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HomeMy WebLinkAboutT12N R3W SEC 4 LT 59 E2Onsite File '3W EC 4 1 4 R Lot Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221183 PID Number: 014-142-07 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade Name HULTQUIST HOMES LLC. ABSORPTION FIELD ❑� Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 2847 LORE ROAD ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 3 0.8 GPD/SF JTotal 14.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6 Ft.8 Gravel depth beneath pipe Subdivision Block Lot T12N R3W SEC4 59 E2 Ft. Fill added above original grade Ft. Gravel length 36 Ft. Township Range Section Gravel width 2.5 Beds: Number of Lines NA Distance between lines NA SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 576F t2 1 NA Ft. Well 100'+ 100'+I NA NA 25'+ TANK Septic ElS.T.E.P. El Holding [:1 Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ 100'+I NA NA Material Number of compartments Lot Line 51+ 10'+ NA NA NA HDPE 2 Foundation 10'+ 10'+ NA NA LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank 3034 Tank to3034 drainfield Little Dipper Drainfield 3034 CO/MT3034 Inspector PES BENCH MARK (Assumed elevation) 98.5 ft Inspection v 11/23/22 11/30/22 Location and description es: 2nd 3`d 12/01/22 4" 12/02/22 Bottom house trim @ B ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date ,SOF .. ...... "Meven I�. an is CE Septic System ApprovedDate 8149 '•• or, 01 a •�OFE' Note: this approval does not include well permit requirements. /o.... nclnn/40\ PROFILE SCALE: NTS 1000G GREER POLY TANK PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) N S EW SCALE: 1"=50' 0 ' 40.002 Crowther Associates Client: Pannone Engineering Services Project: 2847 Lore Road Date: November 23,, 2022 Particle Size Distribution. Table (percent passing subject sieve size) Sample Source Sieve is Percent Finer Percent Finer Percent Finer Percent Finer 3 inch 100 1-1/2 inch 100 3/4 inch 100 #4 96 #10 94 #40 #100 13 #200 10 0.02 mm xx Classification Sand with Silt (SP -SM) 1632 Bellevue Circle /Anchorage, Alaska 99515 Telephone (90 7) 349-2198 / E snail: crowtheroy alaska. net Well Log Permit Number: #Osp221 1 Ji Date of Issue.- 7-6-22 - 3-20-23 - 3-20-23 Date Started. Date Completed. Legal Description. - T1 2N R3W SEC 4 LT 59 E2 G:2134 Property Owner are & Address: Hultquist Homes Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata. From To Is well located at approved permit location? Yes X No VR� casing stick up 0 2 silt & gravel 2 7 sand (brown) 7 39 wet sand (brown) w/ little gravel 39 55 I (grey) moist sana 55 90 silt & gravel 90 115 wet silt & gravel 115 120 coarse gravel w/ H2O 120 125 LAT 61.151978 LON: -149.829107 Water Sample Results: Arsenic: ug/L Nitrates: mg/L Total Coliform Bacteria: colonies/1 OOmL Method of Drilling [W air rotary cable tool Casing type: steel Wall Thickness: .250 inches D 6 is meter.- inches Depth: 125 feet Liner Type: Diameter.- inches Depth: -feet Casing stickup above ground: 2 feet Static water level (from ground level): 53 feet Pumping level: feet after hours pumping _gpm Recovery Rate: 20 gpm Method of Testing: airlift Well Intake Opening Type: R Open End F-1 Open Hole F] Screened Start feet Stopped feet R Perforations Start feet Stopped feet bentonite Grout Type.- Volume: 2 bags Depth. 20' Start ® feet Stopped 2® feet Well Disinfected Upon Completion? Yes No Method of Disinfection: -tabs Comments: R F] Well Driller: Johnny Kay Company: Hefty Drilling, Inc. Mailing Address: po box 112130 Anch, AK Attention: The well driller shall provide a well logy to the On-site Water and Wastewater Section within 30 days of completion. Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. i Development SerAces Department 011, ----------- Building Safety Division . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J J st On-5*te Water Wastewater P�oqram NI, C, �- & "Ar 4700 Elmore Road P,O. Box 196650 A E T Y Mark Begich Anchorage, AK 99507 Mayor www.ni.org/otisite (907) 343-7904 Pump Installation Log NumberSW 0 Dateofissue a Well Drilling Permit : - Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. 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: OSP221183 Work Type: WellSeptic Initial Tax Code Number: 01414207000 Site Legal Address: T12N R3W SEC 4 LT 59 E2 G:2134 Site Mailing Address: 2847 LORE RD, Anchorage Owner: HULTQUIST HOMES INC Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: cnt 1 Department 7/6/2022 7/6/2023 103433 Q Disposal Field 2 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 Special Provisions: • Construction may proceed at your own risk prior to 7 -day groundwater monitoring. Please submit results with the inspection report (or change order, if required). • The sieve analysis result is to be received and evaluated prior to construction. Please submit results with the inspection report (or change order, if required). C.0 -tU i>eA40'"1 5yrfewt .Jl ✓ !!! l z -L55 (Arra to S Issued By: Date: Date: / �2-7, C MUNICIPAUTANCHORAGE Community Development Department'f`ri 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. 014-142-07 Property owner(s) Hulquist Homes inc. Mailing address Site address NHN Lore Road Anchorage AK Day phone Legal description (Sub'd., Block & Lot) T1 2N R3W SEC 4 Lot 59 E2 Legal description (Township, Range & Section) Lot Size 103,433 Sq. Ft. Number of Bedrooms 3 Go-;�7- ) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial R Single Family (SF) ❑ Septic Tank 0 Upgrade ❑ (w/wo AD U) Duplex (D) X❑ Holding Tank ❑ Renewal ❑ 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: 20 Waiver Fees: Date of Payment: 6� a 0, a Date of Payment: Receipt Number: 7 a a ©G Receipt Number: Permit No. Q �,,D22// g Waiver No. Permit App_:- : ._.,:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221183, Deb Wockenfuss, 07/06/22 < tnnOv _ = D Y'. �� -I- C �Ul D(n D-IZ ;7 --q (Ii iC �(n (n O>o � � -0 .J ( (� - ! Oolcn Z <�pmDpm Orn DIN <;>OOmDp� co ti 1i 9 r r� 9 D m cn m z• cn I r Z m z cn r*, ,- z• fTl ��oc�r� 'ofTl lilt 4-: (n -p � �S f t" m��x-0cnm< rj m M;- �z*z>,-D I I Y� X"� (3 !1 C�, "�i mz �imozmmOc� r�wm �im�oZDm�cnZ D O V, z 0 H t D x 2 •• •• m .. 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I "I D •J� i°1 om m O m Azo 0 1 I > Znn NOTES: PANNONE ENG SVC LLC C.1. 1088) CHANGE ORDER P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T12N, R3W, SEC 4, LOT 59 E2 DRAWN DRM HULQUIST HOMES SOIL LOG/ 2847 LORE ROAD NOTES ANCHORAGE, AK ~ 1 REVISIONS DATE 11/23/2022 n m (Dj x I z Z A m A T d V m m > O > Oat lnZ ;T) ZVI p0"< D� is cn r >. mmD x 0' _ _ >mmm2'o v1 TTIm z OOU1y>UI� in rc > moa TFFm-1 In In ;u`< O SSI^ rte- m -r X Or-, --CCO,O D =OD>ln m� SZ, En I" D m m Z z r -• -ice m� a- m m D> - >m m �m\� Ln 1 to '� -i mm �om,N Z -� y o. Row'a W r0� AZ[n-I� m D �0A m oOmmul _{m O --i >NDfmll D ZI<iz'�p mD C)� rap Z s > oOr NO r > �mA c> I^�m 0 U) M;uc -0z--j 3 zomcnc,n C Ln A > 2 _N 02s m> I''Z z L C)Z N _. 00 > «Z v mpm >s AK]D�> 0m 810 > r p - -Ti o zr2 I Ia NOTES: PANNONE ENG SVC LLC C.1. 1088) CHANGE ORDER P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T12N, R3W, SEC 4, LOT 59 E2 DRAWN DRM HULQUIST HOMES SOIL LOG/ 2847 LORE ROAD NOTES ANCHORAGE, AK "` ,, '�E OF- Atq`11, = �P '..... Sf ', �.. y , ' t >}', ........ �PO St— R. Pannone ; - %c ce-alas :�� � ��•. ..� - ES)°" ` `����.......� REVISIONS DATE 11/23/2022 SCALE NTS A D. N042-07 1_ O PERMIT (D T N U N = z e D moa TFFm-1 0 ,•, N m �0A c> I^�m AK]D�> 0m 810 o zr2 I - - - - - - - - - - 0 0 Ay Ia NOTES: PANNONE ENG SVC LLC C.1. 1088) CHANGE ORDER P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 T12N, R3W, SEC 4, LOT 59 E2 DRAWN DRM HULQUIST HOMES SOIL LOG/ 2847 LORE ROAD NOTES ANCHORAGE, AK "` ,, '�E OF- Atq`11, = �P '..... Sf ', �.. y , ' t >}', ........ �PO St— R. Pannone ; - %c ce-alas :�� � ��•. ..� - ES)°" ` `����.......� REVISIONS DATE 11/23/2022 SCALE NTS D. N042-07 1_ PERMIT SHEET 3 OF 3 MUNICIPALITY OF ANCHORAGE 'Zi � AysT" Development Services Department__rf Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 014-142-07 Legal description T12N R3W SEC 4 LT 59 E2 Site address 2847 LORE RD Anchorage AK 99507 Current property owner(s) HULTQUIST HOMES INC Expiration Date: ) 151-2, Z X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/5/2023 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 X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 MUNICIPALITY OF ANCHORAGE A� Development Services Department "'� p p f�=� --� 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. 01414207000 Complete legal description T1 2N R3W Sec4 L59 E2 Location (site address) 2847 Lore Rd Anchorage, AK Current property owner(s) Hultquist Homes 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X 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: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑■ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: FNJ 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 $ 1 i �` 7,6 Date of Payment COSA# (TSC_ Z3f(�0 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist_June 2022 COSA Checklist Legal Description: Parcel ID: If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume 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 Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade 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) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist_June 2022 E. SEPARATION DISTANCES 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 Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ 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. Name of Firm Phone Engineer’s Printed Name Date 2023.06.01 East 1/2 of Lot 59 T12N, R3W, SEC 4, SM Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com AEC# 173042 Group S4 Asbuilt 5/31/2023