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THE TABLELANDS BLK 8 LT 8
The Tablelands Block 8 Lot 8 #051 - 801 - 48 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241098 PID Number: 051-801-48 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name DEREK & SHERRIE BETTS ABSORPTION FIELD — ADVANTEX FAP 2.0 ❑ Deep Trench ® Wide Trench ❑ Bed ❑ Mound Site Address 15623 KING'S WAY DRIVE, ANCHORAGE ❑ Other Phone of Bedrooms Soil Rating Total depth from original grade 7Number 4 2 GPD/SF 2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot THE TABLELANDS 8 8 Fill added above original grade VARIES 1.3 — 1.4 Ft. Gravel length 60 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Pump Basin Tank Line 300 Ft2 1 -- Ft. Well 50'+ 50'+ 50'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ® Other ADVANTEX Manufacturer ORENCO / ANCH. TANK Capacity 1500 Gal. Surface Water 50'+ 50'+ 50'+ Material COMPOSITE PLASTIC Number of compartments 2 Lot Line 5'+ 5'+ 5'+ NA Foundation 10'+ 10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks DECOMMISSIONED OLD SEPTIC TANK / FIELD & INSTALLED NEW AX FAP2 & FIELD. INSULATED AX & FIELD. Alarm location Electrical installed by DRS PIPE MATERIAL House to tank 3034 Tank to drainfield 3034 Installer FRS Drainfield 3034 co/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection 15c 3/15/24 dates: 2nd 3/16l24 Location and description 3rd 3/20/24 4"' 3/20/24 BOTTOM OF DECK SUPPORT ON -SITE WATER AND WASTEWATER SECTION APPROVAL`' At Conditional Approval: Date dW , • • s• TH " " " " " .." /. Curtis Huffman Septic System Approved - Date ��`•. CE 12 991 .• �w`�i e ��'��,•. 06l2o/z4,.`•�U,.''�'' • . . , • �rdW Note: this approval does not include well permit requirements.\�5.�.�► (Rev 05/02/18) Δ Dayna M. Rumfelt R E GISTEREDPROFESSIO N A L L A N D S URVEYORNo. LS 13322 NORTH0 50 ' 10 0 ' SCALE: 1" = 50' 6/25/24 PID:051-801-48 PERMIT:OSP241098 FIRST WATER CONSULTING THE TABLELANDS BLOCK 8, LOT 8 MUNICIPALITY OF ANCHORAGE ,,,ent On -Site Water & Wastewater Program 40 S, PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 V http://www.muni.org/onsite y f Ueparttnent On -Site Wastewater Disposal System Permit Permit Number: OSP241098 Effective Date: 5/29/2024 Work Type: Septic Upgrade Expiration Date: 5/29/2025 Tax Code Number: 05180148000 Site Legal Address: THE TABLELANDS BLK 8 LT 8 G:1559 Site Mailing Address: 22600 SAMBAR LOOP, Chugiak Owner: BETTS DEREK R & SHERRIE D D Lot Size in Sq Ft: 49383 Design Engineer: FIRST WATER CONSULTING Total Bedrooms: 4 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank El Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • Locate the edge of the existing bed to ensure that the required separation is met. l By: r✓5lteA —�o ) �C_ Issued By: Date: Date: Z 9 Z `'l Pp%UO(5 mr �U UHJCD0� U � Y OF ANCHOR D Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section -- Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-801-48 Property owner(s) DEREK & SHERRIE BETTS Day phone Mailinq address 22600 SAMBAR LOOP, CHUGIAK, AK 99567 Site address 22600 SAMBAR LOOP, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) THE TABLELANDS BLOCK 8, LOT 8 Legal description (Township, Range & Section) Lot Size 49383 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field 0 Initial ❑ Single Family (SF) ❑x Septic Tank Xr Upgrade MDuplex (w/wo ADU) (D) ElHolding Tank F-1Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) �erit/Rsh Fees: Waiver Fees: Date of Payment: f5 ho (24 Date of Payment: Receipt Number: 1107-S< Receipt Number: Permit No. 6SRZ.4109% Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! May 23, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: THE TABLELAND BLOCK 8, LOT 8 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one trench with an Advantex FAP 2.0 in the reserve area per the original design to serve the existing 4-bedroom house. The design is based on MOA record documents & test hole conducted in 2004. Groundwater was observed at test hole TH#3 at monitoring and this apparent same TH#3 monitoring tube was still present on our recent site visit on May 15, 2024, in which the total depth was measured at 8’ from grade with groundwater at 4.1’ from grade. Therefore, it appears that the existing absorption bed is encroaching groundwater and will be abandoned in place and the new proposed trench with Advantex FAP 2.0 installed per the attached design. The slopes are moderate at 5-10% at the proposed upgrade location. The lot and area are served by public water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241098, Deb Wockenfuss, 05/30/24 FIRST WATER CONSULTING THE TABLELANDS BLOCK 8, LOT 8 DESIGN CALCS: NO WELLS WITHIN 200' OF PROPOSED SEPTIC TANK. AREA SERVED BY PUBLIC WATER. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. SAM B A R L O O P Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241098, Deb Wockenfuss, 05/30/24 FIRST WATER CONSULTING DESIGN DETAILS: THE TABLELANDS BLOCK 8, LOT 8 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241098, Deb Wockenfuss, 05/30/24 Δ Dayna M. Rumfelt R E GISTEREDPROFESSIO N A L L A N D S URVEYORNo. LS 13322 NORTH0 50 ' 10 0 ' SCALE: 1" = 50' 5/22/24 _• Municipality of Anchorage e ' Development Services Department S Yy�' Building Safety Division \ -/ - On•SIte Water and Wastewater Program. 4700 S. Bragaw St. �/ P.O. Box 198850 Anchorage. AK 995198850 Page www.cl andhorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW0403894Csj yThyr 4-V5 PID Number. 051-801-48 of Name: Troy Davis Homes Wastewater System: t2 New 0 Upgrade 1451 E. Parks Hwy, Suite 207 ABSORPTION FIELD pl Op1w 357-9394 Number � 4 0 peep Troth 0 Saa. Trench Qnad ID Mound ■ alar LEGAL DESCRIPTION Sod Rom 0.3 GPorFY TaMo.ahlaaa4Mgrade: 1.4 Fl, Saxe: Lar auhdrveerx 8 8 The Tablelands Depth M pop mead horn onpr grade: 0.9 Fl. Gravel depth beneath pope: 0.5 Fl. TeeMp RSP: 8ecma Fd added Wove aprr grade: 3.0 n. Gravel L n in 68 Fl, Well: ■New is Upgrade P9 Gravel .ed 30 n. Na brae unber ae 5 D.t between re. 6 FL CS..dctan(Pores A.B. Ck Community Water System Tar Depth Fl Cased e: Fl Tar Pips MMaet PVC pa' S. 2040 Fl, Direr. Doe Dread Sett W. Levet Inner. A&F Contracting pee Mead 9/30/04 Yee GPM Pump Sol al: Fl. CNN Fleur MonGround Ft. TANK SEPARATION DISTANCES o Septic • Holding ❑ S.T.E.P. • Other. To Flom Septic Tank Absorption Field Lift Station Holding Tank Mr/Private Sewer Line MMelada Greer (installed 10/27/05) At 1250 0.L wa4 na na na na na MMael: Steel Nuns a Campaeneru: 2 ar.l.uwit*, na n9/ na na LIFT STATION Lel Lire 35' 15' na na boo. Gel_ MnJrlur. FaadMpn 5' 28' na na 'Prep err' SS al: M 'Papp err waist la Hphvets Mea at M. Careen Dram na na na na Pump Make Medal FJxYal Impeder. peda,ned Lr Ramses BENCH MARK Larson end oaeaplax Nail in tree adj NW bed comer Aea,ned Unstop. n 100 `c OF At Ili = *' STM 'f• • �:* i • 1„ Inspections performed by: Mary Shreves Dates: 1' 9130/04 2nd 9/30/04 / 10/27/05 .:00,. ( • 9le ;�•M L. Shreves �r��?= sl CE 9351 \�� I��109 111\\.\\•I.�```` Developme t Services Depa Int Approval ��l ed and approved by: f1 Date: / g/A/0Y`£� IRaave CO1 CO2 A 39.88 43.79 B 13.54 20.17 LOT 8 118.8 CO3" • 78.44 &1.7 53.08 4781 • • i i 121.5 �/i C /0\ �\ S' B O. tp, oma\ TWO STORY /j.,c DWELLING F DAYLIGHT BASEMENT MT1 MT2 41.68 73.17 4.86 44.95 125.8 'CK 8 AKTHO i 1'=30' 30'X68' BED W/ CENTER HEADEF CP. (S`. NK O • EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITIES CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. �.�oopppp�. Opp Q� : AloryL Shreves .eo s •• �e� CE 9351 d 4 AS BUILT SITE PLANNC RIM INC P.O. BOX 2749 PALMER, ALASKA 99645 PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400130 DATE: 9/7/05 'SCALE: 1" = 30' 1 FILE: 040o13o_WW_2AS LOT 8, BLOCK 8, THE TABLELANDS SUBDIVISION. PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. r AU AKTH#5 30'X68' BED W/ CENTER HEADER • \\--)0:5", 1,250- 4- SEPTIq T• NK PLAN SEPTIC SYSTEM PLOT t FINAL GRADE 1 104.75ft. 1250 -CAL SEPTIC TANK FINAL GRADE / 101.22 ft. INSULATION OVER ALL COMPONENTS II. 00.5 ft. 97.72 f SEPTIC SYSTEM PROFILE • ft 87.05 ft. 97.72 ft. o�DODDpp�q ... .gt'i PSS. .__t1;••&- oD -• DDM pp\, uar(/L Shreves f CE 9351 ,: o c QQ% � o F AS BUILT SEPTIC INC P.O. BOX 2749 PALMER, ALASKA 99645 INC. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400130 DATE: 9/7/05 1 SCALE: 1" = 30' Ina: 0400130_WW_2AS LOT 8, BLOCK B, THE TABLELANDS SUBDIVISION. PLAT No. 2004-25. ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. Io3 UNSUBDIVIDED N8956'28"E 166.83'(R) N8936'14'E 187.15'(C) 33' SECTION UNE EASEMENT —AND BITILDWC' SET$ACR ' > 5P65 49\ b' ,J LEGEND: (R) -RECORD DATA (10w MEASURED DMA (C)- CALCULATED DATA U.C.-UNDERGROUND ELEC.-ELECTRIC N. BLDC.-BUILDING YPC-YELLOW PLASTIC wv 1>1 -WATER VALVE N. ❑-UTILITY PEDESTAL 1" -Cie FOUND 5/8" REBAR w/YPC • r 4094-5 TYPICAL LOT 8 \ \ 49,383 S.F. 4 PLASTIC CAP PIPE TYPICAL 0 TWO STORY DNELLNG w/ DAYLIGHT BASEMENT N BLOCK 8 \ LOT 9 LOT 11 i UFT vIsca STATION "C` Y \`tt ©QS - + -LOT 10 — \ LOT 7 03. .t.? U9;; T1' t Cekr �eip NAVL CAS U.C..G ELEC. 1.1. s )19 CA. 13) �7 ta 41, S. yJ da NOTES: 1. THIS SURVEY COMPLIES WITH ASPLS MORTGAGE LOCATION STANDARDS. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS & CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & TS SUBJECT TO ANY INACCURACIES THAT A SUBSEOUENT BOUNDARY SURVEY MAY DISCLOSE. 4. BUILDING SETBACKS DERNED FROM SUBDIVISION COVENANTS. 5. THIS LOT SERVICED BY A COMMUNITY WATER SYSTEM. EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS. OR RESTRICTIONS WHICH 00 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. AS—BUILT :NC P.O. BOX 2749 PALMER, ALASKA 99645 PAC PHONE: (907)745-0222 FAX: (907)746-0222 F.B. 05-23 W.O. 0400130 PAGE: 1 OF 1 I SCALE: 1" = 60' 1 FILE: 04.00130AS I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGE INSPECTION ON THE FOLLOWING DESCRIBED PROPERTY: LOT 8, BLOCK 8, THE TABLELANDS SUBDIVISION PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCH., AK. EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SURVEYED ON THE 17th DAY OF JUNE, 2005. LQasLa Tint 2ng(neeting, 9ne. Phone (907) 745-0222 Fax (907) 746-0222 akrim@rogershsa.com November 10, 2005 Ms. Julie Makela, P.E. Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 196650 Anchorage, AK 99519-6650 RE: Lot 8, Block 8, The Tablelands Subdivision On -Site Sewer Permit AK. Rim Engineering Ref. No. 04-00130 Dear Ms. Makela: P.O. Box 2749 Palmer, Alaska 99645 This letter is to provide you with information requested on the Onsite Sewer / Well Submittal Comment Sheet. Included with this letter is the amended Inspection Report (see attached). 1. The total depth of the excavation listed on the Inspection Report form as 2.8 feet below original grade was in error. In reviewing my field notes from the final inspection, inadvertently listed the depth below the datum point (a nail in a nearby tree). The depth below original grade is 1.4 feet. 2. On the Inspection Report, I listed the buyers as the current owners, as per Troy Davis Homes. When I contacted them (T.D.H.) after receiving your letter, they said that no, they were still the owners and had not closed on the property yet. 3. On October 27, 2005, the concrete septic tank was pumped and removed from the site, and replaced by A&F Contracting with a 1,250 -gallon Greer steel septic tank. The tank was placed in the same excavation with no changes to the layout of the system. 4. The installer was listed on the Inspection Report as A&F Excavating. The name of their company is A&F Contracting, who are listed on the MOA Approved Excavator List. If you have any questions please feel free to contact me. Sincerely, ALASKA RIM ENGINEERING, INC. d • Mary L. Shreves Professional Engineer CC: AK Rim Engineering File No. 04-00130 Attachments: • MOA On -Site Sewer / Well Permit Application Form gg S •_i . :......w �.c ;• as , Shrevel •,ye= • ,#, .•• CE 9351 � e,t•„ ',4 f11111ESS1 �„i, Engineers • Planners • Surveyors Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Alaska Rim Legal description: The Tablelands Subdivision. Block 8. Lot 8 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. _ O Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. _ O Well log required. O Omission in narrative. ❑ Insufficient fill over tank or field._ O Other. 1.) Total depth of absorption field exceed maximum permitted depth; 2.) A Certificate of Health Authority Approval was not obtained prior to title transfer; 3.) Consteel is not an MOA approved septic tank manufacture; and 4.) On-site wastewater disposal system must be installed by an approved excavating contractor Name of reviewer: Julie Makela. P.E. Date: 10/5/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 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 Renewal Date Issued: Dec 02, 2005 Expiration Date: Dec 02, 2006 Permit Number: SW050443 Parcel ID: 051.801-48 Legal Description: THE TABLELANDS SUBDIVISION BLOCK 8 LOT 08 Design Engineer: 0032 ALASKA RIM ENGINEERING Owner Name: TROY DAVIS HOMES, INC. Owner Address: NHN SAMBAR LOOP EAGLE RIVER , AK 99577 - Site Address: NHN SAMBAR LOOP Lot Size: 49383 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: 0 Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy 0 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 catling (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 Issued By: , l Pak& ieN. Q Apes_ Date: a/A/ Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Npags.nwyza.\ ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051 —sol -I-IFS Permit Number SW Property owner(s) %:4,n 4 Cam. Day phone Mailing address Site address rc\t—• Zip Code Legal description (Lot, Block & Sub'd.) thp.) t g 1 `rc-kM e Legal description (Section, Township & Range) Lot Size L(9r3 Acres THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Swimming Pool ❑ Therapy Pool ❑ Number of Bedrooms Well Only Water Storage 41 Jacuzzi Water Softening Unit 0 0 ❑ 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. 1/4-\\ ct<J (Signature of property own& or authorized agent) Permit/Rush Fees: 5 \lcj . Waiver Fees: Date of Payment: 191 105 Date of Payment: 7141lb _..W\M Receipt Number: (Rev. 09/04) Receipt Number. 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 DIP /530 Date Issued: Sep 17, 2004 Expiration Date: Sep 17, 2005 Permit Number: SW040389 Parcel ID: 051-801-48 Legal Description: THE TABLELANDS SUBDIVISION BLOCK 8 LOT 08 Design Engineer: 0837 ALASKA RIM ENGINEERING Site Address: NHN SAMBAR LOOP Owner Name: TROY DAVIS HOMES, INC. Lot Size: 49383 SQ. FT. Owner Address: NHN SAMBAR LOOP Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER , AK 99577 - This permit Is for the construction of: Disposal Field 0 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. The following special provisions. - Maximum depth of absoption bed shall be 1.5 feet. Received By:� . Ct .� �� Date. / Mlle/ Issued By: A t ,Q Sa 1 1 1( a s SL5/ A Date: 9/ -7/.0M4-1 Parcel I.D. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING p5/ -W311 -4g Permit Number SW Properly owner(s) Troy Davis Homes Day phone 357-9394 ailing address (1) 1451 E. Parks Highway, Suite 207 LO ing address (2) ditZt+4 OP E� Zip Code 99654 QaS� (trLi(' } Legal description (Lot, Block & Sub'd.) Lot 8, Block 8, The Tablelands Subdivision Legal description (Section, Township & Range) Lot Size 49.383 sqft Acres/Sq.Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Swimming Pool 0 Therapy Pool ❑ E Well Only ❑ Water Storage Jacuzzi Water Softening Unit 0 I certify that the above Information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. w. A.. - (Signature of pr perty owner or authorized agent) Permit Fees: Date of Payment: Receipt Number. (Rev. 12/00) q-3- OLit Waiver Fees: Date of Payment: r7 -7 6 Wceipt Number: c}AQaska Tint 2ngineetting, One. Phone (907) 745-0222 Fax (907) 746-0222 akrim@rogorshsa.com September 16, 2004 Ms. Julie Maketa, P.E. Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 196650 Anchorage, AK 99519-6650 RE: Lot 8, Block 8, The Tablelands Subdivision Amended On -Site Sewer Permit Application AK. Rim Engineering Ref. No. 04-00130 Dear Ms. Makela: P.O. Box 2749 Palmer, Alaska 99645 This letter is to provide you with the amended design for the above referenced lot. The groundwater monitor tube (GWMT) located on Lot 9, Block 8, The Tablelands (and adjacent to the lot line for Lot 8) was probed by you and groundwater was encountered at 7.5 feet below ground surface. The same GWMT was probed by me on 9/13/04 and groundwater was encountered at approximately the same depth (7.83' BGS). An additional test hole (AKTH#3) was dug in the area of the proposed replacement bed, and a percolation test was conducted at that time. The percolation rate was 60 minutes per inch. Due to the topography and the configuration of this lot we are requesting a waiver from the maximum bed width of 15 feet. Bed Design The following is a summary of the proposed design of the bed SAS: Percolation rate: Soil application rate (trench): Number of bedrooms: Daily wastewater flow: Drainfield: Septic tank: Minimum absorption area: Req'd separation distance to GW: Total depth (max): Bed dimensions: Effective absorption area: 60 minutes/inch 0.3 gpd/sqft 4 600 gpd Absorption bed 1,250 gallons 2,000 sqft 6ft 1.5 ft 30 ft x 68 ft 2,040 sqft Engineers • Planners • Surveyors Ms. Julie Makela, MOA Page 2 September 16, 2004 The amended Site Plan and Soil Log - Percolation Test form were faxed to your office on 9/13/04. If you have any questions regarding this report or its recommendations, please feel free to contact me. Sincerely, ALASKA RIM ENGINEERING, INC. znfiA41, At Mary L. Shreves Professional Engineer CC: Troy Davis Homes AK Rim Engineering File No. 04-00130 7e.e N89'56'28 -E 186.83' 1011 33' SECTON UNE EASEMENT 107.2 123.0 N AND BUILDING SETBACK ~A9 S♦� ?R%%b. ly \\ \\ \ \ BLOCK 8 LOT 8 1e.e ♦ ♦ 25.8 121.5 'o\ SAO m• G. ♦♦. �C),y\ 4i♦ MT �4,_` co \ )(133 LEGEND: 150 SPOT ELEVATION X150 SPOT ELEVATION 1'1=60' NK PROPOSED TWO STORY DWELLING 51 PROPOSED PAVED / 1 \ DRIVEWAY 47 140.4 \ce'/ 'Q. cck ♦h as 7 EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITIES CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS. COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. 4,o�a000Oppq I?* I 49TH /1 eQ 1^ • Mary L. Shreves %;r ; •. CE 9351 •• _dkldirge SITE PLAN ENC P.O. BOX 2749 PALMER, ALASKA 99645 INC. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400130 DATE: 9/14/04 1 SCALE: 1" = 60' ( FILE: 0400130_WW_2 LOT 8, BLOCK 8, THE TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. $po 00 r X 0 J t` 1 t >porforeto4 e We nmetnV Cloosmat \ I- I monitr too gypat n IST .i1— 1 / moue 4' ITC obi 1ovr1—m 0 11 - e*41 Ta ABSORPTION BED W/ CENTER HEADER PLAN VIEW fe•t•reta NC speetmtatIr SECTION X -X 9 1. J b.alaUaa w Mot. BED DETAIL Not. t foes . mlelmam et 4-t..t .4earth toner (r ordvalet) ow .brpU•. two. 0.o bob et V..t.rn 'oeuttoem tf (r NJ may b. .ubWtab4 nor ... bet .t ..rt serer of to . ma et ten babee et b.al.Uoa. ELEV. so 100.0• 'mulattos 11 1 EIzv. PBS 1 1 EInV.. o2.6' BED SECTION MONITOR TUBE DETAIL 4�0000pp�• \O t":•• .F,1,4,1 0 , Sezi.' �'' Dl1 a *I 49TH r': dD o/f1%'i. k- --f Mary L Shreves : o OQQQQ ., •CE 9351 3) d d 4.00%.0% o - DETAILS ENC P.O. BOX 2749 PALMER, ALASKA 99645 N PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 04001301 DATE: 9/10/04 I SCALE: nts FILE: 0400130_WW_2 LOT 8, BLOCK 8, THE TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. Performed For. Legal Description: A 1 2- 3- 9{,rt 4- .1d.Ltrhtd 5- 6- 7- 8- 9- 10- 11- Kmsf l Depth Feet) 14 15- 16- 17- 18- 19- 20- 11111 a Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.org/onstte (907) 343-7904 Soils Log - Percolation Test Troy Davis Homes Lot 8, Block 8, The Tablelands Subdivision Cjilf wipr&tcS 5iItyfamit w/smut.(, OcAliebet4 COG'/esu ✓vied•dEnstrlettf, dry (4n1) Slope WAS GROUND WATER ENCOUNTERED? yt ��t)(and W1/T1 I�F YES, AT WHAT DEPTH? ed i/� f9 Death to Water After Yes `•�.�,`�%�%%%A�gl4/� i4FNGI AL)•J ¶• • I9'., •glary . Shreves ;• W er% CE9351 .••Gt.: Date Performed; 2/26/04 & 3/3/04 Township, Range, Section: 12 ft CJ� �p Monitoring? IAr AA4 bcµldbtOJ °tett t .OVA') ye Date: 3/3/04 (hWl ) fofl/AiOFTN S L 0 P E Site Plan 7ef t 1i -'d 521-70 Ilan A NN\ 7�} It/ • Reading Date Gross Tune Net Time Depth to Water Net Drop 1 3/3/04 1542 10 min. 714/16 in. 6/16 In. 2 — 1553 10 7 13/16 5/16 3 — 1604 10 7 12/16 4/16 4 — 1615 10 7 12/16 4/16 5 — 1626 10 7 12/16 4/16 6 — 1637 10 7 12/16 4/16 PERCOLATION RATE 40 TEST RUN BETWEEN 40 COMMENTS 'ft -copal( 4 hekrsr (mnn.✓rrh) FT AND 5.0 PERC HOLE DIAMETER a h. FT PERFORMED BY: Kent Sheets, AK Rim Engineering, Inc 1 Mary L. Shreves, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3/10/04 v'^rJc � r '_r^J y taeci 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.munl.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For. Troy Davis Homes Legal Desaiption: A Wilk 1- 2- 3- 4- 5- 6- 7- B- 9 - 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- Depth (Feet) HIM e ,1 Lot 8. Block 8. The Tablelands 5F/4- 5 orics deme) ireyhdr1 (14/C) Vn+fQK1bfTN Slope WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT DEPTH? Depth to Water Agar Monitoring? Date: : Mary /.Shreves % c� /I St. •• CE 9351 • �► '/tui I OFESSI �`` Date Performed: 4/2/04 Township. Range. Section: ND S L 0 P E Site Plan fie far Iced 51t.e P!g N Lb 44 figitA • Reading Date Gross Time Net lime Depth to Water Net Drop 1 4/2/04 1403 30 min. 9-1/4 In. 3/4 in. 2 — 1434 30 9-1/4 3/4 3 — 1505 30 9-1/4 3/4 PERCOLATION RATE 40 TEST RUN BETWEEN B0 COMMENTS Pert test oNy. Presoak began 1530 on 411101. (a0ab.hiN) PERC HOLE DIAMETER a e. FT AND 7.0 FT PERFORMED BY: Kent Sheets. AK Rim Engineering. Inc. II Mary L Shreves, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 4/5/04 Performed For. Legal Description: Agfw#3 1 2- 3- q(hL 4- '(e/24- 5- 6- 7- 8- 0 ye�py 10- 11- 12- 1 14- 15- 16- 17- 18- 19- 20- 3 Depth (Feet) ( 0 1 0 0 0 eii Municipality of Anchorage Development Services Department Building Safety DMsion On -Site Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage. AK 99519-6650 www.munl.orgronslte (907)343-7904 Soils Log - Percolation Test Troy Davis Homes Lot 8, Block 8. The Tablelands 5/ I #at d og Zvi e ) occ. cable, rnol, okctlx1(00 nt6rr-�- Slope WAS GROUND WATER ENCOUNTERED? Yes • • Ma L. Shreves 0 a: 1. ee�c'd` CE 9351 • : • 6a�� rf , Date Performed: 9/13/04 Township, Range. Section: IF YES, AT WHAT DEPTH? 9' D.pth to Water After Monitoring? see note Date: e t 0 P E Site Plan e a -M66 A • t. 47/awl P4 Reading Date Gross Time Net Time Depth to Water • Net Drop 1 9/13/04 1537 30 6-1/2 1/2 2 — 1608 30 6-1/2 1/2 3 — 1639 30 6-1/2 1/2 PERCOLATION RATE 80 OnI ur.ncnl TEST RUN BETWEEN 4.0 FT AND 5.0 COMMENTS Presoak 4 horn. GW level on 9/1104 N MT on Lot 9, Smock 8 was 7'e' OGS. PERC HOLE DIAMETER a inch.. FT PERFORMED BY: Kent Sleets, AK Rim Engineering, Inc 1 Mary L Shreves, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/13/04 t.Qaslea Tint Engineehing, Dile. Phone (907) 745-0222 Fax (907) 746-0222 akrim 0 rogershsa.com August 30, 2004 Ms. Julie Makela, P.E. Municipality of Anchorage Development Service Department Building Safety Division On -Site Water and Wastewater Program PO Box 196650 Anchorage, AK 99519-6650 RE: Lot 8, Block 8, The Tablelands Subdivision On -Site Sewer Permit Application AK. Rim Engineering Ref. No. 04-00130 Dear Ms. Makela: • -s-jilL P.O. Box 2749 Palmer, Alaska 99645 The owner of the above referenced lot is proposing to construct a 4 -bedroom single family dwelling (see attached Site Plan). The proposed dwelling is to be served by a 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 Soils A test hole (AKTH#1) was excavated on February 26, 2004, and a percolation test was conducted. A groundwater monitor tube was installed at that time, and groundwater was detected at 12 feet below ground surface. The monitor tube was probed on March 3, 2004, with a groundwater level of 12 feet below ground surface, and again on April 2, 2004, with a groundwater level of 13 feet 3 inches below ground surface. A second test hole (AKTH#2) was dug on April 1, 2004, for a percolation test only. The attached Site Plan shows the locations of the test holes. The soils in AKTH#1 were classified in the field as SM, consisting predominantly of silty sand with gravel, and in AKTH#2 as similar material. The percolation tests for both test holes yielded a soil percolation rate of 40 minutes per inch. The proposed drainfield will be designed around the 30 -feet radius of the test holes. Considering the history of The Tablelands in terms of groundwater fluctuations and surface water infiltration, we will use a separation distance to groundwater of 6 feet, with the bottom of the trench being no deeper than 6 feet above the 12 feet depth. Insulation will be installed over the septic tank if buried with Tess than 4 feet of cover and over all other components with Tess than 3 feet of soil cover. Engineers • Planners • Surveyors Ms. Julie Makela, MOA Page 2 August 30, 2004 Trench Design The following is a summary of the proposed Percolation rate: Soil application rate (trench): Number of bedrooms: Daily wastewater flow: Drainfieid: Septic tank: Minimum absorption area: Total depth (max): Effective depth: Width: Reduction factor: Minimum length: Effective absorption area: design of the trench SAS: 40 minutes/inch 0.45 gpd/sqft 4 600 gpd 5 -wide type drainfield 1,250 gallons 1334 sqft 6ft 4ft 5ft 0.50 134 ft (2-67ft trenches) 1,340 sgft Topography The topography of this lot is such that it slopes evenly from the southeast to the northwest, with the contours perpendicular to the long lot lines. The slope is approximately 8% to 15% throughout the lot. There are no slopes 25% or greater on the lot. Surface Water There are no surface waters within 100 feet of the proposed septic system. Surrounding Properties This property and the parent subdivision will be served by a community water system. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. Development on this lot will not preclude development of wells and septic systems on neighboring Tots in the future. If you have any questions regarding this report or its recommendations, please feel free to contact me. Sincerely, ALASKA RIM ENGINEERING, INC. Mary L. Shreves Professional Engineer CC: Troy Davis Homes AK Rim Engineering File No. 04-00130 Ms. Julie Makela, MOA Page 3 August 30, 2004 Attachments: • MOA On -Site Sewer / Well Permit Application Form • MOA Soils Log — Percolation Test Form (2) • Site Plan • Septic Plan • Septic Details -21.16 UNSUBDIVIDED N89'56'28'E 3. 3 186.83' SET SPIKE TYP. 33' SECTION UNE EASEMENT SET LAM TYP. .23 AND BUILDING SETBACK N +A ?t ->& . x?s (94\ 1"=60 • • ♦ 2s!y \ % '$e . ,ate LOT 8 \ 49,383 S.F. 619 • • REPLACEMENT FIELD .52 to\ • � �G N BLOCK 8 \ LOT 9 LOT 10 N O• 0 \yo SLOT 7 7 \ c) PROPOSED 2-5Wx4TDx67'1. TRENCH ABSORPTION SYSTEM NSTALL ZABEL FLOW SPUTTER 1 r3 U LPa P %• PROPOSED 1250 GAL. SEPTIC TANK PROPOSED TWO STORY DWELLING PROPOSED DRIVEWAY .52 N (." A.T 4Q9.3.6 N. X 20" / A e." / EXCLUSION NOTE: R IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITIES CONNECTIONS AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS. OR RESTRICTIONS WHICH DO NOT APPEAR ON THE` RECORDED SUBDMSION PLAT. 00 P.O. BOX 2749 PALMER, ALASKA 99645 PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400130 DATE: 8/30/04 'SCALE: 1" = 60' 1 FILE: 0400130_WW LOT 8, BLOCK 8, THE TABLELANDS SUBDMSION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 1 OF 3 1'=40' \ REPLACEMENT FIELD 21.52 B• PROPOSED 2-5'Wx4'EDx67'L TRENCH ABSORPTION SYSTEM INSTALL ZABEL FLOW SPLITTER , Q 90 8 0T 9 PROPOSED 1250 GAL. SEPTIC TANK PROPOSED TWO STORY DWELLING PROPOSED DRIVEWAY SEPTIC SYSTEM PLOT PLAN 1.52 Lin (0 tookarstmos absorption (n. Dolga Shoat 5) SEPTIC SYSTEM PROFILE q�0000Opp� A c:.•PF .....an Siri 49TH AN ':ADD OQ,ot Mary L Shreves O QQ�i • CE 9351 `%. SEPTIC ENG P.O. BOX 2749 A 9645 INC PHONE: (90 )7459 0222 FAX: (907)746-0222 W.O. 0400130 DATE: 8/30/04 (SCALE: 1" = 40' 1 FILE: 0400130_WW LOT 8. BLOCK 8, THE TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 2 OF 3 Mr 4 ln1.G .0ettl PVC YM (.tter 0.01 1001 .t ..m..MnMm) WIDE DRAINFIELD PLAN VIEW perforated AC ew..,r.10uea (lobo d...) SECTION X—X e.a.uo. M Mot. 1 4' Mead, lent► TRENCH DETAIL Met. t..Inlay® r 4-t..t .t ..rte ...a W Coe .t Vonore 'hastor equbaleat) ewer e bsorptC off .0 ) M ..MIa1.d too loot i earth «..r aq to . e.am® at two roe.. Y rwlw.a Mat. t Mao .m.wtMa .eel M Y nae / feet. TRENCH SECTION MONITOR TUBE DETAIL 4�0000ppp. Ti l o o ttc' 49TH rp IAary Shreves QQQ ff��1.CE 9351 ,�`�, d QQnno� .....obdo DETAILS s RIM ENC EE P.O. BOX 2749 PALMER, ALASKA 99645 PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 0400130 DATE: 8 30 SCALE: nts FILE: 0400130_WW LOT 8, BLOCK 8, THE TABLELANDS SUBDIVISION, PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 9 OF 3 Certificate of On -Site Systems Approval Parcel I.D. 051-801-48 Legal description THE TABLELANDS BLK 8 LT 8 Site address 22600 SAMBAR LOOP Chugiak AK Current property owner(s) BETTS Expiration Date: 3/20/2025 X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: a Original Certificate Date: 6/27/2024 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. ►- IkU.Ti15LIuUVII&I COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department 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. 051-801-48 Complete legal description THE TABLELANDS BLOCK 8, LOT 8 Location (site address) 22600 SAMBAR LOOP, CHUGIAK, AK 99567 Current property owner(s) DEREK & SHERRIE BETTS —Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: F-1 Private Well [:] Private Well serving 2 dwelling units D Private Well serving 3+ dwelling units E Community Well or Public F-1 water Storage 4. TYPE OF WASTEWATER DISPOSAL: E Private Septic E] Private Septic serving 2 dwelling units F-1 Holding Tank R Community Septic or Public Sewer 5. SEPTIC TANK: F] Steel Z Plastic F-1 Concrete F-1 Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: Z AWWTS F-1 Bed E] Deep Trench Z Wide Trench R Seepage Pit Waiver request for: Expedited review requested: Z 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 $ 'I q S Waiver Fee $ Date of Payment Date of Payment COSA# Q-5G?J-4J-Z-'Z4 Waiver # COSA Application 2022.doc COSA Checklist copy.docx COSA Checklist Legal Description: THE TABLELANDS BLOCK 8, LOT 8 Parcel ID: 051-801-48 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER 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. Well production at time of test gpm Water storage tank volume NA 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 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NEW AX FAP 2.0 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NA – NEW FIELD ALL standpipes present per record drawing Total measured depth from grade 3.4 ft (max) Measured depth to pipe invert from grade 2.8 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). 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) N If yes, enter date Adequacy test date NA – NEW FIELD Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY – NOT TESTED Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in Effective depth remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. As-built survey does not show foundation cleanout, but it does exist. COSA Checklist copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATIII SEPARATION DISTANCE REQUIREMENTS. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 6/26/24 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 or NO estimate of how long a system 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 & 6/26/24 THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of �Vt,,i of 20 2'l , by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1 advanced Wastewater ,rreatnaent Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description) AN ADVANTEX SYSTEM THE TABLELANDS BLOCK 8, LOT 8 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 5 Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. F It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adj ustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). 3P Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. JF Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. J F- Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. J Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS, The Municipality will give at least 24-hour notice. J Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiv°et% The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction. Choice of L aNy. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: {signature) Date: name) STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT The foregoi qtk instrument was acknowledged before me this day of 20 by OR —NCiTA�IkY KUBLIC FOR ALASKA fiOTARY P SUC My Commission expires: o5jj�-1'2-j U STATE OF ALASKA I wfoww�� m MUNICIPALITY. 2- By:- Date: __(print name) Title: C- ( V1 L (rev. 05/18/2018) Page 3 of 3 Parcel I.D. 051-801-48 Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Expiration Date: 3--/C-16 1. GENERAL INFORMATION Complete legal description The Tablelands, Block 8, Lot 8 Location (site address) 22600 Sambar Loop Current Property owner(s) Donald & K@III Cornwell Day phone Mailing address 22600 Sambar Loop Real Estate Agent Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 l '" Biba MAY 1 6 2014 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System 0 Public Sewer ❑ WaiverNariance request for: Distance: Received btC COSA to be released to the engineer, unless otherwise requested by the engineer. Date: 549 & l i COSA Fee $ 51.4, r Waiver Fee $ Date of Payment S! (G) /14 Ci'd- Date of Payment Receipt Number Receipt Number COSA# O—iTII qS 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE '-j System #1 Approved for 1T bedrooms System #2 Approved for / bedrooms Disapproved Conditional approval for By: Phone (907) 272-8218 Date 5/16/2014 rod atenk '•*liJ fol * 49 m r $seven •PintlOrie • CE 6149 0r`kb, fffsdfa'S cw bedrooms, with the following stipulations: oz Original Certificate Date:- 5 l 1- J T The�ni•�. al' of�3Cnchorage 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 Septic System Advisory Well Flow Advisory COSA blue sheeti' 1. c Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: The Tablelands, Block 8, Lot 8 Parcel ID: 051-801-48 A. WELL DATA Wen type Public If A, 6, or C provide PWSID # AWWU Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. FROM WELL LOG AT INSPECTION Casing height (above ground) in. Date of test Static water level ft. Well production _ g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date of pumping 7/19/2013 Pumper JR's Pumping ft. g.p.m. Collected by: Date installed 9/30/2004 Cleanouts (Y/N) High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 9/30/2004 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.3 GPD/SF System type Bed Length 68 ft. Width 30 ft. Gravel below pipe 0.5 ft. Total depth 4 ft. Eff. absorption area 2040 ft2 Monitoring tube Y Depression over field N Date of adequacy test 5/15/2014 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 665 gal. New depth 2 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. No Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: in. On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Curtain drain 50+ F. COMMENTS Surface water 100+ Wells on adjacent lots 100+ Water main 10+ Driveway, parkingNehicle storage 10+ G. ENGINEER'S CERTIFICATION I certify that 1 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 Date 5/16/2014 COSA brown sheet 10-10-12.doc kit P 1� t. CE -8149 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.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-801-48 1. GENERAL INFORMATION Complete legal description The Tablelands SID, Block 8, Lot 8 COSA# c SC.1P1 Expiration Date: i I/36 /1/02 Location (site address) 22600 Sambar Loop, Chugiak, Alaska 99567 Current Property owner(s) Sam Johnson Day phone 306-6095 Mailing address Lending agency Wells Fargo Day phone (919) 440-6649 Mailing address 22600 Sambar Loop, Chugiak, Alaska 99567 Mailing Address ay pnune Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding Tank ❑ Community 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 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 Douglas T. Kenley, P.E. Phone (907) 746-1073 Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer's Printed Name Douglas T. Kenley Date f1(tb t( • 46-10, • a• 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulati ti r ON 51IE t� 0 ; • ON t- ' oG9» • PR .• a: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitr. e Advisory X By: , XV 4rn Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date: / (%3d Municipality of Anchorage Development Services Department Budding Safety Division: Ori -Site Water & Wastewater Program 4700 Elmore Road 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 S/D, Blodc 8, Lot 8 Parcel ID: 051-801-48` A. WELL DATA Well type Public If A, B, or C provide PWSID # Well Log (YIN) Date completed . . Sanitaryseat (YIN) Wires properly protected (Y Total depth _ ft. Cased to ft. Casing height (ab • ground) in. FROM WELL LOG AT I CTION Datt= of`'ttst Static water level ft. ft. Well production g.p.m. WATER SAMPLE R Coliform colonies/100 mL Nitrate mg/L Collected by: 9-p•nt is ug/L date of sample B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank s 10 . gal. Number of Compartments 2 Date installed 10/2/105 Cleanouts (Y/N) Y Foundation cleanout`(Y/N) Y Depression over tank (YIN) N High water alarm (YJN) N/A Date of pumping 11/16/11 Pumper .1R.S Pumping. cf., ,ABSOP ON FIELD DATA Date instilled 9/313/04 Soil rating (g. p.d:/ftorft2/bdrm) 0.3 System type Bed Length ' ;68 ft. _ 30 ft. Gravel below pipe 0.5 ft. Total depth4.4 Eff. absorption area. 2040,ft2 Monitoring tube Y Depression over field N Date of adequacy tel ` 11/9111 Rester Pass/Fail Pass f For ; 4 bedrooms Fluid depth in absorption field before test • 0.. in. Water added_ 616: gal — ' New4 depth 0, in. Elapsed Time: 35 min. Final fluid depth 0 in. Absorption .rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed 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 & « « • remelts. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM Wl ;LLQ;ON LOT TO. Septic tankilift station on lot On adjacent tots Absorption field on lot On adjacent tots Public sewer er /septic service line Public sewer manhole/cleanout Holding tank SU+ ft. 100+ ft. Animal` containment areasexcrete storage areas Manure/animal SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10+ ft• Property line 10+ it Absorption field 10+'t. 25+ ft Water service line 10+ ft. i00+n ,. Water mainSurface water Wells on adjacent bis 100+ ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 10+ ft. Water main 25+ ft. Water Serviceline 10+ ft- Surface water 1'0©+ ft. 5+ Day, parkingNehide storage Curtain drain None grown Weils on int lot 1°0'11- G. 00+ft• G. ENGINEER'S CERTIFICATION 1 certify that 1 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. Engineers Printed Name Douglas T. Kenley P.E. Date 1/.4,t rtt COSA Fee $ qC1;... Dateofyment I \ '-S —`) t "Date of Payment Receipt N C� a -..C.. Receipt Number (Rev. 4/10) I hereby certify that I have surveyed the following described property- L®T' 6 ,1;3; C Gp yv, • rr Anchorage Recording Precinct, Alaska, and that the improve- ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Eagle this River, Alaska rlay of ROBERT C. JOHNSON Registered Land Surveyor No. 880 -LS Box 77-0456, Eagle River, Alaska 99577 Phone (907) 694-2543 SCALE: 1" = i t,"