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HomeMy WebLinkAboutWYNTER PARK #1 BLK 1 LT 31'NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl-. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ,,~_~ 825 L Street- Anchoraue, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NEW ~4AI LING ADDR ESS ~.~ LEGAL DESORIPTION CT LOCATION Well Absorption area BISTANOE TO: Ma~ufacturor DISTANCE TO: [Inside length Dwelling Dwelling [~UPGRADE N~LpE), OF BEDROOMS PERMIT NO. No, of lines line Foundation, of lines Length Width Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Class Depth Driller DISTANCE TO: Building foundation Sewer line OTHER PIPE MATERIALS SOIL TEST RATING th PERMIT NO. Material Liduid capacity in gallons PERMIT NO. Total effective absorp, tion ar PERMIT NO, Total effective absorption area Nearest lot line Distance to lot line / PERMIT NO. Septic tank I Absorption area(s) 72-013 (Rev. 3/78) Department MUNICIPALITY OF: ANCHORAGE ~ Health and Environmenta? _ Street, Anchorage, AK. Permit ~ ~ ~ 0%~(~ Applicant: ~©tr){-~C~ Location: Legal Description: ~- ~/ ~7 Type of Soil Absorption System Is: Trench: '/ Drainfield: Maximum Number of Bedrooms: 2~ ~rotection ~9501 825 264-4720 * * * HANDWRITTEN PERMIT * * * ~:~i),/OR ON-SITE SEWER PERMIT <' C>J'~/S~- Mailing Address: Phone Number: _ ~<{ ~ Lot Size: DEPTH Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: /C~h ,LENGTH .~-~Lh~GRAVE'- DEPTH __~ ~ WIDTH The length dimension is the length(in feet) of the trench or drainfield. 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 is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(~) TANK SIZE : [c~'c]>C, GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 $ 2 * * * I certify that: (1) I am familiar with the requirements for on-site sewers set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require the reside nc e is remodeled Applicant and wells as enlargement if to include more that 3 bedrooms. Date: SWP/024(1/81) & ENGINEERS, INC. s 7125 OLD SEWARD HWY. ANCHORAGE, ALASKA 99503 349 -6561 SOILS LOG - PERCOLATION TES1 2 3 5 6 7 8 9 - ~--~10 - 11 13- SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT A_~,A 14- 15- 16- 17- 1g- 20- COMM E N TS ,~e'. I'erJ Reading OaJe TEiT RUN BETWEEN .~'~5" - FT AND 7 FT '~ 7' CERTIFIE 72-008 (§/79) Type of Resi~nce ingle Femlly Water Supply ~ individual A~ACH WELL LOG, A w~l log is required for all wells drilled since June 1975. Community For ,~t Public Ullllty wells drilled prior lo that date, give wel~depth~ (attach log if available). Individual Year Individual i.stailed:_ Public Uglity When Connected to Public Utillty~ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspcctor Inspector Inspector Field Notes: MUNICIPALITY OF C,C'[ I fi 1982 RECEIVED (~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well TO Absorption Area Well Log Received Well to Tank Septic Tank Size MUNICIPALITY OF ANCHORAGE ,a Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261242 Parcel ID 051 -491-22 Expiration Date: Legal description WYNTER PARK #1 BLK 1 LT 31 Site address 21131 EASTSIDE DR Current property owner(s) VANSICKLE GARRISON W X The On-site system(s) is/are approved for 3 bedrooms 6/16/2027 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 7/16/2026 Thi Certificate of �tLit5`ystems Approval (COSA) is intended to demonstrate the subject s stems) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department_� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-491-22 Complete legal description WYNTER PARK #1 BLOCK 1 LOT 31 Location (site address) 21131 EASTSIDE DRIVE CHUGIAK, ALASKA 99567 Current property owner(s) VANSICKLE GARRISON 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑ Private Well serving # dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage 0 Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 13 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ 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 Fee $ � 0 O Waiver Fee $ Date of Payment r Z Date of Payment COSA # 05C a- G 1 �' Z Waiver # COSA Application_Apr2025.doc COSA Checklist_May2025.docx COSA Checklist Legal Description: WYNTER PARK #1 BLOCK 1 LOT 31 Parcel ID: 051-491-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA PUBLIC &/OR CLASS “A” WATER 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 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 6/16/26 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 11/15/2013 ALL standpipes present per record drawing Total measured depth from grade 10.3 ft (max) Measured depth to pipe invert from grade 3.9 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 6/16/26 Results Pass Fluid depth prior to test 31 in Water added 450 gal New fluid depth 43 in Elapsed time 1440 min Final fluid depth 30 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 73 in (MOA 6.07 ED) Effective depth used 30 in (Final Fluid Depth) Effective depth remaining 43 in Comments/Deficiencies: COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No *5+ ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *10’+ from main house & 5’+ to garage - Met code at install, which was 5’+ to any foundation. G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 07/10/2026 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 07/10/26