HomeMy WebLinkAboutT12N R3W SEC 15 LT 104TI 2N R3W
Sec 15
Lot 104
#015-483-12
Municipality of Anchorage Page 1 of 3
Development Services Department
On-Sde Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www cl.enchorege.ak.us (907)3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO50332
PID Number. 015.483.12
Alaskan Heritage Homes Inc.
Wastewater System: New
Aeb•••
P.O. Box 211386 Anch., AK 99511
ABSORPTION FIELD
250-0100
Four 4
Deep Trench
LEGAL DESCRIPTION
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8
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SEPARATION DISTANCES
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To
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>100,
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Engineer's Stamp
Inspections performed by: A. HaralaDates:
1' 2114106
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22122 8 23106
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Department of Health
and Human Services approval
1 WCr1AFL F ANDERSON
eft*.
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Reviewed and approved by:
� Date: 1i Z 6-06
i� " iu,-t�"�'��
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Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage. AK. 995196655 -343-7904
Onsite Wastewater Disposal System or Wen Inspection Report
Permit Number. SWO50332 PID No. 015483-12
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ISO
aAIN N90'00'00'E 115.00
EAST 101st Avenue
fir° 49th ti
PLAN AS -BUILT ....
...........................
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SCALE V = 50' Ir�.� No. CE 4381
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PLAN AS -BUILT ....
...........................
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SCALE V = 50' Ir�.� No. CE 4381
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Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 9951 M655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SWO50332
TBM -
92.56'
Page 3 of 3
PID No. 015483-12
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PROFILE AS -BUILT '�'``�..
t^ t NICINEL E. NlDERSON
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Municipality of Anchorage -e*,!R-S 4eeR'SFi Ljf S
Development Services Department b '
• Building Safety Division 1*`4918 s.�
• On-SHe Water and Wastewater Program tI �•� ��• ••!
4700 South Bragaw, Sl. /t
P.O. Box 196650 Anchorage. AK 99519-6650 p•••. ...::�S.r..........
www.eianchorage ak u• n : MICHAEL E. ANDERSGN
(9D7) 343.7904 % 41 •, -4381
Soils Log - Percolation Test 4j,; o� s7s�
Performed For. TA K AI��K ►yG��f� Date Performed: ti 'L prp
Legal Description: L/J T (fl� 1 TownnssshhipRange, Sedton: I C, .
Feet)I S AyC N�
2-
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4-
5-
5- qr-py
8T I
17-
18-
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COMMENTS
WAS GROUND WATER
ENCOUNTERED?
b
IF YES, AT WHAT DEPTH? L
Depth to Water Ahar0
Monitoring? 0 r7 Vq'1JeY e
E
Date: i b to
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
223
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- - - --- .••^ •^•...,o,� rcnp MULE DIAMETER P ••
TESTRUNBETWEEN FT ''ANp `•C�. FT
PERFORMED BY: -^ I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACtORDf,NCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
0■'APR-20-2015 12:26A FROM: 70:6777766 P:1/1
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ARROW PUMP & WEII SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8976
Palmer. (907) 745-9077 • Eagle River: (907) 622-9335
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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 WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Sep 06, 2005
Expiration Date: Sep 06, 2006
Permit Number: SWO50332 Parcel ID: 015-483-12
Legal Description: T12N R3W SEC 15 LT 104
Design Engineer: 0014 Anderson Engineering Site Address: 004615101ST AVE E
Owner Name: ALASKAN HERITAGE HOMES, INC Lot Size: 32200 SO. FT.
Owner Address: PO BOX 211386 Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99521 -
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.
Received By:
Date: L7 --S
Issued By: �,, fy Date:
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 SEWERIWELL PERMIT APPLICATION
t.� . FOR A SINGLE FAMILY DWELLING
Parcel I.D. b IS " Permit Number SW
Property owner(s) Alaskan Heritage Homes, Inc. Day phone 250-0100
Mailing address (1) P.O. Box 211386 Anchorage, AK 99521
Mailing address (2ftU15- East 101a Avenue Zip Code
Legal description (Lot, Block & Sub'd.) Lot 104, Section 15, T12N. 113W
Legal description (Section, Township & Range)
Lot Size 32,200 SF Acre Sq.F
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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:J qb0 f /75' 'e 6444$ Waiver Fees:
Date of Payment (P � b5—
Receipt Number.
(Rev. 12100) IQM
Date of Payment
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
September 5, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 104, Section 15, T12N, R3W
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 104, Section 15, T1 2N, R3W intends to construct a new four-bedroom
home on the lot. A well is currently in place on the lot and will be used to furnish water
to the new house. We are therefore requesting a permit be issued for the construction
of a new septic system to accommodate the home. The attached Site Plan and backup
documentation identify the location and configuration of the existing well and the
proposed septic system along with the alternate site. Also identified on the plans are
the locations of the existing wells on adjacent lots in the subdivision. No conflicts exist
between the proposed well and septic system and those on adjacent lots.
Test holes were recently placed on the lot and in the area of the absorption trench and
alternate site, which indicated a poorly graded sand (SP) material.. The percolation
rate of the materials was determined to be 2.5 minutes per inch. No groundwater was
found during the placement of the test holes and none was noted during the monitoring
period. An application rate of .8 gallons per day per square foot was used in the design
of the absorption system even though soils found justified a higher rate. We are
proposing to place a new 1,250 -gallon septic tank and a 63' long by 3' wide by 6'
effective depth absorption trench to treat and dispose the effluent generated in the
house. The elevation of the distribution line in the absorption trench will be 2' below the
surface and the total depth will be 8'. A minimum of 3' of fill will be placed over the
absorption trenches and 4' over the septic tank.
The ground surface on the lot in the area of the septic system slopes at shallow grades
from southeast to northwest. The new trench will be constructed parallel with the slope
as much as possible in conformance with Municipal requirements. The new septic
system will be constructed a minimum of 100' from the proposed and existing wells and
Lot 104, Section 15, T1 2N, R3W
September 5, 2005
Page Two
any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely, n fo
Michael E. Anderson, P.E.
Attachments
NICHAR E. Ak0[R504
06
e
% N90'00'00'E 115.00 r
o r
105 ag115.00
100
U
t
EAST 101st Avenue
11tA
119A
AREA PLAN
0 : 49th •
SCALE V = 100' 1. E. ANDERSON s'
♦♦♦��j,, No. CE -1301 i•(�.
'2p N90.0000 "E 115.00
50
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Four Bedroom Z
Home
FF. 101.0 1p• •
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rm.
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N90'00'00"E 115.00 m¢,
.••.P�•a
EF
EAST 101st Avenue g�.• ..`q(q� ...
�.'...49th `y:�}1�
SITE PL AN � zMICHAEL L ANDERSON '
00vA,No. CE-1381
1�••,� .•Br,.••'�'•
SCALE V = 40' ���t�Dp niR .•o
LOT 104, SW1/4, SECTION 15, T12N, R3W
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Perc. Rate: 2.5 Min./Inch 1,250 Gallon Septic Tank
Application Rate: .8 GPD/SF 6' Drainfield Rock
4 Bedrooms X 150 GPD/2 GPD/SF(Application Rate) = 750 SF Absorption Area
750 SF/12 SF/LF = 62.5 LF Trench length
THEREFORE: Construct a 63' Long x 3' Wide x 6' Effective Depth Aborption Trench at the
Location Shown. Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth
to be 8' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide
2" of Insulation and 2' of Cover. Maintain 100' Separation Between Existing Wells in the Area
Natural
Backfill
16-
GeotexGle
Fabric
4" Perforated
PVC (Holes Down)
6'0" I I— Drainfield Rock
3'
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
•.
Minimum 4' Separation From Groundwater.
i
Minimum 100' Separation From Private Wells in the Area.
Minimum 100' Separation From Surface Water or Streams..
i
Minimum 10' Separation From Water Service Line.
Performed For.
Legal Description:
Dep*
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2-
3-1
_3•
4. Sir
I
COMMENTS
Soils Log - Percolation Test C��i<<R�eESSIV'
Heritage Homes Date Performed: 8 IZ%i ISS
Township, Range, Section:
�)NG
UNI�oLw•-
Fttt?iTh.D
Mt,
11 6M
M_
TH 1
d
V
FL
m
CL
WAS GROUND WATER
ENCOUNTERED? 1
IF YES, AT WHAT DEPTH? foo
Depth to Water after WAlf 0.
Monitoring? 4
Date: Y "
Site Plan
TH 1
78'' s
D:
N
145'
IIS.or
E. 101" Ave
Reading
a. A
At
Municipality of Anchorage
; `Sr (EN GIINd_! 9'EALP '
Development Services Department
¢, '
•• A'gty .
Building Safety Division
• +1 On -She Water and Wastewater Program
or, * / A - 0'
"• '•' "" =.... o
4700 South Bragaw St.
P.O. BOX 196650 Anchorage, AK 99519-6650
:.: �.
d :° : MICHAEL e. ANDC25ON • �?T w
www.cl.enchor Dtrn.
F' "c�'. CE.4381 .'-`z
4th
(907) 343.7904
sj'• �: •�
Performed For.
Legal Description:
Dep*
ti
^+N
2-
3-1
_3•
4. Sir
I
COMMENTS
Soils Log - Percolation Test C��i<<R�eESSIV'
Heritage Homes Date Performed: 8 IZ%i ISS
Township, Range, Section:
�)NG
UNI�oLw•-
Fttt?iTh.D
Mt,
11 6M
M_
TH 1
d
V
FL
m
CL
WAS GROUND WATER
ENCOUNTERED? 1
IF YES, AT WHAT DEPTH? foo
Depth to Water after WAlf 0.
Monitoring? 4
Date: Y "
Site Plan
TH 1
78'' s
D:
N
145'
IIS.or
E. 101" Ave
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
eta o-�
la: og
�
�: q�-• '
41,75
1313b
�
7�BE
�
RERrM1 eTUIM
Dere 7_
---- —�C;
rcm. muLt VVveETER "
TEST RUN BETWEEN i .D FT rAND ; FT
PERFORMED BY: I CERTIFY THAT THIS TEST WAS
PERFORMED IN AC ORDANCE WITH ALL STATE AND MU141CIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchoragea `4;: ' (ENG INEER'9:5&A1y
Development Services Department •e ; •
Building Safety Division 0 ; 49 T�
• �.e On -Site Water and Wastewater Program C• ''%
4700 South Brapaw Sl. j.,;yr(SI. ...
P.O. Box 196650 Anchorage, AK 99519.6650 NUCHAIL C ANDERSON >.'W'
w w.cl.anchoraoe al. n• �° o• CE -43(31 •T A"`
(907)343.7904 ®O�,r�F••��
Soils Log - Percolation Test i►`r s ; -.�
Performed For. _Hertiage Homes - Dale Performed: $ 2 'Lcorr
Legal Description: Township, Range, Section:
Slone
Depth
H A
Ml -
COMMENTS
TMAY
01+
TH 2
■��to
Dale
Gross Time
Net Time
■■l■,
Net Drop
oS
�NII��
!
Io.b3
81�i7.•
30
■■NE
Cr(A3
NNE111
ro.co
MENIIA
3113
3o
■NE111
0:510
WAS GROUND WATER •1
ENCOUNTERED? N
IF YES,AT WHAT DEPTH? NY4
Depth to Water Ager n
Monitoring?
Dole: v O�
sl
Site Plan
Ils.o'
N
25' TH 2 �
c
C
140'
E. 101" Ave
Reading
Dale
Gross Time
Net Time
Depth to Water
Net Drop
oS
;Iti
!
Io.b3
81�i7.•
30
11,25-
Cr(A3
g(A3
ro.co
3113
3o
I1,Af-
0:510
rcnc MULE DIAMETER L,••
TEST RUN BETWEEN FT rAND —S, o FT
as_ ebSo26k�-/
PERFORMED BY: /71— I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 104, SECTION 15, T12N, R3W
GENERAL:
The scope of this project includes the procurement and placement of a new
1,250 -gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of a new 63' long X 3' wide X 6' effective depth
absorption trench at the location also shown on the Site Plan. The
distribution line in the trench will be placed at 2' below the existing ground
surface. Total depth of the trench will be 8' below the existing ground
surface. The new absorption trench and septic tank must be placed a
minimum of 100' from the well on this lot and in the area and 10' from the
water service line proposed for the lot. A minimum of 100' must separate any
surface water in the area and the septic tank and absorption trench. A
minimum of 3' of cover is required over the absorption trench and 4' of cover
over the septic tank.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Health and Human Services for system installations.
Owners installing their own systems must receive prior approval from
D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,250 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 104, Section 12, T12N, R3W
September 5, 2005
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 104, Section 12, T12N, R3W
September 5, 2005
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5' to 2.5' in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as -built of the completed system.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015463-12
1. GENERAL INFORMATION
Complete legal description Lot 104, section 15,12N, R3W
a .7111111 16
ZD
COSA# tp 61 go
Expiration Date: — 6— O
No
Location (site address) 4(Q IS- East 102 Avenue anchorage, AK 99516
Current Property owners) Alaskan Heritage Homes, Inc.
Mailing address
Lending agency
Mailing address
Real Estate Agent
P.O. Box 211386 Anchorage. AK 99521
Day phone 250-0100
Day phone
Day phone
Mailing Address
Unloss othorwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
Four (4)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
(]
Individual On-site
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑ _
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional Civil
engineer registered In the State of Alaska. Certificates of On -She Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations In effect at the time of Installation.
Name of Finn Anderson Engineering
Phone szz•ma
Address PA Box 240/23 AndKne, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date
6. DSD SIGNATURE
Approved for _4 bedrooms.
Disapproved.
4/19/2006
Conditional approval for . bedrooms, with the following stipulations:
•,,,u V11u 1V 111J.
COSA Checklist _X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: �• 0� Original Certificate Date:
(R«. IM)
G
i
+ Municipality of Anchorage
• Development Services Department
} Building Safety Division
4 Onsite Water 6 Wastewater Program
4700 Bragew Street
P.O. Box 190850
Anchorage, AK 995196850
G www.munlotg/onske
(907) 343-7904
CERTIFICATE OF ONSITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lel 104, serum 1% 12K R3W Parcel ID: 915483.12
A. WELL DATA
Wen type M!-" If A, B, or C provide PWSID 0 _
Date completed _ Sanitary seat (YIN) Y
TOW depth +210 R. Cased to *40 A.
FROM WELL LOO
Date of test
Stable water levet R
Well production 9 -
p.m -WATER SAMPLE RESULTS:
Coliform 0 colonieah00mL Nitrate ND mgfL
Arsenic: ND nW Date of sample: ansAe
B. SEPTICMOLDINO TANK DATA
Tank Type/Material 8813W ERW
Tank size 1.250 gel. Number of Compartments Two
Foundation cleanout (YM) Y Depression over tank (YM) N
Date of pumping New Coneaucam Pumper
C. ABSORPTION FIELD DATA
Date installed 2M -23M
Length ea R
Wen Lag (YM) N
Wires property protected (YM) Y
Geeing height (above ground) >24 in.
AT INSPECTION
411912008
1W A,
a g.p.m.
Other bacteria 0 colonies/100 mL
Collected by: L. Hemandez
Date installed 2114/08
Cleanouts (YM)
Soil raft (g.p.d.dt' or A'/bdan) •a c1PD15F
Width 7
R.
V
High water alarm (YM) N
System type Deep Tomb
Gravel below pipe a n.
Total depth 12.14 tt Eff. absorption area L� It' Monitoring tube Y Depression over field N
Date of adequacy test New Cana. Results (PasslFaiq For _ bedrooms
Fluid depth in absorption field before test in. Water added gal, New depth in.
Elapsed Time: min. Final Auld depth In. Absorption rate >= g.p.d.
Any rejuvenation treatment (peat 12 mo.) (YIN 6 type) If yea, give date
0. LIFT STATION
Date installed
'Pump on' level at _ in.
Size in gallons
'Pump OM level at ,_ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic lank/Oft station on lot »av
Absorption field on lot >1W
Public sewer main WA
Sewer /septic service One —_ >2w
Manhole/Access (YM)
High water alarm level at In
Meets alarm d chrouk regtroenrarns9
On adjacent lots >iw
On adjacent lots >1W
Public sewer menholr/deanout wA
Holding dank WA
Animal containment areas WA Manure/animal excrete storage areas WA
SEPARATION DISTANCES FROM SEPTICIHOLOING TANK ON LOT TO:
Building foundation >S Property line >5_
Absorption field a5
Water main WA Water service line »aoa
Surface water >i
Wells on adjacent lots >+aa
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property One 1• Building foundation »d Water mein WA
Water Service One »a Surface water >IW Ddveway, park Vvehlde storage >29
Curtain drain Nam Noted Wells on adjacent lots >/00f
F. COMMENTS: Ses Lot i.1ha Walm.
0. ENGINEER'S CERTIFICATION /�p�� m •••
I Cer* that I have determined through field krspoxons and e
review of Munktipal records that the above systems are in 49th
cordormance with MOA COSA guk/elines in effect on this date. c�
MCHAD. a ANDOW i
Engineer's Printed Name WWI E. Andwwn. P.E. '•. N CE -4M ,.
Date 4narmoe �s0�
COSA Fee S 12mcul
Date of Payment 4v1�0�,06
Receipt Number )),014
(Rev. 1I m
Waiver Fee $ / • (JD
Date of Payment
Receipt Number
SCS RcLN
1061464001
Client Name
Anderson Engineering
Project Name/N
DLM Lot 104
Client Sample ID
DLM Lot 104
hlatds
Drinking Water
PWSID
0
Sample Remarks
All Dstesffirnes are Alaska Standard Time
PrintedDatc/fime
04/10/2006 15:20
Collected Dateffime
03/282006 15:40
Received Dateffime
03282006 16:00
Technical Director
Stephen C. Ede
Allowahle Prep Analysis
Parameter Results PQI, Units Method Container lD Limits Dale Date Init
Metals by ICP/MS
Arsenic ND 5.00 ug/L CP200.8 C (<=10) 0329106 04/05/06 SCL
Waters Department
Nitrate -N ND 0.100
Microbiology Laboratory
Total Coliform 0
mg/L CPA 353.2 U (<=10) 0329/06 ALR
coU100ml. SM209222D A («I) 0328/06 DPT
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: April 19, 2006
TO: Reviewer
FROM: Mike Anderson, P.E.
SUBJECT: BLM Lot 104, Section 15, T12N, R3W
Well and Septic System As -Built
Certificate of On Site System Approval
Final grading of the subject lot can not be completed until drier conditions allow the use
of mechanical equipment. We are therefore requesting a Conditional Certificate of
Health Authority Approval be issued. All final grading will be completed by June 1,
2006.
The new owner of the property has decided to retain the existing drive just north of the
new absorption trench. This drive has a steep cut slope approximately 12' in depth.
The top of the slope is 24' from the edge of the new absorption trench. The 25% slope
from the edge of the trench extended toward the cut slope does not intersect or
daylight. Final grading will flatten the slope even more and increase the horizontal
distance between the edge of the trench and the edge of the cut slope.
The casing on the existing well on the lot has been raised to more than 2' above ground
and a new sanitary seal placed. No log is available for the well, but recent inspections
indicate the well is more than 210' deep with casing more than 40' below the surface. A
flow test on the well indicated a production rate of 8 gallons per minute.
Thank you for your assistance and please let me know if you have any questions.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
April 19, 2006
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: BLM Lot 104, Section 15,12N, R3W
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
The surface area available for a septic system on this lot combined with the house
location, existing well and protective radius and soil conditions require that absorption
trench and alternate site be placed within 1' of the west property line. Placement of the
absorption trenches at this location will have no adverse affect on septic systems in the
area. The west property line abuts a 60' right of way for Pacer Place and insures the
closest septic system can be no less than 60' away. We therefore request a waiver be
issued allowing the primary and alternate trenches to be 1' from the west property line.
Sincerely,
Michael E. Anderson, P.E.
Municipality of Anchorage
Development Services Department
Building Selloy Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchomge.sk.us
(907)343-7904
WR#: 060013 PID#:015.483-12
Date Received: 4120106
Waiver Review Worksheet
HA#:060140 Pernit#:050332
Legal Description: T15N R3W Section 15 lot 104
Waiver Requested: 1 foot separation distance absorption field to property line.
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
......................./.......................................................
Waiver Is Granted:y Waiver is not Granted.,
Ust Conditions or Reasons for above:
Date: — .2 `f 6 By: `/✓�� / ��! ���/
of� viewer
............................................ ... ..............................
Rec#: 4120108 Amount $175.00 Date Paid: 4120106
Mumcipality of Anchorage
U
1'.O. Ii,�x 100rC'+0 • Anchorngc,.Vnclut 0!I,i19l�fin0 • Telephone ((.N)7) 348-&901 • rmx (!N)7) 31.9diMll)
470011rapau• Stmct • Awhomgc, AhAa 9997117
Mayor Mark Be#ich
4/24/2006
Anderson Engineerin
P.O. Box 240773
Anchorage Ak. 99524
uv�emanLorg
Iluilding Safety Division
Subject: Waiver Request for T12N R3W Section 15 Lot 104
Waiver Request #WR060013
Parcel ID #015483-12
HAM 060140 Permit # 050332
Dear Engineer,
420
r.
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to the property line has been approved. The approved separation distance
is 1.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Jeffr � . Poet
Engineering Technician
On -Site Water & Wastewater Program
Community, Security, Prosperity
i
Ln PACER PLACE
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Municipality of Anchorage
Development Services Department
ar Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Mike Anderson
Legal description: T12N R3W Section 15 Lot 104
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 Well Pit is NOT to code.
❑ Incomplete; missing _
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing.
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required. _
❑ Omission in narrative. _
❑ Insufficient fill over tank or field._
❑ Other.
Name of reviewer: Poet
Date: 4-25-06
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK