HomeMy WebLinkAboutT15N R1W SEC 30 LT 46AT15N R1W
Sec 30
Lot 46A
#051-293-45
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201336 PID Number: 051-293-45
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
PETER & ANNE STANLEY
ABSORPTION FIELD -ADVANTEX
❑ Deep Trench ❑ Wide Trench ® Bed ❑ Mound
Site Address
15870 S BIRCHWOOD LOOP, CHUGIAK
❑ Other
Phone
Number o f Bedrooms
Soil Rating
Total depth from original grade
4
3 GPD/SF
5.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
46A
Fill added above original grade
VARIES 0.42 — 0.92 +/- Ft.
Gravel length
22 Ft.
Township Range Section
15N 1W 30
Gravel width
10 Ft.
Beds: Number of Lines
2
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
220 Ft2
--
-- Ft.
Well
50'+
50'+
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX
Manufacturer
ORENCO / ANCH. TANK
Capacity
1500 Gal.
Surface water
50'+
50'+
Material
FIBERGLASS
Number of compartments
2
Lot Line
5'+
101+
NA
Foundation
10'+
10'+
LIFT STATION
Manufacturer
ORENCO
Capacity
1500 Gal.
Remarks Original system decommissioned per code.
Alarm location
HALF BASEMENT
Electrical installed by
POWER LIGHT &
CONTROL
k to 3034
PIPE MATERIAL House to tank 3034 Tandra
Installer NORTHERN EXCAVATION
n
Drainfield 3034 CO/MT 3034
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
InspectionV 9/24/2020 9/25/2020
Location and description
2nd
3`d 9/25/2020 4t' 9/30/2020
BOTTOM OF SIDING
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Conditional Approval: Date
co
... .... ....•...
�� • '. • •:
Curtis Huffman
tic
pro ed
Approved
-
ppLX Date 1 5 b4AZ0
�Fc•. CE 128991 c`4
is�F�•
10/1/202p.•4P``'
� PROFEWQO
-
Note: this approval does not include well permit requirements.
-'
(Rev uoiuzi iu)
PID: 051-293-45
PERMIT: OSP201336
MIDWAY L1B & L2 WELL 0
VERIFIED / STAKED
PRIOR TO CONST.
200'+ AWAY.
200' WELL RADIUS
J L
MT • MT
COs COs K 50' WELL RADIUS
MT
Q0MTG M TH20-1
0)
N
CARPORT
E
F oco INSTALLED NEW
1500 -GAL
A—C=33.3' MH AX -20 FAP APPORX. LOC.
B -C=7 3' OF LOCATED
A—D=55.5' MH D CID WATER LINE \
B—D=317' o
A—E=62.7' I I FCO B A
SCALES 1' = 3
B—E=40.5'
A—F=62 2'
B — F = 41 O6' `DCO
A — G = 81 8' FCO 98.50 MH MH 98'54 / 95'21 FINAL GRADE 94.71
B—=78,9' G AX20 POD ORIGINAL GRADE 94.29
A—H=82.6' 20' INSUL.
ORG/OL
B—H=80.3' FILL
5.83 89.79 NEW BED 9.79
A — I = 8 7.5' 94.49 1500—GAL FAP5.5'
B — I — 8 5 3'
AD
DTANK X 89.29 2 MOA SAND 9'29 GM/SM
A— J= 8 8 7' 87.29 GRND.WTR.
B—J=861' 90.03 0.03 �® 9'
85.29)
A -K=85 0' 12' 9/24/20
SEPTIC SECTION BOH
B—K=87.8' 92.29 TH20-1
SCALE: NTS
A—L=86 5'
B—L=89.8 SUPPORT T15N R1 W SEC 30 LOT 46A � SERVICES:
A—M=78.4' OF �\ �
B—M-82.1' PREPARED FOR:
A—N-80,3' PETER & ANNE STANLEY
B—N-83,3' 15870 S BIRCHWOOD LOOP ROAD re. 41
Ng TH�
CHUGIAK, AK 99567
FIRST WATER CONSULTINGc't�j��
DATE: 9/29/2020
2020
rtis Huffman
SURVEY: JLC
13030 SUES WAY 1 �� CE 128991 04" AW
DRAWN: 91291
2020e W
ANCHORAGE, AK 99516 1 t
907-350-9566 firstwaterAK@gmail.com SCALE: 1" = 30' '-w
907-350-9566
9/4/2020
MUNICIPALITY OF ANCHORAGE
Development Services Department 7 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-293-45
Property owner(s) PETER & ANNE STANLEY Day phone 201-931-6002
Mailing address 15870 S BIRCHWOOD LOOP,.CHUGIAK, AK 99567
Site address 15870 S BIRCHWOOD LOOP, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section) T1 5N R1 W SEC 30 LOT 46A
Lot Size 48807 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
0
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
Upgrade 0
(D) El
Holding Tank
❑
Renewal ElDuplex
Multiple Dwellings ❑
Privy
❑
(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: � H 4 L'
Date of Payment: "� ��-2.�
Receipt Number: 2.3�
Permit No. Q,o"133(P
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350 -9566 / firstwaterAK@gmail.com
August 24, 2020
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: T15N R1W SEC 30 LOT 46A
The property owner has requested we obtain a permit to upgrade the failed septic system of the
above referenced lot. We propose to install one 10x20 bed with 2 sand filter and 1500-gallon
AX-20 tank to serve the existing 4-bedroom residence. The design is based on the recent test
hole conducted on August 7, 2020. Groundwater was observed at test hole excavation and at
monitoring as noted.
The slopes are moderate at 3-7% at the proposed upgrade location. The lot and area are served
by private water. The design will not impact any of the neighboring properties. Please contact
us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201336, Rebecca Carroll, 09/03/20
FIRST WATER CONSULTING
T15N R1W SEC 30 LOT 46A
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201336, Rebecca Carroll, 09/03/20
FIRST WATER CONSULTING
T15N R1W SEC 30 LOT 46A
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201336, Rebecca Carroll, 09/03/20
4661
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350 -9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: T15N R1W SEC30 LOT 46A
PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 8/24/2020
DEPTH
FEET
OG
SOILS
1
ORG/OL
2
3
4
FILL
5
6
7
8
GM/SM
9
10
11
12
13
BOH
14
15
16
17
18
19
20
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
8/7/20 30 min 6 3 3/16
30 min 6 3 4/16
30 min 6 3 3/16
PERCOLATION RATE 10 (MIN / INCH)
TEST RUN BEWTWEEN 6 & 7 FT
PERC HOLE DIAMETER 6
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
GROUND WATER ENCOUNTERED: YES
IF YES, AT WHAT DEPTH: 10
DEPTH TO WATER AT MONITORING: 9
DATE: 8/21/2020
TESTHOLE # 20-1 DATE PERFORMED: 8/7/2020
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
PERFORMED FOR: PETER STAHLEY
8/24/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201336, Rebecca Carroll, 09/03/20
(rev. 05/18/2018) Page 1 of 3
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the “AGREEMENT" made and
entered into as of this ______ Day of ________________ of 20____, by and between
_________________________________, herein the “OWNER,” and the Municipality of
Anchorage, herein the “MUNICIPALITY”, in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as _____________________________________________________________
located at (legal description)
_______________________________________________________________________
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
____ Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer’s representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment’s approval for operation in the Municipality.
____ It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
____ Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer’s representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
____ Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
Peter A Stahley &Anne V Stahley
AUGUST 20
15870 SOUTH BIRCHWOOD LOOP ROAD, CHUGIAK, AK
T15N R1W SEC 30 LT 46A
27th
(rev. 05/18/2018) Page 2 of 3
____ Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer’s representative or maintenance provider.
____ Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
____ Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
____ Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On-Site Systems Approval.
____ Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner’s AWWTS.
____ Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
OWNER:
By:
(signature)
Peter A Stahley Anne V Stahley(print name)
STATE OF -A�A-SKA Florida 9 )
) ss.
THIRD JUDICIAL DISTRICT Pinellas )
Date: 08/28/2020
The foregoing instrument was acknowledged before me this 28 day of August
2020 , by Peter StahleV Anne Stahley
Sophie Schuh /yam 3,,�Pa°v"°a°�a,� SOPHIE SCHUH
- o ,"'v Notary Public • State of Florida
NOTARY PUBLIC FOR A—LA-SKA- Florida ry//�) _'_ °i=
<�= Commission # GG 335192
09/15/2023
My Commission expires: Expires on September ls, 2oz3
/Pef FSO \�
/gipPP4\W
Notarized online using audio -video communication
MUNICIPALITY:
By: 1��_tol_C9_,_�9_(signature) Date: o20 b
�eb C e Ck C9A_ V` o [ � (print name) Title:
(rev. 05/18/2018) Page 3 of 3
'-1
WE SERVE ALL ALASKA
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
0
r
C
4\
va
•r,
co
0
0
cc.)
a
DEPTH OF WELL
0 0
STATIC LEVEL OF WATER FT
z
1-4
GALS. PER HR
KIND OF CASING
0
X
0
s,
(0
CO
c
N
L^�
H
qa
d
DATE - STARTED
DATE - ENDED
KIND OF FORMATION:
FI U NI I o=_ I'—fl_ I —f '-e OFT Fi N C: Fl F° Ffi O EE
DEPARTMENT ur HEALTH AND ENVIRONMENTAL I ,^OTECTION
825 'L' STREET: ANCHORAGE: FIK. 99501
264-4720
FuEEFA-4 TIF
PERMIT Ni r 810020 )
APPLICANT ?IRGINIA L. K.EKONI
LOCATION
LEGAL TION R1W 5 30 LOT 46A
ST RT BOX: 510 99567
6:9-2955
LOT SIZE 45000 SQUARE FEET
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON—SITE SEWAGE DISPOSAL. SYSTEM I
100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUE:LIC HELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET FIND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE_ TO INSURE PROPER INSTALLATION.
1E=: eF" I Ft:Ew. C, 'lvF=1*IEsE v:
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE _EWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INETALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
SIGNED:
APPLICANT 'VIRGINIA L. K.EK:ONI
ISSUED BY DATE_ ra �.1_ V4. 0
L &Aid
,MUNICIPALITY OF ANCHORAGE r--.
•
Department( Health and Environmentai Irotection
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AAN-D- R "" "'i=Cr:;eg PERMIT
Applicant: U'trenIa. L• Ke oln
Location: S• a -'G/ t2S C9e10 Liyor
Legal Description: i) CN VZ 1 W S. 3a
Mailing Address: 5 R /SU-tG 6-70 C(Oa . /sl('
Phone Number:
(ata>,-c).PSG
Lot Size: % Yc( HCYe._
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: j5 Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH LENGTH GRAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* *
REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS * as
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* # * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 u 1 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
t residence i remodeled to include more that 3 bedrooms.
Signed: Issued by: )621:44.07
Appl ,Gant
SWP/024(1/81)
Date:
GRE, ER ANCHORAGE AREA BOk.AiGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
64/2
��rl /
INSPECTION REPORT ON-SITE CS�EWAGE DISPOSAL SYSTEM
�42Ge_S I� J iisrC��l/v(LING ADDRESS J�2,57 4: °� C�PKONE °-4' S
NAME // / /�L j /�,,
LOCATIONS'" 0tez d 1 %OP LEGAL DESCRIPTION) 961 ` e'- ci ' I '0 R t '" �, %
SEPTIC TANK:
DISTANCE /`
FROM WELL /Q / MANUFACTURER CQe p MATERIALS Vie/
INSIDE LENGTH
TILE DRAIN FIELD:
NUMBER OF
COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -4 ALLONS.
TOTAL LENGTH I�
DISTANCE FROM WELL DQ T UNDATION 3 2 /NEAREST LOT LINE 0 OF LINES S,C�o
NUMBER OF LINES
C
DISTANCE BETWEEN LINES
TRENCH WIDTH g‘ IN TOTAL EFFECTIVE
,,C%
ABSORPTION AREA `5 6 6/WESQ FT LENGTH OF EACH LINE L� '�
•
DEPTH OF FILTER 7 -2 -IN
DEPTH: TOP OF TILE TO FINISH GRADE / ATERIAL BENEATH TILE ABOVE TILE IN
WELL: /
TYPE6 5JS /'� /
BUILDING
FOUNDATION
CONSTRUCTION _ 9 Gv Q DEPTH DISTANCE FROM:
NEAREST
LOT LINE
NEAREST SEPTIC SEEPAGE
SEWER LINE , TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
REMARKS
DISTANCES: `-
/N
f--rtjjGLiri
INSTALLED BY:
SEWER LINE DEPTH:
chtkl-
o4-r I' 0
t
DIAGRAM OF SYSTEM
0'
PIPE MATERIAL-
e
LOT SLOPE: '---J1+'1�vvue�
REMARKS!
Form EQ -032
t
4'
DATEr-71 APPROVED
G.A.A.B.
IDIULUN1 I'S AT FP L I: I-ke VAL: FA�����
DEPARTMENT OF HEALTH AND ENVIRONMENTHL/pROTECTION
2516 E/ UDOR PP�, HNCHURH/i�. RK �w/
276-2221
�� �_ ��� �������
��� ����� �������� ���x^n�
76665 }
-^'
r�RMIT NO.
(
APPLICANT CHHRLESD KEKUNl
• LOCATION SOUTH 8IRCHWDDD LOOP
LEGAL • L46 SEC 30 T15N R1M SM
SRH BOX 505 CHUGIAK
688-2856
LOT SIZE 54284 SQUARE FEET
TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS - 4 SOIL RATING (SQ FT/BR)= 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
�FF,'1E == 11 U EDN I VA == °ER EF1 uifl'Fl. CA= F> -IF VA=
|HE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHlNF7ELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THF GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
�i1ECO_NID,REEIE:0 ���-FIC MFOlica-c. �1„,cf1=.:=-
c:2:5fl FRIRTE �EOLVER:F.DDI
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PR0sFOATION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM
100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL
• SPEClFICHTIVNS AND CDmSTRUCT7ON DIHGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
IS
�11=1,-vr1 -r TD, . C. 0 knE:_Vqrc tR CHM :=JLIPEL7..
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS As SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 7 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
slANFD:
APPLICANT CHHRLESD KEKONI
ISSUED BY_
•
ate.{,,.:.....-
@onsiruction &Jest of ab
"ONE TEST IS WORTH A THOUSAND OPINIONS
3919 SPENARD ROAD, SUITE A • ANCHORAGE. ALASKA 99503 • 277-0231
August 18, 1975
B. V. Lounsbury &-Associates
723 West Sixth Avenue
Anchorage, Alaska 99501
Re: Required GAAB Soils Test for on-site sewage
system for Chuck Kekoni on Lot 46, Sec. 30
T15N, R1W, SM
Attention: Mr. Darl Kvasager
Dear Darl:
As per your request, we have excavated test holes on
the referenced Project.
Test hole 41 was located to the North at the toe of the
fill slope for the homesite. Test hole #2 was located
to the South East oftheproposed homesite at a slightly
higher elevation. We recommend placing the on-site sewage
system in the vicinity of test hole 42 due to the better
soil conditions in that location.
If you have any questions, please contact our office.
Very truly yours,
CONSTRUCTION TEST LAB
James D. Mack
Laboratory Manager
JDM/dt
Perforreu for
Legal Description:
This fora reports: Soils Inc,
Department of ❑nvironmenial i4,.ality
3330 "C" Street
Anchorage, Alaska 99503
•
SO{I,S LOCI - PEROLATION TEST
e es/ Date Performed 8//,3/7_
2.oT 6 --S ec 3o z a &iJs' S/!?
„ Percolation test
Depth
Feet
5 -
0
Fes T Hoze W.2
R xl-YEL PeL L
Coarse Stetidy Cr»ueL
CGP — 6w)
7 - Ley
6,ien DEL.
(Gm- 6c)
12 -'--` �--
13 /
14
Was ground water encouuntered?EDR^"
B -D Roc g
Reading Date Gross Time
i tool) Good
If yes, at what depth?
Net Time
/2
Depth to Water
Net Drop
Percolation rate Uraii Field
-Proposed installatSofT Seepage Pit —
Depth of inlet Depth to bottom off pit r trench � �
COMMENTS BSSS¢-F_1 DI26iyy — -
�;_ J �1 _ Cert9fi:a�U
Per`cM,ed 3 - ed By
Date:
i
L_
tom
If
'
i tool) Good
If yes, at what depth?
Net Time
/2
Depth to Water
Net Drop
Percolation rate Uraii Field
-Proposed installatSofT Seepage Pit —
Depth of inlet Depth to bottom off pit r trench � �
COMMENTS BSSS¢-F_1 DI26iyy — -
�;_ J �1 _ Cert9fi:a�U
Per`cM,ed 3 - ed By
Date:
r-
URLAILK Niuniml1uL IJ., -1: t,l,
Department of. Environmental t4uality
3330 "C" Street
Anchorage, Alaska 99503
t� SOILS Loc: - PEROLATION TESTlt
Performed for .e 04), Date Performed S//5/'75
Legal Description: _Cor i, J C 321 7-/';-N R_,C/C1/ t22
This form reports: Soils _Corti,
- / - Percolation test
Depth Test Wok /
Feet
1-
GR4uE . P,L L
2-
3 _ OR 6Aw/c TO/O o7L.
PT- rn
s _ ,Sd7it0Y GRA on.
(-6P --Gm)
II _ AS -
6 -770 s,i,f
9 Ga.• -
10 - S�
3beter/6t/Oa t
11 -
12 -
13 -
14 -
ope
Was ground water encountered? td) yes, at what depth?
Tie
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
S
.rS
p
I
An
4
ISM
r
S,
i
inL
3beter/6t/Oa t
11 -
12 -
13 -
14 -
ope
Was ground water encountered? td) yes, at what depth?
Tie
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
Percolation rate minute. Oral) Field
•Proposed installation: Seepage Pit _
Depth of Inlet _ Depth tobottom of pit or trench
co,; EUTs: ia.—_,5.Ce.pT p&%/SIA a sR60 2Q l3..E.a.0w4.'-.
f Ori -11--_5 I A e
Performed
T4F5 r� the
Pooh so S
484Z00110
ash y-`
G.r ,oF
0'96 z
IPm
,II
W
,hl
COSA Checklist
Legal Description: T15N R1W SEC 30 LOT 46A Parcel ID: 051-293-45
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 5/1981
Total depth 305 ft
Cased to 40+ ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 6/24/2020
Static water level at beginning of test 201 ft.
Well production at time of test 1.5 gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 1.45 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by & SULLIVAN
Date of Sample: 8/20/2020 & 9/24/2020
Comments
B. TANK DATA
Age of tank(s) 0 years
Tank type/material ADVANTEX / FIBERGLASS
Measured operating fluid level in septic tank *NA
Standpipes/foundation cleanout per record drawing
Date of pumping *NA
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments: *NEW TANK
D. ABSORPTION FIELD DATA
Which system tested (date installed) NEW SYSTEM
ALL standpipes present per record drawing
Total measured depth from grade 5.9 ft (max)
Measured depth to pipe invert from grade 5.4 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
Adequacy test date NEW SYSTEM
Results Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies:
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 *50+ ft
Neighboring Tank > 100’ Yes if No
ft
Absorption Field on Lot > 100’ Yes if No *50+ 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
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ 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 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
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
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S COMMENTS
*ADVANTEX SYSTEM.
G. ENGINEER’S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
9/28/2020
AN ADVANTEX SYSTEM
T15N R1W SEC 30 LOT 46A (15870 S BIRCHWOOD LOOP ROAD)
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 1 - 3 -E j
Expiration Date: // ! ,S
1. GENERAL INFORMATION
Complete legal description I Ey-' g [ 4x )12 tet £bA-
Location (site addrets) tc t5 re, 4e grat(co7 L'f>
Current f xoperty owner(t) 'rf-C.✓AR 17 Sff4wt 5
o
g, Mailing address a, C ?o ,r3LRCt4 P
(2eal'Estate Age9nt 5 Day phone
2. OF DWEWNpi
da Stn iFita y (w/wo ADU)
Duplex
0 Multiple Dwellings (Single Family and/or Duplex)
ter
Day phone
a1
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER D
Individual Well g Individual Ar
Individual Water Storage ❑ Holding Tank 0
Community Class Well ❑ Community 0
Public Water System 0 Public Sewer ❑
WaiverNariance request for:
Distance:
Received by.
A/
COSH to be rel aseengineer, unless otherwise requested by the engineer.
Date: S7/9W I5-
COSA Fee $ ea • `sem
Date of Payment 2!.,7 -S -la
Receipt Number a'nco27
COSA# 01-151cifa
Waiver Fee $
Date of Payment
Receipt Number
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.
Name of Firm Gig fe'b se ,,.uG
Address 7 4f0 r 22*42 13,4y tart
Engineer's Printed Name Clfi t -4—S l34—L2}1wO
6. DSD SIGNATURE , %/
System #1 Approved for T bedrooms
System #2 Approved for _ bedrooms
Disapproved
Conditional approval for
By:
Phone 1511 '555(
Date "2` 5`=�� ;,
,710
. r,,:
.•s,f g
•. 49rµ
l}... -' . ki f.,., SII
le �AtatigsficRalzariOW
M / i
r
4.
Q o.
�� lima
bedrooms, with the following stipulations:
‘s. TY OFa,
ON-SITE
WATER AND m�
:" WASTEWATER 2
y SRAM yrs
`
etACic
r ♦ Original Certificate Date: d-2 "i5
The fetrrniclpali of grrtpfirage Development Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only
upon the represen ions 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 r '• '. c
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: 115 N 39 140.7- tom¢
Parcel ID
051 ~2113
A. WELL DATA
Well type 6` e)n If A, B, or C provide PWSID # Well Log l) O$
Date completed 51/4"1 Sanitary seal 40/N)).Wires properly protected a/N)Yr5
Total depth 3a5 ft. Cased to +'E4 ft. Casing height (above ground) IS i
-,-
FROM WELL LOG ATINSPECTION
Ap•
Date of test . if fi O �D1/2/%
StatiCwaterlevel 2475 ft.
Well,production f° r
WATER SAMPLE RESULTS:
Coliform Angtolonies/100 mL Nitrate 34�g4�q �m�,g,/L
Arsenic 4.10 ug/L Date of sample: /�'j
-1/41276
alief ft.
"F to g.p.m.
Collected by: (.1 iJ f }l ZftP-3-
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material,ia
�pr
C /ctciz Date installed VI/ 76
Tank size '{ gal. Number of Compartments 2' Cleanouts®/N) it5j
Foundation cleanout 94Y65
Depression over tank (YO N0 High water alarm (Y(9 A49
Date of pumping 3/f1//7 Pumper 9"i-7RAy
C. ABSORPTION FIELD DATA
Date installed 4'%lhl` Soil rating (q.p.flt—Z or ft2/bdrm) 1) 5
f
titt�rsrasp
System type
r`NCy
r, lA q
Length es Width 3 ft. Gravel below pipe •/ ft.
Total 4114 ..•� J4t. Eft" aption area CJS ft2 Monitoring tube Depression over field N
Date �f adequficy test' • Results aCiV
Fail)7175 $oo 1 For 9 /bedrooms
Fluida l irfhAliepr�}i field•bef test 0 in. Water added gal. New deptly,�j in.
s R'c•.!7gg7 ;
D. LIFT STATION
Date installed Size in gallon Manhole/Acce (Y/N)
"Pump on" level at in. "Pump off" I el at in. High water rm level at_
Datum Cycles test Meets alar circuit requiremen
IVa L..z.'F'r
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot
(00
' Absorption field on lot 4 (Do
Public sewer main `'F leaf
Sewer/septic service line in
Animal containment areas 'FIB.
e
SEPTIC/HOLDING TANK ON LOT TO:
i
Building foundation 'E 5 Property line t5
Water main +(r Water service line
Wells on adjacent lots *Me
i
ABSORPTION FIELD ON LOT TO:
Property line 4 to Building foundation re/
On adjacent lots 'e6
i
On adjacent lots '} (.B®
Public sewer manhole/cleanout 'l' St& 1
Holding tank + `Z 5
Manure/animal excrete storage areas 40
Absorption field i
s r
4 (0 Surface water 4 1029
Water main "E (0
Water Service line 1-2 Surface water �m Driveway, parking/vehicle storage +5'
jrne-
Curtain drain "E lB Wells on adjacent lots E r,.
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name rd/f-W2
Date
(o-5(45
COSA yellow sheet_2-6-15.doc
•
SOUTH`/ g%eCNWOO'J LOOP ,C07 D
U5.59° F9'35 "5, i sd (M.)
690391/0' E ,64.72 CR-)
"9
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date /C--57--62,c-
(a)
C-_57"-62,c-
(a) Legal Description (include lot, block, subdivision, section, township, range)
'55 Sec 50 %SAJ /F w
Location (address or directions)
// � 333-8057 278.763/
(b) Applicants Name U/7/fl`k s'(�P/;((�,u/ Telephone m Home Business
c ens -
Applicants Address 3334 Zee S/ ?7-5-0
tavatessaaszta
(c) Applicant is (check �one) Lending Institution ; Owner/bxlez
Buyer ; Other f 6 (explain);
(d) Lending Institution ca /moi e/�y��%,)-G-erf/Tele
ll./hone ' /7 V
ity4 2e✓ "�//!/C,` \J[mac ie
Address
/7 9 7 ke( 5S/d l SS
(e) Real Rstate Co. & Agent
Address
Telephone
`F ?3-70
l- u%?
(f) HAA to the following address:
0 ss d' E4^114E213,1NC
e. siLr Idl a ',e,.
604.29M
2. Type of Residence
Single -Family Multi-Familyni Other (describe)
Number of Bedrooms
3. Water Suppl
Individual Weil Community
Public
Note: If community well system, mtlat have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite727T Public' ( Community Holding Tank [
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
5. En;ineerin; Firm Providin; Ins.ections, Tests, File Search Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, 1
verify that my investigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
Address
Date
6. DHEP Approval
Approved for bedrooms By
Approved Disapproved fr
Terms of nditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
RR4/ej/D18
(Page 2 of 2]
(DHEP SEAL)
7-19-84
A. WELL DATA
Well Classification
Well Log Present
Total Depth :50S -
Static Water Level
Casing Height Above Ground
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
.I 50
Legal Description:
T/sP 2 /GAJ
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
JACK 2 4 1985
eiaak
If A, B, or C, D.E.C. Approved(Y/N)
leted 5t/B/ Yield
7` o.s Dep of Grouting "—
Date Co
Cased to T"'
Z 9r ' Pump Set At CC
Sanitary Seal on Casing (Y )
Electrical Wiring in Conduit Q Depression Around Wellhead
Separation Distances from Well:
To Septic/110±dingSank on Lot mr/ On Adjoining Lots /DO /
/`7 ' ; On Adjoining Lots /e) ?
To Nearest Public Sewer q�
Cleancut/Manhole P (�/� f To Nearest Sewer Service3/42196--
Water
Line on Lot ir4 "2
Water Sample Collected By SJ1�s' '7-1 /A ; Date `/ / 2d/SLC
Water Sample Test Results .5',1 7/ . r ,° c Z�+�- ///
Ccoments e -M? Ac/ire J sof /epf9/L a ez-1 �✓ time
O L O &Je (1 Dn r2 t ea ma/OR 7V / f 76 /S O .c) t--42 -r 4L 6,6
41A/0 a.,e Nb"t S' ,e,ce ekfl- La -
B. SEPTIC/HOLDING TANK DATA
Date Installed /776
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line it /A
Standpipes
Depression over Tank (F;
Pumping/Maintenance Contract on
File (Y
,t
Holding Tank High -Water Alarm (YA
(
Size /250
No. of Compartments Z
Air -tight Caps !F' ) Foundation Cleanout /N)
/// 29/Yr
Date Las`tfl it d
%i ; for .��
Temporary Holding Tank Permit (Y77/-
Separation Distances from Septic/ILlding Tank:
To Water -Supply Well /6 7 r
To Property Line /D
To Water Male/Service Lire
To Building Foundation 30
To Disposal Field
/0
To Stream, Pond, Lake, or Major Drainage
Course AS 01.fF-
Comments 0:c). c B,J fiche Tait k feeen'ner/_
Receipt # 8aacea1/4.1
Date Paid: 1-a44•g5
Amount: 541-q-
2-15-84
4=
[Page 1 of 2]
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorp iontrata
Date Installed 9/ 76
Type of System Design ke!?ch
ngth of Field 4,1 G
Width of Field 3 6 w Depth of Field AP'
(c) (4)rave,.l Bed Thickness
Square Feet of Absorptim Area S00 5s2-st! Standpipes Present j7/N)
Depression over Field
Results of Last Adequacy Test ...„5 -775,r -44:72,-,e_.7
Separation Distance frcn Absorption Field:
To Water -Supply hbll /19 (
To Building Foundation
Lot /!O )-fez ; On Adjoining Lots
Date of Last Adequacy Test
To Property Line /0 T
To Existing or Abandoned System an
5,9-74
To Water /Service Line / f To Cutbank(if
To Stream/Pond/Lake/or Major Drainage Course
present)
itf Af re
To Driveway, Parking Area, or Vehicle Storage Area
CLaients
/0
D. LIFT STATION
**
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Cutuents
Dimensions
Manj'iole /Access (Y/N)
vel at
nt (Y/N)
Pumping Cycles during Adequacy Test.
Meets MOA
Check Permitted Pedroan Rating Against HAA Request **
I certify that I have checked, verified,
on the date of this inspection.
Signed
Company
KB1/d5/s
8 &ENGINER H[NQ
onoc. L11,8 AVER. ALASKA , 9577
PH, €01 V073
[Page 2 of 2]
or conformed to all MQA..HAA Guidelines in effect
Date /--2Z—ECS—
MOA
--27.-Ejs`
MOA No.
2-15-84