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AUTUMN RIDGE LT 7
Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 995146650 www.d.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWO10463 PID Number: 015-051-04 Name: Crown Pointe Inc. Wastewater System: New I M. 5400 Abbott Road Anch., AK 99507 ABSORPTION FIELD tome N / ee a 345-6277 Fouraeoepm'. 4 Deep Trench LEGAL DESCRIPTION So Raln°. iq"Depen homppuip Me. .8 C. -We 12 Ft. Block: LaL SnDdMN0r1: Deem b p tici Mom angww gran,: Gavel dept teneam Ppe: 7Autumn Ride 4 Ft. 8 Fl. To _N 3 W 15 : F• weo. vela: ed ape O-Vw Crel aLenpin: 1 Ft. 48 Ft. Well: New Crrveledth: IN wollr,e,. av/K. b.cen ren: 3 Ft. 1 - Ft. CI"/hcaMon 1Pti W. A B. C): Teal Depen: Cax m: Idol aesorpl.pn.rea PPe Mata W. Private 242 F 242 Ft. 768 FP ASTM D3034 PVC I Or.er: Date Dn.ed: SW4 Wale, Lerel Mwaaer: Will V, W . Alpine DFilling 1/9/02 I213 Ft. Sanders & Sanders 1/8/02 Ymtl: I al.Q,.V HootMare Grwaf: TANK 20 cP R. 2 Ft SEPARATION DISTANCES ®septic []Holding O S.T.E.P. ❑ Other. To Septic Absorption Litt Holding Ljibwprtvate From Tank Field Station Tank sewerLlme AnchorageTank Wel >100' >100' N/A N/A >25' Steel �s.d.wal" gLOT >100' >100' N/A N/A LIFT STATION — NONE Lalu" >5' >10' N/A N/A FBM . >5' >10' N/A �. ti in. GN/n prn None Noted P—P IA».e6 Lbde1 EWc ln$P.CIMP1a PertN,rn"1 by: Nemnks: BENCH MARK 4un peon. Top of Finished Floor Iun. 100.0 FL Engineer's Stamp '�.•��tAaae •u+ �;a•• Inspections performed by: Mike Anderson Dates: 1n 1/8/02 :. ; 49th ; L __ .. , Ile p 2 1/0/02 Department of Health and Human Services approval / /�. .r . .. .................. LL'/ o'i^= u-CHAEL E. ANDERSON •� sl; ` ; No.% DE_._,a, ••���Fo Reviewed and approved by: Date: �/9 oz TRa. 10w) ^ •• - ^ ;� :� filet E Permit Number SWO10463 ZIEMIAK CIRCLE O M Ra230.00' R=180.00' _ L=22.35' S 03020'09"E 94.12 =28.02 of ♦ 2 � N G d El0 Four Bedroom Home e� N�. T111 6 I � I I I I I PLAN AS -BUILT ♦( SCALE 1" = 30' I" -- — — — — — — — — — — — —-- _ — — — — j Page 2 of 3 PID No. 015-051-04 th VICHAEL E. ANDERSON No. CE -4381 i M A A B S1 I t I 39.5 S2 46.6 46.7 I 45.9 76.0 M1 72.1 63.0 C5 N 64.4 S1 I (� LiI t- S2 TH71A I 0 N C4 ®M7 I o & rn z C5 I I z Alternate I I Site OTH71 T111 6 I � I I I I I PLAN AS -BUILT ♦( SCALE 1" = 30' I" -- — — — — — — — — — — — —-- _ — — — — j Page 2 of 3 PID No. 015-051-04 th VICHAEL E. ANDERSON No. CE -4381 i M A B S1 43.2 39.5 S2 46.6 46.7 C4 45.9 76.0 M1 72.1 63.0 C5 76.5 64.4 T111 6 I � I I I I I PLAN AS -BUILT ♦( SCALE 1" = 30' I" -- — — — — — — — — — — — —-- _ — — — — j Page 2 of 3 PID No. 015-051-04 th VICHAEL E. ANDERSON No. CE -4381 i M Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage. AK. 99519-6655 .343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWO10463 rf 92. u PID No.: 015-051-04 e U ._ In of PROFILE AS -BUILT Scale: V - 10' FROM ALPIFF DRILLItG FPX N0. : 907 345 6202 Jun. 19 ;W2 12:02PM P1 Municipality of Anchorage Department of Health and Human Services 825'V Stmt P.O. Boz 198650 Anchorage, Alaska 91♦519.8650 wok tWwwer.err-*n0.atn Permit Number. #SW 010463 Date of laser- 11-"I Peed Ideattfieatlon Number. 015-051 Dasa Started: 1-802 Date Comipteied: l -q01 Is well located at approved permit location? ® Yes 0 No IAO Desaiption: Lot 7 Autumn ridge Pterperty Owner Name & Addrea: Crown Pt>k*, tnC PO Boz 112313 Anchorage, Ak 99511 Borehole Data: Soil TYpr. Thies cu & Water Strato atkk-vp Depth (D) from To 0 2 Method of Drilling ® air rotary Q enbk pool Catalog Wan ThkJ mss: .025 mebm organ/ W 2 4 Dituneter. 6 imhes Depth: W fag gravelysNt 4 36 Liner Type: silty sandy grevet H2a,%= stn gravoty slit srlry grovel 56 61 87 F1 61 87 61 135 Diameter inches Depth feet Casing stickup above ground: 2 fxt Statle water levet (from ground kvrl): 7.I1fect �pmg kveL•.Za&et t� 2 homy PurnPing 29 gpm sUrty sand ygravol- wet 135 142 Reeovay Rste: LO Spm alit 142 151 Method of Testiapl:!� silty co00lygravel 151 238 Well Intake OpeaEng Type - water sand & gravel 238 242 ®Open End Q Open Hole Q Screened Start fed Stepped fed. ❑ Perforations Startfret Stopped fat Croat Type j ermaele 9 8 V ohne•. Lb= Depth: Start.0fret Stopped ± fat ramp: Intake Depth _ feet stu Brand Name Well Disinfected Upea Completion? ® Ya Q No Method of Dhltafevdoo: gA2 teDlets Comments: We! Driller. Alpine Dnlfutg & Enterprises P 0 Box 110496 Ancboroga AK 99511 AtumiDn: The well drilla shall provide a well log to the property owner within 30 days of oocnp1edon and the property rn ~ tt.. oolt AOL+ eh.11 .wepAt- • wtl 4... r.. 4... Itis ..rn"hh A A... R'....,.r« v.Nl.:n l.Ih Al nFH.w.nt. ; ... MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ( WATER SUPPLY PERMIT Initial Permit Number: SWO10463 Legal Description: T12N R3W SEC 15 NE4 PTN Date Issued: Nov 08, 2001 Expiration Date: Nov 08, 2002 Parcel ID: 015-051-04 Design Engineer: 0014 Anderson Engineering Site Address: 005400 ABBOTT RD Owner Name: Crown Pointe, Inc. Lot Size: 40516 SO. FT. Owner Address: PO Box 112313 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99511-0000 This permit is for the construction of: LVj Disposal Field Q Septic Tank E] 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. This permit issued for Autumn Ridge Lot 7, under the original PID# for T12N SEE fu6 /NEE/?s 666 -CHF -t9 /�MEapEp !i IM-CKFD. Received By: Issued By: 19Esi #V VAMP Date: I -_a 8<2)t -'<2` Date: f/— 6 —Q/ Municipality of Anchorage Development Services Department Building Safety Division Onsite 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 SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. b/ - bsi— &y Permit Number SWO/D4L3 Property owners) Crown Pointe, Inc. Day phone 345.6277 Mailing address (1) P.O. Box 112313 Anchorage, AK 99511 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 7. Autumn Ridge Subdivision Legal description (Section, Township & Range) Lot Size 40,516 S.F. Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Four Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool p 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. G (Signature of property owner or authorized agent) Permit Fees: "� Date of Payment: Receipt Number: (Rev. 12/00) 11 7q Waiver Fees: Date of Payment: Receipt Number. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: January 16, 2002 TO: Dan Roth n FROM: Mike Anderson, P.E. SUBJECT: Lot Lot 7, Autumn Ridge Subdivision Septic System Construction Permit The test hole placed on Lot 7, Autumn Ridge Subdivision at the revised septic system location will be monitored for groundwater over the next few months. If groundwater develops within 4' of the bottom of the trench it will be reconstructed to insure a minimum 4' separation. Water monitoring results will be forwarded with the certified as - built of the new septic system. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) January 4, 2002 Municipality of Anchorage Building Safety Division On -Site Water and Wastewater Program 4700 S. Bragaw Street Anchorage, AK 99507 Attention: Dan Roth Subject: Lot 7, Block 1, Autumn Ridge Subdivision Onsite Septic System Construction Permit SWO10463 Change Order Dear Dan: The owner of Lot 7, Block 1, Autumn Ridge Subdivision intends to revise the location of the septic system absorption trench to save several trees on the lot. Relocation of the trench will also place it closer to the septic tank decreasing the possibility of plugging of the effluent delivery line in the future. A new Test Hole No. 71A was recently placed on the lot at the location of the new absorption trench. Soils in the hole were found to be similar to those in the other two test holes on the property. The absorption rate of the material at the trench elevation was found to be 13 minutes per inch. The dimensions of the trench will be the same as those originally designed. No groundwater was found in the hole during excavation. None is anticipated during the monitoring period, but a tube was placed to the bottom of the hole to allow for future inspection. We hereby request a change order be issued to the original permit to construct the absorption trench at the location shown on the attached drawing. Please call if you have any questions or require additional information. Sincerely, Michael E. Anderson, P.E. Attachments .00.081=a n .9 dP N DEMUR LANE o S 03°20'09"E 94.12' n W r' _1.1i1M QT1Y0� _ _ Four Bedroom Bome W Z 6' 0 Ci d to OP h N D in p J - 7 . Z 0 O N• z . CO 1,250 Callon tSeptic Tank w ' T1171 A o Q' Z Lon 47' Lon X 3' Wide Z a X 8' Absorpt Depth on Trench .. o�W G Q dP u TII71 da N TH1 6 a+ w_aa�1=:a1 OF A f sQp Alternate Site Z 0 R O' Li cn ��• oa,MICHAEL E. ANI! ERSCH CF_4381 w SITE PLAN Q :<_ 144®,-i ......N�ooy SCALEI"=30' �' .067.b 1 3..00.00.00 N LOT 7, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: Four Bedroom Home Perc. Rate: 1 to 24 MinAnch Avg. Application Rate: .8 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gallon Septic Tank 8' Drain Field Rock 4 Bedrooms X 150 GPD 1.8 GPD/SF = 750 SF of Absorption Area 750 SF/16 SF/LF = 46.9 LF Trench Length Therefore: Construct An Absorption Trench 47' in Length by 3' Wide With 8' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground. Total Depth of Trench to Be 11' from Existing Surface. Mound Over Trench if Necessary to Provide Minimum Cover of 3'. TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. ."` CFOF -......°e� Natural '2 ;;:..: . qtr,•'' f + 61 „" P Op Backfill. ' . :. :• Minimum 100' Separation From Wells in the Area. •ANDERSON Geotextile' 6..:..=: 0"• -4381 O "4" Perforated ; _ •`' PVC (Slots ,Doom) v 8' . .. Drainaeld" ' , " i .Rock : • .. . • ....% , 3' TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. ."` CFOF -......°e� Minimum 6 Separation From Bedrock. . qtr,•'' f + Minimum 10' Separation From Lot Line. „" P Op Minimum 4' Separation From Groundwater. vyG?: 4q IN *1 * Minimum 100' Separation From Wells in the Area. •ANDERSON V�t'�MICHAEL :� A CE 0"• -4381 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: Lot Z. Block 1. Autumn Ridge SLOPE OG/PT Silty Gravel Sand GM Bottom of Hole Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 10/28/01 Date Performed: SITE PLAN See Site Plan OF 4911� r'. • MICHAEL E. ANDERSCN . ^-'�' CE -4381 1/4/02 ,01`PROFESStOo oma' It'��o� o Reading Date Gross Time Net Time Depth To Water Net Drop 1 4 -Jan 11:10 1.75" 2 11:40 30 4.25" 2.5" 3 11:41 1.75" 4 12:11 30 4.13" 2.38" 5 12:12 1.75" 6 1 12:42 30 4.13' 2.38' Pem. Rate: 13 Min./Inch Perc. Hole Diameter. 8" Test Run Between 5 FL and 6 Ft. Comments: Soils Encountered are Similar to Those in Testholes 16 and 71. Test Hole Pre Soaked Prior to Testing. Performed By: Mike Anderson- I, Micha I . And rson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/4/02 ANDERSON'. ENGINEERING P-O BOX 240773 ANCHORAGE, AK 99524 522-7773 11: 522-6779 (FAX) October 23, 2001 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 7, Autumn Ridge Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. The owner of Lot 7, Autumn Ridge Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be Issued for the construction of a new well and septic system to serve the proposed home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the location of the new well on the lot and the test hole locations. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were placed near the location of the proposed absorption trench. These test holes indicate well graded to poorly graded gravel with silt and some sand near the location of the new absorption trench. Percolation tests in the material resulted in rates of less than 1 to 24 minutes per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a deep absorption trench system with 8' of gravel beneath the distribution pipe. The total depth of the trench will be 11'. The distribution pipe will be placed at 3' below the ground surface to provide sufficient drop from the septic tank to the absorption trench. The total length of the new absorption trench will be 47'. The majority of the trench will be centered around Test Hole No. 16 which has a percolation rate of less than 1 minute per inch. We are using an application rate of .8 gallons per day per square foot, however, as a small portion of the trench is covered by Test Hole No. 71 which has soils with a slower percolation rate. The ground surface on the lot slopes as shown on the attached Site Plan with very little to no slope near the proposed septic system site. The new absorption trench will be constructed on a fairly flat surface in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system will be constructed 100' from the well to be constructed on the lot. If the system is constructed in accordance with our design the following statements apply: Lot 7, Autumn Ridge Subdivision October 23, 2001 Page Two 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, 1b�� �S.lt1eQ� OF n uw Michael E. Anderson P.E. ",I,. e STH j .z J . Attachments' �: fi...., ...#...cn..... NXIIAEL E. AUDFMCV :, s� • CC -4331 e�`t��LnasSo•G���` I I • I I I I C"b wf < l 392.9 j ABBOTT s»ROAD a or `' 1 �• Vol / DEDICA ,.sem L -=y. T sr^ _ , �li.s C _ ,tece y Treea I ;<Is� =U.s _ _ _ Z 101 — _ Efl7Sd ,T _ / Pa Ares Tread T ,_ I I •� 3 .2 w.. 1 tn ` I � �(�I4°p0�j j. 4.0 r..1) I-(` / ' 4�• T (l /� 45,474 ft. C"rill ra -tan z^ rmx \*BQ OA(1 40,381 sq.ft ! \ `+' TH-12 / Wert 4C 2 s 296.4 �� � � , •. SII az?ej 3 8 rear. �' •. � n j !� 6 '/4 / ; \� 40,196 s it. �;X\ !!! I 7W-14 1 +I q 1 pec: 4E OO \f.35a �n e \ l.• �)�. Thi •aw. Pro? �i _ ..i_Y—` 5 1.�� Deter. -1 40,516 �� ��•.�`.\; nest I ao:eq \1 ��. 390 � � �4� �; • y ,�� A ��1= 44.111 s .ft t.AREA ZIEMLAK LANE 0 M R .00.08 t=N .9b't£=l S 03°20'09"E 94.12' n PrWpll d 2 ap o- K N � ry U d s AMM MVM 1 Four m ' Bedroom ^� Home z bel 1 . 1 1 ' 1 1 1 1/ ZEE- � F 9r P' m AlICN'cL E. A\7:RSC?1 w �so CE -4231 so Fn o� O N N 1,250 Gallon Sep-tSeptic Tank w W O O O O O � O O O e O O 01 Z � Z v e n 47• Lonq X 3' Wide o� X 8' Eff ctive Depth- E,p' ¢o v Absorpti n Trench o <a TH71 _ Ldp z N ®N n TH1 6 0' Alternate Site o to -1 VI mw p 0 SITE PLAN SCALE 1" = 30' ai n .067b L 31100.00°00 N LOT 7, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Pere. Rate: 1 to 24 Min./Inch 1,250 Gallon Septic Tank Avg. Application Rate: .8 GPD/SF 8' Drain Field Rock 4 Bedrooms X 150 GPD /.8 GPD/SF = 750 SF of Absorption Area 750 SF/16 SFILF = 46.9 LF Trench Length Therefore: Construct An Absorption Trench 47' in Length by 3' Wide With 8' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground. Total Depth of Trench to Be 11' from Existing Surface. Mound Over Trench if Necessary to Provide Minimum Cover of 3'. TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. ``� QF . ^ ! • ` �, Minimum 6' Separation From Bedrock. �.•' Minimum 10' Separation From Lot Line. ,^ ' Minimum 4' Separation From Groundwater, V*: Minimum 100' Separation From Wells In the Area. ,`,.' .... ::z:C, �� :r: CE -4391 'Natural 2'Go: Backfill. ''Geotextile'' •.,Fabric: 'O 9" Perforated' `'' PVC (Slots Down) '..� w Drainfield Rock'. • i o /J.. �rYl 31 TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. ``� QF . ^ ! • ` �, Minimum 6' Separation From Bedrock. �.•' Minimum 10' Separation From Lot Line. ,^ ' Minimum 4' Separation From Groundwater, V*: Minimum 100' Separation From Wells In the Area. ,`,.' .... ::z:C, �� :r: CE -4391 1 OG/PT 2 -3 T THO NO 16 4 5 6 GP/GM . 7 ' ' GM 15 Tan 16 1 1 Was Groundwater. Encountered? •• If Yes, What Depth? .:��P'•• _ i.rel, Municipality of Anchorage part Dement of Health 8 Human Services av(� C �f<M r.� •f 825 L Street, Anchorage, AK 99502-0650 0j r aJCW 21. E. AI:1)E2SC3••� SOILS LOG - PERCOLATION TEST0� �l ;• CE -4331 •: 4.Y Performed For. Bob Kle IQC9FpP•.....•N�`..v n Date Performedalpyll. Legal Description: Lot 7. Autumn Ridge Subdivision SLOPE SITE PLAN 1 OG/PT 2 -3 T THO NO 16 4 5 6 GP/GM . 7 ' ' GM 15 Tan 16 1 1 Was Groundwater. Encountered? No . If Yes, What Depth? .Depth to Water After Monitoring None Date: 122/00 5/11/ni nvre 19 Perc. Rate: LT 1 MiriAnch. Perc. Hole Diameter • 6• Test Run Between "4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A. Harsla. I, Michael F Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1120100 Legal Description: Lot 7. Autumn 9 . S ,bdivi 1 n PTIOL TESTHOLF NO 71 " .4 GM/SM 11 Was Groundwater Encountered? No Net. Time eOF4 Net Drop .......... 4?'� .13 -Dec 1:12 After Monitoring None 2.88' Date: 122100 Municipality of Anchorage "' 30 Department of Health & Human Services P�:�.G. ist^N , 825 L Street, Anchorage, AK 99502-0650 C � : ANUS! FL E. 00 SOILS LOG - PERCOLATION TEST �,''. CE - 42 3 t �@ ��'• ` ."• . 0404 pR9Pr_S'SIO•;•�o':• Performed For. Bob Klein Date Performed: .42/11I9�3 Legal Description: Lot 7. Autumn 9 . S ,bdivi 1 n PTIOL TESTHOLF NO 71 " .4 GM/SM 11 Was Groundwater 15 .1fi •.: 18I U Bottom of 19 Hole Perc. Rale: 24 MinAnch Perc. Hole Diameter. 6" Test Run Between 5 FL and 6 FL Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harah I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date:. 120/00 . Reading Encountered? No Net. Time If Yes, What Depth? Net Drop Depth to Water .13 -Dec 1:12 After Monitoring None 2.88' Date: 122100 -2 5 11 O1 15 .1fi •.: 18I U Bottom of 19 Hole Perc. Rale: 24 MinAnch Perc. Hole Diameter. 6" Test Run Between 5 FL and 6 FL Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A Harah I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date:. 120/00 . Reading Date Gross Time Net. Time Depth To Waler Net Drop 1 .13 -Dec 1:12 2.88' -2 1:42 30 4.75" 1.88" 3 1:43 .2.88"' 4 2:13 30 3.19" 1.31" 5 2:14 2.75" 6 2:44 ' • 30 4- • 1.25" ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 7, AUTUMN RIDGE SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 47' long X 3' wide X 8' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 3' below the existing ground surface. Total depth of the trench will be 11' below the existing ground surface. The new absorption trench must be placed outside the 100' protective radii of wells in the area. 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 1,250 -gallon septic tank must 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 shalt 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. 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. Lot 7, Autumn Ridge Subdivision October 23, 2001 Page 2 of 3 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 level. 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 trench 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, Femco, or equal). Lot 7, Autumn Ridge Subdivision October 23, 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 �, `' On-Site Water and Wastewater Program K ■. Olt (907)343-7904 a Au u V r Certificate of On-Site Systems Approval << 151GJ � Ol 6 g L.(1 Parcel I.D. 4'1.054-10 Expiration Date: Mir. — 1. GENERAL INFORMATION Complete legal description Autumn Ridge; Lot 7 Location (site address) 9398 Autumn Ridge circle *Anchorage 99507 Current Property owner(s) Joseph Dobrzynski Day phone 907-868-7736 Mailing address Real Estate Agent Barbra Ramsey Day phone 907-261-7553 2. TYPE OF DWELLING: ® Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual a Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for:N/A Distance:N/A Received by: L L ... — Date: 5 bo//4. NEP COSA to be released to the ng f er,unl erwise requested by the engineer. COSA Fee $ a-ev Waiver Fee $ Date of Payment RSI Lf hi Date of Payment' Receipt Number CO a '(O& Receipt Number COSA# SC(.1 'i? 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 E. Tudor Road, Suite 101, Anchorage AK, 99507-1259 Engineer's Printed Name Jeffrey A. Garness Date 8/3 49- 1 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic _soist*ti i M, system in accordance with the guidelines and regulations established by the Municipality of 4 { OF Anchorage and industry practices. The reported results describe the condition of the system/s on the ••�1��` .. ,..•• 1 date/s of the evaluation. Separation distances were measured to readily identifiable features. , '_"Sr.. '•• '•1•� 1 Hidden defects or encroachments may exist that were not identified during the evaluation.n desr ` �1 operational life of all wells and septic systems depend on a variety of variables including, but not " * # limited to,soil conditions,groundwater levels(that may fluctuate during the year), quality of 4. • 1..i f construction(materials and workmanship), and the water usage of the family utilizing the system/s. K - 'I 10 These conditions can vary, and are outside the control of GEG. Satisfactory test results do not �•— ... . guarantee future performance of the system/s;therefore, GEG makes no warranty(express or �l 1. la .� implied)regarding the future performance of the well or septic system. GEG makes no ,)e- - A.Games: representation whether an alternative well or septic system can be installed on the property in the 0O " ''' CE-7' i event either of the current systems fail. The content of this report is for the sole benefit of the v **,, / ��.•,' �� person/party who retained GEG. Reliance upon the information provided in this report by any other 44, ,'••1 ,i �..••' `c%49� person or party,including but not limited to subsequent property purchasers,is not authorized.in ♦+� PROF E5S1�¢�4. short, GEG disavows any legal duty to anyone other than the person/party who paid for this report. 4 N II 1111111‘106-•.06. 6. DSD SIGNATURE System#1 Approved for bedrooms ^�Y,1. ', F,;, System#2 Approved for bedrooms •.: hG;_ Olv:ATTEER , Disapproved WATEAND r) Conditional approval for bedrooms, with the followint stiWdliit `JROG:RAP„,i ,,;c' By: � / ,11::' Original Certificate Date: 0 —I 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 COSA blue sheet 9-1-t2.doc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: AUTUMN RIDGE; LOT 7 Parcel ID: 051-054-10 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID# N/A Well Log (YIN) YES Date completed 1/9/02 Sanitary seal (YIN) YES Wires properly protected (YIN) YES Total depth 242 ft. Cased to 242 ft. Casing height (above ground) 184- in. FROM WELL LOG AT INSPECTION Date of test 1/9/02 3/17/16 Static water level 213 ft. 206.5 ft. Well production 20 g.p.m. 5.44- g.p.m. WATER SAMPLE RESULTS: Coliform ND colonies/100 ml. Nitrate 0.496 mg./L. Collected by: GEG. Ltd. Arsenic: <5 ug./L. Date of sample: 7/26/2017 B. SEPTIC/HOLDING TANK DATA *HOME HAS BEEN VACANT SINCE 7/1/2016 (SEE ATTACHED EMAIL) Tank Type/Material SEPTIC/STEEL Date installed 1/8/02 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping *4/6/2016 Pumper *A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 1/8/02 Soil rating (g.p.d./f(204Z/bdrrr 0.8 System type DEEP TRENCH Length 48 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth *8.16 ft. Eff. absorption area 768 ft2 Monitoring tube *YES Depression over field NO Date of adequacy test 3/31/16 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test *0 in. Water added 1290 gal. New depth **10 in. Elapsed Time: 120 min. Final fluid depth **0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date — *BELOW EXISTING GRADE TO BOTTOM OF MT. MT ONLY EXTENDS 3.17' INTO THE EFFECTIVE DEPTH **LAST 900 GALLONS INTRODUCED CAUSE A RISE OF 7 INCHES. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump off" level . High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100 + On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS ,,d600pp� G. ENGINEER'S CERTIFICATION �� OFA ‘,5„19,\c„.... 4'`Ar0 01, I certify that I have determined through field inspections and * ; 91 ‘,`"-.157;Vo review of Municipal records that the above systems are in • d conformance with MOA COSA guidelines in effect on this ,/I Q date. ''•,J- r• •. cines O Engineer's Printeddf Na e JEFFREY A. GARNESS 00 (E— g 3 fop 3 I Date �' aPrOfess'orio4o �D000. , Lg #AECC884 (Rev. 11/05) Municipality of Anchorage Development Services Department i Building Safety Division' On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite ` (907) 343-7904 \V CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ,rte Parcell.D. n����i}%�0 COSA# OJZO� Lfq 1. GENERAL INFORMATION Expiration Date: 9-2-07 Complete legal description AUTUMN RIDGE SUBDMSION: LOT 7 Location (site address) 9398 AUTUMN RIDGE CIRCLE * ANCHORAGE. AK 99516 Community Class Well ❑ Public Water System Current Property owner(s) CRAIG & KATHLEEN WIGGS Day phone 336-2024 Mailing address Lending agency Mailing address Real Estate Agent Mailing address 9398 AUTUMN RIDGE CIRCLE • ANCHORAGE. AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well N 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 ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat 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 riles and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date _ 3 o 0 Conditional approval for bedrooms, with the fllowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other ttlt(wnurft", ``ltl Y OFgN ON-SITE ; c WATER AND ; rn= : WASTEWATER PROGRAM By: Original Certificate Date: .67' -2-- 0 (Rw. 17A5) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragew Street P.O. Box 195650 Anchorage, AK 99519-6850 www.muni.org/onske (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: AUTUMN RIDGE SUBDIVISION: LOT 7 Parcel ID: A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 1/9/2002 Sanitary sea[ (Y/N) YES Total depth 242 ft. Cased to 242 ft. FROM WELL LOG Date of test 1/9/2002 Static water level 213 ft. Well production 20 g,p,m, Well Log (Y/N) YES Wires properly protected (YM) YES Casing height (above ground) 18+ in. AT INSPECTION 11/6/2006 208 ft. 6.5 g.p.m. WATER SAMPLE RESULTS: Coliform C colonies/100 mi. Nitratd0_13_5 mg./L. Other bacteria colonies/100 mi. Arsenic: &Q-ug./L. Date of sample: 4/16/2007 Collected by: GEG Ltd. B. SEPTIWHOLDINO TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 1/8/2002 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YM) YES Depression over tank (YM) NO High water alarm (Y/N) N/A Date of pumping 10/26/2006 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA Date installed 1/0/2002 Soil rating .p.d. r ft'/bdrm) 0.8 System type DEEP TRENCH Length 48 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth '_3ft. EN. absorption area 768 ft' Monitoring tube YES Depression over field NO Date of adequacy test 11/6/2006 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 24 In. Water added 735 gal. New depth 40 in. Elapsed Time: 170 min. Final fluid depth35 in. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N 'Pump on" level at _in. "Pump off" ley High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO Septic tankilift station on lot t 00'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10,+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property rt line t0'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingivehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION " I certify that I have deterrnined through held inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. �. ess. D ' En9 neers Printed Name JEFFREY A. GARNESS j 79 3 �e,• ' X13°�°�••��� Date 413 0 /0 o /eeelo�o\ COSA Fee S Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11105) SGS Rete 1071548001 Client Name Gamcss Engineering Group, Ltd. Project Name/p Autumn Ridge SD Lot7 Client Sample ID Autumn Ridge SD Lot? Matrix Drinking Water P%% SID 0 All Dates/Times are Alaska Standard Time Printed Date/Time 04/302007 9:01 Collected Date/rime 04/162007 9:15 ReceivedDate/Iime 04/162007 11:30 Technical Director Stephen C. Ede Samplc Rcmarks: 300.0 - Delectable amount of chloride in the initial calibration blank; the concentration of chloride in the sample is IOX greater. Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limns Date Date Inn Metals Department I lardncss as CaCO3 96.8 Waters Department Nitrate -N 0.235 Nitrite -N ND Private Individual Analvsis Aluminum ND Antimony ND Arsenic ND Barium ND Cadmium ND Calcium 21400 Chromium ND Copper 203 Iron ND Lead 0.221 Magnesium 10500 Manganese 2.40 Phosphorus ND Chloride 2.67 Fluoride ND Potassium 1210 Selenium ND Sodium 4350 Silicon 5530 5.00 mg/L SM202340B C 04/18/07 0429/07 TK 0.100 mg/L EPA 353.2 D 04/17/07 IDS 0.100 mg/L EPA 353.2 D 04/17/07 JDS 20.0 ug/L EP200.8 C 04/18/07 0429/07 TK 1.00 ug/L EP200.8 C (<6) 04/18/07 0429107 TK 5.00 ug/L EP200.8 C (<I0) 04/18/07 0429107 TK 3.00 ug/L EP200.8 C (0000) 04/18/07 0429107 TK 0.500 ug/L EP200.8 C (<5) 04/18/07 0429/07 TK 500 ug/L EP200.8 C 04/18/07 0429/07 TK 1.00 ug/L EP200.8 C (<I00) 04/18/07 0429/07 TK 1.00 ug/L EP200.8 C (<1300) 04/18/07 0429/07 TK 250 ug/L EP200.8 C (<300) 04/18/07 0429/07 TK 0.200 ug/L EP200.8 C (<15) 04/18/07 0429/07 TK 50.0 ug/L EP200.8 C 04/18/07 0429/07 TK 1.00 ug/L EP200.8 C (<50) 04/18/07 0429/07 TK 200 ug/L EP200.8 C 04/18/07 0429/07 TK 0.100 mg/L EPA 300.0 B (<250) 04/17/07 04/17/07 JDS 0.100 mg/L EPA 300.0 B (Q) 04/17/07 04/17/07 JDS 500 ug/L EP200.8 C 04/18/07 0429/07 TK 5.00 ug/L EP200.8 C (<50) 04/18/07 0429/07 TK 500 ug/L EP200.8 C (!50000) 04/18/07 0429/07 TK 200 ug/L EP200.8 C 04/18/07 0429/07 TK SGS Reta 1071548001 Client Name Gamcss Engineering Group, Ltd. Project Name/N Autumn Ridge SD Lot? Client Sample ID Autumn Ridge SD Loll Matrix Drinking Water PWSID 0 All Dstes/Pimes are Alaska Standard Time Printed Date/Time 04/30/2007 9:01 Collected DatefTime 04/16/2007 9:15 Received Date?ime 04/16/2007 11:30 Technical Director Stephen C. Ede Allowable Prep Analysis Parameter Results PQL Units Method Container ID Limits Date Date Init Private Individual Analvsia Silver Thallium Sulfate Zinc Total Dissolved Solids Nickel I ICO3 Alkalinity CO3 Alkalinity 011 Alkalinity Conductivity pll Alkalinity Total Coliform ND 1.00 ug/L EP200.8 C (400) 04/18/07 04129/07 TK ND 1.00 ug/L EP200.8 C (Q) 04/18/07 04/29/07 TK 7.58 0.100 mg/L EPA 300.0 D (Q50) 04/17/07 04/17/07 1DS 8.78 5.00 ug/L EP200.8 C (<5000) 04/18/07 04/29/07 TK 131 10.0 milli, S\120 2540C D (<500) 04/17/07 KP ND 2.00 ug/L EP200.8 C (400) 04/18/07 04/29/07 TK 108 10.0 mg/L SN1202320B D 04/23/07 KP ND 10.0 mg/L S%120 2320B D 04123/07 KP ND 10.0 mg/L SM20 23206 D 04/23/07 KP 210 1.00 umbos/cm SM2025JOB D 04/23/07 ACF 7.50 0.100 piIunits EPA 150.1 D (6.5.8.5) 04/16/07 KP 108 10.0 mg/L SM20 23206 D 0423/07 KP 0 coVlOOmL SM20 9222B A (<I) 04/16/07 DLC Municipality of Anchorage KlaUtt'i Development Services Department Building Safety Division Onsite 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 FOR A SINGLE FAMILY DWELLING Parcel I.D. /)I5 `b6lf iU COSA# 0005i�, 1. GENERAL INFORMATION • Expiration Date: P_ k% Complete legal description AUTUMN RIDGE: LOT 7 Location (site address) 9398 AUTUMN RIDGE CIRCLE • ANCHORAGE. AK 99516 Current Property owner(s) CRAIG & KATHLEEN WIGGS Day phone 336-2024 Mailing address 9398 AUTUMN RIDGE CIRCLE • ANCHORAGE. AK 99516 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: 4 3. TYPE OF WATER SUPPLY: Individual Well N Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage riles and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Date 11/21/0 Engineers Comments: In conducting this evaluation, GEG, LID. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines b Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory lest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will H confer any legal right whatsoever. 5. DSD SIGNATURE --� Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the filowing CA p , t pgSEwAT J . N ZN 1.4 Attachments: COSA Checklist x Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Reort Nitrate Advisory Other By: Original Certificate Date: ))4Zr6Lm (Rw.1 M) Municipality of Anchorage Development Services Department Building Safety Division Onsite Water 6 Wastewater Program 4700 Bragaw Street P.O. Box 19M Anchorage, AK 99519-WSO www.munLorglonsite (907) 343-711% CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: AUTUMN RIDGE SUBDIVISION: LOT 7 Parcel ID: 015 -05q -/O A. WELL DATA Well type PRIME If A, B, or C provide PWSID# N/A Date completed 1 /9/2002 Sanitary seal (Y/N) YES Total depth 242 ft. Cased to 242 ft. FROM WELL LOG Date of test 1/9/2002 Static water level 213 ft. Well production 20 g.p.m. WATER SAMPLE RESULTS: Coliform Q_ colonies/100 ml. Nitrate DJWMJL. Well Log (YM) YES Wires property protected (YM) YES Casing height (above ground) 18+ in. AT INSPECTION 11/6/2006 206 ft. 6.5 g.p.m. Other bacteria _ 10 _oolonies/100 ml. Arsenic: IV 1/ ug./L. Date of sample: 11 /6/2006 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 1/8/2002 Tank sae 1250 gal. Number of Compartments E Cdeanouts (YM) YES Foundation cleanout (YM) YES Depression over tank (YIN) NO High water alarm (YM) N/A Date of pumping 10/26/2006 Pumper A+ HOME SERVICES Date installed 1/8/2002 Sod rating .p.d. ft'/bdrn) 0_8 System type DEEP TRENCH Length 48 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth *13 ft. Elf. absorption area 768 fe Monitoring tube YES Depression over field NO Date of adequacy test 11 /6/2006 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 24 in. Water added 735 gal. New depthNO in. Elapsed Time: 170 min. Final fluid depth 35 In, Absorption rete >- 600+ g,p.d. Any rejuvenation treatment (past 12 mo.) (YM 8 type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at _in. "Pump off' leve High water alarm level at in. Cycles tested Meets alar & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAiR station on lot t 00 + On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/deanout N/A Holding tank N/A Animal containment areas 50'+ Manurelanimal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 100+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parldnglvehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEERS CERTIFICATION 1 car* that 1 have detemdned through field inspections and review of Municipal records that the above systems are in conformance with MOA COSH guidelines in effect on this date. arness: Engineer's Printed Name JEFFREY A. GARNESS CE -793 Date It / Z / fp8 Pr ..... A('d COSA Fee $ -/ L? C) C) Waiver Fee $ _ Date of Payment �T �(� Date of Payment Receipt Number ) 14 3 'g o Receipt Number (Rev. I IMS) wqi SGS RetN 1066677001 Client Name Gamess Engineering Group, Ltd. Project Name/# Autumn Ridge Lot l Client Sample ID Autumn Ridge Lot 7 Mattis Drinking Nater All Datevrimes are Alaska Standard Time Printed Date/time 11/15/2006 16:30 Collected Date/time 11/06/2006 14:45 Received Date/Time 11/06/2006 15:12 Technical Director Stephen C. Ede Sample Remarks. Parameter Ailossxabte Results PQL Units Method Container ID Limits Prep Date Analysis Date Init Metals by SCP/MS Arsenic Waters Department Nitrate -N Microbioloav Laboratory Total Coliform ND 5.00 0.362 0.100 0 ug/L EP200.8 mg/L EPA 353.2 C (<I0) II/09/06 11/13/06 TK D (<10) col/100ml. S\720922211 A (<I) 11/07/06 ALR 11/06/06 Drr g z a (A C) 3-IC)Hlo MY 11 31Z 27.4• 27.4' c c Z i� T00 in KOTIVHOIJIH do Mt 69S 106 XYd 6S:TT 900Z/6T/TT 9 ♦.b A _,,10' T. do E.. ESMT. r---- i t t t t i i t ----------------- z • . %. pr • •� . y1 0 � g z a (A C) 3-IC)Hlo MY 11 31Z 27.4• 27.4' c c Z i� T00 in KOTIVHOIJIH do Mt 69S 106 XYd 6S:TT 900Z/6T/TT N 00.08'29"W 143.58' _,,10' T. do E.. ESMT. r---- i t t t t i i t ----------------- z t t t t t t t t y1 0 � g �1 rn (*T t N a, 4 • f r � 1 u.o' g z a (A C) 3-IC)Hlo MY 11 31Z 27.4• 27.4' c c Z i� T00 in KOTIVHOIJIH do Mt 69S 106 XYd 6S:TT 900Z/6T/TT c Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Ancho;age, 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 1. GENERAL INFORMATION Complete legal description Lot 7 Autumn Ridge Subdivision Location (site address or directions) Ziemlak Circle HAA # Expiration Date: 11% Qjc Current Property owner(s) Crown Pointe. Inc. Day phone 727-8167 Mailing address 5400 Abbott Road Anchorage, AK 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Four 4 g,?-az_- TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ID ❑ Individual Holding tank ❑ ❑ Community On-site ❑ ❑ Public Sewer ❑ 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 date 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 Engineer's Printed Name Michael E. Anderson, P.E. Date 81712002 5. DSD SIGNATURE t V Approved for ! bedrooms. .. tet.•.. _ Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: j^ i Original Certificate Date: 0C(OZ IR" 1200) Municipality of Anchorage o• Development Services Department Budding Safety Division On -Site Water & Wastewater Program 4700 South Bragaw Sl. P.O. Box 1966.50 Anchorage, AK 99519.6650 www.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 7 Autumn Ridge Parcel ID: 015-051.04 A. WELL DATA Well type Private Date completed 11912002 Total depth 242 ft. If A. B, or C provide PWSID # _ Sanitary seal (Y/N) Y Cased to 242 ft. FROM WELL LOG Date of test 11912002 Static water level 213 ft. Wed production 20 g.p•m. WATER SAMPLE RESULTS: Well Log (YIN) Wires properly protected (Y/N) Y Casing height (above ground) >24 in. AT INSPECTION ft. g.p.m. Coliform 0 coloniesl100 ml. Nitrate .378 mg -A. Other bacteria -L colonies/100 ml. Date of sample: 8/702002 Collected by: MEA B. SEPTICI HOLDING TANK DATA Tank Type/Material Se0ddSteel Date installed 11&2002 Tank size 1.250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 1188002 Soil rating (g.p.dJW or ft'/bdrm) .8 GPDISF System type Deep Trench Length 48 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 13 ft. Eft. absorption area 768 ft' Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For —bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date W D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at _ in. 'Pump off level at —in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main WA Sewer /septic service line >25 On adjacent lots >100' On adjacent lots >iW Public sewer manhote/deanoul WA Holding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >Y Absorption field >5' Water main WA Water service line >10' Surface water >100' Welts on adjacent lots MW SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water. >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots>1190' F. COMMENTS (Rev. 12100) in. ^ G. ENGINEER'S CERTIFICATION Fes~ .�.......: ^ I cer* that I have determined through field inspections and c• •' fir? 4911! review of Municipal records that the above systems are in r conformance with MOA HAA guidelines in effect on this date. j Engineer's Printed Name Michael E Anderson. P.E�C, rw k:CH,:a s : C1-43 ° G 1 Dale/11711002 v `f �EJ�� pROFESS10a^moo` HAA Fee $ Waiver Fee $ Date of Payment � � p Date of Payment Receipt Number . Receipt Number (Rev. 12100) in.