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HomeMy WebLinkAboutT12N R4W SEC 2 PARCEL 25TI2N P,4 Sec. 2 Porcel 25 #012-161 -04 O Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 EImore Road P.O. Box 196650 Anchorage, AK 99507 Page I of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: sw090060 PID Number: 012-161-04 Name: MIKE DUNN Wastewater System: [] New [] Upgrade Address: 2641 STRAWBERRY ROAD, ANCHORAGE, A.K. 99502 ABSORPTION FIELD Phone: Number of Bedrooms: 677-5102 4 [] DeepTrench [] Shallow Trench [] Bed [] Mound [] Other: Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 1.0 GPD~pt2 9.0' Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: PARCEL 25 5.0' Ft. 4.0' Ft. Township: 12N Range: 4W Section: 2 Fill added above original grade: Gravel Length: -0.3/-0.6 Ft. 60.0' Ft. Classification (Private, ~ Total Depth: _......~ Cased to: Total absorption area: Pipe Material: PUBLIC WATER ~ ~.--~-~Ft. Ft. 600 Ft2 ASTM3034/F810PVC Driller: ~ Da't'~l~.J~: Static Water Level: Installer: Date Installed: Ft. GLW ENTERPRISES 9/5/09 ~ GPM Pump Set at: Ft. Casing He~ TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: · T~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: From~ Tank Field Station Tank Sewer Line PREMIER PLASTICS 1300 Gal. Material: Number of Compartments: Well .... N/A- ....... N/A ........ N/A ....... N/A ........ N/A .... H.D.P.E. 2 Surface water 100'+ 100'+ .... N/A ........ N/A .... ~ /..--.Uan~aoturer: ~-~~-...~,~gh ,,~LIFT STATION Lot Line 5'+ 10'+ .... N/A ........ N/A .... Gal. "Pump on" level at: ater alarm at: Foundation 5'+ 10'+ ---N/A ........ N/A .... i~. in Curtain DrainNONE KNOWN .......................... Pump Make &~ Electrical Inspections performed by: Remarks: CONDITIONAL APPROVAL. PROPOSED BUILDING STILL BENCH MARK Location and Description: UNDER CONSTRUCTION, WAITING FOR FINALIZED BOTTOM OF SIDING @POINT C Assumed Elevation: ASBUILT SURVEY TO VERIFY ALL LOCATIONS. 100.00' Ft. Engineering Engineer's Stamp Inspections performed by: 15851 S. Birchwood .Lo. Ed, Dates: 1st 9/3/09 ~; -O[ ~'~'~'~'~'~'~'~'~'~lU~ak~ AJa~ka 99~67 2nd 9~4~09 ~~-~%~E Development Services Department Approval ~ ~,,¢/ Reviewed and approved by: . ,¢_. ~ Date: OQ '.~ 0- / O, PERMIT NO. SW090080 PAGE 2 OF 3 DEVELOPMENT ON-SITE WATER klunicJpo, Lit;y oF Ancho~'o, 9e SERVICES DEPARTMENT- BUILDING SAFETY DIVISION AND WASTEWATER PROGRAM, /~700 BRAGAW STREET 343-7904 ® www,ci,anchor'age,ak,u_~ WELL INSPECTION REPOR' LEGAL T12N R4W SEC 2 PARCEL 25 P.I.D, NO. 012-161-04 LOT 1; ~ MALNARICK LOT 5; 'i Ii S?D BLOCK 6; VILLAGE GREEN '~ I MT2 ~ ~ NEW 1300 GALLON / NEW SHALLOW I i ...... ...... ~ ," HDPE TANK~sT ~1'¢~'~ "': ~.ST2¢ii' TRENCH i TMT ~ -BBL2 LOT 4; PROPOSED -DBL1 4 BEDROOM BLOCK 6; VIL~GE ~N s/~ i] ~ ~ 20 AW ERRY ROAD ENGIN~ST~P PERMIT NO. SW090080 PAGE 3 OF 3 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650e Anchorage, Alaska 99519-6650 eTelephone: 543-4744 On-Site Wasfewafer Disposal System and/or Well Inspection Report LEGAL T12N R4W SEC 2 PARCEL 25 P.I.D. NO. 01 2-- 1 61 --04 FINAL ST1 INLET=95.1'~ 1300 GALLON ~ POLYETHYLENE SEPTIC TANK ORIGINAL = 99.7' C01 MT2CO2MTi CO1 = 99.1' C02 = 99.4' GRADE INSULATION CO1 = 94.7' C02 = 94.7' GRADE = 98.8' INSULATION TOP OF TANK -- 95.9' OUTLET=94.9' A B C FCO 1 45.1 ' ST1 43.8' ~ ST2 44,4' O' ' TMT 44,9, 64.3 DBL1 44, 64.5'- DBL2 45,2' 65,6' C01 _44,4' 76,t' MT1 44,5' 77,3' MT3 70,1' ~ 82.6' C02 I 31.0' 50,4' MT2 131.2' ~93jF FC02 t MT3 =90.'; MT2 =90.7' MT1 =90.7' & NO WATER FOUND ~ B.O.H. SCALE N.T.S. ENOINEER STAMP 30 24 ¢- /× Legal Description: Portion of the SE ¼ of the SE 2, Section 2, T12N, R4W, Seward Meridian, AK described as follows: Commencing at the SW corner of the SE ¼ of the SE ¼ of said Section 2, thence 20 feet due North; thence 24 feet due East to the point ~)f beginning; thence North 150 feet; thence East 100 feet; thence South 150 feet; hence West 100 feet to the point of beginning. I EAST 100.00 4.0 10.9 ? o o SEPTIC VENTS o co .co e~-~% o, Oo 52.7 ~ v~'/V T,S, 2 Story Frame House 2o.o 24.7 i 20' Utility Easement 3~o (Misc. Book64, pg 114) 10' Public Use Easement (Misc. Book 197, pg 133) EAST 100.00 STRAWBERRY ROAD o o r~ O Z rY z _.1 O _J SCALE' 1"= 30' ~-1~3' Notice of Utilization eception No. 2006-082857-0 8352M '"" OFA ~'\ _~'-,t~ ...... t4 \~, . ' " ' " . h t/~ .. Fred Walatka "c~ ~ EASEMENTS OF RECORD, OTHER THAN ~ -~- ~ O THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. Fa ~04, pg ~-65 BE AS-BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property:PORTION OF THE SE1/4, OF THE SE 1/4, SECTION 2, T12N, R3W, SEWARD MERIDIAN, AK, AS DESCRIBED AT TOP OF PAGE. Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not ovedap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 2nd day of AUGUST ,2010 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (~07) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 05, 2009 Expiration Date: Jun 05, 2010 Permit Number: SW090080 Legal Description: T12N R4W SEC 2 PARCEL 25 Design Engineer: 0855 GARNESS ENGINEERING GROU[: Owner Name: MIKE DUNN Owner Address: 2641 STRAWBERRY ROAD ANCHORAGE, A 99502- Parcel ID: 012-161-04 Site Address: 2641 STRAWBERRY ROAD Lot Size: 0 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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 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 ( 18AACS0 ). 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. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (9O7) 343-79O4 ON-SITE SEWER/WELL PERHIT APPLICATION FOR .b, SINGLE FAHILY DWELLING ParcelI.D. 012 '1~ l°Oq Property owner(s) MIKE DUNN Day phone 351-4191 Mailing address 2641 STRAWBERRY ROAD * ANCHORAGE. AK Site address Zip Code cJ~502 T12N, R4W, SECTION 2. SE4, SE4 Legal description (Sub'd, Block & Lot) {'SECTION 2. PARCEL 25 PER MOA TAX ASSESMENTS.3 Legal description (Township, Section & Range) LotSize l ~, ~ Sq,Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR ( [] all that apply): Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage [] THIS APPLICATION IS AN: [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. ~ :.~*. .~, ~ .... :..-.~CONSULTANTS&GENERALCONTRACTORS~-'*-~'~ ~*=:'-='~'~--':'=:': June 5th, 2009 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907) 343-7904 Ref: Proposed Septic Upgrade for TI2N, R4W, Section 2, SE % SE %. (Section 2, Parcel 25 per MOA Tax Assessments.) To whom it may concern: The existing office building is served by public water and private septic system. The office is being converted to a 4 bedroom house. The septic system is undocumented and needs to be upgraded. We are proposing to install a new 1250 gallon septic tank and a 5-wide trench type drainfield. Two test holes were excavated on the property. The drainfield will be designed around the 30 foot radii of these test holes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. Percolation test indicated <1 minute per inch absorption rate, which would normally dictate the use of a sand filter. GEG. Ltd, took a soil sample from test hole #1 at a depth of approximately 4 feet below grade, and had a sieve analysis performed on it. A copy of the sieve analysis is attached. Based on these results, we believe the existing sandy soils mitigate the need for an imported sand filter. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPtlY: As can be seen on the attached design drawing the average topography in the area is 1%-5% running south to north. The slopes below the drainfield are approximately 15%-20% running in the same direction. In short there are no slope concerns. We are unawar~ of,~ F adverse impacts this installation would have on adjacent wells or septic systems. If_you havet my[~u/st~ )ns, please contact us at 337-6179. Thank you for your assistance. ¢ P. M-S. this septic system. (Contact G.E.G. Lid. for 7page construction specification letter.) 3701 E. Tudor Road. Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com CLAJRBORNF ~IA S/D, ~/ /~ I~ . CLNRSORNg , $/D~ NOTE: A~ OTHER PROPERTIES SER~D F~R~ t~/~;/ ~ XC~RBORNE ~'~/O~X LOT 5. '~Z 2 I BY PUBLIC WATER AND S~ER. 'C~ ~ ~ ~--~l ~ ~OT 11~1~11~15. ~L~qBL~ .~RBORNE lA S~D; ~0[ OREEN S/~; m ~ C~RBORNE ~IA S/O' ~C~RBORN[ ~IA S/D; L-~ o.~..~..~.k ~ot., ~.~ , L~' """ ~-"I ~c~o, ,~,., .~., kuo~ is. s~ m ......... ~ __ I ~E GREEN~/, I LOT 1 LOT 2 ~OT 7. BC~K ~/ ~ I ~ I ~ / /LOT O, ~L~K 6 ~~ PUBLI~ WAT[~ ~N ~~ , I ~ ~ / LOT ~, BL~K ~ ~ I" (~P~ox~t[) I _ .......... ~: I ~WBERRY RO~ --- --------~BLIC WATER ~IN ~ uc~ s/D; ~c~ s/D; I F MC~ S/D; ~ LOT 1, BL~K 2 LOT 2, BL~K 2 LOT 2, BLUE 1 I , I I I ~ I m LOT ...... ~ ..... ) I ~ .~ ,xo= m m UC~ S/~; I i LOT 5, BL~K 2 m I I ~[. PR~P~D FOR: IPHON¢ ~U~SER: I PA6~ ~U~B~R: ,~?--~L'~ · ~ .... ~ ....... ~""~j MIKE DUNN I 907-351-4191 I , or ~ k~"'f" ~k*;2t"'Y,~/ · T12N, R4W, SECTION 2, SE4, SE4 A.J.O. SITE P~N 5/27/2009 *SECTION 2, PARCEL 25 PER MOA TAX ASSESMENTS ~.. '~ ~ DESIGN CRITERIA: I~. NOTE: THE CONTRACTOR SHALL HAVE NUMBER OF' ~EDROOMS: 4 "ut' ~0, ~/ THE EAST. NORTH AND WEST LOT LINES C,~.LONS PER DAY (GPD): 600 ~ -~~'~. ~ FLAGGED PRIOR TO CONSTRUCTION BY PERCOLA~ON RATE/S: <1 Z V ~TERNAm Sm: WtU. REGmE DRAINFI[LD DESIGN: LENGTH: 60' M.O~. APPROVED ~AND FILTER: % EF'F[CTIVE: 4' ~ REDUCTION FACTOR: ~ ~0 . .~ ~ .% PRO~SED 4 '" ' .... ; I DESl0N 0 0N AGREE TO ACCE~ ~E ~RMS ~D *"'~' ' 20' C.~ ~EM[~ COND~NS 0~NED. STRAWBERRY ROAD __ ~ __ ~- ~ PUBLIC WATER MAIN GARNESS ENGINEERING G~OUP, Ltd. ~"~:~'4~.~ '"~) PREPPED FOR: PH~[ NUMBER: P~E NUMBER: [ ~ '/'tt'l~ ....... DIscO. D.AWm Or P.OPOS[D S[P~C S~S~[a ~/27/200e *SECTION 2. PARCEL 25 PER MOA TAX ASSESMENTS ~ _~ NOTE: THE CONTRACTOR SHALL HAVE NUMBER OF' BEDROOMS: 4 ~ '~o_~ /~ THE EAST. NORTH AND WEST LOT LINES C~J.ONS PER DAY (GPD): i E ~~ / FLAt. ED ~IOR TO CONSTRUCTION ~Y RERCO~O..*~/S= <, ,n '~ / A REt;:..-S FRED LAND SURVEYOR. PROPOSED .~'PUCAnON RAT[: ,.0 Z \/ r-ALIERNATE SiTE WiLL REQUIRE N ' I rN~TH: 60' ~ '. :..'<L":' :.~ .'?.'.~ PROPOSED 4 g GALLON SEPnC TAN~ '"" ' I DESIGN OPTION B · :>..* ;* .].-, · ..t~.,: :'.., r: ,. * ....~:~. r. O~ ~REE TO ACC[PT THE 'I~.RMS '?' !' ~ ~ CONOmON$ · ,..- ~ KLWBOX STRAWBERRY ROAD I I PUBLIC WATER MAIN GARNESS ENGINEERING GROUP, Ltd. ~.~~'!:.-~..~y~,~ DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM =/z~/zuu~ ~ *SECTION 2. PARCEL 25 PER MOA TAX ASSESMENTS. [SOIL LOG - PERCO~ION ~ES~I LEGAL DESCRIPTION: 'T12N. R4W. SE~ON 2. SE 1/4. SE 1/4 (feet) ~ ITEST HOLE ~ll ~$$: OR~NICS 2- ;=~=:~ ~ ~w :==_~ OR~ ~ GP HL OC OL TH~I~ 'o*~.',, SM OH I 'o'*.',, DEPTH TO DATE ................. 7 -- .0o ..~. GROUNDWATER 'o0o.'., 7/22/2008 · ,o ,, ~, DRY 7/30/08 J TIHE (HINUTES) READIN~ ~**'" ' ~/SP PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19- TEST RUN BETWEEN 5.0 FT. AND 6.0 FT. 20--- A FOUR HOUR PRESOAK WAS PERFORMED: ~ YES ~ NO SOILS LOGGED BY: SU~N OSWALT PERCOLATION TEST PERFORMED BY: DASD GARNESS COHHENTSr WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: *SECTION 2, PARCEL 25 PER MOA TAX ASSESMENTS. GAF(NESS ENGINE~F(ING GF(OUP, Ltd. ~.~'"'~T~(7~ '"'.,'Z. ISOIL LOG - PERCOLATION TESTI ! ~1..~...~.(. ............... ~' , - fey . G 'ness.: DEPTH ~ vPr ~o~O' o (,-0 HOLE :::=~ ORGANICS ~ E -- :., - ',.. GW r::::: ORG I ~ :U:~ ~ sM OH I 6~ I :=:.::~ ..... ~ .......... 7-::~=:~ Sp FINE DEPTH TO DATE ................. :~=~ GROUNDWATER :~=~ DRY 7/22/2008 ~.~ ~/~o/2oo, I _,~t-~'l,.,.,.,. DATE READING CLOCK NET TIME WATER LEVEL NET DROP 11 ~ ! TIME (MINUTES) READING (INCHES) ~ 2 - ::3:::: B.O.IL 17-- ' PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19~ TEST RUN BETWEEN 4.0 FT. AND 5.0 FT. 20--~ A FOUR HOUR PRESOAK WAS PERFORMED: ~ YES ~ NO SOILS LOGGED BY: SU~N OSWALT PERCOLATION TEST PERFORMED BY: DASD ~RNESS COMMENTSr PERFORMED BY GEG. Ltd. I, JEFFR~ A. GARNESS. CERTI~ T~T THIS W~ ~ED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: *SECTION 2, PARCEL 25 PER MOA TAX ASSESMENTS. DEIWL Location: 2641 Strawperr~ HEM Client: Gamess Engineering Group Ltd. Project: Mike Dunrrs property Work Order: A32523 E nglneerlng Classification: Poorly Graded Sand, SP Frost Classification: Not Measured 100 9O ; 80 ~ 7O a 60 · -~50 o. 40 o: :30 o. 20 10 0 100 10 1 0.1 0.01 0.001 Particle Size (mm) Particle Size Distribution ASTM D422 ikab Number 2009400 Received 5/13/2009 ~ Reported 5/15/2009 DavidL. Ande~sen. P.E. 404lBS[me! * Anchorage · Alaska * 99503 · 907/562-2000 · Fax 9071563-3953 i J, 24' .~ (N90'00'00'¥/ 100.25') I - I 10.32, ~ I [ q J , 24.00'-- ,28.59' 37.33' ~ I ~' ~ 25.05 ........... '"'" I : b-~ ~. '" ~<>'/-~ 20' ~ / .~ e ,- :o.~3' bJ ~ i- ~.'.~2:.... N~.~s-~ .....',~,,~ ~ J ~ · j ,.~ ¢ 20' C.E.A.-E -J ' EJ'~I ~'1 100.2]' N89'54'41'E · . ... , .... 74~.s~.~ses~1E ~ · .~".. . . '-- -' .r-~-----~TRA\,/~'RRy Rn, '- ---~-~--.,- ~ - , '/ -'-~'~ - .~. . ,, . . · -~_ %'- .~"-. .~ ". - (~/EST 68-116) '~. :,. ~ ,]' ~BASlS OF BEARING//'''''~ .j- .... - Tony B~ra~nier ."' ~ SPOT ELAVATION J~ ~" "J EXISTING PAVEMENT IIl~)~li/),lholBelrop~tj, dm:rl)e:lh~m~b~k-,~l~y~,~,~ol, ml~lim, II~ol,ll~ j.., ..... it~m~mmls ~lmI~ I~eem ~ ~ md ~o i~ot maooc~ m o~cm~ I~l~ m~ i,l~o~mmls ":'l I: ] PROPOSED DRIVEWAY silualed m odjacml F~tk, s ~o ~ol mo'oodl hm'em, excq~J~s s~oml ~ FOUND MONUMENT II is I~ rqgomt;iil), Gl ~¢ ~ m' ImL4~' Io ~'ilf Fop'~..~l b~'t ~/m'~s ~¢o!i~ W r~J 9'~ lO0' NOO'OO'OO"W MEASURED DISTANCES m~l ~:~isli'~ ut[tis ~s w~ ~ ~ e~ifl~ce ol my msmlmls, Jm~mmls ~' f~Ibct~ms ~ ~ flol o;~ on Ihe reco~d plat. (100' NOO'OO'OO"W) RECORDED DISTANCES PER. 68-116 J DRAW, .¥: .~ff A~d~r~o. J OR.D: A.SW~7 PLOT PLAN FOR: MIKE DUNN SCALE: 1"= 30' VERTICAL D~,TUM: MOA LEGAL DESCRIPTION: REMNANT PARCEL DATE: 04-07-2009 FIELD '.BOOK: DA--01 LOCATED WITHIN SE1/4-SE1/4, Sec. 2, T.I2N., R.4W., S.U., AK. LOT AREA:+/- 1,.3,734 sf 10.32' .[, 24,00' -- ~28.59~ 37.33' ,~ 25.05' i10.13' "*:' ?: ':~-": ~r ~-:~"'2 ~ ~'-': =' '-::- ' .~" ~ Z44.58L N89*54;q'l'E"- ' • '-�� Municipality of Anchorage " za On -Site Water and Wastewater Program (907) 343-7904 s A F E T Certificate of On -Site Systems Approval Parcel I.D. 012-161-04 1. GENERAL INFORMATION: Expiration Date: 7-2,?—.2— ®Z 7 Complete legal description T12N, R4W, SECTION 2; PARCEL 25 Location (site address) 2641 Strawberry Road *Anchorage Current Property owner(s) Mike Dunn Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 907-351-4191 Day phone 4. TYPE OF WATER SUPPLY: 55C� TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual "AZ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 55C� -� 33C9 �l� Waiver Fee $ Date of Payment "AZ Date of Payment Receipt Number 0403`{G Receipt Number COSA # osc 22 1 y 0 Z 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: _ Gamess Enoineedna Group, Ltd f GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: qg In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systems. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. D�IGNATURE System #1 Approved for J bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following #AECC884 Q��1�Y OFtfq���tr�i ON-SITE �vG; WATER AND Its° ASTI_v''ATER � o gY Original Certificate Date: � 1 '24222 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 _ZZ— Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: T12N, R4W, SECTION 2; PARCEL 25 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA AWWU ❑ 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). Date of flow test for CO Static wat at beginning of test ft. B. TANK DATA Age of tank(s) 13 years Tank type/material SEPTIC/HDPE Measured operating fluid level in septic tank 48" ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/3/22 Parcel 1D: 012-161-04 Structure served by this system _ Well production at time of test gpm Water storage tank volume_ ons Well disinfected for c ►ifert test? ❑ Yes ❑ No ❑ Colifo cteria is Negative rate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments - D. ABSORPTION FIELD DATA TRENCH Which system tested (date installed) 914/09 Adequacy test date 7/28/22 ❑ ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade 9.75 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4.67 ft (min) Water added 836 gal ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. if not, state New depth 0 in depth into effective Elapsed time 0 min P ❑ Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600+ and (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N/A date of test) Gallons introduced N/A gallons If yes, enter date ' Comments/Deficiencies: COSA Checklist yellow sheet EJ S E. SEPARATION DISTANCES p►WWU From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100'_..�.�" E] Yes if No ft-"if"N0 ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer ine > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft olding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 1 IAnimal Mv Yes if No ft Water Main > 10' Containment > 50' ❑ Yes if No ft Yes if No ft [] Yes if No ft Water Service Line > 10' [j Yes if No Manure/Animal Excreta Storage > 100' y Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *5'+ ft Surface Water > 100' ID Yes if No ft Property Line > 5' 2] Yes if No ft Wells on Adjacent Lots: Yes Absorption Field > 5' [1 Yes if No ft Private Wells > 100' Mv Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' [] Yes if No ft Water Service Line > 10' [j 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' El Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' El Yes if No ft Surface Water > 100' [✓ Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALLATION G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF a Of H Garr.e s. CE17)5 v ofess'1on°oG nAECCaea 1