~'~-~ ~-,c~ DATE: ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER INSPECTION ENGINEERING STUDIES AND RERORTS WELL INSPECTION &FLOW TEST SOILTEST STRUCTURAL& MECHANICAL INSPECTIONS ONSIIE W/~STEWAT ER DISPOSAL SYSTEM DESIGN October 27, 1994 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAG~ Department of H~alth and Human Services P.O. Box 196650 Anchorage, AK 99519 Req~t ~'o~z iss~ze a permit to replace the 6ept. ie S~6~ 6~'cu,~tg t/~. four bedroom hoc~,e on .¢Jze referenced prop~. A t~st hole was excavated and a percolation t~st performed. TL~ approximate location of the test hole is located on the attached site plan. The monitoring tube within the t~st hole has been checked and found to be ~Ly. The exiSting syStem was reported to be in a state of failure. It is an undocumented system th~£efore it is unknown if it meet~ M.O.A. requirements. The syst~ is to be abandoned completely. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by th6 installa~on of the proposed septic sys£em. The proposed 1250 ~allon septic tank is to be placed outside the we~ protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require any add~onal inform~ion please do not hesitate to contact us. Sincerely, ROBERT C. COWAN, RCC/gk ENCLOSURES 17034 NORTH EAGLE RIVER LOOP · SUITE 204 o EAGLE RIVER, ALASKA 99577 © ~o,~ 30¥~JOdn ] W N,DOW W3M3S 8~AO0 Z )10021 ~3M3S 3AI103~3 i1¥130/N01.i33S SSO~IO zt 'S'I'N ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. SEWER & WATER INSPECTION ENGINEERINGSTUDIES AND REPORTS SITE PLANS ROAD DESIGN SOIL~ESf PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON-SITE WASTEWATER ~ZSPOSAL SYSTEM CONSTRUCTION PRACTICES MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 148C, Sec 53, TI2N, R3W, S.M. GENERAL: The scope of this project includes the installation of a leachfield trench and a 1250 gallon deep bu~al septic tank ou~ide the 100' protective well radius to serve the four bedroom r~sidence located on the referenced property. The existing trench is to be abandoned in place. The existing 1250 gallon sept~c tank is to be excavated, pumped, crushed, and abandoned in place. The existing septic system is undocumented therefore it is unknown whether or not it meet~ M.0.A. requirements. System is to be abandoned completely. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any spe~al provisions or con~ions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground ut~ty locates. U~ess specifica~y agreed otherwise, the property owner sh~ be respo~ible for fin~ grading areas subsequently depressed ~rom soil settling. Contractors i~ta~ng wastewater disposal systems must be certified by the Muni~pal Heath Depar~ent for syst~ i~ta~ations. Owners installing their own syst~,s must also receive prior approval from the Municipal Health Department. SEPTI~ T~K INSTALLATION: I. A septic tank is to be constructed by a certified septic tank manufacturer. Co~truction shat~ include two 4" cleanout~ for pumping access. 2. The septic tank shall be sufficiently bedded to preve~ sctt~g or shifting of the tank. 3. All Standpipes on the septic tank shall extend a minimum of 12 inches above final grade. ON SllE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 148C, Sec 33, TI2N, R3W, S.M. October 27, 1994 o Sept~c tanks installed with less than 4' of cover shall be i~ulated. A foundation cleanout shall be instatled one to four feet from the b~ilding foundation. In the line between the tank and the leachfield there shall be two adjacent clcanouts (u,less an effluent pumping system exists within the septic tank}. These cleano~ shall be located on und~turbed soil not more than 10' from the tank. The first cleanout, in line, shatl be to clean toward the leachfield. The second cl~anout shoal be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensrons shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sideways of the excavation become smeared, they must be raked or scratched {roughed-up) before gravel {sewer rock} placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downw~d. Gravel is then to be placed over the dist~bution pipe to provide a minimum of 2 inches of cover over the pipe. A sl~t barrier must be installed between the final gravel layer and the native sod~ backfill. Ensure the silt bar~er covers the entire gravel surface before placing backfill. Mo~tor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the mo~toring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effec~ve depth of .the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four {24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The fi~sh grade over the t~ench must b6 mounded to prevent the fo~ation of a depression after set~ng. UINIMUUUATERIAL SPECIFICATIONS: I. Any septic tank proposed for installation must be constructed by a Muni~pally approved septic tank manufacturer. Page Three Lot 148C, Sec 33, TI2N, R3W, S.M. October 27, 1994 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Y~s ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Y~s Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick ex~uded d~ect buria~ polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barJ~er (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield ~ravel layer and the native soil backfd~. All leachfield gravel (sewer rock) sha~ be 0.5"-2.5" screened gravel with less than 3% pa~sing the #200 sieve. When sand is being used as a filter material, it~ gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS: Typically there will be a minimum of three {$) inepections required during the installation of the wastewater disposal system. Th~se inspections will occur as follows: The first inspection muSt be conducted after the excavation of ditches, pits, trenches, or bed~ and before the installation of any gravel. A septic tank may be set in place, b~ m~:y not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, ~eanou~, and insulation, but before the placement of any other backfill. Page Fool Lot /48C, Sec 33, T12N, R3W, S.M. October 27, 1994 3. The final inspection is to occur upon final grading of the property. Often there will be more than th~se 3 inspections required, especially with the installation of multiple trenches, sand fi~ers, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting wit2 take place onlsite. The inspecting engineer will not coordinate, d~ect or control in any my the contractor's activities. The owner sha22 contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractu~ arrangement existing between the cont~Lactor and S & S Engineering. S & S Engineering shall be the owner's representative and wi21 inspect the work as stated above to document the cont~Lactor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Enginee~ing shall have no tiability to the owner or to others for act~ or omissions of the contractor or any other persons performing work on th~s project or the lo, lure of the contractor to carry out the work in accordance with these construction docu~ent~. S & S Engineering 's inspecting engineer will not be responsible for the co nstruct~o n m~ans, methods, techniques, sequence, procedu~tes or the safety precautio~ incident to th~ project. CONTRACTOR/INSTALLER Municipalily of Anchorage I DEPARTMENT OF HEALTH & HUMAN SERvicEs 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ~'~ 1 2. 4 5 6 7 8 9 10 [ "T~'~ ["' i ~'~"'~-' ( ~- DATE PERFORM Township, Range, Section: "7'-/¢~/~! /~IA3/ SLOEE Sn'E PLAN WAS GROUND WATER ENCOUNTERED? 11 13- 14- 15- 16 17 18 19 2O COMMENTS IF YES, AT WHAT DEPTEI? Depth to Water Alter M0r~ or no? ()[~V Date: Reading Date Gross Net Depth to Net Time Time Water Drop $.,% --. ~ ,/V,. __ .w~ ~ ,, t ~., ye,, :~ ~, - ~/~'. v~,' :~3 ~ 5~'' ~&" " ~ ~ 2 Y ~l~" ~ ,. PERCOLATION RATE ~¢~- (m~nutes/mch) PERC HOLE DIAMETER __ TEST.U. aETWEEN_ ~ PTAND. /0 PT PERFORMED BY: -(~ ~ -~ ~ f,~6~,,v ~Z .¢ ~ ~(~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) October 31, 1994 Municipality of Anchorage Division of Health and Human Services 825 L Street Suite 502 Anchorage, Alaska 99501 Attention: Jim Cross Program Manager - On Site Services Subject: Owner Installation Option Replacement Septic System Dear Jim: S & S Engineering is preparing a construction plm~ for your review and approval to upgrade a septic system on Lot 148C bordering the Old Seward Highway. My mother (Irene Hitchcock) is the property owner. This plan should be delivered on November 1 to your office. A preliminary copy is attached for your information. As the season is growing short, I would like to request approval to install the system myself, drawing on past experience of myself, my brothers, and my friends to assure a quality job. I would reserve this owner installation permission as an option, as I am currently obtaining quotes from experienced contractors to perform the work. I woukl ouly install the system myself if these quotes are astronomically high or if the scheduling of existing projects is such that a contractor could not guarantee completion of the work in a timely manner. Time is a factor here not only due to the lateness of the season, but also the frequency that we are having to pump the existing system. Currently we are pumping 2-3 times a month, a rapid increase in frequency in just a few months. I have I4 years of experience in the civil construction field (both municipal and private), and have a wealth of family and friends with comparable experience. Some are experienced in installation of new and replacement septic systems similar ~o the design that you will receive. I know that we can perform thejob quickly and efficiently. Again, I am requesting installation permission for myself mainly as a backup in case the contractor that we choose are not able to perform the work in the time frame required. If you have any questions, please don't hesistate to contact me at 345-3946 or 659-5000. Sincerely, November 3, 1994 Municipality of Anchorage Division of Health and Human Services 825 L Street Suite 502 Anchorage, Alaska 99501 Attention: Subject: Jim Cross On Site Services - Program Manager Permissio~'~ for Owner Installation Septic System Upgrade Dear Jim: Following our phone conversation of yesterday, I would like to provide more information about my request for permission to owner install the septic upgrade on Lot 148C on the Old Seward Highway, owned by my mother, Irene Hitchcock. As mentioned in my previous letter, I am requesting this approval due to the lateness of the season as an option in case of scheduling conflicts. Any work done by myself will be closely monitored and will follow the specifications required by the system engineer and the upgrade permit. The people that would perform the work are very experienced equipment operators, with numerous years of backhoe experience (large and small) in gold mines, highway construction, residential construction, landscape work and on the North Slope. None of them are currently operating a construction and/or excavation business in Anchorage, and will be working on this project purely as a personal favor. The equipment used will be rented from somewhere such as Stephans Rentals, Baileys Rent-All, or NC Machinery. I have extensive experience in the surveying field and will be on hand during the project to layout the system, check grade, assure proper setbacks from the property lines and wells, coordinate the engineering inspections and monitor the backfill and final inspection efforts. If you have any questions or com~nents, please feel free to call me at 345-3946. Sincerely, MUNICIPALITY OF ANCHORAGE r�� Development Services Department �\`_ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel]. D. 018-292-64-000 Legal description T12N R3W SEC 33 LT 148C Expiration Date: Site address 15021 OLD SEWARD HWY Anchorage AK 99516 Current property owner(s) PERMAN MATTHEW & ANNA R 6/20/2025 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: 11/6/2024 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. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 018-292-64 Complete legal description T12N R3W SEC 33 LOT 148C Location (site address) 15021 OLD SEWARD HWY, ANCHORAGE, AK 99516 Current property owner(s) MATTHEW & ANNA PERMAN Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - 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 U Waiver Fee $ Date of Payment C / /Z --j Z Date of Payment COSA # �S C L y/ 4 3 z Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: T12N R3W SEC 33 LOT 148C Parcel ID: 018-292-64 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 UNKNOWN Total depth UNK ft Cased to UNK ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 6/20/24 Static water level at beginning of test 88 ft. Well production at time of test 3 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic 9.08 ug/L Arsenic less than MRL (ND) Collected by Date 6/20/24 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank *NEW Date of pumping NEW DEEP BURIAL Required maintenance completed, if AWWTS Comments: *NEW 1500-GAL HDPE TANK Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 12/1/94 ALL standpipes present per record drawing Total measured depth from grade 15 ft (max) Measured depth to pipe invert from grade 8.7 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) 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 2000 gallons 6/19/24 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 6/20/24 Results Pass Fluid depth prior to test 0 in Water added 1250 gal New fluid depth 1 in Elapsed time 20 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 72 in (MOA 6’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 72 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/17/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 10/17/24 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite I 907-343-7904 / Fax: 343-7997 Nitrate Advisory Certificate of On -Site Systems Approval # OSC241432 Subdivision: T12N R3W SEC 33, Block: , Lot: 148c A water sample revealed a nitrate concentration of 9.08 milligrams per liter (mg/Q. 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. Qi ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: BLM LOT 148C T12N R3W Sec33 S.M. PLATS 79-140 & 99-80 SURVEY•CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoulc any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCAM. E -MAIL - AUG 10, 2024 1 "=30schullerakOgmail.com 24-070-2 DRAWN BY: CHECKED BY GRID NUMBER: BOOK AGE: JLS SW3134 240274 s89°59'30"W WIL.DIEN DRIVE * = FND 5/8" REBAR SUR AMW d/00, �...........4....... .......... � Zr � n .,,....i...................:....� '•.JaHN L. SCHULLER.• LS --104080% �f S ww► j • .. x /' 1831 Talkeetna Street icy �• . { to:Anchorage, Alaska 99508 o .®r �► ° f e ©\ \. ,,■• (907) 227--1455 office � l sslc n•a�► (907) 274--4992 fax