HomeMy WebLinkAboutBRISTOW LT 1 Onsite File
Bristow
Lot 1
#017 - 091 - 68
Municipality, of Anchorage
• On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181443 PID Number: 017-091-68
Dwelling: EI Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑ New ❑� Upgrade
Name:
RENNER ABSORPTION FIELD
Address ❑ Deep Trench El Shallow Trench ❑ Bed ❑ Mound
14305 CHAWA C I R ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 0.6 GPD/SF 5 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Snhriivicinn Block Lot 2.0 Ft. 3 Ft.
i3rts'ow LT .1 Fill added above original grade Gravel length
Township Range Section 1-2 Ft. 116 Ft.
Gravel width Beds:Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft. 0 Ft.
To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
Tank Field Lift Station Tank Line
From 1000+ Ft2 1 Ft.
Well 11001+ 100'+ 50'+ TANK 0 Septic ❑S.T.E.P. ❑Holding ❑Other
Manufacturer Capacity
Surface Water 100'+ 100'+ ANCH TANK 1250 Gal.
Material Number of compartments
Lot Line 10'+ 10'+ STEEL 2
NA
Foundation 10'+ 101+ LIFT STATION
Manufacturer Capacity
Curtain Drain UN UN Gal.
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank 3034 Tank to
Installer grainfield 3034
MIKE ANDERSON, P.E. Drainfield 3034 CO/MT3034
Inspector MIKE ANDERSON, P.E. BENCH MARK (Assumed elevation) 105.5 ft
Inspection
1st 12/29/18 2nd 12/31/18 Location and description
3rd 4'h GARAGE SLAB
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
— c Or 4 ;n,
Conditional Approval: Date .,,,‘„?....•'4G�•.... • .:,,
_, £ .r
511:•es
F,.. MICHAEL N. Al-.i.:n;;;:1 •</ / . . .,.....................................................
.�. CE-9469
Approve. il, ‘.."---, -- DateI r l � ^ ,'.c,�:y
Inspection Report_9-1-12.doc
Permit No. OSP181443 Page 2 of 2
Municipality of Anchorage
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
Legal Description: BRISTOW S/D, LOT 1 PID No.: 017-091-68
MARKC/5—. .--
C01 20 '
7 21
CO1 56 104
65 110 /
CO3 66 112
cS5 '
Co4 113 145
MTt 94 116 _ — \
C05 94 115 _
MT2 1177:3.5/211
73 3 4TH#2
C06 175 215 \
`\ . TH#1 I . 1 MT2 C06
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100.8 1510(1ClClColAAX 10�'L 25� tea 95—/ •
1
.0 MICHAEL N. ANDERSON,=t
88.8 / BB •1 C% No. iE4469NO WATER ON 12- 18 •0A •.� ( 9.•• •• 411.SEPTIC SECTION —�'IA I♦ •. , •.
N.T.S. SS1 44
12111/1S' T 4
t2.J 31 l �
/�'" `T� MUNICIPALITY OF ANCHORAGE $
mens ,
On-Site Water&Wastewater Program �o Ste„
PO Box 196650 4700 Elmore Road a
Anchorage,Alaska 99519-6650 Phone.(907)343-7904 Fax:(907)343-7997
T http://www.muni.org/onsite '.
�� I)ctartnit•nt
4,yC.ti UpaVE
On-Site Wastewater Disposal System Permit
Permit Number: OSP181443 Effective Date: 12/24/2018
Work Type: Septic Upgrade Expiration Date: 12/24/2019
Tax Code Number: 01709168000
Site Legal Address: BRISTOW LT 1 G:3039
Site Mailing Address: 14305 CHAWA CIR, Anchorage
Owner: RENNER DARREL R & SUZANNE E Lot Size in Sq Ft: 55946
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
0 Disposal Field E Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
etaReceived By: Date: / / -
Issued By: "t? l al Date: /i2 DI it
MUNICIPALITY OF
ANCHORAGE
Development Services Department \ Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 017-091-68
Property owner(s) SUSAN RENNER Day phone
Mailing address 1090 FISHER GRAVEL PIT RD DECATURVILLE, TN 38329
Site address 14305 CHAWA CIR, ANCH, AK 99516
Legal description (Sub'd., Block & Lot) BRISTOW LT 1
Legal description (Township, Range & Section)
Lot Size 55946 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field E Initial ❑ Single Family (SF) 0
(w/wo ADU)
Septic Tank n Upgrade K _ . . Duplex (D) ❑
Holding Tank ❑ Renewal 1I
Itiple Dwellings ❑
Privy ❑ > F and/or D)
Private Well ❑
Water Storage ❑ a. 1.
c'
4'7 ti
THIS APPLICATION INCLUDES A WAIVER REQU• ST-F0_ • h w
v95
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
IAA-.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 5401 Waiver Fees:
Date of Payment: 1244 11'' Date of Payment:
Receipt Number: It- 10106Receipt Number:
Permit No. 05P/21043 Waiver No.
G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
Dec. 18, 2018
Municipalities of Anchorage
Departments ofUouhhand Human Services
PD.Box )96650
Anchorage, Alaska 9V5l9-6650
Fax 249-7847
Dc: New Septic Permit
Leuu|: 8IlIST()W[Tl
TO Whom dmay concern:
This is urcqueyt fora new septic permit oil the above vc|eronood lot. The old system has Failed and needs
rcp|ooiu�� Th�t*ntca ho|cov�roozcovu1cduodabon�dai|ty�ovc|yK]K�\for the entire l2foot depth, no
perr were done due tuthe cold will bedone during construction. No water was observed during the test
hole excavation but bcdnnckwuafound in both holes at 12 6:u(, therefore 6 feet will be maintained 0othe
bohomuf(benew drain fio|d.
The kx akoocu at 10 to 15 percent near the location for the leach DckL see the site plan., d'u/ flattens out
where the systemwill boinstalled. The permit will not impact any ofthe surrounding noiuhboodue hotills
design.
Please call me if you have any questions.
Sincerelv #AA-
MichaelN.Anderson, P.E.
4661 Natrona
&ncb,Ak995|6
Ph 727-8864
DESIGN CRITERIA: ` MOUND OVER
(TH#2) (TH#1) rGRADE
4 BDRM X 150 =600 GPD ORG ORG 1 c
SOILS = 600/0.6 = 1,000 GPD 1.5 1.5 FILTER FABRIC
1000 GA/5*0.58= 116' "0 PIPE
GM GM -2.0
-SEWER ROCK
(1) TRENCH
5.0' DEEP
3.0' EFFECTIVE -5.0
5.0'WIDE 5.0'
116' LONG 12.0 _ 12.0 —
BEDROCK,NO WATER BEDROCK,NO WATER
SEPTIC FIELD SECTION
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11 ! WELL \�\
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11 m ,�/ SETIC; EE�j''
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DRAINAGE FIELD �i
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Septic Design Prepared for �voiliwaiiII,,
DARREL & SUZANNE RENNER �.•.7E OF •
BRISTOW LOT 1 ��� ......1.-
Anchorage,
•
Anchorage, Alaska % �` 49�TH �� : ' ♦;
i G "Y — •
.•
Michael N. Anderson, P.E. DATE: 12/18/2018
':MICHAEL N. ii:
♦ No. CE 94 9
4601 NATRONA AVE DRAWN: DJR ♦♦� •�.,, Z/Y• .• �.
CliCCI�
ANCHORAGE,ALASKA 99516 ♦♦ .
(907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=200' 4III SS\O'
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SECONDARY SYSTEM TO BE
\ BRISTOW
ADVANTEX W/APPICATION _ 1 ,' LOT 1
OF 3.0 GPD/SF.5'WIDE X 1' ��� ��' • �/
DEER,,X 40'LONG , /' `o/ SHED
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EXISTING% / DECOMMMISSIONED PER -- --
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Septic Design Prepared for 4S*%I *,1
DARREL & SUZANNE RENNER �••�� OF 44444
.•
BRISTOW, LOT 1 4:• ...� %�
Anchorage, Alaska % : 49TH �\
i„as . 4WIN :
Michael N. Anderson, P P.E. DATE: 12/18/2018 �� :MIC NoLN.C g ANDERSON/
4601 NATRONA AVE DRAWN: DJR �• , 467,
ANCHORAGE,ALASKA 99516 _ ••��• •'t2 'a,"-c
(907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50' Oki. ;x..44
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Municipality of Anchorage vklapI�NEE7..s.S j*t)
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Development Services Department m' `'a•' �. •°••-77 t• i
On-Site Water and Wastewater Section ,r; 49TH• '^;
:�: t1
4700 Elmore St. / �,
P.O. Box 196650 Anchorage.AK 99519-6650 ���Zjl" F'•
• C:96.."
ww (907)3.orq/onsite �' ' . °
(907)343-7904 4 MICHAEL N. ANDERSON ..r) f-,
_ e ' CE-9469 -• "�
Soils Log - Percolation Test R
repF/t�r�,t, ',. I(.;;;
Performed For: G-rn Y1ctf^ Date Performed: /ti
Legal Description: (";4%).4,A-v-tQ �t9+ I Township, Range, Section: /7//�//
Slope Site Plan l
Depth
(Feet)
1- l9tpc=j
2- 42. go., r
3-
4-
5-
6 Ali
•
7-
8-
WAS GROUND WATER
9- ENCOUNTERED? /%)O
S
10- IF YES.AT WHAT DEPTH? L
O
Depth to Water After P
1 1- Monitoring? TE
12- — Date. (7/7 Olt/
13- ‘11410h/oWI '
14-
/2'e- ,.,x5t4 k.. Reading Date Gross Time Net Time Depth to Water Net Drop
15- /'tliil/f( 34ilii,n (r 7 ti S-.,
16- 0r trs "
17- V lrC.//
P
18- 1, s"
19 (/l ir5 /r
20-
PERCOLATION RATE 77 u tminutesiinch) PERC HOLE DIAMETER Le
TEST RUN BETWEEN L FT AND 3 FT
COMMENTS
PERFORMED BY: /k'4 NJ I I CERTIFY THAT THIS TEST S
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: (`Z .2.6{
`441®�e.N.v‘#
Municipality of Anchorage A 4c.• f�� ‘A‘%
Development Services Department i y.'• �� c/ 1
On-Site Water and Wastewater Section "* :49TH '
.�,� 4700 Elmore St. 'r �Ot
• ,t..! =
_ P.O. Box 196650 Anchorage,AK 99519-6650
www.muni.org/onsite ••"
(907)343-7904 e MICHAEL N. ANDLRSCN ;o
,'�_ 011C; •• CE-9I46? .....: ,..r;
�.;
Soils Log - Percolation •
61sf0� ?`(l�.'.. • .__; '
Test i)1� !,SSE, „ � -- y
Performed For: g 1-11 h T e Date Performed:
Legal Description: Nt/“0w (it-9t." ( Township,Range,Section: / /S //
Slope Site Plan
4112800
Depth
(Feet)
1- O ,
2-
3- 7 '.74.C.--.' 6-4C p(er) ,
4-
5- 6 nil.
6-
7-
8-
WAS GROUND WATER
9- ENCOUNTERED? /4 0
S '
10- IF YES,AT WHAT DEPTH? L
•
Depth to Water After D
11- Monitoring? P./%1 t
())Y4PV/A-t
12-.. Date 1212114
13- 010tyt
14- Reading Date Gross Time Net Time Depth to Water Net Drop
15- 1/1/441 30Mrh (. // i,�i /
16- L/r /�T-/i
17- /f (/c//
18- " 1,5..,f
19-
20-
PERCOLATION RATE ZQ (minutes/inch) PERC HOLE DIAMETER (0
TEST RUN BETWEEN z- FT AND i '3 FT
COMMENTS
PERFORMED BY: NA IV A I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ,,L (?,6 /.1
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39.75 • CHA N L' O —1b:"\\
I N 79°17'10" E 304. 97 GRAPH/C SCALE: 1 Inch = 30 Feet i< N) OF --<4\
1 Pr(S.\.*
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I 15 0 15 30 60 *49 - '` 1* t
Date Scale Legal Description / ��r/
12/19/2018 1" = 30' I hereby certify that the property described hereon has been surveyed / :BY F. HUItNETT
BOBBY F. BURNETT Grid by me, or at my direction, and that the improvements situated thereon ` 4i
2941 Carriage Drive LOT 1 are within the property lines and do not overlap or encroach on the � 1S-5484 z
•
g SW 3039 AS-BUILT property lying adjacent thereto unless otherwise shown. That no ,I Ca /2_-/7-I C 41
Anchorage, Alaska 99507 BRISTOW SUBDIVISION improvements on the property lying adjacent thereto encroach on the i9p,�
(907) 350-5541 Drawn by Field Book PLAT # 77-166 premises in question and that there are no roadways, transmission `°ESSION�r
BFB ASB2018 lines or other easements on said property except as shown. `_�
GRE,-.,ER ANCHORAGE AREA BOR..dGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
NUMBER OF
DISTANCE ,) ~.--'r)
FROM WELL MANUFACTURER ~ MATERIAL COMPARTMENTS
INSIDE LENGTH ~ / .INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY //¢zCJ/~GALLONS,
TILE DRAIN FIELD:
DISTANCE FROM WELL __
FOUNDATION
NUMBER OF LINES r-.-:;'~'~- DISTANCE BETWEEN LINES
/ TOTAL LENGTH .
NEAREST LOT LINE ~ ~ OF LINES /2'/
//-~'~¢-' TRENCH WIDTH ,.D IN. TOTAL EFFECTIVE
ABSORPTION AREA
DEPTH:
WELL:
TYPE
SQ. FT. LENGTH OF EACH LINE
../? DEPTH OF FILTER
TOP OF TILE TO FINISH GRADE wu~-- MATERIAL BENEATH TILE
___.CONSTRUCTION
IN. ABOVE TILE
IN.
DEPTH DISTANCE FROM:
BUILDING
FOUNDATION
NEAREST NEAREST 2 SEPTIC ?
LOT LINE ..... SEWER LINE__/¢'~) TANK~)~,
SEEPAGE
SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED
DISTANCES:
INSTALLED BY'~- '"
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DISAPPROVED -.-----' REMA R/~S
c;;~'~.~,.]~n¢, ~ D IAG R A M O FSYST EM, ,~ / i~
DATE~--~APPROVED-- -CZS:A~~~
Form EQ-032
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ii,is form reports' So~ls log ,- Percolation
Feet
i-: ............. ;~¥-" ~..'-~
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7
8-
9-
10-
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Was gromld water em]countered? ...... /~..<2 ......... If .yes, at w~aL (h,>>th? '
J~'-. ~ z-..'7~' 1. ~'" :?~,"~ I I ~ " ......I ...................
Percolation rate L"'~/7~,'* minu[e. ................................................
'Proposed ~usLallat~off: Se~,page Pit drain F'irtd ............ ~'_ ...............
Performed l:,y: C~, .... (-)~!-,~J2~-'21 Certl fled By:(~,'z.s-/~,,,.,/z,~,:~ z¥~;e,-.( JaLe: ~' -Z.o°')~
'. '. "')7-' '~ >" ..................................... ~ .... ~ ....................
TIME D~I LL LOG
,., ,~,.~...~//..~__ (~..~~¥ C.H. ":LF DRILLING~:~
~ ,. ~bc) 914 East 78th Avenue
/,?~~ ,, ~~ A~C"O.A~,A~AS~A
STAR ~ COMPLET
TIME WELL LOG DEPTH WELL LOG
PAUL F. ROBISON
KENNETH McCABKEY
ROBERT H. REYNOLDS
'MARVIN S. FRANKEL
ANDREW R. BARISKY
RANDALL E. FARI-EIGH
WILLIAM L. CHOQUETTE
THOMAS WALDOCK
ROBISON. McCASKEY, REYNOLDS. FRANKEL & SARISKY
A PROFE~;SIONAL CORPORATION
ATTORNEYS AT LAW
921 WEST SIXTH AVENUE
ANCHORAGE. ALASKA 9950].
September 10, 1976
Mr. Norman Bristow
Star Route A, Box 449A
Anchorage, Alaska 99507
TELEPHONE
AREA CODE 907
279-7431
MUNICIPAl I'[Y
DL P'r. OF
ENVIRONMENTAL PRO/I('I'iON
SEP 1 4 1976
RECEIVED
Re: Edith'Storck, Notice of Cesspool Location
Dear Mr. Bristow:
My client, Edith Storck, owner of property adjacent to and
at a higher elevation than your property in the Bristow
Subdivision, formerly known as the Storck Subdivisi~-~-~
~d-~s-es me that you are or have constructed a residential
building on your property which building is so located as
to receive drainage from Edith Storck's cesspool and also
ground water runoff. You were advised on 1 August by
Edith Storck of this matter at which time you indicated
you would construct any necessary drainage around your
building to take care of the possible problems mentioned.
This letter is to confirm the notice given you, for the
record, so that should any later complaints arise from any
source over this matter.Edith Storck will in no way be
held responsible nor shall she be required to expend any
time or money should the voluntary location of your
building in the location below her property occasion a
problem.
Very ~ruly yours,
KM-vrr
cc: Municipality of Anchorage,
Department of Health
cc: Edith Storck
MUNICIPALITY OF ANCHORAC
DEPARTML,~ OF HEALTH AND ENVIRONMEN'I, PROTECTION
825 L Street, Anchorage, Alaska 99501
264-4720
Date Received: December 7, 1977
~1: Time 10:30 a.m~ #2: Time ti3: Time
Date 12-12-77 Monday Date Date
In sp Pratt In sp In sp
1. ~end~ng ZnseZ~u~on Request:
Ma~Zkng Address; ~o~ Office Box ~20 995Z0 Phone: 2?6-6300
Property Owner: Norman L. Bristow
Mailing Address: Star Route A Box 449A
99507
Phone: 344-0071
3. Legal Description: Lot 1 Bristow(Storck) Subdivision
4:
Single Family Residence: (
Multiple Family Residence:
Number of Bedrooms:
Number of Bedrooms:
Three
Well System: Individual Well ~ Community/Public System ( )
Permit # ?6535 Depth of Well Well Lo9 on File ( )
Construction Bacterial Analysis
Sewage Disposal System: On-site System
Public Utility ( )
Permit # 76535 Installed
Installer
Septic Tank Size
Manufacturer
Absorption Area
Soils Rate
Material
Distances: Well to Septic Tank
to Sewer Line Nearest Lot line
to Nearest Lot Line
to Absorption Area
Absorption Area
= ....... ,1UNICIPALITY OF ANCHORAGE
~//~-i~-"~,~,~ Department of Health and Environmental Protection
~ 825 L Street, Anchorage, Alaska 99501
264-4720
equest for Approva~ of Zndividual Sewer and Water
1. Property Owner: /'~~~' /' ~
Single Family Residence:
(U~Number of Bedrooms:
Multiple Family Residence:
( ) Number of Bedrooms:
7. Water Supply: * Individual Well (~Public/Community System ( )
If Individual Well, well depth
If Community System, name of system
Sewage Disposal System: *~Dn-site System
If On-site System, date of installation:
Public System ( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 1 Brist, ow(S~torck)Subd~visiD3~_,
Comments:
Affadavit
Approved:
Disapproved:
Attached:~-~( .~~,.__. ,,. Letter_ Attached: ( )
Date:
Department Worksheet:
iroa. if
•
•
Pr<E 04,
• i .'. Municipality of Anchora
On-Site Water and Wastewater Program
(907) 343-7904 5 r C,Y
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 017-091-68 Expiration Date: {^ /S-----/I7
1. GENERAL INFORMATION
Complete legal description _BRISTOW S/D LT 1
Location (site address) _14305 CHAWA CIR, ANCH. AK
Current Property owner(s) _RENNER Day phone
Mailing address _SAME
Real Estate Agent Day phone
2. TYPE OF DWELLING: 5ff #6 7 8 9 70
® Single Family (w/wo ADU) ,,�// ,�
E Duplex i. I
❑ Multiple Dwellings (Single Family and/or I t le*ivti `.
3. NUMBER OF BEDROOMS: 4 c
ti
IZ
4. TYPE OF WATER SUPPLY: 0 E O ,.�a STEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class A Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver/Variance request for: Distance:
Received by: Oa
Date: / J 5-7 e(
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ d 141 *81,GO Waiver Fee $ •
Date of Payment 1/151(7 Date of Payment
Receipt Number Al- /O994 Receipt Number
COSA# O' ?Uq l UO9 Waiver#
a
c
111
5. STATE.I•NT OF INS,P, ION 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 MIKE N ANDERSON,P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 1/14/19
�•e�W�R.N. w
:ic 'Jr 4, 'ilk
—. ..••o •e4.:!1 *1h
• 1-`` *,:I.
7 4,
P' ...-'--,--
'"11.k.o 4 TH . c;� ',t•
6. DSD SIGNATURE •••. .
>e r`'''''System
N. ANDC2�Cid�.''-' '.r
System #1 Approved for Lr bedrooms. J'�°• 7-4o9 System #2 Approved for bedrooms. t . ;.. :: :.
Disapproved. ��'% s:%.-,.: -'"
Conditional approval for bedrooms, with the following stipulations:
o 4)
3 -
0 SITE G�,
Z WATER
AN
o V�IASTEWA M
PRQGRA -
0p 5
41FMT SERv\C '
By: 1 1 t''^ k Original Certificate Date: )— / `I
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory • N
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
•
COSA blue sheet_10.10-12.doc
- If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: BRISTOW Sit) LT I Parcel ID:_017-091-68
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# Well Log (YIN)Y
Date completed_9-1976 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y
Total depth 150 ft. Cased to 26 ft. Casing height(above ground) 12"+
FROM WELL LOG AT INSPECTION
Date of test _9-1976 12.15-18
Static water level 22 ft. 21 ft.
Well production 1-2 g.p.m. 1.6+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 5.24 mg/L
Arsenic: ND ug/L Date of sample: 12-18-18 Collected by: MNA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date installed 12-29-18
Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(YIN)Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping NEW Pumper NEW
C. ABSORPTION FIELD DATA
Date installed 12-29-18 Soil rating (GPD/SF) 0.6 System type 5-WIDE
Length 116 ft. Width 5.0 ft. Gravel below pipe 3.0 ft.
Total depth 5.0 ft. Eff. absorption area 1000 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test in. Water added gal. new depth in.
Elapsed Time: min. Final fluid depth_in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in.High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 100'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 100'+ Holding tank NA
Animal containment areas 100'+ Manure/animal excrete storage areas 100'+
SEPTIC TANK ON LOT TO:
Building foundation 10'+ Property line 10'+ Absorption field 10'
Water main 10'+ Water service line 10'+ Surface water 1001+
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 100'+
Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 101+
Curtain drain 50'+(None Known) Wells on adjacent lots 200'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
~� OF q��l�
I certify that I have determined through field inspections and �.``?q• .•••'• S
review of Municipal records that the above systems are in �
: r %C
conformance with MOA COSA guidelines in effect on this date. =49TH '
... . .... ........... ..
Engineer's Printed Name MIKE N. ANDERSON,PE
.MICHAEL N. ANDCRSCN
Date 118/20191��,•. CE 94 9 1 ;-
t i i` 'ss it
COSA canary sheet 2-6-15.doc
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i N 79°17 10" E 304.97 GRAPHIC SCALE: 1 Inch = 30 Feet ' � ) �•F -46-4.1
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RACE 15 0 15 30 60 1*49T. %\ -7* TA
Date Scale Legal Description �: 110.
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12/19/2018 1 = 30 I hereby certify that the property described hereon has been surveyed /
BOBBY F. BUR1 V E L 1 by me, or at my direction, and that the improvements situated thereon r Be=° F. HURNECf Grid LOT 1 are within the property lines and do not overlap or encroach on the F 64
2941 CarriageDrive
SW 3039 AS-BUILT property lying adjacent thereto unless otherwise shown. That no 4
1 ),/e(—/9
Anchorage, Alaska 99507 BRISTOW SUBDIVISION improvements on the property lying adjacent thereto encroach on the
(907) 350-5541 Drawn by Field Book PLAT # 77-166 premises in question and that there are no roadways, transmission SSLotal.v
BFB ASB2018 lines or other easements on said property except as shown. �`__1111w
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT { • ,f r 907-343-7904
On-Site Water and Wastewater Section \ /� Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC191009
Subdivision: Bristow, Lot: 1
A water sample revealed a nitrate concentration of 5.24 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address:P.0. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
9n 7 vii2N717-E R. WET
RESIDENTIAL&COMMERCIAL WATER AND WELL SERVICES
24HR EMERGENCY SERVICES AVAILABLE
FREE ESTIMATES
907-230-7&6e
12/20/18
In regards to property located at 14305 Chawa Circle Anchorage AK. A camera inspection was done and
was found that the well had no water running into well above 40' but the well is only cased to 23'8"pitless is in
good shape and is at 14'. Well stick up is 1' and the static water level is at 41'.
Thanks John and Katie
907 Water Well Services