HomeMy WebLinkAboutTHE TABLELANDS BLK 4 LT 19The Tablelands
Block 4
Lot 19
#051-741-50
Municipality of Anchorage Page 7 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Boz 196650 Anchorage. AK 99519-6650
www.ci.anchorage ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO40364
PID Number. 051.741.50
ineil Homes
"7piS
Wastewater System: New
1900 W. Northern Lights, Ste. 200 Anch., AK 99517
ABSORPTION FIELD
' h ee
5' Wide Trench
3 45678
SalRr.q
Tatel Ell ham 0122 Vsas
LEGAL DESCRIPTION
.45 GPD/Fit
2 Ft.
ellxx Lar s.EEmwn
Depth b FOPS laltan Ian W" al
Gl iFN brwlh FVs
4 19
The Tablelands
1 Ft.
1 Ft
Towdl Raps
sl
FY saasa sDo.s arprW Vias
Grsrsl L&Vft
24 Ft.
176 Ft.
Well: AWWU Water System
GrswY w.qn.
5
NimCer of Yw.
2
PSIrtcl Isiwsen Wl
>10
Ft.
Ft
CW. m 111'tttas. A 0. c}
Told DsWt
Cassa W.
aul M—PW asa
ps Mil
Fi. Ft
1,011 Fit
ASTM 3034 PVC
Dill
D.s Ol
Stiox Wow lswM
e
Sanders Sanders Sanders
ate Jovial
1012212004
FL
."a
vla ii,t.L
c...ta Am. 6,0
TANK
GRIM
ft.
Ft
SEPARATION
DISTANCES
Septic
To
From
Septic
Tank
Absorption
Field
Ldt
Station
Holding
Tank
drlPrivata
sewer Line
Anchorage Tank
1-11I I1000
WM
>200'
>200'
NIA
N/A
>25'
Steel
s
Two (2)
S.n«. w"
>100'
>100'
WA
WA
LIFT STATION — NONE ON LOT
to Um
>5'
>10'
WA
WA
o,t
Fautldm
>5'
>10'
WA
WA
��`
h
tt
High"a m
h
cM oi.h
None
Noted
�c Maa+
W
Ratnato
BENCH MARK
on
Finished Floor.
100.0 Fl
Engineer's Stamp
. Pit o: qC ��'•
Inspections performed by: T. Kimbrough
Dates: 1" 10122!04
� a9th
'rMYl��
2ne 10122104
De artment of Health and Human Services approval
%NI�HA[L E AND[RSDR J W
•4�1s0
Reviewed and approved by: �t ,.�
I_�i Y n 1 1 eQn Date:
(a„ limN
hss `S"a �..
O �
h
i
jt a Three
Bedroom
Nome
PLAN AS -BUILT
SCALE V - 40'
15' T. & E. ESOT
I
I
Page 2 of 3!
Permit Number. SWO40364
PID No. 051-741-50 I
THE TABLELANDS
SUBDIVISION
LOT 19, BLOCK 4
43,310 S.F.
AlB
I C
S1
45.5
18.6
S2
39.2
22.0
SV
32.5
33.6
C4
47.2
24.7
C5
61.0
37.5
MI
43.5
17.9
M2
58.0
32.8
C7
68.0
29.6
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519.6655 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit No.: SW040364
96.50'—./ ,
96,10'
TBM a
PID No. 051-741-50
5.01' 94.94
PROFILE AS -BUILT
Scole: NONE
`--J6.37'
\96.03'
YY.47'
Fabrig
Dralnfietd Rock
L) = 5.21'
,,r84.0' 99.51'
95.20'
_
I
10
Dralnfleld Rock
5.01' 94.94
PROFILE AS -BUILT
Scole: NONE
`--J6.37'
\96.03'
MUNICIPALITY OFANCHORAGE
Development Services Department
Onsite 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 27, 2004
Expiration Date: Aug 27, 2005
Permit Number: SW040364 Parcel ID: 051-741-50
Legal Description: �a?HE TABLELANDS SUBDIVISION BLOCK 4 LOT 19'
Design Engineer: 0014 Anderson Engineering Site Address: NHN OBERG ROAD
Owner Name: SPINELL HOMES, INC Lot Size: 43310 SO. FT.
Owner Address: NHN OBERG ROAD Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER. AK 99577 -
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.
5. The following special provisions.
iMaximum depth of absorption trenches shall not exceed 4 feet from original grade.
Received By. 1141 ( Ida Date:
Municipality of Anchorage
• Development Services Department
�iBuilding Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw SL
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
Parcell.D. 051-9141—SD Permit Number SW
Property owner(s) Sginell Homes, Inc. Day phone 3445678
cb4ailing address (1)1900 W. Northern Lights Boulevard, Suite 200 Anchorage, AK 99517
address (2) u9tj CEg22h a&A 1_ X54-4- Zip Code
Legal description (Lot, Block & Sub'd.) Lot 19, Block 4. Tablelands Subdivision
Legal description (Section, Township & Range)
Lot Size 43,310 SF —Acres/6q F
THIS APPLICATION IS FOR:
Number of Bedrooms Three (3)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: { 40.0 Waiver Fees:
Date of Payment 81 r A I 6 Date of Payment
Receipt Number r5i.94L o ., Receipt Number.
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
August 27, 2004
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 19, Block 4, Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 19, Block 4, Tablelands Subdivision intends to construct a new three-
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 is identified on the
Site Plan. The drainage pattern will be maintained after developrnerrt 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. No groundwater was found in the test holes during
placement, but was noted at 10' bel w the surface during the monitoring period. Our
design includes the placement of a new 1,000 -gallon septic tank along with 2 - 70' 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 4' below the surface. The
distribution pipe will be 2' below the surface. A minimum of 3' of cover will be placed
atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank.
The ground surface on the lot slopes at shallow grades from south to north as shown
on the Site Plan. The absorption trenches will be constructed parallel with the slope of
the ground surface as much as possible in conformance with Municipal requirements.
The new septic system vnll be constructed a minimum of 10' from the water service
Lot 19, Block 4, Tablelands
August 27, 2004
Page Two
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:
1. The system, if constructed as designed, wip 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,
01--�L
Michael E. Anderson, P.E.
Attachments
0
VICNAEE E. A CERSCN
�
, No. CE -4381 %
EM
THE TABLELANDS SUBDIVISION
LOT 19, BLOCK 4
43.310 S.F.
100'
/
0. 00
P �qS 10'
n4-:� E. ESMT.
aq7
,
� Q'M
lot,
s.w< rar
rl spm.
\O�
5/8' MAR (TYP PER
70'
SITE PLAN
SCALE V = 50'
LOT 19, BLOCK 4, TABLELANDS SUBDIVISION
DESIGN FACTORS:
Three Bedroom House
Perc. Rate: 30-60 Min./Inch
Application Rate: .45 GPD/SF
SYSTEM REQUIREMENTS:
5' Wide Trench System
1,000 Gallon Septic Tank
2' Drainfield Rock
3 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,000 SF Absorption Area
1,000 SF/5 SF' .7 (Red. Factor) = 140 LF Trench Length
THEREFORE: Construct 2 - 70' Long x 5' Wide x 2' Effective Depth Absorption Trenches.
Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth to be
4' 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.
1'6"
6"
2'0"
Natural
Backfill
5'
Geotextile
Fabric
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE) 4
."
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock. w.....,
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Services in the Area. 0
Minimum 100' Separation From Surface Water or Streams. �i
49th
MEL E. MlOE�
No. CE+x+
DEPTII
(fm)
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION` LOT 19, BLOCK 4. TABLELANDS S/D
PERFORMED FOR, SPINFI I
DATE: $/3/2004 PROJECT No M0459
PARCEL ID, #- TECHNICIAN: T. L. KIMBROUGH
TEST HOLE # 1
SILTY ORGANICS/OB SLOPE
SILTY—SANDY—GRAVELS
GM
m
SITE PAN
Cum EY
TH1
02
SFF FUTURE ASRII1I.T
WAS GROUNDWATER R:WIIAT ENCOUNTERED., NO
IF YESR WHATORING: 0%.
DCPTFI OF WATER AFTER MONITORING: NONE
DATE OF MONITORING: ftf[51 2L
DATE
READING
C; BOSS TIME
(MINUTES)
NET TIME
(MINUTES)
WATER
D(INCHES) DE PTH of
NET DRQQP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
10:25
12.0"
CHARGE
2
10:55
30
10.75"
1.25"
3
10:55
12.0"
RECHARGE
4
11:25
30
11.25"
0.75"
5
11:25
12.0"
RECIIARGE
6
1 11:55
1 30
1 11.25"1
0.75"
PERCOLATION RATEL40 (MIN/INCID PERC. HOLE 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:
DEPTH
Irwn
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION, LOT 19, BLOCK 4, TABLELANDS S/D
PERFORMED FOR: SPINFI I
DATE: $/3/2004 PROJECT No --M0459
PARCEL ID#• TECHNICIAN: T. L. KIMBROUGH
TEST HOLE #t ]
SILTY ORGANICS/OB
SILTY—SANDY—GRAVELS
GM
SLOPE
SITE PLAN
'fH1
O
ZH2 <
O ti
SEE FUTUR= AS3UILT
WAS GROUND NATER ENOOINTERED, NO
IF YES @, WHAT DEPTH' 0%
DEPTH OF NATER AFTER MONITORING: 10'
DATE OF MONITORING: 512.12"L
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
Dy A ERF
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
10:25
12.0"
CHARGE
2
10:55
30
10.75'
1.25"
3
10:55
12.0"
RECHARGE
4
11:25
30
11.25'
0.75"
5
11:25
12.0"
RECHARGE
6
11:55
30
11.25'
0.75"
PERCOLATION RATE; -40 (NIIN/INCII) FERC. }TOLE DIA• 6 (NCIIES)
TEST RUN BETNEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TI IIS
DATE:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 19, BLOCK 4. TABLELANDS S/D
PERFORMED FOR: SPINFI I
DATE: 8/3/2004 PROJECT No= M0459
PARCEL ID,4- TECHNICIAN: T. L. KIMBROUGH
Drrnl TEST HOLE # 2
(fcet)
1 SILTY ORGANICS/OB S A
2
3
4
5
6
7
8
9
10
11
12
13
14
IS
16
17
18
19
SILTY -SANDY -GRAVELS
GM
f:Ton
SITE PAN
CURD EY
V
02 k
SFF FUTUR ASRUILT
WAS GROUND WATER ENCOUNTERED? NO
tF YES @ WHAT DEPnR O�
DEPTH OF WATER AFTER MONITORING: NONE
DATE OF MONITORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DpEPTERF
(INCHES)
NET DRQQP
(INCHES/
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
10:26
12.0"
CHARGE
2
10:56
30
10.5"
1.5"
3
10:56
12.0"
RECHARGE
4
11:26
30
10.5"
1.5"
5
11:26
12.0"
RECHARGE
6
11:56
30
10.675'
1.325"
PERCOLATION RATE•2� 1_8 (MINANC1) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and_,IL5_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:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 19, BLOCK 4, TABLELANDS S/D
PERFORMED FOR- SPINFI I
DATE: 8/3/2004 PROJECT No•M0459
PARCEL IDP- TECHNICIAN: T. L. KIMBROUGH
DEPTH
(Tat)
TEST HOLE # 2
SILTY ORGANICS/OB
SILTY—SANDY—GRAVELS
GM
m
SITE PLAN
CURB K\
THS
0
0
S== FUTUR= ASBUILT
N'AS GROUND MATER ENCODNTEREDT NO
IF YES (q WHAT DEPTH! Do,
DEPTH OF NATER AFTER MONITORING: 12'
DATE OF MONITORING; 925'2"L
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER II
(INCHES)
NET DROP
(INCHES)
8/3/04
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
10:26
12.0"
CHARGE
2
10:56
30
10.5"
1.5"
3
10:56
12.0"
RECHARGE
4
11:26
30
10.5"
1.5"
5
11:26
12.0"
RECHARGE
6
11:56
30
10.675'
1.325'
PERCOLATION RATE'2� 1_8 (MINIINCII) FERC. HOLE DIA. 6 (INCIIES)
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. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE,
ONSITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 19, BLOCK 4, TABLELANDS SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a new
1,0000 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of 2 new 70' 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 2' below the existing ground
surface. Total depth of the trenches will be 4' 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 1,000 -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 19, Block 4, 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 silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 19, Block 4, 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.
Municipality of Anchorage
• Development Services Department
Bufldng Safety Division
On -Site Water and Wastewater Program
4700 Brdgaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsfte
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-741.50
1. GENERAL INFORMATION
COSA #_ C) C/ O[4 LI 0
Expiration Date:
Complete legal description W 19, Brod' 4, The Tablelands sebd)vislon
Location (site address) 22359 Oberp Road Chugisk, AK 99567
Current Property owner(s) David and Diane Cooper
Day phone
Mailing address P.O. Box 670011Oxdak.AK99567
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA wiz1 be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
7hreB (3)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑ Individual On-site
Individual Water Storage
❑ Individual Holding Tank
❑
Community Class Well
❑ Community On-site
❑
Public Water System
ID Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based orgy 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 Onsite 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 Finn Anderson Engineering Phone 522-7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Ander on, P.E. Date IMM
7
� 49th
00 A -i MICHAEL E. ANDERSON
6. DSD SIGNATURE 0� ay No. "Y'"e'�
♦ Mfg., fL-1 � � •,
Approved for bedrooms. ••�A4nrres�tl.�
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
0% PROGRAM
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report ).0
Nitrate Advisory Other
By: Original Certificate Date: O
(Rw. riper
Municipality of Anchorage
" Development Services Department
Building Safety Division
OrrSde Water 8 Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muri.orglonMe
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lor 1g. Blorh 4. The Tablelands subdivision Parcel ID: OSI.741-50
A. WELL DATA
Well type _ If A, B, or C provide PWSID 0 _ Well Log (YM)
Date completed _ Sanitary seal (YIN) _ Wires properly protected (Y/N)
Total depth fL Cased to tt Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic: _ ugA Date of sample: _
B. SEPTIC/HOLDING TANK DATA
R
g.p.m.
Other bacteria colonies/100 mL
Collected by.
Tank TypelMaterial Sq*cJSteel Date Installed 1022r2M
Tank size i,000 gel, Number of Compartments Two Cleanouts (YM) y
Foundation Cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 916M Pumper Jrrs Pumping
C. ABSORPTION FIELD DATA
Date installed 10=2004 Soll rating (g.p.d.lft? or f?/bdrm) A5 GPDISF System type S' wide Trandr
Length 170 IL Width 5 ft. Gravel below pipe I ft.
Total depth 4.5 fL Eff. absorption area 1.oi I ft= Monitoring tube y Depression over field N
Date of adequacy test 11r25M Results (Pass/Faiq Paas For 3 bedrooms
Fluid depth in absorption field before test bus in. Water added 50o gal. New depth Ire In.
Elapsed Time: 1.440 min. Final ftukl depth 5 f in. Absorption rate >= 450 g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM 8 type) N If yes, give date
D. UFTSTA71ON
Date installed Size In gallons Manhole/Access (Y/N)
'Pump on' level at _ In. 'Pump ofP level at _ in. High water alar level at in.
Datum Cycles tested Meets alar & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankllift station on lot NIA
Absorption field on lot
WA
Public sewer main NIA
On adjacent lots NIA
On adjacent lots NIA
Public sewer manhole/cleanout N/A
Sewer /septic service line NIA Holding tank
WA
Animal containment areas None Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Building foundation >5' Property line >5' Absorption field >5'
Water main NIA Water service line >to Surfacewater >I W
Wells on adjacent lots >2w
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ►In' Building foundation >Ip Water main >to'
Water Service line >IV Surface water >Iw Driveway, parkingIvehide storage >25
Curtain drain None Noted Wells on adjacent lots >2W
F. COMMENTS: Property Is Swmd by AWWtJ Water System,
G. ENGINEER'S CERTIFICATION♦.
I certify that I have determined through field Inspections and a 49th
review of Municipal records that the above systems are in $
conformance with MOA COSA guidelines in effect on this date. MICHAEL E. AN RJ
Engineers Printed Name M E. Anderson, P.E. ♦♦��sl No CE -us,
Date I212M9 ♦♦ab ESSta::••
COSA Fee $ Waiver Fee $
Date of Payment c le Date of Payment
Receipt Number. IN ? Say Receipt Number
(A". I U05) .
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
December 2, 2009
David and Diane Cooper
P.O. Box 670011
Chugiak, AK 99567
Subject: Lot 19, Block 4, The Tablelands Subdivision
Septic System Inspection and Testing
Dear David and Diane:
We recently inspected and tested the septic system located at 22353 Oberg Road a to determine
whether it was functioning in accordance with Municipal and Stale regulations and whether it
was eligible for certification for resale. The system ryas originally constructed in October of
2004 and includes a 1,000 gallon steel septic tank and 2 - 88' long by 5' wide by 1.0' effective
depth absorption trenches. Municipal records indicate the trench was constructed in silty, soils
with an estimated absorption rate of .45 gallons per square foot per day. The trenches have a
total effective absorption area of 1,011 square feet and were constructed with bottom at 2' below
original ground elevation. The lot is served by the Municipal water system which may have
influenced the water usage in the house.
Our initial probing of the absorption trench found it to have nearly 1.25' of water and septic
effluent in the monitor lube. The trench cleanouts had a minimum of 3" of standing water
indicating the absorption trenches were surcharged. We then noted that the household was in the
process of moving and the system had been subjected to heavy use from laundry and cleaning. In
addition, the weeks prior to the initial inspection had been very wet with heavy rainfall which
influenced the depth of the water in the trenches.
We then monitored the water level in the trenches over the next two weeks and noted the water
continued to drop on a regular basis until November 25 when an adequacy test was performed on
the system. The initial readings in the absorption trenches indicated water depths of 5" in the
north monitor tube and 6" in the south monitor tube. Both depths were at least 6" below the
distribution pipes in each trench. A total of 500 gallons of water was then injected into the
system and the water depths rose to 6" and 8" respectively. The water levels were then measured
24 hours later and found to have receded to their original levels. We can therefore conclude the
system is capable of absorbing more than 450 gallons of water per day and is eligible for
certification.
The Tablelands Subdivision is plagued by drainage issues, dense subsurface soils and high
groundwater. It is not possible to determine the future useful life of the septic system as several
factors may impact its viability including groundwater levels, surface drainage, overuse or abuse
Lot 19, Block 4, The Tablelands Subdivision
December 2, 2009
Page Two
of the system, leaking plumbing fixtures or other unknown variables. We can however state that
as of this date the system is performing in compliance with the original design and meets the
Municipal criteria for certification.
Sincerely,
Michael E. Anderson, P.E.
Municipality of Anchorage
Development Services Department <a
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.sk.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 051.741.50 HAA# p5'Q29A
Expiration Date:�� p
1. GENERAL INFORMATION
Complete legal description Lot 19, Block 4, The Tablelands Subdivision
Location (site address or directions) 07.353 Oberg Road
Current Property owner(s) Spinel Homes, Inc. Day phone 3445878
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
1900 Northern Llahts 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
Three f3i
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, 1 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 Ware) 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 Enaineerina - Phone 522.7773
Address _P.O.9ox 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 6/28!2005
5. DSD SIGNATURE
Approved for bedrooms.
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: I L .. . - t%. _ e L� Original Certificate Date: 7
(Rw 12M)
i
Municipality of Anchorage
• Development Services Department
Building Safety Division
OnSite Water & Wastewater Program
4700 South Bragaw St
P.O. Box 198850 Anchorage. AK 99519-6850
www.cLanchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legai Desaiptlon: Lot 19, Block 4. The Tablelands Subdivision Parcel ID: 051.741-050
A. WELL DATA
Welltype _ If A, B. or C provide PWSID Well Log (Y/N)
Date completed _ Sanitary seal (YM) _ Wires properly protected (Y/N)
Total depth ft Cased to R Casing height (above ground) in.
FROM WELL LOO AT INSPECTION
Date of test
static water level ft.
Well production 9 -
p.m -WATER SAMPLE RESULTS:
Conform colonies/100 ml. Nitrate mg.4. Other bacteria
Date of sample: Collected by.
B. SEPTICIHOLDINO TANK DATA
ft
g.p.m.
Tank Type/Material 80011d3tse1 Date installed 1WY41M
Tank site1.000 gat Number of Compartments 2 Cleanouts (YM) Y
Foundation cleanout (Y/N).Y Depression over tank (Y/N) fi High water alarm (Y/N) Y
Date of pumping Pumper New Constmetion
c. ABSORPTION FIELD DATA
Date Installed 1Q4 Sod rating (g.p.d./fts or fe/bdrrn) A5 OPDISF System type S Wide Shallow Trench
Length 1176 ft Width 5 ft Caravel below pipe t ft
Total depth "ft Elf. absorption area L4 Lie Monitoring tube X Depression over field [!
Date of adequacy test Results (Pass/Fam For _ bedrooms
Fluid depth In absorption field before test _ In. Water added_ gal. New depth_ In.
Elapsed Time: T min. Final Auld depth _ In. Absorption rate K g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, ghre date
D. LIFT STATION
Data installed
'Pump on' level at _ in.
Datum
Size In gallons
'Pump oft' level at _ In.
Manhole/Access (YM)
High water alarm level at
Cycles tested Meets alarm 6 circus requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot WA
Absorption ftekt on lot WA
Public sewer main WA
Sewer /septic service line WA
On adjacent kris WA
On adjacent W WA
Public sewer manhole/deanout WA
Holding tank WA
SEPARATION DISTANCES FROM SEP71CIHOLDING TANK ON LOT TO:
Building foundation W Property NneW Absorption field 1,S
Water main >10' Water service line >10' Surface water 1,11W
Wells on adjacent lots 1,200'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >17 Water main >17
Water Service Nne >10' Surface water >100' Driveway. parkingfthicle storage >T
Curtain drain None Noted Wells an adjacent lots ->2W_
F. COMMENTS
G. ENGINEER'S CERTIFICATION
J certify that I have determined through field inspections and 4,
review of Municipal records that the above systems are in 49th
conformance with MOA HAA guidelines in effect on this date.
rer/IAEL 4 ANUMM
Engineers Printed Name Michset E. Anderson, P.E. Na cc -oast
Date 61211103
HAA Fee E
Date of Payment
Receipt Number 71/3
(Rev. IWO)
Waiver Fee $
Date of Payment
Receipt Number
in.
2004-25
THE TABLELANDS SUBDIVISION
LOT 19, BLOCK 4
43,310 S.F.
AS' BUILT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID
NW 1559
F.B.
05-04
DATE
3/28/2005
JOB NO.
TLS194
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
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