HomeMy WebLinkAboutSUE TAWN ESTATE #2 BLK 3 LT 3Sue Tawn
sta
Block 3
Lot 3
#051-501
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231413
Work Type: SepticTank Upgrade
Tax Code Number: 05150129000
Site Legal Address: SUE TAWN ESTATE #2 BLK 3 LT 3 G:1160
Site Mailing Address: 18912 SUE TAWN DR, Chugiak
Owner: KHUN JEREMY &
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
r�
f
1)epartrnenr
12/26/2023
12/25/2024
102430
❑ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: 11 S "�"� �' �✓�
Issued By:
Date:
3
Date: ! ZZ � 2- 2 �
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-501-29
Property owner(s) JEREMY KHUN & MEAGHAN STEELE-KUHN Day phone
Mailing address 18912 SUE TAWN DRIVE, CHUGIAK, AK 99567
Site address 18912 SUE TAWN DRIVE, CHUGIAK, AK 99567
Legal description (Sub'd., Block & Lot) SUE TAWN ESTATE #2 BLOCK 3, LOT 3
Legal description (Township, Range & Section)
Lot Size 102,430 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 ADU)
Septic Tank
El Upgrade RX
Duplex (D) El
Holding Tank
❑ Renewal ❑
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.
I ature of property owner or auinonzea agent)
Permit/Rush Feesl-,2,9 5
Date of Payment:
Receipt Number: lR 12 5
Permit No. 05Pa31y l3
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment 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
!
!!
December 20, 2023
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT
LEGAL: SUE TAWN ESTATE #2 BLOCK 3, LOT 3
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. A 1500-gallon septic tank may be
considered for current functionality and future consideration or flexibility.
Groundwater was noted in the MOA on-site file at 11.5 below test hole grade and is not
anticipated to affect the septic tank installation. If groundwater is encountered during installation
that may affect this septic tank upgrade, an epoxy coated steel septic tank or other action may be
required.
An existing deck less than 30 high and close to grade is partially over the existing septic tank. A
portion of the deck will be removed for this septic tank upgrade and no deck supports can be
over the tank after installation. The new septic tank manhole and cleanout must be accessible for
future maintenance.
The lot and area are served by private water and any encroaching wells, easements, … must be
staked prior to construction. 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
OSP231413, Curtis Townsend, 12/26/23
FIRST WATER CONSULTING
NO WELLS WITHIN
100' OF PROPOSED
SEPTIC TANK
SUE TAWN ESTATE #2 BLOCK 3, LOT 3
DESIGN DETAILS:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231413, Curtis Townsend, 12/26/23
Municipality orAnchorage
Developmen! Services Depadment
Building Safety Division
On-Site Water and Wast~ler P~am, 4700 S. Bragaw St.
P.O. Box 1~650 Anchorage,~ 99519-6650 Page
~.cl.an~orageak.us (907) 343-79~
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ~OI0130 PIDNumber:
~~ ~.~/y ~¢(~r Nastewater System: ~ New D Upgrade
~"'G~II' .T~l& gv~,~c~. A~ ~y ABSORPTION FIELD
SEPARATION DISTANCES ~ seplic U IloUing U S.T.E.P. U elbe.
1~ Septic Abso~p[ior Uff Holding Pub~s~ ~.: ~ C~,~
Tank Field Station Tank S~r [~e
"~' BENCH MARK
,,
k,, 170" Eagle River Loop R°ad, N°~ 1"
Inspections pedormed ~x: ......... ~ ua[es:
~,..,..r. ~,-.-- - .... 2
Develbpmept Se~ices Department Approval -
Revie~ed and approved by:, ~~ ~ ~ Date:l~-~T-OI
P£R.~IT NO. SW010150
PACE 2 OF 3
DEP~RI'MENT OF HE~TH~ND HUMAN SERVICES
ENViRONMENTaL SERVICES D~VISION
· P.O. I~ox 196650 e._~nChoroge, ~.~loskci 99519-665.0 · Te.t.e,ohone=. 343-4744
ON-SITE WASTEWATER UISPOSAL :SYSTEM AND/OR WELL INSPECTION REPORT
L£CAL LOT 5, BLOCK 3, SUETAWN ESTATE #2 P.I.D. NO.
LOT 2 ',
\
\
051 -501 -29
100° WELL RADIUS
LOT 4
COWAN
CE-8801
PERMI? NO SWOIO1.30
PAGE 3 OR 3
Municip. oLit oF .A.n_ch. oF ag.e .
DEPARTMENT OF HEAYLTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.D. Box J96650 eAnchoc~ge, A[osk= 995J9-6650e Telephone~ 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LECAL LOT 5, BLOCK 5, SUETAWN ESTATE #2
P.I.D. NO. 051--501--29
ST1 ST2 /98.3'
FINAL
___,/I NEW 1000 I~__ ~-
95'8'/ J GALLON j ~9~.6'
I SEPTIC TANK J
MT2
CO1
CO~
CO1 = 97.7'
C02 = 98.7'
GRADE
A B
FCO 6.0' 55.5'
ST1 11.0' 61.0'
ST2 14.0' 62.0'
DBL1 17.0' 62.5'
DBL2~ 18.5' 65.0'
C01 21.0' 65.5'
MT1 22.0' 64.0'
C02 $6.0' 30.5'
MT2 $5.5' 31.5'
CO1 = 93.4'
C02 = 93.2'
MT2 = 89.6 I%iTl = 89.6'
·
WATER FOUND
83.6' B.O.H.
85.1'
DEC-13-2001THU 08:38 i~IKING CAREER CENTER FAX NO, 907 278 6559 P, 01
Mett~og ot'Di.,.-~ -
' '. · ' - ' -- -- waa ~ m I~o paoS)e~ ntiho~it,/. MunlciP~l,~.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: May 23, 2001
Expiration Date: May 23, 2002
Permit Number: SW010130
Legal Description: 'SUETAWN ESTATE #2 BLK 3 LT 3
Design Engineer: 0003 S & S Engineering
Owner Name: RAYMOND E. & KIMBERLY S. MERCER
Owner Address: NHN SUETAWN DRIVE
ANCHORAGE, AK 99504-
Parcel ID: 051-501-29
Site Address:
Lot Size: 102430 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
Ail construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wast°water Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-79O4
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0-5'-/-- .~0 / "Z ?
Propertyowner(s) R~V~ K~'''~1
Mailing address (1) {~ll T~nt'v- ~v~n ~
Permit Number swOIO! 30_
Mailing address (2) fl
Legal description (Lot, Block & Sub'd.) L.. d']- ~j ~ Io C/<' 7, 5 ~ ~ 'To, u.)~/~t~.sYa4e 5 :;~c:~
Day phone
Zip Code
Legal description (Section, Township & Range)
Lot Size '~.L~ ~q.Ft.
IOZ,
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Number of Bedrooms
Well Only
Water Storage
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 app[ica, ble Municipal Codes.
,11¥ 7 /
17034 Eagle River Loop Roe '~ t.-. ,/')-~..~
(Signature of proper~ owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
ROBERT C. COWANo P.E.
2~, 2001
CIVIL ENGINEE;'~
(907) 694-2979
FAX (907) 694421
MUNICIPALITY OF ANCHORAGE
Department of Health and ![uman Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 3, Block 3, Sue Tawn Estates #2
It is requested that you issue a pennit to install a well and septic system to serve the
proposed three bedroom dwelling on the referenced property.
A test hole was excavated, and a percolation test performed. The approximate location of
the test hole is located on the attached site plan. At the time of excavation, 5/15/99, water
was not found. After ground water monitoring, water was found at 11.5'.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
cc jj
Enclosure
7054 EAGLE RM~R LOOP ROAD
EACI. E RrvE9, ALASKA 99577
PHON~ J~ (907)694-2979
r~XJ (907)694-~1251
3, BLOCK 3, SUE
J.H.U. R.C.C.
DESIGN CRITERIA:
5 BDRid = 450 GPD
SOILS = 450 GPD/SO.FT.
450/1.2 = 575 SQ.FT. REQ'D.
TRENCtt CRITERIA:
7' DEEP
4' EFFECTIVE
5' WIDE
58' LONG
LOT
ALL PORTIONS OF SYSTEM
WITH LESS THAN 5.5' OF
COVER R£OUIRE--~NSUEATtON.
6
TAWN ESTATES #2
~ ~,~.~ ~,'D Is"¢[T:
6-8-01 ! OF 2
STRUCTURES. £AS[U[NTS. OR ENCROACHMENTS
SHOWN ON THiS SITE PLAN AR[ AS ~HOWN ON
AN AS-BUiLT SURVEY O~WN BY:
WILUAM O. FLEMING
IT IS THE R[SPONSIBIUTY OF THE CONT~CTOR
TO V[RJ~ EASEMENTS. R[OUiR[O S[PA~TION
DISTANCES, AND PROP[R~ UNES PRIOR TO
CONSTRUCTION.
4
5
~ LOT 3, BLOCK 3, SUE TAWN ESTATES #2
v r ~T~TT ~T~TA, SHOWN ON THIS SIT[ P~N ARE AS SHOWN ON
PROPOSED
~ SEPTIC TANK ~ ~~~~
II ~
. m ~ / ~ THE E~[R ~ VARY THE
~ / ~ E~CT DIMENSIONS AN~ESIGN
/ ~ ~~S IN T~ FIELD, IF
A~ PORTIONS OF S~E~ / ......... / NECES~RY, TO MEET SITE
WITH ~SS THAN 3.5 OF / / ~R~R~ .......
COVER REQUIRE INSU~TION. ~ .............
Municipality of Anchorage.
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L" Street. Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:[0'~'' ~) ]~LO C ~ ~ S~,/~- ']4 I. dA/ F S 7 · j~' ~'-
Township, Range, Section:
4-
5-
6-
7-
8-
9-
10
11
12
13
14
15-
16.
18-
19-
20-
COMMENTS
0/Z[,-4,,,~c $
~ J'rld TR4. c~
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH? '~ pO
E
SITE PLAN
Reading Date Gross Net De~th to Net
Time Time Water Drop
~.//rl~c~ o - ff %" _
. ,, ~" / o ~"
,, ,. ~ '/~" . / ~ ~ '/~ ..
3o
PERCOLATION RATE__l · ~'~" (mmutes~ncn) PERC HOLE DIAMETER ~ ''
TEST RUN BETWEEN ~ FT AND ~L~ FT
PERFORMED BY: ~.7_n?.~ Ir~la ~;vn~' I nn.n Read No. ~2~ I .... ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE 9VIT~'~LP~'~r~EJS'~[~![[( ~4~"I'I~AL OUIDEUN ES ,, EFFECT ON THIS DATE. DATE: ~-/"~ ~ / q ~
72-008 (Rev. 4/85)
SOILTEST
ROBERT C. COWAN, P.E.
CML ENGINEERS
(907) 694-2979
FAX (907) Gg4-12 ! 1
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 3, Block 3, Sue Tawn Estates//2
February 28, 2001
GENERAL:
The scope of this project includes the installation of a 1000 gallon minimum
septic tank and a new trench to serve the proposed three bedroom residence
located on the referenced property.
Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
The contractor shall be responsible for obtaining any necessary underground
utility locates.
Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing their
own systems must also receive prior approval from the Municipal Health
Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include t~vo 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 I',,IO RTH EAGLE RIVER LOOP · SUITE 204 * EAGLE RIvEn. ALASKA 99577
Page 2
Lot 3, Block 3, Sue Tawn Estates #2
February 28, 2001
All standpipes on the septic tank shall extend a minimum of 12 inches above final grade.
Septic tanks installed with less than 4 ft. of cover shall be insulated.
A foundation cleanout shall be installed one to four feet from the building foundation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock)
placement.
Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt baffler must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barfer covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion
of the monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 3, Block 3, Sue Tawn Estatea #2
February 28, 2001
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM FSI0 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or
equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the//200 sieve.
When sand is being used as a filter material, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requirement applies.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wastewater disposal system. These inspections ~vill occur as follows:
Page 4
Lot 3, Block 3, Sue Tawn Estates #2
February 28, 200t
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any grovel. A septic tank may be
set in place, but may not be backfilled before this inspection.
The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-
construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or
control in any way the contractors activities.
The owner shall contract with the contractor to perform the ~vork outlined in these specifications
and plans and in accordance with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be
the owner's representative and will inspect the work as stated above to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR / INSTALLER
o, .' ~ 15 Ol O~:4Ga Palmer Correctional Cent.
ROBERT C. COWAN, P.E.
SEWER & WA!ER
INSPECIION
WELL INSPECTION
&FLOW'[EST
ROADDESIGN
SOILTEST
PERCOLATION
1EST
July 7, 1999
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 3, Block 3, Sue Tawn Subdivision #2
It is requested that you issue a permit to drill a well and install a septic system to
serve the three bedroom dwelling on the referenced property.
One test hole was excavated and a percolation test was performed. The approximate
location of the test hole is located on the attached site plan. Ground water was mon/tored
as shown on the attached soils log and after seven days the depth to water was found at
11-1/2 feet on 5/24/99.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/jhm
Enclosure
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER ALASKA 99577
1" = 80'
SCALE
SiTE J PLAN
25' Creek £$rn(
25' Creek
l" = 30'
SCALE
o
DESIGN
Ot~ ~
DETAIL
0
0
U
Municipality gl Anchorage.
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGALDESCRiPTiON:~.OT- ~) /3~oCK~5~ 7/~L~/ FS)', '~
Township, Range, Section:
6-
7
8
9
SLOPE
SITE PLAN
p-4v
10
11
12
13--
14
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth Io Water After )1 '/~./
~3. O. ~. Monitoring? Date:
15
16-
17-
18-
19-
Gross Net Depth to Net
Reading Date Time Time Water Drop
s' h C,/,~ o - ,~ '6. ,, _
~¢~,,.~ r,¢ ' 5- ,.~ ~,~ ~ '/~" ~"
S-?/~" / o q"
~' " ~ '~" / ~ ~ '5"
,, ,, ~" %~ ~'/~"
- " ¢" ~ ~A"
20 - PERCOLATION RATE / ' ~'' (minutes/tach) PERC HOLE DIAM~T - '
TEST RUN BETWEEN ~._~__ FT AND ~ FT
COMMENTS
PERFORMED BY: *?n?~ ~,.1¢ ~l,,~r t~on ~ou8 No. ~ I ~/~?/ [ ~ ¢?~ CERTIFY THAT THIS TEST WAS PE~RMED IN
~, _.~;... ~I=*.E.~ · * a99577
ACCORDANCE WIT~+AE[~'~r~r~'-~]~'MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
ROBERT C. COWAN, P.E.
WELL INSPECTION
& FLOWTEST
SOIL TEST
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
REFERENCE: Lot 3, Block 3, Sue Tawn Estates//2
July 7, 1999
GENERAL:
1. The scope of this project includes the installation of a 1000 gallon septic tank
and leachfield trench for the proposed three bedroom house located on the
referenced property.
2. Construction shall be in accordance with the approved site plan and design
drawings, Municipal permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any necessary underground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Health Department for system installations. Owners installing
their own systems must also receive prior approval from the Municipal Health
Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling~or shifting of
the tank.
All standpipes on the septic tank shall extend a minimum of 12 inches above(~)~e~
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
Page 2
Lot 3, Block 3, Sue Tawn Estates 5/D #2
July 7, t999
4. Septic tanks installed with less than 4 fi. of cover shall be insulated.
A foundation cleanout shall be installed one to four feet from the building foundation. In
the line between the tank and the leachfield there shall be two adjacent cleanouts (unless
an effluent pumping system exists within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line,
shall be to clean toward the leachfield. The second cleanout shall be to clean toward the
septic tank.
Final grading over the septic tank shall be such that a positive slope exists away from the
septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock)
placement.
Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribution pipe to
provide a m/nimum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion
of the monitoring tube extending through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This is equivalent to the effective depth of
the gravel as noted on the design.
Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The
finish grade over the trench must be mounded to prevent the formation of a depression
after settling.
Page 3
Lot 3, Block 3, Sue Tawn Estates S/D #2
July 7, 1999
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank m~nufacturer.
The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
T~vpe of Pipe Perforated Solid
Cast Iron
ASTM D3034 (PVC)
ASTM F810 (HDPE)
ASTM D2662 (ABS)
Yes Yes
Yes Yes
Yes No
Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting engineer.
Insulation shall be at least 2" thick extruded direct bur/al polystyrene (Dow Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or
equal).
A permeable nontoxic silt ¢~4~r,. (Typar 3401, Mirafi 140N, or equal) must be installed
between the final leachfielr~..av~Llayer and the native soil backfill.
All leach_field gravel (sewer ro~"k)5~l:i}? 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve. ~"~:x ,' ~ i
When sand is being used as a filter mat~fal, its gradation specifications must conform to
current M.O.A. or D.E.C. requirements, which ever requkement applies.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of the
wastewater disposal system. These inspections will occur as follows:
Page 4
Lot 3, Block 3, Sue Tawn Estates S/D #2
July 7, t999
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be backfilled before this inspection.
The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer
is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-
construction meeting will take place on-site. The inspecting engineer will not coordinate, direct
or control in any way the contractors activities.
The owner shall contract with the contractor to perform the work~-~?~n~ in these specifications
and plans and in accordance with the attached M.O.A. permit. ~,~ff~,7¢~11 be no contractual
arrangement existing between the contractor and S & S Engineering. ~c~g.},~,ngineering shall be
the owner's representative and will inspect the work as stated above t6 do~fif~ent the contractors
activities. Final acceptance of the contractors work rests with the owner
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor to
carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
MUNICIPALITY OF ANCHORAGE
r
Development Services Department `R. Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 051-501-29
Certificate of On -Site Systems Approval
Expiration Date: ( u,
Legal description SUE TAWN ESTATE #2 BLK 3 LT 3
Site address 18912 SUE TAWN DR Chugiak AK 99567
Current property owner(s) MICHAEL & CHERYL THOMAS
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Z
Original Certificate Date: 7/25/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services 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 work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory X Arsenic Advisory
Other
COSA ApprovaIjune 2022
MUHMPUTY OF ANCHORAGE
Development Services Department a ' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
�(ttjj,��i
Certificate of On Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-501-29
Complete legal description Sue Tawn Estates #2, 133 L3
Location (site address) 18912 Sue Tawn
Current property owners) Michael Thomas
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone (907) 647-2017
3. TYPE OF WATER SUPPLY: ❑® Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 22 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑®
Distance:
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 $ Q Waiver Fee $
Date of Payment / 2 c;'Z.Z Date of Payment
c
COSA # o S C. 2 3 2 3 5 Waiver #
COSA Application_ June 2022
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC231235
Subdivision: Sue Tawn Estate #2 Block:3, Lot: 3
The septic tank for this property is 22 years old. The average life of an asphalt
coated steel septic tank is 20 years. Typical replacement costs are $10,000 or more,
not including engineering, surveying or MOA permitting fees.
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.
Mailing Address P O Box 196650 Anchorage, Alaska 99519 6650 *www muni org
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
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
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
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)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
Sue Tawn Estates #2, B3 L3 051-501-29
1
4.8
8/27/2001 81 0
81 n
2.23
37
6/14/2023 Steven D. Cinelli
11.5 6/14/2023
50.5
6/9/2023
Tank is partially under a deck. Supports not directly over tank.
6/13/2001
9.33
5.4
3.93
NO
6/14/2023
5.5
450
5.5
103
11
>450
48
11.84
36.16
MT2 & CO2 had been cut and the end of the leach field paved over.
The tubes were located and repaired, the asphalt pavement cut away from the field, and landscape rocks placed to restrict traffic.
n
10100 E Tern Drive, Palmer, AK 99645
(907) 240-0713
steve@eng-exc.com
July 5, 2023
Municipality of Anchorage
On -Site Water and Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: COSA APPLICATION, EXPEDITE REQUESTED
LEGAL: L3 B3 SUE TAWN ESTATES, ADDITION #2
PHYSICAL: 18912 SUE TAWN DRIVE, CHUGIAK, AK 99567
Ladies and Gentlemen,
Engineering & Excavating, LLC has been retained to complete a COSA application for a 3 -bedroom home
at the above referenced location due to a pending sale. We would like to request an expedited review
of this application.
Attached to this letter are the COSA Application, the COSA checklist, a recent as -built survey, and the
most recent pumping receipt from June 9, 2023.
Both the well and the leach field were found to perform adequately when tested. The standing fluid
depth inside the 1,000 -gallon tank was observed to be 50.5 inches, about two inches deeper than the
49.5 inch design depth, which is consistent with the tank being water -tight. The water sample results
indicated that neither coliforms nor e. coli were detected, Total N was 2.23, and arsenic was <MRL. The
well produced about 5 GPM from a hose bib at a maximum observed drawdown of 4.6 ft.
During the site visit neither the cleanout nor the monitor tube at the easterly end of the leach field were
observed. Additionally, about two feet of the septic tank at the inlet end was under a deck. No other
variations from design standards were observed.
Please do not hesitate to contact us if you have any questions or comments.
Sincerely,
F ` �
Steven D. Cinelli, PE
kk�
5��
T H
Steven D. Cinelli
No. CEI 71
5 -July -2023
10100 E Tern Drive, Palmer, AK 99645
(907) 240-0713
steve@eng-exc.com
July 25, 2023
Municipality of Anchorage
On-Site Water and Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: REVISED COSA APPLICATION #3, EXPEDITE REQUESTED
LEGAL: L3 B3 SUE TAWN ESTATES, ADDITION #2
PHYSICAL: 18912 SUE TAWN DRIVE, CHUGIAK, AK 99567
Ladies and Gentlemen,
Engineering & Excavating, LLC has been retained to complete a COSA application for a 3-bedroom home
at the above referenced location due to a pending sale. We have received comments from the MOA
and have addressed them in this second revision.
Attached to this letter are the revised COSA Application, the COSA checklist, a recent to-scale as-built
survey, water test results, and the most recent pumping receipt from June 9, 2023.
The driveway was sawcut and removed over the leach field, the monitor tube and the cleanout located
and repaired, and large rock barriers were placed at the end of the leach field to discourage traffic.
Additionally, there are no deck supports directly over the septic tank.
The well casing (Photo 1) was observed to extend about 37 inches above grade. The well is located
adjacent to a paved driveway. The area is graded downhill away from the driveway and did not appear
to have been recently excavated nor did the well casing appear to have been modified.
Calculations for the outflow performance of the leach field are also attached. The calculations are based
on industry accepted material balance and Darcy flow calculations.
Please do not hesitate to contact us if you have any questions or comments.
Sincerely,
Steven D. Cinelli, PE
25-July-2023
Depth to bottom of trench 112
Trench L 38
Trench w 5
Field Porosity 0.4 40% is MOA requirement. 20% is a good estimate.
Measured Field depth 3.93
Field Pore volume 2234.1264 gallons
T, (hh:mm)Delta T, mins Qin, (gals)
Qin, (gals
cumulative)fluid observation, (in)
Fluid depth,
(in)
Fluid
Depth,
(ft)VLF, (gal)
Delta VLF,
(gal)
Vout, gals
cumulative Qout, (gpm)
6:21 0 0 106.5 5.5 0.46 260.6
6:41 20 90 90 106 6 0.50 284.2 23.7 66.3 3.3
7:17 56 159 249 105 7 0.58 331.6 71.1 177.9 3.2
7:35 74 81 330 103.75 8.25 0.69 390.8 130.3 199.7 2.7
8:04 103 120 450 101 11 0.92 521.1 260.6 189.4 1.8
40% porosity 20% Porosity
Initial fluild volume in leach field 260.6 130.3 gallons
Final Fluid Volume in leach field 521.1 260.6 gallons
Additional fluid stored in leach field 260.6 130.3 gallons
Fluid Absorbed into soil 189.4 319.7 gallons
Total elapsed time 103.0 103.0 mins
Total Qout 1.8 3.1 gpm
Time for remaining fluid to leach @ steady state conditions 141.7 42.0 mins
Total Capacity of leach field 2,649 4,470 Gallons per day
Trench bottom area 221.6666667 sq ft
Final outflow 1.8 gpm
outflow flux 0.00829754 gpm/sq ft
outflow flux 0.001109297 cfm/sq ft
Test Hole Geometry
Hole Diameter 0.83 ft
Hole wetted depth 0.67 ft
Hole End Area 0.55 sq ft
Hole Circumferance 2.62 ft
Wetted area 2.29 sq ft
Wetted Volume of test hole 0.36 cubic ft
pea gravel porosity 26%ideal porosity
Pore space volume 0.094538668 cubic ft
Pore Space vol/in 0.011817333 cubic ft/in
Water outflow from test hole 0.002541116 cubic ft/minute
Pore Space vol/in 0.011817333 cubic ft/in
Inches fall in one minute 4.65 Minutes per inch
Therefore, this percolation rate is consistent with design soil rating.
3. POST TEST ANALYSIS
4. CALCULATE OBSERVED PERCOLATION RATE
1. TRENCH DATAThree Part Calculation:
1) Simplify General Material Balanace Equation to Qin=Qout+∆VLF
to calculuate Qout, the rate of water absorbed.
2. FIELD OBSERVATIONS
2) Assume Darcy Flow and calculate Darcy flux for observed Qout
across wetted portion of leach field.
3) Calculate flow area of standard percolation test hole and use
observed Darcy flux to calculate standard percolation rate.
2. MATERIAL BALANCE CALCULATIONS
PHOTO 1
Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEms APPROVAL
Parcel i[). 051-501-29
1. GENERAL INFORMATION
Complete legal description SUETAWN#2BLK3,LOT3
Expiration Date:
Location (site address) 18912 SUE TAWN DR. EAGLE RIVER AK
Current Property ovYO8r() RAY MERCER Day phone
K8Gi|iDg address P.O. BOX 672172 CHUG!/\K AK 9956
Real Estate Agent Day phone
2. TYPE OFDWELLING:
Z Single Family (wA\wDA[)U)
F] Duplex
F� Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OFBEDROOMS: 3
4. TYPE OFWATER SUPPLY:
TYPE OF WASTEWATERD|SPOSAL:
Individual Well
Individual
z
Individual Water Storage
El
Holding Tank
El
Community Class Well
0
COrDrDuOitv
0
Public Water System
El
Public QeYve[
El
VV8ive[yVa[i8Dc8 request for:
Distance:
�,uo^mpereieoyeomthe engineer, unless otherwise requested bythe engineer.
CO8A Waiver Fee $
u@l8 OT P8yrn8Ol / [}8t8 of Payment
Receipt Number Receipt Number
�� �
CC}SA# VVuiver#
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 MIKE N ANDERSON P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 7/31/17
�n A tl o 0 9 a O � e 8 bP 9 d 2 r1 ry .S 0 0 B .JI
/ 1
6. DSD SIGNATURE °n MICHAEL ,r. a�Dr2scr'� m
F'
System #1 Approved for bedrooms. `rs �;,CE 94'9
System #2 Approved for bedrooms.`
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
,,A I :- e--
g�y^�^ O,�z —riginal Certificate Date:— – t-
The Municipality of Anchorage Development Services D&i ion (DSD) issues Certificates of On -Site Systems I 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
Ifmore than 1 septic system is on the lot:
COSAChecklist #____of____
�mn�naoomedby�isaystem _
Certificate of On -Site Systems Approval Checklist
Legm|Denchodoni SUE TAWN V12 BLK 3, LOT 3 Parcel |D: 051-501-29
A. WELL DATA
Well type PRIVATE |fA.B.orCprovide PVVS|D#Well Log (YYN)
Date completed-8-27-01Sanitary seal (YYN)_2VVinas properly protected (Y/N) Y__
Total depth 81 ft. Cased to81f� Casing height (above ground) _19__
FROM WELL LOG AT INSPECTION
Date oftest 8-27-01_ 6-29-17
Static water level 14 ft. 15 ft.
Well production 25 g.p,m. g.P.m.
WATER SAMPLE RESULTS:
Coliform l0EGco|onias/1OO mL Nitrate 2.21 - mg/L
Arsenic: ND uq/L Date of sample: 6-29-17 Collected by: MNA
B. SEPTIC/HOLDING TANK DATA
TankType/Material Oateinsto|
Tank size 1000 gal. Number ofCompartments 2 C|eannuts(Y?N)
Foundation cleanout (Y7N)y Depression over tank (YYN) High water alarm (Y/N) NA
Date ofpumping Pumper 6-29-17
C. ABSORPTION FIELD DATA —1885SYSTEM TESTED
Date instaUe �-/x-«/o-Uradng (GPD/SF) 1.
Length 38 ft. Width _5ft.Gravel below pipe 4.0 ft.
Total depth 8.0 ftEff. absorption area -3W
System type 5 WIDE
Monitoring tube Y Depression over field N
Date ofadequacy 'test Results (Posa0Fa0_PASS For l_bedrooms
Fluid depth in absorption field before test _1�_ in. Water added _5O0±_gal. New depth 11 in,
Elapsed Timei_1{X>_min. Fina|f|uiddepth_fi_in. Absorption rate ^=5OO±g.pd.
Any rejuvenation treatment (past 12mo.)(Y/N&type) UNKNOWN |fyes, give date________
D. LIFT STATION
Date installed
"Pump on" level atin. "Pump off" level at in. High water alarm level at in.
Datum
_ Size ingallons anho|e/Acoeas(YN)
E SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested Meets alarm & circuit requirements?
Septic tank/lift station on lot 100'+
Absorption field onlot
�
Public sewer main Q90
Sewer /septic service line
Animal containment areas
SEPTIC/HOLDING TANK ONLOT TO:
Building foundation 5'+ Property line 10'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout na
Holding tank na
Manure/animal excrete storage areas
Absorption field
Water main 1 Water service line Surfacewaba
Wells onadjacent lots _Y0O'±
ABSORPTION FIELD ONLOT TO:
Property line Building foundation 10'+ Water main
Water Service line 10'+ Surface water Dhveway, parking/vehicle storage _10'+____
Curtain drain VVe||s on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
/ certify that / have determined through field inspections and
review of Municipal records that the above oyobe/na are /n
conformance with MOA COS4 guidelines in effect on this date.
Engineer's Printed Nome MIKE N. ANDERSON, PE
Date 713112017
C0S*canary shcnLz-6-1s.uon
rcu-ii-euue WhD U13;Z? All KING CAREER Or:' -,R FAX NO. 907 278 6559
02/02
-0-1
200 SLS 'ON Ot'GOZ% (- 3OVE180W "Stritl I-IdN3a TZ -60 Zooz/cl/eo
Mul icipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Waslewater Program
4700 South Elragow St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchoroge.ok.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0.5"/' - 5"0 1 - ~.,.~
1. GENERAL INFORMATION
Complele legal d~scripti0n ~Lo3" .3
Locali;3n (site addre'~s or directions)
HAA# I- A O lo 6-4-7
Expiration Date:
Current Propedy owner(s) P,~¥~,~."o ~ ~'~'~-¥ /~¢.Rc~4 Day phone
Maili~gaddress ~11 '7-,4/~tA. i~.,~¢.,
Lend'i{rg agency Day phone
Mailing address
Real Estnte Agent
Day phone
Maili~g Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: -~
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class __
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
Individual On-site []
Individual Holding tank []
[]
Community On-site
Public Sewer []
The Municipnlity of Anchorage Development Services Department (DSD) Issues Certificates of Health Authorily
Approval (HAA) based only upon the representations given tn paragraph 5 by an independent professional civil
~.ngineer reglslered tn the State of Alaska. Certificales of Health Authority Approval are required for the transfer of
lille (except between spouses) for propedies served by a. single family on-site wastewa{er disposal and/or water
supply syslem. DSD also issues HAAs upon request to homeowners. Certificates of Health Authorily Approval are
valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Cedificates may be reissued for a period of up to one year with
valid water snmples.) Cedific'~les are valid for one year for properties served by Class A or B wells or a public
water syslem. The Municipalily of Anchorage Is not responsible for errors or omissions In the professional
engiaeer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
and regulations In effect at Ihe time of inslallalion. $ & $ ENGINEERING
Name of Firm 17034 Eagle River Leop Road No. 204
Eagle River, Alaska ~57'/
Address
As certified by my sea~ affixed hereto and as of Ih~ validation da{e shown below, I verify lhat my Investigation.
based on procedures outlined In the Health Authority Approval GuldelInes for this application, shows that the
on-site water supply and/or wastewater disposal sygterM Is(are) safe, functional end adequate for Ihe number of
bedrooms and type of structure Indicated hereln. I fudher Verify Iha{ based on the Information oblained fi.om the
Municipality of Anchorage files and from my Invesflga~ion and Inspection, the on-site waler supply and/or
waslewa~er disposal system Is(are) In compliance iNilh all applicable Municipal and Stale codes, ordinances.
Engineer's Printed Name i/:~0d4.~ ~ C. (-...',o~,~,-.
Phone
DSD SIGNATURE
~ Approved for ~
Disapproved.
Conditional approval for ~
bedrooms.
Date I~-/;z~/c/
· -~/xr~ '"... ~ ~t
,
,~.,N~INEER ~
bedrooms, with the following s~ipula~ions:.
Addilional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemenlal Engineer's Report
Olher
Original Cedificate Date: /2 - ,'~ ,~'' 0 [
Municipality of Anchorage
Development Services Department
Bu~dlng Safety Division
On-Sfie Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 19O650 Anchorage, AK 99519-6650
www.ci.anchomge.ak.us
(9O7) 343.7~04
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDascriptlon: LOT ~ l~t-er,,K. 3 Sv,e- 7/~ [$r~7,~J,~l:~ ParcellO:~,S"/-,S''01-'~'°/
WELL DATA
Wall type pR ~ vA 2' {.
pete ~omplet~ ~l~/o~
Tota~ depth '8; ~ ff.
Data of test
Static water level
Well production
IfA, B, or C provide PWSID # --
Casedto '~1 ft.
FROM WELL LOG
ft.
g.p.m.
WATER SAMPLE RESULTS:
Coliform d colonies/100 mL
Dataofsample: I I / ~.. q / ~ I
Nitrate I. I ~' m0./i.
Ceaected by:.
we, Log~/N) Y ~
Wlras propedy protected (~)N),
Casing height (above ground)
in.
AT INSPECTION
ft.
g.p.m.
Other bacteria o colonies/100 mi.
~IGINE~RING
B, SEPTIC/HOLDINGTANK DATA
Tank size. / O O'O gaL:?.. Number of Campartments '~'
Four'arian deanout ~1~1}~ ¥~ $ Depression over tank (Y~ ~' 0
Data of primping' J~ / ~ -:' ~.,~4 ~ Pumper ~
c. A SORP=O. DAT.
Data installed ~//}/e / ,' Soil m~g~or ~/bdrm) /' ~-
17034 Eagle River L~4p Road No. 2G4
River, Alaska
c~eanout~ 4~1)
HIGh water alarm (Y~}
System type
Total depth .~ ft. Eft. absorption area3 f 0 ~ Monitoring tube ¥~,-J Depression over field ~ O_~
Data of adequacy tast ~v//.+ -~.~v' Results(Pass/Fall1/ For ~ bedrooms
Fluid depth in absorption field before ~ Water added
gal.
New
depth
in.
Elapsed Time~Finalfi_u~_.d_e.p_th , in. Absorption rate >= g.p.d.
Any?..~3~ treatment (past 12 mo.) (Y/N & type). Eyes. give date
D. UFT b-rATION
Date installed Size in gallons ~
'Pump on" level at in. 'P~ High water alarm level at
Datum ~.-------"--'-~ycles tested Meets alarm & cimuit requirements?
E. SEPARATION DISTANCES
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tenkJlitt station on lot ] 5"' 6
Absorption field on lot 1/(o
Public sewer main
Sewer/septic senace line
On adjacent lots / O O -~'
On adjacent lots / 0 o -~
Public sewer manhole/deanout
Holding lank ~/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main ~ //~
Wells on adjacent lots
Property line ~' I
Water service line
Absorption field ,J'- ~''
t-- Surface water
Water Service line
Curtain drain/~a
COMMENTS
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
I
Property line ~' Building foundation
]0 ~- Sudacewater I0¢) ~¥-'
,~o~f/~',Well~'on adjacent lots /00 ~
Water main ~ /~1
Ddveway, pafldng/vehidestorage /0 '4-
review of Municipal ~:o~'ds that the above syste~ are in ~-,_,~.'~....~!'
conformance w/th MOA HAA guidelines in effect on this date.
Date / ~- / 3, ~/0 /
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12/00)
Waiver Fee $
Date of Payment
Receipt Number
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AECC#173042
S4
Group Lot 3, Block 3,
Sue Tawn Estates
Addition No. 2 Subdivision
Asbuilt
7/21/2023