HomeMy WebLinkAboutELMORE #1 BLK 5 LT 10Elmore Block 5 Lot 10 #018-172-24 (Rev 05/02/18) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221005 PID Number: 018-172-24 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MATHEW D BLATTMACHR ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 4351 RIVERTON AVENUE, ANCHORAGE ❑ 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 ELMORE #1 5 10 Fill added above original grade Ft. Gravel length Ft. 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 2 Number of trenches Dist. between trenches From Tank Field Tank Line Ft 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 10'+ __ LIFT STATION Manufacturer Capacity Gal. Remarks TANK MT INSTALLED. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer JRS drainfield Drainfield CO/MT 3034 Inspector FWCS BENCH MARK (Assumed elevation) 100 ft Inspection 15` 4/6/22 6/10/22 Location and description 2nd 3`d 4° TOP OF RISER / MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date o '•:tQ,��� / ' . " " " " " ' : ' Curtis Huffman Septic System Approved�••• Date l� Z •..� 9 .• CE 128991 ��'lF�•. 6/17/22 ..•��C�� FO PROFESS10NPi® Note: this approval does not include well permit requirements. ®\0®ESS® (Rev 05/02/18) PID: 018-172-24 PERMIT: OSP221005 STAKED 100' I I WELL RADIUS m 208./2' a POST & WI E1.8' x 33.2' CANT FE Ems`` rn •G ' CO C, • O O ED QO�G� 48, 9 1 WELL ( O C APPROX. 100' 10.3' O --qRIFIEDAP F IOR 15 8' M TO CONST. 1 0 ( \ N 313R / RESIDENCE o a 14 FCO B O '. D MMISSIONED EXISTIN CO S.T. & INSTALLED NE 46 9 01 / I 1000-GALTNPEW DCO C ANK ^ p N A—C=40,2' B—C=44,7' A—D=44,4' B—D=48,9' A—E=47,4' B—E=52.2' ST MT E 0p N �SHEDCO MI 15CO CONNECTED TO'� EXISTING FIELDS 0 EXISTING FIELDS WAO y SEPTIC SECTION SCALEi NTS ELMORE #1 BLOCK 5, LOT 10 PREPARED FOR: MATTHEW BLATTMACHR 4351 RIVERTON AVENUE ANCHORAGE, AK 99516 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmoil.com SUPPORT SERVICES: OF •AZ4' WE c 9 TH* DATE: 1/11/2022 04 SURVEY: HOLT is Huffman DRAWN: FWCS `�-6/17/22 91�w SCALE: 1" = 30' PAGE: 1 OF 1 A*ftssi`01 ' STAKED 100' :' � WELL RADIUS m PRIOR TO CONST. a rn •G ' CO C, • y SEPTIC SECTION SCALEi NTS ELMORE #1 BLOCK 5, LOT 10 PREPARED FOR: MATTHEW BLATTMACHR 4351 RIVERTON AVENUE ANCHORAGE, AK 99516 FIRST WATER CONSULTING 13030 SUES WAY ANCHORAGE, AK 99516 907-350-9566 FirstWaterAK@gmoil.com SUPPORT SERVICES: OF •AZ4' WE c 9 TH* DATE: 1/11/2022 04 SURVEY: HOLT is Huffman DRAWN: FWCS `�-6/17/22 91�w SCALE: 1" = 30' PAGE: 1 OF 1 A*ftssi`01 ' Lot 2 E Lot 3 10' UTILITY EASEMENTS N 89'46'30"E 208.7 I I Lot 4 \ I ' Lot 10 208.72' / 1.8' x 33.2' CANT 12.1' x 12.1' WOODSHED ORGY 48 wit. 241 Q tri 9 rn _. I Lot 11 I I POST & WIRE FENCE Co t C0)It 8.2' x 103' GREENHOUSE RIVERTON AVENUE NOTE: BOTH THE CARPORT AND THE FENCED AREA OF THE CHICKEN COOP ENCROACH ONTO ADJACENT LOT 9. PLOT PLAN AS BUILT X SCALE 1" = 40' GRID SW 3036 Project No. 22-387/R1 ¢} 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & Associates, Inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenOiangsurvey.com O F A ....... �9S�p0 jonathanOlangsurvey.com p©'`�! • I hereby certify that I have surveyed the following described property: Lot 10, Block 5, ELMORE SUBD. ADDITION No. 1 (Plot No. P -635A) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the '?-� Day of TULO ?X22 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Q •49TH -It �. .. ..... ......... KENN " NG o G ' •.LS -5202.••• c, ©� SIONAi. oma' 0 AECC963 U3 M to "' to d o N 2 STORY ;, PD v Lot 9 RESIDENCE o • n 241• 16.a' OD 0 M 46.9' doll . v' ''' -. a 11.6'x24.0' SEPTIC' +NHOLE ' CARPORT T / SEPTIC PIPES•-'''.'" 12.3' x 16.3' CHICKEN COOP WITH FENCED YARD S 89'52'00"W 208.72' — — — — — cA 0 0 GRAVEL ROAD ct RIVERTON AVENUE NOTE: BOTH THE CARPORT AND THE FENCED AREA OF THE CHICKEN COOP ENCROACH ONTO ADJACENT LOT 9. PLOT PLAN AS BUILT X SCALE 1" = 40' GRID SW 3036 Project No. 22-387/R1 ¢} 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lan & Associates, Inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenOiangsurvey.com O F A ....... �9S�p0 jonathanOlangsurvey.com p©'`�! • I hereby certify that I have surveyed the following described property: Lot 10, Block 5, ELMORE SUBD. ADDITION No. 1 (Plot No. P -635A) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the '?-� Day of TULO ?X22 at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Q •49TH -It �. .. ..... ......... KENN " NG o G ' •.LS -5202.••• c, ©� SIONAi. oma' 0 AECC963 MI NVPALITY OF ANCHORAGE C n •S rte Wa lir & Wastewater Program PO Box 1966bo 4700 Elmore Road Anchorage, Alsaka 19-H650 Phone- (907) 343-7404 Fax! { pfj $45.7997 h1 k p: FAvwwmiu d. a r&n s I Ie On -Site Wastewater Disposal System Permit Permit Numbar: OSP221005 Mork Type: SepticTank Upgrade rade Tax Code Number: 01617221040 Site Legal Address: ELMORE#I BLK 5 LT iU :8036 Sit$ Mail Ing Address: 4351 RIVERTCN AVE, Anchomge Ownen DLA-FFMAC HR MATTHEW D Des i g n Eng 4neer-, FIRST WATER CCN -5 U 1 -TING This permit is for the construction of: Effective Date, Expiration Dom: Lot Size in Sq Ft: �i}arrmcrer V19)2022 19)2022 1 M W2026 41362 ❑ Disposal Fuld Sep?ic: T7r7Ic ❑ Holding Tank ❑ Rrivyr ❑ Private Well U Water Skoage All constructio n shall be in accordance w1th; 1. The attached approved design_ 2. All requirements specified in Aneharage Municipal code Chapters 15,56 and 15.65 and the State of Alaska Wastewater Disposal Regulations (1WCA 2) and Drinking hater Regulefflo b (1aAAC80) The wagew:Dter cede requires in sps-;!: )ns during the installation_ Tho crigincer ;had notify the Dcvcloprnent Services Department per AMC 15.63_ Provide nokificatiori by calling (91)7j 343-7904 (24f7), 4, From October 1310 Apri115. a subsurface soil absorplicn system under construction during freezing weather shall be either: a- Opened and dosed on the mm day, or b. Covered. seared, and heated to prevent freezing Received By' IsGued By: � kb6_60efa 1/1912022 Data: Date= 3 Development Services Department T Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax- 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I. D. 018-172-24 Property owner(s) MATTHEW D BLATTMACHR Day phone _ Mailing address 4351 RIVERTON AVENUE, ANCHORAGE, AK 99516 Site address 4351 RIVERTON AVENUE, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) ELMORE #1 BLOCK 5, LOT 10 Legal description (Township, Range & Section) Lot Size 41,362 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo AD U) Septic Tank E Upgrade X Duplex (D) ❑ Holding Tank ❑ Renewal El 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. nature of property owner or authorized agent) Permit/Rush Fees: 9 2 2 5 Waiver Fees: Date of Payment: 1A6A22 Date of Payment: Receipt Number: 5-1 918 3 Receipt Number: Permit No. 0 S P 2;Z 1005 Waiver No. G1Development 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 January 11, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: ELMORE #1 BLOCK 5, LOT 10 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 per the attached design to serve the existing 3-bedroom residence. The owner may decide to upsize the tank for future consideration and flexibility. The lot and area are served by private wells. 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 OSP221005, Rebecca Carroll, 01/19/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221005, Rebecca Carroll, 01/19/22 Development Services Department Building Safety Division On -Site Water & Wastewater Program �rG� BGi o: < 4700 Elmore Road J P.O. Box 196650 a Oro Mark Begich Anchorage, AK 99507 s n E T Y Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: O j S- j rl a- Q Legal Description Property Owner Name �& Address: (�4� �f_ ` \ act -,L, E �more *1 95 L10 n=AVt 5�C, Pump Installation Date: �l � l� Pump Intake Depth Below Top of Well Casing: tiv feet Pump Manufacturer's Name: Pump Model: 5V Pump Size W hp Pitless Adapter Burial Depth: 6 feet Pitless Adapter Manufacturer's Name : Pitless Adapter Installer: Well Disinfected Upon Completion? Method of Disinfection: Comments: ANCHORAGE WELL & PUMP SERV. Pump Installer Name: 330 EAST 76TH AVENUE ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF /ANCHORAGE Development Services Department ` P p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-172-24 1. GENERAL INFORMATION Complete Complete legal description ELMORE #1 BLOCK 5, LOT 10 Expiration Date: C? r 23 — 2 -Z- Location (site address) 4351 RIVERTON AVENUE, ANCHORAGE AK 99516 Current property owner(s) MATHEW BLATTMACHR Day phone Mailing address Real estate agent 4351 RIVERTON AVENUE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 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 $ 55 6 Waiver Fee $ Date of Payment _ L I Date of Payment Receipt Number (1 D 11 I COSA# 0SC2,Z1 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 6110122 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 the111M 1k system and maintenance. The operational life of all well and septic systems are subject to �~ a these various and dynamic characteristics and are outside the control of the evaluator of the •�f(i well and septic system. Therefore, any estimate of how long a system will function satisfactory /��g�P:• • . • !�9 �� for current or future occupants or guarantee that no unseen encroachments, deficiencies or * : .� discrepancies exist can be given by First Water Consulting & F / — 6. DSD SIGNATURE "' "'." 1" r . '. Curtis Huffman System #1 Approved for bedrooms ���F,9% CE 128991 �� TF,pF • .6/10/x2. 4P System #2 Approved for bedrooms ill1dPROFEWDOy Disapproved Conditional approval for bedrooms, with the following stipu`atiw�6kY tOF ((((( j� ON-SITE � WATER PROGRAM By: L`^ Original Certificate Date: l9 ^ ^ 7 2 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 r' • Legal Description: ELMORE #1 BLOCK 5 LOT 10 Parcel 1D: 018-172-24 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) Well production at time of test 3+ gpm Date drilled CIRCA <1964 Water storage tank volume NA gallons Total depth 124* ft Well disinfected for coliform test? ❑ Yes ® No Cased to UNKNOWN* ft ® Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate 0.70 mg/L ❑ Nitrate less than MRL (ND) ® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND) Casing height (above ground) 12+ in. Date of flow test for COSA 6/9/2022 Collected bY NE Static water level at beginning of test 45 ft. Date of Sample 6/1/2022 Comments *PER MOA RECORD DOCS. B. TANK DATA Age of tank(s) 0 years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping 6/8/22 FOR ADEQUACY TEST D. ABSORPTION FIELD DATA Which system tested (date installed) 7/9/1992 ® ALL standpipes present per record drawing Total measured depth from grade 5.6 ft (max) Measured depth to pipe invert from grade 5.1 ft (min) ❑ N/A — pressurized field C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/9/22 Results 0 Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in ® Monitor tubes go to bottom of effective. If not, state depth into effective MOA IR IS 0.51ED Elapsed time <5 min ® Code -required soil cover over field Final fluid depth 0 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) If yes, enter date Gallons introduced gallons Comments/Deficiencies: MT / CO AT GRADE. GOOD SOILS AT ST UPGRADE. F _'I E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ® Yes Septic Tank/Lift Station on Lot > 100' ft Surface Water > 100' ® Yes if No _ 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' if No ft 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 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 _ Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _ 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 l 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. 'awl�. �� ems.' �.' -Nlk� JJJ /:. TM .... .. ......... • Curtis Huffman ��� ��<�••. CE 128991 •. ���Of ft ft ft ft ft ft ft ft ,y • 4 JUN 2 0 92 7,31a, • Municipality of Anchorage = On-Site Water and Wastewater Program 02� " (907) 343-7904 '®E 6 8 L95 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 018-172-24 Expiration Date: t`J c� 31 o 9 1. GENERAL INFORMATION Complete legal description Elmore#1 Block 5 Lot 10 Location (site address) 4351 Riverton Ave. Anchorage Current Property owner(s) Lawrence Jedlicka Day phone Mailing address 4351 Riverton Ave. Anchorage, Ak Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage . ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: A Received by: /1/ a /I' di. Date: 7 i! COSA to be released to the engineer, unless othy is ftquested by the engineer. COSA Fee $ 555D Waiver Fee $ Date of Payment kW/9 Date of Payment Receipt Number ek4* 117g/ Receipt Number COSA# 05(Ja 1 a5-/ 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 ARCTERRA CONSULTING, INC. Phone 696-6111 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/19/2019 Engineer's Comments:This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use,local soil characteristics,groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future +��\ occupants or can Arcterra guarantee that no unseen i�•tiOF A encroachments,deficiencies or discrepancies exist. * 49 T ll Ala ; • 6. DSD SIGNATURE / �►�/ System #1 Approved for 3 bedrooms. /9"`'"N ,;�it`'' Atif System #2 Approved �. , S for bedrooms. �;o �¢ c?° Disapproved. Conditional approval for bedrooms, with the following stipulations: `r\ SOF l(' Cr(i,�� ON-SITE WATER AND r`: -WAS��WATER o PROGRAM J)))))))»»))) • By: t-M'ieA CanYttn Original Certificate Date: J . 2019 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 Yax k vim.. -)( COSA blue sheer 10.10-12.tloc COSA Checklist Legal Description: Elmore#1 Blk 5 Lot 10 Parcel ID: 018"172'24 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 2.5 gpm Date drilled <1964 Water storage tank volume gallons Total depth '124 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 540 ft i Coliform bacteria is Negative ■ Sanitary seal is functioning correctly Nitrate 0.613 mg/L ❑ Nitrate less than MRL (ND) II Wires are properly protected Arsenic ug/L El Arsenic less than MRL (ND) Casing height (above ground) 12 in. Collected by ArcTerra Consulting Date of flow test for COSA 6/5/19 Date of Sample 6/5/19 Static water level at beginning of test 45 ft. Comments * No well log avail. Info from previous MOA documents B. TANK DATA C. LIFT STATION Age of tank(s) 27 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank e/9 Lift station material ■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 6/12/19 **Top of tank to water 10" D. ABSORPTION FIELD DATA Which system tested (date installed) 7/9/92 Adequacy test date 6/5/19 ALL standpipes present per record drawing Results Pass For 3 bedrooms Total measured depth from grade 5'5 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 5.0 ft(min) Water added 450 gal ❑ N/A—pressurized field New depth 0 in II Monitor tubes go to bottom of effective. If not, state Elapsed time 10 min depth into effective II Code-required soil cover over field Final fluid depth 0 in El System presoaked Absorption rate 450 9pd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) 450 If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout > 100' ® Yes if No ft m Yes if No ft Neighboring Tank > 100' ®Yes if No ft Private Sewer/Septic Line >25' m Yes if No ft Absorption Field on Lot> 100' ®Yes if No ft Holding Tank > 100' ®Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community 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 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' 0 Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water> 100' ® Yes if No ft F. ENGINEER'S COMMENTS sibiokrpluitiaiG. ENGINEER'S CERTIFICATION ♦♦4'\... °F ,lb,,g ♦ I certify that I have determined through field inspections and review }' *N..,7 •j of Municipal records that the above systems are in conformance with : MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • On ; • f� ,'�'; 907-343'7904 -Site Water and Wastewater Section `� l Fax: 343-7997 www.muni.org/onsite ' Septic Tank Advisory' • Certificate of On-Site Systems Approval # OSC191254 Subdivision: Elmore #1 Block:5, Lot: 10 The septic tank for this property is 27 years old. The average life for a steel septic tank is 20 years. Typical replacement costs range from $6,000 to $9,000. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. This is an example of what the metal of a 30 year old steel tank MAY look like. . .y #.` Ny 3-per, �• •�'t^4E ' • � � .7;1,-, �J tera _ 4:rte msG • 4� .,,,,:e.S • ` y..•_ at '�- •U j 'r Z � :Wrix3['Ft - , _ ',..-.,::,-'47..r.4:1.,,,,,7..* _ ;'':, 4,04-,-. Ato ir.4,14t, ',.„, . . ,, ,,,,, i,.._ . ,, , . hift. ItOs c { i £�.. II3Y R 'S�Tf' — • pis f..1ait p• 4�j�'.:%L•1 Mailing Address: P.O.Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org