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Municipality of Anchorage
Development Services Department
Building Safety Division =
On -Site Water & Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW080243 PID Number: 050-222-32
Name'
DENNIS LEAF
Wastewater System: ❑ New ■ Upgrade
y P9
Address:
19007 MAN 0 WAR ROAD * EAGLE RIVER, AK
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 250-9456 3
■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating:
0.8
Total Depth from original grade:
GPD/Sq. Ft.
11 MAX Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
— 12C EAGLE RIVER VALLEY RANCHETTES
SEE DWG. Ft.
6.17/6.22 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel length:
_ _
SEE DWG. Ft.
56+ (2 @ 28) Ft.
WELL: ❑ New ❑ Upgrade
Gravel width:
2.5
Number of lines:
2
Distance between lines:
*9
Ft.
1672+
Ft.
Classification (Private, A.B,C): Total Dept •
Cased To:(BEDRaCK)
Total absorption area:
Pipe material:
Ft.
Ft.
so. Ft.
D 3034/ F-810
Driller. Date Drilled:
Static Water Level:
Installer:
DL ENTERPRISE
Date installed:
11/19-25/08
Ft.
7Yeld:
Pump Set At:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
SEPARATION DISTANCES
■ Septic ❑ Holding ❑ S.T.E.P. ❑ Other*
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
Sewer Lines
Manufacturer.
ANCHORAGE TANK
Capacity in gallons:
1250
Well
200'+
200'+
—
—
25'+
Material:
STEEL
Number of compartments:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
**7'
—
—
—
Size in gallons:
Manufacturer:
Foundation
5'+
10'+
—
—
—
"Pump on" level at:
"Pump off" at:
rn
High water olarat:
Curtain Drain
NONE KNOWN
Pump Make el:
Electrical Inspections performed by:
Remarks: *SEE WAIVER #WR08007,8q
BENCH MARK
Location and Description:
**SEE ATTACHED WAIVER REQUEST.
TOP OF SLAB AT SOUTHWEST CORNER OF CAR PORT
Assumed Elevation:
1 00.00
Ft.
Inspections performed by:GEG Ltd. Dates: 1st 11/19/08
ENGINEER'S SEAL
oo600Op0
ooOFACp�4
2nd 11/21/08
Q �� .....; ;
3rd 11/21/08
544
�p�� . • t •. ,�
evelopmetnt Services D)epartment Approval
'.0D
gyp....:.......
Conditional approval: �� `' '� �'fiV Date:
",.H. �...........•:.�...
J ?!' p
• • • • • • , • • • •
(�
QOJeffrb Gar, ess:
044 f,,1 L 1 G
�peaprofessio�oo��
,`/
`'�1"� G� ���
Reviewed and approved by: Date:�'��
oOOOOp0�0
(Rev. 4/06)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILING ADDRESS
LEGAL DESCRIPTION - "J' -
· LoT I --C
LOCATION - ~ '
[~NEW
[] UPGRADE
Well.. / Absorption area ~ ~. Dwelling
DISTANCE TO: I fl/A I
Manufacturer I I
~h~a~ I~ I 5T~I
ILiq. capacity in ~allons I .~.~.... ~ I Inside leno~h I Width
li /2
DiSTANCe TO'
' I I ' I
Manufacturer Materla
PERMIT NO.
E£
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
DISTANCE TO: Well~/~
No. of ,ines] I Length o,.q?,,,%
Top of tile to finish grade~
Length Width
F°undati°ns" 9 '~r Nearest lot line/~
Total length of lines Trench width
~ ~- "~"r ) ~ inches
Material beneath tile 4 ~r
Depth
t~E~MIT NO.
Distance between lines
Total effective absorption area_
PERMIT NO.
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
APPROVED
DATE
LEGAL
7-?- LoT I .-C E,.5' e P,;,ar
72-013 (Rev. 3~78)
- 264-4720
~ * * * HANDWRITTEN PERMIT * * *
Permit #. I ~OR ON-SITE SEWER PERMIT
~MUNICIPALITY OF ANCHORAGE,..,:
Depart_ment,r~f Health and Environmenta ..rotection
825 ~ Street, Anchorage, AK. ~9501
Location: Phone Number:
/ .
Legal Description: ~-Lot Size:
Type of Soil Absorption System Is:
Trench: ~'~ Drainfield: Seepage Bed: __Holding Tank:
Maximum Nuntber of Bedrooms: .~ Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH fOI
LENGTH ,~2!
_ _ . GRAVEL DEPTH ~ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall Pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(M~NG) TANK SIZE = /~,9~5) GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the ntimber
of residences that the well will serve.
* * * TW0(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this departmen
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require e~largement if
t~re~!denc~ is r~ed to include more~3 edT~ th t 3 bedroo s.
~ppiic~ Date:
sw~/024(i/81)
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4-
6-
7-
SLOPE
DATE PERFORMED:
SITE PLAN
10
12
13
14
15
16
17
18
19
20
WAS GROUND WATER .[ S
~Jo
L
ENCOUNTERED? . O
P
E
,F YES. AT W.AV
DEPTH?
Gross Net Depth to Net
Reading Date.," · ' Tim~'%'.~ -- k~,. Water Drop
~"'"' r~",,.'.4'4J 1:
PERCOLATION RATE (minutes/inch)
PERFORMED BY: /**'f '~/'* ~
TEST RUN BETWEEN FT AND
/ FT
CERTIFIED BY:
72-008 (6/79)
?
' APPLI FILLS OUT UPPER HA(?ONLY
Pr0~erty O~;~er ,~s ~,..~,,~,<.~ j~% ~ ~ ~ C. ' PhOne
Buyer OC~ ~ :
Address : Zip C~e
Ty~e of Resi~nce
~ Single Family
~ Multiple Family No. of Bedroo~
~ Other
Water Supply // . .
~ Indivld~l 9~ -~= ~ ~ ,~; ~.'% A~ACH ~LL LOG. A wall log Is required for all wells drilled since June 1975.
Community For wells Oilled prior to that date, give well depth (attach log If available).
Sewer Disposal
~ Indivld~l Year IndivUual Installed:
~ Public ~llily When ~nnected to Public Utility:
~ Holding Tank
NOTE: THE INSPE~ION ~E MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED,
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: C~ ~'¢A~' {4~.~ ~
APPROVAL
( ) DISAPmOVED
( ) CO~DIT~AL APPROVAL'
DATE ~ '2 ~ '~ ~
b4'c„ 7 8 9 1j
44 •
•t r-47 Municipality of Anchora;r: JUN 0 2 2017 xi., : _
On-Site Water and Wastewater Program y; j
(907) 343-7904 E T Y
CLE 8
Certificate of On-Site Systems Approval
Parcel I.D. 050-222-32 Expiration Date: S /0-1e
1. GENERAL INFORMATION:
Complete legal description EAGLE RIVER VALLEY RANCHETTES; LOT 12C
Location (site address) 19007 Man 0 War Rd. *Anchorage 99577
Current Property owner(s) Tim Leaf Day phone 952-2342
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (wlwo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well El Community ❑
Public Water System ® Public Sewer ❑
WaiverNariance request for: Distance:
Received b .11110:11111. Date: (0frilt
COSA to be rete- r'-r,unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment 6f4/9" Date of Payment
Receipt Number d '"`, Receipt Number
COSA# Q J?/ /O 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179
Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 /
Engineer's Printed Name: Jeffrey A. Garness Date: b 11 !(
ro04�\
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o Ol�- A 'N4
in accordance with the guidelines and regulations established by the Municipality of Anchorage and ..••."'.••. 4
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 „,.(---4,2`.•
encroachments may exist that were not identified during the evaluation. The operational life of all wells / * 4 H ••.'c,Un
and septic systems depend upon a variety of variables, including but not limited to, soil conditions, VA
groundwater levels (that may fluctuate during the year), quality of construction (materials and / VA
workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and /. ... .. .
are outside the control of GEG. Satisfactory test results do not guarantee future performance of the a .•,J•ff Corn-ss;' 7
system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of Oh g ' CE— '• • oQG,
the well or septic system. GEG makes no representation whether an alternative well or septic system s �0
can be installed on the property in the event either of the current systems fail to perform adequately in vt\4c,e •'1 '(I. .f- • c°'o
the future. The content of this report is for the sole benefit of the person/party that retained GEG to Nva pro f ess o”°a
perform the evaluation. Reliance upon the information provided in this report by any other person or d444��Qo
party (including subsequent property purchasers) is not authorized, nor will it confer any legal right
whatsoever.
#AECC884
6. DSD SIGNATURE
•
System #1 Approved for 3 bedrooms
System #2 Approved for bedrooms
Disapproved ..
AG 4. 1 7. Q;�i
Conditional approval for bedrooms, with the followin ipul tl1ons: '-
WAT SIT z
_ E
IN,gSr ANll m
n 0pORA
By: h Original Certificate Date:
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 engineer's work.
7. ATTACHMENTS:
COSA Checklist / Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
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. EAGLE RIVER VALLEY RANCHETTES: LOT 12C Parcel ID: 050-222-32
A. WELL DATA PUBLIC WATER
Well type If A. B. or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (Y/N) Wires properly protected (YIN
Total depth ft. Cased to ft. Casing height (ab. • ground) in.
FROM WELL LOG AT I CTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RES
Coliform colonies/100 ml. Nitrate mg./L. Collected by:
' senic: ug./L Date of sample:
B. SEPTIC/HOLDING TANK DATA "DOUBLE CLEAN-OUTS BEFORE TANK
Tank Type/Material SEPTIC/STEEL Date installed 11/19-21/08
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) "NO Depression over tank (Y/N) NO High water alarm (YIN) N/A
Date of pumping 5110/17 Pumper JR'S PUMPING SERVICF
C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE WEST/EAST
Date installed 11;19-25/08 Soil rating p.d.! 'or ft`/bdrm) 0.8 System type DUAL DEEP TRENCH
Length 28/28 ft. Width 2.5/2.5 ft. Gravel below pipe 6.2216.17 ft.
Total depth '11.9/14.0 ft. Eff absorption area 672+ ft' Monitoring tube YES Depression over field NO
Date of adequacy test 5/4/17 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 6/10 in. Water added452/452gaI. New depth 26/26in.
Elapsed Time:180/120min. Final fluid depth 20/21 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date -
-2042 GALLON PRE-SOAK WAS PERFORMED ON 5/3/17 (1014 GALLONS IN WEST TRENCH AND 1028 GALLONS IN
EAST TRENCH).
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at__ in. "Pump off' level at • . wa er alarm level at in.
- .• Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: PUBLIC WATER
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots _
Public sewer main ••• sewer manhole/cleanout
Sewer/septic service line Holding tank
• • . containment areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING 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'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line •7'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway. parking/vehicle storage 0'
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
"SW080243 A HOSE BIBB IS PRESENT(SEE PHOTO) BETWEEN THE TANK AND THE DRAINFIELD AND IS USED FOR WATER
FOR THE GREENHOUSE AND THE YARD THE EXACT LOCATION OF THIS WATER LINE IS UNKNOWN HOWEVER THE LINE
SERVING THE HOSE BIBB IS ASSUMED TO HAVE A 0' SEPERATION TO THE TANK& DRAINFIELD. IT APEARS THAT THE
SEASONAL USE WATER LINE IS HIGHER IN ELEVATION THAN THE SEPTIC TANK& DRAINFIELD. A SMALL PORTION OF
THE TANK IS NEAR/ UNDER THE EDGE OF THE GRAVEL DRIVEWAY(SEE ATTACHED PHOTO)
of 44
G. ENGINEER'S CERTIFICATION :��� . ����
1 certify that 1 have determined through field inspections and ' 9
•
review of Municipal records that the above systems are in (f
conformance with MOA COSA guidelines in effect on this o• •••• ••�i` ••• •Ir••
date. •�^•: J-"•� • Garn-.s:•e`
JEFFREY A. GARNESS • r E-79
Engineer's Print dName • i1i� ` c3
•
Date b +•• '°ROFESS\��--
LICENSE MMmuts`s��
AECC884
(Rev. 10/12/12)
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. -ASBUILT SEI'IARD & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE'p fes- ,a�Q
FOLLOWING DESCRIBED PROPERTY __V " _' �`��' w ��
.� /' /���-fes ; . Gl -�� DATE E. -,-a-__., ;S� ..� R
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS �� Q1..•' •9 ,. -..�f•-�`�
IT IS THE RESPONSIBILITY OF THE ;„ �'rrir�� ::Vi-4',---------
INDICATED. -
OWNER TO DETERMINE TH�_. EXISTENCE OF ANY GRID: t•.•;4•' y/,!„4:,.....•.
EASEMENTS, COVENANTS., OR RESTRICTIONS /We-<cy.," t �
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- ef
a� M�trk Siwa d .: •
VISION .
t !BION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` v 0.1-,,,.... LS�-s�T'3 .'.�'i' �`
!,NY DATA HEREON BE USED FOR CONSTRUCTION _ /��` `� � 't 6% .• t'rZ ,�/,,,P�'i !
OF FENCE LINES, OR FOR ESTABLISHING BOUND- ' • ly %Z?^r;�;h�;=i,\--�';,,-ar
'1.RY LINES. QitAWN: w ,,�.