HomeMy WebLinkAboutTHE TABLELANDS BLK 4 LT 5The Tablelands
Block 4
Lot 5
#051-801-13
Municipality of Anchorage
Page 1 of 3
Development Services Department
On-Sfte Water and Wastewater Program
4700 South Bragaw, Street
P.O. Box 196650 Anchorage. AK 995196650
wwwcl.anchorage.sk.us (907)3417904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
Permit Number. SWO50336 PID Number. 051-801-13
tVMn.
S inellHomes Wastewater System: New
Add p
1900 W. Northern Lights, Ste. 200 Anch., AK 99517
�.
ABSORPTION FIELD
344.5678 ur q4)
5' Wide Trench
LEGAL DESCRIPTION
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The Tablelands
1 Ft.
2
TOw'w"P RMps, SaaLon.
F&add dMaar. Wp
FL
LWw Gl.rM L*Vh
3.4 Ft.
106 Ft.
Well:
Well: AWWU Water System
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5
N�.mw Of . TN—
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Ft.
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2 >10'
Fp. MW
Ft. FL
Oraw
757 Fe
ASTM 3034 PVC
DM. Dmrd $IMC WMW L"
t.
Ft
Sanders & Sanders
1015 612005
rwd PWV SMM Ca+q Aa Grand
GPM Ft. Ft
TANK
SEPARATION DISTANCES
Advantex Treatment System
To
From
Septic
Tank
Absorpuon
Field
Lift
Station
Holding
Tank
uarlPrMete
sewwLhro
Anchorage Tank
T
1,250
WA
>200'
>200'
NIA
WA
>25'
Steel
Two (2)
S�tmwMM
>100'
>100'
NIA
NIA
LIFT STATION — NONE
LM Ln.
>5'
6'
N/A
NIA
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>10'
NIA
NIA
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7BENCH
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nsu a ton er n tre p do ys em. e o ne atver.
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Finished Floor.
100.0 Ft
Engineer's Stamp
Inspections performed by: T. Kimbrough Dates: 1" 10/5/2005
49th L�
M _ y�
2nd 10/612005
��°
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Department of Health and Human Services approval
}-.._» ... _.
�i MCNAt.I E. ANX R504/�
Reviewed and approved by: Date: -.Z O'O(
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 995196655 - 343.7904
Permit Number SWO50336 On -Site Wastewater Disposal System or Well Inspection Report
r« 6W
MW
THE TABLELANDS SUBDIVISION
LOT 5, BLOCK 4
40,000 S.F.
cif 49th •:7}
L ANDERSON
079 300
81 234 112
82 279 194
Ml "I 619
M2 719 802
CS 807 612
C6 733 807
C7 463 237
r
PLAN AS -BUILT
SCALE 1' - 50'
Page 2 of 3
PID No. 051-601-13
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number SW050336
TBM
PID No. 051-801-13
a
U E U
r` N N
U S U
PROFILE AS -BUILT
Scale: NONE
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SWO50336 /
Legal Description: The Tablelands Block Lob4'4
Design Engineer: 0014 Anderson Engineering
Owner Name: SPINELL HOMES, INC
Owner Address: 1900 W. NORTHERN LIGHTS BLVD
ANCHORAGE. AK 99517 -
Date Issued: Sep 07, 2005
Expiration Date: Sep 07, 2006
Parcel ID: 051-801-13
Site Address: Muley Circle
Lot Size: 40000 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
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 specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3_ The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued
Date:
Municipality of Anchorage
-- Development Services Department
Building Safety Division �+
On -Site Water and Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. bS l - g01- e> Permit Number SW
Property owner(s) Soinell Homes, Inc. Day phone 344-5678
Mailing address (1)1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99517
Mailing address (2)o* -k b t�(�=�zC�:(? Zip Code
Legal description (Lot, Block & Sub'd.) Lot 5. Block 4, The Tablelands Subdivision.
Legal description (Section, Township & Range)
Lot Size 40,000 SF Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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: H[tU 'CL/ Waiver Fees:
Date of Payment: VI / 7 /U---) Date of Payment:
Receipt Number. 19�95 Receipt Number.
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
622-7773 677-7766 FAX
August 16, 2005
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 4, The Tablelands Subdivision, Addn. No. 1
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 5, Block 4, The Tablelands Subdivision, Addition No. 1 intends to
construct a new four-bedroom home on the lot. We are therefore requesting a permit be
issued for the construction of a new septic system to serve the new home. The
subdivision is currently served by a community water system. No conflicts exist with
adjacent septic systems or wells and the proposed septic system on this lot. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed septic system and alternate site. The current drainage pattern is
identified on the Site Plan. The drainage pattern will be maintained after development
of this lot is complete.
Test holes recently placed on the lot indicated silty gravel with minor amounts of sand in
the area of the absorption trench and alternate site. The accepting soils were tested
and found to have a percolation rate of 15 minutes per inch. The system is designed
with an application rate of .6 GPD/SF. No groundwater was found in the test holes
during placement and none was monitored during the ensuing period. Our design,
however, is based on the bottom of the trench at 3' below the surface and includes the
placement of a new 1,250 -gallon septic tank along with 2 - 53' long by 5' wide by 2'
effective depth absorption trenches to collect and treat the sewage generated in the
house. The distribution pipe will be 1' below the surface. A minimum of 3' of cover will
be placed atop the trench and a minimum of 4' of cover will be placed atop the new
septic tank. A flow splitter valve will be placed to assure even flow to each trench.
The ground surface on the lot slopes at varying grades from northwest to southeast as
shown on the Site Plan. The absorption trenches will be constructed parallel with the
Lot 5, Block 4, The Tablelands Subdivision, No.1
August 16, 2005
Page Two
slope of the ground surface as much as possible in conformance with Municipal
requirements. The new septic system will be constructed a minimum of 10' from the
water service proposed for the lot and on adjacent lots. It will also be constructed a
minimum of 100' from any surface water in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. 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.
Michael E. Anderson, P.E.
Attachments
MICIIALL E. ANOLRSON
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LOT 5, BLOCK 4, THE TABLELANDS, ADDN. NO. 1
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House 5' Wide Trench System
Perc. Rate: 15 Min./inch 1,250 Gallon Septic Tank
Application Rate: .8 GPD/SF 2' Drainfield Rock
4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/5 LF (Width)' .7(Red. Factor) = 105 LF Trench Length
THEREFORE: Construct 2 - 53' Long x 5' Wide x 2' Effective Depth Absorption Trenches,
Flow Line Elevation In Trenches to be V Below Original Ground Surface. Total Depth to be
3' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trenches. Provide Flow Splitter Valve to Assure Even Flow to Trenches.
3' Cover or 2" Insulation
and 2' Cover
Natural
6" Backfill Geotedle
Fabric
6" 4" Perforated
PVC (Holes Down)
2'0" and
Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock ..._„
Minimum 4' Separation From Groundwater. % j�
Minimum 100' Separation From Welts in the Area.
Minimum 1 00'Separation From Surface Water or Streams: 10
�•_
4M
No. CE4381
>w
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION• LOT 5, BLOCK 4, TABLELANDS S/D
PERFORMED FOR: SPINELL
DATE. 6/6/2005 SOILS LOG PROJECT No - M0513
PARCEL IDR TECHNICIAN: M- El DRIDGE
DePTi I
(reel)
COMMENTS:
TEST HOLE # 1
OB/OG
DRY LOOSE COMPACTION
POORLY GRADED SILTY SANDS
SP
MEDIUM COMPACTION
SILTY GRAVELLY -SANDS
SP -GM
991
WAS GROUND WATER ENCOUNTERED? N�
IF YES ® WHAT DFFnn
DEPTH OF WATER AFTER MONITORING: N—
DATE OF MONITORING: LlgnDDy
NICNAEL E. ANDERSON
THI
O
h <2% I
DATE
READING
G OSS TIME
MINUTES)
NET TI E
S
(MINUTES)
DEPTH of
WATER
(INCHES)
INFT DROQP
NCHES)
8/8/05
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
0915
10.0"
CHARGE
2
0945
30
8.12511
1.87511
3
0945
10.0°
RECHARGE
4
1015
30
8.12511
1.87511
5
1015
10.0"
RECHARGE
6
1045
30
8.37511
1.62511
PERCOLATION RATELLQ.&MINANCII) PERCAIOLEDIA. 6 (INCITES)
TEST RUN BETWEEN: 5 FT. and 6 FT,
NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY TIIAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION. LOT 5, BLOCK 4, TABLELANDS S/D
PERFORMED FOR, SPINELL
DATE: 6/6/2005 SOILS LOG PROJECT No - M0513
PARCEL ID# TECHNICIAN: M. FI DRIDGE
Eli
MICHAEL E. ANDERSON
a
Dr..rrll
I TEST HOLE # 2
(r«q
NET TI)
(MINUTES)
1
INFTDRQQP
NCES)
8/8/05
OB/OG SLOPE SITE PLAN
2
1
0920
<5OR
10.0"
CHARGE
3
2
0950
30
7.375"
2.625"
4
3
0950
10.0"
RECHARGE
g
4
1020
30
7.1875'
2.5625"
TH2
9
5
1020
11.0"
RECHARGE
O
6
1050
30
9.0"
2.0"
7
MEDIUM COMPACTION
SILTY GRAVELLY -SANDS
8
SP -GM
9
SFE FUTURE ASBUILT
10 WAS GROUNDWATER ENCOUNTERED? ND
IF YES ®WIIAT DEPnn <Z%
DEPTH OF WATER AFTER MONITORING: N -
1I DATE OF MONITORING: spy
�n
13
14
15
16
17
18
19
COMMENTS:
N -Tim
DATE
READING
GROSS TIME
(MINUTES)
NET TI)
(MINUTES)
WATER
(INCFIES)
INFTDRQQP
NCES)
8/8/05
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
0920
10.0"
CHARGE
2
0950
30
7.375"
2.625"
3
0950
10.0"
RECHARGE
4
1020
30
7.1875'
2.5625"
5
1020
11.0"
RECHARGE
6
1050
30
9.0"
2.0"
PERCOLATION RATE:I5.Q'MIN/INCII) PERCAIOLEDIA. 6 (INCIIES)
TEST RUN BETWEEN: 5 FT, and 6 FT,
WAS GROUND WATER ENCOUNTERED? NO 1F YES @ WHAT DEPTH?
DEPTI I OF WATER AFTER MONITORING: NONE DATE OF MONITORING: 8/8/05
NO IMPERMEABLE LAYERS ENCOUNTER_[_D_.—rE—sTTTIoLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION• LOT 5, BLOCK 4, TABLELANDS S/D
PERFORMED FOR• SPINELL
DATE: 8/25/2005 PROJECT No - M0513
PARCEL ID.- TECHNICIAN: T-1 KIMRRQIICH
DEPTH TEST HOLE # 3
(rmt)
1
2
3
4
5 =
6 0
7 -
w
8 J
O
2
9
V)
10 w
F-
11-
12--
13-
14
11213
14
15
16
17
18
19
OB/OG
DRY LOOSE COMPACTION
POORLY GRADED SILTY SANDS
SP
MEDIUM COMPACTION
SILTY GRAVELLY -SANDS
SP -GM
ffmi
WAS GROUND WATER ENCOUNTERED? NO
IF YES ® WHAT DEPnn
DEPTH OF WATER AFTER MONITORING:
DATE OF MONITORING:
THI
TH,�o
}{ 2%
DATE
READING
G OSS TIME
MINUTES)
NET TIME
(MINUTES)II
DEPTH OF
WATER
(INCHES)
NET DRQP
(INCHES)
8/25/0
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1140
9.0"
CHARGE
2
1155
15
3.25"
5.75"
3
1155
10.0"
RECHARGE
4
1210
15
4.25"
5.75"
5
1210
10.0"
RECHARGE
6
1225
15
4.25"
5.75"
PERCOLATION RATE. 2_6 (MIN/INCFI) PERC. HOLE DIA.6_[INCHES)
TEST RUN BETWEEN.—L5—FT. and 2.5 Fr.
COMMENTS: Test hole Pre Soaked Prior to Test. No Impermeablc Layers Encountered.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES rN EFFECT ON THIS
DATE:
MUNICIPALITY OF ANCHORAGE
• DEVELOPMENT SERVICES DEPARTMENT
4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION. LOT 5, BLOCK 4, TABLELANDS S/D
PERFORMED FOR, SPINELL
DATE: 8/25/2005 PROJECT No - M0513
PARCEL ID.- TECHNICIAN: T -I - KIMBROUG,
DEPTII TEST HOLE # 4
(&1)
1
2
3
4
5 =
F -
o_
6 w
0
7 a
w
8 J
O
2
9 1• -
In
10 w
11213 11-
12-
13--1
14
15
16
17
18
19
COMMENTS:
5
leTZ716141
MEDIUM COMPACTION
SILTY GRAVELLY -SANDS
SP -GM
WAS GROUND WATER ENCOUNTERED? NO
IF YES 0 WIIAT DF.PITI?
DEPTII OF WATER AFTER MONITORING:
DATE OF MONITORING:
SITE PLAN
TH002
DATE
READING
G OSS TIME
MINUTES)
NET TIME
(MINUTES)
DEPTH OF
WATER
(INCHES)
INET DROP
(INCHES)
8/25/0
TEST HOLE PRESOAKED PRIOR TO TESTING:
1
1045
11.0"
CHARGE
2
1100
15
5.011
6.0"
3
1100
11.0"
RECHARGE
4
1115
15
5.12511
5.875"
5
1115
11.0"
RECHARGE
6
1130
15
5.125'
5.87511
PERCOLATION RATE-(MIN/INCI I) FERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: I_5 FT. and 2_5 FT.
NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
TI IIS WAS PERFORMED IN ACCORDANCE WITI I ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE-
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 5, BLOCK 4, TABLELANDS SUBDIVISION, NO. 1
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 2 new 53' long X 5' wide X 2' effective depth
absorption trenches at the location also shown on the Site Plan. The
distribution line in the trenches will be placed at 1' below the existing ground
surface. Total depth of the trenches will be 3' below the existing ground
surface. A separation distance of 200' from any well and 100' between the
septic tank and absorption trench and any surface water must also be
maintained. A minimum of 3' of fill is required over the absorption trench and
4' over the septic tank. In lieu of the required fill 2" of insulation and 2' of fill
may be placed. A flow splitter valve must be placed to assure even flow to
the trenches.
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 5, Block 4, Tablelands No. 1
August 16, 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 5, Block 4, Tablelands No. 1
August 16, 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 �'mE
Building Safety Division
On -Site Water and Wastewater Program s A E
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FORA SINGLE FAMILY DWELLING
Parcel I.D. o5i-8oi-z3 COSA#
Expiration Date:
1. GENERAL INFORMATION
Complete legal description The Tablelands Blk a Lt 5
Location (site address) 22goo Whispering Birch Dr. ChuoiakAk. gg567
Current Property owner(s) Amber L & Eric M Virden Day phone
Mailing address 22900 Whispering Birch Dr., Chugiak Ak gg567
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
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 -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of 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 engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of 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 Firm Pannone Engineering Services LLC Phone 272-8218
Address P.O. Box 100217, Anchorage AK ggS10
Engineer's Printed Name Steven R. Pannone, P.E. Date
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water �.W* OF
u•/1j44the water usage of the family being served b the system. �•••••••••. that may fluctuate during the you, and Y
1
These conditions are outside the control of the evaluator of this system. All systems eventually fail and �•••'••
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that t? 49 m •• •'.'� 0�
there are no hidden defects or encroachments. PES can therefore not provide any warranty for future �•••••.••• ••• •• • .............
performance nor give any estimate of how long the system will continue to meet the operational j�t -
requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed / teven R.
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it
confer any legal right whatsoever. �1�., o•'�'
i
5. DSD SIGNATURE ♦�0�,,".:.•�•
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
s/
BY: •-2/`` Original Certificate Date: 77 ces —
(Rev.11/0
G+'
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & 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 CHECKLIST
Legal Description: The Tablelands Blk t, Lt 5 Parcel ID: ori-8oz-i3
A. WELL DATA
Well type Public If A, B, or C provide PWSID #
Date completed _ Sanitary se��
Cased to ft.
FROM WELL LOG
Date of test
Static water level
Well production
ft.
WATER SAMPLE RESULTS:
Coliform onies/100 mL Nitrate mg/L
Wires properly protected (YIN)
Casing height (above ground) in.
AT INSPECTION
Arsenic: _ ug/I Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel Date installed 3.0/6/200;
Tank size IM gal. Number of Compartments 2 Cleanouts (YIN)
ft.
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A
Date of pumping 6/28/2022 Pumper Sanitary Septic
C. ABSORPTION FIELD DATA
Date installed 3.o/6/2001 Soil rating (g.p.dde or ft2/bdrm) .8 g..do /s.f. System type Shallow Trench
Length io6 ft. Widths ft. Gravel below pipe 2 ft.
Total depth 3 ft. Eff. absorption area 7rZftZ Monitoring tube Y Depression over field N
Date of adequacy test 7/2/203.2 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test ox in.
Elapsed Time: 90 min. Final fluid depth o_o in.
Water added616 gal. New depth2_0 in.
Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Size in gallons
in. "Pump off'
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot zoo+
Absorption field on lot moo+
Public sewer main 7s+
Sewer /septic service line i;+
Animal containment areas moo+
Manhole/Access (Y/N)
alarm level at in.
Meets alarm & circuit requirements?
On adjacent lots moo+
On adjacent lots moo+
Public sewer manhole/cleanout moo+
Holding tank moo+
Manure/animal excrete storage areas moo+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ;+ Property line _5± Absorption field ;+
Water main mo+ Water service line mo+ Surface water moo+
Wells on adjacent lots moo+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ao+ C2 ' Building foundation mo+ Water main mo+
Water Service line mo+ Surface water moo+
Curtain drain ;o+ Wells on adjacent lots moo+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone, P.E.
Date l 20 ?j
COSA Fee $ IL/46
Date of Payment 7/3//a
Receipt Number l v�
(Rev. 11/05)
Driveway, parking/vehicle storage mo+
Waiver Fee $
Date of Payment
Receipt Number
W
,en R. Panni
No. CE 8149
21
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343.7904
4ragem 1460,
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 051-e01•13
COSA # ja,
1. GENERAL INFORMATION Expiration Date: –� p p
Complete legal description Lots, Block 4. The Tablelands Subdivision
Location (site address) 22909 Whispering Birch Drive
Chuglak, AK 995a7
Current Property owner(s) Sgnell homes, lnc
Day phone sa4ss7—�_
Mailing address 1900 W Northam tights Boulevard, Suite 200 Anchorage AK 99517
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless othenviso requested, COSA will be hold by DSD ror pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY:
Individual Well ❑
TYPE OF WASTEWATER DISPOSAL:
Individual Water Storage0
❑
Individual On-site
Community Class Well ElCommunity
Individual Holding Tank
❑
Public Water System ❑Q
On-site
❑
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 -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval
are valid 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 seat affixed hereto and as of the validation date shown below, 1 verify that my investigation,
based on procedures outlined in the Certificate of Onsite Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information
obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Finn Anderson Engineering
Address P.O.Box24g773 Anchorage.AK99524
Engineers Printed Name Michael E. Anderson. P.E.
6. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone 522-7773
Date 41/18/2008
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X_
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rw. rrros)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: O' 06
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 6 Wastewater Program
4700 eregaw, Street
P.O. Box 198650
Anchorage, AK 99519.8850
Www.muni.org/onsne
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
U19151 0081 rOW: L00. 8b * 4, The TabWwwe &b*, W Parcel ID: 051-001-13
A. WELL DATA
Wen typo AWwu if A, B. or C provide PWSID 0 _
Data completed _ Sanitary seal (YIN)_
Total depth R. Cased to ft,
FROM WELL LOO
Date of test
Static water level ft.
Wen production O.P.M.
WATER SAMPLE RESULTS:
Coliform cobniesl100 mL Nnrate mg1L
Arsenk — nt9ft Date of sample: _
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SeptlrJS"
Tank sae 1.250 gat. Number of Cwnpw merds Two
Foundation cleanout (Y" Y Depression over tank (Yfl* N
Data of pumping New Conal xdm Pumper
C. ABSORPTION FIELD DATA
Date installed %%mos
Length 105 ft.
Total depth I ft.
Wen Log (Y/N)
Wires properly protected (YM)
Casing height (above ground) in.
AT INSPECTION
Boll rating (9.1).d./ft' or fe/bdnn).80PDMF
Width 5 ft
ft.
g.p.m.
Other bacteria colonies/, 00 mL
Collected by:
Date Installed 10/5/2005
Cleanouts (Y/N) Y
High water alarm (YM) N
System type 5 Wide Tnmch
Gravel below pipe 2 ft.
Eft. absorption area 757 fe Mon ftping Um y Dapreas= over field N
Date of adequacy test Now Cart.
Resub(PasslFan) For_ bedrooms
Fluid depth in absorption field before test in. Water added
gal. New depth in.
Elapsed Time min. Final fluid depth in. Absorption rate >_
g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date
D. LIFT STATION
Date ktststled
'Pump on' level at _ in.
Datum
E. SEPARATION DISTANCES
Sae in gallons Manhole/Access (YM)
'Pump off* level at _ in. High Water alarm level at In.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/ ift station an lot
Absorption field an lot
Public sewer main
Sewer /septic service Una
On adjacent lata
On adjacent kits
Public sewer manhole/cleanout
Holding tank
Animal containment areas Manurelanimai excrete storage areas
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation Property line'S_
Water main WA Water service line "a'
Wells on adjacent lots >2W
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Absorption Held a5
Surface water >,0a'
Property line a Building foundation a10' Water main WA
Water Service Una X10' Surface water >iw Driveway, pau ftfthkAe storage a5'
Curtain drain t'lons Ncmd Wella on adjacent Iota > ZOO
F. COMMENTS- Pmper,y is Served by AW WU Water System. See Lot Wra Watwr for AWergbtt TrWOMM
G. ENGINEER'S CERTIFICATION gam'
1 certify that 1 have determined through Bell inspections and a 49th
review of Municipal records that the above systems are in
conformance with MOA COSA guldetines in effect on this daterppM c MM
Engineers Printed Name Mldtaet E. Andersen. P.E. �4 cr-M
Date IM200e 4'es �ESSl
COSA Fee $ >7. 5D 1 175 064 ilk`
Date of Payment ti l Si D t o
Receipt Number PM 0711
tttev.,,ro� jg. G(�
20Iob
`- e.L(a# -'1908"
Waiver Fees _
1 `,t5 - fb
Date of Payment
3
Receipt Number9a
WAtv�-2 Fes-
(�5-°v
LAI zolot,
r+C108-1
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
FAX MEMO
DATE: 4/20106
TO: Jeff
WITH: MoA/On Site
FROM: Mike Anderson
SUBJECT: Lot 5, Block 4, The Tablelands Subdivision
MESSAGE:
We surveyed the slope fronting the absorption trench last night and completed
the attached drawing. The northeast end of the trench actually daylights about
42.5' from the center of the trench or 40' from the edge. The southeast end of the
trench does not daylight until nearly 67'. The slope was figured based on Jim
Cross's directive, which states the 25% slope starts 2.5' above the distribution
line. Please let me know what else you will need as far as documentation to
allow the trench to stay in its present location.
I will move the alternate site to the front of the lot and provide revised
documentation to that effect. Thanks for your help and please let me know if you
have any other questions.
2 Pages Being Transmitted. Please call 522-7773 if not complete.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
MEMORANDUM
DATE: April 20, 2006
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: Lot 5, Block 4, The Tablelands Subdivision
Certificate of On -Site Systems Approval
We have revised the Plan As -Built to show the alternate site at the front of the lot. We
have also modified the inspection report to show the contractor as Sanders and
Sanders. In addition, the slope analysis is attached showing the 25% slope and the
distance from the edge of the absorption trench.
Please advise if you have further questions.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766IFAXI
April 18, 2006
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 5, Block 4, The Tablelands Subdivision
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 and soil conditions require that absorption trenches be placed within 6' 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 subdivision is currently served by the
Municipal water system and all separation requirements from water facilities are easily
met. We therefore request a waiver be issued allowing the trenches to be 6' from the
west property line.
Sincerely,
W44_E44,—)
Michael E. Anderson, P.E.
0 49th
V C'IAEI E. ANO( HSON
l No. C[-4381
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.ci.anchoragc.ak.us
(907)343.7904
WR#: 060012 PID#:051-801-13
Date Received: 4/18/06
Waiver Review Worksheet
HAM 060136 Permit#: 050336
Legal Description: The Tablelands Block 4 Lot 5
l;A4A;MTWZ1r'Y&ic2F-TM,•
Waiver Requested: 6 feet separation distance absorptionfield 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: ✓ Waiver Is not Granted:
Ust Conditions or Reasons for above:
Date: Li— 2 0-06
By:
....................................
Rec#: 4118/06 Amount: $175.00 Date Paid: 4/18/06
®�
Municipality of Anchorage
,
1:0. [>,m 19Gf>,0 • AncLoru�;c. Alnskn 7ti;19�Gf:,O. Tclphanc N><l7) 34:�A101 • raa ((1(p) $3.4H,'IN) <`,��,lf�y, .
$700 lintgaw Swel • A,xhomgc. Alaska vrio
Mayor Mark 13egich a�vmwd.org
Btill(ling Safety Mision
4/20/2006
Anderson Engineering
P. O. Box 240773 Anchorage ,Ak. 99524
Subject: Waiver Request for The Tablelands Block 4 Lot 5
Waiver Request #VfR060012
Parcel ID #051-801-13
IIAA# 060136 Permit # 050336
Dear Engineer,
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 6.0 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,
All / a-ct:
Jeffrey W. Poet
Engineering Technician
On -Site Water & Wastewater Program
COM MIII, ity, Security, Prosperity
2004-25
THE TABLELANDS SUBDIVISION
LOT 5, BLOCK 4
40,000 S.F.
S -BUILT
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID DATE
NW 1559 12/8/2005
F.B. JOB NO.
05-14 TLS54
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE
"= 40'