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T15N R1W SEC 8 LT 26 N2
TISN RIW 8 Lot 26 N2 #051-092 !, -20 N1/2 of LOT 26, SECTION 8, T15N9 R1W wuw a,: CKLD W: D+TL: 9-19-05 s..ccu B.J.J. JHM r R.C.C. "�" 1 OF 1 q DESIGN CRITERIA' CONTRACTOR IS REOUIRED TO OBTAIN UTILITY LOCATES 3 BDRM = 450 GPD PRIOR TO ANY EXCAVATION SOILS = 1.0 GPD/SO.FT. WORK. / 450/1.0 = 450 SOFT. REO'D. 1"34 EAGLE RIVER LOOP ROAD EAGLE RIVER. ALASKA 91777 PWNEJI (907)694-2979 FAXf (907)994-1211 APPROX. WELL RADIUS DRAINFIELD CRITERIA: 3.0' DEEP (ADD 2' MOA APPROVED SAND) D.5' EFFECTIVE (COVER FIELD WITH 2- INSULATION) Z 5' WIDE g 90' LONG (20 45' LONG EA.) CL REDUCT. FACTOR=0.7 PRO ALL PORTDNS OF WITH LEM THAN COVER REQUIRE I 1 LOT 23 FLAT* FLAT* 2-3% SHOP GALLON BALLAST 4 O�VI 0 LA o0 I OF 01 C. COWAN CE -5801 �� •'i SSt+•"� LG y (fid L J n y APPROX. WELL RADIUS CONTRACTOR MAY VARY THE EXACT DIMENSIONS AND DESIGN PARAMETERS IN THE FIELD NECESSARY TO MEET SITE CON01T1 I L 0 by SULLIVAN P.O. BOX 670272, CHUGIAV~ ALASIC~, 99567 · TELEPHONE 686-2759 d UL 0 5 2001 HOLE nATA DEPTH ADDRESS PO ,~3 ~ ~ ~,'~ 0,~ (~. C/~'..! ~ LEGAL DESCRIPTION T /~ ~ ~1~ ~ ~ PERMIT NUMBER OOOIg& Date of lssue ~ -~-.~; T~'INDENTIFICATION NUMBER~- O~ - ~ Is well Io~ted at approved pe~it Io~tion? ~ No Method of Drilling: ~o~ ~ ~ble tool Depth of well: ~O~ Casing Type ~ ~L Wall Thickness ~ ~ inches Diameter ~ inches, depth /~ feet ' Casing Stickup Above Ground: ~ feet S~tic Water Level (from ground level): ~ feet Pumping level: feet affer~ bm. pumping qpm Re~ver Rate: ~ qpm U thod o T ti.g: Well Intake Opening Type: ~n End ~ Open Hole oened: Sra. ~t ~ped feet GmutType: ~, rg V~ume /~a Depth: from ~ feet, to ~ feet Pump Intake Depth: feet Pump Size .bp Brand Name Well Disinfected Upon Completion? ~s ~ No Method of Disinfe~ion: ~l~4~ ~0 ~' Comments: Drillers Name Municipality.o.f Anchora{]e ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. MUNICIPALITY OF ANCHORA GE Department of Health and Human Servfces On-Site Services Program 825 L Street, Room 502 P.O. Box 196650. Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Jun 27, 2000 Expiration Date: Jun 27, 2001 Permit Number: SW000196 Legal Description: T15N R1W SEC 8 LT 26 N2 Design Engineer:. 0000 None Required Owner Name: Raymond & Polly Neketemff Owner Address: PO Box 672036 Chuglak, AK 99567-2036 Parcel ID: 051-092-20 Site Address: 020840 CRABTREE ST Lot Size: 54450 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 2 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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either:. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date:. NAME _.',. : MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT DISTANCE TO: we"~O0 / -/-,- Length of ach line/~Z.. Crib diameter NO. OF BEDROOMS~ NO. of com/partments ~.. Inside length Width .iquid depth Dwelling PERMIT NO. .iquid capacity in gallons · Material Total lang.. 9 f li~es~ I Trer~/wi~lth PERMIT NO. , depth Well Building foundation Nearest lot line Sewer line . Septic tank Building foundation OTHER LEGA. PIPE MATERIALS REMARKS PERMIT NO. Absorpt on area(si .~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [3 PERCOLATION TEST Pouch 6.~50. A~m'age. Al~kl 99602 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: ~~'~ ~ 40 i~'~' O'-/~ DATE PERFORMED: / ? 0~T 7~ SLOPE SITE 2 3- 4- 5- 6 7- 8 9 10 11 12 13 14. 16- 17- 18- 19- 20- DEPTH? COMMENTS 72.008 (7/76) Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN FT AND FT CERTIFIED BY/~~ ,, (minutes/inch) DATEJZW r?/ MUNIUPAUTY OF ANCHORAGE a Development Services Department `� p p p Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-092-20 1. GENERAL INFORMATION Expiration Date: 1 — q 2 © Zo Complete legal description T1 5N R1 W S8 L26 N2 Location (site address) 20840 Crabtree St. Current property owner(s) John Spring Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well FX_1 Private Septic Fx_1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee S 412.50 CO UI 0_ Date of Payment 31/2 r7,1 02 D9 O Receipt Number ( -I 9 9 �16'i COSA # DSC 20) 966 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe 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 soil condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. Phone (907) 745-8200 OF ALgs� ,`P• A 49 THi 6. DSD SIGNATURE lop, • .. ... . • • • • • . • • System #1 Approved for bedrooms Steven f2. 'Pann*o' ie , CE 8149 System #2 Approved for bedrooms ��s'• Disapproved�t Conditional approval for bedrooms, with the following stipulations: llllll((^(({{{{4 ON-SITE WAgT[•'•iril4T�R z PROGRAM o `- G fr' Original Certificate Date: .9bV(j The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or.omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory _ Well Flow Advisory Other COSA Checklist blue sheet Legal Description: T15N R1 W S8 L26 N2 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 8118/2000 Total depth 200 ft Cased to 173 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 31 in. Date of flow test for COSA 8/6/2020 Static water level at beginning of test 64.1 ft. Comments B. TANK DATA Age of tank(s) 15 years Tank type/material STEP/St-1 Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/20/20 D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) 9/28/2005 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.25 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A -pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: Structure served by this system 1 0.51-092-20 Well production at time of test 0.43 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑✓ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 14.149 ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Date of Sample 08121/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station 15 years Lift station material Steel Comments: Adequacy test date 81112020 Results ®✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 500 gal New depth 0 in Elapsed time 0 min Final fluid depth 0 in Absorption rate >450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date IN E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' F,71 Yes Community Sewer Manhole/Cleanout > 100' E] Yes if No ft M Yes if No Neighboring Tank > 100' r-71 Yes if No ft Private Sewer/Septic Line > 25'F71 Yes if No Absorption Field on Lot > 100' Fv� Yes if No ft Holding Tank > 100' 0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' [✓ Yes if No �✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5' F,71 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100'✓l Yes if No. Water Main > 10' ✓� Yes if No ft Community Wells > 200' Q Yes if No. Water Service Line > 10' P/1 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' U✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' Q Yes if No ft Community Wells > 200' 0✓ Yes if No Surface Water > 100' Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that / have determined through field inspections and review �� Y of Municipal records that the above systems are in conformance with 4 MOA COSA guidelines in effect on this date. p te-ven R- an one CE 8149 `i COSA Checklist yellow sheet ft ft ft ft OSA Checklist 41�J, Legal Description: T15N R1W S8 L26 N2 Parcel ID: 051-092-20 If more than 1 septic system on lot: COSA Checklist of Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/20/05 Total depth 73.9 ft Cased to unknown ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA "U!'e°"" .d Well production at time of test 0.43 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes E] No ❑ Coliform bacteria is Negative Nitrate 3.54 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Sullivan's Date of Sample 9/25/20 Static water level at beginning of test not required ft. Comments This data for well #2- per DW no well flow was required on this well. Cap welded on by Sullivan's water wells 10/8/20 see receipt B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 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 ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 81112020 Results ❑Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: data for tank, lift, field and distances for septic system on checklist for well #1- This checklist is for well #2 COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft ✓❑ Yes if No Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ❑✓ Yes if No ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft ❑✓ Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ft ft ft ft ft ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No. Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No. Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date.loon ee COSA Checklist yellow sheet t en F'. Pcaniorie CE 8i4,; - ESS!?vial..- ft ft ft ft DEVELOPMENT SERVICES DEPARTMENT 8Ai On -Site water and Wastewater Section www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC201466 Subdivision: T15N R1W Sec 8, Block: , Lot: 26 N2 907-343-7904 Fax: 343-7997 A water sample revealed an arsenic concentration of 14 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/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. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P. O Box 195650.. *Anchorage, Alaska 99519 6650 *www mum org � , P.O. Box 670269 Chugiak, AK 99567 P: (907) 688-2759 F: (907) 688-2259 TO: Billy Hughes — Precision Home Group 20840 Crabtree Chugiak, AK 99567 Water Samples & Abandonment Run Well. Pull water samples, run to lab, remove system. Approved well abandonment with MOA. Weld on cap so well can be used in the future. Date: 10-8-20 MUNICIPALITY OF ANCHORAGE X Development Services Depailment On , -Site Water & Wastewater Section Phone: 90"1-343-7904 Fax: 907-343-7997 Lift Station/Pump Vault Maintenance Log Owner ptic Tank: - SeStreet Address 20 C -Sludge level . __inches -Pumping: required yes ,f o *Pumping completed e no L�ft statiow. .Pump basket cleaned (Le -c/ no -Effluent filter cleaned es no -Control floats cleaned no -Proper float settings confirmed 0 no -Operation satisfactoryQp �n o -Dedicated electrical alarm circuit @s .tnr no ®Audible inside dwellin es 0 -Alarm system operate satisfactor of satlggLtou il&anhole Riser -Ground water intrusion at riser to tank connection yes n v�r -Ground water intrusion around pipe penetrations e no -Weep hole functionac es io -Manhole lid: Functions �s no Insulate es o Properly SecuredCy Other _;es no -All manufacturer required inspections and maintenance completes es no Comments: Noriff-mmiTj Technician Date of maintenance Company dL-,41 Signature Date I' APPLIC'"'IT FILLS OUT UPPER HA['~"ONLY Buyer Address Zip ~e Phone Address Zip Type ot Resl~nce ~ Other ~ Comm~lty .D / For wells ~111~ prior to th~ date, give well depth (attach I~ If available). Sewer Disposal .. Indlvid~l ' Year Indlv~ual Instatled: ~ Holding Tank NOTE: THE INSPECTION ~E MUST AC~O~A~EK~ RE~EST BEFORE ~OCESSING CAN BE N T ATED Time Time Time Time ~.~/ Inspector Inspector Inspector Inspector -o.e,. ' RECEIVED ( ~APPROVED BEDROOMS~ 'CONDITIONS OF APPROVAL ( ' ) DtSAP~OVED DEPABTMEMUNICIPALITYNTOI: OF ANCHORAGE DEPT C, l- ~.~LT, r! & / I T F HEALTH & ENVIRONMENTAL PROTECI~iI~;~)NM[NT~ p,,OTECTION ~ 11~ I .. ) - JUL 6 '. ENVIRONMENTAL ENGINEERING DIVISIONT. e~.e ~ ~7~ ..RE~EI~~. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES PHONE PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION JPHONE MAILING ADDRESS 4. REALTOR/AGENT JPHONE MAILING ADDRESS SINGLE FAMILY MULTIPLE FAMILY NUMEER OF BEOROOMS C-t One [] Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISIN~SAL sY~rEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY · ATFACH WELL LOG. A well log is requiresl for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) If system is over two {2) years old an adequacy test is required by th[s Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~0t013/78) THIS SIDE FOR OFFICIAL USE ONLY TIME DATE INSPECTOR DIRECTIONS: INSPECTION APPOINTMENTS IME DATE INSPECTOR DATE RECEIVED TIME DATE INSPECTOR 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM f--IINDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified i-'lSeptic Tank or I-'lHolding Tank Size: If Tank is homemade give dimensions: NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL A~SORPTION AREA MATERIAL Septic/Holding Tank 4. DISTANCES WELL TO: Absorption Area to nea~elt Lot Line COMMENTS DATE LEGAL DESCRIPTION [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate} [~DISAPPflOVED 72-010 (Rev. 3/78)