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HomeMy WebLinkAboutDEITZ LT 7B REMOnsite Fila:
t
7
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241363
Work Type: Septic Renewal
Tax Code Number: 01818121000
Site Legal Address: DEITZ LT 7B REM G:3035
Site Mailing Address: 3500 DE ARMOUN RD, Anchorage
Owner: SLATTERY JAIME
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
10/29/2024
10/29/2025
44823
Q Disposal Field © Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
4
Received By: S _S Date:
Issued By: Date: Z
ON -SITE SEWER/WELL PERMIT APPLICATION
Parcel I. D. 0 18-181-21
Property owner(s) Jaime Slattery
Mailing address 3500 DeArmoun Road, Anchorage, AK 99516
Site address 3500 DeArmoun Road
Day phone 907-441-6450
Legal description (Sub'd., Block & Lot) Deitz Subdivision Lot 713 REM
Legal description (Township, Range & Section)
Lot Size - 44,823 —Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(ED all that apply)
Absorption Field
[_X�
Initial El
Single Family (SF) RX
(w/wo ADU)
Septic Tank
1Z
Upgrade R
Duplex R
(D)
Holding Tank
F]
Renewal RX
Multiple Dwellings R
Privy
R
(SF and/or D)
Private Well
R
Water Storage
R
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
3 Date of Payment: D ate of Payment:
Receipt Number:
Permit No.
Receipt Number:
Waiver No.
Permit App_'-'-:-
October 15, 2024
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Deitz Lot 7B REM – 3500 DeArmoun Rd
Septic System Permit RENEWAL
Dear On-Site Services Engineer:
The permit for the construction of a new septic system at 3500 DeArmoun Road has expired. A
site visit was conducted and there have been no substantial changes to this lot or to the surrounding
area since the permit was originally issued. The current design and permit conditions meet all code
requirements. We therefore request the renewal of the permit for the septic system on this lot.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241363, Curtis Townsend, 11/04/24
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231252
Work Type: Septic Upgrade
Tax Code Number: 01818121000
Site Legal Address: DEITZ LT 7B REM G:3035
Site Mailing Address: 3500 DE ARMOUN RD, Anchorage
Owner: SLATTERY JAIME
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
1„ent. S,
O'
Dela rtmerit
8/29/2023
8/28/2024
Lot Size in Sq Ft: 44823
Total Bedrooms: 4./
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: S 7D Fo (-�
Issued By:
Date: �
Date:
c 0 2 Z-3
F�I�UH0CPfik COTe 0 F If%H CCHOR A GE
tiNM4
Community Development Department] Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-181-21
Property owner(s) Jaime Slattery
Mailing address 3500 DeArmoun Road, Anchorage, AK 99516
Site address 3500 DeArmoun Road
Day phone 907-441-6450
Legal description (Sub'd., Block & Lot) Deitz Subdivision Lot 713 REM
Legal description (Township, Range & Section) a�
Lot Size 44,823 Sq. Ft. Number of Bedrooms /
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑X
Initial ❑X
Single Family (SF) ❑X
ADU)
Septic Tank
[AUpgrade
F](w/wo
(D) El
Holding Tank
❑
RenewalDuplex
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
u
(Signature of property owner or authorized agent)
Permit/Rush Fees: Sc( S
Date of Payment:
Receipt Number: -C—,,67q 0.0
Permit No. d �2P2 ? (2 5 -
Permit App_:;- : ..:c
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
August 28, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Deitz Subdivision Lot 7B REM - 3500 DeArmoun Road
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot intends to convert part of his detached garage/shop into an ADU, so
we are submitting this permit application for the construction of a new septic system. The attached
site plan identifies the location of the home, well and existing septic as well as the new septic
location. No conflicts exist between this proposed system and any other well or septic system,
whether on this lot or adjacent lots.
The ground surface on the lot slopes very mildly and is essentially flat in the area of the new septic
system. There are no slopes greater than 25% within 50 feet downslope of either the primary or
alternate site. Contours are shown on the site plan showing the grade and direction of flow.
Stormwater drainage will not impact this septic system. The new trench will be constructed parallel
to the slope as much as possible. Although the proposed ADU is only 1-bedroom, the necessity of
using advanced treatment provides a system with up to a 4-bedroom capacity. We have designed
a trench with the same capacity so as to not limit future possibilities.
Wells on this and adjacent lots are shown. The new system will be a minimum of 50’ from all
wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached
test hole log, plan and profile pages for the septic design. If this design is followed, there will be
no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231252, Curtis Townsend, 08/29/23
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Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
DRIVEWAY EASEMENT
(25'x20' 83-43)
1250-GAL ADVANTEX
FAP 2.0 TANK
w/ PUMP VAULT
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
DEITZ SUBDIVISION, LOT 7B
FEET
0 50 100
FCO
DE ARMOUN ROAD
3-BDRM HOME
280
SEPTIC PLAN
7/28/23
R.O.W. ACQUISITION BY PLAT NO.
2011-75
33
'
R
.
O
.
W
.
E
A
S
E
M
E
N
T
(
2
0
1
1
-
7
5
)
10' T&E EASEMENT
275
285
GARAGE
w/ ADU 20' LONG x 5' WIDE, 0.5' EFFECTIVE
DEPTH ABSORPTION TRENCH
ENSURE 50' SEPARATION FROM
NEARBY WELLS
MTMT
TH#1
MAINTAIN 10'
SEPARATION
BETWEEN WATER
LINE AND ANY PART
OF SEPTIC SYSTEM
EXISTING WELL
EXISTING WELL
ALTERNATE SITE > 6' AWAY
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231252, Curtis Townsend, 08/29/23
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
7/28/23
DEITZ SUBDIVISION, LOT 7B
5'
6"
DESIGN FACTORS:SYSTEM REQUIREMENTS:
150 GPD PEAK FLOW (1 BDRM)
DESIGN FOR 600 GPD (SYSTEM CAPACITY)
PERK RATE: 2.2 MIN/IN
APPLICATION RATE: 6 GPD/SF
5' WIDE TRENCH SYSTEM
1250-GAL ADVANTEX FAP 2.0 SEPTIC SYSTEM
BOTTOM OF TRENCH: 1' BELOW GRADE
FLOW LINE ELEVATION: 0.5' BELOW GRADE
600 GPD / 6 GPD/SF / 5' WIDE * 1.0 RED FACTOR [0.5 DEEP] = 20 LF TRENCH
GEOTEXTILE FABRIC
1.25" PVC w/ 20 - 3
8"
HOLES SPACE @ 1.25'
OC (HOLES DOWN)
6"
DRAINFIELD ROCK
ADD ADDITIONAL 6" FILL
TO ENSURE MIN 2' COVER
AFTER SETTLEMENT
2'INSULATION
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231252, Curtis Townsend, 08/29/23
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DEPTH
(feet)
TEST HOLE 1
DATE READING START TIME NET TIME
(minutes)
DEPTH to
WATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
WAS WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING
IF YES @ WHAT DEPTH?
2.2
7/10 1
2
3
4
5
6
GM (SILTY SANDY GRAVEL)
Professional Engineers Stamp:
NO
Deitz Lot 7B REM
7/10/23 018-181-21
Dan Slattery
1:42 3 0
16
1:53
2:03
2:14
2:24
2:34
1' OB
30
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
PERC TEST LOCATION
TECHNICIAN: M. Jakubisin
9 0
16
-
5.4'
7/17/23
COMMENTS:
SITE PLAN
6 016
USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
7/29/23
TEST HOLE DONE ~80' FROM WELL
3 0
1610 8 15
16 5 15 16
3 0
1610 7 8
16 4 8 16
3 0
1610 7 9
16 4 9 16
3 0
1610 7 10
16 4 1016
3 0
1610 7 9
16 4 9 16
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231252, Curtis Townsend, 08/29/23
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT. herein the "AGREEMENT" made and
entered into as of this )S Day of of 20_gZ, by and berveen
herein the "OVL'\ER," and the Municipality of
Anchorage, herein the "MUNICIPALITY". in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
Advanced Wastewater Treatment Sy=stems. Municipality Grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS).
described as Advantex System
located at (legal description)
Deitz Sub, Lot 7B REM
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each. section)
Throughout the term of this Agreement. the Owner shall enter into a service agreenlelu
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic: efiluent in
accordance with the equipment's approval for operation in the Municipality.
a_(� It shall be the responsibility of the Owner during the term of this Agreeniei t to pay for all
repair(s), maintenance.. adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an ANVVi'TS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 0/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance: provider.
'' Owner aclmowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.0.30.
�A Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWAVTS 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.
L Owner agrees to maintain remote monitoring of the AAWWTS as required by the
AWWTS approval.
3. Term. The tem of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonivafver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision Hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this .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 Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev 05/18/2018) Page 2 of 3
O ER:
By:UZI
% (signature) Date:
arc\p 1 (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrilment w %no le gqd before a this
20by 1e" r � r!
' Y PUBLIC FO AL SKA
My Commission expires: 9_17 ,2o.V
MUNICIPALITY:
By: / (signature)
n -'q C 1 0 w-' S/ 7_ � n (print name)
- 01
• tom*;-
1 '"1
Date: Y -2 2o �_ 3
Title: C Iy(,-
(rev. 05/18121018) Page 3 of 3
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW030358 PID Number: 018-181-21
Name.
Jim Pisk
Wastewater System: ❑ New ® Upgrade
Address:
3500 Dearmoun Rd. Anchorage, AK. 99516
ABSORPTION FIELD
Phone: Number of Bedrooms:
345-6882 3
Deep Trench ❑ Shallow Trench ® Bed ❑ Mound ❑ Other:
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
0.7 GPD/Ft'
2.0+/- Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
713 Deitz Subd.
1.5 Ft.
0.5 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
Ft.
20' & 35' Ft.
Well: ❑ New ❑ Upgrade
Gravel width:
15' & 10'
Number of lines:
5
Distance between lines:
Ft.
5 Ft.
Classification (Private, A, B. C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Private
Ft.
Ft.
650 Fe
D3034 & F810
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed:
Ft.
Owner Install
5/10/2004
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPMJ
FL
Ft.
SEPARATION DISTANCES
® Septic ❑ Holding ® S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:Capacity:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1 250 Gal.
Well
100'+
100'+
NA
NA
25'+
Material:
Steel
Number of Compartments:
2 p
Surface Water
1001+
100'+
NA
NA
LIFT STATION
Lot Line
5'+
10'+
NA
NA
V
Size:
1250
Manufacturer:
Orenco
Gal.
Foundation
5'+
10'+
NA
NA
Pump on" level at:
44ff in.
'Pump ofr level at:
42" in.
High water alarm at:
48" in.
Curtain Drain
NA
*50'+
NA
NA
Pump Make & Model
Electrical Inspections performed by:
Franklin 24
50401 17-1 /2h
Remarks:
*none known
BENCH MARK
Location and Description:
tank & field insulated
Garage slab in front of door
Assumed Elevation:
100 Ft.
Engineer's Stamp
%%1
1F 44
•
••
&�
t
AW
•.
..
�
Inspections performed by: KND Engineering, Inc.Dates: 1 S5/10/2004
�
0? :: ,0„;woa,490440, •s „ „•
2nd 5/12/2004
•° �••• • •�•
•
`
Development Services Department Approval
!� �� ;• ' �) ` `
Reviewed and approved by: Vej)t ii' � (� Date: 1 a 16 h 0 (8
: ��°;
1� �F9� `0�.? � •• �c��®
•• a �.
Q�
)
(Rev. 12/00 ( n(�
_
0p
UUJUC nriQ 2l�
®®OFESS
���
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW030358
DEITZ SUBD. LOT 7B PID# 018-181-21
©► ❑e
A -C= 47.0'
B -C= 63.4'
A -D= 52.8'
B -D= 69.5'
A-E= 61.5'
B-E= 79.3'
A -F= 46.5'
B -F= 68.2'
A -G= 76.8'
B -G= 97.5'
A -H= 58.3'
B-H= 82.5'
oaSTV4 7
IDNM HOUSE
11
aIX
PREPARED FOR:
JIM PISK
3500 DEARMOUN RD,
ANCHORAGE, AK. 99516
(907) 345-6882
FlEU) BOOKS DauvUTM.
eawAnr. DRAM: VBG
STAKM- CEOcm: KMo
A r.. DAM 7/24
D"rl nc cnu 3035
AGO RE" 03023.DWG '108 "" 03023
X.
SCALE, I' = 50'
.r?
gg
SCALE: NTS
93.9 vA,a t.ac
Mll LW ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER. AK 99577-8736
Municipality of Anchorage
Development Services Department
• Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET
To: KND Engineering
Legal description: Deitz Subdivision Lot 78
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 electrical inspection report
® Incomplete; missing letters of non -objection for placement of wastewater disposal system
In the easement
❑ 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. On-site wastewater disposal system must be installed by an ai
Name of reviewer. Julie Makela. P. E.
Date: 1/14/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
MEGGER TEST REPORT
Technical Services Company
Polar Services
PROJECT NUMBER FL V— �kQ� DATE (MIDNYYY) 1 L
PROJECT 'S15- " LC --1. `i,-4j(aXQC- STATION 0 MCMUROO 0 PALMER 0 SOUTH POLE
FEEDER PANEL
IDENTIFICATION
CIRCUIT VOLTS/
NUMBERIFEEDER PHASE/
Nur.73ER CYCLES
PHASE "A!'
TO
PHASE "W,
PHASE"A!'
To
PHASE "C"
PHAsE"B"
TO
PHASE "C"
PHASE -A"
TO
NEUTRAL
PHASE"B"
TO
NEUTRAL
PHAsE"C"
TO
NEUTRAL
PHAsE"A!'
To GROUND
CONDUCTOR
PHASE "B"
To GROUND
CONDUCTOR
PHASE"C"
To GROUND
CONDUCTOR
'7 t
RPSC FIELD ENGINEER
PROJECT ENGINEERfDESIGNEE: DATE
RPSC ELECTRICAL FOREMAN: —DATE
NSF REPITITLE 11 INSPECTOR:
EN -NIPS -725c
FEMC/RPSC Paget I of I Revision 1 11/16/106
t"Sc>-7
DATE
A
L 2016 - 029721 - 0
A
S Recording District 301 Anchorage
K
A 07/22/2016 03:19 PM Page 1 of 4
1203-33A
Grid 3035
EN16015
018-181-21
This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative,
(herein "Chugach"), whose address is PO Box 196300, Anchorage, Alaska 99519 and James A. and
Wendy S. Pisk (herein "Permittee"), whose address is 3500 Dearmoun Road, Anchorage, AK 99516.
I Easement. Chugach is the grantee or user of an casement for the construction and
maintenance of electrical facilities, as follows:
Bureau of Land Management Right -of -Way granted to Chugach, recorded on the 11`h day of
August 1955, per Volume 121, Page 278, on file in the office of the District Recorder,
Anchorage Recording District, Seward Meridian, Alaska, and
Dedicated by Plat 83-43, recorded on the 18`h day of February 1983, on file in the office of the
District Recorder, Anchorage Recording District, Seward Meridian, Alaska,
(herein "Easement") which pertains to the following described real property:
A Twenty Foot (20') Easement centered 20.20 Feet east of the northwest comer of Lot 7B,
Deitz Subdivision, according to Plat No. 83-43, recorded on the 18`h day of February 1983, on
file in the Office of the District Recorder, Anchorage Recording District, Seward Meridian,
Alaska,
Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is
the owner of the fee simple interest in the land subject to the Easement and the following described real
property to which the Easement is adjacent:
Lot 7B, Deitz Subdivision, according to Plat No. 83-43, recorded on the 18'h day of February
1983, on file in the Office of the District Recorder, Anchorage Recording District, Seward
Meridian, Alaska,
(herein "Parcel")
Encroachment Permit - Page 1 of 4
2. Encroachment. Permittee has constructed or purchased the following improvements on or
within the real property subject to said Easement:
An existing leach field that encroaches a width of approximately Ten Feet (10') for a length
of approximately Twenty -Five Feet (25') and an existing rock retaining wall that follows the
western edge of the septic boundary, both improvements encroaching into the east side of
said Easement,
(herein "lncroachment").
3. Permit. Chugach hereby authorizes Permittee to continue the existence of the
Encroachment in its existing location subject to the covenants set forth in this permit.
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims
for personal injury, property damage or other loss arising in any way from the continuation of the
Encroachment.
5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to
which the Encroachment occupies any of the real property encumbered by the Easement without the prior
written consent of Chugach. Chugach has no obligation to provide such consent.
b. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment
and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to
any interest or estate in the real property subject to the Easement or any other real property. Without in
any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any
interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the
common law doctrine of adverse possession. This permit creates no interest in the real property subject to
the easement.
7. Modification of Utility Facilities. If the electric utility facilities located within the
Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's
total costs for such modification which is reasonably attributable to accommodating or preserving the
Encroachment. If such payment is not made within thirty (3 0) days of written demand for same, Chugach
may terminate this permit in accordance with paragraph 9, below.
8. Covenants Running with the Land. The obligations of the Permittee arising from this
permit shall be covenants running with the land which shall burden the Parcel and the Pennittee's interest
in the land subject to the Easement and shall benefit the Easement.
9. Termination. Chugach may terminate this permit after the giving of thirty (30) days
written notice of such termination if:
a. The Encroachment is enlarged, increased or extended within the real property affected by
the Easement,
Encroachment Permit - Page 2 of 4
Page 2 of 4
2016 — 029721— 0
b. The Encroachment is damaged by any means to an extent of more than thirty percent
(30%) of its replacement cost at the time of destruction.
Permittee fails to make the payment described in paragraph 7, above.
10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years
from the date hereof.
11. Entire Agreement. This written permit constitutes the entire agreement between the
parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous
agreements, oral or written, between the par -ties. No modifications, amendments, deletions, additions or
alterations of the pen -nit shall be effective unless in writing and signed by all of the parties hereto.
By:
Shelly Schmitt, §eirlor Manager
Distribution Engineering
Date:
By: GC"�M1fs f 7- p
James A. Pisk
Date:_
By: �2t'i/C--
Wendy S. Pisk
Date:— 7-2-2 -2-Cl/Le,
Encroachment Permit -Page 3 of 4
Page 3 of 4
2016 - 029721- 0
STATE OF ALASKA
) ss
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me this 2P- day of
2016, by
.�cim,-s ft -ell
NOTARY'.
JBLIC.;
STATE OF ALASKA
) ss
THIRD JUDICIAL DISTRICT
7-11
q 1;� !!I
Is
:=N
Notary P06c in and for the State, of Alaska
My commission expires: '7 116
The foregoing instrument was acknowledged before me this "�anj day of
5:16% , 2016, by Shelly Schmitt, Senior Manager, Distribution Engineering of
Chugach tlectric Association, Inc., an Alaska corporation, on behalf of the corporation.
AFTER RECORDING RETURN TO:
Chugach Electric Association, Inc.
PO Box 196300
Anchorage, Alaska 99519-6300
Attn: Land Services Department
Nota Public in and for the State of Alaska
My commission expires:
Encroachment Permit - Page 4 of 4
Page 4 of 4
2016 — 029721— 0
Mar 11 05 10:25a
March 11, 2005
Jim & Wendy Pisk
3500 De Armoun Rd
Anchorage, Alaska 99516
Dear Mr. and/or Mrs. Pisk,
p.2
Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc.
of Alaska has no objection to the septic field encroaching into the T & E easement on the
west property line of Lot 7B, Deitz Subdivision. Known as 3500 DeArmoun Road
located in Municipality of Anchorage city grid 3035.
This letter of non -objection in no way precludes GCI Cable from full use and enjoyment
of any rights it may have within any portion of the utility easement and or the right-of-
way, including unlimited access for servicing its facilities. Also any additional and
extraordinary costs incurred during any future required construction, repair or
reconstruction of GCI's facilities to accommodate any or all of the encroachments shall
be paid by the property owner.
By signing below, you agree to indemnify and hold GO Cable harmless, now and
forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities
and injury to any person or property occurring as a result of the encroachment.
Please indicate your acceptance by signing as
address below.
Sincerely,
e e�ccaColton
OSP Project Manager
Date /
at the
5151 Fairbanks Street - Anchorage, Alaska 99503 ® 907 / 868-5600
CHUGAIC
POWERING ALASMA's FUTUPIE
July 25, 2016
James and Wendy Pisk
3500 Dearmoun Road
Anchorage, AK 99516
Subject: Encroachment Permit Request for Existing Septic System and Retaining Wall
Lot 713, Deitz Subdivision
EN 16015, Grid 3 03 5, MOA ID #018-181-21-000
Dear Mr. and Mrs. Pisk,
Enclosed is the conformed copy of the Encroachment Permit and Easement, on the above referenced
property. If you have any questions, please contact me at 907-762-4753 or
Josh Resnick@chugachelectric.com.
Sincerely,
o rhR e si -c- /gk—
Right of Way Agent 11
Enclosures
Chugach Electric Association, Inc.
5601 Ele.Jron Dr;v-- PO. 96300, "'r--horcoe, Alosko 995 11 P-6300 0 R07) 563-7494 Fox 19071 562-0027 - !80()) z-,'78-7494
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Deriartntent ofTratisp- irtittiol, Ic Fact.
TEMPORARY CONSTRUCTION PERMIT
TIIL (iRANTOR(S), JAMES A. DISK and WEEDY S. PISK, for and in consideration of MUTkJAL
IIINIF(TS, convey(s) and warmnt(s) to the STATE Of ALASKA, DEPARTMENT 0V TRANSPORTATION
AND PUBUC FACILITIL'S, its agents or contractors, dining the period of construction of Alaska Project No.
539871STP-0510(2), permission to enter upon all thatportion of the following described tract of land:
Lot 7 "B", 0 C Ocitz Subdivision, according to Plat 83-43, filed in the Anchorage Recording District., Third
fLielicial DiMict, State of Alaska
wliich lies witbiri Oic bowidarics of the parcels of land designiatcd as Parcel P-6 and 13-7 of said project, delineated as
to said parcel of land on the plat attached hereto and muse a part hereof as page 2 of Us instrument, containing
a pproximately 525sm (5,(x51 square feet), more or less, for the purpose of.
Other Provisions: The Grantee Shall leave said promises in a clean and presentablu condition when said
constniction has been complutacl-
Datcd (Ws—_%7 day of 2002.
— A.—
Gait:s � An �i�- - -
Wundy S. Fisk
11w Smic of Alaska, Deparutictic of Transportation and Public Facilities, hereby accepts this perrnit.
R21'r(ON: Centrat
T(T: P.6110 7
DEPAI;:IUE'N'r OF TRANSPORTATION AND PU13LIC FACILTUES
BY:
For the rnmissq-oncr--
Post-it" brand fax transmittal memo 7671
not pages 1,
To
FrCWID — 1-- - "--
Co.
Co.
De
Phone � 6 7 -06`10
FAX U3 JfS
PtzojE-c,r:STP-05t0(2)/53097
ptgu t ol'2
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
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030358
Legal Description: ;DEITZ LT 7B
C.; 171oLl-
1Zhoon
Date Issued: Sep 04, 2003
Expiration Date: Sep 03, 2004
Parcel ID: 018-181-21
Design Engineer: 0070 KND Engineering Site Address: 003500 DE ARMOUN RD
Owner Name: James A. Pisk Lot Size: 44823 SO. FT.
Owner Address: 3500 DeArmoun Total Bedrooms: 3 Permit Bedrooms: 3
Anchorage . AK 99516-3539
This permit is for the construction of:
❑/ Disposal Field Q✓ Septic Tank E] Holding Tank E] Privy ❑ Private Well E] 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 B
Issued
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 SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel LD 018-181-21 Permit Number SW 030 3SB
Property owner(s) James A_ Pisk
Dayphone 345-6882
Mailing address (1) 3500 DeArmoun Rd__
Anchorage AK 99516
Mailing address (2)
Zp Code
Legal description (Lot, Block & Sub'd.) Deltz
Lot 7B
Legal description (Section, Township & Range)
Lot Size -",!W1 44 J! qok_� cres q.Ft.
Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only ❑
Well Only
❑
Sewer and Well ❑
Water Storage
❑
Sewer Upgrade 19
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.
property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt.Number:
MID ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
11/FAX (907)696-8111
June 27, 2003
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New Sewer Permit — Deitz Lot 7B
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. The septic system is being upgraded due to the DeArmoun Road upgrade. ADOT
is in the process of obtaining non -objection letters to utility easement encroachments
due to the necessary placement of the proposed septic upgrade.
On January 11, 2001, VEI Consultants performed one testhole. The soils log and ATL
soil analysis results are attached. On May 16, 2003 we performed a percolation test and
monitored groundwater. The general slope of this lot is from north to south at a grade
of approximately 0-10%.
We have designed our system utilizing the existing testhole that was excavated for the
existing 3 -bedroom house. The lot is served by an individual well, located in the central
portion of the lot.
Due to the circumstances and the area available for this upgrade, we propose to install
an irregular-shaped bed and therefore request a waiver to bed length and width
requirements. Water was encountered during the excavation at 9', and during
monitoring at 75.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
Subject: Dietz S/D, Lot 7B • Sewer System Upgrade
June 27,2003
Page 2 of 2
If you have any questions, please contact meat 696-6111 /FAX 696-8111.
Respectfully submitted,
KHD Engineering, Inc.
Wenneth M. Duffus, P. .
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
KND Percolation Test
- - - VEI Consultants Soils Log w/ Location Map
ATL Soil Analysis
Excavators/Owners Specs
WELL & WASTEWATER DISPOSAL
I DEITZ SUBD. LOT
SYSTEM DETAILS/SITE PLA
7B
No FvktC WELLS WITHIN Ear or
PROPOSED SYSTEM
NO PRIVATE WELLS WITHIN EDD• 6
PROPOSED SYSTEM EXCEPT AS NOTE&
NO SEPTIC SYSTEMS WITHIN EDI. 6
PROPOSED WELL EXCEPT AS NOTED.
DESIGN DETAILS
3 BDRM X 150 GPD = 450 GPD
450 GPD/0.7 GPD PER SO. FT. (3 MIN/IN.)= 642.9 SO. FT TOTAL
20' (L) X 15' (W) (0.5' OF GRAVEL) = 300 SO. FT.
35' (L) X 10' (W) (0.5' OF GRAVEL) = 350 SO. FT.
USE BED - total absorbtion area (300*350) sq.ft = 650 SO. FT.
Total depth of system Is 2.0' from original grade.
Total depth of gravel below distribution pipe Is 0.5' .
PRESSURIZED LINE DETAILS
1. RESIDUAL HEAD - 5'
2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE 2 30 PSI
3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE = 30 HOLES
4. 150 LF LATERAL/30 HOLES = 5' SPACING PER HOLE
S. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS.
NOTES,
1. USE 1250 GAL S.T.E.P. TANK, INSULATE IF <4' OF COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MINIMUM 27 SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS.
PREPARED FOR,
JIM PISK
3500 DEARMOUN RD.
ANCHORAGE, AK. 99516
(907) 345-6882
nELD BOOKS
STAIOIIa
ASBULT
DNa nr.
AM F E: ,.,,.•,,
COMPUTEa
DRAM: vBG
CKO'M- KMO
DATL 6/27�
atla 3035
03023
Scale, 1'= 100'
PAGE 1 OF 3
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
-611
WASTEWATER DISPOSAL SYSTEM DETAILS
DEITZ SUBD. LOT 7B
0
� i ► 1gA001AEXISTING
K N p I j VE 5 25' NIB S STEM ° °
S1I I SE
35' IUB
S
P T BED
i► I 10 o�IJE�
JAL
1 ► 25' Gam' o
1 ►
PRO OS45 I O ING Ln
.�
GA S.T E:P I IQ °-
I
1
1 IR
I o
I ► o
1 1 �
I EXISTING 3
I FCO BDRM HOUSE
I
100' WELL RADIUS (EXISTING)
I I
1 1
NOTE:
CONTRACTOR WILL STAKE EXISTING WELLS & LOT LINES
TO ENSURE SETBACKS ARE OBSERVED.
DF•AZ'4 i PREPARED FOR,
��, ••' •,'�' 1 JIM PISK
/ GJ: q •'y 3500 DEARMOUN RD. SC0.12l 1'= 20'
* I ....... • • • • • . • • • - • * - 907)ANCHD 345E 6882 99516 PAGE 2 OF 3
f.. j
...,.. .� ........ 3 •... FlELD BOOKS tauwTm
CE-7116 wa @a Artn OMA+ : vBG ENGINEERING
+� 14 / lw �- "1EO0' KMD 20441 PTARMIGAN BLVD.
�` •.....• , ,. A�T: 0AM 7 EAGLE RIVER, AK 99577-8736
PhbFE3310�� 0.c. nc un 3035 ......... ..
\``� ACID ^`E 03023.DWG J00 N' 03023 (907)698-6111/FAX (907)696-8111
WASTEWATER DISPOSAL SYSTEM DETAILS
DEITZ SUBD. LOT 7B
4• MMITORING
1-I". DIA Sill 40 HDPE
DISC "GE LGE FRDN
STEL. TANK AND
MANIFOLD.
3/4• DIA SCK 40 PVC LATERALS
(HOLES . SHIELDS. AND RUSHING
VALVES PER ORENCO DESIGN)
SEE PLAN VIEW FOR DDENSYNS
PLAN VIEW L PLTVmD BARRIER
AR"D PERINITER
—INSULATION
4• MONITORING TUNE FILTER FAMRIC
C MM COVER
FINAL GRADE
r 5-10%
AS NEEDED .............. ..... .. ..�.. .....
� OF AL9sr� 1
... �
KEN ....... D S:
CE -7116 a jo
INS-'40�0
VA �' fESSIOl ,
.�
PREPARED FOR,
JIM PISK
3500 DEARMOUN RD.
ANCHORAGE, AK. 99516
(907) 345-6882
FIELD BOOKS cawTED:
BQRNDMM _ DRAIN: VBG
sTuarNNz _ ND O'm- KMD
ASBIRLT. _ DATE: 6/27
DRI.rLL. cao: 3035
ACRD "`L 03021MG 'HDI M°"2 03023
•
SEE PLAN VIEW
FINAL GRADE
PLTVOOD BARRIER
MOTH
REMOVE TOP C OF SOIL t ORGANICS, L INSTALL
C. OF LEVELING SAND FILTER
Scale, NTS
}�
PAGE 3 OF 3
IM
ID ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
KND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
SOILS PERCOLATION TEST
Performed for. Jim Pisk Date Performed: 05/16/03
Project: Deitz, Lot 7B TEST HOLE # VEI 05
Depth
(Feet) SEE ATTACHED SITE PLAN
1 FOR HOLE LOCATION
2-
3 -
SEE ATTACHED VEI
4- SOILS LOG
5-
- TESTHOLE PERFORMED
6- ON 1/11/01
Ground water measured at 9'
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19 -
HOLE PRESOAKED
20- PRIOR TO TEST
Was Groundwater encountered? YES What depth? 9'
Depth to water after monitoring7 7S' Date? 5/16/03
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
5/16/03
1:00
-
7"
-
2
1:10
10 min
311/16"
35/16"
3
"
1:11
-
7-
4
1:21
10 min
313/16"
33/16"
5
"
1:22
-
7"
-
6
1:32
10 min
314/16"
32/16"
7
'
1:33
-
7"
-
8
1:43
10 min
4"
3-
9
"
1:44
-
7"
-
10
1:54
10 min
315/16"
31/16"
11
1:55
7-
12
2:05
1 10 min
4"
3"
"
Water
Added
Percolation Rate 3.33 (min/in) Perc Hole Diameter 6"
Test Run between 3.5 feet and 4.5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
SOILS LOG
Boring Number TH-5 Dote Completed: 1/11/01
t
SOIL DESCRIPTION
0•
0
aA.B.
O
APPLE NUMBER
o'
St. 72, 57.1; B5.`pcl
0,
BROWN, SLIGHTLY MOIST, *GRAVELLY 40%
o
SAND 060% (FILL)
O
LBLows/Foor
SAMPLER TYPE
W.O. WATER TABLE
i
APPROX. STRATA CHANCE
b
BEDROCK
O'
O
1O SS. 68. 3.27., SW -SM
-2
oeo
o.
O i
GREENISH CRAY, VERY DENSE, SLIGHTLY MOIST,
'p
GRAVELLY 39% SAND 51% WITH TRACE SILT 10%
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-
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O SS, 72, -SW
GREENISH CRAY, VERY DENSE, WET, SAND •80% WITH
.'.O
SOME GRAVEL •20%
-1
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iC
GREENISH CRAY, VERY DENSE. -S 1%jJ7• WITH
SOME GRAVEL '207. AND T= S 5 � 1
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O SS, 93, -SW �•. ».».«.». •• L.»,iCy
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DARK CRAY, DENSE, WET, SAND�4S,T.�TIH
p
TRACE GRAVEL 5%
O4 SS, 37. *SW
NOTES: 1. TOTAL DEPTH WAS 6.55 M
-7
2. *BASED ON FIELD ESTIMATES
3. AFTER BORING WATERTABLE OBSERVED
ON 1/12/01
DWN
CKD JMB
DATE 2/2/01
SCALE ABOVE
LOCATION SKETCH
SEE LOCATION MAP
TEST BORING IS AT TOE OF ROCKWALL AT
EDGE OF DRIVEWAY ABOUT 13 METERS SOUTH
OF DEARMOUN CENTER LINE, LOT 7B, DIETZ
SUBDIVISION
EXPLANATION
UNFROZEN GROUND
ORGANIC MATERIAL
Little Y•iYe ice 0-10 Va
F7S
L-ICE DESCRIPTION
L-FROZEN GROUND
W.D.-MARE DRILLING
TYPICAL SOIL LOG A.B.-AFTER BORING
S• 1.4• SPLIT SPOON WITH 140 LB. HAMMER
Sz 1.4' SPLIT SPOON WITH 340 I.B. HAMMER
SN 2.5' SPLIT SPOON WITH 340 LB. HAMMER
SP 2.5' SPLIT SPOON. PUSHED
A AUGER SAMPLE
T• SHELBY TUBE
T. MODIFIED SHELBY TUBE
C CRAB SAMPLE
SAMPLER TYPE SYMBOLS
O
© MATERIICMATERIAL co
GRAVELRG
® CLAY ® BEDROCK
SILT ® C060LE5 k
BOULDERS
AN
SD . ICE. MASSIVE
SOIL SYMBOLS
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GRID
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a
0•
0
aA.B.
APPLE NUMBER
St. 72, 57.1; B5.`pcl
I OILY DENSITY5'
I
o
L WATER CONTENT
•
LBLows/Foor
SAMPLER TYPE
W.O. WATER TABLE
APPROX. STRATA CHANCE
BEDROCK
PISK SEPTIC SYSTEM
VEIConsultants =j DEARMOLIN ROAD
99063
DWG. NO. TH-5
N W 1 LL
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-----1--uTv- i - ITvAr-----+
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SEWER
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LOT 76
TH #1
LOT 7A
SCALE 1:500
STATE OF ALASKA
DEPARTMENT OF TRANSPORTATION DEARMOUN ROAD RECONSTRUCTION PISK TESTHOLE
AND PUBLIC FACILITIES WESTWIND TO E. 140TH AVE. LOCATION MAP
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KND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907) 696-6111/FAX (907) 696-8111
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS
LEGAL DESCRIPTION: DEITZ SID, LOT 7B
GENERAL:
1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a
single famil residence on the referenced property as delineated on the attached Municipality of
Anchorage MOA) permit and site plan.
2. Construction shall be in accordance with the approved site plan and design drawings; MOA
permit with any special provisions or conditions, and all applicable State and Municipal
Wastewater Disposal Regulations.
3. KND Engineering, Inc (KND) assumes no responsibility of the accuracy of the as -built survey
provided by the owner or owner's representative. _ _ _ -. _ _ .. ._ .
4. The owner or contractor is responsible to notify the engineer of any discrepancies noted on the
design plans or drawings prior to commencing work. These discrepancies could be, but not
limited to, possible encroachments, surface water, varying soils, unplatted easements, types or
use of dwellings on or adjacent to property, nearby public wells, etc.
S. The contractor shall be responsible for locating any necessary underground utilities, easements,
property lines and surface water. The owner and/or contractor shall ensure, if deemed
appropriate, that a registered land surveyor prior to construction flags all setbacks.
6. The contractor shall be responsible for verifying all pertinent separation distances and
COX
layout.
7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading
areas subsequently depressed from soil settling. On all leachfield mound systems, the property
owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded
area.
8. The MOA Development Services Department On -Site Water & Wastewater Program must
certify contractors installing wastewater disposal systems. Owners installing their own systems
must also receive prior approval from said MOA Department.
SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall
include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent
damaging, settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade.
4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will
ensure that the fill over the tank does not exceed the burial depth rating.
5. A foundation cleanout shall be installed one to four feet from the building foundation. In the
line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent
pumping system exists within the septic tank). These cleanouts shall be located on undisturbed
soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward
the septic tank.
6. Final grading over the septic tank shall be such that a positive slope exists away from the septic
tank.
Page 1 of 3
Reference: Deitz, Lot 7[i
Date: 06127103
Page: 2 of 3
7. All H.D.P.E. tanks shall have a vertical length of 4 -inch perforated drainpipe besides the tank
extending to the bottom of the tank to above grade to monitor ground water.
8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy
forces in high -groundwater areas.
9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence.
10. All lift stations shall be wired in compliance with the Uniform Electrical Code and all MOA
guidelines.
11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform
Plumbing Code. The contractor is solely responsible for the abandonment procedure.
ABSORPTION TRENCI11DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the
excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared,
they must be raked or scratched (roughed -up) before gravel (sewer rock) placement.
2. Once the sewer rock is installed, the distributionpipe is installed level with the perforations
facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum
of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure
the silt barrier covers the entire gravel surface before placing backfill.
_. .
4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locations
shown on the design, and extend a minimum of 12 inches above final grade. The portion of the
monitoring tube extending through the gravel shall be perforated from the bottom of the trench
to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as
noted on the design.
5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be
installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the
trench must be mounded to prevent the formation of a depression after settling.
6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent
Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per
manufacturer's specifications and MOA requirements.
MINIMUM MATERIAL SPECIFICATIONS:
1. A MOA approved septic tank manufacturer must construct any septic tank proposed for
installation.
2. The following pipe materials are MOA approved for use in septic system installations:
Typg of Pips PerforateSolid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company
Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or
equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between
the final leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing
the #200 sieve. If deemed necessary, a sieve analysis should be performed.
7. When sand is being used as a filter material, its gradation specification must conform to current
MOA or DEC requirements.
Reference: Deitz, Lot 7B
Date: 06127/03
Page: 3 of 3
INSPECTIONS:
Typically there will be three (3) inspections required during the installation of the wastewater
disposal system. These inspections will occur as follows:
1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds
and before the installation of any gravel. A septic tank may be set in place, but may not be
backfilled before this inspection.
2. The second inspection must be conducted after the placement of the sewer rock, distribution
lines, standpipes, and cleanouts, but before the placement of the silt barrier, insulation, or any
other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required, especially with the installation of multiple
trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted
at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take
place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's
activities.
The owner shall contract with the contractor to perform the work outlined in these specifications and
attached plans and in accordance with the attached MOA permit. All materials, components, and
construction practices shall comply with the MOA's and the State of Alaska's _latest ordinances,
regulations, or policies regarding wells and septic systems. The failure of the inspecting engineer to
notice a material or construction non-compliance does not relieve the contractor of his/her
responsibility to correct such deficiency. There will be no contractual arrangement existing between
the contractor and KND Engineering, Inc. KND shall be the owner's representative and will inspect the
work as stated above to document the contractors activities. Final acceptance of the contractors work
rests with the owner and the MOA.
KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the contractor to carry out the work in
accordance with these construction documents. KND's inspecting engineer will not be responsible for
the construction means, methods, and techniques, sequence, procedures or the safety precautions
incident to this project.
BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR
WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER
ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS.
Owner:
Contractor:
NOTE: PRIOR TO CONSTRUCTION --
CONTRACTOR SHALL HAVE THE 100 -FOOT
RADII AND THE LOT LINES FLAGGED
REGIESTERED LAND SURVEYOR.
THE
WELL
BY A
LOCATION OF WELL (Please complete either ]a, lb or Ic.)
MI.- .9 h
Subdivision Ib, '/4qtfg.
Borough
- I - —
Lo of— of—of
Dc. TDISTANCF AND DIRECTION FROM ROAD INTERSECTIONS
Street Address and Area of Well Location
2. WELL LOG
Material Type
I
a
MM
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No. iii{ j
A.D.L. No.
Section Township N Range E Meridian
So WE]
W
Section
OWNER OF WELL
Address:
Below,
Feet face
Sur fa
4. WELL DEPTH: (final)
1, C o — ft.
5. DATE OF COMPLETION
1 9 — ,I
— -22
Top B 0 Itorn
6. 0 Cable toot '4 Rotary 0 Driven
0 Auger oJettecl 0 Bored
0 Dug
0 Other:
7. USEp Domestic
0 irrigation
0 Test Well
0 Public Supply
0 Recharge
0 Other:
0 Industry
0 Commerical
L'
8. CASING: '0 Threaded JQ Welded
diam.. �1. in. to it. Depth Weight lbs./ ft,
diam. in. to ft. Depth Stickup ft.
4—j—
9. FINISH OF WELL:
Type:
Slot/Mash Size:
Set between
Bockfilling —
Diameter:
Length:
ft. and
Gravel pack
ft.
_
10. STATIC WATER LEVEL:
Above or []
Equipment used:
ft.
Below land surface
—'LZ 9 /
Dote
II - PUMPING LEVEL below land surface and YIELD
ft, after hrs. pumping 9 -p -m,
ft. after hrs. pumping _ g.p.m.
12.GROUTING Well Grouted: Yes E] No
Maarterial:
Mate ric I: E]7Noot Cement
13- PUMP: (if available) HP
Length of Drop Pipe ft. capacity 9 -P.M.
0 Subm. [] Jot 0 Contrifical Other
14. REMARKS:
- - --------
16. WATER AWWROAft -0R T I F I C A T 10 N:
(90 7) 345-0593 15. Water Temperature —0 0 F
This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief;
RLvj7IL.-1 'I- a XA
B se
Name Contract License Number—
d
'Form 02-WWR (11/81) COPY Di`tlibuliorl: WHITE -Stole OGGS, PINK -Drill
------ er,CANARY - Customer
M
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Upgrade
Permit Number: SW980344
Legal Description: DEITZ LT 7B
Design Engineer: 0000 None Required
Owner Name: James A. Pisk
Owner Address: 3500 DeArmoun
Anchorage , AK 99516-3539
Date Issued: Sep 08, 1998
Expiration Date: Sep 08, 1999
Parcel ID: 018-181-21
Site Address: 003500 DE ARMOUN RD
Lot Size: 48731 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑✓ Private Well ❑ Water Storage
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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (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.
Existing well shall be decomissioned as per AMC 15.55
Received By:
Date: 6
/10.
Issued By: ✓ /a (?_ NX&O Date: ` -8 -%
td
I
R. -
I
0
I
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MUNICIPALITY OF ANCHORAGE
DEF. . rMENT OF HEALTH AND HUMAN SERV, S
Environmental Health Division
825 "L'• Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
Address A TO SEPTIC ABSORPTION WELL
_ FROM TANK FIELD
SO OGE l �� WELL
Phone(s) Permit No. No. of Bedrooms 10-3 IDS
346- 5215;-booupo-3 _
LEGAL DESCRIPTION LOT LINE .20 0
Lot Block Subdiws n (J
g 1 FOUNDATION 6 3 6% O
Township,Range, Section
AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
driveway, water bodies, etc.)
TYPE OF SYSTEM
TANKS
x SEPTIC
❑ HOLDING
Manulacturer
original grade
S FT
Capacity in gallons
C oe -
Gravel depth beneath pipe
'
12sa
Material
Gravel length
No. of Compartments
STJ�_:F_L_
FT
Total absorption area
TYPE OF SYSTEM
TRENCH ❑ BED
❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from
Total depth from original grade
original grade
S FT
95 FT
FIII added above original grade
Gravel depth beneath pipe
'
FT
5 FT
Gravel length
Gravel width
7 � FT
FT
Total absorption area
Distance between lines
SO FT
FT
Number of lines
Sod rating
Pipe material
SO FT
Aw" 3o 3,/— F8 D
Installer
Date Instal d
WELLS
PRIVATE
❑ OTHER (Identify)
Classification (A,B,C)
Total Depth
Cased to
_11.e/ //v
FTJ
FT
Installei
Date Installed:
REMARKS:
I
Municipal and State guidelines in effect on this date:
Health Department Approval:
/L -u IJ to/ oz))
Scale: c 60
.�y, F,N�GINEEFi'S.SEAL
Inspe t ns Performed by: � � C%t'.: , •'
✓H• t7' -
Date: �•
f•.. a �s . .
certify that [his inspection was performed according to all N
Date:
:,;N -Sia SE.4 ,.... . i
PERM11T NO: 3'6.'26U
DATE i.."SUED:
APPLICANT: )ARK RUDA
ADDRE Sa: 09 0C:-C'-'odVIEw,
ANCHiiR„u_. AK 9 9` 16
CONTACT PHONE: 345-52':7
LEGAL DcSC,�I': Su.'DIVISIC-�'d: +i'_ Z LC'T
`i=CTICA—. TO'ANSH.IP: 1 C?3 R', -GE: W
LOT Slat: 4,3573 (0'(;.FT. OR
MAX 6,rDROGMS: 3
LISTED aELOW ARE THE Ca Tl,:A5 AVAIL:;,=L�:, TO YOU Ia; D�.-SIGAINC YOUR S .:QTIL
S Y S T M. CHCOSE THE 5PTION THAT .-Z-ST FIT:s YOJR SI,T:,.
T hENCF 0
. D. 1i ,i
DEPTH TO PIPE '.'_OTTON (FT.)
4. a
4.0
GRAVEL DEPTH (FT.)
5
3.5
TOTAL DEPTH (FT.)
7.5
GRAVEL WIDTH (FT.)
GRAVEL L_NGfH (-FT'.)
49.0
GRAVEL VOLUr.E (CU.YD3.)
35.E
TANK SIZE- (GALS)
1.000.0 **
SOIL RATING (S I.FT.l3Fs)
1`'
15u
15D
k* TAN& MUST H.AGE AT LaA3T T:uG -00V-PAFT`^ENTS
I CERTIFY THAT:
1. I AM FAMILIAR WiTY' THE REUIFCMENTS FOR O'l-SITE SEWERS AND ':SELLS AS SET
FORTH HY THE: MUNI CIRALITY OF ;ANCHOR::AG= M)A) AND THE STATE OF ALASKA.
G. I WILL INSTALL THE SYSTE-Ft IN ACCORDANCE WITH ALL. '4OA CODES AND REGULATIONS
AND IN COMPLIANCE WITH THE DEvIaPV CRITERIA OF THI;
Sol/1- ISO
KID.
E
L. e oo I- u 5
c�
0
N
j
A2 i J65�c
�. • • . • • •�a/�c/o �a//�// . • :. • • fy
gyp. o. 2225-E `
S i�•• JUNE 25. 1971
LOT 73, Pr-/7-r-igWss `rO L6e h Gro rkl a -V4 pP, C -
IPPA eV- R V DA ,4,ie: � A-V-
IRI SOI LS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: A// ��6v7A— DATE PERFORMED:
LEGAL DESCRIPTION:_Rl4 Laz 76 .���, 1 %2/V, RJ►'V
DEPTH
S�— SITE PLAN
�/,��r`� Ivff,�
(FEET)
2
d �o
6 o°
4
o G�Avtc w Cod.BcEs
5 n °�
6
7 �' z 9 1
8 660
9
g o l G124VEL —GK/
10
12
0 oa
13
14
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
■✓NI■■■■■■■■
16
,�t�
• • • '� /1y+ C
0011■■■■E■N
■■NS■■■■NIN
■■N■■■■■E1■
9TH • etc ��
17
'.
....o. .. •...�:
■■®■■■■■■I�t�
9
18
Y,.a :
E
..• •.�: rrabr �i
No. 2225-E
H■■E••M•■■
JUNE 25a .1971
N■■■
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
,/ s
/"Zl— L
y� tee E
l
■■9i■■■E■E■
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
■✓NI■■■■■■■■
0011■■■■E■N
■■NS■■■■NIN
■■N■■■■■E1■
■■®■■■■■■I�t�
1
H■■E••M•■■
N■■■
■INN■■
■■■E■■■■■■
NEEM■■■■■■
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
.r
v
TEST RUN BETWEEN FT AND FT
PERFORMED BY: EZAl 1214, -AAO) &1"s4-4 CERTIFIED BY: -( —s DATE:
72-008 (6/79)
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904 .5 ,,1 � r ,
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 018-181-21 Expiration Date: Sep �Jr, aoa�
1. GENERAL INFORMATION
Complete legal description Deitz Lot 7B rem.
Location (site address) 3500 DeArmoun Rd, Anchora
Current Property owner(s) James & Wendy Pisk Day phone 907-345-6882
Mailing address
Real Estate Agent
3500 DeArmoun Rd, Anchoraae. AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
WaiverNariance request for:
3
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 55b Waiver Fee $
Date of Payment 3117 IW26 Date of Payment
Receipt Number IT 4 2q Receipt Number
COSA # (3SC a61®g9 Waiver #
Distance:
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,
—or_dinances,_and_r_egulations_in effect_at_th.e time_of_installation. _ _
Name of Firm ARCTERRA CONSULTING. INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date /7�_.2a
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface
conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future �� �►\
occupants or can ArcTerra guarantee that no unseen or A T�
encroachments, deficiencies or discrepancies exist.
T1 I
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
bedrooms. +1 ANN I M. llurrus- Is j
bedrooms. tra\�o
,
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
ON-SITE
Vy =. Ev'ATER o
J PROGRAM
F
By: auta, &UA Original Certificate Date: b c� 5 oC 0oC
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 AdvisoryJ'[_�
Well Flow Advisory
COSA blue sheet 10-10-12.doc
Other
Legal Description:
Deitz Lot 7B
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 9/9/98
Total depth 160 ft
Cased to 160 ft
Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 30 in.
Date of flow test for COSA 2/19/20
Static water level at beginning of test 46 ft.
Comments
B. TANK DATA
Age of tank(s) 16 years
Tank type/material STEP/Steel
Measured operating fluid level in septic tank 49»
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 2/20/20
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/10/04
ALL standpipes present per record drawing
Total measured depth from grade 5.5x ft (max)
Measured depth to pipe invert from grade ft (min)
FN N/A — pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Parcel ID: 018-181-21
Structure served by this system 1
Well production at time of test 7+ gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes E No
Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L X Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date of Sample 2/14/20
C. LIFT STATION
FO Required maintenance completed
Age of lift station 16 years
Lift station material Steel
Comments:
Adequacy test date 2/19/20
Results ® Pass For 3
Fluid depth prior to test 7
Water added 450 gal
New depth 22 in
Elapsed time 300 min
bedrooms
in
Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate 4504- gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies: *NIT extends at least V below gravel into sand layer
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
® Yes
if No
Septic Tank/Lift Station on Lot > 100'
Surface Water > 100'
® Yes if No ft
Community Sewer Manhole/Cleanout > 100'
Yes
if No
0 Yes
if No
ft
[0 Yes
if No
ft
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25'21 Yes
if No
ft
Absorption Field on Lot > 100' _ ® Yes
if No
ft
_Holding. Tank >__ 1,00'____, __ ®Yes-
if No
ft -----
Neighboring Absorption Fields > 100'
If septic tank is under driveway
comment below
Animal Containment > 50' ® Yes
if No
ft
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Yes
_
if No
ft
®Yes
if No
ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
® Yes
if No
ft
Surface Water > 100'
® Yes if No ft
Property Line > 5'
Yes
if No
ft
Wells on Adjacent Lots:
® Yes
Absorption Field > 5'
Yes
if No
ft
Private Wells > 100'
® Yes if No ft
Water Main > 10'
® Yes
if No
ft
Community Wells > 200'
® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
If septic tank is under driveway
comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
0 Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
r_1 Yes
if No Ox
ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells >' 100
_ ®Yes if No ft
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' ® Yes if No ft
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
* Right-of-way taking by State of Alaska in 2011 after drain field was installed now shows
drainfield MT at new property line.
G. ENGINEER'S CERTIFICATION
l certify that l 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.
COSA Checklist yellow sheet
Municipality
0i
1 �
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 a (907) 343-7904 0 Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
xxKX VARIANCE/WAIVER Xx*X
Waiver#: OSV201xxx COSA#:OSC201097 Permit#:
PID#: 018-181-21
Legal Description: Deitz Lot 7B REM
Engineer: ArcTerra
Applicant: James & Wendy Pisk
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the north property line fronting DeArmoun Road has been approved. The approved separation
distance is 0.0 feet. This waiver should have been applied for and paid for by DOT as part of the
DeArmoun Road Rehabilitation (Plat 2011-75).
This waiver approval applies to the existing absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
avaaaavvvavavmmmaavasaavvavaaaamavvvaaIII ®avmeaavvaaaaavaanaavvavavaameavv0aaaaaI
Waiver is Granted: X Waiver is not Granted:
Date: Approved by:
Name of Reviewer
Is Is mmvvcaavvvvmmamavveavavvamamvvavavavmaaaaeaaamavamaavvvavavaaaavvacaamavaaaI
MUNMPAUTY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Owner
Septic Tank:
-1 - .,Lift Station/Rump Vault__
Street Address 2
D,P
-Sludge level 0' inches -Pumping: requiredyes (no; -Pumping completed (Xg, no
Lift station:
-Pump basket cleaned ( es) no -Effluent filter cleaned (jea) no
-Control floats cleaned ygs', no -Proper float settings confirmedNed, no
-Operation satisfactory �,n o
Alarm System:
-Dedicated electrical alarm circuit -Audible and visual alarm inside dwelling es) no
-Alarm system operation satisfactory, not satisfactory
mannose Kiser
-Ground water intrusion at riser to tank connection law,
-Ground water intrusion around pipe penetrations Y�es �S_
-Manhole lid: Functional esu no Insulated es y no
-Weep hole functional rV_Q__11 no
Properly Secured no
Other
-All manufacturer required inspections and maintenance completed es no
Comments:
Qualified Maintenance Provider:
Technician
Company
Signature
q,
Date of maintenance �)e A—
Dat4 -k
S 89°55'34." E 165.13'
TH
NOTES � l ,l
1. Bearing p p '. MICHAEL , HORNE �
and distance records are pe the tats referenced hereon unless otherwise noted. �yo��
2 Sufficient boundary evidence was recovered to establish the �c LS -5318 �J AG
Not all controlling evidence is sho:✓n hereon. subject parcel on the ground. �FD. '�;!/ S/20
3. Dimensional information on W T&E and Di Easements are � PRdFESSIO�IAI����
4. This sheet prints at 1" = 40' on _Legal Sheet (11" x 14") at 100% sca( ngPiat No. 83 �3.
�yASK,S�
�a n �r,
LC
LEGEND
- SURNG, Iv1APPING, LAND PLAf�1N`hNG, Gi,S Monument
.;
7Gth Ave., Suite 1 0.1 Anchorage, Alaska 995 Septic Vent
FarpointAK.com (907) 522-7770 survey@r'arpointak,corri
ASBUILT SURVEY QT
SURVEY CERTIFICATION: FARPOINT has condu1. cted a physical
Lot 713, Deltz Subdivision. survey of the sublectproperty, the improvements situated _r -' -' -x -' -" `x _
Plat No. 83-43, thereon are within the property lines as shoi th, Existing Fence
Anchorage, Alaska ExcC
US10R NOT S: It is the owners responsib I tY to determine
NARK ORDER Nu. DATE!"� SCALE_ - - - •the existence of any easements, covenants or restrictions whichPREPARED FOR.
Zotil ING:
P-00-24
Mar. 26, 2020 1 '-40 R6 do not appear.en the Flat used for this survey. NOTE: Under. no 35COf0
it jDRAUVN: C1 iEC ED GRID PJo: FS BooKJPAGE: circumstances should any data hereon be used for construction A e Armoun Rd.
I� MC W 0 XXX/y or ?or the establishing o property lines., Anchorage, AI: 99516
Shed
!
1 `� ' ,�rh ���� � �F7���,�?• � ,,22.0
7-
12.0, '
"G,avel Drrver�iay
14.0'
�--10' T&E Easement ^ —
S 89°55'34." E 165.13'
TH
NOTES � l ,l
1. Bearing p p '. MICHAEL , HORNE �
and distance records are pe the tats referenced hereon unless otherwise noted. �yo��
2 Sufficient boundary evidence was recovered to establish the �c LS -5318 �J AG
Not all controlling evidence is sho:✓n hereon. subject parcel on the ground. �FD. '�;!/ S/20
3. Dimensional information on W T&E and Di Easements are � PRdFESSIO�IAI����
4. This sheet prints at 1" = 40' on _Legal Sheet (11" x 14") at 100% sca( ngPiat No. 83 �3.
�yASK,S�
�a n �r,
LC
LEGEND
- SURNG, Iv1APPING, LAND PLAf�1N`hNG, Gi,S Monument
.;
7Gth Ave., Suite 1 0.1 Anchorage, Alaska 995 Septic Vent
FarpointAK.com (907) 522-7770 survey@r'arpointak,corri
ASBUILT SURVEY QT
SURVEY CERTIFICATION: FARPOINT has condu1. cted a physical
Lot 713, Deltz Subdivision. survey of the sublectproperty, the improvements situated _r -' -' -x -' -" `x _
Plat No. 83-43, thereon are within the property lines as shoi th, Existing Fence
Anchorage, Alaska ExcC
US10R NOT S: It is the owners responsib I tY to determine
NARK ORDER Nu. DATE!"� SCALE_ - - - •the existence of any easements, covenants or restrictions whichPREPARED FOR.
Zotil ING:
P-00-24
Mar. 26, 2020 1 '-40 R6 do not appear.en the Flat used for this survey. NOTE: Under. no 35COf0
it jDRAUVN: C1 iEC ED GRID PJo: FS BooKJPAGE: circumstances should any data hereon be used for construction A e Armoun Rd.
I� MC W 0 XXX/y or ?or the establishing o property lines., Anchorage, AI: 99516
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # - a, � HAA # _. �A 120 aQ 19,__1
1. GENERAL INFORMATION
Complete legal description Lei '701, C>e4z- S IL>
Location (site address or, directions) 35-00 0& Ar-l�?octn 13 aC
Property owner T1.n P'rslr Day phone .. 3 Y - 6"662
Mailing address :3 5-00 Pa A, -me ce,,) R,,:,l - A 99S 16'
V
Lending agency — No r i-ior-tf Day phone
Mailing address
Agent N Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev.1/91) Front MOA #21
6. STATEMENT CE INSPECTION Y ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
fume of Firm(a�� Tcchn tc« f S rurc�� Phone ,3 4rr5 - +35=_
Address t yS3� r=cti� S/. /�- c(1Q1-c1!7e 411 <99916-
Engineer's signature fr�y4s-�c� Date 3 ! 23 19 z
Twp'' Y �'-..i',�' a°@'.•��.
�YYY .............. Yaeae rY re aeaa
@,t� Y Y>4 yY
tp'a eeaae eaaeee>aeeeYa
Y .w a THCoDG„� F. S.1OJRE > a
.a>
CE -3589 .' a{{��AV
6. DHHS SIGNATURE
Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the fallowing stipulations:
Additional Comments
By: - fh 51n rrr4 Date 2,1 cl
MEF
72-025 (Rev. 1191) Back MOA#21
Municipality of Anchorage
Department of Health & Human Services Aim
HEALTH AUTHORITY APPROVAL CHECKLIST EN ALITY OF ANCHORAGE
ENTAL SERVICES DIVISION
EN
Legal Description: 1-6,f 7 3 , Dei fz S /n Parcel I.D.
A. WELL DATA
Wellt e Pr���cFe`"�y C
yp If A, B, or C, attach ADEC letter. ADEC water system number IV.
Log present (Y/N) IV Date completed 196-5 Driller u^
Total depth > qL3 r Cased to '> If 9 ` Casing height
Sanitary seal (Y/N) Wires properly protected (Y/N) Y
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
AT INSPECTION
3/16,oe
r
g.p.m. `l. 8 + g.p.m.
x'19`
Septic/holding tank on lot I G 3 ; On adjacent lots
Absorption field on lot 1 03 ; On adjacent lots > I Uo
Public sewer main too' Public sewer manhole/cleanout "�- (CUG
Sewer service line Petroleum tank None s ee-n
WATER SAMPLE RESULTS:
Coliform O ce f / !oa M 4 Nitrate 0. 2 I m y Other bacteria co f hoots -C
Date of sample: 3 116'12E Collected by: 1= (u Fwd % PG� S I -c
B. SEPTIC/HOLDING TANK DATA
Date installed 191
2
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping to "', I
Tank size ! ZS O ff
a Compartments
Foundation cleanout (Y/N) Y Depression (Y/N) (V
Alarm tested (Y/N) (V• A-
Pumper ='s�cacf
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 107 On adjacent lots > !GG ` Foundation �3
To property line '20, Absorption field = S r Water main/service line—
Surface
ine
Surface water/drainage > Poo"
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION N i4
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Meets MOA electrical codes (Y/N)
Manufacturer
Manhole/Access (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
D. ABSORPTION FIELD DATA
Date installed e / e ( 18 611 -
On adjacent lots
"Pump off" level at
Cycles tested
Surface water _
Soil rating f 5'G 0' 1r3"(" System type 7"rc^ ch
Length k5 Width 2 S Gravel thickness
Total absorption area Hs0 r3, Cleanouts present (Y/N)
Total depth
Y
9•S`
Depression over field (Y/N) N Date of adequacy test 3 / f 6 / 9 2
Results (pass/fail) Pas{ for 3 bedrooms
Peroxide treatment (Past 12 months) (Y/N)
If yes, give date N.A.
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 103, Onadjacentlots > 120' Propertyline 10 ��er �ns�,• rc�.o�f
To building foundation 41-7To existing or abandoned system on lot
On adjacent lots > 30 ' Cutbank (\I, a • Water main/service line > 2S' `
Surface water 7> cGc' Driveway, parking/vehicle storage area > to
Curtain drain Won s e & n
E. ENGINEER'S CERTIFICATION
1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Date of Payment
Receipt Number
t)F A
'F'.; • a,
Signature �L
•.�.�.
Engineer's Name
Th eo c(G re F. "c a
-41
'° `j
Date /-larch
23. 1992
�.?a. a.a,e.a,aaea„�a.aaisa.�
�.a�.
..,..?:..,�
THEODORE
°< CE e
- '589
AV
HAA Fee $
Waiver Fee -
Date of Payment
Receipt Number
72-026 (Rev. 3/91) Back MOA 21
Date of Payment
Receipt Number