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STOCKHAUSEN LT 17
Stockhausen Lot 17 #051-062-25 �1\GV VJ/VL/ IVB Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231038 PID Number: 051-062-25 Dwelling: © Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Richard Perron A ORPTION FIELD Existing El De Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 21248 Ginger Lee Dr. Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 /SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Subdivision Block Lot Stockhausen 17 Ft. Fill added above original grade Gr I length Ft. Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist a between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t ches From Tank Field Tank Line Ft2 Well 63' 25+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100+ Anchorage Tank 1250 Gal. Material Number of compartments Lot Line 10+ NA Steel 2 Foundation 53 L ATION Manufacturer Capacity Remarks *See attached letter. Gal. Alarm location Electric lied by Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Drainfield CO/MT D3034 Inspector Arcterra Consulting* BENCH MARK (Assumed elevation) 100 ft Inspection 15� 4/18/23* dates: 2nd Location and description 3rd 4th Bottom corner of man door frame. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date `���P�..•p" "'..,�#��#�# �wriY�r�r4irN9r 1d weir KENNETH M. D FUS Septic System Approved / Date 2 �Z.♦��F'�•4 CE 7116 ai 7 2�,�'AV +ski�� Note: this approval does not include well permit requirements. Mt1tiEiS�S� �1\GV VJ/VL/ IVB AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP231038 ST❑CKHAUSEN LOT 17 PID# 051-062-25 ■►4dull 5► M.dwwo •MNM5 in A -C=28.6' y B -C=8.0' A -D=34.1' B-11=13.9' f & o A -E=35.4' `` 5 B -E=15.5' 2 ° A -F=36.0' N o B -F=16.5' :4- 4- n GARAGE GRAVEL D/W i � -- 1 INC ' . HOUSE // // H -- ---1-1 1*11 / /I%ISTING MA / \ / GALLON TANK C .co co /c0 I r i r I I 1 Mrco r WELL • � R=I9D• I 1 3 1 1 1 FOUNDATI SCALE, NTS AW �' -OF AZ m 9TH a o�N a m N MMI'ffl 5 ❑ CE— 8� ■ E55IOI��' -or W W JJy�j L.f ff flU 5' 1250 GAL SEPTIC % TANK PREPARED FOR: RICHARD PERR❑N 21248 GINGER LEE DR. CHUGIAK, AK FIELD BOOKS BOUNDARY: N! /A STMNG' N/A AMU'LT- JLS DWG. FILE AOAD FIs' FILE COMPUTED: DRAWN: KSD O'ECKED: KMD DAM 55za G'D: NW14E " N°' 23106 GRAVEL W D/W 1 I SCALE: 1, = 30' SCALE, NTS May 11, 2023 ARcTERRA CONSULTING, INC 20441 Ptarmigan Blvd. Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Tank Replacement and Separation Waivers — STOCKHAUSEN LOT 17 During our 4/18/23 field inspection for permit OSP231038 to replace the steel septic tank, we discovered that it and the concrete septic tank had been removed and a 1250 - gallon steel tank had been installed. MOA On -Site personnel were at the site during our inspection, and the new tank was exposed to the inlet and outlet pipes and along the side to below the outlet invert. There were no visible signs of deterioration or damage to the steel tank or the protective coating on the tank. After discussions with those involved the contractor was allowed to re-cover the tank and move off site. The septic pumping receipt from 4/17/23 shows 1250 gallons of effluent was removed from the tank. In our efforts to determine when this new tank was installed, we contacted the deceased owner's family, Anchorage Tank as the supplier, ADEC, and reached out to local septic professionals to determine if any records exist that can provide proof of installation. The only documentation found is the attached septic pumping report from JRs Septic Pumping and Excavation with service date of August 17, 2018, that notes "pumped old tank to be replaced". There is an as -built survey by Schuller Land Surveying (SLS) dated 6/22/14 showing septic tank standpipes depicting the location of the old tanks. We have received an updated survey showing the location of the new tank. This survey does show that the standpipes have moved from the original locations confirming the new tank was installed after June 2014. Survey and field measurements show the existing tank is closer to 63 feet from the well. We are requesting the well to septic tank waiver be modified to 63 feet and 88 feet from well to field. We have field verified the tank to foundation distance of 5', have verified that the tank is outside the in-situ soil prism, and are requesting a waiver of 5' from septic tank to foundation. Assuming the new tank was installed in August 2018 this meet all STOCKHAUSEN, LOT 17 May 11, 2023 Page 2 of 2 other code at time of installation. We do not expect there to be any adverse effects to the existing well or this septic system operations in the existing location. If you have any questions, please contact me at 696- 6111/FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. f' E. Attachments: SLS as -built dated 4/27/23 JRs Septic Pumping Report dated 8/17/18 Sanitary Pumpers report 4/17/23 O Cd ANCHORAGE RECORDING DISTRICT, ALASKA AS—BUILT OF: STOCKHAUSEN SUBDIVISION LOT 17 PLAT P-450 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the Z:) improvements situated hereon are within the property lines and no i i enchroachments exist other than noted. Under no circumstance shout( 1 any information on this drawing be used for construction of fences, istructures, improvements, or for establishing boundary Iiiies. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE. E—MAIL APR 28, 2023 1 =30' schull-er0ok.net 14-02 9 DRAWN BY, ICHECKED BY; GRID NUMBER: Bots AGE JAS NW1 460 230130 ASW O.F V, L A,,V 1�p 491H 0 �A � RA.... : - ....... . .......N ?A P'd .. .............. • .JOHN L. SCHULLER: 0A0 ew • LS -10408 #00 k 0100 1831 Talkeetna Street '4V.201&:- 36 6 Anchorage, Alaska 99508 0 f '0K\'4W essiona\ XAW (907) 227-1455 office lk, (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231038 Work Type: SepticTank Upgrade Tax Code Number: 05106225000 Site Legal Address: STOCKHAUSEN LT 17 G:1460 Site Mailing Address: 21248 GINGER LEE DR, Chugiak Owner: PERRON RICHARD H JR Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: c n r�'.s f. r, � f Department 4/3/2023 4/2/2024 26136 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 Received By: 5 S �- l7 AILC- `r_ Issued By: Date: Date: - 3 2 3 4 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. 051-062-25 Property owner(s) Richard Person Day phone Mailing address _21248 Ginger Lee Dr. Chugiak, AK Site address 21248 Ginger Lee Dr. Chugiak, AK Legal description (Sub'd., Block & Lot) Stockhausen Lot 17 Legal description (Township, Range & Section) Lot Size 26,136 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ Septic Tank X Upgrade rX (w/wo ADU) Holding Tank ElRenewal F-1Duplex (D) X❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Well to Absorption Field. *Well to Tank change Distance: 88' *64, I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: 22 S Waiver Fees: 4 Date of Payment: 3 2 5 Zo Date of Payment: 3 Receipt Number: () 9 Receipt Number: Permit No. 0-3102-31039 Waiver No. OS U 2 3 I OI G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality ®f Anchorage u�pa " M. P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 s (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231014 PID#: 051-062-25 Legal Description: Stockhausen 17 Engineer: Ken Duffus, PE Applicant: Ken Duffus, PE Permit#: OSC231038 Your request for a waiver of the required 100' horizontal separation from the septic field to well has been approved. The approved separation distance is 88'. In addition, your request for a waiver of the required 100' separation from septic tank to water well has been approved. The approved separation distance is.6*''' b3i C4- frz/ z3 This waiver approval applies to the Existing absorption field and new septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. .............................................................................. 1 Waiver is Granted: X Waiver is not Granted: Date: f 3 /2-02 3 Approved by: Name of Reviewer ....................................................... 0 a a N N N ........ 0 0... 0 0 X. 1 **** VARIAN C E/WAIVER REVIEW **** Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231038, Curtis Townsend, 04/03/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231038, Curtis Townsend, 04/03/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231038, Curtis Townsend, 04/03/23 MUNICIPALITY OF ANCHORAGE a DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 0* ENVIRONMENTAL ENGINEERING DIVISION ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME r/ y� c�. // -t/V gyp♦ Ste. PHONE /�7•e7 ❑ NEW ,UPGRADE MAILING ADDRESS LEGAL DESCRIPTION o-' /? 5-700 LOCATION / 7-2) C.C� Gj%-UaiC:v �aL NO. OF BEDROOMS U Well DISTANCE TO: Absorption area Dwelling PER�i NO-/ / ,/ Y a Q wF Manufact� � Material No. of compartments w Liq. capacity in gall nsInside IF HOMEMADE: length Width Liquid depth J�2 DISTANCE TO: Well Dwelling PERMIT NO. = z 4 Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well ' Foundation Nearest lot line PERMIT NO. j LL Z f ? W No. of lines Length of each line Total length of lines Trench width inches Distance between lines FTop p of tile to finish grade Material beneath tile inches Total effective absorption area W Length Width Depth PERMIT NO. Q H wa Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line ClassDISTANCE Depth Driller Distance to lot line PERMIT NO. W W �+ TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS v '0_ 30 3 ( a 7- S� T SOIL TEST RATING4 oZ S �Ct N ,a, 7 t, INSTALLER C REMARKS d L 6/ C't. M PROVED DATE LEGAL -a5 -/?'r 47 /? .S'75��1r�r/sY 74013 (Re'G. 3/78) F= f9 r-4IZ FH f E_= DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501. L fra— r rE= sF_r•-1E F: k -1F l7if FAC:. F• PERMIT NO. C 780981 ) 61or I APPLICANT PETER HOILVERSON ST RT BOX 1124 688 '2115 LOCATION MILE 22 1,'2 PALMER HWY LEGAL L-17 STOCKHAUSEN SUB LOT SIZE 375000 SQUARE FEET TYPE OF SOIL ABSOREITION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 4 SOIL EATING CSC! FT/BR?= 0 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: C:- F= F=' -r F --F = C --e F_ F= r-4 Ca ?' F -F — —5021101 aZ�i FZ F=0' .-oF- F— THE LENGTH DIMENSION IS THE LENGTH CIN FEET? OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATiON (IN FEET). L-4 I C4 T F -F T IF. C -i . kEI ul4_-w F= EE THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET'. PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -F` 1-^J e=) K. ° ? Z t -.F = �' lc e_: `f' % e=e t -a F=i Fes^ E F;: F Y_4'n 1-...1 T F --'F--- C'•_ -- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS, DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEFENDING UPON THE TYPE OF PUBLIC WELL.. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER IN=TALLATION. F_ I-=R.,rwl I _r IFE F_ a F;'�:f=_- c',F=r_:F___ rlE3EF* =1s I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED PETER HOLVERSON .-y ;c_, AND WELLS AS 'SET ENLARGEMENT IF THE ISSUED 4--------DATE_3�112=_VLa_.--- 2 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM i Name df , '�®/�f Mailing Address 10I4,! Location 1= Legal Description ��oCaC/►u�ev 5��, SEPTIC TANK: Distance from well/jXMaterial (W/J, Number of compartments i Liquid capacityAA SO/gallons. Inside length Inside width Liquid depth SEEPAGE SYSTEM: Seepage Pit: Number of pits^Outside diameter or J width , length , , depth_i , lining material 1-06:S` Distance from well .)/01 , building foundation : : , nearest lot line _-& Total effective absorption area (wall area)sq, ft. TILE DRAIN FIELD: Distance from well , foundation , nearest lot line Total length of line$�� Number of lines Distance between lines .Trench width in: Totaleffective absorption area sq. ft. Length of each line. Depth: Top of tile to finish grade Depth of filter material beneath tile in. Above the i WELL: Type I)KIZi"q depth , distance from building foundation nearest lot line 6S", nearest sewer line, septic tank 1 ��, seepage system cesspool_._ , other sources____ DISTANCES: ,-O= lH I : C- 60f DATE; _, APPROVED V'(CLIyJs ��t^ Health Authority SEWAGE DISPOSAL SYSTEM - APPLICATION S PERMIT y// 6-1-ru AJ ii Name of Applicant j �f�1 Mailing Address /0 /G, Ph. # Residence Address Location of Installation Legal Description Application to Install: Septic tank V/ , Seepage Pit., Drain field.,4 Other To Serve the Following Facility_ Financed Through To be Installed by N4)- Percolation omPercolation Test Results Anticipated Date of Completion BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT This is to serve as permit to install a7y'z- as described below. Size of unit to be served • Septic tank size_757b Type &jA)Peepage Area Te YP DISTANCES: DIAGRAM OF SYSTEM -'rtyAjV i' f op Hea th Authoraty I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. .��i C.tiS1Sl� - a DAT-ECEIVED s`—'--- INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE ❑ Two ❑ Five t Jam, MULTIPLE FAMILY ❑ Three ❑ Six1-u„'"` INSPECTOR INSPECTOR INSPECTO MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION DFPT. OF I"'!T" R. ENVIRUi 11,1_ P,: A..;..U•-CTION 825 LStreet- Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION ('Ula j 1932 Telephone 264-4720 DD �((''[ II ``'' REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWED ELI1411CYEE D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different fro above) PHONE 2. BUYER , PHONE MAILING ADDRESS 7 is r� © © l� s tee. 3. LENDINGINSTITUTION PHONE MAI LING ADDRESS 4. REAL R/AGENT PHONE MAILINGADDKtSS el 5. LEGAL DESCRIPTION /� / % /J �i � —"f � i re'�"v STREET LOCATION .. 6. TYPE OF RESIDENCY1 NUMBER OF,BEDROOMS - ❑ One ® Four ❑ Other ❑ SINGLE FAMILY ❑ Two ❑ Five t Jam, MULTIPLE FAMILY ❑ Three ❑ Six1-u„'"` 7. 'WATER SUPPLY ,N INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 19 INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 4 r/ — �V-" a 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY K MULTIPLE FAMILY NUMBER OF BEDROOMS e ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED c,.— INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS C,Y APPROVED FOR _ BEDROOMS /❑� CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY a 72-010 (Rev. 6/79) EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 1 9_ January 15, 1983 f4� SSP MUNICIPALITY OF ANCHORAGE "RIVER, CF PT C' � _ 1_ ENVIR'.TJi,- P,.?..: _o.Sl.1ION Dynamic Realty RECEIVED ATTENTION: Pat Byrd P.O. Box '? Eagle River, Alaska 99577 Dear Ms. Byrd, Reference: Lot 177 Stockhauser Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tanks were pumped and found to have a capacity of 1250 gallons. This capacity was arrived at through a combination of a 750 gallon tank and a 500 gallon tank. The absorption area was tested by a continuous flow of 600 gallons of water over a period of 24 hours without any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the four bedroom duplex located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further service, please do not hesitate to call. Sincerely, 1 ROBERT A. SHAFER, P.E. " RAS/ss cc: Alaska National Bank of the North Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA November 15, 1982 Verne and Melba Sexton 8721 'midland Place Anchorage, AK 99502 v 1L1.a�� P _Pfr 1Co��nS�a>> Subjects Lot 17 Stockhauser)Subd. Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The water analysis report needs to be submitted to this office from the Chem Lab, 5633 h Street, for our review. The septic tank, pumped with a receipt submitted to this department. A four. (4) inch cleanout needs to he installed to the sep- tic tank. A four (4) inch cleanout needs to be installed to the leaching area. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is �L adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264_.4720, Sincerely, Robert C. Pratt Associate Environmental Specialist': RP223/p/EH MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL P .k�,V,,y1 HEALTH & 2510 East Tudor Road, Anchorage, Alaska 99504 2M M AL PROTECTION REQUEST FOR APPROVAL OF SEP 2 8 1978 INDIVIDUAL SEWER and WATER FACILITIES RECEIVED 1. Type of Inspection: CMRO VA FHA CONV X 2. Property Owner: PETER F. AND DARLENE A. HALVERSON Mailing Address: Star Rt.Box 1124 Chugiak Day Phone: 3. Name of Buyer: not sold Mailing Address: Day Phone: 4. Name of Lending Institution: not sold Mailing Address: Phone: 5. Name of Realtor or Agent: Mailing Address: Phone: 6. Legal Description: Lot 17, Stockhausen Sub. Location: Peters Creek area 7. Type of Facility to be Inspected: 8. Water Supply Duplex (4) 2 bedrms.each apt. No. Bdrms. Type of Supply: Public Utility Individual x drilled well If Individual, number of dwellings presently served duplex If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) X If Individual, d 'e of installation 1963 has since been upgraded. S r i PALE/2. �4r ,d4, �► fT&PP rni a2 c� 9ta 1 h a 72-00313/761 �� s��° � `�e 7°' c DeTiaGdC�d f��+q'�• I-, MUNICIPALITY OF ANCHORAGE HEALTHDEPT. OF 6 October 1978 ENVIRONMENNTALPROTECTION OCT 121978 RECEIVED Mr. Peter F. Halverson SRB 1124 Chugiak, AK 99567 Dear Mr. Halverson: A sewer system adequacy test was performed of catedsystem Lotserving 17, your 4 -bedroom duplex (2 -bedrooms per unit) Stockhausen Subdivision. capacity of 750 The septic tank was pumped and verified to haveCOntinuOUs flow The absorption trench was charged by ter over a period provideber 1978. d a water mefor absorptio4-5 n gallons. in excess The percolation through the system pr of 635 gallons. On the basis of the above test, the absorption area is adequate to serve your residence. However, a neva septic tank with a minimum capacity of 1250 gallons will be required before the entire system can be considered adequate. Sincerely, BERT A. S E. / CF; Dept of Health and � � F Environmental Protection Ur . 'No. , t pon white sheet 10-3-78 WMIT Pratt 1-U-0 „ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIMNICIPAUTY 825 L Street - Anchorage, Alaska 99501 OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 6. TYPE OF RESIDENCE Telephone 264-4720 SEP 2 61978 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE®IiAiC'ETVI D LL ll forr processing. DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for 1. PROPERTYOWNER -'?-1 3 0 '(MULTIPLE FAMILY PHONE Peter F. Darlene A. Halverson XXI INDIVIDUAL* MAILING ADDRESS ❑ COMMUNITY Star Route Box 1124 99567 ❑ PUBLIC UTILITY PROPERTY RESIDENT (If different from above) 8. SEWAGE DISPOSAL SYSTEM PHONE 2. BUYER PHONE MAILING ADDRESS ❑ PUBLIC UTILITY 3. LENDING INSTITUTION NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE Marianna Koehler % Great Land Realty 694-9125 MAILING ADDRESS - - Post Office Box 633 99577 5. LEGAL DESCRIPTION Lot 17 Stockhousen Subdivision STREET LOCATION See attached map 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ' EJ One EX Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five '(MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY XXI INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date 1963 I INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) Nothing on file. Also, may need upgrading and would like to make dwelling into a 4-plex, would like you to go through with them and see if it is feasible to do ooLso and where to place it. ,1 -/ L% Q�T ,sf�c,;,,N,a'��-r-.R, 43- L,-wn ��>Ya--r-6,- %a-�yl., , "ft" I eis`C� � n i. THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 7. TYPE OF RESIDENCE ❑ SINGLE FAMILY KMULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO FOUR ❑ SIX SUPPLY 2. VI ISI INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMITNUMBER DEPTH OF WELL DATE DRI LLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑ UBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS \ APPROVED FOR _ BEDROOMS 5--(� o - /❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Title) t r LEGAL DESCRIPTION 72-010 IRev. 3/78) U 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. 051-062-25 Legal description STOCKHAUSEN LT 17 Site address 21248 GINGER LEE DR Chugiak AK Current property owner(s) RICHARD PERRON Expiration Date: / 2 20 Z 3 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 5/12/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 ITU iHMPAUT1 Y OF AHCHORAGE Development Services Department p p i 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. 051-062-25 Complete legal description Stockhausen Lot 17 Location (site address) 21248 Ginger Lee Dr. Chugiak, AK Current property owner(s) Richard Perron 2. ON-SITE SYSTEMS SIZED FOR 4 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 5* - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed © Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Well to field & Well to Tank *:See Waiver Letter Expedited review requested: ❑ Distance: 88' & 63' By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Waiver Fee $ Date of Payment ti 3 Date of Payment COSA #—IJ-S14Waiver # COSA Application_ June 2022 Legal Description: COSA Checklist Stockhausen Lot 17 Parcel ID: 051-062-25 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 1964x*=Total depth 64+ fl Cased to 30+*** ft ✓❑ Sanitary seal is functioning correctly ✓❑ Wires are properly protected Casing height (above ground) 40 in. Date of flow test for COSA 3/21/23 Static water level at beginning of test 62 ft. Comments ***:per 3/1/02 report B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 4/17/23 ❑ Required maintenance completed, if AWWTS Comments D. ABSORPTION FIELD DATA Which system tested (date installed) 9/26/78 ✓❑ ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 4 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑✓ Monitor tubes go to bottom of effective. If not, state depth into effective ❑.i Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 3/21/23 date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 5.6+ qpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑/ N Q Coliform bacteria is Negative Nitrate 5.16 mg/L ElNitrate less than MRL (ND) Arsenic ug/L ✓❑ Arsenic less than MRL (ND) Collected by Arcterra Consulting Date 2/13/23 . FT STATION ❑ Require tenance completed Age of lift station rS Lift station material Comments: Adequacy test date 3/22/23 Results 0 Pass Fluid depth prior to test 44 in Water added 600 gal New fluid depth 64 in Elapsed time 1440 min Final fluid depth 44 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 44 in Effective depth remaining 28 in Comments/Deficiencies Water added to first CO after CO "F" and was seen flowing through the north most CO. Water levels where check at the MT/CO. COSA Checklist June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No 5'** Community Sewer Manhole/Cleanout > 100' ❑ Yes if No 63'* ft 0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25',/❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No gg'* ft Holding Tank > 100'✓❑ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑ Yes if No ft 0 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 5'** ft Surface Water > 100'✓❑ Yes if No ft Tank to Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑✓ Yes if No ft Private Wells > 100'•/❑ Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' © Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *: Waiver submitted. **: field verified, meet code at time of install. 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 Arcterra Consulting Phone (907)-!696-!6111 Engineer's Printed Name Kenneth Duffus Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 Nitrate Advisory Certificate of On -Site Systems Approval # OSC231118 Subdivision: Stockhausen, Block: , Lot: 17 A water sample revealed a nitrate concentration of 5.16 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Marling Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni org HMMEEMMEM From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address P O Box X96650=Anchorage, Alaska 99519 6650 *www muni org o �RCTERRq „ AKcTEIZRA g CONSULTING, INC m� 20441 Ptarmigan Blvd. Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 9�.`iilLtl N�. •� May 11, 2023 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE, STOCKHAUSEN, LOT 17, CHUGIAK, ALASKA ON-SITE WELL & WASTEWATER SYSTEM INSPECTION On May 91h you responded to our request for a Certificate of On -Site System Approvals (COSA) with a number of questions regarding previous COSA's and work performed by us as well as others. In response, please see the following: History Based on the Anchorage Borough Health Authority inspection report dated September 20 1968 a well and septic system was installed on this property. The document stated that the original septic system was comprised of a 1250 -gallon concrete tank with 1 - compartment and an 8' x 8' x 6'(d) crib. Although there was no well log found in the Municipality of Anchorage files (MOA), the original inspection report shows that a well was drilled. This approval was based on the existing codified regulations at that time. On September 26, 1978 the property owner requested approval of the on-site well and septic system for the existing duplex (4-bdrms), in addition to upgrading to a 4-plex dwelling. As part of this process, on October 6, 1978, the system was certified by a Professional Engineer that the tank was determined to only have a capacity of 750 gallons and the field had an absorption capacity in excess of 635 gallons/day (600 gallons was needed for a 4 -bedroom). The engineer letter advised that the tank needed to be increased to 1250 gallons to be considered adequate. In the October 25, 1978 MOA inspection report shows the installation of an additional new 500 -gallon steel septic tank placed after the previous concrete tank, in addition to an existing trench. This was the second approval of the system by the MOA. In November 1982, as part of the property sale request to approve the adequacy to of the on-site systems (well and septic) was required and subsequently approved by the MOA on February 1983. On March 21,2002 the Alaska Department of Environmental Conservation (ADEC) approved the reduced separation distance from the required 100' to 75' and 77' for the tanks and subsequent effluent lines. STOCKHAUSEN, LOT 17 May 11, 2023 Page 2 of 3 In August 2015, we conducted an adequacy test and well flow along with water sampling in accordance with current requirements and received a COSA for the referenced property. Due to elevated nitrates (5.39 mgl) a Nitrate Advisory was attached to the COSA by the MOA. The property survey on 6/22/14 showed the same number and location of stand pipes that we found in our current investigation. These pipes appear to correspond to the trench identified in the 1978 approval by the MOA. Based on MOA documents the system was comprised of a crib and trench. The trench was tested and passed at that time, and approved by the MOA. The COSA shows no indication that the crib was tested, only that the field was comprised of both a crib and a trench. With regards to the installation date on the 2015 COSA there are no documents in the file or our records that support this date and we have to assume that it was in error at this time. Due to the number of unknowns at the time we stated in our COSA, "The wastewater system serving this property has previously been approved as a 4 -bedroom residence/duplex by a ADEC and MOA. Total effective area and other data contained herein is based on MOA/ADEC record docs and visual testing observations". On August 17, 2018 JRs Septic Pumping and Excavation pumped the old 500 gallon and 750 -gallon tanks with an added note "Pumped old tank to be replaced". Investigation of Existing System: Our initial visit in February showed no visible stand pipes. As this is an estate sale, we contacted the responsible party and they uncovered several standpipes to allow us to test the system. On 2/20/23 we conducted another site visit and we were able to find 5 standpipes, which were located as follows; the 2 tank cleanouts, 2 post tank cleanouts, and the cleanout on the beginning of the trench. Subsequently we were able to locate the south end of the trench which was found to be a MT/CO. We were unable to locate the crib due to the snow. On 3/21/23, with access to the MT/CO, we proceeded to inject 2000 gallons of water in order to presoak the system again. On 3/22/23 we pulled 600 -gallons from the onsite well and measured the operation levels within the MT. Elevation taken on site indicate that the MT goes 10' below grade with the bottom of the distribution line approximately 4' below grade. During this test, the system readily absorbed the water and returned to pretest levels within 24 hours. Due to the conditions at the time of the testing no crib was observed or located. In addition to the above, you had several other concerns which I have addressed as follows: A) This is an estate sale. B) The property has been approved multiple times by the MOA. C) Through our recent survey we were able to identify that the well separation variance needed to be adjusted. STOCKHAUSEN, LOT 17 May 11, 2023 Page 3 of 3 D) On April 181h we verified, with the MOA present, the integrity and size of the 1250 -gallon tank under our tank permit OSP231038. E) I cannot address the work conducted by S&S Engineers. I can say that the two stand pipes located at the west side of the property are part of the trench and that we were not able to identify the location of the crib at the time of the testing. The separation distance from the PL to the field is over 10'. F) That the trench was tested in March and absorbed the required water for 4-bdrms. G) We exposed the septic tank and found it to be in good shape. Time is of the essence as they have a closing scheduled early next week. If after review of the records you have any questions regarding the adequacy of this systems or the methods and/or procedures employed during our inspection or evaluation, please feel free to contact me at (907) 696-6111 / Fax (907) 868-3793. Respectfully, ArcTerra Consulting, Inc. Kenneth M Du fF s E. y678970 !� • Municipality of An ti ra e On -Site Water and Wastewate P ogi f) 2015 3 rt (907) 343-7904 $ • *, a ^, CERTIFICATE OF ON—SITE SYSTE o L 6 s Parcel I.D. 051-062-25 1. GENERAL INFORMATION Complete legal description STOCKHAUSEN LOT 17 Expiration Date: Location (site address) 21248 GINGER LEE DRIVE CHUGIAK AK 99567 Current Property owner(s) CORY R. HASELHUHN Mailing address Real Estate Agent PO BOX 671406, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ® Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class _ Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: 9 - COSA to be released to the engineer, unless othe4 y+, jested by the engineer. COSA Fee $5J 2- (a Date of Payment q-/-/ Receipt Number 611B L COSA# o5G5IL116 Waiver Fee $ Date of Payment Receipt Number Waiver # S. STATEMENT OF INS, - BY ENGINEER r'tYsi�;�': 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 8/25/15 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future aa_\ occupants or can ArcTerra guarantee that no unseen �ff , encroachments, deficiencies or discrepancies exist. / �v OF ALS � or k9 TLI* v* 6. DSD SIGNATURE / DSD System #1 Approved for bedrooms. I<F-NKE' .1 s u F % System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: WATER AND By: G€A, 7� Original Certificate Date: (— Theicil chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based onty 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 engineers work. 7. ATTACHMENTS: x COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12Am 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: STOCKHAUSEN LOT 17 Parcel ID: 051.062.25 A. WELL DATA Well type PRVT Date completed Total depth ft. Date of test Static water level Well production If A, B, or C provide PWSID # Sanitary seal (YIN) Y Cased to 40+ ft. FROM WELL LOG WATER SAMPLE RESULTS: ft. g.p.m. ColiformNGS colonies/100 mL Nitrate s..3 mg/L Arsenic: NO ug/L Date of sample:' - B. SEPTIC/HOLDING TANK DATA - 2 TANKS Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 7/24115 ft. 4.4 g:p.m. Collected by: ARCTERRA Tank Type/Material SEPTIC / CONCRETE & STEEL Date installed Circa 1964 & 1978 Tank size 750&500 gal. Number of Compartments 1 Each Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Onside Foundation) Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping w/�- sJ Pumper---ew-ft� �41 C. ABSORPTION FIELD DATA - CRIB WITH TRENCH Date installed 4116/2004 Soil rating (g,p.d./fe or ft2lbdrm) 144 & 225 System type CRIB I TRENCH Length 12 ft. Width 12 ft. Gravel below pipe 6 ft. Total depth 10 ft. (Measured 7/24115) Eff. absorption area 576+ ft2 Monitoring tube Y Depression over field N Date of adequacy test 1/3012014 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 47 in. Water added 715 gal. New depth 55 in. Elapsed Time: 1440 min. Final fluid depth 47 in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Y (Acid - McDonalds) If yes, give date 6114/15 D. LIFT STATION Date installed "Pump on" level at_ in. Datum Size in gallons "Pump off' level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 75' (ADEC Waiver) Absorption field on lot 1004 Public sewer main 751+ Sewer /septic service line 25'+ Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100'+ On adjacent lots 1001+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 1004 Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 104 Building foundation 104 Water main 10'+ Water Service line 104 Surface water. 1004 Driveway, parking/vehicle storage 104 Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 1004 F. COMMENTS The wastewater system serving this properly has previously been approved as a 4 -BR residence 1 duplex by ADEC and MOA. The total effective area and other data contained herein is based on MOA / ADEC record docs and visual testing observations. 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 KENNETH M. DUFFUS Date 8125115 COSA canary sheet 2-e-15.doc 0 Municipality of Anchorage 77 Community Development Department Development Services 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 # 151475 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 17 of Stockhausen subdivision. This inspection revealed a nitrate concentration of 5.39 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. � I N90°00'00"E 150.00' a j- N � �s 15. 5 I SH GARAGE GRAVEL I D/W 26.5' N 44.0' 50.6' W > EXISTING 12.0' HOUSE 16 Q 2' CANT b m 32.0' 52.6' �W SHED 164" r� • 2' CANTO I -ER: RAVEL O LOT 17 °/"Z O o • • SEPTIC CD VENT Z (typ) WELL N90°00'00"E 150.00' 25' 25' ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: STOCKHAUSEN SUBDIVISION LOT 17 PLAT P-450 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a� OF AL lk` y D y�rt , physical survey of this property as shown on this drawing and that the / ��,. • • • • • ��, 0 improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shook / L?: • 49TH � �� N & any information on this drawing be used for construction of fences, / * : .....* �.................... a structures, improvements, or for establishing boundary lines. •� '�', L—' EXCLUSION NOTES: It is the owners responsibility to determine yj'ai ' :"' """...... the existence of any easements, covenants, or restrictions which ,p. L. SCH� do not appear on the recorded subdivision plat. ,1 ��. LS-10408 e,. • • �� / 1891 Talkeetna Street WORK ORDER NUMBER: oJUNgle E 22, 20141'1-= scrag: 1"=30' E-Mwb �, 9p.A' • • : �v.+ta AW Anchorage, Alaska 99508 1 4-029 aeaxx er: ace® er ago auMeat ecce ace `���ofesslono5 L=i (907) 227-1455 office JLS NW1480 140161 ���\\`�� (907) 274-4992 fax SUR 7FALASNw, � � � DM. OVENMONMNUL CONSIMATION IMMIONG WAT K -R ah&W&WEWokTZR MOGRkril 565 CORDOVA TO I ophW),:26V-7696 1XI VNtWRAGE, AX "Ol Fax: (m)26,165A. Faber[ C, C(ma, FM fogle Rives; Alobk, 99577- bV3W WAM of .0 sis061 *4wm and Soiree wellsoving"; Du Mum is re 2P,QTQM tPYGUOUttdf r&olved in chis Dffita.ali tv#»r<.h 5, ZOM N which thp mpitnaunt vm"Uwd want 44pamdou dqol�# WF�41d uxL�wl-g *11� taoluma effumm line wo the ssiating xv ti a wollszrviagfbe 4ploi W. oftIA:17 Stockhousm SabdivbjonI hav clomplat ca+':ieW4ru;ti'6tt Er worroatim w oa do., Alftyugh'th dfigosal &yam located ca h-lmw: .1 i IiiPAYt7Y42EN7°t1FX14VIRO TMMAI, CID NS FR --AMK on )YOCfi1:A'iENTzI`t'ION OVS STE1t4MSTALLATi N 6moaenf d'x4a l�ist6l{P.tic�ti. 'Haai±+nnlyl .%'" o£Wkks'� I % cni - 75kxUrisid�r�'V/ailr SRniF eRariaet3+t:en - i'i�' � fr` #'!! (�h�'s�idkt5�€i,jfr! !� � ...�{ �uiTax(idinu i4avale tai.. i'°"! p chaniinaUort Ka�Cetcl> "`v+ � � �ixs;'wn ('k Mitxni(tiuuavat Ci' iii!1mnp,:iu�c ['] ChlFen lt�.argfyj —�.. [j QaWte;3�hwwxwora Chataaa �t3tfier, o 1eF 4- 46 .�h.`. (jf'�wrarn4Cni - IiiPAYt7Y42EN7°t1FX14VIRO TMMAI, CID NS FR --AMK on )YOCfi1:A'iENTzI`t'ION OVS STE1t4MSTALLATi N 6moaenf d'x4a l�ist6l{P.tic�ti. 'Haai±+nnlyl .%'" o£Wkks'� I % cni - 75kxUrisid�r�'V/ailr SRniF eRariaet3+t:en - i'i�' � fr` #'!! (�h�'s�idkt5�€i,jfr! !� � ...�{ �uiTax(idinu i4avale tai.. i'°"! p chaniinaUort Ka�Cetcl> "`v+ � � �ixs;'wn ('k Mitxni(tiuuavat Ci' iii!1mnp,:iu�c ['] ChlFen lt�.argfyj —�.. [j QaWte;3�hwwxwora Chataaa �t3tfier, o 1eF 4- 46 .�h.`. (jf'�wrarn4Cni - �eL�P �+'etfa9iY: � � �F '9" .:i�iiLi��.'7.-. � ldlih7i4i160.'F •. $gilffGd�.�`tl71iffi4N'Y.%:� - . - - �. - .. ". -�TitXi •. ! "a46FY0f 3fl1�[iiF ... f . �¢j�p'IVfl fill'3 MSt� ,.y f 1F Gfpu,¢d .. -.. � .. IIaef[lAk.. QJnOsnS+$ex"4rfidnKen :: i1>�yaeiY%:8� i !�'1ge4tl1.$.Aginian'M1kRgpEiln i5FU39rt'Ai�jAmattl i,qF, sn'-� xce9&&tibiSnap�ifP'. iuclnfim&lhei{;�1.c��me.i &�kLu.. F;��� a' stAre amn SNa;,?1 'AaJaimt.€�r ; - ., ��. --Y: ' _ -: •. `. ��" �- � � 6mf�a'_ E3orgiwln!'t3A6tinE. WdDr�4u�ifa3li�ti� - - _. p E i # v,!"' .% 6ceYS '�. it •.-..•.time_ i�-'e& tdv16iz. '#Y+ m .- ..__ -•, - ;FtG1£"FTd!.�ta+S.nz^�`�)rA.w���.�Vtl��ftltd7ilP,t�fpjk&4i$neA�iFi$fn!=F,j'.�EiT'`,�iirGNOka'{Y8�i,1i?t$C'.. _-.. - _ ......... _ _ _..... __ _.. w tc .. sm � . [_i 4i tnE': - - L:�eity- -3'auk � WaeipiRT(is _ � sarry5ncy nf#4anRiRY (F10�tou)k. IN�1i1fl'RW P� RMS} 411 04 2002 11:49RH HP L"r61RJET 3200 "MHR=04-2002 1045 5$S ENGINMRINO ! P.1 90'i`04 1211 P.03 xn fnGERifTFj cvr March 1, 2002yt iVC( x211 STATE OF ALASKA Department of Environmental Conservation Division of Environmental Health Drinking Water and Wastewater Program Attn: Kevin K Klewsno, P.E. 555 Cordova Street ° Anchorage, AK 99501 Reference: Lot 17: Stookhousen Subdivision $"G Dear Mr. Kleweno, tenon Request you issue a waiver for the horizontal separation distance between the onsite private well find the extOng 500 gallon septic tank WOMMMAUUMN serving the duplex on the referenced property. ��oes The onsite well was drilled in approximately 1964. per out conversation with the original homeowner, Mr. Peter Halverson, No well tog Is WMft4 VMV available, However, well logs for surrounding wells are attached. The welt i Is cased in excess of so rest, The casing extends 12+ inches above grade, has a well head seal, and soils sloping away from the well. The well has a static water level of 60 feet, and recent water test results were satisfactory arzmrar (attached). The original septic system Was Installed in t9e6 which included a concrete 750 gallon septic tank (separation distance grandfathered) and a seepage .pit, approved by the Greater Anchorage Area Oorough, The second 500 gallon septic tank was Installed In 1976, to serve an addition to the original structure. This upgrade was also approved by the Municipality or sp,TW Anchorage (see attached. Inspection report). While the septic tank in question has been in place for several years, it does not appear to have affected th® water quality of the onsite well, as °o,�"" indicated by bacterial and nitrate testing. In general, septic tanks are not considered a source of constant contamination, as are teachtieids. The onsite leachfields appear to comply with the separation distances In current AVEC regulations. VMMLWALA rapamwe The nitrate level from a current sample Is 357 mall, also consistent with wells In the surrounding areas. Bacterial samptes Indicated 0 colonies present for both coliform and other bacteria. . e,Mf w,51avmw a beaux trnanNoarr+gwsnrttarsauxlr • SUFF Esoc • saateMn wwKaesarr The soils In the area are generally GW/GM down to approxrmatefy 5 feet and then change to SWlSM soils, which provide excellent effluent treatment for any effluent looked in the immediate area around the lank, Thick vegetation would preclude surface migration of effluent from the tank to the well. Also, topograghy of the lot generally slopes away from the well towards the Issohtields. Overflowing effluent from the septfo took(s) would flow to the south for about 30 feet, then tum west (away from the well). There Is no surface water In the vicinity. Groundwater is not a concern in this area, with none of the surrounding properties soils tests demonstrating high levels of groundwater which would be of concern. The well logs from the surrounding area show sand and gravel down to approximately 35 feet (good treatment) and clayey sand and gravel from 35 feet to 50* feet which would serve to confine any leaking effluent and prevent it from reaching the aquifer, The slope of the water table appears to trend to the west, which would carry effluent away from the well. The septic. tank. in question does not appear to pose a threat to onsite well or area wells and we -do not anticipate any adverse results to the public. health or water,quality from the granting of this waiver. Sincerely, L Robert C. Cowan, E. fi qty L RCt3lmJo P; O>�vwweuascv+Awz ,r...._. _.