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Home My WebLink AboutCONIFER HEIGHTS BLK 1 LT 3Conifer Height lock I Lo? 015-093 -37 Municipality of Anchorage Development Services Department ~.~.: .=..=o On-Site Water & Wastewater Program, 4700 South Bmgaw St. P.O. Sox 196650 Anchorage, AK 99519-6650 ~ ~' www.ci.anchomge.ak.us (907) 343-7904 Page 1 of On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW010080 PID Number:. 015--095--57 Name: SEAN & JANIE LIDEY WastewaterSystem: · New [] Upgrade Address: 7910 KIANA CIRCLE * ANCHORAGE, AK 99507 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 544-9786 4 n Deep Trench I Shallow Trench [] Bed [] Mound []Other Lob Block: Subdivision: BelCh te pipe ~ fmw~ eHglnel grade: ~1 del~J~ beae~ 5 1 CONIFER HEIGHTS 2.85-6.45 ~ 3.99 Township: Range: Section: Iml ecMed olxwe erlglnel gr~le.' ~ - - - (-)2.5 TO (+)0.5 n. 50 Gm~ wkl~: Number of llne~: J Dl~enee WELL: · New [] Upgrade 5 ~. 1; -- Ct~lfleetl~ (Pflv~e, A,B,C): Tot=l Oel~h: C~ed To: Totol obeorl~on em~: PIpe nx~et~l: PRIVATE 407 rt. 211 Rt. 500 so. Rt. D 3034/ F-810 ALPINE DRILUNG 6/7-9/01 199 ~ BEEK CONSTRUCTION 5/18-21/2001 1.5 a,,I UNKNOWN n., 2 ,~ TANK SEPARATION DISTANCES .s,puc []Holding [] S.T.E.P. []Other To BepUc Abso~Uon Uft Holding ~ubllc/Px~w~ Men~'eetum~. Celx~l~ In From Tank Field Station Tank s..,r u... ANCHORAGE TANK 1250 Mo~rlol: Numbef ~f We, 100'+ 100'+ - - 25'+ STEEL 2 Surf°c° Wot,, lO0'+ 100'+ - - - LIFT STATION FoundaUon 5'+ 10'+ - - - "P~ ~" bv~ ~ " - Remarks: BENCH MARK Loco, Uoa end TOP OF GARAGE SLAB @ NORTHWEST CORNER BO'FI'OM OF SEPTIC TANK ~ OUTLET = 86.25 Department of Health and Hliman Services approval ~11;,% '.....~1 ....' PERMIT NUMBER: AS B'L~T D~~G PARCELID NUMBER: SW010080 - 015-095-57 /.iTTOP OF SLOP~ ~ ~R~T~ 25 P~E~. ST1 ST2 16~24 35~24 - ~ ~DBL3 18.48 37.73 - , DBL4 19.57 38.55 - / ~ ~~A~ E~ I 39 26 41 51 - ' co~ ~' .... '.o / X ~ ~"~' ~N~ ~o ~o. C02 26.29 - 63.60 / ~X ~ / MT2 23.05 - 61.15 / ~ X ~ ' W~ / ~ ~ ' L ..... ~ / / / / RED COURT / ~ - / ........ 'I~- ~S~ WATER & WASTEWATER CONS~LTANT~, lNG. PREP~ FOR: PH0~E SEAN AND JANIE LIDEY (907) 344-9786 2 OF CONIFER HEIGHTS SUBDIVISION; LOT 5, BLOCK 1 uh?~Z'... ~1 ..."'&~ AS-BUILT OF WELL LOCATION AND SEPTIC SYSTEM -~%%~ PERMIT NUMBER: AS B~T D~Jk.~G PARCELID NUMBER: SW010080 - 015-09,5-57 FINAL GRADE = 95.21 TOP OF TANK AT.--X = / = /'--TOP OF TANK AT SEPTIC TANK INVERT OF BUNG.-/ ~-INVERT OF BUNG AT AT ~NLET = 90.7S ou'rLEr -- 90.35 MT CO /-- FINAL GRADE ~ I_~ /= 93.80+/- / / ~ORIGINAL GRADE .' . :--INVERT OF PIPE ~ , ' = 90.18 (AVERAGE) I-I _ OM OF TRENCH = 88.19 (AVERACE) [~w. ............ CONSULTANTS, INC. ~,HOl DEBARR ROAD, SUITE 2B · ANCHORAGE, AK HHS0Z, ' PHONE IH07~337-'617H "FAX (H07)5:~6-:~2&6 N.ToSo °'' ° ~- . ................ :....~ SEAN AND JANIE LIDEY (907) 3,44-9786 5 OF ~ I[.p: fl' LEGAL DESCRIPTION: CONIFER .E~HTS SUBO~WS~O.~ LOT 3, 8LOCK ,. ~'.,o.'"...~ ........'~.=~'"-°~' PROFILE AS-BUILT OF SEPTIC SYSTEM t FAR NORTH BICENTENNIAL/HIlLSIDE PARK NO ENCROACHMENT CONCERNS NO ENCROACHMENT CONCERNS EXISTING SEF'nC - --ARK---~ ~ -- 4 BEDROOM /I ~_~.,.~,"('~'~I I HOUSE / EX~SnNO/ x .alr'~ / / WELL--/-._ 'X '~. X ~ ----- LOT 4, BLOCK 1J .,,w' ~-'~1 I~)JlJs_ ---I / ./ ~__ .~ ...... 'I~,/~ r~.~ NATE/'"~'""SITE I 100 WELL RADIU I ~ .'"~.~ I , , / \ )(/ J RED _~URT ] ' LOT 6~ BLOCK ,3 x //'x I-----/' --'/ -~-..- .... -.l I PROSPECT .E~OHTS I I '"~'~.-...-~./ I\i\~ -.. ... I I I I ~--~ ' I I I I ~'"-. ..... i ~ CON~ HIEOHTS ~.~\CONiFER HIED~I / I I I I \ I ~ / I I \ I I , LOT 7A. BLOCK 3 II PROSPECT HEICHTS till LOT 7, BLOCK 1 LOT 6. BLOCK 1 LOT 1, BLOCK 1 I CONIFER HIEGHTS CONIFER HIEGHTS CONIFER HIECHTS I ., %',. _ ____ __ _--~ ~'~-~-X.~ .~-;-~.-~t-- OA%/17/2001 _-"' ~r//~A DRAWN BY: //~'~; ' °/' ' ~"~-~ ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~../~ ./# ............. 6,0. DEBARR ROAD, SUITE 2B. NiCHORAGEt AK e,50~, pHOnE ¢~907)357~,7,. FAX (e07,35.$,,6 1"--100' ~. PREPARED FOR PHONE NUMBER: PAOE NUMBER: A~ .... SEAN AND JANIE LIDEY (907) 344-9786 1 OF 2 :fre~/ A. GaUss.-" LEON. DESCRIPTION: q[~-79§3 CONIFER HEIGHTS SUBDIVISION; LOT 3, BLOCK 1 url;?,,.~ .. 17 .... .-" WORK, SITE PLAN FOR EXISTING WELL AND SEPTIC SYSTEM"",'-'- '*--=--- FROM :,ALPINE DRILLING FAX NO. : 907 345 0202 Sep. 14 2801 04:14PM PI Municipality of Anchorage Department of Health and Human Services 825 'L~ Street P.O. Bo:< 196650 Anchorage, Alaska 99519-6050 F~Jck Mystrom http:l/www.cLanci,xrage.ak, us Mayor Permit Number: #SW O_~P080 Date of Issue: 4-25-01 Date Started: 6-7-01 DsteCompleted~ ~-9-01 Legal Descriptiom Conffer Hobts Blk I Lot 3 Property Owner Name & Address: Sean & Janie Lidey 7910 Kiana Circle Anchorage, Ak 99507 r Borehole Data: Depth (f0 Soil Type, Thickness & Wat~ S~am From To stick-up 0 2 silt 2 5 gravelly silt 5 45 sandy silt 45 57 sandy silty gravel 57 109 gravelly silt 109 187 silty gravel 187 205 gravelly silt damp 205 208 bedrock 208 407 Parcel Identification Number: ,0~5-093-37 Is well located at approved permit location? [] Yes ["'] No Method of lling [] air rotary [~ cable tool Casing type: steel Wall Thickness: .025. inches Diameter:. _.6 inches Depth: 211 ~eet Liner Type: __ Diameter: __ inches Depth: .~ Casing stiekup above ground: _2 feet Static water level (~om ground level): 199 feet Pumping level: 407 feet after 2 hours pumping ~.5 gpm Recovery Rate: l.fi gpm Method of Testing: airlift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Sum ~ feet [-]Perforations Start.~ feet Stopped ~ feet Stopped ~, feet Grout Type: Bentonite # 8 Volume: 1 be Depth: Start_O feet Stopped_+ feet Pump: Intake Depth _ ., feet P~-~p. size , ~ Bra~d Name Well Disinfected Upon Completion? [~ Yes n'l No Method of Disinfection: CIorine Teblets Comments: Well Driller:. Alpine Drilling & Enterprises P 0 Box f10496 Anchorage AK 99511 Attention: The well dr~er shall lxovido a well log to ~e property owner within 30 days of completion and the prop¢~ MUNICIPALITY OF ANCHORA GE Development Sen/ices Deparlment On-Site Water & Wastewater Program 4700 Soufh Bragaw Street P.O. Bo× 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Apr 25, 2001 Expiration Date: Apr 25, 2002 Permit Number; SW010080 Legal Description: Conifer Heights Block 1 Lot 3 Design Engineer: 0041 AK Water & Wastewater Consultan' Owner Name: Sean & Janie Lidey Owner Address: 7910 Kiana Circle Anchorage, AL 99507- Parcel ID: 015-093-37 Site Address: 7910 Kiana Circle Lot Size: 31012 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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. Date: /--7/- ~z:~ -O//_ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak, us (907) 343-7904 Parcel I.D. ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number S ~/OI 00~o Property owner(s) SEAN Mailing address (1) 7910 Mailing address (2) AND JANIE LIDEY KIANA CIRCLE * ANCHORAGE. AK 99507 Legal description (Lot, Block & Sub'd.) LOT Legal description (Section, Township & Range) Lot Size g I, 0 1~.+5-759' Acres/Sq.Ft. · THIS APPLICATION IS FOR: Sewer Only Sewer and Well · Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool ['-I BLOCK 1: CONIFER N/^ Number of Bedrooms Day phone 344-9786 Zip Code HEIGHTS SUBDIVISION Well Only [--] Water Storage r'-] Jacuzzi [-'] 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 and is in accordance with applicable Municipal codes. ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Permit Fees: ,~ Date of Payment: Receipt Number: Waiver Fees; Date of Payment: Receipt Number:. ALASKA WATER & WASTEWATER April 3, 2001 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Well and Septic Design for Lot 3, Block 1, Conifer Heights Subdivision To whom it may concern: The proposed 4 bedroom house will be served by a private well and septic system. Test holes were excavated on the property. The proposed septic system will be designed around the 30 foot radii of test hole #1 and #3. We are proposing that a 1250 gallon septic tank and a five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 1.2 gallons/day/ft2 should be used. 2. TRENCH DESIGN: a. Percolation Rate: <1 & 1.7 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 500 ft2 f. Total Depth: 10 feet (max.) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.5 i. Minimum Length: 50 feet long j Effective absorption area = 500 ft2 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography in the area of the proposed septic system is a 5 to 10 percent slope running from approximately south/southeast to north/northwest. The trench is to be installed to the slope contours. There is a slope that is greater than 25 percent north of the proposed drainfield. We request that the setback from this slope be waived to 35 feet. The slope is heavily vegetated and we do not anticipated any adverse impacts on the neighboring property with the granting of this waiver. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. Presiclknt~ NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, 3 soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com FAR NORTH BICENTENNIAL~HILLSIDE PARK NO ENCROACHMENT CONCERNS NO ENCROACHMENT CONCERNS ~PROPOSED SEPTIC SYSTEM ALTERNATE SITE-X /(SEE DESIGN. PAGE2 OF 2) .. ....... -' -'-~?~ '- j- ....... '- '-~ / / s~' ix, I. r'---L LOT 4. BLOCK 1 ./ / PROPOSED ~ '\ ~ L /eTHIII2~ co.,FE..,Ec~/ [ wE,, ~ .~ \ P.~ ~' - / ~ .._fl ..... -~--~-~t----- ~,,/ I HOUSE rr j .,~ __ ~ -- ~ t ~ // I R ~) COURT ' , , , ........ -I .............. ~--- ~,~-J / / / / .--- .... -k. co,,FER ,,~c~s \ ~. Ii / - . --'~r ......... ~'C---~.\ ///---7'------~ I ~ ,-v^~ I I I I I ~------' I ' I I I CONIFER HIEGHTS -~.~\CONiFER HIEGHTSI / I I / 0 I zl I I , II CONIFER HIEGHTS LOT 7, BLOCK I LOT 6. BLOCK I LOT 1, BLOCK 1 I I CONIFER HIEGHTS CONIFER HIEGHTS CONIFER HIEGHTS ' ~$~ WA~ER & ~~F.~ATER c.a.g./a.L.M. ~'" "-.:~'#, 6901DEBN~R ROADI SUITE 2B * ANCHORAGE, AK 9950~ * PHONE {~07~337-~17g * FAX fg07~38-3Z/,6 1" = 100' iq'""' :' " ................ :'" ¥5 SEAN AND JANIE LIDEY (907) $44-9786 1 OF 2 CONIFER HEIGHTS SUBDIVISION; LOT 5, BLOCK 1 TYPE OFWORK: SITE PLAN FOR PROPOSED WELL kOCATION AND SEPTIC SYSTEM NOTE: THE CONTRACTOR SHALL HAVE THE PROPOSED DRNNF1EI. D. EXCAVATE 33' UTILITY EASEMENT AND THE EAST 10' A TRENCH THAT IS 10 FEET DEEP UTILn'Y EASEMENT FLAGGED BY A REGISTERED MAXIMUM BY 5 FEET WIDE BY ~--,TOP OF SLOPE LAND SURVEYOR PRIOR TO CONSTRUCTION. 50 FEET LONG. ADD 4 FEET OF ! THAT IS GREATER CLEAN, WASHED SEWER DRNNROCK, / THAN 25 PERCENT. INSTALL TRENCH PARALLEL TO / ALL SLOPE COIgrOUR$~ ..... _ ~TE s~ .---' ~ .... ~ [- ,..-'"' - "" C.O ~""T ...- '"' - \ / DOUBLE <~3'?'~ PROPOSED ~25~ c,~_oN/~///2Z~-~ V~//~'~ Si :'PT]C TANK ~ F/l/l/JIll -~ ~ ~ I I ~o,,~Z~/ \\\\1 \ ~~ I+""'-I / //11 ..... L .... 4- ...... / RED COURT __/_.~ / ......... F'-- - '-- / / DRAWN BY: ~:~'~. ~'t o. SC.~LE: _. oo,s,,,A,,,.,,o. '"'~"-~ , ~,,""'"'" 6901 DEBARR ROADr SUITE 2B · ANCHORAGE! AK 9950/* · mONE (;907~337'.'617g ' FAX (907~38'5Z&6 '- SEAN AND JANIE LIDEY (907) ~44-9786 2 OF 2 " CONifER HE,GUTS SUbDIViSiON= LOT ~, ~LOC~ ~ DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM RED COURT BLOCK 3 FER HIE(:;HTS V~RIFY LOT CO~ HIE(}HTS VERIFY (9 (907) 344-9786 1 OF ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE. AK. 99504 PHONE (907) 557-6179 * FAX (907) 358-5246 - LEGAL DESCRIPTION: CONIFER HEIGHTS S/D LOT 3, BLOCK 1, PERFORMED FOR: SEAN & JANIE UDEY DATE PERFORMED: 8/10/00 ORGANICS [TEST HOLE GM SP SOIL CLASSIFICATIONS ~GW ~ 0¥¥ ~[~ SM P'~ sc ORG ML CL OL MH CH OH DEPTH TO DATE GROUNDWATER DRY 8/10/00 DRY 8/12/00 DRY 8/18/00 SITE PLAN 1"=100' 'rE~rH0Um APPROXIMATE % +TH~F2 I ./ RED COURT DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 7.5 FT. AND 8.0 FT. COMMENTS: PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY a. GARNESS, CERTIFY THAT THIS WAS PERF(~RIv~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON ALASKA WATI~R & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 PHONE (907) 337-6179 * FAX (907) 338-3246 J SOIL LOC; - PERCOLATION TEST I LEGAL DESCRIPTION: CONIFER HEIGHTS S/D; LOT 3. BLOCK 1. PERFORMED FOR: SEAN & JANIE UDEY DATE PERFORMED: 8/10/00 OR AN,CS ITEST HOLE #2I ML GM SOIL CLASSIFICATIONS ~GW ~.~:'~-'..! GP ~ SW ~ sP SM ORG ML CL OL MH CH OH DEPTH TO DATE GROUNDWATER 11.0' SEEPS 8/10/00 DRY 8/12/00 DRY 8/18/00 SITE PLAN 1"=100' T~-mOLES ARE APPROXIMATE 1 I [~ _/ RED,,,,.C_OUR~.J___~_~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 8/12/00 1 4:25 - 6- - 2 4:55 30 2 1/8" 3 7/8" 3 4-:56 - 6" _ 4 5:26 30 2" 4" 5 5:27 _ 6" - 6 5:57 ,50 2" 4" PERCOLATION RATE 7.5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6.0 FT. AND 6.5 FT. COMMENTS: PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING. PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF~Rlvt~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DATE: ALASKA WATER & WASTEWATER CONSULTANTS, INC. ~-~- 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE. AK. 99504 l SOIL LOC; - PERCOLATION TEST I ~.~....~.~!~j...~.~. ,. .[RrO.UED ro~: s~ · OAN~ Ug~ ~["'~'3~7~ DATE PERFORMED: 8/10/00 ML SOIL C~SSIFICATIONS SITE P~NJ ~:;~,:.,:.~:.~ GW ~ ORG 1"=100' J ~o~ ~ ~,, ~PROXI~~ ~i:.,~ GP ML GH ;CL GC OL ~ SW HH '~t~'t~ SP CH -- ~ I SH OH ~ I I SC X DEPTH TO DATE , GROUNDWATER ~y ~/~o/oo ;'~ GM/SM DRY 8/12/00 // j~ __/. RED COURT DRY j 8/18/oo ~~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 4/25/00 1 4:32 - 6- - 2 4:42 10 O" 6" 3 4:43 - 6" _ 4 4:53 10 O" 6" 5 4:54 _ 6" - 6 5:04 10 o" 6" 15 -- 7 5:05 - 6- - 16-- 9 5:15 10 O" 6" 10 5:15 - 6- - 17 ~ 11 5:25 10 O" 6" 12 5:25 - 6- - 18~ 13 5:35 10 O" 6" 19-- PERCOLATION RATE 1.7 (HIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20-- TEST RUN BETWEEN 7.0 FT. AND 7.5 FT. COHHENTS: PERFORMED BY A~SKA WATER · WAST~ATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFgRM[D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON gATE: DEPTH TO DATE GROUNDWATER DRY 8/10/00 DRY 8/12/00 DRY 8/18/00 00000, .1 ?o JUN1 8' 20i9Fa 8" Municipality of Anchorage, _ .,� On -Site Water and Wastewater Program (907) 343-7904 ZZ . r E T Y s 8 L°C' CERTIFICATE OF ON—SITE SYSTEMS APPROVAL Parcel I.D. 015-093-37 Expiration Date: 1. GENERAL INFORMATION Complete legal description Conifer Hts Block 1 Lot 3 Location (site address) 9200 Nordic St. Anchorage Current Property owner(s) Sean M & Janie L Lidey ` Day phone Mailing address 9200 Nordic St 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: Received by: Date: COSA to be released to the engineer, Unless otherwise requested by the engineer. COSA Fee $ 556 Waiver Fee $ Date of Payment `/q q Date of Payment Receipt Number i' u-ajj Receipt Number COSA # fJC �� la�� 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. D Date 6/14/2019 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, PRcc) RAM ArcTerra can not give any estimate of how long a : y 04,._ system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen \ i encroachments, deficiencies or discrepancies exist. OI 10, * 1�Til�� 6. DSD SIGNATURE System #1 Approved for bedrooms. �t�, "E`^ET 7i�s F1' / System #2 Approved for bedrooms. Disapproved.\•.+� Conditional approval for bedrooms, with the followirt�l�pl(ttiji�is: Original Certificate Date: ^ %9_ 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 blue sheet 10-10-12.doc C1NL-SITE � WATER AND �= PRcc) RAM : y 04,._ Original Certificate Date: ^ %9_ 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 blue sheet 10-10-12.doc Legal Description: COSA Checklist Conifer Hts Blk 1 Lot 3 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 6/7/01 Total depth 407 ft Cased to 211 ft 00 Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 28.5 in. Date of flow test for COSA 6/7/19 Static water level at beginning of test 187 ft. Comments B. TANK DATA Age of tank(s) 18 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 49" It Standpipes/foundation cleanout per record drawing Date of pumping 12/13/18 D. ABSORPTION FIELD DATA Which system tested (date installed) 5/18/01 ALL standpipes present per record drawing Total measured depth from grade 7.1 ft (ma Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective /, (p 00 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: COSA Checklist yellow sheet Parcel ID: 015-093-37 of Structure served by this system 1 Well production at time of test 1.0 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes IN Nc no Coliform bacteria is Negative Nitrate 4.83 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L FO Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 6/14 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 6/7/19 Results 21 Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 620 gal New depth 3 in Elapsed time 65 min Final fluid depth 0 in Absorption rate 620 9pd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No 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' if No ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft ft If septic tank is under driveway comment below 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: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION i 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. COSA Checklist yellow sheet m 8 2 ) j m ( \ § co m /)[7 XMƒ§� § [\i -ml 2m/\ » °8§ km\ > ,/(/ \//j \ \ //) mm <> §77\ ° »>\ 3 G \ ):§ § { =z \§\ OZ -7 m -En ( km _) §(j k7 _ \ 3ii (m \ )TM \ \o # moz §> «zo >- \\1 )63 ( k§ �m m NORDIC STREET S O°OO'OO"E 159.88' M _\ >m: \�9 : M