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HomeMy WebLinkAboutMEADOW RIDGE ESTATES BLK 1 LT 9Onsite File Meadow Ridge Estates Block 1 Lot 9 #051-461-11 Uf MN fl , AUG 10 2u15 Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. •P.O. Box 196650 Anchorage,AK 99519-6650•http://www.muni.org/onsite•(907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141244 PID Number: 051-461-11 ❑ New ❑✓ Upgrade Name: ABSORPTION FIELD Donna Jean Hanson — Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed 0 Mound 20850 Meadow Lake Drive Chugiak,AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Bock Lot Ft. Ft. Meadow Ridge Estates 1 9 Fill added above original grade Gravel length Township Range Section Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic AbsorptionI Tank Field Tank Line Holding Sewer Total absorption area Number of trenches Dist.between trenches Lift Station From Ft2 Ft. Well >100' >100' >100' >75' >25' TANK ID Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1,250Gal. Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two NA LIFT STATION Foundation >5' >10' N/A N/A Manufacturer Capacity Curtain Drain None I Noted Gal. I _ lPL:mp on level at Pump cff level at High water alarm at Remarks Tank Only Replaced Under This Permit. Existing Tank Decommissioned in Accordance With in. in. in. Municipal Code. !Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 03034 Tank to D3034 Installer _ drainfield Stuart Gilbert Drainfield CO/MT Inspector A. Harala BENCH MARK (Assumed elevation) 100.0ft Inspection 151 7/22/14 2"d Location and description 7/22/14 3`d 4m Bottom of Siding at Point A. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engg omptaAtI11 Conditional Approval: Date 01,(/)..h., T •'•:Sir jl� ,* 49f . r • 0 I,�, MICHAEL E. ANDERSON :'- 1,`;'w.•• CE-4381 �$ Approved ,,./ _ � /,. / Date_ll 2q ���11����� '• /� Inspection Report_1-1-12.doc Municipality of Anchorage Page 2 of 3 PID No.: 051-461-11 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage,AK. 99519-6655-343-7904 Permit Number: OSP141244 MEADOW RIDGE ESTATES LOT 9 , BLOCK 1 ,-3 05 o '� s . 25,968 S.F. 2 / 7/ / O�� // 7 Off` O / Existing Septic Tank S�5 CP' / ��C�� // / Decommisioned in Gj Accordance with // Municipal Code. cC r- SCNI\7 9%) / 0. s / / �e 7../// �// ott` � �� s4: / / b0-µ .-Existing Absorption , tl / cel i Trenches LO /V LIN N00 V 7 v� // //� S2 // rS1 / Four 2� // Bedroom FCO 7. Home 37- Water Service-_- NOTE: '4, �\ / As Built Not Completed !y qO /'c. from Surveyor As Built. / Locations are not �p / ' Exact. '_tvg ',,OF 1' SO A B // •.•�P� ' " 1.s♦ Si 31.6' 24.4' Driveway ///'�.e: • �� •' S2 40.3' 21.4'at 4 / Os i49th '\ ` \ \ Q1 V • ;444-CX E L2e.,44.e4n •* ., / ��� O O • 7 , r 7 No 11' 7 •� ;MICHAEL E. ANDERSON ;' t // O.• 70440N •O NO. CE-4381 ti /...�•••.• /.441 OFESS �. cG _ 4 -.•.....• O� \P PLAN AS BUILTX\\c/\''''C) CO Clean END Vent M1 - Monitor Tube TH - Test Hole /SCALE 1' = 30' / FCO - Foundation Cleanout Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage,AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141244 PID No. 051-461-11 I 93.7 N UU i Existin. 1,250 Gallon Septic Tank 88.45 88.3 Tank Only Replaced Under This Permit. Existing Tank Decommissioned in Accordance with Municipal Code. si 49th s'� %. 0 •0 :.MICHAEL E. ANDERSON ;�i i PROFILE AS-BUILT •.f NO. CE 4381 �C% • No Scale 1• '•+ `g.''•°. •*'11 s5.SO4♦4 ♦ On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141244 Tax Code Number: 05146111000 Work Type: SepticTank Upgrade Permit Effective Dates: July 16, 2014 to July 16, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: MEADOW RIDGE ESTATES Site Legal Address: MEADOW RIDGE ESTATES BILK 1 LT 9 G:1362 Owner/Address: HANSON DONNA JEAN 20850 MEADOW LAKE DRIVE CHUGIAK AK 995676231 Site Mailing Address: 20850 MEADOW LAKE DR, Chugiak Lot Size in Sq Ft: 25968 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The field does not meet the required separation to the house foundation. A waiver is to be submitted for review and approval prior to Inspection Report approval. Received B) Issued By: 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. 051-461-11 Property owner(s) Donna Jean Hanson Day phone Mailing address 20850 Meadow Lake Drive Chugiak, AK 99567 Site address Same Legal description (Sub'd., Block & Lot) Meadow Ridge Estates, Block 1, Lot 9 Legal description (Township, Range & Section) Lot Size 25,968 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: (0 all that apply) Absorption Field ❑ Initial Septic Tank IN Upgrade Holding Tank ❑ Renewal Privy ❑ Private Well ❑ Water Storage ❑ ❑X 11 TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D) Multiple Dwellings S ! OBMITTArnd/or D) JUL 1 1 12014 HL THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: 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: a1�J Date of Payment: I Receipt Number: 65bdf- Permit No. P N %2_44 Permit App_- :- Waiver Fees: Date of Payment: Receipt Number: Waiver No. ❑X e July 10, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 9, Block 1, Meadow Ridge Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The septic tank on Lot 9, Block 1 Meadow Ridge Estates Subdivision has failed and must be replaced immediately to prevent a health issue. We are therefore requesting a permit be issued for the construction of a new 1,250 gallon steel septic tank to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing septic system and the location of the new tank. Also identified on the plans is the existing water service on the lot. The subdivision is currently served by a community water system. The existing tank on the lot will be properly disposed in accordance with Municipal Code. The existing absorption system will remain in place for continued service. The ground surface on the lot slopes at a grade of 7% to the southeast in the area of the septic tank. The tank will be constructed near the location of the old tank and in conformance with Municipal requirements. If the tank is constructed in accordance with our design the following statements apply: The tank, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The tank, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The tank, if constructed as designed, will have no adverse impact on reserve Lot 9, Block 1, Meadow Ridge Estates July 10, 2014 Page 2 of 2 space, either surface or subsurface, on any lots located in the area. 4. The tank, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments MEADOW RIDGE ESTATES LOT 9, BLOCK 1 25,968 S.F. 05 10 56���6�6 i i i i i Z�s YK�I��i]�5�L�771 Decommission Existing Septic Tank in Accordance with Municipal Code. Place New 1,250 Gallon Septic Tank and 2 — Post Tank Clean Outs. Tie In Existing Absoorption Trench. /� Sp'(•0°moi Existing Absorption i Trenches c5` i i i� Four 5' S1 i Bedroom FCO Q. Home Q. Water Serv_ice___-\ i i ♦������ 1 so NOTE: ♦ �� ••.q ♦♦ New Septic Tank Driveway • �P •......... ♦ ��:. �♦♦ must be a minimum • ♦ of 5' from Absorption i xl S 49th ♦♦ Trench and House •••:••••••r •••• �.� Foundation. ........................ • O n'; MICHAEL E. ANDERSON / ice• Na. CE -4381 SITE PLAN SCALE 1° = 30' / O LEGEND VP S1 - Septic Vent CO - Clean Out \tel` M1 -Monitor Tube TH - Test Hole FCO - Foundation Cleanout Municipality of Anchorage Page—L— of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: PID Number: L-1 G-, 1 Name: Wastewater System: ew ❑ Upgrade Ad�rss: ABSORPTION FIELD Phone: No. of Bedrooms: ❑ Deep Trenchallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: fL Total Depth from original grade: = / o GPD/Sq. . Ft. �/, 0 Lot: �^ Block:��v11 Su divisiopp � / � Depth to pipe bottom from original.. grade: V Gravel depth beneath pipe ''// 0 ir•/'d° 6v✓ -C— Z— Ft. J Ft. Township: Range: Section: Fill added above original grade: Gravel length: Z-0 Ft. /03 Ft. WELL' // ❑New ❑Upgrade ' Gravel depth: /1 Number of lines: 'L Distance between lines: I G Ft. i /5' Ft. Classification IRA eat , A.B,C): Total Depth: Cased To: Total absorption area: Pipe material:/�STi*�J SU FL Ft. SQ. FL 0,Zh, Driller: Date Drilled: Static Water Level: Installer: _ Date i tailed: Ft. / L Yield: [Pump Set at Casing Height Above Ground: TAN K GPM Ft. Ft. SEPARATION DISTANCES Cf Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines C4 T /j 1is1i Well i tyt)Surfac - Leo Mate 131, 1u/ Number of Compartments: y x/25 /D� / / LIFT STATION Water _'/�r' Lot A, — his /O Size in gallons: Manufacturer: / Line Foundation / / �� �' "Pump on" level at: "Pump off" level High water alarm at: / Curtain Pump Make & Model rical Inspections performed by: Drain / Remarks: Rre-ix- is BENCH MARK � � Location and Description: r _e Assumed Elevation: /00 ENGINEER'S SEAL Inspections performed by, Dates: 1st �'- a 2nd Department of HQaitand Hu in Services appro a ' Z Reviewed and approved by=',1 Date: 72-013 (1/91) MOA 25 a� vermis no. �a� ---- - Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: �"'' �1'��� �J�tpO.J �7 DCi PID No.: IV q'..,.............. \\\ v > I r7l b' �. ..:..Ips. O o / 1_ ill �oOQ �Otl 6 1� 000� �\ d O0 eO C •o 0 o gni , e� IVy Ow / v rv? ��, T� 2,- Permit No, Page of J Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 ® Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: or, -- - - o0 / �O ./ G�r� e / s e IQa n ML-v1)v-) {I1/.Ct. PID No.: >. 4 e PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940404 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:MILBY ROBERT L SR OWNER ADDRESS:20850 MEADOW LAKE DR CHUGIAK, ALASKA 99567 PARCEL ID:05146111 LEGAL DESCRIPTION: MEADOW RIDGE ESTATES BLK T 9 LOT SIZE: 25968 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 L DATE ISSUED:10/18/94 EXPIRATION DATE:10/18/95 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: l61 / Gam- DATE: ��7- ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, ALASKA 99524 October 5, 1994 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 9, Block 1, Meadow Ridge Estates Subdivision Well and Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby request that a permit be issued for the construction of a septic system on the subject property. The location of the system and and the reserve site are shown on the attached site plan. In addition, the topography of the lot and existing drainage pattern is also illustrated on the plan. Soils encountered during the field study indicate acceptable conditions for an onsite sytem. The septic system and replacement site must be placed outside the 100' setback from the lake. The subdivision is served by a community water system so the setbacks are easily attainable. If the system is completed as designed the following statements can be made: 1. The system, if constructed as designed, will have no adverse impact on the wells currently in use as the subdivision is served by a community water system. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as drainage patterns in the area. designed, will have no _ adyerse impact on Sincerely, t`.. k l J -4'i L Michael E. Anderson, P.E. `' `J' MEADOW RIDGE .ESTATES SURD. ; LOT 9, BLOCK 1 25,968 S.F. 60(3bi AL-rERn1A-rC 00, '° 3 LOT 9 / Q / � \ 65 �I IF kp PROPOSED \ y COVERED �} ENTRY D NE / 1O. ��'OOO• 111--.301��o s I a 59209:tO-w 11:0.00 frt-i r ' 444 1r Lot 9, Bloch 1, Meadow Ridge Estates Subdivision DESIGN FACTORS: Four Bedroom Home Perc. Rate: 16 Min./Inch Application Rate: .6 GPD/SF SYSTEM REQUIREMENTS: Wide Trench System 1,250 Gal. Septic Tank 4' Drainfield Rock 4 Bdrms. X 150 GPD / .6 GPD/SF = 1,000 SF of Absorption Area 1,000 SF / 5 LF (Trench Width) / .5 (Red. Factor) = 100 LF of Drainfield Trench Therefore: Construct Two Paralell Trenches Each 50' in Length and 5' in Width. Four Feet of Drainfield Rock :Must Be Placed Beneath the Distribution Lateral. • ` ` 6 " 1 'r M 7 Lt - MDj SQ . rsc- i i i �lws� 0 NOTE: Maintain 4' Separation'`' from Bottom of System to Groundwater. Grade Area Over Trench to Drain Away From Area. Maintain 100' Separation from All Components of Septic System and Open Water. PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG a PERCOLATION TEST r' (ENGINEER',,5 SEAL) 3 431 f •F�� 1�� 1l DATE PERFO'Rrvt'gJD LEGAL DESCRIPTION: II_r�_(� 00 Net Time Depth to Water C S Ti13 /8%7�/ Township, Range, Section: ooap' Df'PTki. 3 /8.32 325 4 SLOPE 1 1 1 SITE PLAN - WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT J DEPTH? Depth to Water Alter /� Monitoring? s Date: Reading Date Gross Time 00 Net Time Depth to Water C S Ti13 /8%7�/ 2 ooap' G� 3 /8.32 325 4 l3, IA/ Z 3,5 l•/ 5 `ir'57 7Z0-��/ y 6 o v /33f� /Z. .min d 7 0 0 rf 8 Pd � o e o 10 11 O 12 d 13- 3 o' 14- 14 16- 15 0 (D*. , Q. L 'O 16 17 0 18 o D. o /e WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT J DEPTH? Depth to Water Alter /� Monitoring? s Date: Reading Date Gross Time Net Time Depth to Water Net Drop Ti13 /8%7�/ /Z. Zi /8.32 325 /l l3, IA/ Z 3,5 l•/ `ir'57 .75 /8•'S 59 S' /" /33f� /Z. .min rf 20 // 77 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER —L— �TEST RUN BETWEEN a �1� FT AND ' iy FT COMMENTS ftsr// A615— 1n/c?S bl"e- PERFORMED BY: /!L� I % •/t t --/i •,c-� - - u```� ERTMY THAT HIS,TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: q 72-008 (Rev. 4/85) ^� ( NG(NEEp's-f PAL) Municipality of Anchoragei3 t DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 r u4sztt��c' SOILS LOGS -- PERCOLATION TEST 4361-L PERFORMED FOR: DATE PERFORMZ � LEGAL DESCRIPTION:I _[\,I KArj Y/42 [iZ— b O 2 3 O� 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 /3e:�;,i./— %f4- Z Township, Range, Section: SLOPE SITE PLAN WAS GROUND WAT ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Alter/ Monitoring? H S o L p P E Date: N Reading Date Gross Time Net Time Depth to Water Net Drop l fOo ,r 1"ev /o, 75 2, i /• O/o 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN r �O FT AND 7 FT COMMENTS 7fST /t Olt-- W,7g PERFORMED BY: ` I r^� `r"�'Z �"�"` r`—ERTtfY-THAT THIS I /TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: V `�' 72-008 (Rev. 4/85) �' 5f, 78970 • .� Municipality of Anchora l MAY p 2 2019 r ° On-Site Water and Wastewater Program r (907) 343-7904 - CERTIFICATE OF ON-SITE SYSTEMS AP `:0,V�• Parcel I.D. 051-461-11 Expiration Date: 1. GENERAL INFORMATION Complete legal description Medow Rid�c e_Estates Block 1 Lot 9 _ Location (site address) 20850 Medow Lake Dr. Current Property owner(s) Donna Jean Hanson Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well U Holding Tank Individual Water Storage Community ❑ Community Class Well ❑ Public Sewer Public Water System WaiverNariance request for: ,tea. e to Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ VIZ) Waiver Fee $ d2 25 Date of Payment 5,.1/9 2 Date of Payment 57W/9 /�29 _ Receipt Number INCPg3 Receipt Number tf�0 COSA# ()SCA/it/1 Waiver# 05 V/q J O 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. 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 4407<l' 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 during 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 i� occupants or can ArcTerra guarantee that no unseen Ayr O`I l encroachments,deficiencies or discrepancies exist. •r ;`-4,s, 4-1 ' p0 6. DSD SIGNATURE ��'�� AMI.11 System #1 Approved for_ bedrooms. ` '• �� System #2 Approved for bedrooms. �n da E�°moi fir.. l'otEss lolov Disapproved. \`q11:41P- Conditional approval for bedrooms, with the following stipulations: \kQ jTY(OEr'1/4f� cce ON-SITE c v WATER AND vvASTEvvAT J AMR o� /JJ O\ By: � �'�"-- -E�✓� ` _ Original Certificate Date: S l The Municipality of Anchorage Development Services Division (D.n) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA bile s,eet 10-10-12 doe COSA Checklist Legal Description: Medow Ridge Estates Block 1 Lot 9 Parcel ID: 051-461-11 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test gpm Date drilled Water storage tank volume gallons Total depth ft Well disinfected for coliform test? El Yes 1 No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height(above ground) in. Collected by Date of flow test for COSA Date of Sample Static water level at beginning of test ft. Comments Public Water System B. TANK DATA C. LIFT STATION Age of tank(s) 5 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank 49" Lift station material ▪ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 4/23/19 D. ABSORPTION FIELD DATA Which system tested (date installed) 12/10/94 Adequacy test date 4/24/19 ▪ALL standpipes present per record drawing Results ZPass For 4 bedrooms Total measured depth from grade 7.9* ft(max) Fluid depth prior to test 0** in Measured depth to pipe invert from grade 3.3* ft(min) Water added 600 *gal ❑ N/A—pressurized field ** New depth 4.5 in • Monitor tubes go to bottom of effective. If not, state Elapsed time 150*min depth into effective Code-required soil cover over field Final fluid depth 0 ** in Absorption rate 600+gpd •System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) Gallons introduced 600* gallons If yes, enter date Comments/Deficiencies:*: Measurements based on south trench. **: Only south trench was tested COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' ❑Yes if No ft ❑Yes if No ft Neighboring Tank> 100' ❑Yes if No ft Private Sewer/Septic Line>25'❑Yes if No ft Absorption Field on Lot> 100' ❑Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' ❑ Yes if No ft ❑Yes if No ft Manure/Animal Excreta Storage> 100' Community Sewer Main > 75' ❑ Yes if No ft ❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ®Yes if No ft Surface Water> 100' ®Yes if No ft Property Line >5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field >5' ® Yes if No ft Private Wells> 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells>200' ® Yes if No ft Water Service Line > 10' ®Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No 6.5 ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells> 100' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells >200' ® Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS Waiver for foundation to leach field distance of 5 feet requested. Only the southern trench was tested. G. ENGINEER'S CERTIFICATION +��P� �Or gz,z.,♦.1 I certify that I have determined through field inspections and review a t� 11 of Municipal records that the above systems are in conformance with ?a 49 gi i *11 MOA COSA guidelines in effect on this date. •• fV KENNETH V'.,v i 11`'r,♦ CE 7116 T COSA Checklist yellow sheet Municipality of Anchorage P.O. Box 196650 •• 4700 Elmore Road nJ Anchorage. Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 epartmenr http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV191024 COSA#: OSC191144 Permit#: PID#: 051-461-11 Legal Description: Meadow Lake Dr. Engineer: Arc Terra Applicant: Donna Hanson Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the foundation has been approved. The approved separation distance is 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. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non-objection have been received from the owner(s) of the affected adjacent property. n Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: Approved l Name of R- iewer ,CTE, :k ARcT EHRA : Asr, CONSULTING, INC v 212 E.51st Ave,Anchorage,AK.99503 1 Office(907)868-3791,Fax(907)868-3793 bf�f'SUIT I NG•A 9.77 ,e May 1,2019 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Leach Field to Foundation Waiver— Meadow Ridge Estates Block 1 Lot 9 During the COSA process it was discovered that one of the previously installed absorption trenches was constructed within 10' of the foundation. Based on current MOA records and our measured verification, the field is approximately 8.5' to the cleanout from the foundation. The field was installed in 1994 and there is no way to determine why the discrepancy exists. The original system inspection report shows the field being this close as well as subsequent work on the system noting the location. Due to these issues combined with the existing characteristics of the lot, we are requesting a waiver of 5' to the foundation from leach field be granted. We do not expect there to be any adverse effect on the subject or adjacent lots by granting this waiver. If you have any questions, please contact me at 696-6111 / FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. glib AIR e• Kenneth M. Duffus, . . Attachments: COSA -1E'll- -- TRACT 61 (POND) �5„ +616 / . V / / •p� 6000 / / 7 / a5y,�/ / / / / / SEN�� / EP / Z / •5E / / 2° .. F, / / Jam: !z / �1 / O O O O C e,en � v Y o� ,64 O J` V. O e 'S90 ,f ,, 2 '6 V Y '. Qr> Y- 4: r`) c.... 01 D sK. o 0 PS�.A14 E 00 7/77 60 7.7 05 • \,Pv -9v SOFq��4a 0) TH AS-BUILT SURVEY 1” = 30' OP s.�o o* 49 — °9 dp D �' NO CORNERS SET THIS DATE • p �V v SHANE A.HOLT m O DO e^ LS-6914 �• 5/44 (HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY 4�o ao OF THE FOLLOWING DESCRIBED PROPERTY 4��� ppQoo�a LOT 9 BLOCK Z MEADOW RIDGE ESTATES SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN /// THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS THf: INS°ORMATION HEREON FA1 THE USE OF LENDING :.ASTIT!i7IDNS SPf..c.LLIc.A:.L.r Ta SHOW EXIST OTHER THAN NOTED. CONFLICTS RETUEE.N EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASE:MLNTS; AND IS DATED AT ANCHORAGE ALASKA THIS 3RD DAY OF NOT TO NE LINED FOR POSITIONING ADDITIONAL STRUCTURES I')PROVEMENTS.. ON FE.NCELINIS ANCHORAGE, ALASKA Of RECORD. OTHER THAN THOSE APPEARING ON THE RECORD PLAT . ARE NOT SHOWN MAY , 2019 HEREON C UNLESS INDICATED) NOTE, FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE. NOT TO HE. USED TO DFTLEMNE'. PROPERTY LINES OR POSI"I0N ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY RE APPROXIMATE DUE TO EXCESSIVE SNOW AND/O4 ICE. HOLT LAND SURVEYING ANCHORAGE,AK\\'',... ...) „„. GROVER DRIVE /4217.F8196-37 345-5513 Property ownerCry phone Ma(ling address Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: y;`c Individual on-site X >CX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State A attesting to the legality and status of system. 72-025 (Rev. 1/81) Font MOA 7{21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater 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 Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm_ rtr� D ILS O ^� �n►G i n� � '1L1 r.9 L� Phone/ . 44— `•9 51 Address P0• gOx Zga773 A0 �0rLA&c A V, qq!s 6. By: Conditional approval for Additional Comments bedrooms, with the following stipulations: The'Muni61p!alit' of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certifidates, based only upon the representations given in paragraph 5 above by an independent professional( engineer;registered in the State of Alaska. The DHHS does this as a courtesyto purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS 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. 72-025 (Re -1/91) Back MOA #21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LU7- 91 PDI vOt - Ir All LA o,,J Parcel I.D. A. Well Data Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell completed Cased to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Driller Casing height _Wires properly protected (Y/N) AT INSPECTION g.p.m. ; On adjacent lots On adjacent lots Public sewer manhole/cleanout Petroleum tank LIV\rv1U;J t iJ Nitrate / Collected by: Other bacteria Date installed /?- l b/,q% L Tank size /. LSr7 Call- Compartments 7�� ^j Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression (Y/N) / V High water alarm (Y/N) /A/ Alarm tested (Y/N) t A Date of pumping 6J �- W Cx 1J c-• 711,Q (-r- /0 "4 Pumper N A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r r Well(s) on lot N' A On adjacent lots > zoy Foundation 7 r r � To property line 4S Absorption field Water main/service line > Surface water/drainage J ADO l 72-026(3/93)'Front CONTINUED ON BACK PAGE rr� r 'yam �o g.p.m. 'z tl "' M 0 G L an ni m Other bacteria Date installed /?- l b/,q% L Tank size /. LSr7 Call- Compartments 7�� ^j Cleanouts (Y/N) Foundation cleanout (Y/N) Y Depression (Y/N) / V High water alarm (Y/N) /A/ Alarm tested (Y/N) t A Date of pumping 6J �- W Cx 1J c-• 711,Q (-r- /0 "4 Pumper N A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r r Well(s) on lot N' A On adjacent lots > zoy Foundation 7 r r � To property line 4S Absorption field Water main/service line > Surface water/drainage J ADO l 72-026(3/93)'Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level NlA "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed I`'[ ,P> Length f ©j Width On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Soil rating (GPD/Ft2) L t -j Gravel thickness Total absorption area ! CJZ,1J Fr-, Cleanout present (Y/N) Date of adequacy test 1\)0J &) %J ? %- Results (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot A o A c To building foundation On adjacent lots On adjacent lots ? /00 /Cutbank Surface water ?/Gd/ Curtain drain /V © J Z�` E. ENGINEER'S CERTIFICATION Surface water System type W Itc%,->Jcfa Total depth Depression over field (Y/N) A S S for After test 0 If yes, give date 1,J1A Bedrooms �> Z-0 () Property line/ To existing or abandoned system on lot 1 / A ^IDA1Ct Water main/service line > �__1 0 Driveway, parking/vehicle storage area ! certify that ! have checked, verified, or conformed to all MOA and HAA guidelines in effecf on the date of this inspection. HAA Fee $ 3 ` �2� cc Waiver Fee $ _ Date of Payment �% r7 U� Date of Payment Receipt Number 17 �� 22, 1 Receipt Number. 72-026 (3/93)` Back