HomeMy WebLinkAboutNORTH WOODS BLK 2 LT 1Northwoods
Block
Lot 1
#051-741-18
Inspection Report
Municipality of Anchorage
Community Development Department Page 1 of 3
On-Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151127
PID Number: 051-741-18 ❑ New ❑✓ Upgrade
Name:
Darrell R Lori Saylor
ABSORPTION FIELD
❑✓ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
22928 Northwoods Drive Chugiak, AK 99567
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
830-0884
4
.6GPD/SF
9.5 Ft,
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5 Ft.
Gravel depth beneath pipe
6.0FL
Subdivision
Block Lot
North Woods
2 1
Fill added above original grade
0-1 Ft
Gravel length
90 Ft
Township Range Section
Gravel width
3Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist, between trenches
From
Tank
Field
Tank
Line
1,080 Fiz
One
Ft.
Well
NA
NA
NA
NA
NA
TANK ❑ Septic O S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Existing
Capacity
I Gal.
Surface Water
>100'
>100'
>100'
>100'
Material
Number of compartments
Lot Line
>5'
1'**
N/A
N/A
NA
Foundation
>5'
>10'
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
Noted
Gal.
RemarksExisting STEP Tank Verified Suitable for
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Continued Use. Existing Trench Remains Available
for Future Use.
Pump make and model
Electrical Inspections performed by
**See Lot Line Waiver.
Installer
PIPE MATERIAL Housetotank D3034 Tankto D3034
drainrield
Red Dog Excavating
Drainfield F810 CO/MT D3034
Inspector MEA
BENCH MARK (Assumed elevation) 100.Oft
Inspection-
dates: 1' 5/16/15
20 5/18/15
Location and description
3" 5/22/15
4'"
Rear Deck
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
+��� gi Stafiw ,1
•�';I
Conditional Approval:
Date
Q 9THE�
PP����V111
... .... ... ...
/.... ..... I......................
MICHAEL E. ANDERSON :0
CE-4381 gam®
II,t���sws
Approved
(�t/• ��g"�
Date
����•
Inspection Report
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number:OSP151127
U ,5
Existing 1,500 Gallon STEP Tank
Finished Grad.
Geotextile Fabric
Page 3 of 3
PID No. 051-741-18
M (O
� U
101.5 n n
i II II
F 99.0
30 - 3/16" Diameter Holes @ 3'
92.0 —�
— 85.0
Groundwater @ 88'
5115/04
Test Hole was placed in 2004 prior to the placement of an additional 2.5' of fill over the area.
The original depth of the test hole was 14'. With the addition of the fill above existing ground
The depth becomes 16.5'.
PROFILE AS -BUILT
No Scale
" — 98.0
"PVc
-
�/— 92.0 Drainfield Rock
F1
30 - 3/16" Diameter Holes @ 3'
92.0 —�
— 85.0
Groundwater @ 88'
5115/04
Test Hole was placed in 2004 prior to the placement of an additional 2.5' of fill over the area.
The original depth of the test hole was 14'. With the addition of the fill above existing ground
The depth becomes 16.5'.
PROFILE AS -BUILT
No Scale
" — 98.0
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP151127
Tax Code Number: 05174118000
Work Type: Septic Upgrade
Permit Effective Dates: May 15, 2015 to May 14, 2016
Design Engineer: ANDERSON ENGINEERING
Subdivision: NORTH WOODS
Site Legal Address: NORTH WOODS BLK 2 LT 1 G:1559
Owner/Address: SAYLOR DARRELL W & LORI A
22928 NORTHWOODS DR CHUGIAK AK 995670000
Site Mailing Address: 22928 NORTHWOODS DR, Chugiak
This permit is for the construction of:
Y Disposal Field N Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 27714
Total Bedrooms: 4
N Private Well N Water Storage
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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: PRIOR TO CONSTRUCTION: Any portion of the property line, utility easement,
and water service line within 20 feet of the proposed drainfield shall be flagged by a licensed
surveyor prior to construction.
Received B
Issued By:
Mu
r of Anchorage
Development Services Division
On -Site Water and Wastewater Program
Ment
NOepartme�Til-
****
VARIANCE/WAIVER REVIEW ****
Waiver#: OSVIS1039 COSA#: Permit#:OSPISI127
PID#: 051-74148
Legal Description: Northwoods: Block 2. Lot 1
Engineer: Anderson Engineering
Applicant: Darrell & Lori Savior`
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the absorption field has been approved. The approved separation distance is 6 feet.
This waiver approval applies to the proposed and existing absorption fields only. Any future
upgrade to the on-site wastewater disposal system will require all separation distances be met or
r another approval from this departri�extt ,
Q The affected adjacent propertyowniO ,hive been given a T day notice regarding this
waiver..
Notarized letter(s) of non -objection have been received from the owner(s) of the affected
ad'
Jacent property.
Adjacent properties are not affected by this waiver.
Waiveria Granted: X Waiver is not Granted:
Date: A— Approved by:
ame of Reviewer
>I
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-741-18
Property owner(s) Darrell & Lori Saylor
Mailing address 22T Northwoods Drive Chugiak, AK 99567
Site address 22928 Northwoods Drive Chugiak, AK 99567
Day phone 830-0884
Legal description (Sub'd., Block & Lot) North Woods, Block 2, Lot 1
Legal description (Township, Range & Section)
Lot Size 27,714 Sq. Ft. Number of Bedrooms
Four (4)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(M all that apply)
Absorption Field E] Initial
Single Family (SF) El
(w/wo ADU)
Septic Tank ❑ Upgrade
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Trench to Trench Distance: 7'
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
'fL(�
of property owner or
Permit/Rush Fees:
Date of Payment: _
Receipt Number: d
Permit No. Qsr
Permit App_9-1-12.doc
U Waiver Fees'.
Date of Payment: S /y
49 Sp
q C7 -Receipt Number: —1 lT
Id _;� Waiver No. 0Sj(5-/03q
May 14, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 2, Northwoods Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing absorption trench on the subject lot has failed and must be replaced prior
to the issuance of a Certificate of On Site System Approval (COSA) for the lot. We are
therefore requesting a permit be issued to construct a new absorption trench to
accommodate the four-bedroom home on the lot. The existing 1,500 gallon STEP tank
will be inspected and verified suitable for continued use. The attached Site Plan and
backup documentation identify the location and configuration of the proposed
absorption trench and the existing septic system and water service. The subdivision is
served by a public water system. No conflicts exist between the proposed absorption
trench and septic system and wells or septic systems on adjacent lots. A lot line waiver
was issued with the original septic system permit for the lot allowing the new system to
be within 1' of the lot line.
The test holes placed on the lot in the area of the absorption trench and alternate site
during the initial permitting indicate the presence of silty sand with some gravel. The
percolation rate of the material was determined to be 12.6 to 20 minutes per inch. No
groundwater was found during the placement of the test hole but registered at 11'
below the surface during the monitoring period. An application rate of .6 gallons per
day per square foot was used in the design of the absorption system. We are
proposing to use the existing 1,500 -gallon STEP tank and a new 85' long by 3' wide by
6' effective depth absorption trench to treat and dispose of the effluent generated in the
house. The elevation of the distribution line in the absorption trench will be 3.5' below
the existing ground surface and the total depth will be 9.5' below ground. This depth is
exactly the same as the existing trench and the bottom of the new trench will be at the
same elevation as the existing trench. An additional 2' to 4' of fill was placed over the
septic area during the construction of the existing absorption trench. A minimum of 3'
of fill or 2" of insulation and 2' of fill will be placed over the absorption trench. The new
trench will be only 7' from the sidewall of the existing trench. A waiver request is
Lot 1, Block 2, Northwoods Subdivision
May 14, 2015
Page Two
attached to allow the encroachment into the rregquuiireed�sseparratti n distance.
The ground surface on the lot in thearea of the septic system is flat. The new trench
will be constructed parallel with the slope as much as possible in conformance with
Municipal requirements. The new septic system will be constructed a minimum of 100'
from all wells and any surface water and 10' the existing water services in the area.
If the system is constructed in accordance with our design the following statements
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,
E
Michael E. Anderson, P.E.
Attachments
49th•••°:
E. ANDERSON
CE -4381
May 14, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 2, Northwoods Subdivision
New Absorption Trench to Existing Trench
Dear Onsite Services Engineer:
Very fl!�,�ar a is avail ble on the subject lot to construct a new absorption system due
to the.l�� the property. The alternate absorption trench site was
approved with the original permit in 2004. The sidewall of the alternate trench was
located 7' from the primary trench. The primary trench has now failed and must be
replaced. The soil on the lot percolates between 12 and 20 minutes per inch. Little
migration of the septic effluent is expected. We therefore recommend the new trench
be placed at the location previously approved and 7' from the existing trench on the lot.
Sincerely,
4 4
Michael E. Anderson, P.E.
49th••••• a
MICHAEL E. ANDERSON
No. CE -4781 .
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LOT 1, BLOCK 2, NORTHWOODS
DESIGN FACTORS:
Four Bedroom Home
Pere. Rate: 20 Min./Inch
Application Rate: VGPD/SF
4 Bedrooms X 150 GPD/.6 GPD/SF (Application
1,000 SF/12 SF/LF = 83.3 LF Trench Length
SYSTEM REQUIREMENTS:
DeepTrench System
1,500 Gallon STEP Tank - Existing
6' Drainfield Rock
Rate) = 1,000 SF Absorption Area
THEREFORE: Construct a 85' Long x 3' Wide x 6' Effective Depth Absorption Trench at the
Location Shown. Flow Line Elevation in Trench to be 3.5' Below Original Ground Surface. Total Depth
to be 9.5' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. Maintain 100' Separation from Wells in the Area.
310" Natural
Backfill
Geotextile
Fabric
6" O 1" Perforated
PVC (Holes Down)
3/16" Diameter Holes
30 Holes @ 2.8' on Center
6'0"
Drainfield Rock
3'
TYPICAL DEEP TRENCH SECTION
NOTE:
(NO SCALE)
Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams:
VeTech Engineering Technical `.
P.O. Box 873141 Wasilla, Alaska 99687-3141
Phone: 907-357-6304 Fax: 907-357-6305
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION- I OT I BI OCK 2. NORTHWOODs _S/D
PERFORMED FOR- LARRY McBAIN _-
DATE: 3/31/2004 PROJECT No - M0414
PARCEL ID#: TECHNICIAN: T.L. KIMBROUGH
f
`49ILI
.•e •'oe•owe ... •
........
s®o MCIIAEL !. ANDERSON •,ate' ,
CE -4381
DEPTH TEST HOLE # 1 Type of Test: ® Percolation ❑ Visual
(feet)
1
READING
2
...
3
s�
4
TEST HOLE PRESOAKED PRIOR TO TESTING:
5
1
11:00
6
7.0"
1
1
OB / OG
PERC ZONE
BROWNISH - GRAY
DAMP SILTY -SANDS W/GRAVELS
ORGANICS SOME COBBLES TO 10"
SLOPE
SITE PLAN
F-'
LU
LU
w
U)
w
}
F-
OTH2 OTHI
e
SEE FUTURE ASBUILT
WAS GROUND WATER ENCOUNTERED? NO
IF YES Q WHAT DEPTH?
2%
DEPTH OF WATEIZ�AFTER MONITOR) NG:
DATE OF MONITORING: 5/15/2004 E
��% f�
i
low
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
WATERF
(INCHES)
INET DROP
(INCHES)
3/31/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:00
7.0"
CHARGE
2
11:30
30
4.5"
2.5"
3
11:30
8.0"
RECHARGE
4
12:00
30
5.625"
2.375"
5
12:00
8.0"
RECHARGE
6
12:30
30
5.625"
2.375"
PERCOLATION RATE: 12.6(MIN/INCH) PERC. HOLE DIA. -(INCHES)
TEST RUN BETWEEN:: 55 FT. and 6.5 FT.
COMMENTS: NO IMPERMEABLES ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR To TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE--
VeTech Engineering
P.O. Box 873141 Wasillc
Phone: 907-357-6304
Technical Servi(
Alaska 99687-3141
Fax: 907-357-6305
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION- 1 OT BLOCK 2 NORTHWOODS SID
PERFORMED FOR* LARRY McBAIN
DATE: 3/31/2004 PROJECT No • M0414
PARCEL ID# TECHNICIAN: T.L. KIMBROUGH
A . 49T–H e
a+m : WCHAEL E. ANDERSON,,-'
CE -4381 <°�,®
6q�tfQFO,�' �1r/ p°�
@®a_pROFESSV-4tp
DEPTH TEST HOLE # 2 Type of Test: ® Percolation
(feet)
8
9
10 ..r.' •y
r,
12--
14—'
2 14 .
I
I
OB / OG
PERC ZONE
BROWNISH - GRAY
DAMP SILTY -SANDS W/GRAVELS
ORGANICS SOME COBBLES TO 10"
SLOPE
SITE PLAN
H—
z
Lu
g
Lu
a
Lu
r
J
OTH2 OTHI
0
SEE FUTURE ASBUILT
WAS GROUND WATER ENCOUNTERED? NO SS
IF YES Q WHAT DEPTH? L 2%
DEPTH OF WATER AFTER MONITORING: 3 O
DATE OF MONITORING: 5/15/2004 Ct
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
NET DROP
(INCHES)
3/31/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:15
8.5"
CHARGE
2
11:45
30
6.875"
1.625"
3
11:45
8.0"
RECHARGE
4
12:15
30
6.5"
1.5"
5
12:15
1 8.0"
IRECHARGE
6
1 12:45
30
1 6.5"
1 1.5"
PERCOLATION RATE:00.004INANCH) PERC. HOLE DIA. 6_ffINCHES)
TEST RUN BETWEEN:: 5_5 FT. and 6.5 FT.
COMMENTS: NO IMPERMEABLES ENCOUNTERED
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
Municipality of Anchorage Page 1 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
Tlnhw.d.ondlorage.sk.us (907) 343.7904
ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO40185 PID Number. 051-741= / $
Mai,
Ascend Construction
Wastewater System: New
Adanea:
P.O. Box 231169 Anch., AK 99523
ABSORPTION FIELD
223.3725 our
Deep Trench
LEGAL DESCRIPTION
Sd Rema.
TaW DORM ham a" Grade.
7
.6 GPINVe
FI.
111 c La lsubd t
Depm m PRO hen agrW Wad-
G,v degm harm pap
2 1 Northwoods . ` %
1 FI.
FA added rd.a cng r Vada.
6 Ft
Qx LffvP
To -wap'. Ranee. sdr - ✓
24 FI.
87 Ft.
Well: Community Water System
esel rrdln.
3
14 n of
1
D.M U.I..en Ines.
Ft.
- FL
clnadrnan lPrN«e. A. a. Q.
Total Deptl Grad m.
a«tleapa wow
PRO MIM.el.
FI. Ft
1,044 Fe
ASTM 3034 PVC
Dnlw:
Date Dntbd: stead Welt Lent:
Ft
Sanders 3 Sanders
6114-1612004
Yem.
PWVsatG"V
1.0 MmwGraem
TANK
GPM
Fl.
FI
SEPARATION DISTANCES
STEP
To
From
Septic
Tank
Absorption
Field
Litt
Station
Holding
Tank
lubliaIvrnate
sewer Line
"
Anchorage Tank
m
1,500
WON
>100'
>100'
>100'
NIA
>25'Steel
Two (2)
aMrwa. w««
>100'
>100'
>100,
WA
LIFT STATION
Latuo
>5'
>10,
>10,
WA
250 G«
Anchorage TanWOrenco
Faum•on
>5'
>10'
>5'
WA
�W 42« n
42 to
I High 44 a«. m.
DMlen Dra+l
>20'
>20'
>20'
PW V M" a Madel
Orenco
EMchKat tnepeanne pwk med by
Certified Electrician
R° ha
BENCH MARK
Finished Floor.
A wmd ENv«wn:
100.0 Ft
Engineer's Stamp
��p�salgss
.� •
Inspections performed by: MEA Dates: 1" 6114/04
wo 49th
•
Zm 6I16I04
r r _. t •
, -�A}y MICHAEL E. ANDERSON/
Department of Health and Human Seryices approval
•. s+ No. CE -4381 F$"
Reviewed and approved by: 4 Date: a 9 -
Date:
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SWO40185
TBM
Page 3 of 3
PID No. 051-741-32
101.24'
Geotextlle Fabrlc
100.87'
PROFILE AS -BUILT
Scole: 1" a 20'
1- PVC
3/16'Holes 2 3' Spacing
Dralnfleld Rock
PROFILE AS -BUILT
Scole: 1" a 20'
Feb 25 05 03:49p
■
Willodell Enterprises Inc 349-9164
WILLORELL L
EntzalrprSO Ir��•.
Phone(907)561-6064
Pax(907)349-9164
Cell Phone (907) 2443754
Emailteveo r1.ak.net
www. w i l l od e l l en t err ris es. a om
February 25, 2005
To whom it may concern,
p.1
P. O. Box 230972
Please know that Lot 1 Block 2 Northwood Phase 2 Septic System is wired to Local and National
Electrical Code, per 2005 NEC Code Book.
General and Electrical Contractor #28550
Permit Number: SW040185
MUNICIPALITY OF ANCHORAGE
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
(.0IILA (oy-401
1011'-3 4 C O
r%4 Mto
Date Issued: Jun 14, 2004
Expiration Date: Jun 14, 2005
Parcel ID: 051-741• 19
Legal Description: NORTH WOODS : 7 3LK 2 LT 1 "
Design Engineer. 0014 Anderson Engineering Site Address: 022225 WHISPERING BIRCH DR
Owner Name: Ascend Construction Lot Size: 27938 SO. FT.
Owner Address: P.O. Box 231169 Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage , AK 99523 -
This permit Is for the construction of:
❑� Disposal Field E 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, seated, and heated to prevent freezing.
Received By.
Issued By.
Date:
Date: G i
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 995195650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 4 1 — 3 Z Permit Number SW
Property owner(s) Ascend Construction Day phone 223.3725
Mailing address (1) P.O. Box 231169 Anchorage, AK 99523
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) Lot 1. Block 2. North Woods Subdivision No. 2
Legal description (Section, Township & Range)
Lot Size 27,TM SF Acrese)
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
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:
Waiver Fees:
Date of Payment 1 0Ci Date of Payment
Receipt Number. Receipt Number.
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
June 1, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 2, North Woods Subdivision No. 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, Block 2, North Woods Subdivision No. 2 intends to construct a four-
bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the new home. The subdivision is
currently served by a community water system. The Site Plan and backup
documentation identify the location and configuration of the proposed septic system
and alternate site. The water service to this lot is also shown. Existing spot elevations
and the current drainage pattern are also identified on the Site Plan. The drainage
pattern will be maintained after development of this lot is complete.
Two test holes were recently placed on the lot, which indicated silty sand with gravel in
the area of the absorption trench. The accepting soils were tested and found to have a
percolation rate of 12 to 20 minutes per inch. No groundwater was found during
excavation but was noted at 11' below the surface during the monitoring period. Our
design includes the placement of a new 1,250 -gallon septic tank along with an 85' long
by 3' wide by 6' effective depth absorption trench to collect and treat the sewage
generated in the house. The bottom of the trench will be 7' below the surface to
provide the required separation from the bedrock. The distribution pipe will be 1' below
the surface. A minimum of 3' of cover will be placed atop the trenches and a minimum
of 4' of cover will be placed atop the new septic tank.
The ground surface on the lot slopes at shallow grades from southwest to northeast to
the midpoint of the lot and then drops off sharply as shown on the Site Plan. The
absorption trench will be constructed parallel with the slope of the ground surface as
much as possible in conformance with Municipal requirements. The new septic system
Lot 1, Block 2, North Woods Subdivision No. 2
June 1, 2004
Page Two
will be constructed 1 00'from all surface water. It will also be constructed a minimum of
10' from any water service in the area.
If the system is constructed in accordance with our design the following statements
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,
w Ea"' ,
Michael E. Anderson, P.E.
Attachments
th
MICHAEL E. ANDERSON
6. No CE -Asst -,
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AREA MAP -� No
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SCALE 1" = 100' �*4 sslo
LOT 1, BLOCK 2, NORTHWOODS SUBDIVISION NO.2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House Deep Trench System
Perc. Rate: 20 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .6 GPD/SF 6' Drainfield Rock
4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area
1,000 SF/12 SF/LF = 83.3 LF Trench Length
THEREFORE: Construct an 85' Long x 3' Wide x 6' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be
T Below Existing Ground. Maintain 10' Separation From Water Service on Lot. Provide T of
Cover Over Trench and 4' Over Septic Tank or Provide 2" Insulation and 2' of Cover.
Maintain 100' Separation Between Open Surface Water and Septic Tank and Absorption Trench.
Natural
6' Backfil Geotextile
Fabric
6^ 4" Perforated
PVC (Holes Down)
aii
;AL DEEP
SCALE)
Drainfield Rock
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams. .
Minimum 10' Separation From Water Service Line.
VeTech
n ical Service
P.O. Box 873141 Wasilla, Alaska 99687-3141
Phone: 907-357-6304 Fax: 907-357-6305
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION OT L RI O K T. NORTHWOODS #2 SID
PERFORMED FOR- LARRY McBAIN
DATE: 3/31/2004 PROJECT No • MO414
PARCEL IDN- TECHNICIAN: T.L. KIMBROUGH
DEPTH
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3
4
6
7
8
9
11
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CE -4381
TEST HOLE # I Type of Test: ® Percolation ❑ Visual
PERC ZONE
BROWNISH - GRAY
DAMP SILTY -SANDS W/GRAVELS
ORGANICS SOME COBBLES TO 10'
WAS GROUND WATER ENCOUNTERED? NO
IF YES @ W HAT DEF n r
DEPTH OF WATEL)ATE RMOMTORING 3'
y(//URATE OF MONITORING: 5/15/2004
SITE PAN
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SFE FUTIRF ASnllll T
2%
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
WATERF
(INCHES) I
NET DROP
(INCHES)
3/31/041
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:00
7.0'
CHARGE
2
11:30
30
4.5'
2.5'
3
11:30
8.0'
RECHARGE
4
12:00
30
5.625'
2.375'
5
12:00
1
8.0'
RECHARGE
6
1 12:30
1 30
5.625'
1 2.375'
PERCOLATION RATE I� 2_6 (MINANCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN --5.5 FT. and 6.5 FT.
COMMENTS: NO IMPERMEABLES ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR To TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED N ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
VeTech Engineering
P.O. Box 873141 Wasilla,
Phone: 907-357-6304
Alaska 99687-3141
Fax: 907-357-6305
SOILS LOG - PERCOLATION TEST
rvi
LEGAL DESCRIPTION- I OT L BI OCK 2. NORTHWOODS #2 SID
PERFORMED FOR- LARRY McBAIN
DATE: 3/31/200/• PROJECT No - M0414
PARCEL IDJP TECHNICIAN: T.L. KIMBROUGH
III
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MICHAEL E. ANDERSON
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CE .4381 •:moi;
✓ice •. A: m
DErnl TEST HOLE # 2 j Type of Test: ® Percolation
tf«n
10 i::
4'•Y�,
12-
13-
14-
15-
16-
171
21314151617
18
19
SITE PAN
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OTH2 OTHI
in
SFF FUTLIRF ASRUII T
WAS GROUND WATER ENCOUNTERED? NO
IF YES Qr WHAT DEPnr? 2%
DEPTH OF WATER AFTER MONITORING: 3•
DATE OF MONITORING: 5/15/2004
DATE
READING
OB / OG
NET TIME
(MINUTES)
WATER
(INCHES)
NET DROP
I (INCHES)
3/31/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
2
1
11:15
8.5'
CHARGE
3
2
4
"'�.:•
6.875'
1.625'
3
11:45
8.0'
RECHARGE
6
-:
PERC ZONE
30
6.5'
1.5'
7
BROWNISH - GRAY
12:15
c:'Sd
DAMP SILTY -SANDS W/GRAVELS
8
'• `'
ORGANICS SOME COBBLES TO 10'
6
12:45
30
9
..,,`.
10 i::
4'•Y�,
12-
13-
14-
15-
16-
171
21314151617
18
19
SITE PAN
H
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OTH2 OTHI
in
SFF FUTLIRF ASRUII T
WAS GROUND WATER ENCOUNTERED? NO
IF YES Qr WHAT DEPnr? 2%
DEPTH OF WATER AFTER MONITORING: 3•
DATE OF MONITORING: 5/15/2004
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
WATER
(INCHES)
NET DROP
I (INCHES)
3/31/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:15
8.5'
CHARGE
2
11:45
30
6.875'
1.625'
3
11:45
8.0'
RECHARGE
4
12:15
30
6.5'
1.5'
5
12:15
8.0'
RECHARGE
6
12:45
30
1 6.5'
I.5'
PERCOLATION RATE`(MIN/INCII) PERC. HOLE DIA. 6 (INCITES)
TEST RUN BETWEEN:: 5_5 FT. and 6.5 FT.
COMMENTS: NO IMPERMEABLES ENCOUNTERED
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 1, BLOCK 2, NORTHWOODS SUBDIVISION NO.2
GENERAL:
The scope of this project includes the procurement and placement of a new
1,250 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of a new 85' long X 3' wide X 6' effective depth
absorption trench at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 1' below the existing ground
surface. Total depth of the trench will be 7' below the existing ground
surface. The new absorption trench must be placed a minimum of 10' from
the water service on this and adjacent lots. A minimum of 100' must
separate any surface water in the area and the septic tank and absorption
trench. The trench must be a minimum of 10' from the lot line.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,250 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
Lot 1, Block 2, Nonthwoods Subdivision No. 2
June 1, 2004
Page 2 of 3
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield 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 ball 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:
Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
Lot 1, Block 2, Northwoods Subdivision No. 2
June 1, 2004
Page 3 of 3
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as -built of the completed system.
Jun -14. 2004 6:34AM 9075226779
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 88524
522-7773 522.6779 (F
DATE: 6/14/2004
TO: Joe Goodall
WITH: MoAJOnSite Water and Wastewater
FROM: Mike Anderson
SUBJECT: Lot 1, Block 2, North Woods Subdivision No. 2
Well and Septic Construction Permit
No -6500 P. 1/1
The groundwater depths in the test holes completed for the septic system design for the
subject lot were measured at 3' total depth or 11' below the surface as measured on
May 15, 2004. The bottom of the absorption trench will be 6' below the surface to
provide a minimum of 4' separation to groundwater.
We have modified the design to include a 1500 -gallon STEP tank athe drop between
the septic tank and the field Is not sufficient to provide gravity flow. as -built for the
system will show the details of the pressure distribution system.
Based on the above information we are hopeful the well and septic system permit can
now be issued. Please let me know if you have additional questions.
y678go
v� R`/S`hli
6 2015
• � Municipality of Anchorage a ;�
On -Site Water and Wastewater Program
j (907) 343-7904 q
R�d I /! I G 9 yn
Certificate of On -Site Systems Approval
Parcel l.D.051-741-18 Expiration Date:
1. GENERAL INFORMATION
Complete legal description North Woods, Block 2, Lot 1
Location (site address) 22928 Northwoods Drive. Chugiak, AK 99567
Current Property owner(s) Darrell & Lori Saylor Day phone 830-0884
Mailing address 22928 Northwoods Drive Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Four
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual
Q
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
.
Public Sewer
❑
WaiverNariance request for:
Received by:
COSA to be released to the
Date: I
COSA Fee $ qZA -(Q6 Waiver Fee $
Date of Payment 5/aTlls Date of Payment
Receipt Number Receipt Number
COSA# (�.SClS(a� 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
Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineers Printed Name Michael E. Anderson, P.E. Date 5/26/2015
APt OF A4
di
4918*
6. DSD SIGNATURE ® eI M ""
System #1 Approved for bedroomsW °°'
/.. .
`, ?,r�M120 EL E. ANDERSON °. Q
System #2 Approved for _ bedrooms �# SO. CE -4381
s .
®�
Disapproved ` f P pr �p� 4��®
ROFESSIO° ��►
Conditional approval for bedrooms, with the following stipulatiofl�q®®ya®"
By: Original Certificate Date: �' �✓�
Thenici li of forage 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet_[ f- L, c
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: Northwoods, Block 2, Lot 1
A. WELL DATA - Public Water System - No Well on Lot
Well type If A, B, or C provide PWSID #
Date completed Sanitary seal (Y/N)_
Total depth ft. Cased to ft.
FROM WELL LOG
Parcel ID: 051-741-18
Well Log (Y/N)
Wires properly protected (YIN)
Casing height (above ground) in.
AT INSPECTION
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: Collected by:
ft.
g.p.m.
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEP/Steel Date installed 6/14-16104
Tank size 1,500 gal Number of Compartments 2 Cleanouts (YM) Y
Y
Foundation cleanout (Y/N)
Date of pumping 12/2014
C. ABSORPTION FIELD DATA
Depression over tank (Y/N) N High water alarm (Y/N) N
Pumper One Stop Pumping
Date installed 5116-18/15 Soil rating (g.p.d./ftp or fe/bdrm) .6 GPD/SF System type Deep Trench
Length 90 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth 9.5 ft. Eff. absorption area 1,080 fe Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
D. LIFT STATION
Date installed 6/19-19/04 Size in gallons 1,500 Manhole/Access (Y/N) Y
"Pump on" level al if in. "Pump off' level as _ in. High water alarm level at 44 in.
Datum Bottom Of Tank Cycles tested 3 Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES - Public Water System -No Well on Lot
WELL ON LOT TO:
NA
Septic tank/liftstation on lot NA
On adjacent lots
Absorption field on lot NA
On adjacent lots NA
Public sewer main NA
Public sewer manholelcleanout NA
Sewer /septic service tine NA
Holding tank NA
Animal containment areas NA
Manure/animal excrete storage areas NA
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property line >51
Water main >10' Water service line >10'
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
1** '
Absorption field >51 .
Surface water >100'
N/A
Property line 1 Building foundation >10 Water main
i Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >
None Noted >100'
Curtain drain Wells on adjacent lots
F. COMMENTS
Property is served by AWWU Water System. **See Lot Line Waiver.
G. ENGINEER'S CERTIFICATION
I certify that t 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 Michael E. Anderson, P.E.
Date 5/9/2015
COSA brown sheet 10.10-12.doc
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I hereby certify that I have surveyed the following described
property: Lot 1, Block 2, North Woods Subdivision, Plat
No. 79-195, Anchorage Recording District, and that no encroachments
exist except as indicated hereon. This As -built will only show the
easements that appear on the recorded subdivision Plat No. 79-195,
Anchorage Recording District; under no circumstances should this data
hereon be used for the construction or establishing of boundary or fence lines.
a25 50
SCAB IN FEET
Surveyed: May 20, 2015
North Woods Subdivision
Lot 1 Block 2
As Depicted on: Plat No. 79-195
Anchorage Recording District
GRID:NW1559
ASBUILT SURVEY
22928 Northwooas Drive
Chuglak, Alaska 99567
APB Land Surveying
12204 East Prince of Peace Drive
Eagle River, Alaska 99577
(907) 227-1361
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program .
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519-650
www.cd.anchorage.sk.us
(907) 343-7904
AlC4A4ec. t- 4oeese,
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 51.741 HAA # DSW(6a4
Expiration Date: '2- - *?- 8 - O 6-
1. GENERAL INFORMATION
A.
Complete legal description Lot 1 Block 2 Northwoods Subdivision = .
Location (site address or directions) 22225 Whispering
Birch Drive q 5,; -A-
Current Property owner(s) Ascend Construction
Day phone 213.3725
Mailing address P.O. Box 231169 Anchorage
AK 99523
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA wN be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑
Individual On-site
Individual Water Storage ❑
Individual Holding tank
❑
Community Class A Well ®
Community On-site
❑
Public Water System ❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation,
based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system Is(are) Safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Anderson Engineering Phone 522.7773
Address P.O. Box 240773 Anchorage. AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 2!21/05
5. DSD SIGNATURE
Approved for _14L bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
ON-SITE
i IAIACTCIA/ATCD
PROGRAM
Maintenance Agreements
Supplemental Engineer's Report
Other
By: �,✓ �� 1 Original Certificate Date:— a. $ - 05
(a«.12M)
Municipality of Anchorage
' Development Services Department
Building Safety Division
On Site Water & Wastewater Program :
4700 South Bragaw, SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.enchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
A. WELL DATA
Well type _ If A, B, or C provide PWSID # 9
Date completed _ Sanitary seal (YIN) —
Total depth ft. Cased to iL
FROM WELL LOG
Data of test
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mi. Nitrate mg.A.
Date of sample: Collected by -
B. SEPTICIHOLDING TANK DATA
Tank size 1.300 gal.
Foundatkm cleanout (YIN)X
Date of pumping
C. ABSORPTION FIELD DATA
Number of Compartments I
Depression over tank (Y/N) _N
Well Log (YRJ)
Wines property p (YM)
Casing height (above ground) in.
AT INSPECTION
R
Other bacteria
Cleanouts (YIN)
colonies/100 ml.
High water alarm (YIN) Y
Date installed UI8R004 Soil rating (g.p.d./fe or fle/bdrm) ,6 GPDISF System type DeeD Trench
Length 87 ft Width
ft. Gravel below pipe 0 ft.
Total depth 12 ft. Eff. absorption area J.044 ftp Monitoring tube I Depression over field tj
Date of adequacy test Results (PasstFaiQ For _ bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 3 type) N If yes, give date
6
D. LIFT STATION
Date installed OR41M Size in gallons 250 ManholelAccess (Y/N) Y
'Pump on' level at 42 in. 'Pump ofr level at 4; in. High water alarm level at 44 in.
Datum Bottom of Tank Cycles tested New Const. Meets alarm b circ ult requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot On adjacent kits
Absorption field on lot On adjacent lots
Public sewer main
Sewer /septic service line
Public sewer manhole clearmxA
Holding tank
SEPARATION DISTANCES FROM SEPTIUHOLDING TANK ON LOT TO:
Building foundation >5' Property line>' Absorption field >S
Water main NIA Water service line >10' Surface water >IW
Wells on adjacent lots >2W
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >Ir Building foundation >10' Water main >10'
Water Service line >10' Surface water MW Driveway. parldrrpNehide storage >2S
Curtain drain >W Wells on adjacent lots >20p
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and r 49th
review of Municipal records that the above systems are in =
conformance with MOA HAA guidelines in effect on this date. .z
;NICMn. L 40M
Tze
Engineers Printed Name Michael E Anderson. RE r►. /, No. cE-43rn
tos-
Date 2121f2004n
HAA Fee E
57 �=
Date of Payment
Receipt Number it, 3953
(Rev. 12000)
Waiver Fee $ 175
Date of Payment Z
Receipt Number
Feb 12 05 11:26a Larry M. McHain 907-333-6102 p.2
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' ANCHORAGE. TALASKA 99501
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LOT 1, BLOCK 2, NOI?TF. T;GODS SUEDIVISIO:,
❑ LOT KNR,LY SURVEY TYPE
❑
SYMBOLS OLS
FOUNDATION1 NULT
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ASPHALT
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❑ ROTMAK ... AS-KLT ... LOT KRMI ... TOPV
O FOUND r"AR �pp WOOD CCNCRETE
IT 15 THE RESPONSIBILITY OF THE BV=ER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND M515LL WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING 'GRADE RELATIVE SHOWN. FENCES. WMJ-% SEPTIC CLEAHOUTS. SIDEWALKS. DRIVEWAYS.
TO FINISHED GRADE AND UTIUTY CONNECTIONS AND TO DETERMINE ETC.. ARE SHOWN IN THEIR APr•RO)CMATE LOCATION. ONLY. SNOW
THE EKISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
"ICH 00 NOT APPEAR ON THE RECORDED SUBDIVISION PUT. ALL OISTANCARE N w
UNDER NO CIRCUMSTANCES SHOULD AN AS-SULT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE UNES
THE SURVEYOR TAKES RESPONSIBRFTY FOR THE VITAL TRANSACTION ONLY AND ASSUMES FINANCIAL UASNTY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS N SCARE
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779_[P
February 21, 2005
.Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 1, Block 2, Northwoods Subdivision.
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer.
The site for the alternate absorption trench for Lot 1, Block 2, Northwoods Subdivision
Phase 2 is located approximately 1' from the south property line. This area was
determined to have the best soil conditions on the lot for an absorption trench. The
house was moved further to the south than originally planned causing both the primary
and alternate absorption trenches to shift to the south. The primary absorption trench
was constructed more than 10' from the property line.
Placement of the alternate absorption trench at the location shown will not impact wells
or adjacent septic systems. The subdivision is served by the Municipal water system
and no wells are located within 200'. We therefore recommend a waiver be issued
allowing the new trench to be constructed at 1' from the south property line if the use of
the alternate site ever becomes necessary.
Sincerely, //
WYJtd'L A. L �.�..c
Michael E. Anderson, P.E.
';J49th /.\ IV
MICHAEL E. ANDERSON
II, No. CE -4381 a
RZunicipality of Anchorage
(" : 0(i 1'.(1. 14,xP.CGR) • AnchurigG.Vasku 10.1519.65(1 • Tdcphune (!X17)333-MN11 • Fax (NM313-82N)
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J/ayor3lark Begich
Iluil(ling Safety DhOslon
28 February 05
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Subject: Waiver Request for Northwoods Subdivision Block 2 Lot 1
Waiver Request #WR050009
Parcel ID #051-741-18
Dear Mr. Anderson:
Your request for a waiver of the required 10 feet from the Absorption Field to the
Property Line is approved. The approved separation distance is 1 feet.
This waiver approval applies to the existing Absorption Field to Property Line
separations only. Any future upgrade to the on-site wastewater disposal system will
require all separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
C
Jeff Poet
Engineering Tech
On -Site Water & Wastewater Program
Community, Security, Prosperity
Municipality of Anchorage
Development Services Department t ..
• +� Building Safety Division'49k`. , 0.
On -Site Water and Wastewater Program `
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: 050009 PID#:051-741-18 HA#:050067 Permit#: 040185
Date Received: 2122/05
Legal Description: Northwoods Block 2 Lot 1
Engineer. Anderson Engineering
P.O. Box 240773, Anchorage, AK 99524
Applicant: Ascend Construction
Waiver Requested: l' separation distance absorntion field to Property line
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
............... ................................................... .a...........
Waiver is Granted: i/ Waiver is not Granted:
List Conditions or Reasons for above:
Date: 2 By:
of Reviewer
..............................................•...............................
Rec#: 83853 Amount: $176.00 Date Paid: 2/22105