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T15N R1W SEC 8 LT 165B
T15N RIW Section 8 Lot 1656 #051-153-42 N LL LL LL co LL N LL m C7 C7 m m _0- �, a c � L) L) M o �~ . * P.z ' CL 3 z Q M •�',�� n 3 a o �o N 0 N L CL E OU @ IL z OD x n CD m C 0 1 0 CO o N c z U7 �' • c O �I: •� N ❑ o ❑y y o c CO o �ro'• �wu W r .' U r 0 o L o U z CL U W `� W d�'1�1,���`' N m O �.�N S* I- LL LL -0 _ ❑ 0 w 11 1 N LL D o Z o� ����t�� a' d m Z w Lij _ ° _ It T �� O m ri m' z N _ D LL co Z r LL W O LL U❑ ° O m C vi ❑ Y Z N Q C o LL LL L Q D rn O N Z N W o a Z z L) Q ui m O m a° Q W (D w LLIa (w� v C CO O V (n p C, a. 0) O C Q ❑ UI ~ Q Q o Q 0 - W E 0 0 �z _� ED 2-c: Q (D E L) (CO z 0 Ll s 3 0 Y�� �0 _ C) �U) v z o a D Z o❑ �� U) Q xCD m d �� o �z=3— LO C {L LL C Q €Q m a a m 0Q a j o o i�NC7�n F -2w 2 J� a O L N Z C)� W x W E o. CL co N (D C: -a W 73 o '5 c t:T) _ _.. U)W Z W 3 C: (0Q) U) D(n m J 1 1 1 1 o O Q Q 0 2~ W W U m ❑ Q< W c s Q) LU Em z m O O O O o F - OZ N N ? H 3 � + + (1) 0 z ❑ c J + + Q Q N V Z a O LO LL ❑ 0 m m (n O O 0 Q ca > o M cn O W a� O O CO O0 Y H � 0 W W o % N Q Z Q N LL a + + 00 + Z 0 0 W — Z Q d IL E O N Lcu n co LL �, U a 00 L 1 1 1 o z N a0 ° vw z `�~ ° Q cn a a�\ o mLLI LU_ OQ z z Q i O z . a o E CO N O N C0 > Lu N T 0± tN U J C Caa O ++ V 0Z E rn o Q J E C d Q Q a� a 3 EQ z U � 8; c war' rn 3 w E m a c U C� Q d D J tom- CI)LU LL N O Ln O a) 2 CHARLES G BALZARINI CE-13854R E G ISTEREDPROFE S S I O N A L E N GINEER 1/20/24 PPP.w 0 W 0 O I— d' 0 LO x 0 m w C7 O v W W W C) Z Q O 0 Q O i-+ b C� 00 i i U Lo lc� F1J�1 T •--I /^� ..y CO OEn 0 � o cz C a tb m Ln a cn a) Q LLI 'n MSI o M, in. d03rn = C's Cd O +� > N N O cd 'S."C4 O T O LJJ U) Ln Q 3 a� -o N N o L � O Q. cCS .-+ 3 k m o __ 0 �. cn 3 •F o0) EL - 0 W +s" H cn C7 O v W W W C) Z Q C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Septic System for T15N R1W Sec8 Lot 165B Dear Reviewer, The new leachfields at the subject property were accidentally installed too close to the east property line as shown on the survey and inspection report drawing. We are requesting a wavier of the 10 foot separation distance. The requested waiver distances is 8.8 feet for both fields. The neighboring lot has recently had a new AWWTS installed and this reduced separation does not adversely affect that or other properties. The neighboring AWWTS (and reserve site location) appear to have been constructed more than 10-feet away from this system based on standpipe locations. Since this shallow trench system has an effective depth of 1' and the neighboring AWWTS has a effective depth of 0.5', the required field to field separation would be 6' which is less than the distance from the fields on this lot to the property line. Additionally, I verified that the tank was pumped during the installation work and it was exposed for my inspection when the lift station was installed. Unfortunately, neither the contractor nor myself have been able to obtain a proof of pumping receipt. I am requesting the COSA be approved based on my first hand verification that the tank was pumped on or about 8/8/2023 when the lift station was installed. The system has only had light use since that time. Thank you for your time in reviewing this request. Please do not hesitate to contact me at 907-854-5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 5/15/24 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231359 Work Type: Septic Renewal Tax Code Number: 05115342000 Site Legal Address: T15N R1 W SEC 8 LT 165B G:1256 Site Mailing Address: 19991 S BIRCHWOOD LOOP RD, Chugiak Owner: MERIDETH CARRIE & JOHN P 50% & Design Engineer: C&M ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: l„cnr Q S' 9(40 11L ljep ll tnlelit 10/19/2023 10/18/2024 41311 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing .eceiv-e�y: 5_5L4ea 40 C 4-1-Y rl Issued By: Date: Date: Z 0// q 2 3 R US 14 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05115342 Property owner(s) MEREDITH Mailing address 19991 S BIRCHWOOD LOOP Site address 19991 S BIRCHWOOD LOOP Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 8 LOT 165B Lot Size 41,311 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 Septic Tank 0 Upgrade❑ (w/wo ADU) Duplex (D) El Holding Tank ❑ Renewal Q Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:. -#232- Waiver Fees: Date of Payment: /9'/23 Date of Payment: Receipt Number: 00010 Z Receipt Number: Permit No. Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System for T15N R1W SEC 8 LOT 165B Dear Reviewer, We are requesting a renewal of the onsite systems permit for the subject property. We conducted a site visit on 10/16/23 and found no changes in conditions which would impact the permitted septic system. Groundwater was found at 8.3’ at a groundwater monitor tube re-installed at the location of the FWC testhole location. A new septic system is being installed at Lot 165A. The installation of that system does not impact this system. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 10/17/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231359, Deb Wockenfuss, 10/19/23 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 Wastewater Disposal System Permit Permit Number: OSP221240 Work Type: Septic Upgrade Tax Code Number: 05115342000 Site Legal Address: T15N R1 W SEC 8 LT 1658 G:1256 Site Mailing Address: 19991 S BIRCHWOOD LOOP RD, Chugiak Owner: MEREDITH CARRIE & JOHN P 50% & rlo^T {A/ATCIJ rn�'^' " TIAI Design Engineer: -F+RS , �G C 4M j5nq This permit is for the construction of: J Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: „gent : I■ f Depal-tment 10/17/2022 10/17/2023 41311 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or ---b.–Covered; sealed] and -heated -to -prevent -freezing --- — ------------------------ Received By: Issued By: Co- tU Govl uorh o nJ s Vs7b- 9 Date: 10/17/2022 Date: %()117 ZZ 3 fel � Development Services Department g� Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-153-42 Property owner(s) CARRIE & JOHN MEREDITH Day phone Mailing address 19991 S BIRCHWOOD LOOP, CHUGIAK, AK 99567 Site address 19991 S BIRCHWOOD LOOP, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) T1 5N R1 W SEC 8 LT 165B Legal description (Township, Range & Section) Lot Size 41,311 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade Q (D) El Holding Tank ❑ Renewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 5 Waiver Fees: Date of Payment: 7���?_ Z Receipt Number: 7-16020 Permit No. OS 10-211 D `� D Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System for T1 5N R1 W SEC 8 LOT 1658 Dear Reviewer, We are requesting a change order to the open permit for the subject property. The FWC design incorporates and Advantex system which is ideal for this lot. However, a well designed and constructed conventional system can be adapted to the site in a cost effective manner. We are proposing to install a new pressurized shallow trench system. The trench shallow trench system will use 1' effective depth of sewer rock underlain by a minimum of 1' of moa filter sand. The design will be based solely on the bottom absorption area of the trench, but the extra effective depth and the interface between the sand and native soils will provide additional absorption. The soils on this lot have been explored extensively. Most recently FWC completed a testhole in 2022 which identified tight soils and seasonal high groundwater. Past soil logging and percolation test efforts identified more favorable conditions. At best, this indicates inconsistent subsurface conditions. We are designing the leachfield based on the FWC soil log. The existing septic tank is steel and was installed in 2011. Due to it's age, it will be inspected for re -use or replaced. We are recommending it be replaced with a new 1250 gal. Min MOA approved steel STEP Tank. Due to the seasonal high groundwater table, a plastic tank may not be suitable at this location. The tank and leachfield are extremely tight to the well radius and utility easement. Both must be flagged prior to construction and great care will be required to ensure the leachfields do not encroach. The new fields will be installed near an abandoned crib system and near the existing trench system. All sewer rock, contaminated soils, and other septic system components must be removed from below the new field and within 6 -feet horizontally. Removed material may be replaced with MASS Type II/IIA material or MOA filter sand. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini(d,)gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 7/30/23 b . .I °A4 j 0 ^ m o am at o�- �seatroy �a,tr°e�®o© 'CHARLES G BALZARINi` f�.��o�, CE13854`�i PROFESStONP`o0w C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Residence: T15N R1W SEC 8 LOT 1658 RESIDENCE/LOT INFO number of bedrooms 3 br Water usage/bedroom 150 gpd/br Water Usage 450 gpd system type: Conventional type: Shallow Trench Calc By: CGB Date: 7/19/2023 m CHARLES G BALZARINI° - CE13854 `moi AMW' t\� PROFESSION, 0.6 Application Rate gpd/sqft required absorption area 750 sgft trench width (W) 5 ft MIN gravel depth (D) 1 ft Shallow trench factor 1 (W+2)/(W+Knot adjusted for gravel depth) Min Required Length: 150 ft USE 2 EA 75' TRENCH Groundwater Depth 5.5 MAX EXCAVATION DEPTH 1.5 FT REFER TO PLANS FOR DETAILS OF CONSTRUCTION Calc By: CGB Date: 7/19/2023 m CHARLES G BALZARINI° - CE13854 `moi AMW' t\� PROFESSION, NOTE: INSTALL ALL COMPONENTS IN ACCORDANCE WITH MUNICIPAL CODE, APPROVALS, POLICIES, AND MANUFACTURER'S RECOMMENDATIONS. AN ASBUILT SURVEY MUST BE COMPLETED AFTER THE INSTALLATION OF THE SEPTIC SYSTEM COMPONENTS. INSPECT EXISTING LINES FOR DAMAGE, SLUDGE, AND / OR BLOCKAGE ' • • • • • .... .:.... . MONITOR TUBES MUST'S WITHIN 1—FOOT OF EACH END OF EACH TRENCHN CHARLES G•BALZARII�i �<`��°. CE -13854 LOT 166 ,' ��� �� JIFF• • a; :a::: • • ® �i< k- PROFESS00' Amw i LOT 1658 LOT 165A � � `�� I I 1 I � I WELL t 1 I I I I I I I I I TANK: INSPECT EXISTING TANK AND I TWO 5'x75'SHALLOW INSTALL ADD-ON 500 GAL LIFT BASIN I 3 BR OR INSTALL NEW 1250 STEP TANK i HOUSE TRENCHES WITH EFF AND 1' (RECOMMENDED) I SAND. 1.25" SCH. 40 PVC W/ 1/8" HOL NEW TANK MUST BE MOA APPROVED I --------------------- AT 2' SP. SEE CROSS SECTION FOR -- STEEL DUE TO POTENTIAL GWT. EXCAVATION DEPTH AND MOUND _ K-+ DETAILS. TOE OF SLOPE FWC DECOMISSION PES OLD FIELD TESTHOLE j 2" SCH. 40 DISCHARGE ' AND MANIFOLD!---' J `10� \ INSTALL MONITOR TUBES BOTH ENDS OF EACH FIELD. S&S I I X' II G' REMOVE G' HEDS _=_-I'I 1T�1}�,�� LI 7TOE OF - GTi Tj tt MOUND FILL 10' UTILITY EASEMENT —C w --- MOVE ANY EXISTING TRENCH OR CRIB COMPONENTS, SEWER ROCK, OR CONTAMINATED MATERIAL WITHIN 6' OF NEW FIELDS AND REPLACE WITH MOA APPROVED SAND OR MASS TYPE II/IIA MATERIAL. LEGEND O CLEANOUT O MONITOR TUBE j ® TEST HOLE I CA NOTES: 1. THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: 100' FROM ANY PRIVATE WELLS 200' FROM ANY PUBLIC WELLS 100' FROM ANY SURFACE WATER ADJACENT LOTS TO THE WEST AND SOUTH (166,171,172) DO NOT HAVE DOCUMENTED ONSITE SYSTEMS. NO WELLS OBSERVED WITHIN 100' OF THIS PROJECT. C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: T15N R1 W SEC 8 LOT 1656 OWNER: MERIDETH I DATE: 7/28/23 REV:O DRAWN: CB REF: SITE PLAN NOTE: INSTALL ALL COMPONENTS IN ACCORDANCE WITH MUNICIPAL CODE, APPROVALS, POLICIES, AND MANUFACTURER'S RECOMMENDATIONS. AN ASBUILT SURVEY MUST BE COMPLETED AFTER THE INSTALLATION OF THE SEPTIC SYSTEM COMPONENTS. INSPECT EXISTING LINES FOR DAMAGE, SLUDGE, AND / OR BLOCKAGE 6" TOPSOIL AND SEED PER MOA REQ'S FILL MOUND z 4" INSULATION J d' W a--- '---- a 6.0 1.5' MAX 1.0' MAX DIST PIPE + + + + 1' EFF + _T SEWER ROCK 10.0' 4.0' 1MIN MOA SAND OR AS REQUIRED TO GET THROUGH TOPSOIL. ---------------------- SEASONAL HIGH GWT, PER FWC ---- -- ORIG GRADE I 2.0' CROSS SECTION DOES NOT SHOW ALL COMPONENTS OF SYSTEM SUCH AS FILTER FABRIC. CONSTRUCT SYSTEM PER MOA REQUIREMENTS. DO NOT OVER EXCAVATE. 5.5' C&M ENGINEERING SERVICES 907-854-5558 LEGAL DESCRIPTION: TlSN R1 W SEC 8 DoT 1656 OWNER: MERIDETH DATE: 7/28/23 REV:O DRAWN: CB REF: SCHEMATIC SECTION Pump Selection for a Pressurized System - Single Family Residence Project GC) -;,�c � Parameters Discharge Assembly Size 2.00 inches Transport Length 5 feet Transport Pipe Class 40 Transport Line Size 2.00 inches Distributing Valve Model None Max Elevation Lift 5 feet Manifold Length 10 feet Manifold Pipe Class 40 Manifold Pipe Size 2.00 inches Number of Laterals per Cell 2 Lateral Length 66 feet Lateral Pipe Class 40 Lateral Pipe Size 1.25 inches Orifice Size 1/8 inches Orifice Spacing 2 feet Residual Head 5 feet Flow Meter None inches 'Add-on' Friction Losses 0 feet Calculations Minimum Flow Rate per Orifice 0.43 gpm Number of Orifices per Zone 68 Total Flow Rate per Zone 29.9 gpm Number of Laterals per Zone 2 % Flow Differential 1st/Last Orifice 6.7 % Transport Velocity 2.9 fps Frictional Head Losses Loss through Discharge 1.8 feet Loss in Transport 0.1 feet Loss through Valve 0.0 feet Loss in Manifold 0.0 feet Loss in Laterals 0.8 feet Loss through Flowmeter 0.0 feet 'Add-on' Friction Losses 0.0 feet Pipe Volumes Vol of Transport Line 0.9 gals Vol of Manifold 1.7 gals Vol of Laterals per Zone 10.3 gals Total Volume 12.9 gals Minimum Pump Requirements Design Flow Rate 29.9 gpm Total Dynamic Head 12.7 feet v�1 a FROUCTMO 1NE WORID'S WA7lR 400 350 300 w d ti 250 F— E m 150 F_ 100 50 0` 0 PumpData X41 5 10 15 20 25 30 35 40 Net Discharge (gpm) PF1005 High Head Effluent Pump 10 GPM, 1/2HP 115/230V 10 60Hz, 200V 30 60Hz PF1007 High Head Effluent Pump 10 GPM, 3/4HP 230V 10 60Hz, 200V 30 60Hz PF1010 High Head Effluent Pump 10 GPM, 1 HP 230V 10 60Hz, 200V 30 60Hz PF3005 High Head Effluent Pump 30 GPM, 1/2HP 115/230V 10 60Hz, 200V 30 60Hz PF3007 High Head Effluent Pump 30 GPM, 3/4HP 230V 10 60Hz, 200/460V 30 60Hz PF3010 High Head Effluent Pump — r'_onn 4 uo System Curve: Pump Curve: o Pump Optimal Range: Operating Point:, 0 Design Point:0 DEPTH FEET OG SOILS I PERFORMED FOR: CARRIE & JOHN MEREDITH ORG/OL — 6" 1 TESTHOLE # 22-1 DATE PERFORMED: 6/17/22 2 3 4 5 6 7 8 9 10 11 12 1.3 14 15 16 17 18 19 20 SM/ML-gm IC • GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 9' & 5.5' DATE: 6/27/22 & 10/7/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION Reading Date Gross Net Time Time 'apality of Anchorage --Gw si ter and Wastewater F4• 051 Warer ." 40 errfuss 107 6" �w w 49 ,M w C 0 N S U L T I N G I�• •• . •• . J P ., n 3 ,. t 4 :d `: 6" . 13030 Sues WayAnchorage, Alaska 99516 - g � • • . • . . ��• �•,. Curtis Huffman � F CE 128991 Tel. 907-350-9566 firstwaterAK@gmail.com � ��slF,p' • 6127✓2�''���'�® SOILS LOG -PERCOLATION TEST l F�pROFESStO X LEGAL DESCRIPTION: T15N R1W SEC 8 LOT 165B DEPTH FEET OG SOILS I PERFORMED FOR: CARRIE & JOHN MEREDITH ORG/OL — 6" 1 TESTHOLE # 22-1 DATE PERFORMED: 6/17/22 2 3 4 5 6 7 8 9 10 11 12 1.3 14 15 16 17 18 19 20 SM/ML-gm IC • GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: 9' & 5.5' DATE: 6/27/22 & 10/7/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION Reading Date Gross Net Time Time Depth to Water Net Drop 6/18/22 30 min 6" 1/316" 30 min 6" 13/16" 30 min 6" 12/16' PERCOLATION RATE 27 (MIN/ INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6" PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/27/22 C0,44 1 Wockenfuss, Deborah M. From: Walters, Michael S. Sent: Tuesday, August 1, 2023 12:22 PM To: Wockenfuss, Deborah M. Subject: RE: Lot 165B Plan.pdf Right of Way has no objections or comments to the proposed action. Thank you, Michael S Walters Senior Plan Reviewer Right of Way Section michael.waltersno.anchoraaeak.aov Office: 907-343-8226 Cell: 907-727-7637 Fax: 907-249-7910 #ANCWORKSI I An online tool for Anchoroge From: Wockenfuss, Deborah M. <deborah.wockenfuss@anchorageak.gov> Sent: Tuesday, August 1, 2023 12:17 PM To: Walters, Michael S. <michael.walters@anchorageak.gov> Subject: Lot 1658 Plan.pdf Mike, The proposed septic system design involves excavating most of the crib (lower right corner of the attachment) and backfilling with sand or Type II material to maintain the required separation between septic fields. Some of the excavation work will be in the Utility Easement. Any objection? Deb Wockenfuss Onsite Water and Wastewater Municipality of Anchorage 907-343-7906 LOT 165-ALOT 166B AULWES SUBD. (83-550) OHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHUOHU ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;;;;;;;; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ;;;;;;;; OHUOHU O H U O H U O H U O H U O H U O H U O H U ; ; ; ; ; BLM LOT 172 ℄ S. BIRCHWOOD LOOP EDGE PAVEMENT 10' UTIL. ESMT. 10' UTIL. ESMT. GR A V E L D R I V E W A Y MB S W S S S SS SSSSSS SC T SHED GARAGE SHED N89° 50' 15"W 154.87 S0 0 ° 0 6 ' 3 0 " E 2 8 0 . 3 4 S89° 49' 04"E 139.83 S0 2 ° 5 7 ' 4 6 " W 2 8 0 . 7 2 50 . 0 ' 50 . 0 ' 33 . 0 ' EG 20.3 40 . 2 79.3 25 . 6 1.2 4.8 14 . 0 20.3 14 . 0 10.8 15 . 9 26.2 14 . 2 10.2 9.9 11 . 7 12 . 2 23.2 3.2 31 . 8 18.7 45.8 75 . 9 5.9 14 6 . 8 16 5 . 3 100 ' WE L L R A D I U S Lot 165-B Subdivision of BLM Lot 165 41,311 Sq. Ft. +/- 19991 S. Birchwood Loop 1 Story Wood Frame House With Attached 2 Car Garage NOTE: SOME FEATURES OF THIS SURVEY MAY NOT BE SHOWN DUE TO ICE/SNOW CONDITIONS. PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. November 14th, 2023. Legend: Scale 1" = 40' Gas Meter Electric Meter/Outside Power Deck Septic Telephone Pole Fence Mailbox Overhead Utility Lot 165-B, Subdivision of BLM Lot 165 General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Carrie Merideth 23-469 11/16/2023 76-266 1256 Light PoleWater Well Tel. Pedestal Concrete MB Street Sign G E S [T W Nov 16, 2023 R E GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier No. L.S. - 9812 SC Septic Tank M.H. Municipality of Anchorage e° Development Services Department < Building Safety Division s. E, On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 - Page 1 of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSP111207 PID Number: 051.153.42 "Zifirey & Donna Hartley Wastewater System: ❑ New ® Upgrade Atldress: 0. Box 671225 ABSORPTION FIELD Phone: Number of Bedrooms. ® Deep Trench O Shallow Trench O Bed 0 Mound D Other: LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 1.2 GPDfFis 9.0 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade. Gravel depth beneath pipe: 1658 4.0 Ft. 5.0 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 15N 1W O Ft. 40.0 Ft. Well: El ❑ Upgrade Gravel width: Number of lines: Distance between lines: 2.5 Ft. 1 Ft Classification (Private, A, B, C): Total Depth: Cased W: Total absorption area Pipe Material: Existing Private Ft. I Ft. 400 Ft= 3034 PVC Driller: Date Dulled: Static Water Level: Installer: Date Installed Ft Flintstone Enter rises 9/2712011 Yield: Pump Set at Casing Height Above Ground: GPM FL Ff. TANK SEPARATION DISTANCES ® septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic/Private Manufacwrer: Capacity: From Tank Field Station Tank Sewer Line Anchorage Tank 1000 Gal. wall 101.0 112.3 52.0 Material: Number of Compartments: Steel 2 Surface Water 100+ 100+ LIFT STATION Lot Line 25.8 11.5 Sim: anumctura. Gal. Foundation 40.5 55.4 Pump on' level at: Pump off' level at: High water alar at: n. in. in. Curtain Drain NIA N/A Pump Make 6 Model Electrical Inspections performed by. Remarks: BENCH MARK Location and Description: Garage FF Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 22011 d 22011 ��q+♦♦ 91ll Development Services Department Approval ���O..... CPy♦♦♦ 'IV, pj Conditional Approval Date: � fie' 49TH /* \ * ♦♦ ..n.. ......... 0 • �j�'�Steven R. Pannone:i - Reviewed and approved by: Date: _2- b i 'l ♦1 S'•., No. CE 8149 i ♦♦`v� ol�tZo�: ♦ u ♦♦1♦1 ESS\ 6,6B 3 3 1 INSTALLED 1000g 5 SOUTH BIRCHWOOD LOOP ROAD 10' UTILITY EASEM SEPTIC TANK (P) WITH DCO EXISTING 2y, /Xrl SEPTIC AREA V 11.5 H-1 UPGRADE DRAIN FIELD (P) 40LFx5'EDx2.5'W, 9'TD B 1 I `-- WELL (E) WELL (E) 3BR HOUSE (E) B \ CONNECTED TO EXISTING FCO I/ EXISTING � ���7 � SEPTIC AREA W/ r -I \—EXISTING CRIB IN FAILURE ABANDONED PER CODE ABANDONED EXISTING 1000g SEPTIC TANK PER CODE NOTES: PAMONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T15N R1W SEC 8, LOT 165B JEFFREY & DONNA HARTLEY P.O. BOX 671225 PLAN CHLIGIAK, AK 99567 11/10/11 rg'�P' -I.9f, scale P.I.D. NO 051-153-42 —Men R.•Pannone PERMIT NO. I CE 8149 ,,��% OSP111207 FESSION=�.` Sheet OOF 3 C 1 41.8 85.9 T1 WD 42.5 88.1 T2 46.2 96.4 CA 47.3 98.5 F1 67.7 125.9 M1 67.9 124.6 F2 57.2 91.5 M2 59.2 96.8 1 I `-- WELL (E) WELL (E) 3BR HOUSE (E) B \ CONNECTED TO EXISTING FCO I/ EXISTING � ���7 � SEPTIC AREA W/ r -I \—EXISTING CRIB IN FAILURE ABANDONED PER CODE ABANDONED EXISTING 1000g SEPTIC TANK PER CODE NOTES: PAMONE ENG SVC, LLC RECORD DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T15N R1W SEC 8, LOT 165B JEFFREY & DONNA HARTLEY P.O. BOX 671225 PLAN CHLIGIAK, AK 99567 11/10/11 rg'�P' -I.9f, scale P.I.D. NO 051-153-42 —Men R.•Pannone PERMIT NO. I CE 8149 ,,��% OSP111207 FESSION=�.` Sheet OOF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: INSTALLED NEW SEPTIC TANK AND SOIL ABSORPTION SYSTEM. 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15 FEET BELOW EXISTING GRADE. 10009SEPTIC \92.6 TANK (P) 92.2 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1-5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 375 SF SYS. TYPE: DEEP TRENCH 5.0' E.D MIN LENGTH: 37.5 LF USED, 40 LF X 2.5' WIDE, 5' E.D., 9' TO TOTAL AREA: 400 SF 87.2 I li PROFILE DEEP TRENCH SEE DESIGN LEGEND — W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T15N R1 W SEC 8, LOT 165B JEFFREY & DONNA HARTLEY P.O. BOX 671225 DETAILS CHUGIAK, AK 99567 4" Dia Per( Pipe F810 HDPE ABBREVIATIONS m p0 5 z 0 2 O zo w w kU 96.2 92.2 87.2 CU COPPER DIP ILTER FABRIC TH TEST HOLE FC 4° D DRAIN PIPE T# TANK CLEAN OUT NO. C# TH-1 96.2 GRAVEL BEDDING M# MONITOR TUBE NO. R.I. 4 J DCO DOUBLE CLEAN OUT DV 0.5 92.2 FS FLOW SPLITTER SM/ 5.0 GM 87.2 II II —12 5f— GRAVEL 6.0 —15 81.2 No groundwater monitored SECTION 4� 00 0 0 wo Fz z zDili z 0 aw 0U U ODU Q 44w _ J O U EQ 0 / 10009SEPTIC \92.6 TANK (P) 92.2 DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1-5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 375 SF SYS. TYPE: DEEP TRENCH 5.0' E.D MIN LENGTH: 37.5 LF USED, 40 LF X 2.5' WIDE, 5' E.D., 9' TO TOTAL AREA: 400 SF 87.2 I li PROFILE DEEP TRENCH SEE DESIGN LEGEND — W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: PANNONE ENG SVC, LLC DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T15N R1 W SEC 8, LOT 165B JEFFREY & DONNA HARTLEY P.O. BOX 671225 DETAILS CHUGIAK, AK 99567 4" Dia Per( Pipe F810 HDPE ABBREVIATIONS m p0 5 z 0 2 O zo w w kU 96.2 92.2 87.2 CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER 11/10/11 *:-•.*1, .... .. ..: ... �teven `Pannope• CE 8149 j s �,1 �,�'•••••'P\,`�` NTS P.I.D. NO PERM T3 NO. OSP111207 Sheet 3 OF 3 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: OSP111207 Tax Code Number: 05115342000 Work Type: Septic Upgrade Permit Effective Dates: August 23, 2011 to August 22, 2012 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: T1 5N R1W SEC 8 Site Legal Address: T15N R1W SEC 8 LT 165B G:1256 Owner/Address: HARTLEY JEFFREY D & DONNA M PO BOX 671225 CHUGIAK AK 995671225 Site Mailing Address: 19991 S BIRCHWOOD LOOP RD, Chugiak Lot Size in Sq Ft: 41311 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank 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 E:,_1 Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor Llan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I. D. C671-7, Property owner(s) &r. VA og-r !e Day phone Mailing address PO -T'x,,K �,7)zz57 , ����1.��� , 4K `1,tS-67 Site address Ig9q ( 6�AJTy g1QeN coo GZ�o l' eno. Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) 't'j'r1Jt +,�,G, 1-0T Lot Size -1911,311 Sq. Ft. Number of Bedrooms � THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (S all that apply) Initial El Absorption Field �t, Septic Tank � Upgrade � Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Sig r or authorized agent) Pe m ~ ush Fees: Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Permit No. L "�.;' Receipt Number: Waiver No. GABuilding\On Site\Forms\Client Forms\Permit App_01 041 1.doc (Rev. 1/11) Pannone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com August 11, 2011 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: T15N R1 W Sec 8, Lot 165B Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing three-bedroom house. Currently the lot is developed. The lot is served by a private well. The existing drain field is in failure and shall be abandoned per code. A new drain field will be installed west of the existing drain field and will be sized to handle a three-bedroom waste stream. The surrounding developed lots are served by private wells. The wells are located over 100 feet from the proposed soil absorption system. 1. Soils. One test hole was excavated by Pannone Engineering Service in August of 2011. See the soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth of fifteen feet (15') below ground level after the monitoring period. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately flat based on the survey information in the area of the septic system. There are no steep slopes within the vicinity of the proposed drain field. Mailing: P,0. Box 100,217, Anc ora , AK 99510 0217 5, East " ' Ave, Cuite B63, Anchorage, AK, 9950,3 T lepii n : 07) 272-8218 FAX: (?) 272-8211 Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, OF �... �.�%•• •Steven R. PannoneAV ••;\//! •���'t�k ��4��'••••0�222222•i'''"' Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: M ing: P,0- Box 100 7a Anchorage, AK 9951,1 2 .. Ph "ical. 6115 East2"t' Av > Suitt B6F inGhorag;., AK 99503j3j i hone: ( tai) t -• .+8 AX: ( gar)27 -821 666 SOUTH BIRCHWOOD LOOP ROAD 10' UTILITY EASEM x x GARAGE INSTALL 1000g SEPTIC TANK (P) WITH DCO EXISTING / SEPTIC AREA 13.0 29 SE \11 WELL (E) \ W WELL (E) 3BR HOUSE o`V (E) X CONNECT TO EXISTING FCO EXISTING cn� � /—SEPTIC AREA 1 10' UTILITY EASEMENT 11.0 EXISTING CRIB IN FAILURE UPGRADE DRAIN FIELD (P) ABANDON PER CODE 40LFx5'EDx2.5'W, 9'TD ABANDON EXISTING 1 OOOg SEPTIC TANK PER CODE I b� b7 NOTES: Ott \ Date FOR CONSTRUCTION PAMONE ENG SVC, LLC ~ OF A� ��l 8/11/11 P.O. BOX 100217 ANCHORAGE, AK 99510 '�� " qS ii Scale PHONE PHONE (907) 272-8218 FAX (907) 272-8211 /Gj • y 'TH •••••• 50. P.I.D. NO T15N R1 W SEC 8, LOT 165B ..... Wo 051-153-42 JEFFREY & DONNA HARTLEY Steven annorie' PERMIT NO. CE 8149 j OSP111207 P.O. BOX 6712256Ice PLAN CHUGIAK, AK 99567 , ,N"' ". �l,` OFESSIO=Sh1 etOF3 PPP.w 0 W 0 O I— d' 0 LO x 0 m w C7 O v W W W C) Z Q O 0 Q O i-+ b C� 00 i i U Lo lc� F1J�1 T •--I /^� ..y CO OEn 0 � o cz C a tb m Ln a cn a) Q LLI 'n MSI o M, in. d03rn = C's Cd O +� > N N O cd 'S."C4 O T O LJJ U) Ln Q 3 a� -o N N o L � O Q. cCS .-+ 3 k m o __ 0 �. cn 3 •F o0) EL - 0 W +s" H cn C7 O v W W W C) Z Q SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. COPPER 3. SCOPE OF WORK: INSTALL NEW SOIL ABSORPTION SYSTEM. DUCTILE IRON PIPE 4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS TEST HOLE OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 15 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER FOUNDATION CLEAN OUT IMMEDIATELY. TANK CLEAN OUT NO. ILTER FABRIC CLEAN OUT NO. 4" 0 DRAIN PIPE MONITOR TUBE NO. TH-1 XGRAVEL BEDDING RIGID INSULATION —1UN -- DOUBLE CLEAN OUT 4.0 DIVERTER VALVE 0.5 FLOW SPLITTER SM/ 5.0 GM -12.5 � GRAVEL 6.0 -15 No groundwater monitored SECTION z oF-F_ m cl QO O O JO 7 FiZ m F -W = pw W W O W O OU OU Z LL O O O ❑ U W z w 4" Dia Perf Pipe /-F810 Z w LU 2 ¢ HDPE Q O 1000 g SEPTIC TANK (P) DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 3 (450 gpd) TANK SIZE: 1000g PERC RATE = 1-5 MPI SOIL RATING: 1.2 GPD/SF AREA RQD: 375 SF SYS. TYPE: DEEP TRENCH 5.0' E.D MIN LENGTH: 37.5 LF USE: 40 LF X 2.5' WIDE, 5' E.D., 9' TD TOTAL AREA: 400 SF PROFILE DEEP TRENCH SEE DESIGN LEGEND W WATER LINE/ WELL RADIUS SS NEW SEPTIC' ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER NOTES: PAMONE ENG SVC, UC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 �� \ pF q� �\ �c�c gsli� j*� TM � 49 ...... - 1051-153-42 Steven R. 1F 9 none j rr Fi �il Fp' P� �w \\�\ OFESSIOCI�� Date s/11/11 FOR CONSTRUCTION Scale P.I.D. NO T15N R1 W SEC 8, LOT 1658 JEFFREY & DONNA HARTLEY P.O. BOX 671225 CHUGIAK, AK 99567 PERMIT NO. OSP111207 DETAILS Sheet 2 OF 3 READING SOILS LOG - PERCOLATION TEST TEST HOLE 1 NET TIME WATER LEVEL READING SLOPESITE PLA OR ORGANICS GARAGE 0 1 :1 2.24 �1 2 3 \ 6.79 313R HOUSE 4 � (E) 5 --_ 6 j JJ 4 x SILTY SAND 7 SM/GM WITH SOME GRAVEL 8 X W/ W 9 TH TH-1\ W e SH DS 10 10' UTILITY EASEMENT 11 --- 12 13 10 MIN 6.68 WAS GROUND WATER SLOPE 14 ENCOUNTERED? N 15 BOH IF YES, AT WHAT TH 16 DEPTH? -0 ' X 17 DEPTH TO WATER AFTER MONITORING? -DRY- 18 DATE: 8/11/11 DATE PERFORMED: 7/8/11 PEROLATION RATE 2.3 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST PAMONE ENG SVC, ITC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ~~OF '4L\\`l r '�� "' ' '4'si lj j*� TM �y*+� Date 8�11�11 FOR CONSTRUCTION Scale NTS T15N R1 W SEC 8, LOT 165B JEFFREY & DONNA HARTLEY P.O. BOX 671225 49 Steven annorie ���Fj�. `FE 814�.\�� Y/ �l�rEjj' P.I.D. NO 051-153-42 PERMIT NO. OSP111207 Sheet SOILS LOG CHUGIAK, AK 99567 - P��;.� il�� OFES�QW--4 3 OF 3 READING DATE CLOCK TIME NET TIME WATER LEVEL READING NET DROP 1 8/4/11 10:07 --- 2.24 --- z 10:17 10 MIN 6.79 4.55 a 10:17 --_ 2.24 --- 4 10:27 10 MIN 6.70 4.46 e 10:27 --- 2.24 --- s 10:37 10 MIN 6.68 4.44 \ Municipality of Anchorage Development Services Department - Building Safety Division - Onsite Water and Wastewater Program. 4700 S. Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 Page1 of www.ci.anchorage.ok.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT - Permit Number. PID Number. D - /.1;'3VZ ran ��n `ra Wastewater System: New ❑><tS Aeansa CC S. �rcYlt•u�rt Leo ,� i 9q5,% ABSORPTION FIELD P'— / O O' 5 S NW a e.i'. : LOS - D wi, o DW Tt n slw$m Trew o mmm oe� , R LEGAL DESCRIPTION Sol R�q / Yc "Ye" T`� °tel/v 9lafx tce I6s SiDA�Mra[ D.Petbpiq Odtan can oAtg GrM .n'4r P'W: FJ FI. Toa p: � � Flanpa' I / ] ri.abn: Q FA eaa•a.0ov. Mond V.�.� Laq.R /.� Ln/ (, FI. Ft. Well: ❑ New ❑ Npgra Grew .M /S IAaMara- DlatarlCa Cat hWg: V14 Ft. Fl. ctas.r"bin (Pmate. A, a t • Taal Do% Cash W Taal Wwpem era 3 6 P" Mataw: E X( �f t e FI. FL O J Flt Dn1w. Data DreaQ SM Waw L": tiNa �/r+K Dat. ftww iv lq$O Ft. Yum. PumpSwa t C.aawWgp AEo Grv.�a TANK GPM Ft. Fl SEPARATION DISTANCES 19 Septic ❑Holding ❑S.T.E.P. ❑Other. eld Lift Station Holding Tank Pubtiorprival Sewer Dne Ltaaa w. q�LFIGRAG4 /%NK cspa ty I�QGaI. WA 0+N.�. aGama.a MAb.rption ()y. LIFT STATION , Sua. cat n H. [asi? 21ow ENcbaal Ltspaawns pMamsE aY'CWain Dtam R" sBENCH (J�,L../ SI�ATr C TI¢NK ONI- MARK LooamaMDasaWwn � r S CSM � t �� V Eiev.0 FL �r FL IQ Enyjil�.tYL+p 5 R S ENGINEERING Eagle River Loop Road, No. 204 17034 Inspections by:Dates: 1 S/ A y 0 ... - - —»� performed • �••— 2ne � % �o '1 1 �. ROBERT t COWAN � Development Services Department Approval rA C,,. CE -8801 Reviewed and approved by:��%i (t/. Date: - / -a 4tttr: PERMIT NO. S NO 10 1 y PACE 2 OF 3 Municipalityof Anchoraqe DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 165-8, SECTION 8, T15N, R1W P.I.D. NO. 05.1 — IJ -3-4;L- 10' UTILITY EASEMENT --------------- ----- — ---------------- Jy o� QP v 3�v 00 GARAGE 4 LOT 165A N EXISTING \ DRIVEWAY JE' O� ?p EXISTING 2 BEDROOM HOUSE A TOM EXISTING EXISTING SOO GALLON ♦O TANK ECO (PUPPED. CRUSHED. SCALE: 1' - 40' AND ABANDONED) 01 T1 DELI & DBL2 %•�+� NEW 1000 GALLON ROBERT C. COWAN SEPTIC SEPTIC TANK STI I EXISTING , � CE -$$Oj — — — — — — — — — — — — — — — — — — — L_J 15'x15' — — CRts + u. — — — +11l� 10' UTILITY EASEMENT ........ PERMIT NOS W 0/ Q 121 PACE 3 OF 3 Municipalityof Anchoraqe DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 165—B, SECTION 8, T15N, R1W P.I.D. NO. ST1 ST2 97.0' FINAL GRADE 92 1 , NEW 1000 GALLON SEPTIC TANK N. T. S. ENC ,.. ..: . pe\ ROBERT C. COWAN f�Q lA+c�;� CE -8801 t11t 1,. A FCO 15.0 5 ST1 67.0'E5 5 ST2 73.0 0 DBL1 77.0 0 DBL2 78.0 63.0 C01 61.0 50.0 MT1 78.5 61 .0 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 18, 2001 Expiration Date: Jun 18, 2002 Permit Number: SWO10194 Parcel ID: 051-153-42 Legal Description: T15N R1 W Section 8 Lot165B Design Engineer: 0003 S & S Engineering Site Address: 19991 South Birchwood Loop Owner Name: Frank O'Meara Lot Size: 41311 SO. FT. Owner Address: 19991 S. Birchwood Loop Total Bedrooms: 2 Permit Bedrooms: 2 Chugiak , AK 99567 - This permit is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: 0 Date: G—/ 17-0 Date: (0—/ S;-01 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 1 /' 1 S 3- Y2- Permit Number SW_0 / 0 /!��SL Property M, Day phone 6 015- Ya S25 Mailing address (1)Rjy e 7 wood Loop Mailing address (2) LtiH�,lr— Ig^ / Zip Code 9 /t� 56 7 Legal description (Lot, Block '& Sub'd.) L o,/_ lO E 6 I I ) Legal description (Section, Township & Range) 5e[Ilor 75, f^�- ) S V �! w Lot Size 11-311=Sq.Ft Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade C9 TOaria y-nvic dt.u7 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. S & S ENGINEERING 17034 Eagle River Loop Road No. 204 -----•- of p (Signature roperty owner or authorized agent) Permit Fees: '3,10.*' Date of Payment: G /IX/0) Receipt Number: (Rev. 12100) oas"7s3 Waiver Fees: Date of Payment: Receipt Number: S& May 23, 2001 ROBERT C. COWAN. P.E. CMLENGINEERS (907)694-2979 FAX(907)694-1211 A�sHOf`n MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 SEWER 6 WATER MARL EXTENSIONS REFERENCE: Lot 165-B, Section 8, TI 5N, RI W, S.M. SEWERBWATER INSPECTION It is requested that you issue a permit to install a septic tank to serve the existing 2 bedroom dwelling on the referenced property. test hole was excavated and a percolation test performed. The approximate location of ENGIA AND�PORTS T"�" the test holes is located on the attached site plan. At the time of excavation 4/18/01 no waterwasfound. After monitoring, groundwater was not found. (f.)2 nae ,nn r.4 Fier, P✓aPoss s). We do not anticipate any adverse effects on neighboring wells, septic systems, reserve TION Ari WW sT areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. SITE PLANS If you require additional information, please contact us. Sincerely, ROAD DESIGN D / Robert C. Cowan, P.E. SOP. TEST RCC/bjj Enclosure PERCOLATION TEST STR=LVIALS MEOWNICAL INSPECTIONS ONSITE WASTEWATER DEIPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 not 0 �Z zr� A� o`^o Cyt y2w �V< tCt�� N ~�C s Hai 1" = 40' DESIGN e� SITE -PLAN x � 2 'n O - m iTJ d I OO ogm � I o _ 0 "'mm 7 I mPTI 0 D I �. < I °J7 m C I 0 D(AO CrJ� / Dm T cc0 I r � H I V , I I I I I y I I� q0 F SIC mo s k m SOA Im nn0 nl D Ir I O n > O XOWx Im Vl Im Zrw Omyl AX m D 0m co-. <- lO AZO moz Z IC ;c' K� r �x e� x � 2 'n O - m iTJ oNM 100.. m I—I w f�< o L OR4 �. OHO ::C1I °J7 N -03 I I D(AO CrJ� OW O m O O A A O z 2 JCAZ9 I cc0 I r � H I V , ?<�p yyN m� I X0 I I ~H0 I I I z � 0 e� W (A K) d O - m iTJ oNM r m o iiou 73 O c) L, �. OHO ::C1I °J7 N -03 I I D(AO CrJ� � G7 �I M >I M I O � I I Y � CA PERF LEGA 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TEST RUN BETWEEN • 5 FT AND �, a FT COMMENTS PERFORMED BY: 17034 Eagle River Loop Road No 204 A� X?ap a ver, as s 577 CERTIFY THAT TH/I$ TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S / R /d I 72-008 (Rev. 4185) MUNICIPALITY OF ANCHORAGE Development Services Department ` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-153-42-000 Legal description T15N R1 W SEC 8 LT 1658 Expiration Date: 9/9/2025 Site address 19991 S Birchwood Loop Rd. Chugiak, AK 99567 Current property owner(s) MERIDETH CARRIE & JOHN P 50% &MERIDETH PETER JAMES 50% X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: 2 bedrooms, with the following stipulations: Original Certificate Date: 9/26/2024 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 orn w rn C'') M C? 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C ❑ U) 0) C N N 7 >' ❑ y ❑_O o El a) O 0) >W QO w L�OmN O O cv O LO CL ca (/ � ❑ L 0 O L I Q) J Q) EI CL O C`7 > c U O y ++ w o �' a.tzE ❑ 4- El C •� wa o N w ❑ _0 D F- N T +, O U) fn � U)m N N w O w v W W F- O Z O N t U)~ Y O *� i v c Z O �- °' a ~ U) > 4- M H LL O LL O E- c7 Q) °' ct U � w w � O a) _0 *+ Z a d CY)0° O F- F- w cn Q a > Q) a) Q > N M L6 co > W m 0 T Q) LL Q) I 69 (D Q) LL Q 0 0'FU 0 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 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’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F.ENGINEER’S COMMENTS 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 Phone Engineer’s Printed Name Date C&M ENGINEERING CHARLES BALZARINI, PE 4/26/24 U MCIP LITY OF ANCHORAGE Development Services Department ^` ' � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051 153 42 1. GENERAL INFORMATION Expiration Date: 2 '�? - 2 2 Complete legal description T15N R1 W SEC8 L165B Location (site address) 19991 S BIRCHWOOD LOOP RD Current property owner(s) HARTLEY Mailing address Real estate agent 2. TYPE OF DWELLING: 7 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: NO N E Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. e O�G2015gy Date of Payment to '21- Z o Receipt Number. aid 039 C4)&A-#- -� y12,'!�?0 <,ov�D 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. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 10/19/2020 1. °F ALgs��� •49 TH 6. DSD SIGNATURE • r System #1 Approved for bedrooms �- CHARLES G BALZARINI System #2 Approved for bedrooms ��$ ��c •. CE -13854 .••cl,� Disapproved PROFESSF�9 ROFESSt�� Conditional approval for bedrooms, with the following stipulations: \ �n XLti i r OF�Jr���� ' O� ON- -�=r—err I,yraa AND m ell )))po) \,�{. By: Original Certificate Date:, i �2'2 0 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 Checklist Legal Description: T15NR1WSEC8 LOT 165B Parcel ID: 051 153 42 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UNK Total depth UNK ft Cased to U N K ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA to/largo Static water level at beginning of test 42 ft. Comments PUMP AT 118' BTC B. TANK DATA Age of tank(s) 9 years Tank type/material Steel Measured operating fluid level in septic tank 50 FOR Standpipes/foundation cleanout per record drawing Date of pumping 10/14/20 Well production at time of test 3.4 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ NO ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C.Balzarini Date of Sample 10/18/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA trench Which system tested (date installed) 2011 Adequacy test date 10/18/20 -❑ ALL standpipes present per record drawing - Results [Z Pass For 3 bedrooms Total measured depth from grade 10 ft (max) Fluid depth prior to test 45 in Measured depth to pipe invert from grade 5 ft (min) Water added 450 gal ❑ N/A — pressurized field New depth 55 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time `1440 min depth into effective ❑ Code -required soil cover over field Final fluid depth 45 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) Gallons introduced gallons If yes, enter date NA Comments/Deficiencies: SYSTEM AT APPROX 75% CAPACITY AT TIME OF TEST 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' F✓ Yes Community Sewer Manhole/Cleanout > 100' r✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' F/� Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' F,71 Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Yes if No ft 7 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E] Yes if No ft 0 Yes if No ft 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' ❑✓ Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F/ Yes if No ft Private Wells > 100'✓0 Yes if No. Water Main > 10' ✓� Yes if No ft Community Wells > 200' 0✓ Yes if No Water Service Line > 10' F7-1 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' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓ -1 Yes if No ft Private Wells > 100' U✓ Yes if No Water Service Line > 10' [✓ Yes if No ft Community Wells > 200' 0✓ Yes if No Surface Water > 100'✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 10/19/20 COSA Checklist yellow sheet co c- 419 •. ... .......... .. j CHARLES G BALZARIPdI CE -13854 9 "PROFESSOP f1 ft f< ft /5c`' 21..2 '%/sG�� �ti�vd�/'✓ 01. 0 ON C7 r'J� rk � • . l�ti� � # 41 PA U C C!3 U) M U a Ld Co ca Qu o ago) P IL iz D �-Ir cs U)� cn a � err" 0 W x �.; ta -wiri W Lu W cry C) �0 \�'F'�41G ALL uj IL un T W C�3T~ �tL` �0 F- AlQWW <$ < pC i+1 it tai aO cn wo..W+LL�lz° �MWW LLJ > z n,zaoa � -lcn 1 w r' �� F- wC)l F0= 2 li �% ��]WTm®WA Lu LL Q �' Ca z V }- }- x—�-v���w4;:>®� Municipality of Anchorage C—� Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D, HAA# a C/D 2Ss7 Expiration Date: ?-/,7-0/ 1. GENERAL INFORMATION 'Complete legal description Lot 165B, Section 8, T15N, R1W, SM Location (site address or directions) 19991 South Birchwood Loop Current Propertyowner(s) Frank O'Meara ❑ Day phone 688-4255 Public Water System ❑ Mailing address 19991 S. Birchwood Loop, Chugiak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 2 3. TYPE OF WATER SUPPLY: Individual Well X❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site El Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm 5 8 5 ENGINEERING Phone L ci `f — _- n % 9 17034 E:gle Rive. E-ol, Road ift 10-4 Address Eagle River, Alaska 99577 Engineer's Printed Name Robert C. Cowan, P.E. Date •`�•lig Q2_ y) � i Ro?ERT C. CCwAN 5. DSD SIGNATURE �l+ q�;;., (z-nc1 Lf Approved for bedrooms. tti�z ;:,:__:+': ?• Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist x Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other gy; ,r/ /moo �r Oricinal Certificate Date: (Rev. IZC0) Municipality of Anchorage • "' Development Services Department Building Safety Division On-Sfle Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519650 www.ci.anahorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: l nr 165'6;: 15 -c e % T s -ti • r2 r.../ Parcel ID.DS/— /S 3 • K.Z A. WELL DATA Well type J:fcl VA -Q - Date completed awv- Totai depth i I I q ft. If A, B, or C provide PWSID # Sanitary seal (Y/N) YV Cased to `t !/ ft. FROM WELL. LOG Date of test Static water level ft. Well production 9•p•m- WATER SAMPLE RESULTS: Coliform _._coloniesl100 ml. Date of sample: -qZ-410, B. SEPTICIHOLDING TANK DATA Tank Type/Material orly Well Log (r0 /-/ Wires properly protected (Y/N) 7 f� Casing height (above ground) / Z+ in. AT INSPECTION !? 1 I ft. 3.3 g.p.m. Nitrate 0• S mg.A. Other bacteria -40' coionies/100 ml. Coi!ected by: Tank size I ry)19 —1. Number of Compartments 2— Foundation Foundation deanoutlYlN) Date of pumping f((� N Depression over tank (Yg 0-10 Pumper tiu I A Date Installed 1 24 d t Cleanouts&) Yi-5 High water alarm (Y/N) / �Y C. ABSORPTION FIELD DATA ��)) Date installed 19� Soil rating (g.p.d.A'F or f 2lbdrm) (fN System type (re f r r Length 15' ft. Width i`i ft. Gravel below pipe � ft. Total depth 110 ft. � Eff. a�bsorption area �ft' Monitoring tube /Q'i Depression over field '4 Z Date of adequacy test ►_ Results (Pass/Fail) SS For 2 bedrooms Fluid depth in absorption field before test � in. Water added�al. New depth�in. Elapsed Time min. Final fluid depth 4l in. Absorption rate >= 4-300 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE AM If yes, give date )t�0►2 & 1Nh1. -F*TI No- UN k . 4tt, CLAa a-4,,NT 5t4 401(,5 JZ-5T� D. LIFT STATION Date installed f4 14 `Pump on' level at _ In. Datum E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N) _ 'Pump off level at _ in. High water alarm level at SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/11241atkm on lot / on I.& - Absorption field on lot t 00 r Public sewer main ^� R ;wxCr /septic service line ? 5 r + Meets alarm & circuit requirements? On adjacent lots / oo /-#. i� On adjacent lots / o n Public sewer manhole/deanout N <A. Holding tank �n SEPARATION DISTANCES FROM SEPTIC/tIOLBMdGTANK ON LOT TO: rr Building foundation S �" Property line 5'r' Absorption field Water main /y 1A Water service line .ZO ' Surface water / �O Wells on adjacent lots / 40 � 4 - SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /0 r Building foundation Water Service line / D a- Surface water / 00 �+ i Curtain drain r+/E- Wells on adjacent lots &2f i - F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field knpectfons and review of Municipal records that the above systems are In conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name " 0,8# T C • cd "q,"? Date b / x/0 / HAA Fee $ 3 OO Date of Payment 6 //x /0 / Receipt Number 0 0 ,r 7 s 3 (Rev. 12/00) Water main *' '1A Driveway, parkingfveldde storage r 0 r Waiver Fee $ Date of Payment Receipt Number -0,k&VAYIPC. COWAN c}f CE -8801 riq