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HomeMy WebLinkAboutTHUNDERBRUSH LT 5Onsite File Thunderbrush Lot 5 #015-142-66 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211252 PID Number: 015-142-66 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name DAPHNE ANN MUCKEY ABSORPTION FIELD - ADVANTEX ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 11411 THUNDERBRUSH, ANCHORAGE ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4' 2 GPD/SF 7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2 Ft. Gravel depth beneath pipe 5 Ft. Subdivision Block Lot THUNDERBRUSH 5 Fill added above original grade VARIES 1.1-2.3 Ft. Gravel length 30 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 300 Ft2 1 -- Ft. Well 50'+ 50'+- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding IZI Other ADVANTEX Manufacturer ORENCO / GREER Capacity 1500 Gal. Surface Water 50'+ 50'+ Material Number of compartments Lot Line 5'+ 5'+ NA HDPE 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer ORENCO Capacity 1500 Gal. Remarks DIVERTER TO EXISTING FIELD. Alarm location BASEMENT Electrical installed by CAPSTONE Installer BCI PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 Co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection 1s' 10/14/2021 end 10/21/2021 Location and description 3`d 10/21/2021 4`h 10/22/21 CEMENT LANDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date 49 7H ....�:* • • • • • • • • • •V• Septic System., A rove / pp t✓� '• Curtis Huffman / �'F�, I 2 �21 • CE 128991 Date �� 11/20/2 1. .•�R r pROFESSIQ0 Note: this approval does not include well permit requirements. ,, _ v vii iv, PERMIT: OSP211252 PID: 015-142-66 C r THUNDERBRUSH CIRCLE MT MT CO 97.93 AX20 POD 97.90 107.15 FINAL GRADE 102 32 MH MH MH 100.07 TH21_1 ORIGINAL GRADE f FILTER FABRIC GRG/OL A — D=16, 2' INSULATION 1.5' B—D=19,8' 97.88 91.52 8.07 98.07 Gm A—E=15,8' 90.18 SEWER ROCK/ 7500 -GAL 9307 93.07 . B—E=25,7' HDPE TANK PUMP NO GRND.wm. BASIN 6/28/21 k A—F=16,5' 2' MOA SAND 10/21/21 B—F=33,5' 14' B-6=23,3' NOTE:ANOMALY SEEP FOUND SEPTIC SECTION 16 BOHW IN NW CORNER OF FIELD AT 9'. C—G=43,5 INSTALLED 2' OF MOA SAND. SCALE, NTS 84.07 INGB—H=32,9' 110'SOF FIELD 1& DRY AWASTn1I6'. C—H=25,1' THUNDERBRUSH LOT 5 SUPPORT®SERVICES: PREPARED FOR: ��� OF �� ^ DAPHNE ANN MUCKEY �� 11411 THUNDERBRUSH CIRCLE C * 9 T1 ANCHORAGE, AK 99516 FIRSTWATER CONSULTING 13030 Sues WayDATE: 11/20/2021 tis Huffman '4: SURVEY: JLS 2021 CE 128991 vA Anchorage, Alaska 99516 DRAWN: FWCS 11/20/20210P,, (907)350-9566 SCALE: 1" = 20' 1 X "ftss1010 AV firstwaterAK©gmail.com Al�- a CONK /} D/W THUNDERBRUSH CIRCLE N 90'00'00" W EXISTING o o M HOUSE M GRAVEL D/W N85 -34029"E ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: THUNDERBRUSH SUBDIVISION LOT 5 PLAT 70-304 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATESCALF- E—MAIL DEC 8, 2021 1"=20' schWierftk.net 21-067-1 ORA'M+ Sr.CHECKED BY MD NUMBER: BOOK AOE JLS SW2637 210375 LOT 5 a z SEPTIC o a VENT _ (tYp) 0 116.55' ® = FND 5/8" REBAR � .. OF A.Z �i . ........ ........ .. ...... L. SCHULLER.: � LS -10408 ®' ii %� fessionot t 8.2' 8.2' O o O N W O O F- V) w F- 0 O 00 0 O HED o Z 6.0' SHED) N 20.2' X I 'p� ',p ADL NDR��� 41 U o C tt1 C'� 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax 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: OSP211252 Work Type: Septic Upgrade Tax Code Number: 01514266000 Site Legal Address: THUNDERBRUSH LT 5 G:2637 Site Mailing Address: 11411 THUNDERBRUSH CIR, Anchorage Owner: MUCKEY DAPHNE ANN Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: 1_ Department 7/7/2021 7/7/2022 Lot Size in Sq Ft: 15463 Total Bedrooms: K y — -- ❑ 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 1SeC.flhSerVa-�iV2 � 1' c o_+ ori re `� � 2.C� � `� - h2c��roo ►ti 5�� No V-JLU s� -Le_ red . — ►a(zoj Z( COQ 2'• S"PS q' below @ m r+k .9-hj I -}re.r\c1A . 3aGlrt�; I1 wl MDi\ S0- r\d -I a 7 '4, r eal r 5 2 ►J+1 '+ e1.11 �.�•'i; Ve 4� 0 r ro j ; d,C. 2' Sel,a� a7fi o vi -i-0- S e e-� S , M'T re w�.i �t e d c�. r � 0-100Ve�elo` 10/21/21 - Received By: Date: / Issued By: / / 9 Date: / A MUNICIPALITY Development Services Department On -Site Water & Wastewater Section - Parcel I.D. 015-142-66 ON-SITE SEPTICM/ELL PERMIT APPLICATION Property owner(s) DAPHNE ANN MUCKEY Day phone Mailing address 11411 THUNDERBRUSH CIR., ANCHORAGE, AK 99516 Site address 11411 THUNDERBRUSH CIR., ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) THUNDERBRUSH LOT 5 Legal description (Township, Range & Section) Lot Size 15,463 Sq. Ft. Number of Bedrooms 3 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx_1 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade El Duplex (D) El. Holding Tank ❑ Renewal ❑ Multiple Dwellings El 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. gnature of property owner or authorized agent) Permit/Rush Fees: 4Gj q-5 Date of Payment: 7 1 Receipt Number: 21 I Oa l Permit No. Q5PZ 11252 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 130030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com June 30, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: THUNDERBRUSH LOT 5 The septic field has been found failed we request a septic permit to upgrade the system on the above referenced lot. We propose to install one pressurized deep trench with an Advantex system and pump vault to serve the existing 3-bedroom residence. The design is based on the recent test hole conducted on June 21, 2021 The slopes are moderate at 5-10% at the proposed upgrade location. The lot and area are served by private water and public 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 OSP211252, Rebecca Carroll, 07/07/21 DESIGN CALCS: q - BDRM X 150 GPD = 600 GPD 600 AaU GPD/>92GPD/SF. = 300 SF SAS 300 SF / (2 x 5' ED) = 30 FT, TRENCH USE 1 TRENCH - 30' (L) X 2' (W) X 5'(ED) TOTAL DEPTH FROM EXISTING GRADES -7' MAX LOT 6 }/T 1\ Q) Ar /mow / CONC c D/W 1NDERBRUSH CIRCLE /T �} 50' WELL RADIUS I LOT 5 8.2' 6.2 o o 0 o p � S\70$ S�70s w _ 30 _ .. .. •Bt£Kffl=L PORrOtr'OF T'RENCW MT Y o EXISTIN o TH21-1 TD -7' HOUSE i,J/ Nw A 1 SA11D o F1�JG5 0 5-10%R 4- 30.0' O O O MT ---1 SHED o Z DIV. MH U• z MH U U - VALVE _ IN PV- DFCO 1.25' PVC MH SHED ® \ cN.j GRAVEL ADD 2" OF INSUL. FOR SERVICE DECOMMISSION 20.V D/, LINES UNDER DRIVE STEP x EXISTING FIELDS I N85 '29"E 116.55 THUNDERBRUSH LOT 5 SUPPORT SERVICES: Aar, PREPARED FOR: OF DAPHNE ANN MUCKEY a �� '`x- 11411 THUNDERBRUSH CIRCLE C �Nq TIH ANCHORAGE, AK 99516 FIRST WATER CONSULTING DATE: 6/30/2021 rtis Huffman SURVEY: JLS CE 128991 QAf 13030 SUES WAY DRAWN: FWCS X6/30/2021 �4 Ao ANCHORAGE, AK 99516 SCALE: 1" = 20' '%onsslo�-, 907-350-9566 FirstWaterAK®gmail.com PAGE: 2 OF 2 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211252, Rebecca Carroll, 07/07/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211252, Rebecca Carroll, 07/07/21 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: THUNDERBRUSH LOT 5 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: 6/30/2021 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 7 8 SM/GM 9 10 11 12 13 14 15 16 SW 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/28/21 30 min 6” 2 1/16” 30 min 6” 2” 30 min 6” 2 1/16” PERCOLATION RATE 15 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 6/28/21 TESTHOLE # 21-1 DATE PERFORMED: 6/21/21 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: DAPHNE ANN MUCKEY 6/30/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211252, Rebecca Carroll, 07/07/21 Municipality of Anchorage Page [ of ~' DEPARTMENT OF HE,~,LTH AND HUMAN SERVICES ENVIRONMENT ~,L SERVICES DIVISION P.O. Box 196650 · Anchorage, ,~laska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal ~ystem and/or Well Inspection Report Permit Number: '"~v~ c~ z~ O I 0'~-. ] ' PID Number: Na~e: , ~ ~ ¢~-~ ~ ~~ Wastewater System: D New ~pgrade Address:I1~11 ~¢0~¢~&~ O~c~ ABSORPTION FIELD Phone: ~+~__~ ~OeepTrench DShallow'Trench DBed DMound ~.Other LEGAL DESCRIPTION.~[ SoilRating: ~ GPD/Sq, Ft. TotalDepth from orlginal grade: Lot: ~ Block: ~~ ~ ~Subdivision: ~ Oeplh~o~to pipe bottom~ fr0m~,~original grade; FtGravel~depth beneath~pipe Ft /~ I /~ Section: / ~ Fgl added above original grade: GraveHength: 'T°wnship:~ Range:~ I W,/~i . -~ ~,. ~a .~' ,,. Driller:~%Date Drgle,: S alic Wale, Level: [ .t Installer:~O~S' Yield: Pump Set at: 'rig Height Above ?ound: ~ ~ ~S.T.E.P. SE.* ST*.CES I se.,,c ~ '' From Tank Field T~nk Sewer Lines ~ , ¢ S;r~ 4/> ~/~ ~ . ~A ~' LiFT STATION ;:: 4,. .,ze,n¢,o..: · ~ "Pump on" level~qfl" level ~alarm at: Foundation ~/~ ~'~ ~del ]Electricallnspectionsperformedby:, ; Remarks: ~ ~¢ ¢ ~ BENCH MARK ¢¢U~0~ ~ ~U~ ~ ~= 831'18' I Assumed Elevation: I oo. oo ~, Inspections performed by: ~~ Dates: lst~ / / , ~ o~ w ~/~+ i . Department of Health and ~uma8 Servmes approval '~/.~~~/~,-~¢~ ,.~¢~ Reviewed and approved by: ~~' ~ Date: 7- 2 72-013 (Rev. 9/91) MOA 25 ;i CE.7953 · 'Permit No; Page ~ of ~ Municipality of Al ~chorage DEPARTMENT OF HEALTH A,ND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O;'Box 196650 · Anc.horage Alaska 99~519-6650 · Telephone: 343-4744 on-site Wastewater Dmposal System and/or Well Inspection Report T~4o~P~...~,~Jz~ ~ .~/~ PID No.: Legal Description: tot ~" p I ~ T CE-79,~3 PAGE MUNICIPALITY OF ANCHOP~AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHOP~AGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NLrMBER:SW940105 DESIGN ENGINEER:ALASKAWATER & WASTEWATER SERVICES OWNER NAME:MUCKEY KENDALL E & BETTY OWNER ADDRESS:il411 THUNDERBRUSH CIR ANCHORAGE, ALASKA 99516 1 OF 1 PARCEL ID:01514266 LEGAL DESCRIPTION: THUNDERBRUSH LT 5 (UPGRADE) PERMIT DATE ISSUED: 5/02/94 EXPIRATION DATE: 5/02/95 LOT SIZE: 15463 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 AiYD THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: i Tom Fink, Mayor uni ipality of Ancl. ra ¢ Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 3, 1994 Jeff Garness, P.E. Alaska Water and Wastewater Services 8471 Brookridge D~ive Anchorage, Alaska 99504 Subject: Waiver Request for Lot 5 Thunderbrush Subdivision Waiver Request #WR940021, PID $015~142-66, SW940105 Dear Mr. Garness: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. waived distance is 1 foot to the south property line. The This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services ljw#7 MUNICIPALITY OF ANCHORA'~ Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR940021 PID# o15-142-66 HA%f~\~AItY%~ ~Permit % Date Received: April 22, 1994 Legal Description: Lot 5 Thunderbrush Engineer: Jeff Garness, P.E., Alaska Water & Wastewater Services 8471 Brookridge Drive, Anchorage~ Alaska 99504 Applicant: Ken Muckey Waiver Requested: Lot line waiver - 1 foot to south property line Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: ~[ £//6. ~7-/} F~f~ Date: .~_ ~ -- ~ By: N~Reviewer Rec 9: 25841/3874 Amount: $ 115.00 Date Paid: April 22, 1994 '1' Alaska Water & Wastewater Services "Preserving The Last Frontier" April 19, 1994 MUNICIPALITY OF ANCHORA®E ENVIRONMENTAL SERVICES DIVISION Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section P.O. Box 198650 Anchorage, Alaska 99519-6650 APR 2 2 1994 RECEIVED Ref: Septic System Upgrade for Lot 5, Thunderbrush S/D. To whom it may concern: Attached is the application, site plan, and design drawings for the subject septic upgrade. Comments regarding the proposed system are as follows: 1~ TRENCH DESIGN: As can be seen from reviewing the attached percolation test results, the soil "perked" at 13.7 minutes/inch at the location proposed for the system. For a trench system, this corresponds to an application rate of ~8 gpd/ft~. Since the existing home has ~ bedrooms, the total design flow is 450 gpd. Based upon this, the. minimum amount of absorption area is 562~5 ft2. The proposed trench'6 feet deep and 55 feet long. This corresponds to an absorption area of 880 ft2. 2. SINGLE FAMILY HOME ON LOT 8, THUNDERBRUSN: The property on Lot 6, Thunderbrush was previously classified as a duplex, with a class "C" well. The property is now being used as a single family home, and it is my understanding that the city has now reclassified it as a single family home. Verification of this in your computer database is requested prior to issuance of the requested permit. 3. PRESSURE DISTRIBUTION SYSTEM: Because it is not possible (due to limited test hole depth) to achieve gravity flow to the new trench, a lift station mill be installed and pressure distribution will be utilized. The lift station will be equipped with an alternator valve and two discharge lines so that the flow can be switched between the old and new systems. 4. LOT LINE WAIVER: Because the existing trench does not have a clean-out on the east end, the actual location of the trench is unknown; however, according to the homeowner, the location is approximately as shown on the site plan provided with this design. Regardless, I would like to place the new Telephone: (907) 337-6179 · Fax: (907) 338-3246 ° 8471 Brookridge Drive ° Anchorage, Alaska 99504 trench only I foot away from the south property line so that the separation distance from the old trench can be maximized. In addition, this would allow us to weave the trench between several existing trees. Based upon the location of adjacent wells and septic systems I don't see any adverse impact associated with this waiver. I am unaware of any adverse impacts that this installation would impose on adjacent wells, or septic systems. If you have any questions, please call me a 337-6179. Sincerely 0 ultant JAG/jag HuckeyS.wps PERFORMED FOR: -- · Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES .825 "L" Street, Anchorage, Alaska 99502-0650 · :~S0iL~ LO..G ' PERCOLATION TEST 1 ~A-~.~,~T~O~ oF- ML. 2 ~t,~ ~,~ITtJ¢ ~)1,-,~ 3 po~-E.~'% 4 7 ,'ti_ 8 9 12 ~ ~0 ~ ~ ' 13~ 14- 15. 16 - 17- 18- 19- 20- ~OMMENTS Township, Range, Section: SLOPE SITE PLAN Gross Net Depth to Net Reading Date Time Time Wate~ Drop '7_ ,, ' SO ~o ] ~-Y4 ~ ,, ~o .~~ ~'~','~ PERCOLATION R~TE I ~ · ~ (minutes/inch) PERC HOLE DIAMETER ~ // TEST RUN BETWEEN ~¢3' ~' FTAND --/' ACOORDANOE WITH ALL STATEAND MUNIOIPAL GUIDELINES IN EFFEOT ON THIS DATE' DATE; 4:~ / ' '7/~z~'' 72-008 (Rev. 4/85) L_ L.zv-q-.E.¢4¢/. ' b, s¢_-~-'¢~-6~- ~--e = ~ · .~ ~o~0 p~'~ = ,~ ~,~ :~ =t~,~' ~P~'"~='t~I~- // L.._[ .~ : .e~s~: ~ =. ~.. - /-~. - ~j. ~ ?~v'~3[.. '~ .... · --/-~ ~ " .'7 2 + Z+ /5- = ,] 3O NET DISCHARG~ GPM ..~' .M u:~ q'.]3aJt:y.b.t Anchoral~' · ..uept, Health'& Human Ser~l~ l' I,OR .  ' ' MUNICIPALITY OF ANCHORAGE <~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 925 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~*~ Manufacturer ~R~ Mat~ri~eC No. ofcompartmen~ Liq. ca~V~lons IF HOMEMADE: Inside lenoth Width Liquid depth ~--~ ~turer ~__ ~aterial / Liquid capacit2n ga No. of lines[ Length o~a~ne Total ,en~ ~,rs Trench ~ inches Total effoct~s~U area ~ ~ Top of tile to finish grad;idth ~ Material beneath tile ~? inches OTHER 72-013, :/78) PERMIT NO. DEPARTMENT ,~. HEALTH ~ND ENVIRONMENTAL ..... ~TECTION o.~= 'k' ~ ' _ . q'~S" ~ ....... :TREET., RN ~HORRGE RK ...... ~l 264-4720 HELL ~ND UN--:. I TE 5EI4ER PF L I _.HNT LOCRT I ON LEGAL I<:EN[:'RLL E i'IU_.KE'r LOT 5 THUNDERBRIJSH S/D LOT SIZE TYF'E OF '--- - "--- ' - c "- ':' _,gill HE,_,uRPTIuN _,'r:,TEM I:,.TF..ENL. H' -' 1._,4~_. SQURRE FEET MR;:..IIMLIM NIIMBER OF BE[:F..Ourl_ =_.~' SOIL RHTIN~ ,.'.'SQ FT,'BR..= 120 c .'~ q-I .- c ' IS THE REQJIRED -,I~-E OF THE _ElL RBSORF'TION :Y_.TErl [)EF"TH--' 1-::': LE~ISTH= ---~- L---~ ~SRR'v'EL C. EF"TFI= 2 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE ENCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. TNE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE E~CA9ATION (IN FEET). RE _F-...~L~ l- ~;.~E E:. SEPT I _. TRiql<"S. T ZE= ~L E~ L?~ E~ F~LL,]h~S PERMIT RPPLICANT HRS THE RE_,FuN_,IBILIT~' TB INFORM THIS DEPRRTMENT DJRING THE INSTALLFITION IN_FEL. TIuN:, OF AN'Y' WELLS FID..TRCENT TO THIS FRJPERTT AND THE NLIMBER OF REz, I[.ENLE:, THt3T THE WELL WILL _,ER,,E. E, ItU...FILLIN~.J OF RNY '-'"2 '-' ~ BY :,T_,TEH WITHOUT FINAL IN:,FECTILN RND APPROYRL THIS DEPFIRTMENT WILL BE _,LIE,..TEF_.T .TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL AND RNY ON-SITE SEWRGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIgATE WELL OR ~50 TO ~00 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC:WELL MINIMUM DISTANCE FROM A PRIgATE 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 THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAS' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PEF~hl I T E>::F" I RES B,E,]Er"IBEF: I CERTIFY THRT i: I R~t FRMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY '¥HE MUNICIP8LITY OF 8NCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH TNE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. _ I JNED ......................................... FIPPLICANT KENDI-tLL E MUCKE'T' ,j C.,EPR~:TMEFt~ '~ HEALTH AND ENVI~LqFIf'IENTP>-~-RLt~OTECTION, 825 L' STREET, RHCHORRI3E, RE PERMIT HO. ( ) AF'F'L I CANT ~¢ ~ LOCRT ~ OH TYF'E OF SOIL RBSORPTION _.~_TEM ~ MRXIMLIt'I NJMP.,EF OF BEDROOMS = P EEF;:.I'*I I T LOT =IZE /~Z¢~ qoIIRRE FEET SOIL RR'¥ I NG '- '' _,¢:,TEM IS: THE REQUIRED SIZE OF THE SOIl_ CB:,OEFTION ¢' '~ ' ¢O' THE LEHGTH DIMENSION I$ THE LENGTH (IN FEET) OP THE TRENC:H OR DRRINFIELD. THE DEPTH OF FI TRENCH OR PIT IS THE ~;~:STRr-ICE BETWEEN THE SURFACE OF THE 6ROUHD RND THE BOTTOM OF THE EXCRVATIOH (IN FEET). THER:E IS NO SET NIDTH FOR TRENCHES THE 6RR'v'EL DEP'FH IS THE MINIHUM DEPTH OF GRRVEL BETWEEN THE OUTFRLI_ PIPE RHD THE BOTTOM OF THE EXCRVRTION (IN FEET). RE~S!I_I I F::ED SE':F'T Z F_.~ 'TRI%II<; ':-; Z PERMIT RPPLICRNT HRS THE RESPOHSIBILITY'TO IHFORM THIS DEPRRTIdEHT DURING THE INST~LLATIOH INSPECTIONS OF RHY NELLS AD.3~CEHT TO THIS PROPERTY RNC, THE HUMBE~ OF RESIDENCES THaT THE NELL NILL SERVE. BACKFILLING OF RH'¢ SYSTEM NITHOUT FINRL INSPECTION RNC, RPPROVRL BY THIS DEPRRTMENT 14ILL BE SLIBJECT TO PROSECUTION. MINIMUM DISTRNCE BETNEEH R NELL RND ANY ON-SITE SENRGE DISPOSRL SYSTEH IS 180 FEET FOR R PRIVRTE NELL OR $SQ TO 2¢D FEET FROH R PUBLIC HELL DEPEH[:,ING UF'EI~ THE TYF'E OF PUBLIC NELL MIHIMUM DISTRHCE FF4:OH R F'RIVRTE HELL TO R PRIVRTE SEI4ER LINE IS 25 FEET RHD TO R COMHUNITY SEWER LIHE IS 75 FEET. blELL LOGS RRE ¢'.EQUI;~'.EO RHD MUST CE RETLIRHED TO THE [:,EF'RRTMEHT NITHIH 3~ DRYS OF THE NELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SF'ECIFICRT~ONS RND CONSTRUCTION DIRGRRHS ARE RVRILRBLE TO INSURE PROPER INSTRL. LRTION. I CEF:TIFY THRT 1: I RM FRMILIRE: NITH THE REQUIF.'Ef'IEHTS FOR ON-SITE SEHERS AND HELLS r~ ' - T Y FORTH B't' THE HUNI_.IFHLI OF RNCHO~4:RCiE. _,'~_~TEtl IH RCCORC, RNCE 14ITH THE CODES. '-"~. I 14ILL INSTRI_L. THE c',,.- , Z: I UH[:,ERSTRNC:, THRT THE ON-SITE SEHER ¢~_.TEM MR"r' f;:EQLIIR:E ENLRRGEfENT,~IF THE ~~ ~:ESID NCE~i~HCLI_ID'E MC, RE THRN S BEDR:OOFIS. i'"'~' " SIGNED :-- 4%' PERFORMED FOR: LEGAL DESCRIPTION: THIS FORM REPORTS: CONSTFTOCTION TEST LAB Mr. Ken Mucky Lot 5 Block [] Visual Soils Examination 180~1. 48TH AVE. STE. Icl ANCHORAGE, ALASKA 99503 248-13:53 DATE PERFORMED: 8/27/80 Subdivision Thunderbrush Percolation Test DEPTH SOIL FEET DESCRIPTION NOTES 2 1/2' Brown Peat 4' Tan Sandy SILT Tan SILT w/ 480 min/ occ. gravels & inch cobbles 10' 11' Coarse GRAVEL 2~ min/inch 90 SF/BR Fine SAND 7½ min/inch 13' 150 SF/BR Tan SILT 480 min/ inch BOTTOM OF HOLE TEST HOLE 1 WAS GROUND WATER~ ENCOUNTERED IF YES, WHAT DEPTH LEGEND ~ -- Perc zone ®S - Sample token [] -- Frozen zone ~' -- Water table NO GENERAL SITE SLOPE READING DATE 8/27/80 PERCOLATION RATE: PROPOSED INSTALLATION: COMMENTS: GROSS TIME 3:30 4:00 4:15 4:30 See above D SEEPAGE PIT NET TIME DEPTH TO H20 NET DRAINAGE 0 39 1/8" 30 80 7/16" 45 89 5/8" 60 96" DRAINAGE REQUIREMENTS: See above O DRAIN FIELD O OTHER 41 5/16" 9 3/]6" 6 3/8" TEST PERFORMED BY: B.P./K.B. DATA CERTIFIED BY: Kinney R. gmw~-c,r; P.~. ' DATE: 8/28/80 MUNICIPALITY OF ANCHORAGE Development Services Department <`,� c Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-142-66 Expiration Date: 1. GENERAL INFORMATION Complete legal description THUNDERBRUSH Location (site address) 11411 THUNDERBRUSH CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) Mailing address Real estate agent DAPHNE ANN MUCKEY Day phone 11411 THUNDERBRUSH CIRCLE, ANCHORAGE, AK 99516 Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 5� 7D Waiver Fee $ Date of Payment 3 OJ Z Date of Payment Receipt Number �l 030Z Receipt Number COSA # 05L 2 l 1 q q0 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 11/20/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to ��11 these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory ��P• • • • • �) for current or future occupants or guarantee that no unseen encroachments, deficiencies or fig••. discrepancies exist can be given by First Water Consulting & FWCS ' *• � TH •'* .. ....... 6. DSD SIGNATURE ' • • • "' �"~'- / Curtis Huffman System #1 Approved for bedrooms �r��F��s•• CE 128991 •. -O w System #2 Approved pproved for bedrooms t`1,F�PROF S510NP�F4�- Disapproved Conditional approval for bedrooms, with the following stipulations: Y OF��i�� O ON -SIT€ �o WATER AND m IAIA V ER z= Jm PRO G a ftp 5� Q\�` . 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 • Legal Description: THUNDERBRUSH LOT 5 Parcel ID: 015-142-66 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled CIRCA 1980 Total depth 150+ ft (PER ACOUSTIC READINGS) Cased to 40+ ft (ASSUMMED) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/1/2021 Static water level at beginning of test 141 ft. Comments B. TANK DATA Age of tank(s) NEW TANK years Tank type/material ADVANTEX / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA — NEW FIELD Which system tested (date installed) NA ® ALL standpipes present per record drawing Total measured depth from grade 9.3 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 of _ Structure served by this system _ Well production at time of test 2.7+ 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 F', Date of Sample 6/22/2021 C. LIFT STATION — PUMP BASIN ❑ Required maintenance completed Age of lift station 0 years Lift station material PLASITC Comments: Adequacy test date NEW FIELD Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ®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) N date of test) If yes, enter date Gallons introduced gallons F�'� Comments/Deficiencies: wr::, 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 Community Sewer Manhole/Cleanout > 100' ❑ Yes if No *50+ ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ❑ Yes if No *50+ ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft ® Yes if No ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No 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 Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No 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 Line > 10' ® Yes if No _ ft Wells on 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *MEETS CAT III SEPARATION REQUIREMENTS. G. ENGINEER'S CERTIFICATION I certify that / 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. /.. .. ....•.. 1 ..... .... ..........� Curtis Huffman �'F••. CE 128991 Fo a1/20/;i-*�\\` PROFESSIO V ft ft ft ft ft ft ft ft By -r' __(signatt►rc) Date:"f� za 2 1 �I G�ytQ,_�`1tllSS — - (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT The foregoing instntment was acknowledged before me this dayof l',j(, j��7 t • 20t by ' NOTARY PUBLIC FOR LA5KA my Commission expires: orn:ta STATE OF ALASKA r+srr?.t�c rJJ'ezitvt�'�E?xes9'62«t Ni lUNICIP:ILITY: Bv: _(signature) Date: --print name) Title: (rev. 05/18i2018) Page 3 of 3 MUNMWAUTY F H RAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 015-142-66 1. GENERAL INFORMATION Complete legal description THUNDERBRUSH LOT 5 Expiration Date: //- /Z —zo Z' Location (site address) 11411 THUNDERBRUSH CIRCLE, ANCHORAGE, AK 99516 Current property owner(s) DAPHNE ANN MUCKEY Day phone Mailing address Real estate agent 11411 THUNDERBRUSH CIRCLE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ Cc ► nal Waiver Fee $ Date of Payment % D 20) l Date of Payment Receipt Number. 310302. Receipt Number COSA # DSC 2 I ) L) 9 O 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY. ANCHORAGE. AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7/2812021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. 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, any estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & FKS 6. DSS SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for „A , bedrooms bedrooms (Pf A 11 TH O� • Curtis Huffman c�L�r, -' •C7,/28/z91•'F\�, PROFESSO 3 bedrooms, with the following) stipulations: wQ,v�N, ,N( l tOF (AAL;�r(/t�_, V\.^, WX 6I -STI r - WATER AND �o WAST'w�'ATER Oz 1 Original Certificate Date: F— L 2. '-2J 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. r�Ir"A'tyChall COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: THUNDERBRUSH LOT 5 Parcel ID: 015-142-66 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 CIRCA 1980 Total depth 150+ ft (PER ACOUSTIC READINGS) Cased to 40+ ft (ASSUMMED) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 6/1/2021 Static water level at beginning of test 141 ft. Comments B. TANK DATA Age of tank(s) NEW TANK PENDING years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping 3/16/21 D. ABSORPTION FIELD DATA — NEW FIELD PENDING Which system tested (date installed) NA ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Well production at time of test 2.7+ 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 N[, a Date of Sample 6/22/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station _years Lift station material Comments: Adequacy test date NEW FIELD PENDING Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ 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) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: F 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 ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No 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 _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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 Line > 10' ® Yes if No _ ft Wells on 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / 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. r 7H i• . .... .......... Curtis Huffman >� CE 128991 .7127/2X, •'ti���� RROFEWQ0 ,vi���� ft ft ft ft ft ft ft ft I � } July 28, 2021 Municipalities of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: CONDITIONAL COSA LEGAL: THUNDERBRUSH LOT 5 Due to unprecedented events contributing to material and labor shortages, we are requesting a Conditional COSA for the above referenced property. The pending permitted 3 -bedroom septic system upgrade has been impeded due these conditions and other factors with no known date on when the Advantex system components may be available. The system will be installed once components become available, which is roughly estimated at the end of August 2021. The system has been working for the occupants and granting of this Conditional COSA will not impact any of the neighboring properties or pose a public health risk. Attached are the installation bids and escrow letter from title for the pending installation. Please contact us if you have any questions. Sincerely, Curtis Huffinan, P.E. Fr I W 11 '[;L. }J" C ?'+'t r `i' 'WA 31 EYld 1ER