HomeMy WebLinkAboutTHE TABLELANDS #1 BLK 9 LT 5The Tablelands
Block 9
Lot 5
#051-741-61
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 Page If of .3
www.ci.anchorage ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. 4t(��5� S PID Number. 05 - 7 4 1 - Co i
Name PIAI,41-- F e_
75
Wastewater System: New El Upgrade
"a'"" Oaw (w '200
ABSORPTION FIELD
Fawne-AW _ Nwroff a Bsarooms 3
D Deal, Trerx )i"flow TrerrJt O Bea O p+p,na 0 Other
LEGAL DESCRIPTION
Sffl Ratnp
Tdat Depth Aimw9rial papa
GPD4P
(:j Fr.
BIW LdsuWmaron
,A
Oepm to ppe bonen hen ohJgv� ro0
9e
15,
avel unn
Graeph Mpee_
45
4— FI.
FI
To srvp Range Seamon
Fon a0aea abpva anprwl pacts
Z-31,1.
Crave Levi,
/ FI.
Well: Kt.,- ❑ yew Upgrade
Cravat wqm
S FI.
Nw dines
/
D�sla e"S=IW
r FI
class .mm (Pnvne. A B. CI
Tdal Dal
c to'
Taal 8b," pn "a `
enn 'I
F
I
J O F1�
J l� V
Dnllar
Date Dalen
SIeI walff n
Ins syr
AV0
M.
9/c/0r
FL
Y:
Pwry Sat n
a
Canp Nepro 6 Grown
TANK
GPM
FI.
Fl
SEPARATION DISTANCES
❑ Septic []Holding S.T.E.P. ❑ Other.
To
From
Septic
Tank
Absorption
Field
LM
Station
Holding
Tank
uouWnvate
Sewer Line
i01w"
c KO �Ac� TL/(
al,eulr
2So Gal
Was
...
.•-
M.Iffw
S7-6!5/L
Number d Companmams
z
Swrace walff
Q'
��f
/pQ�
_
LIFT STATION
LW Lee
/�
V'*
(o �+
(Q'
—
se
/LSO Gal
rower [� / ! �a Q �/
� f7 N/"`�' VFY:/W
Fanaatwn
�{•'
S—
o Fh
Q�f
Pw p p M at ��
Pwnp dr wvei at
39
H,pn -Siff atam at
m
at.
C~ Man
.-
^,
Pwrp Make b Mosel
so os osl�H
Eupncat paclwna pen Dy
E M'-
Rem s
BENCH MARK
1.11,1 1 D11,
o a'r
ASMYrN.i .VW.
/0 Q Ft
performed b : 0✓ C�Dates: 1"06
E aInspections �11
«...
2"az r3 ) c
or �P'e' a �i
Development Services Department Approval
-
'� 04gL
o11
Conditional Approval Date:
00 a
9......
..e.S. .. .............or
,�
C,: 3Ivarl W. Eng ,l W
�I�SfF ;�. ►E 6256
.>Va�
•�
t,1`��pROFES51�'
Reviewed and approved byC%�� Date: -.Z - 0
,x\ ."`••
��e-a4►K
De
Mr, Oal
.[Water Key Box
/ N,, • T & E Easement
Septic Sys er
Does Not P e
Lots From a
Improvement .
Construction
ude Adjoining
tatlon
NORTHRIM
ENGINEERING
17237 Bear Paw Circle
Eagle River. Alaska 99377
907.694_7028
SvoP\51.
,-F A Qc,rC.
DESIGN NOTES:
1. Total Depth of Trench is 0'— Build Up From Groun Level.
Remove organic layer. Thaw ground if frozen.
2. Sewer Service Line minimum 2% slope.
3. Trench is Minimum 10' from Lot Line.
4. Lots Served by Public Water System.
ml TABLELANDS S/D #1 AS—BUILT
Ave M
may,,, 4i
'LAYOUT
"' - LOT 5, BLOCK 9 0.1 --HEEM
_ 6/20/06 2of 3
Tank C.O. 1
34
16
Tank C.O. 2
37
19
c
QL
Manhole
37
20
onitor Tube
30
55
F ndation C.O. 33
15.5
3 Bdrm
F.C.O.
Home
Double C. .'s
T.H.2
Edge
De
Absorption Trench
Reserve Site
125
/
Gallon
STEP Tony
T.H.1
Septic Sys er
Does Not P e
Lots From a
Improvement .
Construction
ude Adjoining
tatlon
NORTHRIM
ENGINEERING
17237 Bear Paw Circle
Eagle River. Alaska 99377
907.694_7028
SvoP\51.
,-F A Qc,rC.
DESIGN NOTES:
1. Total Depth of Trench is 0'— Build Up From Groun Level.
Remove organic layer. Thaw ground if frozen.
2. Sewer Service Line minimum 2% slope.
3. Trench is Minimum 10' from Lot Line.
4. Lots Served by Public Water System.
ml TABLELANDS S/D #1 AS—BUILT
Ave M
may,,, 4i
'LAYOUT
"' - LOT 5, BLOCK 9 0.1 --HEEM
_ 6/20/06 2of 3
N
W L o
a
C) o
U 3 u
4- m 4
O u
a
�° o a
to j
fL
ai, N
+, L > 4 !
.s L -U N
L
1 C 3
d N
CJ
U n i
C% O
< i
a
Q) u
i
NS
Ou £UW S
O U(7+' t
N £ L Q
O
£-0 Ci>0 0
lino :t
a :pd
M
ON7 U
I 4 £ N L
Q N L -"}i 0
a� a -p
odin�)
NayCNp
O£ a£4-
U N J O O LO
N.6 p�U �U
Ly U4'UO
F- C i S 4 -F-
d mu
4- F- d F., y
O '
-P W 0)4,
aF N N=
avrv�3N¢
L
N
N
N
S
u
c
L
L
F-
O
F-
M
ON
II
0
0
C5
v
0
(L
u
L
O
41
C$
Ol
w
S
u
c
N
L
N i
N �
0 d
d J
V1 u
o c
F- d
C)0 i a
-P W
u >
3 O
L £
-P
N
C
U C)
O) d
c 4-
L L
3 3
A h
L �
O 3
4 0
L
Lo
O
O 0
L
In
3 +,
N N
W
II II \V
O O VV Ru
C5
O
> >
ow
, �'r 3
W W
m �C
n
u
C
O
i'
d
N
W
0
yo
0 II
-P y
N U
F- FI
4-
0
CL
0
F-
U
A �
z --�
Q PQ
J
W U")
J
p
Q O
F- J
CV)
0
M
a
f
i
J_
A
V)
Q
w
J
LL.
O
CL
on
?
�a
CO
NI
w
3
tiWa°rte
O
d
c
£}
�
C)
NF -
d
_N
00
:p
[ N
Z W
U
CJ L
O d
io O
S
d
£ O
CD u
cu Q
f u (U
i
O
In
d
N
(�
II
II
0
0
o
_0
>
d
N
j
W
O
L,
W
0
(L
u
L
O
41
C$
Ol
w
S
u
c
N
L
N i
N �
0 d
d J
V1 u
o c
F- d
C)0 i a
-P W
u >
3 O
L £
-P
N
C
U C)
O) d
c 4-
L L
3 3
A h
L �
O 3
4 0
L
Lo
O
O 0
L
In
3 +,
N N
W
II II \V
O O VV Ru
C5
O
> >
ow
, �'r 3
W W
m �C
n
u
C
O
i'
d
N
W
0
yo
0 II
-P y
N U
F- FI
4-
0
CL
0
F-
U
A �
z --�
Q PQ
J
W U")
J
p
Q O
F- J
CV)
0
M
a
f
i
J_
A
V)
Q
w
J
LL.
O
CL
on
?
�a
CO
NI
tiWa°rte
` K
01
v
of
�
C)
me
Z W
N p
Q!
r 1�
Jun 10 00 00:40p (plied nlaska Electric
June 19,2006
Attn: SEC Vc
(007) 077-0004 p.l
Subject: Lift Station Inspections at property stated belo-sf.
This letter is to confirm that the lift station(s) at:
• Lot 5, Block 9—The Tablelands ir-1
ELECTR/CAL
CONTRACT//VC
PAX: (907) act -t- 70,1-(p
was wired by a licensed Journeyman Elect.-ician in accordance with the 2002 National
Electric Code requirements.
If you would like any further information, please feel free to can our office at the
numbers listed below.
Thank you.
Sincerely,
ALLIED ALASKA F.I.F.CTRIC, I..I..C.
Qom_ _
l
sncttc L. Brown,
/ // Vice President/C1'0
cc: file
a Y JUN i y 200E
F.D. Dar 876310. Wasilla. A;aska 99687 (907) 373-3893 qfc; (907) 232.8687 tr11I (907) 373-
3894ju
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 20, 2005
Expiration Date: Dec 20, 2006
Permit Number: SWO50457 Parcel ID: 051-741-61
Legal Description: THE TABLELANDS #1 BLOCK 9 LOT 5
Design Engineer: 0838 North Rim Engineering Site Address: 22315 WAPITI CIRCLE
Owner Name: SPINELL HOMES, INC Lot Size: 56422 SO. FT.
Owner Address: 1900 W. NORTHERN LIGHTS BLVD #2( Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99517 -
This permit is for the construction of: private Well E] Water Storage
❑✓ Disposal Field n-1Septic Tank ❑ Holding Tank ❑ Privy El
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.
5. The following special provisions.
a.) The upper six inches of the mound absorption field shall consist of lop soil and be sufficiently vegetated to prevent
erosion.
b.) Organic material below the trench shall be removed and replaced with filter sand.
Received By.
Date: G—r
t
min
i • : 7M
Municipality of Anchorage
Development Services Department
;\ r~ 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
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. ()flI' qLll—&l
Permit Number SW
Property
Mailing address/ V/
aa3is
Site address
Legal description (Lot, Block & Sub'd.)
Day phone
,2oQ Zip Code 9 95"17
Zip Code % X15`
,.#, -H I_/4_sA s Lo
Legal description (Section, Township & Range)
Lot Size qr�Acr ISq.Ft. Number of Bedrooms
THIS APPLICATION IS FOR:
E]ewer
SOnly
�
Well Only
❑
Sewer and Well
❑
Water Storage
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
El
Hot Tub
11Jacuzzi
13
Swimming Pool
171Water
Softening Unit
Therapy Pool
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
p
(Signature of property owner cr a thorized agent)
Permit/Rush Fees: qwa to Waiver Fees:
Date of Payment: 11 ! n Date of Payment:
Receipt Number: Receipt Number:
(Rev. 09104)
Frw�H._INEERING MEMO
Steve Eng, PE, PH
17237 Bear Paw Circle, Eagle River AK 99577
(907) 694-7028 tel
(907) 694-7026 fax
NorthRimEng@aol.com
Date: 11/16/05 Number of Pages: 6
To: Julie Makela, P.E.
AfOA On -Site Services ,
Subject: The Tablelands #1, Block 9, Lot 5
We are submitting a redesign for the subject wastewater system. We are raising the bottom of the
system to ground surface level. We plan on removing the thin organic layer and constructing the
system.
Thanks -Steve
4ZNINEERING REDESIGN Tablelands S/D #1, Lot 5, Block 9
SPECIFICATIONS &DESIGN GFJIDF,I,INES
Wastewater System Sizing: This is a new 3 -bedroom, single family home. Some of the
neighboring lots are not yet developed. Groundwater was monitored at 7' below the
surface immediately after the high water time of year. A S.T.E.P system will be required
to maintain separation, manufactured by Anchorage Tank & Welding per Orenco
Systems specifications. This lot is over 1 acre in size and no adverse impacts are
expected from development. The neighboring lots are similar. The lots are served by a
public water system. No conflicts to the other lots will take place by this septic system
construction. The easements are located on the drawing and are not encroached upon.
Soil tests revealed sandy soil with low silt. An application rate of 1 GPD/FP with 0.78
reduction factor for utilizing a 5' wide trench. Trench Length = 450 FT=/5'x .78 reduction
factor = 70.2'; 1 line @ 71'. No bedrock was encountered.
Specification Requirements: All components and work must comply with the Municipality
of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and
Wastewater Regulations.
• Two compartment, 1250 gallon S.T.E.P. tank, conforming to Anchorage Tank &
Welding/Orenco Systems Specifications, allowing gravity -flow from outlet.
• Watertight couplings on inlet & outlet
• 5' minimum between the tank and bed. 10' to property lines.
• 2' of cover is required for trench + I inch insulation board.
• Tank & solid pipe must be set on well compacted, stable soil
• 4 inch diameter cleanouts with airtight caps are required I to 4 feet from foundation wall,
prior to any 90 degree bend in 4 inch line.
• All cleanouts must extend to at least ground level
• Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock
• Drain rock to be 1/2 inch to 2'h inch screened. Drain rock to be distributed uniformly
throughout the trench.
• Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices @ 27" on center.
• le 40 PVC, conforming to Anchorage Tank &
Force main shall be 1.25" Schedu
Welding/Orenco Systems specifications. Force main burial to be 4' minimum.
• Silt barrier (filter fabric) to be installed above the drain rock
• Smeared trench sides must be raked or scarified before drain rock placement
• Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS
ASTM D2661, PVC Schedule 40.
• Sewer Service Line is minimum 2% slope
• Septic Tank to be pumped every two years or when required
• Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam FII or equal)
• Maintain minimum 10' separation between water line & wastewater system.
1
Water Key Box
I T & E Easement
// Septic System Construction
Does Not Preclude Adjoining
Lots From A
Improvements.
Sanitation
/ Q
3 Bdrm F.C.O.
Home Double C. .'s T.H•2
Absorption Trench
/ Reserve Site
Gallon STEP Tony
T.HA
7
•I SvoPe
5 \
DESIGN NOTES:
1. Total Depth of Trench is 0'— Build Up From Groun Level.
Remove organic layer. Thaw ground if frozen.
2. Sewer Service Line minimum 2% slope.
3. Trench is Minimum 10' from Lot Line.
4. Lots Served by Public Water System.
TABLELANDS S/D #1
cc I LOT S, BLOCK 9
1' = 40'
REDESIGN
LAYOUT
hW.
11/16/05 1 of 4
NORTHRIM
• ;491ti
ENGINEERING"?
17237 Bear Paw Circle
p,,. py
Eagle Piver. Alaska 99577
'• at-om
907.694.7028
TABLELANDS S/D #1
cc I LOT S, BLOCK 9
1' = 40'
REDESIGN
LAYOUT
hW.
11/16/05 1 of 4
LoEP,I IC
v—
C11—
10�
1
C8
—C9_
Ca
15' T & E,
C iEASEMENT i
VACANT C2
4
J s 46,616
,1 2B1 �; RQo6 sq. Ft.
n
c� d
SEPTIC 6 V
SYSTEM fl
53,610 c
\\ sq. ft.
rE'A1*SEMENT_ 5'T&E
�
Y
NORTHRIM
ENGINEERING
77257 Bear Paw Circle
Eagle River. Alaska 99377
907.694.7028
SEPTIC
SYSTEM SITE
�5 /---;
5§,422
5 \ �
I Lots—Se vrte�
By Pu
d
0
Water System
196.08'
2101 "W-�440.05'(R&M)
\ ` SEPTIC Z
SYSTEM 3
TABLELANDS S/D #1
LOT 5, BLOCK 9
1' 60'_,
I
>/D REDESIGN,
LAYOUT
11/16/05 2 of -41
O C
L
O
>N
0-0
:p
U 3
u
00 UCL
OC >,
f d Z/) O f
u
Nn"\:pd
U I
N
Cl.
o
U
cv ``
.0
L
I
i
c
++ 00
C W U
N
OE
_.
E
3
O�
L
+ N d
Q I
N I,
N`t}
Ui U3U
NCO
i dN
-P U
U
LO
Cy
4
N
N
> (p5
m
,>U
U £ av
L i
I
L)
L
S • UNI
�u.
u I CY
O C
N Obi ¢
N
L-0Np O
00 UCL
OC >,
f d Z/) O f
3
0
Nn"\:pd
U I
d
N
d N(LC
is
U
EN C
E— f
Y
•1
C•
d
<
¢ CL w,
r -
o d N tn
p) Q)
to NANO I
3
p C ClC:4-O
UNJO—O
d
N`t}
Ui U3U
NCO
~U 'YC >54
U
1-0 -
(3J -
F N
SFN
a)
d
\dL
+� LJ 3+.' N ,
c
Qv~Na
c
d
f
N
u
L
0
U
a
S
u
c
N
L
F-
0
F-
L T
O d
:pX
CS L
75 N
U
d
W Y
F- d
y F
N
od
°o
S
N ¢
r W I
s L
L
~ O
U T
0
0
L
N
0
U
O_
W
q U
za
& W
LO cQ
O C
..
MC ] W
F -
f
O_
W
W N Q
U
q
�+Z
Z z =)
X f
Zr Z _
U
Z
W
a¢W
F-
U
L 1
N T
L 1111
N
N N
s >.
d d
4' J
N U
OC
F d
rn
C L
_O
u >•
.3 O
L E
+' N
N
C
U U
CP L
i 3
3 M
A
E �
L C
O 3
W O
L
Lo
o
O i
N
LA X
� W
A QN
mm_
N U
A -i
Z J
Q P1
w Ln
PCI F -
Q 0
I— J
W
W H
H LJ...
>0
A n -
W Y
Z
U F --
Z
LLIw
F
- o n
I W CL n
o
� ( d
? m $ cQc
C) ^ I r
Zw Nac
N
L
O
l�
O
O
3
44
S
3
c
O
4.U
3
L
tn
N I
C
O
U
rn
+;
L I
Q I N
al
U
U d Y„
.a�N
Low 0
oW N
d ,Q
d �N UI 3
�
O� N
d Y F- I n
>11310•7f =
E
£�Y U
C"CC 0
a .d
�+g=l'U..
a
o L �Li
L>
L7 £~ N
0010 .:
C)(UNNI
X £-04'I
W 3 0, oil
£tpq'
N
al d�
30
��\NI
N 3 m
-C o, L
L'
aF0-w3'
U 0
V1 Cu O
W of {+ £
F- L -0 3
F- I
ONS =1
z
zd 3 w�
.l7 O O L
Vl F- fF-
W U'1
.I
q r: CU Mvl
(U
s
3
F-
0) N
C z
T C3
O
c L)
0
\� U
W
4_
N
Vf
f
W
0
V1
}
Vi
0
C z
d W
a �
0
0
z
PI
J
W
3
d7
Y
z
6
F-
0
F -
z
g
O
la.
W
U
K
z
0
U
0
lL
0
r
U
CL
0
a
in
a
c
O
+1
C5
3
N
C
w/
U
4
0
0
O
A
W
2
U
0
i
� r'C
r��A
i i;�•i
50
� r'C
r��A
A�
+ \ SOIL
RFI IIM_
INEERING
LOG — PERCOLATION TEST
Date Performed: 11/2/05
Performed For+ Spinell Homes
Legal Description+ Lot 5, Block 9
Comments, - I
Performed By Rar-+J Rim Eng,
Performed in Accordance with All S
nM THTS DATE. DATE, 11/8/05
NORTH "M *~`49 '
DEPTH
j 17237 Boor Pow Circle
wwp
''• ...a°�
Eogle River. Aloska 99377
1907-694-7028
(FEET)
Organic
2
SP
Slope < 5%
3 -
Sand
4
w/Gravel
5 -
" •r
6
-
Groundwatert No
Depth
7
_
.'After
Water Depth
8
-
Monitorin . 7'
Date, 11/8/05
;:+.,•:
# Date Gross Time Net Time
De th
Net Dro
10-
. ;; ,,: •:.:.
1 11/2 0
--
5
--
11 -
..' .:....
2 11/2 2
2 min.
5.5'
0.5'
12
- _':w:'.�.
3 11/2 5
- -
4.5'
--
13
-
4 11/2 7
2 min.
5'
0.5'
14
-
5 11/2 10
__
4.5'
--
15
-
6 11/2 12
2 min.
5'
0.5'
16
-
17
-
18
-
19
-
20
-
Percolation Rate 4 min./inch
Perc
Hole Diameter
21
-
Test Run Between 3' and 4'
Comments, - I
Performed By Rar-+J Rim Eng,
Performed in Accordance with All S
nM THTS DATE. DATE, 11/8/05
NORTH "M *~`49 '
ENGINEERING
j 17237 Boor Pow Circle
wwp
''• ...a°�
Eogle River. Aloska 99377
1907-694-7028
—_
CERTIFY THAT THIS TES1 WAS
t_o/Municipal Guidelines in Effect
TABLELANDS #1 S/D
GEOTECHNICAL
LOT 5
BLOCK 9
T.H. 1 °a1il/s/o5of 2__
SOILS L
Hill M
EN9INEERING
— PERCOLATION TEST
Date Performed, 11/2/05
Performed Forl Spine(l Hones
Legal Description Lot 5, Block 9
NORTHRIM
ENGINEERING
17237 Beor Paw Circle
Eagle Paler. Alaska 99577
907-694-7028
TABLELANDS #1 S/D
fr+ W -i
o''~""'' GEOTECHNICAL
T. H. 2
LOT 5
BLOCK 9
11/8/05 j a----
DEPTH
(FEET)
Organic
1 -
'•`
2 -
:.; >:• :,:
SP
Slope
< 5%
3 -
Sand
4 -
•:;:
w/Gravel
.;,:
5
6-
Groundwater? Yes
Depth
1
7
."
Water
Depth
8
After
Monitorin 7' Date, 11/8/05
9
-
`..:.,•:
#
Date Gross Time Net Time
De th
Net Dro
10 -
"'w •'
1
11/2 0 --
10'
--
11:.;•:.
-
2
11/2 2 2 min.
10.5'
0.5'
12
-
3
11/2 5 --
--
13
-
4
11/2 7 2 min.
14
-
5
__
11/2 10
10'
--
IS
-
6
11/2 12 2 min.
10.5'
0.5'
16
-
17
-
18
-
19
-
20
-
Percolation
Rate 4 min./inch Perc
Hole Diameter
21
-
Test Run Between'and 4'
Comments,
- I
CERTIFY THAT THIS
TEST WAS
Performed
By Nr)rthRim E_ng.
All State/Municipal Guidelines
in Effect
Performed
in Accordance
with
ON
THIS DATE.
DATE,
11/8/05
-
NORTHRIM
ENGINEERING
17237 Beor Paw Circle
Eagle Paler. Alaska 99577
907-694-7028
TABLELANDS #1 S/D
fr+ W -i
o''~""'' GEOTECHNICAL
T. H. 2
LOT 5
BLOCK 9
11/8/05 j a----
Municipality of Anchorage
Development Services Department
�..r Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.orglonsite
(907)343-7904
ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET
To: NorthRim Engineering
ZD
Legal description: The Tablelands #1. Block 9. Lot 5
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 missing or inadequate.
❑ Incomplete; missing _
❑ Incomplete; missing —
F] 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. Need Class C wetlands permit
Name of reviewer: Julie Makela. P.Et
Date: 11/16/2005
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
OPINION OF COMPLIANCE
ANCHORAGE GENERAL PERMIT 93-10N
Permittee: Spinell Homes
File Number: POA -2005-1984, Peters Creek
Municipal Reference Number: Peters Creek 05-13
The permittee will perform work in waters of the U.S. (wetlands) in accordance with the terms and
conditions of the Anchorage General Permit, as specified below.
Work Description:
Construction of a single-family home driveway, yard fill and septic system.
All work will be performed in accordance with the attached plan, Sheets 1-3 of 3, dated
11/28/05 and Plot Plan 10118105.
Project Location: Chugiak, Alaska.
Anchorage General Permit Conditions:
General Conditions:
1. Water Quality Certification. You must comply with all conditions specified as part of the Alaska
Department of Environmental Conservation Water Quality Certification, which is part of these
General Permits (GPs).
2. Historic and Archaeological Sites. These GPs do not authorize activities, including the use of
material borrow sites, in or that adversely affect known historic properties listed or potentially
eligible for the National Register of Historic Places, nor any such sites listed or found to be
potentially eligible in the future. The pernilee shall stop work when cultural resources are
inadvertently discovered during the course of work and notify the Corps. The Corps will enter Into
consultation with the Alaska Stale Historic Preservation Office to determine if historic properties will
be affected by the permitted work. Work shall resume after cultural resources have been evaluated
pursuant to Section 106 of the National Historic Preservation Act.
3. Inspections. You must permit the District Engineer, or his designated representatives, to inspect
the authorized activity at any time deemed necessary to ensure that it is being, or has been
accomplished in accordance with the terms and conditions of these GPs.
4. Maintenance. You must maintain the authorized activity In good state, and in conformance with
the terms and conditions of these GPs. You are not relieved of this requirement even if you
abandon the authorized activity, although you may make a good faith or legal transfer to a third
party, as described below. Should you wish to cease to maintain the activity or abandon it without
a good faith transfer, you must obtain a modification of the GP authorization from the Corps
Regulatory Branch either directly, or through Municipal Planning Staff. Such modification may
require restoration of the area.
5. Sale or Transfer of Property. If you sell or transfer the property associated with the authorized
activity, you must obtain the signature of the new property owner as the transferee in the space
Spinell Homes-�� _
POA_2005;)984; Peters, Creek
provided on this document and submit a copy of that page to the Municipal Planning Department
and/or Corps Regulatory Branch, along with appropriate documentation of the transaction. You
must submit this information within 30 days of the property transfer, to validate transfer of the GP
authorization to the new party.
Project site restrictions and design criteria:
1. Construction Timing Window. To protect nesting migratory birds, as required by the Migratory
Bird Treaty Act, no work (i.e.. Gearing, grading, excavation, stockpiling, or placing of fill) may occur
on the site between April 15 and July 15, unless: a) the site is sufficiently disturbed prior to April 15
to eliminate suitable nesting habitat; and, b) construction activity will occur continuously through
June 15.
Note: Clearing or other disturbance of the site prior to April 15 may require Corps or other
authorization.
2. Surface Water Features. The project shall incorporate design features and construction methods
to maintain flow of surface water across the site. To accommodate this requirement, the applicant
shall assess the project site to identify drainage patterns and previously unmapped surface
conveyances, such as streams and drainageways. These features must be field verified by Corps
Regulatory, or Municipal Planning or Watershed Management staff. The applicant shall contact the
Office of Management and Permitting (tel.269-8690), Alaska Department of Natural Resources, if
the proposed project will cross any surface flowing waterway.
Surface flow features shall be clearly depicted, along with any appropriate setback(s), on the
proposed plans submitted with the GP application, as shall the measures proposed to maintain
such flows. Cross -drainage may be directed around the development area, but the project must
maintain downstream flows similar in quality, quantity and direction to the pre -project condition. As
discussed under Setbacks, the GPs may allow crossings of unmapped waterways, but do not
authorize permanent diversions, channelization, or other alteration.
3. Local Flooding. The project shall incorporate design and construction features/methods
necessary to ensure that the proposed project will not rause flooding of adjacent properties or
public Infrastructure.
4. Stornwater Functions. The applicant shall demonstrate that the project plans include sufficient
measures to effectively replace the site's pre -project stormwater retention and filtration capacity.
The measures shall be sufficient to approximate zero net runoff increase for storms with 2 -year
frequency and no more than two times net runoff increase for storms with a 10 -year frequency,
Including flows from subdrains. Verification that the project's stormwater design meets this criterion
must be obtained from the Municipal Wetland Management Section or its designee, and must be
included with the GP application package.
Project -specific conditions:
1. Time Limit GP authorization of this project expires on December 20, 2007. If you need
more time to complete the authorized activity, submit a request for extension under these GPs to
the Municipal Planning Department prior to the expiration date. You may not continue work beyond
the expiration date until receiving notification to that effect from the Municipal Planning Department
or the Corps Regulatory Branch.
Note: Permittees should allow at least one month for processing of extension requests.
2. Other Approvals Required Before Starting Work. You must not disturb wetlands for this project
until you have obtained all applicable Municipal and State approvals required for the work. These
approvals include, but are not limited to:
Municipality of Anchorage:
® Land Use Permit
❑ Grading & Fill Permit
❑ Building Pennit
❑ Right -of -Way Permit
❑ Flood Hazard Permit
Spinell Homes
0A-2005-1984; Peters Creek
® UtilityAgreement(s)
❑ Rezoning Approval
❑ Preliminary Plat Approval
❑ Subdivision Agreement
❑ Stormwater Treatment Plan
❑ Parks Right -of -Entry Permit
® Wastewater Disposal
Alaska Department of Environmentat Conservation.-
❑ Stormwaler Treatment Plan
® Wastewater Disposal
❑ Soil Remediation Plan
If any of these—or other—approvals result in a change to the attached plans, you must provide a
description of the change and a revised plan(s) to either Municipal Planning Department Staff or
the Corps Regulatory Branch, and may not proceed with the project until the change is authorized.
4. Limits on Work Area. You must not conduct any of the following activities in wetlands or
waterbodies beyond the approved project footprint (or in any other avoidance area identified above)
during either construction or operation of the project/facility:
➢ Discharge of fill material (even temporarily), including stockpiles; or,
D Excavation and siderasting/backfiliing; or,
➢ Mechanized landclearing; or,
➢ Operation, parking/storage or servicing of equipment.
5. Construction Runoff. You must employ runoff control measures necessary to preclude or
minimize both erosion and the transport of sediment, pollutants, and solid waste beyond the
approved project footprint. These measures shall include, but are not limited to:
❑ Phasing of Site Preparation (to minimize the extent of exposed soil);
® Silt Fence;
❑ Reroute Offsite Runoff around Disturbed Soils (e.g., dike/ditch)
❑ Mulching (e.g., wood chips, straw, grass clippings, gravel);
X Matting (e.g., jute, straw, coir);
X Sheeting for Stockpiles, Temporarily Exposed Slopes (e.g., plastic, geotextile fabric);
❑ Check Dams in Ditches/Drainageways (e.g., hay bales, sand bags, gravel berms);
❑ Surface Roughening (to slow runoff down slope);
❑ Terracing of Slopes;
❑ Sediment Trap(s):
❑ Temporary Sediment Basin;
® Storm Drain Inlet Protection (e.g., hay bales, sand bags, gravel berth)
® Outlet Filtering/Stabilization for Construction Dewatering;
® Revegetation of Fills and Disturbed Soils
❑ Onsite petroleum spill/leak response equipment and supplies and provision for their
proper disposal
6. Contaminated Soil. If contaminated soils are discovered during construction, you must
Immediately cease all work in the vicinity of the contamination. contact the Alaska Department of
Environmental Conservation for instructions, and defer any further activity until you receive ADEC
approval to continue.
7. Endangered Species. The activity must not jeopardize the continued existence of a threatened or
endangered species, as identified under the Endangered Species Act, nor endanger the critical
habitat of such species.
Spinell Homes
�OA.200�-19L Peters Creek
Special Conditions, as required by the Corps of Engineers:
1. The wetlands and vegetation outside of the authorized fill area shall not be disturbed In any
manner. This Includes, but Is not limited to: equipment operations; general storage of
materials or debris; cutting or removing vegetation; ditching; or excavation.
opy of this
2 The l attachments to the home
owner prior to occlupying the h userovide a paper• Should thep pit and I
erty be subsequently transferred, the
permit shall again be provided to the new home owner.
3. All surface water drainage from the authorized fill area shall be directed to the remaining
wetland areas. The runoff waters shall not be allowed to cause siltation of the wetlands or
any other drainage system to protect downstream flows and aquatic resources.
4. All fill areas and rill slopes shall be immediately stabilized against erosion. Fill material
shall not be allowed to erode Into the wetlands during the Spring thaw season.
Your s gr�ature below, as permittee, confirms that you accept and agree to comply with the terms
and condit�ns of Anchorage General Permit 93-10N, as supplemented in this document.
(
(PERMITTE _ AME AND TITLE (DATE)
opinion of Compliance
The signature below confirms the Municipality of Anchorage's opinion that the project
described above meets the terms and conditions of Anchorage General Permit 93-10N .
MUNiICIPAL OFFICIAL', NAME&J
ITLE (DATE)
When the work authorized by the Anchorage General Permit is still in existence at the time the
property is transferred the terms and conditions of the permit will continue to be binding on the
new owner(s) of the property. To validate the transfer of the permit and the associated liabilities
associated with compliance with its terns and conditions have the transferee sign and date
below.
(TRANSFEREE)
(DATE)
Attachments: Final Project Plans [s'heets 1-3_of 3, dated 11128105; plot pian 10128105)
Spinell Homes
�OA,2005-1984 Peters CCreek
SCALE: N.T.S.
WETLANDS MAP DELINEATION 11-28-2005
J?Mljowlmr. L5,B9 THE TABLELANDS SUBDIVISION SHEET 1 OF 3
• HOUSE '
.••` 58f1��SP.
SEEDED YARD W/
4' OF TOPSOIL I 1 Zlt.A,JD.$ rlLL
YAc>/SCOrIG 3,i,+7 sF
}IouSc
_ i.9GC- �
gG135f 40W
'r: TAL9
SITE CA, CU_ATIONS
13$ Ly
NATURAL VEGETATION -
44.518 S.F.
NEW CRASS -
8,915 S.F.
AC DRK WAY -
iMNG
808 S.F.
2-183 S F.
PROPOSED BU -
TOTAL -
58.422 S.F.
SCALE: N.T.S.
PROPOSED VEGETATION PLAN 11-28-2005
JeES,km L5,B9 THE TABLELANDS SUBDIVISION SHEET 3 OF 3
MIN. OF G' i
HEIGHT ABC
1:12
SOILS
SCALE: 3/32"=1'
HOUSE PAD CROSS SECTION 11-2s-2005
HOMES, Irm L5,69 THE TABLELANDS SUBDIVISION SHEET 2 OF 3
1900 W. %>th—l rls all - )=n
9200
MCa094 •9 99510 (901)3'•�M19
lamlav,
It
11
1:12
SOILS
SCALE: 3/32"=1'
HOUSE PAD CROSS SECTION 11-2s-2005
HOMES, Irm L5,69 THE TABLELANDS SUBDIVISION SHEET 2 OF 3
1900 W. %>th—l rls all - )=n
9200
MCa094 •9 99510 (901)3'•�M19
1
ENGINEERING
Northitim Engineering
17237 Bear Pow CirCle
Eagle River, AK 99577
907.694.7028
November 10, 2005
MOA On -Site Water & Wastewater Program
4700 Bragaw St
Anchorage, AK 99519
RE: Tablelands #1, Block 9, Lot 5
A lot is being developed. The soil test was good. Groundwater was monitored and is
present. A conservative design has been completed, similar to the neighbor lot 6.
The neighboring lots are mostly developed. This site should not negatively impact any of
the other area lots. The lot slope is relatively flat.
Please review the wastewater system design for the single family home. l have included
design plans & specs, design guidelines, & soil tests. if there is need for additional
information or clarification please give me a call.
Sincerely,
Steve Eng, PE, PFI
Design Enclosures
1'
I EN(I E�ERING
Tablelands S/D #I, Lot 5, Block 9
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: This is a new 3 -bedroom, single family home. Some of the
neighboring lots are not yet developed. Groundwater was monitored at 7' below the
surface immediately after the high water time of year. A S.T.E.P system will be required
to maintain separation, manufactured by Anchorage Tank & Welding per Orenco
Systems specifications. This lot is over 1 acre in size and no adverse impacts are
expected from development. The neighboring lots are similar. The lots are served by a
public water system. No conflicts to the other lots will take place by this septic system
construction. The easements are located on the drawing and are not encroached upon.
Soil tests revealed sandy soil with low silt. An application rate of 1 GPD/FT2 with 0.78
reduction factor for utilizing a 5' wide trench. Trench Length = 450 FP/5'x .78 reduction
factor = 70.2'; 1 line @ 71'. No bedrock was encountered.
Specification Requirements: All components and work must comply with the Municipality
of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and
Wastewater Regulations.
• Two compartment, 1250 gallon S.T.E.P. tank, conforming to Anchorage Tank &
Welding/Orenco Systems Specifications, allowing gravity -flow from outlet.
• Watertight couplings on inlet & outlet
• 5' minimum between the tank and bed. 10' to property lines.
• 2' of cover is required for trench + I inch insulation board.
• Tank & solid pipe must be set on well compacted, stable soil
• 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall,
prior to any 90 degree bend in 4 inch line.
• All cleanouts must extend to at least ground level
• Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain -rock
• Drain rock to be %2 inch to 2 %3 inch screened. Drain rock to be distributed uniformly
throughout the trench.
• Distribution pipe shall be 1.25" Schedule 40 PVC w/ 1/8" orifices (,a 27" on center.
• Force main shall be 1.25" Schedule 40 PVC, conforming to Anchorage Tank
Welding/Orenco Systems specifications. Force main burial to be 4' minimum.
• Silt barrier (filter fabric) to be installed above the drain rock
• Smeared trench sides must be raked or scarified before drain rock placement
• Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS
ASTM D2661, PVC Schedule 40.
• Sewer Service Line is minimum 2% slope
• Septic Tank to be pumped every two years or when required
• Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam Ill or equal)
• Maintain minimum 10' separation between water line & wastewater system.
Water Key Box
I T & E Ea$e n
/� Septic System Construction
Does Not Preclude Adjoining
\0 � Lots From Sanitation
Improvements.
/ o
3 Bdrm
125 Gallon STEP
T,
'.C.O.
DoubleT.H.2
Absorption Trench
Reserve Site
DESIGN NOTES:
1. Total Depth of Trench is 2'.
Terrain relatively flat.
2. Sewer Service Line minimum 27. slope.
3. Trench is Minimum 10' from Lot Line.
4. Lots Served by Public Water System.
NORTHRIM
�` '
ENGINEERING
17237 Bear Pow Circle
Eagle River, Alaska 99577
w.w nr
•.•CK'W°!
907.694.7028
TABLELANDS S/D #1
LOT 5, BLOCK 9
40 .
LOT
LAYOUT
11/7/05 11 of 4
cil 61
15' T & E
C7 VACANT EASEMENT' CZ
C12 1 \
1 i �
' 4
10 C8 t 46,616
-c9_ , OL2B1
�sr. sq. ft.
06,.
S 04V
SEPTIC 6
�O SYSTEM
53,61: --
SEPTIC
N SYSTE SITE
f 5
} \ sq. ft. / 5/'\ /
1:5-�T&E
N �EASEMENT_
} Jot57-Se. vr�e_d �By Pu
l
W
J00
N
0
/ OV
Water System
196.08'
3. \
S89'52901 "W`440 0 (R&M)-----�'
' \\� SEPTIC Z
\ SYSTEM J
..... � TABLELANDS S/D #1
NORTHRIM *�4'.
ENGINEERING
17237 Bear Pow Circle
a''LET 5, BLOCK 9
' �
Eagle River, Alaska 99577 -
907.694.7028 _- --
S/D
LAYOUT
"1
11/7/05 12 of 4
v
ui
I
S/D
LAYOUT
"1
11/7/05 12 of 4
N ,
i O
N
� d
j U
0 4
C/) U
O
£ (Clu
O N
L
> L�
O L
u a W N
J�
W Lfi
+' LO
O U W
uo
CD
O t
N V1 � 3
\
CNd O'
Cs .2,)
C I
c ,v I
d N i f
£ ,0 Q
O pW v
►-�
LA._
w
O)
A
d d >UL
0
L
+' 0 U L S
dU�+' L
N
Q
£ C L Q
I
L 0 0) 4 I
>� a o °
COL
0U C T I
dV10 •- I
3
O
L
N yNG
3 U
d
as £N � i
U
C °C
o +. £"
d
f a� N `
Fd -
(u O N N0)E
0)L
N= 0)= 0
3
— OCaCC
O
-CV) :3 !
d
C.6 WU CU
aJ
L U U 0
U
C L
e4-I-d—y F—NY
O
+
O ai
d L w`"3 I
'd8\
S
+- W a -p a,
s
atiti3
I W
-; ftJM4ui�6
I_.._...
S
u
C
a,
L
F-
0
F-
N N
q•
W Y
F- 6
N
O d
do
S
CD U
N Q
r. .
O_'
W
F
Q
q U
Z C3
O A
�w
O O
O W W
F
Q
K
W
N Vl
U
fa
Z
Z Z =)
f f 7
Zr Z0 =
U
Z
W
M
Z Z
f f Q
0
N
V Y
C/) U
O
z J
Q Y-1
N
J�
W Lfi
PCI F-
1:3
uo
CD
\
Y
W
W
H
►-�
LA._
w
A
CL
Z
W
Y
z
Q
U
Z
~W
W
�
W
J
H
F-
O
N
d
L
d
E,
z
Q
S
W
u
K
O
4.
U
(L
N
n
IN
191
I
w
O
N
�
� I
O
N
W
Ocu
ma.
S
u
C
�
a
y
d U~ n
q
N O elf
=
COY
L L
u
N
d d
i
+Q~
a
1L
L lJ
.......
> O ~
N
0 N
d
.:
a
(UN W
:3
ESW
t UI
d r
3 0
cu -P
N 3 a
S LI
CL a)51
'
W J NI
q i
ss �',
s >a
u0
N Cu0
W N 4- E,
F- L a 3 .
OF- WS £,
'•,":�
Z auc)
z +,:3
LO O L .
F-Inl
NF-fuj
L
d
E,
z
Q
S
W
u
K
O
4.
U
(L
N
O
:.,
.......
L)
a
LLI
^
'•,":�
0
N
N
cu
O
W
W
0
m
C3
a
z
m
z
a
Q
w
C3
a
y,*.
z
117
•,,
Q
N
a
c
F-
O
-•.'d r.
d
0�
3
A.>:•7
p
u
,
t;
O
r ..
z
0 -
CL
W
t
4-
W
N
..
L
d
+'
d
3
a
C
0
O
L
l7
O
++
'v
Y
U
O
L
a
a,
m
0
i-'
z0
3
H
A Ln
p
A J
Q ON
W Y
Q -i
F- PQ
EPtiwkIS
�,� Municipality of Anchorageir, ra•.
t_ On-Site Water&Wastewater Program ; ;.
(907)343-7904 SA f•r
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-741-61 Expiration Date: C(-- 2- r —1?
1. GENERAL INFORMATION
Complete legal description THE TABLELANDS S/D#1; BLOCK 9,LOT 5
Location (site address) 22315 WAPITI CIRCLE, CHUGIAK,AK 99567
Current Property owner(s) JOSHUA KOPPY&TAMMY ENOCHS Day phone 699-5674
Mailing address 22315 WAPITI CIRCLE,CHUGIAK,AK 99567
Real Estate Agent MIYUN STOGSDILL Day phone 854-1817
2. TYPE OF DWELLING:
U 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 On-site U
Individual Water Storage ❑ Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System U Public Sewer ❑
WalverNarlancerequest for N/A Distance: -
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee$ 550 Waiver Fee$
Date of Payment i61/-71/9 Date of Payment
Receipt Number //�1 05D/06 Receipt Number
t1
COSA# ,`�l'I9./Q' 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 GARNESS ENGINEERING GROUP,Ltd. Phone 337-6179
Address 3701 E.TUDOR ROAD,SUITE 101 "ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date is J( l q
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the �.��ii�I‘t!.
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the ���� OF a file,
condition of the system/s on the date/s of the evaluation.Separation distances were measured to ready identifiable features. 1
,`P, ••,,........ .
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational fife of all waits and septic = ,..•••' ...:1".c7.._
systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate duringThi `I
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the systems.These * . 4. / \ •:* 4
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the ; „�,,, • •
systernis;therefore,GEG makes no warranty(express or implied)regarding the future performance of the welt or septic system.
GEG makes no representation whether an alternative well or septic system can be installed on the properly in the event either of the1.1:
a 1. ....z'. .a
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the �0 (,J: 1- A.Games. 4r
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not 0 0 • , • \
lr
authorized.In short,GEG disavows any legal duty to anyone other than the person/parry who paid for this report. v )'•• `
`, l
6. DSD SIGNATURE LICENSE +k FESS\U".••
/ System#1 Approved forliAECC884
bedrooms.
System#2 Approved for bedrooms.
`kOlttuur((((
Disapproved. `` �G�QP�-QTY 0,,,4„1/4i
Conditional approval for bedrooms, with the following sti �atitns: ON_ y
'0 �wgTEir -
44 7 A/y�
�o pR0G�grR ,
�qM o,�
.:%F,� - �c -,
i //�sl CES��
1))))11)
_______,..---
'Err— 1 V...� (– Original Certificate Date: CC, -I q -17
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10112/12)
COSA Checklist
Legal Description: THE TABLELAND S/D#1; BLOCK 9, LOT 5 Parcel ID: 051-741-61
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. LL DATA PUBLIC WATER
❑Well log i -d with Onsite (or attached) Well production at time of test g.�.
Date drilled Water storage tank volume gallons
Total depth ft Well disinfected f. •. orm test? ❑Yes ❑ No
Cased to ft ❑ Co = •acteria is Negative
❑ Sanitary seal is functioning correctly itrate mg/L ❑ Nitrate less than MRL (ND)
0 Wires are properly protected • -•ic ug/L 0 Arsenic less than MRL (ND)
Casing height(above ground) in. Collected b
Date of flow test for CS . Date of Sample
Static wat- ,e at beginning of test ft.
• ments
B. TANK DATA C. LIFT STATION
Age of tank(s) 13 years ❑■ Required maintenance completed
Tank type/material STEEL Age of lift station 13 years
DI Standpipes/foundation cleanout per record drawing Lift station material STEEL
Date of pumping 09/21/2018 Comments: SEE ATTACHED LIFT STATION/PUMP VAULT
NOTE:47.5"OF L.L. NOTED IN ST1 ON 6/10/2019. MAINTENANCE LOG REGARDING LIFT STATION CLEANING
D. ABSORPTION FIELD DATA 5-WIDE(PRESSURIZED) •
Which system tested (date installed) 2"•1' Adequacy test date 6/10/19
❑� ALL standpipes present per record drawing Results ❑✓ Pass For 3 bedrooms
• Total measured depth from grade 3.9 ft(max) Fluid depth prior to test 10 in
Measured depth to pipe invert from grade * ft(min) Water added 463 gal
0 N/A—pressurized field New depth *20.75 in
❑■ Monitor tubes go to bottom of drainfield. If not, state **918
depth into effective • Elapsed time min
0Code-required soil cover over field Final fluid depth 12 in
Absorption rate 450+ gpd
0 System presoaked
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) NONE
date of test)
Gallons introduced - gallons If yes, enter date
Comments/Deficiencies:'MT MAY EXTEND DEEPER THAN BOTTOM OF SYSTEM.INVERT OF DISTRIBUTION LINE IN DRAINFIELD AND
INVERT OF PRESSURIZED LINE EXITING STEP TANK ARE SET AT THE SAME ELEVATION PER THE 2006 RECORD DRAWINGS.AT
NO POINT DURING TEST DID SYSTEM BACK-UP INTO THE STEP TANK THROUGH THE WEEP HOLE IN THE PIPING IN THE TANK.
**PER THE OWNER,3-5 SHOWERS,MISC.TOILET FLUSHES,AND A LOAD OF LAUNDRY WAS DONE DURING THE RECOVERY
PERIOD.
COSA Checklist yellow sheet
E. SEPARATION DISTANCES PUBLIC WATER
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Se. ' k/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 10 e'
E Yes if No ft if No ft
Neighboring Tank> 100' if No ft Private Sew- - • lc Line>25' []Yes if No ft
Absorption Field on Lot> 100' ❑Yes if No .- olding Tank> 100' ['Yes if No ft
Neighboring Absorption Fields> 1 rr•' Animal • -', ent> 50' E Yes if No ft
II Yes if No ft
Manure/Animal Excreta Sto .• 100'
Co,. y Sewer Main>75' E Yes if No ft I♦ e ' •o ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations> 10' D Yes if No .s,+ ft Surface Water> 100' EE Yes if No ft
Property Line > 5' EE Yes if No ft Driveway/Parking> 0' D Yes if No, comment
Absorption Field> 5' EE Yes if No ft Wells on Adjacent Lots:
Water Main > 10' EE Yes if No ft Private Wells> 100' EEYes if No ft
Water Service Line > 10' EE Yes if No ft Community Wells>200' D Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation> 10' EE Yes if No ft Driveway/Parking> 0' EE Yes if No, comment
Property Line> 10' E✓ Yes if No ft Wells on Adjacent Lots:
Water Main> 10' E✓ Yes if No ft Private Wells> 100' E✓ Yes if No ft
Water Service Line> 10' ❑✓ Yes if No ft Community Wells>200' E{ Yes if No ft
Surface Water> 100' E✓ Yes if No ft
F. ENGINEER'S COMMENTS
*51+ (MET CODE AT TIME OF INSTALLATION).
�'����o.
G. ENGINEER'S CERTIFICATION d
o " �F.• -.'•�s4p
I certify that I have determined through field inspections and review o * •. I 4 4�
of Municipal records that the above systems are in conformance with ,' Ll I IA %.-77 1/0
MOA COSA guidelines in effect on this date. •vA
.. . . ....
I- f - Gcrn-ss; G,
0/CP tf
COSA Checklist yellow sheet �0‘"k. .44, ---
ro f ess�o 4�
#AECC8840
M.
UNICIPALITY OF ANCHORAGE
Development Services Department Phone' 9O7-343-7904
On-Site Water & Wastewater Section Fax 907-343-7997
Lift Station/Pump Vag:{.
Maintenance Log
Owner `•, Lt
Street Address 2. 1 Af)
Septic Tank:
•Sludge level _inches 'Pumping required 1`c's.a„rr>) ',Pumping completed. nc2
Oft $t# tion;
'Pump basket cleaned � o 'Effluent filter cleaned no
'Control floats cleaned ..,no 'Proper float settings confirmed ntw
'Operation satisfactory(a_n
8Iarrn S rm;
'Dedicated electrical alarm circuit f no -Audible and visual alarm inside dwellings
"Alarm system operator .- ,-Ano -t fa.to,.
Menhole Riser
'Ground water intrusion at riser to lank connection yes (22::.
'Ground water intrusion around pipe penetrations yes •W`eep tole function °� no
'Manhole lid: Punctiani 4 nc, insulated c Properly Secured :. ,n
Other
"All manufacturer required inspections and maintenance completed yes no
Comments:
Qualified Maintenance Provider:
Technician ..,—, „ t`>bil6/) Date of maintenance t I-2119
Company r_ i QJ+Are p-i-s
Signature . Date ttiillt3
''. fl}1 - • dr .SS: 0_ X .9 An >ti iso . .rxz i:li' Q:4{t$-66,5
Municipality of Anchorage a, <
On -Site Water &Wastewater Program -
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-741-61 Expiration Date: 13 — / -I?
--
1. GENERAL INFORMATION
Complete legal description THE TABLELANDS S/D #1 BLOCK 9, LOT 5
Location (site address) 22315 WAPITI CIRCLE, CHUGIAK, AK, 99567
Current Property owner(s)
ROB & ABBY
WARREN
Day phone 240-9293
Individual Water Storage
❑
Mailing address
22315 WAPITI
CIRCLE, CHUGIAK, AK,
99567
Community On-site
❑
Public Water System
Real Estate Agent
SHERILYNN BARE
W/ REMAX/DYNAMIC
Day phone 230-9336
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 On-site
E
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
0
Public Sewer
❑
Date: 7
COSA to be released to_M&-a4ineer, unless otherwise requested by the engineer.
COSA Fee $`t`l Waiver Fee $
Date of Payment ��a� l/3 Date of Payment
Receipt Number Q /'�6 Receipt Number
COSA# 6Sfa86 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. l 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineers Comments:
In conducting this evaluation, GEG, UD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulab'ons. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. Tha operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for 3 bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone
337-6179
Date is a
0o6`.1p0
QF.. �0
�O ,J ff y A..•.cdess,..r`
Q CE —79 mQ
'ro f e s son°oma
bedrooms, with the following stipulations:
J= ON-SITE
N_ WATER AND
vdA0TE%A] ATE R
Original Certificate Date: 7" J —J3
Thd4funicoglity d(,Anchbrage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11/05)
L�z Nitrate Advisory
Arsenic Advisory
Other
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: THE TABLELANDS S/D; BLOCK 9, LOT 5 Parcel ID: 051-741-61
A. WELL DATA 1PUBLIC WATER
Well type
Date completed
Total depth ft.
Date of test
Static water level
Well production
WATER SAMPLE
Coliform
If A, B, or C provide PWSID# _ Well Log
Sanitary seal (YIN)
Cased to ft.
FROM WELL LOG
colonies/100 ml.
ug./L.
B. SEPTIC/HOLDING TANK DATA
Nitrate mg./L.
Date of sample:
Wires properly protected (YIN
Casing height (abo round) in.
AT
Collected by:
ft.
Tank Type/Material
S.T.E.P./STEEL
Date installed
2/7-13/2006
Tank size 1250 gal.
Number of Compartments E
Cleanouts (YIN)
YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES
Date of pumping 9 Pumper SA -n J 6v LA- )OU DQ 10 er S
C. ABSORPTION FIELD DATA BELOW EXISTING GRADE TO BOTTOM OF MT
Date installed 2/7-13-2006 Soil rating CkEl orftlbdrm) 1_0 System type SHALLOW TRENCH
Length 71 ft. Width 5
Gravel below pipe 1.5 ft.
Total depth *3.7 ft. Eff. absorption area 450 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 6/13/2013 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test 1 in. Water added 455 gal. New depth 5 in.
Elapsed Time: 120 min. Final fluid depth 3_5 in. Absorption rate >= 450+ g.p.d,
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date —
NOTE: TRENCH WAS INSULATED PER 2006 INSPECTION REPORT. 2'+ SOIL COVER ACHIEVED.
D. LIFT STATION
Date installed 2/7-13/2006 Size in gallons 1250 Manhole/Access (YIN) YES
"Pump on" level at 42 in. "Pump off' level at 36 in. High water alarm level at 45
Datum BOTTOM OF BASKET Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer /septic service line
areas
PUBLIC WATER
On adjacent
On adjacent lots
manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM 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 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that l 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 Pri ted N/9,me
Date JEFFREY A. GARNESS
b�Z,/�3
(Rev. 11/05)
r
BUILDING
2004-131
THE TABLELANDS SUBD., ADDN. NO.
LOT 5, BLOCK 9
56,422 S.F.
�. GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI. R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE. ALASKA 99502
PHONE 248-5454
GRID DATE
NW1559 3/21/2006
F.B. JOB NO.
06-02 TLS159
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
R IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE. NO CORNERS SET THIS DATE
1
***U■1•
��. �� OF 44�1�
r co
'. . 06.....0.1......0.... ,
......,.....a
ellery A. G°st°ICI
�i i AV
LS -6091
•eCP''y....''�• dr°J�`
� lO43NOW %'GV'
Municipality of Anchorage •.,
-� Development Services Department
Building Safety Division ..
On -Site Water& Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650 c t�
www.muni.org/onsite 'Y
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING p
Parcell.D._O�l�-'�t-il-�oI COSA# 099)M-
1. GENERAL INFORMATION Expiration Date: 4 - / I - Q-1—
Complete
J
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
THE TABLELANDS # 1 BLOCK 9, LOT 5
22315 WAPITI CIRCLE *EAGLE RIVER, AK
KASIA GILBERT Day phone 688-1507
22315 WAPITI CIRCLE *EAGLE RIVER, AK
Day phone
FSBO Day phone
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
a
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 samples. (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. 1 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 aft applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSO Guidelines d Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the.......
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
337-6179
Date 4 0l3
...... . .................
9 ........ .........
e rey ness:
�Lr79$3
�Qn e,• �r 0.hia«4004
Conditional approval for bedrooms, with the filowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
V
Arsenic Advisory
Maintenance Agreements
ON-SITE • ,
WATER AND ; m=
: WASTEWATER
PROGRAM ;
Well Flow Advisory Supplemental Engineer's Reort
Nitrate Advisory Other I /
By:L� (/,, Original Certificate Dater
(Rw 1,a5`)
Municipality of Anchorage
-tel Development Services Department `
Building Safety Divisionif °
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519.6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: THE TABLELANDS #1 BLOCK 9, LOT 5 Parcel ID: OS%- 7 ff
A. WELL DATA PUBLIC WATER
Well type If A, B, or C provide PWSID# _ Well Log (YIN)
i
Date completed Sanitary seal (YIN properly protected (YIN)
Cased to ft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate mg./L. Other bacteria
Arsenic Date R sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEP/STEEL Date installed 2/13/2006
Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) YES
Date of pumping 4/11/2008 Pumper SANITARY PUMPERS
C. ABSORPTION FIELD DATA BELQW EXISTING GRADE
Date installed 2/13/2006 Soil rating g.p.d. 'or ft'/bdrm) 1_0 System type TRENCH
Length 71 ft. Width 5 ft. Gravel below pipe 1.5 ft.
Total depth ft. Eff. absorption area 450 ft' Monitoring tube YES Depression over field NO
t
Date of adequacy test "NEW Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test in. Water added =gal. New depth =in.
Elapsed Time: = min. Final fluid depth= in. Absorption rate >= 450+ g.p,d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date -
**ALL PIPES WHERE DRY ON 4/2/2008
c
D. LIFT STATION
Date installed 2/13/2006 Size in gallons 1250 Manhole/Access (Y/N) YES
"Pump on" level at 42 in. "Pump off" level at 36 in. High water alarm level at 45 in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on tot
Absorption field on lot
Public sewer main
Sewer /septic service line
areas
PUBLIC WATER
On adjacent
On adjacent lots
manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM 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 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 200'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION o�, v .4 `
I certify that I have determined through field inspections and p eVE—
leg
review of Municipal records that the above systems are inconformance with MOA COSA guidelines in effect on thisQdate. .......Js:'
Engineer s Printed Name JEFFREY A. GARNESS �Q �
�F a v �Ad4
Date I ' DOn°pror°stogy°`�
COSAFee$-l3U•uy
Date of Payment
Receipt Number IQ A30
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Sonja Gamess
From: Kasia & Erick Gilbert [rebeleagle.ekg@gmail.comj
Sent: Friday, Apri( 04, 2008 4:09 PM
To: Sonja Gamess
Subject: Statement of Residence
We moved into the residence at 22315 Wapiti Circle (Tablelands #1 Lot
5 Block 9) on 28 June 2006.
Kind Regards,
Kasia and Erick Gilbert
\�--9w.;�jA C ,
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www muni org/onsite
rib(907)343 Li -7904
CERTIFICATE OF
ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 1)51-'414 COSA# QiQnoZJ�-
Expiration Date: G- Z 1- O Z
1. GENERAL INFORMATION
Complete legal description % 1/6 'Tf 6_-Z6 4 f ""71 1 /_O'i S
Location (site address) -:?�Z 31Syme/T/ CfjQL' / '
Current Property owner(s) Ha EKE 4 -FDNC Day phone - 9'67do
Mailing address Mo w_ 0 tee6f- fr ZOo
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual On-site
Individual Water Storage ❑ Individual Holding Tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System C& . Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also Issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my 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
Address
Engineer's Printed Name STYE FctfC
Phone ill- 02
Date eh:� a 6 e
�C�~vot' A(4%11
F ,•.Neee•e•
N.
,s ie�vli
5. DSD SIGNATURE v s+
Od �C Steven W. Eng
_ z Approved for _ bedrooms. Or��f PE 6456
Disapproved. 0 C \�>cii'�"
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
BY I Original Certificate Date:
(Rev. 71N5)
Municipality of Anchorage
Development Services Department
Building Safety Division '
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onske
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Tfi%6 _Ti�i5 -% A 4 j '0/ !g9 L S Parcel ID:
A. WELL DATA A ww u CP ACO
Well type
Date completed _
Total depth ft.
Date of lest
Static water leve/
Well production
X
Cprovide PWSID # _ /CTION
ry seal (YM) Wires ped (Y/N)
to ft. Casing heground) in.
ul WELL LOG AT INS
ft.
SAMPLE ESU
S.
Coliform col ies/100 mL Nitrate m
Arsenic: g!1 Date of sampl .
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material 5%�� Z .SneeL
Tank size f ZSQ gal. Number of Compartments
Foundation cleanout (Y/NDepression over tank (Y/N) _AL
Date of pumping Pumper
C. ABSORPTION FIELD DATA
ft.
9.p—
m—W
Other bacteria lonies/100 mL
Collected by.
Date installed zb-r AT
Cleanouts(Y/N) Y
High water alarm (Y/N)
Date installed Z1Q b Soil rating (g.p.dJft= or*1ftn —L� System type 9&A4&W 7_45%r-0
Length 71 ft. Width Aq� - ft. Gravel below pipe . S ft.
Total depth ft. Eff. absorption areaf�Mft2 Monitoring tube Y Depression over field
Date of adequacy test Al EfiJ Results (Pass/Fail) P T For 7 bedrooms
Fluid depth In absorption field before test _ in. Water added_ gal. New depth_ in.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed -a / /3/0� Size in gallons Manhole/Access (Y/N)
"Pump on" level at O_Z� in. 'Pump off' level at 36 in. High water alarm level at t f -s in.
Datum 7;4A!/4 f9drrookCycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: P(J,BLI C w g fEvQ
Septic tank/lift station on
Absorption field on lot
Public sewer main
Sewer /septic sft(vice fine
On adjacent
On adjacent
Public sevv6r manhole%leanout
Animal conntAinment areas Mandre/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation s If Property line /0 rf" Absorption field .5- f
Water main /art Water service line / U r Surface water zoo f
Wells on adjacent lotsZ 0 O
"p-
SEPARATION
r
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line O �{ Building foundation �/Q sir Water main
Water Service line /0 Surface water / O G r� Driveway, parking/vehicle storage 50rt
Curtain drain Wells on adjacent lots Z G '4-
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and J; R* 49
review of Municipal records that the above systems are in so
conformance with MOA COSA guidelines in effect on this date. j ;....... ...
? e
Engineer's Printed Name STE✓F_ r lJ t+ OS9`6) s,«:� w. Eng ; ,` .
�+ •. Pl 6256 ,,.o+
�/zo 47C
Date \� {�anrre:_;••'__'-'
COSA Fee $ s -
Date of Payment 70 0 ro
Receipt Number � l
(Rev. 11/05) VV f
Waiver Fee $
Date of Payment
Receipt Number
