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HomeMy WebLinkAboutT15N R1W SEC 19 LT 15T15N R1W SEC 19 Lot 15 #051-241-10 Municipality of Anchorage •., Development Services Department ' Building Safety Division • tom: „y On -Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Box 195550 Anchorage. AK 99519-6650 Page / www.cLanchorage.ak.us (907) 343-7904 ON-SITE" WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PermitNumber. OVLr bQ D31113 PID Number. 051- P L//- /Q of 3 Name' hAvie, pa wax Wastewater System: p New ❑ Upgrade 7,s4I /l kLoftfe/kC QST 0IfuC14ft ABSORPTION FIELD Number aBedrooms 3 Phone 67,- 53/0 eRDeap Trench 0 SMnow Trench D Baa 0 Mand 0 Onwr. LEGAL DESCRIPTION S,IIRel� j � GPDIFt z TTotalDepth homapNl made /.SFI. Block Lot Subdivision'. / S Depth to pope bottom nope original made- 3.s Ft.Z-11FI Gravel depth beneath pp. Township. I sw Range / Seanrt. ' ' ^ Fa added ton original made' /14 FI. Gravel wider S FL Gravel Length. dumber Ines. / t' /` n- Distancetwf b `eeInes Well❑New III Upgrade of n Ft Classification(Pnva1 A. B. Cf Tot.iD m'. Fl. Cased to Ft TOW absorption sea�� Ft' Pipe Material ����� Dinar D es Ceded S -woe Level Ft Instal.vr �Vk1NF�. Date Installed ^//�/G /Y a Yield I Pump S• 1. GPM Ft. Casing q tort AOaGrand Ft TANK SEPARATION DISTANCES eaeheptic • Holding IN STEP. 0 Other. 'To From Septic Tank Absorption Field Lift Station Holding Tank 'ublic/Plivale Sewer Line MsvA^"" ,/ Ata,f,(g rsifga Cap•'n' /000 Ga Wed/00 rr /06C, f — — 25'- Main W STEEL Number 01 Corryanni.ni. .2 Surface Waler /Oa'. /60 ft - - LIFT STATION Lot Line /d r 4- IL / ' - - 5.z. WI Manilaa✓ef Foundation [-vet .5 V t 50'4. - 'Piano ori leve in 'Pump Of level M in Nigh waive el I. in Curtain Drain - - - - Pump M It M0001 Enanca Inspects $ performed Dy: Remarks BENCH MARK Locai'On art Des=plian. Assume, Eiswiion. /O o FI Eng...• tc.Sjamp -- of q 1 .. 4%p ,I i • ^:y TI sees} *• Inspections performed by:/(NQM/IZf/tl EIC Dates: 151 / 0 ••••sees ... �o 0 ms ..• • tt :• Stavin ��• SI .. '?i 4. CP. :•� PE 6256 �• . ,i % °j/E .e••. e • '�`' � ... •: .. 4to`�opass vele e 2nd 9 /s aV Deve(opm nt Services Department Approval Reviewed and approved by: .._31_.— pQ.Q.. Date: r01t(a/ ]I (Rev.12/00) • O 3 z i z 0 0 4 S p OJ BLM Easement E 0 w y L 0 c 1-- w 0 t 0 0 C) 0 .1� 1- s 0 c 0) L ..J 1▪ � 0 0 0) a 0 c 0 03) 1— (1.3 0 0 1 rn 2. Sewer Service Line minimum 2% slope. 3. Trench is Perpendicular to Slope. 4. Lots Served by Private Water Wells. e0 1- CA o L c 3 +' Q o U D +" C CU ao tiU c E E T.N p 'i"' uz1-1"> N 0. woo a V1 AJ_• 0 J Test Hole 1- z w w tx N w 1- J 3 m op cnp)EnON 1 to(000to pp CO CO 0) N O •w 9 ,O96 0 0 ( 0 Li cco(I)to a) �0w F- Sec.19 Lot15 w 0 • 1 AS -BUILT MEASURE 444,4 o� 0 N u A N 3 0 ft zW o W oundation Cleanou Opposing Cleanouts Between Septic Tank & Trench N S u ci c N L 1-- 0 O Monitor Tube 0 o i o o, o > a o V U 0 O OW + v o 0" O Grade El. = Elevation = 91. N co 11 0 +r 0 o, W on Compacted, +• C W W S iha CO IL II Q C > o +, > CU N W W 11 L 0 +2 U O Q ar v W a, Q, U O S Ce) u a73 Q 73 d O a, a- u o >. o y 011N a s� ul £�o o ▪ oc x+• • po £ 0 X +' O U UI a£ W+� r�a..°ul gip £w vi -a- 0, LN ,s- 0. O £a N ( L-' O as UCS*.r WtA_ 0 N a, U £ 0 cuN1 da a, z SUS i iy O 3 zva03+,a,u Q.N gNNN3 CU A Bottom Test Hole 1 = 74.5' 0 J Q" u Oi (n Q 3 d Z m Dr H U (4- 0 n I I TRENCH END VIEW SEPTIC TANK PR❑FILE AS -BUILT ELEV. • MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ai(139 0 ip 41611 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number. SW040342 Legal Description: ET14‘,11-41W SEC 19 LT 15 Design Engineer: 0838 North Rim Engineering Owner Name: DAVE PERKINS Owner Address: 19411 KLONDIKE DRIVE CHUGIAK , AK 99567.6784 Date Issued: Aug 16, 2004 Expiration Date: Aug 16, 2005 Parcel ID: 051-241-10 Site Address: 019411 KLONDIKE ST Lot Size: 54450 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑Q Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. ,L 4 L ��� Date: Ere" t -o Issued By. t • 0Its_ \ n Date: eiito/O4 Mayor Mark I3cyich Municipality of Anchorage ICO. IGI% 19L(wcl) • Anelnntgc, Alaska !fL5194E) • Telephone (907) 34:1.8301 • Fax (1)071373.8'(0 4700 Ilntgaw Simi • .lnchuntgc, Alaska 91k507 Wau'.nutnLury; Building Safety Division 8/16/2004 NorthRim Engineering 17237 Bear Paw Circle Eagle River, Alaska 99577 Subject: Waiver Request for T15N, RI W, Section 19, Lot 15 Waiver Request #WR040054 Parcel ID 14051-241-10 Permit # SW040342 Dear Mr. Steve Eng: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity • Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ^ iQ Permit Number SW Property owner(s) b4 vi 7Fref r,jJ' Day phone W-7— Tit) Mailingaddress(1) /TIy/ 0414/14-E CH✓GrPfK 4/ Mailing address (2) Zip Code I ISO Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) 7 -7 -S-A/ "AI Sec / 9 Jar- /S, C ti U6/A/t Lot Size "- 1 Acre See -c-051 Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only Well Only 0 Sewer and Well ❑ Water Storage 0 Sewer Upgrade 0 THIS PROPERTY CONTAINS: Hot Tub 0 Jacuzzi 0 Swimming Pool 0 Water Softening Unit 0 Therapy Pool 0 I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property own e9rOr authorized agent) Permit Fees: 4_______6 0 Waiver Fees: _475— Date of Payment: Qj - 6 - 0 et Date of Payment: Receipt Number: . (o 3 g 2 Receipt Number: (Rev. 12/00) A-1.1-a`A 5-6 Sgt 1 -RIM E %INEERING NorthRim Engineering 17237 Bear Paw Circle Eagle River. AK 99577 907-694-7028 907-830-4186 August 5, 2004 Joe Goodall MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: T15N R1 W Sec. 19 Lot 15, Chugiak, AK Dear Joe, The existing septic/crib system on the referenced property has failed. The soil on the north portion of the lot is suitable for a replacement system. We encountered good soil in this location. We are requesting a lot line waiver from 10 feet to 1 foot. This will allow a 5 foot wide trench to be constructed in the best location. Lot 14 to the east will not be impacted adversely by this lot line waiver. There are no easements on this east lot line. This location for the system will provide a superior system: • No lift station will be necessary. • The soil is superior. • The location will allow easier septic tank pumping & maintenance. Please review the replacement septic system design for the existing 3 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Steve Eng, PE, PH Design Enclosures FRIM E SNEERING T15N R1 W Sec. 19 Lot 15 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. The existing septic crib has failed and a new system will be built. This requires a new 1000 gallon septic tank. The lots are about 1 acre in size. No adverse impacts are expected from development. The neighboring sanitation facilities are shown in drawing. The nearest water wells is located on the drawing. This is an older area with developed Tots. No conflicts to any neighbor lots is anticipated. Good soil for a septic system was found; a silty sandy gravel. The system utilized a 5' wide trench with allowable reduction factor. An application rate of 1.2 GPD/FT2 with 0.5 reduction factor for utilizing a 5' wide trench. Monitoring revealed no groundwater. A lot line waiver is requested to the neighbor's lot line to the east, Lot 14. This will allow construction in the best site. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment septic tank • Watertight couplings on inlet & outlet • 5 foot minimum between the tank and bed. 10 foot to property lines. • 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil cover. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cicanouts with airtight caps arc required 1 to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10 feet from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cicanouts must extend to at least ground level • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock • Drain rock to bc% inch to 21/4 inch screened. Drain rock to bc distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be rakcd or scarified before drain rock placement • Backfill over drain rock must not be Tess than 36" • The finish grade must be mounded to promote drainage over the bed • Insulation must be placed over any pipe installed under driveways or parking areas • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board to be extruded dircct burial polystyrene (Dow Styrofoam 111 or equal) • Old Septic Crib/Tank to be pumped, crushed & filled with sand or gravel. O S DESIGN NOTES: BLM Easement O c E o t w •— u) y L U F F - w O .c Q m 0 0 .-1 H slopes toward surface. Terrain 3. Trench is Perpendicular to Slope. 4. Lots Served by Private Water Wells. cm oS c L 73 +.a O U • d' U £ w Z ai N 4., N c c d 0> UZ` O L O • 00£azi U a i-'0 J e0 Test Hole T15N R1W Sec,19 Lot15 0 u nr u, co Oi Q� Foundation Cleanout Monitor Tube on Compacted, U f Q cu 0, 0 > d V O s U c a .a 0, o a, a U 0 >, CS N +. a N� o L N a a c o 30 +' OE X�+' pq£ d 0!+i o U In C. E y ++ 4- ri- LL N �0, E Ti In 15 Cs- C o.N LO ya yam O,U dU N U +P V)� C0L�4-H01 Wta_ d(/) N U £ O N 0 N Zs UQ L yy 0 3 Z a +°' ; c 0, y nV"ati)DiQtx at .4N C)'7U)l0 0 TRENCH END VIEW SEPTIC TANK PR❑FILE ELEVATI❑NS alibi. i;Pte$:•i�!• AgbA . . ! J (OWN! - .44 . AirAiskittle i!i . : 4 s •ii•':'i ..7 - . 'ii • ¥ 7 • . 4p 460405. . . . ' i®i 4 I1 04114•14 )I J 'Aoki. |§ .0 ita 7 . . ' olkoibi7 . . e iiiittepi Niko, .:% . J •401:4.0 . : 4�t ! ke 60.40. 41:4 lit g,EnI A is � J . PriTIPPMI , • THRIM icINEERING Performed For: Dave Perkins Legal Description: T15N R1W Sec. 19 Lot 15 S❑ILS LOG - PERC❑LATI❑N TEST Date Performed: 7/13/04 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 - 11 - 12 - 13 - 14 15 - 16 - 17 - 18 - 19 - 20 - 21 DEPTH (FEET) /7(77/' <.• :4.•; `�. • . ' 1 - '.Q. Organic Groundwater? No GM Depth none Silty Gravel Water Depth After Monitorino.none Date: 7/20/04_ # Date Gross Tine Net Time Depth Net Drop 1 7/16 0 -- 7.5' -- 2 7/16 10 10 Hr. 9.5' 2' 3 7/16 40 -- 8' -- 4 7/16 50 10 nir. 10' 2' 5 7/16 80 -- 7.5' -- 6 7/16 100 10 mfr. 9.5' 2' Percolation Rate 5.0 Min./Inch Perc Hole Diameter 6' Test Run Between 3' and 4' Comments: CERTIFY THAT THIS TEST WAS Performed BytInrthRim Frig. I Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 7/20/04 ISE... NORTHRIM r.' : ' TESTHILE LOG T. H. 1 ENGINEERING 5 am 17237 Bear Pow Clrcl. p •, two Eaglet Me. Alaska 99377 "''''YYYYYY a -4u. `•''.' GE I TECHNICAL bale Pat li of 1 7/13/04 AUG -16-04 10:32 AM FRANCES,PERKIM5 907 608 5318 P.01 ovdd Ave-. TR kinSi 4ocd oit19 -1-e) 11)514 /I Cec.e;e r Serfs" e n-\ ander ) 1-AP.n•-‘- 7f /e'e r a Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR040054 PID#: 051-241-10 HA#: _ Permit#: SW040342 Date Received: 811612004 Legal Description: T15N. R1 W. Section 19. Lot 15 Engineer. North Rim Engineering Applicant: Dave Perking Waiver Requested: Lot Line Waiver Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: Total: Waiver Is Granted: Waiver Is not Granted: List Conditions or Reasons for above: Date: mwot-i Sr:/ YC.L� u` A tVirLD � O ame of Reviewer Rec#: 56382 Amount $111 Date Paid: 811612004 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program - - 4700 South Bragaw St: - — P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 To: NorthRim Engineering Legal description T15N R1W Section 19 Lot 15 • The attached paperwork has been reviewed and is being returned for the following reasons:, Original signature' or stamp missing on Calculation error in: design: :Additional soils information needed:_ Water monitoring results inadequate. •Discrepancy in information submitted. Topographic information missing or inadequate._ Incomplete, missing waiver request for owner installation Incomplete missing Additional adequacy test information needed.' •• Water sample unacceptable:`._ "Measured/proposed distances/dimensions missing Locations of all soils percolation and Water monitoring tests hot shown: ❑ ,.;,Proposed system too deep for soils formation submitted. ❑.: Well log required O. ,'•Omission in narrative: _ ❑ ' Insufficient fill over tank or field. ® Other. 1.) The site plane should show a,) the location of the on-site well and 'ell • components of theexisting and proposed waste disposal system; and b:) measured distances' to all wastewater disposal systems. wells; surface water :or'drainage courses, `roads. . property lines and structures within 200 feet of the location of'enyexisting or proposed on-site wastewater disposal systems 2,) A percolation test four hour pre-soak must be conducted Name of reviewer.' Julie "Makela,"-P.E; Please supply the necessary information and re -submit your request. LEAVE�THIS FORM ATTACHED TO THE PAPERWORK O & E ENG.IIEERING & DEVELOP IVIENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 ��SOIL LOG Performed for: Name: �2t/'/7t ,'" "/�/oc, / Mailing Address' Si/2-•4 So X3y6 C , //4oNo//a Sr., CgLJ�-/4/< Legal Description: Z p / / ' -54-e. /9, //s/V, ' ` / / iA/' Earl Ellis 688-2280 Tel No4RP-2 s Depth (feet) 0 56/L. 1 Ai L. 3 L. i / d r .id /L 2 3 N 5/1,7)-1 6/z4 va Soli Characteristics 4 51)/ U P, 5/1 Po e/iETJ 1 [_ E/t/S.ES 5 o f /�%E©. 5 No, 6--54A/OP £ g/9()EL 1 -`' /4-ni 7//t/d i 17E/IlS r_ 8 9 G✓/// /2i9vet 10 Nd 12 13 Beni-vm/ e f- i 14 15 16 Ground Water Encountered: Yes No °' If yes, what depth Proposed Installation: Seepage Pit— Drain Field 1� [ E&� Comments• - /� ����� � �/2/54. te Ttc1,E'k":- /V /2"--696,r PLOT PLAN llo ien16 PERC. TEST 2NsopF%a4int 4,s, a so CO oe P * 4.9OA 9m'1. Earl P. Ellis • �W y� ® NO. 1745-E AJ 4 vo> *0.0 4°%®R®0��� P.07 Performed by: Date: SPI a /p,2.i- c 5 cier Q 1 v �46 o Ground Water Encountered: Yes No °' If yes, what depth Proposed Installation: Seepage Pit— Drain Field 1� [ E&� Comments• - /� ����� � �/2/54. te Ttc1,E'k":- /V /2"--696,r PLOT PLAN llo ien16 PERC. TEST 2NsopF%a4int 4,s, a so CO oe P * 4.9OA 9m'1. Earl P. Ellis • �W y� ® NO. 1745-E AJ 4 vo> *0.0 4°%®R®0��� P.07 Performed by: Date: SPI Development Services Department On-Site Water & Wastewater Section Phone: (907)343-7904 Fax: (907)343-7997 MUNICIPALITY OF ANCHORAGE 051 -241-10 T15N R1W SEC 19 LT 15 Expiration Date: Parcel ID Legal description Site address 19411 KLONDIKE ST Current property owner(s) PERKINS DAVE E X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments By:Isatou B Njie Original Certificate Date: 12/19/2025 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 Service 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 submittal. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other Well Flow Advisory Nitrate Advisory Arsenic Advisory Certificate of On-Site Systems Approval X OSC251535 11/1//2026 X COSA Checklist_May2025 .docx COSA Checklist Legal Description: T15N R1W SEC 19 LOT 15 Parcel ID: 051-241-10 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 *UNK – CIRCA 1962 Total depth UNK ft Cased to *26 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 11/18/25 Static water level at beginning of test 22 ft. Well production at time of test 4 gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 7.13 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 11/18/25 Comments: *See Sullivan scoping letter. The well was drilled approximately in 1962 when the residence was built per MOA tax records & prior to the 40’ 1977 casing depth requirement. Nitrates are still within the acceptable range. Sullivan also installed a sanitary seal w/ new wiring. Well in heated, cement blocked utilidor – the well is protected in this well vault which can be worked on above grade in the open- air w/ no gasses. Correspondences w/ MOA Curtis Townsend. B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 11/17/25 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D.DISPOSAL FIELD DATA Which system tested (date installed) 9/15/2004 ALL standpipes present per record drawing Total measured depth from grade 7.2 ft (max) Measured depth to pipe invert from grade 3.0 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 gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 11/18/25 Results Pass Fluid depth prior to test 29 in Water added 600 gal New fluid depth 42 in Elapsed time 1440 min Final fluid depth 29 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 48 in (MOA 4’ ED) Effective depth used 29 in (Final Fluid Depth) Effective depth remaining 19 in Comments/Deficiencies: Total measured depths from existing grade. 4’ ED per measurements, visual observations, MOA records & appears approximate with no known freezing issues. The surveyor missed the cleanout (CO) at the far end of the field that was in the woods but is there and is noted on the attached waiver – septic system drawing. COSA Checklist_May2025 .docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No **99 ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *1 ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: 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 *WAIVER #WR040054 issued 8/16/04 **With this submittal – see letter w/ septic system drawing. 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 12/19/2025 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 & 12/19/25 Municipality of Anchorage P.O. Box 196650 ⚫ 4700 Elmore Road Anchorage, Alaska 99519-6650 ⚫ (907) 343-7904 ⚫ Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV251059 COSA#: OSC251535 Permit#: ___________ PID#: Legal Description: T15N R1W SEC 19 LT 15 Engineer: First Water Consulting Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 99.0 feet. This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: ____X_______ Waiver is not Granted: ______________ Date: __________________ Approved by: _________________________________ Name of Reviewer **** VARIANCE/WAIVER REVIEW **** 12/19/2025 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com December 19, 2025 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: T15N R1W SEC 19 LOT 15 – RETRO WELL TO SEPTIC TANK WAIVER PHYSICAL ADDRESS: 19411 KLONDIKE STREET, CHUGIAK, AK 99567 The approved 2205 MOA inspection report notes the steel septic tank to the well to be 100’+. However, per the recent as-built survey it appears that the well to septic tank is approximately 99.5’. Since the install is within the 99-100’ margin of error, the MOA has previously issued this type of slight separation without requiring a waiver fee - we respectfully request the waiver fee NOT be required and that this existing separation be amended with a waiver of 99’ from the septic tank to the private well. The existing well gradient goes downhill towards the 2004 septic tank slope continues downhill and away from the well with no chance of surface effluent from the tank going towards the well. The tank has been in operation for the past 21 years without any known issues or adverse impacts. There is no well log for this specific property that was drilled circa 1962, but per available well logs & knowledge of the area in general these are shallow wells with clay like silty soils at approximately 50’+ that protects any deeper aquifer combined with water results with acceptable nitrate levels. Granting this separation waiver is warranted per these justifications. Please contact us if you have any questions. Respectfully, Curtis Huffman, P.E. Attachments: COSA Docs & Septic System Drawing MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Nitrate Advisory Certificate of On-Site Systems Approval # OSC251535 Subdivision: : T15N R1W SEC19, Block: , Lot: 15 A water sample revealed a nitrate concentration of 7.13 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. 28.7' 52 . 7 ' 52 . 7 ' SH E D 8'x 2 0 ' 8'x10' 12'x12' SHED 12'x1 6 ' SHED SHED 6'x16' SHED RE S I D E N C E FIRST WATER CONSULTING T15N R1W SEC 19 LOT 15 T15N R1W SEC 19 LOT 15 - SEPTIC SITE AS-BUILT LEGEND APPX. EDGE OF GRAVEL DRIVEWAY OVERHEAD UTILITIES POWER POLE APPX. EDGE OF ASPHALT SEPTIC PIPE WELL SATELLITE DISH DECK 28.7' 52.7' 28.7' 52.7' SHED 8'x20' 8'x10' 12'x12' S H E D12'x 1 6 'SHED SHED 6'x16' SHED RESIDENCE TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 25.263 SCALE: 1" = 40 FEET DATE: 12/9/2025 SHEET: 1 of 1 MOA GRID: NW0955 SCALE: 1" = 40 FEET(11"x17") 40'0' 80' AS-BUILT OF: ADDRESS: 19411 KLONDIKE ST, CHUGIAK, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT GOV. LOT 15SECTION 19T15N R1W, S.M.