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Home My WebLink AboutT15N R1W SEC 30 LT 72 E2MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211146 PID Number: 051-302-12 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name REICH ABSORPTION FIELD Wide Trench Q Bed El Mound [:1 Deep Trench Site Address 9133 Darby Rd t❑ er Phone Number of Bedrooms Soil Rating Total depth from original grade 8507974849 3 0.8 GPDISF 5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe 4.2 Ft. 0.8 Ft. Subdivision Block Lot T1 5N R1 W SEC 30 LT 72 E2 Fill added above original grade 0 Ft.l (Gravel length 53.5 Ft. Township Range Section Gravel vridth 13.5 Ft,l Beds: Number of Lines 3 Distance between lines 4 Ft. SEPARATION DISTANCES To Septic From Tank Absorption Holding ' Sewer Field Lift Station Tank Line Total absorption area 722 Ft- Number of trenches 1 Dist, between trenches - Ft. Well 100'+ 100'+ na na ria TANK ❑Septic F] S.T,E.P. [IHcicing ❑ Other Manufacturer Capacity Surface beater 100'+ 100'+ na n a Greer 1250 Gal, Material Number of compartments Lot Line10'+ j 10'+ na na NA Plastic 2 Foundation 1 0'+ + 1 0'+ na na LIFT STATION Manufacturer Capacity Remarks Greer 250 Gat, Alarm location Electrical installed by House Installer J R's PIPE MATERIAL House tb tank D3034Tank to D3034 drainrield Drainfield D3034 C01MT D3034 inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspeectiosn 1.7 5127121 211:15/28/21 3"d 41.1 Locationdateand description Deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date +OF A( 444 ='ry�i * :49TH *ft ♦♦�± Steve z s ?tea � 4 6'/3%21+ Septic System r - Approved Date Note: this approval does not include well permit requirements. 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C+ t+ Q O rD O 5 n 1> fTl �D Q n L4: o 0 5 fel 00 cn JI Ul -- CD O A � Q CO +Q n Q np rD O < rD ro �O C+ N C11 N Ul fTl < N (� Q < np ' ` S O c+ N Q 5 O 5 N NP OC) I'D Cilo CD < 3 O 5 � t+ p O O n 1> s Ln 3 O Z' Q5 N -0 C+ FD - :5 5 td rD Q AS -BUILT MEASUREMENTS T1 A 14 54 T2 16 54 MT1 24 56 MT2 33 61 MT3 44 22 MT4 51 33 5-10% 1 Slope New Leachf ielcl w/ 5-107 1 Slope 1,25" Schedule 40 PVC Pressure Distribution -TH MT4 MT2 MTJ. 3.75-11 k New 1250 Callon T2 Deck STEP Tank T1 B Decommissioned Old r3 Bdrm STEP Tank Per UP 9 , Neigh onf (Icts Flat Well 00.0 Flat Slope 10(ic Well 25' BLM & Utility Easement I Flat Slope 0) Ln C5 Uj m No Neighbor Conflicts No Neighbor Conflicts Darby Road NORTHRIM T15N R1W SECTION 30 1// 50' ENGINEERING SteveEng.comRECORD LOT 72 EAST 2 PO Box 770724 Eagle River, Alaska 99577 StM BV CE --B= 6/3/21 WASTEWATER UPGRADE LAYOUT 0 /-) -7 � 0 A -7n'7 E) 7 A N I V / ID C- T-) Date: HEET. r CV I Q En i �w +- o J I 0� O J 3 0Z) w o � QW. w O h o Lq mow O 7 O3mO J W W Yf'; Z. it£'Z£ 0'b t to a CL a 0 0 uj00 U O 0 4 ° 5 G � I I Q I N N I 0 Ln w Q v LO N 0 0 QW. w mow O 7 O3mO uiW W Yf'; Z. it£'Z£ 0'b t N y WLJ CL a 0 0 = z o : �1'K S g QI )ice PA�,-- o: oVA� Iii Q)0* 1--� r ? 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ACL Ems 0`m a mo `o En U y / 73�H21J oi¢�� m rn I I cn v c Y pc 0-5 Qc 02 min —\ • I Z� N N toil ® „ d p �S" L„ •a- A Y I rn N N = J a �- o p p °O 1 to to p Q r '° O .- \ I `nom I ��° Sy° Q I o� CO O rx to h 0- p O z�m A U " Ai CD T' �m O CLGl m p0 O fjI U.0 > CLL I y m of � x ►. ,n I of U L m a m 0 0 �P 3 ® v �` I I Q E C U, m i m.c N I Z I ^II j °— c L'j c E r m o Roj��a� I o 16 s n0 Lo m I o 3 I Q '° ►• 'p N 'p a l m l v mZ c v LaJ �/I I cn (i)'n 0-0 •- •— TQ N c o y `m 0 N 00'00'45"W 330.02' ( x1 "� -�° O't o u 0 3 s m x O (n m►= o c ►. y A p 3 Til 5 > U% 0 0 0't N m om/ C3�C0- 0t 0° j 0 c i 4 -'' I ¢w I I ° rN.rn-cc° J to I I c o p rt' L 4- Q� 1 t,� 0 �� U) -C N I y m �xv cr-I to�x aE c o ° o S O� J V/ Uma m> a 4- T.-msayc s m• - O .00aMIDm "-�p t +- d J — Q 1a.m D 0 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: OSP211146 o S' Department Effective Date: 5/18/2021 Work Type: Septic Upgrade Expiration Date: 5/18/2022 Tax Code Number: 05130212000 Site Legal Address: T1 5N R1 SEC 30 LT 72 E2 G:0654 Site Mailing Address: 19133 DARBY RD, Eagle River Owner: REICH MATTHEW J & ROBIN M Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Q Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy Lot Size in Sq Ft: 54450 Total Bedrooms: 3 ❑ 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 Received By: Date:_5 Issued By: `e.:(`,oD,. Date: MUNICIPALITY OF ANCHORAGE Development Services Department f '; ' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-302-12 Property owner(s) REICH Mailing address 19133 Darby Rd Site address same Day phone 8507974849 Legal description (Sub'd., Block & Lot) T1 5N R1 W SEC 30 LT 72 E2 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: (® all that apply) Absorption Field 0 Septic Tank El Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial ❑ Single Family (SF) 0 Upgrade (w/wo AD U) � Duplex (D) El EllMultiple Dwellings ❑ (SF and/or D) 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 o-Tproperty owner or authorized agent) Permit/Rush Fees:�� Date of Payment: ,�3/z 1 Receipt Number: 0 272 y D Permit No. OS P21 I ( y 6 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 5/12/21 Number of Pages: To: MOA On-Site Services Subject: T15N R1W Section 30 Lot 72 E 2 Septic System Failure The subject septic system has failed- a new STEP will replace the old one. The existing seepage bed will be rebuilt due to no available space. The original test hole monitor tube is present and dry. Please issue a permit so the septic system can be replaced. Please review as soon as possible. This is a large lot with no nearby neighbor conflicts. Elevations below the house are flat; above the house is indicated. If there is need for additional information or clarification please give me a call. Thanks-Steve Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211146, Rebecca Carroll, 05/18/21 � TH IRM FE,ZINEERING SteveEng.com Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211146, Rebecca Carroll, 05/18/21 T15N Rl W Sec 30 L72 E2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3 -bedroom, single family home. Due to limited area, the only space available is the current septic site- it will be rebuilt. A STEP tank/bed is currently in use- tank will be decommissioned per UPC and new STEP tank w/ bed installed. Neighbor lots are served by septic systems and public/private wells; there are no conflicts. The topography slopes from north to south as depicted in drawing. Previous soil tests reveal GM, the monitor tube is still in place & dry. An application rate of 0.8 GPD/FTZ could be used, since this is a bed. Bed Width = 562.5 FT2/13.5' = 42' bed. An oversized bed will be used, matching the existing footprint, 50'x 13.5' bed, 0.5' effective depth. 5' total depth. Previous bed drain -rock & surrounding soil to be excavated. Leveling the bed with MOA -approved sand. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 1250 Gallon STEP tank. MOA -Approved. • 5' minimum between the tank and bed. 10' minimum to property line from bed. • 4' of cover and insulation is required for force main; 2" Minimum thickness for insulation. • Tank & solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1 ' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Bed to be placed level, minimum of 4' to groundwater, 6' to bedrock. • Drain rock to be 1/2" to 2 1/2" screened. Drain rock to be distributed uniformly. • Force main to be 1.25" Schedule 40 PVC or equal. • Distribution pipe to be 1.25" Schedule 40 PVC w/ 1/8" orifice @ 30" on -center. • Silt barrier (filter fabric) to be installed above the drain rock. • Smeared bed must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) 49TH Steve Eng CE -6256 SSG&1?1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211146, Rebecca Carroll, 05/18/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211146, Rebecca Carroll, 05/18/21 Municipality of Anchorage Development Services Department Building Barely DMsion On -Site Water and Wastewaler Program 4700 South Bragaw SI. P.O. Box 196850 Anchorage, AK 995196650 stww.munlmrglonsito 1907)043.790r Soils Log - Percolation Test I Petlormed For: i1 OF y �� t7Ee.: ; TI5N ; J21 KJ Date Pala Legal Description: lgahl f — MaL Township, Range, Secllon: Depth 1 19- 20 - COMMENTS — M44V[—S -4m WAS GROUND WATER vyzT--� ENCOUNTERED? SIF YES,ATN1iAT DEPTH? L ZT4Vtk) TO t`oTr D.pnmwsllrAMr 0 -1b J621Fy NO Monitoring?P� ' 15&t) D.t« 23 �E t Silo Plan rcm,u.nr.urarwrG 1mwhN��d.I TESTRUNBETWEEN t FT • y'v FERC HOLE DIAMETER FT PERFORMED BY: , S Lh 1i�+ee� RTI THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ATE ANO MUNI y ELINES EFFECT ON THIS DATE. DATE: P1 fl,WE , rcm,u.nr.urarwrG 1mwhN��d.I TESTRUNBETWEEN t FT • y'v FERC HOLE DIAMETER FT PERFORMED BY: , S Lh 1i�+ee� RTI THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ATE ANO MUNI y ELINES EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, TeJephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT B.,.e DISTANCES .~/"/";//~ "'"' ~ ~ )/~ ~ ~ SEPTIC ABSORPTION Addre~ TANK FIELD WELL LEGAL OE~CRI~IlON COT LINE ~- Lot I Block p Subdivision ~ ¢ ~ ~/~ FOUNDATION Township, Range, Section AS-BUILT DIAGRAM (Bhow location of well, septic system, propeAy lines, foundation, ~/~ ~/~ ~ ~ driveway, water bodies, etc.) TANKS ~ SEPTIC ~/~,~' ~ HOLDING Manufacturer Capacity in gallo~s TYPE OF SYSTEM ,_ ./~_ ~TRENCH ~ BED ~ W. DRAIN ~OTHER Depth ,o pipe bottom Bom / TotaL depth Bom oPgina, grade / ~'/~ original grade ~ FT ~,J' FT ~'~t, ~ FT ~ /~ ~ ~, ~ S~FT ~- ~ ~ FT ~ /J'~ SQFI ~ ~ ~. ~/~ Installer ~ g ~ Date Instal,ed WELLS ~ PRIVATE ~,~r/~r ~ OTHER (Identify1 FT FT REMARKS: ~// ~/~ /-~ ~ ~ ~ ~ ~/' Inspections Pedormed by: I ~~ cediiy Iha, this inspe.i0n was pedormed acc0rdinD 72-013 (3/85) PERFORMED FOR: LEGAL DESCRIPTION: 4- 5- 6- 7 8- 9- 10- 11 13- 14- 15- 16- 177 19 20- COMMENTS I~ SOILS LOG MUNICIPALITY OF ANCtHOP..a~E DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PR~OTECTION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ PERCOLATION 825 L, Street, Anchorage, Alaska 99501 264-4720 'JUL1 0 i~SgTM SO,LS LOG-.ERCO'AT,ON TEST RECEIVED ~..¢/'~'~ ~.~j'.~,z' -- ,~$~'~-~ DATE PERFORMED: ~R/a~5 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S Gross Net Depth to Net Reading Date Time Time Water Drop PERFORMED BY: 72-008 (6/79) Eagle Rivor Engin~dno Services p, ~3 I~v ??3297 Eagle River, AK 99577 6g~5195 CERTIFIED BY: ,,DATE: Owr~cm W:[L.I.]EAN H, I :1 l I F']~ ,~D 19],:53 DARBY ROAD .~HLJu:~ J: ~..~,.. ~ AK ~ '?~. ~ 7 Day F'lnone: f..~ ? .,~ ~,8 7 1 P a r' c: e 1 :I: cl: 0 5 1 --:]:..";02'.- 1 L.o'L l...ega.l.: Subc!:i. visic~n: - Lot: '7~:~ Bl~cl-.'.: E :1./~ S~c:tion~ ::50 'T'o~n~h~p~ J. DN Lot Size Dzl. 4DO (sc:I. Et,, or ac:res) Max t~edroc~ms~ Th:i,~ Permit: 3 'r'c:)taI Cap~c:~ty~ cal::ia[::ity~ :1.,000 ga:l.].c)ns. !Eac:h septic ):)ept, h to:, tc~p of sep'L:i.c tank (s) < 4,,0 II'~lF!]t:i:l'~l D,:I-i.H,,S:, F:'F,']:OR Tf) 1ST & 2ND ]:!xlSPE~['Y'f']:DIqS BY E:NG]iNEE:R~ AFTt~:R I]I:::'F:' :t: CIE HOUF/I~i~ CAI.,.L 343-'-4681 AND I,.E~:AVlE A I"IIESSAEiIE~ CONS'I'I'~UCT I:::'ER E~I'qGINEIEI'tS DESIGN,, F!'.liS PIE[RIIIT EXI::'IRIES :t.;2/:5:1./EI':? AND VALID F:OR A S]:IqGLIE F:'AMILY HOME. ]]F:' i:.')ED :I;S INSTAI_..IJED ZN 131.4 A ;Et F:'00]' SAND F;' ]: L'I"E:I::;: W]:L.L,. ]: E;Iii:FCI'II:::'Y 't"I"IA'i',~ I'C)P'I:.H []y th~z' !flun:icit::iality o{ Al"lc:hcipage (Iff(IA) ~r'icJ 'Lhe State c:)[ 2.,, I will :insta.l. 1 i'.!ie syst'.em in ac:copdarlce with all MI]A c:od~]s and arid J,n c:clmpliaric:e wi'Eh the desJ. gn cr.J.'Leria o{' 'Lh:i.s perm:it.. :i~;~ :t: ~*~:i.].:l. adlnere to:) aJ.]. M[)A and State (::ri Alaska r~':,cluiremerd'.s t(::n· i:.h('.,) se'h back d i. sta. ncE)s~ [ru:)m any ~:,x :Lst lng we]. ]. ~, v~ast, ewateP d:ispc:~sal ~;~ystem c:P pub l sE~werage system on th:J.s (::~1' any adjacent ch', near'by ].oi:,. · q..,]: understar]d 'Lh,;~i:. i:.his pePmit is valid f'or' a max:i, mum c:l~' :]; bedr'ooms. also understand that the c:apac:ity (::~{ the i:.ota! system :i.s 3 bedrc~(::)ms arid ~i']y el'i].aPgi.:ame[ii:. ~:L]L:[ p~2(;jilJ, r'e an addJ.'LJ, l:/!la:L pE'Ph]J.t,, (Ownem) 1.1,, 'T II,,,.L.~ ~.~ .......................... ~ ................... ................................................... / NEIGH WELL +100' ND WELLS +100' D 89 J 50' 30~E 165,50 ~DECK " ,GAR.'/H[ USE / lO0' APPRDX, WELL LDC, +tO0' APPRBX, CLASS C WELL LDC. +150' C RIGHT DF WAY EXIST]NB LEACH F]ELD NEfF LEACH FIELD CLEANDUT - o SCALE, l" = 40' IWELL AND SEPTIC SITE PLaN LEGAL: T15N, RiW SEC 30, LBT 78B DWNER: TILLFDRD CBNTRACTDR: RASHUSSDN EAGLE RIVER ENGINEERING PB BX 773E94' EAGLE RIVER, AK, 99577 694-5195 SERVICES Louis A. Butera : ~ c~-~7~ REVISION ~1 06/86/89 + NEIGH V/ELL +100' NO WELLS +100' ]3 89 50' 30"E 165,50 DECK GAR,/H[IUSE' 1oo' 1Si ~ APPROX, WELL LOC, +100' APPROX. CLASS C ~ELL LOC, +i50' WELL AND SEPTI'C STTE PLAN RIGHT DF WAY EXISTING LEACH FIELD :::::::: NEW LEACH F[E[_D :;:;:::, CLEANOUT - · SCALD i' = 40' LEGAL~ T15N, Rig/ SEC 30, LOT 72B Og/NER, TILLFORD CONTRACTOR: RASMUSSON EAGLE RIVER ENGINEERING SERVICES PD BX 773894' EAGLE RIVER, AK, 99577 694-5195 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 728, T15N RlW Sec. 30 GENERAL 1. The well and septic plan are for a 2. The drawing and or site plan shall 3. All materials and workmanship shall Health and State Department requirements. single family residence only. be a part of this specification. meet the Anchorage Department of of Environmental Conservation 4. All soil tests are advisory to the design and are to be verified or modified fn the field by the engfineer. 5. All excavations and depths are advisory and are to be verified or modified in the fleld by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. ?. The excavation ls 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 ]fine posJtion and the location o¢ any easements. BED 1. The bed is to follow the natural 'land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed shall be level, plus or minus 1.5" 3. The total depth of the bed excavation is not to exceed 5' at any point. 4. The sewer line is to replace the existing sewer line that leads to the existing pit. 5. ]'he bed gravel frs to be covered with typar fabrfc material. 6. Soil or combination of soil and extruded board insulation to a depth of 4' or equivalent is to be placed over the leachfield. 7. The area ever the bed is to be fJnlsh graded to prevent ponding of surface water munoff. 8. The septic tank and leaohffeld must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH 5' GRAVEL DEPTtt = 6" BED LENGTH = 50' BED WIDTH=' 13.5' Soil Rating = 150 Bedroom Capacity = 3 Septic Tank Size = 1250 INCLUDING LIFT STATION. Absorbtion Area = 6?5 1' SAND FILTER REQUIRED UNDER BED GRAVEL. LIFT STATION REQUIRED. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION SOILS LOG - PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: DATE PERFORMED: LEGAL DESCRIPTION: ~p1/- 7~-,- ~::~ ~-J~'/ /'-~/~'~'~ J'~; ~ SLOPE SITE PLAN 1 2 3 ,~/ ,?.C ~ 4 5 6 7 9 10 WAS GROUND WATER 1 1 ENCOUNTERED? IF YES, AT WHAT DEPTH? 13- 14- 15- 16- 17- 18- 19-, 2O -: $ Y~S L 0 P E ~.;--z / i I FERFORMED EY MUNICIPALITY OF ANCHORAGE VN05%A Development Services Department= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-302-12 Certificate of On -Site Systems Approval Expiration Date: 7- t/ --Z/ 1. GENERAL INFORMATION Complete legal description T1 5N R1 W SEC 30 LT 72 E2 Location (site address) 19133 Darby Rd Current property owner(s) REICH Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 8507974849 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Z Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $2.904 165', Waiver Fee $ Date of Payment '�20 Date of Payment Receipt Number 6 Z Receipt Number COSA # 05G2 113 (`j S Waiver # 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 5/12/21 -.Ar q1 6. DSD SIGNATURE * ; 49-r *�♦f System #1 Approved for bedrooms System #2 Approved for bedrooms f♦ c Steve Eng i Disapproved I` cE-625612122 Conditional approval for bedrooms, with the following siipula`tlons: N -SITE WAT€o G rip—rrr,z WAST-- TATE r_MJ�o AAM �lJ�/JcNrSE V1GE5o `\\� By: Original Certificate Date: 'Z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) 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 vrork. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory .. 1AI-It 1-1_....A J..d--_.. naL__ -. ... Legal Description: T1 5N R1 W SEC 30 LT 72 E2 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled unk Total depth unk ft Cased to 40'+ ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/28/21 Static water level at beginning of test 24.5 ft. Comments I W1ri1Zt:45T_%r_1 Age of tank(s) new years Tank type/material STEPPistc Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA New Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 5 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 Parcel ID: 051-302-12 of Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 3.7 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 5119/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material PIStC Comments: New Greer STEP Adequacy test date new Results R Pass For 3 Fluid depth prior to test 0 Water added gal New depth in Elapsed time min bedrooms is ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: New septic COSA Checklist yellow sheet E SEPARATION DISTANCES From Private Well onLot to: (Please enter distances if less than required cxifcommuniiyvwa| Septic TonhiLUfStation onLot >1OU �jYeo JN$M Community Sewer Manhole/Cleanout > 100' r�Yeu JNuM r7lYeo F�lYes if No Neighboring Tank >1O8' 21 Yes ifNoM Yen Private Sewer/Septic Line 25,[-1lYes if No Absorption Field VnLot >1OQ' E] Yes ifNo8 Yes Holding Tank >1O8' Yes if No Neighboring Absorption Fields > 100' Yes |fNoft Animal Containment �5U' Yes if No Yoa |[Nn0 Manure/Animal Excreta, Storage 1OO' Community Sewer Main >�75' Yeo i[NoM f-,/�Yes if No From Septic/Holding Tank unLot to: (Please enter distances if less than required) Building Foundations >10' Yes ifNoM Surface Water >10I M R/ Yes if No ft _ Property Line > 5^ �jYeo JN$M ifNO0 Wells onAdjacent Lots: Absorption Field >5' r7lYeo ifNuM Yeo Private Wells >1DO' Yes if No. Water Main >1O' Yen ifNoft Community Wells >2D0' Yes if No. Water Service Line >10' Yes ifNnft Surface VVator>�1U0' |fseptic tank isunder driveway comment below From Absorption Field onLot to: (Please enter distances ifless than required) Building Foundation >10' Yea ifNoft |fabsorption field iounder driveway comment below Property Line >10' 2] Yes ifNO0 Wells 0nAdjacent Lots: Water Main > 10' Yeo JNoD Private Wells �>1OU' Water Service Line >1n' Yes ifNoM Community Wells >2OO' Surface VVator>�1U0' Yes |fNoft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION /certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MCACOSA guidelinesineffect onthis date. M M 2] Yes ifNoft El Yes if No ft