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Home My WebLink AboutBOREALIS LT 8Borealis Lo'l- 8 #015-203-06 Municipality of Anchorage Page Department of Health and Human Services Division of Environmental Se~ices On-Site Senaces Section 825 '1.' Sb'eet Room 502 P.O. Box 196650 Anchorage. AK 99519-6650 www.cLanchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW0003.09 PID Number:. 015-203-06 "'~: Wastewater System: New [] Upgrade Harrilyn Blankenship 4901 Alpha Circle Anch. AK 99516 ABSORPTION FIELD 345-3064 Three(3) oe,~,.~ s,~o,~,.,~ ,~ ~ oc,~. LEGAL DESCRIPTION .45 e, ot~r' 8 Borealis I F,. 8 3. - 2.5 F,. 86 ~,. Well: 3 ~,. 1 Class A F, ~. 1,376 Fe ASTM D3034 PVC r~ A Plus 6/26,27/00 SEPARATION DISTANCES E3 septic I-I Holding I-I $.T.E.P. I-I Othe~. ~ Septic Abso~tJon Lift Holding ,ublic/Pfi-~te Tank Field Stat,on Tank S~,~U~ Anchora§e Tank 3.,000 w,, ,200' >200' N/A N/A >25' Steel Two (2) F~,~,~ >5' >10' N/A N/A ~. . e,,~,,~None Noted. ~,,,,oa,,o~ ~,.,-~-.,.-~,,...~ ..... ~ · BENCH MARK . Existin§ S~pt]c Tank Abandoned. Septic Tank Pumped, Crushed and Backfilled On Si{e. Bull Run Top of Beck on EaSt Side of Diverter Valve Placed and E~istin~ Absorption . 100.0 ~.' Trench Tied In to New System. Insulation Placed Over Septic Tank and Westerly 46' of New Trench. · . Engfr~e~'s'~{amp · Inspections performed by: MEA Dates: 1'~· 6/26¢00 ';.: .49 Department-- -:---;~- . ~-~ ,.z-°f Health and H~man Services approval ~ ~:;... .-',-~ Reviewed and approved b Date: ~ Municipality of Anchorage Page 2 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 -Anchorage, AK 99519-6650 -343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW00109 PID No. 015-203-06 'lO''~ility Basemen~ M A B S1 14.7 52.8 S2 21.7 52.0 C4 67.8 134.4 C5 74.3 55.9 M1 66.0 112.1 M2 75.5 58.0 ' ' -, Four Bedroom llome Tree~ 1 Run ~iyerter valve ALPHA CIRCLE PLAN AS-BUILT SCALE 1" = 20' C4 · Page 3 of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 99519-6650 - 343-4744 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW00109 PID No. 015-203-06 LEGEND Septic Tank Cleanout Bull Run Diverter Valve C - System Cleanout M - Honitor Tube 91.5 / 88.8 2" Insulation Westerl' 46") Drainfield~.~f /%o' Geotextile Fabric Rock 88.8 .4 74.0~ Municipality f Anchorage G¢or.qe 15 1I ue~ch, M~t!lor Buthllng Safety Dh'tsion P.O. Ik~x 19(~,50 · -'[700 S. llragaw Street Anchorage, Alaslm .qOSlg-fXkr'g) * (~7) gg-sq01 &7/2001 h t Ii~://~a~v.cl.m~chomgc.ak.us Harrilyn Blankenship 4901 Alpha Cir. Anchorage AK Subject: Expired On-Site Water and/or Wastewater Permit. Permit Number: SW000109, Parcel ID: #015-203-06 Dear Harrilyn Blankenship: An On-Site WatedWastewater Permit, number SW000109, issued by this office for a single-family system, expired on May 17, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastexvater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As-built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, '{Letters Sent 6/7/01 without copies being made, second printing for file copies} James Cross, PE Manager On-Site Water and Wastewater Program enc: Copy of permit MUNICIPALITY OF ANCHORAGE Department of Heai~h and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box f96650, Anchorage, AK 9951~-6650 (~07) 343-4744 ON-SITE WASTEWATER DISPOSAl SYSTEM PERMIT Upgrade Date Issued: May 17, 2000 Expiration Date: May 17, 2001 Permit Number: SW000109 Legal Description: BOREALIS LT 8 Design Engineer: 0014 Anderson Engineering Owner Name: Harrilyn Blankenship Owner Address: 4901 Alpha Cir. Anchorage, AK 99516- Parcel ID: 015-203-06 Total Bedrooms: 3 Site Address: 004901 ALPHA CIR Lot Size: 16855 SQ. FT. 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 ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Issued By: ~ ? ~ Date: ANDERSON, ENGINEERING. " . ~NCHORAGE,'AK' 99524. ''- ~:.~22:-6779 (FAX: . : May 9, 2000 Muni~:ipality of Anchorage Department of Health and Hu man Services 825 "L" Street A, nchorage, AK 99502-0650 Subject: Lot 8, Borealis Subdivision Septic System Design and Permit Applicatioh Impacts to Adjacent Properties Dear Onsite Services Engineer:. The existing absorption trench On Lot 8, Borealis Subdivision has failed and effluent is currently noted .on the ground surface. It is imperative the system be upgraded immediately to prevent damage to pdvate property and to eliminate a possible health hazard, We are therefore requesting 'a permit be issued as soon as possible-to construct a new absorption trench to serve the four bedroom house on the .lot.. The attached Site Plan and backup documentation show the location and configuration of the new absorption trench as well as the existing trench. The subdivision is served by a community wa!er s,.ystem and all separation distances from the Class A well are met. No conflicts exist with adjacent lots. A test hole was recently placed on the lot to find an acceptable location for the new absorption trench, The hole revealed silty gravel which percolated at 40 minutes per inch. This rate is slower than the'rate used to design the original absorption trench. That trench, however, has been in service for more than 20 years and ha'; apparently worked well up till now. Groundwater was noted during the excavation at a depth of 14' and was monitored at 13' during the ensuing period. We have therefore designed a .'deep trench absorption system with 8' of gravel beneath the distribution lateral. The lateral will be placed at 1'below the ground surface and the total depth of the trench will be 9' below existing ground to provide 4' separation from groundwater. Insulation over the trench or mounding will be required to prevent freezing. The existing septic tank will be exposed to determine whether it Is suitable for continued use. 'It will be replaced if necessary. Two new post tank cleanouts will be placed and a new Zabel Flow D verter Valve. The existing trench will be tied in to the new system, but will receive no flow until it rejuvenates itself. The new trench will receive all septic effluent at this time. The lot surface slopes from south to north at between 5% and 10%.' The absorption trench will be placed with'the slope of the property in conformance with Municipal 'requirements, Attempts will be made not to damag,e, existing mature trees in the back yard of the house. This, however, may not be possible due to the length of the trench ' and the minimal area available for the septic upgrade. Lot 8, Borealis Subdivision May 9,' 2000. Page Two If the system is constructed in accordance with our design the following statements apply: . - ' I. - The system, if constructed 'as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed In the future. The system, if constructed as designed, will hav~ no'adverse impact on reserved space, either surface or subsurface, On any lots located in the area. 4 The system, if constructed as designed, will have no adverse impact on drainage 'patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments / 10' Utility Easement New 85'.Long X 8' Effect1~ Absorption Tx Depth 9' Bel¢ · Trees Ground Tie In Old Absorption Trench ,Zabel Flow Diverter Valve Post Tank Cleanouts :ify Existing Septic Tank )lace If Necessary Four Bedroom Home 3' Wide Depth nch. Total Existing ALPHA CIRCLE ..... --...~. -. , SITE PLAN ' - ~ SCALE 1" = 20' LOT 8, BOREALIS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perc. Rate: 40 Min./Inch Application Rate: .45 GPD/SF Deep Trench System 1,250 Gallon Septic Tank 8' Dralnfleld Rock 4 Bedrooms X 150 GPD I .45 GPD/SF = 1,334 SF of Absorption Area 1,334 SF/16 SF/ LF of Trench = 83.4 LF Trench Length Therefore: Construct a Deep Absorption Trench System With One Lateral 85' in Length with 8' of Dralnfleld Rock Beneath the Distribution Pipe. Distribution Pipe in Trench Placed at 1' Below the Original Ground Surface. Total Depth to be 9' From Orlginal Ground Surface. Insulate or'Mound Over Trench to Provide a Minimum of 3' of Cover. .5' 8.0I NOTE: Natural ' Backfill Geotextile · Fabric 4" PVC }loles Down Drainfield Rock 3;0' I TYPICAL DEEP TRENCH SECTION (NO SCALE) . Grade Area Over Trench to Drain Away. . Provide 3' Cover Over Trench and 4' Over Tank or Maintain 10' Separation From Lot Line. ..~.%~'.. ..~.,~...~.~;~; Maintain 10' Separation ~rom Water Service line. ~ ~;~ ;~% ~, Maintain 100' Separation From All Wells ,.~.m~.~_~ ..... ~.~,, ~.-~a'"P"T'i' //~ Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Harrilyn Blankenshi!3 Legal Description: Lot 8. Borealis Subdivision OG/OL 6 7 9 10 11 GM Silty Gravel Was Groundwater Encountered? If Yes, What Depth? Depth to Water After Monitoring Date: SLOPE North South Yes 14' 13' 5/9/00 SITE PLAN See Site Plan S L O P E 12 13 14 15 16 17 18 SM Bottom of Hole Reading Date Gross Net Depth To Net Time Time Water Drop I 5/2/00 19:07 2.75" 2 19:37 30 3.5" .75" 3 20:07 30 4.25". .75" 4 20:37 30 5" .75" 21 Perc. Rate: 40 Min./Inch Perc. Hole Diameter: 8" Test Run Between 4 Ft. and 5 Ft. Comments: Testhole Presoaked Prior to Percolation Test. Design System for 60 Min.llnct~. Performed By: Mike Anderson. I, ~ Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 5/9/00 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 8, BOREALIS SUBDIVISION GENERAL: The scope of this project inc. ludes the exposing and inspection of the existing septic tank and verification for continued use. If the tank is found to be damaged work will include the procurement and placement of a new 1,250 gallon septic tank. It also includes the construction of two post tank cleanouts and a Zabel Flow Diveder Valve. The existing absorption trench will be tied into the new system with the valve allowing flow only to the new 85' long x 3' wide x 8' effective depth absorption trench to be constructed at the location shown on the attached Site Plan. The total depth from odginal ground of the new trench will be 9' below ground surface. Insulation will be required over the trench or mounding to provide a minimum of 3' of cover to prevent freezing. Existing trees should not be disturbed if at all possible. Construction shall be in accordance with the approved site plan, 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 all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. .4. o Unless specifically agreed otherwise, the contractor shall' be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disp~)sal systems must be certified 'by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. The new 1,250 gallon septic tank, if required, must be procured from an approved source and installed at the location shown on the plans. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3..The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. · · t Lot 8, Borealis Subdivision May 9, 2000 Page 2 of 3 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfleld. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be c(~nstructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum .. 100' away from any pdvate water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench · must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. A minimbm 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall vedfy this condition pdor to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). Lot 8, Borealis Subdivision May 9, 2000 Page 3 of 3 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance. requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. OI GRE~,,ER ANCHORAGE AREA BOR..JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DI.S]POSAL SYSTEM ~ ............... .~,.z - ~ ...... ~-- --- SEPTIC TANK: DISTANCE~/?,,..,~,~ %1¢,//~'~ :~'~,"L FROM WELL'-.-~ '- /''¢~ MANUFACTURER MATERIAL INSIDE LENGTH /~'2 / INSIDE WIDTH LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY ) ~' ~'~-d) GALLONS. TILE DRAIN FIELD: ,~ ~ 1/~,~) / DISTANCE FROM WELL~,,¢'~"'~'~I ~'FOUNOATION .... NEAREST LOT UNE /: NUMBER OF LINES / DISTAMCE BETWEEN LINE& _ . TRENCH WIDTH ~ /IN. ABSORPTION AREA~ ~-- SQ. FT. LERGTH OF EACH LINE DEPTH: / OF LINES TOTAL EFFECTIVE TOP OF TI O FINISH GRADE __MATERIAL BENEATH TILE ' 'IN. ABOVE TILE IN. WELL: TYPE ,~ (4 '"';2~ d)C O NST R U CT ' O N DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION__ LOT LINE____ SEWER LINE , TANK .... SYSTEM CESSPOOL _ OTHER SOURCES APPROVED DISAPPROVED DISTANCES: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS DIAGRAM OF SYSTEM REMARKS: __ Form EQ-032 PERMIT NO. ':; 76846 APPLICANT LOCATION L. EGRL MUM I C: DEPARTMENT ._. HEALTH AND ENVIRONMENTAL 25t6 E. TLI[:,OR RD.., ANCHORAGE., Ak:. 99507 276-222t -"'.=-;; E ~ANDOR CONSTRUCTIO~ ALPHA CIRCLE L8 BOREALIS SUBD 34.24 THOMF'SON LC)T' SIZE :1.6855 SC!UARE F'E:'ET 'I"'T'F'E OF SOIL. ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SO I L RRTI NG ,:: Sr.::! FT,.."BR ::, = 250 THE REC!LIIRED SIZE OF' THE SOl[_ ABSORPTION S'¢STEM IS: [::. El F" 'l- H == J_ 2.'. L_ E f-~ ~'3 "l- H = ~; 2: ,..S F-: R '..-' El b. i::, E F' 'T H == :E: 'I'HE LENGTH DIP1ENSION IS 'THE LENGTH (IN FEET') OF ]"HE TRENCH OF;'. [:,RAINFIEI...D. THE DEPTH OF A TRENCH OR F'IT IS THE DISTANCE BETWEEN THE SURFFH:.':E OF THE GROUND AND THE BOTTOM OF' ]"HE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTF'ALL F'IF'E AND THE BOTTOM OF THE EXCR'v'ATION (IN FEET). P' R E]: ~=:'] R ~.]i E F' L R I'-.I "l- ~.-.: E: ,]:~ lj I E: E [:, E II"HER A CLASS I OR II NSF APPROVED PLANT MR'¢ BE INSTALL. ED. A CONTINUOUS I"IAINTENRNCE AGREEMENT IS REQUIRED. IF' A MAINTENANCE AGREEMENT IS NOT KEPT CURF.:ENT 'T'OU MA'¢ BE REC!UIRED TO ENLARGE THE SOIL. ABSORPTION SYSTEM RND,."'OR '¢OU MA~¢ BE SUBJECT TO PROSECUTION. IF' A C:LRSS I S'T'STEM IS USED ]"HE L. ENGTH Ib 4 .... 0 -' .' 5 FEE:~. IF A P -c',= ,- .... ' ....... ' ..L.M ....II S'¢STEM IS U~E[.' THE LENG]"H IS; "~7' ~ FEET. E:ACKFILLZNG OF AN'T' S'¢STEM WI THOUT FINAL INSF'EC:TION AND APF'RO'v'AL E:'T' THIS [:'EPAR'f'MENT WILL E:E SUB..TEE:]' TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND AN'¢ ON-SITE SEWAGE DISPOSAL. S'¢S"FE:M :I:S ±00 FEET FOR A PRIVATE 14ELL OR 200 FEET EOR A PUBLIC 1.4ELI._. SPECIFICATIONS AND CONSTR. UCTION [:,IAGRAMS'?ARE AVAILABLE TO INSUF.:E F'ROPER I Ns"r RLLAT I ON. F'E:F::f-'I [ 1'- "-.-"RL_ I CERTIF'¢ THRI" :t.: I AM FRMIL. IRR WITH THE REC!UIREMENTS FOR ON-SITE SEWERS AND WE:LI_.S FtS ,S~_:T FORTH B'¢ THE MUNICIPRLI~¢ OF ANCHORA:]E. 2: I WILL ,,INSTALL THE STSTEM IN RF:IZ:OR[:,RNCE WITH THE C:IZE:,ES. ~: I UN[:,ERSTRN[:, 'THAT THE ON-SITE SEWER S'¢STEM MR'¢ REQUIRE ENL~EI"IE~T, I~ THE EESI[:,ENC:E IS REMO[:,ELED TO INC:I_U[:,E MORE THAN 4 E:EDROOMS. v ..... ............ ~;.,~;,> , Anchorage, A! as ka 99b03 ,, . · _- .~,,,..s ,.o~: ,,,,'..o~.~,~o~ 'r~,:~,~ This form reports' Soi'ls log Percolation _F_eet _ ~ i ~- / ,~? ~_.,, >L. .... 10- 11'- 13 ' Was ground water encountered? Reading If yes, at wi)at depth? Net'Time.[__Del)th to ~%ter Net brop -~oz~__ _~_,x_z¥~~~ .... ' ............... brain Field IIupLh of [nle]:.---,,~.. . Deptl'T-"t"6']i~'~-t~n-'~¥-i~it u.~r trench ....... ~ ...................... ............. ~..¢2~.~ ....~.m..~.~.~.~ ~e~ ~, P,',rro,-m~,~ by. '~ ~ m'~ c/~ '- c~,~ti ri~['~y'.'"~ ~'~ -~7-~ '~i;1};":"'7~: ...... 4 ' '. ............................... ' ' '-~ .... ~.. ~ ,.~ ....' '..,.~.~ ~z ~ MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC261194 Parcel ID 015 -203-06 Legal description BOREALIS LT 8 Site address 4901 ALPHA CIR Current property owner(s) ROSE JAMES Expiration Date: 5/14/2027 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments By: Original Certificate Date: 6/26/2026 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject systdm(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On-Site Systems Approval Application 1. GENERAL INFORMATION Parcel I. D. 015-203-06 Complete legal description BOREALIS LOT 8 Location (site address) 4901 ALPHA CIRCLE ANCHORAGE, ALASKA 99516 Current property owner(s) ROSE JAMES 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: 0 Private Well serving # dwelling units F-1 Other Non-public well as regulated by MOA F-1 Water Storage RN Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: FN� Private Septic F-1 Private Septic serving 2 dwelling units r_1 Holding Tank El Community Septic or Public Sewer 6. SEPTIC TANK: X Steel ❑ Plastic R Concrete R Fiberglass Age 26 _ See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed � Deep Trench E] Wide Trench R Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee C) (0 Waiver Fee $ Date of Payment ci Date of Payment COSA # 0 GC01- 6 I t q Waiver # COSA Application—Apr2025.doc COSA Checklist_May2025.docx COSA Checklist Legal Description: BOREALIS LOT 8 Parcel ID: 015-203-06 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 48” Date of pumping 5/14/26 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. DISPOSAL FIELD DATA Which system tested (date installed) 6/27/2000 ALL standpipes present per record drawing Total measured depth from grade 10.3 ft (max) Measured depth to pipe invert from grade 2.2 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 5/14/26 Results Pass Fluid depth prior to test 71 in Water added 620 gal New fluid depth 94 in Elapsed time 1440 min Final fluid depth 70 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 96 in (MOA 8’ ED) Effective depth used 70 in (Final Fluid Depth) Effective depth (ED) remaining 16 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA records & appears approximate with 8’ ED and operating in the top portion of the ED w/ no known freezing issues. COSA Checklist_May2025.docx E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Disposal Field on Lot > 100’ Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10’ Yes if No ft Field to Foundation > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main/Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 06/22/2026 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 06/22/26 LOT 13 X X N 89°58'30" W 120.00' FENCE _ X_x X-A X x x x x X X 10' UTILITY EASEMENT X X �L7) LOT 8 16,855 sq. ft. Cn _ O z O SEPTIC p O STANDPIPES Oo 4�- Ill LOT 7 � v _ '41.7' LOT 9 � 66.0'.................................... � O rn N 2-STORY N o —x� o FRAME o p�j HOUSE DECK 42.7' 16.3' 12.3 CONC.: v,cn 0 7.0' o ASPHALT N) DRIVEWAY �i S 89058'35" E 120.00' *:49 TH (32 ................ ..� B Saliz : �o - - -- -- ALPHA CIRCLE - - - �i� sem'•, LS-14837 J r SFO fit OFESS1000-,-�� 0 15' 30' AS-BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE LOT 8, BOREALIS SUBDIVISION RECORDED SUBDIVISION PLAT (73-146) ARE NOT SHOWN HEREON. ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THIS DOCUMENT DOES NOT CONSTITUTE BOUNDARY SURVEYAND THE IMPROVEMENTSAS DEPICTED HEREON EXISTAS IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SHOWN IN RELATION TO THE PROPERTY LINES. SURVEY MAY DISCLOSE. DATED THIS 19th DAY OF JUNE, 2026, ATANCHORAGE, UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE ALASKA. USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR ESTABLISHING PROPERTY BOUNDARIES. FIXED HEIGHT LLC HEIGHT, C.O. A. 122554 Land Surveying Services WWW.FIXEDHEIGHT.COM JOB # 26176 1 NO CORNERS SET THIS DATE I SCALE 1" = 30' 600 W 41st. Ave, Ste. C, Anchorage, AK 99503 907.290.8949