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HomeMy WebLinkAboutSTUCKAGAIN HEIGHTS #2 BLK 1 LT 8 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number:,OSP241353 PID Number: 041-021-37 Dwelling: 0 Single Family (SF) R with ADU R Duplex (D) El Two Single Family Project: R New 0 Upgrade Name JOSEPH D WHITE ABSORPTION FIELD - EXISTING E] Deep Trench E] Wide Trench R Bed El Mound Site Address 9620 BURNING BUSH DRIVE, Anchorage _" El Other Phone Bedrooms Soil Rating Total depth from original grade 3 GPD/SFJ Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot STUCKAGAIN HEIGHTS #2 1 8 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width 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 trenches From Tank Field Tank Line Ft2 . Ft. Well 100'+ 25'+ TANK 0 Septic [] S.T.E.P. Fl Holding [I Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ Material HDPE Number of compartments 2 Lot Line 10'+ NA Foundation 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks Deep -burial HDPE septic tank. The line to the house was replaced & there is a FCO at grade near the house. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer JRS Drainfield CO/MT Inspector FWCS BENCH MARK (Assumed elevation) 100 It Inspdates: 2ection 1s' 12/9/2024 nd 12/12/24 Location and description 3'd 12/13/2024 4 th FOP OF MANHOLE ON -SITE WATER AND WASTEWATER SECTION APPROVAL A .4 Conditional Approval: Date AM' ll�, Curtiss Huffman [ Septic Syste Aroved - Date t ( CE128991 12/13/24. . Awi"�' AW Note: this approval does not include well permit requirements. (Rev Ub/UZ/ 18) LOT 2 LOT 9 N n \ V nTs� ERq crRic LOT 3 \SFO AV \RMFR \ \ 26�2 i7 00 \NT \ \ \ \ UTILITY \ PEDESTALS \ n \ V \ T LOT 8 48,265 sq. ft. SEPTIC STANDPIPES N n N uS)- SEPTIC MANHOLE 0 OFCk C-D >> p, '1, p, - 3-STORY FRAME 1, ZO' HOUSE Q 6.2, N 2 c° 00, WELL 0R�/�C' REBAR 0 20' 40' i I 1 (5 77 7- - EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (80-101) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEYAND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR IS A VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. AS -BUILT LOT 7 I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 8, BLOCK 1, STUCKAGAIN HEIGHTS SUBDIVISION ADDITION No. 2 ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 16th DAY OF DECEMBER, 2024, AT ANCHORAGE,ALASKA. FIXED HEIGHT, LLC C.O.A.122554 Land Surveying Services WWW.FIXEDHEIGHT.COM 600 W 41 st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949 JOB # 24246B I NO CORNERS SET THIS DATE I SCALE 1" = 40' 27. 0 ' 3- B R HO U S E LOT 8 DE C K CO N C . GRA V E L DRIV E W A Y 25' RE B A R WELL LOT 7 BU R N I N G B U S H D R I V E S 2 0 ° 1 1 ' 1 3 " W 1 6 0 . 0 0 ' S 6 5 ° 5 6 ' 4 5 " E 2 4 0 . 8 2 ' 4.2' 4 . 2 ' 30 . 2 ' PID:041-021-37 PERMIT:OSP241353 FIRST WATER CONSULTING STUCKAGAIN HEIGHTS #2 BLOCK 1, LOT 8 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 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241353 Work Type: SepticTank Upgrade Tax Code Number: 04102137000 Site Legal Address: STUCKAGAIN HEIGHTS #2 BLK 1 LT 8 G:2043 Site Mailing Address: 9620 BURNING BUSH DR, Anchorage Owner: WHITE JOSEPH D Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 10/16/2024 10/16/2025 48265 ❑ 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 eith : a. Op an ed on the, day, or b. ered, sealed, ated to pr t -- Special Provisions: • Show the standpipes in the front yard and label on the IR. —Received -By 7_S,5tAprA Date: Issued By: vT/ Date: 0 /C ZO2. y 3 MUNICIPALITY OF• Development Services Department - - - - - - - - On -Site Water & Wastewater Section Parcel I.D. 041-021-37 ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax- 907-343-7997 Property owner(s) JOSEPH WHITE Day phone Mailing address 8667 CHANCELLOR DRIVE, COLORADO SPRINGS, CO 80920 Site address 9620 BURNING BUSH DRIVE, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) STUCKAGAIN HEIGHTS #2 BLOCK 1 LOT 8 Legal description (Township, Range & Section) Lot Size 48,265 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field F] Initial F1 Single Family (SF) Gi (w/wo, ADU) Septic Tank Upgrade E@ Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicpbl.e.-Mun[cipal Codes. (Sigribt&e"of, .,property, owner or authorized agent) Permit/Rush Fees: AWaiver Fees: Date of Payment: Receipt Number: Permit No. r -E -2122-H 53 Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! October 14, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: STUCKAGAIN HEIGHTS #2 BLOCK 1, LOT 8 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon HDPE deep-burial septic tank per the attached design to serve the existing 3 -bedroom residence. This is a deep system with extensive fill and will require recontouring to install tank at a maximum depth of 10’ from final grade and fix any broken pipes. Also, verify FCO and effluent flow from house. Groundwater was not noted in the MOA on-site file and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank upgrade, an epoxy coated steel septic tank or other action may be required. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241353, Deb Wockenfuss, 10/16/24 3- B R HO U S E LOT 8 48,265 sq. ft. 10 ' U T I L I T Y E A S E M E N T DE C K CO N C . LO T 3 LO T 7 269.17' E 22 5 . 0 0 ' S 6 5 ° 5 6 ' 4 5 " E 24 0 . 8 2 ' 4.2' FIRST WATER CONSULTING STUCKAGAIN HEIGHTS #2 BLOCK 1, LOT 8 DESIGN DETAILS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241353, Deb Wockenfuss, 10/16/24 0 20' 40' i I 1 (5 77 - ----- EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (80-101) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTEA BOUNDARY SURVEYAND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. THIS SURVEY REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS. THIS MORTGAGE LOCATION SURVEY SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. RE -USE OF THIS DRAWING BY THE ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES ATA LATER DATE WITHOUT EXPRESS CONSENT OF THE SURVEYOR ISA VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT. JOB # 24246 1 NO CORNERS SET THIS DATE I SCALE 1" = 40' `t J V 'N ' .............................. i .............................� • Buku Saliz �o LS -14837 rf I� 1�OFESS S II���P``� \` AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 8, BLOCK 1, STUCKAGAIN HEIGHTS SUBDIVISION ADDITION No. 2 ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. DATED THIS 11th DAY OF OCTOBER, 2024, AT ANCHORAGE, ALASKA. FIXED HEIGHT, LLC C.O.A.122554 Land Surveying Services WWW.FIXEDHEIGHT.COM 600 W 41 st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949 · ~ MUNICIPALITY OF ANCHORAGE ',/~m--~ ~--a.,~%' DEPARTME'NT 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 NAME " PHONE &(~¢ ~L J~N EW LEGAL DESCR PTION I ' ' I, ' LOCATION NO. OF BEDROOMS .~ <z Ma.ufa~m~.~Cl4, ~ ~ ~ Material ~q. ~ No. of ~artments ~ b Li capacity in g~llons Inside length Width Liquid depth ~O~ If HOME.DE: ~ Well Foundation ~ . Nearest lot.line ~ DISTANCE TO: ~ J ~-- '~ Trenc w~t~~ '"~ Distance~-~ ~t enlines U°'°f'in"~ I ~Z' ~ inches Top of tile to inish grade ij Material beneath tile Total ef sorption area Depth ~ 7k~ / Dr Distance to lot line PERMIT NO, ~ BuiMing foundation Sewer line Septic tank Absorption area(si ~ DISTANCE TO: OTHER %¢e~ · CE-6793 · &~ APPRO*~~ ~~¢ DATB LEGAL 72-013 (Rev, 8) Date Drilled: Static Water Level Draw Down ~/A 9~12-86 102 feet feet WELL LOG Lot 8 Blk. 1 Stuck Again Heights #2 Gallons Per Minute 2½-3 Total Feet of Casi.ng 88 Type Material Drilled: 0 feet to 4 Top Soil 4 feet to 20 Gravel 20 feet ~;";:~:~"tO.' 22 Gravel w/water .... ~'.. 22 feet '" to 30 Clay w/gravel 30 feet to 50 Silty Sand 50 feet to 88 Cemented gravel 88 ~t to 370 bedrock Many fractures but non producingt water producing at 360 ft. ~ DRiLLiNG ~ 3~4G A~(ULA DRIVE :~!CH~-~GE-AK 99516 (907) 345-0593 JAN S 0 1987 8 6 () 3 2 .q () 9 / 04 / S 6 APPLICANT: l..E 01',t BEI',INETT ADDRESS ~ 6108 STAEDEM ANCFIt.)F;~AGE ~, AK 99504 C:ONTACT I::'I-'I(:.II',!EE Il ~;38-()~196 I..:EGAL )::)IESE;F~IF': SUBD!VIS]:ON: STUCKAGAIN HTS,, :~:2'. SECT ~ [)N L.OT SIZE: 482S9 (SE.L,I:::T~ E)R ACRES) PlAX BEE)ROC)MS: 3 RANGE t._~sted below ar-e 'l'.l'~;~> option"t,=.; available to you in designing '/our' septic syss~'..E~Si,, (]:hogs(s) the oJ.auJ.~ LliaL bes{ fi'Ls ycaur site. i)EF:'TH TO /: IFE BOT'T'OPI tF:'T. ) 4., (-) 4.. 0 4.0 ~'~ d~ / :_ ._. DEF:'TH (1"- I . ) 5.0 - ,. 5 ' ..:.. 5 TEll-Al_ DEPTH (F'"['.) 9.0 4.. 5 7.5 GRAVEt... WIDTH (F'T .,. ,~ .-.':' .~ =~ 18. () 5,, 0 GRAVEL L.E:.NG i'H (F'T.) 42. ] 35,,(") 45. lANK S I Z E (GAl_S) 1,0()0 ,, 0 ¢~"~' ~, ] (: 0., 0 '[-'~' 1, C)()0.0 SOIL ,%A I ~[~ (SQ. F'"I-. /BI:R) 138 138 ~.~ TANK MLIST HAVE ~.~1' LEAS'I 'TWO COMPARTIYIENTS I c:ert:i.£y tha't'.: ]: alii fami 1 Jar ;?,, (4i'l:.h 'Lb6.! requiremen'Ls Cop on.--site .~_-'~e~er's and wells as se'L forth by 'the Municipa].J. ty oF Anchorage (MOA) and the State of Alaska. I will :lnstal:l. 'l:.he sys'Lem in accor'dar~ce ~,,d.'Lh all MOA codes and regulaticCns, and J, ri compl:Lar]c:e ~,~ith the design c:r'iCeria o¢ 'Lhis permit. I will adl~ere 'Lo allt MOA and Sta'l:.e tnf Alaska re~:iuirem~)n'Ls for 'the set back distances from any ex. istirlg ~ell~ ~*~astewater d:i. sposal system [~r' publJ, c sev.)epage system c)n this or any adjac¢.:'rl:., c)r neapby ].ot. I LZFIEI6~PS'(.~]I"iC:I that 'LJ"i:i.~ permit is va].id ~'op a rr~axirllt~m c3¢ 3 bedr'oc:ims and any en].ar'gemerrh ~J].], requipe an acJditional permi'L. ....... [I..I,:~Ii-~LLbD IN AN ARE':A COVERED BY MC)A E:LJIi-i¢~.NE ]]= A J IIi'l- STATIt]hl IlS ",r,'",, ' .... 'THEN (]) AN I::_I:C]RIL,AL I-c. RIIZT AND ~..,luFc. C1].ON MUST BE OBTATNED~ (2) AS-BUIL_TS AF'F't..ICANT: t_EON B~ENNET]" / SOILS LOG PERCOLATION TEST LEGAL DESCRIPTION: ¸3- 5- 6- 7- 8- 9- 10- 12 14 . 15 '16 17 18 19 20 SLOPE SITE PLAN / COMMENTS ~~ DE.T,? f F-]--I-TF I t I I I_J Reading Date I PERCOLATION RATE T~ESI' RUN BETWEEN Time Time [~Depth to Water Net Drop (minutes/inch) '~' LOT- ~ · / 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 OSC241515 Parcel ID 041-021-37 Expiration Date: I a � Ls Z b Legal description STUCKAGAIN HEIGHTS #2 BLK 1 LT 8 Site address 9620 BURNING BUSH DR Current property owner(s) WHITE JOSEPH D X The On -site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments M Original Certificate Date 12/16/2024 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 Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department j 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. 041-021-37 Complete legal description STUCKAGIAN HEIGHTS #2 BLOCK 1 LOT 8 Location (site address) 9620 BURNING BUSH DRIVE, ANCHORAGE, ALASKA 99507 Current property owner(s) JOSEPH D WHITE 'Day phone 2. ON -SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: Z Private Well r_1 Private Well serving 2 dwelling units F-1 Private Well serving 3+ dwelling units R Community Well or Public n Water Storage 4. TYPE OF WASTEWATER DISPOSAL: Z Private Septic EJ Private Septic serving 2 dwelling units M Holding Tank n Community Septic or Public Sewer 5. SEPTIC TANK: R Steel N Plastic R Concrete R Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: F] AWWTS F1 Bed N Deep Trench F1 Wide Trench n Seepage Pit Waiver request for: Distance: Expedited review requested: Z 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 I Z- /-z- Date of Payment COSA # Waiver # COSA Application.doc COSA Checklist Legal Description: STUCKAGAIN HEIGHTS #2 BLOCK 1 LOT 8 Parcel ID: 041-021-37 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 9/12/86 Total depth 370 ft Cased to 88 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground)18+ in. Date of flow test for COSA 1012/24 Static water level at beginning of test 100 ft. Well production at time of test 1_1* gpm Water storage tank volume NONE gallons Well disinfected for coliform test? ® Yes ❑ No ® Coliform bacteria is Negative Nitrate 1.14 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) FWD: Collected by �L -- & Sullivan Date 1012/24 & 11/26/24 Comments *1.1 gpm confirmed by both First Water and Sullivan. Area has low producing wells / water. Water production may be less than 1 qpm at times variable & may require a water storage system for normal or peak use for depending on occupants. Sullivan extended casing with new sanitary seal 1 conduit and chlorinated water system. B. TANK DATA - (NEW TANK) Measured operating fluid level in septic tank NEW Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/7/86 ® ALL standpipes present per record drawing Total measured depth from grade 19.5 ft (max) Measured depth to pipe invert from grade 14.2 ft (min) ❑ N/A - pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 4 ft ® 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 10/1/24 date Any rejuvenation treatment (past 12 months) N If yes, enter date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/2/24 Results 0 Pass Fluid depth prior to test 17 in Water added 600 gal New fluid depth 29 in Elapsed time 1440 min Final fluid depth 14 in Absorption rate 450 gpd FIELD STATUS - POST RECOVERY Effective depth (per record drawings) 60 in (MOA s' ED) Effective depth used 26 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 34 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots MOA record documents & appears approximately that 1 ft of ED is missing — not measurable. The surveyor missed showing the existing foundation cleanout (FCO) at grade. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft 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' ® 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 G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer's Printed Name CURTIS HUFFMAN PE Date 12/16/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or COSA Checklist.docx Parcel I.D. # 1. GENERAL INFORMATION Complete legal description DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section LITY F AN£ OEAGE P.O. Box 196650 Anchorage, Alaska 99519-665r~vIR°N~:N~AL $~VICES DIVISION 343-4744 ,JUN 02 1997 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELL!N~ R E C E i V E D NAA# Location(siteaddressordirections) ~;;)-~2 AulP.~J I'I,J~-- l~ u_q /4'- iOI~IvE Property owner ~_.---~.~- ~-J.~D~C,~-J'-/ Mailing address ~ ~ '~ ~'P~OCc~ Lending agency ,,,.J l~. Day phone Mailing address Agent ~-J I~- Day phone Address /"J I~ Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well ~' Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: ndividual on-site Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72~)25 tReY. 1/91) ~-ront MOA~21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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/o~ wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date Name of Firm Alaska Water & ' 8471 Add ress Engineer's signature this inspection. Phone Date (~¢/~/~"Y' DHHS SIGNATURE ' ~" APproved for J~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: The MdniciPality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority App[oval Certificates based only upon the representations given in paragraph 5 above by an independent proTesaional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their'lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the profesaional engineer's work. 72-O25(Rev. 1/91) Back MOAt~21 Legal Description: A. WELL DATA · ' MUNI .~f~.~X · Mun,c,pality of Anchorage .. ¥1R©C-.IPALITy OFAN DEPARTMENT OF HEALTH & HUMAN SERVICE~~ ~E~T~LSE~I Environmental Se~ices Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-~40 2 ~997 Health Authority Approval Checklist o~l-ozI-g~ Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number Date completed c~/I ~/~ ~' Cased to ~ ~ Well type ~ ~'"' Log present (Y/N) ~'¢~-------~' Total depth Sanitary seal (Y/N) Casing height (above ground) '~' Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level (O~- ~//~ ~' Well production ~. V~: ~ '~ g.p.m. ~-" WATER SAMPLE RESULTS: Coliform (~ Date of sample: ~"/2,-//~ ~" Nitrate Collected by: AT INSPECTION/ Other bacteria g.p.m.~ B. SEPTIC/HOLDING TANK DATA Date installed or/~ Tank size Foundation cleanout (Y/N) ~y~E.-~ Date of Pumping ~/~/~ ~ C. ABSORPTION FIELD DATA [OO~) Number of Compartments '~ Cleanouts (Y/N) ~'~ Depression (Y/N) ~J O High water alarm (Y/N) ,~/~l- Pumper /4~..-~ ~z~,-~ ~'~7_VI ~---~ Date installed ~/(~ Soil rating (g~ or fF/bdrm). / ~ ~ System type Length Z~-~. I ~ ~ / Width P- ° ~ Gravel thickness below pipe Total depth ~/'~ ' Effective absorption area ~r Z~O. Monitoring Tube present (Y/N) ~// Depression over field (Y/N) ~'~ate of adequacy test ~'/'P-//~ Results(Pass/Fail) ~O/~ For ,c~ bedrooms <~ Fluid depth in absorption field befor& test (in.); :~O, ~" Immediately after ~ ~'al. water added (in.): / LFluiddepth '~" (ins) Minutes later: JO Absorption rate =.~ ~ __g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ °~=-- [~/If yes, give date 72-026(Rev. 3/96)* ~,F- /~/~.O o O~c~ /Za~ I'~/~t? U,.~l"~- ~,'E-.,,'~7- :~:2..,4- Date installed ~ Size in gallons ~ ~i;~h~l;ieArC~i~ (,~/~,%)' a~,~.__~ "Pump off" level at*...~...._~ *Datum ~ - E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main /~) ~-/_<- q-~ <¢/o On adjacent lots / / ~. t j: 'TO C/b On adjacent lots ~ I/~- Public sewer manho[e/cleanout ~ ~--0 Lift station Sewer/septic service line SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~c--O / + Property line Absorption field ~ pr~P__ 1~sP' , Water main/semice line ~10 Sudace water/drainage ~ I CO Wells on adjacent lots > I0~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: /. Property line ':~O Building foundation ~' ~--~ Water main/service line Surface water '>" l O O" Driveway, parking/vehicle storage area "~ ~ / Curtain drain ,,.Jo~E~- V-ao,..~,,,J Wells on adjacent lots ~' ~ 00 F. ENGINEER'S CERTIFICATION I certify that I in conference with Signature Engineer's Name Date are HAAFee $ ~ . ~,t~ Date of Payment ~-~/~/~7~''- 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Water & Wastewater 8471 Brookridge Drive ~ Anchorage ~ Alaska 99504 Phone (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers June 1, 1997 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 E-7953 Subject: HAA for Private Well & Septic System. Lot 8, Bk 1, Stuckagain Hts. #2 S/D. To whom it may concern: The subject lot has a 3 bedroom house on it which is served by a private well and septic system. The results of the field investigation and adequacy tests are summarized as follows: A. WELL: The static water level on 5/21/97 was 116' BTC. Water was pumped from the well at a rate of 4.34 gpm for a total of 134 minutes (582 gallons). The test results are summarized as follows: DRAWDOWN: Time (minutes) Water Level in Well: Total Flow (gallons) 0 116 feet 0 20 162 86 35 187 150 60 231 258 90 277 387 134 356 (at pump) 582 RECOVERY: waited for pump to stop (filling hydropneumatic tank) Time (minutes) 0 354 feet 5 346 10 339 20 326 30 313 Water Level in Well Total rise = 41 feet = 61.5 gallons in casing. Recovery = 61.5 gallons/30 minutes = 2.05 gpm at maximum drawdown. MUNICIPALITY OF ANCHORAGI~ ENVIRONMENTAL SERVICES DIVISION JUN 02 1997 RECEIVED Based upon this data it was determined that the capacity of the well exceeds the Municipal requirements for a 3 bedroom house (450 gallons per day). B. SEPTIC SYSTEM ADEQUACY TEST: The drainfield is a 2.5 foot wide trench, which is 42 feet long, and has an effective depth of 5 feet. Prior to starting the adequacy test the M.T. had 30.5 inches of liquid in it. Water was added into the sump at a rate of 4.34 gpm for a total of 134 minutes (582 gallons). The first 258 gallons rose the liquid level 7.75 inches, and the next 324 gallons only resulted in a 1.75 inch rise. The total rise was 9.5 inches. The recovery was monitored for 10 minutes, and the level dropped 2 inches. Based upon this data, it was determined that the absorption rate of the trench exceeds 450 gallons per day, as required for a 3 bedroom house. C. CLEAN-OUT PIPES: The dminfield monitoring tube was perforated F810 drainpipe, including the portion above grade. The clean-out pipes on the trench were solid F810 HDPE pipe also, which is not approved for clean-out pipe. The homeowner excavated below grade on all the pipes, installed Fernco couplings, and replaced the above ground portion with D3034 PVC pipe. NOTE: The adequacy of a septic system ia' influenced by numerous factors, including, but not limited to, seasonal surface water infiltration, groundwater variations, septic system maintenance (frequency of septic tank pumping, usage of biological additives.), condition of drain pipe and pipe joints (which can be damaged by seismic activity and deteriorate with age), type of substances deposited in septic system (cigarette butts, sanitary nap/tins, misc. objects,), and the amount of water being introduced on a continual basis. Consequently, the results of this adequacy test are only valid for the apecific day of the test. Furthermore, because of the limited nature of this investigation, it ia' possible that there are hidden defects which may not have been detected. No warrantee is made regarding the future performance of this well or septic system If you have any questions, please contact me at 337-6179, or on my digital pager at 1-800-481-1162. Thank Sincerely, Princ~{o~/1 for your assistance. 'ness, P.E., M.S. / / ~nchor.~g~ ,Ra':~Fdln~{ Pr~cmot~ AI~'~ LOT SURVEY C~RT~FIC~ · - ~ x ~ re~or ~ {hl~ Prepured by: ~ £, .Propa~y O(j.~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~,~-'~-- ~)/~)~2 ~,~ OF ON-SITE SEWER AND WATER FACILITY 26.-4720 7 - .*. Application Date ~ ,~ 0 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~!~'¢, ~:~-t'~[ t TelePhone: Home ~'~,~_ --(;b~:'4~'~fusiness Applicant Address ~ [ O ~ ,.~¢['~.'i ~ / , ~1,¢~(-~'J¢::::~¢¢¢~-~ j f~F (c) Applicant is (check one): Lending Institution []; Owner/builder~, Buyer []; Other [] (explain); (d) Lending Institution ~ Telephone Address (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: /..- / TYPE OF RESIDENCE Single-Family ~::DMulti-Family Number of Bedrooms Other WATER SUPPLY , ' Individual We(J~:> Community [] Public [] Note: If corem unity well system, must have written confirmation from the State Department of Environmental attesting to the legality and status. Conservation 4. 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EC. Approved (Y/N) Well Log Present (Y/N) ~-~ ~"~'~ateCom~leted (2~/~./~(:~ ~ Yield Total Depth "~"7 (~ .Cased to ~ '~ ~'-'Depth of Grouting ~/I~ Static Water Level [ (~----' Pump Set At '~ ~'~'~ ~ ~ Sanitary Seal on Casing (Y/N) Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole ~ ~'~ Water Sample Collected by ~ai~r!i~mPJe T~$t Resulis ,,~'/~3',~'g2-'~ Comments Depression Around Wellhead ; on Adjoining Lots ~ ~ ~"';~'; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Lin~.~!~.~o~t/(~ ~ ~:~,-,z~_; Date SEPTIC/HOLDING TANK DATA ~. of Compartments Standpipes (Y/N) "~--?~ Air-tight Caps (Y/N) "t~"~ Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~'~::~ Date Last Pumped ~.~'~.4, Pumping/Maintenance Contract on File (Y/N) ~ /1~ ;for ~ Holding Tank High-Water Alarm (Y/N) ~ ~ ~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: ,"~g~% To Water-Supply Well ~~ ~ ~ ~IF- TO Building Foundation TO Property Line ~;) I~ To Disposal Field ~ '¢ To WatSr Main/Service Line ~ r ,_j..._ To Stream, Pond, Lake, or Major Drainage Course I (~(;:~ I ~ Comments Page 1 of 2 72-026(11/841 ABSORPTION FIELD DATA Soils Rating in Absorption Strata, I ,--,-~ ~U~,Type of System Design *~'--"~-.~E~I~C V.I- Date Installed ¢~' /'7/~ ,(, Length of Field 4 Z' Width of Field Depth of Field : c] / /Gravel Bed Thickness '*.~ / ..... Square Feet of Absorption Area ~ Z~.O /~/'~' ~ Standpipes Present (Y/N) "'(' .'~ Depression over Field (Y/N) ~-'-~'~;~ Date of Last Adequacy Test Results of Last Adequacy -I-est Separation Distance from Absorption Fielc]: To Water-Supply Well \ 0 O ~'~'~ To Property Line ~¢O -~'- ~'~ / To Existing or Abandoned System on On Adjoining Lots ---'~(~ "~'~ ~¢:'''j'-Ol'-~ To Cutbank (if present) To Building Foundation Lot To Water Main/Service Line To Stream/PondlLake/or Major Drainage Course To Driveway. Parking Area. or Vehicle Storage Area Comments D. LIFT STATION ** Check Permitted Bedroom Rati. ng A~gainst HAA Request ** I certify that I hav,.cCchecked,v~ifrified, o[ c~on~9' ' ~ rmed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date of Payment Amount: $ ~/~O. -~ ~,,,~,~~~.., ...... ~"' Eno~neers Seal