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HomeMy WebLinkAboutZONA LT 139B Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181011 PID Number: 051-522-22 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: ERNEST J. BROOKS ABSORPTION FIELD Address ❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound 19986 S Birchwood Loop, Chugiak, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.6 GPD/SF 6.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.5 Ft. 4.0 Ft. ZONA 139B Fill added above original grade Gravel length Township Range Section Varies 1.29' — 1.91 Ft. 75 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 750 Ft' 1 -- Ft. Well 100+ 100'+ 100'+ NA NA TANK ® Septic EI S.T.E.P. El Holding ❑ Other Manufacturer Capacity Surface Water 100'+ 100'+ 100'+ NA ANCHORAGE TANK 1250 Gal. Material Number of compartments Lot Line 5'+ 10'+ 5'+ NA STEEL 2 NA LIFT STATION Foundation 6'+ 10'+ 5'+ NA Manufacturer Capacity Curtain Drain NA *50'+ NA NA ANCHORAGE TANK 1250 Gal. Pump on level at Pump off level at High water alarm at *None None known. Existing field & tank decommissioned in place per code. _ 44 in. 42 in. 48 in. Field insulated Pump make and model Electrical Inspeetions performed by Franklin 2445040117— 1/2HP l—v' t t€--kr. I- Fc-k PIPE MATERIAL House to tank 3034 Tank to 3034 Installer Dirtworks drainfield Drainfield 3034 CO/MT 3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspdeates: 151 2/6/2018 2nd 2/8/18 Location and description 3"2/8/18 4th 2/14/18 Bottom of siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engin Conditional Approval: Date or ` „' ` ,s, or T-H. y; VA 49 4 -):-f r, KENNETH IN VF" "S / Ci 11.1. w / Approved + ( Date z r:_sto*a`' ... -4.........--"" eer's Stamp Inspection Report_9-1-12.doc AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP181011 ZONA LOT 139B PID# 051-152-22 ra >1 <1 3-BR HOUSE Ill� ^7 -38. A I O�l',r• ELEC./ALARM I. : illes--•---34.8 BOX ' P iiA.'Z VACANT 1741.76 w 44, LOT 139A w 0 MH CO ,z NE > Q : 1250-GALS P E v MT�` ai a w o 0 o H a NN NTH18-1 /z 0i • NEW 57 'T w `^ `` MT 3 w ` D I-- J m SCALE' 1' = 40' ' , 1 o (101,66 101,71 VA I- A-C=60.8' w ce o B-C-90.0' _ �A-D=64,7' �— ..,---C102.2FINAL GRADE 102.8:, _ 100.9 EB-D=97,5' & — ORIGINAL GRADE- VARIES r<jA-E=84,6' L Il�1ATIIN FILTER FABRIC °B-E=112,2' o -J1250-GAL .- ,,,1-.5. � STEP 98.47 98.47 mA-F=144,0' a TANK SEWER ROCK 4. B-F=146.9' 95.59 95.01 94.47 2/6818 t 88.477ATER 1 C.80.97) MN P _`NIL\ I 75' ow � r SCALE: NTS �). OF At•'Q\ ' PREPARED FOR: CTE D w r�� ' '� ERNEST J. BROOKS Rk C1. 1 19986 SOUTH BIRCHW❑OD LOOP °� �������\`_ 4s`� o EP /* 4 • TH /N * CHUGIAK, AK 99567 �,�1 .'1„\ �� Ot.._. " VO.v / 907-717-5966 a o / • .N D ,V,' . / FIELD BOOKS COMPUTED: ; "` 81111111 Q wa BOUNDARY:BOUNDARY DRAWN: BMW z �, '�► 1r . w / 11111F...�. 'll 1 �' ` ti STAKING: STAKING CHECKED: KMD '1�° 1 11// ti / AsauiLr: FRONTIER DATE: 2/13/2018 `• � �� g i,� 6. ff A E FESSION= DWG. FILE: GRID: NW1256 9�(s c\\�'F \14C9°,�� \``_ ACRD FIE: JOB No.: 18104 �' 1.'OLTING '8736 FILE AK.99577 .7*-�•16, cm*1 1*-RcTERR-1 r AR C T ER RA Aara�, OF ALS �`, CONSULTING, INC: /,<S,' s 212 E. 51St Ave,Anchorage,AK.99503 '7 le Office(907)868-3791, Fax(907)868-3793 / �-d' v ►.. t."',,,,°.:so.,..0•\'`," # KENNET ...Y.99577-� 7t `•l/ SOILS PERCOLATION TEST I `�� �� F •-,1,:_.•tos . Performed for: ERNEST BROOKS Date Performed: 1/19/2018 Nk\`*161:111°- Project: ZONA LOT 139B TEST HOLE# TH 18-1 Depth (Feet) SEE ATTACHED SITE PLAN 't S t I'I ` Org/OL FOR HOLE LOCATION it#i;: 2 ;:i.. trai '3 �? , Was Ground water encountered? NO What depth? NA Ste ; ' z 3-1 '..: - . d Depth to water after monitoring? 12.5' Date? 2/6/18 .r 4-14‘,,.--;1:14 ,,*'`t`, GM/SM Reading Date Gross Net Depth of Net 5 x " Time Time Water Drop 6- '' ' l',-"%. ' 1 1/20/18 1:00 - 6" - 7--` " 2 1:30 30 min 4 9/16" 1 7/16" 8 4' v` 3 * 1:31 - 6" 9- :4. • 4 2:01 30 min 4 9/16" 1 7/16" 'k.1te. Y ,.s 0 ,'".^- 5 * 2:02 - 6" - 11- • ° F •-t 6 2:32 30 min 4 10/16" 1 6/16" 4 12 ',;-:-i'. 7 4 13 F#,,4-,...'7,‘1. '., HOLE PRESOAKED 8 �3 '7,‘1. PRIOR TO TEST 14 '' ' - 9 15 .' . _ 10 +ab•+ I6-. a i 11 � 1 17- • 12 18-; i.;,.. * Water Added ,:4410,!:"-r 19-Y•'•a'" _' , 41 • Percolation Rate 22 (min/in) Perc Hole Diameter 6" 20- ,:'i ,:-:°' B.O•H• Test Run Between 6.5 feet and 7.5 feet I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. '~ t MUNICIPALITY 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 ~ , PHONE '~'AtEW M A ~?/G AD D~.>SS LEGAL DESCRIPTION · Well ~ PERMIT "' DISTANCE TO: Absorption a~ / Dwelling ~/~ ~<FZ Manufacturer ~&6~ Material¢~ No. of compartment% ~ ~ Liq.~capacity in gallons i Inside length Width Liquid depth ~ OO¢~ IF HOME.DE: .~~' DISTANCE TO: Well ~//)q/ Dwelling PERMIT .O. ~ ~ ~ Manufacturer . Material Liquid capacity in 9allons --~ = ~ DISTANCE TO: Well ~ Foundation ~/ Nearest Io, line¢ ,.~ PER.IT NO. Total 1on~hgf I,,l~~ No. of lines / Length o~ eec I~e Trench wi~, ~ Distance between lines~/ ~ Total elf v ~ Top of tile to finish grade ~., Material beneathtile ~¢ inches Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class~ [~t, ~ ~ / ~ Dept~.~_¢ ~ J ~r.~)~/[~Driller ../ Distance to lot line PERMIT NO. ~ ~ ~ I ~/ BuiJd~at~on ~ Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~ARKS ' 72013/ / ) ~'" ¢:': ': : MUNICIPALITY Of ANCHORAGE / Department"--'f Health and Environments/ 9rotection 825 ~ Street, Anchorage, AK. ~9501 264-4720 ~ ~r;~ * * * HANDWRITTEN PERMIT * * * Permit ~_~~' ~ ~5LL AND/0~ ON-SITE SEWER PERMIT ~ ~ _ Legal Description: ~ /~? ~ ~O~ ~ ~/~ Lot Size: T~e of Soil ~sorption System Is: Trench: ~ Drainfield: Seepage Bed: Holding Tank: The Required Size the Soil Absorption System Is:' /o DEPTH LENGTH _ GRAVEL 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(HOLDING) TANK SIZE = 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 8 3 * * * Z certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Mun~pality of Anchorage. (2) I wilj~ns~all thex~ystem in accordance with codes. (3) I u~der~d t~//~he on-site sewer system may require enlargement if ~ ~~~~rvdeZed to include more t~ 3 bedrx7~ S i gn e~ .~ ~x/~'~.c/~ ~/~ Issued by: //~plicant ~ / Date: SWP/024(1/81) ,"~ ,~k%, [~" SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATfON TEST PERFORMED FOR: '~'~'~t~L L 'f~ · EGA' DEBCR,PT,ON, /--O~' /-~? ~7 SLOPE t DATE PERFORMED: ~ SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O COMMENTS No. t 457-E WAS GROUND WATER ~ ~ S ENCOUNTERED? ~ ~ ~. P E IF YES, AT WHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop , / ¢--I~-~ m.,~-/~ - c:::j '~ _ z /o ,=,---,,, /of" · ___~, _.L ', PERCOLATION RATE ~ (,~utes/inch) TEST RUN BETWEEN ~ FT AND '~' /. FT CERTIFIED BY: DATE: ::,?: /SULLivAN :iER WELLS P.O. BOX272, CHUGIAK, ALASKAO9567 · TELEPHONE688-2759 OWNER OF LAND ADDRESS ~& LEGAL DESCRI~IO PE~IT NUMBER f DEPTH OF WELL /OO ~ // STATIC LEVELOF WATER FT. _ 7~9 DRAW DOWN F'T. GAL& PER HR KIND OF CASING KIND OF FORMATION: From ~) Ft. to ~ ~ Ft. From ~ Ft. to :~-/ Ft. From ~"! Ft. to '7-3 Ft. 'From ?-? Ft. to 77 Ft. From 77 Ft. to !~! Ft, From Ft. to__Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From__Ft. to Ft. From Ft. to__Ft, From Ft. to Ft, From__.Ft. to Ft. From__.Ft. to Ft, From Ft. to Ft. From Ft. to Ft. From Ft. to Ft, From.--.Ft. to--Ft. From__.Ft. to Ft. From Ft. to ' Ft. From Ft. to Ft From__.Ft. to--Ft. From___Ft. to Ft. From____Ft. to Ft From__Ft. to Ft. From Ft. to Ft. From Ft. to ,Ft._ From Ft. to__Ft From Ft. to Ft From Ft. to Ft.. From Ft. to Ft From__Ft. to__Ft. From__.Ft. to Ft. From Ft. to ,Ft, MISCL. 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(1 Lo n a9 r: a (TJ o in Co c O C� U Q. Q Q fT5 O Q Q U) Q) 4- U) O O co U a) U z O N N LO O T "' o z LU Z U Lu C7 a T C& LL m CJ ca ❑ mil m cry' >, LL d :vg 0 O co O U 0 0 N N N C-0 VJ L a... Lo o a C6 o co cu Q a p 3 -0 Y C\j >, N =$ a co O U I� II. .- L ❑ U r D O m E U N o Q) "� _0 p_ ro N ❑ m c/) c o o 0 O O _ E ❑ C J w d0 � _CL ❑ Q) i O jEl ) c o O a) -07 }U— Y V ca mca a) Eli Q M W _ 0 ~ ca 0 0 co ❑ a) > - N ❑ W a) m z 00 — (n o EM .L O E a c O Li >� o ❑® ❑ U m m a� rL ( Q) Cl) _! ❑ U1 ❑ Q 0 <C O Q c� l ca o z m L U V, co a o a ❑❑ ❑ 4— Q El�.0 W ao N W ❑ a> _ to a� fA Q ( > (a >,U) Q] LU V `` W W' a)a N z L �- '� O o v o Q ani U a c Q- ul LL LL a � Q 0 �zm, �a) cc m W O m m ai -a UULa. U O es n _co a Q En m tt ;A Q Q > 3 �> N M et to (6 LU CO �O C& LL m CJ ca ❑ mil m cry' >, LL d :vg 0 O co O U 0 0 N N N i Legal Description: ZONA; LOT 139B Parcel ID: 051-152-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA MR Well log is filed with Onsite (or attached) Date drilled 9/15/1983 Total depth 101 ft Cased to 101 ft R Sanitary seal is functioning correctly R Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 4/18/2024 Static water level at beginning of test 69.7 ft. Comments B. TANK DATA Measured operating fluid level in septic tank '44.5" Date of pumping . ❑ Required maintenance completed, if AWWTS Comments: *IN ST1 & 46.75" IN ST2 D. ABSORPTION FIELD DATA Which system tested (date installed) 2/6-14/2018 FE -1 ALL standpipes present per record drawing Total measured depth from grade 7.6 ft (max) Measured depth to pipe invert from grade ft (min) 0 N/A — pressurized field. FE -1 Per record drawings, field is insulated. A] 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) N/A If yes, enter date Well production at time of test 4.4+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑■ Nc 0 Coliform bacteria is Negative Nitrate 1.85 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L FE -1 Arsenic less than MRL (ND) Collected by GEG, LTD. Date 4/18/2024 C. LIFT STATION uired maintenance completed Age of lift station years Lift station material y Comments: Adequacy test date 4/18/2024 Results Q Pass Fluid depth prior to test '27.25 in Water added 700 gal New fluid depth *34.5 in Elapsed time 120 min Final fluid depth *33 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 33 in Effective depth remaining 15 in Comments/Deficiencies: *FOR NORTH MT (SIMILAR RISE/DROP IN SOUTH MT). COSA Checklist June 2022 c,12- E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑■ Yes if No Community Sewer Manhole/Cleanout > 100' ❑i Yes if No ft FE Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' QYes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft 0 Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft Q Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑■ Yes if No ft Surface Water > 100' R Yes if No ft Tank to Property Line > 5' Fs -1 Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' W Yes if No ft Private Wells > 100' Fm_� Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' M Yes if No ft Water Service Line > 10' 0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 D : ' TI �* �) '• e f ey A. orness.: Q�9• '•- CE 79 e`G 01 OCI LICENSE�p`ofess+an�©� #AECC884 MUNICIPALITY OF ANCHORAGE Development Services Department ��- � ,�� Phone: 907-343-7904 Can -Site Water & Wastewater Section Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owneri t Street Address Septic Tank: -Sludge level inches -Pumping: requiredes es -Pumping completed no Lift station: -Pump basket cleaned Se no -Effluent filter cleaned no -Control floats cleaned no -Proper float settings confirmed 8p no -Operation satisfactory no Alarm System: -Dedicated electrical alarm circuit kgy no Audible and.visual alarm inside dwelling e ' no -Alarm system operation atisfacto not satisfacto Manhole Riser -Ground water intrusion at riser to tank connection es n -Ground water intrusion around pipe penetrations es -Weep hole functional es no -Manhole lid: Functional & no Insulated e no Properly Secured &_no Other -All manufacturer requireg inspections and maintenance completed no Latents: Qualli int n nce Provider: Technician nate of maintenance Company !,� - r Signature Date 1IP3H • • • Municipality of Anchorage On-Site Water and Wastewater ProgramALASala a ` ,", I ill. (907) 343-7904 SAFET Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-152-22 Expiration Date: 3 ! ) (~' 1. GENERAL INFORMATION Complete legal description ZONA LOT 139B Location (site address) 19986 SOUTH BIRCHWOOD LOOP ROAD, CHUGIAK,AK 99567 Current Property owner(s) ERNEST J. BROOKS Day phone Mailing address 19986 SOUTH BIRCHWOOD LOOP ROAD, CHUGIAK, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) n Duplex J Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank Li Individual Water Storage ❑ Community Community Class Well n Public Sewer ❑ Public Water System WaiverNariance request for: Distance: Received by: "'/id a6 Date: COSA to be released to the engineer,unless otherwisi-gi.ted by the engineer. COSA Fee $ Caa,LO0 Waiver Fee $ Date of Payment a1 15 f 18 Date of Payment_ Receipt Number 0 a.itt�b Receipt Number COSA# 05C. I 'f O LId Waiver# 5. STATEMEN { NS TI E INEER 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 ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 2/14/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING.CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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,ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen ��\Ngik encroachments,deficiencies or discrepancies exist. OFA 7 6. DSD SIGNATURE x10/_ )( System#1 Approved for 3 bedrooms. ` FcKENNETH + R System#2 Approved for bedrooms. <r, �� �w/ 1 / Disapproved. \� y�`�� ' Conditional approval for _ bedrooms, with the following stipulations: Off' SASE ' v WATER PNq Jo WAS-1.°N 0: By: 1 -G Original Certificate Date: Z—1 S 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 sheet 10-10.12.doc 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: ZONA LOT 139B Parcel ID: 051.152-22 A. WELL DATA Well type PRVT If A, B, or C provide PWSID#_ Well Log (Y/N) Y Date completed 9115/83 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 101 ft. Cased to 101 ft. Casing height(above ground) 18+ in. FROM WELL LOG AT INSPECTION -*PER GEG Date of test 9/15/1983 1/512018 Static water level 70 ft. 71 ft. Well production 4 g.p.m. 3.5+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 4.45 mg/L Arsenic: ND ug/L Date of sample: 1/5/2018 Collected by: GEG B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP I STEEL Date installed 2/8/2018 Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y Date of pumping NA-NEW TANK Pumper C. ABSORPTION FIELD DATA Date installed 218/2018 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 System type SHALLOW TRENCH Length 75 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8.41 ft. (Measured 2/14/18) Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N Date of adequacy test NA-NEW FIELD Results(Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed 2/8/2018 Size in gallons 1250 Manhole/Access (Y/N) Y "Pump on" level at 44 in. "Pump off' level at 42 in. High water alarm level at 48 in. Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements? Y 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 10'+ 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 5'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS *See attached letter-GEG testing. 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. r OF z� Engineer's Printed Name KENNETH M.DUFFUS /<SQ' Date 2/14/2018 �& 4_9 TH Atew_FA-;e-al-- COSA canary sheet 2-6-15.doc KENNE�Mr ,moi FEs Oh A`' Frontier Surveys, LLC Project No: 18-031 Date: February 13th, 2018 NORTH Ordered By: Brent Western PIat:81-183 Grid:N/A Scale 1"=50' BLM 134 BLM 133 N89°53'37"W 164.94 , ZN\ , . m \ 25.6-- I / 38.3' 0 !y\``-4,,„ ^, CNI I I,' N 67.6 rtt/ oi 20.1' `_ 38. N 15.5' 22.4' m N\9.\ 8.0' a ) N g `12.0' l0 4.0' I Iociilla 34.8—.-- t 4.8 �r 1 8.3' 6.0' I I 15,51 % i. i1 I I \ 03 1 I ‘il, s tO 11 `s° 65- i I \ -k10I LOT 139A \ 1 I g BLM 140 0 ISI I 1 % N. I I 1 1 Imo ` � °1 1 e.1 .*. / 11 g S / 1 O i /� g / / / / Zona Subdivision 1 ' Lot 139B '4 -KE/// / 42,904 sq.ft.+1- I / / % 19986 5.Birchwood Loop W w / / 2 Story Wood Framed House // // w/Attached 2 Car Garage 5 / (/ —o-- 0 in / I I I N89°52'27"W 164.94 S d I I ae > 1 I <CULVERT o t I m -- — --- 1- - ---nt S. BIRCHWOOD LOOP ROAD ----- - - I / 1 Legend: ILI Electric Meter/Outside Power f, Telephone Pole II Gas Meter !moi Deck -0- Fence 0 25 50 100 ® Septic O Water Well _3" Light Pole -SMP- Over Hanging PowerImmo immimimilimilim Feet General Notes: 1.This document is created for the purpose of a single property transaction and is subject to Federal Copyright Law. 2.Excepting for gross negligence,the liability for this survey shall not exceed the cost of preparing this survey. 3.All measurements/setbacks are to the visual/apparent building footprint. 4.Dimensions to property lines are plus/minus 0.1ft. ``'. \\N"\\XII t t t This survey complies with ASPLS Mortgage Location Standards.The survey represents visible improvements and tions the ocument does nstitute a �� OF AI Al Iii, inaccuracies aciestth t time subsequent boundarysury y may rreveal.Itis the responsibility of the Owner to determine ary survey and is subject to ny 4cP•' • • /� the existence of any easements,covenants,or restrictions which do not appear on the record plat.Under no .• '� '• 7 // circumstances should this document be used for construction or for establishing a boundary or fence line. 49TH " * �; As-Built Survey of: _..�. Lot 139B, Zona Subdivision / •13 FREDERIC W.AdriER I,Frederic certify NO.L.5:9946 rWagner,gner hereby e fy t h at this Mortgage Inspection Survey was performed by me,or //� under my direct supervision on February 13th,2018. //`rI, ' 2/13/2018 _ ,,rr� FESSIONp��.�p`-- Frontier Surveys, LLC FRONTIER. tttp„sIo ,,,, 650 W.58th Ave.Suite E Anchorage,Alaska 99518 41 Sury- - . PROFESSIONAL SEAL wOww.f ontierrsu a s.comtiersurveys.com ,� '� . MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLIC~TI(IN FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. Ger~al Information Application Date (a) Legal Description (include lot, block, subdivision, section~ township, range) Lot. 139B Zona Subdivision Location (add~ess o~ directions) (b) Applicants Name Paula Barret Telephone 562-7485 Applicants Add~ess 3230 Montclare, Anchorage, Alaska 99503 (c) Applicant is (check one) Lending Institution ~; Owner/builder ~; BuYer .~'-~ ; Other ~ (explain); (d) Lending Institution Frontier Credit Union %%lephone 563-3766 Address 3500 Eide Street, Anchorage, Alaska 99503 (e) Peal Estate Co. & Agent Address Te leph(?ne ./2._ Type, of l~sideno~ Single-Family Fxx~ Numbe~ of Bedrooms 3 o Water Supply Multi-Family ~--~ three Other (describe) Individual Well ~ Comnunity ~-~ Public ~ Note: If co~nity well system, must have w~itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. Is the v~ll adequate fox the number of bedrooms specified in~ this HAA (Y/N) 4. Se~mge Disposal Onsite ~-~ Public ~ Community ~--~ Holding Tank ~--~ Is the wastewater disposal system adequate for the number of' bedrocms (Y/N) [Page 1 of 2] 2-15-84 5. Engineerin_~q_~ P~ovidin~ Ins_Dections~ Tests, D~ta and Information I certify that I have checked, verified~ or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed Date Name of Firm Telephone Add~ess Signed by. Date ( ENGINEER SEAL) This ~epartment has received written confirmation from the engineer(Entech Engineers) and has verified the items under conditional approval have now been completed. This property is now been give~ a full approval. 6. DHEP Approval Approved for three kedrooms Approved ~ Disapp~ox~d ~ Terms of Conditional Approval ' Conditional 26, 198 'Fne Municipality of Anchorage Depa~tmmnt of Health and Environmental Protection dces not guarantee the continued satisfactory perfoL, l~mnce of tb~ wate~ supply and/or the wastewate~ disposal system. This approval indicates that, as of the validation date sho~ above, based on the data and information furnished by an engineer registered in the State of Alaska, the w~ter supply a~d wastewater disposal system is safe and func- tional for the ~3mber of bedrocks and type of structure indicated° (DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] ~ 2-15-84 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEAL'IH DEPAt~fMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUI"HO~ APPROVAL CERTIFICATE 1. General Information Application Date April 16~ 1984 Legal Description (include lot, blodk, subdivision, section, township, range) Ln± 139 ~,~U~]~u2]..~J~i~inn Location (add~ess o~ directions) Birchwood Loop a) b) Applicants Nawe ?aula Barre~ Telephone 562-7485 c) (d) Applicants Address 3230 Montclare~ Anchora6e~ AK 99503 __ Applicant is (check one) Lending Institution O er/ uilder Buyer ~--~ ; Other ~ (explain); I~nding Institution Frontier Oredit Union Telephone 563-3766 Address 3500 Eide Street~ Anchorage~ AK 99503 (e) I~al Estate Co. & Agent Address Te le phone 2. T_~ of Nasidence Single-Family Number of Bedrooms 3. WateF Supply Multi-Family~--~ 3 Other (describe) Individual Well ~ Con~nity ~-~ Public ~ Note: If c~,~'~nity well system, must have written confirmation f~_cm the State Department of Envircrarental Conservation attesting to the legality an~ status. Is the ~11 adequate fo~ the number of bedrooms specified in this HAA (Y/N) Yes 4. Serrate Disposal Onsite ~ Public ~ Cormlunity ~--~ Holding Ta~k ~ Is the wastewater disposal system adequate fc~ the number of bedrooms (Y/N) Ye$ [Page 1 of 2] 2-15-84 ~5~. Engineerin9 Firm P~ovidin9 Inspections, Tests, Data and Information I certify that I have checked, verified, or conformsd to all MOA HAA Guidelines in effect on the date of this inspection.. ~ Signed ~//~n~h~~~nc Date April 16, 1984 Na~e of Firm E t c g' ~, Inc. Telephone 694-3574 Add~ess 13 LeDoux, Eagle River, AK 99577 signed by Vernon L. Roelfs Date April 16, 1984 (ENGINEER SEAL) '6. DHEP Approval Approve d for Approv~d~ ~ bedrooms Disapproved ~ BYC~2a 1 ,~[j~~ Dat~~/ The Municipality of Anchorage Department of Health and Environmental P~otection dss not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date sho~a~ abo%~, based on t~ data and information furnished by an engineer registered in the State of Alaska~ the water supply and wastewater disposal system is safe and func- tional for the rz~abe~ of hedrcoms and type of structure indicated. 7. Mail the HAA to the following (DHEP SEAL) addle ss: KB2/d5/s [Page 2 of 2] 2-15-84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: WELL DATA Well Classification Private Well Log P~esent (Y/N) Yes HEALTH & -r,, ~'i~ONM~NTAL PROTECTION 4 gpm RECEIVED Lot 139 B, Zi0na Subdivision If A, B, c~ C, D.E.C. Approved(Y/N) N/A Date Completed 9-15-83 Yield Cased to 72' Depth of ~outing Unknown 70 ' Pump Set At Unknown Sanitary Seal on Casing (Y/N)¥~ Depression A~ound Wellhoa~/N!Yos Total Depth 100.6 ' Static Water Level Casing Height Above Ground 48" Electrical Wiring in Conduit (Y/N) 'Yes Separation Distances f~om Well: To Septic/Holding Tank on Lo~ '1 ' 100' + ; On Adjoining Lots 100 ' + . To Nearest Edge of Absorption Field on Lot ,100'+ ; On Adjoining Lots 1Q0'$ To Nearest Public Sewer Line N/A. To Nearest Public SeWer · Cleanout/Manhole N/A To Nearest Se~r Service Line'on Lot. ~15' Water Sample Collected By Mike Hagan .- ;Date 4-12-84 Water Sample Test Results 0/100 ml; Negative will be corrected after frost is~out of the ground. Deficiency Owner requests Be a conditional approval. SEPTIC/HOLDING TANK DATA Date Installed 8-27-83 ' Size 1000 gal No. of C~,%~a~tments 2 Standpipes (Y/N) Yes Air-tight Caps (Y/N)¥es Foundation Cleanout (Y/N)Yes Depression ove~ Tank (Y/N)No Date Last Pumped ~ew System Pumping/Maintenance Contract on File (Y/N)N/A ; for N/A Holding Tank High-Water Alarm (Y/N) N/A Temporar~y Holding Tank Permit (Y/N) N/A · Separation Distances f~cra Septic~Holding Tank: To Water-Supply Well 100'+ To Bu{lding Foundation 57' To Property Line 24' To Disposal Field 5' To Water Main/Service Li~5'+ To S~eam, Pond, Lake, c~ Major D~ainage Course N/A Corm~nts 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 8-27-85 Width of Field N/A Square Feet of Absorption A~ea 675 sq£t 225 sqft/bdrmType of System Design Trench Length of Field 68' Depth of Field lQ ' Gravel Bed Thickness __ 5 ' Standpipes Present (Y/N) Ye, s Depression over Field (Y/N) No Date of Last Adequacy Test New Syst6~ Results of Last Adequacy Test New System Separation Distance from Absorption Field: To Water-Supply Well 100'+ To Property Line 40'+ To Building Foundation 70'+ To Existing or Abandoned System Lot N/A ; On Adjoining Lots N/A To Water Main/Service Line 70'+ To Cutbank(if present) I~/A To Stream/Pond/Lake/or Major Drainage Course N/A To Driveway, Parking Area, or Vehicle Storage Area 24' Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Din~ns ions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Cormrents ** Check Permitted Bed~ocm Rating Against HAA Request ** I certify that I have checked, verified, or conforwed to all MOA HAA Guidelines in effect on the date of this inspection./ ' Company Entech F,n~ineers.~±ne. MOA No. S~R~-OJS_ KB1/d5/s ~% ye · 2~-15-84 & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~,~ - TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CENTER ~,~',~,~'~,~ ~ 5633 B Street ~,~'~¥~ Drinking .W~ter Analysis Repo. rt for T,otal Coliform Bacteria · TO BE COMPLETED BY ~/VATER SUPPLIER WATER SVSTEM= '- I I I IJ (*)See b on back I.D. NO. Water System Name Mailing Addres~ (~iW State Mo. Day Year Phone No. SAMPLE NO. 1 SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. 'l ~ [] Treated Water [] Special Purpose [] Untreated Water LOCATION '~0'4'/"/~¢~' ~ Time Collected Zip Code Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: J~Satisfactory [] Unsatisfactory [] sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: [] Fermentation Tube ~FMembrane Filter Lab Ref. No. Result* ] F1-] Analyst J FTq I F~ READ INSTRUCTIONS BEFORE 06-1220 (b) BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1983 Membrane Filte~ Direct Count_ Verification: LTB BGB Final Membrane Filter Results Reported By '~, ~ Time:. Coilform/100ml Coilformll00ml a.m. COLLECTING SAMPLE TNTC = Too Numerous To Count TECH ENGINEERS, INC. CIVIL · SANITARY Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, AK 99501 April 16, 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Re: Paula Barret, Health Authority Approval (HAA) Application; Lot 139 B, Zona Subdivision Dear Sir, RECEIVED During the period from April 14 to April 16, 1984, we performed research, investigations and testing persuant to Health Authority Approval on the above referenced lot. We performed a flow test on the well and found the output to be adequate for a 3 bedroom house. (Refer to Water Yield Test, attached). We also took a water sample for bacteriological analysis and results were negative (Refer to Chemical & Geological Laboratory Analytical Report, attached). We found a large depression around the well head. Due to wet and frozen ground conditions, it is not practical to correct this deficiency at this time and the owner requests a conditional approval. To our knowledge, we have assembled all available information on the HAA Checklist and Application Form. We offer this information for your review. Please call if you have any questions. cc Paula Barret Attachments: HAA Application HAA Checklist Water Yield Test Sewer As-Built Well Log Chemical & Geological Testing Lab, Total Coliform Analysis 13LEDOUXLANE · EAGLE RIVER, ALASKA 99577 · TELEPHONE (907) 694-3574 TECH ENGINEERS, INC. CIVIL · S, qNITARY June 19, 1984 Municipality of Anchorage Department of Health & Environmental Protection 825 "L" Street Anchorage, AK 99501 Re: Paula Barret Health Authority Approval (HAA) Reinspection; Lot 139B, Zona Subdivision Dear Sir, On April 16, 1984 we prepared a Health Authority Approval Application for the above referenced property. At that time there was a large depression around the well casing. Due to wet and frozen ground conditions at the time, the owner applied for conditional approval. We were recently notified that corrective work had been completed. We performed a reinspection and found that the depression has been filled according to Municipal regulations. With this letter we wish to apply for final HAA for the above referenced property. Please call Paula Barret at 688-4851 for pickup of final paperwork. If you have any further questions, please do not hestitate to call. Sincerely, / Vernon T.. Roel.f/~, p'R cc Paula Barret 13LEI30UXLANE · EAGLE RIVER, ALASKA 99577 · TELEPHONE (907) 694-3574 & ENGINEERS, INC. $ 7125 OLD SEWARD HIGHWAY · ANCHORAGE, ALASKA 99502 November 1, 1983 Department of Health and Environmental Protection Environmental Engineering Department 825 "K" Street Anchorage, AK 99501 Re: Lot 139B Zona Subdivision Dear Sirs: This will certify that on October 31, 1983 S & S Engineers, Inc. inspected the septic line as built between the septic tank and its placement under the foundation of the house to be built on Lot 139B Zona Subdivision. The line has a total length of 55.5'. Four lengths of 10.0' Portco ASTMD 3034 connects the septic tank to 4" cast iron pipe. There is a cast iron stand pipe 4.5' from the end of the D3034 and approximately 2.5' from where the foundation will be placed. 11.0' from this stand pipe is the stubout for the septic hook-up within the foundation. The pipe used under the foundation is 4~ cast iron. The line was placed to a depth of 4.0'. If you have any questions, please contact us at 349-6561. Sincerely, WOSE:wel Job 83078 WASILLA (907) 376-3770 S & S Engineers, Inc. William O.S. Evans t ANCHORAGE (907) 349-6561 SOLDOTNA (907) 262-9534