HomeMy WebLinkAboutT15N R1W SEC 9 LT 1383
}
O
J
LO
O
Arctic Pump & Well, Inc.
Page 1 of 1
Arctic Pump & Well Inc.
Jim Sullivan
PO Box 770197
Eagle River, AK 99577
(907) 688-2510
(907) 243-2282 jim@arcticpump.com
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
Parcel Identification Number: 05114431000
Legal Description: T 15N R1W S9
Lot: 138
Block:
Property Owner Name & Address:
William & Sarita Cox
21928 Tarika Ave
Chugiak AK 99567
Pump Installation Date: 8-16-24
Pump Intake Depth below Top of Well Casing: 340
Pump Manufacturer’s Name: Franklin
Pump Model: 1.5 HP cp
Pump Size:1.5 HP
Pitless Adapter Burial Depth:10’
Pitless Adapter Manufacturer’s Name: S-50
Pitless Adapter Installer: U/K
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Well Scoped with a well camera on 4-8-24
40’ + with no perforations or cracks in well casing
The ground around the well has been graded so that everything drains
away from the well
Pump Installer Name:
Arctic Pump & Well, Inc.
N
LL
LL
LL
to LL
N LL
r
a]
cD
M
CL
0
_0
CLa)co
3m
��_��
s
o_
®,�.
�m
O
m
E
n
c
L
(O
O
c O
a� /
CD
��b'
❑
L
n
'a O
N.
m v
N.
c
N
m
n
E
n o
y=i
o
m
W
O���s* ;�,,:)• .v4
p
o
U
Z
U
W E
0-
:�
LL
LL
N
N
L
m 0
c
-Y o
o
co
LL
a
CD
_0
m
O7
o
o s�
m
rn
Ma "'
��
�_
z
��E
a5
L
W
o
o
a)
Q
-
>_
o
co
z
E
W L O
°
°'
N
O
C) Z li
LL C
❑
o
c
LL
LL
J
Q
c
rn 0 O T
Z
..
Q
a
g
Z
Y
L Q'
V O
O F-
P: CL
c
°
_
a)
O
W
Q
c
a) _m
Q
>
C
@ W E O
n' N
n
r
o
Q
o
Q
d
Q
v N
s d 3
N z H
D
O
Q
°
o
-°
3
�
Y
o
c
m
F-
N
o F-
° m
°
=
V
cu
o
d
a ❑
❑ •S
¢
❑
N
n 0
a0
co
0
LL
��a s
cu
O
W
O
o io d
m
Q
-
U)
o ii
O
a7 0
L6
`n
H
J
C
¢
¢ O
0.
W
m
N
cn
z
MCL
E
JLO
N
z
w
a
-0 W o
g
o
--
z
O
3
C LL
G (9 r
N ❑
m
J
U
°)
C C
Z
Z
Z
Z
W
o
U)
o
E
o
N
C
m
¢
.0
Z m
m
+
t
+
J
N
FW-
Cl)
O
� 3
cn
o
o
+
Lo
o
p
`O
o CO
aNi
_Elm>_
Q Z
F-
J
w
p
a
N�
O
O
>
W-0
p
¢
Z
Q
j
cII
C
f� U)
O
U
ow
F
o
+
0
0
+
o
U_
_
g
W
j
a
r
J
Z
Z
LL
H
(9
N N
H
d
E
O
Q
E..
Q
I-
w
m
O
v N
N N
Q>
>
w
.Q
/N
LL LL
� a�
L
O
c
F
d
N
¢
¢
¢
¢
UJ
C7
X
w
o o
W 'Lo
o.
L
O a,
Z
Co
z
z
z
z
z
_0
m
v� Q
;. o
L U)
-0
U
¢
co
U
(4
O
~
`°
s
U)
z ¢
�
(n tiz
>+ �
o
~
E ❑
E
Y
W
❑
F-
2
c
X
P
=
w
c
cB
Cn
O
Z o
co
—
y
u3
F-
cQ
g
o
s
w
d
2
c
>
a N
c
-j
>
n
E
Q
Q
p
J
O
Y
m
O
U
CL
C
"�
Q Q
N3
Em
r
W
z
3o Lo
W
o
LL
W
N.
O
Cl) Q
d 0
z U
in N
0-
J
U)
F
(nj
LL
U
PROFILE
SCALE: NTS PA
N
N
O
N
E
E
N
G
S
V
C
,
L
L
C
(
C
.
I
.
1
0
8
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: OSP241107
Work Type: Septic Upgrade
Tax Code Number: 05114431000
Site Legal Address: T15N R1 W SEC 9 LT 138 G:1258
Site Mailing Address: 21928 TARIKA AVE, Chugiak
Owner: COX WILLIAM C & SARITA L
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
6/7/2024
6/7/2025
Q 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:
• The Record Drawing is to show the surveyed location of the well/radius for Katie Lt 2.
3
• A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to
confirm minimum separation to seasonal high groundwater, as well as percolation rate. Construction may
proceed at your own risk prior to 7-day groundwater monitoring. If results require a design change,
construction shall stop pending approval of a change order. Please submit results with the inspection
report (or change order, if required).
fv 1
Issued By:
-a-- � I "� ?-a I- �
Date:
Date: _ E 7ZZ 11
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-144-31
Property owner(s) William C & Sarita L Cox
Mailing address
Site address 21928 Tarika Avenue
Legal description (Sub'd., Block & Lot)
Day phone
Legal description (Township, Range & Section) T15N R1 W SEC 9 Lot 138
Lot Size 96,000 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑x
Initial ❑
Single Family (SF) ❑x
Septic Tank
❑
Upgrade R
(w/wo ADU)
(D) El
Holding Tank
❑
RenewalDuplex
❑
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: 57g5— Waiver Fees:
Date of Payment:S��r%z y Date of Payment:
Receipt Number: O!V/ O3 G Receipt Number:
Permit No. 0S'Pa 4/107 Waiver No.
Permit App_-'-:- .-.,:c:
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: T15N R1W SEC 9 Lot 138
Septic System Upgrade Permit Request
This is a design narrative for a permit to install a septic system upgrade on the subject property. The proposed
upgrade will serve an existing three -bedroom (3) house. This lot and surrounding lots are served by private wells.
1. Soils:
A test hole was performed on this lot by Pannone Engineering Services, LLC on 05/06/2024. Groundwater was
observed at a depth of thirteen (13.0') feet during the excavation of the test hole, and bedrock was not
encountered. Groundwater was observed in the test hole monitor tube after 7-days at a depth of nine -point -one
(9.1') feet. Based on the surrounding soils, and results of the percolation test and overall soils appearance —an
application rate of 1.2 gpd/SF may be used; however, an application rate of 0.8 gpd/SF was chosen for the design of
a conventional wastewater treatment in the location of the existing test hole due to varying surrounding soils.
2. Soil Absorption System Design: See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
4. Topography: See attached site plan for area topography. There are no slopes exceeding 25% less than 50ft from
the proposed drain field.
5. Drawing Markings: The Drawings are marked "For MOA Review Only". When written notification that the
review is complete and no further comments are received from MoA On -Site Department, the note will be removed
and "For Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
IsTiP
Steven R. Pannone, PE, F. ASCE
Owner/Civil Engineer
16 July 2024
o
_.
2 J0
XXXXXXdSO
'ON IIN83d
1�—titl-ts0
ON '0'I'd
,OS = „1
31VOS
"ZOZ/CZ/SO
Z-9966 >Id `30Vd JOHONd NV-ld HIS
3nN3AV d>IldVi 8Z61Z :SS3KGV 31lS
XOO � dlldVS �? 0 NVIT1IM :2J3NMO dOV 03H03HO
K 1 101 6 03S M ld N511 NMVaO
IOZ9-9bL L06 XV3 00Z9-9tL L06 3NOHd N0110f12l1SN00 210d
9b96 XV '83P]Vd L091 XOO 'O'd
(ego6 *roi 311 OAS ON3 3NONNVd :S31ON
,� 5 �¢
w
W ¢ W � 4 0
Er
UO \ \ \ \ \ % \~0.Lw0
\3 \ \�2 Q�WLu
W� �LwOj
¢U.WW
O Q- q3
O� ) WO
( I/maIL
y
2 3 \\ \ Ct 20. 00¢Q:
p¢ 41 z ~203�4
( w 0.Lu
1 0. O 0.
Ln
( f O w� z� c~ii�0 W JOi'.3
�cn
ca� W� Tom �2 �0:
2
p vi4`—w ----W O0. U� w ti0.0ti0. ��OQ¢
= C; zWOp4i
! ~ry �tiTUW QO �� jcs OJz O�¢4:z WUe>. Vl
W h� _�32W�cnU UQ tiWk�S ;O 4z Jio�¢4 o�V
d 2"fW�Wo oW0.11)2s oWW m 022 �WU ti
= 00 10.tiJ0.Jg- M aze O 0��� ¢irVO
2Wtj41LZ �\ �tn0.z0.W v �VtiWaW WtitiWO
p wji ` I k��03a ?w kw:aR �¢o WOp~ 'Oi¢e
ti 3 J I w 4 U k p O O W O� z �' w 2_ U OO O ti~ 2 Q C��:F`aUtn0 �Q Q. 3�7�?ti=.. to ag�0h
Q 2 x~O I p. 3tiUW O"� OO�WUWo�`U Oj
p �W�\ ~ow�wo w a� �wz�z3oWz �ooW�o 8moW
O s3 I �,oU 2 in Gi ti- >� 2zcr W z
1 0 o V�Q W¢g's¢�noO�l� w I ¢z,zz Q. w
3,� aav,o�0 �n�J w
Q NQ W Ww W 2zvIW�W��'VIW �N�U40,U pOW0.W2
= 2a ( � �nv
W ? m¢Ln,-
' \ pzQ�O 3 O�zOp> W wd.~(QnL',
3^E I q W a I 2¢¢�y�00. tix W
w����
�,Wz I ( 1\/ oaWcoitiW�om�oe�
f17
�owU��U��z oW
o zzwC,, eo�zo
t I o 'y !n � Wn I
��� ..aaaeo
W O p W
U� L�j
�Z Z O Z j W� WV�s Oa
LLJti 00 O Z l`I
�I����� ��� ti O��Q 33 z 4�i 00� WO
Q�n�`r °o,I-� �', LQ
�Jozw��w
j�o W rn O
O NQ pN0 "11� ON O� w O_
Q Q 0C) ��u�s� �.. k�O s H ( I' Zp20I''IQ.
Ln .p�nW�OQ
kz
C N` Q i I
LQ � Q O W O OJ N Q I j W k p O p Q 4
Lim �kw
���W tl Q O 3 W F ti WUOW4 0���
J
zNpQ� ( mz W.O
Oa.21�Q�tnJlcn�tcn�<c� �I,I�O eCI...�o���
9t'10'vZOZ:b A36
Zt'10'1?zoZ:C A38
t0'LO't,ZOZ:Z A38
9O'90'4ZOZ:t A38
SNOISIA38
PA
N
N
O
N
E
E
N
G
S
V
C
,
L
L
C
(
C
.
I
.
1
0
8
8
)
2.2. SCOPE OF WORK: INSTALL SYSTEM IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS.
9.1 FEET
9.1 FEET
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241107, Deb Wockenfuss, 06/07/24
PA
N
N
O
N
E
E
N
G
S
V
C
,
L
L
C
(
C
.
I
.
1
0
8
8
)
COMMENTS: Test hole excavated by Dean Construction & Development.
PERFORMED BY: PANNONE ENGINEERING SERVICES, LLC. I CERTIFY THAT THIS TEST
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF
THIS TEST.
·4.6 (min/inch)
·6"
·4 FT AND 5 FT
·
SOILS LOG & PERCOLATION
TEST
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241107, Deb Wockenfuss, 06/07/24
LOT 4 I
PLAT #98-177
Qa
CJ1
- TARIKA A VE
LOT 1
PLAT #81-331
PP
E E
ESE /CJ
_ �E� 4, O
E
E E (S 89'57' W 330.20')
i
E f E
LOT 2
PLAT #81-331
30'
50' ESMT. FOR tu
/p
ROADWAY & UTILITIES
j PER PATENT
I / I I
----- ----i-=------ 7L 7
I (>QPERF. PIPE 50'
C
11 r \ �p 55.6'
79.6'
CONEX / °�•
/ C GRAVEL
z �
0
0
O
cl QA o
O SHOP
10.2'
LOT 2
PLAT #86-51
70.33'CALC.
i
45.5'
GAS
1TR / DRIVEWAY
niTR
6
RESIDENCE
ROOF OVERHANG --_-j
' 45.5'
PORTION
LOT 138 48'2
100' WELL
RADIUS SHED
ASPLS MORTGAGE LOCATION SURVEY NOTES
NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE
RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS
MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS
MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE
CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES
NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT
A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN
THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR
OTHER IMPROVEMENTS. 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.
00
N
c�
0
D LEGEND
RECORD DATA PER BLM DEEPENDENT RESURVEY
AND SUBDIVISION OF SECTION 9 T15N R1W S.M.
RECORD DATA PER STATE OF ALASKA WARRANTY
)R2 DEED RECORDED IN BOOK 351 PAGE 143
O
O
FOUND 1/2" REBAR NO CAP
E —
OVERHEAD UTILITIES
........
EDGE OF ASPHALT
FENCE
O
SEPTIC PIPE
z
®
WELL
:o
0
-Opp
POWER POLE
CD
®
PORCH
:w
W
:O
r-: o
:"
0'
40' 80'
O
SCALE: 1" = 40 FEET
(11 X17 )
Aoz
v �
(259.90')R2
...................................................................................................... .
(S 89'56'30" W 330.23')CALC.
SIi
*..'49TH
�. �����
/
-.Ryon G. Johnson;
���,• No. 192159 •��
5/8/2024.•;
AS -BUILT OF:
_L
C.l�
'ARIA A Vim'
�E O
z
O
O
rn
CA
0
10.2'-
c14
LOT 2 0
PLAT` #86-51 0
C�
D
I
/O
E
E E (S 89*57' W 330.20')
m
50' ESMT. FOR /�
ROADWAY & UTILITIES DPP p I / 00
PER PATENT
o
10 0 WELL +� co PERE PIPE
RADIUS 19C1 U'
P 55.6'o
I /
79.6'
CONEX /
> GRAVEL
/ 0 =22 ELEC
45MGAS
TR DRIVEWAY MTR
RESIDENCE o
*ROOF OVERHANG— I o
1 45.5'
PORTION
LOT 138 48.2'
100' WELL w
RADIUS SHED
- S
(259.90')R2
(S 89°56'30" W 330.23')CALC.
NOTES
1. NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY.
THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN
HEREON.
2. FLAGGING HUNG IN VEGETATION MAY CHANGE POSITIONS
OVER TIME.
LEGEND
RECORD DATA PER BLM DEEPENDENT RESURVEY
() AND SUBDIVISION OF SECTION 9 T15N R1W S.M.
RECORD DATA PER STATE OF ALASKA WARRANTY
( )R2 DEED RECORDED IN BOOK 351 PAGE 143
/ O FOUND 1/2" REBAR, NO CAP
/ $ FOUND 3.25" ALUM. CAP
E OVERHEAD UTILITIES
EDGE OF ASPHALT
FENCE
SEPTIC PIPE
O WELL
I
0
0
0
-0 pp POWER POLE
® PORCH
0 HUNG FLAGGING
♦ SET LATH MARKED "50' ROW ESMT."
♦ SET LATH MARKED "100' WELL RADIUS"
0' 40' 80'
SCALE: V = 40 FEET
(11"x17")
WORK -SKETCH
70.33'CALC.
GR~:ATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK: ' ' ' / ...... " L.~' ~.-~-~' '
DISTANCE FROM WELL
LIQUID CAPACITY /~
GALLONS.
~_~.~,/ NUMBER OF
COMP' TMENTB
MATERIAL
SEEPAGE SYSTEM: SEEPAGE Plf:
NUMBER OF PITS____ / OUTSIDE DIAMETER
LINING MATERIALJ~'~/~/~---~'- . -
NEAREST LOT LINE ~ ~
OR WIDTH //,~! LENGTH
~ , , DEPTH
· DISTANCE FROM WELL //'/~ /
BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
TILE DRAIN FIELD:
'B~ ~Z~ N/~ ~ TOTAL LENGTH
DISTA M WELL LD~,JND~i , NEAR~,S].,~ . ;.~.,.OE~'Ldlq~ ~
NUM ~- DISTANCE BETWEEN LINES ( //~ ~ -~/ {
TRENCH W~ IN, [OTAL EFFECTIVE
ABSORPTION AREA
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH T~LE
IN. ABOVE TILE
E~ ~ DISTANCE FROM /~ / WATER ~
WELL: TYP ~'~"~ DEPTH , BUILDING FOUNDATION SAMPLE , NEAREST
t NEAREST ~ f SEPTIC ~ q ' SEEPAGE //~ ~ OTHER
LOT LINE /~ ~ ., SEWER LINE ~ .,TANK , SYSTEM , CESSPOOL ~ , SOURCES~
DIAGRAM OF SYSTEM
GREATEI ANCHORAGE AREA . {)ROUGH
flEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501
279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
APPLICATION TO INSTALL: SEPTIC TANK Y, SEEPAGE PIT.~~, DRAIN FIELD , OTHER
PERCOLATION TEST RESULTS~~TICIPATED DATE OF COMPLETION ~ '~ /~ ~
BELOWTO BE FILLED OUT BY HEALTH DEPARTMENT
~ ',
DISTANCES:
DIAGRAM OF SYSTEM
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE 7~ f.~ ~- 2 ~ APPLICANTS SIGNATURE
GREATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
CASE #
Performed For ~F¢~, ( ~)a~ {_~.~ ~ ~.~..~_~_Date Performed_~ 197 0
Legal Deseriptior~, Lot Block Subd~vls2on
This Form Reports a: So~-~s Log__~
Depth
Feet Soll Characteristics
Was Ground Water Encountered?
tf Yes, At What Depth ....
Reading Date
Gross Time
' '~.nu'c~' "
Location Sketch
Net T~me
Depth To H20
I ! I I
.I.I I I
Net Drop
Proposed Instal . ~n: Seepage Pit ~ Drain Field
.D,e. pth Of Inlet
COMMEN ~'S · ,
,, -. ' ~ &t'Z-~, ~-< ~ ./z~_, ,~ _ s~ ~.t ~.~ /~d,.~
l rzL ~ t . ~'~/~r~, ~ / ' 3'~ ~'t ~/~<~'/~dr~ .......
Test Performed B~:.~_ ,, . ,
Data Certified By:__O~g
Date
CD V/
0')C3)
I— I--
I?
`
M Com?
I-- r -
CD O
G) 0)
W C ca
o LL
V �
Q
O
2
U
z
J �
Q^ —• 0
Cn
U L L^`
- 0- W
Z `'>
VyJJ
U
I,
M,
C]
C)
O
i
r
Ce)
I
It
d'
LO
CDN
L)
M
d
ti
(D
LO
rn
rn
Q
0 Y
C
J
rn U
U) Q
Q
Z I --
T- Cb
F-
0 o N
U �
U �
o �
ca
J Cn
U)
O
0
a
a)
m
0
0
a
a
M
N
a)
U)
>,
O
a)
U)
L
O
a)
0
C
0
m
Z3
m
C
0
0
a)
U
0
O
(1)
m
0
M
>
O
Q
CL
M
c
0
C
0
A
CD
O
N
L
0
N
C
O
E
0
Ai
Lel
M.
m
0
0
0
a
a
CL3
'Z5
O
v,
U)
L
O
O
d
x
L
O
p
v
O
C
•�
N
N
•0
cc
N
G=i
O
w
>>
Q
ca
m
�
Q
L
>
>
=
O
0
Q
E
.�
N
,c
a�
CO
t
+=
+�
C
0
L
C
O
(D
Z
w
Q
{-+
N
>
C
=-
'o
p
p
m
'0
0
C
-
O
Q
Q
N
N
0
°
c
o
wi
O
•
m
m
L
O
X
C
U)
o
'
CL
>
O
O
_0
o
QL
U
2
a�
IL
>
-a
O
a)
U.
m
>
d
C
++
O
c
O
U
C
Q
v
Z
W
cn
O
o
W
� a�
C
E
=
U
Q
O
U
N
N
O
V
N
Q.
O
V
Q
N
a
L
a
H
a
U
Q
Q
Q
(6
O
U)
a)
U)
A
CON
O
O
a)
4-
c6
U
a)
U
Z
O
coH ,
O
LL Lf)
Z OI
J
a o
LU
Z
w
0 a
T
00
(Y)
0
rn
C
O
4
U N
O >
>� Q
�L
cu
Z F --
LO OD
N
07
c �
O N
2
U
N
ca
^rn` a)
W N
a)
o
0
a ZZ
O U
U
Al
W
E
m
a-
0
(1)
m
U
�
�
�C
L
O
O
Q)
d
a)
a)
O
U)
N
Q
a)
O
a)
>,
N
a
U
Q
ca
O
:
O
O
CD
U
O
C
O
N
N
�
❑
75
U
C/)a)
_0
a
>,
~
N
❑
N
70
C
O
_0)
w
O
V
a)
O
Q.
Uri
°)
•>
d
U
u
2
❑
❑
�
_
0
a)
a)
_0
.2
>
M
a)
ElN
a)
M
°)
a)
a)
(n
a)
3
O❑
a)
m
c
0
a)
a)
C)
U)
U)
o❑
N
C
LU
o
❑�
ElU
L
m
CL Q.
m
O
a)
�
J
a)
❑
"C
0.0
>
>
fA
CJ
O
N
a
a
O
U)
a)
U
❑
El�
+-% O
c0
E]L
.U-
»>
Q
m
LU
J
a)
cn
c
CO
m
a)
d �+
III
N
w
O
R
LU
W ❑
�
a)
�'
0
Q
Q
Y
L Ci
��
N
V/
w
w
w
a
H
a
U)
aa)
a R
M a)
O
O
U
of
a-
L
c =
cn
a
a
O
(D
H
a
O
H
LU
Q
Co
>
U)Q
>
cu
Q
N
M
L6
CO
w
m Z
W
E
m
a-
0
(1)
m
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
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 Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B.TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D.ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade 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
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies: well investigation was performed by Jim Sullivan to try and determine source of nitrates. No
deficiencies or findings were noted. Spring breakup is suspected to be the source due to the
proximity of the well to the Glenn Highway.
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
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
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ 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 Phone
Engineer’s Printed Name Date
LOT 4
PLAT #98-177
C.)1
1 ARIKA A VE
10.2'
LOT 2
PLAT #86-51
C,4
C-1
0
0
D
F-
0 0
LOT 1
PLAT #81-331
PP
Ao
E
E E (S 89'57' W 330.20')
I Ili
LOT 2
PLAT #81-331
30'
50' ESMT. FOR /I
ROADWAY & UTILITIES PP p \ / Cb
PER PATENT
CA
I I ❑ I I D
----- ----I— ---- °
50
411
G °°
�P 55.6'
79.6'
CONEX / > GRAVEL � `LO
/ w 22.5' ELEC. 45.5' MGAS AR DRIVEWAY
22.5' MTR
RESIDENCE a
ROOF OVERHANG--- o
45.5'
PORTION
sxoP LOT 138 48
w
70.33'CALC.
100' WELL ❑
RADIUS SHED
(259.90')R2
(S 89°56'30" W 330.23')CALC.
NN
ASPLS MORTGAGE LOCATION SURVEY NOTES:
NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE
RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS
MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS
MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE
CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES
NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT
A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN
THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR
OTHER IMPROVEMENTS. 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.
0' 40' 80'
SCALE: V= 40 FEET
(11"x17")
�. OF. A�gsl
j *•••49TH....
••Ryan G Johnson;
r�+,.• No. 192159
7/29/2..*CN,Aw
�
AS -BUILT OF:
LEGEND
()
RECORD DATA PER BLM DEEPENDENT RESURVEY
AND SUBDIVISION OF SECTION 9 T15N R1W S.M.
/
)R2
RECORD DATA PER STATE OF ALASKA WARRANTY
DEED RECORDED IN BOOK 351 PAGE 143
O
FOUND 1/2" REBAR, NO CAP
E
OVERHEAD UTILITIES
T <<<<<«
EDGE OF ASPHALT
FENCE
°°
SEPTIC PIPE
z
O
WELL
0
CD
-pp
POWER POLE
oPORCH
MH
SEPTIC TANK LID
0' 40' 80'
SCALE: V= 40 FEET
(11"x17")
�. OF. A�gsl
j *•••49TH....
••Ryan G Johnson;
r�+,.• No. 192159
7/29/2..*CN,Aw
�
AS -BUILT OF:
I:Tr,
O 01
rn rn
n n
M M
m m
r X
O
ra
0) "
LLJ
Q
O
V
Z
LL
O
M
Q Z
w O
� � U
V_
N
cu
Z a 41
LU ro
� GJ
N
GJ
LU .'-'
U v
Lu
N O
F— bfl
z 1— L
w °� o
a 5 �
O a�a E
Lu i7i 3:
ui
o 0 3:
J E �° a) C o
E x XE 4-1
� N
L ) O
E N O +�+ OU N O
a)
.W -0L c0 4-J .f0 L U d -J
�N N Q1 lb f0
Q N cy- LL U
E a) cu > v L
N L N
U
LbA f0 c6 c0 4-
U z
Ln a�
N U N
O 00 N t N = O 2 d1
�. a 4-1
o u b N
NQ w O° w o
U ° - w Q N
L L
Z, N O
A O V) O
J N Y 4; U
+� f0 U N \ bA Q1 N fD —
>
CC O O Q bA E L " L M N � co
U N d
Q
VO O
Q Co O O O cu
NC H+ ++ 4 -J -0
C E U4— a--� +-+ c0 L U
U 4J O U cv
bo
cn N a U N i� 0) c N
4, (10� O
O _co N
t/ 1 z L' C:°) N v C
Ln Ql > _ —O 0 Fu L
`- m m � a-+ O
H Q N
i+ L C L
O E O c— L .N O
C6 L M N O M a--+ +, O
a-+ ON > >
c0 N L
U > N w E +(U t O L 0
mm ±:fE O
i fu 4J C > m Q N
N Z3 t O a1 O E s
U cn Q H U Q t >. .— �-
Q)
4-
O
a)
V
.^
4-
O
-0
'd
a
4--
°Ca)+J
-0
-°
m
u
-OaJ
L
C
V)ai
'a
3
o
E
a)o
A
CA
>
3
aC1
N
dJ
L
N
EO
o
V;
Qo
cE
-p
—
C
O
~N
-O
�
N
+1
-p
O
O
u
tvo
cu
>
ai
>-
m
o
Oa
'
Q)E
v
a)
_Q
°'
°
C
o
•L
a)
>
'+,
c�
O
a
W-0
a
O
O
�
m
o
u
m
+�
�
o
E
a)
v
E
C
3
N
°u
E
3
aci
-
a)
@
t
on
bD
a)
m
�°
cu
y
a)
E
ao
a)
+�
°'
°
c
a
E
°
E
v
�
m
•�
)
4�
L
"p
a)
4.1
>
�
m
L
L
�
Y
�•-,
dA
Y
c
OL
L
o
a)
_
L
fp
O
O
>
+'
O
4-
C
m
U
U
U
y
C4-1
+
U
p
�
C
u
E
O
3
+�
C
'+�
>
'�
m
'O
C
_0
-0
C
E
m
>
a)
E
p
E
a)
+'
U
L
m
d
m
°
3
u
+
C
in
—
v
v�
m
L
O
m
a)
�-
a1
Q
C
>
O
v
o
a)
a
O
O
°
ai
O
v>
>
i
t
u
�°
m
E
a)
>•
�
m
C
a)
tin
a
°
*Jj
°
'J
U
O
�
a
C
O
m
a)
0
H
+�
+
v
a)
c
c:
3
O
3
N
3
-a
L
C
m
°
C)
c
t
t
t
.3
a)
m
o
u
v
*,�
C
_�
C>
C
E
u
u
3
N
v
C
m
3
O
by
3
-a
bA
E
aJ
�°
C
N
0
O
'�
m
L
m
E
m
a)
.0
O
N
M
3
o
v
o
o
�,
u
LE
a_C
a)
C
,)
_-
O
Qj
Q -v
+�
Q
E
t
�.,
� i
C
a)
uo
m
C
m
O
C
t
a
-
m
N aj
u
�
m
m
`l
u
E
cu
L
,�
L
o
p
°
to
Xo
3
a)
o°
c
o°
`�°
OA
Q)
.a)
m
v
t
.�
a
+'
u
O
v
m
�
°
3
E
v
-
E
Q
c—
-0
v
Fa
•-
�
a)
°
n
>
oL
'c
H
>
V
m
+'
O
C
v
Q)
ou
O
E
O
Ln
o
Q-
a)
o
.E
m
m
4-+,
a
QZ
=
+�
m
LL
v
a)
°
+�
j
O
O
m
`)
mai
.�
r
O
u@
o
N
•a
u
a)
—
a)
110
p
a)
O
N
u
m
L
L
4-
u
t
U
C
L
11
L
20
a)
�
L
3
m
C-�
>
0
O
°
3
Z
m-
-
m
C
C
m
4�
�
N
a)
3
a
C
o
v
Q
v
o
1-+
E
+'
C
c
i
C
°
E
_
3
3
°
m
3
O
m
o
`�
�
L
O
V7
!n
-O
O
v
�
C
a
O
>
'73
a)
s
cn
m
C
a)
E
a)
`+-•
`)
o
o
v
m
v
o
tin
o
f
m
0
o
u
+�
E
v
v
m°
L
C
a)
v
L
O
-O
-O
N
o
in
o
O
+cu
-p
4J
a)
OA
a)
L
C
L
a)
O
m
4-
m
C
O
L
O
L
O
u
a1
Q-
E
°
o
tip
o-'
't
aiE
C
C
s
t10
>.
V)
z
o
a
X
m
o
o$
3
a)
°
o
O
Q
a1
C
L
Q
m
O
a1
OD
'L
�
0O
_
±'
y
0O
_
—
in
m
vi
t
L
O
N
�
'E
4O
O
v
C
cc -6
�
t
O
C
a1
t
o�
+�CL
J
>
m
3
C
nn
E
3
co
E
E
a)
3
0
°
v
n
`°
C
m
o
n
a)
t
L
w
O
a)
a)
u
L
3
�o
i••i
_
m
>
C
a
E
3
u
.E
ai
E-
U
a)
Y
m
Q
y°..
M
,-
O
UO
C
v
Q)
E
C
O
cLo
'D
v
L
o
3
Q
L
L
N
•,n
m
Q
F
N
C
�C
n
C
m
>
>.
a)
C
o
Q
C
u
O
E
m
•`-L°
ci
N
+)
E
O
m
O
+�
a)
C
O
v
m
C
O
L
a)
O
+�
C
m
m
a)
a
m
C
c
+J
to
Y
o
O
V1
m
4-
_
a)
O
bD
O
3
E
m
m
L
m
4.1
m
n
a)
m
N
>
n�
O
m
Q
u
L)
C
N
+'
in
a1
w
On
opA
O
n
+�
a)
a)
Q
L
C
-0
�
m
+�
,n
4-
O
—
v
3
,,
.E
+�
a)
m
L
�
m
+�
a)
+
u
3
m
v
to
4-
m
L
Y
'a
C
"
4--+
L
�--+
C
Q)
L
t
4..i
�
v�
3
C
a)
E
=
+�
L
U
a)
O
L
4-
E
u
m
aj
C
>`
L
E
m
Z
a)
L
a)
L
o
E
L
m
O
41
°
3
°
ai
a)
U
M
a
Z
O
o
Q=
H
LO
L
m
C
a
m
u
Q
v_i
m
ui
O
_
}
v
m
+
fl
W
2
"
a)
=
m
3
l7
a)
�
O
L
vi
O
'
E
m
H
O
N
v
C
Z"
O�
U
L,
,
o
f°
4.
4.
o
E
N
�
(�
j
OA
C
co
ac)
tip
ac)
u
E
Q
L
v,=
3
h
u
m
a)
C
c
bD
}
O
E
p
O
O
o;
X
Co
°
m
a)
a
z
Ln
m
0
H
Lon
m>
v,
o
u
F
3
E
4a)
.°
H
E
co
uj
E
- E
E
0
U
Ln
0
00
0
ami
r -I
Tt
r�4
u
Ln
0
>
0
CL
<
V)
NE
4-J
>
a)
4-d
0W
0
W
Y
W
u
00
m
-14
u
0
co
u
N
Ln
Ln
Ln
E
W
4-J
E
W
V)
0
bn
Ln
m
0
4-J
w
a)
t0
>
%-
0 CL
V)
fes-
u
Q)
E
o
-0 LO-
m
0
—
u� Ln
Ln
r-4
U :E
<
—
N
>
4-0
u
:3
0
CL
-0
V)
4-0
-C
o
-C
4�
E
0
0
W
-0
-a
w
Q
CD
Ln
0
a)
E
s-
0
w
z
V;
Q)
C:
L-
0
W
E
4-J0
4-J
V
V)
q=
1_
0
u
4-J
u
4-j
u
Ln
Ln
0
V)
CL
0
U
ca
0
4-J
u
4-J
4-1
E
>-
0
fp
LL
wCl'
CL
UJ
oj
zuj
ai
m
m
V)
2
LU
QJ
uj
V)
gS
Ca
ru
U4
uj4,
-
�E
M E
CL
3 z
0
cp E
>
C)LLJ
C) �
0
rA
E
- E
E
4�
u
a)
U
Ln
0
00
0
ami
r -I
Tt
r�4
u
Ln
0
>
0
CL
<
V)
NE
4-J
>
a)
4-d
0W
0
W
Y
W
u
00
m
-14
u
0
co
u
N
Ln
Ln
Ln
E
W
4-J
E
W
V)
0
bn
Ln
m
0
4-J
w
a)
t0
>
%-
0 CL
V)
fes-
u
Q)
E
o
-0 LO-
m
0
—
u� Ln
Ln
r-4
U :E
<
—
N
>
4-0
u
:3
0
CL
-0
V)
4-0
-C
o
-C
4�
E
0
0
W
-0
-a
w
Q
CD
Ln
0
a)
E
s-
0
w
U
m
CL
c
0
4�
u
- mo
0
w
-C
4�
4-;'W
c
a)
E
cr
w
S-
E
E
E
4-J
W
u
x
u
V;
Q)
C:
L-
0
W
E
4-J0
4-J
V
V)
q=
1_
0
u
4-J
u
4-j
u
Ln
Ln
0
V)
CL
0
U
ca
0
4-J
u
4-J
4-1
E
>-
0
fp