HomeMy WebLinkAboutT15N R1W SEC 7 LT 35T15N, R1W,
5¢ction 7
Lot 35
#051-161-07
Municipality of Anchorage Peg. 1 of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW000184 PID Number: 051--161--07
Narne:MiKE THOMAS Wastewater System: · New [] Upgrade
Address:
P.O. BOX 770110 EAGLE RIVER, AK 99577 ABSORPTION FIELD
No, of Bedrooms:
Ph°ne:(907'~ 694--2202 [] Beep Trench [] Shallow Trench · Bed [] Mound mOther
LEGAL DESCRIPTION 0.7 oPe/sq. ~1 2.0 - .3.5
Township: 15N 1W 7 0.0 - 0.50 ~,
WELL: · New [] Upgrade 15 Ft 3
PRIVATE 163 Ft. 121 PL 645 S~. ~ ASTM D-5034/F-810
BAILEY'S BACKHOE 8/12/2000
ALPINE DRILLING 7/19/00 45 ~
SEPARATION DISTANCES ·Septic E] Holding n S.T.E.P.
To Septic AbsorpUon Uft Holding Publlc/Prlvote
Tank Sawer Un°. ANCHORAGE TANK 1000
From Tank Field Stotlon
Well 100'+ 100'+ -- -- 25% STEEL 2
SuCac~ 100'+ 100'+ - - - LIFT STATION
Water
Lot 5'+ 10'+ - -I
Line ~, ~'
FoundeUon 5'+ 10'+ - -
NONE KNOWN
Drain I I
Remor~: BENCH MARK
BOT[OM OF SIDING AT POINT "B"
100.00
~ ~F/A~'~%
'
Inspections performed by:. AWWC, INC. Dates: 1st 8/12/2000 ¢~ "':""~/,'/~:~# .... 1"":""~
2nd 8/12/2000 ¢~1 ~'~ ¥/~ I
Department of Health and Human Services approval ~ ~. -.... ~ _.... ,,,~-:~
Reviewed and approved b ~- L-z-,/- ~ Date:/O' / 0- O o ~of.,~.~o~O~
PERM, NU.BER: AS--BUILT DRAWING POm?L'?6~"--~fR~
SWO00184
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CO1 42.9 ¢2.2 .- ~ .... ~ Z~ .~ ,
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co~ ~.~ ~.~ / / ~ I
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I / FS~m, LOCAqON W~ ~P ~
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~ 0~5~2000~ 0~ ~' ~%
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~f'e ~ .~ssi
vOh%.'~, C P7953 .."~
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A B
ST1 48.7 23.9
ST2 54.7 30.3
DBL1 59.7 35.4
DBL2 60.3 .36.2
MT1 64.5 43.1
MT2 71.6 52,4
MT3 43.4 41.6
MT4 53.0 51,1
C01 42.9 4-2.2
C02 48.7 47.3
C03 53.6 52.1
C.J,G.
ALASI(A WATER & WASTEWATER sc^LE:
.................. CONSULTANTS, INC, ~: ........
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
MIKE THOMAS (907) 694-2202 2 OF
LEGAL DESCRIPTION:
LOT 55; SECTION 7, T15N, R1W,
~YPE OF WORK:
AS-BUILT DRAWING OF NEW SEPTIC SYSTEM
swooo,84 AS-BUILT DRAWING .^RoEL,D NUMBER:
PERMIT NUMBER; 051 -- 161 --07
INSLI.A~ION -~ ~, / 5f2
~ J~gffOM OP [~[2 LIJ~5 ~6,27 (AV~,)
~.77 (AV~,)
)ATE:
,o/~/~ooo
~S~ WATER & WASTEWATER C.J.O.
CONSULTANTS, INC.~ SOA~: '~/ ~ ~ '~'
~901 DEBAR RO~, SUITE 2B ' ~CHO~GE, ~ ~50~" PHONE (907)~7-6J7~ ' F~ (~07)~8~6 N.T.S .... . ~, ~ ...........
~ ~o~: ..o.~ .~.~.: ~,~ ~.~: ~ ~ ~.f ........... : ....
~K~ THOMAS (,0~) ~-~0~ ~ Or ~ ~ j. ~. ~,~.. ,
LOT 35; SECTION 7, T15N, RlW,
~PE OF WORK:
PROFILE DRAWING Of SEPTIC SYSTEM UPGRADE
Depa.ment of He 2aslt [h, sat nedetHuman Services
P,O. Box 196650 Anchorage, Alaska 99519-6650
Rick Mystrom h~tp:/Ne~w,~i.anchorage.ak,us
Mayor
Permit Number: #SW 000184 Date of issue: 6-22-00 Parcel Identification Number: 051-161-07
Dale Started: 7-18-00 Date Completed: 7-19-00 ls well Incatcd ~[ approved permit location? [] Yes [] Nn
Legal I)e~cription; T15N R1 W SEC 7 Lot 35
Prol)e~y Owner Name & Address: Mike Thomas
PO Box 770110
Eagle River, Ak 99577
Borehole Data: Depth (ft)
Soil 'I'ypc, Thickness & Water Strata From To
stick-up 0 2
Gravelly silt 2 22
silt 22 97
silty gravel 97 111
silty gravelly sand & H20 11 113
sandstone w/gravel lenses 113 163
Method of Drilling [] air rotary [] cable tool
Casing type: steel
Wall Thickncss: .025 inches
Diameter: _6 h~ches Depth: 121 feet
Liner Type:
Diameter: __ h~chcs Depth: .__
Casing stickup above ground: _2 lbet
fcct
Static water level (from ground level): 45 feet
Pumping level: 163.feet alter
_2 hours pmnping 10 gpm
Recovery Rate: 70 gpm
Method of Testing: air li~
Well Intake Opening Type:
[] Open End [] Open I Iole
[] Screened Slart ~ feet
[] Perforations Start__ f~t
Stopped __ feet
Stopped ~ feet
Grout Type: Bentonite II 8 Volume: [_~g
Depth: Slart_0 IL'ct Stopped + feet
Pump: Intake Depth __ feet
Pump size __ hp Brand Name __
Well Disinfected Upon Completion? [] Yes [] No
Method ofDisinfcctinn: Clodne T~blets
Comments:
Well Driller:
Alpine Drilling & Enterprises
P 0 Box 110496
Anchorage AK 99511
At~ention: The well driller shall provide a well log to the properly owner within 30 days of completion and the property
gO'd ~0Z§-969 'ONI '03 SVNOMI 3H~ ~:tO O0-9z-dos
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PLOT PLAN ASBUILT %. SCALE I" · ~o'
MICHLIG SUBD.
GRID NtV 1~55 Prolect No. Cx:)-o77
laska 99515
Long & Aasoclafes, IRC.(907)11500522-6476Daryl AvenUe,PhoneAnOhoroge, Alaska 99515
Reglsfered Land Surveyors (907) 522-4625 Fox
16515 CENTERFIELD DRIVE, SUITE 201
EAGLE RIVER, ALASKA 99577
(907} 696-2828 FAX: (907) 696-2845
October 9, 2000
The Thomas Company
Mike and Ron Thomas
P.O. Box 770110
Eagle River, Alaska 99577
Ref: T15N, RIW, SEC 7, LT 35, Parcel number 051-1g 1-08
Dear Tl~e Thomas Company:
Ekluma, Inc. has been made aware of the well located on lot 35 is in the easement located by Eklutna,
Inc. Eklutna at this time has no objection to this encroachment.
If you have any questions regarding this, please feel free to give me a call.
ager
Eklutna, Inc
Sent By: Alaska Water and Wastewater Con; 907 338 3246; Oct-9-O0 14:26; Page 5/6
qa nt of Health and Human Services
J 8125 'L" ~treel
. JP.O. Box 19~650 Anchorage, Alaska e9519.6§50
RlckMMaYy~otrr°m ~
Permit Number: ~W 000184 ~ate ut l~uc: 6-22.00 ~1 Idcnti~ea0on Number: 051-~61-07
Date S~: 7-18-00 Dale C mpleted: 7-1g-00 Is wc~] Iocat~ ~H approved permit Iocadnn? ~ y~ ~ Nn
Legal I)~cription: Tf 5N R? W SEC 7 Lot 35
Pml)e~ Owner Na~ & Addr~ Mike Thomas
PO Box 770110
Eagle RiveE Ak ~957~
Depth (R) Method of Drilling ~ air ro~ ~ cable tool
]:r0~ To
[ Borehole Data:
Soil 'l'ypc, Thickness & Wat~ Sfrato
stick-up
Gravelly a/ll
silt
silty gravel
silly gravelly sand & H20
sandstone w/gravel lenses
Attention: The well driller shall pro
0 2
2 22
22 97
97 111
11 113
113 163
Casing type: steel
Wall Thickness:. 025 inches
Diameter: _6 h~ches Depth: 121 feet
Liner Type: __
Dimneter: __ htches Depth: __. feet
(;using stickup above ground: _2 Ii, et
Static water level (from ground level): 46 feet
Pumping level: lt[3 l~et at[er
_2 hours pmnping 10 gpm
Recovery ]late: 10 gpm
Method of Testing: airl~
Well Intake Opening Type:
[] Opctl End [] Open I lolu
[] Screened Slart ~ fo, ut Stopped
[] I'erforal~ons Start__ IL-et Stopped ,.
Grout Type. Bentonite II 8 Volume: [_.~g
.Depth: Start 12 ibct Stopped_+ feel
Pump: Intake Depth feet
Pump sJ~c __ hp Brand Name __
Well Disinfected Upun Completion? [] Yes [] No
Method of Disinfection: Clodne Tab/ets
Commenis:
Well Driller:
Alpine Ddlfing & Enterprises
P 0 Box 110496
Anchorage AK 99511
id~ a well log tn the proper~y owacr within 30 days of completion and thc properly
'~NI '00 $'~fldOHA. 3Hi VS~,:LO O0-gz-deS
FBy: Alaska Water & WastewateP Consu; 907 338 3246; dun*9-o0 9:o1; wage o/~o
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~ : : ~ CONSULTANT~, INC.
MIKE THOMAS W/ TH THOMAS CO. (907) 694-2202
LOT 35; SECTION 7, T15N, RlW ....
/ Lof 24
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Lof 35
~,~ I Acres
SEPTIC
LOt
I
36
N 89°§8'00"W 384.81' -- __
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/ Lot I, MICHLIG SUBD,
I" - 50' GRID NW
PLOT PLAN ASBUILT Y. SCALE
' OC 11500 Daryl Avenue, Anohorage, Alaska
Lang& Ass Isles, inc. ,.....,
· tuu/J .o~z.-o,~./~o ~none
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/ Lot I, MICHLIG SUBD,
ProJeof No.. oo-o77 ,,
99515
I ~,o6' I
I o, I **.oo,
PLOT PLAN.,.... ASBUILT Y-,. SCALE I" - oo' GRID NW 1255, Project No. 00-077
Lan,', &: Associates, Inc. 115o. o Dali Avenue, Anohorage, Alaska 99515
· ~ (9071 52.2 6476 Phone
Regis~fered Land Surveyors (907)522-4625 Fax
GOVERNUEI~T L of $5, SECTION 7, T15N0'RtW, SIr~ARD U£RIDI.AN, ALA.~K.A. ,~'~/,~..."~ .,-,.
Anohorage,Reeordln Dlslrlat, Masks. and that the Improvemenm elluated . ,~.G'~_:;' ~-9.T~{ ~li~ :'~
theraonarewlthln tgo property Ilnee and do nor enoro~oh onfo the properr/ .9..".,~...:.~ ................ ~..'.,
adJaaent thereto, that no Impmvemonfe on the property lying adJaoenf thereto
enaroaah on Ihe .u~eyed premlsee and that there ara no roadways, franemlestan
,n. o. oth.. ~,.,h,....m.n~ o..o,d ,rep.* ..p' a. ,n,.t., h..o..
It Ii the I'~s onllblll of the awner fo determine the exl~fenoe af any ~ ~_ ~'n~ ....... '~:)~
easemente. Peavenalnl~. ar restrlatlons which do n~t appear on the reaorded
eubdlvlslon plat.
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 / WATER SUPPLY PERMIT
Initial
Date Issued: Jun 22, 2000
Expiration Date: Jun 22, 2001
Permit Number: SW000184
Legal Description: T15N R1W SEC 7 LT 35
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Mike Thomas
Owner Address: PO Box 770110 Total Bedrooms: 3
Eagle River, AK 99577-
Parcel ID: 051-161-07
Site Address:
Lot Size: 96268 SQ. FT.
Permit Bedrooms: 3
This permit is for the construction of:
~] Disposal Field [~ 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.
Received By:
Issued By:
Date:
ALASIG WATER & WASTEWATER
June 8, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Well and Septic Design for Lot 35; T15N, RlW, SECTION 7.
To whom it may concern:
The proposed 3 bedroom house *vill be served by a private well and septic system. Test holes
were excavated on the property. The proposed septic system will be designed around the 30 foot
radii of test hole #1 and #3. We are proposing that a 1000 gallon septic tank and a bed type
drainfield be installed. Comments regarding the proposed design are summarized as follows:
1. SOILS: Attached are logs which shows the soil classifications, groundwater monitoring, and
the percolation test results. In TH#1 and TH#2, the soils below the organic layers are a SP to
GP/SP material to a depth of 10.0 feet in TH#1 and to a depth of 7.0 feet in TH#2 (bottom of test
hole). At 10 feet in TH#l, a clay layer was encountered to 11 feet (bottom test hole). In TH#3,
the soils below the organics transitions from SP to SM material from 0.5 feet to 9 feet and tb~n
continues as SM material to depth of 11 feet (bottom of test hole). Groundwater was encountered
at 9.0 feet in TH#1 & TH#3; and at 5.0 feet in TH#2 during the excavation of the test holes.
Seven days later, the monitoring tubes were checked and found groundwater to be a 7.5 feet in
TH#l, at 4.5 feet in TH#2, and at 8.5 feet in TH#3. A percolation test for TH#1 was performed
between the depth of 2.5 feet to 3.0 feet which had a percolation rate of <1 minute/inch. TH#2
was visually rated to be the same as TH#1 A percolation test for TH#3 was performed between
the depth of 3.0 feet to 3.5 feet which had a percolation rate of <1 minute/inch. It is our opinion
that the insitu sandy soils should act as a sand filter and that a application rate of 0.7
gallons/day/fi2 should be used.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 0.7 gallons/day/fi2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimmn Absorption Area: 645 fi2
6901 Debtor' Road, Suite 2B N Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246
f. Total Depth: 3.5 feet (maximum an oiut)
g. Effective Depth: 0.5 feet
h. Width: 15 feet
i. Reduction Factor: N/A
j. Minimum Length: 43 feet long
k. Effective absorption area = 645 ft2
3. SURFACE WATERS: There is a stream approximately 150 feet southeast of TH#1 and
TH#3. There are also some areas with ponding water within 100 feet of proposed septic system.
All such areas will be filled and graded to prevent any ponding within 100 feet of the proposed
septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing, the primary site is to be
placed at or near the base ora 3 to 5 percent slope running fi:om approximately south/southeast to
north/northwest. The area for the primary and alternate site is generally flat; in short, there are no
slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you ~ve any questions, please contact us at 337-6179. Thank you for your
assistance.
Jeffi:,
Presi
E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, three soils logs, and a 7 page
construction specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B - Anchorage, AK 99504 ~ Ph: (907)337-6179 - Fax: (907)338-3246
/ / / '~_
/ / / ·
// SERVED BYA PRNATE WE~ ~SEP~C ~ ~
/
/~ ........... ~ T15N, RlW, SEC 7
/ LOT 2
~/7/2ooo ~-
MIKE THOMAS W/ THE THOMAS CO. (907) 694-2202 1 OF 2
SITE P~N FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM
SOUTHEAST OF H~ # · , ¢' ~.
TO PR~E~ ~ PONDING WI~IN 100 ~ ; ~ ~.~ SEPTIC TANK
/
)ATE:
PREPPED FOR; PHONE NUMBER: PAGE NUMBER:
MIKE THOMAS W/ TH THOMAS CO. (907) 694-2202 2 OF 2
LOT 55; SECTION 7, T15N, RlW ~% ....... · .~
SITE P~N FOR PROPOSED WELL LOCATION AND SEPTIC SYSTEM
ALASKA WATER & WASTEWATER CONSULTANTS, INC.~/.~ oF'-.~' %~""---'"~ "'~
PHONE (907) 337-6179 * FAX (907) 358-3246 ,'~'
I SOIL LOG - PERCOLATION TEST] .¢.c~. ', lc. ~,~, ...-y~(~
LEGAL DESCRIPTION: T15N, RIW, SEC 7, LOT 35, ~ ..... . ..... ~ ..... ~'~ ........
--Il'
PERFORMED FOR: CARLSON CUSTOM HOMES ~.-~'~X~, tJ ,.: "':'-"~
t.....:,d
DATE PERFORMED: 4/25/00 ...,.
DEPTH ~i I TEST HOLE #1 I h~t2;''~ .........
ORGANICS
2--~' SOIL C~SSIFICATIONS /
3 BEDROOM WELL
~'~.~-~,~ GC OL
a~ -~'~ S~ ~ -PROPOSED
6- ~l ~ /
~** ~ . E~~/~ S~P~C
~ 3ROUNDWATER au[~ s~
~ 7.5'
9 --~ / /
10--~ c~Y
11---~ DATE ~EADING CUOCK NET TI~E WATER UEVEU NET DR0~
TI~E (~INUTES) ~ADING (INCHES)
B.O.H. ~
12-- --
13~
14~
15--
17~
19-- PERCOLATION RATE <1 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20--~ TEST RUN BETWEEN 2.5 FT. AND 3.0 FT.
COHHENTS:
PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS
WAS PER~.R~ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE:
DEPTH TO DATE
3ROUNDWATER
9' &/25/00
7.5' 5/1/00
6901 DE~ARR ROAD, SUIT 29 * ANCHORAGE, AKm 9950~
PHONE (907) 337-8179 * FAX (907) 338-3246
I SOIL LOG - PERCOLATION TEST I , :~/'~ '':'~
LEGAL DESCRIPTION: T15N, RlW, SEC 7, LOT 55,
2--:~' SOIL C~SSIFICATIONS / P.OPOSeO / / /P.OPOSED
'~' "'~'~ GP/SP GM
4-- ~?-~-:, GC OL
7-- ~%"~ DEPTH TO DATE
B.O.H. ~ROUNDWATER ALTER__ S~E
/
a- s' ~/2~/oo/
~.5' 5/2/00 ,/:5~
9- /'/ [S~T: PL~,~ /
r'= /
11- DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) REABING (INCHES)
12--
14--
15~
17--
18~
19~ PERCOLATION RATE (HIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 ~ ~ TEST RUN BETWEEN - FT. ANB - FT.
COHHENTS:
PERFORMEB BY A~SKA WATER · WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS
DATE:
DEPTH TO DATE
GROUNDWATER
5' 4125/00
4.5' 5/2/00
ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~-,-~-~"~'~-~'~'~x'*~0F'
PHONE (907) 537-6179 * FAX (907) 33B-5246
LEGAL DESCRIPTION: T15N, RIW, SEC 7, LOT 55, ~/.g..' .... "~.~ ..2/~.-.~
PERFORMED FOR: CARLSON CUSIO~ HOWLS ~ ....f~ ~J'~ A. ~arn*ss.' '"~
OAT[ PERFORM[O: 4/25/00 q0~'~./ &-7955 .."
~u~/_'.... ~ ....
~EP~ [~2: ORGANICS
fee~) ~
· ~*.o SOIL C~SSIFICATIONS
SC SEP~C
7 , DEPTH T0 DATE
, , GROUNDWATER &TER S~E
8 ~ I 9' 4/25/00 /
I 8.5' 5/2/00
9 / [SITE PLA,N
-- _ L ,,,: ,oo /
U~A*&T~ CLOCK NET TIME WATER LEVEL NET DROP
DATE
READING
1
1
TIME (MINUTES) READING (INCHES)
I B~.H.
12
13
~4
15
~7
18
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 TEST RUN BETWEEN 3.0 FT. AND 5.5 FT.
COMMENTS:
PERFORMED BY A~SKA WATER A WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS
WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DEPTH TO BATE
GROUNDWATER
9' 4/25/00
8.5' 5/2/oo
HEFILTH RI'4[:, EN',,,'IF:'.ONHEI",ITI:SlL ' 3TEC:TION
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THE.. F Id EL. E. EFTH I.=, '¥HE I',IINIf'IUH DEPTH L-IF GRF:I'¢EL E, E FHEEN THE OUTFFILL. ' .......
RN[) THE EOTTOH OF THE E'XCFI',,,'~IT:[ON ,::IN FEEiT::,.
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I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OFf, HEALTH AND ENVIRONMENTAL PROTECTION
825 L. St~'eet. Anchorage, A!aska 99501 264-4720
SOILS LOG -- PERCOLATION TEST
[~'~ SOILS LOG
· ~ PERCOLATION
TEST
PERFORMED FOR:.
LEGAL DESCRIPTION:
2
3
4
5
6-
7-
8
9
10
11
12
13
14-
15-
17-
19
20
SLOPE
WAS GROUND WATER JO) SL
~NCOUNTERED? pO
IF YES, AT WHAT
DEPTH?
SITE PLAN
iPERCO LA']'ION RATE (mlnu .'~,'inch )
I Grimes Net I Depth to Net
Reading Date 'Time Time Water Drop
PGR FARMED FM—
;..LEGAL.
OR; `�:t cS,SGc S��ya"Yl�h� DATE PERFLMED'--(LL
LEGAL DESCRIPTION: C�0- S S c-�S �C �'`1
'. SLOPE SITE PLA
I-MENNEN
IMEME
Gross ::::::k�e
Depth to Net
14! Reading Date
Time I Water Drop
DEPTH
�EET1
ve 1
I-MENNEN
IMEME
Gross ::::::k�e
Depth to Net
14! Reading Date
Time I Water Drop
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
Parcel I.D. 051-161-07
1. GENERAL INFORMATION
Complete legal description T15NN R1W SEC 7 L0T
Expiration Date:
Location (site address) 20040 LORI STREET, CHUGIAK, AK 99567
Current property owner(s) TONYA JAMES & MARY TAGABAN Day phone
Mailing address
Real estate agent
PO BOX 873137, WASILLA, AK 99687
2. TYPE OF DWELLING:
Z Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
Date:
COSA Fee $ 550 Waiver Fee $
Date of Payment L%` 2.q Z Z Date of Payment
Receipt Number (C( Z.Z 3 Receipt Number
COSA # 0S CZ1117 1 Waiver #
5. 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 for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 4/28/2022
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 ��
.r7 • • ' •������
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q: • • • • :1
for current or future occupants or guarantee that no unseen encroachments, deficiencies or / g•' '.9 ��
discrepancies exist can be given by First Water Consulting & FWCS / *' �49 7H
.......... •'* �/ .
s
6. DSD SIGNATURE .Curtis Huffman
• . /
+ �F• CE 128991 •���
System #1 Approved for J7 bedrooms 0is•• .• `�_�
System #2 Approved for bedrooms tliPROF SS NP,
Disapproved
Conditional approval for bedrooms, with the following stipulations:
j ON-SITE
WAER R
TER o�
pROGF:AM
J m
BY ��-� CSW � m Original Certificate Date: 5/1 209 �
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other S4.ez.1 +0, Jz
COSA Checklist
Legal Description: T15N R1W SEC 7 LOT 35 Parcel ID: 051-161-07
If more than 1 septic system on lot: COSA Checklist #
of
Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 7/19/2000
Total depth 163 ft
Cased to 121 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 4/28/2022
Static water level at beginning of test 23 ft.
Well production at time of test 4.2 gpm
Water storage tank volume NA 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 of Sample 4/28/2022
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) 22 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49”
Standpipes/foundation cleanout per record drawing
Date of pumping 4/28/22 BY AK QUALITY
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 8/12/2000
ALL standpipes present per record drawing
Total measured depth from grade 3.9 ft (max)
Measured depth to pipe invert from grade 2.9 ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective IR SHOWS 0.5’ ED
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date 4/28/22
Results Pass For 3 bedrooms
Fluid depth prior to test 0 in
Water added 450 gal
New depth 0 in
Elapsed time <5 min
Final fluid depth 0 in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies: CO/MT MEASUREMENTS AT GRADE. SHOTS SHOW 0.5’ ED. IR SHOWS INSULATION.
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
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
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Property Line > 5’ Yes if No
ft
Absorption Field > 5’ 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 septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10’ Yes if No
ft
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
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No
F. ENGINEER’S 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 COSA guidelines in effect on this date.
5/9/22
Septic Tank Advisory
Certificate of On -Site Systems Approval #OSC 221171
Subdivision: T15N R1W Sec? Lot 35
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for
this COSA % property is 22 years old. A leaking septic tank may be a source of contamination to
the aquifer. Typical replacement costs range from $10,000 to $15,000
This advisory must be attached to all copies of the subject Certificate of On -Site Systems
Approval.
This is an example of a 16 -year-old septic tank.
MaiUrig Address P O Box 196650 *,Anchorage, Alaska 99519 6650 * www muni org
ParcelI.D.#
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Sita Services Section
P.O. Box '196650 Anchorage, Alaska 99519-6650
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
051-161-07 HAA# fCCZ~ OO ~ /"~¢/"7
GENERAL INFORMATION
Complete legal description LOT 35, SECTION 7. T15N, Rl W,
Location (site address or directions) LORI STREET EAGLE RIVER. AK 99577
Property owner MIKE THOMAS
Mailing address P.O. BOX 770110
Lending agency
Mailing address.
Day phone~
EAGLE RIVER. AK 99577
Day phone
Agent
Address
Day phone.
Unless othemdse requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OFWATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attests
lng to the legality and status of system,
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding Tank
Community on-site
Public sewer
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
ins to the legafity and status of system,
72-025 (Rev. 1/91 ) Front MOA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $850.00 at,
or prior to, closing for the engineering services provided. J
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, t vedfy that my
investigation of 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 MuniCiPal and State codes, ordinances, and regulations in effect
on the date of this inspection. / ,~[
AN;;::sf F~:~i :EL,~BASRK,~R ~oA~ ~/~:/E!AoT:oR CRAOGNES, UALL~T.~.~.S,;gNS~~ Phone (907/)337-6179
Engineer's Sig natu re i~., ~'~//L¢~ ("~'-~¢ Date io/~
In conducting this evaluation, AWWO, '4' ~r~pted'~° pr°vide a thorough, conscientious engine;ring analysis of the
system in accordance with ADEC and I~OJ~ DHHS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water ~,'~ ,~,~ ~/~
usage of the family being served by the system. These conditions are outside the control of
CE-7955 .," .'
the evaluator of the system. Satisfactory test results do not guarantee future performance
of the system, nor do they guarantee that there are no hidden defects or encroachments.
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or pady is not authorized,
nor will it confer any legal right whatsoever.
6. DHHS SIGNATURE
/~'"/Approved for '~ bedrooms
Disapproved
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of
DHHS do not conduct inspections or analyze data before a cedificate is issued. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA #21 Computer Veto[on
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744
Health Authority Approval Checklist
Legal Description: LOT 55; SECTION 7, T15N, RIW, Parcel I.D.:
A. WELL DATA
Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number
Log present kY/N) YES Date completed 7/19/00
Total depth 163' Cased to 121'
051-161-07
Sanitary seal (Y/N) YES
N/A
Casing height (above ground). 24"+
Date of test
Stafic water level
Well production
FROM WELL LOG
7/19/00
45'
1 o' g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 Nitrate
Date of sample: 10/3/2000
B. SEPTIC/HOLDING TANK DATA
0.50 mq/L
Collected by:
Wires properly protected ky/N) YES
AT INSPECTION
Date installed 8/12/00 Tank size
Foundation cleanout ky/N)
Date of Pumping NEW
C. ABSORPTION FIELD DATA
Date installed 8/12/00
Length 43'
Effective absorption area
Date of adequacy test
Fluid depth in absorption field before test (in.);
Fluid depth - (ins) Minutes later:
Peroxide treatment (past 12 months) ky/N)
72-026 (Rev. 3/96)* Computer Version
YES Depression ky/N)
Pumper -
Other bacteda
A.W.W.C., INC.
1000 ' Number of Compartments 2 Cleanouts kY/N).
NO High water alarm ky/N) N/A
g.p.m.
gal. water added (in.): __
YES
*BELOW FINAL GRADES
Soil rating ~or ft2/bdrm) 0.7 System type BED
Width 15' Gravel thickness below pipe 0.85' Total depth *3.5-4.0'
645 SQ.FT. Monitoring Tube present (Y/N) YES Depression over field ky/N) NO
NEW Results (Pass/Fail) - For 3 Bedrooms
- Immediately after - -
- Absorption rate =
- If yes, give date -
D. LIFT STATION ~
Date installed size
Manhole/Access (Y/N) ~at* "Pump off' level at*
High wa~ *Datum
....~ested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
100'+
100'+
N/A
On adjacent lots 100'+
.On adiacent lots 100%
Public sewer manhole/cleanout
Sewer/septic service line
25'+
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+ Absorption field 5'+
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots. 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+
Water main/service line 10'+
Surface water 100'+
Curtain drain
I cerfify that I have Ide/tf~mi~l/th
of Munic/pal /ecor~s
Signature
Englnee~s Nm/~
Date.
,lONE KNOWN
Driveway, parking/vehicle storage area 10%
Wells on adjaCent lots i~0'+
field inspections and review
systems are in conformance
on this date.
JEFFREY A. GARNESS
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/g6)* Computer Version
Waiver Fee $
Date of Payment
Receipt Number