Loading...
HomeMy WebLinkAboutT15N R1W SEC 18 LT 63 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231183 PID Number: 051-171-06 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MANUEL & BOBBIE BELMUDES ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 19166 BIRCHWOOD LOOP, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 5 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. 63 Township Range Section 15N 1W 18 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Est. between trenches From Tank Field Tank Line Ftz Ft. Well 100'+ __ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ __ NA Foundation 10'+ ILIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer JRS Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 15` 8/17/23 �d 8/18/23 Location and description ction 2 3rd 4'h TOP OF MH / RISER ON-SITE WATER AND WASTEWATER SECTION APPROVAL ._ �� Conditional Approval: Date A '•:tQ�l� Curtis Huffman Septic System Approved LC/ �t2� �1�i�'S�lF��•..•�• �CE128991 � ,W rDate ,8/23/23X��'pROFEWN Note: this approv nes not include well permit requirements. (Nev u*luuiu) PID:051-171-06 PERMIT:OSP231183 FIRST WATER CONSULTING T15N R1W SEC 18 LOT 63 SHED 6. 1 LOT 63, SEC. 18, T15N R1W Seward Meridian 113,256 Sq. Ft. +/- 19166 S Birchwood Loop Road 1 Story Wood Frame House With 1 Car Garage LOT 36 50 ' P A T E N T R . O . W . E A S E M E N T ED G E O F P A V E M E N T SHED T ℄ IN L E T V I E W D R I V E DIRT PARKING PAD DIRT DRIVEWAY 64.0 32.22 8 . 0 2 8 . 0 GREENHOUSE 12.1 16 . 2 10.2 4'X8' SHED 8.0 10.6 21.2 G E N90° 00' 00"E 393.03' N0 ° 0 7 ' 0 0 " W 3 3 0 . 0 0 ' N90° 00' 00"W 290.93' N1 7 ° 0 5 ' 0 8 " E 3 4 5 . 2 4 ' LO T 6 4 A ℄ S BIRCHWOOD LOOP ROAD GUIDE WIRE SC S W 10 0 ' E K L U T N A P O W E R L I N E E A S E M E N T 1 0 0 ' W E L L R A DIUS S S SS S S 59 . 9 12.1 146.1 80.6 90.3 15 6 . 2 183.9 33' PATENT R.O.W. RESERVE NO. 026496 8 . 0 SS SS PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. August 25th, 2023. Legend: Scale 1" = 60' Electric Meter Telephone PoleE Lot 63, Sec. 18, T15N R1W, Seward Meridian General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Audry Mach 23-353 08/28/2023 77-211 1155 E Elec. Pedestal Tel. Pedestal S T A T E O F ALA S K A 49 TH ROYEVRUSDNALLANOISSEFORP DER E T S I G E R Pierre M. Stragier NO. LS-9812 09/05/2023 TWood Deck Chain Link FenceGGas Meter Over Head Utilities SepticS NOTE 1. Research could not find recorded legal description of 50' and 100' easements, shown only for informational purposes.SC Septic Tank M.H.W Water Well 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: OSP231183 Work Type: SepticTank Upgrade Tax Code Number: 05117106000 Site Legal Address: T15N R1 W SEC 18 LT 63 GA 155 Site Mailing Address: 19166 S BIRCHWOOD LOOP RD, Chugiak Owner: BELMUDES MANUEL EDWARD & Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Ment S �C G EG � o Department Lot Size in Sq Ft: Total Bedrooms: 7/17/2023 7/16/2024 113256 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Issued By: Date: 5 MUNICIPALITY OF ANCHORAGE CI- ikov Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-171-06 Property owner(s) Manuel Edward & Bobbie Jean Belmudes Day phone Mailing address 19166 S Birchwood Loop Road Chugiak, AK 99567 Site address 19166 S Birchwood Loop Road Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 18 LOT 63 Lot Size 113,256 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) IN (w/wo AD U) Septic Tank IN Upgrade IN (D) El Holding Tank ElRenewal ElDuplex Multiple Multiple Dwellings ElPrivy El and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: z Date of Payment: 2� Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! June 28, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: T15N R1W SEC 18 LOT 63 – 19166 S BIRCHWOOD LOOP The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon HDPE tank per the attached design to serve the existing 5-bedroom residence. No groundwater was noted in the MOA on-site file, but if groundwater is encountered during installation an epoxy coated steel septic tank may be required. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231183, Curtis Townsend, 07/17/23 DESIGN DETAILS: INSTALL NEW 1500—GAL HDPE WELLS, 100' TO SURFACE WATER, 5' INSULATION. INSTALL PER AMC 15.65 MATERIALS,... APPROX. WELL LOC. INSSIDE 41 0 Municipality of N dmr On-site Water and Wastewater REVIEWED FOR CODE COMWhA OSP2311&3 Curtis TGMBWC 07117 TANK. MAINTAIN 10'+ FROM FOUNDATION, 100' TO TO FIELD & DECK SUPPORTS WITH 4' OF COVER OR 15.55, & MASS ... TANK BEDDING, SEPARATIONS, FCO NOT SHOWN ON — ASB. SHOW ON \ FINAL ASB SURVEY. STAKE 100' WELL RADIUS PRIOR TO CONST. CO APPROX. 100' WELL RADIUS. STAKE PRIOR TO CONST. DECOMMISSION EXISTING S.T. & INSTALL NEW 1500—GAL HDPE SEPTIC TANK WITH NEW DCO & RECONNECT TO EXISTING SEPTIC FIELD. VERIFY 5'+ FROM SX TO FIELD C� DCO CO CO NOT SHOWN ON AS8. SHOW ON FINAL ASB SURVEY. CO CO NO WELLS WITHIN 1 00'OF PROPOSED SEPTIC TANK. RE -VERIFY PRIOR TO CONSTRUCTION. -w— mu— mi,—ar _ mu— mu— mu—mn,—mu— M—tea,—M—M—ua,—mn,—m—am— w BLM RES. ESMT. P.R!{i{V : PAD T15N R1 W SEC 18 LOT 63 SUPPORT®SERVICES: PREPARED FOR: MANUEL & BOBBIE BELMUDES 19166 S BIRCHWOOD LOOP ROAD CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 6/28/23 SURVEY: FRONTIER 13030 SUES WAY DRAWN: FWCS ANCHORAGE, AK 99516 SCALE: 1" = 30' 907-350-9566 FirstWaterAK@gmail.com PAGE: 1 OF 1 OF ALBA * 9 TI is Huffman f� CE 128991 �`� .6/28/23 onss1O0-' Municipality of Anchorage Page /_of 2.-- DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: %,:.~ c/ -~ol/,,,? PIDNumber: Name: M,,~- ¢:, Po~-v,,~u.,~ ~ Wastewater System: ~ New ~Upgrade · ~: )~l~U ~.o ~.~ ~¢/~, ABSORPTION FIELD Phone ~_~1~ [NoofBe~oms ~DeepTrench ~ Shallow Trench DBed ~Mound ~Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION ~,~ ~/s~ ~ Lot: ~ 3 Block: Subdivision: Depth to pipe boltom ,ro~O~inal grade: Ft Gravel depth beneath~ ~"~Pi~e , Ft, Township: [ Range: ~ Section: Fill added above original grade: Gravel length: Number of lb]es: Distance between lines: WELL: ¢~ l%~w U Upgrade Gravel w,dth: ¢% Ft G /¢ Ft Classification (Private AB.C) Total Depth: Cased TO: Total absorption area: Pipe material: Driller: Date Drilled: Static Water Level:Fl Installer: ~ ~ Date installed:~//¢~ , Yield: OPM IPumpSetat: Ft ICasing Height Above Ground:F'. TANK SEPARATION DISTANCES ~s~t~ ~ ~o~di.~ ~ From Ta~k Field Station Tank Sewer Lines ~ ~ Materiak Number of Compartments: Surface ~Z~ w~t~ ¢¢0' '¢~*1 ~ LI STATION LOt Size m gallons: IManufacture: I "Pump on' level at: I"pump off" level at: High water alarm at: Foundation //~ Curtal n Pump M~e & M0de~ [ Electrical Inspections performed by: Drain Remarks: BENCH MARK Assumed Elevation: ENGINE~ SEAL Inspections performed by: ~ >~7~ Dates: 1st ~ /~~ Departmen~ of Health u ices approval~ ~?.... ......~ Reviewed and approved ~ Date: g~ 72-013 (Rev 9/gt) MOA 25 Permit No. ~UO q ~t~,7 Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: PID No,: E N aILIN~,~.,~8. SEAL ,,, co ..' ~:.y~, ....~,'~. ~'. ~ % David ~. Dayton 72-013 A (2/91) MOA 25 PAGE I OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW930167 DESIGN ENGINEER:DAVID R. DAYTON, P.E. OWNER NAME:BELMUDES MANUEL E OWNER ADDRESS:lg166 BIRCHWOOD LOOP EAGLE RIVER, AK 99567 DATE ISSUED: 6/21/93 EXPIRATION DATE: 6/21/94 PARCEL ID:05117106 LEGAL DESCRIPTION: T15N R1W SEC 18 LT 63 LOT SIZE: 113256 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 2. AL1, 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 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 Bo COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ALL PORTIONS OF THE SEPTIC SYSTEM MUST BE WELL AND 10 LINE. RECEIVED BY:~ ISSUED BY:~ ~ 100 FT. FROM THE DATE: FROM , David R. Dayton P.E. · ~- ie,~ Y~-~- ~ ~_._~ ~ ~d~o-,~ 20210 Donalar St. Chugiak, Alaska 99567 MESSAGE f SIGNED RF.~.~F~I._, 4S 468 ~ POLY PAR (50 SETS) 4P468 k__J NO REPLY NECESSARY ~3 REPLY REQUESTED - USE REVERSE SIDE D. R. DAYTON, P.E., R.L.S. ~)~~"Chugiak, Alaska 99567 20210 Donalar [@o7) ~~ 696-2417 Lot 63, Sec. 18, T15N, R1W. Design Narrative The proposed septic system up grade replaces a failed system which was built in the 1960's. The system will be a 1500 gallon tank with 2 80 ft. x-10~ft, trenches with 3 ft. cover. The system is on a large lot, approximately Acres, which slopes from Northwest to Southeast. The system will not have any adverse affects on wells or septic systems on adjoining lots. Drainage and reserved space, surface or subsurface will not be affected. 20210 Don~l~r St. Chuglak, Alaska 99567 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: LEGAL O ESDRIPT,ON:/~r ~.~ ~, n~ m~ 2 3 4 5 6 7 8 9 10 11 13 14- 15- 16- 17- 18- 19- 20- Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Deplh to Water Alter. /.,,~ Monitoring? ,/L/~ ,',J ~ Date: ~ Gross Net Depth to Net Reading Date Time Time Water Drop ?: z.o 17 /~'" G" PERCOLATION RATE ~ ~ (m~nutes/inch) PERC HOLE DIAMETER TEST .UN BETWEEN ¢' ~ FT ^N~ ~Y~ FT COMMENTS ~'~- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / ~ 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST SLOPE 1 2 3 4 7 8 § 12 13- ~5- ~7 20- DATE PERFORMED: Township, Range, Section: WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~) DEPTH? p Monitoring? SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop .,:,,-'/~..~/9~ /o.' oD 3o ~ ~/~ I~/~ /I., oz ~o ~ ~ llp PERCOLATION RATE j~,'~ {minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN ~'" FT AND ~ FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE i ' Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-171-06 Legal description T1 5N R1 W SEC 18 LT 63 Site address 19166 S BIRCHWOOD LOOP RD Expiration Date: 12/15/2023 Current property owner(s) BELMUDES MANUEL EDWARD &BOBBIE JEAN X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 9/15/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 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 Application 1. GENERAL INFORMATION Parcel I.D. 051-171-06 Complete legal description T15N R1W SEC 18 LOT 63 Location (site address) 19166 S BIRCHWOOD LOOP RD, CHUGIAK, AK 99567 Current property owner(s) Manuel Edward & Bobbie Jean Belmudes Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5 6_0 Date of Payment gA3�2:5 COSA # G 23 ) '� I y Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: T15N R1W SEC 18 LOT 63 Parcel ID: 051-171-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled UNKNOWN Total depth UNKNOWN ft Cased to UNKNOWN ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+* in. Date of flow test for COSA 6/22/23 Static water level at beginning of test 10 ft. Well production at time of test 5+ gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 7.60 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 6/23/23 Comments: Well is located in the corner of the house in the bottom floor / half basement. Stickup is 18”+ above grade with a sensor and accessible pump system. See attached services performed by AWPS well scoping letter. B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 7/6/93 ALL standpipes present per record drawing Total measured depth from grade 9.25 ft (max) Measured depth to pipe invert from grade 6.17 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 3.1’ & 2.2’ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 6/22/23 Results Pass Fluid depth prior to test 2” & 14 in (N / S TRENCHES) Water added 770 gal New fluid depth 9” & 26 in Elapsed time 1440 min Final fluid depth 2” & 14 in Absorption rate 750 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 51.6 in (MOA 4.3’ ED) Effective depth used 16.4 & 39.2 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 35.2” & 12.4 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximately 1.2’ of north trench & 2.1 south trench ED is missing. Southern trench is operating in the top 1’ of the ED. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 8/23/23 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 or NO 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 & 8/23/23 Nitrate Advisory Certificate of On -Site Systems Approval # OSC231314 Subdivision: T15N R1W SEC 18, Block: , Lot: 63 A water sample revealed a nitrate concentration of 7.6 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #: 20235477 Bill To: Remax Dynamic Properties 3350 Midtown Pl Anchorage, AK 99503 USA Ship To: Remax Dynamic Properties JOB: 19166 S Birchwood Loop Rd Chugiak, AK 99567 SALESPERSON Mark VanWingerden YOUR NO. 37445 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 8/17/2023 PG. 1 QTY.ITEM NO.DESCRIPTION PRICE DISC %EXTENDED PRICE TX. We appreciate your business. Thank you!SALE AMT. FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE 1 Service Call CAMERA WELL TO 40' FOR LEAK INTRUSION. UPGRADE CASING TO MOA CODE. CHLORINATE WELL FOR DISINFECTION. 1 Field Service 08/09/23 - Remove well seal, camera well and provide recording of results to Remax. No intrusions found - see recording provided. Use jack hammer around well to expose well casing top and weld on casing extension. Install new well seal. Re-plumb pressure tank to accommodate raised exit height of pump outlet. Add Bentonite seal and concrete patch to floor around well casing.Paint well head. Test system operation, normal at this time. $2,337.00 $2,337.00 1 Field Service 08/11/23 - Install water on floor sensor/alarm. 4 ST2-Mark Service Tech 4 ST1-Dave Service Tech 2 ST16-George Water System Ops 1.5 WELL CASING 6" ASTM SCHEDULE 40 $35.00 $52.50 2 FIT-GAL-PIP-1 PIPE-1" GALVANIZED $9.00 $18.00 2 FIT-GAL-CPL-1 COUPLING-1" GALVANIZED $17.00 $34.00 1 FIT-GAL-S90-1 STREET 90*-1" GALVANIZED $19.00 $19.00 2 FIT-BRS-BSH-1X.75 BUSHING-1"X.75" BRASS NO LEAD $10.00 $20.00 1 FIT-BRS-NIP-.75XCLOSE NIPPLE-.75" X CLOSE BRASS $6.00 $6.00 1 FIT-DEU-.75 DIELECTRIC UNION-.75" AYM 5421-032 $35.00 $35.00 1 CKV-BRS-4201E/1-100E 1" CHECK VALVE FLOWMATIC $69.00 $69.00 1 FIT-BRS-NIP-1XCLOSE NIPPLE-1" X CLOSE BRASS $11.00 $11.00 1 FIT-ELC-CRG-.75 CORD GRIPS-.75" ELECTRICAL $25.00 $25.00 1 FIT-PVC-WVT-.5 WELL VENT-.5" NPT WELL SEAL VENT $8.00 $8.00 ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Invoice Invoice #: 20235477 Bill To: Remax Dynamic Properties 3350 Midtown Pl Anchorage, AK 99503 USA Ship To: Remax Dynamic Properties JOB: 19166 S Birchwood Loop Rd Chugiak, AK 99567 SALESPERSON Mark VanWingerden YOUR NO. 37445 SHIP VIA COL PPD SHIP DATE TERMS Net 30 DATE 8/17/2023 PG. 2 QTY.ITEM NO.DESCRIPTION PRICE DISC %EXTENDED PRICE TX. We appreciate your business. Thank you!SALE AMT. FREIGHT SALES TAX TOTAL AMT. PAID TODAY BALANCE DUE 2 FIT-CPR-90-.75 90*-.75" COPPER $6.00 $12.00 1 FIT-CPR-CPL-.75 COUPLING-.75" COPPER $3.00 $3.00 3 FIT-CPR-PIP-.75 PIPE-.75" COPPER TYPE M $7.00 $21.00 1 PRG-940070/0-100PSI 0-100 PSI PRESSURE GAUGE MIDWEST $18.00 $18.00 1 WLS-IRN-SPT-930782/6X1 6"X1" SINGLE PIPE WELL SEAL SPLIT TOP MIDWEST $110.00 $110.00 1 WELDER WELDER RENTAL $175.00 $175.00 1 EQUIPMENT EQUIPMENT DAILY CHARGES: JACK HAMMER / ELECTRIC. $238.00 $238.00 1 PARTS: CONCRETE REPAIR / GROUT. $90.00 $90.00 1 SHOP LABOR CUTTING WHEEL $6.00 $6.00 1 SHOP SUPPLIES GRINDING WHEEL $6.00 $6.00 1 CAMERA WELL CAMERA $400.00 $400.00 1 SHOP SUPPLIES PAINT $15.00 $15.00 1 Electrical Equipment: WATER LEAK ALARM. $265.00 $265.00 1 Freight: WATER DETECTORS UPS 1Z1Y63110222345408 ETA 8/7 $20.16 $20.16 $4,013.66 $0.00 $0.00 $4,013.66 $0.00 $4,013.66