HomeMy WebLinkAboutWILLIAMSON #2 BLK 3 LT 5Williamson #2
Block 3
Lot 5
#015-074-05
Municipality of Anchorage
*0 Development Services Department
Building Safety Division
Onsite Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page Of
www cLanchorageak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW060109 PID Number. 015-074-05
a.m.
Charles and Angela McAllen
Wastewater System: Q New ❑Upgrade
Aa
2422Tulane Anchorage, AK 99504
ABSORPTION FIELD
242-0546 NM Wix lit o . 5
O o.w Tro o VI swxr Trwci pea ❑ Mpam O of
LEGAL DESCRIPTION
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SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
LM
Holding
lubwprtnta
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Tank
Field
Station
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Sewer uns
Anchorage Tank
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>200'
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>100'
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See Lot Line Waiver. See Easement Encroachment
BENCH MARK
Lmi," rp D"av n
Agreement.
Garage Slab
•r.4M
100.00 F,
Inspections performed by: A. Harala Dates: 1m 7/1812006
.Zne 7/192006
10�P,e
Development Services Department Approval
...........
Conditional Approval Date:
0 ..... . ........... ......1
+o f- MKHAEL E ANDERSON :r'
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Reviewed and approved by: Date: a? 0
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.ci.anchoragc.ak.us
(907)343-7904
Waiver Review Worksheet
Waiver# WR090007 PID# 015-074-05 Permit# SW060109
Date Received: January 26, 2009
Legal Description: Williamson #2; Block 3; Lot 5
Engineer. Mike E. Anderson, P.E.
Applicant: Charles and Angela McAllen
Waiver Requested: 6' absorption field to north and west property line separation distance.
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver is Granted: X Waiver is not Granted:
List Conditions or Reasons for above:
Adjacent septic systems are >50 feet from the subject septic system. Subdivision is on a Class C well
that is >150 feet from the subject septic system.
Date:1281 /09 By: Jay Crewdson
Name of Reviewer
Rec#: 60260 Amount: $ 200.00 Date Paid: 1126109
Municipality of .Anchorage
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Malt Claman, Developulcnt Ser %ices Del)."nrcnt
Actinic NJanuary 28, 2009
Alike E. Anderson, F.E.
Anderson Engineering
Subject: Waiver Request for Williamson #2; Block 3; Lot 5
Waiver Request Number: WR090007
Parcel ID: 015-074.05
Permit Number: SW060109
Dear Alike E. Anderson, F.E.:
Your waiver request for the item(s) listed below;
• 6 foot absorption field to north and west property line separation distance
has been approved.
P N,E l47 S
W+
DEPARTMENT
This waiver approval applies to the item(s) listed above 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 concerns or questions regarding this waiver, please call our office
at 343-7904.
'J cs "Jay" Crewdson, 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)
January 26, 2009
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 5, Block 3, Williamson Subdivision No. 2
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
Lot 5, Block 3, Williamson Subdivision No. 2 is only 80' wide restricting the area
available for a septic system absorption trench. During construction the trench was
reconfigured to 63' long due to sloughing sidewalls and loose soil materials. The lot
lines were not clearly marked and the excavator inadvertently came within the 10'
setbacks on both the north and west lot lines.
The subdivision is served by a community water system. In addition adjacent septic
systems are a minimum of 50' from the new trench. No conflicts exist between the new
trench and existing systems. We therefore recommend a waiver be issued allowing the
trench to be within 6' from both lot lines.
Sincerely,
Michael E. Anderson, P.E. f1z'610 I
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Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 995196655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SWO60109
y / h L-) 8)
1,500 Gallon
ieptic Tank
PID No. 015-074-05
97.4
PROFILE AS -BUILT :, MICINELEA3@!
' 1,r -u(n
No. cceI i
No Style ���`-�'_............... � 4
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 5, BLOCK 3, WILLIAMSON SUBDIVISION No. 2
PERFORMED FOR: CHARLIE MCALLEN
DATE: 7/12/06 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
DEPTFI TEST HOLE 1
Ocett)
1
-•'"�:i:r
''
OB/OG
SLOPE
No
SITE PAN
-
10
Y\
���!: �
ff YES @ WHAT DEPTH"
DEPTH TO WATER AFTER MOhTfORD:G:
NaNE
3
.�.;
DATE OF MOhTfORING: 71w1200A
V.. n.
12—'Y
'. _\ til•
-`yam
SILTIER
•i.
' r
SM/GM
DATE
READING
GROSS TIME
NET TIME
DEPTH To
WATERNCHES)
JNFT DROP
13
���� �
:t.-: . •\y.:
(MINUTES)
SEE SITE PLAN y
(INCHES)
"
WELL GRADED SAND/GRAVEL
j
F r'� i:a>•
6
15
ii
7/12
1
10:17
7
8
tri f�i •�: i:
2
10:27
10
DRY
7.125•
16
9
PERCOLATION RATEL1.4 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES)
TEST RUN BETWEEN: 5 FT. and 6 FT.
COMMENTS: TEST HOLE DEEPENED TO VERIFY SOIL CONDITIONS.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 6/23/2007
-•'"�:i:r
''
WAS GROUND WATER ENCOLWEREJr
No
10
Y\
���!: �
ff YES @ WHAT DEPTH"
DEPTH TO WATER AFTER MOhTfORD:G:
NaNE
DATE OF MOhTfORING: 71w1200A
12—'Y
'. _\ til•
-`yam
SILTIER
•i.
' r
SM/GM
DATE
READING
GROSS TIME
NET TIME
DEPTH To
WATERNCHES)
JNFT DROP
13
���� �
(MINUTES)
(MINUTES)
(INCHES)
14
TEST HOLE PRESOAKED PRIOR TO TESTING:
15
T.c,;.
7/12
1
10:17
3.375'
2
10:27
10
DRY
7.125•
16
3
10:28
3.25'
17
M ✓F.l.
w•^
x•,ttr r'
4
10:38
10
DRY
7.25'
18
BOH @ 18.0'
5
10:40
3.50'
19—
6
10:50
10
DRY
7.00'
20—
PERCOLATION RATEL1.4 (MIN/INCH) PERC. HOLE DIA. 8 (INCHES)
TEST RUN BETWEEN: 5 FT. and 6 FT.
COMMENTS: TEST HOLE DEEPENED TO VERIFY SOIL CONDITIONS.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 6/23/2007
t\\ll
r a /
Mayor 31ark Jlegich
October 29, 2008
Municipality of Anchorage
CO. Nix I!MMM a .tiwhrnnge, Alnalut 9!65194iGN) . 47(X1 Ilmymw Sin•cl
011iee: (NM atadiM • 1 m: (!Mli 1 &ii 1+'_IMI lit llr.//aimmitmi.un„
Developrncrlt Scr %iccs Dcparlrncrtt
Craig A. and Sharon A. Ilaymes
5021 East 98h Avenue
Anchorage, Alaska 99507-6602
Dear Property Owners:
RE: Encroachment: Septic System Absorption Trench in 10' Utility Easement
NN illiamson tl2 , Block 3, Lot 5, Grid S W2437, 5021 East 98`" Avenue
menr
c`cC... .Sri.
r
Department
The Right of Way Division has reviewed a request for a letter of nonobjection to an existing septic
system absorption trench, which encroaches 3.0' into the 10.0' Utility Easement running north to south
along the west property line. On the undated and unsigned Plan As -built, submitted with the request, the
petitioner has shown the septic system absorption trench.
This letter of nonobjection is issued with stipulations, and by using it the petitioner is agreeing to the
following:
1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or
injury to any person as a result of the encroachments.
2. All applicable codes and regulations will be observed and maintained within the easement.
3. This letter of nonobjection will in no way preclude MOA from full use and enjoyment of its
rights within any portion of the easement.
4. Additional and extraordinary costs incurred during any future required construction, repair or
reconstruction of MOA improvements to accommodate any or all of the encroachments shall be
paid by the property owner.
5. Obtain letters of nonobjection from the following utilities:
® Anchorage Water & Wastewater Utility ® Alaska Communications Systems
®
Chugach Electric Association, Inc.
❑
Matanuska Telephone Association
❑
Matanuska Electric Association, Inc.
®
Enstar Natural Gas Company
❑
Municipal Light & Power
®
GCI Cable of Alaska
❑
Eyecom (Girdwood Cable TV)
❑
No letters required
All letters of nonobjection should be retained in your permanent files. If yo4 have any questions, please
call me at 343-8033.
Sincerely,
o%. 4ack L. Frost, Jr.
Right of Way Supervisor , 7
Concur
Property Owner(s)
Community, Security, Prosperity
G.Vk-wlopwenl ServknIROMW.obje ,. kfimiNWI.mm M:. Ba 5.1d 5. llunnee.dw
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
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: May 23, 2006
Expiration Date: May 23, 2007
Permit Number: SWO60109 Parcel ID: 015-074-05
Legal Description: WILLIAMSON #2 BLOCK 3 LOT 5
Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 5021 EAST 98TH AVENUE
Owner Name: CHARLES & ANGELA MCALLEN Lot Size: 13989 SO. FT.
Owner Address: 2422 TULANE Total Bedrooms: 5 Permit Bedrooms: 5
ANCHORAGE. AK 99504 -
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
Proposed system too deep for soils information submitted. The Engineer needs to do an additional test hole during
the construction of the septic field. Please submit stamped and signed results with the As -built Inspection Report. If
the results require a design change, construction of the system will stop pending On -Site review and approval.
Received By:
Issued By.
CZiG Date: 52 Y'
Date: 5-7-3-06
Municipality of Anchorage
-• Development Services Department
Building Safety Division'
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-074-05
Property owner(s) Charles and Angela McAllen Day phone 242-0546
Mailing address 2422 Tulane Anchorage, AK 99504 Zip Code
Site address 5021 East 96th Avenue Zip Code
Legal description (Sub'd., Block & Lot) Lot 5, Block 3, Williamson Subdivision No. 2
Legal description (Township, Range & Section)
Lot Size 13,989 SF Sq. Ft. Number of Bedrooms Five (5)
THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN:
Absorption Field 0 Initial
Septic Tank [] Upgrade ❑
Holding Tank ❑ Renewal ❑
Privy ❑
Private Well ❑
Water Storage ❑
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/Rush Fees: I �� s'��c— Waiver Fees:
r
Date of Payment: .J �� Date of Payment:
Receipt Number. �Jr� Receipt Number.
(Rev. 11105)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
May 17, 2006
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 3, Williamson Subdivision No. 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 5, Block 3, Williamson Subdivision No. 2 intends to construct a new
five -bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to accommodate the home. The subdivision is
served by a Class A Water System, which will also serve the proposed house. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed septic system along with the alternate site and the water service line.
Also identified on the plans are the locations of wells and septic systems on the
surrounding lots. No conflicts exist between the proposed septic system and those on
adjacent lots. Drainage arrows are shown indicating the surface slope of the property in
the area of the new septic system.
S&S Engineering placed test holes on the lot in the area of the absorption trench and
alternate site in June of 1992. Their results indicated a well -graded gravel and sand
(GW/SW) material. The percolation rate of the materials was determined to be
between 1 and 5 minutes per inch. No groundwater was found during the placement of
the test holes, and none has been noted during the ensuing monitoring period. An
application rate of 1.2 gallons per day per square foot was used in the design of the
absorption system. We are proposing to place a new 1,500 -gallon septic tank and.a 53'
long by 3' wide by 6' effective depth absorption trench to treat and dispose of the
effluent generated in the house. The elevation of the distribution line in the absorption
trench will be 2' below the surface and the total depth will be 8'. An additional test hole
will be placed during construction of the septic system to verify the results from the
percolation tests and to establish that no bedrock is within 6' of the bottom of the
absorption trench. A minimum of 3' of fill will be placed over the absorption trench and
4' over the septic tank. In lieu of the fill 2" of insulation maybe placed and 2' of fill.
Lot 5, Block 3,
May 17, 2006
Page Two
Williamson No. 2
The ground surface on the lot in the area of the septic system slopes gently to the west.
The new trench will be constructed parallel with the slope as much as possible in
conformance with Municipal requirements. The new septic system will be constructed a
minimum of 100' from all wells and any surface water and 10' the proposed and existing
water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
'vn
v tth
Michael E. Anderson, P.E.
Attachments
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LOT 5, BLOCK 3, WILLIAMSON
SUBDIVISION NO.2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom House
Perc. Rate:1 to 5 Min./Inch
Application Rate: 1.2 GPD/SF
Deep Trench System
1,500 Gallon Septic Tank
6' Drainfield Rock
5 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 625 SF Absorption Area
625 SF/12 SF/LF= 52.08 LF Trench Length
THEREFORE: Construct an Absorption Trench 53' Long x 3' Wide x 6' Effective Depth.
Flow Line Elevation in Trenche to be 2' Below Original Ground Surface. Total Depth to be
8' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Place Flow Splitter Valve to Assure Even Flow to Each Trench.
16 I I Natural
Backfill Geotextile
Fabric
N
A!]Y
3'
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away. a
Minimum 6' Separation From Bedrock. •••• •••••• ••-
Minimum 4' Separation From Groundwater. ..... ..,,,,_...........
Minimum 100' Separation From Wells In the Area. ON, -M LEMDER"
Minimum 100' Separation From Surface Water or Streams: oi�vrA'., N��_
05/16/2006 13:16 9075613419
UCT-39-2003 14:10 50 MINEEP.ING
PQRRORtAEO
LEGAL DESCRRIIPTIONrf L
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COMMENTS
PACIFIC ASPHALT -INC PAGE 04/04
90'1694 1211 P.02/03
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DEPARTMENT OF HEALTH 6 HUMAN CERVICES
825 "L" Street Anchorage Alaska 99602-0660
SOILS LOO - PERCOCATKIN TEST
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section:
PLAN
WASCROUNDWATER
ENCOUNTERED:
✓"�' IF YIS. AT WHAT L
O _
' DEPTH? P
FEPCOLATION MIE ��' jmnmWHcM.PEAC MOLE DIAMETER
TESTRUM1aETmEn _9* FTAND
PERtORMED I'm I&X I CRATIfT THAT THIS TEST WAC PERFORMED IN
77014 Rka Road N4'PSi
ACCORDANCE WITH A.0 !-IDELIMSIN EFFECT CN HIS DATE. DATE:
?2-008 IAti.
was
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77014 Rka Road N4'PSi
ACCORDANCE WITH A.0 !-IDELIMSIN EFFECT CN HIS DATE. DATE:
?2-008 IAti.
05/16/2006 13:16 9075613419
U'T-3e-2003 14::1 SSS ENGUIEERING
PACIFIC ASPHALT -INC PAGE 03/04
907 694 1211 P.03iO3
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DEPARTMENT OF HEALTH a & HUMAN SERVICES
825•L`Street: Anchorage, Atefik! 99502-0850
SOILS LOO -- PERCOLATION TEST
PEReORMED FOR:_ DATE
2
LEGAL DQSCRIoT10N+J,.�Z�, i�IL� TCwnShy. Range, 8eelicrc
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PERCOLATION PATE x•y PnYw:es/in401 FERC HOLE DIAIAStEA I.r'
TEST RUN EETWEEN < FT AND — 15 FT
PERPOAMEDSIY S✓RSTRO1N[aMINO 1
• Rivwq�
ACCCACANC6 WITH/�j,��� � LIN�NlFflCT ON
— CEAI IF THAT TH.S 7EEST VIAS PEAFOAIAED IN
DATE. 7— 1 —41z,
TOTAL F,03
�L�%!Plate,
�m�M��1�
�■IR.cr-_�c�■■��r�
PERCOLATION PATE x•y PnYw:es/in401 FERC HOLE DIAIAStEA I.r'
TEST RUN EETWEEN < FT AND — 15 FT
PERPOAMEDSIY S✓RSTRO1N[aMINO 1
• Rivwq�
ACCCACANC6 WITH/�j,��� � LIN�NlFflCT ON
— CEAI IF THAT TH.S 7EEST VIAS PEAFOAIAED IN
DATE. 7— 1 —41z,
TOTAL F,03
1 v'rV iv
Municipality of Annorage
• -� Development Services Department
Building Safety Division
On -Site Water and Wastewater Program , A „;
4700 Bragaw 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. 015-074-05 COSA # 0 9 3 3
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Williamson Subdivision #2 B3 L5
Location (site address) 5021 E 981, Ave Anchorage, AK 99507
Current Property owner(s) Craig
and Sharon Haemes
Day phone
Mailing address 5021 E 98th Ave Anchorage,
AK 99507
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:
5
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER
DISPOSAL:
Individual Well
❑
Individual On-site
ED
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class A Well
®
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Engineering Services, LLC Phone 272.8218
Address P.O. Box 102954, Anchorage, AK 99510
Engineer's Printed Name Steven R. Pannone, P.E. Date 5/1912009
1
Engineers Comments: In conducting an adequacy test, l attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with AIOA DSD Guidelines & Regulations. The reported results describe the performance of
the system under the Conditions
encountered at the time of the lest, and separation distances measured to readily identifiable features.
The operational life of all wells and septic systems depend on the local soil condition, ground water
.•••��aaa1a
••�St ( crag
levels that may fluctuate during the year, and the water usage of the family being served by the system.
.•`p •.. ��
�i�
These conditions are outside the control of the evaluator of this system. All systems eventually fail and
satisfactory lest results do not guarantee future performance of the system, nor do they guarantee thata
qg rw
there arc no hidden defects or encroachments. PCS can therefore not provide any warranty for future
i
performance nor give any estimate of how long the system will Continue to meet the operational
MOA DSD. The this is for benefit listed
?,A Steven R. Pon.. r
requirements of the content of report the sole of the owner
♦
pie%'.,
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it
No. CE 8149 %<<�
��a
confer any legal right whatsoever.
5. DSD SIGNATURE
• „•�,,,.•/�•.
�aaaass�•Q::•'
Approved for _� bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
rinacnmenis:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: 112 Original Certificate Date:��� 02
lna,.1,
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/onsite
(907) 343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: _Williamson Subdivision 02 B3 LS Parcel ID: 015.074.05.000
A. WELL DATA 22C{
Well type A If A, B, or C provide PWSID I1 c� 1003 I Well Log (YIN)
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.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL
Arsenic: ugA Date of sample: _ Collected byc _
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Anchorage TankUSteel Date Installed 711912006
Tank size 1500 gal. Number of Compartments 2 Cleanouts (YM) Y
Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (YM) N
Date of pumping 5/912009 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed1971 12009 Soil rating (g.p.d./fe or fe/bdrm) 1.2 System type Shallow Trench
Length 68 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth.9�-8 ft. Eff. absorption area ¢80 ftp Monitoring tube Y Depression over field N
Date of adequacy test $11112009 Results (Pass/Fail) PASS
Fluid depth in absorption field before test 0 in.
Elapsed Time: L min. Final fluid depth 0 In.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
For 5 bedrooms
Water added ZLO gal. New depth 0 in.
Absorption rate >= 750+ g.p.d.
If yes, give date
D. LIFT STATK +-----,
Date installed
"Pump on" levet at in
btu
E'-,.%EPARATION DISTANCES
Septic tank/lift station on lot
Absorption field on lot _
Public sewer main
Size in gall ns
Fa evel at —in.
Cycles tested
FROM WELL ON LOT TO:
High wa level at
Meets alarm & circuit req
On adjace s
On adjacent lots
Public sewe
Sewer /septic s ine Holding tank
,,Mirrlal containment areas Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 10+ Absorption field 5+
Water main 25+ Water service line 25+ Surface water 100+
Wells on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 6• Building foundation 10+ Water main 25+
Water Service line ZSt Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION••:P��-«."....IC�eee,
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 Steven R. Pannone. P.E.
�� c y teen R. Ponronei 4
♦ No. CE 8149
ee♦
V�
r6'
Date 5119/2009
"" •.
COSA Fee $ 1-f
Date of Payment 2
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number,
In.
Jun 23 09 11:27a McAllen 9073384024 p.1
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