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� .. ::;.1:: 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