HomeMy WebLinkAboutDEARMOUN ESTATES BLK 1 LT 5r.)eArmoun
Estates
Block i
Lot 5
#017-152-26
k�v uJIU411o/
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page of
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP211059
PID Number: 01715226000
Dwelling: ❑■ Single Family (SF)
❑E with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade
Name
Cal & Fran Dunham
ABSORPTION FIELD
❑ Deep Trench ❑[• Wide Trench E:1 Bed E:1 Mound
Site Address
6700 Dearmoun Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
907-720-6128
4
2 GPD/SF
8.5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.5-4.5 Ft.
Gravel depth beneath pipe
4 Ft.
Subdivision
Block Lot
Dearmoun Estates
1 5
Fill added above original grade
1 +/- Ft.
Gravel length
30 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
300 Ft2
1
Ft.
Well
127'
141'TANK
I] Septic ElS.T.E.P. E]Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1500 Gal.
Surface Water
N/A
N/A
Material
Number of compartments
Lot Line
33'
11.5'
NA
PE
2
Foundation
24.5'
48'
LIFT STATION
Manufacturer
Capacity
Remarks Separation distances accurate within one foot.
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank PVCTank to PVC
drainfield
Installer
Brownson Bros
Drainfield PVC CO/MT PVC
Inspector Grant Mathews, PE
BENCH MARK (Assumed elevation) 100 ft
Inspection ection 15` 4-26-21
4-28-21
Location and description
aro 5-3-21
2nd
4115-5-21
Mark at NW Foundation Corner
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
,—�.�'%,
0F.A�gsi>il
AW
THTMATHEWS
I
CE7354a4
Septic S Ste
('+�Fc.
tlll`Fo
Approved �.
Date
ROF ss�oN`:=�
Note: this approval does not include well permit requirements.
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PROPOSED TRENCH DESIGN
SINGLE TRENCH
30' LONG x 5' WIDE x 4' EFFECTIVE DEPTH
ABSORPTION AREA = 500 SF
TOTAL DEPTH = 7' MIN BELOW GRADE
DESIGN
FOUR BEDROOM HOUSE
' 4"
PERC. RATE = 30-60 MIN/INCH PVCApp-/cunnm nur� = -_-(
= JDO SF ABSORPTION AREA
2 GPD/SF
300 SF - x 0.5 30 LF TRENCH LENGTH
5 SF PER LF
DATUM = 100.00
E5
C-)
4.C/
GRADE TO DRAIN
SCALE: NTS
INLET MIN COVER pU/-
p
RISER OVER TANK RISER-
�3' 99.15
FILTER
POD
TANK INLET
94.20
1500 GAL
POLYETHYLENE TANK
BASE ELEV = 88.70
TIVE SOIL,
COMPACTED
MIN COVER OVER
LO
CO3 | MT | |
TANK
OUTLET DRAIN ROCKINV 95-12
95.70
INV 95.15
o,oc cuc" = 9/.05
30 LF ABSORPTION TRENCH |
SEE CROSS SECTION DETAIL�
THIS SHEET
SCALE: NTS
�7�,�T7��T��Tl�x�TT�
^~ ^ , .~ ^ ^ , ^~ �� ^^^ �` `�, ^�^�~�
P.O. Box 111988
Anchorogo, A]onkn 99511
(907) 501-6537
www.trindok.onm
ASBUILT DETAILS
LOT 5, BLOCK 1 DEARMOUN
ESTATES SUBWASION
JOB No. 20-155 SHEET
SCALE: 1"=50' GRID: SW2636 i
House Detail
1 "=20'
Septic Detail
1 4" Diameter PVC
o
b
O
2.2' Diameter Manhole
neter PVC
,� 7 Vent
c�]—
�*<01T �Da as
Benjamin Holmstrom O.
VV ��
LS 118700 4L�Q
m
a1a�a '�.r����
OQrofe{s9lonat I��
�4000��4
Lot 6
u
8'X 13' shed
SEQUOIA ESTATES
SUBDIVISION
Lot 2
Lot 5
Block g/
35,691.6 sf
O �Y"
Legal Description:
As -built
Legend:
Set Rebar with
:.:....'�?� ':.:..
AL. Monument 0
Lot 5. Block L
Found Rebar
O
De Armoun Estates Subdivision
Monument
\�9W
.
Septic
Pavement
S
Survey Certification: I hereby certify that a Mortgagee's
Inspection was performed on the described property.
Overhang
OO+
existence of any easements, covenants, or restriction which
Wood Deck
\
Existing House
_
It is the contractor's responsibility to check to of foundation
P Y P
Concrete
:,few,._;•,:.,
grade &building setbacks in relation to property lines and
Fence
o 0
easements
Checked by. CB
Drawn by: AR
Scale: 1" = 50'
Lot 5
Block g/
35,691.6 sf
O �Y"
Legal Description:
As -built
Legend:
Set Rebar with
Cap O
AL. Monument 0
Lot 5. Block L
Found Rebar
O
De Armoun Estates Subdivision
Monument
well
.
Septic
Pavement
S
Survey Certification: I hereby certify that a Mortgagee's
Inspection was performed on the described property.
Overhang
Notes: It is the owner's responsibility to determine the
existence of any easements, covenants, or restriction which
Wood Deck
are not on the recorded subdivision plat.
_
It is the contractor's responsibility to check to of foundation
P Y P
Concrete
:,few,._;•,:.,
grade &building setbacks in relation to property lines and
Fence
o 0
easements
Checked by. CB
Drawn by: AR
Scale: 1" = 50'
Grid:
SW2939
Job: 2020-35
Field Book: 150-1
Plat: P-520
Date:
5/20/2021
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone:. (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP211059 Effective Date:
Work Type: Septic Upgrade Expiration Date:
Tax Code Number: 01715226000
Site Legal Address: DEARMOUN ESTATES BLK 1 LT 5 G:2939
Site Mailing Address: 6700 DE ARMOUN RD, Anchorage
Owner: DUNHAM CALVIN C & FRANCES J
Design Engineer: MATHEWS GRANT
This permit is for the construction of:
Cif Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy
S•
Depai-tnient
4/5/2021
4/5/2022
Lot Size in Sq Ft: 35692
Total Bedrooms: 4
❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received B)
Issued By:
Date:
Date:
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 017-152-26
Property owner(s) Calvin & Frances Dunham Day phone
Mailinq address 6700 Dearmoun Road, Anchorage AK 99516
Site address 6700 Dearmoun Road, Anchorage AK 99516
Legal description (Sub'd., Block & Lot) Dearmoun Estates, Block 1, Lot 5
Legal description (Township, Range & Section)
Lot Size 35,692 Sq. Ft. Number of Bedrooms 4 Total
APPLICATION IS FOR:
(® all that apply)
Absorption Field
0
Septic Tank
Fx_1
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage ❑
Initial ❑ Single Family (SF) 0
(w/wo ADU)
Upgrade � Duplex (D) El ❑
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable,Municipal Codes.
rty owner or authorized age
Permit/Rush Fees: 4 69 FJ
Date of Payment: 31519ZO—L
Receipt Number://�� C&(Jr' 3$
U
Permit No. J P 21 los-9
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
z�
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
C V� Topp 16rwwNsotA F09- C.c. Pit key T- q0-7 - 406 - OZq Z
EXCELLENCE IN CIVIL ENGINEERING SINCE 1982 • SITE PLANNING • CIVIL ENGINEERING DESIGN • PROJECT MANAGEMENT
ENGINEERING, LLC PHYSICAL MAILING OFFICE WEB
1300 E. 68th Ave., Suite 210 P.O. Box 111989 907-561-6537 triadak.com
Anchorage, AK 99518 Anchorage, AK 99511
April 5th, 2021
Municipality of Anchorage
Development Services
4700 Elmore Rd.
Anchorage, Alaska 99519-6050
Attention: MOA On Site Water & Wastewater Program
Subject: Lot 5, Block 1 Dearmoun Estates
Septic System Upgrade
Project Scope
The homeowners of the subject property are permitting an ADU addition that will require upgrades to the
existing septic system. The existing system includes a 1250-gallon steel septic tank and two absorption
fields, each 42-ft long, 3-ft wide with 8-ft of effective depth. The system was permitted and installed in 2004.
It was sized to accommodate 4 bedrooms, however field testing indicated that the absorption fields are no
longer performing adequately.
A 4-bedroom Advantex Fully Assembled Package and a wide-trench absorption field is proposed to replace
the existing system. The absorption field will be 30 feet long, 5-feet wide, with a 4-foot effective depth. See
sheet 2 of the drawings for design calculations.
Soils
In 2003, a test hole (TH1) was excavated by Garness Engineering in the vicinity of the proposed absorption
field. An additional test hole (TH3) was dug by Anderson Engineering near the existing northerly
absorption field. Both soils logs indicate silty gravel (GM/ML) underlain with silt (ML). P erc rates were
measured at 40 and 45 min/inch for TH1 and TH3, respectively. Both test holes were excavated to a depth
greater than 15 feet and no groundwater was observed.
Site Conditions
The area of the proposed and existing septic system is within the yard-space and is grassed with gently
sloping topography. No surface water was observed or is known to exist within the vicinity of the system.
Material Specifications
The proposed Advantex system shall meet all current MOA requirements for an Advanced Was tewater
Treatment System and shall be equipped with monitoring per AMCR 15.65.355. The tank shall meet the
specifications of AMCR 15.65.205.
Monitor tubes and cleanout pipes shall be 4” PVC. The portion of the monitor tube within the drain rock
shall be perforated.
April 5th, 2021
Subject: Lot 5, Block 1 Dearmoun Estates
Septic System Upgrade
Page 2 of 3
EXCELLENCE IN CIVIL ENGINEERING SINCE 1982 • SITE PLANNING • CIVIL ENGINEERING DESIGN • PROJECT MANAGEMENT
Drain rock shall be 0.5” – 2” washed aggregate with no more than 1% passing the #200 sieve.
Filter fabric shall meet the MOA specifications for Type A, Class 2 (separation).
Insulation (if provided) shall be 2” of rigid foam board, expanded closed-cell with a minimum R-value of
4.5/inch.
Construction Notes
The contractor shall be responsible for utility locates.
The existing septic tank shall be decommissioned in accordance with the current Uniform Plumbing Code.
The bottom of the tank excavation shall be level and the tank shall be set in undisturbed material.
The bottom of the absorption field excavation shall be level. If the subgrade surface is compacted or
smeared during excavation, it shall be raked to promote infiltration.
The finish grade above the excavation shall be raised 6” to allow for settlement. The area shall be graded
for a smooth transition into the existing terrain.
The contractor will be responsible for establishing final grade. The homeowner will be responsible for top -
soil and seeding disturbed areas, unless otherwise stipulated in the contract.
Minimum Slope Requirements
Waste Line from residence to septic tank = 1/4 inch per foot
Waste line from tank to absorption field = 1/8 inch per foot
Inspections
Four (4) inspections shall be required in accordance with AMCR 15.65.70.
1. Preconstruction
Discuss construction procedures, verify site conditions, confirm layout conforms to the approved
plans and permit.
2. After Excavation
Verify subgrade soils, verify excavation depth.
3. After Drainrock, Distribution Lines, Clean-outs and Monitor Tube Installation
Verify installation in accordance with the approved plans and permit.
4. After Backfill
April 5th, 2021
Subject: Lot 5, Block 1 Dearmoun Estates
Septic System Upgrade
Page 3 of 3
EXCELLENCE IN CIVIL ENGINEERING SINCE 1982 • SITE PLANNING • CIVIL ENGINEERING DESIGN • PROJECT MANAGEMENT
Verify finish grade, verify standpipe locations.
The contractor shall notify the engineer at least two (2) hours in advance of each required inspection.
Waivers
None Required
Notes
The upgrade to this septic system will not prevent the installation of on-site water and wastewater systems
on adjacent lots.
If you require additional information, please call (907) 720-6128 or email me at
grantmathews@triadak.com.
Sincerely,
Triad Engineering, LLC
Grant Mathews, P.E.
E N G I N E E R I N G, LLC
GRANT W. MATHEWS
CE 135444R
E
GI
STEREDPROFES S I O N A LENGINEER4-5-21
E N G I N E E R I N G, LLC
GRANT W. MATHEWS
CE 135444R
E
GI
STEREDPROFES S I O N A LENGINEER4-5-21
MUNICIPALITY OF ANCHORAGE
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of N a, ra of 20�, by and between
0-0 1 y u ( . D G4y,V at f4 , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as(y-a"F1 j 5 e-D-Nc, Sy S:�etn
located at (legal description)
neA�-yoyun E5te&es 9 Lk1. %_ 1 .5'
2. Maintenance, Repairs and Alterations.
4��� Owner is required to read, understand and initial each section)
(�f, Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
el Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
By: (signature) Date: ?- � %
Ca l J (vc J Le— i4 L PK (print name)
STATE OF,4_�' A�Z 170'�`�A- )
The for egoin 'nst 7Jt was acknowledged before me this a7�day of Gf�
20011, by � /,? .�/�l �t�t
,JANEL CAIMPSELL
° t
Notary Public — Arizona
C FOR A2/ zO,✓,� • ''s R Y
;. i.� Tc�rt,+icopa County r
on expires: T DAl(%'-"ig�-'6 Fv'ly Commission ExpiresAL-19ust 1, 202-1
MUNICIPALITY:
By: I&Z (/V (signature)
(print name)
Date: L 5 Z
Title:
(rev. 05/18/2018) Page 3 of 3
Municipality of Anchorage Page 1 of 3
Development Services Department
Onsite Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SWO30414 PID Number. 017.152-26
rptnell Homes
Wastewater System: New
1900 Northern Ll hts Suite 201 Anch., AK 99517
ABSORPTION FIELD
344-5678 Four 4
Deep Trench
Sw F.wq
Taal DapM Iran ongs paa.
LEGAL DESCRIPTION
A5 GPWe
11 Ft.
61a lac S.LOvnb.c
DOW b Pipe Ep.lp.n Iran W V w pans
cowl d.W esnaam p".
1 5 DeArmoun
3 Ft.
8 Fl
To«rlp: F/qs: SsMt
Fir aeOsO a0wsanyW psOs.
2.3
Gant Lwvl
87
Ft.
Ft.
awl.,dn.
NwIl"" a Irw.
Dnlanw bao.aan laud.
Well: New 1
3 Ft.
2
>16 Fl
clauwnsm lPrt .AB. CF
Private
Taal Depth Cub b:
341' 341'
aal aoaagwl Asa
1,392 Fel
s» W.
ASTM 3034 PVC
Alpine Drilling
1/27M04 173W"
Spineil Homes
a 11!1912003
v.b.
Pa'°sm":
c V Aou..Gana.
>2
TANK
60 cpm
Ft.
Ft
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Folding
Tank
lutilwPoIrate
se Line
Greer Tank
1,250
w.+
>100,
>100'
NIA
WA
>25'
Steel
Two (2)
saM.wal.
>100'
>100'
WA
WA
LIFT STATION — NONE ON LOT
LM ins
>5'
>10,
WA
WA
cal
FowUm
>5'
>10'
WA
WA
"' ti
a"p Irt
High �w m III.
in
None
Noted
P""'p Ir""' a uaa.l
El.aaal Irrv.aa.» P+a aT.
Cat.n Drain
BENCH MARK
�n
Top of Front Porch Deck
100.0 Fl
Engineers Stamp
��Nwwahaa
OF 4
.a ;a•
% 49 h
Inspections performed by: A Herala Dates: 1" 1111912003
m
2 1111912003
:�AA MICHAEL E ♦NDERSON y W
Department of Health and Human Services approval
•,2 � No. CE- 381 �
s
'
Reviewed and approved by: Date:
Oita' �
, ,5,;-
Municipality of Anchorage Page 2 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. SW030414
PID No. 017-152-26
PLAN AS -BUILT
SCALE V - 40'
LOT 5, BLOCK 1, DEARM❑UN SUBDIVISI❑N
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SW03D414
U s
Page 3 of 3
PID No. 017-152-26
In
U
SOUTH LEG
U_
98.t
92.55 P11 Dralnfleld Rock
44' (Trench Length)
NORTH LEG
4
PROFILE AS -BUILT
Scale: T - 10'
U
NEL E. ANDERMN
No. CE X381 1
Apr -06-2004 ATM=
Rick Mystrom
Mayor
From-SPINELL NOWS, INC.
/073441976 T-405
MunApality of Anch&age
Department of Health and Human Services
825'1.' Street
P.O. Box 196650 Anchorage, Alaska 99519.6650
hnpllwwvi.cl.anchoraga.ak.ua
P.001/002 F-368
Permit Number: #SW3. 30, 414 Date of Issue: 10-0 -03 Parcel Identification Number: 017-152-26
Date Started: .20-04 Date Completed: ] 22-04 Is well located at approved permit location? ® Yes No
Legal Description: DeArmoun Estates Block 1 Lot 5
Property Owner Name & Address: Spinell Homes
1900 Northern Lights Blvd. Ste 201
A_..ti..,.,..,, er�-4M 00517
Borehole Data:
Soil Type, Thielmess & Water Strata
Depth (ft)FD
From To
d of Drilling ® air rotary ❑ cable tool
Casing e: steel
g tYP
stick-up
organics & silt
silt
gravelly silt
0
2
3
6
2hickness:
3ter:
6
31g
,.250 inches
6 inches Depth: 341 feet
Type:
ter. inches Depth: feet
stickup above ground: 2 feet
cobbty gravelly silt
gravelly silt
31
122
122
217ing
water level (from ground level): J.Mfect
level: 341 feet after
silty water sand & gravel
217
223rs
pumping 60 gpta`'223
gravelly silt
water sand & gravel
240
338
240ery
338
341
Rate: 00 gpm
Method of Testing:!r li
Well Intake Opening Type:
12) Open End ❑ Open Hole
❑ Screened Startfeet Stopped feet
Q Perforations Startfeet Stopped feet
Grout Type: benronire granules Volume: j
Depth: Start 0 feet Stopped 7 feet
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ® Yes No
Method of Disinfection: chlorine tablets
Comments:
Well Driller. Alpine Drilling & Enterprises
PO Box 110496
Anchorage Alaska 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
.�.... .. .4..... 111.111...\.11 ....: }. . x..111.. .. • N. -:......1.1... e^ J.... .1 ..-.-1..1.-
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW030414
Legal Description: Dekiii& i-Eslates Block 1 Lot 5"
Design Engineer: 0014 Anderson Engineering
Owner Name: Spinell Homes
Owner Address: 1900 Northern Lights Boulevard, Ste 201
Anchorage , AK 99517 -
Date Issued: Oct 02, 2003
Expiration Date: Oct 01, 2004
Parcel ID: 017-152-26
Site Address: 6700 DeArmoun Road
Lot Size: 35692 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑✓ Private Well ❑ Water Storage
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.
X0/2 2103 CNG, K FLO G4 rF_ D L" A9 7-6 R
R roeslexv 0+rP-1.7 /v/21/51 �17�cFrFp
Received By:
Issued By:
C
/}S p EYE A71,g.G�.50
Date:
/10-3-0-7
till, 4 Date: 2 Q
Municipality of Anchorage
Development Services Department
Building Safety Division
i 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
Parcel I.D. On — IS Z — No Permit Number SW
Property owner(s) SDinell Homes
Day phone 344.5678
Mailing address (1)1900 Northern Lights Boulevard, Suite 201 Anchorage, AK 99517
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'd.) Lot 5, Block 1, DeArmoun Estates Subdivision
Legal description (Section, Township & Range)
n1tpcf-b n N V M : 1 tl IPA
Lot Size S Acres/Sq.Ft.
Number of Bedrooms Four (4)
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
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: S" S0 � Waiver Fees:
Date of Payment: 9- ZS- o3
Receipt Number: ' zX1 L S _
(Rev. 12100)
Date of Payment:
Receipt Number:
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMO
DATE: 10/2112003
TO: Dan Roth
WITH: MoAIOn-Site Water and Wastewater
FROM: Mike Anderson
SUBJECT: Lot 5, Block 1, DeArmoun Subdivision
Well and Septic System Permit No. SW030414
The owner of the subject lot intends to place the well at the front of the lot to allow for
possible construction of a shop in the future. A third test hole was recently placed on
the property. This hole revealed tight silty soils with a percolation rate of 45 minutes per
inch. We have move the septic system and the well to take advantage of this area. A
copy of the new test hole log and revised site plan are included for your review. Please
modify the permit to allow placement of the well in the new location.
Please let me know if you have additional questions.
2-42'Long x3\
x B' Effective Depth
Absorption Trenches
1 "=40'
ion ,5, 9+o'i
+ oY i
J�
Fo
°S.
NOTE • Alternate Site to be
Advantex Septic Treatment System.
SITE PLAN
SCALE 1' = 40'
�♦J
Lot 5, Block 1, DeArmoun Estates Subdivision
AEI. E. ANDERSON
NO. CE -4381 1
1
2
3
4
5
6
7
8
9
I(
I I
17
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH a HUMAN SERVICES
825 L STREET, ANCHORAGE, AK 99502-0605
SOILS LOG - PERCOLATION TEST
PROJECT #:
PERFORMED FOR: Soinell Homes DATE PERFORMED: 10/16/2003
LEGAL DESCRIPTION: Lot 5. Block 1. DeArmoun Subdivision
TEST HOLE # 3 SLOPE SITE PLAN
_m REDDISH ORGANIC
SILTY -SANDS
Silty Gravel/Silt
GM/ML
- 2%
WAS GROUNDWATER
ENCOUNTERED? NO
IF YES, WHAT DEPTH?
DEPTH OF WATER None
AFTER MONITORING:
DATE: 10/22/2003
` 49th
�...
i.
�.
WHUL L 4RMRSCR
No. M•4381
BOH ��..Ao pRorrcc\ON�':
S
L
0
P
E
N SEE SITE PLAN
NO SCALE / SEE ASBUILT
- 2%
READING DATE
GROSS
TIME
NET
TIME
DEPTH OF
WATER
NET
DROP
Start 10/20
4:10
8.5"
1
4:30
30
7.5"
1"
Recharge
4:31
8.25"
2
5:01
30
7.5"
.75"
Recharge
5:02
8.38"
3
5:32
30
7,62"
.75"
PERC RATE: 45 MIN./INCH PERC. HOLE DIAMETER: 6'
TEST RUN BETWEEN 5.5 FT. AND 6.5 T.
COMMENTS: Test Hole Pre Soaked Prior to Percolation Test
TEST PERFORMED BY: A. HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10/21/2003
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
MEMO
DATE: 101112003
TO: Dan Roth
WITH: MoA/On-Site Water and Wastewater
FROM: Mike Anderson
SUBJECT: Lot 5, Block 1, DeArmoun Subdivision
Well and Septic System Permit
am returning the well and septic system design and permit application for the subject
lot. The owner, Spinell Homes, will be bringing in the original test hole logs and
percolation data completed by Alaska Water and Wastewater Consultants.
Please let me know if you have additional questions.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
September 23, 2003
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 5, Block 1, DeArmoun Estates Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 5, Block 1, DeArmoun Subdivision intends to construct a 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 new home. The attached Site
Plan and backup documentation identify the location and configuration of the new well
and proposed septic system. Also identified on the plans are the locations of the well
and septic systems on the adjacent properties. Drainage arrows are shown indicating
the current patterns. The drainage patterns will be maintained after construction.
Alaska Water and Wastewater Consultants placed the test holes on the lot in June of
this year. Test Hole No. 1 indicated silty gravel, which became mostly silt at depths
below 7'. The percolation rate for material encountered in this test hole was noted at
between 30 and 40 minutes per inch. Test Hole No. 2 indicated tighter soils with
percolation rates in excess of 120 minutes per inch and therefore unacceptable. No
groundwater was found during placement of the test holes and none was noted during
the monitoring period. In addition, recent monitoring indicated the lack of groundwater.
We are therefore proposing to place a new 1,250 gallon septic tank and 2 - 42' long by
3' wide by 8 effective depth absorption trench to treat the effluent generated in the
house. The elevation of the distribution line in the absorption trenches will be 3' below
the surface and the total depth will be 11'. The alternate site will be an Advantex
Septic Treatment System to allow all three trenches to be contained within the 30'
radius of Test Hole No. 1. We acknowledge Test Hole No. 1 is not deep enough to
assure the lack of bedrock is at least 6' below the bottom of the proposed trench. We
intend to complete additional test holes and percolation testing prior to the completion
of the septic system. This information will be forwarded to you as soon as it becomes
Lot 5, Block 1, DeArmoun Estates Subdivision
September 23, 2003
Page Two
available.
The ground surface on the lot slopes at shallow grades from north to south off the
existing road. The trenches will be constructed parallel with the slope as much as
possible in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from the proposed well on the tot and the existing wells
on the adjacent lots. It will also be constructed a minimum of 100' from any surface
water in the area.
If the system is constructed in accordance with our design the following statements
apply:
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,
7VW,4,,t
Michael E. Anderson, P.E.
Attachments
TRACT A
40
ola
� 1
2
eP.
PRISM
qr
5C6
' V $
Zpyy CA
" M1611S /\Vvv R•30
V O1.1x
AREA MAP
6CNf 1' � O
G
0
X L°.NWER9W
No. t Ami r
91
106'
2— 2'Lon x3'
x 8' Effective eptt
Absorption Trenc s
1 "=40'
Ir
NOTE : Alternate Site to be
Advantex Septic Treatment System.
`oma
100'
•�
SITE PLAN
�_ . •,
� •• 5
SCALE V = 40' '49th JS
r "'
.......... ..
......................................
MICHAEL E ANDERSON•.t C
cr. 81
♦ ��
Lot 5, Block 1, DeArmoun Estates Subdivision ♦♦♦��''`��`''���••
LOT 5, BLOCK 1, DEARMOUN SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House Deep Trench System
Perc. Rate: 30-60 Min./Inch 1,250 Gallon Septic Tank
Application Rate: A5 GPD/SF 8' Drainfield Rock
4 Bedrooms X 150 GPD/.45 GPD/SF(Application Rate) = 1,334 SF Absorption Area
1,334 SF/16 SF/LF = 83.4 LF Trench Length
THEREFORE: Construct 2 - 42' Long x 3' Wide x 8' Effective Depth Absorption Trenches.
Flow Line Elevation In Trenches to be 3' Below Original Ground Surface. Total Depth to be
11' Below Existing Ground. Maintain 100' Separation From Well on Lot. Provide 3' of
Cover Over Trench and 4' Over Septic Tank or Provide 2" Insulation and 2' of Cover.
Place a Flow Splitter Valve to Insure Even Flow to Each Trench.
Natural
Backfill
2'6"
Geotextile
Fabric
6" 4" Perforated
PVC (Holes Down)
8'0" 1 1 ,>--t- Drainfield Rock
3
F ' 1
TYPICAL DEEP TRENCH SECTION ..•�OF
���.,
(NO SCALE) ���P�..••' "'
44, C.2
NOTE: Grade Area Over Trench to Drain Away. tc
Minimum 6' Separation From Bedrock. 00-....N....4.9thy......p.....
Minimum 4' Separation From Groundwater. i>A�is«4r
000 ......... .
Minimum 100' Separation From Wells in the Area. � .z L WHAELE. ANDERSON
Minimum 100' Separation From Surface Water or Streams. i ,
Minimum 10' Separation From Water Service Line. �i sig •. No. cE.bN
LOT 5, BLOCK 1, DEARMOUN SUBDIVISION
(ALTERNATE SITE)
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom House Deep Trench System
Perc. Rate: 30.60 Min./Inch Advantex Septic Treatment System
Application Rate: 1 GPD/SF 8' Drainfield Rock
4 Bedrooms X 150 GPD/1 GPD/SF (Application Rate) = 600 SF Absorption Area
600 SF/16 SF/LF = 37.5 LF Trench Length
THEREFORE: Construct a 42' Long x 3' Wide x 8' Effective Depth Absorption Trench.
Flow Line Elevation In Trench to be 3' Below Original Ground Surface. Total Depth to be
11' Below Existing Ground. Maintain 100' Separation From Well on Lot. Provide 3' of
Cover Over Trench and 4' Over Septic Tank or Provide 2" Insulation and 2' of Cover.
Natural
Backfill
2'6"
Geotextile
Fabric
6" 4" Perforated
PVC (Holes Down)
8'0" 1 1 ,>--I— Drainfield Rock
3'
F--1
TYPICAL DEEP TRENCH SECTION ..�.��• �q�/�o
(NO SCALE)
�P ••••"""'""� l
NOTE: Grade Area Over Trench to Drain Away.: t�: ` 49th
Minimum 6' Separation From Bedrock. ,
Minimum 4' Separation From Groundwater. i Y►��
.....;............................
Minimum 100' Separation From Wells In the Area. r Mwuue.u+ceRsor
Minimum 100' Separation From Surface Water or Streams. 0
minimum 10' Separation From Water Service Line. 0#6,rl, No. ce.x,
C
AI1A SKA WATER & WASTEWATER
CONSULTANTS, INC.
SOIL LOG — PERCOLATION TEST
LEGAL DF': ^IPTION: DEARMOLIN ESTATES SLIBOMSION; LOT 5. BLOCK 1 •.
PERFORM'; ''OR: DIETER EHLERS DATE: 6/19/2003
DEPTH
(reef) ORGANICS TEST HOLE #1
1 PA 1 F
7
DATE
DRY
SOIL CLASSIFICATIONS
II�
7/1/2003
9
III
3:30
10
�AGWI
•.
UPPER
I'
4:00
11,
111111111ML
1 1/4 -
12
3
ML
11.111!11GM%//CL
%
—
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS,
4
4:30
GM/ML/_iGCNNtI
5-
•
14
14-
5
4:30
IIIIIIIIIMH
I
F.Q.:.
5:00
SID
5-
CH
•
♦Ilyilllli
SC
c
7
DATE
DRY
8
II�
7/1/2003
9
III
3:30
10
�!I
—
UPPER
I'
4:00
11,
III
1 1/4 -
12
3
ML
13-
3
6-
—
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS,
4
4:30
30
5-
1'
14
14-
5
4:30
15
15
I
F.Q.:.
5:00
16
5-
1'
17
y;
c
18
DEPTH
GROUNDWATER
DATE
DRY
6/19/2003
DRY
7/1/2003
6/25/2003
1
3:30
—
.rA
ss:
�<.Qp
04p°Preresslo^Ooo
I 1
TH11 TN/2 — — Sµ l
i
TEST HOLE
LOCATIONS ARE
APPROXIMATE
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/25/2003
1
3:30
—
6'
—
UPPER
2
4:00
30
4 3/4'
1 1/4 -
BENCH
3
4:00
—
6-
—
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS,
4
4:30
30
5-
1'
5
4:30
—
6-
6
5:00
30
5-
1'
19
PROFESS\OMA OLATION RATE
30 (MIN./INCH)
PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN
1.0 FT. AND
2.0 FT.
20
A FOUR HOUR PRESOAK WAS PERFORMED:
N YES ❑ NO
SOILS LC'i:-D BY:
SUSAN OSWALT PERCOLATION TEST PERFORMED BY: NICK HEITSTUMAN
COMME':'
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS,
CERTIFY THAT THIS
WSJPERFORMED IN ACCORDANCE
WITH ALL STATE AND
MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE:71/10
pp
o OF . o
�.... ... qs;0�
ALASKA WATER & WASTEWATER �: • 14
•-'�� CONSULTANTS, INC. t� 4
SOIL LOG - PERCOLATION TEST
LECAL DESCRIPTION: DEARMOUN ESTATES SUBDMSION; LOT S, BLOCK 1 OQ'A a re A. Go ess.:
PERFORMED FOR: DIETER EHLERS DATE: 6/19/2003 �04ppg -7953 `a.`
6°4
GE"ty
EST HOLE #1 p00000"0'0��
1 (PACE 2 OF 2)
SOIL CLASSIFICATIONS
2
GW =zzz ORG
GM CL
4 w GC OL
°. •°• o SW MH
5 n 22 9 •'• t SP CH SEE SITE PLAN ON
SM ' .' OH PACE 1 OF 2
6 SC
7 Lj DEPTH TO DATE
GROUNDWATER
C
8 •�
v SE NGS 0
2
9— i. E P
a
10 O
w
1t `o
12 V
13
14 V
Q F ...
15-
16-
5 �F .....
w
16 �'
17-
181
7 18 CE 795
PRO FESS\O�rXCOLAT'ONRATE 40 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19TEST RUN BETWEEN 7.0 FT.AND 8.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: SUSAN OSWALT PERCOLATION TEST PERFORMED BY: NICK HEnMMAN
COMMENTSPERFORMED 9Y AKWWC, INC. I, JEFFREY A GARNESS, CERTIFY THAT THIS W PERFORMED IN ACCORDANCE
WITH ALL S NTE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: -741 In 1
DATEREADINGCLOCKNETTIMEWATER
TIME
(MINUTES)
LEVELNET
READING
DROP
(INCHES)
6252003
1
3:336•LOWER
2
4:03
30
5 14•
34'
BENCH
3
4:03
-6'
-
4
4:33
30
5 14'
34'5
4:33-66
5:03
30
5 14'
34•
SOIL LOG - PERCULAIwn IwII p.. .
Q J ffqy-
DE
G ess.:
LEGAL DE$CF:1�710N' DEARMOUN ESTATES SUBDNSION• LOT 5 BLOCK 1 O 9 953
DIETER EHLERS DATE: 8/19/2003 QOa�
PERFORMED FOR: CJ/°�• iSQd�
(f0e ORGANICS ITEST HOLE2
1
.3-
4-
5-
6-
7-
10—
I 567101
12
13
14
15
16
17
16
19
GM/ML
W/ SOME
COBBLES
GM/ML
DARKER W/
COBBLES
ffm
•-
111111111
IrZA II�
Hum
•
ON
111111111
•
i/„�NNiI
Il
YN�
•
DEPTH TO DATE
GROUNDWATER
6.5' 6/19/2003
5.5' 7/l/2003
DATE
CLOCK
TIME
I
TH I THj2 UNSU t,; �-
i
TEST HOLE
LOCATIONS ARE
APPROXIMATE
NET TIME I
WATER LEVEL NET DROP
(MINUTES) READING (INCHES)
6'
PERCOLATION RATE 120+ (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.0 T. AND 3.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: YES ❑ NO
SOILS LOGGED BY:
SUSAN OSWALT PERCOLATION TEST PERFORMED BY: NICK HETTSTUMAN
COMMENTS:
SS, CERTIFY THAT THIS PERFORMED IN ACCORDANCE
PERFORMED BY AK
CT ON THIS DATE:
WITH Au- -TATE AND MUNICIPAL GUIDELINES IN EFFEOl
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 017-15-226
1. GENERAL INFORMATION
Expiration Date: oZ7 - Z/
Complete legal description Dearmoun Estates Blk 1 Lot 5
Location (site address) 6700 Dearmoun Road, Anchorage, AK 99516
Current property owner(s) Calvin & Frances Dunham Day phone
Mailing address
Real estate agent
6700 Dearmoun Road, Anchorage, AK 99516
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
Q
Private Septic
0
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise
requested by the engineer.
COSA Fee $_ 21�
Date of Payment ,IT 0,21
Receipt Number 07-6 q SD
COSA # 05 C.2 112 6
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
QLESE eALL, 110" vitia (*gAC_0r- 610-7-0016-10-7-92-
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Triad Engineering LLC Phone 907-720-6128
Address 1300 E 68th Ave, Anchorage, AK 99515
Engineer's Printed Name Grant Mathews, P.E. Date 5-18-21
6. DSD SIGNATURE ;* 97TH *�
System #1 Approved for bedrooms I," G NTW.t THEWSCE 13544
': "
System #2 Approved for bedrooms (ll`9FOPROFESSIoAa�4 "
Disapproved
Conditional approval for bedrooms, with the following stipulations:
o'er
NATER o n►,
BOriginal Certificate Date:
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 X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Dearmoun Estates Blk 1 Lot 5
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 1-22-04
Total depth 341 ft
Cased to 341 ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) '18 in.
Date of flow test for COSA 11-9-20
Static water level at beginning of test 184 ft.
Comments
B. TANK DATA
Age of tank(S) NEW years
Tank type/material PE
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA NEW SYSTEM - SEE ASBUILT
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade 8.5 ft (max)
Measured depth to pipe invert from grade 3.5 ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
❑ Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies: NEW SYSTEM
COSA Checklist yellow sheet
Parcel ID: 017-15-226
Structure served by this system
Well production at time of test 4.5 gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ N
❑ Coliform bacteria is Negative
Nitrate 0.72 mg/L ❑ Nitrate less than MRL (ND)
Arsenic 0.61 ug/L ❑ Arsenic less than MRL (ND)
Collected by Grant Mathews, P.E.
Date of Sample 11-9-20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
Results ❑ Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
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
if No
Community Sewer Manhole/Cleanout > 100'
0 Yes
if No
ft
❑ Yes
if No ft
Neighboring Tank > 100' ❑✓ Yes
if No
ft
Private Sewer/Septic Line > 25' ❑ Yes
if No ft
Absorption Field on Lot > 100'✓❑ Yes
if No
ft
Holding Tank > 100' ❑ Yes
if No ft
Neighboring Absorption Fields > 100'
if No
ft
Animal Containment > 50' ❑ Yes
if No ft
❑✓ Yes
if No
ft
ft
If septic tank is under driveway
comment below
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' E] 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
ft
Surface Water > 100'
❑✓ Yes if No ft
Property Line > 5'
Q Yes
if No
ft
Wells on Adjacent Lots:
Wells on Adjacent Lots:
Absorption Field > 5'
Yes
if No
ft
Private Wells > 100'
❑✓ Yes if No ft
Water Main > 10'
❑ Yes
if No
ft
Community Wells > 200'
❑ Yes if No ft
Water Service Line > 10'
Q 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'
❑✓
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
❑
Yes
if No
ft
Private Wells > 100' ❑ Yes if No ft
Water Service Line > 10'
❑✓
Yes
if No
ft
Community Wells > 200' ❑ Yes if No ft
Surface Water > 100'
Q
Yes
if No
ft
F. ENGINEER'S COMMENTS
New Ap\)A.,,KEc Sr✓pTt� S �,�T�Lt 2021 A3gutv�`
G. ENGINEER'S CERTIFICATION
"dw " o. AC,gkk1,
1 certify that l have determined through field inspections and review Q.�. ' S
of Municipal records that the above systems are in conformance with /���•' �9�1
MOA COSA guidelines in effect on this date. �'t, TH ••*
/
... ANT W. •THEWS
�t F�PR'0 ESAiON L: F
COSA Checklist yellow sheet
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE ANIS REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this -tl�- Day of Ha rc[A of 20_,� by and between
<? Ivi'u C • D 6t I1 h.z , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as(V-0 u pgl S e1J i,G S (l S erv�
located at (legal description)
2. Maintenance, Repairs and Alterations.
JOwner is required to read, understand and initial each section)
✓� / Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
/P Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
a
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
o assessed in accordance with AMC 14.60.030.
(_�4 Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
`= u
By: (signature) Date:
C4 Io t vt C. D i c. i q a PK (print name)
STATE OF A -*Ktt — A/ �z r )
The foregoin s t was acknowledged before me this R?day of �CA1
20 a21, by �/� d. .
MUNICIPALITY:
1VICIPALI R, :
By: �V -- (signature)
___(print name)
Date: L
Title:
(rev. 05/18/2018) Page 3 of 3
C FOR�j �Dnl
;; y# ' i
t4!at�,ry i'ul�� Arizona
7cs'si�on expires:
ie(OP2 County
Auguot 21
MUNICIPALITY:
1VICIPALI R, :
By: �V -- (signature)
___(print name)
Date: L
Title:
(rev. 05/18/2018) Page 3 of 3
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program £ a
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-152-2fo COSA# 06119Q
Expiration D� % - oZ �n iJ
1. GENERAL INFORMATION
Complete legal description _OEArmoun 461AIe, 6kkt to/ S
Location (site address) 6700 Pe .Arm,«.,, &J., Anchorc.^ j A 99SI 6
Current Property owner(s) V'nes5z SAephnn Day phone 2Y0 - 9024
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
15a /n e
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well 19
Individual Water Storage ❑
Community Class Well ❑
Public Water System
101
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site [�
Individual Holding Tank ❑
Community On-site ❑
Public Sewer ❑
L.5 r
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined In the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm spurkknd Eng',wrrna
Address 203 w1: i5f"A✓e. Sh, 707 ! A�9�, AK 49501
Engineer's Printed Name Lar.S .Sow JLlanX
5. DSD SIGNATURE
t/ Approved for 3 bedrooms.
Disapproved.
Phone 774 -391(0
Date Zda
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: Gam- Original Certificate Date:
(Rm 11J05)
Municipality of Anchorage ••
• Development Services Department
Building Safety Division `
On -Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: V¢ Arv+• ,., &JAJ, Rlk I Lot 5 Parcel ID: OIC- 152- Zto
A. WELL DATA
Well type P if A. B, or C provide PWSID #
Date completed 40Y Sanitary seal (Y/N)
Total depth 341 ft. Casedto 3yl fL
FROM WELL LOG
Date of test t Ju'12co4
Static water level 1-13 ft.
Well production toy g.p.m.
WATER SAMPLE RESULTS:
Well Log (Y/N) y
Wires properly protected (Y/N) Y
Casing height (above ground) t f 53 in.
AT INSPECTION
4 IS zct0
ft.
-3 g.p.m.
Coliform �colonies/100 mL Nitrate 629 mg1L
Other bacteria — colonies/1Do mL
Arsenic: 5 ug/L date of sample: 415 1x10
.,. d
Collected by: ✓` �e,,cl
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material _Grew 11S}'d
Date Installed 11,111 ZoO3
Tank size 1150 gal. - Number of Compartments 2
Cleanouts (Y/N) y
Foundation cleanout (YM) 1 Depression over tank (Y/N) N
High water alarm (YM) Al
Dateofpumping q11512010 Pumper lsrgcs
C. ABSORPTION FIELD DATA
Date installed Soil rating g.p.d./ft= r ft°/bdrm) 0.4 S
System type Oe.f Irr�c�,
Length ft Width 3 ft.
Gravel below pipe S ft.
Total depth 13A ft. Eff. absorption areaft2 Monitoring
tube Y Depression over field /
Date of adequacy test q24 tato Results (Pass/Fail) Pgss For 3 bedrooms
Fluid depth in absorption field before test SR in. Water added 2Lco gal. New depth 92. in.
Elapsed Time: Ido min. Final fluid depth 90 in.
Absorption rate >= y50 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NO
If yes, give date
D. LIFT STATION
Date Installed
'Pump on' Ievel _in.
Datum
E. SEPARATION DISTANCES
Size in gallons Manhole/Access (Y"
'Pump off level atIn. High water alarm level at in.
Cycles test Meets alarm S circ ' equirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot IC0 + On adjacent lots
I
Absorption field on lot 100+ On adjacent lots
Public sewer main /V LA Public sewer manhole/cleanout 6NIA
r
Sewer /septic service tine 25 + Holding tank
r
Animal containment areas 50+ Manurelanimal excrete storage areas /00 +
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation S + Property line 5 + Absorption field 5 r+
�
Water main /VIA Water service line lot + Surface water 100+
Wells on adjacent lots IOOrf
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line tor+ Building foundation lCr+ Water main NIA
Water Service line ID -4- Surface water �� r+ Driveway, parking/vehicle storage 5 r+
r
Curtain drain A10. Wells on adjacent lots 1004-
F. COMMENTS
G. ENGINEER'S CERTIFICATION `` OF
~ .�V.•' ton-'
I certify that / have determined through field inspections and �� b• ``:9tttr
review of Municipal records that the above systems are in O'�9TH�
conformance with MOA COSA guidelines in effect on this date.10
01
, , „, _ r; • •7
Engineers Printed Name
�2i12°tom lRCLp
uc
Date ;
9 J ZotP
Dc •,j�� ~
COSA Fee $ q 9b pO Waiver Fee $
Date of Payment`�I Z111D rC Date of Payment
Receipt Number 04 6Z 5 g Receipt Number
(Rev. 11/05)
k.
Environmental Consulting and Design
Mlk
Municipality of Anchorage April 26, 2010
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw Strect
Anchorage, Alaska 99519
Subject: Scptic System Adequacy'fest
DL Armoun Estates Block 1 L.ot 5
Ladies and Gentlemen:
On April 15'% 2010 1 inspected the septic system. Septic tank clean outs, and absorption trench monitor tubes
were located. The septic tank clean outs were 8.3 feet deep and contained 49 inches of liquid. The monitor
tubes were 13.1 feet deep and contained 21 and 26 inches of liquid prior to the start of the test.
To assess the adequacy of the system a measured quantity of water was added to the absorption field
via the after tank and absorption field clean outs, while the liquid levels in the tank and absorption field were
monitored. One thousand and ten gallons of chin water was added to the absorption field. The liquid level
in the monitors rose 12 and 19 inches, liquid level in the tank rose 5 inches. The water Ien•cl rise in the tank
indicates that there may be a slight negative grade between the drain Geld and septic tank. After the water was
shut off, the liquid level in the monitor tubes dropped 1 and 5 inches, respectively. in 23 hours. This
corresponds to an absorption rate of 200- 250 gallons per day at less than 5011a capacity.
The septic system was retested on April 201h, 2010. Two thousand Iwo hundred gallons was added
to the westcm trench of the absorption Geld from a pump truck. This led to a rise of 53 inches in the monitor
tube, after two hours the liquid level in the trench drop two inches indicating that the system is capable of
disposing more than 450 gallons in a 24 hour period.
Calculations "fat #I
Total rise 31 inches
Total gallons 1010
Gallons per in 33
Total drop 6 inches
Total Absorbed +/-193 gallons in 1380 min
Total absorbed in 1440 +/- 206 gallons
(Using 40% of absorption surface arca)
Calculations Tat Y2
Total rise 53 inches
Total gallons 2200
Gallons per inch 41.5
Total drop 2 inches
Total absorbed +/-83 gallons in 120 min.
Total absorbed 996 gallons in 1440 min.
(Using 68% absorption area)
NOTE: The operational life of all septic systems depaids on the local soil conditions, 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 this septic system. We can therefore not gie c any estimate of how
long this system will function satisfactorily for current or future occupants. Steel septic tanks have a limited
203 Nest 151" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurklandggci.net
spa mand ERGOMMORU
Environmental Consulting and Design
aZ
lite span. Septic tanks older than 20 years are likely corroded and no longer structurally sound. All septic
systems ultimately fail. Some systems last 15-20 years, others fail after lows than five years.
If you have any questions please call me at 279-3916.
�Si�nc,,erely,
L ��f 3
Lars Spurkland. P.E.
Civil Engineer
203 West 151h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, LspurklandCa,gci.net
Parcel I.D.
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsde
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
017-152-26
1. GENERAL INFORMATION
COSA u hl rnm'9
Expiration Date: _':3 — I L} — 0 7
Complete legal description DEARMOUN ESTATES BLK 1 LOT 5
Location (site address) 6700 DEARMOUN ROAD, ANCHORAGE, AK 99516
Current Property owner(s) JILL SCHOMMER TORREY Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
6700 DEARMOUN ROAD, ANCHORAGE, AK 99516
MARYCOX/REMAX
110 W. 38th AVE., ANCHORAGE, AK 99503
Unless otherwise requested, COSA wrN be held by DSD for pickup.
2. NUMBER OF
3
Day phone
Day phone 257.0112
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
✓❑
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of OnSRe 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 singledamily on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage Is not responsible for errors or omissions In the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of OnSfle 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 Watkins Engineering, Inc. Phone 907-349-1651
Address P.O. Box 110443, Anchorage, AK 99511-0443
Engineer's Printed Name Cindy W. Ellis, P.E. Date 12/07/2006
0
6.- DSD SIGNATURE
_Z Approved for _� bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following
MY W. Ellis
CE -town
Attachments:
COSA Checklist X Arsenic Advisory
Septic System Advisory Maintenance Agreements
Well Flow Advisory Supplemental Engineer's Report
Nitrate Advisory Other
By: Original Certificate Date: — / G
Municipality of Anchorage
Development Services Department
Buildup Se" Division '
On -Site Water 6 Wastewater Program
4700 Bragew Street
P.O. Boot 196650
Anchorage, AK 99519850
www.munLorg/onste
(907) 343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: DEARMOUN ESTATES BLK 1 LOT 5 Parcel ID: 017-152-26
A. WELL DATA
Web type PRI @ A, B, or C provide PWSID 0 =
Date completed 1/7112004 Sanitary seal (YM) YES
Total depth 341 R. cow to 341 R.
FROM WELL LOO
Date of test 1122/2004
Static water level 173 ft.
Web production 60 g.p.rr
WATER SAMPLE RESULTS:
Conform 0 coloniesl100 mL Nitrate 0.522 mg/L
Arsenic::0_005 egll Date of sample: 11/28!06
B. SEPTIC/HOLDING TANK DATA
Wen Log (YIN) YES
Wires property protected (Y/N) YES
Casing height (above ground) 24 in.
AT INSPECTION
11/26/08
202 n.
4.s (waMd ur owm) g.p,m.
Other bacteria 0 colonbs/100 mL
Collected by: Cindy W. Ellis, P.E.
Tank Type/Material SEPTIC / STEEL Date Installed 11/19/2003
Tank size 1250 gal. Number of Compartments 2 Cleanout) (YIN) YES
Foundation cleanout (Y"- YES Depression over tank (Y" NO High water starm (Y" NO
Data of pumping Dec. 4, 2006 Pumper Around the Clock Pumping
C. ABSORPTION FIELD DATA
Date installed 111_ I19r= Salivating (g.p.dAe or felbdml) 0.45 System type DEEP TRENCH
Length 87 R. Width 3 R. Gravel below pipe 8 ft.
Total depth 13.5113.6 R Eff. absorption area 1392 fe Monitoring tube 2 Depression over field N
Date of adequacy teat 1214/08 Results (PasslFalQ Pass For 3 bedrooms
Fluid depth in absorption field beforetest 78 avg n. Water added 1125 gal. New depth 94.375 in.
Elapsed Tune: 482 min. Final fluid depth 91.75 in. Absorption rate i. 450 g.p d.
Any rejuvenation treatment (past 12 mc.) (YM 3 type) N If yes, give date
D. UFT STATION
Data installed NIA Size in gallons
'Pump old" level at _ in. 'Pump ofr level at _ in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/Oft station on lot 120
Absorption field on lot 105
Public sewer main 100+
Sewer /septic service line 100+
ManhoWAccess (YM)
High water alarm level at
Meet Glenn ti circuit requirement?
On adjacent lots 100+
On adjacent kms 100+
Public sewer manhole/eleanout 100+
Holding tank 100+
Animal containment areas 100+ Manure/animal excrete storage areas 100+
SEPARATION DISTANCES FROM SEPTICIHOLOING TANK ON LOT TO:
Building foundation 20+ Property One 20+ Absorption field 10+
Water main 100+ water service one 60+ Surface water t00+
Wells on adjacent lots 100+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
In.
Property line 10+ Building foundation 30+ Water main 100+
Water Service One 25+ Surface water 100+ Wnway. parkinly"hicw storage 30+
Curtain drain None noted Wells on adjacent lots 100+
F. COMMENTS: On Nov. 30,20M. a septic adequacy lest was begun but not completed, Initial leveft in the tranches
an that data: 67' and 760.
G. ENGINEER'S CERTIFICATION••`
I ceAW that I have determined Through bold inspections and 7k' 49 L
review of Muni*s/ ►ecords that the above systems are in
corrfamance WO MOA COSA guidelines in effect on this date. _
Engineer's Primed Name Cindy W. EOts, P.E. Cin Y EIAs
CE 10"7
Date 12/07/2006.,,
COSH Fee E q SQ
Date of Payment l4AZ-06
Receipt Number 1IJ 2
ce(Rev. 1 tl03)
Walver Fee E
Date of Payment
Receipt Number
in
.I— tips
SCALE: 488
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON. 'UO
i
of the
B=L
110,
k /
/
/
/
/ NOTE: Asphalt Ioation Is epprorAme
/ due to mow and los.
AS.BDILT NO CORNERS SET TMS DATE
I
Anchorage Recording Pndncl Aleeka, SW Tat fha
Irnpro"meras sausfed Tenon era wftN n the property Ines
and do not avwhp Or encroach on the popery "V
adiscmt Terra trash no "rovements en the property A'bg
agpcem Taro envoach on the pwmbea In grresoon and
Tat Ten M no nedwaye, Iernrrusion Ina wothw
Visible asaemerrts on said property asap sa hkwted
heron.
Dated at Anchorage, Alaska
INs 2nd day of Deoembx Zone
FRED WALATKA 6 ASSOCIATES
mm.e•e �.... Engineers and Surveyors
/
/
of the
B=L
110,
k /
/
/
/
/ NOTE: Asphalt Ioation Is epprorAme
/ due to mow and los.
AS.BDILT NO CORNERS SET TMS DATE
I
Anchorage Recording Pndncl Aleeka, SW Tat fha
Irnpro"meras sausfed Tenon era wftN n the property Ines
and do not avwhp Or encroach on the popery "V
adiscmt Terra trash no "rovements en the property A'bg
agpcem Taro envoach on the pwmbea In grresoon and
Tat Ten M no nedwaye, Iernrrusion Ina wothw
Visible asaemerrts on said property asap sa hkwted
heron.
Dated at Anchorage, Alaska
INs 2nd day of Deoembx Zone
FRED WALATKA 6 ASSOCIATES
mm.e•e �.... Engineers and Surveyors
`-41 LQ.
Municipality of Anchorage
-. Development Services Department
Building Safety Division
On -Site Water and Wastewater Program t
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017.152.26 HAA # O !J0 a 7n
Expiration Date: 9 —'?_ J — d _L�-
1. GENERAL INFORMATION
Complete legal description Lot 5 Block 1 DeAnnoun Subdivision
Location (site address or directions) r 7 DO DeArm6un Road
Current Property owner(s) Saineli Homes Inc.
Day phone .3445678
Mailing address 1900 Northern Lights Blvd
Anchorage AK 99517'_'
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: Four 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well ®
Individual On-site
Individual Water Storage ❑
Individual Holding tank
❑
Community Class Well ❑
Community On-site
❑
Public Water System ❑
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 tK4 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 611712004
5. DSD SIGNATURE ��� =.-t No. ce-uar J�CTi
</" Approved for _ bedrooms. ��,' .•'�
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
0-1
Additional Comments !ZFJ : ON-SITE Gi
WASTEWATER
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
ByC/�z �/������� Original Certificate Date: 0 ' A is — O
(P". 12/W)
Municipality of Anchorage y
Development Services Department
Building Safety Division
On•Sfte Water & Wastewater Program ' `T
4700 South Bregaw St
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.u9
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
�._: nv•. •.a. •..lw• � 1:11/P1 - � �1
A. WELL DATA
well type Efte If A, B, or C provide PWSID S _
Date completed >raM Sanitary seal (YIN) Y
Total depth —H 8. Cased m -21—ft.
FROM WELL LOO
Date of test 11241Y004
Static water level 173 fL
Well production 80 9—
p.m-
WATER SAMPLE RESULTS:
Weil Log (Y/N) Y
Wires property protected (YIN) Y
Casing height (above ground) _ >JL_in.
AT INSPECTION
fl
9—
p.m-
Conform ,_Q_colonies/100 mt. Nitrate _¢L mg -A. Other bacteria _L colonies/100 ml.
B. SEPTICIHOLDING TANK DATA
Tank size 1150 gal.
Foundation cleanout (WN) Y
Date of pumping
C. ABSORPTION FIELD DATA
Number of Compartments j
Depression over tank (Y/N) N
Cieanouts (Y/N) Y
High water alarm (YIN) N
Date insUdW 11tilirM Son rating (9•p•d./fe or fe/bdnn) .43 GPDISF System type Deep Trench
Length 87 It Width 3 it. Gravel below pipe 8 It
Total depth J1 -U It. Eft. absorption area 1.392 fie Monitoring tube X Depression over field N
Date of adequacy test Results (PassfFall) For _ bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in.
Elapsed Tine: _ min. Final fluid depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date
D. LIFT STATION
Date installed
'Pump on' level at _ in.
Datum
Size in gallons
'Pump oft' level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAlft station on lot MW
Absorption field on krt MW
Public sewer main WA
Sewer /septic service line >2S
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots MW
On adjacent kris >1W
Public sewer manhole/cleanout WA
Holding tank WA
SEPARATION DISTANCES FROM SEPTICAHOLDING TANK ON LOT TO:
Building foundation W Property line >V Absorption field >S
Water main >10' Water service line >10' Surface water _ AW
Wells on adjacent kits >1W
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10' Water main _>10'
Wager Service eine >10' Surface water MW Dd way, parkinpNehide storage >V
Curtain drain None Noted Wells on adjacent kris >100
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I car* that I have determined through field inspections and 49th
review of Municipal records that the above systems are in
conformance with MOA HAA guldWiines in eA'ed on this date.
6 NmEw
Engineer's Printed Name Michael E. Anderson. P.E. ` Na a-4�r
Data 6MM004 ••4eew�9lti i
HAA Fee $ u 3n
Date of Payment _ f,
Receipt Number 7 317-g jam,
(Rev. tzroo)
Waiver Fee E
Date of Payment
Receipt Number
in.
P-520
De ARMOUN ESTATES SUBDIVISION
LOT 5, BLOCK 1
0.82 ACRES
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SEPTIC sssTL%
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FINAL STRUCTURE AS -BUILT
AS—BUILT I HEREBY CERTIFY THAT I HAVE SURVEYEE
PROPERTY DEPICTED ABOVE AND THAT NC
GASTALDI LAND SURVEYII ENCROACHMENTS EXIST EXCEPT AS INDICF
JEFF A. GASTALDI, R.L.` IT IS THE RESPONSIBILITY OF THE OWNER
4726 WEST 88TH AVENIDETERMINE THE EXISTENCE OF ANY EASE
ANCHORAGE, ALASKA 99` �PVENANTS OR RESTRICTIONS WHICH DO
PHONE 248-5454 APPEAR ON THE RECORDED SUBDIVISION
UNDER f10 CIRCUMSTANCES SHOULD ANY
p,; -F HEREON BE USED FOR CONSTRUCTION OF
c�1 iz cd ESTABLISHING BOUNDARY OR FENCE LINE
ANCHORAGE RECORDING DISTRICT, ALAS
NOTE: NO CORNERS SET THIS DATE.
1 "= 40'
THE
ED. .�sslkIll �.
e of ALnSTO
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ENP►,„. �� ••0
JA�•.........................�
Fri' Jeffery A. Gastalct
LS -6091 r�'o
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,A •�� O2fessionol '-O ���