HomeMy WebLinkAboutHAMANN ADDN #1 BLK 1 LT 7Homonn
Lot 7
Block 1
#050-611-27
~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 Page of
www.cLanchorage.ak.us (907) 3434744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: -~(,,J O OC,0OC~ ( PID Number: 0 $-0 - ~o I( - 7-7
,,me: ~OfgEf~V C/~/~,do~b Wastewater System: ,~ New [] Upgrade
^~'e~:?O COX 77qOqT. [..F~{~.IZ[~;(Z q¢577 ABSORPTION FIELD
Phone: Number of Bedrooms: "~ n Deep Tre~:~ ~Shallow Trench C] Bed C] MOUnd (~] OLher:
LEGAL DESCRIPTION so, ~n0: ~o~, ~p~ ~o~
FI.
Well: ~ New [] Upgrade ar~vel~¢h: ~ R. I .-- FL
Classiiicaucn (PHva[e, A, e. c): I Total Oep{h: Cased lo: Tolal abso~plJon area: Pipe Ma[eriah ~
?rtV/4~T~ '~O0 Ft. 7~0 n, ~' G -~- Ft~ P
SEPARATION DISTANCES ~'Septic [] ~olding I~ S.T.E.P. [] Offler:
TFrom"'~ Septic Absorption Lift Holding Public/PHvale Manufac~ure~ Caped[y:
Tank Field Sro§on Tank SewerUm /~,~E[/'O~,~fE_ T'/~-/-((¢,
Sure.wa,. IOO' ~' IOOUr / LIFT STATION
Lot Line ~0 (J/~ J~ ~ X Size: Manbfac~re~
"='~'~; .d,-'~Z':~'~ ~;~/~-./-c E.~5-~. BENCH MARK
~ ~.' '..~
Inspections peHormed by:_ l~ Dates' ¢' 1't/oo *: 9 .
Depa~ment of Health and Human Se~ices approval J ~, ~-7~-~..'.~
Reviewed and approved by:~~ ~, ~Da,~. J~,o ~ ~ ~ ~,~'" - '"~+~
~ ~ ~ssto
~D ENGINEERING
20441 PTAILMIGAN BLVD.
EAGLE R1VER, AK 99577-8736
Performed for: CMM
Project:
Hamman #Ir BI~ L7
Depth
(Feet)
SOILS PERCOLATION TEST
Robert Caywood Date Performed: 8/28/00
TEST HOLE # 00-2
ORG - rootmat black to brown
14-
15-
16-
17-
18-
19-
20-
SM/GM-loosemed dense,
w/cobbles to 2'
minor silbmostly
gravelw/some sand
B.O.H. moist, but no water
HOLE PRESOAKED
PRIOR TO TEST
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Grotmd water encountered? NO
Depth to water after monitoring? N/A
What depth? NA
Date? 09/04/00
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 9/1/00 2:00 7"
2 2:10 10 rain 1 7/16" 5 9/16"
3 * 2:11 7"
4 2:21 10 min 1 8/16" 5 8/16"
5 * 2:22 7"
6 2:32 10 rnin 1 9/16' 5 5/16"
7 * 2:33 7"
8 2:43 10rain 113/16" 53/16"
9 * 2:44 7"
10 2:54 10mtn 1 13/16" 53/16"
11 * 2:55 7"
12 3:05 10 rain 1 13/16' 53/16'
· Water Added
Percolation Rate 2.00 (min/Ln) Perc Hole Diameter __
Test Run Between 3 feet and 4 feet
6~
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Mux~icipal guidelines in
effect on this date.
AS-BUILT SYSTEM DETAILS/SITE PLAN Permi'~ swoooo91
HAMMAN S/])~i, LnT 7, BLQQK 1 PIS# 050-611-27
"------"- ~.~~~. SCALE~ 1' : SO'
A-D=S6,O'
B-E=ll2.0' ~ ~ SEPTIC ~]'~ ::~ ~[
OF
~ ~ ...................... ~ ~ PREPARED FaR: ~ ~
~ ~f~9 T~ CMM CBNSTRUCTIBN
k ~ ~ EAGLE RIVER. AK 99577
{.~% .............. ~ ~ st~me SEWARD c.~o: KMD 20441 PTARMIGAN BLVD.
ac~,mOOOO6.OWG ~.o.: 00006 {90?}6"6-6III/FAX (907)696-8111
0CT--12--00 10:50 AM CMM GENER'AL CONTRACTORS 696 8?58 P.O1
OWNER OF LAND~
ADDRESS
ooc b. R !CEIVED
ULLIVAN WATER WEL
P,O, BOX 670272, CHUOIAK, A~S~ 9~67 ~ TELEPHONE
~Unic/pad~ of Anchora
aOR; HOLE DATA Dept. Health & Human Ser~es
DEPTH
LEGALDE$CRIPTION /,~q~/4j~/J,~J ~t~ i
PERMIT NUMBER~ Date of issue
T~ INDENTIFICATION NUMBER ~-~.~
Is well ~o~t~ at appmv~ pe~lt location? ~ No
Method of DHIling: ~a~ ~ cable tool
Depth of well: _
Caaing ~pe ~ ~;~1~ Thickne~ ~ ~ ~ inches
D~amater
..~inohea, depth ~ O' feet
Liner Type
Casing 8tickup ~ve Ground; ... ~. ~eet
Static Water Level (~m ground level): ~ ~ feet
Pumping level: feet affe~hrs, pumping gpm
Ee~ver Rate: ~gp~
Method of Testing;
Well Intake Opening Type; ~ Open End ~ Hole
~ 8creen~; Sta~. ._feet 8topped feet
~ Perforations Sta~ feet Stopped
Grout Type: ~, ~ ~/~ 2_ . feet
· ~' '~ volume ~04d~
Depth; fmc_ ~ feet, to ~ .feet
Pump In,ks Depth:. feet
PumpSize hp Brand Name..
Well Disinfected Upon Completion? ~ ~ No
Method of Disinfection;
Comments:
Driller's Name ,'3. J · .
ATTENTION. It is the ree"onelbi': ......... ' ~ ' '~
' ~, ,,y o, me property Owner tO Suomlt a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Human Services and/or Department of Environments C
Department of Environmental Conservation. onaervatlon. Matsu Borough:
MUNICIPALITY OF ANCHORAGE
Deparlment 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
Initial
Date Issued: May 05, 2000
Expiration Date: May 05, 2001
Permit Number: SW000091
Legal Description: HAMANN BLK 1 LT 7
Design Engineer: 0070 KND Engineering
Owner Name: Robert Caywood
Owner Address: PO Box 774042
Eagle River, AK 99577-
Parcel ID: 050-611-27
Site Address: 024439 COLEMAN CIR
Lot Size: 81143 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
L_/~ 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 not[fy 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: ~..~
0¢/11/2000 20:46 9072604193 I(ND ZNVESTMENTS PAGE
KND ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8756
i'
(907)696-6111~FAX (907)696-8111
August 23, 2000
I am sending tkese corrected plans for Hsmman Subd #% Lot 7, Block 3. because we
made a mistake on the ones submitted and it indicates ;I500 $.T. ~astead of 1000 $,T,
Please give Victor GocLCrey at 868-3791 ff you kave any questions.
Z~a ~. C o,eman
teND Engir~eering
K
WASTEWATER DISPDSAL SYSTEM DETAILS
HAMMAN g/D~l, LrlT 7, ]~LDCK 1
SF
,T,
lry F'i~l,d CE]
M'
~epve Fie
TH~KND99-
PAGE B nF ~
~044! PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
0¢/Zt/2000 20:46 9072604193 KND ZNVESTNENTS PAGE 03
WELL
& WASTEWATER DISPOSAL
HAMMAN SI]]~:i, LOT
~CT 11
SYSTEM
7, ]~LDCK
_L
LODGE POL£ COURT
DETAILS/SITE PLAN
PREPARE]] FOR:
ROBERT CAYWOnD
CNH CDNSTRUCT~fEIN
P,D, BOX 77404R
AK g9577
~"~ R. dqHN$O
R. JOHN.SOl
~,D .Le O00O6
I c~c-'~. KMD
I "^'~ 3./24/00
~Jm SW161
~w~ 00006
$co. le~ 1'= 100'
PAGE 1 DF 1
20441 PTAR~iIGAN BLVD.
EAGLE RIVER, AK 99577-8736
K~D ENGIMEER[NG
20441 PTARMIGAN BLVD.
EAGLB PdVER, AK 995YY-SY36
(907)696-6111/FAX (907)696-8111
April 24, 2000
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: New sewer permit - Hamman Subdivision #1, Block 1, Lot 7
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. On March 22, 2000 we dug one testhole for the proposed system. The result of
the test is attached. The general slope of this lot is from north to south at a grade of
approximately 15-20%. The lot will be served by an individual well. We propose to
install a 5' wide shallow trench. Water was not encountered during the excavation
or monitoring.
There are no public or private wells within 200' of our proposed system location
except as noted. There is no surface water within 100' of the proposed system and
there are no known curtain drains within 50'. We do not expect there to be any
adverse effect on adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
II~I12) Engineering
Kenneth M. Duffus~?~
attachments:
On-Site Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL
WASTEWATER 9ISPBSAL SYSTEM
HAMMAN S/]}~i, LOT 7, 3LOCK
J_
LODG~ POLE COURT
DETAILS/SITE PLAK
1
SEPTIC
DESIGN CRITERIA
1. 3 BEI)RDDMS X 150 GAL./DAY/I)EDROOM = 450 GPD
R, SOILS RATING: 1,9 MIN./INCH = APPL, RATE 1,2 GPD/SF
3, 450 GPU/O,8 GPD/SF = 552,5 3F
4, (562,5 SF/5' (W)) X 0,58(r?) 43' GRAVEL) = 65,25'L
5, NIN, DESIGN SIZE = I TRENCH - 66' LUNG x 5' WIDE x 3,0' DEEP
6, DEPTH UF GRAVEL BELOW PIPE IS 3.0'.
7, TBTAL DEPTH DF SYSTEM IS 5,0' FROM ORIGINAL GRADE,
8 2' HD INSULATION REQUIRED OVER FIELD <3' BF COVER
'. 2' HD INSULATION REQUIRED OVER TANK <4' OF COVER
lO, CONTRACTrlR TO VERIFY AND INSURE MAX 2Y.. GRADE FRON HOUSE TU TANK,
PREPARED FOR:
RODERT CAYWOOD
CNN CONSTRUCTION
P,O, DOX 77,t042
EAGLE RIVER
AK 99577
BOUNOARY:R. JOHNSO ~DR^WU: KMD
ST^KINe: R. JOHNSO
ASBUILT: R. JOHNSO
DWG. FILE:
ACA0 FILE: 00006
CHECKEO; KMD
DATE: 5/24/00
GRID: SW161
Jo~ No.: 00006
Sca[e: 1"= 100'
PAGE 1 OF 1
~) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
] (gOT)6g6-611 i{FAX (go?)6g6-8111
WASTEWATER DISPFISAL SYSTEM
FIaMMAN S/D~41~ LOT 7~ ]3LBCK
Iv1'
er've Fiekd
HffKND99-
DETAILS
PREPARED FOR:
ROBERT CAY~/I]OB
CMM CONSTRUCTION
P,O, BOX 77404~
EAGLE RIVER Al( 99577
FIELD BOOKS
BOUNDARY=R. JOHNSOrlD~A~: KMD
STAglNC: R.JOHNSON: CHECKED: KMD
ASBUILT: R. JOHNSO
DWG, ~qLE:
,',CAD riLE: 00006
, o^~: 5/24/00
CruD: SWl 61
,JOB NO.: 00006
Scc~Le~ 1'= 20'
PAGE 2 OF 2
~) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907/696-61ii/¥~S{ 1907/696-8ii!
~D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 9957%8736
Performed for:
Project:
Depth
(Feet)
CMM
Hamman #1, B1, L7
Kenneth M. Do
SOILS PERCOLATION TEST
Robert Caywood Date Performed: 03/22/00
TEST HOLE # 00-1
14-
15-
16-
17-
18-
19-
20-
ORG - rootmat black to brown
SM/GM - loose med dense,
w/cobbles to 2'
minor silb mostly
gravel w/some sand
B.O.H. moist, but no water
HOLE PRESOAKED
PRIOR TO TEST
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? 13' Date? 04/03/00
Reading Date Gross Net Depth to Net
Time Time Water Drop
I 3/22/00 1:00 8'
2 1:10 10 min 2 7/16' 5 9/16'
3 * 1:11 8'
4 1:21 10 nxh~ 2 8/16' 5 8/16"
5 * 1:22 8'
6 1:32 10mh~ 210/16' 5 6/16'
7 * 1:33 8'
8 1:43 10rain 212/16' 54/16'
9 * 1:44 8'
10 1:54 10min 2 12/16" 54/16'
11 * 1:55 8'
12 2:05 10min 2 12/16' 54/16'
· Water Added
Percolation Rate 1.90 (mh~/in) Perc Hole Diameter 6"
Test Run Between 3 feet and 4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Streef, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Mar 24, 2000
Expiration Date: Mar 24, 2001
Permit Number: SW000037
Legal Description: HAMANN BLK 1 LT 7
Design Engineer: 0070 KND Engineering
Owner Name: Robert Caywood
Owner Address: PO Box 774042
Eagle River, AK 99577-
Parcel ID: 050-611-27
Site Address:
Lot Size: 81143 SQ. FT.
Total Bedrooms: 0 Permit Bedrooms: 0
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 t5.55 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.
5. The following special provisions.
This is for an exploratory well.
Received By: /~-- Date:
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
March 23, 2000
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Hamman #1 Block 1, Lot 7 - Exploratory Well Permit
Gentlemen:
Following a request from the owner, on March 22, 2000 a meeting was held on site to
discuss development of the subject lot. The owner and I determined best areas for the
septic, well and house locations. It is my understanding the owner wishes to develop
the well site prior to committing to full development of the lot. I feel confident with my
knowledge of the area soils and the layout of the identified areas that adequate area is
available for both a primary and reserve area for an on-site septic system.
One testhole was dug and percolation test conducted on March 22, 2000. The result of
the test is attached. Water was not encountered during the excavation, and water
monitoring will occur in a week of this request. The owner and I discussed the need to
provide an approved septic system for the lot before the well can be put into service.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
I~-~ Engineering
Attachment: Soils Log/Percolation Test
20441 PT~IGAN BLVD.
EAGLE ~VER, AK 99577-8736
SOILS PERCOLATION TEST
Per~ozmed~oz: C~ Robert Ca~ood Date
Project:
Hamman #Ir B1, L7
TEST HOLE # 00-1
Depth
(Feet)
ORG - rootmat black to brown
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
14-
15-
16-
17-
18-
SM/GM - loose med dense,
w/cobbles to 2'
minor silt, mostly
gravel w/some sand
B.O.H. moist, but no water
Was Grotmd water encountered? TBA- What depth? TBA
Depth to water after monitoring? TBA Date? TBA
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 3/22/00 1:00 8"
2 1:10 10min 27/16" 59/16"
3 * 1:11 8"
4 1:21 10 rain 2 8/16' 5 8/16'
5 * 1:22 8"
6 1:32 10rain 2 10/16" 5 6/16"
7 * 1:33 8"
8 1:43 10min 2 12/16" 54/16'
9 * 1:44 8"
10 1:54 10min 2 12/16" 54/16'
11 * 1:55 8'
12 2:05 10rain 2 12/16" 54/16"
· Water Added
19-
20-
HOLE PRESOAKED
PRIOR TO TEST
Percolation Rate 1.90 (min/in) Perc Hole Diameter__
Test Ran Between 3 feet and 4 feet
6~
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
EXPLORATORY WELL SITE PLAN
HAMMAN $/D~1, LOW 7, BLOCK 1
7
8
VACANT
"'"-'---._ ~"-"-' -~.~, 1
........
~B£RT CAY~/OOD
................................................. "'~'""~ EAGL~ ~IVE~, AK ~577
,. R, JOHNSQI , KMO
s~, R. JOHNSO] ~ KMD
'~--~SS]o~ ~lr, R. JOHNSOII~~ :; 3/24/00
~' '~: m~: .: SW161
*c~ -m 00006 ~" """: 00006
[ ~ ~ ~8969Z06
6
Scale~ 1~: 100~
PAGE 1 OF 1
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
igNIW33NIgN30N)~ :X~t :~ua$
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
OSC241507
Parcel ID 050 -611-27 Expiration Date:
Legal description HAMANN ADDN #1 BLK 1 LT 7
Site address 24439 COLEMAN CIR
Current property owner(s) KONKOL KEITH A& ELIZABETH
X The On-site system(s) is/are approved for 3 bedrooms
By:
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
12/4/2025
Original Certificate Date:
12/13/2024
c
This Corfificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sys �m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Zlopment 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
Development Services Department
On -Site Water & Wastewater Section
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-611-27
Complete legal description HAMANN ADDN #1 BLOCK 1 LOT 7
Location (site address) 24439 COLEMAN CIRCLE, EAGLE RIVER, AK 99577
Current property owner(s) KEITH & ELIZABETH KONKOL Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 24 - 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 $ 5-50
Date of Payment )"6 -I
COSA # ( G 2 q 1507
Waiver Fee $
Date of Payment
Waiver #
COSA Applicalion.doc
COSA Checklist.docx
COSA Checklist
Legal Description: HAMANN ADDN #1 BLOCK 1 LOT 7 Parcel ID: 050-611-27
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 4/4/2000 Total depth 300 ft
Cased to 20 ft (INTO BEDROCK)
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 19 in.
Date of flow test for COSA 12/4/24
Static water level at beginning of test 121 ft.
Well production at time of test 0.37 gpm
Water storage tank volume NONE* gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 0.285 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 12/4/24
Comments *Previous MOA record docs show water storage & there was none found – only one large and one small
pressure tank located in the garage. SEE MOA low water production advisory.
B. TANK DATA
Measured operating fluid level in septic tank 47”
Date of pumping 12/3/24
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) 9/6/2000
ALL standpipes present per record drawing
Total measured depth from existing grade 6.6 ft (max)
Measured depth to pipe invert from grade 3.3 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective. (ED)
If not, state depth into effective
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 12/4/24
Results Pass
Fluid depth prior to test 6 in
Water added 450 gal
New fluid depth 17 in
Elapsed time 1440 min
Final fluid depth 4 in
Absorption rate 450 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 36 in (MOA 3’ ED)
Effective depth used 4 in (Final Fluid Depth)
Effective depth (ED) remaining 32 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots,
visual observations, MOA records & appears approximate.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
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 12/10/2024
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 &
12/10/24
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite
Well Water Advisory
Certificate of On -Site Systems Approval # OSC241507
Subdivision: Hamann Addition #1, Block: 1, Lot: 7
907-343-7904
Fax: 343-7997
This well's productivity was determined to be .37 gallons per minute. The
recommended well productivity under (AMC 15.55) for a 3 -bedroom residence is
.31 gallons per minute or 150 gallons per day per bedroom. Although the subject
well currently exceeds this minimum recommendation, the production capacity
can fluctuate and may be insufficient to meet your needs.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
On -Site Water and Wastewater Section
www.muni.org/onsite
t. 907-343-7904
Fax: 343-7997
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC241507
Subdivision: Hamann Addition #1 Block:1, Lot: 7
The septic tank for this property is 24 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $15,000 or more,
not including engineering, surveying, MOA permitting fees or site restoration.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
•
•° .�-� Municipality of Anchorage
On-Site Water and Wastewater Program a el•
(907) 343-7904 s T Y
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-611-27 Expiration Date: r- -.ZS
1. GENERAL INFORMATION
Complete legal description _HAMANN ADDN #1 BLK 1 LT 7
Location (site address) _24439 COLEMAN CIR
Current Property owner(s) _BURCH JOHN & ROBYN Day phone
Mailing address _SAME
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver/Variance request for: Distance:
Received by: filittl Date: a V4/
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5240 Waiver Fee $
Date of Payment 3/22412 Date of Payment
Receipt Number 0,0—!O4M Receipt Number
COSA# 03047(l01 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.
Name of Firm MIKE N ANDERSON,P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON,PE Date 3/28/18
t•.•l °u
�-4 L'.oOD th`� .C� ..
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j /� se
d D 0 0 0°O n J°0 9'I
• C O : D C• J D D°°n°:O
6. DS SIGNATURE _ iC1 � k. ANDERSON°°° f
System #1 Approved for 3 bedrooms. t`i,;.. , r /. ° A j'
...,
System #2 Approved for bedrooms. ` °°'
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
LIT Y or
u 14/A �S/TE
•m Po
�AT � m.
0 ROGRAI�R .
By: \, -,,_ l� ^Rl/ft i
l I Original Certificate Date:
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.rr ,
Septic System Advisory Arsenic Advisory 2 -` '
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc '` ,. " .
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: HAMANN ADDN #1 BLK 1 LT 7 Parcel ID: 050-611-27
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed 4.4.2000 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y
Total depth 300 ft. Cased to 20 ft. Casing height(above ground) 24"+
FROM WELL LOG AT INSPECTION
Date of test 4.4-2000 3-14.2018
Static water level 77 ft. 161 ft.
Well production 0.5 g.p.m. 0.5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 0.38 mg/L
Arsenic: ND ug/L Date of sample: 3-14-2018 Collected by: Mike Anderson
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL/ f� Date installed 9-6-2000
Tank size 1000 gal. l Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N)Y Depression over tank (Y/N) N High water alarm (Y/N) Y
Date of pumping 7 /4V Pumper Alaska Quality Pumping_
C. ABSORPTION FIELD DATA-4611.4110811111101119111111111
Date installed 9-6-2000 Soil rating (GPD/SF) 1 1, Z.- System type WIDE TRENCH
Length 65.5 ft. Width 5.0 ft. Gravel below pipe 3.0 ft.
Total depth 5.1 ft. Eff. absorption area 565 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 3.14-2018 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 015 in. Water added 500+gal. new depth 11117 in.
Elapsed Time: 1440 min. Final fluid depth 014 in. Absorption rate >__500+_g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off" level at in.High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 100'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 1001+ Holding tank 100'+
Animal containment areas 100'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 104 Property line 10'+ Absorption field 10'
Water main 1001+ Water service line 1001+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10 Water main 100'+
Water Service line 100'+ Surface water 100'+ Driveway, parking/vehicle storage 7'+
Curtain drain 100'+ Wells on adjacent lots 100'+
�. ..............
F. COMMENTS
....7‘\%**
�%
LOW FLOW WELL ADVISORY,PLEASE READ CAREFULLY HAS STORAGE TANK. e 4 g r H • Vit,��
td
G. ENGINEER'S CERTIFICATION / very•
34•A_
MICHAEL N. ANDERSCN. °,(jk"
3 . CE-94 ••;
I certify that I have determined through field inspections and t`` ^>.• ,, •
review of Municipal records that the above systems are in •• •
'
conformance with MOA COSA guidelines in effect on this date. y�‘ '0oE`�® .v
Engineer's Printed Name MIKE N. ANDERSON,PE
Date 312112018
COSA canary sheet_2-6-15.doc
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT • � 907-343-7904
On-Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Well Water Advisory
Certificate of On-Site Systems Approval # OSC181101
Subdivision: Hamann Addn#1, Block: 1, Lot: 7
This well's productivity was determined to be .5 gallons per minute. The minimum
well productivity required under (AMC 15.55) for a 3-bedroom residence is .31
gallons per minute or 150 gallons per day per bedroom. Although the subject well
currently exceeds this minimum requirement, the production capacity can
fluctuate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org
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. 050-611-27
1. GENERAL INFORMATION
Complete legal description
Expiration Date:
HAMMAN _~,,BLOCK 1, LOT 7
Location (site address or directions)
Current Property owner(s) ROBERT CAYVVOOD
Day phone
Mailing address
P.O. BOX 774042 Eagle River AK, 99577
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2, NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] 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 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 wells 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)
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validatioe date 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 KNI') FnginR~rino
Phone 6~R-611t
Address _2D_4a'~ Pf~rmiga~ [~lvd. F:2OIR RivRr
Engineer's Printed Name I,(¢,nnRt'h
Date
DHHS SIGNATURE
/ Approved for '~
Disapproved,
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Expiration Date: / -
!Rev 11199)
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: / ~ ~ ~ ~'''' O O
Reissue Date:
RECEIVED
Municipality of Anchorage ~
Department of Health and Human Service~cT 2 0 Z000
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650MUNICIPALITYOFANCHORAGE
www.ci.anchorage,ak.us ENVIRONMENTAL SERV CES DIVISION
(907) 343-4744
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type pRIVATE
Date completed 414/2000
Total depth 300 ft
HAMANN #1 BLOCK 1, LOT 7
IfA, B, or C provide PWSID # __
Sanitary seal Y
Cased to 20 ft
Date of test
Static water level 77
Well production 0.5
WATER SAMPLE RESULTS:
Coliform . 0 colonies/100 mi
Date of sample: 10/5/2000
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL
FROM WELL LOG
4/4/2000
Parcel I.D.: 050-611-27
Well Log _Y
Wires properly protected Y_
Casing height (above ground) 24
AT INSPECTION
ft ft
g.p.m g.p.m
in.
Nitrate .5 mg/l Other bacteria -- colonies/100 mi
Collected by: KND Engineering
__ gal Number of Compartments 2_
Depression over tank N_ High water alarm N/A
Date installed 9/6/2000 Tank size 1000
Cleanouts _Y Foundation cleanout Y
Date of pumping Pumper
C. ABSORPTION FIELD DATA
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) 1.~9
Length .65.5 ft Width 5 ft
Total depth _5 ff Effective absorption area 565 ff2
Date of adequacy test Results (Pass/Fail)
Fluid depth in absorption field before test __ in
Elapsed Time: __ rain Final fluid depth __
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
(Rev. 11/99)
Monitoring tube Y
For
Water added gal.
in
System type WIDE TRENCH
Gravel below pipe 3.0 ft
Depression over field N~
bedrooms
New depth__ in.
Absorption rate >= g.p.d.
if yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons
in"Pump off' level at
Cycles tested
__ Manhole/Access
__ in High water alarm level at__ in
Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot inn,+ On adjacent lots 100'+
Absorption field on lot inn'+ On adjacent lots 1nm+
Public sewer main I00'+ Public sewer manhole/cleanout lan,+
Sewer/septic service line Inn'+ Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10'+ Property line 10'+
Water main 100'+ Water service line 'inn'.
Drainage 100'+ Wells on adjacent lots ~t00'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation '10'+ ___
Surface water 'inn'+
Wells on adjacent lots .Ina,+__
Absorption field 10'+
Surface water lnn'+
Water main tnn'+
Driveway, perking/vehicle storage 7'
Property line 10'+
Water Service line ,~nn'+
Curtain drain Inn,+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through fie/d inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guide/ines in effect on this date.
Engineer's Printed Name 14~nn~fh
Date
HAA Fee
Date of Payment
Receipt Number
(Rev. 11199)
Waiw;r Fee $
Date of Payment
Receipt Number