Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutFLAT TOP VIEW #1 BLK 2 LT 5Flat Top View
#1
Block 2
Lot 5
#018-391-29
.,q i t
3 IN 1111111111
x r,,�s i
Development Services Department Phone: 907-343-7904-343-7997115i!18001a! -il-um Fax: 907
Well Log
Permit Number: # 221364 Date of Issue: Parcel Identification Number:
Date Started: 10-21-22 Date Completed: 10-24-22 Is well located at approved permit location? Yes ❑ No ❑
Legal Description: Flat Top View #1 Lot5 Blk2
Property Owner Name & Address: Ashley Sockpiek
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
casing stick up
0
2
overburden
2
4
silt & gravel
4
55
silt & gravel w/1-120 (dirty)
55
57
clay layer
57
60
silt & gravel w/1-120 (dirty)
60
65
clay w/ gravel
65
105
silt & gravel w/ clay
105
126
wet silt & gravel w/ clay
126
137
sand
137
140
clay
140
165
clay w/ H2O
165
169
coarse gravel w/ H2O
169
172
Water Sample Results:
Arsenic: _� ug/L
Nitrates: ,N mg/L
Total Coliform Bacteria: a colonies/100mL
10/3 / /Z
Method of Drilling [M air rotary ❑ cable tool
Casing type: steel
Wall Thickness: -250 inches
Diameter:6 inches Depth: i72 feet
Liner Type:
Diameter: inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 49 feet
Pumping level: feet after
hours pumping _gpm
Recovery Rate: 15 gpm
Method of Testing: airlift
Q
Open End
❑ Open Hole
❑
Screened
Start feet
Stopped feet
❑
Perforations
Start feet
Stopped feet
20' Start 0
20
Well Disinfected Upon Completion? Yes No
Method of Disinfection: tabs Comments:
Well Driller: Johnny Kay
El F-1
Company: Hefty Drilling, Inc.
Mailing Address: po box 112130 Anch AK 99511
Attention: The well driller shall provide a well log to the
On-site Water and Wastewater Section within 30 days of
completion.
Legal Description
F1,4 A v, 01V 41
' Pump Installation Date: 1 U 1)8„ 2a
Pump Intake Depth Below Top of Well Casing: CIO feet
Pump Manufacturer's Name: A/! A
Pump Model: 7 0�e,-, )--'Jo I/ 3w,
Pump Size !a hp
Pitless Adapter Burial Depth: /V feet
Property Owner Name & Address:
Pitless Adapter Manufacturer's Name: CIC VVI
Pitless Adapter Installer: / UQ r A ^ vr.,' F-_ x Ca V®' � � o"1
Well Disinfected Upon Completion? a Yes ❑ No
Method of Disinfection:CA I.ir,),L +.6S
Comments:
I Pump Installer Name: Johnny Kay
Hefty Drilling, Inc.
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Development Services Department
Building Safety Division
i
an
GE Q
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Mark Begich
Anchorage, AK 99507 S A E T Y
Mayor
www.muni.org/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number:
�2 i3bq Date of Issue:
Parcel Identification Number:
Legal Description
F1,4 A v, 01V 41
' Pump Installation Date: 1 U 1)8„ 2a
Pump Intake Depth Below Top of Well Casing: CIO feet
Pump Manufacturer's Name: A/! A
Pump Model: 7 0�e,-, )--'Jo I/ 3w,
Pump Size !a hp
Pitless Adapter Burial Depth: /V feet
Property Owner Name & Address:
Pitless Adapter Manufacturer's Name: CIC VVI
Pitless Adapter Installer: / UQ r A ^ vr.,' F-_ x Ca V®' � � o"1
Well Disinfected Upon Completion? a Yes ❑ No
Method of Disinfection:CA I.ir,),L +.6S
Comments:
I Pump Installer Name: Johnny Kay
Hefty Drilling, Inc.
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage
Community Development Department
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - hitp://www.muni.org/onsiite - (907) 343-7904
Subdivision
Block Lot
T R Section Lot
On-site Water & Wastewater Program certified contractor performing the well decommissioning:
Name:
�t,
Signature:
Company:
Well decommissioning date 10/31/' 2- Method of decommissioning: AMC 15.55.0601.1 a. ❑ b. ❑ C.
Location: Use the space below to provide a drawing of the property showing the following items,
• North arrow
• Decommissioned well,
• Other water wells on the property,
• Two separate swing -tie distances for each well shown on the drawing,
Note: The swing -tie distances shall be measured from either permanent structures or the property comers. i
and
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
http://www.muni.org/onsite
On -Site Water System Permit
Permit Number: OSP221364
Work Type: Well Upgrade
Tax Code Number: 01839129000
Site Legal Address: FLAT TOP VIEW #1 BLK 2 LT 5 G:2934
Site Mailing Address: 3326 STAYSAIL DR, Anchorage
Owner: LANKARD GLEN E JR
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
��1lenr
off,'
ti
v
Departhnent
9/13/2022
9/13/2023
14000
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q 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
Special Provisions: To close out permit please provide water sample test results, well log, pump log along with
an updated survey to verify separations
Received By:
Iss
Date:
Date: ?-13-2-2—_
3
O. (+; me
Development Services Department F` �� Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-391-29
Property owner(s) GLEN E LANKARD JR. Day phone
Mailing address 3326 STAYSAIL DRIVE, ANCHORAGE, AK 99516
Site address 3326 STAYSAIL DRIVE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) FLAT TOP VIEW #1 B2 L5
Legal description (Township, Range & Section)
Lot Size 14,000 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) El
(w/wo ADU)
Septic Tank
❑
Upgrade 0
Duplex (D) ElHolding
Tank
ElRenewal
ElMultiple
Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
Z
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.
ature of property owner or authorized agent)
Permit/Rush Fees: _ -92
Date of Payment: al':"
Receipt Number: n l a
Permit No. J % �2 L? (�
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
F!rst Water
CD N S U L T I N G
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
September 9, 2022
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: WELL UPGRADE PERMIT
LEGAL: FLAT TOP VIEW #1 BLOCK 2, LOT 5
PHYSICAL: 3326 STAYSAIL DRIVE, ANCHORAGE, AK 99516
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE CCN PUANC
OSP221364, Tim Ecklund, 09/13/22
The owner has requested that we obtain a well permit to upgrade the existing aged well on the
above referenced lot. Cole Sullivan recently scoped the well and found the casing in poor
condition. The proposed well is to be drilled in proximity the existing well to maintain proper
code separations and to serve the existing 3 -bedroom residence. A mix of public, private water
and wastewater serves the area. The design will not impact any of the neighboring properties.
Please contact us if you have any questions.
Sincerely,
i
L �
Curtis Huffman, P.E.
F,j'�rr
QE�1IGES
0119U1TON
�
Y+A7 �W Sif IIATLP
Municipality of Anchorage
11
REVIEWED FOR CODE C
OSP221364, Tim Eddund,
DESIGN CRITERIA: DRILL NEW WELL WITHIN 5'+/— OF EXISTING WELL & RECONNECT TO
WATERLINE SERVING THE RESIDENCE. DECOMMISSION EXISTING WELL PER CODE. STAKE ALL
WELL/WASTEWATER SYSTEMS PRIOR TO WELL DRILLING. PROVIDE COMPLETE WELL WATER
SYSTEM WITH NEW "CAN" WATER SAMPLES PER CODE. INSTALL PER AMC 15.65, 15.55, &
MASS... SEPARATIONS, MATERIALS, ETC...
DECOMMISSION OLD DOSRNG
WELL do DRILL NEW PROPOSED STAYSAIL DRIVE
WELLREQUIRED
SEPARATIW VLRIFlCA nONS.
STAKE & VERIFY PROPOSED
APPROX LOC. WELL ® WELL WELL 6 100'+ TO ALL
APPR X LOC, WELL
SEPT] SYSTEMS.
DRIVE
DECK
SINGLE FAMILY
HOUSE
DECKF
SH
LOT 8
T
P
SEPTIC AREA
FLAT TOP
SHED • .T VIEW jt 82
DOSIiNG TANK LOT 5
LOT 4
APPROX LOC. WELL
CLASS 'C WELLS
WELL ON LOT 8 ARE NOW DESIGNATED
SERVES LOTS 8 do 9.1 AS PRIVATE WELLS
WITH 10HW WELL RADII—
LOT 9
LOT 8
LOT 7
APPROX LOC. wm
D.SIGN
ASED FR❑M T DIGI
IZ D AS & M❑A DATA,
FLAT TOP VIEW #1 BLOCK 2, LOT 5 SUPPORT SERVICES:
PREPARED FOR:
� OF A,���
GLEN LANKARD JR
3326 STAYSAIL DR C
ANCHORAGE, AK 99516
* : 9 TH
H>fm»:
FIRST WATER CONSULTING
DATE:
9/12/22
.. rtes 04
13030 SUES WAY
SURVEY: 2013 HOLT
CE 128991 .. $� 10,
ANCHORAGE, AK 99516
907-350-9566 firstwaterAK©gmoil.com
DRAWN: FWCS
SCALE: 1" = 40
PAGE: 1 OF 1
9/12/2022',
X
r'.. ....
.IANC
322
Certificate of On -Site Systems Approval
Parcel 1.0- 018-391-29
Legal description Flat Top View #1 Block 2 Lot 5
Site address 3326 Staysail Dr. Anchorage, AK
Current property owner(s) Lankard
Expiration Date:
12-22-22
The On -sites stems is/area J l I / / 0 ZZ
y () � approved for bedrooms
Conditional approval for -S:z- bedrooms, with the following stipulations:
-
Comments or advisories: Drill a new well Under permit # 221364 along with running new water line
Please decommission the old well and provide a new survev
chow T-)V� Z( eo( 1 t4,,►f
By. Original Certificate Date: 9-22-22
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 Arsenic Advisory
Other
COSA Approval_June 2022
MUNICIPALITY OF ANCHORAGE
0
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I. D. 018-391-29
Complete legal description FLAT TOP VIEW #1 BLOCK 2, LOT 5
Location (site address) 3326 STAYSAIL DRIVE, ANCHORAGE, AK 99516
Current property owner(s) GLEN E LANKARD JUNIOR Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
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 9 - 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 $ 55l) --F q 0 Waiver Fee $
Date of Payment Date of Payment
COSA # - D.1 -5G2 Z 1 y 1 I - Waiver #
COSA Application—July 2022 copy.doc
Legal Description: FLAT TOP VIEW #1 BLOCK 2 LOT 5 Parcel ID: 018-391-29
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) Well production at time of test 15 gpm (NEW WELL —
Date drilled 10/24/2022 Total depth 172 ft SEE LOG)
Cased to 40+ ft Water storage tank volume NA gallons
Well disinfected for coliform test? ® Yes ❑ No
®Sanitary seal is functioning correctly
® Wires are properly protected ® Coliform bacteria is Negative
Casing height (above ground) 24 in. Nitrate mg/L ® Nitrate less than MRL (ND)
Date of flow test for COSA 8/10!22 Arsenic ug/L ® Arsenic less than MRL (ND)
Static water level at beginning of test 49 ft. Collected by HEFTY DRILLING
Date 10/31/22
Comments NEW WELL DRILLED BY HEFTY DRILLING WITH THIS COSA
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping 8/10/22
❑ Required maintenance completed, if AWWTS
Comments: USE STEP MAINT....
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/22-23/13
® ALL standpipes present per record drawing
Total measured depth from grade 9.75 ft (max)
Measured depth to pipe invert from grade 2.75 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 IR & SHOT 7.1' ED
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies: MT/CO AT GRADE.
COSA Checklist July 2022 copy.docx
C. LIFT STATION
® Required maintenance completed
Age of lift station 9 years
Lift station material STEP / STEEL
Comments: *PER MAINTENANCE / FLOATS
Adequacy test date 8/10/22
Results M Pass
Fluid depth prior to test 0 in. -DRY
Water added 450 gal
New fluid depth 11 in
Elapsed time 480 min
Final fluid depth 0 in. -DRY
Absorption rate 450 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 85.3 in
Effective depth used 0 in
Effective depth remaining 85.3 in. -DRY
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
® Yes if No ft ® Yes if No ft
Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® 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
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes if No ft
Surface Water > 100'
® Yes if No ft
Tank to Property Line > 5'
® Yes if No ft
Wells on Adjacent Lots:
Field to Property Line > 10'
® Yes if No ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes if No ft
Community Wells > 200'
❑ Yes if No *119 ft
Water Service Line > 10' ® Yes if No ft
F. ENGINEER'S COMMENTS
If tank or field is under driveway comment below
*ADEC WAIVER GRANTED, 119' CLASS C WELL (LOT 7). "CLASS C" ARE NOW CONSIDERED PRIVATE
WELLS WITH 100' SEPARATION REQUIREMENTS.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer's Printed Name CURTIS HUFFMAN PE Date 11/09/22
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 �•�'�+��°0®i���
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, d , • • ' ' ' • . , �1� ��
local soil characteristics, groundwater levels that may fluctuate during the year, quality of ,r'j�•
construction (workmanship & materials), the water usage of the family being served by the •• �•'�
system and maintenance. The operational life of all well and septic systems are subject to �/ �•!
these various and dynamic characteristics and are outside the control of the evaluator of the . , , . . , „ , , . , ,
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory ���
for current or future occupants or guarantee that no unseen encroachments, deficiencies or } • � � . . •
discrepancies exist can be given by First Water Consulting & FWI.S
Curtis Huffman f
•. CE 128991
+ �J� ' . • 11/09/22..' ,,SW
FpdOW
pROFESSOP . _
COSA Checklist—July 2022 copy.docx
0
6
M
N 89'58'00"W
� wEGG Rpp�
1p0P i' 100.00'
' —WELL
WOODEN WALKWAY
rr--` 8.2 x 10.9'
DECK
1.8`
48.2'
1 STORY
RESIDENCE
1
12.3'
0
0
Lot 4 m
\ o
0
\ O
GRAVEL
Lot 5
14000 s.f.
4.1'8.2' 8.2' DECK
8.2'x16.0'DECK
do WIRE FENCE
SEPTIC PIPES I p
FENCE ;
E'19.7
WOODEN FENCE
MANHOLE
n—
u—
S 89'58'00"E 100
ALLEY
[1 n.w.
PLOT PLAN AS BUILT X SCALE 1" = 30' GRID SW2934 Project No. 22-557/A1
,'
Associates,
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & f� S S o c i a t e S, (nc4 (907) 522-6476 Phone
Professional Land Surve ors (907) 5g2 -46Y5 Fax OF q��o0�
�( ken0lan surve com � ....
jonathan@langsurvey.com
I hereby certify that I have surveyed the following described property: 4
LOT 5, BLOCK 2, FLAT TOP VIEW SUBDIVISION (PLAT NO. P-282) G
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 1 "lt2 Da of N t )� � lu) c r � '�
Day � 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.
49TH
0
?� KENNETH NG
It ttq-
AECC963
Certificate of On -Site Systems Approval
Parcel I.D-. 018-391-29
Legal description Flat Top View #1 Block 2 Lot 5
Site address 3326 Staysail Dr. Anchorage, AK
Current property owner(s) Lankard
Expiration Date:
12-22-22
The On-site system(s) is/are approved for bedrooms
X Conditional approval for 3 bedrooms, with the following stipulations:
Comments or advisories: Drill a new well Under permit # 221364 along with running new water line
Please decommission the old well and provide a new survey
By. Original Certificate Date: 9-22-22
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 Arsenic Advisory
Other
COSA Approval_June 2022
RA UHMPAU Y OFCHORALE
�-
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 018 -391 -
Complete legal description FLATTOP VIEW #1 BLOCK 2, LOT 5
Location (site address) 3326 STAYSAIL DRIVE, ANCHORAGE AK 99516
Current property owner(s) GLEN E LANKARD JUNIOR Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
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 9 - 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 $ _550 Waiver Fee $
Date of Payment g 57/2 -zDate of Payment
COSA # 0S G2'2_ I y ) I Waiver #
COSA Application—July 2022 copy.doc
Legal Description: FLAT TOP VIEW #1 BLOCK 2 LOT 5 Parcel ID: 018-391-29
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) Water storage tank volume NA gallons
Date drilled CIRCA 1969 Total depth 60 ft Well disinfected for coliform test? ❑ Yes ® No
Cased to 40+ ft ® Coliform bacteria is Negative
® Sanitary seal is functioning correctly Nitrate 5.84 mg/L ❑ Nitrate less than MRL (ND)
® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND)
Casing height (above ground) 18 in. FWIH
Date of flow test for COSA 8/10/22 Collected by
Static water level at beginning of test 27 ft. Date 8/10/22
Well production at time of test 3+ gpm
Comments SEE SULLIVAN WELL SCOPING LETTER.
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping 8/10/22
❑ Required maintenance completed, if AWWTS
Comments: USE STEP MAINT....
D. ABSORPTION FIELD DATA
Which system tested (date installed) 10/22-23/13
® ALL standpipes present per record drawing
Total measured depth from grade 9.75 ft (max)
Measured depth to pipe invert from grade 2.75 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 IR & SHOT 7.1' ED
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Comments/Deficiencies: MT/CO AT GRADE.
COSA Checklist—July 2022 copy.docx
C. LIFT STATION
® Required maintenance completed
Age of lift station 9 years
Lift station material STEP / STEEL
Comments: *PER MAINTENANCE / FLOATS
Adequacy test date 8/10/22
Results M Pass
Fluid depth prior to test 0 in. -DRY
Water added 450 gal
New fluid depth 11 in
Elapsed time 480 min
Final fluid depth 0 in. -DRY
Absorption rate 450 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 85.3 in
Effective depth used 85.3 in
Effective depth remaining 0 in. -DRY
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100'
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes if No ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® 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
❑ N/A — Served by Community
Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes
if No
ft
Surface Water > 100' ® Yes if No ft
Tank to Property Line > 5' ® Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10' ® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Main > 10' ® Yes
if No
ft
Community Wells > 200' ❑ Yes if No *119 ft
Water Service Line > 10' ® Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*ADEC WAIVER GRANTED, 119' CLASS C WELL (LOT 7) "CLASS C" ARE NOW CONSIDERED PRIVATE
WELLS WITH 100' SEPARATION REQUIREMENTS.
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer's Printed Name CURTIS HUFFMAN, PE Date
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or 0
discrepancies exist can be given by First Water Consulting & FWU
COSA Checklist July 2022 copy.docx
8/23/22
—�'Odil
*:
-49TH
.. .. ....... J
Curtis Huffman /
1
2% CE 128991
�� ��r • • . 8/23/22. •' C��,�
11F�'opROFESS10Na`��!.=
F V
ifst Wder
C 0 N S U 1. T I N G
FF
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
September 21, 2022
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: CONDITIONAL COSA
LEGAL: FLAT TOP VIEW #1 BLOCK 2, LOT S
PHYSICAL: 3326 STAYSAIL DRIVE, ANCHORAGE, AK 99516
The pending permitted OSP221364 3 -bedroom well upgrade has been impeded due to contractor
availability conditions and other factors. We are therefore requesting a Conditional COSA at
this time and will proceed with the upgrade once conditions allow. The water system has been
working for the occupants and granting of this Conditional COSA will not impact any of the
neighboring properties or pose a public health risk. Attached are 2 drilling and 2 excavation bids
with escrow letter for the pending installation. Please contact us if you have any questions.
Sincerely,
Curtis Huffinan, P.E.
F
W d
1-
6U 1�(iNr,
R�fbtti
y, ,..
'I( ��` �
41 C➢ YAE7
P i 911
Pt mN1EB
MUNICIPALITY
e '-1
Y Phone: 907-343-7904
Development Services Department Fax: 907-343-7997
On -Site Water & Wastewater Section
Owner
Septic Tank:
-Sludge level eKinches
Lift Station/Pump Vault
Maintenance Lo
Street Address
-Pumping: required eso
Lift station:
Pump basket cleaned Q no
-Control floats cleaned rnoo'
•Operation satisfactory
-Pumping completedes no
pub o
-Effluent filter cleaned a no,
-Proper float settings confirmed es' no -
Alarm System:
-Dedicated electrical alarm circuit ve no -Audible and visual alarm inside dwelling es no
-Alarm system operation satisfacto not satisfacto ,
Manhole Riser
-Ground water intrusion at riser to tank connection es
Ground water intrusion around pipe penetrations es no -Weep hole functionaley s no
Manhole lid: Functional es o Insulated es no Properly Secured es no
Other `f
-All manufacturer required inspections and maintenance completedaso
Comments:
Qualified Maintenance Provider:
Technician_ �_Orf-v fG 1 xy
CompanyrG�
Signature
Date of maintenance %q .c
MWNIN
vucuoign tnvelope IU: VAy/UbAt-ZUIU-43l;A-Att4-bUt-C:Alt/1A8U
To: Municipality of Anchorage
Agreement between: Lankard and Sockpick
Property Address: 3326 Staysail Drive, Anchorage, AK 99516
File No. 1795606
Amount withheld: $28,407.00
The undersigned parties authorize Stewart Title to escrow funds in the amount of $28,407.00 from the
seller
For the purpose of: New Well
It is the sole responsibility of the undersigned parties to provide invoices to Stewart Title for payment.
Upon receipt and with Municipality approval, Stewart Title shall pay invoices for the above-mentioned
work. In the event parties are requesting to be reimbursed for invoices they paid out of pocket, Stewart
Title will require evidence of paid invoices before any reimbursement is paid. Once work is complete and
invoices paid; any excess funds will be refunded to the seller.
The undersigned parties hereby jointly and severally indemnify and hold Stewart Title harmless from and
against all costs, damages, judgments, attorneys' fees, expenses or obligations of every kind and
descriptions which, in good faith, it may incur or suffer in connection with this escrow holdback.
9/21/2022
9/21/2022 1 2:35 PDT
Dated:
Buye : DocuTnea by:
Ashley Soc ptc
Seller:
DocuSigned by:
7�
E,l WAL (,cu &arV
EA2E423
Glen E. Lankard Jr.
READ AND APPROVED BY:
Municipality of Anchorage
P.O. Box 670269 Chugiak, AK 99567
P: (907) 688-2759 F: (907) 688-2259
TO: Brent Western
3326 Staysail Drive
Anchorage, AK 99516
Camera Inspection Report
Date: 8-31-22
Starting at 8' to 30'— extreme casing decomposition. The casing is in very poor condition with numerous
cracks (vertical and horizontal) and multiple holes. We could not find an obvious source for the nitrates
but entire area was saturated and any of the cracks or holes could be causing the issue.
Also, the pitless was wet and in one of the worst areas of the casing.
Pitless depth: 11'6"
Static: 26'
Recommend drilling a new well and decommissioning current well.
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Owner
Septic Tank:
-Sludge level (?Kinches
Lift station:
-Pump basket cleaned
-Control floats cleaned
-Operation satisfactory
Lift Station/Pump Vault
Maintenance Log
Street Address
-Pumping: required yes efio -Pumping completed('Y�esno
(�n o -Effluent filter cleaned &no
•Proper float settings confirmed /ved no
rono'
-Dedicated electrical alarm circuit ve no -Audible and visual alarm inside dwelling( yes) no
-Alarm system operation satisfacto , not satisfacto,
Manhole Riser
-Ground water intrusion at riser to tank connectiones
-Ground water intrusion around pipe penetrations es Sf -Weep hole functional ves no
o
-Manhole lid: Functional Insulated es no Properly Secured yes 1 no
Other
-All manufacturer required inspections and maintenance completedaeso
Comments:
Qualified Maintenance Provider:
Technician �-orry vo_
Company + f- \j
Date of maintenance Z3A42_1�
Signature Date) W h L)
Nitrate Advisory
Certificate of On -Site Systems Approval # OSC 221411
Subdivision: Flat Top View #1 Block 2 Lot 5
A water sample revealed a nitrate concentration of 5.84 milligrams per liter (mg/Q.
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Please see the attached "Nitrate Fact Sheet" for important
information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening, or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical' methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Northern Excavation and Construction, LLC
15861 South Birchwood Loop Road
Chugiak, AK 99567
(907)694-1373
NorthernExcavation@Gmail.com
Estimate
ADDRESS
FLAT TOP VIEW #1 B2
L5
3326 STAYSAIL DR
ESTIMATE # 2254
DATE 09/21/2022
DATE ACTIVITY QTY RATE AMOUNT
Services 4,000.00
FLAT TOP VIEW #1 B2 L5
3326 STAYSAIL DR
Thank you for the opportunity to provide you with this
estimate. Acceptance of this estimate will be
acknowledged upon either receipt of a signed copy to
Northern Excavation and Construction (NEC) or an
email stating acceptance and notice to proceed.
Changes that affect or increase specific tasks and
machine time shall be submitted and agreed upon in
writing. All agreements are contingent upon
circumstances beyond NEC's control, i.e. weather,
design changes, unforeseen site conditions, etc. NEC
is licensed, bonded, insured, and maintains safe
digging practice. All methods and material shall be in
accordance with MOA and SOA regulations. NEC shall
not be held liable for affects that may occur to the
property during or after install. Affects such as, trees
left in close proximity of where machine work takes
place, having to stock and later retrieve displaced
excavated material around trees, damage or structural
integrity of retaining walls or fences that may need to
be partially removed or traveled close too, disturbance
to roads/driveways/landscaping, etc. Client is
encouraged to contact NEC prior to start of
construction for clarification of specific affects that may
occur on the property.
Payment in full is due upon completion of backfill.
Payments received after 30 says of completion shall be
charged a 1.5% monthly fee on any unpaid balance.
DESCRIPTION: 2 SITE VISITS FOR EXCAVATION:
Please note that a 48 hour notice to start digging is required by the State of Alaska for utility locates. NEC is not liable for any utility lines not
located by 811 public utility locate i.e., any lines running to detached structures. An extra charge will be incurred for private locate services.
DATE ACTIVITY QTY RATE AMOUNT
1 ST VISIT: Remove 2 small trees. Excavate
approximately 4' to expose existing well head for
decommissioning.
2ND VISIT: Backfill decommission excavation.
Excavate to intercept exiting waterline, install new
pitless in new well, attach waterline to well, splice on to
exiting well wire and stub it up at new well head.
EXCLUSIONS: Re -landscaping or seeding.
Acceptance of this estimate will be TOTAL
acknowledged and scheduled upon either K000.00
receipt of a signed copy to Northern
Excavation and Construction (NEC) or an
email stating acceptance and notice to
proceed.
Accepted By Accepted Date
Please note that a 48 hour notice to start digging is required by the State of Alaska for utility locates. NEC is not liable for any utility lines not
located by 811 public utility locate i.e., any lines running to detached structures. An extra charge will be incurred for private locate services.
Sullivan Water Wells
P. O. BOX 670269
CHUGIAK, AK 99567 US
sullivanwaterwellsoa gmail.com
AUUHBS;
Brent Western _
3326 Staysail Drive
Anchorage, AK 99516
Flat Top View #1 B2 L5
ES x IM %TE it DATE
1086 09/16/2022
ACTIVITY
RATE
AMOUNT.
Water Well Package
1 ,
8,366.80
8,366.80'
Water Well
125
60.00
Casing Shoe
1
200.00
Bentonite
1
200.00'
Well Cap
1
100.00,
Chlorine
1 !
30.00
Well Tag
1
15.00
4% Fuel Surcharge
8,045
0.04
4F11 P07301 S Pump & Installation Package
1
3,171.50
3,171.50
Water Samples
1
400.00
400.00
Well Decommission
1
3,000.00
3,000.00
NOTE: QUOTE IS ONLY FOR SERVICES LISTED. WE DO NOT DO
TOTAL
EXCAVATING SO YOU WILL HAVE TO GET AN ESTIMATE FROM AN
.938 'ngQn®
$14y938.30
. 3
EXCAVATOR.
Accepted By Accepted Date
Hefty Drilling, Inc.
P.O. Box 112130
Anchorage, AK 99511
(907)830-9985 - Johnny
heftydrilling@aol.com - email
www.heftydrilling.com - web
First Water Consulting
Services
New Well
Flat Top View #1 B2 Lot5
3326 Staysail Dr.
Date: 09/18/2022
Quote No.: 10080
Qty
Description
Unit Price
Total
125
Well Drilling per ft
$60.00
$7,500.00
1
6" Drive shoe
$200.00
$200.00
1
6" well cap
$100.00
$100.00
1
Bentonite casing seal
$200.00
$200.00
1
4% fuel surcharge
$300.00
$300.00
1
Pull & reset existing well pump
$800.00
$800.00
1
Decommission 6" water well per muni code
$1,600.00
$1,600.00
Total $10,700.00
Quote is for new water well installed only. Excavating will need to be done by seperate company
for water line work.
Please contact us for more information about payment options.
\
_
/
/
6
( c 0
-o
\3/=
=<a%
)
\§ �\
m
\
y//�
/
/o��
\
CIJ§0
\0ko
a
§ k
! \ � ca
/
m
;\E/o
&EatQ
•
«
c
ES
a±ƒ)2
\{J)\
§
ctm
)\§
'a
E
co
m
am§
»cJD
\
\#m
/k
f
m
e
K@e
a LL CD
E
mEo
Municipality of Anchorage
Community Development Department Page 1 of 3
On-Site Water & Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP 131373 PID Number: 018-391-29 ❑ New ■ Upgrade
Name: KATHY LYTLE
ABSORPTION FIELD
■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address:
3326 STAYSAIL *ANCHORAGE, AK 99516
❑ Other
Phone: No. of Bedrooms:
(907) 501-533-3001 3
Soil Rating:
0.8 GPD/Sq. Ft.
Total Depth from original grade:
8 MAX Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade:
SEE DWG. Ft.
Gravel depth beneath pipe:
7.11 Ft.
Subdivision: Block: Lot:
FLAT TOP VIEW #1 2 5
Fill added above original grade:
SEE DWG. Ft.
Gravel length:
41 Ft.
Owns Ip: — Hange. — ec ion: _
Gravel width:
Beds Number of lines.
Distance between lines:
2.5 Ft.
Ft.
SEPARATION
DISTANCES
Total absorption area:
574 54. Ft.
Number of trenches:
1
Dist. between trenches:
_
Ft.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
Sewer Lines
Well
100'+
100'+
100'+
—
25'+
TANK ❑ Septic i S.T.E.P. ❑Holding ❑ Other
Manufacturer:
Capacity:
Surface Water
100'+
100'+
100'+
—
ANCHORAGE TANK
1500 Gal.
Lot Line
5'+
10'+
5'+
-
N/A
Material:
STEEL
Number of compartments:
2
Foundation
5'+
10'+
5'+
-
LIFT STATION *APPROXIMATE
Curtain Drain
NONE KNOWN
Manufacturer.
Capacity:
ANCHORAGE TANK
1500 Gal.
Remarks: OLD TANK WAS DECOMMISSIONED PER UPC.
"Pump on" level at:
*40"
"Pump off" level at:
*44"
High water alar at:
46"
MOA CONFIRMED WITH ADEC ENGINEER BILL RIETH, P.E.
Pump Make & Model:
20—OSI-05—HHF
Electrical Inspections performed by:
MOA
THAT ADEC WAIVERS WERE VALID FOR CONVENTIONAL SEPTIC
SYSTEM.
PIPE IAATERIAL
House to tank D3034 Tank to D3034
drainfield
Installer
WILCO CONTRACTORS
CO/
MT D3034 Drainfield D3034 CO
MT
GEG, Ltd.
BENCH MARK (Assumed elevation)
100.00 Ft.
Inspection
Dates: 1st 10/22/13 2nd 10/22/13
Location and Description:
3rd 10/23/13 4th —
DOOR THRESHOLD @ BACK OF HOUSE
Community Development Department Approval
Conditional approval: Date:
PP
ENGINEEFUS SEAL
00600 0
o (DF q� opa
o00 l
o g_Ho
..d
... ...............
.... ............:....0
QO .J f A warn sS:
953- •' \c�Op
�p0edp�o e3 o�03�00
��OOOoo�a�
Approved: T�// r�I /� �� Date:. (� /-3
OLDJ`f�ANT(/W ,AS DECOMMISSIONED PER UPC.
�v�
PERMIT NUMBER: AS—BUILT DRAWING PARCEL ID NUMBER:
–
OSP131373 018-391-29
I
I
I
1
1
1
1
/
/
1
1
rI_R�
ST 77.6 72.5
ST
STAYSAI/ D R IV\E\ \`\
` 1
/ \ 1
*o\_'5_ 111 1
f
75.7
74.2
MH
75.1
74.2
C01
72.9
63.6
MT7
72.1
63.2
CO2
52.8
62.1
MT2
52.5
62.9
FCO
21.9
11.8
STAYSAI/ D R IV\E\ \`\
` 1
/ \ 1
*o\_'5_ 111 1
f
p0......
I
(�
I
I
a ;
I
/Q
\
\ B /
o\J5
1
j HOUSE j ���
\ FCO
SHED TO BE
RELOCATED.
\ �O�
o
I f J
w
I I
$p
\
\ PQ
\
— — —
_- MT1__-- per•-
---'
�}-j-4-�
p0......
a ;
\EXISTING 3 BEDROOM /
/Q
\ HOUSE /
\ B /
j HOUSE j ���
\ FCO
o
I f J
w
I I
i)<
x
/Fkl 1 f,N TRENC
�
— — —
_- MT1__-- per•-
---'
�}-j-4-�
SHED n p vtin�
— — — FLAT TOP VIEW#1; _ _ j / _ Kl�o
FLAT TOP VI 1;
BLOCK 2, LOT 4 SOu — —_ �iFBLOC 2, LOT�6
.................._.................................................._–_......-. .-1.500.,._.. _ `_._....._..........__.....STEP2 ALLEY NK PORTION OF XISTING
/ SEEPAGE PIT LLED IN
Y TO MEET THE R OUIRED I \
14 rvuq strA llu -\
FLAT TOP VIEW#1; / / BETWEEN; DRAINFI LDS. N \
/
/FLAT TOP VIEW#1; BLOCK 2, LOT 9 / 1 LOCK 2, LOT 8
/ SCALE:
110 FOOT ADE- 1 " = 40'
/ K'AIVER
/ I f FLAT TOP VIEW#1;
� BLOCK 2, LOT 7
GARNESS ENGINEERING GROUP, Ltd p 4 T yl
CONSULTANTS & GENERAL CONTRACTORS p ...... ... . .... ...........
3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEBSITE: w—gamessengineering.cam
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KATHY LYTLE 501-533-3001 2 OF 3 �O '• f y G mess:
LEGAL DESCRIPTION: DRAWN BY: o0 9�s CE -7 \ceG
FLAT TOP VIEW #1; BLOCK 2, LOT 5 PNBJe s s
TYPE OF WORK: DATE: ���ODOOo *%0
AS—BUILT DRAWING 10/29/13
PERMIT NUMBER: PARCEL ID NUMBER:
OSP131373 AS -BUILT
DRAWING
018-391-29
FINAL GRADE = 97.31-97.39
STl ST2 MH
TOP OF TANKTOP OF TANK
AT INLET = 93.14-\ / AT OUTLET = 93.15
rEW 1500 GALLO
INVERT OF BUNG ` S.T. E. P. TANK
AT INLET = 92.57
FINAL GRADE
= 97.56+
ULATION
74ZINS
FILTER FABRIC
,RTOF PIPE
= 94.94
BOTTOM OF
TRENCH =
87.83
RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 80.33 (GROUNDWATER ® 83.83)
GARNESS ENGINEiERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD, SURE 101 - ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEBSRE:—gamessengineering.00m
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KATHY LYTLE 501-533-3001 3 OF 3
LEGAL DESCRIPTION: DRAWN BY:
FLAT TOP VIEW #1; BLOCK 2, LOT 5 PNB
TYPE OF WORK: DATE:
PROFILE AS—BUILT DRAWING 10/29/13
(Rev. U7lU5)
/��.°F'
Imo: 4 T -�
............... ............
of r y� A. arness:'
CE
—7953
�40,V�,pro f essioloo�
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP131373
Tax Code Number: 01839129000
Work Type: Septic
Permit Effective Dates: October 16, 2013 to October 16, 2014
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: FLAT TOP VIEW #1
Site Legal Address: FLAT TOP VIEW #1 BILK 2 LT 5 G:2934
Owner/Address: LYTLE KATHRYN D
3326 STAYSAIL DRIVE ANCHORAGE AK 995163585
Site Mailing Address: 3326 STAYSAIL DR, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank
Lot Size in Sq Ft: 14000
Total Bedrooms: 3
N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP Ltd.
(Signature of property owner or authorized agent)
Permlt/RushFees. If 530 Waiver Fees:
Date of Payment: �Q Ln0�13 Date of Payment:
Receipt Number. °� a�0$L Receipt Number:
Permit No. 05031,373 Waiver No.
(Rev. 01/11)
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D.r1�q/-429
Property owner(s) KATHY
LYfLE
Day phone 501-533-3001
Mailing address 3326 STAYSAIL *ANCHORAGE AK
Site address 3326 STAYSAIL *ANCHORAGE AK
Legal description (Sub'd, Block & Lot) FLAT TOP VIEW #1 • BLOCK 2,
LOT 5
Legal description (Township, Section & Range)
Lot Size
Sq.Ft. Number of Bedrooms
3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(lel that apply)
Initial ❑
Single Family (SF)
Absorption Field
®
®
(w/wo ADU)
Septic Tank
Upgrade
®
El
Duplex
Duplex (D)
El
Holding Tank
Renewal
❑
Dwellings
El
❑
(SF and/or D)
Privy
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP Ltd.
(Signature of property owner or authorized agent)
Permlt/RushFees. If 530 Waiver Fees:
Date of Payment: �Q Ln0�13 Date of Payment:
Receipt Number. °� a�0$L Receipt Number:
Permit No. 05031,373 Waiver No.
(Rev. 01/11)
�i2F�/ti� �%5►Grf
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
October 11, 2013
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic System Upgrade for Flat Top View #1; Lot 5, Block 2,
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. We are proposing to install a
1500 gallon S.T.E.P. tank and deep trench type drainfield. Attached are a site plan and a design drawing
showing the proposed septic system. One test hole was excavated on the property. The drainfield will be
designed around the 30 foot radius of this test hole. Comments regarding the design are summarized as
follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: As can be seen on the attached site plan, the average topography below the
drainfield is relatively flat. In short, there are no slope concerns.
5. WELL WAIVERS FOR ADJACENT PROPERTY: Due to site constraints, we are requesting a
110' waiver from the class "C" well on the adjacent property (Flat Top View #1; Block 2, Lot 7) to the
proposed drainfield on the subject property. A copy of the ADEC approval is forthcoming.
We are unaware f any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any qt estions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com
I I II
I I II
I I II
-- I
STAYSAIL//DRIVE
RppWS
APPROXIMATE 100' WELL RADIUS
U
Gt3RNESS ENGINEERING GROUP, Ltd.
_.... CONSULTANTS & GENERAL CONTRACTORS __. _...
5701 E. TIOOR ROAD, SURE 101 • ANCHORAGE, A1C 99507 • PHONE (90])5]7-8179 • FM (907)338-3218 • KBSRE: wrv.9omeva•pimMn9.can
PREPARED FOR:PHONE NUMBER: PAGE NUMBER:i
KATHY LYTLE 501-533-3001 1 OF 3
LEGAL DESCRIPTION: DRAWN BY:
FLAT TOP VIEW #1 S/D; BLOCK 2, LOT 5 A.J.G.
TYPE OF WORK: DATE: p
SITE PLAN 108/38•/2013
(Rev. 01105)
IIS
I I �
II �
RADIUS
II �
YORS I /
JCES
NI
\
HOUSE //
/
GE� �
On a ��1.11.
BLOCK 2, LO"
BLOCK 2, LOT 8
BLOCK 2, LOT 7
FLAT TOP VIEW#gi;
SHED °—
TOP
VIEW 1y
— — _ _
_
—BLOCK F76i3
—
_FLAT
BLOCK 2
LOT 6
20' ALLEY
U
Gt3RNESS ENGINEERING GROUP, Ltd.
_.... CONSULTANTS & GENERAL CONTRACTORS __. _...
5701 E. TIOOR ROAD, SURE 101 • ANCHORAGE, A1C 99507 • PHONE (90])5]7-8179 • FM (907)338-3218 • KBSRE: wrv.9omeva•pimMn9.can
PREPARED FOR:PHONE NUMBER: PAGE NUMBER:i
KATHY LYTLE 501-533-3001 1 OF 3
LEGAL DESCRIPTION: DRAWN BY:
FLAT TOP VIEW #1 S/D; BLOCK 2, LOT 5 A.J.G.
TYPE OF WORK: DATE: p
SITE PLAN 108/38•/2013
(Rev. 01105)
IIS
I I �
II �
RADIUS
II �
YORS I /
JCES
NI
FLAT TOP VIEW#1/ /
FLAT TOP VIEW#1;
FLAT TOP VIEW
GE� �
On a ��1.11.
BLOCK 2, LO"
BLOCK 2, LOT 8
BLOCK 2, LOT 7
150' WELL
I1
CLASS C WELL SERVING
/UNDOCUMENTED
//
LOTS 8 & 9
CLA
l
1
WELL SERVING SURVI
/ \
EXCHANGE & RESIDE
ON LOT 7 &
j
1� \
-7 01
%'
WELL RADIUS
U
Gt3RNESS ENGINEERING GROUP, Ltd.
_.... CONSULTANTS & GENERAL CONTRACTORS __. _...
5701 E. TIOOR ROAD, SURE 101 • ANCHORAGE, A1C 99507 • PHONE (90])5]7-8179 • FM (907)338-3218 • KBSRE: wrv.9omeva•pimMn9.can
PREPARED FOR:PHONE NUMBER: PAGE NUMBER:i
KATHY LYTLE 501-533-3001 1 OF 3
LEGAL DESCRIPTION: DRAWN BY:
FLAT TOP VIEW #1 S/D; BLOCK 2, LOT 5 A.J.G.
TYPE OF WORK: DATE: p
SITE PLAN 108/38•/2013
(Rev. 01105)
IIS
I I �
II �
RADIUS
II �
YORS I /
JCES
NI
. . . . ....................
J ffre A.
G rness:
GE� �
On a ��1.11.
13
®0 i
A
"i"!4 "'"'" _ _ _ NOTE: THE CONTRACTOR
NUMBER OF BEDROOMS: 3 $ SHALL HAVE THE SOUTH
GALLONS PER DAY (GPD): 450 LOT LINE, AND ALL WELL
PERCOLATION RATE/S: 8.88 \ \ RADII FLAGGED BY A
ALLOWABLE APPLICATION RATE: 0.8\
MINIMUM DRAINFIELD SQ.FT.: 563 SQ FT REGISTERED LAND SURVEYOR
-
LP \ PRIOR TO CONSTRUCTION.
DRAINFIELD DESIGN:
MAXIMUM DEPTH: 8 FET \
WIDTH: 2 41 FET FET
LENGTH: 4STAYSAIL' DRIVE\
M.O.A. APPROVED SAND FILTER: N/A \
EFFECTIVE: 7 FEET / \
REDUCTION FACTOR: N/A—
ACTUAL SQ.FT.: 574 SQ FT / \
GEG, Ltd. HAS A 7 PAGE SPECIFICATION
LETTER THAT
0 OBTAIN AECOPY SOFO THESLETTERN I\US t �,
CONTACT GEG. BY PROCEEDING FORWARD WEA
WITH CHIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR ANDd.
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND •'a.'+ y' I __77-
AGREE
� / -
AGREE TO ACCEPT THE CONDITIONS OUTUNEDMS AND 1/ �I
p Z / L/1 -Z
1 1 Qi \J EXISTING 3 BEDROOM II Ire
1 I r Q _
HOUSE fo- nq I HOUSE
v --L--
\� INSTALL\Fca%L' 3
/ a
\ EXI ING SEPTIC r
\\ \\ kNK
BE
DETOMMISSIO ED
PER UPC 7�^-`Ln" /
\ \ \ \ SHED TO BE \�1 / PROPOSED /
\ \ RELOCATED OR / DRAINFIELD a
REMOVED. I i ( D
FLAT TOP VIEW#l; / SHED • f FLAT TOP VI 1;
BLOCK 2, LOT 4 BLOCK 2, LO
��ppL� PRAP 0-1500
2 0 ' A L L EY �lX"� / 7 01 PORTION OF EXISTING \ \ \
lYF SEEPAGE PIT TO BE \
<< H FILLED IN SO TO MET \
/ 3 FOOT EPARATION \
FLAT TOP VIEW1; / FLAT TOP VIEW#1; BETWEEN DRAINFIELOS.
BLOCK 2, LOT 9 BLOCK 2, LOT 8
FLAT TOP VIEW#1;
NI 110 FOOT WA REQUEST REQUEST BLOCK 2, LOT 7
/
SCALE:
1an'
(Rev. 01/05)
GARNESS ENGINEERING
GROUP, Ltd.
0
p *:'4
CONSULTANTS & GENERAL CONTRACTORS
Q• • • • • •
.. ....... .........
3181 E. WM R080, SURE 101 • P HOWE. W 98501 • P1 E (907)387-8179 • FM (907)338-8248 • 9R -. www.go omr4Hn.com
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
�Qnnp
•• ...:...
f
KATHY LYTLE 501-533-3001
2 OF 3
y a ss:'
LEGAL DESCRIPTION:
FLA TOP VIEW 1; BLOCK 2, LOT 5
DRAWN BY:
PN g
V 9 ' . CE -79 3 •' m�A
o0�re ' •..10i`}
TYPE OF WORK:
DATE:
���ODjllslorldl
SEPTIC DESIGN UPGRADE (revised)
10/2/13
OOo��000
(Rev. 01/05)
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AN. 99507 • PHONE: (907)331-6179 • M (907)3.16-3246 P WE W. gamawng(nrHr
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: FLAT TOP VIEW S/D; BLOCK 2, LOT 5
PERFORMED FOR: KATHY LYTLE DATE: 9/23/2013
DEPTH��� ORGANICS
(feet) -- TEST HOLE
# 1
1
® 13'
14� I� WEEP
15
B.O.H.
16-
17-
18-
19-
20—
SOILS
617181920SOILS LOGGED BY:
DEPTH TO
GROUNDWATER
�r
WEEP 0 13'
9/23/2013
12
10/1/13
rr
rr
—
r
—
2
PI
rr
2 7/16
rGW
9
—
.
r
4
r
30
2 10/16
3 6/16
5
OR
—
r
—
r
r
4:00
�
2 10/16
ML
%////.CL
r
II�III!II
y
NswIIIIIIIIIMH
GCN1111
•
r
20' ALLEY
r
�
%//%CH
NAT 111P \EX:
�i�.BOHSC
BLOp( R. IAT 9
r
9M1( £. w 8
BId:H 2. IN 7
M"62
I
/
�
1i
J,
® 13'
14� I� WEEP
15
B.O.H.
16-
17-
18-
19-
20—
SOILS
617181920SOILS LOGGED BY:
DEPTH TO
GROUNDWATER
�r
WEEP 0 13'
9/23/2013
12
10/1/13
rr
rr
—
r
—
2
PI
30
2 7/16
3 9/16
9
r
—
.
r
® 13'
14� I� WEEP
15
B.O.H.
16-
17-
18-
19-
20—
SOILS
617181920SOILS LOGGED BY:
DEPTH TO
GROUNDWATER
DATE
WEEP 0 13'
9/23/2013
12
10/1/13
2:30
—
6°
—
/ A. Garnessr
E-795� m�
IQ.IISW3
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
9/28/13 1
2:30
—
6°
—
2
PI
30
2 7/16
3 9/16
3
3:00
—
r
r
4
3:30
30
2 10/16
3 6/16
5
3:30
—
6"
—
6
4:00
30
2 10/16
3 6/16
20' ALLEY
/
MT TOP %9
NAT 111P \EX:
rEAr 1[P NEV:
BLOp( R. IAT 9
r
9M1( £. w 8
BId:H 2. IN 7
I
/
�
1i
J,
SCALE:
/\
i = 100'
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
9/28/13 1
2:30
—
6°
—
2
3:00
30
2 7/16
3 9/16
3
3:00
—
6"
—
4
3:30
30
2 10/16
3 6/16
5
3:30
—
6"
—
6
4:00
30
2 10/16
3 6/16
PERCOLATION RATE 8.88 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5 FT. AND 6 FT.
A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO
ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: �/� �
October 11, 2013
THE STATE
°fALASKA
GOVERNOR SEAN PARNELL
Mr. Jeffrey A. Garness, P.E.
3701 E. Tudor Road, Suite 101
Anchorage, Alaska 99507
Department of Environmental Conservation
Division of Water
Wastewater Engineering Support and Plan Support
555 Cordova Street
Anchorage, Alaska 99501
Main: (907)-269-7519 Fox:(907) 26-3487
Re: Anchorage -Flat Top View # 1: Block 2, Lot 5 & 7 -Request to Waive Separation Distance on a Class
"C" Public Water System to a Replacement Treatment and Onlot Soil Absorption System-ADEC Plan
Tracking Number 9630
Dear Mr. Garness,
On October 8, 2013 the Department received an engineering plan submittal for a waiver of the separation distances
between the new sentic tank and soil absorption system on Lot 5 and the Class "C" source well on Lot 7. You have
requested a waiver of 110 feet from the septic tank and 119 feet from the soil absorption as measured to the source
well on Lot 7.
Based upon the engineer's recommendation, soils information provided, the well logs from the area and the
drinking water samples which indicate that nitrate as nitrogen was not detected. These waivers are approved.
Should the disposal system or septic tank be found to be failing or can be shown to be endangering public
health, corrective engineering actions will be required. ---- _--
The Department has reviewed the engineering plans submitted waivers were granted for the onsite wastewater
disposal and treatment system.
This approval does not imply the granting of additional authorizations nor obligate any state, federal or local
regulatory body to grant required authorizations.
Any person who disagrees with this decision may request an adjudicatory hearing in accordance with 18 AAC
15.195 18 AAC 15.340 or an informal review by the Division Director in accordance with 18 AAC 15.185.
Informal review requests must be delivered to the Division Director, 555 Cordova Street, Anchorage, Alaska
99501, within 15 days of receiving the decision. Guidance information on the informal review process may be
found at http://www.dec.state.ak.us/commish/ReviewGuidance.htm. Adjudicatory hearings requests must be
delivered to the Commissioner of the Department of Environmental Conservation, 410 Willoughby Avenue, Suite
303, P.O. Box 111800, Juneau, Alaska 99801, within 30 days of the decision. If a hearing is not requested within
30 days, the right to appeal is waived.
Thank you for your cooperation. If you have any questions please do not hesitate to contact me at 269-7519.
Respectfully,
William R. Rieth, P.E.
Environmental Engineer
GAABHGI GRsI"TER ANCHORAGE AREA BOROPIl
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279.2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING NAME ✓ O N �� tY S ADDRESS` /w /�e'X ���� PHONE g "o '3
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL % O MAItRIAL COMPARTME.,.a
//qq ;4,�SiVuT �g�q J'�'�t/� LIQUID
LIQUID CAPACITY—/ -00—&O --GALLONS. INSIDE LENGTH INSIDE WIDTH—DEPTH—
SEEPAGE
IDTH DEPTHSEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH _LLENGTH �S , DEPTH
LINING MATERIAL � ITP ` . DISTANCE FROM WELL �"� 7 , BUILDING FOUNDATION S8,
NEAREST LOT LINE 35 / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) 30oo SO. FT.
'ev S Ub[Y,
TILE DRAIN FIELD:
DISTANCE FROM
FOUNDATION , NEAREST LOT
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH
ABSORPTION AREA SO. FT. LENGTH OF EACH LINE
TOTAL LENGTH
OF LINES
TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE EPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
ISTANCE WELL' el DEPTH NC BUILDING FOUNDATION. WATER
TYPE �p�11 � �♦L! SAMPLE All. NEAREST
NEAREST/ SEPTIC �+�/ 1 SEEPAGE OTHER
LOT LINE �G�, SEWER LINE. TANK, SYSTEM ZZ7 , CESSPOOL �, SOURCES_
DISTANCES:
RSB= 98'
A77
S1/
DATE 1� 4z� g
GAAB-H D-2 -, .' GREATEI NCHORAGE AREA ' .TROUGH Case No. /34
t ' IIEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
C 1
NAME OF APPLICANT 1JCH0 -PITTS MAILING ADDRESS PHBNE N111.972 -10G
RESIDENCE ADDRESS S31:3 SMAePRI-) CP 24 LOCATION OF INSTALLATION OI IJAI"�Ct 'Y -t
LEGAL DESC
APPLICATION TO INSTALL: SEPTIC TANK ✓ , SEEPAGE PIT L_�
TO SERVE THE FOLLOWING FACILITY
Ww ' oyvdI
DRAIN FIELD , OTHER �r1.l._
FINANCED THROUGH 5nq TO BE INSTALLED BY — Rl1odej
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION dOVE 10, (q °4t/� �
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS `im , PERMIT TO INSTALL A Q4' .} �
DESCRIBED BELOW. SIZE OF� UNIT
gT-O BE SERVED � TUnXt(c(� ±� te'; o^
SEPTIC TANK SIZE
-1 5D TYPE,SEEPAGE AREA TYPE
�Q=
DIAGRAM OF SYSTEM
DISTANCES:
l�le .�eQe, _ /?o
04
A pp U I"
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE XKea� AE APPLICANTSSIGNATURE
Municipality of Anchorage .a
On -Site Water & Wastewater Program'
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
'/
Parcel I.D. 018-391-29 Expiration Date:
1. GENERAL INFORMATION
Complete legal description FLAT TOP VIEW #1; BLOCK 2, LOT 5
Location (site address)
Current Property owner(s)
Mailing address
Real Estat: Agent
2. TYPE OF DWELLING:
3326 STAYSAIL ANCHORAGE, AK 99516
KATHY LYTLE Day phone 501-533-3001
3326 STAYSAIL ANCHORAGE, AK 99516
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
- Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
Received by:
COSA to be released to the engineer, mless othemvise requested by the engineer.
COSA Fee $ q U -
Date of Payment`.f �1 3
p '_
Receipt Number Q `-3 `[
COSA # 0 Se 013 7 F
Date:
Waiver Fee $ _
Date of Paymen
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. /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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for bedrooms.
0
Phone
337-6179
System #2 Approved for bedrooms. �,4 OF {AIV6Q(el
Disapproved. �i�
�Cj S1iE
Conditional approval for bedrooms, with the following stpLaptions.,D AND
FOV
Original Certificate Date:
The li lvmcipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
ra,,,, llms
/ Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # _of_
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: FLAT TOP VIEW #1; BLOCK 2, LOT 5 Parcel ID: 018-391-29
A. WELL DATA *PER 1969 INSPECTION REPORT **PER SURROUNDING WELL LOGS
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO
Date completed PRE -1969 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth *60 ft. Cased to **40+ ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test NO WELL LOG
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 2.99 mg./L.
Arsenic: NO ug./L. Date of sample: 8/13/13
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/STEEL
Tank size 1500 gal. Number of Compartments 2
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
AT INSPECTION
8/13/13
26 ft.
3.3 9.p -m.
Collected by: GEG. Ltd.
Date installed 10/22-23/13
Cleanouts (Y/N) YES
High water alarm (YIN) YES
Date of pumping NEW Pumper —
C. ABSORPTION FIELD DATA *BELOW FINAL GRADE
Date installed 10/22-23/13 Soil rating (g.p.d./ftor /bdrm 0_8 System type TRENCH
Length 41 ft. Width 2.5 ft. Gravel below pipe 7.11 ft.
Total depth *9.73+ ft. Eff. absorption area 574 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: — min. Final fluid depth — in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date —
D. LIFT STATION *APPROXIMATE
Date installed 10/22/13 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at *40 in. "Pump off" level at *44 in. High water alarm level at 46 in.
Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankA ft station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+PVT/*l 10 CLASS C WELL (LOT 7)
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line 10'+ Building foundation 10'+ Water main_ N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent IOts100'+PVF/*l 19 CLASS C WELL (LOT 7)
F. COMMENTS
ADEC WAIVER GRANTED
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSH guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 0114113
(Rev. 11105)
o ...........
OF A-
4Q
9
H
.J ff
'
A. arnes r
O"y. .•
795
4�e Professl000
0
0
0
5
STAYSAIL_ DRIVE_
NOTE:
NO EASEMENTS APPEAR ON THIS
LOT ON THE RECORD PLAT
THE INFORMATION HEREON I5 FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE.
OFV
oJ; 49TH
i�A 'SHANE A. HO LT Tt
I^ LS -691 4..'O
A5 -BUILT SURVEY V =30'
NO CORNERS SET THIS
DATE
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT S , BLOCK 2, FLAT TOP VIEW SUB.
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS _24TH DAY OF
_OCTOBER , 2013.
11355, FB 161-49
HOLT LAND SURVEYING
600 HIGHVIEW DRIVE
ANCHORAGEAK 99515
345-5513
ARROW PUMP & WEU SERVICE, LLC 'i -d dHW, d(Mp'
P.O. Box 110496
Anchorage, AK 99511NO. 9919
Office: (907) 346-9355 • Fax (907) 345-0202 7
Eagle River: (907) 622-9335
CUSTOMER JOB SITE
F
,�� y
�°zrf. tii>7"ry-a '•_�_..i.e'�__'.�� _r`} < ."w+_ � i`_v�,'
L!—.`l�CC:x.-.J
U
INVD.CE DATE WELL DEPTH SWL
CNLORINATEL'
PVMP DEPTIj SALESPERSON
QUA TITY DESCRIPTION PRICE
AMOUNT
p/
_. ! .... �!✓_."' {� �_._ l:-s--�...3 x> >� �h'_`" _. ._.
j ,.fit
.-
f _._�E:✓«j '`I . `'~.,//�..__>�A>J', _'e'. r"YJ' f.. _., s3't; .. _.._. _.
�L��+%._.._r
I
y
_
..........
___. __._. ......... .. _... ___ ..._--------------- ------ __.
I
.. .I
i
i
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIALS
y
TOTAL LABOR
WORKORDERE7
DATE COMB
TOTAL
LABOR
PAY THIS AMOUNT.,?l
Thank You
SIGNATURE
(I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that if above work is not paid for in 90 days I agree to allow Aarow
Pump & Weil Service, L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10tH OF MONTH FOLLOWING PURCHASE,
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
FILLS OUT UPPER HAONLY
APPLI( HA'! ONLY
Time
t
Property ywner-katl'ryr)
'(�Lt.`
, Lc' '�
Phone
Halling Address
_ 0)4N �, .t It rl/ :' l(A Zip code
Date
Buyer r -f- (%iyl !/
Ro&n
UQ Y(,7![.L ri. 7'i�7 e- U1 (/ ccs�-( fl L:.. iL
Address`-�
/,/� 1 i / / i✓ x/ G'/ .Zlp Code
Inspector
runs�Ituuon
L O r<— ZD-frf/(!✓Vkt
J'-
o�lne/O
/'
)le
I(adread�,7
Zip Code 2
.�Ph
�
Realty Co. 6 Agent
f
Ela -4- JP a?- I t'/e /--Cl)
Phone
rE .
sJ�{'��lr;J/o Zip Code lt'157.33
'y5 i�YF s/'
3 3 3
Address
.
P (Y�
Icy
Legal Description I�- L"'
1 c
,Q,r, � r1 fit 7C o le,(.C� d[/�7C�C.fJJ.(/(J'yL
Kl
y
Street Locatlon Al - AI
I A.c-r< .4'i
app
Type of Residence
❑ Family
❑ iple Family No.
Mult
Multiple
of Bedrooms
( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
R Other
-
( ) CONDITIONAL APPROVAL' \lJ
W
DATE
Water Supply
fai Individual
ATTACH WELL LOG. A well log Is required for all wells drilled
since June 1975.
(] Community
Soils Rating
For wells drilled prior to that date, give well depth (attach log if available).
❑ Public Utility
Well Log Received
Septic Tank Size
Well to Tank
Sewer Disposal
Ck Individual
Year Individual Installed:
[1 Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
1Y)
Time
Time
Time
Tlme `\G
Date
Date
Date
Date
Inspector
Inspector
InsD for
Inspector
Field Notes: (
I PCL,
1
�' F���n
DEPT. OF H=_/.LTII t`
NVIRO.,�`r1`N7AL PROTECTION
P (Y�
Icy
OCT
DLJ-1,ba
G
y
ju �jD
app
RECEIVED
( ) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
-
( ) CONDITIONAL APPROVAL' \lJ
W
DATE
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
?2423 OM
_.�
DAT RECEIVED
r INSPECTION APPOINTMENTS
TIME e.
TIME
TIME
O MULTIPLE FAMILY
® Three O Six
7. WATER SUPPLY
DATE
DATA
ATE
0 COMMUNITY
since June 1975. For wells drilled prior to that date, give well
�4
INSPECTOR
INSPECTOR
INSPECTOR
Px al.
LES/INDIVIDUAL/ON-SITE"
YEAR ON-SITE SYSTEM WAS INSTALLED.
O PUBLICUTILITY
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF MALTH &
825 L Street . Anchorage, Alaska 89501 ENVIRONMENTAL F,0TECTION
• ENVIRONMENTAL SANITATION DIVISION JUL 2 Z 1980
Telephone 2644720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWO"IfillIVILES-Dw.
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPER Y WNER
GtjI ma Leon
PHONE
MAILING ADDRESS
S 3¢ Lam' fon
PROPERTY RESIDENT (If differe t from above)
Rd &e Arimoun
PHONE
Tockil a
2. BUYER '
7WC N LYLl l�
PHONE
MAILING ADDRESS
a LENDING ITTr^ IO1_6�g � 9/VK l
)77 �/ r� �,
PHONE
MAILING ADDRESS
_
4. flEAL70R/Ai/" ktL
a ,7 02V9 �
��/C�jL��
ADDRESS
MAILING CIZ&-f,4' f,4 2FgL7 Y y (Ii L(S-lh Az�e 995b3
5. LEGAL DESCRIPTION U J. ^ lik
^ `la f !b ' ' /ie� /
o` -h / 1(
STREET LOCATION �J ;� I.
9�O G L' C/ /C (1.
6. TYPE OF RESIDENCE
NUMBER OF,BEDROONIS
L9' SINGLE FAMILY YVA PIM . O One 0 Four O Other
O Two 0 Five ..
O MULTIPLE FAMILY
® Three O Six
7. WATER SUPPLY
Q' INDIVIDUAL'
*ATTACH WELL LOG. A well tog is required for all wells drilled
0 COMMUNITY
since June 1975. For wells drilled prior to that date, give well
0 PUBLIC UTILITY
depth (attach log if available.)
& SEWAGE DISPOSAL SYSTEM
/Z
LES/INDIVIDUAL/ON-SITE"
YEAR ON-SITE SYSTEM WAS INSTALLED.
O PUBLICUTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72010 (Rev. 6/79)
.,
72010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY..
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE
❑ TWO ❑ FOUR ❑ SIX
❑ OTHER
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON-SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLED
INSTALLER
SOILS RATING
❑Septic Tank or ❑Holding Tank
Size: _ /00 6 If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER
-�v�--�/
TOTAL ABSORPTION AREA -
MATERIAL
AA1'
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
-
5. COMMENTS
ao
If
W APPROVEDFOR 3 BEDROOMS
L7 CONDITIONAL APPROVAL (letter mksjacmpany certificate)
❑ DISAPPROVED
DATE �,
1—.1�-fb I
BY
Q
.,
72010 (Rev. 6/79)
Tobben Spurkland P.E. n
8155 Cranberry St.
Anchorage, Alaska 99502
Phone (907) 243.5302
Airs Leon Jult 28, 1980
2834 Leighton
Anchorage, Alaska 99503
MUNICIPALITY OF ANCHORAGE
DEPT. OF H_ALTH &
ENVIRONMENTAL FROTECTION
ADEQACY TEST JUL 281980
RECEIVED
Legal; Lot 59 Block 2 Flattop View
Residence; 3 bedroom Trailer
Water: On Site Well
Sewer: Mo Records
Test indicate 1000 gal tank and log crib
Date of Test: July 24, 1980
Test Procedure. System Inspected on July 23, 1980
Crib 8'-8" deep, 64 11 on water
Septic tank 5 feet deep
Both tank and crib pumped on July 24.
1000gal taken from tank, 125) from crib
Crib filled with water and the following readings taken;
Vater Volume Depth Time 4.00 PY
11l 7 500 25
1750 76
July 25 at 9 AM 67
6 FM 64
Absorption Rate.
At a depth of 64 inches 1250 gal remains in crib
500 gal ha been absorbed during a 26 hour period.
'
6491M* ••9*�
...... ...... .. .
...1� ........
No 2225-E .r
JU E 25, 1971 :. ;;
',Municipality
of
Anchorage
11'�m `1-�R-5th
825 "L" STREET �l
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND �E �NVIRONMEENTAL PROTECTION
July 24, 1980 \!� �
Wilma Leon Olt
2834 Leighton
Anchorage, Alaska 99503
Subject: Lot 5 Block 2 Flat Top View Subdivision #1
Approval for your individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report be delivered to this
f� department from Chem Lab, 5633 B Street, for
' our review.
(2) The top of the well casing sealed with a sanitary(ZJLJ
so that it is water tight.
(3) The septic tank pumped with a receipt submitted to
this department. The total number of gallons pumped '
cam, need to be on the receipt to verify the size of the
tank. This will need to be verified by a registered
engineer prior to submittal.
(4) An adequacy test be performed on the existing leaching
area. This test will determine if the system is
• adequate according to National Standards. A listing of
\� private firms performing the test is enclosed. This
\ report needs to be submitted to this department for
our review.
Please notify this department for a reinspection when the
noted descrepancy has been corrected. If there are any
further questions, please call this department at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw