HomeMy WebLinkAboutTHE TABLELANDS BLK 7 LT 1The Tablelands
Block 7
Lot 1
#051-801-33
Municipality of Anchorage Page 1 or 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
' P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 3437904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW040359 PID Number: 051.801-33
Namenellomes :
Wastewater System: New
S i
1900 W. Northern Lights, Ste. 200 Anch. AK 99517
ABSORPTION FIELD
PN : NiHneerdBe°1O01As:
5' Wide Trench
344.5678 Four 4
sW wl,g:
Taal Dwm fan ananr li
LEGAL DESCRIPTION
.45 Gpmrte
3 Ft.
frock: Ld: Subch L :
Dean 10 P-Pe botlan can OV-01 gn0e:
Cfsvel Bean bM lh qpe:
7 1 The Tablelands
2 Ft.
2 Ft.
TOenanlp Rahe: Secban:
FO WOW wove WQ7 l ¢s0e:
Cysts Larpm:
2-4 Ft.
190 Ft.
Grow w h:
wnbw co tree:
Oeunro beovaen rrso:
Well: AWWU Water System
5 Ft.
2
ow—weellorl (Frwsle. A S. C):
Tar Dwm:
aeW n:
Taal wwmwn area:
ripe Matenn:
Ft.
FL
1,357 Fe
ASTM 3034 PVC
Diner:
Dole DneW:
SIMC Will taw:
Innalw:
Pisano's Dirtworks
One "Iew.
9/27.28/2004
Ft.
nolo:
wnp sat at:
aesg ht Aeo. G~id:
TANK
GPM
Ft.
Ft,
SEPARATION DISTANCES
Septic
To
Septic
Absorption
LHt
Holding
blirJPovate
uauww:
Anchorage Tank
Dar+tYn
1,250
Fran
Tank
Field
Station
Tank
sewerl. to
>200'
>200'
NIA
NIA
>25'
Steel
Steel
r�yTwo (2) nm.nu.
Two (2)
We*
>100'
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
suAecawrw
to LW*
>5'
>10,
NIA
NIA
e.
Gr
u a- ww.
>5'
>10'
NIA
NIA
'Pump on' bw sl.
D bw at.
Itgn ralw &u at.
FaaMetron
ei,
ti.
„.
None
Noted
Pump Maks 6 MWr
Ebclrld elspwws pertained W.
Dunam O an
RamWte:
BENCH MARK
Iqn saG IDlwn.
Finished Floor.
radon.
100.0 Fl.
Engineer's Stamp
ts
Inspections performed by: T. Kimbrough Dates: 1s' 9127/04
• 49th
2"O 9128104
00 � � MICHOEL E. ANDERSON ...... W
Department of Health and Human Services approval
�0 s % No. CE- 3811
',5=31-0
fir/' Date:
•��If�f�;..c�r4 �i
RevOewed and approved by: •
44 SSle��.
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit No. SWO40359
S2
C6 1 152.8' 1 352
SV 1 30.1' 17.0'
M7 1 55.2'116.4'
M2 52.4' 29.1'
M3 1 149.4' 1 31.4'
M4 1 70.9-163.8'
/ \9R
t.
o � ♦O Jr' w� Op ♦
Four
A No m room i
S7 B
C4 i
S2 �
M4 M SV
C7
e5
M3 2
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rH 2
Alternate Site
11
PLAN
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Page 3 of 3
PID No. 051-801-33
THE TABLELANDS SUBDIVISION
LOT 1, BLOCK 7
40,990 S.F.
AS -BUILT
SCALE V = 50'
Permit No. SWO40359
TBM -
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
PID No. 051-801-33
V E
H S U
n n 97.20' B n n98.44'
I)rolnfleid Rock
E3G.0' S U
ID f t.96� l 91.70 __ ._-
�� oa1$
MUNICIPALITY OF ANCHORAGE a6bl �
Development Services Department �1
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Aug 24, 2004
Expiration Date: Aug 24, 2005
Permit Number: SWO40359 Parcel ID: 051-801-33
Legal Description:';`fHE TABLELANDS SUBDIVISION BLOCK 7 LOT 1 "
Design Engineer: 0014 Anderson Engineering Site Address: 22731 SAMBAR LOOP
Owner Name: SPINELL HOMES, INC Lot Size: 40990 SO. FT.
Owner Address: 27731 SAMBAR LOOP Total Bedrooms: 4 Permit Bedrooms: 4
EAGLE RIVER. AK 99577 -
This permit is for the construction of:
E] Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
Maximum depth of absorption trenches shall not exceed 3 feet below original grade.
Received By:
Date: E3 1
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. DS(- %ot- 33 Permit Number SW
Property owner(s) Soinell Homes Inc. Day phone 344.5678
Mailing address (1)1900 W. Northern Lights Bouler
9 address (2) JA731 _0_Vn Ar 1. U
Legal description (Lot, Block & Sub'd.) Lot 1. E
Legal description (Section, Township & Range)
Lot Size 4o.g90 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
6•Q. 11g5 -4-A ZiD Code
Number of Bedrooms Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. 1 further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment
Waiver Fees:
Date of Payment: P ' 17 " o �•
Receipt Number. Sftgl3 Receipt Number.
(Rev. 12100) �T—
Municipality ofAnchorage,^�Y
I'.O. Lkix 196fSO •Anchorage, Alaska OO.iI&Gfin() •Telephone (907) 93.4&'S0I •1'az (fM)7) .313-82OO °
/ 37(1) Brngare Slreel • Anchorage, Alaska 9A-()7 s • . r .
nm.munl.org
Mayor Mark Begicfl
Building Safety Dii3sion
8/24/2004
Anderson Engineering
P.O. Box 240773
Anchorage, Alaska 99524
Subject: Waiver Request for The Tablelands Subdivision, Block 7, Lot 1
Waiver Request #WR040055
Parcel ID #051-801-33
Permit # SWO40359
Dear Mr. Anderson: '
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
1.0 foot.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely, ' ^
Julie Makela, P.E.
Civil Engineer
On -Site Water & Wastewater Program
Community, Security, Prosperity
Municipality of Anchorage
Development Services Department
+r Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: WRO40055 PID#:051-801-33 HAM _ Permit#: SWO40359
Date Received: 811710
Legal Description: The Tablelands Subdivision, Block 7. Lot 1
Engineer. Anderson Engineering
Applicant: Soineil Homes, Inc.
Waiver Requested: Lot Line Waiver
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
...............................................................................
Waiver Is Granted: Waiver is not Granted:
List Conditions or Reasons for above:
Date:L L�_ By: 6L . Q ..*4L4
. M�
lame of Reviewer
....................................................... means .... ......e@ ... mass
Rec#: OS56913 Amount: $175.00 Date Paid: 8/2412004
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522.6779 FAX
August 17, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Block 7, Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1, Block 7, Tablelands Subdivision 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 septic system to serve the new home. The subdivision is served
by a community water system and no conflicts exist with adjacent septic systems or
wells. The attached Site Plan and backup documentation identify the location and
configuration of the proposed septic system and alternate site. The water service line is
also shown. The current drainage pattern along with spot elevations are identified on
the Site Plan. The drainage pattern will be maintained after development of this lot is
complete.
A test hole recently placed on the lot indicated silty sand and gravel in the area of the
absorption trench. The accepting soils were tested and found to have a percolation
rate of 40 minutes per inch. Groundwater was found In the test holes during placement
at 9' and remained at that elevation during the monitoring period. Our design includes
the placement of a new 1,250 -gallon septic tank along with 2 - 94' long by 5' wide by 2'
effective depth absorption trenches to collect and treat the sewage generated in the
house. The bottom of the trenches will be 3' below the surface to allow 6' of separation
from groundwater at this time. The distribution pipe will be 1' below the surface. A
minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover
will be placed atop the new septic tank. A lot line waiver is required due to the
extended length of each of the trenches.
The ground surface on the lot slopes at shallow grades from northeast to southwest as
shown on the Site Plan. The absorption trenches will be constructed parallel with the
Lot 1, Block 7, Tablelands
August 17, 2004
Page Two
slope of the ground surface as much as possible in conformance with Municipal
requirements. The new septic system will be constructed a minimum of 10' from the
water service proposed for the lot and on 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,
7t"—L cf1Z4-"7
Michael E. Anderson, P.E.
Attachments
JY 9th
MICHAEL E ANDEH�
;� No. CE -4381
2004-25
THE TABLELANDS SUBDIVISION
LOT 1, BLOCK 7
40,990 S.F.
5/8' REBAR (TYP PER PLAT}—, \\ O/•.
/ /
�� /•/♦p 0
/
/
1.750 Cahn
^ia s.pw Tans
p,• ilo. SPGllan Valve /
7-lop Y wda
A. TM l . 7'' [n.cNl. O.on. /
Mbrnob 5u M 7 /
t0)
Opp /
/ v
• PSE OF
e?s• �,; /SITE PLAN � ,.r «49 h
""'-i q�' SCALE 1' = SO' •,T....
etouEl. L MDERSM i
^
No. CE�381
♦
... r i
•
LOT 1, BLOCK 7, TABLELANDS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House 5' Wide Trench System
Perc. Rate: 30-60 Min.11nch 1,250 Galton Septic Tank
Application Rate: .45 GPD/SF 2' Drainfield Rock
4 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,333.3 SF Absorption Area
1,333.3 SF/5 SF " .7 (Red. Factor) = 186.7 LF Trench Length
THEREFORE: Construct 2 - 94' Long x 5' Wide x 2' Effective Depth Absorption Trenches.
Flow Line Elevation in Trenches to be 1' Below Original Ground Surface. Total Depth to be
3' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Provide 2" of Insulation and 2' of Cover if Necessary. Place a
Flow Splitter Valve to Insure Even Flow to Each Trench.
Natura�
Backfill Geotextile
6" Fabric
6" I 4" Perforated
t PVC (Holes Down)
2'0"
Drainfield Rock
5'
TYPICAL 5' WIDE TRENCH SE
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Services in the Area.
Minimum 100' Separation From Surface Water or Streams.
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION- LOT 1, BLOCK 7, TABLELANDS S/D
PERFORMED FOR- SPINFI I
DATE: 8/3/2004 PROJECT No'M0458
PARCEL ID,#• TECHNICIAN: T. L. KIMBROUGH
DEPTI I
uwl
TEST HOLE # 1
SILTY ORGANICS/OB
SILTY—SANDY—GRAVELS
GM
SLOPE
�r 49th
No. CE- 381
SITE PAN
CURD KEY
TH1
O
'(H2
O
SFE FUTURF ASRUII T
WAS GROUNDWATER ENCOUNTERED? Yes
IF YES 0 WHAT DEPTH' 9' 0%
DEPTH OF WATER AFTER MONI ORING: 9'
DATE OF MONITORING: en51900c• i I
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER(INCHES)
(INCHES)
INET DROP
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
14:45
12.0"
CHARGE
2
15:15
30
11.0"
1.0"
3
15:15
12.0"
RECHARGE
4
15:45
30
11.25"
0.75"
5
15:45
12.0"
RECHARGE
6
16:15
30
1 11.25"10.75"
PERCOLATION RATE, -40 (MM/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and -5 -5 -FT.
WAS GROUND WATER ENCOUNTERED? YES IF YES @ WHAT DEPTH'? 9.0'
DEPTH OF WATER AFTER MONITORING: DATE OF MONITORING:
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY VETECII ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE-
DEPTH
(r«o
1
s
L
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION- LOT 1 BLOCK 7, TABLELANDS S/D
PERFORMED FOR- SPINFI I
DATE: 8/3/2004 PROJECT No•M0458
PARCEL IDN- TECHNICIAN: T. L. KIMBROUGH
TEST BOLE # 2
SILTY ORGANICS/OB SLOPE
SILTY—SANDY—GRAVELS
GM
gm
WAS GROIND NATER ENCOUNTERED? V's
4t
MICHAEL L ANDERSON
No. CE -4381 i
SITE PLAN
CURB
TH1
0
TH2
0
SEE FUTURE AS3UILT
IF YES 9 WHAT DEFTII? 9 � I 0%
DEPTII OF NATER AFTER MONITORING: 9'
DATE OF MONITORING: ^^`��""N•
DATE
READING
G OSS TIME
MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
10:25
12.0"
CIIARCE
2
10:55
30
10.75"
1.25"
3
10:55
12.0"
RECIIARGE
4
11:25
30
11.25"
0.75"
5
11:25
12.0"
RECHARGE
6
11:55
30
1 11.251110.75"
PERCOLATION RATE 40 (MN/INCH) FERC. IIOLE DIA.6(INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 1, BLOCK 7, TABLELANDS SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a new
1,250 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of 2 new 94' long X 5' wide X 2' effective depth
absorption trenches at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 1' below the existing ground
surface. Total depth of the trenches will be 3' below the existing ground
surface. A flow splitter valve must be placed to insure even flow to each
trench. A separation distance of 10' from any water service and 100'
between the septic tank and absorption trenches and any surface water must
also be maintained. A minimum of 3' of fill is required over the absorption
trenches and 4' over the septic tank. In lieu of the required fill 2" of insulation
and 2' of fill may be placed.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,250 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 1, Block 7, Tablelands
August 17, 2004
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A slit barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 1 00'away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 1, Block 7, Tablelands
August 17, 2004
Page 3 of 3
MATERIAL SPECIFICATIONS:
Septic tanks must be constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
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.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
•7773 522.6779 (F
August 17, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 1, Block 7, Tablelands Subdivision
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer.
The absorption trenches for Lot 1, Block 7, Tablelands Subdivision must be a minimum
of 94' long to allow sufficient separation distance between the bottom of the trenches
and the assumed elevation of the groundwater table in the spring. The water table is
currently at 9', but the system was designed for an elevation of 7'. The subdivision is
served by the Municipal water system and no conflicts exist between wells or other
septic systems in the area. The new trenches will be constructed within 4' of the lot
line, but the alternate site, if it becomes required, would be within 1' of the line.
Placement of the new absorption trenches at the locations shown does not impact wells
or adjacent septic systems. We therefore recommend a waiver be issued allowing the
new trench to be constructed at 1' from the northwest property line.
Sincerely,
wuact Ea^
Michael E. Anderson, P.E.
K UMCIPAUTV OF AHC HOGIQOC
Development Services DepartmentPhone: 907-343-7904
1
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 051-801-33
1. GENERAL INFORMATION
Expiration Date: 1-30 -2 0 Z 0
Complete legal description THE TABLELANDS BLOCK 7, LOT 1
Location (site address) 22731 SAMBAR LOOP, CHUGIAK, AK 99567
Current property owner(s) DUSTIN & MEGAN LISKA Day phone
Mailing address
Real estate agent
w1c111 RI:lu1Ya:1 X6161;to] ;11lei 1-11:*T1,Sol 1061.7�1
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY:
Private Septic
Private Well
❑
Holding Tank
❑
Water Storage
❑
Community
❑
Community Well
❑
Public Sewer
❑
Public Water System
Waiver request for:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $55 0. o-0
Date of Payment (®i((l wP g
G
Receipt Number -I W ✓D
COSA# WC/1914Y
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
�� \;.� it
.,ao
Distance:
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 NATRONA AVENUE, ANCHORAGE, AK 99516
Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 10/10/2019
Comments: This investigation was completed in compliance with MOA guidelines, regulations, `\
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change OF �
��� .• A 1
due to subsurface conditions that may not be observed from the surface, changes in land use, •'"'. `7
local soil characteristics, groundwater levels that may fluctuate during the year, quality ofc� .
construction (workmanship & materials), the water usage of the family being served by the /;'
system and maintenance. The operational life of all well and septic systems are subject to * :'49 TH*
these various and dynamic characteristics and are outside the control of the evaluator of the �/ '/I%%'(/'�/
well and septic system. Therefore, any estimate of how long a system will function satisfactory
114.
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by FWCS and Anderson Construction & Engineering. '•?Q� N. ANDERSON. /
1 No. CE 9489
10/10/1s/
6. DSD SIGNATURE ' \
ssto �
System #1 Approved for bedrooms ���•�
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulatioMX(M((([i/,_
����E�9FS DPASM -N_"\`,
:
i
B _ Original Certificate Date: 1c9 "
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: THE TABLELANDS BLOCK 7, LOT I Parcel ID: 051-801-33
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA — PUBLIC WATER
Well log is filed with Onsite (or attached)
Date drilled
Total depth _ft
Cased to _ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) _in.
Date of flow test for COSA
Static water level at beginning of test _ft.
Comments
B. TANK DATA — 9/27/2004 1250 -Gal
Age of tank(s) 15 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 50"
Standpipes/foundation cleanout per record drawing
Date of pumping 9/30/2019
Structure served by this system
Well production at time of test _gpm
Water storage tank volume_ gallons
Well disinfected for coliform test? e Yes e No
Coliform bacteria is Negative
Nitrate _ mg/L o Nitrate less than MRL (ND)
Arsenic _ ug/L e Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
D. ABSORPTION FIELD DATA — TWO @ 95'L x 5'W x 2'ED — 0.45 GPD/SF = 1357SF
Which system tested (date installed) 9/28/2004 Adequacy test date 9/30/2019
ALL standpipes present per record drawing Results Pass For 4 bedrooms
Total measured depth from grade 55+ft (max) Fluid depth prior to test 14 118 in
Measured depth to pipe invert from grade eft (min) Water added 8'?0. gal
N/A — pressurized field New depth 18 / 21 in
® Monitor tubes go to bottom of effective. If not, state Elapsed time 1330 min
depth into effective
Code -required soil cover over field
Final fluid depth 13 / 17 in
System presoaked Absorption rate SQQ+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) L1
date of test)
Gallons introduced _gallons If yes, enter date C
Comments/Deficiencies: Field isopera ting in the upper half of the effective depth NES
COSA Checklist.docx
From Private Well on Lot to: (Please enter distances if less than required or if community well) NO WELL — PUBLIC WATER
Septic I ank lift Station on Lot > 100'
Community Sewer Manhole/Cleanout
® Yes if No
ft vs if No ft
Neighboring Tank > 100' -Y-es, if No
ft Private Sevver,1,1'se l5'tic Line > 25' ®Yes if No ft
if No
ft
Absorption Field on Lot > 100' ® Yes if No
`Holding Tank > 100' ® Yes if No ft
® Yes
if No
Neighboring Absorption Fields > 100'
Animal Contaainment > 50' ® Yes if No ft
1' es if No
ft
if No
Manure/Animal Excreta Storage > 100'
Community_Sedv r Main > 75' ® Yes if No
ft M--?0s-r,itNo ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Wells on Adjacent Lots:
Property Line > 5' ® Yes if No ft Private Wells > 100' ® Yes if No ft
Absorption Field > 5' ® Yes if No ft
Water Main > 10' ® Yes if No ft
Water Service Line > 10' Community Wells > 200' ® Yes if No ft
_ ®Yes if No ft
Surface Water > 100' If septic tank is under driveway comment below
_ ®Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No ft
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
COSA Checklist.docx
�.OF.AL�
*.49Tx *
.p ' MICHAEL N. ANDERSON:
No. CE 9489 w
.. 10/10/19,.- c,4'
�2'ESSIO�A�'
Municipality of Anchorage
•-�� Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 05D-801-33 COSA# 100V1
Expiration Date: 3— /1— t/
1. GENERAL INFORMATION
Complete legal description LOT 1; BLOCK 7; TABLELANDS SID
Location (site address)
72731 SAMBAR LOOP, CHUGIAK AK 99567
Current Property owner(S) GREG d TARA NELSON
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
EVA LOKEN @ PRUDENTIAL XW RE
Day phone 681 734
Day phone
Day phone 689-6476
16635 CENTERFIELD DRIVE 0103, EAGLE RIVER AK 99577
Unless otherwise requested, COSA 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
❑
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 On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (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, 1 verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm S 8 S ENGINEERING
Address 15861 S. BIRCHWOOD LOOP RD. CHUGIAK AK. 99567
Engineer's Printed Name ROBERraSHAFER
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone 694-2979
Date 3-6.10
Conditional approval for bedrooms, with the following stipulations:
WA.CTCU/Ar,=
/J
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: 3 ` 1%— i G
(R« 11M)
Municipality of Anchorage +,.••
Development Services Department wt
Building Safety Division � „' ;,, •
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: � � toCK Zj Ar- �fJB[EU} Parcel lD: t —33
A. WELL DATA no( o 0,47M �3y3f£n'16P0FJUG,
Well type If A, B, or C provide PWSID # _ Well Log (YIN)
Date completed _
Total depth ft.
Date of test
Static water level
Well production
WATER SAMPLE RES
Coliform color
Arse ' . .ug/L
Sanitary seal (YIN) _ Wires properly pro te
Cased to ft. Casing helghtab4v,
FROM WELL LOG AT.JNSECTION'
mL Nitrate mglL
date of sample: _
ground) ip.
ft.
Other bacteria colonies/100 mL
Collected by:
'B. SEPTIC/HOLDING TANK DATA
Tank TypelMaterial Z pT1G `7Teec Date installed
Tank size gal. Number of Compartments A CleanoutsON) t>
Foundation cleanout �1) Depression over tank (Y® High water alarm (Ye
Date of pumping 3 g Pumper
C. ABSORPTION FIELD DATA
Date installed _/y/�/�Q(� 0 . Soil rating (g.p.d.lfe or fe/bdrm) D• 45 System type -5Nt)tcouD Trrw6,s,
' -'7 •& , r
Length ' R5� ft.' Width 5 ft. Gravel below pipe o2 ft.
Total depth � ft Elf. absorption area fait= Monitoring tube Depression over field ��
Date of adequacy test S �D Result((a I) 5� For T bedrooms
Fluid depth in absorption field before test ~ in. Water added fob gat. New depth in.
rr /
Elapsed Time: L min. Final fluid depth � In. Absorption rate :>= �! t 9 P•d•
Any rejuvenation treatment (past 12 mo.) (YI& type) If yes, give date r
D. UFT-3T*TiGN NI e
Date installed Size In gallons
'Pump on' level at —In. 'Pump off i
Datum Cycles tested.
E. SEPARATION DISTANCES
High water alarm level at
Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO: t' ou-)() (� �
Septic tank/lift station on lot On adjacent lots
Absorption field on lot
Public sewer main
Sewer /septic service line
On adjacent lots
Holding tank
manhole/cleanout
areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
r r r
Building foundation s t Property line 5 t Absorption field :54
r �
Water main /D t Water service line /O + Surface water /nn f
Wells on adjacent lots _ Nj(R
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line //%
4 -Building foundation /D + Water main /D +
Water Service line /0+ Surface water Driveway,/
parkingNehicle storage
Curtain drain /` Wn- /{AfOla(1 Wells on adjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined,th ugh field inspections and
review of Municipal records that t e above syste re in
conformance with MOA COSA guid 'nes 'n elle t o this date
Engineer's Printed Name
Date O
COSA Fee
Date of Payment
Receipt Number ei 3 SSQ�
(Rev. 11/05)
Waiver Fee $
15
Date of Payment
Receipt Number,
WA A et�
016 Df7zn
in.
ija&j 4 -
Municipality of Anchorage
Development Services Department
Building Safety Division
_ On -Site Water and Wastewater Program s r
f 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
`QF. www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051.801.33
1. GENERAL INFORMATION
HAA # 050zlo
Expiration Date: S— 3 1 — 0 C
Complete legal description Lot 1, Block 7, The Tablelands Subdivision
Location (site address cr directions) 22731 Sambar Loop
Current Property owner(s) Spinell Homes, Inc. Day phone 344.5678
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address.
1900 Northern Lights Blvd. Anchorage, AK 99517
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 . Date 5/26/2005
c'KL �uau� - ^4DERsw.e
5. DSD SIGNATURE �i f'•., . AM
Approved for _ bedrooms. •�°� AD'S jl-0'�
Disapproved. .
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: —� Original Certificate Date: S' 3 1 0 6-
4
(Ray. 72810)
Municipality of Anchorage
• Development Services Department
Building Safety Division `
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 995194650
www.ci.andwrage.ak.us
(907)343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: rot i. Block T The Tablelands Subdivision Parcel ID: 051-901.33
A. WELL DATA
Well type _
Date completed _
Total depth ft.
Date of test
Static water level
If A, B, or C provide PWSID #
Sanitary seal (YIN)
Cased to ft.
FROM WELL LOG
ft.
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
ft.
Well production g.p.m. 9 -
p.m -WATER SAMPLE RESULTS:
Coliform oolonies/100 mi. Nitrate mg./I. Other bacteria colonies/100 ml.
Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SeWdSteel Date installed 9=2004
Tank size 1.250 gal. Number of Compartments Y Cleanouts (Y/N) Y
Foundation cleanout (YM) Y Depression over tank (Y/N) y High water alarm (YIN) Y
Date of pumping Pumper Now Construction
C. ABSORPTION FIELD DATA
Date installed 912912004 Soil rating (g.p.dJf 2 or f lfbdrm) .43 GPDISF System type T Wide Shallow Trench
Length 190 ft. • Width S ft. Gravel below pipe 2 ft.
Total depth I& ft. Eff. absorption area 1.357 ft2 Monitoring tube Y Depression over field -
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.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on' level at _ in.
Datum
Size in gallons
'Pump off" level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot NIA
Absorption field on lot WA
Public sewer main _WA
Manhole/Access (Y/N)
High water alarm level at
Masts alarm & circuit requirements?
On adjacent lots N/A
On adjacent lots _WA
Public sewer manhole/cleanout NA
Sewer /septic service line _WA Holding tank WA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >S' Property line
Absorption field >S'
Water main >70' Water service line >10' Surface water >1W
Wells on adjacent lots >200'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
in.
Property line >10' Building foundation >10' Water main >10'
Water Service line >10' Surface water >100 Driveway, parking/vehicle storage >5'
Curtain drain None Noted Wells on adjacent lots >2W
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that l have determined through field inspections and
review of Municipal records that the above systems are fn
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson P E
Date 5W 05
HAA Fee $ 5'7 1' t 7 S ~ 2v i N Waiver Fee $ _
Date of Payment s' S'/ — D S Date of Payment
Receipt Number Receipt Number,
(Rev. 17100)
0
2004-25
THE TABLELANDS SUBDIVISION
LOT 1 , BLOCK 7
40,990 S.F.
1)1=401
gMe;�R
AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND SURVEYI 16NCROACHMENTS EXIST EXCEPT AS INDICATED.
JEFF A. GASTALDI, R.L. IT IS THE RESPONSIBILITY OF THE OWNER TO
4726 WEST 88TH AVEN �ENE
VENAINTSNE TOR RESTRICTIONSHE EXISTENCE FWHICH DO NOT ANY
ANCHORAGE, ALASKA 99 PEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR
Nw 1559 1/24/2005 ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
F.13 JOB No. NOTE: NO CORNERS SET THIS DATE.
04-14_ TL517
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