HomeMy WebLinkAboutWARD LT 8Ward
Lot 8
#011-122-87
Municipality of Anchorage ~?~ :~.
Development Services Department
Building Safety DiviSiOll
On-S~e Water and Wastewater Program, 4700 Elmom Road
P.O. Box 196650 Anchorage. AK 99507 Page of
www.d.anchorage.ek.us (907) 343-7904
ON.-~IIE WASTE~AIER DISPOSAL SYSTEM AND[OR WELL INSPECTION REPORT
Permit Number: swo?o232 PID Number. o11-1~..~?
~ Harding Homes of ^laska Waste~ater System: [] New [] Upgrade
9380 Autumn Ridge Circle Anchorage, AK 99507 ABSORPTION FIELD
337-9109 6 D D.e~ t,mm ~ Sh~
LEGAL DESCRIPTION 1.2
a~x~. [~ 8 Sma~e,e~ Ward 8
0-1 Ft. 79 Ft.
Well: [] New [] Upgrade, c~ 5 Ft., ~1 ~ I ~R
Ft Sanders & Sanders 10/9-10/~7
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other..
Tank Field Station Tank Se~er ~ Anchorage Tank 2,000 c,~
we~ N/A N/A N/A N/A N/A Steel Two
u.u,.s~=' w.. >100'>~ >10o'>10- N/^N/^ '~^~u^ ~ ~'~' c~ ..~LIFr STATION
Feu~,aeem >5' >10' N/A N/A . ._~ In
Cma,nD~n None Noted / ~ I~mpU,~e&uaa,
"""'"' BENCH MARK
Garage Stab
100.0 ~L
Engineer's Stamp
InspectJorts perfolTned by: A- Harala Dates: 1~ 10/9/2007
Development Services Deparb.ent Approval o .- -- ·
Conditional Approval Date: . '~~
Reviewed and approved by: i//. te: U/.-.3,-O
Permit Number. SW070232
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmom Road Anchorage, AK. 99519-6655 - 343-7904
Page 2 of 3
PID No. 011-122-87
PENNY ROSE CIRCLE
' I
PLAN AS-BUILT
:~CALE t' = 40'
WARD SUBDIVISION
LOT 4
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 -343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Pemnit Number;. SW070232
Page 3 of 3
PID No. 011-122-87
/--'100.8
2,000 Gallon
Septic Tank
92.1
99.8
/
C-eotextile Fabdc
--~ Drainfield Roc~
88.1.--/
79' (Trench Length) ~ 82.0
No Groundwater
92.2
PROFILE AS-BUILT
No Scale
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Sep 06, 2007
Expiration Date: Sep 05, 2008
Permit Number: SW070232
Legal Description: WARD LOT 8
Design Engineer: 0014 ANDERSON ENGINEERING
Owner Name: HARDING HOMES OF ALASKA, INC.
Owner Address: 9380 AUTUMN RIDGE CIRCLE
ANCHORAGE, AK 99510-7
Parcel ID: 011-122-87
Site Address: NHN PENNY ROSE CIRCLE
Lot Size: 40250 SQ. FT.
Total Bedrooms: 6 Permit Bedrooms: 6
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. Ail 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site 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/~/VELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 011-122-87
Property owner(s) Harding Homes of Alaska, Inc.
Mailing address 9380 Autumn Ridge Circle Anchorage, AK
Site address ,tJ ~J Penny Rose Circle Anchorage, AK
Legal description (Sub'd., Block & Lot) Lot 8, Ward Subdivision
Legal description (Township, Range & Section)
Lot Size 40,250 Sq. Ft.
Day phone 337-9109
Zip Code 99507
Zip Code 99516
Number of Bedrooms Six (6)
THIS APPLICATION IS FOR ([] all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
Priw I-]
Private Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
August 25, 2007
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 8, Ward Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 8, Ward Subdivision intends to construct a new six-bedroom home on
the lot. We are therefore requesting a permit be issued for the construction of a new
septic system to accommodate the home. The subdivision is served by the AWWU
water system. The attached Site Plan and backup documentation identify the location
and configuration of the proposed septic system along with the alternate site. No
existing wells or septic systems are closer than 100' from the proposed septic system.
Drainage arrows are shown on the site plan showing the grade and direction of flow on
the lotThe drainage pattern will not be changed as a result of this project.
The test holes placed on the tract in the area of the absorption trench and alternate site
indicated clean sand (SM/SP/SW) material with some silt. The percolation rate of the
soil was determined to be less than I minute per inch. More than 50% of the soil
particles pass the No. 4 sieve and a sand liner is not 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 2,000-<jallon septic
tank and a 75' long by 3' wide by 6' 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 3' below the surface and the total depth will be 9'. 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 is nearly fiat with a
slight bias to the south at a grade of 2% to 5%. The new trench will be constructed
parallel with the slope as much as possible in conformance with Municipal
Lot 8, Ward Subdivision
August 25, 2007
Page Two
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.
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.
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.
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,
Michael E. Anderson, P.E.
Attachments
, , Hanks Subdivision ' ~-' >,
I I
I I
i I
I I ~--' ._
/
i VACANT
I ,
l~ ~ sq.ft. ~( Lot 2 f/
I 10' T&E Esmt . I . } Dralnage~.XX
I
SCALE 1' = 100'
WAND
SUBDIVISION
LOT 8
40,250 S.F.
PENNY ROSE CIRCLE
IS' GAS
_I
15#!
15.0![
'I
SITE PLAN
SCALE 1' = 40'
LOT 8, WARD SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Six Bedroom Home Deep Trench System
Peru. Rate: 1 MinJInch 2,000 Ga,on Septic Tank
Application Rate: 1.0 GPD/SF 6' Drainfield Rock
6 Bedrooms X 150 GPD/1.0 GPD/SF (A. pplication Rate) = 900 SF Absorption Area
900 SFI12 SFILF = 75 LF Trench Lengm
THEREFORE: Construct a 75' Long x 3' Wide x 6' Effective Depth Aborption Trench at the
Location Shown. Flow Line Elevation in Trench to be 3' Below Odginal Ground Surface. Total Depth
to be 9' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide
2" of Insulation and 2' of Cover. Maintain 10' Separation From Water Services in the Area.
2'6"
# .
Backfill
Geotextile
-- Fabric
4" Perforated
-- PVC (Holes Down)
-- Drainfield Rock
TYPICAL DEEP TRENCH SECTION
NOTE: Grade Ama ~er Tmn~ to D~in Away. ~
Minimum 6' Separation From Bed~. E,t..Z.......~....'" ;~....=..~' ' ...,..~.....~
Minimum 4' Separation From Gmun~ter. ~
Minimum 100' Sepa~on From PHvate Wells in ~e ~a. ~'~?~;~;~'E?~
Minimum 100' Separation From Suda~ ~ter or SEeams ~'~
..... · '
M~mmum 10' Separation From Water Se~ L~ne. e~....
I
5--
6
7
18
PROJECT #:
PERFORMED FOR:
LEGAL DESCRIPTION:
COMMENTS:
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM
/-..700 SOUTH BRAGAW ANCHORAGE, AK 99519
SOILS LOG - PERCOLATION TEST
LanTe~h, In~,
DATE PERFORMED: 2/16/0S
Lot B. Johnston Subdivision
TEST HOLE #
06
'SP/GP
Up to 10% ~itt
Sand and Gravel with Silt
SLOPE
SITE PLAN
See Site P[an
WAS GROUNDWATER
ENCOUNTERED? NO S
L
IF YES, WHAT DEPTH? O
P
DEPTH OF WATER None
AFTER MONITORING: E
DATE: 2/28/2005
B0H 18'
See Site Plan
READING DATE GROSS NET DEPTH TO NET
TIME TIME WATER DROP
Start ' 2/18 1~,:1'/ 6.88"
1 1/*:27 10 15' 8.12'
Recharc)e 1~.:28 6.88"
2 · 1/*:38 10 1/*.88"
Recharge 1/*:39 6.88"
3 1/*:/.9 10 1L,.88" I~"
PERC RATE: 1,25 PhN./INCH PERC.'HOLE DIAMETER;
TEST RUN BETWEEN /*.~ FT. AND 5.5 FT.
Test Hole Pre Soaked Prior fo Percolation Test.
TEST PERFORHED BY: AFl I, HI(;HAEL E. AN(~[R~(~N, CERTIFY THAT THIS TEST WAS PERFORHED IN ACCORDANCE
WITH ALL STATE AND fiUNICIPAL GUIDELINES ON THIS DATE: 2/28/2005
I
2
3--
5
6
7
8
18¸
PROJECT #:
PERFORMED FOR:
LEGAL DESCRIPTION:
COf~MENTS:
MUNICIPALITY OF ANCHORAGE
DEVELOPHENT SERVICES DEPARTMENT/BUILDING SAFETY DIVISION
ON-SITE WATER AND WASTEWATER PROGRAM
/~700 SOUTH BRAGAW ANCHORAGE, AK ~)c)sjc)
SOILS LOG - PERCOLATION TEST
[.anT~h,
DATE PERFORHED: ~/16/05
Lot 9, Johnston Subdivision
TEST HOLE #
O§
O6/0L
SH with SP
Up fo 10% Silt
SLOPE
SITE PLAN
See Site Plan
WAS GROUNDWATER
ENCOUNTERED?
IF YES, WHAT DEPTH?
DEPTH OF WATER
AFTER HONITORING:
Very Dry DATE:
Some Sloughing .
........ · ...';:~
B0H 10'
NO S
L
O
P
None E
2/28/200S
See Site Plan
READING DATE GROSS NET DEPTH TO NET
TIHE TINE WATER DROP
Start 2/18 15:38 6.88'
1 15:~8 10 Dry
Recharge 15:50 6.88"
2 · 16:00 10 Dry
Recharge 16:02 6.88"
3 16:12 10 Dry -10'
PERC RATE: "'~ HiN./INCH PERC. HOLE DIAMETER: 10'
TEST RUN BETWEEN ~,.0 FT. AND S.0 FT.
Test Hole Pre Soaked Prior to Percolation Test.
TEST PERFO~-IED BY: AFl I, HICHAEL E. ANDERSO;'I, CERTIFY THAT THIS TEST WAS PERFORHED IN ACCORDANCE
WITH ALL STATE AND HUNICIPAL GUIDELINES ON THIS DATE: 2/28/2005
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT8, WARD SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a new
2,000-gallon septic tank at the location shown on the Site Plan. Work also
includes the construction of a 75' long by 3' wide by 6' effective depth
absorption trench also at the location shown on the plan. The distribution line
in the trench will be placed at 3.0' below the existing ground surface. Total
depth of the trench will be 9.0' below the existing ground surface. The new
absorption trench must be placed a minimum of 100' from all wells in the area
and 100' from any surface water in the area. The septic system must also
be a minimum of 10' from the water service line on the lot. A minimum of 3'
of cover is required over the absorption trench and 4' of cover over the septic
tank.
Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also vedfy the location of wells in the
area and assure that the separation distances are met.
Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified by the
Municipal Department of Building Safety On-Site Water and Wastewater
Program for system installations. Owners installing their own systems must
receive prior approval from the On-Site Water and Wastewater Program
before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 2,000 gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 8, Ward Subdivision
August 25, 2007
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. Ail standpipes on the septic tank*shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be install(~d one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. Tl~e drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below the distribution line must be perforated.
Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
o
Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
A minimum 2' of accepting soil is required below the drainfield rock for
absorption trenches. All pockets of unacceptable materials must be removed
and replaced.
Lot 8, Ward Subdivision
August 25, 2007
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfiiled.
The second inspection must be conducted after the placement of the geotextile
fabdc, gravel, distribution piping, standpipes, cleanouts and insulation. No
back'fiil should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as-built of the completed system.
Municipality of Anchorage
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
Parcel I.D.
011-122-87
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
COSA# 0 ~b¢--~ / / \
Expiration Date: :~['__%
GENERAL INFORMATION
Complete legal description
Location (site address)
Lot 8, Ward Subdivision
7034 Penny Rose Circle Anchorage, AK 99502
Current Property owner(s) William and Tama Graham
Mailing address 10500 Constitution Street Anchorage, AK 99515
Lending agency
Day phone
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Six (6)
TYPE OF WATER SUPPLY:
Individual Well []
Individual Water Storage []
Community Class __ Well []
Public Water System []
TYPE OF WASTEWATER DISPOSAL:
Individual' On,site []
Individual Holding Tank []
Community On-site []
Public Sewer [] .
The Municipality of Anchorage Development Services Department (DSD) issues Certificates Of On-Site Systems
Approval (COSA) based only upon the representationS' given in paragraph 4 by an independent professional 'civil
engineer registered in the State of Alaska. Certificatesof 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 apUblic 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
o
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 vedfy that based on the information
obtained from the Municipality of Anchorage files and from my investigation, and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations 'in effect at the time of installation.
Name of Firm Anderson Engineering
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
DSD SIGNATURE
';~ Approved for ~_~
Disapproved.
Conditional approval for
bedrooms.
Phone 522-7773
Date 4/6/2011
~'~.~
·,
bedrooms, with the following stipulations:
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
(Rev. 11/05)
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
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.muni.orglonsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Lot 8, Ward Subdivision
Legal Description:
A. WELL DATA
Well type AVVWU
Date completed
Total depth
If A, B, or C provide PWSID #
Sanitary seal (Y/N)
Cased to. ft.
FROM WELL LOG
Parcel ID: 011-122-87
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform __colonies/100 mL
Arsenic: ug/I
B, SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Tank size 2,OOO gal.
Foundation cleanout (Y/N) Y
Date of pumping 4/7/2011
C, ABSORPTION FIELD DATA
Date installed 10/10/2007
Length 79 ft.
Total depth 12 ft.
Date of adequacy test
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
ft. ft.
g.p.m, g.p.m.
Nitrate mg/L Other bacteria
Date of sample: Collected by:
Date installed
Number of. Compartments Two Cleanouts (Y/N)
Depression over tank (Y/N) N High water alarm (Y/N)
Pumper Denali Sewer and Drain Services
Soil rating (g.p.d./ft2 or ~/bdrm) 1.2 GPD/SF
Width 5 ft.
Eft. absorption area 790 ft2 Monitoring tube
4/5/2011 Results(Pass/Fail) Pass
in.
colonies/100 mL
10/9/2007
Y
N
· System type 5~ Wide Trench
Gravel below pipe 4
Y Depression over field __
For 6 bedrooms
Fluid depth in absorption field before test 19.5 in. Water added 920. gal. New depth 23.5
Elapsed Time: 802 min. Final fluid depth 19.5 in. Absorption rate >= 1,050
Any rejuvenation treatment (past 12 mo.) (YIN & type) . N If yes, give date
in.
g.p.d.
LIFT STATION
Date installed,
"Pump on" level at
Datum
in.
E. SEPARATION DISTANCES
Size in gallons
"Pump off level at
Cycles tested
in.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
Animal containment areas
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5'
Water main N/A
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >5'
Water service line >10'
Absorption field >5'
Surface water >100'
Property line, >10. · Building foundation >10'
Water Service line >10. Surface water >100.
Curtain drain None Noted Walls on adjacent lots >100'
COMMENTS: Property is Served by AWWU Water System.
Water main >10'
Driveway, parking/vehicle storage >25'
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 4/6/2011
COSA Fee
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Municipality of Anchorage
Development Services D~partment
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
www. muni.o~/onsite
(9O7) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 011-122-87
1, GENERAL INFORMATION
Complete legal description Lot 8, Ward Subdivis~o~
Location (ske address Pe~ny Rose Circle Anchorage, AK
COSA #
Expiration Date:
Current Property owner(s) Harding Homes of Alesk, a Day phone 337-9109
Mailing address 9380 Autumn Ridge C~rcle, Anchorage, AK 99507
Lending agency
Mailing address
Day phone
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, CO,SA will be held by DSD for pickup.
3. TYPE OF WATER SUPPLY:
Individual Well ' []
Individual Water Storage []
Community Class Well []
Public Water System []
TYPE OF WAS I t=WATER DISPOSAL:
Indi~;idual On-site []
Individual Holding Tank []
Community On-site []
Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a pedod 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 emissions 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 wastowater disposal system is (am) 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 wastewatar disposal system is(are) in compliance with all applicable Municipal and State cedes,
ordinances, and regulations in effect at the time of installation.
Name of Firm A~dem~n Engineering
Address P.O. Box240773 Anchorage, AK99524
Engineer's Pdnted Name Michael E. A~demon, P.E.
DSD SIGNATURE
_._~ Approved for
Disapproved.
· Conditional app,:oval for
bedrooms.
Phone
Date 4/2/2008
bedrooms, with the following stipulations:
By:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
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.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 8. Ward Subdivision
A. WELL DATA
IfA, B, or C provide PWSID #
Sanitar7 seal (Y/N)
ft. Cased to ft.
FROM WELL LOG
Parcel ID: 011-122-87
Well type Awwu
Date completed
Total depth
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mL
Arsenic: ug/~
B. SEPTIC/HOLDING TANK DATA
T~.P Type/Material Sel3fic/Steel
Well Log (Y/N)
Wires propedy protected (Y/N)
Casing height (above ground)
AT INSPECTION
Nitrate __ mg/L Other bacteria
Date of sample: Collected by: .
IL
g.p.m.
in.
colonies/100 mL
Date installed ' 10/9/'2007
Cleanouts (Y/N) ~
High water alarm [Y/N)
Tank size z000 gal. Number of Compartments Two
Foundation cleanout (Y/N) Y Depmssi0n over lank (Y/N) N N
Date of pumping New Construction Pumper
,- - C. ABSORPTION FIELD DATA
Date installed lo/lOr2oo7 Soil rating (g.p.d./ft2 or ft~/bdrm) 1.2 GPDISF System type 5' Wide Trench
Length 7~ fL Width 5 It. Gravel below pipe 4
,. Total depth 12 fL Eft. absorption area 790 ~ ~ Monitoring tube Y Depressio~ over field N
Date of adequacy test New Cons i Results (Pass/Fail) : For bedrooms
Fluid depth in absorption field before test .in. Water'added gal. New depth
Elapsed Time: min. Final fluid depth in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N ~f yes, give date
g.p.d.
D. UFT STATION
Date installed
'Pump on' level at in.
Datum
, E. SEPARATION DISTANCES
Size in gallons
'Pump off' level at in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanMift station on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
Animal containment areas None
Manhole/Access (Y/N)
High water ala~n level at
Meets alam~ & circuit requirements?
None
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
sEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5' Propert~ line >5'
Water main N/A Water service line >10'
Wells on adjacent lots =,4.eo~ ;~ ~ o ~'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation >1o'
Surface water >1o0'
Wells on adjacent lots
Absorption field >5'
Surface water >100'
Property line >10'
Water Service line >1o'
Curtain drain N~ Noted
>25'
Water main >10'
Driveway, parking/vehicle storage
F. COMMENTS: Property is Sewed by AWWU Water System.
in.
G. ENGINEER'S CERTIFICATION
I serbTy that I have delennined 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
Waiver Fee $
Date of Payment
Receipt Number
WARD
2006-13
SUBDIVISION
LOT 8
40,250 S.F.
PENNY ROSE CIRCLE
N Bg'51'lO'E 134.00'
15' GAS ESMT.
15.0' ' ,8'.'
· EXISTING BUILDING GRAVEL DRIVE
~ 5.o' ,I,,.o'
10' UTIL. ESMT.
N 89'52'00'E 134.00'
1 "=30'
AS-BU ILT , HEREBY CERTIFY THAT , HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS,
2000 E. DOWLING RD.. SUITE B COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA
GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
2222 3/17/2008
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B. JOB NO.
'08-02 WARD8 NOTE: NO CORNERS SET THIS DATE