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HomeMy WebLinkAboutSEACLIFF BLK 3 LT 1eacliff Block 3 Lot 1 #011-221-43 Municipality of Anchorage Page of Z - DEPARTMENT OF HEALTH 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 Permit Number: SLJ9(r,0'34/6 PID Number: Oit - 27-I "43 Name: NLK4 Aao De.ie>S Qup ek Wastewater System: ElNew 9 Upgrade Address: 9'z ie o -� sr Pp.. A�>ri.11i Air. q9si� ABSORPTION FIELD Phone: 2g3v 3 iG No. of Bedrooms: ❑ Dee Trench Shallow Trench ❑ Bed ❑ Mound ❑ Other P LEGAL DESCRIPTION Soil Rating: Z Total Depth from griginal grade: ff GPD/Sq. Ft. Lot: I Block: Subdivision: EAC Depth to pipe bottom from original grade: 5,-1 Gravel depth beneath pipe 11 '7 Ll IF F Ft. , Ft. Township: Range: Section: Fill added above original grade: Gravel length: i �. i 0 _ I Ft. 62 Ft. WELL: New ❑ Upgrade Gravel width: y Number of lines: Distance between lines: EXtSt Ft. 1 'i— Ft. Classification (Private, A,B,C): Total Depth:o: Total absorption area: -7 Pipe material: 4COMAVAI Ft. Ft. 3q SO. Ft. As 7 D,3,3F-.9 i U Driller: Date Drilled: Static Water Level: Installer: A`} t4omtc Sr-tuic.Es Date installed: ,�'- 2Z `%L Ft. Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES R Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: -� Capacity in gallons: From Tank Field Station Tank Sewer Lines L At oQ c TAA I C040 WeIN 200,+ZOOM •-- Z5 G i- Material: S"Ft Gf Number of Compartments: Water 1100 I?00G — — — LIFT STATION LottSize in gallons: Manufacturer: Line IOG `� Io Foundation 5 8 ICL �„ o ,..-. "Pump on" level at: off" level at: High water alarm at: Curtainode , p� W f, ktjo6 Pump Ma l Electrical Inspections performed by: Drain PI Remarks: e)(+sT11.I Sr:P;(c AAK LJA5 BENCH MARK Location and Description: �1�cAvRi�a . Pvm t<. eKus ArAD 'r1A — 6AL1L ®ow Ti ABgrfooraGca CorrtPta:r�LY kT �e, �'r �tgai Assumed Elevation: EN,£yf�Q�L Aega��t Ayep� OFAV C�O Of `rAr �• L^:. ( i� Ad d Inspections performed by:s & s ENGINEERING Dates: 1st I -22 m°1t - 00. 1703A Eagle River Loop Road, No. 204 (� 2nd / z` b Eagle River,.Alaske 99577 •; " 9 ROBERT C. COWAN t 2 Y4`C%':� Cc -88 0 Department of He4 Ith an u ices approval Reviewed and approved b : Date: 72-013 (Rev. 9/91) MOA 25 V Permit No. SW960346 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH 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 Description: LOT 1, BLOCK 3, SEACLIFF S/D PID No.: 011-221-43 72-013 A (Rev. 9/91) MOA 25 PAGE / 1 OF �1 MUNICIPALITY OF ANCHORAGE �-)fn DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW960346 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:QUIRK DEVON T & JOAN OWNER ADDRESS:9210 SHORECREST DR ANCHORAGE, AK 99515 PARCEL ID:01122143 LEGAL DESCRIPTION: SEACLIFF BLK 3 LT 1 LOT SIZE: 13500 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: (UPGRADE) PERMIT DATE ISSUED:10/10/96 EXPIRATION DATE:10/10/97 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: /�-�G✓/ ISSUED BY DATE. /e //U /7C DATE:_%©/6)& HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN S&S ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 F September 30, 1996 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 1, Block 3, Seacliff Subdivision Request you issue of a permit to upgrade the septic system serving the existing three bedroom house on the referenced property. A test hole was excavated and percolation test performed in the area of the proposed upgrade. The approximate location of..the test hole is located on the attached site plan. . At the time of excavation no water was encountered and after seven day ground water monitoring, the monitoring tube was found to be dry. Attached is the proposed upgrade design. This property is served by a Community Water System. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, 4Z11,12. /�Vtt�rl Robert C. Cowan, P.E. RCC/gk Enclosure MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION OCT 0 7 1996 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 SITE PL^1Pd DESIGN SCALE M r p x r>, CO ,. . x ro rr,r<-V 3 .�o�o Nw00 I nOmmlTl ' myo mD_i Z C� O K _--i mz�= r, (:1 i 0 cn 10 t- �o0 to toNAD tz� t� a cn o aoyo ay V-1 mri- 0M HO 00 py�0 o>O G� m � 1-3 fid/] I de w 20' UTIL. ESNU. K D a Knm r T y C fME�t'J 9ymm QC)Zm �/� V ) Im I o Z �N F- 0 0 0 I W m c» x 0010 Df D a o 000 D- o Q I I m�� ox Zr� n lil m-1 D I m r Vl o�y X O m t o D > 7U' MIN. < >.o � `x-10' MIN. r_ i(A fl O OOZ p ---1 I Z O I ENDICOTIP STREET Ii r * V, 0 07 v p D r D 0 ZDDL = ccs orcND Z r W rill � O -< m m O ILII -�G R Or o ITIS O om::Ez r C CZDX mm=nmmm — Iv cl -J -0 Vl O Vr M Am Oil O -i I 760 OM 0DD g� O0y ZZ z O� p0 (A H W I JcD r f C7 O -I -I N f'l O o !r o V-I�DNN OHO Z=- Eny<U) ngc Moa? � NZ -O-1 mA r N D 0 ZDDL = ccs orcND _. c,4 AZN>m1m O -i m' O -< m m O co -�G R Or o ITIS O om::Ez r C CZDX mm=nmmm V)0 mz;�Dn cni _ -0 Vl O Vr M Am Oil O -i o ADZ D M O 760 OM 0DD g� O0y ZZ z O� 9l - Z OVal I s� �����• yy FN �m<m� =No O I O r- O F5 : m s t i1 1 S n R O co is , s a, i TI 00 760 D �a� ��,c w•.: i-` i.'gr ��aYEq a ' A�_d PERFORMED FOR LEGAL DESCRIP DEPTH (FEET) 1 t w�13 2 3- 4 4 a 6 _ •''' 7 7� ✓) i` 8- 9 9 >•"� 10- 12 0 12 �n 4 Yj i a 13 14 15 16 17 18 19 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 6v0.� -AO4N DATE PERFORMED: -�Clj";l /g uT I 6 L k 3 Jia CLaF S;Township, Range, Section: SLOPE Fl1,t > 09(.4"1C S 4- S1L'T GFIS� S.O.%I Pd 44L�/ 6-d44)rz j 6=44V�L J, SaVp 20 PERCOLATION RATE C (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND s FT COMMENTS M /ai �0 h'0A S%'L V-�- '-Y S? l 6l-7-W&/c A/ g,� )-C7 WAS GROUND WATER N ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? Da% Date: )0/7104 SITE PLAN 'T I.; S & S ENGINEERING PERFORMED BY: 1 CERTIFY THATTHIS TEST WAS PERFORMED IN I 7U44 Eagle River Loop Road No. 204 ACCORDANCE WITH A1yItSfAXT&,AAI1lIaWt&`lyq",t GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) _ 11 ALAS `�et,,,,Eu6aM,,,,, AASHTO ACCREDITED CONSTRUCTION T E S T L A S I MATERIALS TESTING A Division of DOWL, Incorporated ,gra ' LABORATORY S & S Engineering W.O.#A27051 17034 Eagle River Loop #204 October 1, 1996 Eagle River, Alaska 99577 Attention: Mr. Bob Cowan Subject: Particle -Size Analysis Seacliff Subdivision Dear Mr. Cowan: The particle -size distribution of your soil was measured in the laboratory. The published methods for this test are: • ASTM C 117, "Material Finer Than 75-µm (No. 200) Sieve in Mineral Aggregates by Washing;" • ASTM C 136, "Sieve Analysis of Fine and Coarse Aggregates;" • ASTM D 422, "Particle Size -Analysis of Soils;" • AASHTO T-11, "Material Finer Than 75-µm Sieve in Mineral Aggregates;" • AASHTO T-27, "Sieve Analysis of Fine and Coarse Aggregates;" • AASHTO T-30, "Mechanical Analysis of Extracted Aggregate;" • AASHTO T -88, "Particle Size Analysis of Soils;" and • AK DOT/PF ATM T-7, "Sieve Analysis of Fine and Coarse Aggregates." Alaska Testlab's standard procedure is in conformance with these standards, with the following descriptions: • The coarse fraction of non -extracted soils is not washed unless the coarse particles appear to be significantly coated with fines; • The fine fraction of the soil is always washed; • The plus 3 -inch fraction is not routinely included in the test due to the large sample mass required for a representative sample; The estimated percentage of plus 3 inch material in the sample is shown on the test report; and • The mass of the coarse and fine test fractions are reported. The soil is classified in accordance with ASTM D 2487, "Classification of Soils for Engineering Purposes (Unified Soil Classification System)." The frost classification is identified in accordance with Corps of Engineers and Municipality of Anchorage (MOA) procedures. The test results are attached. If you have any questions regarding the test procedures or the results, please call me. Sincerely, ALASKA TESTLAB Howard K. Weston, P.E., or David L. Andersen, P.E. 4040 8 STREET • ANCHORAGE • ALASKA 0 99503-5999 0 907/562-2000 0 FAX 907/563-3953 wwzo•( o0VON O8g'#N 09'oN os # 06 'ON a£ # oz *ON 9I# OVON S# ti 'oN 0 0 0 0 0 0 0 0 0 o ;gtpAk Xq 2uissed;uaaaad 0 0 0 I r. 0 Q a M a. L 0 coo a U >1 5 C F r J N aM c 0 N o F Y tl o M J .'y W A � " U U a a wwzo•( o0VON O8g'#N 09'oN os # 06 'ON a£ # oz *ON 9I# OVON S# ti 'oN 0 0 0 0 0 0 0 0 0 o ;gtpAk Xq 2uissed;uaaaad 0 0 0 I Q a a. L 0 J a U C F J aM 0 N o F tl o M J W A � " a �o r p x w ¢ N � o N � 0 N � o o Q� o wwzo•( o0VON O8g'#N 09'oN os # 06 'ON a£ # oz *ON 9I# OVON S# ti 'oN 0 0 0 0 0 0 0 0 0 o ;gtpAk Xq 2uissed;uaaaad 0 0 0 I 0 F U bA U M M jJ 0000a. O O O O O� O N J o O 01 0 O Vl 0 O 00 0 O 00 00= k V7 O h O cn m 3 � ❑ M N O 01 � cn 00 00 , m �O z W � V o° 3 0 00 z 0 6 z 0 Z 0 N 0 cn %6 0 7 0 0 kn 0 o c0 70. 0 00 0 0 <D O z 0 C) O z W 3 N o wwzo•( o0VON O8g'#N 09'oN os # 06 'ON a£ # oz *ON 9I# OVON S# ti 'oN 0 0 0 0 0 0 0 0 0 o ;gtpAk Xq 2uissed;uaaaad 0 0 0 I HEALTH AUTHORITY APPROVALS SEWER& WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN s&s\ 7rneeRinG ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 1, Block 3, Seaclif Subdivision September 30, 1996 GENERAL: ROBERTC. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 1. The scope of this project includes the installation of a five foot wide drainfield and a 1000 gallon septic tank to serve the existing three bedroom residence on the referenced property. The existing septic tank is to be excavated, pumped, crushed and abandoned. The existing crib is to be abandoned as such that it may be used in the future. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 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 Department. C TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page Two Lot 1, Block 3, Seacliff Subdivision September 30, 1996 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 ft. 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 TRENCH/DRAINFIELD INSTALLATION: 1. 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 (roughed -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. Page Three Lot 1, Block 3, Seacliff Subdivision September 30, 1996 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (FVC) Yes Yes ASTM F810 (HDPE) 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, Fernco, 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. Page Four Lot 1, Block 3, Seacliff Subdivision September 30, 1996 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: 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. Page Live Lot 1, Block 3, Seacliff Subdivision September 30, 1996 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 �-, GRE, ":R ANCHORAGE AREA BOF __'IGH = Department of Environmental Quality �- 3330 C Street Anchorage, Alaska 99503 JJ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME (/ E7/IGS MAILING ADDRESS8G' )3e 3,23z/ PHON�E33 2 LOCATION 5✓9. o lm -t: LEGAL DESCRIPTION /Z SEPTIC TANK: DISTANCE FROM WEL MANUFACTURER MATERIAL INSIDE LENGTH SEEPAGE PIT: INSIDE WIDTH NUMBER OF COMPARTMENTS LIQUID DEPTH riQUID CAPACITY 10e" GALLONS. NUMBER OF PITS i DIAMETER OR WIDTH d , LENGTH/2 . DEPTH _lam LINING MATERIAL CRIB SIZE: DIAMETER _DEPTH l: DISTANCE FROM: WELLC-'�F1/r2/ 4 TOTAL EFFECTIVE p I�' BUILDING FOUNDATION�o NEAREST LOT LINtds LL ABSORPTION AREA (WALL AREA) 9 /&KOSQ. FT. ADDITIONAL ABSORPTION WELL: TYPK 2"/Z�Jl� CONSTRUCTION BUILDING NEAREST FOUNDATION -,LOT LINE CESSPOOL APPROVED DISTANCES: INSTALLED BY: , OTHER SOURCES DISAPPROVED PIPE MATERIAL: AIS GAS Z ..�Ra/1/ LOT SLOPE: REMARKS: ✓!�`'t' NEAREST SEWER LINE REMA DEPTH SEPTIC TANK_ DIAGRAM 2FSYSTEM v TF P Fo*1j> DATE -5 -30-% APPROVE DISTANCE FROM: SEEPAGE SYSTEM _ G.A.A.B. Form No. EQ -031 I € J '44F0 Lw� � SEW. NAME OF APPLICANT INSTALLATION LOCATION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 - APPLICATION AND PERMIT iRa.7-ff 76 MAILING ADDRESS ✓�//j`bf/� ��• ��,��¢� P ONE LEGAL DESCRIPTION k D i -81—K m oL i'yIr 15/d/ INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD , OTHER , TYPE AND SIZE OF FACILITY �T )O�B BE SERVED � R I)a %n `�rp�1[.� .�,� FINANCED THROUGH - 60 A)tl- j Ila L, TO BE INSTALLED BY �+ `� 37 F ' /1 SOIL TEST RESULTS _��lNq NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 10 0TYPE � SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS T"j,/AI)k,CR�A%_pF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAG TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK 1®® , SEEPAGE PIT 010 DRAIN FIELD SEPTIC TANK, SEEPAGE PIT TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE i Lilr „[4 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. u I I LJ1 € 3330 '•C•• STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 °u°Ib3[o 1\M'pJ SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT ry .n MAILING ADDRESS 0 X PHONt� INSTALLATION LOCATION — LEGAL DESCRIPTION LJ INSTALLATION OF: SEPTIC TANK SEEPAGE PIT TYPE AND SIZE OF FACILITY TO BE SERVED DRAIN FIELD , OTHER `l FINANCED THROUGH TO BE INSTALLED BY 4�11 `-',/moo )cvol"Oi V� !9D n,�D0 SOIL TEST RESULTS / I,�IY�. NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE I 'DOE) ` TYPE - �L ” � os -s- 01 ty4 SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENT/ FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT zo DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL s l SEPTIC TANK 5 , SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE. I �, WELL TO SEPTIC TANK 0�—k"o - , SEEPAGE PIT DRAIN FIELDALSO CONSIDER AREA WELS. II WATER MAIN TO SEPTIC TANK `O l SEEPAGE PIT l O DRAIN FIELD SEPTIC TANK, SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 f D -SOIL. 4 INCH DI AST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A. OR LICENSED DESI NER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. DATE Z 7 APPLICANT'S SIGNATURE CIIRM NPf_ F_o-ni 9 1,5, Municipality of Anchorage /. Development Services Department Building Safety Division j OnSfte Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onshe (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. COSA# DSU In 1 Expiration Date: 1 -3 1. GENERAL INFORMATION � Complete legal description &''Ac rf 61ock 3 tot I - Location (site address) 9210 Shore -- Cress DrIve Current Property owners) 9p}ion Otx-1 ►• n toAgnye (An TtAfDay phone Mailing address ) LDA, JZ 1Qf-, t OA Ra to )Z - Ll� Lending agency Day phone Mailing address t� Real Estate Agent o f7 f [irb(.%L. Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS:_ 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site 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 Onsite 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 .Spura+,a E!2$ne2uns. Address 7P3 W. ISN A,g. SF.. 203. Ane�,arc,-, /i* K 5901 Engineers Printed Name Lays siplaa W o..r% 5. DSD SIGNATURE _],C Approved for 3 bedrooms. Disapproved. Phone 2T'j -391(7 Date ce " r ... �...-" . •fit A.9T{i.; � r Ali 77° W i Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: Original Certificate Date: 4—.23-08 (R" 11A5) \ 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/onsfte (907) 343-7904 CERTIFICATE OrrrrF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Sea CLY OloAL 3 64 1 Parcel 10: O i I "aa 143 A. WELL DATA Well type RACC, Date completed = Total depth — ft. Date of test Static water level If A. B, or C provide PWSID # _ Sanitary seal (Y/N)= Cased to — ft. FROM WELL LOG ft. Well production WATER SAMPLE RESULTS: Coliform �colonies/1o0 mL Nitrate mg/L Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) " in. AT INSPECTION ft. g.p.m. Other bacteria colonies/100 mL Arsenic: i = mgll Date of sample: = Collected by: B. SEPTIC/HOLDING TANK DATA TankType/Material �aror 5%viLS Date installed ) Z2 v9� Tank size _1DOO gal. Number of Compartments Cleanouts (YIN) Foundation cleanout (Y/N) Depression over tank (YM) N High water alarm (YM) Date of pumping Pumper T554 5 PUwlping �-rwcL') C. ABSORPTION FIELD DATA Date installed It Z qto Soil rating (g.p.d.e or ft=/bdrm)System type SQ1.3t,3 t .JN' Length (02 ft. Width 5 ft. Gravel below pipe l r 5 ft. Total depth I0.2 ft. ; Eft. absorption area 3-Ljft2 Monitoring tube J_ Depression over field /V Date of adequacy test _41161 0 B Results (Pass/Fail) Pa1.5 For 3 bedrooms Fluid depth in absorption field before test D in. Water added ,1 0 gal. New depth O in. Elapsed Time: min. Final fluid depth O In. Absorption rate >=115-0 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date '— sl'Jirn Prot -fol t v*% 15-0 fry 110n.5 D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' lev _ in. 'Pump off" level _ in. High water ala vel at in. Datu Cycles ed Meets 8 circuit requirements? E. SEPARATION DISTANCES pi, b L kAfe t SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanknift station on lot Absorption field on lot Public sewer main _ Sewer /septic service line Animal containment areas On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5t + Property line .5t4- Absorption fiel t Water main ro+ Water service line t0 fi Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: , r r Property line tt) + Building foundation I o t Water main l0 '+• Water Service line 101+ Surface water NO- Driveway, parking/vehicle storage I I Curtain drain Al - O, Wells on adjacent lots 720. r F. COMMENTS: i I G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections andi TH_ review of Municipal records that the above systems are in — %,,��n},�+— conformance with MOA COSA guidelines In effect on this date. r �F�' ?' Engineer's Printed Name L ) 0Ur` h I and �t `c`'• 'i Date l E COSA Fee $�l / o Waiver Fee $ Date of Payment / T LOS Date of Payment Receipt Number t d�� �� Receipt Number (Rev. 11105) r trr �„•IK _ . SHQRECREST DRIVE o m I N 89158'00' W 145.00' z N N O 629 ' p O p28.0' kl2.0'v 26.5 of �.,.•. CS -i C) 34.0'Cs'o '� I o f o v 12.0 E)QSTNG Ci HOUSE p m I 15A Ut �'' ' o 28.0' v= 34.0' m I w o m o I 26.5' o mml I )C..s. 0 ! 14A UMVIET a>MCATOW PLOT PLAN IM A�.v rMrr�rM1 •..ar. rrr.�rrww A. r.�Irl rOVAiC1LIRIR AS-BYIT L •.•., a as A. a.4 w� a..1 rrw. sTwlau,E As.•�raLT .. •.� r . rrrY ar rr u tar SWAY Sl1 O •O•.r,oa m aar C3 oft V"amvj c As -WAY O narnAR... s -VA? ... u S 89058.00" E. 145.0( 2 Roberto .1 1N q 30' » O•L A = &Wva'o*4-09 Daft 21-5 rr t A—in .. 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