HomeMy WebLinkAboutASPEN HIGHLANDS #2 BLK 2 LT 9Aspen
Highlands #2
Block 2
Lot 9
#017-013-36
Municipality of Anchorage
_ Development Services Department °
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
v iA cl.andwage.ak.us (907) 3437904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW070097 PID Number. 017-01336
lh� Eric Trevithick
Wastewater System: [Z]New ❑ Upgrade
Ma..a 6200 Lake Otis Parkway Anchorage, AK 99507
ABSORPTION FIELD
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LEGAL DESCRIPTION
1.0 0p ?
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sock La SWorwn
Dapeibppbmanfrvno`"Wsos
Gresmpm b.a.n P"
2 9 Aspen Highlands #2
7.84
it.
ft
To.nyiy RAW solar
Fa ease some aprur V•ea
Gray L& Vn
1-2 Fr.
63 Fr.
Well: ifZ] New ❑ Upgrade
Cr enn
rr.ro.a ram
1
osommewbsen rw
I
5 Fr.
FL
cWNvioon (Pone, A B. Q
Taal Dever
onsa b
Tar anapran ars,
Pp Manor
Private
365 Ft.
171 FL
630 F2
ASTM D3034 PVC
paler
Oeu Qaee
stsbc Were, Level
1n.aaer
Oen Yaarea
Hefty Drilling Company
7113107
205 FL
Red ON Excavating
10125-2612007
yok!
Flap Sera
Leeeq Yr,yl Above Gmvia
TANK
1 GPr
351.5 FL
2 FL
SEPARATION DISTANCES
0 septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Uft
Holding
lutticTriviste
•tli••r
o
Fpm
Tank
Field
Station
Tank
Serer urs
Anchorage Tank
11,250
aaerw
Anna. a carwpr...
wa
>100'
>100'
WA
WA
>26
Steel
Two
Se w"
>100'
>100•
WA
NIA
LIFT STATION
La Line
>5'
>1(7
WA
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ti
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craao-.n
None
Noted
R'""Ae
BENCH MARK
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Garage Slab
aresm
100.90 FL
1025=07
OF;
Inspections performed by: A. Harala Dates: 1"
;`�4�t
.ss•.esir �f
t
2nd 1012612007 612007
�.`Q;••
..•'•••�*
Development Services Department Approval
* 49TH it
�... ... ...f
Conditional Approval Date:
rf'✓��� � �4 t"1'
;M10U,EL F AtJDERSON; R
'•',.
ff �pFp••.....•.••
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Reviewed and approved by: /NA4P Date:
o
OF
i
a
Permit No.: SWO70097
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
ASPEN HIGHLANDS SUBD., UNIT NO. 2
LOT 9, BLOCK 2
J7.ee3 Sr.
LOT 10
LOT 9
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Name
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ti
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A B
S1 24.7 29.8
S2 1
C4 .4 51.9
C5 75.2 83.5
PLAN AS -BUILT
SCALE V - 50'
Page 2 of 3
PID No. 017-013-36
LOT 7
4k�,�
A temate
Site '1n1
L
M1
b
2 e LOT B
7113 W
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BE
IN
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number. SWO70097
Page 3 of 3
PID No. 017-013-36
U �
104.6
FHNaA GreOe
Ground
Geole,d" Fe
95.3 �— 91.5 Drainfield Rock
63' (Trench Length)
NOTE: Effective Depth of Trench was Verified at 4.0' During
Construction. Monitor Tube Has Been Filled with .2' of Rock.
The Pipe Extends to the Bottom of the Trench.
PROFILE AS -BUILT -
No Scale
103.1
— 85.1
No G,aewlabr
ra2aw
yr
U
95.3
Feb 06 08 04:14p Eric Trevithick
Pumpinstallation Log
WCAD _�y
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r e
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907-336-3720 p.2
Alfm
ritlm Adapter Manufacturer's Name: C,. YI.A be I I IbOA
A
Mess Adapter Installer: REGI d zn
I _
PUMP TWC StA i"Jr�GrSi%I�
t MAW &yVt %CL !'
UMCL JU S GiG tri -330
cob& R Pero
ll rar
CROP TtiPC Tr,. Pvc—
CWWSOM
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POWER c at: Tw. u l r
g COMB Y? c v✓
l l CIICTMCAU vasa 3
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rASM WO r. fr tJ, TO ;7
MTAME srm,en,ae: yo. F Ira L t Orf e 5
T. 32r5
CPEN„�.L F� ' J 7 t ' To_
65
COMMUNM well was disinfected upon completion_
method: calcium hypochlorite.
00
—n
T 0.C+ = Top 04 Cas.
YJ
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bregaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT
Initial
Permit Number: SW070097
Legal Description: ASPEN HIGHLANDS #2 BLOCK 2 LOT 9
Design Engineer: 0014 ANDERSON ENGINEERING
Owner Name: ERIC TREVITHICK
Owner Address: 6200 LAKE OTIS PKWY
ANCHORAGE. AK 99507 -
Date Issued: Jun 08, 2007
Expiration Date: Jun 07, 2008
Parcel ID: 017-013-36
Site Address: NHN TRACEY WAY
Lot Size: 37683 SO. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
❑✓ Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and dosed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
THE ENTIRE SUBSURFACE DISPOSAL FIELD IS NOT WITHIN A 30 FOOT RADIUS OF A PERCOLATION TEST.
THE ENGINEER NEEDS TO DO AN ADDITIONAL PERCOLATION TEST PRIOR TO THE CONSTRUCTION OF
THE SEPTIC FIELD. PLEASE SUBMIT STAMPED AND SIGNED RESULTS WITH THE AS -BUILT INSPECTION
REPORT. IF THE RESULTS REQUIRE A DESIGN CHANGE, CONSTRUCTION OF THE SYSTEM WILL STOP
PENDING ON-SITE REVIEW AND APPROVAL.
7110
Received By:
&jell rrvvcd. Ileal srn 514b,'%/,l
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-013-36
Property owner(s) EricTrevithick Day phone 345-1400
Mailing address 6200 Lake Otis Parkway, Suite 202 Anchorage, AK Zip Code 99507
Site address
Code 99516
Legal description (Sub'd., Block & Lot) Lot 9, Block 2. Aspen Highlands Subdivision No. 2
Legal description (Township, Range & Section)
Lot Size 37,683 Sq. Ft.
THIS APPLICATION IS FOR (® all that apply)
Absorption Field
El
Septic Tank
El
Holding Tank
❑
Privy
❑
Private Well
n
Water Storage
❑
Number of Bedrooms Five (5)
THIS APPLICATION IS AN:
Initial
El
Upgrade
Cl
Renewal
❑
certify that the above information is correct 1 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)
Pernit(Rush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
/19_'
Waiver Fees: _
3ID�
Date of Payment:
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
May 23, 2007
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 9, Block 2, Aspen Highlands Subdivision No 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 9, Block 2, Aspen Highlands Subdivision No. 2 intends to construct a
new five -bedroom home on the lot. We are therefore requesting a permit be issued for
the construction of a new well and septic system to accommodate the home. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed well and septic system along with the alternate site. Existing wells and
septic systems in the area are also shown on the attached plans. Drainage arrows are
shown on the site plan showing the grade and direction of flow on the lot. The drainage
pattern will not be changed as a result of this project.
The test holes placed on the lot in the area of the absorption trench and alternate site
indicated gravel and sand and silt (SP/GP/GM) material. The percolation rate of the
soil was determined to be 1 to less than 1 minute per inch. Soil materials in the
percolation zone contained more than 50% sand so not filter is required. No
groundwater was found during the placement of the test holes and none was noted
during the monitoring period. An application rate of 1.0 gallons per day per square foot
was used in the design of the absorption system. We are proposing to place a new
1,500 -gallon septic tank and a 75' long by 5' wide by 4' effective depth absorption
trench to treat and dispose of the effluent generated in the house. The elevation of the
distribution line in the absorption trench will be 6.0' below the surface and the total
depth will be 10.0'. A minimum of 3' of fill or 2' of insulation and 2' of fill will be placed
over the absorption trench and 4' over the septic tank.
The ground surface on the lot in the area of the absorption trench slopes to the
southeast at 5%. No major grade breaks or excessive slopes were noted within 100' of
the proposed septic system. The new trench will be constructed parallel with the slope
Lot 9, Block 2, Aspen Highlands No. 2
May 23, 2007
Page Two
as much as possible in conformance with Municipal requirements. The new septic
system will be constructed a minimum of 100' from all wells and any surface water and
10' from the proposed and existing water services 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, Q /�
Michael E. Anderson, P.E.
Attachments
V C.AC E. AVERSON
t No. CE -4381
5A
2
11 5
5
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5 ADO DIVE 7
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fir 49th
;:::...............- AREA MAP
� �;NICHAEL E. ANDERSON i
I
cEra�ety:`�� SCALE 1' = 100'
LOT 9, BLOCK 2, ASPEN
HIGHLANDS SUBDIVISION NO.2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom House 5' WideTrench System
Perc. Rate: 1 Min./Inch (Est) 1,500 Gallon Septic Tank
Application Rate: 1.0 GPD/SF 4' Drainfield Rock
5 Bedrooms X 150 GPD/1.0 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/5 SF/LF'.5 (Red. Factor)= 75 LF Trench Length
THEREFORE: Construct an Abosrption Trench 75' Long x 5' Wide x 4' Effective Depth.
Flow Line Elevation in Trench to be 6' Below Original Ground Surface. Total Depth to be
10' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Enter Trench at Midpoint with Effluent Flow.
5'6" I Natural
Backfill Geotextile
Fabric
6"
4'0"
5'
Perforated
'C (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTIO"'
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Edge of Lake.
Performed For.
Legal Description:
�1� 1
Depth
D
P]
V
;8:� 4 `i7
COMMENTS
Municipality of Anchorage
Development Services Department
Building Safety Division
On -She Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.el anchorage.ek.us
(907) 3437904
Soils Log - Percolation Test
'M,CV rn+►ev`
Township,
WAS GROUND WATER
_
ENCOUNTERED?
Net Time
.Pa
Net Drop
IF YES, AT WHAT DEPTH? 14
C
Depth to Water After
F
Monitoring?
E
' Date:
fdd
Z.
�49Tl� N s
Date Performs
e. Section:
++' : *X'CHAEI E. ANUR50N f,
)I
CF • 438
4 off#*
'3 21
She Plan
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
3 2'i- c1
14 � l• 8
9.i.g �
�
.QE/
rcn�.�tnu�n Mic I Imnaauntat FERC HOLE DIAMETER
TEST RUN BETWEEN FT 'AND i(c ii FT
PERFORMED BY: - I ; 1L4 Art—f` /CJjAWX0AATIFYTHATTHISTESTWAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: E- 2.3 — 07
Municipality of Anchorage
Development Services Department
Building Safety DMsion
y2 On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
w"ww.cl. enchoraoe.ek.us
(907) 343-7904
Performed For.
Legal Description:
J[f-V
OF• 44%1
00,590NE R'S 99.01}9' �•"f`�
49tH •v
pep c AUU1A Ft E. ANC]A.;GNdw
��,he
• . a,
P TA
Soils Log - Percolation Test; LL�e
zFLt C - Til. rr1ft e(L Date Performed: 3 O 1
ownship, Rarige, Section:
Cope Site Plan
11
1
16-I
WAS GROUND WATER
ENCOUNTERED?
a
IF YES, AT WHAT DEPTH?NO - _ L
Depth to Water After •1!-`rC" D
Monhorinpl E
' Data: (� Ci
I Reading I • Date I Gross Tame I Net Time I Depth to Water Net Drop I
PERCOLATION RATE A . L.6a+t•ahia0 PERC HOLE DIAMETER
TEST RUN BETWEEN FT 'AND SSL"✓ FT
PERFORMED BY: %A )"T I lqrjlAkq, 6 JERSOCERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: S -7 -?-07
Municipality of Anchorage ae'`p(cNGIN
CIr&,O
Development Services Department r * 49�y v .74
Building Safety Division -„•--
On-SReWater and Wastewater Program yyj%f�:�•• �
4700 South Bragaw St. !......••.............. .
P.O. Box 195650 Anchorage, AK 99519.6650 ;AUCAAEL L ANDERSON e
www N anchorao eo us v C. t, CE -4381 •`• e
(907)343.7904 I����•��.�q
f Fo S r
Soils Log - Percolation Test �/ pq�rEssw���%,
Performed For. r� , � ������
�ilcl�i Gl/ 1'1'}FI.� 1 Date Performed:
to
Legal Description:a
/ Township, Range, Section:, .
J7 Y_1 Y Z Slope Sde Plan
iFeet) d�
/r .•�• F•
6-
7.
r
10-
11.
12-
13- '
14-
,B L; f -",/
COMMENTS
WAS GROUND WATER
ENCOUNTERED)
S
IF YES, AT WHAT DEPTH?_ L
DaPth to Water Amer D
Monitoring? WoEt%K E
E
Date
4Dale
PERCOLATION RATE
TEST RUN BETWEEN
Net Tans Depth to Water Net Drop
3.1� i • SL 6 /2
3.70
�.7
(S. 3
ta.nn.✓n�l PERC HOLE DIAMETER
FT 'ANO 5;.o FT
PERFORMED BY: 1114 1�
0 CERTIFY PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THS DATE. DATE: IS TEST WAS
Municipality of Anchorage
Development Services Department
Building Safety Division
/ On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET
To: Anderson Enstineerina
Legal description: Aspen Highlands #2. B2 L9
®Permit ❑C.O.S.A. ❑Inspection Report
The attached paperwork has been reviewed and is being returned for the following reasons:
1. The proposed trench location is not parallel to the contours of the slope. Please provide a cross-
section of the trench that shows that the bottom will not encroach on the required separation
distances.
Name of reviewer. Deb
Date: 6/7/07
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
\ Municipality of Anchorage
.. Development Services Department *A.
Building Safety Division
OnsiteWater 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 SUBMITTAL COMMENT SHEET
To: Anderson Engineering
Legal description: Aspen Highlands #2.82 L9
®Permit ❑C.O.S.A. ❑Inspection Report
The attached paperwork has been reviewed and Is being returned for the following reasons:
1. The site plan shall have a description of the topography, areas of excessive slope, and
extent of slopes and surface drainage patterns within 100 feet of any part of the system
or portion of the lot Intended for use for on-site wastewater disposal. AMC 15.65.030 D.
Please provide this information on the site plan.
v 2. A subsurface disposal field may not be installed in an accepting soil stratum having a
percolation rate faster than one minute per Inch without installing a filtration layer. If the
Insitu soil meets the MOA requirements for a filter material, an additional filtration layer is
not necessary.
J 3. Please use the application rate for a filter material.
Name of reviewer: Deb Date: 5/24107
.S13U 7-alkej w/ /vlke. SJC. slopes 901�'q ,n
Ae o�rOstr dirccfion
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
May 23, 2007
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 9, Block 2, Aspen Highlands Subdivision No 2
Septic System Design and Permit Application
Impacts to Adjacent Properties
SUP '• b E
Dear Onsite Services Engineer:
The owner of Lot 9, Block 2, Aspen Highlands Subdivision No. 2 intends to construct a
new five -bedroom home on the lot. We are therefore requesting a permit be issued for
the construction of a new well and septic system to accommodate the home. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed well and septic system along with the alternate site. Existing wells and
septic systems in the area are also shown on the attached plans. Drainage arrows are
shown on the site plan showing the grade and direction of flow on the lot. The drainage
pattern will not be changed as a result of this project.
The test holes placed on the lot in the area of the absorption trench and alternate site
indicated gravel and sand and silt (SP/GP/GM) material. The percolation rate of the
soil was determined to be 1 to less than 1 minute per inch. No groundwater was found
during the placement of the test holes and none was noted during the monitoring
period. An application rate of 1.2 gallons per day per square foot was used in the
design of the absorption system. We are proposing to place a new 1,500 -gallon septic
tank and a 63' long by 5' wide by 4' effective depth absorption trench to treat and
dispose of the effluent generated in the house. The elevation of the distribution line in
the absorption trench will be 6.0' below the surface and the total depth will be 10.0'. A
minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption
trench and 4' over the septic tank.
The ground surface on the lot in the area of the absorption trench slopes to the
southeast at 5%. The new trench will be constructed parallel with the slope as much as
possible in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from all wells and any surface water and 10' from the
Lot 9, Block 2, Aspen Highlands No. 2
May 23, 2007
Page Two
proposed and existing water services 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,
74.aj
Michael E. Anderson, P.E.
Attachments
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LOT 9, BLOCK 2, ASPEN
HIGHLANDS SUBDIVISION NO.2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom House 5' WideTrench System
Perc. Rate: 1 Min./Inch (Est) 1,500 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 4' Drainfield Rock
5 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 625 SF Absorption Area
625 SF/5 SF/LF'.5 (Red. Factor)= 62.5 LF Trench Length
THEREFORE: Construct an Abosrption Trench 63' Long x 5' Wide x 4' Effective Depth.
Flow Line Elevation in Trench to be 6' Below Original Ground Surface. Total Depth to be
10' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Enter Trench at Midpoint with Effluent Flow.
S UPEd®Ed
5'6" Natural
Backfill Geotextile
Fabric
Ia
4'0"
5'
Perforated
FC (Holes Down)
Drainfield Rock
ICAL 5' WIDE TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Edge of Lake.
No. cEa i
0
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766(
MEMORANDUM
DATE: July 9, 2007
TO: Deb Wockenfuss
FROM: Mike Anderson, P.E.
SUBJECT: Lot 9, Block 2, Aspen Highlands No. 2
Permit No. SW070097
Revised Well Location
The well location for the subject lot has been moved to allow room for construction of
the septic system on the lot to the west. The new location will have no adverse impacts
on wells or septic systems in the area.
Please review this data and revise the permit accordingly.
•
4_ Municipality of Anchorage
On-Site Water and Wastewater Program <
(907) 343-7904 SA ETY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel LD. 017-013-36 Expiration Date: / i! - IC(
1. GENERAL INFORMATION
Complete legal description ASPEN HIGHLANDS#2 BLOCK 2,LOT 9
Location (site address) 13001 TRACY WAY,ANCHORAGE,AK 99516
Current Property owner(s) KYLE & MARNE J SHAFER Day phone
Mailing address 13001 TRACY WAY,ANCHORAGE,AK 99516
Real Estate Agent Day phone
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 El
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver/Variance request for: Distance:
Received by: Date: /e//7V/0
COSA to be released to eer,unless otherwise requested by the engineer.
COSA Fee $ SZ(g. Waiver Fee $
Date of Payment 16 ! 10 r r(g Date of Payment
Receipt Number 4* 1626 Receipt Number
COSA# OSC11 l540 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516
Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 10/02/2018
F
A
° a o
6. DSD SIGNATURE °°°" ' ° ;' ° a
System #1 Approved for ! bedrooms. ;P MICHAEL TI.VARE,RSON
F*', CE..o469
System #2 Approved for bedrooms. /
4 11)Disapproved. ��` •?
Conditional approval for bedrooms, with the following stipulations:
\ ON-SITE
WATERAND;12S
WASTEWATER
m PROGRAM 9
�4 �
By: t,w ate 4 Original 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 blue sheet 10-10-12.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: ASPEN HIGHLANDS#2 BLOCK 2,LOT 9 Parcel ID: 017-013-36
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 7/13/2007 Sanitary seal (Y/N)Y Wires properly protected (Y/N)Y
Total depth 365 ft. Cased to 171 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 7/1312007 612912018_
Static water level 205 ft. 242 ft.
Well production 1 g.p.m. 1.2 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate_4. ' 3 mg/L
Arsenic: ND ug/L Date of sample: 9/28/2018 Collected by: FIRST WATER C.S.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL Date installed 10/26/2007
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N _ Hi h water alarm (Y/N) N
Date of pumping IC-41—Ig
✓'l1`i'g Pumper Crte 'tar (7144-1°
C. ABSORPTION FIELD DATA
Date installed 10/25/2007 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.0 System type WIDE TRENCH
Length 63 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 12.8 ft. (Measured 9/28/18) Eff. absorption area 630 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 9/28/2018 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 760 gal. New depth 0 in.
Elapsed Time: 0 min. Final fluid depth 0 in. Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
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 in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
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 100'+
Animal containment areas 50'+ _ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation'5'+ (PER IR ASB) Property line 10'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
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 50'+(None Known) Wells on adjacent lots 100'+
F. COMMENTS
I Y yPL CooLe-
G. ENGINEER'S CERTIFICATION ��O F Az`1I
I certify that I have determined through field inspections and .�1�;•• •: 1
review of Municipal records that the above systems are in / �?•• 4�� ••9 Pt
conformance with MOA COSA guidelines in effect on this date. -*: 4 9TH ' • * d�
Engineer's Printed Name MICHAEL N.ANDERSON,PE d ..
/ •
MICHAEL N. ANDERSON :,
Date 1010212018 r c-• CE-9469 • `�
lPin-
PR(2/�/'lc.�,,;�'
1400\a"
COSA canary sheet_2-6-15.doc
•
agro
•� 77
Municipality of Anchor • A °*4
�.
On-Site Water and Wastewater Prog r b `
(907) 343-7904 201 s r r e r r
JUL 14
30, ti
Certificate of On-Site Systems At.. oval
Parcel I.D. 017-013-36 Expiration`s 01-6 s
1. GENERAL INFORMATION
Complete legal description Aspen Highlands #2, Block 2, Lot 9
Location (site address) 13001 Tracy Way Anchorage, AK 99516
Current Property owner(s) Casey & Zoe Smith Day phone 644-7949
Mailing address 13001 Tracy Way Anchorage, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
111 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 0 Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: Date: 5511/II
COSA to be released to the engine unless otherwise requested by the engineer.
COSA Fee $ 524, Waiver Fee $
Date of Payment fI (-4-(PE Date of Payment
Receipt Number 0631-7o41e. Receipt Number
COSA it 050 (V-c17 Waiver#
6. STATEMENT OF INSPECTION BY ENGINEER
As certified bymyseal affixed�Ihereto and as of the validation date shown below, |verify that myinvestigation,
based on procedures outlined in the Certificate of0n'Sbe Systems Approval Guidelines for this apphcetion,
shows that the on-site water supply and/or wastewater disposal system is (one) eafe, 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 innpeotion, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations ineffect atthe time ofinstallation.
Name ofFirm
Anderson Engineering
139-----�����U�8��� Anchorage, AK 99503
Address ° "" 34th Ave, ' ~
Engineer's Printed Name Benjamin Schiller, P.E.
6. DSD SIGNATURE
\/System #1Approved for _-L bedrooms
System #2Approved for bedrooms
Disapproved
773
Phone 522-7��`�
Conditional approval for _ bedrooms, with the following stipulations:
-_
WASTEWATEER :Z
Original Certificate Date:
The Municipality n/Anchorage Development Services Division (oGD)issues Certificates nrOn-Site Systems Approval VCOSa>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 isnot responsible for errors momissions mthe professional engineer's work.
7. ATTACHMENTS:
CO88Cheddkst X Nitrate Advisory
Septio System Advisory �_ ArSeniC/\dvo0ry
Well F|ovv'Advioory /` ^�Other
_ _
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: Aspen Highlands #2, Block 2 Lot 9 Parcel ID: 017-013-36
A. WELL DATA
Well type Private If A, B, or C provide PWS ID #
Date completed 7/1 3/07 Sanitary seal (Y/N) Y
Total depth 365 ft. Cased to 171 ft
FROM WELL LOG
Date of test 7/13/07
Static water level 205 ft.
Well production 1
WATER SAMPLE RESULTS:
Coliform N D colonies/10
Arsenic N D ug/L
g.p.m.
mL Nitrate 6.94 mg/L
Date of sample: 6/30/17
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 1250 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y
Date of pumping 6/20/17
C. ABSORPTION FIELD DATA
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 19 in.
AT INSPECTION
8/1/17
62.1 ft.
1.36 9 -
p.m -
Collected by: Anderson Eng.
Date installed 10/26/07
Cleanouts (Y/N) Y
Depression over tank (Y/N) N High water alarm (Y/N) N
Pumper Isaac's Pumping
Date installed 10/25/07 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.0 gpd/sf System type 5' Wide
Length 63 ft. Width 5.0 ft. Gravel below pipe 4.0 ft.
Total depth 12.5 ft. Eff. absorption area 630 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/6/17 Results (Pass/Fail) PASS For 4 bedrooms
Flu)d dep$h in. absorption field before test 0 in. Water added 600 gal. New depth 0 in.
Elapsed'T.ime`:' min. Final fluid depth 0 in. Absorption rate >-600 g p d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
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 in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
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'
SEPTIC/HOLDING TANK ON LOT TO:
>5' >5' >5'
Building foundation Property line Absorption field
>10' >100'0 '
Water main >10' Water service line Surface water
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
>10'
>10'
Property line >10' Building foundation Water main
Water Service line >10Surface water >100 Driveway, parking/vehicle storage >10'
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
vgiblb*41%4
G. ENGINEER'S CERTIFICATION •" 5, air.g7
� 44
I certify that l have determined through field inspections and a •' -rte : .°%,-5"40review of Municipal records that the above systems are in sir►*• 4 c� '"' -5.•;'-,.
;' ..774.
conformance with MOA COSA guidelines in effect on this date. si • •. <*O
Engineer's Printed Name Benjamin Schiller, P.E. 4;41 S �•»•
j+►min Jr ° .
Date July 13, 2017C • % .d
COSA brown sheet 10-10-12.doc
Municipality of Anchorage
Development Services Department 42
Building Safety Division
'4k�t E T Y,,K
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
I
Certificate of On -Site Systems Approval # osc 171297
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 2, Lot 9 of
Aspen Heights #2 subdivision. This inspection revealed a nitrate
concentration of 6.94 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble
in water. Nitrate is not readily filtered or otherwise removed in the soil and can pass
rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is
in the form of ammonia or protein first, which through contact with oxygen and certain
bacteria, converts to the oxidized form known as nitrate. Sources of nitrate from
wastewater include urea, ammonia cleaners, food solids, and bacterial cells. It may also
result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or
three years, but is associated with a potentially fatal infant disease called
methemoglobinemia. In the digestive system of young children, nitrate converts to
nitrite, which can pass through the intestinal wall into the blood stream. There it
combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The
EPA limits the concentration of nitrate in public drinking water supplies to 10 mg/L. The
standard has been lowered from a previous level of 45 mg/L set by the US Public Health
Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and
other common home water treatment systems such as softening or iron filtration does not
readily remove nitrate. The best method for limiting nitrate in well water is source
control. This can include avoiding overdosing of fertilizer near the well and maintaining
good separation distances between septic tank leach fields and the well. A special anion
exchange filter that contains a media with a strong affinity for negatively charged ions in
water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical"
methods using a spectrophotometer to read the final color endpoint. Specific ion
electrodes also can be used to detect the activity of nitrate in water. This laboratory uses
several different wet chemical methods approved under the public water supply
laboratory certification program. They also have test kits available, which the laboratory
uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test
kit results against a certified analysis from the lab occasionally to verify the accuracy of
the kit. We recommend using a specially prepared bottle that has been rinsed in
hydrochloric acid for collecting samples.
•
'o. ,L
^ry -3• \i � °� LOT 7
0 14 14,0, LOT 10 \-10 `�%.
IP �L
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OUSE /' S62°4313644
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,ii.v.keekeo es,
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SCALE 1"=20' °. EXISTING �/ v
BUILDING DETAIL •'`7r; C HOUSE - ~
coC0 '
o LOT 8
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Vv LLS/-120, 4 -- c OHO NOTE: lit
65.80'
V Q��a '�<r �. a`'�O
THIS DRAWING SHALL NOT BE MODIFIED FOR USE `.
40Ar0fessiono� ‘'°a AS A PLOT PLAN WITHOUT THE EXPRESSED — - --_____k�pOOOooa— WRITTEN CONSENT OF LCG LANTECH. \ _ _ — SCALE 1"=40'
MIDORI DRIVE
LEGAL
250 H Street DESCRIPTION: AS-BUILT
Anchorage,Alaska 99501 ADDRESS: 13001 TRACY WAY PARCEL#:017-013-36-000
'"' .r ,( '--- LOT 9, BLOCK 2, SURVEY CERTIFICATION:LCG LANTECH,INC HAS CONDUCTED A PHYSICAL SURVEY OF
Survey Department �+ A THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE
Phone 562-5291 ASPEN HIGHLANDS NO. 2 SUBDIVISION - IMPROVEMENTS SITUATED THEREONARE WRHINTHE PROPERTYLNESAND NO
LEGEND: ENCROACHMENTS EXIST OTHER THAN NOTED.
t.BrhIne Mainline
DRAWN DATE: 7/17/2017 WORK ORDER: 17061 ;::Aspholt: ?:;?:
6 Phone 243-8985 - — - -- — CLEAN OUT r rag EXCLUSIONARY NOTE:IT IS THE OWNERS RESPONSIBILITY TO DETERMINE THE
a CA/Zedit 2e.• e Jineeu.,9 •buo,�ey<n9.. DRAWN BY: AP PLAT: 73-63 0 :. Concrete • EXISTENCE OF ANY EASEMENTS,COVENANTS,RESTRICTIONS OR RIGHT-OF-WAY
WATER WELL - . . ••^ TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION FLAT. UNDER NO
a� Overhang ac. s�i
CHECKED BY: SC GRID: SW2840 _ FENCE —X—X— 9CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION,FOR
-
Wood Decker ESTABLISHING PROPERTY LINES,OR FOR PLOT-PLAN PURPOSES.
ORDERED BY: CASEY&ZOE SMITH SCALE: AS NOTED FB/PG:68/32
- J
l� w
Municipality of Anchorage
Development Services Department •°
!� Building Safety Division �=
On -Site Water and Wastewater Program
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 y
Parcel I.D. o"7 -013 -$ of COSA# bsoa7r
I. GENERAL INFORMATION Expiration Date: S - _-a %— Q f�
Complete legal description Lot 9, Block z AsPen wghlanas subdMrJon No. 2
Location (Site address) 13001 Tracy way Andxwage, AK 99s18
Current Property owner(s) Edo and T zcyTmj"Ck
951-103-73s9Day phone
Mailing address 39791 Links court Temewla, CA 92591
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone,
Mailing Address
Unless otherwise requested, COSA wX be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY.
Individual Well 0
Individual Water Storage El
Community Class Well El
Public Water System 0
TYPE OF WASTEWATER DISPOSAL:
Individual On-site _0
Individual Holding Tank 11
Community On-site 0
Public Sewer 0
The Municipalif of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COS.--) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Slte 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 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 rry seal affixed hereto and as of the validation date shown below. I verify that my investigation,
based on procedures outlined in the Certificate of OnSfte Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-sile 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 Finn Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
Phone 522-77r3
Date =12008
0 ve : miCKAn t ANDERSON; .t.
6. DSD SIGNATURE ��`��g, CE -4381
vl�Approved for _4 bedrooms. ,+1?�Fa�: Z; goo Nom.44P
�j PlAr ecffi �
o
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
ONSITE
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By, Original Certificate Date:
(RN 11X5)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program • • ..
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www.rnuni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 9, Block 2. Aspen Highlands No 2 Parcel ID: 017-013-36
A. WELL DATA
Well type PrHate If A, B, or C provide PWSID # __ Well Log (Y/N) Y
Date completed 7/13107 SanitaryY
seal _ Wires property protected (YM) Y
Total depth 365 R Cased to 171g_ Casing height (above ground) >16 in.
FROM WELL LOG AT INSPECTION
Date of test 7113=07 '
Static water level 205 ft ft
Well production 1 9.p -m.,
g.p.m.
WATER SAMPLE RESULTS:
C.OlifOrm O colonies/100mL Nitrate 6.46 mg/L Other bacteria 3
colonies/100 mL
Arsenic: NM ug/I Date of sample: ti14108 Collected by: A Harala
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SeptkJsteel Date installed 10/15107
Tank size 1.250 gal Number of Compartments Two Cleanouts (YRJ) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YM) N
Date of pumping New' Construction Pumper
C. ABSORPTION FIELD DATA
Date installed 10r2W7 Soil rating (g.p.d./ft2 or ftz/bdrm) 1.0 GPD/SF
System type s•WWesnano.,7md,
Length 63 1
fL Width 5 ft.' Gravel below pipe 4 ft.
Total depth 11 R Eff. absorption area 630 ft2 Monftoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Faio 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.) (YM & type) N If yes, give date
D. UFT STATION
Date installed Size in gallons
Manhole/Access (YIN)
'Pump on' level at _in. 'Pump air level at_
in. High water alar level at In.
Datum Cycles tested
Meets alarm 8 circuit requirements4
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot >1D('
On adjacent lots >100'
Absorption field on lot >1D0'
On adjacent lots >100•
Public sewer main WA
Public sewer manhole/cleanout wA
Sewer/septic service line >25'
Holding tank N/A
Animal containment areas None
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
>s P line >s
Building foundation �rtY
Absorption field >s
Water main NIA Water service line
>10' Surface water >100'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line >t0' Building foundation
>10' Water main >10'
Water Service fine >10' Surface water >100' Driveway, parking/vehicle storage >26
Curtain drain None tooted Wells on adjacent lots
>1�'
F. COMMENTS:
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson. P.E.
Date ?119/2008
COSA Fee S f);/- Waiver Fee $ _
Date of Payment � CkS' Date of Payment
Receipt Number Receipt Number
(Rev. 111W
10*L'6 ANDERSON :,4 F,
CE -4381 4, A.
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SGS WEN
1080621001
Client Name
Anderson Engineering
Project Name/#
L9 B2 Aspen highlands
Client Sample ID
f louse Exterior I lose Bib
lltatrix
Drinking Water
PWSID 0
SMDIC Remarks:
All Dateerimes are Alaska Standard Time
Printed Dalefrime
02/222008 16:00
Collected Dalcrfime
02/142008 14.30
Received Dsicrrime
02/142008 17:05
Technical Director
SlcPhen C. Ede
Parameter ResultsAllowable Prep Analysis
POL Units Method Container ID Limits Date Date Init
Metals by ICP/ms
Arsenic ND 5.00
ug/L EP200.8 C (<IO) 02/19/08 07120/08 NRB
Waters Department
Total Nitrate/Nitritc-N 6.46
Microbiology Laboratory
Colony Count 3
Total Colirorm 0
Fecal Coliform 0
0.100 mg/L SM204500NO3-F B (<to)
eoVI00mL SM209222D
cuV100mL SM209222B
CDUl00mL SM209222B
A (<200)
A (<1)
A (<I)
0221/08 LCP
02/14/08 SDP
02/14/08 SDP
02/14/08 SDP
Municipality of Anchorage
_ I Development Services Department
!�
Building g SafetyDivision
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Nitrate Advisory
Certificate of On -Site Systems Approval # 080037
A Certificate of On -Site Systems Approval inspection and test of potable
water was recently conducted on the well water supply on Block 2, Lot 9 of
Aspen Highlands No. 2 subdivision. This inspection revealed a nitrate
concentration of 6.46 milligrams per liter (mg/L) was reported for the
property's well water sample. The Environmental Protection Agency (EPA)
has established a maximum contaminant level (MCL) of 10.0 mg/L for
public drinking water systems. While private wells are not subject to this
regulation, EPA standards are based on existing health information and can
therefore be used to gauge the relative quality of water from private wells.
Please see the attached "Nitrate Fact Sheet" for important information
regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.