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HomeMy WebLinkAboutT15N R1W SEC 18 LT 132 Number: OS221387 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT PID Number: 051-231-34 Page 1 of 2 Dwelling: ❑Q Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Deborah & Michael Forcht ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 18791 S Birchwood Loop, Chugiak ❑Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 132 Ft. Ft. Fill added above original grade Gravel length Township Range Section 15N 1 W 18 Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station I Holding I Sewer ! Total absorption area Number of trenches Dist. between trenches From Tank Field IIII Tank Line Ft= Ft Well 100'+ 100'+ 100'+ NA 25+ TANK m Septic ElS.T.E.P. El Holding E] Other Manufacturer GREER Capacity 1000 Gal. II Surface Water 100'+ 100'+ 100'+ NA Material Number of compartments Lot Line 101+ 10'+ 10'+ NA NA HDPE 2 Foundation 10'+ ( 10'+ I 10'+NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank Tank to 3034 drainfield 3034 Deans Construction Drainfield co/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 It Inspection dates t'` 10/13/22 ltd 10/28/22 Location and description 31d 4th Nearest Trim Corner on House ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date �zz k �C� OF ALA S® co Stevzn R'. Pin �ra� -9;1. CE 814a Septic System Appro r ,. ,t2ae=-k. Note: this approval does not include well permit requirements.����`'�`� iao„ n�rn�ia a� 2" RIGID INSULATION OVER TANK AND LINES 7 2.0 90.1 1000g 95.9 SEPTIC TANK PROFILE SCALE: NTS r S. - 61RCHWOOD LOOP 7. \ -- L_ _ _ ._ _. _ —i/ _ _ _ _ _ _ ... / / WELL c 1000ga1 SEPTIC TANK DECOMMISSIONED PER 1✓,DA CODE 09.7 / \ DRAIN FIELD DCO I T2 T7 2 BR INSTALLED NEW 1000aa1 SEPTIC TANK v SFO / INSTALLED FCO BEFORE DCO AND AFTER TANK q WELL £ 4 WELL E > / / / DESIGN PARAMETERS A B FC 13.9 8.40 T1 37.9 32.2 T2 41.0 36.6 DCO 44.4 40.5 PRIMARY SEPTIC SYSTEM NO. BEDROOM: 2(300 gpd) TANK SIZE: 1000gal MIN r USED: —1000gal MOA APPROVED SEPTIC TANK. r1OTES: PANNONE, ENG -SVC, SVC LLC (C I. 1088) "",,, �E �F AL �' , -. ......:.. Sten CE -8149 8none � Gt.S %s > ss; ...... REVISIOVIS DATE 10/31/2022 RECORD DRAWING T15N R1 W SEC18 L132 MICHAEL &DEBORAH FORCHT 18791 S. BIRCHWOOD LOOP RD CHUGIAK, AK SCALE 051-231-34 DRAWN...... SITE PLAN PERMIT NO. 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(D in > 0 0 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221387 Work Type: SepticTank Upgrade Tax Code Number: 05123134000 Site Legal Address: T15N R1 W SEC 18 LT 132 G:1055 Site Mailing Address: 18791 S BIRCHWOOD LOOP RD, Chugiak Owner: FORCHT DEBORAH J & MICHAEL L Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date »c.nt �O = ;... U � J Depai,tnlent 10/10/2022 10/10/2023 Lot Size in Sq Ft: 66211 Total Bedrooms: 3 , Ck (or12/2o ZZ ❑ 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: Issued By: Date: Date: 0 20 2 2-- ON-SITE SEWER/VVELL PERMIT APPLICATION Parcel I.D. 051-231-34 Property owner(s) Michael & Deborah Forcht Mailing address 18791 S. Birchwood Loop Rd Site address same Chugiak, ak Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W Sec18 L132 Lot Size 66,211 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X Septic Tank FKUpgrade ❑X (w/wo ADU) Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ignature of property owner or authorized agent) Permit/Rush Fees: o2 a5 Date of Payment: ql go%a a Receipt Number: CQaba341 Permit No. 06,099/382 - Permit App_:- : - . _.,:c Waiver Fees: Date of Payment: Receipt Number: Waiver No. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221387, Curtis Townsend, 10/10/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221387, Curtis Townsend, 10/10/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221387, Curtis Townsend, 10/10/22 MUNICIPALITY OF ANCHORAGE ~' DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ~d~r.~ TANK FIELD Township, Rsnge, Section ~-BUILT DIAGRAM (Show Iooe[ion of well, septic system, properly lines, TANKS No. o~Compa~ments TYPE OF SYSTEM ~ ~ ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER I ~ ~ Depth ,o pipe bottom from Total ,epth from or,ginal grade 4.~ .~ ~' ~j ~ ~' ~,~ FT FT Gr~vel length Gravel width ~t FT ~ FT WELLS ~ PRIVATE ~ OTHER (Identify) ~iassification (A,B,C) Total Depth ~ Cased to ~,~ FT FT installer Dste installed: REMARKS: · Eagle River Engineering Services Municipal and StMe guidelines In effect on this date. ~ x Health Department Approvm: ' 72-013 (3/85) :t .. ]: ~';m .¢ ~stm :i. :1 :i. e, i" ,.,~ :i 'L h 'L h ~::.~ r' (:..: (::itt :i i, ~:(.~m(~,r'~ 't'. ~=.; { ct I- c}r't .....,{!; :i. ~: e::~ ~i(~,~/~((<.~" ~!~ ~.~r'~ d ~,.*e,, ] .I. ::f:,, I ~:i.l] :in~;'~:?~.l.:L 'N"/e) ~y~FL~:;.un ir'i a(:::~:::c)r't::h:~d}~:::(;~, ~JtJ"l a:I.:l ME){.~ ~:::~::~::le~'.~ and ..... , Tom Fink, Mayor January 8, Municipality Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 1990 Catherine Callahan HC 78 Box 2355 Chugiak, Alaska 99567 Subject: T15N R1W Section 18 Lot 132 Permit #890272, PID #051-231-34 The subject permit, issued.by this.office for a ~i'ngle family well and/or on-site wastewater system ha~. expired as of December 31, 1989. Permits are issued on a calendar year basis by authority of the Municipal Code of Regulations. A new permit must be obtained from this office for an well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well this office for documentation of the the permit. log needs to be sent to installation and to close If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) must be sent to this office for review, approval and documentation. When applying for a new permit, 'the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, John Smith, P.E. Program Manager On-site Services JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" (::i:l::)d r c:lc:/m!i; [0 C 0 NST P:LIC;"I' i:;¢',V¢,l'l:Otxff~ Mt.IS'I [,:,d~ OF:'IEIqE~:I)/CLOSIE[) THE SFq"IIE D~.~Y OFf. []IE I..IE:A'FIF:E~ (::)VE~:F~ THIS I:::'ERMI F IS I:::E}I::~ C)N :1. 2',/:'t; :1, EAST 336.47' , ~u. 33' BLM ROAD ROW ': & UTILI'~ EASEM£NT RE'.~ERVE / " - - -z-"~-'~--~-,--/N ..... "-1 ........... '"'- '~ ..... / · ~ ~oo' '//////! ~, P~O~,OS~O / '~ / - //////r ~ w~.u. s~op~ ' ~ ~ ~ ~ , ~ ~ '~' ~ o /. ~, /_~ ~ /// · .~ ~ . ii / +., :1I/I '~" ,, ." // : , w~sr 71.17' ~ - TEsT HOL~ · - MONffOR TUBE o - SEWER CL[ANOUT NO KNOWN CURTAIN DRAINS '~ - WELL NO STREAMS ........ LEACHFIELD EASEMENT LEGAL= LOT 152 T15N, RlW, SEC. 18 OWNER: KATHERINE CAL~HAN CONTRACTOR: N/~ 89-"1 = A EA~L~ RIVER ENGINE~RfNG ~RVICE~ ~A~L~ ~IVER, A~ 995?? (90~) 694-5195 ~A~: (90FJ 694-~9~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST DATE PERFORMED: LEGAL DESCRIPTION: 1 4- 5- 6- 7 8 9 10 11 12 13 14 15 16 17 18 19 20 -- SLOPE SITE PLAN UND WATER S TEREO~ yE ~ O~ P Gross Net Depth to Net Reading Date Time Time Water Drop 6o~ to-S 1 " ~:Z3,'oo I0 ~',~, 7"- ~'" £" Z " 4: s~ :oo " ?"-?'%" '~" 3 ~.'~5 :oo 7"-? % ~ e :5~: oo 7"- ,o" ,, ,, ~ ~~ %~,, PERCOLATION RATE /(~ (minutes/inch) TEST RUN BETWEEN ~L FT AND ~' FT COMMENTS Eagle Rivof Engineering Services CERTIFIED BY: ~ DATE: PERFORMED BY: Eagle River, AK 99577 694,-5195 72-008 (6/79) SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 132, T14N, R1W, Sec. 18 GENERAL 1. The well and septic plan are for a single family residence only, 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department. of Environmental Conservation requirements. 4. All soil tests ere advisory to the design end are to be verified modified in the field by the engineer. 5. All excavations and depths ere advisory and are to be verified or modified in the field by the contractor to meet Municipality ~ Anchorage, Department of Environmental Conservation requtrements~ 6. It is the responsibility cf the owner to obtain all necessary per~'~ or easements and Go locate any adjacent multi-family wells..' :!:~ ?. The excavation is to be exactly in the area shown on the site ~i~'~' any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. BED 1. The bad is to follow the natural land contour to maintain uniform total depth of the bed bottom. 2. The bottom of the bed shall be level, plus or minus 1.5'. 3. The total depth of the bed excavation is not to exceed 3' at any point in relation to monitor tube lays1. 4. The sewer line is to replace the existing sawer line that leads to the existing pit. 5. The bed gravel is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is required to bm placed o~er the lsachfteld. Recommend 4' depth. ?. The area over the bed is to be finish graded to crevent pending of surface water runoff. The septic tank and teachfield must not be closer than 100' to any existing private well. lSD' to any Class "C" well, or 200 foot to any community well, RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH = 3' GRAVEL DEPTH = 6" BED LENGTH = 37.5' BED WIDTH= 24' Soil Rating = 200 Bedroom Capacity = 3 Septic Tank Size = 1000 gallon ~:**NOTE: ***NOTE: ***NOTE: EXISTING PIT TO BE EXCAVATED INTO AND FILLED. SEWER LINE FROM HOUSE TO TANK IS TO BE INSULATED H.D.P.E¢: SEWER LINE WITH 1' MINIMUM MOUND SOIL COVER. SEPTIC TANK. TO BE INSULATED AND COVERED WITH MOUNDED SOIL. LEACHF~ELD TOTAL DEPTH IS iN RELATION TO GROUND SURFACE ELEVATION AT TEST HOLE. WELt. -t-100' SEPTlC NO KNOWN CURTAIN DRAINS NO STREAMS SEPTIC SITE PLAN LEGAL: LOT 132 T15N, RlW, SEC. 18 OWN E Ri-'" ~A'~H ~]~ i-N E'--~,~[~,-HA N A EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, A~ 99577 (soT) ss4-s~ss FAX: (SO7) SS4-.SZS7 TEST HOLE MONITOR TUBE SEWER CLEANOUT WELL LEACHFIELD EASEMENT 9.O ~RIC ~N E~_R~ RD. 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(907) 522-7773 Certificate of On -Site Systems Approval Parcel I.D. 051-231-34 Legal description T1 5N R1 W Sec18 Lot 132 Site address 18791 S. Birchwood Current property owner(s) Forcht Expiration Date: 2-7-2023 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: 4 �` Original Certificate Date:J, 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 Tank Age Advisory Arsenic Advisory Other COSA ApprovMjune 2022 UNMPAUTY 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. 05123134 Complete legal description T15N R1 W Sec 18 L132 Location (site address) 18791 S. Birchwood Current property owner(s) Mike FOrcht 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 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: ®l Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel X Plastic ❑ Concrete ❑ Fiberglass Age New - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS Flffl� Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: 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 Application—June 2022 COSA Checklist Legal Description: T15N R1 W Sec18 L132 Parcel ID: 05123134 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 11/15/89 Total depth 106 ft Cased to 106 ft 0 Sanitary seal is functioning correctly 01 Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 10/28/2022 Static water level at beginning of test 14.1 ft Comments B. TANK DATA Measured operating fluid,level in septic tank New Date of pumping New ❑ Required maintenance completed, if AWWrS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) (P-1 --iQ ❑ ALL standpipes present per record drawing Total measured depth from grade 4.6 ft (max) Measured depth to pipe invert from grade 4.1 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ 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) If yes, enter date Comments/Deficie COSA Checklist June 2022 Well production at time of test 7 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑Q No E� Coliform bacteria is Negative Nitrate mg/L [ Nitrate less than MRL (ND) Arsenic ug/L [ Arsenic less than MRL (ND) Collected by PES Date 10/28/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 10/28/2022 Results Q Pass Fluid depth prior to test 0 in Water added 450 gal New fluid depth 0 in Elapsed time 180 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 0.5 in Effective depth used 0 in Effective depth remaining 0.5 in 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' Community Sewer Manhole/Cleanout > 100' Yes if No ft M Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Mm Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft n Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' (]Yes if No ft 0 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' Q Yes if No ft Surface Water > 100' FEI Yes if No Tank to Property Line > 5' 0 Yes Field to Property Line > 10' 0 Yes Water Main > 10' Yes Water Service Line > 10' Fol Yes F. ENGINEER'S COMMENTS if No ft Wells on Adjacent Lots: if No ft Private Wells > 100' Flfl Yes if No if No ft Community Wells > 200' R Yes if No _ if No ft If tank or field is under driveway comment below ft ft ft 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 Pannone Engineering Services Engineer's Printed Name Steven R Pannone P.E., F. ASCE COSA Checklist—June 2022 Phone 907-745-8200 ,�� OF 49\d ...!` .. .... Steven •FV Pannone 'f CE 51 AS, �� gum MUNICIPALITY OF ANCHORAGE • - EP M- 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. 051-231-34 Expiration Date: L(-S0 i f 1. GENERAL INFORMATION Complete legal description T15N R1 W SEC 18 ( car 3 2_ Location (site address) 18791 S Birchwood Loop Rd. Current property owner(s) Troy Davis Homes Day phone 957-9394 Mailing address 1689 S. Knik Goose Bay Road, Wasilla, AK 99654 Real estate agent Day phone 2. TYPE OF DWELLING: H Single Family (w/wo ADU) n Duplex Multiple Dwellings (Single Family and/or Duplex) Were 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic Water Storage El Holding Tank I Community Well ❑ Community ❑ Public Water System El Public Sewer ❑ Waiver request for: Distance Received by: Date: COSA to be released to the engineer.unless otherwise requested by the engineer. COSA Fee $ a3 . Waiver Fee $ Date of Payment /jdA6�/q Date of Payment Receipt Number UoZYWPD Receipt Number COSA# o3ct?toxo 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 Forge Engineering Phone 907-522-7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, PE Date --/--/-- oF q• 0 i*491H %* / 6. DSD SIG NATURE •.• •. .••, `xi System #1 Approved for 2- bedrooms �/ '. Benja• chiller #,1'fe* ••• CE 12592• System #2 Approved for bedrooms It <9;14:' OFESSIa• • Disapproved l\�\\��.WO Conditional approval for bedrooms, with the following stipulations: TR, S - .4-tc ` � is 2 �ears CCi1�. k64) se A144eol 6kd✓;sid S i b ec p °�j V I vteLr i►� C N Vot4e, � ON-SITE .70 crk WATER ANO o WASTEWATER ' PROGRAM l t ff N es) By: „� Original Certificate Date: �EK 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 ArsenicAdvisory Well Flow Advisory Other fcAG ,k tkd VCS(60( d COSA Checklist blue sheet If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: T15N R1W SEC 18 LT132 Parcel ID:051-231-34 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 11/15/89 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 106 ft Cased to 106 ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/15/89 10/14/2017* Static water level 96 ft. 98 ft. Well production 11 g.p.m. 5+ g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 1/22/19 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/17/90 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout(YIN) **N Depression over tank (Y/N) N High water alarm (YIN) N/A Date of pumping �� 517 Pumper Sanitary Pumpers (unoccupied since pumping) C. ABSORPTION FIELD DATA Date installed 7/1 7/90 Soil rating (g.p.d./ft2 or ft2/bdrm) 200 SF/BDRM System type Bed Length 38 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth 2.3 ft. Eff. absorption area 912 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10/14/2017* Results (Pass/Fail) PASS For 2 bedrooms Fluid depth in absorption field before test 0 in. Water added 310 gal. New depth 1 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 300+ g.p.d. N Any rejuvenation treatment(past 12 mo.) (YIN &type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "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 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 '75' 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: 10' >5' >5' Building foundation Property line Absorption field 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 None Noted Wells on adjacent lots >100' F. COMMENTS *Information taken from previous COSA dated 1/16/18 stamped by Steven Pannone **No foundation cleanout due to grinder lift station in basement G. ENGINEER'S CERTIFICATION �1- )‘,\1 I certify that 1 have determined through field inspections and ��Q . �'9isakki review of Municipal records that the above systems are in /pj • `4` 19 conformance with MOA COSA guidelines in effect on this date. 7*,•'49 TN /\ • * Benjamin Schiller, PE Engineer's Printed Name •. . ..7._ , . •• t�• .• , ,. Date 1/29/19 r, Benja• chiller . / r CE 12592 •�`��/ V 1 •. 129/19 •..4�l;`PROFESSION��� "\\\��~ COSA brown sheet 10-10-12.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT (• ,yt,bid 907-343-7904 On-Site Water and Wastewater Section / Fax: 343-7997 www.muni.org/onsite / Septic Tank Advisory Certificate of On-Site Systems Approval # 0SC191019 Subdivision: T15N R1W Sec.18 Lot 132 The septic tank for this property is 29 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. Y; .,`,z,..„'-'7'.'.7:-',-. .o-1 _.r_ .. .//t i.''. 1 ( ;w. , Jul .,, ` � . .4V t\A °`R T.- 'f;, .r i ty. `•,aka` • .b * .1,',; _ . :4:1•.4',4;-.a' . '6 =7".‘.::''•p.-.,, yam ? �yt • � �qy�. 'tom ,.5�: „ t. �` �` r �^�'y � .' lam r k s . .t±f 0. 3 , k .r.- ' ' t ` rz1' - te. ti ^ ;'. a .'.p' , . ' .••e •R otf 'd 'L J A 3` `L+. � R • F " � , - ': •'It • w '• + - k s "..,i� 2©1 81 1� ` •,...''',.., Kr , , w` • r $ y Mailing Address: P.O. Box 196650 * Anchorage,Alaska 99519-6650 *www.muni.org AP \........_ / / / Lot 124 // Lot 122 Lot 123 / / / 1 _/ / Lot 126 __r /— �' N. / // / BIRCHWOOD LOOP ROAD. / / / / N 90'00'0O'E 336.47 \ _____,----'--1--,S / / - - - - - - - - L — �—� - - — 7 I WELL 100' PROTECTIVE I / 33' R ROAD EASEMENTUTWTY- RESERVES S / 10.0'x18.2' SHED w/ / I ��// 1 FENCED DOG RUN Lot 130 !fib/ SEPTIC PIPES .- \ CA'AVQ. O.. -J/ \ . . r. .� / �J�/ Z 90.7' SEE HOUSE / / DETAIL 8o /_ ` �' E 1/3 Lot 133 8 / ,,� / u w' y")' / tO tO w BLM Lot 132 / ..... ` / 1.54 Acres / 7gp / / 0 / / / / / Lot 131 / / / 50' ELM ROAD & UTILITY / EASEMENT RESERVES / / / HOUSE DETAIL ,N 90'00'OOeW 71.17' // Scale: 1' 4. 20' / / COVERED CONCRETE ENTRYWAY / / / / 0 6a ti Lot 149 / //Lot 151 ,o, 2.0'x20.2' CANT / �� / / a / /11/ / 'v~ 2 STORY RESIDENCE h .5 1.5'x5.2' CANT PLOT PLAN ___ AS BUILT X SCALE 1. _ GRID NW 1055_ Project No. 18-356/65 11500 Daryl Avenue, Anchorage. Alaska 99515-3049 Lang & Associates, •I n C. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenOlangsurvey.com �C�,�F.44\ '11 Jonathonolangsurvey.com \,-; iP.' ..,f-40 I hereby certify that I have surveyed the following described property: °):. I�1W '.77*Q BLM LOT 132, SECTION 18, 115N, RIW, SEWARD MERIDIAN. ALASKA • • 4g �D Anchorage Recording District, Alaska, and that the improvements situated thereon are O within the property lines and do not encroach onto the property adjacent thereto, that 0 no Improvements on the property lying adjacent thereto encroach on the surveyed (70 KENNEM �Q premises and that there are no roadways, transmission lines or other visible `r'1(_� OO easements on said properly except as Indicated hereon. ` � '. ,..,- �,�p 43- Dated this the ,'t, Day of SA'-'-'e WI • Zot9 • of Anchorage, Alaska 17"' it is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 • s,, •, — Municipality of Anchorage t On-Site Water and Wastewater Program ` •,�j I ii " (907) 343-7904 SAF ETY Certificate of On-Site Systems Approval Parcel I.D. 051-231-34 —Z Expiration Date: 2 r1 1. GENERAL INFORMATION Complete legal description T15N R1 W Sec 18 Lot 132 Location (site address) 18791 S. Birchwood Loop Rd. Current Property owner(s) K M Callahan RevOC Trust Day phone Mailing address 18777 Birchwood Loop Rd. Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: [j Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual LI Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: (21t/1$1r Received by. /k(/ :;� I Date: ` COSA to be released to the engineer,unless otherwise requested by 4-ngineer. COSA Fee $ 62'6 Waiver Fee $ Date of Payment I'11-4 Date of Payment Receipt Number D 44Oa I S Receipt Number COSA# oSC tgloll 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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 1/16/2018 6. DSD SIGNATURE :1;i:___ ••• i••- •• f 0 System #1 Approved foredrooms 1 ':Steven . Pannone: ', System #2 Approved for bedrooms CE-8149 . � Disapproved �ItU`� o S:9.0 `-� Conditional approval for bedrooms, with the following stipulations: te-S Seirof 1 c ----tet. lc S FY. 6t.►-c Q(a i\-fr,p.Ai(e7 I , aStet' ( s :L t Z0 .-1 .vs 0 /611 G-.0\\- Y OF,q�y�yo .. ON-SITE w WATER AND r" o WASTEWATER o PROGRAM ,, ow o i -''rSER\J\C 6664 By. 1 I Original Certificate Date: I- 22-/ 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. • ,y,A.,.,.i 7. ATTACHMENTS: :, .I COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Adviso , `` ••' ry . ' • Well Flow Advisory Other • ' COSA blue sheeti" If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: T15N R1 W Sec 18 Lot 132 Parcel ID:051-231-34 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 11/15/1989 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 106 ft Cased to 106 ft Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 11/15/1989 10/14/2017 Static water level 96 ft. 98 ft. 5+ m. Well production 11 g.p.m. g.p WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 2.02 mg/L N D 1/4/2018 collected b : PES Arsenic ug/L Date of sample: y B. SEPTIC/HOLDING TANK DATA Septic/Steel Date installed 7/17/1990 Tank Type/Material p Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N N/A High water alarm (Y/N) Date of pumping 11/15/2017 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA 7/17/1990 200 SF/BDRM Date installed Soil rating or ft2/bdrm) System tYPo BED Length 38 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth 2.3 ft. Eff. absorption area 912 ft2 Monitoring tube Y Depression over field N 1 0/1 4/201 7 Results Pass/Fail PASS For 2 bedrooms Date of adequacy test ( ) Fluid depth in absorption field before test 0 in. Water added 310 gal. New depth 1 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 300+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "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 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 75+ 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 G. ENGINEER'S CERTIFICATION ������� c�of acgtt I certify that I have determined through field inspections and ��g'�Q:' • `� ".*3'1 review of Municipal records that the above systems are in I"'* , . L. 'N • r conformance with MOA COSA guidelines in effect on this date. 1 •_'�+�►.. -‘ . �:*. Engineer's Printed Name Steven Pannone �. • ,, , ..Sleven i.�0anrione. . Date 1/16/2018 �00��. CE-8149 �i lli ` , COSA canary sheet_2-6-15.doc 8468 EAST 336A7 S. BIRCHWOOD LOOP /J co / co o co 33, BLM Road & Utility Reserve / M • / F. f // Im o WeII // SO // L? i / / J / / a u ° p0• o�cn / / 62.4 '�Q / / 0 'cP °>-0 .<0 // // 0 9 co / / Septic vent(typ)1 7,) / / Lot 133 1 Story Frame House °: / / S\ Lot 130 / LOT 132 // �J'`� // / 0� / rn / �G / ai / tN / CV M / �.�. // / p� / c� / A. o / 64e, _.s c.� �h� / o / a� �� // / 9 / J / CD / Z� / / / // os / Qo... Lot 131 / / / / <o / / / / / / / / / / SO / / / EAST 71.17 / Lot 149 / Lot 151 AS-BUILT NO CORNERS SET THIS DATE ��```\\1 / I hereby certify that I have performed a Mortgagee's inspection amp �,• • • .'4 ,4 1, of the following described property:LOT 132,SECTION 18, =, •• ••S,� T15N, R1W, S.M., AK cam. 49th �1� '•-9 �r /*. '\ .* , Anchorage Recording Precinct,Alaska,and that the 001 v k�i/- improvements situated thereon are within the property lines %rJ • and do not overlap or encroach on the property lying • cradjacent thereto,that no improvements on the property lying .Fred Wal a tk0 . 2 / adjacent thereto encroach on the premises in question and , oil $ .°rte•. 3255 — S •••�� that there are no roadways,transmission lines or other I .pF • . C visible easements on said property except as indicated 0 p. SCALE: 1"=50' ,II 1 ortssioNA'-•�`� Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN 1 \\\N.% this 18th day of December ,2017. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON. BE 907-248-1666 Engineers and Surveyors UNLESS OTHERWISE NOTED FB 17-10, pg 68