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HomeMy WebLinkAboutT15N R1W SEC 9 LT 85 REM T15N R1W SEC 9 Lot 85 Rem #051-104-73 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221397 PID Number: 051-104-7": Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Name Page 1 of 3 Project: ❑ New ❑k Upgrade Glen Graham A 0RPTION FIELD Site Address ❑ D Trench ❑ Wide Trench 22144 Birchwood Loop Rd, Chugiak, AK 99567 El Bed ❑Mound Other Phone Number of Bedrooms Soil Rating Total depth from original grade LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe rl Subdivision Block Lot Ft. Fill added above original grade G el length Township Range Section T1 5N R1 W SEC9 LOT 85REM Ft. Elines Gravel width Beds: Number of Lines Dist ce betwSEPARATION DISTANCES Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between Lift Station From Tank Field Tank Line FtZ TANK ❑. Septic ❑ S.T.E.P. ❑ Holding ❑ Other Well >100' >100' N/A N/A >25' Manufacturer Greer Capacity 1000 Surface Water >100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' >10' N/A N/A STATION Manufacturer Capacity Remarks Alarm location Elec r stalled by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 A+ Home Services drainfield Drainfield D3034 CO/MT D3034 Inspector L.Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15' 11/23/22 2�a 11/23/22 Location and description dates: 3'd 4'h Top of Foundation at N side of House ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date 49n•I •*� Septi Ill _ Benjam(rt=Schiller k Approved Date o�i 2 _ ����F�' • . c zi2252z • •���'��,��,® Note: this approval does not include well permit requirements. � ROFESSIONPd (Rev 05/02/18) T1 5N R1 W SECS LOT 85 REM PERMIT # OSP221397 PID # 051-104-73 LOT 72 7- - — — — — — — — — — — TELECOM, WATER, POIFITION [=ACCftfiEK] GOY LOT 85 t LOT 1 7�5 "Co MT1 EXISTING TRENCH 17 w 2G 60, 1 .0 SV 1,000 GAL SEPTIC TANK PORTION COV. L TI -85 LpA 3-BDRM HOME YSHOP LCOT A LOT 96B LOT 96A ENGINEERING I Or- 'q, 49TH :�0 Ar .......... Benja i Schiller Po Fc CE E 2592 12/22/22 PLAN AS -BUILT 0 50 100 FEET 111=50' LOT 84 C FCO 15.0 1 -1 svi 13.5 1 _38.3 39.6 SV2 10.6 1 43.0 2CO 9.3 44.2 MT1 50.6 59.7 1 C01 49.5_1.. 59.4 11 LEGEND CO -CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH -MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PERMIT # OSP221397 a ENGINEERING PID # 051-104-73 V V.Y PROFILE AS-BUILI (NO SCALE) .� �. .......... • • , .. Benja 'n Schiller CE 12592 69'32'52" W 169.82' Lot 2 r S 89'32'52" W 60.39! 0 25 so r ' Jere A. Hurst US SURVEY Y�•'S�a NOTES FEET �� "�OFEiiI Npi -Dimensions shown are grid bearings and ground distances, record boundaries are per USRS T1 5N R1W and Warr. Deed Bk350 Pg96. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or the establishment of property lines. -Numerous easements are shown on the MOA grid map, which are not shown on this survey. It is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed. AS BUILT SURVEY LEGEND 49h Stir Surveying Gov. Lot 85, , Power Pole @ Septic Vent/Cleanout PO Box 738 Sec. 9, T15N, R1W S.M., Girdwood, AK 99587-0738 frs Tele -comm. Pedestal Well. Excepting ROW of (907)891-6111 _...___._..-._.---_____..__ OHF .__._.--_.---- ___----- .__ Jeremy@49thStarSurveying.com Birchwood Loop Rd. overhead Utilites " - W.O. 2211 DATE; 12/20/22 Anchorage, AK Fence SCALE: 1°=50' �nvcwNC iu: roouorul-t:btt$-4l-b9-8443-DE9EE3800712 October 17, 2022 Glen Graham 22144 Birchwood Loop Rd Chugiak, AK 99567 To whom it may concern, Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the existing septic trench within the Telecom, Water and Power easements of Section 9, T15N R1 W in Seward Meridian LOT 85 REM, also known as 22144 Birchwood Loop Rd, Chugiak, AK 99567, city grid ERNW1358, GCI WO# 22-0980-42. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also, any additional and extraordinary costs incurred during any future required construction, repair, or reconstruction of GCI's facilities to accommodate any or all the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now, and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. Sincerely, DocuSigned by: �+ L a,V'G�a & GV'a.�t,aw� DocuSigned by: c3igature 1 /24/2022 1 2:31 PDT Ea648A37D16E7E4DA,. Date . ALEX SLAVENS GCI ( OSP Design Data Management Delivery Engineering 907-868-1049 NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT By this document Matanuska Telecom Association, Inc. (MTA) declares that it has no objection to the existing septic trench find/install clean out encroaching in the Telecom, Water and Power Easement within Lot 85, Section 9, Township 15 North, Range 1 West, Seward Meridian, in the Anchorage Recording District. Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the encroachment as a result of utility construction will be borne by the property owner of record. This document does not authorize the placement of any additional encroachments within the easement area. Property owners are required to obtain utility locates before doing any kind of work in the utility easements and will be liable for any damages caused by their construction work in the easements. This document is in no way an agreement to vacate any portion of the utility easement and should not be interpreted as such Issued for Matanuska Telecom Association, Inc. this 171h day of October 2022 by z Jessica Burnett, Real Estate & Properties Supervisor Matanuska Telecom, Association, Inc. C: (1) t a) .0 _0 C: D- P E -t-I m 0) co m 0 m !E C c o En 0 r a) >1 C: U) Z 0) E c: (n m a) a) m — C: c . C: >, 4) 0 (n 0 o .(n a)oo — < 0 > 4- 31. 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C: < .2 a) c: W " — 5 > C) X a) w (n a) a) a) 0 w V) (D 0 T > m 0) D CL J-- a) a) o w , 2 2 a) — F C) 6 CO 0) 0 o0 in c 0 L) a) (D (D m 0 o cli c6 6 cn x 0 (n (n E E 0 00 < z 0 D 0 tA < U cr cr LU Ln D z LO to CD 0 E m 0. Gi CN (n C*4 x 0 co 0 0- .:z w 0 Anchorage Water & Wastewater Utility Engineering Division February 7, 2023 Glen Graham P.O. Box 670374 Chugiak, AK 99567 Re: T15N R1W Section 9, Lot 85 REM, Tax ID# 051-104-73, Grid NW1358 Request for Letter of Non-objection to an Existing Encroachment On October 13, 2022, the Anchorage Water and Wastewater Utility (AWWU) received a request from your representative, Benjamin Schiller, PE, regarding an existing septic trench on T15N R1W Section 9, Lot 85 REM (the Property). The existing trench encroaches into a 40-foot water easement across the northern portion of the Property. AWWU is using the water easement with a critical water transmission main located within it. AWWU has no objection to the encroachment provided the property owner(s) agree to the following stipulations to allow the existing septic trench and associated appurtenances within the water easement. The property owner(s) agrees to the following: 1. AWWU will be held harmless, now and forever, for any damages or injury to any person resulting from the encroachment. 2. The property owner(s) shall not modify, upgrade, remove, install a new system and associated appurtenances, or otherwise perform any work within the easement without prior written approval from AWWU. 3. Owner(s) shall comply with all applicable codes and regulations pertaining to the septic trench and associated appurtenances. 4. This letter will in no way preclude AWWU from full use and enjoyment of its rights within any portion of the easement. 5. The property owner(s) shall pay any additional and/or extraordinary costs incurred to accommodate the encroachment during any future required maintenance access, construction, or reconstruction of AWWU infrastructure or facilities and, if necessary, reimbursement of AWWU time and materials to remove the encroachment. 6. AWWU’s non-objection does not imply other approvals that may be required for this encroachment. 7. AWWU does not provide a position for any other parcel or utility impacted by the encroachment. Should you have any questions, please call the AWWU Planning Section at 564-2739. Sincerely, Seth Wise Engineering Technician III 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: OSP221397 Work Type: SepticTank Upgrade Tax Code Number: 05110473000 Site Legal Address: T15N R1 W SEC 9 LT 85 REM G:1358 Site Mailing Address: 22144 BIRCHWOOD LOOP RD, Chugiak Owner: GRAHAM GLEN Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date r r V � Department Lot Size in Sq Ft: Total Bedrooms: 10/13/2022 10/13/2023 63032 ❑ Disposal Field © 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 Special Provisions: • Prior to a COSA approval, multiple letters of non -objection are required for the field and service line in the easements. L Date: Date: 10//3 ZZ i 3 Veronica Pope Received By: � GE 2022.10.13 13:30:01 -08'00' Issued By:Vw_� /' / C V Date: Date: 10//3 ZZ i 3 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-104-73 Property owner(s) Glen Graham Mailing address PO Box 670374, Chugiak, AK 99567 Site address 22144 Birchwood Loop Rd Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W Section 9 Lot 85 REM Lot Size 63,032 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 1ZUpgrade ❑X Duplex (D) ElHolding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number: D Receipt Number: Permit No. p'- iP, ", oZ��J�� Waiver No. Permit App__- : - September 27, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T15N R1W Section 9 Lot 85 REM - 22144 Birchwood Loop Rd Septic system design Dear On-Site Services Engineer: The owner of the above lot has a septic tank that has reached its end of useful life, so we are submitting this permit application for its replacement. The attached site plan identifies the location of the 3-bedroom home as well as the wells and septic location. No conflicts exist between this proposed system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing the septic tank with the same size. The new septic tank will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the absorption field. Please refer to the attached plan for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221397, Deb Wockenfuss, 10/13/22 OHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHEOHE XXXXXXXXXXXXXXXXXXXXXXXXX X X X X T Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 2CO T15N R1W SEC9 LOT 85 REM FEET 0 50 100 BIRCHWOOD LOOP ROAD BARN SHOP EXISTING SEPTIC TRENCH FIND OR INSTALL CLEANOUT DECOMMISSION EXISTING SEPTIC TANK 9/27/22 3-BDRM HOME NEW 1,000 GAL SEPTIC TANK INSTALL DOUBLE CLEANOUT BEFORE AND AFTER TANK TELECOM, WATER, POWER EASEMENTS 2CO 2CO2CO MT WELL > 100' AWAYWELL > 100' AWAY Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221397, Deb Wockenfuss, 10/13/22 Lot 72 S 89°32'52" W 100.05' S 89°32'52" W 169.82' S 89'32'52" W 60.39' Portion 9 Oov.]Lot 85 z 6 O DO V Lot w 1 �O O� Lot z ]P olr t lkodnt �� 84 G o�v. ]Lo It o N jGreen 49th Star Lot house 2 _ " Surveying A 2 -Story" / House _ Shop �'=, Bio �• M OF 10.6' �N, 10.6' - r.�t. ; a o Vr . •1 l� ih N 89'32'31" E 239.44' *' H • • ••:* ��/ M Lot Lot / 96B I 96A ••• 0 25 50 •A emy . Hurs 11F�,• LS- 1179 •�� / NOTES Us sFEEvEY l�i ''Q� fSS10NA0Y -Dimensions shown are grid bearings and ground distances, record boundaries are per USRS T15N R 1 W and Warr. Deed Bk350 Pg96. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or the establishment of property lines. -Numerous easements are shown on the MOA grid map, which are not shown on this survey. It is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed. AS BUILT SURVEY LEGEND 49th Star Surveying L!. Gov. Lot 85, (-0,, Power Pole OW Well PO Box 738 Sec. 9, TI 5N, R1W S.M., Q Tele -comm Pedestal Girdwood, AK 99587-0738 Excepting ROW of(907)891-6111 OHE Jeremy@49thStarSurveying.com Birchwood Loop Rd. Overhead Utilites W.O. 2251 DATE: 9/7/22 Anchorage, AK Fence SCALE: 1°=50' Municipality of Anchorage Page 1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~W94n4DR PIDNumber: Nr~lln414 Name: Wastewater System: [] New [] Upgrade El!et&Sandra Seavey/KND Engineering Addreee: ABSORPTION FIELD ,// 20441 Ptarmigan EagleRiver~ AK Phone: No. of Bedrooms: rq Deep Trench [] Shallow Trench [] Bed [] M~'~ [] Other 6 .~ 6- 6111~]r Total Depth m~origlnal grade: LEGAL DESCRIPTION Soil Rating: GPD/Sq. Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gr.~,v~ depth beneath pipe 8 5 15 N 1 W 9 ~' Ft. Ft. Gravel width: Number of lines: Distance betwesn lines; WELL: [] New D3 Upgrade Ft, Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorpti~ea: Pipe material: Private 1 02 Ft. 102 Ft.~ SQ, Ft. Driller: Date Drlged: StatlcWater Level: InstaJJ~ Date inetal~ed: Alaska Now-well/Vern 10/94 64.9 Ft, Yield: Pump Set at; ~ Casing Height Above Ground: TANK SEPARATION DISTANCES [] Septic [] Holding ~T.E.P. WelY 100+ 100+, N/A N/A 65 ' Ma.~ Number of Compartments: Surface / LIFT STATION Water Lot ~ SIzein gallons: Manufacturer: Line ~ ~ "Pump on" level at: ~el at: High water alarm at: Foundation Remarks: Well was moved to provide BENCHMARK Location and Description: positive drainaae awav from wel 1 . / Assumed Elevation: ENGLN~F~R'S SEAL Kenneth M. Duffus Dates:lst ~_0/27/94~'o'-?~ .......... ','~'""~' ............ ,:~ Inspections performed by: Department of Health/arid Human ~erv~ces approval 72-013 (Rev, 9/91) MOA 25 STTE PI AN REPLACEMENT WELL SYSTEM LOT B5, SEC, P,I,D, 051-104-14 Lo~ s:ze, 57~107 PREPARED FOR, ELLET & SANDRA ~EAVEY P.O, ~OX 770232 EAGLE RIVE~ ALASKA 99577 KND ENGINEERING 80441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 907-696-6111 IWell Owner ] Well LoQ Alaska Now-Well/Vern's Drlllllng 12241 Avlon Anchorage, Alaska 99516 (907) ~545-4417 Location Of Well IABorough nchorage J Subd~v~smn T1SN R1W SEC9 LOTaS Well Log Ft Below Surface Lot Block Section No Township NJ PEPMIT #swg4~4E~8 Range Merdian Well Depth (fl) Date or Complelion Material Type 'Fop Bottom [ 102] gravely/cobbles hard pan/gravel/cobbles 12 4~ brown till/gravely 4~ 50 hard pan/gravel/cobb os SO 68 gravely, with till. seepage from 68' 60 100 sandy gravel, with H20 20gpm-30gpm 100 water clearing after developing with DMIIIn9 Method Use Ir°tarY I [domestic Casing Type J welded J Diameter (in.) Deplh (rt.) Weight (lbs/fl) Finish of Well Type Diameter Static Water Level Level (ft.) Date [64'9" Lop casing I 10/28/94J Pumping Level Below T or c (rt.) After (hfs) Pumping (g.p,m) I II I I 6routing YesJ~J HaLerml Pump H P Capacity Type SeLLing (fL) 95 Remarks Installed owners 3/4 hp pump from old well This well was drilled under my Jurisdiction and this report Is true Lo the best of my knowledge and belief. Authorized Representative Date Vernon~ Nowell 110/31/94 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE ~1 OF 1 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940408 DESIGN ENGINEER:KND ENGINEERING OWNER NAME:SEAVEY ELLET L JR & OWNER ADDRESS:22144 BIRCHWOOD LOOP RD CHUGIAK, AK 99567 DATE ISSUED:10/24/94 EXPIRATION DATE:10/24/95 PARCEL ID:05110414 LEGAL DESCRIPTION: T15N R1W SEC 9 LT 85 LOT SIZE: 62726 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. RECEIVED BY: ISSUED BY: SPECIAL PROVISIONS: ~ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 .......... ~ ......... ':1 ': ' :'": ':'""°= ": ................ ~ .......... " ...................... ": ':': :':~: ":'" '"'"':"':""~:'" "" 'i ?!?~'?='i"~.i?i'i Ii i'i"!i "i '{'i'i"iii'.i? il" ?'i'i 'i'ii'i'!i'i'{t?~?ii{' (907)696-6111/FAX (907)696-8111 October 23, 1994 On-Site Services DHHS 825 L Street Anchorage, AK 99501 Dear Sirs: REF: BLM Lot 85, Sec. 9, T15N, R1W, S.M. Attached is our request for an on-site well permit for the above lot to replace an existing well that is in failure. This request is an emergency as the home owners have been without water for almost a week. As shown on the site plan, the existing septic system falls outside the existing and proposed well radii. The existing well is to be abandoned. The proposed location for the well is relatively flat but draining to the north and west. The proposed location does not impact any future replacement septic systems. The existing well system has been operational for over 18 years with no known problems. Examination of the well shows a total depth of 64' into a sandy gravel consisting of 2" minus. Thank you for your consideration of this request. If there are any questions, please call me at 696-6111 or leave a message. Sincerely, Kenneth M. Duf ,~P.E. KND Engineering Attachments: On-Site Well Application Site Plan S1-T F- PLAN ~/ASTE~/ATER DISPOSAL SYSTEM LOT 85, SEC, T15N, Ri~/, S,M, x \ \ G5 Well ELLET & SAN~RA SEAVEY P.O, BOX 770838 EAGLE RIVE~ ALASKA 99577 KND ENGINEERING 80441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 907-696-6111 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 [] NEW NAME /~[~UPGRADE CIA[ LIN G ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer Material ~ ~"~ ~'fln~sidelength_.~._.~Width "~'-~-~ IF HOMEMADE: . NO. OF BEDROOMS No. of compartments Liquid de~pti~ ~ DISTANCE TO: Manufacturer Well DISTANCE Length Width Type of crib Crib diameter Well DISTANCE TO: Class Depth Building foundation DISTANCE TO: MateTi~ beneatl~ tile PERMIT NO. Liquid capacity in gallons Material PERMIT N ~ ' Distance TOIBI ~ffoct~vo absorphon.~rea ~--' LTotal effective absorpti°n a~- ~D~rr tier ~%- ~ //~Tst~nce to lot line PERMIT NO. OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 72-Q,/'3 (Rev. 3/78) LEGAL PERMIT NO. MLIN I C I r --IL I T"r' OF lINCH" RlIGE DEPARTMENT O, HEALTH AND ENVIRONMENTAL ~ ..OTECTION 825 ~L~ STREET., ANCHORAGE., AK. 9~501 264-4720 ON--S I TE SEWER PERrq I T 820790 > APPLICANT LOCATION LEGAL ELLET L SEAVEY TiSNRiW S9 LB5 TYPE OF SOIL ABSORPTION SYSTEM IS: PO BOX 2~2 99577 LOT SIZE TRENCH 688-2801 999999 SQUARE FEET MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= 9 LENGTH= _~ GRlIVEL DEPTH= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCBVATION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES, THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET>. RE(~LI I REE.' SEPT I C TlINK: S I ZE= 2LOOO GIILLONS 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. TWO < 2 ) I r~ISPECT I Or-IS lIRE RE(;IU I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND BNY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR R PRIVATE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MBY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERFI I t EXP I RES DECEMBER _'~.-1.. -198::;. I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BV THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT ELLET L SERVEY ~- ¢'~.~ ISSUED B~_~~ ........ 8TE ............ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST , SOILS LOG [] PERCOLATION TEST PERFORMEDFOR: L---LL~7' ~ , 5 ~ VEY LEGAL DESCR,PT,ON~ L ~ 8 ct SLOPE ~' ~13 ~' ~ ' SITE PLAN 10- 11 13 14 15 16 17- 18- 19~ 20- COMMENTS WAS ~ROUND WATER ~ ~ [ E ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (/1~;I /~ (minutes/inch) TEST RUN BETWEEN .F~-/AND FT MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-104-73 Certificate of On -Site Systems Approval Expiration Date: 3-27-2023 Legal description T1 5N R1 W Sec. 9 Lot 85 REM Site address 22144 Birchwood Loop RD Chugiak AK Current property owner(s) Stimac X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: BY Original Certificate Date: 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 9 us 14 MUNICIPALITY OF ANCHORAGE i", I 'V.. f p Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ------Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-104-73 Complete legal description T1 1\1 R1 W Section 9 Lot 85 REM Location (site address) 22144 Birchwood LOO Current property owner(s) Theresa Stimac 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Rd, Chugiak, AK 99567 Day phone (907) 306-1882 3. TYPE OF WATER SUPPLY: FEI 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: FN� Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age < 1 yr - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed FE� Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑■ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ f{ $a Waiver Fee $ Date of Payment �aC. �oZ� Date of Payment COSA # QSC 2a� l 6-7g- Waiver # oCOSA Application_June 2022 Legal Description: T1 5N R1 W Section 9 Lot 85 REM Parcel ID: 051-104-73 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 10/28/94 Total depth 102 ft Cased to 102 ft ❑ Sanitary seal is functioning correctly NO Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 8/8/22 Static water level at beginning of test 64 ft. Comments B. TANK DATA Measured operating fluid level in septic tank _ Date of pumping NEW ❑ Required maintenance completed, if AWWTS Comments: Installed 11/23/22 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/30/1982 0 ALL standpipes present per record drawing Total measured depth from grade 8.6 ft (max) Measured depth to pipe invert from grade 4.6 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 4.0 ®❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 1700 gallons 12/20/22 date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 5.6 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ON Coliform bacteria is Negative Nitrate 8.50 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date 12/07/22 C. LIFT STATION ired maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 12/20/22 Results 1-01 Pass Fluid depth prior to test 9 in Water added 485 gal New fluid depth 9 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate '450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 0 in Effective depth remaining 48 in Comments/Deficiencies: New MT and CO installed with tank replacement, contractor matched depths as best as possible 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' Community Sewer Manhole/Cleanout > 100' QYes if No ft [-M-1 Yes if No ft Neighboring Tank > 100' Fm] Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' El Yes if No ft Holding Tank > 100' Fm-] 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 Q 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' Q Yes if No ft Surface Water > 100' ❑ Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑® Yes if No ft Private Wells > 100' Fi-I Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' n 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 Forge Engineering Engineer's Printed Name Benjamin Schiller COSA Checklist—June 2022 Phone (907) 522-7773 Date 12/22/22 ' Benjarrr Schiller �F�, •, CE 12592 ���o isle • ' • . • G�, ���� PROFESSO Nitrate Advisory Certificate of On -Site Systems Approval # OSC221572 Subdivision: T15N R1W Sec.9 Lot 85 REM A water sample revealed a nitrate concentration of 8.5 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. 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.