HomeMy WebLinkAboutTIMBERLANE PARK #1 BLK 4 LT 7BMunicipality of Anchorage
_,
Development Services Department == _ __ '.
(• Building Safety Division '
\ On-Site Water 8 Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW060241 PID Number. 019-152-34
Nome:
Wastewater System: ■ New ❑ Upgrade
RICO FERNANDEZ
Address:
12140 HILLTOP DRIVE * ANCHORAGE, AK 99515
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 349-9925 4
■Deep Trench Cl Shallow Trench O Bed ONound OOther
LEGAL DESCRIPTION
sw R":
1.2 GPD/Sq. R
Tow D.Wh nem erlelnal pee.:
9.5 MAX R
Block: Lot: Subdivision:
D.Wh m pro. batt— foo` "kW goer
Cre..l d.Wn bwwalh OP.:
6.14
4 78 TIMBERLANE PARK #1
SEE DWG. R
R
Township:Range: Section: —
Tel edeas ebev. «lglrwl pile''
a'wx Wgum.
51
- -
SEE DWG. R
R
Clovis wlwn:
Number al M:
/bland bNw.m edr
WELL: [INew ❑ Upgrade
2.5 R
1
— R
Cb.whaalwn Prlwl.. A.11.0. Tow
Caw To:
Taw eb.orpDon ane:
626
Pp. mat.rlol:
D 3034/ F-810
R
R
sa.R
slava was« to,*:FL
swan« RED DOG
We swa 11/22/2006
odw P`� Dw. oww:
8�\C
moot Ab. Graend:
d
lin s.t Arces"
TANK
til
R
R
SEPARATION
DISTANCES
■Septic C! Holding 13S.T.E.P. OOther
io
Septic
Absorption
Lift
Holding
abr¢/Prlvat.'"'"''°
CHORAGE TANK
"
1250
From
Tank
Field
Station
Tank
S.w« Ude
Water line
10'+
10'+
—
—
—
yw«ly.
STEEL
NwMw of aanipart^wnt•:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
—
s4. In paean:
bk.Maatwr.
en M..l ul: ell W:
wpn will« alarm al:
Foundation
5'+
10'+
—
—
—
pump tdaY.
Electrical krp.enod p«fomwd by.
Curtain Drain
NONE KNOWN
BENCH MARK
Remarks:
leeelbn ane D.walpuon:
TOP OF CMU NEAR POINT "A"
A.""dd E" soon' 101.31 R
ENGINEER? SEAL
Inspections performed by: GEG, Ltd. Dates: 1st 11/22/2006
11/22/2006
0000004
P ���4p
2nd
..
3rd 11/22/2006
..F
4A, • sr00o
Development Services Department Approval
0�'�:
•.:•.�
Reviewed and approved by: Date:
D
Je ..• •••• •• nese•••: • 0
rr A.
�Q e
CE-79P3
4KOdPro
Date: 2-A 0
Reviewed and approved by: #ell
ressja0aco
(R.r. 4/06) 1000��p00
PERMITNUMBER: AS -BUILT DRAWING PARCEL NUMBER:
SW060241 019-11 52-34
SW0
WATER UNE •;•�'•;. •�•
A
B C '.
STI 1 19.1 1
50.7 28.7 „• �.. ••;; '
•• ••
ST2 18.4
50.1 36.6
+ •' •"
DBLI 18.5
49.7 41.2 + ••" .y
OBL2 19.7
50.2 43.9 4 ' • '
COt 22.2
51.7 47.3'�•��•
MTI 27.8
56.0 94.1 C t� "•�'; ��.
CO2 65.4
81.7 96.0
MT2 61.3
86.1 53.0 NEW 4
BEDROOM
HOUSE
FCO
I
B
2
1
NEW 1250 GA2 n
SEPTIC TANI I
JK
2DRAINFIFIELD
Ld2
TM,�
ALTERNATE SITE
O
y
5 E:
QS=
oc60� �
o
o OF 4p
�4
GARNESS ENGINEERING GROUP, Ltd. pe'?' 4..°V,
CONSULTANTS & GENERAL CONTRACTORS '
)AI L 1N000 W W. AlllC 101 • M9QIIILL M( M�°l • A1011C 00.11-11T • 14l (�01}WJ]H • gSRL �.pn•�p�wKow O
PREPARED FOR: PHONE NUMBER: PACED
3OQQBY: rCE-. Gar ess:
RICO FERNANDEZ 349-9925 2 OF 000
LEGAL DESCRIPTION: DRAWN B F.M. 01.��.•' q�POG
'1��5
TIMBERLANE PARK f1; LOT 7B. BLOCK 4 �o
ppOOQODOO�d�o
DATE.
TWE OF WORK:
AS -BUILT FOR NEW SEPTIC SYSTEM 12/5/2006
(Rwv 01M)
NUMBER: PARCEL NUMBER:
PERMrTSW0 AS -BUILT DRAWING I
SW060241 019-11 52-34
FINAL GRADE - 101.39
STI 512
TOP OF TANK TOP OF TANK
AT INLET 97.31 AT OUTLET 97.31
NEW 1250 GALLON
INVERT of BUNG SEPTIC TANK INVERT OF BUNG
AT INLET - 96.70 AT OUTLET - 96.53
GRADE - 100.26-100.81
ORIGINAL GRADE 99.4Z-\ I
O HIGHEST POINT I I' / FILTER FABRIC
�\�I n
INVERT OF PIPE
96.06
M OF
- 89.92
RELATIVE ELEVATION OF BOTTOM OF
TESTHOLE - 83.92 (NO H20)
- .. ...-... _. - __ _.. . -.
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3NI L 1110011 11010. f 101 . NOOiuOL NI M • ATOM[ (901)"73 In • TNI (10I)3,D o • �U30C W.gyn. wMYymi
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 1
RICO FERNANDEZ 349-9925 3 OF 3
LEGAL DESCRIPTION: DRAWN BY:
TIMBERLANE PARK #1: LOT 7B, BLOCK -4 B.F.M.
DATE:
TYPE OF WORK: 12151200
PROFILE DRAWING FOR NEW SEPTIC SYSTEM
(RWAIX5)
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d 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: Aug 04, 2006
Expiration Date: Aug 04, 2007
Permit Number: SWO60241 Parcel ID: 019-152-34
Legal Description: TIMBERLANE PARK #1 BLOCK 4 LOT 7B
Design Engineer: 0855 GARNESS ENGINEERING GROW Site Address: 12140 HILLTOP DRIVE
Owner Name: RICO FERNANDEZ Lot Size: 80150 SO. FT.
Owner Address: 12140 HILLTOP DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99515 -
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 specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907)343-7904(24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By.
Date: �%L" O�
Date: ��
-\ Municipality of Anchorage
-�` Development Services Department
Building Safety Division
On -Site Water & Wastewater Program 4A.
•
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.enchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. m tl-- _t -5A-34
Property owner(s) RICO FERNANDEZ Day phone 349-9925
Mailing address 1 140 HILLTOP DRIVE • ANCHORAGE. AK 99515
Site address 12140 HILLTOP DRIVE • ANCHORAGE. AK Zip Code 99515
Legal description (Sub'd, Block & Lot ) TIMBERLANE PARK #1. LOT 7B. BLOCK 4
Legal description (Township, Section & Range)
Lot Size 21! 7 Acres/Sq.Ft.
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
19
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms
THIS APPLICATION IS AN:
Initial
Upgrade
❑
Renewal
❑
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.
GARNESS ENGINEERING GROUP, Ltd.
Permit/Rush Feed➢ /e o • O ��
Date of Payment: 7� %lo
Receipt Number. O7G v_3/�2
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number.
GARNESS ENGINEERING GROUP, Ltd.
c _-_— •=�T�
-1 CONSULTANTS & GENERAL CONTRACTORS --
June
June 30,2006
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Septic System for Timbcrlane Park #I Subdivision, Lot 7B, Block 4
To whom it may concern:
The proposed 4 bedroom house is to be served by city water and a private septic system. Two test holes
where dug on the property. The drainfield will be designed around the 30 foot radius of test hole #2 which
has a percolation rate of 2.67 min/inch. We are proposing that a 1250 gallon septic tank and a deep trench
type drainfield be installed. Comments regarding the design are summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See the attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100+ feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached tonography site plan. the average topography in the
area of the proposed drainfield is fairly flat. In short, there are no slope concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems.
please contact us at 337-6179. Thank you for your assistance.
/1.S.
NOTE: Attached is a site plan drmving, a design drawing, Avo soils logs, and a 7 page construction
specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507
Ph: (907) 337-6179 • Fax: (907) 338-3246 4 Website: gamcssengineering.com
I
I
i
I
I
I
. I
I
I
I
I
I
I
I
I
I
I
I
I
I
/ I
/ I
/ I
/ I
� I
� I
I
TIMBERLANE PARK S/D /1
LOT 9, BLOCK 4,
SERVED BY PUBLIC WATER
TIMBERLANE PARK S/D /I;
LOT B, BLOCK 4,
r
\ SERVED BY
PUBLIC WATER
I `\
i
I cr
I TIC
'SPL Yx
` TIMBERLANE PARK S/D /1; n�
I \ LOT 10, BLOCK 3. u
SERVED BY PUBUC WATER
I \ W9
I F
I
I [SEPTIC
I uta
I
SERVED BY
I
PUBLIC WATER '�_ HILLTOP DRIVE
CS—EPTIC
ARA
I
I
I
PROPOSED 4
IBEOROOM HOU!
M.
TTM/+1
-PROPOSED SEPTIC
SYSTEM (SEE DESIGN
PAGE 2 OF 2)
TIMBERLANEPARK S /1
LOT 6,, 4, BLOCK 4,
CSEPTIC
ARS
/ THOMASSON DRIVE
\ - -------------------------
GARNESS ENGINEERING GROUP, Ltd. ;?:`
—•-•- .--�W—•++• CONSULTANTS S GENERAL CONTRACTORS — • • • •
701 [. R I . w 101 . w.baq.GC, we WM) . w (907)337-4170 • FM ae13M-)]N . KBLN:
PREPARED FOR: PHONE NUMBER: PACE NUMBER: ee. I
RICO FERNANDEZ 907-349-9925 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
TIMBERLANE PARK #1: LOT 7. BLOCK 4 1 K.D.W./J.N.T.
TYPE OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
(Rev 01105)
6/30/06
I
I
OF BEDROOMS:4
PER DAY (GPD): 600
ION RATE/S: 2.67 MIN./INCH
D APPUCATON RATE: 1.2
DRAINFIELD SOTT.: 500
AINF
MAXIMUM DEPTH:9.5 FEET
WIDTH: 2.5 FEET
LENGTH:45 FEET
M.O.A. APPROVED SAND FILTER:N/A
EFFECTTVE:6 FEET
REDUCTION FACTOR: N/A
ACTUAL SORT.: 540
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER
CONTACT CEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION, THE ENGINEER,
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
I
PROPOSED I •i ���••
WATER UNE •: ".
PROPOSED FOUR •.7 :;• �/
BEDROOM HOUSE /
PROPOSED 1250
GALLON SEPTIC TAI
INSTALL
FOUNDATION
CLEANOUT
CO
INSTALL DOUBLE
CLEANOUTS
II II
+ I I
PROPOSED /
DRAINFIELD _J CO
MT
PROPOSED
ALTERNATE SITE
/ +
THII
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS 6 GENERAL CON •••• •• .• ..... .••••*•
]MI C TIOOR IIO.D. LIR 101 • NOORMr M( "W7 • FIdS (107J=J li 0 Mi ("7)M -N" OCB4I[: �w.pn�r.pN.wYFOM� O
PREPARED FOR: PHONE NUMBER: PACE NUMBER: 0 ••• •••••••
RICO FERNANDEZ 907-727-3794 2 OF 2 Q .Je A. ess:•
LEGAL DESCRIPTION: DRAWN BY: UO v 79 `SpQ
TIMSERLANE PARK S/D; LOT 7B. BLOCK 4 K.D.W./J.N.T. •!<,(10. e4o
e F o
TYPE OF WORK: DATE: ���dfrOfesS'W'0\
DESIGN DRAWING FOR SEPTIC PERMIT 6/30/06
(R..OL05)
ALASKA NNIXrER & NNASTE AVXrE4 R
CONSULTANTS.INC. _
nwn.nn .....n w....w wn w ............ nw ... w...... -------- w.n.. - w... '--- ..��..w
LEGAL DESCRIPTION: TIMBERLANE PARK SUBDIVISION A1; LOT 7, BLOCK 4
PERFORMED FOR: RICO FERNANDEZ DATE: 4/8/2003
DEPT] ____ ORGANICS
feet TEST HOLE 1
1
GM/SM
LOOSER w/
DEPTH
DEPTH TO
GROUNDWATER
DATE
DRY
4/8/2003
DRY
4/15/2003
4:52
—
6-
1
I
2
4:54
1
0.
6'
3
4:54
,
6-
1GW
i
;
\
\
3
•.
6-
i
i
I TM/2+
—
6.
;
6
5:00
IIIIIIIIIML
0'
6'
7
5:00
I i
;
—
GM
;
; SITE
PLAN
CL
6'
9
5:03
10-100'
6'
—
10
5:06
H/NHS
0'1
•
11
5:06
—
6' 1
—
12
5:09
3
IIIIIIIII
6'
MH
_
II!�l,4li�l,�ll
•
SC
GM/SM
LOOSER w/
DEPTH
DEPTH TO
GROUNDWATER
DATE
DRY
4/8/2003
DRY
4/15/2003
4:52
—
6-
1
I
DATE READING
t
�
/
WATER LEVEL
READING
NET DROP
(INCHES)
4/9/2003 1
4:52
—
6-
1
I
2
4:54
1
0.
6'
3
4:54
,
6-
i
I
i
;
\
\
3
0'
6-
i
i
I TM/2+
—
6.
;
6
5:00
I 7H/1*
0'
6'
7
5:00
I i
;
—
I i
I
;
; SITE
PLAN
0'
6'
9
5:03
10-100'
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/9/2003 1
4:52
—
6-
—
2
4:54
2
0.
6'
3
4:54
—
6-
—
4
4:57
3
0'
6-
5
4:57
—
6.
—
6
5:00
3
0'
6'
7
5:00
—
6'
—
8
5:03
3
0'
6'
9
5:03
—
6'
—
10
5:06
3
0'1
6'
11
5:06
—
6' 1
—
12
5:09
3
0' 1
6'
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: MATT FISHER
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS AS ERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: G W
ALASKA NNIXrLR & NVASTL'NWAT M
CONSULTANTS. INC.
IZPUIL. LUy — rcr%V ULNrrUN IL,311
LEGAL DESCRIPTION: TIMSERLANE PARK SUBDMSION #1; LOT 7, BLOCK 4
PERFORMED FOR: RICO FERNANDEZ DATE: 4/8/2003
DEPTH ORGANICS
(feet) --— TEST HOLE
1
tSOIL
I
�
NET TIME
(MINUTES)
WATER LEVEL
READING
CLAS I ICATIO
4/19/2003
E
4:43
1
I
;
�
i 1GW
2
,.
10
I
3 3/4"
,
,
111111111ML
—
6"
—
4
5:05
TRi2
2 1/4"
3 3/4"
1
5
5:06
j I�111'GM
H,NN�
CL
TM11+
i
5:16
10
1 i
,
;
•
1 t
I
;
FsITE PLAN
6"
—
8
5:26
10
2 1/4-
3 3/4"
II1111111MH
5:27
—
6-
GM//
////.CHSM
10
2 1/4-
3 3/4-
11
(CO
—
6"
—
12
5:47
10
X
OHSC
7-
8-
9—
lo-
11 891011
GM/SM
12 LOOSER w/
DEPTH
13-
14-
16-
17-
18--4
314161718
DEPTH TO DATE
GROUNDWATER
DRY 4/8/2003
DRY 4/15/2003
DATE
I
�
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/19/2003
E
4:43
1
I
;
�
1
1
2
4:53
10
I
3 3/4"
,
,
4:55
—
6"
—
4
5:05
TRi2
2 1/4"
3 3/4"
5
5:06
—
I
—
TM11+
i
5:16
10
1 i
,
;
1 t
I
;
FsITE PLAN
6"
—
8
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/19/2003
1
4:43
—
6"
—
2
4:53
10
2 1 4"
3 3/4"
3
4:55
—
6"
—
4
5:05
10
2 1/4"
3 3/4"
5
5:06
—
6"
—
6
5:16
10
2 1/4-
3 3/4"
7
5:16
—
6"
—
8
5:26
10
2 1/4-
3 3/4"
9
5:27
—
6-
10
5:37
10
2 1/4-
3 3/4-
11
5:37
—
6"
—
12
5:47
10
2 1/4
19 I PERCOLATION RATE 2.67 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 5.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: MATT FISHER
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS AS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 3a
Cop - No NP.ny. I 3- \
� •'. - \ P Lot 10
Lot 9 I � • .Eormrr.t
S �
.Rvc.o. '..... 009Hy�b�
ler Ur
Eeummt�l Y.
LOT _-A
__.__ _ .tt. '1 "-'v_�'_b LI 0•�hE ' S1T410 E 61.611
NSS-Z33W NVV1'00"r 69.211
,37.13
Z.�Ea..mml
Fa9.o x'
co, - No M~g. T" ;..._._.... ~ •.,•'.Gr -__ _ _
5697T10'M 171.01'(Y)
[AST 171.00'(Rl) f�-. _
5, �1,•� $ Lot 6
6 8 I 410047.3 sfftt 8 =
N I
� Lot 6
I
I
§�J--10• UE ..
I Co..mmi
I �neLrtil�� HTC
R
j 1 L6 LEM S.1 3 1/4' ALmY.+.. Cop l7B L6 . 3 1 r
1 N 6.10=1_111
umumr.f m 2 1/x•.30• e. 6. uPN�P3..w.1
/I Row 0 pa Ftu.N 911; Gouts % Ror AMn. pb
LS 7e» ///17 TtE j L=am
m.as(o n x00) �Ep.r..ml
N69'19•4119' 170.91'(Y) N6 N V
EAST 170.00*(RI)EAST ln.60'(Rt)
b BASIS OF _BEARING
06.60'(Y)
_-- EAST 6603.q'!Rt)
• Municipality of Anc rage o 1 M5 R'
Ax
On -Site Water and Wastewater Progr r tct-iat studkiii- <
(907)343-7904 S A 1 9 7
$Certificate of On -Site Systems Approval //�� l��3 1
Parcel 1. D. 019-152- Expiration Date: I l DJ
1. GENERAL INFORMATION
Complete legal description Timberlane Park #1, Block 4, Lot 713
Location (site address) 12170 Hilltop Dr.
Current Property owner(s) Kamsiah Fernandez Day phone
Mailing address 12170 Hilltop Dr. Anchorage, AK 99515
Real Estate Agent
2. TYPE OF DWELLING:
i] 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
Waiver/Variance request
S
Day phone
TYPE OF WASTEWATER DISPOSAL:
® No's rl
Individual
❑
❑
Holding Tank
❑
❑
Community
❑
®
Public Sewer
❑
Received by: 011-,a4 Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ �5o26' Waiver Fee $
Date of Payment 10 1K Date of Payment
Receipt NumberQ g4,1eG Receipt Number
(l
COSA# Ji�E15 'a 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations. The reported results describe 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 fife of all wells and septic systems depend on the local soil
condition, ground water 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 this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone
6. DSD SIGNATURE /
System #1 Approved for `7 bedrooms
System #2 Approved for bedrooms
Disapproved
Phone (907) 272-8218
Date 9/29/2015
Conditional approval for bedrooms, with the following stipulations:
By: A jAAPj_\11 (ry V Original Certificate Data: l�
Th unicipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet <, .., .
If more than 1 septic system is on the lot:
COSA Checklist # + of 1
Structure served by this system
.Certificate of On -Site Systems Approval Checklist
Legal Description:
Timberlane Park #1, Block 4, Lot 7B
A. WELL DATA
Well type Public
Date completed
Total depth ft.
Date of test
Static water level
Well production
YS
Parcel ID: 019-152-x,
If A, B, or C provide PWSID # AWWU Well Log (Y/N)
Sanitary seal (Y/N) _ Wires properly protected (Y/N)
Cased to ft.
FROM WELL LOG
WATER SAMPLE RESULTS:
ft.
g.p.m.
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1,250 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Casing height (above ground) in.
AT INSPECTION
ft.
g.p.m.
Collected by:
Date installed _11/22/2006
Cleanouts(Y/N)
Y
High water alarm (Y/N) N
Date of pumping 10 ` — Pumper [)"I.J A[j Wafu
C. -ABSORPTION FIELD DATA
Date installed 11/22/2006 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type Deep Trench
Length 51 ft. Width 2.5 . ft. Gravel below pipe 6.14 ft
Total depth 9.7 ft. Eff. absorption area 626 fe Monitoring tube Y Depression over field N
Date of adequacy test 9/28/2015 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 37 in.
Elapsed Time: 1 440 min. Final fluid depth 37
Water added 605 gal New depth 4 1 in.
in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo,) (Y/N & type) NO If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at in. "Pump off' level at
Datum Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO:
Manhole/Access (Y/N)
in. High water alarm level at
_ Meets alarm & circuit requirements?
Septic tank/lift station on lot
On adjacent lots
Absorption field on lot
On adjacent lots
Public sewer main
Public sewer manhole/cleanout
Sewer /septic service line
Holding tank
Animal containment areas
Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Water main 10+ rb Water service line 10+
Wells on adjacent lots C.00+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent Iots4_00+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that f have determined through field_ inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone
Date 9/29/2015
COSA.canary sheet 2-&15.doc
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parking/vehicle storage 10+
... M;Y n V.,Ao* inane
Lot 7A S
2
0
� 177
s11, bo, \o
N
24.
^G09 16.0 r 8 `,lz Asphalt
J M
v MCO
M o
32.0
°
I °
° N
I o'aa
2 Story Frame HousJ o P4
I 'N
I
Lot 7B
I
I
I
L----------------
N89°59'41 "W 170.01
0
uc
THOMASSON DRIVE —
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLATARE NOT SHOWN HEREON.
FB 15-9, pg 63-64
8425V
�10' T &Easem;nt
Lot 8
SCALE: V= 50'
OF
49th 0410
�`
1000
i.:...
>/. Fred Walatko
3255 -S
`
I �rE5510NP� �
AS -BUILT NO CORNERS SET THIS DATE
1 hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 7B, BLOCK 4,
TIMBERLANE PARK SUBDIVISION No 1
Anchorage Recording District, Alaska, and that the
Improvements situated thereon are within the property lines
and do not overlap or encroach on the property tying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
1st dayof October ,2816.
FRED WALATKA & ASSOCIATES
BE(987-248-1868) Engineers and Surveyors