HomeMy WebLinkAboutPREUSS #4 BLK 8 LT 6P uss #4
Lot 6
Block 8
#'050-572-50
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section 825'L" Sbeet Room 502
P.O. Box 196650 Anchorage. AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ,~t, JO002~'7 PID Number: 050 - .~'??-- 5'0
Name:
~ELL~[ ~ ~AI~A~,~ ,,~446,/-IV4A} WastewaterSystem: []New ~Upgrade
Address:
2o&c~ LUC4~ AVE./ EA~u~.~lv~t. t AK. 0q~'77 ABSORPTION FIELD
5.. /
~GPM Ft.~sing Height Above Gr°u~:F,' TANK
SEPA~TION DISTANCES ~Sep~c ~ HoId~ng ~ S.T.E.P. ~ O~e~
r~ Sep~c Abso~on Lift ~olding Publ[~dmh Manu~a~rer:
Tank Field S~on Tank Sewer Line
/
- _ ,. / -- ,i ~ /DO
Inspectons pedormed b'~3 ~''eg~ .,, · 9--
Depa"ment of Health and Human Se~ices appr~va{
aS-SUILT SYSTEM ~ETAILS/SITE PLAN PERMIT~ SWOOOPS?
PREUSS S/D BO, LOT 6 PID~ 050-578-50
MAIN ~ATER LINE
....... ........... ............
" '." ~ '"":".~ I
"
'"'-. -. -...."..,,~' ~'~ ~ Fs'.~"~'~~''' /
B-D=84.3' ~ ~
c-~=a~.~' ~ ~
B-E=17.5' ad
C-E=3~.O' m~ .~__ . FINISHED GRABE
A-F=31.7' ~ = _ . ..................................................................................
B-F=17,9' ~ ~ ~0~0 GAL - . -
A-G=49.B'B_G=78.9, ~A~ ~ SEWER ROCK
/
~ ~ ........................ ~ ~ PREPARED
~?" H~ ''''''~ '$ KELLY, .AR.A,A SULLZVAN
~O~Oe LUCUS ~V~NU~
* X 9 T ~ * EAGLE RIVER, AK. 99577
ANCHORAGE, AK 99507
. . FIELD BOOKS CO.PU~O: ~ ENGINEERING
." ~ C~-711;~:/.~ ~ ..NO~ SEWARD o.A~: VBG
~m~""' .......... "~ S,~,N~: SEWARD ~o: KBO ~04~1 P~AR~IGAN BLVD.
~ ........................... ~ ASSU,L~: SEWARD o~: 9/26/00 gAGLB gI~gg, l~ 99877-8788
*c~o n,~ O0022,DWG ~"0': 00022 {907~696-61
(907) 344.-555~
"SPARROWS"
ELECTRIC INC.
7310 Bu~en Dri~ · Anchorage, AK 9950?
FAX: (907) 344.5B'48
2000
CONffiTRUCTION:
TO ~ ~ MAY CONCa~I
RECEIVED.
O~T O~ ~'0¢0
Health a Humrm 8orvices
~=R01~SIONAL~.Y YOURS:
MUNICIPALITY OF ANCHORA GE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519~6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 27, 2000
Expiration Date: Jul 27, 2001
Permit Number: SW000257
Legal Description: PREUSS ~ BLK 8 LT 6
Design Engineer: 0070 KND Engineering
Owner Name: BARBARA SULLIVAN
Owner Address: 20608 LUCAS AVENUE
EAGLE RIVER , AK 99577-8781
ParoDI ID: 050-572-50
Site Address: 020608 LUCAS AVE
Lot Size: 19600 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
Private Well
[] 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date:
Date:
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907) 696-6111/FAX (907) 696-8111
July 13, 2000
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Septic System Upgrade - Preuss Block 8, Lot 6
Dear Gentlemen:
The owner has requested that we proceed forward to obtain a septic permit to upgrade
and replace the existing septic tank on the subject lot. The existing septic tank will be
abandoned in place and in accordance with municipal.
There is no public or private within 200' of our proposed septic tank and existing field
location except as noted. There is no surface water within 100' of the proposed and
existing field and there are no known curtain drains within 50'. We do not expect there
to be any adverse effect on adjacent lots by the replacement of this system's septic tank.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~blI~) Engineering
Attachments: Wastewater Absorption System Details/Site Plan
Testholes
WELL g, VASTEWATER DISPFISAL SYSTEM DETAILS/SITE PLAN
PREUSS :S/I? ]38, LET 6
............... ...... ..............
I
PR0rE~ ,,-~'; O
~'""' 7 ~ 8
I /I 3 31 'I 3
~ESZGN
4 ~gRN X 150 GP~ = 600
600 GPD/L8 GPD PER ~, FT, (8,4 N[N/[N,)= ~00 S~, FT
(500/5'(~)) X O,7(RF) (8,0' 6R~VEL) = 70' FT, TRENCH
U~E ~ TRENCH- 70'(L) X 5'(~) X ~'(g)
Total depth oF ~ys~e~ Is 4,0' FrOM original grade,
PRDP~SE~ SYSTEH, TO~I depth o? gr~vel below distribution plpe Is ~.0' .
NB PRIVATE ~ELLS V[TH[N ~00' ~F NOTES~
NB SEPTIC SYSTEMS VITHIN aO0' DF 1, USE 1~50 GALLUN SEPTIC TANK, INSULATE TANK IF <4' COVER,
~, INSULATE TRENCHES ~]TH ~' H9 ~UR~AL FUAH,,
3. CONTRACTOR W~LL ENSURE NAX~NUH ~N SLOPE INTO SEPTIC TANK,
4, A93~TIONAL FILL ~ILL BE A3~E9 OVER SYSTEM TO ACHIEVE
H~N, 3' COVER,
5, O~NER TO INSTALL GR]N3ER PUMP ~NSIgE HOUSE
~~ 6, SYSTEH PRESURIZE9 TU TANK
KELLY & BARBARA SULLIVAN
....... ~ ................................. :, ......... PAGE
8~N~V: SEWARD o~: VBG
D~. ~m ~D: NW56 :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
*o~.m 00022.DW6 ~.,o.: 00022 (907)696-6111/F~ (907)696-8111
WaSTEWATER DISPFISAL SYSTEM DETAILS
PREUSS S/~ S8, LBT 6
, ,
.
~ .~ .::-'.;' '" '/. TANK
~ .
~ ~ CXISTING SEPTIC
I , ',
i I!
........... .......~y~ ~ PREPgRED FBR~
EAGLE RIVER, aK,
.......................................................... , PAGE
, ~"~:'"~ ....... FIELD BOOKS ~PU~: ~ ENGINEERING
B~ND~Y: SEWARD ~RA~: VBG
'~ ~ "' ~" '~ ~ g0441 P~MIGAN BLVD.
~ ~" ........... ~ ~ sT~m SEWARD mE~: KMD
~ss[O~ ~ SEWARD 6/28/00 EAGLE R~R, AK 99577-8736
~~ ~' ,m ~,~ NW56 ....................................................................
,c~ ~m 00022.DWG ~ "*': 00022 (907)696-6111/F~ (907)696-8111
Performed for: B. Sullivan
Project: Preuss
Depth
(Feet)
1- ORG
2-
3- GM/GP
6= w
SM--increasing density
w/depth
10-
11- seeps
12-
13- -- D.H.
14-
15-
16-
17-
18-
19-
HOLE PRESOAKED
20- PRIOR TO TEST
SOILS PERCOLATION TEST
Date Performed:
Blk 8 Lot 6 TEST HOLE # 00-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? Yes
Depth to water after monitoring? '] t 5 /
What depth? 10'
Date?
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 6/21/00 1:00 8"
2 1:10 10 min 3 9/16" 4 7/16"
3 * 1:10 8"
4 1:20 10 rain 3 14/16" ' 4 2/16"
5 * 1:21 8"
6 1:31 10rain 3 14/16' 4 2/16"
7 * 1:31 8'
8 1:41 10min 314/16" 4 2/16"
9 * 1:41 8"
10 1:51 10min 3 14/16' 4 2/16"
11 * 1:51 8'
12 2:01 10min 3 14/16' 4 2/16"
· Water Added
Percolation Rate 2.42 (rain/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 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.
sGRE, ._ ER ANCHORAGE AREA BOr_ JGH
Department of Environmental (~ualit¥
33;30 C Street
Anchorage, ^laska 99§03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL /~"
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY / ~ ~-<::~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER --OR WIDTH /g/L~,
LINING MATERIAL~'~A~-~//~_~ CRIB SIZE: DIAMETER__
BUILDING FOUNDATION /~/, NEAREST LOT LINE /g/.t .
ADDITIONAL ABSORPTION ~/r/ /~F/~.~'
LENGTH/-~-~' DEPTH / /
_DEPTH ~ DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ,~--
SQ. FT.
WELL:
TYPE /~i~/~
GUI LDING /~ ~ ~/~
FOUNDATION~ ~ / ,
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE ~_~t
OTHER SOURCES
DISAPPROVED
./~ DEPTH
NEAREST SEPTIC
SEWER LINE TANK_
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
INSTALLED BY,
PIPE MATERIAL~ ~'~./C~ S~'-
LOT SLOPE:
REMARKS: ,~ (~/.4~ ¢'
Form No, EQ-031
DIAGRAM OF SYSTEM
GrEATEr ANChORAgE AREA BOROUgh
3330 "C" STREET ANCHORAGE, ALASKA 99503
PERMIT NO.
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK ~
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SO~L TEST RESULTS ~OJ ~ ~
COMPLETION DATE ANTICIPATED
MAILING ADDRESS
SEEPAGE PiT ~
PHONE
, DRAIN FIELD
OTHER
FINAL INSPECTION: 24 HOUR NOT~CE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTIO~ BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK'-
FOUNDATION TO SEEPAGE PIT ., DRAIN FIELD
SEPTIC TANK ,SEEPAGE PIT ., DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAge PIT/(~
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
TO RIVER, LAKE, STREAM.
, SEEPAGE PIT
~ DRAIN FIELD
C~AST IRON INTO AND OUT Of SEPTIC TANK AND INTQ CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
/
SEEPAGE AREA TYPE
~IAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATE/~ANCHORAGE AREA BOROUGH ORDI[~ANCE NO. 28-68 AND THAT THE ABOVE
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVTRONMFNTAL QUALTTY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Case #
14 ,14 Dated Performed_ _. -7
Lot
Performed For
Legal Description:
This Form Reports Soils Log_~_. Percolation Test__
Soil Test Must Be Logged To ~' Below Proposed Seepage System -
Depth
Feet Soil Characteristics
1~_ 'r,p..~: ~~;l~
4--
5~
6~
7~
8~
9~
ll~
13~
14~
Was Ground Water Encountered?__~_~ ,
If Yes, At What Depth?
Reading
Date
Gross Time
Net Time ! Depth to 1t20
Percolation Rate Minute
Proposed Installation: Seepage Pit
Depth of Inlet
COMMENTS:
I
Drain Field
Depth to Bottom of Pit or Trenc!~
I
Net Dropl
Test Per,formed BY
Date CertiFied BY: Date:
MUNICIPALITY OF ANCHORAGE
WATER & WASTEWATER UTILITY
3000 ARCTIC BLVD.
PHONE: (907)564-2762
BLOCK/LOT/TRACT BILK 8 LT 6
SUBDIVISION PRUESS #4
v0- 2jqg
tvo03 -3D
WATER
CONNECT PERMIT 98 - 8670
DATE OF APPLICATION 09/23/1998
SCHEDULED COMPLETION DATE 12/31/1998
`X' SINGLE FAMILY
LI MULTI -DWELLING No. APTS
Lj COMMERCIAL
TAX CODE 5057250 GRID AS -BUILT
STREET ADDRESS 20608 LUCAS AVE
OWNER BARBARA R SULLIVAN PHONE
MAIL ADDRESS 20608 LUCAS AVE EAGLE RIVER, AK 99577
CONTRACTOR C&N
ASSESSMENTS
Repair Existing Service
Main Line Extension
On Property Only
City Tap
Have Been Levied
Hydrant Only
50' or Longer
i To Be Levied
Main Tap - To Property Line Only
X Main Tap & On Property Connect
Row No.l
Ct%_
Comments:
Disconnect
_110
R & R - Main Tap Only
Owner St ?
CONNECT SIZE 1"
ISSUED pcousins
INSPECTION FEE
$
103.00
! AID CASH
PERMIT FEE
$
45.20
F1 CHECK #
$
0.00
OTHER ` t
DEPOSIT
$
0.00
INSPECTED BY l
REIMBURSABLE
TOTAL
$
148.20
WOJONOWSKI
NUMBER
DATE /0 /,F/ f�
REMARKS
PERMITTEE (Please Print) PHONE
MAIL ADDRESS ,
SIGNATURE
POST IN A CONSPICUOUS PLACE AT THE JOB SITE
AWWU INSPECTOR Original
DATE SCHEDULED O9 p TIME 3200 INSPECTOR WOJONOWSKI
SUBDIVISION~ PRUESS #4
BLOCK/LOT/TRACT BLK 8 LT 6
INDICATE NORTH
/Q01i
1e211"DIP
.rc
'— Qs
v 6
ve --�
�i d,
.
key ,t3o y
0
h
.b
2
Q'3 part
1�
a u s e
Sly •,
SIZE CONN 1"
[-DOMESTIC ONLY BOTH FIRE & DOMESTIC
CORP. STOP
I FIRE LINE ONLY [ FIRE HYDRANT ONLY
/ CURB STOP C TO C
DATE OF TAPE /� / 8` IF? BY
3 $ FT. COPPER PIPE
SIZE MAIN �� (; ALLEY fr�STREET f 1 EASEMENT
11/4" OR 2" KEY BOX
TYPE MAIN PIP EXCAVATOR <--
�S FT. THAW -WIRE
DISCONNECTS YES NO SIZE OF DISCONNECT
THAW-PLATE/NUT
COMMENTS 7�Q� I's /0.2 ' 71
KEARNY CONNECTOR
KEY BOX LOCATION
OTHER "Copp Pr h-1 Yo
Gar% PY �6uS
Co pr
INSPECTION REPORT
E BLOWN OUT f 0
INSULATED INSPECTOR
`'K.B. & T.W. - OK AFTER BACK
-FILL DATE / p / /
j OPEN BORE FLUSH / /
COMMENTSq,s
200 LB. TEST
Cd
MAIN CHLORINATED
CHLORINE FLUSHED / C
[i�/OK TO TURN -ON _1 DO NOT TURN -ON
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MUNICIPALITY OF ANCHORAGE
Development Services Department \ r f, Phone: 907-343-7904
On -Site Water & Wastewater Section ' N`"l Fax: 907-343-7997
Lift Station/Pump Vault
��
F Maintenance Log
Owner �d� O eqvex Street Address q09"
Septic Tank:
-S!udge level inches -Pumping: required e no -Pumping completed &2 no
Lift station:
Pump basket cleaned no -Effluent filter cleaned e no
-Control floats cleaned e no ,Proper float settings confirmed & no
Operation satisfactory e no
Alarm Svstem:
-Dedicated electrical alarm circuit e no -Audible and visual alarm inside dwelling e no
•Alarm, system operation sa isfacto not satisfactory
Manhole Riser
-Ground water intrusion at riser to tank connection es
-Ground water intrusion around pipe penetrations Ves
-Manhole lid: Functionales no insulated e no
Other
-Weep hole functional daLno
Properly Secured AeV no
-All manufacturer required inspections and maintenance completed &A no
Comments:
r _ M_t>P� �,� fo use
Qualified Maintenance Pr eider:
Technician0-0J 0 /
-Z-Z'
Date of maintenance i
i
Company ,j (R 5 S C
Signature Date ?—Z,—
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
OSC251429
Parcel ID 050 -572-50
Legal description PREUSS #4 BLK 8 LT 6
Site address 20608 LUCAS AVE
Expiration Date: 5/19/2026
Current property owner(s) NEWBEONE PLUS TRUST
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By: Original Certificate Date: 10/3/2025
Thi ertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
s tem(s) is
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
ur�
Certificate of On -Site Systems Approval Appistion
1. GENERAL INFORMATION 2025
Parcel I.D. 05057250000
Complete legal description PREUSS #4 BLK 8 LT 6
Location (site address) 20608 LUCAS AVE
Current property owner(s) WEAVER PAMELA
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone 242-5276
3. TYPE OF WATER SUPPLY: E] Private Well serving # dwelling units
El Other Non-public well as regulated by MOA R Water Storage
X Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: [_N1 Private Septic EJ Private Septic serving 2 dwelling units
F] Holding Tank R Community Septic or Public Sewer
5. SEPTIC TANK: F] Steel n Plastic nN Concrete n Fiberglass
Age 51 _ See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: E] AWWTS n Bed no Deep Trench E] Wide Trench n Seepage Pit
Waiver request for:
Expedited review requested: r-1
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 Waiver Fee $
Date of Payment
COSA # 0
Date of Payment
Waiver #
COSA Applicabon—Apr2025.doc
COSA Checklist
Legal Description: PREUSS #4 BLK 8 LT 6 Parcel ID: 05057250000
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 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.
Comments
B. TANK DATA
Measured operating fluid level in septic tank 45
Date of pumping 5/19/25
❑■ Required maintenance completed, if AWWTS
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) 9/8/2000
❑■ ALL standpipes present per record drawing
Total measured depth from grade 6 ft (max)
Measured depth to pipe invert from grade 4 ft (min)
❑ N/A — pressurized field.
❑■ Per record drawings, field is insulated.
❑■ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies:
COSA Checklist_May2025.docx
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes elk**
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date
C. LIFT STATION
❑■ Required maintenance completed
Age of lift station 25 years
Lift station material Plastic
Comments:
Adequacy test date 8/19/25
Results ❑✓ Pass
Fluid depth prior to test 0 in
Water added 600 gal
New fluid depth 0 in
Elapsed time 10 min
Final fluid depth 0 in
Absorption rate 600 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings)
Effective depth used 0 in
Effective depth remaining 24 in
24 in
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' FYes if No ft
Sewer Manhole/Cleanout > 100'
n Yes if No ft
Sewer Service/Septic Line > 25'� Yes if No ft
Holding Tank > 100' EJ Yes if No ft
Animal Containment > 50' M Yes if No ft
Manure/Animal Excreta Storage > 100'
n 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' n Yes if No ft Surface Water > 100' H Yes If No ft
Field to Foundation > 10' R1 Yes if No ft. Wells on Adjacent Lots:
Tank to Property Line > 5' � Yes if No ft Wells > 100' M Yes if No
Field to Property Line> 10' � if No 9 ft Community Wells > 200' rV-J Yes if No
Water Main/Service Line > 10' Yes if No ft If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
ft
ft
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my sea[ 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 NorthRim Eng.
Enizincer's Thinted Marne Steve Eng
COSA Checklist—May2025.dom
Phone 694-7028
Date 9/17/25
Municipality
®®
r.
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 ivisi
On -Site Nater and Wastewater Program
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV251042 COSA#:OSC251429 Permit#:
PID#: 050-572-50
Legal Description: Preuss #4 Block 8 Lot 6
Engineer: Alaska Rim
Your request for a waiver of the required 10 feet horizontal separation from the disposal field to
the property line has been approved. The approved separation distance is 9.0 feet.
This waiver approval applies to the existing disposal 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: Approved by -
Name of Reviewer
**** VARIAN C E/WAIVER REVIEW ****
Waiver Request
Steve Eng, PE, PH
(907) 694-7028
SteveEngPE@gmail.com
SteveEng.com
Subject: PREUSS #4 BLK 8 LT 6, 20608 Lucas Ave, Eagle River Date: 10/1/25
Lot Line Waiver Request
To: Ben Cogger, MOA On-Site
Subject property is a 4 bedroom single family home, on public water. A septic system w/lift
station serves the residence. The septic system absorption field was constructed in 2000. The
septic system recently passed a COSA inspection. A new survey was conducted during the
COSA inspection. The survey drawing depicted the absorption trench to be under 10-feet,
violating municipal code. The measured distance from the center of the cleanout to the north
property line is 10.0878 feet; thus the absorption field is likely 9-feet from the north property
boundary. The absorption field is functioning very well, and was completely dry during a recent
test. This is a quiet residential street and there have been no problems with the current
configuration. The water line is located on the other side of the lot, as recently reported by
AWWU with the connect card. Please waiver the current location of the absorption field, which
appears to be 9-feet from the north property boundary.
LEGEND
FOUND 1/2" OR 5/8" REBAR, NO CAP
EDGE OF GRAVEL DRIVEWAY
DECK
CONCRETE
FENCE
RECORD DATA PER PLAT #72-6
SEPTIC PIPE
SEPTIC TANK LID
FOUND 5/8" REBAR, BLUE PLASTIC CAP
'HANSON LS1525'
19.0'
3.9'9.4'3.9'
37.7'
24.0'
66.2'
24.2'
ROOF
OVERHANG
RESIDENCE
ELEC.
GAS
TIMBERLINE SURVEYING AND MAPPING
17035 BARONOFF AVE
EAGLE RIVER, AK 99577
907-242-5320
ryan@timberlinealaska.com
FILE NO.: 25.211
SCALE: 1" = 20 FEET
DATE: 9/18/2025
SHEET: 1 of 1
MOA GRID: NW0056
SCALE: 1" = 20 FEET(11"x17")
20'0' 40'
AS-BUILT OF:
ADDRESS: 20608 LUCAS AVE, EAGLE RIVER, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
LOT 6, BLOCK 8PREUSS SUBDIVISIONUNIT NO. 4, PLAT #72-6
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 050-572-50
Complete legal description · Preusg Block 8, Lot 6
Location (site address or. directi°f~s) 20608 Lucas Avenue; Eagle River, AK 99577
Current Property owner(s): Kelly & Barbara Sullivan Day phone
Mailing address 20608 Lucas Avenue, Eagle River, AK 99577..:..
' Day phone
Lending agency
Expiration Date:
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up.by:
NUMBER OF BEDROOMS: 4
3. TYPEOFWATER SUPPLY:
Individual Well
Individual Water Storage
Community Class ___
Public Water System
Well
[]
[]
[]
[]
TYPE OF WASTEWATER DISPOSAL:'
Individual .On-site
Individual Holding
Community On-site
Public Sewer --
The Municipality of Anchorage Department of Health and Human Services (DHHS) ssues Certificates of Health
Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional
civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) on propedies served by a single family on-site wastewater disposal and/or water
supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
.new water sample .results less than 30 days old. Certificates are.valid for one year for properties served by Class A
or B well~ Or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
(Rev. 11/99)
5. ,STATEMENT OF INSPECTION BY ENGINEER
As certified by my sea[ affixed hereto and as of the validation dare'shown below, I verify that my investigation
based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval
application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm KNr~ F:n0in¢~,ring
Address _2~1441 Pf~rrni0an Rlvrl ~=ngl¢. IRiv~r,
Engineer's Printed Name I(~nn~fh M ~ufCH~
~,14' _q _q .fi 7 7
Phone fi-qfi-fit t t
Date f).q/R fl/20 rIB
DHHS SIGNATURE
Approved for ~
h
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Expiration Date: / 0 ~ .;'"'"'"'"'""~' ~, ~ ~) ~/
(Rev. 11/~9)
Maintenance Agreements
Supplemental Engineer's Repor[
Other
Original Certificate Date:
Reissue Date:
Municipality of Anchorage I~r: ~ [~
Department of Health and Human SerVldes~ E ~ V E
Division of Environmental Services
On-Site Services Section 825"L" Street Room 502 OCT 0 2 ?00(]
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak:us
(907) 343-4744 MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Pre-n-~ Block 8, Lot 6
Parcel I.D.: 050-572-50
A. WELL DATA
Well type PUBLIC
Date completed __
Total depth
ft
Date of test
Static water level
Well production
~D~of sampla:
IfA, B, or C provide PWSID #__ Well Log __
Sanitary seal Wires pro~__
Cased to __ _ff Casing ~e ground)
FROM WELL LOG ~N~PECTION
Nitrate mg/I Other bacteria colonies/100 mi
Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Concrete
Date installed 06/10/1974 Tank size '1250 gal Number of Compartments 1_
Cleanouts ¥ Foundation cleanout_Y Depression over tank n High water alarm na
Date of pumping 9/8/2000 Pumper JR'S
C. ABSORPTION FIELD DATA
Date installed ~0 Soil rating (g.p.d./ft2 or ff2/bdrm) 1.~2 System type Trench
Length 75 ft Width 5 ff Gravel below pipe 2 ft
Total depth 4-~5 ft . Effective absorption area 500+ ft2 Monitoring tube y Depression over field n~
Date of adequacy test Results (Pass/Fail) ... ~
Fluid depth in absorption field before.... N.ew depth --i~.
· enation treatment (past 12 mo.) (YIN & type) n If yes, give date
Rev. 11/99)
D. LIFT STATION
Date installed ~q/8/20nn Size in gallons .~nn
"Pump on" level at44 in"Pump off" level at 42 in
Datum Trip nf ~n,,iA, r Cycles tested 3
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Se~ Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation --10'
Water main 10'+
Drainage 100'+
Property line 10%
Water Service line 10'+
Curtain drain ,Ina,+
F, COMMENTS
Property line 10'+
Water service line ~)'+
Wells on adjacent lots tnB'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 10'
Surface water '~on'+
Wells on adjacent lots tnn,+
Manhole/Access Y_
High water alarm level at 48 in
Meets alarm & circuit requirements?
Absorption field 10'+
Surface water t00'+
Water main -10'+
Driveway, parking/vehicle storage 2A' __
MntP. rinl nnnRiRfRn nln%n whnlR frRnnh
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 HAA guidelines in effect on this date.
Engineer's Printed Name I(~nn~th
Date N~/~NI~NNN
HAA Fee $ ~'~_ (-~,
Date of Payment
Receipt Number
(Rev. 11/99)
Waiver Fee $
Date of Payment
Receipt Number
l. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Add~ess:
3. Legal Description:
4. Location:
!EATER ANCHORAGE AREA BOROUGH
~p'artment of Environmental Oualit?
3330 "C" Street, Anchorage, Alaska 99503 27a~g61
Date Received 9/24/74
Time of Inspection
Date of Inspection_ 2/24/74
REQUEST FOR APPROVA£ OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conventional
Totem Realty
516 E. Fireweed Lane
Frank Romaine
Phone:
Phone:
272-0571
Lot 6, Block 8, Preuss Subdivision
Eagle River Road
5. Type Of facility to be in§pected
6. Welt Data:
A. Type Drilled
C. Construction Standard
7. Sewage Disposal System:
1974 B.
I. Size 1250 gal
1. Absorption Area
A. fnstalled
C, Septic Tank:
D. Seepage Pit:
Single
No.'of bedrooms 4
B. Depth 390'
D. Bacterial Analysis Satisfactory
Installer Hamilton
2. Manufacturer Hamilton
14xl5xll' 2. Material Concrete Rings
E. Disposal Field: Total length of lines
Distances:
A. Nell to: Septic tank 120' , Absorption area
Nearest lot line , Other contamination
B. Foundation to septic tank 8'
C. Absorption area to nearest lot line
, Sewer Lines
, Absorption area
14'
!9'
· " i g-' , two pages
F.Q. -034. !/7~.I Pa e ~ of ,
Page 2 of two pages - Req~-est for Approval of Individual ~..~,~er & Water Facilities
Legal Description
Lot 6~ Block 8, Preuss Sub.
Comments
Approv~b/ ~ /~ Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
10/3/74
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
E0-034 (1/74)