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NEAR POINT KNOLL BLK 2 LT 17A
Near Point Knoll Block 2 Lot 17A #041-021-65 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.d.anchorage.ek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO40111 PID Number. 041-021-65 r r . Crown Pointe, Inc. Wastewater System: ❑ New ❑ Upgrade P.O. Box 112313 Anchorage, AK 99511 ABSORPTION FIELD F101e 345"8271 F" (5) N'• We' 0 Dw Im.0C3 Snr»e Tetimt,❑Sol I--] Ma ❑oe LEGAL DESCRIPTION awRr+p 1.2TOWppnrmmrpnrab+ T ovp,cF FI. Box. La'. S,lewr»n 2 17A Near Point Knoll DOW b ppe 1,VIM tram, xVW 7tiM, 13 SOW!, e.n.rn pp. 3 Ft. 4 Ft To.WV Range Saar Fr eOasU Boon pane, yaa. 13r 111 Lenpm: 2-3 Ft. 63 Ft. Well: [INew ❑ Upgrade 5 Yaxro« 1 ta»e a„p�.� FI. F1 Fl C»eru w (Rt,.r.. A B. C): T" oepn Grua V. Tar swopeon w Vp Mauru, Class A Well b Water System Ft. I Ft 630 Fit ASTM D3034 PVC 0,+»r. nal. D,rw S,eec Witt. L.w e» W. Cole InrWsa Ft Sanders 8 Sanders 6/10/2004 Y»» Perp S« n Grn,p 1»pa Aoo,� Grwa TANK opM Ft. FL SEPARATION DISTANCES ❑Septic ❑Holding ❑S.T.E.P. ❑Other: To Septic Absorption Litt Holding ubicrprvine .au« Y Fran Tank Field Station Tank Sevier Line Anchorage Tank 1,500 Gr W« >200' >200' N/A N/A >200' Mrpr Steel Two (22)"'erb10f"• S,Raoe wow >100' >100' N/A N/A LIFT STATION Lr Le,e >5' >10' N/A NIA Or Fa,naa,cn 1 >5' >10' N/A NIA w ti n o,e., None Noted Pmp Mme a M00N EI. Mix,MLaIF pMp11Ma UT CHIN, R" BENCH MARK Lauuon.w p.anpva, Front Deck Southeast Corner »vnp. 100.0 FL Emrp,4rs cramp. e; �At, 1 T'J ; - •: • ;� �'" Inspections performed by: A. Harala Dates: 1" 6/10/2004 : r '• •••y ••••� ••• '•••• 2 na 6/10/2004 ... 7..�.. Y.JCHA:L E Ar;r-2.;C'J Development Services Department Approval Pry sCE-4331 Conditional Approval by:Date: ios"ante Reviewed and Approved by: Date: (R•• 12") ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 MEMORANDUM DATE: February 1, 2007 TO: Joe Goodall FROM: Mike Anderson, P.E. IK 96L SUBJECT: Lot 17A, Block 2, Near Point Knoll Subdivision Septic System As Built The test hole utilized to design the septic system for Lot 17A, Block 2, Near Point Knoll Subdivision was placed during the subdivision phase of the project. The location was not accurately depicted on the subdivision map. The scaled location was shown on the original site plan. Evidence of the test hole was found during construction of the septic system trench and shown on the as built. Its location on the as built drawing is slightly different than that shown on the original design. The absorption trench, however was constructed in close proximity to the test hole and soils encountered in the trench were exactly as shown on the test hole log. Z O_ (n 90'19 NAZI• 1.00 N ,f6'9C N"Z.ZO.00 N 0 N------------ 1 ®••�• m '11153 _3_fi_'1_.oZ_— _---r— _ L_ In U '17/S3 3Nn NOLL03S ,rc 1 1 o------------------r- JO m" $ i N 1 N Y nn ~ I 0 1 0 vi Sig z OO m m 0. a ®< d z og ry .OS'fOl M-ZI.f IDM N \\\ \\ o 1D o<Mo.mw EyaELOYL '11 H Q E :Oz'u �w 0 1' //1 / E u� m m I> CL b JLL p mA NDo zlj 2 O= � O / I j it 13 I I ISI;I / 1 N I ISI / 1 Zm r ESAfT. E.49.47' R {2'06"E 117.46' �160.00' '^ i ` �,�� Z I e 06 �y� €� �I4�% a KALMIA E� i 11 v _ �p 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. SWO40111 PID No. 041-021-05 r 49th PROFILE AS -BUILT •._`:'°""`"'"' �,�.•._ No. ¢C[ 01 No Scale 91.8 2 3 4 5 6 It MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Crown Pointe, Inc. DATE PERFORMED: 6/10/2004 LEGAL DESCRIPTION: Lot 17A Block 2 Near Point Knoll Subdivision TTjj TEST HOLE # A SLOPE SITE PLAN V I I I II OG/OLPROJECT # I I Well Graded Gravel W/Sand and Silt Gw Trench Wall BOH @ T WAS GROUNDWATER ENCOUNTERED') No ID IF YES, WHAT DEPTH? II DEPTH OF WATER AFTER MONITORING: 10 DATE: 15 16 17 �J A � 49th YrluEl EArQER . NO. CEa l 0 P E READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 6/10 2:14 7,5- 1 224 10 Dry 7.5' Recharge 2:26 r 2 2:36 10 Dry T PERC RATE: 1_5 MIN./INCH PERC. HOLE DIAMETER: 6_ TEST RUN BETWEEN 4.0 FT. AND 5.0 T. COMMENTS: SAME MATERIAL AS ORIGINAL TEST HOLE ON LOT_ PFarN ATIM RATE c G MiunTca .e I.— TEST PERFORMED BY: A. HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/15/2006 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Crown Pointe. Inc. DATE PERFORMED: 6/102004 LEGAL DESCRIPTION: Lot 17A. Block 2. Near Point Knoll Subdivision TEST HOLE # A OG/OLPROJECT # 2 3 GROSS TIME Well Graded Gravel 9 NET DROP VV/Sand and Silt 4 GW 5 1 Trench Wall 51 J BOH @ T 8 —III 17. 49th YiC,MF1EN No. me i JI I t READING DATE GROSS TIME WAS GROUNDWATER 9 NET DROP ENCOUNTERED) NO .S 2:14 L IO 1 IF YES, WHAT DEPTH? 0 10 Dry DEPTH OF WATER P II 2:26 AFTER MONITORING: E I � DATE: 17. 49th YiC,MF1EN No. me i JI I t READING DATE GROSS TIME NET TIME. DEPTH OF WATER NET DROP Start 6/10 2:14 7.5' 1 224 10 Dry 7.5' Recharge 2:26 T 2 2:36 10 Dry T PERC RATE: 1_5 MIN./INCH PERC. HOLE DIAMETER: 6— TEST RUN BETWEEN 4.0 FT. AND 5.0 FT, COMMENTS: SAME MATERIAL AS ORIGINAL TEST HOLE ON LOT. PFern ATIM BATF C r MuniTFc xm i.ie„ TEST PERFORMED BY: A. HARALA I, MICHAEL . ANDERSON. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/152006 —rJ.} 01 Muntelpallty of Anchorage DEPARTMENT OF HEALTH d HUMAN SERVICES 823'L' Street. Anchorage, Alaska 49502.0630 SOILS LOG — PERCOLATION TEST PERFORMED FOR: JOE /-/E/✓%rx GATE ►E LEGAL DESCRIPTION: L.OT /7 Township, Range. Section: DEPT" O -!fit O�dr¢,tJ/G �G/G Z Blore T O £. 2- 41. 4 GP w .To.Nc sem' f/ , 4., s 6 7 8 9 a N� ltr.1 TTal1 � J.r R 11Y ,fki. RFORMED:_ 7 • / % • s% %ZNR2w .T/_ 10 9 — /To, WAS GROUND WATER t' ENCOUNTERED) MCI CI 11 12 13 14 15 16 17 18 19• 20 - COMMENTS _ IF YES. AT WHAT L DEPTH? D E Eem Is Watr Liaam�r�7, .Xwuf*p --fp —bw •Z8•jq no•Sha Dat• T� Time/, Doth oth to W,t.. N•t prop •� Rc M a��'1 /D •• Z. •• ....y on Z r♦ •• 15-9 �•e _ ie PEACONTION RATE tm utevmeh) ►EAC MOLE DUUETER TEST PUN DETWEEN --'/— FT AND S FT PERFORMED By. 69"'IX.v.f2K V I� W11-SCAJ I - / •CERTIFY THAT THIS TEST WAS PERFORMED M ACCDADANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 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 SEWER/WELL SUBMITTAL COMMENT SHEET To: ANDERSON ENGINEERING Legal description: NEAR POINT KNOLL BL2 LT17A The attached paperwork has been reviewed and is being returned for the following reasons: ® 1/30/07 -NEED ENGINEERING STATEMENT WHY INSPECTION REPORT TESHOLE LOCATION DIFFERENT FROM PERMIT SITE PLAN. Name of reviewer. JOE Date: January 30, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 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 SUBMITTAL COMMENT SHEET To: Legal description: NEARPOINT KNOLL BL2 LT17A The attached paperwork has been reviewed and is being returned for the following reasons: ® -NEED TO SUPPLY NEW TEST HOLES SHOWN ON AS -BUILT SITE PLAN. Name of reviewer. JOE Date: January 16, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK • MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040111 Legal Descriptionl.Near Point Knoll Block 2 Lot 17A r Design Engineer: 0014 Anderson Engineering Owner Name: Crown Pointe, Inc Owner Address: P.O. Box 112313 Anchorage . A 99511- .. yr c) 010to— 10,2,C -4., 3 .03t Date Issued: May 11, 2004 Expiration Date: May 11, 2005 Parcel ID: 041-021-65 Site Address: 10550 Shivalik Drive Lot Size: 65982 SO. FT. Total Bedrooms: 5 Permit Bedrooms: 5 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: cS Issued By:'_ 111 11 Date: S Ir og Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Dy/- OZf -6q" Permit Number SW Property owner(s)_Crown Pointe. Inc. Day phone 345.6277 Mailing address (1) P.O. Box 112313 Anchorage, AK 99511 Mailing address (2) Zip Code r - o' IT ov Legal description (Lot, Block & Sub'd.) ""7. Block 2. Near Point Knoll Subdivision Legal description (Section, Township & Range) Lot Size 65,982 SF Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Five (5) 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. NO (Signature of property owner or authorized agent) Permit Fees: Oro— Waiver Fees: Date of Payment: _;S Itl W Date of Payment: Receipt Number: S) LPt-I Receipt Number: (Rev. 12100) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) May 6, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 17, Block 2, Near Point Knoll Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 17, Block 2, Near Point Knoll Subdivision intends to construct a five - 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. A Class A Water System serves the subdivision. The Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. The Class A well on the adjacent lot is also shown along with the water service to this lot. Existing spot elevations and the current drainage pattern are also identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. Test holes placed on the lot during the subdivision phase indicated gravel with some silt and sand in the area of the absorption trench. The accepting soils were tested and found to have percolation rates of 1 to 5 minutes per inch. No groundwater was found during excavation and none was noted during the monitoring period. Our design includes the placement of a new 1,500 -gallon septic tank along with a 63' long by 5' wide by 4' effective depth absorption trench to collect and treat the sewage generated in the house. The bottom of the trench will be 7' below the surface to provide the required separation from the water table. The distribution pipe will be 3' below the surface. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. The ground surface on the lot slopes at shallow grades from east to west as shown on the Site Plan. The absorption trench will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 200' from the Class A well on the Lot 17, Block 2, Near Point Knoll Subdivision May 6, 2004 Page Two adjacent lot and 10' from all water services. 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. Sincerely, c a'J'--n Michael E. Anderson, P.E. Attachments 49th f V MICHAEL E. ANDERSON l,. No. CE -4381 3AIm�± f \ . 2� ,&s% - Wim- #m��- ' % ©�' »n,-,> D -m S! . y • • / e� `; � 1%9 k § �\ .� o� < � z 2 D (A `�� + �441. k z rn ) � � &> m to t 2 / \m 0 LM \ O � £ k c _R < U) ae,_'W ,� « § 0 � \$ z �` \ � - @ / /§ %\ Q _ SECTION UNE ESr 7ƒ »!-E.ESr « � ES� k- . ,� ,a .m3'12*W 51# LOT 17, BLOCK 2, NEAR POINT KNOLL SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom House 5' Wide Trench System Perc. Rate: <5 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 3' Drainfield Rock 5 Bedrooms X 150 GPD/1.2 GPD/SF(Application Rate) = 625 SF Absorption Area 625 SF/5 SF • .58 (Red. Factor) = 62.5 LF Trench Length THEREFORE: Construct a 63' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Provide 2" of Insulation and 2' of Cover if Necessary. 2'6" 6' 4'0" Natural Backfill 5' Fabric 4" Perforated PVC (Holes Down) Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION .••Eof (NO SCALE) .. �. Paam NOTE: Grade Area Over Trench to Drain Away. Oa ; Minimum 6' Separation From Bedrock. :,.„,; ,„., .._ .... ,,,. Minimum 4' Separation From Groundwater. i� r.................. Minimum 200' Separation From Class A Well. ���, MICIMEL E.ANC[RSON Minimum 100' Separation From Surface Water or Streams. *r s�, NO. CE.b, Minimum 10' Separation From Water Services. �i,'••.,_ Municipality of Anchorage / DEPARTMENT OF HEALTH 8 HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG — PERCOLATION TEST /� /R/ PERFORMED FOR: '10'1046 ���� d' 1 DATE PERFORMED:cq _ 7 ' / %' / LEGAL DESCRIPTION: r wo ooxerL JFEETI-D£o/�G�,J/G 1 S/c. 7- 2- GQa r /7 Township. Range. Section: % /Z N /Q Z w AJ GIG L SLOPE SITE PLAN 3- /! / 4 410 w soMG cS1y� 5- 6 7 8 9 10 9 / T WAS GROUND WATER ENCOUNTERED? No 11 _ IF YES. AT WHAT OL 12 DEPTH? P E 13 Depth to Water A,1e• q Monitoring? QRx Date: 'z8' 14 15 16 17 18 19 Reading Date Gross Time Net Time Depth to Water Net Drop • i P�Pc / EO m '� Z �, 20 -� I ul PERCOLATION RATE '/ /'/Zm nutevmchl pERC HOLE DIAMETER TEST �5'Tu L,�RUN �4cTAEN FT AND 71 FT COMMENTS -.� /�Z 30 -7 / .��e/ep /71Ts efy/,3D PERFORMED BY: &::, Te S I - /7�/, w`Z'SO CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. OATS ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 17, BLOCK 2, NEAR POINT KNOLL SUBDIVISION GENERAL: 1. The scope of this project includes the procurement 1,500 -gallon septic tank at the location shown on Ill includes the construction of a new 63' long X 5' 1 absorption trench at the location also shown c distribution line in the trench will be placed at 3' b surface. Total depth of the trench will be 7' be surface. The new septic tank and absorption tr minimum of 200' from the Class A Well on the adj; separation distance of 10' from any water service septic tank and absorption trench and any surfs maintained. and placement of a new e Site Plan. Work also fide X 4' effective depth i the Site Plan. The ;low the existing ground low the existing ground inch must be placed a cent lot. In addition, a and 100' between the ce water must also be 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 1,500 -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 17, Block 2, Near Point Knoll Subdivision May 6, 2004 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 17, Block 2, Near Point Knoll Subdivision May 6, 2004 Page 3 of 3 MATERIAL SPECIFICATIONS: 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. 4U M PA TY OF ANCHORAGE Development Services Department ~" Phone. 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 041-021.65 1. GENERAL INFORMATION Expiration Date: q- I (o2-0 Z Complete legal description _NEAR POINT KNOLL BLOCK 2, LOT 17A Location (site address) 10550 SHIVALIK CIRCLE, ANCHORAGE, AK 99507 Current property owner(s) LOWELL & JOAN HUMPHREY FAM. TRUST Day phone Mailing address 10550 SHIVALIK CIRCLE ANCHORAGE, AK 99507 Real estate agent 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: Private Well Water Storage Community Well Public Water System Waiver request for: 5 SYSTEM Day phone TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Holding Tank ❑ ® Community ❑ ❑ Public Sewer ❑ Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 7 �a-5b�CDU I b-11 Date of Payment % 2ZZZOW Receipt Number 57/22)_3 COSA# OXo 15 r (� Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE. AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 911 912 0 2 0 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. 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 in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance.. 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, any estimate of how long sasystem will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 89 6. DSD SIGNATURE System #1 Approved for �_ bedrooms. System #2 Approved for bedrooms Disapproved .. L- � • • ' • • Curtis Huffman X, �c�c • CE 128991 ,• c`�/ Conditional approval for bedrooms, with the following stipulations: , LaW(Wirar._ r - "IMIll- a .6 ry Y' Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: NEAR POINT KNOLL BLOCK 2 LOT 17A Parcel ID: 041-021-65 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA — CLASS A WATER SYSTEM ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to _ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) _in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) 16 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 48" ® Standpipes/foundation cleanout per record drawing Date of pumping 9/16/2020 D. ABSORPTION FIELD DATA Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by_ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _years Lift station material Comments: Which system tested (date installed) 6/10/2004 Adequacy test date 9/16/2020 *® ALL standpipes present per record drawing Results R Pass For 5 bedrooms Total measured depth from grade 8.7 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 4_7 ft (min) Water added 750 gal ❑ N/A — pressurized field New depth 0 in ® Monitor tubes go to bottom of effective. If not, state E depth into effective lapsed time <1 min ® Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: *ALL PIPES FOUND PER RECORD DRAWING —OWNER TO EXTEND WEST FIELD PIPE ABOVE GRADE. E. SEPARATION DISTANCES From -private Well on Lot to: (Please enter distances if less than required or if community well) NA CLASS A WATER Septic Tank/Lift Station_on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' Surface Water > 100' ® Yes if No ft Yes No ft ® Yes if No ft ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Main > 10' ® Yes Neighboring Tank > 100' ® Yes if No-- ft ` Private Sewer/Septic Line > 25' ® Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft -----Holding Tank > 100' ®Yes if No ft Neighboring Absorption Fields > 100' Animal n ainment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage,_ 100' Community Sewer Main > 75' ® Yes if No ft N-Ves if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 5+ ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ 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 Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 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. or- VVII TH . _ ....... .. .... .vim. Curtis Huffman •CE 128991 . AW� 9119/2Q2AAW PROFESSION N00'13'12"W N00"02'27"W 1P13'ri3SV3 3rai ,Qt 51.0 78.94 i-----------------------51.-06 .�� -------------?r-- -i+------------------ ---------- ------------- --- 1 --0 IN3Yd=S.3 _ r. NOLL03S ,££ J i / I ; 1 1 ; _ t r N l I 0 1 1 ! 00 t� 1 1 p W z �. 'N00'13'12"W 103.50 Cd LLJ N I' C l i r f �. O 1 YI� N ?' ( r ` O F- r7 ir+ '00 _JI co L(7 r r`-�-53.5— t + o®a f1 00 I 153.7 / f 141 1 I` --awl i I quit I Vic^, 1 I � I = t u•i) f 'r ��Itl -uUjY ff 1 ;i .ol vel I ! 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