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T15N R1W SEC 30 LT 63 W100'
Onsite File T15N R1W Section 30 Lot 63 W100 ' #051 - 302 - 36 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT OSP191473 Permit Number: PID Number: 051-302-36 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MATTHEW & ANASTASIA HOWELL ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ® Bed ❑ Mound Site Address 19106 MONASTERY DRIVE, EAGLE RIVER ❑ Other Phone Phone f Bedrooms Soil Rating Total depth from original grade 7�� 5 0.7 GPD/SF 2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 63 W100' Fill added above original grade VARIES 2.82 - 2.93 +/- Ft. Gravel length 72 Ft. Township Range Section 15N 1W 30 Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1,080 Ft' Ft. Well 100'+ 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1500 Gal. Surface Water 100'+ 100'+ Material HDPE Number of compartments 2 Lot Line 10'+ 10'+ NA Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks Original system decommissioned per code. MOA filter sand installed at 2-4' from original grade. Alarm location Electrical installed by Installer DIRTWORKS PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspectio V 6/23/20 2nd 6/23/2020 Location and description 3'd 6/24/2020 4" 6/24/2020 TOP OF PILING ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date *: 49TH .....�:*�� % .."•' "'••••••• Septic System Approved r Curtis Huffman - Date 1 19 a0� 1 �¢ �F�; ••• CE 128991 }`s�F�• •1n5/2021..���?„� pROFESSION�--%'. Note: this approval does not include well permit requirements. \\1� tmev uowu iat 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: T15N R1W SEC30 L63 W100’ PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 6/23/2020 DEPTH FEET OG SOILS 1 ORG/OL 2 3 GW-sw 4 BENCH 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 6/23/20 2 min 6” 6” 2 min 6” 6” 2 min 6” 6” 2 min 6” 6” 2 min 6” 6” 2 min 6” 6” PERCOLATION RATE <1 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. 1 GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: NA DATE: NA TESTHOLE # 20-1 DATE PERFORMED: 6/23/2020 2 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: PERCOLATION TEST PERFORMED PER PERMIT CONFIRMED EXISTING SOIL RATING. TH19-1 DRY PERFORMED FOR: MATTHEW HOWELL 6/23/20 10/24/19 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051-302-36 ON-SITE SEPTIC/WELL-PERMIT APPLI'CATIO Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) MATTHEW & ANASTASIA HOWELL- Day phone 9163966352 Mailina address 19106 MONASTERY DRIVE, EAGLE RIVER, AK 99577 Site address 19106 MONASTERY DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd. Block & Lot) T 151 A R I V� S EC 3 Q LT to co Legal description (Township, Range & Section) Lot Size 33,000 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field © Initial © Single Family (SF) (w/wo AD U) Septic Tank ® Upgrade X]Duplex (D) ❑ Holding Tank ElRenewal 1-1Multiple 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. FWCS - Brent Western (Signature of property owner or authorized agent) Permit/Rush Fees: 'T5015 -CO Waiver Fees: _ Date of Payment: to MT01 O Date of Payment: Receipt Number: 03qqoo Receipt Number: Permit No. 02B 14-7 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc aum Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 / Fax 345 -1391 Support Services Brent M. Western 907-440-4601 September 6, 2019 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: NEW SEPTIC SYSTEM PERMIT LEGAL: T15N R1W SEC 30 LOT 63 W 100 Weve been requested to obtain a septic permit on the above referenced to upgrade the existing septic, which will be decommissioned per code. We propose to install one gravity-fed bed to serve the existing residence. The design is based on the recent test holes conducted on September 6, 2019. The slopes are moderate at 0-5% at the proposed septic location. The lot and area are served predominately by private water. The design will not impact any of the neighboring properties. Please contact Brent M. Western or me if you have any questions. Sincerely, Michael N. Anderson, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191473, Rebecca Carroll, 10/24/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191473, Rebecca Carroll, 10/24/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191473, Rebecca Carroll, 10/24/19 Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage, Alaska 99516 Phone 345 -3377 Fax 345 -1391 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: T15N R1W SEC 30 LOT 63 W100 PERFORMED BY: FWCS / MNA - I MIKE N. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 10/1/19 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 5 6 7 8 GW/sw 9 10 11 12 13 BOH 14 15 16 17 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 9/6/19 < 1 min 6 6 6 6 6 6 6 6 6 6 6 6 PERCOLATION RATE <1 (MIN / INCH) TEST RUN BEWTWEEN 3 & 4 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16 TH. GROUND WATER ENCOUNTERED: YES IF YES, AT WHAT DEPTH: 10 DEPTH TO WATER AT MONITORING: 10 DATE: 9/17/19 & 10/22/19 @ 10 TESTHOLE # 19-1 DATE PERFORMED: 9/6/2019 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: SAND FILTER REQUIRED. VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: MATTHEW HOWELL 10/1/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191473, Rebecca Carroll, 10/24/19 «' "'' MUNICIPALITY OF ANCHORAGE :\\ \ On-Site Water&Wastewater Program ..,..o - 'S;, '7; ', PO Box 196650 4700 Elmore Road i Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 \\,...... ) httpa/www.muni.org/onsite Itt' I): l ,ii Inivni 4,,,;,- ;;.,,i. On-Site Water System Permit Permit Number: OSP171147 Effective Date: 7/13/2017 Work Type: Well Initial Expiration Date: 7/13/2018 Tax Code Number: 05130236000 Site Legal Address: T15N R1W SEC 30 LT 63 W100' G:0654 Site Mailing Address: 19106 MONASTERY DR, Eagle River Owner: HOWELL MATTHEW&ANASTASIA Lot Size in Sq Ft: 33000 Design Engineer: Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907)343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: C 1. If home is upgraded to more than 3 bedrooms, septic system will need to be upgraded as well. 2. To close out this permit, please submit the following: a)Well log b) Pump install log c)Water sample results d) Pump decommissioning log for existing well or documentation to demonstrate well is being kept in k/41„, operation. r II IPI, Received By: 1 Date:/11/laC1 3 X /�V gr.2 c 1 7 Issued By: j2dJ / k l SCzzcf� Date: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7• Development Services Division — Fax: 907- On-Site Water & Wastewater Program \,< r ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-302-36-000 Property owner(s) Matthew & Anastasia Howell Day phone 907-7 '4629 r g'cs Mailing address 19106 Monastery Drive, Eagle River, AK 99577 Site address 19106 Monastery Drive, Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) T15N R1 W SEC 30 LOT 63 W100' Legal description (Township, Range & Section) Lot Size 33,000 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial Single Family (SF) p (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 0 Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: t 2 1 5 Waiver Fees: Date of Payment: (o/11a/1"1 Date of Payment: Receipt Number: a.1 Si Receipt Number: Permit No. ose ti i N 1 Waiver No. Permit App_.:- :•: .,c. 'V'-'- ltlarfi Bogiolt Mayor beweiopmemt' $ervices Departmemt Bu[Bdimg Sofefy bivisiom #m-$r$,@ Wmfer & Wssfiewof€r Pragrom 470* Elmore Rood p.o. Bex rru*ffim# ee6o7 (9O7) 343-7eO4 Well Log/r7///r'7 -/ t Permit Number:" #slY- Date of Issu ", il-ilF Parcel Identitication Number: Datc Started z -44/r TtteCompleted: 9/AV7 Is well located at approved permit rocatlonrfi Yes E No Logal Descrlptlon: 7/5ft' 7:/rA .>f)4-' 3 /' z' / 7. 6, Z froperty Ofrer Name & .Addresg: /llrfz Z1V6') a r' 4/L'P52ft5,/rq lH /'t/8"1 C I ?dd'? /t',t //L'4 Y ,/Jr{'/l/&t'r/a i {",+ it/'€A, .€,/< Y' fS'?' 7* s t f*".tv /6 i? &'-lt .+ & t'd, ao/L7 #tr N* ' tt* r' 4-rXtr w ^{-.t s-" RrC #r.uk -Y*:s ey Borehole Data: Soil Typeo Thickness & Water Strata Water Sample Results: Arsenic: Nitrates: Total Coliform Bacteria: Other Bacteria: Depth (f0 From To us.lL - V ms,lL - tL/ _ colonies/l00ml :_-. col/100ml Method of DriltingffLair rotary [ cable tool s-r"ff€c* Wall Thickness: e Z€lhlnches Diamet rr, 6r inches Depth, W feet LinerType: % Dianreter: %thes Depth:3-d# ?eet Casing stickup above groundl ,?|'4 feet Static water level (from groturd level): Z?Lfeet PlryBing level: feet after @trypyv6;X Y hours pumpi ns &, ;Zftp h fi&'tr/'&& *z grt* _r____r_-_e:eE* Bf $trCft(.*RecoveryRate:- Wh no*n-r1ffie" Method of Testing: -#/A WeII Intake Opening Type: H Open End n OpenHole t Screened Start - feet Stopped - feet fl ferforations Start - feet Stopped - feet wft,trH#trffiH,-." Pump size hp Brand Name 6Y 4{;:rs'7 IVeII Disinfected Upon Completion? E[Yes f] No Method of Disinfection: fueryf:7WzryltYq Comments: WelI Driller dc#rilf* wu,e/rr,c.d-(g *,,s#"?$qff "/g/ "FLF- Attention: The well driller shall provide a well log to DSD within 30 days of completion. {5*# Pump Installation Log Arctic Pump & Well Inc . Jim Sullivan PO Box 770197 Eagle River, AK 99577 (907) 688 -2510 (907) 243 -2282 jim@arcticpump.com ops171147 05130236000 7/13/2017 T15N R1W Sec 30 63 w 100 Matthew/Anastasia Howell Wasilla AK 99654 9/25/2017 346 Feet Franklin 10FRD07P4-2W230 3/4 HP 11 Feet S-50 Well Drilling Permit Number: Parcel Identification Number: Date Of Issue: Legal Description Lot: Block: Property Owner Name Address: Pump Installaion Date: Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name Pump Model: Pump Size: Pitless Adapter Burial Depth: Pitless Adapter Manufacturer's Name Pitless Adapter Installer: Well Disinfected Upon Completion? Method of Disinfection: u/k Yes Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. 5Y Wednesday, April 5, 2023 i //e'V--"V".----rij' d �F'3' dP, n 2.0 1 • 7 V _l______---0 Pro posed I L .%Q5------ 1 6 • .r, 10 ,,k\- d .1k) - • a ` GGD)`ti ! " viik ) • G {` / • 111 ,,,.A .. , b \\ el .F8sq fvii S d R° a PIP /inspdfi , f Olt; CQ f ---:-f ,,,, y 4, �.,Tir �c ,,. ,,co VbV 1' te ��`'hiG yz ,4 1 i„, ,es, Gc � A\` \" r. f r i' ( i r LI .___, ____4- -.,/ t(al .r/d9P° ?9' i e7 ASBUILT SEWARD Et ASSOCIATES LAND SURVEYING 694-0829 HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE-' ' �����nqo FOLLOWING DESCRIBED PROPERTY: _ OF A( tkt4 Y- T�.�� i i G�"5�� T/.5'; '":� - DATE- s '� ''':get, t, AND THAT NO ENCROACHMENTS EXIST EXCEPT AS 4--��- '�. '-.'I INDICATED. IT IS THE RESPONSIBILITY OF THE v ,• ; u 10 OWNER TO DETERMINE THE EXISTENCE OF ANY GRID0 EASEMENTS, COVENANTS, OR RESTRICTIONS —� frire,"`",..;..Pie''' � . '�'`. 0WHICH DO NOT APP> AR ON THE RECORDED SUBDI- # DuCr S6.r+rd ..k 0 VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FS: ¢#t, f.s- c'/ ANY DATA HEREON BE USED FOR CONSTRUCTION /�.- �° s 4. OF FENCE LINES, OR FOR ESTABLISHING BOUND— DRAWN, '1h0.�"'rslrtu�l.- -' ARY LINES. ...,--1..-s---25-- 1L �"'* _..r � Y.a..fr. GAAB-HD-1 GIVER ANCHORAGE AREA BORO H HEALTH DEPARTMENT 327 EA LE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ''- • MAILING , 6.A'4e..,325:—Cot:, 6''�`�— NAMFL S. d .s�7'/}96/fC ADDRESS G�.e-" �3S' 6/1-it(--. PHONEx-25 d LOCATION/ //�3 �r - y LEGAL DESCRIPTION., A _..,,-„,7_,..1." sCC'. Ald T' '' t f/. SEPTIC TANK: � / NUMBER OF / DISTANCE FROM WELL / MATERIAL S, L COMPARTMENTS CrTE-Z/ '% GARB-HD-2 , . GREATE,ANCHORAGE AREA OOROUGH Case No. / 0c7,3 HEALTH DEPARTMENT (Dia'2Q i 327 Eagle St. Anchorage, Alaska 99501 279-2511 ,i,r(,:), f, SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT 0;4/4.1/"PHONE I ,� ,. C- —2/ 145- NAME OF APPLICANT i"--- Air .moi/ ./ 1 • - - MAILING ADDRESSt'��!!' y3s-sic Cr/4� PHONE NO. RESIDENCE ADDRESS 44 17,1,j 46-4---1-- LOCATION OF INSTALLATION LEGAL DESCRIPTION ‘0/00 I hof •' St-e, o , 7c , /t', /(/W c,>1-4-- - APPLICATION TO INSTALL: SEPTIC TANK 4_—/ ,,, SEEPAGE PIT �-' , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY ) ``t77L ``,, . FINA,NCED THROUGH l TO BE INSTALLED BY1ft`e4-W�1 1� N YC.-- TEST RESULTSu /At 1 ' , ANTICIPATED DATE OF COMPLETION -1'2VA 1. /7Z14-( f BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE ASf/ . x&-isf'ae-t-‘ `' t , PERMIT TO INSTALL A =�' • t ' G� AS DESCRIBED BELOW, SIZE O -UNIT TO BE SERVED " �`� ��` - ' 144 . SEPTIC TANK SIZE / ( r TYPE --W" .( SEEPAGE AREA y4i,-0(,c" TYPE -� DIAGRAM OF SYSTEM DISTANC (1)1,"1"1-44"4411.--) _ _A . , i42 ' - LiAl- 1 / i - cc. �r� _tis2-- ,." ,_ ( ot . . . , , Ccd-Li-171/14".--41 `T.' Iti\tii I - -(...<1 (LA. r4-41 , 1e i_i__ �u��- �1; 1 _ r '.). * ffi t # - Y,, , , I HEALTH AUTHORITY OR - - - LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and t at the above described system is in accordance with said code. TG77fe P d 4/// r 97/C- r J 7 / DATE ?/2-/ G APPLICANTS SIGNATURE _ :� �J & *GREATER ANCHORAGE AREA BOROUGH. HEALTH DEPARTMENT CASE 4 327 EAGLE STREET ANCHORAGE, ALASKA 99501 . Performed For_/ts Jer Icr^Pzeifi/�utp Date Performed 02,3 iu f` 7t` Legal Description: Lot `Q,3 Block Sub division sir N7'j5Jy _�T/ This Form Reports a: Soils Log, L____ -Pe Test Depth Feet Soil Characteristics Location Sketci The S'eli m en fr were ' 1 i II 1..._ /2cZi4' ez m p€ /Pct 41 i 744 r a /oro rrwo iju re c:on}eni I 111 3— ± ia1- 1 ME g__.1 ' , 1 64„) 1110 NM ■ 1_ i I1fl q billi 11111i=1I:i!JII � -_1 MIn Immo Was Ground Water Encountered? Az '''' / 111111111111111 ` __ Ila - III " MOM If Yes, At What Depth .11111 1111111111111111 1111111111111111111 - 11111111111111111 P.eading Date Gross Time Net Time Depth To H2O Net Drop __ r I __y •--- i erco a ion nate 1" . f minute Proposed Installation- ep it Depth Of Inlet ,� �3 L., Drain Field COMMENTS: i pth To Bottom Of Pit Or Trench /V , � Test Performed By: &r€cil Data Certified By: - ® - .0, Date �az? _ Al yc zo A----r---/ ,-.75:44x/I 'I-, t-tx.ii-1-01 tt 7;46ti _.4_,..) 1x a0° sem' well well 0 well O T/L FORD (454 zac Q c 13° I sc f,t ic? L 0'4,8 --Lo 7r 63 --z ,_�✓ Iwell 1__—_I mel! w 66 �) 1 ,.,.>:_______ LA/ B _ I ffi ,eEs� Y EA./GCAA/ N--1 130 i ...f, Vat1 5 TE RV ! OR/vE g4, c;sec 30 Eos r a30 . o o43 4/4 A./C E �.4,., � wel/ ��� ° OF 4;41116 ':(I. 9TH •4 �3 AS-BUILT WELLS f` SEPTICS Sec%or7.34, T/SN, � '/W, S.M A/est r 4. c� James O. Rodgersi. (Jua . `Pf�.•••a - 1V- 4367s : 4� / CIF 0 ' •.• .....;)%,i JAMES B. RODGERS • k }.£ ..N,,Ay\ ,Q, Registered Land Surveyor "'' PO 8 0x 6577 Anchorage,A/ask a 99502 (907)345-0927 Date 1 Scale Dawn. by F.B. Grid Sheet 9-Il-8S l''IVD' i.1.. .SA? 85A 1 A/Gf1654 1 of / Gdi. .HD' GREATER ANCHORAGE AREA BOROUGH -• HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ."�A'4'�5 S Z NAMF�- �i.'E� �r-',n Tii1-D!-.,_1. - ADDRESS G-5/4"G//f. /55e- PHONE.7/-2J LOCATION .' / j . Y LEGAL DESCRIPTION, -_ r� '! ? .i MO II SEPTIC TANK: 7-. 40 ar CP..1",,,., / / Q MATERIAL/ %G��- NUMBEROF DISTANCE FROM WELL COMPARTMENTS C-57`. --&-2.-,/ ./Fger G./..e-i46/4,/,-._„2,d)LIQUID LIQUID CAPACITY ,G CTG' GALLONS. INSIDE LENGTH `-'-INSIDE WIDTH t-- DEPTH 4-- SEEPAGE rSEEPAGE SYSTEM: SEEPAGE PIT: r � - i NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH •� , LENGTH ��.S DEPTH G LINING MATERIAL GC. . DISTANCE FROM WELL �.�� / BUILDING FOUNDATION""2�' ' NEAREST LOT LINE /f� '- , TOTAL EFFECTIVE ABSORPTION AREA [WALL AREA; SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELL , FaUNDATION , NEAREST LOT L ► - , OF LINES , NUMBER OF LI " DISTANCE :ETWEEN LINES TRENCH WIDTH IN. TOTAL VE ABSORP •N AREA SQ. F LENGTH OF E. - LINE DE- H: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN, ABOVE TILE WELL: TYPE ./-"---- DEPTH -#6 / ,BUILD NG FOUNDATION. 577 / SAMPLE �G , NEAREST NEAREST ,, - SEPTIC ,,, I SEEPAGE OTHER LOT NE ./6 /7 SEWER LINE TANK �� , SYSTEM ��U , CESSPOOL SOURCES e____e____LI • DIAGRAM OF SYtTEM DISTANCES! 9- /-5-7--//0 (�. \ 0_ \. Noa t3 (Id' ''' ')% : 1 \' C5- gl '""C_, ....-\\Nm '' IV P) —� •.7 • '� I G c_- /927 � / DATE / APPROVED HEALTH AUTHORITY MUNICIPALITY OF ANCHORAGE Development Services Department - T Phone: 907-3437904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-302-36-000 Legal description T15N R1 W SEC 30 LT 63 W100' Expiration Date: 8/25/2023 Site address 19106 MONASTERY DR Eagle River AK 99577 Current property owner(s) HOWELL MATTHEW & ANASTASIA X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory X Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approvdjune 2022 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-302-36 Complete legal description T15N, R1 W, Section 30, Lot 63 W100' Location (site address) 19106 Monastery Drive, Eagle River, AK 99577 Current property owners) Matthew & Anastasia Howell 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS Day phone (915) 396-6325 3. TYPE OF WATER SUPPLY: FE -1 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age 3 yrs - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS 0 Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $./ Waiver Fee $ Date of Payment S�SfZ 3 Date of Payment COSA # D.SG 2 3 If 4 1l Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: North Well T15N, R1W, Section 30, Lot 63 W100' 051-302-36 ** 0.15 9-2-2017 364 1500 44*■ 0.291 24+ 5/4/2023 Crewdson Engineering 24 5/4/2023 *PVC liner to 320 ft, South and North wells both feed into the house storage tank. 67" 7-20-2022 6-24-2020 5.3 4.8 No 5/4/2023 0 750+ 0 180 0 750+ 6 0 6 ■ COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date North Well Crewdson Engineering, LLC James Crewdson 5-17-2023 South well information is on a separate COSA Checklist. 907-280-9493 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: South Well T15N, R1W, Section 30, Lot 63 W100'051-302-36 *** 0.1 unknown*46**1500 unknown ■ 24+ 5/4/2023 Crewdson Engineering Static water level at beginning of test 26 ft. 5/4/2023 *before 8-25-1970, **per Inspection Report, ***South and North wells both feed into house storage tank Septic system information is on the COSA Checklist for the North well. COSA Checklist_June 2022 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Phone Engineer’s Printed Name Date South Well Crewdson Engineering, LLC James Crewdson 5/17/2023 Septic system information is on the COSA Checklist for the North well. 907-280-9493 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Well Water Advisory Certificate of On -Site Systems Approval # OSC231144 Subdivision: T15N R1W, Section: 30, Lot: 63 W100' These well's (south well and north well) productivity was determined to be .1 and .15 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 5 -bedroom residence is .52 gallons per minute or 150 gallons per day per bedroom. Although the well production does not meet this requirement, water storage has been provided to meet minimum code requirements. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval.