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Home My WebLink AboutSTOCKHAUSEN LT 27Municipality of Anchorage Water � On -Site and Wastewater Program • (907) 343-7904 of ON-SITE WASTEWATER INSPECTION REPORT D2820%8 Permit Number: S/J� Sj Q 57 PID Number: Q 5-10 62-33 Dwelling:PSingle Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New PUJpgrade Name: I<A 9ZE ABSORPTION FIELD Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 3.S Q AI —ZZ" % �= (z ❑ Other Phone ber of Bedrooms Soil Rating p Total depth from original grade` 360-S703 5 0. C GPD/SF d. - Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe -5Ft. Subdivision Block Lot '7 L),f EN Z / Fill added above original grade / 2 Ft, Gravel length c� ` q Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines Distance between lines — Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer. Total absorption area Number of trenches Dist. between wenches From Tank Field Tank Line O Fe Ft. Well _ Zs� TANK EISeptic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer lCapacity Surface Water 00 G r Gal. Material Number of compartments Lot Line Foundation /Q /(Q �. LIFT STATION �E / _ Manufacturer Capacity Curtain Drain $'� ` CO ` J _ _ Gal. Remarks Pump on level at Pump off level at High water alarm at in. in, in. Pump make and model Electrical Inspections perforated by _ Installer :' PIPE MATERIAL House to tank Tank to 303 drainfield O Tri Drainfield A30 CO/MT G Inspector 4-1/5 BENCHMARK (Assumed elevation) 1 Q ft Inspection �� ' S dates: 2nd /2.��' Location and description 3rd 4m COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date _t .�..• t6�€i VVV V6%, Approved I BCA �O ! \ L ' "OPESSO vLa Date (/2/2C) I %,i4- Incnvriinn Ronnrf 0-1_17 ,i^^ d 10/0 L P--4 or co D Cy N 0 o Z uj W IY t\, (u o Oj V) x 0 I— u 0 ca Cp 4 -,owl . %fjt Air or co z Cy N 0 o Z uj W IY t\, t:: 0 . Z x 0 LO uj ca Cp z Cy o ED F-1 LLJ WI :D Ln ry 4 -,owl . %fjt Air or co z Cy N 0 o Z uj W IY t\, U . Z x 0 LLJ u ca Cp z Cy o LLJ (L 7.6b, LLJ WI :D < U ED < F—I n 4 -,owl . %fjt Air or co z i�isic N 0 o Z uj W co z N 0 o Z uj W IY t\, . Z x 0 ca Cp z LLJ (L 7.6b, s U E m d 0 41 4~ O V J o U d +' 4' ° C3 0 °' t U) p 0 n >z W Q > I— O u <L W U') 73 O u Q' u o C5 c Ln 01 O d (/1 -- 'n- LF) t, d > 0) W Ln 0� o, cu Ln W O °` o @) c3 v' . mmdO u C � d N `. N :N > d Ua -O > W (U I 0 0� > W @1 � CL t—i C3 dQ w d o, :p 4- W z Q o, L�- ww o > > <C fY v o, u W y _o = I— H' �n d F- z E- n- -N o U W C- z d -0 0) d N d d O S $$ C" LO u O a IT f �• Li > O o c LO C, d r, d C- d, Q)� LO 0 0 @1 uz O Q� O a N W n d U �z O 04 0) - +' o �Z rn d to W Z LU Q W W SOILS TPIM- Er'lllr- Q NEERING Performed For: Kahler Date Per -Formed: 4/14/15 Legal Description; Stockhausen L27 DEPTH (FEET) SM Silty Sand w/ Gravel Dense I 110MM 090=111 Groundwater? No Depth Water Depth After Monitorina.None Date, 4/22/115 # Date Gross Time 2 Depth Net Drop 3 4/14 0 -- 6# -- 5 4/14 10 6 8# 2# 7 4/14 12 8 6" -- 4 4/14 22 9 8# ........... 10 4/14 25 -- 6# -- 13 4/14 35 14 - 8# 2# 15 - 4/14 37 -- 16 - -- 8 17 - 47 10 min, 18 2" c) 19 50 -- 20 10 SM Silty Sand w/ Gravel Dense I 110MM 090=111 Groundwater? No Depth Water Depth After Monitorina.None Date, 4/22/115 # Date Gross Time Net Time Depth Net Drop 1 4/14 0 -- 6# -- 2 4/14 10 10 min, 8# 2# 3 4/14 12 -- 6" -- 4 4/14 22 10 min. 8# 2# 5 4/14 25 -- 6# -- 6 4/14 35 10 min, 8# 2# 7 4/14 37 -- 6# -- 8 4/14 47 10 min, 8# 2" c) 4/14 50 -- 6# 10 4/14 60 10 min, 8# 2# 21 - Percolation Rate 5 minJinch Perc Hole Diameter 6' Test Run Between 5' a n d 6' omments; Presoak , Measured to nearest 11I6th inch, • er-Pormed BYNc)rthR!m Eng, I CERTIFY THAT THIS TEST WAS • erformed in Accordance with All State/Municipal Guidelines in Effect IN THIS DATE, DATE; 4/22/15 NOR THRIM ENGINEERING PO Box 770724 Eagle RlvwAlaska 99577 907.694.7028 wa-�W'j TESTHOLE LOG TH2 GEOTECHNICAL Date: EET, 4/22/15 r2 MUNICIPALITY OF ANCHORAGE · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage. Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRES LOCATION / NO. OF BEDROOMS "~ OlSTANCETO: ]wemm ~ IAbsorptionaroa~o Dwo)]in~ ~ Manufacture~ ~ Material No. of compartments Liq. capacity in gallons Inside length Width Liquid depth IF HOME.DE: , ~ Well Dwelling PERMIT NO. ~ ~ Z DISTANCE TO: ~ ~ ~ Manufacturer Material Liquid capacltv in gallons O Wag Foundation~.~ Nearest lot line~ PERMIT NO. v Ne. of lines / Length -- O~C~ Total IOn~ ~es Tronch~id~inch.s Dis,ante bot~oen linos ~~ ~ ~ inches Total~effe ive sorp ion area ~ ~ ~ Top of tile to finish grad~ ~ ~ Material beneath tile Length Width Depth PERMIT NO. ~ Type of crib Crib diameter Crib depth Total effective absorption area m WeiJ Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. m Building foundation Sewer line Septic tank Absorption area(sD ~ DISTANCE TO: OTHER INSTALLER ~ REMARKS / 72-013 (Rev, 3/78) ' ' ~ ' .... ~ ~ '~AL DESCRiPtiON '~" "~ ~ -- ' ~- ~ ' -A '" ~ tNSIDE WIDIH ~rnp~ C,E SYSTEM: SEEPAQ~ P~: ' iH DEPTH~ '~: DRA~N F ELD: · )' ~' ' ~- ~ ~RENC~_~tD~H~~ - _ ~i ........ DIAGRAM OF SYS[EM [",S PERMIT NO. ( 7B~0t0 ) RI C:HFIRD z, UND LBTOC:KHFIUSEN R[:' . I':IPPL I CFINT LOCRT I 0N LEGRL L27 STOCKHRUSEN LOT _-,Iz.E 4.~.5t, id SQURRE FEET '- "-- ' ' · '-'.": , '- ' FREN_.H T'-,,-'I:'E OF :,OIL RE, z, uF, BTION =,-,_,TEM I:,. ' ' n MFll:.~IMI_IN NUMBER OF BEDROuM_, = 6 '-SOIL RRTING <SQ FT/BR.:,= ¢ .... THE REQUIRED S E SOIL BBSORPTI _,b_TEM [:.EF" T Fl= ~ L E I",..I tT~ T H: g ~'------. B I~-: R "-.-' E b [:,EF"TH= .?.4 ]'HE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL.D. THE DEPTH OF 8 TRENCH OR PIT IS THE DISTBNCE BETHEEN THE SURFRCE OF TFIE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRL.L PIPE RND THE BOTTOM OF THE ENCRVRTION (IN FEET). [qE~]:!Li IRE[:. S;EF"T ! C TRf-I[( 5 I ZE: 5~:--'~0 ...... PERMIT flF'F'LIC:RNT FIRS THE REz, FuN_,IE, ILIT? TO INFORM THIS DEPFtRTMENT DUF..IN.~ THE INSTFILLRTION IN_,FEuTION_, OF RNY WELL=, RDJRRENT TO THIS FR_FERfT RND THE NIJI1BER OF RESIDENCES THRT THE WELL HILL .:,EF. 2E. ......... TI..I~Z, ,:" '--" ":, I I'-.t".:-]PEC:T' I ~'31'-.t.:. FtF:E R~-_]LT! I_.! ]: F-:E[: BRCKFILLING OF' RNY mt_,TEM HITHOI_IT FINRL INSPECTIFIN FIND FIF'PRO',,,'RL E:Y THI'-q DEPFtRTMENT WILL BE mLIBJE~T TO F'ROSEEUTI--N. MINIMUM DIS'FRNCE BETWEEN R WELL RND RNY ON-SITE SEHRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELL: OR ~50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS BND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. CEF.:T I F'T' THFtT I RM FFiMILIRF.'. NITH THE REQ. LIIREMENTS FOR ON-SITE SEWERS RND HELL--N -,:r .... T I 1: FORTH BY THE MLINICIPRLITY OF RNCHORRGE. 2: I HILL INSTRLL THE SYSTEM IN RCCORDRNCE WITFI THE CODES. ]:: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS R~MO~,ELED TCI INCLUDE MORE THRN 6 BEDROOMS. .......... :._ RF'F'L I CRNT RICHARD SUND '-'- ", R t r',RTF V:' I z,z, UEC -~---~ ........... ~ .......................................... ,O ~ E GEe ,ECHNICAL 6r DEVELJPMENT CO. Russell O~$ter 694-2774 Soils Es Foundations Perfomed for: Legal Description: Box go, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Name: Hatltng Address: £erl Ellis SOIL LOG e~-228o Land Developmeht Depth (feet) o 4~ 5 6 Soil Charectertsttcs ~. iOw 11 13 Ground Water Encountered: Yes__ No If yes, what depth._~ Proposed Installation: Seepage Pit . Drain Field__~_ Comments~,~..W~ /¢''/~fz~///~- //-J~ /x/ ~'i2/~//Y///C ~/~'~ G,m,~TER ANCHORAGE AREA BORO,'-'"~ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY ./.~ MAILING LEGAL DESCRIPTION NUMBER OF ~" MATERIAL ~'t ,.,.,.,.,.,.,.,.,.~-'75~.~'71/'~'~ COMPARTMENTS // GALLONS. INSIDE LENGTH INSIDE WIDTH z~ DEPTHLIQUID SEEPAGE SYSTEM: SEEPAGE PIT: /' NUMBER OF PITS OUTSIDE DIAMETER ~ OR WIDTH UN,NO MATER~A~LL '",/~ q/U'w-~e'z--j~'' '~'//*/~':-~ D~STANCE EROM WELL /_~C:> ~ NEAREST LOT LINE ~ ~'~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH r--.2/-// , DEPTH ~ /, BUILDING FOUNDATION~ zO '~---'~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL ~" NUMBER O F.~'~ ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE TOTAL LENGTH '-' FOUNDATION , NEAREST LOT LINE . DISTA CE BETWEEN LINES TRENCH N. TOTAL EFF IIVE, DEPTHDisTANcEOF FILTERFRoMMATERIAL BENEATH,,,.;MS'TILE WATER IN. ABOVE TILE .~::.-"'"'~ DEPTH ~ ~" , BUILDING FOUNDATION /~5:~ SAMPLE. /~'/~' NEAREST WELL: LOT LINE NEAREST ~ SEPTIC SEWER LINE TANK SEEPAGE / SYSTEM /,,~:~9 , CESSPOOL OTHER '~'~, SOURCES__ DISTANCES: DIAGRAM OF SYSTEM HEA{IH AUlHORITY GREATEi, ~.NCHORAGE AREA L '~,ROUGH HEALTH DEPARTMENT' 327 Eagle St. Anchorage, Alaska 99501 279-2511 ' CaseNo. /~ , SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT FINANCED THROUGH PERCOLATION TEST RESULTS APPLICATION TO INSTALL: SEPTIC TANK ~/~"~D ,SEEPAGE PIT ~--~ , DRAIN FIELD ~, OTHER. TO SERVE THE FOLLOWINGFACILIT',' ~'~ ~?~',~,~> , ~'~--~ TO ,E,NSTALLEO BY ~-~~<~/~ ANTICIPATED DAT~ OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED .~3 . ~ ~.2~.~&~.:/~u... .. SEPTIC TANK SIZE ./~t9 L5 ,TYPE SEEPAGE AREA TYPE DIAGRAM OF SYSTE~ DISTANCES: Health Authority I certify that I am familiar with the requirements of Greater Anoho~ag~ Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. OATE ~'--' / ~ ^ppL,CANTSS,GNATURE .--- //...,'. -. ~'. .~.~-~',/ ?-~)REATER~ AN CHORt.o~, AREA HEALTH 327 EAaLE STREET , ANCHORAGE~ ALASKA 99501 r~o.a] Desc~,~ption Lot ~ Baock ~bd~ ~' ~ P~m Re~o s : S~Lo~ ~ --Percoiat~,on Test Location Sketch J ]q , [ , 'T-~ Reading Date Gmoss Time Net ' Time Depth To H20 Net Drop Proposed Instal~Seepage Pit ~/' Drain Field Depth Of ~nle. ~ ~.~; , Depth To Bottom Of P~t Or Trenc~~ '_ Date :~-- GAA§-HD-J G~.~,~TER ANCHORAGE AREA BORO,I-Lm.H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-251 NAME LOCATION· SEPTIC TANK: INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ~ ,' .)~;.~ ,.~ PHONEJ~--~%~/~ ADDRESS LEGAL DESCRIPTION ~'~'+ s~-~ /~'~'-~'- ~'~ ~'/ '~¢~' ~"~' DISTANCE FROM WELl LIQUID CAPACITY GALLONS. NUMBER OF ~ MATERIAL ~ () l"d O'~'""~'-~ COMPARTMENTS~ INSIDE LENGTH_ ~" INSIDE WIDTH DEPTHs__ SEEPAGE SYSTEM: NUMBER OF PITS_ LINING MATERIAL SEEPAGE PIT: OUTSIDE DIAMETER NEAREST LOT LINE OR WIDTH ~' , LENGTH_ '~ DEPTH DISTANCE FROM WELL //(7~O/ BUILDING FOUNDATION '~/~"~ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '2 ~',~ SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL_ NUMBER OF LINES FOUNDATION_ DISTANCE BETWEEN _ NES · NEAREST LOT LINE_ TRENCH WIDTH TOTAL LENGTH OF LINES IN TOTAL EFFECTIVE ABSORPTION AREA SQ, FT LENGTH OF EACH LINE DEPTH: TOP OF TILE TO ~INISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE_ WELL: I'YPE I ~0 DEPTH NEAREST SEPTIC LOT LINE SEWER LINE . TANK DISTANCE ~ROM .BULDNG FOUNDATION. SEEPAGE SYSTEM WATER SAMPLE · CESSPOOL IN. ABOVE TILE. NEAREST OTHER ., SOURCES DISTANCES: DATE DIAG RAM OF SYSTEM APPROVED NAME OF APPLICANT RES'DENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS z. OROUGH GREATEL, ANCHORAGE AREA C.seNo. HEALTH DEPARTMENT ~///327 Ea~le ~ St.. v / ~/~ Anchorage, ~) Alaska~o~ 99501 ~ 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT ~.~/ MAILING ADDRESS ~ PHONE NO LOCATION OF INSTALLATION / , SEEPAGE PIT. , ~RAIN FIELD' , OTHER ~ ANTICIPATED DATE OF COMPLETION AS DESCRIBEB RELOW. SIZE OF UNIT TO BE SERVED ~ .SEPTICTANKSlZE 7<~"'f~) TYPE ~'~/ SEEPAGE AREA ~~'PE ~ BIAGRAM OF SYSTEM DISTANCES: ,/~/,,,/, ~ ~th:ati~uthOrity - I if m 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. DATE Juno 26, 1969 Mr. Dan Rapalee Local Rep~esentative Vetel'aus Administ ~ation P.O. Box 1399 Anchopage. AK. 99501 SUBJECT: Watep and Sewage Facilities Serving Home Of MP. Hubept Reid, Hile 22.5 Glenn Highwe. y~ S 1/2~ SE l/N, ~g 1/~, SW 1/~, Sec. l~ast of High,cay Sec. 3, T15N, R1}I. S . ~1~ $ Deep ?Ip. kapalee. This letter will sepve as an aDproval of the sewa~fe an{] water facilities installed at the subject The systems conai.,]t of a drilled ~-~ell located 102' from an 800 gallou concrete septic tenk in conjunction with Sincere 1y, DAVID ii. L. DU[~CM~, ~,I.D. . ed~cal Director David Sanitarian MUNICIPALITY OF ANCHORAGE I Ar �S Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section4Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051 062 33 Expiration Date: 0,� 0 1. GENERAL INFORMATION Complete legal description STOCKHAUSEN LOT 27 Location (site address) 21435 GINGER LEE Current property owner(s) Mailing address Real estate agent MICHAEL KAHLER 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 3605903 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community I ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: ) rCw-AJ�C-u 0 I o per he- Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ q1 d Date of Payment 1/ 1/1- / q Receipt Number 090&3z) COSA # Qs r 1,9 / 61l6 Waiver Fee $ a � 5 Date of Payment 1 I JIS111 Receipt NumberQ T D A 9 Waiver # 0 Sy 5 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINIDate 11/10/2019 ON-SITE `9 ZEE WATE D tgWATER oz= �m PROGRAM JJJJ O� �� ))))))))l i By: CSI �/l'�� 9. �9�� Original Certificate Date: 1 1 I 1 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 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet �l OF A/ ,co 49 TH - •.* 6. DSD SIGNATURE / C ••C , J .� v System #1 Approved for bedrooms �� CHARLES G BALZARINI �� F� System #2 Approved for bedrooms •.• CE -13854 i91- i Disapproved 111E'9PROFES50�r Conditional approval for bedrooms, with the following stipulations: ON-SITE `9 ZEE WATE D tgWATER oz= �m PROGRAM JJJJ O� �� ))))))))l i By: CSI �/l'�� 9. �9�� Original Certificate Date: 1 1 I 1 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 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: STOCKHAUSEN LOT 27 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Parcel ID: Structure served by this system 1 ns1 nR9 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test +3.2 gpm Date drilled unk Water storage tank volume 0 gallons Total depth 67* ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to +40 ft FOR Coliform bacteria is Negative FOR Sanitary seal is functioning correctly Nitrate 2.88 mg/L ❑ Nitrate less than MRL (ND) FOR Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) +18" in. Collected by C&M ENGINEERING Date of flow test for COSA 10/21/19 Date of Sample 10/10/19 Static water level at beginning of test 48 ft. Comments well casing extended to +18". See comment regarding well depth on second page. B. TANK DATA Age of tank(s) 4.5 years Tank type/material steel Measured operating fluid level in septic tank 50 OR Standpipes/foundation cleanout per record drawing Date of pumping 11/5/19 D. ABSORPTION FIELD DATA 2015 deep trench Which system tested (date installed) 4/2015 ❑ ALL standpipes present per record drawing Total measured depth from grade 11 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced na gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: no lift station Adequacy test date 10/21/19 Results [DPass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 0 in Elapsed time 5 min Final fluid depth 0 in Absorption rate 750 gpd Any rejuvenation treatment (past 12 months) If yes, enter date na no 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 ft Yes Community Sewer Manhole/Cleanout > 100' ✓❑ Yes if No ft Q Yes if No ft Neighboring Tank > 100'✓� Yes if No ft Private Sewer/Septic Line > 25' F,71 Yes if No ft Absorption Field on Lot > 100' ✓❑ Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft ✓❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5'✓❑ ✓® Yes if No ft Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'✓❑ ✓Q Yes if No ft Yes if No ft Private Wells > 100' Q Yes if No Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No Water Service Line > 10' ✓❑ 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' ✓® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 2 ft Wells on Adjacent Lots: Water Main > 10' ✓Q Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' ✓❑ Yes if No ft F. ENGINEER'S COMMENTS * Well depth is indicated as 67' on 1970 inspection report and 95' on 1969 VA Document. Waiver requested for drainfield to lot line G. ENGINEER'S CERTIFICATION AUDI OF j I certify that l have determined through field inspections and review ,,`�. • I�- of Municipal records that the above systems are in conformance with ` MOA COSA guidelines in effect on this date. 'TH CHARLES G BALZARI141 COSA Checklist yellow sheet -�01C/'. • CE -13854 • • �t�� `�%�t�• . •11/15/19. . •�� `��pROFESSI4�P� ft ft ft ft O 0 O renr Sc 1 ` P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section x x* x VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV191095 COSA#:OSC191546 Permit#: PID#: 051-062-33 Legal Description: Stockhausen Lot 27 Engineer: C&M Engineering Applicant: Michael Kahler Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 2.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. .......................................... 0 0 0 M 00. t .... t t .... t t t t a X M 0 a 0 0 N M 0 0 0 X 1 Waiver is Granted: X Waiver is not Granted: Date: 1 I 1 Approved by: R&O-0, &V-Cff Name of Reviewer **** VARIANCEMAIVER REVIEW **** Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Stockhausen Lot 27 Ms. Carroll We are requesting a wavier of the drainfield to lot line separation for the above reference property. The survey prepared by Alaska Construction Surveys shows the drainfield encroaching within 2' of the North property line which is less than the required 10'. We have verified that despite this encroachment, the drainfield location does not appear to encroach on the well, septic, or otherwise impact the adjacent property (Stockhausen Lot 2). The lot is already developed and appears to have enough space for a reserve septic site. Sincerely, Charles Balzarini, PE J 11/17/19 -.+toy' s � ap7 L R 'CHARLES GaBALZARINr f �F� CE13854 lklv�-'PROFEWQO ,� POWER POLE TELECOM RISER MAILBOX FLAGPOLE 4IN PVC STANDPIPE ELEC METER WATER WELL 4IN PVC STANDPIPE GAS METER 4IN PVC STANDPIPE 4IN PVC STANDPIPE S55° 05' 00"E 287.29'S89° 55' 30"W 350.68'N 3 4 ° 5 5 ' 0 0 " E 20 1 . 1 0 ' F E N C E GRAVEL DRIVE G A T E 56.2'56.2'28.1' 28.1' S H E D GREEN HOUSE S H E D SINGLE FAMILY HOUSE BASEMENT ENTRANCECOVERED DECKCONCRETE PATHDR A I N A G E CU L V E R T S 21.6' 22.0' 72.4' 57.2' GRAVEL PADGINGER LEE DRIVECENTERLINEOL D G L E N N H W Y 100' RADIUS FROM WELL LOT 2 LOT 26 LOT 27 CALCULATED FROM RECORD: 28,887 S.F. 0.66 ACRES (PLAT: 0.81 ACRES) ASBUILT SURVEY LOT 27 STOCKHAUSEN SUBDIVISION LOCATED IN SE 1/4, SW 1/4, SEC. 3, T15N, R1W SEWARD MERIDIAN, ALASKA EXCLUSIONS IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS,OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR ESTABLISHING BOUNDARY OR FENCE LINES. ASBUILT CERTIFICATION I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING PROPERTY, LOT 27, STOCKHAUSEN SUBDIVISION, AND THAT NO ENCROACHMENTS EXIST, EXCEPT AS NOTED. 25 Oct 2019 Alaska Construction Surveys 907 E Dowling Rd, Suite 10 Anchorage, Alaska 99518 Office: (907) 344-5505 Fax: (907) 344-4775 Email: mcrow@akconstsurveys.com Site: Residential Address: 21435 Ginger Lee Drive, Chugiak AK Field Survey Date: 10/24/2019 Crew: B.B. Drawn by: A.V. Scale: 1" = 40' PREPARED FOR KAHLER, MICHAEL ALASKA C CONSTRUCTION A SURVEYS S VA . REQUEST FOR ~PPROVAL OF I~DIVIDUAL SEW^Gl AND WATER FACILITIES '2 (Fill out in ~inlicate) Name .of person requesting approval Manta. of property: owner L~ y. al description ~ Number<of~ ~edrooms in house 5. Water Analysis: a, Bacteria] b. Detebgent ' 6. Well data: c. Casing Size //'") ,' Distance from well to closest existing or proposed: 1. Sewer line 2. Septic tank 3. Seepage Area Cesspool' 5. Property Line 6. Other sources of possible contamination, i.e., creeks, lakes, houses~ barn, drainage dltch~ etc. Sewage disposal system. a. Age of system b. Septic tank capacity in gallons c. Name of septic tank manufactu~.r 1. If "home made" show diagram on reverse ~ide of this form. d.' Disposal field or seepase pit size and type 1. Distance to property line to house foundation . e, Percolatlo~Test ~esults f. Percolation Test performed by Use the reverse ,side of this form to show diagram. Diagram should include <he foilowing information: p~operty lines~.well location, house ].ocation, ~ptlc tank location, disposal area location, location of percolation test, and direction of ground slope, 9. The iTrf~ation on this form is true and correct to the best of my knowledge. Si~nature of Appllcant Date Signed _TO BE FILLED OUT BY HEALTH DEPAP, T~.~ENT PERSONNEL ~'T~e above described sanitary facilities are hereby approved, .subject to the ........... ~611owin? cond~tions: ' ' ' Conditions: The above described sanitary facilities are disepproved for the following reasons: / y/ ........ .-',. Approval is valid for one year following the date of approval. CPJ:cw ' ~ ~,.' * APPLI¢~'~NT FILLS OUT UPPER HAF'~ ONLY Phone Mailing Addre~ Address Zip Code Lending InstituUon ~ ~ ~ ~ ~ ~ ~ ~ Phone Address t~~ ~¢~ ~.~b~O~[, ZipSode Legal Description ~Om ~ ~ ~WO~[~ &tm~/~ ~0~ ~- Type of Resi~nce ~ultiple Family No. of Bedroo~ Water Supply dividual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ommunity For wells drilled prior to that date. give well depth (attach log if available). B Public Utility Sewer Disposal ~ndividua, Year Individual Installed: 1¢ 70 Z' B Public Utility When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATEO. Time Time Date Date Inspector Insp6ctor Time Date Inspector ) APPROVED BEDROOMS ) DISAPPROVED ) CONDITIONAL APPROVAL' DATE BY: Date Inspeclor APR 2 7 1983 "Municipality of Anchorage" "Dopt, of Health & *CONDITIONS OF APPROVAL Soils Rating 72 023 Date Se, wet ~s~talled.a~,~¢~/ Well TO Absorption Aria / /7~ ~,~ Well to Tank 15¢ Well Log Received Septic Ta~k Size ALASKA IUII Ollm nTAL COnT[ OL ~n§incePJ~q 8 ~nubonme~laJ St~di~s ALASKA USA/JUNE BENSEN BLVD. ANCHORAGE AK 99503 SELLER - ALEX JOE BUYER-KAHLER SUBDIVISION-STOCKHAUSEN BLOCK-0 MAY 10 1983 LOT-27 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 492 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 920 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 345 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 5 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 5 BEDROOM HOUSE. ~,-_'2,' ..' m -....~4- · · ~.., ~ ~. ..... ~ ~,¥., .~..;~.~ 1500 IS ADEQUATE FOR 1200 LUcsl 33rd/~ucnu¢, Suite ~ · Anchor~% Alaska 99503 * (907) 276-B61 l,O00 (2) C~tober 18, 1978 Cordon Park Security Paolfic ~4ertgage Corporation i0tl East %~dor Road, Suit~ 190 Anchorage, Alaska 99507 SubJeot: ~ot 27 Stockhousen Subdivision Richard/Valeri~ Sund Property B~o~e approval may be grant~.d on th~ subject prot~;rty the following must be compietef~ (1) Tighten the well seal, so that it is water tight. (2) ~ave a p~rcolatlon te~t perforated. ~he firms performing (3) ~qave the septic tank pu~pc<~ and provide this office with a (4) Install a 500 gal!on septic tank, so that the duplex c~ meet the erlteria fo~ a five(5) bedroom dwelling. In the event the pert test fails an upgrade will be required. Prior to th~ upgrade a permit must be issued from this If there are any further ~esttens, please contact this office at 264-4720. Robert Co Pratt~ R. So Associate Specialist RcP/lJw cc~ Max Bevins % Star Realty 640 West 36th Avenue 99~03 17 October 1978 Mr. Richard Sm~d P. O. Box 565 Eagle River, AK 99577 Dear Mr. Sund: The Municipality Health and Environmental Office records do not reflect the upgrade to your seepage system serving the duplex located on Lot 27, Stockhausen Subdivision. The attached sheet reflects approximately the conditions which exist. The septic tank was pumped on 15 October 1978 and approximately 750 gallons were removed. All of the solids could not be pumped out to verify the capacity of the tank; however, in accordance with Municipal records, the existing septic tank is 1,000 gallons. Both the old and new seepage pits were full of water. The new pit was pumped and then recharged with 1,000 gallons of water. 'At the completion of 24 hours, approximately 300 gallons of water were removed through percolation. I regret to inform you that this is not adequate and an additional upgrading of the system will be required. A soil test for this property is on record at the Health and Environmental Office. required~ i Incl Municipal Health and Environnmntal Office. An additional septic tank will also be MUNICIPALITY Cji= ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTiJ~]{~JRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION OCT 6 1978 Telephone 264;4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE Contact } RICHARD C. SUND and VALERIE L. SUND Star Realty --27 MAILING ADDRESS c/o Star Realty 640 West 36th Avenue, Anchorage, Alaska 99503 PROPERTY RESIDENT (If different from above) PHONE (his~ ~ James E. williams (Purchaser) 276~60~0(~ain. 2. BUYER PHONE her work: James E. Williams "Eddie Williams" -or- Carol A. Williams 333-1113 "T-SI MAILING ADDRESS HOME:688 2703 SR Box 1354, Chugiak, Alaska 99567 s. 'E.D,NG,.ST'TOT'ON% f/_.PRONE Security Pacific Mortgage uorporation 276-1933 MAI LING ADDR ESS 1011 East Tudor Rd., Sutie 190, Anchorage, Alaska 99507 PHONE 279-2491 4. REALTOR/AGENT Max Bevins, Star Realty MAILING ADDRESS 640 West 36th Avenue, Anchorage, Alaska 95903 Ix Bevin~ 9-2491 ~rk: K~tchen) irt Shop' 5. LEGAL DESCRIPTION Lot 27, STOCKHAUSEN SUBDIVISION~ _ :: (Chugiak) STREET LOCATION NHN Glen Highway (See attached plat map) S. TyPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other__ [] SINGLE FAMILY [] Two ~[] Five - [] MULTIPLE FAMILY (Duplex) [] Three [] Six 7. WATER SUPPLY [] INDIVI DUAL* * 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 UTI LITY depth (attach log if available.) 8. SEWAGE I~ISPOSAL SYSTEM [] INDIVI DUAL/ON-SITE** **If individual/on-site, give installation date 1968 . If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~)10(3/78) THIS SIDE FOR OFFICIAL USE ONLY · DATE RECEIVED' INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR : INSPECTOR INSPECTOR DIRECTIONS', I~ TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGEEFAMILY [] ONE [] THREE ~;~ FIVE [] OTHER /~ MULTIPLE FAMILY [] [] [] SIX TWO FOUR PERMIT NUMBER 2, WATER SUPPLY INDIVIDUAL DEPTH OF WELL COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED [] PUBLIC UTILITY ~(~ /~l Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: /~d~(~) Ir Tank is homemade SOILS RATING give dimensions: TYPE OF TANK ,a~d//~///~// M A N U E A CT URER SOR, I AR A MATERIAL C ' 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR J~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE 72-010 {Rev. 3/78) / / -i // .-.~ ~-.~t ISOiLLs I~ ~/ELL./SEPTIC -SYS; LOCATIONS