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HomeMy WebLinkAboutTURNAGAIN PARK #2 BLK 1 LT 5Turnagain Park #2 Block 1 Lot 5 #018-241-14 �u�c voivu 1.) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211016 PID Number: 018-241-14 Dwelling: Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ®❑ Upgrade Name George & Amy Brun ABSORPTION FIELD ❑ Deep Trench ❑Q Wide Trench E] Bed E] Mound Site Address 2435 Clements Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft.4 Gravel depth beneath pipe Ft. Subdivision Block Lot ]Gravel Turnagain Park #2 1 5 Fill added above original grade NA Ft, Gravel length 38 Ft. Township Range Section width 5 Ft. Beds: Number of Lines NA Distance between lines NA Ft. SEPARATION DISTANCES To SepticI Absorption Lift Station i Holding I Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 380 y- cs� Ftz 1 NA Ft. Well 100'+ 100'+ NA NA 25'+ TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1250 Gal. Surface Water 100'+ 1001+ NA NA Material Number of compartments Lot Line 5'+ 5.1' NA NA NA. HDPE 2 Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank t03034 Installer drainfield Pomraning Excavation Drainfield 3034 CO/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 174 fl Inspection im 5/3/2021 5/4/2021 Location and description 3,d 2nd 41" Deck trim at point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ,�� OF AC,jk� Seven F2. I'unnone �s Septic System Approved <rw (x+ Date 19 . 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D -9Z_I c O m > x;u, Z z <OZ In - n 0 c: C7 Z D Zr r NOTES: PANNONE ENG SVC LLC (C.1. 1088) """`1 REVISIONS DATE P.O. BOX 102954 ANCHORAGE, A 99510 '�E OF AC', 05/13/2021 RECORD DRAWING _- � q , PHONE 907) 272-8218 FAX (907) 272-8211 =c- �P ' `rfy'h, SCALE s:' '•, NTS TURNAGAIN PARK #2. 81 L5 .. P.I.D. N241-14 DRAWN MJL GEORGE& AMY BRUN • ste en It noon. -fir PERMIT N0. 2435 CLEMENS DRIVE %c ce-etas_ OSP211016 SOIL LOG a •.-.- ANCHORAGE, AK 99516 ``III,E�,��� SHEET 3 OF 3 ��a1 N Tfl- o � N £j z 0 � a m 0 s z m 0 s z m 0 s z m z � y s rn Sty m o = e nr� N I 4 I N I 9 y LOT 5 v w 00 a 00 02 LOT A N 89'9'00" E 100.00' SEPTIC VENTS (tm) b moo. LOT 5 BLK 1 �' 30.5' GRAVEL D/W (�)ELL N89°59'00"E 100.00' O N CLEMENTS DRIVE 0 N i ANCI30RA.G1 RECORDING DISTRICT, ALASKA AS -BUILT OF: 'I'ITR AGAIN PARK SUBDIVISION Not LOT 5 BLOCK 1 PLAT P -160A SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this propem 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: I DATE: SCAlE r—uaw MA° 6, 202 i 1 "=30'-schuilergaknet 21 - 0 3 5MIAMI BY: CHE BY GRfll mjmB : BDQK/ Ate• JLS SV13033 210149 2.2'x2. D' FP CANT U w 06 O �1- 00 ro 2'x6' S: CANT O 14.5' O r O O O Z © = FND 5118" RE13AR 49TH %JOHN L. SCHULLER.•'� O LS-10408AO { °fessionot L� � B SU �� N� LARD W Z 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PnBox 1SW85U � 47UOElmore Road Anchorage, Alaska S9519-OG5O Ph 904 Fax: (307)343-7397 Permit Number: OSP211016 Work Type: Septic Upgrade Tax Code Number: 01824114000 Site Legal Address: TURNAGA|N PARK #2 BLK 1 LT 5 G:3033 Site Mailing Address: 2435CLEK4ENTSDR, Anchorage Owner: BRUNGEORGE G&AMY K Design Engineer: PANNONEENGINEERING SERVICES This permit isfor the construction of: R1 Disposal Field 0 Septic Tank El Holding Tank 171 Privy Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: 2/10/2021 2/10/2022 [] Private Well 171 Water Storage All construction shall beinaccordance 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 VVaab*wehyr Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC8O) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.G5.Provide notification bycalling (8O7)343-7BO4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: e. Opened and Closed onthe same day, or b Covered, sealed, andheated hoprevent freezing Special Provisions: A test hole is required prior to construction of the field to confirm the soil profile and percolation rate for any portion ofthe field that iooutside the 3Uftradius ofopercolation test. Received Z C) i Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV211007 COSA#: Permit#:OSP211016 PID#: 018-241-14 Legal Description: Turnagain Park #2 Block 1 Lot 5 Engineer: Pannone Engineering Services Applicant: George & Amy Brun Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. See engineer's waiver request for justifications. The proposed absorption field must meet the minimum 16 ft separation to the absorption field on the lot to the north. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ■vaaaaavaaaaavaaaaaaaaaasaaavaaavavaaaavvaaaaa■alavaavavavaa0aaaasaavaavavvava1 Waiver is Granted: X Waiver is not Granted: Date: 291d o Q I _ Approved by: xt,�_gt 0,a�i M Name of Reviewer ■vvvvvaavvvvaaavvavvavaaavaaaaaavvaaay.evaavava■aaeaaaaaasaavvvavaavvavavvaaavaI MUNICIPALITY O Community Development Department Development Services Division On -Site Water & Wastewater Program f Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 018-241-14 Property owner(s) George & Amy Brun Day phone Mailinq address 2435 Clements Drive Anchorage, AK 99516 Site address same Legal description (Sub'd., Block & Lot) Turnagain Park #2 B1 L5 Legal description (Township, Range & Section) Lot Size 13,831 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade ❑X (D) F-1 Holding Tank ❑ Renewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Drain Field to lot line Distance: 3p 0 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: Waiver Fees: !� a a 5 , Date of Payment: ) -Z�i' Z I Date of Payment: �Tl 1 Q O21 Receipt Number: O 4 07 9 C2 Receipt Number: 030-1 G Permit No. 25P2 1 1016 Waiver No, O SV Q i i ocn Permit App_:- :• :-.,:c Pannone Engineering ServiceS Lac Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveC@panent?ak.com Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. Q. Box 196650 Anchorage, Alaska 99519 Subject: Turnagain Park #2 B1 L5 Septic System Upgrade Permit Request Design Narrative Mnicipality of And-oroge On-site water and Wastewater REVIEWED FOR CODE CONPUANCE OSP21IOld f becca Carydf, 07140'29 21 January 2021 This is a design narrative far a permit to install a septic system upgrade on the subject property. The proposed upgrade will serve an existing three-bedroom (3) house. This lot and surrounding lots are served by private wells. Currently there are no wells within 100 feet of the proposed upgrade. 1. Soils: A test hole was performed on this lot by Stephen D. Shrader, PE on 9/29/1980, and by Garness Engineering Group (GEG) in 2010. There is no soils fog available for the GEG test hole however, the groundwater monitoring tube is stili on the property and in operating condition. The monitor tube was inspected by Pannone Engineering anti found be dry. Available surrounding test hole data shows similar soil profiles and percolation rates to those used to design this septic system upgrade. Pannone Engineering will perform a test hole during construction of the upgrade to confirm the soil profile and percolation rate. Based on the results of the Shrader test hole, historical data, and the selection of the proposed drain field; an appiication rate of 1.2 galfonslday/square feet was used for a conventional wastewater system in the area of the test hole. 2. Soil Absorption System Design. a. See Sheet 1 of the design package. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field. 4. Topography: See attached site plan for area topography. 5. Waivers: Due to area constraints on the lot the proposed drain field upgrade encroaches on the north property line. The distance required by AMC 15.65 is 10,0'. we are requesting a waiver to 2.5' from the proposed drain field to the north property line on the subject lot. Granting this waiver will not pose a threat to public health on this or surrounding lots. Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 Page 2 of 2 6. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and no further comments are received from MoA On -Site Department, the note will be removed and "For Construction" drawings will be issued. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 745-8200. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745.8200 FAX: (907) 745-8201 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211016, Rebecca Carroll, 02/10/21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPFCTInal RFPnRT NAME / oo' 0 /--PHONE f /� EW ❑ UPGRADE MAILING ADDRESS ` / V LEGAL DESCRIPTION LOCATION 0-60NO. Well Absorption area OY DISTANCE TO: PX- OF BEDROOMS 3 cc�/ Dwelling PERMIT NO. ,b2 160YO wzz ~ Manufacturer Material No. of compartments 2 N Liq. capacity in gallons 00 IF HOMEMADE: Inside length Width Li ui q ddepth 6 Y J(7z DISTANCE TO: Well Dwelling PERMIT NO. 2 zFQ- Manufacturer Material Liquid capacity in gallons D X u z Q ¢ F- C331-57--_ W 0 Well DISTANCE TO: �(�� No. of lines Length of each Ii / i9 Top of the to finish grade Length Width Foundation Nearest lot lin-Ae /UUr.�r{/ z Total Total length of lin s Trench width �3 �9 inches Material beneath rile / -Depth PERMIT NQ.! Distance between lines �/ //j �L' �7 Total effective absorption area ' 7-5 PERMIT NO. i F- wa Type of crib Crib diameterCrib depth Total effective absorption area rn DISTANCE TO: Well Building foundation Nearest lot line J Clase�j� UF1E Depth 7 f Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption areasI OTHER PIPE MATER/IACs IOGiwS C . E SOIL TEST RATING 92 ^/ INSTALLER REMARKS ,a hr t z rR no o ,e OVE E�� " n-nts rRa„ anal , DATE LEGAL a /2 9-°'91-_19°-9 117 19=" 1=19- _ I T Ne CiP vccr-ri.. r_... . i r, , ,,, "-grimur-4MEgTAL 'ROTE .._ 825 '`/ STREET: ANCHORAGE, Ak:. 264-4720 t,.g9=9._9� 1=1!AE> eDr4-- 11-9� E=NJE FT 1=•� rwool im w l f� �ur� PERMIT NO. 811=1048 ? Outn - J ISO APPLICANT GLORIA B. THOMPSON 617 N. IRVIN ST ;_77 ' fil LOCATION OLD & NEW SEWARD HIWYS �u AI LEGAL LO B1 TURNAGAIN PARK #c LOT SIZE 12800 SQUARE FEET' TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = _ =OIL RATING <SQ FT/BR)= 125 THE RE?UIR.ED SIZE OF THE _:OIL_ ABSORPTION SYSTEM IS: E-a9-F"-9-fA—= A El 9_E�94C3-FFI _1. 13FQFA °E=9_ ESE=F`-'ThA== N_, 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 EXCAtrATION ON FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL- F'IF'E AND THE BOTTOM OF THE EXCAVATION (IN FEET). F=° E =1 �a LJ "F FZ E 9" a r ' T 3 rt T FA p-.9 AZ _`: 1 T 9= = AL1A-e CA CA 13 FA 9-"_ Cl r4 I= PERMIT- AP'P'LICANT HAS THE RESF'ONSIBILITY TO INFORM THIS DEPARTMENT DURING THE IN`.TALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. T ._. T 9s-9171 c: _, T 14 in F=* E CD T 1 13 rA in 1'=1 FR Eo 9 � " EO G-41_1 >I F� EF_ L:� BACKFILLING OF ANY SYSTEM WITHOUT FlNAL 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 15 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET" WELL LOC,- ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAY'S OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. r= FEE 9=_ lrl I T Es 11 9-'° I FZ EE E> En C3 EO 81 Ea 9= 90 =J _ fl- S-0 wofflL I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL_ THE SYSTEM IN ACCORDANCE WITH THE CGDE_. _: I UNDERSTAND THAT THE ON-SITE 'SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SI IS: [N SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6-650, Anchorage, Alaska 99502 276-2221 SOILS LOG —PERCOLATION TEST ASI NO. 01980 PERFORMED FOR: Mrs. Gloria Thompson DATE PERFORMED: 9/25/80 LEGAL DESCRIPTION: Lot 5, Block 1, Turnagain Park Subdivision No. 2 SLOPE SITE PLAN u♦yo.iiiu 0.5 t Organic Silt Brown 1.5 d 2 Gray Silt 2.5 — 3 o 0.0 " �/ o °o Silty Sandy 5 ° ��° Gravel p/dam (Dense) 6 w/Boulders .01,07,10O 7 0'O0'° . OD 8 �v 9 r�'J , a o-- Od�j Clements Drive 18 X10, q/Q - I 1 '� WAS GROUND WATER ND 5_ I! , '° ENCOUNTERED? L. �� O I // P { 12 E 7 Y�— °A 0• IF YES, AT WHAT N/A011 _ Q'0 DEPTH? 13 p J -- 0 0 14o•.0 14. T.D. 01- �2 �� ` t� °. �. S4pl:en D. Shrader No. 4143-E 19 �� c9°°°0°...° °..•° °•��,� Reading Date Gross Time Net Depth to Time Water Net Drop 00.0 3:40 ' 0.43' - 5:10 10 0.18' t 4:10 6.0 FT AND 7.3 FT 5:mi.rVinch Pere.rat COMMENTS Test Material was 4:20 10 0.28' 0.78 4:30 less silt. I 4:30 0.50' 4:40 10 0.25' Test Ho Ie 4:50 i M t'1 co n m M i I I 0a.0 LJ , a o-- Od�j Clements Drive 18 X10, q/Q - I 1 '� WAS GROUND WATER ND 5_ I! , '° ENCOUNTERED? L. �� O I // P { 12 E 7 Y�— °A 0• IF YES, AT WHAT N/A011 _ Q'0 DEPTH? 13 p J -- 0 0 14o•.0 14. T.D. 01- �2 �� ` t� °. �. S4pl:en D. Shrader No. 4143-E 19 �� c9°°°0°...° °..•° °•��,� Reading Date Gross Time Net Depth to Time Water Net Drop 0.30 9/25 3:40 0.43' - 5:10 10 0.18' 0.30 4:10 6.0 FT AND 7.3 FT 5:mi.rVinch Pere.rat COMMENTS Test Material was 4:20 10 0.28' 0.78 4:30 less silt. 4:30 0.50' 4:40 10 0.25' 4:50 20 ®�®ROfib � U U. 0.43' - 5:10 10 0.18' TEST RUN BETWEEN 6.0 FT AND 7.3 FT 5:mi.rVinch Pere.rat COMMENTS Test Material was well compacted with some layers more sandy and less silt. PERFORMEDBY: Harry Bates CERTIFIEDBY: Stephen D. Shrader P,.FyATE: 9/26,1980 Alaska bolls Investigations 624 W. Intl Airport Rd. Suite 103 72-008 (7176) Anchorage, AK 99502 MUNICIPALITY OF ANCHORAGE 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. 018-241-14 1. GENERAL INFORMATION Expiration Date: Complete legal description TUrnagain Park #2 131 L5 Location (site address) 2435 Clements Drive Current property owner(s) 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 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distan Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment S �c� �2' Date of Payment Receipt Number Receipt Number COSA # 0 5 C Q 91.2 q 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907) 745-8200 Date OF ALgSIt�� :A H ...... .... o.. ..... Steven •R�•Pannorie I � CE 87 49 - , 'n0FES9.G,®J�� Conditional approval for bedrooms, with the following stipulations: Ut- Ah, w- nN-SITE WATER 0 Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSH Checklist Legal Description: Turnagain Park #2 B1 L5 Parcel ID: 018-241-14 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled `1980 Total depth 110+ ft Cased to 110+ ft Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) in. Date of flow test for COSA 78012020 Well production at time of test 3.7+* gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ No H Coliform bacteria is Negative Nitrate mg/L Fffl� Nitrate less than MRL (ND) Arsenic 1.58 ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 4/7/21 Static water level at beginning of test 92.2* ft. Comments *Data collected from Garness Engineering Group, Ltd inspection letter B. TANK DATA Age of tank(s) <1 years Tank type/material 5e ff�9 Measured operating fluid level in septic tank MA 0_1 Standpipes/foundation cleanout per record drawing Date of pumping New System D. ABSORPTION FIELD DATA Wide Trench C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 5/5/2021 Adequacy test date New Q ALL standpipes present per record drawing Results ❑Pass For bedrooms Total measured depth from grade 8 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade 4 ft (min) Water added gal ❑ N/A — pressurized field New depth in Q Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective Q 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) If yes, enter date Gallons introduced gallons Comments/Deficiencies: System is brand new and does not need an adequacy test COSA Checklist yellow sheet 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 ft ❑ Yes if No Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' Q Yes if No Neighboring Absorption Fields > 100' Yes if No. Water Main > 10' Animal Containment > 50' ❑✓ Yes if No ❑✓ Yes if No ft ✓❑ Yes if No. Water Service Line > 10' ❑✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' ❑✓ Yes if No ft [Z] 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' Q Yes if No. Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: ft Absorption Field > 5' P/1 Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' 0 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' 21 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 5.1 ft Wells on Adjacent Lots: Water Main > 10' ✓D Yes if No ft Private Wells > 100' ❑✓ Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' El Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S 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. COSA Checklist yellow sheet 16 4�H'� � S even R"Po*n' one CE 8149 ft ft ft ft ft ft ft ft ft ft Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parceil.D._01R-241-14 COSA# (2RD0"I5 Expiration Date: r LLQ O — D S 1. GENERAL INFORMATION ' Complete legal description ._ 7VRNAGAIN PARK f 2 LOT 5 BLOCK 1 Location (site address) 2435 CLEMENTS DRrVE. ANCHORAGE exp 9951 — Current Property owners) PAIJI. J. i.1(:HT Day phone Mailing address 3915 W 79T" COURT ANCHORAGE. AK 99502-4205 Lending agency Day phone Mailing address Real Estate Agent TERRI RARRUS Day phone _562-3638 Mailing Address _664313RAYTONDRIVE ANCHORAGE, err 2507 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank Community Class Well ❑ Community On-site Public Water System ❑ Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 ArcTeffa Engineering & Surveying. Inc. Phone 868-3792 Address 20441 PTARMIGAN BLVD EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M DUFFUS Date 02/29/2008 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a !Q'CE'�� pF A\tq 11� system will function satisfactory for current or future .�..•«•••. occupants or can ArcTerra guarantee that no unseen M y,,.• •'Vol encroachments, deficiencies or discrepancies exist. r* iAnTu %. 4Ii 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following vivvn c WATERAND •; Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: b — O 8 (a« ,, as Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water & Wastewater Program • • .. 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: TURNAGAIN PARK a 2. I OT 5 Bli O K 1 Parcel ID: 018-241-14 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID # _ Date completed 19so+J- Sanitary seal (Y/N) y Total depth UNKNOWN ft. Cased to •40+ ft. FROM WELL LOG Date of test Static water level Well production - - 9 -p.m - WATER SAMPLE RESULTS: 1 •- . . r . . rrt Wires properly protected (Y/N) y Casing height (above ground) 36 in AT INSPECTION 91 ft. 7.6 g.p.m. Coliform _Q—colonies/100ml. Nitrate ND mg/L Other bacteria _0 colonies/100 mL Arsenic: mg/I Date of sample: 02/22/2oo9 Collected by: ArcTerra B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed o4/3o/1961 Tank size 1000 gal. Number of Compartments y Cleanouts (YIN) y Foundation cleanout (YIN) y Depression over tank (Y/N) r[ _ High water alarm (Y/N) N --Pate of pumping 02/22/2008 Pumper McDonald,; C. ABSORPTION FIELD DATA Date installed 4/3o/1981 Soil rating (g.p.d./f? or fe/bdrm)125 System type Deep Trench Length _3b-_ ft Width _a ft.' Gravel below pipe &ft. Total depth 13 ft. (measured 2/23/08) Eff. absorption.area 3gfe Monitoring tube y Date of adequacy test 2123/08 Depression over field X Results (Pass/Fail) rass For L. bedrooms Fluid depth in absorption field before test 4M in. Water added.= gal. New depth 69.6Jn. . Elapsed Time: 1411 min. Final fluid depth !UA in. Absorption rate >=450+g. d. P• Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date ..... D. LIFT STATION Date installed Manhole/Access (Y/N) Size in gallons_ 'Pump on' level at—in. 'Pump off" level at—in. High water alarm level at—in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on tot 100'+ - On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main y5'+ Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank 100'+ Animal containment areas sn'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 101+ Surface water t00'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ (None Known) Wells on adjacent lots 100'+ F. COMMENTS *A Row WELL DOCUMENTATION LETTER Vacant residence wastewater syclem was surcharged 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. Engineers Printed Name KENNETH M. DUFFUS Date 0212912008 COSA Fee $430 0 Waiver Fee $ _ Date of Payment JIDo Date of Payment Receipt Number )J0� Receipt Number. (Rev. 11105) .. SGS Ref.# 1080703001 Client lame ArcTerra Engineering and Surveying Project Name/# Tumagain #2 Q1, L5 Client Sample ID Tumagain #2 1)1, L5 Alam: Drinking Water PIVSID 0 Sample Remarks All Dates/rimes are Alaska Standard Time Printed Datelrime 03/05/2008 16:29 Collected Date/Time 02/22/2008 10:45 Received Datelrime 02/222008 11:20 Technical Director Stephen C. Ede Parameter Results PQL Units Allowable Method Container ID Limits Prep Analysis Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug(L EP200.8 C (<10) 03/03/08 03/04/08 M11 Waters Department Total Nitmte/Nitritc-N ND 0.100 m8/L SM204500NO3-P D (<10) 0227/08 LCP Microbiology Laboratory Colony Count 0 coV100ml, SM20 92223 A (<200) 0222/08 DLC Total Coliform 0 col/100ml, SM209222B A (<I) 0222/08 DLC Fecal Coliform 0 coVI00mL SM2092220 A (<I) 0222/08 DLC Cl LOT 5 W O 04 N 89'39'00" E 11 SEPTIC • VENTS • 1p'd DECK/ CARPORT 3.4'x8' CANT LOT 5 BLK 1 N89'59'C LOT 4 CO 1.0 2.2'x2.0' o F FP CANT 00 010 S"0, --A G, M 5��� 0.10 1� 2'x6' CAN 3 o. 4.5 O OFGZeo P O RAVEL O Z D/W fV N WEL®L 100.00' CLEMENTS DRIVE 0 N ANCHORAGE RECORDING DISTRICT ASBUILT OF: TURNAGAIN PARK SUBDIVISION NO 2 LOT 5, BLOCK 1 PLAT P -160A SURVEY CERTEFICATE:1. 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 enchroulunnts exist other than noted Under no circurnstance 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 1OXR rnota MUYBFA: Mx: xtic rrw FEB 22. 2008 1'.30' ene.,peyu,.r VO—VI I ++•ac ocamnc ZWKI I — I aS 3033 001/16 'OF `4h ;7k� .... .A gtt' .. OHN L SCHULLER: LS -10408 +`i FEE -27-2000 10:39A FRa9: 70:8;83793 P.1 AAROW PUMP & WER SERVICE, LLC q �G1dOo �C�G� P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-0355 • Fax (907) 333-8976 Eagle River: (907) 622-9335 N° 07954 CUSTOMER JOB SITE �- 4; Y - 0 e o- i - _1 L- J ICE DATE_- u WELL DEPTH$WL / CKORMATEO PUWDEPTH .0 SA 5 RSQV QUANTITY DESCRIPTION PRICE AMOUNT o WI to rex 0 ct a -IL 11eq i a e 01 a I� W LLJ 01 to Op r Anz-1iH S FEB 'l 7 20 a r �►r B LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP, TOTAL LABOR / _y PAY THIS AMOUNT / OO Thank You SIGNATURE r -- (I Hereby Acknowledge the Satisfactory Completion of the Above Doscribed Work and agree that It above work is not paid for In 90 days I agree to snow Aarow Pump 8 Well Servke, L.L.C. the Mhl to remove unpaid for equipment and charge for labor already pedamied & labor to remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program ° 4700 South Bragaw St. 5 ° f ' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Jeff Gamess Legal description: Mann Block 2 Lot 2 ❑Permit ®C.O.S.A. ElInspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. An absorption field may not be located within 10 feet of a building foundation. 2. Aseptic tank may not be located under a driveway or parking area. Name of reviewer: Poet Date: March 4, 2008 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK