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HomeMy WebLinkAboutMCMAHON BLK 3 LT 4 Municipality of Anchorage Stii,jMITTAL Community Development Department Page of 3 On-Site Water& Wastewater Program Si---P - O 1 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: OSP171191 PID Number: 017-042-04 ❑ New •Upgrade Name: ROBERT RUSSELL ABSORPTION FIELD Address: ❑ Deep Trench ❑ Shallow Trench 0 Bed aund 12540 FURROW CREEK ROAD *ANCHORAGE, AK 0 Other Phone: No.of Bedrooms: 3u'I Rating: Total Depth From orgi ade. 903-1607 3 GPS,Ft, Ft LEGAL DESCRIPTION Depth lopipe mm invert \``v�� c. Subdivision: Block: Lot: Fill added above original grade: / ` Gravel length: Ft. MCMAHON 3 4 VVV. Ft Ft. Township: - Range: - Section: - Gravel width: Beds Number of lines: Distance between lines: Ft FI. SEPARATIONDISTANCES }Dial ahsmp area: Number of trenches: Dist.between trenches: To Septic Absorption Lift Holding Public/Private From Tank Field Station Tank Sewer Lines SQ.Ft. FI Well "80' - - 25'+ TANK IN Septic ❑ S.T.E.P. ❑Holding ❑Other Manufacturer Capacity. Surface Water 100'+ . . - GREER 1500 Gal. ti`- y Maleenl Number of compartments: Lot Line 6 + 4.'r - - N/A H.P.D,E. 2 Foundation 5'+ LIFT STATION Curtain Drain NONE KNOWN ----4-- Manufacturer C-• I Gal. Remarks: 'WR#OSV 171072 "Pump on"level at: "Pump off"level al: (High water alarm at: PER CONTRACTOR.OLD SEPTIC TANK WAS DECOMMISSIONED PER UPC Pump Make 8 Mode- Electrical Inspections performed by: PIPE MATERIAL EXISTING/ EXISTING/ House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES, LLC Drainfield EXISTING CO/MT EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Dates: 1st7/94/7017 2nd - Location and Desorption: 3rd 4th - BOTTOM OF TRIM @ NW CORNER OF HOUSE ENGINEER'S-EAL Community Development Department Approval ��.+•`— !ltS,� �P� . +�i . ` Conditional approval: Date: �•°• �A, *•• ;4.71 4 IH • •SIA . ... • •• Garne-- i t45 i — •1 �J,� CE al It •�: — __ i I rf r� Iry .•.;Fo .'. 1.4•••<<, 4.424, _4,- Approved: —� ` ,_ L--- r _..`;�._��. Date: 0 L j s C1J f LICENSE.bPl ' SS\M4"4 V MAECC884 ����+ Inspection Report 1-1.12.6oc c PERMIT NUMBER: RECORDDRAWING PARCEL ID NUMBER 1 OSP 171191 017-042-04 A B C / --- - DBL1 26.9 10.8 27.6 .��+�--_---- DBL2 26.0 10.8 28.5 / 'i'�'+~ \ ST1 25.3 15.0 33.8 / ii� 1 `�`�`• ` ST2 29.1 19.8 37.3 •+ DBL3 31.5 31.6 38.3 / MCMAHON'.BLOCK 3.LOT 3 \ `•\` DBL4 32.2 22.1 38.2 / ,1 \ • •\ • J / l /� N tt 1 PERIMETER 1 yy ` 1 /' OF EXISTING I 80' ELL RADIUS i r SEEPAGE PIT I I 100'WELL RADIUS IS UNKNOWN i r I NEW 1500 GALLON H.D.P.E.SEPTIC TANK r 4 • I A 1 ' I- 6:',6‘1:, W DBL4& MT31� �� B ;; •4 :.*:....46...�� ` 1N EXISTING - - f'•'••:�:•��• ' : '� �•• / w BEDROOM HOUSE ..:..��•."•.''•.' ' . .. > \ 1- ,!DRIVEWAY}':Rf"'� 1 1- ' i gIIIIII f 7, _ / ..•.Vim'_•';:,•• -.-••} •� •O,T'/,. o UNKNOWN WHERE ¢ "...1.',....%;.'' .,-'''• " .1 SEWER LINE \ �I• �.� ` ENTERS HOME air J11rAlll y �`,:. - EXISTING , . - .F. r-, ..41.,f,*.. ,<•''�• / \ TRENCH RV CO. �..47 ,.,..:".->`rr••.�Syf7 .;,. .r. .• , r f. �•' • RV TENT ::• `.r••.. 4 1 � DRIVEWAYI. .!--.,:-..j.-'.:-.. — MCMAHON:BLOCK 3, LOT 5 / / / N I ISCALE. I1'=40' _.. , .1..._ . • *, GARNESS ENGINEERING GROUP Ltdr... 4'..':..Iii 0 �'` .•��* CIVIL&ENVIRONMENTAL ENGINEERS -� - 0 • • 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE.AK 99507•PHONE(907)3376179•FAX(907)338-3246'WEBSITE:mencgam888gnipm, ,r,gppn . •. PREPARED FOR: PHONE NUMBER PAGE NUMBER: `. J: •y A. Garness = ROBERT RUSSELL 903-1607 2 OF 3 11 -" r. C4-79,3 ° • PROJECT/LEGAL DESCRIPTION: DRAWN BY •.♦ ' (-• -4 MCMAHON; BLOCK 3, LOT 4 L.K.B. •`c'Q�••.. • II. (`. TYPE OF WORK: DATE ',�� ESS1"' . S RECORD DRAWING 9/5/2017 OAECC884 M�a�m�eA� r 0SP171191 RECORD DRAWING ID NUMBER: 017-042-04 ST1 ST2 FINAL GRADE=99.13-99.32 7 2'INSULATION TOP OF TANK AT INLET=95.78 TOP OF TANK AT V///////////i f////////////////, '(//////////// OUTLET=95.79 INVERT OF BUNG J AT INLET=94.83 INVERT OF BUNG NEW 1500 GALLON HDPE TANK AT OUTLET=94.66 .400010111 II Ill i_111.57 .rGARNESS ENGINEERING GROUP, Ltd V.......' II CIVIL&ENVIRONMENTAL ENGINEERS , •,•- ,• 3701 E.TUDOR ROAD.SUITE 101.ANCHORAGE.AK 99507'PHONE 1907)3376179'FAX(907)338-3246'WEBSITE.www.garnessengineenng.com . •••• • Y•_M PREPARED FOR: PHONE NUMBER: PAGE NUMBER: r _; A. - 3 J ta.! iii ROBERT RUSSELL 903-1607 3 OF 3 0.61%, • I E 95 � PROJECT/LEGAL DESCRIPTION: DRAWN BY: •..f<4;�....• •. /1‘ / ` C 4 MCMAHON; BLOCK 3, LOT 4 L.K.B. �. 0•••••••. {{{....•_,u,'„*.•4P TYPE OF WORK: DATE: 44LICENSE OFESS‘T�* ` RECORD DRAWING 9/5/2017 AECC884 `II amiss... • _,'" ALtr• , MUNICIPALITY OF ANCHORAGE �►j� -� �R ,�t�li II On-Site Water&Wastewater Program 5•,, / • PO Box 196650 4700 Elmore Road Anchorage.Alaska 99519-6650 Phone: (907)343-7904 Fax: (907)343-7997 http Nwww.muni.org/onsite l), l,,lrt iii ni On-Site Wastewater Disposal System Permit Permit Number: OSP171191 Effective Date: 7/19/2017 Work Type: SepticTank Upgrade Expiration Date: 7/19/2018 Tax Code Number: 01704204000 2`� f ( � 60 E-( 3,l t_ Site Legal Address: MCMAHON BLK 3 LT 4 G:2835 Site Mailing Address: 12540 FURROW CREEK RD, Anchorage Owner: RUSSELL ROBERT J 50% & Lot Size in Sq Ft: 37089 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 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 20/1 1 CO 1 : T_A --ems size -1.0 1 560 Daton Received By: V' Date: t/2-1317 Issued By: /24)-66049,1/4 -e/ Date: 7 711/620 l /620 1 7 Municipality of° Anchorag ^�� I„r ray mparnnen!nl P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http:llwww.muni.orglOnsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver# OSV171072 COSA#: Permit#: OSP171191 PID#: 017-042-04 Legal Description: McMahon Block 3 Lot 4 Engineer: Garness Engineering Group Applicant: Rob Russel Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 80.0 feet. Although well had nitrate readings in 2016, proposed tank is HDPE which will not corrode, so should not leak. The topography of lot slopes down from the well towards the septic system. So if effluent surfaced, it would be directed away from the well. This waiver approval applies to the proposed septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. n The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. Fl Adjacent properties are not affected by this.waiver. Waiver is Granted: X Waiver is not Granted: Date: 1 11( Approved by:/2Oi Name of Reviewer **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORA f= Community Development Department - Phone: 907-*- y- Development Services Fax: 907- 343-7997 On-Site Water &Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-042-04 Property owner(s) ROB RUSSEL Day phone 903-1607 Mailing address 12540 FURROW CREEK ROAD`ANCHORAGE, AK 99516 Site address 12540 FURROW CREEK ROAD*ANCHORAGE,AK 99516 Legal description (Sub'd, Block& Lot) MCMAHON; BLOCK 3, LOT 4 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (mall that apply) Initial ❑ Single Family (SF) IN Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE!WAIVER REQUEST FOR: WELL TO SEPTIC TANK Distance: 80 FEET I certify that the above information is correct, I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: (5 Waiver Fees: //.2Y Date of Payment: -1-11 I 1-3- Date of Payment: 7/1?//7 Receipt Number: /� n a IZ(gC'1 Receipt Number: Og `�6 Permit No. U SPO ' Waiver No. (35v-n- I V 9- (Rev.01111) t ,..a 4. Quanics .. GARNESS ENGINEERING GROUP, Ltd �'dv3"" r.i�°'".n" `"tt CIVIL&ENVIRONMENTAL ENGINEERS dealer July 12, 2017 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for McMahon; Block 3, Lot 4 To whom it may concern: Per conversations with the previous owner, after the documentation of the septic system and COSA, Garness Engineering was notified by the previous owner Marilyn Matthisen that the septic tank was replaced in 2000 by her husband. GEG then notified the MOA of the septic tank replacement, however, the owners had a copy of the COSA and closed without resolving this issue. Per the request of the current owner Rob Russel, we are replacing the existing undocumented septic tank. We are proposing to decommission the existing septic tank per upc and install a new 1000 gallon HDPE septic tank. We are requesting that your department issue a variance from the required separation distance of 100 feet from well to septic tank down to 80 feet. Justification for granting this waiver is as follows: • The existing septic tank is approximately 80 feet from the well. • Water samples were pulled on 8/8/2016 and the nitrates were found to be 4.31 mg/L. • During the installation, Garness Engineering will attempt to maximize the separation distance. • We are proposing to use an HDPE plastic tank. In short, the proposed HDPE tank will be an improvement over the current steel tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Siqely, re : . , ar -ss, ".E., M.S. Presi nt I 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com GEG,Ltd.HAS A 8 PAGE SPECIFICATION NOTE:THE CONTRACTOR LETTER THAT PERTAINS TO THIS DESIGN.TO SHALL HAVE ALL PERTINENT OBTAIN A COPY OF THE LETTER CONTACT GEG.BY PROCEEDING FORWARD WITH THIS WELL RADII FLAGGED BY A INSTALLATION,THE ENGINEER,WELL DRILLER, ----, REGISTERED LAND SURVEYOR CONTRACTOR AND PROPERTY OWNER AGREE PRIOR TO CONSTRUCTION. THAT THEY HAVE READ THESE -....., \‘‘SPECIFICATIONS AND AGREE TO ACCEPT THE \ TERMS AND CONDITIONS OUTLINED.s. � MCMAHON; BLOCK 3,LOT 3 / �\ --)7 " �`� ` 1 ��` / / i �yP\4:.'' \ 1 / / / \\,`. V� \11 111 i / 1 dS ,CS 1 —� i , PROPOSED 1000 GALLON HDPE SEPTIC` �c&-* 1 1 / TANK;INSTALL DOUBLE CLEANOUTS I �, ASSUMED LOCATION OF/ BEFORE AND AFTER TANK i �- EXISTING SEEPAGE PIT _ l_-� 100•WE'LL -- - i LL !U EXISTING SEPTIC TANK TO BE RAD/US i DECOMMISSIONED PER UPC t. :;':: 11 i V (REPLACED IN 2000 PER PREVIOUS .?�..�... 1 11 OWNER-SEE DESIGN LETTER) 1 ��. •� 1 1 1\S r d\\ rill EXISTING 3 — — ...•...•;_.•.�.. s.!".•;./4' ` i i W iV _ BEDROOM HOUSE 'lir • �- ( • ' � ; U) 0 �11i1 - -• DRIVEWAY••••' i i 1 AI it ,f+' • . : _ :: 11 :� � Vis,.. ; \ g fr. . . . DRAINFIELD INSTALLED IN o IIr III ••j. 1 -: " , \ •',,--' .'. .::• j DRIVEWAY,• T '� •• ..- RV TENT , i• _ ••• -- - - i MCMAHON;BLOCK 3, LOT 5 ;' / i i i 7 i i i i / I I N I II I I I SCALE: 1 1"=40' 1 1001\\\111, �.� OF1 ,/,, ..--,•\r.• , GARNESS ENGINEERING GROUP, Ltd • Ili •' • CIVIL&ENVIRONMENTAL ENGINEERS 0 3701 E.TUDOR ROAD SUITE 101'ANCHORAGE,AK 99507'PHONE(9071 337-6179'FAX(907)338-3246'WEBSITE www.garnessengineering corn A . .. he; PREPARED FOR: PHONE NUMBER: PAGE NUMBER: :,•, .-• = A. a ss :• ROB RUSSEL 903-1607 1 OF 1 v�J,':I CE-79 :Z= PROJECT/LEGAL DESCRIPTION: DRAWN BY: . „•••i . �• MCMAHON; BLOCK 3, LOT 4 D.J.G. •��FOIi"''� ••('�•-- 4� TYPE OF WORK: DATE: '1� ,FPROFESS) -• LICENSE SEPTIC TANK UPGRADE 7/12/2017 #AECC884 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & 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: N/A 65*613z,& PID Number: 017-042-04 ❑ New ■Upgrade Name: MARILYN MATTHISEN ABSORPTION FIELD ■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 12540 FURROW CREEK ROAD *ANCHORAGE, AK ❑ Other Phone: No. of Bedrooms: Soil Ratlng: Total Depth from exlstmg grade'. 345-3040 1 GPD/Sq Ft 5.57-9.7 rt. LEGAL DESCRIPTION Depth to pipe iherthamDngmalgade Gavel depth beneath ape: SEE DWG. Ft 3.5-6.5 (5 AVERAGE) t Subdivision: Block: LOC Fill added above anginal gade'. Gavel lengm: MCMAHON 3 4 SEE DWG. 40 Ft, Ft. Township: Range: Section: - - - caval widm : ads Number of ii nes: D'etanca between llines: 3 Ft. - - Ft. SEPARATION DISTANCES Tamil absoatbn area. 400 tubera tan e: held he reen to re. To Septic Absorption Lift Holding Publid/Pnvata From Tank Field Station Tank Sewer Lines So. Fe. - - Ft. Well 100'+ _ - 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑ Hold in ther ManNectuar: Capacity Surface Water 1 100'+ W EX1SS Gal. Macenal'. Numberotwmpart.als. Lot Line �} 10'+ - N/A Foundation 10'+ - - LIFT STATION Curtain Chain NONE KNOWN Manufaamar. c Gal. Remarks: •Pumpami level at 'Pump or level at High water alarm at WE ARE DOCUMENTING A BOOTLEGGED DRAINFIELD. PER THE HOMEOWNER THE TRENCH WAS INSTALLED IN Pump MakeB Model' Electnral Inspections peRomed by 2011 OR 2012 PIPE MATERIAL *PER ROB CAMPBELL WITH ARM SERVICES, LLC House to tank EXISTING Tank to •F810 drainfield Installer KC ALASKA (PER HOMEOWNER) Drainfield F810 (PERFORATED) CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft Inspection Locatin and Description: Dates: 1st - 2nd _ 3rd 4th BOTTOM OF TRIM @ NW CORNER OF HOUSE ENGINEER'{ SEAL Community Development Department Approval OF colli ............. �P ♦��i Conditional approval: Date: *,e ';*♦ 4 .... �/ .� .. !.. y A.GaFil S i • �1 cis CE -795 I • . I i I � Z I ��It ...1.�'l • 40Approved: • to .,lam Date: 1�FESS\ LICEN�E 11�\\\\\\ #AECC884 Inspection RepDrt_1-1-12dac PARCEL ID PERMIT NUMBER: RECORD D RAW I N G 017-042-42 BER: N/A A B MTI 44.3 50.9 C01 44.0 50.0 MT2 77.7 85.4 CO2 78.6 86.1 MCMAHON; BLOCK 3, LOT I APPROXIMATE LOCATION OF EXISTING SEEPAGE PIT MONITORING TUBE; DID NOT ENCOUNTER SEEPAGE PIT ------------------ 0 _ 100' WELL RADIUS DURING EXCAVATION OF BOOTLEGGED DRAINFIELD - -------- I I I I I EXISTING SEPTIC TANK I � DISTRIBUTION LINE 100 % TO SEEPAGE PIT 1 �10,\ DV B I EXISTING BEDROOM HOUSE• i 111 CID ..DRIVEWAY ' ..; J r0A MT1 I w � I10% O i CO2 MT2 RV TENT ` DRIVEWAY �•"• __ U- UNDOCUMENTED DRAINFIELD INSTALLED IN 2011 PER HOME OWNER MCMAHON; BLOCK 3, LOT GARNESS ENGINEERING GROUP, Ltd(; CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROM, SUITE 101 ' ANCHORAGE, M 99507' PHONE (907) 33]-6179' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARILYN MATTHISEN 345-3040 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 3, LOT 4 L.K.B. TYPE OF WORK: DATE: RECORD DRAWING 10/11/2016 # -ROFESS\J�li ORIGINAL GRADE = 96.12 ORIGINAL GRADE AT THE EAST END OF THE DRAINFIELD IS BELIEVED TO BE AT APPROXIMATELY 1 FOOT BELOW FINAL GRADE.IN SHORT, ALL OF THE EFFECTIVE APPEARS TO BE IN THE SM MATERIAL 3.5 BENCHMARK = BOTTOM OF TRIM AT NORTHWEST CORNER OF HOUSE =100.00 IT IS LIKELY THAT THIS END OF THE SYSTEM IS AT OR CLOSE TO ORIGINAL GRADE: THE END OF THE SYSTEM WAS EXPOSED AND JUST BELOW THE ORGANIC LAYER WE ENCOUNTERED THE SM MATERIAL AS NOTED ON THE SOIL LOG. FILL MATERIAL ADDED OVER DRAINFIELD FOR ADEQUATE SOIL COVER. THE SM MATERIAL WAS ENCOUNTERED IMMEDIATELY BENEATH THE ORGANICS (ABOUT 6' BELOW EXISTING GRADE). IN SHORT, IT APPEARS THAT ALL OF THE EFFECTIVE IS IN THE SM MATERIAL. 6.5 FINAL GRADE = 97.03 TER FABRIC INVERT OF PIPE = 94.05 BOTTOM OF TRENCH PER THE DRIVEN MONITORING TUBE = 9055 RELATIVE ELEVATION OF BOTTOM OF TH#t BELOW EXISTING GRADE=79.03 WEST END OF DRAINFIELD MT CO , FINAL GRADE= 96.14 DOUBLE INSULATED PER CONTRACTOR FILTER FABRIC INVERT OF PIPE = 92.94 BOTTOM OF TRENCH PER THE DRIVEN MONITORING TUBE = 86.44 RELATIVE ELEVATION OF BOTTOM OF TH#1 BELOW EXISTING GRADE=78.14 GARNESS ENGINEERING GROUP, CIVIL & ENVIRONMENTAL ENGINEERS 3701E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907)337-6199 -FAX (907) 336.)246'WEBSITE: x gamessegineenn PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARILYN MATTHISEN 345-3040 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MCMAHON; BLOCK 3, LOT 4 D.J.G. TYPE OF WORK: DATE: DOCUMENTATION OF EXISTING SEPTIC SYSTEM 10/17/2016 TH#1 TH#1 *?�49PW1 W '* a SS ♦ c� ' 795 _�� LICENSE 41111v ESS` '*� #AECC884 ""`' GAAB.HO-1 GC' ER ANCHORAGE AREA BORO`— i DErARTMENT OF ENVIRONMENTAL QUALI'i . _ 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME T/�i��T�s��(/ ADDRE55�`�X�-G —PHONE _5-e- /. LOCATION<�%��/✓/a�_'� LEGAL DESCRIPTION GDT p�L,C�stfi//�i1�if/fU�s'• SEPTIC TANK: NUMBER OF DISTANCE FROM WELL .��'���/(' / MATERIAL ���r�=�- COMPARTMENTS - ID CAPACITY ���� GALLONS. INSIDE LENGTH `� INSIDE WIDTH �- DLI EQPTHD SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER ✓J OR WIDTH � ; LENGTH �2 DEPTH LINING MATERIAL�O� C om ' t�ir�J�� . DISTANCE FROM WELL �--��' ��-�-/ ,BUILDING FOUNDATION NEAREST LOT LINE �S�J / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: DISTANCE FROM W NUMBER OF LINES ABSORPTION A /f /xI FOUNDATIO BETWEEN LINES SQ. FT. LENGTH OF EACH LINE NEAREST LOT LIN TRENCH WIDTH TOTAL LENGTH OF LINES_ IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: G���N�/�������G'C���j / DISTANCE FROM WATER TYPE DEPTH Z Zj BUILDING FOUNDATION. Z/5 f SAMPLE NEAREST NEAREST / SEPTIC SEEPAGE/`i OTHER LOT LINE /C� / SEWER LINE � , TANK ��� SYSTEM_ e, --S , CESSPOOL ✓� ,SOURCE DISTANCES: DIAGRAM OF SYSTEM DATE GAAB-HD-2 GREATER iNCHORAGE AREA (ROUGH Case No. �))2 HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT `�uC�i /l/a/ , V /S CJ)l MAILING ADDRESS °� �� �G' PHONE NO. RESIDENCE ADDRESS LEGAL DESCRIPTIO APPLICATION TO INSTALL: SEPTIC TANK_ TO SERVE THE FOLLOWING FACILITY 2 LOCATION OF INSTALLATION <0 SEEPAGE PIT �fl , DRAIN FIELD FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS�Gi/ �S ANTICIPATED DATE OF COMPLETI BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT , OTHER �� Alm. �� S �l� % ,PERMIT TO INSTALL A THIS IS TO SERVE AS L C, AS DESCRIBED BELOW. SIZE OFNIT�TO BE SERVED SEPTIC TANK SIZE lLe"O TYPE C 60 SEEPAGE AREASe-/ '/P5 Y`SGi E DIAGRAM OF SYSTEM DISTAI�C�EIt I' r✓.r/l 16� r`f�I vel ......-... OR ....-... . LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Are Borough Ordinance No. 28-68 and that the above described system is in accordance with said code, ��//'�� G �,`�11 ��/ ��/°/S �C DATE /l �1 /G/ 7/ APPLICANTS SIGNATOR , GREAA-^ ANCHORAGE AREA BOROUGH DEPART TF,;IVT nsra cn��-.,, ; So 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For c. J. Matthisen Date Performed 9/10/71 Legal Description: Lot 4 Block 3 ST3bdiviSion McMahon This Form Reports Soils Log x 1'er—rcoest Depth Feet Soil t Brown silty sand racteristics (SM) Gray silty sand (SM) with poorly grdded sand seams (SP) Was Ground Water Encountered? no If Yes, At What Depth? Reading I Date r -- Gross Time I Net Time Dept, to H 0 ; Net Drop 2 Percolation Ratp Minutp Proposed Insta aTL ion: Seepage Pit x Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench_ COMMENTS: _225 square feet of drainage area is required per bedroom. Test er orme y R. E. Carlisle Data Certi i 7P_ y: NATIONAL TESTING SERVICES, INC. Date: • GE B� ' •.. j.t.;), Municipality of Anchorage F / 8 9. 19 °W On-Site Water and Wastewater Program n\ ��1,,,', < `� " :, (907) 343-7904 M � \1 ®`,� S a ETY ff St,' � i a . r`" i Certificate of On-Site Systems A 0 iQ oval � - ; Parcel I.D. 017-042-04 Expiration �6 ,,.:-/--< /- — I V - 1. GENERAL INFORMATION: Complete legal description McMahon; Block 3, Lot 4 Location (site address) 12540 Furrow Creek Road*Anchorage,AK 99516 Current Property owner(s) Robert Russell Day phone 903-1607 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Ei Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by:‘, / t, Date: 7)-40c3 COSA to be released to the ` ineer,unless otherwise requested by the engineer. COSA Fee $ Ala 81 -D Waiver Fee $ Date of Payment q/2//9-n Date of Payment Receipt Number d(o '-,J`t(g, Receipt Number COSA# C3‘-,Cl'/Cj!c/ 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 o lined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the o ter supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of Vedrooms 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road,Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: q 'l• 1'7 0000Op�� In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system oQQF A C 4%d o 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 0/:P ( • ••s " evaluation. Separation distances were measured to readily identifiable features. Hidden defects or �� .�'�, •-i--- i7 encroachments may exist that were not identified during the evaluation. The operational life of all wells /' * ; 9 T ��� V0 and septic systems depend upon a variety of variables, including but not limited to, soil conditions, 0 VA groundwater levels (that may fluctuate during the year), quality of construction (materials andVA workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and j . .. .. are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q J- f - ,. Gar ess.: 0 system/s;therefore, GEG makes no warranty(express or implied) regarding the future performance of (/O '•� - E_T. q.�G' the well or septic system. GEG makes no representation whether an alternative well or septic system Q 9 /•. .<e 1 can be installed on the property in the event either of the current systems fail to perform adequately in 4l f•,.P ••�.[9:it'gc<S5,„ the future. The content of this report is for the sole benefit of the person/party that retained GEG to % , ap�Ofessl0�0ao perform the evaluation. Reliance upon the information provided in this report by any other person or `1.%.0.0p0` . party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD SIGNATURE i'rSystem #1 Approved for- bedrooms System #2 Approved for bedrooms .( OFANCI,O Disapproved Q ''I -v _ 1TE Conditional approval for bedrooms, with the follot�ng sf oRp4•D V\J ASEo S• SEW PR�GROA . B . w-. Original Certificate Date: L/ —.2-3-1 F 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 Nitrate Advisory X Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10.12.doc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: MCMAHON; BLOCK 3, LOT 4 Parcel ID: 017-042-04 A. WELL DATA *PER 1971 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1971(?) Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth *100 ft. Cased to UNK ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 9/9/2.016 Static water level � \pG ft. 65.9 ft. Ow Well production g.p.m. 4.3+ g.p.m. WATER SAMPLE RESULTS: Coliform NEC colonies/100 ml. Nitrate 10.9 mg./L. Collected by: GEG. Ltd. Arsenic: <5 ug./L. Date of sample: 7/27/2017 *FCO LOCATED INSIDE HOME AS NOTED ON PREVIOUS COSA; B. SEPTIC/HOLDING TANK DATA ADDITIONALLY, DOUBLE CLEANOUTS WERE INSTALLED BEFORE THE TANK Tank Type/Material SEPTIC/HDPE Date installed 7/24/2017 Tank size, 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N)*YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping NEW Pumper — C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE! Date installed 1971 Soil rating (g.p.d./ft2or tr/bdrrr 225 System type CRIB Length 27 ft. Width 27 ft. Gravel below pipe 6 ft. Total depth *8.5+ ft. Eff. absorption area 648 ftJ Monitoring tube YES Depression over field NO Date of adequacy test **9/9/2016 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 40 in. Water added 657 gal. New depth 55 in. Elapsed Time:1440 min. Final fluid depth 43.5 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **TESTED 1971 CRIB ONLY. TOTAL DEPTH FROM TOP OF CRIB TO BOTTOM IS 4.5 FEET PER THE PREVIOUS HOMEOWNER, AN UNDOCUMENTED TRENCH WAS INSTALLED IN APPROXIMATELY 2011-2012 BUT NO STANDPIPES WERE LOCATED UPON INSPECTION ON 7/18/2016. GEG DOCUMENTED THE SYSTEM WITH ARM SERVICES, LLC ON 8/26/2016, RECORD DRAWINGS ARE ON FILE AT THE MOA. INFORMATION LISTED ABOVE REPRESENTS THE 1971 CRIB ONLY. NEWLY DOCUMENTED TRENCH WAS DRY UPON INSPECTION ON 9/9/2016 AND REMAINED DRY THROUGHOUT TEST. PER MOA, THE TRENCH CANNOT BE USED TO OBATIN A COSA D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level . High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *80 On adjacent lots **100'+ (WITH CAVEAT) Absorption field on lot 100'+ On adjacent lots **100'+ (WITH CAVEAT) Public sewer main 75 + Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *WR#OSV171072 **UNABLE TO CONFIRM SEPTIC LOCATION ON LOT TO NORTH (MCMAHON; BLOCK 3, LOT 3). FENCED OFF AND OWNERS DID NOT WANT GEG ON PROPERTY, SEPARATION DISTANCES WERE TAKEN FROM 2009 SURVEY. 0000000 G. ENGINEER'S CERTIFICATION o,c OF. A�S..--7---vh %, ,S.,,,/ ":-.• 0 I certify that I have determined through field inspections and ..• ' 9 r review of Municipal records that the above systems are in �' IIA conformance with MOA COSA guidelines in effect on this V 0 date. Q, •,Je Games-. �0 Engineer's Printed Name JEFFREY A. GARNESS Q Orio, I x-795 (PO -0- Date . 'ikedpoio�o%0�0000��v (Rev. 11/05) MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • `tc."'" 1 I 907-343-7904 On-Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On-Site Systems Approval # OSC171414 Subdivision: McMahan , Block: 3, Lot: 4 A water sample revealed a nitrate concentration of 10.9 milligrams per liter (mg/L). 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. Mailing Address: P.0. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org 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. Mailing Address:P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org Hefty Drilling Inc. Invoice P.O. Box 112130 Anchorage,AK 99511-2130 Number: 2273 Office..345-0593 Date: March 30, 2018 Bill To: Ship To: Rob Russell 12540 Furrow Creek Rd Anchorage,AK 99516 Description Quantity Price Discount Amount Camera well inspection 1.00 300.00 300.00 Camera well inspected down to 50', no leaks or breaks in well casing at welds or pitless adaptor. Note:A wet spot at 9'was determined to be frost melt where the pump cable was in contact with the casing. Total $300.00 LOT 3 32" EAST 286.43' I •M M M A • - j 04 rOM J G MCMAHON w PSUBDIVISION LAT No. 65-86 ✓-- 1108.1'-- tel-- „..- 37.9' •-1 __ k :� n N ,+s.r rr 22.3 '/- �j' I 1,.8. __ - -- LOT 4 4° EXISTING r�� Y 1f` f„ HOUSE �., Ilf•�__/ �� cc. w cr LOT I A- 1 p ' ail m N- SEPTIC • iIIINI 24.1' r a. STANDPIPE / TYPICAL SHED t� rf Z 4 24,3 114.3' IT M GRACE .= z SUBDIVISIONj- x• ADDITION No. 1 �30.8�� ,! PLAT No. 98-173 EXISTING I ( WEATHERPORtf McMAHON °` AVENUE 4 4 8 RETAINING WALL T YP I M . `M r ,_+_0 30' T EAST 285-18' LOT 5 NOTE: ND THIS DRAWING SHALL NOT RE MODIFIED FOR USE AS A PLOT PLAIN "_ ' �.�A.` SEvnG sTAAOPt�E 0 Mo►�dt WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG IAANTECH aF A L '�.S.‘l NATER MIE.L (r'M! �+ I I FENCE —X—X— :D..rn4;0100010 w� 2S4 H AnchoraStreet ge, Alaska 99�YJ Z LEGAL DESCRIPTION: (� * 49 ♦ / _ AS-BUILT , ADDRESS: 12540 FURROW CREEK PARCEL 0: 017442-04.000 LOT 4, BLOCK 3, T CERTRRGATIDK tee uwtfo,,ANc""a m"°"c'r�A MM9lJ1L SLIMY a. Sut�Cy Ul'�70ilnOgflt THE PROPERTY AS SMARM ON THIS DRAWING AID OMTE+IS THAT THF - � �s41 McMAHON SUBDIVISION o • STEVEN c Gt AN,' of PaPROWNENTSENC �p OTHER pT»"1stE�OP�"`y`Et3w'"° Inc Phone 24; d3C5 DRAWN DATE. 0W' 17 WOIO(ORDER 1707$ his i; VIGCNC41/4.' N atnlaxe V 12034 °: atahifeelr�.te• e vi eear.T9.•ou toeyi.i9 DRAWN BY' ADS PLAT: 55-86 a t/1 I1' • �= EXS ENCStosorOFNW Y I T* IT Ms THE OWNERS T&RESTIRCTIONS$NI,m TO DR R THE ap at'. TTNNcM�W DO NOT APPEAR CPI THEE CORDEDD SUION N,a„on w PtAT Week• ac NO CMECKEDSY: SG GRID: 2835 rOfessbnd ORDERED BY. ROBERT RUSSELL .= �Aro-a#GP O�UNEOAT oR�ROT P%. CaM Ult MO PON�FOR SCALE: 1 40 MPG:6865-66 �u5 6� •J �� �� Municipality ofAnchorage<'° On -Site Water & Wastewater Program (907)343-7904 IC_ OCT 31 2015 CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 017-042-04 Expiration Date: L O J7 1. GENERAL INFORMATION Complete legal description MCMAHON: BLOCK 3, LOT 4 Location (site address) 12540 FURROW CREEK ROAD `ANCHORAGE, AK Current Property owner(s) MARILYN MATTHISEN Day phone 345-3040 Mailing address Real Estate Agent 12540 FURROW CREEK ROAD *ANCHORAGE, AK BOYD 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 WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request for Received by: 4 COSA to be released to the COSA Fee $ ✓ 2(P- U V Date of Payment 11013V %�� U Receipt Number 0i COSA# 3 229-0132 Date: 1160/11, Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: - TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ Date: 1160/11, Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: - 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. 1 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 GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 ' ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation GEG provided an engineering evaluafiDn ofthe well snorer 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 systerNs on the dalels of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identdied during the evaluation. The operational life of all wells and septic systems depend on a variety of variables including, but not limited to, soil conditions, groundwater tents (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family ublizing the systernh. These condBons on vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systeMs, 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 propery in the event either of the current systems fail The content of this report is for the sale benefit of the persoNparty, who retained GEG. Reliance upon the information provided in this report by any other person or party, including but not limited to subsequent property purchasers, is not aulhorized In shod, GEG disavows any legal duty to anyone other than the persoNpary who paid for this report. L_ System #1 Approved for - bedrooms. Phone 337-6179 Date I.Dr 201 It, A....a....ss•:'Q: �I c� •' CI -7951, LICENSE OFES aAECCBBG System #2 Approved for bedrooms. OF (AJVC11"r( rr Disapproved. ` �QQ T%7 iI SITE �' Conditional approval for bedrooms, with the following stiptj4Vbns: o`rcR A140 By: Original Certificate Date: I (- 1,(9—IL The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112/12) If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: MCMAHON; BLOCK 3, LOT 4 Parcel ID: 017-042-04 A. WELL DATA I'PER 1971 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) Date completed ' 1971(?) Sanitary seal (Y/N) YES Total depth `100 ft. Cased to LINK • ft, FROM WELL LOG Date of test . Static water levelqAeV\_-\_OG ft. Well production /NO g.p.m. NO Wires properly protected (Y/N) YES Casing height (above ground) t2+ in. AT INSPECTION 9/9/2016 65.9 ft. 4.3+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 4.31 mg./L. Collected by: GEG, Ltd. Arsenic: ND`5 ug./L. Date of sample: 8/8/2016 B. SEPTIC/HOLDING TANK DATA 45 YEAR OLD SEPTIC TANK IS APPROACHING THE END OF ITS USEFUL LIFE. "PER WILCO EXCAVATION, FCO IS LOCATED INSIDE HOUSE. Tank Type/Material STEEL Date installed 1971 Tank size 1000 gal. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) 'YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 8/9/2016 Pumper QUALITY SEPTIC C. ABSORPTION FIELD DATA -BELOW EXISTING GRADE Date installed 1971 Soil rating (g.p.d./ft2or /bdrm 225 System type Length 27 ft. Width 27 ft. Gravel below pipe Total depth r'8.5+ ft. Eff. absorption area 648 ft' Monitoring tube YES Date of adequacy test "9/9/2016 Results (Pass/Fail) PASS Fluid depth in absorption field before test 40 in. Water added 657 gal. CRIB 6 ft. Depression over field NO Elapsed Time: 1440' min. Final fluid depth 43.5 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN For 3 bedrooms New depth 55 in. 450+ g,p.d. If yes, give date ".TESTED 1971 CRIB ONLY. TOTAL DEPTH FROM TOP OF CRIB TO BOTTOM IS 4.5 FEET. PER HOMEOWNER, AN UNDOCUMENTED TRENCH WAS INSTALLED IN APPROXIMATELY 201.1-2012 BUT NO STANDPIPES WERE LOCATED UPON INSPECTION ON 7/18/2016. GEG DOCUMENTED THE SYSTEM WITH ARM SERVICES, LLC ON 8/26/2016 (SEE ATTACHED GEG RECORD DRAWINGS OF THE PREVIOUSLY UNDOCUMENTED TRENCH). INFORMATION LISTED ABOVE REPRESENTS THE 1971 CRIB ONLY. NEWLY DOCUMENTED TRENCH WAS DRY UPON INSPECTION ON 9/9/2016 AND REMAINED DRY THROUGHOUT TEST. PER MOA, THE TRENCH CANNOT BE USED TO OBTAIN A COSA. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N)— "Pump on" level at in. "Pump off' level at a er alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot '80+ Absorption field on Public sewer main Sewer /septic service line _ 100'+ 75'+ 25'+ On adjacent lots "100'+ (WITH CAVEAT) On adjacent lots "100'+ (WITH CAVEAT) Public sewer manhole/cleanout 100'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5'+ Absorption fielc Water main 10'+ Water service line 10'+ Surface water 5'+ 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 'REQUIRED SEPARATION AT TIME OF INSTALLATION WAS 50 FEET FROM WELL TO SEPTIC TANK. "UNABLE TO CONFIRM SEPTIC LOCATION ON LOT TO NORTH (MCMAHON; BLOCK 3, LOT 3). FENCED OFF AND OWNERS DID NOT WANT GEG ON PROPERTY, SEPARATION DISTANCES WERE TAKEN FROM THE PREVIOUS 2009 SURVEY. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date It b LICENSE #AECC884 (Rev. 10112112) >f