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THE TABLELANDS BLK 4 LT 17
The Tablelands Block 4 Lot 17 #051-741-48 Municipality of Anchorage °°<r .r Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number:SW040077 PIDNumber.'9 " - 051-_741_41S Name: Troy Davis Homes Wastewater System: 0 New ❑ Upgrade y pg Address: 1451 E. Parks Hwy, Ste 207 ABSORPTION FIELD Phone: 357-9394 Numbera(eecrooms: 4 ❑Deep Trench [3Shallow Trerrtlr E] Bed [j Mound ❑Other Soil Rating: Total Depth from anginal grade: LEGAL DESCRIPTION 0.3 GPD/Ft' 2.84 Ft. Block: Lot: Subd;vlsion: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 4 17 " The Tablelands 2.16 Ft. •68 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 0.78+ Ft. 84 Ft. Well: E]New ❑ Upgrade Gravel width: 24 Number of lines: 4 Distance between lines: 6 Ft. FL Classification (Private, A, B, Cy Total Depth: Cased to: Total absorption area: Pipe Material: community water Fl. FC 2,016 FP I Pvc Driller: Data Drilled: Static Water Level: Installer Data Installed: Roy Brown 10/21/04,10/22/04 FL Yield: Pump Set at. casing Height Above Ground: TANK GPM FL Ft. SEPARATION DISTANCES O Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding ublic(Private Manufacturer. capacity: From Tank Field Station Tank Sewer Line Greer 1,250 Gal. Material: Number of Compartments: Well na na na na na Steel 2 Surface water na na na na LIFT STATION Sae: an acturer: Lot Line 32' 10+' na na Gal. 'Pump on' level at: "Pump ofr level at High water alarm at: Foundation 13' 18' ria. ria In. in. in. Pump Make 8 Modei Etectroal Inspections performed by: curtain Grain ria ria ria ria Remarks: BENCH MARK Location and Description: Datum=Bottom of siding, SW corner of house. Assumed Elevation: 100 Ft En�lgji{���p, OF At,, �S�1, F . �,P`� CO Ir1SpeCt10r1S performed by: Kent Sheets, Mary Shreves, Ak Rim Eng. Dates: tat 10/21/04 *"�� 9TH * 00 .,.... .. .............. •......... .2nd 10/22/04 f �m � . Y.- Zt nt.............. DevelopServices Department Approval i;P : MeShreves % CE 9351 ,•' 5 �z Reviewed and approved t AQQate: jhb5lci, vj'rF • • �0 (Rev. IL00) ',''tt _ V v 1 I I K-,) BIRCH DP. L=135.60'(R) WA__ tri 0. UTILITY / LEGEND: —PEDESTAL (M)=MEASURED DATA TYP. (C)=CALCULA#D DATA WATER (R)=RECORD DATA _\ VALVE NATURAL \ GAS UNDERGROUND \ TWO STORY 26' UTILITIES DWELLING DE K ncnv 01 0 N, 1,250- AL 0 SEPTIC ANK R A - W O C04 T AK TH 2 C0 'P r m 24 84' BED % N ABSORP TE 01 c�P BLOCK 4 00 E OF F J � W ? C01 CO2 CO3 C04 C05 C06 MT1 MT2 p A 16.0 21.0 28.0 27.0 26.7 80.7 35.2 79.8 B 38.8 46.4 55.0 54.5 55.2 -- 63.5 1 "=40'N C 32.6 35.1 38.8 37.0 33.7 64.9 40.3 63.5 `D 'LUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED EMENTSRCOVENANTS, ORORESTRCTIONSAWHICHDDOTNOTEAPPEAREONOTH� RECORDED SUBDIVISION EXISTENCE OF ANY �000DDpp SITE PLAN g� s P.O. BOX 2749 qqo OF A �� AS BUILT C Brat PALMER, ALASKA 99645 (E,.......< P �P°,.• ad ENC EE INC. PHONE: (907)745-0222 S;' q d FAX: (907)746-0222 49TH • • �.�� „ D W.O. 0400124 DATE: 10/25/041SCALE: 1 = 40' 1 FILE: 0400124_WW_2 AS :...........• O pal Mar L Shreves LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, ?Q ff.• CE 9351_� PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASK �Qdd n?ROFESSI�NPd � RECORDED PLATOF RAREE NOTO SHOWN THAN HEREON. THOSE SHOWN ON THE C E ED K �. 1,250—JAL _ SEPTIC rANK FIXED DATUM 100.00ft. 1,250 -GAL SEPTIC TANK 01 0: 3 j C04 TWO STORY DWELLING ECK MT AKTH2l 24 84' BED ABSORP TE SEPTIC SYSTEM PLOT PLAN FINAL GRADE 97.78 ft NATURAL GAS UNDERGROUP UTILITIES 4 FINAL GRADE 97.78 ft. 2" INSULATION 97.00ft. (OVER ALL COMPONENTS) ORIG. GRADE DATUM: BOTTOM OF SIDING, SW CORNER OF HOUSE = 100.00'. GW IN GWMT ON 10/1/04 85.98'. ggooDDDD�q� AS BUILT g[AS P.O. BOX 2749 SEPTIC RIM PALMER, ALASKA 99645 �p ,.• 9s�DD ENG EE INC. PHONE: (907)745-0222 ' 9 �� FAX: (907)746-0222 49THe.eee; �D W.O. 0400124 DATE: 10 25 04 SCALE: 1" = 30' 1 FILE: . er...eae.e. s......Q L. Shreves LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, CE 9351 ; vtid PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, •e....e•°°°e��d EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE kOFESSi�?�db`' RECORDED PLAT ARE NOT SHOWN HEREON. m BED DETAIL Nota 8: R a mldmum of hbet of earth cover pas l®t) ovc abwrpgm treaob. One mob of Neetvu %wu fO 0, mal be enbstituted for ane foot of earth Dover up to a medmum of two inches of meWeHon. ABSORPTION BED PLAN VIEW 61M. - 07.78' °°� msWetJm cover S BED SECTION n pmteraw plc hall - SECTION X—X removeable EH -.-P prom" surface MONITOR TUBE DETAIL 4ASK4 P.O. BOX 2749 �p�� •OF A�q %a DETAILS ALASKA 9645 ENC EEM ,INC. PALM ER, (907)7459 0222 c¢9TH ° � FAX: (907)746-0222 �.......... A...`....... . �9 W.O. 0400124 DATE: 10/25/04 SCALE: nts Fu Led rO :°° D L. Shreves °° �p LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, 9351 °evd PIAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK d EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE FESS RECORDED PLAT ARE NOT SHOWN HEREON. I BED SECTION n pmteraw plc hall - SECTION X—X removeable EH -.-P prom" surface MONITOR TUBE DETAIL 4ASK4 P.O. BOX 2749 �p�� •OF A�q %a DETAILS ALASKA 9645 ENC EEM ,INC. PALM ER, (907)7459 0222 c¢9TH ° � FAX: (907)746-0222 �.......... A...`....... . �9 W.O. 0400124 DATE: 10/25/04 SCALE: nts Fu Led rO :°° D L. Shreves °° �p LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, 9351 °evd PIAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK d EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE FESS RECORDED PLAT ARE NOT SHOWN HEREON. a MUNICIPALITY OF ANCHORAGE Development Services Department 1 On-Site4700 South Wastewater Program 4700 South Bragaw Street I P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial -rnr_ 7114 di v Permit Number: SW04007 Legal Description: GLENN VIEW ESTATES NORTH TRF Design Engineer: 0032 Alaska Rim Engineering Owner Name: TROY DAVIS HOMES Date Issued: Apr 23, 2004 Expiration Date: Apr 23, 2005 Oft • -)yl -143 Parcel ID: %-80'1'- Site Address: 23210 WHISPERING BIRCH DRIVE Lot Size: 41040 SQ. FT. Owner Address: NHN WHISPERING BIRCH DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑✓1 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. /UnT1c JP/FA-5E SE& 4FrF_2 P`9 1-1=-'o MRr G, ?oay Fort yrnENOEp Z>e-V y. Iu�ia Plao+ao� s �wk AG -1-V6.,4- kgeSfoLk Ssoc c ,.xdad c oma+ n. C coo .doh bP /,tj>- � o�Q') d. Saco Received By: Date: t� 1 Issued By: ` Date: /�� �'`y- Municipality of Anchorage .� Development Services Department Building Safety Division f On -Site Water and Wastewater Program A F ' , 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www,muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. )Fy ) ' �/ — t 0 S t — "7z41. —4k?-� Permit Number SWO40077 Property owner(s) Troy Davis Homes Day phone 357-9394 Mailing address (1) 1451 E. Parks Highway, Suite 207 Mailing address (2) Wasilla, AK Zip Code 99654 Legal description (Lot, Block & Sub'd.) Lot 17, Block 4, The Tablelands Subdivision Legal description (Section, Township & Range) Lot Size 41,040 soft Acres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only El 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) Date of Payment: Receipt Number: (Rev. 12/00) 6_1q10 N w/;r3'7 Date of Payment: Receipt Number: . ��aslea �'tngiuteehiutg, gUtC. Phone (907) 745-0222 - P.O. Box 2749 Fax (907) 746-0222 __ .. ..... Palmer, Alaska 99645 akrirn @ rogershsa.com' - April 7, 2004 Mr. Dan Roth Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 1966,50, Anchorage, AK 99519-0650 RE: Lot 17, Block 4, The Tablelands Subdivision On -Site Sewer Permit Application AK. Rim Engineering Ref. No. 04-00124 Dear Mr. Roth:. _. The owner of the_above referenced lot is proposing to construct a 4 -bedroom single family dwelling (see attached Plot Plan) The proposed dwelling -is to be served by a community water system and a private septic sysfem. With this letter we'are requesting plan review and_a permit to install an onsiteseptic system to serve the proposed development. DESIGN SUMMARY Soils A test hole was "excavated,on February 25, 2004, and logged by our firm. A monitor tube was installed at that time A percolation test was conducted in the same location on the property on February 26, 2004. The proposed drainfield will be designed around the 30 - feet radius of the test hole. The attached Soils Log — Percolation Test form shows the , -�.w- approximate locafion of the test hole, labeled fiH 1 The soils were rated 1n the field as SP -SM. sand with silt and gravel. The percolation test indicates a soil percolation rate of inutes per inch which translates to a wastewater application rate of 0.45 gpd/sgft. Trench Design The following is a summary of the proposed design of the trench SAS.: Percolation rate: 40 minutes/inch , Soil application rate: 0 45 gj3sgft .r�� "` Engineers • Planners • Surveyors Mr. Dan Roth, MOA Page 2 April 7, 2004 Number of bedrooms , .... 4._ ... ... ..... .. .... . _ �_,_,. ,-, .,...-.. Daily wastewater flow' 600 gpd brainfield: 5 -wide type drainfield Septic tank: 1,250 gallons Minimum absorption area: _ 1,334 sgft Total depth (max): 7 ft Effective, depth: 4 ft _ Width: 5 ft Reduction factor: 0.50 Minimum length: 134 ft (2 67 ft.,trenches) Effective absorption area: 1,340sgft Topography The topography of this lot is relatively flat throughout the north half of the lot then sloping down steeply on the southhalf. The�e.is. equate usable area for an onsiteseptic . system and,replacement system. Surface Water There are no surface wateMwithin 100 feet of the proposed septic system Surrounding Properties This'property and the parent subdivision will be served by community water system. We are unaware of any adverse impacts this installation would have; on,adiacent wells or septic systems. Development on this lot will not preclude development of wells and. septic systems Ion neighboring lots in the future. . If you have any questions regarding this report or its recommendations, please feel free to contact me. Sincerely, w ALASKA RIM ENGINEERING, INC. � QF A�As�',' * TH '..., i Mary L. Shreves (� Professional'Engineer Mary shreves CC: Troy Davis Homes �, cs 9351 `y� FA AK Rim Engineering File No. 04-00124 ��$it, PROFES504 ' Attachments...,,_ , ,. , • MOA On -Site. Sewer/ Well Permit Application Form • MOA Soils Log — Percolation Test Form • Septic System Plot Plan (3 pages) PERMIT NUMBER PID NUMBER 154.' / BIRCH DR. 153.22 �EpgEMEiT \ 9.73 L=1 35.60' 15' �r�? SET PK _ R=53 00 — TYP. LO\ 2� UI DING SETBA PROPOSED 11 \ RIVEWAY .28f 25'1' R A ENT SYSTEM \ PROPOSED �1 ul ONE STORY � INSTALL 1250 GAL. \ DWELLING SEPTIC TANK BOCK 4 ZI 4 e ly ^, 151.25 LOT 16 0 �1 2 X 67 X 5 WIDE 1N N, _ I ALL ZABLE A ( W 1, 1 '6% OW SPU -TER LP OR EQUAL I O) W 1 1 O O: ICb r_ 3L.ufF 1 � LOT417.F. LOT 18 1 \ VOno,hk 1 1 \ � _ _ 10' BUILDING SETBACK _ SB5'20'42"W 01.12 =5 0' _ _ — 01.12 146.78' 01.72== TRACT B-2 EXCLUSION DING0 GRADE REIATIVEHTO FINISSHED IGRADEFANDEUTTILITIES CONNECTIONS• AND RIOR TO DETERMINE TITHE EXVERIFY ISTENCE E 0 PROPOSED q��000DDp� SITE PLAN gLAslf P.O. BOX 2749 D RIM PALMER, ALASKA 99645 PSE •OF q�qs��� ENCEE INC. PHONE: (907)745-0222 c' �9 dd FAX: (907)746-0222 'tee° 49TH***d „ e d W.O. 0400124 DATE: 4Z7/04 SCALE: 1 = 50' FILE: 0400124 ................... • 0. ........... e... � L. Shreves.'moo LOT 17, BLOCK 4, TABLELANDS SUBDIVISION, CE 9351 . °�ti�d PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALAS EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE °RpFESS1�NPoc�' RECORDED PLAT ARE NOT SHOWN HEREON. PERMIT NUMBER 1"=30' 125' t I �1 PROPOSED 1 ONE STORY j 1 DWELLING O G '� zl N �1 1 2 O 4 �0 1 A& 6 7 1 1 1 67' X 5' WIDE SEPTIC SYSTEM PLOT PLAN al Pe *%t PID NUMBER 1� IG to INSTALL I (1250 GAL. SEPTIC TANK ALL ZABLE �O )W SPLITER _p OR EQUAL 1.0) W 1 O 6? 1 .OV nMorpHm SEPTIC SYSTEM PROFILE SEPTICas P.O. BOX 2749 q�0000pp4D >> A<,qf�D RtM PALMER, ALASKA 99645 Q(E.�F ENC EE INC. PHONE: (907)745-0222 d FAX: (907)746-0222 49TH**' 9TH :•* �D W.O. 0400124 DATE: 4/7/04 SCALE: 1 ° = 30' 1 FILE: 0400124 • . . ). . p Mar L. Shrev/es d LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, 3QrfrF� 9... °e vti�cd No. 00OF 2RECONRD PEAR CHOOTHERGE RTHON NG , ANCHORAGEALASKA ° ..CE EMEN SLAT THOSSE rSHOWNN ON THE, QQ %'RDFHSIONPdd�' dd�pppo�d RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 2 OF 3 PERMIT NUMBER beta➢ mou➢m tube at and of trench WIDE DRAINFIELD Nota t: fuatall a pp[or ted Pvc laud PLAN VIEW (w thb o.01 foot of .ema eisrotiw) PID NUMBER r 5' t n pe matad PVC hob mdentatlm (holm dawn) SECTION X -X 49TH` e>r (( Mary L. Shreves e ff°,° CE 9351 V1�d IQnFrp �_ PR.........k*I � SITE PLANALASK P.O. BOX 2749 #RIM PALMER, ALASKA 99645 ENG EE INC. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400124 DATE: 4/7/04 1 SCALE: nts I FILE: 0400124 LOT 17, BLOCK 4, TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. and aurfaoa ELEV. 48.0' mmoveeWe � tl 9 umd oomr �mlatloq Z pumd surfam permaabb yy zedm 9a i // ELEV. 48.01 1 ease•••:••°,0. .Oe•.••4a G06-po PVC ahma L .ti:••;,,,}•. rd, rook holo down}::v✓,.}a::°.•.:• PVC drab w/ ooupftg 0aewm x;;.e�°;a,.}.Kpaffeetfi 0 9/Y09' dN�>evM o 0 rooko ..•....... OQ, 0 0 5.:r,:},,;e;•}:•; {' PVC eatoragd 0 c0 �00 •,°•;}8;e:e �eY: •.{:;:;: 0 b aawm rook �� 0 0 ^:?? =16C I^•Y'er°:e ELEV. 42.0' 0 2220 TRENCH DETAIL md.turhed KK ° eerb NOW 2: Plam a mbimum of 4-faat of eereh cover T �°� Lr egWve mt) oven aMorptlm trench. Ona 'Imnlloam 01 $ ok of Naatara ➢° (m aqJ mq m_ ha en for feet of earth aorar .y,.—®a� m up b a: merlmum of two Bohm of hundatlm. a mead f 0 p Nob Nasasvetbn aha➢ b more 7 fest. ELEV. 38.0 4: and Nota 4: Notot nand m b b Y� o0 BOTTOM TH c MONITOR TUBE TRENCH SECTION DETAIL 49TH` e>r (( Mary L. Shreves e ff°,° CE 9351 V1�d IQnFrp �_ PR.........k*I � SITE PLANALASK P.O. BOX 2749 #RIM PALMER, ALASKA 99645 ENG EE INC. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400124 DATE: 4/7/04 1 SCALE: nts I FILE: 0400124 LOT 17, BLOCK 4, TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. 'r4 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.muni.org/onsite (907)343-7904 Soils Log - Percolation Test Performed For: Troy Davis Homes Date Performed: Legal Description: Lot 17, Block 4, The Tablelands Subdivision Township, Range, Section: )}14TH -j Depth 1im1nm 1 1 1 15- 16 - r %/q 4 WI hili- ksgvvel� r 6Ooi-t rej cold l e5, mpd � deM�O / y6iyw+� a t wtp�ih�- WAS GROUND WATER ENCOUNTERED? Yes IF YES, AT WHAT DEPTH? 13 ft rt,, Depth to Water After �f I earth W Ve' Monitoring? 13 ft 6CA-0+-ea a 0810 h ('Ql7/ / Date: 2/26/04 devtye, r�,�h+ CSM) To s L 0 P E Site Plan 116 Reading Date Gross Time Net Time Depth to Water Net Drop 1 2/26/04 1400 10 min 9 in. 8/16 in. 2 — 1411 10 814/16 6/16 3 1422 10 812/16 4/16 4 1433 10 812/16 4/16 5 1444 10 " 812/16 4/16 6 1455 10 812/16 4/16 PERCOLATION RATE 40 (minutWwh) PERC HOLE DIAMETER filo. `p TES7 RUN BETWEEN 4.5 FT AND 5.0 Fr COMMENTS %'r'i%�It_ '7 1'1DW1'S PERFORMED BY: Kent Sheets, AK Rim Engineering, Inc. I Mary L. Shreves, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3/11/04 Developrr On -Site' o -n 0- 4f on it ancnorage ices Department *AI'l 1asfewater Program3ragaw St.rage, AK 96516 6650 !rage.ak_ds ' X904 __ .. _._.. . . . ' +a �Ilowing reasons: "'' test information needed. iistances/dimensions missing percolation and v�ater moni#onng tests not 'shown deep for soils information sutimitte� _ nk or,ffelti.� (-Apas[ea I�twt Phone (907):745-0222 - P.O. Box 2749 ". Fax (907) 746-0222 Palmer Alaska 99645 akdm@rogershsa.com - May B, 2004 _ Mc Dan Roth Municipality of Anchorage Building Safety Division On -Site Water and,Wastewater Program PO Box_196650 r,n Ancnara a, A( Q9E .9-CG5'0 RE: Lot 17, Block 4, The Tablelands Subdivision, On -Site Sewer Permit Application — Amendment to Original Submittal AK. Rim Engineering Ref. No: 04-00124 Dear Mr. Roth: Attached is an amended septic system plot plan for this project. The homeowner chose , to change the home plan and so these drawings reflect change and the subsequent change to the septic system layout: There are no other_changes to our original submittal. If you have any questions regarding this report or, its recommendations, please feel free to, contact me. ' Sincerely, `��is�tttlle ALASKA RIM ENGINEERING, INC. OF AtglI#.*, THk :. .. Mary L. Shreves, Professional Engineer Mary . shm s '�0.. w. I�c•. Cf 9351 CC: AK RimTroy Engirieee ng File No. 04-00124 vis Homs'!�� Bt° ••oess�o I Pq N Attachments' • Plot Plan (2pages) Engineers • Planners Surveyors PERMIT NUMBER BIRCH DR. JAD L=135..60' -1-R-R \ v LOT 18 =50'- 02 OF U pD *S "49TH/ e9 o. eee........... O Pass aO.e DING SETBACK._ - J w 1 PID NUMBER 1154 i 1 \31 9�� E-S��,ENTj \ SET PK \ TYP. LO J \ C \ r `y BLOCK 4 ,- X1051 LOT 16 OC' O W �1 l 1� W APPROX. EDGE OF SLOPE 1 41,04 S.F. LOT 17 1 � I L 10' BUILDING SETBACK _ 85'20'42"W SITE PLAN S •- 01 146.78' TRACT B-2 NER OR BUILDER, PRIOR TO CONSTRUCTION TO VERIFY PROPOSED ITIES CONNECTIONS, AND TO DETERMINE THS EXISTENCE OF ANY OT APPEAR ON THE RECORDED SUBDIVISION PIAT. AS P.O. BOX 2749 srar PALMER, ALASKA 99645 E INC. PHONE: (907)745-0222 FAX: (907)746-0222 ATE: 5/6/04 1 SCALE. 1 " = 50' FILE: 0400124_WW 6.W ........... : ... L. Shreves LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, 9351 PLAT PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA es EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE IFESRECORDED PLAT ARE NOT SHOWN HEREON. �pppod SHEET S OF 3 �1O j INSTALL 11 ^ JSEPTIC GAL. TANK INSTALL ZABLE FLOW SPLITER OR EQUAL \ AMENDED: 5, \ v LOT 18 =50'- 02 OF U pD *S "49TH/ e9 o. eee........... O Pass aO.e DING SETBACK._ - J w 1 PID NUMBER 1154 i 1 \31 9�� E-S��,ENTj \ SET PK \ TYP. LO J \ C \ r `y BLOCK 4 ,- X1051 LOT 16 OC' O W �1 l 1� W APPROX. EDGE OF SLOPE 1 41,04 S.F. LOT 17 1 � I L 10' BUILDING SETBACK _ 85'20'42"W SITE PLAN S •- 01 146.78' TRACT B-2 NER OR BUILDER, PRIOR TO CONSTRUCTION TO VERIFY PROPOSED ITIES CONNECTIONS, AND TO DETERMINE THS EXISTENCE OF ANY OT APPEAR ON THE RECORDED SUBDIVISION PIAT. AS P.O. BOX 2749 srar PALMER, ALASKA 99645 E INC. PHONE: (907)745-0222 FAX: (907)746-0222 ATE: 5/6/04 1 SCALE. 1 " = 50' FILE: 0400124_WW 6.W ........... : ... L. Shreves LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, 9351 PLAT PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA es EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE IFESRECORDED PLAT ARE NOT SHOWN HEREON. �pppod SHEET S OF 3 PERMIT NUMBER N PID NUMBER T. 0 K TH 1 INSTALL C967' GAL. 1 2 © 4 SEPTIC TANK INSTALL ZABLE FLOW SPLITER 1 OR EQUAL AMENDED: 5/6/04 1"=30' trr 49TH ..:.•..n........... a ... l..:.. Mary E. Shreves CE 9351 �� PROFESSl�N?� APPROX. EDGE OF SL SEPTIC SYSTEM PLOT PLAN Dapped etaaaoaL dblp=de ut .ou sbsorptlon SEPTIC SYSTEM PROFILE SEPTIC X P.O. BOX 2749 RIM PALMER, ALASKA 99645 ENG EE , INC. PHONE: (907)745-0222 FAX: (907)746-0222 V.O. 0400124 1 DATE: 5/6/04 SCALE: 1" = 30' 1 FI VlN 1 LOT 17, BLOCK 4, THE TABLELANDS SUBDMSION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. ��aslea , Tim► u�giuteen��g, 9ne. Phone (967)745-0222 P.O. Box 2749 _. Fax (907j746-0222 -- Palmer, Alaska 99645 akrim @ rogershsa:com October.5, 2004 Ms. Julie Makela Municipality'of Anchorage Development Service Department Buildind"'Sa '-D' vision On -Site Water and Wastewater, Program PO Box `1 66650 " Anchorage, AK 99519-6650 RE: Lot 17, Block 4, The Tablelands Subdivision Amended On -Site Sewer Permit Application (2nd amended application) AK. Rim Engineering Ref. No. 04-00124 Dear Ms. Makela: Attached is the amended septic system site plan for this project. A groundwater monitor tube (GWMT) was installed on this lot on 8/13J04,_ Qn_October 1, M 4, fhe monitort"uba " was'probed and groundwater was detected at 11,8 feet_below ground surface. Bed Design The following is a summary of the proposed design of the bed SAS: Percolation rate,(AKTH#1): 40 minutes/inch Soil ap"plication rate'(bed): ' 0 3 gpd/sgft - Daily Number bedroo4 ms, ". � y tewater flow: 60O gpd Drainfleld: . _bed Septic tank: 1,250 gallons " Minimum absorption area: 2,000 sgft Total depth (max): 7 ft Area: 24 ft x84 ft Effective absorption area: " 2,016 sgft A percolation test wilt_be conducted at the time of excavation in the proposed area of the replacement bed:," It appears that avanance will have to be obtained for the setback from the lot line to the edge ofthe fep1acement bed. Engineers Planners Surveyors Ms. Julie Makela, MOA `Page 2 October 5 2004 If you have any questions regarding this report or its recommendatwns please feel free, to contact me„ -I Sincerely, ALASKA RIM ENGINEERING, INC. OF AC�S.�f����I Mary L. Shreves Professional Engineer CC: Troy Davis Homes �9� ' Mary: snreves AK Rim Engineering File No. 04-00124 i�� �� dpF'•.�� CE 9351 •'� 6�wS Attachments: .:. �� �Pa • Septic System Plot Plan (2 pages) .a 3w Im 1 "=40' 49TH P s4•1°1°••°°•°°••° 1,250 -JAL _ SEPTIC TANK 0 E TWO STORY DWELLING TH 1 SITE PLAN A`A iter ENGt:# C06.c MT2• i !J PMT 'X84' BED RPTION S E�O� OF g��FF �N BUILDER, PRIOR PROPOSED NECIONSAD DETERMINE EXISTENCE OF ANY 4R ON TH( RECORDED SUBDIVISION PLAT. P.O. BOX 2749 PALMER, ALASKA 99645 INC. PHONE: (907)745-0222 FAX: (907)746-0222 )/5/04 1 SCALE: 1 " = 40' 1 FILE: 04001 za_ww_2 dus a.°•eee •.eG Mary .°Shreves �d LOT 17, BLOCK 4, THE TABLELANDS SUBDMSION, CE 9351 vd PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALA Ela EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE a °PkUFESSI�NPdd" RECORDED PLAT ARE NOT SHOWN HEREON. �d000000d maulatim If used sea Nota S m BED DETAIL Note E: PLoe a minimum m hfeet of earth cover (ar '11geet) aver aheorptim trench. one Inch of weataa T••••v••• B• mal be anl.acutod far ono feet of= carer up to a maximum of two Each" of toaulattou. Note O: Yadmum depth of ssoevatton 7' HOS... *; 49TH lk °.* F OMar . L. Shreves .° q s,•, " 9351 -.-*, , m ABSORPTION BED PLAN VIEW d wines El". - GBGBNB SURFACE earth 00V6r no awd earth s °h EM. 7' BGS undbturbed earth grtseand htEh . -t1.8' arsunduater HG9 c BED SECTION n perforated PVC h=do'A"r SECTION X—X 0 IIII'll mll �` MONITOR TUBE DETAIL 4As P.O. BOX 2749 DETAILS 9645 ENG%E25 INC. PHONE: (907)745PALMER, ALASKA 90222 FAX: (907)746-0222 :ed LOT 17, BLOCK 4, THE TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. Municipality of Anchorage INt:t 5'r r y/ Development Services Department / Building Safety Division*; 4 TH �* On -Site Water and Wastewater Program """ " ""' ' • . -�.t ... ..,.... 4700 South Bragaw St. /..................... .......:..1............... P.O. Box 196650 Anchorage, AK 99519-6650ary Shrevea • �„ gp7u9g3�7gpghe /�rP CE 9351 �'4aS Soils Log(- Percolation Test /��t11 pROFESS\oN������� Performed For. Troy Davis Homes Date Performed: 10/6//04 Legal Description: Lot 17, Block 4, The Tablelands Township, Range, Section: a Depth 2- -reri4- Date: Reading Date Gross Time WAS GROUND WATER Depth to Water 9- 1 10/6/04 ENCOUNTERED? NO 30 min. 7-1/21n. 2 — S t0- 7-1/4 in. IF YES, AT WHAT DEPTH? L 1623 -- 7-1/4 in. Depth to Water After p 11- Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 1 10/6/04 1521 30 min. 7-1/21n. 2 — 1552 — 7-1/4 in. 3 --- 1623 -- 7-1/4 in. 1-1/4 in. PERCOLATION RATE 24 (minMoAnch) PERO HOLE DIAMETER - a mebae " TESTRUNBETWEEN 3.0 FT AND 3.5 Fr COMMENTS Percolation Test Only Presoak 4 hours PERFORMED BY: Mary L. Shreves, Alk Rim Engineedng, Inc. I Mary L. Shreves, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN -EFFECT ON THIS 6ATE. DATE: 10/25/04 OF AtgS!/4 Municipality of Anchorage s ENG EALj Development Services Department *t4 1.H Building Safety Division .� On -Site Water and Wastewater Program 4700 South Bragaw St. ¢ P.O. Box 196650 Anchorage, AK 99519-6650 ��rn Mary . Shreves www.muni.org/onsite 10I/csj�'., CE 9351 (907) 343-7904 + PROFESS\ON:`��` Performed For: Legal Description: 1- 2- 3- 11 Depth Soils Log - Percolation Test 411111%ml Troy Davis Homes Date Performed: 8/13/04 Township, Range, Section: Site Plan`s �&w L II,8' 15- -W ykl I- 16- 17- 18- 19- WAS - 16 17- 18- 19 - WAS GROUND WATER Date Gross Time ENCOUNTERED? Yes Net Drop s IF YES, AT WHAT DEPTH? L Depth to Water After j / o P Monitoring? / E Date: / `o Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutWncN FERC HOLE DIAMETER TEST RUN BETWEEN Fr AND Fr COMMENTS Installation of groundwater monitor tube(GWMT). PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage _C�1.W_NGINEEXS SETN�l9;..' Development Services Department*. ;Building 4gTH................ Safety Division On-Site Water and Wastewater Program _ 1. 4700 South Bragaw St. Q% • P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite �'pR, 1 Mary „Shreves �j Cis �•. • ` CE 9351 : �'��: Soils Log 90Percolation Test ������` �� j. ROFESS00MIMI- Performed For: Troy Davis Homes Date Performed: 8/13/04 Legal Description: Lot 6, Block 8, The Tablelands. Township, Range, Section: 13- 14- 15- 16- 17- 18- 19- 20- r GW(�-& '?r0tp, WAS GROUND WATER ENCOUNTERED? Yes s IF YES, AT WHAT DEPTH? L 0 Depth to Water After !z/ni P Monitoring? a lUrr' E Date: Plan &'"YDt Reading Date Gross Time Net Time .Depth to Water NetDrop PERCOLATION RATE (minutas(nch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS Installation of groundwater monftor tube(GWMT). PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE ;ft Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-741-48 1. GENERAL INFORMATION Expiration Date: =2C�r2-02/ Complete legal description The Tablelands Subdivision 134 L17 Location (site address) 23302 Whispering Birch Drive, Chugiak, Alaska 99567 Current property owner(s) Bryan & Kim Majeske Day phone Mailing address Same as above Real estate agent 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: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System n Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6-5b (41L S_b Date of Payment Jrl�?j�U�n Receipt Number COSA # (35C -Q61 -11 -15 - Waiver 5C-Q6I-11-1J- Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. _ OF A/_gS1�) 6. DSD SIGNATURE """' System #1 Approved for bedroomss'teven R. ' ' nncme ''E 8149 System #2 Approved for bedrooms"N"� , Disapproved lt���` Ulf ~ Conditional approval for bedrooms, with the following stipulations: ppI yl ATER nr, By: � ti-- Original Certificate Date: l��)f)11111t?�l.t`� The Municipality of Anchorage Development 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other _ COSA A t. ; e is Y l Legal Description: The Tablelands 134 L17 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments Public water B. TANK DATA Age of tank(s) 16 years Tank type/material Steel Measured operating fluid level in septic tank I ❑® Standpipes/foundation cleanout per record drawing Date of pumping 5/29/2020 D. ABSORPTION FIELD DATA Seepage Bed Which system tested (date installed) 10/04 © ALL standpipes present per record drawing Total measured depth from grade 3.3 ft (max) Measured depth to pipe invert from grade 2.83 ft (min) ❑ N/A — pressurized field 5-9� Monitor tubes go to bottom of effective. If not, state depth into effective R Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: 2" insulation over all components COSA Checklist yellow sheet Parcel ID: 051-741-48 Structure served by this system 1 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date .512112020 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 5/0 in Water added 600 gal New depth 5/3 in Elapsed time 80 min Final fluid depth 5/0 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) No If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' El Yes Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft 0 Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10' Animal Containment > 50' 0 Yes if No ft 0 Yes if No ft [f✓ Yes if No ft Water Service Line > 10' M Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' El Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' 21 Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' [f✓ Yes if No ft Water Service Line > 10' M Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l 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. COSA Checklist yellow sheet C� OF. AC A140 Ts .Z�K. \.. .,even F;. PDnnorae • Cc 814 z�a�vy Municipality of Anchorage v�GE a� < Development Services Department a Building Safety Division 4 On -Site Water and Wastewater Program S A E TY 4700 Elmore 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.D. _ COSA# �c`�'Ci21 1 oZ 6 5t `fir Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 17, Block 4. The Tablelands Subdivision Location (site address) 23302 Whispering Birch Drive, Chugiak, Alaska 99567 Current Property owner(s) Spencer & Rosalee Curtis Day phone(907) 688-0794 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 23302 Whispering Birch Drive Chuaiak Alaska 99567 Day phone Lynda Locke R Re/Max DynamicDayphone(907) 232-1.012 892 E. USA Circle, Suite #100, Wasilla, Alaska. 99654 Unless otherwise requested, COSA will be held by DSO forpickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site lid Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of -On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent, professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my. investigation, based on procedures outlined in the Certificate of 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 Pinard Engineering Phone (907) 357-3647 Address PO Box 871347 hfasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard, P. E. C 5. DSD SIGNATURE , r! Approved for _ bedrooms. Disapproved, Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By:Original Certificate Date:_ — 2 (Rev. ii/05) Municipality of Anchorage • "� Development Services Department Y. Building Safety Division On -Site Water & Wastewater Program A £ T Y 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 17, Block 4, The Tablelands Subd. Parcel ID: OQ- 7 V1—'/J90 A. WELL DATA Well type Public Date completed Total depth ft. If A, B, or C provide PWS ID # _ Well Log (Y/N) Sanitary seal (Y/N) Cased to ft. FROM WELL LOG Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Collected by: Arsenic: _ ug/L date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Dateinstalled 10/22/04 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 (Y/N) NA Date of pumping 6/8/11 Pumper Sanitary Pampers C. ABSORPTION FIELD DATA Date installed 10/22/04 Soil rating (g.p.d./ft2 orth2d� 0.3 System type Seepage Bed Length 84 ft. Width 24 ft. Gravel below pipe 0.65 ft. Total depth 2_84t. Eff. absorption area?016 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4/10/12 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 3. 5 in. Water added 600gal. New depth_ in. Elapsed Time: 50 min. Final fluid depth3. 5 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) None known If yes, give date D. LIFT STATION NA Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off' level at —in. Cycles tested Manhole/Access (Y/N) High water alarm level Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: NA Septic tank/lift station on lot On adjacent lots Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 101+ Property line 101+ Absorption field 5'+ Water main 251+ Water service line 101 + Surface water 100'+ Wells on adjacent lots 2001 + SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10' + Water main 251+ Water Service line 101+ Surface water 1001+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots 2001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that / 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 Paul. E. Pinard, P.E. Date 4/17/12 COSA Fee $ A b • 0W Waiver Fee $ _ Date of Payment q J25112 Date of Payment Receipt Number 1,67gAt Receipt Number, (Rev. 4/10) �oo�1_a in. PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 17, Block 4, The Tablelands Subdivision APPLICANT: Spencer & Rosales Curtis 23302 Whispering Birch Drive Chugiak, Alaska 99567 SEPTIC TANK TYPESIZE: Steel/1250 Gallons, per MOA Records ABSORPTION SYSTEM: Seepage Bed, per MOA Records DAILY FLOW: 4 BEDROOMS x 150 GAVBR = 600 Gallons TEST DATA JOB NUMBER: 12.094 DATE OF TEST: 4/10112 FIELD STAFF: A. Wien NUMBER OF BEDROOMS: 4 SCUM: 0.0' SLUDGE: Minimal NEEDS TO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes XX No Time Flow Rate Volume Cumulative Volume Septic Tank Septic Tank Soil Absorption System Comments pM (GPM) (GALS) (GALS) Liquid Level ' A Level Monitor Tube 1' A SAS 1 Level Monitor Tube 3' 0 SAS Level 7.52 5.4 - - 4.1' - 0.3' - Start Flow -Meter 276127 8:07 5.4 82 82 4.2' 0.1' 0.3' 0.0' 276209 8:22 5.3 82 164 4.2' 0.0' 0.4' 0.1' 276291 8:37 5.4 80 244 4.2' 0.0' 0.4' 0.0' 276371 8:52 5.4 82 326 4.2' 0.0' 0.4' 0.0' 276453 9:07 5.4 82 408 4.2' 0.0' 0.4' 0.0' 276535 9:22 5.4 82 490 4.2' 0.0' 0.4' 0.0' 276617 9:37 - 82 572 4.2' 0.0' 0.4' 0.0' 276699 9:42 28 600 4.2' 0.0' 0A' 0.0' Stop Test - 276727 RECOVERY DateF ST MT SAS MT 4/104.1'/-0.V 0.4'1-0.0' 0.3/-0.1' 'ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: System appears to be operating normally. There was 0.3' of measurable liquid in the SAS MT prior to beginning the test. With the addition of 600 gallons to this system (at the end of a full day of use by the occupants), the level rose 0.1'. Recovery measurements showed adequate absorption with a return to the starting level less than an hour after stopping the test flow. Reviewed by: Paul Pinard Date: 41117112 .�, _ff, Municipality of Anchorage Development Services Department Building Safety Division On -Site 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 Parcell.D. -STM' 1. GENERAL INFORMATION Complete legal description The Tablelands SID, Block 4, Lot 17 Location (site address) 23302 Whispering Birch Drive, Chuglak, AK COSA # OCf 01 R 4 Expiration Date: Ko — 3 D / O Current Property owner(s) Howard M. Hunt and Suzanne Forrest Hunt Mailing address Lending agency Mailing address Day phone 2404719 Day phone Real Estate Agent Mary Cox Day phone= Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System I] TYPE OF WASTEWATER DISPOSAL: Individual On-site ❑,r 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 Dougias T. Kenley, P.E. Aririraec 8806 Northstar Circle, Palmer, AK 89645 Engineer's Printed Name Douglas T. Kenley 5. DSD SIGNATURE Approved for __1—L bedrooms. Disapproved. Conditional approval for Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Phone 907-748.1073 Date 4 a Lr7 • eel _tf:. QF••'Cis�f� bedrooms, with the followinc ON-SITE : c WASTEWATER ••_ PRf1f;RAM Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: 0 Original Certificate Date: 62 (Rev 11,05) 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 level at in. Datum Cycles tested Meets alarm & requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT T Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewe n Public sewer manhole/cleanout Wer /septic service line Holding lank Animal containment areas 60+ ft. Manure/animal excrete storage areas 100+ ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 13 n. Property line 32` ft. Absorption field 11+ft• Water main 25+ ft. Water service line 10*ft Surface water 100+ft. Wells on adjacent lots 200+ ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ft. Building foundation raft. Water main 25+ ft. Water Sei rvice line 10+ ft. Surface water 100+ ft. Driveway. parking/vehicle storage 18* ft. Curtain drain N1ebam( Wells on adjacent lots 200+ ft. F. COMMENTS: 'From M.OA. records on Cie. *'Measurements from two M.T.s west to east. r G. ENGINEER'S CERTIFICATION 40 . .s I certify that I have determined through field inspections and ��DQUJI& . ...� review of Municipal records that the above systems are in o •• + 'v• t>" conformance with MOA COSA guidelines in effect on this date.IDE �. ir*'+�,'h•,T I�iEY: Engineer's Printed Name Douglas T. Kenley r�)yJtZ V I Date 1 COSA Fee $ �— Waiver Fee $ ' Date of Payment iv — 2 ✓r' O Date of Payment Receipt Number Receipt Number (Rev 11/05) 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: The Tablelands SID. Block 4, Lot 17 Parcel ID: 051-801-08 A. WELL DATA Well type Public If A. B, or C provide PWSID # _ Well Log (Y/ Date completed _ Sanitary seal (YIN)_ Wires prop protected (YIN) Total depth ft. Cased to ft. ng height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p•m. 9•P•m• WATER SAMPLE LTS: Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL enic: mg/I Date of sample: _ Collected by: B. SEPTICIHOLDING TANK DATA TankType/Material •SeptidSteel Dale installed '1022104 Tank size '1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N/A Date of pumping 6/1812009 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed '1022104 Soil rating (g.p.d.e or ft2/bdrm)'0.3 g p.d sq. ft. System type 'Bed Length '84 ft. Width '24 ft. Gravel below pipe '0 68 ft. Total depth 2.84 ft. EH. absorption area '2016 ft� Monitoring tube Y Depression over field No Date of adequacy test 06/14/09 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test "fro in. Water added828 gal. New depth "6/0 in. Elapsed Time: 61 min. Final fluid depth "542/0 in. Absorption rate >= 600 g,p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date — ih,e 2Ns/ 9 We Douglas T. Kenley RE 8176 9806 E Northstar Circle, Palmer, Alaska 99645 (907) 746.1073 Legal: Address: Applicant: Date of Test: System Data: Tank Volume Mallonst- SEPTIC ADEQUACY TEST i'/8 // 9e. Time NetTme T== FJRL7�LyIl/.r�'©0� W -W Ms".�W M W. wrm C0 F2Mw3M IWAaWYM System Passed System Failed Additional Comments: 2 Y Municipality of Anchorage Development Services Department Building Safety Division K P On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 tl CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING" Parcel L.D. HAA#1�51�i� Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 17, Block 4, The Tablelands Location (site address or directions) 23302 Whispering Birch Drive, Peters Creek Current Property owner(s) Troy Davis Homes Day phone 357-9394 Mailing address ' 1451 E. Parks Hwy, Ste 207, Wasilla, AK 99654 Lending agency GMAC Mortgage Day phone 694-4622 Mailing address 11409 Business Blvd., Ste 12-01, Eagle River, AK 99577 Real Estate Agent Audrey Mason, Remax of Eagle River Day phone 696-7789 Mailing Address 16600 Centerfield Drive, Ste 201, Eagle River, AK 99577 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Well Public Water System The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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. (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. 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the 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 AK Rim Engineering, Inc. Phone 745-0222 Address PO Box 2749, Palmer, AK 99645 Engineer's Printed Name Mary L. Shreves, P.E. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Date 110/2, OFA Mary V Shreves J• • CE 9351 , ����Z Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: A , � O. .j (( r Q e (Ray.OV02) .tj LAI 600ID VA, Original Certificate Date: WHIS BIh -- y 'RING- UTILITY LOT 15 PEDESTAL k J TYP. WATER \ VALVE z+e i2 NATURAL \ w GAS ;p5 ,. UNDERGROUND \ .:TWO STORY z5t UTILITES DWELLING 66 \ N N N \ 4 � CANT � W ® TYPICAL S i '' NOTES: I, THIS SURVEY" REPRESENTS VISIBLE IMPROVE 2, THIS DOCUMENT DOES NOT CONSTITUTE`A ' INACCURACIES'TNArA'SUBSEOUENT BOUNDARS -3. THIS LOT SERVED BY A COMMUNITY WATEREXCLU' OR RE5ION NOTE IT IS TRESPONSIBILITY TRICTID`N5" WHICH`DO NOTAPPERAON :ANY DATA"HEREON'REUSED FOR`"CONSTROCTI LEGEND (M)=MEASURED DATb (C)=CALCULATED-DATA (R)=RECORD DATA TRACT B-2._ _ 1"=50' -UNOARY—SURVEY s 75 SUBJEO7 TO Ald` - . .... _.., . _... ....... ...;. STREM 'MAY DiSCLO'5E.".. OF AS—BUILT gL���9 it 49TH .,t W 0. 0400124 I .Y.. .r.......YY.L I HEREBY COK c INSPECTION :Rob •t J. Farmer �+o LOT 17, 'BLOCK 'i}S 10615-5 ' ••.. =� � PIAT No. 2004- e4f, • ••••• 'r�°S EASEMENTS OF csslai RECORDED PLAI ALASKA, THIS '8 P.O. PALMER, INV PHONE: I FAX: (9 PAGE 1 of 1 F.B. 04-14 DECKW LOT 16 LOT 18 0 1 w � J a RISER CLEAN RTYPICAI OUT N cNp TYPICAL BLOCK LOT _17 41,040 S.F. NOTES: I, THIS SURVEY" REPRESENTS VISIBLE IMPROVE 2, THIS DOCUMENT DOES NOT CONSTITUTE`A ' INACCURACIES'TNArA'SUBSEOUENT BOUNDARS -3. THIS LOT SERVED BY A COMMUNITY WATEREXCLU' OR RE5ION NOTE IT IS TRESPONSIBILITY TRICTID`N5" WHICH`DO NOTAPPERAON :ANY DATA"HEREON'REUSED FOR`"CONSTROCTI LEGEND (M)=MEASURED DATb (C)=CALCULATED-DATA (R)=RECORD DATA TRACT B-2._ _ 1"=50' -UNOARY—SURVEY s 75 SUBJEO7 TO Ald` - . .... _.., . _... ....... ...;. STREM 'MAY DiSCLO'5E.".. OF AS—BUILT gL���9 it 49TH .,t W 0. 0400124 I .Y.. .r.......YY.L I HEREBY COK c INSPECTION :Rob •t J. Farmer �+o LOT 17, 'BLOCK 'i}S 10615-5 ' ••.. =� � PIAT No. 2004- e4f, • ••••• 'r�°S EASEMENTS OF csslai RECORDED PLAI ALASKA, THIS '8 P.O. PALMER, INV PHONE: I FAX: (9 PAGE 1 of 1 F.B. 04-14