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Home My WebLink AboutLATTA LT 7__ I[I 1 /2 Municipality of Anchorage Page 1 of 2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System andlor Well Inspection Report Permit Number: SW990367 PID Number. 015-142-50 Name: DAVE BERNARD Wastewater System: O New ■ Upgrade Address: 5200 EAST 112th AVE. ANCH. AK, 99516 ABSORPTION FIELD Phone: (907) 346-3868/267-2380 No. of Bedrooms: 3 0 QBeP Trench Cl shallow Trench Cl Bad O MoundOOther LEGAL DESCRIPTION s� 0.45 Tom`' ° ' `��' i 1`'x.2 MAX.F. m/�. FL Lot: Blade Subdttrtslon: Depth to pipe bottom from ortQbW fradss Crawd depth beneath pips 7 — LATTA 4.1 FL7.1 �. Township: — Range: — Section: — Fu adia above aftlnd grads 0 naval kngW 77.25 FL Gravel rtdtlr Run6a of Mea ahlarxs barren Mea ;WELL: ❑ New ❑ Upgrade 2.5 n 1 — M man OW40b. A.9.0>01�—MCaned To: Told absorpttan aro: 1097 Pipe materlak ASTM D -3034/F-810 F, sa FL COW. gale C:E[led: Staub Wdat Leigh Inde er: G & G EQUIPMENT Date bat ted: 11/15/99 FL -7FL Pomp set eaft He%?* Above c�a�:a: TANK CM FL SEPARATION DISTANCES ■ Septic O Holding O s.TZP. TO Septic Absorption Field un Station Holding Tank bae/Prtvato saver Ltr:aa Mandactarar: ANCHORAGE TANK caPadb In Qanona 1000 From Tank well 100'+ 1000+ — — 25'+ STEEL t �m� 2 Surface 1 oo'+ 1000+ — — — LIFT STATION Stm u, Sailor= rtonufaaturar• Lot 5'+ 10'+ — — — Une 'Pump an lard air mp at: avatar warm at: Foundation 5'+ 108+ — — — IHO -.0; Pump (take al: aacirloal hwp*cVww pafamod by: Curtain NONE KNOW Drain f BENCH MARK Remarks: txatlen a:rd oaacriptlan: BOTTOM OF SIDING AT SOUTHWEST CORNER. max 100.00 tt talanNEWS SUL 44p4`ooO� 0 Inspeaidons performed by AWWC, INC. Dates: 1st 11/15/99 Q....:... ... ........:... 2nd 11/15/99 3rd � ess; Q Department of Hea[ nd Human Services approval � —7953 �.�oa QOes •..•.... Reviewed and approved by: t - Date: Z — -2 7-0 ...,,.•• ��p°'profeesto��.—�4� DOD000d —013(Rev. 9/91) MCA 25 PERMIT NUMBER: AS -BUILT SW990367 r- -- -- — -- — A D PAROL ID HUMBER: 015-142-50 — — _ — -- --. --1 II r- -- -- — -- — A 8 C ST1 31.1 18.4 I ST2 36.2 19.8 - t I I j1k NDN° DBL1 38.6 20.1 - 1C01 SEPTIC TANK DBL2 39.7 19.6 I A / DELI - 19.2 29.4 I EXti0R oM I DBL2 MT1 - 22.7 31.7 3 F'0° SE CO2 - 67.4 54.1 �{p I FLOW DNER7ER (Fa) – 67.3 54.3 I , EXISTING DRAINFIELD TO BE53.7 USED AS A RESERVE SM MFD 15.7 — I C e I Col I �� i Mn onamamf I I NEW DRAINFIELD�� CO r.J I � I Fm aza oo- 99.14 (AVGJ sn 517OF OF IANK AttIJ&- 979 r fOP OF fANC /1f 01MR1 - 9798 NSW 1000 GALLON j I \ "=Oro" %P1]G TANK xaF m Af Wxf - 9732 I I Af Olttl.lrf - 97?3 ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD. SURE 26. ANCHORAGE. AK. 99504 PHONE (907) 337-6179/FAX: (907) 338-3246 LEGAL DESCRIPTION: LATTA SUBDIVISION; LOT 7 TYPE OF WORK: AS -BUILT OF SEPTIC SYSTEM UPGRADE PREPARED FOR: PHONE NUMBER: DAVE BERNARD (907) 346-3868/267-2380 QA17E: DRAWN BY: SCALE: PAGE: 12/20/99 K.D.W. 1 = 40' 2 OF 2 fRA ane - I00.91(A0J mRrOF PIPR -96.8 `— MOMOF 100 - 89.1 (AVO) a ' f ........ ... ............ ness; I •• C -7953 e`' G of slot'!'g GREAI'ER ANCHORAGE AREA BORgUGH Anchorage, Alaska 99503 INSPECT~LpN REPORT ON-SITE SEWAGE DISPOSAL SYSTEM , f ~w ....... ~.-, ,,' SEPTIC TANK: DISTANCE ,~_, FROM WELL pi/,.' MANUFACTURER INSIDE LENGTH ~'~ / INSIDE WIDTH NUMBER OF COMPARTMENTS LIQUID DEPTH __,LIQUID CAPACITY /¢--~-~2 GALLONS. SEEPAGE-FPT-T. ~'- ~/~.~, NUMBER OF .PNT-~ / DIAMETER / LINING MATERIAL .~,~t'*~..~ CRIB SIZE: BUILDING FOUNDATION___ OR WIDTH ~ LENGTFI'~ DEPTH DIAMETER___DEPTH '/---~ISTANCE FROM: TOTAL EFFECTIVE NEAREST LOT LINE . WELL ABSORPTION AREA (WALL AREA) ADDITIONAL ABSORPTION SQ. FT. WELL.: TYPE p ¢" a'--~., BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED DEPTH NEAREST SEPTIC SEWER LINE TANK__ REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: (-~'J"i¢.~/.~', ~(,~. . ~ PIPE MATERIAL ' LOT SI_OPE: ....... REMARKS: Form No, EQ~O31 DATE DIAGRAM OF SYSTEM i',II:::t::.::IP'II..IP1 NI.:.II"'II:3F!:Fi: i]F [ii:E[)l:;~:(]CIl"'l:i~ :;: i"Ht]:: I:;i:i!:i:l:i:!i..1:1: I:;;:li!i:l::, S il: ?l:!i: (:11:;~ 'i'HE :i~;I] ]: L. FI[ii:SOF;iI:::'T :1: Ot'.,I 'Z~.'S"ITi:P'I :[ S ' TI'Il:ii: I~.[!i:i",l(:!i"[l"l I:::, :1: P'IE:I'.,IS :1: OIq i S THEi: L[i!:I",I(:!iTH ,:: :[ I",1 I::Ei:~T[' :) ~]F' 'T'I' IE: 'I'I:;i:EI"~!C:I'I i::)Fi: I:::,F;II:::1:1: I",IF ]: Ii:!. !:::'. 'l'l-Iliii: I:)EI:::'TH O1::' I:::1 "I"Fi:Et'.,I(~:H (iF?. I::':1:"1" IS "I'IIE [:,ISTI:::II'.,II:::[:~: BI~iZ'i"I.,.ffLEN THE: :!!;I..l[~ff:'l::ll]::[!i] (]1::' '['H!!: i::!ii:;?.OI. Ji'.,lD F:II'.,ID "['HI:.!: [:i[O"l'T(::ff,'l OF' 'T'I.~I:!!: TI..l[~]:;i![!i: :1: S I'.,IO SET [,.I :[ DTH I:::'[:)Fi: 'l'l..lliii: ~:::il;i:F:l',,,'lii!:l.... I:)I/I::'TH :[ ~!; THE H I::'li'.,t[:, 'FI-I[:~: t3(:)¥"1'(]I',1 (IF' "I"HE: [i[::.::(:::l::i¥1:::lT]:l]i'.~, (:[1'.,! FEEl:T). GREATER ANCIIOIU\Gt: Uel)artment of 333(} "C" Stre(,L Anchorage, Alaska 99503 SOII,S I,O(', I'EI~OI,ATION TEST Performed for .... _C~__6J4'~_~5'7_.Aq._~:_?ZL/_,z_~.__~Z~_ Legal Uescription: ...... ~'~.r~,~ ...... ~__ .&~_~ l'his form reports: Soils log l)ep th Feet ~ ,,v ~ /., ( z /L ,0- ll 12 - 13 - 14 - Was ground water encountered? If .yes, at wila~ depth? Reading Date Gross Time Net Time Depth to Water Net Urof ...... ................................... ~'~ r-~o~'~-t3~T rh~},' - T,;~} ~] ..... i~2h~7$q ................................................... .Proposed installat~oH? ~eepage P~t ...... (~¢.a.~]~c._ Dral -leld Depth of Inlet .................. . Depth to bottom of pit or trench COMMENTS: Lega I ~Desc ri pt l=-~~_/~._~? ~_~'~,_~._/X ~ g-_~d,. This Torm reports: ~ol/s iog__2~- Depth Feet F. GREATER ANCttORAGE AREA BOROI"" Department of Environmental Qu, .ity 3330 "C" Street Anchorage, Alaska 99503 SOILS I.,OG - PEROLATION TEST Date Performed_~~ J Percolation 'Lest 1 0 - 6'?o~~ '11 - t2- 13- Was ground water encountered? .... ./L~S~___ If yes, at what depth? Reading Date Gross l'ime Net 'Fi me Depth to Water Net Drop Percol ati on rate .... ][~i-h-~-C-e-.- ..... Proposed installation: Seepa.qe Pit Drain Field Dept'h'--t-o'l}~-~-o]n~u¥--pi t or ~rench ;}e. pl:h of Inlet COi,lt,!EIITS: Performed By: EQ--040 ((;/74) APPLI(' NT FILLS OUT UPPER HAl ONLY Prop Ow,ler Edward & Renee Rackette Phone Mailing Address SRA BOX 1725 F, Anchorage, A]Laska ZipCode 99507 349-5000 Suyer Address Zip Code [.ending Institution Phone Address Zip Code Realty Co. & Agent Rita Rosenberg/ Re/Max Properties Phone Address 2702 gambell St. Suite 201, Anchorage, AlaskgipCode 99503 276-2761 L. egalDescrJption Lot 7, La%ta Subdivision StreetLoeaU~ 5200 East ll2th Ave. Type of Residence ~ Single Family [] Multiple Family [] Other No. of Bedrooms. 3 Water Supply j [~ Individual [3 Community [] Public Utility Se~r Disposal L~" Individual [] Public Utility [3 Holding Tank ATTACH WELL. LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth {attach Icg if available). Year Individual Installed: 1977 When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time [)ate Inspector [)ate Inspector Date Inspector Date I n s p ec//t,e)r MUNICIPALITY OF ANCHORAGE DEPT· OF HEi',LTtl ~.. ENVIRONM,~NI'AL PROTECTION RECEIVED (. ~' :>) APPROVED BEDROOMS ) DISAPPROVED ) CONDITIONAL APPROVAL* [)ATE ~" ' ( ~ [L...~,,r~ ' ~ 'CONDITIONS OF APPROVAL Soils R~ting/- J Date Sewer Instelled 72.023 (3182) Well To Absorption Area ? ~(_.~ / Well to Tank / ,¢~..~ d Well Log Received Septic Ta,qk Size oRA BO× t725 F Anchorage, AK 99507 Appro',zal for th.e individual sew~r an~ water ~.,.~c ...... ' ' ' ' ' ~.h,~ septic adeqt~ate accordJ, n9 to NationaJ. Star~da~t'~ C C: ALASKA I uIROlllTI rlTAL COIqTROL SE!RUICE{S, IBC. ~n§Jn¢¢rJn§ $ [~nuironrncnloJ Studies 11/10/83 RENEE RACKETTE SRA BOX 1725-F ANCHORAGE AK 99507 SELLER - RENEE RACKETTE BUYER - SUBDIVISION - LATTA BLOCK - 0 LOT - 7 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 454 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 700 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 10/25/83 . SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 3 BEDROOM HOUSE. ~ 1200 ~Ucsl 33rd Auenu¢, ~uit¢ J~ · Anchoro§¢, J~laska 99503 · [907) 276-1361 ,, DA...-.R EC EtV ED NSPECT ON APPOINTMENTS TII~'!E TIME TIME DATE DATE DATF , SPEOTOR ,NSPEOTO. INSPEOTOF~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~)~t)T. OF HEAL'tH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATION DIVISION JUl :2 9 1981 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND S~[i~ ~cVL~rJ~s DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed· Please allow ten (10) days for processing, 1. PROPERTY OWNER ~ ~ I PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) / '- ' PHONE 2. BUYER PHONE MA~LING ADDRESS 3. LEND'lNG INSTITUTION I PHONE 4, REALTOR/AGENT _ PHONE MAILING ADDRESS 5, LEGAL DESCRIPTION /--o7- STREET LOCATION 6. TYPE OF RESIDENCE [i~"/SI NG LE FAMILY [] MULT PLF FAMILY I~IUMBER OF BEDROOMS ' [] One [] Four [] Two ~] Five ~ Three [] Six L-~ Other 7. WATER SU/PPLY ~ INDIVIDUAL' [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~/ NDIVIDUAL/ON-SITE** [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well d~pth (attach log if available.) YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUFST BEFORE PROCESSING CAN BE INITIATED. 72-O10 [Rev. 6/79} THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~]~SINGLE FAMILY [] ONE ~THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY E~"~INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3' i~NDi~GE DISPOSAL SYSTEM PERMIT NUMBER I DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY C~.pnection Verified INSTALLER Septic Tank or []Holding Tank Size: /~) ~ ~ If Tank is homemade SOILS RATING / '~.r-- give dimensions: TYPE OF TA~ .L~.~.-.~ MANUFACTUR ER~_.~,i~.~.<~L~ TOTAL ABSORPTIO~N A~REA MATERIAL 4, DISTANCES ' Septic/Holding Tank IAbsorption Area Sewer Line Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~ "'"~ BEDROOMS [] APPROVED FOR [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72 010 (Rev, 6/79) August 4, 198]. E.A. Rackette-Carter-Chapman Star Route A Box 1725F Anchorage, Alaska 99507 Subject: Lot 7 Latta Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (i) The water analysis report needs to be submitted to th~s office from the Chem Lab, 5633 B Street, for our review. A well log submitted to this office for our review and files. Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit and buried. This will need to be reinspected by this office. (4) The septic tank pumped with a receipt submitted to this office. (5) An adequacy test needs to be performed o[~ e~x~r~rj~ leaching area. This test will determin0e3if the~~ is adequate according to National S~'~rct~~ ,~d~ing of private firms performing the t,~'is e~D~6~%/This report needs to be submitted to this offJ.~ /~ur If there are any further questions, please ca]l this office at 264-4720. Sincerely, / James S. Roberts Associate Environmental Specialist JSR/ljw MtJNICIPALIT'¢ OF ANCHORAGE DEPI'. OF HEAL/TH & RECEIVEE REOUEST FOR APPROVAL OF INDIVIDUAl. WATER AND SEWE[~ FACI[.ITI[S ~I~ECTIONS: Complete all pairs on pail0 1, Incomple~ requesls will no~ be proteus:ed, Please allow ten (10) days [or processing. [ Peter E.< Keck _1344-7140 Security Pacific Mortgage Corporation [279-','i393 MAILINGADDMESS 1011 East Tudor Road, Suite 190 99507 Lot 7 Latta Subdivision NHN East ll2th Avenue r- ~ On~ {~ ) Four [~I Other ~k SINGLE FAMILY ..... ' .......... ~X TWO _J Five [~] MULTIPLE FAMILY [ZI Three ['~J Six ~ INDIVIDUAL~ ' A1 TACH WELl. I_OG. A well Io9 is required for ale wells drilled i~ COMMUNITY since June 1975, For wells drilled prior to d~at date, qive we~ ~X INDIVI DUAL/ON-SI1E'' [, ,n, hv,dual/on-slte, give installation date.. ~._.L~_3~. If system is o~nr two 2 e I~s olc an ac equacv test is leqtlJl'¢'CI L._ ,UBL_ICUIlI.ilY ~, t'' "¢ - , NOTE: THE I¢,JSPECTION FEE MUST ACCOMPANY EACH ~EOUf~ST BEFORE PROCESSING CAN BE INIT~ATEC~. THIS SIDE FOH OFFICIAL USE ONLY INSPECTION APP()INTMENVS [ i:]C:TIONS: ! 'i','PIE OF RESIDENCE ~.;ING LE FAMILY L MUL-I IPLE FAMILY 2 ¥'i/\ (FIR SUPPLY hkIDIVIDUAL_ C:OMMUNITY ;UBLICUTILITY NUMRER OF BEDROOMS OTHER [-] ONE [_3. THREE L] FIVE (-~J 'I-WO ~] FOUR ~J SIX PERMITNUMSER DEPTH OF WELL. DATE DRI I._LE D ommction Verified t_OG RECEIVED ' 3 ': :'¢,LC':iE DISPOSAL SYSTEM PERMIT NUMI]ER '~ ~ 3~,,' )'.A',~ /ON-si-rE -'[)/~-~N~Li.~ ; ' ,": /~ i;' T;mk is homemade --~- SOILS RATING '~ : V?',: OF TANK MANUFACTURER ' : J! ,:.L ,,:xBSOid~1 ION AREA MATERIAt q, !)iS-fAr,~cIEs ............................ Septi~ir~'~lAbsorption Area Sewer Line Neares[ l,o~1 Line {';] CONDITIONAl. APPROVAL (lett/~ust accompany certificate) ~ DISAPPROVED , ', i &t DF_SCEIIPTION MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH 8, DEPARTMENT OF ENVIRONMENTAL QUALITY ENVIRONMENTAL PROTECTION 3330 "C" Street, Anchorage, Alaska 99503 - 274-4,561 OCT 2 6 1978 REQUEST ,oR AP,ROVA,. O, RECEIVED INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: CMRO XX VA FHA CONV Property Owner: Peter E. Keck Mailing Address: SRA Box 1725-F Anchorage 99507 3. Name of Buyer: . Same (refinance) Mailing Address: 4. Name of Lending Institution: secui~_y P,~,?~F¢~ mo~g~g~ ~n~p Nsme of ~eB]tor or Agent: none Mailing Address: Day Phone Day Phone Phone 276 1933 Phone 6. Legal Description: nn~ 7 r,af-'l-~ ,q,/D Location:_NH~ ~.. 7 12f'h .q.I- ~h~ge AK 7. Type of Facility to be inspected:s£r 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth o'f well unknown 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation _ ~g77 No, Bdrms. Individual xx Individual (on-site) zx EQ-037 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality ~~330 "C" Street, Anchorage, Alaska ' 99503 274-4561 ~/'~ ~ ~ ~ Date Received March 7, 1977 ~~ ~' ;~ Time of Inspection. 2X~P.m. ~ ~~ ~ Date of Inspecti0n 3-8~7 Tuesday n~ REQUEST FOR APPROVAL OF Bu~hh~lz N WDUAL SEWER & WATER FACILITIES Conv. l. Approval requested by: Alaska Statebank % Steve Luedke Mailing Address: 310 East Northern Lights Blvd. Phone: 279-7637 2. Property Owner: H. Wilson/G. Mellott Phone: 344-0817 Mailing Address: Star Route A Box 60 99507 344-7960 3. Legal Description: Lot 7 Latta Subdivision 4. Location: ll2th Avenue 5. Type of facility to be inspected Single Family 6. Well Data: No. of bedrooms A. Type Individual B. Depth C. Construction _~ O. Bacterial Analysis Sewage Disposal System: On-site system, Permit ~76554 A. Installed 1976 B. Installer ~ ~ C. Septic Tank: 1. Size /O00 2. Manufacturer. ~.F~'¢~ 105' D. Seepage Pit: 1. Absorption Area ~/~ E. Disposal Field: Total length of lines Distances: 2. Material A. Well to: Septic tank /~o , Absorption area /~ Nearest lot line /~ , Other contamination B Foundation to septic tank · , Absorption area C. Absorption area to nearest lot line , Sewer Lines EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA FHA 1. Type of Inspection: 2. Property Owner:_ /4/ Mailing Address: 3. Name of Buyer: D~::PL Oi: , ':',\L i CONV Day Phone:, Mailing Address: Name of Lending Institution: /~--/~L,~/& ~, Mailing Address: '~/// ~-- /0~ ~'7~ Day Phone:. Phone: 5. Name of Realtor or Agent: Mailing Address: Legal Description: Location: Phone:. 7. Type of Facility to be Inspected: No. Bdrms. -3 Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well /~ Individual 72-003(3/76) Sewage Disposal System Type of System: If Individual, date of installation Public Utility Individual (on-site) Page 2 of two pages .- Re ~st for Approval of Individual · Legal Description T,ot ? Imtta Subd±v±s±on 'er & Water Facilities Comments Appr°ved~a1 ~Disapproved Date ~-~ ?"7~. App~ ~Valid for one year from date signed Greater Anchorage Ar~a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) 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. 015-142-50-000 Expiration Date: 9/3/2023 Legal description LATTA LT 7 Site address 5200 E 112TH AVE Anchorage AK 99516 Current property owner(s) PARKER TIMOTHY D & DAYNA L X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Z Original Certificate Date: 7/3/2023 Thfs 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 Tank Age Advisory x Arsenic Advisory Other COSA Approval_June 2022 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. 015-142-50 Complete legal description LATTA LOT 7 Location (site address) 5200 E 112TH AVE ANCHORAGE, AK 99516 Current property owner(s) TIMOTHY & DAYNA PARKER 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ® 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: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 24 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ 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 $ ,6 '�TO Waiver Fee $ Date of Payment EA A-5 Date of Payment COSA # D 5C 23 1173 Waiver # COSA Applicalion.doc COSA Checklist.docx COSA Checklist Legal Description: LATTA LOT 7 Parcel ID: 015-142-50 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 08/1976 Total depth 93 ft Cased to 93 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/24/23 Static water level at beginning of test 67 ft. Well production at time of test 5 gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 4.61 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 5/25/23 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 5/23/2023 Required maintenance completed, if AWWTS Comments: INSTALLED 11/15/199 C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 11/15/99 ALL standpipes present per record drawing Total measured depth from grade 10.1 ft (max) Measured depth to pipe invert from grade 3.3 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 6.9’ of 7.1’ ED 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 If yes, enter date Adequacy test date 5/24/23 Results Pass Fluid depth prior to test 75 in Water added 470 gal New fluid depth 85 in (UP TO LATTERAL) Elapsed time 1440 min Final fluid depth 75 in (OPERATING IN TOP ED) Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 85 in (MOA 7.1’ ED) Effective depth used 75 in (Final Fluid Depth) Effective depth (ED) remaining 10 in (APPROXIMATELTY 2.4” ED NOT MEASUREABLE) Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & 1999 trench appears to have approximately 6.9’ ED – Missing 2.4” of ED. Also, missing MOA files, but owner had signed MOA Inspection Report. Garness Engineering could not provide missing documents either. Field is operating in top portion of the ED. Switched diverter to original field. COSA Checklist.docx 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/6/23 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 6/6/23 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT of A -W On -Site Water and Wastewater Section 4 www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval # OSC231178 Subdivision: Latta Block: J. Lot: 7 907-343-7904 Fax: 343-7997 The septic tank for this property is 24 years old. The average life of an asphalt coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more, not including engineering, surveying or MOA permitting fees. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. I I - - EAST 112th AVENUE- -- -- -- -- I 0 0 REBAR W/CAP EAST 110.00' REBAR I UTILITY 30' �� WELL S ROAD & UTILITY EASEMENT GUY POLE ANCHOR Lv� UTILITY PEDESTAL GRAVEL wa I I DRIVEWAY iv I I x-xl 116.8' 24.5 '� 1 -STORY x�xJ I �x N FRAME ILL HOUSE N o O Yi O O �x0 N LLQ Q p I o r 1LID CDI 24 28.5' 2 LOT 6 < DECK �_� � xw I O �� x x�x (1J M CD 00 , SEPTIC CD Q , LOT 7 STANDPIPES Z I 16,513 sq. ft. II wl ISHED 10' X 20' UTILITY 30' I I EASEMENT x x AW x— WEST 110.17' --- EE -- SHED I LOT 8 I OF n / 0 15' 30' #: 4 g T * i ........ ...... ............... • B u Saliz �o LS -14837 tilt 0FESSI CNP,-\P-:':"� EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE AS -BUILT RECORDED SUBDIVISION PLAT (70-178) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEYAND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT I HEREBY CERTIFY THAT I HAVE SURVEYED THE BOUNDARY SURVEY MAY DISCLOSE. FOLLOWING DESCRIBED PROPERTY: UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR LOT 7, LATTA SUBDIVISION ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE SURVEY STANDARDS. WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY DATED THIS 22nd DAY OF JUNE, 2023, ATANCHORAGE, TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA ALASKA. VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES FIXED HEIGHT LLC COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. C.O.A. 122554 Land Surveying Services 907.290.8949 JOB # 23080 1 NO CORNERS SET THIS DATE I SCALE 1" = 30' 225 VV 23rd Ave., Anchorage, AK 99503 WWW. FIXEDHEIGHT COM