HomeMy WebLinkAboutDENALY ESTATES BLK 2 LT 14Onsite File
Denaly Estates
Block 2
Lot 14
#067-062-21
(Rev 05/02/18)
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Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP201134
PID Number: 067-062-21
Dwelling: N Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: FE -111 New ❑ Upgrade
Name
Yvonne & James Huber
ABSORPTION FIELD
❑ Deep Trench IRE Wide Trench ❑Bed ❑ Mound
Site Address
25413 McIntyre Rd
El Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
0.8 GPD/SF
7.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.0 Ft.
Gravel depth beneath pipe
4.0 Ft.
Subdivision
Denaly Estates
Block Lot
2 14
Fill added above original grade
--3.1 min —5.2 max Ft.
Gravel length
2@ 38 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
n/a
Distance between lines
n/a Ft.
SEPARATION DISTANCES
To
From
Septic
Tank
Absorption
Field
Lift Station
Holding
! Tank
I
Sewer
Line
Total absorption area
760 Ftz
Number of trenches
2
Dist. between trenches
8.0 Ft.
Well
100'+
100'+
(
25'+
TANK ®Q Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Infiltrator
Capacity
1537 Gal.
Surface Water
100'+
100'+
Material
Number of compartments
Lot Line
5'+
10'+
NA
Plastic
2
Foundation
10'+
10'+
LIFT STATION
Manufacturer
Capacity
Remarks Standpipes bent during
site grading. Fields are
Gal.
a minimum of 8.0' apart as dimensioned on site plan.
Alarm location
Electrical installed by
Installer
Groundbreakers
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Drainfield 3034 CO/MT3034
Inspector Pannone Engineering
BENCH MARK (Assumed elevation) 409 ft
Inspdection 1" 7/22/20
3'd 7/23/20
2„d 7/22/20
4`h 8/6/20
Location and description
Top of foundation wall see site plan
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
�P,�� OF A�, kS�
..
• Steven •R. .Pannone.�.✓`
�� _` �CE /.81 AC
Septic System
Approved
Date jot3bOd
_IV2_
Note: this approval does not include well permit requirements.
(Rev 05/02/18)
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NOTES: P6• NNONE EAG SVC LLC (C.I. 1088)
RECORD DRAWING P.O. BOX 1807 PAUMER, AK 99645
PHONE (907) 745-8200 FAX (907) 745-8201
DENALY ESTATES B2 L14
SITE: 25413 MCINTYRE RD
DRAWN ACP YVONNE & JAMES HUBER
SITE PLAN 14161 KOSO DR
EAGLE RIVER, AK 99577
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P.I.D. NO
067-062-21
PERMIT NO.
OSP201134
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P.I.D. NO
067-062-21
PERMIT NO.
OSP201134
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NOTES: PANNONE ENG SVC LLC (C.I. 1088) """ REVISIONS DATE
RECORD DRAWING P.O. BOX 1807 Pi'CMER, AK 09645 '�E OF 14p 12/15/2020
PHONE (907) 745-8200 FAX (907) 745-8201 - ��P 5�9, REV 1:12/16/20 7SCALE
DENALY ESTATES B2 L14 xst�c�
NTs
P.I.D. NO
DRAWN ACP SITE: 25413 MCINTYRE RD 067-062-21
YVONNE & JAMES HUBER ',� .cE-91aBtp.fitPERMIT N0.
14161 KOSO DR OSP201134
PROFILE a '
SHEET
EAGLE RIVER, AK 99577 3 OF 3
a:
R
OWNER OF LAND: Yvonne & James Huber
ADDRESS:
Bore Hole
Data
Depth
From
To
LEGAL DESCRIPTION Denaly Estates Block 2 Lot 14
DATE: 6-11-20
p
2
PERMIT NUMBER: OSP201134 DATE OF ISSUE: 6-3-20
TAX IDENTIFICATION NUMBER 06706221000
Is well located at approved perrnit location: mYes ❑No
Method of Drilling: ®air rotary cable tool
Depth of Well: 144
Casing Type: Steel Wall thickness 250 inches
Diameter: 6 inches, depth 144 feet
Liner type
Static Water Level: Flowing feet
Recovery Rate 50 ® gpm gph
Method of Testing Air
Well Intake Opening Type: ® open end Fopen hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 150 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes 1-1 no
Method of Disinfection: Chlorine 50 PPM
Comments:
2
4
4
18
18
41
41
70
70
79
79
87
87
92
92
131
131
144
Casing Stickup
Overburden
Silty Sand & Gravel Tight
Silty Sand & Gravel w/ Clay Tight
Silty Sand & Gravel
Hardpan
Sand & Gravel w/ Clay
Clay
Clay & Gravel
Sand & Gravel
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
Matsu Borough: Department of Environmental Conservation.
ARCTIC PUMP & WELL INC.
Jim Sullivan
PO Box 770197
Eagle River, AK 99577
s B AXE (907) 688-2510
(907)243-2282
iima.arctiepump.com
Well Drilling Permit Number: OSP201134
Parcel Identification Number 067-062-21-000
Date of Issue:6-3-20
Ar -clic Pump & bell, Inc.
Page I of I
Legal Description:Denaly Estates
Property Owner Name & Address:
Lot: 1.4
WM Construction
Block: 2
PO BX 4042
Palmer AK 99645
Pump Installation Date: 12-1-20
Pump Intake Depth below Top of Well Casing: 13
Pump Manufacturer's Name:
Pump Model: Jet
Pump Size:
Pitless Adapter Burial DepthA 3
Pitless Adapter Manufacturer's Name: B-10
Pitless Adapter Installer: U/K
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Pump Installer Name:
Arctic Pump & Well, Inc.
Ar -clic Pump & bell, Inc.
Page I of I
Municipality of Anchorage-
P.O. Box 196650 0 4700 Elmore Road
Anchorage Alaska 99519-6650 0 (907) 343-7904 a Fax (907) 343-7997
http://www.muni.org/Onsite
Development ices Department
On -Site Water and Wastewater Section
alcor S
Ddpar tment
x* K X VARIANCE/WAIVER X* x X
Waiver-#: OSV201090 COSA#:OSC201689 Permit#:OSP201134
PID#: 067-062-21
Legal Description: Denaly Estates Block 2 Lot 14
Engineer: Pannone Engineering Services
Applicant: James Huber
Your request for a waiver of the required 8.0 feet horizontal separation between the two sections
of absorption field has been approved. The approved separation distance is 5.0 feet. See
engineer's waiver request for justifications.
This waiver approval applies to the existing dual trench absorption field only. Any future
upgrade to the on-site wastewater disposal system will require all separation distances be met or
another approval from this department.
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Waiver is Granted: X Waiver is not Granted:
Date: 3/d 020 Approved by: xwa, cajucB
Name of Reviewer
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R
THIS SURVEY WAS PREPARED FOR WM CONSTRUCTION. AND SHOULD ONLY BE mgm
USED FOR A SINGLE PROPERTY ACTION. RE -USE OF THIS DRAWING BY THE 1 . THE HEREON REPRESENTED SURVEY DOES
ORIGINAL CLIENT OR BY OTHERS, FOR ADDITIONAL USES AT A LATER DATE e 18NOT CONSTITUTE A BOUNDARY SURVEY.
WITHOUT EXPRESS WRITTEN CONSENT OF HANSON LAND SOLUTIONS IS A`6�ap IT IS SUBJECT TO ANY INACCURACIES
VIOLATION OF FEDERAL COPYRIGHT LAW. UNLESS GROSS NEGLIGENCE IS 05-. THAT A SUBSEQUENT BOUNDARY SURVEY
DISCOVERED, THE LIABILITY OF SAID SURVEYING COMPANY SHALL BE LIMITEDa ��p,, MAY DISCLOSE.
TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF r ry 2. INFORMATION PRESENTED HEREON IS A
THIS PRODUCT. `) REPRESENTATION OF VISIBLE
IMPROVEMENTS AND CONDITIONS PRESENT
AT THE TIME THE SURVEY WAS
PERFORMED ON DECEMBER 9, 2020.
Qy 3. DIMENSIONS OBTAINABLE FROM THIS
DOCUMENT ARE LIMITED TO THOSE
BEARINGS AND GROUND DISTANCES
1 ` a SPECIFICALLY LABELED HEREON. THE
20'
WIDE M.E.A. DOCUMENT DOES NOT PURPORT TO
EASEMENT~ ~ / PRESENT A BASIS FOR SCALING TO
DIMENSIONS NOT LABELED HEREON.
(D K . 3 0J P. 1 1) 4. THIS DOCUMENT IS NOT TO BE USED IN
SUPPORT OF ANY NEW CONSTRUCTION.
f 5. EASEMENTS, COVENANTS AND
L '�' ^0 '030WIDE I &E
DENARESTRICTIONS NOT APPEARING ON THE
~/ EASEMENT RECORDED SUBDIVISION PLAT MAY
EXIST. DETERMINATION OF THEIR
(PLAT 2000-12 } EX i STENCE I S THE RESPONS I B I L I TY OF
/ 1 18, L 0 CK 2 THE OWNER.
f 6. THIS SURVEY WAS COMPLETED IN
lb
� �.`' SUBSTANTIAL ACCORDANCE WITH ASPLS
P' j w. MORTGAGE LOCATION SURVEY STANDARDS,
14
1.08 ACRES¢
_ . L EOf NO
RECOVERED PLASTIC CAP ON #5 REBAR
t I {} UTILITY POLE
y I o, TEST HOLE `
3
rWg WATER WELL v
GAS STUB
STORY METER, ELECTRIC
(� V �MHHOUSE r, SEPTIC CLEANOUT/'VENT
ELECTRIC LOAD CENTER
o ' Vis' O �p G TELEPHONE PEDESTAL
COMMUNICATIONS PEDESTAL
MH MANWAY RISER
/v 600
— —E — — — OVERHEAD ELECTRIC
15
\J �% �' �a cati? s ;_ DECK
f �
BUILDING '
Dal 4. - _ 15 x 15 T &E CONCRETE PAD
EASEMENT,
DEKA L Y ES TA TES\v �x c (PLAT 2018-29) ASPHALT SURFACE
SUBDI VISI L 0 TS1 , 12 CULVERT
1-�1 L0C � s ---
DITCH LINE
TRA C TS A & 8 �' N74 °5811 "JY 255.65 MEASURED DATA
2O0 0 40 60 80 `�
4 � (N74°45'W) (254.70') RECORD PER PLAT (2018-29)
4
US SURVEY FEET
HANSON LAND SOLUTIONS
305 E. FIREWEED AVE.
PALMER, ALASKA 90645
(907)746-7738
,OF,
, N9
N a
'GR G N SON' q Ul
tQ 7L f 22 1 Q'
A L �81jk T
SUR Vf T
I HEREBY CERTIFY THAT
THIS DOCUMENT
REPRESENTS A SURVEY
MADE BY ME OR UNDER
MY DIRECT
SUPERVISION, OF THE
FOLLOWING REAL
PROPERTY:
LOT 14,
8L OCA" 2
VENAL r
ES TA T, CS
S0 ,011VISION
LATS 1--18,
9L ooff 2 8
TRA OTS A 8 B
(Pt AT 2018-29)_
ANCHORAGE RECORDING
DISTRICT
LOCATED WITHIN
WY SEC. 23,
T.14. R.1W.
SM, AK
CONTAINING
1.08 ACRES
MORE OR LESS
SCALE:1'=40' JOB:20-128
DV+1+I . ELF FILE : 20-128 AB
CK:CEH 112/22/20101 OF O1
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
POBox 186850 w7OQElmore Road
Anchorage, Alaska gg519-OG5V Phone: 4 Fox, (907) 343-7997
Permit Number: O8P201134
Work Type: VVeU3epUo|nitia|
Tax Code Number: 06706221000
Site Legal Address: DENALYESTATES BLK 2 L 14 G:0362
Site Mailing Address: 25413 MC IMTYRE RD, Eagle River
Owner: HUBERYVDNNEL&JAMES R
Design Engineer: PANNONE ENGINEERING SERVICES
This permit isfor the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
b/3/202U
G/3/2O21
47171
2 Disposal Field 2 Septic Tank OHolding Tank 0 Privy 2 Private Well El Water Storage
All construction shall beinaccordance with:
1. The attached approved
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 15.85.Provide notification bycalling (807)343-7BO4(24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall bmeither:
a. Opened and Closed onthe same day, or
b. Covered, sealed, and heated hoprevent freezing
pecial Provisions:
The recorded
plat for this subdivision notes that artesian wells are common and that special drilling methods may
be required koprevent waste ofwater via surface discharge.
Received By:
Issued By:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel I.D. 067-062-21
Property owner(s) YVONNE & JAMES HUBER Day phone
Mailing address 14161 KOSO DR, EAGLE RIVER AK 99577
Site address 25413 MCINTYRE RD, EAGLE RIVER AK 99577
Legal description (Sub'd., Block & Lot) DENALY ESTATES B2 L14
Legal description (Township, Range & Section)
Lot Size 47,171 Sq. Ft. Number of Bedrooms 'Ll
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑X Initial ❑X Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑X Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal El
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑X
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: &
Waiver Fees:
Date of Payment: 51-17-1,;16 -16
Date of Payment:
Receipt Number: 65-91 7
Receipt Number:
Permit No. OS PA G 1 l 3y
Waiver No.
Permit App__- : • . ..:c
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201134, Rebecca Carroll, 06/03/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201134, Rebecca Carroll, 06/03/20
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@paneng k.com
23 December 2020
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Rd.
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Denaly Estates B2 L14
Drain Field Separation Waiver
Ladies and Gentlemen:
I am requesting a waiver for the subject property for a
separation distance from an adjacent drain field to be
less than twice the affective depth, in this case from 8
feet to a distance of less than 8 feet. The code
requires that two adjacent drain fields be separated
by eight feet or twice the affective depth. The
contractor installed the two drain fields on this
property eight feet apart. This separation distance
was verified by PES and the MoA Inspector during the
two bottom of excavation inspections. The system
was backfilled and additional fill was added. The MoA
has informed PES that the As -Built Survey is more
correct than the Record Drawing and that we need to
apply for a separation waiver. I disagree. However the
issuance of a COSA and approval of the Record
Drawings are being withheld until a waiver is applied
for and paid for. The soils in this area are typically
Hydrologic Soils Group A which contains organics
underlain by silty sand and gravel. PES conducted a
percolation tests on the lot and found a percolation
rate of under five minutes per inch (3.8 mpi) at the
depth of the drain fields. The soil composition and
percolation rate confirms the soil classification of HSG
A.
Due to the nature of and drainage capacity of the soils
found in the area (HSG A) the designed infiltration line
of 45% for septic system installation in these soils
should be used instead of the assumed/worst case soil
classification infiltration line of 25%. The slopes and
soil types enable installation of any conventional
system without the system effluent affecting the
adjacent drain field located less than 8 feet away.
As a result of the separation distance of less than 8
feet with a 45% infiltration line that will not affect the
adjacent drain field. If you have any questions or
concerns, please contact me at 745-8200.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Ndailling.- P.O. Box 1807, Pah-ner, AK 99645-1,807
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201134, Rebecca Carroll, 06/03/20
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
OSC261082
Parcel ID 067 -062-21 Expiration Date: 3/31/2027
Legal description DENALY ESTATES BLK 2 LT 14
Site address 25413 MC INTYRE RD
Current property owner(s) SMITH BRANDON M & SARAH N
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for
Comments or conditions:
No comments
bedrooms, with the following stipulations:
Original Certificate Date:
4/21/2026
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 Service 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 submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department 4 - 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. 067-062-21
Complete legal description
DENALY ESTATES BLOCK 2 LOT 14
Location (site address) 25413 MCINTYRE ROAD EAGLE RIVER, AK 99577
Current property owner(Q) SMITH BRANDON & SARAH
Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units
r_1 Other Non-public well as regulated by MOA R Water Storage
F-1 Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units
Fj Holding Tank R Community Septic or Public Sewer
5. SEPTIC TANK: F] Steel rN� Plastic ❑ Concrete r_1 Fiberglass
Age 6 _ See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: Fj AWWTS E] Bed F1 Deep Trench N Wide Trench F] Seepage Pit
Waiver request for: Distance:
Expedited review requested: Fj
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 L4 � t ac) 2(. Date of Payment
f`rN
COSA # c C Waiver #
COSA Application—Ap2025.doc
May 2025
COSA Checklist
Legal Description: DENALY ESTATES BLOCK 2 LOT 14 Parcel ID: 067-062-21
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 6/11/20 Total depth 144 ft
Cased to 144 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18 in.
Date of flow test for COSA 3/31/26
Static water level at beginning of test *1 ft.
Well production at time of test 3.5+ gpm
Water storage tank volume None gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate 0.261 mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Date 3/31/26
Comments *Artesian plug.
B. TANK DATA
Measured operating fluid level in septic tank 44"
Date of pumping 3/31/26
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) 12/14/2020
ALL standpipes present per record drawing
Total measured depth from grade 12.8 ft (max)
Measured depth to pipe invert from grade 8.3 ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes (MT) go to bottom of effective (ED).
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) N
If yes, enter date
Adequacy test date 3/31/26
Results Pass (Tested N Trench)
Fluid depth prior to test 16 in
Water added 600 gal
New fluid depth 24 in
Elapsed time 1440 min
Final fluid depth 14 in
Absorption rate 600 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 48 in (MOA 4’ ED)
Effective depth (ED) used 14 in (Final Fluid Depth)
Effective depth remaining 34 in
Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears
approximately with 4’ ED. Tested North Trench by directly adding to the North Trench MT. South Trench had 11” of fluid.
May 2025
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Disposal Field on Lot > 100’ Yes if No ft
Neighboring Disposal Fields > 100’
Yes if No ft
Sewer Line/Main > 100’ Yes if No ft
Sewer Manhole/Cleanout > 100’
Yes if No ft
Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10’ Yes if No ft
Field to Foundation > 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/Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
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
MOA WAIVER OSV201090 – FIELD TO FIELD 5’ WAIVER ISSUED IN 2020 BY MOA.
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 FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 04/10/2026
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
04/10/26
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Parcel I.D. 067-062-21
Certificate of On -Site Systems Approval
Expiration Date: fl&cA
1. GENERAL INFORMATION
Complete legal description Denaly Estates B2 L14
Location (site address) 25413 Mclntyre Rd ER 99577
Current property owner(s) Huber, James Day phone
Mailing address
Real estate agent Day phone
2. TYPE OF DWELLING:
F-1 Single Family (w/wo ADU)
F-1 Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
AA
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
n.
Water Storage
El
Holding Tank
El
Community Well
❑
Community
El
Public Water System
❑
Public Sewer
n
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $
Date of Payment 1119- [;21V20.'?0
Receipt Number 6 3 3.2
COSA # 0 Is C a() I
Date of Payment
Receipt Number
Waiver # () S 109 C)
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA
COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time
of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on
the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not
guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot
provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole
benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly
recommends buyers hire their own engineer to evaluate this report.
Name of Firm Pannone Engineering Services Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name
Steven R. Pannone P.E.
Date 2_1012-10-(
OF A/q�s�
�: 49��•�•_�
6. DSD SIGNATURE
System #1 Approved for bedrooms Steven Pannone
System #2 Approved for bedrooms CE n
S1-r5i \`
y pp s
Disapproved gni �''`�' �\✓
Conditional approval for bedrooms, with the following stipulations:
By: �� ' Original Certificate Dater Oa 0
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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Denaly Estates B2 L14
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 6117!2020
Total depth 144 ft
Cased to 144 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA new
Static water level at beginning of test flowing ft
Comments Artesian well
1=1111111_1iMILIff ill
Age of tank(s) new years
Tank type/material Wt.
Measured operating fluid level in septic tank na
❑ Standpipes/foundation cleanout per record drawing
Date of pumping na d tq aw
D. ABSORPTION FIELD DATA wide trench
Which system tested (date installed) new
❑ ALL standpipes present per record drawing
Total measured depth from grade -12 (+'_ 21 ft (max)
Measured depth to pipe invert from grade-e(+/"2)ft (min)
❑ N/A – pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
a
Parcel ID: 0647-062-21
Structure served by this system 1
Well production at time of test 50 qpm
Water storage tank volume na 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 Hanson Land Solutions
Date of Sample 72A 112020
C. LIFT STATION
❑ Required maint,
Age of liftstati
Lift statio aterial
completed
years
Adequacy test date New
Results a Pass For 4 bedrooms
Fluid depth prior to test in
Water added gal 7*4&t)
New depth in
Elapsed time '— min
Final fluid depth I in
Absorption rate 600+ 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'
0
Yes
Community Sewer Manhole/Cleanout > 100'
r Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' M Yes
if No
ft
Private Sewer/Septic Line > 25'F71 Yes
if No ft
Absorption Field on Lot > 100' M Yes
if No
ft
Holding Tank > 100' 0✓ Yes
if No ft
Neighboring Absorption Fields > 100'
0 Yes if No.
Water Main > 10'
Animal Containment > 50'[,✓ Yes
if No ft
M Yes
if No
ft
Q Yes if No.
Water Service Line > 10'
M
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway
Community Sewer Main > 75' F✓ Yes
if No
ft
M 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'
M Yes if No.
Property Line > 5'
❑✓
Yes
if No
ft
Wells on Adjacent Lots:
M
Absorption Field > 5'
F
Yes
if No
ft
Private Wells > 100'
0 Yes if No.
Water Main > 10'
Q
Yes
if No
ft
Community Wells > 200'
Q Yes if No.
Water Service Line > 10'
M
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' 0 Yes if No ft If absorption field is under driveway comment below
Property Line > 10'
Q✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
0
Yes
if No
ft
Private Wells > 100' U✓ Yes if No
Water Service Line > 10'
M
Yes
if No
ft
Community Wells > 200' Yes if No
Surface Water > 100'
El
Yes
if No
ft
F. ENGINEER'S COMMENTS t_ ( /
C`tck (�i�" A-, ctni C�lLt "R rt j' (fit-' �r'CSfPtif Qe. o�,rfl
RfC.L ,17!3„2
ayj a.A1 F
G. ENGINEER'S CERTIFICATION
I certify that l 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
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