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) /
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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
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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
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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
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A
D
O
L
D
R
A
B
B
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C
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K
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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
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669p1'03'E 617.00 62-130
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669RWE 617.66 64-86
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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
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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
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w / 1/4" flow controller
!
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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
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SHANE A. HOLT �� t
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ASPHALT
METAL BUILDING
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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
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o Jeffery A. Gastaldl ;
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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