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MCMAHON BLK 1 LT 2
McMahon Block 1 Lot 2 #017-041-43 insNeaiun Meport_a-1-12.00c Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201497 PID Number: 017-041-43 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: ROBERT DAUENHAUER ABSORPTION FIELD - EXISTING ® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 3650 HUFFMAN ROAD, ANCH., AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 0.45 GPD/SF 13 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.9 Ft. Gravel depth beneath pipe 10.1 Ft. Subdivision Block Lot MCMAHON 1 2 Fill added above original grade VARIES 0.5'— 1.2 Ft. Gravel length (2 x 421) 84 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic AbsorptionLift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1696 Ft2 2 17+ Ft. Well 1001+ 1001+ NA NA NA TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface water 100'+ 100'+ NA NA Material PLASTIC Number of compartments 2 Lot Line 5'+ 10'+ NA NA NA Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Curtain Drain NA *NA NA NA Gal. Remarks *None known. Pump on level at in. Pump off level at in. High water alarm at Pump make and model Electrical Inspections performed by Installer MNA PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector MNA BENCHMARK (Assumed elevation) 100 ft Inspection ddates: fisc 1/14/2021 2nd 1/15/2021 Location and description 3`d 1/16/2021 4" 1/16/2021 TOP OF MANHOLE COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: 'AMWI OF AZ4 1k Date �* 49TH� *� .p' MICHAEL N. ANDERSON - NO. CE 9469AV Aper Date 2 "ZSR \sszo�� i insNeaiun Meport_a-1-12.00c PERMIT: OSP201221 PID: 051-072-19 Iz 'YELL x 100' PROTECTIVE—\ \ I WELL RADIUS \x I 100' PROTECTIVE 1 / WELL RADIUS FENCE --"I STAKED PRIOR x TO CONST. CO Lot Lot 1 x x / CAT III I 5BR RESERVE A—C=23.3' B—C=44.7' A—D=23,5' B—D=43.5' A—E=30.5' B—E=47,5' A—F=51.6' B—F=67.5' A—G=71.7' B—G=80.3' A—H=82,7' B—H=89.5' A—I=99.7' B—I=108,7' A—J=94,3' B—J=105.0' A—K=73.4' B—K=90.2' BM 1.500 GALLON HDPE TANK f� 1 B R A FCO C D • CO INSTALLED NEW 1500—GAL HDPE SEPTIC TANK I:I TH2O-1 10' UTILITY EASEMENT WEST 147.50' EXISTING 4BR FIELD Col M71 C002 DCO DIVERTER 98.6 i FINAL GRADE I I H, ', SEPTIC SECTION SCALE, NTS MCMAHON BLOCK 1, LOT 2 PREPARED FOR: ROBERT DAUENHAUER 3650 E. HUFFMAN ROAD ANCHORAGE, AK 99516 FD II f FILTER FABRIC Michael N. Anderson, P.E. DATE: SURVEY: 4661 NATRONA AVENUE DRAWN: ANCHORAGE, AK 99516 CHECK: 907-727-8864 / FAX:907-345-1391 SCALE: Lot 3 SCALE, i' = 30' 98.10 2, ORG/OL SEWER ROCK I I 85,1 110'ED 85.1 CO3 98.0—\ SM/ML-9m FINAL GRADE MT2 C04 98.6 97.40 ORIpNAL GRADE FILTER FABRIC DRY — NO GRND.WTR. 20' 12/18/19 94.5 BOH SEWER ROCK 10' ED 77.10 aa.4 84.4 TH2G-1 RELATIVE ELEV. SUPPORT@SERVICES: or F�< Ao �� OF * 4 9 TH 02/3/2021 MICHAEL N. ANDERSON KGL 2020 No. CE 9489 FWCAO MNA 2/3/21 its MNA �v`or 1" = 30' 'ssrO��' 0 Municipality of Anchorage] P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 ® Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section * * * x VARIANCEIWAIVER REVIEW Waiver#: OSV211008 COSA#:OSC201687 Permit#:OSP201497 PID#: 017-041-43 Legal Description: McMahon Block 1 Lot 2 Engineer: Mike N. Anderson Applicant: Robert & Mary Ann Dauenhauer Your request for a waiver of the required 20 feet horizontal separation between the absorption field sections has been approved. The approved separation distance is 17.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing absorption fields only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 2 5 �D,'1 r Approved by: Name of Reviewer .................................................................................. **** VARIANCEIWAIVER REVIEW **** aQ 5 r'd a191, 0 f2QcPt 3t`�o9y Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345-3377 / Fax 345-1391 January 30, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: MCMAHON B1, L2 – FIELD-TO-FIELD WAIVER Due to elevations and to minimize negative property impact, a field-to-field waiver of 17’ between the recently installed trenches is requested. This waiver is justified with the tighter, silty soils and shows any potential effluent transference or interaction between the existing and new fields will be marginal or nonexistence. The mitigating factors of soil type justify the issuance of the waiver and indicate no effect on their functionality. Granting of this waiver will not impact the subject or any of the neighboring properties. Please contact me if you have any questions. Sincerely, Michael N. Anderson, P.E. HOUSE DETAIL Scale: 1" = 30' DECK J2 STORY DECK o RESIDENCE w/ n N DAYLIGHT 23.3' 1z BSMT. C off' 9. DECK �9n19 16.2' J.9 °` u9�0G0G 4.p PANT F G 8.0'x10.2' \ Lot 1 CHAIN-LINK FENCE-/! I ENCE-!I I .I 47.2' SEE HOUSE DETAIL 100' PROTECTIVE------, WELL RADIU RAMP SAUNA Lot 2 33,925 S.F. 10ELECTRIC EASEMENT 'a PIPES Ir — Lot 3 PIPES FENCE 10' UTILITY EASEMENTS WEST 147.50' —1 i— � Lot 11 Lot 12 Lot 13 I I III I NOTE: DUE TO SNOW & ICE COVER, THE LOCATION OF THE DRIVEWAY IS APPROXIMATE. PLOT PLAN —__ AS BUILT _X— SCALE 11 — 50__ GRID _ SW 2835__ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in c . (907) 522-6476 Phone 000��OO� (907) 522-4625 Fax F Professional Land Surveyors kenOlangsurvey.com oo o - A9 0 jonathanOlangsurvey.com �o �,. •.s �0 I hereby certify that I have surveyed the following described property: LOT 2, BLOCK 1, McMAHON SUBDIVISION (PLAT No. 65-86) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. A� , Dated this the ----- y Tb �L: =— �- at Anchorage, Alaska I It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. K....49THENNETH IFC ............ ENNW � AN ..�.o L�2Q�L( '•..LS -5202.-' SJa� oa... deo 40\\ R �PfSSIONAL �o MUNCRALITY OF ANCHORAGE on-sFto Wator &Waste-mter Program PO Box 19wo 47W Elmore Rooct Anchorege.Ak3sks 99610,6560 Phony: X07) 343.7904 FAK (907) 343-7997 hk1FYlfYrwW.munf.orgforis rb Orr -Site Wastewater Disposal System Permit Permit Number: OS 01497 Work Type: Septic Upgrade Ta x C-ade N umber: 01704143304 Site I-equi Address: MOMAHCN 13L K 'I LT 2 G� 5 Site P.AaiEing ,odd rest, 3650 H UFFMAN -RD. Anchorage Owner, OAUENHA4UER ROBERTS & MARY ANN Design Enginaar: FIRST WATER CONSULT1NG This permit Ts for the constmetion of: Effective Oate, Expiration Date - Lot Sime In Sq It Taal Bedrooms: 12117125 1211712121 33925 If Oi spos a'. Field IJ Septic Teak E] Hulding Tank ❑ P(Iv❑ Private Well Q Water tore All construaWn shall be In accordanue with: 1. The attached appraved design. 2_ All requ iFemants weci lied in Anchorage Mun Iclpal code Chapters 15.55 and 15.55 and the State of Abnka Wastewater Disposal Regulo ions (i SAAC7 and OTinki ng Water Regu lations (15AAC55) 3. The wastewater code requirag In acUorls during the iostallatioo. The enginesr shall notify the Development Services DepaAment per AMC 15-65- Providig notificah❑n by calling (907) 34 7904 t2 7). 4, From October 15 to Atip d 15, a subs urface soil absorption systern under ooristru On Ckirirg die ing weaEt er shall be either. a- Opened and Closed ort the same day, or b, Covered, waled, and heated to pmvant freezing Recelved By Issued 8y, f ,rr, 7 1211 702D i te: cage: 5 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com December 8, 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: MCMAHON BLOCK 1, LOT 2 The property owner has requested we obtain a permit to install a 5-bedroom trench to upgrade the septic system of the above referenced lot. We propose to install one deep trench to serve the existing 5-bedroom property. The design is based on the recent test hole conducted on December 8, 2020. No groundwater was observed at test hole excavation and monitoring will be conducted at 7 days and prior to construction. The slopes are moderate at 0-3% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201497, Rebecca Carroll, 12/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201497, Rebecca Carroll, 12/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201497, Rebecca Carroll, 12/17/20 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: MCMAHON B1, L2 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 12/16/2020 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 SM/ML-gm 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 BOH Reading Date Gross Time Net Time Depth to Water Net Drop 12/8/20 30 min 62 1 1/162 30 min 62 1 2/162 30 min 62 1 1/162 PERCOLATION RATE 28 (MIN / INCH) TEST RUN BEWTWEEN 6 & 7 FT PERC HOLE DIAMETER 62 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 12/16/2020 TESTHOLE # 20 -1 DATE PERFORMED: 12/8/2020 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: BOB DAUENHAUER 12/16/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201497, Rebecca Carroll, 12/17/20 \ Municipality of Anchorage Development Services Department ° 4' Building Safety Division _ On•Site Water and Wastewater Program, 4700 Bragaw St. Pae I of 2 P.O. Box 196650 Anchorage. AK 99519-6650 g www.ci anchorage ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number. SwU702.3E PID Number: 017-10y" —`13 H,m.Wastewater System: 0 New Upgrade B04 E )Tc(. Ana Damen ilausr gddr.a,man �� ABSORPTION FIELD ?6So 6. N-" Pm Nwro.r woama o D. TI o 'law TI..rJI O e.d o Llavnd 3 YS - 27 28 T«,i DWM hon Mill a,d. soa Rn.�q LEGAL DESCRIPTION cP ' F' aladc L« S�Od�wuon pagn Io DIp, Donn ham «�gsJl a,d. I depn paroam pD. I 2 iT C tj et FI S,q,an FIn q].d noa. ananN q',da c+,..l LNp:n To.�M-p Rang. iI. FI. n.-..-...-.-- NYIroNOIIMa Dwl IM5 Well: 6—wS7 M New ❑ Upgrade [uaan�rrion (Pine. A 0. CI I TWO D.pn' C,aw _ W SEPARATION DISTANCES To From w«I Septic Absorption Tank Field IUY Lift Holdm Station Tank sJl,w.wns 7lClQ L« Uu �0 r F«ndnan 1 7 r c~ I),& - R."" prtellAc l Sti hRc lc+�k !� n6� ,. L... •, i -L, n as�( n e r Lw« FI Sewer Line f«W b uan r., Pip, M,ImY P D -303y nn,lax Dau nalnl.d q R t TANK ® Septic []Holding ❑ S.T.E.P. Q Other. W,A,PJM I.pX,r AArAeprcc"o-%Ltn4, I.SGO 6r :I LIFT STATION. N.A• • Got 'PJ Cr wvn n wy, wnw .. E."a napw,}rona p.H«m.d by BENCH MARK $1 o(any eta( /(eqn ou% Inspections performed by: FIaL&A TSA S,c Dates: t" — Development Services Department Approval Conditional Approval Date: Reviewed and approved by: (Rw 0 ) Date: VZ 0i M !ii.cMf fD (LLWawd u..uan l G6.o FL Engineers Stamp OF A� ................. THEODORE F. AMRe CE -3589 R =100' PERMIT NO: SW070238 PID NO: 017 1-43 WELL R=100' SWING TIES: PAGE 2 OF 2 LOT 2, BLOCK McMAHON SID NIIIIII. YIIIIIIIII. rIIIIIIIIIIII. rIIIIIIIIII I. r/IIIIIIIIIIII. rIIIIIIIIIIIII/. yY' IIII%i IIIIII I I Y • - IIII%%I d .IIIIII I%II :IIII NIIIII IIIIII NIIII IIII%NI %� IIIIN�I%IIII INIIIIIIIIII N�IINIIIIIN /iiINIfNII/ SINtii 8 C. I i "D" r FROM: COR. "A" COR. "B" TO: S.T. C.O. "C" 19' 25' S.T.C.O.'D" 29' 26.5' DBL. C.O. "E" 31' 26' —NEW 1500 -GALLON SEPTIC TANK DBL. C.O. EXISTING _ SOIL ABS. TRENCH it PLAN VIEW SCALE: 1" = 30' ----------------------------------------------------- ELEV. ELEV. 4' SOIL COVER FROM HOUSE INV. NEW 1500 GALLON ' INV. 93.8' SEPTIC TANK 937 PROFILE VIEW SCALE: 1" = 5' TO TRENCH I MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070238 Legal Description: MCMAHON BLK 1 LT 2 Design Engineer: 0019 FLATTOP TECHNICAL SERVICES Owner Name: ROBERT & MARY ANN DAUENHAUER Owner Address: 3650 E HUFFMAN ROAD ANCHORAGE, AK 99516-2111 Date Issued: Sep 10, 2007 Expiration Date: Sep 09, 2008 Parcel ID: 017-041.43 Site Address: 003650 HUFFMAN RD Lot Size: 33925 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. 7-*/( 9110�Date: % / )Z Issued By: Date: l O 7 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 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 01 q -Ou I - y3 Property owner(s) Ro Se— i E r`ret nr Ann D ..acn lra uc� Day phone ?'V s-- 2 7 ZE Mailing address 3 e'J-0 y..<Ar ct n A -Pe Zip Code 9 9S -r Site address 5;'Q _Zip Code Legal description (Sub'd, Block & Lot) Lo P 2 Q lac to 1. !ter, NAon Legal description (Township, Section & Range) Lot Size 33, I JL5 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank IR Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms S THIS APPLICATION IS AN: Initial Upgrade Renewal Ree (acemen,,t 7b n k' I) ra.^1*y of ex<rhv Co t/e'14're I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. 6 T W- (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: 2/10107 Date of Payment: Receipt Number: qe) Receipt Number: (Rev. 11/05) FL4ATTOP TECHNICAL SERVICES. CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. 14530 ECHO CANYON ROAD PH./FAX: (907)345.1355 ANCHORAGE, AK 99516 E -Mail: tgmoore@gcl.net September 10, 2007 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to replace a septic tank that is nearing collapse on Lot 2, Block 1, McMahon S/D. A site plan and specifications are enclosed for your review. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, J< I* vti Ted Moore. P.E. --------- - - - - ---- ------- ------ --- HUFFMAN ROAD LOT 3 R=100' ; ••`R=100' N401- 1 WELLLr— WELL J LOT 2, BLOCK 1 WELL 7 McMAHON SID R-100 / d HOUSE HOUSE EXISTING 1500 -GALLON SEPTIC TANK TO BE ABANDONED ----------- INSTALL NEW 1500 -GALLON SEPTIC TANK • SEPTIC ` -INSTALL DBL. C.O. AREA SEPTIC ` AREA _ :- 'EXISTING SOIL ABS. TRENCH TO BE RETAINED ---------------------- ------------------------------- --- ------------------------ LOT 11 ------------------------------------------------------ LOT 13 LOT 12 NO WELL WITHIN 100' .`�';.1R'.•:q, ,�� LOT 2, BLOCK 1, McMAHON SID ;,!• r - .f. �' SEPTIC TANK REPLACEMENT 49 DI k •� -kSITE PLAN ................ FLATTOP TECI INICAL SERVICES 1 INCH = 50 FEET .. THEODORE F.MOORE : J. 14530 ECI10 CANYON ROAD DRAWN BY TFM .� C - 3589 : 0 �cu0 ANCI IORAGf„ ALASKA 99516 SEPTEMBER. 2007 •�•• i� ed �Y NOTE: THIS IS NOT A SURVEYED PLAT. L=�"►� ALL LOCATIONS SHOWN ARE APPROXIMATE. Flattop 7echnicalSen ices 14530 Echo Canyon ! pazCylnchorage,AX 99516 Thone (907) 345-13S5 Lot 2, Block 1, I%Ic111ahon SID 3650 Iluffman Road Septic Tank Replacement Specifications 1.0 General: 1.1 The scope of the project consists of abandoning a 1500 -gallon steel septic tank with a collapsing baffle and replacing it with a new 1500 -gallon septic tank located as shown on the site plan. 1.2 Construction shall be as depicted on the approved site plan. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. 1.3 The installer shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The installer shall provide adequate cover material and rough grading over the tank to ensure that proper drainage is achieved after settlement and that there are no residual depressions. 1.5 The homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing 1500 -gallon steel septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1500 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet it shall be insulated with 2 inches of rigid insulation plus 2 feet of soil cover. 2.3 The existing lines from both the residence and the garage/shop shall be properly connected into the tank. A double cleanout shall be installed in the discharge line between the new tank and the point of connection with the existing soil absorption trench. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial discussion with the contractor to finalize the location of the tank and construction procedures, (2) after the tank is set level and piping connected but prior to backfill, and (3) after rough backfill and grading is complete. The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. ' MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME sow /Am �� E LZ � PHONE ❑ NE PGRADE MAI LI NG ADDRESS /' 23C� SSW l ` LEGAL DESCRIPTION LOCATION GG O/c /e p �C%J NO. OF BEDROOMS -� `! Uy Well f DISTANCE TO: - Absorption 9a Dwelling PERMIT NO. uJwzQ ~ Manufacturer Mat r' No. of compartments / Liq. capacity in gallons %. 0 a IF HOMEMADE: Inside length Width Liquid depth 1' JAZ DISTANCE TO: Well Dwelling PERMIT NO, O z a 2 F- Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well Foundation Nearest lot line PERMIT NO. J w Z F Z w No. of lines Length of each line Total length of lines Trench width inches Distance between lines F p Top of tile to finish grade Material beneath tile inches Total effective absorption area w Length Width Depth PERMIT NO. f7 a H wa Type of crib Crib diameter Crib depth Total effective absorption area W rn DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. W ;9 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING /V1� INSTALLER .�t ewX0Al &C, l� 77 REMARKS APPROVE / DATE LEGAL fie - 72 -013'( Rev. 3/78) DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION b l a 825 'L' STREET, ANCHORAGE, AK 99501 264-4720 EF; F�E"K!lrl 1E PERMIT NO. (,800093 APPLICANT BOB TAMBERELLI SRA BOX 1561-Z 349-5785 LOCATION Ht FFMAN AND FURROE CR. RD LEGAL LOT 2 BLK I MCMAHON SUB 1; LOT SIZE 33000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 5 SOIL RATING (SO FT/BR)= 127 - THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DDA INFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE 15 NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). FZEE"D U I FR! 1=1=a !F. Ez- F=* _T_ I C-7 _r n " l<_ !F- I a_;:fF= s :I_ !r' 0 El C -i n 1 L-11:1 " PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. � Fz" E: i::: BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON --SITE SEWAGE DISPOSAL SYSTEM is 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE 15 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F�E=FZMI'Y C_xE='97_.E:ME�F=F, :EZ -1 � A 59 0�3 C-1 I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDE": -ND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENC I-IREMODELE TO CLL MORE THAN 5 BEDROOMS. SIGNEM --------- 'APPLICHrA BOB TAMBERELLI ISSUED V4. 0 GRE' �� ANCHORAGE AREA BOk `N Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ' JA1A5 k2i' MAILING ADDRESS PHONE LOCATION I/IV l AAAI✓ % 4Jr LEGAL DESCRIPTION 4) 1 IIX1�FI14) SEPTIC TANK: DISTANCE / / i FROM WELL �f MANUFACTURER %/'I//g ' 6�L' MATERIAL NUMBER OF COMPARTMENTS / INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY. ---0 GALLONS. TILE DRAIN FIELD: y �7 TOTAL LENGTH a DISTANCE FROM WELL //` FOUNDATION f ' NEAREST LOT LINE �OF LINES g i NUMBER OF LINES j DISTANCE BETWEEN LINES 'fe TRENCH WIDTH "IN. TOTAL EFFECTIVE ABSORPTION AREA/ SQ. FT. LENGTH OF EACH LINE 1 DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE ABOVE TI LE_i�_IN. WELL: TYPE//6"�`z CONSTRUCTION F'"sDEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED DISTANCES: INSTALLED BY:/11%ls Y-- SEWER LINE DEPTH: 14� PIPE MATE ' LOT SLOPE: REMARKS:/L(J Form EQ -032 REMARKS DIAGRAM OF SYSTEM DATE%�`APPROVED G.A A V1 �N GRE' ANCHORAGE AREA Bok H _ PERMIT NO, DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 si weu- SEWAGE DISPOSAL SYSTEI�l® APPLICATION AND PERMIT J/I ej/P NAME OF APPLICANT ' • `-` G MAILING ADDRESS urY eel d f=v' /na INSTALLATION LOCATION LEGAL DESCRIPTION J�-Lo / `I��{`��],,/[[%%`�� 44 INSTALLATION OF:SEPTIC TANK `�'�t T', ELD '�-� '04,: FHER E TYPE AND SIZE OF FACILITY TO BE SERVED \ l `l FINANCED THROUGH TO%BBE, INSTAL D BY 1 SOIL TEST RESULTS /�/� ! • ` NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED - 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. SEPTIC TANK SIZE I &' Dick Soh o MINIMUM DISTANCES, I FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT IIREMENTS SEPTIC TANK TO SEEPAGE PIT WALL DRAIN FIELD SEEPAGE AREA SIZE TYPE — �u��m�r.1 SEPTIC TANK SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK �+ SEEPAGE PIT DRAIN FIELDALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK,SEEPAGE PIT / DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR ENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF G DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. // DATE 9 �4 APPLICANT'S SIGNATURE.L, FORM NO. EQ -016 OF SYSTEM WPM- OF P r{ o i .44 E AREA BOROUGH ORDINANCE NO. 28-68,AND THAT THE ABOVE io 6on1tzuetion 9zit -fag "One test is worth a thousand opinions" Sall TUDOR ROAD, ANCHORAGE, ALASKA 99607 a T[L[►MON[ �'►�" Performed For �$, "� %�%v,7��yr�� �� Date Performed -7.36 75 Lenal nescrintion: Lot Block / Subdivision 'C24 This Form Renorts Soils Loq Percolation Test— Denth Feet Soil Characteristic 2 3 4 5 tY ly %�i/l71-oIiM -/!JrUoU 7 4 _ I[n _W round Water Encountered? C) Sj o� If Yes, At wh t Depth? o & A/,/"/ 1��e- &a �-1M roce, wmm� �T AND Reading Date Qss T' T' e #1 100 or th e 40 t ba '.�ri�lJh �-1 u I— •� 7 5- a v r,s i It w If 7 0 75" o7/Sr3w►� �__ " �-1M roce, wmm� �T AND Reading Date Qss T' T' e #1 100 or th e 40 t ba �-1 u I— •� 7 5- a v r,s It If 7 0 75" o7/Sr3w►� �__ " Percolation Rate /'I 4o PlinuteS. Proposed Installation: Seenane Death of Inlet Ct)MMENTS: 30® SQ-,FJ-__J7Ri�fai46� Pit Drain Field Death To Bottom Of Pit Or Trench Test Performed By M"4 -C- o Data Certified By: !fou-5fT-s Date: 7/30/75 NATER WELL DR' LLURS LOG _DO 140T FILL IN Drilling Co.' t7-s-..���i 4 USL Drill1 J&/i`IDn �. � er tJ� �� Area Well Owner - i'i o f t - • /am AI up 6 //1' Use of Well Location (address of: Township.. Range, & Section (if known); distance from road: • -rf� rWILJ lit - Size of Casing Depth of Holeyfeet. Cased to feet. Static water levelfeet (ase) (below) land surface.- Finish of well (check one) Open end O Screen ( ): Perforated ( ). Describe screen or perforations: Well pumping test at' O gallons per (hr) (moi%) for I ours with feet of drawdown from static level. Remarkse�-�, WELL LOG Depth in feet from Give details of formations penetrated, size of material, ground surface color, and hardness. o , to P � to to�i..� �lD toto 119 IJ P to #777. 9 7 to 94 941 A to ea s.� (7e to 017 to to to to to to to sF.(Aff ,� �- MUNICIPALITY OF ANCHORAGE o Development Services Department r c Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 017.041-43 1. GENERAL INFORMATION Complete legal description MCMAHON BLOCK 1, LOT 2 Expiration Date: 2^Z 1 Location (site address) 3650 HUFFMAN ROAD, ANCHORAGE AK 99516 Current property owner(s) ROBERT & MARY ANN DAUENHAUER Day phone Mailing address Real estate agent 3650 HUFFMAN ROAD, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2l U -Y Z t I 5-0 Date of Payment 12'2-1 - 2-7 0 Receipt Number � t 23� COSA # SSG 2 © l %9-7 Waiver Fee $ Date of Payment Receipt Number Waiver # Dista 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350.9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 2/3/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the lt, well and septic system. Therefore, any estimate of how long a system will function satisfactory /�.%Q:' . • :1,9 �y� for current or future occupants or guarantee that no unseen encroachments, deficiencies or f discrepancies exist can be given by First Water Consulting & 49 TH FWES DSD SIGNATURE Curtis Huffman • : j System #1 Approved for bedroomsFcVs•, CE 128991 . Ar rep' . Z/3/2 IONQ� System #2 Approved for bedrooms \�\\PROESS0 � Disapproved Conditional approval for bedrooms, with the following stipulations: Ali W(9 N� O d vo(. �-�it (Tr ON_s T U1 WA ,-RAND m T n PRO E Gf,,�eA_ R SERVICE By: v`^' Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) 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 Legal Description: MCMAHON BLOCK 1 LOT 2 Parcel ID: 017-041-43 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/23/1975 Total depth 89 ft Cased to 89 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/9/2020 Static water level at beginning of test 58 ft. Well production at time of test 5.8 qpm Comments B. TANK DATA Age of tank(s) NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA Which system tested (date installed) NEW FIELD ® ALL standpipes present per record drawing Total measured depth from grade 14.2 ft (max) Measured depth to pipe invert from grade 4.1 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 5.04 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by F ES Date of Sample 11/30/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date NA Results ❑ Pass For bedrooms Fluid depth prior to test 0 in Water added gal New depth in Elapsed time min ® Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons FWC Comments/Deficiencies: NO FLUID OBSERVED IN 1975 SUMP —SUMP EXTENDS 1.5' BELOW INVERT:,:: 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 Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Community Sewer Main > 75' ®Yes if No ft Manure/Animal Excreta Storage > 100'® Yes if No 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 Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No 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 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' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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. Qj,• *; TH • • • •• • Curtis Huffman: i ! ���, •. CE 128991 ft ft ft ft ft ft ft ft www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC201687 Subdivision: McMahon, Block: 1 , Lot: 2 A water sample revealed a nitrate concentration of 5.04 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P 'O Box 196650:* Anchorage, Alaska 99519 6650 *www muni org From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box 196650* Anchorage, Alaska 99519 6650 *www muni org MUNIC�PAUTY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 017-041-43 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description MCMAHON BLOCK 1, LOT 2 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: `S^ 9 -Z021 Location (site address) 3650 HUFFMAN ROAD, ANCHORAGE, AK 99516 Current property owner(s) ROBERT & MARY ANN DAUENHAUER Day phone Mailing address Real estate agent 3650 HUFFMAN ROAD. ANCHORAGE. AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ a 10 Cxv [ � -1 °I Waiver Fee $ Date of Payment od V o Date of Payment Receipt Number 6 3 yrs Receipt Number COSA Waiver # 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 12/18/2020 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to of A,q�l�l these various and dynamic characteristics and are outside the control of the evaluator of the `v well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q:. .•,9 �)� for current or future occupants or guarantee that no unseen encroachments, deficiencies or f J discrepancies exist can be given by First Water Consulting & FE ' * . 9 TH ....•.* r .. 6. DSD SIGNATURE Curtis Huffman System #1 Approved for bedrooms CE 128991 System #2 Approved for bedrooms � pF�pR FESSIONA��� Disapproved Conditional approval for bedrooms, with the following stipulations: lit i o�,s yon SGA A, J)��%�I1i111)?il� VIA_II� l`'— Original Certificate Date: 2'^� The Municipality of Anchorage Development Services Division (DSD) 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 Legal Description: MCMAHON BLOCK 1 LOT 2 Parcel ID: 017-041-43 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 9/23/1975 Total depth 89 ft Cased to 89 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/9/2020 Static water level at beginning of test 58 ft. Well production at time of test 5.8 gpm Comments B. TANK DATA Age of tank(s) 12 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 49" ® Standpipes/foundation cleanout per record drawing Date of pumping 10/22/2020 D. ABSORPTION FIELD DATA Which system tested (date installed) PENDING NEW 5 -BR FIELD — EXISTING 4BR FIELD 9/30/1975 ® ALL standpipes present per record drawing Total measured depth from grade 5.7 ft (max) Measured depth to pipe invert from grade 4.2 ft (min) ❑ N/A — pressurized field Structure served by this system Water storage tank volume NA gallons ' Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate 5.04 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) FWCS Collected by Date of Sample 11/30/2020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date NA Results II Pass For bedrooms Fluid depth prior to test 0 in Water added gal New depth in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective 1.5'+/- INTO THE IVED Final fluid depth in ® Code -required soil cover over field Absorption rate gpd ❑ System presoaked Any rejuvenation treatment (past 12 months) N (Required if vacant for greater than 30 days prior to date of test) If yes, enter date Gallons introduced gallons F Comments/Deficiencies: NO FLUID OBSERVED IN 1975 SUMP — SUMP EXTENDS 1.5' BELOW INVERT 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' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No 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. Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No. Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No. 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 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' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water? 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 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. or- .. .. ............. Curtis Huffman �F`•• CE 128991 +/ ,0DArr*^111 !`tA -AOr ft ft ft ft a"1 ft ft ft Nitrate Advisory Certificate of On -Site Systems Approval # OSC 201687 Subdivision: McMahon Block 1 Lot 2 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 5.04 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. it may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.