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Home My WebLink AboutTONJESS ESTATES BLK 3 LT 16Onsite File Tonjess Estates Block 3 Lot 16 #051-832-05 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211163 PID Number: 051-832-05 Page 1 of 3 Dwelling: 9 Single Family (SF) ❑ v.,ith ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 upgrade Name Sokol ABSORPTION FIELD ❑Deep Trench El Wide Trench El Bed ❑ Mound ❑ Other Site Address 25220 Schaff Dr Phone 360-1119 Number of Bedrooms 3 Soil Rating GPDISF JTotal depth from original grade Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Tonjess Est B3 L16 Block Lot Fill added above original grade Ft.' (Gravel length Ft. Tovmship Range Section Gravel vndth Beds:'Number of Lines Ft.l - Distance between lines - Ft. SEPARATION DISTANCES To; Septic From Tank Absorption Field Lift StationHolding Sewer Tank Line Total absorption area (Number of trenches Ft' Dist, between trenches Ft. Well 100'+ na na j na TANK Fri Septic (] S.T.E.P. 0 Holding ❑ Other Manufacturer Greer Capacity 1000 Gal. Surface Water 100'+ I n a n a Material Plastic Number of compartments 2 Lot Line 10.+1 na na NA Foundation 101+ I na na LIFT STATION ?alanufacturer Capacity Gal. Remark; Septic Tank Replacement Alarm location Electrical installed by Installer J RS inspector NorthRim Eng. PIPE MATERIAL House to tank Tank to D3034 drainfield D3034 Drainfield CO/MT D3034 BENCH MARK (Assumed elevation) 100 it Inspection 2 , vi 717/21 7/8/21 Location and description 41" Deck ONSITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date Septic System ApproveDate Z -Z Note: this approval does not include well permit requirements. Engineers Stamp c- u u N L 025 y C, d u a n, a, n, n, pq LA -P 0 d 0 m o � m "Ln caj oCl_ -P Q O_ d ;p > d > W N w Ln O c N dz Nd U do F -E co O_ -N C5 a, w N Q>1 > 0 Lr5 pp y C O c- u @J 0 Qf- d 0 d a �QU OO- OW O -P I -P oQ O_ W d o0 N d O > N W N LQ G, o 4- O `Q ur 11 W � W V J 0 U 0 —I pq F � (Y) 00 0 W J H a z W a_ 7- LLJ V U z Q n W U ry H n z W Q ,�,��w�►agppa a n �00 � k.ZQ o° Cf �Z am Q) ZW W O � R1 �1 o (DD Z CD dC�C 7� Z A a x 4 v rq M`�' �1 0 0 (Q rq n � m � 00 v D _ m CD Ul D Z v z Q�� n ry C1 D F z Fri dC�C 7� � ` D W F1 0 O F— F-9 n � m � D _ m CD Ul D Z z 7 CC) D fTl wro CD a a� � d m 0 � II yro -J� CA) o Q�� n ry r- 0 00 D C _ m CD Ul D Z 0 fn X � (+ w w O w W\ � yro n 5 0- 0 0 � o 1n n o fnn v G 771 F— 3 O 9 eco O � GRAVEL'. . DRIVEWAY, r- 0 00 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99515-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http:l/www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Dumber: OSP211163 Work Type: SepticTank Upgrade Tax Code Number: 05183205000 Site Legal Address: TONJESS ESTATES BLK 3 LT 16 6:1462 Site Mailing Address: 25220 SCHAFF DR, Chugiak Owner: SOKOL ROSEMARY J Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date �`�Encntxsfr. �J ry De partinent Lot Size in Sq Ft: Total Bedrooms: 5/28/2021 5/28/2022 49691 ❑ Disposal Field R1 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: Date: TC1 //1 Issued By: Date: 5 Q'? a_a2 3 Development Services Department On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-832-05 Property owner(s) Sokol Mailing address 25220 Schaff Dr Site address same Phone: 907-343-7904 Fax: 907-343-7997 Day phone 360-1119 Legal description (Sub'd., Block & Lot) Tonjess Est B3 L16 Legal description (Township, Range & Section) Lot Size 49,691 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade Q Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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: # 'q '� rJ Date of Payment: S- 2 '-1 " 2- i Receipt Number: 0901-/il D Permit No. ()SP 211 1( 3 Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 5/21/21 Number of Pages: To: MOA On-Site Services Subject: Tonjess Estates Block 3 Lot 16 Septic Tank Failure The subject septic tank has failed- a new tank will replace the old one. The existing seepage trench appears to be working OK. Please issue a permit so the tank can be replaced. Please review as soon as possible. This is a large lot with no nearby neighbor conflicts. Elevations in vicinity flat. If there is need for additional information or clarification please give me a call. Thanks-Steve Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211163, Rebecca Carroll, 05/28/21 SteveEng.com Tonjess Estates B3 L16 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the seepage trench still functions. This lot is large with nearby wells drawn on plan sheet. No adverse impacts are expected from tank replacement. The easements are depicted on the lot. The slope is indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet.  5 minimum between the tank and trench. 5  to property lines & 10  to house.  4 of cover or insulation is required for tank; an equivalent of 1  insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil.  No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel.  4 diameter cleanouts with airtight caps are required 1  to 4  from foundation wall, prior to any 90 degree bend in 4 inch line, in 2 nd tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10  from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 st tank compartment.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Insulation must be placed over any pipe installed under driveways or parking areas.  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661,  Sewer Service Line is minimum 2% slope.  Septic Tank to be pumped every two years or when required.  Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211163, Rebecca Carroll, 05/28/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211163, Rebecca Carroll, 05/28/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211163, Rebecca Carroll, 05/28/21 iz-uio mev. 5//ul C7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 0* ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW o.,;y , UPGRADE MAILING ADDRESS v LEGAL DESCRIPTION J LOCATION NO. OF BEDROOMS U .Y DISTANCE TO: Well , I Absorption area I Dwelling PERM .t . / CL ZQ Manufacturer Mater' No. of compartments ,�j w� Liq. capacity in gallons 060 IF HOMEMADE: Inside length WidtTi Liquid depth 6 Y (D DISTANCETO: Well Dwelling PERMIT NO. _1 = z Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: Well Foundation Nearest lot line f PERMIT NO. %1 J LL Z Z No. of lines p Length of each line i Total length of lies Trench width Distance between line F- w cc / . inches of tile to finish grade j Material beneath the Total effective adsorption area inches Lu Length Width Depth PERMIT N 0 0 < H Type of crib Crib diameter Crib depth Total effective absorption area LU . W DISTANCE TO: Well Building foundation Nearest lot line Class -�- Depth Driller Distance to lot line PERMIT NO. w I l ISAS DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ST SOIL TEST RATING /L/ INSTALLER * �? C...- M REMARKS a& APPROVED DATE LEGAL iz-uio mev. 5//ul C7 142 WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological a Geophysical Surveys ue grani-te blue- Eranit 16. WATER WELL CONTRACTOR'S CERTIFICATION: 10. STATIC WATER LEVEL: ft. �1 E] Above or E] Below land surface Date Equipment used: 11 . PUMPING LEVEL below land surface and YIELD ft. after hrs. pumping g.p.m. ft. after hrs. pumping g. p. m. 1 515 Drilling Permit No. LOCATION OF WELL (Please complete either to, Ib or Ic.) A.D.L. No. lo. BoroughSubdivision Lo" Block Ib. 1/4gtrs. Section No. TownshipNO Range EMeridian An ch Tonjess 1 11 3 —of—of—of WO Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: Mr • Jim Rosen HQ CO FRA Address: Fort Richardson, Ak Street Address and Area of Well Location 99505 2. WELL LOG Feet Below Surface 4. WELL 1D�EPT Tt ( final) 5. DATE OF COMPLETION 7 Material Type Top Bottom J J Dry grave 6. []Cable tool xIaRotary []Driven [] Dug ❑ Auger O Jetted [J Bored E] Other: 0 i 30 .r'r a c ur e 7. USE: omestic � Public Supply � Industry Gray granite '1 Irrigation [3 Recharge 0 Commerical f -I Test Well Other: 156 -ray granite 8. CASING: E] Threaded (IXYelded diam.6in. to9_ ft. Depth Weight 17 1bs./ft. diam, in. to ft. Depth Stickup ft. 171 1 14 Gray granite 174 210 Fracture 29i9. FINISH OF WELL: 11 Open Hole i Type Diameter: Fracture 5 Slot/Mesh Size: Length: Set between ft. and ft. Backfilling Gravel pack ?— 'C J I ue grani-te blue- Eranit 16. WATER WELL CONTRACTOR'S CERTIFICATION: 10. STATIC WATER LEVEL: ft. �1 E] Above or E] Below land surface Date Equipment used: 15. Water Temperature _ This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; Magnuson Drilling AA 5385 Registered Business Name Contract License Number Addres�s:'0. Box/ 504 Eagle River,nAk. 99577 _ Signed March 12, 1983 a E) F C3 C Authorized Represent6ti Form 02-WWR (II/BI) Copy Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY -Customer 11 . PUMPING LEVEL below land surface and YIELD ft. after hrs. pumping g.p.m. ft. after hrs. pumping g. p. m. 1 515 12.GR0UTING Well Grouted: n Yes E-] No Material: F] Neat Cement [] Other: 13. PUMP: (if available) HP Length of Drop Pipe ft. capacity g.p.m. Subm. Jet [3 Centrifical 0 Other 14. REMARKS: Bail tested at 1/2 GPM 15. Water Temperature _ This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; Magnuson Drilling AA 5385 Registered Business Name Contract License Number Addres�s:'0. Box/ 504 Eagle River,nAk. 99577 _ Signed March 12, 1983 a E) F C3 C Authorized Represent6ti Form 02-WWR (II/BI) Copy Distribution: WHITE-Stote DGGS, PINK -Driller, CANARY -Customer TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 145 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: -LC-51 0 ��u:]5-TH= -1-1 CaFZFA%?EEL_ E>E0F0l-VA= �t5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [RAINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE 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 GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET), ��U��E> 'T K��I� �� T 7'�= �� L_�0 04�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ _1F 0_4 co �� I pol", F=" E=w 10 -IFF I CH F=o FZ E= ��I F --'F= E--- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 10 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTION -� ' yl�'S 1="E=7FA?vell-TT E=-:' F='lFZE�00 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 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 IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED:________________________________________ HPPLICHNT JAMES ROSIN ISSUED ______DHTE_Y4.0 141 U-1 141 1 12 1 f"k? I_ 1 0- NO CD F= FA V4 CD NA CD F? FA Ca E= ' DEPARTMENT 825 HEALTH STREET ' AND ENVIRONMENTAL OTECTION ANCHORAGE, HK 9'� 1 ' � ~`- 264-4720 7~� �� P4E> �P4_�I�� I -F / ' PERMIT NO. ( 821193 ) APPLICANT JAMES ROSIN HQ CO FORT RICH 863-6111 LOCATION ER LEGAL LT.16 BLK.] TONJESS EST LOT SIZE 99999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 145 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: -LC-51 0 ��u:]5-TH= -1-1 CaFZFA%?EEL_ E>E0F0l-VA= �t5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [RAINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE 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 GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET), ��U��E> 'T K��I� �� T 7'�= �� L_�0 04�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ _1F 0_4 co �� I pol", F=" E=w 10 -IFF I CH F=o FZ E= ��I F --'F= E--- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 10 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTION -� ' yl�'S 1="E=7FA?vell-TT E=-:' F='lFZE�00 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 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 IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED:________________________________________ HPPLICHNT JAMES ROSIN ISSUED ______DHTE_Y4.0 gw � � � " 11 ''1 1 �c- -, - ��-R -- -- --- -- 7 ! R M M 11 �1-1— I>- TH "UND aclY PRO TI -Er 1011' 264 t,42 cr T -RICH 86-3-61A I -:lpal- EMT., LOCAT I'Xi GR Fel -LT. lfz TMJESS -F-T. T _UCT zfZC SQURRE -IF IL !;GSGPP -7 IL 55�- Ts� TYPE C fs TReit.li I'M r - OF eEDIRL-I'MrS FT�,�RX;r, TWE TH ion -s - t 2, -50 tL RGSORPT Fz La"Har-14 D I MENS i or- IS rHa LEM 71H K 1 n -F-sc 14F n -E mulol OR 5c rw f I - -k 1, 1E OF Tw -,RaTzc-.q 1:R--P,r .,rs fi-iE C -4TAN---:P- -2ETWEat THE 3UWAC cc - <in ZEEF rr�---Q-S IS !� M3 SET 14 E(>'r]4 -FGR' TRENCfn:,'E3- -a, -11�s OUTFR-L PZIPE. THE rug.,R-1440k- cNepriq fs rl-E MpAt'llur, 0-s-prR n -F GRRVEL �EVVKIR- -1 < -:3- �a n0t 4:34��zL-5 C-Nw-E. T -t Hc� i RRC-I-ICAN-f IRRS -1HE 'WE'SM-41518 ELI Ty TO INFORM THIT-S D�--d-Ul-VENT DURUM -To TH IS i"ll THE IN-SIR-LRTION -Rver��MOJNIS i-ly RMY WELLS iiolffqlanT LIP JtJ4 jj�jij- T14E-S ,P4:x,Fr" UNG OF RNY �f-STVI D-,'-PRRr,`ENT 34rLL BE 5UP-JECT, TO PP-0-SECUIr f0m LIS Ify 13'-"-SfTE SaISGE Dlf-,PG� r Dfsrplif 2EMEEIN R FEET -FaR R PR Y V RY, E IN j50 TO, 200 FEET FRIOM -8 P-1-ISLIC We -L 02P0401 I- ON T�C- , Typ- E -R I Tw OTSTANCIG FROM q PR!VR'EE WEELAL TO A fORNSTE SEW'S IS 25. FEFES AIN T C, 19. 1=41TUN f VV Sswepl -UlE rs -r- 5 F -F T T� Wo 01 - FREI- RDRUTRIED RID 1111.1ST el -r RVIl-IRNSO TO U.&C-ReIR-4-DIT WrT-H cn%W5 0F THE R-rz---LL OTHICUR REQUIREMENTS MZRRY R-PPUi�. SPECIFICRTION5 P,.-* comsr P's Ruc r r op., D r scpsms AVIRIL88UE TO M-DURE PIRCOFEER, lH5T,9LLflTlQtl- - clA:-;0 i C��Kpv THRT 1 ;IN FAMEL I AR 14 t TH Tf� REQU I Ts -FOR 13IN-13 I T9 SS14IF-95 RNIP F*RVHI Vj; THE "-Uf!C-rFl!'A-lTY OF 9P9,'fif!RFr-,F- -f-J'q RCCORINqNUGE .1 1 TH C -f IWULL r� -SYSM4 id TV E Mes F '71 -RAT THE 014-SE'll-E '24S� PIRY REQUIRE 0-,PLRRGE7-4a-ff f -�2 15 RE-MICELED TO ilvxff�- PIME _rrifill 3'a-FDR0101ts. ----------------------------- -Mpr-fr JAM- Rot-Ifiq ------- 4al, vU & E ENG-.NEERING & DEVELO, MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG- 688-2280 Performed for: Name: klo S Tel. N0. Address: fe� Legal Description: Lor 81- o C i4 Z'j j-'dE S 155'i 19 7-,E _S Depth (feet) Soil Characteristics 0 Ilit 7— �� .5,0 /4. 2- 3 d1vor 4 5 6 7 8 9 10 11 12 13 P - 6,114-1 ID 55 1 PLOT PLAN A/D Peas-& 14 /91-1 777-e,-1-1 P17- 15 16 OF 41� %it rte: Ground Water Encountered: Yes- NoIf yes, what depth- 0* . * A go :49TH % Proposed Installation: Seepage Pit Drain Field Corn 4' 4 Date: Performed by: Earl P. Ellis MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051-832-05 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Tonjess Est B3 L16 Location (site address) 25220 Schaff Dr Current property owner(s) SOKOL Mailing address Real estate agent 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 12 - Z' Z I Day phone 360-1119 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F Private Septic F Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ .5 50 Date of Payment 8/370202 t Receipt Number oa73 7'b COSA # O S C.2 115 2 8 Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date $/3/21 ON-SIr o WATER AND m �m ER PROGF o �JJJAN Q 1\1 ,9l�� SERV,�11��,\ By- ` Original Certificate Date: Z 2 The Municipality of Anchorage Development SeRices Drision (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 Septic System Advisory Nitrate Advisory Arsenic Advisory OF 6. DSD SIGNATURE s * :49M *#1>< JC System #1 Approved for bedrooms f • • . s. System #2 Approved for 9 bedrooms C - Jr' 4� i•/ 21 Disapproved Conditional approval for bedrooms, with the following stipulations: ON-SIr o WATER AND m �m ER PROGF o �JJJAN Q 1\1 ,9l�� SERV,�11��,\ By- ` Original Certificate Date: Z 2 The Municipality of Anchorage Development SeRices Drision (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 Septic System Advisory Nitrate Advisory Arsenic Advisory Legal Description: Toniess Est B3 L16 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 3/22/83 Total depth 515 ft Cased to 29 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 5/14/21 Static water level at beginning of test 37 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material 5.P """ Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA 6/83 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet of Parcel ID: 051-832-05 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 7/13121 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/14/21 Results Q✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community weil Septic Tank/Lift Station onLot 1OO F1 Yes Community Sewer Manhole/Cleanout >1O0' rvjYeo Surface Water >10U' ifNoA Property Line >6` M/ Yes i[Noft Neighboring Tank >1OU' F�Yes Wells onAdjacent Lots: ifNoft Private Sewer/Septic Line >26'[,-1Yes ifNoft Absorption Field VnLot >�100' E] Yes |fNnft Private Wells >1OO' Holding Tank >100' Yes i[N0M Neighboring Absorption Fields > 100' Yeo ifWnft Animal Containment >5O` Yes |[NoO Yeo ifNoM Yno ifNoft Yes i[Nn8 If septic tank inLinder driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75` Yes |[N0O ��Yen |[N0ft From Septic/Holding Tank onLot to: (Please enter distances if less than required) Building Foundations >1(/ F1 Yes ifNoM Surface Water >10U' Yes ifMoM Property Line >6` E] Yes JN$ft Wells onAdjacent Lots: Wells onAdjacent Lots: Absorption Field >5^ FI-1 Yes\fNoft Private Wells >1D8' El Yes i[NoO Water Service Line > 10' Private Wells >1OO' Yes ifNoft Water Main >1O' Yeo ifWnft ��Yen Community Wells >2OO' Yeo ifNoM Water Service Line >10' Yes i[Nn8 If septic tank inLinder driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation >10' El Yes ifWoft �absorption field isunder driveway comment below Property Line >10' Yes ifNoU Wells onAdjacent Lots: Water Main >1O' Yea i[NoD Private Wells >1D8' El Yes i[NoO Water Service Line > 10' R1 Yes ifNoft Community Wells > 200' 0Yos ifNoft Surface VVeter>100' ��Yen ifNoft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review of Municipal records that the above systems are /oconformance with MCNCO3A quidelines in effect onthis date. Sr,\AP / j- tP `--WELL CR ,,.• 100 FR w ¢ N. ' )3 Lot 17 2.0'x17.7' CANT PORCH o. / 2.0' CANT Itl MANHOLES YN � ,',, : 2.0' CANT ,f ® 45.0'� N / N � ' �----SEPTIC in PIPES 48 / 2.6'x6.2' CANT DECK 1 STORY RESIDENCE c w/ WALKOUT BSMT. ;0 C) ` 05 Lot 1 I co 49,691 S.F. �O 0 25 o N .85'1445"W 233.00' Lot 18 r'r7 � �10' UTILITY / EASEMENT Lot 15 / PLOT PLAN ___ AS BUILT _X_ SCALE _ 1___ 60=_ GRID _ NW 1462Project No. 21_51 / 1____ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in C® (907) 522-6476 Phone (907) 522-4625 Fax OQ�� Professional Land Surveyors ken®Iangsurvey.com jonothan0longsurvey.com � ' 4 oQ- ' ••�S�Q I hereby certify that I have surveyed the following described property: LOT 16, BLOCK 3, TONJESS ESTATES (PLAT No. 82-59) p 1/) 49TH -7* 0� Anchorage Recording District, Alaska, and that the improvements situated thereon are"""""""'"""" ""' """"'( within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed KENNETH, LAN premises and that there are no roadways, transmission lines or other visibleo G easements on said property except as indicated hereon.°Z.( O� frik� Q F� LS -5202. J Dated this the E___ Day of � -3 `_________, _'' �l__, at Anchorage, AlaskapR 4O ' O"ESSIONA\- \Y. If is the responsibility of the owner to determine the existence of any easements, �OpppooQ covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date –7 — 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) PA41 V6 (b) Property Owner PQ(' iNN6� 6/W;Pb_q7!:'3 Telephone: Home Mailing Address (c) Lending Institution Telephone Business Mailing Address (d) Real Estate Company and Agent r-oMiJ5- P�oPe_M6 S - LODIl _12570 Address Telephone 66, -L -7 & S 3 (e) Mail the HAA to the followina address: or: Check here ❑, if hold for pick up. List contact person and day phone number below. 4 EPf s 10077-S t- b 4 s) 2. TYPE OF RESIDENCE Single -Family 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: If 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 (Rev 8/86) Front NOea (92 /9 Aad) szo-Zc Z to Z abed 'NJO A s,aaaul6ua leuolsseload ayl u1 suolsslwo ao saoaaa aol alglsuodsa.i lou sl a6eaoyouy to A111ed1o1un1N ayl -penssl sl aleo1111aao e aaolaq elep azAleue ao suolloadsul lonpuoo lou op SHHa to saaAoidw3 -sluawaalnbaa alels pue leaapal uielaao Als11es of aapao u1 suo11n111su16u1pual alayl pue sawoy to saaseyoand of Asalanoo a se slyl saop SHHa ayl 'eNselV to alelS ayi u1 paaalsIbei aaaulbua leuolsselo.id luapuadapul ue Aq anoge 9 ydeAeaed u1 UGA16 suolleluasa,idaa ayl uodn Aluo paseq sa1eo111laao lenoaddy Aluoylny ylleaH sanss! (SHHo) saolAaaS uewnH pue ylleaH to luawlaedaa 96eaoyouy to A4!ledlolunlN ayl NOIlf1V0 leuoll!puo0 m a�piSS3�Q�d� •• o ea •e •.•e• s • e°•e �f1 0,+e 0eeee9ie De•O DpO°9e D 0e OW e lenoaddy leuoll!PuoO to swaal panoaddeslo —'— panoaddy Aq swooapaq S- aol panoaddy IVA08ddV SHHa C9 / e //— aleo ssaippv 15 19-1,1auoydalal �d j wall to aweN •uo1loadsul slyl to alep ayl uo loalla u1 suo1leln6aa pue `seoueulpao 'sepoo 91e1S pue ledlolunNl lie yl!m aoue11dwoo u1 s1 walsAs lesodslp aalemelsem ao/pue Alddns aalem ails-uo ayl uo1joadsul pue uo11e611seAul Aw woal pue sa111 a6eaoyouy to Al!IedlownVy ayl woal paulelgo uo1lewaolul ayl uo paseq leyl Aj!aaA aaylanl I •ulaaay paleolpul aanlonais to adAl pue swooapaq to aagwnu ayl aol alenbape pue leuo1lounl 'ales s1 walsAs lesodslp aalemalsem ao/pue Alddns aalean alls-uo ayl leyl SMOt4S lenoaddy Aluoylny ylleaH S!yl to uo11e611s9nul Aw 1ey1 Aj!aaA I 'molaq unnoys alep u011ep11EA ayl to se pue olaaay pax!lle leas Aw Aq paipliao sy R NOIlVWHOdNI (INV VIVO 'HO8V3S 311d `S1S3.L `SNO1103dSNl ONIMAOad W813 ON1833NIJN3 '9 A. WELL DATA Well Classification Pq V MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4744 Legal Description: 'T-OmjJ 5 sUe'o . LO T1 16 . aLUCK- 3 If A, B, C, D.E.C. Approved (Y/N) J , G lonq 19 1-06 Well Log Present (Y/N) yG� Date Completed J Z 'f � � Yield � �' p--9 G14 s Tam Total Depth 515 / Cased to a f3�1 Depth of Grouting Static Water Level 57 Pump Set At Casing Height Above Ground 2' Sanitary Seal on Casing (Y/N) a 5 NO Electrical Wiring in Conduit (Y/N) 4 y Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot C�J� ; On Adjoining Lots / ©0 -%_ To Nearest Edge of Absorption Field on Lot 37 f ; On Adjoining Lots To Nearest Public Sewer Line - t 75 To Nearest Public Sewer / Cleanout/Manhole 1 Do To Nearest Sewer Service Line on Lot 4- 25 Water Sample Collected by N�� ; Date J �r �'-7 Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed &0-�" Size /000 No. of Compartments Z Standpipes (Y/N) �t%� Air -tight Caps (Y/N) Foundation Cleanout (Y/N) 11 0 t5 Depression over Tank (Y/N) �© Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well 1'3Z, To Building Foundation To Property Line 4(o To Disposal Field To Water Main/Service Line 1 To Stream, Pond, Lake, or Major Drainage Course M /0 Comments Page 1 of 2 72-026 (Rev 8/86) Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata © i' I ype of System Design TX. IVU-" Date Installed 3 Length of Field r( Width of Fielder Depth of Field Gravel Bed Thickness Square Feet of Absorption Area II 4ZO Standpipes Present (Y/N) V� Depression over Field (Y/N) !y© Date of Last Adequacy Test Results of Last Adequacy Test ��2E% r-vlz. 3 231217-41 Separation Distance from Absorption Field: To Water -Supply Well "� r To Property Line To Building Foundation To Existing or Abandoned System on - r Lot �i 0; On Adjoining Lots 4- ( �% r i To Water Main/Service Line �Jr To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course f1 To Driveway, Parking Area, or Vehicle Storage Area .-/- i© Comments D. LIFT TION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that have checked, verified, or conformed to all OA and HAA guidelines in effect on the date of this inspection. Signed I nr e Date Company P Y MOA No. Receipt No. Date of Payment 4,- 1=11 ®o°e ° (/ e3 /6�Cj MUNICffiHTY OF ANCHORAGE °°°0 1 °° °° °° °° Amount: $ l ENYIRC JTALSERVICES QIVISION D Page 2 of 2 72-026 (Rev 8/86) Back J U L 21987 RECEIVED rr � . Car y . Mey a °0 353 ®Q cPJ eae ®ROFESSO' i cu %�- W E o-17 c� gra , rcE'�E2 O - UT ,o . 25 W �° . F;QousE is uwo�,P ti �• 4onlSTRuCTJan!} rte= i ta. J 0 -- 1 (� c7 �..,� / 9 r ij5 "�•- off') z33.4� -2 ;�i•1+ +!+•seeeee0�b Fpvrr�` 0,5 -TOM e- •��• � .1AO e00 701U0Y4� .ri i > , Owar."d :- A .; �••� LS - 613 4.k %x •�. LL.c.c�` TWIi Zr R.-ew.•..'1uZTirsi:Ir 1''iJ�� ..tr -, "!{ ti.•.n• LOT SURVEY CERTIFICATION LEGEND: Bross cap Monument o Iron Pipe Lot , Block Area Sq. Ft. a Steel Pin o Survey Hub a rack Piot File No. -"9 --Zoning' District Anchorage Recording District, Alaska REVISIONS DATE oY ��D NC1�11'�NSOflI �OSW�i D- Wh(_CH - L C Residence •�-of: ---tt-------------.------ — CN.t G11 1 :t) {oso e srNetT °I fG/�.l_�•_.-z:/ /��v. 1rt��i �/V------------ N ,nI ANCHORAGE, ALASKA ,ry *N + �,{� �,r► SCUM: t � _ :�:Ul7��V�II_� / il.��L:4a^__ u�id: �J�'Y r. oca~cn: Block: ~ ¥oum~ o Oq Gq '. '73t,0o' '1 ~ 7~z q "/%06_5' ~-~q~ oF- NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS. ALASKA 99709 907-479-3115 25~5 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 907.277.8378 Besse, Epps, & Potts 2220 E. 88th Avenue Anchorage, Alaska 99507 Attn: Andy Ports Date Arrived: 6/29/87 Time Arrived: 1510 Date Sampled: 6/29/87 Time Sampled: 1100 Date Completed: 6/30/87 Parameter Unit Result ADEC MCC* Nitrate-N mg/L 4.4 10 Reported By: Date: _7/01/87_ Carol J. Garrison, Vice-President * MCC = Maximum Contaminant Concentration NORTHERN TESTING LABORATORIES, INC. 600 UNIVERSITY PLAZA WEST, SUITE A FAIRBANKS, ALASKA 99709 907,4~9,3115 2505 FAIRSANKS STREET ANCHORAGE, ALASKA 99503 907-277.8378 Quality Control Report. Client: Besse, Epps, & Potts IDS: A062987-17 Listed below are quality control assurance reference samples with a known concentration prior to analysis. The acceptable limits represent a 95% confidence interval established by the Environmental Protection Agency or by our laboratory through repetitive analyses of the reference sample. The reference samples indicated below were analyzed at the same time as your sample, ensuring the accuracy of your results. Samples Parameter Unit Result Acceptable Limit EPA WS378-6 Nttrate-N mg/L 0.93' 0.84 - 1.02 Reported By: [~~-~m~ Date: 7/01/87 ======================================================== APPLI( NT FILLS OUT UPPER HAA —ONLY Property Owner 1 Phone Mailing. Address Zip Code %� S % % Buyer Date Address Zip Code Lending Institution Inspector Phone Address �G J/ Zip Code Fiel otes:��.,jj��< <9 woo s'A t t �QQQQ NfU1VICIPALITY @ A11[�AAGE w-av � DEPT. OF(AAAEALTH £: Realty Co. & Agent ENV IRO\McNTAL PROTECTION Phone Address Zip Code RECEIVED Legal Description 1 o y 'dex, 3 %O� �SS / 1144 C C IC Street Location ( ) DISAPPROVED Tye of Residence ( ) CONDITIONAL APPROVAL' Single Family DATE ❑ Multiple Family No. of Bedrooms BY: ❑ Other Soils Rating Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. if ❑ Community For wells drilled prior to that date, give well depth (attach log available). ❑ Public Utility Sewer Disposal Individual Year Individual Installed: ❑ Public Utility - When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. b Time Time Time Time _&n Date Date Date Date Inspector Inspector Inspector Inspector�� Fiel otes:��.,jj��< <9 woo s'A t t �QQQQ NfU1VICIPALITY @ A11[�AAGE w-av � DEPT. OF(AAAEALTH £: ENV IRO\McNTAL PROTECTION .� AUG 2 3 a )_0 Ida, RECEIVED () APPROVED BEDROOMS `CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE BY: Soils Rating Date Sew r Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72-023 (3182)