Loading...
HomeMy WebLinkAboutPATNODE BLK 1 LT 7 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251377 PID Number: 050-671-01 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Shannon Morgan ABSORPTION FIELD El Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 19143 Jaime Dr ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-717-4255 4 6.0 GPD/SF 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0•5 Ft. Subdivision Block Lot Patnode 1 7 Fill added above original grade 0.6 Ft. Gravel length 2 0. 0 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches 1 Dist. between trenches From Tank Field Tank Line 100 Ft2 N/A Ft. Well >50' >50' N/A N/A >25' TANK❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Advantex 1500 Gal. Surface Water >50' >50' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation > 10' > 10' N/A N/A MFTTATION Manufacturer Capacity Remarks Advantex FAP Gal. Alarm location Electrica led by Installer o D3034 PIPE MATERIAL House to tank D3034 dTank trainfield Northern Excavation Drainfield D3034 CO/MTD3034 Inspector Justin Earls BENCH MARK (Assumed elevation) 100 ft Inspection 1st 11/3/25 11/4/25 Location and description dates: Z nd m th Garage Slab 3rd 4 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp .:F At Conditional Approval: Date ���'•'i4cs,`�.��� 49 (% g Benjan chiller •, ,• / 1E /6/25� •'���c��r` �� VIP •AW Septic System Approved Date (� Z Note: this approval does not include well requirements. • �� F�PROFESSI4NP�'�-,, permit (Kev Ub/U2/1S) ,AA CO /� ,uto-r'� : S E- CPAC' Benjamin Schiller CE 12592R E GISTEREDPROFE S S I O N A L E N GINEER 1"=40' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP251377 PID # 050-671-01 PATNODE, BLOCK 1 LOT 7 FEET 0 40 80 PLAN AS-BUILT 12/8/25 10' UTILITY EASEMENT UPPER MCCRARY RD JA I M E D R 4-BDRM HOME GREEN HOUSE GAZEBO AWNING AREA WOOD SHED SHED EXISTING WELLS w/ 100' RADIUS 1500-GAL ADVANTEX FAP TANK 20' LONG X 5' WIDE, 0.5' EFFECTIVE DEPTH TRENCH 2CO2 MT2 TH#1 CO2 CO1MT1 VACANT WELL >100'MOUNTAIN MANOR B3 L5B WELL >100' EXISTING PIT ABANDONED IN PLACE, SWING TIES TAKEN DURING INSTALL TO MORE ACCURATELY SHOW MT LOCATION. MT FOR PIT NOT SHOWN DIRECTLY IN THE CENTER ON IR. TRENCH HAD TO BE MOVED CLOSER BECAUSE OF THE CONTOURS ON SITE, SEPARATION STILL MET 2CO1 MHP O D B A A B 2CO1 42.6 MH 45.1 POD 48.4 2CO2 48.5 CO1 76.7 MT1 78.2 CO2 93.3 27.1 34.0 37.6 41.4 77.3 78.3 96.6 MT2 91.395.2 WELL ON LOT 6 IS >100' FROM VIEWPORT, CONFIRMED DURING INSTALL PROFILE AS-BUILT (NO SCALE) PERMIT # OSP251377 PID # 050-671-01 PATNODE, BLOCK 1 LOT 7 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 11/6/25 88.6 FINISH GRADE 20' MT TH # 1 GROUNDWATER @ 82.0 10/12/25 84.0 CO CO 77.5 84.5 88.0 ORIGINAL GRADE MT 1500 GAL ADVANTEX FAP 2.0 TANK AX-20 FILTER POD DRAINFIELD ROCK 84.0 84.5 92.6 87.5 93.5 97.1FC O MH 2C O 2C O � m s n F N r� ril tr � v D c) �O LIPoo Of m;o n Nr n v v n ZIO m v� 00` r gZ Ci I I k X O x XG r r a• r A�/� ��.. • , OO TI WcI vm m r'� Oc Dc�-vm mNmN c _rr - Zm G\"o .xVy mmrTO c fix : Z o Z mm =;00 �z Z QT1 I ':�''•.aE On �z0u) mocv zv � o P1 n rr, v r= m z wm m M zco o -I co Z 30, Xj*�. `.., z O m N I NORTH rrn o ry z m Oc-.� -.m n� -•O-o z mom� < naw o '•m �3� m x O O nn-•-. o o 0 w 0n n� �-•� -•w..m, � n O l 0 0 OO -1O O.'. wCO O C" O0 O0 x O w o 2 On, w w Ono'o'w .w...�m ��moO>- voc n-` A c•� o •O 02- o o n n O< nF n .- 0 n O O m O m O 'woo-c w" �nisaN'm••cw p �m�cy n � ��^ 3•�mmmo.m. off,.001O� Rl �� .,O•.w n mw.- �m 0 0n•c D mo::c•�co o m�m�n� Osv CD m c m O w O P m .O•. ,O m 6 m �•c n 06O• OO � �n�w Gm�6J S• -• J »O -.- m w O am-- .•m�mc � � m O .o•.w .. s.e .Di G ry N fwC 000 • O O m n cO�p nn �' wm �c crt •w �Odxcoa.an��90 0 y � m o �. - .a .O -• .ex -<. w« ,v 3-nv to-mOc->•n wmmn-•'p w� m N = c o_ m c m o c A O 6 w CI 3•00-0 a <c- � on- m�-• moss N 0- 3w3 ol� c 00 mm n3m� n' s 0-0O. . .n.• G .m. p m O -C m O c m J O O w O.M -•m A w m � -O - � -.O' n•T3 0 0 o-. O I wm,o •►.c w•c O -O�mmn O O O --1 S — 7 7 = S O •'�-< O_ fD cn O - S rL -• CD _ O S - 7 CD -•� 7 to Q w O O -D s< o - < m < CD n n m m -. rn O 9 7 fD n 7 O_ -� N 7 1 -� -• rt O En -+ w O S-< -< n m D m _ S -• = -r _ X O O O 0S ID o Cl) d o O_ CD O [D -c O -• 7 N O rt O O O C " Ln a.00= W avCar Ln -O C A p 0 -4 Q Q O no CD fD CL v — 7C 3 CL 1 o 0D N -• S-•n -« mmrn=r rn rn o CD m = -• Z CD -w 7 O CD „ f c 7 7 7'D — O. n S CD 1 O CD -�O -•'0 to O <D CD c 1 N 1 D o -< < 7 < - 7 O d fD p _0 O rA 7 OC 67 a72 Do T2 /�' I T NU I �. z > zt �'� a' ►fit •..1i ~v r n ❑• a. II ° 30 r A AO W 5) p.. pAl/EO ROAD . ' • e ` a • l l \ /-1 7 \; / T i �)I AT ;-,A 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: OSP251377 Work Type: Septic Upgrade Tax Code Number: 05067101000 Site Legal Address: PATNODE BLK 1 LT 7 G:0254 Site Mailing Address: 19143 JAMIE DR, Eagle River Owner: FORGE ENGINEERING Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 10/20/2025 10/20/2026 43820 Non -Public Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Water 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. Coodinate with On -Site staff regarding preferred method. 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. Confirm location of well on PATNODE BLK 1 LT 6 prior to installing septic system. Issued To: FORG ENGINEERING Issued By: IL - Date: 10/20/2025 Date: 10/20/2025 4 MUNICIPALITY 0 Development Services Department *n-Site Water & Wastewater Section Parcel I.D. 050-671-01 431v zfflm�i� ON -SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Property owner(s) Shannon Morgan & Paul Mclarnon Day phone 907-717-4255 Mailing address 19143 Jaime Dr, Eagle River, AK 99577 Site address Same Legal description Patnode, Block 1 Lot 7 Number of Bedrooms 4 Engineering Firm Forge Engineering Building Permit Number Not Applicable 0 APPLICATION IS FOR: APPLICATION IS AN: (Z all that apply) Disposal Field E Initial ❑ Septic Tank El Upgrade F I Holding Tank ❑ Renewal ❑ Privy ❑ Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: j- Waiver Fees: Date of Payment: 16 ) 1:5 Date of Payment: Permit No. 0 ',--) PaS-1 �371 Waiver No. May 2025 October 13, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Patnode, Block 1 Lot 7 – 19143 Jaime Dr Septic system design Dear On-Site Services Engineer: The owner of the above lot owns 4-bedroom home on the property. The septic system on the lot has reached the end of its useful life, so we are submitting this permit application for the construction of a new and septic tank and drainfield. The attached site plan identifies the location of the home as well as the proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot has a slope of around 10-15%. While there are sections with >25% slope there are no slopes greater than 25% within 50 feet downslope of either the proposed drainfield. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole log, plan and profile pages 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 OSP251377, Curtis Townsend, 10/20/25 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=40' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PATNODE, BLOCK 1 LOT 7 FEET 0 40 80 SEPTIC PLAN 10/13/25 10' UTILITY EASEMENT UPPER MCCRARY RD JA I M E D R 4-BDRM HOME GREEN HOUSE GAZEBO AWNING AREA WOOD SHED SHED EXISTING WELLS w/ 100' RADIUS EXISTING TANK TO BE DECOMISSIONED ESTIMATED LOCATION OF MT AND SEEPAGE PIT 1150 1145 1140 11351130 1125 1500-GAL ADVANTEX FAP TANK 20' LONG X 5' WIDE, 0.5' EFFECTIVE DEPTH TRENCH 2CO MTTH#1 CO CO MT LOCATE AND CONFIRM WELL >100' FROM PROPOSED LOT 7 SYSTEM VACANT WELL >100'MOUNTAIN MANOR B3 L5B WELL >100' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251377, Curtis Townsend, 10/20/25 PATNODE, BLOCK 1 LOT 7 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 1.25 MIN/IN APPLICATION RATE: 6.0 GPD/SF 5.0' WIDE TRENCH SYSTEM 1500-GAL ADVANTEX FAP SEPTIC TANK BOTTOM OF TRENCH: 4.0' BELOW GRADE MAX FLOW LINE ELEVATION: 3.5' BELOW GRADE 600 GPD / 6.0 GPD/SF / 5' WIDE * 1.0 RED FACTOR [0.5 DEEP] = 20.0 LF TRENCH REQUIRED (20.0 LF SPECIFIED) 10/13/25 6" 6" 3' 6" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251377, Curtis Townsend, 10/20/25 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING DEPTH TO WATER AFTER MONITORING 1.25 10/3/25 1 2 3 4 5 6SM (SILTY SAND) Professional Engineers Stamp: PATNODE, BLOCK 1 LOT 7 10/3/25 050-671-01 SHANNON MORGAN & PAUL MCLARNON 2 8 16 OB 3:00 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: JUSTIN EARLS 8 8 16 6.0' 10/12/25 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED EXCEPT WHERE NOTED. 10/13/25 MOISTURE NOTED AT TIME OF DIGGING?YES 2 8 16 8 8 16 6 0 16 2 8 16 8 8 16 6 0 16 2 8 16 8 8 16 6 0 16 2 8 16 8 8 16 6 0 16 2 8 16 8 8 16 6 0 16 6:00 7:15 7:30 7:30 7:30 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251377, Curtis Townsend, 10/20/25 0 m RI Z 1(Z,60 I mom. c I oacift Fo 3.1 01� > (n I 0 m 0 �O` { S J gZ 0 -■mac X — /I xri r�\ O • !�•■• C X f x� k c0 @ 0 00 '" © © ® f> G f ■ w : o ao r I s� r: s I 7/ V) n�t u� S• < m r D m ��nn D -{ m m m c m D r O O m 9 �S j❑ m nom m z0 �o rr,Z �I m y c� n� z v z • D J � , W �° co D D m m z Z z D� Z 0 ' 30� • / •. 41 6 %A� U);0 m 0 _ c •1�•1.. I C o,o I _ m NORTH M m 0 6 zm _ 0 MOM wnQ nwc 3vpp�w pM s�y�p2 oa-`°np--Dq cc �D D a u.•�' .° n n n' a s a n •o• P '.-` o a-v .c n o w •' �'•a�m ».gym �-.maaa 9 b C,�, O ��• A ® p• -. D D n n g a S b A�GW1'.9 � nl6appb`H'• 2 p � y .•.. ' r- S a a1 3 D n D2. n O � �•voQ,�s.�. nanr�a m'�m.c� �. 30 cawmmnw, 2 N y' p - Rl r-rto �. Q �w.+�mPp� 0"ITI -' D a na•rtc�p w n�.om�y"v zo ppwP go - sN�-nCQ part-•w P O n - _._n . W w v Lp O^5 n6Q ,V O�p, QQC C7rt-•� Q 1Ip o 03 U, wad n�•� i z T=n tic v .�+p .p.. ,P..� vs µ2_0 •on `0na vo ����.•�� Q•-- `na-• oa N nw a�� aDmn.n�a.p s' P 00°n 7.S ppo n•=a w n O o O -_4 7- — 7 7 7 S O y O - 7- G -• CD _ 0 7 3 -0 7 CD y 1 O 0 'D C O — < (D < CD 0 0 fD fD rt CD O 7 (D 1 I n 7 CL rt rt 0 0 rt + y O a< A y D (D CD " 0 _0 7- X 0 0 i1D O rt m CD o CL o r Z r m— m CD 1. 0 a'D m Zm� am C) O N� y' _.�I m 7-00 0 C G 7 7 O- W W 0 -v" -4C) - - C) O O 0 = (cr _ ,O � 0 CD 1. 0 CD (D 1 � � d o' �• N Nd O ,1-. 7 -.0 rt (D CD CD 7' y �. `i • • CD In 7 -• fD + 7 o m 0 rt C 7 7-0 rt d 0 1 7- (D O CD 0 my 3 t•) .� =r -•'0 y o CD [D c 1 In 1 rt N 0 •C 1 < 7 fD O — < 1 1 - y 7• O d N O y 0 7 ocri ` pk. y'• 00 VT r ®o''• �� ' t 0 C 7 \, ¢. a 0 po , 0 a rn. QL `Sif...,•..��ndP.� s �"..... aAO ` + -� d :C'� \\.• :..: �♦ Sip s _ •-�\" `..•r ``,-S !• 4. 4. ' r _ .s i� �' .r ram•• . I , A , L D • s Iy . •. �- PAVED • .•� .,e �. � r Tom) A T f"N I T 1` QGRE/ ~.R ANCHORAGE AREA BOI~' JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: D,ST^NCE //~' FROM WELL INSIDE LENGTH MANUFACTURER ~%'~:'/~7~ / MATERIAL INSIDE WIDTH LIQUID DEPTH l]L//-s- o. COMPARTMENTS LIQUID CAPACITY 4 '~C'~:L"?' GALLONS. SEEPAGE Pit: / LINING MATERIAL SIZE: DIAMETER__ BUILDING FOUNDATION .~ '/ , NEAREST LOT LINE__'~2' ~' ADDITIONAL ABSORPTION LENGTHS(';? DEPTH DEPT,__ D,STANCE FROM: WELL 14~ ' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE ,/~ ~"2/>/;~ ~) CONSTRUCTION BUILDING '"'~.,_ ,,~ ~' NEAREST FOUNDATION ,' ~f--'~ LOT LINE ~.s~.oo. ~/~ .OTH.. ~o..~.~ APPROVED DISAPPROVED SEWER LINE DEPTH __~,~ ~ DISTANCE FROM: SEPTIC ~' , ;"'" "" SEEPAGE /~ ,m ,TANK ///~'2~ , SYSTEM REMARKS DISTANCES: INSTALLED BY: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM ~1 . ~ G.A.A.B. Grea 'r ANCHOrage Area Bol~ DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456 ! Jgh PERMIT O. SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT NAME OF APPLICANT ~-/~/~// ~,.~/~./~1.? ,NSTALLAT,ON LOCAT,ON INSTALLATION Of: SEPTIC TANK ~ SEEPAGE PIT ~ DRAIN FIELD OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ~ / FOUNDATION TO SEEPAGE Pit ~ , DRAIN FIELD SEPTIC Tank TO SEEPAGE Pit WALL SEPTIC Tank ~'J SEEPAGE PIt ~-~ ~) / , DRain field TO neAREST LOT Line. WELL tO SEPtiC tank Drain FIELD ., SEEPAGE PIt //~"')'~) / ALSO CONSIDER AREA WELLS. SEEPAGE PIT ,/ ~) DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD (~/ ~' SEPTIC TANK, ? ~.J~ SEEPAGE PIT TO RIVER, LAKe, STREAM. CAST IRON INTO AND OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. DIAGRAM OF SYSTEM 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT GRAVEL laACKi~iLI~ /CZ CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G .A .A .B. OR ENS D DESI R ~'/ I CERTIFY THAT I AM FAM L Q AND LICANT'S SIGNATURE , DAT - FORM NO. E~-01 6 GREATER ANCtlOId\(iL AREA BOROUh.. Department of EnvironmenLal Quality 3330 "C" Street Anchorage, Alaska 99503 S()II~S I,()(; I~I~ROI,ATION TEST P rmed forII?~,~ ;)ate PerfonH,,d Legal Desc ri pt ion: .-.~-Or-.*--- -e~.~ :?-~~~--,--.~:-a lhis form reports: Sol~s log_ ~~_ verco~a:~on s, Dep th Feet 1 -_ 2- 3- 4- 5- 6- 7- 8- 9- 10~ ll - 12.-- 13- 14- Was round water encountered? ~ If yes, at wilat depth? Percolation rate minute. ,Proposed installation: oeepage Pit Drain Field Depth of Inlet DeptT~'-b6'E't~-m'-6:C'pit or trench EQ-040 (6/74) I. -i DRILLING :COM GALS. PER HR'. 3 ©0 g~~ .................................... KIND .OF CASING ....... ~.:...~'. ............ DRILLER'S NAME ...L~./...~.~.'.L.~.[~.-~.....~.f..~..~.~..~.. .................... 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 OSC251546 Parcel ID 050-671-01 Legal description PATNODE BLK 1 LT 7 Site address 19143 JAMIE DR I ; Expiration Date: I Current property owner(s) WEISS JARRETT & FERNANDEZ GEOR X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: A concrete seepage pit was installed in 1975. This was disconnected from the septic system with the construction of the new tank and field under permit OSP251377 Per the engineer "Seepage pit has been abandoned per standard practices for any unused field. It has concrete blocks not wooden logs and is not in danger of rotting or collapse. There is sufficient separation from the existing pit to the new field. There are no additional health hazards that are specific to this lot that would require special treatment for this one system." By: Curtis Townsend Original Certificate Date 6/11 /2026 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 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 MUNICIPALITY OF F ANCHORAGE Development Services Department 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. 050-671-01 Complete legal description Patnode, Block 1 Lot 7 Location (site address) 19143 Jaime Dr Current property owner(s) Shannon Morgan & Paul Mclarnon Day phone 907-717-4255 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: A Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: * Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: X 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 $ 2-901. Waiver Fee $ Date of Payment 1 1_/1 125 Date of Payment COSA # (<SC 2sis q tr Waiver # COSA Application Ap2025.00c COSA Checklist_May2025.docx COSA Checklist Legal Description: Parcel ID: 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 Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping 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) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade 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 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 Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: 3DWQRGH%ORFN/RW   ■ 1$ ■ ■ ■ ■  ■  )RUJH(QJLQHHULQJ   1(: 1(: ■   ■ 1$1$ 1$ COSA Checklist_May2025.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 Phone Engineer’s Printed Name Date ■■ ■■ ■■ ■ ■ ■■ ■■ ■ ■■ ■■ ■ )RUJH(QJLQHHULQJ   %HQMDPLQ6FKLOOHU3(  MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 1044 Day of of 20 !;S, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex system located at (legal description) Patnode, Block 1 Lot 7 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. To It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). 10 Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. J Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and . ( repairs from the manufacturer's representative or maintenance provider. �(N Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: ��� G✓ By:_(signature) Date: l % /� o2D�• S (Print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of ,(/oVcm V , 20 aS, by W- "Offiei181 Seel" Public NOT Y P BLIC FOR ALASKA Kn „ ll My Commission expires: a Commission # 220528pp8 a Of p: M p O 2l0 �o Zb Fxp: GS128/Z02s MUNICIPALITY-' BY (LL(signature) S /%(print name) Date: Z & Title: C l V-1(— C ^- 4 ("E-1- , _. (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIROf~NTAL HEALTH DEPA~THENT OF. HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, block, subdivision, section, township, rar~e) Location (address or directions) (b) Applicants Name ~,-~,'11,~ ~L~m~,', Telephone - Home Applicants Address ~o~949 (C) Applican~ is (check~) Lendin~ ~us~i~u~ion ~; ~er/b~lder ~; Buyer ~ ; OCherI I(~plain); (d) Lendin~ Ins=itu=ion Te,~ephone A~ss Business (e) Real Estate Co. & Agent Address (f) Telephone , Mail the HAA to the following address: 2. Type of Residence Single-Family~ Number of Bedrooms Multi-Family Other (describe) 3. Water Supply Individual Well~, ,, Community~-~ Public~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Dispos,al . Onsite ~ Public ~--~ Community ~--~ Holding Tank ~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation a~testing to the legality and status. [Page 1 of 2] E.n~ineerin~ Firm Providing Inspecttons~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation dace shown below, I verify that my investigation of' this Health Authority Approval shows Chat the on-site water supply and/or wssCewater disposal system is 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 AnchoraEe files and from my investigation and inspection, the on-site water supply and/or wastewaCer disposal system is in compliance with all Municipal and State codes, ordinances, and re§ula- tions in effect on the date of this inspection. Name of Firm Address Date (ENGINEER SEAL) DHEP Approval Approved for ~t/Za%/%z) bedrooms APproved~ ~/~/~,~ ,, ,.,' Disapproved Terms of Conditional Approval Conditional CA~TION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONHENTAL PROTECTION (DHEP) ISSUES m~.ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN I/~ PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) KK4/eJ/D 18 [Pa§e 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) A~UN~C~P^U~ O~R~UMORiTY APPROVAL (HAA) D~PT. OF ENVIRONMENTAL PR~i~-~ - FEBRUARY 1984 S~P P, 4 ~ Legal Description If A, B, c~ C, D.E.C. Approved(Y/N) Yield Depth of G~outing Well Classification Well Log P=esent (Y/N) ~ ~/ Date C~leted Static Water Level Pump Set At Casing Height Above Ground Elect=ical Wiring in Conduit (Y/N) Sepa=ation Distances f=cm Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Se~r Line N sanitary Seal on Casing (Y/N)~ Depression A~ound Wellhead (y/N)~ ; On Adjoining Lots }(i~/+ ; On Adjoining Lots To Nearest Public Se~r Cleanout/Manhole /~ To Nearest se~r Service Line on Lot Wate= Sample Collected By Qn~&~- ~ ~ ; Date Ware= Sample Test Results Cc~snts B~. SEPTIC/HOLDING TANK ~ATA Date Installed 5~.4 %~79 Size I~00 No. of Ccmpa=tments Standpipes (Y/N) ~ Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N) Depression over Tank (Y/N.) N Date Last Pumped ~ Pumping/Maintenance Contnsact on File (Y/N) N~,; for Holding Tank High-Water Alarm (Y/N)~ Temporaz-~ Holding Tank Permit (Y/N)~ Separation Distances f=cm Septic/Holding Tank: To Wate=-Supply Well . II $'~ To Building Foundation 4i~ To Property Line ~+ To Disposal Field ~' ~'~ To Water Main/Se=vice Line ~4~ To Stream, Pond, Lake, or Major D~ainage Com~lents .m~, Receipt # Date Paid: Amount: ~ [~Page 1 of 2] 2-15-84 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received March 23, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Alaska Mutual Savings Ban Post Office Box 1120 PhOne: 274-3561 William D. Hansen Phone: 694-9493 Box 949, Eagle River, 99577 3. Legal Description: Lot 7 Block 1 Patnode Subdivision 4. Location: See attached map 5. Type of facility to be inspected 6. Well Data: Individual A. Type Single Family B. Depth No. of bedrooms 4 ,_~:" ~ / ' ,' .-' -(., 301' C. Construction D. Bacterial Analysis Sewage Disposal System: On-site system. .. A. Installed 9-30-?5 B. Installer C. Septic Tank: D. Seepage Pit: E. Disposal Field: l. Size ,'"~ '~;~ l. Absorption Area 2. Manpfacturer 2. Material Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRQ VA FHA 1. Type of Inspection: 2. Property Owner: ~-~)/z'/ //2 ''(/I Mailing Address: BO)4 3. Name of Buyer: .~,f..21Z/~,,'Z4,~. /...~. Mailing Address: 4. Name of Lending.Institution: Mailing Address: ,4 5. Name of Realtor or Agent: CONV. ~ Day Phone: Phone: ~?~' S~-~/ Mailing Address: Legal Description: ~.,o T Location: ~-"~ ~ Phone: Type of Facility to be Inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: No. Bdrms. '~ Individual Public Utility If Individual, date of installation . Individual (on-site) 72-003(3/76) Page 2 of two pages - Re st for Approval of Individual er & Water Facilities Legal Description Lot 7 Block 1 Patnode Subdivision Comments Approved ;~~~~~ Di s~ved v/ Approval ~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) C. ABSORPTION FIELD E~TA Soils Rating in Absorption St=ara Date .Installed Width of Field Square Feet of .Absorption A=ea Depression ove~ Field (Y/N) ~3 Date of Last Adequacy Test ~c~ Separation Distance f~cm A~sorption Field: To Wate~-SupDly Well ~D~ ~ To P=operty Line Z5f~ To Building Foundation 90! To Existing or Abandoned System cn Lot A3~ ; On Adjoining Lots I00'+ To Ware= Main/Se=vice Line /OOr4: To Cutbank(if ~esent) ~ To St=earn/Pond/Lake/or Major Drainage Course ~4 ~ To Driveway, Parking Area, or Vehicle Storage A=ea ~f I5o~£/Iw~.,,a:~4~ Type of System Design Length of Field ~o~ Depth of Field ~' ~ ,, Gravel Bed Thickness _ 'Tfo .~ ~ Standpipes P=esent (Y/N) De LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested fo= Electrical Codes(Y/N) . Ccn~ents Dimensions Manhole/Access ,,~.~ o~f"~.,~vel at Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, or eonfc~med to all MOA HAA Guidelines in effect on the date of this inspection. Signed Date cc~ar~y ~o~ ~ ' ~..~..~.~. m/dS/~ %: ~-:""%%:g~-, i.~, [Page 2 of 2] 2-15-84