The URL can be used to link to this page

Home My WebLink AboutSKY RANCH ESTATES #2 BLK 2 LT 17Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT it Number: OSP191136 PID Number: 01'5-302-41 ing: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: STEPHEN & KATHLEEN HEINLE Address 11700 SHETLAND HTS. CIR., ANCHORAGE Phone Number of Bedrooms 3 LEGAL DESCRIPTION Subdivision Block Lot SKY RANCH ESTATES #2 2 17 Township Range Section 3SORPTION FIELD - EXISTING ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other Rating depth from original grade GPD/SFGPD/SFl Ft. Depth to pipe invert from original grade Gravel depth beneath pipe Ft. Ft. Fill added above original grade Gravel length Ft.I Ft.l width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. I Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ft2 -- -- Ft. Well 100'+ NA NA NA NA TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1250 Gal. Surface water 100'+ NA NA NA Material STEEL Number of compartments 2 Lot Line 5'+ NA NA NA NA Foundation 10'+ NA NA NA Curtain Drain NA NA NA NA Remarks Existing septic tank decommissioned per UPC, new tank installed 5'+ from & connected to existing field. New MT installed. LIFT STATION Manufacturer Capacity Gad on level at I Pump off level at IHigh water alarm at in. in. make and model JElectrical Inspections performed by in.l PIPE MATERIAL House to tank 3034 Tank to 3034 Installer A+ SERVICES drainfield Drainfield CO/MT 3034 Inspector FWCS / MNA BENCH MARK (Assumed elevation) 100 ft Inspeection ction I51 5/23/19 2nd 5/24/2019 Location and description 3rd 4'h DOOR SILL COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL®�® ®e OF AL t Conditional Approval: Date .4.9 TH� MICHAEL N. ANDERSON: �T� No. CE 9469 / 7/6/19 Approve �-�--t Date ss10� s nspection Keport_y-i-iL.aoc 1*1 SKY RANCH ESTATES #2 B2, L17 00 rn Q0 W O O O O i 77 - CP C !L SCALE: 1' = 0 A—C=41.6' B—C=21.6' A—D=45.4' B—D=29.2' S 89°59'44" E 101.41' NEW MT� LOT 17 PID: 015-302-41 PERMIT: OSP191136 R, O 200 `9 . 25' r— DECOMMISSIONED EXISTING TANK Il PER CODE & INSTALLED NEW w co D/ 1250 -GAL SEPTIC TANK. f Cp ® N N CO� C A fro as °' a M 5� EXISTING 3BR 0 cr BUILDING rr1 f D z 0 SEPTIC SECTION PREPARED FOR: SUPPORT@SERVICES: STEPHEN & KATHLEEN HEINLE SKY RANCH ESTATES #2 B2, L17 F'WIC. 5 11700 SHETLAND HTS. CIR., ANCH., AK 99516 Michael N. Anderson, P.E. DATE: 7/6/2019 4661 Natrona Ave. DRAWN: FWCS Anchorage, Alaska 99516 (907)727 8864/FAX: (907)345 1391 SCALE: 1" = 30' SCALE: NTS OF A' A -4 * 4 9TH MICHAEL N. ANDERSON No. CE 9469 �'AV 7/6/19 ear `~' 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://www.muni.orglonsite On -Site Wastewater Disposal System Permit Permit Number: OSP191136 Work Type: SepticTank Upgrade Tax Code Number: 01530241000 Site Legal Address: SKY RANCH ESTATES #2 BLK 2 LT 17 G:2737 Site Mailing Address: 11700 SHETLAND HEIGHTS CIR, Anchorage Owner: HEINLE STEPHEN M & KATHLEEN M Design Engineer: AaERSM CpuSTRUCr/ON -i ENGf NEEKiMG This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: "m C t N 5�; f� Delia rtmcen t 4/29/2019 Expiration Date: 4/28/2020 Lot Size in Sq Ft: 20396 Total Bedrooms: 3 ❑ Private Well ❑ Water Storage All construction shall be in accordance. with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal cods Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Locate water service line prior to construction to verify minimum 10 ft separation to septic system, p Received By: Issued By: Date: Date: 9 J ewpws MUNICIPALITY OF ANCHORAGE Development Services Department ' -- Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 015-302-41 Property owner(s) STEPHEN & KATHLEEN HEINLE Day phone 9072309393 Mailing address 11700 SHETLAND HEIGHTS CIRCLE, ANCHORAGE, AK 99516 Site address 11700 SHETLAND HEIGHTS CIRCLE, ANCHORAGE, AK.99516 Legal description (Sub'd., Block & Lot) SKY RANCH ESTATES #2 B2, L17 Legal description (Township, Range & Section) Lot Size 20396 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Septic Tank ® Upgrade ® (w/wo AD U) Holding Tank El Renewal❑ (D) ElRenewal EJ Multiple Multiple Dwellings ElPrivy 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. FWCs - Brent Western (Signature of property owner or authorized agent) Permit/Rush Fees: A25 Waiver Fees: Date of Payment: la5I! Date of Payment: Receipt Number: 05-196190 Receipt Number: Permit No. lI?/136 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 April 24, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SKY RANCH ESTATES #2 B2, L17 To whom it may concern: The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 3- bedroom house. The lot and area is served by a public class A well and this upgrade will not impact any of the neighboring properties due to the lot layout. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191136, Rebecca Carroll, 04/29/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191136, Rebecca Carroll, 04/29/19 GRE,~,ER ANCHORAGE AREA BOR Department of Environmental Quslity 3330 C Street Anchorage, Alaska 99503 JGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM 5FPTIC TANK: DISTANCE ~(~ ~.. ~ FROM WELL _ MANUFACTURER INSIDE LENGTH / INSIDE WIDTH ,NUMBER OF MATERIAL _ __COMPARTMENTS LIQUID DEPTH~/ LIQUID CAPACITY~/'"'~,,~;ALLONS, TILE [:)RAIN FIELD: DISTANCE FROM WELL /~--- FOUNDATION A~SORPT,ON AREA_ F~ ~ '/ SQ. FT. LENC*H O~ E^CH L,NE DEPTII: TOP OF TILE TO FINISH GRADE/~f~i~~/-~l~I~ WELL: F~ TYPE J TOTAL LENGTH ___NEAREST LOT LINE . __OF LINES /,-~-z~'t'-- ABOVE TILE TOTAL EFFECTIVE CONST RUCTION DISTANCE FROM: FOUNDATIO , LOT LINE SEWER LINE__ , TANK , SYSTEM___~ CESSPOOL / OTIIER SOURCES DISTANCES: INSTALLED SEWER LINE DEP-I'FI~.~r~Y ' PIPE MATERIAL. LOT SLOPE: A~ G.A.A.B.~'/' PERMi T' BIO. RI;:'PL I CF~N'T LOCFI'T' I ON L. EGFIL., a.~.~.,4 :E ".¢¢..~, ~-1 L~ ..IL fF' ~- ".~." ~'~' H f~"4t L.. ~--, ,...." ~-~.. H ~ :,] ~ 825 "'L.." STREET, RNCHORFIEiE., ~1 .... 995~kl. ~79-'25:].:].. ............ .' '- . ",- ' BRUCE I~-][~ t,:$~5 J.,. ,:~. HE:,T 27TH FtVE ~PT 2. COR SHET'L.RND I-IGT~ C~R,."SPRUCE DR LiT 82 SKY RANCH EST ~R LOT ~IZEE :1,500E~ S[~!I..,IFiRE FLEET T'~'PE Eft:' SOIl_ RBSORBTION S"¢STEM IS: TRENCH MRXIMUM NUMBER OF' BEDROC.~MS = Z SOIl_ RATING ,::SQ FT,."BR)= ::1.65 THE I:~EQLJlRE[:, SIZE OF THEE SOIL ABSORPTION SM'.E;I"EM IS: THE LENGTH DIMENSION IS THE LENGTN ,::IN FEET) OF I"WE TREi'.,ICN OR DRRINFIEI....D. TME DEPTH OF FI TRENCH {:iR PIT IS TNE L':,ISTFINCE BETI.,.IEEN THE SUI:4::EFICE OF THE GROUNI) FIND THE BOTTOM OF THE EXCAVATION (IN FEE"I'). THERE .1;S NO SET WIDTH FOR TRENCHES. TNE diRFIVEL I}EP'I'H IS THE MINIMUM E:,EPTH OF' GRAVEL BETWEEN THE OUTFF:II...L F:'IF'E THE B,:,TTB 'I TWE. E×C '.mTION EEET:,. EITHER fl .LHm_ I OR II 14_,F 8PPRO',,¢ED PLRNT f'lR'¢ BE{ fl I];ONTII'.,IUOI. JS hlBINTENFINCE RGREEi'"IENT IS REQUIRED. IF FI ttBINTENFINCE AGREEMENT IS NOT KEPT CURRENT YOU MFI"¢ BE REg!tJIRED TO EMLRRC4E THE I~BSORPTION :S'¢STEM RND?OR '¢OU I"1R'¢ BE SUBJECT TO PI~OSECUTII]N. IF Ft CLASS I SYSTEM IS tJSED T'HE LENGTN IS 26. O FEET. IF FI CLASS II SYSTErl IS USED THE LENGTH ES .EC.E:. E~ FEET. "~t'"b,i~:) ,:; ;;--:.". ') Z ~'-,i '_'.2.'; F:' E: C: T' I (] IP.tl '_~; II:aF."E: F~:E.-F2E~:~Lil :[: RE:E]:. BFICKFILLING OF f:lN9 S9STEM WITHOUT FINFtL INSPECTION FIN[) FtPPROVFtL BM THIS DEPBRTMENT WILl,_ BE SUB,IECT TO PROSECU]'ION MIi",IIMUM DIE;-FBNCE BETWEEI",I FI 14EI_L FIND FINY ON-SITE SEWFIGE I}ISPOSFIL. SYSTEM ±Clla FEE','[' FOR FI PRIVFITE WEIJ_ OR ~1[.3 FEET FOR FI PI..IBLIC WELL SPECIF'ICRTIONS AWE.', CONSTRUCTION DIFIGRFIMS ARE FiVRII..FiI3LE TO INSIJRE PROPER i I'.,ISTFtLLBT I (:iN. IS "IF' I CERTIEY THBI' 1: I Fli'd FBI"ilI~IBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FINC, WELLS FIE; !.~E'I' FORTH BY THE MLINICIPRLIT'¢ OF RNCHORFtGE. 2: I I,.lIl~L INSTALL THE S'¢S]'E-".i','I IN RCCORDFINCE 14ITI4 THE Ii:OB, ES. 2~:: I IJNI}EF-:~,TBND 1-NBT T'HE ON-SITE SEFIER S'¢E;TEM t'IFI¥ RE~:HJIRE E]",ILF~RGEME]'4T It::' THE: RESI[)ENCE IS REHODELE[:' 'TO INCLI_.IDE WORE 'T'HBN 3 BEI:)ROOMS. ':; I GNED: :: .......... - ,,¢-'~ .~'. F EFUI.[ T If,ICI. FIPPL :[ CF:IIq T L.I]I]:FIT 101"~ LEGFII I...J. 7' 82 SKY RANCH EEST T"r'F'E Of;;' SO:[L FIB:SORE:T:[ON 5"r'STEH IS: 'FRENCH I'flFIN,[HI.JH NIJHBER OF BEDE:OOHS =: ::~: S]O:[L. RFFT'ING (:E;Q Fq',."BF?.)= THE IRIEI;~I.JZ[~IE[:, SIZE OF:' THIS SOIl.... RB[5ORP]'ZON S;M[STEf'I ) f~ .aif ,.~. ~:~ ..... ~.~E:IF" ~, II .... THE LENG'TFI E] ENSIf. CII'.,I IS THE LEi',J[:~"rH ,::II'.,I FEET::, OF THE 'rr~:Et"4C:H Tf:~' E:'F-:RIIf,IFIEL[::'. THE: E:'E.:PT'H O1:= FI TRENC:H OR F'IT :[2.:, THE D]:~FFFINCE 13ETI.qEEN 'THI:i: ':SIJF:F=RCE OF' THE GI:.~iOL.II",IE:' FIN[) THE EiOTTOI"I OF' THE E',qE:F:I",,'FIT:[ON (:l:I",l FEET::'. "I"HEF~:I::: ]:S NO :SET I.'.IZD FOIl'. "I't~:F£NCHE'.~i;. TH[F. Cq:;;tlZlVEL. DEP"I'H I'"IIN]:i'"ILJI'"I [)E:F'TH rZ:)F' C'i[4:FIVEL 13ETHIEEN TI'fiE OIJTFFILI... I::':[F'E FIN[:) 1"HE 13C)TTC)f"I OF' TF ON ':.'IN I::E.'IZ"['). I I'.,I ~-; T f::l L I.. E E:,. IF FI IH.IN FI:f,IHI,I .E TO THIS I F: FI ...I .......... :[ ., r ::, f Et1 .[ .:, L.I.:,ED THEE L..EEF,IG"I"H IF: FI -' "'::': ,:'u,:' "':' c ....... L.L..H ...... II: ._,r....~lE.i'l :[- I..I::,E.[. THE: I..EIf~GTH IH] .... H:[i'.,I:[HLIH [;, :[ STFINCE E:ETHEEN FI 14EL..I.. FIND F:ll'.,l'~' ON-'.:i;]:TE: SEI,~FtCiiE..' E) :[ SI='OF:;RI... S'.¢STEf,'I :[S ::[.E)E~ FEET [:'OR R I:'RI',,,'RTE HELL. OF,' 2E~E1 FEET F'OI~'. R PIJE:I...~[C HELl._. SPEC I F I (]IRT :[ C)NS Ri',ID CONSTR(JCTI I:)l'..I L':, ]: RC. iRFIHS RRE I:l'v¥1 If I,.I:'I[[ILE 'if'CI :[ N:~Uf:~'.E PROPEl:;?. :[ I",lS T FIL. L I::IT :[ ON. :[ CE[;?.T:[F¥ THFIT 1: I Rf, I FRH I L.. I FIf;.'. I.,.I If TH TFIE F;:Ef¢:!U :[ R[~:t',IEN"I"S F:O[(: ON.--S Z TE 5;EHE:R~i RND NEt..I..S; R'.E; FORTH FY¢ THE HUN:[C~PFII._ZTM OF RI'qCHORFIGE. 2: Z H:[I.-L :[IqS"f'Rt...L. 1"HE Sk'S"I'EH ~1'.,I FICC:OE'.DFII'.,ICE I.,.I[TH THE COl)ES. :2:: Z UNDER'.STFIND THRT THE OI'.,I-S:[TE SEHEE'. ~;'.¢~'TE~:I"I HR'¢ RECCJIRE ENL.R[~:CqEHENT RIE~SZDIEI'.4CE ZS; RE:I'dODEI...ED TO [NCI.I.JDE FIOE:E "['HFII'.,t 2: EE~DROOf"IS. fI~-FL:[L. IIhll :,~;i~.E H _rE . / _.,El ]: F' 'f'HEE August 22, 1975 WO I~17457 Sandy's Construction 8235 Jewell Lake Road Anchorage, AK 99502 Subject: Subsurface Investigation for On-Site Sewer Lot 17, Block 2, Sky Ranch Estates Gentlemen: On August 12, 1975 we placed a test hole'on the above referenced lot to a depth of 20', as located on Figure 1. The test hole was drilled utilizing a Mobile Drill B-50 drill rig mounted on a Flextrac-Nodwell vehicle owned and operated by Denali Drilling, Inc. The drilling was supervised and the test hole logged by Mro O.M. Hatch, senior technician/ staff geologist with Alaska Testlab. The soil strata encountered were alternating layers of saudy silt, unified classification ML, and silty sand, unified classification SM, with some intermixing of gravel ~- see Table A, the test hole log. Because of the amount of fine grained material present, it was ()ur feeling ~hat a percola- tion test was necessary. At 1:45 p.m. o'o. August 14, 1975, water was placed in the hole 'to a depth of 1.1' below the ground surface. On returning the next day, August 15, ].975, a% 9:45 a.m. the water level had dropped to the 10.0' ].eve].. The hole was refilled wJ.i.h water to the 3' level a'L: ]0:00 p.m. and the water ].eve3. ~nonitored until 2:00 p.m. that afternoon, at which point the water depth was 6.10' ~±'his compuhes to a percolation ra'~.e of !0 rain/in. Utilizing, Table 1, "Absoz'p-- tion Area Requirements for Individual Residences", on Page 8 of the "Manual. of Septic Tan]¢ Practice" published by the U.S. Departtuent of Health, Education & Welfare, such a percolation rate the requiz~es an absorption area per bedroom of ].65 square feet. No water table was detected J.n the test hole for :Lts full depth on the date explored. Zt should be noted, though, that tl')e water table ~s norma].ly affected by seasonal and climatic changes and general]y fluctuates occordingly. Sandy's Construction AuguD~ 22, 1975 Page 2 We hope that this data is sufficient for your present needs. If we can offer further clarificagion or explanation of the data presented or be of further help, please do not hesitate to contact us. Very truly yours, ALASKA TESTLAB Melvin R. Nichols, C.E. Laboratory Supervisor MRN:rb Enclosures 02 O6' oo '~/ oo GZ! 0'0 SHE- oo 03 Test Ilole t~1 Table A WO tt17457 Depth in Feet From To 0.0' 0.5' 0.5' ' 5.0' 5.0' 9.0'. 9.0' 16.0' 16.0' 20.0' Soil Description F-4, brown Peat, Pt, damp, soft. F-4, brown to tan very San~_~ Silt, ML, with traces of gravel, dry, stiff, NP. F-2, brown Silty ~r~avelly Sand, SM, silt content 15-20%, damp to dry, maximum rounded particle size 1". F-4, tan Sandy Silt, ML, with traces of gravel, damp, stiff, NP. F-2, brown Silty Sand, SM, with traces of gravel, silt content from 15-20%, damp, medium. Bottom of Test. Hole: Frost Line: Free Wa~er Level: 20.0' None None Observed Sample ]Depth 1 2.5' 2 5.0' 3 7.5' 4 10.0' 5 12.5' 6 15.0' 7 17.5' 8 20.0' Remarks: 1 . 2. 3. 4. 6, 7. Type of Dry .... G ..... ML ..... G ...... .... G ..... S M ..... G .... M L ..... G ..... MI, ..... G ....... ML .... G ........ SM .... G ....... *- ) S St:andard Pcmetira :ioi~ Type of Samp].e, G=Gi. al , , P = ' I)ry StrongLh, N::Nono, L=[,ow, M=l'4ed:[um, II=iI~gl~. (~rou~ refers to s:imJ ] ar ma LerJa] tbJ. s study only. Unif:Led Class]:~:[cah:iol~, see Shoc~L 2. Fros¢ and Texkura] C'la~:s fScc '..o~, see ~hc¢:k 1. Genera] Info.mah:ien, ~me Shoot: 3. OLher Information, so(:: ~: me~e 4 hhrough 7. � PL13iVS MUNICIPALITY OF ANCHORAGE Development Services Department \' Phone: 907-343-7904 On Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-302-41 1. GENERAL INFORMATION Expiration Date: 7-2-3— Z- ©2 0 Complete legal description SKY RANCH ESTATES #2 BLOCK 2, LOT 17 Location (site address) 11700 SHETLAND HEIGHTS CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) STEPHEN & KATHLEEN HEINLE Day phone Mailing address Real estate agent 2. TYPE OF DWELLING: 11700 SHETLAND HEIGHTS CIRCLE, ANCHORAGE, AK 99516 ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Private Well Water Storage Community Well A 3 Day phone TYPE OF WASTEWATER DISPOSAL: Private Septic ❑ Holding Tank; ❑ ❑ Community ❑ ® Public Sewer ❑ Public Water System ❑ f Waiver request for: ` Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ JR2 / QQ Date of Payment Receipt Number 649y COSA # 05067/063 Waiver Fee $ Date of Payment Receipt Number 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4661 NATRONA AVENUE, ANCHORAGE, AK 99516 Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 07/06/2019 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, OF / �� •' . "' Y� 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: The life TH system and maintenance. operational of all well and septic systems are subject to these various and dyhamic characteristics and are outside the control of the evaluator of the * .4 9 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 or od 0��G J�v� `-I ••�� discrepancies exist can be given by F Sand Anderson Construction & Engineering. N. ANDERSON- 6. DSD SIGNATURE No. CE 9489 4,'W� ..,7/6/19 , t System #1 Approved for bedrooms\�.'►�` sstot01, s System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following tttttt«��r�rr YOlt: 11/2, `\\ �.7�jR WA m AS'T� AND m OG r , �))) )1J��1�T By: Original Certificate Date: �^ 1 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 blue sheet . Legal Description: SKY RANCH ESTATES #2 BLOCK 2 LOT 17 Parcel ID: 015-302-41 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA — CLASS A #212916 ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to _ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) _in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA — 5/23/2019 1250 -Gal Age of tank(s) 0 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping NA — NEW TANK Structure served by this system Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _ mg/L ❑ Nitrate less than MRL (ND) Arsenic — ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION - NA ❑ Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA — 39'L x 3'W x 8'ED — @ 165 sf/br = 624SF Which system tested (date installed) 4/11/1977 ® ALL standpipes present per record drawing Total measured depth from grade 6 ft (max) Measured depth to pipe invert from grade 4_6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 1.4' Adequacy test date 4/23/2019 Results M Pass For 3 bedrooms Fluid depth prior to test 79 in Water added 1000 gal New depth 96 in Elapsed time 1380 min ® Code -required soil cover over field Final fluid depth 79 in ❑ System presoaked Absorption rate 450+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced _gallons If yes, enter date Comments/Deficiencies *Fluid testing levels include missing 6.6' D. New MT driven 11.7' post -testing w/ ST install for verification and future use w/ fluid levels <2' in field COSA Checklist Private Sewer copy 3.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tan Uft Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleano L>—rOo' If absorption field is under driveway comment below Yes if No ft Yes if No Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Neighboring Tank > 100'es if No ft Private Sew ptic Line > 25' ®Yes if No _ Absorption Field on Lot > 100' ® Yes if ft olding Tank > 100' ®Yes if No Neighboring Absorption Fields > 100' Containment > 50' ® Yes if No Yif No ft �nimal re/ i I Excreta Storage > 100' Community Sewer _ 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots: Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No. Absorption Field > 5' ® Yes if No ft Community > 200' Yes ® if No. Water Main > 10' ® Yes if No ft If septic tank is under driveway comment below Water Service Line > 10' Yes ® if No ft Surface Water > 100'® Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) ft ft ft ft ft ft Wells ft Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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. COSA Checklist Private Sewer copy 3.docx ` ® of Al *:49 f, .MICHAEL N. ANDERSON- �S -. No. CE 9469 .Z/.6/1.9 nssio o, A \S®ems LOT 16 0 m S890 59'44"E 101.41' IN o C o LOT 17 0 z y V •vim o Oco aQ o EXISTIN( 0-0 i m HOUSE LOT 15 OF A �"�p 49TH ................................ ....................M ..... STEVEN CALLAGHAN o '• LS -12034 ►44 of ,I a ,00 siono\ �od 0 2� 52,w S73 wP�K�Pv LOT 18 NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. ORDERED BY: BRENT WESTERN SUrcvtYCtKIIFILA IIUN:LLULAN Itc.H,INCHAI, LUNDUCILL) APHYSICAL SURVEY OFTHE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST PARCEL#: 015-302-41-000 ADDRESS: 11700 SHETLAND HEIGHTS CIR. OTHER THAN NOTED. LEGAL DESCRIPTION: AS -BUILT EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY LINES, OR FOR LOT 17, BLOCK 2, PLOT -PLAN PURPOSES.