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HomeMy WebLinkAboutMCKINLEY HEIGHTS BLK 2 LT 12Onsite File in ey Hei!ghTS 5"�.��0 0 U JAN 2 8 2029 (Rev 05/02/18) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201187 PID Number: 051-213-26 Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New K Upgrade Name John and Stacee Kleinsmith ABSORPTION FIELD ElI�>a Trench El Wide Trench E] Bed E] Mound Site Address 18064 Amonson Rd Chugiak 7 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from originafg de Gravel depth beneath pipe Ft. Subdivision Block Lot McKinley Heights 2 12 Fill added above original grade Ft. Gr el length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist fl e between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between tr aches From Tank Field Lift Station Tank Line Ftz \ Ft. Well > 1 QQ� na na na 72y' TANK 0 Septic ❑ S.T.E.P. [I Holding ❑ Other Manufacturer Greer Capacity 1000 Gal.Material Surface Water > QQ' na na na PLASTIC Number of compartments 2 Lot Line > 10' na na na NA Foundation > 10' na I na na LIQ. STATION Manufacturer Capacity Gal. Remarks Alarm location Elec r stalled by PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Installer CMM General Contractors Drainfield CO/MT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspection 1-' 7/31/2020 1/7/2021 Location and description 2�d top of concrete slab by back door 3N 411 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Appk,JS`'tiH, Conditional Approval: Date �f ��G H •• 7�,'�{l `S reoe . . e Curbs L. Town end Date t �� L%•;o s Septic Syste r Approved Date2 2 l i No. CE 11 a4 FfFap ¢irf:-`' r?OFESVJI �:;. Note: this approva oes not include well permit requirements. (Rev 05/02/18) r U) of 19 NEIGHBORING SEPTIC IC -. '0' FROM RTY LINE 30RING WELL 00' FROM :RTY LINE SO 'V / SS NEIGHBC IS>10' PROPER ROW PEI OF NON - WELL IN EXIS- EFFE SCOPE OF WORK 1. REMOVED EX 2. PLACED NEW AND TIED IN' SYSTEM. THE MINIMUM 20" FIRST COMP/ 3. ALL CONSTRI WITH ALL Drr-t iricv m ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. VACANT LAND, NO WELL OR SEPTIC Septic Record Drawings Prepared for JOHN AND STACEE KLEINSMITH 18064 Amonson Rd Chugiak, Alaska 99567 MCKINLEY HEIGHTS BLOCK 2 LOT 12 EKLUTNA ENGINEERING, LLC 19162 MOUNTAIN ROAD CHUGIAK, ALASKA 99567 (907) 406-1058 OSP201187 DATE: 1/11/2021 DRAWN: CLT SCALE: 1" = 40' PID: 051-213-26 SHEET 2 OF 3 aND, NO SEPTIC Plzoulj 1 . -1 - .11, S I HEREB'-f CERTIFY -THAT I HAVE SURVEYED THE CA L E: FOLLO.M(ING DESCRIBED PROPERTN": 6E1,1111W & ASSMIKM'i LAND bURMIXIINU 6YA.—UdZY DAT' AND 7MAT NO FMCROACHWENTS &IST EXCEPT AS INDICAT ED. IT IS THE RESPIONSIDI LI T Y OF THE OWNER, T 0 DETERMINE THE EXISTENCE OF ANY G Rd D: EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION, PL -IAT. UNDER NO CIRCUMS TIANCES SjjoU D F f_;,h MY DA A . Al TA HEREON BE USED FOR COM9MUCT ION OF FENCE LUMS, OR FOR ESTABLISHING MUM - DRAWN: ATRY LINES. Duane Merh Saward ap L7 41. 41;�xa 1 N"al Municipality ®f Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV211005 COSA#: Permit#: PID#: 051-213-26 Legal Description: McKinley Heights Blk 2 Lt 12 Engineer: Eklutna Engineering Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. This waiver approval applies to the existing absorption field 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: 2 2 Approved by: Name of Reviewer 0 Z N K B Z R a B . 7 U 0 M 0 0 0 0 0 R 0 U U , n 0 , **** VARIANCE/WAIVER REVIEW **** Eklutna Engineering, LLC curtistownsend@gmaii.com January 11, 2021 Subject: McKinley Heights Block 2 Lot 12 Field to lot line Waiver Request OSP201187 A septic tank was replaced on this property in July 2020. When a new property survey was conducted, it was discovered that the 1986 field is 3.2' away from the western property line. I am requesting a waiver for the reduced separation distances. The following justifications are provided for your consideration. The field on the western edge of lot 12 was installed in 1986. The western most cleanout is 7' away from the property line. I am estimating that the edge of the field is 3.2' away from the property line. Lot 2A is to the west of lot 12. The house on this lot is located northwest of the house on lot 12. The septic system draining the house on lot 2A is west of the house. There is sufficient room on lot 2A to upgrade the septic system and not be impacted by the septic field on lot 12. For the above reasons, we request that the waiver be granted for the current situation. Sincerely, Curtis L. Townsend, P.E. TH Urtis L. o� • end. Date No. CE 1 i ����I�DPROFESSI��P �-� •� 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 http:llwww,muni.orglonsi#e On -Site Wastewater Disposal System Permit Permit Number: OSP201187 Effective Date: Work Type: SepticTank Upgrade Tax Code Number: 05121326000 Site Legal Address: MCKINLEY HEIGHTS BLK 2 LT 12 G:1058 Site Mailing Address: 18064 AMONSON RD, Chugiak Owner: KLEINSMITH JOHN A & STACEE F Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Expiration Date: Lot Size in Sq Ft Total Bedrooms: 6/29/2020 6/2912021 29516 ❑ 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 (2417). 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 B Issued By: y' Date: �/2 ✓ Date: 3 ti MUNICIP'ALIT'Y 0 ANCHORAGE Development Services Department �. Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICMELL PERMIT APPLICATION Parcel I.D. 051-213-26-000 Property owner(s) KLEINSMITH JOHN & STACEE Day phone Mailing address PO Box 770693 Chugiak AK 99567 Site address 18064 Amonson Rd Chugiak AK 99567 Legal description (Sub'd., Block & Lot) MCKINLEY HEIGHTS BLK 2 LT 1-2 Legal description (Township, Range & Section) Lot Size 29,516 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE,:OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo AD U) Septic Tank R. Upgrade (D) El Holding Tank ElRenewal ElDuplex Multiple 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 odes. (Signature of properfy owner or authorized agent) i Permit/Rush Fees: Waiver Fees: _ Date of Payment:�12� f it�1� Date of Payment: Receipt Number: S V60 Receipt Number: Permit No. IOSM01117' Waiver No. . j. G:1Development.Services\Building Safetyl0n Site Water and WastewaterTormsUient FormslPemtit Applicat gn.doc COVID-19 25% DISCOUNT APPLIED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201187, Deb Wockenfuss, 06/29/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201187, Deb Wockenfuss, 06/29/20 POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspection. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE RIGHT OF WAY DIVISION Construction Contact R141158 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this permit. Signature: Date: ANCHORAGE MUNICIPALITY OF Community Development Department t Right of Way Section Development Services Division Phone: 907-343-8240 Fax: 907-343-8250 Mayor Dan Sullivan February 12, 2014 John A. Kleinsmith 18064 Amonson Road Chugiak, AK 99567-6800 RE: Encroachment: Well in Road Easement McKinley Heights Subdivision, Block 2, Lot 12, Grid NW1058, 18064 Amonson Drive, Chugiak, Alaska The Right of Way Section has reviewed a request for a letter of non -objection to an existing well, which encroaches 7 feet into the 50' Road Easement. On the engineering site plan dated 7/28/06, submitted with the request, the petitioner has shown the well. This letter of non -objection is issued with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Maintain letters of non -objection from the following utilities: ® Anchorage Water & Wastewater Utility ❑ Alaska Communications Systems ❑ Chugach Electric Association, Inc. ® Matanuska Telephone Association ® Matanuska Electric Association, Inc. ® Enstar Natural Gas Company ❑ Municipal Light & Power ® GCI Cable of Alaska ❑ Eyecom (Girdwood Cable TV) ❑ No letters required All letters of non -objection should be retained in your permanent files. If you have any questions, please call Daune Wyatt, Right of Way Plan Reviewer at 343-8240. Sincerely, .1' , . aA — ack L. Frost, Jr. Right of Way Supervisor Concur JoM A. Kleinsmith, Owner Mailing Address PA: Bax'996650 Anchorage, Alaska ;99519=6650 ttpa/wwwmuni.org MUNICIPALITY OF ANCHORAGE DI 'RTMENT OF HEALTH AND HUMAN SEF ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES a TO SEPTIC ABSORPTION WELL o �S'o S/r�eei�r� SP�l9�X WE m ���NK ��F©L �. Phone(s) � Pe mit No. No. of Bedrooms � r 3 G� -297 60LB6 1 3 LEGAL DESCRIPTION LOT LINE `0 p� Lot Block SutIdyisio 2 2 �v/G .t/GE S FOUNDATION Z/ Township, Range, Section AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS LXSEPTIC ❑ HOLDING Marin cturer Capacity in gallons NG6-fi IL900 Material 5 dee No. of Compartments z TYPE OF SYSTEM O TRENCH X BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from 1/ original grade 3,S FT Total depth from original grade g FT FII atltletl above original g grade Cj' Gravel depth beneath pipevg FT ^ �J F; Gravel length _ Gravel width / Q 4 S 38 FT / FT Total absorption area & ��� Distance between lines ' SQ FT E7 FT Number of lines Soil rating Pipe material t 3 (3_6 SQ FT p 30 3 c e _,r. Installer Date Installe OWNC/C' Z 86 WELLS,tCIST/�� PRIVATE ❑ OTHER (Identifv) Classification (A, ,C) Total Depth Cased to FT FT Installer I Date Installed: REMARKS: �7 n C c bcale: /V (,j - ENGINEER'S SEAL Inspections Performed by `� 3,� "7 D 4l�� s�oTi C. a a Date. �� Res , ne giAi 0�.2 G z7 6 6 �� s x g �9 y �y p9kgq �,Psaa m a in ,$ lAnrl 19ax certify that this inspection was perlon ted according to all XE E 9VER, ALAS V517 Municipal and Stale gdRNjnFs%WVA this dale: Raa!aetd ShnS®r etc Health Department Approval•�Date:/'lr'4'0 s , ,tf<;:'`'�"' V I. tJ' V Jf . . �.� � �� �� �.�»� p���� DEPARTMENT� p� HEALTH AND ENVIRONMENTAL �ROTECTION ~ 825L. STREET' ANCHORAGEv AK 99501 264--4720 ��...... C:: jE: J"� PERMIT NO: 860286 �NGI'NEERED DESIGN ��/ DATE ISSUED: 08/14/86 APPLICANT: JOE JOHNSON / S&S ENG" ADDRESS: C/O SR BOX 196X EAGLE RIVER, AK 99577 CONTACT PHONE: 694-2979 . LEGAL DEGCRIP: 'oc�/�un� �o .0 /` ��n m,pE" ^= `. LOT SIZE: 4224 SQ"FT" OR ACRES) I certify that: 1. I am �amiliar with the requirements for on-site seweWs aDd wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" 3, I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing we1l, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot" IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1> AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN, APPLICANT: ISSUED BY r .- V\��— SOILS LOG MUNICIPALITY OF ANCHORAGE, • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: t JU 'G L'- G4'a^1 r DATE PERFORMED: LEGAL DESCRIPTION: LU l� 1.2 / r v Se c /6 SLOPE7 SITE PLAN NT -X 1 ��� Torso,/ t/RGANlc F 6 MAVEL L..Sz cubb1eJ �4 p% ���tdrn v'P He OF Ae° 45Yr -::a'be asap©ae .o° eoaw a.a coca ......aa. a... +'a.. a• Louis A. Butera a CG -6736 aa: C, 60 AV a®e0 •e eo eaeaa ��(' pROPESS\�N ■O■■ MEN MEM N iii©i MMrmm INEIRM MIFAN ■■E■ ■.■■ ■„■. MEMO - to V, JK 5 196 Reading G E"LE R ft AK 9 a 5Ve Depth Wat •• + a.,.e. WA Ne aaaas as+++seas baball A. "04 1467r, f 20 -� I `I., r , II I 'PERe6tA�N RATE X( (mmutesfinch) TEST RUN BETWEEN FT AND FT COMMENTS /S-0 �,C, /t?eccor SA4//e"' 2-e'w e'w-hk- PERFORMED BY: We Rlver EnglOEefinp 6ErvIOE$ CERTIFIED BY: �y�`-�'2=c — DATE: lelyp )— >� 0 Ger 77ais4 -bole River, AK 99577 694-5195 72-008 (6/79) 12 LEGAL �-vT 1'Z 3�-�_ Z h'� L �� 1 r._ L DRAWN n n� CKD. Q DATE N,4 _ SHT. Z 2 L C�S�bfo\(1�l +(b1=2b1\/'�\�/ZZ\�1S) -::� �ap- -7�SirC>L2`. i4:- S � ra e eee a 0000.000 0 HQ. 1457•@ s% tom. 2 L)Z-pn 65- A�M CKD. DATE -;a& SHT. 1 r? e S I � �J ®A � S5 USe ! 7ae�d�fif�ifs)feasa�es•.ys . �opif�wY.•Y�sa�M��+�^ i Na. 1457•E C� ��� PprCr'eS10��.yF 1� 1 /L7 �5�,.. �`� ,' AMM& T�°`'�.� Gw��> �•\ Lo ,Q U St. oPf-S > zS 7a Municipality of Anchorage Development Services Department Building Safety Division ; i On -Site Water and Wastewater Program , , T 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLINGQ, �J �J Parcel I.D. 051-213-26 COSA# 093-/ Expiration Date: I d- 2-7 0 R 1. GENERAL INFORMATION Complete legal description McKinley Heights Block 2, Lot 12 Location (site address) 18064 Amonson Road, Chugiak, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Onsite 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. Name of Firm _ArcTerra Consulting, Inc. Phone 868-3792 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 07/17/2009 Engineer's Comments: This Investigation was completed In compliance with ADEC and MOA regulations. 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 Inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a OF A�11t) system will function satisfactory for current or future q �+ occupants or can ArcTerra guarantee that no unseen pj'�,.��sf + encroachments, deficiencies or discrepancies exist. * 4 �,.,,, br , t"IF M NPN..... • q N oiT1V�..Y? 5. DSD SIGNATURE Approved for �_ bedrooms. f �I9Fo�•� o'rr•����•: Disapproved. Conditional approval for bedrooms, with the following stipulations: Septic System Advisory Well Flow Advisory X Nitrate Advisory _9_ Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 7-2-7-01 (Rev. 11/05 \ Municipality of Anchorage • ''`) Development Services Department Building Safety Division ` On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: McKinley Hts. 82, L12 Parcel ID: 051.213-26 A. WELL DATA Well type PRIVATE Date completed = Total depth 250+ ft. Date of test Static water level Well production If A, B, or C provide PWSID # Well Log (Y/N) N Sanitary seal (Y/N) Y Cased to 22' (Into bedrock) ft. FROM WELL LOG ft. Wires properly protected (Y/N) Y Casing height (above ground) 24 In. AT INSPECTION 7!7/09 21 ft. g.p.m. 0.403 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100mL Nitrate 6.89 mg/L Other bacteria 0 colonies/100 mL Arsenic: ND mg/l Date of sample: 7!7109 Collected by. ArcTerra B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date Installed 8126-27/1986 Tank size 1000 gal. Number of Compartments 2 Cieanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/8109 Pumper JRs C. ABSORPTION FIELD DATA Date installed 8/26-27186 Soil rating (g.p.dJf? or f?/bdrm)150 System type Bed Length 38 ft. Width 18 ft. Gravel below pipe 0_5 ft. Total depth 5 ft. Eff. absorption area 675 ft? Monitoring tube Y Depression over field N Date of adequacy test 7/8109 - Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 In. Water added 600 gal. New depth 4_2 In. Elapsed Time: 110 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 'Pump on' level at _in. Datum Size in gallons Manhole/Access (Y/N) E. SEPARATION DISTANCES 'Pump off' level at _in. High water alarm level at _in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 1001+ Public sewer main 75'+ Sewer /septic service line 25'+ On adjacent lots 1001+ On adjacent lots 1001+ Public sewer manhole/cleanout 1001+ Holding tank 100'+ Animal containment areas 501+ Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 101+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 101+ Curtain drain 50'+ Wells on adjacent lots 1001+ F. 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. Engineer's Printed Name KENNETH M. DUFFUS Date 07/15/2009 COSA Fee $490.00 Date of Payment 77— O Receipt Number 1 22 -7 % 1 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage • �� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Nater Well Advisory Certificate of On -Site Systems Approval (COSA) # 090234 During a recent COSA on-site inspection and test of the potable water supply well on Block 2, Lot 12 of McKinley Heights subdivision, the well's productivity was determined to be 0.403 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage • Development Services Department Building Safety Division ' On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 090234 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 12 of McKinley Heights subdivision. This inspection revealed a nitrate concentration of 6.89 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 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. Municipality of Anchorage Development Services Department • +.c Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Bob Schafer Legal description: McKinley Heights Block 2 Lot 12 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 Static Water level in well. ® Incomplete; missing Need Right -of -Way approval for well in easement. ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field.— ® Other. Need 500 gallons of water storage. Name of reviewer. Poet Date: 8-10-06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 2 - I - C SjZ'c W, tlt r�iw�� - Sic �'n �orcy„lin At, vt oto Ir-L%p /I 'VI/SC 4V/ ika►f CL St, . ✓�-1/' Municipality of Anchorage j,,o•, Development Services Department Building Safety Division On -Site Water and Wastewater Program , • , , , 4700 Bragaw Street P.O. Box 196660 Anchorage, AK 99519-8850 www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. D31-� �3 gio COSA # hrQ:;(t3 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Expiration Date: 1. GENERAL INFORMATION Complete legal description rnr 19 P1nok 9 T1rKin Iav ITAi4tiYa Location (site address) 18064 Amonson Rd. Chugiak, AK 99567 Current Propertyowner(s) Joe Brainard Day phone 317-7580 Mailing address PO Box 670438 Chueiak AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site U Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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. Name of Firm_ S tr S Enr.ineeirne Phone 694-2979 Address 17034 N. Eagle River Loop Ste. 204 Eafile River, AK 99577 Engineer's Printed Name Robert A. Shafer S. DSD SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory 0 (Rev. 11105) bedrooms. bedrooms, with the following stipulations: X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onske (907) 343-7904 CERTIFICATE OF ON -SITE -SYSTEMS APPROVAL CHECKLIST Legal Description: LaT I Z oto 2 • k1 u rbl+Ts Parcel ID: Q SI 13 ' A. WELL DATA TA Well type +2rVrtTt5- If A. B, or C provide PWSIIDD� #"" = Date completed = Sanitary seal( J>) fi Totaldepth.25Dtft. Cased to 2Z� ft. TOG) 1wrM Px1mix -r FROM WELL LOG Date of test Static water level J ft. Well production 9 P•m- WATER SAMPLE RESULTS: Coliform O colonies/100 mL Nitrate J,."mg/L 7IN b Arsenic: 0 mgA Date of sample: 6 Well Log (Y V 00 Wires properly protected(nJ) \&S Casing height (above ground) j8u Lin. AT INSPECTION --1h ((s Z'1 ft. g.p.m. +4R LvAIT*- alzvZAhC -rR*0 K - nu (igRM6C Other bacteria 6) colonies/1D0 mL Collected by: Sa'� �y4rK7f�K� B. SEPTICIHOLDING TANK DATA Tank Type/Material S n2-7 4- STS C, Data installed �f � - � Tank size 1600 gal. Number of Compartments Z Cleanouts ffiN) pression over tank (Y10 NO High water alarm (Y� QQ Foundation cleanout�l) �� DeP Date of pumping t Pumper C✓AIt7tT>'r ��►rrPE�S C. ABSORPTION FIELD DATA Date installed q!t�/✓moi rating (g.p.d.1Wft�Axlrm 160 System type 73Eb Length --'4 _ ft, Width /42> ft. Gravel below pipe Total depth S i ft. Eft. absorption area b'�.Sft2 Monitoring tube KS Depression over field -LLO Date of adequacy test f�lq 1,0&- Resu as Fail)z For _3_ -bedrooms Fluid depth in absorption field before test 6 in. Water added gal. New depth ] " in. Elapsed Time: Ito min. Final fluid depth O �in. Absorption rale >= N 50.E g p•d. Any rejuvenation treatment (past 12 mo.) (YAJntyPe) NU If yes, give date — D. LIFT STATION 0/,* Date installed "Pump on' level at _ in. E. SEPARATION DISTANCES Size in gallons (Y/N) at _ in. High water alarm level at in. Cycles tested Meets alarm d circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /00 14 - Absorption field on lot/Q9 t Public sewer main AJ JA - Sewer /sepfic service line 2S'4 - Animal containment areas 50 t+ - On adjacent lots Ido f On adjacent lots /00 'A Public sewer manholeteleanout _ A) A Holding tank _ N f J4 Manureianimal excrete storage areas 1&05 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / Building foundation Property line 5 1 Absorption field 5 '4 - Water main ,u In Water service line /0 1+- Surface water rcL /L Wells on adjacent lots /GYJ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'4- Building foundation /0 Water main &D Water Service line /O l4- Surface water /Gi^ 4 Driveway, parking/vehide storage /0 �L Curtain drain E L'JLYk(YU Wells on adjacent lots /CSO ( F. COMMENTS G. ENGINEER'S CERTIFICATION i certlry that i have determined through field inspections and review of Municipal records the above stems a in conformance with MOA CO line in H this t . ' ": 0 Engineer's Printed Name � a rr Date 171 COSA Fee $ ' Date of Payment g Receipt Number Ea7 9-A (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 3a / 1Zc. ZS''Raa�� fir •r r�"5 04 1 28.3?i _.._ AS -BUILT I hereby certify that 1 have s rveyed the following described . property; Lor ►z� Fl�� k L ; �` 1 '• `• L.6 j fr"„- I J .. ZSR •� d overlap or encroach on the property lying adjacent thereto, that lying e,•C� ` - �• fir •r r�"5 1 28.3?i _.._ AS -BUILT I hereby certify that 1 have s rveyed the following described . property; Lor ►z� Fl�� k L �` 1 '• `• Anchorage'Recordirtg'['rednd, Alaska, and that the'improve-. r� _�i. ments situated thereon are within the property tines and do not •� d overlap or encroach on the property lying adjacent thereto, that lying e,•C� ` - �• no Improvements on property adjacent thereto encroach '- �( . f.; a j On the premises tryquestionand tf�at there are no roadways, • transmission tines orother visible easements on said property except as indicated hereon, y"• •"'° `• ' ..s F �t t'"6"V. • t r.. -s✓ Dated at We River. Alaska - xs'M Ta this day of ROBERT C. JOHNSON 7,r yr , SCALE: Registered Land Surveyor No. 880 -IS V aEe' Box 77-0456, Eagle River, Alaska 99577 --Phone (907) 694'2543 I / I �,� . •tti / ,1 I I / 1 I cn I U) I E- 0 O I aN ` .� xvManiao i3nea0, .. , I I� /� � W �L c3 x �I s� kWo I m U a . m o WI J 1 .-7 o1 M q Ol I c H1 I I E- C) -O m I I I z I T; E-4 I Oa sw,avn }�I I nuz� I NVId-3115 1IV130 AVM3AI210 ,Ob = „l N ROBERT C.COWAN, P.E. CMLENGINEERS August 7, 2006 (907) FAX 694-2979 9 -294-1211 KALTH AUTHORITY APPROVAL$ MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWER&WATER Anchorage, AK 99519-6650 MAIN EMNSIONS g Attn: Deb Wockenfuss SEWER"WATER REFERENCE: Lot 12; Block 2; McKinley Heights S/D INSPECTION This letter is issued at your request for further information about the well that exists inside the private driveway easement on the north side of the referenced property. ENGINEERINGSTUDIES This well is 7 feet inside the easement, 5 feet from the edge of the driveway, and AND RI¢Pans stands over 18" tall. It is highly visible and has existed in this spot since the 60's. We do not believe it is in danger of being damaged during normal usage of the driveway. WELLNSPECTION 8 FLOW TEST We have included a drawing of the lot with well placement at your request. If you require additional information, please contact us. SITE PIANS Since y, ROAD DESIGN SORTEST PERCOLATION TEST STRUCTURAL! MECHANICAL INSPECTIONS ONSITE WASTEWATER DtSPOSALSYSTEM DESIGN A. Shafer, P.E. 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 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.muni.org/onsitc (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 060363 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 2, Lot 12 of McKinley Heights subdivision. This inspection revealed a nitrate concentration of 6.94 milligrams per liter (mg/L) was reported for the property's well water sample. 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. 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.