HomeMy WebLinkAboutWILLIAMSON #1 BLK 1 LT 20AWilliamson #1
Block
Lot 20A
#015-073-48
Municipality of Anchorage
• Development Services Department • =_�-,
Building °-
Safety Division
On-Site Water 8 Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ek.us (907) 343-7904
Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW050202 PID Number. 015-073-48
Name:
JENNIFER BOISVERT Wastewater System: ■ New ❑ Upgrade
Address:
1625 DOLINA CIRCLE a ANCHORAGE. AK 99508 ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 338-1089 3 ■ Deep Trench O Shallow Trench O Bed OMound OOther
LEGAL DESCRIPTION
saa it ""° 0.8
ft a OWh frton tkga wed•:
Block: FOR; Subdivision:
20A WILLIAMONµI
Wo/sa.
a•ptnb pp• eettom Itema
n 13 MAX rt
rdp 6U p•:1
Township: — Range: — Section: —
SEE DWG
rr eeaw at..• a.gina q,ed•:
rt 7.0 F,
G•.N Mastn:
SEE DWG.
rt 2 ® 30 (60)rL
WELL: ■ NewGm,*
❑ Upgrode
wmn:
2.5
Nane•r a r.•: ouaaae• twtw• w..
tawkeal.a (pd.at., &B.4raa D•ptk: tot.a Ta:
PRIVATE
raw m.«paaa area:
n 2 14
R'
pp. na «aI:
247 n 247 n.
O.a•r:
17/29/05
840 so.
n D 3034/ F-810
oat• Orww: stave water l•yI:
HEFTY DRILLING 209 n.
katal•.: pat"N•Ias•o-
ALASKA GENERAL IND. 7/27-8/1/2005
nad: wap set At: CO" tlaant At w G m ;
15
C,)( 05 -C&03
aw UNKNOWN �. 2 n
TANK
SEPARATION
DISTANCES
■septic 0Holding 0S.T.E.P. 0Other
To
I
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
• /pHwah
sew« tine•
up1N11OCh""
ANCHORAGE TANK
cacxnr +a saran•:
1000
Well
100'+
100'+
—
—
Y5•+
tat'na"Naaw«
STEEL
•r tawnp•rinant.:
2
Surface Water
loo'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
wean•:
ManWaetu ..
Foundation
5'+
10'+
—
_
—
°n M.a at
Of I•.wI e1:
«aeon at
Curtain Drain
NO KNOWN
►amp make •
tnea ka°.a;wa We""'a kY
Remarks:
BENCH MARK
and aeecdpk :
BOTTOM OF SEPTIC TANK ® FIRST COMPARTMENT
A•wwn•d E1•wben:
97.61 rt
ENGINEEw7 eEAL
Inspections performed by: GEG, Ltd. Dates: 1st 7/27/2005 0
'�Q
p.......
...........
2nd 7/28/2005 Q
3rd 8/1/2005
... fe ...:... 0
p
Development ervices Department Approval
rness,:...Q
�0� . CE-7953
Reviewed and approved by:
PP i c�
4 red '' mac§
Y Date:
(N«, t�I)
farofeasion°� o�
��OO0000t'
PERMIT NUMBER:
SW050202
F
STI
18.27
38.61
ST2
23.25
40.48
DBLI
27.86
41.38
DBL2
28.79
40.88
FS
29.66
39.33
C01
47.62
48.43
MTI
46.28
46.25
CO2
18.33
29.30
MT2
20.42
29.27
CO3
49.28
39.80
MT3
48.08
37.91
C04
20.44
14.46
MT4
26.57
18.31
AS -BUILT DRAWING
C;pm AAEA—j � \
/ /
TEST PIT—\
NEW OF%JNnms, I
PARCEL ID NUMBER:
015-073-48
/
/ LOT 19. K I
WLLWASONL50 %1
/
THII
1
1
1
1
I
I
I
1
—�► " 1+':' NEW 1000 GALLON 1
SEPTIC TANK 1
100• WELL RADIUS -
VALTERNATE SITE WILL
/ REQUIRE THE USE
' OF AN ADVANCED
' WASTEWATER SYSTEM.
4p
GARNESS ENGINEERI oo�� Syo�00�
NG GROUP, Ltd. p, ; •.
CONSULTANTSi GENERAL CONTRACTORS �•••••• •••••••• ..........
ITN L TDM 11010. 11AC 101 • NCHOAWL m 0 7 •/1101( (pf}VH,r • F" (001)1 " • OSIIC •— rYy.w
PREPARED FOR: PHONE NUMBER: PACE NUMBER: .....1• •••• ••••••• ••••.... D.0
JENNIFER BOISVERT 338-1089 2 OF 3 OOP trey Ga ess. Y�
LECAL DESCRIPTION: DRAWN BY:y
QOC —79 Sp
WILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1, C.J.G. �sre'j•l3'%..•'��40�
TYPE OF WORK: DATE: Profssslo� a\
fQO0000
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM 1/3/2006
e
I
fA _1
PARCEL ID NUMBER:
015-073-48
/
/ LOT 19. K I
WLLWASONL50 %1
/
THII
1
1
1
1
I
I
I
1
—�► " 1+':' NEW 1000 GALLON 1
SEPTIC TANK 1
100• WELL RADIUS -
VALTERNATE SITE WILL
/ REQUIRE THE USE
' OF AN ADVANCED
' WASTEWATER SYSTEM.
4p
GARNESS ENGINEERI oo�� Syo�00�
NG GROUP, Ltd. p, ; •.
CONSULTANTSi GENERAL CONTRACTORS �•••••• •••••••• ..........
ITN L TDM 11010. 11AC 101 • NCHOAWL m 0 7 •/1101( (pf}VH,r • F" (001)1 " • OSIIC •— rYy.w
PREPARED FOR: PHONE NUMBER: PACE NUMBER: .....1• •••• ••••••• ••••.... D.0
JENNIFER BOISVERT 338-1089 2 OF 3 OOP trey Ga ess. Y�
LECAL DESCRIPTION: DRAWN BY:y
QOC —79 Sp
WILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1, C.J.G. �sre'j•l3'%..•'��40�
TYPE OF WORK: DATE: Profssslo� a\
fQO0000
AS—BUILT DRAWING OF NEW WELL AND SEPTIC SYSTEM 1/3/2006
PERMffNUMBER: AS—BUILT DRAWING PARCEL ID NUMBER:
SW0
SW0502020202 — 015-073-48
TH/2
TOP OF TIN( AT
IIET . IOLM
IMEm K
AT O&ET .
_Q
u
NEW 1000 GALLON
SEPTIC TANK
Owo w GRADE
. ".10 •
MOom POw
RELATIVE ELEVATION OF BOTTOM OF TEST
HOLE - 79.10 (TEST HOLE DRY)
PANDC
saes Nw.)
14'+
a
TAME AT
. IOLA2
w Of GUMC AT
OUTLET . 101.0
FABRIC
-WADRT OF PIPE
. 100.20 (AW.)
•80TrOU OF
NO" .
93.10 (AVG.)
RELATIVE ELEVATION OF BOTTOM OF TEST
HOLE AA 66.10 (TEST HOLE DRY) �
TH/2
�` oo .... .... .:' i
GARNESS ENGINEERING GROUP, Ltd. pp�;�' 4�
CONSULTANTS&GENERAL CONTRACTORS �•••• ••• •• •• .••••••.....
,JAI C T ROAD. T 101 • ANCHOR!.(. M( MAT . M (607W? -01T . PAR (00rja ".
'PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • ......... .........
JENNIFER BOISVERT 228-1089 3 OF 3 of a GG essr
LEGAL DESCRIPTION: DRAWN BY: oVoCE-7 53 .`4
WILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1, C.J.G. .. 4Ib.OL'' cAv�
TYPE OF WORK: DATE; ��adPEo(sssio(o'o
PROFILE DRAWING OF NEW SEPTIC SYSTEM 1/3/2006
12-29-05; 3:16PM;ABR. Inc. ;9077701443 O 3i
Rub 03 20 05:44P BRUCE MRCPHERSON (907) 349-6114 .P.1
Ir
�
3RILLTNY
G
.S:51 A1.0:n lhilc MAle h17) 345-o593
Fix , XM .{45-4 i00
\rrFlu.uw.ALIJ.)9n;�IG (40M)2M-8911
STATE OF ALASKA
DF.PARTME..Vr OF NATURAL RESOURCES
DIVISION OFMININC,LAND & WATER
WATER WELL LOG
ikitline Stxrtal07/27 .2005-..__1r_.IA7 , � . iiiir
Clt)^Borough:
Sulxfisision:
BLOCI:
1
LOT
208
rropelry•D1tllcr Nsnw&Addless: Jennifer& Cynthia � Boisvert
1625 Dolina Circle. Anchorage, Ak B9508
Ant )ora
wlliarnson 1
Meridian Tounship
Range
Section Y4 or V4 of V4 or V.
BOREHOLE DATA: (from T.O.C. ) Depth
Drilling method: (X ) Air rotary, ( ) Cable tool. Other
Material: Type. Color & wetness
I From t
0
Perforated: Start _ R, Stopped: ft
Wclt use: ( )Publics ly,
nPP W Domestic. Other
silty sand & gravel
0
20
Depth of hole: _247 it. Casing stickup: 7 ft
Note: _
Cuing typc:y¢� Thielut -:0.250 inc"-
Wet silty day 8 gr-dVAI
20
Cuing diameter. 6 inches Casing depth: 247 R
Depth: from n ft. to _20ii
L incr type: _= Diameter. _inches Depth. ft
wet gravel & Silty Clay
silty sand & fine gravel
34
72
72
yg
Static nater (from tip of easfag):1' 09— ft on W29—/=5
Pumping level & yield: fact ager_ hours at.__. gpin
Recovery rate: 15 gpm Mcthod of testing: airlift
Devcloptnatt method: airlift Duration: 1 hour
boulder
99
101
Well intake opening type: (X) Open end. ( ) Oprn hole Other
Screened: Start: & Stopped R
gravel0211240
Screen IYPC SfoVansh size:
Perforated: Start _ R, Stopped: ft
el
Start: R. Stopped: ft
1bght
Note: _
Grout rype: lapaabxke volume _
Depth: from n ft. to _20ii
Pump intake depth: ft
Pump size: _ hp. Brand name:._,
Coarse gravel W/'H20
240
12471
Was well disinfected upon completion" (X) Yes, ( )NO
Ataska Kate law requires Ihal a copy of this w•dl log be sent to tlw
Dcpatutivlt of Natural Raouram within 45 days: faNes a
oceentahtc. (AK%Mlles 38.03.0210.38.03.035.41.08.020.
46.1 S.020 and AK rcgulatium I I AAC 93.140).
DNPJ Diairion of Mining. Land and Watcr.
$50 W 7th Awnuc, Suite 1020
Andwragc. AK 9950 1-3rrjU
Phone (9071269.6619 and fax (907)764-I M47
Driller eornmentsi disclaims(s:..._.._...__..._..._..._.......___._......._..
We]I drillernamc:..tonDrly.xay..__.__....._.
Company name:
Mailingaddross:_,.�r..4_DAkt119 Dr.
City: A—Mim ge Statc: AK Zip 99516
Phone number:( 907e))–,IA5_ 0593
Drillers signature: &-,—�
Within the City ofhorag ` is required that a copy of the well log ba
to c
sent to the appropri ity oRim within 60 days and that another copy or
the well log be sent to the wcl4MPerty owner within 30 days.
Permit Number. 3w050202
Datcoflssuc:
Parcel Identification Number.,,,Q]r2-- M--48—
'swell locoted of opprovcd pctmil klcatiun" (X) Yes or ( )NO
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SWO50202
Date Issued: Jul 01, 2005
Expiration Date: Jul 01, 2006
Parcel ID: 015-073-48
Legal Description: WILLIAMSON #1 SUBDIVISION BLOCK 1 LOT 20A
Design Engineer: 0855 Gamess Engineering Group, LTD Site Address: NHN E. 98TH AVENUE
Owner Name: JENNIFER & CYNTHIA BOISVERT Lot Size: 28584 SQ. FT.
Owner Address: 1625 DOLINA CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99508 -
This permit is for the construction of:
R Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By.
Date: S
Issued By, Date: 1
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.cl.anchorage.ek.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D.!7/S-6:23'Yf Permit Number
Property owner(s) JENNIFER AND CYNTHIA E301SVERT Day phone NIA—MR0
Mailing 1• \.• CIRCLE * ANCHORAGF.:..
•
LegalMe4in"cidress (2) Zip Code 99508
description• • • • WILLIAMSON 1M •\* LOT 20A. BLOCK
Legal description (Section, Township & Range) _N/A
Lot Size off$ 5V4 Acre Sq.Ft Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. 1 further certify that this application is being made fora
Single Family Dwelling and is in accordance with applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
Permit Fees: 010 + 19)0 1��
Date of Payment: f4z�
Receipt Number: 0 (Z `1
Waiver Fees -
Date of Payment:
Receipt Number.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
June 23, 2005
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Well and Septic for Williamson Subdivision; Lot 20A, Block 1,
To whom it may concern:
The proposed 3 bedroom house will be served by a private well and septic system. We are proposing that
a new 1000 gallon septic tank and a dual 5 -wide trench type drainfield be installed. Two test holes where
excavated on the property. The drainfield will be designed around the 30 foot radius of test hole #1.
Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached design drawing the average topography in the area
of the drainfield is a 15-20 percent slope running approximately north to south. In short there are no slope
concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
If you have any ggestions, please contact us at 337-6179. Thank you for your assistance.
M.S.
NOTE: Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E.G. Ltd. for 7page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 • Fax: (907) 338-3246 " Website: gamessengineering.com
TRACT 28 ------
WILMOTH PARK
I
VIS� � I
JATFj ---- / �
E
LOT 19 BLOCK
WILLWISON S/D Yt
1
TH'
y a — PROPOSED `
y SEPTI: SYSTEM
I LOT 18, �K I
\ � LLIAIASON`5;0 r11
gOT
M7OT
�� s� ri S�OiirsT
I A
0
I
I
I
I
N 1/2, N 1/2, SE 1/4, NE 1/4
SECTION 15, T11/2N, R3W
L.'A/
r--� STREAM
LOT 10, BLOCK 1
SUMMrT ESTATES
I
I
ell
iSUMMrr EStATES7
J II/
11\
I LOY 12 BLOCK 1 r
I 1 SUMMr ESTATES
GARNESS ENGINEERING GRm
-6
CONSULTANTS & GENERAL CONTRACTORS....PREPARED FOR: PHONE NUMBER: JENNIFER BOISVERT 338-1089 PLEGAL DESCRIPnON: OQO°viWILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1UQ�TYPE OF WORK:
SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM 6/23/2005
OF BEDROOMS:3
PER DAY (CPD): 450
ION RATES: 12 MIN.ANCH
D APPLICATION RATE: 0.8
GRAINFIELD SO.FTa 582.5
IM DEPTH:13 FEET
2.5 FEET
1:55' FEET 2 O 27.5 FEET
APPROVED SAND FILTER: N/A
NE: -7 FEET
LEITER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT CEO. BY PROCEEDING FORWARD
WITH THIS INSTALLATION. THE ENGINEER,
WELL DRUM CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY /
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
a
1
DRAINIOSED U //
41
lI DERE PUMP
/ MAY BE NEEDED,,
DEPENDING ON
OF THE HH ELEVAUSE TM' /If
I •' L
• S % \ I 10P000 G
.••� : INSTALL\ �� SEPOC
FOUNDATION
CLEANOUT
PROPOSED I/ I G\l<e
It I
1DI1 MUST BE FLACCEC
Y A RECISTERED LAND
SURVEYOR PRIOR TO
BLOCX
M�LLIAMSON /D Y1
•-- ALTERNATE SITE /
WILL REDUIRE THE
FILTER (SIZED FOR 3
BEDROOMS)
i
INSTALL
DOUBLE
CLEANOUT
ISED
ALLON
TANK
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS R GENERAL CONTRACTORS
=1 L TOGO OOM4 ■1R 101 • M M MIL M1 0„01 • ROIL (,01)wl lft • w (WI)Y " � OIC w•�,r�,•�O
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
JENNIFER BOISVERT 338-1089 2 OF 3
LEGAL DESCRIPTKII: DRAWN BY.
WILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1, 1 R.A.L.
FOR PROPOSED WELL AND SEPTIC SYSTEM
FLOW SPLRER
GRADE
FILTER
13'
IN FROM
SEPTIC
TANK
MTO
OWE
FILTER
13'
GARNESS ENGINEERING GROUP, Ltd. p*?
CONSULTANTS& GENERAL CONTRACTORS •••••• ••. • ••••• ......•••.••
.AO, L Um OMD. KM M1 • roorx w, MMI •not d.h�f-�,r •nut doOav nw . Ml°IG ...�.,�.,,
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: . •• ••••• ......••••••
JENNIFER BOISVERT 338-1089 3 OF 3 re Garness..
LEGAL DESCRIPTION: DRAWN BY:O °o, CE -7953
WILLIAMSON SUBDIVISION; LOT 20A, BLOCK 1. R.A.L
TTPE OF WORK: DATE' 444000 Prof $IC�'ll— moi
DETAIL FOR PROPOSED DRAINFIELD 6/23/2005
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: WILLIAMSON SUBDMSION; LOT 20A. BLOCK—'
PERFORMED FOR: CYNTHIA BOISVERT
( eet EEEE
1==ZZ ORGANICS
=5 lZ
6
7
e
WEEP O 6.5'
E=111111d1®
10
11
12
13
14
15
16
17
18
EST HOLE JE
DEPTH TO
GROUNDWATER
DATE
WEEP O 6.5'
12/30/03
111111111
1/7/04
31191
VZZZ/l
6'
/_%
RUN
1:50
•
Wy
111111111
3
1:50
—
6'
—
11r11``1i
2:20
Y/f/ A
•
1/2.
5
DEPTH TO
GROUNDWATER
DATE
WEEP O 6.5'
12/30/03
14.8'
1/7/04
*DRY TO 10'
6/23/05
6'
—
...... . .. .... ..........
e ey amess:
v CE -7953
•LI.24�sj
�.dp�o hs efoo_�o
A
N
;H# I
1
.[, TH#2
� srxE:
1 100'
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
12/31/2003 1
1:20
—
6'
—
2
1:50
30
538'
58'
3
1:50
—
6'
—
4 1
2:20
30
1 5 1/2-
1/2.
5
2:20
—
6'
—
6
2:50
30
5 1/2-
1/2"
19� PERCOLATION RATE 60 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.5 FT. AND 5.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: KELLY HERSTUMAN PERCOLATION TEST PERFORMED BY: NICK HERSTUMAN
COMMENTS: TEST HOLE IS FULL OF DIRT AT 10 FEET.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER 0R MED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: tilZ�t�•�
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS d GENERAL CONTRACTORS
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: WILLWASON SUBDIVISION, LOT 20A, BLOCK i
PERFORMED FOR: CYNTHIA BOISVERT W
(r °tzzz - TEST HOLE 2
-....--
DEPTH TO
GROUNDWATER
illllllll
DRY
12/30/03
DRY
111191
=01%
6/23/05
rA
NNH
•
2:54
111111111
3 1/8-
2 7/8-
3
2:54
{moi
1111111
�idiB.
•
4 1
3:24
30
DEPTH TO
GROUNDWATER
DATE
DRY
12/30/03
DRY
1/7/04
DRY
6/23/05
6-
—
\`
N
�H#I
i
+TH#2
/ souF:
1 100"
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
12/30/2003 1
2:24
-
6-
—
2
2:54
30
3 1/8-
2 7/8-
3
2:54
—
6-
—
4 1
3:24
30
1 3 1/2-
2 1/2-
5
3:24
—
6-
—
6
3:54
30
3 1/2-
2 1/2-
19 +II H I I u II PERCOLATION RATE 12 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
mill jN� II II GAJ ILII TEST RUN BETWEEN 8.0 FT. AND 8.5 FT.
20 B.O.H. A FOUR HOUR PRESOAK WAS PERFORMED: 0 YES ❑ NO
SOILS LOGGED BY: KELLY HERSTUMAN PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN
COMMENTS:
PERFORMED BY CEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASERF RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: f7 2 0
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. Irfurther 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 MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name M110 N ANDERSON, PE : Date '12/4/15
tOF Al01.1
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6. DSD NATURE ®A
ANDERSON
System #1 Approved for J bedrooms.d� f. q bq
System #2 Approved for bedrooms.
Disapproved.�8®�ao��
Conditional approval for bedrooms, with the following stipulations:
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WASTEWATER --
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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
. COSA blue sheeLl M0712doc. � .�
If more than 1 septic system is on the lot:
COSA Checklist # _of _
Structure. served by this system _
Certificate of On -Site Systems Approval Checklist
WxV\tor„ 5.0 Vt
Legal Description: #1 S/D BLOCK 1. LOT 20A Parcel ID: 015-073-48
A. WELL DATA
Well type_PRIVATE_ 11A, B, or C provide PWSID # T
Date completed -7-29-05— Sanitary seal (YIN) Y
Total depth 247 ft. Cased to 247 ft.
FROM WELL LOG
Date of test 7-29-05
Static water level 209 ft..
Well production 15 g.p.m.
WATER SAMPLE_ RESULTS: .
Well Log (YIN)
Wires properly protected (YIN) Y
Casing height (above ground) 24
AT INSPECTION
11121115
205 ft.
5 g.p.M.
Coliform
NEG
colonies/100 mL Nitrate
0.626 mg/L
Arsenic:
ND
ug/L Date of sample:
11.9.15
Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (YIN) Y Tk' Depression over tank (YIN) N
Date of pumping 11121115 Pumper Around the Clock
Date installed 7.27.05
Cleanouts (YIN) Y
High water alarm (YIN) N
C. ABSORPTION FIELD DATA -1985 SYSTEM TESTED
Date installed 7.27.05 Soil rating (g.p.d.flf or fe/bdrm) 0.8 System type deep trench
Length 2x30 ft. Width 2.5 ft. Gravel below pipe 7.0 ft.
Total depth13 P. Eff. absorption area 840+ fe Monitoring tube Y Depression over field N
Date of adequacy test 11121115 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 36 in. Water added 500+ gal. New depth 50 in.
Elapsed Time: 24 HRS min, Final fluid depth 34 in. Absorption rate >= 500+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) UNKNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in.High water alarm'level at— in.
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES .
WELL ON LOT TO:
Septic tank/lift station on lot 100+
Absorption field on lot 100+ '
Public sewer main 75+
Sewer /septic service line 50+
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Holding tank 100+
Animal containment areas 100+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 504 Water service line 10'+ Surface water 1001+
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Propertyline 10'+� Building foundation 104 Water main 104
Water Service line 101+ Surface water 1004 Driveway, parking/vehicle storage 50'+
Curtain drain 50'+(Nonel(nown) Wells on adjacent lots 1140r+ _
It9 0,
F. COMMENTS
Fow.laklo.. C1+61.06L+ & SIR. eUrwev,. 'd"
G. ENGINEER'S CERTIFICATION
I certify that I have determined through -field inspections and
review of Municipal records fhat the above systems are in y�P° '•'�' d+
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name MIKE N. ANDERSON. PE
�... ............e
7d MIC
• MICHAEL 14. ANDERSON :ft:
Date 121212015 / .
CE 9
COSA canary sheet 2-6-15.doc
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a
F. COMMENTS
Fow.laklo.. C1+61.06L+ & SIR. eUrwev,. 'd"
G. ENGINEER'S CERTIFICATION
I certify that I have determined through -field inspections and
review of Municipal records fhat the above systems are in y�P° '•'�' d+
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name MIKE N. ANDERSON. PE
�... ............e
7d MIC
• MICHAEL 14. ANDERSON :ft:
Date 121212015 / .
CE 9
COSA canary sheet 2-6-15.doc
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