HomeMy WebLinkAboutMCMAHON BLK 2 LT 5 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251013 PID Number: 017-041-27 Dwelling:* Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 9 Upgrade Name MICHAEL & SHERYL GALE A ORPTION FIELD ❑ De Trench ❑Wide Trench ❑Bed ound Site Address 3800 MCMAHON AVE, ANCHORAGE, AK Other Phone Number of Bedrooms Soil Rating Total depth f original grade 907-242-3925 3 ISF Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Ft. Subdivision Block Lot MCMAHON 2 5 Fill added above original gr Ft. G I length Ft. Township Range Section ' Gravel width Ft. Beds: Number of Lines - Dis a between lines Ft. SEPARATION DISTANCES To, Septic Absorption Lift Station f Holding Sewer Total orption area Number of trenches Dist. between fiches From Tank Field Tank Line Ftz Well l 100'+ EXIST. - _ 25'+ TANK ® Septic ElS.T.E.P. ❑ Holding El Other Manufacturer D&S CONCRETE Capacity 1000 Gal. i (EXIST. � Surface Water 1 QQ'-�- I - - Material CONCRETE Number of compartments 2 Lot Line 5'+ EXIST., - - { NA Foundation 5'+ EXIST. - - ATION Manufacturer :;:>41 pacity Gal. I Remarks 7Alarmlocatione;Rr ailed by PIPE MATERIAL House to tank D3034 Tank drainfie ld D3034 Installer NORTHERN EXCAVATION Drainfield EXIST. co/MTD3034 Inspector GARNESS ENGINEERING BENCHMARK (Assumed elevation) 100.00 ft Inspection �, 1 2/17t2025 Location and description dates: 2„" - FRONT DOOR THRESHOLD 3ra 4,, ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date5�� '1 V 49 — — - ---- --------- -- - — ----- — — -- -- D Septic System Approved Date 7/ frCrness, E , 7Q`o3 Note: this approval does not include well permit requirements.AEccse4 �1�o���d� (Rev 05/02/18) I PERMIT OSP251013 RECORD DRAWING PARCEL NUMBER: 017-041-27 I I I I I I I 1 1 1 I 1 1 \ \ MCMAHON; BLOCK 2,LOT 4 11 A B FCO 1 21.5 1 22.3 nRl 1 I q41 I 3(1.6 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. w V McMAHON AVE \ 00' WELL RADII GENERAL LOCATION \ ! I ! I � ! I i _ I I I I I I I i I I I 1 I 1 I 1 I 1 I 1 I \ j i I EXISTING \\ 3-BEDROOM \ HOUSE �\ j I \ \ I Le\ DOUBLE CLEANOUTS FQyl�-0,1 (DBL1 & DBL2)__-- .—HOT CGS % STi TUB O� NEW 1000-GALLON \ CONCRETE SEPTIC TANK DOUBLE CLEANOUTS (DBL3 & DBL4) CO/MT � SHED 'A —EXISTING SEEPAGE PIT AND ASSUMED PERIMETER OF EDGE W OF DRAINROCK. PASSED SEPTIC V) ADEQUACY TEST RECENTLY NOTE: GEG CONSULTANT, JODY MAUS, NOTE: PER THE CONTRACTOR, THE OLD SEPTIC TANK WAS PHYSICALLY MEASURED 115'+ FROM WELL ON LOT 4 TO CO/MT FOR SEEPAGE DECOMMISSIONED IN PLACE PER UPC. PIT. PERIMETER OF DRAINROCK IN UNKNOWN AND WAS NOT VERIFIED. GARNESS ENGINEERING Ltd 9 ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, ALASKA -PHONE (907) 337-6179' WEBSITE: www.gamessengineemg.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SHERYL GALE 907-242-3925 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 2, LOT 5 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK UPGRADE 3/11/2025 z Z W uj J_ in MCMAHON; BLOCK 2. LOT 6 0 ...:................... ♦ r^i e 7 Y A. ss LICEN +44, ®�dFESS� ®®• #AECC884 >o®®�®� PERMIT NUMBER: OSP251013 RECORD DRAWING PARCEL 1NUMBER: 017-04-27 I TOP OF T INLET = INVERT OF FERt BUNG @ INLET = 1000-GALLON D&S CONCRETE SEPTIC TANK GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE. ALASKA -PHONE (907) 337-6179' WEBSITE: w .ganre ngheef4v.=n PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SHERYL GALE 907-242-3925 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 2, LOT 5 J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC TANK UPGRADE 2/25/2025 27 =FERNCO TLET = 91.01 ®*s'®aTAti® ...... ..a .... .................. �.Y ..... .............. r A. �rness re !: C 793 '_r ,,�` LICENSE R®ft E� ♦®O�� #AECC684 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251013 Work Type: SepticTank Upgrade Tax Code Number: 01704127000 Site Legal Address: MCMAHON BLK 2 LT 5 G:2835 Site Mailing Address: 3800 MC MAHON AVE, Anchorage Owner: GALE MICHAEL J & SHERYL D Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 1 /29/2025 1 /29/2026 31317 ❑ Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: , S S �'� `' C r C Issued By: L Date: Date: S f I 14o Z 5 3 UU-11UNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-041-27 Property owner(s) MICHAEL & SHERYL GALE Day phone 907-242-3925 Mailing address 3800 MCMAHON DRIVE, ANCHORAGE, AK Site address 3800 MCMAHON DRIVE, ANCHORAGE, AK Legal description (Sub'd., Block & Lot) MCMAHON; BLOCK 2, LOT 5 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial 0 Single Family (SF) FX-1 (w/wo ADU) Septic Tank f X-1 Upgrade N Duplex (D) ❑ Holding Tank 0 Renewal 0 Multiple Dwellings D Privy 0 (SF and/or D) Private Well M Water Storage El THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 2 2 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. l�P 2 5101 � Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTorrns\Client ForrnsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251013, Curtis Townsend, 01/29/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251013, Curtis Townsend, 01/29/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251013, Curtis Townsend, 01/29/25 ASPLS MORTGAGE LOCATION SURVEY NOTES: (Z) Al-CMAHON AVE. (EAST -140.001) 56 8' 1 247 247 31.6' AD TWO STORY z RF'SIDENCE 20.7' z 63,9'— 0 TV 14.3' lJO T 4 100'WELL BLOCK 2 RADIUS c\j A.ppx� TLOC Sj" i,,\ K F 1) B Y 0'VvN EIR, HOT TUB 75; ry 0 10 CD 0 CD LO T 5 CD CT BLOCK 2 CD FSHED 0) m SHED C/) 10' UTILITY ESMT. E E E E r r p E E E E (S 88" 17'21 pt E 140-07') LOT 18 LO T 17 B I _jOCK 2 BLOCK 2 NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE RECORD PLAT. THERE V/;Y BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE CONDITICNS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MA" DISCLOSE, THE INFORMATI01N CONTAINED IN THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIAB - ILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. A RECORD DATA PER PLAT #65-86 0 FOUND 1/2" IkEBAR, NO CAP EDGE OF AS PHAL T FENCE E E- OVERHEAD UTILITIES pp POWER POLI NVELL (R SEPTIC PIPE [A DECK LOT 6 13LOCK 2 kk OF At,41 S� kt of 3o" ' 9 a 0 * & 60AMW Z+qTH SCALE: V =- 30 FEET fl (11 X.1.7 01F -Ryon G.0 Johnsona-,,,, Low WINTEJZ S UR VE Y NO TE: +/- 6 DVCHES OF a, No. 192159 S NO W SITE A T T1 ME OF S UR VET: ONLY t�' e�lb-.1211612OZ4"C« • VISIBLE IMPROVEA41,,NTS SHOWN HEREON. AW AS-BUILI'OF: 1-JOT 5�; BILOCK 2 Mcl\4A,_H0T�Z S_UTBE)'IVISIOT,�*4 PEAT #-(-86 ADDRESS: 38 McMAHON AVE, ANCHORAGE., -A-K LOCATED IN: ANCHORAGE ]_ CORDING DISTRICT LO T 16 TIMBERLINE SURVEYING AND MAPPING MOAGRID:SW2935 1703 5 13ARONOFF AVE FILE ]KO.: 24.237 BLOCK 2 EAGLE RIVER, AK 99577 SCALE: 1 3 0 FEET 907-242-5320 DATE: 12/16/2024 ryan@ti.mberlinealaska.com SHEET: I of I GRE' 'ER ANCHORAGE AREA BO: UGH  Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 NAME INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM /~/~/,/'~/~ //'~//~/~/Z/~ MAILING ADDRESS ~"~' ~/~' ~ ~''Tz~ PHONE SEPTIC TANK.~'-/:~~/~:':~ ~ '/~'/J/"' ~'~' ~';;~7/~'~//x' D STANCE FROM WELl ?[-'~ MANUFACTURER ~',/~<~/" ,/~z~ MATERIAL INSIDE LENGTH ----' INSIDE WIDTH ~ LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY ~'~'~ GALLONS. SEEPAGE PIT: NUMBER OF PITS // DIAMETER ~<'~" OR WIDTH ~2~,/ LENGTH-2'~, DEPTH LINING MATERIAL,~2-4~-;~' ',~.'~'~-~z~'~'CRIB SIZE: DIAMETER~"~ DEPTHr DISTANCE FROM: WELL / BUILDING FOUNDATION -2'ZI?/-, /2~,/;~'.~/ TOTAL EFFECTIVE . NEAREST LOT LINE ' ~'~-~/. ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE BUILDING FOUNDATION CESSPOOL -- APPROVED CONSTRUCTION /2~/~c-~. / %. Z~-/]/L _/J NEAREST /d/,/?z; ~' ' NEAREST LOT LINE 2~z/ , SEWER LINE /./)?¥ OTHER SOURCES /t~ ~ /~/~/~/~_//~2 DISAPPROVED REMARKS DEPTH .... DISTANCE FROM: SEPTIC /'//~/,,X~? SEEPAGE TANK. /~YO' , SYSTEM / DISTANCES: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM DATE GreaTer ANChorage AReA BOrOUgh /, ] -' ~ !" ' il~'' ': PERM T NO. DEPARTMENT OF ENVIRONMENTAL QUALITY ,L' %:' 3330 "C"STREET ANCHORAGE, ALASKA 99503 / /~ SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK ~ SEEPAGE PIT DRAIN FIELD ~ ., OTHER TO BE INSTALLED BY NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINANCED THROUGH SOIL TEST RESULTS J 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. MINIMUI~J DISTANCES, REQUIREMENTS ) FOUNDATION TO SEPTIC TANK POUNDATION tO BEEPAGE PIT . DRAIN FIELD . SEPTIC TANK TO SEEPAGE PIT WALl SEPTIC TANK ., SEEPAGE Pit ~ DRAIN FIELD WELL tO sePTIC taNK /~ ) , seepage Pit DRAIN FIELD /~ ] ALSO CONSIDER Area WELLS, WATER MaIN TO SEPTIC tANK /~ ~ SEEPAge Pit DRAIN FIELD SEPTIC TANK, /~/ SEEPAGE PIT/~ ., DRAIN FIELD /~ ] I EXCAVATION 5 FEET INTO UNDISTURBED SOIL· 4 INCH DIAMETER CAST IRON S~PHON PIPES ON SEPTIC TANK AND seePAGe PIT FITTED W~TH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION· OR LICENSED DESIGN DIAGI~AM OF SV'STE~I I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. Performed For Legal Description.: This Form Reports ANCHORAGE, ALASKA 99502 Richard J. Blumer Date Performed,, August 3, 1973 Lot 5 Block 2 Subdivision McMahon Soils Log ~ Per'c01ati0'h' ~est Depth Feet 6-- 8-- 10-- 16.--- 18-- Soil Characteristics Tan Sand - Silt Mix (ML) Gray Silty Sand (SM) with silt and poorly graded sand seams With scattered gravel to 14' Ground Water Yes,,'At What Encountered? No Depth? I Reading Date Gross Time Net Time I Depth to H20 [ Net Drop I · nu te . Proposed Insta~'l'ation: Seepage Pit xx Drain-Field Depth Of Inlet Depth To Bottom Of Pit Or Trench 'COMMENTS;..250 square ~etofdrainage area isrequired per bedr'oom below 7 ~otdepth. ' .... Yest Performed By R.F~__C~li.m, le.__ Data Certif'ied BY: ,-'//ex/ - '~ 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 OSC251090 Parcel ID 017-041-27 Legal description MCMAHON BLK 2 LT 5 Expiration Date: 51zo Z -5 site address 3800 MC MAHON AVE Current property owner(s) GALE MICHAEL J & SHERYL D X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: 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 Tank Age Advisory Nitrate Advisory Arsenic Advisory Other MUNICIPALITY OF Development Set -vices Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-041-27 Complete legal description MCMAHON; BLOCK 2, LOT 5 Location (site address) 3800 MCMAHON AVE, ANCHORAGE, AK Current property owner(s) MICHAEL & SHERYL GALE Day phone 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS 907-242-3925 3. TYPE OF WATER SUPPLY: RE Private Well R Private Well serving 2 dwelling units F-1 Private Well serving 3+ dwelling units Fj Community Well or Public R Water Storage 4. TYPE OF WASTEWATER DISPOSAL: � Private Septic E] Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel E] Plastic 0 Concrete F-I Fiberglass Age NEW _ See advisory if steel older than 20 years 6. ABSORPTION FIELD: 0 AWWTS R Bed R Deep Trench R Wide Trench X Seepage Pit Waiver request for: Expedited review requested: El 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$ -5 SO Waiver Fee $ Date of Payment Date of Payment COSA # D 5 C— Q 0 Waiver # COSA Applicalion—June 2022 COSA Checklist Legal Description: MCMAHON; BLOCK 2, LOT 5 Parcel ID: 017-041-27 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA M Well log is filed with Onsite (or attached) Date drilled 611611974 Total depth 99 ft Cased to 99 ft FS-1 Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 12/19/2024 Static water level at beginning of test 54.4 ft Comments B. TANK DATA Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 611974 F01 ALL standpipes present per record drawing Total measured depth from grade 15.9 ft (max) Measured depth to pipe invert from grade *6•9 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. R 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) NIA If yes, enter date Well production at time of test 6.1 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes FM No 0 Coliform bacteria is Negative Nitrate 9.48 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by GEG, LTD. Date 12/19/2024 STATION ❑ Require Age of lift station Lift station r Adequacy test date 12/19/24 Results Q Pass Fluid depth prior to test 96 in Water added 519 gal New fluid depth 108 in Elapsed time 130 min Final fluid depth 101 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 108 in Effective depth used 101 in Effective depth remaining 7 in Comments/Deficiencies: *ASSUMED. BELIEVED TOP OF CRIB IS 5.6 BELOW GRADE. SYSTEM IS ALMOST 94% FULL. IT IS REASONABLE TO BELIEVE THAT THE DRAINFIELD IS APPROACHING THE END OF ITS USEFUL LIFE. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' EYes if No ft ME Yes if No ft Neighboring Tank > 100' R] Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No It Absorption Field on Lot > 100' no Yes if No ft Holding Tank > 100' RYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Yes if No ft ❑i Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' nnYes if No ft R Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' E Yes if No ft Surface Water > 100' R Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' ■❑ Yes if No ft n Yes if No ft Yes if No ft 0 Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' M Yes if No ft 0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *PHYSICALLY MEASURED 115'+ FROM WELL ON LOT 4, BLOCK 2 TO SEEPAGE PIT ON LOT 5, BLOCK 2. EXACT PERIMETER OF DRAINROCK FOR SEEPAGE PIT IS UNKNOWN. 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 Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation, Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 OF' o 4 T y* Q ff ey rness; I�CE?JSE�Q rofesSion �40Ooodo ao �ccaea MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT f 5 907-343-7904 On -Site water and wastewater Section Fax: 907-343-7997 www.muni.org/onsite Septic System Absorption Field Advisory Certificate of On -Site Systems Approval # OSC251090 Subdivision: MCMAHON , Block: 2, Lot: 5 Prior to the absorption field adequacy test, 101 inches of standing water was observed in the absorption field. This indicates approximately 94% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. ; 4700 Elmore'R *;4nchorage Alaska 99507,`� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT I` '�� 907-343-7904 On -Site water and wastewater Section a r Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC251090 Subdivision: MCMAHON , Block: 2, Lot: 5 A water sample revealed a nitrate concentration of 9.48 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. 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. ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Bill To: Sheryl Gale 3800 McMahon Ave Anchorage, AK 99516 Invoice Ship To: Sheryl Gale 3800 McMahon Ave Anchorage, AK 99516 20252875 SALESPERSON YOUR NO. SHIP VIA COL PPD SHIP DATE TERMS DATE PG. RIDGWAY, TYLER S 39784 Net 30 1/20/2025 1 TY. ITEM NO. DESCRIPTION PRICE DISC % EXTENDED PRICE TX. 1 Service Call HIGH NITRATES -CAMERA WELL FOR INCURSIONS 1 FIELD SERVICES 01/17/25 - Check system. Open up 6X1 well $258.00 $258.00 seal to gain access to well casing. Camera well to search for incursions. No incursions or damage found in interior well casing. Reinstall 6X1 well seal. NO INCURSIONS OR DAMAGE FOUND IN INTERIOR WELL CASING. 1 ST5-Tyler Service Tech 1 ST19-Dennis Service Tech Helper 1 CAMERA WELL CAMERA $400.00 $400.00 SALE AMT. $658.00FREIGHT We appreciate your business. Thank you! $0.00 SALES TAX $0.00 TOTAL AMT. $658.00 PAID TODAY $0.00 BALANCE DUE $658.00 S HED SHED 31.6'1.5 '24.7' 27.3 ' 20.3'1.6 '20.7' 16.0 ' 14.3' 16.0 ' 1.0' 24.2 ' 100' WELL RADIUS RESIDENCE TWO STORY ELEC. GAS HOTTUB LEGEND FOUND 1/2" REBAR, NO CAP DECK FENCE OVERHEAD UTILITIES POWER POLE EDGE OF ASPHALT RECORD DATA PER PLAT #65-86 SEPTIC PIPE WELL SEPTIC TANK LID TIMBERLINE SURVEYING AND MAPPING 17035 BARONOFF AVE EAGLE RIVER, AK 99577 907-242-5320 ryan@timberlinealaska.com FILE NO.: 24.237 SCALE: 1" = 30 FEET DATE: 3/17/2025 SHEET: 1 of 1 MOA GRID: SW2835 SCALE: 1" = 30 FEET(11"x17") 30'0' 60' AS-BUILT OF: ADDRESS: 3800 McMAHON AVE, ANCHORAGE, AK LOCATED IN: ANCHORAGE RECORDING DISTRICT LOT 5, BLOCK 2McMAHON SUBDIVISIONPLAT #65-86 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) o Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent ~c~! h1~(~- /~f~_~k~ Address [.¢ ¥_7 ~" ..o/.., Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ..3 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: Day phone If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #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 Address Engineer's signature DHHS SIGNATURE /~ Approved for Disapproved. Conditional approval for Phone Date bedrooms, with the following stipulations: By: Additional Comments Nmi-e: Municipal Codes. There Tb~ well for this~me~ts the State and are nitrates present. It is suggested that periodic testing be performed f~ ~n~3r~ the wells confinu~d. suii'abilitv. ~ate/~/~re 8.3 mg/1. EPA maximum is 10 mg/1. ~?/~/~--~/q3/~.¢~/~ Date~////~/~- ~ 7~., The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to 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~]25 (Rev, 1/91) 8ack MOA #21  Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L ~ '~2 ~¢M/tI~0N Parcel I.D. ~/~-~ RECEIVED SEK ] ...,-' o~.l~oiLiil 8 1991 A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C. attach ADEC letter. ADEC water system number (,~,-~ ec4) Date completed / / Cased to ~ 7 /'/~ Driller Casing height Wires properly protected (Y/N) 12" Y Date of test Static water level Well flow Pump level FROM WELL LOG g.p.m. AT INSPECTION g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Ici~ F'R.~t ¢.0. Absorption field on lot ~%"/ F~o~t ~,O. Poblic sewer main ~/~ Public sewer service line ~\//~ ; On adjacent lots ;,/oo ' ; On adjacent lots ~/oo Public sewer manhole/cleanout '~//~ Petroleum tank WATER SAMPLE RESULTS: Coliform 0 Date of sample: ~'/3/~// Nitrate m~/~- Other bacteria Collected by: ~ LATToP 'TECt-). B. SEPTIC/HOLDING TANK DATA Date installed ~/'7~ ~/~ ~"/~' Tank size [OOO Compartments Cleanouts (Y/N) ~ Foundation cleanout (Y/N) ~ Depression (Y/N) High water alarm (Y/N) ~/~ Alarm tested (Y/N) N/,~ Date of pumping 5-/ 7 / 21 ~ ~/ ! SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot lot ~ F~ C.O, Onadjacentlots //(o ~ F~'~h C.O. Foundation Topropertyline ~/o~ Absorption field L/O' ¢.0, ~-o ¢.o. Watermain/serviceline Surface water/drainage ~/o0' 72-076 (Rev. 3/91) Front MOA21 CONTINUED ON BACK PAGE C. LIFT STATION ~,1,/~. Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed (o/ [~1~ p~ Rtlv~TE R. J~rrcjt h Total absorption area Depression over field (Y/N) Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Soil rating 250 ~'/BDRN Systemtype 5E-EP, ~IT Total depth If yes, give date Gravel thickness Cleanouts present (Y/N) Date of adequacy test for bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: To building foundation On adjacent lots Surface water ,~, /oo Curtain drain Onadjacentlots II 5'~ F¢or~ ¢.0. Propertyline To existing or abandoned system on lot Cutbank ~.~. Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION Signature Engineer's Name Date /~ c~, I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. . ,:':, · ;.'~: ', ' % C( - 35;3 2 ?,,.;;' HAAFee$ / ~0 Date of Payment ~'-~ / Receipt Number ~%~-~'7 ¢ 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number Star E;o~t e .'-..ncC. oz'.age, f.~aska 5."9j32 inch cased water well drilled out to the depth of 99 feet. Drilled at the 'rate of $15o00 por foot. Property ovmer: .('~o Dick ~i~z~a?.er 333-5105 Location of we~ elto:' Lt. ~, B~;. ~ S~odi~sion: ~ ~z'~¢~ ~ L~ill~r: 2er~s Claus of F~part ~ill~g works 3~'-7714 ~el! ~g~ 0-~37' S~ndy clay ~tha few l~ge coppies. ~' 37--63.' ~&~P~-Gravel ~d blue clay compress~. .~. '~ ......63-j~7' dravel~ ~e~ he ~i~l~ug -~th one boulder d. rill¢ through ~ 90 fe.-t~ 97-99~ ',,¢%T&& be~g gravel~ 24 ~ches only me.;Lug 8GP;4- There is only 15 feet of w~ter hazd ~ c~s~g but ~-~th ~ %~ediate recove~*. Oost includes ~ll labor ~ud material for completion of said ?~611. ~':&ke check payable to ~%part ~il~g Wo~4(s for the s~:~ oF $1485.00 Th~2< you very much Bernie Claus of P~mpa~-'; L¥ii_k~,~.' Wor?:s RECEIVFD ./¢¢, & Dept. Health & Human Ser_vices