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DALZELL-SCHNEITER BLK 2 LT 2
t)alzell-Schneiter Block 2 Lot 2 #015-291-14 5•b- PARCEL #' 015%mmZctlmmb Iq uispecuon muporc_1-i-IZ.aoc Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and 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: OSP191021 PID Number: 015-291-14 ❑ New ❑Upgrade Name: Daryl Kuemerle ABSORPTION FIELD ❑ Dee Trench p El Shallow Trench ❑Bed E] Mound Address 5641 Milrob Ave ❑ Other Phone Number of Bedrooms Soil Rating Total depth from on I grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade F Gravy depth beneath pipe // Ft. Subdivision Block Lot Dalzell-Schneiter 2 2 Fill added above original gradeGravel XFt. length Ft. Township Range Section Gravel width F/ B s: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption ar Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100+ N/AI N/A N/A (e) TANK Q Septic ❑ S.T.E.P. ❑ Holding E] Other Manufacturer Anchorage Tank Capacity 1000Ga1. Surface Water 100+ , N/A N/A N/A Material Number of compartments f Lot Line 5+ N/A N/A N/A Steel 2 NA Foundation 10+ I N/A I N/A NIA LIFT STATION I Manufacturer Capacity Curtain Drain 50+ N/A N/A N/A Gal. Remark Pump on level at Pump off level at ,gh water alarm at in. in. in. Pump make and mo Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield A+ Home Services Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation). 475.0 ft Inspection �5 3/15/19 dates: a 2 3/29/19 Location and description 3"' 411 Garage FF COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp O AL, Conditional Approval: Date��► Steven Pennone Approved C�Znr Date i �. CE 8149 �'141, � 111- kl � uispecuon muporc_1-i-IZ.aoc EASEI fi NTI\ I / �/—WELL (E) I 488 _ �\ WELL (E). W 484 \ \ \ SE I 000 SEPTIC TANK (E) J� ` (E) - \` DECOMISSION PER CODE / HOU L INSTALL 1000g SEPTIC TANK (P) 480 \ SLOT VACANT WITH DOUBLE CLEAN OUT A e \\ NO WELLS OR SEPTICS \ �� 476 \ SEPTIC AREA (E) 472 / \ % ` oco DRIVEWAY\ 468 \` �--'� INSTALLED 1000q SEPTIC TANK/ W/ DCO AFTER CONNECTED TO EXISTING DISCHARGE LINE DRAIN FIELD (E) A B T i 35.0 56.9 T2 40.6 60.2 DCO 1 42.5 61.5 NOTES: RECORD DRAWING I DRAWN BY: ACP PLAN FRI W Z— o= < o �z Z Q � W O U PER MOA CODE 10' UTILITY EASEMENT o - z O WO U W m W O w II U 0U !! ~ILLI NEW 10DOgi 6 1 SEPTIC TANK i PROFILE SCALE: NTS PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 DALZELL-SCHNEITER, BLOCK 2, LOT 2 DARYL & DANTE KUEMERLE 5641 MILROB AVENUE ANCHORAGE, AK STe� ve -Rv Pannone' '. CE 8149 l FE ®._ Dote 3/29/19 Scale 1"=50' P.I.D. NO -9?§-291-14 'ERMIT NO. OSP191021 Sheet 2OF2 .'"'""'' MUNICIPALITY OF ANCHORAGE On-Site Water& Wastewater Program mot ,S; e. ; PO Box 196650 4700 Elmore Road ! t { Anchorage.Alaska 99519.6650 Phone:(907)343-7904 Fax (907)343-7997 ` Sr: \� <, http://www.muni.org/onsite I 10 =-'E Depar tmen Nc,,oRo On-Site Wastewater Disposal System Permit Permit Number: OSP191021 Effective Date: 2/4/2019 Work Type: SepticTank Upgrade Expiration Date: 2/4/2020 Tax Code Number: 01529114000 Site Legal Address: DALZELL-SCHNEITER BLK 2 LT 2 G:2537 Site Mailing Address: 5641 MILROB AVE,Anchorage Owner: KUEMERLE DARYL & DANTE G Lot Size in Sq Ft: 49748 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing • // Received By: A 4 . Vm Date: t2(5 oorIssued By: i�-�- Date: 7 EPGANS MUNICIPALITY OF ANCHORAGE Community Development Department • ':0k Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-291-14 Property owner(s) Daryl & Dante Kuemerle Day phone Mailing address 1120 E Huffman Rd Ste 23 #523, Anchorage, AK 99515 Site address 5641 Milrob Avenue Legal description (Sub'd., Block & Lot) Dalzell-Schneiter, Block 2, Lot 2 Legal description (Township, Range & Section) Lot Size 49,784 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E)all that apply) Absorption Field ❑ Initial U Single Family (SF) ❑X (w/wo ADU) Septic Tank [ Upgrade n Duplex (D) n Holding Tank ❑ Renewal n Multiple Dwellings n Privy ❑ (SF and/or D) 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. 1 (Signature of property owner or authorized agent) Permit/Rush Fees: aas Waiver Fees: Date of Payment: ',/I 1/' Date of Payment: Receipt Number: /� 045186 Receipt Number: Permit No. (35 pl q !6o2/ Waiver No. Permit App_ -:•._..:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191021, Deb Wockenfuss, 02/04/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191021, Deb Wockenfuss, 02/04/19 ' MUNICIPALITY OF ANCHORAGE e 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 NAME✓\\ ) a" PHONEV NEW 0ff UPGRADE MAILING ADDR S 06u Lf -94q LEGAL DESCRIPTION L-5chhelfer LOCATION NO. OF BEDROOMS m It Iq 0 0 t ran 3 UY E Well I Absorption area /_ Dwelling PERMIT NO.7 Fo aO a DISTANCE TO: r WwQ d Manufacturer �e.Q-r Material ( No. of compaLtments � l y Liq. capacity in gallons I nsidelerJgtLl Width Liquid depth 10 OQ IF HOMEMADE: n !/a_, G Y DISTANCE TO: Well / Dwelling PERMIT NO. J 0 Z IJ/ /y vt SZ F Manufacturer C�^ Material Liquid capacity in gallons O WellI 1 O Foundation � Nearest lot line r�Q PERMIT NO-78(, a� w= DISTANCE TO: J LL Z No. of lines Length of each line Total length of linEs� Trench width p Distance beiweenjlir�,es F?u+ one �jt7 JO 3Qinches !1[Cc— <F Top of tile to finish grade Material beneath rile Total effectiv b'sorption area D 7J r —7,4 -inches NCO -ii,- Length Width Depth PERMIT NO. W //�� Qh Type of cr o -,rib diameter Crib depth Total effective absorption area 'wa rn DISTANCE TO:: Well Building foundation Nearest lot line p J CIa�7/"`-dLl�l1 Depth Driller Distance to lot line I PERMIT NO. W —7 O.� ha - DISTANCE T0: Building foundation Sewer line Septic tank Absorption areas) PlJ � OTHER I PIPE MATERI D 2i;b3 L/II I SOIL TEST RATING G3 5 + 41-C-1 INSTALLER a / REMARKS IS i ✓l 1� Li-'(P� r5' 1'-f�i) e ►' U u 9a( o' SJ3o3� Gtr Eer O 1 G�r- So 0 2,D PIL APPROVED DATE LEGAL 72-073 (Rev. 3/7 9-_ !!Y-_il r -,.p 1 .iC F=" 1011.. ?= -T_ �� ." C3 F07 10 B' -'Q my _ 1.....E JIT? 101 Ili K. c< b DERF-iRT!'IEh,IT C HEALTH 4 Pdi_ ENVIRONMENTAL 3TE=:TION r_<PIf 825 .�' STREET, : HChCk=PG� , j<_'��i Q. . e xsof„ 264-4720 +,__. �-°a! � ' I__ E.... 1=1Y^-=0 1:1(A 8°-4 -_ "_� 1C --F o-:= --" F=: 3.,,A E� fF=° 11-=" ER 11-1 :iC ""C - PERMIT NO. ( 7311202 ) APPLICANT DAN BRt"` N BOX 4-__47 278 1049 LOCATION MILROB TIFF BIRCH LEGAL L.2 82 DAL El L n:C' NEI!ER .., _ LOT SIZE 49748 SQUARE FEEL. TYPE: OF '=OIL_ NBS•ORB-tION SYSTEM IS: TRENCH A PIR14111UPI NUMBER OF BEDROOMS SOIL RATING <SQ FT!SR)= THE REQUIRED SIZE OF THE 'CIL ABSORPTION SYSTEM IS: E0 1=7 1F" K E--'1 == :1,111 2 _ B"-..9 A::� -u.._ N--!! _"_` -'2;2: n:Er 4-==: F4 % ° E L_.._ I> E.`= F" --F T! H =_ "aE: THE: LENGTH DIMENSION IS THE LENGTH UN FEET) OF THE TRENCH OR LiRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN Trig_' SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR: TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GR:AVEL. BETWEEN THE OUTFALL PIP AND THE. BOTTOM OF THE EXCAVATION &N FEET). 1-aEET s1_tt1W""1 Ire=PEE F'-FI6= L-iF=ru..4K-. 1 N. =_= u'urI_tee PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION ]:!''SPEC:TIONS OF ANY WELLS ADJACENT TO THIS PROPERTY FIND THE NUMBER OF RESIDENCES THAT THE !.'!ELL. WILL SERVE. - ...._. -.R- 0-°-01 e < :2, ::u R !! A 23 F° K °--' -T- I T� n 10FA Ems° K FF-__' E_E IC R L-9 :E F `_ VE, E_ -- - -- BRCKFILLING OF i'!N''f SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL. BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MIr-4Ii'•iUF1 DISTANCE BETWEEN A WELL 1=1C'D ITIC'Y ON --SITE SEWAGE DISPOSAL SYS`! -EM IS. 100 FEET FOR A PRIVATE WELL; OF: 1 50 TO 200 FEET FROM A PUBLIC: WELL DEPENDING L!!='i(N THE TYPE OF PUBLIC WELL - WELL LOGS. ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE. WELL COMPLETION. OTHER R:EI_?UIR`.EMENTS MAY APPLY, SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER: INSTALLATION. F° E7_ FR r-1 1L --' & _ ^ E= a Eot1 Lam. E: F0 _ nL_ .. L.. I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SELER:'S, AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE REMODELED TO INCLUDE MORE 'T!-iAN 3 BEDROOMS;. S 113NEL1: _ _ . _. __ . AF`FLICi=1P+IT DHtd E:F:CiL.IPd ISGIIEDB'r'----------- DATE --- fig_. 0 1 2 3 _4 5 6 7 8 9 10 11 _12 13 14 15 ,16 17 18 191 20' 21 22 23 24 25 �YICCI yr ++ n S m 0 LS ILC"Sr PROJECT TEST HOLE N0. 2-2 CLIENT ELEV. TOP OF HOLE 464+ W. O. DATE 11/2/76 12" Damp, Brown Organic Sandy Silt (OL)_ Damp, s rown, Silty Sandy Gravel (GM) Cobbles Damp, Brown,• Silty Gravel (GM) 2-2 (1) Bottom, Dry Hole Note: Percolation Rate3.5 min./inch 110 SF/Bedroom nL�l �G�Cc-bCn ��� ✓✓.-cz o-� �ew-2t G' U I C': Ltd Y I f� If/ L, -�.o ; 'R r"1 r'1 UPJWkN • SCHESEN • KORYI\JTA of November 11, 1976 Eileen M. Schneiter & Bob Dalzell Box 3001 Anchorage, Alaska 99501 Re: Subsurface Investigation Proposed Subdivision.West of Birch Road Dear Mrs. Schneiter & Mr. Dalzell: This report presents the results of our soil investigation for the proposed subdivision of a 30 -acre tract located west of Birch Road. The investigation was conducted on November 2 and 3, 1976. The results of that investigation are included in this report as follows: Vicinity Map Test Hole Location Sketch Idealized Soil Profiles Test Hole Logs (Sheets 1 through -14) Summary of Laboratory Test Data Standard Explanatory Information Drilling was accomplished utilizing a mobile drill B-50 mounted on a flex track Nodwell vehicle owned and operated by Denali Drilling, Inc. The test holes were logged and percolation tests conducted by our firm. Harding -Lawson & Associates performed the laboratory test data on grab samples taken during the drilling. The purpose of the investigation was to provide soils data fbr establishing the feasibility of on-site disposal of sanitary waste using seepage pits. To accomplish this, we drilled 14 borings distributed across the site as shown on .the test hole location sketch. All borings were drilled to. a depth in excess of 15'. During the drilling, our engineer was present to log the materials encountered and obtain grab samples of the soil types encountered. All soils were visually classified in the field in accordance with the unified soil classifications system as described herein. 54293 JAN o61977 GORDON D. UNWIN,P.E. LEO SCHEBEN,JR.,P.E.,L.S. EARL D. KORYNTA, P.E. ro� -2- n The grab samples were then brought back to the laboratory for further analysis. In addition to the soil sampling, six percolation tests were conducted. Based on visual classification of the soil types and logging of the test holes, the area was divided into zones representing similar soil types which should have somewhat similar percolation characteristics. One or more percolation tests were then conducted in each of the representative soil type zones. SITE & SOIL CONDITIONS The site is a rectangular shaped parcel having approximately 990 lineal feet of frontage along the west side of Birch Road and a depth of 1320 feet. Two original homestead sites, which are still occupied, are located on the site. Both homes utilize on-site waste disposal systems which have operated successfully since 1951. Site topography is varied with general drainage from east to west and north to south. There are no areas with slopes in excess of 25%. The north- easterly portion of the site is characterized by gentle knolls and moderate slopes. The southerly portion of the site is relatively flat with•a gentle slope from east to west. The site is primarily underlain by granular soils with varying amounts of fines to the depths explored. The material ranges from commercial quality gravel across most of the lower bench to silty sands on the higher knolls. The surface of the site is blanketed by an organic mat of forest duff or peat ranging in depth from 6" to 18". Underlying the or- ganic mat is a layer of fine organic sandy silt or silty sand (topsoil) ranging in depth of up to 3 feet. Free water was encountered in test hole No. 2-4 near Birch Road and test hole No. 2-12 along the west property line at a depth of approximtely 13.5 feet at the time of drilling. It should be noted however, that the water level will fluctuate with seasonal and climatic changes changes. CONCLUSIONS The minimum percolation rates observed in the field for the following holes are: Test Hole No. 2-5: 9.6 minutes per inch Test Hole No. 2-7: 7.5 minutes per inch Test Hole No. 2-2: 3.5 minutes per inch Test Hole No. 2-16: Less than 1 minute per inch Test Hole No. 2-19: 3.7 minutes per inch Test Hole No. 2-17: Less than 1 minute per inch - 3 - Based on the observed percolation rates, visual test hole logs and laboratory test data, the site consists ffrates. distinct soil zones for consideration of percolation The tightest soils exist in Zone I located on the in the northeast corner. Predominant soils are dry, dense silty sands. Zone II consists of the transitional slopes from the higher ground. The predominant soil type is fine, clean sand. Zone III is the old alluvium with deposits of clean gravel. Soils in Zone IV are similar to those in Zone III with slightly more fines. Therefore, we estimate the percolation rates for all other holes (using visual, laboratory and percolation data) to be: Test Holes 2-14, 2-15, 2-18, and 1-1, 1-2,: less than 1 minute per inch. Test Holes 1-3, 1-4, 2-11, and 2-12: 3.5 minutes per inch Test Holes 2-1, 2-9, 2710, 2-11 and 2-13: 5 minutes per inch Test Holes 2-3 and 2-6: 8 minutes per inch We hope this is sufficient for your present not needs. ifhesitatwe can offer further clarification, please to contact us. Very truly yours, Earl C�1;�Korynta, Partner EDK:jp Attachments C DAILY DULLING LOG SYREN BROS. DRILLING, INC. 2701 Eagle Street Anchorage, Alaska 99503 274.6437 OWNER OF LAND __an EI:DYin__ DEPTH OF WELL ADDRESS _.3 LLlfinn .ota Ax..,�Anch.r_._�)s. X3. 07 STATIC LEVEL OF WATER WELL—SITE.„___N..E._IIQ=pr of 1At_..__.... DRAW DOWN FT......._ DATE--STARTED_5_—L6-7.a__»_..__ GALS. PER DATE—ENDED ... _... 5.-16. 5=16=7.a -------- _.._____.._.._._„._.._.. RIND OF ...... ....................... _ RIND OF FORMATION: FROM.__......0_....... YT. To...„.._.22_...-FT.sandy._.clay., 3 oom FROM.._._.22.._..FT. To..._ 4.0.i._._FT aandy._clay...loom with gravel. FROM.__.__4A.j .FT. TO..._.....4.6_.__FT..f ina...gravzl..» Fr.Ovol...... __AL.__FT. TO_ _ _ rj Ei..„._ a`a..S aLL1►Esra:�t e�. damp TO..._._.b.0-.__FT.grave2-..and... water ».FT........... _... _.............. FRO:H..._..„„_„„_.......FT. TO..._.._.„_......_„FT«......„„„..__.._.._._._._ .FT.._.._.._......_ ........ _ .„... FR03L„.................. _FT. TO...„.._ _..„. FT..._..__—_ .............. .... FROM. ....................... FT. TO ....... ......... ...„FT ......... _....................... FROM. .......... FROM. ....... _. _ __..„ FT. TO__. _ _ ._.. FT.._..„..„ _ FROM. ......... .......... FT. TO...». _._...FT ..__..... _..._.._....._... FROM .............. _.__..FT. TO ....... .._._._:. FT ._.._ _......„.................. FROM .._.._.._....__.„..FT.. TO....��.-.:_..:.,,:.,FT._..„_._.._____..._....._... FROai.._.._._...._.. .FT. TO ............ _.._.. FT __._.._.. ....._......._._... FROM. ...... ..FT. TO......„.... ...... .FT ................_...................... FR05L......... iT. TO ........ ____.„...FT«..„....»_.„»................... FROM....»._ ..... .......... FT. TO ....... ... ... ..... .... FT... ............................ _„... f FROM...».._....„.._..„...FT. TO ....... __.... 4....... FT ................_....................... FROM.............. ... ....... FT. TO ....... .....: �_..„...FT........................................ FROM..„._...._.._._...FT. TO.„_.._..:_........FT.... ................................. TO........ _._..„».FT« .__ _ _ _._.__ FR01L ._..__..__._».FT. TO..._..„..„_.._._...FT..... ........................... MISCL INFORMATION: - - - 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 OSC251093 Parcel ID 015 -291-14 Expiration Date: 3/12/2026 Legal description DALZELL-SCHNEITER BLK 2 LT 2 Site address 5641 MILROB AVE Current property owner(s) HENSLEY ELIZABETH X The On-site system(s) is/are approved for 3 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments Original Certificate Date: 3/25/2025 Thi�ss certificate of On -Site Sys ems Approval (COSA) is intended to demonstrate the subject syStem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, bevelopment Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other 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 Application 1. GENERAL INFORMATION Parcel I.D. 015 -291 - Complete legal description DALZELL-SCHNEITER BLOCK 2 LOT 2 Location (site address) 5641 MILROB AVENUE ANCHORAGE, ALASKA 99507 Current property owner(s) ELIZABETH HENSLEY 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 6 - 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 $ 50 Date of Payment Vi / ? COSA # 05G2 -910q_5 Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: DALZELL-SCHNEITER BLOCK 2 LOT 2 Parcel ID: 015-291-14 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 5/16/78 Total depth 60 ft Cased to UNK ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 3/12/25 Static water level at beginning of test 43 ft. Well production at time of test 5+ gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 5.76 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 3/12/25 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 49” Date of pumping 3/12/25 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) 1978 ALL standpipes present per record drawing Total measured depth from existing grade 8.1 ft (max) Measured depth to pipe invert from grade 4.6 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) If not, state depth into effective 3.3 ft 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 Adequacy test date 3/12/25 Results Pass Fluid depth prior to test 1 in (After adding 750 gallons) Water added 650 gal New fluid depth 2 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 72 in (MOA 72” ED) Effective depth used 32 in (Missing ED + Final Fluid Depth) Effective depth (ED) remaining 40 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA records & appears approximate with 3.3’ or 40” ED measurable. COSA Checklist.docx 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 FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 03/20/2025 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 discrepancies exist can be given by First Water Consulting & 03/20/25 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite Nitrate Advisory Certificate of On -Site Systems Approval # OSC251093 Subdivision: Dalzell-Schneiter, Block: 2, Lot: 2 907-343-7904 Fax: 343-7997 A water sample revealed a nitrate concentration of 5.76 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. Since nitrates are known to slowly increase, we recommend you monitor the water quality. 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. Nitrate Fact Sheet 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. 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 1.9- 015-291-14 Legal description Dalzell Schneiter Block 2 Lot 2 Site address 5641 Milrob Ave. Anchorage, AK Current property owner(s) Kuemerle Expiration Date: X The On-site system(s) is/are approved fef 3 bedrooms Conditional approval for Comments or advisories: 12-23-12 bedrooms, with the following stipulations: Original Certificate Date: 23 Z Z 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 P� 0 �J_ U\�� 5 MUNICIPALITY NCH Jftw 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. 015-291-14 Complete legal description DalZell Schneiter; Block 2, Lot 2 Location (site address) 5641 Milrob Avenue *Anchorage, AK Current property owner(s) Daryl Kuemerle Day phone 240-5539 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: R 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 3 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed FN 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 $ 15D 330 Date of Payment 9 laag /7--5 COSA # (f S Ca �!L%(� g Waiver Fee $ Date of Payment Waiver # COSA AppIlcaGon June 2022 R' Legal Description: Dalzell Schneiter; Block 2, Lot 2 Parcel ID: 015-291-14 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 5/16/78 Total depth 60 ft Cased to unk ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/30/22 Static water level at beginning of test 43.6 ft Comments B. TANK DATA u Measured operating fluid_ level_ in septic tank _50 Date of pumping b A--) 2 a. ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 1978 ❑ ALL standpipes present per record drawing Total measured depth from grade 7.75 ft (max) Measured depth to pipe invert from grade 4A 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 3.33 ❑ 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) No If yes, enter date Well production at time of test 5.7+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No D/Coliform bacteria is Negative Nitrate � mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, Ltd. Date 8/30/22 C. LIFT STATION F] Required maintenance corn - - Age of lift station ears Lift station tial ments: Adequacy test date 8/30/22 Results ❑ Pass Fluid depth prior to test 0 in Water added 1117 gal New fluid depth *8 in Elapsed time 20 min Final fluid depth 0 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 72 in Effective depth used 32 in Effective depth remaining 40 in Comments/Deficiencies: *3" of water present after introducing the first 663 gallons of water 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' Community Sewer Manhole/Cleanout > 100' ®Yes if No ft ❑i Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' NA Yes if No ft Holding Tank > 100' ME Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No ft ❑i Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft Q 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' Q Yes if No ft Tank to Property Line > 5' ❑■ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Q 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 Garness Engineering Group, LTD, (GEG) Phone 907++-337-6179 Engineer's Printed Name Jeffrey A. Garness Date q) ZZ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist—June 2022 OF AUS 9 . . .. ....... . ... . .......... �...... Q� .J ff A. ess: Q " CE 17053 2 LICENSE `eP r o f e s s;onOoc� #AECC884 �DOOOC Lof 2 a 49,748 S.F. D 10' UTILITY EASEMENT S 89'51'05"W 285.00' w 0 MILROB AVENUE MORTGAGE SURVEY _x SCALE 1 50 GRID __SW -2_537 Project No. – 22-569/Al ,r Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & A S S o C I a t e S inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors ken®langsurvey.corn OF 4 �S,Op jonathan0langsurvey.com 0'`�•' •• O I hereby certify that I have surveyed the following described property: LOT 2, BLOCK 2, DALZELL–SCHNEITER SUBDIVISION (PLAT No. 77-260) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The Information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the �«-1' Day of–_L-r.1LI_t�r7i� C 'L'U_, 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 plot. '.A :' 49TH �1 -�a KEN ETH (r NG o 14 Qp���o •'�.Ls-520.••' ��a ,o p�Q'O"ZsSlow- �4 OQ4oO�`�o AECC963 UALZLL CIRCLE CP P N 86'00'00 R -SO 22.37 L--4 6 L=15.00' ,– R=50.00' 10 UTILITY — EASEMENT RETAINING WALL WELL 24.7' o �•Lg �Ck 34.3' v a o p0 2.0'x30.0• CANT m r- N"' 34.3' 34.3' 4.5'x8.0' PORCH Lot 1 �!- 2.5' PROW CANT 4.0' BALCONY M SEPTIC PIPES-,�'� �.. Lof 2 a 49,748 S.F. D 10' UTILITY EASEMENT S 89'51'05"W 285.00' w 0 MILROB AVENUE MORTGAGE SURVEY _x SCALE 1 50 GRID __SW -2_537 Project No. – 22-569/Al ,r Associates, 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & A S S o C I a t e S inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors ken®langsurvey.corn OF 4 �S,Op jonathan0langsurvey.com 0'`�•' •• O I hereby certify that I have surveyed the following described property: LOT 2, BLOCK 2, DALZELL–SCHNEITER SUBDIVISION (PLAT No. 77-260) Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The Information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the �«-1' Day of–_L-r.1LI_t�r7i� C 'L'U_, 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 plot. '.A :' 49TH �1 -�a KEN ETH (r NG o 14 Qp���o •'�.Ls-520.••' ��a ,o p�Q'O"ZsSlow- �4 OQ4oO�`�o AECC963 C rt•: L.4 ,• Y rn , `.� .�t 1 1 J t u MUNICIPALITY OFANCHORAGE, DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION `% `• DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 '2� g Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) LoT f3 K 2, DA C- >,.I - SC.N N�= ITER ST!� Location (address or directions) TI 123 5aVI T LL�-llLnp B (b) Applicant Name row" Telephone: Home 3�6 �'7��- Business Applicant Address (c) Applicant is (check one): Lending Institution 13; Owner/builder 13; Buyer 13; Other 13 (explain); (d) Lending Institution _lttdMa4A�-_,'6 Telephone Address 0 S' 4t a • { (e) Real Estate Company and Agent �" Address bap Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family ❑ Multi-Family ❑ Other Number of Bedrooms 3 ' 3. WATER SUPPLY Individual Well)( Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite Public ❑ Community ❑ Holding Tank ❑ Note: I community well system, must have written confirmation from the State Department of Environmental 'Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) Al 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH DATA AND INFORMATION y , ii a As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that The on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. l 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 in compliance with all Municipal and Stale codes, ordinances, and regulations in effect on the date of this i pecti Name of Firm Telephone 6. Address Date _ DHEP APPROVA Approved for bedrooms Approved- Disappr Terms of Conditional Approval 49TH .......... W It% Yo, 2225-E JUNE 2S, 1971 .. ^u Engineer's Seat �aJ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) Issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Page 2 of 2 72-M 0vMy A. WELL DATA OF MliNCDUT Of HE.ILTH & •�.V ^' ^ ENVIFONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 284-4720 ,�1±� 281996' 17 Well Classification If A, B. C. D.E.C. Approved (YIN) Well Log Present (YIN) _� Date Completed Yield Total Depth J510- Cased to— Depth of Grouting Static Water Level Pump Set At 0 jl Casing Height Above Ground Electrical Wiring in Conduit (YIN) Separation Distances from Well: ECEIVP Sanitary Seal on Casing (YIN) _lr Depression Around Wellhead (YIN) �N To Septic/Holding Tank on Lot 110 : On Adjoining Lots —I /i� To Nearest Edge of Absorption Field o of -7 : On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by S/ nisnN : Date ,Z/%y Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed Size No. of Compartments Z Standpipes (YIN) Air -tight)— Foundation Clean t (YIN) _,y_ Depression over Tank (YIN) tv Date Last Pumped 7 i6 Pumping/Maintenance Contract on Fite (YIN ) A : for 41d Holding Tank High -Water Alarm (YIN) AI_A Temporary Holding Tank Perm/it (Y/N) Separation Distances from Septic/Holding Tank: / To Water -Supply Well I /N To Building Foundation i I To Property Line � To Disposal Field -� To Water Main/Service Line ��f (? To Stream, Pond, Lake, or Major Drainage Course )y �A Comments Page 1 of 2 72-026111/841 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design 79iA4QV Date Installed 7�4 Length of Field Width of Fields Depth of Field 9 Gravel Bed Thickness a Square Feet of Absorption Area Vfz Standpipes Present(Y/N) Depression over Field (Y/N41 —Date of Last Adequacy Test a. Results of Last Adequacy Test A5 F.•• Y Hi►" Int pr'rao w�Q Separation Distance from Absorption Field: \ To Water -Supply Well _ I/ZR To Property Line % . • , -V n n n ��,,77 I 1203 W. 15th AVE "C" SUITE 203 QO��G�`� �M�3G3�,Q�`�©9 POO ANCHORAGE. ALASKA 99501 • CONSULTING ENGINEER TELEPHONE: (907) 279-3916 R E S I D E N T I A L W E L L I N S P E C T I O N — — — — — — — — — — — — — — — — — — — — — — — — — LEGAL: LOT 2, BLOCK 2, DALZELL SCHNEITER LOCATION: 5641 MILROB OWNER: D.H. BROWN TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 10 GALLONS PER BEDROOM PUMP YIELD: DATE OF INSPECTION: 6 GALLONS PER MINUTE JULY 23, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS FOUND 45 FEET BELOW TOP OF CASING. AT A PUMPING RATE OF 6 GALLONS PER MINUTE THE WATER LEVEL DROPPED IMMEDIATELY TO 49 FEET AN STAYED AT THAT LVEL DURING THE TEST. A TOTAL OF 380 GALLONS WERE PUMPED IN A PERIOD OF 65 MINUTES. WELL RECOVERED 100 % IN THREE MINUTES. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON JULY 24, 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact t1je.cond{tions of the aquifer feeding the well. :a. 2225-E QD rA�rML;1��D,r�o�a CONSULTING ENGINEER 203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE- 19071 279 3916 S E P T I C S Y S T E M A D E Q U A C Y T E S T — — — — — — — — — — — — — — — — — — — — — — — — LEGAL: LOT 2, BLOCK 2, DALZELL SCHNEITER LOCATION: 5641 MILROB OWNER: D.H. BROWN RESIDENCE: SINGLE FAMILY, THREE BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, TWO COMP. 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 360 SQ. FT. SOIL RATING: 85 INSTALLATION DATE: SEPTEMBER 1978 DATE OF PUMPING: JULY 26, 1986 ANCHORAGE CESSPOOL PUMPING DATE OF TEST: JULY 23, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 1.5 FEET OF COVER. LIQUID LEVEL WAS 49 INCHES. CLEAN OUT TO TRENCH WAS FOUR FEET DEEP AND DRY. SUMP WAS 8 FEET DEEP AND DRY. WATER WAS ADDED TO THE TRENCH CLEANOUT WHILE THE WATER LEVELS IN THE TANK AND SUMP WERE MIONITORED. A TOTAL OF 380 GALLONS WAS ADDED AT A ONSTANT RATE OF 6 GALLONS PER MINUTE. THE WATER LEVEL IN THE TANK DID NOT CHANGE AND NO WATER ACCUMELATED IN THE SUMP. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, 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 this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements. -of the Municipality and State. ��•.1 .o. 2225-c;' 0 / 1 `t MUNICIPALITY OF A GE • MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ®ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Aleske 59601 DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION jpj W Avrc-> JAN 307�9 ENGINEERING DIVISION - NUMBER OF BEDROOMS �f SINGLE FAMILY ENVIRONMENTAL 1 ,n � ❑ Two ❑ Five 4.4 Telephone 26720 p E E D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER F CILSV DIRECTIONS: Complete all pans on page 1. Incomplete requests will not M proeeeesd. Please allow ten (101 days for proeeesing. 1. PROPERTY OWNER'^) ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well PH�O--NtE depth (attach log if available.) NQ t1j r�� Oo "If individual/on-site, give installation date- f�tV,e0.�11 to11 MAILING ADDRESSFkpx —9 by this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. O PROPERTY RESIDENT (if different from &bow) H E 2. BUYER MAILING ADDRESSS LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION —}- 1 `t 1 \ t STREET LOCATION M;l An Avrc-> B. TYPE OF RESIDENCE - NUMBER OF BEDROOMS �f SINGLE FAMILY 13One ❑ Four ❑ Other T� ❑ Two ❑ Five ❑ MULTIPLE FAMILY TThree ❑ Six 7. WATER SUPPLY INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE" r�� Oo "If individual/on-site, give installation date- f�tV,e0.�11 If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) t Iiler— THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME - TIME TIME DATE DATE DATE INSPECTOR, , INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE M�SINGLE FAMILY ❑ MULTIPLE FAMILY Met NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY P, -INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM 1phKDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER T OSeoticTankor ❑Holding Tank Size: 1,000._ If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER . TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 13 APPROVED FOR _BEDROOM ❑ CONDITIONAL APPROVAL (letter must mpany certificate) I§—DISAPPROVED DATE(Title) /` l LEGAL DESCRIPTION 72-010 (Rev. 3/78)