HomeMy WebLinkAboutBIRCH HILLS TERRACE #2 BLK 4 LT 3i ch Hills
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Municipality of Anchorage Page
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 and/or Well Inspection Report
Permit Number: ~'A3c~ "Td)OZ¥',.~ PID Number: O~"O--. [4-1-~1
Name: 3~_..~. ~..)~.~..., WastewaterSystem: ~[3(New [] Upgrade
Address: P, O ~O~1~ (:~'7~..-.~O ¢::~<~"~'7 ABSORPTION FIELD
Phone: ~::)~:~.....~.~zH..., [No. of, z~.drooms: 'l~DeepTrench i-'l Shallow Trench I-IBed r-lMound DOther
Total Depth frqm original grad~:
LEGAL DESCRIPTION so,,atm: /. '2. GPD/Sq. Ft. -7- ~''T~
Subdivision: )epth to pipe bottom from original ~rade: Gravel depye/peath pipe
Lot: ...~ Bl°ck.~r [11'~-~_~¥J¢ I-¥t{..L.,~ T~-~--//,A~ ~-";'~ ~-~'{~ Ft. Ft.
Township:~ [Ra~ ISect~.._.. Fill added abo~e origina,o2,' ~ ~.'~¢/'grade: Ft. Gravel ,eng~[ Ft.
WELL: ~,New [] Upgrade Gravel width: 3 /-4.__ Ft. Number of lines:l jIDistanceWtween lines:/%} ~ Ft.
Classification[.) [~-'PJ~(Private' A.~pC): Total{.,~, z.Depth: Ft.Cased~_./iTo: Ft. Total absorption~..,c~.oare~p: SQ. Ft. PipeD~o.~z:~C'material:' ~. F~) j~)
I Oriller:~.t.AL~t ~J~3¢~ Date Willed:+/~ Static Water Level:/~ Ft. Installer:~ Date installed:j
Yield: ~ Pump Set at: ~ Casing Height Above Ground:
/~ ~ u~~ ~.~ /~,,~ ~ TANK
SEPARATION DISTANCES ~Septic ~ Holding D S.T.E.P.
To Septic Absorption Lift Holding ~ubllc/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~, '~
Material: Number ~CompaAments:
Su,.ce ~ LIFT STATION
Water ~ / O0 I~ /~ f
Lot ~ ~u
Line '~O- i~ 4~1~ i facturer:
Cu.ain Drain ~O~'~ ~~ ~ ~ . ~lectrical Inspections peflorme~
Remarks: BENCH MARK
~~~ SOJ ~ * ~ Location and Description:
i
,
e,or e,
Depadment of Health and Human Se~ices approval *,~ ... ,..~L~
Reviewed and approved by: ' ~, ~~ Date: /-
72-013 (Rev. 9/91) MOA 25
A TO S1 = 30,7
i ~ TO S1 = 9,5 ..
~..
A TO S2 = 37,7 N~Wr_
WELL
B TO S2 = 18,0
' A TO CO! = 69
~ B Trl Crll = 685
\ A TO MT : Ts' I:.:...:I /I
\ B TO MT : 62,5
/ A TO COe = e~
~ ............ F~ :' ~1 GENERAL LOCATION
~ NEW HUUS~ ~ ~ ~.:'-'f WDF THE ~RIVEWAY
I l~x .,A' :..' "!
~ ,
'"~-.~.~ .:":':"~:. ' ': ; '. S~"~D8 GENERAL LOCATION OF EXPL ]RATDRY
~ ~ ~ ~ / ~ ~ ~ / TEST HOLE, ND GRDUND~ATE DR
NEW 1850 GALLONJ /~
SEPTIC TANK ~ ~T TH
~DUTH PRDPERTY LINE
NDTE~ THE ~DIL ON THIS PROPERTY APPEARED TO GET BETTER A~
WE MOVED UPHILL (TO THE WE~T), RECOMMEND THAT THE RESERVE
DRAINFIELD ~ITE BE POSITIONED BETWEEN THE ~EPTIC TANK AND THE
~X~S~No ~NCH,
SW970043 PID~: 050-141-51
SEPTZC SYS~E, AS-aU~LT, LOT ~, ~ ~, ~RCH H~L~S T~RRACE S/~'
PREP.RED 9Y, ALASKA WATER , WASTE~ATER,
DATE, 1e/18/97 DRAWN~ GARNESS SCALE, l" = 40' ~'
GROUND ELEV, AT TANK = 101,3 TI] 101,45
1'4IN, COVER = 4 FEET,
07,3
NE~/ 1850 GALLON SEPTIC TANK, 4 INCH ])IA, PVC (I]3034)
ANCHORAGE TANK, INLET INV,
= 96,71, OUTLET INVERT = 96,48
TANK SET LEVEL ~/ITHIN ,01 FEET
CH ])IA, PVC LINE FROM HOUSE
GROUND ELEV, OVER
TRENCH IS 93,55 +
MINIMUM COVER = 4,88 FEET7 / FOR LOCATION OF M,T SEE PLAN DRA~/ING
~ ' '4 INCH ])IA,, ASTM FSlO, PERFORATE]} PIPE
~: B, BOTTOM DF TRENCH = 83,9
],' , C, NB GRBUN])~ATER TD ])EPTH DF 14,5 FEET IN TEST HOLEs,
:'~,".'; D, TRENCH LENGTH = 54 FEET
i~.:.;.i~'"' E, TOTAL ABSORPTION AREA = 540 SQ, FT, +
tlENCHMARK IS GARAGE FLOOR
ASSUNED ELEVATION = 100,00
ALASKA ~/ATER &, 'V/ASTE~/ATER 'Ol~j't-. ~E-7053 .,"~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: DATE PERFO
Township, Range, Section:
SLOPE
LEGAL DESCRIPTION:
3
4
5
7
8
9
10
11
WAS GROUND WATER
ENCOUNTERED? ~'~ ~'~
S
IF YES, AT WHAT /~J/~' (~
DEPTH? p
13 Depth to Water er
14
15
16
17
18
19
2O
SITE PLAN
Monitoring? Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
__ (m~nutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND __
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE,
FT
CERTIFY THAT THINS TEST/WAS PERFORMED IN
DATE; / "2"//i~//~ ~}~'''
72-008 (Rev. 4/85)
998 ?: 'IOPM FROH HLP PLANT/ 9~7 263
SULLIVAN WATER WELLS
P.O. 80}(670272, CHUOIAK, ALASKA 99567, TEL.~PHONE 688-275g
ADDRESS .~
. ~ATE', · ~ta~l,~ .... Ended -. _'~
PER/~IIT NU,~4BER
:KIND OF FORMATION.
~,o~,_¢__.~.,~._~_,-, ........ c~~_..~-~d~,o,,, .......... ~,.,o ....... ~,..
,,..~_._.,,o~_&,, .... 4~_¢~__(¢~,~E~ .,,,.,,,_..
--- . ..... . ~ __. .... FI. Io .....
~ Fi,
Ft
..~Ft. to_.
. Ft.
F,'. to .... FI ...............................
From~ FL m ....... Ft.m .....
From ....... Ft. to ..... Ft ........................
JAN 26 1998
Health & Human Services
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970043
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:BLAKE JAMES E
OWNER ADDRESS:iT816 TEDROW DR
CHUGIAK, ALASKA 99567
DATE ISSUED: 3/24/97
EXPIRATION DATE: 3/24/98
PARCEL ID:05014151
LEGAL DESCRIPTION:
BIRCH HILLS TERRACE #2 BLK
4 LT 3
LOT SIZE: 75592 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT iS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
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 (18AACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
AT THE TIME OF CONSTRUCTION A TEST HOLE SHALL BE EXCAVATED
TO A MINIMUM DEPTH OF 14 FEET AND SUBMITTED WITH AS-BUILT.
RECEIVED BY: ~~z~
ISSUED BY:
DATE: ,-~-.37 - ~7
DATE:
Alaska Water & Vastewater
' 8471 Brookridge [}five ~ Anchorage ~ Alaska 99504
(90?) 337-6179 ~ Fax (90?) 338-3246
Consulting Engineers
March 16, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Well & Septic system for Lot 3, Bk 4, Birch Hills Terrace S/D. Eagle River, Alaska.
To whom it may concern:
The subject property is currently undeveloped, and the owner is proposing to construct a 4
bedroom home on the site. Comments regarding the proposed well and septic system are
summarized as follows:
1. SOILS: Attached is a log which shows the soil profile, and the percolation test results. The
best soils were encountered in TH #2. The soil at a depth of 4' to 4.5' perked at a rate of 2.2
minutes/inch. I am proposing to install a trench system with a total depth of 8 feet. Since the test
hole was only 12 feet deep, I will need to verify, during construction, that there is no bedrock, or
impermeable soils to a depth of 14 feet.
2. TRENCH DESIGN:
a. Percolation Rate: 2.2 minutes/inch
b. Allowable Application Rate: 1.2 gallons/day/ff2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 500 fi2
f. Effective Depth: 6.0 feet
g. Width: 2 feet minimum
h Minimum Length: 42 feet. Will make trench 43 feet long
i Effective absorption area = 516 ft2 (>500 fi2 OK)
4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
5. TOPOGRAPHY: See the attached plot plan (Robert Johnson, L.S.) which show the general
topography of the site. The lot is generally fiat from TH # 2, to the east property line. From TH
#2, to the northwest, the lot rises up to a knoll. The lot (in the vicinity of the septic system) is
generally fiat from the south property line, towards the north, for approximately 100-125 feet.
The lot then slopes down gently towards the north property line. There are no downhill slopes,
within 50 feet of the drainfield, that are greater than 25%.
I' am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems, tf you have any questions, please contact me at 337-6179, or on my digital pager at
1-800-481-1162. Thank you for your assistance.
Sincerely,
~~_Prifle{pat1
Jack Foster Design Package.wps
VACANT LOT
LOT 4, BK 3
BIRCH HILLS
TERRACE
VACANT LOT
LOT 3, BK 3
BIRCH HILLS
TERRACE
TEDRDW DRIVE
LOT 4, BK 4
BIRCH HILLS
TERRACE
PVT. WELL AND
CITY SEWER.
SEWER MAIN IS
IN CULDESAC TO
THE SOUTHWEST,
WELL IS MUCH
GREATER THAN
100 FEET FROM
THE PROPOSED
SEPTIC SYSTEM.
LOT 8, BK 8
BIRCH HILLS
TERRACE
LOT IS ON PVT.
SEPTIC SYSTEM,
AND CITY WATER.
CITY WATER IS
CONNECTED THROUGH
LOTS TO SOUTH,
TO THE WATER LINE
ON SANCTUARY DR.
THE SEPTIC SYSTEM
IS MUCH GREATER
100 FEET FROM THE
PROPOSED WELL,
SEPTIC SYSTEM~
FDR:
I' '
,PRFPARED' BYe,,
IDATE~ 3/16/97
/
THE LOT TO THE SOLTH OF THE SUBJECT P~OPERTY
ARE IN M:ADDW BROD~ S/D, ALL OF THE LOTS ARE ON
ON CITY lATER & SE~ER, iN SH RT, THERE ~RE
NO
WELL DR SYS-EM ENCROA HMENT CDNOERNS,
/
SANCTUARY DRIVE
LOT 3, BK 4, BIRCH HILLS TERRACE
JACK FOSTER
ALASKA WATER & WASTEWATER,
~rlUTH PROPERTY LINE
, ,
SEPTIC SYSTEM: L[qT 3, ])K 4, ]]IRCH HILLS TERRACE S/I),
PREPAREI) FDR ~ JACK FOSTER
PREPARE~ BY, ALASKA WATER ~ WASTE~ATER, t~ ... ...~
DATE: 3/16/97 DRA~N~ GARNE~S SCALE: 1' = 40'
TOTAL TRENCH LENGTH
= 45 FEET,
TOTAL ABSORPTION AREA
= 515 SOUARE FEET.
CKFILL WITH NATIVE SOIL AND MOUND.
TOPSOIL & RESEEDING SHALL BE THE
REPSPONSIBILITY OF THE PROPERTY OWNER,
-- FILTER FABRIC SlLT BARRIER.
2 INCHES OF BOARD INSULATION IF SOIL
COVER IS LESS THAN .3 FEET. INSULATION SHALL
COVER THE ENTIRE WITH OF THE TRENCH.
-- 4 INCH DIA., ASTM F810 PERFORATED PIPE.
INSTALLED WITH HOLES DOWN. PLACE 2"
OF DRAINROCK OVER TOP OF PIPE, AND
ACROSS THE ENTIRE WIDTH OF THE TRENCH.
PIPE SHALL BE LEVEL (WITHIN .01 FEET).
TUBE (TYP).
PERFORA TED IN DRAINROCK.
NO TE:
1. TRENCHES SHALL RUN PARALLEL TO THE
SLOPE CONTOURS.
2. FOR LOCATION OF CLEAN-OUTS AND
MONITORING TUBES, SEE SITE PLAN.
3. CONSTRUCTION PRACTICES, AND MATERIAL
SPECIFICATIONS SHALL COMPLL Y WITH
ANCHORAG~E MUNICIPAL CODE 15.65, "WASTE-
WA TER DISPOSAL REGULATIONS".
4. INSTALLATION SHALL COMPLY WITH SPECIAL
PROVISIONS AS NOTED ON THE SEWER PERMIT.
5. SMEARED BOTTOM AND SIDEWALLS SHALL
BE RAKED.
FEET MIN.
SPECIPICA TIONS.
REJECTED.
DRAINROCK SHALL BE SCREENED PER M.O.A.
DIRTY DRAINROCK WILL BE
TRENCH DETAIL: LOT 3, BK 4, BIRCH HILLS TERRACE S/D.
PREPARED FOR: JACK FOSTER
ALASKA WA TER & WA S TEWA TERSER VICES
DATE: 3/16/97 DWN: GARNESS SCALE: NTS
NOTE
It is the responsibility of the Builder to
field check distances to lot lines prior
to commencing construction.
PRELIMINARY
I hereby certify that I have sur. veyed the following
de,cribed prou.erty ~7 9,,~/*C~t<
Anchorage Recording Precinct, Alaska, a~ that the pro-
posed improvement, as planned thereon by the builder.
will be within the property lines and will not overlap
or' ~croach on the prop~y lying adjacent thereto, that
no ~mRrovements on property lying adjacent thereto
encroach on the premises ~n question and that there are
no roadways, ~ansmission lines or other visible ease-
ments on said pro~rty ex.pt as indicated hereon,
Dated at Eagle River, AlaSka
ROBERT C. JOHNSON
~: Registered Land S~eyor No. 880-LS
1' =~' Box 4~, Eagle River, Alaska
P~ne ~94-2543
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14-
15-
16-
17-
18-
19-
20-
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
~O~ ~,~ ~ Township, Range, Section:
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, ATWHAT
DEPTH?
Deplh to Water A.er ~
Moniloring?
S
Date:
Gross Net Depth to Net
Reading
Date
Time Time Water Drop
PERCOLATION RATE /'~' (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN ~ FT AND "'"" FT
ACOORDANOE*,T. ^L~ ~'r.,TE AND ,~,~.,C,,AL ~U,OE~,NE~ ,N E~C'~ ON TH,S DATE. DATE: ~/"~'/~'
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: t~(~"~"'
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
Township, Range, Section: '1" I~'~,/ i2. Z,l.4././:;¢~;~--, /2..j ~'. fYI.
SLOPE SITE PLAN
I
WAS GROUND WATER
ENCOUNTERED?
s
IF YES, AT WHAT /~
DEPTH? ~ p
E
Depth to Waler A,er h4//0¢
Monitoring? · Date: , , ,
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
COMMENTS
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE,
72-008 (Rev. 4/85)
-. !
!
DrlV,
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L;~bE~;~99L06
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 050 -141-51
Certificate of On -Site Systems Approval
OSC251182
Expiration Date: 4/21/2026
Legal description BIRCH HILLS TERRACE #2 BLK 4 LT 3
Site address 17816 TEDROW DR
Current property owner(s) GUNN KENNETH DALE &
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: Original Certificate Date: 5/20/2025
V1_1 L
This C iificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sys m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
D elopment Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory X
Tank Age Advisory X_ _ Arsenic Advisory
Other
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. 050-141-51
Complete legal description BIRCH HILLS TERRACE #2 BLOCK 4 LOT 3
Location (site address) 17816 TEDROW DRIVE EAGLE RIVER, ALASKA 99577
GUNN KENNETH DALE & TERESA
Current property owner(s) Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units
❑ Other Non-public well as regulated by MOA ❑ Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: M Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 28 - See advisory if steel or fiberglass 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 $ 5 o Waiver Fee $
Date of Payment S� /' 20 2- S� Date of Payment
COSA # S C_ 7-_�- ! r 2 Waiver #
COSA Application—Apr2025 doc
COSA Checklist.docx
COSA Checklist
Legal Description: BIRCH HILLS TERRACE #2 BLOCK 4 LOT 3 Parcel ID: 050-141-51
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 April 1997 Total depth 172 ft
Cased to 171 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 33 in.
Date of flow test for COSA 4/21/25
Static water level at beginning of test 133 ft.
Well production at time of test 4+ gpm
Water storage tank volume None gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 5.24 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 4/21/25
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 4/21/25
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/10/1997
ALL standpipes present per record drawing
Total measured depth from existing grade 9.4 ft (max)
Measured depth to pipe invert from grade 3.9 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
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 4/21/25
Results Pass
Fluid depth prior to test 6 in
Water added 900 gal
New fluid depth 11 in
Elapsed time 1440 min
Final fluid depth 1 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 60 in (MOA 5’ ED)
Effective depth used 1 in (Final Fluid Depth)
Effective depth (ED) remaining 59 in
Comments/Deficiencies:
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 05/07/2025
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 &
05/07/25
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT •
On -Site Water and Wastewater Section
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC251182
Subdivision: Birch Hills Terrace #2 Block:4, Lot: 3
907-343-7904
Fax: 343-7997
The septic tank for this property is 28 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more,
not including engineering, surveying, MOA permitting fees or site restoration.
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.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT And 907-343-7904
On -Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC251182
Subdivision: Birch Hills Terrace #2, Block: 4, Lot: 3
A water sample revealed a nitrate concentration of 5.24 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical' methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Gt SG
• '-� Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904 s F E T Y
Certificate of On -Site Systems Approval
Parcel I.D. 050-141-51
1. GENERAL INFORMATION:
Expiration Date: 4%Z "ZI
Complete legal description _BIRCH HILL TERRACE #2; BLOCK 4, LOT 3
Location (site address) 17816 TEDROW DRIVE, EAGLE RIVER, AK 99577
Current Property owner(s) THOMAS & ELECTA KEAN Day phone 830-0270
Mailing address 17816 TEDROW DRIVE, EAGLE RIVER, AK 99577
Real Estate Agent KEVIN TAYLOR W/ REMAX Day phone 244-7437
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
4
TYPE OF WASTEWATER DISPOSAL:
®
Individual
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ `J5�
Date of Payment 'r� —31 - Z l
Receipt Number, 0 Li ./ lea
COSA # i�5 L Z 1 f J g/
Date:
Waiver Fee $ _
Date of Payment
Receipt Number,
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures 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.
Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507
Engineer's Printed Name: Jeffrey A. Garness Date: J � 4 zo
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.
6. DSD SIGNATURE
System #1 Approved for 4 bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms,
�P. .... •�,• .sic
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with the followini,* a
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%�)))�IFN S,ERv �_.,�`,
By: \v/N,1',ZC Original Certificate Date: q-2--21
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
Septic System Advisory
Well Flow Advisory
Nitrate Advisory_
Arsenic Advisory
Other 1 aV i
COSA blue sheet_10-10-12.doc U3
Legal Description: BIRCH HILLS TERRACE #2; BLOCK 4, LOT 3 Parcel ID: 050-141-51
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system _
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 411997
Total depth 172 ft
Cased to 171 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 10/23120
Static water level at beginning of test 132.8 ft.
Comments
B. TANK DATA
Age of tank(s) 23 ye
Tank type/material ST EL/W'�_
�-'
,
Measured operating fluid level in septic tank 48.5"
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 9/21/2020
D. ABSORPTION FIELD DATA DEEP TRENCH
Well production at time of test 4.3 qpm
Water storage tank volume NONE gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate 6.86 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by GEG,LTD.
Date of Sample 10123/20
FT STATION
❑ 11
Requir aintenance
Age of lift station
Lift station material
Which system tested (date installed) 10/10/87
Adequacy test date 10/23/20
❑ ALL standpipes present per record drawing
Results ❑J Pass For 4 bedrooms
Total measured depth from grade *9.4 ft (max)
Fluid depth prior to test 0 in
Measured depth to pipe invert from grade 3.7 ft (min)
Water added 603. gal
❑ N/A — pressurized field
New depth 0 in
❑ Monitor tubes go to bottom of effective. If not, state
0
depth into effective
Elapsed time min
❑ Code -required soil cover over field
Final fluid depth 0 in
❑ System presoaked
Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) NONE
date of test)
Gallons introduced _gallons
If yes, enter date
Comments/Deficiencies: 'AT MONITORING TUBE (MT).
COSA Checklist yellow sheet
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'
❑ Yes
if No
Community Sewer Manhole/Cleanout > 100'
r Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' M Yes
if No
ft
Private Sewer/Septic Line > 25' Q✓ Yes
if No ft
Absorption Field on Lot > 100' 0 Yes
if No
ft
Holding Tank > 100' Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' Yes
if No ft
M Yes
if No
ft
ft
If septic tank is under driveway comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' M Yes
if No
ft
M Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
❑ Yes
if No
5+ ft
Surface Water > 100'
P( Yes if No ft
Property Line > 5'
✓0 Yes
if No
ft
Wells on Adjacent Lots:
Wells on Adjacent Lots:
Absorption Field > 5'
0 Yes
if No
ft
Private Wells > 100'
0✓ Yes if No ft
Water Main > 10'
P( Yes
if No
ft
Community Wells > 200'✓0
Yes if No ft
Water Service Line > 10'
✓V 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'
Q✓
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'✓❑
Yes
if No
ft
Private Wells > 100' 0 Yes if No ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' 0 Yes if No ft
Surface Water > 100'
0✓
Yes
if No
ft
F. ENGINEER'S COMMENTS
*MET SEPARATION DISTANCE AT TIME OF INSTALL. **DID NOT FIND WELL ON LOT 4, BLK 4; BIRCH HILLS TERRACE #2.
KNOCKED ON NEIGHBOR'S DOOR - NO ANSWER. PHYSICALLY MEASURED 100 FEET WEST FROM THE EXISTING TANK ON
PROPERTY TO SEE IF WELL COULD BE DRILLED WITHIN 100'- SLOPES TO STEEP FOR WELL TO BE -DRILLED WITHIN 100 FEET.
NOTE: TANK SLIGHTLY SHY ON COVER. NO FREEZING ISSUES PER OWNER (SEE ATTACHED STATEMENT)
G. ENGINEER'S CERTIFICATIONOF
o0oo6o�boO
I certify that l have determined through field inspections and review
of Municipal records that the above systems are in conformance with
.• I
MOA COSA guidelines in effect on this date_ �� , . �j',, ;T/. ,*• �n
COSA Checklist yellow sheet
....................
.......
GorAess;
QQ 9= ,cif i/CES 7953
novo
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#AECC884
MUNICIPALITY NCHORAGE
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC211144
Subdivision: Birch Hills Terrace #2 Block 4 Lot 3
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 23 years old. Typical replacement costs range from $8,000 to $11,000
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 20 -year-old steel tank MAY look like.
MUNICIPALITY
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 # OSC 211144
Subdivision: Birch Hills Terrace #2 Block 4 Lot 3
A water sample revealed a nitrate concentration of 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.
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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.orglonsite
(907) 343-7904
CERTIFICATE OF 0N-SITE SYSTEHS
FOR A
SiN / "FAIvlIL_Y DWEL_L_IN
Parcel I.D. 050-141-51
1. GENERAL INFORMATION
COSA#
Expiration Date:
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
BIRCH HILLS TERRACE #2; BLOCK 4, LOT 5
17816 TEDROW DRIVE * EAGLE RIVER, AK * 99577
JACK FOSTER Day phone 694-6301
17816 TEDROW DRIVE * EAGLE RIVER, AK * 99577
Day phone
Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well · Individual On-site ·
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] Public Sewer []
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-family 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 samples. (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.
4. 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 Qn-Site Systems Approval Guidelines for this appfication,
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.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Phone 557-6179
Address .3701 E; TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or u. se of this report by any
other person or party is not authorized, nor will it confer any legal fight whatsoever.
DSD SIGNATURE
~*/ Approved for L./L bedrooms.
Disapproved.
Conditional approval for
~ WATER AND
~ : WASTEWATER : ~
~ ~ PROG~M .'
bedrooms, with the fllowing st pu ation~ ¢,',, ..' _&. ~
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11105)
,,-~) ~,~l I],~, ~'-~u v l:~l y
Maintenance Agreements
Supplemental Engineer's Repor[
Other
Original Certificate Date: ¢ '- f'~ - / ~___
, 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 0N'SITE SYSTEMS ,PPROVAL
. Legal Description:
A. WELL DATA
Well type PRIVATE
Date completed
Total depth 172
4/1997
ff.
CHECKLIST
BIRCH HILLS TERRACE #2; BLOCK 4, LOT 3 Parcel ID:
Date of test
Static water level
Well production 10
WATER SAMPLE RESULTS:
Coli~orm~l~lonies/lO0 mi.
Arseni~JL.
SEPTIC/HOLDING TANK DATA
If A, B, or C provide PWSID# N/A
Sanitary seal (Y/N). YES
Cased to 171 ft.
FROM WELL LOG
4/1997
1,35 ff.
g.p.m.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
7/26/2010
135 ft.
3.27 g.p.m.
YES
YES
24+ in.
Nitr~g./L.
Date of ~sample: 7/26/2010
Other bacteri~ial~,olonies/100 mi.
Collected by: GE(; Ltd.
Tank Type/Material
Tank size 1250 gal.
Foundation cleanout (Y/N) YES
Date of pumping 10/30/09
ABSORPTION FIELD DATA
Date installed 10/10/1997
Length 54 ft.
SEPTIC/STEEL
Number of Compartments 2
Depression over tank (Y/N) NO
Pumper.
I'BELOW EXISTING GRADE]
Soil rating ~or ft2/bdrm) 1.2
Width 3 .ff.
Date installed 10/10/1997
Cleanouts (Y/N) YES
High water alarm (Y/N) N/A
SANITARY PUMPERS
Water added 605 gal.
System type TRENCH
Gravel below pipe 5
in.
NONE
Absorption rate >=
KNOWN
Total depth *9.0 ft. Eft. absorption area 540 ft2 Monitoring tube YES
Date of adequacy test 7/26/2010 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 0 in.
Elapsed Time: - min. Final fluid depth 0
Any rejuvenation treatment (past 12 mo.) (YIN & type)
Depression over field NO
For 4 bedrooms
New depth 0 in.
600+ g.p.d.
If yes, give date -
D. LIFT STATION
Date installed
"Pump on" level at__in.
Datum__.---.--- Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons Manhole/Access ~
"Pump off" leveL~L~igh water alarm level at
100'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas 50'-t-
in.
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
PubliC sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
Building foundation
Water main
Wells on adjacent lots
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
5'+ Property line 5'+
N/A Water service line. 10'+
100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+
Water service line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
Absorption field 5'+
Surface water. 100'+
Water main N/A
Driveway, parking/vehicle storage
10'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the' above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A~ GARNESS
Date
COSA Fee $
DateofPayment'~/~/~'OlO
Receipt Number ~ Z.~4
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
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 # 101151
A Certificate of On-Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 4, Lot 3 of
Birch Hills Terrace #2 subdivision. This inspection revealed a nitrate
concentration of 6.75' 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 Ref.# 1103634001
Client Name Garness Engineering Group, Ltd Printed Date/Time 07/29/2010 8:55
Project Name/# Birch Hills Terrace #2 B4 L3 Collected Date/Time 07/26/2010 8:20
Client Sample ID Birch Hills Terrace #2 B4 L3 Received Date/Time 07/26/2010 12:29
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) 07/27/I0 07/28/10 KDC
Waters Department
TotaINitrate/Nitrite-N 6.75 0.100 mg/L SM20 4500NO3-F B (<10) 07/27/10 LCE
Microbiology Laboratory
E. Coli Negative 1 100mL SM20 9223B A 07/26/I0 DLC
Total Coliform Negative I 100mL SM20 9223B A 07/26/10 DLC
SANITARY PUMPERS
20627 UPPER BOWERY LANE
CHUGIAK, AK 99567 .-
907-688-4602
.~_
ADDRESS /
CASH C.O.D. j ~AR~ ~ A~ J~S~ R~D. PAID OUT
TAX
RECEIVED 8Y
10741
All claims and returnod goods
MUST be accompanied by this bill.
PRODUC'r :.,.~:,..~ ~
Thank You!
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AS-BUILT
I hereby cen'ify that I have surveyed the following described
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 ly~mg adjacent thereto, that
no improvements on property lying adjacent thereto encroach
on the premises in question and tl~at there are no roadways,
transrn~sion lines or other visible easements on said property
except as indicated hereon.
Dated at Eagle River, Alaska
this V,~' ~ day of ~ o---~L, 19. q'
ROBERT C. JOHNSON -~
SCALE: Registered Land Surveyor No. 880-LS
1" = ~" Box 77-0456, Eagle River, Alaska 99577
~ Phone (907) 694-2543
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