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HomeMy WebLinkAboutT15N R1W SEC 18 LT 201T15N RIW Sec 18 Lot 201 #051-232-33 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191056 PID Number: 051-232-33 Dwelling: 9 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Eric Thomson ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench X Bed ❑ Mound Address 18546 Mink Creek Dr. Chugiak, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 726-7007 4 0.7 GPD/SF 9.2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 8.7 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 201 Fill added above original grade 0.9/1.6 Ft. Gravel length 58 Ft. Township Range Section 15N 1W 18 Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 870 Ft2 Ft. Well >100' >100' N/A N/A >25' TANK [C Septic C S.T.E.P. C Holding C Other Manufacturer Anchorage Tank Capacity 1,500 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Septic tank is sized for 5 bedrooms. Absorption bed is.designed for 4 bedrooms. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Northern Excavation Drainfield D3034 CO/MT Inspector J. Millette BENCH MARK (Assumed elevation) 100 ft Inspeectio i5' 4/2/19 4/4/19 Location and description da: Zed 3`d 4/5/19 4'h Bottom of siding @ point B. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp ®®•®'& OF q ° 11111#1 Conditional Approval: Date ♦® .�'�� A49th o'r�sOA 10...................... 0................`tJ p A�n MICHAEL E. ANDERSON No. CE-4381�_� Approved �{% Date ♦� ®F�..,�./�o/zo.,,,.��®.� f%®®eaass®a.®®® s inspection Keport_a-i-il.aoc Tl 5N Rl W SECTION 18 LOT 201 PERMIT_ # OSP191056 PID # 051-232-33 1 it. I I 1 f.` EXISTING WELL �\� z i� 1 00'WELL RADIUS 1 w i 14 Lir L 01 , ( " _ e t I I 100' RAIL4O ASft1ENT �.-._ . B FCOsvi NEW 1500 -GAL SEPTIC TANK zco_._�, EXISTING DRAIN FIELD " s ABANDONED IN PLACE. COr 3 MT1 I co CMT4 J 01 CO2 TH-A`t CO3 PPP 7 4 t � . 58'L'ONGx15'WIDE,®T 10,_ 6" EFFECTIVE DEPTH— �� VI ABSORPTION-BED���` \� WITH 2' FILTER'SAND —`r t j < i ♦'`.� , ESTIMATED LOCATION OF r 1 t ♦ I OVERHEAD P WER _ "33' PATENT RESE-R-VE MEA BLANKET EASEMENT 1 � t (15 FROM CENTER OF­- POWER F POWER LINE)raw -, u -p—, mo 4, ,.'t i A B C E N C I HE ERI N I' 4 FCO 24.4 6.5 w SV1 261 152 PLAN AS -BUILT 0 50 100 SV2 30.0 25.7 LEGEND CO - CLEANOUT 2CO-DOUBLE CLEANOUT FCO - FOUNDATIONCLEANC FS - FLOW SPLITTER VALVE MH - MANHOLE MT -MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE 2C0 31.5 27.7 MT1 81.5 107.4 C01 82.6 109.0 CO2 87.0 113.8 CO3 91.5 118.5 MT2 94.0 121.2 MT3 116.8 116.0 FEET C04 117.3 117.5 - 1 "' C05 119.8 121.5 C06 123.8 1 126.2 MT4 125.7 133.0 T151 Rl W SEC 18 LOT 201 PERMIT # OSP191056 91.0 90.5 PID # 051-232-33 0 100.6 101.3 FINISH GRADE c) 99.7 ORIGINAL GRADE 730 n i n D'RO K AN 88.5 88.5 58' Ll� 83.2 co NO GROUNDWATER 4/30/19 PROFILE AS -BUILT 91.0 90.5 SOILS LOG AND PERCOLATION TEST . E N G I H E E R I HG LEGAL DESCRIPTION: T 15 N R I W SEC 18 L 2 01 PERFORMED FOR: ERIC THOMPSON DATE: 4/2/19 PROJECT No.: PARCELID#: 051-232-33 TECHNICIAN: J. MILLETTE DEPTI-1 TEST HOLE (fee[) 2 Ili ffl-ii,1 HH 1' OB GP (SANDY GRAVEL POORLY : a DEPTH To WATER (INCHES) NET DROP (INCHES) GRADED W/ COBBLES 3" MINUS) 4 t .� 5 6 7 GP (SANDY GRAVEL 8 POORLY GRADED 1" 9 MINUS) 1 o WAS GROUND WATER ENCOUNTERED'? NO IF YES ru WHAT DEPTH? - 1 1 DEPTH OF WATER AFTER MONITORING: NONE DATE OF N-IONITORING: 4/30/19 12 13 "' 14 15 16 17 18 19 I SITE PLAN SEE SITE PLAN L r DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 2/13 PERCOLATION RATE: <1 (MIN/INCH) PERC. HOLE DIA.—±---KINCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: Test hole deepened in order to verify impermeable soil and groundwater separation for deeper installation of absorption bed. _ n.cnt .,., O Municipality of Anchorage Department P.O. Box 196650 a 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proaram * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201079 COSA#: Permit#:OSP191056 PID#: 051-232-33 Legal Description: T1 5N R1W Sec 18 Lt 201 Engineer: Forge engineering Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the absorption field has been approved. The approved separation distance is 7.5 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date: 6 Z Approved by: C6 /,,- wr,,r Name of Reviewer .............................. 0 ■ ............................. ■ ............... 1 **** VARIAN C E/WAIVER REVIEW **** GE E N G I N E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 12, 2020 MOA Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: T15N R1W SEC18 L201 -18546 Mink Creel: Drive Septic System Design Dear On -Site Services Engineer: Due to the difficulty of installation and despite the contractor's efforts to meet all separation requirements, our swing ties indicate a separation of about 7.5' from old existing field to the new bed. We would like to request a waiver for 7.5' separation between the existing trench and the new bed. We expect no adverse impact or communication between them. Clean soils on the lot insure that water absorption will be downward with little or no migration in a horizontal direction. Sincerely, Michael E. Anderson, PE •• r x M .oz.z S �j �m� O w f°: '`' ••�"9�,♦ 0 m m C r mom= C =DZ�CO--ID 000=�o=r r r� AN r ;' z 131 e e ':Cn+j �zj -gyp m (n vCi D= Z [/7 ■yr �-��� :. r n m z;u m D n Z o u)m ► D� io �t►� om{!)cnm� n�D��� ► � : O �-n . �Al C z cn Z C) -{ vmi 0 < I�o' u o: 0 c�l �7 M :c n= cn i m z •';[ia me �� 22<m�CZ CCU) Z0 -<G) +` m: O D mor- -i �3Cm� FA o •. •490 O m D u cn r�'�rOY �� 0 ��OD -7U X -A oasis IL* O Z � (� r m 0 --4 CnDO XM M r m rel � C7D� =zOp�Docn ° o o�oDm Dmz �zz LD o z Lo �m�0 (nm DDODo -Ti �, mzom�0z �ocnzonD o C mm nzm i-^ �_n� 3 �T.9 S �) Z _I � D r M cn O m D mo Omam 0 OmO"mD� ap O O� ��O =0ocmn�mo N ~ czn m � �'�� -7 -t. m �7 00 p 0- z (7 Ul Z 3 z C� z=��-=D cC = D 2 m D m V)0z mD�z�m i = m Z D � W U) ��mmmmm nl D G) 0 Z� =<m cNnm1IN0 ro N M n O� pox =moo )- �, o D Z 0 m< zcn D OOZ3Z L4 om G) n m m Z C 3 0 0 r m o ,50'L9 M .G*.Z N � O Cr- = =mm�m Lo .09'6Z£ �� z>m 0 oLnG)v�) M _ £0.0 N n z / 0 2D -' O D ODOG)Z O M. I 0 D N m m O Z m z m m -Ti m �o v I N O Z o> D�cnm r- EN co z m N m �� fnrl 3Df=�D O i{ m � mz to Lo o � � m 1 m In < O to � o; CA Z m X C) n C D D � D m f= z XZ N m U) () a O 3 m 0 z c) m m --i -Ti J m m N� � co 3 m Ln m x mCZ z �nzzm na D CT1N m-1 m Dm D cn N- -� 0' d cn m o D m D > O � r p I m p mm z � ago z n D -< J z N D C n< m D C r m D >� cmnz o onm r f)V/ II r m Z D m i z .Bb'06 r 1 �� M .oz.z S Z �m� O w N -O ? [(D 0o� VlJ CT# N T r 1 �� a O C Z �m� O w p VlJ O l0 D< c- m � m z v m 0 OND -� _C 0 0 0 0 r 0 0 0 �� cn m a x O D m Cl)II O Z C m m CO 0X I D z m CD 3 D L 0 � 2 O 0z Oo'i-�-iC7 m m < 2H Cl) m m D cn o � � -`'' Z M wL5.T0.0 N c r .£9'6Z£ C) N m g Crj m CD� £OZ 10'1 1N3W*MOJ T r C� a ti N Cn il..J �0 U Z 7z z O N ;o C-) i rn 0 .. m o CD EYa 'Tj] CD cc N 00 m > LA N OD OD 0 m z z 0 r to to r OD CD -Ti C �o -.0 3 r- 0 m m m m m z o o C/) m Dcn<mC Z m 0 m 0 m 0 � O z 0 D M C \ D z Oo D �mZ n O 005Iv o `fi ^ O li li BL6T 101 U m 0 z m � D in r= ,L•g � ,L'OZ ti �0 mms N w g; V) N 3 2 R77K -1 < CD 0 z m � D in r= 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: OSP191056 Work Type: Septic Upgrade Tax Code Number: 05123233000 Site Legal Address: T15N R1 W SEC 18 LT 201 G:1054 Site Mailing Address: 18546 MINK CREEK DR, Chugiak Owner: BOVE-THOMSON ERIK Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Y12 v f� r. DeI)arnnent Lot Size in Sq Ft Total Bedrooms: 3/29/2019 3/28/2020 95832 Q 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 Special Provisions: 1. The asbuilt survey submitted with the Inspection Report is to show the 2015 well location as well as the new septic system. 4 T.4� 2. The Engineer needs to do an additional test hole including percolation test prior to the construction of the septic field. Construction may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and signed results with the As -built Inspection Report. If the results require a design change, construction of the system will stop pending On -Site review and approval. _,� Y/qllI PSG cojtpieite— , I dOl GW Melf.I 1k re enol 5red. Co # 1 ; Vf 5; z 1, �'j _4 n l2 4Z 1500r&,e-- `ilNll,l CC' 2.: Gel to be UeeQer. Received By: X/( Date: Issued By: AZ�Date: q % Al _/1" M UMCPaUry OF ANCHORAGE °l0 Community Development Departmentj one: 907-343-7904 Development Services Division ax: 907-343-7997 On -Site Water & Wastewater ProgramMAR 2019 7Z ON-SITE SEWER/WELL PER PPLICATI ti Parcel I.D. 051-232-33 Property owner(s) Eric Thompson Day phone (907) 726-7007 Mailing address 18546 Mink Creek Drive Chugiak, AK 99567 Site address 18546 Mink Creek Drive Chugiak, AK 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 18 LT 201 Lot Size 95,832 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X Septic Tank ❑X Upgrade FX](w/wo AD U ) ❑ Holding Tank F]Renewal ElDuplex (D) Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: 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: kccl S• 0 b Date of Payment: Receipt Number: 691M 0 Permit No. UP) 9 I U5& Permit Waiver Fees: Date of Payment: Receipt Number: Waiver No. March 26, 2019 MOA Development Services Dept, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T15N R1W SEC18 L201-18546 Mink Creek Dr. Septic System Design Dear On -Site Services Engineer: The septic system serving the four-bedroom home on the subject lot has a failed and must be replaced. We are submitting this design and permit application for the construction of a new septic system. The attached site plan identifies the location of the home and the existing well and existing and proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the east lot line, but in the proposed septic location it is relatively flat and greater than 50' away upslope from slopes greater than 25%. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. Please refer to the attached test hole logs, soils lab analysis, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE Tl 5N R1 W SECTION 18 LOT 201 0 0 0 0 0 0 0, 0 0 o O, ✓' p- —' :o co O N V Eo co O N V c9 � pc' N— � � 1 r � O EXISTING WELL —�� Lu NOTE: -NEW PERK TEST IS TO BE PERFORMED\ 100' WELL RADIUS I PRIOR TO CONSTRUCTION�OF T E NEWT ABSO;RPTIOf FIELD TO CONFIRM SOILS. I \ j + I -MAIf TAIN AIMINIMUM IOF 10' FROI M , \ > EXISTING ABI ORP'ION, FIELD. I LOT) 2 , - o 1250 -GAL NEW - �L / m SEPTIC TANK J /� EW 1250 GAAL II 100' RAILi 0 ASE�VMT I SEPTIC /�A NK, DECOMMISSION EXISTING_ 2J Co I_� I SEPTIC TAN 'K> MOA CODE Ili \ \ 1 Ill � 1� / 4 2Co r I ✓ ll 1 I I 58� LONGrx 15' WIDE,l' I 6" EFFECTIVE DEPT FD 1 �BSORP'TION BED / >10 MT STH\ I WITH 2' FILTER SAND TxO co 2CO INSTALL FLOW � TH (3 DIVERTER FOR FUTURE LOCATION USE OF EXISTING FIELD 1 r i ESTIMATED LOCATION OF I OVERHEAD POWER-LINELl 7\1POWER MEA BLARiCET EASEMENT 33 PATENT RESERV� (15'FROM CENTER Or— LINE) 1 �. ENGINEERING \ NOTE; ® NO SLOPES >25% 10' HIGH WITHIN 50' OR SURFACE WATER WITHIN E•OF.•q�ooLEGEND ® 100' OF THE PROPOSED SEPTIC SYSTEM ••.,`��po CO -CLEANOUT ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS 2CO - DOUBLE CLEANOUT 9th •• „•, ;,, °v PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC FCO - FOUNDATION CLEANOUT �•••••••• ...................• SYSTEMS. FS - FLOW SPLITTER VALVE 1AEL E. ANDERSON ® MH -MANHOLE No. CE -4381 �� ® 0 50 100 3126119 ,,•.•'��ll FEET 0 SLOPES > 25% MT - MONITORING TUBE 9 °ROFESS... 1\1 ® SLOPES > 46% SV - SEPTIC VENT 1 -50 TH - TEST HOLE T1 2N R1 W SEC18 L201 C'o-�Z DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW SHALLOW BED SYSTEM W/ SAND FILTER PERK RATE: <1 MIN/IN 1250 -GAL SEPTIC TANK APPLICATION RATE: 0.7 GPD/SF 600 GPD / 0.7 GPD/SF /15' WIDE = 57.1 LF TRENCH REQUIRED (58 LF SPECIFIED) BOTTOM OF TRENCH: 8'6" BELOW GRADE FLOW LINE ELEVATION: 8'0" BELOW GRADE TOP OF TRENCH: 6" ABOVE GRADE All nX/r% TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE T OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY DCK GE E N GIN E E R I N G SOILS LOG AND PERCOLATION TEST fi H.G IM EEH1'N.G LEGAL DESCRIPTION: T 15 N R I W SEC 18 L 2 01 PERFORMEDFOR: ERIC THOMPSON DATE: 2/13/19 PROJECT No.: PARCEL ID#: 051-232-33 TECHNICIAN: J. MILLETTE DEPTH TEST HOLE A (feet) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 wow GP (SANDY GRAVEL POORLY COMMENTS: SLOPE WAS GROUNDWATER ENCOUNTERED? NO IF YES a WHAT DEPTH? - DEPTH OF WATER AFTER MONITORING: NONE DATE OF MONITORING: 3/l/19 SITE PLAN SEE SITE PLAN x y DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) 2/13 TEST HOLE PRESOAKED PRIOR TO TESTING: 4 11:08 /11:08 00:07 0" / 6" 6 2 11:09 /11:09 00:08 0-1/611 6 3 11:10/11:10 00:07 011/6" 6 4 11:11 /11:11 00:07 0"/6" 6 5 11:12/11:12 00:07 011/6" 6 6 11:13 /11:13 00:07 011/61' 6 PERCOLATION RATE: 0.02 (MIN/INCH) PERC. HOLE DIA.__.§�INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. F�1�G� SOILS LOG AND PERCOLATION TEST C ENGIN E E R I N G LEGAL DESCRIPTION: T 15N R I W SEC 18 L201 PERFORMED FOR: ERIC THOMPSON DATE: 4/2/19 PROJECT No.: PARCELID#: 051-232-33 TECHNICIAN: J. MILLETTE DEPTH TEST HOLE B (feet) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 1' OB SLOPE _ _ - WAS GROUND WATER ENCOUNTERED? NO IF YES =r WHAT DEPTH? - L ' DEPTH OF WATER AFTER MONITORING: -WD-W&0 DATE OF MONITORING: P ,, . • �. ran���•E SITE PLAN SEE SITE PLAN DATE READING '. GP (SANDY GRAVEL POORLY DEPTH To WATER (INCHES) GRADED W/ COBBLES r 3" MINUS) ;'.• f GP (SANDY GRAVEL L:'•."" POORLY GRADED 1" MINUS) SLOPE _ _ - WAS GROUND WATER ENCOUNTERED? NO IF YES =r WHAT DEPTH? - L ' DEPTH OF WATER AFTER MONITORING: -WD-W&0 DATE OF MONITORING: P ,, . • �. ran���•E SITE PLAN SEE SITE PLAN DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) p« PERCOLATION RATE: (MIN/INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN: FT. and FT. COMMENTS: Soils absorb water much faster than 1 minute per inch. OWNER OFLAND: Erik Thomson ADDRESS: PDBOX 77OD |River, Bore Hole Data From To LEGAL DESCRIPTION T15NRlVVSEC 1DLOT 201 DATE: 9-2I-15 PERMIT NUMBER: OSP151318 DATE opISSUE: 9'16-15 TAX IDENTIFICATION NUMBER 05123233000 |swell located atapproved permit location: NYeo[_]No 11�71��38 Method of Drilling: u�uairrotary L�cab|etoo\ Depth ofWell: 104' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches' depth 102 feet Liner type Static Water Level: 60 feet Recovery Rate G gpnn | | 8ph Method ofTesting Air Well Intake Opening Type: Zopen end Dopenho|e F-1 Screened Start feet Stopped �� �_� Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Comp|etion� Zell T] no Method of Disinfection: Chlorine 5OPPM Comments: 4 38 44 44 96 96 104 Casing Stickup Overburden Tight Sand /&Gravel Sand & Gravel —1GPM Silt & Sand w/Clay Silty Sand &Gnave| Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. yWatSuBorough: Department ofEnvironmental Conservation. Legal Description T15N R1W SEC 18 LOT 201 11 Pump Installation Date: 10-1-15 U Pump Intake Depth Below Top of Well Casing: 91 11 Pump manufacturer's Name: GOULDS UPump Model: 5SB05412[L UPump Size: 1/2 11 Pitless Adapter Burial Depth: 9 PidesaAdapter Installer: GUARANTEED SERVICES Disinfected Upon Completion? M yes Fl no Method of Disinfection: CHLORINE 50 PPM 11 Comments: PitlessManufacturer: PUMP MASTER UPump Installers Name: SULLIVAN WATER WELLS Property Owner Name QAddress ER|KTHC}KASON l8S4GMINK CREEK [HUGi/\N,/\K98567 E. feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Municipality of Anchorage Community e o ent Department Can -Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 a http:// .muni.org/onsite - (907) 343-7904 Well Decommissioning legal Address: Subdivision Block Lot T R Section__ Leat Z On-site Water & Wastewater Program oeftified contractor Performing the well decommissioning: Name: Te C<Signature: z� Company: IA I Well decommissioning date Method of decommissioning: AMC 1 5.5, 5.06OLl a, ❑ b. Q c. Location: Use the space below to provide a drawing of the property showing the following items; • North arrow m Recommissioned well, ® Other water wells on the property, • Two separate swing-tie distances for each well shown orl the drawing, Note: The swing-tie distances shall be measured from either permanent structures or the property corners. i`- 7 Z' w. .I i i.f i /ry ai GACommunity Development0evelopment Services\Building Safety\On Site Water and WastewaterTorms—Zlient Forms\Well Decommisio'ning form_doc On -Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151318 Tax Code Number: 05123233000 Work Type: Well Upgrade Permit Effective Dates: September 16, 2015 to September 15, 2016 Design Engineer: Subdivision: T15N R1W SEC 18 Site Legal Address: T15N R1 W SEC 18 LT 201 G:1054 Owner/Address: THOMSON SIMONE REVOCABLE TRUST THOMSON S A J(TRUSTEE PO BOX 770874 EAGLE RIVER AK 995770874 Site Mailing Address: 18546 MINK CREEK DR, Chugiak This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 95832 Total Bedrooms: 1 N Privy Y Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. To close this permit please submit: 1. Well Log 2. Pump Install Log 3. Water sample results 4. Well Decommissioning Log Received Issued By MUNICIPALITY OF Community Development Department ctw Development Services Division On -Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. (55( -232 -33 Property owners) Day phon b 9"7o0r% Mailing address Site address Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section)b Lot Size Sq. Ft. APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ Number of Bedrooms APPLICATION IS AN: TYPE OF DWELLING: THIS APPLICATION INCLUDES A Initial ❑ Single Family (SF) JZL (w/wo ADU) Up6 7 8 9 70 Duplex (D)_ - ❑ a RUSH! Multiple Dwellings ❑ (SF and/or D) SEP 15 2015 A - REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. jL Ctrs ..ure of property owner or authorize agent) Permit/Rush Fees: _Q I �5 r l ZCt = 3 c Waiver Fees: Date of Payment: QI, l S� /�' C'y6 Date of Payment: Receipt Number: 2q 21 Receipt Number: Permit No. - . oseI51�)I$ Waiver No. Permit App_9-1-12.doc 0 0 �Idl Ohl Sz6 h� (el � larza/sic /8 Tis r� p�� AND THAT NO ENCROACHMENTS 3� EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS yw/osy WHICH DO NOT APPEAR ON THE RECORDED SUBDI- ,�3 .o-A�'�i✓T' ��PS6Yvl�P Z. u.1 Q � 'be- 1®a -P4 ASBUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: larza/sic /8 Tis r� p�� AND THAT NO ENCROACHMENTS DATE• EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS yw/osy WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' ANY DATA HEREON BE USED FOR CONsrRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. I ops 2morly.m MUNICIPALITY OI' ANCIIORAGE' flea l and Environmental Protec On fourth I•'loor West 825 L Street Anchorage, Alaska 99501 \^ 264-4720 ` foA-0" ' O INSPECTION REPORT 011 -SITE SEWAGE DISPOSAL SYSTEM NAna 1'�G:,tr'�-1 1 AOVV�SOVv _ _ MAll IF!(; AooRl ,s _ JaX' �1�'i .Z ---- P14ONE Lf-c"AI HS(.RIPTION 1s Blw 5� L�4 ao!_--- SFI'I IC 1-ANK IAHCL NUMBER OF kL`r,1 v'J!-LL .1 0� `.1 �.IJU1 AC IUIiL it S�-�cR'k MAii ;2IAL _ A G�SS COMPARTMENTS -.._Z lu_.li)I ILr1(al II _. __ I NS fU E. to n) nl- L10011�)DF PI II LI QUID CAPACITYh VOGALLONS. Tli_E DRAIN FIELD���^ 1 I TOTAL LENGTH 1 Ull,1, 11, 1 V, LIO _I 0 Flt LAI 10N -N1 -ARI SI LI LINL._. _�0 +0F LINE �q 0 II OL Lines - �.-IW,I,INCC M 1Lv,11 CN I Nf." x._._TRE��ICH H(tMUT!(%IN. TOTAL EFFECTIVE I. 1.� _ 50. 11 t NOIII OF ! ACII L INF ._ c1 Uf_i'TI101 11LICfi PI:. W iii 1II!_ t7 .IISrI Git;,l',f. •5.—NI ,CI (_RIAL (S L'VCAT11 1111 (0()IN_ ABOVE. TILf P;AQL PI T: III .IM II1: __-..__ORA^IIDIHLI:NGTI1- DEPIII ----- .__--- I'oq Crib Rings Cr]_b Sjzo: UTAMLT LR _. _-_ULPHI_...... DISTANCC FROM; 101"'L C(-1-FCTIVC 19U1_ui;A, I LJ; 1;)ll l0'I NEARL;1 I_01 1 IiNL_ _ AFSOHPI ON ARF_A (WALL AREA)_ SGI. FT. 'IE: a 11-.,, : '=Y 1--- -F..-1- n.p " Ci F.-.' F=Y W-4 C—_-1 -A 1.'_ i lrz^ f:'R 1'=p E DEPARTMENT OF iEALTH AND ENVIRONMENTAL P TEC:T'ION 895 'L_' STREET, ANCHORAGE: AK, 9956..... 264-4720 a=::® r4 .... e:=: -E.. �.... REE 1 Y.".Y Imo: fZ.". Y =' 1:: �- F = P'^ Y 7f. -r PERMIT NO. T70987 P APPLICANT 4-!:=iF:RY 1.FdCil''SON BX 874 E. R. I._OCAT Td Nd MINK CR. L.E:DARt... T:*[5NRl.biSi8 LT. 201. LOT SIZE 1040000 SQUARE FEET TYPE OF SOIL FiEc;::ORBT:I:ON SYSTEM IS: TRENCH MAXIMUM hU. M NI_1MBER OF BEDROOMS = 5 SOIL RATING (Sig FT,•'BR )^ 100 THE: REQUIRED SIZE OF THE SOIL.. ABSORPTION SYSTEM IS: 1_E"• EE w -1" F-1— .: B_ C3 1.-_ U-"--: V4 (3i _Y...1-4 — E5 IL C: i Fx" fxf 0"""4 EE 1 _ lot EE, 1 -I- F-1... "_5 THE. LENGTH DIMENSION IS THE: LENGTH (IN FEET) OF THE 'TRENCH OR DRAINdF=IE:LD. THE: DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE: SURFACE OF THE' GROUND AND .THE: BOTTOM OF THE EXCAVATION (IN FEET) THERE 1:: NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE: AND THE BOTTOM OF THE: EXCAVATION ':::ENd FEET). I I•t:" E:: E> "REEF -4- ::1: CT -1-FR PA F-=_ S,' :F lE_ .— _-J_Z5QaQa 1_: n FA L.1---1 _1 M.,4 F-" Fl C2 PC fA 1_"p FE F-" 1_.. w=11"-.1-1- 1. 1 F -T- 11_ A 1'-"1 A PA(::E::A.i.:'rE: PLANT MAY BE: INSTALLED AT THE: PERMITTEE`S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT- IS REQUIRED. IF A I'rAINTENANCE. AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL. ABSORPTION SYSTEM AND/OR YOU MAY BE: SUBJECT TO PROSECUTION. _.._. _.... -1'_ 14 co <- . ° D. 7 1 til ST FA EE Cl 1 1 CA 1"-4=m' F4 Ff E=.;_: FZ E= C:� Y_1 l 1- "[E F.), BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WIL...L.. BE. SUBJECT TO PROSE:CUTU:iN. MIN.T.I'1E1M DISTANCE BETWEEN R WE:L..L... AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM Is i@@ FEET FOR A PRIVATE WEL_L.,. OR 200 FEET FOR H PUBLIC: WELL.. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. l="E7_ 7_ Fes" 1-1 1 ': ' E:. a F'=" l F.::^ I-''.'.: K> En CT En tl E-3 E = r- _t. _- ::4._ 1=r 711 -7 1: 1: AM FAMILIAR WITH THE. REQUIREMENTS FOR ON-SITE _':;EWERS AND WELL'S AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. s:: .T. WILL.. INSTALL THE: SYSTEM IN ACCORDANCE WITH THE: CODE"-. E UNDERSTAND 1..E-1AT THE ON-SITE SEWER SYSTEM MAY REQUIRE; ENLARGEMENT IF THE '::SIDEN,CE IS REMODELED TO INCLUDE. MORE. THAN c BEDROOMS NEIL:_{.G1t.2/7r .._..__�✓ Y�ecC�i:.rr:�:/:___.._..........__......._.........._ hLlsl (E r�iY �7KG} 1�tE•'PT...ICMN'dY Hr•IRR'T THOMSON D El''ri%��`� _...__....f..A..fE: i��d" ?_"Y1P/�p "t+' Ft /u�v�. GREttfER ANCHORAGE AREA BOROUGh DEPARTMENT OF ENVTRONMFtITAL QUA14TY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For HAf2i y D Tgom5oia7 Dated Performed Legal Description: Lot 20l 44ee*5et 16 &r 411v -is On_'J'IS14 R , Sec 14 SM This Form Reports Soils Log_ v Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth MIA)w Feet Soil Chararteristirc --- 15a.ti Gross Time Net Time ' $i./Sa - aryl - Mood s Iyr - 2— ,'a ;`� cry • 52`�rl UfA,I -AVIir- lwte ,a _. nMa a •o �o dra E e fl Xll �� 3— G"t4V S Fa'i3cam Percolation Pate Minutes 4-1 5� (!Yl'• rl� } txLAO-e&V-ST'4Wtr (f ' w IJ,; !w Fr/3nar4 — 6- 7— 8-- s"O; cT -luorSC 9— 4'!J 125 To F•11 NORM 0— 60: 1— t`•� 9r7 Sa��rl . CFta-- p6att - tuat< 2 �. t' w SraF4%none•, 3— -. m . 4 _._ ._.... �``L2Ytrec) SA6.c! �} CrBvcl clrth�t�Li Was Ground Water Encountered? KJO Se Op If Yes, At What Depth? F Reading Date Gross Time Net Time ' Depth to Drop M., "; .� ,6669 Y 4 y Jq "'✓ ;"t U 4�.;-'q• Gro oQ 4 �+�. Iyr ,a _. nMa a •o �o dra E e fl Xll �� Percolation Pate Minutes Proposed Installation: Seepage Pit DrainFl�t "s-- Depth of Inlet as' Bottpm o�Rit or Trench 10, -f- COMMENTS �ol��__u a6 Sn.iv d 6rtdVri wlyj �]a c\�r. T' skou.n g�' AJn tZE7iutR n.L�Uf Tia fMfd]�2T C�RAut l.''iJ 7Nlt Sirs now xisma. AIL 4aiuy ) i& �i rr4e- Than^ PJLR.�M �Rt►ya> ... TG•t_ s '�rtou4ra �l�m, am. sirp st00ya6- FN? urruy 11411 ctF3�:,,:_Prautn,_ Test Performed BY �;11A� f�Gci�cr.i��rc- ri Date Certified BY: Iia Date: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 051-232-33 Certificate of On -Site Systems Approval Expiration Date: 1. GENERAL INFORMATION Complete legal description T1 5N R1 W SECTION 18 LOT 2 1) 1 Location (site address) 18546 Mink Creek Drive Chugiak, AK Current property owner(s) Cash Alaska Day phone (907) 569-0555 Mailing address Real estate agent P.O. Box 240511, Anchorage, AK 99524 Mike Kaupp 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907) 230-8952 1W 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Q Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 3; cm, 1 D- 1 Waiver Fee $ Date of Payment 110 a 0 a Date of Payment Receipt Number ©�O'� 1� Receipt Number COSA # o S C a O 1 G 15 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 11/9/2020 ®®��E Y Op ON_ `v WATER AND ren ,- r R z r� PROGRAM o By: LOriginal Certificate Date: /l /3 r- 0 TheMunicipality of Ancho ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet OF qC ®aee a® ...... .` ®` 49th 6. DSD SIGNATURE ® j_'jZLC'ZZ... System #1 Approved for . .0 ®........................................... . bedrooms `�, WCHAEL E. ANDERSON 2 A System #2 Approved for %No. CE -4381 •• Z� bedrooms ®®��F;••.,• 11/9/20 Disapproved ,,.••`���'+ 4®4611 11VI %�®56®®®o®o Conditional approval for bedrooms, with the following stipulations: Y Op ON_ `v WATER AND ren ,- r R z r� PROGRAM o By: LOriginal Certificate Date: /l /3 r- 0 TheMunicipality of Ancho ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: T15N R1W SECTION 18 Lot 201 051-232-33 11 3.1 9/16/15 None 104 102 5.44 >18 FORGE ENGINEERING 11/4/20 45.8 11/5/20 1.5 SEPTIC/STEEL New Construction System is gravity flow. Absorption Bed 4/2/19 New Construction 10.1/10.8 9.6/10.3 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to:(Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100’ Yes 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 From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’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 septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft 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 If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS G. ENGINEER’S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 11/12/20 ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Septic system constructed 4/2/19. ✔