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HomeMy WebLinkAboutKEE-TOO ACRES TR BKee -Too Acres Tract wl #017-101-44 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page Of www.a.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO20314 PID Number: 017-101-44 Name: Kay and Mark Moustakis Wastewater System: ✓Q New El Upgrade Address: 5455 E. 142nd Avenue Anchorage, AK 99516 ABSORPTION FIELD Phone: Numberuf Sedrooma: 3 ❑Deep Trench ld Shallow Trends O Bail ❑ Mound D Other LEGAL DESCRIPTION Soil Rating: 1.z Total Depth from anginal grade: 6 GPDfFIz Ft. Black: Lot: Tract 8 SabdiNsian: Kee -TOO Ades Depth to pipe bottom ham anginal grade: Gravel depth beneath pipe: 7.5 Ft. .5 Ft. Townshp: Range: Sea9an: Fill added above original grade: Gravel Length: 0-1 Ft. 80 Ft. Well: © New ❑ Upgrade Gravel width: Number of lines: Distance between lines: 5 F. 2 >10 Ft Clasaifiraton Fihede. A. B, Ct Total Depth: Cased b: Total absorption area: Pipe Material: Private 158 Ft. 158 Ft. 400 Fe ASTM D3034 PVC Driller Date Drilled: Stade Water Level: Installer Data Installed: Alpine Drilling 118103 84 Ft. Acreage Systems 10!8!2002 Yield. Pump Set at: Casing Height Above Ground: TANK 12 GPM Pt. 2 R. SEPARATION DISTANCES m Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding lublirJPnvate Mammiciurer. padtc From Tank Field Station Tank Seserune Anchorage Tank 1,250 Gal. Material: Number of Comp eftends: we � >100' >1W >100' N/A >26' Steel Two (2) Sedate Water >100' >100' >100' N/A LIFT STATION see Manufacturer, i -°tune >T >1V >5' N/A Gat. 'Pumpan' level at: °Pump oM level at High water alarm at: Foundation >5' >10' >5' WA in. in, in. Pump Make 8 Model Electrical Inspections pertormed by: Curtain Drain None Noted Remarks: BENCH MARK Location and Desedption: BE Comer Front Deck. Assumed Flewfi.n'. 100.0 Fe. Inspections performed by: A. Haraia Dates: 11 10/8/02 2nd 10/8/02 Q'�••. •• S�#� Development Services Department Approval•••:.* iy' �•�.. Conditional Approval Date: ..... �AlIQ1AB 8 AIWEILSON 'ev m.a 81 Reviewed and approved by: 6ate:�Z'a as All" �e •• ,+i��-0FESSt4: 400 taa��� Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Permit Number: SW020314 PID NO.: 017-10144 S 89'57'46"E 280.17' � I I \� I � I A I B S1 70.5' 40.0' I52 12.1' 44.4' Well C4 44.5' SOY C5 82.2'106.8' ® Mi 62.5' 81.9' C6 52.3' 93.1' f C7 87.7' 18.5' 1 M2 68.9' 104.5' SV 48.8' FF $ B O Three / E � Bedroom I E N Home y ° W I O / v Alternate Site I o N 1 U v 7 I ° 0 o 3 E 0 b 0 y C4 a M7 r O SV �_ O cs z C6 ®THS M2 C7 I KEE TOO ACRES SUBDIVISION TRACT B i 27.000 S.F. 10' Telecom and Electrical Easement S 89'57'46"E 280.19' ......... . ' . 49th 00 . ............. ss 00 .`. t d�✓l PLAN AS -BUILT �.� MICHAEL E ANDERSON N0. CE -4381 ;'�•i SCALE V = 40, ♦1 F � ,b -/'/-/w% F,��• Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW020314 PID No. 017-101-44 iF: 98.4 / N UU U) 1,000 Gallon Septic Tank 8/27102 NORTH TRENCH U � F U 8/27/02 SOUTH TRENCH PROFILE AS -BUILT No Scale 91.9 91.9 Mayor Municipality of Anchorage Department of Health and Human Services 825 "t.° Street A§ P.O. Box 196650 Anchorage, Alaska 99519-6650 http:7/www.ci.anchorage.ak.us Permit Number: #SW 020314 Date of Issue: 8-28-02 Parcel Identification Number: 017-101-44 Date Started: 1-5-03 Date Completed: 1-8-03 Is well located at approved permit location? ® Yes ❑ No Legal Description: Kee -Too Acres Tr 8 Property Owner Name & Address: Ptarmigan Const. 1720 E 5976 Ave. Anrhnrarra Alaska 99507 Borehole Data: Depth (ft) Method of Drilling 2 air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness: .250 inches organics & silt 2 4 Diameter: 6 inches Depth: 158 feet gravelly silt silty sandy gravel H2O 4 135 135 156 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet water sand & gravel 156 158 Static water level (from ground level): 84 feet Pumping level: 158 feet after 2 hours pumping 12 gpm Recovery Rate: 12 gpm" Method of Testing: airlift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite #8 Volume: 1 bg Depth: Start 0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property ____..__ _.. a._......n i_•n _.. _i._n . ___.a n_ _ __n i__._.i._r�__. _crr__ia. n rr_____.. rv_.__� __.•..�. +.. �n _�____ _c__.__�..�_.. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Aug 28, 2002 Expiration Date: Aug 28, 2003 Permit Number: SW020314 Parcel ID: 017-101-44 Legal Description: KEE-TOO ACRES TR B Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: KAY & MARK L. MOUSTAKIS Lot Size: 82486 SQ. FT. Owner Address: 5401 EAST 142 ND AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE, AK 99516-4225 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 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 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: Issued By: Date: t "3"l? " d 2� Date: 6 28 Oz Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program s F E r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage-ak.us (907) 343-7904 �! ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-101-4¢ Permit Number SWO20S74 tcnY t MI414h2 1. I1lOGS1Ti4k/i Property owner(s) Ptarmigan Construction Day phone 563.5776 Mailing address (1)1720 E 59th Avenue Anchorage AK 99507 S/T6 00/ 9H 2_ lit wt_,ANGy 99S'It, -4ZZS Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Tract B Kee -Too Acres Subdivsion Legal description (Section, Township & Range) Lot Size 82,486 SF Acres/Sq.Ft. Number of Bedrooms Three (3) THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: J -700 Waiver Fees: Date of Payment: 8' Ze " 01-- Date of Payment: Receipt Number: Z Y790 Receipt Number: (Rev. 12/00) August 28, 2002 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Tract B, Kee -Too Acres Subdivision Well and Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Tract B, Kee -Too Acres intends to construct a three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the new well and septic system and the parameters used in the design. Also identified on the plans are the well location, test hole locations and the locations of the existing wells and systems on adjacent lots. Drainage arrows are also shown and current drainage patterns will be maintained after construction. The test holes placed near the location of the proposed and alternate absorption trenches indicated fairly clean poorly graded gravel and varying amounts of sand and silt and a percolation rate of 1.2 minutes per inch in the accepting layer. This layer was proposing y found e a at Wl etherefore Wac n et Ho I construct two 5'ewidet surface in Test Hole No.b 40' long absorption trenches with 6" effective depth. The distribution piping depth will be 7' below the surface. Total depth of the trench will be 7.5'. The ground surface on the lot slopes as shown on the attached Site Plan with 10% to 12% slopes from northwest to southeast. The new septic tank and absorption trenches will be constructed parallel with the slope in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from the well on the lot. The system will also be constructed a minimum of 100' from any surface water in the area and 10' from the water service line. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Tract B, Kee -Too Acres August 28, 2002 Page Two 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, nn AA /)L41 9 Michael E. Anderson, P.E. Attachments 330.00 mw" Esmt I s" 49 i ALr. 164.93 S89356'4SE'3c�'�j$ 66008 HVL o r,: PoIiC&1fSL E. ANDERSO" 4381 �s® AREA SYSTEM PLAN�FES� SCALE 1"=100'�+�� oz,9 N 89'57'46" E 280.17' "a�J % I 1ti I I I i TRA 0 (82,486 SQ.' FT.) \.�� d00 CD p 1 p / = D Wide rr C7 J Three X/'6" Effec Depth i r - c� Absor on Trenches 1 000 llonrTI ' i : Z�bel Fl S � tte \ tic nk ��� - Va, \ ,m \ \ vC iZ p `• I Alternate I Site 1L t i I i I Proposed \ Well -----[\C. - —'-- ----.------ — ;• 10' TELEC M & ELEC. EASEMENT w a3.a S '57'46'' W 280.19' ire.z wo 0 0 0 EAST 142 nd. AVENUE . ..q. 4 ...... �. SITE P ■ AN � A MICHAE 'ANDERSON W F` YL llll� .� � •• No CE a381 SCALE 1" = 40' .��♦4P�0 Po ..* TRACT B, KEE-TOO ACRES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 3 Bedroom House 5' Wide Trench System Perc. Rate: 1.2 Min./Inch 1,000 -Gallon Septic Tank Application Rate: 1.2 GPD/SF 6" Drain Field Rock 3 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 375 SF of Absorption Area 375 SF/5 LF (Width)` 1(Red. Factor) = 75 LF Trench Length Therefore: Construct Two 5' Wide Absorption Trenches Each 40' in Length For a Total Length of 801. Flow Line Elevation in Trench to be 7' Below Original Ground Surface. Total Depth to be 7.5' Below Existing Ground. A Zabel Flow Splitter Valve Must Be Placed to Assure Even Effluent Flow to Each Trench. Maintain 10' of Separation Between Each Trench. Provide 3' of Cover or Place 2" Insulation and 2" of Cover Over Trenches. 4' of Cover Required Over Septic Tank. _. NOTE: Is - Natural 7' Backfill Gebtextile Fa ric 6" e forated PVC ASTM 6" Drainfield.Rock 5' TYPICAL WIDE TRENCH SECTION of q (NO SCALE) �.�P� ........... �. Grade Area Over Trench to Dram Away. Minimum 6' Separation From Bedrock. 49th Minimum 4' Separation From Groundwater.ow ""' "'' "" Minimum 100' From Wells in the Area. i � MiaiaE E n"oFRson Minimum 10' Separation From Water Service Line. �� ���fr:• No. CE -4381 .,r Municipality of Anchorage Development Services Department/On-Site Water and Wastewater Program 4700 South Bragaw Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: � 1 M! L A� CDPJ s—, /wc;rtoPj DATE PERFORMED: t"- t it 00 Township, Range, Section: LEGAL DESCRIPTION:.7-K � brL SLOPE SITEPLAN DEPTH 1 � ii IIF /11�~I�1 �l'TII' l 2 O� 3 d, 4 �Wtsv 5 / 12 I 6 i My 7 •, 14 de,,fe 15 . o. 16 9 5i�+ COMMENTS WAS GROUND WATER / I ENCOUNTERED? _ , IF YES, AT WHAT DEPTH? I Depth to Water After N "' 1 _ Date: MoMonwN a 10 11 GM Depth to Net 12 �� 13 Drop 14 de,,fe 15 16 OF 44,. p..... • 17 rt.•' L91h 18 i �y J�Sc 0....... b11-HAEL E ANDER3 19 20 •�� ib pRGFFSS0 COMMENTS WAS GROUND WATER / I ENCOUNTERED? _ , IF YES, AT WHAT DEPTH? I Depth to Water After N "' 1 _ Date: MoMonwN a Gross Net Depth to Net Reading Date Time Time Water Drop Zo: SIS .3 t- �•'. - S• I I, PERCOLATION RATE 1.-L' (minuses inch) PERC HOLE DIAMETER i TEST RUN BETWEEN _L_— FT AND 6 FT u so' PM on �c�tc., cA7rba l c {'Yh Ww / w:91L&4 -�7�FRTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: 8 ^ ",,, OZ, ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. U4� Municipality of Anchorage ff..... 9 i ................ .....................; Development Services Department/On-Site Water and Wastewater Program • z : Mic%n : AND-eso� f w� 4700 South Bragaw Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST #F0 PRO F SS PERFORMED FOR: I,� r YAJ "`rte S�� C: -Tl O� DATE PERFORMED: LEGAL DESCRIPTION: ��% 1 AFI% Ca �'� Township, Range, Section: SLOPE t SITE PLAN OEPTH 10 o G 12 Glll�s 13 14 V 15 16 /j 17 Wr' 18 V 19 20 COMMENTS raD WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT � DEPTH? — .Depth to Water MIler Monitoring? Date: Gross Reading Date Time Net Time Depth to Water 2 3 l 6 7 p 8 9 r 10 o G 12 Glll�s 13 14 V 15 16 /j 17 Wr' 18 V 19 20 COMMENTS raD WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT � DEPTH? — .Depth to Water MIler Monitoring? Date: Gross Reading Date Time Net Time Depth to Water Net Drop PERCOLATION RATE < / (minutes/inch) PERC HOLE DIAMETER TEST RUN /1BETWEEN / .� FT AND FT 1 I rat �GuSG /� X0 /Z / A214- e-XrSfs tVIT s -t c✓ / ft I —7 iv - /a. 2 / PERFORMED BY: �-r /1 AL6�_AA (,A I �Y� may.—;,>-L����� J TIFY THAT THIS TEST WAS PERFORMED IN Z, ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DATE ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: TRACT B, KEE-TOO ACRES SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,000 -gallon septic tank at the location shown on the site plan and the construction of two 40' long by 5' wide by 6" effective depth absorption trenches also shown on the Site Plan. The total depth of the trenches will be 7.5' below existing ground and the distribution pipe will be placed at 7' below the surface. A Zabel Flow Splitter Valve must be placed to assure even flow to each trench. All components of the septic tank and absorption trenches must be constructed a minimum of 100' from the well on this and the adjacent lots. A minimum of 4' of fill must be placed atop the septic tank and 3' of fill above the absorption trenches. In lieu of fill 2" of direct bury insulation may be placed with 2' of fill atop the insulation. 2. Construction shall be in accordance with the approved site plan, 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 all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. The 1,000 -gallon septic tank must be procured from an approved septic tank manufacturer and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Tract B, Kee -Too Acres August 28, 2002 Page 2 of 2 6. A foundation cleanout shall_ be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks 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: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Tract B, Kee -Too Acres August 28, 2002 Page 3 of 3 A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes; cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Parcel I.D. Municipality of Anchorage A < On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL 017-101-44 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent Expiration Date: I KEE—TOO ACRES S/D; TRACT B 5455 E. 142ND AVENUE, ANCHORAGE, AK, 99516 MARK MOUSTAKIS Day phone 5455 E. 142ND AVENUE, ANCHORAGE, AK, 99516 MARK MASLEY W/ REMAX/DYNAMIC Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: 907-223-3527 907-727-7653 ICIU4Lil:1111IhM"I1C11hr/_\I:1Ell] 6yYibylN Individual Well Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well LL Community On-site LJ Public Water System Public Seyrer ❑ 4 i Waiver/Variance request for: n/4 FEBI1 CD ^ 2/lih Distance:= Received by: Date:T— COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 15�\p Date of Payment a Receipt Number �d COSA# 0 a1g1 Waiver Fee $ Date of Payment Receipt Number Waiver 9 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l 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. Name of Firm Address GARNESS ENGINEERING GROUP, Ltd. 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineers 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 ofthe system under the conditions encountered at the time of the test, and separefion 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 of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can thercfore 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 authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following Phone 337-6179 OWS%TE NIp,TER AER W ASTEw M PROGRA The Municipality or Anchorage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory IRcv 1V69 _I Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # _of_ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: KEE—TOO ACRES S/D; TRACT B ParcellD: 017-101-44 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1/8/2003 Sanitary seal (Y/N) YES Total depth 158 ft. Cased to 158 ft. FROM WELL LOG Date of test 1/8/2003 Static water level 84 ft. Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 18+ in. AT INSPECTION 1/27/2014 Well production 12 g,p,m, 4.61+ g,p,rn, WATER SAMPLE RESULTS: Coliform O colonies/100 ml. Nitrate 03mg./L. Collected by: GEG, Ltd. Arsenic: L(D ug./L. Date of sample: 1/31/2014 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 1 D/8/2002 Tank size 1250 gal. Number of Compartments E 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 3 Pumperi C 5'2xQ C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 10/8/2002 Soil rating .p.d./ or ft2/bdrm) 1_2 System type DUAL SHALLOW TRENCH Length 40/40 ft. Width 5/5 ft. Gravel below pipe 0.5/0.5 ft, Total depth *7.8 7.2ft. Eff. absorption area 400 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 1 /27/2014 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test **0 in. Water added 920 gal. New depth E in. Elapsed Time: min. Final fluid depth in. Absorption rate >= 450+ g,p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date **MT IN SOUTH TRENCH ONLY EXTENDS 1" BELOW INVERT OF DRAINPIPE. TEST PERFORMED ON NORTH TRENCH ONLY. NORTH MT EXTENDS 4" BELOW INVERT OF DRAINPIPE. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N)— "Pump on" level at in. "Pump off' level at wa er alarm level at Dak+ Cycles tested Meets alarm & circuit requirements? E7 SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 5D'+ 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 10'+ 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 G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date Zll L11�4 . (Rev. 11105) 'Gf.2AVEIL' EXISTING HOUSE TRACT A 17' TRACT B 10' TELECOMM & ELEC. EASEM S 89'57'46" W 280.1 EAST 142nd. AVENUE DK th m IMz w 0 0 .,_"'" ...... Z SLIa) D o N o .; _49TH Q OF E. 142nd. AVENUE TO TRACT A IS REBUILT TO BE WITHIN FLAG OF TRACT A. b) THE EXISTING ENSTAR NATURAL GAS SERVICE LINE IS MOVED . �O ,Mich el Jokelo .' ¢ INTO THE FLAG OF TRACT A. O LS -77 839 ' O WILL c) THE COST OF RELOCATION OF A AND B ABOVE L BE PAID FOR BY THE 0 OWNER(S) OF TRACT A AT THE TIME OF THE RELOCATIONS OR BY THE OWNER(S) OF TRACT B AT THE TIME 'Gf.2AVEIL' EXISTING HOUSE TRACT A 17' TRACT B 10' TELECOMM & ELEC. EASEM S 89'57'46" W 280.1 EAST 142nd. AVENUE DK th m IMz w 0 0 .,_"'" ...... PLAT NOTES: SLIa) 1. A BUILDING PERMIT FOR TRACT B WILL NOT BE ISSUED UNTIL: THE EXISTING GRAVEL DRIVEWAY TH �0 FROM THE RIGHT OF WAY o .; _49TH Q OF E. 142nd. AVENUE TO TRACT A IS REBUILT TO BE WITHIN FLAG OF TRACT A. b) THE EXISTING ENSTAR NATURAL GAS SERVICE LINE IS MOVED . �O ,Mich el Jokelo .' ¢ INTO THE FLAG OF TRACT A. O LS -77 839 ' O WILL c) THE COST OF RELOCATION OF A AND B ABOVE L BE PAID FOR BY THE Opp ......... so OWNER(S) OF TRACT A AT THE TIME OF THE RELOCATIONS OR BY THE OWNER(S) OF TRACT B AT THE TIME dOA� lea sianol°coc ��ppppoo� OF THE RELOCATIONS OR BY THE OWNER(S) OF TRACT A AND B TOGETHER Al THE TIME OF RELOCATIONS. oao[w[o ar: E:CLU40N NOTES It is the owners' responsibility to delemn a -LEGEND: SET FND DAYS a the s tenee of any ¢o menta, COV¢ %o-. or restriction ado 5/8"RR ./CAP* 5/8" RB O with PTARMIGAN CONSTRUCTION wM1lah not .,pear an the r.... ded eubdM.ion plat. NOTE: Under no dlaumet.naes sh.Oldany data hens, be ..ad tar 3.25' ALMON. a .CKUMENT-o construction or for establishing property lines. Hue & TACK FENCE-— CER LANTEChos soldu tth a KTRdANG- CONCRETE Phys cal sun2y of this property as shown on this won8 DECKS- ECKS drawingand that and that the pro,emH ntsan eio Impy tslied CONCRETE -[ an .1. r thepropertylines nl .ch p„ ¢ and no anCmach ASPO.12 0 mURVEY eats exist n not d CRAWL- RAVEL f —1 A 5 — BUILT O: t£GAL DESCRIPTION: SEPnc STANDPIPES- Q wATLx tru- LAND & CONSTRUCTION SU MORS—PLANNER—ENGINEERS 440 WEST BENSON BLVD.103 Ar ANCHORAGE, ALASKA 995D3 'V 07)\,9r,2-5291 TRCT B WJRK ORDER NUMBER: 2002 wre MAR. 13. 003=50' sUira 9l 119 K E E —TOO ACRES ;;