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HomeMy WebLinkAboutT12N R3W SEC 27 LT 51Onsite File TI 4N KwiW ec 27 t tI%CV VV/UL/ I Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231195 PID Number: 018-092-26 Dwelling: ❑ Single Family (SF) ❑■ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 0 New ❑ Upgrade Name Debbie Shroyer ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench X Bed ❑ Mound Site Address 4284 East 138th Avenue ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 7 0.8 GPD/SF 1.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 51 Fill added above original grade 3 Ft. Gravel length 75 Ft. Township Range Section 12N 3W 27 Gravel width 20 Ft. Beds: Number of Lines 4 Distance between lines 5.0 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1500 Ftz N/A N/A Ft. Well 100'+ 100'+ NA NA 25'+ TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity (1)1500gal, (1)1000gal Gal. Surface Water 100'+ 100'+ NA NA Material Number of compartments Lot Line 51+ 10'+ NA NA NA HDPE (1 EA) PER TANK Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 BTH Construction, LLC. Drainfield 3034 CO/MT3034 Inspector PES BENCH MARK (Assumed elevation) 101.7 ft Inspeection 151 07/12/23 07/13/23 Location and description 3rd 07/17/23 2nd 41h 07/17/23 See Site Plan, Bottom of siding ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: A/-. Date OF 49 TH_ \ �. ...... . ......... Stev nn� R. �f'onnone Septic Syste�F . CE 8149 Approved Date PR E o�'� e: this approval does not include well permit requir e s.®\\ tI%CV VV/UL/ I DESIGN PARAMETERS PRIMARY SEPTIC SYSTEM NO. BEDROOM: 7(1050 gpd) TANK SIZE: 2000g PERC RATE: 3.2 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 1325 SF SYS. TYPE: BED, 20'W MIN LENGTH: 65.6 LE USED: T3 TANK SIZE: 1500ga1,1000gal 75LFx20'Wx0.5'E.D.,1 .0'T.D. TOTAL AREA: 1500 SF 1.) SYSTEM INSTALLED IN LOCATION OF TESTHOLE MONITOR TUBE. a• 1 � I I \ LOT 52 LOT 51 M M M \ M \ DECK E C3 I \ C2� M1 INSTALLED ABSORPTION FIELD (N)\C1 I 75LF x 20'W x 0.5'E.D.,1.0'T.D INSTALLED CO's & MT AS SHOWN MOUNDED TO CREATE 3.0' SOIL COVER 100.9 M - WELL E M \ IM M� WELL E a F :01OG/ Tl 71 DCO2 T3 T4 DC03 94*1 1000GAL U L 1500GAL 93.9 GREER (SINGLE COMP.) POLY TANK GREER POLY TANK 7BR SFD (E) BM` i II A B DCO1 38.2 29.5 T1 33.1 40.9 T2 30.6 45.5 DCO2 29.9 46.9 T3 28.5 49.7 T4 26.8 54.9 DC03 26.5 58.6 M 1 31.4 80.8 M2 35.6 65.9 M3 104.7 135.7 M4 106.2 127.6 C1 33.9 80.7 C2 34.4 76.7 C3 35.5 72.9 C4 37.3 69.2 C5 68.4 100.4 C6 68.6 99.3 C7 101.7 132.1 C8 101.9 129.8 C9 102.5 127.8 C10 102.9 125.5 1.) SYSTEM INSTALLED IN LOCATION OF TESTHOLE MONITOR TUBE. a• 1 � I I \ LOT 52 LOT 51 M M M \ M \ DECK E C3 I \ C2� M1 INSTALLED ABSORPTION FIELD (N)\C1 I 75LF x 20'W x 0.5'E.D.,1.0'T.D INSTALLED CO's & MT AS SHOWN MOUNDED TO CREATE 3.0' SOIL COVER 100.9 M - WELL E M \ IM M� WELL E a F :01OG/ Tl 71 DCO2 T3 T4 DC03 94*1 1000GAL U L 1500GAL 93.9 GREER (SINGLE COMP.) POLY TANK GREER POLY TANK 7BR SFD (E) BM` i II WATER LINE / CONCRETE PATIO W & WALKWAY (E) WELL RADIUS 6.0Go SS NEW SEPTIC ABBREVIATIONS TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. FC FOUNDATION CLEANOUT FS FLOW SPLITTER VT MONITOR TUBE NO. TYP TYPICAL R. 1. RIGID INSULATION 1.) SYSTEM INSTALLED IN LOCATION OF TESTHOLE MONITOR TUBE. a• 1 � I I \ LOT 52 LOT 51 M M M \ M \ DECK E C3 I \ C2� M1 INSTALLED ABSORPTION FIELD (N)\C1 I 75LF x 20'W x 0.5'E.D.,1.0'T.D INSTALLED CO's & MT AS SHOWN MOUNDED TO CREATE 3.0' SOIL COVER 100.9 M - WELL E M \ IM M� WELL E a F :01OG/ Tl 71 DCO2 T3 T4 DC03 94*1 1000GAL U L 1500GAL 93.9 GREER (SINGLE COMP.) POLY TANK GREER POLY TANK 7BR SFD (E) BM` i II J CONCRETE PATIO .° & WALKWAY (E) / 6.0Go I s II s \ w IL \31,S �� wl FIELD CAT ISI ~I LOT 50 0 I � V) co N n O O N Lo 0 N II oz 0 ZN 0 I �� 00 o c w N O Uai �O w0 x F-1 DC03 INSTALLED W/DCO BEFOREv&U AFTER M2 10.9 II r►:•� .° 6.0Go I I \\�RESERVE FIELD CAT III (NIC) o GI -C6 �` ,,� I � n n I w TH-1 PES2023 I SEPTIC AREA (E) ��� �^ D I CIO �4100 N .0 9 "mow �U)��Q Ll Ll �(DI � 0 \M Z Wml� m w WELL E -�- -- M .8.0 --10' LLJ z zo�Q UTZo w w N FILTER FABRIC Z O ~ � CO DRAIN ABOVE RO K 6" MTaCO PIPE INV FG: 95.6 n n n d 32.6 N z 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 Wastewater Disposal System Permit Permit Number: OSP231195 Work Type: Septic Renewal Tax Code Number: 01809226000 Site Legal Address: TI 2N R3W SEC 27 LT 51 G:2936 Site Mailing Address: 4284 E 138TH AVE, Anchorage Owner: SHROYER DEBRA 1/3% & Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �»cnt Department 7/7/2023 7/6/2024 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: 155v11,0 70 4 E' -S Date: Issued By: Date: 14�-� 7 W Community Development Department -343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 018-092-26 Property owner(s) Debbie Shroyer Mailing address Site address NHN 138th Avenue Day phone Legal description (Sub's., Block & Lot) T1 2N, RM, Sec 27 Lot 51 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 7 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF) X❑ Septic Tank RX Upgrade El(w/wo ADU) Duplex (D) ❑ Holding Tank ElRenewal ❑x Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 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: 1 Waiver Fees: Date of Payment: Date of Payment: Receipt Number: Receipt Number: Permit No. �'� Z 3 I I J S� Waiver No. Permit App__- : • :' ., c Certified Drilling Log OWNER OF LAND: Debra Shroyer ADDRESS: 4284 E 138th Ave, Anchorage, AK 99516 LEGAL DESCRIPTION T12N R3W Sec 27 Lot 51 DATE: 9-1-22 PERMIT NUMBER: OSP221131 DATE OF ISSUE: 5-25-22 TAX IDENTIFICATION NUMBER 01809226000 Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 205’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 204 feet Liner type Static Water Level: 130 feet Recovery Rate 30+ gpm gph Method of Testing Air Well Intake Opening Type: open end open hole Screened Start feet Stopped Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 Casing Stickup 2 4 Overburden 4 49 Silty Sand & Gravel 49 52 Silty Sand w/ Some Gravel Water 52 93 Silt & Gravel 93 144 Silty Clay & Gravel 144 182 Silt & Gravel 182 196 Clay 196 205 Sand & Gravel Water Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. AR DOC CO dba OYBILL a COLE PULLMAN WATER WELLS *,*r0PO. Box 670269, Chugiak, AK 99567 688-2759 www.suilivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW _MP Date of Issue Cj oZ15. JL 3( Parcel Identification Number: Legal Description Property Owner Name & Address IV jj S ec- ;7 4jl JU("A L/ 0 - I 3 � i -1,4 A 4,tz- Pump Installation Date: Pump Intake Depth Below Top of Well Casing: i 9s— Pump manufacturer's Name: 6 F U(AfO5 Pump Model: I D 'S Q G, Pump Size: 3Z Pitless Pitless Adapter Burial Depth: Pitless Adapter Installer: U vi Disinfected Upon Completion? E yes EJ no Comments: Pitless Manufacturer: Pump Installers Name: Sullivan Water Wells 1= BE M AsBuilt 8/23/23 Feet 0 40 80 Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Mailing: P.O.Box 1807, Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 29 June 2023 Subject: T12N R3W SEC27 Lot 51 Upgrade Septic System Permit Renwal This is a request to renew the permit for the above-mentioned lot. All site conditions remain the same. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at 745-8200. Sincerely, SRP Steven R. Pannone, P.E. Owner/Civil Engineer Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231195, Curtis Townsend, 07/07/23 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: OSP221131 Work Type: WellSeptic Initial Tax Code Number: 01809226000 Site Legal Address: T1 2N R3W SEC 27 LT 51 G:2936 Site Mailing Address: 4284 E 138TH AVE, Anchorage Owner: SHROYER DEBRA 50%& Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: »cnr o� } ' r Department 5/25/2022 5/25/2023 54450 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: Issued By: Date: �/Z S/22 7 MUNICIPALITY OF ANCHORAGE 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. 018-092-26 Property owner(s) Debbie Shroyer Mailing address Site address NHN 138th Avenue Day phone Legal description (Sub'd., Block & Lot) TI 2N, RM, Sec 27 Lot 51 Legal description (Township, Range & Section) Lot Size 54,450 Sq. Ft. Number of Bedrooms 7 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption FieldX❑ Initial FK Single Family (SF)191 Septic Tank RX Upgrade F-1 (w/woADU) Tank ❑ Renewal El Duplex Duplex (D) El Privy ❑ Dwellings ❑ (SF and/or D) Private Well 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. 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U I_I.I a ¢UNU NNVNn QJ N QWWW2ra �a GU=¢?U Um �Ni m GC Z pJN�-¢LL s1-¢,-t-VIr O4F w1Z-Wli VQj J r F- U O p ,u O N N r N V CS cl� N M N mn mm O N O F Z N N N N N NN N N NN N 7 r 7 h6 ei n rj Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-092-26-000 Expiration Date: Legal description T1 2N R3W SEC 27 LT 51 Site address 4284 E 138TH AVE Anchorage AK 99516 12/6/2023 Current property owner(s) SHROYER DEBRA 1/3% &SHROYER MARILYN 1/3% & X The On-site system(s) is/are approved for 7 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Ac Original Certificate Date: 9/6/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA ApprovaLJune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application_ 1. GENERAL INFORMATION Parcel I.D. 018-092-26 Complete legal description T1 2N R3W SEC27 Lot 51 Location (site address) 4284 East 138th Avenue Current property owner(s) Debbie Shroyer 2. ON-SITE SYSTEMS SIZED FOR 7 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY:❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass Age <1 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS 0 Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑E Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Z-0 Waiver Fee $ Date of Payment COSA # Date of Payment Waiver # COSA Application—June 2022 Legal Description: T12N R3W SEC27 LOT 51 Parcel ID: 018-092-26 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 09/01/2022 Total depth 205 ft Cased to 204 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA New Static water level at beginning of test 130 ft Comments Measured operating fluid level in septic tank New Date of pumping New ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 07/17/2023 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.0 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) No If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 30+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ No Coliform bacteria is Negative Nitrate mg/L [ Nitrate less than MRL (ND) Arsenic ug/L [ Arsenic less than MRL (ND) Collected by Sullivan Water Wells Date 2 4 ` 4- t _ C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date New Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate 1050 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 6 in Effective depth used 0 in Effective depth remaining 6 in From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Community Sewer Manhole/Cleanout > 100' FE Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot? 100' Fs -1 Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft 0 Yes if No ft Community Sewer Main > 75' ® Yes if No ft Manure/Animal Excreta Storage > 100' r -m-1 Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑ Yes if No ft Tank to Property Line > 5' no Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' no Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' © Yes if No ft Water Service Line > 10' n Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC & MOA 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. OF Aiqs� Pannone Engineering Services Name of Firm Steven R Pannone P.E. F. ASCE TH Engineer's Printed Name _ _ -to ren aennon Phone 907-745-8200 `: �� CE 8�4J •4 � COSA Checklist—June 2022 t- Date �.".�.�-''� ���'�e;n�;?f)FESS;G�`��.�'�