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HomeMy WebLinkAboutMOUNTAINSIDE VILLAGE BLK 3 LT 9Mountainside Village Block 3 Lot 9 #020-172-28 w Municipality of Anchorage Department of Health and Human Services Building Safety Division -- On -Site Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Pagel of 4 www.ci.anchorage.ak.us (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number SWSW030507 PID Number. 010-172-28 N.m. Wastewater System: ® New ❑ Upgrade Aca..a ABSORPTION FIELD Pbm. ol. of Beaoarlla, 0 Dano Tr.rch 0 Sn."a. Tr.ncn 0 Bed 0 Mand 0 Dolor. LEGAL DESCRIPTION Sod R" TOW Dpal Gam awr.l rade Bm"L LW aubdnaen: Doom to P" bW= Ian apno Pada Grata depth baram ppa' Toon" Rar" a.waL Fr added ebo.a apnW Pada 2 Ft GI" L .rpm. SR F1 Well: ® New ❑ Upgrade c.va wea Nuna. a M. D.bnce bawe "a faAcalim(Pmaa. A B, ct TOW Dpek Caaad b: Ta.l wbwpeorl.r.a PV. Malena. \ Z F, 290 Fe 14 OmarData D"w SbIK Wa.r L.M. I1.1.Aar Dale katow ,rad Pump sa at Caaep Neplrl Ab. crould Z•a TANK GPM le' FI. FI SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding ubliUPrlvate M'r"'laa'a'r caparnT From Tank Field Station Tank SewerLlne Anch Tank 1250 Ga WON 121.2 145.4 120 Maana NU a`mVanmaaa Steel 2 Sura wet. 100+ 100+ LIFT STATION La w 51.8 19.7 Sao. Marubauer Gal Fand.�m 16 26 •Pump w b.a a. •PuIV or "„a a Ho ever aln a. a k,ti I, Cuba Dram Pump Mak. a ModN Eleari-M oopecb" perlamW by Ram. W 0R 2" id Insulation over entire field and post tank line. BENCH MARK Lo ane D..alpbm: Basement Slab /uonad Eb.anm 100.0 FL Engineer's Stamp `P\E • �...... �b♦i . L'q • Inspections performed by: Pannone Eng. Svc Dates: 1"9119/2004 ' TH i ♦♦♦ 2nO09/19/2004 �.....r... .... .....,.......:L.... Department of Health d Human Services approval �''"':"'a """ ' ' ""'•"•'•' Steven R. ♦ to Funnone.',�i ♦i�% Reviewed and approved by: Datea No. CE 8149: '6' E?cl(22....••' " PERMIT NO: SW030507 RECORD DRAWING P.I.D. NO: 020-172-28-000—OS WASTEWATER DISPOSAL SYSTEM LOT 9, BLOCK 3, MOUNTAINSIDE VILLAGE 01 25' CREEK MAINTENANCE ESMf. R. Pannone�e Mr. Matt Evans 8149 �i 212 Deerfield Drive f fZ21..•_'`�� Anchorage. AK 99515 l JO •. a 101 QiIA SWING TIES 4.0 ON FEET): 8 �rD�IJR� FC �Ae / RESERVE DPj lNnELD • • "' ,,r 58LFxS1Vx3' 25.9 T2 4-9R 8MFC� NEW PRIMARY DRWN FIELD 10.6 T1 58LFx5Wx3'ED, 4'TD , C2 - M2 C1 19.7 F= '---' NEW 1 SOq NOTES: 51,6 SEPTIC ANK 1) All work shall be��— 83.6 performed In accordance with AMC15.65. ,ice 2) Materials used shall be in accordance with those 80.3 specified In AMC15.65, Wastewater Disposal. OR TH vor 3) Maintain 10' separation P\NS\DE MOVt� to all lot lines and proposed ENG. water lines. LLC 4) Lots served by a private 102954 wail. No wells within 100' of ANCHORAGE, ALASKA proposed system. C R. Pannone�e Mr. Matt Evans 8149 �i 212 Deerfield Drive f fZ21..•_'`�� Anchorage. AK 99515 l JO •. a 101 QiIA SWING TIES 4.0 ON FEET): 8 Cc] FC T1 17.0 25.9 T2 24.9 28.5 DC 27.2 29.6 C1 26.1 37.4 C2 83.6 96.9 M1 27.9 39.2 M2 80.3 93.5 TH 48.0 59.0 PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P. 272-8218 Fa: PLAN /M � PERMIT NO: SW020492 DESIGN DRAWING DETAILS P.I.D. NO: 020-172-28-000-05 WASTEWATER DISPOSAL SYSTEM LEGAL DESCRIPTION �:. 491ti R. F 81 3 N O F— LLJ V) Mr. Matt Evans 212 Deerfield Drive Anchorage, AK 99515 (Zo) mow310 (ZI9) 38(11 V011NON r z a o . o� o. as (1,H) 38(11 NOBNOM (lo) inowmo InONV313 NOUVONf103 c r 0 ih ti z 0 J h U FE Lv J in LL - z O PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax TATE: 12/20 04 DESIGN ;ALE: NTS 3 0 a am ooF z 0 sa Jaz c 05.J Q< a, m �:. 491ti R. F 81 3 N O F— LLJ V) Mr. Matt Evans 212 Deerfield Drive Anchorage, AK 99515 (Zo) mow310 (ZI9) 38(11 V011NON r z a o . o� o. as (1,H) 38(11 NOBNOM (lo) inowmo InONV313 NOUVONf103 c r 0 ih ti z 0 J h U FE Lv J in LL - z O PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax TATE: 12/20 04 DESIGN ;ALE: NTS FROM : fl_PINE DRILLING FFN NO. : 907 345 0202 Dec. 21 2004 12:04PM Pi Municipality of Anchorage Department of Health and Human Services AEM 825 *V Street P.O. Box 196650 Anchorage, Alaska 995196650 R'ek Mystmm hV1A~.eLanehempe.a1Lta Mayor Permlt Number. #SRI 3g o507 Date of Issue: 12-29-03 parcel Identification Number: 020-172-28 Date Started: 9-1-04 Data Completed:9-1.04 Is well located at approved permit location? 0 Yes (] No Legal Description: Mountabtslde Wlave Block 3 Lot 9 Property Owner Name & Address:' Matthew & Empy Evans 212 Deerfield Anchonsce, Alaska 99315 Borehole Data: Soil Type. TWcknm & Water Susta Depth (ft) From To Method of Drilling ® air rotary 0 cable tool Casing type: Ated stick-up 0 2 Wall'Ihickness: 250 inches organics & sift 2 3 Diameter: ¢ inches Depth: 32 feet graveP/ sik bedrock 3 23 25 106 Liner Type: Diameter. inches Depth feet Casing stickup above ground: 3 feet Static water level (from ground level): ILfeet Pumping level:_Mf:ct after 2 hours pumping 22t Spm Recovery Rate: z+gpm Method of Tatiag: gip, jt Well Intake Opening Type. ❑ Open End ® Open Hole 0 Screened Stan feet Stopped feet 0 Perfotatioas Start _ feet Stopped feet Grout Type: i>enronire 0 8 Volume: j Depth: Stan g t"t Stopped 1 feet Pump: Intake Depth — feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes [] No Method of Disinfection: chlorine t kigg Comments: Well Driller. Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner widiln 30 days of completion and the property MUNICIPALITY OF ANCHORAGEu v Development Services Department n 11 % ;� On -Site Water d Wastewater Program l `` V 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM f WATER SUPPLY PERMIT Initial Permit Number. SW030507 Legal Description!Mountairiside VAlage Block 3 Lot 9 Design Engineer: 0014 Anderson Engineering Owner Name: Matthew & Emily Evans Owner Address: 212 Deerfield Anchorage , AK 99515- Date Issued: Dec 29, 2003 Expiration Date: Dec 28, 2004 ParcelID: 020-172-28 Site Address: 212 Deerfield Lot Size: 66669 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑,/ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy All construction must be In accordance with: 1. The attached approved design. ❑✓ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907)343-7904(24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued BY AL2-- ' Date: 7'!1Z :Vjl Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. Property ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Number SW n 2 0 172 phone sS7. Z -t5 7 05 Mailing address (1) ef r" -f ': 1,,-,,P Y/ /l f? la H K Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Lot Size tg Acresq.Ft. Number of Bedrooms L% 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 ❑ certify that the above information is correct. I further certify that this application is being made for a Single FJamily`Dwelting and jajn-accordance with applicable Municipal Codes. of prop�rty chner or authorized agent) Permit Fees: / EN n Waiver Fees: Date of Payment:-�z ' 2 �n 3 Date of Payment: Receipt Number:�� rU 3(ri 3 Receipt Number: (Rev. 12/00) ipality of Anchorage o - c ]lark Begich, :Mayor CIL Building Stifcty Division P.O. Box 196650 • 4700 Brapa�e SLrect Anchorarq Alaska 95)319-GLH50 • (907) 343-&301 • FAC (907) 333-8200 DCCCal UCi u, 2003 Matthew &: Emily Evans 212 Deerfield Drive Anchorage, AK 99515 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW020492 Legal Description.Moun"tainsidc Village Block 3 Lot 91 r Dear Mr. R Mrs. Evans: An On -Site Water/Wastewater Permit, number SW020492, issued by this office for a single-family system, will expire on December 31, 2003. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincere 4WM&V Ja s Cross, P.E. M nager On -Site Water and Wastewater Program Enc: Copy of permit MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Dec 31, 2002 Expiration Date: Dec 31, 2003 Permit Number: SW020492 Parcel ID: 010-172-28 Legal Description: mountainside village subdivision b [0 Design Engineer. 0014 Anderson Engineering Site Address: 212 deerfield drive Owner Name: matthew and emily evans Lot Size: 66669 SO. FT. Owner Address: 212 deerfield drive Total Bedrooms: 4 Permit Bedrooms: 4 anchorage , A 99515 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: /^OZ -03 Issued By: `Date: (Z 3t k7Z Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020.172.28 Permit Number SW Property owner(s) Matthew and Emily Evans Day phone 441.0998 Mailing address (1) 212 Deerrield Drive Anchorage, AK 99515 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 9, Block 3, Mountainside Village Subdivision Legal description (Section, Township & Range) Lot Size 66,669 SF Acres/Sq.Ft. Number of Bedrooms Four (4) 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 ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: (f S5O Waiver Fees: Date of Payment: % Z' ZG — O Zr Date of Payment: Receipt Number: 2g53S' Receipt Number: (Rev. 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) December 24, 2002 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 9, Block 3, Mountainside Village Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. The owner of Lot 9, Block 3, Mountainside Village Subdivision intends to construct a four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the new home on the property. The attached Site Plan and backup documentation identify the location and configuration of the new well and septic system and the parameters used in the design. Also identified on the plans are the alternate site, test hole locations and septic systems and wells on the surrounding lots. Drainage arrows are also shown and current drainage patterns will be maintained after construction. A small stream currently traverses the lot near the northern boundary. All components of the septic system will be placed a minimum of 100' from the stream. The test holes placed near the location of the proposed and alternate absorption trenches indicated silty gravel and sand. The percolation rate on the material was measured at between 3 and 5 minutes per inch. No ground water was found near Test Hole No. 1, but was found at 14' in Test Hole No. 2. The water level rose to 9.2' in Test Hole No. 2 during the monitoring period, but was not detected in Test Hole No. 1. We are therefore proposing to place a new 1,250 -gallon septic tank with a new 58' long by 5' wide absorption trench with 3' of gravel beneath the distribution pipe. The total depth of the trench will be 4' below the surface with the distribution pipe at V below the surface. Insulation will be required to prevent frost penetration. Mounding over the trench to provide 3' of cover may be utilized in lieu of insulation. The ground surface on the lot slopes at grades between 10% and 15% from south to north. The absorption trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from the stream on the lot. The system will also be constructed a minimum of 100' from all wells in the area. If the system is constructed in accordance with our design the following statements Lot 9, Block 3, Mountainside Village December 24, 2002 Page Two apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, �^ n 7A,LJl.a,�,L C� a"4" 1 Michael E. Anderson, P.E. Attachments 0 V•CNAEL E. ANDERSON 4 No. CE -4781 j 1 s sem" `''*+4,;,�'"o y* E SWo.XS 8 EE Q, vwwh F o w ,�,� t , VACANT' .'+/ 8• ;,a �. C! M�% 5 Ee Nms,a°E p .yp(A AREA MAP SCALE 1• =100' �E 10 7 N mi ui OD S010522 -E (NR) �O258.28 Sc So / o 0 'V O ZV 0 a CDo m m m/o'So CD Cb N co Cl a o Ln m CD 0 0 a m G Z m -p G D Z ui OD S010522 -E (NR) �O258.28 Sc So / o 0 'V O ZV 0 a CDo m m m/o'So CD Cb N co Cl a o Ln m CD 0 0 a m LOT 9, BLOCK 3, MOUNTAINSIDE VILLAGE DESIGN FACTORS: 4 Bedroom House Perc. Rate: 3 - 5 MinAnch Application Rate: 1.2 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,250 Gallon STEP Tank 3' Drain Field Rock 4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF of Absorption Area 500 SF/S LF (Width)' .58(Red. Factor) = 58 LF Trench Length Therefore: Construct a 58' Long'X 5' Wide Absorption Trench With a 3' Effective Depth. Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be 4' Below Existing Ground. Maintain 100' Separation From Stream on the Lot and the Proposed Well. Place 2" of Direct Bury Insulation and 2' of Fill Over Absorption Trench or Provide Minimum 3' of Cover to Prevent Freezing. Provide 4' of Cover Over Septic Tank. / 3' Natural Backfill 2' Insulation E 2' 13ackfill 2', Insulation 6" Geofeatile Fabric 6" f cl 3' 4" Perforated PVC (ASTM 3034) Drainfield Rock . TYPICAL WIDE TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. 3 49th WCNAEL E. ANDERSON 1& i pp FROM Fk% NO. Jul. 19 22001 01:22PM P2 ALASKA WATER & WASTEWATER CONSULTANTS, INC. SII I OG — PERCOLATION TEST 1 LEGAL DESCRIPTION: MOUNTAINSIDE VILLAGE S/D: LOT 9, BLOCK 3. PERFORMED FOR: JENNIFER C. ALEXANDER DATE PERFORMED: 7/26/00 WEST DEPT) yy^E ORGANICS TEST HOLE #1 feet 1 iilu1Km 6 SM W/ SOME 7 ML 8 10 B.O.H. 11- 12- 13- 14- 15- 16- 17— is- 19 112131415161718 19 20 COMMENTS: SOIL CLASSIFICATIONS (MINUT S) TIME e5 o GW 8/2/00 1 77779 ORG !! r4 _ GP 2 I 11mu ML 2 1 4- GM 3 9:31 CL 6. GCFTTTTI 4 9:41 OL SW 5 9:41 MH ::•.: SP 6 9:51 CH 2 3/4' SH 7 9:51 OH 6- Sc 9 DEPTH TO DATE GROUNDWATER DRY 7/28/00 DRY 8/6/00 ��\ �•_ ��IFOR TH LOCATIO LOT 9. BLOCK 3 ` MOUNTAINSIDE VUAGE `1 DATE READING CLOCK (MINUT S) TIME WATER LEVEL READING NET DROP (INCHES) 8/2/00 1 9:21 — 6' — 2 9:31 10 2 1 4- 3 3/4' 3 9:31 6. — 4 9:41 10 3 1/2� 5 9:41 6� — 6 9:51 10 2 3/4' 3 1/4 7 9:51 — 6- — 9 10:01 10 2 3/4- 3 1/4' 10 10:01 6. — 11 10:11 111 10 2 7/8' 3 1/8- 12 13 1021 10 2 7 8- 3 1/6 - PERCOLATION RATE 3.2 (MIN./INCH PERC. HOLE DIA. 6 (INCHES) TEST RUN BET EN 4.5 FT. AND 5. FT. oron unIr Wes PRFSDAKFD 4t MOURS PRIOR _ PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFCAMED IN ACCORDANCE WITH ALL STATE AND b1UNICIPAL GUIDELINES IN EFFECT ON FR'01I VAX No. Jul. 19 2001 01:23PL1 P3 ALASKA WATER & WASTEWATER CONSULTANTS, INC. 69PHONE (907) 337-6179 •B FAX (907) 33a 32469 SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: MOUNTAINSIDE VILLACE S/D: LOT 9. BLOCK 3. PERFORMED FOR: JENNIrER.C. ALEXANDER DATE PERFORMED: 7/28/00. EAST DEPTH ---- TEST HOLE #2 (feet) ORGANICS 1 2 3 4 5 11 111 6- 7- 10 7 10 1 114 1 12 13-1 {� 14 B.O.H. 15 16 17- 18 19 20 COMMENTS: OFF LENSES SM OIL CI ASSIFLCAT10NS y vi GW ='= ORG W READING LEVEL GP ML 9:33 9:43 GM CL 3 1/4" GC 9:43 OL ' •�s SW 4 MH •' SP CH 5 SM OH • SC 6 DATE 14.0' I . . . . . . . . . . . . . . . . . A. Gamess. —7953 FOR TH LOCATIONS LOT 9. BLOCK 3 \ MOUNTAINSIDE VILLAGE rte^,..-• -� � —� DATE READING TOCK NET TIMEME (MINUTES) W READING LEVEL NET DROP (INCHES) 8/2/00 1 2 9:33 9:43 — 10 6" 2 3 4" 3 1/4" 3 9:43 — 6" — 4 9:53 10 3 1/4" 2 3/4" 5 9:53 6" — 6 10:03 10 3 1/2" 2 1/2" 7 10:03 6" — 9 10:13 10 3 1/2" 2 1/2 10 10:13 — 6" 11 10:23 10 3 3/4" 2 1/4" 12 13 10:23 10:33 — 10 6" 3 3 4' — 2=1 4" PERCOLATION TEST RUN BE' PERC. HOLE WAS PRESOAKCD 4r• E> - 4 FT. AND TO TESTING. HOLE DIA. 6 (INCHES) PERFORMED BY ALASKA WATER do WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFOFyMEO N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 9, BLOCK 3, MOUNTAINSIDE VILLAGE SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 -gallon septic tank at the location shown on the site plan and the construction of a new 58' long by 5' wide by 3' effective depth absorption trench also shown on the Site Plan. The total depth of the trench will be 4' below existing ground and the distribution pipe will be placed at 1' below the surface. All components of the new absorption trench and septic tank must be constructed a minimum of 100' from the proposed well on the lot and 100' from any surface water including the stream traversing the lot. A minimum of 4' of cover is required over the septic tank and 3' over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 -gallon septic tank must be procured from a certified septic tank manufacturer. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Lot 9, Block 3, Mountainside Village December 24, 2002 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Lot 9, Block 3, Mountainside Village December 24, 2002 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-172-28 1. GENERAL INFORMATION Expiration Date: 9.-7-/3 Complete legal description MOUNTAINSIDE VILLAGE BLOCK 3. LOT 9 Location (site address) 17600 MOUNTAINSIDE VILLAGE DRIVE, ANCHORAGE, AK 99516 Current Property owner(s) MATTHEW& EMILY EVANS — Day phone Mailing address Real Estate Agent 4826 JUMAR AVENUE, ANCHORAGE, AK 99516 2. TYPE OF DWELLING: M Single Family (w/wo ADILI) F-1 Duplex F1 Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 19 Individual M Individual Water Storage El Holding Tank El Community Class_ Well El Community R Public Water System 11 Public Sewer F-1 Waiver/Variance request for: COSA to be released to the engineer, unless COSA Fee $ q ,w Waiver Fee $ Date of Payment CLQ9— Date of Payment Receipt Number do253 2 0 Receipt Number COSA 4 '95C131Q3'D 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 ARCTERRA CONSULTING. INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 5130113 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, AYcTerra can not give any estimate of how long a r OF AZ � \, system will function satisfactoryfor current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. _. it Q Ti -j �. 6. DSD SIGNATURE System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulatl kKJ Y (Wl ©F J ON-SITE �aWACTrIAIATC ern PROGRAM 60)) By: Original Certificate Date: �f �7 The MunicipaN y oA orage 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 blue sheet 10-10-12.do 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: MOUNTAINSIDE VILLAGE BLOCK 3 LOT 9 Parcel ID: 020.172.28 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # _ Date completed 911/2004 Sanitary seal (Y/N) Y Total depth 106 ft. Cased to 32 ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: 911104 ft. 20+ g.p.m. Coliform NEG colonies/100 mL Nitrate 3.79 mg/L Arsenic: ND ug/L Date of sample: 5123113 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 5123113 Pumper A+ C. ABSORPTION FIELD DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION 512312013 nil Collected by: ARCTERRA Date installed 9/1912004 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 9119124 Soil rating (g.p.d./ftz or ftz/bdrm) 1.2 System type SHALLOW TRENCH Length 58 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 5.25 ft. (Measured 523/13) Eff. absorption area 290 ftp Monitoring tube Y Depression over field N Date of adequacy test 512312013 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 25 in. Water added 750 gal. New depth 34 in. Elapsed Time: 1140 min. Final fluid depth 23 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at_ in. Datum Size in gallons "Pump off' level at—in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 1001+ Public sewer main 75'+ Sewer /septic service line 25'+ Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 1001+ On adjacent lots 1004 Public sewer manhole/cleanout 100'+ Holding tank 100'+ Animal containment areas 501+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 51+ Absorption field 54 Water main 101+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 1001+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 101+ Surface water 1004 Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(NONEKNOWN) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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 KENNETH M. DUFFUS Date h 3 COSA brown sheet_10-10-12.doc OF ALS', 4q 1H4,," 61. %KENNEI`N M. 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