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HomeMy WebLinkAboutSTORCK #3 BLK 1 LT 1Atorck #3 Block Lot 1 A #017-091-96 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241373 PID Number: 017-091-96 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 9 Upgrade Name David W Burlingame ABSORPTION FIELD ❑ Deep Trench 9 Wide Trench ❑ Bed ❑ Mound Site Address 14195 Old Rabbit Creek Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade Five(5) 1.2 GPD/SF 4.0 / 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5/3.5 Ft. Gravel depth beneath pipe 0.5/0.5 Ft. Subdivision Block Lot Storck #3 1 1 A Fill added above original grade 2.0/0.9 Ft. Gravel length 63/63 Ft. Township Range Section Gravel width 5.0/5.0 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 630 Ftz 2 >6 Ft. Well >100' >100' >100' N/A >25' TANK ❑ Septic 9 S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 2500 Gal. Surface Water >1oo' >100' >100' N/A Material Steel Number of compartments Two(2) Lot Line >5' >10' >10' N/A NA Foundation >10' >10' >10' N/A LIFT STATION Manufacturer Orenco Capacity 250 Gal. Remarks Trenches listed north / south Alarm location Electrical installed by Point B The Alaskan Electrician PIPE MATERIAL House to tank D3034 Tank drainfield D3034 Installer Wilco Excavation Drainfield D3034 CO/MTD3034 Inspector M. Jakubisin & B. Schiller BENCH MARK (Assumed elevation)100 ft Inspdecct sn 1s, 11/18/24 11/19/24 Location and description 2nd Bottom of Siding @ Point B 3'd 11/24/24 4"' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp of A<q��l Conditional Approval: Date r,�Q... ,� }} *�rl %* 9 TM in Schiller � �F Benjamin 592 Septic System �' �2--- Approved Date 11/26/24 ,�klk, � PROFES QAO '-► Not his approval does not include well permit requiremen, s. 1\� (Rev 05/02/18) / // // // // // // / / // / / / / / / / / / / / / // // // // // // / / / / / / / / / / / / / / // // // // // // Benjamin Schiller CE 12592R E GISTEREDPROFE S S I O N A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP241373 PID # 017-091-96 STORCK #3, BLOCK 1 LOT 1A A B MH1 60.8 MH2 66.3 DV1 197.6 A B DV2 197.3 MT1 221.4 MT2 213.3 MT3 236.0 66.7 81.2 179.3 178.7 173.3 182.7 188.7FEET 0 50 100 5-BDRM HOME PLAN ASB 11/26/24 RABB I T C R E E K R O A D O L D R A B B I T C R E E K R O A D 10' UT I L I T Y E A S E M E N T SHOP EXISTING WELL w/ 100' RADIUS EXISTING 4-BEDROOM ABSORPTION TRENCHES TO REMAIN IN SERVICE (2)NEW 63' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCHES TH#1 TH#2 NEW 2500-GAL STEP TANK W/ 20" MANWAYS DIVERTER VALVES WITH SURFACE ACCESS MT3 MT1 MT4 MT2 945940935 930 925 920 915 910 905 900 895 (ALTERNATE SITE) CAT III 25' LONG X 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCH MT4 230.4198.4 DV1DV2 MH1 MH2 BM PROFILE AS-BUILT (NO SCALE) 94.2 89.4 94.8 100.6 FC O MH MH PERMIT # OSP241373 PID # 017-091-96 STORCK #3, BLOCK 1 LOT 1A 118.2 FINISH GRADE 63' DRAINFIELD ROCK MT TH # 1 GROUNDWATER @108.2 10/30/24 112.2 102.7 112.2 112.7 116.2 ORIGINAL GRADE MT Benjamin Schiller CE 12592 R E GISTEREDPROFES S I O N A L E N GINEER 11/26/24 119.1 FINISH GRADE 63' DRAINFIELD ROCK MT TH # 1 GROUNDWATER @ 110.2 10/30/24 114.2 104.7 114.2 118.2 ORIGINAL GRADE MT 2500 GAL STEP TANK NORTH TRENCH SOUTH TRENCH 114.7 MUNICIPALITY OF ANCHORAGE On -Site Water S Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241373 Work Type: Septic Upgrade Tax Code Number: 01709196000 Site Legal Address: STORCK #3 BLK 1 LT 1A G:3039 Site Mailing Address: 14195 OLD RABBIT CREEK RD, Anchorage Owner: BURLINGAME DAVID W Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: *S f, 1)cparrnacrnr 11 /7/2024 11 /7/2025 135531 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 5 Special Provisions: If the 2003 trenches are to remain in service, all stand pipes are to be located and repaired as needed. Received By: i �_�, J_, Date: Issued By: q Date: Parcel I.D. 017-091-96 Property owner(s) David W Burlingame Day phone Mailina address 3305 Arctic Blvd Ste 201, Anchorage, AK 99503 - Site address 14195 Old Rabbit Creek Rd Legal description (Sub'd., Block & Lot) Storck #3 Block 1 Lot 1 A Legal description (Township, Range & Section) Lot Size - 135,531 _Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field nX Initial n Single Family (SF) nX (w/wo ADU) Septic Tank nX❑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: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: I qgZ Waiver Fees: Date of Payment: Receipt Number: Permit No. 0 Se 2-91373 Date of Payment: Receipt Number: Waiver No. Permit App_'-'- : - :-'-:c , November 5, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Storck #3 Block 1 Lot 1 A – 14195 Old Rabbit Creek Rd Septic system design Dear On-Site Services Engineer: The owner of the above lot has a septic system that has reached end of life. We are submitting this permit application for the construction of a new septic system upsized to 5 bedrooms. The attached site plan identifies the location of the home as well as the new septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. During the percolation test for the first test hole, my inspector was called away before he could complete the first test. He was unable to return that day and the ground was frozen the next morning. When the contractor could come back, we made the decision to dig in another spot due to the slower percolation we were observing in the first test hole. We are able to use the groundwater monitoring, at least, from that initial test hole. The ground surface on the lot gradually slopes to the northwest. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241373, Curtis Townsend, 11/07/24 // // // // // // / / // / / / / / / / / / / / / // // // // // // // / / // // // // // // // // // // // Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND STORCK #3, BLOCK 1 LOT 1A FEET 0 50 100 5-BDRM HOME SEPTIC PLAN 11/4/24 RABB I T C R E E K R O A D O L D R A B B I T C R E E K R O A D 10' UT I LITY E A S E M E N T SHOP EXISTING WELL w/ 100' RADIUS EXISTING 1500-GAL S.T.E.P. TANK TO BE DECOMMISSIONED EXISTING 4-BEDROOM ABSORPTION TRENCHES TO REMAIN IN SERVICE (2) 63' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCHES W/ MT WITHIN 1' FROM TRENCH ENDS TH#1 TH#2 NEW 1500-GAL SEPTIC TANK W/ 20" MANWAY PUMP VAULT DIVERTER VALVE WITH SURFACE ACCESS MT MT MT MT 945940 935 930 925 920 915 910 905 900 895 (ALTERNATE SITE) CAT III 25' LONG X 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241373, Curtis Townsend, 11/07/24 STORCK #3, BLOCK 1 LOT 1A TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER DRAINFIELD ROCK 6" 3' DESIGN FACTORS:SYSTEM REQUIREMENTS: 750 GPD PEAK FLOW PERK RATE: 2.0 MIN/IN APPLICATION RATE: 1.2 GPD/SF 5-WIDE TRENCH SYSTEM 1500-GAL SEPTIC TANK W/ ADD-ON LIFT STATION BOTTOM OF TRENCH: 4' BELOW GRADE FLOW LINE ELEVATION: 3.5' BELOW GRADE 750 GPD / 1.2 GPD/SF / 5' WIDE * 1.0 RED FACTOR [0.5' DEEP] = 125.0 LF TRENCH REQUIRED (2x 63' LF SPECIFIED) GEOTEXTILE FABRIC 11 4" PVC w/ 20 - 1 8" ORIFICES EVENLY SPACED @ 6'4" OC 6" 11/4/24 PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 5' 6" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241373, Curtis Townsend, 11/07/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? >30* 10/23 1 GM (TIGHT SILTY GRAVEL) Professional Engineers Stamp: YES STORCK #3, BLOCK 1 LOT 1A 10/23/2024 017-091-96 RYAN WILKINSON 3:40 --- 2' OB --- Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: J. OPHEIM --- 9.0' 8.0' 10/30/24 COMMENTS: SITE PLAN --- USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 11/4/24 *UNEXPECTED CIRCUMSTANCE STOPPED PERK TEST, GROUND FROZE THAT NIGHT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241373, Curtis Townsend, 11/07/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 2 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 2.0 11/1 1 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: NO STORCK #3, BLOCK 1 LOT 1A 11/1/2024 017-091-96 RYAN WILKINSON 11:00 1 0 16 1' OB 30 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: M. Jakubisin 7 0 16 -- Pending Pending COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 11/4/24 OLD ORGANICS FILL(CLAYEY GRAVEL) B.O.H. 2 11:30 1 0 1610 6 8 16 5 8 16 3 11:41 1 0 1610 6 0 16 5 0 16 4 11:51 1 0 1610 5 0 16 5 12:01 1 0 1610 5 0 16 6 12:12 1 0 1610 5 1 16 6 0 16 6 0 16 6 1 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241373, Curtis Townsend, 11/07/24 FND. ALUM CAP MON. BENT AND DESTROYED. SET BPC AT BASE OFAL UM. PIPE. N 898 48' 39" W 334.72 10' TELE & ELEC. ESM'T. 0 FND. AL UM CAP MON. BENT AND DESTROYED. SET BPC AT BASE OF AL UM. PIPE. AT. DISH •SAT. DISH � 1�0 1' r Py r' WELL f �,� ✓ q 0 A O.H. DECK O�G1 o �� �F q tq�;4p 49 TH Y A � SHANE A. HOLT �� t Qp� LS-6914 o`O� ,�\,°fessiona\ Vo ASPHALT METAL BUILDING M.H. • 7 \N �nIIEN� THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 1 A BLOCK 1 STORCK SUB. ADD'N. 3 PLA T 2000-32 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 16TH DAY OF OCTOBER , 2024 HOLT LAND SURVEYING 9309 GROVER DRIVE 16160 239-25 ANCHORAIGE,AK 99507 223-8615 3759GCI.N Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.cLanchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030345 PID Number: 017.091.96 Dav revidredori Burlin ame Wastewater System: New Add,ess 5310 Bishop's Castle Circle Anch. AK 99516 ABSORPTION FIELD Phone 348-0073 NunDar o1 BaOio°""' Four 4 5' Wide Trench LEGAL DESCRIPTION SW RatnV- Taal Daae hom agme, Veda. .8 GPDTT' 3 R. e,oar La Subdnsan: Depth to pops balm from onOma, aede Gravel depth beneath pge 1A Storck No. 2 1 F1. 2 Ft. Town" Range: seoeon: FA added above ages, onade Gevel Length 34 Ft. 106 Ft. Well: New Gew Wrth. Nsnoer of nes: Danenn between etas. 5 Ft. 2 >10 Ft. CMe4ACM.on (Pmele. A. B. Ct: Total Depth: cased to: Tow abadrpian aea Pse maters, Private 307 Fl. 1 58 Ft 757 Fe ASTM 3034 PVC Onix Data Onned stab[ water Level: ,ns,aw. Do,* arstaked AI ine Drillin 10/2312003 56 F, Acreage Systems 9120-2212003 V.Xd Pump Bet at:PA/ Couna ahtAboveGrand TANK 3 G Ff. >2 FI SEPARATION DISTANCES STEP To Septic Absorption Lift Holding lubldidvale Wulwww. panty •wns From Tank Field Station Tank Sewer UM Anchorage Tank 1,500 Well >100, >100, >100, NIA >25' MetreµNumber Steel nmen a Canpes Two (2) surfacawatre >100' >100' >100' NIA LIFT STATION La Lee >5' >10, >10, NIA a. 250 Gay spurs. Anchorage Tank/0renco FwMelgn >5' >10' >5' N/A T'ump on-,e.el at 42 •Pump elr ,ave, a, 42 Hgh walre asrm at 44 n n in. c .bran >20' >20' >201 pump Make a Model Orenco EbWFa, nsWarom preformed or Municipality of Anchorage Ftena`L` BENCH MARK Loukon and De L,on. Garage Slab. Assumed ENvaW 79.3 F,. Engineer's Stamp Cy 000 Inspections performed by: MEA Dates: 1M 9120103 C ,L}�--4y9t--h\ ; t%GrIGS 2nd 9/22/03 Tom' ; 4'CXACL E ANDERSON W Department of Health and Human Services approval to No. CC -4181 �':'`� Reviewed and approved b �-9 PP y % /cat/ �a � Date: -z L{ -U.� �S"-17-os '.•" ���'Dp'��"t,"��--�'"'�`P� .• •,��tl• (Rev 10991 �S\�'''•• S 89.48'39•E 334.72' 10' T. a E. a UTIL ESMT. Page 2 013 ------------------------------------ Permit Number. SW030345 STORCK SUBDIVISION PID No. 017-091.96 ADDITION NO. 3 LOT 1A, BLOCK 1 3.11 ACRES 1 O P N w, 1 m 52 m ® 100 N0 4� e ` <�N ta m• S W \106 ko. LA W +/ N w 5p C'1 + OD A 8 /+ 16M01e N,1 i0 Sl 62.7 513 + S2 65.4 58.3 + ® M2 YN 672 61.3 / W 206.2 8&S 9 YJ 218.8 99.4 sale + MN 0R41� � ✓i' ✓Sv d1�✓�' 5 16 �' :0 6io63 ' ••••P�E.... aaai f 4•y.• ' 49th f.....• ...... • i 11CW1E1. E. ANDERSON PLAN AS-BUILTNo. -4381 �. i' SCALE 1• • 67 �Iaa;��; ��•• Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-79D4 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW030345 PID No. 017-091-95 e --- NORTH -- i Drninfletd Rock NORTH LEG N S 99.5 n 54' (Trench Length)- 3/16'OrlfIces 2 3' SOUTH LEG PROFILE AS -BUILT - Scale: V - 1P Municipality of Anchorage 1W Department of Health and Human Services AWMQ 825'1' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mystrom http1tw .d.enchorage.sk.us Mayor Permit Number: #SW 030345 Date of Issue: 8-29-03 Parcel Identification Number: 017-091-96 Date Started: 10-22-03 Date Completed: 10-23-03 Is well located at approved permit location? ® Yes ❑ No Legal Description: Storck Addition # 3 Block 1 Lot 1A Property Owner Name & Address: David & Lori Burlingame 6310 Bishop's Castle Dircle Anchorage, Alaska 99516 Borehole Data: Soil Type, Thickness R Water Strata Depth (ft) From To Method of Drilling ® air rotary ❑ cable tool Casing type: steel stick-up 0 2 Wall Thickness: 250 inches organic & silt 2 3 Diameter: 8 inches Depth: 58 feet silt 3 11 Liner Type: gravelly silt bedrock 11 55 55 307 Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 56 feet Pumping level: 4,_OZfeet after 2 hours pumping 3 gpm Recovery Rate: 3 gpm Method of Testing: airlift Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type: bentonite # R Volume: 1 bg Depth: Start Q feet Stopped ? feet Pump: Intake Depth feet - Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No RECEIVED Method of Disinfection: _ Comments: Well Driller: Alpine Drilling & Enterprises DEC 1 0 2003 PO Box 110496 Anchorage Alaska 99511 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property --....._....--..J.!.........r----''---.... 1.... .1. - n.... _f... _.J Y..._......(.-'-----%'.. 1. A._._. t_-_._I..•.- Page t of t INSPECTION REPORT AM ICIPALITY OF ANCIiORAGE -- BUILDING SAFETY DMSION 4700 SOUTH BRAGAW STREET, ANCHORAGE, ALASKA INSPECTIONS: Voice: (907) 343-8300 Fax., (907) 249-7777 INFOR.VL4770N.• (90;9343-7962 NAME: 606 PERM1TNWBER: 03 -1 qo7 ADDREss, ItfIQ5 iot-D FZA9F3i-i- GR. RI> DAIS: PHONE 0I:9ZR- 207 ffHONE k2 --'75'Z z3 79 LOT. IA BLOCK. SUBDIVISION. 5?a2GK zti-3 COALVIENTS: TYPE OF INSPECTION.• eNNo non•wmplimw obemcd. 0 Do not wn" wtil roimpwtcd. ] CO. approved. kx crw aemtal as cxpla: wd below. F'l WM rooaamina at neKt iorpecton. ] Cc.O. approved (commcnte bclowl COMMENTS: Rdmpection? El Ga N �1 Tt o��1� EI G,-r�l moi. F=[?,a_.. L1Pef2c)vEy7 Ute► t_t._ ii1 G L k F T • ST o. -r l NV W (R- l N L -i 15 1 tJ �Au- F -09-l N`� G�(o (J D F unlp� cZL-c r2ouINT) !FES `DvF-. UN�j.1 C�� V LECA t tJSC'�-r otJ VsPECTOR: [V 1t e 1(/a t.'. l, L, 1 FLI✓t;- I DATE: + —. eZ5 j — O S , f;AVEN CORRECITONS ARE MADE, PLEASE GILL FOR INSPECTION I DO NOT REMOVE THIS NO77CE MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 9/?_0/DZ— c z. LIC h 9 s:10 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW030345 Legal Description: 'Storck Addition #3 Block 1 Lot 1A Date Issued: Aug 29, 2003 Expiration Date: Aug 28, 2004 Parcel ID: 017-091-96 Design Engineer: 0014 Anderson Engineering Site Address: 5310 Bishop's Castle Circle Owner Name: David & Lori Burlingame Lot Size: 135531 SQ. FT. Owner Address: 5310 Bishop's Castle Circle Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage . AK 99516 - 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: Issued By. Date: 2 K 3 Date: t? < 0.3 Municipality of Anchorage Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ok.us (907)343-7904 Parcell.D. ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING ZD Number SW 036341' Property owner(s) David and Lori BurilneamG —Day phone 1548-0073 Mailing address (1) 15510 l5lnbj2p'n.Ca-itl& Ciral, Anehoraac AK 99616 M Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) I nt 1A Starck S„bdiyiainn Addit.ian No— 15 610UL.I Legal description (Section, Township & Range) Lot Size �35�C;?p01—Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Fmir (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 JDwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: `\ I Date of Payment: Receipt Number. �n-78S;;� (Rev. 1200) Waiver Fees: Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) August16,2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1A, Storck Subdivision Addition No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 1A, Storck Subdivision Addition No. 3 intends to construct a new 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. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system. Also identified on the plans are the locations of the alternate site, proposed well location and the well and septic system locations on the adjacent properties. Drainage arrows are shown indicating the current patterns. The drainage patterns will be maintained after construction. Test holes placed on the lot indicate poorly graded silty sand with some gravel in the area of the new absorption trench and alternate site. The percolation rate for this lense is between 1 and 5 minutes per inch. This material extends to depths approximating 5' and is underlain by a tighter silty gravel with a percolation rate of 40 to 60 minutes per inch. No groundwater was found during placement of the test holes but was noted at 12' below the surface in Test Hole B. No water was found in Test Hole C during the monitoring period. The elevation of the distribution line in the absorption trench will be 1' below the surface to take advantage of the sandy material near the surface. A lift station will be required due to the difference in elevation between the house location and the absorption trench. We are therefore proposing to place a new 1,500 -gallon STEP tank along with a 90' long by 5' wide absorption trench with an effective depth of 3' on the property. An application rate of .8 gallons per day per square foot was used in the design due to the underlying tighter soils. Lot 1A, Storck Subdivision Addn. No. 3 August 16, 2003 Page Two The ground surface on the lot slopes at minor grades from the souththeast to the northwest. The new absorption 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 the proposed well on the lot and the existing wells on the adjacent lots. It will also be constructed a minimum of 100' from any surface water 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, �^ n Michael E. Anderson, P.E. Attachments 49thi MICHAEL E. •NOEHSq No. CE -4381 % EAST 140TH Avenue 14267 MW 196.00 a ,aaaun.wtan ',b H S z s 4 P� 3 2 le 669p1'03'E 617.00 62-130 165.00 las 00 186. M. 172,77 39.49 669RWE 617.66 64-86 � N3 Ppp � O 4 a IA ,� �G g '0 S 6 VACANT $ THA CD ® THS ®TMS 20.02 kno 115. 2A � ab�`CGoteel�Fz V V %!*MUST, 49th_* P rrr , 9.64 A �y MICINEL ENAER90N f �..•�� ARE' A MAP :�`�. p8 SCALE l'- 100' 4iles n��� 334.92 S89 48'39'E 10' Utill Easement Proposed Well N --r_ 20/6 w Four /� w° Z Hoe m 1A m w 1a 1 500 Gallon 2L STEP Tank -, ATHA a 0 ' 90' a Lon x 5' wide x AsonDth b�LoTrench S/ n ®THB 6 ® THC Alternate Site CD CD S, O Q Babb :/ 4 h •. MIC SITE PLAN •....: ,. �'G q �ELEIUmEn..ON f i SCALE I• -BO' ••�,+,.�,•+.• q•Vjj LOT 1A, STORCK SUBDIVISION ADDN. NO.3 LOT 1A, STORCK SUBDIVISION ADDN. NO.3 DESIGN FACTORS: Four Bedroom House Perc. Rate: 1-5 Min./inch & 60 MinJlnch Application Rate: .8 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,500 Gallon STEP Tank 3' Drainfieid Rock 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750SF/5 LF (Width)- .58 (Red. Factor) = 87 LF Trench Length THEREFORE: Construct a 90' Long x 5' Wide x 3' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be 4' Below Existing Ground. Maintain 100' Separation From Well on the Lot Place 2' of Direct Bury Insulation and 2' of Fill Over Absorption Trench or Provide Minimum 3' of Cover to Prevent Freezing. Place 4' of Cover Over Septic Tank. 2' Natural Min. Backfill 2" Insulation eotextile 6" abric 6" 1.25" PVC 3/16" Diameter Holes 30 Each @ 3' Spacing 3'0- Drainfield Rock Delivery Line 1.5" PVC TYPICAL 5' WIDE TRENCH SECTION•�•�4 (NO SCALE) p�QtE .......' NOTE: Grade Area Over Trench to Drain Away. a a9oi Minimum 6' Separation From Bedrock. •. Minimum 4' Separation From Groundwater. » » i Minimum 100' Separation From Wells in the Area. MICMU E MDER Minimum 100' Separation From Surface Water or Streams. ��� sA No. CEue, 2 3 4 5 6 7 8 9 10 12 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: David Burlingame DATE PERFORMED: 8/8/03 LEGAL DESCRIPTION: Lot 1A. Storck Subdivision Addn. No 3 TEST HOLE # A PT/OG Silty Gravel Some Sand GM Silty Sand Some Gravel SM WAS GROUNDWATER ENCOUNTERED? No S L IF YES, WHAT DEPTH? 0 DEPTH OF WATER 12• P AFTER MONITORING: E ...- DATE: 8/16/03 14 S 7� A'. IK,Y[L 41JG[NSOM 15 �0, No 014341 e%1IRROfF5510N* 16 BOH - 16• 17 18 0 o- A N tr a. THA a A \pP THB 0 o ® THC® /reed ad 2% READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 8/8 7:05 8.25' 1 7:35 30 9" .75' Recharge 7:36 8.38' 2 806 30 9" .62' Recharge 807 8.38" 3 837 p 9^ 1 62- PERC RATE: 4_ MIN./INCH FERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 4.5 FT. AND 55 T. COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/16/2003 2 3 4 5 6 7 8 9 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: _ PERFORMED FOR: David Burlingame LEGAL DESCRIPTION: lot to Storck Subdivision Addn. No 3 TEST HOLE # 9 PT/OG Silty Sand Some Gravel SM Silty Gravel Some Sand GM Tight 30 dljl/a a/ WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? d SLOPE No S L 0 12' P E 8/16/03 DATE PERFORMED: 8/8/03 SITE PLAN 0 a P N �' THA A N uTHB a ® THIS / reed ad READING DATE PERI:" GROSS TIME NET TIME DEPTH OF WATER II Start 8/16 11:14 AFTER MONITORING: 12 1 •'M OF •• DATE: • 10 0 65" o , 13- 7.25" 4f1� * l* 14 11:35 10 69th i -.......sem 7.5" Recharge 11:36 A r 1�[wKl4 YU[NSOM y, 15- 3 11:46 10 0 7S - ••1pBOF �SIOM1& 0 • 16 BOH - 16' a•lks ���� d SLOPE No S L 0 12' P E 8/16/03 DATE PERFORMED: 8/8/03 SITE PLAN 0 a P N �' THA A N uTHB a ® THIS / reed ad READING DATE PERI:" GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 8/16 11:14 6.5" 1 11:14 10 0 65" Recharge 11:25 7.25" 2 11:35 10 0 7.5" Recharge 11:36 7.25" 3 11:46 10 0 7S - PERC RATE: .1 MIN./INCH PERC. HOLE DIAMETER:_ " TEST RUN BETWEEN--Z5—FT. AND 35 T. COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/16/2003 2 3 4 5 6 7 8 9 K 11 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENVON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: _ PERFORMED FOR: David Burlingame LEGAL DESCRIPTION: Lot 1A Storck Subdivision Addn No 3 TEST HOLE # c PT/OG Silty Sand Some Gravel SM Silty Gravel Some Sand GM Tight WAS GROUNDWATER ENCOUNTERED? No IF YES, WHAT DEPTH? DEPTH OF WATER None AFTER MONITORING: i■.- DATE: 8/16/03 IJt 05,1, 49n 14 i'Y„JuE No iA•t wcwttcuanw �� W 15 •��'�;k n+>t, r Vel, •� 1a�AOFESS *•+ 16 BOH - 16' �h�.��n 17 S L 0 P E DATE PERFORMED: 8/8/03 READINGDATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 8/16 11:17 8.25” 1 11:27 10 0 815" Recharge 11:28 8.17" 2 11:38 10 0 817" Recharge 11:39 8.25" 3 11:49 10 0 82S - PERI: RATE: I_ MIN./INCH PERC. HOLE DIAMETER:_ " TEST RUN BETWEEN 25 FT. AND 3S T. COMMENTS: Test Hale Pre Soaked Prior to Test TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 8/16/2003 PRESSURE DISTRIBUTION CALCULATION Elevation at Highest Discharge Point Pressure at Highest Discharge Point Liquid Level in Tank (Elevation) Diameter of Holes in Distribution Line Diameter of Distribution Line Hole Spacing in Distribution Line Length of Transport Line Diameter of Transport Line Q=12.4cL = 12.4(.1875)(.1875) 15— = .9748 GPM/Orifice _ .9748.30 = 29.2 GPM TDH = (107-95) + .0192(29.2)(29.2) 12 + 16.4 = 36.2' + .000995(1101(29.2) (1.5) •� + 7.8 102' 5' Head 95' 1875" (3116") 1.25" 1.5' 110' Therefore 30 Orifices @ 3' Spacing With 36.2' Total Dynamic Head. Orifice Diameter 3116" F ,OFt4�rd 0*: 49 I._ 'k r iAZL L A'��Ek�C N.•� r GE -4331 pRCFCSS���1�` 350.00 300.00 F20 -I 01 t� LZJ LL. s 200.00 LQ Mr U 150.00 0 AF P" 50.00 310. L 5.00 10.00 15.00 20.00 25.00 .0035-00 40.00 45.00 50.00 NET DISCHARGE, GPM 2q.2 GPM - - ROSEBILIKG-, OR 974 D (503)673-0 165 .; ORENCOSYSTEMS,INC 2626COLONlALROAD PUM " Hp to11/2Hp 4.! �� (EFF,UENT 1LSPHASE, 60HZ !�� 15/230 VOLT PC#2 20 OSI 15 HHF - 9 stage ; _ + - j..®5%92 1 � may' •�� !r!y 1� i iu� i is 4i f P.4 !: 1 ! 1 1 { : 1 t i i 1 1 1 i 1 itI i i 1 j!+1111 1 1 _ if .=rT 20 OSI 10 HHF - 7 stage „ 1 11 till 11,1 ; 11 fill 1,1 ! .•'_; _w_t � —1_ 1.. 1 1 1 i 171 1 _• !11 �1 iltl Ii l 1 ; 11 ! 1 Ii i I 1 ...1.. 1 .. _1._•_,....1..1 1 1 _� ..��. 1 ..,� ..Lti_ ..t_ .•1_I 1 I-�-�Iti_ 1 1 1 • 1 1 U.J... ....1.J...1... �.. ...1..1W t -L ' 120OSIOSHHF-5 77 444 1.1 1if �•Y' l i 1 I;; 1 i ITS if i....i ! i �� _..i.. ! 3.. 1 �• 1 If i 1 �*T y_♦ .y.1..M ,.�.1_ . _1-1_1 �.t_I if -��11 -y -TI�. —1_ T - -1 .. ... _� .� 1 ..1. ..I.. Y.. + ' T I 1! , ! ' : Y 1.f 1 1 ! 40 OSI 05 iIFi - 2 stage' �._ fir`_ ! i' y t_ 1 .. _,._:.. .r— .;..... ....,......_._..........t..i...,..r....1.. � 1 i 1 ! ; w ailablein "i1�w.jI3 ;-�- 20 OSI 05 HHF-'5 stage _ ..r-• -i i ; w / 1/4" flow controller ! _ 5.00 10.00 15.00 20.00 25.00 .0035-00 40.00 45.00 50.00 NET DISCHARGE, GPM 2q.2 GPM - - ROSEBILIKG-, OR 974 D (503)673-0 165 .; ORENCOSYSTEMS,INC 2626COLONlALROAD ONSITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 1A, STORCK SUBDIVISION ADDN. NO.3 GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 -gallon STEP tank at the location shown on the site plan and the construction of a new 90' 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 the existing ground and the distribution pipe will be placed at V below the surface. All components of the new absorption trench and septic tank must be constructed a minimum of 100' from wells in the area and 100' from any surface water. Insulation will be required atop the trench to prevent freezing. In lieu of insulation a minimum of 3' of cover must be placed atop the trench. A minimum of 4' of cover is required over the STEP Tank. 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 TANKILIFT STATION INSTALLATION 1. The 1,500 -gallon STEP tank must be constructed by a certified tank manufacturer. Construction shall include an 18" manhole to provide access to the lift station. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Lot 1A, Storck Subdivision Addn. No. 3 August 16, 2003 Page 2 of 3 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drain field. 6. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAIN FIELD CONSTRUCTION: 1. The drain field shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drain field 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 drain field 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 drain field 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 trenches to drain away. 8. A minimum 2' of accepting soil is required below the drain field 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. •. r Lot 1A, Storck Subdivision Addn. No. 3 August 16, 2003 Page 3 of 3 MATERIAL SPECIFICATIONS: The lift station must be constructed by a municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 017 -091-96 Certificate of On -Site Systems Approval OSC241498 Expiration Date: Legal description STORCK #3 BLK 1 LT 1A Site address 14195 OLD RABBIT CREEK RD Current property owner(s) BURLINGAME DAVID W X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: / G Ls Original Certificate Date: 12/4/2024 /e' rtificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, opment Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE RU5H Boom= Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcell.D. 017-091-96 Complete legal description Sto rck #3 Block 1 Lot 1 A Location (site address) 14195 Old Rabbit Creek Road, Anchorage, AK 99516 Current property owner(s) David Burlingame — Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: RE Private Well R Private Well serving 2 dwelling units 0 Private Well serving 3+ dwelling units R Community Well or Public Fj Water Storage 4. TYPE OF WASTEWATER DISPOSAL: � Private Septic E] Private Septic serving 2 dwelling units ❑ Holding Tank Fj Community Septic or Public Sewer 5. SEPTIC TANK: RN Steel F] Plastic F-1 Concrete Fj Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: [I AWWTS R Bed [] Deep Trench R Wide Trench R Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ "i L4 G Waiver Fee $ Date of Payment COSA # 0,5C z q I q q Date of Payment Waiver # COSA Application—June 2022 0.522 Forge Engineering 10/10/24 N/A N/A N/A > Benjamin Schiller, P.E. (907) 522-7773 FND. ALUM CAP MON. BENT AND DESTROYED. SET BPC AT BASE OFAL UM. PIPE. N 898 48'39 " W 334.72 10' TELE & ELEC. ESM'T. 0 IND. AL UM CAP MON. BENT AND DESTROYED. SET BPC AT BASE OF AL UM. PIPE. AT. DISH SA T. DISH PJ `/ 00 WELL f� i1 O.H. DECK o �� �F q tq�;4p 49 TH Y A � SHANE A. HOLT �� t Qpm LS -6914 o`O� ,�\,°fessiona\ Vo ASPHALT METAL BUILDING op H. • H. 9 �0� \N �nIIEN� 7 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANI' CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 1 A BLOCK 1 STORCK SUB. ADD'N. 3 PLA T2000-32 ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 26 TH DAY OF NOVEMBER , 2024 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 995,017 16160 239-25,69 223-8615 3759GCiN \ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program f • . i„ 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-091.96 HAA # 0 0-4 Expiration Date: S -.21 S' 016- 1. GENERAL INFORMATION Complete legal description Lot 1A Block 1 Storck Subdivision Addn. No. 3 Location (site address or directions) 14195 Old Rabbit Creek Road Current Property owner(s) David and Lori Burlingame . Day phone 348.0073 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 14195 Old Rabbit Creek Road Anchorage, AK 99516 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Four(4) Day phone Day phone TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 5117/2005 S. DSD SIGNATURE 49th MICKAM r- MIDERRW/ No. CC -4981 / �G Approved for bedrooms. ��� "'—"ip�r�•' Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: S (Rev. 12M) Municipality of Anchorage • • Development Services Department Building Safety Division Onsite Water & Wastewater Program : • •'" 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-0650 www.ci.anchorege.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA Well type Pdvate If A, B, or C provide PWSID # _ Date completed iSanitary seal (Y/N) Y Total depth _ gZ—ft. Cased to eft. FROM WELL LOG Date of test 1012sm Static water level 56 ft. Well production 3 g.p.m. WATER SAMPLE RESULTS Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 in. AT INSPECTION ft. Coliform _L_oolonkWI00 ml. Nitrate .84 mg.A. Other bacteria _L oolonies/100 ml. Date of sample: Y3012005 Collected by: Asrow Well and Pump B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEPISteel Tank size 1.300 _ gal. Number of Compartments I Foundation cleanout (Y/N) Y Depression over tank (Y/N) @ Date of pumping C. ABSORPTION FIELD DATA ' srll.rel.IK Cleanouts (YIN) High water alarm (Y/N) Y .h. •11!1111 •� Date installed 88212003 Soil rating (g.p.d./fe or ft1Axdrm) .8 GPOISF System type T Mde Trench Length 105 ft. Width ft. Gravel below pipe 2 fL Total depth I ft. Eft. absorption area W ftp Monitoring tube X Depression over field N Date of adequacy test 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 Data installed 0012003 Sim in gallons 250 Manhole/Access (YIN) Y 'Pump on' level at!g in. 'Pump ofr level at 4g in. High water alarm level at 44 in. Datum Bottom of Tank Cycles tested Now Const Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankA(ft station on lot MW Absorption field on lot >1W Public sewer main WA Sewer /septic service line >25' On adjacent lots >IW On adjacent lots >IW Public sewer manhole/cleanout WA Holding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >S Property line _�f Absorption field >S Water main WA Water service line >10' Surface water AW Wells on adjacent lots MW SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service Ilse AT Surface water MW Driveway, perkingNehide Mm"a >2S Curtain drain >W Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION •••�P,,: ^"" """' I certify that I have determined through field inspections and E' 49th review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date..e 000OVEi L 4mw&im Engineer's Printed Name Michael E Anderson. RE �G'rh • NM CE -4= +�1 Date 511Tr1005 'eyaa"1S .r HAA Fee S '57 Waiver Fee $ Date of Payment s-- i7- os Date of Payment Receipt Number i!_�s la Receipt Number (Rev. 12/00) 2000-32 STORCK SUBDIVISION, ADDN. LOT 1A, BLOCK 1 3.11 ACRES S 89'48'39"E 334.72' & UTIL ESOT. NO. 3 _---_______ \ V W O N \ O � 137••6. N V, e JI��IN° N \ WELL �xllNG SEPTIC VENTS N 63•� NE +^+\ O � \ moi,'- + \ / �'° }/ • SEPTIC VENTS o + Cia�44y� / / NG ESQ • Ilk 02 \ � e�1�` o. ROpO/ V / 1 "=60' ♦ OF A S♦ ♦�• ' r�i;'49TH•� 9.0 10 r... .................. .... o Jeffery A. Gastaldl ; 40 / 4 °i �• AV LS -6091 AV,•' ♦, �OJassionol L° AS -BUILT GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L. 4726 WEST 88TH AVEN ANCHORAGE., ALASKA 99 PHONE 248-5454 GRID DATE 3039 5/12/2005 F.B. JOB NO. 05-01 SS31Al I HEREBY CERTIFY THAT I HAVE SURVEYE[ PROPERTY DEPICTED ABOVE AND THAT NC ENCROACHMENTS EXIST EXCEPT AS INDICA IT IS THE RESPONSIBILITY OF THE -OWNER DETERMINE THE EXISTENCE OF ANY EASE EOVENANTS OR RESTRICTIONS WHICH DO XPPEAR ON THE RECORDED SUBDIVISION UNDER NO CIRCUMSTANCES SHOULD ANY HEREON BE USED FOR CONSTRUCTION Of ESTABLISHING BOUNDARY OR FENCE LINE! ANCHORAGE RECORDING DISTRICT, ALAS NOTE: NO CORNERS SET THIS DATE. THE TO ENTS, JOT 'LAT. DATA FOR