HomeMy WebLinkAboutTHE TABLELANDS BLK 9 LT 2The Tablelands
Block
Lot 2
#051-741-57
o //'i /
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.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW050087
PID Number: 051-741.57
Name:
S inell Homes Inc.
Wastewater System: New
Address:
1900 W. Northern Us. Blvd., Ste. 200 Anch., AK 99515
ABSORPTION FIELD
Phone:
344-5678
Number of Bedrooms:
Five 5
5' Wide Trench
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
,8 GPD/Fe
2 Ft
Block: Lot: Subdivision-
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
9 2
The Tablelands
1 Ft.
1 FL
Township: Range:
Section:
Fill added above original grade:
Gravel Length:
2-3 Ft.
165 Ft.
Well: AWWU
Gravel width:
Number of lines:
Distance between lines:
5 Ft.
3
>10 FL
Classification (Private, A, B, C):
Total Deptir:
Cased to:
Total absorption area:
Pipe Material:
Ft.
Ft.
948 Fe
ASTM 3034 PVC
Driller:
Date Drilled:
Static water Level:
natation.
Date nstallotl:
Ft.
Pisano's Dirtworks
5126-2712005
Yield:
Pump Set as
Casing eight Above Ground:
TANK
GPM
F,
FL
SEPARATION DISTANCES
STEP
To
Septic
Absorption
Lift
Holding
ublic7Pnvatea
c ren.
ubtraody In a ons:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
2,000
Well
>200'
>200'
>200'
N/A
J
>251
Material:
Steel
Number m Compartments:
Two (2)
Surface Wator
>100'
>100'
>100'
N/A
LIFT STATION
Lot Line
>5'
>10'
>10'
N/A
ae: 250 Get.
Anchorage Tank/Orenco
Foundation
>5'
>10'
>5'
N1A
Pump ortle__ra:
42 in.
'Pump off level at:
42
High watoralarm at:
44
in.
n.
Curtain Drain
r
>20
1
>20
1
>20
Pump Make 8 Motlel
Orenco
Electrical Inspections pedomned by.
Allied Alaska Electric
Remarks:
_
BENCH MARK
ocahon an escnphon:
Finished Floor.
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
OF
ry4
Inspections performed by: TLK
Dates: tat5/26105
49ih `a 0,
,
fl %op soil Vege}aitbn 2nd 5127105
J
i0
MICHAEL •E. ANDERSON
s
�. t+ha4w
approval
.0Q.'
�
�i s
1r,� A
GOnG�%IOa o.� (' rOVa�
�p
No CE-43151
♦1 Tf �' it 0T.•••�'�
Reviewed and approved by: T li c ilo kelp C�l1W� Date: i l�( ��45
♦♦ �Fo p;..F �s.�P:•��
A rouec�'
Gv•
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ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
MEMORANDUM
DATE: November 4, 2012
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: The Tablelands, Block 9, Lot 2
Septic System Permit No. SWO50087
Topsoil and seeding has taken place on the septic system area serving the subject lot.
Revegetation is complete and there is no danger of erosion to the slopes of the
completed mound. The conditional status of the inspection report should be removed.
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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
Permit No. SW050087
TBM 41=100.00
.E.P.
f
PID No.: 051-741-57
2' EPS Insulntlon
83.7 N
s
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 2, BLOCK 9, THE TABLELANDS S/D
PERFORMED FOR- SPINELL HOMES
DATE: 5/27/2005 PROJECT No - M0511
PARCEL ID/?• TECHNICIAN: T. L. KIMBROUGH
Dlarrn TEST HOLE # 7
(&t)
1
2
READING
OB/PT
POORLY GRADED SANDS
NET TIME
(MINUTES)
DEPTH OF
(INCHES)
NET DROP
(INCHES)
SP
3
1
4
11.5'
CHARGE
WELL GRADED SANDS W/GRAVELS
5
11:15
GW -SW
mmm
10
11
12
13
14
15
16
17
18
19
COMMENTS:
SLOPE
SITE PLAN
O H7
SFF FUTURF ASBUII T
WAS GROUNDWATER ENCOUNTERED? NO
IF YES @ WIIATDFmv
DEFTII OF WATER AFTER MONTFORINO: <2%
DATE OF MOMTORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
(INCHES)
NET DROP
(INCHES)
5/27/OE
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
11:05
11.5'
CHARGE
2
11:15
10
4.63'
6.87'
3
11:16
11,25-
RECHARGE
4
11:26
10
4.5'
6.75'
5
11:27
12.0'
RECHARGE
6
11:37
10
5.25-
6.75'
PERCOLATION RATE I,_5 (MIN/INCI I) FERC. IIOLE DIA. 6 (INCITES)
TEST RUN BETWEEN: 1.5 FT. and 2_5 Fr.
HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICFIAEL E. ANDERSON CERTIFY THAT
T1 HS WAS PERFORMED IN ACCORDANCE WITI I ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TI IIS
DATE:
LOT 2, BLOCK 9, THE TABLELANDS SUBDIVISION
(ALTERNATE SITE)
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home Deep Trench System
Perc. Rate: 1-17 Min./Inch 5 Bedroom Advantex Treatment System
Application Rate: 4 GPD/SF 1' Drainfield Rock
5 Bedrooms' 150 GPD/Bedroom = 750 SF Absorption Area
750 SF/4 GPD/SF/5 SF/LF'.87 (Red. Factor) = 32.6 LF Trench Length
THEREFORE: Construct a 33' Long x 5' Wide x 1' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be
2' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over
Septic Tank.
Topsoil & Seed
Upper 6"
Natural
Backfill
6"
6"
5'
3' Cover or 2" Insulation
and 2' Cover
Geotextile
Fabric
1" Perforated
PVC (Holes Down)
3/16" Holes @ 1.5' Spacing
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTIO
NOTE: Grade Area Over Trench to Drain Away. : tE
Minimum 6' Separation From Bedrock. �...
Minimum 4' Separation From Groundwater. 0YY
Minimum 10' Separation From Water Service Line. �
Minimum 100' Separation From Surface Water or Streams: %
MONEL E. MDER
No. CEu l
!!'E'�`2 ELEC ?A CAL
CONTRACTING
_� EL�G'TRIC� /
November 5, 2005
FAX: (907) 677-7766
Anderson Engineering
Attn: Mike Anderson
P.O. Box 240773
Anchorage, AK 99524
Subject: Lift Station Inspections at properties stated below.
This letter is to confirm that the lift station(s) at:
• Lot 2, Block 9 — The Tablelands
• Lot 15, Block 8 —The Tablelands
were wired by a licensed Journeyman Electrician in accordance with the 2002 National Electric
Code requirements.
If you would like any further information, please feel free to call our office at the numbers listed
below.
Thank you.
Sincerely,
ALLIED ALASKA ELECTRIC, L.L.C.
1✓naL_
Janette L. Brown,
Vice President/CFO
cc: file
P.O. Box 876310, Wasilla. Alaska 99687 (907) 373-3893 ofc / (907) 232-8687 cell/ (907) 373-3894 fax
I -d 46BC-CLC (LOG) 0?a10a13 eXsetd patties dtO:20 SO 40 AOW
Permit Number: SWO50087
MUNICIPALITY OFANCHORAGE 5P r )3a
Development Services Department
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: Apr 18, 2005
Expiration Date: Apr 18, 2006
Parcel ID: 051-741-57
Legal Description: THE TABLELANDS SUBDIVISION BLOCK 9 LOT 2
Design Engineer: 0014 Anderson Engineering
Owner Name: SPINELL HOMES, INC
Owner Address: 22200 OBERG ROAD
PETERS CREEK. AK 99567 -
Site Address: 22200 OBERG ROAD
Lot Size: 85906 SO. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
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.
THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE
VEGETATED SUFFICIENTLY TO PREVENT EROSION.
Received By.
Date: 'V-16 —0 S-"
Issued Byi I 1 /N Date: / �1
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
7 tti�j www.ci.anchorage.ak.us
(907) 343-7904
s� ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
ZD
Parcel I.D. f)5/ -3N/- S;t- Permit Number SW
Property owner(s) Spineli Homes, Inc. Day phone 3445678
Mailing address (1)1900 W. Northern Lights Blvd., Suite 200 Anchorage AK 99515
Mailing address (209U) Obern Road Zip Code
Legal description (Lot, Block & Sub'd.) Lot 2. Block 9, The Tablelands Subdivision
Legal description (Section, Township & Range)
Lot Size 85,906 SF Acre Sq.F
THIS APPLICATION IS FOR:
Number of Bedrooms Five (5)
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: 144140 a !—�/5D ` ZS NCaiver Fees:
Date of Payment: �{�/ i ^�� Date of Payment:
Receipt Number: bbOOLI/L/ iA! Receipt Number:
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
April 18, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Block 9, The Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer.
The owner of Lot 2, Block 9, The Tablelands Subdivision intends to construct a new
five -bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the new home. The subdivision is
currently served by a community water system. No conflicts exist with adjacent septic
systems or wells and the proposed septic system on this lot. The attached Site Plan
and backup documentation identify the location and configuration of the proposed
septic system and alternate site. The current drainage pattern is identified on the Site
Plan. The drainage pattern will be maintained after development of this lot is complete.
Test holes recently placed on the lot indicated well graded to poorly graded sand and
gravel with minor amounts of silt in the area of the absorption trench and alternate site.
The accepting soils were tested and found to have a percolation rate of slightly more
than 1 minute per inch to 17 minutes per inch. The system is designed with an
application rate of .8 GPD/SF, which is a conservative average of the soils
encountered. Some groundwater was found in the test holes during placement and
was monitored at 6.5' during the ensuing period. No groundwater was found in Test
Hole 6 and it remains dry today. A large portion of the new absorption trench is
centered near this test hole. Our design includes the placement of a new 1,500 -
gallon septic tank along with 2 - 82' long and by 5' wide by 1' effective depth absorption
trenches to collect and treat the sewage generated in the house. The bottom of the
trenches will be 2' below the surface. The distribution pipe will be 1' below the surface.
A flow splitter valve will be installed to insure even flow to each trench. 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.
Lot 2, Block 9, The Tablelands Subdivision
April 18, 2005
Page Two
The ground surface on the lot slopes at varying grades from south to north as shown on
the Site Plan. The absorption trench will be constructed parallel with the slope of the
ground surface as much as possible in conformance with Municipal requirements. The
new septic system 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,
Michael E. Anderson, P.E.
Attachments
U
MICHAEL E. ANDERSON
i No. CE -4391 I
a N 00'07'59 W 261.84' ,p
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0
31.5' T. do E. ESOT.
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LOT 2, BLOCK 9
THE TABLELANDS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom House 5' Wide Trench System
Perc. Rate: 1-17 Min./Inch 1.500 Gallon Septic Tank
Application Rate: .8 GPD/SF (Average) 1' Drainfield Rock
5 Bedrooms X 150 GPD/.8 GPD/SFctApplication Rate) = 937.5 SF Absorption Area
937.5 SF/5 LF (Width)' .87(Red. Fac = 163.13 LF Trench Length
THEREFORE: Construct 2 - 82' Long x 5' Wide x 1' Effective Depth Absorption Trenches.
Flow Line Elevation in Trenches to be 1' Below Original Ground Surface. Total Depth to be
2' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench.
NaturalGeotextile
Backfill Fahrir.
6' t 4" Perforated
t PVC (Holes Down)
1'0"
5' —11
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTIO"'
(NO
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Service Line.
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 2, BLOCK 9, THE TABLELANDS S/D
PERFORMED FOR• SPINELL HOMES
DATE: 4/1/2005 PROJECT No • M0511
PARCEL ID. - TECHNICIAN: M. ELDRIDGE
DEPTH TEST HOLE # 4
(feet)
1
2
3
4
5
6
7
8
9
11
12
13
14
15
16
17
18
19
OB/PT
POORLY GRADED SANDS
SP
WELL GRADED SANY GRAVELS
GW -SW
SILTY -SANDS W/ GRAVELS
SM -GM
SITE PLAN
OH
O5 THP �H3
OI TH2
O
SEE FUTURE AS9U4T
BOH WAS GROUND WATER ENCOU?ffERED' N1
IF YES 9 WHAT DEPTH, NWF
DEPTH OF NATER AFTER MONITORING: 7' <2%
DATE OF MONITORING:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DjnEjATER F
(INCHES)
NET DROP
(INCHES)
4/1/05
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1415
10.0"
CHARGE
2
1430
15
2.5"
7.5"
3
1430
11.0"
RECHARGE
4
1445
15
3.5"
7.5"
5
1445
11.0"
RECHARGE
6
1500
15
3.5"
7.5"
PERCOLATION RATE; 2(MIN/RVCFD FERC. FIOLE DIA, 6 fINCHES)
TEST RUN BETWEEN: 4_5 F('• an4 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 PERFORINED 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 2, BLOCK 9, THE TABLELANDS S/D
PERFORMED FOR: SPINELL HOMES
DATE: 4/II/2005 PROJECT No • M0511
PARCEL ID/( TECHNICIAN: M. ELDRIDGE
DEPTH TEST HOLE # S
(fccO
1
2
3
4
S
6
7
8
9
11
12
13
14
15
16
17
OB/PT
SILTY -SANDS W/ GRAVELS
SOME COBBLES TO 10"
BOH WAS GROUND WATER ENCOUNTERED, Y^S
IF YES @,' WHAT DEPTH' 9'
DEPTH OF RATER AFTER MONITORING: 6.5'
DATE OF MONITORING: 4/15/7995
SITE PLAN
TH0
0 5 � O
THTH3
O1 TH2
O
SEE FUTURE ASBULT
iF <2%
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
NET DROP
(INCHES)
4/1/05
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1520
12.0"
CHARGE
2
1550
30
10.5"
1.5'
3
1550
12,0'
RECHARGE
4
1620
30
10.25"
1.75"
S
1620
IZ.O"
RECHARGE
6
1650
30
10.25"
1.75"
PERCOLATION RATE I� 7_I (mrN/C•ICH) PERC. IIOLE DIA 6 INCHES)
TEST RUN BETWEEN. 4_5 FT. and 5_5 Fr.
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 TINS
DATE: 4/18/2005
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 2, BLOCK 9, THE TABLELANDS S/D
PERFORMED FOR- SPINELL HOMES
DATE: 4/11/2005 PROJECT No • M0511
PARCEL ID/( TECHNICIAN: T. L. KIMBROUGH
DEPTII TEST HOLE #6
(req
2
3
4
5
6
7
8
9
IC
11
12
13
14
15
17
1
�i
OB/PT
POORLY GRADED SANDS
WELL GRADED SANDS W/GRAVELS
GW -SW
SILTY -SANDS W/ GRAVELS �J
SM -GM
SITE PLAN
TH
O
O 5 T0 OH4TH3
TI TH2
O
SEE FUTURE ASBUILT
WAS GROUND MATER ENCOUNTERED? No
IF YES (a, WHAT DEPFH+
DEPTH OF WATER AFTER MONITORING: NaHe <2%
BOH 7=�n
DATE OF MONITORNG:
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
D(INCHES) EPTH of
WATER
NrFT DROP
FINCHES)
4/1/05
TEST HOLE PRESOAKED PRIOR TO TESTING:
11540
12.0"
CHARGE
2
1600
20
1.25"
10.75'
3
1600
12,0"
RECHARGE
4
1620
20
1.25"
10.75"
5
1620
12.0"
RECHARGE
6
1640
20
1.25"
10.75"
PERCOLATION RATEI 1.9 (MINANCII) FERC.11OLE 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 TIIAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TIIIS
DATE:—
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 9, TABLELANDS SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a new
1,500 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of two new 82' long X 5' wide X V effective depth
absorption trenches at the location also shown on the Site Plan. The
distribution line in the trenches will be placed at V below the existing ground
surface. Total depth of the trenches will be 2' below the existing ground
surface. A Zabel Flow Splitter Valve must be placed to insure even flow to
each trench. A separation distance of 200' from any well and 100' between
the septic tank and absorption trench 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
1. A new 1,500 -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 2, Block 9, Tablelands
April 18, 2005
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 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 2, Block 9, Tablelands
April 18, 2005
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
Development Services Department _ ' Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 0 51-741-57
1. GENERAL INFORMATION
Expiration Date: 10 — N5 " Z.O 2-3
Complete legal description THE TABLELANDS BLOCK 9 LOT 2
Location (site address) 22200 OBERG ROAD, CHUGIAK, AK 99567
Current property owner(s) MATTHEW & ELIZABETH SWENSON Day phone
Mailing address
Real estate agent
22200 OBERG ROAD, CHUGIAK, AK 99567
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
❑
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
®
Public Sewer
❑
Waiver request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5 5 0
Date of Payment o a 5
Receipt Number 90 5 2 S"y
COSA# 05C z 1 1(3 5
Date:
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 10120/2021
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
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the _�`1\\\�`
system and maintenance. The operational life of all well and septic systems are subject to OF
these various and dynamic characteristics and are outside the control of the evaluator of the - �P• . l
well and septic system. Therefore, any estimate of how long a system will function satisfactory �• •
for current or future occupants or guarantee that no unseen encroachments, deficiencies or �g•''.9 �r
discrepancies exist can be given by First Water Consulting& *: TH
FWC5 .. • . •:/
6. DSD SIGNATURE • '. Curtis Huffman
CE 128991
System #1 Approved for bedrooms !♦r �Fc��...
�� TFC •.10/20129'���
System #2 Approved for bedrooms ill�PROF``i.�
Disapproved
Conditional approval for
bedrooms, with the following stipulatio
OF
J -
�1JlNrSER I\G���`,\
c
By: Original Certificate Date:
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
nKT 0 1 Ti-ri-V�
m�
WATER AND
�m WAS_Fr_v'ATER oz^
Jrl!73&G�
411
_1
J -
�1JlNrSER I\G���`,\
c
By: Original Certificate Date:
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
Pt 4
Legal Description: THE TABLELANDS BLOCK 9, LOT 2 Parcel ID: 051-741-57
If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system _
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
Age of tank(s) 16 years
Tank type/material STEP / STEEL
Measured operating fluid.level in septic tank
® Standpipes/foundation cleanout per record drawing
Date of pumping 10/15/2021
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/27/2005
® ALL standpipes present per record drawing
Total measured depth from grade 3+ ft (max)
Measured depth to pipe invert from grade _ft (min)
® N/A – pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective ASSUMED
® Code -required soil cover over field W/ INSULATION
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
Well production at time of test _gpm
Water storage tank volume_ gallons
Well disinfected for coliform test? ❑ Yes ❑ N
❑ Coliform bacteria is Negative
Nitrate _mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date of Sample
C. LIFT STATION
® Required maintenance completed
Age of lift station 16 years
Lift station material STEEL
Comments: *FLOAT LEVELS / SEE MAINT. REPORT
Adequacy test date 10/15/2021
Results M Pass For 5 bedrooms
Fluid depth prior to test 0 in
Water added 750 gal
New depth 1 in
Elapsed time 15 min
Final fluid depth 0 in
Absorption rate 750 gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
IN Yes if No ft
Wells on Adjacent Lots:
Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft
❑ Yes
if No
Neighboring Tank > 100' ❑ Yes
if No
ft
Private Sewer/Septic Line > 25' ❑ Yes
if No
Absorption Field on Lot > 100' ❑ Yes
if No
ft
Holding Tank > 100' ❑ Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ❑ Yes
if No
❑ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' E] Yes
if No
ft
❑ Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑ Yes if No *5+ ft Surface Water > 100'
ft
ft
ft
ft
ft
® Yes if No ft
Property Line > 5
IN Yes if No ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes if No ft
Private Wells > 100' ® Yes if No
Water Main > 10'
® Yes if No ft
Community Wells > 200' ® Yes if No _
Water Service Line > 10'
® Yes if No ft
If septic tank is under driveway comment below
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
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
*PER CODE AT TIME OF INSTALLATION.
G. ENGINEER'S CERTIFICATION
I certify that / 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.
•. 7H
jj
• •
Curtis Huffman :
f¢ �'c'c •. CE 128991
��,�j`�pROFESS AW
M,
ft
MUNICIPALITY
Development Services Department �° Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Lift Station/Pump Vault
Owner Street Addressoa a 0 D obe t -r-- Ra
Septic Tank:
-Sludge level inches -Pumping: required (g no -Pumping completed es no
Lift station:
-Pump basket cleaned Nes I no -Effluent filter cleanedes no `
-Control floats cleanede no -Proper float settings confirmed es no
-Operation satisfactory e no
Alarm System:
-Dedicated electrical alarm circuit yes no -Audible and visual alarm inside dwelling e no
Alarm system operation sat isfactoni not satisfactory
Manhole Riser
-Ground water intrusion at riser to tank connection es no
-Ground water intrusion around pipe penetrationses no •\,�3eep hole functional es no
-Manhole lid: Functional 0 no Insulated yes no Properly Securedes no
Other
-All manufacturer required inspections and maintenance completed & no
Comments:
Qualified Maintenance Provider:
Technician��
Company
Signature 10-4, 1
Date of maintenance I I
...Oza I
�!.
Municipality of Anchorage •
-r On-Site Water and Wastewater Program oma" .„.
,� 1_ (907) 343-7904 LJ
Intl 1 i o
S A r r l Y
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-741-57 Expiration Date: ,
F- 1 5- -4,
1. GENERAL INFORMATION
Complete legal description The Tablelands Block 9 Lot 2
Location (site address) 22200 Oberg Road,Chugiak, AK
Current Property owner(s) Anliker Day phone 529-0193
Mailing address same
Real Estate Agent Joe Lowndes, KW Day phone 317-4830
4.2. TYPE OF DWELLING: �,\'' 1,
® Single Family (w/wo ADU)
❑ Duplex a rr•.;., , L.,:J ,
❑ Multiple Dwellings (Single Family and/or Duplex)=
\,,,______ .
3. NUMBER OF BEDROOMS: 5 r`-
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class C Well ❑ Community ❑
Public Water System ® Public Sewer ❑
Received by: `// Date: //A -7// 7
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ 4, Date:
Date of Payment MAIM'' Date of Payment
Receipt Number 0485ZA Receipt Number
COSA# M04/5-3.0 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm NorthRim Engineering Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 11/14/2017
6. DSD IGNATURE
•
System #1 Approved for 3 bedrooms.
System #2 Approved for bedrooms.
Disapproved. 04/7
Conditional approval for bedrooms, with the following stipula
o'
ON-SITE �;'.
WATER ANO
WASTEWA ER c
AM
-
O,o ANT SER •
Sw& Original Certificate Date: 1 ( r( �(
The Municipality of Anchorage Devlopment 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 blue sheet 9-1-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Sate Systems Approval Checklist
Legal Description: %/V' % 8L 6 L,4iAl?_S 57 4.2 Parcel ID: O 5 f 7 yf 5- 7
A. WELL DATA i c
Well type If A, B, or C provide PWSID# Well Log (YIN)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ig/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material S /�/ S T � Date installed 5/06/(25
Tank size 2i OGOgal. Number of Compartments 2 Cleanouts (Y/N)
Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (YIN) y
Date of pumping • S Pumper 3A Ai i T il"C y Pd./p1/7r(2 S
C. ABSORPTION FIELD DATA
Date installed 5/2 7/o5Soil rating (�p.d,lft2 or ft2/bdrm) O- 8 System type S 1 / r�tich
Length /C 5 ft. Width ft. Gravel below pipe / ft.
Total depth q_C ft. Eff. absorption area !q ye ft2 Monitoring tube y Depression over field
Date of adequacy test ///?I/ 7 Results (Pass/Fail) P For 5 bedrooms
Fluid depth in absorption field before test Q in. Water added—75 O gal. New depth . _ in.
Elapsed Time: 30 min. Final fluid depth 0 in. Absorption rate >_ 7 SO g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N & type) /Av If yes, give date
D. LIFT STATION
Date installed 572416 S Size in gallons 2 So Manhole/Access (Y/N)
"Pump on" level at zip in. "Pump off' level at 3 8 in. High water alarm level at L./ 7 in.
Datum dor-To ", Cycles tested Meets alarm&circuit requirements? V
E. SEPARATION DISTANCES
WELL ON LOT TO: PvBL(C-
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5 'f" Property line lG '+ Absorption field /6 (1f-
Water
*Water main "f- Water service line /CI (-f Surface water /6O "
Wells on adjacent lots 2C I+-
ABSORPTION FIELD ON LOT TO:
Property line /O r� Building foundation l0 'f Water main /0 A!) ` /QC) f 1- id
Water Service line � Surface water /QDriveway, parking/vehicle storage /i".
Curtain drain LlAJ/ Wells on adjacent lots ZOO -f'
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that l have determined through field inspections and "•' 5; -4
review of Municipal records that the above systems are in - �
conformance with MOA COSA guidelines in effect on this date. = ,•
Engineer's Printed Name S E CS r r
Date /(// f//7 •
COSA yellow sheet 2-6-15.doc
L t jit(l4
Municipality of Anchorage
• Development Services Department �•
Building Safety Division
On -Site Water and Wastewater Program `
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D.WI-741.57 HAA# fir) t)5RR
Expiration Date: i�a0un
1. GENERAL INFORMATION
Complete legal description Lot 2, Block 9. The Tablelands Subdivision
Location (site address or directions) 22200 Obem Road
Current Property owner(s) _Spinell Homes. Inc. Day phone 3445676
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
1900 Northern Lights Blvd, Anchorage AK 99517
Day phone
Day phone
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
Five 5
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.
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 11/8/2005
S. DSD SIGNATURE
Approved for _
Disapproved.
_ bedrooms.
a
Conditional approval for 4- bedrooms, with the following stipulations:
r
Anliker, shall be responsible for placing six inches
of top soil on the mound absorption field and vegetating the moon su cent y
to prevent erosion by June 15, 2006. lju
�QNLITYop! r �
Additional Comments
ATFR
o :• PRCG ATFR •; m,
J
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 190850 Anchorage, AK 99519-6850
www.d.arohorage.ek.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 2. Block 9. The Tablelands Subdivision
Parcel ID: 051.74W
A. WELL DATA
! Well type _ If A B, or C provide PWSID 8Well
Log (YIN)
Date completed _ Sanitary seal (YIN) _
Wires properly pfd (YIN)
Total depth fl Cased to ft.
i
Casing height (above ground) in.
! FROM WELL LOG
AT INSPECTION
Date of test
Static water level It
Ij
It,
Well production g.p•m.
1
g,p•m,
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate mg.A.
Other bacteria colonkWI00 ml.
Date of sample: Collected by:
B. SEP ICIHOLDING TANK DATA
Tank TypelMaterial—STEPMeel
Date installed 6/268005
Tank size 2.000 gal. Number of Compartments
Cleanouls (Y/N) Y
Foundation cleanout (YIN) Y Depression over tank (YIN)
High water alar (YIN) Y
t
Date of pumping Pumper New Construction
C
li C. ABSORPTION FIELD DATA
1 Date installed 01@005 Soo rating (g.p•d./fe or fe/bdr) A OPD15F System type -F Wide Trench
Length 165 ft. Width 5
R Gravel below pipe 1 ft.
Total depth &I It. EB. absorption area $}iZtt° Monitoring tuba X Depression over field H
t
Date of adeauacy,test Results (Pass/Fall)
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
it
6
D. LIFT STATION
Date installed _;00s
'Pump on' level at 42 in.
Datum BOOM of Tank
E. SEPARATION DISTANCES
Sae in gallons 250 Manhole/Access (YM) Y
'Pump off" Tavel at 42 in. High water alarm level at M. in.
Cycles tested New Conatrueann Meats alarm 3 ciraril requirements?,y
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAiR station on lot 1UA
Absorption field on lot NIA
Public sewer main -NIA
Sewer /septic service fine -K%.
On adjacent lots _NIA
On adjacent lots _NIA
Public sewer manhole/cleanout _NA
Holding tank _ N►A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Property fine
Absorption field>5
Water main >10, Water service line >f0' Surface water >IW
Wells on adjacent lots >=
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10 Buffding foundatlon _?J Water main >10'
Water Service One >10 Surface water >100' Driveway, parkingAmhide storage >S _
Curtain drain _ None Noted Wells on adjacent jots >jW
F. COMMENTS
G. ENGINEER'S CERTIFICATION OF �saV
I cert Y that I have determined through field in
un' inspections are
and
review of M
rdpal records that the above systems re in 49th
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name_Michael E Anderson P Sj :aOUX L MOM
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HAA Fee Z 5'1 P—
Date of Payment //- h'os
Receipt Number -76- 4-q 2 -
(Rev.
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ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: November 18, 2005
TO: Julie Makela, P.E.
FROM: Mike Anderson, P.E.
SUBJECT: Lot 2, Block 9, The Tablelands Subdivision
Septic System As -Built
Certificate of Health Authority Approval
We have modified the location and type of alternate system site for the subject lot to
include an Advantex Treatment System with a 33' long absorption trench. The location
of the trench is shown on the revised Plan As -Built. We have also verified the electrical
inspections were completed by Allied Alaska Electric and their company name is shown
on the inspection report.
A notarized statement is included from the buyer of the house on the property relieving
Spinell Homes of the requirement to place topsoil and seed on the absorption trenches.
The owner will complete the work in the spring.
The fee has been paid for a conditional Certificate of Health Authority Approval.
Please let me know if you have further questions.
'f3(.e7
'fi.l IS.w
r1
HOMES, Inc.
November 14, 2005
Re: Blaine & Tina Anliker
Lot 2 Block 9 The Tablelands Subdivision
To Whom It May Concern:
r'1
In signing below, the above-mentioned buyers release Spinell Homes, Inc. and accept full
responsibility to topsoil & hydro seed the areas required by the Municipality of
Anchorage for their septic system.
�s //_
Buyer Date
Spinell Homes, Inc.
I (/15105
Date
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W �S a�put�P�A
1900 W. NORTHERN LIGHTS BLVD. • SUITE 200 0 ANCHORAGE, ALASKA 99517.344-5678 • FAX: 344-1976
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: November 8, 2005
TO: Julie Makela, P.E.
FROM: Mike Anderson, P.E.
SUBJECT: Lot 2, Block 9, The Tablelands Subdivision
Septic System As -Built
Certificate of Health Authority Approval
The design and permit for the septic system on the subject lot requires the placement of
topsoil and vegetation to prevent erosion. This work can not be accomplished at this
time due to the inclement weather. The new owner of the property has provided a
statement to the effect he will complete the vegetation of the mound in the spring. A
copy of that letter will be forwarded to you when it becomes available.
Please let me know if you have further questions.
Municipality of Anchorage
Development Services Department
ue*
Building Safety Division : • - - t' `�
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 s A ` TV
www.muni.orglonsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Anderson Engineering
Legal description: The Tablelands, Block 9. Lot 2
The attached paperwork has been reviewed and Is being returned for the following reasons:
❑ Original signature or stamp missing on
❑ Calculation error in design. _
❑ Additional soils information needed.
❑ Water monitoring results inadequate.
❑ Discrepancy in information submitted. _
❑ Topographic information missing or inadequate. _
❑ Incomplete; missing
❑ Incomplete; missing _
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown. _
❑ Proposed system too deep for soils information submitted. _
❑ Well log required.
❑ Omission in narrative.
❑ Insufficient fill over tank or field._
® Other. 1.) Need to pay conditional fee; 2.) Please provide notarized o
50 feet from a slope of greater than 25%
Name of reviewer: Julie Makela, P.E.
Date: 11/16/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK