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AUTUMN RIDGE LT 1
Autumn Ridge Lot 1 #015-054-04 Jul 29 12 12:21 P r k,:;erft Brg,'ch 4ncharnye Walt & Putin--- Ser �-::07.2430742 Development Services Department E u3ld.ng Sttfet�y l)ivisiorr �?no-s►te VVOter A Wcstew>cter Program `7r -)G RMV -e Pood KC, anx 196650 Anchorer ge, Qr, 99rL17 tU WJ?tU!ii.6t'o fCrpghe (90 `!) 343--4V4 Pump Installation Log Well riiiint Permit Nurnber: SW Parcel .identification Nurtibex:_ 0 L5 — 05-/-1— O Ll p I'cTznla rs#ai(.atjop Date: z�..:+ � Ptly" Intal~e I?apth Bebw Top do Wei i Casir�: c=et f'nmp Manufacturer's Warjv: Pump-Modcl: Put -rip size ( lip I-" t'itless Adapter Burial Depfla: i 1 1' fe�:_t P#tiess Adapter Manufacturer's Nan.: Pitless Adapter Instaiiva': wrII Disinfected UPau "OnErtle:don? yes �' No Ii1.'ethad of Di§infe.ctiugi: COMM encs: Pump Installer -Name: Date of Isauc:: Properq' Owner.Nawe &ArPdy Sey- tj P.1 Attention. The -DUMP utstallisr sh:ai' p:cvide G p;jmp installation lad to the DSD wlthi:, 30days! ai pump i*�sllaticn. Municipality of Anchorage Page 1 of 3 Department of Health and Human Services Division of Environmental Services Onsite Services Section 8251' Street Room 502 P.O. Box 1966W Anchorage. AK 99519-6650 www.ci.anchorage.ak.us (907) 3434744 ONSITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: SWO10056 PID Number: 015-051-04 fle": Wastewater System: New Crown Pointe Inc. 5400 Abbott Road Anch., AK 99507 ABSORPTION FIELD PlIala: 11e0.aane: Deep Trench 345-6277 Five 5 sat Rt": Tdsl Depb epn an°rW Agee: LEGAL DESCRIPTION .45 cm/Fr 16 FI. 1110.: Lal $1001V111Gf1: De" b ppe edlcm trap ON" Crawl de" e M live: 1 Autumn Ride 6 Fl. 10 Fl. TowW.p: P.. q.: Semon: Nsfeed ossa argaW rade: Gavel Largln: 84 12N 3W 15 0 Fl. Ft. Garel x,0111: Hlmear al rwa: Dm.lce eal...n Lnee: Well: New 3 F1. 2 20 In. CLD$3,r atm (PmY A 11. C): T" Depin: Cased b: 261 Fl. 260.6 Ft. TbLo able pian ales: 1,680 Fe P"Mete";Private ASTM D3034 PVC 0n .. M -W Drilling, Inc. Dole G'ded: Static WaM1 Level: 10/30/01 218 In. bslab: Sanders & Sanders Dale tis.. 10/18-21-01 eel Cneg AOae Gone: TANK 20 c" FI. 2 F1 SEPARATION DISTANCES O septic ❑ Holding ❑ S.T.E.P. ❑ Other.. To I Fran Septic Tank Absorption Field lJfl station Holding Tank firJPrivate se.erum - �`' Anchorage Tank yn 1,500 Wei >100' >100' N/A N/A >25' Steel pMIIIMLS: Two (2) $IAaae W„. >100' >200' N/A N/A LIFT STATION — NONE ON LOT Lauf. >50 >10' N/A N/A cr. FauWalion >5' >10' N/A N/A °� � b. ° � b. ..1a h. None Noted Ebmra Yupec lm pedan ee Dy. o„ Eir..l Fter"wt�BENCH Test Hole Placed During Construction to 22'. MARK Ypn: Front Porch Deck. Northeast Corner AssuffIed EI 100.0 FIL ' Engineer's Stamp •• 44 •• _ Inspections performed by: Mike Anderson Dates: 1" 10/18/01 th ' 2nd 10/21/01 IST; MICHAEL E. ANS DERSDH f �i Department of Health anO Human Services approval 0 ft No cE-.eel Reviewed and approved by: Date: ? —LO�h � R,Sst� :•• `'��r,:..••' D4.. roust Municipality of Anchorage Page 2 of 3 DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit NumberSWO10056 ABBOTT ROAD No. 015-051-04 (8K. 72, PC. 236) 10' CEA ESWT. BUFFER LANDSCAPE ESWT. W a YIf AEL E. ANDERSON No. CE -4391 } O to 89059'00"E 65.57' L,� --------- 30' LOT 1 N �tp. =40' 1 . Alt. Si TH&B Five Bedroom C 5 19.9' House $ SV C7 p0 ,• S1 C6 ® 25.8' TH70A �d 141 Al��O, G�Vv t. Site PLAN AS -BUILT SCALE 1" = 40' S1 S2 C6 %70..553L8 8 C45 DV9 M15 C5.8 C7 57.9 54.2 M2 I I 68.2 I 44.4 a YIf AEL E. ANDERSON No. CE -4391 } O to 89059'00"E 65.57' L,� --------- 30' LOT 1 N �tp. =40' 1 . Alt. Si TH&B Five Bedroom C 5 19.9' House $ SV C7 p0 ,• S1 C6 ® 25.8' TH70A �d 141 Al��O, G�Vv t. Site PLAN AS -BUILT SCALE 1" = 40' Municipality of Anchorage Page 3 of 3 DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-0650 - 343.7904 On -Site Wastewater Disposal System or Well Inspection Report Permit NumberSWO10056 PID No. 015-051-04 N el y 91.4 v U 97_4 U E Drainfield Rock Trench Length - 42' LEGEND - C - Cleanout S - Septic Vent M - Monitor Tube SV - Flow Splitter Valve in s v NORTH LEG 91.4 1"=10' SOUTH LEG' Job No.: 01-209 Permit No.: SWO10056 Project No.: N/A M -W Drilling, Inc. P.O. Box 110378• Anchorage, AK 99511• •907-345-4000 • 907-345-3287 Fax• Groundwater Well As -Built & Loa • Well Owner. Crown Pointe, Inc. • Use of Well. Domestic • Legal Description: NE'/. Section IST 12N R 3W, S.M.- Lot I Autumn Ridge Subdivision Convtruction • llole Depth: 261' • Casing Size: 6" ♦ Cased To: 260.59' • Afarerlal. A 53 Steel *DrillMethod. Air Rotary _ ♦ Well Completion- Open end X Screen _ Perforated ♦Screen/Perjoratlon description: None • Groul Notes: (2) Sacks- No. 8 bentonite granules Perj. Method: • IVell Development. Method: Air surge Notes: •Static water level (SWL) 218' - (above) (below) top of casing (TOC). • Well yield test at 20 gallons per minute (GPM)/ga11onsperheur{GPl1) for 1 hours with 100% of drawdown (DD) from static level (SIVL). •Alethod. Airlift ♦ Date of completion: 30 October 2001 • Pump Install.• XV -11 i ... Depth In feet from top of casing. Details of formations penttrated, size of material, color and hardness. 0 TO 2 Casing stickup 2 TO 7 To soil, silty: brown 7 TO 30 Silty gravel: brown 30 TO 37 Silt: brown, soft 37.T0 .. 57. Silt: brown, damp, gravelly 57 TO 78 Gravel: dry, slightly silt 78 TO 110 Silty ravel: gray, dam 110 TO 122 Gravel: coarse, muddy, silty, small boulders, wet/dirt - 2 m 122 TO 143 Silty clay: gray, dry, fine to coarse gravel 143 TO 165 Silty clay: gray, sticky, dam 165 TO 202 Silty gravel: gray, some boulders 202 TO 215 Silty clay: gray, sticky, damp; 2' boulders, some gravel 215 TO 224 Boulder gravel: gray, silty 224 TO 243 Boulder gravel: brown,'cobbly, dry and loose 243 TO 252 Gravel clayey: brown, silty 252 TO 260 Gravel: washed, water -bearing MICHAEL E. ANDERSON P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) FAX MEMO TO: Dan Roth WITH: On Site Services FROM: Mike Anderson DATE: November 27, 2001 SUBJECT: Lot 1, Block 1, Autumn Ridge Subdivision Test Hole Logs MESSAGE: Attached are the two test hole logs that should have been included in the health authority package. The originals will be delivered this afternoon. 3 Pages Being Transmitted. Please call 522-7773 if there are any problems. Municipality of Anchorage Development Services Department/On-Site Water & Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519 SOILS LOG - PERCOLATION TEST Performed For. Crown Pointe, Inc. Legal Description' r „ t + Block 1 Autumn Ridgy' SLOPE OGIPT Gravel with Silt NUT Bottom of Hole Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 10/28/01 Date Performed: a.svi 10/21/01 See Site Plan Reading Date Gross Time Net Time Depth To Water Net Drop 1 21 -Oct 11:10 1.75' 2 11A0 30 3.25" 1.5' 3 11:41 1.75" 4 12:11 30 3.13" 1.38" 5 12:12 1.75" 6 12:42 30 3.13' 1.38" Perc. Rate: 22 MinAnch Perc. Hole Diameter. 8' Test Run Between 7 Ft. and 8 Ft. Comments: Soils Encountered are Identical to Those in Testholes 7 and 70. Percolation Rate Slightly Faster. Test Hole Pre Soaked Prior to Testing. Performed By: Mike Anderson. 1, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 10/21/01 Municipality of Anchorage Development Services Department/On-Site Water & Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519 SOILS LOG - PERCOLATION TEST Performed For. Crown Pointe, Inc. Legal Description: r of Block 1 Autumn Ridge OG/PT Gravel with Silt Bottom of Hole Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 10/28/01 Date Performed: See Site Plan Reading Date Gross Time Net Time Depth To Water Net Drop 1 21 -Oct 11:15 .5' 2 11:45 30 1.875" 1.38' 3 11:46 .5' 4 12:16 30 1.875" 1.38' 5 12:17 .5' P6 12:47 30 1.875" 1 1.38" Perc. Rate: 22 MinAnch Perc. Hole Diameter. 8" Test Run Between 9 FL and 10 Ft. Comments: Soils Encountered are Identical to Those In Testholes 7 and 70. Percolation Rate Slightly Faster. Test Hole Pre Soaked Prior to Testing. Performed By: Mike Anderson. I, Michael F. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 10/21/01 /ZPAj MUNICIPALITY OF ANCHORAGE Development Services Department On-SiteWater& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: Apr 09, 2001 Expiration Date: Apr 09, 2002 Permit Number: SWO10056 Parcel ID: 015-051-04 Legal Description: T12N R3W SEC 15 NE4 PTN Design Engineer: 0014 Anderson Engineering Site Address: 005400 ABBOTT RD Owner Name: CROWN POINTE, INC. Lot Size: 40167 SO. FT. Owner Address: 5400 ABBOTT ROAD Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE . AK 99507-4364 This permit is for the construction of: Disposal Field F,71 Septic Tank ❑ Holding Tank ❑ Privy Q✓ 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. C. S. The following special provisions. ,;AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL PERFORM ADDITIONAL GROUND WATERIBEDROCK CHECK IN THE VACINITY OF THE WASTEWATER DISPOSAL FIELDS. je i61AV�ER TO po SOAU TEST % J96P007' tc, us RIFian To rR¢ c7iory of ro 0- R. Received By: Issued By: S r3$y 19J 7°R6PCXE0 IN Ocr %" 0I KE.yp Date: Lt– Date: i 0 Date: 4 — q-0/ A,rVOVNAA Tides. � k Ll (r-04 trs leS-It /) t Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING SA Parcel I.D. O / S— 03- - — 0 ` Permit Number SW O100-'6 Property owner(s) Crown Pointe, Inc. Day phone 345.6277 Mailing address (1) P.O. Box 112313 Anchorage AK 99511 S( dress (2) N N N 2 IEH`Ak DR I vF Zip Code 995-16 Legal description (Lot, Block & Sub'd.) Lot 1 Block 1 Autumn Ridge Subdivision Legal description (Section, Township & Range) Lot Size 4x,167 Acre Number of Bedrooms Five (5) THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 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. MjL�L E (Signature of property owner or authorized agent) Permit Fees: I H240 j Waiver Fees: Date of Paymenty o T d k Date of Payment Receipt Number: (9 n,2, Receipt Number. (Rev. 12100) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: October 9, 2001 TO: Dan Roth FROM: Mike Anderson, P.E. SUBJECT: Lot 1, Block 1, Autumn Ridge Subdivision (Future Legal) Portion of NE114, Section 15, T12N, R3W (Current Legal) Septic System Construction Permit No. SWO10056 Autumn Ridge Subdivision is currently going through the final platting process. Once the plat is recorded the easements shown through Lot 1 will be vacated. The owner of Lot 1 is then requesting a change in the location of the well and septic system to the area now covered by the easements. The attached Site Plan shows the new location of both the septic system, reserve site and the new well. Several test holes surrounding the septic system have been completed indicating uniform soils with percolation rates between 30 and 60 minutes per inch. Copies of these test holes are attached for your review. None of the holes, however, are within 30' of the new septic system sites. We will furnish additional test hole and percolation data prior to the completion of the septic system as-builts. We are hereby requesting the subject permit for the construction of the well and septic system on this lot be modified to include the new locations. Please let me know if you have any questions or additional information is required. SERVICE IIIGH SCHOOL SITE I RACT A Iry-30 saz.�a THIS PROJECT PLI F4. �'A TT AF _. \..- / DEDICATE TO R: .W. 66!824 — •--._ _ ASEMICNT ®— — —I� - _..! T W-1) 1 r Irv. I I1 _ 26 ' \� �t!22 sq.lt��\ 40.167 s`� nl ; I�I ,• ..\ i / / /.; 3.151 sq.it. 40 0,21, •sq�ft. / - o/' / i / I :I� I j �. _ T� -TM-s I•1A WA 1 I•VI WAY II I� .W � / / , TN_26 9, 7N -x5 '`':O Ifl --... , .• J /� �:.�.- 25 ..!/r/// 11 o; (� \ •295 sq. ft./;; �// I' -�'j/l r 111 T /�1 1H 72) / - - �J_i / I / ,1 40.323 8 fl. 1U �S S � �'► 1-,�—;�.� ��:�-, 11Et�LAN� r: " _��� '•,.. I q I �" / • ` �`-��'' ' \ lu pad v/1I r / ' I ; • i 1 , , I' I , I i s �] yy ' r^. 111110 , .• ZZ _,. •. ��„\ II I I, . \ `.22 l M 17 i\ I^I ': �3 pp``� % \40.041. sq II'I I>y@ ' 1J4 3}5 sq.IS'.tlt•. 11 , i Com, 11,,.'} i 1 1 � 1 � III <'.x T'-•� ..iP ,'I'.'1 /. III f ►�� �I tl' ",; ;1;1�, ; ' q It I III I \ — _ -40 q (t.J 494 ' /. ; • 11.I I '� =Y�'r',' 1 r , I �[ 41 1 Ir.if I M-xo ABANDON I IItI _�^ ' .t 7.c' Y',ar'y. ::;,•//lrI -� 1 �1�� DRIVEWAY i' • I lA -i- \ , �' •I .` ;` r / r til r l I II' ! I ;f1tRU LOT 20 1 xl O `. I �\ I '1g � _' )' .;.. :. \` •.1 ,i �._`lilljli; ,/ . ; 20P ;- - ;, rl ,� �i 5 25� sq.ftli�jll ' I1�,lIl i I I I 44.125 s4 ft ! - � \�,` 1' I I � `. , "/ fir{��Ijlllll,�i`� ;'� I i'•I r 1 _. ` AREA MAP 4 SCALE 1"=100' sq.fl.-.\\ ` l..oAGE Legal Description: 1 3 10 11 12 13 14 15 17 .18 19 OG/PT SM Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 1=00 Tan Loose Bottom of Hole Perc. Rate: 24 MinJlnch. Pere. Hole Diameter: 6" Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harala. I, Michael F. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: '1120100 S Date Gross Time L Depth To Water O 1 P Municipality of Anchorage "'•' /} d� Department of Health & Human Services...... E Q;ca 825 L Street, Anchorage, AK 99502-0650 0" •,• CL .4331 m`�f��`•,, SOILS LOG - PERCOLATION TEST . y; C� � P�'OfEES�SIO'��' •"� `�Lt Performed For. Bob Klein Date Performed Z7/2/99 Legal Description: 1 3 10 11 12 13 14 15 17 .18 19 OG/PT SM Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 1=00 Tan Loose Bottom of Hole Perc. Rate: 24 MinJlnch. Pere. Hole Diameter: 6" Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harala. I, Michael F. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: '1120100 S Date Gross Time L Depth To Water O 1 P E Reading Date Gross Time Net Time Depth To Water Net Drop 1 6 -Dec 11:27 5.13- 2 11:57 30 6.75' 1.63" 3 11:59 5.25" 4 12:29 30 6.5" 1.25" 5 1:04 5.5" 6 1:34 30 6.75" 1.25" Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST 4°— . ... 6'.ICiL�=I E. ,J CE -4381 BfES51�����": Performed For. Bob Klein Date Performed: 1212(�.4� OFESS% � Legal Description: tot 22 Autumn Ridge Subdivision SLOPE SITE PLAN 1 4 11 18 19 OG/PT SM Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring ' None Date: 1/22/00 Tan Damp _J Bottom of Hole Pere. Rate: 34 MinAnch Perc. Hole Diameter. 6" Test Run Between 4 Fl. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harala. I, Michael E- Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 S Gross Time L Depth To Net' Water Drop O . P 3.75" E 12:05 Reading Date Gross Time Net Time Depth To Net' Water Drop 1 6 -Dec 11:35 3.75" 2 12:05 30 4.63" .88" 3 12:07 3.5" 4 12:37 30 4.5" 1" 5 1:07 5- 6 1:37 30 5.94" .94" �1 Reading 12 Net Time Depth To Water Net Drop 13 ' �P,`�•OF40 14 2 12:08 30 15 125" .. Stu Tj ^�^�^�' 16 4.06" Municipality of Anchorage .* jj�'••••j••_•••j�••�'�] 30 GP/GM 1.19" Department of Health & Human Services ..• ...... ^"'""`�• •' ` 4' 825 L Street, Anchorage, AK 99502-0650 �� ! ;nucvar. e. n�oreacv : , a 13:11 30 5.19" SOILS LOG - PERCOLATION TEST ♦1,%no •• CE - 4391 ' d�`9ro Pr: .... •���"tib . rESSt Performed For. Bob Klein Date Performed: 1 TI 0W2 y. Legal Description: Lot 2_ Autumn Ridge Subdivision SLOPE SITE PLAN TO R.Q. W: eN.e 1 OG/PT � 2 l f I f 3 gSTHOLE NO. B I® Z ,` 40.46 s d ' �qo . 4 5 Gravel/Sand -me.10'r` _ 6 Some Silt 10, 0+� GWSM 7 1110 \ 8 9 • Was Groundwater Encountered? No S If Yes, What Depth? L 10 Depth to Water O After Monitoring None P — 17 Date: 1!22!00 E Reading 12 Net Time Depth To Water Net Drop 13 4 -Dec 11:38 4' 14 2 12:08 30 15 125" .. 12:10 16 4.06" 4 17 30 GP/GM 1.19" 18 ' Reading Date Gross Time Net Time Depth To Water Net Drop 1 4 -Dec 11:38 4' 2 12:08 30 5.25" 125" 3 12:10 4.06" 4 12:40 30 5.25' 1.19" 5 12AI 4' 6 13:11 30 5.19" 1.19" "1 19 Bottom of Perc. Rate: 25 MinAnch Pere. Hole Diameter. 6" Hole . Test Run Between 4 Ft. and 5 Ft. . Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A- Harala. I, Michael E Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 120100 1 I I OG/PT 3 4 z I It ` 40.46 SqJ1 6_J1 ,. i 5 Sand Some Silt 6 SM 7 81 1 Was Groundwater Some Encountered? No S Cobbles If Yes, What Depth? L Depth to Water O After Monitoring None P Date: 1122/00. E Reading 6�!! OF•gC Net . Time .t,. Net Drop 1 4 -Dec 11:40 Municipality of Anchorage • �•. Department of Health & Human Services n 1_4321 825 L Street, Anchorage, AK 99502-0650 FOr�• CE • SOILS LOG - PERCOLATION TEST ,y' Ofsf�dF••.• .• 12:12 tali D p ••� St��`o<: Performed For. Bob Klein Date Performed: Legal Description: Lot 2. Autumn Ridge 4ibdivision 12:32 SLOPE SITE PLAN 1 I I OG/PT 3 4 z I It ` 40.46 SqJ1 6_J1 ,. i 5 Sand Some Silt 6 SM 7 81 1 Was Groundwater Some Encountered? No S Cobbles If Yes, What Depth? L Depth to Water O After Monitoring None P Date: 1122/00. E Reading Date . Gross Time Net . Time Depth To. Water Net Drop 1 4 -Dec 11:40 5.12" 2 12:10 30 6.19" 1.07*. 3 12:12 5.12" 4 12:32 30 6.19" 1.07" 5 12:34 5.12" 6 13:04 30 6.19" 1.07" Bottom of Perc. Rate: 28 MinAnch Perc. Hole Diameter. 6" ' Hole Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harala- 1, Michael E. Anderson . Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1120100 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) March 26, 2001 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 1, Autumn Ridge Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 1, Block 1, Autumn Ridge Subdivision intends to construct a new five - bedroom home on the lot. The lot is currently vacant and the subdivision is currently going through the final review and plat recordation process. We are hereby applying for a permit to construct a new well and septic system on the lot to serve the new home. The attached Site Plan and backup documentation identify the location and configuration of the new well and septic system and the parameters used in the design. It also shows the location of the alternate site. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were placed at the proposed location for the new absorption trenches and revealed gravel with varying degrees of silt. No groundwater was noted in the test holes during excavation and none was noted during the monitoring period. We are therefore proposing to place two 3' wide by 42' long absorption by 10' effective depth absorption trenches to treat the septic effluent. The pipe will be placed at 2' below the existing ground surface and the total depth of the trench will be 12'. A minimum of 3' of cover will be placed over the bed to prevent frost penetration and possible freezing. The ground surface on the lot slopes as shown on the attached Site Plan with slight grades from north to south. The areas for the new absorption trenches, however, are fairly flat. The new trenches will be constructed parallel to the contours of the surface in conformance with Municipal requirements. Grading will be accomplished to assure surface drainage is away from the new trenches. The existing drainage pattern on the lot will not be affected during development. 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 Lot 1, Block 1, Autumn Ridge March 26, 2001 Page Two 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, ,VJ JI, L Michael E. Anderson, P.E. Attachments ��•` Of At '11 *' 49�' MICHAEL E. ANDERSON :,` d CE -4331 'v• SERVICE IIIGH SCHOOL SITE II;:ACT A M_90 THIS PROJECT - 1 992.9 PLI 'A TT / DEDICATE TO R:�W ASEMENT 1— - — — 1 _ .. . �\ 2 I ► 1 ,--� II \ 40,41/2 402�fl. sq�t 40.167 �q 11i ;' lli / .'' % 73.151 sq.ft.V. 17 s 74 ,Yw_tAN! It IN I —TM -0 Ii(�j�1fI17 iii%/I • I I W1 WAY TM -29 25" / '71 25 Z -J i /. '.-�;.. -nl_j.295q.ft. SOL - 1 l� Tm-8 o = , 101 1. \\ y1 _� I�lI ,•� 24 TM\ T H 721 .:- �`,21E�,ILAM1� I 40.323 sq.ft. •\1jI�5.. I 'I it: 1 J I / !II ,IIIIII i. }22 i ` 3,, �\ I!11 I� /2 ❑ i 40,041 sq.L_ Ill l' JO,335 sq.fk' ' 1� .\`1 ; `In I� -�Sif , .ate -1 ! , ��\ l- 11 �1�•. I i I �• ,Y I .1 I� 11 4. I n`*" I~ ILII �.' i� • ,� Ihrok p " � ,I, ': '1!111 ' I I •III i 9 I I48 ►, 11 \\-�"�•--0\94 q..ft. 1�, '-iYl l,t �, f,.: �-�-!• ::'::�_•1,'i�a�dj�li�ljl l I I \ iH-120 ABANDON DRIVEWAY THRU LOT 20ik In I TM `, i �Ml • TIiIp." 43 20 ���'�\ 1 / AREA , 70511H0 4- MAP gHWS .iltl°'3r€� SCALEI"= i' fc..:+:'S'r`�I ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: October 4, 2001 TO: Dan Roth FROM: Mike Anderson, P.E. SUBJECT: Lot 1, Block 1, Autumn Ridge Subdivision (Future Legal) Portion of NE1/4, Section 15, T12N, R3W (Current Legal) Septic System Construction Permit No. SWO10056 Autumn Ridge Subdivision is currently going through the final platting process. Once the plat is recorded the easements shown through Lot 1 will be vacated. The owner of Lot 1 is then requesting a change in the location of the well and septic system to the area now covered by the easements. The attached Site Plan shows the new location of both the septic system, reserve site and the new well. Several test holes surrounding the septic system have been completed indicating uniform soils with percolation rates between 30 and 60 minutes per inch. None of the holes, however, are within 30' of the new septic system sites. We will furnish additional test hole and percolation data prior to the completion of the septic system as-builts. We are hereby requesting the subject permit for the construction of the well and septic system on this lot be modified to include the new locations. Please let me know if you have any questions or additional information is required. - .'ABBOTT ROAD 405• ' 406'. N 90°00'00"E 84.79' 10' UEC. ESMT. R i LA LOT 1 1 a ' li iC r 1 11=40' Prpport �o 8 Wel ; I •� TIi o ri N 11'2 gein" C) NOTE: asements , Vacated ing Plattiftg b 'Process. . o t Alternate Site Z • _' S � 405' . 5% Zabel Flow Splitter V lve ., % 1,5 0 Gall Five Sep is Tank Bedroom gg e House. -1g,.9 Depth ;.• X2 ctive 20 Ab ption renched of.. C� Tfl •% Qry .� ;��.......�y ' . d P.•' � ,•qs r � o n :. T1I.. .... (� TIi 0-4301 M7CFU.EL E- �\ ' E a 403. SITE PLAN SCALE 1" = 40' ABBOTT ROAD 0 408' 408' N 90°00'00"E 84.79' 10' ELEC. ESMT. ® I Pro p dl r- e eI -hW W LOT 1 I N, I 111-40' I � I�III I L) I , P) w I III I I�� O II p I I g Five I 1 1 Z House I I I I Iil , 405' I III I III Sep�i�GTnjc, I I Zabeil F. oW Splitter o / Valve, O ®� 2-42'L67gIXI g' Wide O' TH7 X 10' I�ffE3ct3ve Depth .CV pltior� IP enches dOF ' c Alternate Site I �j`L .. TH 70 I I ......... .. i. .... /\ f.. MICHAEL E. ANDERSCN : ✓ CE-4381 SIT�R'W�.I�RRN 403' SCALE 1" = 40' LOT 1, BLOCK 1, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Home Deep Trench System Perc. Rate: 44 MinJinch 1,500 Gallon Septic Tank Application Rate: .45 GPD/SF 10' Grainfield Rock 5 Bedrooms X 150 GPD / .45 GPDISF = 1,667 SF of Absorption Area 1,667 SF/20SF/LF = 83.3 LF Trench Length Therefore: Construct Two Absorption Trenches Each 42' In Length by 3' Wide With 10' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 2' Below Existing Ground. Total Depth of Trench to Be 12' from Existing Surface. Placed Zabel Flow Splitter Valve to Assure Even Flow of Effluent to Each Trench. Mound Over Trenches if Necessary to Provided Minimum Cover of 31. 1'-6" 6" 10' - 0" Natural Backfill Geotextile Fabric 4" Perforated PVC (Slots Down) infield 3' TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4Separation From Groundwater. Minimum 100' Separatlon From Well. Minimum 50' Separation From Break in Grade >25% 4� OF A4 14 * 491H %�k, ' -MICHAEL E. ANDERSON "• CE -4361 .: ���f0 PROFESS10Na�' �` :7 s * 491"-/� Municipality of Anchorage Department of Health & Human Services 00 *.MICHAEL .MICHAEL E. ANDERSON : w 825 L Street, Anchorage, AK 99502-0650 �I `s : CE - 4381 SOILS LOG - PERCOLATION TEST �� ��90•. ••' �`'� 41t `RO/ESStB:�e' Performed For: Bob Klein Date Performed: 11?9bM� dLegal Description: Lot 1. Autumn Ride Subdivision SLOPE SITE PLAN n 1 2 4 5 r 6 7 8 1 9 1 1 I I 1C 11 12 14 15 16 17 OG/PT Gravel/Sand Some Silt GM/SM GP/GM Was Groundwater Encountered? If Yes, What Depth? Depth to Water After Monitoring Date: is None 1/22/00 Reading Date Gross Time Net Time Depth To Water Net Drop 1 13 -Dec 1:23 2.5" 2 1:53 30 3.25" .75" 3 1:54 2.5" 4 2:24 30 3.19" .69" 5 2:25 2.44" 6 2:55 30 3.13" .69- 19" Bottom of Perc. Rate: 44 Min./Inch Perc. Hole Diameter: 6" Hole Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A. Harala_ I, Michael E Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: ..1120/00 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: OF p J ••......c Yf�, 4918 *.MICHAEL E. ANDERSCN • CE - 4381 s ff f9Fp•• ..•'fit.: Legal Description: Lot 1Lot 1- Autumn girjoe_SuhdlVlclon Date Performed: r-1 SLOPE SITE P 1 5 7 11 1 15 16 17 18 19 PT/OL Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 1/22/00 GM/SM Bottom of Hole 11 S 40.167 aq kt I ABANDON I DRIVEWAY THRU LOT 1 Reading Date Gross Time Net Time Depth To Water Net Drop 1 11 -Dec 4:05 5.5' 2 4:35 30 6.69' 1.19" 3 4:37 5.44' 4 - 5:07 30 6.69" 5 5:08 5.5" 6 5:38 30 6.69" Perc. Rate: 25 MinJlnch Perc. Hole Diameter: 6" Test Run Between 5 Ft. and 6 Fl. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A.A. H� I, Mi ba I E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 L / /r ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 1, BLOCK 1, AUTUMN RIDGE SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 gallon septic tank at the location shown on the site plan. Work also includes the construction of two new 42' long X 3' wide X 10' effective depth absorption trenches at the location shown. The distribution line in the trenches will be placed at 2' below the existing ground surface. Total depth of the trenches will be 12' below the existing ground surface. A Zabel Flow Splitter Valve shall be placed at the location shown to assure even flow of effluent to each trench. All components of the septic system must be placed a minimum of 100' from the well to be constructed on the lot. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,500 gallon septic tank must be be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Lot 1, Block 1, Autumn Ridge Subdivision March 26, 2001 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of levet. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 1, Block 1, Autumn Ridge Subdivision March 26, 2001 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage °u On -Site Water and Wastewater Program (907) 343-7904 s A Certificate of 4n -Site Systems, Approval Parcel I.D. 015-054-04 Expiration Date: b C' C I , Q 0 1. GENERAL INFORMATION: Complete legal description AUTUMN RIDGE; LOT 1 Location (site address) 9300 Autumn Ridge Circle *Anchorage 99507 Current Property owner(s) Nadia & Bruce Lamoureux Day phone 947-8989 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: M Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class_Well Public Water System 5 TYPE OF WASTEWATER DISPOSAL: M Individual - 0 ❑ Holding Tank ❑ ❑ Community ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ y /2.�0 (� (/ 11� Waiver Fee $ Date of Payment g�d/2U Date of Payment Receipt Number Receipt Number COSA# QSC ZDl969, 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 (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date:' In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or j encroachments may exist that were not identified during the evaluation. The operational life of all wells G� P. ' / J) ''• Si ��� and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and i v workmanship),% and the water usage of the family utilizing the system/s. These conditions can vary, and P� •' • "' • •i... . i are outside the control of GEG. Satisfactory test results do not guarantee future performance of the � ,f tai+ 11 ;�......... system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of Q�+ g, the well or septic system. GEG makes no representation whether an alternative well or septic system ff"1 ........ Gcrn ss: can be installed on the property in the event either of the current systems fail to perform adequately in QO 9. , / /CE—,7 the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or 4�e0, F°o party (including subsequent property purchasers) is not authorized, nor will it confer any legal right�q p oresslo�°o—� whatsoever. #AECC884 6. DS4 SIGNATURE System #1 Approved for 5 bedrooms System #2 Approved for bedrooms k�\�� OF DisapprovedZk '�O Conditional approval for bedrooms, with the following ulatig";SITE WATER AND By: t6IA 00,,JytR Original Certificate Date: ! i 7 �� D The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 4 CSA Checklist Legal Description: AUTUMN RIDGE; LOT 1 Parcel ID: 015-054-04 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA Al Well log is filed with Onsite (or attached) Date drilled 10/30/01 Total depth 261 ft Cased to 261 ft 0_1 Sanitary seal is functioning correctly X Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 7/27/20 Static water level at beginning of test 215.1 ft. Comments B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTICISTEE Measured operating fluid level in septic tank 50" © Standpipes/foundation cleanout per record drawing Date of pumping 8 z' 2 0 D. ABSORPTION FIELD DATA DUAL TRENCH Well production at time of test 7.2+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes 0 No ❑'Coliform bacteria is Negative Nitrate 0, I l'i mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L � Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 7/28/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: N/A Which system tested (date installed) 10/18101 Adequacy test date 7/28/20 n per G EG. On C ALL standpipes present per record drawing Results Q Pass For 5 bedrooms Total measured depth from grade 16.9 ft (max) Fluid depth prior to test 59 in Measured depth to pipe invert from grade 6.25 ft (min) Water added 825 gal ❑ N/A — pressurized field 80 New depth in ❑ Monitor tubes go to bottom of effective. If not, state 120 depth into effective '9.58 Elapsed time min p O Code -required soil cover over field Final fluid depth 68 in 0 System presoaked Absorption rate 750+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) '" Gallons introduced 2,271 gallons If yes, enter date N/A Comments/Deficiencies: 'SOUTH TRENCH "TRENCH PRE-SOAKED ON 7/27/20 -TESTED AND PRE-SOAKED NORTH TRENCH ONLY 6 t e L4'>6 M -1-j' COSA Checklist yellow sheet .IMMIN9 a; E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' Fv Yes if No ft Q✓ Yes if No ft Neighboring Tank > 100' 7✓ Yes if No ft Private Sewer/Septic Line > 25' 0✓ Yes if No ft Absorption Field on Lot > 100' F/� Yes if No ft Holding Tank > 100' ✓� Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' E✓ Yes if No ft R Yes if No ft *MET CODE AT TIME OF INSTALL Manure/Animal Excreta Storage > 100' -Q✓ Community Sewer Main > 75' Z✓ Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *51+ ft Surface Water > 100' F✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' F71 Yes if No ft Private Wells > 100' Yes if No _ Water Main > 10' 0✓ Yes if No ft Community Wells > 200'✓1 Yes if No _ Water Service Line > 10' F✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' [] Yes * if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100'�j✓ Yes if No Water Service Line > 10' F,/� Yes if No ft Community Wells > 200' Yes if No Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *MET CODE AT TIME OF INSTALL Qo�oop �� G. ENGINEERS CERTIFICATION o © ••� F o ��••.. 7.. I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. �. ..,..jE)795 ........ ....... �Q .J f Gorss: �� 9. '• , COSA Checklist yellow sheet QQ d �'r o f e s sio0°oo #AECC884 11�0,G:z ft ft ft W I—A 4 A-' HOME SERVICES, INC. 11'5,01 1---, 1.4(i-th-Avenue. A n c I -io v a g, e, :,",. I -a s k a :49 5 16 1 IS 90 CU$TOMER 9300 rut un-rn Mdge yr,, Anchorage, AjK 99507 8flock DATE DESCRPTION INVOICE :erlvalve and ext Lf 6 2,0 REMARKS G%iff'ons Septic _ L�nch Ani.�o q! Tank � H. Win T, k PROBLEM AREA — CA" FOR MORE WFORMATION NEEDS TO BE DONE AGAIN IN 6 MONT14S G 5ood Shape I Sludge buildup on botic)nri. Jim cap missing or Cut standpine to VaE)o p, ground needs, replacing v AMOUNT TOTAL Standpipes _ Time Floater on ton Needs Sept, tir trinc, Municipality of Anchorage • Development Services Department I' Ai k - " Building Safety Division On -Site Water and Wastewater Program , r 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. 015.05404 1. GENERAL INFORMATION Complete legal description Lot 1, Autumn cadge subdivision Location (site address) 9300 Autumn Ridge Orde COSA #_ 0142 62DI Expiration Date: R- 30-06 Current Property owner(s) Mark and rate Borman Day phone 522 -soar Mailing address 9300 Aubx m Ridge Circle Anchorage, AK 99515 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: Five (5) 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 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 Onsite 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 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 OnSfte 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK M24 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE V Approved for _5 bedrooms. Disapproved. Phone 522 - Date W3=6 .rC,�P(E�'j _49th N1 �MCHAM r 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: Original Certificate Date: 5--30-06 d�U`O (a... 710051 Municipality of Anchorage Development Services Department Swung Safety Division On -She Water 6 Wastewater Program •' ", 4700 BragaW Street P.O. Box 198650 Anchorage, AK 99519-650 www.munLorglonstts (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1. Autumn Ridge aubmNdan Parcel ID: 015-06404 A. WELL DATA Wen type mete If A, B. or C provide PWSID 0 _ Well Log (YIN) Y Date completed LW30M01 Sanitary seal (Y" Y 1Mms prop" protected (YM) Y Total depth 281 fL Cased 10 280.8 fL Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test tOV30=01 5/1542006 Static water level 218 R 214 R Well production 20 g.p.m. 62 O.P.M. WATER SAMPLE RESULTS: Coliform -.L--colonies/IW mL Nitrate 9385 mglL Other bacteria 3 coloniesl100 ml Arsenic: ND mgn Date of sample: Sam Collected by: L Hemendez B SEPTICIHOLDING TANK DATA Tank TypWMaWW Sey6rJSted Date installed WIWI Tank st m 1.600 gal Number of Compartments Tvic Cleanout (Y" Y Foundation dearaut (Y" Y Depression over tank (YIN) N Hgh water alarm (YIN) N Date of pumping anorlooe Pumper Dema Pungrt C. ABSORPTION FIELD DATA Date installed 101x8JWM Soil rating (g.p.dAe or tt=lbdrm) •45 GPWSF system type Deep Trench Length 54 IL Width s fL Gravel below pipe 10 R Total depth 7e fL Elfabsorption area t,6eo _n' Monttoft tube Y Depression over field N Date of adegrmcy test SWAM Results (Pass/Fall) Pea For FNe bedrooms Fluid depth In absorption field before test 0 in. Water added 75D gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 760 g.p.d. Any rejuve OUM treatment (pest 12 mo.) (YM & type) If yes, give date D. LIFT STATION Data installed Size in gallons 'Pump one level at _ in. 'Pump off' level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanIVOR station on lot 3-100' Absorption field an lot 3-100' Public sewer main . WA Sewer /septic service One 3-25' Animal containment areas WA Manhole/Access (Y/N) High water alarm level at in. Meets alarm b drmt m"rerne w On adjacent lots >100' On adjacent lob 3-100' Public sewer manholakk anart WA Holding tank WA Manure/animal Male storage area WA SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 3-5' Property line 3-s Water main WA Wens an adjacent lots 3-100' Water service One 101a' Surface water 3-100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Properly line 3-10' SukWV foundation 3-10' Water main WA Water Service One 3-10' Surface water 3-100' tMveway, parlkrpNehide arorgpe 3-5' Curtain drain Nam NOW Wells on adjacent lots 3-100' F. COMMENTS: G. ENGINEER'S CERTIFICATION I car* that / have deter n/ned aumgh field hspectlons and review of Munk 1pal rawWs that the above systems are it aordbrmance wllh MOA COSA guA*ffnes In eftd an this date. Engines Printed Name s4 had E. Aim P.E. Date 5/23/2006 COSA Fee $- "0.00 Date of Payment 5-?.N"D(o Receipt Number Dh U0' (Rev. 11AM Waiver Fee S Date of Payment Receipt Number 2001-143 AUTUMN RIDGE SUBDIVISION LOT 1 40,029 S.F. (BK. 72. PG. 236) 10' CEA ESMT.- 10' BUFFER LANDSCAPE ESMT: E 0 U) 8905900011E 65.57' LRr20 ?,9 — — — — — — — — 30' LOT 1 1-4 BUILDING DETAIL SCALE: 111-20' FINAL STRUCTURE AS -BUILT �� K.11:d w WELL EXISTING BUILDING (SEE DETAIL) ' SEPTIC SYSTEM AS -BU I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND SURVEYING ENCROACHMENTS EXIST EXCEPT AS INDICATED. JEFF A. GASTALDI. R.L.S. IT IS THE RESPONSIBILITY OF THE OWNER TO 4726 WEST 88TH AVENUE DETERMINE THE EXISTENCE OF ANY EASEMENTS. ANCHORAGE. ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT PHONE 248-5454 APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2437 11/12/2001 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT. ALASKA F.B. doe No. 01-16 ARSt NOTE: NO CORNERS SET THIS DATE. =40' 0 *%u%mk OF to i * n9LH ......................... 411 n i .lrllofy A. nalnldl 000lo ' 4 ♦. °�@ �•.,� LS -6091 Jig • °af..........•• 6 A 6411, w�. AZunicipality of Anchorage • \1 Development Services Department` y':e Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.051-04 HAA # D / 0 , Expiration Date: z z 7.LOZ 1. GENERAL INFORMATION Complete legal description - Lot 1, Autumn Ridge Subdivision Location (site address or directions) Ziemtak Circle Current Property owner(s) Crown Pointe, Inc. Day phone 345-6277 Mailing address Lending agency Mailing address Real Estate Agent . Mailing Address 5400 Abbott Road Anchorage, AK 99507 Unless otherwise requested, HAA will he held by DSD for pickup. 2. NUMBER OF BEDROOMS: Five 5 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ V f The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the dale of issue for properties served by a private or Class C well and may be reissued with new'water sample results less than 30 days old. (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 Health Authority 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, P.E. Date 11126101 ..� C n EENGINEER S �• ...�rl.....1. .. �7rt1'D 1.... � �, ,--- C°-4381 �+ 5. DSD SIGNATURE �` sr� . .;' Approved for _5- bedrooms. r� At •. QOFESSIT w a aLtiti5.4•�'4 Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineers Report Other By: Original Certificate Date:ZL Z/ '—QI (R.. IZ*O) Municipality of Anchorage • y Development Services Department Budding Safety Division Onsite Water 8 Wastewater Program 47W South Sragaw St. P.O. Box 196650 Anchorage, AK 995196650 www.ci.anchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 1 Autumn Ridge Parcel ID: 015451-04 A. WELL DATA Well type PrW9 It A, B, or C provide PWSID # _ Well Log (YIN) Y Date completed 10r30R001 San" seat (YIN) Y WM properly protected (YM) Y Total depth M—ft. Cased to 260.6 ft. Casing height (above, ground) >24 in. FROM WELL LOO AT INSPECTION Date of test 10130@001 Static water level 218 ft. ft' Wen production 20 9 -P.m. 9 -p.m - WATER SMPLE RESULTS: CoRfonn 0 cdonies W mi. Nitrate .6 mg.A. Omar bacteria 0 colonies/100 ml. Date of sample 1112112001 Collected by: Jody Anderson B. SEPTICIHOLDING TANK DATA Tank TypelMaterlal SestielSteel Date u>staded +nM8=1 Tank size IAO gal. Number of Compartments 2_ Cteanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping Pumper New Constructlon c. ABSORPTION FIELD DATA Date installed 10H8R001 Sod rating (g.p dJft' or ft ibdnn) .45 GPDISF System type Deep Trench Length 94 ft. Width 5 ft. Gravel below pipe 10 ft. Total depth 16 ft. Eff. absorption area 1,_600 ft' Monitoring tube Y Depression over field N Date of adequacy test Results (PassfFall) For _ bedrooms Fluid depth in absorption field before test _. in. Water added_ 9ct• New depth_ in. Elapsed Tim —min. Final fluid depth _ in. Absorption rate " 9-p.d. Any rejuvenation treatment (past 12 mo.) (Y/N a 4") N If yes. give date D. LIFT STATION Date instaned "Pump on' level at _ in. Datum Size in gallons 'Pump ofr level at —in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank= station on lot >1W Absorption field on lot >100' Public sewer main WA Sewer /septic service Une >2T Manhole/Access (Y/N) High water alarm level at Meet$ alarm & circult requirements? On adjacent lots MW On adjacent lots >100' Public sewer manhole/cleanout WA Holding lank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >S Property Una >S Absorption field >S Water main WA Water service line AW Surface water Mw Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main MW Water Service line >10' Surface water Aw Driveway, psrkkQNONde storage >25, Curtain drain None Noted Wells on adjacent lots MW F. COMMENTS G. ENGINEER'S CERTIFICATION S I terrify that I have determined through field inspections and review of Muntoal records that the above systems are in x` <• . ...""'� conformance wllh MOA HAA guldellnes in effect on fills date. Engineers Printed Name Michael E Anderson. P.E. Datel1112AM1 r HAA Fee $ 3 ©© Waiver Fee $ Date of Payment - Z 7' o / Date of Payment Receipt Number / Z 9 ©$ Receipt Number. (Raw. 17/)0) in.