HomeMy WebLinkAboutPITZER LT 4Pl*tzer
Lot 4
#090-021-58
FROM : FiLPIN'c IfRILL1NG FAX NO. : 907 345 0202 Jul. 09 2007 09:34PM P2
ALPINE DRILLING & ENTERPRISES
Permit Number: kSWQ= Date of Issue: 7-M:" Pared Identification NumbcrsQ20-021-58
Date Started: 10-6-06 Date Completed: 10-6-06 Is well located at approved permit to ation? ® Yee ❑ No
Ugal Description: or t 4
Property Owner Name & Address: Cendeee Stophonaon � p t[S �Yi► C t^G✓
243 Raleigh Terrace Q
Borehole Dats:
Soil Type. Thielraess & water Strata
Depth (h)
from To
Method of Drilling (g &rotary ❑ cable too)
Casing type: Xtal
Stick-up .
0 2
WallThiclmeas:,2LO inches
sW Ora Vol
2 54
Diameter: ¢ inches ' Depth:14 feet
pro vedyM
54 105
Liner Type:
s1ky sandygrave! H2O
105 140
Diameter: inches Depth: _ feet
Casing stickup above ground: 2 feet
Static nater level (from ground level): Zjfeet
Pumping level: 4 feet after
2 hours pumping IQ SPS
Recovery Rate: 2Q Spm
Method of Testing: e!r l
Well Intake Opening Type:
® Open End ❑ Open Hole
❑ Screened Start fest Stopped `feet
❑ Perforations Startfeet Stopped ` feet
Grout Type: hemonite rynuls Volume: j
Depth: StartQ feet Stopped feet
Pump: intake Depth feet
P=p sire hp Brand Name
Well Disinfected Upon Completion? E Yes ❑ No
Method of Disinfection: chorine teDlets
Comments: Well 42
Well Driller: Alpine DnWng & Enterprises
PO Box 110495
Anchorage Alaska 89511
Attention: The sell driller shall provide a well log to the l roperty owner within 30 days of completion and the property
owner of the well cullet shall provide a well loq to the Dev tlopmaat Services Department within 60 days of compledon.
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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 WATER SUPPLY PERMIT
Initial
Permit Number: SW060208
Legal Description: Pitzer Lot 4
Design Engineer: 0844 WATKINS ENGINEERING
Owner Name: CANDACE STEPHENSON
Owner Address: 245 E. RALEIGH TERRACE
MUSTANG. OK 73064 -
Date Issued: Jul 20, 2006
Expiration Date: Jul 20, 2007
Parcel ID: 090-021-58
Site Address: Seward Highway
Lot Size: 37423 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
-THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55.
PLEASE SEE THE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM".
Received By:
r
Date: V24/o o 6
Issued By: Date:
Municipality of Anchorage
! Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 090-021-58
Property owner(s) Candace Stephenson Day phone
Mailing address 245 E Raleigh Tertace. Mustang. OK Zp Code 73064
Site address Seward Hwy, Indian, AK Zip Code
Legal description (Sub'd., Block & Lot) Pitzer Lot 4
Legal description (Township, Range & Section)
Lot Size 37,423 Sq. FL
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
❑
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
Water Storage
❑
Number of Bedrooms 3
THIS APPLICATION IS AN:
Initial
❑
Upgrade
❑
Renewal
❑
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.
GUMS, PZ-.
(Signature of propedy owner or authorized agent)
Permit/Rush Fees:' U Uu Waiver Fees:
Date of Payment: 1'¢ LZ Date of Payment:
Receipt Number. 08 3 I / 3 Receipt Number.
(Rev. 11105)
Watkins Engineering, Inc.
RO Box 110443, Anchorage, AK 99511
(907)349-1851 cwellis@gci.net
July 14, 2006
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: Pitzer S/D, Lot 4
Proposed Well Development
To Whom It May Concern:
Attached please find the application and supporting documentation to drill a private well
on the referenced property. The existing well, drilled in 2004, is too close to the
adjacent lot's septic system, and is proposed to be abandoned. The well is proposed to
be at least 100 ft from any existing septic system.
I am not aware of any adverse effect that this well development would have on any
adjacent properties' water and wastewater treatment needs.
Thank you for consideration of this permit application. If you have any questions or
need further information, please call me at 349-1851.
Yours truly,
Cindy W Ellis, P.E.
President
septic area \
\ \ Lot 17 avPrex \ \
septic area \ \
q.i \ spprex \
/ U.S.S 3201; lot 32 \ / ,� Lot 18_ \
i well\ I \ � /
\� I \ \ } well I
ExistingExisting \ `� \ aPp� /
septic
system Well -to be Lot,
abandoned , /� \ roplQsed
\� �well-
to
be
_Ml' �� abandoned I Maio �Qb /
CID
Proposedll:a \/ / �� Lott
Well
v Qa�Jt'� Lot
JLot 3
UNDE LOPED /
u47/VQ
\ /
RIGHT-0F-WAY
q�
Pitzer Subdivision Lot 4 5� O..F..A (,Q�pO°
Site Plan for Candace Stephenson
Grid SW4659 Watkins Engineering, Inc. o S'
oo A TH
Parcel ID 090-021-58 p o 49 — .
p... ....��....{../..G.�./.J........ 4
�.}��i44G�.Ill.
Cindy W. Ellis, P.E. Box 110443 Oa; '.. °GSE -10577 is
Styl13, e 1'20100' Anchorage,) 3 99511-0443 °�0`" ..
Phone: (907) 349 1851 Fax (907) 349-1934 o
CO
US Survey 3201, Lot 32
1988 bed
drainfield
970//
/
11
I I
Proposed
well site /
/
Pitzer
\ Lot 1
\ h \79`9?
ejv
Existing well (2004)�\ I I
to be Abandoned
Lot4
hI
J plea
C - /
UNDEVELOPED
A.h
R �ygRo ��'4 A Fqs
Lot 3
( u
Sooas�
pb
wqY qy ti
Based upon a survey
by Shane A. Holt LS -6914
April 19,2006
Pitzer Subdivision Lot 4
Proposed Well Development
Candace Stephenson
Parcel ID: 090-021-58
Cindy W. Ellis, P.E.
July 11, 2006
Scale 1 Inch - 40 ft
Watkins Engineering, Inc.
P.O. Box 110443
Anchorage, Alaska 99511-0443
Phone: (907) 349-1851, Fax: (907) 349-1934
/
/
/
/
49 THW
W. Ews
- 10577
R
C
Municipality of Anchorage
V Development Services Department 7Cy'
Building Safety Division
- On -Site Water and Wastewater Program, 4700 S. Bragaw St. 2
P.O. Box 196650 Anchorage. AK 99519-6650 Page ' of :
www.d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWO40189 PID Number. 090-021-58
Ram.: Candace Stephenson
Wastewater System: ❑ New it Upgrade
Old Seward Hwy, Indian, AK
ABSORPTION FIELD
pa«": Na.Wx of B*&,xm: 3
ODap T«xir OslWb Tn Elaw ❑Mou.a ❑om«
LEGAL DESCRIPTION
���' 3.0AdvanTex
Taao.an o
GPOFP
F,,
abrY LK sWdw,n:
4 Pitzer
oepthw pbo ftw.ong"R,.a:
Gm a.pm t,ee,am pp.:
+0.52 F,.
0.52 Fl.
Tc~q: Row: Sp :
Fa.pese Wow orpna tFaa:
Davi L«ipn:
3.6.4.0 Fr.
20 FI.
Well: i] New [3Upgrade
CNF4 wWL
10
MnW«aMW:
2
GnMnG O.Ivwen r,a:
5
F,,
F,.
Gbwlraian (Pm.b. A 6. GF
Toa Ope,:
caswi b:
7" .bacm, x.a:
FV. MatwW:
Private
123 FI.
123 FL
200 Fe
ASTM D3034
omb .
Alpine Drilling
Data Dano:
9-1504
staac wax L":Inxlrbr.
79
Scoffs Services
Dab wsatw:
10-9-04
F,.
v,a:30
PvpsalOL
C."H. Qa Gra
TANK
GPM
unknown FL
+
SEPARATION DISTANCES
El Septic []Holding ❑S.T.E.P. ❑Other:
To
Septic
Absorption
Litt
Holding
lublidPrivale
Ma" 1 ...'
ty-
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank 8 Welding
1500 Ga.
w«
115
125
135
NA
105
M.tana. 3/16" steel w/epoxy coating
Ru 2 acxm+w ta"b:
SWrW. Wax
100+
100+
100+
NA
LIFT STATION
La Lim
40
25
35
NA
100 Ga.
atlWN.
a Anchorage Tank
'P oW, .N.1:
1- roar Wx a.Ipn..i«w
@1:
Fmwatw
13
30
30
NA
32 b.
22 a,.
36 W
NA
NA
NA
NA
Pbp Max. a Meal
EMxmol Inpx l p«rpnre by.
#,Dj1Xtn Qyy\ltav`
C~Daa,
m KFz++
R~$: Old septic system abandoned in place.
BENCH MARK
Locx,n «a O.wiUan:
Door threshhold, west side of the house
4roton:
100.70 F1.
Engineers Stamp
`rr F
(�•..R.......A�q
Inspections by: Cindy W. Ellis, P.E. Dates: 1°' 10-8-04
h` y
*: 49TH ;.*
performed
2ne 10-9-04
Development Services Department Approval,
Cihdy W. Ellis
Reviewed and approved by: Date:
CE -10577
(Rev. I]Alo)'•
c,'
���/
Permit No. SW040189
Page 2 of 3
DATE: 2/3/05 Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT4, PITZER SUBDIVISION PID No.: 090-021-58
I /
1 /
1 /
\ / OLD DRAINFlELD
X, ,ABANDONED IN PLACE
MT1
\ MT2
MARK
A
B
C
1 0
WELL
69.3
110.0
DC01
50.5
2.6
DCO2
51.5
2.4ST1
67.2
17.2
140.3--
MH (TANK)
74.5
23.2
PUMPVAULT
83.2
31.4
MT1
84.0
34.4
MT2
94.9
49.4
WELL
I$
i
i
A i
D �
i
HOUSE
=bc fzc, B /
DCO2 /
\
AD\AVM POD /
\\ . TH/1 MH I /
ADVANTtX AX-2rd W/ 1,500
/ CALLO�Q 3/STEEL TANK
WR}j EPO COATING
i
PUMP/FAULT
ASBUILT
SCALE: 1'=30'
UNE
_ '491H.
•.*
Cindy W. Ellis
No. 105771
(f1��A4OFE$510��C
Permit No. SW040189 Page 3 of 3
DATE: 11/22/04 Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT4, PITZER SUBDIVISION PID No.: 090-021-58
DCO2 FINAL RA I
11
4'
DCO1 STI
PV (PUMP VAULT)
47'
ADVANTEX
AX -20 POD
—P --TO TRENCH
1,500 GALLON 3/16'
4.1
STEEL TANK WITH
EPDXY COATING
. e
SEPTIC SECTION
N.T.S.
MTI
MT2
FINAL GRADE = 101.93'-102.36'
TOP OF PIPE = 99.06'
INSULATION AND
FILTER FABRIC
98.38' p
p
1.5'0 PIPE WITH 0.25'
SEWER ROCK)
HOLES AT 24' O.C.
SAND
T
ORIGINAL GRADE
98.0' - 98.38'
BOTTOM OF EXCAVA/1ON = 94.57'-95.00'
PIPE INVERT = 98.90'
T
RELATIVE DEPTH OF
TESTHOLE - 90.38'
TRENCH SECTION
WATER AT 94.38'
N.T.S.
i * 49TH *+�/
Ci y W. Ellis
N 10577
o.
11/17/2004 WED 07:42 FAX 907 S:_ 3995 R-iVEN ELECTRIC INC
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Joumcym n Ek-wkian
Ce9: 19071 3016079 nV�Y
Pager 19071Z75-0033 tis=
Pn 19071'N9-9"8
Fa : 19071522-3995 WZ53d�oon Sows
Drove ra.erwk vlche.v"k4 klne.ca Ancna age, AR 99518
FMi : ALPHE DRILLIIIG
Mayor
FA,{ 110. : 907 375 0 OC Ila.,. 29 2W4 07:CL"I Pi
Municipality of Anchorage
Department of Health and Human Services
825'C Street
P.O. Box 196650 Anchorage. Alaska 9951"650
ht4>* ww.dandrorage.akus
Permit Number. #SW 040189 Date of Issue. 6-14-0 i Pared Identification Number.1
Date Started: 544-04 Date Completed: 915-04 is well locared at approved permit location? ® Yes 0 No
Legal Description: PilzerLot 4
Property Owner Name & Address: Candace Stephenson
$709 Denali Street
Borehole Dara:
Soil Type, n1da ass A Wacr Suers
Depth (ft)
From To
Method of Drilling ® air rotary ❑ cable tool
Casing type: sem/
stick-up
0
2
Wall hkkww:,g inches
organics & SN
2
12
Diameter: § inches Depth: 123 feet
slltygravel
12
8o
Liner Type:
gravelly sell - wet
80
120
Diameter: inches Depth feet
Casing strckup above ground: Z feet
water sand & gravel
120
123
Static water level (from ground level): 79 feet
Pumping level: 120 feet after
2 hours pumping 30 gpm
Recovery Rate: 22 Spm
Method of Testing•_ air rift
Well Intake Opening Type:
® Open End ❑ Open Hole
❑ Screened Stare feet Stopped fact
Perforations Start feet Stopped feet
Grout Type-. bertionite # 8 Voloate: j
Depth: Siang feet Stopped Z feet
Pump: Intake Depth feet
Pump sin hD Brand Name
VWell Disinfected Upon Completion? ® Yes ❑ No
Method of Dirinfoction: ,ht�o me te0lofs
Comments:
Wed Driller: Alpine DMing & Enterprises
PO Box 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to the property- owner within 30 days of completion and the property
Municipality of Anchorage
Development Services Department
• Building Safety Division
On-site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 198850 Anchorage, AK 99519-68W
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Watkins Enoineerino
Legal description: Pitzer. Lot 4
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. -
0 Other. 1.1 Please indicated status of old well: 2.) The upper six
Name of reviewer. JTulie Makelo. P.E.
Date: 3/4/2
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
M
MUNICIPALITY OF ANCHORAGE l an rn q�
Development Services Department
On -Site Water 6 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: SW040189
Legal Description. Pitzer Lot 4'
Design Engineer: 0088 Anderson Construction & Eng'g
Owner Name: Candace Stephenson
Owner Address: 5709 Denali St Apt. G
Anchorage , A 99518 -
Date Issued: Jun 14, 2004
Expiration Date: Jun 14, 2005
Parcel ID: 090-021-58
Site Address: Seward Highway
Lot Size: 37423 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
-THE BOTTOM OF THE PROPOSED SEPTIC FIELD NEEDS TO MAINTAIN 4' VERTICAL SEPARATION FROM
GROUNDWATER. TO MAINTAIN THIS 4' VERTICAL SEPARATION FROM GROUNDWATER THE BOTTOM OF
THE SEPTIC SYSTEM NEEDS TO BE AT GROUND LEVEL OR HIGHER.
-EXISTING WELL ON LOT NEEDS TO BE PROPERLY ABANDONED PER AMC CODE PRIOR TO THE
CONSTRUCTION OF PROPOSED SEPTIC SYSTEM.
-PRIOR TO SIGNING OFF THE AS -BUILT, THE PROPERTY OWNER MAINTENANCE AGREEMENT NEEDS TO
BE COMPLETED.
-THIS PERMIT IS FOR THE PROPESED SINGLE FAMILY DWELLING ONLY, AS PROPOSED.
Received By.
Issued By.
Date:
Date: 64/9
Municipality of Anchorage
,,• B4.
-r
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. 690- 021- SS Permit Number SW
Property owner(s) [i1404r-F S7-FP/It2vS6 -J Day phone ?Go -1941- yyij
Mailing address (1) Sqo&"'tLf S7 /MT 'r7
Mailing address
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size r M �q.Ft.
THIS APPLICATION IS FOR:
A fc- Zip Code 945-1 F
Number of Bedrooms 3
Sewer Only ❑ Well Only ❑
Sewer and Well � Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:�/f -7 5- ? G P,5- Waiver Fees:
Date of Payment: ig/ /0 �a Date of Payment:
i
Receipt Number: Receipt Number:
(Rev. 12100) -,
Michael N. Anderson, P.E.
Civil/Structural Engineering
4640 Shoshoni Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
June 10, 2004
Municipality of Anchorage
Department of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re: Lot 4 Pitzer Subd.
To Whom it may concern:
This is a request for a new septic & well permit for the above residence. The existing house is to be
removed and a new residence constructed as the plan shows. The well will also be relocated. The
soils were silty gravel (GM) with water at 4 feet. A thin layer of peet was observed at 2 feet, this will
be removed for the new leach field. Several test holes were excavated with similar results. The perc
rate was 36 minutes per inch in the top of the silty gravel at elevation 1.0 feet. The Omeco Advantex
system has been designed for this lot due to the high water table and poor soils. Drainage is to the west
at about 1 to 2 percent. No slopes greater than 25 percent exist near this property.
This new system will not impact the neighboring properties due to the large lots and layout of the
existing systems. The maintenance agreement will be handed in by the owner when it is complete.
If you have any question please call me at 345-3377
Sineerel
Michael N. Anderson, P.E.
DESIGN CRITERIA: MOUND OVER
4 BDRM X 150 = 600 GPD
SOILS = 600/3.0 = 200 SO FT REO'D GRADE 21 INSULATION
200 SO FT/10' WIDE = 20 FEET RAIN ROCK
T rO &l<
BED SYSTEM GM T
0.5' DEEP -2 OR
0.5" EFFECTIVE GM FILTER SAND
10.0' WIDE
20' LONG -B'0 10.0'
BIRD
TURN4C4/N ARM
Septic Design Prepared For
GEORGE PITZER
LOT 4
PITZER SUBDIVISION
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SIIOSIIONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=500'
JUNE 4, 2004
H,cHHgr
r
0 oRo�
�0
.�
OF A�q tl
*
• 49TH
P` - MICHAEL N. ANDERSON
• CEl 9 69 M
_ 10011 PROP(
EXIT
VACANT LAND
1 44 I 1
J
EXISfjNG WELL TO BE / PROPOSED WELL .1
ABANDONED /
EXISTING SEPTIC SYSTEM TO 11` / EXISTING BUILDINGSj1
BE ABAONDONED IN PLACE / �TO BE REMOVED 1\
EXISTING BUILDINGS
TO BE REMOVED
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PROPOSED DRAINFIELD \
ROAD RICHT-OF-WAY
Septic Design Prepared For
GEORGE PITZER
LOT 4
PITZER SUBDIVISION
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SIIOSIIONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=50'
WELL RADIUS —
SEPTIC
NEW ADVANTEX AX -20
W/ 1,500 GALLON
FIBERGLASS TANK W/ 4'
X 8' POD
JUNE 4, 2004
VACANT LAND
OF At,
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MICHAEL N. ANDERSON . "k -
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Septic Design Prepared For
GEORGE PITZER
LOT 4
PITZER SUBDIVISION
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SHOSHONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
NOT TO SCALE
NOTE:
1. ADVANTEX AX -20 BY
ANCHORAGE TANK, INC.
JUNE 4, 2004
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MICHAEL N. ANDERSON
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Septic Design Prepared For
GEORGE PITZER
LOT 4
PITZER SUBDIVISION
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SHOSHONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
NOT TO SCALE
NOTE:
1. ADVANTEX AX -20 BY
ANCHORAGE TANK, INC.
JUNE 4, 2004
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*:49-r"
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MICHAEL N. ANDERSON
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Pe,formed For:
Legal Description:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www ci anchaace.ak.us
(907) 343-7904
Soils Log - Percolation Test
OF Aj;9 �l
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* • 49TH ;*
Via, MICHAEL N. ANDERSON 'R
i•• CE -9469 -!:N.
SIL6_V!S Da:e Pcrl.-q :ed:
tl/ p Township, Range, Section:
Depth (,7 NI
(Feet)
to tri
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3- 47.4
4-
5-
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7-
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6-o
11
12-
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18-
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Sde Plan
WAS GROUND WATER
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ENCOUNTERED?
S
L
DEPTH?
IF YES, AT WHAT DEPT
Depth to Water After
Monitoring?
,Q 0
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Date: V121-0 K
Reading Date
Gross Time
Net Time
DepthwWater
Net Drop
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0
P--t:RCOLATICN RATE _J6 I—tlli x') PERC HOLE CLU.IETER (01
TEST RUN eETNEEN �Iji- FT AND ICD FT
COMMENTS (1' IM lutA C9.1 9 4n [1. •s in 2�
PERFORMED BY: mt e" (I'( /1014-tV 0M _ ( CERTIFY THAT THIS TEST W
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT Off THIS DATE. DATE: 14�I 710'f
_ A
/ FND. ALUM. CAP
N.W. LOT 1
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G1 SHANE A. HOLT.,
a
oOs� LS -6914
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��n�FE551❑Np`1' �
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL
STRUCTURES OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON.
NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES
OR LOCATE STRUCTURES.
AS -BUILT SURVEY
SCALER" = 40'
I HEREBY CERTIFY THAT I HAVE PERFORMED A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 4, PITZER SUB.
ANCHORAGE RECORDING DISTRICT, ALASKA AND THAT
THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
OTHER THAN NOTED.
DATED AT ANCHORAGE, ALASKA THIS _19TH_
DAY OF _APRIL 2006.
HOLT LAND SURVEYING 10101 B, FB 123-64
TEL. 345-5513
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•
•�1; Municipality of Anchorage 4 r �.
. . _ P Y g MAR 0.1 :y
On-Site Water and Wastewater Program ,,
(907) 343-7904
Certificate of On-Site Systems Approval
Parcel I.D. 090-021-58 Expiration Date: JLLfl e i 3 01
1. GENERAL INFORMATION
Complete legal description Pitzer Lot 4
Location (site address) 171 El Rocko Lane
Current Property owner(s) Candace Stephenson Day phone
Mailing address 3402 Preble St. Bremerton, WA 98312
Real Estate Agent Day phone
2. TYPE OF DWELLING:
E Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well El Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
��.�
Received b Date: 115/1B
'� �
COSA to be released to the engineer,unless otherwise requested .y t - engineer.
COSA Fee $ 502 Waiver Fee $
Date of Payment Naps Date of Payment
Receipt Number 0(0/361 Receipt Number
COSA# Oe-)C/3 Oe-)C/3tU&1 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and 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.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 3/1/2018
OFA
i*'•A • i\ ••*IIr
oi
6. DSD SIGNATURE -cz 0
-J System#1 Approved for 3 bedrooms •Seven R. Pannone:
System#2 Approved for bedrooms } -V . CE-8149• ��
Disapproved ��1 `�R�OFEgS�ONA�
Conditional approval for bedrooms, with the following stipulations:
�\Cr3.1-(.__A •.
� Y`+;��\� to a.t'1 f',��;� 1r�S�� F t'�"T'i aa' .�M/.� T
J 1%� ) ci-s, C,aA c�l.`�-i o ���a i.tii�C'- C o,S f (4- I )2)
SPS�Wp�ER o
,a \N FoGRp,• M j
`0)01 F ScR\IN1/4�
CCLA .)-Cier-U-
By: -I11�Ct Original Certificate Date: 3I ( ?)I 201 S
r �
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 sheet_E '• c
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Pitzer Lot 4 Parcel ID:090-021-58
A. WELL DATA
Well type Private tiejoIf A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed 9/14/200p Sanitary seall((Y/N) Y Wires properly protected (Y/N) Y
Total depth.-12-3.
epth d9ft. Cased tem" ft. Casing height(above ground) 24+ in.
140 ik
F'OM WELL LOG 140AT INSPECTION
Date of test W`1
9/14/2004420N 2/16/2018
Static water level T' 913 ft. 75.3 ft.
Well production 3fe i v g.p.m. 3.0 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 0.555 mg/L
Arsenic ND ug/L Date of sample: 2/16/2018 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material AdvanteX/Septic Date installed 10/8/2004
Tank size 1500 gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depressionever tank (YINN)n/N 1'�1 rHiigh water alarm (Y/N) Yt
Date of pumping Pumper SQ 1 V�L.�.e N--lna-net {C
C. ABSORPTION FIELD DATA
Date installed 10/8/2004 Soil rating (g.p.d./ft2 or ft2/bdrm) 3.0 GPD/SF System type BED
Length 20 ft. Width 10 ft. Gravel below pipe 0.52 ft.
Total depth 0 ft. Eff. absorption area 200 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 2/16/2018Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test DRY in. Water added 450 gal. New depth DRY in.
Elapsed Time: 90 min. Final fluid depth DRY in. Absorption rate >= 450+ g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed 10/8/2004 Size in gallons 100 Manhole/Access (Y/N) Y
"Pump on" level at 32 in. "Pump off' level at 22 in. High water alarm level at 36 in.
Datum Bottom of Tank Cycles tested * Meets alarm&circuit requirements? Yes
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+.;
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO: •
Building foundation 10+ Property line 10+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
*See attached maintenance report.
G. ENGINEER'S CERTIFICATION ,,14'c' OF Aqkkk
1 certify that I have determined through field inspections and r
review of Municipal records that the above systems are in 0* '49 %\ 00,
conformance with MOA COSA guidelines in effect on this date. `•i• • p
Engineer's Printed Name Steven Pannone .', . }even 13.•I5annorie:••",
Date
3/1/2018 61:... CE-8149• fl
k11tk\`` "C
COSA canary sheet_2-6-15.doc
08/14/2017 07:49 8686770 APLUE, PAGE 03
1 290 648 E
MR ■ ■R■R ■ ■RRIN ■ R ■RR RI ■ ■■■■ 3
ulr ■. ■ R M MMM RR ■■ ■ ■ ■ ■■■ ,4
N M ■■ ■■ ■ I. RR MCI M RIRR ■■ No
Advafl17x° Field Maintenance Report
AnchorageTank
Annual Inspection 907-272-3543
?many OwrnUrrecking 0 OPerntor
Candace Stephenson Larry Betts
Site Aedreae Contact Phone
171 El Rocko Lane, Bird Creek AK 99540 907-653-7275
Ax sea IDA caaty to it Pod# nrU ANL A Date of Leat Inspection
AX-103945 SW040189 203796 RTU103468 06/02/2016
Retrieve O&M Info Measure Sludge/Scum
Daily flow Sludge Scum
Reclrc ratio
let Compartment Current f` Previous Current Previous
Timer settings; 'L1
2nd Compartment Current Previous Current Previous
Inspect/Clean AdvanTex Filter
Inspect Clean
Odor: j2IrNormat ❑Pungent Laterals/Orifices 4
Perform Field Sampling/Observations
Blomat: , Normal ❑Excessive Pod Bottom
NTUU(155 a NTUs) pH(6-9) DO(2-6) BrldgIng/Pondl g: IJP None/Minor C Excessive Intake Vent ..2./ • c I Inspect/Clean Discharge Pump System
Odoruof Sample InspectInspect Clean
Typical Musty ❑Earthy ['Moldy Riser/Lid Floats ��r
Non-typical }]Sulfide ❑Cabbage LI Decay Splice Box Pump YI
Oily film in PVU ❑Yes I No Float Cordo
Foam in tank ❑Yea r-�,No Inspect/Service Other System Components
Inspect Clean Inspect Clean
Check Control Panel
Disinfection Equipment rY� Dispersal Laterals/Orlflcerr --❑
Racire Amps Discharge Amps Observations
M..r I'`
IJ l Additional Services Rend red
1
❑clowned textile,sheets? ❑Replaced UV items?
Audible and visual alarms ,OK
❑Replaced/Used other Items?
Dial tone(telemetry only) Yea ]No
Parts Used:W=Warranty,B=Billable(✓appropriate selection)
Inspect/Clean Pump System w a item Number Description
Inspect Clean
Riser/Lid VT
Splice Box 7
Float Cords 7 ry
Floats 7 Y- Final/Safety Inspection -�f
Pump _ RSV reinstalled !—Lids bolted on
Blotubee Filter /Manifold recomected;flush valves closed Control panel reactivated
Biotube Pump VaultSummary/Recommendations
Recirculating Splitter Valve _ _ ]System performing:no further action needed L Tank needs pumping
❑Call for service ❑Other?
Comments
Signature 'ffill4ge°P....'
Date_40_417
Fax completed form to 1-866-384-7404
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND D U&# n aurid Gree-n Ve-e
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
lo Day of 1%brw Ax 5 of 20I , by and between DIfi'n ndatlas l rlen Pic
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 Systems. Municipality grants permission to
Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as
Mil X
located at(legal description).
lei i _ex. L1
2. Definitions.
Alteration. Any change to the design or function of an AWWTS 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 owner 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
H. Owner agrees that the AWWTS installation and maintenance requirements as
provided by the AWWTS vendor/installer and approved by the Municipality are
the governing guidelines for the construction, maintenance and repair of the
Owner's AWWTS.
I. Owner agrees to provide and maintain a telephone connection to the AWWTS as
required by the AWWTS approval.
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: DWW11(\ C C.lyt, E1►'i~.Qnite-
b. Municipality: Director,Community Development or designated authority
service and maintenance provider approved by the municipality and the
manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it
shall be the responsibility of the Owner during the term 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 maintainedby
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.
C. Any attempt to amend, modify,or change this contract by either an unauthorized
representative or unauthorized means shall be void.
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.
s ! R: /
By' AIL A AAA-kA. (signature) Date: " I I
A ! .A (print name)
WWI
STATE OF ALASKA )
)ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was ack owledged before me thisJG y of j, ,
20IS by JD CE.LK'A,J' sr Op ((JJ
I I .._. A A / - '1i .r r o "�-`�c ,
i'O'ARY P :LIC FOR ALASKA 3 FEB 2 6 2018
My Commission expires:Vd
ps
MUNICIPALITY::
By: �RtitL (2CC J%(J
(signature) Date: 3/5/201
R Aoecceax-ro U (print name) Title:
ri _ - - 4
i I FNO.ALUM. CAP
/ N.W. 1
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/// ��Cjv• SCALE 1 AS-BUILT•SURVEY
dtlY' \\ / I HEREBY CERTFY THAT I HAVE PERFORMED A
V . J MORTGAGEE'S DESCRIBED
INSPECTION OF THE FOLLOWING
\\ / DESCRBED PROPERTY.
\ N.
N. / FNO. BRAES CAP LOT 4,FITTER SUB.
41 \ - _ �✓ 6E LOT 3
THE INFORMATI3N HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY 70 SHOW ANY CONFLICTS BETWEEN
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL ANCHORAGE RECORDING DISTRICT.ALASKA AND THAT
STRUCTURES CR FENCELIES THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
PROPERTY UNES AND NO VISIBLE ENCROACHMENTS EXIST
EASEMENTS OF RECORD,OTHER THAN THOSE SHOWN ON THE RECORDED PIAT,ARE NOT SHOWN HEREON.
OTHER THAN NOTED.
NOTE:ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES DATED AT ANCHORAGE,ALASKA THIS 19TH_
OR LOCATE STRUCTURES. DAY OF APRIL 2006.
HOLT LAND SURVEYING 101018•FB 123.84
TTL.345.5513