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HomeMy WebLinkAboutTHE TABLELANDS BLK 4 LT 13The Tebl lands Block 4 Lot 13 #051-741-44 Municipality of Anchorage Page Development Services Department On-S~te Water and Wastewater Program 4700 Bras]aw Street P.O. Box 196650 Anchorage. AK 99519-6650 v/ww.ct, anchomge.ak, us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Peri, it Number:. SW050455 PID Numbe~. 051-741 ~ Wastewater System: New Spinell Homes 1900 W. Northern U.qhts Anch, AK 99518 ABSORPTION FIELD ~ "~" ~ ~'~ ' 5' Wide Trenches 344-5678 Three (3) LEGAL DESCRIPTION 2 c.,~o 3 4 13 The Tablelands No. 1 I F,. 2 3-5 n. 50 Well: AWWU Water System 5 ~ 2 ~,. R 357 ~ ASTM 3034 PVC ~ Paisano's Dirtworks 1/31/2006 '-- c.,,~ I ~"* s"'~. ic.~, ,,~ ,,~., c,,~, TANK SEPARATION DISTANCES Advantex Treatment System Tank Field Sta~on Tank ~ ~e Anchorage Tank 1,500 ~,, >200' : >200' >200' N/A >25' Steel Two (2) s,,~.w.,, >100' >100' >100' N/A ~ / LIFT STATION u,u.. >5' 1' >5' N/A 500 c~ Anchorage TanldOrenco Fo~. >5' >10' >5' N/A 28 ~ 28 c~,~D~ None Noted Orenco Allied Alaska Electric "'""~ BENCH MARK See Lot Line Waiver. Garage Slab 1 00.0 Engineer's S~amp Inspections performed by: TLK dates: 1= 1/31/06 ~'~,~ ~=-- Department of Health and Human Services approval m~ I I I Z <:E _J EL Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspec~on Report Page 3 of 3 Permit Number:. SW050455 PID No. 051-741.44 TBH = 100.00 Garoge Floor' ~%--93.0 Drain FieLd Rock 91.15 97.0 nr. oJn FieLd Rock ~-~1,1 PROFILE AS-BUILT Scale: NONE ~7 06 02:58p Rllied Rlaska Electric (907) 3?3-3894 p.l Suly 27, 2006 Anderson Engineering Attn: Mike Anderson P.O. Box 240773 Anchorage, AK 99524 (907) $22-7773 Telephone (907) 677-7766 Fax Subject: Lift Station Inspections at property stated below. This letter is to confirm ~hat the lift station(s) at: · Lot 13 Block 4 - The Tablelands were wired by a licensed Journeyman Electrician in aeeorflanee with the 2002 National Electric If you would like any further information, please feel free to call our of~ee at the numbers listed below. Tban~' you. Sincerely, Martin D. Brown President/CFO cc: File -~. O. Box 876310, H~axilla. dlaska 99687 (907) 3 73-3893 p,h / (907) 232-8687 cgll / (907) 373-.3894fax 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 Date Issued: Dec 19, 2005 Expiration Date: Dec 19, 2006 Permit Number: SW050455 Legal Description: THE TABLELANDS BLOCK 4 LOT 13 Design Engineer: 0014 Anderson Engineering Owner Name: SPINELL HOMES, INC Owner Address: 1900 W. NORTHERN LIGHTS BLVD #2( ANCHORAGE, AK 99515- Parcel ID: 051-741-44 Site Address: 23152 WHISPERING BIRCH Lot Size: 40000 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1, The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:. Issued By:, Date: Date:.~J..~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/~ELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Pardi I.D. Permit Number SW Property owner(s) Splnell Homes, Inc. Day phone 344-5678 Mailing address (1) 1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99515 Mailing address (2) .-0,-~t~2- Whlspeflnq Birch Drive Zip Code Legal description (Lot, Block & Sub'd.) . Lot 13, Block 4, The Tablelands Subdivision Legal description (Section, Township & Range) Lot Size 40,000 SF AcreslSq. Ft. Number of Bedrooms Three THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERI'Y CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] 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. (Signature of property owner or authorized agent) Permit Fees: '~' 5/~ Date of Payment: //~' Z..- o5' Receipt Number, (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number, ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: TO: FROM: SUBJECT: November 30, 2005 Julie Makela, P.E. Mike Anderson, P.E. Lot 13, Block 4, The Tablelands Subdivision Septic System Permit The revisions to the original permit application are attached for your review. Please advise if further information is required. The design for the septic system for the subject lot has been modified to include an Advantex Treatment System to allow for proper separation from the steep slope on the lot, which exceeds 25%. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 30, 2005 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 13, Block 4, The Tablelands Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The surface area available for a septic system on this lot combined with the house location and soil conditions require that absorption trenches and alternate site be placed within 1' of the north and south property lines. Placement of the absorption trenches at these locations will have no adverse affect on septic systems in the area. The subdivision is currently served by the Municipal water system and all separation requirements from water facilities are easily met. An Advantex Treatment System will be placed on the lot, which is also less harmful to the environment than a standard system. We therefore request a waiver be issued allowing the trenches to be 1' from the north and south property lines. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage Development Services Department Building Safcty Division On-Site Warm' and Wastewatcr Program 4700 Bragaw Strect P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage, ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR050106 PID~: I},,51-741-44 HAg: Date Received: 11/30105 Legal Descdption: The Tablelands Subdivision. Block 4. Lot 13 Engineer: ~J~]jJ~ P.O. Box 240773 Anchorac~e. Alaska 99524 Applicant: Snlnell Homes. Inc. Permit//: SW050455 Waiver Requested: Pr~mprY a~l reserv~ absor,~tlon trench I foot from south and north r>rooertv line. resoectivelv Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ......... ........ ' Ust Conditions or Reasons for above: Rec#: ?4027 Amount: $175.00 Date Paid: 11130/2005 Municipality ofA : choragc Mayor Mark Begfch P.O. Ik~x 19('£~,~ ) * Anchorage, Alaska ~ k'519-fF~'",O · Tclcl~honc (~307) 3~3-8.q01 · Fax (907) Building Safety Dl~'lslon 12/19/2005 Anderson Engineering P.O. Box 240773 Anchorage, Alaska 99524 Subject: Waiver Request for The Tablelands Subdivision, Block 4, Lot 13 Waiver Request #WR050106 Parcel ID #051-741.44 Permit # SWO51M55 Dear Mr. Anderson, Your request for a waiver of the required 10 feet horizontal separation from the primary and reserve absorption fields to the southern and northern property line, respectively, has been approved. The approved separation distance is 1.0 feet. This waiver approval applies to the primary and reserve absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further corlcems or questions regm'ding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On-Site Water & Wastewater Program Community, Security, Prosperity ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) November 30, 2005 Municipality of Anchorage Development Services Depadment On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 13, Block 4, The Tablelands Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 13 Block 4, The Tablelands Subdivision intends to construct a three- bedroom home on the lot. We are therefore requesting a permit be issued for a septic system to serve the new home. The soil conditions, lot configuration and house location along with a steep slope greater than 25% in grade make the construction of a conventional septic system nearly impossible. We have therefore decided to place an Advantex Treatment System on the lot to provide the most effective treatment of the septic effluent prior to discharge into the surrounding soil strata. The location of the absorption system is shown on the attached Site Plan. Drainage patterns are also shown on the plan and will not be modified as a result of the proposed construction. The test holes placed on this lot revealed silty sand and gravel. The percolation rate in the materials encountered was 30 minutes to 60 per inch. No groundwater was found during the excavation but was noted at 10' below the surface during monitoring. The subdivision, however, is plagued by groundwater problems and our design provides for the bottom of the absorption trench to be as shallow as possible. We are therefore proposing to place a three-bedroom Advantex Treatment System. The absorption trenches will each be 25' long x 5' wide x 2' effective depth. The distribution line in the trenches will be placed at 1' below the existing ground level. Total depth of the trenches will be 3' below the surface. 3' of fill will be placed above the trenches and 4' over the septic tank to meet Municipal Code and prevent freezing. The ground surface of the lot is basically fiat near the location of the primary absorption trenches. The trenches will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. A steep bluff exists at the location shown on the site plan. The trenches will be constructed a minimum of 35' from the edge of the bluff. All components of the new septic system will be constructed a minimum of Lot 13, Block 4, The Tablelands November 30, 2005 Page Two 100' from any surface water and 10' from the water service proposed for this lot. If the system is constructed in accordance with our design the following statements apply: I. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments f I. LJ I_d LOT 13, BLOCK 4, THE TABLELANDS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Peru. Rate: 30 to 60 Min./Inch 3 Bedroom Advantex Treatment System Application Rate: 2 GPD/SF 2' Drainfield Rock 3 Bedrooms X 150 GPD/2 GPD/SF (Application Rate) = 225 SF Absorption Area 225 SF/5 SF/LF*.7 (Red. Factor) = 31.5 LF Trench Length THEREFORE: Construct 2 Oversized Trenches Each 25' Long x 5' Wide x 2' Effective Depth. Flow Line Elevation in Trench to be 1' Below Original Ground Surface. Total Depth to be 3' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trenches. Backfill __ O Geotextile -- Fabdc 1" Perforated PVC (Holes Down) 3/16"Holes @ 2' Spacing -- Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCA,E) ,-?~;~..~...~, NOTE: Grade Araa Over Trench ,o Drain Away. /;??'~gth Minimum 6' Separation From Bedrock. ~.~....,~...,..~..,.',.~..~...~.....~ Minimum 4' Separation From Groundwater. ~ ...'~...~....~ Minimum 200' Separation From Wells in the Area. ~~'-.~'~. '#-- U~nimum 100' Separation From Su,~ac~ Water or Streams.-',;~.... MUNICIPALITY OF ,/~NCHORAGE DEVELOPP'IENT SERVICES DEPARTI"IENT /.*700 SOUTH BRAGAW STREET ANCHORAGE, AK c)c)519-bbSO SOILS LOG - PERCOLATION TEST I DEPTI [ 1 2 3 4 5 6 7 8 9 LEGAL DESCRIPTION; LOT 13, BLOCK 4, TABLELANDS S/D PERFORMED FOR: .c;PINFI I DATE: 8/3/2004 PROJECT No ~ M0468 PARCEL ID#' TECHNICIAN: T. L. KIMBROUGH I TEST HOLE# 1 l SILTY ORGANICS/OB SLOPE SITE PLAN SILTY-SANDY-GRAVELS GM BOH 20¸ O% DATE READING GROSS TIHE NET TIHE DwEPA'~I~i~F NET DROF 8/3/04 TEST HOLE PRESOAKED PRIOR TO TESTING: I 14:45 12.0" 2 15:15 30 11.0',' 1.0" 3 15:15 12.0' 4 15:45 30 11.2~" 0.75" I I 5 15:45 12.0 RECllARGE I{ 6 16:15 30 11.25' 0.75 PERCOLATION RATE; 40 (MIN/INCII) PERC. IIOLEDIA, 8 (INCIIES) TEST RUN BETWEEN:_~FT. and ~.~ FT. COMMENTS: Test tlole Presoaked Prior to Percolation Test. TEST PERFORMED BY VETECH ENGINEERING TECtlNICAL SERVICE. I, MICI IAEL E. ANDERSON CERTIFY THAT Ti IlS WAS PERFORMED IN ACCORDANCE WITI I ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON Tills DATE: MUNICIPALITY OF ANCHORAGE DEVELOPHENT SERVICES DEPARTI'IENT /-*700 SOUTH BRAGAW STREET ANCHORAGE. AK OC)51c)-0050 SOILS LOG - PERCOLATION TEST I LEGAL DESCRIPTION; LOT 13, BLOCK 4, TABLELANDS S/D PERFORMED FOR: .c:;PINFI I DATE: 8/3/2004 PROJECT No.: M0468 PARCEL IDt¢' TECHNICIAN: T. L. KIMBROUGH DEr, nj [TESTIIOLE# 2 ] (fc~) SIL'P( ORGANICS/OB 1 5 6 7 SILlY-SANDY-GRAVELS 8 GM 9 BOH SLOPE SITE PLAN · SFF- FUTURF- ASRUI T, mINUTFS) ImINUTES) I (..c.Es> I J8/'/o4 I TEST HOLE PRESOAKED PRIOR TO TESTING: 16:30 30 11.5" 0.5" 16:30 12.0" .m.aRG~ 17:00 30 11.5" 0.5" 17:00 12.0" ~C.*~G~ 17:30 30 11.5" 0.5" PERCOLATION RATE; ~0 (MINHNCI[) PERC. HOLE DIA, 6 (~CIl~) TEST R~ BETWEEN~. ~d~. COMMENTS: Test I1o1¢ Presoaked Prior to Percolation Test. TEST PERFORMED BY VETECll ENGINEERING TECIINICAL SERVICE. I, MICIIAEL E. ANDERSON CERTIFY THAT Tills WAS PERFORMED IN ACCORDANCE WITtl ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON TtllS DATE: ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: December 8, 2005 TO: Julie Makela, P.E. FROM: Mike Anderson, P.E. SUBJECT: Lot t 3, Block 4, The Tablelands Subdivision Septic System Permit We recently completed an accurate survey and cross section of the surface slope on Lot 13, Block 4, The Tablelands Subdivision. A copy of the field results is attached for your review. Our survey indicates TH No. 1 is more than 80' from a break in grade of more than 25%. TH No. 2 is nearly 75' from the grade break. Shallower grade breaks approaching 25% are found closer to the test holes, but the slope at these breaks is less than 25%. A revised site plan is attached which shows the break in grade which is greater than 25%. (... Z t~ ~loola ,C t'to-~.spueteiqe£ ql ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) December 19, 2005 Municipality of Anchorage Building Safety Division On-Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, AK 99507 Attention: Julie Makela, P.E. Subject: Lot 13, Block 4, The Tablelands Subdivision Septic System Design and Permit Application Dear Julie: Test Holes were placed on Lot 13, Block 4, Tablelands Subdivision before the lot was cleared and prior to flagging of the lot lines. The technician on site at the time was unable to determine accurate locations for the holes, which resulted in erroneous locations shown on the original site plan. The location of the bluff on the lot was not accurately located either at the time of the original fieldwork. The technician has been reprimanded and informed of the importance of exact locations for both the test hole locations and the bluff line. Every attempt will be made in the future to assure this miscalculation does not recur. The exact location of the test holes was recently determined using swing ties from the front lot corners and the flagged lot lines. In addition, a survey was completed of the ground surface between the test holes and the bluff line. The revised site plan shows the location of the test holes and the bluff line. The new absorption trenches proposed for construction on the lot will be centered around the test holes. An Advantex Treatment System will be installed due to the limited area available for the absorption system and the presence of the bluff. If the new absorption trenches should be extended outside the 30' radius of the test holes additional percolation tests and test hole logs will be completed and submitted with the as-built. We appreciate your cooperation in the issuance of the septic system construction permit for this lot and apologize for any trouble this may have caused. Sincerely, Michael E. Anderson, P.E. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 {FAX) November 1, 2005 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Su~ect: Lot 13, Block 4, The Tablelands Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 13, Block 4, The Tablelands Subdivision intends to construct a new three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The subdivision is currently served by a community water system. No conflicts exist with adjacent septic systems or wells and the proposed septic system on this lot. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. The current drainage pattern is identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. Test holes recently placed on the lot indicated silty sand with minor amounts of gravel in the area of the absorption trench and alternate site. The accepting soils were tested and found to have a percolation rate of 40-60 minutes per inch. The system is designed with an application rate of .45 GPD/SF. No groundwater was found in the test holes during placement but was noted at 10' below the surface during the ensuing period. Our design, however, is based on the bottom of the trench at 3' below the surface and includes the placement of a new 1,000-gallon septic tank along with 2 - 70' long by 5' wide by 2' effective depth absorption trenches to collect and treat the sewage generated in the house. The distribution pipe will be 1' below the surface. A minimum of 3' of cover will be placed atop the trench and a minimum of 4' of cover will be placed atop the new septic tank. A flow splitter valve will be placed to assure even flow to each trench. The ground surface on the lot slopes at varying grades from northwest to woutheast as shown on the Site Plan. The absorption trenches will be constructed parallel with the Lot 13, Block 4, The Tablelands Subdivision November t, 2005 Page Two slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 10' from the water service proposed for the lot and on adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments Z bJ I,I LOT 13, BLOCK 4, THE TABLELANDS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom House 5' Wide Trench System Peru. Rate: 40 to 60 Min./Inch 1,000 Gallon Septic Tank Application Rate: .45 GPD/SF 2' Drainfield Rock 3 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000SF/5 SF/LF*.7 (Red. Factor) = 140 LF Trench Length THEREFORE: Construct 2 Absorption Trenches Each 70' Long x 5' Wide x 2' Effective Depth. Flow Line Elevation in Trench to be 1' Below Odginal Ground Surface. Total Depth to be 3' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Provide Flow Splitter Valve to Assure Even Flow to Each Trench. Backfill Geotextile Fabdc ,~0 4" Perforated PVC (Holes Down) -- Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (No BO^,E) .......... · ..,~.:.' .~.~;o, NOTE: Grade Area Over Trench to Dra~n Away. ~, ~,. 49~ Minimum 6' Separation From Bedrock. ,~....~.....:..;:.....y...'.~..~..~.....~ Minimum 4' Separation From Groundwater. ~ 7v'~.~,¢~ Minimum 200' Separation From Wells in the Area ~"~'¢~ ";"~-~.".;;;~'~'",~;'-.T~',~' '' ' ' ' ~,~", No c,-~, ~'~' Minimum 100 Separation From Surface Water or Streams.' ~-u, ... · ..---~,~ Minimum 10' Separation From Water Services in the Area. 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/VVELL SUBMITTAL COMMENT SHEET To: Andersen Enqineerin~ Legal description: The Tablelands, Block 4, Lot 13 The attached paperwork has been reviewed and Is being returned for the following reasons: Original signature or stamp missing on Calculation error in design. Additional soils information needed. Water monitoring results inadequate. Discrepancy in information submitted. Topographic information 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. Well log required. Omission in narrative. Insufficient fill over tank or field. [] Other. Name of reviewer: ,Tulle/~ekel=, P,E, Date: .~1/9/05 Please supply the necessary information and re-submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK • Municipality of Anchorage 0' `'`'B`= On-Site Water and Wastewater Program <' Y (907)343-7904 s. r c T Certificate of On-Site Systems Approval Parcel I.D. 051-741 -44 Expiration Date: q- 1. GENERAL INFORMATION Complete legal description Lot 13, Block 4, The Tablelands Subdivision Location (site address) 23152 Whispering Birch Dr, Chuctiak, AK 99567 Bedilion Current Property owner(s) Andy Mueller & Katrina Day phone (907) 555- Mailing address 23152 Whispering Birch Dr, Chugiak, AK 99567 Real Estate Agent Jesse Tanner @ Arolik Day phone 232-8607 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System [ Public Sewer ❑ WaiverNariance request for: Distance: Received by: - � 'ec r-4.1* Date: /, 5 /e COSA to be released to the engineer,unless otherwise requested by the engineer. tfi�{ COSA Fee $ 54.0 Waiver Fee $ Date of Payment (91(Z113 Date of Payment Receipt Number CU1 ! Receipt Number COSA# O5 C ( � s 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 Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 6/1,14.481pstifoth de,'„,tZ,OF 44,4 9014 • 60*049TH '. 6. DSD SIGNATURE140 •••••• ®moa; System#1 Approved for 3 bedrooms 6.0 o oo®oeep.o ®omooO© o Z�Uo© afl Pouf EPtnardSystem#2 Approved for bedrooms d !o Cg-4793 AJ00 °Disapproved c ^ c �. r,JFFSStO `:. Conditional approval for bedrooms, with the following stipufa#ttans,r,-::;. ON-SITE .- WATER ANu \h1ASTCWATER c PROGRAM • Original Certificate Date: z-1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Lot 13, Block 4, The Tablelands Subd. Parcel ID: 051-741-44 A. WELL DATA NA (PWS) Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test. Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Steel Date installed 1 /31 /06 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y Date of pumping Not Needed Pumper See Advantex Inspection Report of 8/29/17 at this time C. ABSORPTION FIELD DATA Date installed 1/31 /06 Soil rating (g.p.d./ft2dri-X1451009 2 System type 5 Wide Trench Length 50 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 3 ft. Eff. absorption area 357 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/4/18 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 480 gal. New depth 0 in. Elapsed Time: 90 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) None Known If yes, give date D. LIFT STATION Date installed 1 /31 /06 Size in gallons 500 Manhole/Access (Y/N) Y "Pump on"level at 28 in. "Pump off" level at 28 in. High water alarm level at 34 in. Datum Bottom Tank Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: NA (PWS) Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: 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 1 '+ * Building foundation 1 n'+ Water main 10' + Water Service line 1 0'+ Surface water 1 00' + Driveway, parking/vehicle storage 25 + Curtain drain None Noted Wells on adjacent lots 100'+ F. COMMENTS * See lot line separation waiver $EA$tag by the MOA G. ENGINEER'S CERTIFICATION 44,,`401tttl 1 certify that I have determined through field inspections and ,��'•�t ti O•q� review of Municipal records that the above systems are in �.tQ'•• '• S t conformance with MOA COSA guidelines in effect on this date. ;11° I° � 11 Engineers Printed Name Paul E. Pinard !•l4•9Y /+e,r ••41! •.014• 0 d Date 6/11 /18 j i• _•• •••••••••E.Pi•••••••/ 1 Hard ����,.• CE-4793 •���,,/ 19� • �' NN161~~~~ COSA yellow sheet_2-6-15.doc • MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the"AGREEMENT" made and entered into as of this Day of of 20 , by and between David H. &Janet L. Mitson , 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 Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System(AWWTS), described as The Tablelands L13 B4 located at (legal description) 23152 Whispering Birch Dr. Chugiak,AK 99567 2. Maintenance,Repairs and Alterations. (Owner is required to read, understand and initial each section) u Throughout the term of this Agreement,the Owner shall enter into a service agreement Yv) 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. Liell It shall be the responsibility of the Owner during the term of this Agreement to pay for all p iv\ repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). 4h'I _ Owner agrees that only maintenance and repair personnel approved by the Municipality 7 or the manufacturer's representative will inspect and make any necessary maintenance, n repairs or permitted alterations to the system. ,ly`lfg Owner acknowledges that regular maintenance of an AWWTS reduces the potential 71/'1 failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 7)(4( Owner acknowledges that the Municipality may request records of maintenance and , repairs from the manufacturer's representative or maintenance provider. i:ltlC 111,)Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. ,I.,"11,^(Jwner agrees to grant the Municipality reasonable access to test and inspect the ( AWWTS. The Municipality will give at least 24-hour notice. �l� Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. g41z( ..,6 Dwner 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. I" ,714 4Qwner 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. Nonwaiver. 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 Law. 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: , 1'1,x.,,,; 71-- 1 (signature) Date: / David H. Mitson Janet L Mitson (print name) STATE OF ALASKA ) )ss. "THIRD JUDICIAL DISTRICT ) Sf The foregoing instrument was acknowledged before me this f day of `J C,L 11 L 20l by v2,6�ef L. Mi.1--Son/ 1jau..1 1+ i�litc;C)r, • „\- NOTARY PUBLIC FOR ALASKA ��J� ....... M ommission expires: 31 )v �.` +►'•: `,' NO MUNICIPALITY: By: !�_._ (signature) Date: j 12? (print (print name) Title: • (rev. 05/18/2018) Page 3 of 3 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-741-44 GENERAL INFORMATION Complete legal description Location (site address) COSA# (~%C.~ \ \\ L~ (~ ~., Expiration Date: Lot 13, Block 4, The Tablelands Subdivision 23152 Whispering Birch Drive Current Propedy owner(s)Mark E Dykman Trust Mailing address 23152 Whispering Birch Dr Lending agency Day phone Chu6iak, Day phone Alaska 99567 Mailing 'address Real Estate Agent Kevin · Mailing Address 865 fl Dykman @ Prudential Day phone (907) 360-8877 Seward Meridian Pkwy #200 Wasiiia, AK 99654 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: e TYPE OF WATER SUPPLY: Individual Well ........ Individual Water Storage Community Class ~ Well Public Water System TYPE OF WASTEWATER DISPOSAL: - - Jndividual©n-site-- * [] Individual Holding Tank [] Community On-site [] Public Sewer [] L I1~ 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 Pinard Address PO Box Engineer's Printed Name EnE~ering 871347 Wasiiia, Paul E. Pinard, Alaska 99687 P.E. 5. 'DsD SIGNATURE ~j Approved for 3 Disapproved,. Conditional approval for bedrooms. Phone (907) 357-36/+7 bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well .Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original certificate Date:, Municipality of Anchorage Development Services Department Building Safety Division On-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 LegalDescription: T.ot 1.3~ B].ock /+~ The Tab'ieianda Subd. ParcellD: 051-7/+1-/+/+ A. WELLDATA )iA - Well type Date completed ... Total depth ~.ft. PWS If A, B, or'C provide PWSID # ~ Sanitary seal (Y/N). Cased to ~.ft. FROM WELL LOG Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION in. Date of test Static water level Well production WATER SAMPLE RESULTS: g.p.m. g.p.m. Coliform colonies/100 mL Nitrate Arsenic: ug/L date of samplei B, SEPTIC/HOLDING TANK DATA Tank Type/Material Ad.~ran'[,ex/S%ee'i Tank'size ..1500 gal. Foundation cleanout (Y/N) ~' Date of pumping 6/?/08 C, ABSORPTION FIELD DATA Number of Compartments Depression over tank (Y/N) Collected by: Pumper Date installed 1/31/06 Cleanouts (Y/N) ~ High water alarm (Y/N) · Total depth .3 ft. Eft. absorption area 35'7 ft2 Monitoring tube ~ Date of adequacy test 1 0/8/11 Results (Pass/Fail) ])aSs Fluid depth in absorption field before test 0 in. Water added /+80gal. Elapsed Time: 90 min. Final fluid depth. 0 in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) lqone Knn~,m Depression over field For ~j bedrooms New depth 0 4~50+ g.p.d. If yes, give date Date installed 1/_31/06 Soil rating (g.p.d./ft2 ~r]~/~;~]rr~ 2 System type ~ Wide Trench Length 50 fl. Width 5 ft. * ' Gravel below pipe 2 ft. of our %es%~ng & per Rea[got has been vacan% since %he summer of 2008. D. LIFT STATION Date installed 1/31/06 "Pump on" level at 28 in. Datum Bot%ou Ta]3~ Size in gallons ;5OO "Pump oft' level at 20 Cycles tested 3 in. Manhole/Access (Y/N) Y High water alarm level at 34 in. · Meets alarm & circuit requirements?Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ]~;IA - PWS Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Animal containment areas Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5 ~ + Property line 5 ~ + Water main 10 ~ + Water service line 10 ' + Absorption field Surface water 10~+ 100~+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I ~ Building foundation 10 ' + Water Service line I 0 ~ + Surface water 100" + Curtain drain ~lone Noted Wells on adjacent lots NA - Water main 10 ~ + Driveway, parking/vehicle storage 25'+ F; COMMENTS See l°t line separation waiver granted G. ENGINEER'S CERTI.FICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA. COSA guidelines in effect on this date. Engineer's Printed Name Paul E. Pinard ~ P.E. Date 1 O/19/11 COSAFee $ ("~0 "-" Date of Payment .... I~"/ct - II Receipt Number I~-~ '"') O~ c~ Waiver Fee $ Date of Payment Receipt Number (Rev. 4/10) 8 0 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND {SadtXrtC'-40 }Mtafl{/r" THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this __Dayof O~'~¢ar of20it , by and between ~dC,~t2~v,.~~ t~tugi~[ herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Definitions. located , Anchorage, Alaska. A. Alteration. Any change to the design or function of an AWWTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On-Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfi:r in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On-Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On-Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of ~) ($__~__.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On-Site approval is issued to the new owner or transferee of the property. 5. Alterations~ Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: C. Owner acknowledges that the fin[ schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding 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 Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: By: Date: MUNICIPALITY: By: Title: Date: STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoir~g ~ent~¢knowledged before me this'~ day of (~,2,'~,,O 2011 ,by ~ ~~I~LASKA My Commission expires: Oct 17 11 12:44p Betty Van Boven 907 688-0993 p.1 SANITARY PUMPERS 20627 UPPER BOWERY LANE CHUGIAK, AK 99567 907-688-4602 ]C;J$ fOI~.~FF';FJ O:~,DEF NO. I PHONE ~DDFESS [ I DAT~ ~ TAX TOTAL 12299 All claims and returned goocs MUST be accompa~nied by tinis bill. PRODUCT Thank You! PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 13, Block 4, The Tablelands Subdivision APPLICANT: Mark Dykman Trust 23152 Whispering Birch Drive Chugiak, Alaska 99567 SEPTIC TANK TYPE/SIZE: Steel/1500 Gallons, per MOA Records ABSORPTION SYSTEM: 5 Wide Shallow Trench, per MOA Records DAILY FLOW: 3 BEDROOMS x 150 GAL/BR = 450 Gallons JOB NUMBER: 11-339 DATE OF TEST: 10/8/11 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 3 SCUM: 0.0' SLUDGE: 0.0' NEEDS TO BE PUMPED: Yes CURRENTLY IN USE: Yes No XX No XX TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank AM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS * Tube 1' Level Tube 2* Level 9:00 5.3 4.0' - 0.0' - 0.0' - Start Flow- Meter 233900 9:15 5.3 80 80 4.1' 0.1' 0.0' 0.0' 0.0' 0.0' 233980 9:30 5.3 80 160 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234060 9:45 5.3 80 240 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234140 10:00 5.3 80 320 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234220 10:15 5.3 80 400 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 234300 10:30 - 80 480 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' Stop Test - 234380 RECOVERY Date Time ST MT SAS MT *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: System appears to be operating satisfactorily. There was no measurable liquid in the SAS MTs prior to or at any time during the test. Reviewed by: Paul Pinard Date: 10/13/11 Municipality o. fAnchorage . Development Services Department~r~' Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street www.muni.orglonsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-741-44 COSA# 0~0~5~ Expiration Date: -7 - ~ I - 0 7 ¶. GENERAL INFORMATION Complete legal description ~t 13, Block 4, The Tablelands SubdMsion Location (site address) 23152 Whispering Birch Drive Current Property owner(s) Spinell Homes, Inc. Mailing address Lending agency Day phone 344-5678 1900 W. Northern Lights Blvd., Suite 200 Anchorage, AK 99517 Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. ' NUMBER OF BEDROOMS: 'rhine 13l 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] .......... .Community.Class Well ...... [] Public Water System [] TYPE OF WASTE'WATER DISPOSAL: Individual On-site [] Individual Holding Tank [] ...... Community On-site ........ [] .......... Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Ceffificates of On-Site Systems Approval (casA) based only upon Ihe representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Ce~ficates of On-Site Systems Approval are required for the transfer of file (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 ara valid for 90 days from the date of issue for properties served by a p~vate 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 ara valid for one year for properties served by Class A or B wells or a public water sys~..e~. 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 vedfy 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 wastowater 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 A.qderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Approved for Disapproved. Conditional approval for Phone Date 7/31/2006 bedrooms. bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Municipalit7 of Anchorage Development Services Department Building Safety I~vtsion O~lte Wate~ & Wastewater Pmg~ 4700 Bragaw Street P.O, Box 196650 www. munLefg/omlte (9O7) 343-79O4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Descztl~: Lot 13t ~ 4, The T_=~=nds E~lxIIvtslcm W-r.U. DATA Well type Date completed Total depttt If A, 8, or C pn~ide PWSlD # FROM WELL LOG weu Log (YA~) ','~Are. properly pfl~-cted Casing height (above ground) AT INSPECTION Date of test 6taUc water level Well production g.p.m. WA1 ~ S,A,MPLE RESULTS: C~lfofm c~x~s/100 mL Nitrate mg/L Arsenic: ~ Date of ~ample: . B. sEPTICA'IOLDING TANK DATA Tank~ize 1~500 gat Number of C~mpadments 2 Fou~datic~ ~le~lc~t (Y/N) Y OepLqession overtank (Y~I) N Date of pumping New CmmmJ~lm~ Pumper c_. R_£U3OA'rA .......... Date instafled 1/31/2006. ~ rating (.g.p.d-/lt~ or ft~rodrm)2 GPD/~'.F T,~al depth 8 It. Date of adequacy test New Const. Results (Pas~Fail) Fluid dep~ in abs~31~ field before test in. Water added Width 5 It. Eft. ab~0n area ~ flJ Monitoring tube Other bacteria Cotlected by: ft. g.p.m. Date installed 1/31/2006 Cleanou~ (Y/N) Y High water alarm Y System type ~ Wide Tmncfl Grovel below pipe 2 ff. Y Del~ofl over field N Fo~ bedrooms gal. New depth in. in. ~rate >~ , g.p.d. If yes,give date' ~ D. LIFT STATION ' Date installed. 1/31/2006 Size in gallons 500 Manh~e/.4,~___, (Y/N) _ Y 'Pump on' level at 28 in. 'Pump off' level at 28 in. High water alarm level at 34 Datum Botl~mofTmlk Cy~mtaat~l Nov, PCoflM. Msel~alarm&~muttmquimmen~? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanlu1'~t station on lot On adjacent Absoq~tlon field on On adjacent lots Public sewer main Pubic sewer manhole/cleonout Sewer/septic service line H,'~ding tank . Animal containmertt areas None Manure/animal excrete storage areas .. None SEPARATION DISTANCES FROM SEPTIC/NOLDING TANK ON LOT TO: Building foundation >5' Property line _>5' .~ field · 10, Water main >10' Water service line >10' Surface water >100' Well,, on adjacent lots>200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:. Propeffy line 1' Building foundation. >10' Water main Water Sewice #ne >10, Surface water >100' Cu~ain drain .None Noted Wells on adjacent lots F. COMMENTS:..Lotks~mdl~AVWVUWater~stem. >25' in. G. ENGINEER'S CERTIFICATION ~~---~------~ Date 7/31/2lX~ Waiver Fee $, Date of Payment Receipt Number 7 > nnx~ I,,' ~cnm~ W Ld I