HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 1 LT 10
Municipality of Anchorage Page 1 of.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alesko 99519-6650 'Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection RepoA
Permit Number: SW990135 PlO Number; 015-302-15
N"me:MICHAEL AND SHARON STEIN WastewaterSystem: ~ New ~ Upgrede
5311 WHISPERING SPRUCE DR, ANCHO~GE, AK 99516 ABSORPTION FIELD
No. of Bedrooms:
=h°ne:(907) 269--5123/ 345-2754 3 a Deep 'French ~ Shallow Trench D Bed D Mound D Other
10 1 SKY RANCH ESTATES 3.9 - 5 n. 6.1
- - - 0,2- 1,3 Ft. 48
~ravel wl~h: Number of lines: ~Dlst~n~ betwsen I~t,,
WELL: D New ~ Upgrade 2'+ FL 1 -- Ft.
/ n. rt. 586 s~.n. ASTM D-3054/F-810
Ddlten ~ Drilled: 5totl~ Water Level: In'taUenATCHESON ENT. 7/28/99
.. TANK
~EPA~TION DISTANCES m Septic 0 Holding 0 S.T.E.P.
Tank Reid Station Tank s,~,~ u,., ANCHORAGE TANK 1000
Well '140'+ '140'+ - - STEEL 2
s.,.o. ~oo'+ ~oo'+ -- - LIFT STATION
Lot 5'+ 10'+ ....
Line
Foundation 5'+ 10'+ .... 'Pump on' Wvel at: '~: IH'gh water ala~ °b
Cu~ain pump M~ Electd~l InspecUon. p.~o~ed
N~NE
KNOW~
R~rk~: * WA~W~ O~ANT~O ,Y A.~.~.C. (L~R 9ATED BENCH MARK
JULY 23, 1999) THRESHOLD OF MAN DOOR IN
3rd 7/28/g9 .J~ff~e ~ A. Garness/
Oepa.ment of Health and Human Se~ices approval }~['~.. b [-'7953
Reviewed and approved b ~ ~. ~Dote: ~-,~- ~ ~ ___. _
PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER:
SW990135 ' 015-302-15
/
/
/ /- D~,N~,~LB
/ ~ / ~ ....................
l
TH~I
/ ........
EXISTING D~NFIELD TO~ INSTALLED FLOW ~ /
ST1 5
DBL1 6~,6 ~2,8 ~ BEOROOM
HOUSE
DEL2 64.7 33.4 / " I-'~-~ D
FO 65.0 3~.5 / 9~
MT1 92.0 58,2
C01 92.2 58.4 /
MT2 54.0 42.7 ~e EmST~Ne
002 54.4 45.0 ~ ~Z"
~~' c~ss
ALASI~ WATER AND WASTEWATER CONSULTANTS, INC. ~ OF
SKY RANCH ESTATES, LOT 10, BLOCK 1 ~., ...... r...~ .................
~PE or WORK,
AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
PREPAREO FOR: PHONE NUMBER:
545--2754
SHARON STEIN 269-5125/
MICHAEL &
pAT~:7/50/99 D~WN BY: SOALE: PACE:
J.W.M. 1 = 30' 2 OF 3
PE.M,T .U~BER, AS BUILT DRAWING
SW990133 " 015--302-15
~- ~11'~ ~ - 9&18 INSU~TION
/
ALASI~ WATER AND WASTEWATER CONS~.TA'NTS, INC.
~o~ =[~aaa aoaa, su~;s =~. a~c.o~[, a.. ooso4
SKY RANCH ESTATES, LOT 10, BLOCK1 ~/' *~ ~ ~ '
~PE OF WORK:
PROFILE AS-BUILT OF NEW SEPTIC SYSTEM [..~&~ ~' :..,.~
*REPAREO FOR: PHONE NUMBER:
SHARON STEIN 269-5~23/ 345-2754
MIOHAEk AND
)ATE: 7/30/99 ID~WN BY: J SCALE: J PAGE:
J,W.M. N.T.S. 3 OF3 ~r o f e s sl°~~
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.us/dec/home/htm
TONY KNOWLES, GOVERNOR
Telephone: (907) 269-7521
Fax: (907) 269-7650
July 23, 1999
Mr. Jeffrey A. Garness
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2-B
Anchorage, Alaska 99504
Subject:
Lot 10, Block 1, Sky Ranch Estates #2, Anchorage, Alaska, ADEC Project
Number 565, Separation Distance Waiver Request.
Dear Mr. Garness:
This letter is in response to your submittals, received in this office on May 27, 1999 and July 21,
1999. The submittals requested a separation distance waiver between the existing Class A Public
Water System (PWSID #211813) Source Well located on Lot 1 l, Block 1, Sky Ranch Estates #2,
and the proposed septic system upgrade on Lot 10, Block 1, Sky Ranch Estates #2.
You have requested the Department waive the separation distance between the referenced Class
A Source Well and the proposed septic tank and trench upgrades from 200 feet to 140 feet. The
Department also understands that the existing trench will not be abandoned and thus, will require
the Department to waive the separation distance between the referenced Class A Source Well and
the existing trench (proposed reserve site) from 200 feet to 130 feet.
I have completed my review of the submitted information which included a cover letter, a site
plan, a percolation test, numerous area well logs, a surthce topography map, and construction
specifications. Based on this review, discussions with the Department's engineering staff, and a
review of nitrate and total coliform bacteria results for the (',lass A source well, it appears that the
proposed septic system upgrade on Lot 10 will not adversely impact the above referenced Class
A well.
Therefore, in accordance with the provisions of 18 AAC 80.030, the following separation
distances are granted:
Between the existing Class A well on Lot 11 and the proposed septic tank and
trench upgrade on Lot 10 fi'om 200 feet to 140 feet.
Mr. Jeffrey A. Garness, P.E. 2 July 23, 1999
Between the existing Class A well on Lot 11 and the existing trench (reserve site)
on Lot 10 fi'om 200 feet to 130 feet.
This approval does not imply the granting of additional authorizations, nor obligate any federal,
state, or local regulatory body to grant required authorizations.
Thank you for your cooperation with this Department. If you have any questions, please contact
me.
SP/cf
Sincerely,
Steven A. Pettis
Env. Eng. Asst. II
MUNICIPALITY OF ANCHORAGE
Dapartment of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
¢07) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW990'133
Legal Description: SKY RANCH ESTATES #2 BLK 1 LT 10
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Michael & Sharon Stein
Owner Address: 5311 WHISPERING SPRUCE DR
Date Issued: Jun 09, 1999
Expiration Date: Jun 08, 2000
%1
Parcel ID: 015-302-15 ~-'~- ;~),~'~.ot (_.~!,~2j]
Site Address: 005311 WHISPERING SPRUCE DR
Lot Size: 17751 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE , AK 99516-2307
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached al)proved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AA072 ) and Drinking Water Regulations ( 18AACa0 ).
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.
Date:
Date: & -?~ ??
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 9950,1
Phone (907) 337-6179 - Fax (907) 338-3246
Consulting Engineers
May 24, 1999
Municipality of Anchorage
Department of Health and Hmnan Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lot 10, Block 1, Sky Ranch Estates Subdivision
To whom it may concern:
The existing 3 bedroom house on the referenced property is served by a Community Class "A"
water system and private septic system that consists of a septic tank and a trench type drainfield.
We propose to excavate, pump, crush, and abandon the existing septic tank by burying it on-site;
a new 1000 gallon septic tank will be installed 140 feet fi'om the Class "A" well. The existing
trench is to be used as a reserve site and a new drainfield is to be installed parallel to the north
property line 140 feet fi'om the Class "A" well. A waiver has been requested fi'om the
Department of Environmental Consmwation (D.E.C.) concurrently with this permit request for a
separation distance waiver of 140 feet fi'Oln the Class "A" well to the proposed septic system.
Comments regarding the proposed design are as follows:
SOILS: One test hole was excavated along the north property line. The soils below the
organics/fill is a SM/SP material to a depth of 17 feet (bottom of test hole). No groundwater was
encountered at the time of excavation and seven days later, the monitoring tube was found to be
dry. A percolation test was performed between the depth of 8.0 feet to 8.5 feet and found the rate
to be at 4 minutes/inch.
TRENCH DESIGN:
a. Percolation Rate: 4 minute/inch
b. Allowable Application Rate: 0.8 gallons/day/sq.ft.
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Mininmm Absorption Area: 563 sq.ft.
f. TotalDepth: 11 feet (max.)
g. Effective Depth: 6 feet
h. Width: 2.5 feet
i. Minimum Length: 47 feet long
j. Effective Absmption An'em 564 sq.ft.
SURFACE WATER: There is no surface water within 100 feet of the proposed upgrade.
TOPOGRAPHY: The average topography in the area of the upgrade is mostly fiat; in short
there are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thatgc you for your
assistance. /(,/)
Jdl~fef,~ ~./~h'ness,"P.~E., M.S.
Presl/deflt (J
NOTE: Attached is a site plan drawing, a design drawing, a soils log, and a 4 page construction
specification letter which are all part of the design package for this septic system.
I TRACT B, EKVAI.L S/D
I NO WELLS WITHIN 100'
LOT 46, NE 1/4, I OF THE PROPOSED UPGRADE.
SEC, 22, T12N, R3W
NO WELLS WITHIN 100'
OF THE PROPOSED UPGRADE.
[
PROPOSED SEPTIC SYSTEM~ / I -~ ~' ~--
(SEE DESIGN, PAGE 2 OF 2) ~ >,,.~/
WHISPERING SPRUCE DRIVE , '~~- -~Z
NOTE: ALL PROPERTIES SHOWN C<+~ ~ / ~ ~X
ALASI~ WATER AND WASTEWATER CONSULTANTS, INC.
SKY RANCH ESTATES, LOT 10, BLOCK 1 -
PREPARED FOR: PHONE NUMBER:
MICHAEL A SHARON STEIN
269-5123/545-2754
~' ~FPROPOSED DRAINFIELD UPGRADE.
EXCAV~E 11 FEET DEEP MAXIMUM
/ BY 2.5 FEET WIDE BY 47 FEET LONG.
ADD 6 FEEl' OF CLEAN, WASHED .~- '-" -
J SEWER DRAINROCK, INSTALL TRENCH ~ ~
J PARALLEL TO SLOPE CONTOURS .... '
/
/
/ j' / ~ ~--EXlSTING SEPTIC T^NK TO
EXISTING TRENCH TO BE INSTALL DBL CO /' ~ /BE ABANDONED COMPLETELY ~_
/ ..... AND MT~ ~l ~]~[~ ~FCO
/ // / ...... 5. EXISTING '
/ ~ 3 BEDROOM
~ ~ HOUSE
/ //
/ EXISTIN¢
/ /
~ / 'i7~-~ CONT~CTOR S~LL HAVE THE NORTH AND WEST
ALAS~ WATER AND WAS~WATER CONS~TANTS, INC.
SKY RANCH ESTATES SUBDIVISION; LOT 10, BLOCK 1,
DESIGN FOR SEPTIC UPGRADE ,,,
MICHAEL & SHARON STEIN 269-5123/345-2754 -~95a .."
DATE:5/21/99// DroWN BY: SCALE: PAGE:
J.L.U. ~ : ~0' 2 OF 2
ALASIqak WATER & WASTEWATER CONSUI,TANTS~ INC.
6901 DEBARR ROAD. SUIYE 2~ * ~CHO~. ~K. 99504
I SOIL LOG - PERCOLATION TEST]
LEGAL DESCRIPTION: SKY RANCH ESTATES, LOT 10, BLOCK 1
~ . · ~ ............ ~...y
~ ~;J; :J SOIL C~SSIFICATIONS
2-- =~h-i,/~,,~ISlTESIZE ~&N] / ~ ~ -~-
r :~ ,~; /"
7--,/~,~: iI DEPTH TO DATE
~ ,> ~, ~ GROUNDWATE: /
8 -- T' ~'. ,,,, I DRY 5/7/99 ..... ~' ......... ~
7 ,v, ] 5/14/99 ~
9--', ~'":'] SM/SP DRY .-
~'~J,I SL~ SAND ..... ~.
10-- ~'¢;% :[ UNIFORM SAND.
;~ ~;,~,~.j: TIME (MINUTES) READING (INCHES)
'~ ~ 2 3:48 10
13 -- ~ 3 3:53 6"
~; J 6 4:14 10 3 5/8" 2 3/8"
15--i , ,,2' 7 4:16
~>~,' 8 4:26 10 3 1/2" 2 1/2"
1
6
~ "'"~ 9 4:27 6"
~l lO ~D -10 ~ ~2~" ...... ~ ~/2"
~7-- B.O.H.
19-- PERCOLATION RATE 4 (HIN./INC~ PERC. HOLE DIA. ~ (INCHES)
/ --
PERFOMED BY A~SKA WATER/ / ] ~~ , CERTI~ THAT
~ w,s=~w,T~, ~. ~
T~S W*S ~.~0.~ ~ ~CCO,~*~C~ W~=~ *~ ST*T~/*~ ~U~ ~U~=U~S ~ ~SCT O~ T,~S
DATE. DATE: ~/~/~)__~--
DEPTH TO DATE
GROUNDWATE~
DRY 5/7/99
DRY 5/14/99
NAME
MUNICIPALITY OF ANCHORAGE
DEPAR'FMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL DESCRIPTION
PHONE '7~ [~] NEW
/- /0 BI
DISTANCE TO: I Well
Liq' capacity in gall°nsI IF HOM~:M/~DE:
DISTANCE TO: [Well
Manufacturer
DISTANCE TO: Well I ~ /
No, of lines / _ j Length
Top of til0 to finish grade~ (
Width
Type of crib Crib diameter
LOCATION
DISTANCE TO:
Class
u/ut7' #
DISTANCE TO:
Absorption area
IInside length
OTHER
__ [Dwelling
I Foundation
Material
Nearest lot line
Total length o
Material bone tile
inches
inches
Crib depth
Total effective absorption area
PIPE MATERIALS
SOIL TEST
REMARKS
NO. OFBEDROOMS
PERMIT NO,
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO,
;MIT NO,
Well Building foundation Near0st lot line
Depth Driller Distance to lot line PERMIT NO.
Building foundation Sewer line Septic tank Absorption area(s)
DATE LEGAL
F'h-~tH [ 1 Nfl < , ~l ,.,cz,
I;:.:: I I'll I'1 II( li'lt~T:]f;: I F [':E[,I;3]CIPI'z:; :.: ~
-:, .:l:. Ot: 'IH[;; S(lll FIF?-:';C1F<F'T'[[IH !S;'r';~I-E]'I
lite LEHGIH (:,IPli~r,!f/,lOi, J IS; IHF t. EHLiTH <.[H FILl'f) OF' l!-IE 'IF:IZi',ICIJ OR [;'RFIiHF'IIEI.D.
'I-HE [)EP'IH OF ~ TRENCH OP. PiT IS; THE DISTFIHC:E DETNEEN THE SURFKJCE OF THE
GP. Cd. JHD 13HD THE E:OI'TOM OF TIlE E',~iC;t~YflTIOI-i (iN FEET)
FHERE IS bio S;l}:'F I,iID]'H FOR TI;~ENCHES,
'I lie GRFI',/E]. DEF'IH 1S THE M INIF1UH DEPTH JIF' Gg'.13VE[.. EUST'bIEEN THE OUTFBI..L PiPE
RN[) 'l HE E',(rI'I'OH Cfi:' 'I-HE; EXCRVf~F I ON ( H.J F'L:.ET;',
]l,::l,'lII FiF'F>t. IC~'INT HFr.:; THE F~f:ZC_,F'ONSIEIIL.['f,¥, -ICl ][HF'CIF'H IH1S
!STFiI. I.(CIIOH '[U:.'~;:'{r;TI('iH.% CIF FIH'-r' ,l.:l.l.'_,-~ £[,.I'Fp-I}{Ni' T'O THIS;
II,It~ER OF I-::I:-SI[:ffSI,IC:ES THFIT 'I'HE HE:LL HII_I.. SER'v'I~L
C'Ef::'FII;:I'f"IISi*?T [:,ljf;~ I i",!G THE
........ - ' f'---I "-' ;it": .-"" ;I] ", f:---; F' i"F{; C]: ' t" ;[ C) i".l LT.-~ !:::'g I%:.'-'* I~:- -:. I:';:':: f':~'-- C--.~ I_..I ]; F;': t'~.
ICI(F:'ILI..IHf;. OF' FIN~'r' SY'::q'I'LtH NI1HCIUT FIHFiI.. IH%F'EC:TION FIi",I[:, :IFFkljVIII_'"'- - BY THIS
J;'FH'('THE~NT I,!II I.. E'I~ '::--,I..IL',.TEL]:' ' .... TO
5L) lO 21bO F[::E:I- FRKirI_. FI FILjEq_IC PJIJ:[_I_ I)EPENDIH[~ LIPCIN THE 'I"T'PI~ OF F LIEI..ICJ ' HELL..
ttFf L.r. SF'fEF:IF[C:I)'TIC0.~:fi; FIN[:, C:()NS'I"f;:UC:TiOFI DiRGRf)P1S
(::[{lq:'1' I I-:~r'
i'tM F'hi"l [ L.. ! I:tli: i4 ~ '[ H TFIE
IF::TH t_:?¥' THE I'IIJhtiCIF'FILIT'¥' OF- I':tNCHORF/(iI~.
HILL IH::':Ti':d..L. THE S"r'S;TEI'I ]:H FtC:COI;',DFiNC:E- Fl.(TH 'r'HFJ CODE::::.
Ui',II)I:~F4Z'Ti-iND 'It.IFil' -FHE
:Si[')F~FIC:E ~HO[:,ISX_EC, TO INC:I_.I..II)[~ i"lOR[i~ 'I-HFIH ]~ f~;E[:'t';?.OCIi"IS,
............ ......... .....................
SEN;/:F.:S laHC, HEI_LS FLS; SET
IF THE
V~. 2
~.s(.
Performed For
Lepal
This
"OH~ ~e~ ~ ~OF~I~ ~ J~Oll~t;(~ O~J~Otl$" ~I:AFER ANCHORAGE ARRA BOROUGH
DSPT, OF ~NVI' O~MENIAL QUALITt
Glacio~ Excavating Date Performed 6-.~-7~
~escr~Dt~on: Lot.,,lO B]ock_1 _Subdivision Sk~ ,
rorm Renorts Soils LOQ,m. yes ' Percolation Test .~
Pegth
Feet
Soil Characteristics
Silty Sand SM
pipe
entrance to crib
Silty Sand SM ( 250 )
16
Bottom of Test Hole
Was Ground Water Encountered?
It Yes, At what Depth?_
Readinq
Percolatio
Proposed
Deoth of
Cnq!~ENTS:
Date Gross
Ti me
Net Time
Rate Hinute
Installation: Seepaae Pit yes Drain
Inlet Depth To Bottom Of
250 sq. ft. draina~e area req/bedroom
No bedrock br water table 4 ft. below seepage pit
Depth to H20 Net Dron
Field
Pit Or Trench
Test Performed By Jim Mack Data Certified B~' Const.
MUNICIPALITY OF ANCHORAGE
Development Services Department 4
p p ' ��� Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 015-302-15
Certificate of On -Site Systems Approval
Expiration Date:
Legal description SKY RANCH ESTATES #2 BLK 1 LT 10
Site address 5311 WHISPERING SPRUCE DR
Current property owner(s) STEIN MICHAEL E & SHARON LJOD)
11/15/24
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: � % Original Certificate Date:_ 10
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are * in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory X Arsenic Advisory
Other
I
COSA Approva"une 2022
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 015-302
Complete legal description SKY RANCH ESTATES #2 BLOCK 1, LOT 10
Location (site address) 5311 WHISPERING SPRUCE DRIVE, ANCHORAGE AK 99516
Current property owner(s) MICHAEL & SHARON STEIN 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 ❑ Plastid ❑ 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 $ S D Waiver Fee $
Date of Payment 1 fl �/ ?,�.{Z2� Date of Payment
COSA # 05c_23 r3 Waiver #
COSA Application.doc
COSA Checklist.docx
COSA Checklist
Legal Description: SKY RANCH ESTATES #2 BLOCK 1, LOT 10 Parcel ID: 015-302-15
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank 49”
Date of pumping 10/09/2023
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) 7/28/1999
ALL standpipes present per record drawing
Total measured depth from grade 10 ft (max)
Measured depth to pipe invert from grade 4 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 10/10/2023
Results Pass
Fluid depth prior to test 0 in
Water added 640 gal
New fluid depth 10 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate 450 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 72 in (MOA 6’ ED)
Effective depth used 0 in (Final Fluid Depth)
Effective depth remaining 72 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per visual observations, measured
shots & 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) - NA
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 *130 ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*ADEC ISSUED WAIVER LETTER DATED 07/23/1999.
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 10/20/23
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 &
10/20/23
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC231396
Subdivision: Sky Ranch Estates #2 Block:1, Lot: 10
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 $10,000 or more,
not including engineering, surveying or MOA permitting fees.
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.
CHAkN LINK FENCE—
Lot 9
JUMAR AVENUE
S 89'59'44" E 142'
SEPTIC PIPES SEPTIC PIPES
i[)
Ix
1 0
Ln
N Fz6w
DECK
W 42W
1 STORY
RESIDENCE
0 WITH DAY LIGHT
b BASEMENT
:fi�byC: 24.3'
DECK
S $9.59'44' E 130.31'
o L'..
0
10' UTILITY EASEMENT
Lot 10
17,751 s.f.
CHAIN LINK FENCE
49.5'
CANT
2.0' X 24.3'
WHISPERING SPRUCE DRIVE
RETAINING WALL
Ld
N
r
W
cp
0
0
b
0
..
Lot 11
—
PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW 2737 Project No. 23-551 Al
Lan& Associates n (� 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
g (907) 522-6476 Phone
Professional Land S u ry a ors kenOlangaurvey.com •+���OF ALkk
Y jonafhanOlangsurvey.com �.
I hereby certify that I have surveyed the following described property: rq.'• .1
LOT 10, BLOCK 1, SKY RANCH ESTATE 2 SUBDIVISION (PLAT 71-290) >k; 49 �Anchorage Recording District, Alaska, and that the Improvements situated thereon are / • • J�� • • • . • -
within the prop" lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible /
easements on said property except as indicated hereon. �� c.. KENNETH G�2LANG ,,Yo
Dated this the1 Day of �� �F9' • . •'S�Q��
, at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,\\�1
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
MUNICIPALITY OF ANCIBORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT GF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF J;:ALTtl &
825 L Street - Anchorage, Alaska 913501 ENVIRONMENTAL P~.O~ ECTION
ENVIRONMENTAL ENGINEERING DIVISION MAR 1 9 t979
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten H0) days for processing,
I, PROPERTY OWNER
MAILING ADDRESS
P~OPERTY RESIDENT ( f different from abow) ~" - '
PHONE
~ BUYER
MAILING ADDRESS
3, LENDING INSTITUTION
VlA LING ADr)RESS
4. R LA,TO R/AG E NT
MAI LING ADDR ESS
PHONE
~* LEG.~J- DESCRIPTION
STREET LO~"ATIO N
~. TYPI-' OF RESIDENCE NUMBER OF BEDROOMS
_-] One _-] Four
j~] SINGLE FAMILY -] Two [] Eive
[] MULTIPt. E FAMILY G~' Three [-- "'
Other
7, WATER SUPPLY
[] INDIVIDUAL'
COMMUNITY
PUBLIC IJTI LITY
ATTACH WELL LOG, A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available,)
~'~, SEWAGE DISPOSAL SYSTEM ~' INDIVIDUAL ON-SITE~
[] PUBLIC UTILITY
'"If individual/on-site, give installation date__//.._..,-"l~ ..
If system is over two (2) veers old an adeduae'~ zest is required
Dy this Department,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
'~2-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSP ECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2. WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[~]PU BLIC UTILITY
Connection Verified INSTALLER ~1~_~..~ D
[]Septic Tank or [] Holding Tank
Size: l~)~,,.~ If Tank is homemade SOILS RATING -..
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
[~]"~CON DITIONA L APPROVAL (letter must accorr ificate) ~ (:~"~ ([
~ DISAP?ROVED 2(..J
LEGAL DI~SCRIPTION
72-010 (Rev, 3/78)