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HomeMy WebLinkAboutSMITHSON LT 97AOnsite File uffso I � 104 � 76 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP231414 Work Type: Well Initial Tax Code Number: 05110476000 Site Legal Address: SMITHSON LT 97A G:1358 Site Mailing Address: 22179 BIRCHWOOD LOOP RD, Chugiak Owner: PORTERFIELD POMPOSA L Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: . r. Department 12/19/2023 12/18/2024 40243 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: ( S SDate: Issued By: Date: 70 Z 2 i rk91 U rN3 I C I P A L ITS 0 F AN C H 0 RAG E -" 4W PhwTI4: 907.40 14 On -Site Water. & 'Afa,stewate-r Soction :Fax* 9W343=79?917 ON -SITE SEPTI-D'kVELL PER-1-MT APPLICATION parc,L,l I.D. 051-104-76 -Property cAwnerfs fi'L 615-569-8697 , ) POM'POS-5a PQrte-f 71d Day phunE Mailing.widre-, %s 22179 N Birchwood Loop Road 'Chugiak S-ite address Lck,gal aiescription (Sub'd.j Blom & Loti SM[flison L-97A, Legal dascaptlon (T-owreii-p, Rimg-a & 8evlkirij Lot -Size %31Ft I-q, Numberiff aerlrncjm, APPLICATION M FOR: APPLICAMN IS ANI: TYPE OF DWELLING: ICE all that apply) Absorpijan Field [In"bal 5jnglc Farr"tily (8,F) 1.71 (vdvio A0,U) Septi c Tank, !__IL) p g,-s cl e ' Duplex,fD) CI H,old's'ng Tank ED Rerlewol El r%-1u]LiW-.,e Dwellings Ell (SF wkd-lor D), Private Well THIS APPLIC ATIONINCLUDES; A WAFVER.REQUEST FOR-.. Distence: .1 ceTtify that the at Information is carTeCL. I further certify 11mi, this iis,fti iacm.rclance with applimble Municipal Codes: 0 ati-tre -of propemy owner -or aut-horjzF_-d eqgent), §4� � tie -of Fens: Date. of Pvyn-ben, t; Recefpt Number. Pemilt No. waiver Feag7 Date. of Pact; RecOpt Numben Walvor No. unt Svroyi;m"Buidn AS a fL I VtOri the W a It! r and 11hus I evimleeiraD "mIrCkem Famm)F'_-;mi I Ami-ir-ef-omdoc @BCH OI{gG� 'tt-ra , WELL FLOW TEST REPORT Conducted by Anchorage Well & Pump Service T640 King Street, Anchorage AK 99513 Ph: (907) 243-0740 Fax: (907) 243-0742 OWNER INFORMATION Owner: Porterfield, Pomposa L Address: Property: 22179 Birchwood Loop Rd Chugiak, AK 99567 PUMP ON Time: 12:50pm PUMP OFF Time: 3:15pm Date: 12/08/22 Date: 12/08/22 PUMP INFORMATION Intake Depth: Static Water Level: Depth of Casing Max Drawdown: Well Production: 20.2 gpm (at time of test) Elapsed Time Water Level Flowmeter Gallons Comments Feet Reading Pumped 12r8/22 12:50pm 107.7 39280 Start test 12:50:11 pm 112.3 39310 12:51pm 112.4 39330 12:52pm 112.4 39335 12:53pm 110.3 39402 Slowing flow 12:56pm 110.2 39440 18 gpm 1:OOpm 110.2 39520 1:02pm 110.5 39554 20 gpm Raise flow 1:1Opm 110.45 39730 1:20pm 110.4 39920 1:30pm 110.4 40120 2:OOpm 110.3 40730 2:20pm 110.3 41133 2:40pm 3:OOpm 3:13pm 3:13:30 pm 110.25 110.25 110.26 108.1 41,550 41,940 42,200 42,203 Stop test - Recovery time 3:14pm 107.8 42,203 3:15pm 107.8 42,203 Well recovered to original static 2,646 gallons in 131 minutes 2,646 _ 131 = 20.2 20.2 gpm * Well chlorinated and flushed prior to test. Test performed at wellhead MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. THE STATE GO-VEI�;I� R P ICI-LAEL I, EiUNLEAV December 14, 2023 Pomposa Porterfield Mt , DIVISION OF ENVIRONMENTAL HEALTH Drinking Water Program 555 Cordova Street Anchorage, Alaska 99501 Main: 907.269.7623 Fax: 907.269.7650 dec.alaska.gov PO Box 670030 File: Birchwood Loop Chugiak, AK 99567 Class: 97A Private, 97B Transient Non -Community porterfieldpompialaska@gmail.com Sources: Groundwater Re: Birchwood Loop — Lots 97A & 97B, Smithson Subdivision Separation Distance Waiver Dear Pomposa Porterfield, On December T" and 12`'', 2023 this office received updates to separation distances from David Nyman, P.E. of Restoration Science & Engineering, LLC. (RSE) and a request to revise the Separation Distance Waiver issued October 2, 2023 for two new groundwater wells to existing onsite wastewater systems located in Chugiak. The revision was requested due to a recent as -built survey conducted by Farpoint Land Services, LLC. This letter issues Separation Distance Waivers as detailed in the submittal outlined below and separation distances in Table 1. Project Description Two new drinking water wells were installed at the previously operational Circle S Grocery property along Birchwood Loop Road, just north of the Glenn Highway. The legal descriptions of these two lots which received a drinking water well are Lots 97A and 97B of Smithson Subdivision. The intent of drilling new wells was to provide safe and dependable drinking water sources for each lot and avoid an existing hydrocarbon impacted groundwater plume on Lot 97B. To avoid any potential hydrocarbon impacts, the wells were installed closer to the onsite wastewater systems and encroach upon the minimum separation distances listed in 18 AAC 80.020. This review is being performed at the request of the current property owner in anticipation that future buyers may have an approved well source. This review/approval is limited to the source - separation distance evaluation to sources of potential contamination. Future construction or modifications for a public water system served by these wells will require the system to be classified and undergo engineering plan review in accordance with 18 AAC 80.200. Site Background The subject properties are located near a steeply sloping bluff that descends roughly 85 feet to the bottom of Peters Creek Valley. Soil consists of dense to very dense silty gravel, gravelly silts, and sandy gravel with cobbles and boulders. Lots 97A & 97B, Smithson Sub. December 14, 2023 Lot 97A consists of the following: • 2 -story single family residence • Shared gravel drive with Lot 97B • Monitoring Wells (1\4W-04, MW -05) • Onsite wastewater system with leach field located within a septic system easement on Lot 97B o Design by Garness Engineeing, Installed 2005 o Anchorage Tank, 1500 Gallon, Steel with Septic Tank Effluent Pump (STEP) o Leach Field: 2.5 -ft wide, 47 -ft long, 6.5 -ft effective depth (731 sq ft absorption area) • New well 97A Lot 97B consists of the following: • 1 -story commercial building • Shared gravel drive with Lot 97A • Monitoring wells (MW -01, MW -02, MW -03) • Onsite wastewater system, o Design by Garness Engineeing, Installed 2006 o Anchorage Tank, 2000 Gallon, Steel with Septic Tank Effluent Pump (STEP) o Leach Field: 15 -ft wide, 70 -ft long (1050 sq ft absorption area) • Hydrocarbon impacted area • Easement for Lot 97A leach field • New well 97B The commercial building located on Lot 97B was once known as Circle S Grocery and included a functioning gas station. In 1995, a gasoline release was identified while removing a 10,000 -gallon gasoline underground storage tank (UST) and 5,000 -gallon diesel UST. The hydrocarbon -impacted soils were removed to a depth of 14 -feet, a hydrocarbon resistant liner was installed in the excavation, and a new dual compartment 11,000 -gallon UST wasinstalled. In 2012, the 11,000 -gallon UST was removed. This site is listed on DEC's Contaminated Sites Database as File No. 2106.26.004, Hazard ID 24797 Circle S Grocery. The site has been subject to a series of environmental assessments in accordance with DEC Contaminated Sites, which showed the existing drinking water well once shared by both Lots 97A and 97B is located within the hydrocarbon impacted groundwater downgradient of the contaminated source area. The site has received of a status of "Cleanup Complete with Environmental Covenants". An additional potential source of contamination to be avoided is the upgradient Three Bears Store parking lot stormwater infiltration gallery located south of Lot 97B. Drinking Water Well Installation Given concern over potential hydrocarbon impacts, RSE used available information to evaluate local hydrogeology and potential or known contaminant sources for locating the two new drinking water wells. Some of the resources consulted are: DEC Drinking Water Watch website, interviews with local residents, review of area wide drinking water well logs, discussion with local knowledgeable well drillers, review of topographic maps, and examination of water well gradients and flow directions as measured in five site monitoring wells (MW -01 to MW -05). The result of the review concluded that a deeper groundwater zone exists that was likely protected from surface impacts. Groundwater flow was noted going south to north. Wells 97A and 97B are currently not connected to any buildings, but are expected to be connected after property re -development as the subject property is currently on the market for sale. 231214—Birchwood Loop Lots 97A and 97B correction_WA.docx Lots 97A & 97B, Smithson Sub. December 14, 2023 Lot 97A Drinking Water Well In November -December 2022, Alpine Drilling & Enterprises installed a new 6 -inch steel casing well to a depth of 159 -feet below ground surface (bgs) with a 3 -foot stickup above ground. The new well is located approximately 95 -feet northwest of the hydrocarbon impacted plume. This well serves a 2 - story single family residence. The well is screened from 153-159 feet bgs. The upper 20 feet of the well was sealed with 10 bags of bentonite chip grout. The well was disinfected with chlorine tablets then flushed, and a well flow test was conducted resulting in an average flow rate of 20.2 gpm and a static water level of 97 feet. The well log shows stick up from 0 to 3 feet, cobbly silty gravel with boulders to 66 feet, silt from 66 to 79 feet, silty gravel from 79 to 95 feet, gravelly silt from 95 to 117 feet, wet silty gravel from 117 to 132 feet, and silty gravel with water from 132 to 162 feet. As a precaution due to known hydrocarbon impacts located southwest of the Lot 97A well, RSE collected field screening and laboratory soil sample from cuttings at approximate depths of 85-86 feet bgs, and a soil field -screening sample from 121 feet bgs. Soil samples were negative for gasoline range organics, volatile organic compounds, and polynuclear aromatic hydrocarbons. Three water samples were collected, two air lifted during drilling at approximately 122 -feet bgs (GW - 1) and 159 -feet bgs (GW -2), and one from the submersible well pump set at 159 -feet bgs (97A- 12822). Sample 97A-12822 exceeded the secondary MCL for aluminum (0.221 mg/L versus the secondary MCL range of 0.05 to 0.2 mg/L). Analyses for total coliform and e.coli bacteria were absent. Total nitrates/nitrites were 6.6 mg/L. Lot 97B Drinking Water Well During the months of December 2022 and January 2023, Alpine Drilling & Enterprises installed a new 6 -inch steel casing well to a depth of 158 feet below ground surface (bgs) with a 2 -foot stickup above ground. The new well is located approximately 85 feet east of the hydrocarbon impacted plume. The well is screened from 153-158 feet bgs. The upper 20 feet of the well was sealed with 7 bags of bentonite granules. The well was disinfected with chlorine tablets and flushed, then a well flow test was conducted resulting in an average flow rate of 20.5 gpm. Static water level is at 96 feet bgs. The well serves a single -story commercial building once known as Circle S Grocery. The well log shows stick up from 0 to 2 feet, cobbly silty gravel with boulders from 2 to 68 feet, silt from 68 to 77 feet, silty gravel from 77 to 96 feet, gravelly silt from 96 to 101 feet, silty gravel wet at 101 feet bgs, and gravelly silt from 101 to 105 feet, silty gravel wet from 105 to 121 feet, and silty gravel with water from 121 to 162 feet. As a precaution due to known hydrocarbon impacts located on Lot 9713, RSE collected field screening soil samples from cuttings at approximate depths of 10 feet bgs, 20 feet bgs, 103-108 feet bgs, 85-86 feet bgs, and a laboratory soil sample (RSE-14-97-B) collected from cuttings at 103-109 feet bgs. Soil samples were negative for gasoline range organics, volatile organic compounds, and polynuclear aromatic hydrocarbons. The driller noted that all soil intervals were dense to very dense. Water sample 9713-11023 was collected during flow testing from the submersible well pump set at 155 -feet bgs. Well 97B sample exceeded the secondary MCL for iron (0.447 mg/L compared to the secondary MCL of 0.300 mg/L). Analyses of the sample for total coliform and e.coh bacteria were negative, and total nitrate/nitrites were 6.6 mg/L. Separation Distance Waivers The department finds that the information, justification, and endorsement of the submitting engineer adequately supports waivers of the minimum distances required in 18 AAC 80.020. 231214—Birchwood Loop Lots 97A and 97B correction_WA.docx Lots 97A & 97B, Smithson Sub. December 14, 2023 The following conditions were taken into consideration as part of these waivers: 1. Configuration and system design requirements prohibited the wastewater system from being installed so that it meets separation requirements; 2. The presence of very dense gravelly silt and silt layers. 3. Sample results collected by submersible pump from the new wells (samples 97A-12822 and 97B-11023) meets all MCLS with minor exceptions: Well 97A slightly exceeded the secondary MCL for aluminum and well 97B slightly exceeded the secondary MCL for iron. Both samples, when subjected to 0.45 filtration, were able to meet the secondary MCLS. Table 1: Separation Distance Encroachments Lot Water Source Potential Contaminant Horizontal Separation Distance Notes 97A 6 -inch well casing, Sch. 40 Black Iron, grouted Lot 97A Septic Tank 75 ft.* S8 ft. 7.8 i$: Lot 97x1 Leach Field 75 ft.* 84 ft 7.4 =ft. Lot 97B Leach Field 62 ft.* 6H -€t-. Lot 97B Leach Field 107 ft. — 7 in. 97B 6 -inch well casing, Sch. 40 Black Iron, grouted Lot 97B Septic Tank 110 ft.* , 12 ftt. , , ;_ Lot 97x1 Leach Field 60 ft. —11.5 in. Located on Lot 98B septic system easement. *Reduction in distance ftom updated as -built survey by Farpoint Land Services, LLC. Dated: 12/07/23. Based on an evaluation of the available information and in accordance with the State's Drinking Water Regulations, 18 AAC 80, a Separation Distance Waiver for the wastewater system encroachments detailed above is issued. Limitations and Appeal Process This waiver is limited to this project and its current site conditions. Any changes, constructed or natural, that affect the conditions to which this waiver was granted may void this waiver and the water or sewer may be required to be relocated to meet separation distance requirements. Approval of this waiver does not obligate the department to approve future waiver requests proposing the same design, is not an approval of omissions or oversights, and does not guarantee correctness of the functional design or waive the owner's responsibility for continued compliance with state, federal, and local regulations. A person authorized under a provision of 18 AAC 15 may request an informal review of a contested decision by the Division Director in accordance with 18 AAC 15.185 and/or an adjudicatory hearing in accordance with 18 AAC 15.195 — 18 AAC 15.340. See DEC's "Appeal a DEC Decision" web page https://dec.alaska.gov/commish/review-guidance/ for access to the required forms and guidance on the appeal process. Please provide a courtesy copy of the adjudicatory hearing request in an electronic format to the parties required to be served under 18 AAC 15.200. Requests must be submitted no later than the deadline specified in 18 AAC 15. 231214_ Birchwood Loop Lots 97A and 97B correction_WA.docx Lots 97A & 97B, Smithson Sub. December 14, 2023 If you have any questions regarding this plan review, please do not hesitate to contact me at 907-269- 7632 or lnichael. erard@alaska.gov. Sincerely, IV cha 1 Gerard 14 Engineer Assistant II, DEC Cc: Bill Rieth, DEC WW, bill.rieth@alaska.gov Kate Earl, Owner's Representative, getaholdofkate@icloud.com Chris Jackson, DEC -DW EPT, chris.jackson@alaska.gov David Nyman., RSE, dnyman@restorsci.com Chris Pletnikoff, DEC -DW, chris.pletnikoff@alaska.gov 231214_BirchNvood Loop Lots 97A and 97B couection_WA.docs Municipality of Anchorage Community Development Department On -Site Water & Wastewater Program 4700 Elmore St. ■ P.O. Box 196650 ■ Anchorage, AK 99507-6650 ■ www.muni.org/onsite ■ (907) 343-7904 Well Decommissioning Log Legal Address: 7 tr Subdivision s/M Q Block Lot / 4 T R Section Lot On-site Water &%Wastewater Program certified contractor performing the well decommissioning: Name: C��� �`�1 ��-� Signature Aw -� "__ ( iC Company: 154, H k O �'jq tr wpC' Well decommissioning date: 16" i� .y� Method of decommissioning: AMC 15:55.060L1 a. ❑ b. ❑ c. A Location: Use the space below to provide a drawing of the property showing the following items; • North Arrow • Decommissioned well, • Other water wells on the property, • Two separate swing -tie distances for each well shown in the drawing, Note: The swing -tie distances shall be measured from either permanent structures of property corners. M �1 fr C-) 0 r i I \y -C) NOTES Line Table CURVE LINE BEARING 1 NOTES Line Table CURVE LINE BEARING DISTANCE L1 N 89'59'07" E 10.00' L2 S 00.00'53" E 148.68' L3 N 77'44'1,3" E 67.79' 1. Bearings and distances are record per referenced plat unless otherwise noted. 2. Not all monumentation for this survey may be shown on this document. 3. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. Curve Table CURVE RADIUS ARC LENGTH DELTA ANGLE CHORD LENGTH CHORD BEARING C1 915.13' 151.33' 1 9'28'28" 151.15' N 04'45'07" W — -- _ — - -- — -- — -- — 10' Gas Easement — 4 �r ora I Fa pOrealls Use � \ wept Drl Ve I tk Septic ' System "s Easement I CD — — — � � o IfD I ((D I� I� C CD I �N CD CD �r 50' ROW Reserve ONE OHF [-1 Greenhouse 32.2' h C6 8.0' o 2 Story House N 32.2' ' Building Detail A Scale 1"=30' mij 1 Story Commercial Building 48.0' O 32.0' Building Detail B Scale 1"=30' LEGEND sx S 0 Found Rebar c� farpoint Land ServiCes, LLC a Cleanout pFqL�>>> _4S'�i�I N SURVEYING, MAPPING, LAND PLANNING, G15 Well /Gj,• • '"� 1 13 1 E. 7Gth Ave., Suite 10 1 Anchorage, Alaska 995 18 Monitoring Well 49T r ': �,/ pro ParpolntAK.com • (907) 522-7770 • survey@farpolntak.com SEP Elec. Pedestal �....... . ASBUILT SURVEY OF: SURVEY CERTIFICATION: FARPOINT has conducted a physical c -Q, Power Pole Lot 97A & 97B, Smithson Subdivision, survey of the subject property, the improvements situated n Sign .Robert .0.•Lumpkin. ••� thereon are within the property lines as shown. No. 10459 ���/ Chugiak, Alaska (Plat 2013-102) EXCLUSION NOTES: It is the owners responsibility to determine SS Septic Access �1 o, 'OS�� the existence of any easements, covenants, or restrictions zl7/2 • PREPARED FOR: llp'�OFE - - --��P�+' WORK ORDER No: DATE: SCALE: ZONING: which do not appear on the Plat used for this survey. NOTE: Restoration Science & l�\\ Dec 7,2023 V=60' CE B-3 Under no circumstances should any data hereon be used for Engineering. 20540 DRAWN: CHECKED: GRID No: FB BOOK PAGE: CB ME/RL NW1358 156/70 construction orforthe establishing of property lines. Municipality of Anchorage ..r Development Services Departmentt Building SarDivisionOn-Site Water 8 Wastewater Progog ram, 4700 South Bragaw St.� P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. SW050153 PID Number. 051-104-12 NOTe'POMPI PORTERFIELO Wastewater System: ❑ New ■ Upgrade Address: P.O. BOX 878605 * WASILLA, AK 99629 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 351-6151 4 ■ Deep Trench O Shallow Trench O Bed OMound OOther LEGAL DESCRIPTION =ow Na g: 1.0 Total Depth rws ay 95MAX cn/� R R Block: Lot: Subdivision: D.PIh to pig bouan Iran Odpinal Eroe.: Grow depth beneatr, plpe: — 97 — SEE DWG. R 7.46 R Township: T15N Range: R1W Section: 9 np added above wtgw grad.: G.p.a Mngth: 47 SEE DWG. R R WELL: ❑ New ❑ Upgrade tiara wNtn: 2.5 N low of kMe: 1 oMtonce W...n knee: — R R CM f4sU n Pd -. Ae.C): Tota D.plh: Ca..d To: Tota Aga, area: "n". macaw: n 731 so. R D 3034/ F-810/ SCH 40 PVC DNMr. „ » IW: static waw Lsvtl C Mt~ OWNER Dol. Ywla.ed: 3/8-13/2006 X55 R Y' M: E: Puny set At: cooing NNght Above Gmw�. TANK DPY R R SEPARATION DISTANCES 0Septic 0Holding ■S.T.E.P. OOther To Septic Absorption Lift Holding ubnc/Prwe LMnubctuw: ANCHORAGE TANK cop iy In 9alwr 1500 Prom Tank Feld Station Tank se.w Llms Well 150'+ 150'+ 150'+ — 25'+ STEEL Nunbw of a Pw ts: 2 Surface water 100'+ too'+ 100'+ — — LIFT STATION Lot Line 5'+ *5 5'+ — _ sae ti paw.. 1500 uanma:Ua.r JANCHORAGE TANK ORENCO SYSTEMS Foundation 5'+ 10'+ 5'+ — — M M OL unp on Mrd aL ph . Orn Ot: Haww 42" 42" 46" Punp W" t tAiMl: a.elrkul kwpw pwfonned br. Curtain Drain NONE KNOWN /20 OSI 05 HHFI RISING SON Remarks: *LOT LINE WAIVER REQUESTED SEE BENCH MARK Laaabn and Dwodptbn: ATTACHED LETTER. TOP OF MANHOLE LID THE OLD SEPTIC TANK AND DRAINFIELD WERE COMPLETELY ABANDONED BY PUMPING, CRUSHING, 100.00R ENGINEE" SEAL AND BACKFILLING IN PLACEGEG. 40� Inspections performed by: Ltd. Dates: 1st 3/8/2006 °.:... ................. 0 Q 2nd 3/13/2006 3rd 3/13/2006 O f A. G rness.r Development S rvi s Departmen pproval 4��• .. C 3 :o a �d°O Reviewed and approved by: A, / � Date:1 �! �4p°lorore99ta"ao� DOOOoo�� (R.. "l) , NUMBER: BUILT DRAWING PARCEL K7 NUMBER: SW0 AS—BUILT 051-104-12 A B C D STI 1 91.0 61.8 1500 GALLON S.T.E.P. TANK STT99.t 70.0 - - MH 100.8 71.3 - - MT7 I - - 155.8 1151.5 MT2 I - I - 1199.5 1198.3 0 I, B NEW \ \\ 1500 GALLON S.T.E.P. TANK \ . \ 1.25 INCH HDPE LINE F W C' \ (SLOPE TO DRAIN \� L^ BACK TO TANK) Y D � � 8 1 \ � ALTERNATE SITE NEW 1 3 EXISTING DRAINFl I =—Z: — WELL CLASS I �'C' WELL g RADIUS I — �TM#Z - I 8 150' WELL r------- - 2 I I GARNGSS ENGINEERING GROUP, Ltd. p T `T �'-�.-+-r....�..•..- CONSULTANTS& GENERAL CONTRACTORS �+-� �"""" "" "•'""' C TI00„ •O,D. l,1R 101 . M,CIOM,G(. N( oom . AO[ Lpl}U)M1T . /Nt (Y07).lY�Mw gS,IL w�.pnwyMwMoaan O PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• •••• •••••;••• POMPI PORTERFIELD 351-6151 2 OF 3 Q e f rey A. arness: LEGAL DESCRIPTION: DRAWN BY: Doo CE -79 3 RG C.J.G.�a�- c°o T15N, R1W, SECTION 9, LOT 97 TYPE OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE 7/24/2006 (R". OIMS) W0 - NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SW50153 051-104-12 4' INSULA FINAL GRADE = 99.70+ TOP OF TANK ST1 ST2 MH AT INLET 95.44 / AT OUTLET TANK95.48 TH#2 NEW 1500 GALLON S.T.E.P. TANK ORIGINAL GRADE • 120.48 O HIGH POIh RELATIVE ELEVATION OF BOTTOM OF ST HOLE . 104.98 (TEST HOLE DRY) FINAL GRADE • 122.04-122.43 FABRIC INVERT OF PIPE . 118.44 (AVC.) •BOTTOM OF TRENCH . 110.98 (AVG.) -INVERT OF BUNG AT OUTLET = 94.87 NOTE: THE DISTRIBUTION UNE IS 1.25 MCH PJC r/ 1/4 INCH HOLES SPACED 18 INCHES ON CENTER. GARNGSS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS �•� =I L T W A 9A[ 101 • M414NLL Mf W]OI • Fd[ (M)}U1-411 • IN (OO*W " • � .. ....d+•..M.a. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: POMPI PORTERFIELD 351-6151 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: T15N, RM SECTION 9, LOT 97 C.J.C. TYPE OF WORK: DATE: PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE 7/24/200L (Rev. 01105) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS�m October 23, 2006 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System for T15N, R1 W, Section 9, Lot 97. To whom it may concern: We request that your department issue a 5 -foot lot line waiver from the east property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for M.S. WAIVER FEE: t �- PAYMENT DATE: RECEIPT #: �5a� 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246Website: www.gamessenginecring.com Municipality of Anchorage Development Services Department Building Sakly Division _ On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 080001 PID#:051-10412 HAM Pernit#:050153 Date Received: 7126107 Legal Description: T15N R1 W Section 9 Lot 97 Engineer. Jeff Garness Garness Engineering Group. Ltd, Applicant: Pomol Porterfield Waiver Requested: 5 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ses.......ssen...... ......esses................................................ Waiver Is Granted: I Waiver is not Granted: List Conditions or Reasons for above: Date: 0 By: � ✓ ,iN?pe Reviewer .............•...g geeneee........... assesses .. geneses........................ Rec#: 7126107 Amount: $175.00 Date Paid: 7126/07 CVi+ , e. �_ MayorMark J3cyich 1/16/2008 Municipality of Anchorage V0. Bm 11MMIF11 * Anchurmic..%htska !k Ail!tilp:ill •;71X1 lilnurce Mull 011i(v: 1!X17)U1 -K411 • Fax: 1!X17)333-K21M1 hult /aue-.nnmimrg Development Services Department Jeff Gamess Garness Engineering Group, Ltd. Subject: Waiver Request for T15N Rl W Section 9 Lot 97 Waiver Request #WR080001 Parcel ID 4051-104-12 Permit # 050153 Dear Engineer, mt•nt Departnu•tit Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Coln untill ity, Security, Prosperity Jul 25 2007 11:21RM Rising Son Electric, Inc. 622-G777 p.2 June 28, 2007 ta/ Rising Son Electric. Inc. 0916 Woodland Drive EagLe River. AIC 99577 14 (907) 622-6777 Pompi Porterfield 22189 North Birchwood Loop Chuglak, AK 99567 Re: 22189 North Birchwood Loop - Chugiak, AK 99567 Dear Pomp!: The lift station at the above referenced property has been wired in accordance with NEC and State/Localcodes. Thank you. Sincerely, nn Kev!A. Hombuckle, Owner Administrator License Number 1284 Specialty Contractor License Number 27285 cc: file ,;z /G -Oz-,� 7 p MUNICIPALITY OF ANCHORAGE k Development Services Department On -Site Water 6 Wastewater Program 1D 1 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 1 �� (907) 343-7904 1 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 02, 2005 Expiration Date: Jun 02, 2006 Permit Number: SW050153 Parcel ID: 051-104-12 Legal Description: T15N R1 W SECTION 9 SUBDIVISION LOT 97 Design Engineer: 0855 Garness Engineering Group, LTD Site Address: 22179 BIRCHWOOD LOOP ROAD Owner Name: POMPI PORTERFIELD Lot Size: 108900 SQ. FT. Owner Address: P.O. BOX 878605 Total Bedrooms: 4 Permit Bedrooms: 4 WASILLA , AK 99629 - This permit Is for the construction of: ❑Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑ Private Well ❑ Water Storage 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: MMUMMA. Date: 6 % Date: G.4.10 -r— MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 02, 2005 Expiration Date: Jun 02, 2006 Permit Number: SWO50153 Parcel ID: 051-104-12 Legal Description: T1 5N R1 W SECTION 9 SUBDIVISION LOT 97 Design Engineer: 0855 Gayness Engineering Group, LTD Site Address: 22179 BIRCHWOOD LOOP ROAD Owner Name: POMPI PORTERFIELD Lot Size: 108900 SO. FT. Owner Address: P.O. BOX 878605 Total Bedrooms: 4 Permit Bedrooms: 4 WASILLA , AK 99629 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By. an n Date: ` z o Municipality of Anchorage Development Services Department Building Safety Division ° On -Site Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-104-12 Permit Number Property owner(s) POMP[ PORTFRFIELO Day phone 351-6151 Mailing address (1) P.O. BOX 878605 • WASILLA. Ak. Ma-inng address (2)Apfq,7 "EkillYCA if617 P,( � G 99629 Legal description (Lot, Block & Sub'd.) LOT 97: T15N. R1 W. SECTION 9. Legal description (Section, Township & Range) —N/A Lot Size UA 61 b U slSq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only 0 Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made fora Single Family Dwelling and is in accordance with applicable Municipal codes. CARNESS ENGINEERING GROUP, Ltd. Permit Fees111n �_UV Waiver Fees - Date of Payment: �/r97/OT Receipt Number l v;:nl sbl( s Date of Payment: Receipt Number: GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 8 GENERAL CONTRACTORS May 24, 2005 Municipality of Anchorage Development Service Department On -Site Water& Wastewater Program 4700 South Bregaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Upgrade for LOT 97; T125N, R1 W, Section 9, To whom it may concern: The existing 4 bedroom house is served by a class "C" well and a private septic system. The septic system is not in compliance with MOA standards and must be upgraded. We are proposing that a new 1500 gallon S.T.E.P. tank and a deep trench type drainfield be installed. A test hole was excavated on the property in the area of the proposed upgrade. The drainfield will be designed around the 30 foot radius of test hole #2. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. The insitu sandy soils will act as a sand filter. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography in area of the drainfield is relatively flat. In short there are no slope concerns. We are unawa5,r of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any Oestions, please contact us at 337.6179. Thank you for your assistance. M.S. NOIFEYAaached is a site plan drawing, a design drawing, a detail drawing, and one soil log, which are all part of the design packagefor this septic system. (Contact C.E.G. Ltd for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 ' Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: gamcssengineering.com OWN LOT B1: T15N, R1W, SECTION 9, (FIELD LOCATE WELL AND SEPTIC SYSTEM) EXISTING SEPTIC 49��p N IQr nowt \ \ IrV[ISTING WELL 150' WEI I RADII Ic I EXISTING I GAS srAr"7 I — — 25' R.O.W. EASEMENT \ 25' R.O.W. ----- —_ --IDr'—ECSENENL----- LOT 104: 715N, R1W, SECTION 9, (VACANT LAID) LOT 98: T15N, RiW, SECTION 9, (FIELD LOCATE WELL AND SEPTIC SYSTEM) "\�' WELL APPROXIXI MATE LOCATION ----------- — 25' R.O.W. EASEMENT \ 25' R.O.W. EASEMENT ..-------- -- LOT 103; T15N, R1W, SECTION 9, (VACATT LAND) GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 6 GENERAL CONTRACTORS Q• ...:. .. ..... .......:... I [ TOd bN. Ylll[ 101 � MIGdMCG Nf M9pt � 111p[ (W7131)�tT .Mit hQ111Y-.VM � QIL w. - - 11 POMPI PORTERFIELD 1 kL DESCRIPTION: LOT 97. T15N. R1W. SECTION : OF WORK: Inw.v�rval 351-6151 1 1 OF 3 PROPOSED SEPTIC SYSTEM UPGRADE R.A.L, .ey ...... am.ess..,3,,:: . � CE -79 3 NUMBER OF BEDROOMS:4 GALLONS PER DAY (CPD): 600 PERCOLATION RATES: <1 MIN./INCH PROPOSED APPLICATION RATE' 1.0 MINIMUM DRNNFIELD SO.FT.:600 IM DEPTH:9.5 FELT 2.5 FEET 1:46 FEET APPROVED SAND FILTER: N/A WE' 6.5 FEET RON FACTOR: N/A 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^ NOTE: THE DISTRIBUTION UNE IS 125 INCH PVC WITH 1 INCH HOLES SPACED 16 INCHES ON CENTER. (30 HOLES TOTAL) INSTALL FOUNDATION PROPOSED 1500 GALLON S.T.EP. TANK- CLASS WELL ABANDONED PROPOSED \ NOTE: ALL WELL RADII SHOWN SHALL BE FLAGGED BY A REGISTERED LAND SURVEYOR DOInD T/1 rnk] T lIl1A1 APPROVED RECIRUTATING TRICKLING FILTER GARNESS ENGINEERING GROUP, Ltd. °*`): 4 CONSULTANTS i GENERAL CONTRACTORS I c niwll IDA furl[ 101 • Aocw4L III Neo1 . NCK (,O)1]Jr In • NII Iwrx, " • vnn ...... ... IEPARED FOR: PHONE NUMBER PAGENUMBER:•• POMPI PORTERFIELD 907 351-6151 2 OF 3 A.n ( AL DESCRIPTION: DRAWN BY. LOT 97; T15N, RiW, SECTION 9, R.A.L OF WORK: DATE: DESIGN FOR PROPOSED SEPTIC SYSTEM UPGRADE I 5/24/2( Inn. Ulm) --------------------------------- OMT ------------------------------- CAP I -\_ I I •_�_ MTo I L----------------- ------------ THE DISTRIBUTION UNE IS TO BE 1.25 INCH SCH 40 PVC WITH I INCH HODS SPACED 18 INCHES ON CENTER. (30 HODS TOTAL) nLTER GRADE —THE DISTRIBUTION UNE IS TO BE 1.25 INCH SCH 40 PVC WITH I INCH HOLES SPACED 18 INCHES ON CENTER. (30 HOLES TOTAL) 9.5• GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS& GENERAL CONTRACTORS Q••••••.•• • .•• • ......•••••• ml L ftA Ino. w ,ol • bdOlORM M Nm1 • MOIL 010W�Ir • W (W7035 n" •ire w. r•• O PREPARED FOR: PHONE NUMBER: PAGE NUMBER: .... . • • •••• ......•••••• POMPI PORTERFIELD 907 Q 351-6151 3 OF 3 Q a • r y arness: 93 LEGAL DESCRIPTION: DRAWN BY: E-79923 �dep LOT 97; T15N, R1W, SECTION 9, R.A.L �0 .a Sly. �o9dt�l TTPE OF WORK: DATE: 04'Oro IF 0000 ioo DETAIL FOR PROPOSED DRAINFIELD 5/24/2005 (ner. algsl 7 ` DRY 4/27/2005 frr•r!-.. GARNESS ENGINEERING GROUP, Ltd. �; .• ya — — CONSULTANTS & GENERAL CONTRACTORS cP SP g(SIDE — 4• ml ;E 101•AMO MLA 1l 0POW. Gln- rm M•MOC14 .•••••• •• .•• ••••••• ......••• 10—�r�>.. — SOIL LOG -----PERCOLATION TEST — 4• 0• LEGAL DESCRIPTION: T15N, RIW, SECTION 9: LOT 97 9 ••. Go ess: ':) PERFORMED FOR: POMPI PORTERFlELD DATE: 4/27/2005 °ov ., CE— 3 1j'/LI f �60 DEPTH et z--- ORGANICS TEST HOLE #2 s P�otesslo�°�� 40000�a 1 r�:.iru SOIL CLASSIFICATIONS PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) GP ML Ef � Irk«y GM CL 4 f� -w M GC OL ` 1 TH#2 t ++, o •.g SW MH QN 1 SP CH 'ri SM i i OHSC I -5 6 r.•r!.. cw_Yx J 7 ` DRY 4/27/2005 frr•r!-.. 5/6/2005 WATER LEVEL READING NET DROP (INCHES) 4/27/2005 1 — — rA; cP SP g(SIDE — 4• WALLS 6' to REMAINED 10—�r�>.. — VERTICAL — 4• 0• DURING 5 ,,��....r EXCAVATION) 6 — 4- 1 19 DEPTH TO GROUNDWATER DATE DRY 4/27/2005 DRY 5/6/2005 WATER LEVEL READING NET DROP (INCHES) 4/27/2005 1 — — TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: THE INSITU SOILS APPEARED TO CONTAIN ENOUGH SAND TO ACT AS A SAND FILTER. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAASS/PERTRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DATE READING CLOCK NET TIME TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 4/27/2005 1 — — 6• — 2 — 4• 0• 6' 3 — — 6• — 4 — 4• 0• 6' 5 — — 1 6- 6 — 4- 0' 6• PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: CALEB GALL COMMENTS: THE INSITU SOILS APPEARED TO CONTAIN ENOUGH SAND TO ACT AS A SAND FILTER. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAASS/PERTRMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 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. 051-104-76-000 Expiration Date: Legal description SMITHSON LT 97A Site address 22179 BIRCHWOOD LOOP RD Chugiak AK 99567 Current property owner(s) PORTERFIELD POMPOSA L 11/21/2024 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 12/18/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory x Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 AQ.NIIL I TY 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. 051-104- 76 Complete legal description SMITHSON; LOT 97A Location (site address) 22179 N. BIRCHWOOD LOOP ROAD, CHUGIAK, AK 99567 Current property owner(s) POMPOSSA PORTERFIELD 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 1-615-569-8697 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: W Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: M Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 17 - 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 $ � 5b . .3 3 G Waiver Fee $ Date of Payment I ZZ/2/2?7 /Z�.y�Z3 Date of Payment COSA # O S C Z 3 I V 6�L_ Waiver # COSA Application June 2022 COSA Checklist Legal Description: SMITHSON; LOT 97A Parcel ID: 051-104- 76 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA R Well log is filed with Onsite (or attached) Well production at time of test 20.2 qpm Date drilled ��/�s/2022 Total depth 162 ft Water storage tank volume N/A gallons Cased to 159 ft Well disinfected for coliform test? ❑ Yes No F0 Sanitary seal is functioning correctly Q Coliform bacteria is Negative 0 Wires are properly protected Nitrate 7.3 mg/L ❑ Nitrate less than MRL (ND) Casing height (above ground) 18+ in. Arsenic ug/L N Arsenic less than MRL (ND) Date of flow test for COSA *12/8/2022 Collected by GEG, LTD. Static water level at beginning of test 107.7 ft. Date 11/21/2023 Comments *WELL TEST PERFROMED BY ANCHORAGE WELL & PUMP SERVICE. B. TANK DATA C. LIFT STATION Measured operatinq fluid level in septic tank 45" Required maintenance completed Date of pumping ' 5 4"' � T- �--5'OrZq— Age of lift station 17.5 years ❑ Required maintenance completed, if AWWTS Lift station material STEEL Comments: Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 3/2006 n ALL standpipes present per record drawing Total measured depth from grade *8.5 ft (max) Measured depth to pipe invert from grade ft (min) n N/A — pressurized field. ❑ Per record drawings, field is insulated. * ❑ Monitor tubes go to bottom of effective. > If not_ state depth into effective 57.1 01 Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 1813 gallons 11/21/2023 date Any rejuvenation treatment (past 12 months) NIA If yes, enter date Adequacy test date 11/21/2023 Results Q Pass Fluid depth prior to test **0 in Water added 901 gal New fluid depth **0 in Elapsed time 0 min Final fluid depth **0 in Absorption rate 600+ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) *89.5 in Effective depth used *21 in Effective depth remaining *68.5 in Comments/Deficiencies: *BASED UPON ELEVATIONS TAKEN ON 11/22/2023, THE MONITORING TUBES ONLY EXTEND 68.5 INCHES BELOW THE DISTRIBUTION LINE INVERT. **IN MT2 (WATER ADDED TO MT1). 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'Community Sewer Manhole/Cleanout > 100' ❑Yes if No *75+ ft 0 Yes if No ft Neighboring Tank > 100' F!] Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No *75+ ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft R Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft Q 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' Q Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' ❑n Yes if No ft Wells on Adjacent Lots: — 60' Field to Property Line > 10' ❑ Yes if No **01 ft Private Wells > 100' ❑ Yes if No -11.5" ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' O Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS qd *WAIVERS GRANTED BY ADEC. SEE ATTACHED DOCUMENT` **SEPTIC FOR LOT 97A LOCATED ON LOT 97B. SEWER EASEMENT GRANTED (SEE SURVEY). .> L c.®� A -Z � So ` a. ra 0 C.1 tit— _V .Z � 2.4-a—� - ! .'Z �P IS � - 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 Engineerinq 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 �60� 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 ca Lq� exist that were not identified during the evaluation. The operational life of all wells and septic systems depend o " T �i 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 _• d C-)_" T the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not . ... ---..t.... •.:. 3uarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regardincl 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 f �_ Go ness": adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG= E — to perform the evaluation. Reliance upon the information provided in this report by any other person or party �p Z-•�'�l• 'c (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. e �, L+CENSE d pro f e s Sion°ova COSA Checklist June 2022 #AECCsaa I' -Titrate Advisory Certificate of On -Site Systems Approval # OSC231467 Subdivision: Smithson, Block: , Lot: 97A A water sample revealed a nitrate concentration of 7.3 milligrams per liter (mg/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Since nitrates are known to slowly increase, we recommend you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. t , $ Mailing Address P �O Box�196650 *Anchorage, Alaska 99519 6650 *www muni org