HomeMy WebLinkAboutCEARK TR FCeark
Tract F
#020-441-07
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241022 PID Number: 020-441-07
Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
JASON A MCLENNAN
ABSORPTION FIELD — ADVANTEX FAP 2.0
❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound
Site Address
15623 KING'S WAY DRIVE, ANCHORAGE
❑ Other
Phone
Number of Bedrooms
Soil RatingTotal
depth from original grade
4
3 GPD/SF
3 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
CEARK TRACT F
Fill added above original grade
VARIES 1.7l'-4.67 Ft.
Gravel length
40 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Pump Basin
Tank
Line
200 Ft'
1
-- Ft.
Well
50'+
50'+
50'+
25,+
TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX
Manufacturer
ORENCO / ANCH. TANK
Capacity
1500 Gal.
Surface Water
50'+
50'+
50'+
Material
COMPOSITE PLASTIC
Number of compartments
2
Lot Line
5'+
5'+
5'+
NA
Foundation
10'+
10'+
10'+
LIFT STATION
Manufacturer
ORENCO
Capacity
75+ Gal.
Remarks DECOMMISSIONED OLD SEPTIC TANK & INSTALLED
NEW AX FAP2 W/ PUMP BASIN & FIELD W/ DIVERTER.
Alarm location
FIRST FLOOR
Electrical installed by
RISING SON
MOA ON-SITE STAFF ON SITE: BEN COGGER
Installer MIKE N ANDERSON, PE (MNA)
PIPE MATERIAL House to tank 3034 d a nfiei d 3034
Drainfield 3034 CO/MT 3034
Inspector MNA & FWC
BENCH MARK (Assumed elevation) 100 ft
Inspection
dates: 1s` 3/15/24 2„d 3/16/24
Location and description
3'" 3/20/24 4'h 3/20/24
TOP OF MANHOLE MH
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
���t�t��
` l
_oOF A
• •
Conditional Approval: Date
�,�Q' ' •:tA,f.'��
TH
r .. .... .........
Curtis Huffman
�� ���; • CE 128991
. • ���
�B'i ' • . 03/22/24.AW
Se tic S st
p Y
Approve -
Dat�j
11iF,pROFESS10�4�~'
Note: this approval does not include well nts.
pp permit requireJe
1\,��11
(Key uoiuui 8)
PID:020-441-07PERMIT:OSP241022
FIRST WATER CONSULTING
CEARK TRACT F
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 Wastewater Disposal System Permit
Permit Number: OSP241022
Work Type: Septic Upgrade
Tax Code Number: 02044107000
Site Legal Address: CEARK TR F G:3242
Site Mailing Address: 15623 KING'S WAY DR, Anchorage
Owner: MCLENNAN JASON A
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
3/5/2024
3/5/2025
$0,
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
Special Provisions:
• Prior to construction, the ends of the existing trenches are to be located in order to ensure that the
required separation will be met.
i
-Re�: u e CA i o /! A) C
Issued By:
Date:
Date: 3A5/ I/
4
IIVIUNICIP LITY OF ANCHORAGE
Development Services Department `' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 020-441-07
Property owner(s) JASON A MCLENNAN Day phone
Mailing address 15623 KINGS WAY DRIVE, ANCHORAGE, AK 99516
Site address 15623 KINGS WAY DRIVE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) CLEARK TRACT F
Legal description (Township, Range & Section)
Lot Size 99000 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
0
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank❑
x
x
Upgrade ❑
(D) El
Holding Tank
❑
RenewalDuplex
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(S gnature of property owner or authorized agent)
Permit/Rush Fees: y
Date of Payment:
Receipt Number:
Permit No. 05C -Z,9 j 0-?-2-
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
March 2, 2024
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: CEARK TRACT F
The property owner has requested we obtain a permit to upgrade the failed septic system of the
above referenced lot. The proposed design has been modified with an AdvanTex FAP 2.0 &
pump basin along with elevating the absorption system with type II soils and MOA sand to allow
for the receiving soils at 8’ per the attached design. We propose to install one shallow trench and
1500-gallon AdvanTex FAP 2.0 septic tank to serve the existing 4-bedroom residence. The
design is based on the associated test holes in the MOA record documents.
The area in general has surface water, groundwater with curtain drains, holding tanks and
advanced wastewater septic systems. However, no groundwater was observed in the MOA test
hole data during excavation or monitoring. The slopes are moderate at 12-17% at the proposed
upgrade location. The lot and area are served by private water. The design will not impact any
of the neighboring properties. Please contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241022, Deb Wockenfuss, 03/05/24
FIRST WATER CONSULTING
CEARK TRACT F
DESIGN CALCS:
NO WELLS WITHIN
100' OF PROPOSED
SEPTIC TANK
NO SLOPES >25% WITHIN 50'
OF PROPOSED FIELD.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241022, Deb Wockenfuss, 03/05/24
FIRST WATER CONSULTING
DESIGN DETAILS:
CEARK TRACT F
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241022, Deb Wockenfuss, 03/05/24
MUNICIPALI'I'Y Oh ANCIIORAGI
ADVANCED V►'AS'I'EWA'1'1;R `I'IZFA'I'MEN'I' SYS'I'FM
MAKFENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this `fes Day of MCA CA(Ch of 20 _� Ll by and between
✓f�l'�__, herein the "OWNER," and the Municipality of
Anchorage. erein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
CLEARK TRACT F
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
raj Throughout the tern of this Agreement, the Owner shall enter into a service agreement
with an AW WTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. "This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance ofan AW1V'fS reduces the potential
failure of the system, which could include sewage backup and costly repairs or draintield
replacement.
(rev. 05/18/2018) I'a,,e I of 3
Owner acknowledges that the Municipalitymay request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
€ ? Owner acknowledges that the fine for Failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State ofAlaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions ofthis Agreement decreed invalid by a court of'competent
jurisdiction shall not invalidate the remaining provisions of tile Agreement.
(rev. 05/18/2015) Page 2 of
ON NEIZ:
By:_/)�.C�C,G�f'� (signature)
rc C L� /� (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
Date:
The foregoing instrument before
L_ day a, -c)()
was acknowledged me this
of ,
20 ?.t by fi
\*\11111111/4/z//A./
5•`•+Or
NOTARY PUBLIC FOR ALASKA
My Commission expires: I
nmi�
MUNICIPALITY:By: LZ - (signature)
(print name)
Date: -M 2 -
Title:
(rev. 05/18/2018) Page 3 or
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER AND WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.us/dee/home/htm
TONY KNOWLES, GOVERNOR
RECEIVED
JUN 1 1998
Municipality of Anchorage
Dept. Health & Human Services
Telephone: (907)269-7696
Fax: (907) 269-7650
May 29, 1998
Mr. Robert E. Beal—
15623 Kings Way
Anchorage, Alaska 99524-0832
Subject: Tract F, Cear�Subdivision, Anchorage, Alaska, Class C Public Water and
Wastewater Disposal Systems, ADEC Project Number 229, Review
Dear Mr. Beal:
I have reviewed your May 7, 1998 submittal regarding the upgrade of your single family home
into a Bed and Breakfast. Based on this review, I have the following comments.
From the submitted information, it appears that the existing water system met all regulations and
guidelines when it was installed. Based on this information and the fact that the demand on the
existing water system will not be increased, it appears that the water system will be able to meet
the demand without modifications. Therefore, the existing Class C Public Water System serving
the two bedroom Bed and Breakfast and a two room single family residence located on the
above -referenced property is approved for the concerns of this Department. A final Operation
Certificate, constituting this approval, is enclosed.
By opening a Bed and Breakfast in your home, the existing water system classification changes
from private to public. The Department is assigning Public Water System Identification
(PWISD) Numbers to all public water systems. The PWSID Number assigned to your public
water systems is 218573 . This number will need to be placed on all forms requesting analytical
results. I recommend that you yearly monitor for total coliform bacteria and nitrates (as
nitrogen).
Since the existing wastewater disposal system has not been operating at full capacity and was just
recently approved for operation, it should be able to accept the volume of wastewater from a two
bedroom Bed and Breakfast and a two bedroom single family residence. Thus, in accordance
with the provisions of 18 AAC 72, Wastewater Disposal Regulations and the Department's
guidelines, the wastewater disposal system serving the facility on the above -referenced property
is approved for operation. A final Operation Certificate, constituting this approval, is enclosed.
Mr. Robert E. Beal 2 May 29, 1998
This approval does not imply the granting of any additional authorizations, nor obligate any state,
federal, or local regulatory body to grant required authorizations.
Thank you for your coordination with this Department. If you have any questions, please do not
hesitate to contact me.
Sincerely,
A1���
Keven Kleweno, P.E.
Environmental Engineer
Enclosures: As Stated
cc: P.E., MOA/DHHS, w/o Enc.
r
Q
3
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8.0' . 12.2' SHED
q11.5'
5.0' ■ 8.0'
BALCONY
SCK o 22.0'
W
24.2 STORY
RESIDENCE
4.0'
2.4'
K
2.0' CANT
HOUSE DETAIL
Scale: 1 " = 30'
N 89'53'17"E 300.00'
�27C UTILITY EASEMENT
3' REMAINDER OF PATENTED
SECTION LINE EASEMENT
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Tract F
99,000 s.f.
TREATMENT POD
SEPTIC MANHOLES
UNSUBDIVIDED
33' PATENTED SECTION
LINE EASEMENT
11.7' x 12.2'
GREENHOUSE
0
4
0
0
0
C
PTI
W
SEPT#C L4
PIPES a
0
ALARM PANEL
S 89'53' 17'W 300.00'
Tract E \
PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 3242 Project No. 24-033 Al
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone ��0�4
(907) 522-4625 Fax 0
Professional Land Surveyors kenOlangsurvey.com d O F A °1�Q
jonothan*langsurvey.com QA0, • !Qs�4n
I hereby certify that I have surveyed the following described property:
Tract F, CEARK SUBDIVISION Plat No. 71x--120)
Anchorage Recording Dist ct, Al aka, and t at the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
Dated this the Day of I ^""` ` at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
491H -11k
KENNETH
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8.0' . 12.2' SHED
q11.5'
5.0' ■ 8.0'
BALCONY
SCK o 22.0'
W
24.2 STORY
RESIDENCE
4.0'
2.4'
K
2.0' CANT
HOUSE DETAIL
Scale: 1 " = 30'
N 89'53'17"E 300.00'
�27C UTILITY EASEMENT
3' REMAINDER OF PATENTED
SECTION LINE EASEMENT
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175.1':
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Tract F
99,000 s.f.
TREATMENT POD
SEPTIC MANHOLES
UNSUBDIVIDED
33' PATENTED SECTION
LINE EASEMENT
11.7' x 12.2'
GREENHOUSE
0
4
0
0
0
C
PTI
W
SEPT#C L4
PIPES a
0
ALARM PANEL
S 89'53' 17'W 300.00'
Tract E \
PLOT PLAN AS BUILT X SCALE 1" = 50' GRID SW 3242 Project No. 24-033 Al
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone ��0�4
(907) 522-4625 Fax 0
Professional Land Surveyors kenOlangsurvey.com d O F A °1�Q
jonothan*langsurvey.com QA0, • !Qs�4n
I hereby certify that I have surveyed the following described property:
Tract F, CEARK SUBDIVISION Plat No. 71x--120)
Anchorage Recording Dist ct, Al aka, and t at the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon.
Dated this the Day of I ^""` ` at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
491H -11k
KENNETH
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Municipality of Anchorage Page I of ,3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: J`W 7477393 PID Number:. o�
Name:���� Wastewater System: New O Upgrade
Addres I
•� �v / vioy /r—r6� ABSORPTION FIELD
Tone: No. of Bedrooms: ❑ Deep Trench 04hallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION Soil Rating: Total Depth from original grade:
. P{ GPD/S . Ft.
'Lot Block: ubdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
5 Ft. Ft
Township: Range: Section Fill added above original grade: Gravel length: `
� Ft. �3 7 Ft.
WELL: if ew 13 Upgrade Gravel width: Numberoflines: DistancebetweenWra
Ft /V Flo FI
Classificati
p-
Dri Iv:,
From
Well
Surface
Water
Lot
Line
Foundati
on (Pr vats. A.B.C): Total Depth: Cased To:
G $A Ft. / Ft.
Oat Drill val
: Static Water Le:
G /i / PO' Ft.
Pump Set at: Wk
-' Casing Heighl Above Ground
�S GPM WkA Fl. /5 Ft.
SEPARATION DISTANCES
TO Septic Absorption Lift Holding PublociPrivali
Tank Field Station Tank Sewer Lines
/Z-7' /0rw'
t -7,r
on
Curtain A11.4—
/ � "
Drain /�/
Remarks: 7CST
Aa
/
me-apS
Total absorption area: Pipe maIaria1:Di t;
SO. Ft. cSL4* 1k7 /°✓G
Installer: Date installed:
TANK
❑ Septic ❑ Holding
Manut4cturer:r�/�G Capacity in gallons:
nu
Mat a� / Number oCompartments:
LIFT STATION
Size in gallo s: I M��u�
"Pump on" level at: "Pump off" level at: High water alarm at:
a
Pump Make A Model Electrical Inspections performed by:
BENCH MARK
Location and ¢escriMon:
Inspections performed by: /. h`•y�'a�(- Dates: 1st IZAP'uz-
Department of Heal
Reviewed and approved by.
72-017 (Hw. 9/91) MOA 25
Humaq Skrvices appro al
ql/M �fto Date. %
Assumed Elevation:
/OO
ENGINEERS SEAL
6G �
e.a+ aw �eOaa GEAS1, Gam:-�snG b
� �• � s n sae M we
1'!'1 /R�c+yCf►!�,^t1N,^'sCRi s _t4; -
�k
Curtain A11.4—
/ � "
Drain /�/
Remarks: 7CST
Aa
/
me-apS
Total absorption area: Pipe maIaria1:Di t;
SO. Ft. cSL4* 1k7 /°✓G
Installer: Date installed:
TANK
❑ Septic ❑ Holding
Manut4cturer:r�/�G Capacity in gallons:
nu
Mat a� / Number oCompartments:
LIFT STATION
Size in gallo s: I M��u�
"Pump on" level at: "Pump off" level at: High water alarm at:
a
Pump Make A Model Electrical Inspections performed by:
BENCH MARK
Location and ¢escriMon:
Inspections performed by: /. h`•y�'a�(- Dates: 1st IZAP'uz-
Department of Heal
Reviewed and approved by.
72-017 (Hw. 9/91) MOA 25
Humaq Skrvices appro al
ql/M �fto Date. %
Assumed Elevation:
/OO
ENGINEERS SEAL
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Permit No. -5 aq40,3q3
Page 3 of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: -7—RAC-7- f- 64tZK- U9• PID No.: 010'L 02
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SOILS LOG — PERCOLATION TEST`
� . ..v
PERFORMED FOR: " ' kms t 114 DATE PERFORMED: /o/Z/-yli;o iL
LEGAL DESCRIPTION: ri*I'GT ���~ L—�,16C�Township, Range, Section:
SLOPE
I
1 C, o .
zj
4
awl
17 '86#-
1 1
1s
19
24
/("-f
PERCOLATION RATE 3/ lei
r
TESTttUN BETWEEN G FT AND
COMMENTS 7-651" k4fe— Was r/'I-Sox lcw,:f A 6^ ft M, S fr&k f 5
4'f if
HOLE DIAMETER
PERFORMED 8Y: ! ,4t66y1�IFY THAT T S TEPT WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
ID: JUL 09'97 10:08 No.002 P.02
CAL'S ELECTRIC
P.O. DOX 779,290 $AGM, XWER, ALASKA 99577-0236
PHONE 907-M-0407 FAX 907-696-0579
TO: Rubert Deal
Anchorage, Alaska
Bob, I inspected the lift $ration on the prepertY at Tract F of Ceark Subdivi`iou,
Dear Valley and found it in complies with with 411 stat* and local Electrical Code
requirements for wet locations,
If I can assist you anymore pleaac call.
Calv(i�n Evans
off,...-�Electrical A2:�-
mnstrAtor
No. (056
MEMORANDUM
DATE: July 7, 1997
TO: Jim Cross, MOA- DHHS
FROM: Mike Anderson, P.E. -M E-0,
SUBJECT: Tract F, Ceark Subdivision
Septic System Construction Permit No. SW940393
The septic system serving Tract F, Ceark Subdivision was originally constructed in October of
1994. Due to problems with payment from the owner of the property the certified as -built was not
submitted until March of this year. An uncertified copy however was submitted long ago.
The property has now changed hands and the new owner must have an approved as -built before he
can obtain his land use permit. Jim Williams initially reviewed the as -built and had several
comments. These comments have now been addressed. He requested the alternate site, the
driveway and the property line location be shown on the as -built.
He also questioned the difference in elevation of the bottom of the two trenches. This issue was
discussed with Robbie Robinson when the system was revised to a pressure distribution system.
The difference in the bottom of the trenches is of no consequence with a pressure system and is
quite common. Mr. Robinson agreed.
Mr. Williams' final comment dealt with the electrical inspection of the lift station. Engineer
Bulletin 90-3 authored by John Smith indicates that in areas not covered by MOA Building Codes
it is the responsibility of the engineer and the contractor to ensure that the electrical installation is in
accordance with applicable electrical codes. To the best of my knowledge the system conforms to
applicable electrical codes.
There is currently no power to the lift station and the septic system is not in operation. It is the
intent of the new owner to construct a new house and provide a new power feed to the lift station.
All work will be completed in accordance with applicable electrical codes. No work can begin
however until the septic system as -built is approved. Please review the attached as -built and the
above information and provide your approval. I am available to answer any questions you may
have.
Municipality of Anchorage �
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
ENGINEER BULLETIN 90-3
April 23, 1990
To: Engineers Designing On-site Wastewater Disposal Systems
Subject: Electrical Permits and Inspections for Wastewater
Disposal System Lift Stations
Please be advised that any electrical work done inside or
outside a dwelling that is located within the area covered by
the MOA Building Codes must be inspected by the Building Safety
Division. This includes all electrical work associated with the
installation of a wastewater disposal system lift station.
As -built submittals for systems which utilize lift stations,
must be accompanied by a copy of the MOA electrical inspection
report.
In areas not covered by MOA Building Codes, it is the
responsibility of the engineer and contractor to ensure that all
electrical installations are in accordance with applicable
electrical codes.
In situations where it is necessary to obtain an MOA inspection
after a lift station has been installed, it is our understanding
that the MOA Building Safety Division may require the following:
1. Confirmation of service wire location and burial depth
between lift station and dwelling.
2. Verification that junction box in lift station manhole is
suitable for use in a moist environment.
3. Inspection of junction box at dwelling.
4. Inspection of breaker and wiring at main electrical panel.
If you have any questions please contact our office at
343-4744. You may also wish to contact Joe Jameson, Lead
Electrical Inspector, Building Safety at 786-8316.
Sincerely,
I
J n Smith, P.E.
Program Manager, On-site Services
cc: Lee Browning, P.E., Manager, Environmental Services
Joe Jameson, Lead Electrical Inspector, MOA Building Safety
"Kids Are Our Future"
07/09/97 WED 15:43 FAX 907 343 8214 BUILDING SAFTY DIV _ _ Im001
t'iUf4.fl..lt?Yt�l l ! lJl ,�I...il11.1�.. 1i f
-t't-t�.A-r'+ 06-
' f.1t'tii.•7�-�"Qf�
INSPECTOR-
W' �N ARE
hi',10E :
r
907) 7£36-E211
rNSPECTTONS: (yi:') 563--34t74
PC MIT
NAME- JACK FORGET
DATE,
U/09/9-"
ADDRESS: 1.2'40 WAG14CR S7
, . ,:.
PHIONE #2" -
LOT: 12 8 BLOCK: 2 5UBDIVI�ION: BOYLE
COMMENTS.,
.�10.0 tom.
rLIw PLCTIOt
T't'PE OF INSPECTION:
J. Ele�,trfcal Set-Vlce 2-
•.
_ _~Nt3YeNONCOMf�LIfiNCE-OESi —i i
i J f+LC1`IU�dr,
e.`1`EXptAINED
BELOW
RVEUM-
f -
luij,
1•Uidl.c.fi�_. UfM i .LL
l'.L1.NSNEC i EO
s
WILL REEXAMINE �t T NEXT :CN';t-•.L i . UI`t G. ,�
sJ�l
_
COMMENTS:
-t't-t�.A-r'+ 06-
' f.1t'tii.•7�-�"Qf�
INSPECTOR-
W' �N ARE
hi',10E :
r
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF WATER
WATER WELL RECORD
LOCATION OF WELL
BOROUGH SUBONISION LOT BLOCK SECTION QTRS
_...fes
LOCATION/SKETCH: II WELL OWNER:
SECTION TOWNSHIP RANGE I MERIDIAN
ON ❑E
❑S ❑W
WELL DEPTH* �r gg DATE OF COMPLETION
DEPTHS MEASURED FROM: casing top ❑ground surface Depth of hole: lJ 7 ft
BOREHOLE DATA:
Depth Depth of casing: 4// 1t
I�C�S;iS; T -.-,-e and CMor Frocn TO
�Naa�tih
CONTRACTOR INFORMA
ature of Authorized Respre
-
DEPTH TO STATIC WATER LEVEL
ft below top of casing ❑ ground surface
Date: __��,� ��
METHOD OF DRILLING: �ir rotary ❑ cable tool
❑ other
USE OF WELL:domestic 11irrigation Elmonitor
❑ public supply ❑ other
CASING STICK-UP' ft. Diam: in. to 411 ft
1-17
Casing type: in. to ft
WELL INTAKE OPENING TYPE: ❑ open end ❑ screened
❑ perforated 76 open hole
Depths of openings: to ft I
SCREEN TYPE: Diam: in.
ft
Slot/Mesh Size: Length:
GRAVEL PACK TYPE: I!
Volume used: Depth to top:
nOt
GROUT TYPE: Volume:
ft ft
P� rSg
Depth: from to
DEVELOPMENT M HOD: CG�L-
Duration:
PUMPING LEVEL AND YIELD:
Ift after hrs pumping gpm
PUMP INTAKE DEPTH: ft Horsepower:
WELL DISINFECTED UPON COMPLETION? -. YES ❑ NO
REMARKS:
/te /�
- PLEASE MAIL WHITE COPY OF LOG TO:
DNR/DIVISION OF WATER
PO BOX 772116
ate
EAGLE RIVER AK 99577-2116
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
343-4744
October 11, 1995
Shawan L Burnett
2108 Misty Glen Circle
Anchorage, Alaska 99503 4643
Subject: Tract F Ceark Subdivision
Permit #SW940393, PID #020-441-07
The subject permit, issued October 11, 1995 by this office for a
single family well and/or on-site wastewater system, has
expired as of October 11, 1995.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as -built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
S'nc rely,
Ja s Cross, P.E.
Program Manager
On-site Services
enc: Copy of Permit
Anderson Engineering
/ /PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE r ;r l 1.) � 0 � ' � ��"✓
DEPARTMENT OF HEALTH AND HUMAN SERVICES j0�!{( LO a;� P/n
P.O. BOX 196650, 825 "L" STkEET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940393
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:BURNETT SHAWN L
OWNER ADDRESS:P.O. BOX 190107
ANCHORAGE, ALASKA 99519
PARCEL ID:02044107
LEGAL DESCRIPTION: CEARK TR F
LOT SIZE: 99000 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:10/11/94
EXPIRATION DATE:10/11/95
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ENGINEER SHALL DEEPEN SOILS TEST AT TIME OF CONSTRUCTION TO
A MINIMUM DEPTH OF 15 FEET.
RECEIVED BY: DATE: 3
ISSUED BY: DATE: / LA �3
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE /,02-
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940393
DESIGN ENGINEER:ANDERSON ENGINEERING
OWNER NAME:BURNETT SHAWN L
OWNER ADDRESS:P.O. BOX 190107
ANCHORAGE, ALASKA 99519
PARCEL ID:02044107
LEGAL DESCRIPTION: CEARK TR F
LOT SIZE: 99000 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:10/11/94
EXPIRATION DATE:10/11/95
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 HOURS) .
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ENGINEER SHALL DEEPEN SOILS TEST AT TIME OF CONSTRUCTION TO
A MINIMUM DEPTH OF 15 FEET.
RECEIVED BY:
ISSUED BY:
DATE:
DATE: %0/.3
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
September 21, 1994
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Tract "F", Ceark Subdivision
Well and Septic System Design
Impacts to Adjacent Properties
Dear On Site Services Engineer:
We hereby request that a permit be issued for the construction of a septic
system and well on the subject property. The location of the system and
well is shown on the attached site plan. In addition, the topography of the
lot is also illustrated on the plan. Soils encountered during the field study
indicate acceptable conditions for an onsite sytem. No groundwater was
encountered in the excavations.
If the system is completed as designed the following statements can be
made:
1. The system, if constructed as designed, will have no adverse impact on
the wells currently in use or to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on
existing septic systems in the area or those to be constructed in the
future.
3. The system, if constructed as designed, will have no adverse impact on
reserved space, either surface or subsurface, on any lots located in the
area.
4. The system, if constructed as designed,
drainage patterns in the area.
Sincerely,
P J.L Ej"��
Michael E. Anderson, P.E.
will have no adverse impact on
o r r
�� eFa s.m. owu• mm3
ase meo 4e.®. om ••.•mmo-••M �
Michael E. Anderson �,j
G�,`oe 481
-E
� y,� 1V{'• AUC �`��,®�. r
tooLX
l6x
330 0
_ y
M.
i
i
TRACT "Ply CEARK .S
UBDIVISION
w�
4.,,i _t
SITE PLAN
Tract "F",
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: 17 Min./Inch
Application Rate: .6 GPD/SF
Reduction Factor: .5
Ceark Subdivision
SYSTEM REQUIREMENTS:
Shallow Trench System
1,250 Gal. Septic Tank (Exist.)
4' Drainfield Rock
4 Bdrms. X 150 GPD / .6 GPD/SF = 1,000 SF
1,000 SF / 5' Wide X .5 (Red. Factor) =
100' LF of Trench
Therefore: Construct 2 Trenches
Each 50' in Length.
Place
Distribution Lines @ 6' Below Grade.
Place 4' of Drainfield Rock
Under Laterals.
...
....... ....... ..... ....._ :'T... ,�s�C .. ......
ZSA b tjt v ,/ . _
__..... ........
S,EPT'ic....T�•J
.......... :...........
._�-----
.........:---�.... .... ...... ... ....
............'. _' \ �►` 11 t �t f/ / �� �
nJ�ru Rl-i..... ........
�._... ._
_ .
... .
':. ......
D
... . i. _....... .. '. ..... ...-
... .... ..... !.. ... .......... _ ...
...._....... .... .... ........................
............ .................... ....
FRtSii►c.
�LA+�.fovTC'ryn�
�v) o. '
_.
'......
::.........
._
.... " .._ ....
................
..
_.:..
....... ....... ..._....
a
....
e
fir..:...... . _.. .. .z'.
......
_.... . ...
.
...... .. ; . _......
.... .- .........
'
Ro c K..
.......
/ ,'" ° h
.............
...5.. ,............. ........
_ .. .
................................ ....
.�0
Tr•c c
y sem-
....... .
�
NP
7
�^ 10
r TYPICAL SHALLOW TRENCH SYSTEM
Wg �Wu 9e� (No Scale)
���;y 1 ���.////jjj�' -,jr'Ij�{/—�,,��' .,, y,►—.�
4" cn.�'•i�r.Fq¢u f�,!�ay�Oe000 us aF�co^�c��:^ ,� .
fi�;chuui L. Anderson
'
4381 NOTE .. Maintain 4' Separation
from Bottom of System to
Groundwater.
Grade Area Over Trenches
to Drain Away From
Field.
l .Y�
Municipality of Anchorage s �� 3 ;
a DEPARTMENT OF HEALTH & HUMAN SERVICES ►—�
a!s ...-
825 "L" Street, Anchorage, Alaska 99502-0650 ,� L Andf.f4:0„
SOILS LOG — PERCOLATION TEST' �� r��' t ''
PERFORMED FOR: SHA DATE PERFORMED
LEGAL DESCRIPTION:
S/U
1
Depth to Net
Water Drop
2
/
/L•8/
/�• 10 H. U / o
/. / // t'i
3-
�.
/K s
.o p
5 \7
6
�Q
7rZ
�
/ + L-
Grl�
o -4-.
Township, Range, Section:
SLOPE
S
SITE PLAN
WAS GROUND WATER Al10 o e ENCOUNTERED? /Y
v • IF YES, AT WHAT / O a_
DEPTH?
12
Depth to Water Atter
13 Monitoring? i Date:
14
15
1s
19
Reading Date Gross Net
Time Time
Depth to Net
Water Drop
+DS /f� o. v
/L•8/
/�• 10 H. U / o
/. / // t'i
/K s
20 -{ I / % q N
ILII PERCOLATION RATE (minutes inch) PERC HOLE DIAMETER
71-.114 TEST RUN BETWEEN 8 FT AND FT
COMMENTS TS G?moi vlaSr-`s �/a•�
PERFORMED BY:� I YuC� �Lr.` CERTIFY THAT THIS TES WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: f /z119y
(ENGIN, t�
W
e Municipality of Anchorage__
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST s.
PERFORMED FOR: 5><IA��.I DU R NI Eli. DATE PERFORMED:
LEGAL DESCRIPTION: 7;P, �i y C��tr� Township, Range, Section:
DEPTH D6/QL / I G STs�4 s/� SLOPE SITE PLAN
1
2 S�
X. S
3
4
5-
6
8
9-
10-
12
1012 0
13
14-
15-
16-
17-
18-
19 1
415161718
191
S�
�O Z Z
T// /
OcL, Gc»��GS v T /
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
S
/ L
O
P
E
Depth to Water After
Monitoring? Date:
5
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
s b os:
2. /3
/ •/$ `/P
/7--
3-0.
20
PERCOLATION RATE _(minutes/inch)`PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND 7-- FT
COMMENTS �s� / W -;Lc
PERFORMED BY: BY: I 741"Lt:.i (:! RTIFY THAT
THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: JHAU^V -&LjtZPJ -T%
( nv A
�'Sv ddSC. V ialJ'`d G36ea oo'i®®a
p,.. moeae@er•oe••• eo•a
Michael E. Anderson
4381 E
rr
r�
`'.. ;des
DATE PERFORMED: iI,L
LEGAL DESCRIPTION: Tit ���� elAr-Car Township, Range, Section:
P Q(✓ vU S/b SLOPE SITE PLAN
-tPgB" I'
2 1,
o
u - _1
3
v.
o SM
12 0
13 — u6 6/-s 74 � „
14
15
18
19
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
A
S
L
O
Depth to Water After
Monitoring? Date*4�
P
E
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
/3-Yf>
/
6,00
1-,-
7 0
/SDS /fig
s
71314.70'
Slo
77' 44,6
20
PERCOLATION RATE S� (minutes/inch�PERC HOLE DIAMETER L
TEST RUN BETWEEN 7 �v FT AND FT
COMMENTS
PERFORMED BY: ,/' I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ! ��(�y
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
October 20, 1994
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Attention: Dan Roth
Subject: Tract "F", Ceark Subdivision
Permit No. SW940393
Dear Dan:
The permit for the
septic
system on
the
subject lot requires a gravity
wide trench system.
The
location of
the
new house, however, will not
allow gravity flow
and a
lift station
and
pressure system is required.
A revised system design is attached for your review along with the
pressure system calculations. Please modify the permit to allow
placement of a 1,500 Gallon S.T.E.P. system. Let me know if you have
any questions or comments.
Sincerely,
Michael E. Anderson, P.E.
Tract "F", Ceark Subdivision
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Wide Trench System
Perc. Rate: 17 Min./Inch 1,500 Gallon S.T.E.P. System
Application Rate: .6 GPD/SF 4' Drainfield Rock
Reduction Factor: .5
4 Bdrms. X 150 GPD / .6 GPD/SF = 1,000 SF of Absorption Area
1,000 SF / 5 LF Wide X .5 Red. Factor = 100 LF Trench
Therefore: Construct a Pressure Distribution System Utilizing a
1,500 Gallon S.T.E.P. System with 2 Wide Trenches, Each 50' in
Length. Place 50' of Drainfield Rock Under Laterals �x K
Pump Type: 20 OSI 05 HHF - 5 Stage
Two Laterals: 50' Long'
Orifices per Lateral: 9 @ 5.55' Spacing
Orifice Size: .1875" Facing Downward
Lateral Diameter: 1
Manifold Diameter: 1.25"
NOTE: Maintain 4' Separation from Bottom of Trench to
Groundwater.
Grade Area Over Trenches to Drain Away.
350-00 -
........... ... ............ . . .. ..........
........ .. ........... ..... ....... ........ ?
TFUMF5
EFFLUEN
.. .............. . .. ..........
1/2 Hp toll Hp
SINGLE PHASE, 60HZ
.. ........ :.
115/230 VOLT
.. ....... ... ... ... ....... 4
....... .... .. ... ... L .... ...
20 OSI 15 HHF - 9 stage ...
PC#2
.....................
.4 .. ...
. .... .. ... .. .... .. . V"i...
300-00
....... ....... .. ... ... ... ..
........... .. ...........
.. .......
......... . .. ........ ...... .. .............. .. .. .. ........... .. .. ... ..........
... . .. .................... I .. .. ......... ...... .. . ... .. ............... .. . .......... . ... ... ....... .. . ..
....... ..... .. . 4 .. ... .4 .. ... .. .. ... ......
........... . ............. .
...........
...... .......
-",** ........... .... .. ........... ... .. ..
.. . . . ...........
..... . ..... .....
.............. . . .. ... ... . ..... .. ...... ....
-20 OSI 10 H 7 stage
HF
250.00-
.. .......... ...
...... ... ... .. ... ....... ....... .. .. .... ....... .. . .. .........
.. ... ......... ......... .. ........
......... . .. ... ...
........ ... ............ ... ..
...... . . .
...... ... .. ........ .. ...... . . ............. ... .. ...
V#4
. ............. . . . . ......... .... ... .......... ... ... ....... ...
......... ....... . ..... ... . . .
..........
... ...... . .. ...... ... .. .......... ......... ... �-4 .. ....
........ .. ....... ....... ... .. ..... . ..
....... ... i ... ... . .. . ... --- --- 11 .. ...... ... ..... . .......
.. ... ...... ...... i_
... ... ...... . .. ..... .....
200-W -
.. .... ................ ... ....... .......... ...... 4 . . . .................
... ....... ... .. I . . ......... ... .. ... ........
... ....... ...... .. ... ....... ... ... ............... .
....... .. ... .4 .. ........... ... .. ... .......... . . . ... .............. .4.4
.. ... ...........
.. ............... .. ... . .............. .... ... ...
....... ... .... ........... 4 4 : ... .... ......
....... ... ....... .. ..
.. ....... ... ... . ... t' .. ........ .. ...
U
.. .... LA ... ..... 20 OSI 05 HH -5 ... .......
. ........... .......
. ... ... .. ...... ... ... ....... ..
Z 150.00-
.... ...... .. ....... ... ... ........ ... ...
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PROMT 2041 ISMIN UMI 206.1(POO ®`• na. Gwen. Mm 01411. to 0'W PHONE TOLL FRES idOF22Sl710
MUNICIPALITY OF ANCHORAGE
Development Services Departments Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-441-07-000
Expiration Date:
Legal description CEARK TR F
Site address 15623 KING'S WAY DR Anchorage AK 99516
Current property owner(s) MCLENNAN JASON A
2/15/2025
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: 3/28/2024
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 Approvdjune 2022
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 Applicationf..
1. GENERAL INFORMATION
Parcel I.D. 020-441-07
Complete legal description CEARK TRACT F
Location (site address) 15623 KING'S WAY DRIVE, ANCHORAGE, AK 99516
Current property owner(s) JASON A MCLENNAN Day phone
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
3. TYPE OF WATER SUPPLY: ® 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 — PENDING ADVANTEX FAP 2.0
Age PENDING - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ® AWWTS ❑ Bed ❑ 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 $ S 0 Waiver Fee $
Date of Payment 3 itz z Z Date of Payment
COSA # S C2 L/ /O 5� Waiver #
COSA Application 2022.doc
COSA Checklist 2022.docx
COSA Checklist
Legal Description: CEARK TRACT F Parcel ID: 020-441-07
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 11/15/1994 Total depth 83 ft
Cased to 41 ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 2/20/2024
Static water level at beginning of test *PLUG ft.
Well production at time of test 6.3 gpm
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 Date 2/15/2024
Comments *NO NOTE OF AN ARTESIAN PLUG IN MOA DOCS, BUT WELL HAS PLUG.
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping NA – NEW ADVANTEX FAP2
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station NEW years
Lift station material PLASTIC PUMP BASIN
Comments:
D. ABSORPTION FIELD DATA – NEW FIELD – OSP241022
Which system tested (date installed) NA – NEW
ALL standpipes present per record drawing
Total measured depth from grade 7.7 ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not 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 NA – NEW
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 6 in
Effective depth used 0 in (NEW - NOT TESTED)
Effective depth remaining 6 in
Comments/Deficiencies: NEW ADVANTEX FAP 2.0 SEPTIC SYSTEM TANK & ABSORPTION FIELD INSTALLED MARCH
2024. PLEASE SEE ATTACHED INSPECTION REPORT.
COSA Checklist 2022.docx
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’
Yes if No *50+ ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No *50+ ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/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 Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 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 > 10’ Yes if No ft
Water Service Line > 10’ Yes if No *50+ ft
Surface Water > 100’ Yes if No *50+ ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No *50+ ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
*MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE
REQUIREMENTS PER NEW ADVANTEX FAP 2.0.
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 3/22/2024
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 &
03/22/24
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 2 Z Day of 'M/'l l/L h of 20zf,L , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as AN ADVANTEX SYSTEM
located at (legal description)
CEARK TRACT F
2. Maintenance, Repairs and Alterations.
(O her is required to read, understand and initial each section)
Troughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
,,accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
/ Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
�461 Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
�WOwner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
iJ by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
VOwner agrees to maintain remote monitoring of the AWWTS as required by the
v AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OV 7%M'D-
By:
ature) Date: J 4
name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this Qday of v ` Gt ✓G j�
2�1_,by A7a��;e
NOTARY PUBLIC FOR ALASKA ySTATE OF ALASKA,nr
My Commission expires: — t j —) 7 NOTARY PUBLIC
C
Natalie C. Carpenter
My Commission Expires Jul 24, 2027
ature) Date:
name) Title:
GLL
(rev. 05/18/2018) Page 3 of 3
Parcel I.D. 020-441-07
Municipality of Anchorage
On -Site Water and Wastewater Program =
(907)343-7904
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description Ceark Tract F
Location (site address) 15623 King's Way Drive
Current Property owner(s) Jessica & Alba Brice
Mailing address
Real Estate Agent
Expiration Date:
Day phone
15623 King's Way Drive Anchorage AK, 99516
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual
Fx I
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance
Received by: I Date:4LIL
�
COSA to be released to theJ gineer, unless otherwise requested by the engineer,
COSA Fee $ �JuP I Waiver Fee $
Date of Payment[- �o fit t J Date of Payment
//
Receipt Number ff��o "1 Receipt Number
COSA# rxCiI'D Waiver#
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 6me 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.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE
�V_01� System #1 Approved for bedrooms
System #2 Approved for _ bedrooms
Disapproved
Date 04/14/2015
Conditional approval for bedrooms, with the following stipulations:
`i;utiltttiifrrll
yt,,
ON-SITE w',
PVVATFA ri
Original Certificate Date: �3
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. TheMunicipality
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
COSAbluesheet_f % le c
If more than 1 septic system is on the lot:
COSA Checklist # + of
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: Ceark Tract F Parcel ID: 020-441-07
A. WELL DATA
Well type Private If A; B, or C provide PWSID # Well Log (Y/N) Y
Date completed 11 /15/94 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 3 ft. Cased to 41 ft. Casing height (above ground) 16+ in.
Date of test
Static water level
Well production
FROM WELL LOG
1 111 5/1 994
5
15
AT INSPECTION
04/13/2015
n. 81 n.
9.p -m. 4.4+ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEly'
colonies/100 mL Nitrate 0? -)l mg/L
Arsenic OD ug/L Date of sample: Collected by:�
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S.T.E.P./Steel Date installed 10/25/1994
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YM) Y Depression over tank (Y/N) YN (�H�igh '��1 water alarm (Y/N) Y
I t
Date of pumping 5 �$ Is Pumper r 40M
� Xez . or C
C. ABSORPTION FIELD DATA
10(25/1994 45 g.p.d./sf Shallow Trench
Date installed .Soil rating (g,p.d./ft2 or ftzPodrm) ' System type
Length 134ft. Width 5 ft. Gravel below pipe 4 ft.
/at/ o
Total depth 9.7 ft. Eff. absorption, arca ftz Monitoring tube Y_. Depression over field N
Date of adequacy test 04/13/2015 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 29 in. Water added 629 gal. New depth 35 � in.
Elapsed Time: 190 min. Final fluid depth 29 in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFT STAVON
Date installed 10/25/1994 Size in.gallons 250 Manhole/Access (Y/N) Y
"Pump on" level at 45 in. "Pump off' level at 45 in. High water alarm level at 47 in.
Datum Bottom of Tank Cycles tested 4 Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
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 75+
Public sewer manhole/cleanout 100+
Sewer /septic service line 25+
Holding tank 100+
Animal containment areas 50+
Manure/animal excrete storage areas 100+
SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Absorption field 5+
Water main 10+ Water service line
10+ Surface water 100+
100+
Wells on adjacent lots.
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+
- Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots
100+
F. COMMENTS _
As -Built on file
G. ENGINEER'S CERTIFICATION
l certify that t 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.
Engineer's Printed Name Steven R. Pannone
Date 04/14/2015
COSA canary sheet 2-6-16.doc
Parcel I.D. 020-441-07
Municipality of Anchorage ` .E
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Complete legal description
Ceark, Tract F
Expiration Date: -7-1& " /3
Location (site address) 15623 King's Way Anchorage, AK 99516
Current Property owner(s) Bill & Georgia Wright Day phone
Mailing address
Real Estate Agent
15623 King's Way Anchorage, AK 99516
Katherine Donohue Day phone 244-6939
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
E
Individual
(]
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
WaiverNariance request for: Distance:
Received by:
COSA to be releaser to
r
unless otherwise requested by the engineer.
COSA Fee $ qel' L %%0 -I/r Q
Date of Payment �a 5 Ll
Receipt Number OAC( Og G
COSA# 05C -1 3110^f
Date
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
_System #1 Approved for bedrooms
0
System #2 Approved for _ bedrooms
Phone 522-7773
Date 4/
49 T
i����a•p - � 4
I t�: WCHAEI E. AtiDEpsoN.'
�' •, CE - 4381
tie
Disapproved -44 it
Conditional approval for bedrooms, with the following stipulations:
Original Certificate Date: 4 `! 6 ( -3
T unici ali of chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the re. entations 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet ! - , c
X Nitrate Advisory-
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Ceark, Tract F
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 11/15/94 Sanitary seal (Y/N) Y
Total depth 83 ft. Cased to 41 ft
FROM WELL LOG
Date of test 11/15/94
Static water level 4 ft.
Well production
WATER SAMPLE RESULTS
15
g.p.m.
Parcel ID: 020-441-07
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >18 in.
AT INSPECTION
4/3/13
19.2 ft.
4.5
g.p.m.
Coliform 0 colonies/100 mL Nitrate •978 mg/L
Arsenic N/D ug/L Date of sample: 4/3/2013 Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/Steel
Tank size 1,500 gal. Number of Compartments 3
A. Harala
Date installed 10/24/94
Cleanouts(Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N)
Date of pumping 4/12/2013 Pumper Around the Clock
,/
C. ABSORPTION FIELD DATA
Date installed 10/19/94 Soil rating (g.p.d./ft2 or ft2/bdrm) .45 GPD System type 5' Wide Trench
Length 134 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 9 ft. Eff. absorption area 1,334 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 4/3/13 Results (Pass/Fail) PBSS For 4 bedrooms
Fluid depth in absorption field before test 36/26 in. Water added 682 gal. New depth 42/34 in
Elapsed Time: 1,380 min. Final fluid depth 36/26 in. Absorption rate , 600 g p d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed 10/24/94 Size in gallons 250 Manhole/Access (Y/N) Y
"Pump on" level at 45 in. "Pump off' level at 45 in. High water alarm level at 47 in.
Datum Bottom of Tank Cycles tested Four Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot >100' On adjacent lots >100'
Absorption field on lot > 100' On adjacent lots >1 00'
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line >25' Holding tank N/A
Animal containment areas >50' Manure/animal excrete storage areas >100'
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >51 Property line >51
Water main >10, Water service line >10'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10, Building foundation >10'
Water Service line >10' Surfacewater >100'
Curtain drain Norse Noted Wells on adjacent lots >100'
F. COMMENTS
Absorption field >5,
Surface water >100'
Water main >10'
Driveway, parking/vehicle storage >10'
G. ENGINEER'S CERTIFICATION
I certify that l have determined through field inspections and�.••`*OF q4���a
• X. ..•
review of Municipal records that the above systems are in 9S !t
conformance with MOA COSA guidelines in effect on this date. r;' 1¢
Engineer's Printed Name Michael E. Anderson, P.E. +*: •49-T—H° i
Date
4/12/13 i»tis
,>5. �AIICNAEf. E. ANDERSON : `t a
P : CE - 4381
COSA brown sheet -1 0-1 0-12.doc
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020441-07 COSA # HClyo�U
Expiration Date: % d — II ` D 9
1. GENERAL INFORMATION
Complete legal description Tract F. Ceark Subdivision
Location (site address) 15623 King's Way Drive Anchorage, AK 99516
Current Property owner(s) Robert and Margaret Beal Day phone
Mailing address 15.0,13=240832 Anchorage, AK 99524
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
Four (4)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
q
Individual On-site
0
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Onsite Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems 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. (Certificates may be reissued for a period of up to one year with valid water
samples.) 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.
4. 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 Onsite 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.
Name of Firm Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
Date WOU2009
OF -A�
•' : MKHAa E ANDERSON :4 0
6. DSD SIG ATURE
�
CE -4381 : �`.0.
� bedrooms. �Ii eft
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: . Original Certificate Date:7—/-oq
Municipality of Anchorage ,.• •.,
• Development Services Department '
Building Safety Division `
Onsite Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650 '
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
,CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Tract F. Ceark Subdivision Parcel ID: 020-441-07
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 11/05194 Sanitary seal (Y/N) Y
Total depth e3 fL Cased to 41 ft.
FROM WELL LOG
Date of test
Static water level
11106164
4.5 - fL
Well production 15
WATER SAMPLE RESULTS:
Coliform o colonies/100 mL
Arsenic: N/D mg/l
B. SEPTICIHOLDING TANK DATA
i
Tank Type/Material STEP/Steel
Well Log (YIN) Y
Wires properly protected (Y/N) Y
Casing height (above ground) >24 in.
AT INSPECTION
6125109
• 6 . ft.
g.p.m. 6.5 g.p.m.
Nitrate 2.16 mg/L
Date of sample: 6115109
Other bacteria 0 colonies/100 mL
Collected by: A. Harala
Date Installed 10/19/94
Tank size' 1.500 gal. - Number of Compartments Three Cleanouts (YIN)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N)
Date of pumping /�� e g Pumper Denali Sewer and Draln
C. ABSORPTION FIELD DATA
Date Installed 10/19.25194 Soil rating (g.p.d.tfe or eibdrm).45 GPD/SF
A
Length 134 ft. Width 5 ft.
Total depth_!_, ft. Eff. absorption area 1,334 ftp
Date of adequacy test 6125/09 Results (Pe
Fluid depth in absorption field before test 12.122• in.
i
Y
Y
System type 5' Wide Trench
Gravel below pipe 4
ft.
Monitoring tube Y Depression over field N
s/Fail) Pass For 4 bedrooms
Water added 650 gal.- New depthte•12e• in.
Elapsed Time: 11440 min. Final fluid depth 12'122• in.
Any rejuvenation treatment (past 12 mo.) (YM & type)
N
Absorption iate b4,'606 g.p.d.
If yes, give date
r
D. UFT STATION
Date installed 10/19/94 Size in gallons 250 Manhole/Access (Y/N) Y
'Pump on' level at 45 in. 'Pump oft level at 45
in. High water alarm level at 47 in.
Datum Bottom of Tank Cycles tested 5
Meets alar 8 circuit requirements? Y
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 N/A
Sewer /septic service line >25'
Holding tank N/A
Animal containment areas None
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Building foundation >5' Property line>5_
Absorption field >5'
Water main N/A Water service line
>10' Surface water >100,
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10 Building foundation >10' Water main >10'
Water Service line >10' Surface water >100'
Driveway, parking/vehicle storage >2Y
Curtain drain None Noted 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 COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 71112009
COSA Fee $ yG0
Date of Payment i''/I Zm
Receipt Number OySq n 3
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
* 4918
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PLOT PLAN AS BUILT SCALE I'v5d GRID'> d•t Projecx No. 271-124-_
1�, �g
R ��qq 1731 4e0r6e Bell Circle
Komm 13th GL
G. Lam& .8% Aaehorage, Alaska 99515 (907) 34S•6476
1 Hereby certify that 1 have surveyed the following described properly:
_Itteeir� TiLa.cT Pe .QtrAtt*w 2SI21V1 lNbj Of A
ltecordl0g Dlstricl, p .. ""•`
�otza.rati, _ Alaska, sad that the Im rovemenu aitueled �►P'`¢"�• • ;g�+
lhareou are within the property lines and do not encroach 01320 the property �s ;' '•,�
adjacent thereto, that 0e Improvements on the property lying edJaoanl thereto%49Tt} ,
encroach on the surveyed promises and that there aro no roadways, Iranamlulon .asrr••.u... ....es:
linea or other visible onsoments on said property except as Indicated hereon.
Dated Ihla lbe 'tf Day of F, 19,4, at Anchorage, Alaska i4 % !cues ray
15.5202 ;
It is this responsibility of the owner to datormlmo the existence of may casomeots, 44f� 'ry�""•'� ld'
covenants, of restrictions which do not appear on the recorded subdivision plat. h�u v�
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