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Home My WebLink AboutSTYMANS LT 1Styman Lot I #015-272-48 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number OSP221065 PID Number: 015-272-48 Dwelling: Q Single Family (SF) Q with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New IN Upgrade Name LAWLER ABSORPTION FIELD ❑ Deep Trench L] Wide Trench L1 Bed El Mound Site Address 11200 ELMORE RD. El other Phone FNber of Bedrooms Soil Rating Total depth from original grade LEGAL DESCRIPTION GPD/SFJ Ft. Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot STYMANS, LOT 1 Ff. Ft. Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Ft Total absorption area Number of trenches Ft Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100,+1 1 1 5(Y+ TANK 11 Septic 0 S.T:EP. 0 Holding ❑ Other Manufacturer Capacity Surface water 100'+ GREER TANK 1000 Gal. Material Number of compartments �. Lot Line 10'+ NA PLASTIC 2 Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks TANK DEMO PER UPC, Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank sank to 3034 drainfield 3034 MIKE N ANDERSON, P.E. Drainfield COrMT3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 100 ft Inspection 7� , /Z Z Z, Location and description dates: l 3i0 41h TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Eia�r $t�mp Conditional Approval: Date ° '•''' lit,} • 49TH d A. MICHAEL N. AkVkRSGN +<§��,•, C -9469 Septic System Approved Date i !� -zoz �`''., ,o t��~'�'�'`••�b.�ZPR Note: this approval does not include well permit requirements. ��`��"�r fp_ nkrn311a� W LOT 2 0, to 112TH AVE 0. to to 10') ullun Ki q a orz. r-,.' 11 11 \Ai 1 0 rz. n 7' ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: STYMANS SUBDIVISION LOT I PLAT 74-259 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoul4 any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE_- SCAM --MAS: M"AR 30, 2022 1 = 40' schullerftknot 22 - 0 16 -2 DRAWN BY: CHECM BY. GRID NUMBER: BOOK /PAGE: JLS SW2635 220141 C) < U.1 0 ry V) Ld z CY- 0 0 V) > � 0 Ld TRAPLINE DRIVE 3.5'XS' CONC 2' 30' Aft-liqlqw-01, _,� 0 F 41 SU L A N AW 00, AW 0� A07 0 49TH .... ........... . ... .................... L JPHN L. SCHULLER.- 0 AWA _%S0 LS -10408 qJ few O� W_ 1831 Talkeetna Street �°� ' •3:.3C?: Z'' 6 low Anchorage, Alaska 99508 NVII Ofessjond\ \-0 (907) 227-1455 office Alw (907) 274-4992 fax FND MONUTTMENT FND 5/8" REBAR 0 = FND IRON PIPE Aft-liqlqw-01, _,� 0 F 41 SU L A N AW 00, AW 0� A07 0 49TH .... ........... . ... .................... L JPHN L. SCHULLER.- 0 AWA _%S0 LS -10408 qJ few O� W_ 1831 Talkeetna Street �°� ' •3:.3C?: Z'' 6 low Anchorage, Alaska 99508 NVII Ofessjond\ \-0 (907) 227-1455 office Alw (907) 274-4992 fax 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.rnuni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221065 Work Type: SepticTank Upgrade Tax Code Number: 01527248000 Site Legal Address: STYMANS LT 1 G:2635 Site Mailing Address: 11200 ELMORE RD, Anchorage Owner: LAWLER CHRISTY Design Engineer: ANDERSON CONSTRUCTION 8, ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 3/29/2022 3/29/2023 37108 ❑ Disposal Field m 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 Special Provisions: 1. On the Record Drawing, address the septic system location for the lot to the south. 2. Repair the standpipe at the end of the field if neccessary and have the surveyor show it on the new asbuilt survey. Received By: Issued By: Date: / / 2 Z— Date: ✓2 Z Z RU5H MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 015-272-48 Property owner(s) CHRISTY LAWLER Mailing address 11200 ELMORE RD, ANCH AK Site address SAME Day phone Legal description (Sub'd., Block & Lot) STYMANS LT 1 Legal description (Township, Range & Section) Lot Size 37,108 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo AD U) Septic Tank Q Upgrade 0 Duplex (D) ElHolding Tank ElRenewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: -on-5 } �3_� Waiver Fees: Date of Payment: Receipt Number: Permit No. OS)i2ZZ1Qh_Q_ Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc March 26, 2022 Municipalities of Anchorage On-Site Water and Waste Water Section 4700 Elmore Rd Anchorage, Alaska Phone 343-7904 Re: New septic tank permit Legal: STYMANS LT 1 To whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. The tank will be decommissioned per the Uniform Plumbing Code (UPC). Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221065, Deb Wockenfuss, 03/29/22 1"=50' SHED PROPERTY LINE EXISTING HOUSE REMOVE AND REPLACE WITH NEW 1,000 GALLON PLASTIC SEPTIC TANK AND 20" RISER, DECOM. PER UPC, MAINTAIN 5' BETWEEN TANK AND FIELD, EXISTING DRAINAGE FIELD -EAST 112TH ROAD- EXISTING WELL 100' RADIUSDRIVEWAY SCALE: DJRDRAWN: DATE: STYMANS, LOT 1 Anchorage, Alaska CHRISTY LAWLER 3/24/2022 DCO DCO LOT HAS COMM. WATER SYSTEM Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221065, Deb Wockenfuss, 03/29/22 LOT 2 10, U ESQ 112TH AVE %i RQ°r-,'1 1 "W 1'?r, r) o' i^ o F- j a w O cl� elf > o � w0Q- v TRAPLiNE DRIVE — 3.5'x8' CONC 2' 40' 30' ANCHORAGE RECORDING .DISTRICT, ALASKA }- = FND MONUMENT AS -BUILT OF: I * = FND 5/8" REBAR STYMANS SUBDIVISION 0 = FND IRON PIPE LOT 1 PLAT 74-259 Stj T John LSchuller, H u ted a i O F ,� �� .� SURVEY CERTIFICATE: I, Jo L. Have con Ld c �- physical survey of this property as shown on this dra-kving and that the /' `0; . • ' . ;� ° improvements situated hereon are within the property lines and no AOT enchroachments exist other than noted. Under no circumstance should Under 0 49� any information on this drawing be used for construction of fences, % ........ , . . ; . '.. structures, improvements, or for establishing boundary lines. Al ... • , .. FA � � n p g ? ? EXCLUSION NOTES: It is the owners responsibility to determine . e . ............... . .. . . .� the existence of any easements covenants or restrictions which �° '.J HN L. SCHULLER,• o % `• •` ' ' � ` s LS --10408 �•` • . do not appear on the recorded subdivision plat. / ''-;• ••M'' �,, • • .. . •' �� / 1831 Talkeetna Street WORKORDER NUMBER: DATE: SCALE: E-MAIL t �Q, �j ,,, �[, 4::� !` Anchorage, Alaska 99508 MAR 21, 2022 1 =40 schulierOok.net A�, pts ,�, _._. DRAWN B'� 101ECKED BY G11D NUMBER: BOOK/PAGE: � o f e a� � .r► (907) 227--1455 office 22 016JLS SW2635 220141 1�� ssion.. (907) 274-4992 fax 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 PHONE [] NEW Liq. ca~a~allons IF HOME.DE: Inside length Width Liquid depth Well Found~ 0 Nearest lot Kine PERMIT NO. DISTANCE TO: ~dd ¢~0 , ~ -1 ~ inches Top of tile to flnlsh grade Material beneath tile ~ OTHER 72-0ff3 (~ev. 3/78] · a,F'F'[_ I CFINT LOCFIT ]; Cfi",! LEI3FfL f .IJ _'-,;:, ....... DR:FIEiFIH L:I ..... ! ~ i'll' t,I J. 74.:!.'-'d"! T'T'F'E 3F 50 1 L. ~ ,:, _. F.E, F ] _ bl ::, * _., I E..ll :[ 51;: 'T'F~:ENI:TH L..O T .:', Z ,.:.E P'iFIX~t"ll...II'"I NI._IHE:E[;: OF EE'"[':,f;'OON'5 ::: ~: -IHE REg!L1:1: R:E:D .:, .I. ,¢.E. Cfi::' THE '5 E ]: _.. FIEff'SEJRF'T ]: ON :_, :.,, E.f I Z 5: THE LENGTH DIf'lt:ENS]:ON ]::5 THE L. EI",IG"FH ,:::IN F:EEI"::' OF: THE "FF;:EENE:H CIF: E:,F;;'.R!I",!F']E!.E:,. THE DEPTH OF' R TFtE:NE:H OI7 P Z"r :t!:_:; THE E:,IS'T'RNCE DI73"I4EE:N THE SUI;;'.F:F[CE OF: THE: GROUND FIND THE; E',OT['OFi OF THE Ek.:CFI'v'FTF:[Cfl'.,! ,::~N FEE-F:). THEF~'.E :[5 NO SET I.,.IIDTH F-'OR: TF:ENCHE'_':;. YHEi GI:~'.Ff,,,'[:~L DEF'TH Z~; THE: P1]:N!NLIht E:,EF:'TH OF GF:'.F~'v'[.H_._ Efl-E'f'kECEN RND THE BOTTOP'I OF:' THE E',:.:;CRVFFF ]: ON (:I:N FEET). 'T'H :[ 5 DEF'F:IR:THEN'T E:,t...IE~'. ): [",lEi THE t F F[ t'; F:!I'.,!E:, FI'lIE 'f'14 :i; 5.1; .......... F i'"[ZI",i!I'"IUH E:,]:E;TFII",tCE E,'E'f'I-qEEN R P.!ELL. FIND F!N"r' ON'--5;I_"t"E :-".;EI,.!RGE E:,Z:!i;F'OSf:IL. :5;"r'5;'['E:N t:5 :tOO F'EET FOR Ft F'I:~:!',/FITE I.,.IEL. I...; Eft('. :2.~;C1 'FO 2_:.'(!~iel FEEZT [:'F,'.Cfi'fl FI F'dJE:!..:[C HEt.L. DEF'EHD]:NG I._IF'CH'-,! THE I"'./PE: I;:ll:: F'UEC.tC: 14EL.! CrT'HE[?. R'.EQU :[ REHENT55 I"lFf'¢ Fff:'PL'T'. SPEC :1: F' :[ C!:!-I" ): I::)['.,}% FIND CCIN'J:i;TF'.IJC:T T. ON, E:' ): I:;l(31::::f::lf"i'_'i!; /qRtE: !:I',,,'F! ! L..FIE:LE: "fEI l I",ISLIRE PF:OPEER Z NS'FI'%.LF:IT ]: ON. ~' Z CEP:'.TZF"¢ "i-HAT ~.: _T. FIN FAH:[L..ZFff(: 14171"H 'l"k.llE F;~:E:g!LI:[F:EHE:NT':"5 FOR: OhF.-2;ITE '_E:E:!.,.IEF;:5; FIND H[E!..L.SJ; FL-)F..".TH D'¢ THE: I',IUN'_r.C]:F'FILZT'¢ ElF 2: Z F.IZ!..L. ]:NLSTF-ILL THE L'--.,'¢'.~;-F[:3'I ZN FiCC:OR'.E)FlhlC:E [,.!]TH THE Z-':: I UIqDE:.[~'.E;TF:INE:, THF[T TI..tF_: ON-...~_;,ZTE 5EHER: 5"r'STE:P'I I'!f~'r' I:?.EI;:¢J.T.F:E E-;NJ FIFUSiENE:NT ZF F~%%]:E:,ENCE :['5 R:EI'IODE:LEE:' -FO ZNC:L.UD[C I"IOF:E THFiN 2: PERFORMED FOR: LEGAL DESCRIPTION: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONNIENTAL PROTECTION Pouch 6-550, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST DATE PERFORMED: ~ SOILS LOG [] PERCOLATION TEST 1 7 8 9- 10- 11 13- 14- 15- 16- 17- 18 19 2O o/ 6 LOPE SiTE PLAN _ WAS GROUND WATER y '~,~ ENCOUNTEREO? IF YES, ATWHAT /O /[ /' DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN · ET AND FT COMMENTS 72-008 (7/76) "Distance to w~ter 'while pumping .............. J:._.~:....::.~.:.:.r. ................................. at rate ' 960 of ........................ : ............................... gallons per hour. , · · Description of Formation · from to Clay~ Sang,Gray'el Brn; ' San~ & Gra~,el :::2 Grey -' I~ard 110 ~snd A Gravel V;ith ~¥ater... · 1~0 'q~U6 1 9 RE 01 �(j a 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. 015-272-48 Legal description STYMANS LT Site address 11200 Elmore Rd Current property owner(s) Lawler 1 Expiration Date: 4WIt z —4-0 -7- I 3 The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 1/11/2023 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 Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF / r�A` � � Development Services Department r. On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-272-48 Complete legal description STYMANS LT 1 Location (site address) 11200 ELMORE RD, Current property owner(s) LAWLER 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 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 X Plastic ❑ Concrete ❑ Fiberglass Age 2022 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: 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 $ J�J�y Waiver Fee $ Date of Payment /15 -lad ata Date of Payment COSA # OS0_.z3100 6 Waiver # #- 005-191 COSA Application_ June 2022 COSA Checklist Legal Description: STYMAN LT 1 Parcel ID: 015-272-48 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA X Well log is filed with Onsite (or attached) Date drilled 8/30/71 Total depth 168 ft Cased to 168 ft ❑ Sanitary seal is functioning correctly ❑Q Wires are properly protected Casing height (above ground) 24 in. Well production at time of test 4 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes X No X Coliform bacteria is Negative Nitrate 1.56 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Date of flow test for COSA 3/11/22 Collected by MNA Static water level at beginning of test 146 ft. Date 12/27/22, 2ND TEST Comments NEW PRESSURE TANK INSTALLED IN THE GARAGE, WELL PIT FILLED. B. TANK DATA Measured operating fluid level in septic tank Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: " NEW PLASTIC TANK INSTALLED D. ABSORPTION FIELD DATA Which system tested (date installed) 7/5/79 0 ALL standpipes present per record drawing Total measured depth from grade *6.5 ft (max) Measured depth to pipe invert from grade 4.0 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 2 ❑ 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) If yes, enter date C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date NEW Results Q Pass Fluid depth prior to test 0_ in Water added 450 gal New fluid depth 0 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 24 in Effective depth remaining 24 in Comments/Deficiencies:. MT, can't get to the bottom due to solids. '* MT dry COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Fol Yes if No _ ft Community Sewer Manhole/Cleanout > 100' Fi Yes if No ft E Yes if No _ ft Neighboring Tank > 100' Q Yes if No _ ft Private Sewer/Septic Line > 25' E] Yes if No :5 ft Absorption Field on Lot > 100' FS] Yes if No _ ft Holding Tank > 100'❑Yes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft no Yes if No ft _ _ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑e Yes if No ft i s l Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑u Yes if No _ ft Surface Water > 100' ❑� Yes if No Tank to Property Line > 5' Fol Yes if No _ ft Field to Property Line > 10' Q Yes if No _ ft Water Main > 10' Q Yes if No _ ft Water Service Line > 10' 111 Yes if No _ ft Wells on Adjacent Lots Private Wells > 100' Community Wells > 200' F!] Yes if No 0 Yes if No _ ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS well and septic installed prior to separation distance requirements 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 Mi h " 4,V, -U. %Pi E Phone 727-8864 Engineer's Printed Name IVU 1%.e- re, ��. .(?a�� A`X' - �A�zi s •.e 9 4 4a 49Tw 1,-_ dA �• MICHAi tRh' Ck tr° CE 5369 s rUt,lt^ "f^i b COSA Checklist June 2022 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/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DVVELLING Parcel I.D. 015-272-48 1. GENERAL INFORMATION Complete legal description Styman Lot 1 COSA# Expiration Date: Location (site address) 11200 Elmore Rd, Anchorage, AK 99516 Current Property owner(s) ]acob&: Bonnie Gurney Day phone Mailing address 'gen~Y Lendinga Mailing address Real Estate Agent 11200 Elmore Rd, Anchorage, AK 99516 Day phone Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water ,Storage Community Class __ Public Water System 3 Well 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. By: (Rev. 11/05) 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. DSD SlG~NATURE ~// Approved for Disapproved. Conditional approval for Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/12/2011 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 dudng 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 .... system will function satisfactory for current or future , ii ~~ 'i .~. occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. ! ~ ~ ;..".'~'.. "t.~,:.. , .,, bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory 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/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: STYMAN, LOT 1 Parcel ID: 015-272-48 A. WELL DATA Well type PRIVATE IfA, B, or C provide PWSlD # __ Well Log (Y/N) Y Date completed 8/30/1971 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 168 ft. Cased to 168 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8/30/71 10/3/2011 Static water level 145 ff. 146 f. Well production 15 g.p.m. 4.29 g.p.m. WATER SAMPLE RESULTS: Coliform NEC colonies/100mL Nitrate 1,6 mg/L Arsenic: ND mg/I Date of sample: 9/30/2011 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/5/1979 Tank size 1000 gal. Number of Compartments _2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) na Date of pumping 10/3/11 Pumper A+ C. ABSORPTION FIELD DATA Date installed 7/5/1979 Soil rating (g.p.d./ft2 or ffe/bdrm) 100 System type Trench Length 39 ft... Width --3 ff. Gravel below pipe 4,0 ft. Total depth 6,_~5 It, (Measured 9/28/2011)* Eft. absorption area,3~, ft2 Monitoring tube __Y Date of adequacy test 9/28/2011 Fluid depth in absorption field before test 0 in. Depression over field N Results (Pass/Fail) Pass For 3__ bedrooms Water added 450 gal. New depth 0 in. Elapsed Time: O min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N__lf yes, give date--_c- D. LIFT STATION Date installed "Pump on" level at __ Datum Size in gallons in. "Pump o~ level at Cycles tested E. SEPARATION DISTANCES Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ;tOO'+ Absorption field on lot ;tOO'+ Public sewer main ~3'+ Sewer/septic service line 5' ** Animal containment areas 5O'+ On adjacent lots On adjacent lots ;tOe'+ Public sewer manhole/cleanout Holding tank ;tOO+ Manure/animal excrete storage areas ;tOO'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field $'+ Water main ;tO'+ Water service line ;tO'+ Surface water Wells on adjacent lots ;tOo'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ;tO'+ Building foundation llY+ Water Service line 10'+ Surface water ;tOo'+ Curtain drain ~Y+ (Nene Y~aew~) COMMENTS Water main Driveway, parking/vehicle storage Wells on adjacent lots I0'+ *Bottom of lateral is 4' from existing grade and measureable effective depth in MT is 2.5' +/-. **Well and septi~ line installed prior to current separation distance requirements. Well enclosed in concrete vault for protection. G. ENGINEER'S CERTIFICATION ! 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 Date ;t0/12/201_;t COSA Fee $490.00 Date of Payment I ~ [F"I Receipt Number \ (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 8339D E. 112th Avenue LOT 2 S89°55'11"E 125.02 J 35.0- 10' Util. Esm't LOT 1 N89°51'46"W 125.02 LOT B-7 SIEFKER SUBD. 40 o o -.-Conc. curb '"--Conc. curb 4O 1 I SCALE: 1"= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 09-2, pg 42-4-3 BE n,' 0 The location of the ¢iru~tu(e(Sj~g shown on this record dra,Cclng AS-BUILT NO CORNERS SET THiS DATE I hereby certify that I have performed a Mortcla.qee's inspection of the following described property: LOT' ~, STYMANS SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not ovedap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 22nd day of April ,2009 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) ........... SG,$ ........ SGS Ref.# 1114647002 Client Name ArcTerra Engineering and Surveying Printed Date/Time 09/30/2011 8:04 Project NameJ# Water Samples Collected Date/Time 09/26/2011 12:30 Client Sample ID StymanLot 1 Received Date/Time 09/26/2011 12:57 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals b~ ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 09/27/11 09/29/11 NRB Waters D e~o ar ~gaont Total Nitrate/Nitrite-N 1.60 0.100 mg/L SM204500NO3-F B (<10) 09/26/11 AYC Microbioloc~ Laborator~ E. Coli Total Coliform Negative 1 100mL SM20 9223B A 09/26/11 CR Negative 1 100mL SM20 9223B A 09/26/11 CR Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL SUBMITTAL COMMENT SHEET () To: Tobben Spurkland Legal description: Stymon Lot ! The attached paperwork has been reviewed and is being returned for the following reasons: [] Original signature or stamp missing on __ [] Calculation errorin design. __ [] Additional soils information needed. __ [] Water monitoring results inadequate. __ [] Discrepancy in information submitted. [] Topographic information missing or inadequate. __ [] Incomplete; missing Foundation cleanout [] Incomplete; missing 5ur-/ey As-built [] Additional adequacy test information needed. __ [] Water sample unacceptable. __ [] Measured/proposed distances/dimensions missing. [] Locations of ail 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. Need ~.' fill or insulation over field [] Other. Nor~hwind NOT on opproved pumper. Wells on edjecaent lots to tank needs filled Name of reviewer: .Tell Date: 8-29-02 Please supply the necessary information and re-submit your request. LEA VE THIS FORM ATTACHED TO THE PAPERWORK DeVelopment Services Department Building Safety Divi§i0h On'Site Watei~ ~nd wastew~t~FPi~°gra~ ~.i.~ / ~i e,ak. us Parcel I.D. Gu Mailing Lending Agency Ma'i!ing ~' ~'A. ~ .q Day pho'ne 2, NI TYPE OF W~$~EER~i~S~O-$~: Individual On-site The Mur ~ftifi~ht (DSD) titl~ 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as 9~ the valiqa!!.(~n ~a~ s_hg~vq.~elow. I verify that my investigation. based on procedures outlined in the Health Authority Approval Guidelines for this application, shows thai the oh-. site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the numbel of bedrooms and type of structure indicated heroin. I further ~[ify 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 "'~ ~z~4 Address ~ Engineer's Printed Name DSD SIGNATURE Approved for bedrooms. Disapproved· Conditional approval for bedrooms, with the followin§ stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemefltal E~i~ee~ ~' R'~lSO~t Other By: O r!gj~al_ ~ _e d_i¢!cat~ Da!e: De lOP nts s Department ve me em/ice Building Safety Division ram EALTH KLI ST ID 01~'~ If A, B, or C provide PWSID W Well Cased to ft. ft ft. Wires properly protected (Y/N) '~' Casing height in. g,p.m. ~- ~ g.p.m. ~ colonies/100 mi. Nitrate I. I I mg./I. Depression over tank (Y/N) . .. Soil ratin Other bacteria ~!~ colonies/100 mi. I ft. Width ~ Eft. absorotion ares "~i,Z ft2 ft. Grave ft. Monitoring tube V Depression over field 4~¢ Results(Pass/Fa,li ~ For { bedrooms in. Water added ~ga New depth ~ 0 in, Final fluid depth ~ ~ in. Absorption rate >= /.j~- C) g.p,d. If yes, give date ~/' Date installed ~{//~-"/"~ .~.. Cleanouts (Y/N) ~'/ ~'¥,~/ High water alarm [Y/N) Pumper N e~ ~ (g,~ 'pe DEPT. 07 ~ :,U.TH & ~ JU~I ~ ~979 ENVIRONMENTAL ENGINEERING DIVISION }IBEDTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processleg. PHONE REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES 1. PROPERTY OWNER 3, LENDING INSTITUTION PHONE no1 MAILING ADDRESS PHONE M/~JJ.J N_~ ADDRESS __ 4. REALTOR/AGENT 5. LEGAL DESCRIPTION TREET LOCATION of- 6. TYPE OF RESI[~NCE NUMBER OF BEDROOMS ,~ ~ One E] Four · SINGLE FAMILY Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY ~:~/_.¢.~ /LO.~-O;...~.~ ~ I NDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 197§. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ IND}VIDUAL/ON-SITE** [] PUBLIC UTI LITY **if individual/on-site, give installation date'r%~C-// /OC-C~ d 7~) 7='4 ~') / 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. THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME CATE DATE DATE INSPECTOR INSPECTOR INSPECTOR -- DIRECTIONS: 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 INSTALLER E~septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS _- .PROVEO FOR --% BEDROOMS [] CONDITIONAL APPROVAL II0tter must aceom~ificate) LEGAL DESCRIPTION 72-010 (Rev. 3~78) ,.1OH CERTIFICATE OF APPROPRIATION OF WATER No.....45.7.o .................... Certificale ~ PA ';E O I b ! Know All t~Ien ~ty ~hese ~tresents that the State of Alaska, pursuant to A.S. 46.i5, as amended and the rules and regulations promulgated thereunder, hereby grants to..~.~...~.~...$~[Y'~;!~.~!~...~!).~ ........ the right to the use oL.~.~P...9.~!J.PD.~....P. PE..9.~ ............................... from the public waters of the State of The lo¢a~ion of the water sour~'to~hifh~the wa~e~ righLherei~ gra~ted shall appe~ain is...~.. ~" well 158 feet deep wiLhip,~:E~NE~f-I,~SE~NE~ Section 21,.T~??ip 12 North, Range 3 West, Seward Ne~idian ~ : . ; ~d the right to said ~a~e~zshall,~appurtenant to that:ce~tain;:traet of real property described as .C/?-E½NE¼N~SE~NEP4..Sectjon 21, Township 12 ~'r~h¢,i Ranqe .3 West, Seward Mer'~d~an.. ~ ~a~ ¢~*'t~-~0[~ 'the said water right with the appurmnances thereof unto the'said Grantee and..._.~.~.~. .................. heir~ and assi~s forever, subject to the provisions of A. S. 46.15.140-160.. ~]li ~t~tim~n!l tlIll~r~f the State of Alaska has caused these presents to b~ executed by the Director ; ,:.,: i ':~ : ," az the ~zvlszon o~ ~ands pursuat to A. S. 46.15, as amended, this ':: - ilth . ' . December 78 day of ................................................................ A.D. 19 ........... Water Management State Record of Water Right Certificates v XVIII ' 4573 ADL 44926 ol ............................. Page ............................ -., _ uti i '; , ,, LAND AND WA TER MANA GEA IENT SOUTHCENTRAL DISTRICT February, 26~ 1979 Re: Certificate of Appropriation File Ilo. ADL 44926 Certificate Ilo. 4573 3327 FairbanL's Street Anchorage, Alaska 99503 CERTIFIED MAIL NO. 359876 RETURN RECEIPT REQUESTED John R. & Wilma C, Stymans Star Route Box 1735-C Anchora§e, Alaska 99502 It is with great pleasure that I enclose your Certificate of Appropriation which entitles you to tile use of public waters For beneficial purp~:es in the quantitiy and area as shown on the certificate. This certificate sho.gld be recorded in the recording district in which your appropriation is located. Should you sell or otherwise dispose of yom~ prope~dv, the certificate should be conveyed along with land deed to the purchase,'. This water right will continue in effect for as long as you continua yonr water use. See Section 46.15.140 of the enclosed Water Use Act covering "Abandonment, Forfeiture, and Reversion of Appropri.ations". This water right is appurtenant to th'e land and will be conveyed along with title when the land is sold unless it is specifically exempted. If the water right is to be severed from the land, sold, or altered substan- tially, the approval of the Departlnent of Natural Resources must be acquired. See Section 46.15.160, "Transfer and Change of Appropriations". If you have any questions or if we can be of further assistance to you, please contact us. Sincerely, L. A. Dutton District Hanager Enclosures EXCERPT FROM WATER USE ACT~ CIIAPTER 15 Sections 46o15.1401 46.15.1501 46o15.160 and 46.15o170 Section 46.15.140 ABANDONMENT) FORFEITURE, AND REVERSION OF APPROPRIATIONS (a) The commissioner may declare an appropriation to be wholly or partially aban- doned and revoke the certificate of appropriation if an appropriator, with inten- tion to abandon, does not make beneficial use of all or a part of his appropriated water. An appropriation so forfeited and abandoned reverts to the state and the water becomes unappropriated water. ~ (b) The commissioner may declare an appropriation to be wholly or partially for- feited and shall revoke the certificate of appropriation if an appropriator voluntarily fails or neglects, without sufficient cause, to make use of all or a part of his appropriated water for a period of five successive years. Section 46.15.150 PREFERRED USE (a) An applicant who asserts and proves a preferred use shall be granted a per- mit and shall be granted preference over other appropriators. A preferred use of water is for a public water supply. (b) To be entitled to a preference an applicant must show that his use will be preve~{ed or substantially interfered with by a prior appropriation; the use is a preferred use; the applicant agrees to compensate a permit or certificate holder of the prior appropriation for any damages sustained by the preferred use, and other information which the con~issioner requires by regulation~ Section 46.15.160 TRANSFER AND CItANGE OF APPROPRIATIONS (a) The right to use water under an appropriation or permit shall be appurtenant to the land or place where it has been or is to be beneficially used, provided, that water supplidd by one person to another person's property shall not be appurtenant to the property unless the parties so intend. An appurtenant water right shall pass with a conveyance of the land, or transfer, or by operation of law unless specifically exempted from the conveyance. (b) With the permission of the commissioner, all or any part of an appropriation may be severed from the land to which it is appurtenant, may be sold, leased or transferred for other purposes or to other lands and be made appurtenant to other lands. A permit or certificate or a deed, lease, contract, assignment of permit or other instrument transferring an appropriation must be filed for record in the office of the commissioner and a certified copy of the instrument must be recorded in the recorder's office of the recording district in which the appropriation is located. Section 46.15.170 EFFECT OF RECORDING (a) A deed, lease, contract, assignment of permit or other instrument transferring an appropriation is void as against a subsequent innocent purchaser who in good faith paid a valuable consideration for the appropriation or any portion of it and whose instrmnent is first filed and recorded under sec° 16&(b) of this chapter. Section 46.15.170 continued) (b) A deed, lease, contract, assignment of permit or other instrument transferring an appropriation which is recorded under sec. 160(b) of this chapter is constructive notice of its con~ents to subsequent purchasers of the appropriation or any portion of it. An unrecorded instrument is valid between the parties to it and as against one who has actual notice of it.