HomeMy WebLinkAboutGLEN EAGLE BLK 3 LT 4Glen Eagle
Block 3
Lot 4
#050-601-06
AS -BUILT DRAWING
CRIB DATA
-137" - FROM TOP OF PIPE TO BOTTOM OF CRIB
-74" - FROM TOP OF PIPE TO TOP OF CRIB
-10" - PIPE STICK-UP ABOVE GROUND
CO/MT WAS FOUND DRY ON 8/3/2000.
SyF�
EXISTING 1000
GALLON CONCRE'
SEPTIC TANK -
3 eF�R00% /
M
EXISTING UNDOCUMENTED
TRENCH NOT IN USE.
TRENCH IS BELIEV D TO BE
INSTALLED IN THEP4RIME E
OF THE EXISTI CRIB.
—Pli— Al— —
jl` QF�11�►Fti F�
/EXISTING SEEPAGE PIT. (EXACT
TH01 —/ LOCATION IS NOT KNOWN)
PASSED SEPTIC ADEQUACY
TEST ON 5/24/2000.
DATE: QO�6QQO
8/11/2000 o F
DRAWN BY: ...... • . 040
ALASKA WATER & WASTEWATER SCALE: ./J.L.M. * ADO
CONSULTANTS, INC. *Q
6901 DEBARK ROAD. SUITE 28 •ANCHORAGE, AK 99504 •PHONE (907)337-6179 •FAX (907)33842 46 1" —- 30, ...... ...................0O Y/
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .• ••• •• .Q
ROBERT PAULUS (907) 694-4597 1 OF 1
Q fre A. am ss.-
LEGAL
s;LEGAL DESCRIPTION: OQOe9j • •, C 795
GLEN EAGLE SUBDIVISION; LOT 4, BLOCK 3,
TYPE OF WORK: 4�Qod Professi000'
AS—BUILT OF EXISTING SEPTIC SYSTEM 44�OD000d�
Permit Number: SW000300
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Aug 16, 2000
Expiration Date: Aug 16, 2001
Parcel ID: 050-601-06
Legal Description: GLEN EAGLE BLK 3 LT 4
Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: 023820 SUNNY GLEN DR
Owner Name: Robert Paulus Lot Size: 46750 SQ. FT.
Owner Address: 23820 Sunny Glen Dr. Total Bedrooms: 3 Permit Bedrooms: 3
Eagle River, AK 99577-9572
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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Date: $ 14 I&ILW-
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LOT 3B, BLOCK 1,
GLEN EAGLE S/D
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LOT 7, BLOCK 2,
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GLEN EAGLE S/D
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SERVED BY A PRIVATE
WELL AND SEPTIC
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SYSTEM.
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NO ENCROACHMENT CONCERNS.
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EEAAGGLE
PARK
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SUNNY
GLEN DRIVE \\
---------_-----------\-
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EXISTING i\
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3 BEDROOM \
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LOT 3, BLOCK 3,
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LOT 5, BLOCK 3,
GLEN EAGLE S/D
GLEN EAGLE S/D
SERVED BY A PRIVATE
I
---
SERVED BY A PRIVATE
WELL AND SEPTIC SYSTEM.
I
WELL AND SEPTIC SYSTEM.
NO ENCROACHMENT CONCERNS.
I
EXISTING
NO ENCROACHMENT CONCERNS.
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— � SYSTEM
TH 1®--- SEPTIC ®—
--------------------
LOT B. BLOCK 3,
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-----------------------
LOT 7, BLOCK 3,
--------------------
LOT 6, BLOCK 3,
GLEN EAGLE S/D
I
GLEN EAGLE S/D
GLEN EAGLE S/D
SERVED BY A PRIVATE
(
SERVED BY A PRIVATE
SERVED BY A PRIVATE
WELL AND SEPTIC SYSTEM.
(
WELL AND SEPTIC SYSTEM.
WELL AND SEPTIC SYSTEM.
NO ENCROACHMENT CONCERNS.
I
NO ENCROACHMENT CONCERNS.
NO ENCROACHMENT CONCERNS.
- - - - - - -
- CLEARING DRIVE
------------------------
------------
------------
DATE:
;..
:., 3:
8/11/2000
-OF �lq
aaame swaexRwaa e n
DRAWN BY:
ALASKA WATER & WASTEWATER
J.L.M.
;n
CONSULTANTS, INC.
T_
SCA'.
6901 DEBARR ROAD, SUITE 2B' ANCHORAGE, AK 99504 • PHONE (907)337-6179 • FAX (907)338-3246
— 100,
.......
PREPARED FOR PHONE NUMBER:
PAGE NUMBER:
ROBERT PAULUS
694-4597 1
1 OF Ir
A. Garness,-
�t1 •' —7953
4'+;'f
LEGAL DESCRIPTION:
GLEN EAGLE SUBDIVISION;
LOT 4, BLOCK 3,
11V el.•. ��?
fession�: «��~
�ProfesslOSO
TYPE OF WORK:
SITE PLAN FOR 1985 WELL LOCATION
''
Sent By: Alaska Water & Wastewater Consu; 907 338 3246; Aug -15-00 14:16;
AUG'-' 4-00 FRI 8:35 AM TWEED EXCAVATING FAX N0, 694 1250
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Sent By: Alaska Water & Wastewater Consu; 907 338 3246; Aug -15-00 14:16; Page 3/3
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
I SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: GLEN EAGLE SUBDIVISION; LOT 4, BLOCK 3,
PERFORMED FOR: ROBERT PAULUS
DATE PERFORMED: 5/15/00
DEPT
(feet) �;���
H FILL/ORGANICS TEST HOLE #1
ORGANICS
DEPTH TO
GROUNDWATER
I5,
f GM/SM
5/15/00
15.5''
DRY
5/18/00—
5/24/00
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DEPTH
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DATE
DRY
5/15/00
15.5''
DRY
5/18/00—
5/24/00
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DEPTH TO
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DATE
DRY
5/15/00
15.5''
DRY
5/18/00—
5/24/00
_
—
A. Gamess:
—7953
SEE ATTACHED DRAWING
DATE
READING
CLOCK NET TIME
TIME (MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
_. _
___..... PER--..._-----
PERCOLATION RATE — (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN — FT. AND — FT.
PERFORMED BY ALASKA WATER Sc WASTEWATER. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFO M D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE:
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r. n GREOR ANCHORAGE AREA BOWGH
�A Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL
NAME LOUD/KE Cdr15r MAILING ADDRESS
/� Q PHONE
f �-
.LOCATION Ml1.6 yrs �/�Gtt= i&elt /FX1 I" LEGAL DESCR IPTION I" y v��K� l7YP.p-CA64- Juk
SEPTIC TANK:
D(STANCE.. ��L //_� //.�NUMBER OF
FROM WELL MANUFACTURER AftkE w?Sr. MATERIAL u'^CMEI�r COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH - LIQUID CAPACITY-- O�GALLONS.
SEEPAGE PIT: Q ''
NUMBER OF PITS DIAMETER 90' OR WIDTH'', LENGTH ?e/, ..DEPTH
LINING MATERIAL 14b9 CRIB SIZE: DIAMETER"! DEPTHAL DISTANCE FROM: WELL
TOTAL EFFECTIVE.
BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA). -SQ. FT.
ADDITIONAL ABSORPTION
WELL: q F CIl //Rru�AYr
TYPE �kI LLED CONSTRUCTION - DEPTH DISTANCE FROM:
BUILDING NEAREST - NEAREST SEPTIC SEEPAGE
FOUNDATION LOT LINE SEWER LINE - TANK -,SYSTEM
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:
INSTALLED BY:
U/AGG14GE 6n5r,
PIPE MATERIAL:
615r Lrloa
LOT SLOPE:
REMARKS:
Form No. EQ -031
s DIAGRAM OF SYSTEM
APPROV
s
„ GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3330 "C" STREET ANCHORAGE, ALASKA 99503
IIU�gNII� �I� TELEPHONE 274-4561
u1011N1w.•oJ
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
�Dh
NAME OF APPLICANT- � � MAILING ADDRESS PHONE
INSTALLATION LOCATION
LEGAL DESCRIPTION /-
INSTALLATION
INSTALLATION OF: SEPTIC TANK G/ SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED of �il� Li✓�
FIELD OTHER ,
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS 1 -`T -/Z �/tl%;i //Z —/5 ` 2'sZV NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
5
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEEPAGE AREA SIZE
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK S- ' , SEEPAGE PIT DRAIN FIELD /O /
TO NEAREST LOT LINE.
r
WELL TO SEPTIC TANK /`� D SEEPAGE PIT
DRAIN FIELD n ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK - �!' , SEEPAGE PIT
DRAIN FIELD
��y/ / -.
SEPTIC TANK, l SEEPAGE PIT /y ef , DRAIN FIELD �57 ,
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5. FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST [RON.SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.S.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ,
DATE ZZ_�_� APPLICANT'S
FORM NO. EQ -016
r1f
C.:on.iftuatiOYL JEst 1.QU
"One test is worth a thousand opinions"
0020 TUDOR ROAD. ANCHORAGE. ALASKA 00507 • TELEPHONE O33•0472
Performed For Klondike -Alaska Date Performed 11/9/74
Legal Oescrintion: Lot 4 Block 3 'Subdivision Glen Eagle
This Form Renorts Soils Lon YES Percolation Test
Penth
Feet Soil Characteristics
I _ Overburden
2 —
Gravel, Poorly graded
3 —
(100)
4-
5 —
6 —
?—
B-
9-
10 —
Gravelly Silty Sand
SM 250
is, Bottom of Test Hole
Was Ground Water Encountered? No
IF Yes, At what Depth?
Oli =
MMMIFITUMM
Reading Date Gross Time Net Time Depth to H2O Net Dron'
'r—
Percolation Rate Minute
Proposed Installation: Seenaae Pit Yes Drain Field
Deoth of Inlet Depth To Bottom Of Pit' Or Trench
CnMMENTS; 180 sq. rainage area required per bedroom
No bedrock or water table encountered
Test Performed ByyIr
Data
Certified By:CONSTRUCTION TEST
mime natn.
MUNICIPALITY OF ANCHORAGE
Development Services Department<.: Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 050 -601-06
Certificate of On -Site Systems Approval
OSC251128
Expiration Date: 3/27/2026
Legal description GLEN EAGLE BLK 3 LT 4
Site address 23820 SUNNY GLEN DR
Current property owner(s) KWOLEK JENNIFER 50% &
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: Original Certificate Date: 4/18/2025
.,,.
Th s Certificate o n -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
6evelopment 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
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE 14
Development Services DepartmentPhone:907
P -343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 050-601-06
Complete legal description Glen Eagle Block 3 Lot 4
Location (site address) 23820 Sunny Glen Dr
Current property owner(s) KWOLEK JENNIFER
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone (907) 406-3214
3. TYPE OF WATER SUPPLY: RE Private Well F] Private Well serving 2 dwelling units
F-1 Private Well serving 3+ dwelling units El Community Well or Public
Fj Water Storage
4. TYPE OF WASTEWATER DISPOSAL: nN Private Septic n Private Septic serving 2 dwelling units
F-1 Holding Tank FI Community Septic or Public Sewer
5. SEPTIC TANK: R Steel R Plastic RN Concrete R Fiberglass
Age 50 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: E] AWWTS E] Bed EJ Deep Trench E] Wide Trench RN Seepage Pit
Waiver request for:
Expedited review requested: RE
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 $
Date of Payment
COSA # 0 S C_
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
Glen Eagle Block 3 Lot 4 050-601-06
>5
138 N/A
138
24+
4/2/25
1975
10.6
2,000 4/2/25
N/A
4/2/25
60
602
54
1440
30
>600
72
>5*
(907) 522-7773
Benjamin Schiller, P.E.
Development Services Department ,h Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 050-601-06
1. GENERAL INFORMATION
Complete legal description GLEN EAGLE BLOCK 3, LOT 4
Expiration Date: / 0 ^ Z d
Location (site address) 23820 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577
Current property owner(s) CHRIS SCHULTZ & AISLINN MCBETH Day phone
Mailing address
Real estate agent
23820 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $_-6SC/
Date of Payment
Receipt Number.
COSA# 06r_Z I 1367
Date:
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 6/30/2021
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 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 & Fas
6. DSD SIGNATURE
System #1 Approved for 3
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
bedrooms
gam?:•'.TM '1 *�
4..- .....:..rrr
Curtis Huffman
F,/•, CE 128991
�llF,q PROFESS10NA���
bedrooms, with the following stipulations:
0§� \�\IY OF A,(66
-_� Original Certificate Date:
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
WATER AND
WASTif VVATER z
UUNAM GO
-_� Original Certificate Date:
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
Legal Description: GLEN EAGLE BLOCK 3 LOT 4 Parcel ID: 050-601-06
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 3/13/1985
Total depth 138 ft
Cased to 138 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 6/28/2021
Static water level at beginning of test 71 ft.
Well production at time of test 4.9 gpm
Comments
B. TANK DATA
Age of tank(s) 41 years
Tank type/material SEPTIC / CONCRETE
Measured operating fluid level in septic tank 61"
® Standpipes/foundation cleanout per record drawing
Date of pumping 5/26/21
D. ABSORPTION FIELD DATA
Structure served by this system
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 1.17 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by NES
�..
Date of Sample 6/28/21
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Which system tested (date installed) 3/1975
Adequacy test date 6/28/2021
® ALL standpipes present per record drawing
Results N Pass For 3 bedrooms
Total measured depth from grade 10.3 ft (max)
Fluid depth prior to test 2 in
Measured depth to pipe invert from grade *5.6 ft (min)
Water added 470 gal
❑ N/A — pressurized field
New depth 13 in
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective *4.7' OF THE 6' ED CRIB
Elapsed time 1400 min
® Code -required soil cover over field
Final fluid depth 2 in
❑ System presoaked
Absorption rate 450 gpd
(Required if vacant for greater than 30 days prior to
Any rejuvenation treatment (past 12 months) N
date of test)
Gallons introduced gallons
If yes, enter date
Comments/Deficiencies: *MEASURED / ASSUMED TOP OF CRIB AS THE INVERT TO CRIB TOTAL DEPTH.
FW
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'
if No ft
® Yes
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ®Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100'
Property Line > 5' ® Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ® Yes if No ft Private Wells > 100'
Water Main > 10' ® Yes if No ft Community Wells > 200'
Water Service Line > 10'
® Yes if No ft
ft
ft
ft
ft
ft
® Yes
if No ft
® Yes
if No ft
® Yes
if No ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
*PER CODE AT TIME OF INSTALL.
G. ENGINEER'S CERTIFICATION
1 certify that l have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.TH
,Mk
Curtis Huffman
�Fc• CE128991 W
Awl
i•
ROFESSIONQ`;'�V
Municipality of Anchorage
On -Site Water and Wastewater Program r `{
(907)343-7904
rtb' 2G1 s . E .-
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-601-06
1. GENERAL INFORMATION
Complete legal description Glen Eagle Block 3 Lot 4
Expiration Date: "�__ - 1�?_- /Y
Location (site address) 23820 Sunny Glen Dr, Eagle River, AK
Current Property owner(s) Sawdon Gene Day phone 696-1700
Mailing address same
Real Estate Agent Cindy Wilson Day phone 244-1930
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class C Well
Public Water System
3
TYPE OF WASTEWATER DISPOSAL:
®
Individual
❑
Holding Tank
❑
❑
Community
❑
❑
Public Sewer
❑
Received by � Date: %
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5a(,_�P_
Date of Payment
Receipt Number L 7 f
COSA # aSC1411OS&
Date of
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 NorthRim Engineering Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng
6. DSD SIGNATURE
_z System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
3 bedrooms.
bedrooms.
bedrooms, with the following stipulations:
/
By: / i Original Certificate Date: J, ' !2
The Municip lily of Anchorage Devlopment 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet 9-1-12.tloc
X Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the tot:
. COSA Checklist # _of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description:Co�Eilf z114 Q6 &3 Ly Parcel ID: 05S0-60/- 06
A. WELL DATA
Well type / If A, B, or C provide PWSID #
Date completed 4/4/S
Total depth 29 ft.
Date of test
Static water level
Sanitary seal (Y/N)
Cased to/ 3 ft T
FROM WELL LOG
3/3 8S
3,43
ft.
Well production 3 g,p,rn,
WATER SAMPLE RESULTS:
Well Log (Y/N) x
Wires properly protected (Y/N)
Casing height (above ground) n.
AT INSPECTION
Z�
6z ft.
9.p -m.
Coliform _<)—colonies/100 mL Nitrate 3.93 mg/L
Arsenic 0.22 ug/L Date of sample: Collected by: ii%d2i �g
B. SEPTICIHOLDING TANK DATA
Tank Type/Material S fg-f(c. / ��ne/��R Date installed -�
Tank size 1j1 Q . gal. Number of Compartments Cleanouts (Y/N) V
Foundation cleanout (Y/N) Depression over tank (Y/N) A/-- High water alarm (Y/N)
Date of pumping �! Z$ L3pumper _ T -?2 S
C. ABSORPTION FIELD DATA
Date installed -4F 75 Soil rating (g.p.d./ft2 or ft2/bdrm) Q- 2So System type C2//3
Length 3 ft. Width // ft. Gravel below pipe ft.
Total depth -4/ --ft. Eff, absorption area 5-106—ft Monitoring tube Depression over field AJ
Date of adequacy test Z Results (Pass/Fail) to For 3 bedrooms
Fluid depth in absorption field before test -/-a- in. Water added gal. New depth�l in.
Elapsed Time: _Q_ min. Final fluid depth 1_ in. Absorption rate >= 41111 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) LAIK If yes, give date
D. LIFT STATION Nt
Date installed
"Pump on" level at _
Datum
Size in gallons
in. "Pump off" level at
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested
Septic tank/lift station on lot /0 d If
Absorption field on lot /0 G `e
Manhole/Access (YIN) _
in. High water alarm level
Meets alarm R circuit requirements?
On adjacent lots
On adjacent lots /410 rd
Public sewer main N/I Public sewer manhole/cleanout N.4
Sewer /septic service line 5 Holding tank V,4
Animal containment areas SO `r Manurelanimal excrete storage areas / OO 'r
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation S Property line�d Absorption field
Water main A-1?f Water service line Z 5 r/ Surface water !e-
Wells
fWells on adjacent lotsO� 0 f
ABSORPTION FIELD ON LOT TO:
in.
Property line r� r� Building foundation �4 (F Water main iU.ff
Water Service line Q `f Surfacewater 1GO ;,4 Driveway, parking/vehicle storage �S t
Curtain drainyrt/k. Wells on adjacent lots Od 'e
F. COMMENTS
COSA brown sheet_10-10-12.doc
G. ENGINEER'S CERTIFICATION
�'w�°®••°°O°�
I certify that I have determined through field inspections and
r. '• ti
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name S%�f/F /�.c/6
:- Stc `°:`"'
Date
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4
MUNICIPALITY OF ANCHORAGE
• �` DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 9951M650
(907)343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FORA SINGLE FAMILLY DWELLING
C�
Parcel I.D. # 050-601-06 HAA #d(�1[1
1. GENERAL INFORMATION
Complete legal description GLEN EAGLE SUBDIVfSION: LOT 4. BLOCK
Location (site address or directions) 23820 SUNNY GLENN DRIVE a RIVERAK 99577
Property owner ROBERT PAULUS Day phone (907) 694-4597
Mailing address_ 23820 SUNNY GLENN DRIVE EAGLE RIVER, AK 99577
Lending agency - Day phone
Mailing address
Agent RANEY W1 REMAX PROPERTIES Day phone (907) 694-4200
Address 16600 CENTERFIELD DR. EAGLF RIVER. AK 99577
Unless otherwise requested, HAA will be held for pickup.
2.NUMBER OF BEDROOMS: 3
3 TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding Tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of systema
72-025 (Rev. 1191) Fmnt MOA #21 Computer Version
,
i
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1,770.00 at,
or prior to, closing.for the engineering services provided.
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 of this Health Authority Approval application 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.1 further verify that based on the information obtained from the Municipality of '
Anchorage files and from my investigation and inspe n, the on-site water supply and/or wastewater .
disposal system is in compliance with all Municipal a State codes, ordinances, and regulations in effect
on the date of this inspection.R &
Name of Firm ALASKA W W ER CONSULTANTS INC. - phone (907) 337-6179 -
Address 6901 DEBARK AD S 1 CHO GE ALASKA 995(k1
Engineer's SignatureDate S l/ Gv
In conducting this evaluation, AWWC, Inc.' p to provide a thorough, conscientious engineering analysis of the
system in accordance with ADEC and MOD H uidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the focal soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of
the evaluator of the system. Satisfactory test results do notguarantee future performance o ��
of the system nor do they guarantee that there are no hidden defects or encroachments p� s DO
AWWC,Inc. can therefore not provide any warre n ty for future estima te of ho w long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or party is not authorized, . ....
nor will it confer any legal tight whatsoever. OQ elf y A. GOmess,
CE -7953 ' op
6. DHHS SIGNATURE p�t�; NIP
Approved for 3 bedrooms uV44edprofeeeiot,°off
Disapproved ��Oop000�
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
0
Date 53 - / (, -06:'
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of
DHHS 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 engineer's work.
72-025 (Rev. 1/91) Back MOA #21 Computer Version
RECEIVED
'AUG 14 2000
Municipality of Anchorage MUNICIPALITY OF ANCMp
DEPARTMENT OF HEALTH & HUMAN SERVKWAwwAtsERvlces
Environmental Services Division
825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744
Health Authority Approval Checklist
Legal Description: GLEN EAGLE SUBDIVISION; LOT 4, BLOCK 3, Parcel I.D.: 050-601-06
A. WELL DATA *SEE ATTACHED WELL PERMIT APPLICATION AND LETTER. OLD WELL (4/26/78) WAS
WAS ABANDONED PER AMC 15.55.060 WATER WELL ORDINANCE BY TWEED EXCAVATING.
Well Type PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Log present (YIN) YES Date completed *3/13/85
Total depth 138' Cased to 138' Casing height (above ground) 24"+
Sanitary seal (YIN) YES Wires properly protected (YIN) YES
FROM WELL LOG
Date of test 3/13/85
Static water level 30' IN HOLE
Well production 3 EST. g.p.m.
WATER SAMPLE RESULTS:
AT INSPECTION
5/24/00
Coliform 0 Nitrate 1.45 mg/L Other bacteria 0
Date of sample: 8/3/2000 Collected by: A.W.W.C., INC.
B. SEPTICIHOLDING TANK DATA
9.p -m.
Date installed 3/75 Tank size 1000 Number of Compartments 1 Cleanouts (YIN) YES
Foundation cleanout (YIN) *YES Depression (YIN) NO High water alarm (YIN) N/A
Date of Pumping 8/12/2000 Pumper JR'S PUMPING
C. ABSORPTION FIELD DATA *DATA FOR CRIB ONLY. BOOTLEG TRENCH IN CRIB PERIMETER. **CALCULATED
Date installed 3/75 Soil rating (g.p.d./ft2 o dr 100-250 System type *CRIB
Length 34' Width 11, Gravel thickness below pipe 6' Total depth 10' — 11'
Effective absorption area **540 SQ.FT. Monitoring Tube present (YIN) YES Depression over field (YIN) NO
Date of adequacy test 5/24/00 Results (Pass/Fall) PASS For 3 Bedrooms
Fluid depth in absorption field before test (in.); 27" immediately after 983 gal. water added (in.): 40"
Fluid depth 34.5" (ins) Minutes later. 1055 Absorption rate = 450+
Peroxide treatment (past 12 months) (YIN) NONE KNOWN If yes, give date -----
72-026 (Rev. 3I96p' Computer Version
D. LIFT STATION
Date installed Size in ertb�
LManhole/Access (YIN) on" level at* "Pump off' level at*
er alarm level *Datum
sted
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+ Lift station N/A
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+ Absorption field 5'+
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line UNKNOWN Building foundation
Surface water
Curtain
F. ENGINEER'S
I certify that I i
of Municipal n
with MOA HA,
Engineer's
HAA Fee S 30D.01)
Date of Payment
Fr�< tf�av
100'+
+ Water main/service line 10'+
Driveway, parking/vehicle storage area 10'+
fd inspections and review
stems are in conformance
this date.
Receipt Number ® 6 / q-8
72-026 (Rev. 3mr Computer Version
Wells on adjacent lots 100'+
Waiver Fee
Date of Payment
Receipt Number
ALASKA WATER & WASTEWATER
CC>NSULTANTS, INC. _....
August 10, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Health Authority Approval for Glen Eagle Subdivision, Lot 4, Block 3,
This letter is to address the well and septic concerns serving the existing 3 bedroom house on the
referenced property.
WELL: The original well serving the property was drilled on 4/26/1978. Per the homeowner, a
new well was drilled on 3/13/1985 due to the first well was not functioning. It does not appear
that this well was permitted. On 5/24/2000, a well flow test was performed on the 1985 well and
it was concluded that the well production was in excess of 3.0 gallons/minute. Attached is the
well application permit, a 100 scale site plan, and a well log for the 1985 well. On 8/3/2000,
water samples for nitrate and total coliform bacteria were taken and found the results to be
satisfactory (see attached). The 1978 well has been completely abandoned per AMC 15.55.060
water well ordinance by Tweed Excavating.
SEPTIC: The original septic system was installed in March of 1975. The original septic system
consisted of a 1000 gallon septic tank and a crib type system with a 34 feet by 11 feet perimeter.
Per the homeowner, the septic system backed up into the house while he was out of town and his
wife had a excavator, named Larry Wright, "repair" the septic system. This work was performed
in the 1980's per the homeowner. Attached is a letter from Mr. Wright stating the work that was
performed. On 5/24/2000, we performed an adequacy test on the crib only and found the crib to
be passing for a 3 bedroom house per MOA requirements. It is our opinion that the bootleg
trench was installed in the crib perimeter and it appears to have continuity with the crib. A test
hole was excavated to the south of the crib to confirm soils and the groundwater level (see
attached). Earlier this summer, the homeowner contracted Tweed Excavating to reconnect the
crib. Attached you will find a sketch of the repairs made by Tweed Excavating.
Based upon this data, it can be concluded that both the well and septic meet the MOA
requirements for a 3 bedroom house; and we request you issue a Health Authority Approval.
If you have any
please contact us at 337-6179. Thank you for your assistance.
.S.
6901 Debarr Road, Suite 2B — Anchorage, AK 99504 — Ph: (907)337-6179 — Fax: (907)338-3246
