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HomeMy WebLinkAboutLANG LT 1Lang Lot 1 #015-273-56 Jun 2521 10:34a Anchorage \Vel; & Pu: --,p Se, 907241074'2 P. Pump Installation Log Well Dri Ulug Permit Nuinber. 56 Legal Description Block 1,ot L FLUE p lxtst.kuation Date of Issue: Property Owner Same _Address: p !Pump Intake Depth Bd%v Top orWcLi Casing: feet P"'alp Model: PUMPSize: —hp Pitless AdRp(er.Bu,t,jal Depth: feet Pitless Adapter Installer; Well Disinfected Upon Cavxpj,etjon? L31'y(ls 0, No Metbod of _Disi.nfection; Comments: Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE COMPanY- ___ 7640K.,,gStreet Anchorage. AK 9951,9 Mailing Address: P11: (907) 243-G?40, State: Attention. rho ptwp jr.zUjjer &jjaU pro.,71d. r- PutqP i)st;a" lat" Ov '0o to tan -site ;v-" Ui in 30 days of numn installation. 5`2m' 1 1 #%L AUG 6 2013 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni,org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131222 PID Number: 015-273-56 ❑ New ❑✓ Upgrade Name: ABSORPTION FIELD Benjamin & Janet Shefsky ❑ Deep Trench [Z] Shallow Trench ❑ Bed ❑ Mound Address 3920 O'Malley Road Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 522-4506 4 1.2 GPD/SF 8.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.5 FL Gravel depth beneath pipe 4.0 Ft. Subdivision Block Lot Lang 1 Fill added above original grade 1-3 Ft, Gravel length 52 Ft. Township Range Section Gravel width 5-7FL Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 520 Fly One Ft. Well >100' >100, N/A N/A >25' TANK ❑+ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1 1,250Gal. Surface Water >100' >100' N/A N/A Material Steel Number of compartments Two Lot Line >5' >10' N/A N/A NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain None Noted Pump on level at Pump off level at High water alarm at Remarks Flow Diverter Valve Placed. in. in. in. Existing Septic Tank Decommissioned in Accordance with Municipal Code. Pump make and model Electrical Inspections performed by PIPE MATERIAL Housetotank D3034 Tankto drainfeld D3034 Installer G & R Excavating Drainfield HDPE C01MT D3034 Inspector MEA BENCHMARK (Assumed elevation) 100.Oft Inspection >r 1 7/30/13 2 ° 7/31/2013 Location and description dates: Bottom Step of Deck. 3" 8/1/2013 4'" COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL E`g�W% 114 ►•4�c-.of •.. 4f� Conditional Approval: Date ,P.•° S��® . • MICHAEL ...4n6 N •: J : GE -4381 �r Approved `?/, Date -30-�0! pROFESSMNWW •• Inspection Report- 1-1-12/dot/ v Permit Number: OSP 132122 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 — 343-7904 OMALLEY ROAD EAST 289.58 PID No.: 015-273-56 —� — — _ 10_ T&E EASEMENT ------------------I--- ---------------- I 4" Insulation 4' Wide LEGEND S1 — Under Driveway and I Over Septic Tank. I I I \, DV — Foundation Clean Out I C4 +—I wl w TH1 al e w �I C' i M1 I C5 8 C S1 34.7' 28.3' S2 42.6' 33.6' C5 76.4' 90.0' 64 84.8' 64.5 I I M1 74.1' 87.0 I NOTE Drawing Not Completed From Surveyor As Built. Locations are not Exact. Swing Ties are I I Relative to the Existing House. I I N86'Oi'18"W LEGEND S1 — Septic Vent C4 — Clean Out M1 — Monitor Tube FCO — Foundation Clean Out FDV — Flow Diverter Valve ❑ — Existing ❑ — Proposed LANG SUBDIVISION LOT 1 71,722 S.F. Existing 1.000 Gallon Septic Tank Decommissioned in Accordance with Municipal Code. Four Bedroom Home Existing wPu Garage PLAN AS BUILT SCA1E 1' - 40' Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP131222 PID No. 015-27356 &1-13 PROFILE AS -BUILT - No Scale On -Site Wastewater Disposal System Permit Permit Number: OSP131222 Tax Code Number: 01527356000 Work Type: Septic Permit Effective Dates: July 30, 2013 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 to July 30, 2014 Design Engineer: ANDERSON ENGINEERING Subdivision: LANG Site Legal Address: LANG LT 1 G:2635 Owner/Address: SHAFSKY BENJAMIN C & JANET S 3920 OMALLEY ROAD ANCHORAGE AK 995161501 Site Mailing Address: 3920 O'MALLEY RD, Anchorage This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 71722 Total Bedrooms: 4 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. Received Issued By MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-273-56 Property owner(s) Benjamin and Janet Shafsky Day phone 522-4506 Mailing address 3920 O'Malley Road Anchorage, AK 99516 Site address Same Legal description (Sub'd., Block & Lot) Lang, Lot 1 Legal description (Township, Range & Section) Lot Size 71,722 Sq. Ft. Number of Bedrooms Four (4) "j�d 3� 13 (� APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: Receipt Number: (M all that apply) Absorption Field � Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank El Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 'L CE I/"L__-1 property owner or authorized agent) Permit/Rush Fees: S 30 Waiver Fees: Date of Payment: "j�d 3� 13 (� Date of Payment: Receipt Number: �G Receipt Number: Permit No. O,c-if 131 01 -aa Waiver No. Permit App_9-1-12.doc ANDERSON ENGINEERING P.O. BOX 244773 ANCHORAGE,; AK 99524 522-7773 677-7766 FAX July 23, 2013 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 1, Lang Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The existing absorption system on the subject lot has failed and must be upgraded. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the four-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic system. The existing 1,000 Gallon Septic Tank will be replaced with a new 1,250 Gallon Septic Tank. The existing tank will be decommissioned in accordance with Municipal Code. The existing absorption trench will be left intact and tied to the new system with a flow diverter valve. Also identified on the plans are the locations of the existing well on this and adjacent lots and adjacent septic systems. No conflicts exist between the proposed septic system and the wells on this or adjacent lots. Protective radii are shown to the adjacent wells. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. A test hole was recently placed on the lot which indicated Gravel with Silt and Sand (GM/GW). The percolation test performed on the underlying material resulted in an absorption rate of 4 minutes per inch. We have designed the new trench to be within the 30' radius of the location of the test hole with an application rate of 1.2 gallons per date per square foot. We are proposing to place a 50' long trench by 5' wide with a 4' effective depth. The total depth of the system will be 8' with the distribution line at 4' below the existing surface. A minimum of 3' of fill will be placed over the new absorption trench and 4' over the new septic tank. The ground surface on the lot slopes slightly to the southeast in the area of the new and existing absorption trenches. The new trench will be placed parallel to the contours of Lot 1, Lang Subdivision July 23, 2013 Page Two the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments OMALLEY ROAD + --------------++------------------------------ ------------------------------------------------------ , u ' I I 1A z ; i WO wen g rn In, rrl j Ex®O9 J/ CIRCLE Wall I I � I , 1B amirg Wmi ® I I well f .I it I ---------, 7`1L _____________________________ _________ r______ i OFi 49th �..� 1 ............................................ ;MICHAEL E. ANDERSON'; 1�; AREA MAP ' v � f :• t`l0, CE -4381 � ♦♦••��1�FESSI�Pi�i•• SCAI E 1' 100' I \ I I X� I EXISTIN 50' Long x 5' x 3.5' Eff tiv Depth Absor � Trench Ca j r—I <\ wcnl �qqI W' I I 5 Loi o I x 4' 1 sorpt I 11 �I I I I I NO Place 4" x 5' Wide :tive Depth Areas E I or Surface 1�q 10 ' of Any P I Sep 'c System. —I I_ N86-01'1�"W/ 141.40 LEGEND SV — Septic Vent CO — Clean Out MT — Monitor Tube FCO — Foundation Clean Out DV — Diverter Valve ❑ — Existing ❑ — Proposed of the SITE PLAN SCALE 1' - 40' C L1 S f%move Existing 7.000Gallon Septic Tank Place ew 1,250 Gallon 'k ec mission EAstin Tank in Accordance with Muni pal Code. LOT17 LANG SUBIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area 500 SF/5 SF/LF-.5 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 36" Below Original Ground Surface. Total Depth to be 8.0' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Place a Flow Diverter Valve to Tie in Existing Trench. 3'6"I I Natural Backfill Geotextile Fabric 6"O 4" Perforated PVC (Holes Down) 4'0" Drainfield Rock 5' TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: Lot 1, Lang Subdivision PERFORMED FOR: Ben and Janet ShafSky DATE: 7/19/13 PROJECT No.: PARCEL ID#: TECHNICIAN: JB or PTH TEST HOLE 1 (Peet) 1 2 OB/OG 3 4 SILTY SAND W/GRAVEL 5 SM/SW 6 7 8 9 1 O WAS GROUND WATER ENCOUI IF YES @ WH 1 I DEPTH OF WATER AFTER MO DATE OF MO 12 14 15 B.O.H. 16 17 18 19 M c 49th MICHAEL E. ANDERSON NO, CE -4381 AT DEPTH? NITORING: None PVVV NfTORfNG: 7/223/13 E GROSS TIME NET TIME DEPTH To NET DROP DATE READING (MINUTES) (MINUTES) WATER (INCHES) (INCHES) 7/19/13 TEST HOLE PRESOAKED PRIOR TO TESTING.- 1 ESTING:1 1:44 5.00" 2 2:14 30 11.13" 6.13" 3 2:15 4.50" 4 2:45 30 10.50" 6.00" 5 2:46 4.75" 6 3:16 30 10.75" 6.00" PERCOLATION RATE: 5 (MIN/INCH) PERC. HOLE DIA.I0 (INCHES) TEST RUN BETWEEN: 4 FT. and.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7/23/13 PERCOLATION RATE: 5 (MIN/INCH) PERC. HOLE DIA.I0 (INCHES) TEST RUN BETWEEN: 4 FT. and.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 7/23/13 MUNICIPALITY OF ANCHORAGE DE ;TMENT OF HEALTH AND HUMAN SER' =S Environmental Health Division / J 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name• — a b LAA10 DISTANCES TO FROM SEPTIC TANK/ ABSORPTION FIELD/ WELL Address " // // /l03$3 /L./C'ffi• I 99S/// WELL — _ Phone(s) Permit No. // .410 No. of Bedrooms 3 LOT LINE /Q�,fi �,.) V A) LEGAL DESCRIPTION Lot Block/ AfA Subdivision I L;�I FOUNDATION ` 7e 3.3 Township, Range, Section AS-BUILT DIAGRAM tShow location of well, septic system, property lines, foundation, driveway. water bodies, etc-) TANKS SEPTIC ❑ HOLDING Manufacturer Capacity in gallons - Material No. of Compartments TYPE OF SYSTEM ❑ TRENCH ❑ BED W. DRAIN []OTHER Depth to pipe bottom Irom original grade FT Toiarom original grade � —� FT FII added above original grade G� FT _ Gavet depth beneath pipe 3..S FT I — — — Gral lveength FT_ Gravel width FT I Total absorption area erlw SQ F_f Distance between lines - FT is ,rt Number of lines Soil rating /5'0 SOFT Pipe matenal / ��/o ))0 \ re16 — r-- I 3 4 I t Installer Dale Installed WELLS X PRIVATE ❑ OTHER (Identify) �� — A0 r t7 1 3' -- G ELL Classification (A.B.C) _ Total Depth Cased to FT FT -- — Inslallci Date Installedar-- REMARKS: /AfP44411O1l /aiAM VJV19Jtt 1 /,r4u4+7/011 rn/We n4 Scale: In ltvC-S Dale. y(,lrg Performed A: by:/ pJ/c r ENGINEER'S SEAL — �' Y � ✓ �� cerlily that this inspection was performed according to all a Municipal and State guidelines in ellect on [his date: g Health Department Approval:./'^ S._-_���`�"� �—_ Date: F? •-�- r `� rU I a tomo) PERFORMED FOR LEGAL DESCRIPTION: G DEPTH ` (FEET) 1 2 3 4 5- 6 7 - 8- 9- 10- 11 - 12- 13-�� 14- 15- 16 17 18- 19 - A eo"4L�INI d�6l 666664 ��;•"® old, °day' 4y Municipality of Anchorage 10 a DEPARTMENT OF HEALTH & HUMAN SERVICI' ��r 6646 6646.66 825 "L" Street, Anchorage, Alaska 99502-0650 66.64.. a. e.a .4.6644 SOILS LOG �- PERCOLATION TEST OA,a� 1i �e z2si JR• ®� n" 51e 7�1 .514AA A / lfx/� s� SEAL) DATA P' Township, Range, Section: T/, -A/ /Z-�d ice Z/ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P _ E Depth to Water After Monitorinp7 Date: Re Date Gross Net Depth to Net Time Time Water Drop 20 - PERCOLATION RATE — (minutes/inch) PERC HOLE DIAMETER AlEST RUN BET/WEEN --- FT AND FT / / '�/ COMMENTS Sa�L � C7,CON /%J 11,)d7 ` �y' ��le %/07( �GIC� � �%��/�fL 70 [ t!�//� PERFORMED BY: I Ke"5 1 CERT IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: e9 _ (e~(7/'/ --_ 72-008 (Rev. 4/85) 'DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROEClION , 825 L STREEl, ANCHORA(�E; AK 995O1 264`472O WHAT— lit ][lFU TnTUE�RAN 9��0 Q 1VAKEMM]['y �ERMIT NO: 870104 OATE ISSUED: 05/27/87 110003011 HERB LANG / AECS INC^ �UDRESS: PO 8OX 110383 ANCHORAGE, AK 99511 �ONTACT PHONE: 561~5040 ^EGAL DESCRIP: SU8DIVISION: PROPOSED^LANG LOT: 1 BLOCK: NA SECTION: 21 TOWNSHIP: 12N RANGE: 341 -UlSIIE: 72723 (SQ.FT. OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. Aj.�:11 L�to AL !1;-4 DEvll1 TO PIPE BOTTOM (FT") 5.0 4.0 GRAVEL DEPTH (FT.> 0.5 3.5 TOTAL DEPTH (FT^) 5"5 7,5 SRAVEL WIDTH (F[.> 18,O 5"0 GRAVEL LENGTH (FT.) 35.0 45.0 GRAVEL VOLUME (CU"YDS.) 23,4 33,4 TANK SIZE (GALS) 1,0O0.0 ** 1 0^0 ** 150 11- RATING (SQ,FT./UR) 138 138 ** TANK MUST HAVE A[ LEAST TWD CUMPARTMENTS l certi�y that: 1. l am iamiliar with the r on~si�e sewers and wells as set 1orih by the Municipality o4 Anchorage (MOA> and the State of Alaska` 2. I will insial] the system in accordance with all MOA codes and regulations, and in compliance with the desiqn criteria o{ ihis permit" 3. I .1. .1. adhere to a1l 11 A and State o{ Alaska requirements [or the set back stances |rom any existing well, wastewater disposal system or public sewerage sysLem on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum o� 3 bedrooms and any enlargement will require an additional rip) rmii" 1F A LIFT STATION IS INSTALLED lN AN AREA COVERED BY MDA 8UILD{1\1G CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE O8TAINED; (2} AS-BUILTS WILL NOl BE APPROVED WITHOUF AN ELECTRTCAL INSPECTIUN REPORT; AND (3) THE ELECTRlGAL. WORK MUST BE A, L MTHAH) 0 MUMMA% SIGNED DATE: APPLICANT: HOB ()No v i rA., ISSUED BY DAT1: Municipality of Anchorage DEPARTMENT OF HEALTH R HUMAN S 825 "L" Street, Anchorage, Alaska 9950, SOILS LOG — PERCOLATION' PERFORMED FOR: //kee "- CBf�S �•hr_RJ2�iv.5. Q` /7 �^+� (ENGINEER'S SEAL) eir `-� •••N •• .••s ,. Ae 0 !*06•4�TH ••-f�*fie ••....,.... ., •.••.,..R S U:ROY C. t ID JR. o r If 1 �i •�'••....••' • \OQ a' 6 ° LEGAL DESCRIPTION: }•[v/ �P" s� Township, Range, Section: T/y/0 23�a 7 Fp7w7l SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1E 17 1E 1� !2Q coMA4e.0�1) S7SAc.,,, %Zan7e pe , se WAS GROUND WATER 0 ENCOUNTERED? /w,� p L IF YES, AT WHAT O DEPTH? P E Depth to Water After Monitoring? No. a Dale: r 0 20/ PERCOLATION RATE S, Z (minutes/inch) PERC HOLE DIAMETER / TEST RUN BETWEEN — `Jr FT AND �t—_ FT COMMENTS I//��«eq P" ^•rPn d SO 17' 1.6 1;?— '%ySe_ !� '"/ V Z "/ a0CIr- X SO / /V --t,9 PERFORMED BY: /' 1 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. S/7 3 72-008 (Rev 4,851 10 0' 0 \10 -�•s ? I °;°•77 :'6.16 O '' 'MOR M 280.00 0 N $0.00 72-69 w -- a o1 72.69 1 69 .55 I n � u J ate• 00 o o a o I 01 58. 00 , o u-• e•sS• m w to � A N W W y -n O lam/ m • (fi n � qV s 5e 00 1 �99Ln Q Q > as 1 Q 493.58 45. m, N, 135.17 150.19 I S00°12'24"E 611.27 Qp s N L5 ? . �O • • • I W `� '.•''•fah 00 $ � fro : �.`C1 �!► 1 i c p I . I r� Al- ' I jr s 11,00'08'31"W 610.63 °p 31 5.63 10� 9�Ilb_ I Reser e I m N O VnCO GD Cp • O N �} G� -V �• V / L 00 O Viw s+ V oK O N p dA_ VI =" � I V 00 N _ M \-r-' Z -4- W 10 0' 0 \10 -�•s ? I °;°•77 :'6.16 O '' 'MOR M 280.00 0 N $0.00 72-69 w -- a o1 72.69 1 69 .55 I n � u J ate• 00 o o a o I 01 58. 00 , o u-• e•sS• m w to � A N W W y -n O lam/ m • (fi n � qV s 5e 00 1 �99Ln Q Q > as 1 Q 493.58 45. m, N, 135.17 150.19 I S00°12'24"E 611.27 Qp s N L5 ? . �O • • • I W `� '.•''•fah 00 $ � fro : �.`C1 �!► 1 i 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 Parcel I.D. 015-273-56-000 Expiration Date: 9/6/2025 Legal description LANG LT 1 Site address 3890 JANET LEE CIR Anchorage AK 99516 Current property owner(s) SHAFSKY BENJAMIN C & JANET S X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 10/16/2024 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 Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 .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 Application 1. GENERAL INFORMATION Parcel I.D. 015-273-56 Complete legal description LANG; LOT 1 Location (site address) 3890 JANET LEE CIRCLE, ANCHORAGE, AK Current property owner(s) BENJAMIN SHAFSKY 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 907-748-0083 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer S. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 11 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 $ Waiver Fee $ Date of Payment U Z / 2- 1 Date of Payment COSA # 0,S7G 2 Y) `I07 Waiver # COSA Applicefion_June 2022 COSA Checklist Legal Description: LANG; LOT 1 Parcel ID: 015-273-56 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UNKNOWN Total depth 99.5+ ft Cased to UNKNOWN ft Q Sanitary seal is functioning correctly Q Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 9/6/2024 Static water level at beginning of test 93.3 ft. Comments B. TANK DATA Measured operating fluid level in septic tank *50" Date of pumping 4111 -1' ❑ Required maintenance completed, if AWWTS Comments: *IN STI / 49" IN ST2 D. ABSORPTION FIELD DATA Which system tested (date installed) *8/30/2013 W ALL standpipes present per record drawing Total measured depth from grade 10.7 ft (max) Measured depth to pipe invert from grade *4.4 ft (min) ❑ N/A - pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective **3.5'-3.7' ❑ 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) N/A If yes, enter date Well production at time of test 6.3+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes IN No EI-61iform bacteria is Negative Nitrate ! mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L },Arsenic less than MRL (ND) Collected by GEG, LTD. Date 9/6/2024 T STATION ❑ Require ' tenance compi Age of lift station rs Lift station nal Adequacy test date 9/6/2024 Results Q Pass Fluid depth prior to test 0 in Water added 758 gal New fluid depth 19.5 in Elapsed time 120 min Final fluid depth 18 in Absorption rate 600'11 gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used **22 in Effective depth remaining **26 in Comments/Deficiencies: FOR 2013 TRENCH THERE ISA 3" ELEVATION DIFFERNCE FOR DISTRIBUTION LINE FROM ONE END TO THE OTHER. "BASED UPON GEG ELEVATIONS. LAST 257 GALLONS OF WATER ADDED TO TRENCH ONLY CAUSED 3.75" RISE. THE 1987 TRENCH MT WAS DRY AT BEGINNING AND THROUGHOUT TEST. 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' W Yes if No Community Sewer Manhole/Cleanout > 100' ❑i Yes if No ft 0 Yes if No ft Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Fol Yes if No ft Holding Tank > 100' Fa -1 Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft ❑■ Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑■ Yes if No ft ❑■ 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' W Yes if No ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' [E Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑■ Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' 50� Yes if No ft Community Wells > 200' FE1 Yes if No ft Water Service Line > 10' 0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS 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 Gayness Engineering Group, LTD. (GEG) Phone Engineer's Printed Name Jeffrey A. Gamess 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 907-337-6179 �. .... fr y A—Garness: E-79 3 V9 pti�-•. :�eG LICENSE Q� p��`ess+ono #AECC884 �'V��`�•pd� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907-343-7904 On -Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC241407 Subdivision: Lang, Block: , Lot: 1 A water sample revealed a nitrate concentration of 5.90 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. 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. O MALLEY ROAD EAS T 289.58 MUNICIPALITY OF ANCHORAGE " DEPARTMENT OF HEALTH & HUMAN SERVICES N��i Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY rte' APPROVAL FOR A SINGLE FAMILY DWELLING Parcel 1. D. # E�1 —a] -2D — _'!�iC/o HAA # _ 1,l �I 2)C) Q �j 2l 1. GENERAL INFORMATION Complete legal description Lo T 1 / LO -01i G' Location (site address or directions) -392-0 XrA6�uit 0 -,A `f ►�C�AD 1. n► ' ..AA E�E ' L c t Property. owner., B CN: Su 4F5►�y Day phone 6-6 3 - 5530 Mailing address ��.cl'Zo' or�°��`( �Oq9� 4�cN A� C? Cf 5z2 - 450 H11, Lending'agency :" PJ1e Day phone �A MaiPing address AI s, w / Agent N Day phone Al Address N Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water X NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: 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 021 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 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 134-71 Engineer's signature 6. DHHS SIGNATURE Approved for L bedrooms. Disapproved. Conditional approval for M Additional Comments 5E5 Phone 337-17'1 Date _97 9 /C� Z bedrooms, with the following stipulations: lnrtr 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 DHHS 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �_o7 1. . LAJ (�;S/D Parcel I.D. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number NIA Log present (Y/N) NODate completed VIQ"0v4n1 Driller UNkiJrx.JrJ Total depthyNKt1DW(J Cased to UN Kuawr.) Casing height I q"y y L Sanitary seal (Y/N) _ 6-5 Wiresro erl p p y protected (Y/N) `1I z - . .--A n :� o MUNICIPALITY OF RROMRIN LL LOG AT INSPECTION _ ENVIRONMENTAI.S VICES DIVISION t Cc) Date of test Static water level HAY 12 19 9 �� /o" (i8Low 6ao%w0 O O Well flowE-V RECE 9 -P.M. �• q (DS 9 -P.M. MrnI NLES fV (67(o(67(o &acCm�S Pump level UKNt%AJN N SEPARATION DISTANCES FROM WELL TO' N%A Septic/holding tank on lot I ; On adjacent lots ? 100 FT TO '4my P. L 2 Absorption field on lot t Z 3 FI' '. ; On adjacen N6s 19v FE�-r' 7ro CLosEs' OEv�1,oP+�O P. L Public sewer main N 1A Public sewer manhole/cleanout N /A Sewer service line 5> I o FT. oPPDs ti'r Petroleum tank N /Ai -Pae- hoHacywEIZ SIDES of t+ou5- WATER SAMPLE RESULTS: Coliform Nitrate 4.1 M Other bacteria - Date of sample: �/ �% Z Collected by: G�A(��55 S. SEPTIC/HOLDING TANK DATA Date installed ,�16._/`,$7Tank size IOO2 C_"A Compartments Iwo CleanoutsY%N)4 Y��S Foundation cleanout (Y/N) Depression (Y/N) N� High water alarm (Y/N) Alarm tested (Y/N)N Date of pumping,_ . ZS z Pumper a + HV/- 4f SE2y(C � SEPARATI'ON.DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10.0 r"T On adjacent lots 5 "=' c'wFJ7- � PF2 „. 1 Foundation 24- FT'� To property lineN ©�t Absorption field 31 Fr' 2 Water main/service line I FT • OPPaS+vr StD6S oF- I-4Du5E. Surface water/drainage >,> tC)CO 7 W 1 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date i d Size in gallons Vent(Y/N) High water alarm level " level at Manufacturer Manhole/Access (Y, Meets MOA electrical codes (Y/N SEPARATION DISTANCE FROM LIFT STATION TO: EM On adjacent lots "Pump off" level at Cycles tested Surface wa D. ABSORPTION FIELD DATA `�'/ Date installed (,&/e-7 Soil rating 150 so' E ' System type 0 O W IDG pp_4W/Tacw<G4 Length 50 Width 5 FT - Gravel thickness �' `' ET' Total depth -7' 5 FT Total absorption area Fr? o Cleanouts present (Y/N) �� 5 Depression over field (Y/N) NO Date of adequacy testi Z Results (pass/fail) p�SS for H QEr-- bedrooms Peroxide treatment (past 12 months) (Y/N) N A If yes, give date N �IA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: O > i"r5G f7-, CZ) Well on lot ('Z 3 On adjacent lots sE.F- 1-"62- LEDPUZProperty line 30 Fr. CU Jo c wT1 nN To building foundation 4'o FT' To existing or abandoned system on lot uNl-NovJtJ rv�A /�1 » toFi• OOr- WV SEs On adjacent lots N Water main/service line CP161EVSL0F6-P Tn11L 2 Surface water N riveway, parking/vehicle storage area ZO 171- Curtain TCurtain drain N� I• 1459E(notJ p�paftG' Dam 616/8.7 Z, r-.n.,C9,M S i P& VIS.04-) f- Et D ✓H su (lF�iF� tT " E. ENGINEER'S CERTIFICATION „tJ 5-1y/01 2- I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature — 1 7 Engineer's Name _ Date 5-19 GF -f 2 V A • GAP,-)1ES5 2 HAA Fee $ i1U c(D Waiver Fee: $ — Date of Payment Date of Payment Receipt NumberV77 Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Alaska Water 8c Wastewater Services "Preserving the Last Frontier" May 9, 1992 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 ,f Anchorage, Alaska 99516650 Ref: Health Authority Approval (HAA) Application for Lot 1, Lang Subdivision To whom it may concern: 1. WELL. ADEQUACY TEST: Attached is the MAA application for the subject lot. An adequacy test was run on the well by pumping 4.905 GPM (average flow rate) for a total of 138 minutes. The total volume pumped was 677 gallons. The static water level, at the beginning of the test, was 100.83 feet from the top of the well casing. The drawdown on the well, at the end of the adequacy test, was 101.83 feet from the top of the well casing. Thirty minutes later, the well had completely recovered to 100.83 feet. Based upon this data, it can be concluded that the well is capable of producing 450 GPD, as required for a three bedroom home. 2. SEPTIC SYSTEM ADEQUACY TEST: The septic system adequacy test was performed concurrently with the well test. Water was introduced into the clean-out, located at the end of the trench, at a rate of 4.905 GPM for a total of 138 minutes (677 gallons). The water level in the system was monitored with a float located in the monitoring tube.. During the test the water level in the monitoring tube rose a total of 8.5 inches (79.6 gallons per inch). The recovery of the system was monitored for 90 minutes after the water was shut off, and the results were plotted on log vs. log paper (attached)_ Based upon this data, the system is adequate for a three bedroom house (450 GPD). 3. SEPARATION DISTANCE TO WELLS AND SEPTIC SYSTEMS ON ADJACENT LOTS: As can be seen from the attached as -built survey, there are no developed lots within 1OO feel: of my client's well_ The closest well is located on the lot (a BLM tract) to the west of Lot 1, Lang S/D_ It; is my belief that this is a class "C" well which serves two private Telephone - Fax 338-3246 • 8471 Brookridge Drive • Anchorage, Alaska 99504 residences. The separation distance from my client's septic tank and absorption system to this well was verified to be greater than 150 feet. If you have any questions regarding this system please call me at 337-6179. If all goes well, please mail the HAA to the homeowner. Thank you. Sincerely, J1.1,1rVA. Garne P.E. 0nsultant JAG/jag 5hafsky2.wps (F7NP, 5Ie�" REPAP_ /51 PE;Gj OSMAt�r-Y 90AD 5g� EAs�' 71 q,tj 3 o o o z � 0 N N \S\ v1 ` N \0)I X60 Dt 0' It .. do j dot 0, wc-L J '0 Q QI�'b EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. F r � q►I IA06 AS-EiUiLT ,� NO CORNERS SET THIS DATE T F � cr I t ( I hereby certify that I have performed a Mortagee's in- spection of the following described property: — LO T" I _ L_AIJG— -�5u Pam. Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent there- to, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 4--(H day of Al A Y 19_J z— FRED WALATKA & ASSOCIATES Engineers and Surveyors CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FAX: (907) 561-5301 ANALYSIS RESULTS for INVOICE # 53346 Chemlab Ref.# 92.1871 Sample # I Matrix: WATER Client Sample ID LOT 1 LANG SUBDIVISION KITCHEN SINK PWSID UA Collected MAY 1 92 @ 13:00 hra. Received MAY 1 92 @ 15:03 hxB. Preserved with AS REQUIRED Analysis Completed MAY 4 92 Laboratory Supervisor STEPHEN C. EDE Released By C Client Name :AK WATER & WASTEWATER SERVICES Client Acct :AKWTRWS BPO# PO# :NONE RECEIVED Req# Ordered By Send Reports to: i)AK WATER & WASTEWATER SERVICES 2) ................................................................................................,.............................. Parameter Results Units Method Allowable Limits ------------------------------------•-------------------------------------------------•----------------------------------------- NITRATE-N 4.1 mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: GARNESS. Remarks: ............................................... ........... .,.............. ................. .......... ...................._........a,.. 1 Tests Performed ` See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Less Than, GT -Greater Than AS? S13S Mernber of the SGS Group (Societe Generale de Surveillance)