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HomeMy WebLinkAboutT15N R1W SEC 9 LT 96B Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221128 PID Number: 051-104-59 Dwelling: Fal Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Fm� Upgrade Name STEVE NORTHCUTT ABSORPTION FIELD El Deep Trench Q Wide Trench El Bed El Mound Site Address 22111 MCKINLEY VIEW AVENUE, CHUGIAK, AK 99567 __:�Number ❑ Other Phone of Bedrooms Soil Rating Total depth from original grade 907-302-9703 3 1.0 GPD/SF SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 0.69 Ft. Subdivision Block Lot - 96B Fill added above original grade SEE DWG, Ft. Gravel length 94 (2 @ 47 t. Township Range Section T1 5N 1 W 9 Gravel width 5 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 470 Ftz 2 6 Ft. Well *100'+ *100'+ - - 25'.+. TANK (j] Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER TANK Capacity 1000 Gal. Surface Water 100'+ 100'+ _ _ Material Number of compartments Lot Line 51+ 10'+ - - NA PLASTIC 2 Foundation 10'+ 10'+ _ _TION Manufacturer Capacity Remarks *WELL RADII WERE FLAGGED BY A REGISTERED Gal. kle`ctn LAND SURVEYOR PRIOR TO CONSTRUCTION. Alarm location ' " M-'falled by Installer PIPE MATERIAL House to tank D3034 Tankto D3034 OWNER Drainfield D3034 CO/MTD3034 Inspector GEG CONSULTANT, JODY MAUS BENCH MARK (Assumed elevation) 98.46 ft Inspectio 1st 8/15/22 2�a 8/15/22 Location and description aro 8/15/22 4'n 8/16/22 1 TOP OF MANHOLE LID ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp �0 F I 4 4 Conditional Approval: Dateo� A-Q. �� J...... .... e;f�ey ess. �p Q CE -795 -' e p Septic System Approved Date o Note: this does ��4p°re55 00�� approval not include well permit requirements. #AECC884 HOZ kmuv voiuu 101 1� I PERMIT NUMBER: PARCEL ID NUMBER: OSP221128 RECORD D RAW I N G 051-104-59 DBL1 46.5 1 57.5 78.9 DBL2 46.9 1 57.3 78.5 MH 47.4 1 57.2 78.0 ST1 48.8 56.9 76.9 DBL3 49A 56.8 76.6 DBL4 49.9 56.7 76.1 FD 53A 56.7 74.1 FS 105.6 90.6 87.3 C01 101.8 1 86.0 81.8 MTI 101.9 1 85.7 80.8 CO2 138.0 1 117.7 104.6 MT2 138.4 118.2 105.3 CO3 110.1 95.7 92.7 MT3 110.9 95.9 92.2 C04 143.9 124.5 113.0 MT4 144A 125.2 113.9 NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. INSTALLED POLYLOK FLOW SPLITTER (FS) - APPROXIMATE LOCATION OF 1990 T.H. BY ROBERT A. SCHAFER, PE EXISTING DRAINFIELD INSTALLED POLYLOK FLOW DIRECTOR (FD) INSTALLED DOUBLE CLEANOUTS (DBL3 & DE NEW GREER TANK Tl 5N R1 W SECTION 9 LOT 95 1000 -GALLON HDPE SEPTIC TANI VG INSTALLED DOUBLE CLEANOUTS (DBL1 & DE EXISTING SEWER LINE (FROM TO HOUSE TO DBL NOTE: OLD SEPTIC TANK WAS DECOMMISSIONED PER UPC PER THE CONTRACTOR NOTE: THE 100 -FOOT WELL RADII SHOWN ON THIS DRAWING WERE STAKED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. NEW DRAINFIELDS - - - - SUMP�L GEG TH#1 i°O.W CO j / '1 lAPPR0 � )S % 1 / I 1 1700�w F� 1 \ 1 \ EXISTING WELL 1 I I \ EXISTING \ DRIVEWAY - C \ A 3 BEDROOM \ HOUSE ' \\ CO---" � a 1 N 9 �ENGINEERING SALES CONSULTING 3701 EAST TUDOR ROAD SURE 101 'ANCHORAGE, ALASKA' PHONE (907) 337$179 • WEBSITE: w gamossenginsenng.com PREPARED FOR PHONE NUMBER: PAGE NUMBER: STEVE NORTHCUTT 907-302-9703 2 OF 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: T15N, R1 W, SECTION 9; LOT 96B J.L.M. TYPE OF WORK: DATE: RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 8/22/2022 PERMIT NUMBER: PARCEL ID NUMBER: OSP221128 RECORD DRAWING 051-104-59 TOP OF MANHOLE FINAL GRADE (MH1) = 98.46 = 97.40-97.49 0 TOP OF TANK @ INLET = 92.34 - INVERT OF BUNG @ INLET = 91.67— NORTHWEST MT3 CO3 INSULATION PER I I I I rFILTER 2+ INCHES OF I FABRIC OF M.O.A. APPROVED T SAND FILTER BOTTOM OF EXCAVATION = 79.34 — NEW 1000 -GALLON GREER PLASTIC SEPTIC TANK FINAL GRADE = 84.68-64.71 /-ORIGINAL GRADE @ HIGHEST POINT = 84.34 (FOR BOTH TRENCHES) 2+ INCHES OF INSULATION PER INVERT OF DIST. INVERT OF DIST. LINE = 82.13 LINE = 82.13 TOP OF SAND TOP OF SAND FILTER = 81.44 FILTER = 81.44 6 -FEET TOP OF TANK @ OUTLET = 92.32 INVERT OF BUNG @ OUTLET = 91.47 NO GROUNDWATER WAS ENCOUNTERED IN TANK EXCAVATION SOUTHEAST MT1 C01 2.1' OF APPROVED SAND FILTER BOTTOM OF EXCAVATION = 79.34 — FILTER FABRIC FINAL GRADE = 84.88-86.22 GEG TH#1 RELATIVE ELEVATION OF BOTTOM OF GEG TH#1 = 71.84 (TH DRY ON F 1�.....:...... ENGINEERING SALES CONSULTING s 3701 EAST TUDOR ROAD SU [TE 101 'ANCHORAGE, ALASKA' PHONE (907) 337-6179' WEBSITE: w .gamassangineenng.00m 19 •••• i f ' jo 7PREPARED FOR: PHONE NUMBER: PAGE NUMBER: f (n Je ey AGamess 4v e STEVE NORTHCUTT 907-302-9703 3 OF 3 aj��J, ;•,( CE -79 3 ' ��l: PROJECT/LEGAL DESCRIPTION: DRAWN BY: `®® �� `.,�j 2 Z�+.41 ���� T15N,_R1 W, SECTION 9; LOT 96B J.L.M. � t. • • '�� �, • TYPE OF WORK: DATE: ®,1�p®R ESS\® *,: RECORD DRAWING OF SEPTIC SYSTEM UPGRADE 8/22/2022 #AE 0884 GARNESS ENGINEERING GROUP, Ltd..... ..... .... �.�.1,...... ................® ENGINEERING „ SALES:CONSULTING _ 7 Ton,,O 3701 EAST TUDOE ROAD. SUITE 101 'ANCHORAGE. ALASKA' PHONE (907) 337-6179WEBSITE. w w.gemessengineenng.com •';o -77` ••••' SOIL LOG - PERCOLATION TEST °oc� `s/ c A7 53 mess ' LEGAL DESCRIPTION: Tl 5N, R1 W, SECTION 9, LOT 96BApr PERFORMED FOR. STEVE NORTHCUTT DATE: 717/2022 ®44 "ROFESS\�P o® LICENSE DEPTH 6"-I' ORGANICS #AECC884 (feet) �---� W� LOAM (SM) TEST HOLE #1 ms=s: 2 a' DRY 7/7/2022 DRY 111111111 3 7/19/2022 DRY %/% 4 �y IIIIIIIII 5� ilmilill ti_ ``L`� 6 (GP TO GM) `a= BETWEEN 7 ``` = 3.0 TO 5.5 WERE 8 - LENSES OF t` zz SAND 9a fist 10 `tom 12 B.O.H. 13 14 15 16 17 18 SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 7/7/2022 DRY 111111111 II�III!11 7/19/2022 DRY %/% Hun • IIIIIIIII Rm ilmilill V, ``L`� DEPTH TO GROUNDWATER DATE DRY 7/7/2022 DRY 7/8/2022 DRY 7/19/2022 DRY 7/26/2022 SITE P �a N SCALE: 1"= 100' DATEWATER LEVEL NET DR I READING I NET TIME I READING (INCHES) I (INCHESS) 7/8/2022 ABSORBED WATER AS FAST AS IT WAS ADDED - -1 GPM (5 GALLONS ABSORBED IN -5 MINUTES) 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 5.5 FT. AND 6.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES 91 NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: JODY MAUS COMMENTS: PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FOR ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 1 ?- Z.2 -- r MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program ---------P0-6ox-196650-----4700-Elmore-Road----------------- Anchorage, 6650-- —4700 -Elmore -Road -_ ----Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 ` „f= http://www.muni.org/onsite On -Site Wastewater Disposal Perml, Permit Number: OSP221128 Work Type: Septic Upgrade Tax Code Number: 05110459000 Site Legal Address: T15N R1W SEC 9 LT 96B G:1358 Site Mailing Address: 22111 MC KINLEY VIEW AVE, Chugiak Owner: NORTHCUTT STEVEN C Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date:. Lot Size in Sq Ft: Total Bedrooms: �l L; IV )ci)(ir[meitt 5/2512022 5/25/2023 40144 Q Disposal Field CQ 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: A test hole is required prior to construction of the absorption field to confirm minimum separation toimpermeable soil and seasonal high groundwater, as well as percolationrate. Construction may proceed at your own risk prior to 7-daygroundwater monitoring. If results require a design change, constructionshall stop pending approval of a change order. Please submit results withthe inspection report (or change order, if required). Received Issued By: �— Date: I Date: 22 3 ANCHORAGE ------ Development Services De artment F`p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-104-59 Property owner(s) BRENDA SAGE Day phone 907-302-9703 Mailing address 22111 MCKINLEY VIEW AVENUE *CHUGIAK, AK Site address 22111 MCKINLEY VIEW AVENUE *CHUGIAK, AK Legal description (Sub'd., Block & Lot) T1 5N R1 W SECTION 9 LOT 96B Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) Q Septic Tank ❑ Upgrade x❑ (w/wo AD U) _. Holding Tank ❑ Renewal ElDuplex (D) ❑ Privy ❑ Multiple Dwellings ❑ (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 applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 455 5 Waiver Fees: Date of Payment: - !E/J/ 1) 2Z Date of Payment: Receipt Number: t°77 & G GV C, Receipt Number: Permit No. O. -S 29 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221128, Deb Wockenfuss, 05/25/22 ARE APPROXIMATE IN REGARD TO CONFIGURATION/LOCATION AND MAY BASED SOLELY ON PUBLICLY AVAILABLE MOA GIS RECORDS. THE LOCATION OF ALL WELLS AND SEPTIC SYSTEMS SHOWN ARE APPROXIMATE AND MAY BE BASED SOLELY ON INFORMATION OBTAINED FROM PUBLICLY AVAILABLE MOA ONLINE RECORDS ANO/OR AS -BUILT SURVEYS / i PELLISSIER;LOT2 pp \\ \ l l2F �-I�iy�gr El 9pA I c qr / T15N SECTION 9 LOT T15N R1 W SECTION 9 LOT 95 T15N R1 W SECTION 9 LOT 96A En I � - o v� 74 0 �y T MC KINLEY VIEW AVE. \ ' I T15N R7 W SECTION 9 LOT 105A APPROXIMATE LOCATION FT, R1 W SECTION 9 LOT 106A OF 200• WELL RA SERVED BY WELL ON 1 1 PROPERTY TO WEST ` 11 Tp `v Ltd 9 ENGINEERING SALES, CONSULTING, 3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE, ALASKA -PHONE (907)337-6179 * WEBSITE: vmw.gamessenginee6ng.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRENDA SAGE 907-302-9703 1 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: Tl 5N R1 W SECTION 9 LOT 96B D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE 5/5/2022 N OF ®®® i............... ' .....® .. , ♦ � '; rear A. Gar less ;� w s V 953 LICENSE ®p®lkFE/SS, #AECC884 ---- -DESIGN-CRITERIA: _ NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 PERCOLATION RATE/S: PROPOSED APPLICATION RATE: 1.0 MINIMUM DRAINFIELD SQ.FT.: 450 FT' DRAINFIELD DESIGN: MAXIMUM DEPTH OF EXCAVATION: 5.5 FEET WIDTH: 5 FEET LENGTH: 45 AND 45 (90 FEET TOTAL) M.O.A. APPROVED SAND FILTER: 2.1 FEET EFFECTIVE: 0.5 FEET REDUCTION FACTOR: N/A ACTUAL SQ.FT.: 450 FT' CONTRACTOR TO HAVE THE 100' WELL RADII AND WEST LOT LINE FLAGGED BY A PLS PRIOR TO CONSTRUCTION GEG, Ltd. HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. APPROXIMATE LOCATION OF 1990 T.H. BY ROBERT A. SCHAFER, PE -- PROPOSED 1000 GALLON HDPE GREER TANK; INSTALL DOUBLE CLEANOUTS BEFORE AND AFTER TANK EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER UPC- T15N R1 W SECTION 9 LOT 95 VACANT r �o r PROPOSED DRAINFIELD I _ _ — — y� M / S % / / R0OF N �N 3 .,. BEDROOM HO SE .. �nonl t: ----- .R -- 1V UTILITY EASEMENT - ENGINEERING � SALES- CONSULTING • ,.w... _ .- . 3701 EAST TI100R ROAD SUITE 101 'ANCHORAGE, ALASKA' PHONE (907) 337.6779 •WEBSITE: www.gamesseng(nearing,com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: BRENDA SAGE 907-302-9703 2 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: T15N R1W SECTION 9 LOT 96B D.J.G. TYPE OF WORK: DATE: DESIGN OF SEPTIC UPGRADE 5/24/22 N SCALE: / 0 y�ey.. Gar ess � � 4i��J,•. � C �-7953 •' Z,o ®�® �pROFE5S��®o®�® LICENSE It TA #AECC884 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 %" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCES Address FROM~ SEPTIC ABSORPTION i~..0 ,r~,~ L'"~ ~'7- ~1,, ~A~,~. ~~~ TANK FIELD WELL Phone(s) Permit No. ' ' NO. ~1 Be~ooms WELL / O~ ~ f LEGAL DE6CRIPTION L0T LINE I © ' t Township, Range, Section / O' t / 0 TANKS [~ :o ~ SEPTIC ~ HOLDING A ~i~' ~ ~J~, TYPE OF SYSTE~ ~TRENCH ~ BED ~ W. DRAIN ~ OTHER ~ original grade ~ FT ~ FI To~at absorption area Distance between I,nas ~ ~ T~ ~ ~ ' ~ ~0~ SQ FT 0 FT Number of lines [ Soil rating Pipe material ~0 ~ t WELLS ~ PRIVATE ~ OTHER (Identify) c~ass~ncatio~ (A,~,C) Tota~ ~epthCased to F; REMARKS: ~ A:; i"';[] " 17034 Eagle River Loop Road No. 204 ' ....... a~77 ~aAily Ihal Ibis inspe~ion was ped~rmed according lo all Municipal an~ State gal~elines In ellecl e~s ~ale:~j~ ..... Date: (3/85) [ Ixl~ill i AL, L. t':~tlii:t::~' Ifil:hi/:'; :t: l'~lliii:l:::l::~::~ AI:::'F:'I;;i'.(::F~I!i:D D[!;]~!i~ :1: (~)t\t ,, NO'F :[ F'Y I:)l"lF"l!iil I:::'l::;t :1: OI::~ i!:!:/>~(t:.!'l ]:l'*l'.:i~F'E;i:;t I:!:;IN,, I*t6:IXiI:I¥tUH !.)I:':.F:"I'H I:)F:: liliXIiZ;l'.)V*'~'l'il:(i:)lsf ND"I' lEI iiii:XE;l!ii:lli[:)::) ""?' X:)l,gi:i:l. I. :): lxli:'; (:)lgl 'q (:'d",l/) liii: X I:;:' :[ I::~',E:S (;.)ltl :[ ;:;' /::;,!; :1,/'7() ,, Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE PERFORMED LEGAL DESCRIPTION: ~[~ ~ ~c~ W~ Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Waler After, Monitoring? ~ d ~.~ Reading Date 1 2 3 4 5 6- 7 8 9 10 11 12 13 14- 15- 16 17 18 19. 20- SITE PLAN /t,j O Gross Time Net j Depth to Time I Water Net Drop IN PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER COMMENTS TEST RUN BETWEEN .7,,~-~ND FT E~gleRiver, Aia~k -' ~' / CERTIFY TH~HIS TE~T WAS PERFORMED ;;(~;~;,t.N;i~;ITH ALL STAT~ AND MUNICIPAL GUIDELIN~"T ON THIS DA,~ DATE' ~71~ QGREA ,eR ANCHORAGE AREA BORL .,GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE 2 ~~ NUMBER OF 2~- FROM WELl /"~'- MANUFACTURER ~If MATERIAL COMPARTMENTS INSIDE LENGTH (~'~/ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~ GALLONS. NUMBEROF~ ~ . DIAMETER OR WIDTH 3 ~ LENGTH~ ;EPT. '~ '~'~ ~ / TOTAL EFFECTIVE -- - / / BUILDING FOUNDATION , NEAREST LOT LINE / ABSORPTION AREA (WALL AREA) ~ ~/~Q. FT. ADDITIONAL ABSORPTION DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION __ LOT LINE__ SEWER LINE TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE:. REMARKS: DIAGRAM OF SYSTEM DATE APPROVED Form NO. EQ-031 PERMIT NO. APPL I CANT LOCAT I ON LEGAL. RL LRMOREAUX L96B SEC ~ TiSN 9488 BIRCHWOOD LCOF RE, LOT aide 4~i..~.,. S~LIARE FEE.:.']' TYPE OF' SOIL 8BSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS SOIL. RBT ING "['HE REQLIIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [::, E F" T'H = ~N~3TlY= 26 6RR'v'E L. D,E F' T"Fi=' THE LENGT N IS 'THE LENGTH (IN FEET;, OF THE TRENCH OR [:,RRINFIEL[:,. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF 'T'FIE GROUND AND THE BOTTOM OF THE E×CRVATION ,.'.IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OU'FFAt_L PIPE AND THE BOTTOM OF THE EXCRYRTION (IN FEET). F. E6~LI ! RE[-', SEPT I C 'lrRNk::, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPEOTION AND RPPROVFIL BY THI,S DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEEN B WELL AND AN"r';~N-SITE ~EWAGE DI~F'O~E. S4~TEM IS JO0 FEET FOR A PRIVATE NELL ORx 200 FEET ~R R PLIBEIC WELL SPECIFICATIONS RND CONSTRLICTIO~ DIAGRAMS ~RE AVRILiRBL. E 'TO' IN~L.IRE PROF:'ER I NSTRLLRT I ON. F'IERI"I I T 'VRL I [) FOR OI'-,IE '¢ERFi." F'ROI'.I I S S;L,IEZ I CERTIFY THRT i: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN RCCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF' ']"HE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. .................... 8PPLICRNT RL LRMORERUN OErE CO. Russell Oyster 694-2774 Soils ~ Foundations Performed for: Legal Description:... Depth (feet) 0 2 GEOTECHNICAL DEVELOPMENT Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 E~tl Ellis S, OIL LOG ~8-228o Land Development Mailing Address:,,, '~.~ ,b,, ,.-, .-"; ,.,, ,~ ~.,,, ~, .,~,,,,p ~r~ ~'~,~.~,, :,~.: ~ ~.~ Ii lO 12 13 2¸6 Ground Water Encountered: Proposed Installation: Seepm.De Pit Comments: ' ' ~' "~'-j:~.',.:,~v~-'~7 Performed by' - \ Yes~ No____~r' If yes, what depth " Drain Fte~d .... %, ':7"~ '~F7 f~/ , I,,,-, ix,: ,~ ,, .~.' '7 ".3 I'IUN ! C: :[ pI::IL ][ T'"r' OF DEPARTMENT OF HEALTH AN[> ENVIRGNMENTAL. qP~OTE~TION D 8NCHORAGE, Ilk:' .9.,A'? / - ,.. TUDOR R '., -' _; ..... /_..~,L-' ,25.'L0 E, .'", .......... APPLICANT AL LAMERA~ BOX 9488 ~ LOCATION ~.~l N 8IRCHWOOD LOOP LEGAL ~9~B SEC ~ TiSN R~/ LOT SIZE ,¢~2~ SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND AMY ON-SITE SEHAGE DISPOSAL S~'5TEM 16~ FEE~OR A PRIVATE WELL OR 2~ FEET ~OR A PUBLIC WELL WELL LOU- ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN "J~O DAV5 OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER I NSTALLAT I ON. F'ER~I I T YAL I D FOR ONE 5'EAR FROM I I CERI'IFV THAT ~' H.~, .:,ET l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND, WEL.Lz. -':' '-'~ FORTH BV THE MUNICIPALITV OF ANCHORAGE. 2: I WILL INSTALL THE S~'STEM IN ACCORDANCE WITH THE CODES. SI Gl,lED:-~~~ ............... ...... ............... by 3. & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2558 OWNER OF LAND ADDRESS dL LEGAL DESCRIPTION Z ~/'~ 6 5~(-- DATE- Started "?/::~ / / Z,G __ Ended / PERMIT NUMBER 74, ~1 DEPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASINO KIND OF FORMATION: Fro n ' ' Ft. to ~ Ft .... From F~om._ , Ft. to .: ¢ Ft. ---~_o'~ V c,o-.~ V~om From :, '~Ft. to From 12 Ft. to /~/ Ft. ,$Rmp From ,- From ~r,.~ Ft to / /8'Ft. .~ ~ ~/ ,~,dTt:/& From / From Ft. to Ft. From From.~ Ft. to Ft. From From Ft. to Ft From From Ft. to Ft From From _Ft. to ~Ft From~ From Ft. to Ft From~ From Ft. to Ft. From From Ft. to Ft. From From Ft. to Ft From Ft. to Ft. Ft. to_ Ft. From Ft. to Ft From ...... Ft. to Ft From_ Ft. to__ Ft From Ft. to Ft Ft. to _Ft. __.Ft. to__Ft, __Ft. to Ft. Ft. to __Ft. Ft. to__ Ft. __Ft. to Ft. Ft. to Ft. Ft. to _Ft. Ft. to Ft. Ft. to Ft. Ft. to Ft M1SCL. INFORMATION: DRILLER'S NAME /', MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-104-59-000 Legal description T15N R1 W SEC 9 LT 96B Expiration Date: 9/12/2023 Site address 22111 MC KINLEY VIEW AVE Chugiak AK 99567 Current property owner(s) SAGE BRENDA X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/12/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 NHUPA QTY OF Development Services Department On -Site Water & Wastewater Section NCHUGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-104-59 Complete legal description T1 5N R1 W SECTION 9 LOT 96B Location (site address) 22111 MCKINLEY VIEW AVENUE *CHUGIAK, AK 99567 Current property owner(s) STEVE NORTHCUTT Day phone 907-302-9703 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: FR 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: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench FN� 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 Waiver Fee $ Date of Payment Date of Payment COSA # S Z 15 Waiver # COSAApplicaUan_June 2022 COSA Checklist Legal Description: T15N R1 W SECTION 9 LOT 96B Parcel ID: 051-104-59 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 7/22/1976 Total depth 122 ft Cased to UNK ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 11/23/2021 Static water level at beginning of test 98.2 ft. Comments B. TANK DATA Measured operating fluid level in septic tank WeLu Date of pumping "Z),A ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/2022 0 ALL standpipes present per record drawing Total measured depth from grade *4.78 ft (max) Measured depth to pipe invert from grade "2.55 ft (min) ❑ N/A — pressurized field. 0 Per record drawings, field is insulated. A Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced NA gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 4.0+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑Q No 0 Coliform bacteria is Negative Nitrate 8.21 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by GEG Date 6/2/2023 C. LIFT STATION ❑ Required maintena:�e?rs Age of lift station Lift station nal Adequacy test date N/A Results 0 Pass Fluid depth prior to test _ Water added - gal I61 New fluid depth in Elapsed time min Final fluid depth in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 8.3 in Effective depth used 0 in Effective depth remaining 8.3 in Comments/Deficiencies: *PER AUGUST 2022 INSPECTION REPORT ALL DATA IS FOR 2022 TRENCH. THE 1990 TRENCH WAS NOT EVALUATED. 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' -1 ❑i Yes if No ft FO Yes if No ft Neighboring Tank > 100' no Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' E Yes if No ft Holding Tank > 100' DYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ns Yes if No ft ❑i 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' [E Yes if No ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' F. ENGINEER'S COMMENTS Q Yes if No ft Q Yes if No ft Yes if No ft M Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' Fol Yes if No ft Yes if No ft If tank or field is under driveway comment below 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 Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date /t In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systems on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 OF A L"�p -.,49T CE -7953 rEa V P LICENSE r0fess1c) 1A1=1 Nitrate Advisory Certificate of On -Site Systems Approval # OSC231193 Subdivision: T15N R1W Section 9, Block: , Lot: 96B A water sample revealed a nitrate concentration of 8.21 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. g `B x{ 96650 Anchorage, Alaska 99519 6650 *www mum org MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING F~arcel I.D. # L¢'~ ~/;'3 ~ - ~ ['~ ~ - ~/-~c~ HAA# 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (includ'~ !bt, block, subdivision, section township, range) Lot 96"B" S6c. 9, TISN, R1W, S.M. Location (address or directions) NHN Lamor~ Court- (b) Property owner. A,~ L~mn~om~ Telephone: (home) 688-9091 Business Mailing Address (c) Lending Institution Mailing Address Telephone (d) Real Estate Comaany and Agent RE/MAX OF EAGLE RIVER ATTN: Darl6n& Address 16600 C~nt~rfi~Id Driv6 #201 , E~gl~ ~iv~, Ak. 995?7 Telephone (e) Mail the HAA to tl~e following address: (or check here,~ if hold for pick up.) List contact person and day phone number below: S & $ ENGINEERING 17o34 Eagle Ri~er L~3 Road Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family ~ Number of bedrooms 3, WATER SUPPLY Individual Well [~x, Community [] Public [] Note: If community, well system must have written confirmation from the State Department of Environmental "Conservation attesting to th legality and status, 4, SEWAGE DISPOSAL >,On-site[~X b Public [] :' ~ Community I-i,,~ Holding Tank [] :' , ~' . ~ .... ~,~, Note: If community well system, must have written conflrmat on from the State Department of Environmenta ~:' C0'ns~&ati0n attesting to the i~gallty and status. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION,.. '~:~' *v;~- hereto and as ofthe va datc n date shown be ow ver, i,fy,t,~~ ~y ~nvestlgatlon of thru ~ ~:~ ~ AD shows that the o~s te water supp y and/or,wastewa~d~sp~sa~ ~ysteme~s safe, ~ u r the number of bedrooms and type of structure nd cated hereln~l~u~her verify ' at on obta ned from the Mun c~pahty of Anchorage f les and from my ~nvestigabon and .,: ,. ~. the inform ..... . .. ~ .... ,,,~,~ ,,~,,. ~ :~ . . ~,, ~ . the oh:~ite 'wAte~ sucpl~ and/~F~astewater disposal, system',s m State codes, ordinances, and regu latlons in effect on the date of this inspection., -:,'~ ~ ~":,~'~ ' ':': .... Telephone Name of Firm "' ""~ S & SENGINE'~'~i~G 17034 Eagle River Loop Road No. 204 Date 6. DHHS APPROVAL '~pproved for '~-~ ........ ,'",',: .... ,, / h?;,. Approved _,2~ "/~-', Disapproved Terms of'Conditional Approval bedrooms by ' ~"~~ / Conditional The Munici pa ity of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an ndependent p~;(~f~si(~nal engineer registered in the State of Alaska. The DHHS 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 (~;~.lyze data before a certificate is issued. The Municipality of Anchorage isnot responsible for errors or omissions in the professional engineer's work. 72-025 ~ev 7/88' Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) - FE.RUA.Y 1984 NMEN rAL [~LRVIC~ 3 DiVi~.4744 A. WELL DATA R E C E Well Classification Well Log Present (Y/N) I,~ Date Completed Total Depth /-~2 ' Cased to z~o'l Depth of Grouting Legal Description: Static Water Level c~ Casing Height Above Ground / ~> "~ Electrical Wiring in Conduit (Y/N) Pump Set At I ? lq" Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Public Sewer Line To Nearest To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments ; On Adjoining Lots ( ©O / /')O ~ ; On Adjoining Lots / To Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date Installed '~ ~ "~ -~i ~) Size Standpipes (Y/N) ~J Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) ( ,~0074/ No. of Compartments Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N) Date Last Pumped ,',.),//Pt /'~,t)e,,d ) ;for ' ~Temporary Holding Tank Permit (Y/N) ~V/~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line / 0 To Water Main/Service Line / ~ '7' To Stream, Pond, Lake or Major Drainage Course Comments To Building Foundation To Disposal Field 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~"- Width of Field ~% ~o ~' Square Feet of Absortion Area _~ GO '~ Depression over Field (Y/N) /~ Results of Last Adequacy Test /~//~ SEPARATION DISTANCE FROM ABSORPTION FIELD: ~,/~ Type of System Design Length of Field "% ~ Depth of Field ~ Gravel Bed Thickness ~ Statndpipes Present (Y/N) Date of Last Adequacy Test To Water-Supply Well ! f3¢ Y To Building Foundation /© ~-/ To Water Main/Service Line ( O To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area ,/~ To Property Line / O ~' To Existing or Abandoned System on ; On Adjoining Lots ~2~ To Cutback (if present) Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for /v Meets MOA Electrical Codes (Y/N) Comments "~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect inspection. $ & $ ENGINEER~NG Signed 17034 .Eagle River Loop Road No. 204 Eagle River, Alaaka ~9577 Company Date ~ .~4~~ MOA No. 4::~cP~ Receipt No. ,-~//~-~.~,/.~-~ Date of Payment Amount: $ 72-026 (Rev. 7/88) B6ck date of this Receipt No, Waiver Fee: $ Date of Payment Page 2 of 2 wgrg §m\ §§; k�§ § N;§ q;■ \ \\�\ � � LL I 2 m9:«/ \ /»m C/3 / �\§ \ �$\ %Im t \ ten® 2Ra ® \ \§� K Cl o � 2 6\x «3@2¥R f [ o■az«o LL,>. k/E® § \ mm% 5Qcc $ g\§\\\ §m\ §§; k�§ § N;§ q;■ Q\� \\�\ � � LL I 2 m9:«/ O: I]/// §m\ §§; k�§ § N;§ q;■ CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS NEPORT ~Y SAMPLE for Work Order # 26322 Data ~eport Printed: AUO 16 90 E 09:55 Client Sample ID:L~6"E' SEC PWUID :UA Collected AU0 10 90 ~ 15:30 Received AUG 10 90 e 17:00 Preserved ~lth :AS REQUIRED Client Name : S ~ S ENGINEERING Client Acct : 8NSENOP P.O.t NOWE ~ECEIVED Roq t Ordered By : ~. SH~FEN Analysis Completed =AUG 15 90 Semi ~eports to: Laboratory Suporv~%EL_:.~NEN C. EDE 1)S & S EN~INEEEING Epocial Instruct: Chemlab Raf E: 902977 Lab Umpl ID: 3 ~atrix: WATER Allo.able NITRATZ-N 4.0 ~/1 EPA 353.2 10 Sample ROUTINE SAMPLE. Renarka: SAMPLE COLLECTED BI NOJ. Tests Perfozaed Sea Special Instructions Above UA-Unavailable None Detected '* See Sample ~onarks Above Not Analyzed LT-Leas Than, GT-6roatar Than SGS Ref.# 1232369001 LOQ Units Client Name Gamess Engineering Group, Ltd (GEG) Printed Datefrime 06/08/2023 18:17 Project Name/# T15N, RIW, Section 9, Lot 96B Collected Date/Time 06/01/2023 11:35 Client Sample ID T15N, RIW, Section 9, Lot 96B Received Date/Time 06/02/2023 9:30 Matrix Drinking Water Technical Director Stephen C. Ede Sample Remarks: Parameter Results LOQ Units Method Container ID Allowable Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 B (<10) 06/05/23 06/06/23 ACF Waters Department Total Nitrate/Nitrite-N 8.21 0.200 mg/L SM21 450ONO3-F C (<10) 06/02/23 EBH Microbiology Laboratory E. Coli Negative 1 100mL SM21 9223B A 06/02/23 M.A Total Coliform Negative 1 100mL SM21 9223B A 06/02/23 M.A 2of5