HomeMy WebLinkAboutT15N R1W SEC 9 LT 60T15N R1W
SEC 9
LOT 60
#051-103-13
Municipality of Anchorage Page / of 2-
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: S/r/!"/nr^v7 PID Number es,- 4.._,-/ '5
Name:
,V.rAern .0,--...4..-A,... fir,f-,^r-
Wastewater System: New ❑Upgrade
A0°`°'°ABSORPTION
a? /as- ..4 7.../..",r /✓'ter-es .,5 Lin
FIELD
Phone:
No. of Bedrooms:
0 Deep Trench cir Shallow Trench ❑ Bed 0 Mound 0 Other
LEGAL DESCRIPTION
Soil Rating:
D. a GPD/Sq Ft
Total Depth from original grade:
j..7
Lot: Block: Subdivision:
60
Depth to pipe bottom from original grade:
Ft
Gravel depth beneath pipe
/, 5- Ft
Township:
/r. ..e✓
Range:
//I/
Section:
9
Fill added above original grade:
is r Ft.
Gravel length:
2 e c0 ' r '0,' ' Ft
WELL: ®New • Upgrade
Gravel depth: H•Aorr
5..... Ft
Number of lines:
Z
Distance between Imes.
tit, FI
Classification (Private, A,B,C):
�t�lv-47/
Total Depth:
G 5 Ft
Cased To:
6 q Ft.
Total absorption area:
6.2C SO FI
Pipe material:
H bPF 1 n
Driller.
51AL(eJAI✓
Date Drilled.
Lila k/
Static Water Level:
Z4 Ft.
Installer.
oWnIFP_
Date Installed:
Sholoct
Yield:
30 GPM
Pump Set at:
to Jk FI
Casing Height Above Ground:
3 Ft.
TANK
SEPARATION DISTANCES
'septic OHolding OS.T.E.P.
To
From
Septic
Tank
Absorption
Field
IA
Station
Holding
Tank
Public/PrInI.
Sewer Lines
Manufacturer
eA-15 SEQ'J,EC C
Capacity in gallons.
/ 300
Well
/i0 �
!79 "
//5 "
/
) o7 v
Materlal:9t4s1 G
Number of Compartments.
1
sea
watterer
/6,71
//S"
ivy'
f/co /
LIFT STATION
Lot
Line
yG'
/S
!/S
v
��
Size In gallons:
SSO
Manufacturer:
p,i/t, scrore /'i
Foundation
9'
i''
/7'
0
'Pump on" level at:
5L"
`Pump oft" level at:
9Z"
High water alarm at:
'I rt
Curtain
rso'
est)'
,' ro'
/
TSor
Pump Make &Model
EleSCrical EVE� Inspections peh rmed4j:
5To I- SFR
Remarks: i,Jl,,m- , ,, ,fA%,t,,
BENCH MARK
P 0nX t,ft tunes ARC 1" PIP(
Location end Description:
.49-44.2 ��,! rerr- 4"
JAssumed Elevation:
- /!'!".OD Ft
E., , L
4s a L `9
/ �'
Inspectionsperformed b : F Er F. sle:
P Y Dates' 1st f�iv/e�/
� � //rte/Ir •
•
% CHRISTOPHER R. W000
L1' CE:10387
2nd 5/ /3 /O y
Department of Health and Human Services approval
Reviewed and approved by: Date' 3l9q 0s"ssG+f:o.�9
I
2-013 (1NI) MOA 25
`:
Permit No. SW040047
Page 2 of 2
Municipality of Anchorage
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
Legal Description: LOT 60, SEC. 9, T15N, R1W,
PID No.: 051-103-13
N89'59'301W 330.2'
•
MONITOR TUBE
SEWER CLEAN Our
WELL
EASEMENT
NEW LEACH FIELD
DRIVEWAY
TEST HOLE
B
E
1100 GALLON
PLASTIC SINGLE
CHAMBER
N89'59'30'W
550 LON
(FAT ALBERT)
LIFT BASIN
330.2'
ELEVATIONSc NAIL IN TREE
(NOT TO SCALE) ASSUMED ELEV - 100.00•
4.0'
1300 6Ta
94.5 TANK
1R1 114'
1R2 tit
W11 t7•1
1..
cM.
TTM16
RE 144' "f 1 '
TR2 HX TR2t t4V
TEST
HOLE
SCALE 1 - 60'
w
f)
n
SWING TIES
A
C
26.0'
210'
D
37.0'
40.0'
E
41.0'
16.0'
7/14/04
ENGINEER'S SEAL
0000�p��
OFAC"\
7 / •/FJ �� J
QA 1ii�.A!r� ',i tF
a
O v 'CHRISTOPHER WOOD i
VO C7Cic CE-10387
00� -ic\f‘ .........
o•
f
NAME:
ADDRESS:
• RAY'S SERVICES & SUPPLIES
_ 3bQcidlii!hg ilr on-site water and wastewater
1 nou N.(AtILP men LOd. nuq MRilt Pot
1 PMY R tun n, 0.4A7RA RM/1
I 1Pl Rngpli A071•RR.lR•A4
PO moll tM.IPw � 7F �� S
DATE:.�C '
INVOICE NIJMOEfi:
22 \3S ./
PHONE N • go -7090
DESCRIPTION
_Z. 21
'p.
:-
ardea Stec. i/ r.
c T/S,V� '!W
o rez// led
AMOUNT
130o Gia 2 STU g 13 si grJ-c cOl 737
l .55t t' . Fi47 m, of- C riL Fl N Ire
1 SP fc pawl' czr w G W)O $1�r� Iv
n ''o / 1GL r/c / -,
cl 130 ,2 /Pi
TO/TO 39Vd
C/P s771 N /a , .1 70 e , 2y
30
/800
Zza600
loo
ZZZZTLZ 99:60 D00Z/Z1/90
(lCertitieb Drilling tog
toc0.th.
SULLIVAN WATER WELLS
P.O. BOX $7027t. OHUOIAK, ALASKA 59667 • '
OWNER OF LAND- R,cI44 o: z; le'a4'
ADDRESS:
LEGMOESGIWftorr '1 i / lI r Go . SPr
t 4rAbi
PERMIT NU/BM°glib qa Dab dhsura- -t. 9
,y►xIDDRIFICOMON NUMBER o?I- /03 - l3
is well boated at approved penult location? bt tr No
Method of DONT Iisilfeatay U cable tool
Depth of welt 64
casing -typo sun, wae,htck,assa
Diameter 6 /.` inches. depth 6 9 feet
t:+« Yype n) #0 g
f&g Stickup Above Owlet 3 feet
Slott Water Lane a feet
Recover Rate: ppm
Matti of'lbstirp: 4 !
weeneeeOperiig1'jn limifenerst Qopenhole
:I Screenecfi • Stan feet Stopped feet
CI Perforations Start ted Stooped feet
Grout TweeNitur►rreiIz Wm. O Loi.
Depot corn D feet, tob feet
NA Disinfected Upon Completion? &t Cl No
Method ofDdtnraelloc Q Mr. b4t J$ FL) /Wm
COMMONS
BOREHOLE
DKPL
DtflH.
wow
0
3
3
5 -
al
�r
3;
41
yI
egr
9s
5'
C•n Sri tilt OP
0v(I4 J4ge ••3
£i 644 -et 4 Co n3.a
lh%co%R•-e•
,S ;•war
4,fyq..fi0 64ost e—
tc1,f r►=e
Dramas Name
U TBdflON: It Is the responsibility of the property owner to aubmk a copy of the well lop to the proper authority. Municipality
><Anchorage Department d Health & Human Setybes and/or Department of Envtonm rttal Conservation. MatSu Baouptt
)epater* of Envkormental Conservation.
I0/f0 39Vd
NVAI11fIS 6SLZ889 I8:00 6661/10/t0
•
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
Sictioy- I O lain
5I13 0 q—IZttiooK
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Upgrade
Permit Number: SW040047
Legal DescriptionM5N R1 W SEC 9 LT .60
Design Engineer: 0024 Eagle River Engineering Services
Owner Name: RICHARD & DEANNA CRESAP
Owner Address: 22135 AURORA BOREALIS ROAD
CHUGIAK . AK 99567-6163
Date Issued: Apr 08, 2004
Expiration Date: Apr 08, 2005
Parcel ID: 051-103-13
Site Address: 022135 AURORA BOREALIS RD
Lot Size: 108900 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑.r Private Well ❑ Water Storage
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 DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By. 1 CC ,; cavge 2-i Date. 10/0700Y
Issued By C
Date: 4/8/04
Oct -14-03 12:57P Permit Counter 907 343 8250
Municipality of Anchorage
Development Services Department
Budding Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWERIWE(.I PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 6 511b 313
P.01
Permit Number SW 040047
Property owner(s) RtcI44RD a IJEA-NnA cQ&SAP Day phone 680 - I&) o
Mailing address (1) 2213 S s40. e-oQ.4 t3oRkht.tS J2o AD
Mailing address (2) GNmAr 4K .4ic
Zip Code g 9 517- UI3.
Legal description (Lot. Block & Sub'd.) Loi 60
Legal description (Section, Township & Range) Y /CA.' R t W S G c- cf Leer
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Number of Bedrooms $
❑ Well Only
Water Storage
0
❑ Jacuzzi
❑ Water Softening Unit
0
0
0
0
certify that the above information is correct. I further certify that this application is being made for a
Single Famil Dwelling and iiss in accordance with
applicable Municipal Codes.
Aie l/ 1 �r�'�// / • (O4z r )
(Signature of property owner or authorized agent)
Permit Fees: ( 03 S
Date of Payment:
L, -t) (SC
Receipt Number:
(Rev. 12100)
Waiver Fees:
Date of Payment:
Receipt Number:
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW Rd. Suite 201
Eagle River, AK 99577-3294
(907) 694-5195 tel
(907) 694-3297 6
April 6, 2004
Jim Cross, P.E.
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: T15N, RI W, Sec. 9, Lot 60
Narrative & Permit Application
Dear Mr. Cross:
This letter is to request approval for a new septic system and well permit at the above referenced
property. The property currently has a concrete septic tank and a log crib. The on-site well is
located within the house, only 85 feet from the undocumented system. The exact location of the
log crib is unknown, but the homeowner believes it is just to the north east of the septic tank.
The homeowner would like to drive a new well and install a new septic system that meets current
specs and regulations.
The proposed leachfield upgrade will have very limited impact on adjacent properties for the
following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +20' distance from the proposed
system, and no private wells within 100' of the proposed leachfield replacement.
3. This permit is for a new well and septic system.
4. Drainage will not be affected and is not a major consideration in our design.
The new leachfield will be in an area near where the old log crib is believed to be. The new
leachfield trenches will be adjusted to stay clear of the old crib, if it is encountered. There is
room within the radius of our test holes to fit a replacement system, if necessary in the future.
This work will not affect the reserve septic areas on adjacent lots. If you have any questions
please call our office at 694-5195.
Sincerely,
Chr stopher R. Wood, P.
Principal
\2003\03-058 SEPncNARRAnvarec
N89'59'30"W
330.2'
50' PATENT ROW RESERVE
WELL + 200'
SEPTIC +30--.-
Z
100' WELL RADIUS
INSTALL FOUNDATION
CLEANOUT
REMOVE OLD
SEPTIC TANK
HOUSE \
75'—I PROPOSED NEW 1750 CALLON
y//- NEW WELL S.T.E.P. TANK
Y
WATER KEYBOX 0 -
DIVERTER VALVE 0
TEST HOLE ¢ _
N89'59'30'W 330.2'
MONITOR TUBE
SEWER CLEAN OUT
WELL
EASEMENT
0'!
01
r
n
NOT04'301Y
— - PROPOSED LEACH FIELD
- EXISTING LEACH FIELD
o - DRIVEWAY 1. NO KNOWN CURTAIN DRAINS
WELL/SEPTIC SITE PLAN
LEGAL: LOT 60, SEC. 9, T15N, R1W, S.M.
OWNER: RICHARD AND DEANNA CRESAP
CONTRACTOR: N/A
JOB#04-017WS
DATE: 04/06/04
SCALE 1 "=50'
AEAGLE RIVER ENCINEERINC SERVICES
P.O. Box 773294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
•
•
ettlidtF",ZI 11444
,n .CHRISTOPHER R. WOOD. E /
•• CE -10387 i
,+
41114"... CrEsslol+w ger
Eagle River Engineering Services
Christopher R. Wood, P.C.
10421 VFW Rd. Suite 201 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: TISN MW Sec. 9, Lot 60 April 6, 2004
A. GENERAL
1. The well & septic plan is for a 5 bedroom single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of health requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi -family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. It is always recommended that a surveyor locate the nearest lot line position and the location of any
easements.
9. Any remaining open test hole excavations shall be filled.
13. SEPTIC TANK WITH LIFT STATION
1. The septic tank shall be an Anchorage Tank 1750 gallon septic tank with integral OSI lift station pump
model OSI -05-20-1111F.
2. A receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all
applicable codes.
C. DRAINFIELD
1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield
bottom.
2. The bottom of the drainfield shall be level, plus or minus 1.5".
3. The total depth of the drainfield excavation is not to exceed 4.3' at any point with relation to ground
surface.
4. The effluent line within the drainfield shall be laid level within 0.03'.
5. The drainfield gravel is to be covered with typar fabric material.
6. A combination of 2' of soil and 2" extruded board insulation to an equivalent depth of 3' is to be
placed over the leachfield.
7. The area over the drainfield is to be mounded to prevent ponding of surface water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing private well, or 100 feet to
any surface water, spring or outfall.
9. Contractor shall stay 10 feet from old leach pit, if encountered during installation of drainfield.
RECOMMENDED LEACIIFIELD DIMENSIONS:
TOTAL DEPTH = 4.3' max. GRAVEL DEPTI1= 1.5' under pipe, 2" over pipe
DRAINFIELD LENGTH = 2 X 50' DRAINFIELD WIDTII = 5'
SOIL RATING = 0.6 GPD/R2 BEDROOM CAPACITY = 5
SEPTIC TANK = 1750 gal w/lift sta.
EFFLUENT PIPE = 1" PVC with 1/8" holes oriented down spaced at 4' OC. 2 runs of 1" effluent pipe in
each leachfield 2' between pipes 1.5' from sidewall of drainfields. Provide 2" insulation over piping run
from tank to manifold, and on manifold.
Twenty-four (24) hours notice required for all inspections.
\1997\04-017drainfield-sys & lift spec.doc
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 04-017
Calculated By: CW
Date: 04/06/2004
Legal: T15N, R1 W, Sec 9, L60
Single Family 5 Bedroom Dwelling
TEST HOLE 1142
Shallow Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom =
Percolation rate =
Wastewater application rate =
Required absorption area =
Trench width (W) =
Gravel depth (D) =
750 gallons
1 minutes per Inch
1.2 gallons per day per square foot
625 square feet
5 feet
1.5 feet
Required length = Shallow trench factor • Required absorption area / W
Shallow trench factor = (W + 2) / (W + 1 +2 D)
Shallow trench factor = 0.78
Total Excavation Depth = 3.5 feet
Required length = 97 feet
04-017 drainfieldCalc.xls
8:14 AM04/06/2004
Weia 9 �
Effluent Pumps
J P20, PJ18 Series
12 hpto1-1/2hp: 1
r
._.
-TIL
_.
6
O
f0
3
O
IO
A
N
CL-
N
a
1a1'(Hai) peel; olweuAQ 1emo1
II II /II
-4:4*;!9;!";!q o
vi vi pX in
li
.3 Up . i� m u gra. 5. '. ,
~O _n Q 9
Et a A
To = -Eo c g
R
1V
N
O
N
Net Discharge, gpm
E € eYHHJHHYUU EI
e Pv rl�vioo.♦000 pip
r
R€1
Performed For.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
yaw* cl.anchorage ak uQ
(907) 343-7904
Soils Log - Percolation Test
RSGNf brAnnNk• CP(CAf
Date Performed:
3/29/0'1
Legal Description: tor 60 T ,' J . R;s) c f C,' Township, Range, Section: T S ��/ R / , / SF,r! 9
Slope Site Plan
1-
2
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
Depth
Feet)
s I -TY stint)/ ToPSort-
o
6°-
6
6
D e.
O5
T
6P -SIN vJ/cot,e,.cs
DARK. AU/
CjoMC
v
•
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT DEPTH?
Depth to Water Atter
Monitoring?
Date
BOTTOM OFt$T Fbt.E
1/e:5
/O r
95.33Liksky
S
L
0
P
E
P
VC
Pt
TN -
1
v
F -L
47-
Reading
r
Reading
Date
Gross Time
Net Tune
Depth to Water
Net Drop
.1
3/2'344
0
o
S! 6 'l
0
2
‘:?2
C:71
61-o"
6 "
3
coo
s,-1 ..
y
i
/`fits
6 zs
6 _o"
6 .r
S
16•'00
o
s'•- [ ,r
b
G
72.25
6; 7 c
0 =0 "
4 'r
rcrtwwuvn nnra /, tmalt nth) PERC HOLE DIAMETER
TEST RUNSETWEEN C, FT AND 4 Fr
COMMENTS M N THE PAY/Or/Oki eir- Tor rvec, TttEkr r s- s: 1- s/IND
PERFORMED BY: P..,TC (,‘f Ock 1�2/,�ZZ Gd CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL UIDELINES IN EFFECT ON THIS DATE. DATE: 3/2 q/oq
Performed For.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 995196650
r,
yaw, d.anchoraae ak.us
(907) 343.7904
Soils Log - Percolation Test
!toff b Anikk. CRCMIf
Date Performed:
Legal Description: i O. T I S 41. R I tJ S F c �i Township, Range. Section: 7 city 2 I M
Scope Site Plan
1-
2
Depth
(Feet)
3-
TM -a
Sit -rt SAt t"l
l oPsot t-
b'p•t{' 6w-604 W/cotetts
d_o
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
COMMENTS /Up FI? i) -
t:
WAS GROUND WATER ,
kit
N[4
ENCOUNTERED?
$
IF VES. AT WHAT DEPTH? ,deer L
Depth to Water Atter D
0
Monitoring? N/4 $'ice' E
Date: ta(
SPY 9
P
QRS CRh6x
tmg
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
1
3/74/01/
O
v
3!6"
o
z
6:35-6:;s
t)f J
(rt
3
44,0
v
31-,(r
0
Li
111-1/o
6:40
bhe
6 "
S
16:00 1
0
11-4"
0
n:Lia I
c*: go
Dal
C.
rtnwlAT10N RATE /- (mf AnMd.)I PERC HOLE DIAMETER Aj 1'
TEST RUN BETWEEN 7 FT AND :q FT
Alia')MT rlc?4/lit, (fit -DA ocv-y. 41°/r,' t- 5,4&b .
PERFORMED BY: G NRa S t, et 1��Z2��2%lEc- lel ridCERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPA GUIDELINES IN EFFECT ON THIS DATE. DATE: j/�9lj} C,
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
1. APPROVAL REQUESTED BY: 7/0,,(,QQ,/�(�/y1,�, �)
ADDRESS: 1/# 'too 7 / leu /'C%
PHONE:. %digs ' 94?
2. PROPERTY OWNER:
3.
4.
j,/jIUL- PHONE:
LEGAL DESCRIPTION: ,L 60i 7/67) ,i
TYPE FACILITY TO BE INSPECTED:5M( ( /(ItAu e,,, STREET: C rtitt'c-( CiuccrzuL/
NUMBER OF BEDROOMS:
5. WELL DATA:
A. TYPE 0141-tbd/"✓l itO aPIG< /xAJ t.(
B. DEPTH
C. SIZE
D. CONSTRUCTION
E. BACTERIAL ANALYSIS
6. SEWAGE DISPOSAL SYSTEM:
A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
1. SIZE 7.5-6 � UR. hua-Q--
2 . AGE /7,W
3. MANUFACTURER
4. INSTALLER
tt l�zvA, r
APPROVAL REQUEST SEWER & WATER FACILITIE,
PAGE TWO
B. SEEPAGE PIT
1. SIZE
2. LINING DiUCALti
C. DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LENGTH
7. REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
C. WELL TO SEWER LINE
D. WELL TO PROPERTY LINE
E. WELL TO OTHER POSSIBLE CONTAMINATION
F. FOUNDATION TO SEPTIC TANK
G. FOUNDATION TO SEEPAGE PIT
H. SEEPAGE PIT TO PROPERTY LINE
8. COMMENTS:
.-741 41•te?e ' layC (JY_ - - - i.t.64-29u-2lX111A. (141744ltt old
APPROVED:I7-41.0 DISAPPROVED:
DATE:
7/lr %:4
DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY
04XGE
Municipality of Anchorage =
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-103-13
1. GENERAL INFORMATION
Complete legal description T1 5N R1 W Sec 9 Lot 60
Expiration Date: �i q—
a e2Z -z_
Location (site address) 22135 Aurora Borealis Rd. Chugiak, AK
Current Property owner(s) Richard & Deanna Cresap Day phone-------..
Mailing address 22135 Aurora Borealis Rd. Chugiak, AK
Real Estate Agent Day phone J
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class _ Well
❑
Public Water System
❑
Waiver/Variance request for:
5
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 550 Waiver Fee $ _
Date of Payment L//9/Z I Date of Payment
Receipt Number 05G2: 111/7 Receipt Number
COSA # O S C a� I 1--/ 7 Waiver #
Distance:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN_ BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS _ Date
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface
conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future ��'�►\
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms. `\ i�r3nEr? »6 pui r .;:�
bedrooms. ' \, �E' -Aor
bedrooms, with the foil
V
By: Vv._ Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist _ X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other _
COSA blue sheet 10-10-12.doc
�g
WP ER,, -SER
By: Vv._ Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist _ X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other _
COSA blue sheet 10-10-12.doc
Legal Description: T15N R1W Sec 9 Lot 60
If more than 1 septic system on lot: COSA Checklist # of _
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 4/12/04
Total depth 64 ft
Cased to 64 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 22 in.
Date of flow test for COSA 3/21/22
Static water level at beginning of test 26 ft.
Comments
B. TANK DATA
Age of tank(s) 18 years
Tank type/material Step/Steel
Measured' operating fluid level in septic tank 42
Standpipes/foundation cleanout per record drawing
Date of pumping 4/18/22
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/13/04
10 ALL standpipes present per record drawing
Total measured depth from grade 6.3 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Parcel ID:
Structure served by this system
051-103-13
Well production at time of test 5.5 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes E No
01 Coliform bacteria is Negative
Nitrate 3.86 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Areterra Consulting
Date of Sample 3/21/22,—
C. LIFT STATION
Required maintenance completed
Age of lift station,, 18-. years
Lift station material Steel
Comments:
Adequacy test date 3/21/22
Results Q Pass For 5 bedrooms
Fluid depth prior to test 0 in
Water added 750 gal
New depth �0 _ in
Elapsed time 10 min
Final fluid depth 0 in
Absorption rate 750+ gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
[0 Yes
if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
ft
Water Main > 10' -
Animal Containment > 50' ® Yes
if No ft
® Yes
if No
ft
ft
Water Service Line > 10'
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
comment below
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No
ft
Property Line > 5'
® Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes
if No
ft
Private Wells > 100'
® Yes if No
ft
Water Main > 10' -
® Yes-
if Nc -
ft
Community Wells > 200'
® Yes if No
ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if
less than required)
Building Foundation > 10'
Yes
' if No
ft.
If absorption field is under driveway comment below
Property. Lihe'> 10'
-0Yes
if No
ft
Wells oil Adjacent Lots.
Water Main > 10'
® Yes
if No
ft
Private Wells? 100'
® Yes if No
ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No
ft
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION ,��►�' Ut'
certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with 49 g3
MOA COSA guidelines in effect on this date.��"'�
COSA Checklist yellow sheet
Lift Stationl'Pump Vault
�\
D
OwnerL/�ky1Street Address
I Septic Tank:
Y/ -
*Sludge level inches -Pumping: required ~PUrO iDgCDDOphetG
Lift station:
~Pump basket cleaned no -Effluent filter cleaned yes no
- --Control floats cleaned Pno' ' °Proper float settings confirmed - -' ' --
-Operation satisfactory ve' no
Alarm System:
-Dedicated 8|ocTi OdviSuo| u|ann inside dwelling
-Alarm system operation satisfactory, not satisfaqtM
1 Manhole Riser
|intrusion waterriserto tank connection es/��\ |
-Ground water intrusion around penetrations
pq
,�DhO|8|}d� Functional |0SQ�abad ~~ Properly
K8Secured (j4) no
ther =
-All manufacturer required inspections and maintenance completed (�5Lno
Signature
Date of maintenance
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