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HomeMy WebLinkAboutSUE TAWN ESTATE #2 BLK 3 LT 7Sue Tawn #2 states Lot 7 Block 3 #051-511-33 Municipality of Anchorage Page ___ of_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519~6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~-~Nq~ ~,Ct (~) PID Number: ~.~) I ',5~//~ C~C~ __ N~: ~ ~ Wastewater Syste~= ~New D Upgrade Address: ~]~V~F~ ~ [~ ABSORPTION FIELD Total Depth from original grade: LEGAL DESCRIPTION So,.~ng:I,~ ~.D/Sq.~. L~' LOt:? BIOCk:%~ ~ ~~ Depth to pipe bo,o~ from original grade: Gravel dept~n~ath pipe Township: IRange: Jsection: Fill added above origi:sl grade:. ~ _ J ~ Ft. Gravel[ength:~.4 Ft. WELL: ~New ~ Upgrade Total absorption a[e Yield: ~ J Pump Set at: . J dasing He~bo~e Ground: I I SEPARATION DISTANCES a Septic a Holding ~S.T.E.P. TO Se,tic Absorption L(, Holding Public/Priv.,e ~ra~ From Tank Field 8talion Tank Sewer Lines 8udace )~/~ ~¢'~ j~'+ J~¢~ J~/+ ~X.X1 LIFT STATION Remarks: OV~OO BENCH ~ARK Location and Description: E~GINEBR'8 SEAL Jnspeotions pe~ormed by: ~ ~~J~Q-Dates: ls~~ Depadment of Health and,Human Se.ic ¢2¢¢;C i Reviewed and approved by: ate: ~ 72~)13 (Rev. 9/91 ) MOA 25 AS-SUILT SYSTEN I]ETAILS?SITE PLAN Pc~.i, swssoos4 SUE TAWN EST, S/D ~2, LOT 7, ~LBCK 3 P~S~05~ 832-24 ,, A-C=iO,4' ~ s A-B=16,4' ~ o , o~ ~ ~ ~ FINISHED GRADE 9-E=97,8' * S,T,E,P, __ A-F=68.1' ; ~ ~AN~ ~ SEWER R~CK ~ SCALE: Bou~o~Y: SEWARD o~: ~MD ASSOILT: SEWARD 0Am 12/15/99 EAGLE RIVER, AK 9957?-8736 -- ~O~sslO~ ' ......... '......'.... ...... '.....- ..... JAN--O~-00 MON 11:40 AM DISCOVERY-TRAVEL 90?6948589 P.Ol SULLIVAN WELLS P.O. BOX 670272, OHUGIAK, ALASKA 99~87 · TELEPHONE 688.2759 ~.. eDgE HOL~ 0~TA ~ DEPTH ADDRESS LEGAL DESCRfPTION ...... ........ .. ...... PERMF¥ NUMBER_..~...,~_~,~:,;~ .~:~ Date of I~$ue ~ ~ ,~,~c,~,o~ ~u~,~, ~t.._~/ -.,. Is well Ioceled at a~roved permit Io~tio~ ~ No Method of Drilling' ] Ct~ ~ cable Depth Of well:. ~, Cas,rig Type ~_..._Wall Thickness, ~ ¢ inches O~arneter ___~ ~ inches, depth, ~, fee~ Liner Type ._~ Casm9 Stickup Above Ground: ~. __~_feet Stalic Water Level ffrom ground level): . ~ O ~__ feet Pumpqg level: feet a~er hfs pumping gpm Recover Rate; Method of Teshng. Well intake Opening Type: ~End ~ Open H01e ~ Screened: , Stad ..... feet S~opped~ .. ~feet (~ Pedorahons Start feet S~opped ' Grout Type. ~'F~--¢ ~A__/~ .feet Depth from __~feel, to ..feet Pump Intake Depth: feet Pump S~ze hp Brand Name Well b~sinfected Upon Compl~Jion?,, .~ ~ No Driller's Name ATTENTION: It is the responsibility of the"preperty of Anc. hnrndn' I~¢,,-,c,.:-,-,,.,,., .,~ u~ ..,. ..... owRar to subBjl e col:)v of thn w~ll Inn t,-, th 81/05/2000 L0;45 19076886777 R~SZNG SON ELECTRIC P/~E 8~ .~~~.~,, Rising Son ilElectric P.O. Box 670687 Chugiak ~, 99567 (907) 688 I~,: Lot 1 To ~hom tt ~ (.oncarn: ,6777 : ~onl~actor ~ould lou h~ve a~ qu~tlorm or requlr~ addit!aM~ ~,,tl~Clrt~[ Admlnlalra~r/Ovmr T~ae~iatt1 &ontractor I.k, eea. ~,~trlt. al Administrator LAc, emro information, ph~a. do Mt hemltat~ Llnda Fram: : [ ~. ~ L8969Z06 ~9NIW~3NION3 qNN :AG ~ues MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date issued: Aug 18, 1999 Expiration Date: Aug 17, 2000 Permit Number: SW990290 Legal Description: SUETAWN ESTATE #2 BLK Design Engineer: 0070 KND Engineering Owner Name: Linda Frank Owner Address: 11420 Old Glenn Hwy #102 Eagle River, AK 99577- 3LT 7 Parcel ID: 051-511-33 Site Address: Lot Size: 63166 SQ. FT. Total Bedrooms: 3 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 carling (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: KN1D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 August 7, 1999 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer & well permit - Sue Tawn Estates S/D #2, Lot 7, Block 3 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On July 8, 1999 we dug one testhole for the proposed system. The results of these tests are attached. The general slope of this lot breaks at the middle flowing east and west at a grade of approximately 2 - 5%. We have designed our system utilizing the testhole we excavated for the 3~bedroom house, which is proposed for this lot. The lot will be served by an individual well. We propose to install a 5' wide shallow trench. Water was encountered during excavation at 12' and at 11.5' from the ground surface after monitoring. We have designed the system so that the bottom of the system is not less than 6' below the existing ground surface. 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'. The drainage easement to the south of the property is not constructed and has no flowing water through it. We do not expect fl~ere 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, neer~ing Duffus, P.E. attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL/WASTEWATER DISPFISAL SYSTEH DETAILS/SITE PLAN SUE TAWN EST, S/D LOT 6 VACANT LOT 7 3 icu LOT B VA DESIGN DETAILS 3 BDRM X 150 GPD: 450 GPO 450 GPO/l.2 GPO PER SQ. FT. <2.2 MIN/IN.)= 375 SQ. FT (375/5'(W)) X 0.5(RF) (4' GRAVEL) = 37.5 FT. TRENCH USE i TRENCH - 38(L) X 5' (W) X 4'(D) Total depth oF system Is 6' Ppom original 9rcde, Total depth oF orave[ below distribution pipe is 4,0' , NOTES~ 1. USE lOgO GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER. 2, INSULATE TRENCHES WITH 2' HD BURIAL FOAM, 3, CONTRACTOR WILL ENSURE MAXIMUM 2Y. SLOPE INTO SEPTIC TANK, 4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS & SEPTICS. )REPARED FOR: LINI]A FRANK 11420 OLD GLENN HWY, #102 EAGLE RIVER, AK 99577 <907)694-2525 FIELD 800KS COMPUTED: BOUNDARY: SEWARD om^va: KMD ST^K)~G: SEWARD CHECK[D: KMD SEWARD ^CAD FILE: 99061.DWG DA~E: 8/6/99 6RID: NWl060 JOB No,: 99061 ScaLel 1'~= 100' PAGE 1 OF 2 ~/~ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6iii/BAX (9o?)696-8n ! K D WASTEWATER DISPOSAL SYSTEM DETAILS SUE TAWN EST, S/D ~a, LHT 7, 9LBCK 3 1000 S,T CB MY ESER PITIHAITY SYST MT TH ~-KM]3 99 1 PREPARED FOR~ LINDA FRANK 11420 (]LB GLENN H~Y, #192 EAGLE RIVER, AK 99577 (907)694-2525 FIELD BOOKS 8OUNOARY: SEWARD BRMI~: KMD S~AKIN6: SEWARD CHECKEO: KMD ^SBUILT: SEWARD ACAO FILC: 99061.DW6 o^m 8/6/99 GRID: NWl060 JOB No.: 99061 ScaLe~ 1'= 20' PAGE 2 OF 2 ~P~N~ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 /907)696-6! II/FAX /907}696-81! ! ~ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 Performed for: SOILS PERCOLATION TEST Linda Frank Project:. Sue Tawn Est #2 Blk 3 Lot 7 TEST HOLE # 99-1 Depth 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 13- 14- 15- 16- 17- 18- Org.- rootmat GW/SW- brown, gray Boulders to 24" SW/GW - gray, boulders, moist B.O.H. SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? YES What depth? 12' Depth to water after monitoring? 11.5' Date? 7/15/99 Reading Date Gross Net Depth to Net Time Time Water Drop i 7/8/99 2:00 10" 2 2:10 10 rain 4- 6- 3 * 2:11 10" 4 2:21 10 rain 5' 5" 5 * 2:22 10" 6 2:32 10 rain 6' 4" 7 * 2:33 10" 8 2:43 10 min 5 5/16" 4 11/16" 9 * 2:44 10" 10 2:54 10 min 5 3/8" 4 5/8' 11 * 2:55 10' 12 3:05 10 min 5 3/8" 4 5/8" · Water Added 19- 20- Percolation Rate 2.2 (min/in) Pert Hole Diameter. 6" Test Run Between 4 feet and 5 feet HOLE PRESOAKED PRIOR TO TESTING I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. C: M /W O LL V a_ NQ li O 2 U Z LLQ OI 4 � I a 0 a) U c/) U M Q� Z� o 3: U / O� 06 co L C> E 0-a)O > C/) 00 A N O N O (D C) C O .Q x W 0 0 0 cy') r LO LO O v cu I- (.0 Ln H CY) J CF) C'7 Q J m N W (� Q �o U) Z W Z Q H W W U) Q co C 00 O r - Q N U O a) -O ca C J (!) r I t. O U U O O C7 0 a) O Q CL cu L ca cn E U) N a) c O a) L E2 Alu E O A N O N O r .e, u u o a o m a a) Q Q. O N i- O � U a)O (DC V 7 .FM N C O N O r Q U) .NN Q U) O 3 a) a > C CL -0 O CL .Q Q. Q O d) U) 'a U) 0�a)_ R U) = N v� N E -a O c O 0 CL O > a) C V1 O cn N C �j E o w y0r .0 � � V Q C � Z Q Xx 0 U) .5 _0 z -0 O N Y O > U u- -0 OC Q U O a) CL Q WU) C O E 2UQI—O 2 U FQ-- H Q tl- V O Cid O) CY) A A C'7 C ) rnrn C O U 0.. Q Q (C3 O CL Q Cn (v U\) ^^ C 0 O N CB U IN OO O O Q M L0 O oZ 0 W Z L W CL T - ti J C) J m it LU Q 7 /^ I v ) ` W H D W O 00 CO c 00 o CL ^ 'i U) U N V a) -p ca a) 0 m � 0 Q O U U r� V A T m a) LL m m i U U O =3CL a) c _ a) O fn U) cu _ o m O a) cm L ❑ .O cm O L E a) Q U 0 3 U O U) E]'J a) CV C 'O O E ECL ❑ a) (n O U to O w _ W ❑ ❑ CD L- O Q a) c m LL F L cm U) O ❑ cu -Ta a) N O El TO \ � cmLL /^j 2 W _co O o ❑ ElU 0 ca 0 m 0 L. C Q. "- O m I � 4? � J ❑ L N ❑ n = co 2! C/)U_ O y m L i ///�� V/ ❑ ❑ Ln,( C 0 O ❑ O W d W 0 ❑ Qy C/) m —i a) d 9+ 2 W a) Wv y V W W F. a) m ~ U)co Y Z o Q °) c ~ n > 4° mW W H a) ` O O v � _= (� d P: N O 0 OW. _� Z �.. �. W rn m a) _0 Q L O F— F- N Q Q Q > N C -i Lfl ?: W m 0 T m a) LL m m i COSA Checklist Legal Description: SUE TAWN ESTATE #2 BLK 3 LT 7 Parcel ID: 05151133000 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 8/20/99 Total depth 92 ft Cased to 92 ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 9/10/24 Static water level at beginning of test 56 ft. Comments B. TANK DATA Measured operating fluid level in septic tank STEP Date of pumping 6/10/24 ❑■ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 8/6/99 ❑■ ALL standpipes present per record drawing Total measured depth from grade 6 ft (max) Measured depth to pipe invert from grade 2 ft (min) ❑ N/A — pressurized field. ❑■ Per record drawings, field is insulated. ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑■ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 9/9/24 date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 8+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 2.04 mg/L ❑■ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by NRim Eng. Date 9/10/24 C. LIFT STATION ❑■ Required maintenance completed Age of lift station 25 years Lift station material steel Comments: 500 gallons Adequacy test date 9/10/24 Results g Pass Fluid depth prior to test Water added 450 gal 12 in New fluid depth 18 in Elapsed time 30 min Final fluid depth 14 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 Effective depth used 14 in Effective depth remaining 34 in in 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 Community Sewer Manhole/Cleanout > 100' Yes if No ft■❑ Yes if No ft Neighboring Tank > 100' ❑■ Yes if No ft Private Sewer/Septic Line > 25' [k Yes if No ft Absorption Field on Lot > 100'❑ Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' ❑■ Yes if No Water Main > 10' Animal Containment > 50'■❑ Yes if No ft Mm Yes if No ft ❑■ Yes if No Water Service Line > 10' FEI Yes if No Manure/Animal Excreta Storage > 100' If tank or field is under driveway Community Sewer Main > 75' ❑■ Yes if No ft ■l 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 Surface Water > 100'■❑ Yes if No Tank to Property Line > 5' ■❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑■ Yes if No ft Private Wells > 100' ❑■ Yes if No Water Main > 10' ■❑ Yes if No ft Community Wells > 200' ❑■ Yes if No Water Service Line > 10' FEI Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS ft ft Iii 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 NorthRim Engineering Phone 694-7028 Engineer's Printed Namc Steve Eng `,�j 9/30/24 OF 4 N 10 .. ; , 10Steve Erg i CE -6256 1 9'/30/� COSA Checklist June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section �.`. Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner\x, C t ✓ Street Address ! 8 fj (j0 5u { a�✓� Dr� Septic Tank: -Sludge level Ainches -Pumping: required *M •Pumping completed ygs no Lift station: -Pump basket cleaned `� es no -Effluent filter cleaned no -Control floats cleaned EdsD no -Proper float settings confirmed veg` no -Operation satisfactory J;eS. no Alarm System: -Dedicated electrical alarm circuitVe no •Audible and visual alarm inside dwelling e no •Alarm system operation satisfacnot satisfacto Manhole Miser *Ground water intrusion at riser to tank connection es n *Ground water intrusion around pipe penetrationses o -Weep hole functional e no *Manhole lid: Functional -ie-* no insulated es no Properly Secured e no Other -All manufacturer required inspections and maintenance completed V&no Comments: Qualified Maintenance Provider: Technician ' �C��,., Date of maintenance__0 3�'2az� Company Sr. £ P� C �� t ' ny 'ej, �, r4.0d i Signature `-1 ?— Date '� 0-�1 -�r N o rn 0) Q1 M M M M � X Ql LL W NQ I.i O V Z Q LL r 0, J r � a W V ~N — av Z 03 N W L-) m v > �: :t LLJ N M -- F- L W Z w ro a � E 0 E W in 3 0 0 3 co O I -- CL Q Q Q N a) 4- N Ul 4- (O cu v au t O U? O.. N � fD O E L O O O Lr) 0 O f0 L O a --i N c O 4- O N 4. (IJ c -I c U o~ (� N N fU 0 Q QC N+� E aj nn >- Ln c _ Ln ^ ++ O m U m N LU H Q) to ra 4J cc O p Ln L >' Ln N N L Q o Q- N t 4-+ O v (p N n O QJ E � _ II CU U a ~ N >. o .N Y C M U N L ) bn E Q O ` b �_ W L 4A c L Q) Qi E L N U U N v 4- O N O O U O 4 - L u ca a, n � O N N Y -z'b+0 v N v O E O m L N -0 +-' Q y N N N W M = a--' L > Ou U cn I— C: I— co O I -- CL Q Q Q N a) 4- N Ul �E r3L Municipality of Anchorage - _�� On -Site Water and Wastewater Program (907) 343-7904 . CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-511-33 Expiration Date:O 1. GENERAL INFORMATION Complete legal description Sue Tawn_ Estates #2 Block _3_Lot 7 Location (site address) 18680 Sue Tawn Dr. Chugiak, AK Current Property owner(s) Michael Parker Day phone Mailing address P.O. Box 671368 Real Estate Agent 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: ❑ Individual Well ❑ Individual Water Storage ❑ Community Class _ Well ❑ Public Water System ❑ WaiverNariance request for: Tank to Building foundation Day phone TYPE OF WASTEWATER DISPOSAL: Individual ®.. Holding Tank ❑ Community ❑ Public Sewer ❑ Distance: 1.5' Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �5� _ Waiver Fee $ r7, 5Q Date of Payment ��/ 2 Z _ Date of Payment 5h a1 AD1Q1q Receipt Number �� Z �7 _ Receipt Number 6 &baa G COSA # 05G 2.Z J_Z0.6 _ 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 ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER,_ AK_ 99577 Engineer's Printed Name KENNETH M. DUFFUS _ Date S jt Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerrauarantee that no unseen encroachments, deficiencies or discrepancies exist. �0` ` Zj c, '1' 1-1 6. DSD SIGNATURE t J System #1 Approved for bedrooms.7,"16r' 'G System #2 Approved for bedrooms.�\ n,l� %, tG~i GS.--r0.� Disapproved. ���,..� Conditional approval for bedrooms, with the following stip`\\,, RRQR ((�, — ----- SITE -- -- - --- ` j —CSN- —�-:- g WATER AND�z �o �AST`;o; -- co _ -- lO EA l u -n J Original Certificate Date: 5 a- d .� o_? 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 Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12,doc Nitrate Advisory Arsenic Advisory Other '(m 'I ri{v�siuc^y A t COSA Checklist Legal Description: Sue Tawn Estates #2 Block 3 Lot 7 Parcel ID: 051-511-33 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA jE1 Well log is filed with Onsite (or attached) Date drilled 8/18/99 Total depth 92 ft Cased to 92 ft 0 Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 4/15/22 Static water level at beginning of test 63 ft. Comments B. TANK DATA Age of tank(s) 23 years Tank type/material Step/Steel Measured operating fluid level in septic tank 42" Standpipes/foundation cleanout per record drawing Date of pumping 10/26/21 D. ABSORPTION FIELD DATA Which system tested (date installed) 8/6/71 ® ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ❑! Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 5.7 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes E Nc 0 Coliform bacteria is Negative Nitrate 2.54 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L UN Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 4/8/22 C. LIFT STATION FW Required maintenance completed Age of lift station 23 years Lift station material Steel Comments: Adequacy test date 4/15/22 Results Q✓ Pass For 3 bedrooms Fluid depth prior to test 26.5 in Water added 450 gal New depth 33 in Elapsed time 120 min Final fluid depth 26.5 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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 Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [Z Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 1.5+* ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' ® Yes if No ft Community Wells > 200' Yes if No. Water Service Line > 10' ® 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) ft ft ft ft ft ft ft ft Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *Waiver reauested G. ENGINEER'S CERTIFICATION / certify that 1 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. COSA Checklist yellow sheet OF •s 1 � 49 3H CE 11C/tom:' Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221206 Subdivision: Sue Tawn Estates #2 Block 3 lot 7 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for Phis COSA / property is 23 years old. A leaking septic tank maV'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. Ma�lmg Address P O Box 196650 *Anchorage, Alaska 99519 5650 *www mum org P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV221029 COSA#:OSC221206 Permit#: PID#: 051-511-33 Legal Description: Sue Tawn Estate #2 Block 3 Lot 7 Engineer: ArcTerra Applicant: Michael Parker Your request for a waiver of the required horizontal separation from the septic tank to the building foundation has been approved. The approved separation distance is 1.5 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. mmm..mm..m.m....mm.smmmmmmm..mm...moo.m.m.m..m....mmmmm....m...m...m..mm.mm.m.� Waiver is Granted: X Waiver is not Granted: Date: Approved by: V1,J_&W �Uv� Name of Reviewer ■■.mmm.m..m..m.mmm......mmmmmm.mm.mmm.m.m..mmmmmmm.m.m..m.mms..m.mmm...m.amoa.� of �RCT'ERRq ,• RC ERRA CONSULTING, INC 20441 Ptarmigan Bld, Eagle River, AK 99577 fR,y0NSV1.TING •N6 Office (907) 696-6111, Fax (907) 868-3793 A' �K 993T!•'9lJ May 5, 2022 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Separation Waiver — Sue Tawn Estates #2 Block 3 Lot 7 On April 15, 2022 we inspected and preformed a septic adequacy test on the above referenced proerty. The septic system was installed in 1999 and it passed our adequacy test with no problem. We did not find any signs of tank failure. During the inspection it was noted that the existing deck was enclosed as an arctic entry and the sonatube foundation is approximately four feet from the septic tank standpipe. We contacted the owner and he confirmed he constructer the entry sometime after purchase in 2012. He stated the sonotubes are buried more than six feet below the existing grade due to the gravelly soils encountered. At no time did he see or consider the septic tank. The top of the tank is 40 inches below grade thus the closest edge of the tank is 1.5 feet to the edge of the foundation. By our calculations the weight distrubution on the foundation does not effect the tank integrity. There has been no sign of failure of either the tank or foundation since the construction in 2012 including the 2018 earthquake that caused damage in the area. We are requesting a waiver between the tank and foundation to 1.5 feet. We do not expect there to be any adverse effects to the foundation or this tank in the existing location. If you have any questions, please contact me at 696-6111/FAX 868-3793. Respectfully submitted, 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 o t,,RcTERRq >` F t � s gYfA SILTING •ei�a AN. 999'1' RC ERRA CONSULTING, INC 20441 Ptarmigan Bld, Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 ArcTerra consulting, Inc. Kenneth M. Duffus, P.E. 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 Ste_ .�O ❑C„ _ 4,42 1 SEP-PC I VENTS ROCK (n'P) I WALL f I r ill GRAV O/W It -A x O ll LCT 8 .2 24.5' a 7 epi Exls�lNG HDU x�x�x I Q l 42. a t "<7.5 -d), I 1 Ca I GRAV m SHED 1+1 I D/W �S•�' ^O I 25'05, S' a b I N LO 1 o ROCK I / WALL LOT 6 28.5 � ® WELL o�w I / I � 1 f I � i— LOT 7 i 00 BLOCK 3 _ __ tl �Po -k\ r ` ' 25 ,CREEK ES�A� y n jo 1 9 4.03' r � N07-0B' 5' W �r U) o SIT iLE PETERS CREEK - � f - z r � ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: SUE TAWN ESTATES ADD. NO.2 LOT 7 BLOCK 3 PLAT 76-268,2 of 2 4��, SURVEY CERTIFICATE: I, John L. Schuller, Have Conducted a AW ❑F' A�'�1 ��C E�1p physical survey of this property as shown on this drawing and that the .,� �� . ' '� improvements situates! hereon are within the property lines and no�i enchroachments exist other than noted. Under no circumstance 5houW ; 49' any information on this drawing be used for construction of fences, ; .� structures, improvements, or for establishing boundary lines, J( EXCLUSION NOTES: It is the owners responsibility to determine ■ ' " . " ; "' ' ""' """' ""' "'' "' 4 z . o the existence of any easements, covenants, or restrictions which f �, �aHN LSCHULLER: m LS-10408 do not appear on the recorded subdivision plat. , m •. �y .•• � / ";• .� ��, � WORK ORDER NUMBER: DA' 9GUE: E-4AL e N Qq II �J AUG 31, 2009 1"=5t7' 09-001 MON BY, CWC1=B am . °fessiondl A,yn SUS' JLS NW1060 0804/42 �������� MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION ComCete description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone · Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ,~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site If community well system, provide written confirmation from State ADEC attest- ., lng t~o the legality and status of system. X Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 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 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. Name of Firm ~',~'~D ~~Y-'~ Phone ~q¢' ¢~ Address ~b~ ~~~ ~- EngineeCs signat~~ ~~ Date ~ DHHS SIGNATURE X __ Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the foil?wing stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based 0nly upon the representations given in paragraph 5 above by an independent profess!onal engineer registered in the State of Alaska, The DH HS does this as a cou rteey 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 certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE~ Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 Health Authority Approval Checklist A. WELL DATA We, type Log present (Y/N) [,-~'~ Date completed Total depth q C'-'~] ~'j Cased to qm~/ Sanitary seal (Y/N) FROM WELL LOG Static water level Well production ~ g.p.m. WATER SAMPLE RESULTS: Coliform (~ Date of sample: ]c~/'~[q~ B. SEPTIC/HOLDING TANK DATA If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) AT~TION Ne,V',,I Nitrate Other bacteria Collected by: H ~ ~Z) Date installed Foundation cleanout (Y/N) ~ Date of Pumping ~'x~/~ C. ABSORPTION FIELD DATA Date insta,,ed q Length ~q .)-J' ' Width Tank size Number of Compartments __ Cleanouts (Y/N)._[.~ Depression (Y/N) N High water alarm (Y/N) Pumper Soil rating ~or fF/bdrm) /' .~ System type ?-,~(~I,.}ID~O '~"(-~_~ Gravel thickness below pipe Total depth Effective absorption area ._r_~C]4 -~Monitoring Tube present (Y/N)___~r_ Depression over field (Y/N) ~ Date o"~f'ad~ Results (Pass/Fail) For .bedrooms Perox~ ~e-da~e~ __ 72-026 (Rev. 3/96) ~ D. LIFT STATION Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons "Pump on" level at* "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot /~)~) / Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation / (-~ "~- Property mine /(~) y'~- Absorption field Waterr. a n/serv ce".e /©/+ Su,acewater/dra nage We,eo. adiacent,ots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Propertyline /6 / -j Building foundation /~-~ 1 ~ Water main/service line /~-~/7~ Surface water / D(~ / ~ Driveway, parking/vehicle storage area /~/~- Cu.ain drain ~/~ Wells on adjacent lots /~0/~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review in conformance with MOA HAA guidelines in effect on this date. Signature ~ Engineer's Name HAA Fee $ Receipt Number ~/'~ ~/"~/ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number