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Home My WebLink AboutT15N R1W SEC 18 LT 72B DEPT. OF ENVIRONMENTAL CONSERVATION TONY KNOWLE$, GOVERNOR RECEIVED ~IAR 4 1999 MunJcipal~ty ot Anchorage Dept. Health & Human Services cOMPUTATION SHEEr SUBJECT: SHEET / OF / CKD ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL MAILING ADDRESS Top of tile to finlsh grade Materifllibegcath tile Width Depth W dth Material N*O, OF BEDROOMS Liquid depth PERMIT NO. PERMIT NO, PERMIT NO. Type of crib Crib depth Well DISTANCE TO: Class Depth Driller DISTANC'E TO: Building foundation Sewer line OTHER PIPE MATERIALS SOIL TEST RATIND~.~ INSTALLER REMARKS ' Total effective absorption area ation Nearest lot llne Distance to lot llne i P RMIT NO, IAbsorption area(s) APt ROVED / ] /~'~'~"' DATE LEGAL ',72.013 (R~v. 3/78) ~:: ...... ' ~ / .:.~*~". ' ~ """~'"':~:~' .~ ,4%~"~' '~%*'m:~,*~.~=.. ~ . . '. ....... [ .................. EXCAVATION ROBERTA.$RAFER WORK May 20, 1983 CIVIL ENGINEER 694-2979 State of Alaska Department of Environmental Conservation 437 E. Street Anchorage, Alaska 99501 ATTENTION: Bruce Erickson Reference: Lot 72B: BLM Tract in Section 18, '':. · hk-~, T15X; An examination of the well and sources of coetaminatien for that well was made on the referenced property. All sources of sewage contamination from septic systems and drain fields exceed the 150 foot horizontal distance requirement to this well with the exception of the septic system serving the trailer located on the same property. The septic tank is approximately 110 feet and the drain field 120 feet from the well. An underground gas or petroleum operation on the adjoining lot exceeds 100 feet from the well. It is recommended, based upon the soil conditions which exist in this area and the topography that a waiver be granted which will allow this well to be used to serve a second mobile home which is to be installed, on the back of the same property. The septic system for the additional mobile home will be re~]ired to be 150 feet or more from the existing well. It should be noted that a sizable depression currently exists over the existing septic tank and absorption trench serving the trailer located on this property. The owners are required by this letter to have these depressions.filled and the septic system grated to prevent accumuIations of run-off water which could tend to saturate the absorption area. If we may be of further us.. ., //// SincJel~;, ~ service, please do not hesitate to contact cc: Ellen Anderson SRIJ 196X EAGLE,R VER, ALASKA HEALTH AUTHORITY APPROVALS SEWER & WATER MA~N EXTENSIONS SEWER & WATER INSPECTION SYSTEM DESIGN WELL ~NSPECTION & FLOW TEST SITE PLANS SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESION ROBERT A, SHAFER CIVIL ENGINEER March 24, 1985 State of Alaska Department of Environmental Conservation. 437 E Street Anchorage, Alaska 99501 REFEREblCE: Lot 72B: B~M Tract: Section R1W We submitted a request~for a waiver on the referenced property dated May 20, 1983. A copy of that request is attached. At that time the developer was involved with a fire in her mobile home and did not wish to continue with the request, however, she is now ready to proceed with the work and we are now again requesting a certificate to construct a Class C water system and an on-site waste water disposal system. The existing well is intended to serve two mobil homes. An on-site waste water disposal system was installed under a Municipality of Anchorage permit in 1980 for the one mobile home. Horizontal separation distances are as shown on the attached plat and described in our letter of May 20, 1983. There are no known problems with septic systems in this general area. Soils are relatively tight, consisting of highly silted sand and gravel~with a percolation rate of approximately 25 minutes per inch. The on-site waste water disposal system for the second trailer will meet the specifications used for the installation of the existing system. I hope this letter provides any additional information necessary to grant the requested permits with waiver. If :~be of further service, Sincerely, please call. SRB 196X EAGLE RIVER, ALASKA 99577 ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 302 ANCHORAGE, ALASKA 99501 274-2533 April 5, 1985 Robert Sharer S & S Engineerin9 SRB 196X Eagle River, Alaska 99577 SUBJECT: Horizontal Separation Waiver Between $!ell and Septic Tank, Lot 72B, BLM Tract, Section 18, NE 1/4, Tt5N, 8521-WA-129 Dear Mr. Shafer: The department has reviewed the subject waiver request and cannot ap- prove the waiver. The report did not show that the separation re- qulred by 18 AAC 72.021 was clearly not necessary in this situation. Si ncerely, SE/dd Steve Eng, P..E~ District Engineer EXCAVATION ROBERTA. SHAFER WORK Flay 20, 1983 CIVIL ENGINEER 694-2979 State of Alaska Department, of Environmental Conservation 437 E. Street Anchorage, Alaska 99501 ATTENTION: Bruce Erickson Reference: Lot 72B; BLM Tract in Section 18; NEJz; T15N: R1W An examination of 'the well and sources of contamination for that wel-1 was made on the referenced property. All sources of sewage contamination from septic systems and drain fields exceed the 150 foot horizontal distance requirement to this well with the exception of the septic system serving the trailer located on the same property. The septic tank is approximately 110 feet and the drain field 120 feet fr~m the well. An undercround a . operation on the ad4oinl~ ~ .... ~ g s or petroleum J ,,~ ~ exceeds £00 feet from the well. It is recommended, based upon the soil conditions which exist in this area and the topography that a waiver be granted which will allow this well to be used to serve a second mobile home which is to be installed, on the back of the same property. The septic system for the additional mobile home will be required to be 150 feet or more from the existing well. ' It should be noted that a sizable depression currently exists over the existing septic tank and absorption trench serving the trailer located on this property.. The owners are required by this,letter to hav~ these depressions filled and the septic system gr4ed to prevent, accumulations of run-off water which could tend to saturate the absorption area. If .we may be of further service, please do not hesitate US. .~ · ~4AFER, P.E. to contact cc: Ellen Anderson SR8 196X EAGLE R VER. ALASKA CONSTRUCTIONAND OPERATION CERTIFICATE ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM /~PPROVAL TO CONsTRucT Plans for the construction of ~07~ 72 !3 ¥ a/- - in. I~' public water system located , Alaska, sgbmitted in accordance with 18 AAC 80.100 [] approved ~ conditionally approved (se~ attached ~ondi,~ons). have been reviewed and are DATE If construction has not started within two years of ~he approval date, this certificate is void and new plans and specifications must be submitted for review and ac proval before :onstruction. .APPROVED CHANGE ORDERS Change (contract oraer no. Approved by Date or ae$criptive referellce) The '"APPROVAL TO OPERATE sect'on must be completed before any water the public. ~PP~OVAL TO OPERATF The construction of the. public Cater system was corn pleted on (date). The system is nereoy granted interim approval to cperate for 90 days followin~ '[he cum pletion date, S maae availaDiB to BY ~rlTLE DATE As-built plans submitted during the inter m approval period, or an inspection by the Department has confirmed the system was (~onstructed according to the approved plans. The system is hereoy granted final approval to operate," BY ' {3ATE FERflI] N]. TREN _.H L:':O I L RATING i::IF'F'LIC,qNT ELLEN HN[EF.....,UN -,RH E,O,.-., ":"."":" LOCRTI ON LEGRL T±SN RiH '= ..... ' ._ EE.I,:, L?2-B TYF'E OF '=- -,UZL RBSORPTICd'.,I ':'."- ", ,-. - -, ~ .:TEI"I I.=,. HFI;:':,'IHUH NUItEEF.. OF BEI}ROOP'I?:, = '~: THE REQUZRED '~[TE OF THE -,UZL - "--'- ' '' - - - HB-,ORF 1 Z oN '-' "- , ,-. E'::. E:~ F" -I- I!-t == "-:" EI_'IT ¢ -,I~E 688-3:254 9'9999'9 E;QI.JRRE F'EET (SQ FT,."BR'.,= '-'":'c THE LENGTH C'IMENSIOI,4 IS THE LENGTH '::IN FEET::, OF THE TRENCH OR [.ERINFIELC. THE [:'EPTH OF R TRENCH OR PIT IB THE DISTRNCE BETWEEN THE SURF'FICE OF THE GROUND FIN[:, THE BOTTOM OF THE E,.,L. HS, RTI_N (IN FEET::'. THERE ID NO -,ET 1.4IDTH FZD" ' -E ~,- FEEN _.HE:,. THE GRB',/EL DEPTH ZS THE MINIMUM DEPTH OF GRFIVEL BETHEEN THE OIJTFBLL PIF'E BN[:, THE BOTFuI OF THE E,-,,UN,,,NTILN (IN FEET... · --. E. F T ~ C:: T' ~ ~-~ ~: -~ ~ -~ - PERMIT RF'F'LIC:IRNT HR~; THE REE]F'ONSIBILITY TO INFORM IH.L, DEF'RRTt','IENT DURING THE I[L:THLLPITICN INSPECTIPIN'; OF RNY HELLS R[:',IRCENT TO THIS F'ROF'ERTY FIND THE NJIIEER OF RE~;IDENC:E'5 THRT THE 1.4ELI_ HILL SER',,,'E. EHt.,K. FILLtNb OF FINY :'"- ,' -.,~=,TEft HITHOUT FINRL INSPEC:TIF*N ~ND RF'F'ROVRL BY THI~ [:'EF'RRTHENT HILl_ BE '- ...... TO PROSECUTION. :,LIE, JEL.] ' I'IZNZHLtH B'Z~TRNC:E BETHEEN R HELL RND RNY ON-~ZTE ~EI4RGE [.Z-,Fu_,HL - -.~-, TEl t I=, ::[C~C~ FEET FOR R PRZVRTE 14ELL OR t58 TO 2F~C4 FEET FROM R PLIBL~C: HELL DEPENDZNG JFOH THE TYF'E OF F'JE:LZC' HELL i'IINZHUH DZSTRNC:E FROH R F'RZ',,,'~TE HELL TO 'TO FI COHHUNZTY SEHER L~NE [..S 75 FEET. "- ,=.-' FEET [af',lE:' OTHER REQLIZREI"IENTS t'IRY RPF'[ y ~ '- - · -FEL. ZFZCHTZoN~ ~ND CON'gTRUC:TZON [:,Z~GRi=iI,'IS HRE ~, H.I. LHBLE TO ~N_ URE PROF'ER ZN:~TRLLRTZCN. Z C:ERTZF'.r' THRT 1: ~ RH F-' '- ' HHZLZHR HZTH THE REQLIZREI"IENTS FF*R ON-qZTE 2EWER.=, RND HELL_, R.=, ...,ET FORTH BY THE MUNZCZPFILZTY OF RNC4ORRGE. - ' - '- '"- ' ' '= '- '= .... Fz: Z HZLL ZN-,THL. L THE c~,,- .,. -,r:,TEII IN RCCORC, FINCE NZTH THE CODES. 3:: Z UNDERSTRND THRT THE OF,I-S~TE 5EI.,IER SYSTEM MRY RE~t ~'E - - '~ ',' '- ..... ENLNR=EIIEF,IT ZF THE RESZDENCE Z=, REH}C, ELE[, TO ZNCL DE MORE THRN 3: BEDROOMS. RF'PLZC:RNT ELLEN - , ,-- H~D ER:,uN ............... CAT WORK May 20, 1983 CIVIL ENGINEER 694-2979 State of Alaska Department of Environmental 437 E. Street Anchorage, Alaska 99501 ~onservat ion ATTEN'P[ON: Bruce Erickson Neference: Lot 72B: BLM Tract in Section ].8: NE~: T15N~ R1W An examination of the well and sources of contamination for that well was made on the referenced property. All sources of sewage contamination from septic systems and drain fields exceed the 150 foot horizontal distance requirement to this well with the exception of the septic system serving the trailer located on the same property. The septic tank is approximately 110 feet and the drain field 120 feet from the well. An underground gas or petroleum operation on the adjoining lot exceeds 100 feet from the well. It is recommended, based upon the soil conditions which exist in this area and the topography that a waiver be granted which will allow this well to be used to serve a second mobile home which is to be installed, on the back of the same property. The septic system for the additional mobile home will. be required to be 150 ¢eet or more from the existing well. It should be noted that a sizable depression currently exists over the existing septic tank and absorption trench serving the trailer locat,~d on this property. ~h ownors are ro~uired b thi.; prevent accumulations of run-off Water which coul~ tend to saturate the absorption area. _ If we may be of US. S i nc'e?~ ~-y, further service, please do not hesitate to contact cc: Ellen Anderson SR8 196X EAGLE RIVER, ALASKA CONSTRUCTION AND OPERATION CERTIFICATE ALASKA DEPART~EN'I[ OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the constm:tion of_ in__ -~--~'~ ) ~ -- .public water system located ~ ' ., Alaska, submitted in accordance with 18 AAC 80.100 [] approvea, _have Peel] revieweo and are F} conditionally approved (see attached conditions}. BY I[ constructior nas not startea within two years nf the approval date. [his certificate isvoic~ ann new plans and specJficat OhS must De submitted for review aha approval befme construction. APPROVED CHANGE ORDERS Change (contract order no. or aescr gtive referoncoj Approved by Da te The "APPROVAL -FO OPERATE" section must be compleLod before any water is made available to tho public. .APP.___R. OVAL I'Q, OPERATE The construction of the. ...public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. BY As-built plans sLIbmitted dLIring the interim approval period, or an inspection by the Department has confirmed the system was constructed according to 'the approved plans, The system is hereby granted fioal approval to operate. MtJ~ICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT MAILING ADDRESS ~ LEGAL DESC IPTI N ~ ~ DISTANCE TO: Manufacturer DISTANCE TO: No. of lines nlsh grade NO. OF aEDROOMS ~ '~' ~ ~%' f compartments ~=~E: Inside length Well Dwelling PERMIT NO. y in ga OhS Type of crib Crib depth DISTANCE TO: Well Class Depth Driller DISTANCE TO: Building foundation OTHER Trench width Distance between lines inches ire @bsorption area inche tire absorption area Nearestlotline Distance to lot fine Septic tank 3MIT NO. SOIL TEST RATING 'NSTALLE. REMARKS 3/78) DATE LEGAL unicipality of 825 "L" STR E£T ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPARTMENI~ OF HEALTH AND ENVtRONMENTAL PROTECTION Certified #741917 October 24, 1980 Ellen Anderson 7800 De Barr Road #519 Anchorage, Alaska 99504 Subject: Dear Mrs. T15N R1W Section 18 Lot 72 On-site Sewer System #800562 Anderson: On October 22, 1980, this department performed an on-site sewer inspection. The trench was filled with gravel. This is a violation of Municipal Ordinance 15.65.040 C. The gravel will be removed from the trench by November 7, 1980 or a citation will be issued. Another first i ' nspectlon is required. If there are any further questions, please call this department at 264-4720. Sincerely, Lynn Lindquist Principal Code Enforcement Officer LL/ljQ CC: Ken Norman Municipal Legal Department 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M, SULLIVAN, MAYOR DEPAHTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION November 3, 1980 Mr. Anderson % Ellen Anderson 7800 De Barr Road #519 Anchorage, Alaska 99504 Subject: T15N R1W Section Permit #800562 This noon (1) (2) 18 Lot 72 letter confirms our two(2) phone conversations as of this date, specifically: The water found during an initial inspection, has subsequently been declared not a seasonal water table by O & E Engineering. The open trench can be backfilled with gravel under the conditions noted; (a) Obtain approved gravel pit sewer rock. (b) Use the gravel backfill already on the site which was removed from the trench because of illegal backfilling. The gravel was subsequently contaminated during removal and will have a condition attached. Severity of gravel contamination was considerable, therefore if this gravel is used, the sewer system will have to have an adequacy test when a health authority approval is requested for resale reasons. The subject of this department calling the gravel distributor was questioned. This department is responsible for gravel standards and frequently references the distributor if field samples appear questionable. Additionall , thi . usually requested to ln~ ~ ...... Y. s department is ~,-' ~ - ~ ~= ~vei prior to sale. I find ~nls Qepartment took the time to call the distribu · f any error had bee- ~ ...... · tor, to check . - .,,~u= z~ar~lng rock specifications and your delivery, is appropriate and to the public s advantage. Mr. Anderson November 3, 1980 Page Two There are two(2) distinct items regarding your property and this department's inspections: (1) Water was noted in the excavation which is not allowed in on-site sewer systems. Therefore, the water was rightfully challenged. (2) Your sewer system had been excavated by a non-licensed excavator and backfilled without inspection. This is a violation of your permit. Subsequent problems with gravel contamination are a result of this activity. This department will make the final inspection when gravel is in the trench and the pipe in place. If there are any further questions please call this department at 264-4720. ' Sincerely, Les N. Buchholz, R.S. Sen] or Lnvlronmental Specialist LNB/ljw ~'"ILItI"-~ I ,7: I F'RL ~" -~, , ~.- FERHIT NO (. ~O~e~~ ', 0~-~ ~- · T~ ~~ ........ - __... ....... ~Mb~_.ON '~,~ , LOcRI I0N BIRPHNOOc, ,r,n~ . ...... , oeo [:.EBRRR %p 519 .. ,~/'~ ~ ~ . ~ LOT S~ZE ,~ - - ]¢PE OF ~Zl RB~ORPT.~r' ~,,~ ~ · . ..... iLN SysTEM I=.; TRENCH HR¢4IMI.IM NUMBER OF BEDRoONS =' ~ " ~OZ' ~ ............... THE REQUIRED -'SIZE OF THE SOIL RBSORPTION SVSTE~ DEPTH== 8 LE[4m3TH= 87 GRR'¢EL DEF.TH= THE LENGTH DIMENSION l~ THE LENGTH (IN FEET> OF THE TRENCH OR THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE THERE IS NO SET NIDTH FOR T' E~CRVRTION (IN FEET) RENE. HES. ' THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE E~;CRVRTION (IN FEET). PERMIT ' ~' RFPLZ~RNT HRS THE BESPONSIB~L~T,¢ TO ~NFO~M TH~S BEPR~TMENT DU~IN6 THE ZNSTFILLRTZON ~N-PEL. T~ON~, OF RN~ NELLS RD.7~CENT TO THZS P~OPE~T'¢ RND THE NUHBER OF RESZBENCEs THRT THE NELL NZLL 8RCKFILLIN~ OF ~tN't' '; -,Y~TEN NITNOUT FINRL DEPRRTMENT NILL BE SUBJECT TO P - INSPECTION RND RPPROVRL BV THIS ROSEE. UTI 2N ' - t'lZNZNUM DZ-,TRNE. E BETNEEN R NELL RND RN~ ON-SZTE SENRGE i88 FEET FOR R PRZVRTE NELL OR &58 TO 288 FEET F~ON R PUBLIC NELL DEPENDING UPON THE T'¢PE OF PUBLIC NELL MINIMUN DISTRNCE FROM R PRIVRTE NELL TO fl PRIVRTE SENER LINE IS 25 FEET RND TO R COMMUNITV SENER LINE IS 75 FEET. NELL LOGS RRE RESUIREB RND NUST BE RETURNED TO THE DEPRRTMENT NITHIN OF THE NELL CONPLETION. OTHEr: REQUIREMENTS NRY RPPL~'. SPECIFICRTIONS 8ND CONSTRUCTION R'v'RZLRBLE TO INSURE PROPER INSTRLLRTZON. I CERTIFv THRT i: I RM FRMILIRR NITH THE REQUIREMENTS FOR ON-SITE SENERS RND ~ ~ ,- FORTH B~' THE MUNIcIPRLIT~' OF RNCHORRGE. 4EL. L=, RS SET HILL INSTRLL THE SYSTEM IN RCCORDRNCE NITH THE - ' E, ODE5. 'Z' I UNDERSTRND THRT THE ON-SITE SENER S'¢STEM M8'¢ REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO IN_-LUDE MORE THRN ~ BEDROOMS. SIGNED: ..................... ' ' ' 3 ' % /~0 - ~ , ~ ~ Russell Oyster 694-2774 O & E ENG,,~IEERING & DEVELOI-,vlENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Name: Performed for: Mailing Address: '7 ~ ~'}~ Legal Description: /--.__~7- '7~ E3j SOIL LOG Depth (feet) Soil Characteristics 0 1 AZ/L ~',LZ' ~'~./~ Earl Ellis 688-2280 5_ 6_ 7_ 8~ 9~ PIzOT PLAN 12 14_ 15__ 16_ _ PERC. TEST ~ OF Ground Water Encountered: Yes__ No / If yes, what ~ depth~ ~... Proposed Installation: Seepage Pit. _ Drain Field~ Comments:_ Date:_ From Address Other Pertinent Data P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 5633 "B" STREET TELEPHONE 279-4014 ANALYTICAL REPORT Product Date Aalalyzed by Date Lab No. REPORT OF ANALYSIS MESH 8 18 35 60 120 230 230 INCHES <4-2 2-1.25 1.25- .75 .75-0.187 0.187-0.0937 0.0937-0.0394 0.396-0.0197 0.0197-0.0098 0.0098-0.0049 0.0049-0.0025 0.0025-<0.0025 MILLIMETERS ...... ,2,p~f PERCENT BY WEIGHT -~100-50 50-31.5 19.0- 4.75 2.36-1.00 ~ ~, ~. ~, ~ ? o.5oo-o.25o o. 5-o.o m O. 063-~0.063 /~.r 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264 4111 October 29, 1980 Certified #741918 Ellen Anderson 7800 De Barr Road #519 Anchorage, Alaska 99504 Subject: T15N R1W Section 18 Lot 72 On-site Sewer System #800562 This will confirm my conversation with Mr. Anderson today. On October 29, ].980, I inspected the open trench on the above property. I found water seeping at the four(4) foot level in the area of the septic tank excavation. I found water seepage in the bottom of the trench at the eight(8) foot level. Prior to approval and second inspection, a soils test will need to be performed to determine the depth of the ground water. The gravel on the site was very silty and muddy and over- sized. I kave taken a sample to our laboratory for a sieve analysis, which will indicate whether or not the gravel meets Municipal standards of minus 3% fines in gravel and ½ inch to 2½ inch screen rock. The trench must remain open until the lab report is given to me and the soils information is received at this office. If there are any further questions, please call this department at 264-4720. Sincerely, Lynn Lindquist .~-~ Principal Code Enforcement Officer LL/ljw cc: Ken Norman /O~ Municipal Legal Department • e *, i1Municipality of Anchorage-. _ On-Site Water and Wastewater Program (907) 343-7904 Certificate of On-Site Systems Approval Parcel I.D. 05117249 Expiration Date: C(--2-3 —1 7 1. GENERAL INFORMATION Complete legal description T15N R1W SEC 18 LOT 72 B Location (site address) 19110 S. BIRCHWOOD LOOP Current Property owner(s) ROBERT AND PATRICE PRIESTLEY Day phone Mailing address 19110 S. BIRCHWOOD LOOP Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: NONE Distance:NA Received b - Date:6 /A-747 COSA to be released to the ineer,unless otherwise requested by the engineer. COSA Fee $ 6Z Waiver Fee $ Date of Payment 050 Date of Payment Receipt Number 03cif 9 D Receipt Number COSA# 05C(?'/ /g- Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Phone 854-5558 Address 30840 PRUDHOE BAY Engineer's Printed Name CHARLES BALZARINI Date 06/01/17 6. DSD SIGNATURE - System #1 Approved for _ -3 bedrooms , . : `. : • . • • • • HARLES G BALZARINl1 1'r System #2 Approved for bedrooms $°¢��c'� `• 5• •••�� Disapproved eyFa al.. I•�`��s �,, pR,0,,E,5Si4� Conditional approval for bedrooms, with the following silfp ' # ON siTE WATER ANn rn WASTEWATER �RQGRA �c • By: w` 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 blue sheet2: - If more than 1 septic system is on the lot: COSA Checklist# 1 of1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: T15N R1W SEC.18 LOT 72B Parcel 0:95i- 17)- -10 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# Well Log (YIN) N Date completed UNK Sanitary seal (YIN) Y Wires properly protected (Y/N)Y Total depth UNK ft. Cased to +40 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test UNK 5/11/17 Static water level UNK ft. 48 ft. Well production UNK g.p.m. +2.5 g.p.m. WATER SAMPLE RESULTS: Coliform 4Jt, colonies/100 mL Nitrate ("c mg/L Arsenic .//7 ug/L Date of sample:(l4,1i7 Collected by: C&M ENGINEERING B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 11/1980 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) NO Date of pumping 5/30/17 Pumper SANITARY PUMPERS C. ABSORPTION FIELD DATA Date installed 1980 Soil rating (getAletgar ft2/bdrm) 230 System typeTRENCH Length 69 ft. Width 3 ft. Gravel below piper Li ft. Total depth 9 ft. Eff. absorption area ILft2 Monitoring tube Y Depression over field N Date of adequacy test 5/11/17 Results(Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 36 in. Water added 450 gal. New depth 42 in. Elapsed Time: 900 min. Final fluid depth 36 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment(past 12 mo.) (YIN & type) NONE KNOWN If yes, give date NA D. LIFT STATION Date installed NA Size in gallons NA Manhole/Access (Y/N) NA "Pump on" level at NA in "Pump off' level at NA in. High water alarm level at NA in. Datum NA Cycles tested NA Meets alarm &circuit requirements? NA E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot +100 On adjacent lots +100 Absorption field on lot +100 On adjacent lots +100 Public sewer main +100 Public sewer manhole/cleanout +100 Sewer/septic service line +25 Holding tank +100 Animal containment areas +50 Manure/animal excrete storage areas +100 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 ABSORPTION FIELD ON LOT TO: Property line +10 Building foundation +10 Water main +10 Water Service line+10 Surface water +100 Driveway,parking/vehicle storage +10 Curtain drain +50 Wells on adjacent lots +100 F. COMMENTS � �cp A;? Ads 7c' E VA/DE/2S..TPE 'i 3 Biz Coj7E5, 134 54",› 49,,r /1e65Prca-A/cP ?Todv Er- orkT wtr¢X AAvr t'jr 4-1E r.> 4 S 4 F vT c-fze 3 i3A. P c j7cr9CFr✓!E4-J 4_2-78.• G. ENGINEER'S CERTIFICATION gor # i !AL, ! certify that t have determined through field inspections and ,Aprr A\ i• -4,♦ review of Municipal records that the above systems are in - �• - •y I conformance with MOA COSA guidelines in effect on this date. T -[ _* �y Engineer's Printed Name CHARLES BALZARINI 410 10, Date 6/01/2017 f CHARLES G BALZARINI ! f �t1 C -13854 :. e,9� 6/!/lam ROFESS'i.O COSA canary sheet_2-6-15.doc T 151,jR 1 4/ 5c C i C,07,- 7; i'. THG G r r r.✓(, 1-jOct tl F.Ge-i /PP 4R$ Tv Mile 13 a--/e,,,-' .Z''- %.4c44-11 CL�PTLT1- £r�o las r. 134 5 C D 0 Ai 'role.- ?AV, 77'1 _2 r��c 7-7-0,,, RE17,I T F r) 5c9 P-- R4 T2?t' (', l-IE 5 /5 i c.--r t 1/it i 13 c C,A,0 E a 5-1.-Z 12!a Fetz 3 1 A ClePiii5 . 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J‘, • -•,-, .. _ 9 / . \ .6 ' .: .7 . .• f _ p rte`/G '�/.>1 , -- /X1.1-C�f' -/1al ' �o)o ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE ,f7 �`,kiti,* FOLLOWING DESCRIBED PROPERTY: OF Aj ' ,y 'DT.7e.Bs �/ T/S iP �/`, - DATE: r • •• 'Q 4ND THAT NO ENCROACHMENTS EXIST EXCEPT AS 1,��9 ,.•'" ' y.. ., .' s INDICATED. IT IS THE RESPONSIBILITY OF THE r * ; ' ' )WNER TO DETERMINE THE EXISTENCE OF ANY GRID: s 7.* •VEASEMENTS, COVENANTS, OR RESTRICTIONS l/fir +' ,.� VHICH DO NOT APPEAR ON THE RECORDED SUBDI- Du erk Seward . •0 /ISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' -2 Z .4 f;•... LS, t •_., o ANY DATA HEREON BE USED FOR CONSTRUCTION ' ,. )F FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN: 4%oil.� , '� "; CRY LINES. �m�