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HomeMy WebLinkAboutSCIMITAR #1 BLK 3 LT 7cirniarIt Block 3 Lot 7 #051-132-33 Municipality of Anchorage Community Development Department ,R a of 3 17 2U 1� On-Site Water & Wastewater Program JUL 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:dwww.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 121157 PID Number: 051-132-33 ❑ New ®Upgrade Name: FREDERICK HICKS ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 19890 TULWAR DRIVE *CHUGIAK, AK 99567 ❑ Other Phone: No. of Bedrooms: Son Rating: Total Depth from original grade: (907) 688-1599 3 GPD/Sq. Ft. Ft. LEGAL DESCRIPTION Depth to pipe Invert from original grade: Gravel depth beneolh e: Ft. Subdivision: Block: Lot: Fill added above original grade: Grav gin: SCIMITAR #1 3 7��NG GfavM wldth: �\C \v J " FL s Number of Unto Diatoms between lines: Ft owns ip: — ange: — ec ion: _ SEPARATION DISTANCES Total abaorpti area: umber of trenMes: Diet between trenches: To Septic Absorption Lift Holding Public/PNvato From Tank Field Station Tank Sewer Linea SD. R. Ft Well 100'+ 0 — — 25'+ TANK IN Septic ❑ S.T.E.P. ElHolding ❑Other Manufacturer: Capacity: Surface Water 100'+ — — ANCHORAGE TANK 1000 Got. Lot Line 5'+ — _ N�A Material' Number of compartments: STEEL 2 w Foundation 5'+ — _ LIFT STATION Curtain Drain NONE KNOWN Manufacturer. copaaty: Gal. lump on' level at �V S-��NG Nt r aorto at: Remarks: OLD SEPTIC WAS PUMPED, REMOVED, CRUSHED, & BURIEDhmp Make &Model• ctdeal Inspections performed by: ON SITE. PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer NORTHERN EXCAVATION Drainfield EXISTING CO MT EXISTING CO/MT GEG, Ltd. BENCHMARK (Assumed elevation) 100.00 Ft Inspection LoCation and Description: Dates: 1 st 7/9/1 2nd — 3rd — 4th — BOTTOM LOG 0 NE CORNER OF HOUSE Community Development Department Approval EN(NNEERY REAL Conditional approval: Date: :' •� 0 Q A. Garness:' OQOeor .• C —7 53 1O 1 (2 2'' A� 4 Date: ,ON PERMtr NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: OS dl bSP121157 051-132-33 IN r SCIMITAR #1; BLOCK 3, LOT 6 jS- 4 \c F A B s\ ST1 9.33 19.60 \ ST2 14.62 20.31 DBL1 16.98 21.20 P\ DBL2 18.10 21.84 \ \ \ FCO 5.50 19.83 \\ ,EXISTING DRAT LD <.' DBL1&2 \ 0 T2 0 ST1 \ B FCO A NEW 1000 GALLON SEPTIC TAN\ 'a,': ..• AT LOCATION OF OLD TANK. INSTALL EXISTING 3 \ BEDROOM HOUSE a. PER FIELD INSPECTION < 5.75' FROM TANK TO / TRENCH, AND 5'+ FROM \ TANK TO FOUNDATION. GARAGE GARNESS ENGINEERINGG GROUP, Ltd. CONSULTANTS S GENERAL CONTRACTORS ....... .. ...... .. ...... 17(11 E W" E0 . SUNS 101 • MWWE, M NW7 • PHONE (00337-8178 . FAC (807)339-3148 • 81E95N - xww.0omrnn9h Kngs PREPARED FOR: PHONE NUMBER: PAGE NUMBER: FREDERICK HICKS 688-1599 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SCIMITAR #1; BLOCK 3, LOT 7 P.N.B. TYPE OF WORK: DATE: AS -BUILT DRAWING 7/12/12 CE -793 d� PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: OSP121157 051-132-33 TOP OF TANK AT INLET = 96.25 INVERT OF BUNG AT INLET = 95.55 INSULATION FINAL GRADE = 98.92-99.05 ST1 ST2 /— TOP OF TANK / AT OUTLET = 96.23 NEW 1000 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 95.43 GARNESS ENGINEERING GROUP, Ltd. -. CONSULTANTS & GENERAL CONTRACTORS =1 E MOOR ROOD, SURE 101 - INWIORIOE, M 8850) - NONE (807)117-8199 - FIX (9072136-3216 r 91EIME: xwx.90 rneuangineertn8sdn PREPARED FOR: IPHONE NUMBER: PAGE NUMBER: FREDERICK HICKS 688-1599 3 OF 3 LEGAL DESCRIPTION: DRAWN B7 - SCIMITAR #1; BLOCK 3, LOT 7 P.N.B. TYPE OF WORK: DATE: PROFILE AS—BUILT DRAWING 7/12/12 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121157 Tax Code Number: 05113233000 Work Type: Septic Upgrade Permit Effective Dates: June 29, 2012 to June 29, 2013 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: SCIMITAR #1 Site Legal Address: SCIMITAR #1 BLK 3 LT 7 G:1261 Owner/Address: HICKS FREDERICK M & DEBORAH L 19890 TULWAR DRIVE CHUGIAKAK 995679714 Site Mailing Address: 19890 TULWAR DR, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 43670 Total Bedrooms: 3 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Bv: / _5f- _ Issued By: Date: �13 1 Z Date: 6 Z l Z MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application �c For A Single Family Dwelling W Parcel I.D. 1 il32-38 Property owner(s) FREDERICK HICKS Day phone 688-1599 Mailing address 19890 TULWAR DRIVE *CHUGIAK, AK 99567 Site address 19890 TULWAR DRIVE *CHUGIAK, AK 99567 Legal description (Sub'd, Block & Lot) SCIM4TAR #1; BLOCK 3, LOT 7 Legal description (Township, Section & Range) Lot Size Sq.FL Number of Bedrooms 3 THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (®all that apply) Initial ❑ Absorption Field ❑ Upgrade Septic Tank ❑ Renewal ❑ Holding Tank Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 0200' Waiver Fees: Date of Payment:�.5IQ Date of Payment: Receipt Number: Qa 2& Receipt Number: Permit No. 419N.21157' Waiver No. (Rev. 01/11) June 21, 2012 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Tank Upgrade for Scimitar #1; Block 3, Lot 7; To whom it may concern The existing 3 bedroom house is served by a private well and septic system. Gayness Engineering was informed that the existing septic tank needed to be replaced and we were requested to supply a design and submit for a septic tank permit. We are proposing to remove the existing 1000 gallon septic tank and replace it with a new 1000 gallon septic tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. M.S. NOTE. Attached is a design drawing, which is part of the design package for this septic system. (Contact G. E.G. Ltd for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com TANK DESIGN SCIMITAR #1L / / 2, LOT SCIMITAR #1; BLOCK 2, LOT 16 SEPTIC AREA \ \� 100' WELL LETTER THAT PERTAINS TO THIS DESIGN. GALLON /1000 SEPTIC TANK CONTACT GEG. BY PROCEEDING FORWARD TO BE DECOMMISSIONED WELL DRILLER, CONTRACTOR AND PER UPC PROPERTY OWNER AGREE THAT THEY SCIMITAR #1; BLOCK HAVE READ THESE SPECIFICATIONS AND / GARAGE SEPTIC AREA \ \� 100' WELL LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY SCIMITAR #1; BLOCK HAVE READ THESE SPECIFICATIONS AND 3, LOT 8 AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. / \ROPOSED 100' WELL RADIUS \I`s� NOTE: THE CONTRACTOR �F( SHALL HAVE ALL WELL RADII FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. \ s AFIELD \ SCIMITAR #1 6 LOCK /� C LL'S 6L \ �n1 / \P@OPOSED \ 1000IGALLON EXISTING —INSTALL FCC / 3 BEDROOM / HOUSE / \/ / /SCIMITAR #1; BLOCK 3, LOT 15 / / / I SCIMITAR #1; BLOCK / 3, LOT 14 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GE.NERAL CONTRACTORS 3701 E W" R . SME 101 • . GRAM M 99307 • P w (90])33]-8179 • Fm (967)330-3218 N M-. , .gam n9fnaarings PREPARED FOR: PHONE NUMBER: PAGE NUMBER: FREDERICK HICKS 688-1599 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: SCIMATAR #1; BLOCK 3, LOT 7 PNB TYPE OF WORK: DATE: SEPTIC TANK UPGRADE 6/21/12 slim �Jerr\� ess-7953 �O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE; SEWAGE DISPOSAL SYSTEM AND/OR Vr1FLL INSPECTION REPORT NAME PHONE 1AEW P— /'`S_/�1 _.— --- --------------- ----—�5—--V�I/ ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION — A 7-je 37l�n / 614/ c� _ LOCATION _ NO. OF BEDROOMS .3 Well �/ Absorpi` io9 i_ n area Dwelling U Y DISTANCE TO: I I % PERMIT NO. N Z Manufacturer Material a No. LU Q of compartments N Liq. capacity in gallons Inside length Width I IF HOMEMADE: Liquid dei 1 Gth r 0�Y e z DISTANCE TO: — Well —--- -- Dwelling — PERMIT NO. `L S — F• Manufacturer Material — Liquid capacity in gallons DISTANCE TO of lines ach line 7Ln9th�,f Foundation m�Nearest lot line Total length of lines Trench width PERMIT NO.x c9,2CJS P _No. Distance between lines inches_ Q E. .7 -- Top of the to finish grade -- _ _.36 Material beneath tile Total effective absorption area �- s W Length Width Depth - - —� PERMIT NO. LU LU Type of crib Crib diameter Crib depth Total effective absorption area N DISTANCE TO: Well Building foundation Nearest lot line T LU Class s Depth �- Driller Distance to lot line PERMIT NO. DISTANCE TO: Building oundation Sewer line r Septic tank f Absorption area(s) OTHER r PIPE MATERIALS SOIL TEST RATING .GL INSTALLER REMARKS I -6, - - - �upc'tE4/c'�+' C�-�'/fJP/CP�c�•%�J G?���.(t±r //� — � – — — LEGAL vAPPRO/VFD��1}DATE zr� ' Xa , �._ TYPE OF SOIL HBSORPTI�M SYSTEM IS� TRENCH MHXIMUM NUMBER OF BEDROOMS � ] SOIL RHTING (SQ FT/8R)� 90 THE REQUIRED �IZE OF THE SOIL HBSORPTION SYSTEM IS� THE LENGTH DIMENSION lS THE L�NGTH (IN FEET) OF THE TRENCH OR DRHINFIEL0 THE DEPTH OF H TRENCH GR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF TH— GROU�D HND THE BOTTOM OF THE EXCHVHTIOH (IN FEET) THERE IS NO SET WIDTH FOR T�ENCHES T1 dE GRHYEL DEPTH IS THE MIMIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PlPE HND THE 8OTTOM OF THE EXC9VHTION (IN FEET) �T� if if�� PERMIT APPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTM�NT DURI�G THE IMSTHLLHTION INSPECTIONS OF 8NY WELLS HDJHCENT TO THIS PROPE�TY HHD rHc HUMBER OF RESIDENCES THHT THE NELL WILL SERVE� 6HCKFILLING OF HNY SYSTEM NITHOUT FlNHL INSPECTION HHD HPPROVHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION HPPLICRNT HL�MN OLSEN � �; / ��. .a g7m - ¢•14 �11r•3 )_ I_ = a^ -11 1 3 if- =-}i f! �xf is, j,:FPi ![ 1ti- 'r :-.i i? !°i ileTl! i('JCr F(j•fl`{f P}�,1.. i -t !r1 _°. 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Ln :'1 i°i ti -1L` i .'-'�i T1-;� _ I�ti`y _--.: [•:; _ ;t.1:�>; f-` :-'} t.?',?"1� >-, _t: q f f :?.-: ' 11 , dF .} f,. -T# .. r 1 t_!i'- }`if�-S� t -„ }c:i =1'1F.Ff n. f.. = �t 1 f.f T r`yFv7.J i(}1 T`l _i3 F i` Fri?) s�i�i� _ F.:i'ii?:- lfT"rf_.c'!('( �.sl-:`✓{�ti - i r Solo Development 724 E. 15t -h Avenue Anchorage, AK Permit 4 810246 January 4, 1982 Subject: LOT 7 BLK 3 SCIMITER A permit issued by this department for a well and/or sewer system has expired as of December 31, 1981. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, ,q�-G�l,� Les N. Buchholz �/ x ts. Program Manager Sewer and Water Program Enclosure: Copy of Permit MUNICIPALITY OF ANCHORAGE 5 I C) Department - Health and Environmenta protection 825 L Street, Anchorage, AK. 99501 264-4720 (�,1 Q�a- (J ' 11 i HANDWRITTEN PERMIT WELL AND7 ON-SITE SEWER PERMIT Applicant: JO �C) j/. Mailing Address: Location �U L W A-{'- Phone Number: 2 7Z - p J/ Legal Description: /•o T7 �Ce/< 3 S)c ho Lot Size: Type: of Soil Absorption System IS- Trench: s:Trench: vl' Drainfield: __Seepage Bed: Holding Tank: Maximum Number of Bedrooms: �_ Soil Rating(sq.ft/br) JAS9 The Required Size of the Soil Absorption System Is: - DEPTH % r �, LENGTH S _ GRAVEL DEPTH 3 �A_ WIDTH The length dimension is the length(in feet) of the trench or drainfield. The aepth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). # REQUIRED SEPTIC(HOLDING) TANK SIZE _ /DKr _ GALLONS # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # TWO(2) INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer _line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion.. Other requirements may apply. Specifications and construct:ion diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is.remodeled to include more that 3 bedrooms. Issued b: Signed: ( iy: — g � r ppl cant r Date: .J SWP/024(1/81) r X SOILS LOG MUNICIPALITY OF ANCHORAGE a4.i`S DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR:`^ /��-,�1k,64,z.f� 4yDATE PERFORMED: LEGAL DESCRIPTION: 6--4 DEPTH J� SLOPE SITE PLAN 3 Date Gross Time 4 �~ Net Drop 5 leeey 6! A� 7 8- 9 10- �e 11 - --� 12 13 14 15 16 17 18 19 JG W WAS GROUND WATER S ENCOUNTERED? L O P — IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN e FT AND FT COMMENTS i� j f`� t��� ) I� rIKod _ PERFORMED BY: /_- ILly— +` CERTIFIED BY: 72-008 (6/79) I VERN'S DRILLING & ENTERPRISES J STAR RT. A - BOX 1560 - ANCHORAGE, ALASKA 99507 - (907) 344.1422 ll M�-Iy :50, 1981 To 11, AJoy. r!oncern: On J,Tav *50, 1981 , I C:i.(:l ,I(-,-vc!lDl mont vic_-k on ()[I jvc'Ll. locatml Block 1 't 7 c I m J t,_l r ,S'u b J -1. vJ.,,:;:L o n fl."Ic vic"t.1 vjr'a surgod a.nd bailcO tr check: rec,wery. The moon flow vlus from 'nerforatec- I o 441 tl() 43 - The flow tested, to be lj- rrpm, which 576 Callon,; p-�r day. The well wul,; only bailed -1�)wn enough to cr,Lertfliiic the :7rcITI the porfoj--,--AcoJ' and lid not. tape :1-n-- L0-,',1C0tML thC-) viut2r secping 1':-olli the YoLt-,5 v(..,. -,i v T 71 T T T T T T �1 Ott nl T T T T `f1 T T T T T T O O O O O O O O O O O ON) 'I , TI it T T T T T T T T T r+ rF N r+ r+ r+ rf f+ T T T T T T T T T T T O O O O O O O O O O O TI T T T T T T T T T T O O O E O O O O E O O r1 _r+ M .rr+ r+ r+ r+ r+ r+ h T rf T T T O D D roil p D M r M r :0 m O rn �J n m r I =� m m T cn W 0 W p D M r O T n m r O D ap m T cn m z P m P i L P Dm mhoow rm- 4rA O 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. 051-132-33 Legal description Scimitar #1 Block 3 Lot 7 Site address 19890 Tulwar Dr Current property owner(s) Frederick & Deborah Hicks Expiration Date: 11-26-22 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: r Original Certificate Date: 3'2 6 — 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 Other COSA Approval_June 2022 MUHMP A UTY OF ANCHORAGE 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. 05113233000 Complete legal description SCIMITAR #1 BLK 3 LT 7 Location (site address) 19890 TULWAR DR Current property owner(s) HICKS FREDERICK & DEBORAH Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 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 10 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: field to lot line Expedited review requested: ❑ Distance: 4' 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 $ 550 Waiver Fee $ 2 Z!3 Date of Payment 2 �(" 2 2 Date of Payment COSA # 0C- 221 W31 Waiver # _O s V 22 059 COSA Application_ June 2022 Legal Description: SCIMITAR #1 BLK 3 LT 7 Parcel ID: 05113233000 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 1981 Total depth 305 ft Cased to 305 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '24 in. Date of flow test for COSA 7/21/2022 Static water level at beginning of test 36 ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping July 25, 2022 ❑ Required maintenance completed, if AWWTS Comments: steel tank installed 2012 Which system tested (date installed) 1982 ❑ ALL standpipes present per record drawing Total measured depth from grade 5.8 ft (max) Measured depth to pipe invert from grade 3.3 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 0 ❑ 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) no If yes, enter date Well production at time of test 0.35 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 2.74 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Curtis Townsend Date 7/21/2022 STATION ❑ Require inti Age of lift station . Lift station material Comments: nce completed Adequacy test date 7/21/2022 Results Fa -1 Pass Fluid depth prior to test 0 in Water added 575 gal New fluid depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 36 in Effective depth used � 6 in Effective depth remaining ' 30 in Comments/Deficiencies: monitor tube only extends 30" into effective depth. there was no water in bottom of MT throughout test. There is less than 6" of water in the trench, exact amount undetermined. 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' R Yes if No ft Community Sewer Manhole/Cleanout > 100' RYes if No ft ® Yes if No ft Neighboring Tank >.100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' r-ol Yes if No ft Holding Tank > 100' FE Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' © Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Q Yes if No ft ❑ 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 5 ft Surface Water > 100' Q Yes if No ft Tank to Property Line > 5' R Yes if No ft Field to Property Line > 10' ❑ Yes if No 4 ft Water Main > 10' R Yes if No ft Water Service Line > 10' ® Yes if No ft F. ENGINEER'S COMMENTS Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' E Yes if No ft Yes if No ft If tank or field is under driveway comment below 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 C U�/y (r /U7/�/1` IZ/y Phone 907.406.1058 Engineer's Printed Name tt1 S 70 wA,S /✓V� Date COSA Checklist June 2022 ENGINEER'S 2$T> "' F° Municipality 00 I cpartmcnt P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program Waiver#: OSV221059 COSA OSC221431 Permit#: PID#: 051-132-33 Legal Description: Scimitar #1 BLK 3 lot 7 Engineer: Townsend Applicant: Fred Hicks Your request for a waiver of the required 10 feet horizontal separation from the drain field to the lot line has been approved. The approved separation distance is 4. This waiver approval applies to the Existing Trench only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. ■mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm� Waiver is Granted: X Waiver is not Granted: 2- Date:(� 2- Approved Name of Reviewer mmmmmmmmmmmmammmmmmmmmmmmmmmmmmmmmmmmmmmmmmmsmmammmmmmmmmmmmmmmmmmmmmmmmmmmmmmt n 1 A.. .�� Eklutna Engineering, LLC curtistownsend@gmail.com August 23, 2022 Subject: Scimitar #1 Block 3 Lot 7 Field to lot line waiver request OSC221431 A COSA is being sought for this property. A new survey as -built was completed since a new septic tank was installed in 2012. It was discovered that the septic pipe is 6' away from the northeastern boundary line. I am requesting a waiver for the reduced separation distance. The following justifications are provided for your consideration. The field in the northern portion of lot 7 was installed in 1982. The sump for this field is 6' away from the northeastern boundary line. The effective depth of this field is 3'. Lot 6, to the northeast has a field located in the northern corner of this lot. It was installed in 2004 and has an effective depth of 4'. The nearest distances between the two fields on these lots is 95'. The distance between these two fields is at least twice the effective depth of either trench. Lot 6 has room to construct any future upgraded trench. The edge of the trench on lot 7 is estimated to be 4' away from the eastern boundary line. For the above reasons, we request that the waiver be granted for the current situation. Sincerely, Curtis L. Townsend, P.E. �unici ality o A c orae <<::.:R �.. Development Services Department : .............. ................ Building Safety Division F E T Y On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC221461 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 7 of Scimitar #1 subdivision, the well's productivity was determined to be .35 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. 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Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING c Parcel I.D. 0 1.132-33 HAA # Q_ C,b Z> Expiration Date: 12 3 - O 3 1. GENERAL INFORMATION Complete legal description Lot 7 Block 3 Scimitar #1 Location (site address or directions) 19890 Tulwar Drive, Chugach, AK 99567 Current Property owner(s) Allan & Suzanne Olsen Day phone 688-9735 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 19890 Tulwar Drive, Chugach, AK 99567 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding-tank—[D— Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to nome owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (Rm I IM) 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, 1 verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En -g. Svc. Phone 272.8218 Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 61!21 b'3 Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & 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 le-vels 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. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 6. DSD SIGNATURE 1/' Approved for __�3 bedrooms. Disapproved. r _ 49TH �'��+ ESS Conditional approval for bedrooms, with the following stipulations: 149 Additional Comments Note: The well for this property meets existing State and ER Municipal Codes. There are nitrates present. It is suggested that periodic testing b4 _performed to insure the wells continued Suitability ratrrrnt-nitratn rnnnontrat— ion is 5.99 mg/1. EPA maximum concentration is 10.0 mg/1. More information on n1trates is available trom the Un—Site Services Program, at 343-7904. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: a .iif.�y Original Certificate Date: G _A3.O Expiration Date: Reissue Date: (Rev. 11199) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 7 Block 3 Scimitar #1 Parcel I.D.: 021-132-33 A. WELL DATA Well type E If A, B, or C provide PWSID # Well Log Y Date completed/ 033 /1981 Sanitary seal y 1 ap Wires properly protected Y Total depth 50 _ft Cased to �ft 7 qv . Casing height (above ground)�3 In. FROM WELL LOG AT INSPECTION Date of test 5/30/1981 6/6/2003 Static water level 44-48 ft 37.3 It Well production .4 L 9 -p.m 0.32 9 -p.m WATER SAMPLE RESULTS: Coliform Scolo�e /1 0 mlLn�� j Nitrate 5•99 mg/I Other bacteria �Q colonies/100 ml B`f 3 t. Date of sample: Collected by: Laura Pannone B. SEPTIC/HOLDING TANK DATA Tank Type/Material Greer Steel Date installed 8/911182 Tank size 1000 gal Number of Compartments 2 Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm //A Date of pumping 6/6/2003 Pumper Chugach Pumping C. ABSORPTION FIELD DATA Date Installed/9$ /1982 Soil rating (. .. Z or ft%drm) $0 System type Trench Length .4Lft Width .� _ ft Gravel below pipe ,3 ft Total depth Ll ft Effective absorption area Z flz Monitoring tube x Depression over field N Date of adequacy test 6/612003 Results (Pass/Fail) __e_ For 2 bedrooms Fluid depth In absorption field before test Pjy in Water added450 gal. New depth35 in. Elapsed Time: 40 min Final fluid depth Pa in Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date (Rev. 11/99) Curtain drain None Observed Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date G /17- /6-3 HAA Fee $_,S775 � Date of Payment (Q 113 10 3 Receipt Number 3 7 O 3 1 (Rev. 11199) Waiver Fee $ Date of Payment Receipt Number ., r .,ry! • 40TH . .. ...............%..� P.Slevcn R. •Ponnon'i • No. CF 8149 D. LIFT STATIONXP Date installeds Manhole/Access "Pump on" level at t in High water alarm level at in Datum Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line 75+ Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 7 Property line 30+ Absorption field 6+ Water main 100+ Water service line 50+ Surface water 100+ Drainage None Observed Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 16 Water main 100+ Water Service line 50+ Surface water 100+ Driveway, parking/vehicle storage 11• Curtain drain None Observed Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date G /17- /6-3 HAA Fee $_,S775 � Date of Payment (Q 113 10 3 Receipt Number 3 7 O 3 1 (Rev. 11199) Waiver Fee $ Date of Payment Receipt Number ., r .,ry! • 40TH . .. ...............%..� P.Slevcn R. •Ponnon'i • No. CF 8149 Municipality of Anchorage •�, Development Services Department �_ . f •a Building Safety Division , . .. On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 030257 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block 3, Lot 7 of Scimitar #1 subdivision, the well's productivity was determined to be 0.32 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. .s sp TM 3 jF �, � ', APPROJClLOGAT �OrJ \ / Y NOTES o I. RECORD INFORMATION BASED UPOW � AN HpO}�F�EI RIETGORD1t�G Li1S R1G1' 1' PLAT tJp- 74-{E� 4 AM! 114FOKMATIOM OW PLATS REf...O1ZLeD PRI TO TO OR / AFTi i� THE 6EPOM MENTIONED SU150NISIOW PIAT IS V40T SMOW11. 2. (P) FOUND INFORMATIONAL CALLS 3. (R) RECORP INFORMATIONAL CALLS. 4 NO MONWMAMMTS SbT PHIS SURVE`(. 5. IMFI7DY Ft -IT +TIES ARE SHOWW TO THC.: NEAR6rST FOOT, ACCURACY VAL10 t OR- 1.0 . S, H@R wge GER'flfY THAT Z HAVE SUMAi- 9 THE PROPERTY T be4LARE THAT A43 - OUI L:r DC-"SCRIEWD ON THIS PLAT. HANE haSABT6 AND TIOFEN ELSHEvTOHE BLE EUT MY FKOES61013AL KNoZW�'IEDG�AND SEL1E {, n n C LOT 7 BLOCK 3 . � DATE`x STTNN EN .SEA S RL. 2os'!-5 SCIMITAR SUBDIV1510M EXCLUSION TH115 `PURVEY IS POMC THE USE OF LF„Nt71NG E.0INSTITU- ANY COFUCTS B - SPIFIEAL %( TO SHOW NE U\ j IT MTIONS YYWroam E7U4.TING bT1�4CTU " ANP PL.Ary�.T my LOT Wwas N OR EA6EhMiNTb. UNRER NO CIRgUMroTANCEs SH06lW ANY PA -TA HF_KWW BE. USED r -OK POSITIONING AIPPIT10l1- At- 6T9UCTUfM5j 5U1LDING PPLOCKS.1 OIC LOCATING 3 A AKS 4ASSOCIATES LEi vl -5d pATEs 12-20I-66 50WO40,kRY L.It4F-,. IT IS THE RE5PGNS1$ILITY OF THR OWNBR TO GIiTER6 LIWW SUMyo'RS DRAW ; CHaCKEDt P&TSKMWE TME EKIroT1aNCE OF ANY EA'SEMF-NT OK RE.STX%C,Ttot4 WHICH APPGARONTHE V Po. sox zea 5.E•s. DOES NOT EAG1E X1%41 l^%-ASKA 99577 KEGOROEP lSWSDtVISION PLAT AND TC VERIFY THAT THM IMPROV6.MI=NTS srruAT£D ON TH%S PARCB L� PREPA ED MKS GRtDs PeTSm'B2- FI@LD Boat MEIi.T k%-%- SUEsD1VIrotOtJ COV£ ANT5 AND ZD ►NG ORDINANCES. AL OISEN G EK BZ 9 - P.O. 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