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Home My WebLink AboutRASMUSSON LT 83BRasmusson Lot 83B #051-282-46 Municipality of Anchorage Development Services Department Building Safety Division �• On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6550 Page of� www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: �"1 3� PID Number. �5_/^�3•��^ q2 Wastewater System: %New ❑Upgrade ABSORPTION FIELD Pnpns Nun,Wr a Bsara+ms _ � 3 ❑Deep Trem>,P(snalbr Trercn O ea O Mara o Olrw LEGAL DESCRIPTION SW R&IM JODGPaFi' Taal Depen lean alpml areas Fi. alaat Laaplh auDOMrm 3 R Deem to ppe Oollan hon mpw q Gr br owl wlh pps' LJ �'/I 51/• / FI. J FI 7o .p- Ripe saa,m- FlYaOaeatlowmp'Wraae 3+ TF1. Growl L iLl FI. Well: ONew ElUpgrade G'Nv Y+an. NVTD of J D,Narin pelM.erl 1Ml'. FI. FI Cla;yl� IL S. C)' 7atl Dapm'. 1 Caw 215 TOW naorpum rea / P ,p�a1.0 -TE fT kVA /00 FI. FI 6 FF gQ Draw SVU.I%IAO a)MrV. Dau mW. sW¢WnNLe+M i '+ner 0.16fti.11urysat /7q 15 C e2 Ft —�� l/`7 YNIa IDGPM Pune sn n' 17 aa.q Hepm Fpow Gam] a' TANK FI. Ft SEPARATION DISTANCES JWSeptic ❑ Holding ❑ S.T.E.P. ❑ Other. ic Absorption Litt Holding ubllUPnvate amow ' ty k Field Station Tank Sewer Line Cf' fDGN/+.Mat•r,al Q /\r-+ N ^or aCaryirt emap/`/'/t1LJL(-�jj/q,) •f' -'— LIFT STATION J��Tank L / zer M. NvM n. 'Poop ar w H,, wval•r rrm atn nPump 4 OI.1 WW Mahe a Elect," haparom perlm pYOno Remaraa BENCH MARK Lwpm irx, D•w,pom o s'd1 t ,, ,r a em V. tif Ft. Sd&Erchwoodng at� Inspections performed by: 15861 S. Birchwood to, Rd. Dates: 1 ! Chuoak, Alaska 99567 Engineef mp ��p . ai nd r`i�� •,a,.•�. Development Services Department Approval ,!��;' :. '•ti%7j •.-«.F... Conditional Approval Date: ; • •• a, .••.r» .� Reviewed and approved by: � ate: ' Z 'd . 1457•! �46L� PERMIT NO. SW040233 PAGE 2 OF 3 Municipalityof Anchora e DEPARTMENT OF HEATH 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 LOT 83B. RASMUSSON S/D P.I.D. NO. 051-282-46 LOT 57 o ANEW rn r SEPTIC HOUSE A e AREA TBM NEW 1000 GALLONST1 HDPE SEPTIC TANK * ST2 NEW TRENCH DBL1 & DBL2 TMT THA CO1 CO2 MTI MT2 _ ALT. SITE 10' MIN. 100' WELL RADIUS SCALE: V 40' EN l� NMP Ap fr 0 ` .s .:.`.«T4 .. ......... A. lhofw a'•T `�t\M Via Y.� PERMIT NO.SW040233 PAGE 3 of 3 Municipalit of Anchorage DEPARTMENT OF HEATH 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 LOT 8313, RASMUSSON S/D P.I.D. NO. 051-282-46 ST1 FINAL GRADE •:: 2" INSULATION 95.7' NEW 94.6' 1000 GALLON POLYETHYLENE 94.3' SEPTIC TANK CO1 MT2 CO2MT1 CO' = 99.3' CO2 = 99.2' —FINAL GRADE MT2 = 90.9' ►JCfll ., MT1 = 91.0' NO WATER FOUND 82.9' B.O.H. N. T. S. Certitieb 3Brilling 10g by oocCO. db. SULLIVAN WATER WELLS P.O. BOX 8l0M CHUGIAK. ALA8XA 99M • _.. ' . . 0W"M0FIM4D �lsalS ftJC �Y^ V's- . if- .• / i I .1 . . t Wol Intake Opening Types O open end O open hole +a PelforaSons Slant feet Stopped feat Gro[A TMW r?cs. r: rTc� wwwane 7 S L3S Dop ft from o feet, tO z J feet Wag D6rdected upon OMV*bm? tett O No Method atD-wdQC6orr C t/"A...r4� M /M C-.4r/,J6 s r rGKJP C5 J lEg i3 s LDE,j TsIA<� l.3Qe.cE-� • Io -rr� Slfrf cC MENTION: it Is me responsronny of the property owner to suenat a copy of the weu log to the proper authority. Mu clp" A Mctwragr: Department of Health & HLYnan Servers anNor Department of EffArormental Conservation. Matsu BorouglL ]eparbTwi of Envlronrnental Conservallon. I0/i0 39Cd NVAI-17 S 6SZZ809 LIUI 000Z/iZ/I0 .- . 'T I�3j.1)DLA 1360 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SWO40233 Legal Description: Rasmusson Cot 83B- Date Issued: Jun 30, 2004 Expiration Date: Jun 30, 2005 ParcelID: 051-282-46 Design Engineer: 0003 S & S Engineering Site Address: 18075 Patches Ave 44 Owner Name: Denis Winters Lot Size: 44520 SO. FT. Owner Address: 18075 Patches Ave 44 Total Bedrooms: 3 Permit Bedrooms: 3 Eagle River. A 99577 - This permit Is for the construction of: ❑Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Issued By. Date: G - 30 —'f Date: 3 ' 0 Municipality of Anchorage -. Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 -ON-SITE SLWER/WELL PERMIT APP CAT!'.:i': FOR A SINGLE FAMILY DWELLING Parcell.D. V5�'e�b�' 1� Permit Number SW 0,4033 Property owners) Q l S 0 N -C Day phone b7Z , 330 9 Mailing address (1) 4S Mailing address (2) Q9/F 1(—d•/y (� Q _ Zip Code Legal description (Lot, Block & Sub'dJ s + aSWIN SS/7/) S Q Legal description (Section, Township & Range) Lot Size'" 5 -IW Acres q.F . Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only El Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable unicipal Codes. g S ENGINEERING 17034River River Loop Road No. 204 Frale River , Alaska 99577 (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12100) G19+ /7S Waiver Fees: 6 / a ? / o H Date of Payment: O S H f B 11 I(A Receipt Number: June 10, 2004 ROBERT C. COWAN, P.E. CML ENGINEERS (907)694-2979 FAX(907)694.1211 W EAUHA THMN MUNICIPALITY OF ANCHORAGE APPROVALS Development Services Department P.O. Box 196650 Anchorage, AK 99519 SEWER l WATER UM1ECTEM S REFERENCE: Lot 83B, Rasmusson Subdivision SEWER&WATER It is requested that you issue a permit to install a new well and a septic system to WSPECTIM serve the proposed three bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of MrNEERMSTWIES the test hole is located on the attached site plan. At the time of excavation 3/19/02, no ANDRE"0if water was found. After monitoring, ground water was not found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve WEU MKCTION areas or drainage patterns by the installation of the proposed septic system. The aPLOW TOT construction of this system will not prevent any future development on any of the adjacent properties. GREPTAM If you require additional information, please contact us. Sincerely, ROAD DESIGN *Roert. Cowan, P.E. SOITEST RCC/bjj Enclosure PEFAX ATIM TEST STRu PRAL& TAECRAPW,AL NSPECnONS CNSRE WASTEWATER DISPOSALSYSTEM DESR71 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 tom' f m 8 j r X9 i r ui r• I I O I z I ^ O,u F I mox p I vyy/a I I rc.a O- V J.O O z.3m ommO i "ice I uon3 o= I z �u5 p0 W a u r I O O�mo or. I O 10�lQKOQO oo k to C 1 1� I ��W v opo •• 1,4 a I o Wl ISI i n I I v 1 J o mz u O �z o I U) mF a � I V o I a U O I CO i C\�F u- w 1^, I a VV) / 0pNNMSf NIIcoNmII N p v7 �-+ O 11 MJ O' O N W.�yVI 1�0 rUO!IIOAJOS88 StK W ->-----------------------��_U w W 8Y . i Ci+aWw .OZ �nY ... LL, W 1... O Z o= ib AR- VA13•'°a-.$ mon r.y W W — O O W 3 Z-D J issais NossrnivsvH o= 0�6 i Id JL NVId-311S NOIS30 ,09 = "L Municipality of Anchorage Development Services Department 01Aaffig.Saky Division • OnSieVA" andV�bwaWPtegnm . 4700 SwAh Bragaw SL P.O. Box 196670 M dwage, AK 995194650 WWW O.a1W=100.ak.us Pon 74}7W4 Soils Log -Percolation Test Perfomxed For. - -AIAPJ 'iymusso^ Date Perfomeed: 13—IQdz Legal Deser"on: J_e4 83 B Towmhip. Range. Secb= T 15 Q 2W SM 525 :et)I nat.OfoAn;es 5- : j: 6- :; 6w, W/J'cAmo Loast. 13rowWAS GRDUIIO MATER s- E4CCK*ffWED7 1O-tFTESATNMATDEP V0 _ L ��. C 0070 to MhaN AlIN ' 11- ! / Alonear"? E 12- Dace: COMMENTS - - Readkg Date Gross Tore Net Time Depth to Water Net Drop SOA :0 TSF 3 Tot 1 3-+aQz i&i :5z 463M.6 7" " Z 3 -r9 -az I5: oo 6. yZA,;, 67. G « 3 "5-+•1.07— 15;09 6.149Ms 6 7., G .. VLAQ UI, xrAc4 1. r_,wu,ewsnl FtnC HOLE DuxI=a.R (A�. TESTRUN BETWEEN NF1 AND 5E. FT , PEAFCRMED BY'/JJ�r.�. ��.r_� P %�-'.• /r✓•'�'/-•CERTIFY THAT THIS TEST WAs ;ERFCR"S0IN ACCORDANCE VPTH ALLSTAiZ.OND MUNICIPAL GUIDELINES IN UFEC.70N THIS DATE. DATE.—"r'•-, :—�—._• _'L Me PWAMba months of April and May of 2002. Readings were taken on April 15, 2002 and May 15, 2002 to determine gramd water level in the monitor tunes left in place after the test We excavation. All readings taken on each lot showed no signs of gtoandwatet. This establishes that there is no ground water table to a depth of 14' below the ground surface on to 83A, and a depth of Won lot 83B throughout the high -nater season for the area If you have any questions, Thank You, Matthew J. Nardini, Y.E. Principal Engineer .>1/ 8' `�� S& ROBERT C. COWAN, P.E. CML ENGINEERS (907)694.2979 FAX(907)694-1211 ON-SITE NVASTENVATER DISPOSAL SYSTEM W- TNWJf10RIf1' CONSTRUCTION PRACTICES APPRO4ALS and MATERIAL SPECIFICATIONS SEWER 6 WATER MkIN UTENSIM REFERENCE: Lot 8313, Rasmusson Subdivision June 10, 2004 SMA&WATER INSPECTION GENERAL: 1. The scope of this project includes the installation of a new 1000 gallon IIDPE septic tank, and installation of a new trench to serve the proposed three "Np$T101E$ referenced bedroom residence located on the reerenceproperty. P lx Y• ANOMP a+oREPORra 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all ON applicable State and Municipal Wastewater Disposal Regulations. aF"FLLO,'�PST 3. The contractor shall be responsible for obtaining any necessary underground utility locates. SITE PLANS 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. ROADDESIGN 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health SMTEST Department. SEPTIC TANK INSTALLATION: PERCOLATION TEST 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. STRUCTURAL& MECKNOCAL ISnCRONs 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99677 Page 2 Lot 83B, Rasmussen Subdivision June 10, 2004 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 fl. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCIUDRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 836, Rasmusson Subdivision June 10, 2004 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (IIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: Page 4 Lot 836, Rasmusson Subdivision June 10, 2004 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre - construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER Uc U • Municipality of Ancha On -Site Water and Wastewater Pry ram (907) 343-7904 JUN 0 5 2014 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-282-46 Expiration Date: 9 1. GENERAL INFORMATION Complete legal description RASMUSSON LOT 83B Location (site address) 15863 RASMUSSON STREET, EAGLE RIVER, AK 99577 Current Property owner(s) DEREK & ANDREA ANDERSON Day phone Mailing address Real Estate Agent 15863 RASMUSSON STREET, EAGLE RIVER AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ r:pmmunity Clacc _ 1A1a11 F -I Community I❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: COSA to be released to the engineer, unless COSA Fee $ `� 2_1� J /' Date of Payment (Q [ e bq Receipt Number ?__41 COSA # 0SCj14 M Vj 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/3/14 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future _\ occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. ' oi �� Tll �~ 6. DSD SIGNATURE w System #1 Approved for bedrooms.""" ,r `pus System #2 Approved for bedrooms. , 0 `� /��°1s S(OW, Disapproved. Conditional approval for bedrooms, with the following stipulations: By: U!/ . Original Certificate Date: — The 42c, o nchorage 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. ATTACHMENTS: COSA Checklist X 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: RASMUSSON LOT 83B Parcel ID: 051-282.46 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 7/1512004 Sanitary seal (YIN) Y Total depth 180 ft. Cased to 43 ft. FROM WELL LOG Date of test 7115104 Static water level 52 ft. Well production 10 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate No mg/L Arsenic: NO ug/L Date of sample: 5128/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 HDPE Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 5128/14 Pumper JRS C. ABSORPTION FIELD DATA Well Log (YIN) Wires properly protected (YIN) Y Casing height (above ground) 24+ in. AT INSPECTION 5/28114 ft. Collected by: ARCTERRA Date installed 713112004 Cleanouts (YIN) Y High water alarm (YIN) N Date installed 713112004 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 System type SHALLOW TRENCH Length 46 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 7.7 ft. (Measured 5/28/14) Eff, absorption area 396 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/28/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 520 gal. New depth 2 in. Elapsed Time: 20 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1004 Absorption field on lot 1004 Public sewer main 75'+ Sewer /septic service line 25'+ Animal containment areas 501+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots 1004 On adjacent lots 1004 Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 1004 Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 101+ Surface water 1004 Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 104 Water Service line 104 Surface water 1001+ Driveway, parkingtvehicle storage 104 Curtain drain 50'+ (NONE KNOWNI Wells on adjacent lots 1004 F. COMMENTS G. ENGINEER'S CERTIFICATION I 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 KENNETH M. DUFFUS Date 613114 CCSA brown sheet 10-10-12.doc Aw, OFA I /SQ _ `I' , 4TH; t %Kesn;s�•rTM.�b�Ee s � \`moi in. Municipality of Anchorage • -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 'CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. b 51 COSA # —09 0019 Expiration Date: 1. GENERAL INFORMATION Complete legal description Location (site address) Lot 83B; Rasmusson Subdivision 15863 Rasmusson Chugiak, AK 99567 Current Property owner(s) Dennis Winter Day phone 622-3309 Mailing address same 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: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑� Individual Holding Tank ❑ Community On-site ❑ 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 On -Site 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 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 S & S Engineering Address 15861 S. Birchwood Loop Engineer's Printed Name Phone 694-2979 Date lh J tA. sw. w.. 1157•f 5. DSDSIGNATURE Approved for 3 bedrooms. ►� 5+°'`�• 4a.w4r�'a. 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: 1 Original Certificate Date: 2 ` 0� (R. 11M) Municipality of Anchorage ' Development Services Department Building Safety Division ' On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ONSITE SYSTEMS APPROVAL CHECKLIST / Legal Description: LOT U J� Parcel ID: 0$ A. WELL DCA, Well type r1VM Date completed-/ 15 094 Total depthiio ft. Date of test Static water level If A, B, or C provide PWSID # Sanitary seal (Y/ ) _ Cased to -46Lft. FROM WELL LOG 6 - Well production XD WATER SAMPLE RESULTS: ft. 9 - p.m - Coliform -XE-Colonies/100 mL Nitrate N ' /mg/L Arsenic: Albug/L date of sample: /7/U B. SEPTIC/HOLDING TANK DATA Tank Type/Material vEr�f_ Date installed�/�� Tank size gal. Number of Compartments of Cleanout) Foundation cleanou J 1)& Depression over tank (1 " High water alarm (Y40 L)6 Date of pumping a g Pumper C. ABSORPTION FIELD DATA r -- Date installed 3/ D ,� Soil ratingg.p.d.W r etbdrm) System type '3lgntW1) 1 0C&r-t( r Length ft. Width 5 ft. Gravel below pipe_ -ft. Total depth 6•3rft. E7 abs rption area _C' ft2 Monitoringtube It.7 Depression over field Date of adequacy test 1 0 ResultsPass Fait) Ills For 3 bedrooms n Fluid depth in absorption field before test in. Water added/ vgal. New depth b in. r Elapsed Time: U min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) `YO type) 00 If yes, give date Well Lo' 5(N) e Wires properly protecte (Y N) Casing height (above ground) n. ft. 9 - p.m - Other bacteria colonies/100 mL Collected by: D. LIFT STATION Q 1 Date installed Size In gallons 'Pump on' level at _in. lev( Datum Cycles tested. E. SEPARATION DISTANCES (Y/N) at _ in. High water alarm level at SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank lift station on lot 1/0 r Absorption field on lot 0 Public sewer main A.) /q Sewer /septic service line 06 .tl Animal containment areas 50 11- Meets alar 8 circuit requirements? r On adjacent lots On adjacent lots GY5 74 Public sewer manhole/clean�ut ZP Holding tank -p Manure/animal excrete storage areas /G'L7 4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: I Building foundation �� t Property line ILP 1 Absorption field 54- Water A - Water main - Water service line /O ff Surface water 160 / Wells on adjacent lots 100 /.1 In. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I r Property line Building foundation _ Water main Water Service line Surface water Driveway, parkinglvehicle storage /D h Curtain drain �' KXZWMells on adjacent lots 1iL"_ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records at a above j�E_( in conformance with MOA COS gul line in Mee. Engineer's Printed Name J P � Date COSA Fee $ Waiver Fee $ Date of Payment I ZZ 0�> Receipt Number 025991) (Rev. 11/05) Date of Payment Receipt Number SCS ReLN Client Name Project Name/# Client Sample ID Matrix 1'NN'SID Sample Remarks: 1080097001 S & S Engineering L83B Rassmusson L83B Rassmusson Drinking Water All Dates rimes are Alaska Standard Time Printed Datefrime 0121/2008 8:33 Collected Date/time 01/092008 12:20 Received Date/rime 01/092008 13:50 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date ]nit Metals by ICP/MS Arsenic ND 5.00 ug/L EP200.8 C (<10) 01/14/08 01/16/08 hill Waters Department Total Nitratc/Nitrite-N ND 0.100 Microbiology Laboratory Total Coliform 0 mg/L Shi20 4500NO3-r B (<10) coVIOOmL SN1209222B A (<I) 01/15/08 1DS 01/09/08 SDP o'n. r G, AS -BUILT. 14L9, 76 '1 hereby certify', that I have surveyed the following described r1t 'r•u H C 5 A V C, propertyt-L P Fo �inussarl t. Led it %%1^ 4� y 'i' Anchorage Recording'Prednct."Alaska, and that the improve. ments situated thereon are within the Property lines and do not �` 1 j>L• ; .••"•t%r� • r�i',, V -�• ; .overlap or encroach on the property lying adjacent thereto, that i ,. no improvements on property lying sdI'acent thereto encroach '.on.lhe . y premises in question and that there are no roadways, transmission lines or other visible easements on saidry rt 'except P Pr Y "'• .�„ �1-Yy<<vt •, as indicated hereon. at s Nv7-F, . Dated Eale River, Alaska t3o1M �lJinr ani y this, i! L`I dayoE 200 ' �' tti j r ROBERT C. JOHNSON, i AZZ244 • * 1 •. r r s , �,' r SCALE: • :r r ,' Registered Land Surveyor No.S8(i-LS 1 Boa 77-0456, Eagle River, Alaska 99577 + M•.n`t!' ws.r•no J l07' 41?A_ , t Phone (907) 694.2547 ' l • r for. u: -a °,f. Ler VIE; fir...., I.S'B 6 3 Y i' ��•' .� �"R>.•rrJvssvil fir..r..�.i'. N tc : tt . kJ. • L`fM'f o'n. r G, AS -BUILT. 14L9, 76 '1 hereby certify', that I have surveyed the following described r1t 'r•u H C 5 A V C, propertyt-L P Fo �inussarl t. Led it %%1^ 4� y 'i' Anchorage Recording'Prednct."Alaska, and that the improve. ments situated thereon are within the Property lines and do not �` 1 j>L• ; .••"•t%r� • r�i',, V -�• ; .overlap or encroach on the property lying adjacent thereto, that ra ��,, •� , •� �+'.. °+" '•t ,. no improvements on property lying sdI'acent thereto encroach '.on.lhe X ,. • rl r<f,• .i. i -;�;, I •• ; 1} "^ ,; premises in question and that there are no roadways, transmission lines or other visible easements on saidry rt 'except P Pr Y "'• .�„ �1-Yy<<vt •, as indicated hereon. at s Dated Eale River, Alaska t3o1M �lJinr ani y this, i! L`I dayoE 200 ' �' tti j r ROBERT C. JOHNSON, i AZZ244 • * 1 •. r r s , �,' r SCALE: • :r r ,' Registered Land Surveyor No.S8(i-LS 1 Boa 77-0456, Eagle River, Alaska 99577 + ; , t Phone (907) 694.2547 ' l • r