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HomeMy WebLinkAboutT13N R1E SEC 4 TR 4 NW4MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196850 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:llwww.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211425 Work Type: Septic Upgrade Tax Code Number: 06762108000 Site Legal Address: T13N R1 E SEC 4 TR 4 NW4 G:0804 Site Mailing Address: 3230 MISTY MOUNTAIN RD, Eagle River Owner: SMITH MICHEL GERARD Design Engineer: EKLUTNA ENGINEERING, LLC" This permit is for the construction of: 21 Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date 1z�ent G � MiT. v. Department Lot Size in Sq Ft: Total Bedrooms: 11/4/2021 11/412022 207930 ❑ 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 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received B Issued By: f Y Date: P e-12-0 Z/ Date: 3 H MUNICIPALITY OF ANCHORAGE Development Services Department `i'a= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 067-621-08 ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) MICHEL SMITH Mailing address 3230 Misty Mountain Rd Eagle River Site address 3230 Misty Mountain Rd Eagle River Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) AK AK Day phone T1 3N R1 E SEC 4 TR 4 NW4 Lot Size 207,930 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field � Initial El Single Family (SF} �] (w/wo AD U) Septic Tank ❑ Upgrade FX_1 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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 Munici lal Codes. � 3C (Signature of property owner or authorized agent) Permit/Rush Fees: 45q'55 Waiver Fees: Date of Payment: / ��l�Z Date of Payment: Receipt Number: D a772f Receipt Number: Permit No. OSP Z I I L-1 Z 5 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Eklutna Engineering, LLC curtistownsend @gmail.com November 2,2021 Subject: T13N R1E SEC 4 TR 4 NW4 Upgrade Septic Field Permit Request Narrative osP2rr425 This is a design narrative for a permit to install a new septic field on this property. The existing field is 40 years old. The homeowners are desiring to add an additional field. The proposed system will serve an existing three (3) bedroom house. The homeowners desire to size this field to accommodate 4 bedrooms. Soils. The soil in this area are composed of gravel. Please see the attached soil log and percolation rate. The soils percolate faster than 1 mpi, so this field will require a sand layer. Soil Absorption System. The soils percolate faster than 1 mpi, so this field will require a sand layer. Wells. This lot and the surrounding lots are served by private water wells. MOA has documentation for these wells. There are no wells within 100' of the proposed septic system. Neighboring Wastewater systems. lmmediate neighboring septic systems are all +L0' distant from property lines. Surface Water: There is no surface water within 100' of the field. The proposed field upgrade will maintain at least 100' from all surface water and drainage ditches. Topography: The existing topography in the area of the field is approximately 21o/o. The slope downstream of the trenches is 63%. The criteria of L5.65.210 B.l..d can't be met, as the proposed field draining the house is less than 50' up-gradient from the 63% slope. The 'steep slope' provisions of this code will apply. Construction of the septic system will meet allthe conditions of 15.65.2L0 B.4.a i, ii, iv. 15.65.210 8.4.a iii will apply to this case and all existing vegetation on the 63% slope will remain intact. The slopes will not be disturbed. 15.65.210 B.4.a.v The disposal field is less than 100' up-gradient from any slope exceeding 46%. As shown on sheet 2 of the design package, a line of 46% slope starting at2.5' above the invert of the perforated pipe does not daylight the existing ground for at least 35'. The well log for this property shows that there is no bedrock till at least a depth of 100'. The soils in this area have a percolation rate of < 1 mpi. The proposed installation will not affect the future development of this or the surrounding lots. Sincerely, Curtis L. Townsend, P.E. 1. 2. 3. 4. 5. 6. 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RIGHT OF WAY EASEMENT KNOW ALL MEN BY THESE PRESENTS, that we the undersigned (whether one or more), whose address is jz l a rrI r I✓�, 9 9►r7.7 for a good valuable consideration, ttfe receipt whereof is hereby acknowledged, do hereby grant unto MATANUSKA ELECTRIC ASSOCIATION, INC., a cooperative corporation thereinafter called the "Grantee") whose post office address is Sox 2929 Palmer, Alaska 99fi46,and to its successors or assigns, the right to enter upon the lands of the undersigned, situated in the ftlebAt Recording District, State of Alaska, and more particularly described as follows: ,bei being in Section Township 13 N, Range ISE, S.M., and to construct, reconstruct, rephase, repair, operate and maintain on, over or under the above described lands and/or in, upon or under all streets, roads or highways abutting said lands, an electric (or telecommunication) transmission and/or distribution line or system; to inspect and make such repairs, changes, alterations, improvements, removals from, substitutions and additions to its facilities as the Grantee may from time to time deem advisable, including, by way of example and not by the way of limitation: the right to increase or decrease the number of conduits, wires, cables, hand holes, manholes, connection boxes, pedestals, transformer enclosures, to cut, trim and control the growth by machinery or otherwise of trees and shrubbery located within feet of the center line of said line or system, or that may interfere with or threaten to endanger the operation and maintenance of said line or system (including any control of the growth of other vegetation in the right of way which may incidentally and necessarily result from the means of control employed); to keep the easement clear of all buildings, structures or other obstructions. The undersigned agree that all poles, wires and other facilities including any main service entrance egwi„ meat, installed in, upon or,under the above described lands at the Grantee's expense shall remain the property of the Grantee, - removable at the option of the Grantee. The Grantee, its successors or assigns, is hereby expressly given and granted the right to assign said right-of-way and easement herein granted and conveyed, or any part thereof, or interest therein. TO HAVE AND TO HOLD unto the GRANTEE, its successors or assigns, together with the right of ingress to and egress from the premises for the purpose herein granted. The undersigned covenant that they are the owners of the above described lands, and that the said lands are free and clear of encumbrances and liens of whatsoever character except as may appear of record as of the date set forth below, and those held by the following persons: IN WITNESS WHEREOF, the undersigned have set their hands and seals this day of 20_D .3 - TORP, Grantor Grantor STATE OF ALASKA)SS- THIS IS TO CERTIFY that on this day of , 20 before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and swam as such, personally appeared a Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument and acknowledged to me that he/she/they signed -and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS WHEREOF, ' I have hereunto set my hand and official seal the day and year first above written SEAL an V Notary Public in and of Alaska My commission expires of -Alaska W/ P/S Role ! Return to: / Subd 7 C000 y I Plat _ Misc Map Easement MEA, PO Box 2929, Palmer, AK 99645 Y -PUBLIC Quad S anon Lund Rev.=S Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201407 PID Number: 067-621-08 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑® Upgrade Name Jean Truscott APTION FIELD ❑ Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 3230 Misty Mountain Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Subdivision Block Lot 4 NW4 Ft. Fill added above original grade Ft. G el length Township Range Section 13N 1 E 4 Ft. Gravel width Ft. Beds: Number of Lines Dist a -between Ft. SEPARATION DISTANCES TO Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between t ches From Tank Field Tank Line Ftz t. Well > 100' NA NAI NA >25' TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water > 100' NA NA I NA Material Number of compartments Lot Line > 10' NA NA NA NA plastic 2 Foundation > 10' NA NA NA LI STATION Manufactur Capacity Remarks Gal. Alarm location Elec ' e ' stalled by Installer PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 JRs Septic Drainfield CO/MT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspection 15` 10/10/2020 2�� 10/17/2020 dates: Location and description 3"' 4m top of concrete slab by dog door ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date U X��••Th1F}}, ..!........s •� P .001................ ��.e Date � Septic Approved �^-.. �= Date 3r� ��2 04 �c�'•.eElls...• Aar � TF�FiPROFESSI���,�®� Note: this approval does not include well permit requirements. to. ncinomo% ����'®��'� ' 0 0 O W / mM o M :2 / m W WZ� Z Z0(C) UV)OZY )- )-OJ-Z �m 0 �OU7 LWiJSQp< Of QJLLJ (nWOI-W�zW �QUWZ O Z 0 Z~~ o~ o- ZTWZ Q ?�FZ _Q p O U� 00 JW_ Z = F-- LO OWQZQ�; 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: OSP201407 Work Type: SepticTank Upgrade Tax Code Number: 06762108000 Site Legal Address: T1 3N R1 E SEC 4 TR 4 NW4 G:0804 Site Mailing Address: 3230 MISTY MOUNTAIN RD, Eagle River Owner: TRUSCOTT G JEAN Design Engineer: EKLUTNA ENGINEERING, LLC* This permit is for the construction of: ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date �' - 0.19 r Department Lot Size in Sq Ft: Total Bedrooms: 10/1/2020 10/1/2021 207930 ❑ 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 t. b. Covered, sealed, and heated to prevent freezing .,�Special Provisions: Prior to inspection report approval, the proximity between the well and the dog kennel and t associated cesspool shall be addressed. Received B) Issued By: 3 �� Date: [ l � 'I / Date: ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 067-621-08 Property owner(s) JEAN TRUSCOTT Day phone_ Mailing address 3230 Misty Mountain Rd Eagle River AK Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 3N R1 E SEC 4 TR 4 NW4 Lot Size 207,930 Sq, Ft. Number of Bedrooms 3 APPLICATION IS FOR: (N all that apply) Absorption Field ❑ Septic Tank E Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial Upgrade Renewal ❑ Single Family (SF) ❑ (w/wo AD U) X Duplex (D) ❑ El Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal,podes. (Signature of owner or authorized Permit/Rush Fees: tr ��� �/ S CaV I �-�5� Waiver Fees: _ Date of Payment: 0 Date of Payment: Receipt Number: Receipt Number: Permit No. O Sf 1 y bWaiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201407, Rebecca Carroll, 10/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201407, Rebecca Carroll, 10/01/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201407, Rebecca Carroll, 10/01/20 1 11-01 1-00 2 m UJ a) LO UJ (D 0 0 Q � W co L T13N, R1 E, SECTION TRACT 4 S 1/2 SE1/4 NW 1/4 NW 1/4 (Plat No. 66-54) TRACT 3 = A C7 r,2() f) el W %J W %J %J %J - C6 Well LO 0 O� 33.8 Carport (Z) Shed u C11) deck Well Shed 16.0 _Q) 1.4 OH V 12.6 0 Cabin co 0 0 65 Septic vent ,o� C: C: 243.5 10' Utility Easement EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON UNLESS OTHERWISE NOTED. SCALE: 1 If= 50' deck 1.0 OH qGreenhouse Chain link fence I 5' Utility Easement �" I 001, 0 0 131.2 I - IPI I� 6 7 %'M U") 30 30 - — — — — — I EAST 630.00 1 Lot 3 L®t 2 1 % TRACT A <1 PYRENEES ESTATES 0 JANET DAVIS SUBD. 0 a '44 a= I(Platr%\ No. 2000-10) 9 QI 49th 97 � 9 0 Note: 60' Private Access property and do not overlap or encroach on the property lying Easement across Tract A � 0 granted by Plat No. 2000-96 adjacent thereto encroach on the premises in question and 0��,. Elizabeth Walatka ff 00 30 - — — — — — I EAST 630.00 1 Lot 3 L®t 2 1 % AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have performed a Mortgagee's inspection in accordance with ASPLS Standards of the following *NXXX% 11 Lot 1 41W OF described property: TRACT 4 located in E 1/2 NW 1/4 JANET DAVIS SUBD. 0 a '44 NW 1/4, SEC, 4, T1 3N, R1 E, S.M., Al, OVT- Anchorage Recording District, Alaska, and that the 49th 97 � improvements situated thereon are within the lines 00 00•11 0 0 0 0 • a 0 • 0 0 •0 •0 •0 0 property and do not overlap or encroach on the property lying 00 00 adjacent thereto, that no improvements on the property lying 00 adjacent thereto encroach on the premises in question and 0��,. Elizabeth Walatka ff 00 that there are no roadways, transmission lines or other visible easements on said except as indicated _�/ AW 8036 - LS property hereon. AW 0�'\Y� AMW ESS IONNL Dated at Anchorage, Alaska this 10th day of AUGUST 2020. FRED WALATKA & ASSOCIATES, L.L.C. FB 20-4, pg 20-24 4��_ 5 BE Engineers and Surveyors 907-248-1666 HOWARD TEAL 344-0498 WATER WELLS 665 W. 87th Avenue Anchorage, Alaska 99502 WELL CONSTRUCTION LOG Drilling Co. '„Z t USGS no. Driller Type a f rig — gfg--b4'.0 Date well completed —7 _7 2 2 Well owner Nearest community We I I locat i on: (address & legal description)'v /v'&v';;� Location sketch or remarks , 211 ? Depth of well t. Casing: depth __;_�f t . d i am. --4—i n . Static water I t . (above, below) land surface. Date__21�&_, Finish of well: (open-end, screen, perforated, open -hole, other) Describe intervals and size: Well yield tested by (pumping, bailing, air) at LA, gal/min. for hours with _f t . of drawdown from static leve I . DRILLER'S MATERIAL LOG Depth below land surface in teet Give (size of material, description of strata penetrated color, hardness of drilling, and water content) to C'A'4 L to t W, t 0 t V 0— t a— to— t 0— to— to_ to — to 0tot to t0— t 0— t 0— to— t o to HPPL2CF T G, JEHN PO BOX 301 EAGLE RIVE,.,-,,,: 694 2]]5 LOCHTION LEC RL ME! LOT SIZE 87120 SQUARE FEET MINIMUM DISTANCE BETWEEN H HELL HND HNY ON-SITE SEWAGE QI5POSRL 5YSTEM I5 100 FEET FOR R PRIVATE WELL; OR M50 TO 201D FEET Fl PUBLIC WELL DEPEN0ING THE TYPE OF PUBLIC WELL WELL LQQS !'---I F", MBST BE RETU NED TO THE DEPRRTMENT WITHIN 31) DHYS Cl' THE WELL COMPLETION. OTHER FREMIRENENTS MGY APPL4 SPEC! FICHTI0NS F -ND CONST U TI N IHGRRM5 HRE AVAILABLE TO INSURE PV0PER IWSTHLLHTIQN Fo"FRE M M I -T F,:, ]"._, EF so M EZ CD K Pei PEI K 0_, I CERTIF9 THHT 1: I HM FMILIHR 141 -FH THE REQUIREMENTS FOR Off -SITE SEWERS HN") WELLS HS SET FORTH BY THE MLVICIPIF! ITY OF HNCHO 8E 2: I WILL INSTALL E WITH THE CODES, SIMEW: WJ MUED 1-3 MUNICIPALITY F ANCHORAGE Development Services Department r: Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 067-621-08 1. GENERAL INFORMATION Expiration Date: L I &— Complete legal description T1 3N R1 E SEC 4 TR 4 NW4 Location (site address) 3230 Misty Mountain Rd Current property owner(s) JEAN TRUSCOTT Mailing address Real estate agent Eagle River Day phone 18110 Maclaren St Eagle River AK Keira Dreher 2. TYPE OF DWELLING: ❑ Single Family (w/, rivo AUU)�, F-1Duplex �� ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 ,M Day phone (907) 529-4660 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ASO Waiver Fee $ Date of Payment —11 `2, Date of Payment Receipt Number Cl � 3 Z )0 Receipt Number COSA # Waiver # 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 Eklutna Engineering, LLC Address 19162 Mountain Rd Chugiak AK 99567 Engineer's Printed Name Curtis Townsend, PE 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Phone 907.406.1058 Date • . Curtis L. own�seitd or; Date 1 q o. CE 11504 1k. OFESSIC°lF bedrooms, with the following stipulations: By: 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 COSA Checklist Legal Description: T1 3N R1 SEC 4 TR 4 NW4 Parcel ID: 067-621-08 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) Well production at time of test 4.9 Qpm Date drilled 1981 Water storage tank volume 0 gallons Total depth 161 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to 161 ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate 0.37 mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) ' 12 in. Collected by Bart Quimby/Curtis Townsend Date of flow test for COSA 72112020 Date of Sample 3/3r2021 Static water level at beginning of test 139 ft. Comments tested well #2 serving the house B. TANK DATA C. LIFT STATION Age of tank(s) `1 years ❑ Required maintenance complete Tank type/material septic PLASTIC Age of lift station y Measured operating fluid level in septic tank - Lift station material Al Standpipes/foundation cleanout per record drawing Comment Date of pumping new tank installed Oct 2020 D. ABSORPTION FIELD DATA Which system tested (date installed) 1981 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.33 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 Adequacy test date 712112020 Results [D Pass For 3 bedrooms Fluid depth prior to test 42.25 in Water added 459 gal New depth 42.75 in Elapsed time 1440 min ❑® Code -required soil cover over field Final fluid depth 28 in ❑ System presoaked Absorption rate ' 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) no date of test) Gallons introduced 1,685 gallons If yes, enter date Comments/Deficiencies: No cleanout infield to determine pipe invert. See description of test procedure for this absorption field. 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' 0 Yes Community Sewer Manhole/Cleanout > 100' M✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25'2] ✓ Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' Q Yes if No ft Fv� Yes if No ft Yes if No ft Water Service Line > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' Q Yes if No ft 2 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: ✓0 Absorption Field > 5' (l✓ Yes if No ft Private Wells > 100'✓0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200'✓Q Yes if No ft Water Service Line > 10' 0 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells > 100' P✓ Yes if No ft Water Service Line > 10' F- Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance$ MOA COSA guidelines in effect on this date. >.. �NGINEIER�S COSA Checklist yellow sheet rco •• • oma.,' nd ... Date ttiL�e N, CE .. 11� Legal Description: T1 3N R1 E SEC 4 TR 4 NW4 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1979 Total depth 145 ft Cased to 145 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) ' 12 in. Date of flow test for COSA Static water level at beginning of test 140 ft. Comments well #1 serving the kennel B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft ax) Measured depth to pipe invert from gr e ft (min) ❑ N/A —pressurized field ❑Monitor tubes go to bott of effective. If not, state depth into effective ❑ Code -required oil cover over field ❑ System esoaked (RequirF if vacant for greater than 30 days prior to dat f test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 067-621-08 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 0.39 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Bart Quimby/Curtis Townsend Date of Sample 72/292020 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 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) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25'[Z] Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' Z Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 7 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 7Yes if No ft � Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water >' 100 _ ❑Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells >100' _ F1 Yes if No 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 interior plumbing of kennel has been disconnected, only exterior hose bib remains cesspool has been excavated and backfilled kennel enclosures removed within 50' of water well G. ENGINEER'S CERTIFICATION l certify that 1 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 ENGINEER'S ft ft Eklutna Engineering, LLC curtistownsend@gmail.com March 22, 2021 Subject: T13N R1E Sec 4 Tract 4 NW Septic Field Adequacy Narrative The existing 3 bedroom house is drained by a 33' x 30" x 5' effective depth trench. This trench was installed in 1981. The house had been occupied so I proceeded with an adequacy test of the field on July 14, 2020. The water level in the monitor tube was 4" at the beginning of the test. I inserted 470 gallons into the field and the water level rose up to 41". 24 hours later the water level was at 28". 1 suspected that this field was failed to the 28" mark and decided to do another adequacy test with a presoak. On July 21, 2020 a pre soak of this field was conducted. 33'x 2.5' x 5' = 412.5 cf 412.5 cf = 3,086 gallons 0.4 x 3,086 = 1,234 gallons minimum At the beginning of the presoak, there was 19.5" of water in the monitor tube. An amount of 1,685 gallons was inserted into the field as a presoak. The water level rose to 42.25" An additional 459 gallons of water was inserted into the field. The water level rose to 42.75". 24 hours later the water level was at 28". Two tests were conducted and it appears the field is holding water to a depth of 28". The field has 53% of capacity remaining. Sincerely, Curtis L. Townsend, P.E. 0 J 0 0 0 m m W LO Lu 0 0 C:) w � M r, J TRACT 3 I rn� I CHJ I t�C5U.V3 � \ \ \ 5' Utility Easement \ I T13N, RIE, SECTION 4 I TRACT 4 I 1\ \\ i Well S1/2 SE1 /4 NW 1/4 NW 1/4 i \ _ 33•,9 (Plat No. 66-54) I \ Carport o Shed ' mL t \\ \ I I deckWell Shed \\ \\ E( 16.0 2 \ \ W l Cabin 126 / o o °� \ \\ I y l N Septic vent i