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HomeMy WebLinkAboutPARADISE VALLEY BLK 9 LT 34: 02.o /7
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231138 PID Number: 020-414-17
Dwelling: F15 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Shirley Dam
A RPTION FIELD
[01 De Trench El Wide Trench El Bed ❑Mound
Site Address
18201 Golden View Drive
Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
907-854-5822
4
SFJ
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original g Gravel depth beneath pipe
Ft. Ft.
Subdivision Block Lot
Paradise Valley 9 34
Fill added above original grade Gra length
Ft. Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Dista between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between tre es
From
Tank
Field
Tank
Line
Ftz
Well
>100'
N/A
N/A
N/A
>25
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
Greer 1250 Gal.
Surface Water
> 1 oo'
N/A
N/A
N/A
Material
Plastic
Number of compartments
2
Lot Line
>5'
N/A
N/A
N/A
NA
Foundation
>10'
N/A
N/A
N/A
L TATION
Manufactur
Capacity
Remarks Insulation placed over tank
Gal.
Alarm location
Electn led by
Installer
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
ACES
Drainfield D3034 CO/MT D3034
Inspector B Schiller
BENCH MARK (Assumed elevation) 100 ft
Inspect1m 6/27/23
Location and description
2ion
nd
r
Concrete Slab @ Man Door
3 4m
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
®F A�,�
Conditional Approval: Date
.t9
49— ••
Benjam ri.,Schiller
�¢ �'F••
Septic Syste
Approved Date qA
CE 12592 ,•i��`��
�VP,
F9FppROFESSION�t���
Note: this approvalcj�a s not Include well permit requirements.
kr[Cv UJ/UL/ 16f
a 1 a . 1 . •
PERMIT # i
PID # 020-414-17
EXISTINaTRENCH TO REMAIN IN
\ ( SERVICE
- 1 - --- - CHIN LINK FENCE I 10' UTILITY EASEMENTS /
I
I I
CO
LOT 35
NEW 1250 SEPTIC TANK
r F LCAT 3 /
I
(( �h / / LOT 4- !
G01 OA �O DECK L —I \ \ \ \
BM ^j r' SHED/ \ )
DECK \ \
,... \
LOT 34 '~ 4
r
r
LOT 31A
r \ \
\ tf
ENGINEERING
..i -.r --or- ski
Benja i Schiller
I��csJF�F,C812412392
l�►,�pROFESSIONP ,a
0 50 100
hE =1 INE ME FEET
1 "=50'
A B
2C01 23.2 27.6
MH
27.8
31.8
SV
32.0
35.9
I
33.8
i
CO
LOT 35
NEW 1250 SEPTIC TANK
r F LCAT 3 /
I
(( �h / / LOT 4- !
G01 OA �O DECK L —I \ \ \ \
BM ^j r' SHED/ \ )
DECK \ \
,... \
LOT 34 '~ 4
r
r
LOT 31A
r \ \
\ tf
ENGINEERING
..i -.r --or- ski
Benja i Schiller
I��csJF�F,C812412392
l�►,�pROFESSIONP ,a
0 50 100
hE =1 INE ME FEET
1 "=50'
A B
2C01 23.2 27.6
MH
27.8
31.8
SV
32.0
35.9
2CO2
33.8
1 37.9
LEGEND
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
PERMIT # OSP231138
ENGINEERING
PID # 020-414-17
PROFILE AS -BUILT
(NO SCALE)
INSULATION
AQ
7H
.. ... ... . ......
......... ..........
Benja Schiller
CE 142112
8!24.3
Lot 35 10' UTILITY \
/ EASEMENTS
c6 \
'"E 170.01' Lot 3
30 E
/ Lot 4
WELL \ `\
� O��v `
4 <37 \
_ry s'\
'OR /OT
FcT LF %
RgOj�S /
Lot 31 A /
PLOT PLAN _ _ AS BUILT X SCALE 1" = 40' GRID — SW 3538 Project No. __ 23-18�A2_
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
ken®langsurvey.com ®4�►�®�1�
Professional Land Surveyors jonathan0longsurvey.com .� '� OF At
trovis®langsurvey.com • ' ' ' ' • • !9�1
I hereby certify that I have surveyed the following described property:
LOT 34, BLOCK 9, PARADISE VALLEY SUBDIVISION (PLAT No. 87-16)
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 _ -11 "V"Day of _r �� v "= ° at Anchorage, Alaska
t
If 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.
49TH u
.. . ...�
KENNETH G. LANG 4 �/
i c NoC202
State of Alaska AECC963
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
Departnient
On -Site Wastewater Disposal System Permit
Permit Number: OSP231138 Effective Date: 6/15/2023
Work Type: SepticTank Upgrade Expiration Date: 6/14/2024
Tax Code Number: 02041417000
Site Legal Address: PARADISE VALLEY BLK 9 LT 34 G:3538
Site Mailing Address: 18201 GOLDEN VIEW DR, Anchorage
Owner: DAM SHIRLEY M Lot Size in Sq Ft: 25372
Design Engineer: FORGE ENG Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
-Received:Sy_: ..L55tAe
Issued By:
Date:
Date: ��� Z
MUNICIPALITY OF ANCHORAGE
Community Development Department; Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-414-17
Property owner(s) Shirley Dam Day phone 907-854-5822
Mailing address 1120 East Huffman Suite 24 PMB 695, Anchorage AK 99515
Site address 18201 Golden View Drive
Legal description (Sub'd., Block & Lot) Paradise Valley Block 9 Lot 34
Legal description (Township, Range & Section)
Lot Size 25,372 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) ❑x
Septic Tank
❑X
Upgrade ❑
(w/wo ADU)
Holding Tank
ElRenewal
ElDuplex
(D) ❑
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / 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: 2 Z S Waiver Fees:
Date of Payment: 6Z-� Date of Payment:
Receipt Number: O G7,Z0D Receipt Number:
Permit No. 0 S P_2-'3 I / --?-, '? Waiver No.
Permit App_-'.:- .-.,:c.
May 30, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Paradise Valley Block 9 Lot 34 - 18201 Golden View Drive
Septic Tank Replacement
Dear On-Site Services Engineer:
The owner of the above lot has a septic tank that has reached its end of useful life, so we are
submitting this permit application for its replacement. The attached site plan identifies the location
of the home as well as the wells and septic location. No conflicts exist between this proposed
system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing
the septic tank with the same size designed for 4 bedrooms.
The new septic tank will be a minimum of 100’ from all wells and surface water. Please refer to
the attached plan for the septic design. If this design is followed, there will be no adverse impacts
to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231138, Deb Wockenfuss, 06/14/23
x
x
x
x
x
x
x
x
x
x
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
2CO
PARADISE VALLEY BLOCK 9 LOT 34
FEET
0 50 100
CO
GO
L
D
E
N
V
I
E
W
D
R
I
V
E
3-B DR
M
HO
M
E
SEPTIC PLAN
9/7/22
DECK
DECK
SHED
CHAIN LINK FENCE 10' UTILITY EASEMENTS
EXISTING 71' TRENCH TO REMAIN
IN SERVICE
EXPOSE END OF
TRENCH AND INSTALL
CLEANOUT
NEW 1250 SEPTIC TANK
INSTALL 2CO BEFORE THE TANK
(OR FOUNDATION CLEANOUT)
KEEP OUTSIDE 100' WELL
RADIUS
B
U
L
G
A
R
I
A
D
R
I
V
E
2CO
DECOMMISSION
EXISTING 1250-GAL
SEPTIC TANK PER UPC
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231138, Deb Wockenfuss, 06/14/23
I
I
25.0'
I I
I
FENCE
n
I
Lot 35 10' UTILITY \
EASEMENTS
\ I R"� \a f k[ ?j
��u
WSEPnc
' I - \ PIPES'?
+ h S <
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f� O
3 °Fwgr {IJ zs 3 �.
9•
W ro 73.6' °Fck
55:O
i,
O
Z o A,
W Z
o I Lot 2 34
0 N--�
10
10.6'x12.2' GREENHOUSE hk^
o�r�F
F Lot 3 \
S QS 2
Lot 4
'fie• x\
WELL I
ZOO F \
�Se pROT
RSO/GS l
Lot 31A
PLOT PLAN ___ AS BUILT _x_ SCALE __1" =_49__ GRID _ SW 3538__ Project No. ____23=18V 1____
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlongsurvey.com\
Professional Land Surveyors jonathanOlangsurvey.com ? OF A� 1
trovisOlongsurvey.com i P'��! �ts�.�t1,
I hereby certify that I have surveyed the following described property:
LOT 34, BLOCK 9, PARADISE VALLEY SUBDIVISION (PLAT No. 87-16)
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.
N;
Dated this the ---«'_—_ Day of 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.
*• 49TH *1
y KENNETH G. LANG
Fcs' No. 202 .'
�1l%J511G 3' 0
State of Alaska AECC963
. ~,~, ,, 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 ~, PHONE ~NEW
LEGAL DESCRIPTION ~
NO. OF REDROOMS
AbsorptiqD~rea Dwelling PERMIT NO.
~N~ Z ~ Manufacturer ~~ Material ~ ~ ~o. of comoartments
kiq. capacitg in ~allons Inside length ~idth kiquid dopth
~ ~ DISTANCE TO: Well ~ Dwelling PERMIT NO.
~_~O ~ ~ Manufacturer ~ ~ Material Liquid capacity in gallons
~ DJSTANCETO: Well ~ ~ ~ Foundation ~ ~ Nearestlotline~ PERMITNO.
- Distance between lines
~ No, of Hnes Length of each line Tota, length of ,i~O *rench~
-- Z ~ [ '--~ ~ inches
~ ~ ~ To~ of tile to finish grad~ Material beneath tile ~ (~ Total effective absorption area
~ i~ ~0 '~ ~ ~x~ ~ O inches
Length Width Depth PERMIT
Type of crib me Crib depth Total effective absorption area
m Building foundation Nearest lot line
~ DISTANCE TO:
J~ s~ [~B Depth Driller Distance to lot line PERMIT NO.
~ ' Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
SOl L TEST RATING ~ ~'¢ )t ~ ~
INSTALLER
(
72-013 (Rev. 3/78)
, x- [.':,EPFtF'.Tf'IENT OF HEFILTH PII`,t[)
,, ::::'::'R ." ." ':;TF.'EE"",
~---II E'SZ L I! ..... . Ir:Il IP-.~ [::, (::n ~-..~ ....... rE.T,
F'E'F.':H]:T 1'.40. ,' 7':F.:06'2::E: ',
FFLT ..-I~T
I~.OCFIT ]: FiN
LEGFtL
[::,FI',,,'):.[:, FOR£:,' J'ORi'.]i'..t ..TEI`-]k:I~5 SRI::I EOX ~J..,'~'~='~-:~..~l.,- Fli'.]CFIOF.':FIGE
EiOL[.'.,EI`-,I V :1: El.,] BI..ILGFI[.i: I Ft
L _-'::4 E:
'95 FJ:72 S~;:!LIF-1t:;?.F£ FEET
T'¢F'E OF SOIL I:IBSOR~T.~EiN :B¢S'['EH I_~,.;~-~TRE:N~:H
: ~ :q E.i't .T,S:
THE RE(;!LI:[RED SIZE OF THE '::0
T'FIE L_EI`.]G'rH .F.'.,II',IEN'...:.;IOI'.,I TS THE LEI`.,IGTH ,::Ii"4 FEET) OF THE' 'i"RENCH OR DRRIIqFIEL.[:,.
]'HE DEPTH OF F:I TRENCH OF..: PIT :t:S THE D:[STRI`,IC[:_' BE:TI-,.IEEf',I THE SUF::F'RC'E OF THE
GROUND RND THE BOTTOH OF THE EXCRVFII"ION (]:N FEET::,.
'THERE IS NO SET I.,.IIB','FH FOR TRENCHES.
'T'HE'GI';.'tFIVEL C, EF'TH !S THE M):N~i"IUH [;:,EF"t'H OF:' GRFI',/EI~. E=E'I"!.,IEEN 'THE OUTFRL.L PZF'E
RN[::, TFIE BOTTOH OF,,TFIE E',qC:RVFIT]:ON ,.':]:N F'EET.':,.
tI~:E:E ~2..:.~ILII Z 1):,14: E: [:, 2~;E:F'qF' Z ~:: 'T"F'¢lt'..,lt::: ."E; i ;.-:-:.".E =: ;'I1. "::::~,:E& ~.LEiF'¢IL_..~,ii:;; CX',B.,,~:E.';;
F'ERI"I] T FIF'F:'L): CRNT HI:IS THE RESPONS ]:lB Z L :t: T'.r' TO i NF:'ORH TH I S B',EPFIRTHEI`.]T' DUR I I`'.IEi THE
:!:I'SSTFtLLRT.f. ON II'4SPECT]:OI",IS OF RI".!'¢ NEL. LS RB',O'RCEI',IT TO THIS F:'ROPERT'¢ FIND THE
NUi'"IBEF..' OF RESIB',ENCES THFfT 'i'HE NELL MILL SERVE.
RRCKFIt_LING OF FIN¥ =.r::,lEI1 1.4):THOUT F~I`.,IFtI_ INE;F'ECTIOI`',I FINE:, FIPF'F.:OVFII.... E',"r'
[::'EPRR'I"I'IEI",I"I" 14 :[ LL. E;E E;LIB.J'ECT TO F'fS'."'SE 'Z. '1":1: Oi`',1.
M!i"]ti"lUH B'ISTFINCE BE*I"!4EEI"] R 14ELL. RND F:li`,l"r' ON'""SITE L::;EI.,.IRGE DISPOSF!I.... S'¢STEI"'! IS
;±00 FEET FOR R PR. IVRTE !-,.IELL.~ OR
.':t. 50 'i'O 200 FEET FROH FI PUE:LIC !.4ELL [:'EF'EI"]DII`,IG UPON THE '['"r'F'E OF F'UBL!C I.,.IEL.L..
1.4ELL LOG"-"'; RRE REC!U:[RE[.':' FIND r'ttJST BE RE'i"URNE[:' 'Fi;) THE DEF'FIRTPIENT 14 :[ TH Z i',I 2~:O DFI"r'::5
OF THE 1.4ELL COHF'LE'TIOI'4.
'OTHER RESK.IIREi"IENTS i'"lFl"r' RF'PL"r'. SPECIF'ICRTI'ONS RN[:' COI`']S'I'RUC¥ION DZFIGt:;~Rf"[S FIRE
RVRIL. RBLE TO .'I:NSLIRIE PROPER INS'rRLL. FITION.
IF=' E F-." ~",'~ l." *'IF* F_.F_Z ,',=-=." F' % F:: IE~: :'.=.;~; It:Z:, EE: Ill: EL ir'-ll ~: EE IF;-.'. .~-- ..~ .... :..l._ c:: ,~ ,,=.
I CERTIF"¢ TFIRT
:'L: :[ Ri"1 FFIP1]:LIRR !.,.II'I"H THE RE(-'.!LI:[REHENTS FOR ON-SITE SEI4ER"_q RI'.][::, 1.4EL. L:.?, F:IS :~ET'
F'OR'f'I4 D"? THE HUNIC]:PFIL]:I""r' OF FINE:HOF;.:RGE.
2: I P.ITL_L ~.N'.:STRL. L THE S'¢STEI"I ]:i`',l RCCOR[:.:'RNCE I.'.II'TH THE CODES.
:ii:: ~ UNDER?.';TF-IND THRT THE ON-SITE SENEI:~: S'¢STEH HI::I'¢ RES!U:[RE Ei"]LRF;.:GEHEI",Ff' IF' THE
RESIDENCE ISB REHOI)ELE[:' TO );i`-,tl..-2b, IJ[)E f'ILqF:E 'f'FIFtN ]: E:EDF.:OF$1S. ZLt
, ~';S U El:;, B '¢¥L. '~.~~ _U:~_' ....................... t'::, FI T E .:.'~1 ...k...%%~-_L ?,'_ ..........
PER FOEIM E-D FOR:
LEGAL DESCRIPTION:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-050, And~orage, A!~sk;.~ 99502 276-222T
SOILS LOG - PERCOLATION TEST
DATE PERFORMED:
PERCOLATION
TEST
4
5
6
7'
8
1G -I
17 't
18-
SLOPE
SITE PLAN
WAS GROUND WATER .i / -'}~ L
ENCOUNTERED?
0
IF YES, AT WHAT ." :
DEPTN?
[)ate
Time Time Wa[er
Read
(minutes/inch) ;' '
FT
PERCOLATION RATE
'T'EST RUN BE IWf.!EN F'r AND
PERFORMED BY: :"- ' ! ) ~ ~ ' ' ,' ' ' CERTIFIED BY: i , ' ~ ~/ '~ "
DATE:
72 008 (?/761
© © 0 0 © 0 © 0 0 0 ©
© 0 0 0 © 0 0 0 0 0 0
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. 020-414-17 Expiration Date: f �025
Legal description PARADISE VALLEY BLK 9 LT 34
Site address 18201 GOLDEN VIEW DR Anchoraqe AK
Current property owner(s) DAM
X The On -site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: S ! 12o-2—'y
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services 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 work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory x
Tank Age Advisory Arsenic Advisory
Other
COSA Approval —June 2022
MU HHCFAU T Y OF ° NCHO R GEE
Development Services Department �;''-�4 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-414-17
Complete legal description Paradise Valley Block 9 Lot 34
Location (site address) 18201 Golden View Dr
Current property owner(s) Shirley NI Dam
2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone (907)864-5822
3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑® Plastic ❑ Concrete ❑ Fiberglass
Age 1 yr - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for: Absorption Field to Lot Line Distance: ? _ EJ
Expedited review requested: ❑
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 $ > Waiver Fee $
Date of Payment 2 3 7p Z `% Date of Payment
COSA # �.2 z-/ fit Waiver #
COSA Application June 2022
Municipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road
_Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * x x
Waiver#: OSV241016
P I D#: 020-414-17
COSA#:OSC241116 Permit#:
Legal Description: PARADISE VALLEY BILK 9 LT 34
Engineer: Forqe 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 2.5 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.
............................................... ■ ............................. ■ 1
Waiver is Granted: X Waiver is not Granted
Date: Approved by:
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
April 30, 2024
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Paradise Valley Block 9 Lot 34 - 18201 Golden View Drive
Absorption Field to Lot Line Waiver
Dear On-Site Services Engineer:
The existing documentation for this septic trench includes an inspection report from 1978 which
shows a dimension of 13’ from the 4” sump to the west lot line (and 25’ to the north property line).
However, in our inspections of the system we suspected that these measurements were not very
accurate. The recent as-built survey confirms that the sump is located approximately 3.5’ from the
west property line, which means the trench is likely closer to 2.5’.
We cannot say how the distance was measured or estimated back in 1978. However, there does
not appear to be any significant problems with the location. The trench is still absorbing effluent
adequately, and it does not adversely affect the ROW. The location doesn’t affect the neighbors to
the north and doesn’t constitute a maintenance problem for either this lot or the ROW for Golden
View Drive.
We respectfully request that a waiver be issued for a 2.5’ separation from the trench to the west
lot line.
Sincerely,
Benjamin Schiller, PE
7.92
4/17/24
N/A
New installation
N/A N/A
N/A
Benjamin Schiller, P.E.
(907) 522-7773
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC241116
Subdivision: PARADISE VALLEY, Block: 9, Lot: 34
A water sample revealed a nitrate concentration of 7.92 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
i
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
~.-~ MUNICIPALITY OF ANCHORAGE
· - DIVISION OF E6BfIRONMENTAJ~ HEAL~JH
DEPARTMENT OF HEALTH AND ~NS/IRON]WR~NTAL PR(TI~ECT_ION
APPLICATION FOR HEALTH ~3THORITY APPROVAL CERTIFI~JtTE
i'. General Information Application Date
(a) De. gal Description (include lot, block, subdivision, section, township, range)
Location (adcl~ess o~ directions)
(b: Applicants Na~___~P~f//D
Applicants Address
Telephone ~,5--/5~ 8
?¢5 -
(c) Applicant is (check one) Lending Institution ~; Owr~er/builder ~ r
Buyer ~r Other ~ (explain); __~_e !!~ f-
(e) Real Estate Co. & Agent
Address
Telephone
2. TyDe of Residence
Single-Family~
Nua~er of Bedrocgs
Wa ter S_~po~p~lJ~
Individual Well
Multi-Family ~-~
Other (describe)
Con~unitYF--/. Public~
Note: If co~r~nity well system, must have written confirmation from the State
Department of Environmsntal Conservation attesting to the legality and status.
Is the well adequate fo~ the number of hedrccms specified in this HAA (Y/N)
4. Se___~_ge Disposal
Onsite ~ Public ~-~ Con~nity ~ Holding Tapk ~ '
Is the wastewater disposal system adequate for the number of b~droans (Y/N)
[Page 1 of 2]
2-15-84
5a E__ngineerin~ Firm Pro_vidin~ .!.9~_Te.~sts, Data and Information
I oertify that I have checked, verified, or conformed to all M3A ~ Guidelir_cs in
effect on the date of this inspection°
Name of Firm G/~/~ / ,ii /uT ~'/~ ~r Telephone flz/£- 723
Address
Signed by
(ENGINEER SEAL)
Date
6. DHEP Approval
Approved fo= ____
Approved ~
Disapproved E~ Conditional
Terms of Conditional Approval
'lhe Municipality of Anchorage .'Department of Health and Environmental Protection doe~s
not guarantee the continued satisfactory ~e=fom~anoe of the wate= supply and/or the
wastewate= disposal system. This approval indicates that, as of the validation date.
shown abo.~, based on the data and information furnished by an e~ineer registered in
the State of Alaska, M]e w-ate~ supply and wastewater disposal system is safe and func~
tiona~ fo~ the number of bedrocks and type of structure indicated.
(E~EP SEAL)
7. Mail the HAA to the following address: U~Ii
KB2/d5/s
[Page 2 of 2]
2-15-84
MUNICIPALITY OF ANCHORAGE (MOA)
~EALTH AUTHORITY APPROVAL (NAA)
CHECKLIST - FEBRUARY 1984
Well Classification /,~IG'/~D,~ ~
Well Log Present (Y/N) /'
Total Depth ~ ~ Cased to
Static Water Level / ~ ' Pump Set At
Casing Height Above Ground /'
Electrical Wiring in Conduit (Y/N) 7
Separation Distances f~cm Well:
To Septic/Holding Tank on Lot / ¢~ o/~
To Nearest Edge of Absor~ption Field on Lot//~-/
To Nearest Public Sewer Line /~o ~ ~
Date Completed
; On Adjoining Lots /~
~; On Adjoining Lots /
To Nearest Public Sewer
Cleancut/Manhole /~ ~/~ To Nearest Sewer Service Line on Lot
Water Sample Collected By ~/~? ~J /9~rZ&~TF ; Date. ~$f L~ /~-f
Water Sample Test Results f~£/ (~ RS?~ /
jOt +
Cca[[t~nts
Be
SEPTIC/HOLDING TANK DATA
Date Installed ~-'//- 7~ Size
Standpipes (Y/N) / Air-tight Caps (Y/N)
Depression ove~ TamJ< ~(Y/N) /u
Date Last Pumped
No. of C~pa~tments 2
~ Foundation Cleanout (Y/N)
p~mping/Maintenance Contract on File (Y/N) ; for
Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances f~om Septic/Holding Tank:
To Water-Supply ~11 /¢~
To P~operty Line
To ~ter Main/Service Line
Course
To Building Foundation /~/4-
To Disposal Field 3- /
To Stream, Pond, Lake~ c~ Majo~ D~ainage
Conm~nts
[Page 1 of 2]
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed .~-//- ? ~
Width of Field ZL/"
Square Feet of Absorption A~ea
Type of System Design
Length of Field 1(2Y '
Depth of Field ~ '
Gravel Bed Thickness ~/
Standpipes P~esent (Y/N)
Depression over Field (Y/N) /~/ Date of Last Adequacy Test
Results of Last Adequacy Test ?o,~ ~,~'~ ~',~' ,~o~-~ /3Y ~',qc ~ z'.~r¢/,~
Separation Distance f~om Absorption Field: /$ /~?~r~. /~ ~ ~g Z6~
To ~te~-Supply ~11 //~' To ~o~ty Li~
To Building Foun~tion ~ d ~ ~' To Existing or ~ndo~d System
/
Lot ~ ~,~ ; ~ Adjoining ~ts / o ~
To Wate~ Main/~vi~ Line ~/~' To ~t~(if p~e~nt)
To St~e~ond~ke/~ Majo~ ~aina~ C~se / ¢ ~ / ~
To ~iveway, Pa~ki~ ~ea, ~ Vehicle Sto~a~ ~ea /
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested fo~
Electrical Codes(Y/N)
Dimensions
Manhole/Access (y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
Corm~nts
** Check Permitted Bed~ocra Rating Against HAA Request
I certify that I have checked, verified, o~ conformed to all MO~"HAA ~.i~_ ig~s in effect
on the date of this inspection. --,r~ ,- -~./,. ~ ~ ·
Company ~-~ /~t~/ ~I /~ ~..L £ ~tf MOA No.
Km/dS/s
[Page 2 of 2]
2-15-84
MUNICIPALITY OF ANCHORAGE /vlUNICIPAI. I~ OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF U,:,^,LTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL Pr, o-rECTION
ENVIRONMENTAL ENGINEERING DIVISION AU(~ t 6 f979
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~I~61EI~r)¢~ D
DIRECTIONS: Complete all parts on page 1. Incomplete requests will ,ct be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER PHONE
David L./Joann Jenkins 344-4587
MAILING ADDRESS
Star Route A Box 480-J 99507
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAILING ADDRESS
3. LENDING INSTITUTION I PHONE
National Bank of Alaska % Ruth La BarI 276-1132~
MAI LING ADDRESS
Pouch 7-025 99510 ,~ x 2883
4. REALTOR/AGENT PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
Lot 34 Block 9 Paradise Valley Subdivision
;TREET LOCATION
Golden View Drive
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four [] Other__
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY X:I~ Three [] Six
7. WATER SUPPLY
INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give welt
depth (attach Icg if available.) WELL LOG IS ATTACHED.
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
If indlwdual/on-slte, give installation date 1978
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
', THiS SIDE FOR OFFICIAL US ONLY .,
DATE RECEIVED .
INSPECTIQN APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSP ECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
-[~[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO ~ FOUR [] SIX
2, WATER SUPPLY PERMIT NUMBER
-E~] 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 ~ '- \~- -
INSTALLER
'~]Septic Tank or E~ Holding Tank (~¢~,_-)~J~J~_ ~L~' ~ ,.~L L:)L~.
Size: ~,~3~--'~. If Tank is homemade SOILS RATING
give dimensions: ~
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/FleldMg\L___~)! Tank Absorption1 \~'~ Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[] CONDITIONAL APPROVAL (letter must accompa~cm~ertif[cate)
° /?
DATE BY (Title) / / .
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
//.'~ ~'~ · 2 6 4 - 4 7 2 0
~~ al of individual Sewer and Water Facilities
~~quest for Approv
1. Property Owner: David L. Ford & Jo ~n Jenkins
Mailing Address: S~ Box ~80-J ~chora~e, ~ 99507 Phone: 344-4587
mo
Name of Buyer:
Mailing Address:
Lending Institution:
Mailing Address:
NA Construction-Permanent
Same as above Phone:
National Bank Of Alaska '
Pouch 7-025 Anchorage, AK 99510 Phone:
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
NA
NA Phone: ________
Lot 34, Block 9, Paradise Valley S/D
000 Golde~ View Drive Anchorage, AK 99507
Single Family Residence:
Multiple Family Residence:
(x) Number of Bedrooms:
( ) Number of Bedrooms:
water Supply: *Individual Well (x)
If individual Well, well depth _
If Con~nunity System, name of system
Public/Community System
( )
Sewage Disposal System: *~n-site System ~ Public System ( )
If On-site System, date of installation: __~.C~, -·.~J~-
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
· test is required, by this department.
A fee of $25.00 must accompany each request before processing
can be initiated. · /~ ~ //~ /6/~/~ ~