HomeMy WebLinkAboutNETTLETON ACRES #3 BLK 1 LT 1AN- 4tlc
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP251203 PID Number: 015-062-54
Dwelling: Z Single Family (SF) [:] with ADU F-1 Duplex (D) El Two Single Family Project: El New 0 Upgrade
Name
RAYMOND E CLEMENTS
ABSORPTION FIELD — EXISTING
2 Deep Trench n Wide Trench El Bed El Mound
Site Address
6800 LOUISE COURT, ANCHORAGE
El Other
Phone
Number of Bedrooms
Soil Rating;
Total depth from original grade
4
GPD/SF;
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
Fill added above original grade
Ft.
Gravel length
Ft.
NETTLETON ACRES #3 1 1A
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To; Septic Absorption i Holding Sewer
Total absorption area
Number of trenches
Dist. between trenches
1
From Tank Field Lift StationTank Line
Ft2
Ft.
Well 100'+1 25'+
TANK 0 Septic [I S.T.E.P. ❑ Holding [I Other
Manufacturer
GREER
Capacity
1500 Gal.
Surface Water100'+1
Material
HDPE
Number of compartments
2
Lot Line 5'+ NA
Foundation 10'+
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks DEEP -BURIAL SEPTIC TANK
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
Installer NORTHERN EXCAVATION
Drainfield CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspection 1" 7/22/25 7/23/25
Location and description
dates: 2
3rd 4'"
ITOP OF RISER (MH)
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
AG
Conditional Approval: Date
f!L . ......... .
--- -------
Septic Syst
.. ... ........
Curtis Huffman
,
Approve
0%
CE 128991
Date at
F•.- 8/21/25 .
N, j - - - - - X, AW
k�, OPROFESSO
Note: this approval does not include well permit requirements.
(R 05/02/18)
G_
PID:015-062-54 PERMIT:OSP251203
FIRST WATER CONSULTING
NETTLETON ACRES #3 BLK 1 LT 1A
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.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251203
Work Type: SepticTank Upgrade
Tax Code Number: 01506254000
Site Legal Address: NETTLETON ACRES #3 BLK 1 LT 1A G:2439
Site Mailing Address: 6800 LOUISE CT, Anchorage
Owner: CLEMENTS RAYMOND E
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
❑ Disposal Field C✓I Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
7/1/2025
7/1/2026
61488
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Receive(
Issued B
Date: 71112025
Date: 7/1 \/2025
4
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I. D. 015-062-54
Property owner(s) RAYMOND E. CLEMENTS Day phone
Mailing address 6800 LOUISE CT, ANCHORAGE, AK 99507
Site address 6800 LOUISE CT, ANCHORAGE, AK 99507
Legal description
NETTLETON ACRES #3 BLK 1 LT 1A
Number of Bedrooms 4
Engineering Firm FIRST WATER CONSULTING
Building Permit Number
APPLICATION IS FOR:
(M all that apply)
Absorption Field ❑
x❑
El
Septic Tank
Holding Tank
Privy
Well
Not Applicable ❑
APPLICATION IS AN:
Initial
❑
Upgrade
FxJ
Renewal
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
Permit/Rush Fees: 2 S-0-0 Waiver Fees:
Date of Payment: b LA3/2s— Date of Payment:
Permit No. CS129Std 07) Waiver No.
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
June 19, 2025
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT
LEGAL: NETTLETON ACRES #3 BLOCK 1, LOT 1A
The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic
tank on the above referenced lot. For current functionality and future consideration or flexibility,
we propose to install a 1500-gallon deep-burial HDPE tank per the attached design to serve the
existing 4-bedroom residence.
No groundwater was noted in the MOA on-site file, but if groundwater is encountered during
installation an epoxy coated steel septic tank or other action may be required. The lot and area
are served by private water and any encroaching wells, easements, … must be staked prior to
construction. The design will not impact any of the neighboring properties. Please contact us if
you have any questions.
Sincerely,
Curtis Huffman, P.E.
FIRST WATER CONSULTING
NO WELLS WITHIN 100' OF
PROPOSED SEPTIC TANK.
NETTLETON ACRES #3 BLK 1 LT 1A
DESIGN DETAILS:
/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME ~
LEGAL DESCRIPTION
LOCATION
Absorption area
Manufacturer
Well
Liq. capacity in gallons
DISTANCE TO:
Inside length
Dwelling
Material~ .j¢(~. (
Width
~NEW
NO. OF BEDRO4.~L_MS
PERMIT NO.
No, of compartments
Liqaid depth
IF HOMEMADE:
Well Dwelling PERMIT N~.Q._
Manufacturer Material Liquid capacity in gallons
Well
DISTANCE TO:
No. of lines
to finish grade
¢ Fonndation ~ Nearest lot line
/-~rme (, , Total length of linesL~ l ' Trench width~, fi~hes
~ , Maters beneat,t e ~ ,~s
Width
"~'~) diam et er
Depth
C~dib.dept
Building foundation
Driller
absorption
Length
Nearest lot line
Distance to lot line
Type of crib
DISTANCE TO:
Depth
DISTANCE TO: Building foundation Sewer line Septic tank
PERMIT NO,...~ ¢~ 0 '...~/~ (~
Distance between),) lin~sL~
Total effective absorption area
PERMIT NO.
PERMIT NO,
Absorpt on area(s)
OTHER
PiPE MATERIALS
SOIL TEST RATING
1 5)0
INSTALLER
DATE
LEGAL
72-013 (R~v. 3~78)
!.Iii!CF:it ]i Cd",! Ii:i~i::'l:' !"!OM~::iii!i;!'!~!:i~::IC' 117.!i).
TI-Ii!i: t.¢!:I",ll:!i I'l I [::, :1: I"ll!F:i",ki!; ]: I;':11'.,I J: :::i; 'il'Iix: !.[:::HCi i'1'1
I['IE f:::,F!:F:"I'I'I CIF:' I::1 '['!;i:!EHC:I"i CI!:;i: F:' !: "i' .-. :!: :i i; 't'tI!E I::, :!: :!!;T',:::Ii",IC:[::: I~!',l~i:fhlFi!:!:i:t"4
I::ii,i:Ot..tb![) l::ff',i[::, TI'Ii:i: I:?,CF!'TCq'! ()[::' 'f"! lie
i'!.lli:!:;i:lE :[:i:i; H(:I :!i;l~ !' l,!:[D'i'!l I::;'CfI';iI
T!-!ii:: I::il:;i:l:::l',,,'l!i:! [:,[::!:'Ttl :1: :i; Fl'Il: l'"i :!: [",1 i( I'11..tt'"t
l':'ff-,il::, 'il Ii!ii: i!i',C!I"'['I.::IH ()1::' TI'il I::.'XI:::I:::I',,,'t:::IT
::I..: ]: I:::ll"i F:'l:::li"i ]: l_. ]: f:'ii;i: t,]:I:TII 'l't'll:::; Fi:h.h:i:K.t]:t~:!!!:H[i!%t't::!; I:'O1:;i: CIH..:il;:[ ['1:i: :ii;t!i!:l.,.![!!:l:;i::!!!; F:II",E:, !,lt:[...t..:!:i; l::!'.!i; :!ii;!:[]"
t::'C!F:II! !i:!'/'r' Till:i: t'"llli'.,!:[l:::'[l:::'l::ll ]:'F? CIF:'
;::i:: ]: !,.! :i: 13. :i: bE!;TI::!I ..i. I"l'!hi: :ii;'v%'i'l:}i:l'l :!: t",! F:!I::':I;:::!31:;i:I::,I:'!HI::::I!: !.,.! :!: I'!'t t'! I[i!:
::!i:: :[ I..Ih![)t::I::i::[i;Tt:::iH[::, i'iff:!l' Till:: O[",f' :!i; :!: 'T l:!!: :!!;!!:I,.!E:Fi'. ':':i;'./'_:!;"l"lEh'! t"ll:::l"d l;;:ti:(;!l...t ): !:;i:! i: [::['.,!l.l:::i[-i:(:!ii!i:l'"[ii:h!'t :i:!'::' TI.It:i::
Fi:[i:::ii;]:l)F:]",IC:l!: :!::!i; l::;:!i:l"i()f::,t!i:l.[!:!:::' '!'O :!:t'.,!C:!..I..!!::,E: t'IC~[:i:!!: THI:'I[",I ,:'I
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6.650, Anchorage, Alaska 99502 276-2221'
SOILS LOG- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: ,/-~, //
1
2
3
4
5
6
7
8
[] PERCOLATION
TEST
DATE PERFORMED:
SLOPE
SiTE PLAN
q' - t --' -
~,---i--~~ 4
10
11
12
13
14
15
16
17
18
19
2O
WAS GROUND WATER
~F YES~ AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE .(minutes/inch)
TEST RUN BETWEEN , FT AND __ FT
COMMENTS
PERFORMED BY: ~/~',/L,Y ,~ /~'i ~.¢.,(,.
CERTIFIED
72-008 (7/76)
MUN!C',i~A!.!TY C F
IV'i '-~"'~,!V DRILl, lNG, Mc,
P.O. [3OX 4 1224 ¢ 1210C Ihte n,diona[ Anpo~t Road
(907) 274-4(;t ]
AN(iIIORAGE, A ASKA 99b09
DiIiLLINO) LOG
Robert- Hi]by
Use of Well Domes tic:
l,ocation (address of: Townshi)), llan¢;e Section, if hnown; or distance mare roacl .....
Blk 1 Lot lA Net:tier'on Anchorape
Size of casing _ 6" Depth of Itole 86 . feet Casedto $~ ._ feet
Static water leveL_50 __ ft. (fi4aWCL'¢) (below) land surface. Finish of well (check ar, e) open end ( xx );
Screen ( ); Perforated ( ).
Describe screen or perforation_ _N/A .............................
Well pumping test. at 2 gallons per ~N_~Xt:¢) (minute) for ..... 1.. hours with ~Z)O?Z~ elk.
of drawdo~vn from static level.
Date of completion l~O/~2~2~/~ 9 ..........
WEI. L LOG
Depth in feet from
gl'Otllld surface Gi{,e details of formntions penetrated, s/×e ol lll~q[ei'Ja], co]oF [lrid hardness
0 TO _._ 2. _
2 TO 3
3 _TO 9
...... 9 TO ......
... 29 TO 33
33 .TO ....
7~_ TO
_ TO
. '['O
.... TO
TO
T
TO
..... q'O.
(os_trig ~J:ickup
Or_garlics
S i~l_t.y__ sravel
__Sandy g~r a~eJ ............................
. _Sandy gra~.el: dam8 __ .
~iA~y kard pan .................................
_ Wale]:: gravel ..
.........................
1 -CUSTOMER
LOT SIZE x ........ ', - SQL.IRRE FEET
SO:II_ RRTINO <SA FT,.-'E:R>=
THE REL;!UIRE[.'., SIZE OI= ]'FIE SOIL FtBSORF"f'IC~I'4 5YSTEP1 IS:
U F-: H \¢ [£ t .... [) E-,: t- T i,--!
'THE LEN(ITH DIMENSION I% THE LENG1-H (j. fq FEET) OF THE TRENCH OR DS:F~INFtELD.
THE DE.P']'H OF R TRENCH OR Pi~[ IS ','H.E '.'b;STRNCE rdET~4EEN THE SURF,~,CE OF T?iE
GROUND RND THE BO]'TO¥~ OF THE EXC~'iVRTION (IN FEET)_
THERE IS NO SET bI:[DTH FOR TRENCHES.
THE GRF~VEL DEPTH IS 'THE MINIhlLIhl DEF"FH OF- GRFtVEL BETPlEEN THE OUTFF1LL PIPE
RND THE BOTTOM OF THE E>,'CR'¢RT~ON (ZN FEET).
PERMi'F'FIF'PLIC:RNT HFI5 ]'HIE RESPONSiE:ILITY 'FO INFORH THIS ['.,EPRRTMENT DURING THE
INSTRLLRTIOH INSF'ECTICNS OF RHt¢ NELI_5 FI[>JRCENT TO THIS F'ROF'ERT~¢ FINe, TH[;
NUMF3ER OF RESIE)FN';E:5 'fliRT THE HELL IqlL. L .SERVE.
-- , ~. ,,., ,-
~,,I=ICKFTLLTNCt OF' FIN'¢ E,,"r".STI~,M !.4.'[-i"HOLIT F']:Nt=tL INSPECTION F~i".!D HFPi.O',RL ~&r' TF'IIq
DEF'FtRTMENT N ILL_ BE' SUBJECT I'O PROS.;ECUTICff4.
MIHIMLIM DISTRNCE BETWEEH £~ HELL RND RN¥ ON--SITE SENRGE DISPOSRL S¥~;TEP1 IS
:LOO FEET FOR R PR IVRTE HELL; OR
±50 TO 200 FEET FROM R PUL::LIC P~ELL. DEPENDING UPON THE: TYPE OF PUBLIC P.IEL. L
HELL LOGS RRE REQUIRED FIND MU:-."ST E:E RETURNED TO THE DEPIRRTHENT NITI4IN ~0 DRYS
OF THE PlELL COMPLETION.
.OTHER REf;!IJ~[REMENTS P1FIt¢ RPPL'¥'. SPECIFICRTIONS RN[) CON!.;TRUCT[ON DIlaGRRI,1S RRE
RVRILRBLE 'TO INSURE PROPER INSTRLLRTI
P E] F:~ hl Z T F] ."~.* F" ]: IF~ E: 2; [.", E": L'Z: fEZ !'-'i 8 E R .--,=: =1_ .. '.cL.. 9 '7"" .~.
I CERTIF'¢ 'FHRT
±: I FIM FFIMILIRR [4i'~FI 'ride F~:EL:~IJ:[REMENTS FOR ON-SITE 5ENER5 RND 14E~L5 las SET
FORTH B'¢ THE HLINICIF'RLIT'¢ OF RNCHORFIGE. ~
2: I '[4II..L INSTRL. L THE S'¢STEH IN RE:CORI}RNCE WITH THE CODES.
~: I UNDERSTRND THRT TtaE ON-SITE SEP]ER Sb'STEM HRY RE64UIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE ]HRN 3 E:EDROOHS.
-- '- -' D~,TE RECEIVED
INSPECTION APPOINTMENTS "
TIME TIME TIME
DATF ~- [DATE DATE
I NSP EC'~R INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF I'. 'AI_TII &
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~I~ONMENT,:,L ,,. ~'1ECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION FEB 2., 5 19 30
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on pago 1, Incomplete requests will not be processed, Please allow ten (10) days for processing.
1. PROPERTY OWNER )-~ ! PHONE
~R Dp E R Ty R ES I D~NENT/(~diff~erent f ro~v~K ~(~) ~ PHONE
2, BUYER R E,~S S~/~ Y ~ ~~) ~,~ (:2 / --~? ,~ PHONE
3, LENDING INSTITUT/T~3)N PHONE
MAILING ADDRESS
4. REALTOR/AGENT ,~--) PHONE
MAILING ADDRESS
6, TYPE OF RESIDENDE NUMBER OF~BEDROOMS
-"~ F-lOne /~1'~ Four []
SINGLE FAMILY [] Two Five
[] MULTIPLE FAMILY [] Three [] Six
Other
7, WATER SUPPLY
/~ INDIVIDUAL~
[] COMMUNITY <~'~ '
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well Log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ I N DIVI D UAL/ON-SI'YE** /~/~
[] UT UTY
YEAR ON-SITE SYSTEM WAS INSTALLED,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[~] PUBLIC UTILITY
Connection Verified__ LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY / ~-.~ '~'~)~
Connection Verified
[~lSeptic Tank or [] Holding Tank
Size: ) ~i~,?'-L~ If Tank is homemade SOILS RATING
give dimensions:
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
I
Absorption Area to nearest Lot Line
5. COMMENTS
[~--APPR OV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVFD
DATE BY
72-010 (Rev, 6/79)
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 015 -062-54
Certificate of On -Site Systems Approval
OSC251368
Expiration Date: 5/29/2026
Legal description NETTLETON ACRES #3 BLK 1 LT 1A
Site address 6800 LOUISE CT
Current property owner(s) CLEMENTS RAYMOND E
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
A
Original Certificate Date: 8/26/2025
This Ce ' icate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sys (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
velopment 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 X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
Development Services Department
On -Site Water & Wastewater Section
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-062-54
Complete legal description
Location (site address)
NETTLETON ACRES #3 BLOCK 1, LOT 1A
6800 LOUISE COURT, ANCHORAGE, AK 99507
Current property owner(s) RAYMOND E CLEMENTS
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: � Private Well serving # 1 dwelling units
El Other Non-public well as regulated by MOA El Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units
El Holding Tank F-1 Community Septic or Public Sewer
5. SEPTIC TANK: R Steel FEJ Plastic ❑ Concrete n Fiberglass
Age NEW _See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: E]AWWTS E:]Bed 0Deep Trench ❑ Wide Trench E]Seepage Pit
Waiver request for: Distance:
Expedited review requested: F
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ p;0 Waiver Fee $
Date of Payment 'C6 /)-ri 1i5 Date of Payment
COSA # 4 Sc �-s 13 �00 Waiver #
COSA Application—ApF2025. doe
COSA Checklist_May2025 copy 2.docx
COSA Checklist
Legal Description: NETTLETON ACRES #3 B1 L1A Parcel ID: 015-062-54
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 10/22/1979 Total depth 86 ft
Cased to 84 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 5/29/25
Static water level at beginning of test 41 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 4.12 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 5/29/25
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping NEW TANK
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) 10/10/1979
ALL standpipes present per record drawing
Total measured depth from grade 10.5 ft (max)
Measured depth to pipe invert from grade 7 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective 3.6
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 5/29/25
Results Pass
Fluid depth prior to test 11 in
Water added 700 gal
New fluid depth 23 in
Elapsed time 1440 min
Final fluid depth 11 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 72 in (MOA 6’ ED)
Effective depth used 40 in (Unmeasurable ED + final fluid depth)
Effective depth remaining 32 in
Comments/Deficiencies: CO & MT at the end of the septic field. Approximate total measured depths from existing grade.
ED per elevation measured shots & appears approximately 2.4’ or 29” ED is unmeasurable.
COSA Checklist_May2025 copy 2.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 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 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
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 08/18/2025
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 &
08/18/25
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22
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9
'
44.3
'
42
.
1
'
27.8
'
19
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5
'
16.1
'
30'
30'
2
5
'
2
5
'
WORK ORDER No:DATE:SCALE:
DRAWN:
LL/MB
CHECKED:
ROL
ZONING:
1"=50'Aug 17, 2025 R6
GRID No:FB BOOK/PAGE:
SW2439 173/41
SURVEY CERTIFICATION: Alaska Remote Imaging has conducted
a physical survey of the subject property, the improvements
situated thereon are within the property lines as shown.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions
which do not appear on the Plat used for this survey.
NOTE: Under no circumstances should any data hereon be
used for construction or for the establishing of property lines.
PREPARED FOR:
First Water
Consulting Services
ASBUILT SURVEY OF:
Lot 1A, Block 1,
Nettleton Acres Unit No.3 (Plat 78-32),
Anchorage, Alaska
Found Rebar
Cleanout
Elec Meter
ALASKA REMOTE IMAGING
Surveying Mapping Land Planning LIDAR
6239 B Street, Suite 201, Anchorage, Alaska 99518
(907) 519-0339 survey@alaskaremoteimaging.com
1.Bearings and distances are record per referenced plat unless otherwise noted.
2.Not all monumentation for this survey may be shown on this document.
3.Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey.
Sewer Lid
S U R V E Y I N G A
L
A
S
K
A
IMAGING
SURVEYING
DRAFTING