HomeMy WebLinkAboutKNIK HEIGHTS BLK H LT 5Onsite File
Knik Heights
Block H
Lot 5
#017-372-05
(Rev U5/02/18)
Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP211253
PID Number: 017-372-05
Dwelling: [E Single Family (SF)
El with ADU El Duplex (D) 0 Two Single Family Project: El New Z Upgrade
Name
WILLIAM & EDNEY HUPPRICH
ABSORPTION FIELD
19 Deep Trench M Wide Trench F71 Bed ❑ Mound
Site Address
12940 BAINBRIDGE ROAD, ANCHORAGE
El Other
Phone71
f Bedrooms
Soil Rating
Total depth from original grade
74
0.6 GPD/SFI
8 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3 Ft.
Gravel depth beneath pipe
5 FL
Subdivision
Block Lot
KNIK HEIGHTS
H 5
Fill added above original grade
VARIES 1.03 — 1.88 Ft.
Gravel length
(2 X 40') 80 Ft.
Township Range Section
Gravel width
3 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
I Tank
I Field
Tank
Line
800 Ft'
2
10+ Ft.
Well
100'+
100'+
'+
25Manufacturer
TANK 0 Septic El S.T.E.P. 171 Holding 0 Other
GREER
Capacity
1250 Gal.
Surface Water
100'+
1001+
Material
HDPE
Number of compartments
2
Lot Line
5'+
10'+
NA
Foundation
i 10'+
10'+
LIFT STATIONManufacturer
Capacity
Gal.
Remarks
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034 Tank to drainfield 3034
Installer JRS
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspection 1s 7/28/21
nd 7/29/21
Location and description
dates:
2
3'd7/29/21
4" 7/30/21
TOP OF MANHOLE
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
kk�
Aq
Conditional Approval:
Date
Awl C2. -
TH
Curtis Huffman
Septic System
Approved
-
Date
• CE 128991
7/30/202.1.
Note: this approval
does not include
well permit requirements.
(Rev U5/02/18)
PERMIT: OSP21253 PID: 017-372-05
Lot 5
43,500 s.f.
FD F
I MT K CO
MT
CO J
10' UTIL ESMT.
� *BM—TMH
C
E
INSTALLED NEW
1250—GAL HDPE SEPTIC TANK
WITH NEW DCOs.
A—C=66.4'F00
z
/ ,p rtis Huffman
FIRST WATER CONSULTING
DATE: 8/3/2021
13030 Sues Way
CO MT
B
-C=67,6'
DRAWN: FWCS
SCALE: 1" = 30
O
O
8
ESMTS & WELL
RADII STAKED
AT CONST.
SHED
FirstWaterAK®gmail.com
J(
O
-D=70.9'
TH21-1
EXISTING
FIELD
C
0
4
C
95.90
CO G
MT
- D
= 71.1'
r
H
INSUL.
Cl
3
�Co
A
- E
MT
95'32
FD F
I MT K CO
MT
CO J
10' UTIL ESMT.
� *BM—TMH
C
E
INSTALLED NEW
1250—GAL HDPE SEPTIC TANK
WITH NEW DCOs.
A—C=66.4'F00
/ ,p rtis Huffman
FIRST WATER CONSULTING
DATE: 8/3/2021
13030 Sues Way
CO MT
B
-C=67,6'
DRAWN: FWCS
SCALE: 1" = 30
DFCOM 99.90 CO DCO DIV
8
PAGE: 1 OF 1
FirstWaterAK®gmail.com
J(
A
-D=70.9'
95.90
B
- D
= 71.1'
INSUL.
A
- E
= 7 4.5'
95'32
SPLITTER
1250 -GAL
95.15
B-
E=
7 3 7'
HDPE TANK
A
-F=107.9'
S 89 58'W 1300'
B
CA
CO MT
7 FINAL GRADE I 86.80
84.92
ORIGINAL GRADE
FILTER FABRIC TH21-1
2'
ORG/OL
92 8,.92
SEWER ROCK
32 76.92 SM/ml
82.22 CO MT FINAL GRADE CO MT 82.15
B -F=110.4 81.12 NO GRND.
A - G -12 3.8' ORIGINAL GRADE/—WATER
6/25/21
B -G=144.8' FILTER FABRIC
16'
A—H=136.4' 78.12 78.12 BOH
SEWER ROCK 65.12
B -H=154.2' SEPTIC SECTION 73,12 73.12 RELATIVE ELEV. TO
A -I=1342' SCALE: NTS LOWER TRENCH
B -I -1376' KNIK HEIGHTS BLOCK H, LOT 5 SUPPORT$SERVICES: ' OF \�\
A J=1423' PREPARED FOR: �`� AZ`��
B -J=141.0' WILLIAM & EDNEY HUPPRICH 6�� � 1
A -K=129.6' 12940 BAINBRIDGE ROAD � � �* CJ TH*
B -K=131.7' ANCHORAGE, AK 99516IN
/ ,p rtis Huffman
FIRST WATER CONSULTING
DATE: 8/3/2021
13030 Sues Way
SURVEY: KGL
,;
1 r� CE 128991 w
Anchorage, Alaska 99516
DRAWN: FWCS
SCALE: 1" = 30
' 8/3/2021 .04"
� j
(907)350-9566
PAGE: 1 OF 1
FirstWaterAK®gmail.com
Lot 15
I
Lot 4/
DRIVEWAY ENCROACHES ONkO ADJACENT
N 89' 'E/300'
LOT
I
y
J \ \
1 STORY RESIDENCE WITH WALKL}UT BASEMENT`°5�
C� "
10.7'
x 11.7' RETAINING WALL 7.11' BALCONY `i'•
SHED ABOVE DECK
"'
Z
�.
ro
^O WOODEN WALKWAY
C?
SEPTIC PIPES 63
w
�0?
WELL
Lot 14
6j
2.1' x 18.7' CANT
87.0'
\ 2g,9
MANHOLE
CANT WITH FIREP CHASE
Lot 5 /
2.1'
AND 18.7' BALCONY ABOVECK
V
43,500 s.f.
/
t_S
89'58J300' \
10' UTILITY EASEMENTS
Lot 13
I I
Lot 6
30.0'
I
PLOT PLAN AS BUILT X SCALE —IL 550' GRID SW 2836 Project No. 21-394/A2
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, in C. , (907) 522-6476 Phone 000pOppp
(907) 522-4625 Fax oo OF q�ppp
Professional Land Surveyors kenolongsurvey.com c �. . q
jonothanOlangsurvey.com Al. �,.•' A ' •.Se4h.
I hereby certify that I have surveyed the following described property: 0AV(-�X'' 7-41
LOT 5, BLOCK H, KNIK HEIGHTS SUBDIVISION (Plot No. P-452) o 49TH *
Anchorage Recording District, Alaska, and that the Improvements situated thereon are """"""""' ""'•""
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed 0'p' 'KENNETH G. x
premises and that there are no roadways, transmission lines or other visible DO 1 I
easements on sold property except as Indicated hereon.
�y, G
.�S-5202.• y�o
Dated this the 2 = Day of 1�U at Anchorage, Alaska �4 `�a • • • • • o
O
0
�� ppRa�SSIONA��
It is the responsibility of the owner to determine the existence of any easements, 040000��
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
MUNICIPALITY OF ANCHORAGE
On -Site Wate r & Vwa stewater Pro g rarn
PO BW 1966K 4744 Elmore Road
Anamrage. ,mks W51 MVSO Phnna_ ('907) 343-7004 Fax: (907) 3d-3-7997
h�Ipl�wrw.rrNaru .4�jr4„Y31C
On -Silo Wastewater Disposal System Permit
Permit NiAmber: OSP211253
Work Type: Septic Upgrade
Tax Cade Number: 01707205000
Site Legal Addr-ess' KNIK HEIGHTS ELK H LT 5 G,2836
Site Mailing Atldriess= 12940 BAINBRIDCE RD, Anchorage
Clwdrier= HtjPPRIC H WIUTAM R &
Oesign Englnee ; FIRST WATER C*NBULTIN
This permit is for the construction of:
Effectoae Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
7 1!702 1
7F21IW22
43500
Q Disposal Field 0 5eplic Tank ❑ Holding Tank ❑ Privy D Private W9111 11 Water Storage
All construction shall be in accordancewith.,
1. Tih a attached epproued design_
2- Al l r uiremen is specAed In Ancho rage Mu ral-cipal code Chapters 15.55 a nd 15.65 and the State of Alas ka
Wastewater Disposal Regulations (1 G72) and Drinking Waller Regulalions (1 M\ 80)
3_ The wastewater code raquVas Ingpectlorrs duririg EN IThe onglrl00r Shall noli:ry tft 1>+ 16pment
Services Department per AMC 15.65_ Provide notffrcation by calci rig J907j 343.-7904 (24f7).
4. Frorn 0clober 15 to April 15, a su bsurfaae sail absorption system uncle r nonstruetlon during freezi ng wealher
Shall be elther;
a. Oponeid and Gloved on tho -aarne day, or
b_ Covered, sealed, and heated to prevent freezing
Riaciaived E :
P21/2021
Dale:
Date:.
4
MUNICIPALITY C
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTICM/ELL PERMIT APPLICATION
Parcel I.D. 017-372-05
Property owner(s) WILLIAM & EDNEY HUPPRICH Day phone
Mailing address 12940 BAINBRIDGE ROAD, ANCHORAGE, AK 99516
Site address 12940 BAINBRIDGE ROAD, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) KNIK HEIGHTS BLOCK H LOT 5
Legal description (Township, Range & Section)
Lot Size 43,500 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
0
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
0
Upgrade 0
Duplex (D) ElHolding
Tank
ElRenewal
ElMultiple
Dwellings ❑
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 Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: _#J�' cl 5
Date of Payment: a �2 I
Receipt Number: 21 I O2 2
Permit No. 05 P2_11 2.53
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
July 12, 2021
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: KNIK HEIGHTS BLOCK H, LOT 5
The property owner has requested we obtain a permit to upgrade the failed septic system of the
above referenced lot. We propose to install two deep trenches and 1250-gallon tank to serve the
existing 4-bedroom residence. The design is based on the recent test hole conducted on June 15,
2021. No groundwater was observed at test hole excavation or monitoring.
The slopes are moderate at 10-15% at the proposed upgrade location. The lot and area are served
by private water. 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
OSP211253, Rebecca Carroll, 07/21/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211253, Rebecca Carroll, 07/21/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211253, Rebecca Carroll, 07/21/21
4661
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350-9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: KNIK HTS. BLOCK H,, LOT 5
PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 7/1/2021
DEPTH
FEET OG
SOILS
1
ORG/OL
2
3
4
SM/ml
5
6
7
8
9
10
11
12
13
14
15
16
17
BOH
18
19
20
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
6/25/21 30 min 6 3 3/16
30 min 6 3 3/16
30 min 6 3/2/16
PERCOLATION RATE 10 (MIN / INCH)
TEST RUN BEWTWEEN 5 & 6 FT
PERC HOLE DIAMETER 6
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
GROUND WATER ENCOUNTERED: NO
IF YES, AT WHAT DEPTH: NA
DEPTH TO WATER AT MONITORING: DRY
DATE: 6/25/21
TESTHOLE # 21-1 DATE PERFORMED: 6/15/21
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
PERFORMED FOR: BILL HUPPRICH
7/1/2021
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211253, Rebecca Carroll, 07/21/21
Lot 15
Lot 4/
— DRIVEWAY ENCROACHES ONkO ADJACENT
N 89' 'E/300'
LOT
�Q.� \ \
I
J'PSQ4
1 STORY RESIDENCE WITH WALKgUT BASEMENT
RETAINING WALL 7.0' BALCONY
ABOVE DECK
.
Z
10.7'
z 11.7' SHED --,,,,,,,,m
,��� WOODEN WALKWAY
N
o
I e?
w
t02
WELL
o
Lot 1'4 f
SEPTIC PIPES o,
cFck
71 I
\
a
TEST
2.1' . 18.7' CANT
87.0'
0. /
u
HOLE \
299
2.1' CANT WITH 2.2' FIREPLACE CHASE
Lot 5 /
AND 18.7' BALCONY ABOVE DECK \ CA
43,500 S.f.
S 89'58!j300' \
710.
/
UTILITY EASEMENTS
Lot 13
I l
Lot 6
I
I•
•
PLOT PLAN AS BUILT X SCALE 1" —=50' GRID SW 2836 Project No. 21-394/A1
inc. (907) Daryl Avenue, Anchorage, Alaska99515-3049Lang & Associates,
(907) 522-6476 Phone
(907) 592-465 Fax
Professional Land Surveyors pF q��oo�
kenOlan surveycom
jonaihanOlongsurvey.com SOP S QO
I hereby certify that I have surveyed the following described property:
LOT 5, BLOCK H, KNIK HEIGHTS SUBDIVISION (Plat No. P-452)
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
Dated this the Zti, Day of Jv ` at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
r* 49TH •'•.•�*
• K.• •Ml
,c- 1[mty
.•�S-5202.••' y�p0
pq Ngo
�Q� �F'ESSIONAU �o
AECC963
MUNICIPALITY OF ANCFIORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division ¢ / F ,~ 7
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
05-
,~TRENCH [] BED [] W. [] OTHER
or~glnalDeplh togladuplpe bottomr.~lf Ol/~ ¢' FT I oral deplh Ir o~gin~l grade FT
/~0 ,{) --~" FT ,..~ /
,~. PRIVATE [] OTHER ('1~_
In~ Date
REMARKS:
FT
F'r
y _p c .
DISTANCES
SEPTIC
TANK
ABSORPTION
I:IELI]
(
10¢ %
WELL
WELL
Scale:
Inspecbons Pe~..~mod by
was pellorflled according to all
ENGINEER'S SEAL
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17,
18-
19-
20-
~1~"~/-//'/,.~' Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
S
L
IF YES, ATWHAT O
DEPTH? p
E
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~FTAND L~ FT
COMMENTS ~
PERFORMED BYS & $ ENGINEERI.N,G
:110~4 ~aCe ~r ~~~~ C~T~Y THA~ THIS TEST WAS PERFORMED IN
ACCORDANCE ~"~*~A~'~PAL GUI~FFECT ON THIS DATE. DATE: ¢2~¢ ~
72-008 (Rev. 4/85) / - ~/
E) I',1 ....~i~; :1; "1' Ei: i:: IE I/,; IE IR I:::' Ei; IR ?1 :I: 'T'
l!i!', r'f Cl :i. r / c,:,! c.! p
El 1 c:m' I.' I: I...I
:1:I\lt:::'Ql::q¥1 .O =, I.~1~ H ,, !!!;. t:;:'F/:1: Eli;:?. "l"f,:] :1. S1" 8,: 2NJ::) :[ I\l,filPl!ii:i:]T :1: l:)l',l!?i BY [!i:lxll3 1BtlE:IE:I:R, ]: I:::'
r'~F:l"lEl::i ::::::::::::::::::::::::: I'"IEILIF;~E;!~ Ci':,]L..!.... ::!:".zl.:::.!;..~,(I.,~l~t:l. {.~hlD LI!i:AViJ}: [f..~
[:::[~iIxI!!ii'I"IRL.II:::T F:'l:!!:l::i'. li!i:l',lt3:l:l,,If, ii:E:l::i'.li!i F.Y'I'T~'.'ff]H!!~:!:) AF:'Iu:'I::ID',?IiDD
I:::'li!:l::i'.lq :1: T liii: X F::' :1: IRliES :1. 2/:::.!; :1./138 ,,
F'IEFi'.Iq :!: 'I Vf.~l... :1: ]:) FEll:i: f.~ [;3 ]: 1',1(31..1:~ I:::'AM ]: I...Y I:;il!![[/i ]: D[!!:IqC;I!~ E!I\II....Y ,,
GR ~'ER ANCHORAGE AREA BOROI t
O~:,~RTMENT OF ENVIRONMENTAl. QUAI..I,~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC
MAILING :2
ADDRESS ///%)
LEGAL DESCRIPTION //'
DISTANCE FROM WEI.L/Y~,.; ?/,',,~-,'.~7~:?~__ MATERIAL
LIQUID CAPACITY_//.''~ ( GALLONS. INSIDE LENGTH.
PHONE ,*).>'
;' //./?
NUMBER OF /
COMPARTMENTS
INSIDE WIDTH ,~) DEPTH LIQUID
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMEIER
MATERIAL > (' -
OR WIDTH /--' , LENGTH /' , DEPTH
DISTANCE FROM WELL ~:~"~A~w~ /~'~ ~)/~; BUILDING FOUNDAIION ~'~ (
TILE DRAIN FIELD:
DISTANCE FROM WELL_ FOUNDATION ,NEAREST LO1 LINE
NUMBER OF LINES .~"-~- DISTANCE BEIWEEN LINES ~'~ fRENCH WIDTH
ABSORPTION AREA./ SQ. Ff. LENGTH OF EACH LINE
TOTAL LENGTH
OF LINES
IN. IO~AL EFFECTIVE
DEPTH: 'lOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
TYPE/~:Erl/C' DEPTH
NEAREST -
LOT LINE , SEWER LINE
.. DISTANCE FROM _ WATER
,BUILDING FOUNDATION. ___ SAMPLE
SEPTIC / SEEPAGE . .:
, TANK "~'; /,':C/',';: , SYSTEM ~,'(E,,'::'x..(.~_, CESSPOOL
DIAGRAM OF SYSTEM
, NEAREST
OTHER
, SOURCES___
DISTANCES:
ix';,~ :> .'
lh//i).')//. ,., /
,.,~ t ~,/~1,~ ~
DATE
GREAl'ER ANCHORAGE AREA BOR,,..;UGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 0-650
ANCHORAGE. ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
LEGAL
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED TNROBGH ~---/"""~,
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
SEEPAGE PIT -- , DRAIN FIELD , OTHER
To s El N ST A L L E D B Y
NOTE: THIB PERtYIIT 18 NOT VALID WITHOUT SOIL TES~'
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED, BACKFILLING OF ANY SYSTEM WITHOLJT FINAL INSPECTION BY THE:
HEALTH DEPARTMENT AUTItORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK S]ZE /g:/~'~ TYPE
MINIMUM DISTANCEB, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT '~/~ ~
SEPTIC TANK TO SEEPAGE PIT WALL--/~"
, SEEPAGE PIT
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
, DRAIN FIELD
· DRAIN FIELD
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABL. E CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION,
DIAGRAM OF BYBTEI~I
Certificate of On -Site Systems Approval
Parcel I.D. 017-372-05
1. GENERAL INFORMATION
Complete legal description KNIK HEIGHTS BLOCK H LOT 5
Expiration Date: 1V0V �, 20�
Location (site address) 12940 BAINBRIDGE ROAD ANCHORAGE AK 99516
Current property owner(s) WILLIAM & EDNEY HUPPRICH
Mailing address
Real estate agent
Day phone
12940 BAINBRIDGE ROAD ANCHORAGE AK 99516
Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
4. TYPE OF WATER SUPPLY:
Private Well
Water Storage
Community Well
Public Water System
4
TO 0Z+ A
®
Private Septic
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA # 0,5 e � f V_1'1-? Waiver #
5. 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 for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY ANCHORAGE AK 99516
Engineer's Printed Name CURTIS HUFFMAN PE Date 7130/2021
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 1
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 yy
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies orTH
•' J (�
discrepancies exist can be given by First Water Consulting & c •• i�j
FRFs .. ........
6. DSDSIGNATURE Curtis Huffman
V/ / System #1 Approved for bedrooms ���$����s� • CE 128991
ROFOS �t`�'�-.®.m
System #2 Approved for bedrooms ���PROFESS
Disapproved
Conditional approval for bedrooms, with the following stipulations:
�= 0V4 -SITE
NAT „ATEA
PROGRAM
JJ 0
By: Original Certificate Dater 070.2 l
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist
Legal Description: KNIK HEIGHTS BLOCK H, LOT 5 Parcel ID: 017-372-05
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled *6/23/1978 *(PER MOA DOCS)
Total depth *286 ft
Cased to *140 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 6/8/2021
Static water level at beginning of test 152 ft.
Well production at time of test 1.2 gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 0.880 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample 7/13/2021
Comments
B. TANK DATA
Age of tank(s) NEW TANK years
Tank type/material SEPTIC / HDPE
Measured operating fluid level in septic tank *
Standpipes/foundation cleanout per record drawing
Date of pumping *
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments: *NEW SYSTEM
D. ABSORPTION FIELD DATA
Which system tested (date installed) NEW SYSTEM
ALL standpipes present per record drawing
Total measured depth from grade 9.9 ft (max)
Measured depth to pipe invert from grade 4.9 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date NEW SYSTEM
Results Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies:
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
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
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ 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 septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10’ Yes if No
ft
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
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S COMMENTS
G. ENGINEER’S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
7/31/2021
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES ~.)l "~
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range) .
,5-
Location (address or directions)
(b) Properly Owne,'PEr,'¢ ~'/r/~'-Z~m..$'* m Telephone: Home
Mailing Address /'~--~/--/O
(c) Lending Institution , Telephone
Mailing Address.
Business
(d)
Real Estate Company and Agent
Address
(e)
Telephone
Mail the HAA to the followina address: or: Check here ~, if hold for pick up.
List contact person and day phone number below.
TYPE OF RESIDENCE
Single-Family,~
Number of Bedrooms
WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite/~ Public[] Community[] Holding Tank[]
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 fRev 8/861 Fronl
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NOI/¥1NIdO:INI aNY YJ.¥a 'H:::)~l¥:aS a-II:t 'S±S:a± 'SNOI/O:IdSNI 9NlalAO~tcl INIJI-I 9NII:I~]:INIeN:I
~U_~NICIPALITY OF ANCHORAC/~UNiClPALiTY OF ANCHORAGE (MOA)
ENVi~C, NMENrAL SERVICES DIVI,~i~LTH AU'rHORITY APPROVAL (HAA)
CHECKLIST - FEBRUAFIY 1984
A JG 1 5 L988 264-4744
RECEIVED LegalDescriptJon: ~'0~- ~'(_/?/ )
WELL DATA
Well Log PresentCW-~) _/___ Date Completed 6/~ ,.~/'~ ~ Yield /,
& ' . //
Total Depth ~'~"¢' Cased to /' 4zzO Depth of Grouting ¢0
Static Water Level /' ~ ~' '
Pump Set At ~
Casing Height Above Ground / ~ ~ ~
Sanitary Seal on Casing )
Electrical Wiring in Conduit N) Depression Around Wellhead (Y
Separation Distances from Well:
To Septic/hl4~:~:~Tank on Lot ~'~o c~z.- ; On Adjoining Lots /"~D
To Nearest Edge of Absorption Field on Lot //'~::~L~ ~-- ; On Adjoining Lots ./"~'D ~-
To Nearest Pu bile Sewer Li ne/.t//~)/,~-¢r To Nearest Public Sewer
Cleanout/Manhole ~. To Nearest Sewer Service Line on Lot
Water Sample Collected by
Wate r Sa m pie Test Res u its <~-~/~ .-Z~/,5--~'/,,~ ~ .~'-'~/~y ~ ,~,~ .--C-
Comments
SEPTIC/HOLDING TANK DATA
Standpipes (~,N) Air-tight Cap (~_~N) Foundation Cleanou~N)
Depression over Tank (Y~) Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) '/~ / ~ ; for
Holding Tank High-Water Alarm (Y/N) ~/t.//,/'2,-- Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/~Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026 IRev B 86~ Fronl
Soils Rating in Absorption Strata
Date Installed ¢¢ //'-~/~'~
Width of Field ~', ~
Square Feet of Absorption Area
Depression over Field (YN~.
Results of Last Adequacy Test ,/d //2).
Separation Distance from Absorption Field:
To Water-Supply Well
'fo Building Foundation
Lot ¢70
To Water Main/Service Line
f
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Are.a
Comments .~/c.~,,.," ~ ~ - ~-~/pF,¢-~/~
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present ~N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~.,~D --/:-
To Cutbank (if present)
D. LIFT STATION
Date Installed
Dimensions
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all M/dA an/d HAA guidelines in effect on the date of this inspection.
Signed 5&~ENF. MNEF. RING Date ~///'///
C 17034 Eagle RiYer L°°p Road Ne,42~ No.
o m pa n~91e River, Al~.ka 99577
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72 026 IPev 8 861 Back
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
FEDERAL TAX ID # 92-0040440
ANALYSIS REPOR~ BY SAMPLE for Work O~der ~
Date Report Printed: JUL 22 88 ~ 14:13
Client Sample tD:LR, BI{ KNIK HTS.
PWSID :UA
Collected JUL 19 88 @ Il:dO hrs.
Received JUL 19 88 ~ 12:30 hrs.
Preserved with :4 DEG. C
Analysis Completed :3UL 21 88
Laboratory S pe E? yDE
Released By : ~ ~ ~
Special
~nstruct:
Client Name : S & S ENGINEERING
Client Acct: SNSENGP
P.O,~I NONE REC'D
Ordered By : RJS
Send Reports to:
1)S & S ENGINEERING
2)
Chemlab Ref ~: 1845 Lab Smpl ID: 1 Matrix: Water
Allowable
Parameter Tested Result/Units Method Limits
NITRATE-N ND(O.IO) ms/1 EPA 353.2 10
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY RJS.
I Tests Performed See Special Instructions Above UA=Unavailable
ND= None Detected "See Sample Remarks Above
NA= Not Analyzed LT-Less Than, GT=Graater Than
APPLIC FILLS OUT UPPER HAl ONLY
PropertyOwner~/(/j~.~/ /.~..). ~( ~c?r/ ~ ~'~///~,/~:'~/ Phone
Mailing Addre~ .... ,, /, j,. (. ' Zip Code
Buyer
Address Zip Code
Lending Institution /'~//~7~-),%//_ _ ~ '/ Phone
~ealty ~o, & Agent Phone
Addres~ .~' Zip Gode
Type of Residence
~Single Family
~ 'Multiple Family No. of Bedrooms
g Other
Water Supply
Individual f.( ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
Community~- ~..~ ,( L..~ ' For wells drilled prior to that date, give well depth (a[tach Jog if awilable).
Sower ~isposal
Year Individual Installed:
Individual
~ublic OHIHy Whon Gonnoc~eO ~o ~ublic ~tility:
~ Holding Tank
NOTE: THE INSPECT~ON FEE MUST ACCOMPANY ~ACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector
Field Notes:
Inspector
( ) APPROVED BEDROOMS
MUNIC!P,~LITY OF ANCHORAOE
I%Pt, OF h~AI.TH &
/~NVII~ONM~ N I'AL PROI-ECTION
'CONDITIONS OF AA~TA~- -VJ~-~.
( ~)~DISAPPROVED
( ) CONDLTrONAL APPRO.VAL*
BY: ("~(~-
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well to Tank
Well Log Received
Septic Tank Size