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HomeMy WebLinkAboutSMITH TERRACE LT 14AOnsite File Smith Terrace Lot 14A PID# 051-101-33 Formerly Lots 14 and 15 Municipality of Anchorage `r Development Services Department Building Safety Divislon - On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW080034 PID Number: 051.101.16 """' . Wastewater System: ElNew ® Upgrade "°""` Davis Ct. Chuglak. AK 99567 ABSORPTION FIELD PhNumbN a' ewromr v I„ 727-551A 1 C3 D«p Trwm 17 ahad Trench D Bed O Mm" ® oow TANK s�R'6"0 TPWDpMeomorrpkWarwe LEGAL DESCRIPTION • t. GPD Ft' Ft. Bbck' ld au0d^narom I. .'�t 11a{�l', ..-.. .'••, Dom b PIP4 Ewom hem orlgnol made GravN de M0anawl PIPs 14 815 • Smith Terrace Ft. Ft To ,p Rwoe Ssnwn: Fu wdw woe. 0"InN pews Grav LeVW Ft. Fl. Well ❑New ❑Upgrade GravN wgn Nu roar Nlnaa Dutwnawpaw Ft. Fl. C4ar6cwan (Pol. A.a. GI Tool DepM Geed b: Taw aow'pwP eraa Pipe Mal.w exist{n Ft. Ft FI Drdw Dole D.1W stew wet. LevN www Dole InNNIw Ft Flinstone Enterprises 1 512108 Ywd Pump sol N Ma aght Atb Ground TAN K GPM Ft. Ft. Ft. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Litt Holding ublb/Prtvate Molw'adu'e' Anchorage Tank n 1250 From Tank Field Station Tank Seer Line w GN Matrw Num aCar*wmrro. ww 102.6' » .. •• - Steel 2 sw'wewal. 100+ » •• LIFT STATION re anu anme' W u» 3.4' « « « Gal -Pun* p . a N -Pom M N N High w.lW 411W. N FouMa�on 43' « « Irlump „ In, _ la •• » Pump Make a M N Ew " Impea�o'u per'ormw by C~ Ma,14 R"" mBENCH MARK Tank only. Request lot line waiver per permit request letter. _ Louuan and Dewipum. WAIVER FEES: I'�J Window sill north of water valve M .;Wduvaecn... DATE OF PAYMENT: e? OSS 100.0 FL RECEIPTNUMBER: Engineer's Stamp Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1" 51212008 2ntl 5/212008D41 P�.•"�F"A�.,♦i Development Services Department Approval : ��'' `9♦ Conditional Approval Date: .,,,,,, „ :. ..... .... .... ...... � r j ':Ste den••R, P nnone� i ♦ G� �//-'� ♦ � no. CE 8149Ila - 2 �d ♦♦♦ � � Reviewed and approved by: U e ...... (RcI. 0106) ♦�,,, ss u ��� / AREA UNDEVELOPED NO WELLS OR SEPTICS W/IN 100 FEET. ti, - �Iu A� Sl' j , �.•' .9 �� *••*•% • •teven Onn Re•/ / �I,��. CE 8149 \ ,Ilk �q?OiE55�0 osiz77oa scale le t RECORD DRAWING Smith Terrace S/D, LOT 14 Michael Shomer 23110 Davis Ct. Chugick, AK 99567 P.I.D. Na -1o1 -1s PE RMIT Na. SWO80034 PLAN E/STING WI EXISTI 4 BR HOL EXIST'G COLLAPSED 1250g ASEPTIC TANK ABANDONED IN PLACE \PER CODE CONNECTED TO €XISTIG CLEAN,,-OUT- .N LEANOUT• CO A F1 T1 171. 12.0 T2 179.3114.5 k NEW 1250g SEPTIC TANK EXIST'G FIELD CLASS B WELL RADIUS \ w --� w > SEPTIC lr / AREA / 02.6 VA3 \ CONNE 0 EXIST'G FIELD / LOT UNDEVELOPED W NO WELLS OR SEP{ICS w W/IN 100 FEET. y=' MF" \-GARAGE F2 -------------------------- ---- --------------- / EXIST'G SEPTIC / AREA 10' Util Esmt ------------------------ FTI WIN EXIST'G SEPTIC tFN AREA NOTES: PANNONE ENG SVC, LLCOF P.O. BOX 102954 ANCHORAGE, AK 99510�� PHONE (907) 272-8218 FAX (907) 272-8211 A� Sl' j , �.•' .9 �� *••*•% • •teven Onn Re•/ / �I,��. CE 8149 \ ,Ilk �q?OiE55�0 osiz77oa scale le t RECORD DRAWING Smith Terrace S/D, LOT 14 Michael Shomer 23110 Davis Ct. Chugick, AK 99567 P.I.D. Na -1o1 -1s PE RMIT Na. SWO80034 PLAN Sneet 2 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: 4—BEDROOM HOUSE UPGRADE, NEW 1250g SEPTIC TANK, ABANDON EXISTING TANK PER CODE, CONNECT TO EXISTING DRAIN FIELD. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 20 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. EXISTING TANK SHALL BE ABANDONED IN ACCORDANCE WITH THE CODE BY PUMPING, CRUSHING, AND FILLING WITH COMPACTED CLEAN EARTH MATERIAL. s O uaZ DO Z Z0 L) W 5 �z 7 Q Q Dto Q �� Z... ..._.,._ .,. O� U U 4 Dia Pea Pipe is 97 2 3034 PVC 1 93.2 NEW 1250 g 92'5 SEPTIC TANK 92.3 18.5 LF 4 0 92 1 �;, 3034 PVC Y S=0.0100 44.5 LF 4"0 3034 PVC EXISTG DRAIN FIELD S=0.0150 TANK REPLACEMENT SECTION DESIGN PARAMETERS ABBREVIATIONS LEGEND TANK UPGRADE CU COPPER —w—w— WATER LINE NO. BEDROOM: 4 (600 gpd) DIP DUCTILE IRON PIPE WELL RADIUS TANK SIZE: 1,250 gallon TH TEST HOLE FC FOUNDATION CLEAN OUT — ss — w — EXIST'G SEPTIC T# TANK CLEAN OUT NO. C# CLEAN OUT NO. — — ss — NEW SEPTIC MX MONITOR TUBE NO. R.I. RIGID INSULATION 0— CHAINLINK FENCE DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER NOTES: /� PAMONE ENG SVC, LLC —��OF A/- " '' qS �I 0ate 6/14/08 P.O. BOX 102954 ANCHORAGE, AK 99510 272-8211 " f ( scale RECORD DRAWING PHONE (907) 272-8218 FAX (907) ' C.• TH #,,�/ "" "L """' ,,--r "�teven Pcnnone % �.•CE 8149 �� /IIS • � NTS Smith Terrace S/D, LOT 14 Michael Shamer 23110 Davis Ct. Chugiak, AK 99567 P.LO. NO 051-101-16 PERMIT NO. SW080034 Sheet DESIGN NOTES �Afp\ "= 3 Municipality of Anchorage c, 1 V0. Mm 1!MNCMI•.lnrhurnl;r,.11a.ki NAM.WN) 11num Hwul 011ier. CM013-N911 • 14s: 1!MIi I:S;:{-AYIN1 hup://a��u.nnmi nrl! Mayor Mark I3cgich Development S-mices Dep.u•tnrcnl 6/24/2008 Steve Pannone Pannone Engineering Svc. LLC P.O. Box 102954 Anchorage, Ak. 99510 Subject: Waiver Request for Smith Terrace Lot 14 Waiver Request #WR080036 Parcel ID #051-101-16 Permit # 080034 Dear Engineer, mcnt -CN�e4 Department Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Coniminiity, Security, Prosperity Municipality of Anchorage Development Services Department P r � I Building Safety Division On -Site Water and Wastewater Program 1J 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 080036 PID#:051.101-16 HAM Permit#: 080034 Date Received: 6119108 Legal Description: Smith Terrace Lot 14 Engineer. Steve Pannone Pannone Engineering Svc LLC P O Box 102954 Anchorage Ak. 99510 Applicant: Michael Shomer Waiver Requested: 3 feet separation distance absorption field to proeortv line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ............................................................................... Waiver Is Granted: L� Waiver Is not Granted: List Conditions or Reasons for above: Date: „ - a q — M ......... son .......... one ... ones ... as, ...LQ...S.{a... 0... a . . . . . seem ...........• Rec#: 6-19-08 Amount: $175.00 Date Paid: 6-19-08 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 SEWER/WELL SUBMITTAL COMMENT SHEET To: Steve Pannone Legal description: Smith Terrace Lot 14 815 ❑Permit [:]C.O.S.A. ®Inspection Report sue•• The attached paperwork has been reviewed and is being returned for the following reasons: 1. Need to apply for a Lot Line Waiver. 2. How much cover over tank ? 3. Existing swing ties?--6LAP,N4-ries Tv e=`-(S�'� C•CJ•S Name of reviewer: Jeff Date: May 30, 2008 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OFANCHORAGE 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 PERMIT Upgrade Date Issued: Apr 28, 2008 Expiration Date: Apr 28, 2009 Permit Number: SWO80034 Parcel ID: 051-101-16 Legal Description: SMITH TERRACE LT 14 Design Engineer: 0062 PANNONE ENGINEERING SERVI( Site Address: 023110 DAVIS CT Owner Name: MICHAEL SHOMER Lot Size: 9030 SO. FT. Owner Address: 23110 DAVIS COURT Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: ❑ 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 speed 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: Date: Issued By l 1, //�� / �i�/ (/ Cr'� / Date: 2 dg Municipality of Anchorage Development Services Department Building Safety Division On -Site / Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 651-101- ►(4 Property owner(s) Michael Shomer Day phone 727.5516 Mailing address23110 Davis CourtChugtak. AK Zip Code 99567 Site address 23110 Davis Court Zip Code 99567 Legal description (Sub'd., Block & Lot) Smith Terrace Lots 14& 15 Legal description (Township, Range & Section) Lot Size 9030 & 9030 Sq. Ft. THIS APPLICATION IS FOR Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage (® all that apply): El ❑ 17 Number of Bedrooms 4 THIS APPLICATION IS AN: ZD Initial ❑ Upgrade Renewal ❑ 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 Municipal Codes. Pannone LLC (Signature of property owner or authorized agent) Permit/Rush Fees: 4tto — Waiver Fees: Date of Payment: ql"qg Date of Payment: Receipt Number: log t -l]) Receipt Number: (Rev. 11/05) Pannone Engineering Services, LLC P.O. Box 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218 (907) 272-8211 Fax April 26, 2008 Municipality of Anchorage Development Services Department On -Site Water R Wastewater Program 4700 S. Bragaw Street Anchorage, Alaska 99519 Subject: Smith Terrace S/D, Lot 14 EMERGENCY Septic Tank Replacement Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new septic tank be issued for this lot. The proposed systems will serve an existing four-bedroom house. Currently the lot is developed. The existing septic system was designed and installed for a four- bedroom house and is operating adequately for four bedrooms. The tank has collapsed and the Owner is pumping daily to keep sewage off the ground. The surrounding lots are served by private water systems and are over 100 feet from the proposed soil absorption system. This lot is served by private water and the well is located greater than 100 feet from the proposed system. 1. Upgrade Tank Design. a. Number of Bedrooms: 4 b. Septic Tank Size: 1,250 gallon 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: Lot 14 slopes to the south at approximately 1 percent based on existing contour information. The proposed installation will be located in the southern portion of the lot adjacent to the property line. 4. Waiver Request: I request a lot line waiver be issued for this tank replacement. To place the tank outside the 100' well radius and maintain five feet from the existing drain field the tank needs to be located approximately three feet from the lot line. I request a waiver to two feet be granted for this tank upgrade. The adjacent lot is undeveloped and will not affect the development of the lot. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Page 1 of I s 5 s CLASS B WELL RADIUS "—"— _ ------- /Ex ..'.\�\ G SEPTIC AREA AREA UNDEVELOrED / NO WELLS OR SEPTICS •� / # W/IN 100 FEE/ . , EXISTING WELL Q :1 EXISTING I 1 j 4 BR HOUSE OQ I � EXIS& COLLAPSED I 1250c1 SEPTIC TANK A ABANLONIN PLACE 1002 % \\PER CODE —\ CONNECT TO EXIST'G\ i CLEA OUT CONNECT TO FXIST'G \ / •� •�•\ i LOT UNDEVELOPED \ NO WELLS OR SEPTICS PROPOSED 12509 3.0 F _ " W/IN 100 FEET. SEPTIC TANK ,�i ••�"—" GARAGE EXIST'G FIELD TO BE REUSED \�> F2----------- -- — — — — —— -- — —- — --————--——————- - 101 Util Esmt EXIST'G SEPTIC EXIST'G SEPTIC AREA / AREA / R NOTES: PAMONE ENG SVC, LLC ��OF... 04/27/08 P.O. BOX 102954 ANCHORAGE, AK 99510 272-8211 j�p.•' �) scale 'SSUED FOR CONSTRUCTION PHONE (907) 272-8216 FAX (907) * � • • .... P.I.D. NO Smith Terrcce S/D, LOT 14051-101-16 5te'ven Michael Shome! 23110 Davis Ct. rc. nor+e / �, 49 CE 8149 (��c •.� �1l%....... snt PERMIT NO . sw..xxxx PLAN Chugick, AK 99567 OF2 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: 4—BEDROOM HOUSE UPGRADE, NEW 12509 SEPTIC TANK, ABANDON EXISTING TANK PER CODE, CONNECT TO EXISTING DRAIN FIELD. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 20 FT. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 14 FEET BELOW EXISTING GRADE. NOTIFY THE ENGINEER IMMEDIATELY. 5. EXISTING TANK SHALL BE ABANDONED IN ACCORDANCE WITH THE CODE BY PUMPING, CRUSHING, AND FILLING WITH COMPACTED CLEAN EARTH MATERIAL. k k kk a k U 932— g 1250 q 92'5 SEPTIC TANK 92.3 18.5 LF 4 tin 92. I , •- s •'•... 44.5 LF T 0 3034 PVC S0100=.03034 PVC ::. S=0.0150 EXIST'G DRAIN FIE TANK REPLACEMENT SECTION DESIGN PARAMETERS ABBREVIATIONS LEGEND TANK UPGRADE CU COPPER —w—w— WATER LINE NO. BEDROOM: 4 (600 gpd) DIP DUCTILE IRON PIPE WELL RADIUS TANK SIZE: 1,250 gallon TH TEST HOLE FC FOUNDATION CLEAN OUT — ss — es — EXIST'G SEPTIC Ty TANK CLEAN OUT NO. C# CLEAN OUT NO. ss ss NEW SEPTIC M(/ MONITOR TUBE NO. R.I. RIGID INSULATION ---- CHAINLINK FENCE DCO DOUBLE CLEAN OUT DV DVERTER VALVE FS FLOW SPLITTER NOTES: PANNONE ENG SVC, LLC ��OFA�gSI� 04`/27/08 P.O. BOX 102954 ANCHORAGE, AK 99510 tp .•'' ��0Scale ISSUED FOR CONSTRUCTION PHONE (907) 272-8218 FAX (907) 272-8211 * *��/ NTS NO Smith Terrace S/D, LOT 14 P.I.D.01 Michael Shomer .. / 061-101-1s �•�teven nnor+ CE 8149/ PERMIT NO. DESIGN NOTES Chuglio0k, Davis IAK99567 /'���; � S tetOF 2 1 \,= MUNICIPALITY OF ANCHORAGE VLF[ -WD DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME , 11 In PHON ❑NEW ZG UPGRADE MAILING ADDRESS ® 5 LEGAL DESCRIPTION L A- LOCATION N0. OF BEDROOMS Well Absorption area Dwelling DISTANCE TO: PERMIT NO. Q _Y F Z Manufacturer Material No. of compartments `W FQ- U) Liq. capacity in gallons Inside length IF HOMEMADE: Width Liquid depth Y Z DISTANCE TO: Well Dwelling PERMIT NO. 2zFQ- Manufacturer Material Liquid capacity in gallons W = Well Foundation DISTANCE TO: Nearest lot line PERMIT NO. J LL Z Zw No. of lines Length of each line Total length of lines Trench width Distance between lines ~ f Top of tile to finish grade Material beneath tile inches Total effective absorption area inches Length 9 Width Depth W PERMIT N0. a a H W° Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. W W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOI L TES I HAI NU a am INSTALLER, OF C.1 REMARKS L R R VED Mi1mv ( `D1ATE LEGAL A k i i 1 f1ti�� Cl - 1 1, DEPARTMENT OON F HEALTH FIND ENVIRMENT19L PR6_ECTION 825 O'L-STREET., ANCHORAGE, AK 99501 264-4720 COLO jr)l nm C -I V-4 --- !Z—;.T7rE:"_=--F=L4E�pe UF­01�F-�Flr_jF_7 jos.In-X)-72 PERMIT NO. ( _780499 **, ,APPLICANT .44M PLATZ6K P. 0. BOX 522 CHUGIAK 0-01--.-ATION twLILK�.". UKEEK LEGAL LOT' 14-15 SMITH TERRACE SUB LOT SIZE 13000 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBEROF BEDROOMS 4 SOIL RATING (SO FT/BR)= 0 THE REQUIRED 'SIZE: OF THE SOIL ABSORPTION SYSTEM IS: -1 "_ 1 .2121 . THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH 15 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. -FWRD < P21 > N -9-7. lF> E -Z IZ- -F I C R. EEFZ FE' U I V, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL. SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. !F�o 1= F-.* M I "r U X F- I oma' F= _-. C -A FEE 0 E: M E? F= F? =3 -_�L , A- *--I 7 :E. I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS FIND WELLS, AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL. INSTALL THE CYSTE IN ACCORDANCE WITH THE CODES. E f_l SEWEF T IF THE 3: 1 UNDERSTAND THAT _IP4 SITE I :.' ' TEM MAY REQUIRE ENLARGENEN RESIDENCE IS REMODELEE� Tjj.�4 NCL UDE MOR THA- 4 BEDROOMS. SIGNED: PLATZEK' ISSUED BY-- ---- ---- — __DATE_l_!5 ------- 2 GAI,B-H0.' GRE 'ER ANCHORAGE AREA BOROV ' DEPTIWRTMENT Of ENVIRONMENTAL QUALIi� 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM i l <P NAME LJ {"�}Ub� N10 L, MAILING -- ADDRESS/��, �4A'«� d�d�'� PHONE LOCATION �E. �E 11 of k -i- Ll _ LEGAL DESCRIPTION SEPTIC TANK DISTANCE FROM WELL MATERIAL�� NUMBER OF COMPARTMENTS LIQUID CAPACITY �� C GALLONS. INSIDE LENGTH INSIDE WIDTH LIQUID _— DEPTH - SEEPAGE SYSTEM: SEEPAGE PIT NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH /7 LENGTH / �� DEPTH—6 / LINING MATERIAL .fie"*,y6,xC� DISTANCE FROM WELL ! o _ BUILDING FOUNDATION NEAREST LOT LINE �'-� '" =� TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) �"�✓• SQ. FT. An) 7� , DATE APPROVED` �� ;?I IZ GREA' `ER ANCHORAGE AREA BOR UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 T ANCHORAGE, ALASKA 99502 TELEPHONE 279-6686 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO. .- /�/7L� �j L -S � / �'�"1 -27,;; — NAME OF APPLICANT + MAILING ADDRESS �- e2 PHONE ��TD INSTALLATION LOCATION�'//L�iG, LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK�- SEEPAGE PIT DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH �—acs %y/�llf TO BE INSTALLED BY SOIL TEST RESULTS ��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 HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE e � � G' TYPE, fT Z .-� SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �`-`� / DRAIN FIELD J. i SEPTIC TANK TO SEEPAGE PIT WALL S SEPTIC TANK SEEPAGE PIT �© DRAIN FIELD -J TO NEAREST LOT LINE. WELL TO SEPTIC TANK / SEEPAGE PIT /�Zo ' DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD �9 SEPTIC TANK, Aj SEEPAGE PIT �d/' DRAIN FIELD 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. HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THc Aon"r DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE alr't e'-4 GREATER ANCHORAGE AREA BOROUGH DEPAFi�,,ENT OF ENVIRONMENT",L CUAL_i CASE # 3500 TUDOR ROAD ANCHORAGE, ALASKA 99502 Performed For William Maus Date Performed 10/12/71 Legal Description: Lot Block 14 Subdivision Smith Terrace This Form Reports Soils Log x ' erco ation Test Depth Feet -_ Soil Characteristics I Reading Date Gross Time ! Net Time I I Brown silty sandy gravel (GM) I ' Gray sandy gravel (GW) 3 — with boulders and cobbles intermixed slightly silty 4.5 - 6` 4 d 5 -- b -- erco atlon ate 8 �-- ` 10 Was Ground Water Encountered? no If Yes, At What Depth? I Reading Date Gross Time ! Net Time I I �I I ' i erco atlon ate I Reading Date Gross Time ! Net Time I I jDepth to H2O Net Dro I ' i erco atlon ate Proposed Insta atTT o L- Seepage Pit x Drain Field Depth Of Inlet Depth To Bottom Of Pit Or Trench COMMENTS: _95 squarefeet of adrainage area is required pe bedroom The material may be used s backfill if silty portion is removed. Test er orme y R. E. Car ,.s a ata ertl le Y: Nation Datee:al Testing Sys I Inc. Time APPLIG, IT FILLS OUT UPPER HAL' ONLY Property Ownerk-1 I; y, 4� u-- 1� Phone - � :;✓K (.'%moi r'"! - b-aO ✓J,7 Mailing Address — - _ .� [r Zip Code Date Date LInspector Date [Address:yer t_. i 4 v) % Field Notes: Zip Code Lending Institution -J > , /�' Tel {��`� i t.i� .✓ - r (� �, .[. C/ / 71 / (V /L%%�� '� - ria rJ ��losl/l<f!�/{� hone Address "/;O U /I -- ✓ h Zip Code J r✓t .J 2 _ �..,G� Realty Co. & Agent j�'i'° RECEIVED Phone Address Zip Code ( ) CONDITIONAL A_PPEtQVAALL' Legal Description Iq I- Street Location 1 5 / /.- dence Family BY: e Family P No. of Bedrooms_ Date Sewer Installed Well To Absorption Area Well Log Received al nityp ATTACH WELL LOG. A well lag is required for all wells drilled since June 1975. ❑ Public Utility \� For wells drilled prior to that date, give well depth (attach log if available). Sewer Disposal Individual Year Individual Installed: 1171 ❑ Public Utility ❑ Holding Tank When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Date Date LInspector Date Inspector Inspector Inspector Field Notes: � MUNICIPALITY OF ANCHORAGE DEPT. OF Nd "t?cb CrIleL _ foot GQ HEP,LTFI Co: ENVIRONM'NTAL PROTECTION Ge�,.seJtQ 1 f} g 3.�,. rl `j 'E,,fO e d u ts4:✓ j�'i'° RECEIVED ( )APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL A_PPEtQVAALL' DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received - 11-71 Well to Tank �� - Septic Tank Size—U 72-023(3182) 5. Lott r�E�ScanToN1.5 Smith Terrace Subdivision - MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ! ENVIRONMENTAL ENGINEERING DIVISION NUMBER OF BEDROOMS Telephone 264-4720 ❑ One ❑ Four ❑ Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE 688-3048 Ronald H. Moore MAILING ADDRESS *ATTACH WELL LOG. A well log is required for all wells drilled NHN Chapel Drive since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) PHONE 2. BUYER - PHONE 276-5125 Thomas Weir ❑ INDIVIDUAL/ON-SITE** MAILING ADDR ESS ❑ PUBLIC UTILITY 3. LENDING INSTITUTION - PHONE 274-7661 Lomas and Nettleton Company MAILING ADDRESS 4449 Business Park Boulevard 99503 4. REALTOR/AGENT PHONE 694-3053 Bill Hummel MAI LING ADDRESS Executive Realty 5. Lott r�E�ScanToN1.5 Smith Terrace Subdivision - STREET LOCATION NHN Chapel Drive 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other SINGLE FAMILY 10 Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY KX INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date . ❑ INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) IAJ w1r���1`- << (,z �F3- :.3 A3 192 143 ItJ•/ m• 6x" b9 $t" 1 10 . 430�M.. -L i II u i'HIS SIDE FOR OFFICIAL USE ONL. - ,,��frt V. -c l SPECTION APPOINTMENTS (�1� TE RECEIVED TIME W-) IDS TIME TIME DATE a DATE q --)R JJLL, ,s DATE INSPECTf�R J INSPECTO,f? (1S1�L' INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY E-1MULTIPLEFAMILY NUMBER OF BEDROOMS VNE E:1THREE ❑ FIVE ❑ OTHER WO #V<f0UR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM U dI QbIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED /��/ INSTALLER 1+5eptic Tank or ❑ Holding Tank Size: % If Tank is homemade give dimensions: SOILS RATING _ i TYPE OF TANK -T- MANUFACTURER TOTAL ABSORPTION AREA MATERIAL C 4. DISTANCES WELLTO:� Septic/Holding Tank Absorption Area /pv Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTSPer 11K APPROVED FORBEDROOMS C3j-kA ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE—� � � r BY (Title) LEGAL DESCRIPTION n �� L � � 72-010 (Rev. 3/78) Parcel I.D. 051-101-16 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Smith Terrace, Lot 14 s ftp i t A", 4Yq �.Vi iyj['F p. Expiration Date: // IO I5— Location (site address) 23110 Paul Davis Cir. Chugiak, AK Current Property owner(s) Securitized Asset Backed Receivables LLC Day phone Mailing address 12650 Ingenuity Dr. Orlando, FL 32826 Real Estate Agent Relocation Company Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual n Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request Received by: A0_ "� Date: I U i U / S COSA to be released to the eljjneer, unless otherwise requested by the engineer. COSA Fee Waiver Fee $ Date of Payment 1 I II5 Date of Payment Receipt Number Receipt Number COSA # O 215 /126 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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE 0 System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 3/27/2015 Conditional approval for y bedrooms, with the following stipulations: The Municipality of 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 Septic System Advisory Well Flow Advisory COSAbluesheet t Nitrate Advisory Arsenic Advisory Other if more than 1 septic system is on the lot: COSA Checklist #? of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Smith Terrace, Lot 14&15 A. WsLC DATA Well type Private If A, B, or C provide PWSID # Date completed 1971*** Total depth 240*** ft. Date of test Static water level Well production _ Sanitary seal (Y/N) Y Cased to =ft. FROM WELL LOG Unknown Unknown ft. Unknown g p.m WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 3.76 mg/L Arsenic ND ug/L Date of sample: 3/26/2015 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 3/18/201 - Depression -over tank (YIN) -N 5 Pumper JR's Pumping Parcel ID: 051-101-16 Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 3/30/2015 161 11+ 9.13 -m - Collected by: PES Date installed 5/2/2008 Cleanouts (YIN) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA f�& oO�j�s'ro Date installed 6120-27/1978_ Soil rating (g.p.d./ft2 or ft2lbdrm) 95 SF/BR system type Crib/Trench Length 17/44 ft. Width 17/Unknown ft. Gravetbelowpipe 6/3.5 ft Total depth 1110 ft. Eff. absorption area "" ftz Monitoring tube Y Depression over field N Date of adequacy test None -3/23/2015 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption Feld before test 0 in. Water added 850 gal. New depth 2 in. _ Elapsed Time: 25 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm_ovel at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 95* On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 10Q+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO:_ 4-1 Building foundation 5+ Property line J. III Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+_ ABSORPTION FIELD ON LOT TO: Property line 0** Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ -Wells on adjacent lots 100+ F. COMMENTS *WR#060073 **See Ingress Egress Easement 11/15/2006. ***Per previous COSA Crib size per 1971 inspection report,.Trench per field measurments. G. ENGINEER'S CERTIFICATION t certify that I have determined through field inspections and revlew of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 4/15/2015 COSA canary sheet 2-6-15.doc Elec. Ea Wood Sr No Four Encroacl as show NOTE: Distances are measured to the building trim. SCALE : 1 " = 20' 0' 10' 20' 40' I hereby certify that an accurate survey of the following described property: SMITH TERRACE SUBDIVISION (63-69) LOTS 14 & 15 was made on April 16, 2015 and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Easements other than those shown on the record plat may not appear on this drawing. Anchorage Alaska, this 16th day of April 2015. Municipality of Anchorage •., ' Development Services Department o• / Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 J� y4 Anchorage, AK 995195650 Wuri .�, iii www.muni.org/onste s ®®® ��_ (907) 343-7904 ^ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1751- b(- ICO COSA#2p0r5sb 1. GENERAL INFORMATION Expiration Date: Z- / r" 0 7 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address SMITH TERRACE S/D: LOT 14&15 23110 DAVIS COURT " CHUGIAK. AK 99567 JOHN dr LAURA WILMOT Day phone P.O. BOX 771002 • EAGLE RIVER, AK 99577 Day phone 688-2074 ANDREA GRIBBON w/ PRUDENTIAL Day phone 223-5824 3801 CENTERPOINT DRIVE 0200 • ANCHORAGE, AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site 0 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 samples. (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 5. 4s certified by my seal affixed hereto and as of the validation date shown below, l verify that my vdstigation, based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application, shows thatZheon: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 riles 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 Finn GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD, attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the Gme ofthe test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater 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 the system. Satisfactory test results do not guarantee future performance ofthe system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not aulhorized, nor will it confer any legal right whatsoever. Attachments: 337-6179 Date I ( 0/cf. COSA Checklist Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Reort Nitrate Advisory Other •.ON-SITE.• WATER AND WASTEWATER By: Original Certificate Date: 5�- 0 G (Rw. I V05) i. h Municipality of Anchorage • Development Services Department Building Safety Division ' On81te water 6 Wastewater Program t 47W Bragaw Street �. P.O. Boa 1966W 'r Anchorage, AK 995196650 www.muni.oryonalte I, (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SMITH TERRACE S/D: LOT 14&15 Parcel ID: 0 _6�1-1 0 i 1 �0 A WELL DATA 'PER 1971 INSPECTION REPORT Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (YIN) NO Date completed 1971 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES Total depth 0240 ft. Cased to 40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/24/2006 Static water level ,� V� ft. 165 ft. NO Well production g.p.m. 6.8 g.p.m. WATER SAMPLE RESULTS: Coliform —4-- colonies/100 ml. Nitrate ?.0'+mgdL. Other bacteria ALcolonies/100 mi. Arsenic: N D ug./L. Date of sample: 10/24/200 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 10/21/1971 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 6/29/2006 Pumper JR's PUMPING C. ABSORPTION FIELD DATAEXISTING 10/21/1971 Date installed 6/27/1978 Soil rating (g.p.d./Wor(fj!� 95 System type CRIB/TRENCH Length 17/44 ft, Width 17/UNKNOWN ft. Gravel below pipe408 6/`••3.5 ft, Total depth '11.3 9.oeft. Eff. absorption area UNK ft' Monitoring tube YES Depression over field NO Date of adequacy test 10/24/2006 Results (Pass/Fail) PASS For 4 bedrooms ••56.5 76 Fluid depth in absorption field before test "18 In. 70 Water added 1284 gal. New depth 37 in. Elapsed Time: 180 min. Final fluid depth31 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 8 type) NONE KNOWN If yes, give date — *"TESTED BOTH THE TRENCH AND CRIB r•• PER FIELD MEASUREMENTS D. LIFT STATION Date installed Size in gallons Manhola/Access (Y/N "Pump on" level at _in. "Pump off* le High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: • INSTALLED PRIOR TO 1973 Septic tankAiR station on lot '50'+ On adjacent lots 100'+ Absorption field on lot "95 On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line "'0' Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS .. SEE ATTACHED WAIVER REQUEST LETTER G. ENGINEER'S CERTIFICATION I car* that I 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. J Engineer's Printed Name JEFFREY A. GARNESS a Date 1 6 A76 �4p00 COSA Fee S '4:30 .1191 Ns- - Date of Payment tYl Receipt Number (Rev. 11/05) CE -79 �. II` �.j11 9• a, 6°� Waiver Fee $ 11,51).06 Date of Payment jr�, Dj10 Receipt Number 1`15/-15 O Dla#or Mark Begich Municipality of Anchorage MI Ik,x I(fi(M • Anchomgc, .tanskn 9A519.OZ-A) • Telephone (907MMIM • Pux ((X)7) 343 -K -IM 47(X) Ihnimw $(reel • Awhomge, Ala%kn 9fM7 wim umi.org November 15, 2006 Jeffrey Garness, P.E. I3uilding Safety Division Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Subject: Waiver Request for Smith Terrace Lot 14 & 15 Waiver Request WR#: 060073 Parcel ID # 051-101-16 ITA060550 Dear Jeffrey Garness, P.E.: Your request for a waiver of the required 100 feet horizontal separation from the absorption field to the private well has been approved. The approved separation distance is 95.0 feet. Also approved with this waiver is a 0 lot line waiver for the septic absorption field between lot 14 & 15. This waiver approval applies to the existing absorption field to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there arc any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, rdall iviI Engineer On -Site Water & Wastewater Program Community, Security, Prosperity "NOV.1-5.2006 09:14 907258585 AX SALES 5th AVE SERVICE #1563 P.002 /003 Ingress/Egress Easement Grant made this 15i' day of November 2006, between John William Wilmot and Laura Barnes Wilmot, 231 10 Davis Court Chugiak, Alaska, hereinafter referred to as Grantor, and of John William Wilmot and LauraDame% Wilmot, 2-3110 Davis Court Chugiak, Alaska, hereinafter referred to as Grantee. Whereas, the grantors am owners as tenant, in the entirety of the following described tcalry: .. Smith Terrace, i.oLS 14 & 15, according to the official Plat # 630069 in the Anchorage Recording District. lUrd Judicial, District, State or Alaska, And, Whereas, the grantees are desirous ol'enjoying the use of a certain portion of the grantor's land for the sole purposes of ingress and egress to Grantees land for the purpose of maintaining a private septic system And, Whereas, the grantors have agrccd to grant to the grantees as casement solely for said defined purposes and for no other, Now, this dant witnesses that in return for said specified consideration the Grantors hereby grant to the Grantees, their heirs :ml, assigns, full and foe right to maintain a private septic upon a portion of the Grantors hind. 111is Grant of Easement is intended to be appurtenant to Grantees above described Land and touches, concerns and runs with said lands. This is not intended to be an exclusive easement_ The Grantor herein expressly reserves unto themselves equal rights ol'ingress and egress and all other rights as the owners as tenants in the entirety of the. described premises. Any disputes or disagreement arising under or in any way concerning this instrument shall be submitted fear resolution to the process of binding arbitration in accordance with the Alasb statures made and provided for said arbitration. The jurisdiction of the Arbitrator shall commence 60 days from the onset of the dispute and shall operate to toll all applicable Statutes of Limitation. NOV.1.5.2006 09:15 907258585 AK SALES 5th AVE SERVICE #1563 8.003 /003 In Witness Whereor the Grantor and Grantee year above written. State of Alaska ) )sq. '11ird Judicial District) Laura Barnes Wilmot - Crantolf John illiam Wilmot - Grantee T.tunt R ares Wilmot - Grantee and 'oris is to certify that on this Zt— day of _,IAV .2006 before me the undersigned, allolary Public in and ror the Slate orAlaska, duty commissioned and sworn, personally appeared John William Wilmot and Taunt Dames Wilmot, to me known to be the persons described in and who executed the above and foregoing instrument, and acknowledged to me that they signed and scaled the same freely and voluntarily for the uses and purposes therein mentioned. Witness my hand and official seal the day and year in this certificate fust above written. My Commission Municipality of Anchorage Development Services Department • Building Sarcty Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907) 343-7904 Waiver Review Worksheet WR#:060073 PID#:051-101-16 HA/Permit# HA060550 Date Received: November 15, 2006 Legal Description: Smith Terrace Lot 14 & 15 Engineer: Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Applicant: John Wilmot Waiver Requested: 95 foot horizontal separation from well on -lot to septic absorption field on -lot Criteria: Geology Points: A. Water Table 7.42 B. Soil Sorption 2.63 C. Permeability 2.48 D. Water Table Gradient 2.90 E. Horizontal Separation 2.8 Total:. -_--__18.224,_._ _._-___ ...•...................................................................... Waiver is Granted: X List Conditions or Reasons for above: Waiver is not Granted: Date:1/1 15108 By: Joe Goodall Name of Reviewer Rec#: 74545 Amount: $1M Q Date Paid: 11/15/2006 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3, 1985) Waiver Request for: Smith Terrace Lot 14 & 15 ParcelID#: 051-101-16 Waiver Request Number WR#: 060073 Waiver Requested: 95 foot horizontal separation from well on4ot to septic absorption field on -lot Engineer: Jeffrey Gamess, P.E. IIA060550 Seatic Field Data The encroaching septic field was installed in 1978. A small portion of the end of the septic absorption field is with in the 100 fol: well radius. The bottom of the absorption field is approximately 11 feet deep. The area is generally flat and there is located between the well and the septic absorption field. Well Data Unfortunatetly there is no well log for Smith Terrace Lot 14 & 15, however, Gamess Engineering provided other well logs in the surrounding area, which show soil strata. The well log depth vary from 191 to 222 feet. For the purpose of calculating points the well log for lot 19 was used up to a depth of 191, for a worst case scenario. There are layers of silty/sand/gravel/clay, and hardpan that have served to inhibit the migration of untreated effluent into the aquifer. The water samples for lot 14&15 are with -in municipal standards. State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 3,1985) Waiver Request for: Smith Terrace Lot 14 & 15 Parcel ID#: 051-101-16 1_, Waiver Request Number WR#: 060073 %Wa :Q-,%� :.x Waiver Requested: 95 foot horizontal separation from well on -lot to septic absorption field on -lot Engineer: Jeffrey Gamess, P.E. IIA060550 Water Table Depth of well: 191 Depth of septic system: 11 180 Distance from the bottom Point Clean Gravel of the system to the highest value 1 water table in feet 1.5 Sand wl Small Amt of Clay 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 10 • Straight line Interpolation Is permitted between any two values Soil Sorbtion Soil Type Point Value Clean Gravel 0 Fractured Rock 1 Course Clean Sand 1.5 Sand wl Small Amt of Clay 2.5 Silt 3.5 Clay and Sand Equal 4.5 Clay 6 Points un 7.42 Points un 2.63 1_44 13.5 + 1180, 1 + [ 180 2.5 + 1180 1.5 + k8 -o-) +1-78-0) + N08-0-) 0 + [7800-1 0 0.9 + 0 + 1.6 + 0.1 0 + 0 + 0 + 0 *Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type I Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 Points ,.n 2.48 rol2 $3) +(180,3 +x;701.4 +� 1801 1 +1180, 1 +1180, 1+ r 180, 1 0.49 + 0.02 + 1.93 + 0.04 0.00 + 0.00 + 0.00 + 0.00 *Use the predominant soil type but values can be averaged for a mixture Gradient %Slope Points Value -60% 0 In Feet .30% 0.3 0 -20% 0.7 50 -10% 1.2 2 -5% 2 150 0% 2.93- .9}5% 5% 4.5 10% 6 60% 7 slopes toward well gat slopes away from well *If the gradient is unknown, assume the worst case Horizontal 95 Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 Points .n 2.90 Points ,.n 2.8 *Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points:1 18.224 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS November 8, 2006 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Waiver Request for Smith Terrace Subdivision; Lot 14 & 15 To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. During our site visit to perform a COSA evaluation, we discovered that the drainfield was encroaching on the 100' well radius. According to our field measurements with a Topcon total station, the separation distance between the well casing and the first drainfield cleanout is 96 feet. We request you grant a 95 foot separation distance waiver from the well to the drainfield on the referenced lot. The following items are justification for the waivers: • The lot is generally flat in the area. The septic system and the well are on opposite sides of the residence; which can be seen in the attached site plan. If the septic system was to overflow, it appears that the effluent would not travel towards the well head. • The location of the septic system is also in a very visible area directly behind the residence. If any effluent was to surface, it is likely that it would be noticed and the problem corrected. The other path of contamination is subsurface migration of wastewater. As can be seen on the attached well logs, the total depth of the wells range from 191 to 222 feet, and the static water levels range from 145 to 180 feet. There appears to be over 200 feet of silty sand/gravel/clay, and hardpan soils that have served to inhibit the migration of untreated wastewater into the aquifer. Recent water sample results indicated nitrate levels of 3.07 and coliform bacteria to be undetected. Based upon the aforementioned facts, and the fact that the existing encroachment has existed for 28 years, it appears that there is minimal risk associated with granting the requested 95 foot separation distance waiver. We also request that your department issue a 0 -foot lot line waiver from the south east property line of Lot 14, to the trench. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have app questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamcsscngincering.com FA GARAGE TRENCH EXIST]ZZ N�V' CRIB 0' L0T UNE WAVER REQUEST GARNESS ENGINEERING GROUP, Ltd. ppm?' IH CONSULTANTS& GENERAL CONTRACTORS �'••" .. "" ......"•' 3A1 L TA011 NWD. W 101 • O CHORWL Mt 9 6 • FIOM[ 007)M71 1T • FM (W1uM-i1N • ew.pwwwylewp.aae PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • ......• ......••• JOHN WILMOT 688-2074 1 OF 1 Q Y mess: LEGAL DESCRIPTION: DRAWN BY: QO ' . CE %9�5 3 e, SMITH TERRACE; LOT 14&1591 B.F.M. ��Dee'•�I�B/.Q&'�oo TYPE OF WORK: ROTE: 44O�Orco SITE PLAN FOR WAIVER REQUEST 10/27/2006 (Rev. 01)051 Nov -06-06 03:40pm From-Homestate llortaage OOTZT37215 T-681 P.002/002 F-680 tk Let lµ-' :l"GF-I.,fle r• `� �'. i I Y.i nn.Gl c• �. WA lyEk7i � . ' ice. / .. .. •• , • 1 r{C.l'w / ,4 �w\ yr i .. -. ... .. 1 I• \ - -r•- . i Lo7.. 1 C N ASBUMT I Eezeby°certify that I have afirmyed the:fgUow.ing described -property: Ldii /sr':C j'::•r . - •/. •'• '�1 f��l.� / .•l'.9 •%\/ ` '� t t♦t� -'-, �T-rte Anchorage ,Recording' Prieinct. hlaska, `and' .that the _7 �:�-� - .. Improvements [[tuated thereon are within -theproperty .. �•.. -.5 .•• • ,.; lines end do not 'Overlap or encrwh -on the property:: . •r'',;•" )Yin ad pp Vii'; ' g' tattot' thereto, no improvements on'�proP:. i••z.-C,;,... � :` . .thot ,..::'; 1TW lYing adjacent thereto encroach On -the premises,tn, .,�•� t, ` ` question and that there. are no roadvaeY0. tranlmiaslait: . fines or other vWbie easements on Wd propetty'irYupt" � as Indicated hereon, . C• '. � �' e� ... i . Dated at 1<aglo River, ;Alaska . � .. 24`—G:-. i�:e �'•'''•,• ..,� .'?::' thi•..3 -1 .:dsyc>" :�.t•or/r • "' _ '��♦.^.'^' _,,:..: ;".:. ROHntERT�C. JOIi]QSO/��"'�.'• . • <: t, :' , : N'� SCALE: =-F `,_ r RRee siered I"oad S Na: 8802.q•. ,;:.y; .: •: .. ja,r I'='ZO Box 4w.ff4�7e JU.,r • }:.. • Aleeka ... --'- -• Phone 804-2b4II . _ MUNICIPALITY OF ANCHORAGE Department o -f 11ealth and Environmental Protection £325 L Street, Anchorage, Alaska 9950.1 279-2511, ext. 224, 225 uest for Approval of Individual Sewer and i•',ater Facilities 1. Property Owner: Nailing Address Ronald H. Moore NSA Chapel Dr. Phone: 688-3048 2. Mame of Buyer: Thomas Weir Mailing Address: Anchorage,',' Motel _ Phone 276-5125 3. Lending Institution: The Lomas .& Nettleton Co. Mailing Address • 4449 Business Park Blvd. Phone: 274-7661 4. Realtor/Agent: Bill Hummel Mailing Addre-,s: Executive Realty Phone: 694-3053- 5. Legal Description: Lots 14 & 15,Smith Terrace s d -. Street Location: NSA Chapel Dr. 6. Single Family Residence: (X) Number of Be«-oo,�s: 2 Multiple Family Residence: ( ) Number of Bedrooms: 7 . i Sp�1.y: ind.'_�i� ual We' {X Pub' �_i _•�c, us;c:tu;:� �y �i stteer::ager . If. Individual well, ;ell depth If Community of S- ste:': U. CV.`it��([i� Disposal Sys;. e=5: 1. iii, S S T' {A) 'l ) n:t os� G.i-s _ t=e:1 P.i,_li.c S} St ..1 { ) :[f On- si.Le System, d . _. o-, insta _la Lion MUN � T. p OF ANCyTI,O .:G'.?�;: A well log i s re:n c_. on _ Li. c;e lis d- i_Llea since ikd F HEqL RAGS NMENrAC PRecrlo,V l!a`J 1 i% RECEi V E® 3:7 G GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 2/25/74 Time of Inspection 6:00 pm Date of Inspection 2/26/74 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA 1. Approval requested by: Alaska National Bank Mailing Address: Pouch 7010 Anchorage AK 99501 Phone: 277-2511 x 35 2. Property Owner: Paul Davis Phone: 688-2477 Mailing Address: 3. Legal Description: Lots 14 & 15 Smith Terrace 8D 4. Location: By Peters Creek Chapel 5. Type of facility to be inspected Single No. of bedrooms 4 6. Well Data: A. Type Drilled B. Depth 240' C. Construction D. Bacterial Analysis Satisfartnry 7. Sewage Disposal System: A. Installed 1971 B. Installer WM Maus C. Septic Tank: 1. Size 1250 Gals 2. Manufacturer stack Steel D. Seepage Pit: 1. Absorption Area gixg,x6l 2. Material Log E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank 58' , Absorption area 100' Sewer Lines , Nearest lot line Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Regdest for Approval of Individual S,er & Water Facilities Legal Description Comments A Disapproved Date Pal Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM N �I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date