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HomeMy WebLinkAboutGREAT LAND ESTATES #3 BLK 4 LT 6at Land states lock 4 Lot 6 051 - 133 -20 MUMCIPAUTY OF ANCHORAGE 0n-S4e Dater& Wastewater Program a PO BcLw 196650 4700 Elmore RDpd Anchmp. Alo*R 9951 M650 Phone: (007) ,343-7004 Fax; (907) 343-7997 htlpAvww.munl.prgr3ruciq@ On -Site Wastewater Disposal System Permit PeernitNunnber OSP211437 Effective Date: 1011$2021 Work Type. Septic Initial Exp1ratlon fate: 1000;2022 Tax Code Number: 051 13320000 ;site Legal Add res$; GRIEAT LAND ESTATES #3 BLK 4 LT 6 G:1260 Site Mailing Address; 19830 UPPER GREATLAND DR, Chugiak Owner: JONES IVIF-GAN & ZACHARY Lot Six* in Sq rt: 95396 nesign Engineer: FIRST WA7ER CONSULTING Total Bad moms, 1 This permit is for the ca nstrucfian of - 0 IDisposal Field 0 Septic -ark ❑ Holding 7a nk ❑ Privy ❑ Private Well ❑ Water storage AIJ constru etilon sha I I be i n accordance wl the 1. The attached approv desigr)_ 2. All requirements specified in Anchorage Municipal code Chapters 15,85 and 15,85 and the State of Alaska astewaler Disposal Regulations (1WC72) and Finking Water Regiulatlans (1$AAC;80) 3_ The wastewaler oode requires inspeotiQns during the installation. The engineer skull notify the Development Services DeparImenl per AMC 15.65. Provide notlfioalion by calling (907) 343-7904 (24/7). 4, From October 15 to April 15, a subsurface soil` absuTWn system Under construction during freazing weather shell be either- a. ithera. Opened and Closed on the same day, or b. Covered, sealed, a n d h eated to prevent froezi ng Received By., Issued By: 1 011 81202 1 Dale' Date: IT ti orn rnrn rti 00 rnrn c � O LL LL 00❑❑❑❑ H J Q� m V U E � Z � L Q � � N Z U � /a)� C,6v/ L 0 E3: Q O � > C/) 00 z O Q _U J f'– LL LLQ M J J LU LU U) LU Z O C) MN C) C`7 LO 0 7A a) U cu Fi7 ti CO LCA d7 07 c Q 0 cu sZ Q j U L1J CO p Z 0 O Z � J Q U (D N Of N LLI 06 0- z a - Q D O L1J CMy) w O L Cn c En 0 -0 CO 0) Q O Ocu d LO m O7 Y Q U D U LU Q Q W OfU LLI M a - D O M TOT VJ vl ° .O M m Cn CD d' m C7 U E O O LJJ) Z 0 Q Q 12� w ° z a U) 06 J a) cts U , O Q LL m C!J .i] O O U H 0 0 rn Q CL LO U) U m a) m N cts ca Cn J 0 J 6 z J W cl LL 0 LU a H Q U) Z _O H Q U_ J a a a El ❑ ❑ LL U^ E Q m 0 LL a) c �n 0 ❑ ❑ a) cu D ry w 00❑❑❑❑ L m cn a a) U Z LL Y a) cu " C o c caI-- CCS o Q� Q LU C � CO L U ® O U) a >, > ca > a) ca C a Q 0 0 0 Z, 12 ca rn m CD U CD U) aa) E 0_ 0 am a) 0 Mr m U C= ca O U U ca C a) L a) cu to E E C6 O Z O LL n- Z 0 L O ON Q L > a) >> > Q' CU m U (B a) L a] ON U 7 T ° m N M a 0 ►` E 0 Z N _ m 0 c o >— iZ Q cn a)a) U O LL E _a Q E �. o O 0.. Z o Z c 0 0 o Q y U Ucu a)_ 0 6- 0 0) d 0 C U CL — m 0 0 0 Z, 12 ca rn m CD U CD U) aa) E 0_ 0 am a) 0 Mr 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com October 8, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: NEW SEPTIC SYSTEM PERMIT – 1BR ADU LEGAL: GREAT LAND ESTATES #3 BLOCK 4, LOT 6 The property owner has requested we obtain a new septic permit for the above referenced lot. We propose to install one shallow trench and 1000-gallon tank to serve the proposed 1-bedroom ADU residence. The design is based on the attached test holes conducted in September, 2021. The structure will be served by the existing well. The slopes are moderate at 5-10% at the proposed field location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211437, Deb Wockenfuss, 10/18/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211437, Deb Wockenfuss, 10/18/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211437, Deb Wockenfuss, 10/18/21 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : GREAT LAND EST. #3 B4, L6 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10/8/21 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 GM/gp 7 8 9 10 11 12 13 14 BOH 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 9/27/21 10 min 6” 5 4/16” “ 6” 5 3/16” “ 6” 5 2/16” “ 6” 5 1/16” “ 6” 5 1/16” “ 6” 5 1/16” PERCOLATION RATE 2 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 10/7/2021 TESTHOLE # 21-1 DATE PERFORMED: 9/27/2021 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: MEGAN & ZACH JONES 10/8/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211437, Deb Wockenfuss, 10/18/21 g ULJ n M U u U Z�6�[ (Rev 05/02/18) Municipality of Anchorage 17 N 2 8 2021 90 On -Site Water and Wastewater Section • (907) 343-7 4 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201352 PID Number: 051-133-20 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name VERNON T. FERRELL ABSORPTION FIELD -EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 19830 UPPER GREATLAND DRIVE, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Fill added above original grade Ft. Gravel length Ft. GREAT LAND EST. #3 4 6 Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ -- 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ -- Material HDPE Number of compartments 2 Lot Line 10'+ -- NA Foundation *8'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks *Tank insulated & installed 5'+ to field & outside foundation soil bearing prism. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 drainfield Tank to 3034 Installer JRS Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 1M 10/21/2020 nd 10/22/20 Location and description dates: 2 3'd 4'" BOTTOM OF SIDING ON-SITE WATER AND WASTEWATER SECTION APPROVAL of •AC:4>>ll • Conditional Approval: Date ��Q.�-• • •�,� �� TH • •. .... • • • ...... . Curtis Huffman ��� �'F��•,_ CE 128991 •.•�c��/� 0� s�F�• Septic Syste Approved - Date 2 5 ,20.2 . ,1/28/21 . •����.� ,k FOPROFESSION�s ,\����11� Note: this approval does not include well permit requirements. (Rev 05/02/18) PID: 051-133-20 PERMIT: OSP201352 O O� P01 Z� G � SCALE: 1' = 30 A—C=34,5' B—C=12,4' A—D=35.3' B—D=15,4' A—E=33,7' B—E=15,3' PAVED (1.1 D/W (r� 35.9 X N Y, CONC 35.0' +� 1.3' CANT / G 100' WELL � RADIUSS X � H N c0 GAZEBO + DCO CO k\kms SUMP �+`�� �- X X FCO61H CO f DCO JLS DRAWN: // 98.41 SCALE: fFlNAL GRADE 94.72 INSUL 94.14 1,000 -GALLON 3.97 HDPE TANK EXISTING FIELD TANK IS OUTSIDE OF SOIL BEARING PRISM SEPTIC SECTION SCALE, NTS GREAT LAND ESTATES #3 134, L6 PREPARED FOR: VERNON T FERRELL 19830 UPPER GREATLAND DRIVE CHUGIAK, AK 99567 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 firstwaterAK@gmail.com SUPPORT® SERVICE �wcs 4�z� DATE: 1/27/2021 SURVEY: JLS DRAWN: FWCS SCALE: 1" = 30' * 9 TH rtis Huffmani CE 128991 4' 1/27/2021 mssio'0 AV MUNCCIPALITY OF ANCHORAGE Ori -Site dater & Wastewater Program RO Sox 19655D 4700 Elmom Rbad ArK%or e, A185ka X5515.6650 NOW,,: (907) 343-7904 Fax: (907) 343-7997 tmpJAwiw.muni .gr9f4)nslte On -Site Wastewater ater Disposal System Permit Permit Number: O P201352 Work Type: SepttcTank Upgrade Tax Cede Dumber: 05113320DOO Site Legal Aridness. GREAT LAND ESTATES 43 BILK 4 LT o :126{. Sfte MaMny Address: 1983-0 UPPER GREATLAND DR. Chugiak Owner: FERRELL VERN-0N T Design Engineer: FIRST WATERCOhlSULTING This permit is for the construction of: Ef octnra Rate, Expiration Date Lot Size ir1 :5q Ft: Total Bedrooms - 4ritienr t� r. 1 �t��}�irimriiS 9122f2-020 512021 El Disposal Field CM Septic Tank ❑ Holding Tank ❑ Privy ❑ Private W01 ❑ dater Storage All construction shall be in accordance with: 1_ The attached 8pproved design_ 2. All req uiramenis specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (16AAC72) and Drinking Water Regulations (1 SAAC80) 3. The wa�tewatercode requires inspections during the installation. The engine-ershali notify Ilse Development Services Dapertm+enf per AMC 15.65. Provide notrFcaticn by call 1% (907) 3434904 42417). 4- From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the sarne day, or b. Covered, healed, and heated to prevent freezing Recelved By: Date: Issued By: Date 9!2212020 9 zz 3 LIM HMPAL0TVMJF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051-133-20 �_` HCH O R GE ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) VERNON FERRELL Day phone 9076880058 Mailinq address 19830 UPPER GREATLAND DRIVE, CHUGIAK, AK 99567 Site address 19830 UPPER GREATLAND DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) GREAT LAND EST. #3 134, L6 Legal description (Township, Range & Section) Lot Size 95396 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: f 16.75 Date of Payment: �� I � 9 Id 0A0 Receipt Number: 102 a 5 l Permit No. 05 Pa, C' I ^'�5:z Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350 -9566 / firstwaterAK@gmail.com August 31 , 2020 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: GREAT LAND ESTATES #3 BLOCK 4, LOT 6 PHYSICAL: 19830 UPPER GREATLAND DRIVE, CHUGIAK, AK 99567 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank outside any deck supports to serve the existing 3-bedroom residence. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201352, Deb Wockenfuss, 09/22/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201352, Deb Wockenfuss, 09/22/20  ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT 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 IP.H°NE. J¢,4~ EW ~ ~ Manufacturer 0 ~ ~ Manufacturer Material Liquid caOacitg in ~allons ~ DISTANCE TO: Length~ ~ / Total~g~f li~es .~ Distance be~ ~ Top of tHe to finish grade ~ ~ Mater,albeneat~tile ~O" Total effective ab~/ption area ~ i~hes Length Width Depth  ! Type of crib Crib diameter ib Total effective absor~8~ ~ / ' ' ENVirONMENTAL p~OTEC~ ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ CJass~~ Dept. ~' ~ ~ ~ /-Driller4 Distance to lot line U ~RMI~' ~ ~ DISTANCE TO'. Building foundation Sewer line Septic tank~%~' ~ ~--~ ~ '~' OTHER ~.~ PIPE MATERIALS INSTALLER ' REMARKS 4~ % / ',~:... ...'~ ~u~ 'iD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 © 0 ~,-,'~ !t_.~ th,,~ ][ ir'.]: % IF=.' ,::~ IL_ :[ T' %'" E_"3 IF' f~ Pd ~,. tr. E~ 1~, ,¢~ E~ F~Z E q ¢IRO, ,,%=NTAL F'ROTECT l ON DEPARTMENT OF HEALTH AND ' ~ ' ~/' ~' 825 L, ~TRE,~:F~ A,qCHGRAGE~ At< 9~501 264-47,20 PERM I T NO: DATE ISSUED: 08/21/84 AF'PL ICANT: ADI)RESS: CONTACT F:'I"~,ONE: C/O S & S ENG'G. PAUL BERGERON SRB :[96X 'EAGLE RIVER, AK 99577 694.--2979 GRAVEl_. WIDTH (FT.) GRAVEL L. ENGTH (FT.) GRAVEL. VOLUME (CU.YDS.) TANK SIZE (GALS) SOIL.RA]"ING (SQ. FT. /BR) LEGAL DESCRIP: SUBDIVISION: GREATLAND ESTATES ¢3 LOT: 6 BLOCK: SECTION: :[0 T()WNSHIP: :[5N RANGE: 1W LO]' SIZE: 4000() (SQ.FT. OR ACRES) MAX BEDROOMS: 3 L. isted' below ape the options available to you in designing your septic, system. Choose '[.he op{ion that bes~: ¢its youp site,, ~- DEPTH 'TO PIPE BOTTOM (FT.) //4.0 , ' 6.5 4.0 CRA~EL DEl Tll (, T.; / 5..~ ~ .... J ...:,..~ I"OTAL DEF'TH (FT.) / 9.0- 7,0 7.5 2.5 14.0 5.0 33.() / ?~8.0 41.0  :[6.8 / 14 5 :[2 5 1,000.0 ,A'~'.~ 1, ¢~6~q...._. ('~., ~..~ 1,000.0 .~ 2:[07 85 :[25 ~ . ~ TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certiCy tlnat: I am {amiliap ~,i{h the requirements for on-site seweps and (,~eils as set ¢or{h by the Mun:[cipa].ity o¢ Anchorage (MOA) and the State of Alaska. 2, I will ins{all the system in accopdance wit. h ali MOA c:~des and regulations, and in compliance with the design cpitepia o¢ this penmit. 3. I will adhere to ali MOA and State <~¢ Alaska requirements for the set. back distapces from a. ny existing well~ ~.~aste~ater dzsposa], syst. em or pubIic sewerage system on this or. any adjacent or nearby lot.. 4. I understand that this permit is valid ~op a maximum o¢ 3 bedrooms arid any enlargement will requipe an additional pepmit.. · IF A LIFT STATION IS If'~STALLED IN AN AREA COVERED BY MOA BUILDING CODES.~ THEN (1)' AN ELECTRICAL F'ERIdlT AND INSF'ECTION MUST BE OBTAINED[i (2) AS"H'BU:[I_TS WILL NOT BE APPROVED WI]]'"lOUT AN ELECTRICAL .[,I,:,'"I:.CTtO,~, REF'ORT; AND (3) THE 'ELECTRICAL WORK MUST BE: DONE BY A LICENSED ELECTRICIAN. APPLICANT: C/O S.& S ENG'G. F'AUL ]:SSUED BY ~.~_._~~ ~ ...................................................... DATE: PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 12'- ~3 14 ~7 18- 20- COMMENTS PERFORMED BY: 72-008 (6/79) L/ [,,,.~./2 ,~ SOILS LOG MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE SITE PLAN ' / ~ ~.~ ~ :~ '-F~ IF YES, AT WHAT E DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) FT AND -- FT DATE: M UMCWAUTY OF AmCHORAGE 0 1, r � Development Services Department 7 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-133-20 Expiration Date: 1. GENERAL INFORMATION Complete legal description GREAT LAND ESTATES #3 BLOCK 4, LOT 6 Location (site address) 19830 UPPER GREATLAND DRIVE, CHUGIAK, AK 99567 Current property owner(s) VERNON T. FERRELL Mailing address Real estate agent Day phone 19830 UPPER GREATLAND DRIVE, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment " 2(-1-2-1 Receipt Number s y 2 6 tl COSA# 0SC211),9O Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907.350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/22/2021 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 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 & rWCS DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved t oeA Aw 4\��11 *:.49 TM ....�:* Curtis Huffman CE 128991 PROFEWO Conditional approval for bedrooms, with the following stipulations: Bv: / 1 ./`^ \ky`Y �V OF f Ak4,6/ AIVn/ice 70 )dNIATER AND �o WASTsv`:!ATER 01 FNT SERU\NI G`,\. Original Certificate Date: 2-'Z 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. �:tiar_Ty:i►y,i:4 iIK&I COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® 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' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft ft ft ft rti From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft 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) 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' ® Yes if No —ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review .Asp',t`Q•: •' • • • •�i���� of Municipal records that the above systems are in conformance is g ' •:� with MOA COSA guidelines in effect on this date. TH ......... .. .... ....�..�... 1I • . Curtis Huffman ��� ��� •. CE 128991 .•���,� PROFESSIONP�ti-®'�.� Legal Description: GREAT LAND ESTATES #3 BLOCK 4 LOT 6 Parcel ID: 051-133-20 If more than 1 septic system on lot: COSA Checklist # of _ Structure served by this system _ A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8/28/1984 Total depth 143 ft Cased to 42 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/26/2021 Static water level at beginning of test 46 ft. Well production at time of test 0.74 gpm Comments B. TANK DATA Age of tank(s) NA — NEW TANK years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping NA D. ABSORPTION FIELD DATA Which system tested (date installed) 10/1984 ® ALL standpipes present per record drawing Total measured depth from grade 8_5 ft (max) Measured depth to pipe invert from grade 4.6 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 3.9' OF THE 5' ED Water storage tank volume 100 gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 4.3 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) FWE Collected by Date of Sample 5/7/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Adequacy test date 9/17/2021 Results Z Pass For 3 bedrooms Fluid depth prior to test 38 in Water added 500 gal New depth 46 in (AT FIELD INVERT) Elapsed time 120 min ® Code -required soil cover over field Final fluid depth 38 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: FIELD WAS OPERATING IN THE TOP 1' OF THE 5' EFFECTIVE DEPTH F Municipality of Anchorage :....:.:._4, Development Services Department ::_ Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC211270 During a recent COSA on-site inspection and test of the potable water supply well on Block 4, Lot 6 of Great Land Estates #3 subdivision, the well's productivity was determined to be .74 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 ~ www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-133-20 COSA# (~C i i I 0~:) Expiration Date: .~- / [- /f GENERAL INFORMATION Complete legal description Great Land Estates No. 3, Block 4, Lot 6 Location (site address) 19830 Upper Greatland Drive Chugiak, AK 9956 Current Property owner(s) Sandra Ann Brooks Mailing address HCRI Box 5490 Kaloli 28th Keaau, HI 96749 Lending agency Day phone Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise ~equested, COSA will be held by DSD for pickup. 2;' NuMBEROF '': BEE~:RooMs: Three (3) 3. ~YPE:OFW~TER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual HOlding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems 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. (Certificates may be reissued for a period of uP to one year with valid water samples.) 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. 4. 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 vedfy 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name DSD SIGNATURE V/"' Approved for Disapproved. Michael E. Anderson, P.E. bedrooms. Date 2/8/2011 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory X Nitrate Advisory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ~"'~ ;~0-¢~ Original Certificate Date: ~ -/ /~ // Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS'APPROVAL CHECKLIST Lot 6, Block 4, Great Land Estates Subdivision No. 3 Parcel ID: 051-133-20 Legal Description: A. WELL DATA Well type Private IfA, B, or C provide PWSID # Well Log (Y/N) Date completed 8/28/84 Sanitary seal (Y/N) Y Wires propedy protected (Y/N) Total depth 143 ft. Cased to 42 fl:. Casing height (above ground) __ FROM WELL LOG AT INSPECTION Date of test 8/28/84 2/5/2011 Static water level 45 ft. 48.5 ft. Well production 1.0 g.p.m. .51 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 4.55 mg/L Other bacteda 0 colonies/100 mL Arsenic'.- N/D mg/I Date of sample: 1/25/11 Collected by: A. Harela 14 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tanksize 1,oo0 gal. Date installed lo/1/~ee~ 1~/~5~ Number of Compartments TWo Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Date of pumping 7/15/10 ABSORPTION FIELD DATA Date installed 10/84 Length 33 ft. Total depth 10 ft. Depression over tank (Y/N) N High water alarm (Y/N) N Pumper JRs Pumping Soil rating (g.p.d./ft~ or ft2/bdrm) 109 SF/BDRM Width ~ ~-' ft. Eft. absorption area 330 ft2 Monitoring tube Date of adequacy test 2/5/2011 Results (Pass/Fail) Pass Fluid depth in absorption field before test 0 in. Water added 472 gal. New depth Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 450 Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date System type Deep Trench Gravel below pipe 5 Y Depression over field For 3 bedrooms 0 Y in. in. g.p.d. LIFT STATION Date installed "Pump on" level at Datum. in. Size in gallons "Pump o~ level at Cycles tested in. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main N/A Sewer/septic service line >25' Animal containment areas >50' On adjacent lots >1o0' On adjacent lots >1oo' Public sewer manhole/cleanoUt Holding tank N/A Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field Water main N/A Water service line >1o' Surface water NIA >100' >5' >100' Wells on adjacent lots >1oo' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >1o' Building foundation >1o' Water main >1o' Water Service line >1o' Surface water >1oo' Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >1oo' >25' F. COMMENTS: G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines-in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 2/9/2011 COSAFee $ /-~.~ "'"", Date of Payment Waiver Fee $ Date of Payment. Receipt Number (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On-Site Systems Approval (COSA) # 111033 During a recent COSA on-site inspection and test of the potable water supply well on Block 4, Lot 6 of Great Land Estates #3 subdivision, the well's productivity was determined to be 0.51 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3-bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SG, S ........... SGS Ref.# 1110272001 Client Name Anderson Engineering Printed Date/Time 02/03/2011 8:39 Project Name/# Great Land Ests Sub L6,B4 Collected Date/Time 01/25/2011 12:10 Client Sample ID Kitchen Sink Faucet PrivateWel Received Date/Time 01/25/2011 16:37 Matrix Drinking Water Technical Director Stephen C. Erie Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 01/27/11 02/01/11 NRB Waters Department Total Nitrate/Nitrite-N 4.55 0.100 mgFL SM20 4500NO3-F B (<10) 02/02/11 AYC Microbiology Laboratory E. Coli Negative 1 100mL SM20 9223B A 01/25/11 SDP Total Coliform Negative 1 100mL SM20 9223B A 01/25/11 SDP HOUSE DETAIL 10T 5 CABIN DETAIL UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABIUTY ONLY FOR THe COST OF THe SURVEY. LISTED DISTANCES PREVAIL OVER SCAUNG. REPRODUCTION MAY CAUSE ERRORS IN SCALE. [] LOT SURVEY SURVEY TYPE SYMBOLS [] FOUNDATION A~BUILT [] FINAL S"I~UCTIJRE AS--BUILT ' SET REBAR ~ ~I~ DRAINAGE ~ ASPHALT [] PlOt Plan... AS-BUILT... LOT SUR~... TOPO~APHY O FOUND REBAR ~ ~ WOOD FENCE ~ CONCRETE [] A~BUILt... NO CORNERS SET [] ReCERTIRCATION AS-BUILT... NO CORNERS s~-r ~ ASSUMED EifV. × × × METAL FENCE ~ WOOD DECK PLOt PLANS & 10t SURVEYS NOTE: it iS the RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONlY THOSE IMPROVEMENTS ABOVE GROUND AND ViSible WILl BE CONSTRUCTION, TO VERIFY PROPOSEd BUILDING GRADE RELATIVE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UtilitY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN Their APPROXIMate LOCATION, ONLY. SNOW The EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS fROM BEING SEEN AND Located. WhiCh DO NOt APPEar ON the rECOrDEd SUBDIVISION PLat. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. survey CERtIFICaTION _~l~m. P re ~ o red b y kno~edge and abilities. ~1 dlmm~ h~e be~n ~;~£ 49th Scale: Eec. Lot S.F. Rec, Pier File No. fo~.0^~o. AS-BU,'T ..... ~ .................................... : ..... ~ 1" = 100' h~ ~m~..*d ~. ~*-Suat ~y of the ~ ................................................~11~ Date Surveyed: Drawn b~. Checked bL._~A~ dlmmaleaaf~JndutI~ o~ ~l lot .d ~t ~11 t~e~nd Inform<irish ~ ~m~ h~r~ ~. :: ROBERT E. JOHNS, JR. ." ~ 01/21/11 REJovv L ~ '.. 4121-S ... ~.~ 01/24/11 260 11-15 FINALi. Rd~.rtSTRUCTUREF_ ~*~n~ ~r, h.r~yAS-BUILTc~ th*t i ~ ~'e °°°°o° ,,~** ~,~ Legal Description: '~"-th"'of ~"--" ~. GREAT LAND. ESTATES #3 ~/" MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL ~EALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE General information Application Date (a) Legal Des. cription~(i~clude ~ot, blgc~, su~divis~ign, sectigp, township, range) (b) Applicants Na,~ ~fr}~_~/O ~ /T~elephone- '~Hf~-- ~lB~C~us'~nesS Applicants Address zz~ dc~ ' /0 ~ ?/Y /~ (¢) Applicant is (check~ one~) Lending Institution ~--~ ; ~er/builder ~; Buyer ~ ; Other ~ (~plain); " ' (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address (f) Telep~.~e %~1 ~he HAA to the following address: 2. Type of Residence Single-Family~. Number of Bedrooms Be Multi-Family ~--~ Other (describe) Water Supply Individual Well~ Community~-~ Publtc~--~ Note:~ If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Sewage Disposal 0nslte~ Public ~-~ Community ~-~ Holding Tank ~-~ Note: If community Well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providin8 Inspections~ Tests~ File Search~ Data and Information 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 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 w~ter supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone Address 8 ~ ~ EN{~I[qE~81~G~ DHEP Approval A roved fo~ ~ ~ bedroom Approved ~ Disapproved __ Condition~ Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES WEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP 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. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 . A. Total Depth / ~ Cased to Static Water Level ~O'~ / Casing Height Above Ground ~/~ Electrical Wiring in Conduit/~ Separation Distances f~cm WeIl: · ' "~--" DEPT. OF HE,L, LT~.i '~-~MUNICIPALITY OF ANCHORAGE (MOA) ENVUiON;,?,ENTAL Pf:CT~'CilOhl HEALTH AUTHORITY APPROVAL (HAA) NOV 2 i 1.984 CHECKLIST - FEBRU~RY 1984 If A, B, c~ C, D.E.C; Approved(Y/N) ~Z ' De~h of G~outing Pum~ SetAt ~ ~( Sanitary Seal on Casing Eep~ession A~ound Wellhead TO Septic/~ Tank on Lot /~ ~ ; On Adjoining Lots To Nearest Edge of abs°~gtion Field on Lot/~ / ; On Adjoining Lots TO Nearest Public Sewer Line /~/~3~ To Nearest Public Sewer Cleanout/Manhole /3//~ To Nearest Sewe~ Service Line on LOt Wate~ Sample Collected By ~ ~F~///~;e~//~? ,; Date /<//~/~ ~ C~ents SEPTIC/HOLDING TANK DATA Date Installed /d~/~//~ ~' Size /~ No. of Co~¥artments Foundation Standpipes~) ~ Ai~-tight Caps~Y~N) Cleanou~~/~) Depression over Tank-(~ Date Last~//~_P.umped ' /~J~~ Pumping/Maintenance Contract on File (Y/N~ ; for /~3 HOlding Tank High-Water Alarm (Y/N) /~ Temporary Holding Tank Permit (Y/N')~3~ Separation Distances frcm Septic/Holding Tank: / To Water-Supply Well / ~ 3 / To Building Foundation To Property Line //L9 r/-- ~ / To Disposal Field To Water M~[iu~TService Line ~ ~ ~- ? To Stream, Pond, Lake, c~ Major D~ainage Course /~'~ © ~ ~ Con,~ents /%JO ~J -~ Receipt Date Paid: Amount: [Page 1 of 2] 2-15-84 Soils Rating in Absorption, Strata Date .Installed /~)/~_/~ Width of Field ~ ~ Square Feet of Absorption A~ea Depression over Field Results of Last Adequacy Test Separation Distance f~m Absc~Dtion Field: To ~ater-Supply Well //~ ~ / To P~operty Line /~)~/ Type of System Design Length of Field ~ 3 / Depth of, Field 7 ' zGravel Bed Thickness ~o ~ Date of Last Adequacy Test /~ ~ ~-~ To Existing or Abandoned System cn TO Building Foundation Lot '/'J .//~- ; On Adjoining Lots To Water ~a{~n/Service Line ~ ~ To Cutbank( if present) To St~eam/Pond/Lake/c~ Major D~ainage Course To D~iveway, Pa~king A~ea, o~ Vehicle Stc~age A~ea ~-o D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Ala_~m Level at Tested for Elect2zical Codes(Y/N) Dimensions ~'Pump~ Level at Vent _(Y/N) Pumping Cycles du~ing Adequacy Test. ~ets MOA Co~nts Check Permitted Bedroom Rating AGainst HAA Request I certify that I have checked, verified, or conform_~d to all MOA HAA Guidelines in effect on the date of this inspection.. Signed S~ ~{~m{ · . ..... Company , ~,'- ~,!.~: ~!~.~j?9 MOA No. KB1/dS/s [Pa~ 2 of 2] 2-15-84