HomeMy WebLinkAboutTHE TABLELANDS BLK 6 LT 1The Tablelands F 11 Lot 1 #051-801-24 Municipality of Anchorage Development Services Department _ =_ Building Safety Division - On -Site Water & Wastewater Program, 4700 South Bragaw St. r :: P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW040084 PID Number: us I —ELI — Name` WALLACE HOMES Wastewater System: ■ New ❑ Upgrade Y p9 Address: NHN WHISPERING BIRCH DRIVE ABSORPTION FIELD Phone: No. of Bedrooms: (907) 230-9199 4 ❑ Deep Trench ■ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: 0.6 Total Depth from original grade: 6.5 MAX GPD/Sq. Ft. Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 6 1 TABLELANDS SEE DWG. Ft. 3.96-4.12 Ft. Township: Range: Section: Fill added above original grade: Grovel length: — — — SEE DWG. Ft. 2©50 = 100 FL WELL: Grovel width: Number of lines: Distance between lines: ❑ New ❑ Upgrade 5 Ft 2 16 FL Classification (Private, A,B,C): Cased TO:(BmROCK) Total absorption area: Pipe material: FL Ft 1000 so. D 3034/ F-810 Driller. Pv t!�\ Date Drilled: I Static Water Level: Installer. GREEN GENERAL Date installed: 6/4-7/2004 FL Yield:Pump Set At: FHeight Above Ground: TANK GPM FL FL SEPARATION DISTANCES ■Septic ❑Holding ❑S.T.E.P. 11 Other To Septic Absorption Lift Holding Public/Private Manufacturer. ANCHORAGE TANK Capacity In gallons: 1250 From Tank Field station Tank Sewer Lines Well N/A N/A — — 25'+ Material: STEEL Number of compartments: 2 Surface Water 100'+ 100'+ — — — LIFT STATION Lot Line 5'+ 10'+ — — — Size in gallons: Manufacturer. P N Foundation 5'+ 10'+ — — — Pump on' level at: Pump off' at: High water alar at Curtain Drain NONE KNOWN Pump Make el: Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: TOP OF CMU FOUNDATION Assumed Elevation: 100-00 FL ENGINEER'S SEAL oo�oopp �� Inspections performed by: GEG, Ltd. Dates: 1st 6/4/2004 149 H i .:..;....... ........ 2nd 6/5/2004 �..� .. .... ...... ........0 3rd 6/7/2004 effr y . am ss..* �O Development Services Department Approval n n Reviewed and approved by: � Cc y. �,�c�c Date: J 23/� 9- E 79 Q �c v PP • .•. •••. A O �� -�' 1Z rofessio�a� a� 40�00�0040 (Rev. 12/01) PERMIT "UMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO4OO84 051-801-,&8 93 i VA NEW FCO 43.71 34.93 ST1 42.88 35.32 5T2 42.85 37.22 DBL7 43.23 38.19 DBL2 43.59 36.84 FD 49.23 51.52 C01 41.07 70.34 CO2 57.90 74.90 003 78.49 35.51 C04 87.50 24.0° MT1 43.94 85.72 MT2 80.18 71.38 M73 74.00 37.43 MT4 57.05 28.29 NEW 1250 GALLON \ SEPTIC TANK TOBBEN SPURKUWD \ TEST HOLE \ / Ir EXISTING 4 BEDOOM MOLISE �A 8L7 / A ALTERNATE SrrE wILL i, ?•'••"•:�~'`,{ / / REQUIRE USE OF ` ADVANTEX SYSTEM s:�j•.'i`.i'•.`;� �03 ••`i i wY L. APPROXIMATE :1 F LOCATION OF WATER LINE j/ Q GARNESS�ENGINEERING GROUP, Ltd.. ON 3701 E. TUDOR ROAD, SUITE 101' ANCHORAGE. All 99507 • PHnNE W7)%17 170 0 rnv ldf]Rm .e,. WALLACE BOSSERMAN 7 M.E.W 230-9199 1 2 OF 3 TABLELANDS SUBDIVISION; LOT 1. BLOCK 6 E OF WORK: AS—BUILT DRAWING OF SEPTIC SYSTEM MUNICIPALITY OF ANCHOR4GE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw, Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial u) P rn-1 Date Issued: Apr 27, 2004 Expiration Date: Apr 27, 2005 Permit Number: SW040084 Z-7Fvpe.EswupS,act; r771 Parcel ID: 051-801-08 Legal Description: GLENN VEAV-E&TATES�� Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: Owner Name: Wallace Homes Lot Size: 40000 SO. FT. Owner Address: 1 Total Bedroom 4 Permit Bedrooms: 4 'd$R'a5t ex�Ch 1Dt � �- {� � This permit is for the construction of: Q✓ Disposal Field Q Septic Tank Holding Tank ❑ Privy El Private Well E] 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 j Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). j 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling 1 (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. 5. The following special provisions. THIS PROPERTY IS CURRENTLY CALLED GLENN VIEW ESTATES NORTH TRACT F BUT HAS BEEN OFFICIALLY SUBDIVIDED TO THE TABLELANDS SUBDIVISION BLOCK 8 LOT 1 Received By: . Date: Z�� y Issued By: __QIj" Date: f Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & 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 FOR A SINGLE FAMILY DWELLING Permit Number Property owner(s) WALLACE HOMES Day phone 230-9199 Mailing address (1) 18306 PARKVIEW TERRACE LOOP * EAGLE RIVER AK Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 1. Rl 0 K 60 TARLFLANnS SUBDIVISION Legal description (Section, Township & Range) Lot Size Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ■ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑. Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. Permit Fees: 4 Date of Payment: _ /0 Receipt Receipt Number: n . 0V I Waiver Fees: Date of Payment: Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS April 19, 2004 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic System for Lot 1, Block 6; Tablelands Subdivision To whom it may concern: The proposed 4 bedroom house will be served by public water and a private septic system. We are proposing to install a 1250 gallon septic tank and a 5 -wide trench type drainfield. Two test holes have been excavated on the property. The drainfield will be designed around the 30 foot radii of this test holes. Comments regarding the design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 0.60 gallons/day/ft' should be used. 2. TRENCH DESIGN: a. Percolation Rate: 12 minutes/inch b. Proposed Application Rate: 0.60 gallons/day/ft2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 1000 ft2 f. Total Depth: 8 feet (maximum at any point) g. Effective Depth: 4 feet h. Width: 5 feet i. Reduction Factor: 0.50 j. Minimum Length: 100 feet total len (2 @ 50 feet long each) k Effective absorption area= 1000 3701 E. Tudor Road, Suite 101 " Anchorage, AK 99507 Ph: (907) 337-6179"Fax: (907) 338-3246' Website: gamessengineering.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system. 4. TOPOGRAPHY: The area around the proposed drainfields is relatively flat. In short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. , Thank you for your assistance. Sincerely, P.E., M.S. NOTE: A site plan drawing, a design drawing, two soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: gamessenro neering.com LOT 4, BLOCK 8; TABLELANDS S/D LOT 3, BLOCK 8; TABLELANDS S/D 'fY ------ LOT 2, BLOCK 7; \\\ TABLELANDS S/D l LOT 1, BLOCK 7; ✓✓ TABLELANDS S/D✓✓ ✓ ✓ ✓ ✓ ✓ f / � ✓ U N S U B D IVI D ED IN: IILLE BELSERVED EBYIEPUBLIOCWN WATER. LOT 2, BLOCK 8; TABLELANDS S/D --------------------------I-el ✓ LOT 1, BLOCK 8; ,.✓ /- TABLELANDS 5/D ✓✓ ✓ ALTERNATE SITE /✓ ✓ PROPOSED SEPTIC ✓✓ /' ✓� SYSTEM (SEE DESIGN ✓ ✓✓ PAGE 2 OF 2)� ✓ t /✓ LOT 3, BLOCK 6; / TABLELANDS S/D . l (APPROXIMATE LOCATION) LOT 2, BLOCK 8; / f TABLELANDS S/D GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS d GENERAL CONTRACTORS WALLACE HOMES PHONE NUMBEI 230-9199 TABLELANDS SUBDIVISION; LOT 1, BLOCK 6, E OF WORK: SITE PLAN FOR PROPOSED SEPTIC SYSTEM ENUMBER; ,E $� 1 OF 2 \ \ PO \F O,pPROPOSED 1250 �G \ \ c\ �tl / GALLON SEPTIC TANK \ ,„G�i may" / / NSf CLEANOUTTION \ / V'" / NSTALL TERNATE RE SNE. WILL \ \y / USE OF SP ER ADVANTEX SYSTEM. \ \ INSTALL /� TOBSEN SPURKIAND \ / DOUBLE / // TEST HOLE \ / l \ LINE XIMATE rRAT•/j //iH�� / LOCATION) J 10 V PROXIMAl / ". !. :'T • •:.', KEY BOX •' :v •::r LOCATION ULD. EXCAVATE IAT ARE B FEET / ANY POINT BY S / WIDE BY 50 FEET LONG EACH FEET LOTAL LENGTH). ADD 4 / T OF CLEAN, WASHED SEWER DRAINROCK. / zo7z- NOTE DEPENDING OF THE ELEVATION OF THE HOUSE. A RINDER PUMP OR A UFT STATION MAY BE REQUIRED. NOTE THE CONTRACTOR SHALL VE THE SOUTH WEST LOT VN GED BY A REGISTERED LAN SURVEYOR PRIOR TO CONSTRUCTION. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS B GENERAL CONTRACTORS 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-0179 • FAX (907)338-3246 PREPARED FOR: PHONE NUMBER: WALLACE HOMES 230-9199 TABLELANDS SUBDIVISION; LOT 1, BLOCK 6, E OF WORK: DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM 4/19/2004 AWN BY: RAL ,LE: 4�* 1 = 40• ..... . ........ iE NUMBER: 2 OF 2 �QO p '• d f y r ess:' 795 e� 4��f% e1Av45�1 DEPTH TO GROUNDWATER DATE 0 O �. ••••.... .. GARNESS ENGINEERING GROUP, Ltd. CONTRACTORS �...w.+gam G koo o wnxww«anea »� CONSULTANTS i GENERAL . ..... ... .. O .... .......... . 30 3 1 2" 2 1 3 SOI LOG - PERCOLATION TEST — ....... LEGAL DESCRIPTION• LOT 1, BLOCK 6; TABLELANDS SUBDMSION O a •_J f Ga nesse OQ�r E 79 PERFORMED FOR: WALLACE HOMES DATE: 1/28/2004 3 1 2" `F• PTH (feet -W-111 �0' rofeaalo,\ � — ORGANICS EST HOLE oo�o 1 4:35 30 3 1 2" — — LOAM SOIL CLASSIFICATIONS ! 2 ---_ GW ORG 3 GP ML GM CIL 4 GC OL ' S/D TH SW MH • 5 . •� SP CH j TH#1 SM � � i OH � �• / 6 � SC 7 SM/ML 8 w/SOME1/28/04 GRAVEL2/16/04 94/a/04I SITE PLAN "=100' 1 10 11 12 13 14—B.O.H. 15 16 17 18 PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 19 TEST RUN BETWEEN 4.0 FT. AND 4.5 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: RICK LYON COMMENTS: PERFORMED BY GEG Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS ER ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: DEPTH TO GROUNDWATER DATE DRY DRY DRY — 2 DATE 15- 16- 17- 18 READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL ' READING (INCHE NET DRj-: 1/2a/2004 1 3:05 — 6" — 2 3:35 30 3 1 2" 2 1 3 3:35 — 6" — 4 4:05 30 3 1 2" 2 1 5 4:05 — 6" — B 4:35 30 3 1 2" 2" 2 1/2- Municipality of Anchorage Development Services Department Building Safety Division �.t On -Site Water and Wastewater Program 4700 South Bragaw St. R P.O. Boz 196650 Anchorage, AK 99519.6650 \ www.ci,anchoraoe,ak.us - (907)343.7904 ''�`•. CE -2225 tf Soils Log - Percolation Test .. ,•^eC =cr A s�(-{ 1 c- -OEFy C o nr1' Dale Performed: e:al Cescr oto1: L N V i k �/ ��DiLt rt Township. Range, Section: LO Ti l0 3 K 7 Slope -- LOT-/ �Klo �VFeel, Ldo) 12ErANits .'.7A WAS GROUND WATER Dale ENCOUNTERED? Net Time Depth !o Water I •;r<; •,: 5 IF YES. AT WHAT DEPTH? P Depth toWater Aher Monitoring?. d d •� E E Date: r Reading Dale Gross Time Net Time Depth !o Water I •;r<; •,: ill 3-Z l-0 P E 30 lor�L 11:3v ; i o %y s x' 4A V S IDaI 30 wo ° 'A aaerry erw.. Dere 1 A vv 70 n.. r."CuwraE rEY (p TEST RUN BETWEEN_ FT AND X14 FT 775. CERTIFY TN:.T 71i.S'_c_ ... -20 '+ A-COROANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. :3:,T fQ-oZ GEG, Ltd., Year 2004 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS rm Standard Construction Specifications for Single Family Wells & Onsite Wastewater Disposal Systems ►44i►►rt}}/iiVitii}iiii►►}}V}Vrri}iii►►►►}}iii►►►i44t}►►i}}}iiV►rtr►}4VVii I. REFERENCE PROPERTY: Tablelands Subdivision; Lot 1, Block 6. The design is for a four (4) bedroom residence H. 1. Property owner or homeowner: The legal property owner or his/her appointed representative (not GEG, Ltd.). 2. Engineer: Gamess Engineering Groop, Ltd. (GEG, Ltd.) 3. Contractor: The company hired by the property owner to install the septic system. If the property owner installs the system then he/she would also be the contractor for purposes of this installation. 4. Well Driller: The person or company hired by the property owner to drill the well. 5. DSD &/or MOA: Municipality of Anchorage, Development Services Department, On -Site Water & Wastewater Program }i►}4srri►►►4»rrr»s}♦q►+i►#rrirtrq#www•4»rrr»ar}V♦iirr4►VVVirr»#4irir►»►}Virrti»» M. RESPONSIBILITIES: » Property Owner Responsibilities: 1. CONTRACTUAL RELATIONSHIP: The property owner shall contract with the contractor to perform the work outlined in these specifications and plans, in accordance with the attached DSD permit. There is no contractual relationship between the contractor and the engineer. The engineer shall inspect the work, as required by DSD, so as to document the installation. Final acceptance of the contractor's work rests with the owner and the DSD. 2. SINGLE FAMILY RESIDENCE ONLY: This well and/or septic system design is for a single family residence only. The homeowner is responsible for notifying the engineer if the residence is used as a duplex, business, or multi -family dwelling. In such cases, the installation permit must be obtained from the State of Alaska, Department of Environmental Conservation. 3. DISCLAIMER REGARDING AS -BUILT SURVEY: The validity of the design site plan is limited by the accuracy of the as -built survey provided to the engineer by the property owner or his/her representative. The property owner shall notify the engineer regarding any known inaccuracies associated with the as -built survey. The engineer assumes no responsibility for the accuracy of the survey. 4. UNPLATTED EASEMENTS: The property owner is responsible for notifying the engineer and the contractor of any unplatted easements, not shown on the as -built survey, which the new well or septic system may encroach into. Such easements are typically identified in the property title report. 5. DISCLOSURE OF SITE CONDITIONS: The property owner shall notify the engineer and the contractor of any seasonal groundwater or surface water runoff conditions known to him/her which could potentially effect the operation of the septic system The proposed septic system must be at least 100 feet from any streams, ponds, creeks, swamps, bogs, or any other surface water as defined by the DSD. This Page 1 of 7 CEG, Ltd., Year 2004 disclosure is of particular significance when the site evaluation and design work is being done during the winter months when surface waters are frozen and there is snow cover. The property owner shall notify the engineer and the contractor of any known subsurface conditions that would prohibit or restrict the installation of the septic system Items of concern would include, but are not limited to buried piles of construction debris, undocumented septic systems, areas which consist primarily of fill (imported) soil, subsurface drainage systems, & abandoned wells. 6. DRINKING WATER WELLS: The property owner is responsible for notifying the engineer if, to his/her knowledge, any of the adjacent properties are used as a duplex, business, or multifamily dwelling. The new septic tank and leachfield must be at least 100 feet from any private well, 150 feet from any class "C" well, and 200 feet from any class "A" or `B" well, unless appropriate waivers are obtained. Furthermore, the property owner shall notify the engineer of any undocumented or abandoned wells, known to him or her, that are located on the subject or adjacent properties. 7. CURTAIN DRAINS: The new drainfield must be at least 20 feet down gradient and 50 feet upgradient from any subsurface drains. This includes foundation drains. The property owner should notify the engineer of any such drains that are not shown on the design drawings for this installation. 9. POST CONSTRUCTION SITE RESTORATION: Unless specifically agreed upon otherwise, the property owner is responsible for final grading of the areas, which settle after construction. Prior to awarding the contract, the homeowner should communicate to the contractor any expectations regarding, but not limited to post construction site clean up, re -landscaping, and restoration of any asphalt, fences, trees, decks, ect. that are effected by the construction. All mound type drainfields are required by the MOA to be re -vegetated. The property owner is responsible for this work unless other arrangements are made with the contractor. If the property is being sold, the property owner shall ensure that the aforementioned items are addressed with the buyer, and, if the work is to be completed after the sale of the property, that necessary funds are escrowed to fund the completion of the work. 9. PROPERTY OWNER INSTALLATION OF SEPTIC SYSTEM: If the property owner intends to install the septic system he/she must fust have obtained approval from the Municipality of Anchorage, DSD (343-7904). Homeowner installations typically require more time for engineer inspections. The homeowner should discuss the additional costs associated with such inspections with the engineer prior to starting the project. 10. ENGINEER CHARGES TO INSPECT THE INSTALLATION: The property owner is responsible for payment of all the engineer inspection charges. These charges are in addition to the soils testing and design work that was required to obtain the MOA sewer/well permit. The number of inspections will vary depending on the actual field conditions encountered and the construction methods used. If there are any questions by the property owner, or his/her representative, regarding charges for installation inspections they should be discussed prior to beginning construction. GEG, Ltd. will provide you with a written copy of the fee schedule. 11. CHANGES IN THE SCOPE OF WORK: See Section V, "Disclaimers" regarding design changes. See "Contractor Responsibilities", paragraphs 1, 2, & 13. In addition, see "Engineer Responsibilities", paragraphs 2, 4, & 5. • Contractor Responsibilities: 1. PRE -CONSTRUCTION LAYOUT: The contractor is responsible for locating all buried utilities, easements, property lines, surface water setbacks, well radii, and water service lines which may be encroached upon by the proposed septic system. The contractor shall ensure that all setbacks are flagged by a registered land surveyor, or other appropriate means, prior to construction. GEG, Ltd. field engineers/inspectors will not be responsible for establishing or confirming any of the aforementioned setbacks. contractor should recognize that the location of all wells, surtace waters, structures, ana Omer m en on the design drawings are typically derived from as -built surveys, and municipal records. The surveys and municipal records (prepared by professional engineers & land surveyors) have b med to be accurate for purposes of this design; however, the accuracy has not necessarily been f Page 2 of 7 GEG, Ltd., Year 1004 Prior to beginning any construction the contractor shall field locate all items which b re setbacks and verify that there are no encroachment concerns. Any encroachments, for wl have not been granted, should immediately be brought to the attention of the property owner resentative) and the engineer. The test hole pipes shalltrot be removed/abandoned until after the engineer has established their location relative the new drainfield during the fust inspection of the drainfield installation or during the pre - construction layout. The new drainfield/s must be within a 30 foot radius of the test hole/s used for establishing the design criteria. The contractor should establish the elevation of all existing and proposed system components prior to starting construction so as to insure that the necessary grades can be maintained. This is particularly significant when the elevation of the existing system components is unknown because clean -outs are not present, buried, or non-functional (can't measure down them because of obstructions). It is recognized that conditions can be discovered that will materially change the design and the construction costs. 2. DISCREPANCIES BETWEEN DESIGN DRAWINGS AND SPECIFICATIONS: Construction shall be in accordance with the approved site plan and design drawings, and any special provisions noted on the municipal sewer permit. The contractor is responsible for notifying the engineer of any discrepancies noted on the design plans or drawings, prior to starting work. 3. CHECK GROUNDWATER LEVELS IN TEST HOLE MONITORING TUBES: Prior to beginning construction, the contractor shall check the liquid level in the test hole monitoring tubes to ensure that there has been no change in the groundwater levels that would impact the proposed design. Any rise in the liquid level should be brought to the attention of the engineer so that design changes can be made if necessary. 4. MA)UMUM DEPTH OF DRAINFIELDS: The maximum depth of the drainfield is shown on the design drawings or is noted in the narrative portion of the design package. The contractor shall notify the engineer of any inconsistencies noted in the design package. For purposes of this installation, the maximum depth of the drainfield will be based upon taking a measurement at the deepest part of the excavation between the highest ground elevation encountered (usually on the uphill side of the excavation) and the bottom of the trench or bed excavation. The contractor shall exercise caution not to remove evidence of the original grade prior to establishment of the total system depth. In short, don't remove the organic layer until after the originalgrade elevations are established by the inspectin engineer. S. SUITABILITY OF MATERIALS USED FOR CONSTRUCTION. The contractor shall ensure that all materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. This includes, but is not limited to, the following: a. Drainrock b. Sand filter material for conventional beds, trenches, or mound systems. c. Sand filter material and pea gravel for Intermittent Sand Filters (ISF). d. Anchorage Sand and Gravel (AS&G) "block pea" material for Upflow Filters. It is recommended that the contractor provide the engineer with current sieve analysis`. from the sand/gravel supplier to document the suitability of the material. The engineer assumes no responsibility for ensuring that the materials delivered meet the MOA requirements. 6. BURIAL RATING OF TANKS: The contractor shall ensure that the septic tank, lift station, or holding tank purchased has a burial depth rating suitable for the actual installation. 7. SEPTIC TANK AND STEP TANK SIZES: Prior to purchasing a septic tank or lift station the contractor shall verify that it is adequately sized for the number of bedrooms shown on the permit issued by MOA. The minimum septic tank size is 1000 gallons and the minimum STEP tank size is 1250 gallons. These size tanks will handle residences with up to 3 bedrooms. For each additional bedroom over three (3) the septic tank or the STEP tank volume shall be increased by a minimum of 250 gallons. For example, a four (4) bedroom residence must have a 1250 gallon septic tank or a 1500 gallon STEP tank. Page 3 of 7 GEG, Ltd., Year 1004 8. INSPECTIONS - ENGINEER NOTIFICATION: The contractor shall notify the engineer at least 24 hours prior to starting construction. If deemed necessary, a pre -construction site visit shall take place. The contractor shall coordinate with the engineer any inspections which will be required during weekends, holidays, or beforelafter normal working hours (8:00 am to 5:00 PM). The property owner may incur additional charges for inspections, which do not occur during normal business hours. It is the contractor's responsibility to notify the engineer a least 2 hours prior to any inspection. 9. REGULATORY NON-COMPLIANCE. The contractor shall report to the engineer and the property owner any observed condition which would put the septic system in violation of State or Municipal regulations. 10. BACKFILL OLD TEST HOLES: Any remaining test hole excavations shall be filled and mounded as part of this project. Unless instructed otherwise by the engineer, the old test hole groundwater monitoring pipes shall be removed. 11. FINAL GRADING FOR DRAINAGE: The contractor is responsible for final grading so as to ensure that surface runoff does not adversely effect the septic system constructed, adjacent septic systems, or adjacent structures. 12. SOIL COVER REQUIREMENTS: The contractor shall ensure that the final cover over the tank and drainfield is either compacted adequately when backfilling, or mounded sufficiently to ensure that there is adequate soil cover over the tank and drainfield after settlement occurs. If seasonal conditions prevent this, the property owner (or his representative) shall be notified that additional fill may be required after settlement occurs. This notification is of extra significance when the property is changing ownership. 13. CHANGES IN CONSTRUCTION COSTS: The contractor is responsible for obtaining approval from the property owner for any additional construction costs associated with design modifications or changing field conditions poor to doing the work. 14. WORKING IN RIGHT-OF-WAYS AND TRESPASSING PRIVATE PROPERTY: The contractor is responsible for coordinating (including payment of encroachment permit fees) all access through public and private properties with the appropriate authorities and/or property owners. Furthermore, the contractor shall inform all parties of any potential impacts to adjacent properties prior to beginning any construction. 15. MAINTENANCE & OPERATIONS MANUALS: The contractor shall provide the homeowner with the manufacturer's installation/maintenance manuals for all system components installed under this contract. If not given directly to the property owner, the manuals should be enclosed in a protective cover (plastic bag) and placed/secured in a prominent location so the property owner can find it. 16. INNOVATIVE SEPTIC SYSTEMS. START-UP INSPECTIONS: The contractor shall notify Anchorage Tank & Welding Company (272-3543) after the installation of an Intermittent Sand Filter kit or Advantex system (supplied by Anchorage Tank) is installed so that the appropriate start-up inspection can be scheduled. This notification also activates the quarterly maintenance schedule. Such notification is usually not required for BioCycle installations since "BioCycle of Alaska" is typically involved with the installation. The contractor shall contact BioCycle of Alaska (283-9003) regarding any start-up notification requirements. • Well Driller Responsibilities: 1. The well driller shall ensure that he has a well permit in possession prior to drilling the well. 2. The well driller shall physically verify that the there are no septic systems, or other potential sources of contamination, within the protective radius of the proposed well prior to drilling it. • Engineer Responsibilities: 1. SYSTEM DOCUMENTATION: The engineer is responsible for inspecting the installation of the septic system and preparing as -built documentation, to the satisfaction of the M.O.A.. Inspections are performed as necessary to document the construction of the system to the satisfaction of the M.O.A. In all cases, inspections shall be performed as necessary to establish the following: * The original grades at the drainfield/s site • The bottom of all trenchlbed excavation • Top of sand on all sand filters ' Top of drainpipe Page 4 of 7 GEG, Ltd., Year 2004 • Septic tank, or lift station, or holding tank prior to backfill • Placement of filter fabric and insulation • After final grading is completed 2. LIlv1ITED AUTHORITY: The inspecting engineer has no direct authority over the contractors activities or construction/safety practices. Should the engineer identify conditions which dictate a design change, he or she will recommend that work be stopped, and/or the design be modified. If design modifications are necessary, the engineer shall notify the property owner or his/her representative. The inspecting engineer does not have the authority to direct the contractor to modify the system design in such a way that it would be in violation of State or MOA regulations. 3. SEPTIC TANK INTEGRITY: The engineer shall inspect the condition of the existing septic tank and determining its suitability for re -use. If the engineer determines the septic tank to be structurally unsound, it must be replaced. 4. COORDINATION OF DESIGN CHANGES WITH THE MOA: If design changes are necessary, the engineer will coordinate the approval of the changes with the MOA. The contractor does not have the authority to proceed with any design modifications until verbal or written approval is obtained from the MOA. 5. COORDINATION OF WAIVERS: If, during construction, it is determined that a waiver will be required in order to install the system as designed, the engineer will apply for the necessary waiver/s to the appropriate State or MOA regulatory bodies. The engineering services and State/MOA fees associated with such waivers will be additional charges to the property owner, over and above the installation inspection fees charged by GEG, Ltd. xxa+++xx+++x+xxxxx+x+xexx++x+xxxxx+++xxxxx+xxxx+xxxxx++x+xxxxx++x+xxxxxx++xxxxxxx++ SECTIONIR CONSTRUCTION GUIDELINES: Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the municipal well and/or sewer permit. All materials, components, workmanship, and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as DSD policies. The failure of the inspecting engineer to notice a material or • Septic Tank, Holding Tank, or Lift Station Installation: 1. The burial rating of the tank shall be adequate for the actual burial depth encountered. 2. The tank shall be level and sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed with less than 4 feet of cover shall be insulated. See "Contractor Responsibilities", paragraph 12 regarding final soil cover. S. The sewer service line from the house to the tank shall be sloped a minimum of 1/4" per foot, unless prior approval is obtained from the engineer. 6. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be adequately compacted to prevent future settlement of the soil. 7. A foundation clean out will be installed (14 feet from the house) if one does not currently exist. 8. Post tank clean -outs shall be installed per MOA requirements. Does not apply to holding tanks or lift stations with pressurized lines. 9. In high groundwater areas, all tanks shall be anchored to resist buoyancy forces when there is not adequate soil cover to resist the uplift force. The engineer shall make this determination. 10. The final soil cover shall be graded so that there is positive drainage away from tank. 11. All holding tanks and lift stations shall have an audible and visible alarm inside the residence. 12. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and inspections must be obtained in areas where required by the Municipality of Anchorage. 13. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing Code (UPC). The contractor is solely responsible for the abandonment procedure. Page 5 of 7 GEG, Ltd., Year 2004 14. ISF AND ADVANTEX INSTALLATIONS: The control panel for the Intermittent Sand Filter and Advantex systems shall be located outside the residence, for easy access during inspections. A remote alarm must be installed inside the residence as per DSD requirements. Mounting the panel directly to an exterior wood wall should be avoided because the closing of the relays creates a "clanking" noise that may be offensive to the property owners. 15. ISF INSTALLATIONS: The air compressor shall be equipped with 0 to 10 psi gauge for the purpose of monitoring air flow to the sand filter. The pressure gauge will be located so that it is easily monitored by the property owner. • Installation of Conventional Absorption Bed & Trenches: 1. Excavate the proposed bed/trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level (2 inch maximum variation between high and low spots). If the sidewalls or bottom of the excavation become smeared, they must be raked or scarified before placement of the filter sand or drainrock. 2. The trench or bed should be at least 5 feet from the test hole excavation. 3. All soil tests and excavation depths are advisory to the design and are to be verified in the field by the engineer. If design changes are necessary, and the changes effect the contractor charges to the property owner, the contractor shall obtain approval from the property owner prior to proceeding with the work. 4. Once the draimock is installed, the distribution pipe is to be placed level (0.02 feet difference between high and low shots) with the perforations faced downward. Draimock is then to be placed over the distribution pipe, to provide a minimum of 2 inches of cover over the pipe. The dranrock shall not be pyramided over the drainpipe but shall be the same elevation over the entire trench/bed width. 5. A silt barrier must be installed between the final draimock layer and the native soil backfill. The silt barrier shall cover the entire draimock surface. 6. Monitor tubes shall be installed at the locations shown on the design drawings, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the draimock shall be perforated from the bottom of the trench/bed to the invert of the distribution pipe. 7. Backfill over the final dmimock layer must not be less than 2 feet. Insulation must be installed when the backfill depth is less than 3 feet. The insulation shall cover the entire width of the trenchlbed. the contractor shall "shoot" the final grades to ensure cover depth is adequate, prior to notifying the engineer that the work is complete. The final cover over the drainfield must graded so that there is no potential for water to pond over the trench/dtainfield. See "Contractor Responsibilities", paragraph 12 regarding final soil cover. 8. If an alternator valve was installed with this design the contractor shall provide a functional valve key to the property owner rr►ss►►rrss+rrrr►rrr►rs►►r►►arrrr►ss►r►►rsarr►r srasrrrrsar►►ssrsrrrrs•►►r►rsrrr►r► SECTION V. DISCLAIMERS • UNFORESEEABLE SITE CONDITIONS: The design of this septic system, prepared by GEG, Ltd., was based upon a limited evaluation of the soil, groundwater, and site conditions. The extent of the evaluation is consistent with standard engineering practice in the field. Furthermore, this design was evaluated and approved by the engineers or technicians on staff at the Municipality of Anchorage, DSD, based upon the information provided to them. Occasionally, during construction, unforeseeable subsurface conditions (high groundwater, poor soils, buried debris,....) are encountered that make the proposed installation not feasible. In such cases it is typically necessary to do more soils testing, groundwater monitoring, and design work. These additional engineering services will be performed on a fee basis at an hourly rate. GEG, Ltd. will obtain verbal authorization from the property owner (or his/her representative) prior to proceeding with the work, and will provide a written estimate if requested. The property owner should discuss with the contractor any changes in the installation cost associated with the design changes. • IF THE PROPERTY BEING SOLD AND FUNDS ESCROWED FOR THE UPGRADE, it is important to bear in mind that the ability to upgrade the septic system on this property is not 100% certain (for the reasons stated in the previous paragraph). There is always the possibility that Page 6 of 7 GEG, Ltd., Year 1004 conditions could be encountered that would prevent the installation of anything other than a holding tank. Although such a situation would be rare, it is important that all parties recognize that such a scenario is possible. SEPTIC SYSTEM PERFORMANCE: The design of this septic system is based upon limited soils testing, groundwater monitoring, and a visual assessment. It is possible that the actual soil conditions are less favorable then the testing data indicated and that adverse, unforeseeable, changes in the surface/subsurface water conditions could impact the performance of the system. Numerous other factors, out of the control GEG, Ltd., may adversely effect the long term performance of the system. Such factors include, but are not limited to, excessive number of residents in the house, plumbing leaks, the use of septic system additives, failure to pump septic tank regularly, failure to alternate drainfields (when this is an option), or/and excessive use of water. Given these variables, it is not possible to warrantee the performance of a septic system By proceeding forward with this installation, the Engineer, Well Driller, Contractor, and Property Owner agree that they have read these specifications and agree to accept the terms and conditions outlined in them A final invoice will be issued once all work is complete for inspections and documentation as required by the M.O.A. Please refer to the following estimated inspection costs: 1. Conventional septic system with a single trench/bed, no sand filter: $700.00 2. Conventional septic system with a single trench/bed, sand filter: $800.00 3. Conventional septic system, dual trenches, no sand filter: $900.00 4. Conventional septic system, dual trenches, sand filters: $1000.00 5. Alternative Technology septic systems: $1000.00 6. Lined Intermittent Sand Filter with secondary drainfield : $1500.00 Page 7 of 7 i •• c.. Municipality of Anchorage =°'`` "8`"` On-Site Water and Wastewater Program < �n 121 s (907) 343-7904 5* ,T v Certificate of On-Site Systems Approval Parcel I.D. 051-801-24 Expiration Date: (P-- 3 d - (ZS 1. GENERAL INFORMATION Complete..,1e9al description Lot 1 , Block 6, The Tablelands Subdivision Location (site:address) 22925 Whispering Birch Drive, Chugiak, AK 99567 Current property owner(s) Debbie Ingle Day phone Mailingaddress 22925 Whispering Birch Drive, Chugiak, AK 99567 Real Estate Agent Dar Walden Day phone (907) 865-6408 2. TYPE OF DWELLING: [ Single Family (w/wo ADU) El Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual a Individual Water Storage ❑ Holding Tank ❑ Community Class Well 0 Community ❑ Public Water System CAC Public Sewer ❑ WaiverNariance request for. Distance: Received by: rDate:_4_13_ r 7 COSA to be release. o t engineer,unless o erwise requested by the engineer. COSA Fee $ .�- - 0133E Waiver Fee $ Date of Payment V l/93/P7 Date of Payment Receipt Number o.642. Receipt Number COSA* (`a5G 111 .6T Waiver* S. 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) 232-1347 Address PO Box 871347, Wasi 11a, AK 99687 Engineer's Printed Name Paul E. Pinard Date 21 rt t sw.41,,11 .02,0 ..••••••_.0,-4_ ,1640w oo At?' • . TSF •* , 0� �.`.o 49n 6. DSD SIGNATURE toe ........ 411. Vbems System#1 Approved for %f�n9 o•f►�!!�°o O°°•c ,��,a."Pou1`�. Pinard System#2 Approved for bedroomsea`�'is° CE-4793 o°e Disapproved R 'Qe•••o°o°"m \. � � ��+°ROFESz,';, alp Conditional approval for bedrooms, with the following stipulatio AE `� ON SITt= WAN1 WASTEWAATER Eh PROOR!��'i Original Certificate Date: --319-1 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other • COSA Slue sheet r .: c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On Site Systems /A, pprovaH Checklist Legal Description: Lot 1 , Block 6, The Tablelands Subd. Parcel ID: 051-801 -24 • A. WELL DATA NA - Public Water System Well type If A, B, or C provide PWSID# Well Log (YIN) _ Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG 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 Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 6/7/04 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) N Date of pumping 9/26/14 Pumper JRs Pumping C. ABSORPTION FIELD DATA Systemtype installed 6/7/04 Soil rating (g.p.d./ft2 or�� 0. 6 5 W Trench Length ;2 .@ 50 :-ft. Width 5 ft. Gravel below pipe 4 ft. ,X44 Tc5:4 i6}3fh 8 ft. Eff. absorption area 1 000 ft2 Monitoring tube Y Depression over field N Date,of adequacy test 6/17/17 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 18 in. Water added 600 gal. New depth 22 in. Elapsed Time: 60 min. Final fluid depth 18 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) No If yes, give date D. LIFT STATION NA 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 &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: NA Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 + Property line 1 0' + Absorption field 5 + Water main 1 0' + Water service Iine10' + Surface water 100'+ Wells on adjacent lots 200' + ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10' + Water main 10' + Water Service line 1 0 + Surface water 100'+ Driveway, parkinglve storage 201+ Curtain drain None Known Wells on adjacent lots 200' + F. COMMENTS This property has been vacant for a year. Septic System was presoaked w/2000 gallons of water prior to testing. Septic tank scum & sludge levels were checked; tank does not need to be pumped. G. ENGINEER'S CERTIFICATIONallo�11�tt�1 I certify that I have determined through field inspections and r'��;*41Felptofh.''i review of Municipal records that the above systems are in �4b,.conformance with MOA COSA guidelines in effect on this date. ' '`_ •/*. Tom •*. •• ti/ •••• •••a • •r Engineer's Printed Name Paul E. Pinard S Date 6/21 /1 7 lik; Paul E. Pinard : r / 10; CE-4793 .. P ROFESSION,,,Ow COSA yellow sheet_2-6-15.doc Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-801-24 Expiration Date: L 2 q-17 1. GENERAL INFORMATION Complete legal description The Tablelands Block 6 Lot 1 Location (site address) 22925 Whispering Birch Drive, Chugiak, AK Current Property owner(s) Bussey Day phone 694-4994 Mailing address same Real Estate Agent : Brandon, Partners Real Estate Day phone 694-4994 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5" , Date of Payment -7124/5- Celp— Receipt Number 0;t15';)Tlb COSA# 05nS I;Yj Date: Date of Receipt Number. Waiver #. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6, DS'V D SIIGGNATURE System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. Date 7/2/2015 .sw°��ai1ry� o Atv. AV GaA� • . - stoven W. En d J�; PE 62 6 Q�Fc� u = bedrooms, with the following stipula'�ba', By: / �o L/� Original Certificate Date: The Munici Anchorage Devilopment 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 bi...heet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: 2;�11E T,48L f -v I- 4a1A S Sir / Parcel ID: 0 A. WELL DATA P0841C Wogr4Z Well type If A, B, or provide PWSID # Date completed Sanitary seal (Y/N) _ Total depth ft. Cased to ft. FROMWELLLOG Date of test. Static water level ft. Well production g.p:m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Well Log (YIN) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION Collected by: ft. Tank Type/Material SEPRC,. S7.6EL Date installed 4<'IZZQV _ Tank size /250gal. Number of Compartments 2 Cleanouts (Y/N) i Foundation cleanout (Y/N) Depression over tt-ank (Y/N) -Al High water alarm (Y/N) X1 Date of pumping. Pumper C. ABSORPTION FIELD DATA Date installed > ? o Y Soil rating (g.p.d./fe or felbdrm) C. System type 7ZO/V CN Lgoq,h> 2 so Pft? Width J ft. Gravel below pipe ft. r: ` S�fo#a1.&pth jLL ft. Efre absorption area ZX10 -f? Monitoring tube V Depression over field Al kDate of adequacy test % j IS Results (Pass/Fall) )' For -Y_ bedrooms R IN fluid deptti in absDCptioq.flf before test 0� in. Water added��� gal. New depth20 in. t , iE•LC �i -14 Elapsed Time: Final fluid depth l L in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) /i/ 6 If yes, give date D. LIFTSTATION N4 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 & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: AM Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation s f Property line` Absorption field Water main /O Water service line /d r Surface water I dO "t Wells on adjacent lots ZOQ `!t ABSORPTION FIELD ON LOT TO: Property line / a r Building foundation�J `f Water main �d Water Service line z Surface water. o I Driveway, parking/vehicle storage 26' `e - Curtain drain UVIK Wells on adjacent lots 00 �¢ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that / have determined through field inspections and review of Municipal pcords that the above systems. are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name�F Date COSA yellow sheet_2-6-15.doc Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-801-24 1. GENERAL INFORMATION \�J Expiration Date: J _'2 1-2, — Complete legal description The Tablelands Block 6 Lot 1 Location (site address) 22925 Whispering Birch Drive, Peters Creek, AK Current Property owner(s) Bussey, Ron Day phone 688-8232 Mailing address same Real Estate Agent Hope Russo Day phone 301-0701 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Received by: 1 Date: Z2S COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 'tqU Date of Payment 524//3 Receipt Number 6O5/ 21 oS COSA# G'3Cl31at7 Date of Receipt Number. Waiver 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7025 Address PO Box 770724 Eagle River Engineer's Printed Name Steve Eng Date rf i y J 6. DSD SIGNATURE / System #1 Approved for T bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: BybMunicipali G/6 j Original Certificate Date: - Ty of Anchorage Devlopment 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 blue sheet 9-1-12.doc X Nitrate Advisory Arsenic Advisory Other Y If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: 7—Ile' %iFS_e-4=4 dd_s djac_ c t; LoT,/ Parcel ID: 0 51- e01-Zc// A. WELL DATA PugGtG-., ww O Well type If A, B, or C provide P SID # Date completed Sanitary se /N) Total depth ftCas o ft. FROM LL LOG Date of test Static water level ft. Well production g,p,m, WATER SAMPLE RESULTS: Coliformcolon' 100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SePflc- Well Log (Y/N) Wires properly protected (YIN) Casing height (above ground) - in. AT INSPECTION ft. g.p.m. Collected by: Date installed <5Z-7 6 Tank size /Z S4 gal. Number of Compartments Z • Cleanouts (Y/N) y Foundation cleanout (Y/N) � / Depression over tank (Y/N) /� High water alarm (Y/N) /V _ Date of pumping 64 A2 Pumper Sr_ .t &,n{ P, per -S C. ABSORPTION FIELD DATA Date installed 1{T{ Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length 2� -< ft. Width _S ft. Gravel below pipe 4y A/ /ft. Total depth �% ft. Eff. absorption area�f Monitoring tube Depression over field /V Date of adequacy test S 2Z i3 ResultsPass/Fail f'+SS ( ) For _�( bedrooms Fluid depth in absorption field before test 6' in. Water added 00 gal. New depth in. Elapsed Time: 00 min. Final fluid depth �_ in. Absorption rate >= Q G'` g.p.d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) Wk- If yes, give date D. LIFT STATION Date installed _ "Pump on" level Size in gallons in. "Pump ofr level at Datum / . Cycles tested E. SEPARATION DISTANCES WELL ON LOTTO: NA Septic tank/lift station on lot Absorption field on lot Public sewer mai Sewer /sep' service line Anim ntainment areas in. Manhole/Access (Y/ High water ala evel at Meets alarm circuit requirements? On adjacent lots On adjacent lots Public sewer me Holding tank/ excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation f / Property line _ 0 Absorption field Water main 40 t Water service line / Q "` Surface water /610 Wells on adjacent lots z 6 0 1 1& ABSORPTION FIELD ON LOT TO: Property line /0 Building foundation f Water main l d ''Vt- Water Service line O Surface water / Driveway, parking/vehicle storage f0 Curtain drain V dK Wells on adjacent lots 26° F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name 725V6 AUG Date 5�2Z3 COSA brown sheet 10-10.12.doc in. T �3 f >i 'e id. g� S%alb in. T Municipality of Anchorage '' • �" Development Services Department ' Building Safety Division .. .,... On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. QS1 - 4)011 -A HAA# tics (11915 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address or directions) WALLACE BOSSERMAN Day phone 230-9199 16306 PARKVIEW TARRACE LOOP • EAGLE RIVER, AK. 99577 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address BIRCH DRIVE • CHUGIAK, AK. 99567 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ individual On-site N 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 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysts of the system In accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described 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 soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor. do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DS. D SIGNATURE —SIApproved for _ bedrooms. Disapproved. Conditional approval for bedrooms, with the Phone_ 337-6179 Date rFR PNS„ Attachments: HAA Checklist_ Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By. ��� Original Certificate Date: (nor. irmi) Municipality of Anchorage • ' ` Development Services Department Building Safely Division Onsite Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us { (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: TABLELANDS SUBDIVISION: LOT 1, BLOCK 6 Parcel ID: bblb► -&4 A. WELL DATA PUBLIC WATER Well type If A, B, or C provide PWSID# Well Log (Y/N)— Date completed Sanitary seal (Y/N properly protected (Y/N) Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g -p -m- g.p.m. R WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate—mg./L. Other ba t r y fi Date of sample: Collected by: 8. SEPTIC/HOLDING TANK DATA Tank Type/Matedai STEEL/SEPTIC Date Installed 6/4-7/2004 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) NO Date of pumping NEW Pumper FIELD DATA C. ABSORPTION Date installed 6/4-7/2004 Soil rating.p.d. r ft%drm) 0_6 System type DUAL TRENCH Length 2 O 50 ft. Width 5 ft. Gravel below pipe 3.96-4.12 ft. Total depth *8-2-8.5 ft. Eff. absorption area 1000 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) For_4 caems Fluid depth in absorption field before test _ in. Water ad New depth _in. Elapsed Time: _ min. epth _ In. Absorption rate >=, g.p.d. na ion treatment (past 12 mo.) (Y/N 8 type) If yes, give date Date installed Size in "Pump on" level at _in. E. SEPARATION DISTANCES _ In. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot Absorption field on lot Public sewer main service line PUBLIC WATER On adjacent lots On Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed ame JEFFREY A. GARNESS Date j 1 /f �V 5" HAA Fee $ Waiver Fee $ Date of Payment 01710 Date of Payment Receipt Number o&o9q3Receipt Number (Rev. 12/01) . , V ;. G.... e8,... • 7953 2004-25 THE 'TABLELANDS SUBDIVISION LOT 1, BLOCK 6 40,006 S.F.