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HomeMy WebLinkAboutSUNSET HILLS BLK B LT 85unse Hill Block B Lot 8 #018-201-33 ° Municipality of Anchorage o,_-:._- ' Development Services Department~=:" ' -:-'% Building Safety Division On-Site Water & Wastewater Program, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 '~ www.cl.anchorage.ak, us (907) 343-7904 Page 1 of ' On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number:. SW000506 PID Number:. 018--201--5:3 Name: MAURICE CLOUSER Wastewater System: D New ' · Upgrade Addreas: 1~1oo SPECKIN~ AYe. * ANCHO~¢E, AK 99515 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 348-8818 4 I'1 Deep Trench [] Shallow Trench · Bed []Mound []Other LEGAL DESCRIPTION '~ "~: 0.8 o~D,,s~. ILo[: Block: Subdivt,ion: I~ to ~pe bottom from original grade: 8 B SUNSET HILLS 1.20-2.59 ITowneh;p: Range: Section: Fll o44ed obov~ M~lno! ,grade: - - - 0.38-1.04 'WELL: [] New [] Upgrade 14 =k~eh'*~:~:~,~on (Private, A,B.C): Total ~ CMed To: TMal obeor/)~on ~: pipe motiM: / 756 PVCS'CH40/ F-810 ~ DENALI SEWER 4/25/01 o~ ~ ~ TANK SEPARATION DISTANCES ~ s..tio •,aiding To Septic AbeF~er{~dtion lift Holding Publlc/Prl~t~ U~nufoct, nm r~om Tank S~oUon Tank S,,,- U,. ANCHORAGE TANK 1500 . we~ 100'+ 100'+ - - 25% STEEL 2 Su,a~. wet.. ~0o', ~0c~'+ - - - LIFT STATION Lot Une 5'4- ~1'+ -- s~z, In ~ I - - 1500 ANCHORAGE TANK Foundation 5'4- 10% - - - '~'~" ~''42"k~ o~ II'n~ ~'42"~'~ 0~,I~h '~' ~6E Curtain Dro~n N( iNE KNOW~I ' 20 051 M.O.A. R~a~: *LOT UNE W~VER #WROOm10 BENCH MARK GROUND WATER MUST BE MONITORED PRIOR TO TOP OF MANHOLE HOOKING UP OLD SEEPAGE PIT TO S.T.E.P. TANK. OLD CONCRETE SEPTIC TANK WAS ABANDONED IN 99.77 PLACE ~ ....... ~ ", ............ Department of I-Ioalt~.~=n d ~n~ ~_~e, approYa~ ! O~*~'~ll~o,.'t"".,~[-~ ? o'3~.......}/,~ ~ ~,~,~ R(~viewed and approved by~ Dote: ~//7/~ ' · ,~ ~'~-- Pr. RUff NUMB£R: AS BU]A./T D~I~~G PARCEL ID NUMBER: SWO00506 - 018-201 ~/~:"_.... . . ~ ................................. ~z?oo, ~_ ~Je~fh; A. Oomess/ ~,, ..~. .......... · ;L!;~ ALASKA ;VATER & ~VASTE~VATER c.J.O. ~ CONSULTANTS, INC., ..... ~: PREP~ FOR: PHONE NUMBS: PAGE NUMBER: MAURICE CLOUSER (907) 548-8818 2 OF ~ D~CRI~ON: SUNSET HIL~ SUBDIVISION; LOT 8, BLOCK B. ~E OF WORK: AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ,. -.---A B ST1 51.6 63.1 ST2 60.0 69.3 MH 61.6 70.3 MT1 69.0 96.8 MT2 80.7 105,7 MT3 88,1 81.4 MT4 78,9 70,5 SW000506 018-201 _--::_7-- / 98~-99,27 I ORIOI~ G~E~ I I ~CH i g5.62 IE OF PiPE ~~ ...................... 5/5/2001 ~SI~ WATER & WASTEWATER -- CONSULTANTS, INC. PREP~ FOR: ~8-~18 P~[ NUMBS: MAURICE CLOUSER (gO7) 348-8818 3 OF 3 SUNSET HILLS SUBDIVISION; LOT 8, 8LOCK B, ~E OF WORK: PROFILE AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ~.' SPARROW3 ELE A~D~$$: 14100 3PF. L2~qG LOT:. g BLOC~: B PERM1F ~' DAY'E: $~IBDMYlION: SUNSET 01-770fl [-] D~ not~on~sluntll r~.insp¢~ea_. C.C.O. approv~ (~ommmts below). [-] 5itr/offsi~ ' ~Seh/notbein~controllcd D Instsll/corr~nr~balcs. I00~ ,LL.~.tYS DNI(I'IIQR iii9 gtc /.06 XY..I 0I:0! lO0l/£O/!IO MUNICIPALITY OF ANCHORAGE Building Safety Division MEMORANDUM DATE: March 11, 2003 TO: File of Subset Hills Subd. Block B Lot 8 FROM: Dan Roth Engineer II, On-Site Water Wastewater Program SUB J: Abandonment of the existing seepage pit The program Manager of the On-Site Services Program has given authorization to approve the subject as-built inspection report without the requirement by authority of the U.P.C. to permanently abandone the seepage pit that exists on the subject property. The seepage pit shall not be used again in the future without groundwater monitoring. Justification for not permanently abandoning the seepage pit is the rings in the pit are concrete and not subject to decaying and possible caving in at some future date. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box Ig6650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Dec 28, 2000 Expiration Date: Dec 28, 2001 Permit Number: SW000506 Legal Description:~rS~J~lS .E'~..HILLS BLK'i'B LT ".8 .".i" Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: MAURICE CLOUSER Owner Address: 14100 SPECKING AVE ANCHORAGE, AK 99515-4123 Parcel ID: 018-201-33 Site Address: 014100 SPECKING AVE Lot Size: 15500 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] D sposal Field [] SepticTank [] 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: Issued By: Date: MUNICIPALITY OF ANCHORAGE OI8 Department of Health & Human Services On-Site Sewer/Well Permit Application SINGLE FAMILY DWELLING Parcel Identification Number NOTE: Application must be filled e~t completely Property Owner Name Mailing Address. I/-J'loO Legal Description Lot ~'LOd $~"~ Day Phone ~ -- R~I ~ ~Je, J~4~o¢,'~t, ~1~. Zip Code ~'1 ~1,~' % Lot Size /-~,J~'~AcreG Number of Bedrooms ~_ .~r . Inspections will be conducted by: CApproved Engineering Firm [] Municipality (pe~'mit fee included) Does your house contain any of the following: [] Hot Tub [-1 Swimming P0ol [] Therapy Pool [] Jacuzzi This application is for: Range [] Water Softener Unit [] Sewer Only [] Sewer and Well l~Sewer Upgrade [] Well Only [] Water Storage II certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and in accordance with applicable Municipal Codes. ............. Waiver Fees: } ..~1 f' 72-012 (Rev. 4/98? } t /i /oo 'ALAS'i - WATER Fo- WASTEWATER December 7, 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: Septic System Upgrade Design for Lot 8, Block B, Sunset Hills Subdivision To xvhom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system consists of a 1963 concrete septic tank and a seepage pit type drainfield. The existing drainfield is in need of an upgrade. A test hole was excavated northwest of the existing septic system. The proposed septic upgrade will be designed around the 30 foot radius of this test hole. We are proposing that a new 1500 gallon S.T.E.P. tank and 2 five foot wide drainfields be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached log xvhich shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that the insitu sandy soils should act as a sand filter and an application rate of 0.8 gallons/day/ft2 should be used for a bed system. 2. TRENCII DESIGN: a. Percolation Rate: <1 minutes/inch b. Allowable Application Rate: 0.8 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 750 tt2 f. Total Depth: 3.5 feet (maximum - at any point) g. Effective Depth: 0.5 feet h. Width: 15 feet i. Reduction Factor: N/A i. Minimum Length: 50 feet total length j Effective absorption area = 750 112 Note: this is a pressurized system. The distribution lines are to 1-1/4 inch schedule 40 PVC pipe xvith 1/8 inch diameter holes spaced every 2 feet on center. There is to be 12 holes per lateral with a total of 72 in the entire system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: ak~ve.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPIIY: The entire lot is generally flat; in short, there are no slope concerns. 5. LOT LINE WAIVER: We would like to request that your department issue a property line waiver on the subject property for separation between the drainfield and the northwestern property line at one (1) foot. There are no wells, septics, or water lines that have been encroached upon. We do not anticipate any adverse effects by this waiver. We are una~vare of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 33%6179. Thank you for your assistance. ~ P.E., M.S. Presi NOTE: Attached is a site plan drawing, a design draw#tg, a two page soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com ~ ' CONSULTANTS, INC., ..... MAURICE CLOUSER (907) 348-8818 1 SUNS~ HIL~ SUBDIVISION; LOT 8, BLOCK B, ~',~ '..-~ .' ~E OF WORK: SITE P~N OF SEPTIC SYSTEM UPGRADE \\, /11 . ~ / ' PROPOSED PR~SURIZED ~I~NO S~C ~Sl~ ~TER & ~ASTE~ATER x.o.w. ....... ~o~~.,~.~ ... .: .... ~...........~ ~ D~CRI~ON: SUNSET HIL~ SUBDIVISION; LOT 8, BLOCK B ~. '- ........... '~ DESIGN OF SEPTIC SYSTEM UPGRADE II/~' ~~ ~ / I-,/~" ~0~1/~ ~ ~--- I ~ ~ J I I I I I I I I I I I ' VIEW Mf Mf .............. D~ ~: .. * *' . PR[P~ED FOR: PHONE NUMBER: ~',. ..:...z.~ MAURICE CLOUSER (907) 54B-88i8 5 OF ~ ~,~ ~]/k.~rnes~: ~ ~ .~cR~o.: vo~"-J ~E~95~ ..' :~ SUNSET HIL~ SUBDIVISION; LOT B, BLOCK B ~_'~'.,~-~ .." ~ PROFILE DESIGN OF SEPTIC SYSTEM UPGRADE -~~ ALASKA WATER & WASTEWATER CONSULTANTS, INC..~.~.,'~'~.0.'~... b~ ,~9o,~ D~:~R .~. s,.,,,~ ~.~ · ~c.o~:. ,,,x. 99.~o,,,.~./",t-~ ~'~' i, ':~I~0 ,,o,c (90,) ~,,-~,,9 · ~,~ ~o,~ ~-=,~ ...-' r'/. ~'-.~ LEGAL DESCRIPTION: SUNS~ HIL~ S/D; LOT 8, BLOCK B, ' .... PERFORMED FOR: ~URICE CLOUSER ~" ~'..t '.-+...j.~. __:'""'~ DATE PERFORMED: 11129/00 ~z~'...' ~r-7953 ~E~ ~ fl~ PAGE I OF 2 IIIIIIIIII ~ML SOIL C~SSIFICATIONS I~ 2 ' OM CL X SH OH ,, ,, t sc ~~'~ ~~X _,,,,,.,..,,,,,.,,,. . .. ~lllllllJl  ~ GROUNDWATER " ' 7,5' SEEp ~11/29/00 x,'~ LO~, ~L~K 1 l~ll~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MIN~ES) READING (INCHES) 12 1/30/00 1 SM/ML 2 5 O" 6' 13 3 4 5 O" 6' 14 .... 5 6' 6 5 O" 6' 15 16 17 18 19 PERCO~TION RATE <1 (MIN./INCH) PERC. HOLE DIA, 6" (INCHES) 20 TEST RUN BETWEEN 3.0 FT. AND 3.5 FT. COMMENTS: PERC-HOLE W~ PRE-SOAKED FOR 4+ HOURS. THE INS~ ~NDY SOI~ SHOUL ACT ~ A SAND RLTER. PERFORMED BY A~S~ WATER & W~ATER I, JEF~ A. GARNESS, CER~ THAT THIS W~S ~RFORMED IN ACCORDANCE WI~ ALL ~ATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE 7.5' SEEP 11/29/,00 S.5' 11/30/00 9.4' 12/7/00 ALASKA WATER & WASTEWATER CONSULTANTS, INC. ' -~'~"~-~'~ I SOiL LOG - PERCO~TION TEST J ?' LEGAL DESCRIPTION: SUNS~ HIL~ S/D; LOT 8, BLOCK B, ~'~[:'"~"~ ...... :'~' PERFORMED FOR: ~AURICE CLOUSER ...... '~,~' Je~fr~ A. ~nes~ ~TE ~ER~ORU~D: ~/~/00 ~0~ '? TEST HOLE ~ ~, 1- PAOE 2 OF 2 '~~ I ~_ SO~L C~SS,F~CAT,ONS ! I ~ ow ~ -- ~ GC OL ~-_ .... ' sP , CH SEE SITE PLAN - ~ sc ~G~ I OF I Z SROUNDWATER 8-- 0 z o~~ 9-- 0 ~o- ~ 11-- ~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP ~ TIME (MIN~ES) READING (INCHES)  ~ 11/~0/00 1 12 ~ 2 2 O" 6" 1~ ~ ~ 6" / ~ 4 2 O" 6" 0 / 16-- 19-- PERCO~TION ~TE <1 (HIN./INCH) PERC. HOLE DIA. 6' (INCHES) 20 ~ ~ TEST RUN BETWEEN 4.5 FT. AND 5.0 COHHENTS: PERC-HOLE W~ PRE-SOAKED FOR 4+ HOURS PERFORMED BY A~ WA~R ~ W~ATER I, dEFFR~ A. GARNES, CER~ THAT THIS W~]P~FORMED IN ACCORDANCE WITH ~L ~ATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO DATE SROUNDWATER Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-79O4 Waiver Review Worksheet WR#: 000110 PID#: 018-201-33 HA#: Permit~: SW000506 Date Received: 12/19100 Legal Description: SUNSET HILLS SUBDIVISION LOT 8 BLOCK B Engineer:. ALASKA WATER & WASTEWATER CONSULTANTS~ INC. 6901 DeBARR ROAD~ SUITE 2B~ ANCHORAGEr AK 99504 Applicant: MAURICE CLOUSER Waiver Requested: ONE FOOT FROM THE PROPOSED ABSORPTION FIELD TO THE NORTHWEST PROPERTY UNE Criteria: Points: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: X Waiver is not Granted: ListConditionsorReasonsforabove: .~EE E/d~I/VEfR '~ Name of Reviewer Rec~: 0152 Amount: 115.00 Date Paid: 12/19/00 Municipality of Anchorage ' Building S,'dEty Division .Public Works P.O. l~)x 196650 · 4700 S. Bragaw Street Anchorage, Alaska 99519-6650 · (907) htt l~://www.cl.anchon~gc.uk.us 12128/00 Alaska Water & Wastewater Consustants, Inc. 6901 DeBarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Sunset Hills Subdivision Lot 8 Block B Waiver Request #WR000110 Parcel ID #018-201-33 Permit number SW000506 Dear Mr. Gamess: Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to properly line has been approved. The approved separation distance is 1.0 foot. This waiver approval applies to the existing on-site wastewaterdisposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On-Site Water & Wastewater Program HEALTH ALITHOEUt'Y APPROVAL I~,IDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYST[M PART I.--.TO BE COMPLETED BY FHA INSURINg.- OFFICE MORTGAGEE . MORTGAGOR OR SPONSOR PROPERTY ADDRESS _su'D'v's'cz / ,/,4,'/6 TOTALj NUMBER: [] BASEMENT / ~ / Yes WATER SUPPLY B¥~ [] Public system {~New installation E]Cmnmunity system SERIAL NO. i BLOCK NO. 1 LOT NO. additional bodrooms? [ ~ (If Xes, how many~) Yes 7]No ~ [~ Individual SYSTEM DESIGNED FOR SEWAGE DISPOSAL BY~ system ~j Community system J~] Individual · .°.n..°.T .'L Tn- _ac_ C_n~pL_eT_e_n .u.y .u.__..n. LT.U' _n__..m.~..O.T~__..~.,T KETCH ,inio. of the [] State [] County [] Local Department of Health that this individual water-supply system [] is not satisfactory as a domestic water supply for the subject property. opinion of the ~] State [] County [] Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~_~1 Can be expected to function satisfactorily, and ~ Cannot be expected to function satisfactorily _ is not li~ly to crease au insanitary condidon .............. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that'the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ~[~CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 Rev. July 1958 '~aaj 0 ~,/ '~u!su~ jo q~daQ Ja gta jo Xlddns alunbap~ t[smJnj m ~!u!0!a alu!patuus! u} SllaaX jo aJnlleJ jo plo>as lua0aa ssou~ o^[D 'pooqaoqqT?u u! XJ*tuolsn) sou ale [] ale ]~ SllaaX Ignp!a!puI ~ I~ 'sag>u! 'u!utu jo az!g 'saaj-- 'u[utu Jalwa 0}lqnd asaYuau os a~ums!G Wt/SAS XlddrtS'tlllVM IvrlaIAIQNI~NOI/3ldSNI .10/i]Odat] 'saq~u! uaaj-- uaaj - 1vnalAIQNI~NOIIDIdSNI dO 11JOd{~l MEMORANDUM TO. FHA PENDING FILE DATE 4 October 1963 ~'~OM r.m.a, san~l~Jlion s~c. SUBJECT_ Lot 8. Block B Sunset Hills Subdivision Approval[ letter hand carried by Mr. ~alvin Winey October 4, 1963. 1 co~y of perc test data retained in file. HOME OFFICE ~'L3-1779 Perco].ation Yest Test Location: Lot ~ Block ~ Test Bole Log 15' Sub d. FAIRE~ANKe OFFICE .HON. ~!b~ll60 6~g~ ~eat Hole Location Filled with ].st. Filling: Bottom of hole to drain out. 2nd. Filling: Bottom of hole Il approximate slope water and allowed filled with ~"~ of water and test run. Percolation Rate: ~-~ ~ min./in. These results are only the visual soil conditions and theoretical percolation rate on this date for this test hole, GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. APPROVAL REQUESTED BY: ADDRESS: FOR PHONE: , , } } /'~1~ ''~' TYPE FACILITY TO BE INSPECTED' C'/t(//¢c/i STREET, NUMBER OF BEDROOMS: WELL DATA: ^. B. DEPTH Co D. E. SEWAGE S I Z E /F/'" CON=RD:ION BACTERIAL ANALYSIS DISPOSAL SYSTEM: 2. AGE / 3. MANUFACTURER DIAGRAM ON BACK) 4. INSTALLER APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO B o SEEPAGE PIT 1. SIZE 2. LINING C. DISPOSAL FIELD 1. NUMBER OF LINES 2, TOTAL LENGTH REQUIRED MEASUREMENTS A. WELL TO SEPTIC TANK B. WELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. WELL TO PROPERTY LINE '?~ ~ E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT ~- H. SEEPAGE PIT TO PROPERTY LINE COMMENTS: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Gerald T. Goat'd Auchoc~ge. Alaska The percolaglon gaak for. l,og 8, Blo~k ~ewag~ diopoaal (;yatem const~ging of an adequately ~ized aeptic tank and an 8' x 13' x 6~ log ~apaga p~t surro~,~d~d by ~wo f~at of {.~ood [~r~da l~ravel ~o gha i:op of ~htl lo8 DAVXD R0 L. DUNCAN, M,D. DHP~roa • Municipality of Anchorage °r V On -Site Water and Wastewater Program (907)343-7904 sA F ErY Certificate of On -Site Systems Approval Parcel I.D. 018-201-33 1. GENERAL INFORMATION: Expiration Date: _ / 2 v i-2_ Complete legal description SUNSET HILLS; BLOCK B, LOT 8 Location (site address) 14100 Specking Ave. *Anchorage 99515 Current Property owner(s) Clouser Clarice's Family Trust Day phone 242-1308 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for. Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5,50 Waiver Fee $ Date of Payment 3/� �i `� Date of Payment Receipt Number 0 6 33 6 Receipt Number COSA # o S c a a 1_0g9 Waiver # 4�_P? 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: Gamess Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507 Engineer's Printed Name: JeffrevA. Garness Date: �I10/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 sepfic 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 whatsoever. #AECC884 6. DSD SIGNATURE ``-\ LITY pF System #1 Approved for bedrooms p,�,�i/� System #2 Approved for J Disapproved Conditional approval for bedrooms �r -wq 0 r�RgN _ bedrooms, with the foil" Stowk6hipi rFR m J� � JJ��J1ll1lllC �\\�;� Y Original Certificate Date: 3-i� zozZ 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other-Li—&—i S�C_ ie LL Legal Description: SUNSET HILLS; BLOCK B, LOT 8 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled '900) Total depth *118.5+ ft Cased to UNKNOWN ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in Date of flow test for COSA 2/24/22 Static water leve! at beginning of test 93.0 ft. Comments *PER GEG INSPECTION - B. TANK DATA Age of tank(s) 21 years Tank type/material Measured operating fluid level in septic tank 50'(ST,) ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/26/21 D. ABSORPTION FIELD DATA BED Which system tested (date installed) 4/24/01 ❑ ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field no 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 N/A gallons r t < Parcel ID: 018-201-33 Structure served by this system Well production at time of test 5.3+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ® No Coliform bacteria is Negative Nitrateo .0-mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L &R.Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 2/2PJ22 C. LIFT STATION Al Required maintenance completed Age of lift station 21 years Lift station material STEEL Comments: Adequacy test date 2/24/22 Results [✓ Pass For 4 bedrooms Fluid depth prior to test 1 in Water added 681 ga! New depth 3 in Elapsed time 150 min Final fluid depth 1.5 in Absorption rate 600+ gpd Any rejuvenation treatment (past 12 months) NONE If yes, enter date N/A Comments/Deficiencies: 'SOUTH MTS ARE SET CORRECTLY •NORTH MTS ARE NONFUNCTIONAL COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) I of fn- 4PIAnSLm ontpr Septic Tank/Lift Station on Lot > 100' tacc th n rannirari) Building Foundation > 10' Community Sewer Manhole/Cleanout > 100' if No Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'21 Yes if No ft Absorption Field on Lot > 100' Yes if No It Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50'[]✓. Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100'❑✓ Community Sewer Main > 75' Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' QQ Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'C]✓ Yes if No ft Private Wells > 100' R Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' Q Yes if No ft If septic tank is under driveway comment below Frnm Ahcnrntinn FIPid an I of fn- 4PIAnSLm ontpr dict nr•cc if tacc th n rannirari) Building Foundation > 10' Yes if No ft If absorptiory field is under driveway comment below Property Line > 10' ❑ Yes if No *1'+ ft Wells on Adjacent Lots: Water Main > 10' Q✓ 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 ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS *WR#000110 G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF��po r,,, -„l— :.. . O 9� CE -793 ��ea pro f e s sio�' #AECC884 4��00000� e 4 Gitrr 8C01 z tlStation/Pump Vault Maintenance Log Cwner.J�Ifc'c' V4tob .{4 - Legal Deso,_ PjD____ Sludge levet inches Pumping: required *Pumping completed ift Mian: -rump basket oleaner '�YjZa�� L'M -Effluent filter cls, anp-d 10 7 ro. 1 -Contral boats cleaner eyp Il2 *Proper f1f)aL settings confirmed ria -Operation satlsfactoq QILI!5_nC ,Dedicated electr;cal a arm circuit. e Y-ea—ao -Audible and visual alarm. inside dwelling Y_C!'3" na -Alarm system opeeratti m -Ground water intrusio i at riser -1.0 tank connecti'on y -w. -Grourid waer intrusio -, Oro und`ipe perletrafions 4 mac' Weep hole, functional, -Vianhole fid: Functu,nai tyes, no InstAlated Propariysecured v i', .AHI rnamrfiacturer requii-ed inspections and maintenance- completed _C_0ZIIWM= technician Company Signature I *11;� _L_'k�c � n Date of maintenance J " — -1 ' DEVELOPMENT SERVICES DEPARTMENT On -Site Water and Wastewater Section www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221084 Subdivision: Sunset Hills Blk B lot 8 907-343-7904 Fax: 343-7997 Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for this COSA / property is 21 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank. Ma�lmg Address P O Box 196650 *Anchorage, Alaska1995196650 *www muni org