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HomeMy WebLinkAboutMCMAHON BLK 3 LT 19McMahon Block 3 Lot lc) #0! 7-042- ! 9 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL ~NSPECTION REPORT Permit Number: OSP101069 PID Number: 017-042-19 Name: BILL MAZOCH Address: 4100 FURROW CREEK RD Phone: 345-0445 Number of Bedrooms: LEGAL DESCRIPTION Block: Lot: 3 19 Subdivision: McMAHON Township: Range: Section: Well: [] New [] Upgrade Classification (Private, A, B, C): ] Total Depth: Cased to: EXISTING PRIVATE Ft. Ft. Driller: Date Ddlled: Static Water LeveI: I Ft. Yield: GPM Pump Set at: Ft. Casing Height Above Ground:Ft. TO Wastewater System: [] New [~ Upgrade ABSORPTION FIELD [] DeepTrench 15~ ShatlowTrench [] Bed [] Mound [] Other: Absorption Lift Field Station Holding Tank Soil Rating: GPD/Ft2 Depth to pipe bottom from original grade: Ft. Fill added above original grade: Gravel width: Total absorption area: Installer: A+ HOME SVC Ft, Ft. Total Depth from original grade: Gravel depth beneath pipe: Gravel Length: Number of lines: Ft. i Distance between lines: Ft. Pipe Material: 30 34 PVC Date Installed: 6/22/2010 TANK SEPARATION DISTANCES [] Septic [] Holding F-~ S.T.E.P. ~ Other: Septic Capacity: Tank >ublic/Private Sewer Line 60.91 /-/ Manufacturer: ANOH TANK Material: STEEL t 000 Gal, Number of Compartments: 2 We, 105,~ Surface Water 100+ Lot L, ne 34.9 Foundation 46 Curtain Drain ~ Remarks: TANK UPGRADE ONLY. EXISTING TANK ABANDONED PER LiFT STATION Size: I Manufacturer: "Pump on" Ievel at: i "Pump off" level at: t High water alarm at: in. Electrical inl in Pump Make & Model Inspections performed by: BENCH MARK Location and Description: CODE BACKDOOR THRESHOLD Assumed Elevation: 100,0 Ft Inspections peflormed by: PANNONE ENG. SVC, LLC Dates: 1st 6/22J2010 2nd 6/2412010 Development Services Department Approval Conditional Approval Date: Reviewed and approved by: , , ' Date: (Rev. 04/(}6) Engineer's Stamp / 976 DRAINFiELD (Fl) 19{}o DRAiNFIELD (E) ~ FURROV~j' REEK ROAD 100.2 A B ..... I~S_.TAL_L DC_O AFTFlR TANK & CO © DRAI SEPTIC AR 22 \ 3&.9 //- VV'ELL (E) 108.7 SEPTI( AREA (E) ~ WELL (Fi I O00g SE PER CODE 1,000g SEPTIC TANK (N) CO I A-~ B 11 46.0 48.1 C~ J 46.5 / 54.8 E'~F 69.t6 i 79.~3 E2 / / ED IN PLA 1 i SEPTIC ARFlA (E) A / WELL NOTES: RECORD DRAWING PLAN ?ANNONE, F_,NG SVC, I_,LC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX {907) 272-821i McMAHON S,/D, Elk 3, Lot Bill Mazoch 4100 Furrow Creek Rd Anchorage, AK 99516 345-0445 19 Date 6/24/: 0 Scare 1 "=50' PAD. NO )17-..042-19 PERMIT NO. OSP101069 Sheet 1 OF2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALl_ BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITF WAS~-EWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. SCOPE OF WORK: INSTALL NEW 1000 GALLON SEPTIC TANK, abandon exist'g tank per code 4. GROUNDWA1'ER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION~ AS EVIDENCED BY 7HE SOIL TEST HOLE INFORMATION ABOVE 16 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN i4 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. / 91.8 i 97.4 "90.8 1, TANKSEPTIcNEW 1000g PROFILE 90.4 DESIGN PARAMETERS NEW SEPTIC SYSTEM NO. BEDROOM: 5 TANK SIZE: 1,000 gallon ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE KC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE KS FLOW SPLITTER LEGEND ~ w wWATER LINE/ WEi L RADIUS --ss--ss-- EXIST'G SEPTIC --ss ~ss-- NEW SEPTIC ---o o o C½A!NLINK FENCE NOTES: RECORD DRAWING DESIGN NOTES PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-821! McMAHON S,/D, Elk 5, Lot Bill Mazoch 4100 Furrow Creek Rd Anchorage, AK 99516 345-0445 19 Date 6/24fl 0 $coJe NTS P.I.D. NO 017-042-! PERMIT NO. 0SP101069 Sheet 20F2 Permit Number: OSP101069 Tax Code Number: 01704219000 Work Type: Septic Permit Effective Dates: June 22, 2010 On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to June 22, 2011 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: MCMAHON Site LegalAddress: MCMAHON BLK 3 LT 19 G:2835 Owner/Address: MAZOCH WILLIAM LEE & ELAINE 4100 FURROW CR ANCHORAGE AK 995162877 Site Mailing Address: 4100 FURROW CREEK RD, Anchorage Lot Size in Sq Ft: Total Bedrooms: I Department 32162 3 This permit Is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:. A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/¥VELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-042-19 Property owner(s) Bill Mazoch Mailing address4100 Furrow Creek Road, Anchora.cle, AK Site address 4100 Furrow Creek Rd Legal description (Sub'd., Block & Lot) McMahon S/D, Block 3, Lot 19 Legal description (Township, Range & Section) Lot Size 32162 .Sq. Ft. .Day phone 345-0445 Zip Code 99516 Zip Code 99516 Number of Bedrooms 3 THIS APPLICATION IS FOR ([~;~] all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Slngle Family Dwelling and is in accordance with applicable Municipal Codes. Pannone Engineering Services, LLC~~;;;~ (Signature of property owner or authorized agent) Permit~Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) 6.2-..I-/O Waiver Fees: Date of Payment: Receipt Number: Pannone En§ineerin§ Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve~oanen~.ak.com June 21, 2010 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subjec[: McMahon S/D, Block 3 Lot 19 RIJSII SepticTank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1000 gallon Septic tank be issued for this lot. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a three-bedroom house and is operating adequately for three bedrooms. The existing tank is within 87 feet of the existing well. Per MoA comments, you will not issue a waiver for this 30 year old tank. The house is scheduled to sell on June 30. The existing tank will be filled with clean gravel and abandoned per code. The surrounding lots are served by public water systems and there are no wells within 200 feet of the proposed septic tank. This lot is served by private well. PES will verify all required separation distances at time of installation. ,* Upgrade Tank Design. a. See Sheet 2of2ofthe plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 19 slopes to the northwest at approximately 1 to 3 percent in the area of the septic system and house. The proposed installation will be located in the central portion of the lot next to the existing septic tank and absorption system. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82"d Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. pannone Stcvcn R. ?annonc, ?.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82nd Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 FURRO 1980 DRAINFIELD (E) ~~ % ;,O00g~EE%T~:DEi i ............. TANK (P) I I SEPT~C AREA (E) N -~ ~-- TAN~ER TANK I K J ~ CO ¢ DRAINFIELD~TM - SEPTI~ AREA (E) ~ ~ WELL Sco~e 1'=50' Mo2och 4100 Furrow Creek Rd~9 :~¢~- '~ SW090188 Anchorege, AK 99516 ~-¢~'. .... :,'~ Sheet PLAN 345_ 0445 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATFACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALL NEW 1000 GALLON SEPTIC TANK, obondon exist'§ tonk per code 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 16 Fl'. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. Z< ~ NEW ~O00g 8EPTIO ............ EXIST'G P OFILE DESIGN PARAMETERS ABBREVIATIONS LEGEND NEW SEPTIC SYSTEM CU COPPER w~w WATER LINE/ NO. BEDROOM: 3 DIP DUCTILE IRON PiPE WELL RADIUS TANK SIZE: 1,000 gollon TH TEST HOLE FC FOUNDATION CLaN OUT ~ ss ~ EXIST'G SEPTIC T~ TANK CLaN OUT NO. C~ CLEAN OUT NO. ~ ~ ~ ~ NEW SEPTIC M~ MONITOR TUBE NO. R.I. RIGID INSU~TION ~ CHAINLINK FENCE DCO DOUBLE CLaN OUT DV DIVERTER VALVE FS FLOW SPLICER SW090188 DESIGN NOTES 345-0445 , ~~ Sheet3 Or 4 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 LOCATION LEGAL DESCRIPTION Well .~-~ [~,c~/ Absorption areZ DISTANCE TO: ~" ~(: I'~.:>"/"*'~F.~ ( DISTANOE TO: Inside length IF HOMEMADE: Well Dwelling Manufacturer DISTANCE TO: N°' °' linesl Top of tile to finish grade Foundation ~g Dwelling W dth Material NO. OF 13~_~OOMS PERM,T g No, of compartment~::~ Liquid depth PERMIT NO. Liquid capacity in gallons ;Nearest lot lin~ ~..~. Tre rich v~.hj, Distance bet ~n/7/~' ' (_./(¢,,~ inches T°tal~~'~ct~l~s°rpti°n area  inches PERM T NO. Length Width Depth Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TQ: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER REMARKS APPR~ _.~ /~) ~ DATE LEGAL PERMIT NfL DEPRRTMENT (K-'HERLTH RND ENVIRONMENTRL r~DTECTION 825 "L STREET, RNCHORRGE., BK. 264-4?20 E,t'-.~--S I TE "---],E~--IER F'EF~:~"~ I T -,,. RF'F'LICRNT [:,RNIEI. MIDDRLIGH SRR BU,s '~.~"'" ~' ~ -,--- ,~,~,-,-~ .--~..~.] ~-,c.-. RN,_.HUF. H.~E ~ i%;,~,~ LEGRL. .L'. 2~ BZ~ MCMRHON LOT SIZE 32000 SQURRE ~EET TYPE OF SOIL RBSrRPTI~3N =~_TEM IS: TRENLH MRXIMItM NLIME:ER rIFE, EE. ROOi'I.:, = ¢' ] ¢ ' ' - 2L~0 --,L IL RRTING '::SQ FT, E,R.- THE REQUIRED SIZE OF THE SOIL RE:SORPTIO~.'i S~r'STEM IS: .5; LE~-4i3TH= 2' ,3R~3%-'EL E~EF'TH= B. EPTH= ~; THE LENGTH ~IMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT I3 THE DISTRNCE BETWEEN THE ~URFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCR',,,'RTION (IN FEET). F'ERMtT RPF'LICRNT HRS THE RE_,PUN=,IBILITS TO INFORM THIS DEPRRTMENT r)IIRING THE INSTRLLRT.ION INSPECTIONS OF RN'¢ WELLS R[:,JRCENT TO THIS PROPERT'¢ RND THE ~ ', F' "~ ~ ' '~, NI_IME:ER OF RE:,IE. EN..E= THRT THE WELL WILL =,ER/E. T I.-.~C, .:: 2 .':, 1' I"-.ISF'EL-:T I OI'-.IS RRE R E,_---.I. LI I ER: r':LFiLLiNL~:' - -' OF RN'T~ S'T'STEM WITHOLIT FINRL IN=,FECTILN'- ' -' ] RND MFFR_' ' ' 'r~',',,RL B"r' THIS CEFMRTMENT HILL BE .=,LIBJEL. T TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R HELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ,100 FEET FoR R PRIVRTE HELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE HELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEHER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPL~'. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS BRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F"EF..:f'I T T E::-;P I F-.E_ [:,EC:EI'IBER git.. '1 I CERTIF'¢ THRT 'i: I RM FRMIL!RR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLIT'¢ OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. 3:: I UNDERSTRND THRT THE ON-SITE SEWER S'¢STEM MR9 REQUIRE ENLRRGEMENT IF THE F.:ESI[:,ENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. RPPL I CRNT [:.R~ EL M ~DRI_IGH -:,., ',,,'4. 0 PERMIT NO. iPPL I CRNT PAMELA M I DD~LIGH _OCRTION FURROI,I CREEK?LESLIE ST _EORL :LOT :1.9 8L.K ]: MCMRHON SUB DEPRRTMENT OF HERLTH 8ND ENVIRONMENTRL PROTECTION 825 'L.* STREET, RNCHORR(3E, AK. 99581 264-4728 g]~4--S I TE 5]ENEF~: PFRi~I I T ( 888:[~2 ) SRA 1568-D LOT SIZE 27888 SQURRE FEET 'YPE.OF SOIL BBSORF'TION SYSTEM IS: TRENCH tAXIMUM NUMBER 0F BEDROOHS = 3 SOIL RRTINO (SQ FT?BR)= 'HE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L E l~ ~S-l- H= g]R~%.~E L Ii'.. E F' T t-!== THE LENGTH DIMENSION IS ']'HE LENGTH (IN FEET) OF' THE TRENCH OR DRRINFIEL.[:,. THE DEPTH OF A TRENCH Of-? PIT IS 'file r).[s'r~NcE BETNEEN THE SURFRC'E OF -[HE GROLIND Fff.4D THE 80TTObl OF' THE E]×:CI-]V8TION (IN FEET). THERE IS NO SET MIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRR'./EL BETWEEN THE OUTFRLL PIPE Fff.l[:, THE 80TTOM OF THE EXCF¢,/RTION (IN FEE-['). 'ERMIT RF'PLICFINT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DI.R!NG THE NSTRLLATION INSF'ECTIONS 8F RNY WELLS F~DJRCENT TO THIS PRZF"ERTY FIND THE lUMBER OF RESIDENCES THAT THE PlELL WILL =,ER,E, '-I'- l.-J ~2~ ,:: ;:.-? ::, I ~ S F' E C: T I i_-.~ ~4 :..------ R R E I~: E 6). L.I I F-:: ~-] [:, ::RC:KFILLING OF RNY _,Y_,T[..H HITHOLrr FINAL IN_,PE...~ION RND RPPRnVR[ E,"Y THIS ,EF'RF:TMENT WILL BE ~LIBJECT TO PROSECUTION. IlNIMUM DISTANIZ:E E:ETI,IEEN FI NELL AND AH"r' LH _ITE SENAGE DIbF£.x, RL 'SYSTEM FEET FOR R PRIVATE 14ELL OR 15E~ TO 280 FEET FROM R PUBLIC 14ELL [)EPEN[:'ING .IPON THE TYF'E OF F'USLIC NELL !INIHUH [)ISTRNC'E FRSH 8 PRIVATE PlEL. L TO R PRI',,,'RTE SEI,.IER LINE IS 25 FEET AND COr,IHLINITY SEI.,~ER LtNE IS; ¢._ F'EET. ,rHEF: REQI_.IIREr,IEHTS MAY APPLY. SF'ECIF.TCRTIONS FIN[:, ]ONSTRLICTION [:,IAGRRMS RRE ~'v'RIL. RE:L.E TO INSURE Ff, LFEF. INSTRLLRTION. ' ...ERFIF ~ THAT .__ l I AM FFtMIL. IRR NITH THE REQUIREMENTS FOR: ON-SITE' bEPE..:, BND HELLS 8S :ORTH BY THE MUNICIPRLITY OF RNCHORRGE. ~: I HILL INSTRLL THE SYSTEM IN RCCORDRNC:E WITH THE CODES. ;:' I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRSEMENT IF THE RPPL I C:F4NT PRMELR M I [:C FII.~ ..................... ..... -r ......... GRE,..ER ANCHORAGE AREA BOR,.dGH Department of EnvironmentsI Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DI STANCE FROM WELL-/''~ INSIDE LENGTH MANUFACTURER ~/~,,i.,L,~' C)r-,~ MATERIAL INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY.__ GALLONS. TILE DRAIN FIELD?'~ DISTANCE FROM WELL~)~¢ /00 FOUNDATION NUMBER OF LINES ~ DISTANCE BETWEEN LINES ABSORPTION AREA ~"~¢"~ SQ. FT. LENGTH OF EACH LINE I DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE "~ MATERIAL BENEATH TILE TOTAL LENGTH NEAREST LOT LINE OF LINES TRENCH WIDTH ¢"/~"' IN. TOTAL EFFECTIVE IN. ABOVE TILE (4~' IN. WELL: TYPE BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION. 0)~- NEAREST LOT LINE OTHER SOURCES DISAPPROVED NEAREST SEPTIC SEWER LINE__ TANK__ REMARKS DEPTH SEEPAGE SYSTEM DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ-032 [:,LEPFIF~:-t MEN]' : t~lc."'~ ... I H Ftf',t[:' t:.1'4, ].P..L. fli']Et' I- L ROtEC'I"tON ;;i'.~.~.jl..l:.~ E:. ]" U [) O I::;'. RI:,.;~;:~7'6-::'~:.':~;;2:t" FIN Z H L i...OCiq't Z ON FL.IRIq:OI4 CRE'E'K RE) I...EGI:4L. t... J.:E) B Z; MCMFiHON SUB "iYPE OF' SOIL FiE:SOR~:'FIC~N S;~'STEM I'.~;; TRENCH i'"liqi;.::IMLIM NLIhiE~ER OF BEE:,ROOMS = 3: SOIL RITflTING THE LENG'I'H DZI"IEN.E;:[C~N :(S THE LENGI'H (tN FEET) OF THE 'T'RENC:H CIR DRiqINF.[ELP. THE I;,IEF"TH OF' R 'TRENCH OR PIT IS 'THE DZSTPtNCE 8E"I'WEEIq 'THE SURI::'RC:E: OF 'l'Hl-i:: GROUND FiND ]'HE: BOTTOi"I OF' THE EXCR',,,'Ri"iON (IN FEET). THERE );S; NO SET WIDTH FOR 'T'RENCHE!E;. iHE Gt.4'.Ft',/EL [)Et::"I'H iS THE MINIMUM DEPTH OF EiRFIVEI.. BETP.IEEN THE (]U'I"t::F:IiJ_.. F:iN!.) THE BOTTOM OF' THE EXCRVRTTON (iN FEET). E]:'I"FtEi~:: Fi CLRE;S I OI;..: i]: NSF FIF'F'RO',,,'ED FLHN'f I"1R'¢ E:E II'.,IL:.i'T'EILL. Et}. F:t COt'.,I'tlNLICdJS; MI:tlI'.,!'/'ENFff.,ICE h.~ .,EEftENi IS RE6:!IJIRE:B,. :CF' F:I MF:tlNTENFliqC:E P.~r.r_Eft~:i'4 ZS NCI]" KEF'T CURRENT 'T'OU MFI'T' E:E I~'EQLI:i:IREr':, Tf'l ENL_FtRGE THE FiE'::r'i~'PT'[ON =,.r_, let] RND,-"OR ~.'O1_1 MF-t'¢ BE SUBJECT TO F't:4:'""=,E'K:IITZ "iN iF' Ft CI_.RE;S t E;'-r'S;TEM I:, U.:,E[ 'T'HE LENGTH IS 2:.1._ E:.t FEET. )~F' R CLF. iS:S Ii =,-r .... Eli I::, IJ'.'.~iE[:, THE LENG't"H IS .... (::l FEET. , .-, ' ....... El "r' i:::Ri:)F:]'.'ILL):t",~] ()F RNiT' S'¢S"t-'EM Pii"I"HCIIJ'I' FtNFtL INSF'Er'L:TI'r:N RiqB, PFFF_ ,HL 'T'HI'-'{; [:,EF'FiR"i'I',1ENT 14 ]: LL t::.:E 'E;L 8JEf]T ]"0 F'F.:OSEE:UT l ON. i.tiNIMdr,i DiSTFINCE BETHEEN R HELL FIN[.', FtNY ON-SITE :i..e'~r_."~ FEET FOR FI PR.'[VRTE HELL OR 2E¢.:.~ FEET FOR Ft PUBLIC HELL. HELl.. LOGS FIRE RE~]:!t.J~RED FIND MUST BE RETURNED "t"O THE DEPRRTf'IENT HI'THIN ]i:6~ DF:I"r'E; OF:' "FIqE !4ELL E:Oi'dPLETTON. SPEC ]. F I Ciq'T' IONS t:tt"~.i) CONSTRUCT I ON [:' I FIGRRM?., RRE FI',,,'R I LFIBLE I NS"i FiLLI~T Z ON. I CER'i" J: F;"T' "t-HFtT 1' t F~i',l i:~'Rf,iIL.:[I:;II:4: LqI'T'H THE RE[.:Ej:[RFMENTS F:]R ON-SITE SEP.IERS FIN[:, !4EL. LS FiE; E;E/" F:()R'IH B'¢ 'THE: i-,1UNICIPFtLtT'¢ OF FfN'¢HEF.'FIGE. 2: I I.,.IiI...L ]:N2i'i'FII..L THE ---,T .... E.~I It",i RC:COF?.I:)FINCtiE HITH ]'HE: CODES. ;.ii:: :[ ..tlqL. l:.r~.::, i'HN[ 'Fl-IRT 'f'Hi:;Z _i',l-_-, I E =,E.!..EF.. ::,Tz, TE. rl MFt'T' Fi:Ei;:!IJlRE ENL.Hf4 _~E-J'I[:. '~ I )iF:' '!"HE 14 ES i [:,ENCE 15; cR-'EMOE:,Et-E[:' 'Fo l NE:IJJE:,E MI]RE "i'HRN ): E:EE:,ROOMS:,. ,s I 1 ¢ . z ......... ]~,-,r:,, ' ......... -~" ' .... it,-~'" *~4t It'll HI-" F L.t.L.',I~I"4]' '- I...'HN~EL. t/, I].~Wlf. Ht...tbH ..... , ....... ............. ./...% ............ Aerobic Sewag'~ Purification, Inc, 3- 4- 5 6- 8- 9- lO- ll 12- GP~-~fER ANCHORAGE AREA BOROUGH Deparu.lent of Environmental Quality 3330 "C" Street Anchorage, Alaska 99503 Performed for Z~/L¢~' ~"~'~ Date performed cn~s rom reports: Soils l~g __~ ,¢ Per~%~ ~ Depth 13- water encountered? "Reading Percolatlorl ra'Ce ~-¥opose~.~ installation; Date Gross Time mi nute ' .~e ]~g~ Pit Net Time Depth to H20 Net Drop Drain Field ' ' Dep? of Io,]_e't . Depth to bottom of pit o~? t:'i76~i'c-~ ........ . coMM~m'~,~ /~A-7_.~Z~'~ '~'- ..... ~-- _% =' "~' If yes, at what depth? .... August 1, 1980 R&M No .051001-64 Mr. Daniel Middaugh 1421 L Street Anchorage, Alaska 99501 Re: Adequacy Test on Existing Sanitary Sewer System~ Consisting of a Multi-Flow with a Drain Field; Lot 19, Block 3, McMahn, Alaska Dear Mr. Middaugh:: Per your request of July 30, 1980, Peter Herstek of R~ Consultants con- ducted a test of the sanitary sewer system on the above described property. The test indicates acceptance rates determined under conditions at the time tested. Actual system performance over long periods of time depend on factors which cannot be evaluated by this test thus our office cannot warrant the suitability or fitness of the system for either an extended period of time or for user demand in excess of the expected flow noted herein. Factors affecting system performance include: o Actual use demand on the system; o Fluctuations in groundwater levels; O Physical conditions of the septic tank, leach field, trench or seepage pit and soil. It should be noted that while a septic tank and leach field disposal system is one of the most reliable methods of sewage treatment and disposal it is ~ nearly certain that the leach field or seepage pit will fail sometime during Mr. Daniel Middaugh August 1, 1980 Page 2 the useful life of the structure. Studies indicate leach fields, trenches and pits have a life expectancy of ten to twelve years under optimum con- ditions. Ail septic systems have a finite hydraulic loading capacity which can be expected to decrease with time. Because the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. During this test the liquid level in the multi flow and cleanout standpipe was monitored as water was added to the system. The measurements are summarized in the following table: FIRST DAY Date: July 31, 1980 Water Added To Drain Field Cleanout Standpipe: Liquid Level Measurements Taken From Top Of Standpipe: TIME GALLONS TOTAL LIQUID TI~ GALLONS ADDED GALLONS LEVEL ADDED TOTAL LIQUID GALLONS LEVEL 2:50 0 0 34" 2:56 50 50 28" 3:00 10 60 27" Remarks: Water level in multi-flow unit and the drain field cleanout rose 7" with the addition of 60 gallons of water. Water backing up into house test discontinues. The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. The total daily load for the 3 bedroom residence is 500 gallons; surge capacity is 400 gallons. Mr. Daniel Middaugh August i, 1980 Page 3 The Municipality requires the system to accept a surge capacity of 80% of the total daily load at a rate of 10 gallons per minute, tested for a two day period and to accept the total daily load in twenty-four (24) hours. The first day of testing, the system accepted 60 gallons in 10 minutes which is less than 80% of the total daily load. The total daily load of 500 gallohs was not accepted. Based on the above data we therefore conclude the system is not disposing of effluent at an adquate rate. Failure Criteria: 1. Water rises excessively in multi-flow at or before 80% of total load added and backed up into the house. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Janice Cecere Project Manager JC/WJT/jh/AT-N Richard S. Giessel Staff Engineer MU-miNP _Y OF _ U� U� i Development Services Department Phone- 907-343-7904. On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 017-042-19 1. GENERAL INFORMATION Expiration Date: -1 J Z 2 Complete legal description McMahon Block 3 Lot 19 Location (site address) 4100 Furrow Creek Current property owner(s) Alan & Jeanine St. John Mailing address Real estate agent same 2. TYPE OF DWELLING: E Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic n 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 $ Waiver Fee $ Date of Payment- 2 Z Date of Payment Receipt Number d L Receipt Number COSA # CSG 22 Iy 1 9 Waiver # 5. STATEMENT OF INSPECTIG .Y 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E., F. ACE Date OF AC � 6. DSD SIGNATURE ...4.. TH S, System #1 Approved for bedrooms Steven 'F: Pannone" System #2 Approved for bedrooms ���`�� : • cc 0" 14J Disapproved �qn.-�;s�o`r Conditional approval for bedrooms, with the following stipulations:. Original Certificate Date: 9-Z3 - 2. Z 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 COSA Checklist blue sheet Legal Description: McMahon Block 3 Lot 19 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Parcel ID: 017-042-19 Structure served by this system 1 A. WELL DATA 0 Well log is filed with Onsite (or attached) Well production at time of test 5 gpm Date drilled 1121/15 Water storage tank volume na gallons Total depth 70 ft Well disinfected for coliform test? ❑ Yes ❑✓ No Cased to 70 ft Q Coliform bacteria is Negative W Sanitary seal is functioning correctly Nitrate 11.5 mg/L ❑ Nitrate less than MRL (ND) R Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL (ND) Casing height (above ground) 12+ in. Collected by PES Date of flow test for COSA 8/3/22 Date of Sample 81222 Static water level at beginning of test 52.2 ft. Comments Sullivan Water Wells performed well flow and inspection of well casing. Well casing report is attached B. TANK DATA C. LIFT STATION Age of tank(s) 12 years ❑ Required maintenance completed Tank type/material 'tC "S P" Age of lift station years Measured operating fluid level in septic tank 50" Lift station material Q Standpipes/foundation cleanout per record drawing Comments: Date of pumping 8/13/2022 D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) Q ALL standpipes present per record drawing Total measured depth from grade 14.7111.7 ft (max) Measured depth to pipe invert from grade 4.714.7 ft (min) ❑ N/A — pressurized field 0 Monitor tubes go to bottom of effective. if not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: see section F below COSA Checklist yellow sheet Adequacy test date 6/02/22 Results [D Pass For 3 bedrooms Fluid depth prior to test 66/72 in Water added 450 gal New depth 84/83 in Elapsed time 1440 min Final fluid depth 66/72 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' 0✓ Yes Community Sewer Manhole/Cleanout > 100' 0✓ Yes if No ft ✓� Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' 0✓ Yes if No ft Water Main > 10' Animal Containment > 50' ❑✓ Yes if No ft P-1 Yes if No ft FVJ Yes if No ft Water Service Line > 10' Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' []✓ Yes if No ft 0✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0✓ Yes if No ft Surface Water > 100' P71 Yes if No ft Property Line > 5' M Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' [✓ Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' FVJ Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' [Z] 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' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS Based on condition and age of drain fields the 1976 drain field is 75-80% used. The 1980 drain field is 90-95% used. 3.5" of standing water in double clean out. Recommend inspection by camera to determine cause. G. ENGINEER'S CERTIFICATION OF A���s��� I certify that I have determined through field inspections and review �Co of Municipal records that the above systems are in confonnance with ; * 49 TH MOA COSA guidelines in effect on this date. �/ 2 f . Pannon �! Stever-. � e** ti•'. CE 814-0 �- �Fi COSA Checklist yellow sheet 0 C; r7 Lot 18 O Co 0 0 0 O 0 FURROW CREEK ROAD N 90'00'00"E 170.84 PIPES L' -1-1F2,0'1 23.5' CWT 46.2' 1 i 10' UTILITY EASEMENTS LLJ o I Loft 20/ CD I / 0 0 O Z N 88'05'00' 170.94111Lot 22 —___.--- Lot 21 I MORTGAGE SURVEY X SCALE 1" = 40' GRID SW 2835 Project No. 22-510/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, i nc (907) 522-6476 Phone (907) 522-4625 Fax o�� F Professional Land Surveyors ken@langsurvey.com o Jonathan@Iangsurvey.com � 4 9s 0� I hereby certify that I have surveyed the following described properly: LOT 19, BLOCK 3, McMAHON SUBDIVISIONPlat No. 65-86)49TH+ Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a �""""""""' """' """"'� representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall ��^'. KENNEiH LANGo G not be used to establish any fence, structure, or other improvements. �n `ink ^ ��`I-�4Z:Z- V0 LS -5202. Dated this the ��� Day of F"`+=moi '�'' at Anchorage, Alaska Y 40OR0�SSIONM�- It is the responsibility of the oviner to determine the existence of any easements, �4pppoa� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 Lot 19324' 32,162 S.F. :.:o:• p• 1OCTURAL I .GRAVEL -` FEATURE La Nom}= MW 16.9' n 1.5' CAW PIPES L' -1-1F2,0'1 23.5' CWT 46.2' 1 i 10' UTILITY EASEMENTS LLJ o I Loft 20/ CD I / 0 0 O Z N 88'05'00' 170.94111Lot 22 —___.--- Lot 21 I MORTGAGE SURVEY X SCALE 1" = 40' GRID SW 2835 Project No. 22-510/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, i nc (907) 522-6476 Phone (907) 522-4625 Fax o�� F Professional Land Surveyors ken@langsurvey.com o Jonathan@Iangsurvey.com � 4 9s 0� I hereby certify that I have surveyed the following described properly: LOT 19, BLOCK 3, McMAHON SUBDIVISIONPlat No. 65-86)49TH+ Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a �""""""""' """' """"'� representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall ��^'. KENNEiH LANGo G not be used to establish any fence, structure, or other improvements. �n `ink ^ ��`I-�4Z:Z- V0 LS -5202. Dated this the ��� Day of F"`+=moi '�'' at Anchorage, Alaska Y 40OR0�SSIONM�- It is the responsibility of the oviner to determine the existence of any easements, �4pppoa� covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 U L L V'#% WATER ELLS Drilling a Piling o Pumps P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Jeanine St John 4100 Furrow Creek Road Anchorage, AK 99516 Camera Inspection Report Casing is 18" above grade. Grade to 8' — no leaks or perforations 8' to 28' — no leaks or perforations 28' to 48' no leaks or perforations 48' to 53' static — no leaks or perforations Date: 8-16-22 DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC 221419 Subdivision: McMahon Block 3 Lot 19 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 11.5 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. Madmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 ' www mum 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 or g Municipality of Anchorage ® Development Services Department .............. ............ ............... z Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci. anchorage. ak. us (907) 343-7904 Septic Svstem Advisory Certificate of On -Site Systems Approval # OSC221719 During a recent adequacy test on the septic system for Block 3, Lot 19 of McMahon subdivision, 3.5 inches of standing water was observed in the absorption field. This indicates that approximately 95% of the absorption area is inundated. AlthouLh 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 Parcel I.D. o~7-o4:z-~9 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 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING COSA# Expiration Date: GENERAL INFORMATION Complete legal description McMahon $/D Bloxk 3 Lot ~-9 Location (site address) 4zoo Furrow Creek Road, Anchorage, .AK 9c)~;~6 Current Property owner(s) William Lee & Elaine Mazoch Mailing address Day phone 345-o445 Lending agency Mailing address Real Estate Agent 4~-oo Furrow Creek Road, Anchorage, AK 99fi~-6 Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 Well Day phone TYPE OF WASTEWATER DISPOSAL: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System [] Individual On-site [] Individual Holding Tank [] Community On-site E~] [] Public Sewer E~ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-famiily on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: A. WELL DATA McMahon Block ~ Lot x9 Well type P Date completed :to/2~;/xq7~; Total depth 70 ft. Parcel ID: ox7-o42-z9 If A, B, or C provide PWSID # __ Sanitary seal (Y/N) Y_ Cased to 7o ft. FROM WELL LOG Date of test lO/2~;/lq7¢; Static water level 43 Well production ';-7 WATER SAMPLE RESULTS: Coliform o colonies/100 mL Arsenic: o ug/I SEPTIC/HOLDING TANK DATA ft. g.p.m. Nitrate ~.~. mg/L Date of sample: ~l~z.12oxo Tank Type/Material Tank size ~.ooo gal. Foundation cleanout (Y/N) Y Date of pumping Anchorage Tank Steel Number of Compartments _~ Depression over tank (Y/N) N Pumper t~. ~"~-CL~ Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) AT INSPECTION ,;l~.41:zo~.o 5~ ff. 4.9 g.p.m. in. Other bacteria o colonies/100 mL Collected by: Laura Pannone Date installed 6/2z/~o~.o Cleanouts (Y/N) 2 High water alarm (Y/N) N/A C. ABSORPTION FIELD DATA~ Date installed 8/~xh. q76 / lSoil rating (g.p.d./ft2 or ft2/bdrm) / Length =~/44 ft. Width ~/~ ft. Total depth :~5/zo ft. Eft. absorption area ,;8o/6~6 ft2 Monitoring tube Y/Y Depression over field N Date of adequacy test ~l~.z,l:zo:~o Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 66160 in. Water added4,;o gal. New depth66/6o in. Elapsed Time: _o min. Final fluid depth 6616o in. Absorption rate >= 4,;0+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date System type DeepTrench/D~i~ ~ Gravel below pipe zo/7 ft. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory. Certificate of On-Site Systems Approval # 101079 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 3, Lot 19 of McMahon subdivision. This inspection revealed a nitrate concentration of 8.41 milligrams per liter (mg/L) was reported for the property's well water sample. 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. SGS ReL# 1102154001 Client Name Pannone Eng. Srv. Printed Date/Time 05/20/2010 10:54 Project Name/# Lt 19 Bk 3 McMahon Collected Date/Time 05/14/2010 12:00 Client Sample ID Lt 19 Bk 3 McMahon Received Date/Time 05/14/2010 13:00 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 05/14/10 05/17/10 SCL Waters Department Microbiology Laboratory E. Coli Nezative Total Coliform Negative 0.I00 mg/L SM20 4500NO3-F B (<10) 05/14/10 AYC 1 100mL SM20 9223B A 05/14/10 DLC 1 100mL SM20 9223B A 05/14/10 DLC ,/FURROW CREEK ROAD / ,; \ \\ 'WELL / 53, I COs !0' tJTIL ESMT 22 N88" ©6' 0O"W 1 21 UI~4~E~ NO CIRCUMSTANCES SHCPJ~_B AN AS-BUIlT BE U~O FO~ CONS~UC~0N 0R FOR ESTADUSHING 30*gNOARY OR ~;ENCE LNES, ~ ~or ~¥ SURVE":.' TYPE PLOT PLANS E LOT SURVEYS )T ~S THE RESPONSibiLITY OF THE BCqLDER OR O~ER, PRIOR TO TO RN!S~ED GRAOE AND U~ILiTY CONNEC~ONS AND TO DETERMINE ~-~E EXiSt%NCE OF ANY EASEMENTS, COVENANTS OR RES~C~ON$ WHICH DO ~OT APPEA~ ON THE RECORDED SUBD~MIS~ON SYMBOLS ~s,'t~ ~ ~ ASPP, ALT SET RE,AR ,4~""m I~ O, RA~N,A~E F~:NO REBAR ~ ~O ~E~CE ~ CONC~'~B NOTE: ONlY THOSE IMF*~Q',~'E:~ENT~ AT, DYE OF;COLIN~ ANE~ A~L B~STANCES ARE RECORD UNLESS OThERWiSE Prepared by Robert E. Jo, ns, ,Jr. ,~% /~,, ~ SOC~ Professione Lend Surveyors 642 E~ ~2 A~, ANCHORAGE, ,~ASKA 9950~ I =40'~;~.,Ej '~G~ .......... ~ s"~"'~: 5/~ 7/~ 0 LOT 19 BLOCK 3 MCMAHON