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HomeMy WebLinkAboutKNIKWOOD LT 67A05\ GR~.¥ER ANCHORAGE AREA BOROUr~H HEALTH DEPARTMENr 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC lANK: DISTANCE FROM WELL_ LIQUID CAPACITY 4 J ~ '"'~) GALLONS. ADDRESS LEGAL DESCR,PT,O. ~ ~ I/'~ z~'l~ ~-~ NUMBER OF f MATERIAL k ~-~.~-~'(/~-x~: ,/~ COMPARTMENTS INSID~ LENGTH INSID~ WIDTH DEPTH~ SEEPAGE SYSTEM: iiSE AGE P,T: NUMBER OF PITS / ii OUTSIDE DIAMEIER NEAREST LOT LINE ,.-/~¢0 l"')~' '~' .... ' ...... OR WIDTH__ DISTANCE FROM WELL__ ~' 7 TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAl , LENGTH ,//~ DEPTH TILE DRAIN FIELD: i DISTANCE FROM WELl NUMBER OF'rIM S~ ABSORPTION AREA DEPTH: TOP OF TILE TO FINIS:H GRADE FOUNDATION= ............ ~ NEAREST LOT LINE DI&T~A~'~'CE BETWEEN LINES WIDT4~- SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH OF LINES 'C~T V ' ~'--' IN. TOTAL EFFE E IN. ABOVE TILE DISTANCE FROM WELL: TYP /L. DEPTH ~ , BUILDING FOUNDATION. r'NEAREST SEPTIC ~t SEEPAGE LOT LINE ~..~ ~' ~:, SEWER LINE ~ , TANK , SYSTEM WATER /~,,~ , SAMPLE NEAREST OTHER , CESSPOOL "- , SOURCES__ DISTANCES: DIAGRAM OF SYSTEM ~_/g/ . DATE APPROVED GAAB-HD-2 GREATEI, 3~ Eagle St. ANCHORAGE AREA HEALTtt DEPARTMENT Anchorage, Alaska 99501 - 3ROUGH 279-2511 h SEWAGE DISPOSAL SYSYEM - APPLICA¥1ON & PERMIT NAME OF APPLICANT ~!;l[J~ RESIDENCE AD D R E55 ..~_~.~ i Lo~i~ ~o,,~ LEGAL DESCRIPTION..f~ ' APPLICATION TO INSTA~L: SEPTIC TANK_ ,SEEPAGE PIT F NANOEDTHROUGH_ MAILING ADDRL:SS ~:~¢~' 15;5 PHONE NO. A/b~r~,~ _. LOCATION OF INSTALt. ATION_ .%.~. '~ ..... DRAIN FIELD __,OTHER. TO BE INSTALLED BY C~.~___~_~o~l<. -~,,/~.~ ~,~, .~.~.~,-v,'~-~ PERCOLATION TEST RE~[JLTS-'~t~O~¢ J~?~_~.~-&V',,~.5 ANTICIPATED DATE OE COMPLETION. ~-~,wt. I-.5-J qrTO BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNITTO BE SERVED ~' _. SEPTIC TANK SIZE/000 ¢.¥*~---TYPE C'°~'¥~q~c SEEPAGE AREA ~_~..~.TYPE-~-- [llAGRAM OF SYSTEM DISTANCES: I certify that I am fam~har with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described systemi!~s in accordance with said code. APPLiCANTSSiGNATURE.,./~.z,,,~'z,,.~..,,~/~.~4 ~,~'~-,,.,-' ... GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTbtENT 327 EAGLE STREET ANCHORAGE~ ALASKA 99501 Depth Feet Was Ground Water Encountered?~ tf Yes ~ Wba~ Depth Reading Date G~oss Time Net Time Location Sketch Depth To H20 Net Drop ?~opose~ I ' ' nstallat~on: Seepage Pit~__~ ....~DPain Field Depth ~t~~ D~t~ To B~o,~ o~ Pit o~ Test Perfor,mDd B~:._~L i' Data Ceptifi~d By: Date: ,J~.~-::~...L~__~ , GRE^TER ANCHORAGE AREA BOROUGH Department of Environmental quality 3500 Tudor Road, Anchorage, Alaska 99507 279~8686 Date Received November 8, 1973 Time of Inspection 9:30 a.m. Date of Inspection 8Nov73 REQUEST FOR APPROVAL OF I~)IVIDUAL SEWER & WATER FACILITIES FOR 1, Aoproval Re, quested By: FHA 1st National Address: 646 West 4th A_v.e_nNe_AnchD, r~age_~]~__ 3. Le~,.ql )cmc~iptton: LllJL_fkT-, Sec 7 ZI5N. R1N, Type of P~)6i].fty to be Inspected:_~Sir~Fam~]]gte_l]j~ Number ), Bedrooms 6. Wel] Data A, 'Fvne Dr~tLl_ed. <:~ <';onsiJYucti on~anrlamd Sewage Otsaosal System: a. Dss'call ed 1 970 C. Sectiic Tank: 1. Size Do Seepage Pit~ 1. SSze ]6X]g 2. T):t. sv~sa.! Field: Total Length of Lines Distances ;~ Phone: Phono:~ B. De pt h__~-l~, D, Bacterial Analysis Satisfactor~__~, ?tell To: Septic Tank 8. Installer RalE~ Anderson 1000 ga_12. Manufacturer Wallace , Absorption Area__._,oz~~ ....... , Sewer Lines , Nearest Lot [.ir.e~_.~, Other Contamination B, Foundation to Sootic Tank ';, AbSorotion Area C~ Abso~iPtton Area to Nearest Lot Line ............ 7~eqmst for ApProvsl of ' ividual Sewer & Water Fact. liti~ · 'i V d Dar e~~[ [ / Aporova] Valid for One Year From Dahe Signed ~eater Anchorage Area Borough, Department of Environ~.ental quali%y DIAGRAM OF SYSTEM, I c~rC.f, ti-.,a~,' the.zmn~,~aa,.xon' contained_, in this request fo:¢ app:~oval to be a true ~mdac~m._~, a~.. ~" ~.'~ ~?er>reseDt, al;". orr, of the subSect se~er and _,,m'~~-~,,,~, acxl.[[,zes located at: Siqned .............................. ~Date ii¸ i~an Subjec .: Lot 67, bactto~ ?, Tlli~(, t~IW il be ~t~sfac ~ory. bb 3500 Tudor ~;h:,~d, anchoracm, Alaska 99507 , 1, Aop¥oval Requested '~v: .... : .............................. d. Well Data C. Const~ucc~ on D, 7. Sewage Dis%'osa]. A. ~n~ta [lled C, Sepbid} Tank: ], .Size D, Seepage Pit: DJ spo~,a 1 F'ie]d ~ Depth '/~ /* i~acteria 1 A.,a ,., ..,z.. :Instal!er Size 2, Material. Tot:al Length of Lines A. Well *~o', Septic Tank ................... , Absom)t'[nn, _ Area ................... , Sewer Lines ~i , hfeare:'h Lo~ f i,-~6 , Ot;he~ Cor~t, amination . C. AbsorOt;J. on A:ea f~, l,~eare~;t I,rt Line ............................................................................. Request for Ap]'oroval Page Two 9. Comments ,qp~:~rov~ Valid for One ',',~ar {!, ][ cert~f;, that,: the infocmatJ,'.m containe-] ~n this request for approval to be a true and accurate " ','~'~,~",'> ':~'~ of ecl r,ep.cs,.,.ta ~,~ 'i:.he m~bi sawer and wa-her '('act)J ;Ses i~mated .. EATER ANCHORAGE AREA BOROb...~ APPROVAL ADDRESS: PHONEii DEPARTMENT OF ENVIRONMENI'AL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: /.~ SEWER AND WATER FACILITIES FOR REQUEST FOR APPROVAL OF INDIVIDUAL REQUESTED BY: 2. PROPE TY OWNER:.,?/?/. ? ~t:m?~'.q? ~Z~/Y/'.,¢~(/ PHONE: ~ -' ~'/'7 , ! ' / NUMBE~ OF BEDROOMS: WELL DATA: I1~ A. T~PE B. DEPTH C. StlZE D. C ~ N S T R U C T I 0 N c,..: z~u/%x('.c~z,i,~/2 E. B~CTERIAL:, - ANALYSIS :, SEWAGi'~it. DISPOSAL. SYSTEM: A. S~PTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) [ii s zF I000 APPROiVAL REQUesT FOR SEWER & WATER FACIL1 ~ES PAGE ?FWO SEEPAGE PIT 11; SIZE '- ~ / ~L-v~ }~ ii, C. [)iISPOSAL FIELD 'lii~ NUMB LINES 211.!i, TOTAL LEN~ REQUI!RED MEASUREMENTS A. W!ELL TO SEPTIC TANK {'~-' B. W!ELL TO SEEPAGE PIT C. WELL TO SEWER LINE D. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. F,~UNDATION,,,~ TO SEPTIC TANK ~ G. ~OUNDATION, TO SEEPAGE PIT~: H. S!EEPAGE PIT TO PROPERTY LINE COMMF. NTS: APPROiyED:, DISAPPROVED: DATE'I! DATE: APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED· iGREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY i: FHA Eorln 25?3 FEDERAL HOUSJNG AD1,DNiSTRATJON Budget Bureau No, 63.R0296 HEALTH AUTHORITY APPROVAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PAR? I,--tO BE COMPLETED BY FHA INSURING OFFICE Anchorage MORTGAGEE / SERIAL NO. / The First National Bank of Anchorage 111-013991 MOR?GAGOR OR SPONSOR Calihan, Don L. & Sttsan D. SUBDIVISION NAME None rOYAL t'4UM BJlh PROPERTY ADDRESS NHN Birchwood Loop Road, Chugiak, Alaska J BLOCK NO. ILO¥ NO, #67 --- Sec..7,_ __ BASEMENT Yes J~ No ] New installation 1 WATER SUPPLY BY~ [~ Public system i E] Community system [] Individual Can ettlc or other area be mede Into Townsh add tJonal bedroomJ? (,f Yes, ho~y,) SEWAGE DISPOSAL BY: ~ [77] Public system I EJ Community system [] Individual SYSTEM DESIGNED FOR 1 [~] Yes ~] No PARY II.-~TO BE COMPLETED BY HEALTH DEPARTN~ENT HEALTH DEPARYMENT INSPECTOR'SI SKETCH It is the opinion of the.~ State [---] County [--] Local Department of Health that this individual water-supply system [] is [~ is not satif;factory asa domestic water supply for the subject property. It is the opinion of the I ] State tern w'th proper maintenance: ~ Can be expected to function satisfactorily, and I I I is not ikely to create'lan nsanitary condition DA?E [~] County D Local Department of Health that this individual sewage-disposal sys- 1~1 Cannot be expected to function satisfactorily J SIO~ATORE! , J TffLE NOTE: The heali~ euthorlty ~hould complete the approprlete opinion statement above end affix date, signature ~nd title in the Ipecet provided, j Use of the abo~te grid for Fleulth Department Inspector's sketch as well as use el the back of this form ii at the option of the health authority. : PART III.~FOR USE OF FHA OFFICE H THE CHIEF UNDERWRIy~R~ ?o I have reviewed the f6tegoingH and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-s~pply system be considered [] Acceptable [] Not Acceptable Sewage disposal ~ considered [] Acceptable [] Not Acceptable. jlATE SIG!ATURE ] CHIEF ARCHITECT ~l! HEALTH AUTHORITY APPROVAL !iNDIVIDUAL WATIR SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 'omu!tu ~ad suo[F§ 61 uo!.Dadsu} jo al~CI ,iq paDadsul ',{~VotDnv qll~aH 1~ ~ 'AlunoD ~ 'alms ~ :~q ap~m uop~dsu1 · Xu~ j~ 's~q~qxa p;~oadd~ q]~ Xldmo> ~ou saop ~ s~p ~ uoDql~lsuI · uopdmnsuo2 uumnq Joj XJoDgjs{lgs lou s} ~ s~ ~ Jalg~ jo a~p a*~g .,'saX., s~ Ja~su. Jl 'oN ~ 'saX ~ iapgm ua~ Ja~ jo uop~u~m~xa [*2}golo]Jal~.q suH 'SUOlle~ 'X~p~deD '~aeaO ~ 'amsso~d ~ :a~eams jo · oN ~ 'saX ~ :~qg~a~e~ gupunom dm~ 'oN ~ 'saX ~ :pau~rap lla~oad m~dm~ '~d dm~ ~ 'punoa~ a~oq~ osnoqdmnd ~ 'ma~aseq ~o moo~dm~ ~ '~uamas~ ~ :u~ 'Xlp~de~ d~ 'loaj ~ ad~d doap Jo q~ua~ 'lla~ daa~ ~ 'lla~ ~Oll~qS ~ :dwnd 'o N ~ 'saX ~ :lqX}nal~/~ ~a~o~ lla~ u~ s~muadO 'lma~ ~ '~o~ ~ 'a~a~u~ ~ :~;ao> 'llg~q ~uu}p~o ~ 'X~l0 palpp~ ~ 'mo~ lua~aD ~ :q~ pal.aS gu}s~) punoJ, a.~ds 'pl~!A alem!xoJddv 'la~j ~msg~ jo adg£ '~aoj 'a~nu!m aad SUOlle~ Jale,.~. jo Alddns a~enbape qs!umj m ,{~up.^ a]e!patutu! u! sham jo aJn[}gj jo pJo>a~ ~ua3aJ lsom aa!{) · pooqJOqqg}au u! ~gu~olsn) lou aae [] a.m [] S[la.~ [.np!^!puI WI,LSAS AlddfIS-Ut.I,V/~A 1YtIOIAIONI NOI.I.::)iIdSNI .10 J. UOd3U 'saq2u! 'saq>u! --6I uo!Dadsu! Jo al'eCl -,iq pol:~lsuI '&!Joqmv qlieaH leOOq ~ 'lmnoD ~ 'alms ~ :lq epDm UOl~SUl s~os ~ 'apes ~ quo~j ~ ~ audi ~oI l~a~au :laaj 'uog~punoJ gWpl~nq '.laaj 'lla~ :~o~j aou~s~ [~pa~em ~u~u~ '~aaj 'q~daQ '3a~ Ja~a~eSp ap~smO .... s~d jo $~mnN :~ld eB~d~s 'al9 aaao le~aa~sm Ja~lg jo q~da(l -soq3m %[9 q~eau~ le~Jo~em Ja~lg jo q~daQ Jaq~O 'auras u;~oJ~ ~ '[aaeJO ~ :le~jale~ i;llg jo ~a& apeJ2 qs}u~ ol a[~ jo dm 'qldaQ 'l~J audi q~ea jo ql2u~ 'sau!l a[p jo q~uaI lm%L :pled Iolodlla.ellJ. 'SUOlleS · laaj 'qid.~p pmb!q ",aat 'q~p!.'* ap!guI 'laaj '~uam~.mdtuoo :~a, lU! A]Ded'eD -sUOlle:4 smatmJedmo> jo aaqmnN -- 1eU0}elN 'laaJ--' W1xsAs lVSOd$1(]-iIOVMtS 1YflOIAIONI--NOI.I.::)tdSNI lO .tHOdtii 'loodssaD [] '>~um ,!ldag [] jo s~s!suo* xNIW,L'~IIII ~.liVWlUd FHA Forn~ 25?3 Rev. July 1958 i FEDERAL HOUSING ADMINISTRATION Budget Bureou No, 63-R0296 ~ HEALTH AUTHORITY APPROVAL I DIVIDUALWATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ~; PAIRY L--¥O BE COMPLETED BY FHA INSURING OFFICE J J MORTGAGEE ISERIAL NO. PROPERTY ADDRESS E]New installation J' BLOCK NO. LOT NO. J!~; 7 I additional bedroomJ? : ~"':' :; 1 L[~] Yes [~No  SYSTEM DESIGNED FOR MORTGAGOR OR SPONSOR J SUBDIVISION NAME TOTAL NUMBEII: ---- ~ BASEMENT ~ Public system J ~ ~mmuni~ system SEWAGE DISPOSAL 8Y~ ~ ~blic system ~ ~mmuaity system :1 HEALTH DEPARTMENT INSPECTOfl'~ PART II.~YO BE COMPLETED BY HEALTH DEPARTMENT SKETCH It is the opinion of the ~ State [] County J--] Local Department of Health that this individual water-supply system [] is [] is not sati~'actory asa domestic water supply for the subject property. It is the opinion of the ~ State J--J County J'~ Local Department of Health that tiffs individual sewage-disposal sys- E] Cannot be expected to function satisfactorily tern with proper mainten,qnce: I J~] Can be expected to function sat sfactorily, and is not likely to createlllan insanitary condition DATE J S,ON:~TURE TITLE NOTE: The heaJtl~ uuthorlty should complete the appropriate opinion statement above and ofiqx date, signature and title In the Ilpacel provided. Uso of the ~bov~i:grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the health authority. PARt Ill.--FOR USE OF FHA OFFICE YO tHE CHIEF UNDERWRITER: I have reviewed the forego ng and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-sUpply system be considered ~ Acceptable [] Not Acceptable Sewage disposal bee considered E] Acceptable [~] Not Acceptable. DATE SIG TURE CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT ~i HEALTH AUTHO~--XppROVAL INDIVIDUAL WARE. SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 ¸6l · amu!tu lad sUOllU~ · ainu!tn ]*d sUOlle~ '~u!se> jo q~d*Cl uo!~nllod 01q!ssod jo so>mos laqm ~a*j 'PI*ti [esods!p :~aaj- ~um ~Dd0s :~*J '~oJ [] 'op!s [] quo~j [] ~e *U!l mI ~s~au ~**J loodss~ u;~j- · pooqJ6qq~?u u~ XJ~ulolsn~ leu aJ~z [] oJR [] Slla,'a lunp!^!pUl Wt.LSXS AlddflS-IttlVM 1VI'lalAlaNI--NOIJ. DtdSNI lO 1UOdIU · ~aoj -- -s;~q~u!- -laoj 61 uo[l)adsu! jo aluCI ,iq pal x,xts uI · ~hHoqinv qHsoH ir)oH ~ -X]un(0 ~ -,]*lg ~ :Xq OpDm UOIP~IUl [~pa~em ~u}u[q ']aaj -'q]daG '~aaj ~ Jala~e~p ap~s~n0 ..... sl~d jo J~mnN al~ Jaao lmJa~em JaHg jo q]da(l 'saq~m °aH1 q]e~u~ leUalem Jal[~ jo qlda~ Jaq]o lega]ucu ?tu!u!q 'SUOlff.~ A~oede> p!nb[q -]aaj 'tDdac1 'l,~'J '.~eaJ [] 'ap!s [] 'luoJj [] lz auH loI lsaJ'eau !laaj uo!l,~punoj '4aaj ']aaj 'q]dap p!nbq '~a~l 'lU0tlJIledtuo) laJUl Xl!~t~d:~D 'suoJJe~/ q~p!,., ap!gu 'loodssaD [] WI.LSAS 1YSOdSla-IoYMIS IYOOIAIQNI~NOIJ. DIdSNI t0 /itOd:lU ii, /1' E)iyif'onme. ntal Special ¢3,!; iF,,tlA ,~ U,r, E,kin . n, t;ox 135 Chuqfak, Alaska Parcel I.D. 051-161-16 Q E ` Municipality of Anchorage FG On -Site Water and Wastewater Program -" (907) 343-7904 5 n EjT'Y Certificate of 4n -Site Systems Approval 1. GENERAL INFORMATION: Expiration Date: _ I Z - I - Z'Z, Complete legal description KNIKWOOD; LOT 67A Location (site address) 19816 South Birchwood Loop *Chucliak Current Property owner(s) Carol Connell Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 907-360-2501 Day phone 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ SSCP Waiver Fee $ T-30 '-2 z, Date of Payment Receipt Number 0 V-7 ZS COSA # 05 G ZZ ( x-13 6 Date of Payment Receipt Number Waiver # M 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: Gamess Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 r Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were identified during the not evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, � � groundwater levels (that may fluctuate during the year), quality of construction (materials and (/ - 4`� workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and G"""""'"' ""'."" "' are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systems; therefore, GEG makes no warranty (express or implied) regarding the future performance of ...... . • • • • • .. • • •.. • • • .. the well or septic system. GEG makes no representation whether an alternative well or septic system !�� t. i e., A. Gar'ess: "!) can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to 1E �� "�2 perform the evaluation. Reliance upon the information in this by .� ���Z.a�✓r provided report any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.so� #AECC884 6. DSD.51GNATURE System #1 Approved for —2-==. bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the �; By: `'`" Original Certificate Date: z The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: KNIKWOOD; LOT 67A Parcel ID: 051-161-16 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 3.7+ gpm Date drilled **1958(?) Water storage tank volume N/A gallons Total depth *63.5+ ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to UNKNOWN ft [y 0 Coliform bacteria is Negative Q Sanitary seal is functioning correctly �f Nitrate 1.3 E mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic- ug/L Arsenic less than MRL (ND) Casing height (above ground) 12+ in. Collected by GEG, LTD Date of flow test for COSA 6/12/22 Date of Sample 8111/22 Static water level at beginning of test 60.6 ft Comments *PER GEG EG -R( fN **SEE ATTACHED LETTER SEE ATTACHED CAMERA B. TANK DATA I INSPECTION Age of tank(s) 52 years Tank type/material SEPTIC/CONCRETE Measured operating fluid level in septic tank 58" ( ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/22/22 D. ABSORPTION FIELD DATA SEEPAGE PIT C. LIFT STATION ❑ Required maintenance completed Age of lift station ye Lift station materia Which system tested (date installed) 6/15/7° Adequacy test date 8/12/22 ❑ ALL standpipes present per record drawing Results F- Pass For 2 bedrooms Total measured depth from grade 9.83 ft (max) Fluid depth prior to test 40 in Measured depth to pipe invert from grade 3.16 ft (min) Water added 455 gal ❑ N/A — pressurized field 53 ❑ Monitor tubes go to bottom of effective. If not, state New depth in depth into effective 6.66' Elapsed time 120 min A Code -required soil cover over field Final fluid depth 48 in ❑ System presoaked Absorption rate 300+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NIA date of test) Gallons introduced *2011 gallons NONE KNOWN (PER OWNER'S If yes, enter date DAU ,HTER) Comments/Deficiencies: PRE-SOAK PERFORMED ON 8/11/22 COSA Checklist yellow sheet E0 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes *50'+ Community Sewer Manhole/Cleanout > 100' Surface Water > 100' ❑ Yes if No ft jam✓ Yes if No ft Neighboring Tank > 100' R Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No **70 ft Holding Tank > 100' R Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' **** Animal Containment > 50' P1, Yes if No ft 0✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [DYes it No ft P Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' P Yes if No ft Property Line > 5' M Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' R Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' Q Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' Q Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' Q Yes if No ft Private Wells > 100' [] Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' D Yes if No ft F. ENGINEER'S COMMENTS *MET SEPARATION REQUIREMENTS AT TIME OF INSTALL **SEE ATTACHED WAIVER REQUEST ***NO REQUIRED SEPARATION DISTANCE AT TIME OF INSTALL ****NO DRAINFIELD PIPES FOUND FOR LOT 67B - MEASURED APROXIMATELY 150' TO SEPTIC TANK G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review _ of Municipal records that the above systems are in conformance with O� 4 T MOA COSA guidelines in effect on this date. • , _ .. • • • ... -arn ss. Q Q 9. CE -795 �p COSA Checklist yellow sheet d rofessio� 40 NAECCsaa Municipality of Anchors e gQ _ _ _ - Vepartmcnt P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 • Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * COSA OSC 221436 PID#: 051-161-16 Legal Description: Knikwood Lot 67A Engineer: GEG Applicant: Carrol Connell Your request for a waiver of the required 100 feet horizontal separation from the drain field to the well has been approved. The approved separation distance is 70 feet. This waiver approval applies to the Existing Trench only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 -day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. Eg Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: r ApprNN 0oved by. me of Ret�.r " viewer plC orr l�%RON **** VARIAN C E/WAIVER REVIEW **** qqnics GARNESS ENGINEERING GROU, Ltd n a ell ENGINEERING- SALES =CONSULTING 44���.,..,a:... August 29'n, 2022 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Knikwood; Lot 67A — Well to drainfield waiver request To whom it may concern, The subject lot is served by a private well and septic system. Per MOA records, the septic system was installed in 1970. Per a letter in MOA records dated 7/17/1972, it states "The well has now been upgraded". It is plausible that this is referencing the drilling of a new well, however, this could not be confirmed. In short, the well may have been drilled in 1958 when the home was built and upgraded in 1972, however, it would not affect the separation distance requirements as well to tank and drainfield were the same in 1958 and 1972 (50 feet for tank and 100 feet for drainfield). Per GEG field measurements, the existing concrete septic tank is approximately 60 feet from the existing well, which met the code at time of installation (50 feet) and the drainfield is approximately 70 feet (which does not meet code). It should also be noted that the sewer line is located approximately 5 feet from the well head, however, there was no code requirement for well head to sewer line at the time of installation. We are requesting that your department issue a variance from well to drainfield down to 70 feet. Justification for granting this waiver is as follows: This encroachment has existing for approximately 50 years Per water samples that were taken on 8/12/2022 the results are as follows: o Nitrate — 1.38 mg/L o Arsenic — Non -Detectable (<5 mg/L) o E. Coli and Total Coliform - Negative The area of the well head is in the "lawn" area (see attached photo). If effluent were to overflow, it would be noted by the homeowner and corrective action taken. E OF. 9 . Jef by •.Garn ss i CE -79- �tlFFFQ AM ,&,: \,&?ROFESSION— �ct,9 �� 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 (3 � _Z,ZZ Phone: (907) 337-6179' Fax: (907) 338-3246 * Website: www.garnessengineering.com f OF At ..49 TH a o s SHANE A. HOLT �� f �O m LS -6914 tessionzk o— THESURVEYDATA AND MEAS[IREMENTSHEREONAREPREPARED FOR THE OWNER OF RECORD AS OF THE DATE OF THIS SURVEY. ANYUSEOF THIS DRAW/NG BY THIRD PAR77ESISPROH1BfTED UNLESS WRITTSV PERM1SS10N 1S PR0WDEO. THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHON ANY CONFLICTS BMIE£N EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOAIN HEREON ( UNLESS INDICATED) NOTE= FENCELINES THAT MAY APPEAR ON THIS DRAUING ARE NOT TO BE USED TO DET£RMN£ PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOMN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOM AND/OR ICE. 0 SEWER SYSTEM PIPE AS-BUILTSURVEY f" = 30' NO CORNERS SET THIS DATE /HEREBY CERT/FY THAT / HAVE PERFORMEDA SURVEY OF THE FOL LOWING DESCRIBED PROPERTY LOT 67 A KNIKWOOO SUB. ANCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE VIS/BLEIMPROVEMENTSS/TUATED THEREON AREW/THIN THEPROPERTYLINESAND NO VISIBLEENCROACHMENTS EXIST OTHER THAN NOTED. DATED ATANCHORAGE,ALASKA THIS 5TH DAYOF AUGUST 2022 15575 225-20 HOLT LAND SURVEYING 9399 GROVER DRIVE ANCHORAGE,AK 99597 223-8615