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Home My WebLink AboutT12N R3W SEC 27 LT 23Onsite File T12N R3W Sec 27 Lot 23 #018-092-22 Municipality of Anchorage On-Site Water and Wastewater Section e (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211106 PID Number: 018-092-22 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: FE-1 New ❑ Upgrade Name Hultquist Homes, Inc. ABSORPTION FIELD ❑ Deep Trench NO Wide Trench ❑ Bed ❑ Mound Site Address 4331 E. 138th Avenue ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 2 Q•8 GPD/SF JTotal 8.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.0 Ft. Gravel depth beneath pipe 4.0 Ft, Subdivision Block Lot 23 Fill added above original grade 14 Ft. Gravel length 60.0 Ft. Township Range Section 12N 3W 27 Gravel width 5 Ft. Beds: Number of Lines NA Distance between lines NA Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 600 Ftz 1 NA Ft. Well 100'+ 100'+ NA NA 25'+ TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ 100'+ NA NA Material Number of compartments Lot Line 10'+ 101+ I NA NA NA HDPE 2 Foundation 10'+ 101+ NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield Hultquist Homes Drainfield 3034 CO/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation) 100 ft Inspdection v, 04/29/21 n 04/30/21 Location and description 2 3`d 05/03/21 41h Top of Foundation ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: OFF AL �AA kk Date , - Tii VeI) R ('aniiorie �� f CE 81 9 Septic System Approved &Itz Date Note: this approval does not include well permit requirements.�� r\uv UO/u/1 101 PRIMARY/ RESERVE SEPTIC SYSTEM NO. BEDROOM: 2(300 gpd) TANK SIZE: 1000g (MIN) PERC RATE: 6.6 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 375 SF SYS. TYPE: WIDE TRENCH 4.0'ED RF: 0.50 MIN LENGTH: 37.5 LF USED: 60LFx5'Wx4.0' E.D., 8.0' TD TOTAL AREA: 600 SF ,mfg TH TEST HOLE W WATER LINE / (P) PROPOSED WELL RADIUS (E) EXISTING SS NEW SEPTIC CO CLEAN OUT NO. FC FOUNDATION CLEANOUT FS FLOW SPLITTER MT MONITOR TUBE NO. TYP TYPICAL R.I. RIGID INSULATION — --�-r ----� (NEW) PRIMARY DRAIN FIELD/ " (PROPOSED) RESERVE DRAIN FIELD 60LF x 5'W x 4.0'ED x 8.01TD INSTALLED CLEAN OUT AND MONITOR TUBE AT EACH END ti M2 / M1 TH-2 �! Cl NEW 1000g SEPTIC TANK ANDERSON 2017 DCO INSTALLED FOUNDATION CLEAN OUT AND DOUBLE CLEAN OUT T2 WITH RIGID INSULATION OVER (TANK \ �\ \ T1 / FCO A I \ J ► '� 2BR HOUSE (P) + I \ � 3 E 3 { C SCALE: �7 1"=50' 41 i3 NEW WELL1 / i / a / 50' ROADWAY RESERVE zz $ 4-T - NOTES: PANNONE ENG SVC LLC C.'. 7�$$� "" REVISIONS DAIL RECORD DRAWING PHONE 9 B)X71808200�L FAX AK 99745-8201 r��45 P�i 0. A4 'S11fy''i, SCALE 09/2021 50' T12N, RX Sec 27, LOT 23 = - P.I.D. NO DRAWN DRM HULTQUIST HOMES INC. = o1s-o92-22 c, Ste CE -i!149 "— PERMIT NO. 138th AVENUE _ " OSP211106 SITE PLAN ANCHORAGE AK SHEET "........` 2OF3 A B FC 15.8 37.1 T1 14.8 38.4 T2 16.8 39.8 DCO 19.3 42.6 C 1 35.4 75.6 MT1 37.3 76.8 C2 71.7 66.0 M2 70.1 63.8 NOTES: PANNONE ENG SVC LLC C.'. 7�$$� "" REVISIONS DAIL RECORD DRAWING PHONE 9 B)X71808200�L FAX AK 99745-8201 r��45 P�i 0. A4 'S11fy''i, SCALE 09/2021 50' T12N, RX Sec 27, LOT 23 = - P.I.D. NO DRAWN DRM HULTQUIST HOMES INC. = o1s-o92-22 c, Ste CE -i!149 "— PERMIT NO. 138th AVENUE _ " OSP211106 SITE PLAN ANCHORAGE AK SHEET "........` 2OF3 W m W m I` z � F— O ~ O O O 0' Of O o z o z NEW Q 0 w zm z w O QO O-j O Of-' 213R HOUSE -1 o w w � C) w TOP FOUNDATION: 100.0 L` U Lf) ' O ' 101.0 —oQ zFG 99.0 -- - OG 99.6 t- 09R9.6 96.4 NEW 96.2 -95.6 1000g 95.6 SEPTIC TANK FIELD (60LF) 91.6- -91.6 GM RIGID INSULATION OVER TANK 85.1 DRY (4/29/2021) NOTES: PANNONE ENG SVC LLC (Ci.'. 1088) P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 "" i '�E OF. q(qs,, REVISIONS DATE 11/09/2021 RECORD DRAWING SCALE T12N, RX Sec 27, LOT 23 HULTQUIST HOMES INC. 138th AVENUE - - = Sfaven R. Pannone ; " CE-sits ��'_ P.I.D. NO 018-092-22 DRAWN DRM - - -PERMIT N0. OSP211106 T SOIL LOG ANCHORAGE, AKSHE OF 3 MUMMY OF ANCHHORRAO GE ems'- -- � ��--,�...� �--sit-,-�,�-°<••,.r. >-t-<-=-<--.�-,.,�-----r�---��---m—... Development Services Department •�. , - Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Well Log Permit Number: # 211106 Date of Issue: 04/23/21 Parcel Identification Number: Date Started: 05/24/21 Date Completed: 05/27/21 Is well located at approved permit location? Yes Q No ❑ Legal Description: T1 2N R3W SEC 27 Lot 23 G:2936 Property Owner Name & Address: Hultquist Homes, Inc. Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To casing stick up 0 2 fill/overburden 2 5 silt & gravel 5 20 wet silt & gravel 20 22 silt & gravel 22 197 clay silt & gravel 97 149 silt & gravel 149 182 silt & gravel w/ H2O 182 202 clay 202 207 silt & gravel w/ H2O 207 208 coarse gravel w/ H2O 208 211 N 610 05. 768' W 149" 48. 124' Water Sample Results: Arsenic: �1D _ ug/L Nitrates: 1, (6'4 mg/L O'Z G [ 2. Total Coliform Bacteria: Neq colonies/I OOmL Method of Drilling FE -91 air rotary ❑ cable tool Casing type: steel Wall Thickness: •250 inches Diameter: inches Depth: feet Liner Type: Diameter:6 inches Deptli:211 feet Casing stickup above ground: 2 feet Static water level (from ground level): 137 feet Pumping level: feet after hours pumping rpm Recovery Rate: 30Rpm Method of Testing: airlift Well Intake Opening Type: [] Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet i yt,G. volume: z nags 20 Start 0 feet Stormed 20 Well Disinfected Upon Completion? Yes No Method of Disinfection: tabs Comments: Well Driller: Johnny Kay ❑ ❑ Company: Hefty Drilling, Inc. Mailing Address: P.O. Box 112130 Anch. AK 99511 Attention: The well driller shall provide a well log to the On-site Water and Wastewater Section within 30 days of completion. 11 Development Services Department Building Safety Division G On -Site Water & Wastewater Program os Zw� -'G , 4700 Elmore Road U P.O. Box 196650 Mark Begich Anchorage, AK 99507 S A E T Mayor www,muhi.org/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: &W-ov 2 1)10( Date of Issue:'-/ 21 Parcel Identification Number: Legal Description -T u ci-c )7 t-oid � " Pump Installation Date: 9 - I - � I Pump Intake Depth Below Top of Well Casing: )?' j feet Pump Manufacturer's Name: � rui o( �. — F Pump Model: Pump Size N hp Pitless Adapter Burial Depth: P feet Pitless Adapter Manufacturer's Name: 610 Pitiless Adapter Installer: A-4 ,,;07 Well Disinfected Upon Completion? 4 Yes n No Method of Disinfection: 7410 S Comments: Pump Installer Name: Johnny Kay Hefty Drilling, Inc. Property Owner Name & Address: J�L-j +114 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. S89'52'00"W 165.03' Lot 23 N 54,450 sf N LU o ® LO r7 � 0 0 50' Patent Roadway Reservation Lot 51 Lot 50 + Lot 49 Legal Description: Asbuilt 'An Lot 23 of Section 27, Township 12 North, Range 3 West, S.M. OF A � gyp �. , .........y........ . Survey Certification: I hereby certify that a Mortgagee's Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the existence of any easements, covenants, or restrictions which are not on the recorded subdivision plat. This asbuilt shall not be used for construction or for establishing property lines. Checked by: BH Drawn by: AR Scale 1" = 60' Job: 2017-94 Field Book: 140 Plat: BLM enjamin Holmstrom : LS—„ 708 ,t O sio o� o Legend: Well Septic QS Pavement Overhang Wood Deck Concrete Fence Grid SW2936 Date: 10/28/2021 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP211106 Work Type: WellSeptic Initial Tax Code Number: 01809222000 Site Legal Address: T1 2N R3W SEC 27 LT 23 G:2936 Site Mailing Address: 4331 E 138TH AVE, Anchorage Owner: HULTQUIST HOMES INC Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: �17cnr sem,. Q � �, .� Della I' till ell Lot Size in Sq Ft: Total Bedrooms: 4/23/2021 4/23/2022 54450 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q 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: Issued By: L4,(N Date: Date: Z 2 K t , - MUNICPAUTY OF ANCHORAGE r �n Community Development Department . , Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 018-092-22 Property owner(s) Hultquist Homes, Inc. Day phone Mailing address 12570 Old Seward Highway, Ste. 204, Anchorage, AK 99515 Site address NSN 138th Avenue Legal description (Sub'd., Block & Lot) T12N, R3W, Sec 27, Lot 23 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial FZ Single Family (SF) ❑X Septic Tank ❑X Upgrade ❑ (w/wo AD U) Holding Tank ❑ Renewal ❑ Duplex (D) ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑X Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 032_0 Waiver Fees: Date of Payment: L� 15 21 Date of Payment: Receipt Number: D 127 6 G Receipt Number: Permit No. 05 P 2 M 0.6 Waiver No. Permit App_ :- Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211106, Deb Wockenfuss, 04/23/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211106, Deb Wockenfuss, 04/23/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211106, Deb Wockenfuss, 04/23/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211106, Deb Wockenfuss, 04/23/21 M [j tl 1 w {? ti l - Ca ...� :f i�:: l' e. Ga '" �� 1 Ei r.W"3.si PL:zT��)'n Developm, nt Services Department Phone. 907-343-7904 On -Site Wafer & Wastewater Section �` Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 01809222000 1. GENERAL INFORMATION Complete legal description T1 2N R3WS27 L23 Location (site address) 4331 E 138th AVe Current property owner(s) Mailing address Real estate agent 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 2 Expiration Date: b { if 'q0a, -P Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ �� Waiver Fee $ Date of Payment1 0°I o� 2 Date of Payment Receipt Number --_0T' 1 3 �_' G Receipt Number COSA # o S C d, 11 G 53 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. / Date OF A 4 P Awl T IYta 6. DSD SIGNATURE • - • • - -� System #1 Approved for bedrooms -. � "s'te>>nt; C- 0149 System #2 Approved for bedrooms Disapproved�,m �1 �+?.iii f'1; -r:: :r•,,•t.;,•�. Conditional approval for bedrooms, with the following stipulations: of ) OWYVI J o WASTv lA� - . > O J P _ BY ISLn 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory _ _ _ Other COSA Checklist blue sheet Legal Description: T12N R3WS27 L23 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 06/27/21 Total depth 211 ft Cased to 211 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA new Static water level at beginning of test 137 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material "-P"""°PE Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new tank D. ABSORPTION FIELD DATA wide trench Which system tested (date installed) 6/8/21 ❑ ALL standpipes present per record drawing Total measured depth from grade 9.4 ft (max) Measured depth to pipe invert from grade 5.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: new COSA Checklist yellow sheet Parcel ID: 01809222000 Structure served by this system 1 Well production at time of test 30 gpm Water storage tank volume na gallons Well disinfected for coliform test? ❑ Yes ❑✓ No ❑ Coliform bacteria is Negative Nitrate 1.62 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Date of Sample 10/26`2' C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date new Results [Z]Pass For 2 bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' F-1 Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft ❑✓ Yes if No Neighboring Tank > 100' F/ Yes if No ft Private Sewer/Septic Line > 25' Fv-� Yes if No Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' F/ Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' '✓[�, Yes if No r✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/ Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' M Yes if No ft Surface Water > 100' ft ft ft ft ft M Yes if No ft Property Line > 5' F-1 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F/ Yes if No ft Private Wells > 100' Yes if No. Water Main > 10' ✓l Yes if No ft Community Wells > 200' 0 Yes if No. Water Service Line > 10' M 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' U Yes if No ft If absorption field is under driveway comment below Property Line > 10' F/ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓l Yes if No ft Private Wells > 100' Yes if No Water Service Line > 10' M Yes if No ft Community Wells > 200' F/ Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. 2t Gt&0 COSA Checklist yellow sheet Rumal" tever f f�anronP E . CF_ 8149 ft ft ft ft