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Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page of
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231023 PID Number: 017-411-13
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
JAMES W WOOLEVER
ABSORPTION FIELD - EXISTING
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
12401 TOILSOME HILL DRIVE, ANCHORAGE
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
4
GPD/SF
JTotal
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
WOOLEVER 2 1
Fill added above original grade
Ft.
Gravel length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ftz
Ft.
Well
100'+
--
25'+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1500 Gal.
Surface Water
100'+
--
Material
HDPE
Number of compartments
2
Lot Line
10'+
__
NA
Foundation
10'+
__
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks 1500-GAL INSULATED TANK INSTALLED FOR
CURRENT FUNCTIONALITY & FUTURE FLEXIBILITY.
Alarm location
Electrical installed by
Installer DENALI EXCAVATION
Tankto
PIPE MATERIAL House to tank 3034 dra infield 3034
Drainfield CO/MT
Inspector FWC
BENCH MARK (Assumed elevation) 100 ft
Inspdection 1" 3/8/23 2nd 3/8/23
Location and description
3rd 4'h
TOP OF MANHOLE
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
14
Conditional Approval: Date
Vjp�
Curtis Huffman
Septic System
Approved -
2 V
�1''• CE 128991 /f
Date �
(1���'�F • 12/15/23..•��C�Am,
Note: this approval does not include well permit requirements.
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-411-13 PERMIT: OSP231023
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LOT 1
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100' RADIUS
STAKED AT > ABM: MH TOP
CONST. /
NOTE: SURVEYOR LOCATED
WELL & VISIBLE SEPTIC
PIPES ON LOFTY HTS. LOT 1'
& APPEARS THE SUBJECT
WELL ENCROACHES ADJACENT
LOT'S TANK & THERE
IS A 90' WAIVER IN
THE LOT 1A FILE.
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DECOMMISSIONED EXISTING
VERIFIED 5'+ FROM
S.T. & INSTALLED NEW
SEPTIC TANK TO EXISTING 1500-GAL HDPE SEPTIC TANK
O
ABSORPTION FIELD.
WITH NEW DCO.
WELL TO THE SOUTH
I
IS APPROX.
118' AWAY FROM PL.
A—C=41.1'
B—C=28.0'
A—D=44.8'
B—D=32.1'
A—E=47.9'
B—E=34.4'
S89°58'50"E 148.69'
SEPTIC SECTION
7.3'
90' WELL
RADIUS• /� j
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SEPTIC
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SUPPORT® SERVICES:
WOOLEVER B2 LT1 ® OF A,�\®
PREPARED FOR: ��
JAMES W WOOLEVER
12401 TOILSOME HILL ®* 9 TIH*
ANCHORAGE, AK 99516
FIRST WATER CONSULTING DATE: 12/15/23 ` rtis Huffman /
13030 SUES WAY SURVEY: JLSr CE 128991
ANCHORAGE, AK 99516 SSCALE 1" = 30' `® 12/15/202 i� �
ssto��'
907-350-9566 firstwaterAK@gmail.com
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HUFFMAN ROAD
N89'58'00"W 148.69'
10' UTILITY ESMT GRAVEL
(_ PARKING
® WELL
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SEPTIC •
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ANCHORAGE RECORDING DISTRICT, ALASKA
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S89°58'50"E 148.69'
AS -BUILT OF:
WOOLEVER SUBDIVISION
LOT 1 BLOCK 2 PLAT 70-113
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance shoulc
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
WORK ORDER NUMBER: DATE SCALE: E—MPdL
OCT 22, 2023 1"=30' schuIIer0ak.net
23— 1 DRAWN BY: CfiECKID BY umo NUMBEAC
R: BOOK E:
JLS SW2841 230342
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M �• 1IJOHN •L. •SCHULLER:•
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-1831 Tallceetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fear
•
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: OSP231023
Work Type: SepticTank Upgrade
Tax Code Number: 01741113000
Site Legal Address: WOOLEVER BLK 2 LT 1 G:2841
Site Mailing Address: 12401 TOILSOME HILL DR, Anchorage
Owner: WOOLEVER JAMES W
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
t -S,
'f
Q
Depai- nent
Lot Size in Sq Ft:
Total Bedrooms:
2/28/2023
2/28/2024
24341
❑ 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. Stake nearby well radii prior to installation of new septic tank.
2. When you complete survey as built after tank installation, please confirm horizontal distance between
water well on lot to the neighboring septic system (tank and field) on Lofty Heights L1A1.
Received By:
Issued By:
Date:
Date: Z z p zo i
2
MUNICIPALITY OF ANCHORAGE
Development Services DepartmentPhone: 907-343-7904
On -Site Water & Wastewater Section ^�'� Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 017-411-13
Property owner(s) JAMES W WOOLEVER Day phone
Mailina address 12435 TOILSOME HILL DRIVE, ANCHORAGE, AK 99516
Site address 12401 TOILSOME HILL DRIVE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) WOOLEVER B2, L1
Legal description (Township, Range & Section)
Lot Size 24,341 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) Q
(w/wo ADU)
Septic Tank
Upgrade Q
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A 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: .226 -
Waiver Fees:
Date of Payment: 2 1.2 %L. Date of Payment:
Receipt Number: id 29-13 Receipt Number:
Permit No. a 'seA_31aa3 Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
February 28, 2023
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT - URGENT
LEGAL: WOOLEVER BLOCK 2, LOT 1
The owner has requested that we obtain a septic permit to upgrade the existing aged septic
tank that has collapsed on the above referenced lot. Although the tank appears to be
operating and there appears to be no health or safety issues with this collapsed tank, we would
recommend issuing septic tank upgrade permit as soon as possible.
We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-
bedroom residence. If possible, we would recommend a 1500-gallon HDPE tank be installed for
future consideration or flexibility. No groundwater was noted in the MOA on-site file, but if
groundwater is encountered during installation an epoxy coated steel septic tank may be required.
The lot and area are served by private water. Although not associated with this septic tank
upgrade the septic tank and/or system on Lofty Hills Lot 1A1 may encroach the well on this lot
(Woolever B2, L1). In any case, adjacent wells will be staked by a registered land surveyor prior
to septic tank upgrade and if a waiver is warranted the MOA will be notified prior to any septic
installation. The design will not impact any of the neighboring properties. Please contact us if
you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231023, Curtis Townsend, 02/28/23
FIRST WATER CONSULTING
WOOLEVER B2 LT1
DESIGN DETAILS:
NO PRIVATE
WELLS WITHIN
100' OF PROPOSED
SEPTIC TANK
RLS TO STAKE ALL
WELL RADII PRIOR
TO CONSTRUCTION.
UPPER HUFFMAN ROAD
TOILSOME HILL DRIVE Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231023, Curtis Townsend, 02/28/23
QGREA
'J ANCFIORAGE AREA BOR.
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM
NAME L~//~' ('~Jg;~/g~..Z~., _ MAILING ADDRESS ~J~'" ,~/~--~'~,~,~,,~'~'~ ,W/¢~',4' ¢~..~dP~NONE ~ iff/_ ~/,~,~'
LOCATiON././L~'t~/.~',d/V ~ ~'~/X.5'~/g'c9///'////~/'~: LEGAL DESCRIPTION '~/Zz /' /<~/.~,6: ~ ~/~x~'~}~'/~~ ~-/~/
SEPTIC TANK:
DISTANCE /y'/,c///f'~/~ , ~"<'//~-~'/~ NUMBER OF
FROM WELL_/&V/ ¢/_~'I~NUFACTURER ~¢",/'/~.4~/~ g-/~'~ MATERiAL~, :,~' COMPARTMENTS_~/
INSIDE LENGTH ~ INSIDE WIDTH ----' .LIQUID DEP'rH_~ LIQUID CAPACITY //~,~d~ GALLONS.
/
SEEPAGE PIT:
NUMBER OF PITS__ / DIAMETER_ ~ OR WIDTH ~ LENGTH---'., DEPTH /'62-///
~7/ DISTANCE FROM: WELL
LINING MATERIAL ~0~.~2~ CRIB SIZE: DIAMETER Wp/ DEPTH
BUILDING FOUNDATION~~¢, NEAREST LOT LINE ~ /'f' TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) SQ. FT,
ADDITIONAL ABSORPTION ~---
WELL:
TYPE. /~,~/z~:~'-~ __CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE TANK __ SYSTEM
CESSPOOL ., OTHER SOURCES
APPROVED____ DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY:
_/7%
PiPE MATERIAL:
LOT SLOPE:
REMARKS: /~,~',~dJ/'~ ,~'~?~
Form No. LQ-031
,/7,,F/~r-~-i:/z~Z/ DI~RAM OF SYSTEM
/ / o/~/~.~ DJ~IJ-. ,O~,~?/~l-"
GREATER ANCHORAGE AREA BOROUGH
£)EPAI:~TMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456!
SEWAGE DISPOSAL SYSI'EM -- APPLICATION AND PERMIT
PERMIT NO..
INSTALLATION LOCATION '~/~',~'~'~,~¢~¢,~'?'~ .~ ~'~- ~
~ ·
INSTALLATION of: SEPTIC TANK ~ SEEPAGE PIT~/ , DRAIN FIELD
. OTHER
TO BE INSTALLED BY
NOTIE~ THIS PERMIT I$ NOT VALI/WITHOUT SOIL
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANl( SIZE ~7~_~:~/ TYPE .~¢~'~'-'~ SEEPAGE AREA SIZE TYPE
SEPTICTANK TO SEEPAGE PITWALL
DRAIN FIELD
DRAIN FIELD
SEPTIC TANK, J~'~ ' _, SEEPAGE Pit
SEEPAGE PIT _,/~)
/~ /
-, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET [NTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON P[PES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BAC:KFILL
CONFORM TO BOROUGH REGULATIONS REGARDIN INSTALLATION.
LICENgED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 2B-OB AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDAN E WITH SAID CODE.
DATE ~/~/~/ L ICANT'S SIGNATURE ~ ~~
J
, GREATER ANCtIORAGE AREA BOROUGH
~.i' . ., . DEPARTMENT OF ENVIRONMFNTAL QUAL[I'Y
!)',,' ~,~l~v~'O 3330 "C" Street
~A~ _ ~ l~/G ANCHORAGE, ALASKA 99503
P e r f ~'m~IAN~:~u~A~J~u~OO[eve~
~egal Description: ~t_ ~ Block
This Form Reports Soils Log
Soil Test Must Be Logged To 4'
Depth
Feet Soil Characteristics
1 --. Pe~
2~
3 --- gravel
5--- Medium-to-coarse gravel with
6~- sand, trace of silt SW-SP
11--
12--
13--
14--
16":
Was
Case #
Coarse gravel with cobbles and
coarse sand, with silt
SW-SP-
SM
Ground Water EncousLer'ed9. Nv
If Yes, At What Depth?
Dated Per'gormed~_M~y_~_1974
2 Subdivision W_pole_v~ Sub~!ivh~i.o]~ .....
Percolation l'esL X
Below Proposed Seepage System -
Reading
Date
Gross Time
Net Time Deptt] to H20 Net Dro
Percolation Rate MinuLe
Proposed Installation: Seepage Pit X Drain Field
Depth of Inlet Depth ~o Elottom of--Pit Or l'renc~--~
COMMENTS: We recommend 203 sq.£t, per bedroom basedonBoroug!Lrequirements
Test Performed BY J.Jameson Date Certifiecl BY:
Date:
Alaska Mineral & Materials Lab
Tom Fink,
Mayor
icipali y of Anchor e
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
August 30, 1988
James W. Woolever
12435 Toilsome Hill Drive
Anchorage, Alaska 99516
Subject:
Encroachment of the Well on Lot 1 Block 2 Woolever
Subdivision to the Septic Tank on Lot lA Lofty Heights
Subdivision
]Dear Mr. Woolever:
In response to your letter dated August 8, 1988, I called the
engineer who discovered the alleged encroachment of your well
the neighbors septic tank on Lot lA Lofty Heights Subd.
to
He explained that like you he also measured a separation
distance from your well to your neighbor's septic tank of
101 feet. Our Department standards however, as mandated by the
Alaska Department of Environmental Conservation, require that
the minimum separation distance between surface or subsurface
drinking water sources and potential sources of contamination be
measured horizontally. The engineer explained that this
measurement was taken on a slope of approximately 30 % and makes
the actual horizontal separation distance only 96 feet.
This separation distance will require a waiver study to
determin9 if contamination is possible of the ground water
supplying the drinking water in your well and the wells in the
surrounding area. If you do not apply for this waiver, then at
a future time when you attempt to sell your home, our department
will deny health approval until the well is in compliance with
State and Municipal regulations.
If you have further questions regarding this matter, I can be
reached at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
Acting Manager, On-Site Services
Program
Tom Fink,
Mayor
Municipality of Ancliorage
Department of Health and Human Services
825 "L" Street
P,O. Box 196650 Anchorage, Alaska 99519-6650
August 1, 1988
Gary A. Capps
].2500 Toilsome Hill Drive
Anchorage, Alaska 99516-3352
Subject: Septic Tank on Lot lA Lofty Heights subd. Being
Encroached Upon by the Well on Lot i Blk 2 Woolever
Subdivision
Dear Hr. Capps:
It has recently been brought to my attention during the Health
Authority Approval process for your neighbor's lot, Lot lA
Lofty Heights Subdivision, that you]: Well is located 90 feet
from his septic tank. The required separation distance as
stated in Title 15.65, Municipality of Anchorage Wastewater
Disposal Regulations, Section 15.65.040, (I.1), is 100 feet.
Your neighbor cannot receive a full approval of his septic
system from the department until this matter is resolved.
Because the date of your neighbors septic system construction
is Ouly 19, 1971, and your well was constructed at e later
date, the responsibility of correcting this matter would be
yours. The two options available for you to correct this
matter are: (1) You may hire an approved engineer to perform a
waiver study on the 90 foot separation to determine the
possible impact on the well water and submit it to the
department for approval, or (2) you may apply for a permit from
the department to abandon the old well and drill a new one to
meet the required 100 foot separation distance to the ~'eptic
tank on Lot lA.
You must bring your well into compliance by August 31, 1988 or
the department may take legal action to have this matter
resolved.
If this deadline is unreasonable or you have any questions
regarding the above you can contact me at 343-4~44.
Sincerely,
Daniel J. ~Roth
Civil Engineer
On-Site Services
cc: A1Sundquist, P.E., Manager
On-Site Services/Water Quality Programs
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
OSC241510
Parcel ID 017-411-13 Expiration Date: '
Legal description WOOLEVER BLK 2 LT 1
Site address 12401 TOILSOME HILL DR
Current property owner(s) WOOLEVER BRUCE
X The On -site system(s) is/are approved for 4 bedrooms
0
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
Original Certificate Date:
2/4/2025
This Certificate dfJOn-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 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
Absorption Field Advisory
Tank Age Advisory
Other
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
MUNICIPALITY OF ANCHORAGE
1 \
Development Services Department �i 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. 017-411-13
Complete legal description WOOLEVER BLOCK 2 LOT 1
Location (site address) 12401 TOILSOME HILL DRIVE, ANCHORAGE, AK 99516
Current property owner(s) JAMES W WOOLEVER Day phone
2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS
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: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ® Plastic ❑ Concrete ❑ Fiberglass
Age 1 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ® Seepage Pit
Waiver request for: Well to adjacent tank & field Distance: 92' & 91'
Expedited review requested: ❑
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 $ S- 5u Waiver Fee $
Date of Payment ) ZZ—gLzV Date of Payment
COSA # (9 S C -L y' ��( Waiver # ( S 1a 2 C (0
COSA Application.doc
COSA Checklist
Legal Description: WOOLEVER BLOCK 2 LOT 1 Parcel ID: 017-411-13
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 UNKNOWN Total depth UNK ft
Cased to 18 ft (Per Sullivan Scope —see letter)
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 10/28/24
Static water level at beginning of test 14 ft.
Well production at time of test 1_7 gpm
Water storage tank volume NONE gallons
Well disinfected for coliform test? ❑ Yes ® Nc
® Coliform bacteria is Negative
Nitrate 5.03 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by -S Date 10/28/24
Comments Sullivan scoped well casing, and it was found in good condition — see attached letter. Also, a new well pump
was installed, and the well was sealed/sleeved to prevent potential upper water intrusion see Sullivan email information.
B. TANK DATA
Measured operating fluid level in septic tank 65"
Date of pumping 11/21/2024
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/19/1974
® ALL standpipes present per record drawing
Total measured depth from existing grade 8_6 ft (max)
Measured depth to pipe invert from grade 3.2 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 5.4'
❑ 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
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 10/28/24
Results 0 Pass
Fluid depth prior to test 35 in
Water added 600 gal
New fluid depth 43 in
Elapsed time 1440 min
Final fluid depth 35 in
Absorption rate 600 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings)108 in (MOA WED)
Effective depth used 78 In (Missing ED + Final Fluid Depth)
Effective depth (ED) remaining 30 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual
observations, MOA records & there appears to be 3.6' or 43" of ED missing / not measurable based on the invert to the bottom of the crib.
COSA Checklist.docx
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
® Yes
if No ft
Neighboring Tank > 100' ❑ Yes
if No *92+
ft
Private Sewer/Septic Line > 25' ® Yes
if No ft
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No ft
Neighboring Absorption Fields > 100'
Animal Containment > 50' ® Yes
if No ft
❑ Yes
if No *91+
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® 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' ® Yes if No ft
Tank to Property Line > 5'
® Yes
if No
ft
Welts on Adjacent Lots:
Field to Property Line > 10'
® Yes
if No
ft
Private Wells > 100' ❑ Yes if No *81+ ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*WAIVER REQUESTED WITH THIS SUBMITTAL.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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 02104/2025
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 & NIC-5
COSA Checklist.docx
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MUNICIPALITY OF ANCHORAGE
907-343-7904
Ors -Site Water and Wastewater Section i Fax: 34-799
WVJVJ.n1U11i.org/cnsite_
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC241510
Subdivision: WOOLEVER , Block: 2, Lot: 1
A water sample revealed a nitrate concentration of 5.03 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
13021 Montego Circle, Anchorage, AK 99516
907-350-9566 / FirstWaterAK@gmail.com
Attachments: Well Waiver Drawing, Sullivan Letter, Sullivan Email & Pump Log
February 4, 2025
Municipalities of Anchorage (MOA)
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: WOOLEVER B2, L1 – WELLS TO FIELD & SEPTIC TANK WAIVER
Per the as-built survey by John L. Schuller of October 22, 2023, along with our attached drawing based on the
available information from the MOA record documents and previous discussions with MOA staff, the assumed closest
portion of the adjacent Lofty Heights Lot 1A1 existing absorption field (crib) and septic tank was measured or
determined to be at approximately 93’ & 94’ respectively to the well located on Woolever B2, L1. Also, the
Woolever B1, L1 well is approximately 83’ to the seepage pit of Woolever B2, L1. We are therefore requesting a
waiver of 91’ between the referenced well on Lot 1 to the absorption field on Lot 1A1, 92’ between the well on Lot 1
to the tank on Lot 1A1 and 81’ from the seepage pit on Woolever B2, L1 to the well on Woolever B1, L1.
The existing MOA record documents of these properties contain information regarding this previous encroachment.
Granting of this separation waiver is justified in the fact that the attached coli, arsenic & nitrate (CAN) water samples
show moderate nitrate levels, and the area also shows low-moderate nitrate levels, such as Lofty Heights Lot 1A1
3.59 10/2014 & 5.33 3/2007, & L7A Ginami 2.97 12/2012. The Woolever B2, L1 well was scoped by Sullivan and
the casing integrity was in good shape with water coming in below the casing. See attached Sullivan letter. Due to this
water intrusion, Sullivan sleeved & sealed off to seat the casing properly and prevent this upper water intrusion. A
new well pump also had to be installed at this time. See well pump log & the attached Sullivan email.
The Lot 1A1 2002 installed “fiberglass” or plastic septic tank is of higher material quality than the decommissioned,
previous old steel septic tank. The actual separation of this steep surface run is approximately 100’ between well &
the septic system (tank & field) and any potential effluent path does not flow directly towards the well. Existing
information along with area well logs & soil logs indicate mainly silty sandy material, bedrock and some gravel with
good treatment of effluent, lower sorption & permeability thus protecting the aquifer or water producing veins. The
well on Lot 1 has positive drainage away from the wellhead and was recently extended with new sanitary seal &
conduit. The Lot 1A1 septic system has been in operation for around 50+ years with no known side effects.
These rationales also pertain to the encroachment of the well on Woolever B1, L1 and the seepage pit on Woolever
B2, L1 with any potential effluent path flowing away from the well northwestward, the nitrate levels of Woolever B1,
L1 are ND or at low levels and there has not been any know issues for 50 years with this separation. Granting of this
waiver will not adversely impact any of the neighboring properties. Please contact us if you have any questions.
Respectfully,
Curtis Huffman, P.E.
FIRST WATER CONSULTING
WOOLEVER BLOCK 2, LOT 1
Municipality of Anchorage io
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tmrnt
P.O. Box 196650 0 4700 Elmore Road
Anchorage Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * *
Waiver#: OSV241064 COSA#:OSC241510 Permit#:
P I D#: 017-411-13
Legal Description: WOOLEVER BLK 2 LT 1
Engineer: First Water Consulting
Your request for a waiver of the required 100 feet horizontal separation from the absorption field
to the private well has been approved. The approved separation distance is 91.0 feet. Your
request for a waiver of the required 100 feet horizontal separation from the septic tank to the
private well has been approved. The approved separation distance is 92'. Your request for a
waiver of the required 100 feet horizontal separation from the absorption field to the private well
has been approved. The approved separation distance is 81'.
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: i�
Date: G- UZ- `� Approved by:
Name of Re fewer
**** VARIAN C EMAIVE R REVIEW ****
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www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP Date of Issue
Parcel Identification Number:
Legal Description Property Owner Name & Address
WOOLEVER Block 2 Lot 1 Brent Western
12401 Toilsome Hill Anchorage, AK 99516
Pump Installation Date:
1-24-25
Pump Intake Depth Below Top of Well Casing:
70 feet
Pump manufacturer’s Name:
F&W
Pump Model:
4F07P05301S
Pump Size:
½ hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Unknown
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Unknown
Date: 12/27/24
P.O. Box 670269 Chugiak, AK 99567
P: (907) 688-2759 F: (907) 688-2259
TO: Brent Western
12401 Toilsome Hill
Anchorage, AK 99516
Camera Inspection Report
Well scope was performed due to high nitrates.
We found only 18’ of casing to bedrock.
The 18’ of casing is in good shape.
Water comes in between casing shoe and bedrock.
Static is 17’
