HomeMy WebLinkAboutTHE TABLELANDS #1 BLK 9 LT 7The Tablelands Block 9 Lot 7 #051-741-63 Inspection Report_1-1-12.tloc - Municipality of Anchorage Community Development Department Page 1 of 3 On-Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSPI21139 PID Number: 051-741-63 ❑ New Upgrade Name: Andrew & Julie Rabung ABSORPTION FIELD ❑ Deep Trench ❑✓ Shallow Trench ❑ Bed ❑ Mound Address 22322 Wapiti Circle ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.8GPD/SF O.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 0 Ft. Gravel depth beneath pipe O.SFt. Subdivision Block Lot The Tablelands #1 9 7 Fill added above original grade 2.5 Ft, Gravel length 150 Ft. Township Range Section Gravel width SFt. Beds: Number of Lines - Distance between lines -Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 750 Ft2 3 10.0 Ft. Well N/A N/A N/A NIA N/A TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer N/A Capacity Gal. Surface Water 100+ 100+ N/A N/A Material Number of compartments Lot Line 55.2 15.7 N/A N/A NA Foundation 10 73.0 N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain NIA N/A N/A N/A N/A Gal. RemarksDrain field only. Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPEMATERIAL Housetotank PVC Tankto drainfield PVC Flintstone Enterprises Draintield PVC Co/MT PVC Inspector Steven R. Pannone BENCH MARK (Assumed elevation) 100.Oft Inspection1v g/19/2012 dates: 2�a 6/19/2012 Location and description 3" 4th Garage Slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date 4`�� r•� ,49..E40A 'teven rannome CE " *,-, 8149 Z�9f�7b - W Approved c` /� Date �QI Inspection Report_1-1-12.tloc - A B M1 113.9 102 M3 109.6 92.0 M4 156.3 136.5 I M6 1 142.2 1 118.9 1 LOT UNDEVELOPED NO WELLS OR SEPTICS DEeR PARK DRIVE II I 4BR 1500g S.T.E.P. TANK (E) HOUSE INSTALL�OUTLET TO NEW FIELD (E) ffi W/ VALVES 1% DRAIN FIELD (E) (2EA) 66LF x 5'W x VED x 3.5'TD REUSE AS RESERVE ,,, V 1 % 12 p i`4Y M1I�^o UPGRADE DRAIN FIELD (P) (3EA) 50LF x 5'W x 0.5'ED x 0.5'TD D/W � �Vv 4� P\ 3 l M2( "1 IIS H11 39.7 10.0 M6 / M4 \ 0o k w LIMIT OF FILL \ v�wi 1 % w w in NOTE: EASEMENTS WITHIN 20' OF THE DRAIN FIELD WERE FLAGGED BY A LICENSED SURVEYOR PRIOR TO CONSDate tT]RAU7�Ct1TIIiON.NOTES�7 M, 7 RECORD DRAWING. PANNONE ENG SVC, LLC SOF q�,ys�l, 6/26/2012 P.O. BOX 100217 ANCHORAGE, AK 99510 .. PHONE (907) 272-8218 FAX (907) 272-8211 Scale .... ... —A P.I.D. NO THE TABLELANDS #1, BLOCK 9, LOT 7051-741-63 ANDREW AND JULIE RABUNG I Steven �. Pannone PERMIT NO. I/. CE 8149 .,� j OSP121139 22322 WAPIPI CIRCLE PLAN CHUGIAK, AK 99567 ilkjll�' ftFE` SheetOF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK WAS IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: FLAGGED EASEMENTS. INSTALLED SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS MONITORED AT 4.6 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. AN APPARENT WATER TABLE WAS NOT OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.6 FEET BELOW EXISTING GRADE. 6" TS&V 3 TH-1 1 r 2.0� 99.0 �0.5 T-2.0 M 4.2 � 1 -4.6 (6/12/2012) GM 6M 1 X" 0 PERF PIPE J6" HOLES 0 24" O.C. -5.09USE FILTER FABRIC 01 1DRAIN ROCK 3 r 1 GANICS AND SILT SAND' CREATE 4.1' SEPARATION TO WATER TABLE SECTION 1500 g S.T TANK (E) DESIGN PARAMETERS UPGRADED SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 30-60 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 150 LF USED: (3EA) 50 LF X 5' WIDE, 0.5' E.D., 0.5' TD TOTAL AREA: 750.0 SF 97.1 SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THE TABLELANDS #1, BLOCK 9, LOT 7 ANDREW AND JULIE RABUNG 22322 WAPIPI CIRCLE DESIGN DETAILS CHUGIAK, AK 99567 :: C : M'o, CU COPPER DIP -12.01 87.0 mo mo TEST HOLE FC FOUNDATION CLEAN OUT mz �z Q'0 0 F o' o'm zz z DOUBLE CLEAN OUT n ziS //-INSULATION 1 }<" 0 PERF PIPE z 11 2�- FLOW SPLITTER BFG II < / X" HOLES 024" ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE 1500 g S.T TANK (E) DESIGN PARAMETERS UPGRADED SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 30-60 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 150 LF USED: (3EA) 50 LF X 5' WIDE, 0.5' E.D., 0.5' TD TOTAL AREA: 750.0 SF 97.1 SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC DRAWING P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THE TABLELANDS #1, BLOCK 9, LOT 7 ANDREW AND JULIE RABUNG 22322 WAPIPI CIRCLE DESIGN DETAILS CHUGIAK, AK 99567 :: C : M'o, CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE Date 'ev.• I"9 T# Iscole NTS *�. •iw .iei. ►SRT...* � o i n ni CE 8149 2 051-741-63 DERMIT NO. OSP121139 Sheet 3 OF On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121139 Tax Code Number: 05174163000 Work Type: Septic Upgrade Permit Effective Dates: June 14, 2012 to June 14, 2013 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: THE TABLELANDS #1 Site Legal Address: THE TABLELANDS #1 BLK 9 LT 7 G:1559 Owner/Address: RABUNG ANDREW J & JULIE A 22322 WAPITI CIRCLE CHUGIAK AK 995675375 Site Mailing Address: 22322 WAPITI CIR, Chugiak Lot Size in Sq Ft: 41609 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation: The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: The contractor shall ensure the ground water monitor tube for testhole TH1 is kept intact and useable for the MOA inspector to use during the bottom -of -hole inspection. Received Issued By, MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Progran USN! Mayor Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Phone: 907-343-7904 Fax: 907-343-7997 Parcel 1. D. OG -1-741-63 Property owner(s) RJ&Nc, Day phone Mailingaddress?-7-5t?,WAfl-rl C -1&4.s ICHt%tAK_f 19K 94,66-7 Siteaddress 2Z32.L WAerj G,ectC Legal description (Sub'd., Block & Lot) --r#t -Tj& AAe4S 1cej,_(&�,Je_gi 1,&-7 Legal description (Township, Range & Section) Lot Size yll661 Sq. Ft. Number of Bedrooms 41 THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Field Initial ElAbsorption Septic Tank ❑ Upgrade Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I 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. property owner or authorized agent) to Permit/Rush Fees: (120- Waiver Fees: Date of Payment: 40&1 -A Date of Payment: Receipt Number: Qom 6 Receipt Number: Permit No. QSPl211.39 Waiver No. GABuilding\On Site\FormsVient FormsTermit App01041 t.doc (Rev. 1 /11) Pannone Engineering Services «c Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com June 14, 2012 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: The Tablelands #1, Block 9, Lot 7 Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing 4 bedroom house. Currently the lot is developed. The existing drain field will be re -used as a reserve. The new drain field will be built just south of the existing field. The lot is served by public water. The surrounding lots to the north south and east are served by public water as well. The developed lot to the west is served by a private well located over 200 feet from this system. 1. Soils. A single test hole was excavated by Pannone Engineering Services in June of 2012, and the ground water monitored for seven days. Groundwater was monitored to a depth of 4.6 feet after the seven day monitoring period. I believe this is the peak high ground water for the season due to the amount of snow the Anchorage bowl received and the length of time it took for it to melt off. Additionally, extensive ground water monitoring has been performed in this subdivision and this is the highest water levels seen in the history of this subdivision. The last test hole showed a ground water depth of 6.5 feet below ground level in October of 2004. The bottom of the system will be located four feet above the ground water level monitored on 6/15/2012. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 0.8 gallons/day/square feet should be used for a conventional waste water system. 2. Soil Absorption System Design. a. See Sheet 2 of the design package 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 4. Topography: The topography in the area generally quite flat with a slope of approximately 1% to the west in the area of the proposed drain field. S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On -Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments -Soils Log -Septic System Design Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical. 332 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Df eR "'4w DRIVf LOT NO WELLS OR SOEPTIDCS I ^ 1 w II I 4BR 15DOg S.T.E.P. TANK (E) HOUSE INSTALL OUTLET TO NEW FIELD (E) W/ VALVES I 1% DRAIN FIELD (E) ^ ,� (2EA) 66LF x 5'W x VED x 3.5'TD \ REUSE AS RESERVE � /)% _ 1% I �/� 4 UPGRADE DRAIN FIELD (P) (3EA) 50LF x 5'W x 0.5'ED x 0.5'TD 38.6 ook w I LIMIT OF FILL\ Vy��,�. N ^ 1 % Lo M � 0 FIELD SHALL BE FLAGGED BY A LICENSED SIIRVFYnR PRInR Tn rnmO TRII(:TIC)N FA NOTES: PAMOM ENG SVC LLC +�'pF q ��l Date FOR CONSTRUCTION �,�..... L,gsll+ 6/14/2012 P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 /rg�Qy�` Scale 1"=50' .... .. .. .... P.I.D. NO THE TABLELANDS #1, BLOCK 9, LOT 7 / 051-741-63 Steven .�. ann ANDREW AND JULIE RABUNG No. () f� 9F.•. CE 8149 �,� OSPI21139 22322 WAPIPI CIRCLE c�'r PLAN CHUGIAK, AK 99567 pROFESSIONP sheet _.._ `S\�� 1 OF 3 SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 3. SCOPE OF WORK: FLAG EASEMENTS. INSTALL SOIL ABSORPTION SYSTEM. 4. GROUNDWATER WAS MONITORED AT 4.6 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4.6 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1500 g S.T. TANK (E) DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 30-60 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 150 LF USE: (3EA) 50 LF X 5' WIDE, 0.5' E.D., 0.5' TD TOTAL AREA: 750.0 SF F SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC FOR CONSTRUCTION P,O, BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THE TABLELANDS #1, BLOCK 9, LOT 7 ANDREW AND JULIE RABUNG 22322 WAPIPI CIRCLE DESIGN DETAILS CHUGIAK, AK 99567 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH 1 Yn" B PERF PIPE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. X" HOLES 0 24" O.C. MONITOR TUBE NO. R. 1. RIGID INSULATION DCO 6" TS&V 5.0 FILTER FABRIC FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE DRAIN ROCK FINISH GRADE TS&V TOPSOIL AND VEGETATE S TH-1 ----- -'�Tr'.0.5 ML �1 T_ —2.0 4.1 1.5 I REMOVE ORGANICS AND SILT _ -4.6 (6/12/2012) USE 1.5' OF SAND TO CREATE 4.1 SEPARATION TO WATER TABLE sv SECTION -12.0 mo mo z ¢'o o F o� /-INSULATION o� zqzq z N z� 0¢ / i Aa" 0 PERF PIPE -Z oU 1y" HOLES 0 24" O.C. m¢ 1500 g S.T. TANK (E) DESIGN PARAMETERS UPGRADE SEPTIC SYSTEM NO. BEDROOM: 4 (600 gpd) TANK SIZE: 1500g S.T.E.P. PERC RATE = 30-60 MPI SOIL RATING: 0.8 GPD/SF AREA ROD: 750 SF SYS. TYPE: WIDE TRENCH 0.5' E.D MIN LENGTH: 150 LF USE: (3EA) 50 LF X 5' WIDE, 0.5' E.D., 0.5' TD TOTAL AREA: 750.0 SF F SEE SECTION & PARAMETERS PROFILE LEGEND W WATER LINE/ WELL RADIUS SS — NEW SEPTIC NOTES: PAMONE ENG SVC, LLC FOR CONSTRUCTION P,O, BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 THE TABLELANDS #1, BLOCK 9, LOT 7 ANDREW AND JULIE RABUNG 22322 WAPIPI CIRCLE DESIGN DETAILS CHUGIAK, AK 99567 ABBREVIATIONS CU COPPER DIP DUCTILE IRON PIPE TH TEST HOLE FC FOUNDATION CLEAN OUT T# TANK CLEAN OUT NO. C# CLEAN OUT NO. M# MONITOR TUBE NO. R. 1. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPLITTER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&V TOPSOIL AND VEGETATE Date 6/14/2012 Scale NTS PERMIT NO. CE 8149 ,•�� ,,,, 2 OF 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 TEST HOLE 1 OR ORGANICS ML BROWN SILT 6112112 GRAY SILTY SM/GM ISANDAND SILTY GRAVEL _7 _ 6/5112 BOH DATE PERFORMED: 615/12 SOILS LOG - PERCOLATION TEST SLOPE SITE PIA WAS GROUND WATER ENCOUNTERED? Y IF YES, AT WHAT DEPTH? -7-' DEPTH TO WATER AFTER MONITORING? -4.6'- DATE: 6112112 SLOPE D/W TH X READING DATE CLOCK NET TIME WATERTIME LEVEL READING NET DROP 1 6/5112 10:15 --- 4.40 --- 2 10:25 10 MIN 5.09 0.69 3 10:25 -- 4.40 -- 4 10:35 10 MIN 5.21 0.81 5 10:35 -- 4.40 --- 6 1 1 10:45 1 10 MIN 1 5.21 1 0.81 PEROLATION RATE 12.3 (min/inch) PERC HOLE DIAMETER 6 inches TEST RUN BETWEEN 3 FT AND 4 FT COMMENTS: Test hole excavated by FLINTSTONE ENTERPRISES. Prec hole was presoaked. Test run for one hour. Last 3 readings reported PERFORMED BY: Steven R. Pannone, P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC LLC - Op A \\i Date FOR CONSTRUCTION L 1 6/14/2012 P.O. BOX 102954 ANCHORAGE, AK 99510 r �� q�S 1t PHONE (907) 272-8218 FAX (907) 272-8211 /�g�Q '�y+, Scale * �/ NTS ...... .. .. .. P.I.D. NO THE TABLELANDS #1, BLOCK 9, LOT 7 c1 741-63 ANDREW AND JULIE RABUNG ' S'te've'n 'f�" annone PPERMIT N0. 22322 WAPIPI CIRCLE 'tF�J�' CE 8149 OSP121139 � SOILS LOG CHUGIAK, AK 99567 tI ...... Sheet 3 Municipality of Anchorage . Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 Page of ,3 www.ci.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: Oq R6. PID Number: N.m. Wastewater System: Allew ❑ Upgrade •��SOX 3817 R4tj1 2 ABSORPTION FIELD 11. W .1 B.propmf Plwm 74( 40— 60 Qa O O D..p TnnM )d SMnow Tr.nCr O BM O Mount! O Oln.r LEGAL DESCRIPTION app Raang , �% GpDrFs Tp. D.pF .pmon,mgr % S FI BIW /Z lol Su00p,r �y a+ 7 D.pin lo p W l onom kpn onp,nal praos cravat oaten Mrraln pp. // FL Fi Toanan�p Range S.won F. ap0.p above o^erm prow 'r" 2 Fl. Gravel Length. �O Ft. Well: PVA rc- ❑ New ❑ U rade Gravel vnplh NUIMar M IIM. Z D,nana p.Iw..n MN. Illated Ft. Ft Clasoerauon (Pnv.le. A B. C) Tom D.pmGab W Tom ab.orpbon area P,pe Mabnal, .7CE4 1. FI 7SO FT 6 Dnu.r Du. Drn.aStatic W. UvN abn.r Dals ennui. FL /oi / 7 a v,nn PumpB.l.l canrgH.,gh wov.Grouq TANK GPM FI. FI SEPARATION DISTANCES ❑ Septic []Holding T.E.P. ❑ Other: To Septic Absorption Lift Holding lubll ?rrvate Manufact.0, capaoty From Tank Field Station Tank Sewer Line 42 d Gy Well — I — '� Malanr r� -S / Numbs of Compmmu,u Z swlacew.le' 14001f• /00 �_ /00;x — LIFT STATION Lot LM/Li �.f 10rr q,� Gal W 01 /T rw�alu.,r-NiI C � /L FourMal,on S ' ,� ll /O tr r •PM' l.val at ump •Pump ow l•wl at or H,gn wStw Nm al N 36 in $n Cunun D,vn — I — v� Pump 1Mv. B Mop.l pso 051 Elep NepKUM. porno bT F s ostyp t. 1c Ramams BENCH MARK Lou4on ane Daacnpbon e Faun/ #t yore/ e4ocF- WrMa �a Q FL IF .. h .� a.• q �j ' '. Inspections performed by: Of iNt �r1 Dates: 1`I /2 / o -;a*a••• . .......... Cjo 2 �L /7 o I � . sl... ^a w✓ Development Services Depa mentApproval FE 6256 Reviewed and approved by: Date: 11p, r'fi t��� PROFESS -O".. %�• Septic System Construction ryv Does Not Preclude Adjoining Lots From Sanitation Improvements. $ 1500 allon PTEF Reserve Site 14 95.5 c 101 86 4 a� Foyla Rne , Alaska 99377 907-691-7o2d '� ••'••"•• LOT 7, BLOCK 9 m u, 0 w �u JS in MT I1 M. T Tank Water Line est Hole Tank C.O. 1 Tank C.O. 2 Monitor Tube 1 Monitor Tube 2 Foundation C.O. A B 18.5 14.5 25.6 14 95.5 83 101 86 4 20 DESIGN NOTES: 1. Total Depth of Trench is 1.5'. Terrain relatively flat. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lots Served by Public Water System. I' = 60' E . -•` " h S..., � k NOR THRIM sy~P' TABLELANDS S/D #1 LOT ENGINEERING Gt 172J7 &"r Pow Circle b o") LAYOUT Foyla Rne , Alaska 99377 907-691-7o2d '� ••'••"•• LOT 7, BLOCK 9 7/6/05 2 of 3 m w a 3n- U Own 0 LLJ m 00 zz� 00W a to aaCL W N N 0 3 _U D U i £ fcl S C U L z z Z N U z Z OAI- N (U 6v i S E Q Vl L 3 d Nd O' aj d +' U U E L 0 -0 aj oo lws OL, Cl. O � L L CJ 0Ui S N £ U +' £ O N 0 `b W Q o-0°'0 0 VU0 , +' d V1 O ++ 3 o a +' o c a 0N3 SU c: E: L U O+. £M A �LCL w �dL�v£ S N COL p L a£t� 00 UNJO0O £ C.6 C,U�U d a L.y u+'VO U (-Li*""- OT- 4-Fd-HF-d•y O O I CIL . LS -WO +' wof cu 3 'o CIF-; 3"(5 E,,= 3 C:j w30a t0 -4 c,i of v vi%6 C: d f u ZO L o, o L< II U o a L - s i I-- d L ~ O S 0 a u T ° +' 0 x x N o a, F S U L C d a, > L 0 F- U d � A � 0 0 0 N s F L 0 u x 0 +0' a• W y in H d + N Y o It O £ N r. O II d C, Cy L £ 00 O s � n d> Ian a Q ~ W zo in N If) N Y u It - O O C J A C, +' O fU N r: 3 N Sr 0 0 0 :p > d N f S r 0 0, Q w � > y i co U � II o W £O 11 41 > o W W W 4 O 2 d +' N 3 F- L2 O cro 4 O 3 W in A N Y U O - O Z J Q H J A W I� J W H Q O N CD � J � n 3 W W � LL - O A � W Y = Q ~ Z W Wp; J W H LL - O FROM : SILVA WRUIIfS FW M. : 9878922453 ro SuvmfSennces LAM UW7a w+ Juy 5.20 Made GUbm Hornea PO Box 3189 PATW AK9964S Th Whom R &W Concerrc Jul. eS 2005 10:31AN Pt Re tM 3btan Ut 7 Blodk a T*Wardg P41am Gook Alaska Wa M au detltrd M lb Cantor CM prjperty dsrr6ad 1bow. AS a port Of our oor*wd" hookup K dasons. WO hw a oonrgWW fa sR atsbim a000rdny m the pmd+t* m mia loxes spae adore. Riau here any ques5ms or MWhL- KVO*'8 . pleM eorbd me at ft of -_ r \ l� 9moer tuar� once Mama 2/2rd 920Lb69L06Tr01 n S££35bLL06i t10I1�1S.U9 2l3tJd'L':W021j Sbr2T 5202-9--T'tf MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 6 Wastewater Program I 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Nov 23, 2004 Expiration Date: Nov 23, 2005 Permit Number: SW040486 Parcel ID: 051-741-63 Legal Description: THE TABLELANDS ADDN 1 r (jLOC-%9 j LOT -7 Design Engineer: 0838 North Rim Engineering Owner Name: TURNER CONSTRUCTION Owner Address: P.O. BOX 3897 PALMER, A 99567 - Site Address: NHN WAPITI CIRCLE Lot Size: 41609 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. r✓ Disposal Field Q Septic Tank ❑ Holding Tank E] 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. a.) Depth of absorption trenches shall not exceed 1.5 feet below original grade. b.) The upper six Inches of the mound absorption field must consist of top soil and be vegetated sufficiently to prevent erosion. Received By. Issued By: Date: O Date: Municipality of Anchorage • --1 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 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. (lel -'-7y - t o 12� Permit Number SW Property 17uL eoao Mailing address /710. ,8 ole' 3 1-7 � /�/JLx� � /�iG Zip Code 9 P <SlS Site address (A/A?I%i C I(Z c s , e Fft/C/.¢k. Zip Code _ 2 9 Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size Acre q. Ft. 441) LD69 THIS APPLICATION IS FOR: OCA Number of Bedrooms Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I 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 owkl�or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: / / - / & - D Y Date of Payment: Receipt Number: 0 6 D % Receipt Number: (Rev. 09/04) 1 .y, ' J �INEERI� NSG Northitim Engineering 17237 Bear Paw Circle Eagle River, AK 99577 907.694-7028 November 16, 2004 MOA On -Site Water & Wastewater Program 4700 Bragaw St Anchorage, AK 99519 RE: Tablelands S/D Addition # 1, Lot 7, Block 9, Chugiak The Tablelands Subdivision is being developed. Neighboring lots have not yet been developed. Favorable soil was encountered; groundwater was monitored at 6.5 feet below the surface during the high water time period. This will require a STEP tank lift station. The lot topography is flat. General drainage for the area is to the southwest. Please review the new septic system design for the planned 4 bedroom single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. � Sincerely, Z— eve En PE Design Enclosures `r �NERING PINE Tablelands S/D #1, Lot 7, Block 9 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4 -bedroom, single family home. This is a new subdivision and the neighboring lots are not yet developed. Groundwater was monitored at 6.5' below the surface; this will require a S.T.E.P system to maintain separation, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. The previous subdivision soils test recorded groundwater at 5.5', this will be used for design. This lot is over �/2 acre in size and no adverse impacts are expected from development. The neighboring lots are similar. The lots are served by a public water system. No conflicts to the other lots will take place by this septic system construction, since other lots are not yet developed. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with low silt. An application rate of 0.8 GPD/FT2 with 0.87 reduction factor for utilizing a 5' wide trench. Trench Length = 750 FT2/5'x .87 reduction factor = 130.5% 2 lines @ 66' each. No bedrock was encountered. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1500 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications, allowing gravity -flow from outlet. • Watertight couplings on inlet & outlet • 5' minimum between the tank and bed. 10' to property lines. • 2' of cover is required for trench + 1 inch insulation board. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cleanouts with airtight caps are required l to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. • All cicanouts must extend to at least ground level • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock • Drain rock to be %, inch to 2 %, inch screened. Drain rock to be distributed uniformly throughout the trench. • Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices @ 27" on center. • Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) 0 Maintain minimum 10' separation bctwtcn water line & wastewater system. Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. A 0 S F- 1500 1500 allon STEP Tank Reserve Site rlveway c d E I Water Line N W � Test Hole W I / 0 o � � Absorption Trenches M DESIGN NOTES: 1. Total Depth of Trench is 1.5'. Terrain relatively flat. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lots Served by Public Water System. V = 60' -�6 OF `~" NORTHRIM �,: .. •m TABLELANDS S/D #1 LOT ENGINEERING 17257 8"r Pow C,ro,. • • • • EaVe R/~. Noako 99577 } '••. a ,. � LAYOUT - LOT 7, BLOCK 9 11/15/04 11 of 4 ui c L O 3 U U d da a > L N O L� U L •N N j UI OW(j 4' £ N O;r L EN £ 3 d d O L Cm di U U EN L S -0 0 a is u a t rn Tud > U d +} E y 0 E UM+- C X0034 4- oaa)o 0 u4,0. u 0 C: >. CJ ino t! 0 a +• d Mo 3 U C- Cin S -P £" U7 a~)� d '.i Q. N 0-c E N C L p L aC � UNJ OUZO oea NU6U Ly V+'UO F E i C 4 F N �y s a L wN3 a� w6 qui N3Na -; ai (-iv ui�6 w W Q 0 A s o in Q' W L 3 N L7 PO L I -- C3 O ..JL L /- O .•-� D O W d 4. v w 0 nln o, 1-- ��> u L �a f f q ~ W 11 U Q H .Z -..Z E3 j N Ld r�- f f q J o 3 c f— \ = O Z Z ►." C 30 cu N O W L i 3 J Lu :;'; •'• (�� A Lf CL A Q. N - LJ Y Z W = Q tA U F - Z W LLJ d J a 6 w W LL. L 3 o iW- d N a, N Q' �+• rn� > d o d E N • + U O d ~ u C L c"�'•��,, Y 7 d �j O r tn> S W •`y. a'• H ►-� U o C %, b NN �Q 111. n: 7 Ip1S* j O Lj �2 Uri 3 tiW 4 d X22 3 0�� 0 2W fig, N N O o� � C Y H V to 0 ►•�0 F, +Q iw W' > C I -- 0 O �N U i 0 N UVI 0, £ O 3 3 U, O, tn £sW LO 3 O .:•1 N 111 41 s� vs L ny- iJ•F. VI U 0 D f- 4) +1 3 O ►- a, s c Z -83 00,E NFiF- Vl PI -4 cu (1)v zO %O cu N Ol W U O QO \ 3 0 fa W x U N U CL N N .r 0 O a N w x U Z W D: F J W J J cy Q Q d Q N W x Z Q S w U W O W U CL N Z O F Q U_ U w 0- V) N s w N N O U Z w cz O O Z A w W 3 Y Z Q F- W O Q 0 x U z a O c 2 � a, d O 7 O U H O Z a a r W � n J p A � V Z W ::;Jj O A J 0 Z H J a - WY PQ M c Q J a PQ � u� Q � J N lf7 W Q r = W � n J p A � V Z W O A J 0 Z H J a - WY PQ M c Q J a PQ � u� = W U J 2: Z W 0 � a - � Z z Q � J N lf7 W Q Y/ S❑ILS LOG - PERC❑LATI❑N TEST L0111r- _ Date Performed: 10/8/04 � NEERING Performed For: Rex Turner/ Rick Besse Legal Description: Lot 7, Block 9 1 - 2 - 3 - 4 - 5 - 6 - 7 - e- 9 - 10 - 11 - 12 - 13 - 14 - 15 - 16 - 17 - 18 - 19 - 20 - 21 - DEPTH (FEET) Organic SP Sand w/Gravel Slope < 5% Location See Drawing Groundwater?to Depth -- Water Depth After Mnni+nrinnAc:;' n„+o. tniICZinn # Date lGross Time Net Time Depth Net Drop 1 10/8 0 -- 5' 2 10/8 10 10 min. 6.25' 1.25' 3 10/8 40 -- 5' -- 4 10/8 50 10 min. 6.25' 1.25' 5 10/8 80 -- 4.5- 6 10/8 90 10 min. 5.75' 1.25' Percolation Rate 8 min./inch Perc Hole Diameter Test Run Between 3' and 4' Commentst_PrP-Snnkarlt Mnni+nr nP+j Performed By NnrthRim Fng, Imo` Performed in Accordance with F ON THIS DATE, DATE: 10/15/04 CERTIFY THAT THIS TEST WAS ll St /Municipal Guidelines in Effect NOR THRIM :R�"' TABLELANDS S/D #1 m.A ENGINEERING € LOT 7 17237 Boor Pow C,ro,o., a BLOCK 9 raVe R/~. A/ojko 99377 1 -an •3 ` 07-694-7028 GE❑TECHNICAL 10/15/04 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 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: NorthRim Engineering Legal description: The Tablelands Addition #1. Block 9. Lot 7 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. Groundwater depth of 5.5 feet recorded by SAS Engineering on 12/4/2002. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. Please include maximum depth minimum length of each trench and Minimum effective absorption area in Specifications d Design Guidelines Name of reviewer: Julie Makela. P.E. Date: 11/19/2004 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK I' 2 1 3 4 i 5 \ I I ,p I it _ I 1 1 I DEED LOT I 9 I I. I 1 8 \\ I I — l I I I I . I I 1 = 300' I December, 2002 TRACT I 7 0 12 192 \20 1318 14 21 15 17 pU82 16 , 3L C)L1 _ \ CX 1 7 6 5 • o.' TRACT H 19 2 TH-2 3 JTH TH-1 21 lb 4 5 4;� 3 2 3 I 2 o\ 7 p 0 M 10 15 18 17 16 TRACT B ;1 ;I' 011; 22 I Gt li J00 —rl' / / „ 23 24 .25 �— ; I!TRACT A \ 23 /n` 22�\ \\ 1 r. 6 , I 2 I 1 ;1; o ti 21020 21 `l; �I 1 �� � 1 I III / Of ;1 �� ice_��----------------------------------� �� it i \ 19 4_ \ 18% \ c, ='�=' i =-''� 20\.1'" 1 i �'i -- i---I---r--i--------�j�•�``9 � � �I, 17 1 -------1---- I I 1 1 I TRACT A 18�1 - I 1 1 2 16 T--- I 3 4 1 , v. / , ►, BESSE ENGINEERING TEST BORINGMcMANUS PARCEL 1890 W. ,am. Mart. Ga. DEED LOT (BOOK 469, PACES 155 k 156), ANCHORAGE MASIL-A. AV- 7 949 96965 LOCATION MAP SECTION RECORDIy4. DT15N1 R1W,LSEWARD MERIDIAN, ALAS A4 OCATED WITHIN THE NE 1/ 907- L, .t r - T. .:.. _... ._...MW11 bafv�ld, - • � � tits-�a hv6h*Jtor Turner Construction„ LbdJ beiaHRdl: NE 1/4; Sec 4; T 15_,N; R 1 H b" (kr3el Organics. H/SH 42• ii- 'O Bon .� .. �d 141k okouMf toft)Eb1 . No- Ibrl�t.AtMiubmili -n/a- e • tKbW�.�tANsl . 5 `l � E b;k12/4/02 Rou" C CE -6 27/Oi See Site Plan LotA;Block I:i IthcblAiRA KAM "Um"I 6Ehc 110U b Jktth (per i - I�gfHUHb�fu€�Il.. ff AHb �' kt EoIJi,IGNi� .,4.1 btHkbllblEfi u�:ji thtlkr i l tAt lNl? btHkbHlitfJNJAbbbhtl �I VAtt" b i GbtU 1CLlNE51N€tkt- M oN1lsbM. bAtt: i1 Z m RM NIM IthcblAiRA KAM "Um"I 6Ehc 110U b Jktth (per i - I�gfHUHb�fu€�Il.. ff AHb �' kt EoIJi,IGNi� .,4.1 btHkbllblEfi u�:ji thtlkr i l tAt lNl? btHkbHlitfJNJAbbbhtl �I VAtt" b i GbtU 1CLlNE51N€tkt- M oN1lsbM. bAtt: i1 Z INR EEING �N Tablelands S/D #1, Lot 7, Block 9 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a new 4 -bedroom, single family home. This is a new subdivision and the neighboring lots are not yet developed. Groundwater was monitored at 6.5 feet below the surface; this will require a S.T.E.P system to maintain separation. This requires a 1500 gallon S.T.E.P. tank, manufactured by Anchorage Tank & Welding per Orenco Systems specifications. This lot is over 1/2 acre in size and no adverse impacts are expected from development. The neighboring lots are similar. The lots are served by a public water system. No conflicts to the other lots will take place by this septic system construction, since other lots are not yet developed. The easements are located on the drawing and are not encroached upon. Soil tests revealed sandy soil with low silt. The system utilized a 5' wide trench with allowable reduction factor. An application rate of 0.8 GPD/FT2 with 0.87 reduction factor for utilizing a 5' wide trench. No bedrock was encountered. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wasteµater Regulations. • Two compartment, 1500 gallon S.T.E.P. tank, conforming to Anchorage Tank & Welding/Orenco Systems Specifications, allowing gravity -flow from outlet. • Watertight couplings on inlet & outlet • 5 foot minimum between the tank and bed. 10 foot to property lines. • 2 feet of cover is required for trench + 1 inch insulation board. • Tank & solid pipe must be set on well compacted, stable soil • 4 inch diameter cleanouts with airtight caps arc required I to 4 feet from foundation wall, prior to any 90 degree bend in 4 inch line. • All cleanouts must extend to at least ground level • Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock • Drain rock to be % inch to 2 %2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices @ 27" on center. • Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank & Welding/Orenco Systems specifications. Force main burial to be 4' minimum. • Silt barrier (filter fabric) to be installed above the drain rock • Smeared trench sides must be raked or scarified before drain rock placement • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, PVC Schedule 40. • Sewer Service Line is minimum 2% slope • Septic Tank to be pumped every two years or when required • Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam HI or equal) 0 Maintain minimum 10 foot separation between water line & wasteaatcr system. A �- --7 Septic System Construction Does Not Preclude Adjoining Lots From Sanitation Improvements. $ 15 T & E Eosemen r — — 1500 3allon STEP Tank Reserve Site riveway c v ,E, I / Water Line N Test Hole Li Li I / at 0 Absorption Trenches In M DESIGN NOTES: 1. Total Depth of Trench is 2'. Terrain relatively flat. 2. Sewer Service Line minimum 2% slope. 3. Trench is Minimum 10' from Lot Line. 4. Lots Served by Public Water System. 1 ' = 60' s-0; . CF A! 4' NORTHRIM *�"'m• TABLELANDS S/D #1 LOT ENGINEERING --, 17237 8.ar Pow crrc,. .p b LAYOUT i O LOT T. BLOCK 9 11/15/04 i of 4 DEER Iq f' p ?k / R.c / 71.28' 2700pr off. 'r-- R=2010• ' L=32.59' E:ut� i SEF- HOUSE EEHOUSE TAII Aim i I R-=50.40' L-24.93Lr34.72 i BLOCK ! r` ► R=50.00' •' 16' 1 F. O� I I i I i I SLI6H- �NELC�IBJIR 1�G L❑T ARE UNDEVELOPED ryc�RAINAGE T❑WA6 SW l t Ey •GEN D 1 0 3 1/40 ALUMN04 4>4U-*j4r 1 rt �ntT�inr NORTHRIM * a9m "v TABLELANDS S/D #1 S/D ENGINEERING 77237 Bear Pow C,,c,. rood Rhow. No0a 99.577 ••., a -.a. LAYOUT h'° .... LOT 7. BLOCK 9 11/15/04 MT a tn 0 cl0 CQ ) §§ ® u { o�u { 2CU $¥ ) £) / a -ax Cl )®[ k f $\ uta & QI>u � 10-oc L pk°t ¥ 2°w® 2 < ©°°a k 2 (I ° � u2J0 f gE�p Q `)~s U � 0 :3 § RSI - f K). 0,t jtL 2\/k[ =C4j�o 2�Q3%G t�� -PUo e�re 0Q)_u 0 CL _ Cl: LL®0 #��t� A6A>o< 6w¥wa E \k Rh C�K 0m EE) t §[� ) { k •• � D ��� Ln o m << cy 4)w U \\> t b 0 o > d )§n u S 22§ Q 222 3 $ ¥ a ; 7 ED 2 552 a (_ §§k k c \ £ ƒ{2 L 6 u / w ) m k .. LL— L) ? � ^ ~ n 3 k � L S ¢ 3tn k w ° U d / ® w $} ] m O G M© � e ® 5 > 2 C: 0 c0) 2$ � � ^°` O .X j\ d0 �U �u �u \{ \I 0 % /2k( u } 1-Z \ g/ ) /§§ _g. N N 0 oa, dsL u Not) C .. C C +Q a L yLj >C F- O N N U L C N N d d 7 d y 'A _ 3 O fl)y\N x�sl +10> L A i J +' N U 0 D H L -0 3 C3 N S £ z a u c N F f Fi U7 Li m_;(U r)v zo cu N m) W U K O \ 3 0 IT Pi W x U N U CL N N Q' Li C:3 Q W x z Q S W U O L� U CL N w x U z W J W J J Q Q_ ¢ CL s N z O F�- Q U W U W a N N x W f - N N N 0 U z W w O L13 z A J W 3 z z ¢ W U d' O x U z ¢ O f - S d' O W z u U O H 0 z a a C 0 +' d 3 N C M 0 zo a 0 IV 94 Li x U N U CL in N A � A J Q ON J W Y W 0 Q J = W U —J Z L.L- W W Pl Z 3 Q J In w H N w ZD N W ZZ Vvi Z W oz ZW �$ �W 4 N Ld U zo a 0 IV 94 Li x U N U CL in N A � A J Q ON J W Y W 0 Q J = W U —J Z L.L- W W Pl Z 3 Q J In w H N w ZD N W ZZ Vvi Z W oz ZW �$ �W MUNICIPALITY OF ANCHORAGE :, e..)' 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. 051-741-63 Expiration Date: L! _I l� ^�Lo 1. GENERAL INFORMATION Complete legal description THE TABLELANDS #1 BLK 9 LT 7 Location (site address) 22322 Wapiti Cir Current property owner(s) GARRITY Day phone 244-1930 Mailing address Real estate agent Cindy Wilson Day phone 244-1930 8 2. TYPE OF DWELLING: uy '1 6 v gz0 >> x Single Family (w/wo ADU) tiFlP4 14G 4-'1 H Duplex s n Multiple Dwellings (Single Family and/or Duplex) a tirt� `� [Did z �Q 3. NUMBER OF BEDROOMS: 4 z ti 41 1 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Ix I Water Storage Holding Tank ❑ Community Well H Community ❑ Public Water System H Public Sewer n Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Waiver Fee $ Date of Payment O5l19 Date of Payment Receipt Number 0c/B0a1 Receipt Number COSA# (55C/ i iUY 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 NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 4/12/19 • 6. DSD SIGNATURE ;41111111.IP' ,.• "' System #1 Approved for "/ bedrooms ®y�`' ,:`,' eik System #2 Approved for bedrooms 8''�` - =rya` ,�410 i PRoFESS19e''..3.f# Disapproved V0'mliges►"'- Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: `y / 7 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 Ciec,IIst b'.ue sheet I COSA Checklist Legal Description: The Tablelands#1 Block 9 Lot 7 Parcel ID: 051-741-63 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑Well log is filed with Onsite (or attached) Well production at time of test gpm Date drilled Water storage tank volume gallons Total depth ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to ft ❑ Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height(above ground) in. Collected by Date of flow test for COSA Date of Sample Static water level at beginning of test ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) 12/14/04 years 0 Required maintenance completed Tank type/material Steel Age of lift station 14 years Measured operating fluid level in septic tank STEP Lift station material Steel ❑■ Standpipes/foundation cleanout per record drawing Comments: Date of pumping 2/`1 to—I D. ABSORPTION FIELD DATA 6/19/12 Which system tested (date installed) 6/19!72 Adequacy test date 4/12/19 MALL standpipes present per record drawing Results ID Pass For 4 bedrooms Total measured depth from grade 3 ft(max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade ft(min) Water added 600 gal ❑■ N/A—pressurized field New depth 2 in ❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 30 min depth into effective ❑■ Code-required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) unk date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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' Community Sewer Manhole/Cleanout > 100' ❑Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ✓❑ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' ✓❑ Yes if No ft 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' p 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 .... t-Air,.. 441 I certify that I have determined through field inspections and review P'4 :' 44110 of Municipal records that the above systems are in conformance with ,per.",74 ,ti • : .* ro MOA COSA guidelines in effect on this date. L ',' 0 04 V' ,•: Sicev:n _ .. e.tipof .14<>2e6,7 •,( 1/,nr,,� COSA Checklist yellow sheet 8�` OFES 01"'- .�.... .� .. .r. ., JUV 17545 Kahiltna dr Date Eagle River, AK 99577 04/16/19 907-688-4602 TRUCK sanitarypumpers@gmail.com sanitarypumpers.com Name/Address Ship To NORTHRIM ENGINEERING PO BOX 770724 EAGLE RIVER, AK 99577 Contact Phone Alt. Phone Alt. Contact Gallons Pumped STEVE ENG 694-7028 Hoses Memo Customer Since/pumps Item Description Cost Total SEPTIC PUMP 22322 Wapiti X13 HOURLY TRUCK i aNOM RATE R• emove and clean pump basket and effluent filter. --1 ,Nrt U Clean floats and other components, ensure system performance.NIE F• loat controls in compliance with Manfacturer/MOA settings. cne._ ri E• nsure alarm system is functioning, audible and visual. O NQ Inspect manhole riser to tank connection for ground water intrusion. OY-- iV Inspect Manhole lid for functional, insulation and properly secured. 0)2-- 1E Ensure outlet weep hole is functional to protect from freezing. T• wo separate circuits for alarm and pump. b 4441/9 111111111W I f\ k" L2. nett GY S eezW S Marti �G� Total �GU� � � Directions Directions 2 Directions 3 S 84'13'29"E 71.28' L g5 98, °EE , /, , R.270 Op. /� 1 4,0D N R/ V^ WOOD �' r FENCE 2.Q`x 10.4' � N CANT Q, .._,. 112.2' x 12.2' OCG o 1 c3`,. •O. GREENHOUSE �V� •••3 -.1-• / TITH 4.0' DECK I 41 :6, cz- 4.5' /79.5r 4.a 48 0,5o -. /4/ / f0 2.0' '-)`'' 00 / c / '. . I 21.9. - .. . - ' .. / �V / • LSEP1lC • 3a�.•..'' • 4• �� / / EANOUT / MANHOLE` *C'S ♦ /Z `12.2' x 10.2 *C'S / SHED I SHED ,')NS'�O' / 4 / / • vci 40T4 . j...) / ham• / 17 / • # I f z / z u v 0 I / ( \\ < q o a i ttA 03 15' ILK \ u EASEMENT / \ II1 C4 -A_ / \. v I \ / / CT \ LOT 7 �` �. � — � 1 54,088 S.F. I1 LOT 5 31.5' T&E zz- EASEMENT ` Oo' 1 O1 N LOT 6 I ? 11 \ I I 1 PLOT PLAN AS BUILT X SCALE 1' = 40' GRID NW1559 Project No. 12-095A1 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone X044 Registered Land Surveyors (907) 522-4625 Fax 4Q . AoNN kerl®langaurvey.com / jonathan®langsurvey.com ,7� ,_ t I hereby certify that I have surveyed the following described property: �G'' `.*** ;•'' ' • LS '-'i LOT 7, BLOCK 9, THE TABLELANDS SUBDIVISION, PLAT # (2004-131) c'2 ' •'7 0 Anchorage Recording District, Alaska, and that the improvements situated thereon are a * 49� , '.��a within the property lines and do not encroach onto the property adjacent thereto, that 0 - V no improvements on the property lying adjacent thereto encroach on the surveyed i / \( premises and that there are no roadways, transmission lines or other visible F.` :�.r�••.�••• . •✓••••••••0 easements on said property except as indicated hereon. ilk •. KENNET}- G. LA! ''Q d • �� LS-5202 4. ,e0 Dated this the z9' ' Day of Jt1N4- , ZUVI- , at Anchorage, Alaska 04c�A�'•,r. '�:'-?I,' ' s,.ks It is the responsibility of the owner to determine the existence of any easements, 0 �SSIONA1o, covenants, or restrictions which do not appear on the recorded subdivision plat. ��4444Q� - ----------- Municipality Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 r _i CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE-FAMILY DWELLING Parcel I.D. o5i=7qz-63 COSA # a,5 C /0,/ �` J Expiration Date: 6-29-13 1. GENERAL INFORMATION Complete legal description The Tablelands #i Block g, Lot 7 Location (site address) 22322 Wapiti Circle Current Property owner(s) Andrew & Julie Rabung Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 22322 Wapiti Circle, Chugiak, AK 49567 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System 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 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, 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, andiregulations in effect at the time of installation. Name of Firm _Pannone Engineering Services, LLC Phone 272-8218 Address P.O. Box 1oo217. Anchorage, AK ggslo Engineer's Printed Name Steven R. Pannone, P.E. Date l 2-D 6Z& Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. �.�P„OF These conditions are outside the control of the evaluator of this system. All systems eventually fail and : �••°• "• �1 satisfactory test results do not guarantee future performance of the system, nor do they guarantee that : Jr there are no hidden defects or encroachments. PES can therefore not provide any warranty for future ,•••••r .. •. •••• ••••^• •h••••y performance nor give any estimate of how long the system will continue to meet the operational ............. „ ................. requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed '�stavan R. Pannone; above. Any reliance upon or use of this report by any other person or party is not authorized nor will it �I�:S No. cE 8149 • e confer any legal right whatsoever. 1.�• 5. DSD SIGNATURE e_�I• Approved for __L�_ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: 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:_ W -,2q -lo (Rev 11/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST Legal Description: The Tablelands #z.Block q Lots ParcellD: ori -741-63 A. WELL DATA Well type Public Total depth Date of test If A, B, or C provide PWSID # Sanitary seal (YIN) Cased to ft. WELL LOG Well Log (Y/N) Wires properly protected (YIN) J Casing height (above ground) in. AT INSPECTION Static water level ft, Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: ug/l Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material S.T.E.P.I steel Date installed 12/1a/2oo4 Tank size -i5oo gal. Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (Y/N) Y Date of pumping 46/ P2-- Pumper JR's Pumpin C. ABSORPTION FIELD DATA Date installed 6119/2012 Soil rating (g.p.d./ft2 or ft2/bdrm) o.8 GPDISF System type Wide Trench Length 15o ft. Width ft. Gravel below pipe o.r ft. Total depth ,moo ft. Eff. absorption area 75o ft2 Monitoring tube Y Depression over field N Date of adequacy test New 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) If yes, give date D. LIFT STATION Date installed 12114/2004 Size in gallons coo "Pump on" level at ga in. "Pump off' level at i in. Datum Bottom of Tank Cycles tested z E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: on lot Absorption field on Public sewer main Sewer /septic service line Animal containment areas Manhole/Access (YIN) High water alarm level at 45 in. Meets alarm & circuit requirements? Y On adjacent lots On adjacent lots sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line io+ Absorption field 5+ Water main io+ Water service line io+ Surface water ioo+ Wells on adjacent lots zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line i5.1 Building foundation 7a.o Water main %o+ Water Service line xo+ Surface water ioo+ Driveway, parking/vehicle storage io+ Curtain drain F. COMMENTS G. ENGINEER'S CERTIFICATION Wells on adjacent lots zoo+ 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. Engineer's Printed Name Steven R. Pannone, P.E. Date /?V &7-5 COSA Fee $ `f0 Date of PaymentyJ//�? Receipt Number (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number !? ,en R. Panne No. CE 8149 a 8.2' x 8.2' SHED FENCE 12.2' x 12.2' GREENHOUSE 1yITH 4.0' DECK LOT 7 54,088 S.F. T&E EASEMENT OF 0 Fip pgRk �� F ax\ N N R OCG 5' -2. / 48 CM. .:.:,Rz- 12.2' x 10.2�f� SHED LOT NMV`�O /LOT 4 M a l� r-15' T&E EASEMENT / \ \ LOT 5 1 1 \ 6 \ 1 1 1 PLOT PLAN AS BUILT X SCALE 1' = 40' GRID NW1559 Project No. 12-095A1 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax oo���oop ken®langsurvey.com / jonothan®langsurvey.comc6 OF A o,�� ..............I 4 I hereby certify that I have surveyed the following described properly: G P s OO LOT 7, BLOCK 9, THE TABLELANDS SUBDIVISION, PLAT # (2004-131) a0�;' 0 Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 * . 4 9- , 9 00 within the property lines and do not encroach onto the property adjacent thereto, that / t/ ............ 0 no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible (7 ` `�}• • •} • ✓ ........ easements on said property except as indicated hereon. (7o F KENNEhI G. IJP(, p Q0 LS -5202 �.. Dated this the -Z2 Day of i 1n 'Lm7- , of Anchorage, Alaska '•`: ��O It is the responsibility of the owner to determine the existence of any easements,0 �SSIONN c covenants, or restrictions which do not appear on the recorded subdivision plat. ��Opppo we • CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 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 Parcel I.D. (ZS 1-I LI /-(03 HAA # 60; () Expiration Date: 1. GENERAL INFORMATION % Complete legal description 7:j.o.- / r j t LOT 7 Location (site address or directions) W 71 Current Property owner(s) �lS _--n cJS (144 'n," C wo_ _ Day phone %y6 Cc 0a Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 11!7 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 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 4 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. (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 Address Engineer's Printed Name SR ✓e �K4 5. DSD SIGNATURE I/ Approved for L4 bedrooms. Disapproved. Phone t< &1-70z? Date 6 dS �Q(E•OF ACOS%1 V fc/ ( Sl :•• PE 6256 Conditional approval for bedrooms, with the following Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By:A Q, Original Certificate Date:_ (Rev. OV02) Municipality of Anchorage • Development Services Department Building Safety Division ' On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CIH. ECKLIST Legal Description:: / d/A�Q.�nd f #/ B&cK �% Lc�T % Parcel 10: C" -71i 1 - LD3 A. WELL DATA . /. VAC. WQJ f t4' Well type Date completed _ Total depth ft. Date of test Static water level Well Droduction/ WATER SAMPLE RESULTS: Coliform Arsenic: /_ mg.A. 7If A, , or C provide PWSID # Sanitary seal (Y/N) Cased to ft. A WELL LOG ft. g.p.m. 0 mi. Nitrate /a./L B. SEPTICIHOLDING TANK DATA C - . Date of Wgy Log (Y/N) Wires operly protected (YIN) Cas' g height (above ground) INSPECTION.. g.p.m. Tank Type/Materlalog0&&8AdJ= 7—o* %/cMr4d!z- j Tank size0.-gal. - . '' <, tYumber of Compartments Z Foundation deanoat Y/N) .Depression over tank (Y/N) 11 Date of pumpinPumper ABSORPTION FIELD -DATA Date installed ��0q ' SojlAting (g.p.d./ft2 or(tzlbdnrt) Q� '-"T ` -' r . LongtfrZ� �''l Width S ft. Other Collected by: colonies/100 ml. Date installedZ"7� far{ Cleanouts (YIN) High water alarm (Y/N) System "S 4&4 7.6-4 f. Gravel below pipe / ft. Total depth * ft. Eff. absorption area MOW Monitoring tube _�_ Depression over field _A Date of adequacy test /QIP -u r Results (Pass/Fail) It =W J'7JT4tj%,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) If yes, give date D. LIFT STATION Date installed ( Size in gallons SOO Q Manhole/Access (Y/N) "Pump on" level at _4�1- in. "Pump otf" level at .34 in. High water alarm level at in. Datum ',— k, Cycles tested Z Meets alarm a circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: %�U61rC Septic tank/lift station on Absorption field on Public sewer Sewer /septicXervice line 7On�djacent kits n adjacent lots Public sewer manholefeleanout Holding tank SEPARA-00N DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: r i Building foundation 'r Property line 'l Absorption field S *' rt /OO rf Water main _/O t Water service line Surface water _/O Wells on adjacent lots /00 '"r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / 0 ift Building foundation 1 V r Water main /0 �t Water Service line /Off Surface water or �Ca fDriveway. parking/vehicle storage p r� Curtain drain W(/R Wells on adjacent lots /QO r'� F. COMMENTS G. ENGINEER'S CERTIFICATION s F I certify that I have determined through field inspections and j 1t ►� % k' review of Municipal records that the above systems are in �, • "" conformance with MOA HAA guidelines in effect on this date. �,„...... ........... Sfb�e LK7 Engineer's Printed Name �j�s'ti rt eue W Date HAA Fee $ 5 q _ � I ( �. rD Date of Payment 14 Receipt Number 'rU(o f (Rev. 12/01) '_t Waiver Fee $ Date of Payment Receipt Number — -- BLOCK 8 2t —�— DEER Do* �4p �� \Jre � 9S 9e• / L-32./59' \ ' Rw,80.00 % 4 L� 34.72 1 BLOCK •Ra50.00' I L-89.47' ----�( 5 00 ! LO ti v 3 Q 0 z I 1 0 I I I I I 1 1 I 1 I 1 1 O 1 1 1 I 1 1 I 1 1 1 1 0 n 1 I I I I 1 31.5' T 6 E I EASEMENT I _F� o sept) Ra50.00' LQ24.93' / / I i 1 15' T & E EASEMENT X11 _.O 3 1/4" ALUMINUM MONUMENT 9 2' CL ALCAP MONUMENT • 5/8' REBAR I I 0 unutt PDLE I r I GUY ANCHOR I I ---0E-- OVERHEAD ELECTRIC ONES 1, 11 NOTES 1. IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN MEETS ALL SVBOINSION COVENANTS AND ZONING ORDINANCES. 2. IT IS THE RESPONSBIUtt OF THE BUILDER TO VERIFY ALL ELEVATIONS YAM RESPECT TO ALL UTILITIES. 3. THIS AS -BUILT REPRESENTS THE PARCEL OF PROPERTY DESCRIBED BELOW TAKEN FROM INE RECORDED PLAT DESCR18ING THAT PARCEL WSIRUMENTS RECORDED PRIOR TO OR AFTER THE FILING OF THE RECORDED PLAT ARE NOT SHOWN ON THIS AS -BUILT. 4 THE INFORMATION SHOWN ON THIS AS -BUILT IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN MSDNG STRUCTURES AND PLATTED LOT LINES OR EASEMENTS. THE AS -BAIT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES I FOUNDATION DETAIL l1"-30' 9 Ur g4T,I••:Richard L. Besse : �G��•, 4094-S 49, I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCPoBED ON THIS AS -BUILT AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS AS -BUILT. DATED THIS 23 "DAY OF 12/23/04 AS,UUILI LOT 7. BLOCK 9, THE ED .60• TABLELANDS SUBDIVISION, 4-131 ADDITION No. 1, LOCATED WITHIN S4• T1SN. R1W S.M.• A. NCHORACF RECORDING DISTRICT. ALASK Iw. UA: BO1-25A D,G TABLL7B9.Dvr0 L": 12/21/04 `• U N UY: 1890 Jaime Marie Circle MLK Wasilla• Alaska 99554