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Home My WebLink AboutT12N R3W SEC 33 LT 115 & 114 PTN (E15' LT 114 N147' & W110' OF S183' LT 115) Onsite File T12N R3W Sec 33 Lot 115 & 114 PTN (E15 ' Lt 114 N14T & WhO ' of 5183 ' Lt 115 ) #018 - 252 - 22 Bill To: Al Smay 2601 Porcupine Trail Rd Anchorage, AK, 995016 Invoice Invoice #: 20235966 Ship To: Al $may 2801 Porcupine Trail did Anchorage, AK 995016 SALESPERSON YOUR NO. SHIP VIA CDL PPD SHIP DATE TERMS ANCHORAGE WELL & PUMP $ERVICE, INC. David J VanWingerden 37873 7640 KING STREET 10/1112023 1 ANCHORAGE, AK 95518 PH, 807-243.0740 „.w Bill To: Al Smay 2601 Porcupine Trail Rd Anchorage, AK, 995016 Invoice Invoice #: 20235966 Ship To: Al $may 2801 Porcupine Trail did Anchorage, AK 995016 SALESPERSON YOUR NO. SHIP VIA CDL PPD SHIP DATE TERMS DATE PG. David J VanWingerden 37873 � Net 30 10/1112023 1 TY. ITEM NO, DESCRIPTION PRICE 3 DISC %4 EXTENDER I TX. PRICE Scope of Work: _.. ..........._......_........_._. _............. UPGRADE WELL CASING TO ,.. ,... .... . , ., ,.... ... ...... .._.............. -..... _................... ........ ....... .... ..... .... MUNICIPAL CODE, 1 Field Service 08/20/23 - Service call - Check crawl space $258.00. 100% for well upgrade and take pictures. 0.5 ST1-Dave Service Tech 1 Field Service 10/05/23 - Upgrade well casing per Quote. 5903.00 $903.00 3 STI -Dave Service Tech 21 ST2-Mark Service Tech I ST9-Service Tech Helper Service Tech Helper - Tallon 3.5 WELL CASING W ASTM SCHEDULE 40 $35.00 $122.50 1 WELDER WELDER RENTAL $175.00 $175,00 3 FIT -CPR -PIP -1 PIPE -1" COPPER TYPE M $11.00 $33.00 2 FIS` -CPR -90-1 90"-1" COPPER $11.00 $22.00 5 FIT-ELC-FLX-CND-90-,5 90-.5" FLEX CONDUIT ELECTRICAL $4.00 $20.00 2 F1T-ELC-RMX-CON-.5 CONNECTOR -.5" ROMEX ELECTRICAL. $4.00 $6.00 .._.... - - ........ ...... ..... .... -- - ... ._....__....._ SALE AMT. $1,283.50FREIGHT We appreciate your business. Thank you! $0.00 SALES TAX $0.40 TOTAL AMT. $1,283.50 PAID TODAY $0.00 BALANCE DUE $1,283.50 m " -ft 01- —Dw yy��pp�� \. • � „`aie. T -iii (Hev uwo2/18) Municipality of Anchor-age On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191061 PID Number: 018-252-22 Dwelling: ❑® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New F Upgrade Name Alvin Smay ABSORPTION FIELD ❑ Deep Trench H Wide Trench El Bed E] Mound Site Address 2861 Porcupine Road ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.2 GPD/SF 8.0 Fl. LEGAL DESCRIPTION Depth to pipe invert from original 4.0 grade Ft. Gravel depth beneath pipe 4.0 Fl. Subdivision Block Lot 114&115 PTN Fill added above original grade 0.0 Ft. Gravel length 40.0 Ft. Township Range Section 12N 3W 33 Gravel vridth 5.0 Ft. Beds: Number n/a of Lines Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 400 Ft2 1 n/a Fl. Well 60.6 60.8'+ I 9.0 TANK ❑® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1000 Gal. Surface water 100'+ 100'+ Material Number of compartments Lot Line 5.0'+ 10.0'+ NA Steel 2 Foundation 10.0'+ 10.0'+ I I LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank 3034Tank to 3034 drainfield Installer A+ Home Services Drainfield 3034 Co/MT 3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 98.0 ft 1-` 3/29/19 Inspect 4/1/19 Location and description es: 3rd 4/1/19 2nd 4m 15/5/19 top of deck @ point A ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF Ak,,'k Conditional Approval: Date � � • F2. •PannOne.� Septic Syste �/i% JCeven � ��F� . CE 8149 ;w Approved Date /6 20 Q's�?l1D�df Note: this approval oes not include well permit requirements.��'�`�'A�� G1. !D8 (Hev uwo2/18) wl 0� Dc m m z -T c� F c c' -1-11, C 00 2 DmNo' mm�v-ZoD 0 000-- r z-�-m0 N p CO m A O xC� F- op mDrnD (i— En � O— 0 D (A0 D �� ZOrN00 G �[Tn p�rnOnpo(r)mx�0m�D M ---i nD-mm0V) O W z D0N0mZ2O= -O om O :E(A v Om D 07 p E:E-) om0 0 _C Dry O mN_NO N OWO� U) mmz m;urZpO z (n �� 70-nG)Vo��Dv Z p mD Ln D O�� n LO mm z p CA r ;a � _ -Tl cz -' m D _ r o Un i 41 ma m i z n cm N� S i O o �7 w m z •P m 0 wl 0� Dc m m z -T c� F c c' REVISIONS ( 0 SCALE 1" = 50' REV 2: 3/19/20 REV 3: 4/8/20 N N 0 A O N O En � O— 0 D (A0 LA " w / r D m i �a =N W r X m om i Ln I� n O O cs 0 _C Dry N Tm DJ Z x Do W W 5 O rn Ln (n z � m D 0 r -A —I x -j 10 Un m Co no V i 41 S i O CO N w m z •P I v D CC D Ll I m l I v I NOTES: PANNONE ENG SVC LLC (C 1. 1088) RECORD DRAWING P.O. BOX 1807 PALLIER, AK 99645 PHONE (907 745-8200 FAX 907 745-8207 T12N R3W SEC33 L114&115 PTN DRAWN ACP ALVIN SMAY SITE PLAN 2861 AORCUPINE NCHORAGE, A ILROAD ��"�� - oFA/,. ��P• ' S+r TH • ••• / / `Steven E;anriorie� CE ��, -: REVISIONS ( 0 SCALE 1" = 50' REV 2: 3/19/20 REV 3: 4/8/20 N N PERMIT NO. O N O (A LA 41 4 .p� 41 (A W Ln O N Ln W CO D N •P DJ N Do W W W W Ln (n m m Ln -A Cn -j 10 Un N V CD 41 v CO N CY) (O •P NOTES: PANNONE ENG SVC LLC (C 1. 1088) RECORD DRAWING P.O. BOX 1807 PALLIER, AK 99645 PHONE (907 745-8200 FAX 907 745-8207 T12N R3W SEC33 L114&115 PTN DRAWN ACP ALVIN SMAY SITE PLAN 2861 AORCUPINE NCHORAGE, A ILROAD ��"�� - oFA/,. ��P• ' S+r TH • ••• / / `Steven E;anriorie� CE ��, -: REVISIONS DATE 12/16/19 REV 1: 3/16/20 SCALE 1" = 50' REV 2: 3/19/20 REV 3: 4/8/20 P.LD. NO 018-252-22 PERMIT NO. SHOEP191061 2 OF 2 O Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve(@panengak.com March 16, 2020 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road P. 0. Box 196650 Anchorage, Alaska 99519 Subject: T12N R3W SEC33 L115 & L114 PTN 2861 PROCUPINE TRAIL ROAD Septic tank to drain field separation distance Waiver Request Ladies and Gentlemen: I am writing to request a separation distance waiver between the upgraded 1000g septic tank to the upgraded soil absorption system. MOA code requires a separation distance of 5.0'. Based on swing tie measurements taken on 15/5/2019, as shown on the record drawing the separation distance is 4.0'. we are requesting a waiver to 4.0'. As shown on the record drawing the septic tank is located outside of the assumed flow path of effluent from the drain field. This lesser distance will not hinder the operation of the drain field or compromise the integrity of the septic tank. Granting this waiver will not pose a threat to the safety of this lot or the surrounding lots. Please contact me if you have any comments or concerns. Sincerely, { March 16, 2020 Steven R. Pannone, P.E. Owner/Civil Engineer .flnchora`;e Mailing: P Bo 1 1' 1„” ` — C .0. ��i �.00- .i.7, h �c��cra�, i��l< X95'10-0217 Palmer iViailing: P.O. Box :1.807, Painner, r'd< 99645 Telephone: (0107) 745-8200 FAX: (907) 5'8�G1 7/4 J �1 { i w 0 i m I M Om m O 0 O D � a� n to C 2� zx —I M 0C:D z 2` m i NOTES: PANNONE ENG SVC LLC (C.I. 1088) P.O. BOX 1807 PALMER, AK 99645 PHONE 907) 745-8200 FAX 907) 745-8201P �e��\\\\\ REVISIONS DATE 12/16/19 RECORD DRAWING REV 1: 3/16/20 SCALE T12N R3W SEC33 L114&115 PTN REV 2: 3/19/ 20 f 49 * � ''' 1" = 50' P.I.D. NO 018-2s2-22 DRAWN ACP ALVlN SMAYevel2:"Y�ann�`o' 2861 AN e j ,oma �tti,t SHOTP191061 DETAILS ANCHORAORCUPINE GE, AAKLROAD y \ 3 OF 3 Lot 11 ( t?I d -I W J Q U XI J V? d Z CL H a a +- m NJ 0 a� Q :Z °�dpnn 41�./, LoI� I �`t:' P N% V� M Q: of O)l U) (1A _ '_ S LO W N �j {two© :z Q p 00 -C ( t?I d -I W J Q U XI J V? d Z CL H a N C — m 4 E Q m p O CD y C 'O v .a aN U m C�L- 0 O N U X m m m -C .c.— a - a +- m N L .0C a �- � C O m m IV CD a m m L N U C m } 4 00 -C 0 >. O m e - O p O I CL cCoo ma L- c_j m a c e I ,l j +� > am. U LU. m O C C D E= �0° U. a m ro I cM-E 3�e�oc=n i p ZO.Cm0.m.. I U 0,-q -C wcr 0— 000>.op 3OW<t'V (D C X O N V) S m A U C 8 >mr •- Somp 0= m p I c+mL .-ON O)- C -t Q i Q c AO -o 't o `o I N �MUOc*-N I 0 rnme 0' ca CL »- CL 0 roZ�'Ur EV) pco.m Q3 o N C — m 4 E Q m p O CD y C 'O v .a aN U m C�L- 0 O N U X m m m -C .c.— a - ,>/jot(t MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program ••' 3(, PO Box 196650 4700 Elmore Road 4' Anchorage.Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 •;5i �'t% nttp://www.muni.org/onsite; 016 g 007 Department 40C on?-6`. On-Site Wastewater Disposal System Permit Permit Number: OSP191061 Effective Date: 3/27/2019 Work Type: Septic Upgrade Expiration Date: 3/26/2020 Tax Code Number: 01825222000 Site Legal Address: T12N R3W SEC 33 LT 115& 114 PTN (E15' LT 114 N147' &W110' OF S183'LT 115) G:3034 Site Mailing Address: 2861 PORCUPINE TRAIL RD, Anchorage Owner: SMAY FAMILY TRUST THE Lot Size in Sq Ft: 73590 • Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: El Disposal Field I J Septic Tank ❑ Holding Tank ❑ Privy ❑ 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: 4 r Date: 3/2 b/ Issued By: `," „r Date: 3407 F - .Punt Municipality of Anchorage S;. - Ur.p:ntment P.O. Box 196650 ® 4700 Elmore Road Anchorage. Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV191006 COSA#: Permit#:OSP091061 PID#: 018-252-22j tank 1-2 ��prvx Legal Description: T12N R3W Sec 33 Lt 115 & Lt 114 PTNS lJ Engineer: Pannone Engineering Services Applicant: Smay Family Trust Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to the private well has been approved. The approved separation distance is 60.0 feet. This waiver approval applies to the proposed absorption field and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted: Date:Z�Z A roved b : or pP Y_ kwl�) "/�� Name of Review ............................ ■ ............................. ■ ................. 1 **** VARIAN C E/WAIVER REVIEW **** E P LAWS MUNICIPALITY OF ANCHORAGE Community Development Departmentb 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. 018-252-22 Property owner(s) Smay Family Trust Day phone Mailing address P.O. Box 110235, Anchorage, AK 99511 Site address 2801 Porcupine Trail Road Legal description (Sub'd., Block & Lot) Lt 115 & 114 PTN (E15' Lt114 N147' & W110'of S183' L115) Legal description (Township, Range & Section) T12N, R3W, Sec 33 Lot Size 73,590 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial _ Single Family (SF) 1X1 (w/wo ADU) Septic Tank n Upgrade ❑X Duplex (D) ❑ Holding Tank [ Renewal C Multiple Dwellings (— Privy n (SF and/or D) Private Well ❑ Water Storage n THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Well to septic system Distance:60 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: 5q5Waiver Fees: I, (7O Date of Payment: 3/l4 119 Date of Payment: k3///Q1/9 Receipt Number: 090z86 Receipt Number: Cir 080 Permit No. 105pl7n/0�pl Waiver No. ( V19/dQ6 Permit App_:. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191061, Deb Wockenfuss, 03/27/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191061, Deb Wockenfuss, 03/27/19 Page 2 of 2 The ground water in this area typically flows from the northeast to the southwest. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for alt components. As outlined under 18 AAC 80,020 and 18 AAC 72.021(a), i have calculated the following points: Lot 3 Septic Tank to Well: Distance from sewer system bottom to groundwater 6.5 Soil sorption below sewage system 3,0 Soil permeability below the system 2.0 Water table gradient 0.0 Horizontal separation 1.7 Total Points Z3.2 The sum of the above values could equate to the following conditions: 12-16 "No bacteriological pollution possible but chemical pollution possible buy unlikely from household chemicals." Additionally, this system has been in operation for over 50 years with a separation distance of approximately 50' with no apparent ill effects. The new system will be placed further from the well increasing the safety of the lot. In my opinion, this waiver request meets the above criteria for approval and does not constitute risk to health. 1 Dope the above information will assist you in determining that the waiver should be granted. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 754-8200. Sincerely, 0 Steven R. Pannone ,CE 8149 Steven R. Pannone, P.E. ❑wner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191061, Deb Wockenfuss, 03/27/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191061, Deb Wockenfuss, 03/27/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191061, Deb Wockenfuss, 03/27/19 1811110 10111 WOODEN FENCE F"TJ "IN 62.3' 17 '35V !P 2 STORY 20.2 RESIDENCE M2 WELL 1.0'x8.0' CANT SEPTIC PIPES-/ E 6.8' PORCH-) RAMP— (6 N 90'00'00-W 125.00' PORCUPINE TRAIL 10.4' 1345.00' METAL FENCE Aniffs mw 25'x110' EASEMENT FOR THE BENEFIT OF THE W I OF E 220' OF THE S 183' OF BLM LOT 115 G e N 90'00'0 "W 220.00' E OF E 220' OF S 183' OF LOT 115 W j OF E 220' OF S 183' OF LOT 115 33' BLM ROAD RESERVATION — I Lot 1 A L 571 VIRMI-1:1 6fo 'k "A to toin N c:, w Z, 0 :z 0 0- 0 X 00 C;,o ®0_``E® O� rn >1 co0 5 wn ro 0 > C,4 W 0 m to -4t 0 00 (n0 C-4 C-4 600 N 04 Me= 0 b > c:6 in to in r r 0 0.a IZ 0 0- g0 CL L 0 0 0 c c 0 cc 0 E 0-cL 0 0 o wo 00 > a. mm 0 0. - c 0 0 c 0 —x 0 M::5 E 4 0 0 Lo em II 'mo 1 0 E C 0 ul C m Z. 0 0 a L- > 0 -:j,6 = 0c 0-4) ou, 0 LLJ 0 B:: 46 fx "0 Wc in 3� 0 C-0 r 31: LLJ 0 ci C3:3 (D CL x r V) 0 m V) > :-:r- W tn— 0 0 c 0 0 -r -a Q G c— 0 C 0 C4 CL V� 0 8691 tti .00�— U) N) 0 M r C I- U) t as ix 8.E c 0 0 0 z c)) z 00 0 .0 -0 Lo, CL IV 0 0 L-ZwV)=zOr-- EE E-Re 0 9 c e CL x a- 0 <c > 0 Arctic Pump & Well, Inc. PCS Box 770197 Eagle Muer, AK 99577 Al Smay Jim Sullivan 688-2510 or 2,4$-2282 Fax:688-2543 Email; jim(marcticpump_com Franklin Key Dealer Invoice # 10920 Po; Date of Completion:: 111612018 , .......... Phone: Cell Phone: (907) 360-0059 Fax Number - Email Address; asmay49@hotmail.com Property Information Legal; Street: 2801 Porcupine Static Levet. 97 ( City - Description L--- pricep$ r Unit Price - -Amount - - -.. -- 1 5Y-10FRD05P4-2W230 $1,292,00 $1.292.00 $1,282.00 115 Sch 120 $3.98 $3.58 $457.70 1 GALVI_NIZE❑ PIPE $3,98 $3.98 $3,96 125 SUBMERSIBLE PUMP WIRE DOUBLE JACKETED $2.45 $2.45 $306.25 1 check valve long $50,00 $50,00 $50,00 1 WATER SPLICE $28.00 $26.00 $28,00 1 Well Seat 6x1 $48.00 $48.00 $48.00 1 REMOVE AND RESET PUMP; CHLORINE & FLUSH $1,000.00 $1,000.00 $1,000.00 1 REMOVE OLD MATERIAL. $200.00 $0.00 $0,00 Payment due on receipt of Invoice unless prior arrangements made. All account Past ❑us will be charged 1 112% per month. $25 second billing charge. THANK YOU Municipalicy of Anchorage August 26, 1987 P.O. B: .196650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Leroy Reid, P.E., PhD Alaska Environmental Control Services 1200 W. 33rd Avenue, Suite B Anchorage, Alaska 99503 Subject: West Portion of Lot 115, T12N, R3W, Sec 33, S.M. Waiver Request WR87-048 Dear Dr. Reid: Your request for a waiver of the 100 foot separation required between the septic system proposed to serve the subject lot and the well serving the single family dwelling on the adjacent property (Lot 114 and a portion of Lot 115) has been granted. The required separation has been waived to 90 feet in this case. 1. As a condition of this waiver the septic system must be constructed in accordance with design plans. A two foot sand filter meeting gradation requirements specified in the wastewater ordinance must be installed below the proposed bed -type absorption system. The department has received a notarized letter of non -objection from the owners of the affected well. This waiver is valid for the existing two bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer on-site Services cc Gus Andress, P.E. Manager, on-site and Water Quality Programs MUNICIPALITY OF ANCHORAGE Development Services Department '' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-252-22-000 Expiration Date: 9/8/2024 Legal description T12N R3W SEC 33 LT 115 & 114 PTN (E15' LT 114 N147' & W110' OF S183' LT 115) Site address 2801 PORCUPINE TRAIL RD Anchorage AK 99516 Current property owner(s) SMAY FAMILY TRUST THE X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: a Original Certificate Date: 12/28/2023 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 Tank Age Advisory Arsenic Advisory X Other COSA ApprovW_June 2022 MUMUPAUT10" OF ANCHORAGE Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section Far.: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 018-252-22 Complete legal description N147'& W110' of BLM Lot 115 & W15' of BLM Lot 114 T12N R3W SECTION 33 Location (site address) 2801 Porcupine Trail Road *Anchorage Current property owner(s) Alvin Smay Day phone 907-360-0059 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: R 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: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 4 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 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 $ SAO Date of Payment ^C Z � I COSA # 05C 2 314'37 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Legal Description: N147' & W110' of BLM Lot 115 & W15' of BLM Lot 114 T12N R3W SECTION 33 Parcel ID: 018-252-22 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA In "unfinished" area of basement (see photos) ❑ Well log is filed with Onsite (or attached) Date drilled 1952 (?) Total depth *101.2+ ft Cased to UNKNOWN t ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+in. Date of flow test for COSA 9/8/23 Static water level at beginning of test 98.0 ft. Comments *PER GEG WELL FLOW TEST B. TANK DATA Measured operating fluid level in septic tank 51 Date of pumping 8/28/23 ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 2019 FN ALL standpipes present per record drawing Total measured depth from grade 8.91 ft (max) Measured depth to pipe invert from grade 4.0 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 us r more than 30 days prior to date of test Gallons introduced gallons date Any=s,enter reatment (past 12 months) ate Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5.3+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes IN No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 15.6 ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, Ltd. Date 9/8/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station ye Lift station mater' Adequacy test date _ Results Q Pass Fluid depth prior to test Water added 489 gal 9/8/23 New fluid depth 14 in Elapsed time 120 min Final fluid depth 11 in 7 in Absorption rate 450+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 48 in Effective depth used 11 in Effective depth remaining 37 in 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' Community Sewer Manhole/Cleanout > 100' ❑Yes if No *60+ ft [jE Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100 ❑ Yes if No *60+ ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' ** Animal Containment > 50' Q Yes if No ft ❑i Yes if No ft Community Sewer Main > 75' Manure/Animal Excreta Storage > 100' Yes if No ft 0 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' 0 Yes if No ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' ❑i Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10' [E Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *OSV#091006 ** WR#87048 Existing waiver for 90' to septic system on lot to the east. Actual distance appears to be closer to 75'. See attached survey for lot to east. ***Per 2019 Inspection Report. Well on lot (2801 Porcupine) dates back to 1952 (?). 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 Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date 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 septic 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 party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 carne s,� V�� 7953rPr•••��a.�at(1�•� �Qo � o ,EQAE ,',profess;,o� & #AECC884 Lot 1 1 i Lcst 1 i OA i Lot 11 OB � f • • • • ••• • • { Lof 1168 • • C PAU-: 7 ! • vi, r i ` • ACY)• • ♦ a• •�,7ir P • • r 0 jkv 9A9 0 ��44##��Pir• E 0 X 0 # , + CQ0 4- •�r• 0 0 0 •FI1 iriM• E1 iii i}y/M�y, fir• "" }c� •{�,.,�i T"' ysagsp ""` c ( WW" Wow in c. *w CL ' 0 �i/jgir p �" 1M t 000 C " i Ob 04 0110 *;i �p�,yrt iWWlf�r 0 0 w•.. 0, ••• T yy�yy��. 0) 0.#.. C w �i ' L (4 :YT7 rygry �a � � cCiyy� � •w/ jr�r aMr. 0 .c 0 04. 0 .j awob Ad Ix u 0 >.0 `_ c CL 0 Iii tx 0 Q �r�.I•r. �7 X ce. ! 1,Iyy7�1r o : 0 C 3� 0 0 `11 0 , 0 ..moi 0O.0 Ld -< *0 X 1-+•s 0 C #�;r, 0 O.0 c -4-0 iiWWW. �A CN •FnrY �y z�r ��0••••••... c E •i rr •i••Mp c 0 rte' �#4T C v�.++ w. Q• ' 12 t �: •rw+. V S7A3 AiR- 7 N 90*00'OD'V E L —CONCRETE :PAC, r -DECK, 2.0' CA.�Ni -WELL ONE STORY WOOD,E 2' X 2.0' RESIDE,= .0 H f Mlk ti r�AkNILNK FEIN'C-�- 311 D E R7,8' X 8.6' PORCH 5 -OT 115 0 WEST, 110 L SATE'L-iT :)SHI 20,130 S'.1. til .GRP . z S---p7c VAdN H 0 LE FENCE 'Z� -POWER POLE 33' Ef WOODEN FENCE ks DIA EE N T Glil/ *RE PORCUPINE TEAIL N 90*00'00"E 110.00' PLOT PLAN AS BUILT X SCALE 1' = 30' GRID 3034 Project No. 06-074 — Long Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fox C kgIcngIs*oIaskc.net / 1clongIsOoloskonat .....-,F .... '4 I hereby certify that I have surveyed the following described property: GGVTLOT 1 1 5,THE SOUTH 183' OF THE WEST 110' OF THE EAST 220', SEC 33, T1 2N, R3W, S.M. 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 promises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the Day of at Anchorage, Alaska It Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plot. 49TH* t. KENNETH G. LtNG LS -5202 SSIONAL