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HomeMy WebLinkAboutZONA LT 138BOnsite File -IM�>��»� Inspection Repok_9�1 -1 2.doc Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 040112 PID Number: 051 15 220 Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: 0 New ❑ Upgrade Name: Zona Dahlman ABSORPTION FIELD M Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 19972 Birchwood Loop Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 688-2929 3 0.6 GPD/SF 10.85 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.70 Ft. Gravel depth beneath pipe 7.15 Ft. Subdivision Block Lot Zona 1388 Fill added above original grade NA Ft. Gravel length 58 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines NA Distance between lines NA Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1852.6 Ftz 1 NA Ft. Well, 106' NA NA 155' TANK KSeptic ElS.T.E.P. El Holding El Other Manufacturer Anchorage Tank Capacity 11000 Gal. Surface Water >100' >100' NA NA Material Steel Number of compartments 2 Lot Line 25' 25' NA NANA Foundation10 25' NA NA LIFT STATION Manufacturer NA Capacity Gal. Curtain Drain NA NA NA NA Remarks ** All Pipe Is PVC 3034 Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL Housetotank ** Tank to drainfeld Installer Bailey's Backhoe Dreinfield** CO/MT** Inspector Kent Sheets BENCH MARK (Assumed elevation)100 ft Inspection � 6-6-04 6-7-04 Location and description dates: 2. 3b 6-7-04 06-8-04 Top of block, foundation wall @ ground surface COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp ,*.OF 444 J# Conditional Approval: Date �P.• • �j9��, iS1Z`b rZo/3 • ,� 4+•• Charles A. L CS 480 �� ,• ' Approved Date O iAOFE55bN ��+• t Inspection Repok_9�1 -1 2.doc LOT 138A QS'gE,0F. q<, �` 49TH Z°•°Charles•A. Leet•• ' CE 10480 LOT 138B DWELLING 1— SEF 1 DBL( B4, /` 7 ED X 58' DEEP -jf (NCR -- SOIL ABSORPTION Sly.\TEM 1 I 1 / J 10' UTIUW EASEMENT / .11 BIRCHWOOD LOOP Conventional SITE PLAN ZONA SUBDIVISION, LOT 139A STEEL K P,30' TEST #1 SAS PERC TEST y2 -TESTHOLE 01 ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim@oloskarim.com : WEB: www.alaskarim.com W0: 13-00399 PAGE: 1 Single — Family Residential LOT 1388 ©20131 i / QS'gE,0F. q<, �` 49TH Z°•°Charles•A. Leet•• ' CE 10480 LOT 138B DWELLING 1— SEF 1 DBL( B4, /` 7 ED X 58' DEEP -jf (NCR -- SOIL ABSORPTION Sly.\TEM 1 I 1 / J 10' UTIUW EASEMENT / .11 BIRCHWOOD LOOP Conventional SITE PLAN ZONA SUBDIVISION, LOT 139A STEEL K P,30' TEST #1 SAS PERC TEST y2 -TESTHOLE 01 ALASKA RIM ENGINEERING, INC. 9131 E. FRONTAGE ROAD, SUITE 1 PALMER, AK 99645 PH: (907)745-0222 : FAX: (907)746-0222 EMAIL: akrim@oloskarim.com : WEB: www.alaskarim.com W0: 13-00399 PAGE: 1 Single — Family Residential LOT 1388 ©20131 SEPTIC SYSTEM PLOT PLAN TBM TOP OF BLOCK FINAL GRADE � 100.0 ft. 100.07 ft. 95.65 ft. El FINAL GRADE / 100.23 ft. An DATUM (TEMP.) = TOP OF BLOCK = 100.0 ft. 87 NOTE: MEASUREMENT OF ORIGINAL GRADE REFLECTS MEASUREMENTS OF FINAL SAS INSPECTION. FINAL GRADE BASED ON 7-15-13 MEASUREMENTS TAKEN DURING ADEQUACY TEST. SEPTIC SYSTEM PROFILE SEPTIC ALASKP.O. BOX 2749 AS BUILT i RIM PALMER, ALASKA 99645 ENG EE PHONE: (907)745-0222 INC. FAX: (907)746-0222 W.O. 1300399 1 DATE: 8/26/13 1 SCALE: 1 " = 30' 1 FILE: 1300399_WWAS I LOT 1388, ZONA SUBDIVISION, PLAT No. 81-183, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. Note 1: fa f ell pmforatad PVC level (wBAin 0.0 foot of adore olavetion) TRENCH DETAIL Note 8: Test hole ahneBoa depth . datarmhud attar meagmivg to the bottom of roccka the ' rocl acmantt for Namael gronndweSer The elavLL end eabmgam og elevation ere reprsesatad Nota 8: 8eeeCoal growdwater ndfueted for t:dT reedtug 8' Note 6: Vield eknatlov tekev duridg Baal WpecYoe 0-6-8084 Note B: asiaHvy sepBc sPdem bm a memm�de mond to oroad. n.cemdn aovm TRENCH SECTION DEEP TRENCH PLAN VIEW 3' ± pertoreted pec hale orledfe d (holes own)) SECTION X—X FG. ELEV 100.23' Surface elevation at teat hole location 88.85' ramoveebL ory E1010d��� // 11 Berth OG. ELEV aaVer nA'l' PIPE INVERT 7.15' afteaNve depth ELEV. 87.B5' uvdiaturbea .girth 0 c� eeeeoml high ELEV. B1.6' growdweter see Note 8 ELEV. ME, MONITOR TUBE DETAIL M SITE PLAN A,Asx P.O. BOX 2749 AS BUILT RIM PALMER, ALASKA 99645 ENC EE I , INC. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 1300399 DATE: 8/26/13 SCALE: nts I FILE: 1300399_WWAS Lot 138 B ZONA SUBDIVISION, PLAT No. 1981-183, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 3 OF 3 Municipality of Anchorage Development Services Department Building Safety Divisuu>n S On -Site Water and Wastewater Program 470D Elmore Road P.O. Box 19M Anchorage, AK 99507 www.a anchoraae.ak.us (907) 343-7904 Soils Log - Percolation Test 4L-1 Performed For. 1 �hli^��rtt..6+R..1-�%J Date Performed: Legal Description: L c,'r- ms(s aC>r, . SU LA Township, Range, Section: _ Depth R,4s %ck- (t.T`t mus) . �/pvpc L -T4 CC{-��eV'axek �e 7 1 1 1 COMMENTS WAS GROUND WATER �t� ENCOUNTERED? NO S IF YES, AT WHAT DEPTH? L O Depth teWaterAeer P Moneodw. £ Date-�5-zof3 .,.� i oivurcn I,1a-rEY_ pntxcn�r Cturie A Leet �•.... _..t Cly= Reading Date Gross Time Net Time Depth to Water - Net Drop 2a� A:o1 I 7-'rf. 17/1 ISO Bite 71 S PERCOLATION RATE 1:1,1 (rkeleaf ch) PERC HOLE DIAMETER 10 TEST RUN BETWEEN $ FT AND % FT PERFORMED BY: (1, L e ck 1 (" Le -2 y CERTIFY THAT THIS TEST W S PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: V Lot Performed For. Legal Description: COMMENTS Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage. AK 99507 www.ei.anchoraae.ak.us (907) 3437904 Soils Log - Percolation Test -�62. mavi V-'- Date Ped' Ivo 1383 ZPrux Township, Range, Section: WAS GROUND WATER Date ENCOUNTERED? Net Time Depth to Water S IF YES, ATWHATD ? O Depth toW AiYv P Mon Do? Dale: E Reading Date Gross Time Net Time Depth to Water Net Drop 1 -?--zb13 4:11 1 1Dff Z 1 4 7 m;n (lb 1 716, 51k _0 '9A1 L I Yt I z 1 s PERCOLATION RATE U.0 (mea *Wmh) PERC HOLE DIAMETER 6_ TEST RUN BETWEEN (6-- FT AND 4�p FT PERFORMED BY: ` LST ( ( , �^'�f� CERTIFY THAT THIS TEST W PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: - 14 WI !S ALASKA RIM ENGINEERING, INC. ENGINEERS—PLANNERS—SURVEYORS 9131 E. Frontage Road Palmer, Alaska 99645 Telephone (907) 745-0222 Fax (907) 746-0222 Online at: w .alaskarimcom August 20, 2013 Mr. James A. Crewdson, P.E. On -Site Services Program MOA Department of Health & Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 RE: Zona Subdivision, Lot 138 B Subject: Change Order review — COSA Submittal Dear Mr. Crewdson: The owner of the above referenced lot constructed a 3 -bedroom single-family residence in 2004. We requested and received a permit at that time. During construction, changes were made and documented by our firm; some of those changes were approved, others, unfortunately were not. This document and its attachments are being submitted to rectify this oversight on our part. In addition, we are also requesting a COSA so the home owner may sell her home. We understand hourly review fees apply to this as well as the COSA fees. We will gladly pay by credit card upon receipt of the amount of the hourly fees. Solis The relocation of the septic system required additional percolation tests and soil log in the vicinity of the septic field. This was not done in 2004. One test hole was excavated and two percolation tests were performed by Alaska Rim Engineering, Inc. on July 7„ 2013. The approximate location of the test hole is located on the attached site plan and is identified as TH #1. The soils were visually rate silty gravel (GM), no ground water was observed in the test hole. Percolation test holes were excavated near the existing septic field see site plan for location to verify the percolation rate see percolation test sheets. The percolation. On July 15, 2013, groundwater monitoring was performed, again no water was present. The soil rating did not change as a result of relocating the septic system. Surrounding Properties There are no water wells within 100 feet of the relocated system. ALASKA RIM ENGINEERING, INC 2 Zona Subdivision Lot L38 B Charles A. Leet There are not any adverse effects on the neighboring septic systems, reserve areas or drainage patterns by the installation of the septic system in it current location. Should you have any questions or comments please do not hesitate to contact me by telephone or email chuckkalaskarim.com. Sincerely, Alaska Rim Engineering, Inc. • -It rA•rn... [.,ds •... 13 ,�`�•,� cnCEia8eeu Charles A. Leet, P.E. Project Engineer Encl: Permit Application Permit fees Soil Logs(1) — Percolation Tests (2) Site Plan (3) MOA Inspection Report COSA Brown and Blue Water Test Reports Ce: Client AK Rim File # 13-00399 ALASKA RIM ENGINEERING, INC Engineers... Planners... Surveyors 01/01/1999 08:01 68822`9 SUIIVAN certitieb 30orf lling In by Doe cm ew SULLIVAN WATER WELLS P.O. BOX 6707,2, CHUGIAK, ALASKA WSW • ' . F.101 IMM F• oil - W.4�e DecrF�_ � IUT NtaMaEFI: d 9 a f /0 Date oc tssue_6�-1L- 04 TAX tDE anCMON Nuri:`L_- o Is wen located at appra W permit bca6m? tgs C'No WIhod of Drilling: 0.91 ;txy U cable tool Depth of well d 43 0 Casing Type SlIM-WallM*lness' S'b Inches Diameler rte_� kretm dam a O a feet LirrerType �. It pt/ca Casing Stckup Above Gram feet Stant water Levet (n O — iced Recover' nates %m Method of Tesfirxs A A Nen Intake Opa*V Type: 0 open end U open Mote :tSGreenoct. Start feet Siopped feet a perforations Start feet Njopped feet GRXA Types .13c—.Nto'�. r� C�� Dapttc from d feet, to fed Well Distrrfeeted Upon Completion? bl<3 11 NO Method of DAn cfot C fico'Z r.J = TD P,�.r k"I" : . PAGE 02/02 calf, ,jc_ S rC.rJ P Sit -7'? 5 .4,J0 S,ai Y brfFrJE� (J h'Irl a.J f t (f20 SrT.��r;s.JS Ca4GE2.+�lac?% .5�4..IOS is •++6 DMerls Name / • el -1 L UTENI'ION: It Is the responsibility of the property owner to Submit a copy of the wen log to the proper authority. Mwkipafity )f Archorage: Department of Health 6 Human Services ancIfor DeParbnem of Emkorurrerdal Corm"tton. MatSu B=MIT ]epartrnera of EnvirawnerM Cortisxvation. 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 I WATER SUPPLY PERMIT Initial Permit Number: SW040112 Legal Description: Zona Lot 1386: Date Issued: May 11, 2004 Expiration Date: May 11, 2005 Parcel ID: 051-152-20 Design Engineer: 0032 Alaska Rim Engineering Site Address: 19968 Birchwood Loop Owner Name: Zona Dahlman Lot Size: 42754 SQ. FT. Owner Address: 19968 Birchwood Loop Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , A 99567 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5'-20-0V Received By: WLSt /a1-� -. �or /3C��-t f� �roptr/�7 11�'�Ci� fu.M1. L 7f 00t Date: '//-01% Issued By: Date: S'111 o Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OSI — 15-1-20 Permit Number SW Property owners) Zona Dahlman Day phone 688-2929 Mailing address (1 19968 Birchwood Loop Mailing address (2) Chugach Zip Code 99567 Legal description (Lot, Block & Sub'd.) Lot 138 B. Zona subdivision Legal description (Section, Township & Range) Lot Size 1 acre +/- Acre 1Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only El Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family DwelliWgd isjo-occordance with applicable Municipal Codes. of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12=) Waiver Fees: Date of Payment: Receipt Number: eligilteehittg, 911c. Phone (907) 745-0222 Fax (907) 746-0222 akdm®rogershsa.com April 27, 2004 Mr. Dan Roth Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 196650 Anchorage, AK 99519-6650 RE: LOT 138 B, Zona Subdivision AK. Rim Engineering Ref. No. 04-00271 Subject: On -Site Sewer Permit Application Dear Mr. Roth: P.O. Box 2749 Palmer, Alaska 99645 The owner of the above referenced lot is proposing to construct a 3 -bedroom single family dwelling (see attached Plot Plan). The proposed dwelling is to be served by an onsite well community water system and a private septic system. With this letter we are requesting plan review and a permit to install an onsite septic system to serve the proposed development. DESIGN SUMMARY Topography The topography of this lot is that it slopes evenly from the south to the north, with the contours perpendicular to the long lot lines. The slope is approximately 2%-6% throughout the lot. The back north west comer drops of with slopes 25% or greater. Soils A test hole was excavated and a percolation test performed by Alaska Rim Engineering, Inc. on April 2, 2004. The approximate location of the test hole is located on the attached site plan and is identified as AKTI-I1. The soils were visually rate GM. The percolation test indicates the use of an application rate of 0.6 gal/day/sft. On April 12, 2004 the monitoring tube was checked, no groundwater was observed in the monitoring tube. Engineers • Planners • Surveyors LOT 138 f3, Zona Subdivision April 27, 2004 Trench Design The following is a summary of the proposed design of the trench SAS: Percolation rate: 20 minutesAnch Soil application rate: 0.6 gpd/sgft Number of bedrooms: 3 Daily wastewater flow: 450 gpd Drainfield: 7 -foot deep trench Septic tank: 1,000 gallons Minimum absorption area: 750 sqft Surface Water Total depth (max): Effective depth: Width: Reduction factor: Minimum length: Effective absorption area: There are no surface waters within 100 feet of the proposed septic system. Surrounding Properties Page 2 9 f 7 ft 2 it NA 55 ft 770 sqft This property will be served by an onsite well. Development on this lot will not preclude development of wells and septic systems on neighboring lots in the future, Lot 138 A and Lot 13%,have existing wells and septics on them. If you have any questions regarding this report or its recommendations, please feel free to contact me. Sincerely, ALASKA RIM ENGINEERING, INC. 0-a (3`j Charles A. Leet, P e - Professional Engineer CC: Wolfe Homes LLC. AK Rim Engineering File No. 04-00271 Attachments: MOA On -Site Sewer/ Well Permit Application Form MOA Soils Log — Percolation Test Form Septic System Plot Plan (3 pages) PERMIT NUMBER 1V N 2-3z REPLACEMENT SYSTEM AK m RESIDENTIAL `s. WELLING SEPTIC SYSTEM PLOT PLAN =P at...wt SEPTIC OF `1 .•9*�0 49TH W .. ... .:.4 P , Charles A. Leet ;•rd CE 10480•; �d �QOf�Pfe PID NUMBER 7' E.D.1 X 55' DEEP 1000AL. SEPTI TANK z O N O J O 07 N an� w.nwt oou obooryuou (ow f ho 9 of 11)) 1 "�30' SEPTIC SYSTEM PROFILE K' P.O. BOX 2749 R�df PALMER, ALASKA 99645 NC EE INC. PHONE: (907)745-0222 FAX: (907)746-0222 TJA I DATE: 4/27/04 1 SCALE: 1" = 30' I FILE: 0400271 Lot 138 B ZONA SUBDIVISION, PLAT No. 1981-183, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 2 OF 3 PERMIT NUMBER N0CHBMNC SERnC 1"=60' IT IS THE I RELATIVE TO ENANTS, OR goppDDOp�� SITE PLAN Pt .�F•A<g'p, E •491U. v� 11 •�.* 0, W.O. 0400: LOT 135 VACANT N89'53'37"W 143.88' ox. LOCATION OF TOP OF BLUFF 4$ LOT 138 B 42,752 S.F. 589'52'27"E 143.89' PID NUMBER LOT 134 VACANT X 55' DEEP TRENCH AL TANK NEIGHBORING scrnG LOT 139 VER OR BUILDER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED TIES CONNECTIONS, AND TO DETERMINE THE EXISTENCE OF ANY JT APPEAR ON THE RECORDED SUBDIVISION PLAT. ASK P.O. BOX 2749 Rau HOPALMER,:ALASKA 99645 —022 Eg ,INC. PHONE: (907)745-0222 ! FAX: (907)746-0222 11DATE: 0400271 Charles A. Leet 4 Lot 138 B ZONA SUBDIVISION, CE 10480 •v�d PLAT No. 1981-183, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK PR •••..•Np` �4v" EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE nom_ DFESSI�_�cy RECORDED PLAT ARE NOT SHOWN HEREON. PERMIT NUMBER PID NUMBER mel.0 mown. wpe et e.e of 4.eok prlonlee a• PVC b,. M OemWMW 1-fool ew Nob 1 mu e...r nok 0 0 10 0 0 B 0 0 X = \� C 3' t < o "moo 0 0 X o ma" o 0 0 colla a• 1M B3. NO'. .. n Pvc w 55 t v DEEP TRENCH prfan1id eve W. a .l Uo. Mob 1: m.tm w Pelf w Pve 1--4 PLAN VIEW (hal.4.) 0.0f...., «m. w—um) SECTION X-X f.v.\.d wf.n ELEV. 95.0' nmon.pl. «P e.M m.w.Uo4 N .Nd M..r Io.w.Uo.. i ero.ed ewfen P.n.«kle e.e Not. 1 eW111111. EI.F.V 990' �� .o.-fwtonlW PVC .Pon 1,� ' U'C=i� O!'JrI.CNTia e...r rook .ff..u.7 a.Plk Ory 0 O Rim {• Pve M.fa.ba 'o • e' m �qq8 m ....r reek ELEV. 91.0' 0+(0 Ocy 0 iata�i'••.iititt ° O TRENCH DETAIL° m Nab 4 ft.. mlelmum N a-f. of eerw o..er a 1e.W.w..0 o..r ek.erpuo. Ue.ad 0.. mak of P..le..N o.nr 1...1 0• (or p.) m.V e...a.e1 klek 0 .0 up l.tN fat... b.l ..rlk w rjr- n Q. .P b • om,em.m N bo Irckw sf Iu.1.Uod e11Oa••-w � D • `•���Mggb Nob 9: N.>imum e. Ua..k.4 M tw mon a 1e ELfV. 85.0 Mole a: No{ 0. BOTTOM TH TRENCH SECTION MONITOR TUBE DETAIL ooDDDDQ SITE PLAN Ar Sa K' P.O. BOX 2749 _ Rim PALMER, ALASKA 99645 P ...F•.�a<yfDaD ENG EE INC. PHONE: (907)745-0222 P S�: • '•. �y d� FAX: (907)746-0222 9TH W.O. 0400271 DATE: 4/27/04 SCALE: nts FILE: 0400271 ..:... ...... ..:... ... D n Charles. A. Leet Lot 138 B ZONA SUBDIVISION, QP CE 10480 '��`d PLAT No. 1981-183, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK QQOff�f� •.,•,,,..••� �d EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE n11%b000 000bo RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 3 OF 3 Performed For. Legal Description: Depth (Feel) 1 t) 2_ a 3- 1 1 1 1 18 - Soils Log - Percolation Test 1%rRa Wol@Homes, LLC / Zona Dalmann Date Performed: 4/2/04 Lot 138 B. Zona subdivision Township, Range, Section: ^ COMMENTS Gin ire WAS GROUND WATER .I 1� OF :4j4 � Gross Time ENCOUNTERED? Municipality of Anchorage b: "ENGIN R'S • f+ - Development Services Department * Building Safety Division Program • • • • • • • • • •' On-SBe Water and Wastewater • • • • •• • 4700 South Bragaw St. • : q, P.O. Boz 196650 Anchorage, AK 99519-6650 0,''• Ctl4rleS A, Leet •� •, www.munl.orglonsile (907) 343-7904 : Z �'rIr CE 10480 ••�`>;ep\� Date: 4/12/04 Performed For. Legal Description: Depth (Feel) 1 t) 2_ a 3- 1 1 1 1 18 - Soils Log - Percolation Test 1%rRa Wol@Homes, LLC / Zona Dalmann Date Performed: 4/2/04 Lot 138 B. Zona subdivision Township, Range, Section: ^ COMMENTS Gin ire WAS GROUND WATER Date Gross Time ENCOUNTERED? NO Net Drop FILL 4/2/04 s IF YES, AT WHAT DEPTH? L O Depth to Water After P Monitoring? 0 E Date: 4/12/04 1500 Reading Date Gross Time Net Time Depth to Water Net Drop FILL 4/2/04 PRESOAK 5" 1430 5" 1500 30MIN 6-7/16" 1-7/16" 5" 1530 30MIN 6-7/16" 1-7/16" 1600 30MIN 6-7/16" 1 -7/16 - PERCOLATION RATE 20 (mnawnM) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 6 FT AND 7 FT PERFORMED BY: Kant Sheets I Charles Leel, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4127104 Certificate of On -Site Systems Approval Parcel I.D. 051-152-20-000 Legal description ZONA LT 138B Expiration Date: 7/13/2023 Site address 19972 S BIRCHWOOD LOOP RD Chugiak AK 99567 Current property owner(s) WORRELL JEFFREY B & CYNTHIA A X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Az Original Certificate Date: 8/23/2021 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE .R Development Services Department p p Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-152-20 Complete legal description ZONA LT 138B Location (site address) 19972 S Birchwood Loop Rd Current property owner(s) WORRELL 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 854-8079 3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: 0 Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 19 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ■❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 5556 Date of Payment gfZO�z COSA # vs C- 2.11502 (�e cetl Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Legal Description: ZONA LT 138B Parcel ID: 051-152-20 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 5/21/04 Total depth 260 ft Cased to 200 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 36+ in. Date of flow test for COSA 7/13/21 Static water level at beginning of test 74 ft. Comments B. TANK DATA Measured operating fluid level in septic tank 50 Date of pumping 4/18/23 ❑ Required maintenance completed, if AWWTS Comments: Steel, 19 yrs D. ABSORPTION FIELD DATA Which system tested (date installed) 6/8/04 ❑ ALL standpipes present per record drawing Total measured depth from grade 12 ft (max) Measured depth to pipe invert from grade 5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 6+ gpm Water storage tank volume0 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 NRimEng Date 4/11/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 7/13/21 Results M Pass Fluid depth prior to test 72 in Water added 450 gal New fluid depth 76 in Elapsed time 30 min Final fluid depth 73 in Absorption rate 450 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 84 in Effective depth used 73 in Effective depth remaining 11 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Q Yes Community Sewer Manhole/Cleanout > 100' ❑Q Yes if No ft [D Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' Q Yes if No El Yes if No ft if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if Manure/Animal Excreta Storage > 100' Building Foundation > 10' Community Sewer Main > 75* 0 Yes if No ft E] Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10 Q Yes if No ft Surface Water > 100'❑ Yes if No Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' 0 Yes if No Water Main > 10' Yes if No ft Community Wells > 200'❑ Yes if No Water Service Line > 10' Q 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' Q Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' [E] Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' Yes if No ft Community Wells > 200' El Yes if No Surface Water > 100' Q 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. OF 44.1"11 144� r*Steve Eng CE -6256 ?�A 'h x•/3%21= ENGINEERS ft ft ft ft ft ft ft ft ft If, Parcel I.D. 051 15 220 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 s . Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description Lot 138B, Zona Subd Location (site address) Expiration Date: l "'_ z3 -- 1 '� 19972 Birchwood Loop Rd Current Property owner(s) Zona Dahlman Mailing address Real Estate Agent same unk 2. TYPE OF DWELLING: E] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 688-2929 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well F-1 Individual x❑ �.-_--- Individual Waterowiaye r-1 Li Boldin- nuiuuiy Tann n u Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by:e✓L4 )� Date: COSA to be release to the engineer, unless otherwise requested by the engineer. COSA Fee $ 910 % Date of Payment y//lo-3 Receipt Number ck 3218 #-1 &loy4/3- COSA# as 41g3g 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. Name of Firm AK Rim Engineering, Inc. Address 9131 E. Frontage Rd, Palmer, AK 99645 Engineer's Printed Name Charles A. Leet 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for _ bedrooms Disapproved Conditional approval for 0 The Municipality of Anchors e D I Phone 745-0222 Date 8/19/13 bedrooms, with the following stipulations: Certificate Date: 9 ---.9—%_? g eve opment 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 Septic System Advisory Well Flow Advisory COSA blua sheet Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # 1 of 2 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Lot 1388, Zona Subd A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 5-21-04 Sanitary seal (Y/N) Y Total depth 260 ft. Cased to 200 ft. FROM WELL LOG Date of test 5-21-04 Static water level 60 ft. Well production 6 9 - p.m - WATER SAMPLE RESULTS Parcel ID: 051 15 220 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 39 in. AT INSPECTION 7-15-13 75.5 ft 5.5 9.p -m. Coliform 0 colonies/100 mL Nitrate <mdl of 1.0 mg/L Arsenic <mdl of 5 ug/L Date of sample: Collected by: 7/15/2013 Brandon Jones, AlaskaRim Engineer, Inc. B. SEPTIC/HOLDING TANK DATA Tank Type/Material AnCh. Tank/Steei Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping NA Pumper NA Date installed 6-8-04 Cleanouts (YIN) Y High water alarm (Y/N) NA C. ABSORPTION FIELD DATA Date installed 6-8-04 Soil rating (g.p.d./ft2 or ft2/bdrm) 250 System type Deep Trench Length 58 ft_. Width 3 ft. Gravel below pipe 7.35 ft Total depth 12 ft. Eff. absorption area 852.6 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7-1 S!, 13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth (In absorption field before test 43 in. Water added 744.3 gal. New depth 62 in. Elapsed Time: 24hr ruin. Final fluid depth 50.5 in. Absorption rate >= 450 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed NA Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 148' Absorption Feld on lot 106' Public sewer main NA Sewer /septic service line NA Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO: Building foundation 22' Property line >20' Water main Water service line Wells on adjacent lots > 100' ABSORPTION FIELD ON LOT TO: Property line 25' Building foundation 25' Water Service line >25' Curtain drain NA F. COMMENTS G. ENGINEER'S CERTIFICATION On adjacent lots > 100' On adjacent lots >I 00' Public sewer manhole/cleanout NA Holding tank NA Manure/animal excrete storage areas >100' Surface water >100' Wells on adjacent lots >100' l certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA CO guidelines an effect on this date. Engineer's Printed Name / � Date z �X0 3 COSA brown sheet 10-10-12.doo Absorption field 18' Surface water >100' Water main NA Driveway, parking/vehicle storage11 o' �. Cherie h rn • a 4. L CE1r •. CEtO4BD PRaroSeT Be9Ym R ar_v. {ASarYm) N89" 53'37"W 143.88' maroSn ewuwo o ffi Etev. (ASAYYII) zanXc asmlcT 1"T a ue.. sereAa I 9R &WdXG 41B/.tl( I I I SW,. evened sere.« I I I I I I I I I o I 4 � I I OUSE I 1a 2 I I I I cok 3 � `r cN sa °o 138A wl O z 139A o 51 I N I I I I I I I I I I I I I I i I I —_____—__�J I I I I V UTII. ESMT 143.89' S89°52'27"E m BIRCHWOOD LOOP ----------------------------------- UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE UNES. THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE, Lj LOT SURVEY SURVEY TYPE - SYMBOLS ❑ FOUNDATION AS -BUILT SET REBAR DRAINAGE ASPHALT ❑ FINAL STRUCTURE AS -BUILT 0 FOUND REBAR 6--s�Y) W000 FENCE CONCRETE ❑ PLOT PLAN ... AS -BUILT ... LOT SURVEY ... TP WNY OD Il ASSUMED ELEV. - METAL FENCE WG00 DECK AS -BUILT .. . NO CIXM 5 SET RECERtIRCARQl1N AS AS -BUILT ... Na C N R T PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN, FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION *" OF Prepared by Robert E. Johns, Jr. & Assoc. PLOT PLAN �.•�E, q��+ �_`. ..,,.wna.'IM» Ne let tram me awerc a n.wn, ma mat 1 ....'••••"• j �♦ Professional Land Surveyors w» N.oe m wtmll+nw w or a. mt w,e.s YM w vw wl er my AV'rJ• -J 1700 Brink Drive ANCHORAGE, ALASKA 99504 w .wm m pm me .,..o.e.a w• me .ow,:L AV. ♦ 49th { Saale. Ir Y Ree. Lot S.F. Ret. Plat File No. AS -BUILT �•• ....... - 1 = 60 FOUNDATION 1. emwt c .w.... A.. I,.�y ew+ur met » p»IumM m A• -bet mire d N. io,oeorw� N. ,• ;www, / ,�,� `/ •••Y •0 ✓'ROBERT Date Surveyed '� 08/16/13 Drawn b " REJ Checked b IS K a^ NL lot we Nw ,w eM I— ma haw..etw. w ne." N»+w:' m. ,,.. ma oe .,mwnNimw um ww.. mw ,N-�- E•i.• ♦s NS ♦ i ♦♦�`fl Date Drawn: 08/19/13 Grld: 1 Z56 W.D. 13-401 •'•, 421—S it FINAL STRUCTURE AS -BUILT E ;'• �i°f' •., ,.• JA,� Legal Deecrlption: I. RMw W .J.,.ft _y .1 .a» yr/mnN m b-9uYt mY o! m. 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