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HomeMy WebLinkAboutSTRUEMPLER LT 2truempler Lot 2 #017-421-15 Municipality of Anchorage j Community Development Department � '' ` `'�'. Page 'i �Dr 3 On-Site Water & Wastewater Program) 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • 0343-904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171291 PID Number: 017-421-15 ❑ New E Upgrade Name: TARA GALLAGHER ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bedound Address: 12440 TURKS TURN STREET *ANCHORAGE, AK ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from origina ade: 344-3424 5 GPD/Sq. Ft Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: F Grave pth beneath pipe: Ft. Subdivision: Block: Lot: STRUEMPLER _ 2 Fill added above original grade: �iw FL Gravel length: Ft. Beds Number of lines: Distance between lines: Ft. Township: - Range: - Section: - Gravel width: FL SEPARATION DISTANCES Total absorp area: SO. Ft Number of trenches: Dist. between trenches: Ft. To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sewer Lines Well 100'+I A 25'+ TANK ■ Septic ❑ S.T.E.P. ❑Holding ❑ Other Manufacturer: Capacity: Surface Water 100'+ _� N/A ANCHORAGE TANK 1500 Gal. Lot Line 5'+ �� Material: STEEL (10' MAX BURIAL) Number of compartments: 2 LIFT STATION Foundation 5'+ Manufacturer: C Gal. Curtain Drain NONE KNOWN Remarks: PER CONTRACTOR, OLD SEPTIC TANK WAS DECOMMISSIONED PER UPC 'Pump on" level at: "Pump off'level at: High water alarm at: Pump Make & Motle Electrical Inspections performed by: PIPE MATERIAL EXISTING/ House to tank D3034 Tank to D3034 drainfield Installer ARM SERVICES, LLC EXISTING/ Drainfield EXISTING CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Dates: 1st 11/22/2017 2nd Location and Description: 3rd - 4th - BOTTOM OF TRIM Q SW HOUSE CORNER ENGINEER'S SEAL Community Development Department Approval Conditional approval: Date: �.••""'%4 oil ••• ••�' ♦♦ .• Am ;♦ .., ...................0 ; :.o ♦ :ff Garness d us ♦♦ �' E-795 •.°�• =,i LICENse ��OFESSI � •• #AECC884 1 a IL ;i*` Approved: KUYE c9 A axxx Date:1,2/15/0 Inspection Report _1-1.12.doc PERMIT NUMBER: OSP171291 RECORD DRAWING A I B I C ST1 41.9g21.4g41.7ST2 44.9DBL1 45.4DBL245.7\GP4F STRUEMPLER; LOT 1 \ \ 100' WELL RADIUS / 'P EXISTING 5 BEDROOM /• \ HOUSE ST s Ti DBL1 & `� DBL2 EXISTING DRAINFIELD G PARCEL ID NUMBER: 017-421-15 m - NEW 1500 GALLON'4-A-&- DEEP BURIAL (10' MAX) STEEL SEPTIC TANK / / / / / T12N, R3W, SECTION 25, N2SE4NE4NW4NW4 AF VAP A.si_ _7.vd%�cz GARNESS ENGINEERING GROUP, Ltd - - - CIVIL & ENVIRONMENTAL ENGINEERS _ — - --- - 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507' PHONE (907) 337-6179' FAX (907) 338-3246' WEBSITE: www.gwnessengineering.com PREPARED FOR: PHONE NUMBER: I/ TARA GALLAGHER 344-3424 } PROJECT/LEGAL DESCRIPTION: DRAWN BY: STRUEMPLER; LOT 2 L.K.B. TYPE OF WORK: d / 11/29/2017 PARCEL ID NUMBER: 017-421-15 m - NEW 1500 GALLON'4-A-&- DEEP BURIAL (10' MAX) STEEL SEPTIC TANK / / / / / T12N, R3W, SECTION 25, N2SE4NE4NW4NW4 AF VAP A.si_ _7.vd%�cz GARNESS ENGINEERING GROUP, Ltd - - - CIVIL & ENVIRONMENTAL ENGINEERS _ — - --- - 3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507' PHONE (907) 337-6179' FAX (907) 338-3246' WEBSITE: www.gwnessengineering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TARA GALLAGHER 344-3424 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: STRUEMPLER; LOT 2 L.K.B. TYPE OF WORK: DATE: �,_ RECORD DRAWING 11/29/2017 0 N V=40' PERMIT NUMBER: OSP171291 RECORD DRAWING PARCEL ID NUMBER: 017-421-15 TOP OF TANK INSPECTED BY MOA ONSITE EMPLOYEE TIM ECKLUND ON 11/22/2017 FINAL GRADE = 101.91 - 102.47 STI ST2 TOP OF TANK AT INLET = 95.48 TOP OF TANK AT OUTLET = 95.40 INVERT OF BUNG / AT INLET = 94.86 J NEW 1500 GALLON SEPTIC TANK INVERT OF BUNG (10' MAX BURIAL) AT OUTLET = 94.66 �.•,�� OF --------------------------------------- ------ Aw GARNESS ENGINEERING GROUP, Ltd 9 ..... ..... .. - - --- ___ -, CIVIL & ENVIRONMENTAL ENGINEERS 3701E TUDOR ROAD, SUITE 101 - ANCHORAGE, AK 99507PHONE (907) 337-6179 - FAX (907) 338-3246' WEBSITE. www.garnessengineering.com.... .. ......, . ••�/ y AeSS W •���5 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TARA GALLAGHER 344-3424 3 OF 3 C 795 • ?1w ♦� �(� ••..� ��Z'••• AV �1� FQ •'p•.. '` �4W PROJECT/LEGAL DESCRIPTION: DRAWN BY: STRUEMPLER; LOT 2 L.K.B. •...�• LICENS E,,� 1�„S;\� • TYPE OF WORK: RECORD DRAWING DATE: 11/29/2017 I#AECC884 'JoS�pm,rYQR MUNICIPALITY OF ANCHORAGE �,r t. ,r On-Site Water &Wastewater Program \`' j�f j L'\‘ PO Box 196650 4700 Elmore Road _ Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997r. httpalwww.muni.orglonsite e " ,NCM OP0% On-Site Wastewater Disposal System Permit Permit Number: OSP171291 Effective Date: 10/2/2017 Work Type: SepticTank Upgrade Expiration Date: 10/2/2018 Tax Code Number: 01742115000 Site Legal Address: STRUEMPLER LT 2 G:2840 Site Mailing Address: 12440 TURKS TURN ST, Anchorage Owner: VOLMER ZACHARY J & GALLAGHER TARA J Lot Size in Sq Ft: 49409 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: 0/3/1 4 Issued By: (2?✓z Date: D 0,2 ,201 SEP 282017 MUNICIPALITY OF ANCHORAGE• ti Community Development Department t / Phone: 907-343-7904 Development Services l / Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel ID, 017-421-15 Property owner(s) TARA GALLAGHER Day phone 344-3424 Mailing address 12440 TURKS TURN STREET'ANCHORAGE,AK 99516 Site address 12440 TURKS TURN STREET*ANCHORAGE,AK 99516 Legal description (Sub'd, Block& Lot ) STRUEMPLER; LOT 2 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ®all that apply) Initial 0 Single Family(SF) Absorption Field 0 (w/wo ADU) Septic Tank ® Upgrade Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: N/A Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 15 Waiver Fees: Date of Payment: 41123 /i Date of Payment: Receipt Number: 09W/34 3 Receipt Number: Permit No. d5 P1712,Q! Waiver No. (Rev.01111) GARNESS ENGINEERING GROUP, Ltd Advanced rruatmkvr g/Systcyrr - CIVIL&ENVIRONMENTAL ENGINEERS Dealer September 27, 2017 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Struempler S/D; Lot 2 To whom it may concern: The existing 5 bedroom house is served by a private well and septic system. The septic tank is in a state of failure and must be replaced. We are proposing to replace the existing septic tank with a new 1500 gallon steel septic tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. -rely, - - e . ar P.E., M.S. Presi. 3701 East Tudor Road,Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com _1 Q CC I- CE _i U Q I- r T12N,R3W,SECTION 24, COLD WINDY DESOLATE HEIGHTS;LOT 3 QI Z SUSITNA SUNSET;LOT 4 W2W2SW4SE4SW4 S PTN Q } U II ` I UPPER HUFFMAN RD. i`' — - - - — — —,' — - -� — — — // 1 r 1 II 1 I T12N,R3W,SECTION 25, I 10 WELL RADIUI I NW4NE4NW4NW4 LESS$150' STRUEMPLER;LOT 1 ter'+ ~� I 1 1 moi' `. I 1 ?�/ \ `\1 I / T12N,R3W,SECTION 25, \ / N2NW4NW4NE4NW4 off i • I 1 �i ��++ �.f- '�..� I 100'WELL RADIUS I `8EVTIC AREA//moi �`,` I '/�/z•/� . .4 1 1 II �'� T12N,R3W, / 1 1 I (!)I SECTION 25. 1 `I `5' `�• Y Z T12N,R3W,SECTION 25 NW4NE4NW4NW4 1 1 . .F. . �,� j 52NW4NW4NE4NW4 S150' I 100'WELL RADIUS I .� . ` ,„ I- 00 4 z-� U? 1 11 ., 5 I ' 4.. Si 1 tit •11? \ ' 5' N. , / �y N • i N. `�� ��/ �/ \\ T12N,R3W,SECTION 25, `. ... P \\ S2NW4NE4NW4 ZERKEL;LOT 1 * / 1 1 1 VACANTti 1I I 100'WELL RADIUS 1 1' I T12N,R3W,SECTION 25, ; I N2SE4NE4NW4NW4 1 1 1 • \ i/• / • / ' , .\ .� S ALE. 1'= 100' .de t al'1••lIl&rallbbr 4,417``%,,%... ,"):...,••'''''''' '''''' ••. y�i GARNESS ENGINEERING GROUP, Ltd ' �� ��_ ; CIVIL&ENVIRONMENTAL ENGINEERS •• I •• • • • 3701 E TUDOR ROAD,SUITE 101'ANCHORAGE.AK 99507'PHONE(907)337-6179'FAX(907)338-3246'WEBS,TE:www garnessengmeermy Torn PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 •re ' e-mess TARA GALLAGHER 344-3424 1 OF 2 �t-r .• -795 „, � PROJECT/LEGAL DESCRIPTION: DRAWN BY: •0.1(x••' /)'f) ';•''‹ • STRUEMPLER; LOT 2 L.K.B. 4. p"•p••��'•V•,F_••••••••,''�•P�, �+ TYPE OF WORK: DATE: LICENSE ,1M1�i�S`,r.4 SITE PLAN 9/27/2017 r+AECC884 T I 1 //' \ `~ I N I / ` I I // \ \ / \ -I I / \ l .� - // \\ \ I 6e , 1 STRUEMPLER:LOT 1 \ \\ I // �\ \ Iii I \••..... 1- I .'....1I ----- I- 100'WELL RADIUS.. I I _•_`:i11, • l •\ \\ .e •a. l \ 1 I \ • a I \ \ • , \ \ a� •e / \ • -1° .. . 41 / s��v \ - oQ / I \ C \ 0 o / 1t // I i- Q� EXISTING 5 • d / LU BEDROOM / I CC I40, *•••••. HOUSE '/ I CONTRACTOR IS TO HAVE ...... . Z SOUTH PROPERTY LINE M ~ _ Z PROFESSIONALLY LOCATED w PRIOR TO CONSTRUCTION G w I D // 440,/ c INSTALL FCO IF EI I EXISTING SEPTIC TANK TO BE ONE IS NOT . I- M / DECOMMISSIONED PER UPC ii PRESENT-•.1�►=! NAME GREA I ER ANCHORAGE AREA BOR.JGH Department of Environmental Quality �I� fli'6 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS PHONE LOCATION 4Y,4 P/ � S� "`�� E DESCRIPTION Zo � ti u41 0/er 7/ SEPTIC TANK: DISTANCE NUMBER OF ^7 FROM WELL MANUFACTURER MATERIAL COMPARTMENTS G� INSIDE LENGTH INSIDE WIDTH / LIQUID DEPTH S LIQUID CAPACITY[ ALLONS. TI LE Dfb%R*+4E-L �': ell 1 " TOTAL LINES LENGTH NEAREST LOT LINE DISTANCE FROM WELL FOUNDATION � 22 NUMBER OF LINES%D'ISTANCE BETWEEN LINES A�TRENCH WIDTF k"OIN. TOTAL EFFECTIVE ABSORPTION AREA l SQ. FT. LENGTH OF EACH LINE"O DEPTH OF FILTER ..coT� -rno nc rig r Tn cinncu raonF MATFRIAI RFNEATH TILE 9�IN. ABOVE TILE � IN. WELL: /Uof _r-jNjs1teaj `(_1A1Le 0-F S2W � TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION , LOT LINE CESSPOOL , OTHER SOURCES NEAREST SEPTIC SEEPAGE SEWER LINE , TANK , SYSTEM_ APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY:� SEWER LINE DEPTH: — 7— PIPE MATERIAL: LOT SLOPE: REMARKS: &6_4DATE=�/� 7 �rar F.,m ED -032 DIAGRAM OF SYSTEM G.A.A.B. DISTANCE FROM: - " DEPARTMENT Al HEALTH AND ENVIRONMENTAL PROTECTION . 825 /L' STREET / ANCHORAGE, HK 99501 ' � � -:41 279-2511 -FEE two C3 P41_13 :C 15 E? bA En FT ������� PERMIT NO. ( 77415 ) / �/�'�'�~�' `^ APPLICANT NORM BRISTOW SRH BOX 449H 344-0071 LOCATION UPPER HUFFMHN & TURKS TURN LEGHL 1 2 STREUMPLER SUBD LOT SIZE 54600 SQUARE FEET TYPE OF SOIL H8SORBTInN SYSTEM IS: TRENCH , MAXIMUM NUMBER OF BEDROOMS - ] SOIL RATING (SQ FT/PR)= 180 � THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ` �-Ik �����hV-- 43A. NAFIFINAEEU_ ������ '�1'5- THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET) 10"NC3 < 1 005 1W Ez7 KTI -T - I �Fe. rcr_ FE% c-",!! OR !F:,!: K:�-- 8HCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 10 DRYS OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. I CERTIFY THAT 1� I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO IACLUDE THAN It BEDROOMS. HPPLICHNT N ISTOW SOILS LOG " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276.2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR: /v a /l, /"I *& /,S- TO sy DATE PERFORMED: C— 7— -7 ! LEGAL DESCRIPTION:. 2 tl %L ./' j DEPTH SLOPE SITE PLAN (FEET) � I F I l 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 V 6A -A VL Date WAS GROUND WATER / Cl Net Time Depth to Water L ENCOUNTERED? /V L i P E IF YES, AT WHAT S'N$ DEPTH? 16 J I 1 s/ S-A 17 18 -1 -- 19 Reading Date Gross Time Net Time Depth to Water Net Drop /17 20u PERCOLATION RATE / / q /i /N (minutes/inch) ,iTEST RUN BETWEEN 9' s FT AND /7 FT COMMENTS l' * ce aOr.' -7D ?/(C" C/x A,A Tib /,j fo%E C/F ;r e'16 S0:6 S CRY"L`Ln�S //✓ r/d/" 7L'S7 /�/I A F( //SSG° TIaN of 7/3(: /(a7c' )�'� /'A 1; Ca S/{0 t/ F /" /'?XIcf PERFORMED BY: C7 /l -Y '!� /'"7 F4 e-' C7/7 CERTIFIEDBY: ";V": "IG '' DATE: /0-77 72-008 (7/76) _�M-W DRILLING, INC. DRILLING LOG Norra Bristow dom Well Owner Use of Well Location (address of: Township, Range, Section, if known; or distance main road �,o,:ya.,truenpler Size of casing--6:---'!Depth of Hole 1. /5 feet Cased to 25 . 6 feet Static water level GO ft. (MVe) (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation N/A Well pumping test at 2Ogallons per (i»irr} (minute) for-----I--hours with 1-00 r{t• of drawdown from static level. - Date of completion 10/15/77 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO Casing stickup 2 mn 5 Fi_11' 5 TO 7 Organics 7 rn 19 1.9 TO 175 TO TO Silty ,�xavel Bedrock: waerr Seeps in sporadic retcturesi ' f tnroughoar.: 10V.''x '�' conuactor 2 — STATE Parcel I.D. 017-421-15 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 8" U B Certificate of On -Site Systems Approval MAR 1. GENERAL INFORMATION Complete legal description Struempler, Lot 2 6 2014 Expiration Date: C / y- % Location (site address) 12440 Turks Turn Anchorage, AK 99516 Current Property owner(s) Norman & Patricia Bristow Day phone 884-1441 Mailing address 16925 Bedford Chase Circle Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Five 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 7 Individual 7 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water Svstem ❑ Public Sewer ❑ WaiverNariance request Received by: t---� Date COSA to be releaseddto the engineer, unless othervnse requested by the engineer. COSA Fee $ 610o Date of Payment 4(2114 Receipt Number Cj/ / 826 COSA # 0scW IU"7D Waiver Fee $ Date of of Payment Receipt Number ©�fQ82 Waiver # 0,5 p/�l to3 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 Phone Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Datg_. 6. DSD SIGNATURE _j�System #1 Approved for 5 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms 522-7773 3/2014 ���a GO ao���il hK84. e 49 TH iJ g Cr with the following stipulatiok.t.` �2l<e-4l> By: �Oriinal Certificate Date: The MGnic'ipity, An h rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory_ Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet [, . 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: Struempler, Lot 2 Parcel ID: 017-421-15 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/15/77 Sanitaryseal (Y/N) Y Total depth 175 ft. . Cased to 25 ft. FROM WELL LOG Date of test 10/15/77 Static water level Well production 20 ft. 20 g.p.m. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >12 in. AT INSPECTION 2121/14 28.7 ft. 6.4 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 7.59 mg/L Arsenic N/D ug/L Date of sample: 2/18/14 Collected by: Anderson Engrg. B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/77 Tank size 1,500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N Date of pumping 3/6/2014 Pumper Around the Clock Pumping C. ABSORPTION FIELD DATA Date installed 6/77 Soil rating (g.p.d./ft2 or ftZlbdrm) 180 SF/BDRM System type Deep Trench Length 61 ft. Width 3 ft. Gravel below pipe 7.0 ft. Total depth 11-14 ft. Eff. absorption area 854 ft2 Monitoring tube Y Depression over field N Date of adequacy test 2/21 /14 Re-sdlts (Pass/FalljPass-- ----- For —5 bedrooms - " Fluid depth in absorption field before test 0 in. Water added 840 gal. New depth 14 in. Elapsed Time: 1,440 min. Final fluid depth 0 in. Absorption rate , 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >1 00' 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 SEPTICIHOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Absorption field >5 Water main >10 Water service line >10 Surface water >100 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO Property line 21 Building foundation >10' Water main N/A Water Service line > 10 Surface water >100, Driveway, parking/vehicle storage > 10 Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS The Absorption Trench is 46 SF short of the area required for a 5 bedroom home. The septic system was approved in 1993 with this information known. The septic system is now more than 40 years old with a history of satisfactory performance. The remaining life of the system is unknown and cannot be predic G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and QF pA �t review of Municipal records that the above systems are in conformance with MOA COSA as in effect this date. r W�e guidefr on EWS Engineer's MlChael E AfIdeFSOfI, P.E. fAIa TH f '3 <s — - -Printed -Name 3/6/14 .. Date /. aKAtC!§.AF, E AN^H50 +a'e`, r C€-4381 z ��ldlV l4YPlsc �` �' COSA brown sheel_141412.doc - Municipality of Anchorage s Community Development Department Development Services Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval 4 141070 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 2 of Struempler subdivision. This inspection revealed a nitrate concentration of 7.59 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX March 6, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 2, Struempler Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The septic system was constructed on Lot 2, Struempler Subdivision in June of 1977. The absorption trench is located 2' from the south property line at the west end and 5' at the east end according to a surveyor as built completed in 2011. A lot line waiver was not requested when the system was constructed nor when it was approved by the City in 1993. We are now requesting a waiver be issued allowing the absorption trench to remain in its current location. Placement of the trench in this area does not impact the property to the south or the well and septic system on that lot. We recommend a waiver be issued allowing the trench to be 2' from the south property line. Sincerely, _1 ;"iL C.�C-�_u�.�t ._. Michael E. Anderson, P.E. ON1 Municipality of Anchorage • Development Services Division On -Site Water and Wastewater Program rt.eur S, 1a e c � O. N Ie partment **** VARIANCE/WAIVER REVIEW **** Waiver#: oso141034 PID#: 017-421-15 COSA#: osc141070 Permit#: Legal Description: Struemoler Lot 2 Engineer: Anderson Engineering Applicant: Norman & Patricia Bristow Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 2.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ................................................. 0.......................... 0.. Waiver is Granted: X Waiver is not Granted: Date: ly y Approved by: ,✓ D O J J st J - ti 7 e� � r fJ J `L r� tL � I I � I l la c c y s.0 c iNI •-vi p .. 0 c `m m a _ o s ipL m cmc �E m�tO= 'm - x O I 0 o° m E c t c'fl aJi E L — m 0 `T' d 0 N o r N mc C 0 N a N D V ll m a 2 a L N m c d o p TJi c m o .r m n t m c a �n 'N ? O T a d y N N V OC o p m n C°` 'n d E° C 0 x •_• I�JI 4@ C m N p y C C E p ro n vi 9 c Thr m O O- > u c 0 c C� O O � = J c_ N ? t c p c m u MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D.# Cit-1–LGA 1- \6 HAA # l� ��l �l1 Lug Lly 1. GENERAL INFORMATION / Complete legal description LoT P.1" p Location (site address or directions) Z y yy 7u R/<s -T u2 Property owner No o?,,A 15TH— Day phone Mailing address ZI Y q 7c p,,elc-s;_ -T ieey 3 �We Lending agency t S�i4 7 M7 Day phone c2 6 l 3 �� Mailing address '71 w 3G �Y-txe / on Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. n 72-025 (Rev. 1/91) Front MOA #21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. eon9s% G� >2s Phone 3�6-Z000�(o� -yo58 Name of Firm � � Address Engineer's signature DHHS SIGNATURE Jam._ Approved for bedrooms. Disapproved. Conditional approval for Additional Comments im Date g-1,9 —i3 bedrooms, with the following stipulations: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the profEasional engineer's work. ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST RECEIVED Legal Description: Lz S'Yc-u• j2IP/ Parcel I.D. AIjr 1 ® 199-z A. Well Data Municipality of Anchorage Dept. Health R Human Services Well type If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) T Date completed / O -/: - 7 Driller M1Z Total depth I S� Cased to Z S Casing height 7d Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell Wires properly protected (Y/N) Y FROM WELL LOG /0 -/ s-- ZO 2 O g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot -F too' t loo' Public sewer main 't- 104 AT INSPECTION -//3//-S,3 Z�- On adjacent lots 4-too On adjacent lots t 100' sewer manhole/cleanout +too Sewer service line -+-too, Petroleum tank WATER SAMPLE RESULTS: Coliform 0 Nitrate 0,3 Date of sample: -7/3 /Zs3 Collected by: B. SEPTIC/HOLDING TANK DATA rtoo, Other bacteria W Date installed F r'7? Tank size 15cxa Compartments Z Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N - High water alarm (Y/N) Iv la Alarm tested (Y/N) — Date of pumping F- 0144/`yJ Pumper A /-lcwE �E2d�cc 5 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot -+- t o ' On adjacent lots +t 0o Foundation to' To property line -" 20, Absorption field 51 Water main/service line +\00' Surface water/drainage 72-026 (3M)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date Installed Size in gallons Vent(Y/N) High water alarm level "Pump on" level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots le/Access (Y/N) "Pump off" Level at Cycles tested Surface water Date installed h-+ Soil rating (GPD/Ft2) System type 1 Izr Nc,11 Length Width Gravel thickness 7 Total depth I y Total absorption area 0,54 5 ( Cleanout present (Y/N) y Depression over field (Y/N) N Date of adequacy test l h,1 / 9-, Results (pass/fail) F4 ss for = Bedrooms 5 El Water level in absorption field before test After test Peroxide treatment (past 12 months) (Y/N) N If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot (-'C7o On adjacent lots To building foundation + Zb' On adjacent Ic Surface water Curtain drain +2;' F-1 oo' f -5b' E. ENGINEER'S CERTIFICATION 4 -Wo' Property line To existing or abandoned system on lot N A Cutbank N n Water main/service line parking/vehicle storage area +-loo + :r I' I certify that I have checked, verified, or conformed to all MOA and HAA guidelines effect.on the, pate of this inspection. ..;�. Signature a Engineers NameGpA)S; , CN(�/G j Ytl [G 4th6Y[F{{A U R#P+1C Poi C< .a Date HAA Fee $ Date of Payment 9- 3 Receipt Number %1g �ia2 72026 (3/93)' Back Waiver Fee $ _ Date of Payment Receipt Number.