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HomeMy WebLinkAboutGLENN VIEW ESTATES NORTH BLK 1 LT 19Glen View Estates North Block 1 Lot 19 #051-821-31 Municipality of Anchorage Page 1 of 3 Development Services Department Orl Water and Wastewater Program 4700 South Bragaw Street P.O. Box 195650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Numhorr RWfl41S4n -- - ---- flu Number: 051.821.31 Name: MUM Contractin Inc. Wastewater System: New Address: P.O. Box 670495 Chu ink AK 99567 ABSORPTION FIELD Phone. Number M Bedrooms .1236 : 688Four,(4) 5' Wide Trench LEGAL DESCRIPTION So" Refi'g To al Depth from original grade: _. _.:.. _.. Black Lot: subdivision: 1 19 Glenn View Estates North .6 GPD/Ft' Depth to Pipe bottom from anginal grade: 6 Ft. Gravel depth beneath pipe: Township: P Range: Section: 2 Ft. Fill added above anginal grade: 4 Ft. Gravel Length: 0.2 Ft. 90 Ft. Well: Municipal water System Gavel vnd h. Numbero lines: Dis ansa between lines: Classification5 (Private, A, B, C): I owl Depth: Cased to: Ft. Total absorption area 1 Ft. Pipe Material: FL Ft. Driller 900 Ft, ASTM 3034 PVC Data Drilled: Static Water Level: Installer Date nstalled: Ft. MM&M Contracting, Inc. 5/20.21/04 Yield: Pump Set at: Casing eigM Above Ground: GPM Ft. F, TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Holding bhc/Pnvate a From Tankn Tank Sewer Line Anchorage Tank 1250 r Well >200' N/A >25' Steel um ro Pa mens: Two (2) Surface Water >700' WN/AN/A NIA LIFT STATION — NONE ON LOT Loi Line >5' N/A " Gal. FoundaENone N/A umpm eye ump ars Ig eraam : n. n. in. Curtain Noted Pump MakeB Model Elecbipllnsprclions performetl by: Remarks: BENCH MARK Loultion and camp wn: Finished First Floor su ev ion: 100.0 FL Engineer's Stamp ...... �F.... X41 Inspections performed by: T.L. Kimbrough Dates: 1" 5120104 % 49th 0mnt.. nnon no. ... •n..••� tad 5121/04 -� Department of Health and Human Services approval 0.�!.t ......•..� / �• �: MICHAEL E ANDERSON �J Reviewed and approved by:Date: i� •. No. CE -4381 �t =I •♦i (aw. noise) *,,r• 1til "ROFESSO' 0'� Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030510 l Jq) Ott �G0 LOT 19, BLOCK 1 GLENN VIEW ESTATES NORTH SUBDIVISION Four Bedroom Home TH7 MICHAo. cE No. cE.asai pER$oN i; a PLAN AS -BUILT •.,,._ ' ��'��� SCALE 1" = 40' Page 2 of 3 PID No. 051-821-31 18.9' 5.2' 24.6' 17.8' 26.0' 25.1' 28.3' 32.0' rr-4 29.7' 32.9' 32.7' 58.8'58.6'31.8' 58.6' MICHAo. cE No. cE.asai pER$oN i; a PLAN AS -BUILT •.,,._ ' ��'��� SCALE 1" = 40' Page 2 of 3 PID No. 051-821-31 Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW030510 PID No. 051-821-31 97 TBM PROFILE AS -BUILT Scale: 1" = 20' .32' I MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 14,700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-665.0 I SOILS LOG - PERCOLATION TEST DEPTH (feet) 1- 2 - 3 - 4 - 5 - 6 - 7 - 8- 9 - 10- 11- 12- 14 15 16 17- 18- LEGAL DESCRIPTION; L 19, B I, GLENN VIEW ESTATES NORTH S/D PERFORMED FOR` P'IM8M CONTRACTING DATE: 5/20/2004 PROJECT No PARCEL IDi TECHMC T L KIMBROU I .IAN. GH �— TEST HOLE # 2 Type of Test: ® Percolation OG/PT 2% GRAY SILTY -SANDS W/GRAVELS SOME COBBLES TO 10" MEDIUM COMPACTION GM DRY I1 WAS GROUND WATER ENCOUNTERED IF YES @ WHAT DEPTH DEPTH OF WATER AFTER MO DATE OF MO C R iAEL E. ANDERS12N NO. CE -4381 MONITORING NONE � MONITORING 5/30/04 E 2% 1 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH oP WATER' (INCHES) NET DROP (INCHES) 5/20/0° TEST HOLE PRESOAKED PRIOR TO TESTING: 1 8:45 11.0" 2 9:15 30 8.75" 2.25" 3 9:15 12.0" 4 9:45 30 9.93" 2.07" 5 9:45 12.0" 6 10:15 30 10.0" 2" PERCOLATION RATE: 15 (MINANCII) PERC. HOLE DIA. 6 (INCHES)i1 TEST RUN BETWEEN: 4.5 FT. and 5_5 FT. COMMENTS: - NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR, TO TEST: EST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10/21/04 ANDER5OWENO l{ IG ' 4; , ,, P.O. BOX 2407f3 ANCHORAGE; AK 99534 522-7773'.. .,_ MEMORANDUM DATE: October 26, 2004 TO: Julie Makela, P.E. FROM: Mike Anderson, P. E. SUBJECT: Lot 19, Block 1, Glenn View Estates North Subdivision Certificate of Health Authority Approval We have modified the percolation test data to reflect actual conditions, added the cleanout to the surveyor's as -built, paid the septic permit revision fee and made a slight revision to the plan as -built sheet for the subject lot. Please let me know if you have further questions or comments prior to issuing the Certificate of Health Authority Approval for this lot. _�r/ - 606 3E to -,Z`-©� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Braga IV Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 �Z0jaq— l joy -V S/zi / Oc L-- ( o-aA ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Dec 30, 2003 Expiration Date: Dec 29, 2004 Permit Number: SW030510 Legal Description:"Ifenn V7iq § a e prttl'BIOCK p��j' Parcel ID: 051-821.31 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Site Address: Unknown Owner Address: P.O. Box 670495 Lot Size: 40013 SO. FT. Chugiak , AK 99567- Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank Ej 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 65 and the ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification ). 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: r o Date: /L 6 o 0 Municipality of Anchorage • Development Services Department Building Safety Division a 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 PERMIT APPLICATION iiFOR A SINGLE FAMILY DWELLING Parcel I.D. - l _? I Permit Number SW Property owners) MM&M Contracting Day phone 688.1238 Mailing address (1) P.O. Box 670495 Chugiak, AK 99567 WI&g address (2) =3a5 Y1 P ( BtAV8 Zip Code Legal description (Lot, Block & Sub'd.) Lot 19 Block 1 Glenn View Estates North Subdivision Legal description (Section, Township & Range) Lot Size 40.013 Acres/ q.Ft. THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Number of Bedrooms Four (4) ® Well Only ❑ ❑ Water Storage ❑ ❑ Jacuzzi ❑ ❑ Water Softening Unit ❑ 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. w'a....... � — N, up- ty uwi itis ur aumonzea agent) Permit Fees: Waiver Fees: Date of Payment: 72 - T -q -o 3 Receipt Number: `fb 06-j (Rev. 12/001 Date of Payment: Receipt Number: AND:Ef ar t� December 29, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 19, Block 1, Glenn View Estates North Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 19, Block 1, Glenn View Estates North Subdivision intends to construct a four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The subdivision is currently served by a community water system. The attached Site Plan and backup documentation identify the location and configuration of the water service and proposed septic system and alternate site. No conflicts exist between the water service and septic system on this lot and those on adjacent properties. Drainage arrows with representative surface slopes are shown on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. A test hole placed on the lot in the area of the new absorption trench completed by Tobben Spurkland, P.E. indicated silt with sand with a percolation rates of 11 minutes per inch. No groundwater was found in the monitor tube and none was noted during the monitoring period. We are therefore proposing to place a new 1,250 -gallon septic tank along with a 75' long by 5' wide by 4' effective depth absorption trench to collect. and treat the sewage generated in the house. The bottom of the trench will be 6' below the surface. A minimum of 3' of cover will be placed atop the trench and 4' atop the new septic tank. The ground surface on the lot slopes at shallow grades from south to north toward Shadowy Spruce Drive. The absorption trench will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 10' from the water service on the lot and on adjacent lots. It will also be constructed a minimum of Lot 19, Block 1, Glenn View Estates North Subdivision December 29, 2003 Page Two 100' from any surface water in the area. 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. 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, wkd -, E 0"--, Michael E. Anderson, P.E. Attachments 0 MICHAEL E. ANDERSON No. CE -4381 j. 5Q a° 1,250 �1 Gallon Septic Tank 5' 5• ®H1 75' Long x 5' Wide x 4' Effective Depth Absorption Trench Alternate Site �1 �1 LOT 19, BLOCK 1 GLENN VIEW ESTATES NORTH NOTE: No Conflicts With Neighboring Septic SUBDIVISION Systemtemor S Systems or Water Services. J Subdivision is Served by a Community Water System. i ....... •..49,h ........ ... .:.. SITE PLAN m'; MICHAEL E. •. ANDERSONW l No. CE -4381 .'�2�� SCALE 1" = 40' 4r4 FE LOT 19, BLOCK 1, GLENN VIEW ESTATES NORTH SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom House 5' Wide Trench System Perc. Rate: 11 Min./Inch 1,250 Gallon Septic Tank Application Rate: .8 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD/.8 GPD/SF Application Rate) = 750 SF Absorption Area 750 SF/5 LF (Width)' .5 (Reda Facto = 75 LF Trench Length THEREFORE: Construct a 75' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 6' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Natural Backfill 1"6" Geotextile Fabric 6" 4" Perforated PVC (Holes Down) EN 61 TYPICAL 5' WI Drainfield Rock H SECTIOf NOTE: Grade Area Over Trench to Drain Away. g 4L Minimum 6' Separation From Bedrock. �.... ••••49 ......... Minimum 4' Separation From Groundwater. .. Minimum 10' Separation From Water Service Line. MICHAELE ANDERSON Minimum 100' Separation From Surface Water or Streams. *j0iJT., No. CE -4381 ROM,: COUNTRY REALTY PHONE NO. 9076881238 ofAnckorage Dec. 05 2003 10:20AM P1 sundingSa". Division + J U on-site water and Wastewater Program4700 South 8tegaw SLP O. Boz 196650Anchorage:.AK9951"650 www.d.andtordoe.ak.us ..- . .... c-:1 (907)343-7804 f11-35; Soils Log -Percolation Test Performed For; e9LENV I G'W N DRri-I Date Performed: T )'i lom Leoal Description: I-0-1 �z skzg Township. Range. Section: l of (� Slope Site Plan I ' i- \lt� L.n�trq 2AT111 7 10- 17- 12- 13- 14- 15- 16- 17- 18- 15- COPAIAEN T S ML tea. �1Lr `J`r�um � 1zs M� WAS GROUND WATER O ENCOUNTERED? Net Time Depth to Water S IF YES. AT WHAT DEPTH? L Depth to Water Arysr Monitoring? P R E Date: j jAjjC1 7 - Reading Reading Date Gross Time Net Time Depth to Water Net Orop IL.L '11-7107- !Z CS O/ =A5 6 8 'AlfI 01Z3/ i PERCOLATION RATE l { fffam Wmhi PERC HOLE DIAMETER (v 01 TEST RUN BETWEEN '�j SFT AND FT PERFORMED SY: ') , -� i �- CERTIFY THAT THIS TE T w S P'e RFOR+.IED iN ACCOROANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS OATS. DATE: q311 b z. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICA"TIOIVS SUBJECT: LOT 19, BLOCK 1, GLENN VIEW ESTATES NORTH SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 75' long X 5' wide X 4' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 2' below the existing ground surface. Total depth of the trench will be 6' below the existing ground surface. The new septic tank and absorption trench must be placed a minimum of 10' from the water service on this and adjacent lots. 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. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 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. A new 1,250 -gallon septic tank must be procured from an approved source 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. d " Lot 19, Block 1, Glenn View Estates North Subdivision December 29, 2003 Page 2 of 3 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. 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 area 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. m Lot 19, Block 1, Glenn View Estates_ North Subdivision December 29, 2003 Page 3 of 3 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). 5. 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. l ' 1] Municipality of Anchorage • Development Services Department ° Building Safety Division On-Site Water and Wastewater Program , ° CTV 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING `lry �t Parcel I.D. 051-821-31 COSA # R4 V `100r2 0 Expiration Date: :� — C , / O 1. GENERAL INFORMATION Complete legal description Glenn Yew Estates North B1 L19 Location (site address) _ Chugiak. AK 99567.22375 Shadowy Spruce Drive Current Property owner(s) _ Robert T and Sherry F Eubank Day phone _ (907)350.1597 Mailing address 22375 Shadowy Spruce Drive Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ 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 seat 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. Name of Firm Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 102954, Anchorage, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date 2-2-2009 Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & 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 then are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the 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. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: B Original Certificate Date: C1 (Rm 11 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/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Glenn View Estates North 01 L19 Parcel ID: 3 A. WELL DATA Well type AWWU Date completed NA Total depth NA—ft. Date of test Static water level It A. B, or C provide PWSID # AWWU Sanitary seat (Y/N) NA Cased to NA ft. FROM WELL LOG Well production _ WATER SAMPLE RESULT Coliform ug/I B SEPI OLDIN AN 00 mL Nitrate T C/H G T K DATA WellILog(Y/N) NA Wires properly protected (Y/N) NA Casing height (above ground) _I(! A in. I AT INSPECTION mg/L Other colonies/100 mL L Date of sample: _ Collected by: _ Tank Type/Material ANCHORAGE TANK STEEL Date installed 512012004 r Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YM) NA i Date of pumping 12.16.08 Pumper SANITARTY PUMPERS i C. 'ABSORPTION FIELD DATA Date Installed 512012004 Soil rating (g.p.d./ft2 or ftp bdrm) Q BSystem type TRENCH Length 90 ft. Width S ft. Gravel below pipe A ft. Total depth ¢ft. ) Eff. absorption area W& Monitoring tube Y Depression over field N Date of adequacy test 9)30109 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 12 In. Water added IN gal. , New depth 2Q In. Elapsed Time: LOQ min. Final fluid depth n in. Absorption Irate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N ! If yes, give date f Date Installed "Pump on" level at _ in. Datum ---------- E. SEPARATION DISTANCES Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal cont Inrrnent areas "Pump off' IeN Cycles tested FROM WELL ON LOT TO: Manhole/Access (Y/N ig water alarm level at In. Meets alarm & circuit r ntsmt s? On adjacen adjacent lots Public sewer ole/cleanout Holding tank Manure/animal excrete storage areas DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 10+ Absorption field 5+ Water main 100+ Water service line 25+ Surface water 1Vr- -100A- Wells 1noA- Wells on adjacent lots 100+ q11?6.V11 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 100+ Water Service line 25+ Surface water 100+ Driveway, parking/vehicle storage0� + Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and n review of Municipal records that the above systems are in , + conformance with MOA COSA guidelines in effect on this date. i ;even Engineer's Printed Name Steven R. Pannone, P.E. *0 .s r:. 8149 ely No. CC SIa9����, • Date 21212009 h. �.���,�•• COSA Fee $q t) Date of Payment Receipt Number (7 2-. 40 3 77 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number ,hnJuwy Srrv�s yr. ri Ar�ipc� ' t 2 f {i r 49th y Roycrt C. rM tJ � 7'� � Es.•+'f; AS -BUILT 1 hereby certify that 1 have surveyed the following described property; Lor 14, Erioc_({ ( G/annVitwL-tft.f<r Norri ty►J Anchorage Recording Precinct, Alaska, and that the improve. ments situated thereon are within the Property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on 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 *s Indicated hereon. Dated at Eagle River, Alaska this rt -f day of Np ✓ • 200= SCALE. ROBERT C. JOHNSON Registered Land Survevor No. 880 -LS Municipality of Anchorage • -� Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.O. 051-621-31 1. GENERAL INFORMATION LIZ " a - COSA# 01nO701) Expiration Date: 67-30-0-7 Complete legal description trot 19, stock 1, Gen View Estates North Subdivision Location (site address) 22375 Shadowy Spruce Drive Chugtak. AK 99567 Current Property owner(s) Francis and Sylvia Freeland Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 22375 Shadowy Spruce Drive Chugiak, AK 99%7 Unless otherwise requested, COSA w771 be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. • TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System (] Day phone 688-9062 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite 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 Onsite 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, 1 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Mchael E. Anderson, P.E. Phone 522-7773 Date _ `74=6 49th 5. DSD SIGNATUREc�1Qpf� o, cEr� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineets Report Other By: 0z// Z' rel Original Certificate Date: 5-- - 0 -- W Vn rims) Municipality of Anchorage ., Development Services Department BSafety Division onsiteWatater�& wastewaterProgram- 47M Bregaw street P.O. Box 198650 Andorage, AK 99519650 www.munLayonsQe (907) 343-79W CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal nsi w on Lae 1% Blodr 1 • clan View Estates worm SubdNlaim Parcel ID: 051-e21-31 A. WELL DATA `�14..[ai— Date competed — if A• B. or C provide PWSID #— Well Log (Y/N) Sanitary seal (YM) _ Total depth fL Cased to R FROM WELL LOG Date of test Static water level R Well production 9— p.m-WATER SAMPLE RESULTS: Colbform cdonies/10D mL Arsenic: _ mg/I Nitrate mg1L Wires properly protected (YM) Casing height (above ground) in. AT INSPECTION Date of sample: _ Collected by: R 9— p.m- Tank TypelMatertal septws" Date installed 6/2Y20p4 Tank stm 1.2m gal Number of Compartments Two Cleancuts (YM) Y Foundation cleanout (YM) Y Depression over tank (Y/N) N High water alarm (YM) N Date of pumping 5W -W6 Pumper t KAWY Punpers G. ABSORPTION FIELD DATA Date installed 6mrmi 4 Soti rating (g.p.d.W or (tzlbdrm) •e C—'11W Sym type s wise Twich Length tp R Width 5 R Gravel below pipe 4 R Total depth —Ls --R ER absorption area loo fe Monitoring tube Y Depression over field N Date of adequacy test 6231 = Results (Pass/Fail) Pan For Y bedrooms Fluid depth in absorption field before test a in. Water added� gal. New depth o in. Elapsed Time. C min. Final Auld depth G in. Absorption rate >= 6W g.p.d. Airy rejuvenation treatment (past 12 mo.) (Y/N 6 type) If yes. give date D. LIFT STATION Date installed Size in gallons 'Pump on' Level at_ in. 'Pump oft' level at _ in. Datur Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ManhdefAccess (YIN) High water alarm level at Meets alarm & cinnA requiremxds? Septic tankAift station on krt On adjacent kits Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/dearwut Sewer /septic service line Holding tank Animal containment areas Manuretanimal excrete storage areas SEPARATION DISTANCES FROM SEPTIC HOLDING TANK ON LOT TO: Building foundation >6 Property line W Absorption field aT Water main WA Water service line >t0 SLOB ver >1W Wells on adjacent k:ts >20(r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One >1w Building foundation >1(r Water main MIA Water Service One >1e' Surface water >1W Driveway. parkingArotkda storage >V Curtain drain Nana NOW Wells on adjacent kft >2W F. COMMENTS: Lot Lea Served M AMU wsw System. G. ENGINEER'S CERTIFICATION I cervry that I have determined thim9h flea irspectf= and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect an oris date. Engineer's Printed Name Mich" E. Anderson, P.E. Date 6242006 COSA Fee $ i.59 00 Date of Payment & Receipt Number 90 32-1 (rev. 71AX) Waiver Fee $ _ Date of Payment Receipt Number, 49th in. FROM COUNTRY REALTY PHOIE NO. : 9076881238 Oct. 20 2004 10:38AM P2 f..f" - Y1 • • -f .:.... i._ •�. �T; 1. .., s: �=!-:. ^' G • 2a '��j/'OBJ •'. •.> .' . :��''•i:'ti:y.�... Ly it �• �� l•. t••`-^� ti�� + ::^:: ..b•a ate\ ;— :':: ��;�. .�:. .. :4. Ls♦lir ;y _ .._ ,•_.':L: r:' =i •sT i.+l, i.•:. •?•. �• ',—,;'i•' •: ..ter .�tr.'>,' N: i'i:. ,f •yi}.T t�".F„1'•s''a` ;:• :.�::Y*y:"J•:.:9��.%�•5.'w'"•. �'� ._ � � •LS.S- .}] (• .. .•}: 5 .. fY.�.i-'y .:n=v;..,a "a ..t_'. f: -' t"1' l t5e. .. .'• 7: 'sJi. ?T,t,..kf j b '•f. `{ r• � .+rj+'y't �'_�' " t n j•_Yn..I. •'�. 1 Sj: i.v •.µ • .•.: •: •'Ili.. • ;,*.:: � 1'.w . � . a'7: -^!-`.rte,, y.',� 1.. I heieSy ee j that. i k ivt" stay `3 the > oBoivin'g' des z'ied` .. '• , ..LOI r�i i--��•"��`eB IOr:Ii'. �R �^"�'=.• t«.:r •:i� j� j y�i%"Y. - .. � .G�.GNI Y/-Q.1{l C.i4iti fi/er'�tJ �N.r-ti 9p ... 1. • Y_`�. .. •• !T•+�.'�Y...a•¢r77�"IS,-� twr'S7Gf(:, [• .-:...."7+t; '� ,n+. ' • +v�ti • it _ ' .. _ ' .. 1 1'tniage Reasa3at8;.. ` -_Alas .' fld d aftX mpro\'e-v 3�^j e . w a>ZMStif C7 t�1OtOA RLI iWLhRf l Ff?OjsCT� t ind d0 gs,18a k as n t eC t /�improv nksas CaajeQnt Yicreto ettwodr _ r ii t9 om Oh P. y}n. Qu, s aia Shii fhexr }temc ioadwi�•t i aSic td3tfl is �' :triz 'Bnes'ac xAer vist�k osem—ts on sad proper 7-! •;yst C �:isoR,: o �.\ .': fes• -L^.• f'd�v ,atim. .t, r:.._ r..F z.ROBERTiQi{NSOt%,!c�,i,.s. i -:: ��,,,.•�� :fAx B4'.r-.•r,.�,�`�s '• SCAIE:••r •3: .'i.- iatid;5iav arjito8S�-L3i':.. - d R�SIDtRCd. ey .Z►.fi �•_'��'♦�1�'0 ..>�: •.`l;�.flf-O •:.:; L :,.�'.:.n+''•$w�%0056'z:EiCTe $1VeLi.74.i5ka Vic: Mun:cipaliiy of Anchorage • Development Services Department"o- Building Safety Division On -Site Water and Wastewater Program 5 , E r, 4700 South Bragaw St:' P.O. Box 196650 Anchorage, AK 99519-6650 i\ www.ci.anchorage.ak.us \�\) (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 51.821.31 HAA # X405 1 Expiration Date: *J 1. GENERAL INFORMATION Complete legal description Lot 19 Block 1 Glenn Yew Estates North Subdivision Location (site address or directions) 22375 Shadowy Spruce Drive Current Property owner(s) MM&M Contracting Day phone 688.1236 Mailing address P.O. Box 670495 Chu iak AK 99567 Lending agency Day phone Mailing address Real Estate Agent M ilin Address Day phone a 9 - Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer El The Municipality of Anchorage Development. Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 less than 30 days old_ (Certificates may be reissued 1hxl1 er a pA B welleriod of s — a puto one blic watear er _: engineer's yalLQ�raie.�.satupe�.ea._)x�u .�.�+.: x_..•,-...-�..------•--•-- system. The Municipality of Anchorage is not responsible for errors or omissions in the pi 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 Health Authority 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchoraqe, AK 99524 Engineer's Printed Name Michael 8. Anderson P.E. Date 10/21/2004 5. DSD SIGNATURE Approved for --4— bedrooms. Disapproved. Conditional approval for ' bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: (Rev. 12/00) ?: ON-SITE —` WATER AND • r TFIA11{TFIR ' PROGRAM Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Department 6sion 5 a E r iter Program vi.. AK 995 j9 ,6650 m iii %i A 1 ®III�MII� �Y,ukB�a1" `"vaT'ivb`�A"`✓�x` :Si`,w';A i`G Sv:�':s'u';i v) i .. ,. wr ..vmmcvrWlamwrM"vP+'�*�.e $�y.ss pFst4s�rcWMr.pmakAyLti qua ype ererrc e ow pipe' , siotean over f*d tl oecfrop%s , �a�`�" N`ew t7eptFi_ in: �4h.WYa4k:YJ. ».swuibn!*airr. M Ih field inspections and u above systems are in ••• E Waiver Fee $ 7 Date of Payment �7g I/„4 Receipt Number 'U, 0 s a