HomeMy WebLinkAboutT13N R1E SEC 5 NE4 PTNMunicipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 1
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231236 PID Number: 05040201000
Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New N Upgrade
Name
JOHNSON
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
30535 EAGLE RIVER RD,
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
T13N R1 E SEC 5 NE4 PTN
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
-
_
_
+75
TANK K Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1000 Gal.
Surface Water
+100
—
_
_
Material
Number of compartments
Lot Line
+10
-
-
-
NA
POLY
2
Foundationx-10
_
LIFT STATION
Manufacturer
Capacity
Remarks WELL FOR PERMIT SW060297 WAS NOT ABLE TO
Gal.
N BE LOCATED. APPEARS TO NOT HAVE BEEN DRILLED.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank EXIST drainfieldTank to
EXIST
GUARANTEED SVCS
Drainfield EXIST CO/MT 3034
Inspector C.BALZARINI
BENCH MARK (Assumed elevation) 100 ft
Inspdection 'I5t $/7/23 8/8/23
Location and description
2nd
TOP OF SONOTUBE
3'd 4`"
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
�F A`gSil�
Conditional Approval: Date
r '��'•
P
,aero
,.. ... .��..rr
W11• . • •%
Septic Syste
CHARLES G BALZARINI
Approved Dat
�����`c�' CE -13854 ••���/�
*
N e: this approval does not include well permit require6nt
OFESSIONP��
7/30/2�3`0
trcev U01
CHARLES G BALZARINI
CE-13854R
E
G
I
S TEREDPROFE S S I O N A L E N GINEER
8/13/23
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: OSP231236
Work Type: SepticTank Upgrade
Tax Code Number: 05040201000
Site Legal Address: T13N R1 E SEC 5 NE4 PTN G:0803
Site Mailing Address: 30535 EAGLE RIVER RD, Eagle River
Owner: JOHNSON DOUGLAS
Design Engineer: C&M ENGINEERING SERVICES
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
rcLcnt S
0
0"
Depai-tment
8/2/2023
8/1/2024
❑ 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
Received By: l S.5
Date:
I
Issued By: I Date:
ZZ Z 3
3
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
,r
Parcel I.D. 05040201
Property owner(s) JOHNSON
Mailing address
Site address 30535 EAGLE RIVER RD
Legal description (Sub'd., Block & Lot) T1 3N R1 E SEC 5
Legal description (Township, Range & Section)
Lot Size 40,036 Sq. Ft. Number of Bedrooms 3
Day phone
NE4 PTN
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) El
Septic Tank
ElUpgrade
R.Duplex
(w/wo ADU)
(D) El
Tank
El
Renewal El
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
NONE
Distance: NA
certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
C&M ENGINEERING
(Signature of property owner or authorized agent)
Permit/Rush Fees: 3 6 c% Waiver Fees:
Date of Payment:
Receipt Number:
Permit No.
05S2 312 3 tr
Date of Payment:
Receipt Number:
Waiver No.
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C&M ENGINEERING SERVICES
Ph: 907-854-5558
Municipality of Anchorage
Onsite Water & Wastewater Program
4700 Elmore Rd Anchorage, Ak 99507
RE: Proposed Septic System for T13N R1E SEC 5 NE4 PTN
Dear Reviewer,
The above referenced property is currently served by an older septic system with a leaking tank that
needs to be replaced immediately. We are requesting an expedited review of this application.
Our review of available documentation and field investigation show that this project will not adversely
impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, or drainage flowing
onto and off of the subject property.
As shown on the plan, the tank will be greater than 10’ from the house foundation.
The tank will be of MOA approved construction.
The tank shall be covered with a minimum of 2” moa approved insulation and 3’ of cover or a minimum of
4’ of cover without insulation.
The repair must be performed by a moa certified installer in accordance with MOA requirements.
The lot is huge and repair of the proposed system will not negatively impact adjacent lots.
Upon completion of the installation, a record drawing will be submitted showing the location of the new
tank, leach field, well, and other applicable features.
Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854-
5558 or by email cgbalzarini@gmail.com with any questions or concerns.
Sincerely,
Charles Balzarini, PE
7/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231236, Curtis Townsend, 08/02/23
CHARLES G BALZARINI
CE-13854REGISTEREDPROFESSION A L E N GINEER
7/18/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231236, Curtis Townsend, 08/02/23
CHARLES G BALZARINI
CE-13854REGISTEREDPROFESSION A L E N GINEER
7/8/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231236, Curtis Townsend, 08/02/23
MA UM IPALITY OF ANCHORAGE
Development. Services Department a
p p r Phone: 90.7-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-402-01-000 Expiration Date: 11/30/2023 -
Legal description T1 3N R1 E SEC 5 NE4 PTN
Site address 30535 EAGLE RIVER RD Eagle River AK 99577
Current property owner(s) JOHNSON DOUGLAS G
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
BY Original Certificate Date: $/30/2023
'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
Tank Age Advisory Arsenic Advisory
Other
COSA ApprovaUune 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 05040201
Complete legal description
T13N R1 E SEC 5 NE4 PTN
Location (site address) 30535 EAGLE RIVER RD
Current property owner(s) JOHNSON
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone
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 0 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS 0 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 $ .550 /
Date of Payment
COSA#_ OSC2312q�-1
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
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.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
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)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade 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
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
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 Phone
Engineer’s Printed Name Date
C&M ENGINEERING
CHARLES BALZARINI, PE 8/11/23
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.
HAA# CO O ~ 5-'oz-'
Expiration Date:
t. GENERAL INFORMATION "~', -
.... ;:. legal
Complete ~: . .
NE4,NE4,NE4&E2,NW4,'NE4,NE4&E2,SE4,NE4,NE4&NW4,SE4,NE4,NE4 of Sec. 5, T13N,R1E,SM
Location (site addre§s Or directions) 30535 Eagle River Rd. Eagle River, AK 99577
Current Property oWr~er(s) Steve Dike : :. ~ Day phone 278-8878
' 12601 Athert°n Anchorage, AK 995'16
Mailing address ~
Lending agency ' Day phone
description
Mailing address
Real Estate Agent
Eva Loken Day phone
Mailing Address
Un/ess otherwise requested, HAA will be held by DHHS for
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual Well []
individual Water Storage []
Community Class Well []
Public Water System []
~ickup. HAA picked up by:
TYPE OF WASTEWATER DISPOSA'_L: '
Individual On-site ~ [] :!
Individual Holding tank ~]: []
Community On-site - []
Public Sewer ' []
The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues 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 properties served by a single family on-site wastewater disposal and/or water
supply system. DHHS also issues HAAs upon reguest 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. Cedificates are va[id for one year for propedies served by Class A
or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
prefessional engineer's work.
5. STATEMENT OF INSPECTION BY ENGINEER
As cedified by my seal affixed hereto and as of the validation date shown below, I verity 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 fudher verity 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 KNn Fn~in~rin~
Address ~n44,1 pfnrmi~nn Rlvd F:nol~ I~ivnr~ AK .q_qR77
Engineer's Printed Name 14'~nnc)fh M. r)~mff{m~
Phone R-qR-611'I
Date
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Expiration Date:
(Rev. 11/99)
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Reissue Date:
Municipality of Anchorage A~
Department of Health and Human SeR, i~:eC E ~ V E
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650 SJ~P ~. 8 2[}00
www.ci.anchorage.ak.us
(907) 343-4744 t~[/NI~IP^LITY OF ANCH0~GE
I~NVIRONMENTAL SERVICES DIVISION
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
sec5,T13N,RIE,SM
A. WELL DATA
Well type private IfA, B, or C provide PWSID #__
Date completed"6/5F2'0E0 ~l/~q{ Sanitary seal y
Total depth~:~) ft Cased to 60 ff
FROM WELL LOG
Date of test 9/2211991
Static water level 0 fi[
Well production 20 g.p.m
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi
Date of sample: 8/29/2000
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel
Date installed 10/10/1994 Tank size
Cleanouts ¥ Foundation cleanout y
Date of pumping 615/2000 Pumper JR's Pumpin~t
C. ABSORPTION FIELD DATA
/~'~ Soil rating (g.p.d./ft2 or ff2/bdrm) 6.3,
Date
installed
Length _61.3 fi[ Width ?5.9 fi[
N E4,NE4,NE4&E2,NW4,NE4,NE4&E2,SE4,NE4, NE4&NW4,SE4,NE4,NE40f
Parcel I.D.: 050-402-01
Well Log y
Wires properly protected y
Casing height (above ground) 38 in.
AT INSPECTION
6/5/2000
11
4.5 g.p.m
Nitrate 0.614 mg/I Other bacteria 0 colonies/100 mi
Collected by: KND Engineering
1000 gal Number of Compartments 2_
Depression over tank n High water alarm na
System type ~E:.~
Gravel below pipe 0,5 fi[
Total depth 1_ ff Effective absorption area 974.7 ft2 Monitoring tube y Depression over field n~
test 0~/O~,/&'O Results (Pass/Fail) pass For_3 bedrooms
Date
of
adequacy
Fluid depth in absorption field before test _0 in Water added450 gal, New depth2.25 in,
Elapsed Time: 1440 rain Final fluid depth 0 in Absorption rate >= ~/5"'~ ~g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) n If yes, give date
(Rev. ll/99)
D. LIFT STATION
"Pump on" level at in"Pum.p...Q~ in High water alarm level at in
Datum ~Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 11g'
Absorption field on lot '~?'+
Public sewer main na /,~/,h
Sewer/septic service line ~a ~- '~/~'
On adjacent lots
On adjacent lots /¢)b/¢-
Public sewer manhole/cleanout na
Holding tank ~a
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation _~!:4" Property mine tnn'+
Water main lpg' ~' Water service mine
Drainage. /~0' ~' Wells on adjacent lots
Absorption field.
/D
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line _41'
Water Service line 2,¢/'~
Curtain drain _aa
Building foundation ,~na'+
Surface water
Wells on adjacent lots
Surface water 100'+
Water main /~'~
Driveway, parking/vehicle storage
F. COMMENTS
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 ~'~nn,~fh I~I 13Hr~
Date ~ ~/? ~"/.~.~,o ~
HAA Fee $
Date of Payment
Receipt Number
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