HomeMy WebLinkAboutSCIMITAR #1 BLK 2 LT 7Scimitar #1
Lot 7
Block 2
#0§'1-132-1§
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231078 PID Number: 051-132-15
Dwelling: ® Single Family (SF) ® with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
TAMARA L WILLARS
ABSORPTION FIELD - EXISTING
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
24324 WHAELY AVENUE, CHUGIAK
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
SCIMITAR #1 2 7
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
1250 Gal.
Surface Water
100'+
--
Material
HDPE
Number of compartments
2
Lot Line
10'+
--
NA
Foundation
101+
__
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks Tank insulated. 3BR HOUSE & 1 BR ADU.
New MT installed in existing trench.
Alarm location
Electrical installed by
Installer NORTHERN EXCAVATION
Tank to
PIPE MATERIAL House to tank 3034 dra nfield 3034
Drainfield CO/MT 3034
Inspector FWCS
BENCH MARK (Assumed elevation) 100 ft
Inspdection 15` 5/5/23 tl 5/8/23
Location and description
2
3'd 5/10/23 41h
BOTTOM OF WINDOW SILL
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
�
Conditional Approval: Date
��Q"�`.•''
. 4..- .....�. r
/.... ........'......
Curtis Huffman /
Septic System
A j� ved -
ppfM �S
�������s� sEt128099123
, Date �z3
•., •.• A -W,
�lF
kih, P%ROFES�V1O-'WA
Note: this approval does not include well permit requirements.
(Rev uo/uzr-its)
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PID:051-132-15 PERMIT:OSP231078
FIRST WATER CONSULTING
SCIMITAR #1 BLOCK 2, LOT 7
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: OSP231078
Work Type: SepticTank Upgrade
Tax Code Number: 05113215000
Site Legal Address: SCIMITAR #1 BLK 2 LT 7 G:1261
Site Mailing Address: 24324 WHALEY AVE, Chugiak
Owner: WILLARS TAMARA L
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
,-%,enr
ION
Department
5/2/2023
5/1/2024
54016
❑ 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:
• Verify if detached ADU has a foundation cleanout. If not, provide double cleanouts.
Received By: ( S 5v(c_z 7--0 r wL
Issued By:
Date:
Date:
4
MUNICIPALITY OF ANCHORAGE
Development Services Department
"
p p Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-132-15
Property owner(s) TAMARA L WILLARS Day phone _
Mailing address 15340 W GUNSIGHT DRIVE, SUN CITY WEST, AZ 85375
Site address 24324 WHALEY AVENUE, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) SCIMITAR #1 BLOCK 2, LOT 7
Legal description (Township, Range & Section)
Lot Size 54,016 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) 0
Septic Tank
0
Upgrade Q
(w/wo ADU)
(D) ElRenewal
Holding Tank
El
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.
(Signature -of property owner or authorized agent)
Permit/Rush Fees: 225 Waiver Fees:
Date of Payment:T �i�23 Date of Payment:
Receipt Number: G l 2 S Receipt Number:
Permit No. 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
!
!!
April 25, 2023
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT
LEGAL: SCIMITAR #1 BLOCK 2, LOT 7
The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic
tank on the above referenced lot. We propose to install a 1250-gallon HDPE tank per the
attached design to serve the existing 4-bedroom residence. 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. 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
OSP231078, Curtis Townsend, 05/02/23
FIRST WATER CONSULTING
SCIMITAR #1 BLOCK 2, LOT 7
DESIGN DETAILS:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231078, Curtis Townsend, 05/02/23
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- Municipality of Anchorage Page ? of ~'
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343~4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: .~UI/~P_P4.)O/O ':,~... PID Number: o ~/- ~
Wastewater System: ~ New ~Upgrade
Phone:~_~6~ JNo. oIBedroo% ~DeepTrench ~ Shallow Trench ~Bed ~Mound gOther
LEGAL DESCRIPTION so,,~,.g: J. ~ GPD/Sq. FI. TotaiDepth from originai grade:? Z
Township: ~ R~nge' I Section: Fill added above original grade: Gravel length:
~ Ft. 7~ Ft.
I
~ U pgrade~ Gravel ~: ~.~ ~ Et. Number/of lines:.10is~ance ~tweeno lines:Ft.
WELL:
New
Classdicalion (Private, A,B,C): Torsi Deplh: ~sed TO: Fl. Tolal absorption area: ~ SQ. Ft. ~ ~ Z~ ~¢ ~ ~/ ~7
Yield~G IPump Se[ at: ICasing Height Ab0ve GrOu"d: TANK
- PM Ft. Ft.
SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Publlc/Pdvate Manufaclurer: Capacily in gallons:
FFO~ Tank Field ate,ion Tank Sewer Lines ~f~ ~ I ~ ~0
Material: Number of Compartmenls:
s~,~ LIFT STROH
( ~ ~ / ~ "Pump on" level at: ~mp oil" level at: High water alarm
Foundation
Drain
¢¢~ ~ BENCH MARK
ENGINEER'S SEAL
Department of Health and Human Services approval e~. c~i~
Permit No. ~-~--c~a/a~... Page 1 of 1
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 34.9-4-744
On-Site Wastewoter Disposal System and/or Well Inspection Report
Legal Description: Lot7, Block2, Scimitar
PlO No.: --~ SP /~--15-
Scole 1"=60'
Whole), Ave. __
Nsg'00-00-W 210'
Swing Ties
A 8
C 40' 21
O 98' 99'
NO WELLS +100
NO SEPTICS +.30
/10%
82' ~
tOO'R ~'
UTILITY EASEMENT 10'
N89'OO-OO-W 210'
NO WELLS OR SEPTICS +100
§
/
/
~ - TEST HOLE
,, - MONITOR TUBE
o - SEWER CLEAN OUT
+ - WELL
-- -- - EASEMENT
6-21-00
ENGINEER'S SEAL
g~.." 49THru '%-7, ~,
% ~2'- -"'x~
~ cO'' ....... , ~
MUNICIPALITY OF ANCHORAGE
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: May 15, 2000
Expiration Date: May 15, 2001
Permit Number: SW000102
Legal Description: SCIMITAR#1 BLK 2 LT 7
Design Engineer: 0024 Eagle River Engineering Services
Owner Name: Gerald & Sharon Tieman
Owner Address: PO Box 670362
Chugiak, AK 99567-0000
Parcel ID: 051-132-15
Site Address: 024236 WHALEY AVE
Lot Size: 54016 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
~ Disposal Field I~ SepticTank [] 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.
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
May 10, 2000
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Lot 7 Block 2, Scimitar
Narrative & Permit Application
Dear Mr. Cross:
The proposed septic upgrade will have very limited impact on adjacent properties for the
following reasons:
1. The surrounding lots are lin'ge, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance, wells are in excess of
200'.
3. Reserve space is adequate, due to absorption capacity and size of lot.
4. Drainage will not be affected and is not a major consideration in our design.
THIS IS AN OWNER BUILDER INSTALLATION
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\1997\00-02Dq~
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5'195
ERES Project No.: 00-021
Calculated By: LB
Date: 5/'i 0/00
Legal: Scimitar Lot 7 BIk 2
Single Family 4 Bedroom Dwelling
TEST HOLE '1
Deep Trench Subsur[ace Wastewater Disposal Field
Water use at 150 gallons per bedroom = 600 gallons
Percolation rate = 1 minutes per inch
Wastewater application rate = 1.2 gallons per day per square foot
Required absorption area = 500 square feet
Trench width ON) = 3 feet
Gravel depth (D) = 4 feet
Required length = Required absorption area / 2 / D
Required length = 500 /
Required length = 63 feet
Total Excavation Depth = 10.0 feet
2
/ 4
00-021cal
10:03 AM5/iO/O0
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577~3294~ (907) 69'~-3297 fax
LEGAL:
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
Lot 7, Blk 2, Scimitar
May 12, 2000
A. GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. It is always recommended that a surveyor locate the nearest lot line position and the location of any
easements.
9. Any remaining open test hole excavations shall he filled.
B. SEPTIC TANK
1. Septic tank shall be 1250 gallon approved tank.
2. Existing septic tank and pit is to be abandoned by pumping, opening up, adding lime and backfilling
with clean earth material
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 10' at any point.
4. The sewer line is to replace the exist(ng server line that leads to the existing pit. The eff~uen~zline~c~
within the trench shall be laid level within 0'.03,.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed
over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any
Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 10' GRAVEL DEPTH = 4' under pipe, 2" over pipe
TRENCH LENGTH = 63' TRENCH WIDTH = 3'
SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 4
SEPTIC TANK =1250 gallon
Twenty-four (24) hours notice required for all inspections.
\1997\00-021spec. doc
NO WELLS OR SEPTICS
t N89'OO-OO-W 2 lO~m"~~
10%
,
NO WELLS +100 g 00' ~ o
NO SEPTICS +30 ~ ~ 10~ ~
/
I 5 /
[ ~
,, UTI~I~ EASEMENT 10'
NO WELLS OR SEPTICS +100
~ - TEST HOLE
· - MONITOR TUBE
o - SEWER CLaN OUT
~ - WELL
NO SURFACE WATER ~SEMENT
NO KNOWN CURTAIN DRAINS PROPOSED L~CH FIELD
~- EXISTING L~CH FIELD
LEGAL: LOT 7~ B2
OWNER: SCIMITAR
CONTRACTOR: OWNER
P.O. Box 778294
EAGLE RIVER, AK. 99577
(907) 694-5195 FAX: (907) 694-3297
LL
PERFORMED FOR:
LEGAL DESCRIPTION:
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
.~.~ f- ? /~,Z-K2. ~'¢ ~',,,.~ ',¢'.,~-Township, Range, Section:
SLOPE
SITE PLAN
4 - ~'" ~'.~ ~ '/'
5-
6
8-., ~ ~_~
10-
b 5 ~, DEPTH?IFYES'ATWHAT
~ [ ~ lO Water
13 - ~ ~ ~ Z Monitoring;'
pO
Gross Net Depth to Nat
Reading Date 3']me Time Water Drop
~' /;-z:z:z,P /;.~oc''' ~'~g'" g; '/
14-
15
16
17-
18-
19-
20-
PERCOLATION RATE (minutes/tach) PERC HOLE DIAMETER --
TEST RUN RETWEEN o/ . FT AND o~- ~ FT
PERFORMED BY: ~"~' ~'~' ~' i --"~ ~ CERTIFY THAT THiS TEST WAS PERFORMED IN
ACCOROANCE WLTH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE.
72-008 (Rev. 4~85;
oGRr 'ER ANCHORAGE AREA BOi IJGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ,'/: :. ' "' - :"~' MAILING ADDRESS ~ ::'. [
LOCATION '" ::'" ":-~" ; LEGAL DESCRIPTION
"',: PHONE
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER : · " MATERIAL
_ INSIDE WIDTH LIQUID DEPTH
NUMBER OF
~ : - t COMPARTMENTS
.LIQUID CAPACITY '- ; GALLONS,
SEEPAGE PIT:
NUMBER OF PITS ,: - DIAMETER
LINING MATERIAL ¢ ¢- [ CRIB SIZE:
OR WIDTH /:~ i L[;NGTH ' DEPTH ": '
DIAMETER ,:' DEPTH DISTANCE FROM:
TOTAL EFFECTIVE
WELL
SQ. FT.
BUILDING FOUNDATION -~' NEAREST LOT LINE ': ":' ABSORPTION AREA (WALL AREA)
WELL:
TYPE /" "' : CONSTRUCTION <:x¢-'/ ¢ ~- ; ,~'~¢" "-:-DEPTH
BUILDING NEAREST NEAREST SEPTIC
FOUNDATION LOT LINE_ SEWER LINE TANK.
CESSPOOL
APPROVED
OTHER SOURCES_
DISTANCE FROM:
SEEPAGE
SYSTEM
DISAPPROVED
DISTANCES:
INSTALLED BY:
PIPE MATERIAl -
LOT SLOPE:
REMARKS:
Form No. EQ-031
DIAGRAM OF SYSTEM
-I
DATE
APPROVED
G.A.A.B,
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-456 I
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION LOCATION
. . ~EEPAGE PI~.~ .£ -¢ , ,. DRAIN FI.E~D % ~ , OTHER
SOIL TEST RESULTS NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION bY THE
DEPARTMENT OF ENViR.?~MENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
/
MINIMUM DISTANCES. REOUIR£M~NT~S/
FOUNDATION TO SEPTIC TANK
SEPTIC TANK TO SEEPAGE PIT WALL //'~)'
DRAIN FIELD
SEPTIC TANK SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TAN K
DRAIN FIELD
DRAIN FIELD
,,
WATER MAIN TO SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD
/./.~
. SEEPAGE PiT --. ,. '(, , DRAIN FIELD
TO RIVEr, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND iNTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
/ , 0 R
%y LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER AN~zH/ORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ¢~//~ __ ¢ ~// r
O~E
Russe# Oyster
694-2774
Soils 8- Foundations
GEOTECHNICAL 8- DEVELOPMENT
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
CO.
Earl Ellis
688-2280
Land Development
SOIL LOG
Perfomed for:
Legal Descrtption:.,,Z~z- ~,
D_ge~_h.__(feet)
~:'-/t~ VV~
0
6
So!I Charac_t.e_ri~
WEst
11
Ground Water Encountered: Yes No ~ If yes, what depth~
Proposed Installation: Seepage Pit Drain Fie~d~
~ 7
F' 0 Ii.:.':0::.:: ::I..'.D7 E. Fi:.
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OF' TI'"IfE HELl.... COh'IPI...IET]:Oi"4.
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[I MICIPALITY OF ANCHC? ,C2VIJ. ifirb
9�1 WJNMOTALEALTH PROTLL I: N �rrtU t
• by
APR 1 .l 151 A & L DRILLING COMPANY
RL C E 7__D BOX 97, EAGLE RIVER, ALASKA 99577 a TELEPHONE 694-2588
OWNER OF LAND-�b2iILQ T lz,,nAu DEPTH OF WELL
ADDRESS Cts✓G-, Ne gl,�67 STATIC LEVEL OF WATER FT
LEGAL DESCRIPTION / 7 /3 4k � SCI✓YI IT44
DATE, - Started4/—'77 Ended 3124
PERMIT NUMBER
KIND OF FORMATION:
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MISCL. INFORMATION:
i 3 Tar•f-
DRILLER'S NAME
· NIUNICIPALITY OF ANCliORAGF.
:DEPARTMENT,~.., I-IEAL'FH AND ENVIRONMENTAL , ROTECTION '-
' 825'" L Streeg, Anchd~age, Alaska~' 99501
Date :Received: March 30, 1977
1st Inspection: Time ,,. //.'0_~ ~M
Date
Inspector __~/.
2nd Inspection: Time
Date
Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
l. Lending Institution Request: Alaska Statebank
Mailing Address: 310 East Northern Lights Blvd.
2. Property Owner: Gerald/Sharon Tieman
Mailing Address; Box 362 Chugiak 99567
o
Phone: 279-7637
Phone: 277-5571
694-9292(mrs'.)
Legal Description: Lot 7 Block 2 Scimitar Subdivision
Single Family Residence: (x)
Multiple ~ ' '
._ tamlly Residence: ( )
5. Well Data.: Type Individual
Construction
Number of Bedrooms:
Number of Bedrooms:
Depth-72'
Bacterial Analysis
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
Well Log Filed ( )
to Absorption Area
Distances: Well to Septic Tank
to Sewer Lines Nearest Lot Line
Absorption Area to Nearest Lot Line
On-site system (. Public Utility
Installed Installer
Manufacturer
Soils Rate Material
Pag~ Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 7 Block 2 Scimitar Subdivision
Comments:
Affadavit Attached
Disapproved:
Letter Attached: ( )
Date:
Date:
bepartment Worksheet:
1. Type of Inspection:
2. Property Owner:_
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWEF~ and WATER FACILITIES
CMRO VA
Gerald and Sharon Tieman
MUNICIPALITY OF ANCHORAG~
DEPT. OF HEALTH &
ENVIRONMENI'AL PROTECTION
U 1977
RECEIVED
FHA CONV /~
Mailing Address:_ Box 362 Chugiak Alaska
Name of Buyer: N/A Refinance
Day Phone:..277-5 ~71/694- 9292 ( her )
Mailing Address:.
Name of Lending Institution:
· Day Phone:.
Alaska St atebank
Mailing Address: 310 E. Northern Lights Anchphone: 279-7637
5. Name of Realtor or Agent:. N/A
Mailing Address:
Phone:
6. Legal Descrpton Lot 7 Blk 2 Scimitar S/D
Location: Whaley Ave Anchorage, Alaska
Type of Facility to be Inspected:.
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served _
If Individual, depth of well
Sewage Disposal System
Type of System:
Public Utility
If Individual, date of installation
Single Family
No. Bdrms. ~
.Individual
Individual (on-site)
72 003(3/76)
N
DTI001635
MUNICIPALITY OF ANCHORAGE
Ii4
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
�
Parcel I.D. 051-132-15 Expiration Date:
Legal description SCIMITAR #1 BLK 2 LT 7
Site address 24324 WHALEY AVE Chugiak AK
Current property owner(s) TAMARA WILLARS
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By
Original Certificate Date: 5/15/2023
This Certificate of On -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 Services 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 work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory X
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-132-15
Complete legal description SCIMITAR #1 BLOCK 2, LOT 7
Location (site address) 24324 WHALEY AVENUE, CHUGIAK, AK 99567
Current property owner(s) TAMARA WILLARS Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ® Private Well serving 2 dwelling units (1BRADU)
❑ 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 NEW - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ h� 5�/ Waiver Fee $
Date of Payment / /F'�Z� _ Date of Payment
COSA # V SG Z j'1 I Waiver #
COSA Application 2022.doc
COSA Checklist 2022.docx
COSA Checklist
Legal Description: SCIMITAR #1 BLOCK 2, LOT 7 Parcel ID: 051-132-15
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 3/31/1977 Total depth 200 ft
Cased to UKNOWN ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 4/20/2023
Static water level at beginning of test 92 ft.
Well production at time of test 1.4 gpm
Water storage tank volume 165 gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 7.98 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 4/20/2023
Comments Water storage seems to be for peak use. Sullivan installed new seal & conduit. Adjacent well on L8
had 5.83 nitrate level 20 years ago and seems to correspond with the recent nitrate results of this lot.
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping NEW TANK
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/26/2000
ALL standpipes present per record drawing
Total measured depth from grade 8.5 ft (max)
Measured depth to pipe invert from grade 4.7 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective. (ED)
If not, state depth into effective 4.1’ of 4.8’ ED
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 5/9/2023
Results Pass
Fluid depth prior to test 2 in
Water added 700 gal
New fluid depth 7 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 58 in (MOA 4.8’)
Effective depth used 9 in (Missing ED + Final Fluid Depth)
Effective depth remaining 49 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots &
appears approximately 0.7’ ED is missing.
COSA Checklist 2022.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’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
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
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 5/11/2023
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 &
5/11/23
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC231129
Subdivision: Scimitar #1, Block: 2, Lot: 7
A water sample revealed a nitrate concentration of 7.98 milligrams per liter (mg/L).
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.
"Mailing Address P D Box 196650 * Anchorage,'Alaska 99519 6650 *www muni org
G
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.
r MaU�ng Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www mum'org