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HomeMy WebLinkAboutLEOS LT 9Onsite File � zH -„s +yu, 5%,Astem reported f 22) 0 I s Lot 051 - 053 -35 Municipality of Anchorage ~:~ ~,," Development SerVices Oepadment Building Safety Division On.Site Water and Wastewater Program. 4700 S. Brag'aw P.O. Box 196650 Anchorage. AK 99519-6650 Page I .of~ www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~]_/,,_~,~Q q PIgNumber: O.~[--(~'~'-~' ~-'~5-1 t~,~,.~.s<¢,~ 9,~,ef E,~/dOu~,-,/~ff q~.¢'77 ABSORPTION FIELD LEGAL DESCRIPTION '~ Ra""' Town~t~ip: Range: ,~ec~on: I~11 added alx~ ~nal ~rad~: Numl~'r I~e~: Di.~an~ce bebeeen line,J: ', SEPARATION DISTANCES ~sepac I-I Holding I-I S.T.E.P. [] Other:. TFmm~~ Septic Absoq~on Uti Holding ,ubllctl:'rivate ~ p/fl.~~ C~i:~. Tank Field Slation Tank Sewer Une P/~'~. ~ F t~_~ ~ C~. ~-',. I0~' 105' ~ ~5'.,~-, H~P~ "'"~': BENCH MARK '"" I Inspections performed oy:_ . ,~,,.,,~,,.~,.,,.~. ~.... 2.,lO... b.,O"5 ~..g¢:~-.,~..-~.~'~..': Development Services Department Approval PERMIT NO. SW030394 ON-SITE PAGE 2 OF 3 DEPARTMENT OF AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e.~Anchoroge, Ataskc~ 99519-6650·Telephone, 343-4744 WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 9, LEOS S/D P.I.D. NO. 051--055-35 LOT 3 BBL1 A BBL2~TMT ~CO1 MT1 ~TH M~2~ ~ HDPE SEPTIC TANK ~/ FFCO LOT/3 ~.,:~o.o, ~/B ~ ~c**, / 3 BEDROOM ~ HOUSE I ~ ~ ~ ~.~oPos~ _,oo' w~ ~,~,u~ ~ ~ ~ o ~ /.~. ~~~. / ~ / ~ NO..SW030.39 4 Ivlunicip. ati'tv oF Anchor'o, cie DEPARTMENT OF HEALTH AND HUI"'TAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.B. Box 196650 ®Anchor'c~ge, Atc~$ko 99519-6650·Tetephone, 343-,4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECA~. LOT 9, LEOS S/D P.I.D. NO. 051 --05,3--35 ST1 ST2 /-99.8' '95.6~5.5, COl=100.0' =101.0' FINAL GRADEJ : ~ ' : I[t_~. ~ C01=95,5' MT1 =88,5'~ MT2=90.0'~- · NO WATER FOUND ~ ~'~ ~ "" 82.5' B.0.H A B FCO 2,5' 44,0' ST1 `3`3,5' 61,0' ST2 `36,5' 63,5' TMT `39,0' 66,0' DBL1 `39,5' 65,5' DBL2 40,0' 65,0' C01 47,0' 72,0' MT1 45,0' 68,5' M7"2 61,5' 44.5' ¢02 63,5' 46.0' nOl]En r c. COWAN. P.E. no~Enr A. St lAP-Eh, P.E. CIVIL ENGIHEErlS Date: (go7) 694-297g FAX(gO'/) 694-121 t It~PECIIOIq N~O rEr,onts w~LLlt~s~clloN & PLOW 1 EST st~El~L/J~ bE~A~T~ENT OF IIE~-~T~t A~D tiui~ sE~vzc~s p,o, ~ox ib6650 n~l~ho~age~ Alaaka 995~9-6650 Tile aepbi~ i~specbiolm for .~he _re[erenced property, w.ere nerfokmed o, l~-'/q2~ and /0-~-0~ Prior ~o submitting [iie O,-S~e wa'~a~r. D[spo~i ~a~dZo~ Well Repork we a~e wat'king ~or the ~,~ue~ to be comple~ed~ If we may be of further Service please contact us. S~hce~eiy, Rober~ C ~ dowatt, P,E. 'r t zo34 Honill EAeLE hivEn LoOp ~ sUitE 204 ~ EAOLE raven. ALASKA 995~z 4/22/2004 Municipality of Anchorage Mark Begich, Magor Building Safety Division P.O. Box 196650 • 4700 Bragavv Street Anchorage, Alaska 99519-6650 • (907) 343-8301 • Fax (907) 343-8200 h ttp: //��rnnv. m uni . org Bob Cowan S&S Engineering 17034 Eagle River Loop Rd Eagle River, Alaska 99577 Subject: Waiver Request for Leo's S/D Lot 9 Waiver Request #WR040019 Parcel ID #051-053-35 HA#040155 Dear Bob Cowan: �f 8L Q.P i p C � G 2 Your request for a waiver of the required 5 feet horizontal separation from the septic tank to property line has been approved. The approved separation distance is 4.0 feet. This waiver approval applies to the existing septic tank to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, 11 reGoodall Civil Engineer On -Site Water & Wastewater Program S LD *C D1 0.88i -h 0r) , Thr Ir2A,ueSk -For e, w a" -p -A o n,\ ol�sor Pro ?Qr_ CL_ , r 0 \1 9 4 , ,,/�A�nn dS-Vt;v\,CQL �r i ma.Vrv� SJ -+- rz��oSec1 Y eS�r V e c►X-� �� cgau 5/12-1,21 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.ci.anchorage.ak.us (907)343-7904 WR#:4la 0019 PID#:051-053-35 Date Received: 513/04 Legal Description: Leo's S/D Lot 9 Engineer: S&S Engineering Waiver Review Worksheet HA#:040155 Permit#: Applicant: Dennis Winter Waiver Requested: 4 foot t lot line waiver av'\ d Criteria: Geology 5 �o4 cel-� �;el� a -o lob I�v�e t.3�v�n. nnnn Points: 5j t.j 2,A A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ............................................................................... Waiver is Granted: Waiver is not Granted. List Conditions or Reasons for above: Date: 5 o By: Name of Reviewer ............................................................................... Rec#: 51451 Amount: $175 Date Paid: 5/3/2004 Q11'..-erfifteb �Drttfing log by DOO 00, .. WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 • OWNER OF LANDJ� ADDRESS: LEGAL DESCRIPTION: 4,6-- QS 4 0 DATE: Itl,, As PERMIT NUMBER.0 30 3 t 4 Date of lssuej—' -!91- U TAX IDENTIFICATION NUMBER. © 5�/ - D 53 - 3 5 Is well located at approved permit location? Utes U No Method of Drilling: &A-arr rotary LJ cable tool Depth of well: / Y" Y Casing Type_M11 L_Wall Thickness of inches It Diameter r�, d _ inches, depth l feet Liner Type: tJo I j 17 - Casing Stickup Above Ground: a` feet Static Water Level: / S-5' feet Recover Rate: 1 S qpm Method of Testing: '4112- Well 4/2Welt Intake Opening Type: U -6p --en end U open hole J Screened; _ Start feet Stopped feet j Perforations Start feet Stopped feet o f 7'>= c/ p S Grout Type: I1 �� �T Volume Depth: from O feet, to A O feet Well Disinfected Upon Completion? 6 -Ye -s 7_No Method of Disinfection1c n �.� "J i : `0 0 �epd"Iq Comments: BORE HOLE DATA DEPTH . From To O, 3 a� a Driller's Name 3 ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality )f Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: )epartment of Environmental Conservation. MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Sep 24, 2003 Expiration Date: Sep 23, 2004 Permit Number: SW030394 Legal D e s c riptio n :r~L~.~.~o.~9_'~ Design Engineer: 0003 S & S Engineering Owner Name: Dennis Winter Owner Address: 15851 Rasmusson Street Eagle River, AK 99577- Parcel ID: 051-053-35 Site Address: 24205 Leo's Road Lot Size: 10185 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field ~--~ Septic Tank [--~ Holding Tank r--] 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: Date: Date: _.~~O,~ MupicipalitY of APchorase Developmelff Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. mUni.org/onslle (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SWO~'O ~'~" Properly owner(s) Mailing address (1) / ~ ~-I "~/'~ S ~'1 L.I Mailing address (2) ~~* ¢~ Legal description (Lot, Block & Sub'd.) '~~ Legal description (Se~n, Township & Range) LotSize /O/ ~ Acres/Sq.Ft. Day phone ~',~.~- ' 5~'07 . Zip Code Number of Bedrooms .~Itls THIs APPLICATION IS FOR: Sewer Only []' Sewer and Well ~ Sewer Upgrade El PROPERTY CONTAINS: Hot Tub [] Swimming Pool [] Therapy Pool [] Well Only Water Storage Jacuzzi Water Softening Unit I certify Ihat tile above inform,a.~p correct. I certify that ti'tis application is being made for a Slrlgle Fatnlly DWelling and s rn accordance' Ill applicable Municipal Codes. (Signature of properly, ~gent) Waiver Fees: Date of Payment: Receipt Number: MUNICIPALITY OF ANCHORA GE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Sep 15, 2003 Expiration Date: Sep 14, 2004 Permit Number: SW030377 Legal Description: Design Engineer: 0003 S & S Engineering Owner Name: Dennis Winter Owner Address: 15851 Rasmusson Street Eagle River, AK 99577- Parcel ID: 051-053-35 Site Address: 24205 Leo's Road Lot Size: 10185 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: r7] Disposal Field r~ Septic Tank Holding Tank [~ Privy E~] Private Well r--] 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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: Issu ed By:-/4~,~'.,(-'"~/_~ ~~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O, Box 196650 Anchorage, AK 99519-6650 www.ci .anchorage .ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPI..ICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. o¢'[ -0'~3 ' ~ Property owner(s) ~)z:~ ;¢ ~-~;r'~''~'~/''-~'' Day phone Mailing address (1) )(,.~.~-_~t,~ ?_,C,~.~'~'~'-'-~O'L'' ~'~' Mailing address (2) Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size A., h~)~/[/~ Acre~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade Permit Number SWi~ ~ O3 77 Zip Code Lobby, 5/D Number of Bedrooms ~ THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Well Only Water Storage Jacuzzi ['-I Water Softening Unit I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling a_nd is in accordance with applicable Municipal Codes. "~~2 ~ '-- S&SENGINEERIN~ 17034 Eagle River Loop Road No. 204 · l~_.le River. Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: (~ Date of Payment: ' ~ / ~' 7 {0 3 Receipt Number: (Rev. 12/00) ~ji9 Waiver Fees: Date of Payment: Receipt Number: zneemnq ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE. September 22, 2003 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER MAIN EXI'ENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES ANOREPORTS WELL INSPECTION & FLOW TEST SITE PtANS ROAD D~SIGN ,e~:)ILTEST PEFICOLATION TEST STRUCTUR,~& & ONSlTE WA~TEWATER DISPOGALS~TEM DESIGN MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 9, Leo Subdivision It is requested that you issue a permit to install a well and approve the modification of the septic system design attached, (existing permit in place) to serve the proposed three bedroom dwelling on the referenced property. A lot line waiver of six feet is also requested from the proposed trench to the west lot line. A test hole was excavated and a percolation test was performed on 8/10/03, and on 9/17/03. The approximate location of the test holes are located on the attached site plan. At the time of excavation 8/10/03 and 9/17/03, water was not found. After monitoring, no ground water was found. The soils logs are attached for review. Based on the existing soils and ground water monitoring information on the subject lot and surrounding properties, we ask that a permit be issued immediately. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation ofthe proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. Is~yOu~ional information, please contact us. J 703,~ NORTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIVER. ALASKA 99577 Pedormed For: Legal Description: 5- 6- 7- 8- 9- '10- tt- t2- '13- 't5- '~6- '17- 18- 20- COM,~,~EHTS MUi-flcipaliiy 0,t' Anchoi'age beveloPmenl Serv,ces ,bepar{men~ Bulldlng Sa[ely On-Site Water and Waslewater Program 4700 South Bragaw SL P.O, Box t 96650/~chorage, AK 9951 ~6650 www,cJ.anchoraqe.ak.us -- (~7) 343-7.~M Soils Log- Percolation Test Slope E'qCOU~' ITEF~D? s ~ L IF YES, AT WFA~' OEP~'tI? O Depth to ¥1ater After I' klonttorlng? E Data: Reading [)ate Gross Time Site Plan . Net Time I Depth to Water '5o Net Drcp FERC HOLE OlAf.,IETER ~ FT PERFORM~.D BY: PERFORMED IH ACCORDANCE WITH ALL CEP, TIFY THAT THIS TEST WAS EFFECT OH THIS DATE. DATE: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 I'~r_~J.TH ~JTHORITY N'PROVN.~ SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE Pt. ANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTUF~. & MECHANICAL INSPECTIONS ON SITE W/,~TEWATER DISPOSAL S'~TEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 9, Leo's Subdivision September 22,, 2003 GENERAL: The scope of this project includes the installation a 1000 gallon HDPE septic tank and a trench to serve the proposed three bedroom residence located on the referenced property. e Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. .. Unless specifically agreed otherwise, the p. roperty owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive pr/or approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: .1. A septic tank is to be constructed by .a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP '* SUffE 204 * EAGLE RIVER. ALASKA 99577 Page 2 Lot 9, Leo's Subdivision September 22, 2003 All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 9, Leo's Subdivision September 22, 2003 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: TYPe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (/kBS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. o When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) irispeetions required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 9, Leo's Subdivision September 22, 2003 The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acc.eptance ofthe contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER - - - - - - - - - --- 1 I L I TY -- I N C _ _ G --- - - - - - -- Development Services Department 7 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval 051 Parcel I.D. 053 35 Expiration Date: (�- 1-y- 1. GENERAL INFORMATION Complete legal description LEO'S LOT 9 Location (site address) 24205 LEO'S Current property owner(s) JACKSON Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F-71 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ N O N E Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55 O Waiver Fee $ Date of Payment (0 d 2 Date of Payment Receipt Number 0 1 3b_ M Receipt Number COSA # 0S C `a 113 0 9 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 C&M ENGINEERING Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Phone 8545558 Date 6/1/21 t *: 49 TH 6. DSD SIGNATURE • 2... �• System #1 Approved for V bedrooms r� ' ' ' ' ' ' ' / CHARLES G BALZARKI System #2 Approved for bedrooms ��6" CE -13854 Disapproved �ll%pROFE5S10N�� Conditional approval for bedrooms, with the following stipulations: l I S l Y Y OF /'1A1-nI-rr `gm WATER AND J� WAST DiVATER o ARA / J�JJJJJA1 -SERV By� Original Certificate Date: n The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory_ Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: LEO'S LOT 9 Parcel ID: 015 053 35 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 912003 Total depth 184 ft Cased to 184 ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 5/20/21 Static water level at beginning of test 153 ft. Comments WATER SAMPLES BY FWCS B. TANK DATA Age of tank(s) 18 years Tank type/material SEPTIC PLASTIC Measured operating fluid level in septic tank Na 7 Standpipes/foundation cleanout per record drawing Date of pumping 5/18/21 TANK INTEGRITY WAS VISUALLY INSPECTED. D. ABSORPTION FIELD DATA TRENCH Which system tested (date installed) 2013 ❑Q ALL standpipes present per record drawing Total measured depth from grade 11.8 ft (max) Measured depth to pipe invert from grade 4.3 ft (min) Al N/A - prrss­m+--ed-fiei- ❑■ 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: SEE SUPPLEMENT COSA Checklist yellow sheet Well production at time of test +3.0 gpm Water storage tank volume - gallons Well disinfected for coliform test? ❑ Yes ❑0 No ❑E Coliform bacteria is Negative Nitrate 5.76 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑■ Arsenic less than MRL (ND) Collected by FIRST WATER CONSULTING Date of Sample 5/20/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/20/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 54 in Water added 450 gal New depth 64 in Elapsed time 1440 min Final fluid depth 52 in Absorption rate +450 gpd Any rejuvenation treatment (past 12 months) NA If yes, enter date NA 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' Q✓ Yes if No Community Sewer Manhole/Cleanout > 100' ✓v Yes if No ft jz✓ Yes if No Neighboring Tank > 100' 0✓ Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No Absorption Field on Lot > 100' 0✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment i 50' Yes if No 0✓ Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' p Yes if No ft 0✓ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) ft ft ft ft ft Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ❑ Yes if No 4 ft Wells on Adjacent Lots: Private Wells > 100' Yes if No Absorption Field > 5' Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10'✓0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' 0✓ 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' ✓l 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' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS SEE SUPPLEMENT. THE SEPTIC WAS FOUND TO BE APPROXIMATELY 60% FULL AT THE TIME OF TESTING. SUMMER MELT WATER INFILTRATION MAY HAVE IMPACTED TESTING. DRAINFIELD WAS NOT IN USE DURING TESTING G. ENGINEER'S CERTIFICATION / certify that / 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. 6/5/21 COSA Checklist yellow sheet %* 9TH '•*fir CHARLES G BALZARII • ' r�� �F��•. • CE-13854AGW , •'�`�r tl`F10PROFESSIGN - ft ft C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: COSA for Leo's Lot 9 Dear Reviewer, We were hired for a second opinion on the condition and adequacy of the septic system at the above referenced property. The system was recently tested by a different firm. Upon completion of our field investigations, we discovered that the system had been reported as failed, although it was not yet reported as failed when we were hired. Several deficiencies were corrected: There was not sufficient drop between the tank and field. The grade differential was corrected and there is now positive flow between the tank and the field. • There was a broken pipe in the drainfield which was repaired. • The drainfield distribution pipe was full of dirt. It was jetted and the line pumped out. Prior to testing, the system appeared to be operating at about 2/3 capacity under normal usage. We believe the results of testing conducted by the other firm, may have been skewed by the unusual spring melt-down conditions. We observed many systems fuller than usual during the month of may. It is assumed that melt -water and water usage inside the home contributed to a failed test. The plugged distribution pipe and grade differential between the tank and field would have further pointed towards replacement being a reasonable option. We tested the system later in the spring when the influx of meltwater may have been reduced. The septic was also not in use at the time of testing. Cleaning of the distribution pipe may have aided in the more even distribution and absorption of wastewater. Given the age of the system, it would be reasonable to proactively replace the drain field at the new owner's convenience. The remaining life of the system is largely dependent on use. A family of six who spend every day at home will cause the field to fail faster than a 1 or 2 individuals who spend everyday at work or school. Thank you for your time in reviewing this COSA Application. Please do not hesitate to contact me at 907- 854-5558 or by email cgbalzarini(@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE .�� OF'•Q�gSI`� 6/1/21 ���.�P• •�9 �� 49 TH r� t:HARLES G BALZARNI ���,�c�dTF� • OE -13854 • ����i/ 11 il,F� PROFES SiONt`�� -- - MUNICIPALITY -OF AC A E _ DEVELOPMENT SERVICES DEPARTMENT o,i 907-343-7904 On -Site Water and Wastewater Section Fax: 343-7997 www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC211309 Subdivision: Leo's Lot 9 A water sample revealed a nitrate concentration of 5.76 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519-6650 * www.muni.org Report date: Printed by: Ident: Analysis from: File: Method: Run operator: Analysis number: S~LMPLE: : Vial number: Volume: Dilution: Amount: 01/05/2004 04:59:00 JS 2186-01B 01/05/2004 04:43:00 O5010443.CHW Anionsll.mtw JS 12227 27 1.0 pl 1.00 1.0000 Last save: 12/04/2004 19:08:25 1:20 100- 90 '7O 60- 50- 4O 3O 2O I ~ I'0 1'1 ,'2 !'3 f4 1'S min Quantitation method: Custom No Retention Height min mV 1 3.18 0.02 2 3.58 0.25 3 4.28 0.02 4 5.36 118.36 5 6.44 0.06 6 7.01 0.01 7 7.50 0.66 8 9.22 11.52 9 12.57 0.24 10 14.81 17.73 Area mV*sec 0.120 3.961 0.202 1249.596 0 660 0 072 18 981 215 227 9 955 520 181 Conc. mg/L 0.000 0.067 0.000 32.599 0.009 0.000 0,000 2.484 0.303 20.244 10 16.01 148.88 2018.955 55.705 This report has been created by IC Net Name Fl~de Chloride Nitrite-N System Nitrate-N o-Phosphate Sulfate