HomeMy WebLinkAboutTHE TABLELANDS #1 BLK 8 LT 19The Tablelands
Block 8
Lot 19
#051-801-64
Municipality of Anchorage Page 1 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519.6650
www cl.anchorage.sk.us (907)3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO50223 PID Number. 051.801-64
inell Homes
"7piS
Wastewater System: New
1900 W. Northern LI hts Ste. 200 Anch., AK 99517
ABSORPTION FIELD
4
5' Wide Trench
344-5678 Four
sw R"
7" Depth from wQrW pate
LEGAL DESCRIPTION
1 DPwe
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Gavel depth Iden, Fps
8 19 The Tablelands
0 Ft.
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126 Fl.
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630 Ft
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TANK
DPM
Ft.
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SEPARATION DISTANCES
Advantex Treatment System
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
ublmdPrtvate
sewer Line
AnchorageTankl0renco
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well
>200'
>200'
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NIA
>25'
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>100'
>100'
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Allied Alaska Electric
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BENCH MARK
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Finished Floor.
100.0 FL
Engineees Stamp
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Inspections performed by: T. Kimbroueh Dates: 1" 1013/2005%
49ih
2nd 1014!2005
Department of Health and Human SSeervi es approval
� A MCmuEL E. ANDERSON W�
•,C, r 0. ���:
by: / Date: - - O 6
_CE-etet
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Reviewed and approved
Municipality of Anchorage
Permit No.: SV450223 DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3
PID No. 051-001-64 4700 South Bragaw Street Anchorage, AK 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
N 89'52'01 0E 282.83'
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THE TABLELANDS, ADDN. NO. 1
LOT 19, BLOCK 8
60,745 S.F.
�1
15' T. do E.
B LAC KTAI L
CIRCLE
PLAN AS -BUILT
SCALE 1' = 50'
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report Page 3 of 3
Permit Number. SW050223
TBM = 100.00
Y .
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PID No. 051-801-64
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In Mar 21 06 01:30p Allied Alaska Electric (907) 373-3894 p.1
W61a4& ONTRA CT/NG
March 21, 2006
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 18, Block 8 —The Tablelands
• Lot 19, 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.
anette L. Brown,
(P ice Presidcnt/CFO
cc: file
P.O. Box 876310, Wasilla, Alaska 99687 (907) 373-3893 ofc / (907) 232-8687 cell/ (907) 373-3894 fax
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: April 4, 2006
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: Lot 19, Block 8, The Tablelands Subdivision No.1
Certificate of On -Site Systems Approval
Attached is the documentation for the Certificate of On -Site Systems Approval for Lot
19, Block 8, The Tablelands Subdivision No. 1. The final grading, topsoil placement
and seeding of the area over the absorption trenches cannot take place until conditions
allow. We therefore request a conditional approval be issued pending completion of all
grading and revegetation by June 15, 2006. The conditional fee along with the usual
fee have been paid for the certificate.
Please advise if you have further questions.
HOMES, Inc.
March 27, 2006
Re: Lot 19 Block 8 The Tablelands
Richard and Lisa Loubriel
22432 Blacktail Circle
Chugiak, AK 99654
To Whom It May Concern:
In signing below, the above mentioned buyers accept full responsibility to topsoil &
hydroseed the areas required by the Municipality of Anchorage for their septic system.
Spinell Homes, Inc. agrees to provide the proper final grade for the septic system.
1 GGi (,-
Richard Loubriel
�o'A- ' r'//7, � I
Lisa Loubriel _
Spinell Homes, Inc.
Before
Richard and Lisa Loubriel.
`i. NOTAgy .
PUBLto z: 9
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Before ' Mf-" this
Chemene Breiner. .4-4_�'
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s a.�
o N� PUBLIC fir; ti
.�Ia�4.91F OF P�py.
a+i
1900 W. NORTHERN LIGHTS BLVD. • SUITE
03 -2,:P- 06c
Date Nn�
-D/61t.to
Date
of March, 2006, appeared
of March, 2006, appeared
Exp
ALASKA 99517.344-5678 • FAX: 344.1976
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 6 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jul 12, 2005
Expiration Date: Jul 12, 2006
Permit Number: SWO50223 Parcel ID: 051-801-64
Legal Description: THE TABLELANDS #1 SUBDIVISION BLOCK 8 LOT 19
Design Engineer: 0014 Anderson Engineering Site Address: 22432 BLACKTAIL CIRCLE
Owner Name: SPINELL HOMES, INC. Lot Size: 60745 SO. FT.
Owner Address: 1900 W. NORTHERN LIGHTS BLVD STI Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99515 -
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.
a.) The upper six inches of the mound absorption field must consist of topsoil and be sufficiently vegetated to prevent
erosion.
Received By:
Issued By:
Date: 7_//
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
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. (SSI - So)- ug Permit Number SW
Property owners) Soinell Homes, Inc. Day phone 344.5678
Mailing address (1
Mailing address
Code
Legal description (Lot, Block & Sub'd.) Lot 19, Block 8, The Tablelands Subdivision # 1
Legal description (Section, Township & Range)
Lot Size 60.745 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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 owner or authorized agent)
Permit Fees: 4110 Waiver Fees:
Date of Payment
Date of Payment
Receipt Number. �JOIOG �� �� Receipt Number.
(Rev. 12100)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522.6779 FAX
July 8, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 19, Block 8, The Tablelands Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 19, Block 8, The Tablelands Subdivision intends to construct a four-
bedroom home on the lot. Groundwater and soil conditions in the area are such that
we are proposing to install an Advantex Septic Treatment System for a four-bedroom
home on the property. The attached Site Plan and backup documentation identify the
location and configuration of the new septic system and alternate site and the
parameters used in the design. Also identified on the plans are the location of the
surface drainage, test holes and water service on the lot. The system will not conflict
with those on the surrounding lots. Drainage arrows and spot elevations are shown
indicating the current drainage patterns. The drainage patterns will be maintained after
construction.
The test holes placed on this lot revealed silty sand with some gravel. The percolation
rate in the material ranged from 40 minutes to 60 minutes per inch. Groundwater was
recently noted at 6' below the surface. We are therefore proposing to place a four-
bedroom Advantex Treatment System. The terrain of the lot is such that gravity flow
from the filter to the absorption trenches is not possible and a second lift station will be
required. The absorption trenches will each be 60' long x 5' wide x 1' effective depth for
a total absorption area of 600 square feet. The trenches will be constructed at the
existing ground level with a total depth of 1'. A minimum of 3' of cover will be placed
atop the trenches and 4' of cover over the septic tank.
The ground surface on the lot slopes as shown on the site plan from southwest to
northeast at shallow slopes. The absorption trenches will be constructed parallel with
the slope as much as possible in conformance with Municipal requirements. All
Lot 19, Block 8, The Tablelands
July 8, 2005
Page Two
components of the new septic system will be constructed a minimum of 100' from any
surface water and 10' from the water service on this and adjacent lots.
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
49th
MICHAEL E. ANDERSON
N 89'52'01'E 282.83'
THE TABLELANDS, ADDN. NO. 1
LOT 19, BLOCK 8
60,745 S.F.
.z 49th f^► '.
MICHAEL L ANDERSON
No. CE -4381 ,+
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120' 120'
BLACKTAIL
CIRCLE
SITE PLAN
SCALE V = 50'
ADVANTEX AX -20
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SEPTIC SYSTEM ANCHORAGE TANK A WELDING, DlC.
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ANCHORAGE, ALASKA
STANDARD
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LOT 19, BLOCK 8, THE TABLELANDS SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Advantex Treatment System for Four Bedroom Home
Perc. Rate: 31.60 MinAnch 500 Galton Lift Station w/ Pressure Distribution System
Application Rate: .45 GPD/SF 5' Wide Trench with 1' Drainfield Rock
4 Bedrooms x 150 GPD/Bedroom/1 GPD/SF (Application Rate) = 600 SF Absorption Area
600 SF/5 SF/LF = 120 LF Trench Length
THEREFORE: Construct 2 - 60' Long x 5' Wide x 1' Effective Depth Absorption Trenches. Flow Line
Elevation in Trenches to be At the Original Ground Surface. Total Depth to be .5' Below Existing
Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. In Lieu of Fill
Place 2" of Direct Bury Insulation and 2" of Natural Cover.
3' Depth
Natural
Backfill
Fabric
I I \ 13 PVC Holes Down)
16"(Holes @ 2 4' Spacing
Drainfield Rods
5'
TYPICAL 5' WIDE TRENCH SECTION
CF %
(NO SCALE) •• �� »• »
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock..:_: ° h
Minimum 4' Separation From Groundwater. 9; -/ � „,�,��
Minimum 100' Separation From Wells in the Area. 0% M EL E.woEredl
Minimum 100' Separation From Surface Water or Streams.• %,%,Al. NO. CE. l
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 19, BLOCK 8, TABLELANDS S/D
PERFORMED FOR- SPINELL
DATE: 4/15/2005 PROJECT No • M0523
PARCEL ID,#• TECHNICIAN: T. L. KIMBROUGH
DEPTII TEST HOLE # 1
(far)
1
READING
OB/OG
NET TIME
(MINUTES)
2
INF]INTCDROP
HES)
SILTY SANDS W/GRAVELS
TEST HOLE PRESOAKED PRIOR TO TESTING:
MEDIUM COMPACTION -MOIST
3
12:08
SM -GM
4
RECHARGE
5
12:38
30
6
.63'
WELL COMPACTED SILTY SAND
3
WITH GRAVEL
,7
10.75'
SM
8
4
9
30
10.25'
SLOPE
E. ANDERSON
WAS GROUNDWATER ENCOUNTERED'
101 IF YES ®WIIAT DEmn
DEPTH OF WATER AFTER MONTORHNG: A
I I DATE OF MONITORING: 6rz2nyH
1 *.
14 BOH
15
16
17
18
19
0%
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
D P ERP
(INCHES)
INF]INTCDROP
HES)
4/15
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
12:08
10.63'
RECHARGE
2
12:38
30
10.0'
.63'
3
12:39
10.75'
RECHARGE
4
1:09
30
10.25'
.5'
5
1:10
10.75'
RECHARGE
6
1:40
30
10.25'
.5'
PERCOLATION RATE; (MIN/INCII) PERC. HOLE DIA, INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/8/2005
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 19, BLOCK 8, TABLELANDS S/D
PERFORMED FOR- SPINELL
DATE: 4/15/2005 PROJECT No - M0523
PARCEL ID,#• TECHNICIAN: T. L. KIMBROUGH
DEPTII TEST HOLE # 2
(t«1)
I
2
OB/OG
SILTY SANDS W/GRAVELS
SLOPE
MEDIUM COMPACTION -DRY
3
SM -GM
4
rn
0
5
0
0
6
7
g
WELL COMPACTED SILTY SAND
WITH GRAVEL
9
SM
E
1
1
1
WAS GROUND WATER ENCOUNTERED'
TF YES Q WIUT D17nn
DEPTH OF WATER AFTER
DATE OF MONTTORTNO,
MONITORfNO: �» �} � 0%
eavmes EP
DATE READING GROSS TIME NET TIME
DEPTH OF
jNFT DRQQP
(MINUTES) (MINUTES) (INCHES) NCHES!
4/15 TEST HOLE PRESOAKED PRIOR TO TESTING:
1 9:14 12.0' RECHARGE
2 9:45 30 11.25' 0.75'
3 9:46 12.13' RFCHARC.F
4 10:16 30 11.38' 0.75'
5 10:17 12.0' RECHARGE
6 10:47 30 11.25' 0.75'
PERCOLATION RATEI40 (MINANCIO PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 3 Ff. and 4 FT.
COMMENTS: NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/8/2005
PERCOLATION RATEI40 (MINANCIO PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 3 Ff. and 4 FT.
COMMENTS: NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 7/8/2005
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 19, BLOCK 8, THE TABLELANDS SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new Four Bedroom Advantex Treatment System, which includes a
septic tank sized for four bedrooms with an AX -20 Pod to serve the
proposed home on the lot. A second lift station will also be required.
The new system will be placed at the location shown on the Site Plan.
The new septic system also includes the construction of 2 new 60'
long X 5' wide X 1' effective depth absorption trenches at the location
also shown on the Site Plan and at the configuration shown. The
distribution line in the trenches will be placed at the existing ground
surface. The total depth of the trenches will be 1' below the surface.
The new system must be placed a minimum of 10' from the water
service on the lot and those on adjacent lots and 100' from any
surface water located near or on the lot.
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.
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
The Advantex Treatment System must be installed in conformance
with specifications and regulations furnished by the manufacturer,
Anchorage Tank and Orenco Systems Incorporated. No variances
Lot 19, Block 8, The Tablelands
July 8, 2005
Page 2 of 4
from the manufacturer's specifications will be allowed without
permission from the manufacturer and Municipal representatives.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
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 trenches shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C" Well or 200' from any community well.
6. Direct bury insulation must be placed over the distribution system if
less than T of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trenches to drain away.
Lot 19, Block 8, The Tablelands
July 8, 2005
Page 3 of 4
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.
MATERIAL SPECIFICATIONS:
1. 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.
SAND GRADATION:
1. Sand used to level the new absorption bed must have the following
gradation:
50% Passed the No. 4 Sieve
2% Passed the No. 100 Sieve
1% Passed the No. 200 Sieve
2. The sand source must be approved prior to use.
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
Lot 19, Block 8, The Tablelands
July 8, 2005
Page 4 of 4
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as -built of the completed system.
Municipality of Anchorage
Development Services Department
�.r Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Anderson Engineering
Legal description: The Tablelands Subdivision Addition #1. Block 8. Lot 19
ZD
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. Proposed absorption field to be constructed over organic layer.
Name of reviewer: Julie Makela. P.E.
Date: 7/8/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Municipality of Anchorage -
On -Site Water & Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-801-64 Expiration Date:
1. GENERAL INFORMATION
Complete legal description THE TABLELANDS #1 • BLOCK 8 LOT 19
Location (site address)
Current Property owner(s)
Mailing address
Real Estate Agent
22432 BLACKTAIL CIRCLE *CHUGIAK AK 99567
LOUBRIEL RICHARD Day phone C/O AGENT
CMR 489 BOX 1465 APO AE 09751
DAYTON WILL Day phone
2. TYPE OF DWELLING:
N Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
317-8712
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
Public Sewer
❑
Received by: {'�f�1 ;;�
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 0'�O
Date of Payment I C) k VAh3
Receipt Number O:3 5 a
COSA # oSC 1315
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seat 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. 1 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal tight whatsoever.
6. DSD SIGNATURE
i
System #1 Approved for bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone
337-6179
Date �� �d /1 3
oo6�0O
OF A �4p
49T y�d0
_
�...:....... ...... ......
*.
ff Gorn as.-
E— mp
009• �J? t� p
Pro f e s sio""\\
bedrooms, with the following stipulations:
By:J� (:fJ(6 �. _ r Original Certificate Date: C
The Municipality or Anchorage Develop, emt 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. ATTCHMENTS:
COSA Checklist f/ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
rR— >>ms
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
Legal Description: THE TABLELANDS #1; BLOCK 8, LOT 19 Parcel ID: 051-801-64
A. WELL DATA
Well type
Date completed
Total depth ft.
Date of test
Static water level
Well production
WATER SAMPLE RE:
PUBLIC WATER
If A, B, or C provide PWSID# _ Well Log
Sanitary seal (Y/N)—
Cased to ft.
FROM WELL LOG
Coliform _colonies/100 ml.
ug./L.
B. SEPTIC/HOLDING TANK DATA
g.p.m.
Nitrate mg./L.
Date of sample:
Wires properly protected (Y/N)
Casing height (aboround) in.
AT IN CTION
ft.
9-P M.
Collected by:
Tank Type/Material STEP/STEEL Date installed 10/3-4/05
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping Pumper See 111 Lck) A r
C. ABSORPTION FIELD DATA *BELOW EXISTING GRADE
Date installed 10/3-4/05 Soil rating (g.p.d./ft'or /bdrm
Length 2 O 63' ft. Width 5 ft.
System type SHALLOW TRENCH
Gravel below pipe 1 ft.
Total depth *3.79+/3.91 + ft. Eff. absorption area 630 ft' Monitoring tube YES Depression over field NO
Date of adequacy test **9/31 /13 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test E in. Water added 1 140 gal. New depth 6_5 in.
Elapsed Time: 225 min. Final fluid depth E in. Absorption rate >= 600+ g.p.d,
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date -
**SOUTH TRENCH TESTED ONLY. NORTH TRENCH HAD 1 INCH OF LIQUID IN IT AT TIME OF INSPECTION.
D. LIFT STATION
*SEE ATTACHED MAINTENANCE REPORT
Date installed 10/3-4/05 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at TIMER in. "Pump off" level at TIMER in. High water alarm level at 11 in.
9�5 w--
Datum TOP OF PUMP f' Cycles tested * Meets alar & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent
Absorption field on lot On adjacent lots
Public sewer main
Sewer /septic service line
areas
manhole/cleanout
Holding tank
Manurelanimal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+ _
Water main 10'+ Water service line 10'+ Surface water, 100'+
Wells on adjacent lots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Properly line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date f Ob 13
(Rev. 11105)
NE I WAI
A. ssr
79 3
r
0
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND 01+ P� -� 14JC,;0_q L —
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
wAe2t. J 7'
Day of of 201 ?, by and between Aabi 'Lit L., rJ kS 4+ 44LL,
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Maintenance and Repair Agreement agree as follows:
1. Advanced Wastewater Treatment Svstems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
located at (legal description).
2. Definitions.
Alteration. Any change to the design or function of an AW WTS that
includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design.
Certificate of On -Site Systems Approval (COSA). An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with Anchorage
Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that
the systems are adequate for the homes that they support and meet the
codes that were in place at the time of system construction.
Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
Permit. An On -Site Wastewater Disposal Permit as required by AMC
15.65 to construct and operate an AWWTS.
3. Term. The term of this Maintenance and Repair Agreement shall begin on the
date of approval by the Municipality to operate the installed system or issuance of a
COSA, and shall continue while the AWWTS is in use or is operational or until the
property is sold or title is transferred by the oil ner and a new COSA is issued to the
new owner or transferee of the property.
4. Alterations, Installation and Removal of Additional Equipment. Prior to
performing any alterations to an AWWTS. the owner agrees to obtain an On-site
Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65.
5. Maintenance and Repairs.
A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall
maintain their AWWTS in a satisfactory condition capable of producing treated
septic effluent in accordance with the equipment's approval for operation in the
Municipality. The owner shall enter into a service agreement with an AWWTS
0
0
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the A W WTS. In addition, it
shall be the responsibility of the Owner during the tenn of this Maintenance and
Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay
for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement
costs, and (5) inspection costs.
B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules
and orders for the AWWTS.
C. Upon request by the Municipality, the owner agrees to provide the Municipality a
written schedule of routine maintenance and repairs which have been performed
on the system. When a record of maintenance is documented and maintained by
the system vendor, the owner agrees to allow the Municipality access to this
information.
D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS
may be assessed in accordance with AMC 14.60 for improper discharge.
E. Owner agrees that only maintenance and repair personnel approved by the
Municipality will inspect and make any necessary maintenance, repairs or
permitted alterations to the system.
F. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
G. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AW WTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AW WTS.
6. Nonwaiver. The failure of either party at any time to enforce a provision of this
Maintenance and Repair Agreement shall in no way constitute a waiver of the
provisions, nor in any way affect the validity of the Maintenance and Repair
Agreement or any part hereof, or the right of such party thereafter to enforce each and
every provision hereof.
7. Amendment.
A. This Maintenance and Repair Agreement shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with
the same formality'that this Maintenance and Repair Agreement was executed
with, and such writing shall be attached to this Maintenance and Repair
Agreement as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this agreement, the only authorized representatives of the parties
are:
a. Owner:
b. Municipality: Director. Community Development or designated authority
C. Any attempt to amend, modify, or change this contract by either an unauthorized
representative or unauthorized means shall be void.
0
8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance
and Repair Agreement shall be brought in the Superior Court for the Third Judicial
District of the State of Alaska at Anchorage. The laws of the State of Alaska shall
govern the rights and obligations of the parties under this Maintenance and Repair
Agreement.
9. Severability. Any provisions of this Maintenance and Repair Agreement decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining
provisions of the Maintenance and Repair Agreement.
OWNER:
e) D
By � /i �% (signature) D /U 7 /
(Prt ame)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
jh
The foregoing instrume t was acknowledged before me this day of
201 , by WQYrt*, n ,
&ate vfAkska
JNOTARY PUBLIC
Stacle Horne
NOTARY P BLIC FOR AL Kl�$ A mywmlwo„Dom 901,loll
My Commission expires: 12 i l
MUNICIPALITY:
By: _ (signature) Date:
name) Title:
L911A t{kIn(uWZ
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and 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
FOR A SINGLE FAMILY DWELLING
Parcell.D. 051-501.64
COSA #__LXpn i 13
1. GENERAL INFORMATION Expiration Date: F — —0 %
Complete legal description Lot 19. Block 8, The Tablelands Subdivision No. 7
Location (site address) 22472 Blacktall Circle Chugiak, AK
Current Property owner(s) SpineA Homes, Inc.
Day phone 344-5678
Mailing address 1900W' Nanhem Lights Blvd., suite 200 Andwrage, AK 99517
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be
hold by DSD for pickup.
2. NUMBER OF BEDROOMS:
Four (4)
3. TYPE OF WATER SUPPLY:
Individual Well
TYPE OF WASTEWATER DISPOSAL:
Individual Water Storage
❑
❑
Individual On-site
Community Class Well
❑
Individual Holding Tank
❑
Public Water SystemIDPublic
Community On-site
❑
Sewer
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite Systems Approval
are valid water for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
sample Certificateslare valid fos. (Certificates
one y atrfor properties lssued servedor a by Class A or B wells orod Of UP to eyear a public �wa valid water
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 Onsite Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and Inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of Installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineers Printed Name Michael E. Anderson, P.E.
Phone 522-7773
Date 3121=6
�
49th *N*
6. DSD SIGNATURE �c
pwai L c muXSOI
�l �1��j� No. tt-43e1
✓ Approved for T/' bedrooms.
44 )4
Disapproved. shr,sn�`r
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
445)
By: !N Original Certificate Date: 6
in«. 11405)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water b Wastewater program
4700 Bragew Straet
P.O. Box 19=0
Anchorage, AK 9951 94M
Www.muni.org/onsite
(907) 343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: La 19, Hlodr 0. TM rsoon,e. SubdlMM Na t Pa=I ID eat -W144
A. WELL DATA
Well type,_, BA, 8, or C provide PWSID d
Date completed _ Sanitary seal (YM) —
Total depth R. Cased to R.
FROM WELL LOO
Date of teat
Static water level 1L
Wait production 9 -p.m -
WATER SAMPLE RESULTS:
Coliform colonlea/100 mL Nitrate mg&
Arsenic: — . mgA Date of sampia:
B. SEPTICIHOLDING TANK DATA
Tank Type/Materiel ssonr sr„uAdvwIte7
Tank sae iAco gal. Number of Compartments Two
Foundation deenout (Y" Y Depression over tank (YIN) N
Date of pumping New Corasrresorn Pumper
C. ABSORPTION FIELD DATA
Wed L09 (YIN)
Wires property protecw (YIN)
Casing height (above ground) in.
AT INSPECTION
R.
9 -P.M.
Other bacteria coloniesMoo mL
Collected by:
Date Installed lam an
Cleanouts (Y" v
High water alarm (Y/N) v
Date Installed iamos Safi rating (g.p.d.fle or R°/bdnn) .4a oPOrsF
SyEtem type s Wbs Trerrdr
Length 120 R. Width 5
R• Gravel below pipe t R
Total depth t R. Eft. absorption area eoo R' Monitoring lube Y Depression ova fieldN
Date of adequacy test New Cann Rssuits (PasalFaff) For _ bedrooms
Fluid depth in absorption field before test in. Water added
gal. New depth in.
Flamed Time.
mm. Final fluid depth in. Absorption rate
g.p.d.
Any raluvenatbn treabrrerd (peat 12 mo.) (YIN d type) If yes, give data
D. LIFT STATION
Date installed Size in gallons
'Pump on' level at _ in. 'Pump ofr level at _ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankilifi station on lot
Absorption field on let
Public sewer main
Sewer Iseptb service Ina
ManholelAeeess (YM)
High water alar level at in.
Meets alarm b circuit requirements?
On adjacent Iota
On adjacent Iota
Public sewer manhole/cleanout
Holding tank
Animal r 1 inment areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation >5' Property line>S
Water main »e' Water service line »a
Absorption field W
Surface water >iw
Wells on adjacent lots >,=
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property Una »a Building foundation >iC Water main »a
Water Service Ina »a Surface water >100' Ddvevrsy, paftWvehkJe storage >2S
Curtain drain Nara NOW Wells on adjacentbis »lw
F. COMMENTS: totl0servedbyANNV1JWeWsyarom.
O. ENGINEER'S CERTIFICATION
I certify that I have determined through field kmpecfto and
review of Municipal records chat the above systems are in
cordormance with MOA COSA guldelines in effect on flits date.
Engineer's Printed Name Mklud E- Anders^ P.E.
Date 11412005
COSA Fee $ 57 sr+ + 115
Walver Fee S _
Date of Payment 44 - 4 - GIs Date of Payment
Receipt Number 19Pq Receipt Number
(Rev. lit"
aJ 49th
2004-131
THE TABLELANDS, ADDN. NO. 1
LOT 19, BLOCK 8
60,745 S.F.
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 9950:
PHONE 248-5454
GRID DATE
Nw 1559 12/26/2005
F.B. JOB N0.
05-16 TL5198
B LAC KTAI L
CIRCLE
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE
OF q'411Pj
••..f
�.:::..AIV co49I1i••�1....: *•0
Air
. J•tt•ry A. Gastaldl
L$-6091 : AV
