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Home My WebLink AboutHAWKINSON LT 1Onsite File Hawkinson Lot 1 #015-235-04 foi /7n/Cn nasal - a -sluawaa!nba.i 1!wjad Ilam apnlou! jou slop lenoidde s!ql :GION Akl-��f%` panoaddy �- :.... •. >�. walsAS olldaS 'N 13`yE4J[LV • C3� f?� . ,..a.00aooa°°.oc •o..o..F� <<•e000000000�a•oe� 617. e r °,� ,�� a;ea :lenoiddV leuoll!puoO `0`e• •• ° o 0 0 0 • °� � � ,av -lVAO?lddVN01103S 2131VM31SVM aNid U3iVM 311S -NO S � S 3 S) yjb wE V V�JV EJ uo!;duosep pue uo!;e0o-I 8 b/ZZ/9 PUZ 81,4Z/9 ,:6 uo;oadsul ad t76 (uo!;enala pawnssy) NUVW HON38 '3Fd `NOS2j3aNV N �INIA jo;oadsul bE0£lwro0 tcoc PlaauleJo '3'd `N0S�IDONV N 3INIW veoc PI !Julep t COC glue; o; esnoH -lVIU31VW 3dld Jallelsul 11W2:13d `dOW �DNVd �:101d31Nl S-1I0S 2]31139 Cq palle;su! 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Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: HAWKINSON LOT 1 PID No.: 015-235-04 M RK A B C 01 47 25 0232 56 C01 32 58 / CO2, i 30 63 T1 90 95 T2 i 110 107 I I I BENCH, G RAGES B ELL I I 1 \ CO1 \ B / i 1CO 1 CO- •, TCO2 I #1 DRIVEWAY DRIVEWAY I /�/ • // MT� /UT -r NEW 1500 GALLON STEEL STEP TANK ASBUILT SCALE: 1"=50' N.T.S. OG DF R ff 49 TH DRY, MAY 2018 ;MICHAEL N. ANDERSON; tZA No. CE 9469 •.•4-6-20 • AV ............... ESS ��.� / i I I I BENCH, G RAGES B ELL I I 1 \ CO1 \ B / i 1CO 1 CO- •, TCO2 I #1 DRIVEWAY DRIVEWAY I /�/ • // MT� /UT -r NEW 1500 GALLON STEEL STEP TANK ASBUILT SCALE: 1"=50' N.T.S. OG DF R ff 49 TH DRY, MAY 2018 ;MICHAEL N. ANDERSON; tZA No. CE 9469 •.•4-6-20 • AV ............... ESS ��.� •UOIIenaasuo0 le}uawuoa!nu3 jo }uaw:pedao :gSnoaog nSjeA uo!leAaasuo0 leluawuoalnu3 10 }uaw:wedao ao/pue saa!naaS uewnH '8 glleaH 10 juawliedaa :@SeaogauV jo A}!led!a!unA Ajpogjne aado,id ay} o} Bol Ilam aqj jo Ado e }!wgns of aaunno A:Wado.id aqj jo Al!l!q!suodsaa ay} s! 11 :NOI1N311V uenllin5 aloe :aweN saall!a0 N0o.lpa8 laneag 'Q pueS A4I!S Aelg /nn laneag 7g PUeS Ajl!S uapanq.lan0 dn�aljS.Ou!seg XIMME 85 9T 9T ti ti Z Z 0 01 woaj y�da(] e;eo aloH agog sjuawwo0 Add OS au!aolg0 :u01jaalu!s!Q 10 pogjaA 0 F-1 saA® :uoljaldwo0 uodN pa}aaju!s!Q IIaM jaaj Zti 01 '1@@j Z woaj:41daa sql OS :awnlOA ajluojuaq :adAl jnoag paddojS ;aaj jaejS suoljeaoJaad ❑ paddojS }aaj Jaejs pauaaaaS FI aloy uado® pua uado ❑ :adAl Su!uad0 aNejul IIaM a!V ;lu!}sal 10 poglaA yd8 ❑ wdS ® ST a}ed Aaanoaa8 �aad 6T :lanal aajeM a!}ejS adAj aau!1 laaj V9 gjdap 'sagow 9 :aa}awet4 sapul OSZ' ssauN:)!q} IleM IaaIS :adAi gu!se0 ,EOT :IIaM jo gjdaa loos algeaR Aae}oa .ile® :Bu!II!aa jo Poq;aA ON 11 saA® :uoljeaol jlwaad panoidde }e paleaol Mann sl 000170SUSTO H3SAnN NOI1VJ1311N301 XVI 8T -8-S :3nSSl 30 31V4 ZLOT8TdSO :2J39ygm 11Ai13d 8T -S-6 :31VG T fol uosu!NnneH N011dlUDS34 IV931 :SS3WICIV za.ua!ing sasloA — FDA :GNVI 30 d3NMO BSLZ-889 L9566 )1V `Me16ng0 `69ZOL9 xo8 'Od S113M U31VM NVA1110TO), eqp 00 000 ol uiliiaa pal jilaa:) www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP181072 Date of Issue 5-8-18 Parcel Identification Number: 01523504000 Legal Description Property Owner Name & Address Hawkinson Lot 1 MGJ Pump Installation Date: 9-25-18 Pump Intake Depth Below Top of Well Casing: 90 feet Pump manufacturer’s Name: F&W Pump Model: 4F11P05301S Pump Size: 1/2 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Mike Anderson- Anderson Engineering Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Martinson Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Coy cr m � cnDi i)m � :- I Cop = T O CD b CD D Fn 0 x r� O'4 CD IV prop CD '1 0 � CD bx aq w e* w y `3 o t7' 0 d 40 m Q p,00�o�' Cb m � OD 0 cl RR V V 4. H N Q z 19'02 L M <00<ZO.00 N In Ha W 02 v m CD b CD r� O'4 CD IV prop CD '1 0 � w e* w y K p � 40 m o p,00�o�' Cb m � OD 0 O] RR 19'02 L M <00<ZO.00 N In Ha W 02 v 4,00 -°—""Ty0 MUNICIPALITY OF ANCHORAGE `„C„r • On-Site Water&Wastewater Program :\° 5.;. f • r 71.::—) PO Box 196650 4700 Elmore Road y �f Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997�� /// http://www.muni.org/onsite liblitir C„oaPG� Dt i m tmcnt 9 h On-Site Water & Wastewater System Permit Permit Number: OSP181072 Effective Date: 5/8/2018 Work Type: WellSeptic Initial Expiration Date: 5/8/2019 Tax Code Number: 01523504000 Site Legal Address: HAWKINSON LT 1 G:2739 Site Mailing Address: 7300 ALATNA AVE, Anchorage Owner: GUTIERREZ MOISES Lot Size in Sq Ft: 42700 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: C✓I Disposal Field Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: N. Date: // Issued By: fJiA2. eDate: 5 g 16' ltd,50 MUNICIPALITY OF ANCHORAG a Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-235-04 Property owner(s) MJG Building Group Day phone Mailing address Site address Legal description (Sub'd., Block & Lot) Hawkinson s/d Lot 1 Legal description (Township, Range & Section) Lot Size 42700 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑x Initial Single Family (SF) (w/wo ADU) Septic Tank C8I Upgrade ❑ 6c ;, : (D) ❑ Holding Tank 11] Renewal 111 �)t ti ,�p ellings 111Privy ❑ I°i�� /a , o r D) Private Well MAY 0.2 2018 Water Storage ❑ a THIS APPLICATION INCLUDES A VARIANCE/WAIVER '/:,_t_17. - L9 %''ti A 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: 4 12,9f,40 Waiver Fees: Date of Payment: 5 f r3 Date of Payment: Receipt Number: C'.k4$ 1523 Receipt Number: Permit No. OSPL9I oia Waiver No. Permit App__-: : .,c • May 2, 2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: New Septic& Well Permit Legal: Hawkinson Lot 2 / To Whom it may concern: This is a request for a septic and well permit on the above referenced lot. A test hole was excavated and found silty gravels GM,for the entire depth with no bedrock or water observed.The perc rate was 12 minutes per inch. From the site plan the slopes are fairly flat (less than 5-10 percent) at the test hole locations. The lot is large (one acre plus) and the soils are good with no ground water or bedrock. This permit will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely �� it, Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 `tf DESIGN CRITERIA: 4' I MOUND OVER (TH#1) -- GRADE 4 BDRM X 150 = 600 GPD10 SOILS .ORGW = 600/0.8 = 750 GPDI SM FILTER FABRIC 750 12 = 62' 1 0 m,.>+ 1.25"0 SEWERR ROC ROCK (1)TRENCH 7.0' DEEP -7.0 6.0' EFFECTIVE GM 2.0' WIDE 12.0' I 62' LONG 18.0 SEPTIC FIELD SECTION J_---- - - - - --t I I I I / IS\ ' I . PROPOSED t I WELL 100' WELL N, /- RADIUS I\ I / —1 I rSEF�'TIC \\ i ._/ I — J L — ,— —4 ,.. l --� . ''-ALATNA-AVENUE- �� - T - t -\ _ - -�- - - , — - � t is 1 11 PROPOSED • t 11 A I 1 tI I i / n 1 I ' WELL I 1 II WELL HOUSE \ / `II' / I \ \ \ / /JIi . \ ' \ II --'•' ��PROPERTY LINE ---'' II SEPTIC' IIPROPOSED II SEkTIc DRAINAGE FIELD �`� VACANT LO4 > T _ — — — W 0 J J \ L .. _. I I I Septic Design Prepared for MGJ BUIDLING GROUP X44% OF q4'*•• • HAWKINSON LOT g! °• '— ♦♦♦ Anchorage, Alaska ; �`:�• 449T—"4......I\ ♦, • • Michael N. Anderson, P.E. DATE: 4/26/2018 .0A3\,..1::MICHAEL N. ANDERSON/ 4601 NATRONA AVE ♦ No. E 46 : DRAWN: DJR 1♦♦s� •.••• ANCHORAGE,ALASKA 99516 �t� •7 .•••'•...._v: �4 (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=200' ♦lit, "ss\ ibi 41 _ / BREITZMAN I / LOT 4 L — ' \ ice'------- \\ / \ / -ALATNA AVENUE- \ r \ , .,--PROPERTY LINE I cr I WELL �� ., i r, r,MT I C? .�T—_1`` I i i ► 1 01 • 1 o /`, / \ / \ / J \\\ PROPOSED 4 /' �•\ `yi =I \\\ BEDROOM .1'4.- NJ MT \\ HOUSE /' PROPOSED ,/ PROPOSED WELL RESERVE FIELD—1%— FC CO 't „ 100'RADIUS CO �A. TCO HAWKINSON _ I LOT 1 2'CONTOURS HAWKINSON I TYP LOT 2 PROPOSED 1,500 \\\ GALLON STEP TANK I z I w 2 w Q w _ F n O 10'UTILITY EASEMENT TENGBERG TRACT B2A Septic Design Prepared for MGJ BUIDLING GROUP .•.% OF 44 11 HAWKINSON LOT$ / :c-)..•• I, ..7.• Anchorage, Alaska �`:� 49TH /\ Y . P.E. i. • i alit/4 . il%� �� • Michael N. Anderson, PDATE: 4/26/2018 ?\1-.MICHAEL N. ANDERSON/,i it 4601 NATRONA AVE �4G:),.%•. No. 7,E 4 ' ANCHORAGE ALASKA99516 DRAWN: DJR 1 ' SCALE: 1"-50' •11 i', / .' .�� (907) 727-8864/FAX: (907) 345-1391 4i, SS,**�� Municipality of Anchorage F, GRNIt=k'S°SE41,,c,"h p Y 9 p L •• •• /-- :a Development Services Department• o,, '. " ; On-Site Water and Wastewater Section d 'fit' '4 9TH ' �. . '/ 4700 Elmore St. �� J �. f P.O. Box 196650 Anchorage.AK 99519-6650 r/ G ! ". •�... '' �� .1k4 / ww (907)3.orq/onsite ' ••• •••.... , (907)343-7904 le^• MICHAc1. N. , .,,•. A`N/D£R�CN • Soils Log - Percolation Test @� .gip•' • `' Performed For: Z.) VA. bigt,tl�tY 4(iv\ Date Performed: 57 ;,t/IAIS\ '- Legal - Legal Description: i4o j k t N 4-U 0 L c)+' ( Township,Range.Section: Slope Site Plan Depth (Feet) • 1------------ 2- ------2- "( ;oe\ k t 67'r'e__—' 3 �6t - c- /2(d1,74- j� 5 6- 4)/ // 1-7 7 (Zrvv.t(r 8- WAS GROUND WATER 9- ENCOUNTERED? Ni c) 10- IF YES,AT WHAT DEPTH? U . Depth to Water After P 1 1- Monitoring? Pi.-1 F 12- Date (y/ , /7- 13- 0 - 13 0/Y Ortl 14- Reading Date Gross Tim Net Time Depth to Water Net Drop 15- S/1 /7 Zi Or i r, co, ii Z. S" 16- (D /1 ?/ K'/ 17- Co /r 7, C ,r 18- /r ?t 5 ('/ 19-tea(5 0 V v✓t 20- PERCOLATION RATE '�_(rninutes.ircrn PERC HOLE DIAMETER Le" TEST RUN BETWEEN 4 FT AND 5 FT COMMENTS PERFORMED BY: Nf N1✓ . I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5(i/ e (... bi LOT SQUARE FOOTAGE 42,700 S.F. LOT COVERAGE 08.46% A E A T\ A AVE \ U E — ® BFB: O 4� . r ec, N 89°54'49" W 265.22 1 �s I \D „t9 50 I- 0 o U) z - o U O 60.0 27.0 ml-- -I Z Pl O 28.0 O N ` O "0 O CA b fT) O D N U N 9 17 .0 a (1) r. F.G.F. ELEV 934.5 Q 111 0 AJ m o 6 m .: I- z O 43.0 75.0 P1 2 O CA 0 C O) 50 N 89°54'41 " W 285.00 ��-�� GRAPHIC SCALE OF AL\ LEGEND 1 Inch = 40 Feet I / �� 4 SPOT ELEVATION /<<�' i' , y DRAINAGE DIRECTION 20 0 20 40 60 of*49 TH 6? ' * BOBBY I. BURNETT 2941 Carriage Drive Anchorage. Alaska 99507 Legal Description (907) 350-5541 gI hereby certify that the property described hereon has been / r / surveyed byme, or at mydirection, and that the improvements BOBBY F. BURNETT Date Scale Lot 1 y p ` N 4 20 2018 1' 40' are within the property lines, and do not overlap or encroach on 1 a�, LS-5484 , Grid - the property lying adjacent thereto unless otherwise shown. That 2739 PLOT PLAN HAWKINSON SUBDIVISION no improvements on the property lying adjacent thereto encroach 1 p� �P� Air on the premises in question and that there are no roadways, \ ssioru , Aor Drawn by Field Book PLAT # 2003-4 transmission lines or other easements on said property except aslib' BFB shown. `` Certificate of On -Site Systems Approval Parcel I.D. 015-235-04 Legal description HAWKINSON LT 1 Site address 7300 Alatna Ave Anchorage Current property owner(s) Carol and Landon Grills Expiration Date: '7 -40 2 3 - i X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 4/7/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory X Tank Age Advisory Arsenic Advisory Other COSA ApprovW_June 2022 UH C I LQ 1 Y OF' H0R% „ G 4 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-235-04 Complete legal description Hawkinson Lot 1 Location (site address) 7300 Alatna Ave, Anchorage, AK 99516 Current property owner(s) Carol & Landon Grills Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 9 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 5 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed X 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 $, 5L Waiver Fee $ Date of Payment qA7 Date of Payment COSA # 'OSC 2 -1078 Waiver # COSA Application_June 2022 Hawkinson Lot 1 015-235-04 4.7 103 64 6.30 18 3/22/23 Forge Engineering 15.3 3/20/23 48" 3/2/23 A+ 6/22/23 11.4 N/A N/A N/A N/A 5 Steel 3/22/23 40 838 64 1440 41 >600 90 41 49 Benjamin Schiller, P.E.3/24/23 (907) 522-7773 -®Titrate Advisory Certificate of On -Site Systems Approval # OSC231079 Subdivision: Hawkinson, Block: , Lot: 1 A water sample revealed a nitrate concentration of 6.3 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged -- ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. 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WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 9/5/18 Total depth 103 ft Cased to 64'+ ft 0 Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 24"+ in. Date of flow test for COSA NEW Static water level at beginning of test 19 ft. Comments B. TANK DATA Age of tank(s) NEW years Tank type/material STEPISTEEL Measured operating fluid level in septic tank NEW 0 Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA NEW SYSTEM Which system tested (date installed) NEW 0 ALL standpipes present per record drawing Total measured depth from grade 10.5 ft (max) Measured depth to pipe invert from grade 3.0 ft (min) ❑ N/A — pressurized field 0 Monitor tubes go to bottom of effective. If not, state depth into effective 0 Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-235-04 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 0 No 0 Coliform bacteria is Negative Nitrate 9.66 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L 0 Arsenic less than MRL (ND) Collected by MNA Date of Sample 4/1/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station NEW years Lift station material STEEL Comments: Adequacy test date NEW Results p✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added NEW gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ✓❑ Yes Community Sewer Manhole/Cleanout > 100' F/ Yes if No ft M Yes if No Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ✓0 Yes if No ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' —❑✓ Community Sewer Main > 75' ❑✓ Yes if No ft Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 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'✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that 1 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 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904 On‐Site Water and Wastewater Section Fax: 343‐7997 www.muni.org/onsite Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Advisory Certificate of On‐Site Systems Approval # OSC201138 Subdivision: Hawkinson, Lot: 1 A water sample revealed a nitrate concentration of 9.66 milligrams per liter (mg/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached “Nitrate Fact Sheet” for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On‐Site Systems Approval. Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org Nitrate Fact Sheet From Northern Testing Laboratories, Inc. Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells. SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil. TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry oxygen. For this reason, methemoglobinemia is referred to as “blue baby” disease. The EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization. TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home water treatment systems such as softening or iron filtration does not readily remove nitrate. The best method for limiting nitrate in well water is source control. This can include avoiding overdosing of fertilizer near the well and maintaining good separation distances between septic tank leach fields and the well. A special anion exchange filter that contains a medi a with a strong affinity for negatively charged ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate. TESTING: Nitrate analysis is usually done by one of the several “wet chemical” methods using a spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect the activity of nitrate in water. This laboratory uses several different wet chemical methods approved under the public water supply laboratory certification program. They also have test kits available, which the laboratory uses to perform an inexpensive “screening test”, and with which the homeowner can monitor the change in nitrate levels from their well. They recommend comparing the test kit results against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.